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Examining short-term and long-term outcomes in octogenarians undergoing isolated surgical aortic valve replacement 认领 引用
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作者 Marcus Taylor Antony Walker +1 位作者 David Rose Mohamad N Bittar 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2026年第4期228-234,共7页
BACKGROUND As the transcatheter approach to aortic valve disease become more common,the role of surgical aortic valve replacement(SAVR),particularly in older patients,is increasingly contentious.This study aimed to ex... BACKGROUND As the transcatheter approach to aortic valve disease become more common,the role of surgical aortic valve replacement(SAVR),particularly in older patients,is increasingly contentious.This study aimed to examine short-term and long-term outcomes in octogenarians undergoing isolated SAVR.METHODS All consecutive patients aged 80 years and over undergoing isolated first-time SAVR in two cardiac surgery centres between 1997 and 2019 were included.Primary outcomes were in-hospital,1-year and 5-year mortality and overall survival.Secondary outcomes were re-exploration,post-operative renal replacement therapy,post-operative stroke,post-operative permanent pacemaker implantation and post-operative length of stay(PLOS).The multivariate Cox regression analysis was used to identify variables independently associated with overall survival.RESULTS The study comprised 524 patients,which represented 14.9%of all isolated SAVRs performed during the study period(n=524/3516).Mean age was 83.2±2.7 years and 28.1%of patients(n=147)were aged 85 years and above.59.0%of patients(n=309)were female.There were 11.1%of patients(n=58)who underwent minimally invasive surgery and mean logistic EuroSCORE was 12.1%±6.6%.Median PLOS was 9(7-14)days.Overall in-hospital,1-year and 5-year mortality were 4.2%(n=22),9.7%(n=51)and 34.5%(n=181),respectively.For patients who survived to hospital discharge,1-year survival was 94.2%(n=473/502).Median follow-up time was 77(44-101)months and estimated median overall survival was 81(76-86)months.CONCLUSIONS SAVR remains a safe operation in octogenarian patients.Findings from this study suggest that for appropriately selected patients,SAVR can provide durable long-term benefit and should still be considered an appropriate treatment strategy. 展开更多
关键词 octogenarians long term outcomes short term outcomes transcatheter approach cardiac surgery isolated surgical aortic valve replacement transcatheter aortic valve replacement surgical aortic valve replacement savr particularly
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Predictors of early cerebrovascular events after transcatheter aortic valve replacement:a systematic review and meta-analysis 认领 引用
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作者 Yi ZHANG Ying ZHANG +2 位作者 Yi-Jun YAO Tian-Yuan XIONG Mao Chen 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2026年第5期309-316,共8页
Background Early cerebrovascular events(CVEs)following transcatheter aortic valve replacement(TAVR)are severe complications,but effective methods for predicting and preventing these events have not been well establish... Background Early cerebrovascular events(CVEs)following transcatheter aortic valve replacement(TAVR)are severe complications,but effective methods for predicting and preventing these events have not been well established.A systematic review and meta-analysis were performed to identify significant predictors of early CVEs post-TAVR.Methods MEDLINE/Embase databases were searched for articles published between December 2015 and April 2023.Original studies evaluating predictors of CVEs within 30 days post-TAVR after adjusting for confounders were included.Two investigators independently extracted data following the PRISMA statement.Meta-analyses of multivariable data were performed using Der Simonian and Laird random-effects models,with results expressed as odds ratios(ORs)and 95%confidence intervals(CIs).Robustness was assessed via Harbord's test,nonparametric trim-and-fill analysis,leave-one-out sensitivity analysis,the QUIPS quality assessment tools,meta-regression,and subgroup analyses.Results Among the 74 included studies,multivariate meta-analyses identified 11 predictors of early CVEs,including 9 patientlevel predictors-a CHA2DS2-VASc≥5,no prior heart failure,diabetes,isolated aortic stenosis,carotid artery stenosis,peripheral artery disease,advanced age,New York Heart Association class≥Ⅲ,and significant left ventricular outflow tract calcificationand 2 procedure-level predictors:the absence of cerebral embolization protection and post-dilation.Additionally,10 patient-level factors and 5 procedure-level factors were not associated with early CVEs,although significant heterogeneity was observed in most analyses.Conclusions This study identified multiple patient-level and procedure-level factors associated or not associated with early CVEs after TAVR.These findings support the development of a comprehensive risk prediction model that can accommodate diverse patient populations and evolving procedural techniques,thereby enhancing clinical risk management strategies. 展开更多
关键词 Meta analysis Transcatheter Aortic Valve Replacement transcatheter aortic valve replacement tavr cerebrovascular events cves following Predictors CHA DS VASc Score systematic review Early Cerebrovascular Events
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Proceed with caution:addressing the evidence gap and patient bias in transcatheter aortic valve replacement for bicuspid aortic stenosis 认领 引用
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作者 Yao-Ying JIAO Tian-Yuan XIONG 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2026年第6期364-367,共4页
With the comparative evidence between transcatheter aortic valve replacement(TAVR)and surgical aortic valve replacement(SAVR)now being well-established,TAVR has become an effective alternative to surgery in all risk s... With the comparative evidence between transcatheter aortic valve replacement(TAVR)and surgical aortic valve replacement(SAVR)now being well-established,TAVR has become an effective alternative to surgery in all risk spectra.In recent years,TAVR has been increasingly adopted,with its procedural volume surpassing that of SAVR and is being performed in progressively younger patients.[1]As the age of patients undergoing TAVR decreases,the proportion of those with bicuspid aortic valve(BAV)anatomy is likely to rise.The applications of TAVR have also expanded to BAV patients,[2]but the condition often involves complex anatomical challenges such as heavy leaflet calcification and aortopathy.Although the current recommendations for TAVR in BAV patients remain prudent in the major guidelines,[3]current widespread adoption of TAVR in BAV patients is of concern. 展开更多
关键词 Transcatheter Aortic Valve Replacement Bicuspid Aortic Stenosis Leaflet Calcification Aortic Valve Anatomy Evidence Gap Surgical Aortic Valve Replacement Patient Bias surgical aortic valve replacement savr now
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Geriatric nutritional risk index associated to long-term prognosis and length of hospitalization in the contemporary transcatheter aortic valve replacement era 认领 引用
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作者 Nick Mattelat Roman Uebelacker +3 位作者 Philipp C Seppelt David Leistner Andreas M Zeiher Silvia Mas-Peiro 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2026年第4期235-245,共11页
BACKGROUND Malnutrition is a common comorbidity in elderly patients with severe aortic valve stenosis undergoing transcatheter aortic valve replacement(TAVR).The geriatric nutritional risk index(GNRI),a validated and ... BACKGROUND Malnutrition is a common comorbidity in elderly patients with severe aortic valve stenosis undergoing transcatheter aortic valve replacement(TAVR).The geriatric nutritional risk index(GNRI),a validated and easy-to-use tool,has been previously associated with short/mid-term outcomes in such patients.This study aimed to confirm this association in the long-term in the contemporary TAVR era using new-generation devices and to evaluate its impact on length of hospitalization.METHODS A total of 1090 consecutive patients aged≥65 years undergoing TAVR between October 2015 and December 2021 at a single tertiary center were included.Patients were stratified into two groups based on baseline GNRI:the GNRI>98(low-risk)group and the GNRI≤98(moderate-to-high risk)group.The primary endpoint was all-cause mortality.Secondary endpoints included total length of hospitalization and length of intensive care unit stay.Kaplan-Meier curves and Cox regression models were used to assess survival differences and potential independent predictors.RESULTS Patients with GNRI≤98 had significantly higher cumulative mortality rates at all evaluated time points compared to patients with GNRI>98(30-day:6.9%vs.2.7%,1-year:39.1%vs.11.4%,5-year:67.3%vs.53.2%,all P<0.05).A multivariable Cox regression analysis showed that GNRI was an independent predictor of long-term mortality(up to five years)after adjusting for clinical,echocardiographic and laboratory parameters(HR=0.94,95%CI:0.92-0.96,P<0.001),with an increasing effect over time.The impact of GNRI on clinical outcomes was observed in patients in all three EuroSCORE II categories(low risk,intermediate risk,and high risk).Total hospitalization and intensive care unit stays were longer in patients with GNRI≤98[8(6-13)days vs.7(5-9)days,P<0.001 and 3(2-5)days vs.2(2-4)days,P<0.001,respectively].CONCLUSIONS In this large European cohort,GNRI was confirmed to be an independent predictor for long-term mortality up to five years in the contemporary era of TAVR use with new-generation devices.Hospital stay was longer in patients with lower GNRI.This easyto-use index could play a valuable role in the preprocedural assessment of patients undergoing TAVR and studies to explore the use of nutritional preprocedural optimization of patients with low GNRI values are warranted. 展开更多
关键词 Transcatheter Aortic Valve Replacement transcatheter aortic valve replacement tavr Long term Prognosis con Length Hospitalization geriatric nutritional risk index gnri Geriatric Nutritional Risk Index Malnutrition
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Application of the best evidence for preventing central venous catheter-related thrombosis in patients undergoing continuous renal replacement therapy 认领 引用
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作者 Lili Li Jing Wu +4 位作者 Ying Zhang Miaojie Yu Hangyan Ye Yongze Dong Huiping Yao 《International Journal of Nursing Sciences》 CSCD 2026年第2期194-200,I0004,I0005,共7页
Objective:This study aimed to implement evidence-based practice(EBP)for the prevention and management of catheter-related thrombosis(CRT)in patients undergoing continuous renal replacement therapy(CRRT)and to evaluate... Objective:This study aimed to implement evidence-based practice(EBP)for the prevention and management of catheter-related thrombosis(CRT)in patients undergoing continuous renal replacement therapy(CRRT)and to evaluate its clinical effectiveness in enhancing nurses’knowledge and reducing CRT incidence rates.Methods:A systematic approach was employed to retrieve,screen,evaluate,and synthesize literature,identifying best evidence for CRT prevention and management in CRRT patients.From August 1,2023 to February 29,2024,the Ottawa Model of Clinical Application guided the development of audit criteria based on best evidence.Clinical audits were conducted to identify barriers and facilitators to the implementation of evidence,refining the EBP content for CRRT patient CRT prevention and management.Subsequently,from March 1,2024 to September 30,2024,this EBP was implemented in the ICU of a tertiary hospital in Zhejiang Province.A comparative analysis was conducted to assess the implementation rates of audit criteria,nurses’knowledge scores on CRRT patient CRT prevention and management,and patient CRT incidence rates before and after the EBP intervention.Results:A total of 51 nurses and 247 patients were enrolled in this study,with 123 patients assigned to the pre-EBP phase and 124 patients to the post-EBP phase.Compliance rates for all 16 established review indicators demonstrated a significant upward trend following EBP implementation;however,four key indicators failed to meet the 90%compliance threshold:nurse-conducted risk factor assessment,ultrasound-guided venipuncture,X-ray imaging for catheter dysfunction,and administration of thrombolytic therapy.Nurses’knowledge regarding CRT prevention and management was significantly enhanced,with questionnaire scores increasing from(77.72±4.96)to(87.02±6.17)(t=-12.180,P<0.001).Notably,the incidence of CRT decreased substantially from 28.46%to 15.32%,with the difference reaching statistical significance(t=10.257,P<0.001).Conclusion:Evidence-based nursing practice tailored to prevent CRT in patients undergoing CRRT significantly enhances nurses’specialized knowledge in CRT prevention and management,effectively reduces the incidence of CRT,and further fortifies safeguards for patient safety by optimizing clinical nursing quality. 展开更多
关键词 Continuous renal replacement therapy Evidence-based nursing Critical care nursing Central venous catheters Catheter-related thrombosis
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Compressive Stress-Strain Behavior of Seawater Sea-Sand Recycled Aggregate Concrete under Different Strain Rates and Replacement Ratio of Aggregates 认领 引用
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作者 ZHANG Kaijian ZHOU Kunjie +1 位作者 LIN Wenqiang ZHANG Qingtian 《Journal of Wuhan University of Technology(Materials Science)》 SCIE EI CAS CSCD 2026年第3期658-673,共16页
The stress-strain curves of seawater sea-sand recycled aggregate concrete(SSRAC)with different replacement ratios of recycled coarse aggregate(RCA)or sea-sand under different strain rates were studied.The effects of d... The stress-strain curves of seawater sea-sand recycled aggregate concrete(SSRAC)with different replacement ratios of recycled coarse aggregate(RCA)or sea-sand under different strain rates were studied.The effects of different replacement ratios of RCA or sea-sand,and ages on the characteristic parameters of the stress-strain curve and corresponding dynamic increasing factor(DIF)of SSRAC were analyzed.Scanning electron microscopy(SEM)and nanoindentation tests were used to explain the variation of the characteristic parameters from the microscopic point of view.The results show that,when the replacement ratio of RCA or seasand is 50%,the strain rate sensitivity of elastic modulus is higher than that of peak stress;the DIF of peak stress exhibits a pattern of initially decreasing and then increasing with the increasing replacement ratio of RCA or sea-sand.Conversely,the DIF of elastic modulus initially shows an increase followed by a decrease.The introduction of seawater and sea-sand promotes hydration,resulting in a denser microstructure for SSRAC as compared to that of recycled aggregate concrete,which influences its strain rate sensitivity.Finally,a stressstrain prediction model of SSRAC is proposed,which can provide a theoretical basis for its experimental research and engineering application. 展开更多
关键词 seawater sea-sand recycled aggregate concrete(SSRAC) replacement ratio dynamic increase factor(DIF) strain rate sensitivity stress-strain curve model
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Navigating the therapeutic tightrope:Precision use of plasmapheresis and continuous renal replacement therapy in liver failure 认领 引用
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作者 Manish Manrai Aditya V Pachisia +2 位作者 Saurabh Dawra Siddharth Shukla Atul A Jha 《World Journal of Hepatology》 2026年第5期69-88,共20页
Liver failure,which includes acute liver failure(ALF)and acute-on-chronic liver failure(ACLF),is a life-threatening condition characterised by severe loss of hepatocytes,systemic inflammation,and multi-organ dysfuncti... Liver failure,which includes acute liver failure(ALF)and acute-on-chronic liver failure(ACLF),is a life-threatening condition characterised by severe loss of hepatocytes,systemic inflammation,and multi-organ dysfunction,often leading to mortality rates exceeding 50%.Therapeutic plasma exchange(TPE,also known as plasmapheresis)and continuous renal replacement therapy(CRRT)are essential extracorporeal treatments that detoxify the blood,stabilise patients,and act as a bridge to recovery or transplantation.The debate surrounding the use of TPE and CRRT in liver failure(ALF and ACLF)is ongoing,with a recognised need to clearly define the patient groups,timing,and modality of application.This minireview synthesises evidence from 2016 to 2025,obtained from PubMed,EMBASE,and the Cochrane databases,and examines the mechanisms,indications,protocols,and outcomes of TPE and CRRT in ALF and ACLF.Correct patient selection,timing,and monitoring are essential to optimise benefits while minimising risks such as bleeding,infections,or citrate toxicity.This review examines various aspects of both therapies to help determine the most suitable treatment for liver failure.It highlights the importance of standardised guidelines to improve outcomes across different settings. 展开更多
关键词 Acute liver failure Acute-on-chronic liver failure Therapeutic plasma exchange Continuous renal replacement therapy Extracorporeal therapies Multiorgan failure
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Slow continuous ultrafiltration and prolonged intermittent renal replacement therapy: Tailoring renal replacement therapy in intensive care unit 认领 引用
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作者 Guido Gembillo Matteo Floris +3 位作者 Lorenzo Lo Cicero Giuseppe Spadaro Luca Soraci Domenico Santoro 《World Journal of Nephrology》 2026年第2期122-139,共18页
Acute kidney injury complicates the clinical course of nearly half of all critically ill patients admitted to intensive care,conferring a three-to five-fold elevation in mortality risk.The management of these patients... Acute kidney injury complicates the clinical course of nearly half of all critically ill patients admitted to intensive care,conferring a three-to five-fold elevation in mortality risk.The management of these patients has evolved considerably beyond standardized protocols toward individualized therapeutic strategies.Within this paradigm shift,two modalities warrant particular attention:Slow continuous ultrafiltration(SCUF)and prolonged intermittent renal replacement therapy(PIRRT).SCUF operates through isolated fluid extraction at rates between 100 mL and 500 mL per hour,targeting patients whose preserved kidney function nonetheless fails to manage severe volume overload.The clinical experience with SCUF reveals a complex picture,while certain patient populations,particularly those receiving extracorporeal membrane oxygenation or battling refractory cardiac failure,have shown encouraging results with shortened intensive care stays,equally robust cohorts have experienced concerning progression rates to complete renal replacement therapy and mortality approaching or exceeding 50%.The distinction appears to hinge on meticulous patient selection,with systolic perfusion pressure emerging as a pivotal hemodynamic threshold.PIRRT extends conventional intermittent therapy from the traditional 3-4 hours window to sessions lasting 6-12 hours.Multiple investigations support that this approach achieves comparable mortality and renal recovery outcomes to continuous modalities while reducing costs,facilitating patient mobilization,and decreasing nursing requirements.Current guideline recommendations increasingly favor restrictive,patient-centered approaches over rigid algorithmic initiation.Accumulating evidence supports ultrafiltration rates of 1-1.5 mL/kg/hour,adjusted dynamically according to hemodynamic tolerance and disease trajectory.Yet despite these refinements in our understanding of optimal therapy delivery,fundamental questions persist:Which patients derive maximal benefit from alternative modalities?When should these therapies be initiated or withdrawn,and how can we predict individual treatment response?This review synthesizes current evidence to establish practical decision frameworks for implementing SCUF and PIRRT in critically ill populations,examining clinical indications,safety parameters,fluid removal strategies,and outcome determinants.Our objective is to advance renal replacement therapy from a standardized intervention toward precision nephrology for high-acuity patients. 展开更多
关键词 Heart failure Chronic kidney disease Acute kidney injury Diuretic resistance Renal failure Intensive care unit Slow continuous ultrafiltration Prolonged intermittent renal replacement therapy
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Mitochondrial replacement therapy for advanced maternal age and diminished ovarian reserve:Efficacy,challenges,and Vietnamese landscape 认领 引用
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作者 Luan Nguyen Thanh Dung Le Thi Thuy +1 位作者 Thuy Tran Thi Thinh Ngo Van 《Asian pacific Journal of Reproduction》 CAS 2026年第4期149-159,共11页
Mitochondrial replacement therapy(MRT)has emerged as a disruptive frontier in reproductive medicine to address the challenges of advanced maternal age(AMA)and diminished ovarian reserve(DOR).These conditions are prima... Mitochondrial replacement therapy(MRT)has emerged as a disruptive frontier in reproductive medicine to address the challenges of advanced maternal age(AMA)and diminished ovarian reserve(DOR).These conditions are primarily driven by mitochondrial dysfunction,which leads to adenosine triphosphate(ATP)depletion,oxidative damage,and increased embryonic aneuploidy.Heterologous techniques,such as maternal spindle transfer(MST)and pronuclear transfer(PNT),have demonstrated high clinical efficacy,with studies reporting fertilization rates up to 88.4%and significantly improved blastocyst formation in patients with poor prognoses.While these methods show promise,autologous strategies utilizing stem cell derived mitochondria offer an alternative to maintain full genetic relatedness and avoid the ethical complexities of"three-parent"embryos.However,MRT remains an investigational procedure globally due to critical safety concerns,including mitochondrial"reversion"where maternal mitochondrial DNA(mtDNA)regains dominance and potential mitonuclear incompatibility.In Vietnam,where infertility affects approximately 7.7%of couples,there is a rising demand for such interventions despite significant gaps in national data and specific regulatory frameworks.Establishing a strategic roadmap that includes a national AMA/DOR database and modernized legal guidelines is essential to ensure the safe and ethical integration of MRT into Vietnam’s clinical landscape. 展开更多
关键词 Mitochondrial replacement therapy Mitochondrial dysfunction Mitochondrial donation Advanced maternal age Diminished ovarian reserve
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Learning curve of total ankle replacement from the lateral approach 认领 引用 被引量：1
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作者 Henryk Liszka Artur Gądek +5 位作者 Anna Maria Zięba Kaja Surowiecka Jakub Kwiatkowski Tomasz Kozioł Michał Sebastian Bochenek Konrad Kwolek 《World Journal of Orthopedics》 2026年第3期52-63,共12页
BACKGROUND According to recent systematic reviews and meta-analyses,the long-term results of total ankle replacement(TAR)are equivalent or superior to ankle arthrodesis with an average 10-year survival approaching 90%... BACKGROUND According to recent systematic reviews and meta-analyses,the long-term results of total ankle replacement(TAR)are equivalent or superior to ankle arthrodesis with an average 10-year survival approaching 90%.Almost all fourth-generation TAR implants are inserted from the anterior approach except for ZimmerTM,which is implanted laterally and with lateral malleolus osteotomy.AIM To evaluate the clinical outcomes and complication rates and to define a multifactorial learning curve of lateral approach TAR.METHODS This single-center retrospective cohort study included 85 ZimmerTMlateralapproach TARs performed by one surgeon from 2019 to 2024.Patient-reported outcome measures were evaluated in 65 patients using the Manchester-Oxford Foot Questionnaire(MOXFQ)and European Foot and Ankle Society(EFAS)scores.Underlying diagnoses,functional outcomes,operative time trends,secondary procedures,and complications rates were analyzed to define a learning curve considering the first 60 consecutive cases.RESULTS The mean follow-up was 30.8 months.Post-traumatic arthritis was the most common underlying diagnosis accounting for 53.5%of cases.Mean EFAS improved by 13.0 points(P0.4),indicating that proficiency is readily achieved due to the short learning curve of this technique.Operative time decreased from approximately 175 min to 125 min after about 25-30 cases.Complication rates declined with experience.In the first 30 cases,there were 19 reoperations in 13 patients(43%)with an additional 5 being managed conservatively compared with 10 reoperations in 7 patients(23%)with 2 conservatively treated complications in the subsequent 30 cases(relative risk=1.86,P>0.05).Infection-related revisions also decreased markedly from 5(16.7%)to 1(3.3%)(relative risk=5.00,P>0.05)between these cohort.Two cases of deep infection occurred in patients with rheumatoid arthritis.One was successfully managed with debridement,and the other required implant removal with cement spacer implantation.CONCLUSION Lateral-approach TAR achieved early patient-reported outcome measure benefits with efficiency and safety improving with experience,requiring 30 cases.This rapid learning curve integrates functional outcomes,operative timing,and complication rates. 展开更多
关键词 Arthroplasty replacement ankle Osteoarthritis Ankle joint Surgical procedures operative methods Surgical approach Lateral approach Learning curve Patient-reported outcome measures
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Human stem cell-based cell replacement therapy for Parkinson’s disease:Enhancing the survival of postmitotic dopamine neuron grafts 认领 引用 被引量：1
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作者 Tae Wan Kim 《Neural Regeneration Research》 SCIE CAS CSCD 2026年第2期689-690,共2页
Parkinson’s disease(PD)is the second most common neurodegenerative disorder.The progressive degeneration of dopamine(DA)producing neurons in the midbrain is the pathological hallmark,which leads to debilitating motor... Parkinson’s disease(PD)is the second most common neurodegenerative disorder.The progressive degeneration of dopamine(DA)producing neurons in the midbrain is the pathological hallmark,which leads to debilitating motor symptoms,including tremors,rigidity,and bradykinesia.Drug treatments,such as levodopa,provide symptomatic relief.However,they do not halt disease progression,and their effectiveness diminishes over time(reviewed in Poewe et al.,2017). 展开更多
关键词 neuronal survival cell replacement therapy dopamine neurons human stem cells bradykinesiadrug treatmentssuch Parkinsons disease neurodegenerative disorderthe parkinson s disease pd
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Dietary β-carotene improves the ovary development and antioxidant capacity of replacement gilts 认领 引用
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作者 Jingya Jiang Langduan Chen +6 位作者 Weiying Ma Tingting Wen Rui Liu Guiyan Chu Xiangfang Zeng Shiyan Qiao Chuanjiang Cai 《Journal of Animal Science and Biotechnology》 SCIE CAS CSCD 2026年第3期1695-1711,共17页
Background β-Carotene exhibits distinct biological effects that enhance reproductive performance in mammals;however,the mechanisms underlying these effects remain poorly understood.This study aimed to evaluate the ef... Background β-Carotene exhibits distinct biological effects that enhance reproductive performance in mammals;however,the mechanisms underlying these effects remain poorly understood.This study aimed to evaluate the effect ofβ-carotene on ovarian development in replacement gilts and to investigate its potential mechanisms.Results A total of 20 gilts,aged 130 d,were randomly assigned to control group orβ-carotene group(β-C group,diet containing 10 mg/kg of β-carotene).Each group consisted of 10 replicates,with one gilt per replicate,over a 60-d trial.β-Carotene significantly increased the number of follicles measuring 2-5 mm in diameter,elevated estradiol concentrations in both blood and follicular fluid of replacement gilts(P<0.05).Compared to the control group,theβ-C group exhibited a significant increase inβ-carotene concentration within ovarian follicular fluid(P<0.05).Transcriptomic analysis of GCs revealed that β-carotene could significantly upregulated the expression of Forkhead Box L2(FOXL2).When β-carotene and its metabolic product were administered to granulosa cells(GCs),validation of differentially expressed genes in the transcriptome suggests the possibility that β-carotene,rather than its metabolic product,is responsible for the upregulation of FOXL2 in ovarian GCs,which subsequently may regulate StAR and enhance estradiol synthesis.Furthermore,β-carotene is likely to promote lipolysis,providing essential substrates for estradiol and adenosine triphosphate(ATP)production.Concurrently,β-carotene appears to increase the activity of the antioxidant enzymes superoxide dismutase 1(SOD1)and glutathione peroxidase 4(GPX4)in gilts,thereby reducing reactive oxygen species(ROS)(P<0.05)and maintaining redox balance.Conclusions Our findings suggest thatβ-carotene could promote lipolysis,activate the FOXL2-StAR pathway to increase estradiol synthesis in GCs,and alleviate oxidative stress,thereby contributing to follicle development. 展开更多
关键词 β-Carotene Estradiol Follicular development Oxidative stress Replacement gilts
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Mechanism of ultrasound enhanced selective oxygen pressure leaching of Ga and Ge from zinc powder replacement residue 认领 引用
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作者 Yuan-xin LIANG Meng SUN +9 位作者 Bo-yi LUO Biao DING Zhe SHEN Tian-xiang ZHENG Qiang LI Bang-fei ZHOU Chun-mei LIU Cai-gui WU Wei-li REN Yun-bo ZHONG 《Transactions of Nonferrous Metals Society of China》 SCIE EI CAS CSCD 2026年第3期956-973,共18页
The leaching mechanism of gallium(Ga)and germanium(Ge)from zinc powder replacement residue(ZPRR)was investigated through ultrasonic-assisted sulfuric acid leaching.Characterization via XRD,SEM,XPS,and FT-IR revealed t... The leaching mechanism of gallium(Ga)and germanium(Ge)from zinc powder replacement residue(ZPRR)was investigated through ultrasonic-assisted sulfuric acid leaching.Characterization via XRD,SEM,XPS,and FT-IR revealed that ultrasonic treatment promotes the dehydration of H4SiO4colloids,thereby reducing their adsorption capacities for Ga and Ge complexes.Additionally,ultrasound enhances the dissolution of CaS in H2SO4,increasing H2S production,which aids in the reduction of Fe3+and mitigates iron precipitate formation.Process parameters including ultrasonic power(0-450 W),temperature(100-120℃),and leaching time(30-120 min)were systematically optimized,achieving optimal leaching efficiencies of Ga and Ge at 95.7%and 94.5%,respectively. 展开更多
关键词 oxygen pressure acid leaching ultrasound treatment zinc powder replacement residue gallium germanium leaching mechanism
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Synthesis and insecticidal activity evaluation of sulfonamide derivatives oriented by atom replacement strategy 认领 引用
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作者 Hao Qian Xinru Tan +8 位作者 Guixun Wu Lei Wang Ziyu Wang Hongxiang Liu Mei Tian Minjie Zhang Keyin Yu Wenjun Wu Jiwen Zhang 《Advanced Agrochem》 CAS CSCD 2026年第1期49-57,共9页
The single-atom replacement strategy is a typical approach which just converts elements in lead compounds into their analogues with very small chemical changes.In this research,we implemented this strategy to modify t... The single-atom replacement strategy is a typical approach which just converts elements in lead compounds into their analogues with very small chemical changes.In this research,we implemented this strategy to modify the sulfonamide scaffold identified in our previous work,and resulting in the synthesis of 40 novel sulfonamide derivatives not previously reported in the literature.The insecticidal activities of these compounds against the Mythimna separata and Plutella xylostella were assessed.Our findings indicate that the pyridine sulfonamide structure significantly enhances insecticidal efficacy.Specifically,compound 7c exhibited LC 50 values of 0.157 and 0.256 mg/mL against the M.separata and P.xylostella,which significantly increased 97-and 41-fold compared to celangulin V,respectively.The experimental results revealed that pyridine sulfonamide analogues could serve as potential green insecticides. 展开更多
关键词 Sulfonamide Synthesis Insecticidal activity Atom replacement Celangulin V
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Topology-aware predictive maintenance via joint replace ment and reconfiguration for BESSs under heterogeneous capacity degradation 认领 引用
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作者 Mengzi ZHEN Zhen CHEN +1 位作者 Tangbin XIA Ershun PAN 《ENGINEERING Management》 CSCD 2026年第2期335-362,共28页
Efficient maintenance of battery energy storage systems(BESS)is critical for reliable operation under large-scale renewable integration.In modular architectures,heterogeneous degradation creates strong interactions be... Efficient maintenance of battery energy storage systems(BESS)is critical for reliable operation under large-scale renewable integration.In modular architectures,heterogeneous degradation creates strong interactions between component health and system topology,meaning system capacity and risk depend not only on individual states but also on dynamic module configuration.Conventional maintenance policies often assume a fixed mapping from component states to system performance and thus fail to address topology-induced bottlenecks and imbalancedriven risks,which frequently leads to premature replacements or hidden safety hazards.This study proposes a novel predictive maintenance(PdM)framework that synergistically coordinates module replacement and structural reconfiguration.Unlike existing approaches,our method treats maintenance as a coupled decision process where replacement restores component health while reconfiguration reshapes the topology to mitigate degradation constraints.The problem is formulated as a nested mixedinteger nonlinear programming(MINLP)model.To solve this computationally challenging problem,we develop a tailored Bayesian Hierarchical Optimization with Adaptive Large Neighborhood Search(BHO-ALNS)algorithm that efficiently explores the joint decision space of replacement thresholds and reconfiguration actions.Numerical experiments based on data-driven degradation simulations demonstrate that the proposed strategy significantly outperforms various common conventional schemes.Specifically,compared to the fixed-threshold replacementonly strategy frequently employed in real-world maintenance practice,our approach increases net economic benefit by approximately 23%,while simultaneously enhancing capacity utilization and mitigating safety risks.These findings highlight the necessity of jointly managing component degradation and system configuration,offering a paradigm shift from passive component renewal to active structural adaptation in BESS. 展开更多
关键词 BESS PdM heterogeneous degradation replacement and reconfiguration MINLP
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Significant quality of life improvement following total knee replacement for end-stage osteoarthritis:Retrospective cohort study 认领 引用
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作者 Mohammed H Abushal Osama M Embaby +2 位作者 Mahmoud Mersal Emran Badghish Mohamed Elalfy 《World Journal of Orthopedics》 2026年第3期64-70,共7页
BACKGROUND Total knee replacement(TKR)is a cornerstone intervention for advanced knee osteoarthritis(OA),yet real-world data directly comparing its impact on healthrelated quality of life(HRQoL)against non-surgical ma... BACKGROUND Total knee replacement(TKR)is a cornerstone intervention for advanced knee osteoarthritis(OA),yet real-world data directly comparing its impact on healthrelated quality of life(HRQoL)against non-surgical management using standardized patient-reported outcome measures remains limited,particularly from the Middle East.This study addresses this gap by evaluating HRQoL changes in a Saudi Arabian cohort.AIM To compare the change in HRQoL,measured by the EuroQol five-dimension,fivelevel questionnaire(EQ-5D-5 L)instrument,between patients undergoing TKR and those receiving conservative treatment for severe knee OA.METHODS This retrospective cohort study was conducted at a tertiary orthopedic center in Saudi Arabia,analyzing data from patients with Kellgren-Lawrence grade III-IV knee OA between January 2018 and December 2022.This study is reported following the STROBE guidelines.Patients were allocated into two groups:The TKR group(n=480)and the conservative management group(n=400).The primary outcome was the change in the EQ-5D-5 L index score from baseline to one-year post-intervention.Statistical analyses included paired and independent t-tests,with a P value<0.05 considered significant.RESULTS A total of 880 patients were included in the final analysis.The TKR group demonstrated a substantial and clinically significant improvement in mean EQ-5D-5 L scores,from 0.35±0.08 at baseline to 0.76±0.09 at one year(mean change:+0.41;95%confidence interval:0.39-0.43;P<0.001).This improvement far exceeded the minimal clinically important difference of 0.07-0.12.In contrast,the conservative management group showed a minimal,nonsignificant improvement from 0.36±0.07 to 0.42±0.08(mean change:+0.06;95%confidence interval:0.04-0.08;P=0.07),which did not meet the minimal clinically important difference.The between-group difference in HRQoL improvement was statistically significant(P<0.001).CONCLUSION This study provides strong evidence that TKR leads to substantial and clinically meaningful improvements in HRQoL for patients with severe knee OA,whereas conservative management offers limited benefits.These findings reinforce the effectiveness of TKR in the management of advanced OA,support timely surgical referral,and validate the use of the EQ-5D-5 L as a robust patient-reported outcome measure in this patient population. 展开更多
关键词 Total knee replacement Knee osteoarthritis Health-related quality of life Patient-reported outcome measures Conservative management Retrospective cohort study
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Ten-year enzyme replacement therapy in early childhood-onset lysosomal acid lipase deficiency:A case report 认领 引用
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作者 Irem Kaplan Deniz Kor +3 位作者 Fatma D Bulut Gokhan Tumgor Derya Alabaz Neslihan Onenli Mungan 《World Journal of Hepatology》 2026年第5期296-302,共7页
BACKGROUND Lysosomal acid lipase deficiency(LAL-D)is a rare autosomal recessive lipid storage disorder caused by biallelic pathogenic variants in the LIPA gene.The clinical phenotype ranges from the rapidly progressiv... BACKGROUND Lysosomal acid lipase deficiency(LAL-D)is a rare autosomal recessive lipid storage disorder caused by biallelic pathogenic variants in the LIPA gene.The clinical phenotype ranges from the rapidly progressive infantile form(Wolman disease),which usually results in death within the first year of life,to the childhood/adult-onset form,historically known as cholesteryl ester storage disease.Diagnosis of the later-onset form is often delayed owing to nonspecific clinical features,such as hepatomegaly,elevated transaminases,dyslipidemia resembling heterozygous familial hypercholesterolemia,and/or intestinal manifestations such as malabsorption.CASE SUMMARY A 21-month-old boy presented with abdominal swelling and fever.Physical examination and laboratory evaluation revealed short stature,hepatomegaly,dyslipidemia,and mildly elevated hepatic enzyme levels.Liver biopsy showed fibrosis,lobular inflammation,microvesicular steatosis,and portal inflammation.Lysosomal acid lipase enzyme activity was undetectable,and genetic analysis revealed a biallelic c.894G>A(p.Gln298=)pathogenic variant in the LIPA gene,confirming the diagnosis of LAL-D.The patient was initiated on enzyme replacement therapy with sebelipase alfa at 3 years and 11 months of age through a compassionate use access program.Over 10 years of follow-up,the patient showed clear clinical benefit,including normalization of liver enzymes,improvements in dyslipidemia,reduction in hepatomegaly and hepatic fat content,improvement in liver histopathology,and catch-up growth.No treatment-related adverse effects were observed.CONCLUSION This case highlights the long-term effectiveness and safety of sebelipase alfa initiated in early childhood and emphasizes the importance of early recognition and treatment of LAL-D to prevent irreversible organ damage and disease progression. 展开更多
关键词 Cholesteryl ester storage diseases Wolman disease Enzyme replacement treatment Sebelipase alfa Lysosomal acid lipase deficiency Lysosomal storage disorders Case report
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C3H8synergistic fluegas(CO2+N2)replacement of CH4 hydrate 认领 引用
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作者 Jinyuan Guo Xiao Chen Xia Gui 《Chinese Journal of Chemical Engineering》 SCIE EI CAS CSCD 2026年第2期18-32,共15页
There are bottleneck problems in the binary replacement process of fluegas(CO2+N2),such as the decreased stability of the sediment layer of hydrates after replacement and the decline in replacement efficiency.Th... There are bottleneck problems in the binary replacement process of fluegas(CO2+N2),such as the decreased stability of the sediment layer of hydrates after replacement and the decline in replacement efficiency.This paper innovatively proposes a pathway for the replacement of natural gas hydrates by fluegas with the synergistic effect of C3H8.The study reveals that doping a trace amount of C3H8(approximately 2%(mol))can increase the dissociation enthalpy value of fluegas hydrates by nearly 20 kJ·mol-1.The crystal structure of the hydrates significantlytransforms from the sI type to the sII type,which promotes the occupation of N2molecules in the small cages(with an increase of about 5%).This leads to a reduction of the phase equilibrium conditions by 15% to 25% through molecular scale pressure sharing.C3H8and N2have a synergistic effect on the recovery of CH4 hydrates.Compared with the fluegas without C3H8doping,the fluegas doped with 3.5% C3H8can increase the CH4 recovery rate by approximately 4.5% and the N2sequestration rate by about 5%,while maintaining a high CO2sequestration rate.Since it is a surface reaction,doping an excessive amount of C3H8(more than 5%)does not significantly improve the CH4 recovery rate.This study provides a new option for the design of engineering schemes and processes for the replacement-based exploitation of natural gas hydrates. 展开更多
关键词 Natural gas hydrate C3H8 Flue gas Replacement mechanism CO2sequestration
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Laboratory soil-column investigation of thermo-hydro-saline migration in saline soil with sand replacement layers under evaporation 认领 引用
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作者 GAO Junli LI Zihao +3 位作者 LIU Feiyu DAI Zili GAO Jinbo ZHANG Zhen 《Journal of Arid Land》 SCIE CAS CSCD 2026年第6期1031-1058,共28页
In arid regions,saline subgrades are highly susceptible to deterioration caused by evaporation-driven water-salt migration,which can induce salt accumulation,cracking,and long-term loss of stability.To investigate the... In arid regions,saline subgrades are highly susceptible to deterioration caused by evaporation-driven water-salt migration,which can induce salt accumulation,cracking,and long-term loss of stability.To investigate the role of sand replacement layers in regulating thermo-hydro-saline(THS)migration under evaporation,we conducted indoor soil-column experiments in combination with microstructural observations.The effects of sand type(coarse,medium,and fine sand)and replacement ratio(0.00%,20.00%,35.00%,and 50.00%)were systematically examined under simulated high-temperature and strong-evaporation conditions typical of northwestern China,with continuous monitoring of temperature,relative humidity(RH),and electrical conductivity(EC).The results show that sand replacement effectively inhibited capillary rise,reduced surface salt accumulation,and alleviated shrinkage cracking.Among the tested sand types,coarse sand exhibited the strongest inhibitory effect on upward water-salt migration,whereas fine sand showed the weakest effect because its smaller pores and stronger capillary continuity facilitated upward water-salt migration.Under the medium sand condition,increasing the replacement ratio was associated with stronger suppression of surface salt accumulation,with the 50.00%replacement ratio showing the strongest effect.However,the influence of replacement ratio was not monotonic across all response indicators.A replacement ratio of approximately 35.00%maintained relatively continuous pathways for heat and moisture transfer,whereas higher replacement ratios produced a looser soil skeleton and weaker capillary continuity.Microstructural observations further revealed that salt crystals mainly accumulated near the evaporation front and the lower replenishment zone,while coarse sand tended to form larger pores and reduce matric suction,thereby disrupting upward migration pathways.These findings provide a theoretical basis and technical support for optimizing saline subgrade design and mitigating salt-related damage in arid regions. 展开更多
关键词 saline soil sand replacement layers thermo-hydro-saline(THS)migration evaporation microstructural analysis
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Letter to the Editor:Learning curve considerations in lateralapproach total ankle replacement 认领 引用
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作者 Raktim Swarnakar 《World Journal of Orthopedics》 2026年第7期115-117,共3页
This letter comments on a retrospective cohort study published in World Journal of Orthopedics by Liszka et al,examining the learning curve of lateral-approach total ankle replacement(TAR)using the Zimmer™system.The s... This letter comments on a retrospective cohort study published in World Journal of Orthopedics by Liszka et al,examining the learning curve of lateral-approach total ankle replacement(TAR)using the Zimmer™system.The study provides a multidimensional evaluation of surgeon performance by integrating patientreported outcome measures,operative efficiency,and complication profiles.Notably,improvements in pain and function,assessed using the Manchester-Oxford Foot Questionnaire and the European Foot and Ankle Society score,were consistent from the earliest cases,suggesting early stabilization of patient-reported outcomes despite increasing surgical experience.In contrast,operative time and complication rates improved progressively and plateaued after approximately 25-30 cases,reflecting maturation of technical proficiency.This article highlight key methodological strengths,including single-surgeon consistency,validated outcome measures,and structured learning-curve analysis,while also addressing limitations related to retrospective design,attrition,procedural heterogeneity,and generalizability.The concentration of infection-related complications in patients with inflammatory arthritis underscores the importance of careful patient selection and preoperative optimization,particularly during the early learning phase.Overall,the in-press study contributes meaningful insights into the learning dynamics of lateral-approach TAR and informs surgical training,credentialing,and future prospective investigation. 展开更多
关键词 Total ankle replacement Learning curve Lateral approach Patient-reported outcome measures Surgical complications
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