Homogenizing The Low-Dimensional Phases for Stable 2D-3D Tin Perovskite Solar Cells.

2D-3D tin-based perovskites are considered as promising candidates for achieving efficient lead-free perovskite solar cells (PSCs). However, the existence of multiple low-dimensional phases formed during the film preparation hinders the efficient transport of charge carriers. In addition, the non-homogeneous distribution of low-dimensional phases leads to lattice distortion and increases the defect density, which are undesirable for the stability of tin-based PSCs. Here, mixed spacer cations [diethylamine (DEA+) and phenethylamine (PEA+)] are introduced into tin perovskite films to modulate the distribution of the 2D phases. It is found that compared to the film with only PEA+, the combination of DEA+ and PEA+ favors the formation of homogeneous low-dimensional perovskite phases with three octahedral monolayers (n = 3), especially near the bottom interface between perovskite and hole transport layer. The homogenization of 2D phases help improve the film quality with reduced lattice distortion and released strain. With these merits, the tin PSC shows significantly improved stability with 94% of its initial efficiency retained after storing in a nitrogen atmosphere for over 4600 h, and over 80% efficiency maintained after continuous illumination for 400 h.

Coexistence of adeno-associated virus 2 with adenovirus 18 or herpesvirus may be associated with severe lingual papillomatosis in an immunocompromised individual.

Next-generation sequencing (NGS) has significantly improved the accuracy and efficiency of pathogen diagnosis for a wide range of diseases. In this study, viral metagenomics analysis was conducted on fecal and tissue samples from a 13-year-old recipient of hematopoietic stem cell transplantation (HSCT) afflicted with severe lingual papillomatosis. The analysis revealed a high abundance of adeno-associated virus 2 (AAV2), alongside potential helper viruses, herpesvirus type 1 (HSV-1), and the uncommon adenovirus serotype 18 (AdV18). Although a direct causal relationship was not definitively established, the concurrence of these viruses indicated a plausible link to the development of severe lingual papillomatosis in immunocompromised individuals. Notably, the study generated a complete genome sequence of AdV18, offering insights into adenovirus genetic variability, origin, and pathogenicity. Noteworthy findings include three amino acid substitutions in the polymerase and one in the hexon, distinguishing them from previously published strains of AdV18. Phylogenetic analysis unveiled a close relationship between both the polymerase and hexon regions of AdV18 in our study and previously reported AdV18 sequences. This study underscores the pivotal role of comprehensive viral scrutiny in elucidating infections among HSCT patients with lingual papillomatosis.

Risk factors of missed early gastric cancer in endoscopic resected population: a retrospective, case-control study.

BACKGROUND: Missed early gastric cancer (MEGC) is prevalent during esophagogastroduodenoscopy (EGD), which is the first-line recommended strategy for detecting early gastric cancer (EGC). Hence, we explored the risk factors for MEGC and different types of MEGC, based on the endoscopic resected population. METHODS: This retrospective, case-control study was conducted at Nanjing Drum Tower Hospital (NJDTH). We included patients who were diagnosed with EGC during screening EGD, underwent endoscopic resection, and were confirmed by postoperative pathology at the NJDTH from January 2014 to December 2021, and classified them into different types according to the different root causes of misses. Univariable, multivariable, subgroup and propensity score analyses were used to explore the risk factors for MEGC and different types of MEGC. RESULTS: A total of 447 patients, comprising 345 with initially detected early gastric cancer (IDEGC) and 102 with MEGC, were included in this study. Larger size (≥ 1 cm) (OR 0.45, 95% CI 0.27-0.74, P = 0.002) and invasion depth of submucosa (OR 0.26, 95% CI 0.10-0.69, P = 0.007) were negatively associated with MEGC. Use of sedation (OR 0.32, 95% CI 0.20-0.52, P < 0.001) and longer observation time (OR 0.60, 95% CI 0.37-0.96, P = 0.034) exhibited protective effect on MEGC. CONCLUSIONS: Smaller and more superficial EGC lesions are more susceptible to misdiagnosis. The use of sedation and prolonged observation time during EGD could help reduce the occurrence of MEGC.

Three-gene signature revealing the dynamics of lymphocyte infiltration in subchondral bone during osteoarthritis progression.

Osteoarthritis (OA), a degenerative joint disorder, has an unclear immune infiltration mechanism in subchondral bone (SCB). Thus, this study aims to discern immune infiltration variations in SCB between early- and late-stages of OA and identify pertinent biomarkers. Utilizing the GSE515188 bulk-seq profile from the Gene Expression Omnibus database, we performed single-sample gene-set enrichment analysis alongside weighted gene co-expression network analysis to identify key cells and immune-related genes (IRGs) involved in SCB at both stages. At the meanwhile, differentially expressed genes (DEGs) were identified in the same dataset and intersected with IRGs to find IR-DEGs. Protein-protein interaction network and enrichment analyses and further gene filtering using LASSO regression led to the discovery of potential biomarkers, which were then validated by ROC curve analysis, single-cell RNA sequencing, qRT-PCR, western blot and immunofluorescence. ScRNA-seq analysis using GSE196678, qRT-PCR, western blot and immunofluorescence results confirmed the upregulation of their expression levels in early-stage OA SCB samples. Our comprehensive analysis revealed lymphocytes infiltration as a major feature in early OA SCB. A total of 13 IR-DEGs were identified, showing significant enrichment in T- or B-cell activation pathways. Three of them (CD247, POU2AF1, and TNFRSF13B) were selected via the LASSO regression analysis, and results from the ROC curve analyses indicated the diagnostic efficacy of these 3 genes as biomarkers. These findings may aid in investigating the mechanisms of SCB immune infiltration in OA, stratifying OA progression, and identifying relevant therapeutic targets.

Nirmatrelvir/ritonavir or Molnupiravir for treatment of non-hospitalized patients with COVID-19 at risk of disease progression.

BACKGROUND: In randomized controlled trials, Nirmatrelvir/ritonavir (NMV/r) and Molnupiravir (MPV) reduced the risk of severe/fatal COVID-19 disease. Real-world data are limited, particularly studies directly comparing the two agents. METHODS: Using the VA National COVID-19 database, we identified previously uninfected, non-hospitalized individuals with COVID-19 with ≥1 risk factor for disease progression who were prescribed either NMV/r or MPV within 3 days of a positive test. We used inverse probability of treatment weights (IPTW) to account for providers' preferences for a specific treatment. Absolute risk difference (ARD) with 95% confidence intervals were determined for those treated with NMV/r vs. MPV. The primary outcome was hospitalization or death within 30 days of treatment prescription using the IPTW approach. Analyses were repeated using propensity-score matched groups. RESULTS: Between January 1 and November 30, 2022, 9,180 individuals were eligible for inclusion (6,592 prescribed NMV/r; 2,454 prescribed MPV). The ARD for hospitalization/death for NMV/r vs MPV was -0.25 (95% CI -0.79 to 0.28). There was no statistically significant difference in ARD among strata by age, race, comorbidities, or symptoms at baseline. Kaplan-Meier curves did not demonstrate a difference between the two groups (p-value = 0.6). Analysis of the propensity-score matched cohort yielded similar results (ARD for NMV/r vs. MPV -0.9, 95% CI -2.02 to 0.23). Additional analyses showed no difference for development of severe/critical/fatal disease by treatment group. CONCLUSION: We found no significant difference in short term risk of hospitalization or death among at-risk individuals with COVID-19 treated with either NMV/r or MPV.

Study on the mechanism of glucocorticoid receptor mitochondrial translocation and glucocorticoid-induced apoptosis in macrophages.

OBJECTIVE: Our research aimed to investigate the therapeutic effects of Tubastatin-A, a glucocorticoid receptor (GR) mitochondrial translocation inhibitor, and mitoquinone (MitoQ), an antioxidant, on attenuating dexamethasone (DEX)-induced macrophage apoptosis. METHODS: We treated RAW264.7 macrophages with different combinations of DEX and either Tubastatin-A or MitoQ. Parameters such as mitochondrial GR translocation, mitochondrial reactive oxygen species levels, mitochondrial membrane potential, mitochondrial permeability transition pore opening, cytochrome C efflux to the cytosol, and apoptosis were subsequently evaluated in the different treatment groups via qRT-PCR, western blotting, and immunofluorescence assays. RESULTS: DEX intervention increased the translocation of GRs into the mitochondria, while reducing the expression of the mitochondrial gene MT-CO1 and the activity of mitochondrial respiratory chain complex IV in macrophages. In addition, DEX administration increased mtROS levels, mitochondrial permeability transition pore opening, and mitochondrial cytochrome C release in macrophages, which promoted their apoptosis. We found that Tubastatin-A inhibited mitochondrial GR translocation and reversed the DEX-induced increase in GR levels within the mitochondria. Furthermore, Tubastatin-A mitigated various mitochondrial changes induced by DEX, including reducing the efflux of mitochondrial cytochrome C and inhibiting macrophage apoptosis. Similarly, MitoQ exerted its effects on macrophage apoptosis by reducing mtROS levels through the mitochondrial pathway. CONCLUSIONS: The DEX-mediated translocation of GR into mitochondria disrupts the mitochondrial function of macrophages, which induces their apoptosis. By inhibiting mitochondrial translocation of GR and reducing mtROS levels, Tubastatin-A and MitoQ can effectively attenuate macrophage apoptosis, which has clinical implications for reducing the notable side effects associated with glucocorticoid use.

Reconstitution of peripheral blood T cell receptor ß immune repertoire in immune checkpoint inhibitors associated myocarditis.

PURPOSE: Immune checkpoint inhibitors (ICIs)-associated myocarditis was a rare yet severe complication observed in individuals undergoing immunotherapy. This study investigated the immune status and characteristics of patients diagnosed with ICIs- associated myocarditis. METHODS: A total of seven patients diagnosed with ICIs-associated myocarditis were included in the study, while five tumor patients without myocarditis were recruited as reference controls. Additionally, 30 healthy individuals were recruited as blank controls. Biochemical indices, electrocardiogram, and echocardiography measurements were obtained both prior to and following the occurrence of myocarditis. High-throughput sequencing of T cell receptor (TCR) was employed to assess the diversity and distribution characteristics of TCR CDR3 length, as well as the diversity of variable (V) and joining (J) genes of T lymphocytes in peripheral blood. RESULTS: In the seven patients with ICIs-associated myocarditis, Troponin T (TNT) levels exhibited a significant increase following myocarditis, while other parameters such as brain natriuretic peptide (BNP), QTc interval, and left ventricular ejection fraction (LVEF) did not show any significant differences. Through sequencing, it was observed that the diversity and uniformity of CDR3 in the ICIs-associated myocarditis patients were significantly diminished. Additionally, the distribution of CDR3 nucleotides deviated from normality, and variations in the utilization of V and J gene segments. CONCLUSION: The reconstitution of the TCR immune repertoire may play a pivotal role in the recognition of antigens in patients with ICIs-associated myocarditis.

Strong and Robust Core-Shell Ceramic Fibers Composed of Highly Compacted Nanoparticles for Multifunctional Electronic Skin.

Functional fibers composed of textiles are considered a promising platform for constructing electronic skin (e-skin). However, developing robust electronic fibers with integrated multiple functions remains a formidable task especially when a complex service environment is concerned. In this work, a continuous and controllable strategy is demonstrated to prepare e-skin-oriented ceramic fibers via coaxial wet spinning followed by cold isostatic pressing. The resulting core-shell structured fiber with tightly compacted Al-doped ZnO nanoparticles in the core and highly ordered aramid nanofibers in the shell exhibit excellent tensile strength (316 MPa) with ultra-high elongation (33%). Benefiting from the susceptible contacts between conducting ceramic nanoparticles, the ceramic fiber shows both ultrahigh sensitivity (gauge factor = 2141) as a strain sensor and a broad working range up to 70 °C as a temperature sensor. Furthermore, the tunable core-shell structure of the fiber enables the optimization of impedance matching and attenuation of electromagnetic waves for the corresponding textile, resulting in a minimum reflection loss of -39.1 dB and an effective absorption bandwidth covering the whole X-band. Therefore, the versatile core-shell ceramic fiber-derived textile can serve as a stealth e-skin for monitoring the motion and temperature of robots under harsh conditions.

[Spatio-temporal Evolution of Drought and Its Impact on Key Resources in the Important Ecological Functional Area: A Case Study in the Yellow River Basin].

This study explored the characteristics of spatial and temporal changes in drought in the Yellow River Basin from 2001 to 2020 based on TVPDI, surface runoff, vegetation net primary productivity, and grain yield data. Further, the effects of drought on water resources, grain resources, and vegetation resources were also analyzed using data spatialization methods, slope trend analysis, and Pearson correlation analysis. The results showed that:① The spatial distribution of drought in the Yellow River basin was stepped from southeast to northwest, and 60.6 % of the basin was in drought. The overall trend of drought in the basin was decreasing annually, and 94 % of the basin was gradually changing from drought to wet conditions, and the trend of drought from spring to winter decreased first and then increased. ② From the spatial and temporal changes in important resources in the basin, 53 % of the key surface runoff areas showed an increasing trend and were mainly located in the southwest of the basin; the net primary productivity (NPP) of vegetation and grain yield of food resources also showed an increasing trend. ③ Drought and the three types of resources showed significant spatial correlations, and the higher the degree of drought, the more significant the effects on surface runoff, vegetation productivity, and grain yield. However, the important resources in areas that had become wetter in recent years had not increased significantly, which indicated that the effects of drought on the three types of important resources had a time lag, and their lags had significant differences in spatial distribution and geographical differentiation patterns. This study has important theoretical implications for agricultural production, drought mitigation, and ecological conservation in the Yellow River Basin.

Enhancing strategies of photosynthetic hydrogen production from microalgae: Differences in hydrogen production between prokaryotic and eukaryotic algae.

Hydrogen production through the metabolic bypass of microalgae photosynthesis is an environmentally friendly method. This review examines the genetic differences in hydrogen production between prokaryotic and eukaryotic microalgae. Additionally, the pathways for enhancing microalgae-based photosynthetic hydrogen generation are summarized. The main strategies for enhancing microalgal hydrogen production involve inhibiting the oxygen-generating process of photosynthesis and promoting the oxygen tolerance of hydrogenase. Future research is needed to explore the regulation of physiological metabolism through quorum sensing in microalgae to enhance photosynthetic hydrogen production. Moreover, effective evaluation of carbon emissions and sequestration across the entire photosynthetic hydrogen production process is crucial for determining the sustainability of microalgae-based production approaches through comprehensive lifecycle assessment. This review elucidates the prospects and challenges associated with photosynthetic hydrogen production by microalgae.

The impact of COVID-19 on the clinical course and outcome of patients with cirrhosis: An observational study.

Background and Aims: Severe outcomes of COVID-19 are associated with advancing age and comorbidities. The specific aim of our study was to determine the impact of COVID-19 on the clinical course and outcome of patients with cirrhosis. Methods: We retrieved data from VA national repository and identified patients tested for SARS-CoV-2 RNA who had cirrhosis. Each virus positive patient was propensity-matched with virus negative subjects by demographics and comorbidities. Primary endpoint was death within 30 days of COVID-19 diagnosis and secondary endpoint was hospitalization within 14 days. Results: Among 1,115,037 individuals tested for SARS-CoV-2 RNA, 31,680 had cirrhosis. Of those patients, 4456 virus positive patients were propensity-matched with 8752 virus negative subjects. In this cohort of 13,208, median age was 67 years and 95% were male. Most had multiple comorbidities. Alcohol use, hepatitis C and MASH were the dominant etiologies of cirrhosis. At baseline, median MELD was 6% and 21% had hepatic decompensation. Advanced age was the most significant determinant of hospitalization and mortality. Comorbidities, alcohol use and MELD increased the likelihood of hospitalization whereas SARS-CoV-2 positivity had lower Day-14 hospitalization hazard. MELD was associated with higher mortality hazard whereas vaccination reduced the hazard of hospitalization and death. SARS-CoV-2 positivity increased the hazard of death at Day-30 by 72% and at Day-90 by 26%. Conclusion: Although patients with cirrhosis who developed COVID-19 were less likely to be hospitalized, they were more likely to die within 30 days compared to their virus negative counterparts. Vaccination was effective in reducing both hospitalization and death.

Robust Principal Component Analysis Based on Fuzzy Local Information Reservation.

Principal Component Analysis (PCA) aims to acquire the principal component space containing the essential structure of data, instead of being used for mining and extracting the essential structure of data. In other words, the principal component space contains not only information related to the essential structure of data but also some unrelated information. This frequently occurs when the intrinsic dimensionality of data is unknown or when it has complex distribution characteristics such as multi-modalities, manifolds, etc. Therefore, it is unreasonable to identify noise and useful information based solely on reconstruction error. For this reason, PCA is unsuitable as a preprocessing technique for most applications, especially in noisy environment. To solve this problem, this paper proposes robust PCA based on fuzzy local information reservation (FLIPCA). By analyzing the impact of reconstruction error on sample discriminability, FLIPCA provides a theoretical basis for noise identification and processing. This not only greatly improves its robustness but also extends its applicability and effectiveness as a data preprocessing technique. Meanwhile, FLIPCA maintains consistent mathematical descriptions with traditional PCA while having few adjustable hyperparameters and low algorithmic complexity. Finally, we conducted comprehensive experiments on synthetic and real-world datasets, which substantiated the superiority of our proposed algorithm.

Asymmetric Magnon Frequency Comb.

We theoretically show the asymmetric spin wave transmission in a coupled waveguide-skyrmion structure, where the skyrmion acts as an effective nanocavity allowing the whispering gallery modes for magnons. The asymmetry originates from the chiral spin wave mode localized in the circular skyrmion wall. By inputting two-tone excitations and mixing them in the skyrmion wall, we observe a unidirectional output magnon frequency comb propagating in the waveguide with a record number of teeth (>50). This coupled waveguide-cavity structure turns out to be a universal paradigm for generating asymmetric magnon frequency combs, where the cavity can be generalized to other magnetic structures that support the whispering gallery mode of magnons. Our results advance the understanding of the nonlinear interaction between magnons and magnetic textures and open a new pathway to exploring the asymmetric spin wave transmission and to steering the magnon frequency comb.

Tuning the D-Band Center of Bi2S3─MoS2 Heterostructure Towards Superior Lithium-Sulfur Batteries.

Lithium-sulfur (Li-S) batteries are one of the most promising energy storage devices due to their environmental friendliness, low cost, and high specific capacity. However, the slow electrochemical kinetics and the "shuttle effect" have seriously hindered their commercialization. Herein, the nanoflower Bi2S3─MoS2 (BMS) heterostructure is synthesized by a two-step hydrothermal method, and then the Bi2S3─MoS2-Polypropylene (BMS-PP) interlayer is constructed. The heterostructure is rich in active sites, in which BMS has strong adsorption to lithium polysulfides (LiPSs) and can effectively anchor LiPSs while catalyzing LiPSs and promote the redox of Li2S at the same time, which can improve the utilization of active substances. More importantly, the d-band center can be tuned by the formation of Bi2S3─MoS2 heterostructure. Thus, Li-S batteries containing the BMS-PP interlayer show excellent rate performance (841.6 mAh g-1 at 5 C) and cycling performance (70.3% capacity retention after 500 cycles at 3 C). This work provides a new route for high-performance lithium-sulfur batteries.

Polar Bloch points in strained ferroelectric films.

Topological domain structures have drawn great attention as they have potential applications in future electronic devices. As an important concept linking the quantum and classical magnetism, a magnetic Bloch point, predicted in 1960s but not observed directly so far, is a singular point around which magnetization vectors orient to nearly all directions. Here we show polar Bloch points in tensile-strained ultrathin ferroelectric PbTiO3 films, which are alternatively visualized by phase-field simulations and aberration-corrected scanning transmission electron microscopic imaging. The phase-field simulations indicate local steady-state negative capacitance around the Bloch points. The observation of polar Bloch points and their emergent properties consequently implies novel applications in future integrated circuits and low power electronic devices.

Robot-assisted total knee arthroplasty system provides more precise control of the femoral rotation angle: A retrospective study.

BACKGROUND: Rotational alignment in total knee arthroplasty (TKA) is a crucial technical point that needs attention. We conducted a retrospective study to investigate whether a new robot-assisted TKA (RA-TKA) could improve the accuracy of rotational alignment and whether rotational alignment affects postoperative pain and functional evaluation of the knee. METHODS: A total of 136 consecutive patients who underwent TKA were included in this study. Half of the patients underwent RA-TKA and the other half underwent conventional TKA (CON-TKA) by the same group of surgeons. Collect the relevant parameters. RESULTS: The postoperative femoral rotation angle (FRA) was -0.72 ± 2.59° in the robot-assisted group and 1.13 ± 2.73° in the conventional group, and were statistically significantly different (p < 0.001). CONCLUSION: This study provides preliminary evidence that the RA-TKA provides more precise control of FRA than CON-TKA, and verifies that tibial rotation angle and combined rotation angle affect postoperative knee pain and functional evaluation.

Association between renal α-klotho and renal pathology among patients with chronic kidney disease.

INTRODUCTION: This study was designed to investigate whether renal α-klotho levels are associated with renal pathology. This is the first report on patients with chronic kidney disease (CKD). METHODS: We conducted a retrospective observational study. A total of 65 CKD patients were enrolled. Serum and renal biopsy samples were collected. Estimated glomerular filtration rate (eGFR) was examined by biochemical test. And α-klotho expressions were assessed by RT-PCR and immunohistochemistry. In addition, detailed microscopic findings were reviewed. RESULTS: Renal α-klotho levels are associated positively with eGFR, and negatively with renal pathology, including interstitial fibrosis, inflammatory cell infiltration, and tubular atrophy. CONCLUSIONS: The renal α-klotho is related to renal pathology.

Facile Fabrication of Highly Efficient Chitosan-Based Multifunctional Coating for Cotton Fabrics with Excellent Flame-Retardant and Antibacterial Properties.

Interest in the development of eco-friendly, sustainable, and convenient bio-based coatings to enhance flame retardancy and antibacterial properties in cotton fabrics is growing. In this work, chitosan was protonated at its amino groups using a method with a high atom economy using an equimolar amount of amino trimethylene phosphonic acid (ATMP), resulting in the fabrication of a single-component chitosan-based multifunctional coating (ATMP-CS), thereby avoiding any additional neutralization or purification steps. Cotton fabrics coated with various loads of ATMP-CS were prepared through a padding-drying-curing process. The morphology, thermal stability, mechanical properties, antibacterial properties, flame-retardant behavior, and flame-retardant mechanism of these fabrics were investigated. The coating exhibited excellent film-forming properties, and it imparted a uniform protective layer onto the surfaces of the cotton fabrics. When the load capacity reached 11.5%, the coated fabrics achieved a limiting oxygen index of 29.7% and successfully passed the VFT test. Moreover, the ATMP-CS coating demonstrated antibacterial rates against Escherichia coli and Staphylococcus aureus reaching 95.1% and 99.9%, respectively. This work presents a straightforward and gentle approach to fabricating colorless, environmentally friendly, and highly efficient fabric coatings that have potential applications in promoting the use of bio-based materials.

Case report: Rapidly progressive desmoid tumor after surgery for esophagogastric junction cancer and slowly progressive primary desmoid tumor: a report of two cases and literature review.

Background: Desmoid tumor (DT) is a rare locally aggressive but non-metastatic mesenchymal soft tissue neoplasm that predominantly occurs in the abdominal wall, abdominal cavity, and extremities. Its occurrence in the mesentery is relatively uncommon. Case reports: This article reports two cases of desmoid tumor treated at the Department of Gastrointestinal Surgery, Weifang People's Hospital. The first case was a 59-year-old male patient who had previously undergone surgery for esophagogastric junction cancer. Postoperatively, he developed an intra-abdominal mass that rapidly increased in size within three months. The second case was a 60-year-old male patient who incidentally discovered a mass in the left lower abdomen. Both patients underwent surgical treatment, and the postoperative pathological diagnosis was mesenteric desmoid tumor. Conclusion: The treatment of desmoid tumor remains challenging. Simple surgical resection often yields unsatisfactory outcomes, and the efficacy of adjuvant radiotherapy and chemotherapy is also limited. Further research and clinical practice are necessary to improve diagnostic and therapeutic strategies, aiming to enhance patient survival and quality of life.

Neurosonological Parameters May Predict the Risk of Cerebral Hyperperfusion Syndrome After Carotid Artery Stenting.

OBJECTIVE: Cerebral hyperperfusion syndrome (CHS) is a critical complication in patients who underwent carotid artery stenting (CAS). We sought to explore neurosonological parameters and additional risk factors associated with CHS in patients following CAS and further to develop a prediction model for CHS after CAS. METHODS: A total of 197 patients who underwent CAS were included in this observational study. All patients were divided into CHS and non-CHS groups. Demographic, clinical, treatment, and laboratory data were extracted from electronic medical records. Logistic regression analysis and nomogram listing were used to build a CHS prediction model. Machine learning algorithms with five-fold cross-validation were used to further validate the CHS prediction model. RESULTS: Twenty-two patients had clinically manifested CHS. Four parameters were detected as risk factors associated with CHS, including effective collateral circulation (P = 0.046), asymmetry ratio of peak systolic velocity of the middle cerebral artery (P = 0.001), severe stenosis or occlusion of the contralateral carotid artery (P = 0.010), and low-density lipoprotein cholesterol (P = 0.025). The area under the curve for the prediction model of CHS in the cohort was 0.835 (95% confidence interval 0.760-0.909). CONCLUSIONS: In this study, CHS following CAS was associated with effective collateral circulation, ARP, contralateral ICA severe stenosis or occlusion, as well as low-density lipoprotein cholesterol. Subsequently, the CHS prediction model for CAS was built, which has the potential to facilitate tailored and precise management as well as treatment strategies for patients at high risk of CHS.