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Abstract Background As precipitation patterns are predicted to become more erratic, it’s vital to understand how abrupt climate events will affect woody seedlings that develop different hydraulic strategies. We cultivated anisohydric Robinia pseudoacacia L. and isohydric Quercus acutissima Carr. in a greenhouse, and subjected an abrupt precipitation event during a successive drought. Patterns of leaf and root gas exchange, leaf and stem hydraulics, seedlings growth, and non-structural carbohydrate (NSC) patterns were determined. Results We found that as an anisohydric species, R. pseudoacacia seedlings adopted a strategy of sacrificing leaves in response to stress, resulting in the lowered photosynthesis and ultimately leading to a decrease in NSC accumulation. In contrast, isohydric Q. acutissima maintained the integrity of leaves by reducing respiratory consumption in response to drought stress, thereby ensured the stability of NSC pool. Conclusion R. pseudoacacia exhibited an extravagant strategy with efficient water transport, photosynthetic assimilation, and growth capabilities, but its resistance to embolism was relatively weak, while Q. acutissima adopted a resource-saving strategy with higher hydraulic safety. We also found that Q. acutissima seedlings were prone to allocate carbohydrates to maintain growth, while R. pseudoacacia preferred to sacrifice growth and aboveground NSC limitation only happened when precipitation was subjected after total stomatal closure. We thus believe that hydraulic strategy could define seedlings responses to drought and recovery, and further may adversely affect their re-sprouting capacity after drought stress relief.

Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) not only posed major health and economic burdens to international societies but also threatens patients with comorbidities and underlying autoimmune disorders, including Crohn’s disease (CD) patients. As the vaccinated population is gradually relieved from the stress of the latest omicron variant of SARS-CoV-2 due to competent immune responses, the anxiety of CD patients, especially those on immunosuppressive treatment, has not subsided. Whether the use of immunosuppressants for remission of CD outweighs the potential risk of severe coronavirus disease 2019 (COVID-19) has long been discussed. Thus, for the best benefit of CD patients, our primary goal in this study was to navigate the clinical management of CD during the COVID pandemic. Herein, we summarized COVID-19 outcomes of CD patients treated with immunosuppressive agents from multiple cohort studies and also investigated possible mechanisms of how SARS-CoV-2 impacts the host immunity with special consideration of CD patients. We first looked into the SARS-CoV-2-related immunopathology, including lymphocytopenia, T-cell exhaustion, cytokine storms, and their possible molecular interactions, and then focused on mechanistic actions of gastrointestinal systems, including interruption of tryptophan absorption, development of dysbiosis, and consequent local and systemic inflammation. Given challenges in managing CD, we summarized up-to-date clinical and molecular evidence to help physicians adjust therapeutic strategies to achieve the best clinical outcomes for CD patients.

Abstract Background Although low-dose computed tomography (LDCT) screening effectively reduces LC mortality in high-risk individuals with a history of smoking in China, the feasibility and efficacy of lung cancer screening (LCS) in individuals who never smoked versus individuals who smoked remains unclear. Methods We conducted a retrospective analysis of prospective cohort studies at the National Cancer Center (NCC) in China from January 2006 to December 2022. A comprehensive LCS initiative was undertaken, involving 30,468 participants (54.5% male). Participants underwent LCS using LDCT. Potential malignancies were managed through joint consensus between patients and their physicians. Epidemiology, screening eligibility criteria, and LC detection rates and survival outcomes were compared between individuals who smoked and individuals who never smoked. Results Among 30,468 participants, 339 LCs were pathologically confirmed in 289 patients. The LC detection rate was 0.9% (289/30,468) overall, 0.8% in individuals who smoked (71/9,042), and 1.0% in individuals who never smoked (218/21,426). In individuals who smoked, LC detection rates were 0.5% (21/4516) and 1.1% (50/4526) in the

Abstract Background The Editorial Board of EJNMMI Radiopharmacy and Chemistry releases a biannual highlight commentary to update the readership on trends in the field of radiopharmaceutical development. Main body This selection of highlights provides commentary on 19 different topics selected by each coauthoring Editorial Board member addressing a variety of aspects ranging from novel radiochemistry to first-in-human application of novel radiopharmaceuticals. Conclusion Trends in radiochemistry and radiopharmacy are highlighted. Hot topics cover the entire scope of EJNMMI Radiopharmacy and Chemistry, demonstrating the progress in the research field in many aspects.

In the era of intelligent construction, engineering management requires diverse abilities that cannot be provided through traditional engineering management education. Moreover, few studies focused on the competency requirements for engineering management undergraduates. In this study, a questionnaire with 12 competency indicators, including traditional engineering management competencies and new competencies arising from the advancement of information technology and artificial intelligence (AI), was designed and distributed to 942 employees from enterprises related to engineering construction. A total of 723 responses were received, of which 514 were deemed valid. The survey results indicate that the competency in traditional engineering management is considered “strongly necessary” or “necessary” by 84.24% of respondents. Similarly, competencies in analyzing and processing large-scale construction data, and in assisting feasibility analysis with AI, are valued by 80.35% and 78.99% of respondents, respectively. The above results illustrate that the integration of intelligent construction into traditional engineering management competencies is critical for future engineering management undergraduates. Therefore, courses on intelligent construction, such as data analysis, Building Information Modeling, and the regulated use of large language models, should be included in engineering management education. This study can provide significant support for reforming the education of engineering management.

Abstract The aim of this study was to evaluate the prognostic value of peripheral blood inflammation indexes in patients with metastatic Colorectal Cancer (CRC) and to establish a predictive scoring system. A total of 324 CRC patients diagnosed through pathological examination from January 2017 to July 2022 at the Third Affiliated Hospital of Kunming Medical University were included. The prognosis of patients with metastatic CRC was examined, and the correlation between IL-10 expression in pathological tissues and IL-10 expression in serum was analyzed. The results showed that the prognosis of CRC was poorer when metastasis occurred (P

Zirconium-based metallic glasses (Zr-MGs) are demonstrated to exhibit high mechanical strength, low elastic modulus and excellent biocompatibility, making them promising materials for endosseous implants. Meanwhile, tantalum (Ta) is also well known for its ideal corrosion resistance and biological effects. However, the metal has an elastic modulus as high as 186 GPa which is not comparable to the natural bone (10–30 GPa), and it also has a relative high cost. Here, to fully exploit the advantages of Ta as endosseous implants, a small amount of Ta (as low as 3 at. %) was successfully added into a Zr-MG to generate an advanced functional endosseous implant, Zr58Cu25Al14Ta3 MG, with superior comprehensive properties. Upon carefully dissecting the atomic structure and surface chemistry, the results show that amorphization of Ta enables the uniform distribution in material surface, leading to a significantly improved chemical stability and extensive material-cell contact regulation. Systematical analyses on the immunological, angiogenesis and osteogenesis capability of the material are carried out utilizing the next-generation sequencing, revealing that Zr58Cu25Al14Ta3 MG can regulate angiogenesis through VEGF signaling pathway and osteogenesis via BMP signaling pathway. Animal experiment further confirms a sound osseointegration of Zr58Cu25Al14Ta3 MG in achieving better bone-implant-contact and inducing faster peri-implant bone formation.

Unmanned Aerial Vehicles (UAVs) are gaining increasing attention in many fields, such as military, logistics, and hazardous site mapping. Utilizing UAVs to assist communications is one of the promising applications and research directions. The future Industrial Internet places higher demands on communication quality. The easy deployment, dynamic mobility, and low cost of UAVs make them a viable tool for wireless communication in the Industrial Internet. Therefore, UAVs are considered as an integral part of Industry 4.0. In this article, three typical use cases of UAVs-assisted communications in Industrial Internet are first summarized. Then, the state-of-the-art technologies for drone-assisted communication in support of the Industrial Internet are presented. According to the current research, it can be assumed that UAV-assisted communication can support the future Industrial Internet to a certain extent. Finally, the potential research directions and open challenges in UAV-assisted communications in the upcoming future Industrial Internet are discussed.

Abstract Despite recent findings indicating a paradoxical association between high-density lipoprotein cholesterol (HDL-C) levels and cardiovascular disease (CVD) mortality, the impact of HDL-C on subsequent outcomes after ischemic stroke remains unclear. The study aims to investigate the relationships between HDL-C levels and post-stroke functional outcomes while examining the potential modifying influence of HDL-C-related single nucleotide polymorphisms identified through genome-wide association studies. This cohort study included 1,310 patients diagnosed with acute ischemic stroke (AIS), all of whom had their admission serum lipid profile and genotyping information. Participants were categorized into four groups based on gender and HDL-C level. Prognostic outcomes were assessed using a modified Rankin Scale (mRS) at 1, 3, and 12 months post-admission. Multivariate logistic regression and restricted cubic spline regression analysis were used to assess the associations between HDL-C levels and outcomes. The mean age of patients was 61.17 ± 12.08 years, and 69.31% were men. After adjusting confounders, patients with the highest HDL-C level group had a significantly higher risk of poor functional outcomes at 1, 3, and 12 months following stroke compared to the reference group. Restricted cubic splines depicted a nonlinear association between HDL-C levels and poor prognosis in both men and women. The ABCA1 gene rs2575876 AA genotype combined with abnormal HDL-C levels exhibited a significantly heightened risk of post-stroke adverse outcomes at 1 and 3 months compared to patients with normal HDL-C levels and GG + GA genotype. These findings suggest that the combined effects of ABCA1 genetic variants with either low or high HDL-C levels could further heighten this risk.

0–3 type ferroelectric–phosphor composite ceramics cannot be prepared by the traditional solid-state sintering (SSS) method due to the strong chemical reaction between ferroelectrics and phosphors during high-temperature sintering. The cold sintering process (CSP) may solve this issue by densifying ceramics at ultralow sintering temperatures. In this work, dense 0–3 type 0.8BaTiO3–0.2CaTiO3:Pr3+ (0.8BT–0.2CT:Pr3+) binary composite ceramics were fabricated at an ultralow temperature of 225 °C via CSP with the Ba(OH)2·8H2O hydrated flux. The effects of the Ba(OH)2·8H2O content, sintering temperature, and sintering time on the microstructure and densification of the ceramics were investigated. The density of the composite ceramics prepared by the optimized sintering parameters reaches 89%. Both energy-dispersive X-ray (EDX) spectroscopy and X-ray diffraction (XRD) confirm the existence of BT and CT:Pr3+ phases in the prepared ceramics. A strong ferroelectric performance is obtained, and the luminescent properties of CT:Pr3+ are preserved for the ceramics. Furthermore, the 0.8BT–0.2CT:Pr3+ composite ceramics prepared by CSP have stronger photoluminescence and photo-stimulated luminescence than their counterparts prepared by cold sintering assistance (CSA) and SSS methods. Therefore, CSP is a promising method for combining luminescent and ferroelectric properties into 0–3 type composite ceramics.

Abstract Currently, flexible capacitive sensors have a wide range of application scenarios in the field of wearable electronic devices. In order to detect more subtle joint movements of the human body, a method of fabricating stacked capacitive sensors is demonstrated. An ultrathin dielectric elastomer film of about 110 μm by the “secondary calendering” method was prepared. The shape of the electrode layers was designed, printed the electrode materials on the dielectric elastomer film by screen-printing, realized the stacked-layer technology, and connected each sensor unit in parallel by the electrode columns formed inside. A 12-layer flexible capacitive sensor with an initial capacitance of 10.2nF, good resolution (1% strain), high sensitivity (1.09) and stability under 10,000 cycles is fabricated. The sensor fabricated in this paper can recognize the motion at various joints of the human body, such as elbow and knee joints. This paper provides a new method for fabrication of stacked flexible capacitive sensors, which opens up new applications in flexible sensors, wearable electronic devices and human-computer interaction.

We present here, a case of a neonate with an unbalanced chromosomal translocation due to a maternal chromosomal translocation carriage that resulted in the presence of trisomy 9p combined with a partial trisomy 12p. Karyotype analysis was performed using conventional cytogenetic chromosomal analysis using the GTG-banding technique. The mother was a carrier of a balanced chromosomal translocation of 46, XX, t(9;12)(q13;p11.2), that resulted in an unbalanced translocation of the offspring, who had a karyotype 47, XX, +der(9)t(9;12)(q13;p11.2)dmat, featuring a combined trisomy of 9q13→9pter region and 12p11.2→12pter region. Clinical phenotype of the infant included cephalo-facial deformity, growth retardation, hypertonia, opisthotonus, laryngeal wheezing, foot deformity, and congenital heart disease.

In this paper, the electrochemical and corrosion behavior of pure titanium (TA1) in simulated Proton Exchange Membrane Water Electrolysis (PEMWE) anodic environment was investigated. In this condition, the corrosion potential of TA1 was −689 mV, with a self-corrosion current density of 232.5 μA cm–2, and a polarization resistance of 125.9 Ω cm2. During potentiostatic polarization at 2 V, the current density was maintained at approximately 6 mA cm–2. However, the passivation process exhibited instability. Furthermore, this process has been shown to significantly facilitate the formation of surface oxides, and the passive film that formed displays the lowest bound water and OH−, and the highest content of O2–, exhibiting the highest average valence. Notably, dynamic potentials caused current transients, among which square wave potential was the most remarkable. The square wave potential shows an O2– content just below that of 2V potential polarization when fluctuating potentials are applied. The interfacial contact resistance (ICR) of 2 V potentiostatic polarization was slightly higher than that of square, sine and triangular waves. Additionally, the high temperature condition of PEMWE will aggravate the corrosion of TA1 by fluoride ions.

Background Coronavirus disease 2019 (COVID-19) has a considerable impact on the global healthcare system. Individuals who have recovered from COVID often experience chronic respiratory symptoms that affect their daily lives. This study aimed to assess respiratory dynamics such as airway hyperresponsiveness (AHR) and bronchodilator response in post-COVID patients. Methods This study included 282 adults with respiratory symptoms who underwent provocation tests. The demographic details, clinical symptoms and medical histories were recorded. Baseline spirometry, methacholine challenge tests (MCT) and post-bronchodilator spirometry were performed. Patients were divided into the following four groups: Group 1: non-COVID-19 and negative MCT; Group 2: post-COVID-19 and negative MCT; Group 3: non-COVID-19 and positive MCT; and Group 4: post-COVID-19 and positive MCT. Results Most post-COVID-19 patients (43.7%) experienced AHR, and wheezing was more common. Patients in Group 4 exhibited increased intensities of dyspnoea, cough and wheezing with the lowest pulmonary function test (PFT) parameters at baseline. Moreover, significant decreases in PFT parameters after the MCT were observed in these patients. Although the prevalence of a low forced expiratory volume in 1 s to forced vital capacity ratio (

BackgroundPatients recovering from stroke experience a variety of symptoms that present as a synergistic and mutually reinforcing “symptom cluster,” rather than as singular symptoms. In this study, we researched and systematic analyzed these symptom clusters, including core and bridge symptoms, to help determine the relationships between symptoms and to identify key symptom targets, providing a new approach for formulating precise symptom management interventions.MethodsConvenience sampling was applied to select 432 stroke recovery patients treated in the Seventh People’s Hospital of Changzhou City from August 1, 2023 to April 14, 2024. Subsequently, a cross-sectional survey was conducted using the General Information Questionnaire and Stroke Symptom Experience Scale to extract symptom clusters via exploratory factor analysis. Finally, the “qgraph” and “bootnet” packages in the R language were used to construct a network layout to describe the relationships between symptoms and calculate the centrality index.ResultsThe average age of the 432 enrolled recovering stroke patients was 68.17 ± 12.14 years, including 268 males (62.04%) and 164 females (37.96%), none of whom underwent surgical intervention. Among this cohort, the 3 symptoms with the highest incidence rates were “limb weakness” (A2, 80.56%), “fatigue” (A5, 77.78%), and “limitations of limb movement” (A1, 68.06%). A total of 5 symptom clusters were extracted: the somatic activity disorder, mood-disorder-related, cognitive–linguistic dysfunction, somatic-pain-related, and foot dysfunction symptom clusters. In the symptom network, the 2 most common symptoms in terms of intensity and expected impact were “fatigue” (A5, rs = 1.14, re = 1.00) and “pessimism about the future” (B3, rs = 1.09, re = 1.02). The symptom with the strongest bridge intensity was “limb pain” (D1, rs = 2.64).ConclusionThis study uses symptom network analysis to explore the symptoms of stroke patients during recovery, identifying core symptoms and bridge symptoms. Based on these findings, we can develop more targeted management plans to improve the accuracy and efficiency of interventions. Through this management approach, we can enhance treatment effectiveness, reduce unnecessary medication, lower adverse drug reactions, and optimize the allocation of medical resources.

BackgroundThis study was aimed to identify the independent risk factors for falls n hospitalized older patients and develop a corresponding predictive model.MethodsA retrospective observational study design was adopted, comprising 440 older patients with falls history and 510 older patients without falls history during hospitalization. Data collected included demographic information, vital signs, comorbidities, psychiatric disorder, function absent, current medication, other clinical indicators.ResultsMobility disability, high-risk medications use, frequency of hospitalizations, psychiatric disorder, visual impairment are independent risk factors for falls in older patients. The A-M2-HPV scoring system was developed. The AUC value of the nomogram was 0.884, indicating the model has excellent discriminative ability. The AUC value of the A-M2-HPV score was 0.788, demonstrating better discrimination and stratification capabilities.ConclusionThe A-M2-HPV scoring system provides a valuable tool to assess the risk of falls in hospitalized older patients and to aid in the implementation of preventive measures.

Resources scarcity is prevalent in natural microbial communities, affecting both biodiversity and coexistence. However, its intricate impacts on community assembly remain incompletely understood. In this study, we examined the bacterial community assembly processes in low-resource soil patches along the sandy coast of Southern China, focused on the relative importance of abiotic and biotic factors. Our study revealed a slightly decreasing trend in bacterial community similarity with increasing geographic distance, whereas the spatial heterogeneity of soil resource availabilities, including total nitrogen (TN), ammonium (NH4+-N), and total phosphorus (TP), explained 75 % of the total variation in the soil bacterial community. Nitrogen was identified as the primary limiting resource, playing a key role in shaping the composition of bacterial communities. Notably, elevated N availability did not alleviate N limitations or promote biodiversity. Instead, it led to deterministic community assembly processes by increasing the overall demand for N and intensifying negative biological interactions among taxa. These processes favored the selection of specific communities dominated by highly competitive species with overlapping niches. Our findings offer novel insights into the biogeographic patterns of soil bacterial communities, highlighting how resource availability shapes their compositions and has potential ecological implications, including effects on seedling establishment and the resilience of belowground communities to disturbances.

Abstract Background Evidence from observational studies indicates that lung cancer screening (LCS) guidelines with high rates of lung cancer (LC) underdiagnosis, and although current screening guidelines have been updated and eligibility criteria for screening have been expanded, there are no studies comparing the efficiency of LCS guidelines in Chinese population. Methods Between 2005 and 2022, 31,394 asymptomatic individuals were screened using low-dose computed tomography (LDCT) at our institution. Demographic data and relevant LC risk factors were collected. The efficiency of the LCS for each guideline criteria was expressed as the efficiency ratio (ER). The inclusion rates, eligibility rates, LC detection rates, and ER based on the different eligibility criteria of the four guidelines were comparatively analyzed. The four guidelines were as follows: China guideline for the screening and early detection of lung cancer (CGSL), the National Comprehensive Cancer Network (NCCN), the United States Preventive Services Task Force (USPSTF), and International Early Lung Cancer Action Program (I-ELCAP). Results Of 31,394 participants, 298 (155 women, 143 men) were diagnosed with LC. For CGSL, NCCN, USPSTF, and I-ELCAP guidelines, the eligibility rates for guidelines were 13.92%, 6.97%, 6.81%, and 53.46%; ERe for eligibility criteria were 1.46%, 1.64%, 1.51%, and 1.13%, respectively; and for the inclusion rates, they were 19.0%, 9.5%, 9.3%, and 73.0%, respectively. LCs which met the screening criteria of CGSL, NCCN, USPSTF, and I-ELCAP guidelines were 29.2%, 16.4%, 14.8%, and 86.6%, respectively. The age and smoking criteria for CGSL were stricter, hence resulting in lower rates of LC meeting the screening criteria. The CGSL, NCCN, and USPSTF guidelines showed the highest underdiagnosis in the 45–49 age group (17.4%), while the I-ELCAP guideline displayed the highest missed diagnosis rate (3.0%) in the 35–39 age group. Males and females significantly differed in eligibility based on the criteria of the four guidelines (P

Abstract Anaplastic lymphoma kinase (ALK) fusion-positive colorectal cancer (CRC) is a rare and chemotherapy-refractory subtype that lacks established and effective treatment strategies. Additionally, the efficacy and safety of ALK inhibitors (ALKi) in CRC remain undetermined. Herein, we examined a series of ALK-positive CRC patients who underwent various lines of ALKi treatment. Notably, we detected an ALK 1196M resistance mutation in a CRC patient who received multiple lines of chemotherapy and ALKi treatment. Importantly, we found that Brigatinib and Lorlatinib demonstrated some efficacy in managing this patient, although the observed effectiveness was not as pronounced as in non-small cell lung cancer cases. Furthermore, based on our preliminary analyses, we surmise that ALK-positive CRC patients are likely to exhibit inner resistance to Cetuximab. Taken together, our findings have important implications for the treatment of ALK-positive CRC patients.

Abstract Background Current data on post-discharge mortality and rehospitalization is still insufficient among in-hospital survivors of cardiogenic shock (CS), including acute myocardial infarction (AMI) and non-AMI survivors. Methods Patients with CS who survived after hospital discharge were selected from the Taiwan National Health Insurance Research Database. Each patient was followed up at 3-year intervals. Mortality and rehospitalization were analyzed using Kaplan-Meier curves and Cox regression models. Results There were 16,582 eligible patients. Of these, 42.4% and 57.6% were AMI-CS and non-AMI-CS survivors, respectively. The overall mortality and rehospitalization rates were considerably high, with reports of 7.0% and 22.1% at 30 days, 24.5% and 58.2% at 1 year, and 38.9% and 73.0% at 3 years, respectively, among in-hospital CS survivors. Cardiovascular (CV) problems caused approximately 40% mortality and 60% rehospitalization. Overall, the non-AMI-CS group had a higher mortality burden than the AMI-CS group owing to older age and a higher prevalence of comorbidities. In multivariable models, the non-AMI-CS group exhibited a lower risk of all-cause mortality (adjusted hazard ratio [aHR] 0.69, 95% confidence interval [CI] 0.60 to 0.78) and CV mortality (aHR 0.65, 95% CI 0.54 to 0.78) compared to the AMI-CS group. However, these risks diminished and even reversed after one year (aHR 1.13, 95% CI 1.03 to 1.25 for all-cause mortality; aHR 1.27, 95% CI 1.09 to 1.49 for CV mortality).This reversal was not observed in all-cause and CV rehospitalization. For rehospitalization, AMI-CS was associated with the risk of CV rehospitalization in the entire observation period (aHR:0.80, 95% CI:0.76–0.84). Conclusions In-hospital AMI-CS survivors had an increased risk of CV rehospitalization and 30-day mortality, whereas those with non-AMI-CS had a greater mortality risk after 1-year follow-up.

Abstract Objective To determine the optimal scan duration for ultrafast DCE-MRI in effectively differentiating benign from malignant breast lesions. Methods The study prospectively recruited participants who underwent breast ultrafast DCE-MRI from September 2021 to March 2023. A 30-phase breast ultrafast DCE-MRI on a 3.0-T MRI system was conducted with a 4.5-s temporal resolution. Scan durations ranged from 40.5 s to 135.0 s, during which the analysis is performed at three-phase intervals, forming eight dynamic sets (scan duration [SD]40.5s: 40.5 s, SD54s: 54.0 s, SD67.5s: 67.5 s, SD81s: 81.0 s, SD94.5s: 94.5 s, SD108s: 108.0 s, SD121.5s: 121.5 s, and SD135s: 135.0 s). Two ultrafast DCE-MRI parameters, maximum slope (MS) and initial area under the curve in 60 s (iAUC), were calculated for each dynamic set and compared between benign and malignant lesions. Areas under the receiver operating characteristic curve (AUCs) were used to assess their diagnostic performance. Results A total of 140 women (mean age, 47 ± 11 years) with 151 lesions were included. MS and iAUC from eight dynamic sets exhibited significant differences between benign and malignant lesions (all p 0.05). Conclusions Ultrafast DCE-MRI with a 67.5-s scan duration appears optimal for effectively differentiating malignant from benign breast lesions. Critical relevance statement By evaluating scan durations (40.5–135 s) and analyzing two ultrafast DCE-MRI parameters, we found a scan duration of 67.5 s optimal for discriminating between these lesions and offering a balance between acquisition time and diagnostic efficacy. Key Points Ultrafast DCE-MRI can effectively differentiate malignant from benign breast lesions. A minimum of 67.5-sec ultrafast DCE-MRI scan duration is required to differentiate benign and malignant lesions. Extending the scan duration beyond 67.5 s did not significantly improve diagnostic accuracy. Graphical Abstract

Abstract Crystallization is a fundamental phenomenon which describes how the atomic building blocks such as atoms and molecules are arranged into ordered or quasi-ordered structure and form solid-state materials. While numerous studies have focused on the nucleation behavior, the precise and spatiotemporal control of growth kinetics, which dictates the defect density, the micromorphology, as well as the properties of the grown materials, remains elusive so far. Herein, we propose an optical strategy, termed optofluidic crystallithography (OCL), to solve this fundamental problem. Taking halide perovskites as an example, we use a laser beam to manipulate the molecular motion in the native precursor environment and create inhomogeneous spatial distribution of the molecular species. Harnessing the coordinated effect of laser-controlled local supersaturation and interfacial energy, we precisely steer the ionic reaction at the growth interface and directly print arbitrary single crystals of halide perovskites of high surface quality, crystallinity, and uniformity at a high printing speed of 102 μm s−1. The OCL technique can be potentially extended to the fabrication of single-crystal structures beyond halide perovskites, once crystallization can be triggered under the laser-directed local supersaturation.

Abstract In this scoping review, we evaluated the performance of artificial intelligence (AI) in clinical radiology practice and examined health professionals' perspectives regarding AI use in radiology. This review followed the Joanna Briggs Institute (JBI) methodological guidelines. We searched multiple databases and the gray literature from March 15, 2016 to December 31, 2023. Of 49 articles reviewed, 13 assessed the performance of AI in radiology clinical practice, and 36 examined the attitudes of health professionals toward the use of AI in radiology. In four separate studies, AI significantly improved the diagnostic sensitivity or detection rate. Furthermore, six articles emphasized a significant reduction in case reading times with AI use. Although three studies suggested an increase in specificity with the assistance of AI, these findings did not reach statistical significance. Health professionals expressed the belief that AI would have a significant impact on radiology but would not replace radiologists in the near future. Limited knowledge of AI was observed among health professionals, who supported increased education and explicit regulations and guidelines related to AI. Overall, AI can enhance diagnostic efficiency and accuracy in clinical radiology practice. However, knowledge gaps and the concerns of health professionals should be addressed by prioritizing education and reinforcing ethical and legal regulations to facilitate the advancement of AI use in radiology. This scoping review provides evidence toward a comprehensive understanding of AI's potential in clinical radiology practice, promoting its use and stimulating further discussion on related challenges and implications.

Abstract The evolution of Artificial Intelligence of Things (AIoT) pushes connectivity from human‐to‐things and things‐to‐things, to AI‐to‐things, has resulted in more complex physical networks and logical associations. This has driven the demand for Internet of Things (IoT) devices with powerful edge data processing capabilities, leading to exponential growth in device quantity and data generation. However, conventional data preprocessing methods, such as data compression and encoding, often require edge devices to allocate computational resources for decoding. Additionally, some lossy compression methods, like JPEG, may result in the loss of important information, which has negative impact on the AI training. To address these challenges, this paper proposes a two‐step attribute reduction approach, targeting devices and dimensions, to reduce the massive amount of data in the AIoT network while avoiding unnecessary utilization of edge device resources for decoding. The device‐oriented and dimension‐oriented attribute reductions identify important devices and dimensions, respectively, to mitigate the multimodal interference caused by the large‐scale devices in the AIoT network and the curse of dimensionality associated with high‐dimensional AIoT data. Numerical results and analysis show that this approach effectively eliminates redundant devices and numerous dimensions in the AIoT network while maintaining the basic data correlation.

ABSTRACT Aims/Introduction Cardiovascular mortality risk is elevated among patients with diabetes and concurrent chronic kidney disease. However, controversy surrounds the use of aspirin for primary prevention within this population. This study aims to assess the effectiveness and safety of low‐dose aspirin for primary prevention in patients with diabetes and pre‐end‐stage renal disease. Materials and Methods This was a retrospective population‐based cohort study using the National Health Insurance Research Database in Taiwan. The study included adults with type 2 diabetes who were enrolled in the pre‐end‐stage renal disease pay‐for‐performance program and had no atherosclerotic cardiovascular disease. We used propensity score analysis to control baseline characteristics between the two groups. Clinical outcomes including cardiovascular mortality, all‐cause mortality, major bleeding, and renal disease progression were compared between patients who first received aspirin and those who did not. Results Between January 2012 and December 2015, a total of 2,155 low‐dose aspirin users and 6,737 nonaspirin users were identified. Following propensity score adjustment, aspirin use exhibited a comparable risk of cardiovascular death compared with nonaspirin users (adjusted hazard ratio [aHR] 1.12; 95% confidence interval [CI] 0.65–1.95; P = 0.681). The risk of all‐cause mortality was similar between the two groups (aHR 1.07; 95% CI 0.92–1.24; P = 0.385). Similar risks were observed in terms of major bleeding and renal disease progression. Conclusions In patients with diabetes and pre‐end‐stage renal disease who lacked atherosclerotic cardiovascular disease, low‐dose aspirin did not demonstrate a reduction in mortality. These findings do not support the use of aspirin for primary prevention in this high‐risk population.

Abstract Topological phononic cavities, such as ring resonators with topological whispering gallery modes (TWGMs), offer a flexible platform for the realization of robust phononic circuits. However, the chiral mechanism governing TWGMs and their selective routing in integrated phononic circuits remain unclear. This work reveals, both experimentally and theoretically, that at a phononic topological interface, the elastic spin texture is intricately linked to, and can be explained through a knowledge of, the phonon eigenmodes inside each unit cell. Furthermore, for paired, counterpropagating TWGMs based on such interfaces in a waveguide resonator, this study demonstrates that the elastic spin exhibits locking at discrete frequencies. Backed up by theory, experiments on kHz TWGMs in thin honeycomb‐lattice aluminum plates bored with clover‐leaf shaped holes show that together with this spin‐texture related angular‐momentum locking mechanism at a single topological interface, there are triplicate parity‐frequency‐space selective wave routing mechanisms. In the future, these mechanisms can be harnessed for the versatile manipulation of elastic‐spin based routing in phononic topological insulators.

The treatment time window for acute cerebral infarction in global guidelines is within 24 h. We report a patient who was admitted to the hospital and underwent endovascular treatment reaching 40 h. During vascular examination, the thrombus moved to distant segment, and then the surgeon quickly performed endovascular treatment. The patient ultimately achieved a good outcome. This case indicates that thrombus is moveable at any time, we expected to provide advice to clinical doctors that vascular examination should also be arranged as soon as possible to clarify the etiology in stroke patients especially with low NIHSS scores.

Arthroscopic capsular release is required in some patients with frozen shoulder (FS). In some cases of recalcitrant FS, arthroscopic capsular release is difficult because of the abnormal narrowing of the joint space. The aim of this article is to introduce an arthroscopic double posterior approach combined with lateral and anterior approaches that is used to complete release of the glenohumeral joint capsule at 360°, subacromial debridement, and long head of biceps tenotomy. This article shows that this double posterior technique is a safe and highly effective totally intra-arthroscopic release technique for recalcitrant FS.

Our research is dedicated to combating HIV by targeting its Matrix (MA) domain, which is crucial for viral assembly and replication. This strategy specifically aims to interrupt early-stage infection and deter drug resistance by focusing on this essential domain. Due to the MA domain’s conservation across different HIV strains, our approach promises broad-spectrum efficacy, which is particularly crucial in regions marked by significant genetic diversity and resistance issues. In our study, we introduce CNP0269688, a natural product that exhibits high affinity for the HIV-1 Matrix. Through detailed molecular dynamics simulations, we have assessed the compound’s structural stability and interaction dynamics, particularly its potential to hinder Protein-tRNA interactions. This analysis lays the groundwork for future experimental investigations. Our efforts are steps toward enhancing HIV treatment, reducing viral transmission, and curbing drug resistance, with the ultimate aim of controlling and eradicating the pandemic, thereby contributing significantly to public health and scientific advancement.

Summary: Cardiovascular diseases (CVDs) and metabolic disorders (MDs) have surfaced as formidable challenges to global health, significantly imperiling human well-being. Recently, microneedles (MNs) have garnered substantial interest within the realms of CVD and MD research. Offering a departure from conventional diagnostic and therapeutic methodologies, MNs present a non-invasive, safe, and user-friendly modality for both monitoring and treatment, thereby marking substantial strides and attaining pivotal achievements in this avant-garde domain, while also unfurling promising avenues for future inquiry. This thorough review encapsulates the latest developments in employing MNs for both the surveillance and management of CVDs and MDs. Initially, it succinctly outlines the foundational principles and approaches of MNs in disease surveillance and therapy. Subsequently, it delves into the pioneering utilizations of MNs in the surveillance and management of CVDs and MDs. Ultimately, this discourse synthesizes and concludes the primary findings of this investigation, additionally prognosticating on the trajectory of MN technology.

Proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) is a rare disease without standardized treatment modalities. Daratumumab is a human IgG monoclonal anti-CD38 antibody that has been demonstrated to be highly effective and safe in the treatment of PGNMID. This article reports a 66-year-old female who suffered from edema in both lower limbs and face for 6 years with mild proteinuria and hypoproteinemia. Renal biopsy displayed eight glomeruli, among which two presented with glomerulosclerosis, and the remaining six exhibited moderate diffuse hyperplasia of glomerular mesangial cells and stroma with endothelial cell proliferation. Immunofluorescence microscopy revealed lumpy and diffuse deposits of C3, C1q, IgG, and κ light chain in the glomerular mesangium, with strongly positive staining for IgG3 and varying degrees of weak to negative staining for IgG1, IgG2, IgG4, and λ light chain. Additionally, ultrastructural analysis unveiled that the glomerular basement membrane was segmentally thickened, accompanied by diffuse pedicle fusion, segmental tethered insertion, subendothelial deposits, and electron-dense material in tethered areas. The patient received a total dose of 800 mg of daratumumab (400 mg daily for two consecutive days), as well as daily prednisone (25 mg) and valsartan (80 mg), for treatment and achieved complete remission after three-month follow-up. This case represents an early attempt to treat PGNMID with low-dose daratumumab but requires long-term follow-up.

Dehalogenating bacteria are still deficient when targeted to deal with chlorinated hydrocarbons (CHCs) contamination: e.g., slow metabolic rates, limited substrate range, formation of toxic intermediates. To enhance its dechlorination capacity, biochar and its composites with appropriate surface activity and biocompatibility are selected for coupled dechlorination. Because of its special surface physical and chemical properties, it promotes biofilm formation by dehalogenating bacteria on its surface and improves the living environment for dehalogenating bacteria. Next, biochar and its composites provide active sites for the removal of CHCs through adsorption, activation and catalysis. These sites can be specific metal centers, functional groups or structural defects. Under microbial mediation, these sites can undergo activation and catalytic cycles, thereby increasing dechlorination efficiency. However, there is a lack of systematic understanding of the mechanisms of dechlorination in biogenic and abiogenic systems based on biochar. Therefore, this article comprehensively summarizes the recent research progress of biochar and its composites as a “Taiwan balm” for the degradation of CHCs in terms of adsorption, catalysis, improvement of microbial community structure and promotion of degradation and metabolism of CHCs. The removal efficiency, influencing factors and reaction mechanism of the degraded CHCs were also discussed. The following conclusions were drawn, in the pure biochar system, the CHCs are fixed to its surface by adsorption through chemical bonds on its surface; the biochar composite material relies on persistent free radicals and electron shuttle mechanisms to react with CHCs, disrupting their molecular structure and reducing them; biochar-coupled microorganisms reduce CHCs primarily by forming an “electron shuttle bridge” between biological and non-biological organisms. Finally, the experimental directions to be carried out in the future are suggested to explore the optimal solution to improve the treatment efficiency of CHCs in water.

Abstract Background Lung cancer significantly impairs exercise capacity and health-related quality of life (HRQL). Pulmonary rehabilitation (PR) has demonstrated positive effects on exercise capacity and HRQL in lung cancer patients. However, its impact on cardiopulmonary function needs further exploration. The aim of this study was to explore the effects of PR on cardiopulmonary function, exercise capacity and HRQL in patients with lung cancer. Methods Patients with lung cancer were enrolled in a 12-week PR program. Each participant underwent a thorough evaluation, which included spirometry, cardiopulmonary exercise testing, respiratory muscle strength test, and evaluation of HRQL using the Chronic Obstructive Pulmonary Disease Assessment Test (CAT). Results Fifty-six patients completed the PR program. Following PR, exercise capacity significantly improved, as evidenced by increased peak oxygen uptake and work rate (both p

Sleep disordered breathing (SDB) is highly prevalent and may be linked to cardiovascular disease in a bidirectional manner. The Taiwan Society of Cardiology, Taiwan Society of Sleep Medicine and Taiwan Society of Pulmonary and Critical Care Medicine established a task force of experts to evaluate the evidence regarding the assessment and management of SDB in patients with atrial fibrillation (AF), hypertension and heart failure with reduced ejection fraction (HFrEF). The GRADE process was used to assess the evidence associated with 15 formulated questions. The task force developed recommendations and determined strength (Strong, Weak) and direction (For, Against) based on the quality of evidence, balance of benefits and harms, patient values and preferences, and resource use. The resulting 11 recommendations are intended to guide clinicians in determining which the specific patient-care strategy should be utilized by clinicians based on the needs of individual patients.

Background: Proper identification of the polymicrobial microorganisms in patients with limb-threatening diabetic foot ulcers (LTDFUs) using conventional culture is insufficient. This prospective study evaluates the potential value of adjuvant molecular testing assisting in identify fastidious micro-organisms in LTDFUs compared to standard treatment alone. Methods: Ninety patients with LTDFUs received interdisciplinary and standard antibiotic treatment in a referral diabetic foot center. A simultaneous 16S amplicon sequencing (16S AS) specimen along with conventional culture collected at admission was used to retrospectively evaluate the microbiological findings and its association with amputation outcomes. Results: The microorganism count revealed by 16S AS overwhelmed that of conventional culturing (17 vs. 3 bacteria/ulcer respectively). The Stenotrophomonas spp. revealed in 29 patients were highly correlated with major (above ankle) amputation (OR: 4.76, 95% CI 1.01–22.56), while only one had been concomitantly identified by conventional culturing. Thus, there were 27 cases without proper antibiotics coverage during treatment. Conclusions: Adjuvant molecular testing assisted identification of fastidious pathogens such as Stenotrophomonas infection and might be associated with major amputation in patients with LTDFUs.

Abstract Objective The aim of this study was to investigate the clinical, imaging and pathological features of extraskeletal osteosarcoma (EOS) and to improve the understanding of this disease and other similar lesions. Methods The data for 11 patients with pathologically confirmed extraosseous osteosarcoma, including tumour site and size and imaging and clinical manifestations, were analysed retrospectively. Results Six patients were male (60%), and 5 were female (40%); patient age ranged from 23 to 76 years (average age 47.1 years). Among the 11 patients, 7 had clear calcifications or ossification with different morphologies, and 2 patients showed a massive mature bone tumour. MRI showed a mixed-signal mass with slightly longer T1 and T2 signals in the tumour parenchyma. Enhanced CT and MRI scans showed enhancement in the parenchyma. Ten patients had different degrees of necrosis and cystic degeneration in the mass, 2 of whom were complicated with haemorrhage, and MRI showed “fluid‒fluid level” signs. Of the 11 patients, five patients survived after surgery, and no obvious recurrence or metastasis was found on imaging examination. One patient died of lung metastasis after surgery, and 2 patients with open biopsy died of disease progression. One patient died of respiratory failure 2 months after operation. 2 patients had positive surgical margins, and 1 had lung metastasis 6 months after operation and died 19 months after operation. Another patient had recurrence 2 months after surgery. Conclusion The diagnosis of EOS requires a combination of clinical, imaging and histological examinations. Cystic degeneration and necrosis; mineralization is common, especially thick and lumpy mineralization. Extended resection is still the first choice for localized lesions. For patients with positive surgical margins or metastases, adjuvant chemoradiotherapy is needed.

The field of multi-source remote sensing observation is becoming increasingly dynamic through the integration of various remote sensing data sources. However, existing deep learning methods face challenges in differentiating between internal and external relationships and capturing fine spatial features. These models often struggle to effectively capture comprehensive information across remote sensing data bands, and they have inherent differences in the size, structure, and physical properties of different remote sensing datasets. To address these challenges, this paper proposes a novel geometric-algebra-based spectral–spatial hierarchical fusion network (GASSF-Net), which uses geometric algebra for the first time to process multi-source remote sensing images, enabling a more holistic approach to handling these images by simultaneously leveraging the real and imaginary components of geometric algebra to express structural information. This method captures the internal and external relationships between remote sensing image features and spatial information, effectively fusing the features of different remote sensing data to improve classification accuracy. GASSF-Net uses geometric algebra (GA) to represent pixels from different bands as multivectors, thus capturing the intrinsic relationships between spectral bands while preserving spatial information. The network begins by deeply mining the spectral–spatial features of a hyperspectral image (HSI) using pairwise covariance operators. These features are then extracted through two branches: a geometric-algebra-based branch and a real-valued network branch. Additionally, the geometric-algebra-based network extracts spatial information from light detection and ranging (LiDAR) to complement the elevation data lacking in the HSI. Finally, a genetic-algorithm-based cross-fusion module is introduced to fuse the HSI and LiDAR data for improved classification. Experiments conducted on three well-known datasets, Trento, MUUFL, and Houston, demonstrate that GASSF-Net significantly outperforms traditional methods in terms of classification accuracy and model efficiency.

Summary: Bronchoscopic-assisted discrimination of lung tumors presents challenges, especially in cases with contraindications or inaccessible lesions. Through meta-analysis and validation using the HumanMethylation450 database, this study identified methylation markers for molecular discrimination in lung tumors and designed a sequencing panel. DNA samples from 118 bronchial washing fluid (BWF) specimens underwent enrichment via multiplex PCR before targeted methylation sequencing. The Recursive Feature Elimination Cross-Validation and deep neural network algorithm established the CanDo classification model, which incorporated 11 methylation features (including 8 specific to the TBR1 gene), demonstrating a sensitivity of 98.6% and specificity of 97.8%. In contrast, bronchoscopic rapid on-site evaluation (bronchoscopic-ROSE) had lower sensitivity (87.7%) and specificity (80%). Further validation in 33 individuals confirmed CanDo’s discriminatory potential, particularly in challenging cases for bronchoscopic-ROSE due to pathological complexity. CanDo serves as a valuable complement to bronchoscopy for the discriminatory diagnosis and stratified management of lung tumors utilizing BWF specimens.

Abstract Background We conducted a comparative study to examine the differences in the use of complementary therapies (CT) among patients who attended diabetic clinics for follow-up treatment between 2007 and 2023 in Taiwan. Methods This study employed a cross-sectional survey design to recruit individuals with diabetes from two regions (northern and southern) of Taiwan. A total of 183 and 307 participants were included in the surveys of 2007 and 2023, respectively. The data were analyzed using IBM SPSS Statistics version 28.0 to compare the survey results between the two time periods. Results Among the various CTs, nutritional supplements remained the most prevalent, with a significant increase in usage from 68.3% in 2007 to 89.9% in 2023. Conversely, other therapies, such as Chinese herbal medicines, manipulative-based therapies, supernatural healings, and bioelectromagnetic-based therapies, demonstrated a significant decrease in usage between the two time periods. Furthermore, the disclosure rate of CT use to healthcare professionals remained persistently low, with only 24.6% in 2007 and a slight increase to 30.3% in 2023. Conclusion The significant rise in the use of nutritional supplements in conjunction with conventional medicine, without adequate monitoring and guidance from healthcare professionals, poses a substantial risk of unregulated blood sugar control, compromised diabetes management, and potential harm to health outcomes.

AIM: To compare the clinical efficacy of the Balanced energy system versus the conventional torsional ultrasound system in phacoemulsification surgeries for cataracts with varying nuclear hardness.METHODS: In this study, 120 patients(122 eyes)with age-related cataracts scheduled for surgery between November 2021 and November 2022 at our hospital were randomly divided into two groups: 58 patients(59 eyes)in the experimental group underwent surgery using the Balanced energy system, while 62 patients(63 eyes)in the control group were treated with the conventional torsional ultrasound system. Intraoperative cumulative dissipated energy(CDE), case time(CT), aspiration time(AST), and estimated fluid used(EFU)were recorded. Patients were followed-up for 3mo to examine and record the best-corrected visual acuity(BCVA)and corneal endothelial cell density(ECD), and to calculate the rate of endothelial cell loss.RESULTS: Comparing the intraoperative parameters between the two groups, there was no significant difference in CT(P>0.05), but the CDE, AST and EFU of the patients in the experimental group were lower than those of the control group(P0.05). In grade IV nuclear hardness cataracts, the rate of endothelial cell loss in the experimental group was significantly lower than that in the control group(4.63%±4.10% vs. 6.63%±4.49%, P

Abstract Although the origin of the fat-tail characteristic of the degree distribution in complex networks has been extensively researched, the underlying cause of the degree distribution characteristic across the complete range of degrees remains obscure. Here, we propose an evolution model that incorporates only two factors: the node’s weight, reflecting its innate attractiveness (nature), and the node’s degree, reflecting the external influences (nurture). The proposed model provides a good fit for degree distributions and degree ratio distributions of numerous real-world networks and reproduces their evolution processes. Our results indicate that the nurture factor plays a dominant role in the evolution of social networks. In contrast, the nature factor plays a dominant role in the evolution of non-social networks, suggesting that whether nodes are people determines the dominant factor influencing the evolution of real-world networks.

Microneedles (MNs) can be used for the topical treatment of skin disorders as they directly deliver therapeutics to the site of skin lesions, resulting in increased therapeutic efficacy while having minimum side effects. MNs are used to deliver different kinds of therapeutics (e.g., small molecules, macromolecules, nanomedicines, living cells, bacteria, and exosomes) for treating various skin disorders, including superficial tumors, wounds, skin infections, inflammatory skin diseases, and abnormal skin appearance. The therapeutic efficacy of MNs can be improved by integrating the advantages of multiple therapeutics to perform combination therapy. Through careful designing, MNs can be further modified with biomimetic structures for the responsive drug release from internal and external stimuli and to enhance the transdermal delivery efficiency for robust therapeutic outcomes. Some studies have proposed the use of drug-free MNs as a promising mechanotherapeutic strategy to promote wound healing, scar removal, and hair regeneration via a mechanical communication pathway. Although MNs have several advantages, the practical application of MNs suffers from problems related to industrial manufacture and clinical evaluation, making it difficult for clinical translation. In this study, we summarized the various applications, emerging challenges, and developmental prospects of MNs in skin disorders to provide information on ways to advance clinical translation.

Crisp Nile tilapia (Oreochromis niloticus) is a kind of valuable fish product with high muscle firmness and crispiness texture. However, with the change of physicochemical in crisp Nile tilapia, the frozen storage parameters and quality would be different comparing to normal Nile tilapia. Thus, the aim of this study was to analyze the changes in texture, chemical quality indices and volatile compounds of Nile tilapia fillets during frozen storage. The remaining storage time of the crisp Nile tilapia fillets could be estimated within 120 days. During frozen storage, fillets resulted in softer started at 90-day, and 36.75%, 45.74%, 48.81% and 20.37% reduction of hardness, springiness, gumminess and chewiness were observed at 120-day. Thiobarbituric acid reactive substances (TBARS) for frozen samples showed similar with fresh fillets within 60 days, while the TBARS was 1.97 folds higher than fresh one at 120-day. Low-field nuclear magnetic resonance (LF-NMR) indicated that the water loss of Nile tilapia fillets was significant changed at 120-day, which reduced more than 12.5% water out of weight. The volatile compound analysis showed that more free fatty acid will be detected at 120-day comparing to the fresh fillets. The combined results demonstrated that the crisp Nile tilapia fillets had the best quality before 60 days frozen storage then loss of some quality properties in longer freezing. Thus, these results identified the ideal storage strategy for the preservation of crisp Nile tilapia without affecting sensory appeal and commercial value.

Abstract Increasing evidence shows the African lineage Zika virus (ZIKV) displays a more severe neurovirulence compared to the Asian ZIKV. However, viral determinants and the underlying mechanisms of enhanced virulence phenotype remain largely unknown. Herein, we identify a panel of amino acid substitutions that are unique to the African lineage of ZIKVs compared to the Asian lineage by phylogenetic analysis and sequence alignment. We then utilize reverse genetic technology to generate recombinant ZIKVs incorporating these lineage-specific substitutions based on an infectious cDNA clone of Asian ZIKV. Through in vitro characterization, we discover a mutant virus with a lysine to arginine substitution at position 101 of capsid (C) protein (termed K101R) displays a larger plaque phenotype, and replicates more efficiently in various cell lines. Moreover, K101R replicates more efficiently in mouse brains and induces stronger inflammatory responses than the wild type (WT) virus in neonatal mice. Finally, a combined analysis reveals the K101R substitution promotes the production of mature C protein without affecting its binding to viral RNA. Our study identifies the role of K101R substitution in the C protein in contributing to the enhanced virulent phenotype of the African lineage ZIKV, which expands our understanding of the complexity of ZIKV proteins.

Abstract Background The present study aimed to investigate the differences in chronobiology and prevention between patients with acute type-A aortic dissection (ATAAD) complicated with sleep apnea syndrome (SAS) and without sleep apnea syndrome (non-SAS). Methods We retrospectively analyzed the clinical information of ATAAD patients using hospital medical records and regional meteorological and chronological information between January 2013 and December 2019. Results An early mortality rate of 16.9% (196 out of 1160 cases) was observed, comprising 95 cases of aortic rupture before surgery and 101 surgery-related deaths. Eighty-one of the 964 survivors were screened for SAS using complete morphological characteristics. Of these patients, 291 (33.0%) suffered from SAS, while 590 (67.0%) had no SAS. Based on a Circular Von Mises distribution analysis, the non-SAS patients experienced a significant morning peak in the occurrence of ATAAD at 10:04 (r1 = 0.148, p 0.05). Furthermore, SAS patients experienced a peak on Fridays (χ2 = 36.419, p

In recent years, the number of underwater road tunnels in Chinese cities has increased. However, the current situation of personal fire safety literacy as it pertains to these tunnels remains unclear. To address this gap, a questionnaire survey was conducted to investigate people’s awareness of escape slides, evacuation signs, and the correct evacuation paths for fire escape. A total of 1049 respondents in Changsha, China, were surveyed, with 791 valid questionnaires collected and analyzed. The findings revealed that a significant proportion of respondents (81.80%) were unaware of the presence of escape slides in underwater road tunnels, while 87.86% could not recognize them and 93.05% could not use them. Only 42.04% of respondents could identify evacuation signs in underwater road tunnels. In the event of a fire, just half of the respondents could select the appropriate escape or evacuation path. Additionally, demographic differences among respondents also influenced their level of fire safety literacy. Based on these findings, it is recommended that the government and relevant organizations should enhance the dissemination of knowledge regarding escape slides and evacuation signs in underwater road tunnels.

Early rehabilitation has beneficial impacts on functional outcomes for patients with acute stroke. However, whether the addition of virtual reality (VR) training could further improve these patients’ muscle strength, functional recovery, and psychological health is unknown. A randomized controlled trial was conducted on 33 patients with first-time acute ischemic stroke. The patients were randomly assigned using a 1:1 randomization ratio to either the experimental group (EG) or the comparison group (CG). Both groups received early rehabilitation, and the EG received extra VR training during their stay in the hospital. Muscle strength, functional status, and psychological health were assessed before the intervention and at discharge. Generalized estimating equations were used to examine the intervention effects via the interaction of time and group. After adjusting for potential covariates, the EG showed a more significant decrease in depression at discharge than the CG (ß = 3.77, p = 0.011). There were no differences in muscle strength and functional recovery between groups after intervention. Adding VR training into early rehabilitation facilitates substantial positive effects on psychological health, specifically depression, but not muscle strength and functional recovery, compared to receiving early rehabilitation alone in patients with first-time acute stroke during their hospitalized period.

Abstract Porcine deltacoronavirus (PDCoV) is a novel coronavirus that causes enteric diseases in pigs leading to substantial financial losses within the industry. The absence of commercial vaccines and limited research on PDCoV vaccines presents significant challenges. Therefore, we evaluated the safety and immunogenicity of recombinant pseudorabies virus (PRV) rPRVXJ-delgE/gI/TK-S through intranasal mucosal immunization in weaned piglets and SPF mice. Results indicated that rPRVXJ-delgE/gI/TK-S safely induced PDCoV S-specific and PRV gB-specific antibodies in piglets, with levels increasing 7 days after immunization. Virus challenge tests demonstrated that rPRVXJ-delgE/gI/TK-S effectively improved piglet survival rates, reduced virus shedding, and alleviated clinical symptoms and pathological damage. Notably, the recombinant virus reduced anti-inflammatory and pro-inflammatory responses by regulating IFN-γ, TNF-α, and IL-1β secretion after infection. Additionally, rPRVXJ-delgE/gI/TK-S colonized target intestinal segments infected with PDCoV, stimulated the secretion of cytokines by MLVS in mice, stimulated sIgA secretion in different intestinal segments of mice, and improved mucosal immune function. HE and AB/PAS staining confirmed a more complete intestinal mucosal barrier and a significant increase in goblet cell numbers after immunization. In conclusion, rPRVXJ-delgE/gI/TK-S exhibits good immunogenicity and safety in mice and piglets, making it a promising candidate vaccine for PDCoV.