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Electrochemical actuators directly converting electrical energy to mechanical energy are critically important for artificial intelligence. However, their energy transduction efficiency is always lower than 1.0% because electrode materials lack active units in microstructure, and their assembly systems can hardly express the intrinsic properties. Here, we report a molecular-scale active graphdiyne-based electrochemical actuator with a high electro-mechanical transduction efficiency of up to 6.03%, exceeding that of the best-known piezoelectric ceramic, shape memory alloy and electroactive polymer reported before, and its energy density (11.5 kJ m −3 ) is comparable to that of mammalian skeletal muscle (~8 kJ m −3 ). Meanwhile, the actuator remains responsive at frequencies from 0.1 to 30 Hz with excellent cycling stability over 100,000 cycles. Furthermore, we verify the alkene–alkyne complex transition effect responsible for the high performance through in situ sum frequency generation spectroscopy. This discovery sheds light on our understanding of actuation mechanisms and will accelerate development of smart actuators. Transduction efficiency in electrochemical actuators hardly exceeds 1% because the current electrode materials do not allow to efficiently exploit microstructural changes to achieve large actuation effects. Here the authors demonstrate transduction efficiencies up to 6% in actuators by using graphdiyne as electrode material.

Background The prevalence of depression symptoms and related modifiable factors in prostate cancer (PCa) are not well evaluated. We aimed to assess the effects of perceived social support, hope and resilience on depressive symptoms within 18 months after diagnosis of PCa, and to evaluate the role of hope and resilience as mediators of that relationship. Method A cross-sectional study was analyzed in consecutive inpatients with PCa during the months of January 2018 and August 2019. A total of 667 patients eligible for this study completed questionnaires on demographic and clinic variables, Center for Epidemiologic Studies Depression Scale, Multidimensional Scale of Perceived Social Support, Adult Hope Scale, and Resilience Scale (14 items). All registered patients were all volunteers and anonymous. Depressive symptoms, perceived social support, hope and resilience were measured anonymously. Out of 667 patients, a total of 564 effective respondents (< 30% missing data) became our subjects. Hierarchical linear regression was used to identify the factors associated with depressive symptoms. Asymptotic and resampling strategies were used to conduct the mediating effects of hope and resilience. Results The prevalence of depressive symptoms was 65.9% in PCa patients. Hierarchical regression analyses indicated that perceived social support, hope, and resilience together accounted for 27.5% variance of depressive symptoms. Support from family, hope, and resilience significantly associated with depressive symptoms, respectively. Hope (a*b = − 0.0783, BCa95% CI: − 0.134 to − 0.0319, p  < 0.05), and resilience (a*b = − 0.1315, BCa95% CI: − 0.1894 to − 0.0783, p  < 0.05) significantly mediated the association between perceived social support and depressive symptoms. Conclusions The high prevalence of depressive symptoms among PCa patients should receive more attention. Perceived social support, hope and resilience could be positive resources for combating depressive symptoms, and hope and resilience mediated the association between perceived social support and depressive symptoms. Enhancing social support, particularly the support form family, and improving patients’ outlook and resilience may be potential targets for future psychosocial interventions aimed at reducing depressive symptoms.

CaTiO3 nanocuboids (width 0.3–0.5 μm, length 0.8–1.1 μm) have been synthesized by a hydrothermal route using commercial P25 as the titanium source. The as-prepared sample was systematically characterized by means of x-ray powder diffraction, field-emission scanning electron microscopy, field-emission transmission electron microscopy, x-ray photoelectron spectroscopy, Brunauer–Emmett–Teller, ultraviolet–visible diffuse reflectance spectroscopy and electrochemical impedance spectroscopy. The photocatalytic activity of the sample was evaluated by degrading rhodamine B under simulated sunlight irradiation. It is demonstrated that CaTiO3 nanocuboids exhibit superior photocatalytic activity when compared with CaTiO3 nanoparticles. By investigating the effect of scavengers on the dye degradation and the yield of hydroxyl (·OH) radicals, it is concluded that ·OH is the dominant reactive species.

Treatment of ocular infection involves pharmacotherapy with steroids and antibiotic drops, such as moxifloxacin hydrochloride (MFH) and dexamethasone sodium phosphate (DSP). To characterize the pharmacokinetics of these two compounds, we performed and validated a liquid chromatography-mass spectrometry (LC-MS/MS) method to quantify them in rabbit ocular tissues and plasma. We used protein precipitation to extract the compounds. The analyte and internal standard (IS) were separated using a Shim-pack Scepter C18 column. The mobile phase was composed of 0.1% formic acid water (A) and methanol (B). MFH and DSP were detected using positive ion electrostatic ionization (ESI) in multiple reaction monitoring mode (MRM). The calibration curves for both compounds showed good linearity over concentrations ranging from 0.5 to 200 ng/mL in rabbit ocular tissues and plasma. The lower limit of quantification for both MFH and DSP was 0.5 ng/mL. We validated this method for selectivity, linearity (r2 > 0.99), precision, accuracy, matrix effects, and stability. Thus, we used this method to assess the pharmacokinetic (PK) characteristics of MFH and DSP in rabbit ocular tissues and plasma after single doses. Our results indicate that this method can be used for the simultaneous analysis of moxifloxacin hydrochloride and dexamethasone sodium phosphate in clinical samples.

Objectives Advanced cancer patients face various symptoms, which can cause physical and psychological distress. As a multidimensional construct, spiritual well-being (SWB) may be an inner resource for dealing with these problems. Our study explored the impact of different dimensions of SWB on physical and psychological symptoms in advanced cancer patients admitted to a palliative care unit. Methods This cross-sectional study was conducted among 108 advanced cancer patients in the Hospice Ward, Shengjing Hospital of China Medical University. Patients completed questionnaires on SWB and cancer-related symptoms (insomnia, fatigue, pain, depression and anxiety) at the time of admission. Linear regression analysis was applied to determine the relationship between SWB (meaning, peace and faith) and symptom distress. Results SWB accounted for an additional variance of cancer-related symptoms (17.8% to 44.4%). Meaning was negatively associated with insomnia (β = -0.516, p < 0.001) and fatigue (β = -0.563, p < 0.001). Peace and faith were related to lower psychological symptoms, while meaning represented a positive effect on anxiety (β = 0.275, p = 0.036). Higher peace was associated with lower cancer pain (β = -0.422, p < 0.001). Conclusions Our findings suggested that achieving peace and faith appeared to function consistently as a positive resource for advanced cancer patients on depression, anxiety and pain, while meaning may serve to facilitate or hinder positive adjustment. Future studies should focus on the potential clinical implications by identifying the distinct dimension of SWB as symptom management targets in the palliative care practice.

Our review systematically outlines the bioactivity and industrial applications of key functional compounds in roses, with a particular focus on their potential in food and pharmaceutical industries from technical, economic, and commercialization perspectives. We summarize the evidence supporting the efficacy of rose-derived polyphenols, flavonoids, and essential oils in areas including antioxidant, anti-inflammatory, antibacterial, and neuroprotective effects, which provide a scientific basis for their use in functional foods and preventive medicines. We further evaluated the commercial viability of processing rose by-products. Additionally, we analyze current and potential applications of rose bioactive compounds in natural food preservatives, functional dietary supplements, herbal medicines, and cosmetic products. Finally, we discuss the remaining challenges and future directions for the industrial utilization of roses, including standardization, efficacy validation in humans, and scalable economic models, to facilitate the transition from experimental research to commercially sustainable applications.

[1] High myopia, which is more than −6.00 D, increases the possibility of visual impairment due to ocular complications caused by extended axial length (AL), which include posterior uveioma, retinal detachment, choroidal new vascularization, and so on. [...]the prevention and control of myopia is a difficult and important public health issue that has attracted great attention from the World Health Organization and the Chinese government. [...]it calculates the actual refractive value of each pixel point. [...]this study measures the peripheral defocus of different degrees of myopia checked by MRT in young students and aims to explore the relationship between retinal defocus and myopia. According to the values, we found that the retinal peripheral refractive error increased with increasing eccentricity.

Prehospital trauma triage is essential to get the right patient to the right hospital. However, the national field triage guidelines proposed by the American College of Surgeons have proven to be relatively insensitive when identifying severe traumas. This study aimed to build a prehospital triage model to predict severe trauma and enhance the performance of the national field triage guidelines. This was a multisite prediction study, and the data were extracted from the National Trauma Data Bank between 2017 and 2019. All patients with injury, aged 16 years of age or older, and transported by ambulance from the injury scene to any trauma center were potentially eligible. The data were divided into training, internal, and external validation sets of 672,309; 288,134; and 508,703 patients, respectively. As the national field triage guidelines recommended, age, 7 vital signs, and 8 injury patterns at the prehospital stage were included as candidate variables for model development. Outcomes were severe trauma with an Injured Severity Score ≥16 (primary) and critical resource use within 24 hours of emergency department arrival (secondary). The triage model was developed using an extreme gradient boosting model and Shapley additive explanation analysis. The model's accuracy regarding discrimination, calibration, and clinical benefit was assessed. At a fixed specificity of 0.5, the model showed a sensitivity of 0.799 (95% CI 0.797-0.801), an undertriage rate of 0.080 (95% CI 0.079-0.081), and an overtriage rate of 0.743 (95% CI 0.742-0.743) for predicting severe trauma. The model showed a sensitivity of 0.774 (95% CI 0.772-0.776), an undertriage rate of 0.158 (95% CI 0.157-0.159), and an overtriage rate of 0.609 (95% CI 0.608-0.609) when predicting critical resource use, fixed at 0.5 specificity. The triage model's areas under the curve were 0.755 (95% CI 0.753-0.757) for severe trauma prediction and 0.736 (95% CI 0.734-0.737) for critical resource use prediction. The triage model's performance was better than those of the Glasgow Coma Score, Prehospital Index, revised trauma score, and the 2011 national field triage guidelines RED criteria. The model's performance was consistent in the 2 validation sets. The prehospital triage model is promising for predicting severe trauma and achieving an undertriage rate of <10%. Moreover, machine learning enhances the performance of field triage guidelines.

Background Frailty is associated with mortality among older adults. We aimed to determine the appropriate time and frailty index (FI) threshold for frailty intervention in Chinese community-dwelling older adults. Methods In this prospective cohort study, we used data from the 2011 wave of the Chinese Longitudinal Healthy Longevity Study. Follow-up was performed for seven years from baseline. Using the FI to evaluate frailty and define frailty status, we explored the best time point and FI score for frailty intervention, by comparing the relationships of FI and frailty status with mortality. Results From 2011 to 2018, 8642 participants were included and followed-up. A total of 4458 participants died during the study period. After adjusting for variables such as age, sex, marital status, education level, and living conditions, the hazard ratio (HR) of mortality risk based on the FI at baseline was 37.484 (95% confidence interval [CI]: 30.217–46.498; P  < 0.001); female sex, living in the city, being married, and living with spouse were found to be protective factors, whereas ageing was a risk factor for frailty. The mortality risk was higher in pre-frail than in frail participants (HR: 3.588, 95% CI: 3.212–4.009, P  < 0.001). Piecewise linear regression analysis revealed an FI score threshold of 0.5. When the FI score was > 0.5, the HR of mortality based on the FI was 15.758 (95% CI: 3.656–67.924; P  < 0.001); when the FI score was ≤ 0.5, the HR of mortality based on the FI was 48.944 (95% CI: 36.162–66.244; P  < 0.001). Conclusion Using FI as a continuous variable to predict death is more accurate than frailty status. The advancement of early interventions for mortality risk reduction is more beneficial in pre-frail than in frail patients, and an FI score of 0.5 was found to be the threshold for mortality prediction using the FI.

Background Diabetic retinopathy (DR) is a serious microvascular complication of type 2 diabetes mellitus (T2DM). The aim of this retrospective study was to reveal the risk factors for the severity of DR in individuals with T2DM. Demographic data and biochemical parameters were collected and analyzed. Methods A total of 518 individuals with type 2 diabetes were included. These individuals were classified into three groups according to the severity of diabetic retinopathy: non-diabetic retinopathy (NDR) group ( N  = 172), non proliferative diabetic retinopathy (NPDR) group ( N  = 184), and proliferative diabetic retinopathy (PDR) group ( N  = 162). Demographic and clinical measurement data of the individuals were collected by reviewing medical records and direct interview. The demographic data and biochemical parameters between groups were compared using Student’s t-test. Moreover, the factors related to severity of diabetic retinopathy were identified by using the multivariate logistic regression analysis. Results No significant difference in age, gender, body mass index (BMI), and diabetes duration was found among these three groups. The serum uric acid (SUA), total cholesterol (TC), low density lipoprotein cholesterol (LDL-c), homocysteine, and urinary albumin levels were significantly higher in the NPDR and PDR group than those in the NDR group ( P  < 0.05). The individuals in the PDR group had obviously higher levels of SUA, homocysteine, and urinary albumin than individuals in the NPDR group ( P  < 0.05). The multivariate logistic regression analysis revealed that high SUA, homocysteine, TC, LDL-c, and urinary albumin levels were associated with more serious diabetic retinopathy (OR > 1; P  < 0.05). Conclusion The concentrations of SUA and urinary albumin are associated with the severity of DR in individuals with T2DM.