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Background Postoperative sleep disturbance and anxiety are common after cesarean delivery and may impair early maternal recovery and psychological well-being. Dexmedetomidine (DEX), a selective α₂-adrenergic agonist, provides sedative and anxiolytic effects that may confer perioperative benefits beyond hemodynamic stabilization. Methods This prospective observational cohort study enrolled 120 women (22–38 years, ASA physical status II) undergoing elective cesarean delivery under combined spinal–epidural anesthesia. Participants were categorized into DEX or control groups according to intraoperative dexmedetomidine administration. The primary outcome was postoperative sleep quality assessed using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) on postoperative days 1–3. Secondary outcomes included anxiety evaluated by the State-Trait Anxiety Inventory (STAI), postoperative pain assessed by the visual analog scale (VAS), hemodynamic parameters, perioperative adverse events, and neonatal Apgar scores. Statistical analyses included independent-samples t tests, χ² tests, and repeated-measures analysis of variance. Results All 120 participants were included in the analysis (DEX: n  = 60; control: n  = 60), with comparable baseline characteristics between groups. Compared with controls, the DEX group demonstrated significantly lower PSQI and ESS scores across postoperative days 1–3 (day 1 PSQI: 4.88 ± 1.15 vs. 6.42 ± 1.21; ESS: 7.18 ± 1.64 vs. 9.32 ± 1.85; both P  < 0.001). Repeated-measures analysis confirmed significant group, time, and group-by-time interaction effects (all P  < 0.01). Anxiety levels decreased more prominently in the DEX group (48 h STAI: 34.85 ± 3.98 vs. 37.62 ± 4.16, P  = 0.002). Postoperative pain scores were consistently lower with DEX (VAS at 24 h: 2.68 ± 0.74 vs. 3.52 ± 0.79, P  < 0.001). Intraoperative hemodynamic variability was reduced in the DEX group for mean arterial pressure (Δ + 5.6 vs. +9.8 mmHg, P  < 0.001) and heart rate (7.8 vs. 12.1 bpm, P  < 0.001). No significant differences were observed in adverse events or neonatal Apgar scores. Improvement in anxiety was moderately associated with better postoperative sleep quality (β = 0.46, P  < 0.001). Conclusion Intraoperative dexmedetomidine administration was associated with improved short-term postoperative sleep quality, reduced anxiety, and enhanced hemodynamic stability without compromising maternal or neonatal safety in women undergoing cesarean delivery.

Premature ovarian failure (POF) is a multifactorial disease that refers to the occurrence of secondary amenorrhea, estrogen decrease, and gonadotropin increase in women under the age of 40. The prevalence of POF is increasing year by year, and the existing instances can be categorized as primary or secondary cases. This disease has adverse effects on both the physiology and psychology of women. Hormone replacement therapy is the recommended treatment for POF, and a multidisciplinary strategy is required to enhance the quality of life of patients. According to recent studies, the primary mechanism of POF is the depletion of ovarian reserve function as a result of increased primordial follicular activation or primordial follicular insufficiency. Therefore, understanding the processes of primordial follicle activation and associated pathways and exploring effective interventions are important for the treatment of POF.

Premature ovarian insufficiency (POI) is an endocrine disorder that seriously affects the reproductive health and quality of life of women of reproductive age. At present, there is no effective treatment to restore ovarian function. In recent years, accumulating studies have demonstrated that mesenchymal stem cells-derived exosomes (MSC-EXO) can restore ovarian function and fertility in POI animals by inhibiting apoptosis of ovarian granulosa cells, inflammatory response or fibrosis, and improving vascular function. However, there are still many deficiencies in this new treatment, such as the lack of standardized production of EXO, long-term safety and efficiency issues, and low homing efficiency, which limit its clinical translation and widespread application. Therefore, further research is required to address challenges such as achieving standardized mass production and targeted delivery of EXO, as well as to fully elucidate their underlying mechanisms of action. This review comprehensively summarizes the current progress of MSC-EXO in POI treatment, covering topics including MSC-EXO extraction and identification techniques, their therapeutic mechanisms in POI, POI animal models, and the clinical application potential of MSC-EXO, aiming to provide support for advancing basic research and facilitating clinical applications in this field.

Ovarian organoids are essential in female reproductive medicine, enhancing our understanding of ovarian diseases and improving treatments, which benefits women’s health. Constructing ovarian organoids involves two main processes: differentiating induced pluripotent stem cells (iPSCs) into germ and ovarian somatic cells to restore ovarian function and using extracellular matrix (ECM) to create a suitable ovarian microenvironment and scaffold. Although the technology is still in its early stages, future advancements will likely involve integrating high-throughput analysis, 3D-printed scaffolds, and efficient iPSC induction, driving progress in reproductive and regenerative medicine.

Background Bacteria usually secrete a variety of extracellular enzymes to degrade extracellular macromolecules to meet their nutritional needs and enhance their environmental adaptability. Bacillus cereus 0–9, a biocontrol bacterial strain isolated from wheat roots, has three genes annotated as encoding amylases in the genome, but their functions are unknown, and whether they are involved in the colonization process of the bacterium remains to be further studied. Methods Mutant gene strains and fluorescently tagged strains were constructed by homologous recombination, and amylase protein was expressed in the prokaryotic Escherichia coli BL21(DE3) expression system. The iodine staining method was used to measure the activity of amylase proteins. We further observed the colonization abilities of the test strains in wheat roots through frozen section technology. Results The results showed that there were three amylase-encoding genes, amyC , amyP and amyS, in the B. cereus 0–9 genome. Among the three amylase encoding genes, only amyS produced extracellular amylase whose secretion was related to signal peptide at position 1–27. The AmyS protein encoded by the amyS gene is an α-amylase. The growth of Rhizoctonia cerealis was inhibited 84.7% by B. cereus 0–9, but the biocontrol ability of the Δ amyS strain decreased to 43.8% and that of Δ amyS / amyS was restored when the amyS gene was complemented. Furthermore, the biocontrol ability of the Δ amySec strain was decreased to 46.8%, almost the same as that of the Δ amyS mutant. Due to the deletion of the amyS gene, the colonization capacities of Δ amyS (RFP) and Δ amySec (RFP) in wheat roots decreased, while that of Δ amyS / amyS (RFP) was restored after the amyS gene was complemented, indicating that the amyS gene influences the colonization of B. cereus 0–9 in wheat roots. In addition, the colonization and biocontrol abilities of the mutant were restored after the addition of sugars, such as glucose and maltose. Conclusions B. cereus 0–9 encodes three genes annotated as amylases, amyC , amyP and amyS . Only the deletion of the amyS gene with a signal peptide did not produce extracellular amylase. The AmyS protein encoded by the amyS gene is an α-amylase. Our results indicated that the amyS gene is closely related to the colonization abilities of B. cereus 0–9 in wheat roots and the biocontrol abilities of B. cereus 0–9 to fight against R. cerealis . The extracellular amylase produced by B. cereus 0–9 can hydrolyze starch and use glucose, maltose and other nutrients to meet the needs of bacterial growth. Therefore, it is very possible that the secretion and hydrolytic activities of extracellular amylase can promote the colonization of B. cereus 0–9 in wheat roots and play important roles in the prevention and control of plant diseases. Our results contribute to exploring the mechanisms of microbial colonization in plant roots.

Objective Polycystic ovary syndrome (PCOS) is one of the risk factors for cardiovascular diseases (CVDs). However, the possible association between PCOS and common CVDs remains inconclusive. The aim of this study was to explore the potential relationship between PCOS and CVDs using genetic polymorphisms. Methods We conducted two-sample Mendelian randomization (MR) analyses. In our study, 14 single nucleotide polymorphisms (SNPs) in Europeans and another 13 SNPs in Asians were applied as instrumental variables for PCOS. The largest published meta-genome-wide association studies of European ancestry and the BioBank Japan Project of Asian ancestry were used to collect the outcome data. MR analysis was performed using inverse variance weighting as the primary method. Several sensitivity analyses and instrumental variable strength evaluations were also performed to verify the reliability of results. Results Our analysis revealed that any potential causal association between genetically-predicted PCOS and the risk of CVDs do not exist. These CVDs include peripheral artery disease, atrial fibrillation, arrhythmia, cardiovascular diseases, heart failure, peripheral vascular disease, hypertension, ischemic stroke, myocardial infarction and venous thromboembolisms. Associations could not be found even after the SNPs linked to these possible confounders (body mass index, waist-to-hip ratio, and serum testosterone) were deleted. Sensitivity analysis demonstrated no presence of horizontal pleiotropy or heterogeneity. Conclusion The present mendelian randomization study suggests that genetically-predicted PCOS may not be associated with the risk of CVDs.

Placenta accreta spectrum (PAS) refers to the abnormal invasion of trophoblastic tissues. Because of its increasing morbidity and possibility of catastrophic outcomes, PAS requires an antenatal diagnosis and making full preparations in advance to realize safe delivery. Current clinical screening modalities for PAS are not always conclusive. Recently, it has been reported that bio-markers detected in maternal serum have the potential for predicting PAS during pregnancy. Some of these biomarkers, such as β-hcg, AFP, PAPP-A, and cffDNA, can be clinically detected. It is convenient for us to test and compare with standard threshold. However, how can we distinguishing PAS from other pregnancy complications through these biomarkers remains complicated. Some biomarkers are specific, such as microRNA and placenta-specific mRNA. They are stability and reliability. These biomarkers are currently research hotspots. This study aims to summarize the characteristics of the newly reported biomarkers and to point out their potential application and current limitations to provide a basis for future research. Finally, the combination of imageological examination and biomarkers will be an attractive future theme to study in diagnosing this challenging condition.

While smoking is widely acknowledged as a risk factor for rheumatoid arthritis (RA), the connection between secondhand smoke (SHS) exposure and RA in never-smoking adults remains limited and inconsistent. This study aims to explore and quantify this association using serum cotinine levels. We conducted a cross-sectional study with 14,940 adults who self-report as never smokers, using National Health and Nutrition Examination Survey data from 1999 to 2018. Based on previous literature, SHS exposure was categorized into four groups according to serum cotinine levels. Compared to individuals in the unexposed group (serum cotinine < 0.05 ng/mL), the adjusted odds ratio (OR) for RA was 1.37 (95% CI 1.14–1.64, p = 0.001) in the low exposure group (serum cotinine at 0.05 to 0.99 ng/mL) after adjusting for covariates. However, no significant association was found in the moderate exposure group (serum cotinine at 1 to 10 ng/mL) or the heavy exposure group (serum cotinine ≥ 10 ng/mL). Furthermore, we detected a non-linear, positively saturated correlation between the cotinine levels after log2 transformation and RA, with a turning point at approximately − 2.756 ng/mL (OR = 1.163, 95% CI 1.073–1.261, p = 0.0002). The stability of the results was confirmed by subgroup analysis.

The quickly processable solution deposition and accurately controllable vacuum deposition are the two competing mainstream fabrication techniques for perovskite films. However, the former may inevitably leave pinholes on film surface and calls for further treatment, the latter exhibits a generally low processing rate. In this work, we develop a solution-vacuum hybrid batch fabrication to precisely deposit nanoscale two-dimensional (2D) capping layer via all-vacuum evaporation on a solution-deposited three-dimensional bulk film. The all-vacuum-deposited 2D perovskite capping layer can be finely controlled with desired composition and stoichiometry to passivate defects and heal the pristine pinholes. We demonstrate the high processing scalability of this solution-vacuum hybrid deposition with the fabrication of 30 cm × 30 cm pinhole-free perovskite submodules, which achieve a champion power conversion efficiency (PCE) up to 22.10% (certified PCE of 21.79%). Our discovery lays out a novel way for efficient and reproducible large-scale production of perovskite modules. Traditional solution- and vacuum-deposition may leave pinholes on film surface or suffer from low throughput, respectively. Here, authors vacuum-deposit a 2D capping perovskite layer on solution deposited 3D bulk film, realizing pinhole-free solar submodules with certified efficiency close to 22%.

Background Sepsis-associated encephalopathy (SAE) is a fatal complication of sepsis, with a high mortality rate worldwide. This study aimed to reduce mortality and improve the quality of life of patients with SAEs by developing a practical nomogram to predict the risk factors associated with ICU mortality. Method The MIMIC database was used as the training set to build the model, and the eICU-CRD served as the validation set for external verification. LASSO regression analysis was conducted to identify predictive variables and develop the nomogram model. Receiver Operating Characteristic (ROC) curves were generated to assess the model’s discriminative ability. Model calibration was assessed using calibration curves and the Hosmer-Lemeshow goodness-of-fit tests. Clinical decision curves were plotted to assess the model’s net benefit and evaluate its clinical applicability. Results A total of 5,242 patients from the MIMIC database and 3,103 from the eICU-CRD were included in the study. LASSO regression, identified eight predictive variables for inclusion in the final model. The nomogram was evaluated against standard ICU scoring systems, including SAPS II, SOFA and GOS scores, with AUROC values of 0.832, 0.769, 0.607, and 0.575, respectively, in the training set. Conversely, the validation set demonstrated AUROC values of 0.825, 0.715, 0.714, and 0.587. P-values from the Hosmer-Lemeshow goodness-of-fit test for both the training and validation sets were 0.129 and 0.583, respectively, indicating a good fit quality. DCA revealed that the nomogram consistently provides greater net benefits compared to SAPS II, SOFA, and GCS scores. Conclusion Developing mortality prediction models for SAE patients in the ICU can facilitate early intervention strategies and potentially reduce mortality rates in this high-risk population. Clinical trial number Not applicable.