Enhancing the continuing willingness of Chinese college students to engage in volunteer services for older adults

Background

The ageing population presents a substantial challenge to conventional care services for older adults in China. College students' voluntary service constitutes an integral component of youth volunteerism, and investigating their continuing willingness to engage in volunteer services to benefit older adults holds immense importance for fostering a stable and enduring framework for China's older adults' care team.

Method

Drawing on the extended theory of reasoned action, this study establishes an analytical framework to examine the willingness of Chinese college students to engage in volunteer services for older adults. Using micro-survey data, we employ structural equation modelling and the bootstrap mediation effect test method to empirically investigate the influencing mechanism behind this willingness.

Results

(1) Attitude has the strongest influence on the continuing willingness of Chinese college students to engage in volunteer services for older adults, and plays a mediating role between subjective norms and continuing willingness to engage in volunteer services, which reveals the special role of attitude in the continuing engagement of Chinese college students in volunteer services for older adults. (2) Personality trait has a substantial positive impact on Chinese college students' willingness to engage continuously in volunteer service for older adults, and subjective norms and attitudes have a chain mediating effect in this influence relationship. (3) The theoretical model constructed in this study is reasonable, reliable and robust.

Conclusion

This study elucidates the potential relationship between attitude, subjective norms, personality traits and the willingness to engage in volunteer services, offering a novel perspective for understanding the continuing willingness of Chinese college students to engage in volunteer services for older adults. Furthermore, it highlights the value of incorporating the extended theory of reasoned action into the policy design of college students' engagement in such services.

Solution-processed colloidal quantum dots for internet of things

Colloidal quantum dots (CQDs) have been a hot research topic ever since they were successfully fabricated in 1993 via the hot injection method. The Nobel Prize in Chemistry 2023 was awarded to Moungi G. Bawendi, Louis E. Brus and Alexei I. Ekimov for the discovery and synthesis of quantum dots. The Internet of Things (IoT) has also attracted a lot of attention due to the technological advancements and digitalisation of the world. This review first aims to give the basics behind QD physics. After that, the history behind CQD synthesis and the different methods used to synthesize most widely researched CQD materials (CdSe, PbS and InP) are revisited. A brief introduction to what IoT is and how it works is also mentioned. Then, the most widely researched CQD devices that can be used for the main IoT components are reviewed, where the history, physics, the figures of merit (FoMs) and the state-of-the-art are discussed. Finally, the challenges and different methods for integrating CQDs into IoT devices are discussed, mentioning the future possibilities that await CQDs.

A Cysteinyl-tRNA Synthetase Mutation Causes Novel Autosomal-Dominant Inheritance of a Parkinsonism/Spinocerebellar-Ataxia Complex

This study aimed to identify possible pathogenic genes in a 90-member family with a rare combination of multiple neurodegenerative disease phenotypes, which has not been depicted by the known neurodegenerative disease. We performed physical and neurological examinations with International Rating Scales to assess signs of ataxia, Parkinsonism, and cognitive function, as well as brain magnetic resonance imaging scans with seven sequences. We searched for co-segregations of abnormal repeat-expansion loci, pathogenic variants in known spinocerebellar ataxia-related genes, and novel rare mutations via whole-genome sequencing and linkage analysis. A rare co-segregating missense mutation in the CARS gene was validated by Sanger sequencing and the aminoacylation activity of mutant CARS was measured by spectrophotometric assay. This pedigree presented novel late-onset core characteristics including cerebellar ataxia, Parkinsonism, and pyramidal signs in all nine affected members. Brain magnetic resonance imaging showed cerebellar/pons atrophy, pontine-midline linear hyperintensity, decreased rCBF in the bilateral basal ganglia and cerebellar dentate nucleus, and hypo-intensities of the cerebellar dentate nuclei, basal ganglia, mesencephalic red nuclei, and substantia nigra, all of which suggested neurodegeneration. Whole-genome sequencing identified a novel pathogenic heterozygous mutation (E795V) in the CARS gene, meanwhile, exhibited none of the known repeat-expansions or point mutations in pathogenic genes. Remarkably, this CARS mutation causes a 20% decrease in aminoacylation activity to charge tRNACys with L-cysteine in protein synthesis compared with that of the wild type. All family members carrying a heterozygous mutation CARS (E795V) had the same clinical manifestations and neuropathological changes of Parkinsonism and spinocerebellar-ataxia. These findings identify novel pathogenesis of Parkinsonism-spinocerebellar ataxia and provide insights into its genetic architecture.

Three-Dimensional Fast Spin Echo Pituitary MRI in Treatment-Naïve Cushing's Disease: Reduced Impact of Reader Experience and Increased Diagnostic Accuracy

BACKGROUND

In patients with Cushing's disease, the preoperative identification of pituitary adenomas is crucial to treatment. However, increasing diagnostic accuracy remains an unresolved issue.

PURPOSE

To evaluate the diagnostic accuracy and the impact of readers' experience regarding high-resolution contrast-enhanced magnetic resonance imaging (hrMRI) for identifying pituitary adenomas in comparison with conventional contrast-enhanced MRI (cMRI) and dynamic contrast-enhanced MRI (dMRI).

STUDY TYPE

Retrospective.

POPULATION

Sixty-five patients (median age, 39 years; interquartile range [IQR], 28-53 years; 60% females) with treatment-naïve Cushing's disease.

FIELD STRENGTH/SEQUENCE

3-T, seven fast spin echo sequences.

ASSESSMENT

The diagnostic accuracies of identifying pituitary adenomas on cMRI, dMRI, combined cMRI and dMRI (cdMRI), and hrMRI were independently evaluated by six readers with three experience levels (high: >20 years, modest: 10-20 years, low: <10 years; two readers for each experience level). Readers were asked to localize the lesion, and measure its diameter on the sequence where identified. The reference standard was postoperative histopathology. The impact of readers' experience and interobserver agreement were assessed. Image quality was assessed using a 5-point Likert scale, including overall image quality, sharpness, and structural conspicuity.

STATISTICAL TESTS

McNemar's test, Cochran's test, Wilcoxon signed-rank test, Mann-Whitney U test, and κ statistics for interobserver agreement. A P-value <0.05 was considered statistically significant.

RESULTS

For identifying pituitary adenomas (median diameter, 5 mm; IQR, 4-5 mm), hrMRI had significantly higher sensitivity (87.7%-93.8%) than cMRI, dMRI, and cdMRI (52.3%-75.4%) for readers with different experience levels. The interobserver agreement was moderate (κ = 0.461-0.523). The sensitivity for hrMRI was comparable between readers with different experience levels (P = 0.371). All image quality scores on hrMRI were significantly higher than cMRI and dMRI (5.0 vs. 4.0).

DATA CONCLUSION

For identifying pituitary adenomas in patients with treatment-naïve Cushing's disease, hrMRI may show high diagnostic accuracy and seems not to be affected by readers' experience.

LEVEL OF EVIDENCE

3 TECHNICAL EFFICACY: Stage 2.

Microstructural abnormality of white matter tracts in rheumatoid arthritis

BACKGROUND

Structural and functional brain imaging studies have reported abnormalities of gray matter morphology and functional activities in patients with rheumatoid arthritis (RA). However, it is largely unknown whether patients with RA show alterations of white matter microstructural organization.

OBJECTIVES

To automatically identify alteration of white matter microstructure in patients with RA and further examine how this alteration associates with clinical characteristics.

METHODS

This single-institutional prospective study included 66 participants (33 patients with RA [52 ± 9 years, 29 women] and 33 sex/age-matched healthy controls [53 ± 12 years, 27 women]), who underwent diffusion MRI scan from January 2021 to December 2021. The white matter microstructure was assessed using fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity. Voxelwise analyses were conducted on white matter skeleton using an automated, observer-independent tract-based spatial statistics analysis. The relationship between white matter microstructural alterations and clinical and neuropsychological variables was evaluated using correlation analysis.

RESULTS

Compared with healthy controls, patients with RA exhibited lower fractional anisotropy in several major white matter tracts (threshold-free cluster enhancement at P < 0.05 for multiple comparison correction, permutation test), involving the forceps minor, bilateral inferior fronto-occipital fasciculus, bilateral anterior thalamic radiation, and bilateral uncinate fasciculus. Lower fractional anisotropy values in the patients with RA were significantly associated with pain-related assessments, including tender joint count (r = -0.43, P = 0.015), Clinical Disease Activity Index score (r = -0.36, P = 0.049), pain severity rated through visual analogue scale (r = -0.45, P = 0.012), and Simplified Disease Activity Index score (r = -0.36, P = 0.045). No significant group difference was found in mean diffusivity, axial diffusivity, and radial diffusivity.

CONCLUSIONS

We report the first anatomical evidence for aberrant microstructure organization of several major white matter tracts and its associations with pain processing in patients with rheumatoid arthritis.

Discrete-Time Adaptive Control for Three-Phase PWM Rectifier

This paper proposes a dual-loop discrete-time adaptive control (DDAC) method for three-phase PWM rectifiers, which considers inductance-parameter-mismatched and DC load disturbances. A discrete-time model of the three-phase PWM rectifier is established using the forward Euler discretization method, and a dual-loop discrete-time feedback linearization control (DDFLC) is given. Based on the DDFLC, the DDAC is designed. Firstly, an adaptive inductance disturbance observer (AIDO) based on the gradient descent method is proposed in the current control loop. The AIDO is used to estimate lump disturbances caused by mismatched inductance parameters and then compensate for these disturbances in the current controller, ensuring its strong robustness to inductance parameters. Secondly, a load parameter adaptive law (LPAL) based on the discrete-time Lyapunov theory is proposed for the voltage control loop. The LPAL estimates the DC load parameter in real time and subsequently adjusts it in the voltage controller, achieving DC load adaptability. Finally, simulation and experimental results show that the DDAC exhibits better steady and dynamic performances, less current harmonic content than the DDFLC and the dual-loop discrete-time PI control (DDPIC), and a stronger robustness to inductance parameters and DC load disturbances.

Charge Carrier Regulation for Efficient Blue Quantum-Dot Light-Emitting Diodes Via a High-Mobility Coplanar Cyclopentane[b]thiopyran Derivative

The performance of blue quantum dot light-emitting diodes (QLEDs) is limited by unbalanced charge injection, resulting from insufficient holes caused by low mobility or significant energy barriers. Here, we introduce an angular-shaped heteroarene based on cyclopentane[b]thiopyran (C8-SS) to modify the hole transport layer poly-N-vinylcarbazole (PVK), in blue QLEDs. C8-SS exhibits high hole mobility and conductivity due to the π···π and S···π interactions. Introducing C8-SS to PVK significantly enhanced hole mobility, increasing it by 2 orders of magnitude from 2.44 × 10-6 to 1.73 × 10-4 cm2 V-1 s-1. Benefiting from high mobility and conductivity, PVK:C8-SS-based QLEDs exhibit a low turn-on voltage (Von) of 3.2 V. More importantly, the optimized QLEDs achieve a high peak power efficiency (PE) of 7.13 lm/W, which is 2.65 times that of the control QLEDs. The as-proposed interface engineering provides a novel and effective strategy for achieving high-performance blue QLEDs in low-energy consumption lighting applications.

Assessment of cheese sign and its association with vascular risk factors: Data from PUMCH dementia cohort

BACKGROUND

In the clinic, practitioners encounter many patients with an abnormal pattern of dense punctate magnetic resonance imaging (MRI) signal in the basal ganglia, a phenomenon known as "cheese sign". This sign is reported as common in cerebrovascular diseases, dementia, and old age. Recently, cheese sign has been speculated to consist of dense perivascular space (PVS). This study aimed to assess the lesion types of cheese sign and analyze the correlation between this sign and vascular disease risk factors.

METHODS

A total of 812 patients from Peking Union Medical College Hospital (PUMCH) dementia cohort were enrolled. We analyzed the relationship between cheese sign and vascular risk. For assessing cheese sign and defining its degree, the abnormal punctate signals were classified into basal ganglia hyperintensity (BGH), PVS, lacunae/infarctions and microbleeds, and counted separately. Each type of lesion was rated on a four-level scale, and then the sum was calculated; this total was defined as the cheese sign score. Fazekas and Age-Related White Matter Changes (ARWMC) scores were used to evaluate the paraventricular, deep, and subcortical gray/white matter hyperintensities.

RESULTS

A total of 118 patients (14.5%) in this dementia cohort were found to have cheese sign. Age (odds ratio [OR]: 1.090, 95% confidence interval [CI]: 1.064-1.120, P <0.001), hypertension (OR: 1.828, 95% CI: 1.123-2.983, P = 0.014), and stroke (OR: 1.901, 95% CI: 1.092-3.259, P = 0.025) were risk factors for cheese sign. There was no significant relationship between diabetes, hyperlipidemia, and cheese sign. The main components of cheese sign were BGH, PVS, and lacunae/infarction. The proportion of PVS increased with cheese sign severity.

CONCLUSIONS

The risk factors for cheese sign were hypertension, age, and stroke. Cheese sign consists of BGH, PVS, and lacunae/infarction.

Chitin microspheres: From fabrication to applications

Chitin microspheres (CMs) have attracted increasing attention due to their biocompatibility, uniform size and shape, large surface area, and porous structure. Considerable research efforts have been focused on developing CMs and promoting their applications in various areas. In this context, this review aims to describe the most recent progress in the fabrication and application of CMs. Different routes that can be used to prepare CMs, such as the drip method and the emulsion method, are emphatically introduced. Moreover, the applications of CMs as drug delivery systems, wound dressings, three-dimensional (3D) scaffolds, water purification, and functional supporting materials in the fields of biomedicine, tissue engineering, environmental protection, and energy storage are also highlighted. We hope this review can provide a comprehensive and useful database for further innovation of CMs.

The booster immunization using commercial vaccines effectively protect chickens against novel variants of infectious bursal disease virus (genotype A2dB1)

The novel variant IBDV (nVarIBDV, genotype A2dB1), characterized by bursal atrophy of fabricius and decreased lymphocytes, has been emerging on a large scale in Asia (including China) since late 2018. nVarIBDV is a new threat to the poultry industry, yet the currently licensed commercial vaccines, including the live viral vector vaccine, IBDV immune complex vaccine or VP2 subunit vaccine, are ineffective against nVarIBDV infection. In this study, specific-pathogen-free (SPF) chickens and broilers divided into 3 groups were vaccinated with the live viral vector vaccine, the VP2 subunit vaccine or the IBDV immune complex vaccine at 1 day-old, respectively. The SPF chickens received a secondary vaccination with the live B87 strain vaccine at 11-day-old. The bursa/body weight ratio, histopathology lesion of the bursa, and the differentiation between infected and vaccinated animals (DIVA) by qRT-PCR confirmed that the live viral vector vaccine or immune complex vaccine plus live B87 strain booster could provide at least 80% protection against the FJ2019-01 strain of nVarIBDV in SPF chickens. The broilers also received a secondary vaccination using a live W2512 G-61 strain vaccine at 14-day-old, and analyses showed that the VP2 subunit vaccine or immune complex vaccine plus the live W2512 G-61 strain booster also provided more than 80% protection against the FJ2019-01 strain of nVarIBDV. Unfortunately, the live viral vector vaccine plus live W2512 G-61 strain booster provided poor to moderate protection against FJ2019-01 in broilers. These findings suggest that combining commercial vaccines with rational booster immunization can effectively protect chickens against an nVarIBDV challenge.

Bioinspired Gradient Covalent Organic Framework Membranes for Ultrafast and Asymmetric Solvent Transport

Gradients play a pivotal role in membrane technologies, e.g., osmotic energy conversion, desalination, biomimetic actuation, selective separation, and more. In these applications, the compositional gradients are of great relevance for successful function implementation, ranging from solvent separation to smart devices; However, the construction of functional gradient in membranes is still challenging both in scale and directions. Inspired by the specific function-related, graded porous structures in glomerular filtration membranes, a general approach for constructing gradient covalent organic framework membranes (GCOMx) applying poly (ionic liquid)s (PILs) as template is reported here. With graded distribution of highly porous covalent organic framework (COF) crystals along the membrane, GCOMx exhibts an unprecedented asymmetric solvent transport when applying different membrane sides as the solvent feed surface during filtration, leading to a much-enhanced flux (10-18 times) of the "large-to-small" pore flow comparing to the reverse direction, verified by hydromechanical theoretical calculations. Upon systematic experiments, GCOMx achieves superior permeance in nonpolar (hexane ≈260.45 LMH bar-1) and polar (methanol ≈175.93 LMH bar-1) solvents, together with narrow molecular weight cut-off (MWCO, 472 g mol-1) and molecular weight retention onset (MWRO, <182 g mol-1). Interestingly, GCOMx shows significant filtration performance in simulated kidney dialysis, revealing great potential of GCOMx in bionic applications.

Exploring the role of exosomal MicroRNAs as potential biomarkers in preeclampsia

The complex pathogenesis of preeclampsia (PE), a significant contributor to maternal and neonatal mortality globally, is poorly understood despite substantial research. This review explores the involvement of exosomal microRNAs (exomiRs) in PE, focusing on their impact on the protein kinase B (AKT)/hypoxia-inducible factor 1-α (HIF1α)/vascular endothelial growth factor (VEGF) signaling pathway as well as endothelial cell proliferation and migration. Specifically, this article amalgamates existing evidence to reveal the pivotal role of exomiRs in regulating mesenchymal stem cell and trophoblast function, placental angiogenesis, the renin-angiotensin system, and nitric oxide production, which may contribute to PE etiology. This review emphasizes the limited knowledge regarding the role of exomiRs in PE while underscoring the potential of exomiRs as non-invasive biomarkers for PE diagnosis, prediction, and treatment. Further, it provides valuable insights into the mechanisms of PE, highlighting exomiRs as key players with clinical implications, warranting further exploration to enhance the current understanding and the development of novel therapeutic interventions.

Interfacial Passivation Engineering for Highly Efficient Quantum Dot Light-Emitting Diodes via Aromatic Amine-Functionalized Dipole Molecules

Blue quantum dot (QD) light-emitting diodes (QLEDs) exhibit unsatisfactory operational stability and electroluminescence (EL) properties due to severe nonradiative recombination induced by large numbers of dangling bond defects and charge imbalance in QD. Herein, dipolar aromatic amine-functionalized molecules with different molecular polarities are employed to regulate charge transport and passivate interfacial defects between QD and the electron transfer layer (ETL). The results show that the stronger the molecular polarity, especially with the -CF3 groups possessing a strong electron-withdrawing capacity, the more effective the defect passivation of S and Zn dangling bonds at the QD surface. Moreover, the dipole interlayer can effectively reduce electron injection into QD at high current density, enhancing charge balance and mitigating Joule heat. Finally, blue QLEDs exhibit a peak external quantum efficiency (EQE) of 21.02% with an operational lifetime (T50 at 100 cd m-2) exceeding 4000 h.

Preparation of Sol-Gel-Derived CaO-B2O3-SiO2 Glass/Al2O3 Composites with High Flexural Strength and Low Dielectric Constant for LTCC Application

Low-temperature co-fired ceramic (LTCC) substrate materials are widely applied in electronic components due to their excellent microwave dielectric properties. However, the absence of LTCC materials with a lower dielectric constant and higher mechanical strength restricts the creation of integrated and minified electronic devices. In this work, sol-gel-derived CaO-B2O3-SiO2 (CBS) glass/Al2O3 composites with high flexural strength and low dielectric constant were successfully prepared using the LTCC technique. Among the composites sintered at different temperatures, the composites sintered at 870 °C for 2 hours possess a dielectric constant of 6.3 (10 GHz), a dielectric loss of 0.2%, a flexural strength of 245 MPa, and a CTE of 5.3 × 10-6 K-1, demonstrating its great potential for applications in the electronic package field. By analyzing the CBS glass' physical characteristics, it was found that the sol-gel-derived glass has an extremely low dielectric constant of 3.6 and does not crystallize or react with Al2O3 at the sintering temperature, which is conducive to improving the flexural strength and reducing the dielectric constant of CBS glass/Al2O3 composites.

Association Between Wnt Target Genes and Cortical Volumes in Alzheimer's Disease

The disproportionate cortical atrophy is an established biomarker for the pathophysiological process of Alzheimer's disease (AD). However, the genetic basis underlying the cortical atrophy remains poorly defined. Herein, we aim to illustrate the effect of the Wnt target genes on the cortical volumes of AD patients. 82 sporadic AD patients were recruited. All the subjects had history survey, blood biochemical examination, cognitive assessment, MRI morphometry and whole exome sequencing. This report focused on 84 common variants (minor allele frequency > 0.01) of 32 Wnt target genes, including the APC, DAAM1, DACT1, DISC1, LATS2, TLR2, WDR61, and the AXIN, DVL, FZD, LRP, TCF/LEF, WNT family genes. The Wnt target genes showed asymmetric effects on the cortical volumes of AD patients. The right temporal/parietal/occipital cortices were more affected than left temporal/parietal/occipital cortices. Nevertheless, the reverse applied to the frontal cortex. The DACT1 affected the cortical thickness most, followed by the TCF3 and APC. The DACT1 rs698025-GG genotype displayed greater right temporal pole and left medial orbito-frontal gyrus than rs698025-GA genotype (2.4 ± 0.4 vs. 2.0 ± 0.6, P = 0.005; 5.2 ± 0.6 vs. 5.0 ± 0.6, P = 0.001). The brain region most influenced by the Wnt target genes was the right calcarine cortex. In conclusion, the common variants of the Wnt target genes exert asymmetric effects on the cortical volumes of AD patients. The Wnt signaling pathway may play a role in the cortical atrophy of AD patients.

Individualized Functional Decompression Options for Adult Chiari Malformation With Syringomyelia and A Novel Scale for Syringomyelia Resolution: A Single-Center Experience

OBJECTIVE

To compare outcomes of posterior fossa bony decompression alone (PFD) versus PFD with duraplasty (PFDD) versus PFDD with additional obex exploration (PFDDO) in patients with Chiari malformation type I (CMI) combining syringomyelia.

METHODS

Clinical records of adult patients who underwent decompressions from 2014 to 2022 were retrospectively analyzed. The decompression procedure was individualized based on the cerebrospinal fluid pulse in the surgical field. The Chicago Chiari Outcome Scale (CCOS) was used to assess the prognosis of the patients and a novel syringomyelia resolution scale, based on 3-dimensional volume, was introduced. The percentage change in the cervical syrinx volume was classified as follows by resolution: ≥ 70%, 30%-70%, and < 30%.

RESULTS

Seventy-eight individuals were enrolled, of which 22, 20, and 36 underwent PFD, PFDD, and PFDDO, respectively. The three decompression groups had no significant difference in the preoperative characteristics and postoperative prognosis. Multivariate analyses revealed that better CCOS was significantly correlated with younger age at surgery (p = 0.018), syrinx originated from lower cervical levels (p = 0.037), narrower preoperative cerebral aqueduct (p = 0.005), and better syrinx volume resolution (p = 0.004). Additionally, a better cervical syrinx volume resolution was significantly correlated with higher CCOS (p = 0.017), narrower cerebral aqueduct (p = 0.035), and better tonsillar descent resolution (p = 0.007).

CONCLUSION

Individualized functional decompression induced an equal effect on CCOS and syrinx volume resolution for all CMI patients with syringomyelia. Our syringomyelia resolution scale facilitates communication and prediction of CMI prognosis.

Health care utilisation and education outcomes of children with rare diseases: a born in Bradford cohort study

The purpose of this study is to describe the burden of health care utilisation and early education outcomes of children with and without rare diseases. Using the Born in Bradford birth cohort and its linked routine health care and education data, we looked at cumulative primary care episodes, hospital admissions and medication prescriptions. We assessed education outcomes using Early Years Foundation Stage Profile and the National Curriculum Tests-Key Stage 1 results. Among analytical sample of 13,858, 1711 or 12.3% children were identified with a rare disease by an average age of 14 years. Children with rare diseases were twice more likely to be admitted to hospital compared to children without. Average length of stay was around 5 days in those with rare diseases group compared to less than 1 day in those without. The average number of primary care episodes was 45.4 in children with rare diseases and 28.2 visits in those without. These children were over three times more likely to be on multiple medications. Children with rare diseases had 30% higher risk of being below academic expectations at Foundation Year and, depending on subject, between 50 and 60% higher risks at KS1 tests.  Conclusions: Children with rare diseases are significantly more likely to have increased primary care episodes and to have more regular medications. They are likely to have more hospital admissions with a longer stay also. Educationally, they are at higher risk of failing to achieve expected standards in early-year settings. What is Known: • Existing studies of rare diseases have used cross sectional data to describe secondary care data. Previous research has not explored the impact of rare diseases on academic outcomes in children. What is New: • Using Born in Bradford birth cohort and its linked primary and secondary care data, this study provides the most comprehensive estimate of prevalence of rare diseases in any study to date. Children with rare diseases were not only significantly more likely to have contact with primary care and to be admitted to hospitals; they were also more like to be on more regular medications and had higher risk of not achieving expected standards in early-year education outcomes. • Our study is unusual in being able to access linked health and education data and reinforces the importance of adopting a whole system approach to children's health and wellbeing that recognises the close links between health and education.

Pembrolizumab for the treatment of progressive multifocal leukoencephalopathy in China

The aim of this study is to analyze the clinical characteristics and outcomes of Chinese patients with progressive multifocal leukoencephalopathy (PML) who were treated with programmed cell death protein 1 (PD1) blockade therapies. We retrospectively analyzed patients who were admitted to our hospital between October 1, 2020, and October 1, 2022, diagnosed with PML and treated with PD1 blockade therapies. Four patients with PML who were treated with PD1 blockade therapies were identified. All patients were male, and their ages ranged from 19 to 54 years old. One patient (Case 2) exhibited mild pleocytosis, while three patients (Cases 2-4) had markedly reduced T lymphocyte cell counts prior to treatment. The time interval between symptom onset and treatment initiation ranged from six to 54 weeks. All patients received pembrolizumab treatment, with a total of two to four doses administered. Three patients who responded to pembrolizumab treatment showed clinical improvement starting around 8 weeks after the initiation of therapy. Although one patient did not show clinical improvement, they ultimately survived until the last follow-up. None of the patients in this study exhibited immune-related adverse events or immune reconstitution inflammatory syndrome. PD1 blockade appears to be a promising novel therapeutic option for PML; additional prospective studies are necessary to confirm its efficacy.

Imaging of Angiogenesis in White Matter Hyperintensities

Background White matter hyperintensities (WMHs) are areas of increased signal intensity on T2-weighted magnetic resonance imaging (MRI). WMH penumbra may be a potential target for early intervention in WMHs. We explored the relationship between angiogenesis and WMH penumbra in patients with WMHs. Methods and Results Twenty-one patients with confluent WMHs of Fazekas grade ≥2 were included. All the participants underwent 68Ga-NOTA-PRGD2 positron emission tomography/magnetic resonance imaging. WMH penumbra was analyzed with masks created for the WMH and 7 normal-appearing white matter layers; each layer was dilated away from the WMH by 2 mm. Angiogenesis array and ELISA were used to detect the serum levels of angiogenic factors, inflammatory factors, HIF-1 alpha, and S100B. Fourteen patients with increased 68Ga-NOTA-PRGD2 maximum standardized uptake (>0.17) were classified into group 2. Seven patients with maximum standardized uptake ≤0.17 were classified as group 1. WMH volume and serum levels of integrin αvβ3, vascular endothelial growth factor receptor 22, and interleukin-1β tended to be higher in group 2 than in group 1. In group 2, 68Ga-NOTA-PRGD2 uptake was significantly increased at the border between the WMH and normal-appearing white matter than in WMHs (P=0.004). The structure penumbra, defined by fractional anisotropy, was wider in group 2 (8 mm) than in group 1 (2 mm). The cerebral blood flow penumbra was 12 mm in both groups. Angiogenesis showed a correlation with reduced cerebral blood flow and microstructure integrity. Conclusions Our study provides evidence that angiogenesis occurs in the WMH penumbra. Further studies are warranted to verify the effect of angiogenesis on WMH growth.

Magnetically Responsive Superhydrophobic Surface with Reversibly Switchable Wettability: Fabrication, Deformation, and Switching Performance

Responsive surfaces with reversibly switchable wettability have attracted widespread attention due to their diverse range of potential applications in the past few years. As a representative example, the magnetically actuated dynamic regulation structured surfaces provide a convenient and unique approach to achieving remote control and instantaneous response. However, (quasi)quantitative design strategies and economical fabrication methods with high precision for magnetically responsive surfaces with both superhydrophobicity and superior wetting switchability still remain challenging. In this work, a manufacturing technique for high-aspect-ratio magnetically responsive superhydrophobic surfaces (MRSSs) via the integration of micromilling, replica molding, and coating modification is proposed. The geometrical parameters of magnetic micropillar arrays (MMAs) on the surface are specially designed on the basis of the Cassie-Wenzel (C-W) transition critical condition in order to guarantee the initial superhydrophobicity of the surface. Benefiting from the reconfigurable microstructures of MMAs in response to magnetic fields (i.e., shifting between upright and curved states), the wettability and adhesion of MRSSs can be reversibly switched. The smart wetting controllability presented on MRSSs is proven to be largely determined by the geometrical parameters and deformation capacity of the micropillars, while the visible wetting switching is mainly ascribed to the variation in wetting regimes of droplets. The modification of the superhydrophobic coatings on the micropillar top is also demonstrated to be capable of further enhancing the initial hydrophobicity and switchable wettability of surfaces, producing water droplets with a volume of 4-6 μL to exhibit the reversible switch from low adhesive superhydrophobicity to high adhesive hydrophilicity. In addition to providing an alternative fabrication strategy, this work also presents a set of design concepts for more applicable and sensitive MRSSs, offering a reference to both fundamental research and practical applications.

Reversibility of Impaired Large-Scale Functional Brain Networks in Cushing's Disease after Surgery Treatment: A Longitudinal Study

INTRODUCTION

Chronic exposure to excessive endogenous cortisol leads to brain changes in Cushing's disease (CD). However, it remains unclear how CD affects large-scale functional networks (FNs) and whether these effects are reversible after treatment. This study aimed to investigate functional network changes of CD patients and their reversibility in a longitudinal cohort.

METHODS

Active CD patients (N = 37) were treated by transsphenoidal pituitary surgery and reexamined 3 months later. FNs were computed from resting-state fMRI data of the CD patients and matched normal controls (NCs, N = 37). A pattern classifier was built on the FNs to distinguish active CD patients from controls and applied to FNs of the CD patients at the 3-month follow-up. Two subgroups of endocrine-remitted CD patients were identified according to their classification scores, referred to as image-based phenotypically (IBP) recovered and unrecovered CD patients, respectively. The informative FNs identified by the classification model were compared between NCs, active CD patients, and endocrine-remitted patients as well as between IBP recovered and unrecovered CD patients to explore their functional network reversibility.

RESULTS

All 37 CD patients reached endocrine remission after treatment. The classification model identified three informative FNs, including cerebellar network (CerebN), fronto-parietal network (FPN), and default mode network. Among them, CerebN and FPN partially recovered toward normal at 3 months after treatment. Moreover, the informative FNs were correlated with 24-h urinary-free cortisol and emotion scales in CD patients.

CONCLUSION

These findings suggest that CD patients have aberrant FNs that are partially reversible toward normal after treatment.

Optical Integration in Wearable, Implantable and Swallowable Healthcare Devices

Recent advances in materials and semiconductor technologies have led to extensive research on optical integration in wearable, implantable, and swallowable health devices. These optical systems utilize the properties of light─intensity, wavelength, polarization, and phase─to monitor and potentially intervene in various biological events. The potential of these devices is greatly enhanced through the use of multifunctional optical materials, adaptable integration processes, advanced optical sensing principles, and optimized artificial intelligence algorithms. This synergy creates many possibilities for clinical applications. This Perspective discusses key opportunities, challenges, and future directions, particularly with respect to sensing modalities, multifunctionality, and the integration of miniaturized optoelectronic devices. We present fundamental insights and illustrative examples of such devices in wearable, implantable, and swallowable forms. The constant pursuit of innovation and the dedicated approach to critical challenges are poised to influence diverse fields.

Multidelay MR Arterial Spin Labeling Perfusion Map for the Prediction of Cerebral Hyperperfusion After Carotid Endarterectomy

BACKGROUND

Multidelay arterial spin labeling (ASL) generates time-resolved perfusion maps, which may provide sufficient and accurate hemodynamic information in carotid stenosis.

PURPOSE

To use imaging markers derived from multidelay ASL magnetic resonance imaging (MRI) and to determine the optimal strategy for predicting cerebral hyperperfusion after carotid endarterectomy (CEA).

STUDY TYPE

Prospective observational cohort.

SUBJECTS

A total of 79 patients who underwent CEA for carotid stenosis.

FIELD STRENGTH/SEQUENCE

A 3.0 T/pseudo-continuous ASL with three postlabeling delays of 1.0, 1.57, and 2.46 seconds using fast-spin echo readout.

ASSESSMENT

Cerebral perfusion pressure, antegrade, and collateral flow were scored on a four-grade ordinal scale based on preoperative multidelay ASL perfusion maps. Simultaneously, quantitative hemodynamic parameters including cerebral blood flow (CBF), arterial transit time (ATT), relative CBF (rCBF) and relative ATT (rATT; ipsilateral/contralateral values) were calculated. On the CBF ratio map obtained through dividing postoperative by preoperative CBF map, regions of interest were placed covering ipsilateral middle cerebral artery territory. Three neuroradiologists conducted this procedure. Cerebral hyperperfusion was defined as a CBF ratio >2.

STATISTICAL TESTS

Weighted κ values, independent sample t test, chi-square test, Mann-Whitney U-test, multivariable logistic regression analysis, receiver-operating characteristic curve analysis, and Delong test. Significance level was P < 0.05.

RESULTS

Cerebral hyperperfusion was observed in 15 (19%) patients. Higher blood pressure (odd ratio [OR] = 1.08) and carotid near-occlusion (NO; OR = 7.31) were clinical risk factors for postoperative hyperperfusion. Poor ASL perfusion score (OR = 37.33), decreased CBF (OR = 0.74), prolonged ATT (OR = 1.02), lower rCBF (OR = 0.91), and higher rATT (OR = 1.12) were independent imaging predictors of hyperperfusion. ASL perfusion score exhibited the highest specificity (95.3%), while CBF exhibited the highest sensitivity (93.3%) for the prediction of hyperperfusion. When combined with ASL perfusion score, CBF and ATT, the predictive ability was significantly higher than using blood pressure and NO alone (AUC: 0.98 vs. 0.78).

DATA CONCLUSIONS

Multidelay ASL can accurately predict cerebral hyperperfusion after CEA with high sensitivity and specificity.

EVIDENCE LEVEL

2 TECHNICAL EFFICACY: Stage 5.

Raw to charred: Changes of protein oxidation and in vitro digestion characteristics of grilled lamb

This study aimed to evaluate protein oxidation and in vitro digestion characteristics of lamb that was grilled from raw to charred (0-30 min). Results showed that protein oxidation was aggravated with the time of grilling, indicated by a significant linear increase in carbonyl groups and a linear decrease in sulfhydryl groups. Proteins had the highest simulated gastric and gastrointestinal digestibility at 10-15 min of grilling. Newly formed specific peptides were continuously released during the grilling process. The identified peptides were mainly derived from creatine kinase, phosphoglycerate kinase, actin and myosin light chain. Protein oxidation was closely related to digestive characteristics, and grilling for >15 min would aggravate protein oxidation and reduce its digestibility. Therefore, at 220 °C lamb should not be grilled for longer than 15 min.