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This research pursues a systematic review and meta-analysis concerning the cardiovascular event risk prediction models for maintenance hemodialysis patients. Through systematic literature searching, the titles and abstracts of 23,707 related papers were initially screened, ultimately including 16 papers covering 17 prediction models. The results reveal that among these models, a total of 16 predictive variables were chosen at least twice, with age, diabetes history, and history of cardiovascular disease being the primary predictors. Regarding model validation, 14 models underwent internal validation, 3 models underwent external validation, while 3 models were not subjected to any form of validation. Additionally, calibration testing was performed on 14 models. Risk of bias assessment showed that only 1 model was rated as low risk bias, while the other models were rated as high risk bias due to issues with study cohort characteristics and methodology. Meta-analysis results showed that the combined C-statistic for 13 prediction models was 0.80 (95%CI = 0.74, 0.86), and no significant publication bias was detected. Thus, future construction and validation of prediction models should strictly follow reliable methodological standards and enhance external validation to provide more reliable evidence-based guidance for predicting cardiovascular event risk in maintenance hemodialysis patients.

Background Extracellular vesicles (EVs) derived from bone marrow mesenchymal stem cells (MSCs) pretreated with atorvastatin (ATV) (MSC ATV -EV) have a superior cardiac repair effect on acute myocardial infarction (AMI). The mechanisms, however, have not been fully elucidated. This study aims to explore whether inflammation alleviation of infarct region via macrophage polarization plays a key role in the efficacy of MSC ATV -EV. Methods MSC ATV -EV or MSC-EV were intramyocardially injected 30 min after coronary ligation in AMI rats. Macrophage infiltration and polarization (day 3), cardiac function (days 0, 3, 7, 28), and infarct size (day 28) were measured. EV small RNA sequencing and bioinformatics analysis were conducted for differentially expressed miRNAs between MSC ATV -EV and MSC-EV. Macrophages were isolated from rat bone marrow for molecular mechanism analysis. miRNA mimics or inhibitors were transfected into EVs or macrophages to analyze its effects on macrophage polarization and cardiac repair in vitro and in vivo. Results MSC ATV -EV significantly reduced the amount of CD68 + total macrophages and increased CD206 + M2 macrophages of infarct zone on day 3 after AMI compared with MSC-EV group ( P  < 0.01–0.0001). On day 28, MSC ATV -EV much more significantly improved the cardiac function than MSC-EV with the infarct size markedly reduced ( P  < 0.05–0.0001). In vitro, MSC ATV -EV also significantly reduced the protein and mRNA expressions of M1 markers but increased those of M2 markers in lipopolysaccharide-treated macrophages ( P  < 0.05–0.0001). EV miR-139-3p was identified as a potential cardiac repair factor mediating macrophage polarization. Knockdown of miR-139-3p in MSC ATV -EV significantly attenuated while overexpression of it in MSC-EV enhanced the effect on promoting M2 polarization by suppressing downstream signal transducer and activator of transcription 1 (Stat1). Furthermore, MSC ATV -EV loaded with miR-139-3p inhibitors decreased while MSC-EV loaded with miR-139-3p mimics increased the expressions of M2 markers and cardioprotective efficacy. Conclusions We uncovered a novel mechanism that MSC ATV -EV remarkably facilitate cardiac repair in AMI by promoting macrophage polarization via miR-139-3p/Stat1 pathway, which has the great potential for clinical translation.

Background Bone marrow cells (BMCs), especially mesenchymal stem cells (MSCs), have shown attractive application prospects in acute myocardial infarction (AMI). However, the weak efficacy becomes their main limitation in clinical translation. Based on the anti-inflammation and anti-apoptosis effects of a Chinese medicine-Tongxinluo (TXL), we aimed to explore the effects of TXL-pretreated MSCs (MSCs TXL ) in enhancing cardiac repair and further investigated the underlying mechanism. Methods MSCs TXL or MSCs and the derived exosomes (MSCs TXL -exo or MSCs-exo) were collected and injected into the infarct zone of rat hearts. In vivo, the anti-apoptotic and anti-inflammation effects, and cardiac functional and histological recovery were evaluated. In vitro, the apoptosis was evaluated by western blotting and flow cytometry. miRNA sequencing was utilized to identify the significant differentially expressed miRNAs between MSCs TXL -exo and MSCs-exo, and the miRNA mimics and inhibitors were applied to explore the specific mechanism. Results Compared to MSCs, MSCs TXL enhanced cardiac repair with reduced cardiomyocytes apoptosis and inflammation at the early stage of AMI and significantly improved left ventricular ejection fraction (LVEF) with reduced infarct size in an exosome-dependent way. Similarly, MSCs TXL -exo exerted superior therapeutic effects in anti-apoptosis and anti-inflammation, as well as improving LVEF and reducing infarct size compared to MSCs-exo. Further exosomal miRNA analysis demonstrated that miR-146a-5p was the candidate effector of the superior effects of MSCs TXL -exo. Besides, miR-146a-5p targeted and decreased IRAK1, which inhibited the nuclear translocation of NF-κB p65 thus protecting H9C2 cells from hypoxia injury. Conclusions This study suggested that MSCs TXL markedly facilitated cardiac repair via a new mechanism of the exosomal transfer of miR-146a-5p targeting IRAK1/NF-κB p65 pathway, which has great potential for clinical translation.

Background Bone marrow-derived mesenchymal stem cells (MSCs), which possess immunomodulatory characteristic, are promising candidates for the treatment of acute myocardial infarction (AMI). However, the low retention and survival rate of MSCs in the ischemic heart limit their therapeutic efficacy. Strategies either modifying MSCs or alleviating the inflammatory environment, which facilitates the recruitment and survival of the engrafted MSCs, may solve the problem. Thus, we aimed to explore the therapeutic efficacy of sequential transplantation of exosomes and combinatorial pretreated MSCs in the treatment of AMI. Methods Exosomes derived from MSCs were delivered to infarcted hearts through intramyocardial injection followed by the intravenous infusion of differentially pretreated MSCs on Day 3 post-AMI. Enzyme linked immunosorbent assay (ELISA) was performed to evaluate the inflammation level as well as the SDF-1 levels in the infarcted border zone of the heart. Echocardiography and histological analysis were performed to assess cardiac function, infarct size, collagen area and angiogenesis. Results Sequential transplantation of exosomes and the combinatorial pretreated MSCs significantly facilitated cardiac repair compared to AMI rats treated with exosomes alone. Notably, compared to the other three methods of cotransplantation, combinatorial pretreatment with hypoxia and Tongxinluo (TXL) markedly enhanced the CXCR4 level of MSCs and promoted recruitment, which resulted in better cardiac function, smaller infarct size and enhanced angiogenesis. We further demonstrated that exosomes effectively reduced apoptosis in MSCs in vitro. Conclusion Sequential delivery of exosomes and pretreated MSCs facilitated cardiac repair post-AMI, and combined pretreatment with hypoxia and TXL better enhanced the cardioprotective effects. This method provides new insight into the clinical translation of stem cell-based therapy for AMI.

The success of deep learning (DL) relies heavily on training data from which DL models encapsulate information. Consequently, the development and deployment of DL models expose data to potential privacy breaches, which are particularly critical in data-sensitive contexts like medicine. We propose a new technique named DiffGuard that generates realistic and diverse synthetic medical images with annotations, even indistinguishable for experts, to replace real data for DL model training, which cuts off their direct connection and enhances privacy safety. We demonstrate that DiffGuard enhances privacy safety with much less data leakage and better resistance against privacy attacks on data and model. It also improves the accuracy and generalizability of DL models for segmentation and classification of mediastinal neoplasms in multi-center evaluation. We expect that our solution would enlighten the road to privacy-preserving DL for precision medicine, promote data and model sharing, and inspire more innovation on artificial-intelligence-generated-content technologies for medicine.

Urinary tract infections (UTIs) frequently affect individuals of all ages, necessitating antibiotic treatment and medical care, which can impair quality of life and cause psychological strain. Online Health Consultation (OHC) platforms serve as a widely used communication tool, offering integrated support for medical guidance and disease management. By examining OHC interactions, this study explores the concerns and difficulties experienced by UTI patients to better understand their perspectives. Data from 20,000 anonymized UTI-related records (2020-2024) were obtained from a major Chinese online healthcare platform, Good Doctor Online. Analysis occurred in two stages: BERTopic extracted key themes and keywords from text data, followed by sentiment analysis of these findings using a generative AI language model. All data was publicly accessible and de-identified. Analysis of 18,479 cleaned records using BERTopic identified six key themes: \"Polite Expressions for Consultation,\" \"Symptom and Management Challenges,\" \"Differential Diagnosis of Cystitis,\" \"Etiology Related to Sexual Activity,\" \"Nocturnal Symptoms and Fever,\" and \"Perinatal Considerations.\" Sentiment analysis showed predominantly negative emotions, reflecting the condition's substantial physical and mental toll. The \"Etiology Related to Sexual Activity\" theme had the highest negativity (97%), while \"Polite Expressions for Consultation\" showed the most positivity (9%). These research results highlight the important role of online communities in providing support and information to patients, and the insights derived from this study can provide valuable reference for social media developers, medical service providers, and policymakers.

Deployable mechanism has received more attention in the medical field due to its simple structure, dexterity, and flexibility. Meanwhile, the advantages of the Magnetic Anchoring and Guidance System (MAGS) are further highlighted by the fact that the operators can remotely control the corresponding active and passive magnetic parts in vivo. Additionally, MAGS allows the untethered manipulation of intracorporeal devices. However, the conventional instruments in MAGS are normally rigid, compact, and less flexible. Therefore, to solve this problem, four novel deployable tubular mechanisms, Design 1 (Omega-shape mechanism), Design 2 (Fulcrum-shape mechanism), Design 3 (Archway-shape mechanism), and Design 4 (Scissor-shape mechanism) in this paper, are proposed integrated with MAGS to realize the laser steering capability. Firstly, this paper introduces the motion mechanism of the four designs and analyzes the motion characterization of each structure through simulation studies. Further, the prototypes of four designs are fabricated using tubular structures with embedded magnets. The actuation success rate, the workspace characterization, the force generation and the load capability of four mechanisms are tested and analyzed based on experiments. Then, the demonstration of direct laser steering via macro setup shows that the four mechanisms can realize the laser steering capability within the error of 0.6 cm. Finally, the feasibility of indirect laser steering via a macro-mini setup is proven. Therefore, such exploration demonstrates that the application of the deployable tubular mechanisms integrated with MAGS towards in vivo treatment is promising.

Tea plants prefer NH4+-N to NO3−-N, and thus nitrification would be detrimental to the N uptake of tea. However, the effects of different stand ages on nitrification and nitrogen oxide (NO and N2O) emissions in tropical and subtropical regions remain unclear. We performed an incubation experiment with tea field soils from different stand ages (5, 15, and 30 years) under different water contents in subtropical (Changsha, Hunan; C5L, C15L, C30L, C5H, C15H, C30H) and tropical regions (Baisha, Hainan; B5L, B15L, B30L, B5H, B15H, B30H). The results showed that the highest net nitrification rate was in C15L and B15. The results indicated that there was more NO3−-N loss in the 15-y tea field soil in both regions. The highest nitrogen oxide emissions from the subtropical and tropical plots were in C15H and B30H. Available K was the key variable for NO and N2O emissions in Changsha county, whereas SOM, pH, and available P were the key factors affecting NO and N2O emissions in Baisha county. Our findings suggest that more attention should be paid to NO3−-N loss in middle-aged (10–30 years) tea fields. Similarly, the focus should be given to nitrogen oxide emissions from middle-aged tea plantations in subtropical regions and old tea plantations (≥30 stand years) in tropical regions.

Cooking activities are responsible for substantial emissions of both particulate matter (PM) and volatile organic compounds (VOCs), two key indoor air pollutants, which can lead to numerous adverse health effects, including premature mortality. Chicken breast was prepared following tightly constrained cooking procedures with contrasting cooking methods in a well‐controlled research kitchen to investigate the PM and VOC emissions by simultaneous measurements with reference instruments (an optical aerosol spectrometer measuring light scattering of single particles for continuous PM monitoring and a proton‐transfer‐reaction time‐of‐flight mass spectrometer [PTR‐ToF‐MS] for VOCs). Peak concentrations of PM 2.5 ranked in the order (median [ μ g m −3 ]) pan‐frying (92.9), stir‐frying (26.7), deep‐frying (7.7), boiling (0.7), and air‐frying (0.6). Peak concentrations of VOCs ranked in the order (median [ppb]) pan‐frying (260), deep‐frying (230), stir‐frying (110), boiling (30), and air‐frying (20). Key VOCs from different frying methods were identified in a detailed principal component analysis (PCA), including aldehydes, ketones, furans, aromatic hydrocarbons, alkenes, pyrazines, and alkanes. The cooking temperature was found to be the key factor that positively correlated with both PM and VOC emission strength, while the oil weight was negatively correlated with the PM levels. We also determined PM emission rates (varying over a wide range, e.g., for PM 2.5 from 0.1 to 2931  μ g min −1 ) and PM exposures (ranging, e.g., for PM 2.5 from approximately 2 to more than 1000  μ g m −3  min). In addition, by using EPR spectroscopy, we measured environmentally persistent free radicals (EPFRs) that formed from heating and cooking processes at levels of approximately 10 9 spins μ g −1 of PM mass. These EPFR concentrations were shown to be unaffected by ozone exposure.