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PurposeElevated oxidative stress has been proposed as an important factor in the pathogenesis of polycystic ovary syndrome (PCOS)-related infertility. Our study was aimed at simultaneously exploring local and systemic oxidative stress in PCOS individuals and its relationship with embryo quality.MethodsWe recruited 86 PCOS cases and 60 controls. Five representative oxidative stress markers, namely, total oxidant capacity (TOC), total antioxidant capacity (TAC), malonaldehyde (MDA), glutathione (GSH), and superoxide dismutase (SOD), were measured in both follicular fluid (FF) and serum.ResultsWomen with PCOS compared to normal controls had higher levels of TOC in both FF (10.13 ± 2.68 vs.7.03 ± 2.45, P < 0.001) and serum (11.76 ± 2.92 vs. 8.82 ± 2.57, P < 0.001). The oxidative stress index (OSI, the ratio of TOC to TAC) was also higher in PCOS cases. They were still significant after BMI adjustment (Padj<0.01). In addition, the serum OSI level was much higher than the FF OSI level in both groups. Correlation analysis showed that the FF and serum TOC were negatively correlated with the high-quality embryo rate on day 3 and the later blastocyst formation rate in the PCOS group (P < 0.05). The correlation coefficient was higher in FF. Moreover, as the regression analysis data showed, the FF MDA level was significantly associated with embryo quality indicators (P < 0.05).ConclusionsPCOS was accompanied by elevated oxidative stress in both serum and FF. Even though serum oxidative stress was severe, the study suggested that FF oxidative stress contributed more to embryo quality, to which we should give more attention in the future.

This study employs the TVP-VAR-DY model to examine the risk spillover effects and dynamic interactions between traditional energy markets and green financial markets across both time and frequency domains. Furthermore, it evaluates the influence of climate policy uncertainty on these risk spillovers. The findings reveal substantial risk spillover effects between traditional energy markets and green financial markets. In the time domain, the total spillover effects exhibit distinct time-varying characteristics, with particularly pronounced changes under the influence of policy shocks. In the frequency domain, risk spillovers are significantly higher in the short term compared to the medium and long term. Additionally, climate policy uncertainty emerges as key driver of intensified risk spillovers between markets, with its influence initially increasing and then gradually diminishing over time. This study not only provides theoretical support for optimizing climate policies but also offers empirical evidence for prevention and mitigation of risk contagion between energy and green financial markets.

Background Maternal morbidity and mortality, encompassing pregnancy-related complications and obstetric disorders, pose a persistent global health challenge with significant multigenerational consequences. As the second leading cause of disability-adjusted life years (DALYs) among women of reproductive age globally, these conditions exert profound impacts on perinatal outcomes and intergenerational health equity. The Global Burden of Disease Study (GBD), recognized as the most comprehensive epidemiological surveillance system, provides critical evidence for optimizing maternal health policies through systematic quantification of disease burden patterns. This multinational study employs GBD 2021 data to conduct a spatiotemporal analysis of maternal disorder burden across 21 GBD regions and 204 countries and territories from 1990 to 2021, utilizing standardized metrics including DALYs, prevalence rates, and mortality incidence. Methods This population-based multinational investigation employed systematically collected epidemiological evidence from the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2021, with data acquisition was conducted through the standardized Global Health Data Exchange platform ( https://vizhub.healthdata.org/gbd-results/.GBD Results Tool; data retrieval date: November 11, 2024). We systematically analyzed temporal trends in maternal disorder burden from 1990 to 2021 using a standardized analytical framework stratified across three dimensions: age cohorts (10–54 years), 21 GBD-defined geographical regions, and socio-demographic index (SDI) quintiles—a composite metric integrating income, education, and fertility rates. The burden quantification employed five core metrics: (1) Disability-adjusted life years (DALYs): Integrating years of life lost (YLLs) and years lived with disability (YLDs). (2) Mortality counts: Absolute maternal deaths by etiology. (3) Estimated annual percentage change (EAPC). (4) Age-standardized mortality rate (ASMR). (5) Age-standardized DALYs rate (ASDR): Adjusted using the GBD reference population structure. All estimates reported with 95% uncertainty interval (UI) derived from 1,000 Bayesian posterior draws. Results Quantitative analysis of the Global Burden of Disease (GBD) 2021 dataset reveals significant advancements in maternal health metrics. Between 1990 and 2021, maternal mortality decreased by 60% (age-standardized mortality rate [ASMR]: 12.45 to 4.87 per 100,000), with disability-adjusted life years (DALYs) declining by 43.5% (age-standardized DALY rate [ASDR]: 780.8 to 315.3 per 100,000). The estimated annual percentage change (EAPC) for mortality (-3.1%, 95% CI: -3.2 to -2.99) and DALYs (-3.0%, 95% CI: -3.1 to -2.89) underscores sustained global progress. Maternal abortion and miscarriage (-4.67% EAPC), Maternal hemorrhage (-4.06% EAPC), and Maternal obstructed labor and uterine rupture (-3.68% EAPC) drove maternal mortality reductions. Maternal mortality peaked at ages 20–24 globally, with variations in high-income regions (peaks at 25–34 years). Hemorrhage dominated in sub-Saharan Africa, whereas high-income regions prioritized hypertensive disorder management. The highest maternal mortality remained in low-SDI regions, with a substantial 63% decrease (51.85 to 19.44 per 100,000), while high-SDI regions showed minimal changes. Disease burden from hemorrhage, hypertensive disorders, and abortion declined significantly, while ectopic pregnancy saw stagnation. Regional trends revealed substantial improvements in Southern Asia, while Sub-Saharan Africa remained challenged. Conclusions The significant decline in global maternal mortality and DALYs over the past three decades highlights the progress made in improving maternal health. However, the persistent disparities across regions and SDI levels underscore the need for targeted interventions. The findings emphasize the importance of continued surveillance and monitoring of maternal health indicators to guide policy and resource allocation. Strengthening the healthcare systems, particularly in low-SDI regions, is crucial to further reduce the burden of maternal disorders.

A bacterium showing excellent flocculation performance was isolated from sludge. Through 16S rDNA sequencing, morphological observation, and enzyme characterization, the strain was found to represent a novel bacterium of the Pseudomonas sp., termed Pseudomonas sp. GXUN74702. Pseudomonas sp. GXUN74702 was isolated from the sludge of Siyuan Lake in Guangxi Minzu University. Research showed that strain GXUN74702 had good flocculation performance. After the strain was cultured in fermentation medium (pH 7.0) containing glucose as carbon and urea as nitrogen, shaking at 30 °C 180 rpm for 36 h, the flocculation rate reached 92.5% when treating kaolin suspension with 2 mL of the fermentation broth. The microbial flocculants (MBF) GXUN74702 contained 78.90% total sugars and 6.78% protein. Ion chromatography detection showed that the monosaccharide constituents of MBF-GXUN74702 were most mannose (10.55 µg/mg), glucose (5.34 µg/mg), and glucosamine hydrochloride (1.48 µg/mg). The use of MBF-GXUN74702 for treating aquaculture wastewater was then explored, demonstrating chemical oxygen demand (COD) and biochemical oxygen demand (BOD) removal rates of 52% and 20%, respectively. In summary, Pseudomonas sp. GXUN74702 is a newly identified Pseudomonas sp. strain that shows highly efficient flocculation performance in treating aquaculture wastewater, suggesting its potential value in wastewater treatment applications. The fermentation medium components of Pseudomonas sp. GXUN74702 identified in this study are simple and easy to obtain, and the fermentation conditions of the strain are mild and not harsh, so a large number of fermentation liquid with high flocculation performance can be obtained in a short time. The main component of MBF-GXUN74702 has been proved to be polysaccharides that are superior to inorganic and synthetic organic flocculants owing to their non-toxicity, biodegradability, high efficiency, free secondary pollution, and wide adaption to pH variation. At present, the team has obtained the flocculants powder of the strain under laboratory conditions. The production process of this powder is simple, the yield and flocculation rate are high, and the property is stable and easy to preserve.

IntroductionEmbryoGlue, a commercially available hyaluronic acid (HA)-enhanced culture medium, is commonly recommended as an adjunct to support embryo implantation. Given the current lack of conclusive evidence regarding its efficacy and safety, this study aims to evaluate the effectiveness and safety of HA-enriched medium in women undergoing in vitro fertilisation (IVF) treatment.Methods and analysisThis multicentre, patient-blinded, randomised controlled trial involves couples planning a single fresh or frozen blastocyst-stage embryo transfer. On the morning of embryo transfer, individual blastocysts are randomly allocated to either a high-concentration HA medium (EmbryoGlue, 0.5 mg/mL) or a conventional low-concentration HA medium (G-2 PLUS, 0.125 mg/mL). The primary outcome is live birth rate per embryo transfer, with secondary outcomes including biochemical pregnancy rate, clinical pregnancy rate, miscarriage rate, ectopic pregnancy rate, ongoing pregnancy rate, multiple pregnancy rate, as well as obstetric and perinatal outcomes and related complications. The trial plans to enrol 858 female patients from four IVF centres in China, with 429 patients in each group.Ethics and disseminationThe study has been approved by the Ethics Committee of Northwest Women’s and Children’s Hospital (approval no.: 2024–127), and all participating centres have obtained approvals from their respective institutional review boards or ethics committees. Results will be disseminated through publication in a peer-reviewed open-access journal and oral presentations at relevant domestic and international academic conferences.Trial registration numberNCT06492785.

Background With the increased use of assisted reproductive technology (ART), assessing the potential health risks of children conceived on ART important to public health. Most research in this area has focused on the effects of ART on perinatal, metabolic, and oncological risks in children. Although an increased risk of immune-related diseases has been reported in children born after ART, there are no studies on the immunological status of these children. This study aimed to evaluate the impact of different embryo transfer methods and fertilization strategies on the immune status of the offspring. Methods A total of 69 children born to women treated with ART and a matched control group of 17 naturally conceived (NC) children, all aged from 3 to 6 years, were recruited in the reproductive hospital affiliated to Shandong University. The frequency of immune cells in the peripheral blood was assayed using flow cytometry; plasma cytokine levels were determined by multiplex cytokine immunoassay with human cytokine magnetic beads. Results Compared to children born after natural conception, children born after ART had elevated interferon-γ (IFN-γ) levels, regardless of embryo transfer and fertilization strategies. Children in the fresh-embryo transfer group had significantly higher IL-4 levels and a lower ratio of IFN-γ to IL-4 than those in the NC group (( P  = 0.004, 10.41 ± 5.76 pg/mL vs 18.40 ± 7.01 pg/mL, P  = 0.023, 1.00 ± 0.48 vs 0.67 ± 0.32, respectively). Similar results were shown in either the in vitro fertilization (IVF) group or the intra-cytoplasmic sperm injection (ICSI) group ( P  < 0.05 and P  = 0.08 for IVF; P  < 0.05 and P  < 0.05 for ICSI, respectively). These alterations in IL-4 concentrations and the ratio of IFN-γ to IL-4 were statistically significantly correlated with supra-physical E 2 (estradiol) levels on the day of hCG administration ( R  = 0.502, P  = 0.017; R  = − 0.537, P  = 0.010, respectively). Consistently, the frozen embryo transfer did not result in alterations of these immune indicators in the offspring. Overall, there were no significant differences between the ART group and NC group in the frequencies of T cells, B cells, natural killer (NK) cells, CD4 + T cells, CD8 + T cells, T helper (T H )1 cells, T H 17 cells, and regulatory T (T reg ) cells and cytokine levels of IL-10 and IL-17a (all P  > 0.05). Conclusions Immunological alterations existed in children born after the use of ART. The elevated E 2 levels before embryo implantation contributed to the increased IL-4 levels in children conceived by fresh embryo transfer. The assessment of immunological alteration is of importance to children conceived by ART for early monitoring and intervention.

Purpose The aim of the study was to evaluate the value of lung ultrasound (LUS) in patients with cardiogenic shock treated by venoarterial extracorporeal membrane oxygenation (VA-ECMO). Methods A retrospective study was conducted in Xuzhou Central Hospital from September 2015 to April 2022. Patients with cardiogenic shock who received VA-ECMO treatment were enrolled in this study. The LUS score was obtained at the different time points of ECMO. Results Twenty-two patients were divided into a survival group (n = 16) and a nonsurvival group (n = 6). The intensive care unit (ICU) mortality was 27.3% (6/22). The LUS scores in the nonsurvival group were significantly higher than those in the survival group after 72 h (P < 0.05). There was a significant negative correlation between LUS scores and PaO 2 /FiO 2 and LUS scores and pulmonary dynamic compliance(Cdyn) after 72 h of ECMO treatment ( P  < 0.001). ROC curve analysis showed that the area under the ROC curve (AUC) of T 72 -LUS was 0.964 (95% CI 0.887 ~ 1.000, P < 0.01). Conclusion LUS is a promising tool for evaluating pulmonary changes in patients with cardiogenic shock undergoing VA-ECMO. Trial registration The study had been registered in the Chinese Clinical Trial Registry(NO.ChiCTR2200062130 and 24/07/2022).

Background Dexmedetomidine, an α2-receptor agonist, provides potent sedation, analgesia, and anxiolysis without respiratory depression and is used in a variety of surgical and procedural situations. Aim of the review The aim of this study was to estimate the incidence of bradycardia in pediatric patients who received dexmedetomidine as a sole agent for any procedural, intensive care or surgical sedation. Method Literature was searched in electronic databases and studies were selected by following pre-determined eligibility criteria. Meta-analyses were carried out by pooling the percent incidence of bradycardia to attain a weighted overall effect size. Age-wise subgroup analyses and meta-regression analyses for the identification of factors affecting the incidence were also performed. Results Data of 2835 patients from 21 studies were included. The mean age was 62.21 ± 35.68 months. Initial, maintenance and total doses of dexmedetomidine (mean ± standard deviation) were 1.63 ± 0.33 μg/kg body weight, 0.86 ± 0.68 μg/kg/h, and 26.7 ± 20.8 μg/kg. The overall incidence of bradycardia (95% confidence interval) was 3.067 (2.863, 3.270)%; P  < 0.0001. However, range was wider (0–22%) with 9 studies observed 0% incidence. The mean change in the heart rate was −17.26 (−21.60, −12.92); P  < 0.00001. In the meta-regression analyses, age, body weight and dexmedetomidine dose were not significantly associated with the incidence of bradycardia. The minimum heart rate observed during the dexmedetomidine treatment period was positively associated with baseline heart rate. Conclusion Incidence of bradycardia in dexmedetomidine treated pediatric patients is 3%.

Common chemotherapeutic agents such as oxaliplatin often cause neuropathic pain during cancer treatment in patients. Such neuropathic pain is difficult to treat and responds poorly to common analgesics, which represents a challenging clinical issue. Corydalis yanhusuo is an old traditional Chinese medicine with demonstrated analgesic efficacy in humans. However, the potential analgesic effect of its active component, levo-tetrahydropalmatine ( l -THP), has not been reported in conditions of neuropathic pain. This study found that l -THP (1–4 mg/kg, i.p.) produced a dose-dependent anti-hyperalgesic effect in a mouse model of chemotherapeutic agent oxaliplatin-induced neuropathic pain. In addition, we found that the anti-hyperalgesic effect of l -THP was significantly blocked by a dopamine D 1 receptor antagonist SCH23390 (0.02 mg/kg), suggesting a dopamine D 1 receptor mechanism. In contrast, l -THP did not significantly alter the general locomotor activity in mice at the dose that produced significant anti-hyperalgesic action. In summary, this study reported that l -THP possesses robust analgesic efficacy in mice with neuropathic pain and may be a useful analgesic in the management of neuropathic pain.