[Research on the status and development of medical and public health informatization in China, from the perspective of medical and preventive integration]

Medical and preventive integration effectively bridges the gap between "treating diseases" and "preventing diseases". Over the years, medical and preventive integration research has focused on chronic and chronic infectious diseases, with insufficient attention to acute ones. Confronting newly emerging infectious diseases establishing continuous monitoring, early warning, emergency response, and appropriate treatment will be a key focus for developing and reforming the healthcare system. Interoperability and sharing of medical and health data are essential prerequisites for bridging the gap between medical treatment and disease prevention and are also important for promoting intelligent surveillance and early warning of infectious diseases. Informatization is necessary to achieve efficient collaboration between medical treatment and disease prevention. Reviewing the development of medical and health informatization in the United States and Europe, this paper compares and discusses the problems and challenges in developing medical and health informatization in China. The aim is to provide references for the development of medical and health informatization and the innovation of medical and preventive integration mechanisms in the country.

High-entropy alloy electrocatalysts go to (sub-)nanoscale

Alloying has proven power to upgrade metallic electrocatalysts, while the traditional alloys encounter limitation for optimizing electronic structures of surface metallic sites in a continuous manner. High-entropy alloys (HEAs) overcome this limitation by manageably tuning the adsorption/desorption energies of reaction intermediates. Recently, the marriage of nanotechnology and HEAs has made considerable progresses for renewable energy technologies, showing two important trends of size diminishment and multidimensionality. This review is dedicated to summarizing recent advances of HEAs that are rationally designed for energy electrocatalysis. We first explain the advantages of HEAs as electrocatalysts from three aspects: high entropy, nanometer, and multidimension. Then, several structural regulation methods are proposed to promote the electrocatalysis of HEAs, involving the thermodynamically nonequilibrium synthesis, regulating the (sub-)nanosize and anisotropic morphologies, as well as engineering the atomic ordering. The general relationship between the electronic structures and electrocatalytic properties of HEAs is further discussed. Finally, we outline remaining challenges of this field, aiming to inspire more sophisticated HEA-based nanocatalysts.

[Interpretation of Chinese guideline for the clinical management of patients with ruptured intracranial aneurysms (2024)]

Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening neurological emergency with high mortality, and even patients receiving optimal medical care may develop long-term disability, which seriously affects their quality of life and increases the heavy medical burden on society and families. To provide comprehensive clinical management advice, the Society of Neurosurgery of the Chinese Medical Association, the Society of the Chinese Stroke Association of the National Medical Center for Neurological Diseases, and the National Clinical Research Center for Neurological Diseases jointly formulate "Chinese Guidelines for the Clinical Management of Patients With Ruptured Intracranial Aneurysms in 2024". The evidence sources are divided into the Chinese population and other populations, using a modular format to provide recommendations, summaries of relevant opinions, and future research directions on epidemiology, clinical imaging diagnosis, prognosis evaluation, treatment strategies and choices, anesthesia management, perioperative care, and recommendations for the management of aSAH in special populations. It provides practical clinical guidance and recommendations for doctors and related professionals.

Sub-2 nm Microstrained High-Entropy-Alloy Nanoparticles Boost Hydrogen Electrocatalysis

High-entropy alloys (HEAs) confine multifarious elements into the same lattice, leading to intense lattice distortion effect. The lattice distortion tends to induce local microstrain at atomic level and thus affect surface adsorptions toward different adsorbates in various electrocatalytic reactions, yet remains unexplored. Herein, this work reports a class of sub-2 nm IrRuRhMoW HEA nanoparticles (NPs) with distinct local microstrain induced by lattice distortion for boosting alkaline hydrogen oxidation (HOR) and evolution reactions (HER). This work demonstrates that the distortion-rich HEA catalysts with optimized electronic structure can downshift the d-band center and generate uncoordinated oxygen sites to enhance the surface oxophilicity. As a result, the IrRuRhMoW HEA NPs show a remarkable HOR kinetic current density of 8.09 mA µg-1 PGM at 50 mV versus RHE, 8.89, 22.47 times higher than those of IrRuRh NPs without internal strain and commercial Pt/C, respectively, which is the best value among all the reported non-Pt based catalysts. IrRuRhMoW HEA NPs also display great HER performances with a turnover frequency (TOF) value of 5.93 H2 s-1 at 70 mV versus RHE, 4.6-fold higher than that of Pt/C catalyst, exceeding most noble metal-based catalysts. Experimental characterizations and theoretical studies collectively confirm that weakened hydrogen (Had) and enhanced hydroxyl (OHad) adsorption are achieved by simultaneously modulating the hydrogen adsorption binding energy and surface oxophilicity originated from intensified ligand effect and microstrain effect over IrRuRhMoW HEA NPs, which guarantees the remarkable performances toward HOR/HER.

High-Volumetric Density Atomic Cobalt on Multishell ZnxCd1-xS Boosts Photocatalytic CO2 Reduction

The volumetric density of the metal atomic site is decisive to the operating efficiency of the photosynthetic nanoreactor, yet its rational design and synthesis remain a grand challenge. Herein, we report a shell-regulating approach to enhance the volumetric density of Co atomic sites onto/into multishell ZnxCd1-xS for greatly improving CO2 photoreduction activity. We first establish a quantitative relation between the number of shell layers, specific surface areas, and volumetric density of atomic sites on multishell ZnxCd1-xS and conclude a positive relation between photosynthetic performance and the number of shell layers. The triple-shell ZnxCd1-xS-Co1 achieves the highest CO yield rate of 7629.7 μmol g-1 h-1, superior to those of the double-shell ZnxCd1-xS-Co1 (5882.2 μmol g-1 h-1) and single-shell ZnxCd1-xS-Co1 (4724.2 μmol g-1 h-1). Density functional theory calculations suggest that high-density Co atomic sites can promote the mobility of photogenerated electrons and enhance the adsorption of Co(bpy)32+ to increase CO2 activation (CO2 → CO2* → COOH* → CO* → CO) via the S-Co-bpy interaction, thereby enhancing the efficiency of photocatalytic CO2 reduction.

Assembled RhRuFe Trimetallene for Water Electrolysis

Industrializing water electrolyzers demands better electrocatalysts, especially for the anodic oxygen evolution reaction (OER). The prevailing OER catalysts are Ir or Ru-based nanomaterials, however, they still suffer from insufficient stability. An alternative yet considerably less explored approach is to upgrade Rh, a known stable but moderately active element for OER electrocatalysis, via rational structural engineering. Herein, a precise synthesis of assembled RhRuFe trimetallenes (RhRuFe TMs) with an average thickness of 1 nm for boosting overall water splitting catalysis is reported. Favorable mass transport and optimized electronic structure collectively render RhRuFe TMs with an improved OER activity of an overpotential of 330 mV to deliver 10 mA cm-2, which is significantly lower than the Rh/C control (by 601 mV) and reported Rh-based OER electrocatalysts. In particular, the RhRuFe TMs-based water splitting devices can achieve the current density of 10 mA cm-2 at a low voltage of 1.63 V, which is among the best in the Rh-based bifunctional catalysts for electrolyzers. The addition of Fe in RhRuFe TMs can modulate the strain/electron distribution of the multi-alloy, which regulates the binding energies of H* and OH* in hydrogen and oxygen evolution reactions for achieving the enhanced bifunctional OER and HER catalysis is further demonstrated.

Comparing coronary artery cross-sectional area among asymptomatic South Asian, White, and Black participants: the MASALA and CARDIA studies

BACKGROUND

South Asian individuals have high risk of atherosclerotic cardiovascular disease (ASCVD). Some investigators suggest smaller coronary artery size may be partially responsible.

METHODS

We compared the left anterior descending (LAD) artery cross-sectional area (CSA) (lumen and arterial wall) among South Asians in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study with White and Black participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study, adjusting for BMI, height, and other ASCVD risk factors. We used thin-slice non-contrast cardiac computed tomography to measure LAD CSA. We used linear regression models to determine whether race/ethnicity was associated with LAD CSA after adjusting for demographic factors, BMI, height, coronary artery calcium (CAC), and traditional cardiovascular risk factors.

RESULTS

Our sample included 3,353 participants: 513 self-identified as South Asian (44.4% women), 1286 as Black (59.6% women), and 1554 as White (53.5% women). After adjusting for age, BMI, height, there was no difference in LAD CSA between South Asian men and women compared to White men and women, respectively. After full adjustment for CVD risk factors, LAD CSA values were: South Asian women (19.9 mm2, 95% CI [18.8 - 20.9]) and men (22.3 mm2, 95% CI [21.4 - 23.2]; White women (20.0 mm2, 95% CI [19.4-20.5]) and men (23.6 mm2, 95% CI [23.0-24.2]); and Black women (21.6 mm2, 95% CI [21.0 - 22.2]) and men (26.0 mm2, 95% CI [25.3 - 26.7]). Height, BMI, hypertension, CAC, and age were positively associated with LAD CSA; current and former cigarette use were inversely associated.

CONCLUSIONS

South Asian men and women have similar LAD CSA to White men and women, and smaller LAD CSA compared to Black men and women, respectively, after accounting for differences in body size. Future studies should determine whether LAD CSA is associated with future ASCVD events.

[Progress in research of rash and fever syndrome surveillance and early warning]

Objective: To introduce the progress in research of rash and fever syndrome (RFS) surveillance and early warning both at home and abroad, and provide reference for surveillance and prevention of RFS in China. Methods: The keywords "fever" "rash" and "surveillance" and others were used for a literature retrieval by using China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, PubMed and Web of Science. The languages of literatures were limited in Chinese and English. The key information of the literatures were collected and analyzed with Excel. Results: A total of 36 study papers (21 in Chinese and 15 in English) were included. The studies mainly focused on the pathogen surveillance of RFS (n=19). The pathogens included measles virus, varicella-zoster virus, rubella virus, enterovirus, human B19 virus, dengue virus, streptococcus group A, Salmonella typhi and Salmonella paratyphoid,human herpesvirus, mumps virus and adenovirus. Eight studies were about the surveillance in major events, such as sport game, World Expo and religious gathering, or sudden natural disasters, such as earthquake and tropical storm, during 2010-2015. Eight studies focused on case or epidemic surveillance, most of which were studies from other counties. The surveillance sites were medical institutions. RFS was diagnosed according to the International Classification of Diseases, 9th (ICD-9) and symptoms descripted in chief-complaint. Only one study in Mongolia conducted RFS epidemic prediction. The analysis methods of 36 papers included simple descriptive analysis, time-based early warning models (such as regression analysis, fixed threshold method, Hugh Hart control chart method and cumulative sum control chart method) and time series analysis method. Conclusions: In the future, RFS surveillance system should cover both known pathogens and emerging pathogens. Automatic surveillance using information capture and intelligent modelling can be applied to improve the sensitivity and specificity of RFS surveillance and early warning.

Low-Electronegativity Mn-Contraction of PtMn Nanodendrites Boosts Oxygen Reduction Durability

Platinum metal (PtM, M=Ni, Fe, Co) alloys catalysts show high oxygen reduction reaction (ORR) activity due to their well-known strain and ligand effects. However, these PtM alloys usually suffer from a deficient ORR durability in acidic environment as the alloyed metal is prone to be dissolved due to its high electronegativity. Herein, we report a new class of PtMn alloy nanodendrite catalyst with low-electronegativity Mn-contraction for boosting the oxygen reduction durability of fuel cells. The moderate strain in PtMn, induced by Mn contraction, yields optimal oxygen reduction activity at 0.53 A mg-1 at 0.9 V versus reversible hydrogen electrode (RHE). Most importantly, we show that relative to well-known high-electronegativity Ni-based Pt alloy counterpart, the PtMn nanodendrite catalyst experiences less transition metals' dissolution in acidic solution and achieves an outstanding mass activity retention of 96 % after 10,000 degradation cycles. Density functional theory calculation reveals that PtMn alloys are thermodynamically more stable than PtNi alloys in terms of formation enthalpy and cohesive energy. The PtMn nanodendrite-based membrane electrode assembly delivers an outstanding peak power density of 1.36 W cm-2 at a low Pt loading and high-performance retention over 50 h operations at 0.6 V in H2 -O2 hydrogen fuel cells.

[Analysis of clinical characteristics of children with adenoid hypertrophy and pharyngolaryngeal reflux]

Objectives: To explore the clinical characteristics of children with adenoid hypertrophy (AH) and laryngopharyngeal reflux (LPR) by detecting the expression of pepsin in adenoids as a standard for AH with LPR. Methods: A total of 190 children who were admitted for surgical treatment due to AH were included in the study. The main clinical symptoms of the patients were recorded, and the degree of adenoid hypertrophy was evaluated. Before the surgery, Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) were used to evaluate the reflux symptoms. After the surgery, pepsin immunohistochemical staining was performed on the adenoid tissue, and according to the staining results, the patients were divided into study group (pepsin staining positive) and control group (pepsin staining negative). SPSS 19.0 software was used for statistical analysis. Quantitative data conforming to normal distribution between the two groups were tested by two-independent sample t test, and quantitative data with skewed distribution were tested by Mann-Whitney U test. Results: The positive rate of pepsin staining in the 190 AH patients was 78.4% (149/190). The study group had higher levels of preoperative symptoms such as erythema and/or congestion of the pharynx(2.1±0.7 vs. 1.8±0.6,t=2.23), vocal cord edema[1.0(0, 1.0) vs. 1.0(0, 1.0), Z=2.00], diffuse laryngeal edema[0(0, 1.0) vs. 0(0, 0), Z=2.48], posterior commissure hypertrophy[(1.4±0.6 vs. 1.1±0.5), t=2.63], and a higher total score on the RFS scale than the control group(6.2±2.7 vs. 5.0±2.6, t=2.47), with statistical differences (P<0.05). The sensitivity and specificity of RFS score in diagnosing AH with LPR were 24.8% and 80.5%, respectively. When RFS>5 was used as the positive threshold, the sensitivity and specificity of RFS score in diagnosing AH with LPR were 61.1% and 58.5%, respectively. There was a statistical difference in the number of positive cases of RFS score between the study group and the control group(91 vs. 17,χ2=5.04,P=0.032). Conclusions: LPR is common in AH children. Children with AH and LPR have specific performance in electronic laryngoscopy, such as erythema with edema in the pharynx, posterior commissure hypertrophy, and vocal cord edema.

Intermetallic Nanocrystals for Fuel-Cells-Based Electrocatalysis

Electrocatalysis underpins the renewable electrochemical conversions for sustainability, which further replies on metallic nanocrystals as vital electrocatalysts. Intermetallic nanocrystals have been known to show distinct properties compared to their disordered counterparts, and been long explored for functional improvements. Tremendous progresses have been made in the past few years, with notable trend of more precise engineering down to an atomic level and the investigation transferring into more practical membrane electrode assembly (MEA), which motivates this timely review. After addressing the basic thermodynamic and kinetic fundamentals, we discuss classic and latest synthetic strategies that enable not only the formation of intermetallic phase but also the rational control of other catalysis-determinant structural parameters, such as size and morphology. We also demonstrate the emerging intermetallic nanomaterials for potentially further advancement in energy electrocatalysis. Then, we discuss the state-of-the-art characterizations and representative intermetallic electrocatalysts with emphasis on oxygen reduction reaction evaluated in a MEA setup. We summarize this review by laying out existing challenges and offering perspective on future research directions toward practicing intermetallic electrocatalysts for energy conversions.

[Impact of SARS-CoV-2 infection on graft composition and early transplant outcomes following allogeneic hematopoietic stem cell transplantation]

Objective: To assess the feasibility of using donors with novel coronavirus disease 2019 (COVID-19) for allogeneic hematopoietic stem cell transplantation (allo-HSCT) when there are no other available donors and allo-HSCT cannot be delayed or discontinued. Methods: Seventy-one patients with malignant hematological diseases undergoing allo-HSCT between December 8, 2022, and January 10, 2023, were included. Of these, 16 received grafts from donors with mild COVID-19 (D-COVID(+) group) and 55 received grafts from donors without COVID-19 (D-COVID(-) group). The graft compositions were compared between the two groups. Engraftment, acute graft-versus-host disease (aGVHD), overall survival (OS), and relapse were also evaluated. Results: There were no serious side effects or adverse events in the D-COVID(+) group. The mononuclear cell dose and CD34(+) cell dose were comparable between the two groups, and no additional apheresis was required. There were no significant differences in the lymphocyte, monocyte, and T-cell subset doses between the two groups. The median natural killer cell dose in the D-COVID(+) group was significantly higher than that in the D-COVID(-) group (0.69×10(8)/kg vs. 0.53×10(8)/kg, P=0.031). The median follow-up time was 72 (33-104) days. All patients achieved primary engraftment. The 60-day platelet engraftment rates in the D-COVID(+) and D-COVID(-) groups were 100% and (96.4±0.2) %, respectively (P=0.568). There were no significant differences in neutrophil (P=0.309) and platelet (P=0.544) engraftment times. The cumulative incidence of grade 2-4 aGVHD was (37.5±1.6) % vs. (16.4±0.3) % (P=0.062), and of grade 3-4 aGVHD was 25.0% ±1.3% vs. 9.1% ±0.2% (P=0.095) in the D-COVID(+) and D-COVID(-) groups, respectively. The probabilities of 60-day OS were 100% and 98.1% ±1.8% (P=0.522) in the D-COVID(+) and D-COVID(-) groups, respectively. There was no relapse of primary disease during the study period. Conclusion: When allo-HSCT cannot be delayed or discontinued and no other donor is available, a donor with mild COVID-19 should be considered if tolerable. Larger sample sizes and longer follow-up periods are required to validate these results.

Precise synthetic control of exclusive ligand effect boosts oxygen reduction catalysis

Ligand effect, induced by charge transfer between catalytic surface and substrate in core/shell structure, was widely proved to benefit Pt-catalyzed oxygen reduction reaction by tuning the position of d-band center of Pt theoretically. However, ligand effect is always convoluted by strain effect in real core/shell nanostructure; therefore, it remains experimentally unknown whether and how much the ligand effect solely contributes electrocatalytic activity improvements. Herein, we report precise synthesis of a kind of Pd3Ru1/Pt core/shell nanoplates with exclusive ligand effect for oxygen reduction reaction. Layer-by-layer growth of Pt overlayers onto Pd3Ru1 nanoplates can guarantee no lattice mismatch between core and shell because the well-designed Pd3Ru1 has the same lattice parameters as Pt. Electron transfer, due to the exclusive ligand effect, from Pd3Ru1 to Pt leads to a downshift of d-band center of Pt. The optimal Pd3Ru1/Pt1-2L nanoplates achieve excellent activity and stability for oxygen reduction reaction in alkaline/acid electrolyte.

[Effects of modified proper digital artery island flap in repairing complex fingertip defects]

Objective: To investigate the surgical method and clinical effects of the modified proper digital artery island flap in repairing complex fingertip defects. Methods: A retrospective observational study was conducted. From January 2017 to December 2021, 15 patients (15 fingers) with complex fingertip defects, involving the pulp, nail bed, and lateral wall of the nail, who met the inclusion criteria were admitted into General Hospital of Northern Theater Command, including 11 males and 4 females, aged from 18 to 55 years. The area of the post debridement wound was from 2.5 cm×2.0 cm to 3.5 cm×3.5 cm, and all the wounds were repaired by using modified proper digital artery island flap (including 3 parts: main flap, tongue-shaped flap, and triangular flap), of which the main flap was used to cover the finger pulp defect, the tongue-shaped flap was used to cover the nail bed and the nail lateral wall defect, and the triangular flap was inserted into the edge of the finger pulp wound to cover the vessel pedicle. The range of the flap ranged from 3.0 cm×2.0 cm to 4.5 cm×3.0 cm. The wound at the donor site was repaired with full-thickness skin graft of the groin, and the donor site of the skin graft was sutured directly. After operation, the survival of the flap and skin graft as well as and the appearance of the affected finger were observed. During the follow-up, the fingertip morphology of the affected finger was observed, two-point discrimination distance of the affected finger pulp was measured, and the patients' satisfaction with the efficacy (including very satisfied, satisfied, and dissatisfied) was asked, and the affected finger function was evaluated by the total active movement (TAM) system evaluation standard recommended by American Academy for Surgery of Hand. Results: After operation, the main flaps and skin grafts in 15 patients all survived; but the incision at the edge of tongue-shaped flap in one patient healed poorly, and one patient developed venous stasis at the distal end of the tongue-shaped flap; the triangular flap at the pedicle was slightly bloated in the early postoperative period and became smooth after 2 to 3 months. Overall, two patients developed subcutaneous hematoma in their flaps. All the complications were healed by appropriate dressing change, suture removal, or compression bandaging. After operation, the appearance of the flap was full and formed a prominent fingertip shape. During the follow-up of 6 months to 5 years, the fingertips of the affected fingers were prominent and full; the two-point discrimination distance of the affected finger pulp was (8.6±1.4) mm; 8 patients were very satisfied with the efficacy, 6 patients were satisfied, and one patient was dissatisfied; the functional assessment of the affected fingers were all excellent. Conclusions: The modified proper digital artery island flap can repair complex fingertip defects involving the pulp, nail bed, and lateral wall of the nail. The operation is simple, and the shape and function of the fingertip are good after surgery.

Single-Atom Cr-N4 Sites with High Oxophilicity Interfaced with Pt Atomic Clusters for Practical Alkaline Hydrogen Evolution Catalysis

Although dispersing Pt atomic clusters (ACs) on a conducting support is a promising way to minimize the Pt amount required in hydrogen evolution reaction (HER), the catalytic mass activity and durability of Pt ACs are often unsatisfactory for alkaline HER due to their unfavorable water dissociation and challenges in stabilizing them against agglomeration and detachment. Herein, we report a class of single-atom Cr-N4 sites with high oxophilicity interfaced with Pt ACs on mesoporous carbon for achieving a highly active and stable alkaline HER in an anion-exchange-membrane water electrolyzer (AEMWE). The as-made catalyst achieves the highest reported Pt mass activity (37.6 times higher than commercial Pt/C) and outstanding operational stability. Experimental and theoretical studies elucidate that the formation of a unique Pt-Cr quasi-covalent bonding interaction at the interface of Cr-N4 sites and Pt ACs effectively suppresses the migration and thermal vibration of Pt atoms to stabilize Pt ACs and contributes to the greatly enhanced catalytic stability. Moreover, oxophilic Cr-N4 sites adjacent to Pt ACs with favorable adsorption of hydroxyl species facilitate nearly barrierless water dissociation and thus enhance the HER activity. An AEMWE using this catalyst (with only 50 μgPt cm-2) can operate stably at an industrial-level current density of 500 mA cm-2 at 1.8 V for >100 h with a small degradation rate of 90 μV h-1.

Diversity of the free helical rim flap: A case series tailoring the microsurgical technique to esthetically optimize full-thickness nasal defect reconstructions

INTRODUCTION

The free helical rim (FHR) flap offers like-with-like reconstruction for full-thickness nasal defects. A case series of nasal reconstruction using an FHR flap was presented, detailing surgical steps and refinements, as well as functional and esthetic outcomes.

METHODS AND MATERIALS

This is a retrospective cohort study of composite nasal defect reconstruction with FHR flap from August 2018 to March 2020. Descriptive data were analyzed by SPSS software.

RESULTS

Six cases were recruited, four were unilateral alar defects, one was hemi-nose, and one was ala plus tip. The average size of the defect was 2.5 × 2.8 cm2. Three FHR flaps were designed with retrograde pedicles and three with anterograde pedicles. The facial artery and veins were the recipient vessels in all cases. Vascular grafts were used in all six cases. Descending branch of the lateral circumflex femoral (DLCxF) artery and vein functioned as interposition vascular conduits in five cases. Superficial forearm vein grafts were used in one case. One patient needed flap re-exploration due to venous congestion. One patient had partial flap necrosis due to delayed infection, and one developed delayed wound dehiscence in the irradiated wound. The average follow-up was 18 months.

CONCLUSION

The FHR flap has consistent vascular anatomy. It can be raised as an anterograde or retrograde flap for a contralateral or ipsilateral inset. FHR flap can be used in extensive composite nasal defects. This case series demonstrates that interposition vascular grafts are invariably needed and the possibility of using forearm vessels as grafts instead of DLCxF artery and vein.

Cu-Doped Heterointerfaced Ru/RuSe2 Nanosheets with Optimized H and H2 O Adsorption Boost Hydrogen Evolution Catalysis

Ruthenium chalcogenide is a highly promising catalytic system as a Pt alternative for hydrogen evolution reaction (HER). However, well-studied ruthenium selenide (RuSe₂ ) still exhibits sluggish HER kinetics in alkaline media due to the inappropriate adsorption strength of H and H₂ O. Herein, xx report a new design of Cu-doped Ru/RuSe₂ heterogeneous nanosheets (NSs) with optimized H and H₂ O adsorption strength for highly efficient HER catalysis in alkaline media. Theoretical calculations reveal that the superior HER performance is attributed to a synergistic effect of the unique heterointerfaced structure and Cu doping, which not only optimizes the electronic structure with a suitable d-band center to suppress proton overbinding but also alleviates the energy barrier with enhanced H₂ O adsorption. As a result, Cu-doped heterogeneous Ru/RuSe₂ NSs exhibit a small overpotential of 23 mV at 10 mA cm^-2 , a low Tafel slope of 58.5 mV dec^-1 and a high turnover frequency (TOF) value of 0.88 s^-1 at 100 mV for HER in alkaline media, which is among the best catalysts in noble metal-based electrocatalysts toward HER. The present Cu-doped Ru/RuSe₂ NSs interface catalyst is very stable for HER by showing no activity decay after 5000-cycle potential sweeps. This work heralds that heterogeneous interface modulation opens up a new strategy for the designing of more efficient electrocatalysts.

[The correlations between influenza and meteorological factors in 15 cities of northern China, 2008-2020]

Objective: To understand the influence of meteorological factors on the morbidity of influenza in northern cities of China and explore the differences in the influence of meteorological factors on the morbidity of influenza in 15 cities. Methods: The monthly reported morbidity of influenza and monthly meteorological data from 2008 to 2020 were collected in 15 provincial capital cities, including Xi 'an, Lanzhou, Xining, Yinchuan and Urumqi (5 northwestern cities), Beijing, Tianjin, Shijiazhuang, Taiyuan, Hohhot, Ji'nan, Zhengzhou (7 northern cities), Shenyang, Changchun and Harbin (3 northeastern cities). The panel data regression model was applied to conduct quantitative analyze on the influence of meteorological factors on influenza morbidity. Results: The univariate and multivariate panel regression analysis showed that after controlling the population density and other meteorological factors, for each 5 ℃ drop of monthly average temperature, the morbidity change percentage (MCP) of influenza was 11.35%, 34.04% and 25.04% in the 3 northeastern cities, 7 northern cities and 5 northwestern cities, respectively, and the best lag period months was 1, 0 and 1 month; When the monthly average relative humidity decreased by 10%, the MCP was 15.84% in 3 cities in northeastern China and 14.80% in 7 cities in northern China respectively, and the best lag period months was 2 and 1 months respectively; The MCP of 5 cities in northwestern China was 4.50% for each 10 mm reduction of monthly accumulated precipitation, and the best lag period months was 1 month; The MCPs of 3 cities in northeastern China and 5 cities in northwestern China were 4.19% and 5.97% respectively when the accumulated sunshine duration of each month decreased by 10 hours, the best lag period months was 1 month. Conclusions: In northern cities of China from 2008 to 2020, the temperature, relative humidity, precipitation and sunshine duration all had negatively impact on the morbidity of influenza, and temperature and relative humidity were the main sensitive meteorological factors. Temperature had a strong direct impact on the morbidity of influenza in 7 cities in northern China, and relative humidity had a strong lag effect on the morbidity of influenza in 3 cities in northeastern China. The duration of sunshine in 5 cities in northwestern China had a greater impact on the morbidity of influenza compared with 3 cities in northeastern China.

[Assessment of intensity of seasonal influenza activity in Beijing-Tianjin-Hebei region, 2019-2021]

Objective: To explore the feasibility of moving epidemic method (MEM) in the assessment of seasonal influenza (influenza) activity intensity from the perspective of urban agglomeration, assess influenza activity intensity in the Beijing-Tianjin-Hebei region from 2019 to 2021 and evaluate the reliability of surveillance data and the effectiveness of the MEM model application. Methods: The weekly reported incidence rate (IR) of influenza and the percentage of influenza-like illness (ILI%) from 2011-2021 in Beijing-Tianjin-Hebei region were collected to establish MEM models respectively. The model fitting effect and the reliability of the two data were evaluated for the purpose of establishing an optimal model to assess the influenza activity intensity in Beijing-Tianjin-Hebei region from 2019-2021. A cross-validation procedure was used to evaluate the performance of the models by calculating the Youden's index, sensitivity and specificity. Results: The MEM model fitted with weekly ILI% had a higher Youden's index compared with the model fitted with weekly IR at both Beijing-Tianjin-Hebei region level and provincial level. The MEM model based on ILI% showed that the epidemic threshold in Beijing-Tianjin-Hebei region during 2019-2020 was 4.42%, the post-epidemic threshold was 4.66%, with medium, high and very high intensity thresholds as 5.38%, 7.22% and 7.84%, respectively. The influenza season during 2019-2020 had 10 weeks (week 50 of 2019 to week 7 of 2020). The influenza season started in week 50 of 2019, and the intensity fluctuated above and below medium epidemic level for six consecutive weeks. The high intensity was observed in week 4 of 2020, the threshold of very high intensity was excessed in week 5, and the intensity gradually declined and became lower than the threshold at the end of the influenza season in week 8. The epidemic threshold was 4.29% and the post-epidemic threshold was 4.35% during 2020-2021. Influenza activity level never excessed the epidemic threshold throughout the year, and no epidemic period emerged. Conclusions: The MEM model could be applied in the assessment of influenza activity intensity in Beijing-Tianjin-Hebei region, and the use of ILI% to assess influenza activity intensity in this region was more reliable than IR data. Influenza activity intensity in Beijing-Tianjin-Hebei region was higher during 2019-2020 but significantly lower in 2020-2021.

Bioturbation in sediment cores from the Clarion-Clipperton Zone in the northeast Pacific: Evidence from excess 210Pb

Radioactivity levels of ²¹⁰Pb and ²²⁶Ra were measured to evaluate the bioturbation coefficients and mixing depths in one sediment core collected from the polymetallic nodule area inside the Clarion-Clipperton Zone (CCZ), a contract area of the China Ocean Mineral Resources Association (COMR) in the eastern Pacific Ocean. With a steady-state diffusion mode, the bioturbation coefficient and mixing depth of the sediment core were estimated to be 81.5 cm²/a and 51.3 cm, respectively, higher than that of the sediment core from the previous results from abyssal or global areas, which may be attributed to the distribution of total organic carbon (TOC) abundance. In addition, the transport flux of TOC from the surface layer to the deep layer were evaluated to be 1.15 mmol/(cm²·a), resulting in 83,200 tons of carbon buried annually into the sediment in the CCZ, indicating that a potential carbon sink will be disturbed with future exploration.

Amorphous MoOx with High Oxophilicity Interfaced with PtMo Alloy Nanoparticles Boosts Anti-CO Hydrogen Electrocatalysis

Advancing electrocatalysts for alkaline hydrogen oxidation/evolution reaction (HOR/HER) is essential for anion exchange membrane-based devices. The state-of-the-art Pt-based electrocatalysts for alkaline HOR suffer from low intrinsic activities and severe CO poisoning due to the challenge of simultaneously optimizing surface adsorption toward different adsorbates. Herein, this challenge is overcome by tuning an atomic MoO_x layer with high oxophilicity onto PtMo nanoparticles (NPs) with optimized H_ad , OH_ad , and CO_ad adsorption for boosting anti-CO-poisoning hydrogen-cycle electrocatalysis in alkaline media. For alkaline HOR, this catalyst exhibits high kinetics and an exchange current density of 3.19 mA µg_Pt ^-1 at 50 mV versus reversible hydrogen electrode and 0.83 mA cm_Pt ^-2 , 10.3- and 3.8-fold higher than those of commercial Pt/C, respectively. For alkaline HER, it achieves an unprecedented overpotential of 37 mV at 10 mA cm^-2 . Experimental and theoretical studies show that the orchestrated electronic and oxophilic regulation of the PtMo/MoO_x interface NPs simultaneously optimizes H_ad and OH_ad adsorption for boosting alkaline hydrogen electrocatalysis, whereas reactive oxygen from the amorphous MoO_x atomic layer lowers the CO oxidation reaction barrier, leading to superior anti-poisoning ability even at 100 ppm CO.

Base MRI Imaging Characteristics of Meningioma Patients to Discuss the WHO Classification of Brain Invasion Otherwise Benign Meningiomas

PURPOSE

Compared and analyzed the MRI imaging features of brain invasion otherwise benign (BIOB) meningiomas and WHO grade 1, grade 2 meningiomas, discussed the WHO grading of BIOB from the perspective of imaging.

MATERIALS AND METHODS

A retrospective analysis was performed on 675 meningiomas patients who carried on MRI examination from January 2006 to February 2022. Setting the 2022 Central nervous system (CNS) WHO Guidelines as the gold standard for pathological diagnosis. Statistical analysis of age, gender, and MRI features of meningiomas in relation to WHO grade and brain invasion.

RESULTS

Among 675 cases meningiomas, 543 (80.4%) were WHO grade 1, 123 (18.2%) were WHO grade 2, and 9 (1.3%) were WHO grade 3. There were 108 cases meningiomas with brain invasion (BI) (16.0%) and 567 cases without BI (84.0%). Among BI cases, 67 cases were BIOB. Compared the MRI features between BIOB and WHO grade 1 meningiomas, multivariate analysis demonstrated that the most strongly factors associated with distinguish them were enhancement degree, peritumoral edema, tumor-brain interface, fingerlike protrusion, mushroom sign, and bone invasion (AUC: 0.925 (0.901∼0.945), sensitivity: 0.925, specificity: 0.801). Compared the MRI features between BIOB and WHO grade 2 meningiomas, multivariate analysis demonstrated that the most strongly factors associated with distinguish them were enhancement degree and the tumor-brain interface (AUC: 0.779 (0.686∼0.841), sensitivity: 0.746, specificity: 0.732), their efficacy was slightly weaker.

CONCLUSIONS

BIOB is more similar to WHO grade 2 meningiomas in clinical and imaging features than WHO grade 1, so we think that it may be reasonable to classify BIOB as WHO Grade 2 meningiomas in the guidelines.

[Hepatitis C elimination among drug users in China: challenges, strategies and experiences]

The prevalence of hepatitis C among drug users in China is high, and thus it is one of the populations that needs attention to achieve hepatitis C elimination. However, due to the complexities of this population's situation, hepatitis C elimination still faces many challenges, such as difficult screening, low cure rate, poor compliance, and high reinfection rates. Therefore, the existing diagnostic and therapeutic system cannot meet the needs of this population. China has pledged to establish a unified system for drug users that will integrate drug treatment programs, education, medical care, and rehabilitation, creating favorable conditions for integrating hepatitis C diagnosis and treatment and improving the accessibility of drug users. Starting with the current situation and challenges of eliminating hepatitis C among drug users in China, in combination with cases from other countries, this paper discusses the strategy for eliminating hepatitis C and introduces what Hainan Province did to eliminate hepatitis C among drug users.

Local Coordination Regulation through Tuning Atomic-Scale Cavities of Pd Metallene toward Efficient Oxygen Reduction Electrocatalysis

Moderate adsorption of oxygenated intermediates takes a significant role in rational design of high-efficiency oxygen reduction reaction (ORR) electrocatalysts. Long-serving as a reliable strategy to tune geometric structure of nanomaterials, defect engineering enjoys the great ability of adjusting the coordination environment of catalytic active sites, which enables dominant regulation of adsorption energy and kinetics of ORR catalysis. However, limited to controllable nanocrystals fabrication, inducing uniformly dispersed high-coordinated defects into ultrathin 2D nanosheets remains challenging. Herein, atomic-scale cavities (ASCs) are proposed as a new kind of high-coordinated active site and successfully introduced into suprathin Pd (111)-exposed metallene. Due to its atomic concave architecture, leading to elevated CN and moderately downshifted d-band center, the as-made Pd metallene with ASCs (c-Pd M) exhibits excellent ORR performance with mass activity of 2.76 A mg_Pd ^-1 at 0.9 V versus reversible hydrogen electrode (RHE) and half-wave potential as high as 0.947 V, which is 18.9 (2.7) times higher and 104 (46) mV larger than that of commercial Pt/C (Pd metallene without ASCs). Besides, the durability of c-Pd M exceeds its commercial counterpart with ≈30% loss after 5000 cycles. This work highlights a new-style mentality of designing fancy active sites toward efficient ORR electrocatalysis.