Polypeptide organic radical batteries.

In only a few decades, lithium-ion batteries have revolutionized technologies, enabling the proliferation of portable devices and electric vehicles1, with substantial benefits for society. However, the rapid growth in technology has highlighted the ethical and environmental challenges of mining lithium, cobalt and other mineral ore resources, and the issues associated with the safe usage and non-hazardous disposal of batteries2. Only a small fraction of lithium-ion batteries are recycled, further exacerbating global material supply of strategic elements3-5. A potential alternative is to use organic-based redox-active materials6-8 to develop rechargeable batteries that originate from ethically sourced, sustainable materials and enable on-demand deconstruction and reconstruction. Making such batteries is challenging because the active materials must be stable during operation but degradable at end of life. Further, the degradation products should be either environmentally benign or recyclable for reconstruction into a new battery. Here we demonstrate a metal-free, polypeptide-based battery, in which viologens and nitroxide radicals are incorporated as redox-active groups along polypeptide backbones to function as anode and cathode materials, respectively. These redox-active polypeptides perform as active materials that are stable during battery operation and subsequently degrade on demand in acidic conditions to generate amino acids, other building blocks and degradation products. Such a polypeptide-based battery is a first step to addressing the need for alternative chemistries for green and sustainable batteries in a future circular economy.

Astringency and its sub-qualities: a review of astringency mechanisms and methods for measuring saliva lubrication.

Astringency is an important mouthfeel attribute that influences the sensory experiences of many food and beverage products. While salivary lubricity loss and increased oral friction were previously believed to be the only astringency mechanisms, recent research has demonstrated that nontactile oral receptors can trigger astringency by responding to astringents without mechanical stimulation. Various human factors have also been identified that affect individual responses to astringents. This article presents a critical review of the key research milestones contributing to the current understanding of astringency mechanisms and the instrumental approaches used to quantify perceived astringency intensity. Although various chemical assays or physical measures mimic in-mouth processes involved in astringent mouthfeel, this review highlights how one chemical or physical approach can only provide a single measure of astringency determined by a specific mechanism. Subsequently, using a single measurement to predict astringency perception is overly idealistic. Astringency has not been quantified beyond the loss of saliva lubrication; therefore, nontactile receptor-based responses must also be explored. An important question remains about whether astringency is a single perception or involves distinct sub-qualities such as pucker, drying, and roughness. Although these sub-quality lexicons have been frequently cited, most studies currently view astringency as a single perception rather than dividing it into sub-qualities and investigating the potentially independent mechanisms of each. Addressing these knowledge gaps should be an important priority for future research.

Severe anemia is associated with increased short-term and long-term mortality in patients hospitalized with cirrhosis.

INTRODUCTION AND OBJECTIVES: The relationship between anemia and the outcome of patients with cirrhosis is not completely clear. Therefore, we performed this large-scale epidemiological study to investigate the prevalence and severity of anemia in patients with cirrhosis and acute decompensation or liver injury and how anemia impacts short-term and long-term outcomes. PATIENTS AND METHODS: Patients with cirrhosis and acute decompensation (AD) or acute liver injury (ALI) were enrolled in the Chinese AcuTe on CHronic LIver FailurE (CATCH-LIFE) studies, which consisted of two large, multicenter, prospective, observational cohorts between January 2015 and December 2016 and July 2018 and January 2019. We conducted data analysis on the prevalence of anemia and determined the relationship between anemia and prognosis. RESULTS: Among 1979 patients, 1389 (70.2%) had anemia, among whom 599 (41.3%) had mild anemia, 595 (15.8%) had moderate anemia and 195 (2.4%) had severe anemia. A linear association between hemoglobin level and 90-day or 1-year LT-free mortality was shown, and a 10 g/L decrease in hemoglobin level was associated with a 6.8% extra risk of 90-day death and a 5.7% extra risk of 1-year death. Severe anemia was an independent risk factor for 90-day [HR=1.649 (1.100, 2.473), p=0.016] and 1-year LT-free mortality [HR=1.610 (1.159, 2.238), p=0.005]. Multinomial logistic regression analysis further identified that severe anemia was significantly associated with post-28-day mortality but not within-28-day mortality. CONCLUSIONS: Anemia is common in patients with cirrhosis admitted for acute events. Severe anemia was associated with poor 90-day and 1-year prognoses in these patients.

MELD score < 18 rule out 28-day ACLF development among inpatients with hepatitis B-related previous compensated liver disease.

The acute-on-chronic liver failure (ACLF) development is highly dynamic. Currently, no satisfactory algorithm identifies patients with HBV at risk of this complication. The aim of the study was to characterize ACLF development in hospitalized HBV-related patients without previous decompensation and to test the performance of traditional prognostic models in ruling out ACLF development within 28 days on admission we conducted a cohort study. Two multi-center cohorts with hospitalized HBV-related previous compensated patients were analyzed. Performances of MELD, MELD-Na, CLIF-C AD, and CLIF-C ACLF-D in ruling out ACLF development within 28 days were compared and further validated by ROC analyses. In the derivation cohort (n = 892), there were 102 patients developed ACLF within 28 days, with profound systemic inflammatory levels and higher 28-day mortality rate (31.4% vs. 1.0%) than those without ACLF development. The MELD score (cut-off = 18) achieved acceptable missing rate (missed/total ACLF development) at 2.9%. In the validation cohort (n = 1656), the MELD score (<18) was able to rule out ACLF development within 28 days with missing rate at 3.0%. ACLF development within 28 days were both lower than 1% (0.6%, derivation cohort; 0.5%, validation cohort) in patients with MELD < 18. While in patients with MELD ≥ 18, 26.6% (99/372, derivation cohort) and 17.8% (130/732, validation cohort) developed into ACLF within 28 days, respectively. While MELD-Na score cut-off at 20 and CLIF-AD score cut-off at 42 did not have consistent performance in our two cohorts. MELD < 18 was able to safely rule out patients with ACLF development within 28 days in HBV-related patients without previous decompensation, which had a high 28-day mortality.

Hysteresis in hybrid perovskite indoor photovoltaics.

Halide perovskite indoor photovoltaics (PV) are a viable solution to autonomously power the billions of sensors in the huge technology field of the Internet of Things. However, there exists a knowledge gap in the hysteresis behaviour of these photovoltaic devices under indoor lighting conditions. The present work is the first experimental study dedicated to exploring the degree of hysteresis in halide perovskite indoor photovoltaic devices by carrying out both transient J-V scan and steady state maximum power point tracking (MPPT) measurements. Dependence of hysteresis on device architecture, selection of electron transporting layers and the composition of the perovskite photoactive layers were investigated. Under indoor illumination, the p-i-n MAPbI3-based devices show consistently high power conversion efficiency (PCE) (stabilized PCE) of greater than 30% and negligible hysteresis behaviour, whereas the n-i-p MAPbI3 devices show poor performance (stabilized PCE ∼ 15%) with pronounced hysteresis effect. Our study also reveals that the n-i-p triple cation perovskite devices are more promising (stabilized PCE ∼ 25%) for indoor PV compared to n-i-p MAPbI3 due to their suppressed ion migration effects. It was observed that the divergence of the PCE values estimated from the J-V scan measurements, and the maximum power point tracking method is higher under indoor illumination compared to 1 Sun, and hence for halide perovskite-based indoor PV, the PCE from the MPPT measurements should be prioritized over the J-V scan measurements. The results from our study suggest the following approaches for maximizing the steady state PCE from halide perovskite indoor PV: (i) select perovskite active layer composition with suppressed ion migration effects (such as Cs-containing triple cation perovskites) and (ii) for the perovskite composition such as MAPbI3, where the ion migration is very active, p-i-n architecture with organic charge transport layers is beneficial over the n-i-p architecture with conventional metal oxides (such as TiO2, SnO2) as charge transport layers. This article is part of the theme issue 'Developing resilient energy systems'.

Prevalence and Clinical Significance of Portal Vein Thrombosis in Patients With Cirrhosis and Acute Decompensation.

BACKGROUND & AIMS: Portal vein thrombosis (PVT) is a common and serious complication in patients with cirrhosis. However, little is known about PVT in patients with cirrhosis and acute decompensation (AD). We investigated the prevalence and clinical significance of PVT in nonmalignant patients with cirrhosis and AD. METHODS: We performed a retrospective study of 2 cohorts of patients with acute exacerbation of chronic liver disease who participated in the Chinese AcuTe on CHronic LIver FailurE study, established by the Chinese Chronic Liver Failure Consortium, from January 2015 through December 2016 (n = 2600 patients) and July 2018 through January 2019 (n = 1370 patients). We analyzed data on the prevalence, clinical manifestations, and risk factors of PVT from 2826 patients with cirrhosis, with and without AD. RESULTS: The prevalence of PVT in patients with cirrhosis and AD was 9.36%, which was significantly higher than in patients with cirrhosis without AD (5.24%) (P = .04). Among patients with cirrhosis and AD, 63.37% developed PVT recently (the first detected PVT with no indication of chronic PVT). Compared with patients without PVT, a significantly higher proportion of patients with PVT had variceal bleeding (47.33% vs 19.63%; P < .001) and patients with PVT had a significantly higher median serum level of D-dimer (2.07 vs 1.25; P < .001). Splenectomy and endoscopic sclerotherapy were independent risk factors for PVT in patients with cirrhosis and AD. The 1-year mortality rate did not differ significantly between patients with vs without PVT. CONCLUSIONS: In an analysis of data from 2826 patients with cirrhosis, a significantly higher proportion of those with AD had PVT than those without AD. PVT was associated with increased variceal bleeding, which would increase the risk for AD. Strategies are needed to prevent PVT in patients with cirrhosis, through regular screening, to reduce portal hypertension. ClinicalTrials.gov no: NCT02457637 and NCT03641872.

Real-time insight into the doping mechanism of redox-active organic radical polymers.

Organic radical polymers for batteries represent some of the fastest-charging redox active materials available. Electron transport and charge storage must be accompanied by ion transport and doping for charge neutrality, but the nature of this process in organic radical polymers is not well understood. This is difficult to intuitively predict because the pendant radical group distinguishes organic radical polymers from conjugated, charged or polar polymers. Here we show for the first time a quantitative view of in situ ion transport and doping in organic radical polymers during the redox process. Two modes dominate: doping by lithium ion expulsion and doping by anion uptake. The dominance of one mode over the other is controlled by anion type, electrolyte concentration and timescale. These results apply in any scenario in which electrolyte is in contact with a non-conjugated redox active polymer and present a means of quantifying doping effects.

The liver fibrosis index is superior to the APRI and FIB-4 for predicting liver fibrosis in chronic hepatitis B patients in China.

BACKGROUND: The purpose of this study was to prospectively investigate the value of real-time ultrasound elastography (RTE) for the diagnosis of liver fibrosis (LF) in patients with chronic hepatitis B (CHB), to correlate the elastography findings with the histologic stage of LF and to compare RTE findings with those from noninvasive tests of LF calculated using laboratory blood parameters. METHODS: Liver biopsies, laboratory blood testing, and RTE were performed in 91 patients with CHB. The LF index (LFI) was calculated using a multiple linear regression equation involving 11 parameters, which represented the degree of LF. The higher the LFI is, the greater the degree of LF. RESULTS: The mean aspartate aminotransferase-to-platelet ratio index (APRI) and the mean fibrosis index based on four factors (FIB-4) were significantly different for the 5 stages of LF, respectively. The APRI (r = 0.43, P = 0.006), FIB-4 (r = 0.51, P = 0.012) and LFI (r = 0.562, P = 0.004) were correlated with the stages of LF. For discriminating stage F0 from F1, only the LFI had significant power (P = 0.026) for predicting stage F1. For discriminating stage F4 from F3, only the LFI had statistically significant power (P = 0.024) in predicting stage F4. The areas under the receiver operating characteristic curves (AUCs) of the LFI for diagnosing significant, advanced LF and liver cirrhosis were significantly higher than those of the APRI and FIB-4, and the LFI had better sensitivity and specificity. CONCLUSIONS: The LFI calculated by RTE is reliable for the assessment of LF in patients with CHB and has better discrimination power than the APRI and FIB-4.

A Smart Fluorescent Probe Based on Salicylaldehyde Schiff's Base with AIE and ESIPT Characteristics for the Detections of N2H4 and ClO.

Smart and versatile salicylaldehyde Schiff's bases have been proved their excellent performances including large shocks shift, dual emission wavelengths and sensitive to environment for fluorescence analysis. Herein, a simple salicylaldehyde Schiff's base molecular (PBAS) with aggregation-induced emission (AIE) and the excited-state intramolecular proton-transfer (ESIPT) effects was constructed for detecting N2H4 and ClO-. The highly specific and sensitive response to N2H4 was witnessed by the fast turn-on of the strong blue fluorescence and to ClO- was observed by the rapid turn off of the weak green fluorescence simultaneous decomposing of the probe. The results of mass spectrum analysis showed that probe PBAS decomposed under the influence of N2H4, whereas probe PBAS can complex with ClO- and prevent effective ESIPT process. Benefiting from its high properties, this fluorescence molecular provides an effective tool for probing N2H4 and ClO- in live cells.

Acute-on-Chronic Liver Failure in China: Rationale for Developing a Patient Registry and Baseline Characteristics.

Definitions and descriptions of acute-on-chronic liver failure (ACLF) vary between Western and Eastern types, and alcoholism and hepatitis B virus (HBV) are, respectively, the main etiologies. To determine whether there are unified diagnostic criteria and common treatment programs for different etiologies of ACLF, a multicenter prospective cohort with the same inclusion criteria and disease indicators as those used in the European Consortium Acute-on-Chronic Liver Failure in Cirrhosis Study is urgently needed in Asia, where the prevalence of HBV is high. A multicenter prospective cohort of 2,600 patients was designed, drawing from 14 nationwide liver centers from tertiary university hospitals in China, and 2,600 hospitalized patients with chronic liver disease (both cirrhotic and noncirrhotic) of various etiologies with acute decompensation or acute hepatic injury were continuously recruited from January 2015 to December 2016. Data were collected during hospitalization, and follow-ups were performed once a month, with plans to follow all patients until 36 months after hospital discharge. Of these patients, 1,859 (71.5%) had HBV-related disease, 1,833 had cirrhotic disease, and 767 had noncirrhotic disease. The numbers and proportions of enrolled patients from each participating center and the baseline characteristics of the patients with or without cirrhosis are presented.

Testing the validity and reliability of the Self-Administration of Medication (SAM) instrument in Chinese chronic disease patients: A cross-cultural adaptation.

AIMS: To develop a culturally appropriate and functional standard Mandarin Chinese translation of the Self-Administration of Medication tool and to examine its validity and reliability. METHODS: We used Brislin's guidelines for the translation and back-translation procedures. We recruited 130 patients from June 2015 to September 2016. Correlation analysis, Cronbach's alpha coefficient, split-half reliability, item analysis and the content validity index, and exploratory factor analysis were performed. RESULTS: Strong and moderate correlations were seen between the total Self-Administration of Medication score and nurses' and patients' perceptions. Item analysis indicated that the correlation coefficient ranged from 0.744 to 0.975. Cronbach's alpha ranged from 0.933 to 0.976. The split-half reliability ranged from 0.911 to 0.936 for the instrument's subscales, and 0.953 for the total scale. The content validity index value ranged from 0.823 to 0.972 for individual items and was 0.968 for the total scale. The factor loading matrix of the SAM ranged from 0.514 to 0.837. A moderate correlation existed between the scores of the Self-Administration of Medication tool and the Barthel Index. CONCLUSION: The Chinese version of the Self-Administration of Medication tool is statistically acceptable and can be used in the evaluation of self-medication ability based on self-report and nurses' assessment.

Comparison of physicochemical indexes, amino acids, phenolic compounds and volatile compounds in bog bilberry juice fermented by Lactobacillus plantarum under different pH conditions.

This study aimed to investigate the effect of Lactobacillus plantarum strains on quality improvement of bog bilberry juice. Bog bilberry juice with different pH conditions was fermented by Lactobacillus B7 or C8-1 strain. Physicochemical index, amino acids, phenolic compounds, and volatiles of these fermented juices were compared. Results indicated that Lactobacillus plantarum strains preferred to metabolize malic acid and reducing sugar in non-pH-adjusted juice (NJ, pH 2.65), whereas quinic and citric acids were largely consumed in pH-adjusted juice (AJ, pH 3.50). Shikimic acid and aromatic amino acids were significantly accumulated in pH-adjusted juice, and phenolic compounds in both juices were significantly reduced. These strains enhanced the composition and concentration of volatiles compounds in non-pH-adjusted juice and improved the floral and fruity flavors. However, concentration and complexity of volatiles were reduced in pH-adjusted juices.

Scalable Synthesis and Multi-Electron Transfer of Aniline/Fluorene Copolymer for Solution-Processable Battery Cathodes.

In this study, the authors report the highly efficient, multigram-scale synthesis of an ester-functionalized, poly(aniline-co-fluorene) polymer. The excellent solubility and film-forming ability of this polymer facilitate its application as a reversible battery cathode. Electrochemical quartz crystal microbalance with dissipation monitoring confirms a multi-electron transfer process, resulting in a specific discharge capacity of 51 mAh g-1 and a high reversible doping level of 0.69. Galvanostatic cycling at 1 C demonstrates excellent electrode stability with a capacity retention of 95.2% after 100 cycles. Therefore, this work demonstrates a novel electroactive polymer that exemplifies how chemical functionality may be used to properly balance processability and electroactivity of macromolecular battery cathodes.

Unusual Internal Electron Transfer in Conjugated Radical Polymers.

Nitroxide-containing organic radical polymers (ORPs) have captured attention for their high power and fast redox kinetics. Yet a major challenge is the polymer's aliphatic backbone, resulting in a low electronic conductivity. Recent attempts that replace the aliphatic backbone with a conjugated one have not met with success. The reason for this is not understood until now. We examine a family of polythiophenes bearing nitroxide radical groups, showing that while both species are electrochemically active, there exists an internal electron transfer mechanism that interferes with stabilization of the polymer's fully oxidized form. This finding directs the future design of conjugated radical polymers in energy storage and electronics, where careful attention to the redox potential of the backbone relative to the organic radical species is needed.

Dibasic Ammonium Phosphate Application Enhances Aromatic Compound Concentration in Bog Bilberry Syrup Wine.

A nitrogen deficiency always causes bog bilberry syrup wine to have a poor sensory feature. This study investigated the effect of nitrogen source addition on volatile compounds during bog bilberry syrup wine fermentation. The syrup was supplemented with 60, 90, 120 or 150 mg/L dibasic ammonium phosphate (DAP) before fermentation. Results showed that an increase of DAP amounts accelerated fermentation rate, increased alcohol content, and decreased sugar level. Total phenol and total flavonoid content were also enhanced with the increase of DAP amounts. A total of 91 volatile compounds were detected in the wine and their concentrations were significantly enhanced with the increase of DAP. Ethyl acetate, isoamyl acetate, phenethyl acetate, ethyl butanoate, ethyl hexanoate, ethyl octanoate, ethyl decanoate, isobutanol, isoamyl alcohol, levo-2,3-butanediol, 2-phenylethanol, meso-2,3-butanediol, isobutyric acid, hexanoic acid, and octanoic acid exhibited a significant increase of their odor activity value (OAV) with the increase of DAP amounts. Bog bilberry syrup wine possessed fruity, fatty, and caramel flavors as its major aroma, whereas a balsamic note was the least present. The increase of DAP amounts significantly improved the global aroma attributes, thereby indicating that DAP supplementation could promote wine fermentation performance and enhance the sensory quality of bog bilberry syrup wine.

Airway basal cell­derived exosomes suppress epithelial­mesenchymal transition of lung cells by inhibiting the expression of ANO1.

Disruption of the epithelial-mesenchymal transition (EMT) of activated lung cells is an important strategy to inhibit the progression of idiopathic pulmonary fibrosis (IPF). The present study investigated the role of exosomes derived from airway basal cells on EMT of lung cells and elucidate the underlying mechanism. Exosomes were characterized by nanoparticle tracking analysis, transmission electron microscopy imaging and markers detection. The role of exosome on the EMT of lung epithelial cells and lung fibroblasts induced by TGF-ß1 was detected. RNA sequencing screened dysregulated genes in exosome-treated group, followed by the bioinformatical analysis. One of the candidates, anoctamin-1 (ANO1), was selected for further gain-and-loss phenotype assays. A bleomycin-induced pulmonary fibrosis model was used to evaluate the treatment effect of exosomes. Exosomes were round-like and positively expressed CD63 and tumor susceptibility gene 101 protein. Treatment with exosomes inhibited the EMT of lung cells activated by TGF-ß1. 4158 dysregulated genes were identified in exosome-treated group under the threshold of |log2 fold-change| value >1 and they were involved in the metabolism of various molecules, as well as motility-related biological processes. A key gene, ANO1, was verified by reverse transcription-quantitative PCR, whose overexpression induced the EMT of lung cells. By contrast, ANO1 knockdown reversed the EMT induced by TGF-ß1. In vivo assay indicated that exosome treatment ameliorated pulmonary fibrosis and inhibited the upregulation of ANO1 induced by bleomycin. In conclusion, airway basal cell-derived exosomes suppressed the EMT of lung cells via the downregulation of ANO1. These exosomes represent a potential therapeutic option for patients with IPF.

Opsin-Free Activation of Bmp Receptors by a Femtosecond Laser.

Bone morphogenetic protein (BMP) signaling plays a vital role in differentiation, organogenesis, and various cell processes. As a member of TGF-ß superfamily, the BMP initiation usually accompanies crosstalk with other signaling pathways and simultaneously activates some of them. It is quite challenging to solely initiate an individual pathway. In this study, an opsin-free optical method to specifically activate BMP receptors (BMPR) and subsequent pSmad1/5/8 cascades by a single-time scan of a tightly-focused femtosecond laser in the near infrared range is reported. Via transient two-photon excitation to intrinsic local flavins near the cell membrane, the photoactivation drives conformational changes of preformed BMPR complexes to enable their bonding and phosphorylation of the GS domain in BMPR-I by BMPR-II. The pSmad1/5/8 signaling is initiated by this method, while p38 and pSmad2 are rarely perturbed. Based on a microscopic system, primary adipose-derived stem cells in an area of 420 â€…× 420 µm2 are photoactivated by a single-time laser scanning for 1.5 s and exhibit pSmad1/5/8 upregulation and osteoblastic differentiation after 21 days. Hence, an opsin-free, specific, and noninvasive optical method to initiate BMP signaling, easily accomplished by a two-photon microscope system is reported.

Study on Austenite Transformation and Growth Evolution of HSLA Steel.

HSLA steel is widely used in various applications for its excellent mechanical properties. The evolution of austenite transformation and growth has been systematically studied in HSLA steel Q960 during the heating process. A thermal expansion instrument and optical microscope were adopted to analyze the kinetics of austenite transformation, which is a nonlinear continuous process and was accurately calculated by the lever rule based on the dilatation curve at the holding time within 10 min. The austenite growth behavior at temperatures above Ac3 was explored using TEM and DSC. The main precipitates in austenite were Nb-rich and Ti-rich (Nb, Ti)(C, N), and the particle size increased and amount decreased with the increase in the heating temperature, which resulted in the rapid growth of austenite. With the increase in holding temperature and time, the growth of austenite progressed through three stages, and a heat treatment diagram was established to describe this evolution.

Airway epithelium regeneration by photoactivated basal cells.

The airway epithelium is the footstone to maintain the structure and functions of lung, in which resident basal cells (BCs) maintain homeostasis and functional regeneration of epithelial barrier in response to injury. In recent clinical researches, transplanting BCs has shown great inspiring achievements in therapy of various lung diseases. In this study, we report a noninvasive optical method to activate BCs for airway epithelium regeneration in vivo by fast scanning of focused femtosecond laser on BCs of airway epithelium to active Ca2+ signaling and subsequent ERK and Wnt pathways. The photoactivated BCs present high proliferative capacity and maintain high pluripotency, which enables them to plant in the injured airway epithelium and differentiate to club cells for regeneration of epithelium. This optical method can also work in situ to activate localized BCs in airway tissue. Therefore, our results provide a powerful technology for noninvasive BC activation in stem-cell therapy of lung diseases.

Relationship between perceptions of recurrence risk and depression state among first-episode ischemic stroke patients in rural areas: The mediating role of coping style.

AIMS: To investigate the relationship between stroke survivors' perceptions of recurrence risk, coping styles and depression state, and the role coping styles play in mediating that relationship. DESIGN: A cross-sectional descriptive study. METHODS: From one hospital in Huaxian, China, 320 stroke survivors were randomly selected as a convenience sample. In this research, the Simplified Coping Style Questionnaire, the Patient Health Questionnaire-9 and the Stroke Recurrence Risk Perception Scale were all used. Structural equation modelling and correlation analysis were used to analyse the data. This research followed the EQUATOR and STROBE checklists. RESULTS: There were 278 valid survey responses. There were mild to severe depressive symptoms in 84.8% of stroke survivors. In stroke survivors, there was a significant negative relationship (p < 0.01) between the positive coping of perceptions of recurrence risk and their depression state. Recurrence risk perception's impact on depression state was partly mediated, according to mediation studies, by coping style, with the mediation effect accounting for 44.92% of the overall effect. CONCLUSIONS: The connection between perceptions of recurrence risk and depression state was mediated by the coping mechanisms of stroke survivors. A lower degree of depression state among survivors was connected with positive coping to the beliefs of recurrence risk.