Abstract4D printing technologies are currently suffering from the inability to produce rapid motions, which limit their applications that require fast shape transformation such as rapid unlocking and deployment of aerospace equipment. Herein, inspired by the shooting mechanisms of Viola verecunda fruit for seed dispersal, the 4D‐printed biomimetic catapult is developed. Based on the structure change characteristics of gradient fan‐shaped cells of the fruit pods during seed ejection, the biomimetic smart catapult is processed via the programming of spatial distribution of heterogeneous materials with various storage modulus enabled by additive manufacturing. This catapult can achieve high‐speed ejection with the logically stimuli of external force, temperature, light, humidity, or electricity. The proposed biomimetic 4D printing strategy has broken through the limitations in motion speed, which helps fully unleash the potential of 4D printing.

Spider silks exhibit excellent mechanical properties and have promising application prospects in engineering fields. Because natural spider silk fibers cannot be manufactured on a large scale, researchers have attempted to fabricate bio-inspired spider silks. However, the fabrication of bio-inspired spider silks with dynamically tunable mechanical properties and stimulation–response characteristics remains a challenge. Herein, the 4D printing of shape memory polyurethane is employed to produce dynamic bio-inspired spider silks. The bio-inspired spider silks have two types of energy-absorbing units that can be adjusted, one by means of 4D printing with predefined nodes, and the other through different stimulation methods to make the bio-inspired spider silks contract and undergo spiral deformation. The shape morphing behaviors of bio-inspired spider silks are programmed via pre-stress assemblies enabled by 4D printing. The energy-absorbing units of bio-inspired spider silks can be dynamically adjusted owing to stress release generated with the stimuli of temperature or humidity. Therefore, the mechanical properties of bio-inspired spider silks can be controlled to change dynamically. This can further help in developing applications of bio-inspired spider silks in engineering fields with dynamic changes of environment.

The role of microbiological factors in the development of neurodegenerative diseases is attracting increasing attention, while the relationship remains debated. This study aimed to comprehensively summarize and evaluate the associations between microbiological factors and the risk of neurodegenerative disorders with an umbrella review. PubMed, Embase, and the Cochrane library were used to search for papers from the earliest to March 2021 for identifying meta-analyses and systematic reviews that examined associations between microbiological factors and neurodegenerative diseases. AMSTAR2 tool was employed to evaluate the methodical quality of systematic reviews and meta-analyses. The effect size and 95% confidence interval (95% CI) were recalculated with a random effect model after the overlap was recognized by the corrected covered area (CCA) method. The heterogeneity of each meta-analysis was measured by the I2 statistic and 95% prediction interval (95% PI). Additionally, publication bias and the quality of evidence were evaluated for all 37 unique associations. Only 4 associations had above the medium level of evidence, and the rest associations presented a low level of evidence. Among them, helicobacter pylori (HP), infection, and bacteria are associated with Parkinson's disease (PD), and the other one verifies that periodontal disease is a risk factor for all types of dementia. Following the evidence of our study, eradication of HP and aggressive treatment of periodontitis are beneficial for the prevention of PD and dementia, respectively. This umbrella review provides comprehensive quality-grade evidence on the relationship between microbial factors and neurodegenerative disease. Regardless of much evidence linking microbial factors to neurodegenerative diseases, these associations are not necessarily causal, and the evidence level is generally low. Thus, more effective studies are required.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/#searchadvanced, PROSPERO, identifier: CRD42021239512.

To investigate the status quo of cognitive appraisal of health and its influencing factors among pregnant women with gestational diabetes mellitus. Methods: A cross-sectional survey was conducted from June 2020 to November 2020. Participants were recruited from a tertiary hospital by a convenient sample method. A total of 300 pregnant women with gestational diabetes mellitus completed the survey, including self-compiled individual information questionnaire, Cognitive Appraisal of Health Scale, Pregnancy Stress Rating Scale and General Self-Efficacy Scale. Results: For cognitive appraisal of health, the median score of challenge dimension was 3.75 (3.50, 4.00), benign/irrelevant was 2.75 (2.00, 3.50), harm/loss was 2.38 (2.00, 3.00) and threat was 2.40 (2.00, 2.80), respectively. Regression analyses showed that gestational age, mode of conception, history of abortion, insulin usage, pregnancy stress and self-efficacy were the predictors of cognitive appraisal of health. Conclusions: This study revealed that pregnant women with gestational diabetes mellitus tended to make positive cognitive appraisal of health. And healthcare providers need to make full use of their predictors of cognitive appraisal of health to improve cognitive appraisal to manage stress and ameliorate pregnancy outcomes.

Aim: This meta-analysis aimed to systematically evaluate the effectiveness of auricular acupressure on pain management during labor.Methods: Six English and three Chinese electronic databases were comprehensively searched from inception to 6 November 2021. The PRISMA checklist was followed. The methodological quality of the included studies was assessed with the Cochrane Collaboration Bias Risk Assessment Tool. The metaanalysis was performed using Review Manager 5.3 software. Heterogeneity between studies was calculated using I 2 . Results: Five studies comprising 312 participants were included. The labor pain scores of the auricular acupressure group were significantly lower than those of the usual care group at cervix dilations of 6, 8, and 10 cm, with mean differences (95% confidence intervals) of À1.05 (À1.41, À0.69), À1.44 (À2.07, À0.82), and À1.96 (À3.30, À0.61), respectively. Auricular acupressure can thus effectively improve the labor pain perception at cervix dilations of 6, 8, and 10 cm. Moreover, auricular acupressure shortened the active phase, and had the trend of shortening the second and third stages of labor. There was no evidence that auricular acupressure had an effect on the rate of cesarean section or the 1 and 5 min Apgar scores. Conclusion: Effective labor pain relief, better labor pain perception, and the lack of adverse effects support the use of auricular acupressure. More highquality and rigorous trials are needed to verify our findings before we can make strong recommendations.auricular acupressure, labor pain, pain management, randomized controlled trials, systematic review and meta-analysis | INTRODUCTIONPain is a common and inevitable part of the labor process and is the result of the integration of a combination of physiological and psychosocial factors (Mathur et al., 2020). Pain associated with labor has been described as one of the most severe instances of pain that women will experience in their lives, and it always