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Abstract Patients with rheumatoid arthritis (RA) can test either positive or negative for circulating anti-citrullinated protein antibodies (ACPA) and are thereby categorized as ACPA-positive (ACPA+) or ACPA-negative (ACPA−), respectively. In this study, we aimed to elucidate a broader range of serological autoantibodies that could further explain immunological differences between patients with ACPA+ RA and ACPA− RA. On serum collected from adult patients with ACPA+ RA (n = 32), ACPA− RA (n = 30), and matched healthy controls (n = 30), we used a highly multiplex autoantibody profiling assay to screen for over 1600 IgG autoantibodies that target full-length, correctly folded, native human proteins. We identified differences in serum autoantibodies between patients with ACPA+ RA and ACPA− RA compared with healthy controls. Specifically, we found 22 and 19 autoantibodies with significantly higher abundances in ACPA+ RA patients and ACPA− RA patients, respectively. Among these two sets of autoantibodies, only one autoantibody (anti-GTF2A2) was common in both comparisons; this provides further evidence of immunological differences between these two RA subgroups despite sharing similar symptoms. On the other hand, we identified 30 and 25 autoantibodies with lower abundances in ACPA+ RA and ACPA− RA, respectively, of which 8 autoantibodies were common in both comparisons; we report for the first time that the depletion of certain autoantibodies may be linked to this autoimmune disease. Functional enrichment analysis of the protein antigens targeted by these autoantibodies showed an over-representation of a range of essential biological processes, including programmed cell death, metabolism, and signal transduction. Lastly, we found that autoantibodies correlate with Clinical Disease Activity Index, but associate differently depending on patients’ ACPA status. In all, we present candidate autoantibody biomarker signatures associated with ACPA status and disease activity in RA, providing a promising avenue for patient stratification and diagnostics.

Abstract Globally 3 billion people are consuming water with moderately high concentrations of fluoride and arsenic. The development of a simple point of care (PoC) device or home device for the detection of fluoride/arsenic ensures safety before consuming water. Till date, lateral flow assay (LFA) based PoC devices can detect nucleic acids, viruses and diseases. An aluminium complex of rhodamine B functionalized oxacalix[4]arene (L) was designed to execute the LFA-based PoC device. Initially, Al3+ and Fe3+ ions were involved in complexation with the rhodamine B functionalized oxacalix[4]arene (L), resulting C 1 (L-Al3+) and C 2 (L-Fe3+) complexes respectively. The receptor L, as well as the probes (C 1 , C 2 ), were characterized thoroughly using mass spectroscopy, FTIR, NMR, and EA. C 1 and C 2 were further utilized as recyclable probes for the detection of aqueous fluoride (21 ppb) and arsenate (1.92 ppb) respectively. The computational calculation indicates that upon complexation, the spirolactam ring opening at the rhodamine B site leads to optoelectronic changes. The consistency of LFA-based portable sensing device has been tested with water samples, synthetic fluoride standards and dental care products like toothpaste and mouthwash with concentrations ≥ 3 ppm. Moreover, fixed cell imaging experiments were performed to ascertain the in-vitro sensing phenomena.

Filtered-sunlight phototherapy (FSPT) that blocks ultraviolet light and reduces infrared radiation is safe and non-inferior to intensive electric phototherapy (IEPT) for treating mild-to-severe neonatal hyperbilirubinemia. In this randomized non-inferiority trial, the safety, efficacy, exchange transfusion (ET), and mortality rates of FSPT versus IEPT among Nigerian neonates with severe-to-hazardous hyperbilirubinemia were investigated. Safety was defined as the absence of hyperthermia, hypothermia, dehydration, or sunburn; efficacy by the proportion of assessable treatment days during which total serum or plasma bilirubin (TSB) increased by < 0.2 mg/dL/hr for newborns aged ≤ 72 h-old or decreased for newborns > 72 h-old. A treatment day was deemed assessable if a neonate received phototherapy for ≥ 4 h, and non-inferiority was inferred for differences within a 10% margin. We enrolled 192 newborns (admission TSB ≤ 62 mg/dL), assigned to FSPT (n = 98) or IEPT (n = 94). FSPT was effective on 94.2% of the assessable treatment days compared with 97.1% for IEPT. The mean difference in efficacy between FSPT and IEPT was -2.9%, 95% CI: -7.6, 1.9). 2.6% of newborns who received FSPT developed controlled hyperthermia, and no baby met the criteria for withdrawal for safety reasons. Overall, 50.6% (39/77) of newborns who received FSPT and 53.7% (51/95) of newborns who received IEPT had ET (p = 0.89) and 7 in each group (9.1% vs 7.4%; p = 0.86) died. In conclusion, FSPT is safe and non-inferior to IEPT for treating neonates with severe-to-hazardous hyperbilirubinemia, it is not associated with significantly higher rates of ET and mortality and should be considered where practicable when IEPT cannot be assured. Clinical Trials.gov Number: NCT02612727 (24/11/2015). [ABSTRACT FROM AUTHOR]

Climate change and its negative effects are driving the global shift from fossil fuels to renewable energy sources. To tackle the dependency on traditional energy sources in harsh winter regions and improve heating quality during periods of thermal demand fluctuations, this paper proposes a new distributed heating peak shaving system (DHPS). The system combines municipal heat and clean energy within the secondary network while reducing the return water temperature in the primary network. It comprises solar collectors, electric thermal storage tanks (ETST), and absorption heat pump (AHP) units, integrated into conventional heat exchange stations. The system operates in two modes to manage peak and off-peak loads respectively, with TRNSYS simulation used to evaluate performance across a range of peak-shaving gradients. A multidimensional comprehensive assessment is conducted between the DHPS under optimal peak shaving coefficient (θ) conditions and conventional peak clipping boiler (PCB). Results indicate that DHPS achieves a high primary energy ratio (PER) of 1.251 at θ = 0.5, reducing combustion emissions by nearly 40%. The static payback period (PBP) of the system is 3.5 years. When the electricity price drops to 0.275 CNY, its operational costs are comparable to PCB. DHPS caters to the energy characteristics of cold regions where electricity supply exceeds demand. It enables flexible peak shaving while ensuring the complete utilization of clean energy and effectively utilizing waste heat from power plants. [ABSTRACT FROM AUTHOR]

Hemolytic peptides are therapeutic peptides that damage red blood cells. However, therapeutic peptides used in medical treatment must exhibit low toxicity to red blood cells to achieve the desired therapeutic effect. Therefore, accurate prediction of the hemolytic activity of therapeutic peptides is essential for the development of peptide therapies. In this study, a multi-feature cross-fusion model, HemoFuse, for hemolytic peptide identification is proposed. The feature vectors of peptide sequences are transformed by word embedding technique and four hand-crafted feature extraction methods. We apply multi-head cross-attention mechanism to hemolytic peptide identification for the first time. It captures the interaction between word embedding features and hand-crafted features by calculating the attention of all positions in them, so that multiple features can be deeply fused. Moreover, we visualize the features obtained by this module to enhance its interpretability. On the comprehensive integrated dataset, HemoFuse achieves ideal results, with ACC, SP, SN, MCC, F1, AUC, and AP of 0.7575, 0.8814, 0.5793, 0.4909, 0.6620, 0.8387, and 0.7118, respectively. Compared with HemoDL proposed by Yang et al., it is 3.32%, 3.89%, 5.93%, 10.6%, 8.17%, 5.88%, and 2.72% higher. Other ablation experiments also prove that our model is reasonable and efficient. The codes and datasets are accessible at https://github.com/z11code/Hemo. [ABSTRACT FROM AUTHOR]

Heat stress poses a significant environmental challenge that profoundly impacts wheat productivity. It disrupts vital physiological processes such as photosynthesis, by impeding the functionality of the photosynthetic apparatus and compromising plasma membrane stability, thereby detrimentally affecting grain development in wheat. The scarcity of identified marker trait associations pertinent to thermotolerance presents a formidable obstacle in the development of marker-assisted selection strategies against heat stress. To address this, wheat accessions were systematically exposed to both normal and heat stress conditions and phenotypic data were collected on physiological traits including proline content, canopy temperature depression, cell membrane injury, photosynthetic rate, transpiration rate (at vegetative and reproductive stage and 'stay-green'. Principal component analysis elucidated the most significant contributors being proline content, transpiration rate, and canopy temperature depression, which exhibited a synergistic relationship with grain yield. Remarkably, cluster analysis delineated the wheat accessions into four discrete groups based on physiological attributes. Moreover, to explore the relationship between physiological traits and DNA markers, 158 wheat accessions were genotyped with 186 SSRs. Allelic frequency and polymorphic information content value were found to be highest on genome A (4.94 and 0.688), chromosome 1A (5.00 and 0.712), and marker Xgwm44 (13.0 and 0.916). Population structure, principal coordinate analysis and cluster analysis also partitioned the wheat accessions into four subpopulations based on genotypic data, highlighting their genetic homogeneity. Population diversity and presence of linkage disequilibrium established the suitability of population for association mapping. Additionally, linkage disequilibrium decay was most pronounced within a 15–20 cM region on chromosome 1A. Association mapping revealed highly significant marker trait associations at Bonferroni correction P < 0.00027. Markers Xwmc418 (located on chromosome 3D) and Xgwm233 (chromosome 7A) demonstrated associations with transpiration rate, while marker Xgwm494 (chromosome 3A) exhibited an association with photosynthetic rates at both vegetative and reproductive stages under heat stress conditions. Additionally, markers Xwmc201 (chromosome 6A) and Xcfa2129 (chromosome 1A) displayed robust associations with canopy temperature depression, while markers Xbarc163 (chromosome 4B) and Xbarc49 (chromosome 5A) were strongly associated with cell membrane injury at both stages. Notably, marker Xbarc49 (chromosome 5A) exhibited a significant association with the 'stay-green' trait under heat stress conditions. These results offers the potential utility in marker-assisted selection, gene pyramiding and genomic selection models to predict performance of wheat accession under heat stress conditions. [ABSTRACT FROM AUTHOR]

This retrospective cohort study describes the real-world incidence and maintenance of clinically meaningful intraocular pressure (IOP) reduction ("response") following stand-alone phacoemulsification for 667,987 eyes with suspected or confirmed glaucoma in the IRIS Registry (Intelligent Research in Sight) from 1/1/2013–9/30/2019. Intraocular pressure responders had ≥ 20% IOP reduction in daily mean IOP from baseline on two consecutive postoperative visits. We declared failure if a responder no longer maintained ≥ 20% IOP reduction. The estimated IOP responder rate was 41.3% by Kaplan–Meier analysis. Multivariate analysis demonstrated relationships between IOP response and baseline IOP (hazard ratio (HR) (95% confidence interval)) 1.48 (1.48–1.49), per 3 mmHg, P < 0.0001), age (HR 1.14 (1.13–1.14), per 10 years, P < 0.0001), male sex (HR 1.13 (1.12–1.15), P < 0.0001), prostaglandin analogue (HR 0.88 (0.87–0.90), P < 0.0001), and Rho-kinase inhibitor use (HR 1.50 (1.32–1.70), P = 0.01). Fifty percent of IOP responders failed at a median time of 14.3 months. Multivariate analysis demonstrated relationships between failure and baseline IOP (HR 0.75 (0.75–0.76), per 3 mmHg, P < 0.0001), nitric oxide donating prostaglandin (HR 1.78 (1.46–2.18), P < 0.0001) and Rho-kinase inhibitor use (HR 1.73 (1.43–2.09), P < 0.0001). Clinicians may counsel glaucoma patients with risk factors on whether to anticipate an IOP response and its expected duration after stand-alone phacoemulsification. [ABSTRACT FROM AUTHOR]

In addition to stabilizing blood pressure (BP), ephedrine and phenylephrine have distinct effects on regional cerebral oxygen saturation (rSO2). However, whether its effect on rSO2 affects the occurrence of postoperative delirium (POD) remains unclear. Therefore, the aim of this study is to compare the effects of ephedrine and phenylephrine for BP maintenance on the incidence of POD in olderly adults who underwent knee arthroplasty under general anesthesia. One hundred twenty patients who were between 60 and 90 years old and underwent knee arthroplasty were included in this study. The patients were randomly divided into two groups: the ephedrine group and the phenylephrine group. After anesthesia induction, ephedrine and phenylephrine were continuously infused to maintain the intraoperative mean arterial pressure within the normal range (baseline mean arterial pressure ± 20%). The primary outcome measures included the incidence of POD within 1–3 days after surgery. The incidence of POD on the first day after surgery was lower in the ephedrine group than in the phenylephrine group (33% vs. 7%, P < 0.001). However, there was no significant difference in the incidence of POD between the two groups on the second and third postoperative days. Compared with the phenylephrine group, the ephedrine group experienced significantly greater cardiac output (CO) and rSO2 (P < 0.05). Clinical Trials Registry: ChiCTR2200064849, principal investigator: Changjian Zheng. [ABSTRACT FROM AUTHOR]

Motorbike spoke wheel injuries (SWIs) among children are a notable public health concern, especially in low and middle-income regions. The primary objective of this study is to comprehensively examine the patterns of motorbike spoke wheel injuries (SWIs) in children. Additionally, the study introduces a novel classification system for these injuries. The implementation of this classification system aims to streamline the management of SWIs, making it more efficient and facilitating the development of standardized treatment protocols. This prospective observational study was conducted in the Accident and Emergency Department from January 2019 to 2021. Children < 14 years of age of either gender with foot and ankle injury due to motorbike spoke wheels as passengers and presenting within 3 days were included. The motorbike SWI was assessed for its location and classified by a new classification as Class I, Soft tissue injury without skin loss; Class II, Skin loss of more than 1 cm without underlying tissue involvement; Class III, Skin loss with underlying tissue involvement, this class is further divided on basis of underlying soft-tissue involvement; Class IV: mangled foot/toe. Management plan and outcome were noted. In our study158 children suffering from SWI were registered with a mean age of 6.2 ± 5.4 years, 127 (80.37%) males and 31 (19.62%) females. Class I injury was seen in 18 (11.39%) patients, class II in 69 (43.67%), and class III in 68 (43.03%) patients. Class III injuries were further subcategorized as follows: IIIT (Tendon) injuries, which accounted for 32 cases (20.25%); IIIB (Bone) injuries, with 29 cases (18.35%); and IIINV (Neurovascular) injuries, identified in 7 cases (4.43%). Class IV injuries were observed in 3 (1.8%) children. The flap was needed in 33 (20.88%) patients. There were no complications like flap necrosis or graft rejection. In this current study, a new classification system specific for a motorbike SWI has been introduced along with its application on children presenting at tertiary care hospital's emergency department. The application of the proposed classification will enable universal management guidelines for SWIs, especially in the Ino-Pak region where SWIs are common. [ABSTRACT FROM AUTHOR]

To describe the epidemiology, clinical and social characteristics, management, and outcomes of patients with secondary glaucoma in Central China, a total of 1,129 cases (1,158 eyes) among 710 males (62.89%) and 419 females (37.11%) were analyzed. The mean age was 53.75 ± 17.11 years. The New Rural Cooperative Medical System (NCMS) played the most important role in reimbursement (60.32%) for secondary glaucoma-related medical expenses. The predominant occupation was "farmer" (53.41%). Neovascularization and trauma were the leading causes of secondary glaucoma. Cases of trauma-induced glaucoma decreased substantially during the coronavirus disease 2019 (COVID-19) pandemic. An education level of senior high school or above was uncommon. Ahmed glaucoma valve implantation was the most commonly performed surgery. At the final follow-up, the overall intraocular pressure (IOP) in patients with vascular disease- and trauma-related secondary glaucoma was 19.53 ± 10.20 mmHg, 20.26 ± 11.75 mmHg, and 16.90 ± 6.72 mmHg, while the mean visual acuity (VA) was 0.33 ± 0.32, 0.34 ± 0.36, and 0.43 ± 0.36. In 814 (70.29%) eyes, the VA was < 0.01. Effective preventive measures for at-risk populations, increased NCMS coverage and the promotion of higher education are necessary. These findings will help ophthalmologists detect secondary glaucoma early and manage it in a timely manner. [ABSTRACT FROM AUTHOR]

Environmental crises, declining factor productivity, and shrinking natural resource is a threat to global agricultural sustainability. The task is much more daunting in the Indo-Gangetic northern plains of India, where depletion of the underground water table and erratic rains due to the changing climate pose a major challenge to agriculture. To address these challenges a field investigation was carried out during 2016–2018 to test the efficacy of biopolymeric superabsorbent hydrogels namely Pusa Hydrogel (P-hydrogel: a semi-synthetic cellulose derivative-based product) and kaolin derivative of Pusa Hydrogel (K-hydrogel: semi-synthetic cellulose derivative) to assess their effect on crop and water productivity, soil moisture, root dynamics, and economics of soybean (Glycine max L.)–wheat (Triticum aestivum L.) system under three irrigation regimes namely full irrigation, limited irrigation and rainfed. The results revealed that the full irrigation along with P-hydrogel led to enhanced grain yield, biomass yield, and water productivity (WP) of soybean (1.61–10.5%, 2.2–9.5%, and 2.15–21.8%, respectively) and wheat (11.1–18.3%, 12–54% and 11.1–13.1%, respectively) over control plots. Likewise, under water stressed plots of rainfed conditions with P-hydrogel exhibited 52.7 and 20.6% higher system yields (in terms of wheat equivalent yield) over control and other combinations during the respective study years. Whereas the magnitude of increase in system yield under limited irrigation with P-hydrogel was ~ 15.1% and under full irrigation with P-hydrogel was 8.0–19.4%. Plots treated with P-hydrogel retained 3.0–5.0% higher soil moisture compared to no-hydrogel plots, while K-hydrogel treated plots held the lower moisture (4.0–6.0%) than the control. In terms of profitability, full irrigation along with P-hydrogel plots registered 12.97% higher economic returns over control. The results suggested that P-hydrogel (2.5 kg ha−1) reduces runoff water loss in full irrigation applied plots and retained more water, where loss of water is more thus reduces number of irrigations. Hence P-hydrogel with irrigation water is a viable option for sustainable production of soybean-wheat systems in the Indo-Gangetic plains of India and other similar eco-regions of the world. [ABSTRACT FROM AUTHOR]

This study provides new insights on the formation of the nanocrystallites of phase pure BiFeO3 prepared using sol–gel method with tartaric acid as the fuel as comprehended based on the local structure and magnetic hyperfine fields at Fe sites using Mossbauer spectroscopy. Important steps involved in the growth of the nanocrystallites of BiFeO3 in the sol–gel reaction are elucidated in a detailed manner in this study for the first time. Three important stages with the second stage marked by the formation of as high as 75% of nanocrystallites of BiFeO3 occurring over a narrow calcination temperature interval 700–723 K have been deduced in this study. Variation of hyperfine parameters with calcination temperature of the dried precursor gel leading to an increase in the mean size of crystallites of BiFeO3 has been deduced. The nanoparticles of BiFeO3 are deduced to exhibit weak ferromagnetic property in addition to being strongly ferroelectric based on the magnetization and P-E loop studies. Consequently an appreciable magneto electric coupling effect in terms of significant changes in P-E loop variation with the application of external magnetic field is elucidated in this study, which is comprehended based on the defects associated with BiFeO3 nanoparticles. [ABSTRACT FROM AUTHOR]

To address current challenges of difficult standardisation of dynamic determination of roadbed bearing capacity and excessive deviations in deflection control, this paper proposes a improved measurement method for roadbed load-bearing capacity based on the dynamic modulus control using a portable falling weight deflectometer (PFWD). The detection range of PFWD is determined by theoretical analysis. Based on the range, a finite element numerical model was developed, the spatial distribution and attenuation of the dynamic stress of the roadbed soil in the depth and horizontal directions are determined. The variation of the vertical dynamic stress with depth is not characterized by a gradual decrease, as is commonly believed, but rather by an increase followed by a decrease. The underlying reasons for the difference between static and dynamic indicators are explored. Using the improved method, a prediction model with dynamic bending as the detection index and static rebound modulus as the control index was developed. The proposed model can improve precision accuracy as well as detection efficiency, verify the effectiveness of the improved method, which is important for accurate dynamic measurement and evaluation of highway roadbed bearing capacity., (© 2023. The Author(s).)