Marginal cord insertion in the first trimester is associated with furcate cord insertion.

OBJECTIVES: To evaluate the potential connections between marginal cord insertion during the first trimester and furcate cord insertion later in pregnancy. METHODS: This is a prospective study of screening data on the cord insertion site in 3178 singleton pregnancies. The cord insertion site was examined in two stages. The first stage was screening for the cord insertion site between 10-13 weeks of gestation, the purpose is to determine the category of umbilical cord insertion. The second stage, performed at 22-28 weeks of gestation, was to follow up on the relationship between the cord insertion site and the placenta and to identify any changes in the category of umbilical cord insertion. This was performed to diagnose or exclude furcate cord insertion by identifying whether the umbilical cord trunk separated or branched before it reached the placenta. Factors influencing progression to furcate cord insertion and perinatal complications were assessed. RESULTS: Fourteen cases (0.44%) with progression to furcate cord insertion, all of which showed marginal cord insertion on ultrasound in the first trimester (p < 0.001). without progression to furcate cord insertion, there were no changes in the category of umbilical cord insertion in 3050 cases (96.40%) compared to the early pregnancy. 114 cases (3.60%) with changes in the category of umbilical cord insertion that was not consistent with furcate cord insertion. A total of 14 cases progressed to furcate cord insertion, all showed the cord insertion site were in close proximity, and 11 (78.57%) cases showed a low insertion site (p < 0.001). Regarding the choice of mode of delivery, elective caesarean delivery was done in 8/14 (57.14%). The incidences of spontaneous vaginal delivery were 5/14 (35.71%) (p < 0.001). One (7.14%) case of progression to furcate cord insertion due to haematoma at the root of the umbilical cord ended with an emergency caesarean section. In terms of perinatal complications, marginal cord insertion that progressed to furcate cord insertion had higher incidences of SGA infants, abnormal placental morphology, retention of the placenta, and cord-related adverse pregnancy outcomes than not progressed to furcate cord insertion (p < 0.05). CONCLUSIONS: Marginal cord insertion in the first trimester has the potential to progress to furcate cord insertion. We suggest that ultrasound-diagnosed marginal cord insertion in the first trimester should be watched carefully in the second trimester, which is clinically useful to accurately determine the category of cord insertion and to improve the rate of prenatal diagnosis of furcate cord insertion.

Patterns and predictors of symptom burden and posttraumatic growth among patients with cancer: a latent profile analysis.

PURPOSE: The study identified different patterns of symptom burden and posttraumatic growth (PTG) among patients with cancer and to explored the effects of sociodemographic, disease-related, and family resilience factors, which could provide reference for the development of personalized nursing measures. METHODS: A questionnaire survey was conducted with 329 patients with cancer who were undergoing treatment. Latent profile analysis (LPA) was used to explore the patterns of symptom burden and PTG among patients with cancer, and multiple logistic regression analysis was used to explore the influencing factors of different patterns. RESULTS: Based on the fit indicators of LPA, a three-class pattern model of posttraumatic responses was shown to be optimal, including resisting, struggling, and growth groups. In the resisting group (34.34%), patients reported low symptom burden and low PTG; in the struggling group (19.15%), patients showed a high symptom burden and moderate PTG; in the growth group (46.51%), patients showed low symptom burden and high PTG. Moreover, patients with cancer with high levels of family resilience were more likely to fall into the struggling and growth groups. Specifically, those with lower scores in the optimistic attitude and higher scores in the family and social support dimension of family resilience were more likely to fall into the struggling group, whereas those with lower scores in the transcendence and spiritual belief dimensions of family resilience were more likely to fall into the resisting group. Additionally, patients with at least three children were more likely to fall into the struggling group. CONCLUSIONS: This study showed heterogeneity in symptom burden and PTG patterns among patients with cancer. Patients' growth must include both psychological growth and the mitigated symptom burden. Family factors may be intervention targets to improve the growth patterns.

Diabetes mellitus is a risk factor for incident chronic kidney disease: A nationwide cohort study.

Objective: Diabetes mellitus and chronic kidney disease are multifactorial conditions with multiple etiologies that share similar pathophysiologies. This nationwide cohort study examined the impact of diabetes mellitus on the follow-up development of chronic kidney disease. Methods: By retrieving the Longitudinal Health Insurance Database 2005, 5121 patients with diabetes mellitus were included in this study and 5121 patients without diabetes mellitus, who were matched according to sex, age, and Charlson comorbidity index made up the control group. The adjusted hazard ratios for chronic kidney disease were calculated using Cox proportional hazards regression analysis. Kaplan-Meier analysis was used to estimate the cumulative incidence of chronic kidney disease rate in the diabetes mellitus and control groups. Results: After adjusting for sex, age, and Charlson comorbidity index score, the diabetes mellitus group had a 1.380 times higher (95% CI: 1.277-1.492) risk of developing chronic kidney disease than the control group. Further stratified analysis showed that patients with diabetes mellitus had a significantly higher risk of developing chronic kidney disease regardless of their sex, age, and Charlson comorbidity index score, compared to those without diabetes mellitus. Conclusions: There is a possibility that diabetes mellitus serves as an independent risk factor for chronic kidney disease development. Early screening and monitoring of diabetes mellitus appear to be of great importance in the prevention of chronic kidney disease.

Polysaccharides derived from natural edible and medicinal sources as agents targeting exercise-induced fatigue: A review.

Exercise-induced fatigue (EF) is a common occurrence during prolonged endurance and excessive exercise and is mainly caused by energy depletion, harmful metabolite accumulation, oxidative stress, and inflammation. EF usually leads to a reduction in initiating or maintaining spontaneous activities and muscle performance and ultimately results in a decrease in the quality of life of people who engage in physical work. Therefore, the interest in investigating EF-targeting agents with minimal side effects and good long-term efficacy has substantially increased. Natural edible and medicinal polysaccharides have shown positive anti-EF effects, but the relevant reviews are rare. This review comprehensively summarizes studies on natural polysaccharides from edible and medicinal sources that can relieve EF and improve physical performance from the past decade, focusing on their sources, monosaccharide compositions, anti-EF effects, and possible molecular mechanisms. Most of these anti-EF polysaccharides are heteropolysaccharides and are mainly composed of glucose, arabinose, galactose, rhamnose, xylose, and mannose. In EF animal models, the polysaccharides exert positive EF-alleviating effects through energy supply, metabolic regulation, antioxidation, anti-inflammation, and gut microbiota remodeling. However, further studies are still needed to clarify the anti-EF effects of these polysaccharides on human beings. In summary, the present review expects to provide scientific data for the future research and development of natural polysaccharide-based anti-EF drugs, dietary supplements, and health-care products for specific fatigue groups.

An alternative method to reconstruct grade-3 hypoplastic thumb by hemi-metacarpal transfer.

We designed a new method using hemi-longitudinal second metacarpal bone to reconstruct grade-3 hypoplastic thumbs. Seven patients were treated in two stages. In the first stage, the second metacarpal was split longitudinally and transferred to reconstruct the first metacarpal. In the second stage, opponensplasty was performed by transferring the FDS tendon. Bone union was achieved in all cases. All patients could oppose to their middle finger at least. They managed to do daily activities such as writing, eating, using smartphones and so on. This is a useful procedure to preserve a 5-digit hand with good function in treating grade-3 hypoplastic thumbs, with no harm to the foot and no need for vascular anastomosis. LEVEL OF EVIDENCE: IV.

Coulomb blockade and Coulomb staircases in CoBi nanoislands on SrTiO3(001).

We successfully fabricated two-dimensional metallic CoBi nanoislands on SrTiO3(001) substrate by molecular beam epitaxy, and systematically investigated their electronic structures by scanning tunneling microscopy and spectroscopyin situat 4.2 K. Coulomb blockade and Coulomb staircases with discrete and well-separated levels are observed for the individual nanoisland, which is attributed to single-electron tunneling via two tunnel junction barriers. They are in excellent agreement with the simulations based on orthodox theory. Furthermore, we demonstrated that the Coulomb blockade becomes weaker with increasing temperature and almost disappears at ∼22 K in our variable temperature experiment, and its full-width at half-maximum of dI/dVpeaks with temperature is ∼6 mV. Our results provide a new platform for designing single-electron transistors that have potential applications in future microelectronics.

Curative effect of external fixation combined with kirschner wire versus hollow screw in the treatment of first metacarpal bone base fracture.

PURPOSE: This study was conducted aimed at comparing the curative effect of external fixation combined with Kirschner wire fixation versus hollow screw fixation in the treatment of first metacarpal bone base fracture. METHODS: The current retrospective study included a total of 80 patients diagnosed with first metacarpal bone base fracture who were admitted in Wuxi 9th People's Hospital Affiliated to Soochow University between October 2017 and October 2020. The patients enrolled were equally divided into the combined group (40 cases, receiving external fixation combined with Kirschner wire fixation), and the control group (40 cases, receiving hollow screw fixation). Perioperative indices were collected and compared between the two groups. Pain scores before operation and three months, six months, and one year after operation were compared. Additionally, we compared the finger function in the last follow-up visit ( the follow-up period was 1 year) and rate of complications. RESULTS: Operation time, amount of bleeding, length of incision, length of hospital stay, and fracture healing time did not differ between the two groups (all P > 0.05). Pain score was comparable between the two groups before operation (P = 0.704). Despite lower results showing at 3, 6, and 12 months after operation in both groups, the pain score did not significantly differ in any time point between the two groups (all P > 0.05). Additionally, no significant differences were observed in finger function and rate of complications at the last follow-up between the two groups (both P > 0.05). CONCLUSION: External fixation combined with Kirschner wire fixation and hollow screw fixation exhibited similar curative effect in treating first metacarpal bone base fracture, indicating both surgery methods may be considered as the preferred approach.

Restoration of intrinsic hand function by superficial radial nerve: an anatomical study.

BACKGROUND: The contralateral seventh cervical (cC7) nerve root transfer represents a cornerstone technique in treating total brachial plexus avulsion injury. Traditional cC7 procedures employ the entire ulnar nerve as a graft, which inevitably compromises its restorative capacity. OBJECTIVE: Our cadaveric study seeks to assess this innovative approach aimed at preserving the motor branch of the ulnar nerve (MBUN). This new method aims to enable future repair stages, using the superficial radial nerve (SRN) as a bridge connecting cC7 and MBUN. METHODS: We undertook a comprehensive dissection of ten adult cadavers, generously provided by the Department of Anatomy, Histology, and Embryology at Fudan University, China. It allowed us to evaluate the feasibility of our proposed technique. For this study, we harvested only the dorsal and superficial branches of the ulnar nerve, as well as the SRN, to establish connections between the cC7 nerve and recipient nerves (both the median nerve and MBUN). We meticulously dissected the SRN and the motor and sensory branches of the ulnar nerve. Measurements were made from the reverse point of the SRN to the wrist flexion crease and the coaptation point of the SRN and MBUN. Additionally, we traced the MBUN from distal to proximal ends, recording its maximum length. We also measured the diameters of the nerve branches and tallied the number of axons. RESULTS: Our modified approach proved technically viable in all examined limbs. The distances from the reverse point of the SRN to the wrist flexion crease were 8.24 ± 1.80 cm and to the coaptation point were 6.60 ± 1.75 cm. The maximum length of the MBUN was 7.62 ± 1.03 cm. The average axon diameters in the MBUN and the anterior and posterior branches of the SRN were 1.88 ± 0.42 mm、1.56 ± 0.38 mm、2.02 ± 0.41 mm,respectively. The corresponding mean numbers of axons were 1426.60 ± 331.39 and 721.50 ± 138.22, and 741.90 ± 171.34, respectively. CONCLUSION: The SRN demonstrated the potential to be transferred to the MBUN without necessitating a nerve graft. A potential advantage of this modification is preserving the MBUN's recovery potential.

Controllable adhesion behavior in underwater environments.

Microstructure adhesive pads can effectively manipulate objects in underwater environments. Current adhesive pads can achieve adhesion and separation with rigid substrates underwater; however, challenges remain in the control of adhesion and detachment of flexible materials. Additionally, underwater object manipulation necessitates considerable pre-pressure and is sensitive to water temperature fluctuations, potentially causing object damage and complicating adhesion and detachment processes. Thus, we present a novel, controllable adhesive pad inspired by the functional attributes of microwedge adhesive pads, combined with a mussel-inspired copolymer (MAPMC). In the context of underwater applications for flexible materials, the use of a microstructure adhesion pad with microwedge characteristics (MAPMCs) is a proficient approach to adhesion and detachment operations. This innovative method relies on the precise manipulation of the microwedge structure's collapse and recovery during its operation, which serves as the foundation for its efficacy in such environments. MAPMCs exhibit self-recovering elasticity, water flow interaction, and tunable underwater adhesion and detachment. Numerical simulations elucidate the synergistic effects of MAPMCs, highlighting the advantages of the microwedge structure for controllable, non-damaging adhesion and separation processes. The integration of MAPMCs into a gripping mechanism allows for the handling of diverse objects in underwater environments. Furthermore, by merging MAPMCs and a gripper within a linked system, our approach enables automatic, non-damaging adhesion, manipulation, and release of a soft jellyfish model. The experimental results indicate the potential applicability of MACMPs in underwater operations.

Classification and treatment of congenital central slip hypoplasia.

OBJECTIVES: The aim of this study is to make a diagnosis and a classification for congenital central slip hypoplasia. The surgical treatment was determined according to the classification. METHODS: A retrospective study of 25 treated digits in 13 patients with congenital central slip hypoplasia was carried out. The central slip was classified into two types. Type I: The distance between the insertion of central slip and the proximal interphalangeal joint was shorter than or equal to 5 mm. Type II: The distance between the insertion of central slip and the proximal interphalangeal joint was longer than 5 mm. Tendon advancement or tendon graft was used for type I or II, respectively. RESULTS: The preoperative mean extension lag was 91° (range, 80°-100°), and the mean follow-up duration was 18 months (range, 9-24 months). The postoperative mean extension lag was 19° (range, 0°-50°). No matter whether in type I or II, the postoperative ranges of proximal interphalangeal joint extension had significant improvement compared with the preoperative ones. There was no statistical difference of proximal interphalangeal joint extension lag changes before and after surgery between the two types. CONCLUSION: Congenital central slip hypoplasia could be classified into two types. Either tendon advancement or tendon graft might be effective, which depended on the classification.

The temporal and spatial signature of microglial transcriptome in neuropathic pain.

Microglial activation following peripheral nerve injury is crucial for neuropathic pain (NP) development; however, studies on time-specific and spatial characteristics of microglial transcriptome are scarce. Firstly, we comparatively analysed microglial transcriptome of different brain regions and multiple timepoints after nerve injury by analysing the gene expression profile of GSE180627 and GSE117320. Then, we performed a mechanical pain hypersensitivity test on 12 rat neuropathic pain models using von Frey fibres at various timepoints after nerve injury. To further explore the key gene clusters closely related to the neuropathic pain phenotype, we conducted a weighted gene co-expression network analysis (WGCNA) on the GSE60670 gene expression profile. Lastly, we performed a single-cell sequencing analysis on GSE162807 for identifying microglia subpopulations. We found that the trend of microglia's transcriptome changes after nerve injury was that mRNA expression changes mainly occur early after injury, which is also consistent with phenotypic changes (NP progression). We also revealed that in addition to spatial specificity, microglia are also temporally specific in NP progression following nerve injury. The WGCNA findings revealed that the functional analysis of the key module genes emphasized the endoplasmic reticulum's (ER's) crucial role in NP. In our single-cell sequencing analysis, microglia were clustered into 18 cell subsets, of which we identified specific subsets of two timepoints (D3/D7) post-injury. Our study further revealed the temporal and spatial gene expression specificity of microglia in neuropathic pain. These results contribute to our comprehensive understanding of the pathogenic mechanism of microglia in neuropathic pain.

Effects of dyadic-based physical activity intervention on cancer-related fatigue among cancer survivors: A scoping review.

Objective: Cancer-related fatigue is one of the most common adverse reactions to cancer survivors, which has a significant impact on the daily life. As a traumatic event, cancer not only brings great physical and mental harm to patients, but also poses a threat to the physical and psychological health of caregivers. Current studies have shown that physical activity improves cancer-related fatigue in cancer survivors. And studies have suggested that dyadic interventions are more effective in improving patient outcomes and may also provide some benefits to caregivers. But the literature on the effects of dyadic-based physical activity on improving cancer-related fatigue has not been synthesized. This scoping review described the scope and impact of studies on cancer-related fatigue with dyadic-based physical activity interventions. Methods: Six databases which is PubMed, Cochrane Library, Web of Science, Embase, CINAHL and Medline were searched for all studies of dyadic-based physical activity interventions with outcome measures including cancer-related fatigue published since the inception of the databases through May 2022. The search strategy was developed based on PICO principles. Results: This article includes 6 pre and post-test designs and 2 randomized controlled trial design. The majority of participants were survivors with breast and lung cancer. The overall results showed that the effectiveness of dyadic-based physical activity interventions in improving cancer-related fatigue was unsatisfactory. Conclusions: This scoping review suggests that current dyadic-based physical activity interventions are not well-researched among cancer survivors. In the future, more high-quality studies with more sophisticated and rigorous interventions are needed.

Nano Si-Doped Ruthenium Oxide Particles from Caged Precursors for High-Performance Acidic Oxygen Evolution.

RuO2 is well known as the benchmark acidic oxygen evolution reaction (OER) catalyst, but its practical application has been impeded by its limited durability. Herein, it is presented that the stability of ruthenium oxide can be significantly improved by pretrapping RuCl3 precursors within a cage compound possessing 72 aromatic rings, which leads to well carbon-coated RuOx particles (Si-RuOx @C) after calcination. The catalyst survives in 0.5 M H2 SO4 for an unprecedented period of 100 hours at 10 mA cm-2 with minimal overpotential change during OER. In contrast, RuOx prepared from similar non-tied compounds doesn't exhibit such catalytic activity, highlighting the importance of the preorganization of Ru precursors within the cage prior to calcination. In addition, the overpotential at 10 mA cm-2 in acid solution is only 220 mV, much less than that of commercial RuO2 . X-ray absorption fine structure (FT-EXAFS) reveals the Si doping through unusual Ru-Si bond, and density functional theory (DFT) calculation reveals the importance of the Ru-Si bond in enhancing both the activity and stability of the catalyst.

Delayed endovascular repair for traumatic aortic pseudoaneurysms: experience from an Asian single center.

BACKGROUND: Traumatic aortic pseudoaneurysms (PSAs) classified as grade III aortic injuries are conventionally repaired as procedural emergencies, generally within 24 h of arrival. These patients typically require adequate resuscitation and treatment of multiple traumatic injuries, which complicate optimal management strategies of aortic PSAs. This study reviews the experience of an Asian single center to evaluate the efficacy and safety of delayed (> 24 h) endovascular repair for PSAs. METHODS: Twenty-seven patients with blunt aortic injury (BTAI) were brought to our institution between February 2014 and May 2020. Patients with other grades of aortic injuries (grade I, II, or IV) were excluded from the study, and the remaining patients with grade III aortic injuries were placed into the early (< 24 h) and delayed (> 24 h) groups according to the timing of repair. Medical records and follow-up computed tomography (CT) scans were reviewed to document the outcomes of the procedures. Primary outcomes included mortality and complications. RESULTS: During this period, there were 14 patients (13 males and 1 females) with aortic PSAs, and each patient received thoracic endovascular aortic repair (TEVAR). Of these 14 patients, 1 underwent emergent TEVAR, and 13 underwent delayed repair (median 7 days, range, 3-14 days). Over a period of 8 years, the overall survival of our series was 100%. No paraplegia, stroke, ischemia of limb or other serious procedural complications were observed during the duration of follow-up. CONCLUSION: The experience of our center indicates that delayed repair for selected PSAs could be permissible, which enables a repair in more controlled circumstances.

Comparison of diaphyseal and metaphyseal ulnar shortening osteotomies for the treatment of ulnar impaction syndrome.

BACKGROUND: Ulnar shortening osteotomy (USO) is a common surgical procedure for the treatment of ulnar impaction syndrome (UIS). The purpose of this study was to compare the results of metaphyseal and diaphyseal USO.  METHODS: This retrospective study compared the clinical outcomes and complications of 32 patients who underwent diaphyseal step-cut USO (n = 10), diaphyseal oblique USO (n = 12), or metaphyseal USO (n = 10). RESULTS: Patient characteristics, ulnar variance, wrist range of motion, preoperative pain, grip strength, and functional scores (quick disability of the arm, shoulder, and hand and patient-rated wrist evaluation) were comparable. Both operation time (79.5 vs. 138/139 min) and incision length (7.80 vs. 9.67/13.00 cm) were shorter in the metaphyseal USO than in the diaphyseal oblique/step-cut USO. Compared with diaphyseal oblique/step-cut USO, metaphyseal osteotomies were associated with greater improvement in the pain on postoperative day 3 and shorter bone healing time. The requirements for implant removal were the same among the three groups. No complications were observed in any group. CONCLUSION: Compared with diaphyseal USO, metaphyseal USO has advantages for operation time and incision length, early postoperative pain, bone healing in UIS management. The results suggested that metaphyseal USO could be widely applied to the surgical treatment of UIS. However, the long-term outcomes of these techniques still require further evaluation using more large-scale, randomized clinical trials.

Cage-modified hypocrellin against multidrug-resistant Candida spp. with unprecedented activity in light-triggered combinational photodynamic therapy.

Infections caused by multidrug-resistant fungi pose a devastating threat to human health worldwide, making new antifungal strategies urgently desired. Antimicrobial photodynamic therapy (aPDT) has gained increasing attention due to its potential in fighting against fungal infection. However, the preparation of highly efficient and water-soluble photosensitizers (PSs) for this purpose remains a challenge. Herein, we present a new strategy to prepare powerful PSs for efficient aPDT by introducing a porous cage compound, which could facilitate the transportation of O2 and reactive oxygen species (ROS). Specifically, the natural PS hypocrellin A (HA) was attached to a novel organic cage compound (covalent organic polyhedra 1 tied, COP1T) with polyethylene glycol (PEG) chains to improve its water solubility. It was found that the resulting COP1T-HA exhibited in vitro antifungal efficiency several folds higher compared to the free HA in fighting against four types of multidrug-resistant fungal planktonic cells and biofilms, including the "super fungus" Candida auris. Interestingly, the red-shift of COP1T-HA adsorption led to the realization of phototheranostic aPDT for cage-modified HA or derivatives. Additionally, COP1T-HA exhibited good biocompatibility, excellent disinfection capacity and wound healing efficiency without obvious toxic effects in vivo of rat model. With further development and optimization, COP1T-HA has great potential to become a new class of antifungal agent to fight against drug-resistant pathogens.

Influencing Factors and Application of Spontaneous Imbibition of Fracturing Fluids in Tight Sandstone Gas Reservoir.

This work is based on high-precision fluid spontaneous imbibition experiments to quantitatively study the imbibition rate, imbibition capacity, and imbibition curve characteristics of fracturing fluids in tight sandstone reservoirs. The objective of the work is to explore the influence of tight sandstone physical characteristics, fracturing fluid composition, salinity, viscosity, surface tension on fracturing fluid imbibition, and further analyze its main controlling factors. To evaluate imbibition characteristics more deeply, the pore throat structure and micromorphology of tight sandstone before and after imbibition were described by mercury intrusion test and scanning electron microscope test, respectively. Furthermore, the mineral composition and dilatation characteristics of the tight sandstone samples were identified by XRD and a linear dilatometer, respectively. The results show that the drilled tight sandstone samples from the Shaximiao Formation reservoir have strong heterogeneity, high clay mineral content, more developed micro/nanopores, less developed fractures, and strong hydration expansion. Since the average pore throat radius of tight sandstone samples is between 0.1 and 0.2 µm, the imbibition driving force is strong. The imbibition rate is fast, and the imbibition basically reaches a steady state within 24 h, which makes the imbibition capacity basically greater than 50%. Based on the analysis of the main control factors of imbibition, the surface tension of the fluid properties has the greatest impact on the imbibition recovery factor. The result not only helps to understand the absorption mechanism of fracturing fluid in tight sandstone reservoirs and then evaluates the degree of interaction between fluid and tight sandstone but it is also crucial for the prediction of flowback rate.

Complex skin modes in non-Hermitian coupled laser arrays.

From biological ecosystems to spin glasses, connectivity plays a crucial role in determining the function, dynamics, and resiliency of a network. In the realm of non-Hermitian physics, the possibility of complex and asymmetric exchange interactions ([Formula: see text]) between a network of oscillators has been theoretically shown to lead to novel behaviors like delocalization, skin effect, and bulk-boundary correspondence. An archetypical lattice exhibiting the aforementioned properties is that proposed by Hatano and Nelson in a series of papers in late 1990s. While the ramifications of these theoretical works in optics have been recently pursued in synthetic dimensions, the Hatano-Nelson model has yet to be realized in real space. What makes the implementation of these lattices challenging is the difficulty in establishing the required asymmetric exchange interactions in optical platforms. In this work, by using active optical oscillators featuring non-Hermiticity and nonlinearity, we introduce an anisotropic exchange between the resonant elements in a lattice, an aspect that enables us to observe the non-Hermitian skin effect, phase locking, and near-field beam steering in a Hatano-Nelson laser array. Our work opens up new regimes of phase-locking in lasers while shedding light on the fundamental physics of non-Hermitian systems.

The use of traditional Chinese medicines in relieving exercise-induced fatigue.

Exercise-induced fatigue is a non-pathological fatigue and indicated by a reduction of muscle performance that is caused by excessive physical activity. It seriously affects the daily lives of people, in particular athletes, military personnel, and manual laborers. In recent years, increasing attention has been paid to improving the adverse effect of exercise-induced fatigue on people's daily activities. Thus, studies and applications of traditional Chinese medicines (TCMs) in relieving exercise-induced fatigue have become the focus because of their good curative effects with fewer side effects. This review aims to document and summarize the critical and comprehensive information about the biological processes of exercise-induced fatigue, and to know the types of TCMs, their active components, and possible molecular mechanisms in alleviating exercise-induced fatigue. The peripheral and central mechanisms that cause exercise-induced fatigue have been summarized. A total of 47 exercise-induced fatigue relief TCMs have been collected, mostly including the types of visceral function regulation and emotional adjustment TCMs. Polysaccharides, terpenes, flavonoids/polyphenols are demonstrated to be the major bioactive components. The underlying molecular mechanisms are mainly related to the improvement of energy metabolism, elimination of excess metabolites, inhibition of oxidative stress and inflammatory response, regulation of HPA axis and neurotransmitters. Although current results are obtained mostly from animal models, the clinic trials are still insufficient, and a very few TCMs have been reported to possess potential hepatotoxicity. These findings still offer great reference value, and the significant efficacy in relieving exercise-induced fatigue is impossible to ignore. This review is expected to give insights into the research and development of new TCMs-derived drugs and health care products in relieving exercise-induced fatigue.