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Combining traditional textiles with triboelectric nanogenerators (TENGs) gives birth to self-powered electronic textiles (e-textiles). However, there are two bottlenecks in their widespread application, low power output and poor sensing capability. Herein, by means of the three-dimensional five-directional braided (3DB) structure, a TENG-based e-textile with the features of high flexibility, shape adaptability, structural integrity, cyclic washability, and superior mechanical stability, is designed for power and sensing. Due to the spatial frame-column structure formed between the outer braided yarn and inner axial yarn, the 3DB-TENG is also endowed with high compression resilience, enhanced power output, improved pressure sensitivity, and vibrational energy harvesting ability, which can power miniature wearable electronics and respond to tiny weight variations. Furthermore, an intelligent shoe and an identity recognition carpet are demonstrated to verify its performance. This study hopes to provide a new design concept for high-performance textile-based TENGs and expand their application scope in human-machine interfacing. Low power output and poor sensing ability are bottlenecks for the practical application of fabric-based triboelectric nanogenerators (TENGs). The authors develop a shape adaptable and highly resilient 3D braided TENG, which is endowed with enhanced power output and improved pressure sensitivity.

Background Metagenomic next-generation sequencing (mNGS) has been increasingly applied in sepsis. We aimed to evaluate the diagnostic and therapeutic utility of mNGS of paired plasma and peritoneal drainage (PD) fluid samples in comparison to culture-based microbiological tests (CMTs) among critically ill patients with suspected acute intra-abdominal infections (IAIs). Methods We conducted a prospective study from October 2021 to December 2022 enrolling septic patients with suspected IAIs ( n  = 111). Pairwise CMTs and mNGS of plasma and PD fluid were sent for pathogen detection. The mNGS group underwent therapeutic regimen adjustment based on mNGS results for better treatment. The microbial community structure, clinical features, antibiotic use and prognoses of the patients were analyzed. Results Higher positivity rates were observed with mNGS versus CMTs for both PD fluid (90.0% vs. 48.3%, p  < 0.005) and plasma (76.7% vs. 1.6%, p  < 0.005). 90% of enrolled patients had clues of suspected pathogens combining mNGS and CMT methods. Gram-negative pathogens consist of most intra-abdominal pathogens, including a great variety of anaerobes represented by Bacteroides and Clostridium . Patients with matched plasma- and PD-mNGS results had higher mortality and sepsis severity. Reduced usage of carbapenem (30.0% vs. 49.4%, p  < 0.05) and duration of anti-MRSA treatment (5.1 ± 3.3 vs. 7.0 ± 8.4 days, p  < 0.05) was shown in the mNGS group in our study. Conclusions Pairwise plasma and PD fluid mNGS improves microbiological diagnosis compared to CMTs for acute IAI. Combining plasma and PD mNGS could predict poor prognosis. mNGS may enable optimize empirical antibiotic use.

HighlightsThe 3D honeycomb-like fabric decorated with MXene is woven as solar evaporator.The honeycomb structure enables light-trapping and recycling of convective and radiative heat.The 3D honeycomb-fabric evaporator possesses high solar efficiency up to 93.5% under 1 sun irradiation and excellent salt harvesting ability.Solar steam generation technology has emerged as a promising approach for seawater desalination, wastewater purification, etc. However, simultaneously achieving superior light absorption, thermal management, and salt harvesting in an evaporator remains challenging. Here, inspired by nature, a 3D honeycomb-like fabric decorated with hydrophilic Ti3C2Tx (MXene) is innovatively designed and successfully woven as solar evaporator. The honeycomb structure with periodically concave arrays creates the maximum level of light-trapping by multiple scattering and omnidirectional light absorption, synergistically cooperating with light absorbance of MXene. The minimum thermal loss is available by constructing the localized photothermal generation, contributed by a thermal-insulating barrier connected with 1D water path, and the concave structure of efficiently recycling convective and radiative heat loss. The evaporator demonstrates high solar efficiency of up to 93.5% and evaporation rate of 1.62 kg m−2 h−1 under one sun irradiation. Moreover, assisted by a 1D water path in the center, the salt solution transporting in the evaporator generates a radial concentration gradient from the center to the edge so that the salt is crystallized at the edge even in 21% brine, enabling the complete separation of water/solute and efficient salt harvesting. This research provides a large-scale manufacturing route of high-performance solar steam generator.

REV-ERBα, the NR1D1 (nuclear receptor subfamily 1, group D, member 1) gene product, is a dominant transcriptional silencer that represses the expression of genes involved in numerous physiological functions, including circadian rhythm, inflammation, and metabolism, and plays a crucial role in maintaining immune functions. Microglia-mediated neuroinflammation is tightly associated with various neurodegenerative diseases and psychiatric disorders. However, the role of REV-ERBα in neuroinflammation is largely unclear. In this study, we investigated whether and how pharmacological activation of REV-ERBα affected lipopolysaccharide (LPS)-induced neuroinflammation in mouse microglia in vitro and in vivo. In BV2 cells or primary mouse cultured microglia, application of REV-ERBα agonist GSK4112 or SR9011 dose-dependently suppressed LPS-induced microglial activation through the nuclear factor kappa B (NF-κB) pathway. In BV2 cells, pretreatment with GSK4112 inhibited LPS-induced phosphorylation of the inhibitor of NF-κB alpha (IκBα) kinase (IκK), thus restraining the phosphorylation and degradation of IκBα, and blocked the nuclear translocation of p65, a NF-κB subunit, thereby suppressing the expression and secretion of the proinflammatory cytokines, such as interleukin 6 (IL-6) and tumor necrosis factor α (TNFα). Moreover, REV-ERBα agonist-induced inhibition on neuroinflammation protected neurons from microglial activation-induced damage, which were also demonstrated in mice with their ventral midbrain microinjected with GSK4112, and then stimulated with LPS. Our results reveal that enhanced REV-ERBα activity suppresses microglial activation through the NF-κB pathway in the central nervous system.

Myometrial invasion affects the prognosis of endometrial cancer. However, discrepancies exist between pre-operative magnetic resonance imaging staging and post-operative pathological staging. This study aims to validate the accuracy of artificial intelligence (AI) for detecting the depth of myometrial invasion using a deep learning technique on magnetic resonance images. We obtained 4896 contrast-enhanced T1-weighted images (T1w) and T2-weighted images (T2w) from 72 patients who were diagnosed with surgico-pathological stage I endometrial carcinoma. We used the images from 24 patients (33.3%) to train the AI. The images from the remaining 48 patients (66.7%) were used to evaluate the accuracy of the model. The AI then interpreted each of the cases and sorted them into stage IA or IB. Compared with the accuracy rate of radiologists’ diagnoses (77.8%), the accuracy rate of AI interpretation in contrast-enhanced T1w was higher (79.2%), whereas that in T2w was lower (70.8%). The diagnostic accuracy was not significantly different between radiologists and AI for both T1w and T2w. However, AI was more likely to provide incorrect interpretations in patients with coexisting benign leiomyomas or polypoid tumors. Currently, the ability of this AI technology to make an accurate diagnosis has limitations. However, in hospitals with limited resources, AI may be able to assist in reading magnetic resonance images. We believe that AI has the potential to assist radiologists or serve as a reasonable alternative for pre-operative evaluation of the myometrial invasion depth of stage I endometrial cancers.

Abstract Objective To identify the analgesic effectiveness of acupuncture after total knee replacement by systematic review. Methods A search of randomized controlled trials was conducted in five English medical electronic databases and five Chinese databases. Two reviewers independently searched in five English medical electronic databases and five Chinese databases. Two reviewers independently retrieved related studies, assessed the methodological quality, and extracted data with a standardized data form. Meta-analyses were performed with all-time-points meta-analysis. Results A total of seven studies with 891 participants were included. The meta-analysis results indicated that acupuncture had a statistically significant influence on pain relief (standardized mean difference = −0.705, 95% CI −1.027 to −0.382, P = 0.000). The subgroup analysis results showed that acupuncture’s effects on analgesia had a statistically significant influence (standardized mean difference= −0.567, 95% CI −0.865 to −0.269, P = 0.000). The main acupuncture points that produced an analgesic effect when they were used after total knee replacement included the Xuehai, Liangqiu, Dubi, Neixiyan, Yanglingquan, and Zusanli points. Electroacupuncture frequency ranged between 2 and 100 Hz. Conclusions As an adjunct modality, the use of acupuncture is associated with reduced pain and use of analgesic medications in postoperative patients. In particular, ear acupuncture 1 day before surgery could reduce analgesia .

HighlightsA fully fabric-based mechanical energy harvester with a sandwich structure is developed, which can respond to the pressure change by the fall of leaves.A self-powered keyboard with the ability of biometric recognition is demonstrated, which is able to resist illegal intrusion by judging the keystroke behaviors.Combination flexible and stretchable textiles with self-powered sensors bring a novel insight into wearable functional electronics and cyber security in the era of Internet of Things. This work presents a highly flexible and self-powered fully fabric-based triboelectric nanogenerator (F-TENG) with sandwiched structure for biomechanical energy harvesting and real-time biometric authentication. The prepared F-TENG can power a digital watch by low-frequency motion and respond to the pressure change by the fall of leaves. A self-powered wearable keyboard (SPWK) is also fabricated by integrating large-area F-TENG sensor arrays, which not only can trace and record electrophysiological signals, but also can identify individuals' typing characteristics by means of the Haar wavelet. Based on these merits, the SPWK has promising applications in the realm of wearable electronics, self-powered sensors, cyber security, and artificial intelligences.

Cancer research is undergoing a paradigm shift from solely studying tumor cells to investigating systemic effects of cancer in the tumor macroevironment, with an emphasis on the interactions between host organs and tumors. The theory of homeostasis is an important basis for explaining biological functions from the perspective of the organism. Organic homeostasis relies on brain-body crosstalk through interception, immunoception, nociception and other supervisory processes, guaranteeing normal physiological function. Recent studies reveal that malignant tumors can hijack and exploit the brain and its central-peripheral neuronal networks to disrupt the body's homeostasis. Tumors likely disrupt normal brain-body crosstalk by establishing bidirectional brain-tumor connections. On the contrary, organism utilize these mechanisms to hinder tumorigenesis and progression. Standing at the perspective of brain-body crosstalk also promotes the conceptional evolution of cancer initiation and development, and more importantly, provides additional insight for cancer treatment. In this review, we summarize current knowledge about brain-body crosstalk under tumor-bearing contexts and propose some novel anti-cancer strategies. Graphical Abstract Brain-body crosstalk participates in the battle between tumors and the organism: The homeostasis of the organism is collectively maintained by interoception, nociception, neuroception, endocriception, metaboception and immunoception. However, in tumor states, tumors hijack the brain-body crosstalk system to exploit these homeostatic mechanisms, thereby constructing a macroenvironment conducive to their survival and progression. While tumors hijack the brain-body crosstalk to reestablish homeostasis, the host organism simultaneously counteracts the tumor through brain-body crosstalk, safeguarding its intrinsic homeostasis from disruption. The brain-body crosstalk between tumors and multiple organs mediated by the HPA axis-driven humoral regulation and the sympathetic and parasympathetic nerves plays a significant role in the battle between tumors and the organism. TME, tumor microenvironment; HPA, hypothalamic-pituitary-adrenal; SAS, sympatho-adrenal system. This figure was created using BioRender ( https://biorender.com/ ). Highlights ● Cancer research has experienced a conceptional evolution, from simply regarding cancer as an unorganized cell mass to a newborn organ. Therefore, standing at the perspective of interactions between organs provides novel insight for this area. ● The organic homeostasis is supervised and exerted respectively by interception, nociception, neuroception, endocriception, metaboception and immunoception, which are tightly associated with brain and other components of the nervous system. ● Tumors could hijack the brain-body crosstalk to facilitate their own survival and progression. In turn, the host could utilize this axis to constrain cancer development, and ideally promote cancer elimination. ● According to theory of brain-body crosstalk, the importance of approaches such as targeted treatment, combined therapy and comprehensive therapy is worthy of emphasis and implementation.

The relationship between serum uric acid (SUA) and mortality in patients with cardiovascular disease (CVD) remains controversial. We aimed to explore the relationship between SUA and all-cause mortality (ACM) and cardiovascular mortality (CVM) in adult patients with CVD. This cohort study included 3977 patients with CVD from the National Health and Nutrition Examination Survey (2005–2018). Death outcomes were determined by linking National Death Index (NDI) records through December 31, 2019. We explored the association of SUA with mortality using weighted Cox proportional hazards regression models, subgroup analysis, Kaplan-Meier survival curves, weighted restricted cubic spline (RCS) models, and weighted threshold effect analysis among patients with CVD. During a median follow-up of 68 months (interquartile range, 34–110 months), 1,360 (34.2%) of the 3,977 patients with cardiovascular disease died, of which 536 (13.5%) died of cardiovascular deaths and 824 (20.7%) died of non-cardiovascular deaths. In a multivariable-adjusted model (Model 3), the risk of ACM (HR 1.38, 95% CI 1.16–1.64) and the risk of CVM (HR 1.39, 95% CI 1.04–1.86) for participants in the SUA Q4 group were significantly higher. In patients with CVD, RCS regression analysis revealed a nonlinear association ( p  < 0.001 for all nonlinearities) between SUA, ACM, and CVM in the overall population and in men. Subgroup analysis showed a nonlinear association between ACM and CVM with SUA in patients with CVD combined with chronic kidney disease (CKD), with thresholds of 5.49 and 5.64, respectively. Time-dependent ROC curves indicated areas under the curve of 0.61, 0.60, 0.58, and 0.55 for 1-, 3-, 5-, and 10-year survival for ACM and 0.69, 0.61, 0.59, and 0.56 for CVM, respectively. We demonstrate that SUA is an independent prognostic factor for the risk of ACM and CVM in patients with CVD, supporting a U-shaped association between SUA and mortality, with thresholds of 5.49 and 5.64, respectively. In patients with CVD combined with CKD, the association of the ACM and the CVM with SUA remains nonlinear.