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The inventory levels of pickup points play an important role for the same-day or next-day pickup and delivery services. The previous inventory optimisation research usually makes an assumption about demand distribution, does not use the real dataset or consider shipping strategies for this problem. In this study, we introduce a new strategy, mixture of anticipatory and emergency shipping, and propose forecasting-optimisation integrated approach to optimise multi-items' inventories in each pickup point based on big data analysis. We explore a real dataset including 23,808,261 records with 54 pickup points and 4018 items. We first cluster the dataset based on the distances between pickup points and the warehouse, then, implement the forecasting-optimisation integrated algorithms to select the more profitable strategy for each group. The result indicates that compared with the original algorithms, our proposed approach can effectively increase the profits, particularly, the novel algorithm, Long Short-Term Memory networks – Quantile Regression, performs better. Additionally, we find that the 100% anticipatory shipping is not necessarily superior to emergency shipment, when the pickup point is farther from the warehouse, the advantage of emergency shipment is more significant. However, the mixture of anticipatory and emergency shipping can contribute to higher profits for online retailers. [ABSTRACT FROM AUTHOR]

Electrothermal instability and its effect on the uniformity of discharge channels during underwater electrical wire explosions at different energy deposition rates have been investigated. According to the liquid–vapor transition mechanism, we classified underwater electrical explosion into "phase explosion mode" and "supercritical mode." Two sets of experiments corresponding to the two modes were conducted, and the exploding wires were observed by a shadow imaging system. Results showed that a bamboo-shaped discharge channel was formed in the phase explosion mode, whereas the discharge channel in the supercritical mode was a uniform cylinder. Self-consistent magnetohydrodynamic simulation results indicated that exploding wires transfer into liquid–vapor coexistence phase in the phase explosion mode, accompanied by a rapid increase in the density perturbation and the formation of bamboo-shaped structures. Moreover, a small perturbation model was derived to analyze the electrothermal instability in different thermodynamic states. It was indicated that the density perturbation is easier to grow in the liquid–vapor coexistence state than the supercritical state, which provides a theoretical explanation for the differences between the two electrical explosion modes. [ABSTRACT FROM AUTHOR]

Boron-based compounds have triggered substantial attention due to their multifunctional properties, incorporating excellent hardness and superconductivity. While tetragonal metal borides LiB4 and NaB4 with BaAl4-type structure and striking clathrate boron motif have been induced under compression, there is still a lack of deep understanding of their potential properties at ambient pressure. We herein conduct a comprehensive study on I4/mmm-structured LiB4 and NaB4 under ambient pressure via first-principles calculations. Remarkably, both LiB4 and NaB4 are found to possess high Vickers hardness of 39 GPa, which is ascribed to the robust boron framework with strong covalency. Furthermore, their high hardness values together with distinguished stability make them highly potential superhard materials. Meanwhile, electron–phonon coupling analysis reveals that both LiB4 and NaB4 are conventional phonon-mediated superconductors, with critical temperatures of 6 and 8 K at 1 atmosphere pressure (atm), respectively, mainly arising from the coupling of B 2p electronic states and the low-frequency phonon modes associated with Li-, Na-, and B-derived vibrations. This work provides valuable insights into the mechanical and superconducting behaviors of metal borides and will boost further studies of emergent borides with multiple functionalities. [ABSTRACT FROM AUTHOR]

Erastin, a classic ferroptosis inducer, mediates ferroptosis through various molecular pathways. A highly efficient and convenient synthesis of erastin has been developed, starting from 2-nitrobenzoic acid through 7 steps in an overall yield of 21.6%. This synthesis approach features the efficient construction of the key quinazolinone core and highly selective bromination. [ABSTRACT FROM AUTHOR]

Polycrystalline SnSe, renowned for its environmental sustainability, holds promise as a significant thermoelectric material, attracting considerable research attention. This study focuses on the thermoelectric properties of p-type polycrystalline SnSe doped with silver copper telluride (AgCuTe). Our experimental results conclusively show that the decomposition products of AgCuTe not only fill Sn vacancies but also act as acceptors, thereby introducing additional hole carriers. This leads to a notable improvement in both carrier mobility and concentration. Importantly, the thermal conductivity of the doped samples remains largely unchanged, as the lattice flattening strategy significantly boosts electrical performance without affecting lattice thermal conductivity. Ultimately, the doped sample Sn0.97Se-0.5%AgCuTe resulted in a power factor of 6.2 mW mK−1 and a peak ZT value of 1.4 at 798 K, representing a 109% improvement in ZT value. All samples exhibits superior stability and reproducibility, emphasizing its reliability for practical applications. [ABSTRACT FROM AUTHOR]

Within each of 170 physicians, patients were randomized to access e‐assist, an online program that aimed to increase colorectal cancer screening (CRCS), or control. Compliance was partial: 78.34%$$ 78.34\% $$ of the experimental patients accessed e‐assist while no controls were provided the access. Of interest are the average causal effect of assignment to treatment and the complier average causal effect as well as the variation of these causal effects across physicians. Each physician generates probabilities of screening for experimental compliers (experimental patients who accessed e‐assist), control compliers (controls who would have accessed e‐assist had they been assigned to e‐assist), and never takers (patients who would have avoided e‐assist no matter what). Estimating physician‐specific probabilities jointly over physicians poses novel challenges. We address these challenges by maximum likelihood, factoring a "complete‐data likelihood" uniquely into the conditional distribution of screening and partially observed compliance given random effects and the distribution of random effects. We marginalize this likelihood using adaptive Gauss–Hermite quadrature. The approach is doubly iterative in that the conditional distribution defies analytic evaluation. Because the small sample size per physician constrains estimability of multiple random effects, we reduce their dimensionality using a shared random effects model having a factor analytic structure. We assess estimators and recommend sample sizes to produce reasonably accurate and precise estimates by simulation, and analyze data from a trial of a CRCS intervention. [ABSTRACT FROM AUTHOR]

The development of effective dispersants for nanoparticle suspensions is crucial for enhancing the performance and stability of various functional materials. In this study, we investigated a series of comb‐like block copolymers with well‐defined structures, including both categories of block copolymers and uniformly composed random copolymers, as dispersants for cerium oxide (CeO2) suspensions. Acrylic acid (AA) units were used for anchoring and electrostatic repulsion, while methoxy polyethylene glycol acrylate (MPEGA) units provided additional steric hindrance and solubility. We explored stabilization mechanisms involving polymer topologies, chain lengths, compositions, and molecular interactions from kinetic and thermodynamic perspectives. The results demonstrate significant improvements in dispersion stability with both categories of well‐controlled copolymers, especially with uniformly composed random copolymers due to their uniformly distributed multi‐point anchoring and balanced electrostatic and steric stabilization. This research not only enhances the fundamental understanding of polymer‐nanoparticle interactions and polymer dispersants, but also provides valuable guidance for the tailored design of dispersants for specific industrial and scientific needs. [ABSTRACT FROM AUTHOR]

Developing nonchemical cross‐linked natural rubber (NR) latex gloves with antibacterial properties and simultaneously enhanced mechanical strength and elongation at break is challenging. In this study, liquid‐like silica (SiO2) nanofluids (SiO2 nfs) with hard SiO2 cores and soft organic molecule shells are synthesized and then self‐assembled with graphene oxide (GO) via electrostatic interactions to create GO@SiO2 nfs hybrids, which are blended with NR latex. Strong hydrogen bonding and electrostatic interactions between NR latex particles and GO@SiO2 nfs hybrids form physically cross‐linked GO@SiO2 nfs/NR composite films. The rigid GO in the hybrids provided reinforcement, while the vicious SiO2 nfs facilitated the energy dissipation during stretching. This synergy results in simultaneous improvements in the mechanical strength and elongation at break of the GO@SiO2 nfs/NR composite films. Their tensile strength increased by 95.2% compared with pure NR films and by 20.6% compared with GO/NR composite films, and the elongation at break improved by 27.8% and 19.4%, respectively. Furthermore, the presence of quaternary ammonium cation in SiO2 nfs conferred excellent antibacterial efficacy against Escherichia coli and Staphylococcus aureus to the GO@SiO2 nfs/NR composite films. These results offer valuable insights for the development of high‐performance, nonchemical cross‐linked NR latex products. [ABSTRACT FROM AUTHOR]

Purpose: Village-level archives are the most basic construction unit of rural archives in China, yet the village-level archival work is the most poorly delivered. However, the evolution of the laws and rules on village-level archival work in recent years signal that Chinese village-level archival work has stepped into a new era. In this context, this article aims to review the detailed history of village-level archival legislation, examine the legislation' implementation effect and discuss the existing problems with a view to providing improvement measures. Design/methodology/approach: A historical research method is used to review the legislation' history, and the analysis involving the implementation effect is mainly based on literature of two kinds, which are investigation reports on sample villages' archival work carried out by scholars, and summary reports and work schemes on national or local village-level archival work given by the archival management or administrative management departments at various level. Findings: At first, China only issued non-legal administrative orders toward village-level archival work. Later, some regions issued local rules, and finally the national rules and even Archives Law with relevant provisions were promulgated. However, their implementation faced two fundamental problems; firstly the insufficient endogenous demand for archival work in some villages, and secondly the mechanism problem involving village level archives management. The countermeasures are also discussed building on these two points. Originality/value: This is the first article to systematically combine a review of the history of Chinese village-level archival legislation and in addition to examine their implementation effect including analyzing the existing problems from the macro level. [ABSTRACT FROM AUTHOR]

Background: Previous researches have reported the relationship between uric acid and cardiovascular disease. We aimed to investigate the association of Life's Essential 8, a recently updated measurement of cardiovascular health, with the prevalence of hyperuricemia (HUA) and gout among US adults. Additionally, we also explored the relationship between LE8 and all-cause mortality among patients with HUA or gout. Methods: Participants from the National Health and Nutrition Examination Survey in 2007–2016 were involved in this study. LE8 score was categorized into low, moderate, high CVH groups according to American Heart Association definitions. Multivariable logistic regression and cox regression analyses, restricted cubic spline models, subgroup analysis and sensitivity analysis were used to explore the associations. Results: A total of 23,619 adult participants were included in this study, which included 4,775 hyperuricemia patients and 1,055 gout patients. Among all participants, the overall median LE8 score was 65.62 (21.25) and the prevalence of hyperuricemia and gout of were 20.2% and 4.5%, respectively. After fully adjusted the potential confounders, participants in high CVH group had a lower prevalence of hyperuricemia and gout compared with the low CVH group, with a OR (95%CI) of 0.50 (0.39–0.63) and 0.50 (0.30–0.82), respectively. The restricted cubic spline showed a significantly inverse relationship between LE8 and hyperuricemia and gout. Similar patterns were also identified in the association between LE8 scores and all-cause mortality in HUA and gout patients. Conclusions: Higher LE8 scores are associated with lower risk and lower all-cause mortality of HUA and gout among US adults. Adherence to optimal CVH metrics may be an appropriate prevention and management strategy for reducing the socioeconomic burden of hyperuricemia and gout. [ABSTRACT FROM AUTHOR]

To optimize the resistance performance of autonomous underwater vehicle (AUV) hull, many previous scholars mainly studied the geometric shape and materials of AUV, but lacked the research on the surface roughness effect on the hull resistance. In this paper, take the Myring-shaped AUV hull for example, the computational domain distribution, grid independence verification and turbulence model are analyzed and discussed in detail. A computational fluid dynamics (CFD) calculation model is systematically established to predict the resistance performance of AUV hull. The simulation results are in good agreement with the theoretical data, which proves the reliability of the CFD model. Subsequently, the surface roughness effect on the hull drag is studied. First, taking the hull surface roughness height K s as 0.8 μm—100 μm, the friction resistance, pressure resistance and total resistance changes of the hull with the surface roughness height K s are studied when the advance speed is 1.5 m/s. It is found that the total resistance is the lowest when K s is 27.5 μm. Second, taking the surface roughness height as 0.8 μm, 12.5 μm, 50 μm, 75 μm and 100 μm, the change of the hull resistance with the advance speed is analyzed. It is found that the hull resistance increases with the increase of the speed. Third, when the speed is 1 m/s, 2 m/s and 2.5 m/s, respectively, the change of the hull resistance with the surface roughness height is analyzed. The results show that the corresponding optimal surface roughness heights are 39 μm, 21.5 μm and 17 μm, respectively. Finally, the surface roughness effect on the resistance performance of a torpedo-shaped hull is analyzed. It is found that its optimal surface roughness height is very close to that of the Myring-shaped hull. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between thyroid peroxidase antibody (TPOAb) positivity in the first trimester and maternal metabolic syndrome in pregnancy. Methods: The study retrospectively reviewed the medical records for 787 pregnant women. Serum-free thyroid hormone, thyroid stimulating hormone, and TPOAb levels were measured in early pregnancy (<13 weeks gestation). Baseline demographics, clinical characteristics, thyroid function, and pregnancy outcomes were compared between women who were TPOAb positive or TPOAb negative in the first trimester. Associations between TPOAb positivity in the first trimester and the occurrence of gestational diabetes mellitus, hypertensive disorders complicating pregnancy (HDCP), maternal metabolic syndrome in pregnancy, and adverse pregnancy outcomes were explored. Results: Data for 787 women with a singleton pregnancy were included in the analyses. In women who were TPOAb positive compared to TPOAb negative in the first trimester, baseline HDL-C was significantly lower (1.51 [1.33, 1.81] vs. 1.62 [1.40, 1.87], p = 0.028), and there was a significantly higher incidence of HDCP (15.8% vs. 6%, p < 0.0001), maternal metabolic syndrome in pregnancy (18.8% vs 6.4%, p < 0.0001) or preeclampsia (7% vs, 2.5%, p = 0.024). There was a significant nonlinear association between TPOAb levels in the first trimester and the incidence of HDCP or maternal metabolic syndrome in pregnancy (both p < 0.001). The logit of the probability of having HDCP or maternal metabolic syndrome in pregnancy increased rapidly at TPOAb (log10) ≤ 1.5 (TPOAb (log10) = 1.07 as reference). After adjusting for confounders (maternal age, pre-pregnancy BMI, gravidity, parity and history of adverse events during pregnancy), there was a significantly higher risk of HDCP (odds ratio [OR], 3.029; 95% confidence interval [CI], 1.586, 5.622, p = 0.001), maternal metabolic syndrome in pregnancy (OR, 2.841; 95% CI, 1.473-5.260, p = 0.001), or preeclampsia (OR 3.315, 95% CI 1.305-7.788, p = 0.008) in women who were TPOAb positive compared to TPOAb negative in the first trimester. Conclusion: TPOAb positivity in the first trimester may increase the risk of HDCP, maternal metabolic syndrome in pregnancy, and preeclampsia, emphasizing the need for universal screening for thyroid disorders and better diagnostic criteria and management strategies for metabolic disorders during pregnancy. [ABSTRACT FROM AUTHOR]

This article explores how shaonügan, a media-driven aesthetic of womanhood, is practiced and promoted in contemporary China through a case study of a well-received woman-themed talent show. This article first conceptualizes shaonügan in postfeminist discourses to unpack how a narrowly-constrained female beauty ideal paradoxically both empowers and disciplines women who embrace normatively feminine pursuits in a neoliberal consumer culture. This article then examines how shaonügan is constructed and perpetuated by the celebrity sisters through their bodily performance of girlish cuteness and relentless pursuit of eternal youth in the show. Ultimately, the postfeminist beauty norm embodied by the celebrity sisters rearticulates a heteropatriarchal definition of female beauty and readdresses women's subjectivities in neoliberal consumerism that is further complicated and enhanced by media techniques in contemporary Chinese society. [ABSTRACT FROM AUTHOR]

Fire accidents in oil tank farms can trigger domino effects, leading to multiple tank fires with catastrophic consequences. Preventing losses in large‐scale tank farms requires a dynamic assessment of fire‐induced domino accidents. Existing research often focuses on calculating the time to failure (TTF) of storage tanks but overlooks the influence of failure modes. This study develops numerical models to explore failure modes of oil storage tanks with uniform and stepwise walls exposed to thermal radiation. Factors such as the flame heights of combustion tank, adjacent spacings, wall thickness, and tank volumes are considered. The numerical model employs a solid double‐layer flame model to determine thermal radiation intensity and temperature, followed by a dynamic stress–strain and buckling analysis to obtain time to buckling (TTB) and time to yielding (TTY). If TTB < TTY, the failure model is buckling; otherwise, the failure model is yielding. Results indicate that failure modes in nonuniform thermal fields include buckling and yielding, with stepwise walls favoring buckling and uniform walls favoring yielding. When the wall thickness is below the critical value, failure is yielding; otherwise, it is buckling. These findings support risk management and emergency response for fire‐induced domino effects in oil tank farms. [ABSTRACT FROM AUTHOR]

Exosomes regulate lipid metabolism by carrying miRNAs, nucleic acids, and proteins, thereby influencing the function of receptor cells. Glucose-regulated protein 78 (GRP78) is also involved in the regulation of lipid metabolism. However, it remains unclear whether exosomes derived from fatty hepatocytes (OA-Exo) regulate lipid metabolism through the enrichment of GRP78. In this study, we observed the expression of GRP78 was significantly increased in fatty hepatocytes (incubating hepatocytes with oleic acid (OA) for 24 h) and OA-Exo (P < 0.05). In addition, OA-Exo (50 μg/mL) and GRP78 protein (1 μg/mL) significant increased the content of triacylglycerol (TG) and total cholesterol (TC), as well as up-regulated the expression of GRP78 and inositol-requiring enzyme-1alpha (IRE1α) protein (P < 0.05). We further used YUM70 (an inhibitor of GRP78) to inhibit endogenous GRP78, and compared with the YUM70 group, OA-Exo reversed the effect of YUM70 and increased the content of TG, TC, and the expression of GRP78 protein in hepatocytes (P < 0.05). Furthermore, the inhibition of the IRE1α pathway with 4μ8C resulted in a significant decrease in TG content compared to the control group (P < 0.05). However, when compared with the 4μ8C group, OA-Exo and GRP78 reversed the effect of 4μ8C and significantly increased TG content (P < 0.05). Taken together, these results indicated that OA-Exo activated IRE1α to promote lipid accumulation in hepatocytes through the enrichment of GRP78. This study provided a new perspective for further exploration of exosomal lipid metabolism in fish. [ABSTRACT FROM AUTHOR]

Pad Thai, an innovation of Chinese kway teow through Thai-ization that became an iconic national dish of Thailand, played a significant role in shaping national identity and constructing the country's national image. This study explored the relationship between nationalist policies and the localization of kway teow during the Phibunsongkhram government (1938-1944), which contributed to the popularity of kway teow in Thailand's lower class in terms of both production and consumption. The examination of government policies and recipes revealed that Thais infused their emotions and the sense of national identity into the production and consumption of kway teow, thereby enhancing the bond between individuals and the nation and laying a more solid base for the implementation of nationalist policies. The innovation of Pad Thai was one such nationalist policy that was disseminated top-down by the Phibunsongkhram government, making it a national food of Thailand by highlighting its Thai characteristics and including it in its National Nutrition Project. However, Pad Thai was not purely a national Thai dish; rather, it was one that existed in Thais' imagination. In revealing the nature of national cuisine and its importance in nation-building, this study's findings contribute to the significant role of localizing Chinese food in Thai nation-building. [ABSTRACT FROM AUTHOR]

Summary: Jujubes are an excellent source of sugar and nutrients, making them well‐suited for fermentation. Previous research on jujubes has primarily focused on their use in fermented beverages and fruit wines, but their potential for vinegar production has not been sufficiently explored. Therefore, this study produced jujube vinegar from jujube as raw material using microbial fermentation technology, and the changes in bioactive substances and volatile components during different fermentation stages were monitored. Results revealed that the primary organic acids in jujube vinegar were acetic acid, malic acid and lactic acid. The levels of phenolic compounds, such as epicatechin and ferulic acid, increased significantly by 3.5‐fold and 3.2‐fold, respectively, after acetic fermentation, resulting in an improvement in antioxidant activity. In addition, a total of seventy‐three volatile substances were detected in jujube vinegar, with acids accounting for 72.13% of the overall content. Isoamyl alcohol, ethyl phenylacetate, benzaldehyde and 3‐hydroxy‐2‐butanone were also the principal flavour compounds of jujube vinegar, which are the main source of its intense flavour. This study reveals the dynamic law of nutrients and flavour compounds during the fermentation process of jujube vinegar. The findings provide a theoretical reference and practical basis for the production of jujube vinegar. [ABSTRACT FROM AUTHOR]

An exquisite mesostructure model was presented to predict the effective elastic modulus of concrete, in which concrete is realized as a four-phase composite material consisting of coarse aggregates, mortar matrix, interfacial transition zone (ITZ), and initial defects. With the three-dimensional (3D) finite element (FE) simulation, the highly heterogeneous composite elastic behavior of concrete was modeled, and the predicted results were compared with theoretical estimations for validation. Monte Carlo (MC) simulations were performed with the proposed mesostructure model to investigate the various factors of initial defects influencing the elastic modulus of concrete, such as the shape and concentration (pore volume fraction or crack density) of microspores and microcracks. It is found that the effective elastic modulus of concrete decreases with the increase of initial defects concentration, while the distribution and shape characteristics also exert certain influences due to the stress concentration caused by irregular inclusion shape. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BRCA) is one of the most common malignant tumors. The structural maintenance of chromosome (SMC) gene family has been shown to play an important role in human cancers. However, the role of SMC families in BRCA is unclear. This study aimed to explore the role and potential clinical value of whole SMCs in BRCA. Methods: TIMER and UALCAN database were used to analysis the expression level. Genetic variations were analyzed by cBioPortal. Promoter methylation and protein level were analyzed by UCLCAN. GO and KEGG were analyzed by Metascape database. Prognostic value of SMCs was analyzed by Kaplan–Meier and multivariate cox regression analyses. Immune infiltration analysis was conducted by CIBERSORT. Immunotherapy outcome prediction was conducted by Cancer Immunome Atlas. Targeted drug therapy outcome prediction was taken by GDSC and R language. The cell viability was tested by CCK8 and migration was tested by wound healing assay. Xenograft model was used to investigate the in vivo role of SMC2. Results: Expression levels of SMC1A, SMC2, SMC4, SMC5 and SMC6 mRNA were increased in BRCA tissues, and negatively correlated with promoter methylation. Overexpression of SMC2 and SMC4 was negatively correlated with survival. Function of SMCs family regulatory genes was mainly related to ATPase activity. Expression of most SMCs was negatively correlated with immunotherapy and drug therapy outcomes. Interfere SMC2 and SMC4 decreased IC50 values of 5-fluorouracil and oxaliplatin and inhibited the migration of MCF7 cells. Tumor growth and weights were significantly decreased in si-SMC2 groups. Conclusions: Combined bioinformatics and clinical specimen analysis verified SMC2 and SMC4 as independent prognostic factors in BRCA, suggesting their significance for the diagnosis and treatment of BRCA. [ABSTRACT FROM AUTHOR]

Summary: A novel hybrid‐multiplexed fifteen‐switch converter (HM‐15SC) topology, which can simultaneously output a set of three‐phase AC and three sets of DC, is proposed to address the problems of a single type of power electronic converter and the complexity of coordinated control of AC/DC hybrid systems for smart grid. In this paper, we conduct a detailed analysis of the topology and operating principles of HM‐15SC. This includes an examination of the converter's effective switching states in relation to output voltage, current paths, and maximum voltage stress. In addition, a modulation strategy combining single‐leg independent model prediction current control (SL‐MPCC) and time‐sharing cooperative (TSC) ideas is proposed to establish a single‐leg AC current prediction model, which effectively reduces the prediction arithmetic under the premise of realizing three‐leg independent prediction control and optimal control of AC/DC hybrid outputs. Finally, we verify the feasibility and superiority of the proposed HM‐15SC topology and its modulation strategy using the Typhoon HIL 402 platform. [ABSTRACT FROM AUTHOR]

Hypoxic hypoxia arises from an inadequate oxygen supply to the blood, resulting in reduced arterial oxygen partial pressure and a consequent decline in oxygen diffusion into tissue cells for utilization. This condition is characterized by diminished oxygen content in the blood, while the supply of other nutrients within the blood remains normal. The brain is particularly sensitive to oxygen deficiency, with varying degrees of hypoxic hypoxia resulting in different levels of neural functional disorder. Since the brain has a specific threshold range for the perception of hypoxic hypoxia, mild hypoxic hypoxia can trigger compensatory protective responses in the brain without affecting neural function. These hypoxic compensatory responses enable the maintenance of an adequate oxygen supply and energy substrates for neurons, thereby ensuring normal physiological functions. To further understand the hypoxic compensatory mechanisms of the central nervous system (CNS), this article explores the structural features of the brain's neurovascular unit model, hypoxic signal transduction, and compensatory mechanisms. [ABSTRACT FROM AUTHOR]

Aim: To investigate the associations of metabolic syndrome (MetS) with cognitive function, dementia and its subtypes. Methods: Based on the participants recruited by UK Biobank, this study aims to investigate the associations of MetS with cognitive function, dementia and its subtypes. Generalized estimating equations, Cox proportional risk models, and multiple linear regression models were respectively used to assess associations between MetS and dementia‐related outcomes. Results: Among the 363,231 participants, 95,713 had MetS at baseline. The results showed that MetS was significantly associated with cognitive function related to fluid intelligence and prospective memory at follow‐up. Among participants aged ≥60 years, MetS was correlated with elevated risk of all‐cause dementia, particularly vascular dementia (VaD) [hazard ratio 1.115 (95% confidence interval: 1.047, 1.187), hazard ratio 1.393 (95% confidence interval: 1.233, 1.575), respectively]. With increasing MetS components, the risk of all‐cause dementia and VaD tended to be elevated. MetS has also been associated with dementia‐related structural changes in the brain, including alterations in overall brain volume, white matter volume, grey matter volume and white matter integrity. Conclusion: MetS was associated with poorer cognitive performance and might increase the risk of all‐cause dementia as well as VaD, but the effect on Alzheimer's disease was not significant. Holistic control of the MetS may benefit the prevention and control of cognitive impairment and dementia. [ABSTRACT FROM AUTHOR]

Purpose: Based on traditional Chinese filial piety, this article examines the impacts and mechanisms of the two-dimensional filial piety concept "Qinqin – Zunzun" on gender wages in China via China Family Panel Studies (CFPS) conducted in 2014 and 2018. Design/methodology/approach: This article construct regression models to examine the relationship between filial piety concepts and wages. Also, it uses unconditional quantile regression and decomposition to explore the impact of filial piety concepts on the wage gap. Findings: It is found that: (1) The effects of two-dimensional filial piety are heterogeneous in terms of gender. Specifically, authoritarian filial piety significantly suppresses individual wages and has a stronger suppressive effect on women's wages, whereas affinity filial piety significantly enhances individual wages without gender heterogeneity; (2) Parents' time support in the intergenerational exchange model is a crucial mechanism by which filial piety affects wages, exhibiting significant gender heterogeneity; (3) Regarding wage distribution, authoritarian filial piety mainly widens the gender income gap in the low and middle income-groups, while affinity filial piety narrows the gender wage gap by "raising the floor", with its converging effect being most significant in the middle and high-income groups. This article deepens the understanding of the gender wage gap and intergenerational income mobility, providing policy references for better utilizing the social governance function of culture. Originality/value: The article deepens the understanding and mechanisms of the gender wage gap and inter-generational income mobility, providing policy reference for better utilizing the social governance function of culture. [ABSTRACT FROM AUTHOR]

Background: Current diagnostic methods cannot effectively distinguish between latent tuberculosis infection (LTBI) and active tuberculosis (ATB). This study aims to explore novel non-invasive diagnostic biomarkers for LTBI and to elucidate possible molecular mechanisms of LTBI pathogenesis. Methods: Three GEO datasets (GSE19439, GSE19444, and GSE62525) were utilized to analyze the differentially expressed genes (DEGs). Functional enrichment studies were then performed on these DEGs. To ascertain potential diagnostic biomarkers, we utilized two different machine learning techniques: LASSO and RF. ROC curves were constructed in both the training and validation datasets to assess the diagnostic efficacy. The expression of identified biomarkers was verified by RT-qPCR in our own Chinese cohort. Using CIBERSORT, we estimated the abundances of 22 immune cell types in LTBI group, and subsequently analyzed the relationship between biomarker expression and immune cell infiltration. Results: 166 DEGs were identified between ATB and LTBI groups, which are primarily associated with immune responses, inflammatory signaling pathways, and infection factors. Following that, 22 candidate diagnostic biomarkers for LTBI were selected in the machine learning process. Three up-regulated genes, MORN3, LLGL2, and IFT140, whose expression levels were not previously reported in TB, were validated using the training and validation cohort datasets. In our own Chinese cohort, we also found that MORN3 and LLGL2 showed good diagnostic effect using RT-qPCR method. Finally, we revealed the specific infiltration features of immune cells in LTBI and observed a notable correlation between potential marker expression and immune cells. Conclusions: MORN3 and LLGL2 emerged as candidate diagnostic biomarkers for LTBI, following the elucidation of the key immune cell types involved. Our findings will contribute to providing a potential target for early noninvasive diagnosis of LTBI patients. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of nirmatrelvir-ritonavir has mainly been shown in non-hospitalized patients with mild-to-moderate coronavirus disease 2019 (COVID-19). The real-world effectiveness of nirmatrelvir-ritonavir urgently needs to be determined using representative in-hospital patients with COVID-19 during the Omicron wave of the pandemic. Methods: We performed a multicentre, retrospective study in five Chinese PLA General Hospital medical centers in Beijing, China. Patients hospitalized with COVID-19 from 10 December 2022 to 20 February 2023 were eligible for inclusion. A 1:1 propensity score matching was performed between the nirmatrelvir-ritonavir group and the control group. Results: 1010 recipients of nirmatrelvir-ritonavir and 1010 matched controls were finally analyzed after matching. Compared with matched controls, the nirmatrelvir-ritonavir group had a lower incidence rate of all-cause death (4.6/1000 vs. 6.3/1000 person-days, p = 0.013) and a higher incidence rate of clinical improvement (47.6/1000 vs. 45.8/1000 person-days, p = 0.012). Nirmatrelvir-ritonavir was associated with a 22% lower all-cause mortality and a 14% higher incidence of clinical improvement. Initiation of nirmatrelvir-ritonavir within 5 days after symptom onset was associated with a 50% lower mortality and a 26% higher clinical improvement rate. By contrast, no significant associations were identified among patients receiving nirmatrelvir-ritonavir treatment more than 5 days after symptom onset. Nirmatrelvir-ritonavir was also associated with a 50% increase in survival days and a 12% decrease in days to clinical improvement. Conclusion: Among hospitalized patients with COVID-19 during the Omicron wave in Beijing, China, the early initiation of nirmatrelvir-ritonavir was associated with clinical benefits of lowering mortality and improving clinical recovery. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) technologies have been consistently influencing the progress of education for an extended period, with its impact becoming more significant especially after the launch of ChatGPT-3.5 at the end of November 2022. In the field of physics education, recent research regarding the performance of ChatGPT-3.5 in solving physics problems discovered that its problem-solving abilities were only at the level of novice students, insufficient to cause outstanding alarm in the field of physics education. However, the release of ChatGPT-4 presented substantial improvements in reasoning and conciseness. How does this translate to performance in solving physics problems, and what kind of impact might it have on education? This study undertakes a comprehensive assessment of ChatGPT-4's performance in solving physics problems from the perspective of physics conceptual understanding and reasoning, and compares its performance with that of students. It is concluded that ChatGPT-4's performance in solving physics problems has significantly improved compared to ChatGPT-3.5, and was notably superior to the majority of middle school and high school students. This finding presents both a challenge and an opportunity for physics education and the broader educational field, and triggers immediate considerations for coping with this challenge in future teaching and assessment environments. [ABSTRACT FROM AUTHOR]

Background: The metastatic cascade, a multifaceted and highly aggressive process, is the primary cause of mortality. The survival of quiescent cancer cells in circulatory system during metastasis is crucial, yet our comprehension is constrained by the absence of universally accepted quiescent cancer models. Method: We developed a quiescent cancer cell model using high-density cultivation. Based on the scRNA-seq analysis, IP-MS, metabolomics, mouse lung metastasis models, cholesterol assay, PLA and other molecular experiments, we explored the molecular mechanism. Immunofluorescence, atomic force microscope, FluidFM, and shear stress stimulation were used to analyze the cytoskeleton and membrane properties contributing to mechanical force resistance. Result: We established a quiescent cancer cell model induced by high-density cultivation. Single-cell RNA sequencing (scRNA-seq) analysis reveals that CDC25A plays a crucial role in the transition to quiescence, with its expression significantly elevated in the quiescent state. Depletion of CDC25A leads to an increased proliferative capacity, and reduced metastasis under high-density conditions. Mechanistically, upregulated CDC25A in quiescent cells enhances cholesterol metabolism via endosome pathways, leading to cell cycle arrest. This increase in cholesterol reinforces the cytoskeleton, alters membrane properties, and improves resistance to mechanical forces in circulatory system. Conclusion: CDC25A significantly increased the cholesterol metabolism through endosome pathway in quiescent cancer cells, leading to the significant changes in cytoskeleton and membrane properties so as to enhance the resistance of mechanical force in circulatory system, facilitating lung metastasis. [ABSTRACT FROM AUTHOR]

Background: Non-small cell lung cancer (NSCLC) has high incidence and mortality rates. The discovery of an effective biomarker for predicting prognosis and treatment response in patients with NSCLC is of great significance. Bacterial lipopolysaccharide-related genes (LRGs) play a critical role in tumor development and the formation of an immunosuppressive microenvironment; however, their relevance in NSCLC prognosis and immune features is yet to be discovered. Methods: Differentially expressed LRGs associated with NSCLC prognosis were identified in the TCGA dataset. Prognostic LRG scoring and nomogram models were established using single-variable Cox regression, Least Absolute Shrinkage, and Selection Operator (LASSO) regression. The prognostic value of the scoring and nomogram models was evaluated using Kaplan-Meier (KM) analysis and further validated using an external dataset. Patients were stratified into high- and low-risk groups based on the nomogram score, and drug sensitivity analysis was performed. Additionally, clinical characteristics, mutation features, immune infiltration characteristics, and responses to immunotherapy were compared between the two groups. Results: We identified 15 differentially expressed LRGs associated with NSCLC prognosis. A prognostic prediction model consisting of 6 genes (VIPR1, NEK2, HMGA1, FERMT1, SLC7A, and TNS4) was established. Higher LRG scores were associated with worse clinical prognosis and were independent prognostic factors for NSCLC. Subsequently, a clinical risk prediction nomogram model for NSCLC was constructed, incorporating the status of patients with tumor burden, tumor T-stage, and LRG scores. The nomogram model demonstrated good predictive performance upon validation. Additionally, NSCLC patients classified as high risk based on the model's predictions exhibited not only a poorer prognosis but also a more pronounced inflammatory immune microenvironment phenotype than low-risk patients. Furthermore, high-risk patients showed disparate predicted responses to various drugs and immunotherapies compared with low-risk patients. Conclusion: The LRGs scoring model can serve as a biomarker that contributes to the establishment of a reliable prognostic risk-prediction model, potentially facilitating the development of personalized treatment strategies for patients with NSCLC. [ABSTRACT FROM AUTHOR]

Background: Glioma patients often experience neurocognitive deficits, particularly mild cognitive impairment (MCI), which affects their perioperative safety. The use of auditory event-related potentials (AERPs) might be a promising method for reflecting perioperative cognitive function in patients, even under unresponsive sedation. In this study, we aimed to investigate the relationships between the AERP under sedation and preoperative cognitive performance in glioma patients. Methods: Patients with primary supratentorial gliomas who were scheduled for elective craniotomy under general anesthesia were included in this prospective observational study. The patients were categorized into MCI and non-MCI groups based on their preoperative Montreal Cognitive Assessment (MoCA) scores. AERP characteristics, including mismatch negativity (MMN), P300, and event-related spectral perturbation (ERSP) in the theta bands, were analyzed under different propofol-induced sedation conditions. Differences in these parameters between groups and their relationships with preoperative cognitive performance were subsequently investigated. Results: Twenty-nine eligible patients were included in the analysis. Compared to that in the non-MCI group, the average amplitude of the MMN component evoked by the novel stimulus significantly decreased during the recovery period in the MCI group (−3.895 ± 1.961 μV vs. -1.617 ± 1.831 μV, p = 0.003). Theta-ERSPs also differed between the two groups under standard (0.021 ± 0.658 μV2/Hz vs. 0.515 ± 0.622 μV2/Hz, p = 0.048) and novel (0.212 ± 0.584 μV2/Hz vs. 0.823 ± 0.931 μV2/Hz, p = 0.041) stimulation conditions under light sedation. After correcting for age, education level, site of lesion, WHO pathological grade and combined symptomatic epilepsy as confounders, the frontal theta-ERSP induced by standard and novel stimuli under light sedation was inversely related to the preoperative MoCA score (standard stimuli: β = −0.491, p = 0.011; novel stimuli: β = −0.594, p = 0.007), as was the average MMN amplitude induced by novel stimuli during the recovery period (β = −0.356, p = 0.035). Conclusion: The AERP neural response characteristics of glioma patients during propofol sedation were associated with preoperative cognitive performance, which might be a potential neurophysiological indicator for monitoring perioperative cognitive function, especially theta-ERSP. [ABSTRACT FROM AUTHOR]

Background: Hibiscus syriacus L. is a deciduous shrub with a strong environmental resistance and wide application prospects. The genetic background and ploidy levels of Hibiscus cultivars are complex, and polyploid breeding has long been an important method for developing new Hibiscus cultivars. However, the relationship of ploidy levels with leaf morphology, stomatal characteristics, and leaf anatomy remains unclear. Results: This study analyzed three ploidy levels (triploid, tetraploid, and hexaploid) of Hibiscus syriacus. Flow cytometry confirmed the ploidy levels, and morphological traits were evaluated. Leaf length, leaf width, and petiole length decreased with increasing ploidy. Stomatal length, stomatal width, guard cell length, and guard cell width increased and stomatal number and density decreased with increasing ploidy. The hexaploids exhibited the highest midrib diameter and palisade tissue thickness values. Correlation analyses revealed that stomatal morphology served as a reliable marker for determining ploidy levels. Conclusion: This study highlights the impact of varying ploidy levels on the leaf and stomatal morphologies and leaf anatomy of Hibiscus syriacus. These findings can provide theoretical guidance for improving Hibiscus cultivars in terms of stress resistance, adaptability, and ornamental traits, and for developing new cultivars with enhanced characteristics. Future research should focus on utilizing these morphological markers to optimize breeding strategies for Hibiscus cultivars. [ABSTRACT FROM AUTHOR]

The potential risk of lead (Pb) leakage from lead halide perovskite materials poses a significant challenge in the commercialization of perovskite solar cells (PSCs). To address this issue, a viable strategy involves endowing the materials in PSCs with the ability to immobilize Pb. Herein, we introduce a straightforward technique for carbon-based PSCs that utilizes phosphate as a multifunctional additive, which exhibits both bonding and chemical adsorption effects. A playdough-like carbon material can be made by mixing a phosphate aqueous solution with graphite powder, and then be pressed into shape to serve as the top electrode of PSCs. In addition to good compatibility with small-area PSCs and modules, this versatile carbon electrode effectively mitigates the Pb leakage from damaged devices to a safe level. [ABSTRACT FROM AUTHOR]

Although Ni-based materials are widely used as electrocatalysts, it remains necessary to further explore their selectivity towards the four- or two-electron oxygen reduction reaction (ORR). Herein, it is proposed to synthesize NiO@NCNTs (NCNTs = N-doped carbon nanotubes) using a metal–organic framework (MOF), [Ni(BZIDA)(H2O)]n (NiMOF, BZIDA = benzimidazole-5,6-dicarboxylic acid), as a precursor after calcination with dicyandiamide (DCDA). Regarding NiO@NCNTs, small NiO particles are distributed in NCNTs derived from DCDA homogeneously. NiO@NCNTs act as a typical two-electron electrocatalyst. The H2O2 production rate of NiO@NCNTs reaches 0.5 mol g−1 h−1 at 0.46 V (vs. RHE). After the doping of Co2+ in NiMOF, Co/NiO@NCNTs were synthesized using a similar method, with the four-electron character shown in ORR. A Zn–air battery was assembled by applying Co/NiO@NCNTs as the cathode material. When discharge occurs at 5 and 10 mA cm−2, its specific capacitance reaches 779.3 and 832.2 mA h g−1 with an energy density of 928.6 and 948.5 W h kg−1, respectively. Theoretical calculations suggest a variation in ORR selectivity between NiO@NCNTs and Co/NiO@NCNTs, which results from their different interactions with OOH*. This study demonstrates the effect of the structure on ORR selectivity for Ni-based electrocatalysts. [ABSTRACT FROM AUTHOR]

The quinoxaline scaffold occurs in many pharmaceuticals, natural products and organic materials. In this study, a Cu(II)/Rh(III)‐catalyzed regioselective annulation‐olefination sequence for the formation and modification of quinoxalines was developed using ethanol and water as the solvent, with relatively broad substrate scope and functional group tolerance. This protocol has been successfully applied to the derivatization of natural products and pharmaceuticals. Additionally, the derivatives exhibited enhanced antiproliferative activities against A‐2780 and HCT‐116 cell lines, underscoring their potential as promising lead compounds for ovarian cancer and colon cancer treatment. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the performance of GPT-3.5, GPT-4, GPT-4o and Google Bard on the United States Medical Licensing Examination (USMLE), the Professional and Linguistic Assessments Board (PLAB), the Hong Kong Medical Licensing Examination (HKMLE) and the National Medical Licensing Examination (NMLE). Methods: This study was conducted in June 2023. Four LLMs (Large Language Models) (GPT-3.5, GPT-4, GPT-4o and Google Bard) were applied to four medical standardized tests (USMLE, PLAB, HKMLE and NMLE). All questions are multiple-choice questions and were sourced from the question banks of these examinations. Results: In USMLE step 1, step 2CK and Step 3, there are accuracy rates of 91.5%, 94.2% and 92.7% provided from GPT-4o, 93.2%, 95.0% and 92.0% provided from GPT-4, 65.6%, 71.6% and 68.5% provided from GPT-3.5, and 64.3%, 55.6%, 58.1% from Google Bard, respectively. In PLAB, HKMLE and NMLE, GPT-4o scored 93.3%, 91.7% and 84.9%, GPT-4 scored 86.7%, 89.6% and 69.8%, GPT-3.5 scored 80.0%, 68.1% and 60.4%, and Google Bard scored 54.2%, 71.7% and 61.3%. There was significant difference in the accuracy rates of four LLMs in the four medical licensing examinations. Conclusion: GPT-4o performed better in the medical licensing examinations than other three LLMs. The performance of the four models in the NMLE examination needs further improvement. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Objective: The safety of proximal gastrectomy (PG) for the treatment of advanced Siewert II adenocarcinoma of the esophagogastric junction (AEG) remains debatable. In this study, we aim to evaluate the oncological safety of PG and the metastasis rate of key distal lymph node dissection, which is typically excluded in PG. Method: This study retrospective collected advanced Siewert II AEG patients who underwent gastrectomy at the First Medical Center of the General Hospital of the People's Liberation Army (PLA) from January 2014 to December 2019. A total of 421 patients were enrolled, including 237 PG and 184 total gastrectomy (TG). Propensity score matching (PSM) in a 1:1 ratio was performed to reduce the influence of confounding variables. Results: After PSM, 153 cases were matched in each group. The TG group had longer operation time, more lymph node detection and longer postoperative hospitalization time than the PG group (Both P < 0.05). The postoperative complications of the two groups were not statistically significant (P > 0.05). For long-term complications, the incidence of reflux esophagitis and anastomotic stenosis were significantly higher in the PG group than in the TG group (Both P < 0.05), but dumpling syndrome and anemia were significantly lower in the PG group compared to the TG group (Both P < 0.05). The 3-year overall survival (OS) and disease-free survival (DFS) between the two groups were no statistically significant difference (OS: 77.4% and 80.9%, P = 0.223; DFS: 69.7% and 76.1%, P = 0.063). Distal lymph node metastasis rates for No.4d, 5, and 6 were all less than 5%, and the therapeutic value index were also relatively low, with values of 1.09%, 3.26%, and 1.45%, respectively. In addition, the distal No.4d, 5, or No.6 lymph node metastasis rates were significantly higher in patients with tumor size ≥ 4 cm and T4 stage (14.29% and 23.40%) than in patients with tumor size < 4 cm and T2-3 (2.78% and 5.11%) (Both P < 0.05). The results of subgroup survival analysis showed that for patients with tumor size ≥ 4 cm or T4 stage, the TG group had better DFS compared with the PG group (HR 0.618, 0.387–0.987, P = 0.044), while no significant survival benefits were observed in other subgroups. Conclusion: In summary, for Siewert II AEG with tumor size < 4 cm and T2-3 stage, PG may be a reasonable choice with comparable oncological efficacy to TG. But for higher survival benefits, TG remains gold standard particularly for patients with tumor size ≥ 4 cm or T4 stage. [ABSTRACT FROM AUTHOR]

The study aims to develop and validate a predictive model for effectively predicting in-hospital mortality in patients admitted to the intensive care unit due to Gastrointestinal bleeding (GIB). A retrospective cohort study was conducted, including data from patients in the Electronic Intensive Care Unit Collaborative Research Database (eICU-CRD) and Medical Information Mart for Intensive Care-IV Database (MIMIC-IV) with a diagnosis of GIB. Patients from the eICU-CRD were randomly allocated into both development and validation sets, and those from MIMIC-IV were assigned as an external validation group. Multivariate logistic regression was employed to create a predictive model, which was depicted as a nomogram. This study included a total of 2929 patients with GIB from the eICU-CRD and 718 patients from the MIMIC-IV. To access the dynamic nomogram, please use the following link: https://kangzou.shinyapps.io/DynNomapp%5fGIB/. The area under the receiver operating characteristic curve for the nomogram was 0.893 in the development set, 0.860 in the internal validation set, and 0.781 in the external validation set. The mortality rate was 25.7% in the high-risk group (nomogram scores > 101.974) and 2.8% in the low-risk group (nomogram scores ≤ 101.974). The nomogram exhibited excellent discrimination, calibration, and clinical utility in predicting in-hospital mortality among patients admitted to the intensive care unit with GIB. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to compare mean platelet volume/platelet count ratio (PVPR) and other indicators' predictive abilities. Simultaneously, a new nomogram for predicting recurrence-free survival (RFS) after gastrointestinal stromal tumors (GISTs) R0 resection was developed. Methods: From January 2010 to July 2019, 295 patients with GIST who were operated on at Harbin Medical University Cancer Hospital were retrospectively reviewed. With a 4-year RFS as the end point, using the Kaplan–Meier methods and log rank test, and then conducting Cox regression analysis, we compared and identified meaningful indicators for predicting prognosis. Finally, a nomogram was developed and validated using calibration curves. Results: The receiver operating characteristic curve indicated that a cutoff point of 0.044 was the ideal threshold for PVPR, and patients were divided into a high-PVPR group (≤0.044) and a low-PVPR group (>0.044). Kaplan–Meier curves suggested that PVPR>0.044 had obvious associations with better RFS (p < 0.001). In accordance with multivariate analysis, PVPR (>0.044 vs. ≤0.044) (p = 0.005), National Institutes of Health (NIH) risk category (p < 0.001), and Ki-67 (p = 0.005) were the independent prognostic indicators of RFS. Tumor size, gastrointestinal bleeding, mitotic index, NIH risk category, CD34, and Ki-67 all exhibited an obvious correlation with PVPR (all p < 0.05). The nomogram's probability of concordance was 0.823, indicating that the nomogram predictions were well calibrated. Conclusion: In GISTs, RFS can be independently predicted by PVPR. Patients with higher PVPR have better RFS. The nomogram including PVPR could be used to assist clinical treatment decision-making. [ABSTRACT FROM AUTHOR]

Background: Lung cancer is a leading cause of cancer-related deaths globally, with non-small cell lung cancer (NSCLC) accounting for approximately 85% of cases. While immune checkpoint inhibitors (ICIs) have transformed treatment for advanced NSCLC, the role of bone metastasis in modulating ICI efficacy remains unclear. Bone metastasis, occurring in 30-40% of advanced NSCLC cases, is associated with worse outcomes. However, how this affects the therapeutic benefit of ICIs has not been fully elucidated, highlighting a critical knowledge gap in optimizing treatment for this patient population. Methods: A comprehensive literature search across multiple databases, including PubMed, Embase, and Cochrane, identified 13 studies with a total of 3,681 patients, of whom 37.6% had bone metastasis. Overall survival (OS) and progression-free survival (PFS) were compared between NSCLC patients with and without bone metastasis. Data were analyzed using a random-effects model to account for study heterogeneity. Results: The meta-analysis demonstrated that bone metastasis significantly worsened overall survival (OS) and progression-free survival (PFS) in NSCLC patients treated with ICIs. Specifically, bone metastasis was associated with a 45% increased risk of death (HR: 1.45, 95% CI: 1.30–1.62, p < 0.001) and a 40% increased risk of disease progression (HR: 1.40, 95% CI: 1.25–1.58, p < 0.001). No statistically significant impact on PFS was observed. (HR: 1.28, 95% CI: 0.77–2.10, p = 0.34). High heterogeneity was observed in some subgroup analyses (I² = 72%), indicating variability in the results. Conclusion: Bone metastasis is a significant negative prognostic factor for NSCLC patients treated with ICIs, associated with a higher risk of mortality and disease progression. These results underscore the importance of tailored treatment approaches for NSCLC patients with bone metastasis and call for further research to optimize therapy outcomes in this group. [ABSTRACT FROM AUTHOR]