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INTRODUCTION: Patients experience high symptom burden during critical care hospitalization and mechanical ventilation. Medications are of limited effectiveness and are associated with increased morbidity such as delirium and long-term cognitive and psychological impairments. Music-based interventions have been used for pain and anxiety management in critical care but remain understudied in terms of music selection and range of symptoms. This study aimed to describe the ways in which a diverse sample of critically ill adults used personalized music listening and their perceptions of the effects of music listening on symptom experience after critical injury. METHODS: Semi-structured interviews (N = 14) of adult patients, families and friends who were provided with personalized music in an urban, academic, neurotrauma intensive care unit were collected and analyzed with grounded theory methodology. Open coding of transcripts, field notes and memos was performed using Atlas.ti.9.1. Recruitment and data collection were deemed complete once thematic saturation was achieved. RESULTS: We identified 6 uses of personalized music listening in critical care: 1) Restoring consciousness; 2) Maintaining cognition; 3) Humanizing the hospital experience; 4) Providing a source of connection; 5) Improving psychological wellbeing; and 6) Resolving the problems of silence. Patients used music to address psychological experiences of loneliness, fear, confusion, and loss of control. Personalized music helped patients maintain their identity and process their trauma. Additional benefits of music included experiencing pleasure, hope, resilience, and feelings of normalcy. Patients disliked being sedated and used music to wake up. Findings also highlighted the problem of the lack of meaningful stimulation in critical care. CONCLUSION: Critically injured adults used personalized music to achieve psychological and cognitive homeostasis during critical care hospitalization. These results can inform future studies designed to explore the use of music-based interventions to prevent and treat the cognitive and emotional morbidity of critical care.

Observers can discriminate between correct versus incorrect perceptual decisions with feelings of confidence. The centro-parietal positivity build-up rate (CPP slope) has been suggested as a likely neural signature of accumulated evidence, which may guide both perceptual performance and confidence. However, CPP slope also covaries with reaction time, which also covaries with confidence in previous studies, and performance and confidence typically covary; thus, CPP slope may index signatures of perceptual performance rather than confidence per se. Moreover, perceptual metacognition-including neural correlates-has largely been studied in vision, with few exceptions. Thus, we lack understanding of domain-general neural signatures of perceptual metacognition outside vision. Here we designed a novel auditory pitch identification task and collected behavior with simultaneous 32-channel EEG in healthy adults. Participants saw two tone labels which varied in tonal distance on each trial (e.g., C vs D, C vs F), then heard a single auditory tone; they identified which label was correct and rated confidence. We found that pitch identification confidence varied with tonal distance, but performance, metacognitive sensitivity (trial-by-trial covariation of confidence with accuracy), and reaction time did not. Interestingly, however, while CPP slope covaried with performance and reaction time, it did not significantly covary with confidence. We interpret these results to mean that CPP slope is likely a signature of first-order perceptual processing and not confidence-specific signals or computations in auditory tasks. Our novel pitch identification task offers a valuable method to examine the neural correlates of auditory and domain-general perceptual confidence.

PurposeCurrent research has not extensively explored the correlation between Systemic Inflammatory Index (SII) and prostate-specific antibody (PSA) levels. This study aimed to investigate the relationship between the SII and PSA levels in American males aged > 40 years without prostate cancer.MethodsData were obtained from the 2003-2010 National Health and Nutrition Examination Survey (NHANES). Patients without complete SII or PSA data were excluded. Multiple linear regression models were used to investigate the possibility of a linear association between the SII and PSA levels. Fitted smoothed curves and threshold effect analyses were used to characterize the nonlinear relationships.ResultsThe study included 5982 male participants over the age of 40 years from the United States. The average SII (mean ± standard deviation) was 562.78 ± 355.60. The mean value of PSA was 1.85 ± 3.24. The results showed that SII exhibited a positive correlation with PSA (β = 0.0005, 95% CI: (0.0002, 0.0007)), and an interaction test indicated that the effects of age, body mass index, hypertension, and diabetes were not significant for this positive correlation between SII and PSA (all P > 0.05). We discovered an inverted U-shaped connection between the SII and PSA with a turning point (K) of 1168.18 by using a two-segment linear regression model. To the left of the turning point, there was a positive connection between SII and PSA (β = 0.0009,95% CI: (0.0006, 0.0012); P < 0.0001).ConclusionIn the population of men over 40 years old without prostate cancer, SII and PSA exhibited a non-linear relationship. Specifically, there was a positive correlation between SII and PSA levels when the SII value was < 1168.18.

The agricultural WSN (wireless sensor network) has the characteristics of long operation cycle and wide coverage area. In order to cover as much area as possible, farms usually deploy multiple monitoring devices in different locations of the same area. Due to different types of equipment, monitoring data will vary greatly, and too many monitoring nodes also reduce the efficiency of the network. Although there have been some studies on data fusion algorithms, they have problems such as ignoring the dynamic changes of time series, weak anti-interference ability, and poor processing of data fluctuations. So in this study, a data fusion algorithm for optimal node tracking in agricultural wireless sensor networks is designed. By introducing the dynamic bending distance in the dynamic time warping algorithm to replace the absolute distance in the fuzzy association algorithm and combine the sensor's own reliability and association degree as the weighted fusion weight, which improved the fuzzy association algorithm. Finally, another three algorithm were tested for multi-temperature sensor data fusion. Compare with the kalman filter, arithmetic mean and fuzzy association algorithm, the average value of the improved data fusion algorithm is 29.5703, which is close to the average value of the other three algorithms, indicating that the data distribution is more even. Its extremely bad value is 8.9767, which is 10.04%, 1.14% and 9.85% smaller than the other three algorithms, indicating that it is more robust when dealing with outliers. Its variance is 2.6438, which is 2.82%, 0.65% and 0.27% smaller than the other three algorithms, indicating that it is more stable and has less data volatility. The results show that the algorithm proposed in this study has higher fusion accuracy and better robustness, which can obtain the fusion value that truly feedbacks the agricultural environment conditions. It reduces production costs by reducing redundant monitoring devices, the energy consumption and improves the data collection efficiency in wireless sensor networks.

PurposeSarcopenia is considered to be an important predictor of adverse outcomes following spinal surgery, but the specific relationship between the two is not clear. The purpose of this meta-analysis is to systematically review all relevant studies to evaluate the impact of sarcopenia on spinal surgery outcomes.MethodsWe systematically searched PubMed, Embase and the Cochrane Library for relevant articles published on or before January 9, 2023. The pooled odds ratio (OR) with 95% confidence intervals (CIs) was calculated in a random effects meta-analysis. The main outcome was the risk of adverse outcomes after spinal surgery, including adverse events and mortality. This systematic review and meta-analysis was conducted following the PRISMA guidelines to evaluate the impact of sarcopenia on spinal surgery outcomes. In addition, we also conducted a subgroup analysis and leave-one-out sensitivity analyses to explore the main sources of heterogeneity and the stability of the results.ResultsTwenty-four cohort studies, with a total of 243,453 participants, met the inclusion criteria. The meta-analysis showed that sarcopenia was significantly associated with adverse events (OR 1.63, 95% CI 1.17-2.27, P < 0.001) but was no significantly associated with mortality (OR 1.17, 95% CI 0.93-1.46, P = 0.180), infection (OR 2.24, 95% CI 0.95-5.26, P < 0.001), 30-day reoperation (OR 1.47, 95% CI 0.92-2.36, P = 0.413), deep vein thrombosis (OR 1.78, 95% CI 0.69-4.61, P = 0.234), postoperative home discharge (OR 0.60, 95% CI 0.26-1.37, P = 0.002) and blood transfusion (OR 3.28, 95% CI 0.74-14.64, P = 0.015).ConclusionThe current meta-analysis showed that patients with sarcopenia have an increased risk of adverse events and mortality after spinal surgery. However, these results must be carefully interpreted because the number of studies included is small and the studies are significantly different. These findings may help to increase the clinicians' awareness of the risks concerning patients with sarcopenia to improve their prognosis.

Small molecular heat shock proteins (sHSPs) belong to the HSP family of molecular chaperones. Under high-temperature stress, they can prevent the aggregation of irreversible proteins and maintain the folding of denatured proteins to enhance heat resistance. In this study, the CmHSP17.9-1 and CmHSP17.9-2 genes, which were cloned from chrysanthemum (Chrysanthemum×morifolium 'Jinba') by homologous cloning, had a complete open reading frame of 480 bp each, encoding 159 amino acids. The protein subcellular localization analysis showed that CmHSP17.9-1 and CmHSP17.9-2 were located in the cytoplasm and mostly aggregated in granules, especially around the nucleus. Real-time quantitative PCR (qRT-PCR) analysis showed that the relative expression level of the CmHSP17.9-1 and CmHSP17.9-2 genes was highest in the terminal buds of the chrysanthemum, followed by the leaves. CmHSP17.9-1 and CmHSP17.9-2 overex-pression vectors were constructed and used to transform the chrysanthemum; overexpression of these genes led to the chrysanthemum phenotypes being less affected by high-temperature, and the antioxidant capacity was enhanced. The results showed that chrysanthemum with overex-pression of the CmHSP17.9-1 and CmHSP17.9-2 genes had stronger tolerance than the wild type chrysanthemum after high-temperature treatment or some degree of heat exercise, and overex-pression of the CmHSP17.9-1 gene led to stronger heat resistance than that of the CmHSP17.9-2 gene, providing an important theoretical basis for the subsequent molecular breeding and pro-duction applications of chrysanthemum.

Relationship Extraction (RE) is a central task in information extraction. The use of entity mapping to address complex scenarios with overlapping triples, such as CasRel, is gaining traction, yet faces challenges such as inadequate consideration of sentence continuity, sample imbalance and data noise. This research introduces an entity mapping-based method CasRelBLCF building on CasRel. The main contributions include: A joint decoder for the head entity, utilizing Bi-LSTM and CRF, integration of the Focal Loss function to tackle sample imbalance and a reinforcement learning-based noise reduction method for handling dataset noise. Experiments on relation extraction datasets indicate the superiority of the CasRelBLCF model and the enhancement on model's performance of the noise reduction method.

A linking procedure establishes a "bridge" between the scores from different patient-reported outcome (PRO) instruments that measure similar constructs. After developing a linking relationship however, it is critical to evaluate whether this relationship can be generalized to different groups. Our study aims to validate a published crosswalk for score conversion between the Brief Symptom Inventory Depression subscale and the Patient-Reported Outcomes Measurement Information System Depression 8a using an independent sample. Data were from a sample of young men who have sex with men (MSM), which differs in terms of participant age, race, and ethnicity from the sample used to develop the existing crosswalk. The validity of the newly derived crosswalk was evaluated in terms of the correlation, mean difference and standard deviation between the observed and the linked scores. The two crosswalks were further compared to evaluate if the difference was within an acceptable range. More than half of the item parameters obtained from the two samples were found to overlap in their confidence intervals. Differences between each pair of scores in the two crosswalks was within three T-score points, well within the range of each crosswalk score's standard error. This study concludes that an existing crosswalk is replicable on a sample that differs from that used for crosswalk development, but future research should continue to examine the generalizability of the linked parameters and evaluate the reproducibility of this crosswalk to other populations.

Humans perceive light in the visible spectrum (400-700 nm). Some night vision systems use infrared light that is not perceptible to humans and the images rendered are transposed to a digital display presenting a monochromatic image in the visible spectrum. We sought to develop an imaging algorithm powered by optimized deep learning architectures whereby infrared spectral illumination of a scene could be used to predict a visible spectrum rendering of the scene as if it were perceived by a human with visible spectrum light. This would make it possible to digitally render a visible spectrum scene to humans when they are otherwise in complete "darkness" and only illuminated with infrared light. To achieve this goal, we used a monochromatic camera sensitive to visible and near infrared light to acquire an image dataset of printed images of faces under multispectral illumination spanning standard visible red (604 nm), green (529 nm) and blue (447 nm) as well as infrared wavelengths (718, 777, and 807 nm). We then optimized a convolutional neural network with a U-Net-like architecture to predict visible spectrum images from only near-infrared images. This study serves as a first step towards predicting human visible spectrum scenes from imperceptible near-infrared illumination. Further work can profoundly contribute to a variety of applications including night vision and studies of biological samples sensitive to visible light.

A previous report demonstrated the strong association between the presence of antibodies binding to an epitope region from SARS-CoV-2 nucleocapsid, termed Ep9, and COVID-19 disease severity. Patients with anti-Ep9 antibodies (Abs) had hallmarks of antigenic interference (AIN), including early IgG upregulation and cytokine-associated injury. Thus, the immunological memory of a prior infection was hypothesized to drive formation of suboptimal anti-Ep9 Abs in severe COVID-19 infections. This study identifies a putative primary antigen capable of stimulating production of cross-reactive, anti-Ep9 Abs. Binding assays with patient blood samples directly show cross-reactivity between Abs binding to Ep9 and only one bioinformatics-derived, homologous putative antigen, a sequence derived from the neuraminidase protein of H3N2 influenza A virus. This cross-reactive binding is highly influenza strain specific and sensitive to even single amino acid changes in epitope sequence. The neuraminidase protein is not present in the influenza vaccine, and the anti-Ep9 Abs likely resulted from the widespread influenza infection in 2014. Therefore, AIN from a previous infection could underlie some cases of COVID-19 disease severity.

[This corrects the article DOI: 10.1371/journal.pone.0044899.].

The Chinese government has established definitive goals to reach a "carbon peak" by 2030 and achieve "carbon neutrality" by 2060. Investigating the attainment of these emission reduction objectives while simultaneously fostering regional economic growth and enhancing living standards holds critical importance. This study examines the link between higher education and carbon intensity across China's thirty provincial-level administrative regions, employing fixed effects models on provincial panel data spanning 2001-2020. The findings, validated through robustness tests and a mediation effect model, elucidate the mechanisms by which higher education influences carbon intensity. Notably, the results reveal that enhancing higher education markedly lowers carbon intensity; specifically, a 1% increase in the logarithmic transformation of per capita investment in higher education in a province decreases its carbon intensity by 0.219%. Additionally, higher education's output similarly contributes to reductions in carbon intensity. The influence of higher education on reducing carbon intensity is particularly pronounced in the central and western regions of China. Moreover, higher education facilitates the reduction of carbon intensity through mechanisms such as promoting environmental consciousness, advancing industrial structure, and encouraging technological innovation.

The purpose of this study is to explore nonlinear and threshold effects of traffic statuses and road geometries, as well as their interactions, on traffic accident severity. In contrast to earlier research that primarily defined road alignment qualitatively as straight or curved, flat or slope, this study focused on the design elements of road geometry at accident locations. Additionally, this study considers the traffic conditions on the day of the accident, rather than the average annual traffic data as previous studies have done. To achieve this, we collected road design documents, traffic-related data, and 2023 accident data from the Suining section of the G42 Expressway in China. Using this dataset, we tested the classification performance of four machine learning models, including eXtreme Gradient Boosting, Gradient Boosted Decision Tree, Random Forest, and Light Gradient Boosting Machine. The optimal Random Forest model was employed to identify the key factors infulencing traffic accident severity, and the partial dependence plot was introduced to visualize the relationship between severity and various single and two-factor variables. The results indicate that the percentage of trucks, daily traffic volume, slope length, road grade, curvature, and curve length all exhibit significant nonlinear and threshold effects on accident severity. This reveals sepecific road and traffic features associated with varying levels of accident severity along the highway section examined in this study. The findings of this study will provide data-driven recommendations for highway design and daily safety management to reduce the severity of traffic accidents.

Multiple intersecting situational tasks in the field of aviation often cause air traffic controllers to face issues pertaining to interruption and task switching. To investigate the impact of task interruption on the situation awareness of air traffic controllers, two experiments were conducted. Experiment 1, which focused on 44 new graduates preparing to work in the field of air traffic control, revealed that task interruption reduced the participants' levels of situation awareness. Experiment 2, which focused on 80 new air traffic control graduates, employed a 2 (primary task modality: visual, auditory) × 2 (interruption modality: visual, auditory) between-subjects design and revealed that the negative effect of task interruption on situation awareness was moderated by task modality. Interruptions that occur in the same modality as the primary task were shown to result in greater decreases than were cross modal interruptions. Visual interruption led to a greater decrease in situation awareness than did auditory interruption, and interruption of the visual task also caused a greater decrease in situation awareness than did interruption of the auditory task. These findings might be valuable in attempts to enhance situation awareness among air traffic controllers by providing insights into the design of human‒computer interactions in the context of an air traffic control automation system.

ContextEstrogen receptor α (ERα) is a key regulator of reproductive function, particularly in ovarian development and function, yet the specifics of its role at the molecular level remain unclear.AimsThe study aims to elucidate the molecular mechanisms of ERα-regulated transcriptional dynamics in ovarian cells using ERα knockout (αERKO) mice created via CRISPR/Cas9.MethodsSingle-cell RNA sequencing (scRNA-seq) was used to compare transcriptomes from individual ovarian cells in both wild type and αERKO mice. Bioinformatics analyses identified distinct cell populations and their transcriptional profiles post ERα deletion.Key resultsDistinct oocyte and granulosa cell populations were identified, with ERα deletion disrupting the regulation of genes linked to ovarian infertility, the ovulation cycle, and steroidogenesis. Greb1 expression in granulosa cells was found to be ERα-dependent.ConclusionsERα deletion significantly alters the transcriptional landscape of ovarian cells, affecting genes and pathways central to ovarian function and the ovulation process.ImplicationsThe findings provide an in-depth, single-cell view of ERα's role in the reproductive system, offering insights that may lead to novel treatments for ovarian disorders.

The virtual crop stands as a vital content in crop model research field, and has become an indispensable tool for exploring crop phenotypes. The focal objective of this undertaking is to realize three-dimensional (3D) dynamic visualization simulations of rice individual and rice populations, as well as to predict rice phenotype using virtual rice. Leveraging our laboratory's existing research findings, we have realized 3D dynamic visualizations of rice individual and populations across various growth degree days (GDD) by integrating the synchronization relationship between the above-ground parts and the root system in rice plant. The resulting visualization effects are realistic with better predictive capability for rice morphological changes. We conducted a field experiment in Anhui Province in 2019, and obtained leaf area index data for two distinct rice cultivars at the tiller stage, jointing stage, and flowering stage. A method of segmenting leaf based on the virtual rice model is employed to predict the leaf area index. A comparative analysis between the measured and simulated leaf area index yielded relative errors spanning from 7.58% to 12.69%. Additionally, the root mean square error, the mean absolute error, and the coefficient of determination were calculated as 0.56, 0.55, and 0.86, respectively. All the evaluation criteria indicate a commendable level of accuracy. These advancements provide both technical and modeling support for the development of virtual crops and the prediction of crop phenotypes.

[This corrects the article DOI: 10.1371/journal.pone.0103440.].

Preventing the progression of acute pancreatitis (AP) to severe acute pancreatitis (SAP) is crucial for AP patients. The use of clinical parameters in laboratory facilities for predicting SAP can be rapid, efficient, and cost-effective. This study aimed to investigate the predictive and prognostic value of collected clinical detection parameters, such as serum alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) levels, and their ratios, such as ALP-to-hemoglobin (Hb) and LDH-to-Hb ratios, for the prediction of SAP occurrence, complications, and mortality. In all, 50 healthy controls (CON), 455 patients with mild acute pancreatitis (MAP), 127 patients with moderately severe acute pancreatitis (MSAP), and 93 patients with SAP were included in the study. Thirty clinical parameters were collected, measured, compared, and analyzed. The ratios of ALP/Hb and LDH/Hb were subsequently calculated and evaluated with respect to gender and age and whether they could predict SAP occurrence, complications, and mortality. The results revealed that 15 parameters were significant for the prediction of AP. Furthermore, the following 6 indicators are associated with the occurrence of SAP: ALP, ALP/Hb, LDH, LDH/Hb, CRP, and blood glucose. Among these parameters, the predictive abilities of ALP/Hb and LDH/Hb for SAP were most effective. However, they fail to differentiate between MAP and MSAP or gender in SAP patients. Positive correlations were only observed between the levels of these indicators and age at onset of SAP. In addition, receiver operating characteristic (ROC) curves were generated to predict SAP incidence rates, complications, and mortality. The area under the curve (AUC) values for the ALP/Hb ratio ranged from 0.7097 to 0.7837, whereas those for the LDH/Hb ratio ranged from 0.5043 to 0.7778. These findings suggest that ALP and LDH alone or in combination with Hb possess unique predictive characteristics that may serve as independent factors for predicting SAP occurrence, complications, and mortality; of these, the ALP/Hb ratio is especially predictive of SAP mortality.

AimTo systematically appraise, compare, and summarize the measurement properties of intimate partner violence screening instruments for the general population and provide recommendations.MethodsWe searched PubMed, Embase, Web of Science, ProQuest Dissertations & Theses Global and EBSCO Psychology Behavioral Sciences Collection from their establishment to March 2024 using systematic search strategies. The methodological quality of the instruments that met the inclusion criteria and their measurement properties were assessed using the COSMIN methodology, and the COSMIN recommendations were followed. We reported this study using PRISMA 2020 checklist.ResultsA total of 23 studies were eventually included, and 18 instruments were identified. The evaluation of the methodological quality indicates poor content validity but good structural validity; however, that of the criterion validity in most of the studies was inadequate. Measurement error and responsiveness were not assessed. Four screening instruments could be used in the interim. The remaining 14 instruments were not recommended for use.ConclusionsThe overall methodological quality of most of the assessed instruments was insufficient. A rigorous intimate partner violence screening instrument with good measurement properties is urgently required to identify and screen for intimate partner violence in the general population.Prospero numberCRD42022365247.

BackgroundPoor sleep quality is increasingly considered to be an underlying cause of cerebrovascular diseases. This is a slowly progressing condition that gradually leads to vascular cognitive impairment and stroke during ageing. At present, randomized clinical trials examining the non-pharmacological therapies in the management of this comorbidity are very limited. Transcranial current stimulation (tCS) is a non-invasive technology for promoting cognitive function and treating brain disorders. As advanced modalities of tCS, transcranial random noise stimulation (tRNS) and transcranial alternating current stimulation (tACS), could deliver frequency-specific waveforms of currents that can modulate brain activities in a more specific manner.Methods and designChinese individuals between the ages of 60 and 90 years, who are right-handed and have mild vascular cognitive impairment (VCI) with sleep disturbances, will participate in a randomized study. They will undergo a 2-week intervention period where they will be randomly assigned to one of three groups: high-frequency (hf)-tRNS, 40 Hz tACS, or sham tCS. Each group will consist of 15 participants. Before the intervention, high-resolution magnetic resonance imaging (MRI) data will be used to create a computational head model for each participant. This will help identify the treatment target of left inferior parietal lobe (IPL). Throughout the study, comprehensive assessments will be conducted at multiple time points, including baseline, 2nd week, 6th week, and 12th week. These assessments will evaluate various factors such as sleep quality, domain-specific cognitive performance, and actigraphic records. In addition, the participants' adherence to the program and any potential adverse effects will be closely monitored throughout the duration of the intervention.ConclusionsThe primary objective of this study is to examine the safety, feasibility, and effectiveness of hf-tRNS and 40 Hz tACS interventions targeting left IPL in individuals with mild vascular cognitive impairment (VCI) who experience sleep disturbances and cognitive dysfunction. Additionally, the study seeks to evaluate the program's adherence, tolerability, and any potential adverse effects associated with frequency-specific transcranial current stimulation (tCS). The findings from this research will contribute to a deeper understanding of the intricate relationship between oscillation, sleep, and cognition. Furthermore, the results will provide valuable insights to guide future investigations in the field of sleep medicine and neurodegenerative diseases.Trial registrationClinicalTrials.gov Identifier: NCT06169254.

BackgroundAging is the primary risk factor for sarcopenia and mobility limitations. Exercise reduces these risks, but older adults have low levels of participation in physical activity and exercise. We investigated the preliminary effectiveness of a live, online exercise program on community-dwelling older adults' physical activity levels.MethodsA mixed-method pilot randomized controlled trial was conducted according to CONSORT 2010 statement: extension for pilot and feasibility trials. Sedentary older adults (65-80 years) were randomly assigned to the online exercise intervention (ACTIVE) or a waitlist control (CON) group. Outcomes were measured pre-randomization and following the 8-week intervention for ACTIVE and CON and two months following the end of the intervention for the ACTIVE group. Outcomes included habitual physical activity levels, depression, anxiety, loneliness, life-space mobility, nutrition risk, and feasibility. All participants were invited to participate post-intervention in individual semi-structured qualitative interviews. Reporting of the qualitative research followed the checklist for the Consolidated Criteria for Reporting research.ResultsSeventeen older adults (71% women) were allocated to ACTIVE group, while 15 were allocated to CON group (87% women). Following the intervention, participants in the ACTIVE group reported reduced symptoms of depression (ACTIVE: pre = 4.2 ± 2.5; post = 2.2 ± 1.9; CON: pre = 3.5 ± 2.1, post = 3.5 ± 2.1; p ConclusionsOur online exercise program was acceptable to older adults, had good adherence, reduced depression, and increased life space. Participants reported improved functional and mental health benefits. Further research is warranted to expand on these findings.Trial registrationNCT04627493; 13/11/2020.

The floor plan layout of museum exhibition spaces is the skeleton network of the museum, which determines the internal circulation and spatial form of the museum. This paper studies the method and practice of using artificial intelligence technology to assist in the space design of exhibition halls in urban cultural museums. First, it introduces the limitations of traditional space design methods for exhibition halls in urban cultural museums and the superiority and application prospects of the CGAN (conditional generative adversarial network) model in space design. Second, the principle and training process of the CGAN model are explained in detail, and the experimental results and analysis are given. By learning 100 floor plans of exhibition halls of urban culture museums, the CGAN model can generate a new floor plan design for an exhibition hall, which provides a new idea and innovative method for this design task. Finally, the limitations and future research directions of the CGAN model in the space design of urban cultural museum exhibition halls are discussed. The study shows that using the CGAN model to learn the floor plans of exhibition halls of urban cultural museums can effectively improve the innovation and practicability of space design and has the following advantages: (1) It can quickly generate a large number of exhibition hall floor plans, shorten the design cycle, and improve design efficiency. (2) The generated floor plan designs of the exhibition hall are diverse and personalized, meeting the design requirements of different scenarios and needs. (3) The method promotes the deep integration of space design and artificial intelligence technology and provides new possibilities and ideas for space design. These conclusions provide new ideas and methods for the space design of exhibition halls of urban cultural museums and provide a reference and inspiration for space design and intelligent applications in other fields, such as office space design, home decoration space design, landscape space design, and historical arcade and building renovation design.

BackgroundStates are key actors in global health governance, particularly in the prevention and control of infectious diseases. The emergence and re-emergence of infectious diseases in recent decades pose profound challenges to global health security. As the first coronavirus pandemic, the COVID-19 caused significant damage worldwide, but responses and outcomes varied greatly among states. Using COVID-19 as an example, this study aims to compare the policies and measures implemented by different states during the COVID-19 pandemic and to synthesize experiences to strengthen global health governance for future infectious disease crises.MethodsWe used Arksey and O'Malley's five-stage scoping review framework and PRISMA methodology was used for literature search and decision on relevant studies. English databases were searched using combinations of keywords and articles examining COVID-19 prevention and control policies in representative countries were included. A comparative analysis across these four states (United States, Sweden, India, and Nigeria) was then conducted to analyse the differences, rationale, and challenges of the approaches taken by these states.ResultsA total of 36 studies were included in the analysis. The management of the COVID-19 by states is divided into two main categories: domestic governance and international governance. Domestically, the United States and India have taken more measures, yet notable disparities in infection source control, transmission interruption, vulnerable population protection, collaborative governance, and so on were observed among all four states. Globally, the United States and Sweden were more proactive in international governance, and all four states have variations in their adherence to global regulations, information sharing, resource distribution, and cooperative engagement.ConclusionsSignificant disparities occurred during the response to early COVID-19 in four states, which may be due to differences in politics, economy, and culture. To prevent and mitigate the impact of infectious diseases, states should, in future, prioritize solidarity and cooperation, and improve governance domestically and internationally based on national contexts and global health principles.

There are currently no studies exploring omicron infection and male sexual function and semen quality. Our aim was to estimate changes in sexual function and semen quality in men recovering from infection since the COVID-19 Omicron pandemic started in China in late 2022. We collected 1540 questionnaires and assessed male function before infection and acute phase after infection by using International Index of Erectile Function-5, Premature Ejaculation Diagnostic Tool, and Arizona Sexual Experience Scale. We also collected the before and after semen analysis results of 247 male patients. During the acute phase after infection, the proportion of erectile dysfunction was significantly higher than before infection, but ejaculatory function was not significantly altered; In addition, semen analysis showed significant difference in semen concentration, semen activity and PR a+b sperm forward movement after infection compared to pre-infection.: COVID-19 Omicron can affect erectile function as well as sexual experience in male patients in the acute phase. Decreased sexual function due to COVID-19 Omicron may be related to body temperature and anxiety during infection.

HypothesisThe objective of this study is to evaluate the predictive ability of the TyG index for the presence of adenoma and multiple adenomas in an asymptomatic population.DesignA secondary analysis was conducted on a prospective cohort of asymptomatic subjects aged between 50 and 75 who underwent CRC screening. Fasting blood glucose (FBG) and lipid profiles were measured within three months prior colonoscopy. TyG index was estimated as ln [fasting triglycerides (mg/dL) × FBG (mg/dL)/2]. Multivariate logistic regression was performed to assess the association between the TyG index and the risk of adenoma. Its association with multiple adenomas (≥5) and the continuous number of adenomas were assessed by multinomial regression and log-normal linear regression, respectively.ResultsA total of 1,538 subjects were recruited among which 876 subjects (57%) had at least one adenoma detected. Elevated TyG index was positively associated with the incidence of adenoma (adjusted odds ratio [aOR]: 1.26, 95% confidence interval [CI]: 1.04-1.54). Compared with the lowest TyG index (≤ 8) group, the risk of adenoma was the highest among subjects in the highest TyG index (> 10) group (aOR: 3.36, 95% CI: 1.44-7.73). As compared to the non-adenoma group, the TyG index was also positively associated with multiple adenomas (aOR: 1.74, 95% CI: 1.17-2.57), and the estimate was also the highest in the highest TyG group (aOR: 14.49, 95% CI: 3.12-67.20). As for the number of adenomas, the positive association was maintained (Estimates: 1.06, 95% CI: 1.01-1.12) while the number of adenomas increase the most in the highest TyG index group (Estimates: 1.35, 95% CI: 1.10-1.65).ConclusionsElevated TyG index is associated with an increased risk of colorectal adenoma and an increased number of adenomas for asymptomatic subjects aged ≥50.Trial registrationThis study was registered on clinicaltrials.gov (NCT03597204 and NCT04034953).

The lack of obvious difference between germinated seeds and non-germinated seeds will cause the low accuracy of detecting rice seed germination rate, remains a challenging issue in the field. In view of this, a new model named Rice Seed Germination-YOLOV8 (RSG-YOLOV8) is proposed in this paper. This model initially incorporates CSPDenseNet to streamline computational processes while preserving accuracy. Furthermore, the BRA, a dynamic and sparse attention mechanism is integrated to highlight critical features while minimizing redundancy. The third advancement is the employment of a structured feature fusion network, based on GFPN, aiming to reconfigure the original Neck component of YOLOv8, thus enabling efficient feature fusion across varying levels. An additional detection head is introduced, improving detection performance through the integration of variable anchor box scales and the optimization of regression losses. This paper also explores the influence of various attention mechanisms, feature fusion techniques, and detection head architectures on the precision of rice seed germination rate detection. Experimental results indicate that RSG-YOLOV8 achieves a mAP50 of 0.981, marking a 4% enhancement over the mAP50 of YOLOv8 and setting a new benchmark on the RiceSeedGermination dataset for the detection of rice seed germination rate.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes Coronavirus Disease 2019 (COVID-19), which can result in severe disease, often characterised by a 'cytokine storm' and the associated acute respiratory distress syndrome. However, many infections with SARS-CoV-2 are mild or asymptomatic throughout the course of infection. Although blood biomarkers of severe disease are well studied, less well understood are the inflammatory signatures in lung tissues associated with mild disease or silent infections, wherein infection and inflammation are rapidly resolved leading to sequelae-free recovery. Herein we described RNA-Seq and histological analyses of lungs over time in an omicron BA.1/K18-hACE2 mouse infection model, which displays these latter features. Although robust infection was evident at 2 days post infection (dpi), viral RNA was largely cleared by 10 dpi. Acute inflammatory signatures showed a slightly different pattern of cytokine signatures compared with severe infection models, and where much diminished 30 dpi and absent by 66 dpi. Cellular deconvolution identified significantly increased abundance scores for a number of anti-inflammatory pro-resolution cell types at 5/10 dpi. These included type II innate lymphoid cells, T regulatory cells, and interstitial macrophages. Genes whose expression trended downwards over 2-66 dpi included biomarkers of severe disease and were associated with 'cytokine storm' pathways. Genes whose expression trended upward during this period were associated with recovery of ciliated cells, AT2 to AT1 transition, reticular fibroblasts and innate lymphoid cells, indicating a return to homeostasis. Very few differentially expressed host genes were identified at 66 dpi, suggesting near complete recovery. The parallels between mild or subclinical infections in humans and those observed in this BA.1/K18-hACE2 mouse model are discussed with reference to the concept of "protective inflammation".

ObjectiveTo explore the medical significance of methylated septin9 (mSEPT9) in monitoring recurrence and prognostic assessment in individuals with surgically treated colorectal cancer (CRC).MethodsTo investigate the role of Septin9 in colorectal cancer, we utilized the TIMER2.0 database to analyze its differential expression between tumor tissues and adjacent normal tissues. Colorectal cancer RNA-seq data from the TCGA database was downloaded and curated. The clinical relevance of mSEPT9 in colorectal cancer was explored by examining the correlation between Septin9 methylation levels and clinical characteristics using UALCAN and MethSurv software. Peripheral blood samples were obtained from 130 CRC subjects who underwent surgery for the detection of mSEPT9 and carcinoembryonic antigen (CEA) expression, along with collection of clinicopathological data such as age, gender, tumor site, TNM stage, and tumor differentiation. Patients were followed up for at least 3 years post-surgery until the death or final follow-up dates (31/12/2022). Additionally, peripheral blood samples were collected from 30 colorectal cancer surgery patients for mSEPT9 detection before and 7 days after surgery.ResultsThrough bioinformatic database analysis, we identified higher expression levels of SEPT9 mRNA in most tumor tissues compared to normal tissues. Similarly, both paired and unpaired CRC tissues exhibited elevated expression of Septin9 when compared to normal tissues. Following GO and KEGG analysis of Septin9 target genes, we discovered their significant associations with ncRNA metabolic processes, ribonucleoprotein complex biogenesis, spliceosomes, and viral carcinogenesis. Furthermore, the overexpression of mSeptin9 was observed in CRC tissues, and it demonstrated a correlation with colon cancer staging and histologic classification. In our clinical sample study, The positive rate of mSEPT9 in CRC patients 7 days after surgery was 43.44% lower than that of preoperative. The differences in TNM stage, tumor differentiation degree, and preoperative CEA expression level between the preoperative mSEPT9 positive and negative groups of CRC were statistically significant (P < 0.05). Recurrence free survival (RFS) and overall survival (OS) were shorter in the preoperative mSEPT9-positive group, meaning preoperative mSEPT9 status was a risk factor for CRC recurrence and prognosis (P < 0.05). The sensitivity, specificity, and AUC value of preoperative mSEPT9 and CEA levels for predicting postoperative recurrence in CRC patients were 88% vs. 72%, 56.19% vs. 55.24%, and 0.721 vs. 0.636 respectively, well the AUC value of the combined prediction of postoperative recurrence was 0.758.ConclusionThe detection of mSEPT9 combined with CEA in preoperative plasma helps predict recurrence in colorectal cancer patients.

To address the conflict between pressure relief and support effectiveness caused by large-diameter boreholes in roadway surrounding rock, this paper proposes a method involving variable-diameter boreholes for pressure relief and energy dissipation. With a typical rock burst coal mine as the engineering context, the study establishes a mechanical model for variable-diameter boreholes through theoretical analysis to examine the elastic stress distribution around boreholes within the coal body. Physical similarity simulation tests are conducted to investigate the influence of conventional borehole and variable diameter borehole on the transmission pattern of dynamic load stress waves. Furthermore, numerical simulations are employed to explore the effects of reaming diameter, depth, and spacing on pressure relief, energy dissipation, and attenuation of dynamic stress wave transmission in roadway surrounding rock. The results demonstrate that stress within the coal surrounding the variable-diameter borehole correlates with the borehole radius, lateral pressure coefficient, and distance from the point to the borehole center, the extent of the plastic zone is influenced by borehole diameter, spacing, and depth. Increased diameter, reduced spacing, and greater depth of deep reaming holes exacerbate the transfer of stress concentration from the surrounding rock of the roadway to the deeper regions, facilitating the formation of stress double peak areas. Moreover, the variable diameter position should be within the original stress peak position of the surrounding rock in the roadway, with deep reaming passing through the stress concentration area for optimal results. This study offers guidance on the prevention and control technology for rock bursts in deep coal mining operations.

This study aimed to evaluate the effectiveness of Exergaming in improving executive function and motor ability across different groups of children and adolescents. We searched several databases, including PsycINFO, Web of Science, Embase, PubMed, SPORT Discus, Scopus, and the Cochrane Central Register of Controlled Trials, for randomized controlled trial (RCT) studies published from inception until November 25, 2023, to identify studies investigating the effect of Exergaming on motor and executive function in children. The protocol was registered with PROSPERO (CRD42023482281). A total of 37 randomized controlled trials were included in this study. Our results indicate that Exergaming can influence children's cognitive flexibility [SMD = 0.34, 95%CI(0.13,0.55), I2 = 0.0%, P = 0.738], inhibition control [SMD = 0.51, 95%CI (0.30,0.72), I2 = 0.0%, P = 0.473], global cognitive [SMD = 0.87, 95%CI (0.50,1.23), I2 = 0.0%, P = 0.974], working memory [SMD = 0.18, 95%CI(-0.16, 0.52), I2 = 46.5%, P = 0.096], gross motor skills [SMD = 0.82, 95%CI (0.30, 1.35), I2 = 79.1%, P

As an important part of terrestrial carbon cycle research, net primary productivity is an important parameter to evaluate the quality of terrestrial ecosystem and plays an important role in the analysis of global climate change and carbon balance. Anhui Province is in the Yangtze River Delta region in eastern China. Based on the theoretical basis of CASA model, this paper uses MODIS NDVI, vegetation type data, meteorological data, and LUCC to estimate the NPP of Anhui Province during 2001-2020 and analyzes its spatial-temporal pattern. The results showed that the average NPP in Anhui province was 508.95 gC· (m2 ·a) -1, and the spatial heterogeneity of NPP was strong, and the high value areas were mainly distributed in the Jiangnan Mountains and Dabie Mountains. NPP increased in most areas of Anhui Province, but decreased significantly in 17.60% of the area, mainly in the central area affected by urban and rural expansion and the transformation of the Yangtze River. The dynamic change of NPP in Anhui province is the result of climate change and land use change. Meteorological data are positively correlated with NPP. Among them, the correlation between temperature and solar radiation is higher, and the correlation between NPP and precipitation is the lowest among the three. The NPP of all land cover types was more affected by temperature than precipitation, especially forest land and grassland. The decrease of cultivated land and the increase of Artificial Surfaces (AS) may have contributed to the decrease of NPP in Anhui Province. Human activities have weakened the increase in NPP caused by climate change. In conclusion, this study refined the drivers of spatial heterogeneity of NPP changes in Anhui province, which is conducive to rational planning of terrestrial ecosystems and carbon balance measures.

This cross-sectional study investigated the association between participation in traditional sports and esports performance, analyzing data from 1,549 survey respondents, with a specific focus on 617 individuals assessed for their esports capabilities. The analysis suggests that participation in traditional sports is associated with enhanced performance in first-person shooters. However, no similar association was observed in multiplayer online battle arena games across various platforms. Furthermore, although no substantial link was found between overall gameplay duration and esports performance for the majority of the games examined, time spent playing Honor of Kings was significantly associated with improved in-game rankings, likely due to its unique matchmaking and rating system. The findings also indicate that participants from different categories of traditional sports show no significant differences in esports performance, suggesting similar physical and athletic requirements across these sports. This underscores the necessity for further exploration and methodological refinement to investigate the associations between specific types of physical exercise and enhancements in esports performance. Additionally, esports participants demonstrated higher levels of engagement in traditional sports compared to their non-esports counterparts, suggesting potential reciprocal benefits between esports and physical exercise. Future research should further investigate these mutual advantages. Conducting additional rigorous empirical research to substantiate these associations is essential for the sustainable development of esports.

During maturation oocytes at the germinal vesicle (GV) stage progress to metaphase II (MII). However, during in vitro maturation a proportion often fail to progress. To understand these processes, we employed RNA sequencing to examine the transcriptome profile of these three groups of oocytes from the pig. We compared our findings with similar public oocyte data from humans. The transcriptomes in oocytes that failed to progress was similar to those that did. We found in both species, the most upregulated genes in MII oocytes were associated with chromosome segregation and cell cycle processes, while the most down regulated genes were relevant to ribosomal and mitochondrial pathways. Moreover, those genes involved in chromosome segregation during GV to MII transition were conserved in pig and human. We also compared MII and GV oocyte transcriptomes at the isoform transcript level in both species. Several thousands of genes (including DTNBP1, MAPK1, RAB35, GOLGA7, ATP1A1 and ATP2B1) identified as not different in expression at a gene transcript level were found to have differences in isoform transcript levels. Many of these genes were involved in ATPase-dependent or GTPase-dependent intracellular transport in pig and human, respectively. In conclusion, our study suggests the failure to progress to MII in vitro may not be regulated at the level of the genome and that many genes are differentially regulated at the isoform level, particular those involved ATPase- or GTPase-dependent intracellular transport.

Fluctuations in the financial market are influenced by various driving forces and numerous factors. Traditional financial research aims to identify the factors influencing stock prices, and existing works construct a common neural network learning framework that learns temporal dependency using a fixed time window of historical information, such as RNN and LSTM models. However, these models only consider the short-term and point-to-point relationships within stock series. The financial market is a complex and dynamic system with many unobservable temporal patterns. Therefore, we propose an adaptive period-aggregation model called the Latent Period-Aggregated Stock Transformer (LPAST). The model integrates a variational autoencoder (VAE) with a period-to-period attention mechanism for multistep prediction in the financial time series. Additionally, we introduce a self-correlation learning method and routing mechanism to handle complex multi-period aggregations and information distribution. Main contributions include proposing a novel period-aggregation representation scheme, introducing a new attention mechanism, and validating the model's superiority in long-horizon prediction tasks. The LPAST model demonstrates its potential and effectiveness in financial market prediction, highlighting its relevance in financial research and predictive analytics.

BackgroundThe significance of problem-solving ability has been confirmed in numerous studies worldwide, highlighting its role in enhancing the skills of nursing interns and reducing psychological pressure. However, existing research indicates that the problem-solving ability of nursing interns urgently needs to be further improved. Limited research has been conducted on the problem-solving ability of nursing interns, and the correlations among problem-solving ability, future time perspective, and future work self of Chinese nursing interns are unclear.ObjectivesTo investigate problem-solving ability, future time perspective, and future work self among the Chinese nursing interns, and to examine the relationships among these variables. Additionally, the study aims to explore the mediating role of future work self between problem-solving ability and future time perspective.MethodsA cross-sectional and correlational design was employed, adhering to the quality reporting conformed to the STROBE Checklist. From May 8, 2023, to February 15, 2024, 1,251 nursing interns were recruited from 15 tertiary grade-A hospitals across six cities in China. The Demographic Characteristics Questionnaire, Social Problem-Solving Inventory, Future Time Perspective Inventory, and Future Work Self Scale were used. The data was analyzed using descriptive statistics, univariate, correlation, and process plug-in mediation effect analyses.ResultsThe total scores for problem-solving ability, future time perspective, and future work self were 64.39 ± 18.55, 45.08 ± 11.37, and 16.92 ± 5.28, respectively. Problem-solving ability was positively correlated with future time perspective (r = 0.638, p < 0.001) and future work self (r = 0.625, p < 0.001). Additionally, future work self partially mediated mediating role between problem-solving ability and future time perspective, accounting for 39.7% of the total effect.ConclusionThe problem-solving ability, future time perspective, and future work self among the Chinese nursing interns were relatively moderate, indicating a need for improvement. It is suggested that nursing managers and educators should actively implement career management and planning programs. By enhancing the future time perspective and future work self of nursing interns, their problem-solving ability can be improved. This, in turn, will facilitate their adaptation to clinical work, enhance the quality of nursing care, and promote the development of their nursing profession.

In the digital era, digital economy has a far-reaching impact on the collaborative agglomeration of manufacturing and service industries. This research aims to examine the economic relationship between digital economy and industrial collaborative agglomeration. Based on a panel data set of 286 Chinese cities, this research employs Tobit model, moderating effect model, and mediating effect model to conduct data analysis. It is found that digital economy has a nonlinear relationship with industrial collaborative agglomeration, and this relationship is a U-shape. Moderating effect analysis reveals that government intervention significantly regulates the role of digital economy in industrial collaborative agglomeration. Mediating effect analysis indicates that digital economy promotes industrial collaborative agglomeration through entrepreneurial activity. Heterogeneity analysis shows that the facilitating effect of digital economy on collaborative agglomeration in high-end industries comes earlier than in middle- and low-end industries. Moreover, this research finds that digital economy plays a significant role in industrial collaborative agglomeration in central and western regions of China but not in the eastern region. To enhance the impact of digital economy on industrial collaborative agglomeration, it is crucial to strengthen the engagement of the government and ensure the availability of digital technology.

Continuous adductor canal block (CACB) is almost a pure sensory nerve block and can provide effective analgesia without blocking the motor branch of the femoral nerve. Thus, the objective of this study was to systematically evaluate the efficacy of CACB versus continuous femoral nerve block (CFNB) on analgesia and functional activities in patients undergoing knee arthroplasty. PubMed, Embase and the Cochrane Central Register of Controlled Trials (from inception to 3 October 2023) were searched for randomized controlled trials (RCTs) that compared CACB with CFNB in patients undergoing knee arthroplasty. Registration in the PROSPERO International prospective register of the meta-analysis was completed, prior to initiation of the study (registration number: CRD42022363756). Two independent reviewers selected the studies, extracted data and evaluated risk of bias by quality assessment. Revman 5.4 software was used for meta-analysis and the summary effect measure were calculated by mean differences and 95% confidence intervals. Eleven studies with a total of 748 patients were finally included. Pooled analysis suggested that both CACB and CFNB showed the same degree of pain relief at rest and at motion at 12 h, 24 h and 48 h in patients undergoing knee arthroplasty. Compared with CFNB, CACB preserved the quadriceps muscle strength better (P

In the analysis of electroencephalography (EEG), entropy can be used to quantify the rate of generation of new information. Entropy has long been known to suffer from variance that arises from its calculation. From a sensor's perspective, calculation of entropy from a period of EEG recording can be treated as physical measurement, which suffers from measurement noise. We showed the feasibility of using Kalman filtering to reduce the variance of entropy for simulated signals as well as real-world EEG recordings. In addition, we also manifested that Kalman filtering was less time-consuming than moving average, and had better performance than moving average and exponentially weighted moving average. In conclusion, we have treated entropy as a physical measure and successfully applied the conventional Kalman filtering with fixed hyperparameters. Kalman filtering is expected to be used to reduce measurement noise when continuous entropy estimation (for example anaesthesia monitoring) is essential with high accuracy and low time-consumption.

ObjectivesParents of children diagnosed with severe-to-profound sensorineural hearing loss may experience a range of emotions owing to a lack of knowledge and experience in dealing with such children. However, most audiology clinics only attend to children with deaf and hard of hearing (DHH) and not their parents. Thus, parents' emotional and support needs are frequently excluded from the intervention sessions, making their own needs invisible. This study aimed to identify academic and clinical instruments used for assessing parental emotional status (PES) and ecological support systems (ESS) in early intervention and determine the factors affecting PES and ESS among parents of DHH children undergoing cochlear implantation.Materials and methodsThis scoping review followed the rigorous methodological framework; searched Medline (via OVID and EMBSCO), Scopus, and Web of Science; and selected studies relevant to validated instruments used to evaluate the PES and ESS among parents of DHH children below 6 years old. Before selecting and reviewing relevant articles, two reviewers independently assessed article titles and abstracts from the data sources. Two reviewers verified half of the first reviewer's extracted data.ResultsOverall, 3060 articles were retrieved from the database search, and 139 were selected for full-text review following title and abstract reviews. Ultimately, this study included 22 articles. Among them, 23 and 12 validated instruments, most of which are generic measures, were used for assessing PES and ESS, respectively. Three condition-specific instruments were identified and designed to be administered following cochlear implantation surgery.ConclusionsThis study revealed that healthcare professionals who interact with parents of DHH children lack the necessary instruments, particularly for parents of children undergoing cochlear implantation surgery. Therefore, it is necessary to develop condition-specific instruments for parents who consider cochlear implantation for their children.

ObjectiveTo evaluate the efficacy and safety of upadacitinib in the treatment of moderate-to-severe atopic dermatitis (AD), and provide reference for rational clinical medication.MethodsPubMed, Medline, Embase, Web of Science, Clinical Trials Website, and Cochrane Library databases were searched from the time of establishment until January 6, 2024, to compile a list of all randomized controlled trials (RCTs) including upadacitinib in the treatment of moderate-to-severe AD. The quality of the included studies was evaluated using the Cochrane Systematic Review. Review Manager 5.3 software was utilized for statistical analysis of outcome measures.ResultsA total of five studies were included in the meta-analysis. The results revealed that the 15 mg and 30 mg upadacitinib significantly improved Eczema Area and Severity Index (EASI) 75% {[Odds Ratio (OR) = 8.58, 95% confidence interval (CI) (5.84-12.60), P < 0.00001] [OR = 15.62, 95% CI (10.89-22.42), P < 0.00001]}, Numerical Rating Scale (NRS) ≥ 4 {[OR = 7.13, 95% CI (5.63-9.01), P < 0.00001] [OR = 11.30, 95% CI (8.93-14.31), P < 0.00001]}, and Investigator's Global Assessment (IGA) 0/1 {[OR = 8.63, 95% CI (6.60-11.27), P < 0.00001] [OR = 16.04, 95% CI (12.26-20.99), P < 0.00001]} compared to placebo. In terms of safety, although 15 mg and 30 mg upadacitinib significantly increased the overall adverse events rate compared to placebo {[OR = 1.31, 95% CI (1.09-1.58), P = 0.004] [OR = 1.85, 95% CI (1.54-2.21), P < 0.00001]}, there was no significant difference in the serious adverse events rate {[OR = 0.73, 95% CI (0.41-1.29), P = 0.28] [OR = 0.69, 95% CI (0.39-1.23), P = 0.21]} and withdrawal rate due to adverse events {[OR = 0.66, 95% CI (0.39-1.11), P = 0.12] [OR = 0.85, 95% CI (0.52-1.38), P = 0.50]} compared to placebo.ConclusionThis meta-analysis preliminarily suggests that upadacitinib is effective and safe for usage in the treatment of moderate-to-severe AD. Additionally, upadacitinib can instantly relieve itchiness and effectively reduce symptoms and signs, with its 30-mg dose being more effective than the 15-mg dose.

BackgroundThere is a paucity of evidence regarding the definition of the quality of primary health care (PHC) in China. This study aims to evaluate the PHC quality for chronic diseases in rural areas based on a modified conceptual framework tailored to the context of rural China.MethodsThis comprehensive study, involving a patient survey, a provider survey and chart abstraction, and second-hand registered data, was set in three low-resource counties in rural China from 2021 to 2022. Rural patients with hypertension or type 2 diabetes, and health care workers providing care on hypertension or diabetes were involved. The modified PHC quality framework encompasses three core domains: a competent PHC system (comprehensiveness, accessibility, continuity, and coordination), effective clinical care (assessment, diagnosis, treatment, disease management, and provider competence), and positive user experience (information sharing, shared decision-making, respect for patient's preferences, and family-centeredness). Standardized PHC quality score was generated by arithmetic means or Rasch models of Item Response Theory.ResultsThis study included 1355 patients, 333 health care providers and 2203 medical records. Ranging from 0 (the worst) to 1 (the best), the average quality score for the PHC system was 0.718, with 0.887 for comprehensiveness, 0.781 for accessibility, 0.489 for continuity, and 0.714 for coordination. For clinical care, average quality was 0.773 for disease assessment, 0.768 for diagnosis, 0.677 for treatment, 0.777 for disease management, and 0.314 for provider competence. The average quality for user experience was 0.727, with 0.933 for information sharing, 0.657 for shared decision-making, 0.936 for respect for patients' preferences, and 0.382 for family-centeredness. The differences in quality among population subgroups, although statistically significant, were small.ConclusionThe PHC quality in rural China has shown strengths and limitations. We identified large gaps in continuity of care, treatment, provider competence, family-centeredness, and shared decision-making. Policymakers should invest more effort in addressing these gaps to improve PHC quality.

The purple nonsulfur bacteria, Rhodospirillum rubrum, is recognized as a potential strain for PHAs bioindustrial processes since they can assimilate a broad range of carbon sources, such as syngas, to allow reduction of the production costs. In this study, we comparatively analyzed the biomass and PHA formation behaviors of R. rubrum under 100% CO and 50% CO gas atmosphere and found that pure CO promoted the PHA synthesis (PHA content up to 23.3% of the CDW). Hydrogen addition facilitated the uptake and utilization rates of CO and elevated 3-HV monomers content (molar proportion of 3-HV up to 9.2% in the presence of 50% H2). To elucidate the genetic events culminating in the CO assimilation process, we performed whole transcriptome analysis of R. rubrum grown under 100% CO or 50% CO using RNA sequencing. Transcriptomic analysis indicated different CO2 assimilation strategy was triggered by the presence of H2, where the CBB played a minor role. An increase in BCAA biosynthesis related gene abundance was observed under 50% CO condition. Furthermore, we detected the α-ketoglutarate (αKG) synthase, converting fumarate to αKG linked to the αKG-derived amino acids synthesis, and series of threonine-dependent isoleucine synthesis enzymes were significantly induced. Collectively, our results suggested that those amino acid synthesis pathways represented a key way for carbon assimilation and redox potential maintenance by R. rubrum growth under syngas condition, which could partly replace the PHA production and affect its monomer composition in copolymers. Finally, a fed-batch fermentation of the R. rubrum in a 3-l bioreactor was carried out and proved H2 addition indeed increased the PHA accumulation rate, yielding 20% ww-1 PHA production within six days.

ObjectiveAcute myocardial infarction (AMI) is a severe condition with high morbidity and mortality rates. This study aimed to identify hub genes potentially associated with AMI and assess their clinical utility in predicting AMI occurrence.MethodsGene microarray data were obtained from the Gene Expression Omnibus (GEO) database. Differential expression analysis and weighted gene co-expression network analysis (WGCNA) were conducted on samples from patients with AMI and control samples to identify modules significantly associated with AMI. GO and KEGG analyses were applied to investigate the potential functions of these hub genes. Lastly, the mendelian randomization (MR) method was applied to analyze the causal relationship between the hub gene TNF and AMI.Results285 differentially expressed genes (DEGs) were identified through WCGNA and were clustered into 6 modules. The yellow module appeared most relevant to AMI. Further exploration through GO and KEGG pathway enrichment showed that key hub genes in the yellow module were linked to positive regulation of cytokine production, cytokine receptor binding, NF-kappa B signaling pathway, IL-17 signaling pathway, and TNF signaling pathway. The top 10 genes identified through Cytoscape software analysis were IL1B, TNF, TLR4, TLR2, FCGR3B, MMP9, CXCL8, TLR8, ICAM1, and JUK. Utilizing inverse variance weighting (IVW) analysis, we discovered a significant association between TNF and AMI risk, with an OR of 0.946 (95% CI = 0.911-0.984, p = 0.005).ConclusionsThe result of this study indicated that TNF, TLR2, TLR4, IL1B and FCGR3B may be potential biodiagnostic markers for AMI. TNF can inhibit inflammatory and oxidative stress responses in AMI, exerting a protective role in the heart.

BackgroundThrombosis with thrombocytopenia syndrome (TTS) is a very rare prothrombotic disorder that is a safety concern for some COVID-19 vaccines. We aimed to devise a case definition to estimate the incidence of thrombosis with thrombocytopenia as a proxy for TTS in a national insurance claims database.MethodsWe conducted a retrospective observational study using the National Health Insurance Research Database (NHIRD) in Taiwan over the three-year period prior to the SARS-COV-2 pandemic (2017-2019). Our case definition was all patients with newly diagnosed thrombosis co-occurring with a diagnosis of thrombocytopenia within seven days before or after the thrombosis diagnosis. Cases were identified using International Classification of Disease-10 codes.FindingsWe identified 2010 patients with newly diagnosed thrombosis co-occurring with thrombocytopenia during the study period. The mean age was 64.71 years; female:male ratio 1:1.45. The most frequent thrombotic events were coronary artery disease (18.81%), cerebral infarction (16.87%), and disseminated intravascular coagulation (13.13%). Cerebral venous sinus thrombosis was rare (InterpretationWe observed that the demographic and clinical characteristics of thrombosis with co-occurring thrombocytopenia using our case definition is different from that of TTS. Further research is needed to refine the case definition of TTS in the post-COVID-19 vaccination period.

BackgroundAlthough clear cell sarcoma of kidney (CCSK) is rare, it is the second most common renal tumor in children after Wilms' tumor. NWTS and SIOP are two major groups which had made tremendous efforts on renal tumors, but the strategies are different, for NWTS follows the upfront surgery principle providing definite pathology and the SIOP follows the upfront chemotherapy principle, each has its own advantages. Here we aimed to evaluate the outcomes of CCSK in China following NWTS strategies to analyze the prognostic factors.MethodsFor this multicenter retrospective study, a total of 54 patients were enrolled from three children's hospitals, between April 2003 and December 2021. Treatment comprised upfront radical nephrectomy, followed by radiotherapy and intensive chemotherapy. Clinical records were regularly updated. Prognostic factors and survival rates were evaluated.ResultsThe 54 enrolled patients had a median age of 37 months (range, 4 months to 11.4 years). The stage distribution was 16% stage I (n = 9), 30% stage II (n = 16), 39% stage III (n = 21), and 15% stage IV (n = 8). Among stage IV, metastasis sites included the lung (n = 6), bone (n = 1), and intra-orbital/cervical lymph node (n = 1). After a median follow-up of 5.6 years, the 5-year event-free survival (EFS) was 82.4±5.4%, and overall survival was 88.1±4.6%. The EFS was 100% for stage I, 93.8 ±6.1% for stage II, 71.1±10.0% for stage III, and 68.6±18.6% for stage IV. Univariate analysis revealed that staging (III/IV), tumor rupture, and inferior vena cava tumor thrombus were inferior prognostic factors. Multivariate analysis revealed that tumor rupture was independent poor prognostic factor (P = 0.01, HR 5.9). Among relapsed patients, relapse occurred a median of 11 months after diagnosis (range, 4-41 months), and 50% (4/8) achieved a second complete remission after multiple treatment. None of the six lung metastasis patients received lung RT, only one patient developed a relapse and was salvaged by RT after relapse.ConclusionsTumor rupture was independent poor prognostic factor. Upfront surgery of NWTS strategies can make a definite pathology diagnosis, but how to reduce tumor rupture during surgery is important especially in developing countries. The outcomes of patients with stage I-III CCSK in China were comparable to findings in other developed countries. Better outcomes were achieved in stage IV CCSK by using an intensive chemotherapy regimen including carboplatin, which require further confirmation by AREN0321. Lung RT may be safely omitted in selected patients who achieve a compete radiographic response after 6 weeks of systemic treatment (including surgery). Treatment should be encouraged even in CCSK cases with metastasis and relapse.

A prevailing animal model currently used to study severe human diseases like obstructive cholestasis, primary biliary or sclerosing cholangitis, biliary atresia, and acute liver injury is the common bile duct ligation (cBDL). Modifications of this model include ligation of the left hepatic bile duct (pBDL) or ligation of the left bile duct with the corresponding left hepatic artery (pBDL+pAL). Both modifications induce cholestasis only in the left liver lobe. After induction of total or partial cholestasis in mice, the well-being of these animals was evaluated by assessing burrowing behavior, body weight, and a distress score. To compare the pathological features of these animal models, plasma levels of liver enzymes, bile acids, bilirubin, and within the liver tissue, necrosis, fibrosis, inflammation, as well as expression of genes involved in the synthesis or transport of bile acids were assessed. The survival rate of the animals and their well-being was comparable between pBDL+pAL and pBDL. However, surgical intervention by pBDL+pAL caused confluent necrosis and collagen depositions at the edge of necrotic tissue, whereas pBDL caused focal necrosis and fibrosis in between portal areas. Interestingly, pBDL animals had a higher survival rate and their well-being was significantly improved compared to cBDL animals. On day 14 after cBDL liver aspartate, as well as alanine aminotransferase, alkaline phosphatase, glutamate dehydrogenase, bile acids, and bilirubin were significantly elevated, but only glutamate dehydrogenase activity was increased after pBDL. Thus, pBDL may be primarily used to evaluate local features such as inflammation and fibrosis or regulation of genes involved in bile acid synthesis or transport but does not allow to study all systemic features of cholestasis. The pBDL model also has the advantage that fewer mice are needed, because of its high survival rate, and that the well-being of the animals is improved compared to the cBDL animal model.

Myocardial ischemia-reperfusion injury (MIRI) refers to the secondary damage to myocardial tissue that occurs when blood perfusion is rapidly restored following myocardial ischemia. This process often exacerbates the injury to myocardial fiber structure and function. The activation mechanism of angiogenesis is closely related to MIRI and plays a significant role in the occurrence and progression of ischemic injury. In this study, we utilized sequencing data from the GEO database and employed WGCNA, Mfuzz cluster analysis, and protein interaction network to identify Stat3, Rela, and Ubb as hub genes involved in MIRI-angiogenesis. Additionally, the GO and KEGG analysis of differentially expressed genes highlighted their broad participation in inflammatory responses and associated signaling pathways. Moreover, the analysis of sequencing data and hub genes revealed a notable increase in the infiltration ratio of monocytes and activated mast cells. By establishing key cell ROC curves, using independent datasets, and validating the expression of hub genes, we demonstrated their high diagnostic value. Moreover, by scrutinizing single-cell sequencing data alongside trajectory analysis, it has come to light that Stat3 and Rela exhibit predominant expression within Dendritic cells. In contrast, Ubb demonstrates expression across multiple cell types, with all three genes being expressed at distinct stages of cellular development. Lastly, leveraging the CMap database, we predicted potential small molecule compounds for the identified hub genes and validated their binding activity through molecular docking. Ultimately, our research provides valuable evidence and references for the early diagnosis and treatment of MIRI from the perspective of angiogenesis.