This study presents a novel broadband metasurface-based polarization converter unit cell. The proposed structure operates in reflection using a cost-effective and readily available substrate with a thickness of 1.6 mm. Efficient cross-polarization conversion is achieved across the Ku-band (12-18 GHz), K-band (18-27 GHz), and Ka-band (27-40 GHz). The polarization conversion performance of the unit cell is validated through reflection coefficient analyses conducted using Ansys HFSS and CST Microwave Studio, as well as real-time free-space measurements performed on a fabricated prototype. Both numerical simulations and experimental results confirm linear-to-linear polarization (LP-LP) conversion with a polarization conversion ratio (PCR) exceeding 90% over the 13.01-27.36 GHz frequency band. In addition, due to the inherent characteristics of linear polarization converters, linear-to-circular polarization (LP-CP) conversion is achieved within the 11.88-12.19 GHz band. The proposed design maintains its performance with a PCR above 80% at an incidence angle of [Formula: see text] over the 12.78-15.50 GHz and 17.86-21.11 GHz frequency ranges. Following the polarization analysis, the proposed unit cell is reconfigured into a coded metasurface arrangement to investigate its radar cross-section (RCS) reduction capability. In this context, both monostatic and bistatic RCS reduction analyses are systematically examined. The presented work is compared with other studies reported in the literature, demonstrating that, among comparable studies, this work provides one of the most comprehensive RCS reduction simulation analyses using a highly accessible and low-cost substrate.
Wave energy converters deployed in farms can experience intense hydrodynamic interactions due to the scattered and radiated waves on the free surface, making farm modeling challenging in realistic sea states. This study introduces a spatial-temporal surrogate model based on a transformer encoder architecture to predict the motion of multiple interacting wave energy converters in various sea states. The framework leverages experimental data from the SWELL dataset, predicting array responses in a previously unseen layout, i.e., a farm configuration, not available during the model's training phase. The model embeds incident wave time series together with device coordinates into a unified spatial-temporal representation. Self-attention then jointly captures the temporal evolution of motion dynamics and inter-device spatial dependencies. Across three irregular sea states, the model predicts device responses with high accuracy, showing close agreement with experimental measurements. These findings provide an initial proof-of-concept, highlighting the potential of an attention-based spatial-temporal surrogate model as a building block for predicting the dynamics of several interacting wave energy converters in previously unseen array configurations.
Wideband oscillations in converter-dominated power systems exhibit complex multi-band characteristics, strong nonstationarity, and weak spatial coherence, posing significant challenges to conventional oscillation source localization methods that are primarily designed for narrowband low-frequency scenarios. In particular, medium- and high-frequency components tend to be highly localized and rapidly attenuated, making global-consistency-based approaches less effective. To address these challenges, this paper proposes a novel spatiotemporal graph learning framework, termed LCGS-Net (Local-Contrast Global-Smooth Network), for wideband oscillation source localization. The proposed method introduces a dual-branch representation mechanism that explicitly disentangles globally smooth propagation patterns from locally contrastive high-frequency perturbations. In addition, a hierarchical channel interaction module is developed to capture the coupling relationships among multi-channel measurements, enabling more expressive feature representations. An adaptive fusion strategy is further employed to dynamically balance local and global information. Simulation studies on IEEE benchmark systems demonstrate that the proposed method outperforms several representative temporal and graph-enhanced baseline models. In particular, LCGS-Net shows improved performance under high-frequency oscillation scenarios, where conventional smoothing-oriented graph aggregation methods may suppress localized source-related features. Additional experiments on the IEEE 39-bus system provide an initial validation of the scalability of the proposed framework. The results indicate that LCGS-Net can effectively capture local contrastive spatial characteristics of wideband oscillations in benchmark systems, while further validation on realistic large-scale converter-dominated grids remains necessary.
The development of hydrogel-based flexible sensors is hindered by their inherent swelling and performance degradation in physiological environments. Inspired by the structure-function integration of natural muscle, a biomimetic multifunctional smart hydrogel with a triple-crosslinking structure via polyvinyl alcohol (PVA) crystalline domains, dynamic borate ester bonds, and high-density hydrogen bonds among phytic acid, PVA, and hydroxypropyl cellulose is designed in this study. The network ensures robust structural integrity and long-term stability while maintaining flexibility, exhibiting a swelling ratio of only 2.5% in simulated body fluid (SBF) after 40 days. Embedded MXene nanosheets serve as nano-reinforcers, electronic conductive pathways, and photothermal converters, enabling near-infrared (NIR)-triggered reversible modulation of lubrication and electrical properties of the hydrogel. The obtained hydrogel demonstrates a stable ultra-low friction over extended friction periods (10 h) and exhibits a unique capability for synchronous monitoring of thermal, mechanical, and frictional stimuli through a single resistance signal. This design provides a promising platform for advanced applications in biomimetic articular cartilage, smart wearable interfaces, and adaptive soft robotics.
Polysaccharide modulation is an effective strategy for tailoring the texture and stability of plant-based fat substitutes. This study investigated the modulatory effects of κ-carrageenan, konjac gum, and pullulan at three mass ratios (emulsion:polysaccharide = 5:1, 4:1, 3:1) on the stabilization of Pickering emulsion gels containing potato-soy protein composite nanoparticles. The results indicated that the modulatory effects were dependent on the type of polysaccharide. The pullulan group (3,1) imparted the smallest oil droplet size and optimal freeze-thaw stability to the emulsion; its gel water retention and oil retention reached 98.51% and 99.52%, respectively, with the best elasticity and cohesiveness. The κ-carrageenan group (3,1) maximized gel hardness and storage modulus, forming the network with the highest mechanical strength; konjac gum exhibited effects intermediate between the two. Mechanistically, polysaccharides act as physical fillers that synergize with proteins through steric exclusion and hydrogen bonding, promoting an increase in the content of α-helices and β-sheets; Raman spectroscopy confirmed the absence of covalent cross-linking. The dense, uniform network effectively converts free water into non-free water, reducing water mobility. This study elucidates the structure-property relationship between polysaccharide molecular characteristics and gel network configuration, providing a theoretical basis for designing plant-based fat substitutes with adjustable texture and controllable stability.
It is unknown what the impact of leveraging an emergency department observation unit (EDOU) for alternative purposes during a public health emergency might be. The study objective was to determine the impact of shifting observation patients from an EDOU to inpatient beds on hospital observation outcomes-length of stay (LOS), total cost, and inpatient admission rate. This is a retrospective observational difference-in-differences study across 4 hospitals within a large academic health system in Atlanta, Georgia. All had type 1 EDOUs managed by the department of emergency medicine. At the onset of the pandemic, the intervention hospital converted the EDOU to a COVID unit, displacing all observation patients to inpatient beds (April 2020). The remaining 3 hospitals maintained operations and served as controls. Data were abstracted from hospital clinical and financial observation databases. Comparisons were made between the preintervention period (August 2019 to March 2020) and the intervention period (April 2020), and between intervention and control hospitals. The primary outcomes included: average per patient cost, total (observation + inpatient) LOS, observation LOS, and inpatient admission rate. Outcomes were evaluated using mixed-effects gamma regressions and logistic regressions. Analyses were adjusted for age, sex, triage level, diagnosis, and procedural International Classification of Diseases codes. We present mean ratios (MRs) for continuous outcomes, odds ratios for binary outcomes, and 95% CIs. The difference-in-differences effect was tested using a time-by-site interaction term. Over the study period there were 22,263 observation patients (3080 intervention patients, 19,183 control patients). Average age was 58 (43 to 72), and 56% were female. Five most common Clinical Classification System (CCS) conditions were chest pain (10.8%), hypertension (5.4%), fluid electrolyte disorders (3.7%), syncope (2.5%), and abdominal pain (2.4%). The difference-in-differences interaction was significant for all outcomes. Total cost for the control hospitals remained stable ($3876.6 vs $3997.1; MR =1.03, 95% CI: 0.99-1.08) but increased from $3449.1 to $4645.5 (MR = 1.35, 95% CI: 1.20-1.52) for the intervention hospital. For total LOS, control hospitals saw a significant decrease in LOS (36.4 h vs 34.3 h, MR = 0.94, 95% CI: 0.90-0.99); the intervention hospital saw a nonsignificant increase (32.1 h vs 36.6 h, MR = 1.14, 95% CI: 1.00-1.30). For only observation LOS, control hospitals saw a significant decrease (23.8 h vs 19.8 h; MR = 0.83, 95% CI: 0.79-0.87), whereas the intervention hospital saw a significant increase (21.3 h vs 26.1 h; MR = 1.22, 95% CI: 1.09-1.38). Finally, for admission rates, control hospitals remained stable (16.4% vs 16.8%; odds ratio of 1.02, 95% CI: 0.88-1.19), whereas the intervention hospital saw an increase from 13.3% to 21.0% (odds ratio of 1.74, 95% CI: 1.16-2.61). The findings were similar when studying only discharged patients. Displacing EDOU observation patients to inpatient beds to accommodate disaster or surge patients is associated with increases in observation patient cost, LOS, inpatient bed use, and inpatient admission rate.
The residual risk of atherosclerosis (AS) extends beyond low-density lipoprotein cholesterol (LDL-C) and involves a complex interplay between lipid metabolism and inflammation. Among lysophospholipids (LPLs), lysophosphatidylcholine (LPC) and lysophosphatidic acid (LPA), the two most abundant and bioactive LPL species in AS plaques, serve as central hubs in this interaction. Hyperlipidemia provides the substrate for LDL oxidation; the resulting oxidized LDL is hydrolyzed by lipoprotein-associated phospholipase A2 (Lp-PLA2) to generate LPC, which is further converted by autotaxin to the more potent LPA. These LPLs activate specific G protein-coupled receptors (GPCRs) on endothelial cells, macrophages, and vascular smooth muscle cells, thereby triggering inflammatory signaling, impairing reverse cholesterol transport, and promoting macrophage pyroptosis. Spatial metabolomics has identified LPC (18:0) and LPA (18:1) as subspecies enriched in macrophage-rich regions of vulnerable plaques, providing direct in-situ evidence for their pathogenic roles. This review systematically examines the biosynthesis, receptor-mediated signaling, and pathological effects of LPC and LPA in AS, with an emphasis on the LPC-LPA axis as a self-reinforcing driver of plaque progression and destabilization. We further critically evaluate translational advances, including failed clinical trials of Lp-PLA2 and autotaxin inhibitors, and discuss emerging strategies such as multi-node combination therapy and subtype-specific precision targeting of LPLs. By integrating mechanistic insights with spatial metabolomics and therapeutic perspectives, this review aims to inform future strategies to overcome the residual risk of AS.
With the rapid rate of industrial modernization, the continuous emissions of carbon dioxide (CO2) are greatly disturbing the natural carbon balance and contributing to global warming. To mitigate this effect, photocatalytic reduction of carbon dioxide has gained popularity as a means of converting it into useful products. This study examined the photocatalytic reduction of aqueous CO2 under ultraviolet irradiation (UV) using green carbon dots (CDs) made from pomegranate peel, nano titanium dioxide (TiO2), TiO2/CDs composite, and metal-loaded carbon dots-modified titanium oxide (Cu-CDs/TiO2). The reduction of CO2 gas in water was carried out in a batch reactor utilizing the four photocatalysts. In order to verify the catalysts' functional groups, nanoscale shape, and composite production, FTIR and TEM were used for characterization. The findings demonstrated that oxygenated products were preferred by pure CDs, but the performance of TiO2 was very pH dependent, with ester formation being promoted in acidic environments and CO formation in alkaline ones. An increase in CO selectivity resulted from the TiO2-CDs composite's enhanced charge separation and electron transfer; a change toward decreased hydrocarbons in product distribution was brought about by the addition of Cu, which opened hydrogenation pathways.
Despite the established importance of hydrogen sulfide (H2S) in redox biology, strategies to modulate its endogenous levels remain largely unexplored. Here, we show that a keratin fraction (KF) obtained from natural sources modulates H2S homeostasis and protein redox state through sulfhydration. Chemoproteomic analysis identified keratin 2 (K2; UniProtKB P25691, keratin, type II microfibrillar, component 5) as the most hyperreactive keratin toward sulfhydration. Oral administration of K2 to mice alleviated lipopolysaccharide (LPS)-induced inflammatory fever and led to the generation of K2-derived peptides (K2Ps) and their sulfhydrated form (K2P-SSH) in the intestine. Compared with K2Ps, K2P-SSH showed enhanced anti-inflammatory and antioxidant activities and promoted widespread protein sulfhydration. Mechanistically, K2P-SSH induced sulfhydration of high-mobility group box 1 (HMGB1) at Cys23 and Cys106, which was associated with reduced disulfide bond formation and dimerization, impaired interaction with toll-like receptor 4 (TLR4), and attenuation of downstream inflammatory signaling. Taken together, this study reveals a previously unrecognized role of K2 in converting H2S into protective sulfhydration signals and identifies K2P-SSH as a bioactive intermediate that alleviates oxidative-inflammatory stress via sulfhydration of HMGB1 at Cys23 and Cys106.
Gastric cancer (GC) remains a major clinical challenge, with most patients exhibiting primary resistance to anti-programmed cell death protein-1 (anti-PD-1) immunotherapy and a lack of effective predictive biomarkers. Most advanced GC presents as immune-excluded "cold" tumors that respond poorly to immune checkpoint blockade. Traditional Chinese medicine (TCM) "Yong (abscess)" syndrome and the "treating GC as Yong" theory are widely applied in clinical practice, yet lack clear molecular and immunological mechanisms. Here, by translating these clinical observations into modern biological terms, we present an original, testable hypothesis proposing the "Yong" syndrome-cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) axis as the central molecular bridge connecting TCM syndrome subtypes, GC histological subtypes, and TME reprogramming. We hypothesize that heat-clearing and blood-activating TCM monomers activate cGAS-STING in a subtype-selective manner to convert "cold" tumors to "hot" immunogenic phenotypes, directly addressing the critical clinical dilemmas of primary anti-PD-1 resistance and insufficient biomarkers in GC immunotherapy. This hypothesis translates universal cGAS-STING mechanisms into a clinically actionable, syndrome-based precision strategy for GC.
Structural coronary microvascular dysfunction (CMD) is a major pathophysiological mechanism underlying ischaemia with non-obstructive coronary arteries and is associated with persistent angina and impaired functional capacity. Although contemporary European guidelines recommend a structured, stepwise pharmacological approach, invasive confirmation of physiological improvement following this specific treatment protocol remains limited. An 82-year-old woman presented with typical angina and stress-induced ischaemia on myocardial scintigraphy. Coronary angiography demonstrated a proximal left anterior descending artery stenosis <50% with a fractional flow reserve (FFR) of 0.90. Continuous thermodilution performed in the left anterior descending artery revealed reduced coronary flow reserve (CFR 2.2) and elevated minimal microvascular resistance (798 WU), consistent with structural CMD.A structured, symptom-guided pharmacological optimization strategy was initiated, including statin therapy, angiotensin-converting enzyme inhibition, beta-blockade, calcium-channel blockade, and ranolazine.At 4-month follow-up, angina was markedly improved. Repeat invasive assessment in the same coronary territory demonstrated improvement of microvascular indices (CFR 3.8; minimal microvascular resistance 461 WU). This case illustrates that guideline-directed medical therapy for coronary microvascular dysfunction may be associated with both symptomatic improvement and objective changes in microvascular function.
Objective: To evaluate the visual acuity, refractive predictability, and vision-related quality of life in patients with myopia and presbyopia 3 months after laser blended vision (LBV) surgery, and to analyze factors associated with postoperative dissatisfaction. Methods: This was a retrospective case series study. Clinical data were collected from 43 patients (86 eyes) who underwent LBV surgery for presbyopia correction at Zhongshan Ophthalmic Center, Sun Yat-sen University, from February 2025 to November 2025 and completed the postoperative 3-month follow-up. There were 21 males (48.8%) and 22 females (51.2%), with a mean age of (44.21±2.20) years. Uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA) (both converted to the logarithm of the minimum angle of resolution, logMAR), manifest refraction, postoperative satisfaction scores, and the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) scores were recorded before and after surgery. Postoperative visual acuity, refractive predictability, and vision-related quality of life were analyzed. Patients were divided into a satisfied group and a dissatisfied group according to satisfaction scores. The logistic regression was used to identify factors associated with postoperative dissatisfaction, with results expressed as odds ratio (OR) and 95% confidence interval (CI). Results: At 3 months postoperatively, binocular UDVA and UNVA were -0.07±0.08 and 0.07±0.10, respectively. The postoperative spherical equivalent was (-0.13±0.34) D in dominant eyes and (-1.06±0.39) D in non-dominant eyes. All patients reported no need for regular presbyopia-correcting spectacles, and 32 patients (74.4%) were in the satisfied group. The scores of general vision, ocular discomfort, near activities, mental health, role difficulties, and driving in the satisfied group were significantly higher than those in the dissatisfied group (all P<0.05). Multivariate Firth-corrected logistic regression analysis showed that each 1-mm increase in axial length was associated with 3.31-fold higher odds of postoperative dissatisfaction (OR=3.31, 95%CI: 1.11-16.18, P=0.029). By contrast, elevated tear film break-up time (OR=0.74, 95%CI: 0.47-0.98, P=0.034) and elevated negative relative accommodation (OR=0.10, 95%CI: 0.01-0.51, P=0.003) were both associated with lower odds of postoperative dissatisfaction. Conclusions: LBV surgery provided favorable UNVA and UDVA and good refractive predictability, with a high level of spectacle independence and overall satisfaction in patients with myopia and presbyopia. The dissatisfied patients had lower vision-related quality of life scores in near activities and role difficulties. Longer axial length was associated with an increased risk of postoperative dissatisfaction, whereas better tear film stability and greater negative relative accommodation were associated with a reduced risk, suggesting that preoperative assessment of the ocular surface status and accommodative function may be useful for patient selection and perioperative management. 目的： 评价近视合并老视患者接受激光融合视觉（LBV）方案矫正老视后3个月的视力、屈光可预测性及视觉相关生活质量，并分析术后不满意的相关因素。 方法： 回顾性病例系列研究。收集2025年2月至11月在中山大学中山眼科中心接受LBV方案矫正老视并完成术后3个月随访的患者资料43例（86只眼），其中男性21例（48.8%），女性22例（51.2%），年龄（44.21±2.20）岁。记录术前及术后裸眼远视力（UDVA）和裸眼近视力（UNVA）（均转化为最小分辨角的对数）、显然验光结果、术后满意度及美国国家眼科研究所视觉功能问卷（NEI VFQ-25）评分，分析术后视力、屈光可预测性及视觉相关生活质量。根据满意度评分将患者分为满意组和不满意组，并采用Logistic回归分析术后不满意的相关因素，结果以比值比（OR）及95%置信区间（CI）表示。 结果： 术后3个月，双眼UDVA和UNVA分别为-0.07±0.08和0.07±0.10。优势眼和非优势眼术后等效球镜度数分别为（-0.13±0.34）和（-1.06±0.39）D。所有患者均报告无需常规配戴老视矫正眼镜，满意组32例（74.4%）。满意组在总体视力、眼部不适、近距离活动、心理健康、角色困难及驾驶维度评分均高于不满意组（均P<0.05）。Logistic回归分析显示，眼轴长度每增加1 mm，术后不满意的发生比升至原来的3.31倍（OR=3.31，95%CI：1.11~16.18，P=0.029）；泪膜破裂时间增加（OR=0.74，95%CI：0.47~0.98，P=0.034）和负相对调节增加（OR=0.10，95%CI：0.01~0.51，P=0.003），术后不满意的发生比降低。 结论： LBV手术可使近视合并老视患者获得较好的远、近裸眼视力和屈光可预测性，并具有较高的脱镜率和总体满意度。不满意者在近距离活动和角色困难等视觉相关生活质量维度评分较低。眼轴长度增加与术后不满意风险升高相关，泪膜稳定性较好和负相对调节能力较强与不满意风险降低相关，提示术前眼表状态及调节功能评估对患者筛选和围手术期管理具有一定参考价值。.
A 660 kg, 11-year-old Irish Sport Horse gelding underwent general anaesthesia for an out-of-hours emergency exploratory laparotomy. After approximately 5 hours of anaesthesia, transfer to the recovery box began, using a ceiling-mounted hoist. As the horse crossed the theatre-recovery interface, the hoist failed due to mechanical disengagement. This resulted in loss of electrical power, leaving the anaesthetised horse suspended approximately 150 cm above the floor for approximately 10 minutes. The horse could not be advanced, reversed, or lowered using standard controls. Activity was paused, and clear roles were allocated; the anaesthesia resident maintained anaesthetic depth and ventilation, while the medicine team prepared the operating table beneath the horse. Continuous physiological monitoring could not be maintained during suspension. Only anaesthetic depth and pulse were assessed, and both remained stable. The operating table was raised to support the horse before the hobbles were cut and the horse was transported to an alternative recovery box. Head and tail rope assistance was used during recovery, which occurred without apparent injury. A no-blame morbidity and mortality review involving clinical facilities and management staff classified the episode as a high-risk near-miss patient safety incident and identified latent system factors. These included a single-point dependency on a powered hoist without a manual override, intermittent pre-event malfunctions, limited formal hoist training, and the out-of-hours context. Organisational responses included maintenance review, simulation training, protocol revision, and a proposal for a hoist upgrade. Safety-II analysis, which examines how adaptive performance creates safety under variable conditions, highlighted how team coordination and organisational learning converted a potential adverse outcome into an opportunity for system improvement.
The planar-to-Dewar valence isomerisation of 4a,8a-azaboranaphthalene (BNNaph), a π-extended BN-doped analogue of azaborine, is investigated to evaluate how BN incorporation reshapes the minimum-energy pathway on the ground state. This process is, for example, relevant in the context of molecular solar thermal (MOST) energy storage, where absorbed sunlight is converted into chemical energy through reversible photoisomerisation. Structures and vertical excitations were computed using DFT and TD-DFT, minimum-energy pathways were mapped with nudged elastic band (NEB) calculations and pathway energetics were refined with state-averaged XMS-CASPT2. In addition, azaborine was examined as a comparison system, with particular emphasis on whether substituents at nitrogen and boron promote Dewar formation. Compared with the carbon analogue, the conversion pathway becomes asymmetric with a metastable intermediate stabilised by a transient boron-carbon contact. The transition structure closely resembles an S0/S1 conical intersection, which is consistent with a vibrationally activated nonradiative funnel. For tuning MOST properties, screening of single substituents across the whole molecule reveals predominantly red-shifted S1 energies together with increased oscillator strengths and indicates that appropriate substitution can improve Dewar formation in azaborine derivatives.
Nuclear depletion and cytoplasmic mislocalization of TDP-43 are central pathological features of amyotrophic lateral sclerosis and frontotemporal lobar degeneration. TDP-43 protein levels are normally maintained by autoregulation through its native 3' untranslated region (3' UTR), but whether this feedback remains protective during chronic cytoplasmic bias is unclear. To address this, we engineered full-length human TDP-43 carrying an N-terminal nuclear export signal (NES) while retaining the native 3' UTR autoregulatory module. In HEK293T cells, NES insertion imposed cytoplasmic bias and promoted detergent-insoluble TDP-43 species. In differentiated SH-SY5Y cells, nuclear splicing defects and autoregulatory changes scaled with export-biased load; detergent-insoluble accumulation was already detectable within a low-load range, defined by whole-cell RIPA-soluble exogenous TDP-43 ≤ 30% of endogenous levels. Human iPSC-derived neurons showed a comparable cytoplasmic shift, discrete TDP-43-immunoreactive foci, and TDP-43-dependent splicing defects. Endogenous TARDBP depletion provided a functional rescue test: nuclear-competent WT-TDP-43-3' UTR restored TDP-43-dependent nuclear readouts, whereas NES-TDP-43-3' UTR did not. In the NES condition, weakened autorepression increased transgene-derived TARDBP transcripts, but the added output failed to expand the soluble, splice-competent pool and instead partitioned into insoluble fractions. Increasing soluble NES-TDP-43 to endogenous-equivalent levels likewise did not normalize splicing, indicating that abundance alone is insufficient when output remains export-biased. These findings support a model in which persistent export bias converts native TARDBP autoregulation into maladaptive feedback: compensatory output is uncoupled from productive nuclear recovery and diverted toward cytoplasmic insoluble/fragmented species.
Rheumatoid arthritis (RA) disproportionately affects adults over 50 years of age, highlighting how age-related immune remodelling undermines tolerance and promotes autoreactivity. In later adulthood, immune cells progressively lose metabolic resilience because of impaired nutrient sensing, reduced metabolic flexibility and disrupted anabolic-catabolic balance. In RA, these vulnerabilities are compounded by mitochondrial insufficiency across innate and adaptive immune lineages, creating a state of nutrient deprivation characterized by NAD⁺ and ATP scarcity and diversion of carbon away from oxidative phosphorylation. Mechanistic studies identify this bioenergetic fragility as a core defect that limits cellular longevity and promotes inflammatory, non-apoptotic death pathways, including pyroptosis and PANoptosis. The hypoxic, nutrient-restricted synovial environment adds pressure that exceeds the diminished metabolic adaptability of aged immune cells. In RA T cells, accelerated mitochondrial injury initiates maladaptive stress responses, disrupts mitochondria-lysosome-endoplasmic reticulum communication and induces gasdermin D-dependent pore formation and inflammatory lysis. Synovial MerTK⁺ reparative macrophages undergo a parallel metabolic crisis, whereby autocrine C1q sensing activates mitochondrial SARM1, causing NAD⁺ degradation, ATP depletion and PANoptotic cell death. Together, these findings position ageing-associated metabolic exhaustion and organelle disintegration as unifying mechanisms that convert immune cells into tissue-damaging effectors and explain the heightened susceptibility to RA in older adults.
Several synthetic strategies for obtaining C-2 functionalized l-idose or l-iduronic acid derivatives were investigated. Synthesis of protected derivatives with a C-2 hydroxy group proceeded smoothly, however, these compounds were prone to competing elimination reactions during subsequent oxidation and HWE steps. Elimination during oxidation could be minimized by replacing benzylidenes with alternative protecting groups, resulting in satisfactory overall yields of the corresponding unsaturated carboxylate derivatives following HWE reaction. However, the corresponding phosphonate analogues were not accessible via this method. A 1,6-anhydro-l-idose derivative was successfully converted into a C-2 phosphonate derivative in good yield via an oxidation/HWE sequence without competing elimination, however, it could not be successfully elaborated into the desired final product.
Luminol chemiluminescence (CL) is widely used in bioanalysis and forensics, yet stringent alkalinity, flash-type kinetics, and blue emission strongly hinder in vivo applications. Here, we report QC4A-8C, a single compartmentalized supramolecular platform that simultaneously addresses these limitations. QC4A-8C is an amphiphilic quaternary ammonium calix[4]arene with orthogonally functionalized upper and lower rims. The cationic cavity selectively encapsulates luminol, induces a pKa shift, and converts luminol into a glow-type emitter at near-physiological pH. In parallel, the hydrophobic lower rim self-assembles into nanoaggregates that compartmentalize fluorescent acceptors (DTBT, MCCH, DCI) in nanometer proximity, enabling sequential chemiluminescence resonance energy transfer (CRET) with high efficiency and red-shifted emission (650-700 nm). As a result, tissue penetration and emission lifetime are substantially extended, and in a lipopolysaccharide-induced peritonitis model, QC4A-8C delivers pronounced signal enhancement over free luminol. This work validates macrocyclic host-guest chemistry as a programmable route to integrate CL amplification with optical spectral engineering for diagnostic imaging.
Purpose Clinical documentation is a critical competency in dental hygiene (DH) education, yet its administrative burden often detracts from patient care. The purpose of this pilot study was to evaluate the perceived impact of an Artificial Intelligence (AI) - assisted documentation system on student workflow efficiency and patient-provider connection to determine students' perceived value of AI integration in the DH curriculum.Methods A prospective, pilot study was conducted with second-year DH students (n = 33) during the Spring 2025 term. Participants used an AI platform designed to convert real-time clinician-patient dialogue into structured notes. Data were collected via self-administered questionnaires at three intervals: baseline, mid-rotation (1 month), and post-rotation (3 months). Outcomes included perceived documentation efficiency, note quality, and patient-provider communication. Data were analyzed using Friedman and Wilcoxon signed-rank tests.Results Baseline data confirmed that traditional documentation hindered workflow (97.0%) and patient-provider connection (81.1%). While mid-rotation results showed only modest improvements, significant shifts occurred by the post-rotation period. Perceived documentation efficiency increased significantly (p = 0.014), with 48.0% of students reporting significant and extreme improvement. Perceived quality of patient connection also improved significantly (p = 0.038), particularly between the mid- and post-rotation phases (p = 0.016). Furthermore, satisfaction with note quality rose substantially (p = 0.005), and initial concerns about the transition to microphone-based recording shifted to broad acceptance.Conclusions Integration of AI-assisted documentation into DH education is highly valued by students. Benefits to efficiency and patient-provider connection emerge following a period of sustained clinical exposure. These findings suggest that AI tools can mitigate administrative burdens, allowing students to prioritize patient-centered care and clinical skill development.
Developing an efficient and blue-light-excitable near-infrared (NIR) phosphor that simultaneously possesses relatively long-wavelength emission (λem,max ≥ 850 nm) is crucial for enabling multifunctional applications, yet balancing these properties remains challenging. Herein, a Cr3+-activated NaInSi2O6 pyroxene silicate was investigated, which exhibits an emission peak at 884 nm (distinct from the previously reported 936 nm) and a photoluminescence quantum yield (PLQY) of 63.6% under 470 nm excitation. Moreover, as the Cr3+ concentration increases from 1% to 10%, the emission peak wavelength gradually red-shifts from 882 to 898 nm, the full width at half maximum extends from 172 to 186 nm, and the emission intensity and thermal stability reach a maximum at 2% Cr3+ concentration. The mechanisms underlying this Cr3+-concentration-dependent performance were explored. Finally, a NIR phosphor-converted light-emitting diode (pc-LED) was fabricated using this material, delivering a NIR output power of 19.01 mW and a photoelectric conversion efficiency of 6.75% at 100 mA, which presents promising prospects for applications in information security, night vision, and non-destructive testing.