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The Division for Early Childhood (DEC) collaborates with the Early Intervention and Early Childhood Special Education (EI/ECSE) community and allied partners to create resources (such as publications like Young Exceptional Children [YEC] and The Journal of Early Intervention [JEI] and products like The DEC Recommended Practices and Learning Decks) that reflect collective expertise. These resources address field needs and support DEC's mission of guiding early intervention and special education services for infants, toddlers, and preschoolers with or at-risk for disabilities and their families. To advance equity, DEC members are committed to studying, discussing, and applying DEC's Racial Equity Point of View (RE POV; Division for Early Childhood [DEC], 2023) to all its resources and the system that produces them. To create transformative change within DEC's resources, this article includes reflections on how DEC's RE POV can inspire new associated practices and policies to foster a more equitable and inclusive resource system. Also included are reflective questions for readers, DEC members, and non-members alike, to build their critical consciousness related to the need to disrupt structural racism and ableism and (re)build DEC's resource system into one that prioritizes equity.

Embodied cognition posits that processing concepts requires sensorimotor activation. Previous research has shown that perceived power is spatially embodied along the vertical axis. However, it is unclear whether such mapping applies equally in the two languages of bilinguals. Using event-related potentials, we compared spatial embodiment correlates in participants reporting the source of auditory words as being presented from above or below their sitting position. English bilinguals responded faster for congruent presentations of high-power words (presented above) but not for congruent presentations of low-power words (presented below) in both languages. Low-power words together also failed to modulate N400 amplitude or interact with language. However, follow-up analyses on high-power words showed congruency effects on N400 amplitude in Chinese but not in English. Finally, English controls showed no effect. This suggests that spatial embodiment differs across languages in bilinguals, but the roles of culture and proficiency require further research.

Objective: We present first-trimester application of expanded non-invasive prenatal testing (NIPT) in the genetic investigation of fetal 1p36 deletion syndrome associated with a familial unbalanced reciprocal translocation of 46,XX,der(1)t(1;2) (p36.2;q37.3)dmat. Case report: A 37-year-old, gravida 2, para 0, woman underwent expanded NIPT at 13 weeks of gestation because of advanced maternal age and the fear of complications of invasive procedures of prenatal diagnosis. She had experienced one spontaneous abortion. The pregnancy was conceived by in vitro fertilization and embryo transfer (IVF-ET) because of tubal occlusion. NIPT was positive for 1p36 deletion. At 17 weeks of gestation, she underwent amniocentesis but intrauterine fetal death occurred after amniocentesis and the pregnancy was terminated. Amniocentesis revealed a derivative chromosome 1 with an aberrant short arm terminal segment of chromosome 1. Subsequent cytogenetic analysis of parental bloods showed a karyotype of 46,XY in the father and a karyotype of 46,XX,t(1;2) (p36.2;q37.3) in the mother. The karyotype of amniocytes was 46,XX,der(1)t(1;2) (p36.2;q37.3)dmat, consistent with partial monosomy 1p (1p36.2→pter) and partial trisomy 2q (2q37.3→qter). Array comparative genomic hybridization (aCGH) analysis on the DNA extracted from cultured amniocytes revealed the result of arr 1p36.33p36.22 (852,863–11,303,452) × 1.0 and arr 2q37.3 (242,785,405–243,068,396) × 3.0 [GRCh 37] with a 10.451-Mb deletion of 1p36.33-p36.22 encompassing 116 OMIM genes including RERE and a 283-kb duplication of 2q37.3 encompassing one OMIM gene of PDCD1. Conclusion: Expanded NIPT has the advantage of early detection of familial unbalanced reciprocal translocation in the fetus.

Citrus bacterial canker (CBC) is resulted from Xanthomonas citri subsp. citri (Xcc) infection and poses a significant threat to citrus production. Glutathione S-transferases (GSTs) are critical in maintaining redox homeostasis in plants, especially in relation to abiotic and biotic stress responses. However, the function of GSTs in resisting CBC remains unclear. Here, citrus glutathione S-transferases were investigated applying a genome-wide approach. In total, 69 CsGSTs belonging to seven classes were identified, and the phylogeny, chromosomal distribution, gene structures and conserved motifs were analyzed. Several CsGSTs responded to Xcc infection, as observed in the upregulation of CsGSTF1 and CsGSTU18 in the CBC-sensitive ‘Wanjincheng’ variety but not in the resistant ‘Kumquat’ variety. CsGSTF1 and CsGSTU18 were localized at the cytoplasm. Transient overexpression of CsGSTF1 and CsGSTU18 mediated reactive oxygen species (ROS) scavenging, whereas the virus-induced gene silencing (VIGS) of CsGSTF1 and CsGSTU18 caused strong CBC resistance and ROS burst. The present study investigated the characterization of citrus GST gene family, and discovered that CsGSTF1 and CsGSTU18 negatively contributed to CBC through modulating ROS homeostasis. These findings emphasize the significance of GSTs in infection resistance in plants.

Abstract During the operation of load cell, heat is generated by the strain gauge and the electronics on the PCB board, which leads to temperature gradients within the sensor itself. These temperature gradients are unstable at different ambient temperatures. Compensation inaccuracies can also occur when compensating for sensor measurements at different temperatures This paper proposes a method to change the position of temperature compensation resistors to address errors caused by the temperature field effect of the strain gauge sensor itself. Without affecting the sensor’s strain measurement, the correctness of the proposed method is demonstrated through steady-state thermal simulation results in ANSYS and experimental results, effectively addressing errors caused by unstable temperature gradients during the operation of strain gauge sensors.

Abstract Tea gray blight disease is a significant threat to the tea industry. In this study, a biological activity approach was utilized to investigate the efficacy of green fungicides from Magnolia officinalis stem bark against Neopestalotiopsis ellipsospora. The active compounds were isolated and purified, and their structures were elucidated. In vitro and in vivo activity screenings revealed that the n-hexane extract, which contained magnolol and honokiol, exhibited strong activity against N. ellipsospora, showing complete inhibition at 100 mg/L. The EC50 values of magnolol and honokiol were 5.11 and 6.09 mg/L, respectively. Mechanistically, magnolol was found to disrupt N. ellipsospora invasion by damaging the cell membrane, increasing permeability, and causing leakage of intracellular substances. Transcriptome analysis revealed that magnolol treatment downregulates membrane-related genes and leads to the enrichment of lipid metabolism pathway genes. This study revealed that magnolol inhibits N. ellipsospora growth by affecting lipid metabolism and compromising cell membrane integrity.

Abstract Ferroptosis is a regulated cell death process dependent on iron, triggered by the accumulation of lipid peroxidation. The environmental context significantly impacts cellular sensitivities to ferroptosis. Serum, constituting the extracellular fluid composition in vivo, provides crucial environmental biomolecules. In this study, we investigated the influence of sera on ferroptosis induction, pinpointing the serum protein apolipoprotein H (APOH) as a pivotal inhibitor of ferroptosis. Moreover, we elucidated that APOH suppresses ferroptosis by activating the phosphoinositide 3-kinase (PI3K)-AKT-sterol regulatory element-binding proteins (SREBPs) pathway, thereby elevating stearoyl-CoA desaturase (SCD) levels and augmenting cellular monounsaturated fatty acid-containing phospholipids (MUFA-PLs). Furthermore, ApoHinfer, the peptide derivative of the active region of APOH, mimics its ferroptosis inhibitory activity. Our findings underscore the critical role of serum protein APOH in the inhibition of ferroptosis and indicates potential therapeutic applications in treating cancer and diseases associated with ferroptosis.

Abstract Background Serum (1,3)-β-D-glucan (BDG) detection for diagnosis of Pneumocystis jirovecii pneumonia (PJP) in non-human immunodeficiency virus (HIV) immunocompromised patients lacks intensive care unit (ICU)-specific data. We aimed to assess its performance and determine the optimal cutoff for PJP in ICU population. Methods This retrospective study included critically ill non-HIV immunocompromised patients admitted to a medical ICU with suspected pneumonia, undergoing simultaneous microbiological testing for P. jirovecii on lower respiratory tract specimens and serum BDG. Confounders affecting BDG positivity were explored by multivariable logistic regression. Optimal cut-offs were derived from Youden’s index for the entire cohort and subgroups stratified by confounders. Diagnostic performance of serum BDG was estimated at different cutoffs. Results Of 400 patients included, 42% were diagnosed with PJP and 58.3% had positive serum BDG. Serum BDG’s area under the receiver operating characteristic curve was 0.90 (0.87–0.93). At manufacturer’s 150 pg/ml cut-off, serum BDG had high sensitivity and negative predictive value (94%), but low specificity and positive predictive value (67%). Confounders associated with a positive serum BDG in PJP diagnosis included IVIG infusion within 3 days (odds ratio [OR] 9.24; 95% confidence interval [CI] 4.09–20.88, p

ABSTRACT Importance Nutrition is associated with neurodevelopment. Infants at high risk of cerebral palsy (CP) usually suffer from undernutrition, yet the relationship between nutritional status and neurodevelopmental levels is unclear. Objective To describe the nutritional status characteristics of infants at high risk of CP, and to explore the relationship between neurodevelopmental levels and nutritional status. Methods This single‐center cross‐sectional study enrolled infants at high risk of CP, with corrected age from 0 days to 12 months. Weight and height were measured and calculated into z‐scores, which were used to classify the nutritional status based on the World Health Organization growth charts and American Society for Parenteral and Enteral Nutrition standards. The Bayley Scales of Infant and Toddler Development were used to evaluate the developmental levels of gross motor, fine motor, cognition, receptive communication, and expressive communication. Results A total of 479 infants at high risk of CP were recruited, with 43.4% classified as undernutrition. Compared to those with normal neurodevelopment, the odds of moderate and severe undernutrition were about 1.8 and 3.9 times higher in gross motor delay, 2.2 and 3.1 times higher in fine motor delay, 2.5 and 9.4 times higher in cognition delay, 2.2 and 3.9 times higher in receptive communication delay, and 3.0 and 5.6 times higher in expressive communication delay. There were significant positive correlations between nutritional status and neurodevelopmental levels (P < 0.001). Interpretation Undernutrition and neurodevelopmental delays are prevalent among infants at high risk of CP. Worse nutritional status was correlated with lower neurodevelopmental levels.

A recent review of literature indicated limited research about the preparation of doctoral students in early intervention/early childhood special education (EI/ECSE). The purpose of this pilot study was to address this gap in research and investigate the mentorship of doctoral students who participated in the Division for Early Childhood's Consortium for Innovations in Doctoral Excellence (DECIDE). Mentors and mentees who participated in the DECIDE Mentoring Initiative participated in focus groups and interviews to share their mentoring experiences and provide suggestions for the mentorship of doctoral students. Qualitative research methods were used to analyze themes. Findings indicated (a) shifts in power dynamics occurred between the mentor and mentee dyad, (b) mentoring infrastructures may be beneficial, (c) mentoring relationships are unique for each dyad, and (d) further research is needed to investigate the mentoring needs of students from culturally, linguistically, and economically diverse backgrounds.

A semistructured preschool motor program was developed in response to the paucity of evidence-based motor programs for preschoolers with disabilities in inclusive classrooms. A randomized controlled trial (RCT) was undertaken to examine the impact of the "CHildren in Action: Motor Program for PreschoolerS (CHAMPPS)," a 21-week intervention that includes 42 Universal Design for Learning--embedded lessons with suggestions for supporting school readiness skills. Eight intervention and 8 control classrooms across 2 states participated in the RCT. Data on 51 children with disabilities provide initial evidence on how "CHAMPPS" positively impacted children's active engagement, motor, and social development. The promising results include gains in motor skills, sustained physical activity levels during motor play, increased on-task behavior, and high feasibility and usability ratings by teachers. Implications for practice and future research are discussed.

With intentional adult guidance, all children have opportunities to learn new skills across developmental domains during motor play. We collected and analyzed 501 written responses from 16 preschool teachers regarding their perceptions of intervention outcomes across domains, based on their observations during the CHildren in Action: Motor Program for PreschoolerS (CHAMPPS) intervention. This 21-week class-wide, semi-structured motor program was implemented in eight inclusive preschool classrooms. The findings reveal that teachers noticed many positive changes in children's social, communication, and pre-academic skills as well as their approaches to learning during the months when they implemented the CHAMPPS program. In addition to sharing data from this qualitative analysis, we discuss: (a) the value of motor interventions and purposefully embedding learning opportunities across developmental domains for young children with and without disabilities, and (b) the benefits of gathering end-users' perspectives as we collaborate with them to implement new interventions.

The importance of early science, technology, engineering, and math (STEM) learning opportunities for all young children has become increasingly documented by research and recommended practices. In addition, high quality inclusive settings where all children can access and benefit from learning activities continues to demonstrate optimal outcomes for all children. This manuscript reports findings from a survey broadly disseminated related to early childhood practitioners' and directors' perceptions related to STEM and inclusion and explores what practices related to STEM and inclusion are currently being used by early childhood practitioners and directors. While the majority of respondents supported the importance of both STEM and inclusion, there were varied responses related to relevance for infants and toddlers and inconsistent reports of specific practices being used. The findings suggest the need to emphasize and provide professional development opportunities focused on STEM and inclusion for our early childhood workforce more explicitly. Additional implications for research and practice are discussed.

Mixing Vane Grid (MVG) is considered as one of the most important components in the fuel assembly which not only plays the role of supporting the rod bundles but also improves the Critical Heat Flux (CHF) in the reactor core. Modeling and measuring the flow behavior accurately in the rod bundle is the key to understanding and learning complex grid performance in the fuel assembly and will develop high performance MVG. Usually, the fuel assembly in the reactor core consists of 17 × 17 or 16 × 16 rod bundles, it is hardly to use the original MVGs to perform study. The representative smaller prototypical grids are applied. Different bundle sizes are used including 1 × 1, 2 × 1, 3 × 3 and 5 × 5 et al. It is an absolute question of how the smaller size rod bundles are prototypical that could fully reflect the true flow and heat transfer behavior in a reactor core. In this paper, the effect of bundle size on flow and heat transfer is investigated under sizes of 2 × 1, 3 × 3 and 5 × 5. Firstly, the boundary settings in 2 × 1 are studied and the surface averaged secondary flow and local flow at the gap with 5 × 5 results are compared. Then the 3 × 3 and 5 × 5 bundle sizes are compared under subcooled flow. The center subchannels temperature and the void fraction distributions are analyzed. The effect of non-prototypical cold walls on heat transfer is discussed. The study shows that, different bundle sizes will produce different flow phenomena in the rod bundle, the flow pattern may not be the same with the reactor core fuel assembly, the typical bundle size selection should be based on the research purpose.

Background The key task in China's medical and health field during the "14th Five-Year Plan" period is to realize treatment-prevention integration and innovate the mechanism of treatment-prevention integration. Objective This paper analyzes the implementation mechanism of treatment-prevention integration under the background of integrated service system construction, and provides reference for exploring the path of medical and prevention integration adapting to the strategy of "Healthy China". Methods Taking 2018 as the time node, relevant literature was searched on CNKI and Wanfang Data Knowledge Service Platform with keywords of "treatment-prevention integration" "medical and prevention coordination" "combination of prevention and treatment" and literatures on case policies, measures and implementation effects of integrated service systems such as medical alliance. Finally, 18 literatures and 15 cases were selected. Based on the rainbow model, system integration, organizational integration, professional integration, service integration, functional integration and normative integration were determined as condition variables from macro, meso and micro levels and supporting factors, and the effect of treatment-prevention integration was determined as result variable. QCA was adopted to explore the implementation mechanism of medical and preventive integration under the background of integrated service system construction. Results There were four configuration paths that could effectively improve the effect of treatment-prevention integration, and the four paths were in line with the multi-layer integrated path and the medium-micro integrated path respectively. The following results were obtained: (1) It was more effective to carry out treatment-prevention integration relying on the integrated service system, and there are multiple paths that can effectively improve the effect of treatment-prevention integration under the integrated service system; (2) Service integration plays a fundamental role in improving the effect of medical and preventive integration; (3) The setting of relevant policy indicators for improving the system integration, professional integration and functional integration of treatment-prevention integration is not perfect. Conclusion (1) Relying on the construction of integrated service system to promote the improvement of treatment-prevention integration effect; (2) Give full play to the basic guarantee role of service integration; (3) Make reference to the successful experience of multi-level integration cases, set policy indicators at macro, meso and micro levels in a balanced manner, and improve the integration of system integration, professional integration and supporting elements.

Abstract Background Breast cancer is one of the most common malignant tumors in women. Cell division cycle associated 5 (CDCA5), a master regulator of sister chromatid cohesion, was reported to be upregulated in several types of cancer. Here, the function and regulation mechanism of CDCA5 in breast cancer were explored. Methods CDCA5 expression was identified through immunohistochemistry staining in breast cancer specimens. The correlation between CDCA5 expression with clinicopathological features and prognosis of breast cancer patients was analyzed using a tissue microarray. CDCA5 function in breast cancer was explored in CDCA5-overexpressed/knockdown cells and mice models. Co-IP, ChIP and dual-luciferase reporter assay assays were performed to clarify underlying molecular mechanisms. Results We found that CDCA5 was expressed at a higher level in breast cancer tissues and cell lines, and overexpression of CDCA5 was significantly associated with poor prognosis of patients with breast cancer. Moreover, CDCA5 knockdown significantly suppressed the proliferation and migration, while promoted apoptosis in vitro. Mechanistically, we revealed that CDCA5 played an important role in promoting the binding of E2F transcription factor 1 (E2F1) to the forkhead box M1 (FOXM1) promoter. Furthermore, the data of in vitro and in vivo revealed that depletion of FOXM1 alleviated the effect of CDCA5 overexpression on breast cancer. Additionally, we revealed that the Wnt/β-catenin signaling pathway was required for CDCA5 induced progression of breast cancer. Conclusions We suggested that CDCA5 promoted progression of breast cancer via CDCA5/FOXM1/Wnt axis, CDCA5 might serve as a novel therapeutic target for breast cancer treatment.

Abstract Background With its minimally invasive approach, laparoscopic surgery has transformed the medical landscape. As the demand for these procedures escalates, there is a pressing need for adept surgeons trained in laparoscopic techniques. However, current training often falls short of catering to medical school education. This study evaluates the impact of a custom-designed laparoscopic training workshop on medical students’ surgical skills and career aspirations. Methods This prospective experimental study was conducted at the E-Da hospital in Kaohsiung City, Taiwan. Medical students from Taiwanese medical schools undergoing Clerk 5, Clerk 6, and Postgraduate Year 1 and 2 were invited to participate. Medical students (n = 44) underwent an endoscopic skill training workshop consisting of lectures, box training, and live tissue training. The trainees performed multiple tasks before and after training using our objective evaluation system. The primary outcome was assessed before and after training through a questionnaire assessing the influence of training on students’ interest in surgery as a career. The secondary outcome measured improvement in skill acquisition, comparing the task completion time pre- and post-workshop. For the primary outcome, descriptive statistics were used to summarize the questionnaire responses, and paired t-tests were performed to determine significant changes in interest levels post-workshop. For the secondary outcome, paired t-tests were used to compare the time recorded pre- and post-training. Results Post-training, participants exhibited significant proficiency gains, with task completion times reducing notably: 97 s (p = 0.0015) for Precision Beads Placement, 88.5 s (p

ObjectiveTo understand the structural variation in hospitalization costs for patients with cervical cancer and to investigate the reasons for these variations. MethodsUsing the degree of structural variation (DSV) analysis and grey relational analysis methods, we analyzed the hospitalization data of 5 654 cervical cancer patients from three class A tertiary hospitals in northern China from 2013 to 2022. The DSV was used to describe the overall characteristics and dynamic trends of the hospitalization cost composition, while gray relational analysis assessed the correlation between hospitalization costs and individual cost items. ResultsDuring this period, the average individual total cost of hospitalization for all patients studied showed an upward trend with a low overall DSV and an average annual DSV of 18.60%. Diagnostic fees and drug costs were two significant factors influencing cost changes. In particular, the structural variation values of diagnostic fees and drug costs showed positive changes during this period. The top three cost items contributing to the change in hospital cost structure were other fees (contribution rate: 35.87%), diagnostic fees (32.09%), and drug costs (16.44%), with a cumulative structural contribution rate of 84.40%. The proportion of diagnostic fees has increased significantly, contributing to the structural variation, indicating that diagnostic fees are a major component of hospitalization costs. Although the proportion of drug costs has decreased in recent years, it remains an important factor influencing cost changes. Gray relation analysis showed that from 2013 to 2022, other fees had the highest correlation with hospitalization costs (correlation coefficient: 0.855), followed by diagnostic fees (0.824) and drug costs (0.781). ConclusionFor the hospitalization costs of cervical cancer patients from tertiary hospitals in northern China, diagnostic fees, drug costs, and other fees contribute significantly to the cost structure and have the highest correlation with hospitalization costs, which are significant factors influencing the fluctuation of hospitalization costs. The structural contribution rates of comprehensive medical service fees and treatment fees are relatively low, and their correlation with hospitalization costs is also lower, so they have minimal impact on the structure and changing trends of hospitalization costs.

Abstract Background Primary cervical cancer screening and treating precancerous lesions are effective ways to prevent cervical cancer. However, the coverage rates of human papillomavirus (HPV) vaccines and routine screening are low in most developing countries and even some developed countries. This study aimed to explore the benefit of an artificial intelligence-assisted cytology (AI) system in a screening program for a cervical cancer high-risk population in China. Methods A total of 1231 liquid-based cytology (LBC) slides from women who underwent colposcopy at the Chinese PLA General Hospital from 2018 to 2020 were collected. All women had received a histological diagnosis based on the results of colposcopy and biopsy. The sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), false-positive rate (FPR), false-negative rate (FNR), overall accuracy (OA), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and Youden index (YI) of the AI, LBC, HPV, LBC + HPV, AI + LBC, AI + HPV and HPV Seq LBC screening strategies at low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL) thresholds were calculated to assess their effectiveness. Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic values of the different screening strategies. Results The Se and Sp of the primary AI-alone strategy at the LSIL and HSIL thresholds were superior to those of the LBC + HPV cotesting strategy. Among the screening strategies, the YIs of the AI strategy at the LSIL + threshold and HSIL + threshold were the highest. At the HSIL + threshold, the AI strategy achieved the best result, with an AUC value of 0.621 (95% CI, 0.587–0.654), whereas HPV testing achieved the worst result, with an AUC value of 0.521 (95% CI, 0.484–0.559). Similarly, at the LSIL + threshold, the LBC-based strategy achieved the best result, with an AUC of 0.637 (95% CI, 0.606–0.668), whereas HPV testing achieved the worst result, with an AUC of 0.524 (95% CI, 0.491–0.557). Moreover, the AUCs of the AI and LBC strategies at this threshold were similar (0.631 and 0.637, respectively). Conclusions These results confirmed that AI-only screening was the most authoritative method for diagnosing HSILs and LSILs, improving the accuracy of colposcopy diagnosis, and was more beneficial for patients than traditional LBC + HPV cotesting.

Abstract To investigate the effect and safety of percutaneous endovascular angioplasty (PEA) with optional stenting for the treatment of severe stenosis or occlusion of subclavian artery, patients with severe stenosis ≥ 70% or occlusion of subclavian artery treated with PEA were retrospectively enrolled. The clinical data were analyzed. A total of 222 patients were retrospectively enrolled, including 151 males (68.0%) and 71 females (32.0%) aged 48–86 (mean 63.9 ± 9.0) years. Forty-seven (21.2%) patients had comorbidities. Subclavian artery stenosis ≥ 70% was present in 201 (90.5%) patients and complete subclavian occlusion in 21 (9.5%) cases. Angioplasty was successfully performed in all (100%) patients. Balloon-expandable stents were used in 190 (85.6%) cases, and self-expandable stents in 20 (9.0%) cases. Only 12 (5.4%) cases were treated with balloon dilation only. Among 210 patients treated with stent angioplasty, 71 (33.8% or 71/210) cases underwent balloon pre-dilation, 139 (66.2% or 139/210) had direct deployment of balloon-expandable stents, and 2 (1.0% or 2/210) experienced balloon post-dilation. Distal embolization protection devices were used in 5 (2.3% or 5/222) cases. Periprocedural complications occurred in 3 (1.4%) patients, including aortic dissection in 2 (0.9%) cases and right middle cerebral artery embolism in 1 (0.5%). No hemorrhage occurred. Among 182 (82.0%) patients with 6-month follow-up, restenosis > 70% occurred in 1 (0.5%) patient, and among 68 (30.6%) patients with 12-month follow-up, restenosis > 70% took place in 11 (16.2%) patients. Percutaneous endovascular angioplasty can be safely and efficiently performed for the treatment of severe stenosis ≥ 70% or occlusion of subclavian artery.

Petrocodon liboensis Sheng H.Tang & Jia W.Yang is a new species of Gesneriaceae from Guizhou, southwestern China. The new taxon has a pale-yellow corolla and is most similar to P. luteoflorus. However, it differs from the latter by having a urceolate (vs. cannulate) corolla tube, an abaxial corolla lip 0.8–1.1 mm (vs. 2–2.2 mm) long, and filaments 1.5–1.7 mm (vs. ca. 7 mm) long that are straight (vs. S-shaped or geniculate near the middle). The new taxon is assessed as “Data Deficient” (DD) according to the IUCN standards.

Abstract Background During the COVID-19 pandemic, medical workers were concerned about the care of their children or family members and the impact of being separated from them. This increased stress could harm the relationship between nurses and patients. This study assessed how medical workers’ parental role may affect burnout during such a high-stress period. Methods This cross-sectional observational study was carried out in 2021 during the COVID-19 pandemic. The client burnout (CB) scale of the Copenhagen Burnout Inventory, the Nordic Musculoskeletal Questionnaire, and a demographic questionnaire were used. Statistical methods such as the t-test, one-way ANOVA, and univariable/multiple linear regression were applied. Results A total of 612 nurses were included in this study. The likely risk factors of CB were identified and the parenthood effect was found to be associated with reduced CB. The parental role and leisure activity with family and friends on CB were found to have an impact. Engaging in leisure activity with family and playing the role of a parent diligently will help relieve nurses’ burnout from frequent contact with patients and their families, thus lowering the risk of clinical burnout. Conclusion The parental role, family/friends relationships, and a complex work environment associated with nurses’ burnout during the COVID-19 pandemic. This finding allows us to re-examine the importance of family life and parent–child relationships in high-stress work environments.

Abstract Background The prevalence of multiple nosocomial infections (MNIs) is on the rise, however, there remains a limited comprehension regarding the associated risk factors, cumulative risk, probability of occurrence, and impact on length of stay (LOS). Method This multicenter study includes all hospitalized patients from 2020 to July 2023 in two sub-hospitals of a tertiary hospital in Guangming District, Shenzhen. The semi-Markov multi-state model (MSM) was utilized to analyze risk factors and cumulative risk of MNI, predict its occurrence probability, and calculate the extra LOS of nosocomial infection (NI). Results The risk factors for MNI include age, community infection at admission, surgery, and combined use of antibiotics. However, the cumulative risk of MNI is lower than that of single nosocomial infection (SNI). MNI is most likely to occur within 14 days after admission. Additionally, SNI prolongs LOS by an average of 7.48 days (95% Confidence Interval, CI: 6.06–8.68 days), while MNI prolongs LOS by an average of 15.94 days (95% CI: 14.03–18.17 days). Furthermore, the more sites of infection there are, the longer the extra LOS will be. Conclusion The longer LOS and increased treatment difficulty of MNI result in a heavier disease burden for patients, necessitating targeted prevention and control measures.

Background Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common chronic liver disease in the world and carries an increased risk of liver-related events, but no approved medicine. Electroacupuncture has been used to treat non-alcoholic fatty liver disease, but its effect was uncertain because of the poor quality of prior studies. We designed this trial to evaluate the efficacy and safety of electroacupuncture for MAFLD.Methods/design This is a multicentre, randomised, sham acupuncture-controlled, patient-blinded clinical trial. Participants will take part in a total of 20 weeks of study, containing three phases: a 4‐week run-in period, 12‐week treatment (36 sessions of acupuncture) and 4‐week follow‐up. A total of 144 eligible patients diagnosed with MAFLD will be randomly allocated to the electroacupuncture or sham acupuncture groups. The primary outcome is the percentage of relative liver fat reduction on the MRI proton density fat fraction from baseline to 12 weeks. Secondary outcomes include magnetic resonance elastography, liver and metabolic biomarkers, anthropometry parameters, blinding assessment, credibility and expectancy, and adverse events. All patients who receive randomisation will be included in the intent-to-treat analysis.Discussion The finding of this trial will provide evidence of the efficacy and safety of electroacupuncture for the treatment of MAFLD. The results of this study will be published in peer-reviewed journals.Trial registration number www.chictr.org.cn, ChiCTR2200060353. It was registered on 29 May 2022.

Taste quality is one of the most important indicators for assessing the quality of rice. However, there has been a lack of systematic studies investigating the impact factors of taste quality. In this study, chromosomal segment substitution lines (CSSLs) with notable differences in physicochemical properties were obtained by screening the CSSL population. A correlation analysis between the physicochemical properties and the taste qualities of rice revealed that amylose and protein content are significantly negatively correlated with the taste value of both freshly cooked and rehydrated instant rice. The alkali spreading value (ASV) had limited impact on the taste value of rice, but low-ASV rice is more resistant to cooking. Grain chalkiness played a critical role in maintaining the integrity of freshly cooked rice and instant rice grains after rehydration. In summary, our study provides crucial insights and guidance for rice breeding, with the goal of developing excellent quality and enhancing the processing of instant rice.

Postoperative pain management has consistently been a critical topic in the medical field, with patient-controlled intravenous analgesia (PCIA) being one of the most commonly utilized methods for postoperative analgesia. Currently, opioids remain the primary choice for PCIA in clinical practice. However, in recent years, an increasing number of studies have explored analgesic strategies aimed at reducing or eliminating the use of opioids in PCIA to mitigate the associated side effects and dependence. This article systematically reviews the progress of research on opioid-free analgesic strategies in PCIA through a comprehensive analysis of relevant literature.

Background The incidence and mortality of cervical cancer remain high in female malignant tumors worldwide. There is still a lack of diagnostic and prognostic markers for cervical carcinoma. This study aimed to screen differentially expressed genes (DEGs) between normal and cervical cancer tissues to identify candidate genes for further research. Methods Uterine cervical specimens were resected from our clinical patients after radical hysterectomy. Three patients’ transcriptomic datasets were built by the next generation sequencing (NGS) results. DEGs were selected through the edgeR and DESeq2 packages in the R environment. Functional enrichment analysis, including GO/DisGeNET/KEGG/Reactome enrichment analysis, was performed. Normal and cervical cancer tissue data from the public databases TCGA and GTEx were collected to compare the expression levels of 10 selected DEGs in tumor and normal tissues. ROC curve and survival analysis were performed to compare the diagnostic and prognostic values of each gene. The expression levels of candidate genes were verified in 15 paired clinical specimens via quantitative real-time polymerase chain reaction. Results There were 875 up-regulated and 1,482 down-regulated genes in cervical cancer samples compared with the paired adjacent normal cervical tissues according to the NGS analysis. The top 10 DEGs included APOD, MASP1, ACKR1, C1QTNF7, SFRP4, HSPB6, GSTM5, IGFBP6, F10 and DCN. GO, DisGeNET and Reactome analyses revealed that the DEGs were related to extracellular matrix and angiogenesis which might influence tumorigenesis. KEGG enrichment showed that PI3K-Akt signaling pathway might be involved in cervical cancer tumorigenesis and progression. The expression levels of selected genes were decreased in tumors in both the public database and our experimental clinical specimens. All the candidate genes showed excellent diagnostic value, and the AUC values exceeded 0.90. Additionally, APOD, ACKR1 and SFRP4 expression levels could help predict the prognosis of patients with cervical cancer. Conclusions In this study, we selected the top 10 DEGs which were down-regulated in cervical cancer tissues. All of them had dramatically diagnostic value. APOD, ACKR1 and SFRP4 were associated with the survivals of cervical cancer. C1QTNF7, HSPB6, GSTM5, IGFBP6 and F10 were first reported to be candidate genes of cervical carcinoma.

ABSTRACT To explore the influence of storage temperature and time on the stability of different concentrations of hepatitis C virus nucleic acid (HCV RNA) samples and to provide data reference for laboratory quality control. Serum samples of 10 patients with HCV RNA detection quantitation of 106–108 IU/mL were collected. The samples of each patient were diluted into three concentrations: high, medium, and low. Then the samples of each concentration were divided into 21, which were divided into three groups according to the storage conditions of −20°C, 4°C, and 25°C, with seven samples in each group. The samples were selected from each group for quantitative detection of HCV RNA on day 0, day 1, day 3, day 5, day 7, day 14, and day 30. The results of each concentration and storage temperature sample remained stable within 5 days. Based on the mixed-effect linear model, the main effects of temperature, time, and concentration were statistically significant (P < 0.01). There was an interaction effect between concentration and time (P = 0.0448), and there was also an interaction effect between temperature and time (P < 0.01). There was no interaction effect between concentration and temperature (P = 0.11) or between concentration, temperature, and time (P = 0.90). The results of serum samples with different concentrations of the HCV RNA remained stable within 5 days. The lower the initial concentration of HCV RNA serum sample, the worse the stability; the higher the storage temperature, the worse the stability. If conditions permit, the laboratory should store such samples at −20°C.IMPORTANCEPreviously, there were few reports about the influence of different concentrations of sample nucleic acid on the stability of samples at various temperatures and times in various literatures. Therefore, it is necessary to analyze the influence of concentration factors on the stability of samples and test results at different storage times and temperatures. This study took the concentration of hepatitis C virus nucleic acid as the research object to further understand the stability of hepatitis C virus nucleic acid test samples under various storage conditions, to provide data reference for the treatment of hepatitis C virus nucleic acid and RNA test samples before clinical laboratory test, and provide guidance and help for the improvement of laboratory quality control.

ABSTRACT Black shank disease in tobacco, caused by Phytophthora nicotianae, can lead to yield losses of 30%–50% upon outbreak. Recently, biochar derived from agricultural waste has shown significant potential in controlling soil-borne diseases, though its mechanisms remain unclear. Over a 3-year observation period, we found that the incidence of black shank was significantly lower in plots amended with biochar compared with normal cultivation plots. To investigate the underlying mechanisms, we studied both the direct and indirect effects of biochar on black shank. Direct antifungal assays indicated that biochar reduced the total number of sporangia by 53.91%. Further pot experiments revealed a 62.34% reduction in the P. nicotianae population in the soil following biochar application. Additionally, biochar application led to notable changes in soil physicochemical properties and microbial community composition. Microbial species analysis showed that biochar promoted the aggregation of beneficial microbes such as Sphingomonas, Flavisolibacter, and Mucoromycota. Functional predictions using the PICRUSt 2 software revealed that biochar enhances bacterial functions related to antimicrobial substance synthesis (Tetracycline biosynthesis), detoxification metabolism (D-arginine and D-ornithine metabolism, arginine and proline metabolism), and lipid and fatty acid metabolism (Lipopolysaccharide biosynthesis, fatty acid biosynthesis), while fungal functions showed no significant changes. This suggests that rhizosphere bacteria play a more prominent role in the suppression of black shank by biochar, a finding supported by partial least squares path modeling analysis. Therefore, we hypothesize that biochar not only directly inhibits P. nicotianae growth but also regulates the composition of the rhizosphere microbial community, inducing the production of antimicrobial substances by rhizosphere bacteria, effectively preventing P. nicotianae invasion.IMPORTANCEBlack shank, a global soil-borne fungal disease in tobacco, currently lacks effective control methods. Notably, biochar derived from agricultural waste has shown significant potential in controlling soil-borne diseases. Over a 3-year observation period, we found that plots amended with biochar had a significantly lower incidence of black shank compared with normal cultivation plots. However, the mechanisms of disease suppression remained unclear. Through in vitro antifungal assays and pot experiments, we discovered that tobacco-derived biochar can directly inhibit the growth of the pathogen. Additionally, biochar regulates the composition of the rhizosphere microbial community, inducing rhizosphere bacteria to produce antimicrobial substances, effectively preventing pathogen invasion. This discovery reveals both the direct and indirect mechanisms by which biochar suppresses black shank in tobacco. It provides a scientific basis for developing green control technologies for black shank and offers theoretical support for the application of biochar in managing soil-borne diseases in tobacco cultivation areas.

Background and aimCholangiocarcinoma (CCA) is a rare cancer, yet its incidence and mortality rates have been steadily increasing globally over the past few decades. Currently, there are no effective targeted treatment strategies available for patients. ACLY (ATP Citrate Lyase), a key enzyme in de novo lipogenesis, is aberrantly expressed in several tumors and is associated with malignant progression. However, its role and mechanisms in CCA have not yet been elucidated.MethodsThe expression of ACLY in CCA was assessed using transcriptomic profiles and tissue microarrays. Kaplan-Meier curves were employed to evaluate the prognostic significance of ACLY in CCA. Functional enrichment analysis was used to explore the potential mechanisms of ACLY in CCA. A series of assays were conducted to examine the effects of ACLY on the proliferation and migration of CCA cells. Ferroptosis inducers and inhibitors, along with lipid peroxide probes and MDA assay kits, were utilized to explore the role of ACLY in ferroptosis within CCA. Additionally, lipid-depleted fetal bovine serum and several fatty acids were used to evaluate the impact of fatty acids on ferroptosis induced by ACLY inhibition. Correlation analyses were performed to elucidate the relationship between ACLY and tumor stemness as well as tumor microenvironment.ResultsThe expression of ACLY was found to be higher in CCA tissues compared to adjacent normal tissues. Patients with elevated ACLY expression demonstrated poorer overall survival outcomes. ACLY were closed associated with fatty acid metabolism and tumor-initiating cells. Knockdown of ACLY did not significantly impact the proliferation and migration of CCA cells. However, ACLY inhibition led to increased accumulation of lipid peroxides and enhanced sensitivity of CCA cells to ferroptosis inducers. Polyunsaturated fatty acids were observed to inhibit the proliferation of ACLY-knockdown cells; nonetheless, this inhibitory effect was diminished when the cells were cultured in medium supplemented with lipid-depleted fetal bovine serum. Additionally, ACLY expression was negatively correlated with immune cell infiltration and immune scores in CCA.ConclusionACLY promotes ferroptosis by disrupting the balance of saturated and unsaturated fatty acids. ACLY may therefore serve as a potential diagnostic and therapeutic target for CCA.

This review comprehensively examines the impact of anesthesia and surgical interventions on the immune function of cancer patients postoperatively. Recent studies have shown that surgery and its accompanying anesthesia management can significantly influence immune function in cancer patients, potentially affecting their prognosis. This review synthesizes clinical studies and basic research to summarize the specific effects of anesthesia methods, drugs, postoperative analgesia, intraoperative transfusion, surgical techniques, and trauma extent on the immune function of cancer patients post-surgery. Additionally, this review discusses optimization strategies based on current research, aiming to refine anesthesia and surgical management to maximize the preservation and enhancement of postoperative immune function in cancer patients, with the potential to improve clinical outcomes.

IL-23 is a cytokine produced by myeloid cells that drives the T helper 17 pathway and plays an essential role in the pathophysiology of plaque psoriasis. IL-23 activation initiates a cascade of cytokines subsequently inducing the expression of many psoriasis-related proteins. This study aimed to better understand the underlying mechanisms driving the differences between IL-23 and IL-17A blockade in patients with psoriasis and their implications for durability of clinical responses. Serum and/or skin biopsies were isolated from patients treated with guselkumab or secukinumab for evaluation of potential biomarkers of pharmacodynamic response to treatment. Guselkumab treatment led to significantly greater reductions of IL-17F and IL-22 serum levels than treatment with secukinumab at weeks 24 and 48, demonstrating sustained regulation of the IL-23/T helper 17 pathway. Analyses of proteomic and transcriptomic profiles of patient sera and skin biopsies demonstrated differential regulation of proteins involved in chemokine, TNF, and relevant immune signaling pathways to a greater degree with guselkumab than with secukinumab treatment. These data provide insights into the differences between the mechanisms and impact of IL-23 and IL-17A blockade in psoriasis, with implications for efficacy observations and treatment paradigms. Trial Registration: The original study was registered at ClinicalTrials.gov (NCT03090100).