Tilting homeostatic and dyshomeostatic microglial balance in health and disease:transforming growth factor-beta1 as a critical protagonist

Adult microglia,by continuously sensing changes in their environment and communicating with nearly all brain cell types,are considered to be the immune sentinels of the brain.In the healthy central nervous system(CNS),microglia display a unique molecular homeostatic signature(i.e.,Tmem119,P2ry12,Sall1,Siglech,Gpr34,and Hexb)(Figure 1A).

Unlocking hypoglycemia–associated brain microvascular dysfunction:critical insights from proteomic analysis

Hypoglycemia-a critical complication linked to worsened brain function in diabetic subjects:Hypoglycemia is characterized by a decline in circulatory glucose levels below sta nda rd physiological thresholds.Mild hypoglycemia,classified as level 1 hypoglycemia,is defined by blood glucose levels below 70 mg/dL and can be effectively addressed through carbohydrate intake.Severe hypoglycemia,denoted by blood glucose levels less than 54 mg/dL,poses a life-threatening risk if left untreated.Individuals with type 1 and type 2 diabetes undergoing insulin treatment are particularly susceptible to hypoglycemia due to impaired counterregulatory mechanisms.

Deep eutectic solvents for separation and purification applications in critical metal metallurgy:Recent advances and perspectives

Solvent extraction,a separation and purification technology,is crucial in critical metal metallurgy.Organic solvents commonly used in solvent extraction exhibit disadvantages,such as high volatility,high toxicity,and flammability,causing a spectrum of hazards to human health and environmental safety.Neoteric solvents have been recognized as potential alternatives to these harmful organic solvents.In the past two decades,several neoteric solvents have been proposed,including ionic liquids(ILs)and deep eutectic solvents(DESs).DESs have gradually become the focus of green solvents owing to several advantages,namely,low toxicity,degradability,and low cost.In this critical review,their classification,formation mechanisms,preparation methods,characterization technologies,and special physicochemical properties based on the most recent advancements in research have been systematically described.Subsequently,the major separation and purification applications of DESs in critical metal metallurgy were comprehensively summarized.Finally,future opportunities and challenges of DESs were explored in the current research area.In conclusion,this review provides valuable insights for improving our overall understanding of DESs,and it holds important potential for expanding separation and purification applications in critical metal metallurgy.

Liquefaction susceptibility and deformation characteristics of saturated coral sandy soils subjected to cyclic loadings-a critical review

Coral sandy soils widely exist in coral island reefs and seashores in tropical and subtropical regions.Due to the unique marine depositional environment of coral sandy soils,the engineering characteristics and responses of these soils subjected to monotonic and cyclic loadings have been a subject of intense interest among the geotechnical and earthquake engineering communities.This paper critically reviews the progress of experimental investigations on the undrained behavior of coral sandy soils under monotonic and cyclic loadings over the last three decades.The focus of coverage includes the contractive-dilative behavior,the pattern of excess pore-water pressure(EPWP)generation and the liquefaction mechanism and liquefaction resistance,the small-strain shear modulus and strain-dependent shear modulus and damping,the cyclic softening feature,and the anisotropic characteristics of undrained responses of saturated coral sandy soils.In particular,the advances made in the past decades are reviewed from the following aspects:(1)the characterization of factors that impact the mechanism and patterns of EPWP build-up;(2)the identification of liquefaction triggering in terms of the apparent viscosity and the average flow coefficient;(3)the establishment of the invariable form of strain-based,stress-based,or energy-based EPWP ratio formulas and the unique relationship between the new proxy of liquefaction resistance and the number of cycles required to reach liquefaction;(4)the establishment of the invariable form of the predictive formulas of small strain modulus and strain-dependent shear modulus;and(5)the investigation on the effects of stress-induced anisotropy on liquefaction susceptibility and dynamic deformation characteristics.Insights gained through the critical review of these advances in the past decades offer a perspective for future research to further resolve the fundamental issues concerning the liquefaction mechanism and responses of coral sandy sites subjected to cyclic loadings associated with seismic events in marine environments.

Acute pancreatitis in the critical care setting:A review of assessment and intervention strategies

The incidence of acute pancreatitis(AP),a condition characterized by inflammation in the pancreas,has been increasing globally and is associated with several complications.This review elaborated on the etiology,clinical presentation,severity assessment,and treatment modalities of AP,mainly in the critical care setting.Patients with severe AP,as indicated by organ failure(>48 hours from onset),warrant treatment in the intensive care unit setting.The most common etiologies,biliary disease and alcohol consumption,and the advanced diagnostic tools used for the identification of the cause are highlighted.Different severity assessment tools are utilized for grading the severity of the disease,predicting patient outcomes,determining the associated risk,and guiding treatment decisions.The treatment interventions comprise various approaches,such as anti-infective therapy enteral nutrition,analgesics for pain,or minimally invasive surgical procedures,thereby demonstrating an evolving landscape of AP management.Furthermore,various complications such as necrosis,organ failure,and hemorrhage,necessitate disease monitoring and differential diagnosis and are crucial for optimal management of patients.Novel treatment modalities and advancements in multidisciplinary care emphasize the potential for reducing the burden of AP in critical care settings.

Pros and cons of live kidney donation in prediabetics: A critical review and way forward

There is shortage of organs,including kidneys,worldwide.Along with deceased kidney transplantation,there is a significant rise in live kidney donation.The prevalence of prediabetes(PD),including impaired fasting glucose and impaired glucose tolerance,is on the rise across the globe.Transplant teams frequently come across prediabetic kidney donors for evaluation.Prediabetics are at risk of diabetes,chronic kidney disease,cardiovascular events,stroke,neuropathy,retinopathy,dementia,depression and nonalcoholic liver disease along with increased risk of all-cause mortality.Unfortunately,most of the studies done in prediabetic kidney donors are retrospective in nature and have a short follow up period.There is lack of prospective long-term studies to know about the real risk of complications after donation.Furthermore,there are variations in recommendations from various guidelines across the globe for donations in prediabetics,leading to more confusion among clinicians.This increases the responsibility of transplant teams to take appropriate decisions in the best interest of both donors and recipients.This review focuses on pathophysiological changes of PD in kidneys,potential complications of PD,other risk factors for development of type 2 diabetes,a review of guidelines for kidney donation,the potential role of diabetes risk score and calculator in kidney donors and the way forward for the evaluation and selection of prediabetic kidney donors.

Dosage and utilization of dexamethasone in the management of COVID-19: A critical review

BACKGROUND The severe respiratory manifestations observed in severe coronavirus disease 2019(COVID-19)cases are often associated with an excessive inflammatory response.Dexamethasone,a synthetic glucocorticoid,exerts its anti-inflammatory effects by inhibiting the transcription of pro-inflammatory genes and suppressing the activity of various immune cells.This mechanism has implications for mitigating the cytokine storm observed in severe COVID-19 cases.Early on in the pandemic,the Recovery Collaborative working group showed a mortality benefit of using dexamethasone in decreasing mortality in patients with COVID-19 requiring respiratory support.However,the optimal dosage of corticosteroids remains debatable.Several studies that compare different doses of dexamethasone in COVID-19 exist,but the results are conflicting.AIM To review the latest evidence regarding dosage,safety,and efficacy of dexamethasone in severe COVID-19.METHODS We followed preferred reporting items for systematic reviews and meta-analysis guidelines.A detailed literature search was conducted across PubMed,Google Scholar,and Medline to include publications up to March 2024.Our keywords included“COVID-19”“SARS-CoV-2”“dexamethasone”“corticosteroid”“steroid”and“glucocorticoid”-along with their combinations.We employed the Cochrane Risk of Bias Tool and the Newcastle-Ottawa scale to evaluate the integrity and potential of bias in the included studies.A meta-analysis was conducted using a random-effects model,assessing pooled odds ratios and mean differences,with heterogeneity gauged by the I2 statistic and theχ^(2) tests.RESULTS No statistical differences were found in 28-day all-cause mortality[pooled odds ratio(OR)=1.109,95%CI:0.918-1.340],60-day all-cause mortality(OR=0.873,95%CI:0.744-1.024;I2=47.29%),mean length of hospital stay(mean difference=-0.08 days,95%CI:-0.001 to 0.161)and adverse events(OR=0.877,95%CI:0.707-1.087).CONCLUSION Differing doses of corticosteroids have no clinical implications on mortality,mean length of hospital stay,and adverse events in COVID-19 patients.Additional research is required in patients requiring invasive or noninvasive ventilation.

Significance of Live Streaming in Shaping Business: A Critical Review and Analytical Study

With the rise of live streaming on social media, platforms like Facebook, Instagram, and YouTube have become powerful business tools. They enable users to share live videos, fostering direct connections between businesses and their customers. This critical literature review paper explores the impact of live streaming on businesses, focusing on its role in attracting and satisfying consumers by promoting products tailored to their needs and wants. It emphasizes live streaming’s crucial role in engaging customers, a key to business growth. The study also provides viable strategies for businesses to leverage live streaming for growth and customer engagement, underscoring its importance in the business landscape.

Diagnosis and management of severe pulmonary and extrapulmonary tuberculosis in critically ill patients:A mini review for clinicians

Among critically ill patients,severe pulmonary and extrapulmonary tuberculosis has high morbidity and mortality.Yet,it is a diagnostic challenge given its nonspecific clinical symptoms and signs in early stages of the disease.In addition,management of severe pulmonary and extrapulmonary tuberculosis is complicated given the high risk of drug-drug interactions,drug-disease interactions,and adverse drug reactions.To help clinicians acquire an up-to-date approach to severe tuberculosis,this paper will provide a narrative review of contemporary diagnosis and management of severe pulmonary and extrapulmonary tuberculosis in critically ill patients.

Comparative Studies of Teacher and Peer feedback in L2 Writing:A Critical Review

7 studies on the effectiveness of peer and teacher feedback have been critically reviewed in this paper,some problems being perceived either in the research design or their research findings.Based on the detected problems,I put forward some suggestions for the future study and then draw some pedagogical implications.

A Critical Review on Language Learning Strategies and Implications for College English Teaching

This paper reviews the current developments of language learning strategy researches in the world, both approval and critical voices on the issue of strategy instruction. Then it summarizes the current developments of learning strategy instruction in China. It indicates college English teachers should model learning strategy and make the instruction explicit. Students are advised to be active in seeking for strategies suitable for themselves through their own exploration and reflection.

A Critical Review on Singapore English

A critical review is given on Singapore English. The historical introduction of the language provides readers a longitu dinal insight into the development of this special variety. Then, the language features of Colloquial Singapore English and Stan dard Singapore English are discussed, and a comparison of the use of Singapore and standard British English is made to show the differences in grammatical and lexical features of these two varieties of English.

A Critical Review of Critical Period Hypothesis in Second Language Acquisition

The researches on Critical Period Hypothesis(CPH) aims to explain the importance of the age factor in the process of learning a second language.In this essay,a critical review of the theoretical issues and empirical research on the CPH will spread out.Meanwhile,the discussion of implication and limitation of the CPH research will be concerned as well.

面向Critical MTC的无连接传输

关键机器类通信(Critical MTC)对时延和可靠性都有极高的要求。支持海量Critical MTC的终端是一个巨大挑战。提出了一种面向海量Critical MTC终端的无连接传输方案。为了降低时延,提出了基于竞争的无连接单次传输方案;为了实现高可靠性,设计了具有极低导频碰撞概率的稀疏正交多导频。进一步利用大规模多输入多输出(MIMO)的增益来提高可靠性以及在空域复用大量用户。仿真结果表明,提出的方案可以支持海量Critical MTC终端,同时满足低时延和高可靠的严格要求。

Mental health status among COVID-19 patients survivors of critical illness in Saudi Arabia:A 6-month follow-up questionnaire study

BACKGROUND Psychological assessment after intensive care unit(ICU)discharge is increasingly used to assess patients'cognitive and psychological well-being.However,few studies have examined those who recovered from coronavirus disease 2019(COVID-19).There is a paucity of data from the Middle East assessing the post-ICU discharge mental health status of patients who had COVID-19.AIM To evaluate anxiety and depression among patients who had severe COVID-19.METHODS This is a prospective single-center follow-up questionnaire-based study of adults who were admitted to the ICU or under ICU consultation for>24 h for COVID-19.Eligible patients were contacted via telephone.The patient’s anxiety and depression six months after ICU discharge were assessed using the Hospital Anxiety and Depression Scale(HADS).The primary outcome was the mean HADS score.The secondary outcomes were risk factors of anxiety and/or depression.RESULTS Patients who were admitted to the ICU because of COVID-19 were screened(n=518).Of these,48 completed the questionnaires.The mean age was 56.3±17.2 years.Thirty patients(62.5%)were male.The main comorbidities were endocrine(n=24,50%)and cardiovascular(n=21,43.8%)diseases.The mean overall HADS score for anxiety and depression at 6 months post-ICU discharge was 11.4(SD±8.5).A HADS score of>7 for anxiety and depression was detected in 15 patients(30%)and 18 patients(36%),respectively.Results from the multivariable ordered logistic regression demonstrated that vasopressor use was associated with the development of anxiety and depression[odds ratio(OR)39.06,95% confidence interval:1.309-1165.8;P<0.05].CONCLUSION Six months after ICU discharge,30% of patients who had COVID-19 demonstrated a HADS score that confirmed anxiety and depression.To compare the psychological status of patients following an ICU admission(with vs without COVID-19),further studies are warranted.

Advances in low-field nuclear magnetic resonance(NMR) technologies applied for characterization of pore space inside rocks:a critical review

NMR serves as an important technique for probing rock pore space,such as pore structure characterization,fluid identification,and petrophysical property testing,due to the reusability of cores,convenience in sample processing,and time efficiency in laboratory tests.In practice,NMR signal collection is normally achieved through polarized nuclei relaxation which releases crucial relaxation messages for result interpretation.The impetus of this work is to help engineers and researchers with petroleum background obtain new insights into NMR principals and extend existing methodologies for characterization of unconventional formations.This article first gives a brief description of the development history of relaxation theories and models for porous media.Then,the widely used NMR techniques for characterizing petrophysical properties and pore structures are presented.Meanwhile,limitations and deficiencies of them are summarized.Finally,future work on improving these insufficiencies and approaches of enhancement applicability for NMR technologies are discussed.

Critical Solvation Structures Arrested Active Molecules for Reversible Zn Electrochemistry

Aqueous Zn-ion batteries(AZIBs)have attracted increasing attention in next-generation energy storage systems due to their high safety and economic.Unfortunately,the side reactions,dendrites and hydrogen evolution effects at the zinc anode interface in aqueous electrolytes seriously hinder the application of aqueous zinc-ion batteries.Here,we report a critical solvation strategy to achieve reversible zinc electrochemistry by introducing a small polar molecule acetonitrile to form a“catcher”to arrest active molecules(bound water molecules).The stable solvation structure of[Zn(H_(2)O)_(6)]^(2+)is capable of maintaining and completely inhibiting free water molecules.When[Zn(H_(2)O)_(6)]^(2+)is partially desolvated in the Helmholtz outer layer,the separated active molecules will be arrested by the“catcher”formed by the strong hydrogen bond N-H bond,ensuring the stable desolvation of Zn^(2+).The Zn||Zn symmetric battery can stably cycle for 2250 h at 1 mAh cm^(-2),Zn||V_(6)O_(13) full battery achieved a capacity retention rate of 99.2%after 10,000 cycles at 10 A g^(-1).This paper proposes a novel critical solvation strategy that paves the route for the construction of high-performance AZIBs.

Semi-analytical solution for drained expansion analysis of a hollow cylinder of critical state soils

The expansion of a thick-walled hollow cylinder in soil is of non-self-similar nature that the stress/deformation paths are not the same for different soil material points.As a result,this problem cannot be solved by the common self-similar-based similarity techniques.This paper proposes a novel,exact solution for rigorous drained expansion analysis of a hollow cylinder of critical state soils.Considering stress-dependent elastic moduli of soils,new analytical stress and displacement solutions for the nonself-similar problem are developed taking the small strain assumption in the elastic zone.In the plastic zone,the cavity expansion response is formulated into a set of first-order partial differential equations(PDEs)with the combination use of Eulerian and Lagrangian descriptions,and a novel solution algorithm is developed to efficiently solve this complex boundary value problem.The solution is presented in a general form and thus can be useful for a wide range of soils.With the new solution,the non-self-similar nature induced by the finite outer boundary is clearly demonstrated and highlighted,which is found to be greatly different to the behaviour of cavity expansion in infinite soil mass.The present solution may serve as a benchmark for verifying the performance of advanced numerical techniques with critical state soil models and be used to capture the finite boundary effect for pressuremeter tests in small-sized calibration chambers.

China's Total Emission Control Policy:a Critical Review

As part of a comprehensive environmental management system, many countries establish emission control targets for mass emissions of a pollutant. Such targets are often the key objective of an environmental policy, such as an emission trading program. In China, however, it is more than just an objective of one particular policy; it has become a concept that has influenced many national environmental policies and activities. The objective of this article is to review the implementation of the total emission control policy in the past 10 years and explore emerging issues in its implementation. The article has three sections: a summary of the implementation experience, issues with the design and implementation of the policy, and policy recommendations.

Utility of flexible fiberoptic bronchoscopy for critically ill pediatric patients:A systematic review

AIM: To investigate the diagnostic yield, therapeutic efficacy, and rate of adverse events related to flexible fiberoptic bronchoscopy(FFB) in critically ill children. METHODS: We searched Pub Med, SCOPUS, OVID, and EMBASE databases through July 2014 for English language publications studying FFB performed in the intensive care unit in children < 18 years old. We identified 666 studies, of which 89 full-text studies were screened for further review. Two reviewers independently determined that 27 of these studies met inclusion criteria and extracted data. We examined the diagnostic yield of FFB among upper and lower airway evaluations, as well as the utility of bronchoalveolar lavage(BAL). RESULTS: We found that FFB led to a change in medical management in 28.9%(range 21.9%-69.2%) of critically ill children. The diagnostic yield of FFB was 82%(range 45.2%-100%). Infectious organisms were identified in 25.7%(17.6%-75%) of BALs performed, resulting in a change of antimicrobial management in 19.1%(range: 12.2%-75%). FFB successfully reexpanded atelectasis or removed mucus plugs in 60.3%(range: 23.8%-100%) of patients with atelectasis. Adverse events were reported in 12.9%(range: 0.5%-71.4%) of patients. The most common adverse effects of FFB were transient hypotension, hypoxia and/or bradycardia that resolved with minimal intervention, such as oxygen supplementation or removal of the bronchoscope. Serious adverse events were uncommon; 2.1% of adverse events required intervention such as bag-mask ventilation or intubation and atropine for hypoxia and bradycardia, normal saline boluses for hypotension, or lavage and suctioning for hemorrhage. CONCLUSION: FFB is safe and effective for diagnostic and therapeutic use in critically ill pediatric patients.