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Fully restoring the lost population of cardiomyocytes and heart function remains the greatest challenge in cardiac repair post myocardial infarction. In this study, a pioneered highly ROS-eliminating hydrogel was designed to enhance miR-19a/b induced cardiomyocyte proliferation by lowering the oxidative stress and continuously releasing miR-19a/b in infarcted myocardium in situ. In vivo lineage tracing revealed that ∼20.47 % of adult cardiomyocytes at the injected sites underwent cell division in MI mice. In MI pig the infarcted size was significantly reduced from 40 % to 18 %, and thereby marked improvement of cardiac function and increased muscle mass. Most importantly, our treatment solved the challenge of animal death--all the treated pigs managed to live until their hearts were harvested at day 50. Therefore, our strategy provides clinical conversion advantages and safety for healing damaged hearts and restoring heart function post MI, which will be a powerful tool to battle cardiovascular diseases in patients.

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PURPOSE: The current commonly-used metrics for evaluating the quality of auto-segmented contours have limitations and do not always reflect the clinical usefulness of the contours. This work aims to develop a novel contour quality classification (CQC) method by combining multiple quantitative metrics for clinical usability-oriented contour quality evaluation for deep learning-based auto-segmentation (DLAS). METHODS: The CQC was designed to categorize contours on slices as acceptable, minor edit, or major edit based on the expected editing effort/time with supervised ensemble tree classification models using seven quantitative metrics. Organ-specific models were trained for five abdominal organs (pancreas, duodenum, stomach, small and large-bowels) using 50 MRI datasets. Twenty additional MRI and nine CT datasets were employed for testing. Inter-observer variation (IOV) was assessed among six observers and consensus labels were established through majority vote for evaluation. The CQC was also compared with a threshold-based baseline approach. RESULTS: For the five organs, the average AUC was 0.982±0.01 and 0.979±0.01, the mean-accuracy was 95.8±1.7% and 94.3±2.1%, and the mean risk-rate was 0.8±0.4% and 0.7±0.5% for MRI and CT testing dataset, respectively. The CQC results closely matched the IOV results (mean-accuracy of 94.2±0.8% and 94.8±1.7%) and were significantly higher than those obtained using the threshold-based method (mean-accuracy of 80.0±4.7%, 83.8±5.2%, and 77.3±6.6% using one, two, and three metrics). CONCLUSION: The CQC models demonstrated high performance in classifying the quality of contour slices. This method can address the limitations of existing metrics and offers an intuitive and comprehensive solution for clinically oriented evaluation and comparison of DLAS systems.

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Cardiac biological pacing (BP) is one of the future directions for bradyarrhythmias intervention. Currently, cardiac pacemaker cells (PCs) used for cardiac BP are mainly derived from pluripotent stem cells (PSCs). However, the production of high-quality cardiac PCs from PSCs remains a challenge. Here, we developed a cardiac PC differentiation strategy by adopting dual PC markers and simulating the developmental route of PCs. First, two PC markers, Shox2 and Hcn4, were selected to establish Shox2:EGFP; Hcn4:mCherry mouse PSC reporter line. Then, by stepwise guiding naïve PSCs to cardiac PCs following naïve to formative pluripotency transition and manipulating signaling pathways during cardiac PCs differentiation, we designed the FSK method that increased the yield of SHOX2+; HCN4+ cells with typical PC characteristics, which was 12 and 42 folds higher than that of the embryoid body (EB) and the monolayer M10 methods respectively. In addition, the in vitro cardiac PCs differentiation trajectory was mapped by single-cell RNA sequencing (scRNA-seq), which resembled in vivo PCs development, and ZFP503 was verified as a key regulator of cardiac PCs differentiation. These PSC-derived cardiac PCs have the potential to drive advances in cardiac BP technology, help with the understanding of PCs (patho)physiology, and benefit drug discovery for PC-related diseases as well.

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Purpose: Secukinumab, a monoclonal antibody targeting interleukin (IL)-17A, is approved for the treatment of psoriasis, psoriatic arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, enthesitis-related arthritis, and hidradenitis suppurativa. This study compared the pharmacokinetics (PK), safety, and immunogenicity of CMAB015, a candidate secukinumab biosimilar, with the reference product secukinumab (Cosentyx®) in healthy Chinese male subjects. Patients and methods: This double-blind, parallel-group study randomized healthy Chinese male subjects (N=130) to receive either a single dose of 150 mg CMAB015 or secukinumab subcutaneously. Primary study endpoints were PK parameters such as the maximum concentration (Cmax) and area under the curve from zero to infinity (AUC0-inf), while safety and immunogenicity were secondary endpoints. Results: The 90% confidence intervals (CIs) of the geometric mean ratios (GMRs) of Cmax and AUC0-inf for CMAB015 to secukinumab were all within the bioequivalence limits (80.00-125.00%). Other PK parameters were comparable between the groups. The safety profile of CMAB015 was similar to that of secukinumab, with no serious adverse events related to treatment. The incidence of TEAEs was slightly higher in the CMAB015 group, but these events were mild to moderate in severity and did not lead to any withdrawals from the study. Immunogenicity analysis revealed low rates of anti-drug antibody (ADA) positivity, with similar rates between CMAB015 and secukinumab. Conclusion: This study demonstrated equivalent PK, comparable safety, and immunogenicity of CMAB015 to secukinumab in healthy Chinese male subjects. These findings support further clinical evaluation of CMAB015 as a secukinumab biosimilar. Trial Registration: The trial was registered on Clinicaltrials.gov (Identifier No. NCT05734482) and Chinadrugtrials.org.cn (Identifier No. CTR20230105).

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Plastics aging reduces resistance to microbial degradation. Plastivore Tenebrio molitor rapidly biodegrades polystyrene (PS, size: < 80 µm), but the effects of aging on PS biodegradation by T. molitor remain uncharacterized. This study examined PS biodegradation over 24 days following three pre-treatments: freezing with UV exposure (PS1), UV exposure (PS2), and freezing (PS3), compared to pristine PS (PSv) microplastic. The pretreatments deteriorated PS polymers, resulting in slightly higher specific PS consumption (602.8, 586.1, 566.7, and 563.9 mg PS·100 larvae-1·d-1, respectively) and mass reduction rates (49.6 %, 49.5 %, 49.2 %, and 48.7 %, respectively) in PS1, PS2, and PS3 compared to PSv. Improved biodegradation correlated with reduced molecular weights and the formation of oxidized functional groups. Larvae fed more aged PS exhibited greater gut microbial diversity, with microbial community and metabolic pathways shaped by PS aging, as supported by co-occurrence network analysis. These findings indicated that the aging treatments enhanced PS biodegradation by only limited extent but impacted greater on gut microbiome and bacterial metabolic genes, indicating that the T. molitor host have highly predominant capability to digest PS plastics and alters gut microbiome to adapt the PS polymers fed to them.

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The increased global prevalence of metabolic dysfunction-associated steatohepatitis (MASLD) has been closely associated with chronic disorders of the circadian clock. Herein, we investigate the role of Clock, a core circadian gene, in the pathogenesis of MASLD. Wild-type (WT) and liver-specific Clock knockdown (Clock-KD) mice were fed a Western diet for 20 weeks to induce MASLD. A cellular MASLD model was established by treating AML12 cells with free fatty acids and the effects of Clock knockdown were examined following transfection with Clock siRNA. Increased lipid deposition and more severe steatohepatitis and fibrosis were observed in the livers of Western diet-fed but not normal chow diet-fed Clock-KD mice after 20 weeks compared to WT mice. Moreover, the Clock gene was found to be significantly downregulated in WT MASLD mice. The Clock gene was shown to regulate the expression of lipophagy-related proteins (LC3B, P62, RAB7, and PLIN2) in vivo and in vitro. Knockdown of Clock was found to inhibit lipophagy resulting in increased accumulation of lipid droplets in the mouse liver and AML12 cells. Interestingly, the CLOCK protein was shown to interact with P62. However, knockdown of the Clock gene did not promote transcription of the P62 gene but suppressed degradation of the P62 protein during lipophagy in AML12 cells. The hepatic Clock gene regulates lipophagy and affects lipid droplet deposition in liver cells, and thus plays a critical role in the development of MASLD induced by a Western diet.

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To construct an efficient regulating layer for Zn anodes that can simultaneously address the issues of dendritic growth and side reactions is highly demanded for stable zinc metal batteries (ZMBs). Herein, we fabricate a hydrogen-bonded organic framework (HOF) enriched with zincophilic sites as a multifunctional layer to regulate Zn anodes with controlled spatial ion flux and stable interfacial chemistry (MA-BTA@Zn). The framework with abundant H-bonds helps capture H2O and remove the solvated shells on [Zn(H2O)6]2+, leading to suppressed side reactions. The HOF layer also helps form electrolyte-philic surfaces and expose Zn (002) crystal planes which benefit for rapid conduction and uniform deposition of Zn2+, and weakened sides reactions. Additionally, the electrochemically active zincophilic sites (C=O, -NH2 and triazine groups) favor the targeted guidance and penetration of Zn2+ and provide advantageous sites for uniform Zn deposition. High Young's modulus of the HOF layer further contributes to a high interfacial flexibility and stability against Zn plating-associated stress. The MA-BTA@Zn symmetric cells thereby obtain a substantially extended battery life over 1000 h at 4 mA cm-2. The MA-BTA@Zn||Cu half-cell demonstrates a highly reversible Zn stripping/plating process over 1500 cycles with impressive average Coulombic efficiency (CE) of 99.5% at 10 mA cm-2.

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BACKGROUND: To evaluate the clinical performance of two deep learning methods, one utilizing real clinical pairs and the other utilizing simulated datasets, in enhancing image quality for two-dimensional (2D) fast whole-body scintigraphy (WBS). METHODS: A total of 83 patients with suspected bone metastasis were retrospectively enrolled. All patients underwent single-photon emission computed tomography (SPECT) WBS at speeds of 20 cm/min (1x), 40 cm/min (2x), and 60 cm/min (3x). Two deep learning models were developed to generate high-quality images from real and simulated fast scans, designated 2x-real and 3x-real (images from real fast data) and 2x-simu and 3x-simu (images from simulated fast data), respectively. A 5-point Likert scale was used to evaluate the image quality of each acquisition. Accuracy, sensitivity, specificity, and the area under the curve (AUC) were used to evaluate diagnostic efficacy. Learned perceptual image patch similarity (LPIPS) and the Fréchet inception distance (FID) were used to assess image quality. Additionally, the count-level consistency of WBS was compared between the two models. RESULTS: Subjective assessments revealed that the 1x images had the highest general image quality (Likert score: 4.40 ± 0.45). The 2x-real, 2x-simu and 3x-real, 3x-simu images demonstrated significantly better quality than the 2x and 3x images (Likert scores: 3.46 ± 0.47, 3.79 ± 0.55 vs. 2.92 ± 0.41, P < 0.0001; 2.69 ± 0.40, 2.61 ± 0.41 vs. 1.36 ± 0.51, P < 0.0001), respectively. Notably, the quality of the 2x-real images was inferior to that of the 2x-simu images (Likert scores: 3.46 ± 0.47 vs. 3.79 ± 0.55, P = 0.001). The diagnostic efficacy for the 2x-real and 2x-simu images was indistinguishable from that of the 1x images (accuracy: 81.2%, 80.7% vs. 84.3%; sensitivity: 77.27%, 77.27% vs. 87.18%; specificity: 87.18%, 84.63% vs. 87.18%. All P > 0.05), whereas the diagnostic efficacy for the 3x-real and 3x-simu was better than that for the 3x images (accuracy: 65.1%, 66.35% vs. 59.0%; sensitivity: 63.64%, 63.64% vs. 64.71%; specificity: 66.67%, 69.23% vs. 55.1%. All P < 0.05). Objectively, both the real and simulated models achieved significantly enhanced image quality from the accelerated scans in the 2x and 3x groups (FID: 0.15 ± 0.18, 0.18 ± 0.18 vs. 0.47 ± 0.34; 0.19 ± 0.23, 0.20 ± 0.22 vs. 0.98 ± 0.59. LPIPS: 0.17 ± 0.05, 0.16 ± 0.04 vs. 0.19 ± 0.05; 0.18 ± 0.05, 0.19 ± 0.05 vs. 0.23 ± 0.04. All P < 0.05). The count-level consistency with the 1x images was excellent for all four sets of model-generated images (P < 0.0001). CONCLUSIONS: Ultrafast 2x speed (real and simulated) images achieved comparable diagnostic value to that of standardly acquired images, but the simulation algorithm does not necessarily reflect real data.

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Transition metal sulfide (TMs) offers ultra-high specific capacity through multi-electron transfer, showing promise for aqueous batteries. However, the poor cycling performance and the uncleared energy storage mechanism are restricted from further development. Herein, CoS2 nanowire arrays grown on carbon cloth (CoS2/CC) are proposed as binder-free and self-supporting electrodes for aqueous copper-ion batteries. The energy storage mechanism is clarified by a series of ex-situ tests: a multi-electron electrode reaction through a three-step reaction of CoS2 â†’ CuS → Cu7S4 â†’ Cu2S. Electrochemical results suggest that the CoS2/CC cathode exhibits excellent long cycle stability (capacity retention of 99.7 % after 1000 cycles at 10 A/g) along with high specific capacity (762.3 mAh g-1 at 1 A/g). The carbon cloth with stable three-dimensional (3D) conductive structure can not only offer high-speed pathways to promote the transfer of electrons but also inhibit the volume change. Meanwhile, CoS2 nanowire arrays with high surface-to-volume ratios can improve wettability of electrolyte and promote redox reactions. Furthermore, an advanced Zn-CoS2/CC hybrid ion aqueous battery reveals an energy density of 724 Wh kg-1 and an output voltage of 1.24 V, providing a promising strategy for the establishment of transition metal sulfide cathode in high-energy aqueous batteries.

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Uveal melanoma (UM) is an aggressive intraocular malignancy derived from melanocytes in the uvea tract of the eye. Up to 50% of patients with UM develop distant metastases which is usually fatal within one year; preventing metastases is therefore essential. Metabolic reprogramming plays a critical role in UM progression and metastasis. However, the metabolic phenotype of UM cells in the hypoxic tumor is not well understood. Here, we report that hypoxia-induced BNIP3 reprograms tumor cell metabolism, promoting their survival and metastasis. In response to hypoxia, BNIP3-mediated mitophagy alleviates mitochondrial dysfunction and enhances mitochondrial oxidative phosphorylation (OXPHOS) while simultaneously reducing mitochondrial reactive oxygen species (mtROS) production. This, in turn, impairs HIF1A/HIF-1α protein stability and inhibits glycolysis. Inhibition of mitophagy significantly suppresses BNIP3-induced UM progression and metastasis in vitro and in vivo. Collectively, these observations demonstrate a novel mechanism whereby BNIP3 promotes UM metabolic reprogramming and malignant progression by mediating hypoxia-induced mitophagy and suggest that BNIP3 could be an important therapeutic target to prevent metastasis in patients with UM.Abbreviations: AOD: average optical density; BNIP3: BCL2/adenovirus E1B interacting protein 3; CQ: chloroquine; CoCl2: cobalt chloride; GEPIA: Gene Expression Profiling Interactive Analysis; HIF1A: hypoxia inducible factor 1, alpha subunit; IHC: immunohistochemistry; mtROS: mitochondrial reactive oxygen species; NAC: N-acetylcysteine; OCR: oxygen consumption rate; OXPHOS: oxidative phosphorylation; ROS: reactive oxygen species; TCGA: The Cancer Genome Atlas; UM: uveal melanoma.

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The report demonstrated that a member of cockroach family, Blaptica dubia (Blattodea: Blaberidae) biodegraded commercial polystyrene (PS) plastics with Mn of 20.3 kDa and Mw of 284.9 kDa. The cockroaches digested up to 46.6 % of ingested PS within 24 h. The biodegradation was confirmed by the 13C isotopic shift of the residual PS in feces versus pristine PS (Δ Î´13C of 2.28 ‰), reduction of molecular weight and formation of oxidative functional groups in the residual PS. Further tests found that B.dubia cockroaches degraded all eight high purity PS microplastics with low to ultra-high molecular weights (MW) at 0.88, 1.20, 3.92, 9.55, 62.5, 90.9, 524.0, and 1040 kDa, respectively, with superior biodegradation ability. PS depolymerization/biodegradation pattern was MW-dependent. Ingestion of PS shifted gut microbial communities and elevated abundances of plastic-degrading bacterial genes. Genomic, transcriptomic and metabolite analyses indicated that both gut microbes and cockroach host contributed to digestive enzymatic degradation. PS plastic diet promoted a highly cooperative model of gut digestive system. Weighted gene co-expression network analysis revealed different PS degradation patterns with distinct MW profiles in B. dubia. These results have provided strong evidences of plastic-degrading ability of cockroaches or Blaberidae family and new understanding of insect and their microbe mediated biodegradation of plastics.

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BACKGROUND: Prior studies have shown that cardiovascular disease (CVD) can be effectively managed through telehealth. However, there are little national data on the use of telehealth in people with CVD or CVD risk factors. We aimed to determine the prevalence of telehealth visits and visit modality (video versus audio-only) in people with CVD and CVD risk factors. We also assessed their rationale and satisfaction with telehealth visits. METHODS AND RESULTS: A nationally representative sample of 6252 participants from the 2022 Health Information National Trends Survey 6 was used. We defined the CVD risk categories as having no self-reported CVD (coronary heart disease or heart failure) or CVD risk factors (hypertension, diabetes, obesity, or current smoking), CVD risk factors alone, and CVD. Multivariable logistic regression, adjusting for major sociodemographic factors, assessed the relationship between CVD risk and telehealth uptake. The weighted prevalence of using telehealth was 50% (95% CI, 44%-56%) for individuals with CVD and 40% (95% CI, 37%-43%) for those with CVD risk factors alone. Individuals with CVD had the highest odds of using any telehealth (audio-only or video) (adjusted odds ratio [OR], 2.02 [95% CI, 1.39-2.93]) when compared with those without CVD or CVD risk factors. Notably, 21% (95% CI, 16.3%-25.6%) of patients with CVD used audio-only visits (adjusted OR, 2.38 [95% CI, 1.55-3.64]) compared with patients without CVD or CVD risk factors. CONCLUSIONS: In a nationally representative survey, there was high prevalence of any (video or audio-only) telehealth visits in people with CVD, and audio-only visits comprised a significant proportion of telehealth visits in this population.

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The pediatric International IgA Nephropathy (IgAN) Prediction Tool comprises two models with and without ethnicity and is the first method to predict the risk of a 30% decline in estimated glomerular filtration rate (eGFR) or kidney failure in children at the time of biopsy using clinical risk factors and Oxford MEST histology scores. However, it is unknown if the Prediction Tool can be applied after a period of observation post-biopsy. Using an international multi-ethnic cohort of 947 children with IgAN, 38% of whom were followed into adulthood, the Prediction Tool was updated for use one year after biopsy. Compared to the original pediatric Prediction Tool, the updated post-biopsy Prediction Tool had a better model fit with higher R2D (51%/50% vs 20%), significant increase in 4-year C-statistics (0.83 vs 0.73/0.69, ΔC 0.09 [95% confidence interval 0.07-0.10] and ΔC 0.14 [0.12-0.15]) and better 4-year calibration with lower integrated calibration indices (0.74/0.54 vs 2.45/1.01). Results were similar after internal validation and when the models were applied two years after biopsy. Trajectories of eGFR after a baseline one year post-biopsy were non-linear and those at higher predicted risk started with a lower eGFR and experienced a more rapid decline over time. In children, eGFR had a variable rate of increase until 15-18 years old and then decreased linearly with a more rapid decline in higher risk groups that was similar to young adults of comparable risk. Thus, the original pediatric Prediction Tool should be used in children at the time of biopsy, and the updated pediatric Prediction Tool should be used to re-evaluate risk one or two years after biopsy.

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The electrochemical CO2 reduction reaction (CO2RR) to produce methanol (CH3OH) is an attractive yet challenging approach due to a lack of selective electrocatalysts. An immobilized cobalt phthalocyanine (CoPc) molecular catalyst has emerged as a promising electrocatalyst for CH3OH synthesis, demonstrating decent activity and selectivity through a CO2-CO-CH3OH cascade reaction. However, CoPc's performance is limited by its weak binding strength toward the CO intermediate. Recent advancements in molecular modification aimed at enhancing CO intermediate binding have shown great promise in improving CO2-to-CH3OH performance. In this Perspective, we discuss the competitive binding mechanism between CO2 and CO that hinders CH3OH formation and summarize effective molecular modification strategies that can enhance both the binding of the CO intermediate and the conversion of the CO2-to-CH3OH activity. Finally, we offer future perspectives on optimization strategies to inspire further research efforts to fully unlock the potential for methanol synthesis via the CO2RR using molecular catalysts.

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BACKGROUND: Observational studies have documented increased serum IL-6 levels in elderly individuals afflicted with sarcopenia. Nevertheless, the relationship between serum IL-6 concentrations and sarcopenia prevalence in the aging population is yet to be defined. METHODS: We executed a systematic review and meta-analysis of cross-sectional studies that scrutinized serum IL-6 levels in older adults with and without sarcopenia. Relevant studies were sourced from PubMed, Scopus, Embase, Cochrane Library, and Web of Science from inception until 10 September 2023. The standard mean differences (SMDs) in serum IL-6 levels between studies were synthesized using a random-effects model. To examine the influence of demographic and clinical factors on these outcomes, we performed subgroup analyses and meta-regression, focusing on variables such as sex, age, and body mass index (BMI). We also assessed the relationship between serum IL-6 levels and the defining components of sarcopenia: muscle mass, muscle strength, and physical performance. We used Fisher's Z transformation to standardize the interpretation of effect sizes from these relationships. The transformed values were then converted to summary correlation coefficients (r) for a clear and unified summary of the results. RESULTS: We included twenty-one cross-sectional studies involving 3,902 participants. Meta-analysis revealed significantly elevated serum IL-6 levels in older adults with sarcopenia compared with those without sarcopenia (SMD = 0.31; 95% CI 0.18, 0.44). The difference was highly pronounced in the subgroups of male and those with female percentage below 50% or a mean BMI below 24 kg/m2. Serum IL-6 levels were inversely correlated with muscle mass (summary r = -0.18; 95% CI -0.30, -0.06), but not with handgrip strength (summary r = -0.10; 95%CI: -0.25, 0.05) or gait speed (summary r = -0.09; 95%CI: -0.24, 0.07). CONCLUSIONS: This meta-analysis establishes a link between increased serum IL-6 levels and sarcopenia in the elderly, particularly in relation to decreased muscle mass.

Several studies have demonstrated elevated serum IL-6 levels in elderly individuals with sarcopenia, while the relationship between serum IL-6 levels and sarcopenia remains unclear.This is a systematic review and meta-analysis of 21 cross-sectional studies for the relationship between serum IL-6 levels and sarcopenia.Elevated serum IL-6 levels appear to be associated with sarcopenia in older adults, especially in relation to reduced muscle mass.

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The subcortical maternal complex (SCMC), which is vital in oocyte maturation and embryogenesis, consists of core proteins (NLRP5, TLE6, OOEP), non-core proteins (PADI6, KHDC3L, NLRP2, NLRP7), and other unknown proteins that are encoded by maternal effect genes. Some variants of SCMC genes have been linked to female infertility characterized by embryonic development arrest. However, so far, the candidate non-core SCMC components associated with embryonic development need further exploration and the pathogenic variants that have been identified are still limited. In this study, we discovered two novel variants [p.(Ala131Val) and p.(Met326Val)] of NLRP2 in patients with primary infertility displaying embryonic development arrest from large families. In vitro studies using 293T cells and mouse oocytes, respectively, showed that these variants significantly decreased protein expression and caused the phenotype of embryonic development arrest. Additionally, we combined the 'DevOmics' database with the whole exome sequence data of our cohort and screened out a new candidate non-core SCMC gene ZFP36L2. Its variants [p.(Ala241Pro) and p.(Pro291dup)] were found to be responsible for embryonic development arrest. Co-immunoprecipitation experiments in 293T cells, used to demonstrate the interaction between proteins, verified that ZFP36L2 is one of the human SCMC components, and microinjection of ZFP36L2 complementary RNA variants into mouse oocytes affected embryonic development. Furthermore, the ZFP36L2 variants were associated with disrupted stability of its target mRNAs, which resulted in aberrant H3K4me3 and H3K9me3 levels. These disruptions decreased oocyte quality and further developmental potential. Overall, this is the first report of ZFP36L2 as a non-core component of the human SCMC and we found four novel pathogenic variants in the NLRP2 and ZFP36L2 genes in 4 of 161 patients that caused human embryonic development arrest. These findings contribute to the genetic diagnosis of female infertility and provide new insights into the physiological function of SCMC in female reproduction.

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BACKGROUND: The remarkable advancements in surgical techniques over recent years have shifted the clinical focus from merely reducing mortality to enhancing the quality of postoperative recovery. The duration of a patient's hospital stay serves as a crucial indicator in evaluating postoperative recovery and surgical outcomes. This study aims to identify predictors of the length of hospital stay for children who have undergone corrective surgery for Ebstein Anomaly (EA). METHODS: We conducted a retrospective cohort study on children (under 18 years of age) diagnosed with EA who were admitted for corrective surgery between January 2009 and November 2021 at Fuwai Hospital. The primary outcome was the Time to Hospital Discharge (THD). Cox proportional hazard models were utilized to identify predictors of THD. In the context of time-to-event analysis, discharge was considered an event. In cases where death occurred before discharge, it was defined as an extended THD, input as 100 days (exceeding the longest observed THD), and considered as a non-event. RESULTS: A total of 270 children were included in this study, out of which three died in the hospital. Following the Cox proportional hazard analysis, six predictors of THD were identified. The hazard ratios and corresponding 95% confidence intervals were as follows: age, 1.030(1.005,1.055); C/R > 0.65, 0.507(0.364,0.707); Carpentier type C or D, 0.578(0.429,0.779); CPB time, 0.995(0.991,0.998); dexamethasone, 1.373(1.051,1.795); and transfusion, 0.680(0.529,0.875). The children were categorized into three groups based on the quartile of THD. Compared to children in the ≤ 6 days group, those in the ≥ 11 days group were associated with a higher incidence of adverse outcomes. Additionally, the duration of mechanical ventilation and ICU stay, as well as hospital costs, were significantly higher in this group. CONCLUSION: We identified six predictors of THD for children undergoing corrective surgery for EA. Clinicians can utilize these variables to optimize perioperative management strategies, reduce adverse complications, improve postoperative recovery, and reduce unnecessary medical expenses.

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The increasing clinical significance of Mycobacterium abscessus is owed to its innate high-level, broad-spectrum resistance to antibiotics and therefore rapidly evolves as an important human pathogen. This warrants the identification of novel targets for aiding the discovery of new drugs or drug combinations to treat M. abscessus infections. This study is inspired by the drug-hypersensitive profile of a mutant M. abscessus (U14) with transposon insertion in MAB_1915. We validated the role of MAB_1915 in intrinsic drug resistance in M. abscessus by constructing a selectable marker-free in-frame deletion in MAB_1915 and complementing the mutant with the same or extended version of the gene and then followed by drug susceptibility testing. Judging by the putative function of MAB_1915, cell envelope permeability was studied by ethidium bromide accumulation assay and susceptibility testing against dyes and detergents. In this study, we established genetic evidence of the role of MAB_1915 in intrinsic resistance to rifampicin, rifabutin, linezolid, clarithromycin, vancomycin, and bedaquiline. Disruption of MAB_1915 has also been observed to cause a significant increase in cell envelope permeability in M. abscessus. Restoration of resistance is observed to depend on at least 27 base pairs upstream of the coding DNA sequence of MAB_1915. MAB_1915 could therefore be associated with cell envelope permeability, and hence its role in intrinsic resistance to multiple drugs in M. abscessus, which presents it as a novel target for future development of effective antimicrobials to overcome intrinsic drug resistance in M. abscessus. IMPORTANCE: This study reports the role of a putative fadD (MAB_1915) in innate resistance to multiple drugs by M. abscessus, hence identifying MAB_1915 as a valuable target and providing a baseline for further mechanistic studies and development of effective antimicrobials to check the high level of intrinsic resistance in this pathogen.

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PURPOSE: This study aims to explore the correlation between PET and CMR in integrated [68Ga]Ga-FAPI-04 PET/CMR multimodal imaging and its value in the diagnosis and risk assessment of hypertrophic cardiomyopathy (HCM). METHODS: This study included 20 HCM patients and 11 age- and gender-matched controls. PET analysis evaluated left ventricular (LV) [68Ga]Ga-FAPI-04 uptake, including SUVmax, TBR, cardiac fibroblast activity (CFA) and volume (CFV), and total SUV of the 16 segments. CMR tissue characterization parameters included cardiac function, myocardial thickness, late gadolinium enhancement (LGE), relaxation time, extracellular volume (ECV), and peak strain parameters. The 5-year sudden cardiac death (SCD) risk score and the 2-year and 5-year atrial fibrillation (AF) risk scores were calculated for each patient. The study analyzed differences between HCM patients and controls, the correlation between [68Ga]Ga-FAPI-04 PET and concurrent CMR imaging results, and the predictive value of PET/CMR. RESULT: The FAPI uptake, myocardial mass, myocardial thickness, and T1/T2 mapping values were significantly higher in HCM patients compared to controls. Twenty HCM patients and their 320 myocardial segments were discussed. Increased [68Ga]Ga-FAPI-04 uptake in the left ventricular wall was observed in 95% (19/20) of the patients, covering 48.8% (156/320) of the segments. On concurrent CMR, 80% (16/20) of the patients showed LGE, including 95 (29.7%) segments. The FAPI(+)LGE(+) segments exhibited the highest myocardial PET uptake, greatest thickness, longest T1/T2 native values, largest ECV value and the greatest loss of myocardial strain capacity (P < 0.05). There was a significant correlation between FAPI uptake and CMR parameters (P < 0.05). Higher [68Ga]Ga-FAPI-04 uptake showed a positive correlation with SCD and AF risk scores (P < 0.05). The number of LGE(+) segments, mapping parameters, and ECV values in CMR also had prognostic significance. Combining PET with CMR aided in further risk stratification of HCM. CONCLUSION: [68Ga]Ga-FAPI-04 PET/CMR multimodal imaging has potential value in the detection of damaged myocardial lesions and risk assessment of HCM patients. [68Ga]Ga-FAPI-04 PET can detect more affected myocardium compared to CMR, and segments with abnormalities in both PET and CMR show more severe myocardial damage.

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Graphene oxide (GO)-based humidity sensors are attracting widespread attention due to their high responsivity and low cost. However, GO-based humidity sensors generally suffer from slow response and recovery as well as poor stability. Here, we report a flexible resistive humidity sensor based on a MoS2/GO composite film that was fabricated by mixing different volumes of MoS2 and GO dispersions with adjustable volume ratios. The MoS2/GO composite film has been used as a sensing layer on screen-printed interdigital electrodes. The results show that the best device performance was achieved at a dispersion volume of 0.05 mL with a MoS2/GO volume ratio of 5 : 1, featuring a high responsivity (∼98%), a fast response/recovery time (1.3/12.1 s), excellent stability and low cost. Furthermore, the humidity sensor exhibits good linearity over a wide humidity range (33%RH-98%RH) at room temperature (25 °C) and can be fabricated easily and feasibly. The application of the humidity sensors we prepared in human respiration detection and human fingertip proximity detection has been demonstrated. These findings indicate the great potential of the MoS2/GO composite in developing next generation high-performance humidity sensors.