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The prevalent issue of cadmium (Cd) in naturally selenium (Se)-enriched soils has significantly impacted the safe utilization of Se-rich soils. Although Se antagonizes Cd and is affected by Se:Cd stoichiometry, the mechanism behind this interaction remains unclear. To reveal the relation between the soil bioavailable Se:Cd molar ratio (AMR-Se:Cd) and the transformation of Se and Cd fractions, as well as to identify the principal controlling factors, we conducted a study in Shanggao County, Yichun City, a naturally Se-rich area in Jiangxi Province, and quantitatively analyzed the distribution features of Se, Cd, and AMR-Se:Cd across different soil types and land use types. The results demonstrated that soil AMR-Se:Cd was statistically positively correlated with the bioavailable Se content (r = 0.331, p < 0.01) and had a negative correlation with the bioavailable Cd content (r = −0.402, p < 0.001). Cd was transformed from highly bioavailable fractions to less bioavailable fractions as the AMR-Se:Cd increased. A suitable AMR-Se:Cd was conducive to achieving a higher mobility of Se (mobility factor of 12.31%) and a lower mobility of Cd (mobility factor of 23.49%) simultaneously. Spearman correlation analysis and partial least squares path modeling revealed that soil type and land use type modulated the morphological transformation of soil Se and Cd by influencing changes in free Fe-Al oxides and soil organic matter content, which in turn altered the AMR-Se:Cd. Therefore, the findings of this study can offer guidance for regulating the appropriate AMR-Se:Cd in Se-rich soils through management practices to enhance the bioavailability and mobility of soil Se while diminishing the bioavailability and mobility of Cd.

Abstract Cervical cerclage is an established procedure for treating cervical insufficiency; however, its efficacy in twin pregnancies remains uncertain. This study aimed to evaluate the effectiveness of transvaginal cervical cerclage in twin pregnancies complicated by cervical insufficiency. Data were retrospectively collected from 155 women with twin pregnancies diagnosed with cervical insufficiency. Participants were divided into two groups: the cerclage group (n = 131) and the non-cerclage group (n = 24). The cerclage group was further subdivided into emergency cerclage and ultrasound-indicated cerclage subgroups for detailed analysis. The duration of gestation was found to be longer in the cerclage group compared to the non-cerclage group. Procedures performed included both emergency and ultrasound-indicated cerclage. No significant difference in gestational outcomes was observed between the ultrasound-indicated cerclage subgroup and the non-cerclage group, regardless of cervical length ( 1 cm or ≤ 1 cm). Overall, cervical cerclage appears to improve pregnancy outcomes in twin pregnancies under specific conditions. While ultrasonographically indicated cerclage did not significantly enhance pregnancy outcomes, emergency cerclage may be effective in improving perinatal prognosis.

Abstract Background Acute fatty liver of pregnancy (AFLP) is an uncommon but potentially life-threatening complication. Lacking of prognostic factors and models renders prediction of outcomes difficult. This study aims to explore factors and develop a prognostic model to predict three-month mortality of AFLP. Methods This retrospective study included 78 consecutive patients fulfilling both clinical and laboratory criteria and Swansea criteria for diagnosis of AFLP. Univariate and multivariate cox regression analyses were used to identify predictive factors of mortality. Predictive efficacy of prognostic index for AFLP (PI-AFLP) was compared with the other four liver disease models using receiver operating characteristic (ROC) curve. Results AFLP-related three-month mortality of two medical centers was 14.10% (11/78). International normalised ratio (INR, hazard ratio [HR] = 3.446; 95% confidence interval [CI], 1.324–8.970), total bilirubin (TBIL, HR = 1.005; 95% CI, 1.000-1.010), creatine (Scr, HR = 1.007; 95% CI, 1.001–1.013), low platelet (PLT, HR = 0.964; 95% CI, 0.931–0.997) at 72 h postpartum were confirmed as significant predictors of mortality. Artificial liver support (ALS, HR = 0.123; 95% CI, 0.012–1.254) was confirmed as an effective measure to improve severe patients’ prognosis. Predictive accuracy of PI-AFLP was 0.874. Area under the receiver operating characteristic curves (AUCs) of liver disease models for end-stage liver disease (MELD), MELD-Na, integrated MELD (iMELD) and pregnancy-specific liver disease (PSLD) were 0.781, 0.774, 0.744 and 0.643, respectively. Conclusion TBIL, INR, Scr and PLT at 72 h postpartum are significant predictors of three-month mortality in AFLP patients. ALS is an effective measure to improve severe patients’ prognosis. PI-AFLP calculated by TBIL, INR, Scr, PLT and ALS was a sensitive and specific model to predict mortality of AFLP.

Objective: Twin pregnancies are associated with a higher risk of adverse pregnancy outcomes than are singleton pregnancies. Although the risk factors and predictors of adverse outcomes in singleton pregnancies have been clearly identified in numerous studies, those specific to twin pregnancies remain less consistent. This study was performed to summarize and evaluate the risk factors and predictors of adverse outcomes in twin pregnancies. Mechanism: A comprehensive review was conducted using the PubMed and Web of Science databases to analyze and identify the relevant risk factors and predictors of avderse outcomes in twin pregnancies. Findings in Brief: The risk factors and predictors of adverse outcomes in twin pregnancies are largely similar to those in singleton pregnancies, particularly in relation to preeclampsia and preterm birth and especially for conditions not unique to twin pregnancies. However, there remains a gap in the study of complications specific to twin pregnancies, largely because of their chorionicity. Conclusions: Early identification of risk factors and predictors for adverse outcomes in twin pregnancies facilitates earlier prevention and intervention and lead to improved management of serious complications in twin pregnancies.

Abstract Prostaglandins and their receptors regulate various physiological processes. Carboprost, an analog of prostaglandin F2α and an agonist for the prostaglandin F2-alpha receptor (FP receptor), is clinically used to treat postpartum hemorrhage (PPH). However, off-target activation of closely related receptors such as the prostaglandin E receptor subtype EP3 (EP3 receptor) by carboprost results in side effects and limits the clinical application. Meanwhile, the FP receptor selective agonist latanoprost is not suitable to treat PPH due to its poor solubility and fast clearance. Here, we present two cryo-EM structures of the FP receptor bound to carboprost and latanoprost-FA (the free acid form of latanoprost) at 2.7 Å and 3.2 Å resolution, respectively. The structures reveal the molecular mechanism of FP receptor selectivity for both endogenous prostaglandins and clinical drugs, as well as the molecular mechanism of G protein coupling preference by the prostaglandin receptors. The structural information may guide the development of better prostaglandin drugs.

Introduction: We evaluated the quality of the published clinical practice guidelines on placenta accreta spectrum (PAS) disorders to provide reference for the development of high-quality PAS guidelines. Methods: China National Knowledge Infrastructure (CNKI), Wan Fang, PubMed, Embase, Web of Science, and Cochrane Library were systematically searched. Quality assessments were conducted using the appraisal of guidelines for research and evaluation (AGREE) II framework and Reporting Items for practice Guidelines in Healthcare (RIGHT) checklist. Intraclass correlation coefficients (ICCs) were used to measure the agreement among reviewers. Results: In total, 13 guidelines from different countries, published between 2015 and 2021 were included. There included 9 official guidelines, 3 consensuses, and 1 standard reference and covered subjects including epidemiology, diagnosis and treatment. The mean standardized scores across 6 domains (scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence) were 53.63%, 27.35%, 33.57%, 72.01%, 19.39% and 41.02%, respectively. Of the 13 guidelines, 11 were classified as grade B, whereas 2 as grade C. According to the RIGHT checklist, the overall reporting rate of the 13 guidelines ranged from 28.57% to 54.29%. Conclusion: The current guidelines for PAS demonstrate commendable methodological and reporting qualities. However, the methodological and reporting quality of PAS CPGs still need to be further improved, particularly in stakeholder involvement, the rigor of development, applicability, and editorial independence domains.

Commercial graphite anode has advantages such as low potential platform, high electronic conductivity, and abundant reserves. However, its theoretical capacity is only 372 mA h g−1. High-energy lithium-ion batteries have been a research hotspot. The Si anode has an extremely high specific capacity, but its application is hindered by defects such as large volume changes, poor electronic conductivity, and a small lithium-ion diffusion coefficient. Here, the Si/thermally reduced graphite oxide@carbon (Si/RGtO@C) composite was fabricated by electrostatic self-assembly followed by thermal treatment. The RGtO synergistic carbon coating layer can effectively compensate for the low electronic conductivity and buffer the volume expansion effect of the Si nanoparticles during charge/discharge cycles. The Si/RGtO@C anode demonstrated a significantly increased capacity compared to the RGtO. After 300 cycles, Si/RGtO@C kept a discharged capacity of 367.6 mA h g−1 at a high current density of 1.0 A g−1. The Si/RGtO@C anode shows an application potential for commercial high-energy lithium-ion batteries.

ABSTRACTBackground: The termination of pregnancy in patients with placenta accreta spectrum disorder (PASD) during the second trimester remains uncertain. In addition, interventional radiology techniques, such as arterial embolization and balloon placement, are potential options. We evaluated the outcomes of pregnancy termination in patients with PASD during the second trimester and the effectiveness of preoperative interventional radiology techniques.Methods: This retrospective study analyzed 48 PASD patients who underwent pregnancy termination during the second trimester between January 2016 and May 2021.Results: Of the 48 patients, 20 (41.67%) underwent transvaginal termination, whereas 28 (58.33%) underwent cesarean section. Notably, no significant differences were observed in success rates between the transvaginal termination and cesarean section groups (80.00% vs. 92.86%, P = 0.38). Furthermore, no statistically significant differences were observed in the success rates (94.12% vs 90.32%, P = 1.00) and blood loss (512.35 ± 727.00 ml vs 804.00 ± 838.98 ml, P = 0.23) between the artery embolization and non-embolization groups. In the vaginal termination group, statistically significant differences were observed in gestational weeks (16.70 ± 3.12 vs 22.67 ± 3.63, P

Abstract Background Intrauterine adhesion and cesarean scar diverticulum are the main complications of poor healing after uterine injury. Human umbilical cord MSCs transplantation has been regarded as the most potential treatment in the clinic, the safety and efficacy of which in the clinic, however, remains unclear. Methods In this study, ten patients were enrolled: six with intrauterine adhesion and four with cesarean scar diverticulum. All the patients were injected with human umbilical cord MSCs twice into the uterus. Beside the chest X-ray, ECG and abdominal ultrasound, many laboratory tests including blood routine, liver and renal function, ovarian function, tumor biomarkers, and immune function were used to estimate the safe after stem cell transplanted. In addition, the efficacy of stem cell transplanted was shown by the endometrial thickness, the volume of the uterus, and cesarean scar diverticulum based on 3D ultrasound imaging. Results We found that all results of these laboratory tests were normal in these enrolled patients before and after cell injection. Meanwhile, the results of the chest X-ray and ECG were also normal in the treatment process. The abdominal ultrasound showed that the size of the left and right kidneys was inconsistent in one patient after cell therapy, while those of other patients were normal. In addition, endometrial thickness, the volume of the uterus, and cesarean scar diverticulum showed an improving tendency, but no significant difference was noted. Conclusion In summary, intrauterine injection of clinically graded human umbilical cord MSCs was safe for poor healing after uterus injury. Trial registration NCT03386708. Registered 27 December 2017, https://clinicaltrials.gov/ct2/show/NCT03386708?cond=CSD&cntry=CN&draw=2&rank=2

Objective: To compare the predictive value of different risk assessment methods for puerperium venous thromboembolism (VTE). Methods: This study included 55 women with and 165 women without puerperal VTE. Using the cases, 11 assessment methods were compared. Results: The area under the curve (AUC) value of the 11 assessments was highest for the modified Caprini risk assessment model for pregnancy (a modified risk scoring method from Caprini, AUC = 0.805). Pairwise comparison of the AUC values of the 11 assessment methods indicated no significant difference among the five methods with AUC values > 0.7. Among them, the modified Caprini, the risk scoring method recommended by the Swedish Guidelines (Swedish method), and the risk scoring method recommended by the Shanghai consensus (Shanghai method) performed better than the other six methods with AUC values

Intercellular communication in the decidua plays important roles in relaying information between the maternal and fetal systems in the maintenance of pregnancy and the transition to labor. To date, several studies have explored cell-cell communications in the decidua during different periods of pregnancy, but studies systematically decoding the intercellular communication network, its internal cascades, and their involvement in labor are still lacking. In this study, we reconstructed a decidual cell-cell communication network based on scRNA-seq of peripartum decidua via the CellCall method. The results showed that endometrial cells (EECs) and extravillous trophoblasts relayed most of the common intercellular signals in the decidua both before delivery (DBD) and after delivery (DAD). Endothelial cells and EECs controlled many WNT-signaling-related intercellular communication factors that differed between DBD and DAD, some of which could be candidate biomarkers for the diagnosis of labor. Analysis of intercellular communications related to T cells identified abundant maternal-fetal immune-tolerance-related communication, such as TNFSF14-TNFRSF14/LTBR and FASLG-FAS signalings. We further explored the characteristics of the B cell receptor (BCR) and T cell receptor (TCR) repertoires by single-cell BCR/TCR sequencing. The results showed no significant differences in clonal expansion of B/T cells between DAD and DBD, indicating there was no significant change to adaptive immunity at the maternal-fetal interface during delivery. In summary, the findings provide a comprehensive view of the intercellular communication landscape in the peripartum decidua and identified some key intercellular communications involved in labor and maternal-fetal immune tolerance. We believe that our study provides valuable clues for understanding the mechanisms of pregnancy and provides possible diagnostic strategies for the onset of labor.

Objective: To evaluate the use of tourniquet and forceps to reduce bleeding during surgical treatment of severe placenta accreta spectrum (placenta increta and placenta percreta).Methods: A tourniquet was used in the lower part of the uterus during surgical treatment of severe placenta accreta spectrum. Severe placenta accreta spectrum was classified into two types according to the relative position of the placenta and tourniquet during surgery: upper-tourniquet type, in which the entire placenta was above the tourniquet, and lower-tourniquet type, in which part or all of the placenta was below the tourniquet. The surgical effects of the two types were retrospectively compared. We then added forceps to the lower-tourniquet group to achieve further bleeding reduction. Finally, the surgical effects of the two types were prospectively compared.Results: During the retrospective phase, patients in the lower-tourniquet group experienced more severe symptoms than did patients in the upper-tourniquet group, based on mean intraoperative blood loss (upper-tourniquet group 787.5 ml, lower-tourniquet group 1434.4 ml) intensive care unit admission rate (upper-tourniquet group 1.0%, lower-tourniquet group 33.3%), and length of hospital stay (upper-tourniquet group 10.2d, lower-tourniquet group 12.1d). During the prospective phase, after introduction of the revised surgical method involving forceps (in the lower-tourniquet group), the lower-tourniquet group exhibited improvements in the above indicators (intraoperative average blood loss 722.9 ml, intensive care unit admission rate 4.3%, hospital stays 9.0d). No increase in the rate of complications was observed.Conclusion: The relative positions of the placenta and tourniquet may influence the perioperative risk of severe placenta accreta spectrum. The method using a tourniquet (and forceps if necessary) can improve the surgical effect in cases of severe placenta accreta spectrum.

Background/Aims: Current therapies for spinal cord injury (SCI) have limited efficacy, and identifying a therapeutic target is a pressing need. Sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2 (SERCA2) plays an important role in regulating calcium homeostasis, which has been shown to inhibit apoptosis. Exendin-4 has been shown to inhibit the apoptosis of nerve cells in SCI, which can also improve SERCA2 expression. In this study, we sought to determine whether exendin-4 plays a protective role in a rat model of SCI via SERCA2. Methods: To investigate the effects of exendin-4 on SCI, a rat model of SCI was induced by a modified version of Allen’s method. Spinal cord tissue sections from rats and western blot analysis were used to examine SERCA2 expression after treatment with the long-acting glucagon-like peptide 1 receptor exendin-4 or the SERCA2 antagonist 5(6)-carboxyfluorescein diacetate N-succinimidyl ester (CE). Locomotor function was evaluated using the Basso Beattie Bresnahan locomotor rating scale and slanting board test. Results: Cell apoptosis was increased with CE treatment and decreased with exendin-4 treatment. Upregulation of SERCA2 in female rats with SCI resulted in an improvement of motor function scores and histological changes. Conclusion: These findings suggest that exendin-4 plays a protective role in a rat model of SCI through SERCA2 via inhibition of apoptosis. Existing drugs targeting SERCA2 may be an effective therapeutic strategy for the treatment of SCI.

Histone deacetylase 6 (HDAC6) is a unique cytoplasmic enzyme in the HDAC family. The HDAC6 has been shown to play important roles in several biological processes. Meanwhile, it is also an attractive therapeutic target for a variety of diseases. However, the mechanism of HDAC6 function is not fully understood yet, and it is still lacking highly specific targeted drugs. Here, we generated a homozygous HDAC6 knockout human embryonic stem cell (hESC) line, WAe009-A-21 by the CRISPR/Cas9-based gene editing method. The WAe009-A-21 cell line does not express HDAC6 protein, while maintaining normal 46, XX karyotype, pluripotency, and trilineage differentiation potential.