Green Solvent γ-Valerolactone (GVL) Facilitates Photocatalytic C-H Bond Activation.

Solvents can significantly influence chemical reactions in condensed phases. Their critical properties are increasingly recognized in various research domains such as organic synthesis and biomass valorization. However, in semiconductor photocatalysis, solvents are primarily viewed as mediums for dissolving and diffusing substances, with their potential beneficial effects on photocatalytic conversions often overlooked. Additionally, common photocatalysis solvents like acetonitrile (ACN) pose serious safety and environmental concerns. In this study, we demonstrate that novel and safe green solvents, such as γ-valerolactone (GVL), can significantly enhance the performance of semiconductor photocatalysis for C-H bond activation. Non-specific solvent-solute interactions are the primary contributors to increased photocatalytic activity in the self-coupling of benzylic compounds. Specifically, GVL's large dielectric constant and high refractive index lower the energy barrier for the rate-determining C-H bond activation step, facilitating a faster coupling reaction. The versatility of GVL is further demonstrated in reactions with multiple reagents and in various oxidation and reduction photocatalytic systems beyond classic C-H bond activation. This work not only pioneers the use of green solvents but also provides comprehensive insights for proper solvent selection in semiconductor photocatalysis.

Zinc-indium-sulfide favors efficient C - H bond activation by concerted proton-coupled electron transfer.

C - H bond activation is a ubiquitous reaction that remains a major challenge in chemistry. Although semiconductor-based photocatalysis is promising, the C - H bond activation mechanism remains elusive. Herein, we report value-added coupling products from a wide variety of biomass and fossil-derived reagents, formed via C - H bond activation over zinc-indium-sulfides (Zn-In-S). Contrary to the commonly accepted stepwise electron-proton transfer pathway (PE-ET) for semiconductors, our experimental and theoretical studies evidence a concerted proton-coupled electron transfer (CPET) pathway. A pioneering microkinetic study, considering the relevant elementary steps of the surface chemistry, reveals a faster C - H activation with Zn-In-S because of circumventing formation of a charged radical, as it happens in PE-ET where it retards the catalysis due to strong site adsorption. For CPET over Zn-In-S, H abstraction, forming a neutral radical, is rate-limiting, but having lower energy barriers than that of PE-ET. The rate expressions derived from the microkinetics provide guidelines to rationally design semiconductor catalysis, e.g., for C - H activation, that is based on the CPET mechanism.

Unusual facet and co-catalyst effects in TiO2-based photocatalytic coupling of methane.

Photocatalytic coupling of methane to ethane and ethylene (C2 compounds) offers a promising approach to utilizing the abundant methane resource. However, the state-of-the-art photocatalysts usually suffer from very limited C2 formation rates. Here, we report our discovery that the anatase TiO2 nanocrystals mainly exposing {101} facets, which are generally considered less active in photocatalysis, demonstrate surprisingly better performances than those exposing the high-energy {001} facet. The palladium co-catalyst plays a pivotal role and the Pd2+ site on co-catalyst accounts for the selective C2 formation. We unveil that the anatase {101} facet favors the formation of hydroxyl radicals in aqueous phase near the surface, where they activate methane molecules into methyl radicals, and the Pd2+ site participates in facilitating the adsorption and coupling of methyl radicals. This work provides a strategy to design efficient nanocatalysts for selective photocatalytic methane coupling by reaction-space separation to optimize heterogeneous-homogeneous reactions at solid-liquid interfaces.

MicroRNA-130b Suppresses Malignant Behaviours and Inhibits the Activation of the PI3K/Akt Signaling Pathway by Targeting MET in Pancreatic Cancer.

There has been interested in the microRNAs' roles in pancreatic cancer (PC) cell biology, particularly in regulating pathways related to tumorigenesis. The study aimed to explore the hub miRNAs in PC and underlying mechanisms by bioinformatics and fundamental experiments. RNA datasets collected from the Gene Expression Omnibus were analysed to find out differentially expressed RNAs (DERNAs). The miRNA-mRNA and protein-protein interaction (PPI) networks were built. The clinicopathological features and expressions of hub miRNAs and hub mRNAs were explored. Dual-luciferase reporter gene assay was performed to assess the interaction between microRNA and target gene. RT-qPCR and western blot were employed to explore RNA expression. The roles of RNA were detected by CCK-8 test, wound healing, transwell, and flow cytometry experiment. We verified 40 DEmiRNAs and 1613 DEmRNAs, then detected a total of 69 final functional mRNAs (FmRNAs) and 23 DEmiRNAs. In the miRNA-mRNA networks, microRNA-130b (miR-130b) was the hub RNA with highest degrees. Clinical analysis revealed that miR-130b was considerably lower expressed in cancerous tissues than in healthy ones, and patients with higher-expressed miR-130b had a better prognosis. Mechanically, miR-130b directly targeted MET in PC cells. Cell functional experiments verified that miR-130b suppressed cell proliferation, migration, promoted apoptosis, and inhibited the PI3K/Akt pathway by targeting MET in PC cells. Our findings illustrated the specific molecular mechanism of miR-130b regulating PC progress. The miR-130b/MET axis may be an alternative target in the therapeutic intervention of PC and provide an opportunity to deepen our understanding of the pathogenesis of PC.

Contribution of a Circulating 2'-O-methylated MicroRNA Panel to the Diagnosis of Pancreatic Ductal Adenocarcinoma.

Background: We conducted an assessment of 2'-O-methylated (2'OMe) microRNAs (miRNAs) present in the circulation of individuals suffering from pancreatic ductal adenocarcinoma (PDAC). Subsequently, we devised a set of circulating 2'OMe miRNAs that can be utilized for the screening of PDAC patients within a group at increased risk. Methods: A four-step, multicenter research was carried out. The initial screening phase involved analyzing 10 samples from patients with pancreatic ductal adenocarcinoma (PDAC) and 10 specimens from donors who were in good health. RNA sequencing was performed on these specimens after pre-treatment via NaIO4. The instruction and confirmation phases involved the use of 2'OMe miRNA profiling and multivariate analysis to examine applicant 2'OMe miRNAs in a sample of 248 individuals. In a prospective registration population of 135 individuals, a clinical screening panel was created and confirmed. The performance of individual 2'OMe miRNAs or the biomarker panel was evaluated using the receiver operating characteristic curve. Results: Abnormal circulating 2'OMe miRNAs were detected in individuals suspected of pancreatic ductal adenocarcinoma (PDAC). A circulating panel of 3-2'OMe miRNAs, namely miR-28-3p, miR-143-3p, and miR-151a-3p, was subsequently identified. These miRNAs continually exhibited up-regulation in plasma samples of patients with pancreatic ductal adenocarcinoma (PDAC). The panel's area under the curve (AUC) was 1.0 in the experimental group and 0.928 in the verification cohort when comparing PDAC patients in all clinical stages to normal controls. During the application study, both the specificity and sensitivity were found to be 75.00% and 89.72% respectively, with an AUC value of 0.868. In the comparison between early-stage (I-II) PDAC patients and control subjects, the panel demonstrated an AUC of 1.0 in the training cohort and 0.924 in the validation population. In the application group the AUC was 0.810 (95% CI 0.729-0.876) in comparison to the high-risk symptomatic group. Conclusion: Abnormal circulating 2'OMe miRNAs were detected in individuals with pancreatic ductal adenocarcinoma (PDAC). Consequently, we devised a 2'OMe miRNA biological marker panel that holds promise as an initial detection tool for PDAC.

In Situ UV-Vis-NIR Absorption Spectroscopy and Catalysis.

This review highlights in situ UV-vis-NIR range absorption spectroscopy in catalysis. A variety of experimental techniques identifying reaction mechanisms, kinetics, and structural properties are discussed. Stopped flow techniques, use of laser pulses, and use of experimental perturbations are demonstrated for in situ studies of enzymatic, homogeneous, heterogeneous, and photocatalysis. They access different time scales and are applicable to different reaction systems and catalyst types. In photocatalysis, femto- and nanosecond resolved measurements through transient absorption are discussed for tracking excited states. UV-vis-NIR absorption spectroscopies for structural characterization are demonstrated especially for Cu and Fe exchanged zeolites and metalloenzymes. This requires combining different spectroscopies. Combining magnetic circular dichroism and resonance Raman spectroscopy is especially powerful. A multitude of phenomena can be tracked on transition metal catalysts on various supports, including changes in oxidation state, adsorptions, reactions, support interactions, surface plasmon resonances, and band gaps. Measurements of oxidation states, oxygen vacancies, and band gaps are shown on heterogeneous catalysts, especially for electrocatalysis. UV-vis-NIR absorption is burdened by broad absorption bands. Advanced analysis techniques enable the tracking of coking reactions on acid zeolites despite convoluted spectra. The value of UV-vis-NIR absorption spectroscopy to catalyst characterization and mechanistic investigation is clear but could be expanded.

The prognostic value of the visually assessed time difference between mitral valve and tricuspid valve opening score for patients with heart failure with mildly reduced ejection fraction.

BACKGROUND: The visually assessed time difference between the mitral valve and tricuspid valve opening (VMT) score was correlated with the increase of left ventricular filling pressure (LVFP). HYPOTHESIS: We suspected that the VMT score might be a valuable prognostic biomarker for heart failure with mildly reduced ejection fraction (HFmrEF) patients. This study was to evaluate the predictive value of VMT score for 1-year all-cause and cardiovascular disease (CVD)-cause mortality in HFmrEF patients. METHODS: This cohort study enrolled 379 patients aged ≥18 years old with HFmrEF. Univariable and multivariable Cox regression analysis was employed to assess the association between VMT score and all-cause or CVD-cause mortality in HFmrEF patients. Hazards ratio (HR), and 95% confidence interval (CI) were effect sizes. Kaplan-Meier curves showed the survival probability of patients. The area under the curve (AUC) evaluated the prognostic value of the VMT score. RESULTS: The risk of all-cause mortality was increased in HFmrEF patients in the VMT score of 2 (HR = 2.80, 95%CI: 1.04-7.52) and 3 (HR = 4.29, 95%CI: 1.58-11.66). The VMT score of 3 was associated with an increased risk of 1-year CVD-cause mortality in patients with HFmrEF (HR = 7.63, 95%CI: 1.70-34.33). The AUC of VMT score for predicting 1-year all-cause mortality of HFmrEF patients was 0.724, and for predicting 1-year CVD-cause mortality of HFmrEF patients was 0.748. The survival probability of patients with the VMT score < 2 was higher than those with the VMT score of 2 and 3. CONCLUSION: The VMT score might be a reliable prognostic index for 1-year all-cause or CVD-cause mortality of HFmrEF patients.

Machine learning-based model for predicting major adverse cardiovascular and cerebrovascular events in patients aged 65 years and older undergoing noncardiac surgery.

BACKGROUND: Few evidence-based prediction models have been developed for predicting major adverse cardiovascular and cerebrovascular events (MACCE) in patients aged 65 years or older undergoing noncardiac surgery. In this study, we aimed to analyze the risk factors for perioperative MACCE in patients aged 65 years or older undergoing noncardiac surgery and construct a prediction model. METHODS: In this nested case-control study, a total of 342 Chinese patients who were aged ≥ 65 years and underwent medium- or high-risk noncardiac surgery in our hospital were included. There were 84 cases with MACCE (the MACCE group) and 258 without MACCE (the control group). Univariable logistic regression analysis was performed to identify the risk factors for MACCE. Least absolute shrinkage and selection operator (LASSO) regression was used to screen the variables. Nomogram was constructed using the selected variables. Machine learning methods, including Decision Tree, XGBoost, Support Vector Machine, K-nearest Neighbor, and Neural network, was used to establish, validate, and compare the performance of different prediction models. RESULTS: A prediction model based on nine variables, including age ≥ 85 years, history of ischemic chest pain, symptoms of decompensated heart failure, high-risk surgery, intraoperative minimum systolic blood pressure, postoperative systolic blood pressure, Cr levels over 2.0 mg/dL, left ventricular ejection fraction, and perioperative blood transfusion, was constructed. This LASSO logistic regression model showed good discriminatory ability to predict MACCE (area under the curve = 0.89; 95% confidence interval, 0.818 - 0.963) and fit to the test set (Hosmer-Lemeshow, χ2 = 7.4053, P = 0.4936). The decision curve analysis showed a positive net benefit of the new model. Compared with logistic regression model, the XGBoost model showed better prediction ability (area under the curve = 0.903). A preoperative prediction model based on five variables, including age ≥ 85 years, symptoms of decompensated heart failure, ischemic chest pain, high-risk type of surgery and Cr levels over 2.0 mg/dL was also constructed. This model showed good discriminatory ability to predict MACCE before surgery (area under the curve = 0.720 [95% CI, 0.591-0.848]. Both models compared with the modified RCRI score had improvement in reclassification. CONCLUSION: By analyzing Chinese patients aged ≥ 65 years undergoing medium- or high-risk noncardiac surgery, the risk factors for perioperative MACCE were identified. Then, simple prediction models were constructed and validated, which showed good prediction performance and may be used as a decision-making assistant tool for clinicians. These findings provide a basis for preventing and improving the perioperative management of MACCE.

High-performance Cu/Mn modified ceramsite as a persulfate activator to degrade oxytetracycline in batch Erlenmeyer flask and continuous-flow fixed-bed column systems: An exploration of its practicability and non-radical mechanisms.

Persulfate non-radical oxidation have excellent catalytic capability for degrading specific contaminants in complicated water environments. Nevertheless, the preparation of high-performance activators and their application in actual water treatment in continuous flow mode are still scarce and unsatisfactory. In this work, copper-, manganese-, and copper/manganese-doped ceramsites (Cu-C, Mn-C and Cu/Mn-C), successfully fabricated through a facile impregnation-calcination approach, were characterized and evaluated for their performance to activate potassium peroxydisulfate (PDS) and degrade oxytetracycline (OTC) under different pH, ceramsite dosages, and PDS dosages. Compared with Cu-C and Mn-C, Cu/Mn-C showed the highest OTC degradation rate (0.0264 min-1) via activating PDS with an OTC removal efficiency of 98.2% in 240 min at an initial OTC concentration of 40 mg/L. The removal efficiency of OTC by Cu/Mn-C only decreased to 92.8% after 5 cycles; the activating ability of the used Cu/Mn-C was almost completely recovered through 2 h of calcination at 500 °C. The results of electron paramagnetic resonance and radical quenching suggest that singlet oxygen (1O2) was unveiled to be the dominant reactive oxygen species (ROS) for contaminant degradation, originating from the regrouping of superoxide ions or reduction of active Cu/Mn sites. Synergies between Cu and Mn species to enhance ROS yield were the primary activating mechanisms. Six possible routes of OTC decomposition were inferred. Additionally, Cu/Mn-C behaved excellently in treating an actual wastewater using a continuous flow fixed-bed reactor. It is believed that this novel Cu/Mn-C/PDS system may create a fresh path to design effective and cheap metal-ceramsite hybrid activators for degrading recalcitrant contaminants in the actual application process.

Photo-Driven Iron-Induced Non-Oxidative Coupling of Methane to Ethane.

Photo-driven CH4 conversion to multi-carbon products and H2 is attractive but challenging, and the development of efficient catalytic systems is critical. Herein, we construct a solar-energy-driven redox cycle for combining CH4 conversion and H2 production using iron ions. A photo-driven iron-induced reaction system was developed, which is efficient at selective coupling of CH4 as well as conversion of benzene and cyclohexane under mild conditions. For CH4 conversion, 94 % C2 selectivity and a C2 H6 formation rate of 8.4 µmol h-1 is achieved. Mechanistic studies reveal that CH4 coupling is induced by hydroxyl radical, which is generated by photo-driven intermolecular charge migration of an Fe3+ complex. The delicate coordination structure of the [Fe(H2 O)5 OH]2+ complex ensures selective C-H bond activation and C-C coupling of CH4 . The produced Fe2+ can be used to reduce the potential for electrolytic H2 production, and then turns back into Fe3+ , forming an energy-saving and sustainable recyclable system.

Effectiveness of ischemic compression on myofascial trigger points in relieving neck pain: A systematic review and meta-analysis.

BACKGROUND: Ischemic compression is widely used to clinically treat neck pain. However, no meta-analysis has been conducted to evaluate the effects of this process on neck pain. OBJECTIVE: This study aimed to evaluate the effects of ischemic compression on the myofascial trigger points for improving neck pain-related symptoms (mainly pain, joint mobility limitation and function limitation) and to compare ischemic compression with other therapies. METHODS: Electronic searches were conducted in PubMed, OVID, Web of Science, EBSCO, SCOUPS, Cochrane Library, PEDro, Wanfang, CNKI and Chinese VIP Database in June 2021. Only randomised controlled trials on the effects of ischemic compression on neck pain were included. The major outcomes were pain intensity, pressure pain threshold, pain-related disability and range of motion. RESULTS: Fifteen studies involving 725 participants were included. Significant differences were observed between ischemic compression and sham/no treatment group in pain intensity, pressure pain threshold and range of motion immediately and in the short term. Significant effect sizes of dry needling were observed over ischemic compression in terms of improving pain intensity (SMD = 0.62; 95% CI: 0.08 to 1.16; P= 0.02), pain-related disability (SMD = 0.68; 95% CI: 0.19 to 1.17; P= 0.007) and range of motion (MD =-2.12; 95% CI: -2.59 to -1.65; P< 0.001) immediately after treatment. Dry needling also showed a significant small effect size for the short-term reduction of pain (SMD = 0.44; 95% CI: 0.04 to 0.85; P= 0.03). CONCLUSION: Ischemic compression can be recommended in the immediate and short-term pain relief and increase in the pressure pain threshold and range of motion. Dry needling is superior to ischemic compression in relieving pain and improving pain-related disability and range of motion immediately after treatment.

MBNL1-AS1 Promotes Hypoxia-Induced Myocardial Infarction via the miR-132-3p/RAB14/CAMTA1 Axis.

Background: Mounting evidence have indicated that long noncoding RNA (lncRNA) muscleblind like splicing regulator 1 antisense RNA 1 (MBNL1-AS1) play a crucial regulatory role in cardiovascular disease, myocardial infarction (MI) included. In this research, we sought to probe into the biological function and potential mechanism of MBNL1-AS1 in MI. Methods: Cardiomyocytes were treated under hypoxic conditions for 0-12 h. Functional assays including CCK-8 and flow cytometry were performed to assess hypoxia-stimulated cardiomyocyte viability and apoptosis, respectively. Moreover, bioinformatics analysis and mechanical assays were conducted to reveal the competitive endogenous RNA (ceRNA) mechanism of MBNL1-AS1. Results: The upregulation of MBNL1-AS1 was found in hypoxia-stimulated cardiomyocytes. Functionally, the downregulation of MBNL1-AS1 dramatically promoted hypoxia-induced cardiomyocyte viability and inhibited apoptosis. Mechanistically, miR-132-3p bound to MBNL1-AS1 in hypoxia-induced cardiomyocytes, and miR-132-3p directly targeted RAB14, member RAS oncogene family (RAB14) and calmodulin binding transcription activator 1 (CAMTA1). Furthermore, MBNL1-AS1 upregulates the expression of RAB14 and CAMTA1 in hypoxia-stimulated cardiomyocytes via targeting miR-132-3p. Conclusions: The current study revealed the critical role of the MBNL1-AS1/miR-132-3p/RAB14/CAMTA1 axis in MI, indicating MBNL1-AS1 as an innovative therapeutic target for MI.

Evaluation of Fe3O4-MnO2@RGO magnetic nanocomposite as an effective persulfate activator and metal adsorbent in aqueous solution.

A reduced graphene oxide (RGO) supported Fe3O4-MnO2 nanocomposite (Fe3O4-MnO2@RGO) was successfully prepared for catalytic degradation of oxytetracycline (20 mg/L) by potassium persulfate (PS) and adsorption removal of mixture of Pb2+, Cu2+, and Cd2+ ions (each 0.2 mM) in the synchronous scenario. The removal efficiencies of oxytetracycline, Pb2+, Cu2+, and Cd2+ ions were observed as high as 100%, 99.9%, 99.8%, and 99.8%, respectively, under the conditions of [PS]0 = 4 mM, pH0 = 7.0, Fe3O4-MnO2@RGO dosage = 0.8 g/L, reaction time = 90 min. The ternary composite exhibited higher oxytetracycline degradation/mineralization efficiency, greater metal adsorption capacity (Cd2+ 104.1 mg/g, Pb2+ 206.8 mg/g, Cu2+ 70.2 mg/g), and better PS utilization (62.6%) than its unary and binary counterparts including RGO, Fe3O4, Fe3O4@RGO, and Fe3O4-MnO2. More importantly, the ternary composite had good magnetic recoverability and excellent reusability. Notably, Fe, Mn, and RGO could play a synergistic role in the improvement of pollutant removal. Quenching results indicate that surface bounded SO4•- was the major contributor to oxytetracycline decomposition, and the -OH groups on the composite surface shouldered a significant role in PS activation. The results indicate that the magnetic Fe3O4-MnO2@RGO nanocomposite has a good potential for removing organic-metal co-contaminants in waterbody.

A New Predictive Model for In-Hospital Major Adverse Cardiac and Cerebrovascular Events in Chinese Patients After Major Noncardiac Surgery.

Prediction tools focused on cardiovascular and cerebrovascular events after noncardiac surgery are lacking, particularly for Chinese patients. We developed and validated what we believe is a new predictive tool for postoperative major cardiovascular and cerebrovascular events (MACCEs) in Chinese patients in this study. Overall, 401 variables derived from 598 patients who received noncardiac surgery at our center were retrospectively analyzed to develop and validate the new predictive model for MACCEs during hospitalization. The 7 strongest predictors for MACCEs in the development cohort were chronic heart failure, age, atrial fibrillation, general anesthesia, history of coronary heart disease, high-risk procedures, and lymphocyte count. The area under the receiver operating characteristic curve was 0.698 (95% confidence interval 0.616 to 0.780) for the new predictive tool with the validation cohort. Receiver operating characteristic curve analysis showed the new predictive tool had better performance than the Revised Cardiac Risk Index and the American College of Surgeons National Surgical Quality Improvement Program scores. This new predictive tool is effective for the prediction of postoperative MACCEs in patients who undergo noncardiac surgery.

Soy isoflavone-specific biotransformation product S-equol in the colon: physiological functions, transformation mechanisms, and metabolic regulatory pathways.

Epidemiological data suggest that regular intake of soy isoflavones may reduce the incidence of estrogen-dependent and aging-associated disorders. Equol is a metabolite of soy isoflavone (SI) produced by specific gut microbiota and has many beneficial effects on human health due to its higher biological activity compared to SI. However, only 1/3 to 1/2 of humans are able to produce equol in the body, which means that not many people can fully benefit from SI. This review summarizes the recent advances in equol research, focusing on the chemical properties, physiological functions, conversion mechanisms in vitro and vivo, and metabolic regulatory pathways affecting S-equol production. Advanced experimental designs and possible techniques in future research plan are also fully discussed. Furthermore, this review provides a fundamental basis for researchers in the field to understand individual differences in S-equol production, the efficiency of metabolic conversion of S-equol, and fermentation production of S-equol in vitro.

Automatic upper-extremity Brunnstrom Classification for Stroke Survivors with a Minimum Number of Tasks.

Motor function evaluation plays an important role in post-stroke rehabilitation. However, the traditional evaluation is subjective and laborious, which may bring a heavy burden to both physicians and stroke survivors. Therefore, an automatic and objective rehabilitation evaluation is needed to minimize the burden of physician, so as to achieve a simplified and objective evaluation process. The main purpose of this study is to investigate the minimum number of tasks for upper-extremity actions in objective assessment of stroke survivors with a Brunnstrom stage (BS) based on wearable sensing device, which can achieve a satisfactory result to reduce the burden of stroke survivors. In this study, we employed 20 stroke survivors and 7 healthy participants, performing three types of daily living activities (drinking, teeth brushing, face washing). The acceleration, angular velocity and surface Electromyography signals on five parts of the forearm were simultaneously acquired. Then, we compared the effects of each action combination under multiple classifiers. The results show that the use of a single action can achieve competitive results compared with multiple action combination classifications, and the use of K nearest neighbor (KNN) algorithm for the average recognition accuracy of face washing action shows better performance, with the highest accuracy reaching 85.65±6.21% (mean ± standard error), 23 of the 27 subjects were accurately classified. These findings indicate that the predominant qualitative assessment after stroke can be supplemented by corresponding quantitative solutions, and that stroke rehabilitation can be automated with less professional therapist involvement.

Effects of robot-assisted therapy on upper limb and cognitive function in patients with stroke: study protocol of a randomized controlled study.

BACKGROUND: Impairments in upper limb motor function and cognitive ability are major health problems experienced by stroke patients, necessitating the development of novel and effective treatment options in stroke care. The aim of this study is to examine the effects of robot-assisted therapy on improving upper limb and cognitive functions in stroke patients. METHODS: This will be a single-blinded, 2-arm, parallel design, randomized controlled trial which will include a sample size of 86 acute and subacute stroke patients to be recruited from a single clinical hospital in Shanghai, China. Upon qualifying the study eligibility, participants will be randomly assigned to receive either robot-assisted therapy or conventional therapy with both interventions being conducted over a 6-week period in a clinical rehabilitation setting. In addition to comprehensive rehabilitation, the robot-assisted therapy group will receive a 30-min Armguider robot-assisted therapy intervention 5 days a week. Primary efficacy outcomes will include Fugl-Meyer Assessment for Upper Extremity (FMA-UE) and Mini-Mental Status Examination (MMSE). Other secondary outcomes will include Trail Making Test (TMT), Auditory Verbal Learning Test (AVLT), Digit Symbol Substitution Test (DSST), and Rey-Osterrieth Complex Figure Test (ROCFT). All trial outcomes will be assessed at baseline and at 6-week follow-up. Intention-to-treat analyses will be performed to examine changes from baseline in the outcomes. Adverse events will be monitored throughout the trial period. DISCUSSION: This will be the first randomized controlled trial aimed at examining the effects of robot-assisted therapy on upper limb and cognitive functions in acute and subacute stroke patients. Findings from the study will contribute to our understanding of using a novel robotic rehabilitation approach to stroke care and rehabilitation. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100050856 . Registered on 5 September 2021.

Salting-out re-distillation combined with sensory-directed analysis to recover odor-active compounds for improving the flavor quality of instant Pu-erh tea.

The objective of this study was to develop an effective recovery technology of odor-active compounds (OACs) to improve the flavor quality of instant Pu-erh tea (IPT) based on their released behaviors. Salting-out re-distillation (SRD) combined with sensory-directed analysis was developed. The contributing factors, including the soaking time of tea, recovery volume of condensed water of first distillation, amount of sodium chloride, recovery volume of condensed water of SRD, and re-use times of sodium chloride, were studied systematically. Under optimized conditions, 41 OACs were recovered in the first distillation, and the total recovery rate was 83.94%. Forty-one OACs were recovered via SRD, and the total recovery rate reached 72.29%, significantly better than membrane method (33.46%). The IPT prepared by adding OACs that recovered via SRD showed strong aroma attributes intensities and good coordination. This developed method can provide a more effective scheme to improve the flavor quality of IPT.

A Nomogram for Predicting In-Hospital Major Adverse Cardio- and Cerebro-Vascular Events in Patients Undergoing Major Noncardiac Surgery: A Large-Scale Nested Case-Control Study.

Purpose: Few evidence-based predictive tools are available to evaluate major adverse cardio- and cerebro-vascular events (MACCEs) before major noncardiac surgery. We sought to develop a new simple but effective tool for estimating surgical risk. Patients and Methods: Using a nested case-control study design, we recruited 105 patients who experienced MACCEs and 481 patients without MACCEs during hospitalization from 10,507 patients undergoing major noncardiac surgery in Beijing Chaoyang hospital. Least absolute shrinkage and selection operator (LASSO) regression and likelihood ratio were applied to screen 401 potential features for logistic regression. A nomogram was constructed using the selected variables. Results: Chronic heart failure, valvular heart disease, preoperative serum creatinine >2.0 mg/dL, ASA class, neutrophil count and age were most associated with in-hospital MACCEs among all the factors. A new prediction model established based on these showed a good discriminatory ability (AUC, 0.758 [95% confidence interval (CI), 0.708-0.808] and a well-performed calibration curve (Hosmer-Lemeshow χ2 = 7.549, p = 0.479), which upheld in the 10-fold cross-validation (AUC, 0.742 [95% CI, 0.718-0.767]. This model also demonstrated an improved performance in comparison to the modified Revised Cardiac Risk Index (RCRI) score (increase in AUC by 0.119 [95% CI, 0.056-0.180]; NRI, 0.445 [95% CI, 0.237-0.653]; IDI, 0.133 [95% CI, 0.087-0.178]. The decision curve analysis showed a positive net benefit of our new model. Conclusion: Our nomogram, which relies upon simple clinical characteristics and laboratory tests, is able to predict MACCEs in patients undergoing major noncardiac surgery. This prediction shows better discrimination than the standardized modified RCRI score, laying a promising foundation for further large-scale validation.