BackgroundFibromyalgia, insomnia, depression, and anxiety share common clinical comorbidities, but their underlying genetic architecture and mechanism remain unclear.MethodsWe conducted phenotype-specific Genome-wide association study (GWAS) meta-analyses for fibromyalgia, insomnia, depression, and anxiety, respectively. Genomic structural equation modeling was employed to identify a shared genetic factor (mvFibroPsych). Lead SNPs and associated genes were annotated using Functional Mapping and Annotation (FUMA), followed by gene-set and tissue enrichment analyses. The Latent Causal Variable (LCV) method was utilized to identify modifiable risk factors and phenotypes influenced by mvFibroPsych. Additionally, brain-wide and proteome-wide Mendelian randomization (MR) analyses were applied to explore brain regions and biomarkers associated with mvFibroPsych. Multi-layer molecular quantitative trait locus (QTL) analyses were conducted for mechanistic insights into mvFibroPsych.ResultsStrong genetic correlations were observed among the four phenotypes (rg = 0.55-0.84), with excellent model fit for the common factor [comparative fit index (CFI) = 0.999, standardized root mean square residual (SRMR) = 0.015]. The mvFibroPsych GWAS identified 49 lead SNPs across 43 loci, including 32 novel loci. Gene prioritization revealed 342 protein-coding genes, and pathway analysis indicated enrichment in synaptic function pathway. LCV identified 133 phenotypes causally linked to mvFibroPsych. Brain-wide MR found fractional anisotropy in the splenium of the corpus callosum to be inversely associated with mvFibroPsych. Proteome-wide MR identified five proteins significantly associated with mvFibroPsych, while multi-layer brain QTL analysis prioritized CD40 as a potential target.ConclusionsThis study provides strong evidence for a shared genetic factor underlying fibromyalgia, insomnia, depression, and anxiety, linked to synaptic function, brain structure integrity, and neuroinflammatory pathways.

Purpose:Low back pain (LBP) is a leading cause of disability worldwide with limited effective pharmacotherapies. We aimed to identify novel therapeutic candidate targets for LBP through integrative genomics. Methods:We employed summary-data-based Mendelian randomization (SMR) with GWAS data from FinnGen (13,178 cases/164,682 controls) and tissue-specific expression quantitative trait loci (eQTLs) from peripheral blood (Westra cohort: n = 5,311; 15,636 genes) and brain tissue (UKBEC: n = 134; 16,309 genes). Heterogeneity in dependent instruments (HEIDI) analysis validated causal associations. Candidate targets were further assessed by pathway enrichment, drug prediction, and phenome-wide association studies (PheWAS). Results:Peripheral blood eQTLs identified four genes associated with LBP (PSMR < 3.2×10-, HEIDI P > 0.05): BTN2A3P, GFPT1, UHRF1BP1, SNRPC; brain eQTLs identified four genes associated with LBP (PSMR < 3.07×10-, HEIDI P > 0.05): CHST3, DCC, UHRF1BP1, SNRPC. Cross-tissue integration prioritized UHRF1BP1 and SNRPC as consensus candidates. Drug prediction suggested levamisole and taxifolin as potential UHRF1BP1-modulating compounds. PheWAS indicated low pleiotropic risk, with associations mainly with hypertension and celiac disease. Conclusion:This multi-omics framework prioritizes UHRF1BP1 (involved in epigenetic regulation) and SNRPC (RNA splicing modulator) as mechanistically novel, genetically supported candidate targets for LBP, providing a foundation for future experimental validation and therapeutic development.

Ovarian cancer (OC) remains one of the most lethal gynecologic malignancies often resistant to immune checkpoint blockade (ICB) due to poor infiltration of cytotoxic CD8⁺ T cells and type 1 conventional dendritic cells (cDC1s) into the tumor microenvironment (TME). To overcome this, we engineered magnetic resonance imaging (MRI)-visible mesenchymal stem cells (MSCs) to co-express interleukin-15 (IL-15) for T-cell activation and XC motif chemokine ligand 1 (XCL1) for cDC1 recruitment, aiming to remodel the TME and enhance therapeutic outcomes. MSCs were engineered via lentiviral transduction to stably express Il15, Xcl1, and a ferritin reporter for MRI tracking. In vitro validation included assays for gene expression, cytokine secretion, T-cell proliferation, and DC migration. Therapeutic efficacy was evaluated in subcutaneous (ID8) and disseminated (intraperitoneal FLUC-eGFP-ID8 and intra-omental FLUC-eGFP-OVHM) murine OC models. Mice received peritumoral (subcutaneous model) or intraperitoneal (disseminated models) injections of engineered MSCs (1×107 cells). Anti-PD-1 antibody (10 mg/kg, twice weekly) was administered intraperitoneally in disseminated models. Tumor progression was monitored by MRI, bioluminescence imaging, and survival analysis. Immune cell infiltration and phenotypes were assessed using flow cytometry, qPCR, immunofluorescence, and immunohistochemistry. Engineered MSCs sustainably secreted IL‑15 and XCL1, enhancing T cell proliferation and cDC1 migration in vitro. In vivo MRI confirmed efficient MSCs homing to subcutaneous tumors, suppressing tumor growth. In disseminated models, multi-armored MSC therapy inhibited tumor progression and prolonged survival, with combination therapy achieving superior outcomes. Mechanistically, this treatment drove a robust infiltration of CD8⁺ T cells and cDC1s into the TME. Flow cytometry revealed a beneficial shift in the CD8⁺ T-cell compartment toward progenitor-like, proliferative, and effector phenotypes. Furthermore, tumor-infiltrating cDC1s displayed elevated expression of co-stimulatory molecules CD80 and CD86, indicating enhanced activation. MRI-visible MSCs co-expressing IL-15 and XCL1 effectively target ovarian tumors and remodel the immune microenvironment to foster potent anti-tumor immunity. By recruiting activated cDC1s and promoting durable, functional CD8⁺ T-cell responses, these multi-armored MSCs synergize with ICB to overcome therapeutic resistance. This cellular immunotherapy represents a promising strategy for ICB-resistant OC and warrants clinical translation.

BACKGROUND:Pulmonary arterial hypertension (PAH) and associated heart failure (HF) are emerging global health challenges. OBJECTIVES:This study aimed to analyze the global, regional, and national burden of PAH and PAH-related HF from 1990 to 2021 with the use of GBD (Global Burden of Disease) 2021 estimates, to observe temporal trends, and to predict future patterns through 2050. METHODS:Data on prevalence, incidence, disability-adjusted life years (DALYs), and deaths were derived from GBD 2021. Joinpoint regression was adopted for analyzing trends and changes, decomposition analysis for quantifying impacts of age structure, population growth, and epidemiologic changes, and the Bayesian age-period-cohort model for predictions. RESULTS:In 2021, global PAH prevalence was 2.28 per 100,000, slightly down from 1990 (average annual percent change [AAPC]: -0.03; 95% CI: -0.05 to -0.01), and incidence rose to 0.52 per 100,000 (AAPC: 0.10; 95% CI: 0.10-0.11). DALYs fell to 8.24 per 100,000 (AAPC: -1.52; 95% CI: -1.64 to -1.40), and deaths dropped to 0.27 per 100,000 (AAPC: -0.82; 95% CI: -0.95 to -0.68). Increased PAH deaths from aging and growth. Women had higher PAH prevalence and incidence, and by 2021 surpassed men in DALYs and deaths rates. For PAH-related HF, prevalence rose to 191,808 cases and years lived with disability rose from 9,788 to 17,765, although rates declined. These trends are projected to persist through 2050, with cases and deaths rising but rates stable from 2019 to 2021. CONCLUSIONS:The burden of PAH persists due to aging and population growth, despite declining age-standardized rates. Future interventions should address regional and sex disparities in PAH.

OBJECTIVE:To investigate the associations between inflammatory markers changes before and after free flap reconstruction and postoperative complications, and to develop and validate a nomogram with perioperative inflammatory markers changes to predict complications. METHODS:Eight hundred fifty patients who underwent free flap reconstruction of oral and maxillofacial defects between January 2022 and December 2023 were randomly allocated into the primary and validation cohorts at a 7:3 ratio. In the primary cohort, the authors used logistic analysis to evaluate the adjusted associations between changes in inflammatory markers, including elevation in neutrophil-to-lymphocyte ratio (NLR) and in platelet-to-lymphocyte ratio (PLR), and postoperative complications. In addition, the authors used a generalized additive model (GAM) to visualize the associations. By using the Akaike information criterion, nomograms with and without NLR elevation and PLR elevation were developed. Validation of the nomograms were performed in the primary and validation cohort. Discrimination of the nomograms was assessed by concordance index (C-index), and calibration was assessed by calibration curve. RESULTS:Both NLR elevation and PLR elevation demonstrated significant linear relationships with postoperative complications. While NLR elevation was negatively associated with the complications [odds ratio (OR), 0.916; 95% CI: 0.848-0.990; P=0.027], PLR elevation showed a positive correlation with them (OR: 1.618; 95% CI: 1.165-2.247; P=0.004). The nomograms with NLR elevation and PLR elevation had higher C-indexes (0.705 and 0.680, respectively) and better calibration in the primary and validation cohort. CONCLUSIONS:NLR elevation and PLR elevation were shown to significantly negatively and positively correlated with complications after free flap reconstruction, respectively. Incorporating these changes in inflammatory markers into the nomogram could increase predictive accuracy. Clinicians could apply this nomogram to develop preventive and treatment strategies.

BACKGROUNDRemimazolam is a new ultra-short-acting benzodiazepine used in anaesthesia, valued for its rapid metabolism and reversibility. Despite its growing clinical use, a comprehensive assessment of its real-world safety profile remains essential.OBJECTIVETo evaluate the postmarketing safety of remimazolam using adverse event (AE) data from the US and Japanese pharmacovigilance databases.DESIGNRetrospective analysis of AEs associated with remimazolam using disproportionality analysis techniques.SETTINGFDA Adverse Event Reporting System (FAERS) and Japanese Adverse Drug Event Report database (JADER) from January 2020 to December 2023.PARTICIPANTSPatients who experienced remimazolam-related AEs reported in the FAERS and JADER databases.MAIN OUTCOME MEASURESIdentification of significant AEs using reporting odds ratio, proportional reporting ratio, Bayesian confidence propagation neural network and multiitem gamma Poisson shrinker. Categorisation of AEs using the 'Important Medical Event Terms List' (IME) list (version 26.1).RESULTSWe identified 199 remimazolam-related reports (69 from FAERS, 130 from JADER) revealing 20 significant AEs. Key findings include previously unlabelled serious AEs such as cardiac, cardio-respiratory, and respiratory arrests; nine events classified as Important Medical Events, including hypotension and anaphylaxis; four AEs not included in current Food and Drug Administration (FDA) labelling; and low-frequency but clinically significant off-label events including arrhythmias and postoperative delirium.CONCLUSIONSWhile remimazolam shows a generally acceptable safety profile, our pharmacovigilance analysis identified serious unlabelled reactions requiring clinical vigilance. Practice recommendations include judicious administration with balanced crystalloids and comprehensive cardiorespiratory monitoring. Future research should address prospective surveillance of rare serious events, optimal administration protocols to prevent vascular occlusions and investigation of anaphylactic reactions.TRIAL REGISTRATIONNot applicable.

The Jahn-Teller effect of Mn3 + brings drastic structural changes to MnO2 -based materials and accelerates the destruction and deactivation of the internal structure of the materials, thus leading to severe capacity fading and phase change of MnO2 -based materials in aqueous zinc ion batteries (AZIBs). Here, this study doped high valent vanadium ions into MnO2 (VMO-x) to inhibit manganese's Jahn-Teller effect. Through a series of characterizations, such as X-ray diffraction (XRD), Raman spectroscopy, and scanning electron microscopy (SEM), it was discovered that the introduction of vanadium ions effectively increased the interlayer spacing of MnO2 , facilitating the transport of ions into the interlayer. Additionally, Fourier transform infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS) demonstrated vanadium doped could effectively adjust the electronic structure, decreasing the average oxidation state of manganese, thereby inhibiting the Jahn-Teller effect and significantly enhancing the stability of the VMO-x cathode. The theoretical calculation showed that introducing vanadium ions enhanced the interaction between the main material and Zn2 + , optimized its electron transport capacity, and led to better electrical conductivity and reaction kinetics of the VMO-5. Benefiting from this, the VMO-5 cathode exhibited an outstanding capacity of 283 mAh/g and maintained a capacity retention rate of 79% after 20 0 0 cycles, demonstrating excellent electrochemical performance. Furthermore, the mechanism of H+ /Zn2 + co-intercalation/deintercalation was demonstrated through mechanism analysis. Finally, the test results of the pouch cell demonstrated the excellent flexibility and safety exhibited by the VMO-5 make it have great potential in flexible devices. This work presented a novel approach to doping high valence metal ions into manganese-based electrodes for AZIBs. (c) 2025 Published by Elsevier B.V. on behalf of Chinese Chemical Society and Institute of Materia Medica, Chinese Academy of Medical Sciences.

Purpose:The present study aimed to investigate the association of perioperative dynamic changes of systemic inflammation markers with AKI after radical cystectomy and their predictive value through machine learning algorithms. Patients and Methods:Patients undergoing radical cystectomy with urinary diversion for bladder cancer from 2013 to 2022 at three university-affiliated tertiary hospitals were gathered. Perioperative dynamic changes of systemic inflammatory markers were calculated based on peripheral blood cell counts from pre- and post-operative values and categorized using restricted cubic splines (RCS). The number of positive changes in these markers was recorded as the perioperative inflammation index. Multivariable logistic regression was utilized to identify risk factors for AKI after radical cystectomy. AKI prediction models were constructed through various supervised machine learning algorithms and evaluated by the area under the receiver operating characteristic curve (AUROC). Results:727 patients were finally enrolled in the study, with 151 (20.8%) patients experiencing AKI following radical cystectomy. Postoperative hemoglobin (p = 0.003; OR, 0.977; 95% CI, 0.962-0.992), albumin level (p = 0.007; OR, 0.906; 95% CI, 0.843-0.974), intraoperative fluid infusion rate (p < 0.001; OR, 0.769; 95% CI, 0.665-0.890) and the perioperative inflammation index (p < 0.001; OR, 1.507; 95% CI, 1.209-1.877) were identified as independent risk factors with predictive value for AKI following radical cystectomy with urinary diversion. Among various machine learning models, XGBoost performed best (AUROC: 0.801; 95% CI: 0.735-0.867) in AKI prediction. Conclusion:The association between perioperative dynamic changes of inflammatory markers and AKI after radical cystectomy reinforced the necessity of perioperative inflammatory evaluation. AKI predictive models, integrating perioperative metrics, enable early identification and optimize perioperative management for AKI prevention.

Wearable pressure sensors with excellent performance have broad application potential in flexible electronics, motion detection, healthcare biomonitoring, etc. However, it remains a critical challenge to achieve high sensitivity, broad sensing range, excellent mechanical stability, fast response/recovery, and advanced characteristics simultaneously. Herein, a 3D flexible wearable piezoresistive sensor with high sensitivity, broad range, and rapid response is established via the utilization of reduced graphene oxide (rGO), zeolitic imidazolate framework-8 (ZIF-8), and polyurethane (PU) sponge. This rGO-ZIF-8@PU hybrid sensor exhibits ultrahigh sensitivity (243.24 kPa-1), wide detection range (0-200 kPa), fast response/recovery time (70 ms/80 ms), outstanding repeatability (over 5000 cycles), and satisfactory sensitivity retention (similar to 90%). In addition, this sensor also achieves an outstanding bacteriostatic property and brilliant breathability, providing ample convenience for the comfort and health of wearable devices. Besides, the strong ability to recognize multiple target objects endows our sensor with a more advanced mission, which could be of great help in assisting the lives of blind people. This outstanding 3D piezoresistive sensor shows broad application prospects in the next generation of electronic skin, healthcare, and artificial intelligence.

P2-Na0.66Mn0.6Li0.1Ti0.1(MgAlCuZn)0.05O2 is a potential high-entropy cathode for sodium-ion batteries, showing high initial reversible capacity of 245.56 mA h g-1 at 0.05C. Despite this, it still faces deficiencies in cycle and rate performance. Our experimental and theoretical findings indicate that strategic F doping can substantially improve the crystal stability and Na+ transport dynamics. Notably, the Na0.66Mn0.6Li0.1Ti0.1(MgAlCuZn)0.05O1.7F0.3 stands out for its enhanced cycling stability and rate performance.

In the field of intelligent tactile perception, achieving synchronous and precise monitoring of pressure and friction forces represents a fundamental challenge for replicating authentic tactile interactions. This complexity primarily stems from the intricate signal coupling between pressure and friction modalities. Drawing inspiration from the biomechanical mechanisms of human fingerprints, a dual‐mode bionic fingerprint tactile sensor (BFTS) is developed that generates distinct capacitive responses to both pressure and friction stimuli. The sensor demonstrates remarkable pressure sensitivity, enabling precise discrimination of 3D blocks with varying hardness levels. Furthermore, its superior friction‐sensing capability achieves accurate differentiation of 2D fabric surfaces with texture variations. To address the inherent signal coupling in concurrent pressure‐friction detection, a hybrid deep learning architecture is devised, synergistically integrating Convolutional Neural Network (CNN), Long Short‐Term Memory (LSTM), and Attention Mechanism (AM). This multimodal fusion model achieves exceptional signal decoupling performance ( R 2 ≥ 0.95) through spatiotemporal feature extraction and adaptive weight allocation. Implemented on the BFTS platform, the integrated intelligent tactile perception system (ITPS) attains 97% classification accuracy for six visually similar citrus varieties. The proposed methodology not only resolves long‐standing challenges in tactile signal decoupling but also establishes a new paradigm for multimodal perception in next‐generation intelligent tactile systems.

New electrochemical energy storage systems have stringent requirements for energy storage materials, and traditional MnO2 cannot comply with the requirements because of the problems of electrical conductivity and phase transition. In this work, a novel polypyrrole (PPy) intercalation MnO2 (MnO2/PPy-x) material was prepared and proved to be suitable for use in a high performance cathode of aqueous zinc ion batteries (AZIBs). The material characterization results proved that PPy played a key role between MnO2 layers, and the reduction of Mn and extension of Mn-O bonds inhibited the distortion reaction of MnO2, resulting in enhanced structural stability and excellent cycle life. In addition, electrochemical analysis revealed the H+/Zn2+ co-intercalation mechanism, and MnO2/PPy-1 had high electrical conductivity, and fast reaction kinetics. Density functional theory (DFT) calculation proved the change of electron distribution between the MnO2 layers. The PPy endowed MnO2 with excellent electrical conductivity. Moreover, as an interlayer spacer, it hindered charge transfer and decreased the binding ability of Zn2+ and MnO2. As a result, the electrochemical performance of MnO2/PPy-1 was greatly enhanced. The final results demonstrated that MnO2/PPy-1, which has a high conductivity and wide layer spacing, offered a superior capacity of 234 mA h g-1 and a long cycle life of 2000 cycles at a current density of 1 A g-1. In addition, according to the test results of pouch batteries, MnO2/PPy-1 shows great potential for the flexible device market because of its superior flexibility and safety. This work provides a new method and approach for the modification of MnO2-based materials.

BackgroundHead and neck free flap reconstruction presents challenges in managing intraoperative circulation, potentially leading to prolonged length of stay (PLOS). Limited research exists on the associations between intraoperative circulation and PLOS given the difficulty of manual quantification of intraoperative circulation time-series data. Therefore, this study aimed to quantify intraoperative circulation data and investigate its association with PLOS after free flap reconstruction utilizing machine learning algorithms.Methods804 patients who underwent head and neck free flap reconstruction between September 2019 and February 2021 were included. Machine learning tools (Fourier transform, et al.) were utilized to extract features to quantify intraoperative circulation data. To compare the accuracy of quantified intraoperative circulation and manual intraoperative circulation assessments in the PLOS prediction, predictive models based on these 2 assessment methods were developed and validated.ResultsIntraoperative circulation was quantified and a total of 114 features were extracted from intraoperative circulation data. Quantified intraoperative circulation models with a real-time predictive manner were constructed. A higher area under the receiver operating characteristic curve (AUROC) was observed in quantified intraoperative circulation data models (0.801 [95% CI, 0.733–0.869]) compared to manual intraoperative circulation assessment models (0.719 [95% CI, 0.641–0.797]) in PLOS prediction.ConclusionMachine learning algorithms facilitated quantification of intraoperative circulation data. The developed real-time quantified intraoperative circulation prediction models based on this quantification offer a potential strategy to optimize intraoperative circulation management and mitigate PLOS following head and neck free flap reconstruction.

Background: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) potentially increase the risk of pulmonary aspiration resulting from impaired gastric emptying (IGE). We evaluated the association between GLP-1RAs and IGE using the US Food and Drug Administration Adverse Event Reporting System (FAERS). Methods: We analysed FAERS data from 2004 Q1 to 2024 Q1, identifying the top 10 drugs linked to IGE and determining the proportion of GLP-1RA use. Disproportionality analysis using the reporting odds ratio was conducted to assess the relative IGE risk for each drug. Logistic regression analysed the impact of age, weight, and sex on IGE risk. Cumulative incidence and time to onset of IGE events were examined using Kaplan-Meier and Weibull shape parameter tests. Results: Among the top 10 drugs associated with IGE reports, five were GLP-1RAs, accounting for 49.5% (982/1982) of cases. Dulaglutide (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.94-1.00, P=0.033) and semaglutide (OR 0.96, 95% CI 0.94-0.97, P=0.001) showed lower IGE risk with older age. For exenatide, higher weight (OR 0.99, 95% CI 0.98-1.00, P=0.033) and male sex (OR 0.39, 95% CI 0.20-0.68, P=0.033) were associated with lower IGE risk. Median onset times ranged from 40.5 days (semaglutide) to 107.5 days (tirzepatide) from intitiation of therapy. The Weibull shape parameter b was <1 for all GLP-1RAs, indicating a higher IGE risk early in treatment. Conclusions: GLP-1RAs were notably associated with reports of impaired gastric emptying in the FAERS. Age, weight, and sex were significantly associated with impaired gastric emptying risk for certain GLP-1RAs. IGE events tended to occur early in treatment, with risk diminishing over time. These findings provide valuable references for future research on perioperative safety with GLP-1RAs.

The integration of memristors and temperature sensors enables high-precision temperature recognition and realtime monitoring. Importantly, understanding the impact of temperature variations on the human body is also critical. In this study, the Co-TCPP (TCPP: 4 (4-carboxyphenyl)) nanosheet-based memristor demonstrates typical synaptic plasticity at a low operating voltage of 160 mV, with synaptic characteristics remaining well-preserved even after 2000 bending cycles with a 5 mm radius. The neuromorphic system constructed using flexible CoTCPP nanosheet-based memristor achieves a recognition accuracy of up to 95.99 %, meanwhile has a faster pixel image reconstruction speed. Notably, the Co-TCPP nanosheet-based memristor and NTC (negative temperature coefficient) temperature sensor effectively simulate moisture turnover at different temperatures. As the temperature increases, both moisture consumption and replenishment rise accordingly. These results highlight the significant potential of this approach in artificial intelligence and the future development of bionic robots.

Background:Nerves in the tumor microenvironment (TME) promote malignant phenotypes of cancer. Neuron-targeting cancer treatment strategies have garnered significant attention. However, existing pharmacological or surgical methods of denervation can lead to side effects such as pain and respiratory system issues. Targeted delivery of local anesthetics to the TME using nanotechnology to suppress nerves appears to be a promising approach. Methods:NP-BUP, an acid-responsive nanoparticle encapsulating the local anesthetic bupivacaine, was synthetized using a nano-precipitation method. Immunofluorescence staining was employed to identify the primary types of nerves in breast tumors. In vitro, the impact of the neurotransmitter on the recruitment of macrophages by tumor supernatant is assessed using the transwell assay. ELISA assays and intracellular Ca2+ measurement experiments were conducted to evaluate the inhibitory effect of NP-BUP on noradrenergic neurons. In vivo, the impact of NP-BUP on noradrenergic neurons, tumor-associated macrophages (TAMs) infiltration, and tumor growth within the TME were assessed. Results:The predominant type of neuron within breast tumor tissues was found to be noradrenergic neuron. Noradrenergic neuronal uptake of NP-BUP at pH 6.5 was 2.4 times higher than at pH 7.4. In vitro, NP-BUP significantly inhibited the release of norepinephrine (NE), a neurotransmitter that promotes macrophage migration, from adrenergic cells. In vivo, tumor tissues from 4T1 tumor-bearing mice treated with NP-BUP showed a significant reduction in NE content and macrophage infiltration, with tumor volume and weight decreasing by approximately 70% compared to the PBS group. Conclusion:Our study provides a TME pH-responsive nanoplatform for targeted suppression of neuronal control within the TME. Our results demonstrate that specifically modulating innervation within the TME can influence the growth of breast cancer.

The platelike nickel-terephthalate-type metal-organic framework nanoarrays (Ni-BDC NAs) on carbon cloth are obtained by employing agaric-like Ni(OH)2 NAs as sacrificial templates. The microenvironment of Ni-BDC NAs is modulated by various neighboring functional groups (-NH2, -NO2, and -Br) on the carboxylate ligand, exerting minimal destructive effects on the structure and morphology of Ni-BDC NAs. The electrochemical oxygen evolution reaction (OER) of Ni-BDC-NH2 NAs, Ni-BDC-NO2 NAs, and Ni-BDC-Br NAs exhibited a significant enhancement compared to that of Ni-BDC NAs alone, as evidenced by both experimental and theoretical assessments. The presence of neighboring groups exerts a positive influence on the electronic coupling between Ni and O atoms, thereby facilitating the thermodynamically favorable formation of *O intermediates on Ni sites and accelerating the kinetics of the OER. The findings presented here provide valuable insights for the design and utilization of carboxylic acid molecules with functional group effects, enhancing the activity of the OER across diverse Ni centers.

Introduction Propofol is the preferred sedative for painless hysteroscopy and other procedures due to its fast onset and short duration. However, its limitations, including injection pain, respiratory depression, blood pressure decline, and bradycardia, cannot be disregarded. Ciprofol, a new short-acting gamma-aminobutyric acid receptor agonist, has shown effectiveness and safety in painless gastrointestinal endoscopy. This study aims to demonstrate that ciprofol is not inferior to propofol in terms of sedation efficacy for painless hysteroscopy.Patients and methods A randomized study was conducted with 124 women to evaluate the anesthetic effect of ciprofol during outpatient painless hysteroscopy. The primary outcome assessed was the success rate of hysteroscopy, while secondary indicators included induction and recovery time, injection pain, tidal volume and respiratory rate. Safety indicators comprised hypotension, hypoxemia, and sinus bradycardia.Results A total of 124 patients were enrolled in the study, with 62 in each group. The success rate of hysteroscopy was 100% in both groups. Patients in the ciprofol group had higher diastolic pressure, pulse oxygen saturation levels and minute breathing during surgery than patients in the propofol group, but their induction time and recovery time were longer. The proportion of patients in the propofol group who reported pain during intravenous anesthesia was 41.935%, which was significantly higher than that of patients in the ciprofol group (1.613%).Conclusion During painless hysteroscopy, ciprofol demonstrates non-inferiority to propofol in terms of anesthetic efficacy. Despite slightly longer induction and recovery times, ciprofol results in lower instances of injection pain and less impact on respiration and circulation compared to propofol.Trial number Clinical trial Registration Identifier: NCT06172140.