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Abstract Background The COVID-19 pandemic has forced nucleic acid detection to be essential for prevention and control. The psychological and physical health of healthcare staff who conducted nucleic acid sampling (NAS) should be paid attention to. This study aims to investigate the status and explore the predictors of stress among nucleic acid sampling support nurses (NASSNs) by an online survey. Material and methods Totally 388 NASSNs were recruited through cluster random sampling for the research. An online cross-sectional survey with structured questionnaires was used, including socio-demographic information, the stressor scale of nucleic acid sampling nurses (SSNASN), and the challenge–hindrance stress scale (CHSS). T-tests, ANOVA, and multivariable linear regression model were used to analyze data. Results A total of 324 NASSNs filled out questionnaires online with a response rate of 83.51%. NASSNs had an overall mean score of (2.199 ± 0.917) for challenge stress and (2.014 ± 0.805) for hindrance stress. The item "the amount of responsibility I have" scored highest in the challenge stress dimension, while "the lack of job security I have" scored highest in the hindrance stress dimension. The predictors of challenge and hindrance stress include concern about the preparedness of NASSNs and their families, working environment, and competence of emergency disposal. An additional socio-demographic predictor of challenge stress was motivation, while that of hindrance stress was longer nursing experiences. Conclusions During the COVID-19 pandemic, stress among NASSNs was moderately low. The factors detected to be predictors of stress include motivation, nursing experiences, concern about the preparedness of NASSNs and their families, working environment, and competence in emergency disposal. Therefore, in advance of responding to a public health event, we recommend that subsequent short-term psychological counseling be given to healthcare workers and accompanying psychological counseling be provided to prevent the emergence of mental health problems thereafter.

Abstract Background The oral health of older people is closely related to their overall health. Timely and effective intervention in oral issues is necessary to maintain their overall health. This study aimed to evaluate the feasibility and effectiveness of an Oral Health Promotion Program (OHPP) in Geriatric Care Facilities (GCFs). Methods The OHPP was implemented in two GCFs and evaluated using a pre/post-design. Questionnaires on self-efficacy and attitude for providing oral care were sent to 42 nurse participants before and three months after the implementation of the OHPP. Outcomes of 295 patient participants were assessed at four time points (T1-baseline, T2-one month, T3-two months, and T4-three months post-implementation) including Activities of Daily Living (ADL), Mini-Mental State Examination (MMSE), and Oral Health Assessment Tool (OHAT). Results The oral health and daily activity ability of patient participants showed an improving trend at four time points pre/post-implementation of the OHPP. The proportion of patients with healthy mouths (OHAT: 0–3 points) increased from 29.8 to 67.8% and their scores of OHAT and ADL were significantly better at T4 compared to T1, T2, and T3 (p

Abstract Background The world’s population is getting older. This issue is accompanied by a rise in the number of older people suffering from dementia and disability, for whom oral hygiene care is challenging. Nurses’ attitudes toward providing oral care (POC) are critical for the elderly, while few studies have investigated the determinant factors of nurses’ attitudes by identifying the current work pressure, resilience and self-efficacy in geriatric care facilities (GCFs). It is of great significance to explore the nurses’ attitudes toward POC and associated influencing factors related to psychological aspects including resilience, self-efficacy, and stress from the workplace. Methods Attitudes for Providing Mouth Care (A-PMC) in Chinese version were used in this cross-sectional study with 160 nurses in 2 GCFs. Data were collected using online questionnaires and analyzed by multiple linear regression analysis. Statistically significant values were considered at p

Abstract Background Even though chemotherapy-induced nausea and vomiting (CINV) can be well controlled in the acute phase, the incidence of delayed CINV remains high. In this study, we intend to investigate whether prolonged use of NK-1 receptor antagonist (RA) in addition to 5-HT3 RA and dexamethasone (DEX) was more effective in preventing delayed CINV. Methods This randomised, open-label, controlled study was designed to compare the efficacy and safety of fosaprepitant 150 mg given on days 1,3 (prolonged group) versus on day 1 (regular group) in patients receiving highly emetogenic chemotherapy (HEC). All patients also treated with palonosetron on day 1 and DEX on days 1–3. The primary endpoint was the incidence of delayed nausea and vomiting. The second endpoint was AEs. All the above endpoints were defined according to CTCAE 5.0. Results Seventy-seven patients were randomly assigned to prolonged group and seventy-nine to regular group. Prolonged group demonstrated superiority in controlling delayed CINV to regular group, with statistically significant lower incidence of nausea (6.17% vs 12.66%, P = 0.0056), and slightly lower incidence of grade 1 vomiting (1.62% vs 3.80%, P = 0.0953) in the delayed phase. In addition, prolonged use of fosaprepitant was safe. No significant difference was found between the two groups regarding constipation, diarrhea, hiccough, fatigue, palpitation and headache in delayed phase. Conclusions Prolonged use of fosaprepitant can effectively and safely prevent delayed CINV in patients receiving HEC.

Abstract Aims To investigate nurses' self‐efficacy and attitudes of providing oral care in geriatric care facilities (GCFs) and compare differences between individuals, facilities and countries. Design A cross‐sectional and multicentre study. Methods Data were collected from 852 nurses in 42 GCFs using two scales, “Self‐Efficacy for Providing Mouth Care” (SE‐PMC) and “Attitudes for Providing Mouth Care” (A‐PMC), and analysed using t‐test and ANOVA. Results Totally 852 nurses (844 females, 99%) participated in this study with an effective response rate of 85.2%. Scores of SE‐PMC and A‐PMC of nurses varied significantly among GCFs with different sizes, types and years of establishment and differentiated among staff about the length of employment (p

Background: TP53 is frequently mutated in solid tumors, but its basic mutation mapping is mixed, particularly in aggressive-stage lung cancer. Experimental Design: We curated a total of 139 advanced non-small cell lung cancer (NSCLC) patients who harbored wild-type TP53 (TP53wt) or mutated TP53 (TP53mut) based on next-generation sequencing (NGS) to analyze multiple-dimensional data types, including tumor mutation burden (TMB), programmed death receptor ligand 1 (PD-L1) expression, co-mutant alterations, hotspot mutations distribution, and therapy response. Results: TP53 was evident in 125 mutations and significantly associated with male sex, adenocarcinoma differentiation, smoking history, PD-L1 tumor proportion score, and TMB level. The most frequent mutations were distributed on exon 8, but there were no distinct hotspot mutations. After outlining the co-mutation genes, it is interesting to note that DNA damage repair (DDR) genes were frequent alterations in the mutated TP53 cohort. Even though there was no significant difference between the TP53wt and TP53mut cohorts on therapy response, patients with nucleotide variation in G>T achieved a relatively higher durable clinical benefit (DCB) rate. Conclusions: This real-world retrospective study suggests that molecular stratification on the basis of TP53 mutations should be deeply explored for NSCLC to optimize and modify clinical therapy choices.

Objectives This study aims to assess the volunteer motivation and stress load of patient volunteers in the Fangcang shelter hospitals (FSHs), examine their associations, and explore the potential influence factors of volunteer motivation.Design Cross-sectional online survey conducted from 21 April to 20 May 2022.Setting Questionnaires were collected from patient volunteers selected by random cluster sampling in the FSHs in Shanghai, China.Participants 197 participants who met the inclusion criteria as patients who were asymptomatic or presenting with mild symptoms in the FSHs and who volunteered to assist with routine work under quarantined settings.Outcome measures We investigated sociodemographic information, stress load and volunteer motivation through an online survey using the Volunteer Function Inventory and the Stress Overload Scale. Comparisons between groups were conducted by applying t-tests or analysis of variance. The correlation between volunteer motivation and stress was analysed by Pearson correlation. Influencing factors of volunteer motivation were determined by multivariable linear regression models. A value of p

The Omicron wave of the COVID-19 pandemic significantly affected Shanghai, China, from March to June 2022. Numbers of Fangcang Shelter Hospitals (FSHs) were conversed from stadiums and exhibition centers to tackle the pandemic. This study aimed to identify the stress load profiles of nurses working in FSHs and explore the characteristics and factors influencing stress load profiles. Totally, 609 out of 700 FSH nurses (with an effective response rate of 87%) participated in an online survey investigating their socio-demographic information, work-related stressors, and stress load. Results of the latent profile analysis identified four classes of stress load, which were labeled as the low (Class 1), mild (Class 2), moderate (Class 3), and high (Class 4) stress load class. Maternity status and self-perceived health condition were significantly different between the four stress load classes by comparisons using the Chi-square test and the Kruskal–Wallis test. The contributors to the stress load profiles were determined by the multinomial logistic regression analysis, including age, education, maternity status, self-perceived health condition, working time in FSHs, and the four dimensions of work-related stressors. Participants who were less healthy (OR = 0.045, 95% CI:0.012,0.171), worked longer time in FSHs (OR = 40.483, 95% CI: 12.103,135.410), faced with more workload (OR = 3.664, 95% CI: 1.047,12.815), and worse working environment (OR = 12.274, 95% CI: 3.029,49.729) were more likely to be classified to the high stress load class. The task arrangement and working environment for FSH nurses should be optimized, and psychological training should be conducted routinely.

Abstract Background With more and more target medicine application in lung cancer, lots of patients take medicine at home, the treatment bone metastasis and screen of bone metastasis always has been neglected until skeletal‐related events (SREs) such as bone pain, hypercalcemia of malignancy and pathologic fractures emerging which significantly impairs the patients' daily activity ability, seriously lower quality of life. Aim To identify the clinical characteristics of patients which influence the overall survival (OS) of EGFR‐TKIs effective in EGFR‐mutant NSCLC with bone metastasis (BM) and the bone metastatic image features. Methods We conducted a retrospective study in patients (treated with EGFR‐TKIs ≥6 months) of lung adenocarcinoma with BM in our hospital from October 2014 to October 2017. The Kaplan–Meier survival curves were calculated using the log‐rank univariate test. Multivariate regression analysis was conducted using Cox's regression model. Comparison between the different subgroups of bone metastasis was conducted using Pearson Chi‐Square test. Results A total of 79 patients were diagnosed as EGFR‐mutant lung adenocarcinoma with bone metastases. At univariate analysis, age

Abstract Aims To investigate the oral health status of aged residents and explore the possible factors associated with oral health and the effect of cognitive impairment (CI) on it in geriatric care facilities (GCF) using oral health assessment tool (OHAT) in Shanghai, China. Background Oral health is closely associated with overall health. Problems like missing teeth, dental caries, dental pain, periodontal diseases, oral infections and dysphagia are common in GCFs. Furthermore, residents in GCFs with CI are becoming a dominant group and this prevalence increases with age. Detection of oral problems earlier and taking oral care actions is required for these special populations. Methods The study was an observational cross‐sectional study conducted in 42 GCFs. Data were collected from 657 subjects, including oral health assessment (OHAT), cognitive impairment (Mini‐Mental State Examination, MMSE) and respondents’ characteristics. The subjects were divided into CI group and non‐CI group based on MMSE. Oral health conditions were compared between the two groups. Results Oral health status in the CI group was significantly worse than that in the non‐CI group (p

BackgroundIn recent years, oral care for older people has received extensive attention in long-term care facilities. The Self-Efficacy for Providing Mouth Care (SE-PMC) and Attitudes for Providing Mouth Care (A-PMC) scale evaluated the self-efficacy and attitude of nursing staff while providing oral care. However, whether this scale is valid and reliable for Chinese nursing staff in China remains unverified. This study aims to translate the English version of SE-PMC and A-PMC into Chinese and determine their reliability and validity.MethodsAfter obtaining the author's consent, the procedure for a double-back translation and cross-cultural adaptation was conducted to develop the Chinese version of SE-PMC and A-PMC. The validity and reliability of the Chinese version of SE-PMC and A-PMC were evaluated in a cross-sectional observational study with 852 nurses from 42 Geriatric Care Facilities (GCFs). Exploratory factor analysis (EFA) (n = 427) and confirmatory factor analysis (CFA) (n = 425) were conducted to test the construct validity and quality of the factor structures. We applied the item discrimination test and homogeneity test for item analysis. Cronbach's alpha coefficient and split-half coefficient were adopted to evaluate internal consistency.ResultsThe Chinese version of SE-PMC (11 items, 3 factors) and A-PMC (11 items, 2 factors) included 22 items, reflecting adequate construct validity and reliability. In addition, test-retest reliability was 0.809 for SE-PMC and 0.811 for A-PMC, evincing good stability. The Cronbach's α coefficient of SE-PMC was 0.831, with each factor ranging from 0.793~0.906. The Cronbach's α coefficient of the A-PMC was 0.768, with each factor ranging from 0.814~0.824. Item-Content Validity Index (I-CVI) of SE-PMC and A-PMC ranged from 0.84 ~1.00 and 0.82~1.00, respectively.ConclusionThe Chinese version of SE-PMC and A-PMC was validated as a reliable assessment tool to evaluate the self-efficacy and attitude of nursing staff in GCFs for providing oral care in China.

Objective Research is lacking regarding the experiences of patients after colostomy, which is needed so as to take necessary specific actions. In this study, we aimed to describe the trajectory of symptom clusters experienced by patients after colostomy over time. Methods This was a longitudinal observational study using data from 149 patients with colorectal cancer after colostomy. We investigated symptoms and symptom clusters at 2 weeks, 1 month, 3 months, 6 months, and 1 year after colostomy. Results Four main symptom clusters were identified, including a psychological symptom cluster, digestive and urinary symptom cluster, lack of energy symptom cluster, and pain symptom cluster in patients after colostomy in the first year after surgery. We further explored the symptom trajectory. Conclusions We explored symptom clusters and the trajectory of symptom resolution in patients after colostomy during the first year after surgery. Four stages were proposed to describe the different statuses of symptom clusters experienced by patients. Our findings may provide insight into how to improve symptom management and postoperative quality of life for patients after colostomy.

Background A retrospective study was conducted to assess the efficacy and toxicity of lobaplatin‐etoposide (EL) chemotherapy for small cell lung cancer (SCLC). Methods The clinical data of 50 patients treated in our department from May 2014 to March 2018 were obtained. Untreated patients with SCLC administered LBP intravenously (IV) at 30 mg/m2 on day 1 and etoposide IV at 100 mg/m2 on days 1, 2, and 3 were enrolled. The treatment was cycled every 21 days. Results The median overall and progression‐free survival rates of the 50 patients were 11.67 (range: 7.30–16.04) and 6.8 (range: 5.25–8.35) months, respectively, with an overall response rate of 66% and a disease control rate of 90%. The most frequent drug‐related adverse effects were leukopenia and neutropenia, and no grade 3/4 hepatotoxicity or nephrotoxicity was observed. Conclusion These results indicate that LBP‐containing chemotherapy is effective and tolerable for SCLC in terms of response and survival.

Tyrosine kinase inhibitor (TKI) have been proved to be effective in the treatment of advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) sensitive mutation, which is superior to chemotherapy. However, there are still some patients with sensitive mutations have primary drug resistance. It may be related to the coexistence of susceptible and resistant mutations of EGFR gene, downstream mutations of EGFR pathway, MET amplification and BIM deletion polymorphism. We present 2 cases of primary drug resistance and analyze the reasons.

Per- and polyfluoroalkyl substances (PFASs) can disrupt lipid metabolism, and changes in cord blood fatty acid composition have been observed in small newborns. Emerging evidence suggests that exposure to PFASs during pregnancy is linked to decreased newborn size, although the evidence is not consistent. The modifying effect of fatty acids on the associations of gestational PFAS exposure with newborn size is still unknown. Here we show that the nutritional status of the fetus, as indicated by the level of fatty acids in the cord blood, mitigates the adverse effects of gestational PFAS exposure on the size of the newborn. Our study confirms the adverse developmental effects of PFASs and identifies emerging short-chain PFASs as the primary drivers of reduced newborn size, despite their lower exposure burden compared to legacy PFASs. Additionally, we find the protective role of cord blood fatty acids, suggesting potential strategies for mitigating the detrimental effects of emerging environmental exposures on human health. Our findings provide new evidence of the potential toxicity of emerging PFASs and call for further toxicity evaluations of these pollutants for regulatory purposes. Future studies should consider the complex interaction between exposure and nutrition within the human body, particularly during the first thousand days of life, to promote lifelong health.

Autoimmune diseases (ADs) are a collection of immunological disorders in which the immune system responds to self-antigens by producing autoantibodies or self-sensitized cells. Current treatments are unable to cure ADs, and achieving long-term drug-free remission remains a challenging task. Hematopoietic stem cell transplantation (HSCT) stands out from other therapies by specifically targeting ADs that target various cell subpopulations, demonstrating notable therapeutic benefits and resulting in sustained drug-free remission. Since different ADs have distinct mechanisms of action, the comprehensive understanding of how HSCT works in treating ADs is crucial. This review provides a detailed overview of the latest research and clinical applications of HSCT in treating ADs, offering new insights for clinicians aiming to optimize its use for ADs management.

Human exposure to per- and polyfluoroalkyl substances (PFASs) has received considerable attention, particularly in pregnant women because of their dramatic changes in physiological status and dietary patterns. Predicting internal PFAS exposure in pregnant women, based on external and relevant parameters, has not been investigated. Here, machine learning (ML) models were developed to predict the serum concentrations of PFOA and PFOS in a large population of 588 pregnant participants. Dietary exposure characteristics, demographic parameters, and in particular, serum fatty acid (FA) data were used for the model development. The fitting results showed that the inclusion of FAs as covariates significantly improved the performance of the ML models, with the random forest (RF) model having the best predictive performance for PFOA (R2 = 0.33, MAE = 1.51 ng/mL, and RMSE = 1.89 ng/mL) and PFOS (R2 = 0.12, MAE = 2.65 ng/mL, and RMSE = 3.37 ng/mL). The feature importance analysis revealed that serum FAs greatly affected PFOA concentration in the pregnant women, with saturated FAs being associated with decreased PFOA levels and unsaturated FAs with increased levels. Comparison with one-compartment pharmacokinetic model further demonstrated the advantage of the ML models in predicting PFAS exposure in pregnant women. Our models correlate for the first time blood chemical concentrations with human FA status using ML, introducing a novel perspective on predicting PFAS levels in pregnant women. This study provides valuable insights concerning internal exposure of PFASs generated from external exposure, and contributes to risk assessment and management in pregnant populations.

Abstract Due to the existence of the magnetic pole edge effect, the actual cogging torque of the existing segmented step skew motor does not reach the theoretical minimum. Thus, a method for suppressing cogging torque of permanent magnet synchronous motor considering the magnetic pole edge effect is proposed. The magnetic pole edge effect is creatively converted into the amplitude and phase offset of the cogging torque generated by each pole segment. On this basis, an optimization problem is constructed in which the fundamental component of cogging torque is zero and the total harmonics is minimum. The optimal magnetic pole length and skew angle parameters of each segment are obtained by solving the optimization problem quantitatively. The results can provide theoretical guidance for motor design, which can minimize the cogging torque of step skew structures. The effectiveness of the proposed method in weakening the cogging torque of the step skew motor is demonstrated by theoretical calculation, 3D finite element analysis, and experimental results.

Abstract The ongoing global pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), has caused devastating impacts on the public health and the global economy. Rapid viral antigenic evolution has led to the continual generation of new variants. Of special note is the recently expanding Omicron subvariants that are capable of immune evasion from most of the existing neutralizing antibodies (nAbs). This has posed new challenges for the prevention and treatment of COVID-19. Therefore, exploring broad-spectrum antiviral agents to combat the emerging variants is imperative. In sharp contrast to the massive accumulation of mutations within the SARS-CoV-2 receptor-binding domain (RBD), the S2 fusion subunit has remained highly conserved among variants. Hence, S2-based therapeutics may provide effective cross-protection against new SARS-CoV-2 variants. Here, we summarize the most recently developed broad-spectrum fusion inhibitors (e.g., nAbs, peptides, proteins, and small-molecule compounds) and candidate vaccines targeting the conserved elements in SARS-CoV-2 S2 subunit. The main focus includes all the targetable S2 elements, namely, the fusion peptide, stem helix, and heptad repeats 1 and 2 (HR1-HR2) bundle. Moreover, we provide a detailed summary of the characteristics and action-mechanisms for each class of cross-reactive fusion inhibitors, which should guide and promote future design of S2-based inhibitors and vaccines against new coronaviruses.

Abstract Compared with the traditional permanent magnet synchronous motor (PMSM), the double‐stator permanent magnet synchronous motor (DS‐PMSM) can utilise the internal space adequately and has high power density. In this study, the design method of this kind of motor will be researched. Different rotor magnetic circuit topologies are analysed while keeping the outer diameter of outer stator unchanged, and the rotor magnetic circuit topologies with higher power density are selected. Furthermore, the effects of pole‐arc coefficient and stator split ratio on the power density of the motor are analysed, so a high power density DS‐PMSM can be designed. On this basis, a kind of magnetic pole structure with unequal pole‐arc coefficient is proposed to solve the problem of large torque ripple in DS‐PMSM. Finally, the DS‐PMSM is investigated by the FEA, compared with the traditional single stator PMSM, the average torque of the DS‐PMSM is increased by 62.2%, and the torque ripple is only 3.2%.

Abstract Permanent magnet (PM) motor with consequent pole (CP) rotor can improve the PM utilisation ratio. However, one group of PMs with the same polarity is replaced by iron core, which deteriorates the electromagnetic performances of the motor, including asymmetric air‐gap magnetic field and larger torque ripple. To solve this problem, this study analyses the relationship between the torque ripple and the stator‐rotor magnetomotive force (MMF) harmonics, determines the harmonic orders causing the torque ripple of the CP PM (CPPM) motor, and proposes an unequal‐turn four‐layer winding structure which can eliminate the determining harmonics in the stator MMF. Furthermore, the electromagnetic performances of the CPPM motors with the proposed winding structure and traditional CPPM motors are investigated by the finite‐element analysis. It is verified that the CPPM motor with the proposed structure has better motor performances.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and related sarbecoviruses enter host cells by receptor-recognition and membrane-fusion. An indispensable step in fusion is the formation of 6-helix bundle by viral spike heptad repeats 1 and 2 (HR1 and HR2). Here, we report the construction of 5-helix bundle (5HB) proteins for virus infection inhibition. The optimal construct inhibits SARS-CoV-2 pseudovirus entry with sub-micromolar IC50. Unlike HR2-based peptides that cannot bind spike in the pre-fusion conformation, 5HB features with the capability of binding to pre-fusion spike. Furthermore, 5HB binds viral HR2 at both serological- and endosomal-pH, highlighting its entry-inhibition capacity when SARS-CoV-2 enters via either cell membrane fusion or endosomal route. Finally, we show that 5HB could neutralize S-mediated entry of the predominant SARS-CoV-2 variants and a wide spectrum of sarbecoviruses. These data provide proof-of-concept evidence that 5HB might be developed for the prevention and treatment of SARS-CoV-2 and other emerging sarbecovirus infections.

Alongshan virus (ALSV), a newly discovered member of unclassified Flaviviridae family, is able to infect humans. ALSV has a multi-segmented genome organization and is evolutionarily distant from canonical mono-segmented flaviviruses. The virus-encoded methyltransferase (MTase) plays an important role in viral replication. Here we show that ALSV MTase readily binds S-adenosyl-L-methionine (SAM) and S-adenosyl-L-homocysteine (SAH) but exhibits significantly lower affinities than canonical flaviviral MTases. Structures of ALSV MTase in the free and SAM/SAH-bound forms reveal that the viral enzyme possesses a unique loop-element lining side-wall of the SAM/SAH-binding pocket. While the equivalent loop in flaviviral MTases half-covers SAM/SAH, contributing multiple hydrogen-bond interactions; the pocket-lining loop of ALSV MTase is of short-length and high-flexibility, devoid of any physical contacts with SAM/SAH. Subsequent mutagenesis data further corroborate such structural difference affecting SAM/SAH-binding. Finally, we also report the structure of ALSV MTase bound with sinefungin, an SAM-analogue MTase inhibitor. These data have delineated the basis for the low-affinity interaction between ALSV MTase and SAM/SAH and should inform on antiviral drug design.

To reduce the iron loss and torque ripple of an external rotor consequent pole (ERCP) motor used in an electric vehicle air-conditioning compressor, the magnetic pole structure of the motor was improved, and an unequal piecewise consequent pole (CP) structure was designed. The performance of the motor is optimized by reducing the harmonic content in the air gap flux density and reducing the iron saturation degree of the motor. The designed CP structure can significantly reduce the iron loss and torque ripple of the motor. Based on the Taguchi method, the optimal size parameters of the unequal piecewise CP structure are determined, and the final optimization design scheme is obtained. The results of finite element simulation and high-precision iron loss model show the following: compared with the original motor, the iron loss and torque ripple of the motor with the final optimized design scheme are significantly reduced.

Abstract Mesenchymal stem cells (MSCs) can be widely isolated from various tissues including bone marrow, umbilical cord, and adipose tissue, with the potential for self-renewal and multipotent differentiation. There is compelling evidence that the therapeutic effect of MSCs mainly depends on their paracrine action. Extracellular vesicles (EVs) are fundamental paracrine effectors of MSCs and play a crucial role in intercellular communication, existing in various body fluids and cell supernatants. Since MSC-derived EVs retain the function of protocells and have lower immunogenicity, they have a wide range of prospective therapeutic applications with advantages over cell therapy. We describe some characteristics of MSC-EVs, and discuss their role in immune regulation and regeneration, with emphasis on the molecular mechanism and application of MSC-EVs in the treatment of fibrosis and support tissue repair. We also highlight current challenges in the clinical application of MSC-EVs and potential ways to overcome the problem of quality heterogeneity.

Model systems to study SARS-CoV-2 infection are required to better understand the immune response. Here the authors use a lung and macrophage co-culture system by differentiation of human pluripotent stem cells to better understand the phenotype and gene expression changes in host lung cells and macrophages after SARS-CoV-2 infection in vitro.

BackgroundNeonatal sepsis is one of the major causes of morbidity and mortality in newborns. However, atypical clinical manifestations and symptoms make the early diagnosis of neonatal sepsis a challenge. Relatively high-serum soluble urokinase-type plasminogen activator receptor (suPAR) has been implicated as a diagnostic biomarker for adult sepsis. Therefore, the meta-analysis is intended to explore the diagnostic value of suPAR for neonatal sepsis.MethodsThe PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, China Biological Medicine Disk, and Wanfang databases were retrieved from inception to 31 December 2022 to collect diagnostic accuracy studies about suPAR for neonatal sepsis. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias in the included studies using the quality assessment of diagnostic accuracy studies-2 (QUADAS-2) tool. Then, a meta-analysis was performed using Stata 15.0 software.ResultsA total of six articles involving eight studies were included. The results of the meta-analysis showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 0.89 [95%CI (0.83–0.93)], 0.94 [95%CI (0.77–0.98)], 14 [95%CI (3.5–55.2)], 0.12 [95%CI (0.08–0.18)], and 117 [95%CI (24–567)], respectively. The area under the curve (AUC) of summary receiver operator characteristic (SROC) curves was 0.92 [95%CI (0.90–0.94)]. Sensitivity analysis confirmed the stability of the results, and publication bias was not observed. Fagan’s nomogram results demonstrated the clinical availability of the findings.ConclusionCurrent evidence suggests that suPAR has potential diagnostic value for neonatal sepsis. Owing to the limited quality of the included studies, more high-quality studies are needed to verify the above conclusion.