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Abstract The high non-radiative energy loss is a bottleneck issue that impedes the improvement of organic solar cells. The formation of triplet exciton is thought to be the main source of the large non-radiative energy loss. Decreasing the rate of back charge transfer is considered as an effective approach to alleviate the relaxation of the charge-transfer state and the triplet exciton generation. Herein, we develops an efficient ternary system based on D18:N3-BO:F-BTA3 by regulating the charge-transfer state disorder and the rate of back charge transfer of the blend. With the addition of F-BTA3, a well-defined morphology with a more condensed molecular packing is obtained. Moreover, a reduced charge-transfer state disorder is demonstrated in the ternary blend, which decreases the rate of back charge transfer as well as the triplet exciton formation, and therefore hinders the non-radiative recombination pathways. Consequently, D18:N3-BO:F-BTA3-based device produces a low non-radiative energy loss of 0.183 eV and a record-high efficiency of 20.25%. This work not only points towards the significant role of the charge-transfer state disorder on the suppression of triplet exciton formation and the non-radiative energy loss, but also provides a valuable insight for enhancing the performance of OSCs.

Abstract Post-stroke dysphagia (PSD) is an increasingly common complication of stroke. Despite its intuitively unfavorable impact on secondary prevention medication use, limited awareness is available regarding this issue. Herein, a cross-sectional survey was conducted to determine the current use, patient-perceived needs and preferences for secondary prevention medications among PSD patients. To emphasize the unique context related to dysphagia, we recruited Chinese stroke patients with a duration of less than 5 years. These patients were initially categorized into PSD respondents with and without dysphagia. Among the 3490 eligible respondents, 42.7% reported experiencing dysphagia after stroke. Those PSD respondents were more likely to consume multiple medications and suffer from anticoagulants-associated gastrointestinal bleeding as compared to non-PSD ones (p

Abstract Despite substantial breakthroughs in the treatment of hepatocellular carcinoma (HCC) in recent years, many patients are diagnosed in the middle or late stages, denying them the option for surgical excision. Therefore, it is of great importance to find effective therapeutic targets of HCC. In this study, it is found that Gap junction protein beta‐2 (GJB2) is highly enriched in malignant cells based on single‐cell RNA sequencing and higher expression of GJB2 indicates a worse prognosis. The localization of GJB2 in HCC cancer cells is changed compared with normal liver tissue. In cancer cells, GJB2 tends to be located in the cytoplasm and nucleus, while in normal tissues, GJB2 is mainly located on the cell membrane. GJB2 is related to glycolysis, promoting NF‐κB pathway via inducing the ubiquitination degradation of IκBa, and activating HIF‐1α/GLUT‐1/PD‐L1 pathway. In addition, GJB2 knockdown reshapes tumor immune microenvironment and Salvianolic acid B inhibits the activity of GJB2. In conclusion, GJB2 promotes HCC progression by activating glycolysis through cytoplasmic translocation and generating a suppressive tumor microenvironment. Salvianolic acid B inhibits the expression of GJB2 and enhances the sensitivity of anti‐PD1 therapy, which may provide insights into the development of novel combination therapeutic strategies for HCC.

ObjectiveDelayed enhancement cardiac computed tomography (CT) empowers the diagnosis of left atrial appendage thrombus while limited to scanning heterogeneity. We optimized the spectral CT scan and post-process protocols, incorporating delayed enhancement and spectral iodine analysis to discriminate left atrial appendage (LAA) thrombus with better morphological relationships between the left atrium, pulmonary vein, and esophagus.MethodsA total of 278 consecutive patients were retrieved from January 2019 to June 2023. All patients underwent transesophageal echocardiography (TEE) and spectral CT scan of the left atrial and pulmonary vein, with a complete period including the pulmonary venous phase and three delay phases. TEE diagnosis was used as the standard reference. For patients exhibiting LAA filling defects during the pulmonary venous phase, a delayed scan of 30 s (phase I) was performed. If the filling defects persisted, a further delayed scan of 1 min (phase II) was conducted. In cases where the filling defects persisted, an additional delayed scan of 2 min (phase III) was carried out. Iodine concentration in the filled defect area of LAA and the left atrium was measured in phase III. Moreover, 30 patients were randomly selected for water-swallowing and the other 30 for calm breathing. The image quality and esophageal dilation of the two groups were assessed by two experienced surgeons specializing in radiofrequency ablation.ResultsIn total, 14 patients were diagnosed with thrombi by TEE. The sensitivity, specificity, positive predictive values, negative predictive values, and AUC of phase III delayed combined with iodine quantification for thrombi diagnosis were all 100%. The water-swallowing group exhibited significantly greater esophageal filling and expansion than the calm-breathing group, contributing to a better morphology assessment with no significant difference in image quality.ConclusionCombined with iodine quantification, delayed enhancement of spectral CT imaging presents a promising diagnostic potency for LAA thrombus. Incorporating water swallowing into the CT scan process further enables anatomical visualization of the esophagus, left atrium, and pulmonary vein, thereby providing more objective and authentic imaging evidence to assess the esophageal morphology and positional relationships.

The status of coinfection during the national outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron BA.5.2 or BF.7 in China in the winter of 2022, which is suspected to contribute substantially to the overloaded severe cases, needs to be investigated. We analyzed the coinfection status of 385 severe patients infected with the Omicron variant in Guangzhou using metagenomic sequencing. We found that 317 (82.3 %) patients were coinfected with at least one additional pathogen(s), including bacteria (58.7 %), fungi (27.1 %) and viruses (73.5 %). Pseudomonas aeruginosa (P. aeruginosa) (24.2 %), Staphylococcus aureus (S. aureus) (14.0 %), and Klebsiella pneumoniae (K. pneumonia) (13.4 %) ranked as the top three coinfected bacteria. Aspergillus fumigatus (A. fumigatus) (39.5 %), Pneumocystis jirovecii (P. jirovecii) (24.4 %) and Canidia albicans (C. albicans) (22.1 %) were the top three coinfected fungi. Epstein-Barr virus (EBV) (63.1 %), Human herpesvirus 7 (HHV-7) (34.8 %), and Herpes simplex virus 1 (HSV-1) (32.6 %) were the top three coinfected viruses. Of note, the detection of multiple coinfections of potential pathogenic bacteria, fungi, and viruses, despite lacking consistent patterns, highlighted a complicated synergistic contribution to disease severity. Our study presents the most comprehensive spectrum of bacterial, fungal, and viral coinfections in Omicron-associated severe coronavirus disease 2019 (COVID-19), implying that the coinfection of conditional pathogens might synergistically deteriorate the Omicron infection outcomes.

Highlights A novel A/B-sites co-substitution strategy was introduced to enhance the performance and durability of Ruddlesden–Popper perovskite Sr3Fe2O7−δ (SF)-based air electrodes for reversible protonic ceramic cells (RePCCs). Simultaneous Sr-deficiency and Nb-substitution in SF result in Sr2.8Fe1.8Nb0.2O7−δ (D-SFN), offering improved structural stability under RePCC conditions by suppressing the formation of Sr3Fe2(OH)12 phase. The introduction of Sr-deficiency enhances oxygen vacancy concentration in D-SFN, promoting efficient oxygen transport within the material and contributing to excellent activity in RePCCs.

Objective Thermal ablation (TA) is a safe and effective treatment for benign thyroid nodules (BTNs). However, there has been no consensus on the optimal maximum diameter (MD) of BTNs for TA. This study aimed to identify the optimal MD of BTNs for TA based on complete disappearance rate after TA.Materials and methods This retrospective study included 639 BTNs treated with TA from June 2014 to January 2022. The complete disappearance rate of BTNs after TA was summarized, related influencing factors were explored, and the optimal MD of BTNs for TA was identified.Results At the final follow-up (median: 40 months, range: 24–95 months), the overall volume reduction rate was 95.4 ± 9.0%, and 50.5% of the BTNs (323/639) completely disappeared. The MD was significantly negatively correlated with complete disappearance (odds ratio 0.89, 95% confidence interval 0.87–0.92; p 25.0 mm had a greater complication rate (6.5% vs. 2.4%, p = 0.012).Conclusions The MD of BTNs was negatively correlated with complete disappearance after TA; an MD > 25.0 mm indicated a reduced likelihood of complete disappearance compared with an MD ≤ 25.0 mm. An MD of 25.0 mm is an appropriate threshold of BTNs for TA on the basis of complete disappearance rate.

Background and objectiveDespite its acknowledged benefits, the selection of an optimal regional block for analgesia pediatric hernia surgery remains a subject of debate. This study endeavored to conduct a network meta-analysis and systematic review of randomized clinical trials, aiming to amalgamate insights from both direct and indirect comparisons concerning the analgesic effectiveness and safety of various regional blocks post-inguinal hernia repair in children.MethodA comprehensive literature search was performed across PubMed, EMBASE, Web of Science, and the Cochrane Library up to 12 November 2022 by two independent reviewers, employing a standardized protocol. The inclusion criteria encompassed randomized trials focusing on children undergoing inguinal hernia repair utilizing either local infiltration analgesia or regional analgesia. The primary outcomes assessed were pain scores at 2, 6, and 24 h post-operation.ResultsThe initial search yielded 281 records relating to 1,137 patients. The analysis of ranking probability indicated that Paravertebral Block (PVB) holds the highest likelihood (88% and 48%) of being the most effective in alleviating pain at 2 h and 6 h post-surgery. Trans vs. Abdominis Plane Block (TAPB) emerged as the superior choice for mitigating pain (83%) and decreasing morphine consumption (93%) at 24 h following the operation. Local Anesthetic Infiltration (LAI) was identified as the most effective in shortening the hospital stay, with a 90% probability.ConclusionsRegional anesthesia significantly enhances postoperative pain management in pediatric inguinal hernia repair surgery. For short-term postoperative pain relief, PVB emerges as the most effective technique. Meanwhile, TAPB provides more prolonged analgesia. Although TAPB does not exhibit a pronounced advantage in short-term analgesia, its simplicity and the absence of a need for a special position render it a viable option. However, the interpretation of these results should be approached with caution due to the presence of limited data and heterogeneity.Systematic Review RegistrationPROSPERO (CRD42022376435; www.crd.york.ac.uk/prospero).

Summary: Background: Sleep disturbances are widespread but usually overlooked health risk factors for coronavirus disease 2019 (COVID-19). We aimed to investigate the influence of pre-existing sleep disturbances on the susceptibility, severity, and long-term effects of COVID-19. Methods: We searched PubMed, Web of Science, and Embase for relevant articles from inception to October 27, 2023 and updated at May 8, 2024. Sleep disturbances included obstructive sleep apnea (OSA), insomnia, abnormal sleep duration, night-shift work, and any other sleep disturbances. Outcomes were COVID-19 susceptibility, hospitalization, mortality, and long COVID. The effect sizes were pooled odds ratios (ORs) and 95% confidence intervals (95% CIs). This study is registered with PROSPERO (CRD42024503518). Findings: A total of 48 observational studies (n = 8,664,026) were included. Pre-existing sleep disturbances increased the risk of COVID-19 susceptibility (OR = 1.12, 95% CI 1.07–1.18), hospitalization (OR = 1.25, 95% CI 1.15–1.36), mortality (OR = 1.45, 95% CI 1.19–1.78), and long COVID (OR = 1.36 95% CI 1.17–1.57). Subgroup analysis showed that younger individuals with sleep disturbances were associated with higher susceptibility and hospitalization and a lower risk of mortality than older individuals. Males with sleep disturbances were associated with higher mortality. For specific sleep disturbances, the susceptibility and hospitalization of COVID-19 were associated with OSA, abnormal sleep duration, and night-shift work; mortality of COVID-19 was linked to OSA; risk of long COVID was related to OSA, abnormal sleep duration and insomnia. Interpretation: Pre-existing sleep disturbances, especially OSA, increased the risk of COVID-19 susceptibility, hospitalization, mortality, and long COVID. Age and sex played important roles in the effect of sleep disturbances on COVID-19. Funding: The National Natural Science Foundation of China and the Key Laboratory of Respiratory Diseases of Liaoning Province.

Abstract Spiders are representative arthropods of adaptive radiation. The high-quality genomes have only been reported in several web weaver spider species, leaving the wandering spiders’ genomic information scarce. The pond wolf spider, Pardosa pseudoannulata, is a representative species in the retrolateral titial apophysis (RTA) clade. We present a chromosome-level P. pseusoannulata genome assembly of 2.42 Gb in size with a scaffold N50 of 169.99 Mb. Hi-C scaffolding assigns 94.83% of the bases to 15 pseudo-chromosomes. The repeats account for 52.79% of the assembly. The assembly includes 96.2% of the complete arthropod universal single-copy orthologs. Gene annotation predicted 24,530 protein-coding genes with a BUSCO score of 95.8% complete. We identified duplicate clusters of Hox genes and an expanded cuticle protein gene family with 243 genes. The expression patterns of CPR genes change in response to environmental stresses such as coldness and insecticide exposure. The high-quality P. pseudoannulata genome provides valuable information for functional and comparative studies in spiders.

At 01:45 on January 8, 2022, an MS6.9 earthquake occurred in Menyuan County, Haibei Tibetan Autonomous Prefecture, Qinghai Province. In order to gain a deeper understanding of the activity characteristics of this earthquake, the author conducted a preliminary investigation and analysis of the surface rupture zone and traffic system damage in the Liuhuanggou based on the investigation of earthquake disaster losses, combined with various methods such as drone low altitude photogrammetry and aftershock data analysis. The fault activity was mainly characterized by left-lateral strike-slip motion, accompanied by a certain thrust component, with a maximum left lateral displacement of 3.1 m. At the same time, the earthquake caused serious damage to the Liuhuanggou bridge and the Daliang tunnel of the Lanxin high-speed railway, mainly manifested as beam overturning and sliding, track distortion and deformation, and internal structure displacement and deformation of the tunnel. Finally, this article provides opinions and suggestions on the seismic fortification measures for bridges in the region.

Fusarium root rot is an increasingly severe problem in soybean cultivation. Although several Fusarium species have been reported to infect soybean roots in Heilongjiang province, their frequency and aggressiveness have not been systematically quantified in the region. This study aimed to investigate the diversity and distribution of Fusarium species that cause soybean root rot in Heilongjiang province over two years. A total of 485 isolates belonging to nine Fusarium species were identified, with F. oxysporum and F. solani being the most prevalent. Pot experiments were conducted to examine the relative aggressiveness of different Fusarium species on soybean roots, revealing that F. oxysporum and F. solani were the most aggressive pathogens, causing the most severe root rot symptoms. The study also assessed the susceptibility of different soybean cultivars to Fusarium root rot caused by F. oxysporum and F. solani. The results indicated that the soybean cultivar DN51 exhibited the most resistance to both pathogens, indicating that it may possess genetic traits that make it less susceptible to Fusarium root rot. These findings provide valuable insights into the diversity and distribution of Fusarium species that cause soybean root rot and could facilitate the development of effective management strategies for this disease.

Abstract Background Lung cancer is the leading cause of cancer‐related death worldwide. This study aimed to establish novel multiclassification prediction models based on machine learning (ML) to predict the probability of malignancy in pulmonary nodules (PNs) and to compare with three published models. Methods Nine hundred fourteen patients with PNs were collected from four medical institutions (A, B, C and D), which were organized into tables containing clinical features, radiologic features and laboratory test features. Patients were divided into benign lesion (BL), precursor lesion (PL) and malignant lesion (ML) groups according to pathological diagnosis. Approximately 80% of patients in A (total/male: 632/269, age: 57.73 ± 11.06) were randomly selected as a training set; the remaining 20% were used as an internal test set; and the patients in B (total/male: 94/53, age: 60.04 ± 11.22), C (total/male: 94/47, age: 59.30 ± 9.86) and D (total/male: 94/61, age: 62.0 ± 11.09) were used as an external validation set. Logical regression (LR), decision tree (DT), random forest (RF) and support vector machine (SVM) were used to establish prediction models. Finally, the Mayo model, Peking University People's Hospital (PKUPH) model and Brock model were externally validated in our patients. Results The AUC values of RF model for MLs, PLs and BLs were 0.80 (95% CI: 0.73–0.88), 0.90 (95% CI: 0.82–0.99) and 0.75 (95% CI: 0.67–0.88), respectively. The weighted average AUC value of the RF model for the external validation set was 0.71 (95% CI: 0.67–0.73), and its AUC values for MLs, PLs and BLs were 0.71 (95% CI: 0.68–0.79), 0.98 (95% CI: 0.88–1.07) and 0.68 (95% CI: 0.61–0.74), respectively. The AUC values of the Mayo model, PKUPH model and Brock model were 0.68 (95% CI: 0.62–0.74), 0.64 (95% CI: 0.58–0.70) and 0.57 (95% CI: 0.49–0.65), respectively. Conclusions The RF model performed best, and its predictive performance was better than that of the three published models, which may provide a new noninvasive method for the risk assessment of PNs.

Abstract BackgroundRemovable partial denture (RPD) design is crucial to long-term success in dental treatment, but shortcomings in RPD design training and competency acquisition among dental students have persisted for decades. Digital production is increasing in prevalence in stomatology, and a digital RPD (D-RPD) module, under the framework of the certified Objective Manipulative Skill Examination of Dental Technicians (OMEDT) system reported in our previous work, may improve on existing RPD training models for students. ObjectiveWe aimed to determine the efficacy of a virtual 3D simulation–based progressive digital training module for RPD design compared to traditional training. MethodsWe developed a prospective cohort study including dental technology students at the Stomatology College of Chongqing Medical University. Cohort 1 received traditional RPD design training (7 wk). Cohort 2 received D-RPD module training based on text and 2D sketches (7 wk). Cohort 3 received D-RPD module pilot training based on text and 2D sketches (4 wk) and continued to receive training based on 3D virtual casts of real patients (3 wk). RPD design tests based on virtual casts were conducted at 1 month and 1 year after training. We collected RPD design scores and the time spent to perform each assessment. ResultsWe collected the RPD design scores and the time spent to perform each assessment at 1 month and 1 year after training. The study recruited 109 students, including 58 (53.2%) female and 51 male (56.8%) students. Cohort 1 scored the lowest and cohort 3 scored the highest in both tests (cohorts 1-3 at 1 mo: mean score 65.8, SD 21.5; mean score 81.9, SD 6.88; and mean score 85.3, SD 8.55, respectively; PPPPPPP ConclusionsCohort 3 obtained the highest score at both time points with retention of competency at 1 year, indicating that progressive D-RPD training including virtual 3D simulation facilitated improved competency in RPD design. The adoption of D-RPD training may benefit learning outcomes.

Zinc (Zn) is an essential trace element but can lead to water contamination and ecological deterioration when present in excessive amounts. Therefore, investigating the photosynthetic response of microalgae to Zn stress is of great significance. In this study, we assessed the photosynthetic responses of neutrophilic Chlamydomonas reinhardtii and acidophilic Chlamydomonas sp. 1710 to Zn exposure for 96 h. The specific growth rate (μ), chlorophyll-a (Chl-a) content, and chlorophyll fluorescence parameters were determined. The results demonstrated that Chlamydomonas sp. 1710 was much more tolerant to Zn than C. reinhardtii, with the half-maximal inhibitory concentration (IC50) values of 225.4 mg/L and 23.4 mg/L, respectively. The μ and Chl-a content of C. reinhardtii decreased in the presence of 15 mg/L Zn, whereas those of Chlamydomonas sp. 1710 were unaffected by as high as 100 mg/L Zn. Chlorophyll fluorescence parameters indicated that the regulation of energy dissipation, including non-photochemical quenching, played a crucial role in Zn stress resistance for both Chlamydomonas strains. However, in the case of C. reinhardtii, non-photochemical quenching was inhibited by 5 mg/L Zn in the first 48 h, whereas for Chlamydomonas sp. 1710, it remained unaffected under 100 mg/L Zn. Chlamydomonas sp. 1710 also exhibited a 20 times stronger capacity for regulating the electron transfer rate than C. reinhardtii under Zn stress. The light energy utilization efficiency (α) of Chlamydomonas sp. 1710 had the most highly non-linear correlation with μ, indicating the energy utilization and regulation process of Chlamydomonas sp. 1710 was well protected under Zn stress. Collectively, our findings demonstrate that the photosystem of Chlamydomonas sp. 1710 is much more resilient and tolerant than that of C. reinhardtii under Zn stress.

Traditional Chinese medicine polysaccharides (TCMPs) have gained increasing attention in the field of nanomedicine due to their diverse biological activities and favorable characteristics as drug carriers, including biocompatibility, biodegradability, safety, and ease of modification. TCMPs-based nano-drug delivery systems (NDDSs) offer several advantages, such as evasion of reticuloendothelial system (RES) phagocytosis, protection against biomolecule degradation, enhanced drug bioavailability, and potent therapeutic effects. Therefore, a comprehensive review of the latest developments in TCMPs-based NDDSs and their applications in disease therapy is of great significance. This review provides an overview of the structural characteristics and biological activities of TCMPs relevant to carrier design, the strategies employed for constructing TCMPs-based NDDSs, and the versatile role of TCMPs in these systems. Additionally, current challenges and future prospects of TCMPs in NDDSs are discussed, aiming to provide valuable insights for future research and clinical translation.

In this study, two intramammary infusions of cefquinome sulfate were investigated for pharmacokinetics and bioavailability. Twelve lactating cows for each group were administered an effective dose of 75 mg/gland for cefquinome, with milk samples collected at various time intervals. The concentrations of cefquinome in milk at different times were determined by the UPLC-MS/MS method. Analyses of noncompartmental pharmacokinetics were conducted on the concentration of cefquinome in milk. Mean pharmacokinetic parameters of group A and group B following intramammary administration were as follows: AUClast 300558.57 ± 25052.78 ng/mL and 266551.3 ± 50654.85 ng/mL, Cmax 51786.35 ± 11948.4 ng/mL and 59763.7 ± 8403.2 ng/mL, T1/2 5.69 ± 0.62 h and 5.25 ± 1.62 h, MRT 7.43 ± 0.79 h and 4.8 ± 0.78 h, respectively. Pharmacokinetic experiments showed that the relative bioavailability of group B was 88.69% that of group A. From our findings, group B (3 g: 75 mg) shows a quicker drug elimination process than group A (8 g: 75 mg), which suggests that the withdrawal period for the new formulation may be shorter.

This study explores the impacts of multiple factors (noise, intra-motif coupling, and critical bifurcation parameter) on noise-induced motif synchrony and output regularity in three-node feed-forward-loops (FFLs), distinguishing between coherent FFLs with purely excitatory connections and incoherent FFLs formed by transitioning the intermediate layer to inhibitory connections. Our model utilizes the normal form of Hopf bifurcation (HB), which captures the generic structure of excitability observed in real systems. We find that the addition of noise can optimize motif synchrony and output regularity at the intermediate noise intensities. Our results also suggest that transitioning the excitatory coupling between the intermediate and output layers of the FFL to inhibitory coupling—i.e., moving from the coherent to the incoherent FFL—enhances output regularity but diminishes motif synchrony. This shift towards inhibitory connectivity highlights a trade-off between motif synchrony and output regularity and suggests that the structure of the intermediate layer plays a pivotal role in determining the motif’s overall dynamics. Surprisingly, we also discover that both motifs achieve their best output regularity at a moderate level of intra-motif coupling, challenging the common assumption that stronger coupling, especially of the excitatory type, results in improved regularity. Our study provides valuable insights into functional differences in network motifs and offers a direct perspective relevant to the field of complex systems as we consider a normal-form model that pertains to a vast number of individual models experiencing HB.

Mesotrione (MET) belongs to the p-hydroxyphenylpyruvate dioxygenase (HPPD)-inhibiting class of maize post-emergence herbicides, and it is safe for maize at the recommended doses, but the safety of MET differs among maize varieties in actual field production. In this study, four different maize varieties, ZD958, SN3, ST6 and POP16, were used as experimental materials to analyze their physiological responses to MET by comparing the activities of photosynthesis and antioxidant enzymes as well as the HPPD activity. The results showed that ZD958 was the most resistant to MET, followed by SN3 and ST6, and POP16 was the most sensitive to MET. The primary photosynthetic and antioxidant enzyme indices of all four maize varieties indicated that the resistant variety ZD958 was significantly higher than the sensitive variety POP16. HPPD activity was highest in ZD958 followed by SN3 and ST6 in both treated and control groups. POP16 exhibited the lowest HPPD activity. The results showed that the differences in resistance to MET in different types of maize varieties were closely related to the photosynthetic efficiency of plants and the HPPD activity. MET had minimal impact on common maize but showed a significant effect on popcorn.

Abstract It is challenging to regenerate periodontal tissues fully. We have previously reported a heparan sulfate variant with enhanced affinity for bone morphogenetic protein-2, termed HS3, that enhanced periodontal tissue regeneration in a rodent model. Here we seek to transition this work closer to the clinic and investigate the efficacy of the combination HS3 collagen device in a non-human primate (NHP) periodontitis model. Wire-induced periodontitis was generated in ten Macaca fascicularis, and defects were treated with Emdogain or collagen (CollaPlug) loaded with (1) distilled water, (2) HS low (36 µg of HS3), or (3) HS high (180 µg of HS3) for 3 months. At the endpoint, microscopic assessment showed significantly less epithelial down-growth, greater alveolar bone filling, and enhanced cementum and periodontal ligament regeneration following treatment with the HS-collagen combination devices. When evaluated using a periodontal regeneration assessment score (PRAS) on a scale of 0–16, collagen scored 6.78 (± 2.64), Emdogain scored 10.50 (± 1.73) and HS low scored 10.40 (± 1.82). Notably, treatment with HS high scored 12.27 (± 2.20), while healthy control scored 14.80 (± 1.15). This study highlights the efficacy of an HS-collagen device for periodontal regeneration in a clinically relevant NHP periodontitis model and warrants its application in clinical trials.

Synchronous dynamics play a pivotal role in various cognitive processes. Previous studies extensively investigate noise-induced synchrony in coupled neural oscillators, with a focus on scenarios featuring uniform noise and equal coupling strengths between neurons. However, real-world or experimental settings frequently exhibit heterogeneity, including deviations from uniformity in coupling and noise patterns. This study investigates noise-induced synchrony in a pair of coupled excitable neurons operating in a heterogeneous environment, where both noise intensity and coupling strength can vary independently. Each neuron is an excitable oscillator, represented by the normal form of Hopf bifurcation (HB). In the absence of stimulus, these neurons remain quiescent but can be triggered by perturbations, such as noise. Typically, noise and coupling exert opposing influences on neural dynamics, with noise diminishing coherence and coupling promoting synchrony. Our results illustrate the ability of asymmetric noise to induce synchronization in such coupled neural oscillators, with synchronization becoming increasingly pronounced as the system approaches the excitation threshold (i.e., HB). Additionally, we find that uneven coupling strengths and noise asymmetries are factors that can promote in-phase synchrony. Notably, we identify an optimal synchronization state when the absolute difference in coupling strengths is maximized, regardless of the specific coupling strengths chosen. Furthermore, we establish a robust relationship between coupling asymmetry and the noise intensity required to maximize synchronization. Specifically, when one oscillator (receiver neuron) receives a strong input from the other oscillator (source neuron) and the source neuron receives significantly weaker or no input from the receiver neuron, synchrony is maximized when the noise applied to the receiver neuron is much weaker than that applied to the source neuron. These findings reveal the significant connection between uneven coupling and asymmetric noise in coupled neuronal oscillators, shedding light on the enhanced propensity for in-phase synchronization in two-neuron motifs with one-way connections compared to those with two-way connections. This research contributes to a deeper understanding of the functional roles of network motifs that may serve within neuronal dynamics.

Tens of thousands of students worldwide have been forced to start learning online, and online learning has never been more compelling. Understanding the effectiveness and satisfaction of online learning has become crucial. Previously, researchers have explored many determinants of online learning, but so far, only a few have focused exclusively on the field of higher education in dance. Therefore, this study delved into the satisfaction derived from online dance learning by employing the stimulus–organism–response framework, social learning theory, and constructivism theory. The aim was to examine how the effectiveness of online learning and the characteristics of online systems influence satisfaction in dance online learning. Data collection took place from January 1, 2023, to January 31, 2023, with university students majoring in dance participating as respondents in China. The analysis utilized structural equation modeling for data interpretation. The results reveal that the organism (students online learning effectiveness and the online system characteristics) directly impacted students’ satisfaction with online education. While changes in four stimulus factors (learning experiences; instructor’s inspiration; learning hindrance; quality of technology) indirectly impact online learning satisfaction. Our research enriches the exploration of students’ satisfaction factors in dance higher online education, thus filling the research gap in related fields, intending to guide relevant practitioners in the future.

IntroductionCOVID-19 continues to spread worldwide, with an increasing number of individuals experiencing reinfection after recovering from their primary infection. However, the nature and progression of this infection remain poorly understood. We aimed to investigate the immune response, severity and outcomes of Omicron BA.5 reinfection among individuals previously infected with different SARS-CoV-2 variants. MethodsWe enrolled 432 COVID-19 cases who had experienced prior infection with the ancestral SARS-CoV-2 virus, Delta variant or Omicron BA.2 variant between January 2020 and May 2022 in Guangzhou, China. All cases underwent follow-up from March to April, 2023 through telephone questionnaires and clinical visits. Nasal lavage fluid and peripheral blood were collected to assess anti-RBD IgA, anti-RBD IgG and virus-specific IFN-γ secreting T cells.ResultsOur study shows that 73.1%, 56.7% and 12.5% of individuals with a prior infection of the ancestral virus, Delta or Omicron BA.2 variant experienced reinfection with the BA.5 variant, respectively. Fever, cough and sore throat were the most common symptoms of BA.5 reinfection, with most improving within one week and none progressing to a critical condition. Compared with individuals without reinfection, reinfected patients with a prior Delta infection exhibited elevated levels of nasal anti-RBD IgA, serum anti-RBD IgG and IFN-γ secreting T cells, whereas there was no noticeable change in reinfected individuals with a prior BA.2 infection.ConclusionThese results suggest that BA.5 reinfection is common but severe outcomes are relatively rare. Reinfection with a novel SARS-CoV-2 variant different from the prior infection may induce a more robust immune protection, which should be taken into account during vaccine development.

Severe endometrial injury caused by invasive uterine operation and/or endometritis often results in intrauterine adhesions (IUAs), which are named Asherman’s syndrome (AS), further leading to menstrual disorders, infertility and severe complications during pregnancy and delivery. IUAs or AS has been a challenging medical problem. Stem cells are a promising therapeutic modality for endometrial regeneration in patients with refractory AS. Here, we developed a new system of adipose‐derived mesenchymal stem cells (ADMSCs) implantation on silk fibroin/polycaprolactone (SF/PCL) electrospun nanofibers (ADMSCs-SF/PCL) and used it in the damaged endometrium of a rat model. After SF/PCL enhanced the proliferation of transplanted ADMSCs, the results showed that the ADMSCs-SF/PCL system could recover morphology, promote regeneration of the glands and angiogenesis by increasing CD31 expression, and reverse endometrial fibrosis by decreasing TGF-β/Smad expression. In addition, the ADMSCs-SF/PCL system also increased the expression of differentiation and decidualization markers, including HOXA11, HAND2 and FOXO1. Most importantly, the ADMSCs-SF/PCL system could remodel the special immune microenvironment, resulting in dominant NK infiltration and a normal Th1/Th2 bias in the endometrium. Moreover, this treatment had a lower but more persistent effect than estrogen. Thus, the ADMSCs-SF/PCL system enhanced endometrial restoration, suggesting a promising strategy for damaged endometrial regeneration and immune microenvironment remodeling.

Objective: This study aimed to employ bibliometric approaches to assess the worldwide scientific achievements in acupuncture for facial paralysis research from 2013 to 2023, and explore the hotspots and frontiers. Methods: Articles related to acupuncture facial paralysis were retrieved from the Web of Science Core Collection (WoSCC). CiteSpace was utilized to examine journals, publication year, country, institution, cited authors, as well as authors.Research hotspots and trends were analyzed by mapping co-citation networks and keywords. Results: The period from January 1, 2013, to July 31, 2023, yielded nearly 145 research records on acupuncture treatment for facial paralysis, with a steady increase in the number of annual publications.In terms of the number of publications, OTOLARYNGOLOGY HEAD NECK had the highest publication count, while AM J CHINESE MED exhibited the highest centrality and citation frequency among the cited journals. Further, 54.4 % of publications originated from China, followed by USA (8.2 %) and Germany (8.2 %). Guangzhou University of Chinese Medicine stood out with the highest publication volume among institutions. Guntinas-lichius, Orlando was the most prolific author, and PEITERSEN E was the most cited author. The keywords ''Randomized controlled trials'' and ''multicenter'' displayed high frequency and centrality, indicating that clinical trials with a randomized controlled design and multicenter studies were prevalent research methods, likely to remain a future trend. Conclusion: Acupuncture's potential in the treatment of facial paralysis merits further research. Authors from different countries/regions and organizations need to eliminate language and academic barriers and strengthen collaboration and communication. Current research hotspots focus on “brain”, “nerve”, “electrical stimulation”, “RCT” and “guidelines”. The study of acupuncture mechanisms, especially based on the central nervous system mechanism, may be the future research hotspot.

Animal models have been indispensable in shaping the understanding of myopia mechanisms, with form-deprivation myopia (FDM) and lens-induced myopia (LIM) being the most utilized. Similar pathological outcomes suggest that these two models are under the control of shared mechanisms. miRNAs play an important role in pathological development. Herein, based on two miRNA datasets (GSE131831 and GSE84220), we aimed to reveal the general miRNA changes involved in myopia development. After a comparison of the differentially expressed miRNAs, miR-671-5p was identified as the common downregulated miRNA in the retina. miR-671-5p is highly conserved and related to 40.78% of the target genes of all downregulated miRNAs. Moreover, 584 target genes of miR-671-5p are related to myopia, from which we further identified 8 hub genes. Pathway analysis showed that these hub genes are enriched in visual learning and extra-nuclear estrogen signaling. Furthermore, two of the hub genes are also targeted by atropine, which strongly supports a key role of miR-671-5p in myopic development. Finally, Tead1 was identified as a possible upstream regulator of miR-671-5p in myopia development. Overall, our study identified the general regulatory role of miR-671-5p in myopia as well as its upstream and downstream mechanisms and provided novel treatment targets, which might inspire future studies.

Aging is associated with gradual changes in liver structure, altered metabolites and other physiological/pathological functions in hepatic cells. However, its characterized phenotypes based on altered metabolites and the underlying biological mechanism are unclear. Advancements in high-throughput omics technology provide new opportunities to understand the pathological process of aging. Here, in our present study, both metabolomics and phosphoproteomics were applied to identify the altered metabolites and phosphorylated proteins in liver of young (the WTY group) and naturally aged (the WTA group) mice, to find novel biomarkers and pathways, and uncover the biological mechanism. Analysis showed that the body weights, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increased in the WTA group. The grips decreased with age, while the triglyceride (TG) and cholesterol (TC) did not change significantly. The increase of fibrosis, accumulation of inflammatory cells, hepatocytes degeneration, the deposition of lipid droplets and glycogen, the damaged mitochondria, and deduction of endoplasmic reticulum were observed in the aging liver under optical and electron microscopes. In addition, a network of metabolites and phosphorylated proteomes of the aging liver was established. Metabolomics detected 970 metabolites in the positive ion mode and 778 metabolites in the negative ion mode. A total of 150 pathways were pooled. Phosphoproteomics identified 2618 proteins which contained 16621 phosphosites. A total of 164 pathways were detected. 65 common pathways were detected in two omics. Phosphorylated protein heat shock protein HSP 90-alpha (HSP90A) and v-raf murine viral oncogene homolog B1(BRAF), related to cancer pathway, were significantly upregulated in aged mice liver. Western blot verified that protein expression of MEK and ERK, downstream of BRAF pathway were elevated in the liver of aging mice. However, the protein expression of BRAF was not a significant difference. Overall, these findings revealed a close link between aging and cancer and contributed to our understanding of the multi-omics changes in natural aging.

Gastrointestinal (GI) cancer is the leading cause of cancer-related deaths worldwide. Computed tomography (CT) is an important auxiliary tool for the diagnosis, evaluation, and prognosis prediction of gastrointestinal tumors. Spectral CT is another major CT revolution after spiral CT and multidetector CT. Compared to traditional CT which only provides single-parameter anatomical diagnostic mode imaging, spectral CT can achieve multi-parameter imaging and provide a wealth of image information to optimize disease diagnosis. In recent years, with the rapid development and application of spectral CT, more and more studies on the application of spectral CT in the characterization of GI tumors have been published. For this review, we obtained a substantial volume of literature, focusing on spectral CT imaging of gastrointestinal cancers, including esophageal, stomach, colorectal, liver, and pancreatic cancers. We found that spectral CT can not only accurately stage gastrointestinal tumors before operation but also distinguish benign and malignant GI tumors with improved image quality, and effectively evaluate the therapeutic response and prognosis of the lesions. In addition, this paper also discusses the limitations and prospects of using spectral CT in GI cancer diagnosis and treatment.

To implement state policies of zero-markup drug policy and medical service fee adjustment for public hospitals, this study constructed game models of the pharmaceutical supply chain, consisting of a drug supplier and a public hospital. The study obtained the optimal medical service level and pricing under the new state drug policies. In addition, it analyzed the impacts of the degree of public benefit of hospitals on the medical service level, the medical service price, and the drug price. Finally, from the perspective of cooperation between drug suppliers and public hospitals, the specialized coordination contract was designed to maximize overall social welfare. This study found an anomalous but meaningful conclusion: in the background of the zero-markup drug policy, a higher public benefit of hospitals could increase the drug prices, but it could reduce the medical service prices further to cut down on the overall treatment fees for the patients. The novel coordination contract can optimize the pharmaceutical supply chain and achieve a win-win situation for the drug suppliers, public hospitals, and patients. When the public benefit of hospitals is higher, the profit of a decentralized decision-making supply chain is greater than a centralized one, while the pharmaceutical supply chain will not coordinate itself.

IntroductionWe describe herein a large-scale, multidisciplinary course-based undergraduate research experience program (CRE) developed at Lawrence Technological University (LTU). In our program, all students enrolled in CRE classes participate in authentic research experiences within the framework of the curriculum, eliminating self-selection processes and other barriers to traditional extracurricular research experiences.MethodsSince 2014, we have designed and implemented more than 40 CRE courses in our College of Arts and Sciences involving more than 30 instructors from computer science, mathematics, physics, biology, chemistry, English composition, literature, philosophy, media communication, nursing, and psychology.ResultsAssessment survey data indicates that students who participate in CRE courses have an enhanced attitude towards research and discovery, as well as increased self-efficacy. This intervention is particularly relevant for non-traditional students, such as students who commute and/or have significant work or childcare commitments, who often experience limited access to research activities.DiscussionHerein we highlight the importance of a systemic institutional change that has made this intervention sustainable and likely to outlast the external funding phase. Systemic change can emerge from a combination of conditions, including: (1) developing a critical mass of CRE courses by providing instructors with both incentives and training; (2) developing general principles on which instructors can base their CRE activities; (3) securing and maintaining institutional support to promote policy changes towards a more inclusive institution; and (4) diversifying the range of the intervention, both in terms of initiatives and disciplines involved.

ObjectiveTo examine the incidence of adverse events following immunization (AEFI) among old people receiving booster dose of coronavirus disease 2019 (COVID-19) vaccine and to provide reference data for evaluating the safety of COVID-19 vaccine booster immunization in the population. MethodsUsing a self-designed questionnaire on AEFI, we conducted person-to-person telephone interviews among 1 157 vaccinees aged 60 years and above 7 – 14 days after receiving booster dose of COVID-19 vaccine at a community healthcare service station between October 2021 and March 2022. ResultsOf all the elderly interviewed, 122 (10.54%) reported AEFI. Local reaction was the most frequently reported AEFI (112 person times in 90 participants) and the majority (64.29%, 72/112 person times) of the local reactions was pain at the injection site. Of the 90 participants reporting AEFI, 58.89% (n = 53) had their adverse events spontaneously improved one or two days after the vaccination. Totally 46 person times of systemic reactions were reported by 38 participants, and 32.61% (15 person times) of the systemic reactions was fatigue; the reported systemic reactions also spontaneously improved in 21 (55.26%) of the sufferers one or two days after the vaccination. There were 6 participants reporting both local and systemic reaction. No significant association of hypertension, diabetes and hyperlipidemia with the occurrence of AEFI was observed. There was a significant difference in the incidence of AEFI among the participants having different booster immunization schedules (χ2 = 14.705，P < 0.05). Among the participants having inactivated vaccines, the incidence of AEFI was 12.59% (36/286) for those with the booster dose of homologous vaccine from the same manufacture as their routine vaccination and the incidence was 9.50% (67/705) for those with the booster dose of homologous vaccine but from different manufacture; among the participants having two doses recombinant novel coronavirus vaccine (type 5 adenovirus vector, abbreviated as adenovirus) the AEFI incidence was 13.33% (2/15); among the participants having non homologous vaccine booster dose, the AEFI incidence was 22.41% (13/58) or 4.30% (4/93) for those with the booster dose of adenovirus vaccine or recombinant novel coronavirus vaccine (CHO cell vaccine). ConclusionThe incidence of AEFI was lower in the elderly after receiving booster dose of COVID-19 vaccine with different immunization schedules and most of the AEFI were transient, self-limiting reactions, indicating a good safety of booster immunization of COVID-19 vaccine .

Deltamethrin, an important pyrethroid insecticide, is frequently detected in human samples. This study aims to assess the potential effects of deltamethrin on human health and investigate the patterns of residue enrichment and elimination in 112 healthy laying hens. These hens were administered 20 mg·kg−1 deltamethrin based on their body weight. Gas chromatography-mass spectrometry (GC-MS) was used to investigate the residue enrichment pattern and elimination pattern of deltamethrin in the hens. The results indicated a significant increase in the concentration of deltamethrin in chicken manure during the treatment period. By the 14th day of administration, the concentration of deltamethrin in the stool reached 13,510.9 ± 172.24 μg·kg−1, with a fecal excretion rate of 67.56%. The pulmonary deltamethrin concentration was the second highest at 3844.98 ± 297.14 μg·kg−1. These findings suggest that chicken feces contain substantial amounts of deltamethrin after 14 days of continuous administration, and that it can easily transfer to the lungs. After 21 days of drug withdrawal, the residual concentration of deltamethrin in the fat of laying hens was 904.25 ± 295.32 μg·kg−1, with a half-life of 17 days and a slow elimination rate. In contrast, the lungs showed relatively low elimination half-lives of 0.2083 days, indicating faster elimination of deltamethrin in this tissue. These results highlight differences in the rate of deltamethrin elimination in different tissues during drug withdrawal. The fat of laying hens exhibited the highest residue of deltamethrin and the slowest elimination rate, while the lungs showed the fastest elimination rate. Moreover, deltamethrin was found to accumulate in the edible tissues of eggs and laying hens, suggesting that humans may be exposed to deltamethrin through food.

Abstract A highly efficient Ruddlesden‐Popper structure anode material with a formula of Sr3Fe1.3Mo0.5Ni0.2O7‐δ (RP‐SFMN) has been developed for hydrocarbon fueled solid oxide fuel cells (HF‐SOFC) application. It is demonstrated that a nanostructured RP‐SFMN anode decorated with in‐situ exsolved Ni nanoparticles (Ni@RP‐SFMN) has been successfully prepared by annealing the anode in reducing atmosphere similar to the operating conditions. The phase compositions, valence states, morphologies, and electrocatalytic activities of RP‐SFMN material have been characterized in detail. In addition, the in‐situ exsolution mechanism of the metallic Ni phase from the parent oxide is clearly explained by using density function theory calculation. The peak output power density at 800°C is significantly enhanced from 0.163 to 0.409 W/cm2 while the electrode polarization resistance is effectively lowered from 0.96 to 0.30 Ω cm2 by the substitution of B‐site Fe by Ni, which is attributed to the improved electrocatalytic activities induced by the in‐situ exsolved Ni nanocatalysts. Moreover, the single cell with RP‐SFMN anode exhibits good stability in 3% H2O humidified H2 and syngas for 110 and 60 h at 800°C, respectively. Our findings indicate that RP‐SFMN is a greatly promising anode candidate of HF‐SOFCs due to its good electrochemical performance and stability during the operation.

ObjectiveTo investigate the prevalence and influencing factors of influenza vaccine hesitancy among parents of children in primary/secondary schools and kindergartens in Guiyang city for providing references to influenza prevention in schools and kindergartens. MethodsUsing two-stage stratified random cluster sampling, we conducted an online survey among 12 338 parents of children from 15 secondary/15 primary schools and 15 kindergartens in Guiyang city, Guizhou province during September 2021. The study adopted a modified questionnaire developed by domestic researchers based on the theory of confidence, complacency, and convenience (“3C”). ResultsOf the 12 885 respondents (9 538 mothers and 2 747 fathers aged 37.74 ± 7.44 years) with valid replies, 62.27% reported the acceptance of their children′s influenza vaccination; 24.42% expressed neutral attitude towards the vaccination; and 13.13% refused to have their children vaccinated against influenza. Univariate analysis of variance showed that the parents′ influenza vaccine hesitancy was positively correlated with their complacency score (F = 365.061, P < 0.001) but inversely with confidence score (F = 175.758, P < 0.001) and convenience score (F = 71.173, P < 0.001). The results of multivariate linear regression analysis showed that the respondents being mother and having two children were more likely to have a lower confidence in influenza vaccines; the respondents being mother, having two children and with a youngest child of more than 6 years old were more likely to have a higher complacency; the respondents with the education of college and having an average monthly income of more than 5 000 yuan RMB were more likely to have a higher perceived convenience for their children′s vaccination and a lower influenza vaccine hesitancy. ConclusionBased on "3C" model, the parents′ hesitancy for their children′s influenza vaccination is associated with their confidence, complacency, and convenience in the vaccination. The results suggest that measures on improving confidence but reducing complacency in influenza vaccine could be implemented among parents to increase influenza vaccination coverage among children.

ObjectiveTo examine the prevalence and influencing factors of influenza vaccination among junior high and primary school children and kindergarten children in Guiyang city of Guizhou province during an influenza season. MethodsUsing convenient sampling, we recruited 4 597 junior high/primary school and kindergarten students receiving vaccination services at 6 clinics for planned immunization in Guiyang city of Guizhou province. An online survey with a self-designed questionnaire was conducted among the students′ parents or guardians during November – December, 2020. ResultsAmong the 4 563 students with complete information, 50.14% were reported having been vaccinated against influenza, 15.76% not having been vaccinated due to lack of vaccines, 24.96% being ready to be vaccinated, and only 9.14% of the students′ parents/guardians reporting the unwillingness for their children′s influenza vaccination. The results of multivariate logistic regression analysis showed that the students′ parents/guardians with following characteristics were more likely to have their children to be vaccinated against influenza: with the children in primary school (odds ratio [OR] = 1.705, 95% confidence interval [95% CI]: 1.391 – 2.089), working as teachers (OR = 1.928, 95% CI: 1.003 – 3.706), working as medical staff (OR = 1.857, 95% CI: 1.076 – 3.204), believing in the effect of influenza vaccine against influenza infection (OR = 1.351, 95% CI: 1.145 – 1.593), having the knowledge about the requirement of annual influenza vaccination (OR = 1.749, 95% CI: 1.515 – 2.019), with the children ever having influenza vaccination before July 2020 (OR = 7.603, 95% CI: 6.512 – 8.877), and being worried about dual prevalence of coronavirus disease 2019 (COVID-19) and influenza (OR = 1.643, 95% CI: 1.390 – 1.942) (P < 0.05 for all). ConclusionUnder the circumstance of COVID-19 epidemic, the parents/guardians of junior high/primary school and kindergarten students in Guiyang city had a higher willingness for their children′s influenza vaccination in 2020 – 21 influenza season and more than a half of the students had been vaccinated by the end of December 2020. The parents′/guardians′ willingness were significantly influenced by their knowledge about influenza and influenza vaccine.

Leiomyosarcoma with heterologous differentiation is relatively rare. To date, only 19 cases have been reported in the English literature. Heterologous components frequently show histological pleomorphism, while those exhibiting well-differentiated morphology are seldom reported. Here, we report a 34-year-old female diagnosed with leiomyosarcoma and developed abdominal wall recurrence 8 years after primary surgery. The recurrent tumor mainly comprised well-differentiated chondrosarcoma except a single focus of leiomyosarcoma. Due to the rarity and prolonged onset of such a transition, our case provides insight into the understanding of this phenomenon.

BackgroundGrowth hormone (GH)/thyroid stimulating hormone (TSH) cosecreting pituitary adenoma (PA) is an exceedingly rare kind of bihormonal pituitary neuroendocrine tumors (PitNETs). Its clinical characteristics have rarely been reported.ObjectivesThis study aimed to summarize the clinical characteristics and experience of diagnosis and treatment among patients with mixed GH/TSH PAs from a single center.MethodsWe retrospectively reviewed GH/TSH cosecreting PAs from 2063 patients diagnosed with GH-secreting PAs admitted to Peking Union Medical College Hospital between January 1st, 2010, and August 30th, 2022, to investigate the clinical characteristics, hormone detection, imaging findings, treatment patterns and outcomes of follow-up. We further compared these mixed adenomas with age- and sex-matched cases of GH mono-secreting PAs (GHPAs). The data of the included subjects were collected using electronic records from the hospital’s information system.ResultsBased on the inclusion and exclusion criteria, 21 GH/TSH cosecreting PAs were included. The average age of symptom onset was 41.6 ± 14.9 years old, and delayed diagnosis occurred in 57.1% (12/21) of patients. Thyrotoxicosis was the most common complaint (10/21, 47.6%). The median inhibition rates of GH and TSH in octreotide suppression tests were 79.1% [68.8%, 82.0%] and 94.7% [88.2%, 97.0%], respectively. All these mixed PAs were macroadenomas, and 23.8% (5/21) of them were giant adenomas. Comprehensive treatment strategies comprised of two or more therapy methods were applied in 66.7% (14/21) of patients. Complete remission of both GH and TSH was accomplished in one-third of cases. In the comparison with the matched GHPA subjects, the mixed GH/TSH group presented with a higher maximum diameter of the tumor (24.0 [15.0, 36.0] mm vs. 14.7 [10.8, 23.0] mm, P = 0.005), a greater incidence of cavernous sinus invasion (57.1% vs. 23.8%, P = 0.009) and a greater difficulty of long-term remission (28.6% vs. 71.4%, P

Saliva plays important roles in insect feeding, but its roles in insect reproduction were rarely reported. Here we reported that the knockdown of a salivary gland-specific gene NlG14 disrupted the reproduction through inhibiting the ovulation of the brown planthopper (BPH), Nilaparvata lugens (Stål), one of the most devastating rice pests in Asia. NlG14 knockdown caused the displacement of the lateral oviduct secreted components (LOSC), leading to the ovulation disorder and the accumulation of mature eggs in the ovary. The RNAi-treated females laid much less eggs than their control counterparts, though they had the similar oviposition behavior on rice stems as controls. NlG14 protein was not secreted into the hemolymph, indicating an indirect effect of NlG14 knockdown on BPH reproduction. NlG14 knockdown caused the malformation of A-follicle of the principal gland and affected the underlying endocrine mechanism of salivary glands. NlG14 reduction might promote the secretion of insulin-like peptides NlILP1 and NlILP3 from the brain, which up-regulated the expression of Nllaminin gene and then caused the abnormal contraction of lateral oviduct muscle. Another explanation was NlG14 reduction disrupted the ecdysone biosynthesis and action through the insulin-PI3K-Akt signaling in ovary. Altogether, this study indicated that the salivary gland specific protein NlG14 indirectly mediated BPH ovulation process, which established a connexon in function between insect salivary gland and ovary.

ObjectiveTo determine whether the inclusion of white blood cell (WBC) counts in the SYNTAX score (SS) or SS II models could improve the models’ performance for risk stratification in individuals with chronic renal insufficiency (CRI) following percutaneous coronary intervention (PCI).MethodsIn total, 2,313 patients with CRI, who were subjected to PCI and had data available on in-hospital WBC (ih-WBC) counts, were recruited. Patients were divided into 3 groups as per their ih-WBC counts (low, medium, and high). The primary endpoints were all-cause mortality (ACM) and cardiac mortality (CM). The secondary endpoints incorporated myocardial infarction, stroke, unplanned revascularization, and major adverse cardiovascular and cerebrovascular events (MACCEs).ResultsDuring a median follow-up of 3 years, the high WBC group had the highest incidences of CM (2.4% vs. 2.1% vs. 6.7%; p

Abstract Background Recently, side effects from Dopamine Receptor Agonist Drugs (DAs) in treating pituitary prolactinoma have raised widespread concern. This study explores the incidence and influencing factors of DAs-related side effects in Chinese prolactinoma patients. Methods A cross-sectional study was conducted. 51 prolactinoma patients treated with DAs, 12 prolactinoma or pituitary microadenoma patients without DAs treatment, and 33 healthy controls were included. The Barratt impulsivity scale-11, Patient Health Questionnaire 9, and the ICD screening questionnaire were all used to evaluate the psychological and physical side effects of DAs. Clinical data of all subjects were collected from their electronic medical records. Results The incidence of ICDs in the treated group, the untreated group, and control group was 9.8% (5/51), 16.7% (2/12), and 9.1% (3/33), respectively. In the treated group in particular, there were 1 patient (2%, 1/51), 2 patients (3.9%, 2/51), and 2 patients (3.9%, 2/51) with positive screening for punding, compulsive shopping, and hypersexuality, respectively. In terms of depression, the incidence of "minimal", "mild" and "moderate" depression in the treated group was 62.8% (32/51), 25.5% (13/51), and 5.9% (3/51), respectively. The incidence of physical symptoms was 51.0% (26/51) in the treated group and gastrointestinal symptoms were the most common symptoms (33.3%, 17/51). In addition, we found that the various parameters of DAs treatment had no association with the occurrence of physical symptoms or ICDs (all P > 0.05). Conclusions Chinese prolactinoma patients treated with DAs had a lower incidence of ICDs (9.8%), while gastrointestinal symptoms were common. In this way, more attention should be paid to side effects, especially physical symptoms, in Chinese prolactinoma patients with DAs therapy during follow-up regardless of dose.

Abstract Portable spirometers has been approved for diagnosing chronic obstructive pulmonary disease (COPD). However, their diagnostic accuracy has not been reviewed. Therefore, the purpose of this study was to systematically evaluate the diagnostic value of portable spirometers in detecting COPD. A comprehensive literature search for relevant studies was conducted in PubMed, Embase, CNKI, Wan Fang, and Web of Science databases. Pooled sensitivity, specificity, summary receiver operating characteristic (SROC), area under the curve (AUC), and other related indices were calculated using the bivariate mixed-effect model. Subgroup analysis was performed to explore the source of heterogeneity. Thirty one studies were included in the meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic ratio (DOR), SROC, and AUC of the SROC of portable spirometers were 0.85 (0.81–0.88), 0.85 (0.81–0.88), 5.6 (4.4–7.3), 0.18 (0.15–0.22), 31 (21–46) and 0.91 (0.89–0.94), respectively. Among the three commonly used types of portable spirometers, the accuracy of PIKO-6 was higher (0.95) than that of COPD-6 (0.91) and PEF (0.82). Subgroup analysis indicated that the accuracy of a multi-indices portable spirometer was higher than that of a single-index one (P

Three new species, Pseudocandona cheni sp. nov., Cyclocypris pangi sp. nov., and Tonnacypris rectangularis sp. nov., collected from northern China, are described in this study. Pseudocandona cheni, of the compressa group, is difficult to be distinguished from other members of the same group by carapace morphology alone, but can be readily recognised by the structure of the hemipenis comprised of a long lobe a, distally inflated lobe h, and exteriorly pointed lobe b, as well as thick trunks of the male fifth limb endopodites. Cyclocypris pangi, despite its similarity in carapace morphology to its congeners, can be identified based on the morphology of the hemipenis, which bears a slender, slightly curved lobe h, and an S-shaped process accompanying lobe b, in addition to the rectangular trunk of the male fifth limb endopodite. On the other hand, Tonnacypris rectangularis, described on the basis of females only, can be distinguished from other Tonnacypris Diebel & Pietrzeniuk, 1975 representatives by its distinct sub-rectangular carapace alone. Other differences include the length of the swimming setae, the length of the distal claws on the second antennae, and the morphology of the pincer organ on the seventh limb. This study contributes to the poorly known extant non-marine ostracod fauna of Inner Mongolia and Beijing, and generally to the central-eastern Palaearctic region. In addition, the known distribution range of Tonnacypris is extended eastwardly by T. rectangularis. The valve-morphology data are useful for identifying fossil/sub-fossil representatives.

The diagnosis of gastric volvulus can be a clinical challenge as it is rare, and the symptoms are often nonspecific and intermittent. Upper endoscopy is a minimally invasive intervention that may be repeated more than once to provide key information and ultimately establish such a diagnosis. To emphasize the role of upper endoscopy in surgical cases with recurrent upper gastrointestinal obstructions, we present a case of intermittent gastric volvulus in a patient with a remote history of complex chest wall reconstruction for invasive breast cancer using an omental flap. She presented with substernal chest pain, belching, nausea, and vomiting. Although the initial imaging suggested duodenal obstruction, exploratory laparotomy and intraoperative upper endoscopy did not show any pathology in the stomach or duodenum. Repeat upper endoscopy due to recurrence of obstructive symptoms shortly after the initial exploratory laparotomy revealed a gastric volvulus. This resulted in abnormal duodenal orientation which caused intermittent duodenal obstruction while the pathology was in the stomach. Gastric volvulus may be spontaneously reducible, leading to discordance in findings during the clinical course. This could explain the absence of visible twisting on initial exploratory laparotomy in this patient and the subsequent findings of volvulus on upper endoscopy. Thus, it is important to consider gastric volvulus as a possible cause of symptoms despite initial negative findings as it is a dynamic process and may only be discovered through relook upper endoscopy and imaging.

Abstract The Naples prognostic score (NPS) is an effective inflammatory and nutritional scoring system widely applied as a prognostic factor in various cancers. We aimed to analyze the prognostic value of the NPS in patients diagnosed with non-small-cell lung cancer (NSCLC). We prospectively collected 395 patients diagnosed with NSCLC between January 2016 and December 2018 in two university-affiliated hospitals. Patients were divided into three groups according to their pretreatment NPS (Group 0: NPS = 0; Group 1: NPS = 1–2; Group 2: NPS = 3–4). Kaplan–Meier survival curves indicated that patients with higher NPS had a poorer overall survival (OS) and progress-free survival (PFS) (both P

Objective: To determine whether sildenafil has an effect on pregnancy outcomes in patients with poor endometrial development. Methods: This study included 472 infertility patients who underwent in vitro fertilization/intracytoplasmatic sperm injection and frozen-thawed embryo transfer (IVF/ICSI-FET) and subsequently suffered from poor endometrial development during hormone replacement cycle (HRC) from April 2017 to July 2019. The patients were divided into two groups: the sildenafil group (n ​= ​88) and the control group (n ​= ​384). We analyzed endometrial thicknesses and types on endometrial transformation day, as well as pregnancy outcomes after FET (biochemical pregnancy, clinical pregnancy, early abortion, late abortion, and live birth rates) between the two groups. Results: After adjusting for confounding factors, we found no significant differences in endometrial thicknesses and types on endometrial transformation day between the sildenafil group and the control group (0.79 ​± ​0.08 vs 0.81 ​± ​0.09, P ​= ​0.144; 79.76% vs83.87%, P ​= ​0.402). There were also no statistically significant differences in biochemical pregnancy rate (75.0% vs 76.8%, P ​= ​0.892), clinical pregnancy rate (59.09% vs 69.53%, P ​= ​0.087), early abortion rate (17.31% vs 14.61%, P ​= ​0.557), late abortion rate (3.85% vs 4.49%, P ​= ​0.859), or live birth rate (45.45% vs 55.47%, P ​= ​0.101) between the two groups. In subgroup analysis, the application of sildenafil was unable to improve endometrial thickness (group one: 0.80 ​± ​0.08 ​cm vs 0.82 ​± ​0.08 ​cm; group two:0.78 ​± ​0.08 ​cm vs 0.80 ​± ​0.10 ​cm; group three:0.75 ​± ​0.11 ​cm vs 0.77 ​± ​0.08 ​cm, p ​> ​0.05) and type endometrium on transformation day (group one: 78.57% vs 86.78%; group two: 80.65% vs 77.78%; group three: 81.82% vs 83.78%, p ​> ​0.05). Moreover, sildenafil use was not closely associated with clinical pregnancy outcomes, clinical pregnancy rate, early abortion rate, late abortion rate, and live birth rate (p ​> ​0.05). Conclusions: Sildenafil did not benefit endometrial development and pregnancy outcomes in patients with poor endometrial development during the hormone replacement cycle.

Groundwater is an essential water source for drinking, domestic, irrigation and industrial production in Luxi Plain, Shandong Province, China. Understanding the spatial–temporal changes in groundwater quality and its influencing factors in the region were required for better utilization of groundwater resources and efficient design of groundwater management strategies. In this study, the hydrochemical characteristics of groundwater in the study area were analyzed, and significant evolution was found from 2018 to 2020 due to silicate and carbonate weathering, evaporation and human activities. Moreover, the entropy water quality index (EWQI) was used to assess groundwater quality from 2018 to 2020. The EWQI values in 2018–2020 were 129.5, 90.5 and 94.0, respectively, and 31.7% of the groundwater in 2019 and 20.0% in 2020 can be used directly for drinking in the study area; others can be used for domestic water or irrigation. The potable groundwater, with an EWQI value of

Since COVID-19 emerged in 2019, significant levels of suffering and disruption have been caused on a global scale. Although vaccines have become widely used, the virus has shown its potential for evading immunities or acquiring other novel characteristics. Whether current drug treatments are still effective for people infected with Omicron remains unclear. Due to the long development cycles and high expense requirements of de novo drug development, many researchers have turned to consider drug repositioning in the search to find effective treatments for COVID-19. Here, we review such drug repositioning and combination efforts towards providing better handling. For potential drugs under consideration, aspects of both structure and function require attention, with specific categories of sequence, expression, structure, and interaction, the key parameters for investigation. For different data types, we show the corresponding differing drug repositioning methods that have been exploited. As incorporating drug combinations can increase therapeutic efficacy and reduce toxicity, we also review computational strategies to reveal drug combination potential. Taken together, we found that graph theory and neural network were the most used strategy with high potential towards drug repositioning for COVID-19. Integrating different levels of data may further improve the success rate of drug repositioning.

Gibberellin (GA) is an important endogenous hormone involved in plant responses to abiotic stresses. Experiments were conducted at the Research and Education Center of Agronomy, Shenyang Agricultural University (Shenyang, China) in 2021.We used a pair of near-isogenic inbred maize lines comprising, SN98A (light-sensitive inbred line) and SN98B (light-insensitive inbred line) to study the effects of exogenous gibberellin A3 (GA3) application on different light-sensitive inbred lines under weak light conditions. The concentration of GA3 was selected as 20, 40 and 60 mg L-1. After shade treatment, the photosynthetic physiological indexes of SN98A were always lower than SN98B, and the net photosynthetic rate of SN98A was 10.12% lower than SN98B on the 20th day after shade treatment. GA3 treatments significantly reduced the barren stalk ratios in SN98A and improved its seed setting rates by increasing the net photosynthetic rate (Pn), transpiration rate (Tr), stomatal conductance (Gs), photosynthetic pigment contents, photochemical efficiency of photosystem II (PS II) (Fv/Fm), photochemical quenching coefficient (qP), effective quantum yield of PSII photochemistry (ΦPSII), and antioxidant enzyme activities, where the most effective treatment was 60 mg L–1GA3. Compared with CK group, the seed setting rate increased by 33.87%. GA3 treatment also regulated the metabolism of reactive oxygen species (ROS) and reduced the superoxide anion (O2-) production rate, H2O2 content, and malondialdehyde content. The superoxide anion (O2-) production rate, H2O2 content and malondialdehyde content of SN98A sprayed with 60 mg L-1 GA3 decreased by 17.32%,10.44% and 50.33% compared with CK group, respectively. Compared with the control, GA3 treatment significantly (P < 0.05) increased the expression levels of APX and GR in SN98A, and APX, Fe-SOD, and GR in SN98B. Weak light stress decreased the expression of GA20ox2, which was related to gibberellin synthesis, and the endogenous gibberellin synthesis of SN98A. Weak light stress accelerated leaf senescence, and exogenous GA3 application inhibited the ROS levels in the leaves and maintained normal physiological functions in the leaves. These results indicate that exogenous GA3 enhances the adaptability of plants to low light stress by regulating photosynthesis, ROS metabolism and protection mechanisms, as well as the expression of key genes, which may be an economical and environmentally friendly method to solve the low light stress problem in maize production.

In practice, it is difficult to represent both biodiversity and recreational values in urban green spaces, mostly due to the lack of knowledge concerning people's biodiversity perceptions and recreational preferences. This study investigated the relationship between biodiversity, perceived biodiversity and recreational preference in urban green spaces in a Chinese urban environmental context. A compound factor was used to assess the actual biodiversity in biotopes while visitor-employed photography (VEP) was adopted to collect the perceptions of biodiversity and recreational preferences of participants, who were professional teachers and college students. Kruskal-Wallis tests were applied to compare the perceived biodiversity and recreational preferences across different biotopes. The reasons for which participants identified biodiversity or preferred the biotopes were also analyzed through binary logistic regression models and Kruskal-Wallis tests. Lastly, the differences between perception and recreational preference as effects of ecological knowledge were analyzed by Mann-Whitney tests. The results indicated that the participants could identify the biodiversity in different biotopes and preferred the water biotope. Landscape content was the most important environmental factor contributing to both the perception and recreational preference trends. The teachers focused more on spatial configurations while students noticed greater management in the biotopes. The study explored and identified people's attitudes and recreational preferences towards biodiversity in urban green spaces in China, and discussed balanced strategies for biodiversity conservation and recreation.