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Purpose This study evaluated the elastic characteristics of the pulmonary trunk and distal branches in fetuses diagnosed with tetralogy of Fallot (TOF) using Doppler echocardiography. Methods Data on 42 fetuses diagnosed with TOF and 84 gestational age–matched normal fetuses were prospectively collected from the Second Xiangya Hospital of Central South University between August 2022 and January 2023. The severity of TOF was classified into three categories based on the z-score of the pulmonary annulus diameter: mild (z-score ≥-2), moderate (-40.05). Conclusion Fetuses diagnosed with TOF exhibited increased vascular stiffness in the MPA and reduced stiffness in the distal pulmonary artery (PA). Larger-scale follow-up studies are required to elucidate the relationships between these changes in vascular stiffness and PA development in patients with TOF.

BackgroundPrevious observational clinical studies and meta-analyses have yielded inconsistent results regarding the relationship between vitamin D and headache, and the causal relationship remains unclear. The aim of this study was to investigate the causal relationship between vitamin D and headache by bidirectional two-sample Mendelian randomisation (MR) analysis.MethodsThe relationship between high levels of vitamin D and headache was investigated by two-sample MR analysis using publicly available genome-wide association study (GWAS) data. The primary method was inverse variance weighting (IVW), and secondary methods were weighted median and MR-Egger methods. No heterogeneity or horizontal multidirectionality was found in the MR results. The robustness and validity of the findings were assessed using the leave-behind method.ResultsA significant causal relationship was found between high vitamin D levels and headache using the IVW method (OR = 0.848; p = 0.007; 95% CI = 0.752–0.956). However, in a reverse analysis, no evidence of a causal relationship between headache and high levels of vitamin D was found using the IVW method (OR = 1.001; p = 0.906; 95% CI = 0.994–1.006). Our MR analyses showed no significant horizontal multidimensionality or heterogeneity (p > 0.05). Sensitivity analyses confirmed that MR estimates were not affected by single nucleotide polymorphisms (SNPs). Confirmation that our results are robust and valid has been obtained by the leave-one-out method.ConclusionOur study suggests that high levels of vitamin D prevent the risk of headache. However, there is no evidence of a causal relationship between headache and high levels of vitamin D. Vitamin D may reduce the risk of headache.

Abstract Background We investigated the synergistic effect of stress and habitual salt preference (SP) on blood pressure (BP) in the hospitalized Omicron-infected patients. Methods From 15,185 hospitalized Omicron-infected patients who reported having high BP or hypertension, we recruited 662 patients. All patients completed an electronic questionnaire on diet and stress, and were required to complete morning BP monitoring at least three times. Results The hypertensive group (n = 309) had higher habitual SP (P = 0.015) and COVID-19 related stress (P

Abstract Background Sepsis is a life‐threatening organ dysfunction caused by a dysregulated host response to infection and progressive immunosuppression with high mortality. HLA‐DR, CD64, and PD‐1 were assumed to be useful biomarkers for sepsis prediction. However, the ability of a combination of these biomarkers has not been clarified. Methods An observational case‐control study was conducted that included 30 sepsis patients, 30 critically ill patients without sepsis admitted to the intensive care unit (ICU), and 32 healthy individuals. The levels of HLA‐DR, CD64, and PD‐1 expression in peripheral blood immune cells and subsets was assayed on Days 1, 3, and 5, and the clinical information of patients was collected. We compared these biomarkers between groups and evaluated the predictive validity of single and combined biomarkers on sepsis mortality. Results The results indicate that PD‐1 expression on CD4−CD8−T (PD‐1+CD4−CD8−T) (19.19% ± 10.78% vs. 9.88% ± 1.79%, p = .004) cells and neutrophil CD64 index (nCD64 index) (9.15 ± 5.46 vs. 5.33 ± 2.34, p = .001) of sepsis patients were significantly increased, and HLA‐DR expression on monocytes (mHLA‐DR+) was significantly reduced (13.26% ± 8.06% vs. 30.17% ± 21.42%, p = 2.54 × 10−4) compared with nonsepsis critically ill patients on the first day. Importantly, the expression of PD‐1+CD4−CD8−T (OR = 0.622, 95% CI = 0.423–0.916, p = .016) and mHLA‐DR+ (OR = 1.146, 95% CI = 1.014–1.295, p = .029) were significantly associated with sepsis mortality. For sepsis diagnosis, the mHLA‐DR+, PD‐1+CD4−CD8−T, and nCD64 index showed the moderate individual performance, and combinations of the three biomarkers achieved greater diagnostic value (AUC = 0.899, 95% CI = 0.792–0.962). When adding PCT into the combined model, the AUC increased to 0.936 (95% CI = 0.840–0.983). For sepsis mortality, combinations of PD‐1+CD4−CD8−T and mHLA‐DR+, have a good ability to predict the prognosis of sepsis patients, with an AUC = 0.921 (95% CI = 0.762–0.987). Conclusion These findings indicate that the combinations of HLA‐DR, CD64, and PD‐1 outperformed each of the single indicator in diagnosis and predicting prognosis of sepsis.

BackgroundEndovascular or surgical treatment of wide-neck, large basilar apex aneurysms is challenging. We present a novel concept for the treatment of complex basilar apex aneurysms using flow-diverter devices combined with the flow-T stenting-assisted coiling technique. Assess the efficacy and safety profile of the technique in this complex aneurysm.Case descriptionA patient with multiple unruptured intracranial aneurysms underwent staged treatment. A large basilar apex aneurysm was treated with a flow-diverter stent combined with a flow-T stenting-assisted coiling technique in the first stage, and a giant supraclinoid aneurysm was treated with a flow-diverter stent applied in the second stage. Clinical presentations, technical details, intra- and perioperative complications, and clinical and angiographic outcomes were recorded, with a 9-month follow-up.ResultsThe patient achieved full neurologic recovery postoperatively. Cerebral angiography performed postoperatively showed revascularization, good laminar flow, and no in-stent or adjacent stenosis.ConclusionFlow-diverter stents combined with flow-T stenting-assisted coiling for the treatment of giant basilar apex aneurysms is a feasible technique with efficacy demonstrated at a 9-month follow-up. Staged endovascular treatment of multiple intracranial aneurysms may be a safe and viable option.

Cobalt-chromium-nickel (Co-Cr-Ni) alloys were prepared by two techniques of the sub-rapid solidification (SRS) and vacuum sintering (VS). The effects of the preparation processing and the content of Cr, Ni on the microstructure evolution were investigated in detail. Results show samples under SRS present a typical dual-phase dendrite microstructure of the face centered cubic (γ-fcc) crystal and the hexagonal closest packing (ε-hcp) crystal, which is independent of the raw material composition. The γ-fcc phase forms in dendrite arms, while the ε-hcp phase forms in inter-dendrites. With the increase of the solidification rate, the secondary dendrite spacing decreases. The main solute elements Cr and Ni take segregation between the two phases of γ-fcc and ε-hcp. Cr concentrates in inter-dendrites, and Ni exists in dendrite arms. The microstructure of cobalt chromium nickel alloy prepared by VS is determined by its composition, and the sintered body of low nickel content alloy is single-phase ε-hcp structure, the grains exhibit a sharp coarsening characteristic with the increase of sintering temperature. The sintered body of high nickel content alloy is γ-fcc+ ε-hcp dual phase structure, the grains are small and γ-fcc phase exhibits obvious twinning and stacking fault structures. Compared with the casted alloy, the sintered alloy exhibits a marked improvement in the uniform plastic elongation. The dislocation defect is the prime microstructural unit that promotes the improvement in the mechanical property of the sintered alloy with the single-phase structure of ε-hcp, while the defects of the crystal twins and stacking faults are considered as the key factors determining both the strength and toughness for those with the dual-phase structure of ε-hcp and γ-fcc.

CoCrFeNi-(Nb, Ta) high-entropy alloys (HEAs) were prepared by a vacuum arc melting process, and the synergistic effect of Nb and Ta concentrations on the microstructure evolution and mechanical properties was investigated in detail. Nb and Ta concentrations in the HEAs affect the microstructure compositions, eutectic phase lamella spacings, Laves phase size topographies, phase volume fractions and compositions. The alloy with an equal atomic ratio of Nb/Ta show an eutectic microstructure of the face centered cubic (FCC) crystal matrix and Laves phase, while those with non-equal atomic ratio of Nb/Ta exhibit the microstructure of the eutectic (FCC+Laves) phase and primary Laves phase. The volume fraction and grain size of the primary Laves phase monotonically increase with the increase of Nb/Ta atomic ratio. The compressive yield strength of HEAs is monotonously improved with the volume fraction of Laves phase, whereas the ultimate strength is hardly affected by the microstructure composition. Compression plasticity is negatively correlated with the volume fraction, type, and size distribution of Laves phase. The strengthening mechanism of CoCrFeNi-(Nb, Ta) HEAs was analyzed with theoretical calculation, and the relationship between the microstructure composition and the alloy strengths was established. The results indicate that the fine-grain strengthening and second phase strengthening of Laves phase are the main factors for the improvement of yield strength.

Topological magnetic textures are promising candidates as binary data units for the next-generation memory device. The precise generation and convenient control of nontrivial spin topology at zero field near room temperature endows the critical advantages in skyrmionic devices but is not simultaneously integrated into one material. Here, in the Kagome plane of quantum TbMn 6 Sn 6 , the expedient generation of the skyrmion bubbles in versatile forms of lattice, chain, and isolated one by converging the electron beam, where the electron intensity gradient contributes to the dynamic generation from local anisotropy variation near spin reorientation transition (SRT) is reported. Encouragingly, by utilizing the dynamic shift of the SRT domain interface, the straight movement is actualized with the skyrmion bubble slave to the SRT domain interface forming an elastic composite object, avoiding the usual deflection from the skyrmion Hall effect. The critical contribution of the SRT domain interface via conveniently electron-assisted heating is further theoretically validated in micromagnetic simulation, highlighting the compatible application possibility in advanced devices., (© 2024 Wiley‐VCH GmbH.)