High Mass Research Articles

Global burden of atrial fibrillation/atrial flutter and its attributable risk factors from 1990 to 2021.

To devise effective preventive measures, a profound understanding of the evolving patterns and trends in atrial fibrillation (AF) and atrial flutter (AFL) burdens is pivotal. Our study was designed to quantify the burden and delineate the risk factors associated with AF and AFL across 204 countries and territories spanning 1990 to 2021. Data pertaining to AF and AFL were sourced from the Global Burden of Disease Study (GBD) 2021 study. The burden of AF/AFL was evaluated using metrics such as incidence, disability-adjusted life years (DALYs), deaths, and their corresponding age-standardized rates (ASRs), stratified by age, sex, socio-demographic index (SDI), and human development index (HDI). The estimated annual percentage change (EAPC) was employed to quantify changes in ASRs. Population attributable fractions (PAFs) were calculated to determine the proportional contributions of major risk factors to age-standardized AF/AFL deaths. This analysis encompassed the period from 1990 to 2021. Globally, in 2021, there were 4.48 million incident cases (95% uncertainty interval [UI]: 3.61 to 5.70), 8.36 million DALYs (95% UI: 6.97 to 10.13), and 0.34 million deaths (95% UI: 0.29 to 0.37) attributed to AF/AFL. The AF/AFL burden in 2021, as well as its trends from 1990 to 2021, displayed substantial variations based on gender, SDI quintiles, and geographical regions. High systolic blood pressure emerged as the leading contributor to age-standardized AF/AFL incidence, prevalence, death, and DALYs rate globally among all potential risk factors, followed closely by high body mass index. Our study underscores the enduring significance of AF/AFL as a prominent public health concern worldwide, marked by profound regional and national variations. Despite the substantial potential for prevention and management of AF/AFL, there is a pressing imperative to adopt more cost-effective strategies and interventions to target modifiable risk factors, particularly in areas where the burden of AF/AFL is high or escalating.

Modulating the Bader Charge Transfer in Single p-Block Atoms Doped Pd Metallene for Enhanced Oxygen Reduction Electrocatalysis.

Metallene is considered as an emerging family of electrocatalysts due to its atomically layered structure and unique surface stress. Here we propose a strategy to modulate the Bader charge transfer (BCT) between Pd surface and oxygenated intermediates via p-d electronic interaction by introducing single-atomp-block metal (M = In, Sn, Pb, Bi) into Pd metallene nanosheets towards efficient oxygen reduction reaction (ORR). X-ray absorption and photoelectron spectroscopy suggests that doping p-block metals could facilitate electron transfer to Pd sites and thus downshift the d-band center of Pd and weaken the adsorption energy of O intermediates. Among them, the developed Bi-Pd metallene shows extraordinarily high ORR mass activity of 11.34 A mgPd-1 and 0.86 A mgPd-1 at 0.9 V and 0.95 V in alkaline solution, respectively, representing the best Pd-based ORR electrocatalysts ever reported. In the cathode of a Zinc-air battery, Bi-Pd metallene could achieve an open-circuit voltage of 1.546 V and keep stable for 760 h at 10 mA cm-2. Theoretical calculations suggest that the BCT between Pd surface and *OO intermediates greatly affects the bond length between them (dPd-*OO) and Bi doping could appropriately reduce the amount of BCT and stretch the dPd-*OO, thus enhancing the ORR activity.

The Modeled Cost-Effectiveness of a Prevention Program Targeting Both Eating Disorders and High BMI.

Prevention programs for eating disorders (EDs) and high body index mass (BMI) have the potential to reduce the onset of these interconnected public health concerns. However, it remains unclear whether routine implementation of such programs would be cost-effective. This study aims to determine the cost-effectiveness of an intervention that aims to prevent both ED and high BMI. A Markov model was developed to evaluate the incremental cost-effectiveness of a targeted school-based program, Healthy Weight, that aims to prevent both EDs and high BMI among Australian adolescents with body image concerns (aged 15-18 years), versus a "no intervention" comparator. A cost-utility analysis was conducted from a "healthcare and education" sector perspective with costs (measured in 2019 Australian dollars) and health impacts modeled over the lifetime of the target population. An incremental cost-effectiveness ratio (ICER), expressed as cost per health-adjusted life year (HALY) gained, was calculated. Sensitivity analyses were done to test model assumptions. The mean intervention cost and HALYs gained were AUD$2.13 million (95% CI, AUD$1.83-2.43 million) and 146 (95% CI, 90-209), respectively. With healthcare cost-savings (AUD$3.97 million) included, the intervention was predicted to be cost-saving (AUD$1.83 million; 95% CI, AUD$0.51-3.21 million). Primary findings were robust to extensive sensitivity analyses. The Healthy Weight intervention is likely to represent good value-for-money. To ensure the successful implementation of this program at the population level, further research on its feasibility and acceptability among schools and the wider community is required.

Hexa‐atom Pt Catalyst Fabricated by a Ligand Engineering Strategy for Efficient Hydrogen Oxidation Reaction

Atomically precise supported nanocluster catalysts (APSNCs), which feature exact atomic composition, well‐defined structures, and unique catalytic properties, offer an exceptional platform for understanding the structure‐performance relationship at the atomic level. However, fabricating APSNCs with precisely controlled and uniform metal atom numbers, as well as maintaining a stable structure, remains a significant challenge due to uncontrollable dispersion and easy aggregation during synthetic and catalytic processes. Herein, we developed an effective ligand engineering strategy to construct a Pt6 nanocluster catalyst stabilized on oxidized carbon nanotubes (Pt6/OCNT). The structural analysis revealed that Pt6 nanoclusters in Pt6/OCNT were fully exposed and exhibited a planar structure. Furthermore, the obtained Pt6/OCNT exhibited outstanding acidic HOR performances with a high mass activity of 18.37 A·mgpt‐1 along with excellent stability during a 24 h constant operation and good CO tolerance, surpassing those of the commercial Pt/C. Density functional theory (DFT) calculations demonstrated that the unique geometric and electronic structures of Pt6 nanoclusters on OCNT altered the hydrogen adsorption energies on catalytic sites and thus lowered the HOR theoretical overpotential. This work presents a new prospect for designing and synthesizing advanced APSNCs for efficient energy electrocatalysis.

Atomic-Layer IrOx Enabling Ligand Effect Boosts Water Oxidation Electrocatalysis.

An in situ formed IrOx (x ≤ 2) layer driven by anodic bias serves as the essential active site of Ir-based materials for oxygen evolution reaction (OER) electrocatalysis. Once being confined to atomic thickness, such an IrOx layer possesses both a favorable ligand effect and maximized active Ir sites with a lower O-coordination number. However, limited by a poor understanding of surface reconstruction dynamics, obtaining atomic layers of IrOx remains experimentally challenging. Herein, we report an idea of material design using intermetallic IrVMn nanoparticles to induce in situ formation of an ultrathin IrOx layer (O-IrVMn/IrOx) to enable the ligand effect for achieving superior OER electrocatalysis. Theoretical calculations predict that a strong electronic interaction originating from an orderly atomic arrangement can effectively hamper the excessive leaching of transition metals, minimizing vacancies for oxygen coordination. Linear X-ray absorption near edge spectra analysis, extended X-ray absorption fine structure fitting outcomes, and X-ray photoelectron spectroscopy collectively confirm that Ir is present in lower oxidation states in O-IrVMn/IrOx due to the presence of unsaturated O-coordination. Consequently, the O-IrVMn/IrOx delivers excellent acidic OER performances with an overpotential of only 279 mV at 10 mA cm-2 and a high mass activity of 2.3 A mg-1 at 1.53 V (vs RHE), exceeding most Ir-based catalysts reported. Moreover, O-IrVMn/IrOx also showed excellent catalytic stability with only 0.05 at. % Ir dissolution under electrochemical oxidation, much lower than that of disordered D-IrVMn/IrOx (0.20 at. %). Density functional theory calculations unravel that the intensified ligand effect optimizes the adsorption energies of multiple intermediates involved in the OER and stabilizes the as-formed catalytic IrOx layer.

Hexa-atom Pt Catalyst Fabricated by a Ligand Engineering Strategy for Efficient Hydrogen Oxidation Reaction.

Atomically precise supported nanocluster catalysts (APSNCs), which feature exact atomic composition, well-defined structures, and unique catalytic properties, offer an exceptional platform for understanding the structure-performance relationship at the atomic level. However, fabricating APSNCs with precisely controlled and uniform metal atom numbers, as well as maintaining a stable structure, remains a significant challenge due to uncontrollable dispersion and easy aggregation during synthetic and catalytic processes. Herein, we developed an effective ligand engineering strategy to construct a Pt6 nanocluster catalyst stabilized on oxidized carbon nanotubes (Pt6/OCNT). The structural analysis revealed that Pt6 nanoclusters in Pt6/OCNT were fully exposed and exhibited a planar structure. Furthermore, the obtained Pt6/OCNT exhibited outstanding acidic HOR performances with a high mass activity of 18.37 A·mgpt-1 along with excellent stability during a 24 h constant operation and good CO tolerance, surpassing those of the commercial Pt/C. Density functional theory (DFT) calculations demonstrated that the unique geometric and electronic structures of Pt6 nanoclusters on OCNT altered the hydrogen adsorption energies on catalytic sites and thus lowered the HOR theoretical overpotential. This work presents a new prospect for designing and synthesizing advanced APSNCs for efficient energy electrocatalysis.

Regulation of d‐Band Center of Ruthenium Sites via Electronic Complementary Effect of C60 Fullerene Molecules and Manganese Atoms for Efficient Alkaline Hydrogen Evolution

AbstractDeveloping advanced electrocatalysts is crucial for alkaline hydrogen evolution reaction (HER). A balance in adsorption energy for each reaction intermediate on the catalyst determines the overall catalytic rate. This balance is closely linked to the d‐band center, which is, in turn, controlled by the electronic structure of the active sites. Herein, C60 molecules with electron‐withdrawing properties and manganese (Mn) atoms with electron‐donating properties to drive charge redistribution on Ru active sites are strategically utilized. The synergistic and complementary effects of C60 and Mn regulate the d‐band centers of Ru sites to an optimal position, optimizing both the water adsorption and hydrogen desorption of the synthesized Ru catalysts. The constructed MnRu/C60‐3 catalyst exhibits a low overpotential of 8 mV at 10 mA cm−2, a large TOF value of 15.5 s−1, and a high mass activity of 2.39 A mg−1Ru at an overpotential of 100 mV in 1.0 m KOH. The anion exchange membrane water electrolyzer, assembled with MnRu/C60‐3 as the cathode, demonstrates excellent water electrolysis performance and high stability under industrial operational conditions. This work offers a fresh perspective on catalyst design principles by manipulating the d‐band centers of active sites using two complementary components.

The effects of Ganoderma leucocontextum triterpenoids treatment on the D-galactose and aluminum chloride-induced Alzheimer-like pathology in mouse brain

Ganoderma leucocontextum T.H. Li, W. Q. Deng M. Wang & H.P.Hu. is a highland herbal medicine that has been shown to nourish the nervesand prolong life. Nevertheless, there is no evidence to indicate that Ganoderma leucocontextum triterpenoids (GLTs) reduce the damage triggered by Alzheimer's disease (AD). The aim of this investigation was to ascertain the protective effects of GLTs on AD mice models and cells, as well as to look into potential pathways. In this study, the phytochemical characterization of GLTs was performed by High Performance Liquid Chromatography (HPLC) and Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS). The AD mouse model was induced by injecting intraperitoneally with D-galactose (120 mg/kg) and administering orally with aluminum chloride (20 mg/kg) daily for 28 days. After that, donepezil (5 mg/kg) and GLTs (0.4, 0.8, and 1.6 g/kg) were administered orally for 35 days. During the treatment period, aluminum chloride (20 mg/kg) and D-galactose (120 mg/kg) were continuously administered. And the behavior of the animals and the molecular changes of the hippocampus were determined after the whole experimental procedure. Furthermore, BV-2 cells were employed to validate GLTs' anti-neuroinflammatory properties. The total triterpenoids content was 443.12 ± 0.21g/kg and was inferred to contain 19 classes of substances such as organic acids, amino acids, vitamins, flavonoids, and other chemicals in GLTs. Treatment of D-galactose/aluminum chloride-induced mouse with GLTs can ameliorate AD symptoms, counteract cognitive decline, improve Aβ1-42 deposition, reduce the expression level of pro-apoptotic proteins, and attenuate the activation of hippocampal microglia and astrocytes. GLTs significantly increased the expression of antioxidant enzymes and significantly reduced the expression of inflammatory factors. GLTs inhibits nuclear factor kappa B (NF-κB) nuclear translocation and preserves myd88/traf6-mediated mitogen-activated protein kinase (MAPK) phosphorylation. Furthermore, GLTs (2 and 5mg/mL) inhibited the generation of nitric oxide and protected lipopolysaccharide (1mg/L)-induced neuroinflammation in BV-2 cells. Taken together, Ganoderma leucocontextum triterpenoids can improve cognitive functions, including learning and memory, by reducing neuroinflammation and oxidative stress, preventing apoptosis, and controlling amyloid genesis.

Modifiable Risk Factors for Breast Cancer Mortality in Türkiye from 1990 to 2019: A Temporal Analysis of Global Burden of Disease Data.

Breast cancer is the leading cause of cancer-related mortality in women in Türkiye. Explore the trends in female breast cancer mortality rates and the associated modifiable factors in Türkiye between 1990 and 2019. Epidemiological descriptive analysis. The database of the Global Burden of Disease study was used to obtain data regarding breast cancer-related mortality and modifiable (behavioral and metabolic) risk factors among women in Türkiye from 1990 to 2019. The average annual percentage change (AAPC) for female breast cancer mortality rates was computed using the Joinpoint regression method. From 1990 to 2009, the breast cancer mortality rates in Türkiye tended to increase [from 12.26/105 in 1990 to 12.65/105 in 2019; AAPC=0.1 "95% confidence interval (CI): 0.1-0.1"]. In terms of breast cancer mortality attributed to modifiable factors, a 3% increase was observed from 1990 (20.4%) to 2019 (23.1%), the highest contributor being high body mass index (3.19% in 1990 to 5.87% in 2019; AAPC=1.5; 95% CI: 1.3-1.5), followed by high fasting plasma glucose (5.01% in 1990 to 7.72% in 2019; AAPC=1.4; 95% CI: 1.3-1.5). The proportion of breast cancer-related deaths attributed to metabolic factors has been increasing in Türkiye from 1990 to 2019. Therefore, health policies aimed at managing metabolic factors in women are warranted to reduce breast cancer-related mortality in Türkiye.

Social impact of brain fog and analysis of risk factors: Long COVID in Japanese population.

To reveal the clinical features and assess risk factors linked to brain fog and its societal implications, including labor productivity, providing valuable insights for the future care of individuals who have experienced coronavirus disease 2019 (COVID-19). We analyzed a comprehensive cohort dataset comprising 1,009 patients with COVID-19 admitted to Japanese hospitals. To assess brain fog, we analyzed patients who responded to a questionnaire indicating symptoms such as memory impairment and poor concentration. The prevalence of brain fog symptoms decreased 3 months posthospitalization but remained stable up to 12 months. Neurological symptoms such as taste and smell disorders and numbness at hospitalization correlated with a higher frequency of identifying brain fog as a long COVID manifestation. Our findings indicated that advanced age, female sex, a high body mass index, oxygen required during hospitalization, chronic obstructive pulmonary disease, asthma, and elevated C-reactive protein and elevated D-dimer levels were risk factors in patients exhibiting brain fog. Additionally, we demonstrated the negative impact of brain fog on labor productivity by presenteeism scores. This study clarified the clinical characteristics of patients experiencing brain fog as a long COVID manifestation, specifically emphasizing neurological symptoms during hospitalization and their correlation with brain fog. Additionally, the study identified associated risk factors for its onset and revealed that the emergence of brain fog was linked to a decline in labor productivity.

The global burden of disease attributable to high body mass index in 204 countries and territories: Findings from 1990 to 2019 and predictions to 2035.

Our study aims to provide an updated estimate of age- and sex-specific deaths and disability-adjusted life years (DALYs) associated with high body mass index (BMI) from 1990 to 2019 at the global, regional and national levels, and to forecast the global burden of disease attributed to high BMI from 2020 to 2035. We used the data for the number of deaths, DALYs, age-standardized rate (per 100 000 population), percentage change and population attributable fraction from the Global Burden of Disease Study 2019 (GBD 2019) to examine the disease burden attributable to high BMI. We further applied an autoregressive integrated moving average (ARIMA) model to predict the disease burden for the period 2020-2035. From 1990 to 2019, the deaths and DALYs attributable to high BMI increased by 148% and 155.86% for men, and by 111.67% and 121.78% for women, respectively. In 2019, high BMI directly accounted for 8.52% [95% uncertainty intervals (UI) 0.05, 0.12] of all-cause deaths and 5.89% (95% UI 0.04, 0.08) of global DALYs. The highest death rates were observed in men aged 65-69 and women aged 75-79. The highest DALY rates were observed in the age group of 60-64 for both sexes. In 2019, the highest age-standardized deaths and DALY rates were observed in the Central Asia region [163.15 (95% UI 107.72, 223.58) per 100 000 people] and the Oceania region [4643.33 (95% UI 2835.66, 6902.6) per 100 000 people], respectively. Fiji [319.08 (95% UI 213.77, 444.96) per 100 000 people] and Kiribati [10 000.58 (95% UI 6266.55, 14159.2) per 100 000 people] had the highest age-standardized deaths and DALY rates, respectively. In 2019, the highest age-standardized rates of high BMI-related deaths and DALYs were observed in the middle-high socio-demographic index quintile and in the middle socio-demographic index quintile. The age-standardized deaths and DALY rates attributable to high BMI are projected to increase in both sexes from 2020 to 2035. The death rates are projected to rise from 62.79 to 64.31 per 100 000 people, while the DALY rates are projected to rise from 1946 to 2099.54 per 100 000 people. High BMIs significantly contribute to the global disease burden. The projected rise in deaths and DALY rates attributable to high BMI by 2035 highlights the critical need to address the impact of obesity on public health. Our study provides policymakers with up-to-date and comprehensive information.

Direct activation of PI3K in osteoblasts and osteocytes strengthens murine bone through sex-specific actions on cortical surfaces.

Intracellular phosphoinositide 3-kinase (PI3K) signaling is activated by multiple bone-active receptors. Genetic mutations activating PI3K signaling are associated with clinical syndromes of tissue overgrowth in multiple organs, often including the skeleton. Bone formation is increased by removing the PI3K inhibitor PTEN, but the effect of direct PI3K in the osteoblast lineage has not been reported. We introduced a known gain-of-function mutation in Pik3ca, the gene encoding the p110α catalytic subunit of PI3K, in osteocytes and late osteoblasts using the dentin matrix protein-1 Cre (Dmp1Cre) mouse and assessed the skeletal phenotype. Femur shape was grossly normal, but cortical thickness was significantly greater in both male and female Dmp1Cre.Pik3caH1047R mice, leading to almost doubled bone strength at 12weeks of age. Both sexes had smaller marrow areas from 6weeks of age. Female mice also exhibited greater cross sectional area, which continued to increase until 24weeks of age, resulting in a further increase in bone strength. While both male and female mice had increased endocortical mineralizing surface, only female mice had increased periosteal mineralizing surface. The bone formed in the Dmp1Cre.Pik3caH1047R mice showed no increase in intracortical remodeling nor any defect in cortical bone consolidation. In contrast, on both endocortical and periosteal surfaces, there was a greater extent of lamellar bone formation with highly organized osteocyte networks extending along the entire surface at a greater thickness than in control mice. In conclusion, direct activation of PI3Kα in cells targeted by Dmp1Cre leads to high cortical bone mass and strength with abundant lamellar cortical bone in female and male mice with no increase in intracortical remodeling. This differs from the effect of PTEN deletion in the same cells, suggesting that activating PI3Kα in osteoblasts and osteocytes may be a more suitable target to promote formation of lamellar bone.

654 Laparoscopic Cholecystectomy in Class III (Morbid) Obesity

Abstract Background High Body Mass Index (BMI) has been associated with increased operative-time, conversion to open-surgery and poorer outcomes. Criteria for day surgery often includes BMI, with centres excluding patients with BMI>40kg/m2 . However, as cholecystectomies are routinely performed laparoscopically with low complication rates in patients with higher BMI, this cut-off is being reviewed. Aim To examine outcomes of Laparoscopic Cholecystectomy in patients with increased BMI, particularly when comparing patients with morbid obesity (Class-III;BMI>40 kg/m2) to those with lower BMI. Method Data was collected between 01/01/2022 and 31/07/2023 from hospitals throughout the Aneurin-Bevan University Health-Board, South Wales, UK. Data on BMI, surgical indication, operative duration, length of admission and 30-day complications, amongst others, was collected. Results This study included a total of 1007 patients (77.92% female, 22.08% male). Patients were placed into 5 BMI categories: BMI<25(n=117),25-29(n=284),30-34(n=285),35-39(n=193), and>40(n=135). The median BMI was 31kg/m2 and overall complication-rate 5.36%. There were three 30-day mortalities, one in BMI category <25(p=0.19) and two in 25-29(p=0.06). When comparing patients with BMI>40 to those with lower BMI there was no significant difference in complications including bile-leak (0%vs1.79%;p=0.35), significant bleed (0.10%vs0.20%;p=0.41) or bile-duct injury (0%vs0.1%;p=0.71). The duration of surgery was increased, almost reaching statistical significance (83.5vs78mins;p=0.05). Due to existing Health board admission criteria, length of admission was significantly raised for BMI>40 (median1vs0days;p=0.00). Conclusions This retrospective study finds Laparoscopic Cholecystectomy safe in patients with Class-III obesity with no increased association with intraoperative or post-operative complications. Criteria for day-surgery based solely on BMI>40 appears inappropriate.

Deciphering Transcriptomic and Metabolomic Wood Responses to Grapevine Trunk Disease-Associated Fungi

Esca is one of the main grapevine trunk diseases affecting vineyards worldwide. Phaeoacremonium minimum and Phaeomoniella chlamydospora are thought to be two of the main causal agents of this disease. However, the molecular mechanisms underlying plant defense responses in the grapevine trunk against esca-associated pathogens are poorly understood. To provide a first glimpse at the trunk responses to P. minimum and P. chlamydospora, transcriptomic and metabolomic analyses were performed to compare and contrast host responses to these pathogens. Transcriptomic analysis revealed different gene expression reprogramming in the trunk in response to each fungus. The main significant differences were found among genes associated with secondary metabolism, signaling, and hormone signaling. An untargeted liquid chromatography–high resolution mass spectrometry metabolomic approach performed 3 weeks after inoculation was used, and dereplication mainly highlighted flavonoids and stilbenes as plant defense metabolites in the infected trunk. Some metabolites were overproduced with both fungi, but specific responses were also observed. Particularly, a lipophilic flavonoid cluster was emphasized after P. minimum inoculation. The assessment of fungal infection 6 weeks postinfection showed more copies of P. minimum than P. chlamydospora. This dissimilarity in the level of colonization could be linked to the metabolomic responses observed. Our results reveal both different gene expression reprogramming and metabolomic-specific signatures depending on the wood pathogen. Altogether, these observations suggest that grapevine trunks can differently perceive and respond to P. minimum and P. chlamydospora. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .

Intrahepatic cholestasis of pregnancy: current clinical and treatment and diagnostic approaches

BACKGROUND: The article is devoted to the current problem of intrahepatic cholestasis of pregnancy. This disease complicates the course of pregnancy, worsens the quality of life of patients and is a predictor of obstetric and perinatal complications. AIM: To analyze clinical features, epidemiology, treatment, and diagnosis of patients with verified intrahepatic cholestasis of pregnancy, to study the relationship between the level of bile acids and the severity of skin itching and the development of complications in newborns. MATERIALS AND METHODS: Using a retrospective analysis technique, medical histories of patients with intrahepatic cholestasis of pregnancy were studied. RESULTS: Verified intrahepatic cholestasis of pregnancy was found to be associated with the age over 30 years old, high baseline body mass index (more 25 kg/m2), and with consecutive pregnancy. Most patients (64%) were diagnosed with intrahepatic cholestasis after 36 weeks of pregnancy. Skin itching is the main clinical symptom of intrahepatic cholestasis of pregnancy, which in most cases (46.7%) was pronounced. Meanwhile, the intensity of itching, depended on the level of bile acids (p = 0.00000000001). There is a relationship between the degree of increased levels of bile acids and the appearance of various respiratory disorders in newborns (p = 0.003). CONCLUSIONS: The topic under consideration will be of interest to specialists in the field of obstetrics and gynecology, gastroenterology, hepatology, and therapy. The issue of diagnosis and treatment of intrahepatic cholestasis of pregnancy requires further study.

RGO@MoS2 as the host-separator modifier with efficient polysulfides trapping and fast Li+ diffusion for lithium-sulfur batteries

Lithium sulfur battery is widely regarded as the most promising next generation energy storage systems because of its high specific energy (2600 Wh kg−1). However，its commercial application is still limited by numerous challenges, including the insulation of charging/discharging products sulfur and Li2S2/Li2S, as well as the "shuttle effect" triggered by the soluble polysulfides. Herein, we report that a functional separator modified by a rGO@MOS2 composites comprising ultrathin MoS2 nanosheets in-situ growth on the surface of reduced graphene oxide (rGO). This composite boasts -an abundant mesoporous structure and large specific surface area can effectively adsorb lithium polysulfides (LiPSs). Additionally, the introduction of high conductive rGO and ultrathin MoS2 nanosheets with rich edge active sites can accelerate the catalytic transformation reaction from LiPSs to Li2S2/Li2S, thus inhibiting the "shuttle effect". In comparison to Li-S batteries without rGO@MoS2 composites, batteries equipped with the functional separator exhibit an impressive initial discharge capacity of 1125.4 mAh g−1 at 1 C, and retain at 910.4 mAh g−1 after 200 cycles, with a low capacity decay rate of 0.09 % per cycle, indicating excellent cyclic stability. Moreover, the areal capacity of the electrode with high sulfur loading mass of 4.1 mg cm−2 is 4.1 mAh cm−2, approaching the practical application standard at a current density of 0.1 C.

DART-HRMS reveals metabolic changes of whey through microparticulation and fermentations

Despite native whey (hereafter termed WHEY) being a watery by-product rich in high-value nutritional components, it poses environmental concerns. Recently, the techniques of thermal-mechanical microparticulation to produce microparticulated whey (MPW) and a further process to ferment MPW (FMPW) were suggested, in order to recycle whey into a protein concentrated soft dairy cream that acquires also fat mimicking functionality. Aiming at monitoring the effects of this recycling process on the products’ metabolic profiles, samples (n = 8) of WHEY, MPW and two sub-types of FMPW were analysed by combining direct analysis in real time coupled with high resolution mass spectrometry (DART-HRMS). The most informative ions were used to build a partial least squared discriminant analysis (PLS-DA) model to assess the biochemical compounds that characterize and differentiate WHEY from MPW and FMPW. The DART-HRMS fingerprints acquired in negative mode accurately differentiated samples throughout the steps of microparticulation and fermentation. Post-fermentation, greater relative abundances of lactic acid, glucosamine and histidyl-aspartic acid were detected in both subtypes of FMPW, which were moderately differentiated by DART-HRMS. Moreover, while WHEY and MPW contained high relative abundances of hydroxyglutaric and malic acids, the fermented derivates (FMPW) were characterised by elevated levels of volatile compounds (tetradecanal, hexadecene and tetradecene) and fermentative end-products (diethyltartrate and histidyl-aspartic acid). DART-HRMS successfully captured a pool of informative biomarkers useful to understand the chemical and metabolomic changes occurring in microparticulation and fermentation processes used to recycle whey. This analytical technique is an operative supporting step needed for comprehensive assessment of the nutritional and organoleptic properties of the proposed whey-based soft cream dairy food.

Western diet reduces small intestinal intraepithelial lymphocytes via FXR-Interferon pathway

The prevalence of obesity in the United States has continued to increase over the past several decades. Understanding how diet-induced obesity modulates mucosal immunity is of clinical relevance. We previously showed that consumption of a high fat, high sugar “Western” diet (WD) reduces the density and function of small intestinal Paneth cells, a small intestinal epithelial cell type with innate immune function. We hypothesized that obesity could also result in repressed gut adaptive immunity. Using small intestinal intraepithelial lymphocytes (IEL) as a readout, we found that in non-inflammatory bowel disease (IBD) subjects, high body mass index correlated with reduced IEL density. We recapitulated this in wild type (WT) mice fed with WD. A 4-week WD consumption was able to reduce IEL but not splenic, blood, or bone marrow lymphocytes, and the effect was reversible after another 2 weeks of standard diet (SD) washout. Importantly, WD-associated IEL reduction was not dependent on the presence of gut microbiota, as WD-fed germ-free mice also showed IEL reduction. We further found that WD-mediated Farnesoid X Receptor (FXR) activation in the gut triggered IEL reduction, and this was partially mediated by intestinal phagocytes. Activated FXR signaling stimulated phagocytes to secrete type I IFN, and inhibition of either FXR or type I IFN signaling within the phagocytes prevented WD-mediated IEL loss. Therefore, WD consumption represses both innate and adaptive immunity in the gut. These findings have significant clinical implications in the understanding of how diet modulates mucosal immunity.

Factors leading to surgical site infection (SSI); a 6 years analysis of general surgical cases in a newly developed teaching hospital.

Objective: To determine the major factors leading to surgical site infection in elective surgeries. Study Design: Retrospective Cross Sectional study. Setting: Department of Surgery, Government Teaching Hospital Shahdara, Lahore. Period: January 2016 to December 2021. Methods: The cases of surgical site infections were collected from well-organized data according to health care commission’s format of recording data in surgical site infection Register. Emergency patients were excluded. Each infected case was thoroughly investigated according to Performa and presented in meeting of infection control committee. Demographics were recorded and the factors were determined in individual case. Frequency and percentages of infected cases and main factors in all cases were analyzed by SPSS version 24. Results: We had 61 cases of SSI out of 2962 cases operated during the study period with calculated rate of 2.06%. Seventy two percent cases had age more than 40 years. 39(63.93%) were female and 22(36/07) were male. Mean age was 43.02 years with standard deviation of ± 8.98. 72% of infected cases. BMI in infected cases was 29.56 mean and Standard deviation ± 2.74 and 27.29 in non-infected cases (significant). Diabetes and Rank of surgeon had significant difference with increased infection in resident level. Smoking and gender of patients had no statistically significant impact. Conclusion: High Body mass index, diabetes, longer duration of procedure, rank of surgeon and use of mesh are the leading factors causing surgical site infection. Smoking, age and gender had no significant effect on SSI.

Quality of endoscopic surveillance of Lynch syndrome patients in a Swedish cohort.

Background and study aims Risk factors for colorectal cancer (CRC) in Lynch syndrome (LS) include sex, age, smoking, high body mass index (BMI), surveillance interval length, and risk genotype. The Boston Bowel Preparation Scale (BBPS) produces a standardized bowel cleanliness rating. A low BBPS score might be a risk factor for missed early lesions. The aim of this study was to investigate the correlation between BBPS score and adenoma detection (with known risk factors for CRC) and surveillance interval with CRC detection in LS patients. Methods A retrospective cohort study including 366 LS patients with 1,887 colonoscopies under surveillance in Stockholm, Sweden from 1989 to 2021 was conducted. Associations were tested using linear and logistic regression. Results We found no association between BBPS score and number of adenomas detected. A low BBPS score was found to be associated with older age (regression coefficient (coeff) -0.015; 95% confidence interval [CI] -0.026 to -0.004; P = 0.007) and obesity (coeff = -0.48; 95% CI: -0.89 to -0.062; P = 0.024). A higher number of detected adenomas was associated with older age (coeff = 0.008; 95% CI 0.004 to 0.012; P < 0.001), male sex (coeff = 0.097; 95% CI 0.008 to 0.19; P = 0.033) and CRC (coeff = 0.28; 95% CI 0.061 to 0.50; P = 0.012). Surveillance interval length was not significant in CRC detection. Conclusions Bowel cleanliness was not associated with adenoma detection and was less likely achieved in patients who were older and had higher BMI. Adenoma detection was associated with older age and male sex. The results indicate the need for better adherence to guidelines and attention to older age groups, men, and patients with obesity.