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The purpose of this study is to evaluate the efficacy and safety of stimulating the vagus nerve in patients with disorders of consciousness (DOCs).Methods: A comprehensive systematic review was conducted, encompassing the search of databases such as PubMed, CENTRAL, EMBASE and PEDro from their inception until July 2023. Additionally, manual searches and exploration of grey literature were performed. The literature review was conducted independently by two reviewers for search strategy, selection of studies, data extraction, and judgment of evidence quality according to the American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) Study Quality Scale.Results: A total of 1269 articles were retrieved, and 10 studies met the inclusion criteria. Among these, there were 3 case reports, 5 case series, and only 2 randomized controlled trials (RCTs). Preliminary studies have suggested that stimulation of vagus nerve can enhance the levels of DOCs in both vegetative state/unresponsive wakefulness state (VS/UWS) and minimally conscious state (MCS). However, due to a lack of high-quality RCTs research and evidence-based medical evidence, no definitive conclusion can be drawn regarding the intervention's effectiveness on consciousness level. Additionally, there were no significant adverse effects observed following stimulation of vagus nerve.A definitive conclusion can't be drawn from this systematic review as there was a limited number of eligible studies and lowquality evidence. The findings of this systematic review can serve as a roadmap for future research on the use of stimulation of vagus nerve to facilitate recovery from DOCs.

Objectives Traumatic brain injury (TBI) affects millions annually and is a leading contributor to disability and mortality. The condition is marked by oxidative stress, inflammation, and pyroptosis, which play significant roles in neuronal impairment and functional deficits. Recent findings suggest that vagus nerve stimulation (VNS) provides neuroprotective effects in TBI, though the underlying mechanisms remain unclear. This study aims to determine in an animal model whether VNS enhances neural functional recovery post-TBI by inhibiting pyroptosis via the Orexin-A (OX-A)/NLRP3/Caspase-1/GSDMD signaling pathway, the role of OX-A was addressed via administration of the OX-A receptor antagonist SB334867. Methods Four groups of Sprague Dawley rats were randomly assigned: Sham group, TBI group, TBI + VNS group, and TBI + VNS + SB334867 group. A modified Feeney's method was utilized to induce TBI, followed by VNS administration. Neurological functions post-TBI were assessed using the modified neurological severity scale (mNSS) and morris water maze (MWM). Furthermore, a variety of techniques, including electron microscopy, Nissl staining, immunofluorescence, and quantitative polymerase chain reaction (qPCR), were employed to examine brain tissue damage, neuroinflammation, pyroptosis, and signaling pathway proteins. Results The findings revealed that VNS significantly enhanced neurological function, as indicated by lower mNSS scores and improved performance in the MWM test, suggesting a marked recovery in TBI-affected rats. Regarding tissue damage, VNS-treated rats displayed reduced brain injury, evidenced by enhanced mitochondrial integrity and diminished neuronal degeneration. Additionally, VNS reduced neuroinflammation, demonstrated by lower levels of IL-6, IL-1β, and TNF-α in the brain tissue of the TBI + VNS group as compared to the TBI group. Crucially, VNS inhibited pyroptosis by decreasing the expression levels of NLRP3, Caspase-1, ASC, and GSDMD in brain tissues. The introduction of the OX-A receptor antagonist SB334867 counteracted these protective effects, implying that VNS predominantly promotes neuroprotection via the OX-A pathway. Conclusions VNS may alleviate neurological deficits and avert brain injury following TBI by attenuating neuroinflammation and pyroptosis, likely through the OX-A/NLRP3/Caspase-1/GSDMD signaling pathway, underscoring the pivotal role of OX-A in VNS-induced neuroprotection. Consequently, VNS represents a promising therapeutic strategy for TBI, providing a novel approach to reduce inflammation and pyroptosis.

With the integration of large-scale wind power clusters into the power system, wind farms play a crucial role in grid reactive power regulation. However, the range of its reactive power remains uncertain, posing challenges in formulating a viable program for regulating reactive power to ensure the safe and cost-effective operation of the power system. Based on this, this paper develops a bi-level reactive power optimization for wind clusters integrating the power grid while considering the reactive capability. Firstly, this paper carries out a refined analysis of the wind power clusters, taking into account the characteristics of different areas to estimate the exact value of the reactive power capability in wind power clusters. Secondly, a bi-level reactive power optimization model is established. The upper-layer optimization aims to minimize active losses and voltage deviation in power system operation, while the lower-layer optimization focuses on maximizing reactive power margin utilization in wind farms. To solve this bi-level optimization model, an improved artificial fish swarm algorithm (AFSA) is employed, which decouples real variables and integer variables to enhance the optimization ability of the algorithm. Finally, the effectiveness of our proposed optimization strategy and algorithm is validated through the simulation results.

Background Eradication of oral Helicobacter pylori ( H. pylori ) not only reduces the infection rate from the transmission route but also improves the success rate of intragastric eradication. MAXPOWER Biological Bacteriostatic Liquid, developed in our previous work, is a composite biological preparation with strong antibacterial ability and unique antibacterial mechanism. The present study evaluated the efficacy of the MAXPOWER biocontrol solution on H. pylori and its success rate in eradicating oral H. pylori in clinical patients. Methods Live-dead cell staining and hemolysis test were used to evaluate the cellular safety of MAXPOWER biocontrol solution; plate spreading, live-dead bacterial staining, and scanning electron microscopy methods were used to evaluate its antimicrobial effect against H. pylori . Transcriptomics was used to analyze the changes in H. pylori genes before and after treatment. After seven days of gavage treatment, H&E staining and mice feces were collected for 16SrDNA sequencing to evaluate the animals’ safety. Oral H. pylori- positive patients were randomized to be given a placebo and MAXPOWER Bio-Bacteriostatic Liquid gargle for seven days to evaluate the effect on oral H. pylori eradication. Results In vitro tests demonstrated that this product has excellent biocompatibility and hemocompatibility and can effectively eradicate oral H. pylori. In vivo tests further showed that it has good biosafety and virtually no adverse effect on intestinal microflora. Transcriptomics analysis revealed that it kills H. pylori cells mainly by disrupting their cell membranes and metabolism. Additionally, the results of randomized controlled trials on humans disclosed that the oral H. pylori eradication rates achieved by MAXPOWER Biological Antibacterial Liquid were 71.4% and 78.9% according to the intention-to-treat and the per-protocol analysis, respectively. Conclusion MAXPOWER Biological Antibacterial Liquid is both safe and efficacious in the eradication of oral H. pylori . Trial registration This study was retrospectively registered in the ClinicalTrials.gov Trial Registry on 21/09/2023 (NCT06045832).

Multiple inverters–paralleled photovoltaic microgrid is a typical cyber‐physical system with varying line impedances and unsynchronized nodes that result in unbalanced power sharing and are prone to cause circulating current. Therefore, a complex network based on a finite‐time consensus pinning control method for microgrids is proposed in this paper. First, the distributed generators are regarded as agent nodes, and a small‐world network model is established based on complex network theory. To overcome the subjectivity of relying on expert experience to select pinning nodes in previous pinning control methods, a selection algorithm that uses only nodes with large out‐degree as pinning nodes is proposed to reduce the communication bandwidth requirement of the system. Second, the finite‐time consensus algorithm and the pinning control method are integrated to form a finite‐time consensus pinning control method. By introducing voltage and frequency correction in the primary control layer, the finite time consensus pinning control method is applied to design distributed secondary controllers. The finite‐time stability of the system is analyzed through Lyapunov stability theory. Finally, a hardware‐in‐the‐loop simulation platform is built in StarSim HIL. Compared to the traditional finite‐time control method, the proposed method can reduce the peak deviation of nodes by at least 7.7%. The experimental results validate that the proposed method can realize the accurate sharing of active and reactive power in finite time, and the dynamic response speed of the system is significantly improved, with good robustness.

In multi-input–multi-output (MIMO) dual-function radar–communication (DFRC) systems, the inevitable amplitude–phase errors increase the sidelobe of transmit beampattern and distort the synthesized waveforms, which degrades both radar and communication performance. Due to this, a robust low-sidelobe MIMO DFRC waveform design method is proposed. Firstly, a DFRC transmit signal model based on the uncertainty sets of amplitude–phase errors is established. The robust low-sidelobe MIMO DFRC waveform design problem is then formulated. In this problem, the sidelobe of transmit beampattern is minimized with the constraints on the mutual interference and the desired waveforms. To decrease the computational complexity, an alternating direction method of multipliers (ADMM)-based waveform design method is proposed, and the convergence is proved. Finally, some simulation results are presented to validate the effectiveness of the proposed method.

In the distributed multiple input multiple output (MIMO) system with the integrated radar and communication (IRAC) waveform transmitted, the synthesized transmit beampattern usually suffers from high sidelobes. To decrease the sidelobes of the transmit beampattern and accomplish radar and communication functions simultaneously in the distributed MIMO system, this paper proposes two IRAC waveform design methods. First, to minimize the maximal sidelobe of the transmit beampattern, this paper proposes the IRAC waveform design method with low sidelobes, and the designed IRAC waveform can produce the desired radar waveform in the target direction and communication waveform in the user direction, respectively. However, the designed IRAC waveform may have non-constant modulus, and it will be distorted if the power amplifier works in the saturation region. Then, to make sure the modulus of the designed IRAC waveform is constant, this paper proposes the IRAC waveform design method with constant modulus. In addition to producing the desired waveforms, the designed IRAC waveform has constant modulus. Moreover, the transmit beampattern has low sidelobes. Finally, the simulation results show that the proposed IRAC waveform design methods can simultaneously accomplish radar and communication functions and form the transmit beampattern with low sidelobes.

Early detection of caries is an urgent problem in the dental clinic. Current caries detection methods do not detect early enamel caries accurately, and do not show microstructural changes in the teeth. Optical coherence tomography (OCT) can provide imaging of tiny, demineralized regions of teeth in real time and noninvasively detect dynamic changes in lesions with high resolution and high sensitivity. Over the last 20 years, researchers have investigated different methods for quantitative assessment of early caries using OCT. This review provides an overview of the principles of enamel caries detection with OCT, the methods of characterizing caries lesion severity, and correlations between OCT results and measurements from multiple histological detection techniques. Studies have shown the feasibility of OCT in quantitative assessment of early enamel lesions but they vary widely in approaches. Only integrated reflectivity and refractive index measured by OCT have proven to have strong correlations with mineral loss calculated by digital microradiography or transverse microradiography. OCT has great potential to be a standard inspection method for enamel lesions, but a consensus on quantitative methods and indicators is an important prerequisite. Our review provides a basis for future discussions.

Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a potentially effective neuromodulation technique for addressing neurological disorders, including disorders of consciousness. Expanding upon our prior clinical study, which demonstrated the superior effectiveness of a 4-week taVNS treatment in patients with minimally conscious state (MCS) compared to those in a vegetative state/unresponsive wakefulness state, the aim of this investigation was to evaluate the safety and therapeutic efficacy of taVNS in individuals with MCS through a sham-controlled randomized double-blind clinical trial. A cohort of 50 adult patients (male = 33, female = 17) diagnosed with a MCS were randomly assigned to either the active taVNS ( = 25) or sham taVNS ( = 25) groups. The treatment period lasted for 4 weeks, followed by an 8-week follow-up period. The Coma Recovery Scale-Revised (CRS-R) and Glasgow Coma Scale (GCS) were administered at baseline and weekly during the initial 4 weeks. Additionally, the Disability Rating Scale (DRS) was used to assess the patients' functional abilities via telephone at week 12. Furthermore, various neurophysiological measures, including electroencephalogram (EEG), upper-limb somatosensory evoked potentials (USEP), brainstem auditory evoked potentials (BAEP), and P300 event-related potentials (P300), were employed to monitor changes in brain activity and neural conduction pathways. The scores for the active taVNS group in the CRS-R and GCS showed greater improvement over time compared to the sham taVNS group (CRS-R: 1-week, Z = -1.248, = 0.212; 2-week, Z = -1.090, = 0.276; 3-week, Z = -2.017, = 0.044; 4-week, Z = -2.267, = 0.023. GCS: 1-week, Z = -1.325, = 0.185; 2-week, Z = -1.245, = 0.213; 3-week, Z = -1.848, = 0.065; 4-week, Z = -1.990, = 0.047). Additionally, the EEG, USEP, BAEP, and P300 also demonstrated significant improvement in the active taVNS group compared to the sham taVNS group at week 4 (EEG, Z = -2.086, = 0.037; USEP, Z = -2.014, = 0.044; BAEP, Z = -2.298, = 0.022; P300 amplitude, Z = -1.974, = 0.049; P300 latency, t = 2.275, = 0.027). Subgroup analysis revealed that patients with MCS derived greater benefits from receiving taVNS treatment earlier (CRS-R, Disease duration ≤ 1-month, mean difference = 8.50, 95% CI = [2.22, 14.78], = 0.027; GCS, Disease duration ≤ 1-month, mean difference = 3.58, 95% CI = [0.14, 7.03], = 0.044). By week 12, the active taVNS group exhibited lower Disability Rating Scale (DRS) scores compared to the sham taVNS group (Z = -2.105, = 0.035), indicating a more favorable prognosis for MCS patients who underwent taVNS. Furthermore, no significant adverse events related to taVNS were observed during treatment. The findings of this study suggest that taVNS may serve as a potentially effective and safe intervention for facilitating the restoration of consciousness in individuals diagnosed with MCS. This therapeutic approach appears to enhance cerebral functioning and optimize neural conduction pathways. http://www.chictr.org.cn, Identifier ChiCTR2200066629.

Exploiting high-performance and cost-effective non-noble metal catalysts for oxygen reduction reaction (ORR) is still greatly important for energy storage devices such as metal-air batteries and fuel cells. In this work, CeO 2 , NiCo 2 O 4 , and NiCo 2 O 4 /CeO 2 were synthetized by facile hydrothermal method and used as an ORR catalyst. The as-prepared CeO 2 , NiCo 2 O 4 , and NiCo 2 O 4 /CeO 2 samples were measured by XRD, XPS, SEM, and TEM. Electrochemical characterization tests exhibit that the ORR activity of NiCo 2 O 4 is evidently enhanced by blending with CeO 2 nanoparticles. The NiCo 2 O 4 /CeO 2 composite exhibits more superior electrocatalytic performances and stability in alkaline solution as compared to the pure CeO 2 and NiCo 2 O 4 . The electrochemical performance of composite is very near to that of 20 wt% Pt/C. Owing to the synergistic interactions, NiCo 2 O 4 /CeO 2 favors a four-electron pathway in ORR and exhibits a higher ORR activity than CeO 2 and NiCo 2 O 4 . The outstanding performance confirms the NiCo 2 O 4 /CeO 2 composite as a promising efficient ORR catalyst in metal-air batteries and fuel cells.