Poor Recovery Research Articles

Exploring better sparsely annotated shadow detection

Sparsely annotated image segmentation has attracted increasing attention due to its low labeling cost. However, existing weakly-supervised shadow detection methods require complex training procedures, and there is still a significant performance gap compared to fully-supervised methods. This paper summarizes two current challenges in sparsely annotated shadow detection, i.e., weak supervision diffusion and poor structure recovery, and attempts to alleviate them. To this end, we propose a one-stage weakly-supervised learning framework to facilitate sparsely annotated shadow detection. Specifically, we first design a simple yet effective semantic affinity module (SAM) that adaptively propagates scribble supervision to unlabeled regions using a gradient diffusion scheme. Then, to better recover shadow structures, we introduce a feature-guided edge-aware loss, which leverages higher-level semantic relations to perceive shadow boundaries, while avoiding interference from ambiguous regions. Finally, we present an intensity-guided structure consistency loss to ensure that the same images with different brightness are predicted to be consistent shadow masks, which can be regarded as a self-consistent mechanism to improve the model’s generalization ability. Experimental results on three benchmark datasets demonstrate that our approach significantly outperforms previous weakly-supervised methods and achieves competitive performance in comparison to recent state-of-the-art fully-supervised methods.

Myoclonus After Cardiac Arrest did not Correlate with Cortical Response on Somatosensory Evoked Potentials.

Myoclonus after anoxic brain injury is a marker of significant cerebral injury. Absent cortical signal (N20) on somatosensory evoked potentials (SSEPs) after cardiac arrest is a reliable predictor of poor neurological recovery when combined with an overall clinical picture consistent with severe widespread neurological injury. We evaluated a clinical question of if SSEP result could be predicted from other clinical and neurodiagnostic testing results in patients with post-anoxic myoclonus. Retrospective chart review of all adult patients with post-cardiac arrest myoclonus who underwent both electroencephalographic (EEG) monitoring and SSEPs for neuroprognostication. Myoclonus was categorized as "non-myoclonic movements," "myoclonus not captured on EEG," "myoclonus without EEG correlate," "myoclonus with EEG correlate," and "status myoclonus." SSEP results were categorized as all absent, all present, N18 and N20 absent bilaterally, and N20 only absent bilaterally. Cox proportional hazards with censoring was used to evaluate the association of myoclonus category, SSEP results, and confounding factors with survival. In 56 patients, median time from arrest to either confirmed death or last follow up was 9 days. The category of myoclonus was not associated with SSEP result or length of survival. Absence of N20 s or N18 s was associated with shorter survival (N20 hazard ratio [HR] 4.4, p = 0.0014; N18 HR 5.5, p < 0.00001). Category of myoclonus did not reliably predict SSEP result. SSEP result was correlated with outcome consistently, but goals of care transitioned to comfort measures only in all patients with present peripheral potentials and either absent N20 s only or absence of N18 s and N20 s. Our results suggest that SSEPs may retain prognostic value in patients with post-anoxic myoclonus.

Impact of oral antithrombotic agents on urinary continence recovery following robot-assisted radical prostatectomy: a retrospective cohort study

BackgroundRobot-assisted radical prostatectomy (RARP) is a preferred minimally invasive surgical treatment for prostate cancer. The number of elderly patients and those with cardiovascular and/or cerebrovascular issues undergoing surgery is increasing, and many of them are taking antithrombotic (AT) agents. However, the effect of AT agents on postoperative urinary recovery has not been adequately studied. In this study, we analyzed the differences in the postoperative recovery of urinary continence and oncological outcomes in patients undergoing RARP for localized prostate cancer between AT agent adherents and non-adherents.MethodsA total of 394 patients who underwent conventional anterior RARP between February 2015 and February 2021 were categorized into two groups: those taking oral AT agents (AT group) and the control group. Urinary continence recovery, complications, and oncological outcomes were compared between the groups. A Cox proportional hazards analysis was performed to identify clinical factors that affect urinary continence recovery.ResultsThe background data and bleeding complications did not differ significantly between the groups. The recovery of continence was significantly poorer in the AT group in terms of complete pad free (HR: 0.53 [95% CI: 0.39–0.71]) and use of ≤ 1 safety pad (HR: 0.74 [95% CI: 0.59–0.94]). The rate of anastomotic leakage on cystography was significantly higher in the AT group (20.9% vs. 6.7%). A univariate analysis revealed that taking antithrombotic agents, higher prostate-specific antigen levels, and a more advanced clinical stage were associated with a poor urinary continence recovery; a multivariate analysis showed that taking AT agents was an independent factor negatively associated with urinary continence recovery. There was no significant difference between the groups in the positive surgical margin rate (19.0% vs. 23.8%) or the biochemical-recurrence-free rate.ConclusionTaking oral AT agents may be associated with poor urinary continence recovery after RARP.

Evaluation of the relationship between the real-time changes of macular structure and visual function in patients with rhegmatogenous retinal detachment after silicone oil tamponade

PurposeTo evaluate the relationship between the real-time changes of macular structure and visual function in rhegmatogenous retinal detachment (RRD) patients. MethodsForty-six patients were enrolled in this retrospective study. The best corrected visual acuity (BCVA) and macular structural changes were analyzed within 3 months after silicone oil tamponade. ResultsThe mean final BCVA was significantly better than the preoperative BCVA (P = 0.002). The parafoveal thickness became thinner, the proportion of subretinal fluid (SRF) decreased, and the proportion of intact external limiting membrane (ELM) increased within 3 months postoperatively. The recovery stage and the integrity of ELM in the SRF (-) group were significantly faster than that in the SRF (+) group (all P < 0.05). The central foveal thickness (CFT), the inferior and temporal thickness of the parafovea, and the integrity of the ELM were significantly correlated with BCVA at each time point (all P < 0.05). Long duration of preoperative RRD, thinner CFT at 1 month postoperatively, and without integrity of ELM at 3 months postoperatively were associated with poor final BCVA recovery (R2 = 0.462). ConclusionsThe macular microstructural tended to restore integrity within 3 months. The presence of SRF in macula delayed the recovery of RRD patients but did not affect the visual function.

Exploring the effectiveness of eHealth interventions in treating Post Intensive Care Syndrome (PICS) outcomes: a systematic review

BackgroundIt remains unclear how to optimise critical care rehabilitation to reduce the constellation of long-term physical, psychological and cognitive impairments known as Post Intensive Care Syndrome (PICS). Possible reasons for poor recovery include access to care and delayed treatment. eHealth could potentially aid in increasing access and providing consistent care remotely. Our review aimed to evaluate the effectiveness of eHealth interventions on PICS outcomes.MethodsStudies reporting eHealth interventions targeting Post Intensive Care Syndrome outcomes, published in Medline, CINAHL, PsycINFO, Embase, and Scopus from 30th January 2010 to 12th February 2024, were included in the review. Study eligibility was assessed by two reviewers with any disagreements discussed between them or resolved by a third reviewer. Study quality and risk of bias were assessed using the Mixed Method Appraisal Tool. Further to the identification of effective strategies, our review also aimed to clarify the timeline of recovery considered and the outcomes or domains targeted by the interventions.ResultsThirteen studies were included in our review. Study duration, eHealth intervention delivery format, and outcome measures varied considerably. No studies reported a theory of behavioural change and only one study was co-produced with patients or carers. Most studies were conducted in the early post-discharge phase (i.e., < 3 months) and had feasibility as a primary outcome. The cognitive domain was the least targeted and no intervention targeted all three domains. Interventions targeting the psychological domain suggest generally positive effects. However, results were underpowered and preliminary. Though all studies were concluded to be feasible, most studies did not assess acceptability. In studies that did assess acceptability, the main facilitators of acceptability were usability and perceived usefulness, and the main barrier was sensitivity to mental health and cognitive issues.ConclusionOur systematic review highlighted the promising contributions of eHealth with preliminary support for the feasibility of interventions in the early stages of post-critical care rehabilitation. Future research should focus on demonstrating effectiveness, acceptability, the cognitive domain, and multi-component interventions.

Overcoming strong retention barriers of A- and V-series nerve agents on silica sorbents

The present study explores the potential of silica solid phase extraction for gas chromatography mass spectrometric analyses of A- and V-series nerve agents. Owing to the presence of basic amidine and amine moieties, these analyte undergo strong ionic interactions with inherently acidic silica surfaces, producing poor recoveries. Subtle optimizations in the elution composition empowered the analytes to overcome the retention barriers from sorbent surfaces. Acetone containing 10 % (v/v) NH4OH effectively minimized strong analyte-sorbent interactions allowing good to excellent recoveries. Recoveries for A-series agents ranged from 88 to 96 %. VX, which is reported to be poorly recoverable from such sorbent matrices offered best data so far, reaching up to 74 % under optimized conditions. The method detection limits for the selected analytes in mass spectrometric analysis ranged from 47 to 171 ng/ml. Strong affinities of analytes towards silica sorbent were further exploited to expand the scope of analysis and establish the method's efficacy for a wide range of organic matrices. The applicability of the method to the real world applications was also validated in blind spiking exercises in diverse organic liquid samples received in 48th, 50th and 52nd proficiency tests conducted by the Organization for the Prohibition of Chemical Weapons (OPCW).

Meta-analysis of cardiac magnetic resonance in prognosticating left ventricular function in peripartum cardiomyopathy.

Peripartum cardiomyopathy (PPCM) may result in a number of detrimental adverse cardiovascular events, notably persistent left ventricular ejection fraction (LVEF) reduction or even mortality. Imaging parameters on cardiac magnetic resonance (CMR) and their prognostic implications have rarely been perused in PPCM. We aimed to describe CMR's prognostic value in predicting poor left ventricular (LV) function recovery using late gadolinium enhancement (LGE) and T2-weighted or T2 mapping. PubMed, Europe PMC, and ScienceDirect were screened for studies on late gadolinium enhancement (LGE) and myocardial oedema using CMR and PPCM. The outcome of interest was poor LV function recovery, with a follow-up period of at least 6months. Comparisons between groups with the presence of LGE, myocardial oedema, and recovered against non-recovered patients were pooled. A random-effects model was employed to calculate the effect size. All pooled results were expressed as risk ratios (RRs) and 95% confidence intervals (CI). The area under the curve (AUC) was generated to test overall prognostic accuracy. Six cohort studies with 162 patients were included. The mean age of participants in this study was 30.6years, and the majority of patients were diagnosed with PPCM after delivery. LGE was associated with a higher risk of poor LV function recovery, particularly when conducted at a later stage of disease (≥2.8months) [RR=2.83 (95% CI=1.25-6.40); P=0.001]. On the contrary, CMR conducted early (<2.8months) exhibited a greater predictive value for myocardial oedema perceived by T2 mapping [RR=3.44 (95% CI=1.04-11.34); P=0.043]. Diagnostic-test accuracy meta-analysis revealed that LGE had a sensitivity of 73% (95% CI, 56-85%), specificity of 79% (95% CI, 45-95%), and AUC of 0.78 (95% CI, 0.75-0.82) in predicting poor LV recovery when performed in the later phase, whereas significant myocardial oedema in those with non-recovered LV function had a sensitivity of 12% (95% CI, 2-52%), specificity of 68% (95% CI, 39-88%), and AUC of 0.40 (95% CI, 0.36-0.44) while undertaken in the latter phase. Our findings support the notion that inflammation plays a significant role in PPCM and that alterations to tissue composition occur in a time-dependent manner. Contrast-enhanced CMR can be utilized as an adjunct examination in post-partum PPCM patients to stratify the risk of poor LV function recovery while conducted at a suitable point in time.

Pain Is Modulated Differently Between Females with and without Patellofemoral Pain: Factors Related to Sensitization.

Patellofemoral pain (PFP) has poor long-term recovery outcomes. Central sensitization describes central nervous system changes altering pain modulation, which can complicate recovery (poorer prognosis, worse function). Signs of central sensitization include amplified pain facilitation, pain hypersensitivity, and impaired pain inhibition, which can be measured with temporal summation of pain (TSP), pressure pain thresholds (PPTs) and conditioned pain modulation (CPM), respectively. Sex differences exist for these test responses, but female-only PFP investigations of sensitization are uncommon. Understanding pain modulation in females with PFP could improve treatment protocols. To determine whether females with PFP exhibit signs of central sensitization (greater TSP, lower PPTs, reduced CPM) compared to pain-free females. Cross-sectional Setting: Laboratory Patients or Other Participants: Thirty-three females [(20 PFP, 13 pain-free); Age: PFP 29.2 ± 7 years, pain-free 28 ± 7 years; Height: PFP 166.7 ± 5.9cm, pain-free 166 ± 9.5cm, Mass: PFP 66.7 ± 9.6kg, pain-free 69.3 ± 7.5kg). TSP was assessed with ten punctate stimuli applied to the knee and calculated by the difference in pain intensity between beginning and end responses. PPTs were tested at four sites [3 for local hypersensitivity (knee), 1 for widespread hypersensitivity (hand)]. CPM was conducted by comparing PPTs during two conditions (baseline, ice immersion). CPM response was defined as the percent difference between conditions. Between-group differences in TSP response were analyzed with a Welch's test. Separate Welch's tests analyzed group comparisons of PPTs and CPM responses at four sites. Females with PFP exhibited greater TSP response (P=0.019) and lower CPM response at patella center (P=0.010) and hand sites (P=0.007) than pain-free females. PPT group differences were not observed at any site (P>0.0125). Females with PFP modulate pain differently than pain-free females. Clinicians should recognize signs of central sensitization and their potential impact on treatment options.

Evaluating the Effects of Solid-Phase Cartridge Chemistry on Extraction of Bisphosphonates and ITPP From Equine Plasma.

Bisphosphonate drugs and myo-inositol trispyrophosphate are of concern to the racing industry and have been listed as prohibited substances in equine sports. The current bisphosphonate plasma screening analysis employed at the Australian Racing Forensic Laboratory involves the use of sequential solid-phase extraction procedures, passing the samples through a mixed mode cartridge, followed by a weak anion exchange cartridge. The eluates collected following the second extraction are then methylated and analysed by liquid chromatography-mass spectrometry. Under these extraction conditions, some bisphosphonates have shown poor recovery. To improve the extraction efficacy, the effects of cartridge chemistry were evaluated. In particular, the weak anion exchange cartridges used for screening were compared to an affinisep AttractSPE polymeric phase cartridge. The effectiveness of each extraction approach was assessed through both a visual comparison of signal to noise in extracted chromatograms and recovery measurements to determine the best approach for routine screening.

Glomerular Hematuria as a Predictor of Renal Prognosis in Malignant Hypertension Patients with Thrombotic Microangiopathy: A Propensity Score-Matched Analysis of a Biopsy-Based Cohort Study

Introduction: Malignant hypertension (mHTN) is a hypertensive emergency. Thrombotic microangiopathy (TMA) is a widespread complication of mHTN. Few studies have evaluated whether glomerular hematuria provides prognostic information for renal dysfunction in patients with mHTN-associated TMA. Methods: This observational cohort study included 292 patients with mHTN-associated TMA based on renal biopsy. Propensity-score matching (PSM) analysis was conducted to adjust for clinical characteristics in a comparison between with and without glomerular hematuria. Cox regression was employed to identify risk factors for renal prognosis. Results: A total of 70 patients with glomerular hematuria were compared to 222 patients with non-glomerular hematuria. After PSM, 67 pairs of patients with mHTN-associated TMA were matched. Patients with glomerular hematuria exhibited lower serum albumin levels, higher 24-h proteinuria, and a higher prevalence of glomerular sclerosis than those with non-glomerular hematuria. Glomerular hematuria was independently associated with deteriorated renal function compared with non-glomerular hematuria (HR: 0.51; 95% CI: 0.29–0.89, p = 0.019). This association remained significant after PSM (HR: 0.51; 95% CI: 0.28–0.91, p = 0.022). Additionally, glomerular hematuria was independently associated with renal replacement therapy (RRT) (HR: 3.14; 95% CI: 2.06–5.66, p < 0.001). This difference remained significant after PSM comparison (HR: 2.41; 95% CI: 1.34–4.33, p = 0.003). Furthermore, despite intensive blood pressure control, patients with glomerular hematuria experienced a higher incidence of RRT and a poorer recovery in renal function, specifically a 25% reduction of creatinine levels, compared to patients with non-glomerular hematuria. Conclusion: Glomerular hematuria is significantly associated with an increased risk of adverse renal outcomes in patients with mHTN-associated TMA.

Synthesis and enhanced H2S gas sensing performances of Co-doped NiO@g-C3N4 heterocomposites

Metal doping is an efficient approach to improve H2S gas sensing performances, but the metal-doped NiO is still faced poor recovery capability at low working temperature. Herein, Co-doped NiO@g-C3N4 heterocomposites were constructed firstly via a simple solid phase reaction. Texture characterizations indicate that Co-doped NiO@g-C3N4 heterocomposites with the architecture of hierarchical microspheres show high specific surface areas and rich surface oxygen vacancies. The gas-sensitive measurements exhibit that the response value of the heterocomposites with g-C3N4 content of 30 wt% (Co-NiO@g-C3N4-3) increases to 45 toward 20 ppm H2S gas at 172 °C, which is about 1.8 times of Co-NiO (23), as well as response/recovery times decreased to ca. 100/130 s. Besides, excellent repeatability, stability and selectivity of Co-NiO@g-C3N4-3 sensors are obtained. The improved H2S gas sensing performances of Co-NiO@g-C3N4 heterocomposites is mainly contributed to the formation of nano-heterojunctions, which promotes electron accumulation at nano-heterojunctions near Co-NiO, facilitates O2 molecules adsorption on the material surface and accelerates the resistance change of the sensors, resulting the enhanced gas sensing performances.

Early sleep apnea treatment in stroke (eSATIS) - a multicentre, randomised controlled, rater-blinded, clinical trial: The association of post-stroke cognition with sleep-disordered breathing and its treatment.

Sleep-disordered breathing (SDB) is linked to cognitive dysfunction. Although SDB is common in stroke patients, the impact of SDB and its early treatment on cognitive functioning after stroke remains poorly investigated. Therefore, we explored the association between SDB and post-stroke cognitive functioning, including the impact of early SDB treatment with adaptive servo-ventilation (ASV) on cognitive recovery from acute event to 3 months post-stroke. We used data from two studies, which included ischaemic stroke patients (n = 131) and no-stroke controls (n = 37) without SDB (apnea-hypopnea index, AHI <5/h) and with SDB (AHI≥20/h). Cognitive functioning was assessed within 7 days and 3 months post-stroke in stroke patients, or at study inclusion in no-stroke control group, respectively. Stroke patients with SDB were randomized to ASV treatment (ASV+) or usual care (ASV-). Linear regression adjusted for main confounders assessed the impact of SDB and its treatment on cognitive recovery. The intention-to-treat analysis did not show significant associations of SDB ASV+ (n = 30) versus SDB ASV- (n = 29) with cognitive recovery. In an exploratory subanalysis, compliant SDB ASV+ (n = 14) versus SDB ASV- showed improvements with ASV in visual memory and cognitive flexibility. Combining the stroke and non-stroke datasets, SDB (n = 85) versus no-SDB (n = 83) was associated with deficits in visual memory and response inhibition independently of stroke. SDB ASV- versus no-SDB (n = 51) was associated with less improvement in visual memory. There was no substantial evidence for benefits of intention-to-treat ASV on cognitive recovery. Exploratory analysis indicated that compliant ASV treatment could benefit visual memory and cognitive flexibility, whereas untreated SDB could contribute to a poor recovery of visual memory.

Sudden sensorineural hearing loss: audiological profile during the COVID-19 pandemic.

Sudden sensorineural hearing loss (SSNHL) is an otological emergency that requires prompt recognition and intervention to prevent devastating impacts on people's lives. During the COVID-19 pandemic, sensory deprivations have been reported in patients positive for SARS-CoV-2 virus, including deleterious effects on the auditory pathway. This study aims to describe the audiological profile of individuals with SSNHL during the COVID-19 pandemic and to correlate hearing recovery in subgroups of individuals with or without COVID-19. Prospective cohort including patients diagnosed with SSNHL evaluated in a tertiary care center between March 2020 and September 2022. Hearing loss was confirmed with pure-tone and speech audiometry, with Speech Recognition Threshold (SRT) and word recognition score (WRS). Audiometric testing was performed at the moment of diagnosis, then 7, 30 and 120 days after diagnosis. The average degree of hearing loss was assessed by calculating the 4-frequency pure tone average (4fPTA). The investigation of COVID-19 included RT-PCR technique for the SARS-CoV-2 virus and collection of information regarding disease severity. A statistical analysis was performed using an analysis of covariance (ANCOVA) model to compare the 4fPTA between the four groups (with and without a history of COVID-19, unilateral and bilateral cases) at the end of the follow-up period. Fifty-two patients with SSNHL were assessed, 40 (76.9%) with unilateral and 12 (23.1%) with bilateral hearing loss, totaling 64 ears included. Of those, 15 (28.8%) patients tested positive for SARS-CoV-2 and were symptomatic for COVID-19. Of all unilateral cases, 22.5% were seropositive and showed symptoms of COVID-19, a number that increased to 50% for bilateral cases. Comparing the COVID-19 positive groups, individuals with unilateral SSNHL went from 40 dB as their average 4fPTA at onset to 20 dB as their average 4fPTA after 120 days, whereas those with bilateral SSNHL went from an initial average of 60 dB to a final average of 66 dB. Although the 4fPTA value of individuals with unilateral SSNHL improved in 7 days, the mean values showed no significant difference between positive and negative groups. There was a higher incidence of bilateral simultaneous SSNHL in patients who had not been vaccinated against COVID-19 and who presented with symptoms of severe COVID-19. Infection with SARS-CoV-2 resulted in more severe SSNHL, in bilateral SSNHL, and in poorer recovery from SSNHL in bilateral cases. Bilateral SSNHL was seen more frequently in patients who had not received vaccination against COVID-19.

Revealing the impact of sample enrichment method on concentration and cytotoxicity of volatile disinfection byproducts in drinking water: A quantitative study for liquid-liquid extraction

Liquid-liquid extraction (LLE) combined with the N2 blow-down method is a promising tool for bioanalysis of drinking water. However, detailed information on which disinfection byproduct (DBP) classes are retained in LLE extracts is currently unavailable. In this study, the recovery of seven classes of volatile DBPs and total adsorbable organic halogens (TOX) during the LLE method, combined with three common N2 blow-down methods, for bioanalysis in real tap water was analyzed at a 2-L scale, along with their corresponding cytotoxicity. The total concentration of seven classes of volatile DBPs in drinking water in Suzhou ranged from 64.6 to 83.0 µg/L, with the majority contributed by trihalomethanes (THMs: 59.9 µg/L), haloaldehydes (HALs: 5.4 µg/L), haloacetamides (HAMs: 3.4 µg/L), and haloacetonitriles (HANs: 3.2 µg/L). During the LLE - N2 blow-down process for bioanalysis, about 69–85 % of targeted volatile DBPs and 64–75 % of TOX were lost, respectively. Seven classes of volatile DBPs accounted for 52.8–64.3 % and 23.8–61.3 % of TOX in tap water and LLE - N2 blow-down samples, respectively, suggesting that targeted aliphatic DBPs are the key contributors to TOX. Furthermore, although LLE - solvent exchange had a better recovery performance than other N2 blow-down methods, the recoveries of volatile DBPs using this method were still not ideal. For example, HALs and HAMs had a slightly better recovery (>50 %), while most volatile DBPs had a poor recovery, including iodo-trihalomethanes (I-THMs, 0 %), haloketones (28 %), THMs (26 %), halonitromethanes (33 %), and HANs (38 %). During LLE - solvent exchange, 31 % and 36 % of targeted DBPs and TOX, respectively, in real tap water can be retained, which shows better performance than non-ionic macroporous copolymers (XAD). More importantly, the water volume required in this method for cytotoxicity analysis is 2 L, which greatly reduces the burden of water sample collection, transport, and pre-treatment compared to XAD (which typically requires 5 or 10 L). In general, this paper reveals the fate of volatile DBPs during LLE - N2 blow-down and indicates that LLE - solvent exchange is a good substitute for the XAD method in bioanalysis.

The polytannic acid‐Fe(III) functionalized graphene oxide in poly (propylene carbonate) nanocomposite enabling enhanced shape memory, UV‐resistance, and self‐healing performance

AbstractPolypropylene carbonate (PPC) is a promising candidate of substrate materials used for human wearable devices due to its excellent ductility and biocompatibility. However, PPC is prone to be deformed, thus resulting in poor shape recovery property. One effective solution is to construct composites. In this work, poly (tannic acid) with Fe3+ (FPTA) @ graphene oxide (GO) was added to fabricate FPTA@GO/PPC composites. The results show that FPTA@GO can construct a tight network of hydrogen bonds into PPC to improve shape memory and self‐healing properties. By varying the FPTA@GO content, the composites exhibit tunable shape memory property. Dynamic mechanical analysis confirms that FPTA@GO/PPC composites show better shape memory properties compared with pure PPC. 5 wt% FPTA@GO/PPC composite demonstrates superior shape fixation ratio (Rf = 99%) as well as superior shape recovery ratio (Rr = 94%) in 37°C. Moreover, 5 wt% FPTA@GO/PPC composite possesses great self‐healing efficiency of 81% and tensile strength (17.2 MPa). The UV absorption capacity of 5 wt% FPTA@GO/PPC is increased by 150% (far and mid‐UV regions) and 400% (near‐UV region) compared with pure PPC. Thus, FPTA@GO/PPC composites have potential applications in developing shape memory, self‐healing, and UV‐resistant materials for human wearable devices.

Staying Ahead of the Curve: The Case for Recovery Curves in Total Knee Arthroplasty

BackgroundSensor technology embedded within the total knee arthroplasty (TKA) implant has the potential to record data that can track recovery and provide diagnostic information. In this study, we introduce the concept of physical function recovery curve analytics, which are created from daily spatial-temporal gait metrics and step counts from a large cohort of TKA patients. MethodsIn our study population, 258 patients underwent a primary TKA with a smart implanted tibial extension between October 4, 2021, and July 15, 2022, by 33 surgeons. The average age was 63 years, with 138 (54%) women. All kinematic data was collected on a Health Insurance Portability and Accountability Act (HIPAA)-compliant cloud data management platform. ResultsSummaries of the gait parameters at 6 weeks are suggestive of differences between people over and under 65 years, with the older patients walking more slowly and having shorter stride lengths. The 6-week percentiles demonstrated a strong, linear correlation to the 12-week percentiles for each gait parameter, with correlation coefficients ranging from 0.87 to 0.92. ConclusionsA novel screening gait test at 6 weeks shows promising results for predicting patients who will likely have poor recovery based on at least 1 gait parameter recovery curve at 12 weeks with high sensitivity and specificity. A future study is needed to validate the screening tool with an independent set of patients.

A carrier-free nanovaccine combined with cancer immunotherapy overcomes gemcitabine resistance

Drug resistance is a significant challenge in cancer chemotherapy and is a primary factor contributing to poor recovery for cancer patients. Although drug-loaded nanoparticles have shown promise in overcoming chemotherapy resistance, they often carry a combination of drugs and require advanced design and manufacturing processes. Furthermore, they seldom approach chemotherapy-resistant tumors from an immunotherapy perspective. In this study, we developed a therapeutic nanovaccine composed solely of chemotherapy-induced resistant tumor antigens (CIRTAs) and the immune adjuvant Toll-like receptor (TLR) 7/8 agonist R848 (CIRTAs@R848). This nanovaccine does not require additional carriers and has a simple production process. It efficiently delivers antigens and immune stimulants to dendritic cells (DCs) simultaneously, promoting DCs maturation. CIRTAs@R848 demonstrated significant tumor suppression, particularly when used in combination with the immune checkpoint blockade (ICB) anti-PD-1 (αPD-1). The combined therapy increased the infiltration of T cells into the tumor while decreasing the proportion of regulatory T cells (Tregs) and modulating the tumor microenvironment, resulting in long-term immune memory. Overall, this study introduces an innovative strategy for treating chemotherapy-resistant tumors from a novel perspective, with potential applications in personalized immunotherapy and precision medicine.

Fabrication of metal‐organic frameworks macro-structures for adsorption applications in water treatment: A review

Metal-organic frameworks (MOFs) are emerging porous organic–inorganic hybrid materials composed of metal centers/clusters and various organic ligands, which are widely used in water and wastewater treatment applications due to their large specific surface area, high porosity, tunable chemical properties and abundant active sites. However, pure MOFs powders have limitations such as poor recovery, blocked pipelines and secondary contamination in practical water treatment processes. Enabling the magnetization of MOFs or immobilizing MOFs as macroscopic MOFs materials offers new opportunities to improve solid–liquid separation performances of powdered MOFs. Besides, macroscopic MOFs materials with outstanding adsorption performance and mechanical properties by the combining of 3D particles and 2D nanosheets MOFs with other substrates are widely used for water treatment. This paper provides a comprehensive review of recent advancements in MOFs macro-structures. We firstly summarized the synthesis strategies of magnetic MOFs composites and various MOFs macro-structures such as hydrogels/aerogels, membranes, beads/spheres, others composites, etc. which can be constructed by various methods, including in-situ growth, solvothermal method, direct mixing, self-assembly, layer-by-layer growth, etc. Innovative preparation strategies to improve the mechanical properties of MOFs macro-structures were highlighted. Next the article discusses its application for adsorptive removal of various pollutants (i.e., dyes, heavy metal ions, oils and organic pollutants) from water. Finally, the challenges of macroscopic MOFs materials and their practical applications are presented, while future research directions to overcome these existing limitations are also pointed out.

Effects of fluid therapy combined with a preoperative glucose load regimen on postoperative recovery in patients with rectal cancer.

Patients with rectal cancer undergoing radical resection often have poor postoperative recovery due to preoperative fasting and water deprivation and the removal of diseased tissue, and have a high risk of complications. Therefore, it is of great significance to apply appropriate rehydration regimens to patients undergoing radical resection of rectal cancer during the perioperative period to improve the postoperative outcomes of patients. To analyze the effects of goal-directed fluid therapy (GDFT) with a preoperative glucose load regimen on postoperative recovery and complications in patients undergoing radical resection for rectal cancer. Patients with rectal cancer who underwent radical resection (n = 184) between January 2021 and December 2023 at our hospital were randomly divided into either a control group or an observation group (n = 92 in each group). Both groups received a preoperative glucose load regimen, and routine fluid replacement and GDFT were additionally implements in the control and observation groups, respectively. The operative conditions, blood levels of lactic acid and inflammatory markers, postoperative recovery, cognitive status, hemodynamic indicators, brain oxygen metabolism, and complication rates were compared between the groups. The colloidal fluid dosage, total infusion, and urine volume, as well as time to first exhaust, time to food intake, and postoperative length of hospital stay, were lower in the observation group (P < 0.05). No significant differences were observed between the two groups in terms of operation time, bleeding volume, crystalloid liquid consumption, time to tracheal extubation, complication rate, heart rate, or mean arterial pressure (P > 0.05). Compared with the control group, in the observation group the lactic acid level was lower immediately after the surgery (P < 0.05); the Mini-Mental State Examination score was higher on postoperative day 3 (P < 0.05); the pulse pressure variability (PPV) was lower at 30 min after pneumoperitoneum (P < 0.05), though the differences in the PPV of the two groups was not significant at the remaining time points (P > 0.05); tumor necrosis factor-α and interleukin-6 levels were lower on postoperative day 3 (P < 0.05); and the left and right regional cerebral oxygen saturation was higher immediately after the surgery and 30 min after pneumoperitoneum (P < 0.05). GDFT combined with the preoperative glucose load regimen is a safe and effective treatment strategy for improving postoperative recovery and risk of complications in patients with rectal cancer undergoing radical resection.

Nanofiltration membranes in asymmetric flow field-flow fractionation for improved organic matter size fractionation

Size fractionation of organic matter (OM) by asymmetric flow field-flow fractionation (FFFF) with ultrafiltration (UF) is limited by solute loss and peak resolution, particularly for low molecular weight fractions (<10 kDa). Nanofiltration (NF) with a molecular weight cut-off (MWCO) of ≤1 kDa can achieve significant OM retention and may improve OM fractionation. NF membranes with MWCOs ranging from 0.3 to 3 kDa were used to evaluate the retention and fractionation of nine OMs in the humic, polyphenol, biopolymer, and low molecular weight organic classes in stirred cell NF and FFFF. Membranes with an MWCO of 0.2–0.3 kDa (with a pure water permeability of 5–16 L.m−2.h−1.bar−1) with low OM interaction exhibited high peak recovery and resolution and hence improved OM fractionation. Loose NF (MWCO 3 kDa) exhibited a poor peak recovery because of a high OM loss due to both adhesion and permeation, particularly at high ionic strengths (>10 mM). A mixture of nine types of OM and natural organic matter samples from rivers, swamps and lakes achieved good fractionation with a 0.3 kDa (NF270) membrane at low ionic strength. The performance of NF for the analysis of OM and colloids in the smallest size range (≤1 kDa MW) could be further improved by optimizing the salt composition of the mobile phase and by overcoming the pressure limitations of FFFF channels.