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Herein, we synthesized fly ash aggregates (FAAs) through a hydrothermal synthesis process utilizing fly ash, quicklime, and cement under saturated steam conditions at 180 °C. We systematically investigated the influence and mechanisms governing the physical and mechanical properties of autoclaved FAAs by incrementally replacing cement with quicklime in 5% equal mass intervals. Our results revealed that the substitution of cement with quicklime yielded lightweight aggregates (LWAs) exhibiting water absorption ranging from 1.33% to 22.88% after 1 h and 1.67% to 26.22% after 24 h, loose bulk densities between 847 kg/m3 and 1043 kg/m3, apparent densities spanning from 1484 kg/m3 to 1880 kg/m3, and cylinder compressive strengths varying from 11.9 MPa to 18.5 MPa. Notably, as the proportion of quicklime substitution for cement increased, there was a corresponding augmentation in water consumption during granulation, resulting in an elevated water–cement ratio ranging from 27.5% to 51.39%. This led to an enhancement in the water absorption of the FAAs, accompanied by a decrement in cylinder compressive strength and overall density. The hydration products, including tobermorite and calcium silicate hydrate, contributed to the creation of a dense microstructure within the FAAs. However, with higher quantities of quicklime replacing cement, the content of hydration products increased while the proportion of unreacted fly ash particles decreased significantly. The resultant weakening micro-aggregate effect emerged as a pivotal factor contributing to the observed decrement in the strength of these FAAs. The findings of this research are anticipated to provide significant theoretical insights and technical support for the selection of calcareous materials in the resource-recycling process of fly ash. [ABSTRACT FROM AUTHOR]

Background: Ischemic left ventricular (LV) aneurysm is associated with LV thrombus and subsequent embolic events. However, there is currently no evidence-based recommendation for anticoagulation in these patients., Objective: To determine the characteristics of LV aneurysms associated with a high risk of thrombus formation., Methods: This retrospective study included all hospitalized patients with ischemic LV aneurysm who underwent cardiac magnetic resonance (CMR) from September 2015 to June 2023. Baseline characteristics and CMR parameters were compared between patients with and without LV thrombus. Factors associated with LV thrombus were identified using univariable and multivariable logistic regression analyses., Results: Among the 317 patients included in this study, 88 (27.8%) had LV thrombus. Patients with LV thrombus demonstrated a higher prevalence of heart failure, lower left ventricular ejection fraction, and greater volume, mass, and global extent of late gadolinium enhancement (LGE). They also exhibited distinct LV aneurysm characteristics, such as a larger maximum transverse dimension (maximum width), a wider aneurysm neck, and a higher aneurysm shape index (ratio of maximum length to neck width). Multivariable logistic regression analyses identified aneurysm neck width (OR 1.33 per 5 mm, 95% CI 1.00-1.77, P = 0.047), shape index (OR 1.63 per 20%, 95% CI 1.23-2.16, P = 0.001), and LGE global extent > 50% (OR 6.58, 95% CI 3.04-14.27, P < 0.001) as significant predictors of LV thrombus., Conclusions: A wider aneurysm neck, a higher aneurysm shape index, and LGE global extent > 50% are associated with LV thrombus in patients with ischemic LV aneurysm., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Background: The anti-tumor effects of Traditional Chinese Medicine has been recognized in regulating the tumor microenvironment. Jianpi Jiedu Recipe (JPJDR) is clinically effective in enhancing the chemotherapy efficacy in Colorectal Cancer (CRC) treatment and significantly improved the quality of life of CRC patients. However, its therapeutic mechanism remains to be investigated., Material and Methods: The active compounds of each herb in JPJDR were obtained from the HIT2.0 and HERB databases supported by evidence in literature. Single-cell RNA sequencing data of CRC were obtained from published studies (PMID: 32451460, 32103181, and 32561858). Pathway enrichment was analyzed using the reactome database, and gene correlation analysis was performed using the corrplot R software package. Gene expression regulated by JPJDR was verified by RT-qPCR., Results: Ye Pu Tao Teng, Ba Yue Zha, Huang Qi, Bai Zhu, Yi Yi Ren and Dang Shen contained 4,7, 18, 26,3 and 30 compounds, respectively, and they target to 38, 7, 262, 309, 50, 54 genes, respectively. JPJDR is involved in a range of immune-related biological processes, including cytokine signaling, cell proliferation, apoptosis and cellular senescence. JPJDR regulates various cell types in the CRC microenvironment, including malignant CRC cells, immune cells (including CD4+ T cell, CD8+ T cell, B cell, plasma cell, mast cell, and myeloid cell), and stromal cells (including fibroblast, pericyte, enteric glial cell, and endothelial cell). We confirmed that JPJDR significantly downregulated the expression of HMGB1 and MT2A in CRC., Conclusions: JPJDR regulates a range of cell types in the CRC microenvironment, including malignant CRC, immune cells and stromal cells. Downregulation of HMGB1 and MT2A might be the important mediators for JPJDR to modulate the CRC microenvironment., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Frailty is an independent risk factor for cardiovascular events. It is uncertain whether frailty modifies the efficacy of intensive blood pressure (BP) control among participants with type 2 diabetes mellitus(T2DM)., Methods: The Action to Control Cardiovascular Risk in Diabetes Blood Pressure (ACCORD BP) trial, a two-by-two factorial trial, examined the effects of systolic BP (<120 vs <140 mm Hg) and glycaemic control on cardiovascular events in T2DM. We constructed a frailty index using the Rockwood cumulative deficit approach. Cox proportional hazard models were used to estimate the effectiveness of intensive BP treatment according to frailty status. The primary composite outcome was non-fatal myocardial infarction, non-fatal stroke or death from cardiovascular causes., Results: There were 4733 participants (mean age: 62.7 years; 39.9% frailty). The mean average number of antihypertensive medications was higher in frail patients compared with non-frail patients in both the standard (2.2 vs 1.7) and intensive (3.1 vs 2.7) treatment groups. In the standard glycaemic arm, intensive BP treatment reduced the risk of the primary outcome (HR 0.75, 95% CI 0.58 to 0.97) regardless of frailty status (p value for interaction=0.86). The benefits of intensive BP intervention were consistent across the spectrum of the frailty index (p value for interaction=0.96) in the standard glycaemic arm. However, no benefits of intensive BP treatment (HR 1.08, 95% CI 0.82 to 1.43) were observed in the intensive glycaemic arm., Conclusions: In the ACCORD BP study, the benefit of intensive BP treatment was consistent regardless of frailty in the setting of standard glycaemic control. Frailty should not be a barrier to intensive BP control in patients with T2DM treated with guideline-recommended standard glycaemic control., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.)

Background: We aim to determine the effectiveness of a community-based, health instructor led, multifaceted family intervention, as compared with usual care, on blood pressure (BP) management among Chinese rural residents, with or without hypertension., Methods/design: The Healthy Family Program is a cluster randomized controlled trial being undertaken in 80 villages (each with approximately 100 residents) with a target to enroll a total of 8000 older adults (aged 40-80 years). Villages were randomly assigned in a 1:1 ratio to either an intervention group to receive multifaceted strategies or a control group to continue with usual standard of care. The main components of the multifaceted intervention strategies include: 1) Establishing a BP management team led by family health instructors, with team members including family leaders and village doctors, and 2) Implementing an intervention that focused on six areas: education for a healthy lifestyle, free provision of sodium substitute, weight management, physical exercise, BP monitoring, and appropriate antihypertensive treatment for individuals with hypertension. The primary outcome is change in systolic BP from baseline to 6 months in all participants, reported as the absolute difference between intervention and control groups. After the 6-month intervention, support from the study coordination center and the distribution of low-sodium salt will be withdrawn, and all participants will be followed up until 12 months. As of December 31, 2024, 24 villages in the intervention group have completed the 6-month intervention., Conclusion: The Healthy Family Program will provide critically important data on the effectiveness of a novel BP management strategy in rural China., Trial Registration: The study is registered at ClinicalTrials.gov (NCT06427096)., (Copyright © 2025. Published by Elsevier Inc.)