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Development of practical deuteration reactions is highly valuable for organic synthesis, analytic chemistry and pharmaceutic chemistry. Deuterodehalogenation of organic chlorides tends to be an attractive strategy but remains a challenging task. We here develop a photocatalytic system consisting of an aryl-amine photocatalyst and a disulfide co-catalyst in the presence of sodium formate as an electron and hydrogen donor. Accordingly, many aryl chlorides, alkyl chlorides, and other halides are converted to deuterated products at room temperature in air (>90 examples, up to 99% D-incorporation). The mechanistic studies reveal that the aryl amine serves as reducing photoredox catalyst to initiate cleavage of the C-Cl bond, at the same time as energy transfer catalyst to induce homolysis of the disulfide for consequent deuterium transfer process. This economic and environmentally-friendly method can be used for site-selective D-labeling of a number of bioactive molecules and direct H/D exchange of some drug molecules. Deuterodehalogenation of organic chlorides is a useful strategy to install deuterium atoms at specific positions, however, it has several drawbacks. In this study, the authors report an organophotocatalytic system consisting of an aryl-amine-based photocatalyst and a common disulfide co-catalyst, for efficient deuteration of a wide range of aryl chlorides, alkyl chlorides and other halides, at room temperature in air.

The direct and selective coupling of benzenes with aliphatic hydrocarbons is a promising strategy for C(sp 2 )-C(sp 3 ) bond formation using readily available starting materials, yet it remains a significant challenge. In this study, we have developed a simplified photochemical system that incorporates catalytic amounts of iron(III) halides as multifunctional reagents and air as a green oxidant to address this synthetic problem. Under mild conditions, the reaction between a strong C(sp 2 )-H bond and a robust C(sp 3 )-H bond has been achieved, affording a broad range of cross-coupling products with high yields and commendable chemo-, site-selectivity. The iron halide acts as a multifunctional reagent that responds to visible light, initiates C -centered radicals, induces single-electron oxidation to carbocations, and participates in a subsequent Friedel-Crafts-type process. The gradual release of radical species and carbocation intermediates appears to be critical for achieving desirable reactivity and selectivity. This eco-friendly, cost-efficient approach offers access to various building blocks from abundant hydrocarbon feedstocks, and demonstrates the potential of iron halides in sustainable synthesis. The direct and selective coupling between unactivated C(sp2)-H and C(sp3)-H bonds is widely recognized as one of the most challenging tasks in organic synthesis. Here, the authors present an iron halidepromoted photochemical aerobic oxidation strategy for achieving such transformations.

Population aging has led to accelerated decline in pulmonary function, rising prevalence of depressive symptoms, and cognitive impairment, posing significant public health challenges. Although epidemiological evidence links poorer pulmonary function to subsequent cognitive decline, the pathways driving this relationship are not fully understood. We therefore investigated whether depressive symptoms mediate this relationship in older Chinese adults. Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS), including 2,320 participants aged 60 years and older. Pulmonary function was measured using peak expiratory flow (PEF). Depressive symptoms were assessed with the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). Cognitive function was evaluated through tests of episodic memory and mental intactness. Mediation analysis was conducted using Baron and Kenny's framework, and bootstrap analysis with 1,000 resamples was performed to assess direct and indirect effects. Sensitivity analyses ensured result robustness. Spearman correlation analysis showed that PEF was positively correlated with cognitive function (r = 0.20, P < 0.001) and negatively correlated with depressive symptoms (r = -0.15, P < 0.001). After adjusting for confounders, multivariate linear regression analysis indicated that baseline PEF was positively associated with subsequent cognitive function (β = 0.131, P < 0.001) and negatively associated with depressive symptoms (β = -0.064, P < 0.001). The mediation effect of depressive symptoms accounted for 9.1% of the total effect regarding baseline pulmonary function on cognitive function. Depressive symptoms partially mediate the relationship between pulmonary function and cognitive function in older adults. These findings emphasize the need for mental health interventions to mitigate cognitive decline linked to reduced pulmonary function.

Azulene-based conjugated systems are of great interests due to their unusual structures and photophysical properties. Incorporation of a transition metal into azulene skeleton presents an intriguing opportunity to combine the d π - p π and p π - p π conjugated properties. No such metallaazulene skeleton however has been reported to date. Here, we describe our development of an efficient [5 + 2] annulation reaction to rapid construction of a unique metal-containing [5-5-7] scaffold, termed metalla-dual-azulene (MDA), which includes a metallaazulene and a metal-free organic azulene intertwined by sharing the tropylium motif. The two azulene motifs in MDA exhibit distinct reactivities. The azulene motif readily undergoes nucleophilic addition, leading to N-, O- and S-substituted cycloheptanetrienyl species. Demetalation of the metallaazulene moiety occurs when it reacts with n Bu 4 NF, which enables highly selective recognition of fluoride anion and a noticeable color change. The practical [5 + 2] annulation methodology, facile functional-group modification, high and selective fluoride detection make this new π-conjugated polycyclic system very suitable for potential applications in photoelectric and sensing materials. Azulene-based conjugated systems are of great interests due to their unusual structures and photophysical properties but incorporation of a transition metal into azulene skeleton presents remains elusive. Here, the authors describe an efficient [5 + 2] annulation reaction for the rapid construction of a metalla-dual-azulene.

Cordyceps militaris ( C. militaris ) is a fungus with a long history of widespread use in folk medicine, and its biological and medicinal functions are well studied. A crucial pharmacological effect of C. militaris is immunomodulation. In this review, we catalog the immunomodulatory effects of different extracts of C. militaris , namely total extracts, polysaccharides and cordycepin . Total extracts obtained using water or 50% ethyl alcohol and polysaccharides from C. militaris were discovered to tend to promote type 1 immunity, whereas total extracts obtained using 70–80% ethyl alcohol and cordycepin from C. militaris were more likely to promote type 2 immunity. This article is the first to classify the immunomodulatory effects of different extracts of C. militaris . In addition, we discovered a relationship between different segments or extracts and differing types of immunity. This review can provide the readers a comprehensive understanding on the immunomodulatory effects of the precious folk medicine and guidance on its use for both health people and those with an immunodeficiency.

To assess the effects of virtual reality training on the cognitive, affective and psychomotor domains in nursing education among nursing students. The use of virtual reality in nursing education immerses students in realistic and interactive environments, greatly enhancing their learning experiences. However, research on its effectiveness in nursing education has shown inconsistent results, particularly regarding its impact on learner emotions related to clinical skills. Systematic review and meta-analysis. Related studies were sourced from PubMed, Cochrane, Web of Science and Embase databases from their inception until October 3, 2024. Comprehensive Meta-Analysis software was used for data analysis and the risk of bias was assessed using the Risk of Bias Tools. Eight randomized controlled trials met our inclusion criteria. The results revealed that virtual reality training significantly enhanced the development of clinical skills, having a positive impact on the cognitive, affective and psychomotor learning domains in nursing students. The following effect sizes were obtained: (1) knowledge: 0.237 (95 % CI: 0.054–0.421, p = 0.011); (2) skill: 0.682 (95 % CI: 0.299–1.064, p < 0.001); (3) self-confidence: 0.287 (95 % CI: 0.008–0.567, p = 0.044); and (4) learning satisfaction: 0.458 (95 % CI: 0.256–0.661, p < 0.001). Virtual reality nursing training enriches students’ cognitive, emotional and psychomotor skills; provides a secure setting for honing critical skills, thus boosting student confidence; and increases students' overall learning satisfaction, but shows limited impact on improving self-efficacy. Integrating virtual reality into pre-departure nursing technology education and training can enhance students' understanding of the nursing process, improve the accuracy of technical operations and promote overall learning effectiveness. •Virtual reality training significantly enhances cognitive, affective, and psychomotor learning in nursing students.•Virtual reality training in nursing education improves learning satisfaction and student confidence.•Virtual reality provides a safe and realistic environment for developing critical nursing skills.

Reduced peak expiratory flow is a common physiological change in older individuals and age is an important predictor for sarcopenia. We analyzed nationwide survey data to determine the relationship between peak expiratory flow rate and sarcopenia in older Indonesians. Community-dwelling Indonesian individuals aged ≥60 years (n = 2422; mean age = 67.21 y) from the fifth-wave data of the Indonesian Family Life Survey was selected. Sarcopenia was diagnosed based on handgrip strength, gait speed, and appendicular skeletal muscle mass measurements. Peak expiratory flow rates (PEFRs) were categorized according to their percentage of predicted flow rates as <50%, 50% to 80%, and >80%. Confounders previously determined to be associated with sarcopenia occurrence were included. Sarcopenia prevalence was 50.25%. After adjustment for confounders, PEFRs of <50% and 50% to 80% were associated with an increased sarcopenia risk (odds ratio = 5.22 and 1.88, respectively) compared with PEFRs of >80%. Poor lung function was independently associated with sarcopenia occurrence. Future studies should explore the usefulness of PEFR as a risk factor of sarcopenia.

Based on the theory of polarization conversion, this paper designs and implements two electromagnetic units with a 180-degree reflection phase difference in the range of 10-40 GHz. By coding and optimizing the spatial arrangement of the two basic units to obtain a metasurface, which makes the incident electromagnetic waves reflect diffusely, the energy in a single beam direction is reduced to realize the reduction of the radar cross section (RCS). The full wave simulated and experimental results of the reduction of the RCS of the metasurface have been presented. The RCS of the proposed metasurface can be reduced by more than 10 dB in the two broadband bands of 12.5-17.4 GHz and 20.5-36.2 GHz, and the maximum reduction can reach 26 dB, compared with a metallic surface of the same size. In addition, the optimized metasurface can also maintain a good reduction effect under oblique incident wave directions of 30, 45, 60, and 70 degrees. A very good agreement between simulation and measurement results is observed.

Objective To evaluate the effect of the individualized positive end-expiratory pressure (PEEP) lung protection ventilation strategy by combining driving pressure (ΔP) and pulmonary ultrasound (LUS)-based titration on lung function and postoperative cognitive function in patients with chronic obstructive pulmonary disease (COPD) during laparoscopic surgery. Methods A total of 108 patients with COPD undergoing laparoscopic gastrointestinal surgery under general anesthesia were included in this study. They were randomly divided into three groups (n = 36): traditional volume ventilation group (Group C), fixed PEEP 5 cmH 2 O group (Group P), and ΔP combined with LUS-based PEEP titration in the resuscitation room group (Group T). All three groups were given volume ventilation mode, I:E = 1:2; In group C, VT was 10 mL/kg and PEEP was 0 cmH 2 O; In groups P and T, VT was 6 mL/kg and PEEP was 5 cmH 2 O; After mechanical ventilation for 15 min in Group T, ΔP in combination with LUS was used to titrate PEEP. The oxygenation index (PaO2/FiO2), airway platform pressure (Pplat), dynamic lung compliance (Cdyn), Montreal Cognitive Assessment (MoCA), and venous interleukin-6(IL-6) were recorded at the corresponding time points, and the final PEEP value in Group T was recorded. Results The final PEEP value of Group T was (6.4 ± 1.2) cmH 2 O; Compared with groups C and P: PaO 2 /FiO 2 and Cdyn in Group T were significantly increased ( P  < 0.05) and value of IL-6 was significantly decreased ( P  < 0.05) at the corresponding time points. Compared with group C, the MoCA score on day 7 after surgery in Group T was significantly higher ( P  < 0.05). Conclusion Compared with the traditional ventilation strategy, the individualized ΔP combined with LUS-based PEEP titration in patients with COPD during the perioperative period of laparoscopic surgery can play a better role in lung protection and can improve postoperative cognitive function.

Purpose To examine the effects of health coaching on self‐management and quality of life (QOL) in patients with chronic kidney disease (CKD) and to evaluate whether self‐efficacy and patient activation mediate the effect of health coaching on self‐management and QOL. Design and Methods A single‐center, parallel‐group, randomized controlled trial. A total of 108 patients with stages 1 to 3a CKD participated in the study. Participants were randomly assigned to a health‐coaching intervention group or a usual care control group. Participants’ QOL (World Health Organization Quality of Life Scale), self‐management (CKD Self‐Management instrument), patient activation (Patient Activation Measure), and self‐efficacy (CKD Self‐Efficacy instrument) were measured at baseline, immediately after, and 6 weeks after the intervention. Findings Health coaching improved QOL, self‐management, patient activation, and self‐efficacy at postintervention and at 12 weeks’ follow‐up. Health coaching had a significant indirect effect on QOL through improvements in patient activation. Health coaching exerted a significant indirect effect on self‐management through improvements in self‐efficacy and patient activation. Conclusions The findings demonstrated that health coaching can effectively improve QOL and self‐management. A health‐coaching intervention can raise self‐efficacy and activation levels through which self‐management and QOL further improve. Clinical Relevance Health‐coaching strategies can be used to assist patients with early‐stage CKD in reaching their health goals and becoming activated in self‐management of their diseases.