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Owing to its 100% theoretical salt rejection capability, membrane distillation (MD) has emerged as a promising seawater desalination approach to address freshwater scarcity. Ideal MD requires high vapor permeate flux established by cross-membrane temperature gradient (∆T) and excellent membrane durability. However, it’s difficult to maintain constant ∆T owing to inherent heat loss at feedwater side resulting from continuous water-to-vapor transition and prevent wetting transition-induced membrane fouling and scaling. Here, we develop a Ti 3 C 2 T x MXene-engineered membrane that imparts efficient localized photothermal effect and strong water-repellency, achieving significant boost in freshwater production rate and stability. In addition to photothermal effect that circumvents heat loss, high electrically conductive Ti 3 C 2 T x MXene also allows for self-assembly of uniform hierarchical polymeric nanospheres on its surface via electrostatic spraying, transforming intrinsic hydrophilicity into superhydrophobicity. This interfacial engineering renders energy-efficient and hypersaline-stable photothermal membrane distillation with a high water production rate under one sun irradiation. Membrane distillation is susceptible to thermal inefficiency and membrane wetting issues during seawater desalination. Here, authors design a MXene-engineered membrane that imparts efficient localized photothermal effect and strong water repellency, achieving sustainable freshwater production.

The ever-increasing demand for low-carbon energy underscores the urgency of harvesting renewable energy sources. Despite notable progress, current energy harvesting techniques are still limited by low efficacy and poor durability. Biological systems exhibit diverse principles of energy harvesting owing to their ability to interact with the environment. In this Review, we explore diverse energy harvesting processes in nature to establish a fundamental understanding of nature’s strategies and provide a biomimicry design blueprint for high-efficiency energy harvesting systems. Next, we systematically discuss recent progress in nature-inspired surface/interface designs for efficient energy harvesting from water, sunlight and heat. We then highlight emerging hybrid approaches that can integrate multiple energy conversion processes within a single design through interface engineering to achieve mutual reinforcement. Finally, we deliberate on remaining fundamental and technical challenges to guide future research directions and potential applications of sustainable energy harvesting.Nature evolves intricate surfaces/interfaces to achieve high energy efficiency, providing a promising, low-carbon solution to energy crisis. This Review explores diverse energy processes in nature and how to translate nature’s inspiration to efficiently harvest energy from water, sunlight, heat and their hybrids, especially through interfacial engineering.

The intestinal epithelium provides an important barrier against bacterial endotoxin translocation, which can regulate the absorption of water and ions. The disruption of epithelial barrier function can result in water transport and tight junction damage, or further cause diarrhea. Therefore, reducing intestinal epithelial barrier injury plays an important role in diarrhea. Inflammatory response is an important cause of intestinal barrier defects. Daidzein improving the barrier integrity has been reported, but the effect on tight junction proteins and aquaporins is not well-described yet, and the underlying mechanism remains indistinct in the human intestinal epithelium. This study aimed to investigate the effects and mechanisms of daidzein on intestinal epithelial barrier injury induced by LPS, and a barrier injury model induced by LPS was established with human colorectal epithelial adenocarcinoma cell line Caco-2 cells. We found that daidzein protected the integrity of Caco-2 cell monolayers, reversed LPS-induced downregulation of ZO-1, occludin, claudin-1, and AQP3 expression, maintained intercellular junction of ZO-1, and suppressed NF-κB and the expression of inflammatory factors (TNF-α, IL-6). Furthermore, we found that daidzein suppressed the phosphorylation of the PI3K/AKT and P38 pathway-related proteins and the level of the related genes, and the PI3K/AKT and P38 pathway inhibitors increased ZO-1, occludin, claudin-1, and AQP3 expression. The study showed that daidzein could resist LPS-induced intestinal epithelial barrier injury, and the mechanism is related to suppressing the PI3K/AKT and P38 pathways. Therefore, daidzein could be a candidate as a dietary supplementation or drug to prevent or cure diarrhea.

Omniphobic membranes, due to their exceptional properties, have drawn significant attention for overcoming the bottleneck in membrane distillation (MD) technology. This study demonstrates an innovative method for fabricating an omniphobic membrane that is simple and facile compared to other methods such as wet/dry etching and photolithography. The surface morphology of springtails was imitated using electrospraying technique to coat a polyvinylidene fluoride substrate with concave-shaped polystyrene beads that were successfully developed by controlling the electrical traction (voltage) and air resistance (humidity). Then, the lipid coating of springtail surfaces was mimicked by dip-coating the membrane in a low-toxicity short-chain perfluoropolyether lubricant. The concave structure’s tiny air pockets increased membrane hydrophobicity significantly, indicated by the fact that the first round of water bouncing took only 16.3 ms. Finally, in MD treatment of seawater containing 1.0 mM sodium dodecyl sulfate, the optimized omniphobic membrane maintained a stable 99.9% salt rejection rate. Here, authors successfully fabricated a springtail-inspired nano-concave reentrant structured polystyrene (PS) membrane using electrospraying technology followed by lubricant dip-coating, which endowed the membrane with omniphobic properties.

To investigate the predictive value of sarcopenia and systemic immune-inflammatory index (SII) for short-term complications and long-term outcome after radical surgery in patients with distal cholangiocarcinoma. Retrospective collection of clinical data from patients who underwent radical surgery for distal cholangiocarcinoma was conducted. The patients were then divided into two groups: sarcopenia group and normal group, based on their skeletal muscle index (SMI). Logistic regression was employed to analyze the risk factors for major postoperative complications (Clavien-Dindo ≥ grade III). Additionally, Cox proportional hazards model was used to identify independent risk factors for overall survival (OS) and disease-free survival (DFS). Also, a nomogram model was developed for predicting OS and DFS at 1 and 3 years after surgery. A total of 111 patients were finally included in the study based on the inclusion-exclusion criteria. Multifactorial logistic regression analysis revealed that sarcopenia was an independent risk factor for major postoperative complications in distal cholangiocarcinoma patients ( P  < 0.001). Furthermore, multifactorial Cox regression analysis indicated that sarcopenia and high SII levels were independent risk factors affecting OS and DFS ( P  < 0.05). A nomogram model, incorporating preoperative sarcopenia, SII, and other factors, exhibited strong predictive efficacy, calibration, and clinical utility for OS and DFS after radical surgery. Sarcopenia and high SII levels are associated with poor prognosis and are independent risk factors for OS and DFS in patients undergoing radical surgery for distal cholangiocarcinoma. Sarcopenia and SII are convenient, inexpensive, and reliable markers for improving postoperative prognosis and new therapeutic strategies for patients with distal cholangiocarcinoma.

Background The current study explored the effect of virtual simulation and jaw model on development of preclinical periodontal skills in undergraduate students. The study also sought to explore effectiveness of VR in periodontal preclinical training and determine adequate performance mode in basic periodontal education to improve future preclinical training strategies. Methods Sixty volunteer sophomores and juniors from the stomatology department in Lanzhou university were enrolled to the current study. Participants were randomly assigned into four groups (each group, n  = 15) including the traditional jaw model group (Group J) which was the control group, virtual reality group (Group V), virtual-jaw group (Group V-J), and jaw-virtual group (Group J-V). Participants received training on uniform basic periodontal knowledge before completing the first theoretical assessment. Participants further underwent a total 8 h of operation training and completed a second theoretical assessment. Performance of participants was evaluated using the supragingival scaling processes, and clinical operation scores were graded by a blinded professional using an established standard scoring system. Results The findings showed no significant difference in the first theoretical outcomes between the four groups ( P  > 0.05). The scores of the second theoretical assessment were significantly improved for the V-J and J-V groups (60.00 ± 4.47, 58.33 ± 4.35) compared with the scores of the first theoretical exam (49.67 ± 4.81, 48.00 ± 4.93, P  < 0.05). The operation process scores of students in Group V-J and J-V (72.00 ± 5.92; 70.00 ± 3.05) were significantly higher compared with the scores in the other two groups (V: 61.67 ± 7.85; J: 60.67 ± 2.58). The scaling process performance of students in Group V-J and J-V (53.00 ± 3.05; 63.40 ± 4.39) was improved compared with that of students in the other two groups (V: 41.90 ± 5.23; J: 47.40 ± 4.31). Conclusion The findings show that combination of virtual reality and jaw model during periodontal preclinical training increases students’ grades and improves acquiring of professional skills. Findings from the current study indicate that the jaw model should be applied prior to virtual reality to ensure high efficacy.

Periodontitis is a chronic inflammatory disease driven by dysbiotic microbial biofilms and localized reactive oxygen species (ROS) accumulation, with inflammation management made challenging by recurrent infections from residual pathogenic bacteria in the periodontal pockets. To address this, we engineered an injectable pH-responsive hydrogel (MH@ZIF-8/CS/β-GP) through the integration of minocycline hydrochloride (MH)-encapsulated zeolitic imidazolate framework-8 (ZIF-8) nanoparticles into a chitosan (CS) and β-glycerophosphate (β-GP) crosslinked matrix. The MH@ZIF-8 displayed broad-spectrum antimicrobial efficacy against key periodontal pathogens including Porphyromonas gingivalis ( Pg ), and Aggregatibacter actinomycetemcomitans ( Aa ), primarily attributed to the synergistic antimicrobial effects of Zn ions and MH. Additionally, MH@ZIF-8 effectively eliminated ROS by inhibiting the NLRP3/Caspase-1/IL-1β signaling pathway, demonstrating potent anti-inflammatory effect in lipopolysaccharide (LPS)-stimulated RAW264.7 cells. The MH@ZIF-8/CS/β-GP hydrogel, which exhibited favored cytocompatibility with human gingival fibroblasts (HGFs), undergoed a rapid sol-gel transition and pH-responsive sustained-release drug delivery under the acidic conditions of periodontal pockets, effectively responding to periodontitis microenvironment. Meanwhile, this hydrogel effectively alleviated alveolar bone loss in vivo. Overall, the developed MH@ZIF-8/CS/β-GP hydrogel presents a novel strategy for chronic periodontitis treatment and demonstrates promising clinical application potential. Graphical abstract

Background Chronic obstructive pulmonary disease (COPD) patients face elevated perioperative risks, yet evidence-based guidelines for preoperative hemoglobin optimization in non-cardiac surgery remain undefined. This study investigated the association between preoperative hemoglobin levels and postoperative outcomes in the high-risk population, with emphasis on nonlinear dynamics and clinically actionable thresholds. Methods In this retrospective cohort study, 346 COPD patients undergoing non-cardiac surgery were analyzed. Multivariable regression models (adjusted for demographics, comorbidities, and surgical factors) evaluated the association of hemoglobin and length of stay (LOS), mortality, and other complications. Restricted cubic splines and threshold analysis characterized nonlinear relationships, while subgroup analysis and sensitivity analysis assessed effect heterogeneity. Results For every 1 g/L increase in Hemoglobin, LOS was shortened by 0.09 days (95% CI −0.15 ~ −0.04; P  = 0.001) and mortality was decreased by 9% (OR = 0.92; 95% CI 0.86 ~ 0.98; P  = 0.013). Moderate/Severe anemia (Hb < 90 g/L) increased mortality 23-fold (OR = 23.42; 95% CI 1.8 ~ 304.23; P  = 0.013) and postoperative delirium (POD) risk ninefold (OR = 9.27; 95% CI 1.77 ~ 48.53; P  = 0.02). There was a non-linear relationship between Hemoglobin and LOS/POD. Subgroup analysis and forest plots indicated heterogeneity in the inverse hemoglobin-LOS association. Sensitivity analysis showed the effect of anemia on LOS was significant in the elderly (OR = 5.19, 95% CI −1.1 ~ 11.49; P  = 0.007) and pulmonary hypertension subgroup (OR = 6.88, 95% CI 2.33 ~ 11.43; P  < 0.001). Conclusion Preoperative hemoglobin optimization may be particularly beneficial for COPD patients undergoing non-cardiac surgery, with effects potentially more pronounced in elderly patients or those with pulmonary hypertension. However, our study was underpowered to confirm subgroup-specific effects due to sample size limitations. Future research should prioritize these high-risk subgroups for targeted preoperative optimization trials.

In this prospective study of an in-vivo cervical examination using optical coherence tomography (OCT), we evaluated the diagnostic value of non-invasive and real-time OCT in cervical precancerous lesions and cancer diagnosis, and determined the characteristics of OCT images. 733 patients from 5 Chinese hospitals were inspected with OCT and colposcopy-directed biopsy. The OCT images were compared with the histological sections to find out the characteristics of various categories of lesions. The OCT images were also interpreted by 3 investigators to make a 2-class classification, and the results were compared against the pathological results. Various structures of the cervical tissue were clearly observed in OCT images, which matched well with the corresponding histological sections. The OCT diagnosis results delivered a sensitivity of 87.0% (95% confidence interval, CI 82.2–90.7%), a specificity of 84.1% (95% CI 80.3–87.2%), and an overall accuracy of 85.1%. Both good consistency of OCT images and histological images and satisfactory diagnosis results were provided by OCT. Due to its features of non-invasion, real-time, and accuracy, OCT is valuable for the in-vivo evaluation of cervical lesions and has the potential to be one of the routine cervical diagnosis methods.

Background Early childhood caries (ECC) is a major global public health concern, necessitating its early screening. This study aimed to establish a caries risk assessment (CRA) platform for managing caries in community preschool children in underdeveloped regions of Northwest China. Methods We collected clinical examination and questionnaire data of children aged 3 to 5 years in six regions of Gansu Province. Then we selected variables using least absolute shrinkage and selection operator (LASSO) regression and constructed a CRA model utilizing multivariate logistic regression analyses. The predictive performance was assessed by the receiver operating characteristic (ROC), calibration, clinical decision and impact curves. The subgroup application was analyzed on the basis of the residence of children. Results The CRA model included age, residence, feeding pattern within six months of birth, history of toothache, and history of dental visits as predictors. The Hosmer–Lemeshow test showed that the model fitting was acceptable (χ 2  = 7.049, P  = 0.531). And the model exhibited an excellent discriminatory performance in external cohort, as evidenced by the ROC curve parameters, with an area under the ROC curve (AUC) of 0.804 (95% CI: 0.765–0.844), sensitivity of 0.807, and specificity of 0.660. The calibration curves showed that the model exhibited good predictive accuracy, and the clinical decision and impact curves showed that the model was useful within reasonable threshold probabilities. Finally, we created an online prediction platform to ensure public use of the CRA model. Conclusions The presented CRA model offers a novel public platform with the potential to serve as an effective tool for the screening and management of deciduous caries at the community level in underdeveloped regions of Northwest China.