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Catalysts for warm cloud seeding have significant potential for applications in warm cloud catalytic precipitation and fog elimination. In recent years, numerous innovative materials have been developed, each with the potential to be used in warm cloud catalysis. However, a universally recognized ideal formulation has not yet been established. It is necessary to conduct a scientific analysis on the performance of various hygroscopic catalysts under consistent experimental conditions.Therefore, 9 types of typical powdered hygroscopic catalysts are collected, and experiments involving fog chamber and static testing of catalysts are conducted at CMA Key Laboratory of Cloud-precipitation Physics and Weather Modification in May 2023. Fog elimination capabilities and hygroscopic characteristics of various catalysts are comprehensively evaluated and compared. Results indicate that, under the same fog conditions, salt type catalysts demonstrate the shortest time to eliminate fog, and porous composite materials (PCM-100 and PCM-10) are also effective, while fog elimination effects of modified starch, molecular sieves, organic bentonite and sodium bentonite are not obvious after seeding. In static detection, under normal temperature and humidity conditions, CaCl2 exhibits the strongest static hygroscopicity, followed by porous composite materials such as PCM-100 and PCM-10. Composite salt catalysts exhibit strong hygroscopic absorption, whereas the static hygroscopic absorption capacity of other catalysts is not as pronounced. In high humidity conditions, bentonite and molecular sieve catalysts still do not exhibit moisture absorption characteristics. The hygroscopic abilities of CaCl2, PCM-100, and PCM-10 are significantly higher than those of other catalysts. The performance of various catalysts in the fog chamber experiment and static detection is basically consistent.Microstructures of various catalysts with strong hygroscopic properties do not show significant changes after 30 minutes. PCM-10 primarily exists in the form of liquid droplets after standing for 5 minutes and can continue to provide hydration. PCM-100 remains in irregular crystal form after 5 minutes and transforms into droplets after 30 minutes. CaCl2 absorbs moisture rapidly under the microscope, initially existing as liquid droplets for 5 minutes. Subsequently, there are no significant changes, primarily small droplets. Complex salts always form crystals, while the size of liquid droplets formed is larger.It should be noted that, although the hygroscopicity and the ability of fog elimination of various catalysts are important indicators, the dispersibility, corrosiveness and ease of preparation and storage of the catalyst are also important parameters of whether they can be used as efficient warm cloud catalysts. Follow-up research and evaluation of various catalysts will be conducted.

In the context of China's commitment to improve air quality enhancement, cities within severe cold climate zones, exemplified by Harbin continue to confront the exigent issue of fine particulate matter (PM2.5) pollution, notably during winter. Despite nationwide initiatives aimed at mitigating air pollution, Harbin's unique geographical and climatic conditions, combined with its predominant economic activities, have led to consistently high levels of PM2.5 during winter. An episode of severe PM2.5 pollution is observed in January 2020, with the monthly average mass concentration of PM2.5 peaking at 155.0 μg·m-3, significantly surpassing national standards. To explore the mechanism of this severe PM2.5 pollution episode, an integrated analysis of chemical compositions and influencing factors is conducted during this period. In the meantime, methods of backward trajectory clustering and the weighted potential source contribution function (WPSCF) are employed to investigate source areas and transport pathways of air pollutants. Results indicate that the severe PM2.5 pollution in Harbin mainly originates from primary emissions, with biomass burning contributing significantly. During the observation period, the concentration of levoglucosan in PM2.5, a common tracer of biomass burning, reaches as high as 1.1 μg·m-3, which is 3.7 to 5.5 times higher than that in other regions experiencing severe biomass burning pollution during winter. Furthermore, research findings indicate that meteorological conditions play a significant role in exacerbating PM2.5 pollution in Harbin. High relative humidity (averaging at 80.0%) combined with extremely low temperatures (averaging at -18.0 ℃) provided favorable conditions for secondary aerosol formation. Under such low-temperature and high-humidity conditions, the average sulfur oxidation rate reaches as high as 25.6%, and the nitrogen oxidation rate reaches 10.8%. It significantly increases the contribution of secondary aerosols to PM2.5 in Harbin. Additionally, this study also reveals the impact of regional transportation on the air quality of Harbin. It indicates that the air quality of Harbin is influenced not only by local emissions but also by the transportation of pollutants from neighboring cities such as Suihua, Daqing, Changchun, and Songyuan. The inter-city transfer of pollution highlights the close connection of air pollution issues within the region. Through the comprehensive analysis of causes of a severe PM2.5 pollution event in Harbin during winter from multiple perspectives, a scientific basis is provided for understanding causes for air pollution in similar cold climate.

Primary biliary cholangitis (PBC) is an autoimmune liver disease. During the diagnostic process, the patient’s autoimmune antibodies are routinely examined. Approximately 20% of PBC patients have positive anti-centromere antibody (ACA). We evaluated the clinical characteristics of ACA-positive and ACA-negative PBC patients to explain the differences in disease progression between these two groups. Retrospective data from 961 PBC patients at Beijing Youan Hospital from 2010 to 2019 were gathered and separated into two groups based on ACA positivity. We collected and evaluated clinical laboratory indices, gastroscopy findings, and liver function assessments. In addition, 60 liver biopsies were available for comparison between the 2 groups. Pathologists staged the histological findings using the Ludwig staging criteria and Nakanuma staging and grading. Immunohistochemical staining was also performed on liver biopsies to examine the expression of cytokeratin 7 (CK7) in the tissue. A synthesis of clinical indicators in the large cohort showed that alanine transaminase, aspartate aminotransferase, total bilirubin, IgG, white blood cell, and platelet were significantly lower in the ACA-positive group, indicating that the overall status of liver injury was more moderate in the ACA-positive group. Additionally, ACA-positive patients in the non-cirrhotic group were more likely to present with gastroesophageal varices related to portal hypertension. Finally, analysis of pathologic findings showed that parameters were mostly comparable in the two groups, but CK7 differed and was more significantly lower in the ACA-positive group in albumin–bilirubin grade 2 and 3 patients. In summary, we characterized and compared the clinical features of ACA-positive and ACA-negative PBC patients, corroborating previous studies on the relationship between ACA positivity and portal hypertension cross-sectionally. It suggested that gastroesophageal varices might happen in the earlier course of PBC natural progression in the ACA-positive group.

To deeply investigate the effect of rare earth （La/Ce） on inclusions and fatigue properties of 20CrMnTi gear steel， the inclusions in 20CrMnTi and 20CrMnTi-RE gear steel treated with 0.002 7% rare earth were analyzed and characterized by various analytical and testing methods， the change of fatigue property was compared and analyzed. The ultra-high weekly fatigue test was carried out and analyzed the change of fatigue properties.The results show that rare earth can react with O element in gear steel to form rare earth oxides， and co-exist with other inclusions such as CaS and MgAl2O4， which become the core of TiN， the complex phase of CaS-MgAl2O4-（MnS）-TiN is transformed into the complex phase of CaS-MgAl2O4-（MnS）-RE2O3-TiN. After addition of rare earth， the amount of inclusions in 20CrMnTi steel decreased significantly， and the inclusions with size over 30 μm basically disappeared. In addition， rare earth improves the anti-fatigue property of gear steel. The fatigue limit of gear steel with rare earth is 26.6 MPa higher than that of gear steel without rare earth at the condition of 50% failure probability for 107 cycles， with better anti-fatigue performance.

Pilong Shi,1,* Yuetong Sha,1,* Xinran Wang,1,* Tao Yang,1 Jiawei Wu,1 Jiajun Zhou,1 Kai Liu,1 Xue Guan,2 Song Wang,1 Yongsheng Liu,1 Jingquan Gao,3 Hongli Sun,1 Tao Ban,1 Yonggang Cao1 1Department of Pharmacology, Harbin Medical University, Heilongjiang, 163319, People’s Republic of China; 2Morphological Experiment Center, Harbin Medical University, Heilongjiang, 163319, People’s Republic of China; 3Department of Nursing, School of Medicine, Lishui University, Lishui, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yonggang Cao; Hongli Sun, Email 437343482@qq.com; sunhongli@hmudq.edu.cnPurpose: Myocardial ischemia-reperfusion injury (MI/RI) is associated with increased oxidative damage and mitochondrial dysfunction, resulting in an elevated risk of mortality. MI/RI may be alleviated by protecting cardiomyocytes from oxidative stress. Lutein, which belongs to a class of carotenoids, has proven to be effective in cardiovascular disease treatment due to its remarkable antioxidant properties, but its application is limited due to its poor stability and low bioavailability in vivo.Methods: In this study, a delivery system was developed based on distearoyl phosphatidyl ethanolamine (DSPE)-thiol-ketone (TK)-PEG2K (polyethylene glycol 2000) (abbreviated as DTP) and PCM-SH (CWLSEAGPVVTVRALRGTGSW) to deliver lutein (abbreviated as lutein@DTPP) to damaged myocardium. First, lutein, lutein@DTP, or lutein@DTPP were injected through the tail vein once a day for 3 days and then MI/RI model rats were established by exposing rats to ischemia for 45 min and reperfusion for 6 h. We employed a range of experimental techniques including qRT-PCR, Western blotting, transmission electron microscopy, immunohistochemistry, immunofluorescence, flow cytometry, immunoprecipitation, molecular docking, and molecular dynamics simulations.Results: Lutein@DTPP exhibited good myocardial targeting and ROS-responsive release. Our data suggested that lutein@DTPP effectively suppresses ferroptosis in cardiomyocytes. Mechanistically, we observed an upregulation of mouse double minute-2 (MDM2) in the hearts of MI/RI models and cardiomyocytes exposed to hypoxia/reoxygenation (H/R) conditions. In addition, NADH-ubiquinone oxidoreductase 75 kDa Fe-S protein 1 (NDUFS1) translocation from the cytosol to the mitochondria was inhibited by MDM2 upregulation. Notably, no significant variation in the total NDUFS1 expression was observed in H/R-exposed cardiomyocytes following treatment with siMDM2. Further study indicated that lutein facilitates the translocation of NDUFS1 from the cytosol to mitochondria by directly binding and sequestering MDM2, thereby improving mitochondrial function and inhibiting ferroptosis.Conclusion: Lutein@DTPP promoted the mitochondrial translocation of NDUFS1 to restore mitochondrial function and inhibited the ferroptosis of cardiomyocytes by directly binding and sequestering MDM2. Keywords: myocardial ischemia-reperfusion injury, lutein, ROS, MDM2, NDUFS1, ferroptosis

Yunfeng Jia,1 Yayi Liu,1 Yiming Zuo,1 Junping Zhang,1 Yanyang Li,2,3 Xuezheng Liu,1 Shichao Lv1 1Department of Geriatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine (National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion), Tianjin, 300381, People’s Republic of China; 2Department of Integrated Traditional and Western Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People’s Republic of China; 3Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, People’s Republic of ChinaCorrespondence: Shichao Lv; Xuezheng Liu, Department of Geriatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 88 Changling Street, Xiqing District, Tianjin, 300193, People’s Republic of China, Email dr_lv@foxmail.com; drhare1975@163.comAbstract: Heart failure (HF) represents a serious manifestation or advanced stage of various cardiac diseases. HF continues to impose a significant global disease burden, characterized by high rates of hospitalization and fatality. Furthermore, the pathogenesis and pathophysiological processes underlying HF remain incompletely understood, complicating its prevention and treatment strategies. One significant pathophysiological mechanism associated with HF is the systemic inflammatory response. PANoptosis, a novel mode of inflammatory cell death, has been extensively studied in the context of infectious diseases, neurodegenerative disorders, cancers, and other inflammatory conditions. Recent investigations have revealed that PANoptosis-related genes are markedly dysregulated in HF specimens. Consequently, the PANoptosis-mediated inflammatory response may represent a potential mechanism and therapeutic target for HF. This paper conducts a comprehensive analysis of the molecular pathways that drive PANoptosis. We discuss its role and potential therapeutic targets in HF, thereby providing valuable insights for clinical treatment and the development of novel therapies.Keywords: PANoptosis, pyroptosis, apoptosis, necroptosis, cell death, heart failure

Xiao Wang,1,* Ying Cao,2,* Jing Hu,3 Lian-Cheng Jia,4 Bo Li,3 Baoli Liu,5 Wei-Hai Yao,2 Xiao-Lu Pei,6 Wei Peng,2 Shuang Wang,2 Cun-Zhi Liu,1,7 Jian-Feng Tu,1,7 Zhi-Cheng Qu2 1School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People’s Republic of China; 2Emergency Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China; 3Evidence Based Medicine Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China; 4Urinary Surgery, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China; 5Nephrology Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China; 6Nursing Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, People’s Republic of China; 7International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhi-Cheng Qu, Emergency Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, 23 Meishuguanhou Street, Dongcheng District, Beijing, 100010, People’s Republic of China, Email qzhch0824@163.com Jian-Feng Tu, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, People’s Republic of China, Email tujianfeng1@126.comIntroduction: Analgesia is often delayed for suspected acute renal colic due to urinary calculi (ARCUC) even in emergency department. Acupuncture has a rapid onset and is effective for analgesia, however, evidence about early-acupuncture for suspected ARCUC is limited. This trial aims to evaluate the efficacy of early-intervention acupuncture compared with sham acupuncture on pain relief among emergency department suspected ARCUC patients.Methods and Analysis: A total of 84 eligible patients who are suspected diagnosed with ARCUC will be randomly allocated to the acupuncture group or the sham acupuncture group. Each patient will receive 1 session of acupuncture or sham acupuncture before diagnostic imaging. The primary outcome will be the response rate at 10 min after needle manipulation, defined as the proportion of patients whose Numeric Rating Scale (NRS) score decrease by at least 50% from baseline. Secondary outcomes will include pain intensity assessed by NRS, further analgesia requirement, revisit rate, surgical intervention rate, satisfaction evaluation, and adverse events. The final diagnosis rate determined by radiography will be recorded and reported. All patients who receive randomization will be included in the intention-to-treat analysis.Conclusion: This study’s findings are anticipated to evaluate the analgesic effect of early-intervention acupuncture for acute renal colic in emergency department, which could be useful for moving the timing of analgesia forward and aligning pain management for acute renal colic more with the guidelines.Trial Registration Number: ChiCTR2100049069 (https://www.chictr.org.cn/showproj.html?proj=125338).Keywords: acupuncture, complementary medicine, pain management, emergency medicine, renal colic

Panax ginseng, a venerable herb in traditional Chinese medicine, boasts a rich history of usage in the treatment of dementia, particularly in its various manifestations. However, despite its long-standing popularity and empirical evidence of effectiveness, the precise mechanisms underlying its therapeutic actions have remained elusive. Currently, research on pharmacodynamic components and mechanisms predominantly utilizes serum pharmacology and metabolomics research methods that are based on liquid chromatography-mass spectrometry technology. However, these methods are unable to capture the spatial distribution information of relevant substances, leading to a lack of comprehensive understanding of the pharmacodynamic components and their underlying mechanisms. To bridge this gap in knowledge, a method of spatial metabolomics and air flow assisted desorption electrospray ionization mass spectrometry imaging (AFADESI-MSI), was used to delve into the molecular mechanisms of Panax ginseng in treating Alzheimer’s disease (AD). The pharmacodynamic results demonstrated that Panax ginseng extract can significantly improve the state of brain pathological damage and spatial learning memory ability in AD model rats. This finding highlights the potential of ginseng as a therapeutic agent in AD management. Furthermore, the metabolomics analysis revealed that Panax ginseng modulates the levels of 19 biomarkers that are intricately linked to AD. These biomarkers span across 8 key metabolic pathways, including arginine and proline metabolism, purine metabolism, the tricarboxylic acid (TCA) cycle, and fatty acid metabolism. These pathways are essential for maintaining neuronal health and function, and their dysregulation is often associated with the pathogenesis of AD. Importantly, the study identified 7 active ginseng constituents that accumulate in brain tissue. These compounds work in a holistic manner to treat AD by modulating metabolites related to neuroinflammation, neuronal damage, energy deficits, and abnormal fatty acid metabolism. The comprehensive approach suggests that Panax ginseng may offer a multifaceted therapeutic strategy for AD. The unique capabilities of mass spectrometry imaging allow to analyze the spatial distribution of both endogenous and exogenous substances in parallel. This correspondence not only provides a deeper understanding of the specific effects of drug components, but also sheds light on how these components interact with the body’s endogenous metabolic networks to exert their therapeutic effects. In conclusion, the study provides new light on the mechanisms of action of Panax ginseng in treating AD and paves the way for future research and clinical applications of the ancient herb.

With the increasing proportion of human papilloma virus (HPV) infection in the pathogenic factors of oropharyngeal cancer, a series of changes have occurred in the surgical treatment. While the treatment mode has been improved, there are still many problems, including the inconsistency between diagnosis and treatment modes, the lack of popularization of reconstruction technology, the imperfect post-treatment rehabilitation system, and the lack of effective preventive measures. Especially in terms of treatment mode for early oropharyngeal cancer, there is no unified conclusion whether it is surgery alone or radiotherapy alone, and whether robotic minimally invasive surgery has better functional protection than radiotherapy. For advanced oropharyngeal cancer, there is greater controversy over the treatment mode. It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy, or a treatment mode of surgery combined with postoperative chemoradiotherapy. In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer, this expert consensus, based on the characteristics and treatment status of oropharyngeal cancer in China and combined with the international latest theories and practices, forms consensus opinions in multiple aspects of preoperative evaluation, surgical indication determination, primary tumor resection, neck lymph node dissection, postoperative defect repair, postoperative complication management prognosis and follow-up of oropharyngeal cancer patients. The key points include: ① Before the treatment of oropharyngeal cancer, the expression of P16 protein should be detected to clarify HPV status; ② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resection of oropharyngeal cancer. Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction; ③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months, it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment; ④ Early-stage oropharyngeal cancer patients may opt for either surgery alone or radiation therapy alone. For intermediate and advanced stages, HPV-related oropharyngeal cancer generally prioritizes radiation therapy, with concurrent chemotherapy considered based on tumor staging. Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma (including primary and recurrent) and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy; ⑤ For primary exogenous T1-2 oropharyngeal cancer, direct surgery through the oral approach or da Vinci robotic surgery is preferred. For T3-4 patients with advanced oropharyngeal cancer, it is recommended to use temporary mandibulectomy approach and lateral pharyngotomy approach for surgery as appropriate; ⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth >3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients, selective neck dissection of levels IB to IV is recommended. For cN+ HPV unrelated oropharyngeal cancer patients, therapeutic neck dissection in regions I-V is advised; ⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node, or imaging suggests continuous enlargement of lymph nodes, the patient should undergo neck dissection; ⑧ For patients with suspected extracapsular invasion preoperatively, lymph node dissection should include removal of surrounding muscle and adipose connective tissue; ⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps, with priority given to adjacent flaps, followed by distal pedicled flaps, and finally free flaps. The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.

Structural variations (SVs), a newly discovered genetic variation, have gained increasing recognition for their importance, yet much about them remains unknown. With the completion of whole-genome sequencing projects in oil crops, more SVs have been identified, revealing their types, genomic distribution, and characteristics. These findings have demonstrated the crucial roles of SVs in regulating gene expression, driving trait innovation, facilitating domestication, making this an opportune time for a systematic review. We summarized the progress of SV-related studies in oil crops, focusing on the types of SVs and their mechanisms of occurrence, the strategies and methods for SV detection, and the SVs identified in oil crops such as rapeseed, soybean, peanut, and sesame. The various types of SVs, such as presence-absence variations (PAVs), copy number variations (CNVs), and homeologous exchanges (HEs), have been shown. Along with their genomic characterization, their roles in crop domestication and breeding, and regulatory impact on gene expression and agronomic traits have also been demonstrated. This review will provide an overview of the SV research process in oil crops, enabling researchers to quickly understand key information and apply this knowledge in future studies and crop breeding.

This study investigates the tensile and impact property of TRIP (transformation-induced plasticity)-aided steel with different retained austenite (RA) stability at different temperatures. The RA stability of experimental steels processed by hot rolling-coiling at 450 °C, short tempering and long duration tempering followed the sequence: un-temper (C450)

MAB phases represent a class of ternary layered transition metal borides that are structurally analogous to the well-established MAX phase, and they exhibit promising potential in various applications, including mechanics, catalysis, wave-absorption, batteries, and high-temperature environments. However, only a few MAB phases have been experimentally synthesized, making the exploration of new phases a pressing challenge. In this study, three potential Ti-based MABs (Ti2AlB2, Ti3AlB4 and Ti4AlB6) are predicted via first-principles calculations and density functional theory (DFT). The computational analyses confirm the thermodynamic and mechanical stability of these phases, with their lattice parameters determined, providing valuable references for future experimental endeavors. Crystal structure analysis reveals a distinctive feature of MABs, the B–B zigzag chains, which are absent in MAX phases, endowing them with superior in-plane strength. Mechanical analyses show that these compounds exhibit elastic anisotropy, which is closely related to the microstructure of Ti–B slices. Electronic studies confirm the metallic nature of these compounds, while the highly reactive Al atomic layer suggests a significant potential for selectively etching to yield two-dimensional (2D) MBene. Optical studies indicate that these compounds possess excellent polarization and dielectric loss capabilities, making them promising candidates for next-generation materials in photo-thermal conversion, sensing and wave-absorbing devices.

Liquid droplet impingement (LDI) treatment changes the roughness and introduces residual compressive stress on 321 stainless steel (SS). Compared to untreated 321 SS, 1 h of LDI treatment with 100, 150 and 175 m/s gradually increases the pitting potential of 321 SS, while 1 h of LDI treatment with 200 m/s decreased the pitting potential of 321 SS. The passive films grown on the 321 SS after LDI treatment with 100, 150 and 175 m/s show a decreased receptor density, an increased Cr content and an increased thickness, whereas a dense passive film with good corrosion resistance cannot be formed on the 321 SS after LDI treatment with 200 m/s. The effect of the change in surface state due to LDI treatment on the electrochemical passivation behavior is explained in detail.

Abstract Background Tumor metastasis is a major threat to cancer patient survival. The organ‐specific niche plays a pivotal role in tumor organotropic metastasis. Fibroblasts serve as a vital component of the metastatic microenvironment, but how heterogeneous metastasis‐associated fibroblasts (MAFs) promote organotropic metastasis is poorly characterized. Here, we aimed to decipher the heterogeneity of MAFs and elucidate the distinct roles of these fibroblasts in pulmonary metastasis formation in breast cancer. Methods Mouse models of breast cancer pulmonary metastasis were established using an in vivo selection method of repeated injections of metastatic cells purified from the mouse lung. Single‐cell RNA‐sequencing (scRNA‐seq) was employed to investigate the heterogeneity of MAFs. Transgenic mice were used to examine the contribution of tryptophan 2,3‐dioxygenase‐positive matrix fibroblasts (TDO2+ MFs) in lung metastasis. Results We uncovered 3 subtypes of MAFs in the lung metastatic microenvironment, and their transcriptome profiles changed dynamically as lung metastasis evolved. As the predominant subtype, MFs were exclusively marked by platelet‐derived growth factor receptor alpha (PDGFRA) and mainly located on the edge of the metastasis, and T cells were enriched around MFs. Notably, high MF signatures were significantly associated with poor survival in breast cancer patients. Lung metastases were markedly diminished, and the suppression of T cells was dramatically attenuated in MF‐depleted experimental metastatic mouse models. We found that TDO2+ MFs controlled pulmonary metastasis by producing kynurenine (KYN), which upregulated ferritin heavy chain 1 (FTH1) level in disseminated tumor cells (DTCs), enabling DTCs to resist ferroptosis. Moreover, TDO2+ MF‐secreted chemokines C‐C motif chemokine ligand 8 (CCL8) and C‐C motif chemokine ligand 11 (CCL11) recruited T cells. TDO2+ MF‐derived KYN induced T cell dysfunction. Conditional knockout of Tdo2 in MFs diminished lung metastasis and enhanced immune activation. Conclusions Our study reveals crucial roles of TDO2+ MFs in promoting lung metastasis and DTCs’ immune evasion in the metastatic niche. It suggests that targeting the metabolism of lung‐specific stromal cells may be an effective treatment strategy for breast cancer patients with lung metastasis.

There is a growing interest in preparing large-size Cu(111) foil for achieving high performance in various applications. In this work, a simple two-step method using graphene induction and contactless annealing was designed to rapidly prepare Cu(111) foil with large single-crystal grains. The graphene film grown on the Cu surface in the first step by chemical vapor deposition serves as a template for the orientation transition of the Cu foil in a subsequent high-temperature annealing. The (111) orientation transformation of the entire Cu foil was achieved within 20 min with single-crystal grains in size of above 30 cm2, and the corresponding speed is ten times higher than that prepared in traditional annealing process. This work provides a facile and rapid fabrication approach for preparing Cu(111) foil with large grains.

Abstract A search for neutral long-lived particles (LLPs) decaying in the ATLAS hadronic calorimeter using 140 fb −1 of proton-proton collisions at s $$ \sqrt{s} $$ = 13 TeV delivered by the LHC is presented. The analysis is composed of three channels. The first targets pair-produced LLPs, where at least one LLP is produced with sufficiently low boost that its decay products can be resolved as separate jets. The second and third channels target LLPs respectively produced in association with a W or Z boson that decays leptonically. In each channel, different search regions target different kinematic regimes, to cover a broad range of LLP mass hypotheses and models. No excesses of events relative to the background predictions are observed. Higgs boson branching fractions to pairs of hadronically decaying neutral LLPs larger than 1% are excluded at 95% confidence level for proper decay lengths in the range of 30 cm to 4.5 m depending on the LLP mass, a factor of three improvement on previous searches in the hadronic calorimeter. The production of long-lived dark photons in association with a Z boson with cross-sections above 0.1 pb is excluded for dark photon mean proper decay lengths in the range of 20 cm to 50 m, improving previous ATLAS results by an order of magnitude. Finally, long-lived photo-phobic axion-like particle models are probed for the first time by ATLAS, with production cross-sections above 0.1 pb excluded in the 0.1 mm to 10 m range.

Abstract A search for the resonant production of a heavy scalar X decaying into a Higgs boson and a new lighter scalar S, through the process X → S(→ b b ¯ $$ b\overline{b} $$ )H(→γγ), where the two photons are consistent with the Higgs boson decay, is performed. The search is conducted using an integrated luminosity of 140 fb −1 of proton-proton collision data at a centre-of-mass energy of 13 TeV recorded with the ATLAS detector at the Large Hadron Collider. The search is performed over the mass range 170 ≤ m X ≤ 1000 GeV and 15 ≤ m S ≤ 500 GeV. Parameterised neural networks are used to enhance the signal purity and to achieve continuous sensitivity in a domain of the (m X , m S ) plane. No significant excess above the expected background is found and 95% CL upper limits are set on the cross section times branching ratio, ranging from 39 fb to 0.09 fb. The largest deviation from the background-only expectation occurs for (m X , m S ) = (575, 200) GeV with a local (global) significance of 3.5 (2.0) standard deviations.

Abstract Objective To retrospectively evaluate thoracic duct (TD) congestion in hepatic lymphorrhea (HL) and propose treatment suggestions. Methods Retrospectively analyze cases of postoperative HL admitted from August 2007 to November 2023. Twenty cases were enrolled and followed up. The medical history, ascites characteristics, lymphoscintigraphy, direct lymphangiography, and other clinical data were reviewed. Results Twenty patients with ascites after cholecystectomy or radical gastrectomy were included. There were 15 patients with cirrhosis and 5 patients with hepatitis. Ascites were light yellow even if the patients had a non-low-fat diet. Triglyceride level mean of ascites was 0.61 ± 0.20 mmol/L. There were 94.1% (16/17) of patients whose ascitic cholesterol ≥ 45 mg/dL or SAAG

Abstract Background The spontaneous echo contrast (SEC) in patients with atrial fibrillation (AF) indicates a prethrombic state that ultimately progresses into thrombus formation. A comprehensive understanding of specific plasma metabolomics characteristics may protect AF patients from thrombus, particularly in the early stage. Objectives Through the investigation of metabolic pathways, we endeavor to uncover the metabolomic characteristics associated with SEC states, and to examine the differential metabolites by which may exert their influence on thrombotic states. Methods Patients with AF were enrolled, and the participants were divided into three groups based on the results of the echocardiogram: non-SEC, low-SEC and high-SEC group. Samples were collected and subjected to non-targeted metabolomics analysis. The analytical process included data quality control, metabolite difference analysis, component analysis, Kegg cluster analysis, etc. Results Our metabolic phenotype revealed a clear differential metabolic pattern between the SEC and non-SEC. Specifically, we identified 35 and 142 significantly differential metabolites in venous and atrial plasma, respectively, suggesting that SEC may be involved in pervasive metabolic dysregulation and that the degree of metabolic dysregulation in atrial plasma is more severe than that in venous blood. Conclusion Patients with SEC have a significantly different metabolic pattern compared to those without SEC. Our work promoted the understanding of mechanism of the occurrence and development of SEC, facilitated the screening of the target metabolites for its therapeutic intervention, and provided evidence for the prevention and treatment of SEC or thrombosis in AF. Our work also provided new directions for subsequent research in related fields. In conclusion, our study not only provides a theoretical basis for understanding the occurrence and development of SEC in AF, but also provides recommendations for the daily diet of AF patients with SEC, such as a balanced intake of essential amino acids, avoiding excessive intake of benzoic acid, and intake of appropriate inositol. Clinical trial number Not applicable.

Abstract The Indo-Pacific king mackerel, scientifically known as Scomberomorus guttatus, is a valued marine species that holds significant commercial importance in the Indo-Pacific region. However, the lack of genomic resources has hindered a comprehensive understanding of this species. In this study, we constructed a genome of Indo-Pacific king mackerel at the chromosome level using a combination of PacBio HiFi reads and a chromosome contact map (Hi-C). The resulting genome had high contig and scaffold N50 values of 8.84 Mb and 32.9 Mb, respectively. In the genome assembly, which is 797.66 Mb in size and consists of 24 chromosomes, we also identified 35.89% repetitive elements and predicted 25,886 protein-coding genes. Our study not only benefits to reveal the possible mechanism of adaptive evolution in this fish, but also offers insight for the future sustainable management of these valuable biological resources.

Abstract The small-scale yellowfin (Plagiognathops microlepis) is a highly valued species in East Asian aquaculture due to its adaptability and high yield. However, the lack of genomic data has impeded genetic research and breeding efforts. In this study, we utilize PacBio Hifi long-read sequencing and Hi-C technologies to construct a highly detailed genome of P. microlepis at the chromosomal level. The assembly encompasses 976.41 Mb, with an exceptional 99.84% distribution across 24 chromosomes. Notably, the contig N50 was 34.41 Mb and scaffold N50 was 38.38 Mb. The completeness of the P. microlepis genome assembly is underscored by a BUSCO score of 98.08%. A total of 25,389 protein-coding genes were identified, with a BUSCO score of 96.98%, and 99.85% of these genes were functionally annotated. Synteny relationships at the chromosome level with Danio rerio and Chanodichthys erythropterus genomes uncover small-scale chromosomal rearrangements. This high-fidelity genome assembly serves as a pivotal resource for forthcoming endeavors such as the genome structure, functional elements, comparative genomics, and evolutionary characteristics of P. microlepis and its relative species.

Abstract Background Integrating optical and LiDAR data is crucial for accurately predicting aboveground biomass (AGB) due to their complementarily essential characteristics. It can be anticipated that this integration approach needs to deal with an expanded set of variables and scale-related challenges. To achieve satisfactory accuracy in real-world applications, further exploration is needed to optimize AGB models by selecting appropriate scales and variables. Methods This study examined the impact of LiDAR point cloud-derived metrics on estimation accuracies at different scales, ranging from 2 to 16 m cell sizes. We integrated WorldView-2 imagery with LiDAR data to construct biomass models and developed a genetic algorithm-based wrapper for variable selection and parameter tuning in artificial neural networks (GA-ANN wrapper). Results Our findings indicated that the highest accuracies in estimating AGB were yielded by 4 m and 6 m cell sizes, followed by 8 m and 10 m, associated with the dimensions of vegetation canopies and sampling plots. Models integrating WorldView-2 and LiDAR data outperformed those using each data source individually, reducing RMSEr by 5.80% and 3.89%, respectively. Combining these data sources can capture the canopy spectral responses and vertical vegetation structure. The GA-ANN wrapper model decreased RMSEr by 1.69% over the ANN model and dwindled the number of variables from 38 to 9. The selected variables included vegetation density, height, species, and vegetation indices. Conclusions The appropriate cell size for AGB estimation should consider the sizes of vegetation canopies, tree densities, and sampling plots. The GA-ANN wrapper effectively reduced variables and achieved the highest accuracy. Additionally, canopy spectral and vertical structure information are vital for accurate AGB estimation. Our study offered insights into optimizing mangrove AGB models by integrating optical and LiDAR data. The approach, data, model, and indices employed in this research can effectively predict AGB estimates of any other forest types or vegetation cover types in different climate regions.

Abstract Salt bladders, specialized structures on the surface of quinoa leaves, secrete Na+ to mitigate the effects of the plant from abiotic stresses, particularly salt exposure. Understanding the development of these structures is crucial for elucidating quinoa’s salt tolerance mechanisms. In this study, we employed transmission electron microscopy to detail cellular differentiation across the developmental stages of quinoa salt bladders. To further explore the developmental trajectory and underlying molecular mechanisms, we conducted single-cell RNA sequencing on quinoa protoplasts derived from young leaves. This allowed us to construct a cellular atlas, identifying 13 distinct cell clusters. Through pseudotime analysis, we mapped the developmental pathways of salt bladders and identified regulatory factors involved in cell fate decisions. GO and KEGG enrichment analyses, as well as experimental results, revealed the impacts of salt stress and the deprivation of sulfur and nitrogen on the development of quinoa salt bladders. Analysis of the transcription factor interaction network in pre-stalk cells (pre-SC), stalk cells (SC), and epidermal bladder cells (EBCs) indicated that TCP5, YAB5, NAC078, SCL8, GT-3B, and T1P17.40 play crucial roles in EBC development. Based on our findings, we developed an informative model elucidating salt bladder formation. This study provides a vital resource for mapping quinoa leaf cells and contributes to our understanding of its salt tolerance mechanisms.

Abstract Background Combination therapy is required for the treatment of moderate acne vulgaris. However, patient compliance in applying multiple topical formulations is poor. Objective To assess the efficacy and safety of a fixed-dose combination gel with adapalene 0.1% and clindamycin 1% (adapalene-clindamycin) relative to adapalene 0.1% monotherapy and clindamycin 1% monotherapy in patients with moderate facial acne vulgaris. Methods This was a randomized, controlled, assessor-blind, phase III study conducted in patients with moderate facial acne vulgaris. Results A total of 1617 patients were enrolled. At week 12, patients in the adapalene–clindamycin gel treatment group showed a significant reduction in the percentage change from baseline in total lesion count (− 66.85%), compared with adapalene alone (− 50.82%) or clindamycin gel alone (− 57.61%). The difference in the least square means of the adapalene–clindamycin gel group and adapalene group, or clindamycin gel group was − 16.08% (95% CI − 19.95% to − 12.21%) and − 9.38% (95% CI − 13.25% to − 5.51%;), respectively. At week 12, 19.28% of participants who received adapalene–clindamycin gel achieved at least 2-grade improvement in IGA, versus 7.74% with adapalene gel (OR 3.05, 95% CI 1.93, 4.80) and 14.77% with clindamycin gel (OR 1.42, 95% CI 0.97, 2.07). The study also achieved all its secondary endpoints. Adverse event rates were mostly mild to moderate and comparable across the three treatment groups. Conclusion Adapalene 0.1%–clindamycin 1% combination gel is well tolerated and demonstrated superior efficacy over 0.1% adapalene gel monotherapy and 1% clindamycin gel monotherapy for the treatment of moderate acne vulgaris. Trial Registration ClinicalTrials.gov identifier NCT03615768.

Abstract Background In recent years, the use of endocrine-disrupting chemicals (EDCs) has become increasingly common, leading to severe environmental pollution and harm to aquatic organisms. 17α-Methyltestosterone (MT) is a synthetic androgen that can cause immunotoxicity in aquaculture, affecting fish health. To address this issue, this study aimed to investigate the effect of Vitamin C (VC) on MT-induced immunotoxicity and determine the optimal VC supplementation. Results Carassius auratus was exposed to 50 ng/L MT and treated with 25, 50, and 150 mg/kg VC for 7, 14, and 21 d. Morphological indicators, histological characteristics, hepatic antioxidant capacity, and immune-related gene expression were analyzed. Additionally, RNA-seq was performed on the liver tissues of the control, MT, and MT + 25 mg/kg VC groups after 21 d. Results showed that, MT treatment significantly increased liver malondialdehyde content and inhibited immune-related gene expression (TNF-α, IL-8, INF-γ, IL-10, Caspase-9, and IGF-I), causing oxidative stress and immunotoxicity, leading to hepatic steatosis. However, supplementation with 25–50 mg/kg VC effectively alleviated the MT-induced damage to the hepatic structure and immune system. RNA-seq revealed significant enrichment of differentially expressed genes in multiple signaling pathways, including the mTOR, MAPK, and Wnt pathways. Conclusions In summary, 25–50 mg/kg VC alleviated inhibitory effect of MT on immune-related genes in C. auratus liver, reducing MT-induced tissue damage. VC not only alleviated inflammation, oxidative stress, and immunotoxicity induced by MT through the regulation of the mTOR, MAPK, and Wnt signaling pathways, but also indirectly enhanced cellular antioxidant defense mechanisms by regulating the NRF2 pathway. This provides a theoretical basis for VC application in aquaculture, improving fish health and increasing efficiency.

Abstract Background Fibrosis is the ultimate, common pathological ending of most chronic inflammatory diseases and increases the chances of developing life-threatening illnesses. Pyroptosis, a newfound form of lytic programmed cell death initiated by the inflammasome, has received more and more attention because of its association with fibrotic diseases. Therefore, this study visualizes the connection between pyroptosis and fibrosis research through bibliometric methods, aimed at providing global research hits and tendencies in the field. Methods We collected and analyzed the articles on pyroptosis and fibrosis from 2010 to 2024 via Web of Science. Visual data analysis was performed for countries, institutions, authors, references, and keywords in the field using VOSviewer, CiteSpace software, the “Bibliometrix” R package, the bibliometric website ( https://bibliometric.com/ ), and Excel software. We analyzed the data by utilizing the bibliometric review method. Results A total of 566 articles and reviews relating to pyroptosis and fibrosis were identified in the Web of Science. The number of publications in the domain has continued to grow since 2010. These scientific outputs were mainly from 129 countries/regions and 1919 institutions, particularly China (n = 423) and the USA (n = 83). More importantly, although China publishes a vast majority of articles, its centrality is lower than that of the USA (0.59 vs 0.61). Among the 3833 authors involved in this field, Feldstein, A. E. is the most prolific author. Shi, J. J. is the world’s most-cited author among the 12,143 authors in these academic journals. Frontiers in Immunology was a prolific contributor, and Nature was the most frequently cited journal. After analysis, Cleavage of GSDMD by inflammatory caspases determines pyroptotic cell death were the top-cited articles. The analysis of keywords displayed that pyroptosis, fibrosis, and pathways were the main research hotspots and frontier directions in recent years. Conclusion We analyzed the characteristics of published articles and drew a fundamental knowledge structure on pyroptosis and fibrosis research via bibliometric analysis. The potential mechanism between fibrosis and pyroptosis is deeply tied to the current moment. Our findings can help researchers make clear the research status and value of fibrosis and pyroptosis and provide new directions for future research as soon as possible.

Abstract Background Citrus reticulata Blanco ‘Orah’ is one of the most widely grown citrus varieties in southern China. It has been proven that microbial and organic manure fertilization improve the yields and appearances of ‘Orah’ fruits. However, details regarding the mechanisms underlying the effects of combined fertilization on the agronomic traits and rhizosphere bacterial community of plants still need to be elucidated. Results This study compared the rhizosphere bacterial community and carotenoids of ‘Orah’ with (WYT group) and without (WYCK group) combined fertilization in a local orchard in Wuming town from Nanning, Guangxi, China. The WYT group was sprayed with 50 ml Strongreen and 250 g of Yumeiren five times while WYCK group did not sprayed. Combined fertilization increased fruit weight and the Citrus color index (CCI) significantly (p

Abstract PD-1/PD-L1 blockade therapies have displayed extraordinary clinical efficacy for melanoma, renal, bladder and lung cancer; however, only a minority of colorectal cancer (CRC) patients benefit from these treatments. The efficacy of PD-1/PD-L1 blockade in CRC is limited by the complexities of tumor microenvironment. PD-1/PD-L1 blockade immunotherapy is based on T cell-centered view of tumor immunity. However, the onset and maintenance of T cell responses and the development of long-lasting memory T cells depend on innate immune responses. Acknowledging the pivotal role of innate immunity in anti-tumor immune response, this review encapsulates the employment of combinational therapies those involve PD-1/PD-L1 blockade alongside the activation of innate immunity and explores the underlying cellular mechanisms, aiming to harnessing innate immune responses to induce long-lasting tumor control for CRC patients who received PD-1/PD-L1 blockade therapy.

Abstract Precise regulation of gene expression is crucial to development. Enhancers, the core of gene regulation, determine the spatiotemporal pattern of gene transcription. Since many disease-associated mutations are characterized in enhancers, the research on enhancer will provide clues to precise medicine. Rapid advances in high-throughput sequencing technology facilitate the characterization of enhancers at genome wide, but understanding the functional mechanisms of enhancers remains challenging. Herein, we provide a panorama of enhancer characteristics, including epigenetic modifications, enhancer transcripts, and enhancer-promoter interaction patterns. Furthermore, we outline the applications of high-throughput sequencing technology and functional genomics methods in enhancer research. Finally, we discuss the role of enhancers in human disease and their potential as targets for disease prevention and treatment strategies.

Abstract Background This study aimed to predict metastasis risk and identify prognostic factors of gastrointestinal signet ring cell carcinoma (SRCC) using data from the SEER database, the largest cancer dataset in North America. Methods Data were obtained from the SEER database, covering 17 cancer registries from 2004 to 2020. Demographic and clinical data included sex, age, race, tumor location, size, pathological grade, stage, overall survival time, and treatment modalities. Statistical analyses were conducted using SPSS and R software. Propensity Score Matching (PSM) ensured comparable baseline characteristics between gastric cancer (GC) and colorectal cancer (CRC) groups. LASSO regression analysis identified predictors of metastasis, leading to the construction of predictive models using the lrm function in R. Nomograms were visualized with the “rms” package and assessed via ROC curves, calibration curves, and decision curve analysis (DCA). Cox regression analyses identified prognostic indicators for overall survival (OS), and Kaplan–Meier curves compared OS between high-risk and low-risk groups. Results From 2004 to 2020, 7680 SRCC patients were identified, including 4980 GC and 2700 CRC patients. CRC patients were older and had larger tumors, higher staging, and worse differentiation. Nomograms demonstrated good discriminative ability, with AUCs of 0.704 and 0.694 for GC, and 0.694 and 0.701 for CRC in training and validation cohorts, respectively. The DCA curve indicates that this predictive model has a high gain in predicting metastasis and OS. Conclusions The nomograms effectively predicted metastasis risk and OS in metastatic SRCC patients, offering clinical utility in stratifying patients and guiding treatment decisions, thereby enhancing personalized treatment approaches.

Abstract Introduction Clinical practice guidelines are essential tools for standardizing medical practices and improving healthcare quality. However, current guideline implementation is unsatisfactory. Barriers to guideline implementation include external environmental factors (e.g., medical personnel, medical institutions, local policies) and intrinsic characteristics (e.g., context, format, language etc.), with the latter being addressable by optimizing the guidelines themselves. This study aims to develop an appraisal tool to promote effective guideline implementation. Existing guideline implementability appraisal tools lack a clear theoretical basis, evidence of reliability and validity, and/or empirically-based guidance for effective implementation, all of which will be addressed in this study. Methods and analysis The research is divided into four phases: (1) Generating a theoretical framework for guideline implementability (i.e., scoping review and concept analysis method); (2) Conducting a factorial experiment (i.e., guideline users simulate the use of different guideline versions to examine the relationship between constructs in the framework and implementability), and removing constructs with weak relationships to form the final implementability theoretical framework; (3) Generating dimensions and items for the guideline implementability appraisal tool based on the constructs in the theoretical framework, conducting comprehensive reliability and validity testing, usability testing, and iterative optimization according to the COSMIN guidelines; (4) Integrating the validated tool with the STAR guideline rating system for guideline appraisal and feedback to promote guideline implementability. Strengths and limitations (1) Our research will follow a standardized and rigorous process for developing measurement scales, ensuring that the resulting evaluation scale for the implementability of CPGs is theoretically grounded, internally consistent between theory and practice, and reliable and valid. (2) The theoretical framework developed in our study will strengthen the validity and rationality of constructs in the real world. (3) In the confirmatory factor analysis, this study will determine the dimensions and items’ weight through factor loadings, allowing for the quantification of the implementability of CPGs and providing users of the guidelines with objective evaluative results. In addition, the clinical practice guideline implementability evaluation tool developed in this study can assist guideline developers in enhancing implementability before, during, and after guideline formulation.

Abstract Background Understanding the experiences of doctoral students regarding courses and comprehensive examinations is crucial to enhance the quality of doctoral programs. Scarce information is available on the experiences of nursing doctoral students on the courses and comprehensive examinations in China. The purpose of this study was to understand the nursing doctoral students’ experiences on courses and comprehensive examinations of the doctoral program at Xiangya School of Nursing, Central South University, and propose improvements. Design A convergent parallel mixed methods design adhering to EQUATOR guidelines for Good Reporting of a Mixed Methods Study. Methods A total of 20 doctoral students were recruited through purposive sampling in September 2022 from the Xiangya School of Nursing, Central South University. They completed the self-designed questionnaire on demographic data, course, and comprehensive examination evaluations and participated in focus groups. Quantitative data were analyzed using descriptive statistics. Qualitative data were recorded and transcribed for content analysis. Results Regarding course experience, doctoral students preferred in-person lectures (80%) and group discussions (60%) for specialized compulsory courses. They were satisfied with the course novelty (85%), difficulty (75%), and practicality (85%), and half of the students found the credit allocation reasonable. The qualitative findings revealed their preference for appropriate and blended teaching methods, needs for additional interdisciplinary courses, statistics, and inter-school collaborative courses, accessible Nursing Philosophy and Theory courses, and high proportion of compulsory course credits. Regarding comprehensive examination experience, only 20% considered it necessary, and qualitative data revealed that they prefer more distinctive and effective contents; moreover, students were confused about the purpose of comprehensive examinations. The triangulation of quantitative and qualitative data demonstrated relative convergence. Conclusions These findings illustrated nursing doctoral students' experiences on courses and comprehensive examinations and provide suggestions on improving the courses and comprehensive examinations in China and possibly in the world. This study contributes to improving the quality of nursing doctoral programs in China and can serve as valuable guidance for nursing doctoral programs with similar educational environment around the world that are undergoing course and comprehensive examination reform.

Abstract Background The purpose of the study is to explore the current level of nursing students’ study skills self-efficacy, and whether general self-efficacy and self-directed learning ability mediate the relationship between perceived stress (including positive stress and negative stress) and study skills self-efficacy. Methods The survey was conducted among 1,289 nursing students including 795 students from Jinzhou Medical University and 494 students from Dalian University. Participants completed a self-designed questionnaire, which included the Study Skills Self-Efficacy Scale, Perceived Stress Scale, General Self-Efficacy Scale, Self-Directed Learning Instrument, gender, age, academic year, and other demographic characteristics. Descriptive analysis, independent-samples t-test, one-way analysis of variance, Pearson correlation analyses, and the bootstrap method were used for data analysis. Results Positive stress significantly positively predicted students’ study skills self-efficacy, with an effect size of 0.686. Moreover, general self-efficacy and self-directed learning mediate the relationship between positive stress and study skills self-efficacy in nursing students, with effect sizes of 0.235 and 0.245, respectively. The direct effect of negative pressure on students' study skills self-efficacy is not statistically significant, but it has a significant negative predictive effect on study skills self-efficacy under the mediation of general self-efficacy and self-directed learning, with effect sizes of -0.337 and -0.238, respectively. Conclusion This study explains how stress affects students’ study skills self-efficacy, and the results have certain enlightenment significance for improving the stress management ability and study skills self-efficacy of college students in the future.

Abstract Background Ethical competency is important to head nurses’ transformational leadership, however, few researches have explored their correlation, Additionally, most studies used variable-oriented approach to examine ethical competence, without considering it as a multidimensional concept. This study aimed to identify the latent profiles of head nurses’ ethical competence and examine differences in transformational leadership across latent profiles. Methods Convenience sampling was used to recruit 329 head nurses from four tertiary hospitals in Changsha, Hunan province, China. This study collected data by using social-demographic survey, Ethical Competence Questionnaire, and Head Nurse’s Transformational Leadership Self-rating Scale between July and August 2023. Latent profile analysis (LPA) was employed to identify latent profiles of ethical competency. One-way ANOVA test and the Kruskal–Wallis test were used to compare the transformational leadership scores across latent profiles of ethical competency. Results The mean scores of ethical competence and transformational leadership were 4.045 ± 0.394 and 4.555 ± 0.419, respectively. This study identified three latent profiles of head nurses’ ethical competence, and those profiles labelled “low ethical competence” (n = 60, 18.2%), “moderate ethical competence” (n = 217, 66.0%) and “high ethical competence” (n = 52, 15.8%). The average score of transformational leadership was also statistically different (F = 26.446, p = 0.000) across the three profiles. Conclusion Our findings underscore the importance of tailoring interventions to address the varying profiles of ethical competence among head nurses. Enhancing ethical competence can strengthen transformational leadership, ultimately leading to improved patient outcomes and overall healthcare quality.

Abstract Traumatic brain injury (TBI) represents a common and severe medical condition necessitating prompt risk stratification to enhance patient outcomes. Although substantial research has been conducted on the prognostic utility of various biomarkers for TBI, no single biomarker has been definitively recognized as the most precise predictor of disease outcomes. In comparison to other markers, the neutrophil-albumin ratio (NAR) has emerged as a cost-effective and reproducible inflammatory biomarker, demonstrating potential in evaluating the severity of inflammation and prognosticating outcomes in infections and cerebrovascular diseases. This study evaluated the prognostic significance of the NAR in comparison to two other readily accessible and cost-effective composite indices: the Neutrophil-Lymphocyte Ratio (NLR) and the Platelet-Lymphocyte Ratio (PLR) in individuals with TBI. We conducted a retrospective cohort analysis involving 297 hospitalized TBI patients, gathering comprehensive demographic, anthropometric, medical, clinical, laboratory, and imaging data to assess the expression changes of these biomarkers. Our findings suggest that both the NAR and the NLR possess predictive value regarding prognosis following TBI. However, receiver operating characteristic (ROC) curve analysis revealed that NAR outperformed NLR as a prognostic predictor. In conclusion, our examination of blood biochemistry composite indicators indicates that, while both NAR and NLR serve as significant prognostic markers, NAR is a more effective predictor of outcomes in patients with TBI.

Abstract To analyze the causes, locations, associated injuries, and relevant factors of lower limb and pelvic fractures in hospitalized children in China to provide a theoretical basis for reducing the incidence of such fractures. A retrospective analysis of children with lower limb and pelvic fractures admitted to 27 tertiary children’s hospitals affiliated with China’s Futang Research Center of Pediatric Development between December 1, 2015, and December 31, 2019, was conducted. Inpatient cases were analyzed in the following age groups: Infants (

Abstract Transthoracic echocardiography (TTE) is widely recognized as one of the principal modalities for diagnosing tricuspid regurgitation (TR). The diagnostic procedures associated with conventional methods are intricate and labor-intensive, with human errors leading to measurement variability, with outcomes critically dependent on the operators’ diagnostic expertise. In this study, we present an innovative assessment methodology for evaluating TR severity utilizing an end-to-end deep learning system. This deep learning system comprises a segmentation model of single cardiac cycle TR continuous wave (CW) Doppler spectra and a classification model of the spectra, trained on the TR CW Doppler spectra from a cohort of 11,654 patients. The efficacy of this intelligent assessment methodology was validated on 1500 internal cases and 573 external cases. The receiver operating characteristic (ROC) curves of the internal validation results indicate that the deep learning system achieved the areas under curve (AUCs) of 0.88, 0.84, and 0.89 for mild, moderate, and severe TR, respectively. The ROC curves of the external validation results demonstrate that the system attained the AUCs of 0.86, 0.79, and 0.87 for mild, moderate, and severe TR, respectively. Our study results confirm the feasibility and efficacy of this novel intelligent assessment method for TR severity.

Abstract Numerous studies have suggested that the hemoglobin-to-red blood cell distribution width ratio (HRR) is associated with the onset, progression, and prognosis of various diseases. However, to the best of our knowledge, no research has conducted statistical analyses to determine the association between HRR and stroke. This cross-sectional study was conducted among adults with complete data on hemoglobin-red cell distribution width ratio (HRR) and stroke from the 2005–2018 National Health and Nutrition Examination Survey (NHANES). HRR was calculated by dividing hemoglobin (HGB) in grams per deciliter (g/dL) by the red blood cell distribution width (RDW). Weighted multivariable logistic regression and generalized additive models were employed to investigate the independent and nonlinear relationships between HRR and stroke. Threshold effects were assessed using two-piece linear regression models. Additionally, subgroup analyses and interaction tests were performed. A total of 36,215 participants were included, with 2.92% classified as stroke patients. The prevalence of stroke decreased across increasing tertiles of HRR (Q1: 5.07%; Q2: 2.63%; Q3: 1.69%; P 30. Using a two-piece linear regression model, a threshold effect was identified at a BMI of 30 (K = 1.16). To the left of this breakpoint, there was a negative association between HRR and stroke (OR = 0.55, 95% CI: 0.27–0.97), whereas no such association was detected to the right of the breakpoint (OR = 6.49, 95% CI: 0.75–56.11). HRR is negatively associated with the likelihood of stroke, with a lower risk of stroke in individuals with higher HRR levels.

Abstract Harvesting is a direct and simple artificial method to regulate submerged macrophyte communities. However, there is still a gap in whether the succession of different seasonal submerged macrophytes can be achieved by harvesting. The morphological, physiological index, competition intensity of Hydrilla verticillata (H. verticillata) and underwater light under different harvesting intensities of Potamogeton crispus (P. crispus) was studied by a controlled experiment. Under moderate harvesting intensity (harvest 30% and 45% of plant height) of P. crispus, H. verticillata was the least inhibited, resulting in accumulating more Chl a and higher plant height. The underwater light created by moderate-intensity harvesting was favorable for H. verticillata to compete with P. crispus. Thus, moderate-intensity harvesting of P. crispus can promote the growth of H. verticillata. In practice, moderate harvesting intensity of P. crispus can be used to create conditions for the growth of summer species to achieve seasonal succession of submerged macrophytes and maintain the clear-water state of the lake.

Abstract Head and neck squamous cell carcinoma (HNSCC) is notorious for poor prognoses, and effective biomarkers are urgently needed for early diagnosis of HNSCC patients. We investigate the role of alkaline ceramidase 1 (ACER1) and its relationship with immune infiltration in HNSCC. The differential expression and clinical prognostic significance of ACER1 in HNSCC patients are explored using bioinformatics methods and verified in human HNSCC samples. Genetic mutation, DNA methylation and drug sensitivity linked with ACER1 are examined. The potential biological function of ACER1 co-expression genes is assessed, and a series of functional assays are performed on ACER1in vitro. The results comprehensively reveal a relationship between ACER1 and immune infiltration in HNSCC patients. ACER1 expression is significantly downregulated in HNSCC tissues and closely correlated with better prognoses for HNSCC patients, and this prognostic significance is determined by distinct clinical characteristics. Genetic alteration and promoter hypomethylation of ACER1 are involved in progression of HNSCC, and ACER1 expression is significantly related to several drug sensitivities. Functional analysis shows that ACER1 co-expression genes are mainly enriched in the sphingolipid signaling pathway associated with inhibition of tumorigenesis, leading to better prognoses for HNSCC patients. In vitro, ACER1 overexpression inhibits proliferation and migration, induces apoptosis, and promotes adhesion of Fadu and SCC9 cells. In addition, high ACER1 expression is closely linked with infiltration levels of immune cells, and strongly associated with biomarkers of immune cells in HNSCC, suggesting the important role of ACER1 in regulating tumor immunity in HNSCC patients. In summary, ACER1 may be a useful indicator for diagnosis and prognosis, and may regulate immune infiltration in HNSCC patients, thus promising targeted immunotherapy for HNSCC.

Abstract Background About one in four Chinese people might suffer or have already suffered from anxiety conditions, with a lifetime prevalence rate of 4.8%. However, many of those who could have benefited from psychological or pharmacological treatments fail to be recognized or treated due to the lack of timely recognition and accurate diagnosis. Objective This study used a topic modeling approach to explore people’s anxiety-related concerns raised on a computer-mediated Chinese health platform, YOU WEN BI DA (questioning and answering), to provide implications for accurate diagnosis, targeted education, tailored intervention, and informed policy-making in the course of addressing this condition of public concern. Methods First, we extracted data from YOU WEN BI DA between May 2022 and February 2023. After cleaning the extracted data both using the Python text processing tool spaCy and manually, we ascertained the optimal number of topics by drawing on the coherence scores and used latent Dirichlet allocation (LDA) topic modeling to generate the most salient topics and related terms. We then categorized the topics ascertained into different classes of themes by plotting them onto a 2D plane via multidimensional scaling using the pyLDAvis visualization tool. Finally, we analyzed these topics and themes qualitatively to better understand people’s anxiety-related concerns. Results 5 topics with different overall prevalence were ascertained through data analysis. Topic 2 (tinnitus phobia-incurred concerns, n = 639) is the most popular dominant topic, occurring in 25.1% of the 2545 collected concerns, closely followed by Topics 1 (neurosis-incurred concerns, n = 512;) and 3 (sleep, dyskinesia, bipolar, cognitive, and somatic disorders-incurred concerns, n = 619), which appeared in 20.1% and 24.3% of the 2545 concerns respectively. Topic 5 (social phobia-incurred concerns, n = 428) ranks as the fourth most popular dominant topic, showing up in 16.8% of the 2545 concerns. Topic 4 (autonomic nerve dysfunction-incurred concerns, n = 347) accounts for 13.6% of the 2545 concerns. The t-distributed Stochastic Neighbor Embedding analysis reveals partial similarities between Topics 2 and 5 as well as between Topics 4 and 5 because many concerns involved in Topics 2 and 5 pertain to people’s psychological status of fear and anxiety and the relief and dispelling of such symptoms through medication, and many concerns involved in Topics 4 and 5 relate to people’s worries about the negative impact on their nerves and the adjustment and conditioning of such effects through medication. Conclusion This was the first study that investigated Chinese people’s anxiety-related concerns raised on YOU WEN BI DA using the topic modeling technique. The automatic text analysis and complementary manual interpretation of the collected data allowed for the discovery of the dominant topics hidden in the data and the categorization of these topics into different themes to reveal the overall status of people’s anxiety-related concerns. The research findings can provide some practice implications for health and medical educators, practitioners, and policy-makers to make joint efforts to address this common public concern effectively and efficiently.

Abstract Highly accurate nighttime cloud detection in satellite imagery is challenging due to the absence of visible to near-infrared (0.38–3 μm, VNI) data, which is critical for distinguishing clouds from other ground features. Fortunately, Machine learning (ML) techniques can more effectively leverage the limited wavelength information and show high-accuracy cloud detection based on vast sample volume. However, accurately distinguishing cloud pixels solely through thermal infrared bands (8–14 μm, TIR) is challenging, and acquiring numerous, high-quality and representative samples of nighttime images for ML proves to be unattainable in practice. Given the thermal infrared radiation transmission process and the fact that daytime and nighttime have the same source of radiance in TIR, we propose a sample generation idea that uses daytime images to provide samples of nighttime cloud detection, which is different from the traditional sample construction methods (e.g., manually label, simulation and transfer learning method), and can obtain samples effectively. Based on this idea, nighttime cloud detection experiments were carried out for MODIS, GF-5 (02) and Himawari-8 satellites, respectively. The results were validated by the Lidar cloud product and manual labels and show that our nighttime cloud detection result has higher accuracy than MYD35 (78.17%) and the ML model trained by nighttime manual labels (75.86%). The accuracy of the three sensors is 82.19%, 88.71%, and 79.34%, respectively. Moreover, we validated and discussed the performance of our algorithm on various surface types (vegetation, urban, barren and water). The results revealed that the accuracy of the three sensors over barren was found to be poor and varied with surface types but overall high. Our study can provide a novel perspective on nighttime cloud detection of muti-spectral satellite imagery.

Abstract Backfat thickness is an important economic trait that affects pork quality and flavor. The Lijiang pig (LJP), a local breed in Yunnan province, China, exhibits variations in growth and body composition. However, the molecular basis for these variations is unclear. This study aimed to analyze transcriptome profiles of backfat at different growth stages in LJP with discrepant body size: two months (M2), four months, and six months. Firstly, we analyzed the gene expression differences and discovered a significantly highest number of differentially expressed genes (DEGs) at the M2 stage. Secondly, we identified four gene profiles with reverse expression trends in LJP populations with different body sizes, and the related genes mainly associated with immune response functionality. Thirdly, we observed a lower correlation in LJP with large body size at the M2 stage, with a specific enrichment of DEGs with high genetic differentiation related to neural activity. Finally, we correlated transcriptome profiles of muscle and backfat and discovered the lowest correlation at the M2 stage. Highly correlated genes exhibited more significant differences and were prominently enriched for immune response processes. This study unveils candidate genes linked to backfat growth in LJP, emphasizing the specificity of the early growth stage of backfat.

Abstract Recently, colistin and carbapenem-resistant hypervirulent Klebsiella pneumoniae (CCR-hvKP) has been observed sporadically. The aim of this study was to report a nosocomial outbreak due to CCR-hvKP, so as to control the transmission of CCR-hvKP and prevent future outbreaks. The clinical characteristics of five involved cases were analyzed and infection prevention and control measures were documented. Five CCR-hvKP isolates were discovered from the five involved cases. Molecular features of the isolates including sequence type, capsule locus, antimicrobial resistance genes, virulence factors and phylogenetic relationship were analyzed by whole-genome sequencing. Validation of the role of the deleterious amino acid mutations to colistin resistance was examined by complementation assays. PCR was performed to identify insertion sequences within the mgrB gene. Mouse intraperitoneal infection models were used to assess virulence phenotype. Five cases infected with CCR-hvKP were identified with a high attributable mortality rate of 60% in the patients. The five outbreak isolates belonged to the high-risk ST11-KL64 clone and were closely clustered. They were highly resistant to commonly used antibiotics and showed hypervirulent in vivo. WGS revealed multiple antimicrobial resistance genes such as blaKPC-2 and blaCTX-M-65 and important virulence factors. Concerning colistin resistance, amino acid mutations G53S in pmrA gene, and T157P, T246A and R256G in pmrB gene were indentified. Among them, the deleterious mutation T157P in pmrB gene was validated to be responsible for the resistance phenotype of isolate KP01, KP03 and KP05. In addition, disruption of mgrB gene by insertion sequences of ISKpn26 and IS903B was indentified in isolate KP02 and KP04, respectively. This is the first report of an outbreak caused by CCR-hvKP. The study highlights infection prevention and control measures are key to successfully fight against CCR-hvKP dissemination and nosocomial infections. Continuous surveillance should be performed to limit the spread of these isolates.

Abstract Diabetic kidney disease (DKD) is the main cause of deaths due to diabetes mellitus (DM). Due to the complexity of its onset, it is difficult to achieve accurate prevention and treatment. The classically activated macrophage (M1) polarization is a crucial proinflammatory mechanism of DKD, while the interaction and cascade effects of oxidative stress and inflammatory response remain to be elucidated. A urine proteomic analysis of patients with DM indicated that peroxiredoxin 2 (PRDX2) had the higher abundance in DKD. We recently found that PRDX of parasitic protozoa Entamoeba histolytica, which was similar to human PRDX2 in amino acid sequence and spatial structure, could activate the inflammatory response of macrophages through toll-like receptor 4 (TLR4). Hence, our study was designed to explore the role of PRDX2 in chronic inflammation during DKD. Combined with in vivo and in vitro experiments, results showed that the PRDX2 was positively correlated with DKD progression and upregulated by high glucose or recombinant tumor necrosis factor-α in renal tubular epithelial cells; Besides, recombinant PRDX2 could promote M1 polarization of macrophages, and enhance the migration as well as phagocytic ability of macrophages through TLR4. In summary, our study has explored the novel role of PRDX2 in DKD to provide a basis for further research on the diagnosis and treatment of DKD.

Abstract This study aimed to evaluate the diagnostic performance of combined dynamic stress CT myocardial perfusion imaging (CTP) and coronary CT angiography (CTA) alongside CT-derived fractional flow reserve (CT-FFR) in detecting hemodynamically significant coronary artery disease (CAD). A total of 33 patients (86 vessels) who underwent coronary CTA, dynamic stress CTP, and coronary angiography were included. Vessels exhibiting 30–90% stenosis were subjected to FFR analysis based on coronary angiography (Angio-FFR). Hemodynamic significance, determined by Angio-FFR ≤ 0.80, and imaging findings were evaluated. The evaluation involved a comparison between the combined use of coronary CTA, CTP and CT-FFR, versus the sole use of coronary CTA. Out of 86 coronary vessels, 17 (19.8%) exhibited hemodynamically significant stenosis. The sensitivity, specificity, and accuracy of coronary CTA for detecting ischemia were 94.12%, 34.78%, and 46.51%, respectively. Adding CTP to CTA improved specificity to 88.41%, and accuracy to 87.21%, respectively. The area under the curve (AUC) for the discrimination of functional significant stenosis was 0.798 when using CTA alone, and for CTA plus CTP, it reached 0.910. Furthermore, the combination of CTA, CTP and CT-FFR, showed accuracy of 88.37%, sensitivity of 88.24% and specificity of 88.41% with the AUC of 0.946. The integration of dynamic CTP with CTA significantly enhances the diagnostic accuracy for identifying patients with hemodynamically significant CAD, compared to the use of CTA alone. This study underscores the value of combining CTP, CT-FFR, and CTA in improving diagnostic precision for CAD. The combination of CTP, CT-FFR and CTA offers a multifaceted assessment for patients with CAD by simultaneously providing anatomical detail, functional analysis, and physiological quantification, which facilitating rapid, accurate, and optimal clinical decision-making and significantly enhances patient management.

Abstract Metabolic-associated fatty liver disease (MAFLD) is a common chronic condition that poses a significant threat to human health. Mitochondrial dysfunction, particularly involving the mitochondrial Ca2+ uniporter (MCU), plays a key role in its pathogenesis. This study aimed to investigate the impact of the MCU gene on hepatic lipid metabolism in mice fed a high-fat diet. Using MCU knockout and wild-type mice, subjected to either a high-fat or normal diet for 14 weeks, we observed notable Steatosis and liver weight gain in MCU-deficient mice. Liver function markers, serum triglycerides, very low-density lipoprotein (VLDL) levels, and ApoB protein expression were all significantly elevated. Mechanistic studies revealed that MCU deletion led to mitochondrial dysfunction, increased oxidative stress. These findings highlight the critical role of the MCU gene in maintaining hepatic lipid balance and suggest its potential as a therapeutic target for managing nonalcoholic fatty liver disease.

Abstract Parkinsonian tremor (PT) and Essential tremor (ET) exist as upper limb tremors in clinical practice. Notably, their types of trembling share similar presentations and overlapping frequencies. To enhance objectivity and efficiency in the diagnosis of these two diseases, there is a pressing need for more objective tremor classification procedures. This study proposes a novel multimodal fusion network based on a cross-attention mechanism (MFCA-Net) to automate the classification of upper limb tremors between PTs and ETs. To this end, 140 patients with PTs and ETs were recruited, and acceleration and surface electromyography (sEMG) signals were collected from the forearm during tremor episodes. To comprehensively capture the global and local features of input signals, a multiscale convolution in MFCA-Net was designed. Furthermore, the cross-attention mechanism was applied to fuse the features of the two input signals. The results demonstrate that the final classification accuracy exceeded 97.18% when MFCA-Net was used. Compared with the single acceleration signal and single sEMG signal inputs, the recognition accuracies increased by 18.91% and 10.04%, respectively. Therefore, the proposed MFCA-Net in this study serves as an objective and potential tool for assisting clinicians in the diagnosis of PT and ET patients.