Direct recovery of phosphorus from Sargassum spp. in the form of magnesium-whitlockite (Ca9.5MgO28P7) was proposed for the first time. The effects of the acid digestion and calcination sequence on the naturally adsorbed minerals in Sargassum spp. were investigated through two treatment approaches (I and II). Treatment I (producing Ash-1) consisted of acid digestion followed by calcination, while Treatment II (producing Ash-2) involved initial calcination, subsequent acid digestion, and a final calcination step. It was found that Treatment I is effective in obtaining ashes containing magnesium-whitlockite (Mg-WH) together with diatoms frustules. Whereas Ash-2 showed an almost complete absence of diatom frustules and phosphate-based components. It was revealed that in Treatment I, a significant fraction of phosphorus, particularly organic ones, were less susceptible to acid digestion and therefore remained intact. During subsequent calcination, together with calcium- and magnesium-containing species, they can be thermally decomposed or oxidized, and Mg-WH will be the preferred final product. In contrast, in Treatment II, the initial calcination predominantly transformed organic phosphorus into acid-soluble inorganic forms, resulting in almost no phosphorus remaining after final calcination. Conclusively, this work unravels the importance of acid digestion and calcination sequence in phosphorus recovery and determining the yield and properties of the minerals. This study can shed light on the requirements and limitations of this efficient treatment in promoting the valorization of marine biomass and supporting sustainable strategies for mitigating the environmental impacts of excessive sargassum proliferation in coastal regions.
Survival estimates for frontotemporal lobar degeneration (FTLD)-related syndromes by incorporating fluid biomarkers are essential to better assess their prognostic value and explore how they might inform long-term outcomes in FTLD. Population-based registries provide valuable data for these predictions. The aim of the present study was to assess whether NfL and GFAP levels correlate with mortality risk in a population-based registry of incident FTLD. Incident cases with FTLD-spectrum, occurring between 2018 and 2020, were followed for up to six years. Survival and hazard analysis according to biomarkers levels were conducted. Median survival was 6 years from symptom onset and 3 years from diagnosis. While FTD-ALS phenotype showed significantly shorter survival, no differences were observed among bvFTD, PPAs, and CBS/PSP. Biomarkers were significantly associated with survival. Higher plasma GFAP (HR = 1.006, 95%CIs 1.001-1.012; p = 0.026) and plasma NfL (HR = 1.027, 95%CIs 1.003-1.053; p = 0.025) were associated with increased mortality risk in bvFTD, PPAs, and CBS/PSP. These results highlight the potential of NfL and GFAP as valuable biomarkers for assessing prognosis in FTLD and underscore the importance of incorporating biomarker analysis into clinical practice for more accurate patient management. Further studies are needed to refine prognostic models for FTLD.
The spleen serves as a critical reservoir of immune cells that play a key role in chronic inflammation and malignancy. While migration of immune cells from the spleen to the tumor immune microenvironment has been described, the dynamics of this process are poorly understood. Tracking the in vivo dynamics could provide valuable insights for understanding tumor immune biology, as well as potentially improving immunotherapy-based treatment regimens. In this study, splenocytes were labeled with superparamagnetic iron oxide (SPIO) nanoparticles conjugated with protamine-indocyanine green (SPIOpICG) for noninvasive, biocompatible, and real-time tracking. Transmission electron microscopy confirmed spherical SPIO and SPIOpICG with average sizes of 9.3 ± 3.1 and 12.7 ± 2.7 nm, respectively. SPIO exhibited a hydrodynamic volume of 110.37 ± 10.56 nm with a polydispersity index (PDI) of 0.356 ± 0.075, whereas SPIOpICG showed a hydrodynamic volume of 1078.48 ± 24.23 nm with a PDI of 0.399 ± 0.540. Ex vivo labeling of splenocytes demonstrated high cell viability (96.2 ± 2.8%) and uptake efficiency (94.3 ± 2.1%) after 24 h, confirming the nanoconjugate biocompatibility. Tumor-bearing Buffalo rat models received intravenous injections of free SPIOpICG or SPIOpICG-splenocytes. MRI performed before and 24 h postinjection revealed a significant reduction in T2* signal intensity in the liver and spleen, suggesting splenocyte migration to these organs. Iron accumulation was confirmed by Prussian blue staining in histology and atomic absorption spectrophotometry. While free SPIOpICG predominantly accumulated in the liver and spleen, SPIOpICG-splenocytes exhibited localization in the tumor, as evidenced by reduced T2* MRI signal (100 ± 7.6 to 70 ± 5.6%, p < 0.001) and elevated iron content (29.8 ± 29.7 to 598 ± 26.8 ppm/g, p < 0.001). Flow cytometry analysis of tumor tissues revealed a significantly higher accumulation of SPIOpICG-positive cells in the SPIOpICG-splenocyte group (50.45 ± 6.15%) compared to free SPIOpICG (16.10 ± 0.42%). Phenotypic analysis of positive cells revealed that macrophages, particularly the M2 subtype, constitute the predominant SPIOpICG-positive population within the tumor. These findings demonstrate that splenocyte-mediated delivery is largely driven by macrophage trafficking to tumor sites. This capability provides valuable insights into splenic immune cell trafficking and highlights splenocytes, particularly macrophages, as effective natural carriers for targeted nanoparticle delivery, offering a biocompatible platform for the development and optimization of immune cell-based immunotherapies.
The use of injectable end-of-life symptom control medications is complex and a risk-prone healthcare activity in the community. Attention is often directed towards the immediate causes of medication-related incidents; however, valuable learning can be gained by examining 'origin incidents', the first adverse event occurring in incident chains that resulted in patient harm or the potential for harm. Understanding these origin incidents can underpin improvements in system resilience to ensure the provision of timely, effective and safe symptom management. System resilience arises from capacities at individual, team and structural levels that enable a complex system to adapt practices and maintain essential functions under varying conditions. To understand the nature of reported origin incidents involving injectable end-of-life symptom control medication in the community and to identify how system resilience can be improved. Retrospective observational study and mixed-methods analysis of nationally reported community injectable medication patient safety incidents, sourced via the National Reporting and Learning System database. Community-based care in England and Wales. A stratified random sample of 2150 incidents was screened for eligibility: 317 incident reports were included. Incident reports involving injectable end-of-life symptom control medications were included. These related to adult patients (aged 18+) receiving end-of-life care in the community, between 2017 and 2022. Eligible incidents involved reported chains of incidents (events) influenced by an origin incident. Incident narratives were coded to classify incident types, contributory factors, patient impact and harm severity. Data analysis utilised a mixed methods approach. An initial quantitative descriptive analysis informed subsequent qualitative thematic analysis lines of inquiry. Ineffective and unsafe symptom control care is influenced by injectable medication origin incidents occurring across the full range of medication management processes. 67.5% (214/317) of reports described actual harm to patients. System resilience was impeded by ineffective transfers of care, difficulties sourcing timely symptom management input from clinical teams, and medication stock and supplies issues. Chains of negative incidents were often exacerbated by discontinuity of care, inadequate communication between in-hours and out-of-hours care providers, mistakes and omissions, failure to follow protocols and insufficient staffing capacity. Examining upstream origin incidents generated valuable system-wide insights, as these initial events influence subsequent actions and system resilience. Enhancing system resilience to support timely and safe symptom management requires improved coordination during transfers of care, reliable access to equipment and valid permission to administer charts, and adequate staffing to provide responsive, cross-organisational care.
Although roles of CD44 in the genetic predisposition for bronchopulmonary dysplasia (BPD) has been recognized, the immune characteristics of CD44+ monocytes in BPD are unclear. We aimed to (1) compare the expression and function of CD44 on monocytes in BPD and non-BPD infants; (2) explore the roles of CD44 on monocytes in hyperoxia-induced inflammation. Flow cytometry assessments of the expression pattern and cytokine-secreting response upon LPS stimulation of CD44+ monocytes were conducted using peripheral blood samples from BPD infants (n = 80) and non-BPD infants (n = 106). The role of CD44 on monocytes was validated in hyperoxia exposure. CD44 expression and inflammatory cytokine secretion ability increased with postmenstrual age. The ability of CD44+ monocytes to secrete IL-6 and TNF-α was significantly greater than that of CD44-monocytes. Compared with those of non-BPD infants, the response capacity of the monocytes in BPD infants to secret IL-6 and TNF-α, especially TNF-α sourced from CD44+ intermediate monocytes, was greater upon LPS stimulation. CD44 expression significantly increased in hyperoxia, and CD44 knockdown significantly ameliorated the inflammation induced by hyperoxia. CD44+ monocytes played important roles in mediating the hyper-inflammatory response in BPD. One specific subpopulation, TNF-α+/CD44+intermediate monocytes, might be a valuable marker for identifying BPD. 1. This study revealed the key role of an immune cell subtype-CD44+ monocytes-in hyperoxia-induced bronchopulmonary dysplasia (BPD) and characterized the expression and function of CD44+ monocytes between premature infants with BPD and those without BPD. 2. CD44 was closely associated with the proinflammatory cytokine secretion capacity of monocytes. A specific subpopulation-TNF-α+/CD44+ intermediate monocytes- might serve as a valuable marker for the identification of BPD in the future. 3. Our findings added new evidence of the association between CD44+ monocytes and BPD pathogenesis, which provided new insights into the immune mechanisms for BPD.
Patient-reported outcomes (PROs) help dermatologists better understand patient perspectives to facilitate shared medical decision-making. Despite merit-based incentive payment system (MIPS) measure to collect quality of life assessments at least once every 12 months for patients with chronic skin diseases, routine PRO collection remains uncommon in clinical practice. This semi-structured interview study aimed to elicit key preferences, facilitators, and barriers for routine PRO collection in dermatology practices. Clinicians were recruited from Emory Dermatology, which has implemented routine PRO collection. Verbatim transcripts were coded and analyzed deductively using the Theoretical Domains Framework to generate salient themes. We interviewed nine dermatologists and one advanced practice provider (APP). Professional roles of all interviewed clinicians aligned with PRO collection. Memory, attention, and decision-making requirements for PRO collection by clinicians were minimized via institutional automation in the electronic health record (EHR). Skills in navigating EHR were needed to retrieve PRO data. Environmental factors affecting PRO collection included patient portal access, IT support for EHR integration, institutional interest in PROs, limited clinician oversight on PRO collection by other staff members, and high patient volume in dermatology clinics. Social support between staff could allow workflow division and maximized opportunities for PRO collection, while clinician perceived patient survey fatigue and skepticism on PRO utility affected PRO collection. This study was limited to clinician perspectives in a single clinic. Automating PRO collection and utilization in EHR, demonstrating PRO value, establishing institutional support, and streamlining workflow are needed to broadly implement routine PRO data collection. Patient reported outcomes (PROs) data offers valuable insights from the patient perspective to dermatology clinicians about their skin conditions, facilitating shared medical decision-making. However, most dermatology clinics do not collect PROs. This study explores key preferences, facilitators, and barriers to routine PRO collection among dermatology clinicians within an academic institution that has implemented PRO collection. Through qualitative interviews, the most salient themes identified by our participants include clinician perceived patient value proposition, clinician value proposition, stakeholder engagement and the importance of automated data collection through the electronic health record to minimize disruptions in clinical workflow. Automated, pre-clinical visit PRO collection presents an opportunity to enhance clinical decision making but successful implementation requires recognition of PRO value, institutional support, clear role delineation, clinician, staff and patient education and improved EHR visualization of PRO results.
This study investigated the potential of the fast-growing invasive plant Solidago altissima for phytoremediation of nanoparticle-contaminated soils. Plants were grown in soils treated with titanium dioxide (TiO2) and silver (Ag) nanoparticles at concentrations of 0, 10, 100, 1000, and 5000 mg/kg to evaluate growth performance and nanoparticle accumulation. TiO2 and Ag nanoparticles were selected due to their widespread industrial use and increasing environmental occurrence, raising concerns about their persistence in terrestrial ecosystems. S. altissima exhibited stable eco-physiological performance, including chlorophyll content, height growth, and biomass production across treatment levels. The plant tolerated TiO2 nanoparticles up to 5000 mg/kg without significant growth inhibition. In Ag nanoparticle-treated soils, biomass showed a concentration-dependent response: compared with the control (9.70 g), total dry biomass increased at 10 mg/kg (11.74 g) but decreased at higher concentrations (6.72-6.43 g at 1000-5000 mg/kg). Nanoparticle accumulation was predominantly observed in roots, and root concentrations increased with increasing soil nanoparticle levels, indicating strong belowground retention of Ti and Ag. The extensive rhizome system and high biomass production of S. altissima suggest its potential for soil-targeted phytoremediation. Overall, the results indicate that the remediation role of S. altissima is more consistent with root-based phytostabilization than with shoot-based phytoextraction. These findings suggest that utilizing this species in disturbed environments, such as roadside soils where it is already widely established, may provide dual benefits by contributing to nanoparticle stabilization in soils while supporting invasive plant biomass management. Further studies are needed to evaluate long-term ecological impacts and field-scale applicability. This study provides a comprehensive assessment of Solidago altissima’s potential for phytoremediation of nanoparticle-contaminated soils, demonstrating its unique dual benefit as both a remediation agent and invasive species management tool. This study transforms a typically problematic invasive species into a valuable resource for soil decontamination, particularly focusing on emerging contaminants like TiO2 and Ag NPs. The findings reveal the exceptional tolerance and soil mineral and metal absorption of S. altissima for these NPs, offering a sustainable and cost-effective solution for soil remediation while simultaneously addressing invasive species concerns.
Myasthenia Gravis (MG) is divided into ocular (OMG) and generalized (GMG) subtypes. While clinical diagnosis is well-established, understanding the underlying biochemical mechanisms and metabolic shifts during disease progression remains challenging; untargeted metabolomics offers a novel perspective to explore these systemic alterations. To characterize the serum metabolic landscape of MG patients and identify potential metabolic signatures associated with disease subtypes (OMG and GMG) via untargeted metabolomics. 91 participants (41 GMG, 22 OMG, 28 healthy controls [HC]) were enrolled. Fasting serum samples were analyzed by LC-MS/MS. Multivariate analyses (PCA, PLS-DA/OPLS-DA), differential metabolite screening (VIP > 1.0, p < 0.05), and KEGG pathway enrichment were performed. HC and MG groups showed distinct metabolic profiles. MG had 515 (175 up, 340 down) and 368 (146 up, 222 down) differential metabolites in positive/negative ion modes, respectively. Key perturbed pathways included glycerophospholipid, sphingolipid metabolism, and unsaturated fatty acid biosynthesis. Ten representative metabolites (e.g., ubiquinone, cortisol) differed significantly among groups; clustering analysis revealed distinct metabolite abundance trajectories across HC, OMG, and GMG. MG is associated with notable systemic metabolic dysregulation, particularly in lipid-related pathways. Rather than serving as immediate diagnostic tools, these integrative metabolic signatures provide a crucial biochemical framework for understanding disease pathogenesis and offer valuable clues for future hypothesis-driven research and prospective validation.
GATA transcription factors play important roles in plant development as well as light and hormone responses. Carrot is a kind of valuable root vegetable. The above-ground part of the carrot is affected by light during growth, which in turn affects the growth status of taproots. The functions of GATA factors have been characterized in several plant species. Little is known about the GATA factors in carrot biological process. In this study, 30 GATA family members were first identified in the carrot genome and classified into four subfamilies, named A-GATA, B-GATA, C-GATA, and D-GATA. C-GATA and D-GATA have specific functional motifs suggesting evolutionary conservation among plants. Predicted cis-elements of GATA factors revealed their potential hormone-responsive and light-responsive functions. Among them, B-GATA has been studied extensively and is represented by the GNC and GNL genes. There were three GNC/GNL homologs in carrot: DcGATA18, DcGATA20, and DcGATA22. Functional analysis revealed that the GNC homolog gene DcGATA20 was mainly expressed in carrot leaves, followed by petioles, and was barely detectable in taproots. Overexpression of DcGATA20 exhibited promotion of chlorophyll accumulation and increased the expression levels of DcGUN4 and DcCHLI1, along with a significant increase in expression of the transcription factor, DcGLK1, which is important for chlorophyll synthesis. In addition, the expression of the chlorophyll degradation gene DcSGR1 (STAY GREEN 1) was decreased. These results indicated that GNC genes exhibit functional conservation in carrot and may be helpful for understanding other GATA members' functions.
Transcriptomic data is a valuable resource in precision medicine, providing crucial insights into disease diagnosis and treatment. Differential regulation relationship analysis, focusing on changes in regulatory relationships between different phenotypes, is an essential research direction to elucidate the mechanisms of complex molecular networks. However, many existing studies overlook associations with non-differential genes that exhibit quantitative changes in phenotypes. This study analyzes transcriptomic features by examining correlations among high-dimensional features through feature construction. We define the difference between an mRNA feature's predicted and actual expression as the mqTrans feature and build a predictive model. Three features with no differential expression in the original transcriptomic values across three independent SLE datasets were identified as latent biomarkers. By constructing a PPI network of latent biomarkers and biomarkers at the original expression levels, we explore interactive relationships between genes and discover functional interactions involving the latent biomarker ANXA2 and seven hub genes. In conclusion, mqTrans analysis can uncover essential biomarkers that traditional differential expression analysis often misses.
To explore how receiving gerontological nurse telephone support assisted caregivers of older adults to provide care after hospital discharge. Informal caregivers are vital to the recovery of older patients after hospital discharge, but often feel under-prepared and unsupported. The need to strengthen caregiver support is becoming increasingly important due to the growing population of older adults and their needs for hospital services. This secondary analysis of a randomized controlled trial examined how nurse telephone support assisted caregivers in their caring role at the time of hospital discharge. A qualitative descriptive study. A purposive sample of informal caregivers (n = 47) who had received nurse telephone support was recruited. In-depth semi-structured interviews were conducted with participants at six (March 21-January 23) and 12 months (August 2021-June 2023) after the older adult's discharge. The nurses used a problem-solving approach to provide support. Transcripts were analysed inductively using content narrative analysis. Two themes emerged: (i) mastery and skills to care; (ii) empowerment to care. Caregiver mastery was developed through nurses providing tailored support that assisted caregivers to develop a structured approach to problem-solving, apply problem-solving to their personal circumstances, increase capacity and skills, and manage workload more effectively. Empowerment resulted from nurses creating a nurturing environment where caregivers developed a positive inner dialogue, increased confidence and capacity to foster a positive relationship with the care recipient and valued themselves. Synthesizing these themes via a concept map explained how nurse support assisted caregivers of older adults become more prepared to care and increase self-efficacy. Nurse telephone support can facilitate caregivers of older adults discharged from hospital to undertake problem-solving that is effective for their individual circumstances and empower them to care. Telephone calls enabled nurses to provide timely, tailored support for caregivers of older adults after hospital discharge. Nurses can provide expert, professional guidance via telephone to support caregivers be more prepared to care when older adults are discharged from hospital. This support should extend beyond instructions related to the care recipients' immediate needs and include the provision of knowledge and coaching to support a structured approach to problem-solving. Allocating dedicated time for hospital nurses to deliver caregiver support should be considered an integral component of person-centred care. This research strengthens the evidence for the valuable contribution that nurses can make to improving hospital discharge services. This study was reported using the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. The research team includes consumer investigator (HL) who provided input throughout the research, including design, procedures, data analysis and manuscript authorship. Australian New Zealand Clinical Trials Registry Identifier: ACTRN12620000060943.
This study aimed to evaluate the diagnostic utility of urinary exosomal microRNAs (miRNAs) in subclinical rejection following kidney transplantation by comparing miRNA expression profiles in urinary exosomes between patients with no evidence of rejection and patients with subclinical T-cell-mediated rejection (sc-TCMR), as confirmed by protocol kidney biopsies performed 3 months after transplantation. To elucidate these differences, a comprehensive miRNA expression analysis was conducted using microarray profiling. Consequently, 38 urinary exosomal miRNAs were detected, among which three were upregulated and five were downregulated in patients with sc-TCMR. To further evaluate the diagnostic value of these miRNAs, quantitative real-time PCR analysis was performed using urinary exosomes collected at the time of protocol biopsy from 70 kidney transplant recipients. This analysis confirmed that miR-5100 and miR-7975 were differentially expressed in patients with sc-TCMR at the time of the 12-month protocol biopsy. Importantly, miR-7975 demonstrated the ability to distinguish among three groups-no evidence of rejection, borderline changes, and sc-TCMR-with high diagnostic accuracy, as indicated by an area under the receiver operating characteristic curve of 0.825. In vitro, exposure of proximal tubular epithelial cells to transforming growth factor-beta 1 resulted in a reduction in miR-7975 expression within urinary exosomes, implicating these cells as a potential source of exosomal miR-7975. Collectively, these findings suggest that urinary exosomal miR-7975 may serve as a promising noninvasive biomarker for diagnosing and monitoring sc-TCMR, offering valuable insights for future research and clinical applications.
Microarrays enable high-throughput detection of single-nucleotide variants, making them valuable tools in genetic research. The use of this technology in multiple myeloma, a genetically complex malignancy with highly variable outcomes, may facilitate the identification of novel prognostic biomarkers. To identify single-nucleotide variants with prognostic value in newly diagnosed multiple myeloma and to evaluate the ability of microarray technology to distinguish multiple myeloma from monoclonal gammopathy of undetermined significance. A total of 56 newly diagnosed multiple myeloma and 14 monoclonal gammopathy of undetermined significance patients were retrospectively analyzed using the Infinium Global Screening Array-24 v3.0. Binary discriminant and principal component analyses were employed to identify single-nucleotide variants associated with post-induction response. Kaplan-Meier curves and log-rank tests were used to evaluate overall survival and progression-free survival. A total of 692 single-nucleotide variants were associated with post-induction response, of which 42 (t-score >4) were the most discriminant. Variants in the PTPRD, NOTCH4, SH3RF3, DCC, and CSMD1 genes were linked to poorer treatment responses: carriers of alternative alleles showed higher partial remission rates (p-value = 0.005) and early relapse (p-value = 0.021). These patients also showed a reduced 5-year overall survival (p-value = 0.008) and shorter progression-free survival (p-value = 0.017). The current cohort exhibited higher minor allele frequencies for SH3RF3, PTPRD, and CSMD1 relative to broader Latin American datasets. Additionally, 13 single-nucleotide variants were multiple myeloma-specific and eight were specific for monoclonal gammopathy of undetermined significance. Single-nucleotide variants of the PTPRD, NOTCH4, SH3RF3, DCC, and CSMD1 genes emerge as promising prognostic biomarkers in newly diagnosed multiple myeloma. Microarray-based single-nucleotide variants profiling shows potential for personalized risk stratification, warranting further validation and functional characterization.
The rapid integration of artificial intelligence (AI) into higher education is producing divergent learning behaviors, as student AI anxiety appears to both hinder and motivate learning. However, the psychological mechanisms that explain why these divergent responses occur remain underexplored. To address this gap, this study investigates how AI anxiety is associated with university students' motivated and avoidance learning by examining challenge and hindrance appraisals as key mediating mechanisms. The study employed a cross-sectional questionnaire design using established scales adapted to the educational AI context. An online survey was administered to students from three universities in China, yielding 591 valid responses after data screening. Results show that AI learning anxiety is primarily associated with hindrance appraisal, while AI job replacement anxiety is associated with both challenge and hindrance appraisals. Challenge appraisal is positively associated with motivated learning and negatively associated with avoidance learning, whereas hindrance appraisal shows the opposite pattern. AI learning anxiety exhibits consistent negative effects through both direct and indirect pathways, while AI job replacement anxiety exerts entirely indirect effects mediated by appraisal processes. These findings highlight cognitive appraisal as a crucial mechanism explaining the divergent behavioral associations of AI anxiety and offer valuable insights for educational intervention.
This exploratory pilot study was designed to evaluate the effectiveness of pulse contour analysis (PCA) for real-time hemodynamic monitoring in patients undergoing transcatheter edge-to-edge tricuspid valve repair (T-TEER). Additionally, it examined whether continuous PCA monitoring can identify indicators of procedural success and improve perioperative management. Prospective, hypothesis-generating pilot, single-center study. Single tertiary care university hospital. A total of 12 patients undergoing T-TEER. Real-time PCA was used throughout the intervention period, from preoperative assessment up to 4 hours postprocedure, to monitor hemodynamic parameters (cardiac output [CO], cardiac index [CI], stroke volume, stroke volume variation, and blood pressure). At 4 hours after T-TEER, CO-PCA had increased by 30% (p = 0.0124), accompanied by a 0.68-L/min/m² rise in CI (p = 0.008). T-TEER also resulted in a persistent reduction in stroke volume variation-PCA, with a sustained 3% decrease after the intervention (p = 0.009). Implantation of the first device triggered a notable peri-interventional increase in systolic arterial pressure of 17 mmHg (p = 0.026). In addition, the right atrial v-wave decreased by 8 mmHg (p = 0.034). No meaningful changes in central venous oxygen saturation or central venous pressure were detected during or following the procedure (p = 0.73 and p = 0.27, respectively). This study demonstrated that PCA using FloTrack monitoring can provide valuable continuous hemodynamic information and characterize acute hemodynamic responses to T-TEER. PCA detected meaningful hemodynamic improvements during T-TEER, characterized by increased CO, enhanced CI, and more stable preload conditions.
The sulfidation is widely adopted for treatment of arsenic-contained solution. Within the copper smelting industry, multivalent arsenic hazards primarily arise from copper smelting waste acid (CSWA) and electrolytic refining purification solution (ERPS), also containing valuable copper resources. Due to the diversified competitive sulfidations of multivalent arsenic, the conventional mixed treatment process of Cu(Ⅱ)-As(Ⅲ) and Cu(Ⅱ)-As(Ⅴ) solutions is difficult to achieve efficient copper recovery and arsenic removal. According to Avrami kinetics, the sulfidation reaction rates for Cu(Ⅱ), As(Ⅲ), and As(Ⅴ) are 35.0339 M-1 s-1, 34.7333 M-1 s-1, and 0.05551 M-1 s-1, respectively. Thus, Cu/As separation causes 72.02% arsenic content in the Cu(Ⅱ)-As(Ⅲ) sulfide precipitates, and less than 6.45% arsenic content in the Cu(Ⅱ)-As(Ⅴ) sulfide precipitates. Interestingly, the rapid nucleation of As(Ⅲ) sulfide provides a heterogeneous nucleation and secondary growth platform for As(Ⅴ) sulfide, facilitating rapid settling of As(Ⅲ)-As(Ⅴ) sulfide. Therefore, based on the difference in sulfidation rates, a novel process for Cu/As separation in CSWA and ERPS is proposed, involving copper split recovery and arsenic mixed removal. Value assessment of this process suggests that arsenic reuse can be diminished by approximately 645 tons annually through copper split recovery, and the particle size of As(Ⅲ)-As(Ⅴ) sulfide increases at least 44.3% via arsenic mixed removal. This study improves the sulfidation process of Cu/As separation in the copper smelting industry, which is significant for environmental protection and resource recovery.
Clinical empathy refers to a healthcare professional's ability to understand a patient's experiences and emotions through cognitive and affective perspective taking, and to communicate that understanding through compassionate and appropriate professional behaviors. Aging simulation suits are experiential educational tools designed to replicate the sensory and physical limitations associated with aging. However, evidence regarding their effectiveness in enhancing clinical empathy among active healthcare professionals remains limited. This study aimed to evaluate the effects of an aging simulation suit on clinical empathy among healthcare professionals working in long-term care settings. A randomized controlled trial was conducted with 82 healthcare professionals from four nursing homes in Madrid and Asturias (Spain). Participants were randomly assigned to an experimental group (EG) (n=41) or a control group (CG) (n=41). Both groups received the same structured educational session on empathy and aging. The experimental group additionally participated in an immersive experience using the GERT aging simulation suit, whereas the control group did not receive the simulation component. Self-reported empathy were measured pre- and post-intervention using the Interpersonal Reactivity Index (IRI) and the Jefferson Scale of Empathy-Health Professions version (JSPE-HPS). No significant differences were found between groups in IRI scores. However, the experimental group showed significant improvements in total JSPE-HPS scores and in the subscales Perspective Taking and Compassionate Care (p < 0.05), compared with the control group. These findings suggest that the immersive intervention enhanced both cognitive and affective components of clinical empathy. The use of an aging simulation suit was associated with improvements in specific dimensions of clinical empathy among healthcare professionals working in long-term care. This educational tool offers a valuable experiential approach that enhances understanding and compassion toward older adults. However, these findings are limited to short-term, self-reported measures, and no behavioral or patient outcome data were collected. Further longitudinal studies are needed to determine the long-term sustainability of these effects and their translation into clinical practice. ClinicalTrials.gov, Unique Protocol ID: 2711201916919; ClinicalTrials.gov ID: NCT07280689. Date of registration: 10/10/2025. Retrospectively registered.
Medicago varia Martyn. exhibited enhanced cold tolerance that was correlated with coordinated adjustments in root xylem structure, modulation of cell wall components, and reprogramming of secondary metabolism, suggesting an integrated adaptive mechanism linking structure, composition, and metabolism. Alfalfa, as one of the most valuable perennial forage crops, is cultivated worldwide. However, its productivity is being threatened by extreme cold events. This study tried to understand the mechanisms of Medicago varia Martyn. (MvM) and Medicago sativa L. (MS) to combat cold climate through chemical, anatomical, spectral, and metabolic analysis. The results showed that MvM had higher content of neutral detergent soluble (74.60%) and soluble proteins (0.15 mg/g), yet lower content of cellulose (10.45%) as compared to MS. Additionally, fourier transform infrared spectroscopy analysis also confirmed differences in functional groups associated with cellulose, hemicellulose, and lignin between MS and MvM. The smaller diameter and higher density of vessel in MvM were consistent with anatomical traits predicted to enhance hydraulic safety under freeze-thaw stress. Metabolomic profiling identified 831 and 604 differentially accumulated metabolites in MvM roots at flowering and senescence stages, with significant enrichment in pathways related to isoflavonoid biosynthesis, arginine/proline metabolism, and tryptophan metabolism. Key metabolites, such as Calceolarioside B, hydroxytyrosol, and Medicarpin, were markedly up-regulated in MvM. Hierarchical clustering highlighted species-specific accumulation of phenylpropanoids and alkaloids in MvM. These findings suggested that the enhanced cold tolerance of MvM might involve in coordinated structural adjustments in root xylem, modulation of cell wall composition, and reprogramming of secondary metabolism. This study provided new insights into the integrative mechanisms of cold adaptation in alfalfa and supported the development of cold-resistant varieties for cultivation in high-latitude regions.
Chlorostoma rustica is an economically important species that thrives in rocky intertidal zones and is frequently exposed to salinity fluctuations. In this study, RNA sequencing and metabolomic profiling were performed on foot muscle tissues from C. rustica exposed to four salinity levels (18, 23, 28 control, and 38 psu) for 6 and 24 h to profile transcriptional and metabolic responses, respectively. A total of 93.18 Gb of high-quality clean reads were generated, resulting in 130,291 unigenes with N50 = 1113 bp and a mean length of 890.64 bp. Compared with the control group, the high-salinity group demonstrated 3370 and 3468 differentially expressed genes (DEGs) at 6 and 24 h, respectively. In the low-salinity Group 1 (18 psu), 3522 and 3489 DEGs were identified at 6 and 24 h, respectively. In the low-salinity Group 2 (23 psu), 3103 and 4293 DEGs were detected at 6 and 24 h, respectively. KEGG analysis showed that DEGs in low- and high-salinity groups were significantly enriched in core immune response and apoptosis-related pathways. ABCA3, MAP3K7IP2, and CLEC4G were identified as key genes in terms of salinity adaptation. Six DEGs were randomly selected for quantitative RT-PCR validation, confirming the reliability of the transcriptomic data. Metabolomic profiling identified 488 differential metabolites (DMs) in low-salinity group 1 (18 psu), mainly enriched in lipid and amino acid metabolism pathways. In the high-salinity group (38 psu), 363 DMs were detected, primarily enriched in amino acid metabolism and nutrient absorption-related pathways. In low-salinity group 2 (23 psu), 308 DMs were identified; however, no metabolic pathways were significantly enriched. Integrative transcriptomic and metabolomic analyses revealed coordinated changes in pathways related to osmotic regulation, energy metabolism, membrane lipid metabolism, and oxidative stress responses. These findings indicate that salinity induces the stress response of C. rustica by regulating osmotic balance (e.g., L-proline, spermine), lipid metabolism (e.g., acylcarnitines, sphingolipids), and transport systems. Overall, this study provides valuable insights into the molecular mechanisms underlying salinity tolerance in intertidal gastropods.
Aurora kinase A (AURKA) is a key therapeutic target for cancer, and natural products from medicinal plants are important sources for developing targeted inhibitors. This study screened and identified high-affinity AURKA ligands from Eomecon chionantha Hance root extract, with molecular docking and molecular dynamics verifying their stable binding ability. These natural ligands, especially the alkaloid protopine with favorable binding energy, provide promising candidates for the development of AURKA-targeted cancer inhibitors, and offer valuable references for the research and translation of natural product-based anti-cancer drugs.