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In this trial involving patients with intracerebral hemorrhage, intensive BP lowering (target systolic BP <140 mm Hg) did not significantly reduce the rate of the primary outcome of death or major disability but did significantly improve overall functional outcomes. Acute intracerebral hemorrhage, which is the least treatable form of stroke, affects more than 1 million people worldwide annually, 1 , 2 with the outcome determined by the volume and growth of the underlying hematoma. 3 – 5 Blood pressure often becomes elevated after intracerebral hemorrhage, 6 frequently reaching very high levels, and is a predictor of outcome. 7 – 11 On the basis of the results of the pilot-phase study, Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial 1 (INTERACT1), 12 – 14 we conducted the main-phase study, INTERACT2, 15 to determine the safety and effectiveness of early intensive lowering of blood pressure in patients with intracerebral hemorrhage. . . .

Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta-burst stimulation (iTBS) can be used to manage post-stroke spasticity, but a meta-analysis of the recent randomized-controlled trials (RCTs) is lacking. Our aim is to perform a meta-analysis of the RCTs that investigated the efficacy of rTMS in patients with post-stroke spasticity. PubMed, Embase, and Cochrane Library databases were searched for eligible papers published up to February 2020. The primary outcome was the Modified Ashworth Scale (MAS), measured as the effect of rTMS compared with controls and after rTMS (using a change score calculated separately in the active and sham treatment groups). Finally, five papers and eight data sets were included. rTMS had no significant benefit on MAS in patients with post-stroke spasticity compared to sham treatment (WMD = − 0.29, 95% CI − 0.58, 0.00; P = 0.051). When analyzing the change score in the treatment groups, a significant effect of rTMS was observed (WMD = − 0.27, 95% CI − 0.51, − 0.04; P = 0.024). When analyzing the change score in the sham treatment groups, no significant effect of sham treatment was observed, indicating no placebo effect (WMD = 0.32, 95% CI: − 0.40, 1.04; P = 0.387). We included the sample size, year of publication, percentage of male patients, and age difference in each study as covariates, and performed a meta-regression. The results showed no association between these variables and the MAS. Compared with sham stimulation, rTMS did not show a significant reduction in MAS for the patients who experienced post-stroke spasticity, but the patients reported a better outcome in MAS on a before-after scenario.

Human umbilical cord mesenchymal stem cell‐derived exosomes (hucMSC‐exosomes) have been implicated as a novel therapeutic approach for tissue injury repair and regeneration, but the effects of hucMSC‐exosomes on coxsackievirus B3 (CVB3)‐induced myocarditis remain unknown. The object of the present study is to investigate whether hucMSC‐exosomes have therapeutic effects on CVB3‐induced myocarditis (VMC). HucMSC‐exosomes were identified using nanoparticle tracking analysis (NTA), transmission electron microscopy (TEM) and Western blot. The purified hucMSC‐exosomes tagged with PKH26 were tail intravenously injected into VMC model mice in vivo and used to administrate CVB3‐infected human cardiomyocytes (HCMs) in vitro, respectively. The effects of hucMSC‐exosomes on myocardial pathology injury, proinflammatory cytokines and cardiac function were evaluated through haematoxylin and eosin (H&E) staining, quantitative polymerase chain reaction (qPCR) and Doppler echocardiography. The anti‐apoptosis role and potential mechanism of hucMSC‐exosomes were explored using TUNEL staining, flow cytometry, immunohistochemistry, Ad‐mRFP‐GFP‐LC3 transduction and Western blot. In vivo results showed that hucMSC‐exosomes (50 μg iv) significantly alleviated myocardium injury, shrank the production of proinflammatory cytokines and improved cardiac function. Moreover, in vitro data showed that hucMSC‐exosomes (50 μg/mL) inhibited the apoptosis of CVB3‐infected HCM through increasing pAMPK/AMPK ratio and up‐regulating autophagy proteins LC3II/I, BECLIN‐1 and anti‐apoptosis protein BCL‐2 as well as decreasing pmTOR/mTOR ratio, promoting the degradation of autophagy flux protein P62 and down‐regulating apoptosis protein BAX. In conclusion, hucMSC‐exosomes could alleviate CVB3‐induced myocarditis via activating AMPK/mTOR‐mediated autophagy flux pathway to attenuate cardiomyocyte apoptosis, which will be benefit for MSC‐exosome therapy of myocarditis in the future.

It is crucial to realize the point‐of‐care (POC) testing of harmful analytes, capable of saving limited agricultural resources, assisting environmental remediation, ensuring food safety, and enabling early disease diagnosis. Compared with other conventional POC sensing strategies, aggregation‐based analytical chemistry facilitates the practical‐oriented development of POC nanosensors by altering the aggregation status of nanoprobes through the action of multiple aggregation‐induced “forces” originating from the targets. Herein, we have proceeded with a comprehensive review focusing on the aggregation‐based analytical chemistry in POC nanosensors, covering aggregation‐induced “forces”, aggregation‐induced signal transductions, aggregation‐induced POC nanosensing strategies, and their applications in biomolecular monitoring, food safety analysis, and environmental monitoring. Finally, challenges existing in practical applications have been further proposed to improve their sensing applications, and we expect our review can speed up the development of cost‐effective, readily deployable, and time‐efficient nanosensors through aggregation‐based analytical chemistry. This review summarizes the recent progress of aggregation‐based analytical chemistry in POC nanosensors. After reviewing the aggregation‐induced “forces” for nanoprobes, the aggregation‐induced signal transductions and POC nanosensors are discussed. Subsequently, the application of aggregation‐based analytical chemistry‐driven POC nanosensors in medicine, food, and environment are reviewed. This review is expected to provide new insights into the fabrication of POC nanosensors through aggregation‐based analytical chemistry and promote the development of aggregation‐based analytical chemistry with high speed.

Urban co-creation is an approach to urban design that actively involves stakeholders and end-users in the design process. As designers increasingly use digital tools to manage design information, stakeholders and residents may find it difficult to participate, resulting in a lack of engagement. The emergence of metaverse technologies offers a crucial opportunity to employ user-friendly and collaborative tools, enabling more effective participation. In the study presented in this article, a custom-designed digital game with virtual reality environment was used to facilitate a series of co-creation workshops. The study focused on changes in participants’ experience by comparing baseline and endline survey results against the design outputs. It employed a holistic framework considering four dimensions: game design, participatory experience, learning outcomes and co-creation results. The findings indicate that the digitally gamified approach helped enhance participation and knowledge sharing, and even though game design ratings varied, the use of video games motivated engagement, particularly in an intergenerational context. The co-creation workshop design documented in this article offers new methods to enhance community engagement in urban design. Especially during digital transformation, it opens renewed discussions on balancing traditional output-driven approaches with more participant-centric methods and design objectives.

Engineering multimetallic nanocatalysts with the entropy‐mediated strategy to reduce reaction activation energy is regarded as an innovative and effective approach to facilitate efficient heterogeneous catalysis. Accordingly, conformational entropy‐driven high‐entropy alloys (HEAs) are emerging as a promising candidate to settle the catalytic efficiency limitations of nanozymes, attributed to their versatile active site compositions and synergistic effects. As proof of the high‐entropy nanozymes (HEzymes) concept, elaborate PdMoPtCoNi HEA nanowires (NWs) with abundant active sites and tuned electronic structures, exhibiting peroxidase‐mimicking activity comparable to that of natural horseradish peroxidase are reported. Density functional theory calculations demonstrate that the enhanced electron abundance of HEA NWs near the Fermi level (EF) is facilitated via the self‐complementation effect among the diverse transition metal sites, thereby boosting the electron transfer efficiency at the catalytic interface through the cocktail effect. Subsequently, the HEzymes are integrated with a portable electronic device that utilizes Internet of Things‐driven signal conversion and wireless transmission functions for point‐of‐care diagnosis to validate their applicability in digital biosensing of urinary biomarkers. The proposed HEzymes underscore significant potential in enhancing nanozymes catalysis through tunable electronic structures and synergistic effects, paving the way for reformative advancements in nano‐bio analysis. As a proof of concept for high‐entropy nanozymes (HEzymes), a class of PdMoPtCoNi nanowires with abundant active sites and tuned electronic structure are designed, and with density functional theory calculations it is demonstrated that their peroxidase‐mimicking activity is comparable to HRP originating from the d electrons self‐complementation effect. The HEzymes are combined with a portable electronic device to achieve IoT‐activated POC digital urinalysis.

Pursuing nanozymes with predominant catalytic activities holds great potential in meeting the needs of multi‐field applications, such as in the environment, yet remains challenging. Herein, the cutting‐edge strategies for boosting nanozyme catalysis are systematically analyzed from four synergistic dimensions, and a theoretical framework is developed integrating morphological structure, electronic structure, external stimulation, and machine learning (ML)‐aided design. From the morphological perspective, the structure‐activity relationship between nanostructures and catalytic performance is elucidated, revealing the regulatory mechanism underlying active site exposure, substrate accessibility, and electron transfer kinetics. Subsequently, the electronic structure governed by catalytic activities through precisely optimizing adsorption energy and reaction pathways, such as d‐band center, eg occupancy, defect engineering, spin state, etc., is discussed in depth. Then, the mechanism underlying the dynamic regulation of catalytic activity via external stimulations, such as ultrasound, light, electric field, etc., is systematically summarized. Notably, the revolutionary role of ML‐driven high‐throughput screening in analyzing complex structure‐activity relationships and accelerating the discovery of high‐performance nanozymes is emphasized. Ultimately, this paper highlights the key role of interdisciplinary integration, encompassing material science, catalytic engineering, and artificial intelligence, etc., in overcoming current bottlenecks, unlocking the potential of nanozymes to address global challenges, and providing a new perspective for advancing the development of nanozymology. This review systematically analyzes cutting‐edge strategies for boosting nanozyme catalysis through multi‐dimensional synergistic engineering, containing morphology, electronic structure modulation, external stimulation, and machine learning‐aided design. A theoretical framework is proposed to decode structure‐activity relationships, offering interdisciplinary insights to improve the nanozymes' catalysis in addressing global challenges, thus advancing nanozymology.

Highlights Review of the state-of-the-art synthesis strategies for single-atom nanozymes. Analysis of the recent advances in single-atom nanozymes for monitoring and control of environmental pollutants. Challenges and perspectives of single-atom nanozymes in environmental pollutants monitoring and control. As environmental pollutants pose a serious threat to socioeconomic and environmental health, the development of simple, efficient, accurate and cost-effective methods for pollution monitoring and control remains a major challenge, but it is an unavoidable issue. In the past decade, the artificial nanozymes have been widely used for environmental pollutant monitoring and control, because of their low cost, high stability, easy mass production, etc. However, the conventional nanozyme technology faces significant challenges in terms of difficulty in regulating the exposed crystal surface, complex composition, low catalytic activity, etc. In contrast, the emerging single-atom nanozymes (SANs) have attracted much attention in the field of environmental monitoring and control, due to their multiple advantages of atomically dispersed active sites, high atom utilization efficiency, tunable coordination environment, etc. To date, the insufficient efforts have been made to comprehensively characterize the applications of SANs in the monitoring and control of environmental pollutants. Building on the recent advances in the field, this review systematically summarizes the main synthesis methods of SANs and highlights their advances in the monitoring and control of environmental pollutants. Finally, we critically evaluate the limitations and challenges of SANs, and provide the insights into their future prospects for the monitoring and control of environmental pollutants.

The escalating global burden of infectious diseases demands biosensing technologies that transcend the complexity‐sensitivity‐accuracy trade‐off in real‐world applications. Herein, an interpretable machine learning‐empowered multimodal biosensor synergizing electron transfer‐enhanced nanozymes and aggregation‐induced emission luminogens (AIEgens) for ultrasensitive pathogen detection is presented. By engineering aminophenol formaldehyde resin nanobowls anchored with monodisperse Pt nanoparticles, interfacial electron transfer (N→Pt→O) induces an upshift of Pt d‐band center relative to the Fermi level, as validated by density functional theory. This electronic modulation optimizes H2O2 adsorption energy, lowers the energy barrier of the rate‐determining step, and reduces activation energy, resulting in a 3.4‐fold enhancement in peroxidase‐like activity over conventional Pt nanozymes. Then, AIEgens are strategically integrated to generate cross‐validated anti‐interference signals, achieving a record‐low detection limit for Salmonella typhimurium, surpassing classical immunoassays in sensitivity and accuracy. A SHapley Additive exPlanations (SHAP)‐guided eXtreme Gradient Boosting (XGBoost) algorithm dynamically fuses multimodal signals, enhancing sensitivity by five fold over single‐mode detection and delivering 100% diagnostic accuracy for positive samples. SHAP further deciphers the synergetic mechanism, revealing concentration‐dependent signal contributions and validating decision logic. This work pioneers a nanozyme‐AI co‐design framework, bridging d‐band‐driven catalytic precision and machine learning‐powered signal intelligence to redefine biosensing paradigms for combating public health emergencies. This study pioneers a rational nanozyme design strategy guided by electron transfer mechanisms while advancing biosensing paradigms through interpretable machine learning‐enhanced signal intelligence. By transforming biosensors from passive transducers to active diagnostic systems, this work establishes a versatile framework for addressing global health crises through synergistic nanomaterial engineering and artificial intelligence.

Current therapeutics options for viral myocarditis are unsatisfactory. Melatonin (MLT), a hormone secreted by the pineal gland and other organs, has protective effects on ischemic heart injury. However, the potential therapeutic effect of MLT on viral myocarditis is unknown. In this study, we investigated the protective effect of MLT on viral myocarditis in a mouse model of myocarditis infected with coxsackievirus B3 (CVB3) and explored the probable mechanisms. Mice with CVB3-induced myocarditis displayed inflammatory cell infiltration and interstitial edema. MLT treatment significantly ameliorated the myocardial injuries. In addition, the rate of autophagy changed, although apoptosis was inhibited in mouse hearts following treatment with MLT. These results suggest that MLT has a strong therapeutic effect on acute viral myocarditis, which is associated with changes in autophagy and apoptosis in the heart. Thus, MLT could be a promising novel therapeutic approach against viral myocarditis.