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Abstract Background Radiofrequency catheter ablation (RFCA) is a widely employed method for restoring sinus rhythm(SR) in patients with drug-refractory paroxysmal atrial fibrillation (PAF). Three-dimensional speckle tracking echocardiography (3DSTE) is a precise and practical imaging technique for clinically assessing myocardial function in the left atrium. The objective of this study was to assess alterations in three-dimensional strains and predict recurrence in patients with PAF following RFCA. Methods A total of 109 patients diagnosed with drug-refractory PAF and scheduled for RFCA were included in this study between September 2019 and June 2022. Conventional echocardiography and 3DSTE were performed prior to and one year(median period of 12.2 months) after RFCA. Global three-dimensional left atrial (LA) strain parameters, along with those of the left ventricle, were measured and analyzed statistically. The primary study endpoint was the recurrence of atrial fibrillation (AF). Results Among the 109 patients, 78 maintained a stable SR during the one-year follow-up after RFCA, while 31 experienced a recurrence of AF. Notably, patients who sustained SR demonstrated significant improvements in various LA strain parameters, including reservoir, pump, and conduit functions, compared to both their preoperative levels and those of patients who experienced recurrence(p

Abstract Background Human adenovirus (HAdV) infection causes acute respiratory diseases in immunocompetent individuals worldwide. Infections by HAdV-55, one of the important pathogens leading to respiratory tract infections, often develop into pneumonia and are frequently associated with outbreaks in military camps and schools. Methods We studied 186 HAdV-55-positive nasopharyngeal swab samples that were collected from patients with respiratory infection in Wuhan, China, from 2018 to 2019. Fifteen samples with high viral loads were selected for viral isolation and cultured with MRC-5 cells. These strains were then whole-genome sequenced to investigate their genetic characteristics by phylogenetic analyses. We then selected three HAdV-55 strains to quantify viral replication and further assessed the pathogenic characteristics of one strain in Syrian hamsters and BALB/c nude mice. Results HAdV-55-174 exhibited the highest replication ability in cultured cells compared to other strains, so this strain was selected for further investigation. Although the hamsters and mice were not so susceptible to HAdV-55-174 infection, viral loads were detected in the lungs and tracheas of the animal models, and persistent HAdV-55-174 replication was only observed in BALB/c nude mice. Histopathological lesions, including a widened alveolar septum and inflammatory cell infiltration, were observed in the lungs and tracheas of HAdV-55-174 infected animals. Conclusion We isolated and characterized the HAdV-55 strains circulating in Wuhan from 2018 to 2019, which may be meaningful for further studies on HAdV-55 infection and pathogenesis.

Abstract This study aims to monitor and identify adverse events (AEs) associated with cetuximab, a drug used to treat various late-stage (metastatic) tumors, to improve patient safety and guide drug use. This study retrospectively analyzed the cases reported in the FDA adverse event reporting system (FAERS) related to the application of cetuximab from 2013 Q1 to 2022 Q4. Disproportionality analyses, including the reporting odds ratio (ROR), the proportional reporting ratio (PRR), the Bayesian confidence propagation neural network (BCPNN), and the empirical Bayesian geometric mean (EBGM) algorithms, were employed to quantify the signals of cetuximab-associated AEs. A total of 8364225 reports were contained in the FAERS database, of which 5186 reports of cetuximab were identified as ‘primary suspected (PS)’ AEs. The application of cetuximab resulted in AEs in 22 system organ classes (SOCs), which preserved 176 significant disproportionality preferred terms (PTs) through the computation of four algorithms. The main SOCs (Skin and subcutaneous tissue disorders, investigations, metabolism and nutrition disorders, and blood and lymphatic system disorders) accounted for 58.63%. Some AEs were not on the drug label: speech disorder, intervertebral discitis, glomerulonephritis rapidly progressive and disseminated intravascular coagulation. This study identified new signals of adverse drug reactions (ADRs) other than those mentioned in the specification associated with cetuximab, providing valuable insights into the relationship between ADRs and cetuximab use. The findings highlight the importance of continuous surveillance to detect and manage AEs effectively, ultimately improving patient safety during treatment with cetuximab.

Abstract Objective The aim of this study was to investigate the correlation between age, red cell distribution width (RDW) levels, and 180-day and 1-year mortality in giant cell arteritis (GCA) patients hospitalized or admitted to the ICU. Methods Clinical data from GCA patients were extracted from the MIMIC-IV (3.0) database. Logistic and Cox regression analyses, Kaplan–Meier (KM) survival analysis, restricted cubic spline (RCS) analysis, and mediation effect analysis were employed to investigate the association between age, RDW levels, and 180-day and 1-year mortality in GCA patients hospitalized or admitted to the ICU. Predictive models were constructed using machine learning algorithms, and SHapley Additive exPlanations (SHAP) analysis was applied to evaluate the contributions of age and RDW levels to mortality in this patient population. Results A total of 228 GCA patients were eligible for analysis. Our study identified both age and RDW levels (both with OR > 1, P 1, P

Abstract Background Traditional detection methods face challenges in meeting the diverse clinical needs for diagnosing both lung cancer and infections within a single test. Onco-mNGS has emerged as a promising solution capable of accurately identifying infectious pathogens and tumors simultaneously. However, critical evidence is still lacking regarding its diagnostic performance in distinguishing between pulmonary infections, tumors, and non-infectious, non-tumor conditions in real clinical settings. Methods In this study, data were gathered from 223 participants presenting symptoms of lung infection or tumor who underwent Onco-mNGS testing. Patients were categorized into four groups based on clinical diagnoses: infection, tumor, tumor with infection, and non-infection-non-tumor. Comparisons were made across different groups, subtypes, and stages of lung cancer regarding copy number variation (CNV) patterns, microbiome compositions, and clinical detection indices. Results Compared to conventional infection testing methods, Onco-mNGS demonstrates superior infection detection performance, boasting a sensitivity of 81.82%, specificity of 72.55%, and an overall accuracy of 77.58%. In lung cancer diagnosis, Onco-mNGS showcases excellent diagnostic capabilities with sensitivity, specificity, accuracy, positive predictive value, and negative predictive value reaching 88.46%, 100%, 91.41%, 100%, and 90.98%, respectively. In bronchoalveolar lavage fluid (BALF) samples, these values stand at 87.5%, 100%, 94.74%, 100%, and 91.67%, respectively. Notably, more abundant CNV mutation types and higher mutation rates were observed in adenocarcinoma (ADC) compared to squamous cell carcinoma (SCC). Concurrently, onco-mNGS data revealed specific enrichment of Capnocytophaga sputigeria in the ADC group and Candida parapsilosis in the SCC group. These species exhibited significant correlations with C reaction protein (CRP) and CA153 values. Furthermore, Haemophilus influenzae was enriched in the early-stage SCC group and significantly associated with CRP values. Conclusions Onco-mNGS has exhibited exceptional efficiencies in the detection and differentiation of infection and lung cancer. This study provides a novel technological option for achieving single-step precise and swift detection of lung cancer. Graphical Abstract

AIM: To describe the anatomic characteristics of the lacrimal sac and its adjacent bone structures and to provide surgical recommendations for endoscopic dacryocystorhinostomy (EN-DCR). METHODS: This retrospective comparative study involved 118 sides with complete nasolacrimal duct obstruction and 83 unaffected sides from 126 patients. Computed tomographic-dacryocystography (CT-DCG) scans were performed before lacrimal surgery, and image reconstruction was used to obtain continuous 0.75-mm axial, coronal, and segmental sections for review. The morphology of the lacrimal sac and its relationship with adjacent bony structures were determined for measurement, as well as the obstructed location. RESULTS: The height of the lacrimal sac was 12.99±2.10 mm in this study. The operculum of the middle turbinate (OMT) was located vertically in the lower third of the lacrimal sac. Horizontally, the junction between the maxillary bone and the lacrimal bone (MB-LB) was close to, mostly (60.2%) posterior to, the lacrimal sac. The uncinate process was more frequently attached to the lacrimal bones (75.1%). The obstructions were generally located around the entrance of the nasolacrimal duct (NLD). However, some were placed higher, with 7.63% blocked not lower than the OMT. There was a negative correlation between the diameter of the lacrimal sac and the level of obstruction (r= -0.35, P

The development of scaffolds for repairing critical-sized bone defects heavily relies on establishing a neuro-vascularized network for proper penetration of nerves and blood vessels. Despite significant advancements in using artificial bone-like scaffolds infused with various agents, challenges remain. Natural bone tissue consists of a porous bone matrix surrounded by a neuro-vascularized periosteum, with unique piezoelectric properties essential for bone growth. Drawing inspiration from this assembly, we developed a periosteum-bone-mimicking bilayer scaffold with piezoelectric properties for regeneration of critical-sized bone defects. The periosteum-like layer of this scaffold features a double network hydrogel composed of chelated alginate, gelatin methacrylate, and sintered whitlockite nanoparticles, emulating the viscoelastic and piezoelectric properties of the natural periosteum. The bone-like layer is composed of a porous structure of chitosan and bioactive hydroxyapatite created through a biomineralization process. Unlike conventional bone-like scaffolds, this bioinspired bilayer scaffold significantly enhances osteogenesis, angiogenesis, and neurogenesis combined with low-intensity pulsed ultrasound-assisted piezoelectric stimulation. Such a scheme enhances neuro-vascularized bone regeneration in vivo. The results suggest that the bilayer scaffold could serve as an effective self-powered electrical stimulator to expedite bone regeneration under dynamic physical stimulation.

Abstract Introduction The core objective of this study was to precisely locate metastatic lymph nodes, identify potential areas in nasopharyngeal carcinoma patients that may not require radiotherapy, and propose a hypothesis for reduced target volume radiotherapy on the basis of these findings. Ultimately, we reassessed the differences in dosimetry of organs at risk (OARs) between reduced target volume (reduced CTV2) radiotherapy and standard radiotherapy. Methods and materials A total of 209 patients participated in the study. We used image registration techniques to map patients’ neck metastatic lymph nodes onto a template CT of healthy individuals. Using MIM software, we integrated all patients’ lymph node images onto the template CT images and conducted an in-depth analysis of their distribution characteristics and metastatic patterns. Subsequently, we randomly selected the localization images of 30 patients and used paired t test methods to compare the differences in the dosimetry of target volumes and OARs between reduced target volume radiotherapy and standard radiotherapy. Results A total of 2314 metastatic lymph nodes were identified and mapped. There were no metastatic lymph nodes observed at level VIIb or within the lateral border of the common carotid artery. The percentages of metastatic lymph nodes at levels Ia, Ib, IIa, IIb, III, IVa, IVb, Va, Vb, Vc, VIa, VIb, VIIa, VIIb and VIII accounted for 0%, 1.5%, 22.8%, 41.1%, 15.9%, 3.0%, 0%, 4.4%, 1.0%, 0.3%, 0%, 0%, 9.7%, 0% and 0.3%, respectively, of the 2314 metastatic lymph nodes. Further analysis of the dosimetric outcomes revealed a significantly lower mean dose to the oral cavity, laryngeal cavity, esophagus, trachea, pharyngeal constrictor muscles, parotid gland, submandibular gland and thyroid gland with the implementation of reduced-target radiotherapy than with standard radiotherapy. Conclusion IMRT sparing level I, IVb, VI, and VIIb lymph nodes and the area within the lateral border of the common carotid artery for stage II-IVa NPC patients is feasible. This method can significantly reduce the dose to peripheral organs at risk.

Abstract Endocrine therapy with CDK4/6 inhibitors is standard for estrogen receptor-positive, HER2−negative metastatic breast cancer (ER+/HER2− MBC), yet clinical resistance develops. Previously, we demonstrated that low doses of palbociclib activate autophagy, reversing initial G1 cell cycle arrest, while high concentrations induce off-target senescence. The autophagy inhibitor hydroxychloroquine (HCQ) induced on-target senescence at lower palbociclib doses. We conducted a phase I trial (NCT03774472 registered in ClinicalTrials.gov on 8/20/2018) of HCQ (400, 600, 800 mg/day) with palbociclib (75 mg/day continuous) and letrozole, using a 3 + 3 design. Primary objectives included safety, tolerability, and determining the recommended phase 2 dose (RP2D) of HCQ. Secondary objectives included tumor response and biomarker analysis. Fourteen ER+/HER2− MBC patients were evaluable [400 mg (n = 4), 600 mg (n = 4), 800 mg (n = 6)]. Grade 3 adverse events (AEs) included hematological (3 at 800 mg), skin rash (2 at 600 mg), and anorexia (1 at 400 mg), with no serious AEs. The best responses were partial (2), stable (11), and progression (1). Tumor reductions ranged from 11% to 30%, with one 55% increase. The two partial responders sustained tumor size reductions of 30% to 55% over an extended treatment period, lasting nearly 300 days. Biomarker analysis in responders demonstrated significant decreases in Ki67, Rb, and nuclear cyclin E levels and increases in autophagy markers p62 and LAMP1, suggesting a correlation between these biomarkers and treatment response. This phase I study demonstrated that HCQ is safe and well-tolerated and the RP2D was established at 800 mg/day with continuous low-dose palbociclib (75 mg/day) and letrozole (2.5 mg/day). These findings suggest that adding HCQ could potentially enhance the efficacy of low-dose palbociclib and standard letrozole therapy, pending verification in larger randomized studies.

Abstract Background In recent years, public health emergencies, such as the COVID-19 pandemic and Ebola outbreaks, have occurred with increasing frequency worldwide, posing significant threats to global public health security. Policies serve as the foundation and institutional framework for effective emergency responses. Consequently, evaluating and optimizing the formulation and implementation of Public Health Emergency Response Policies (PHERPs) to enhance emergency response capacities has become an urgent and important research priority. Methods This study developed an evaluation system for PHERPs using content analysis of policy texts, expert consultations, and the PMC-Index model. It quantitatively analyzed 33 central-level PHERPs in China issued between 2003 and 2020. Results The analysis revealed an average PMC-Index score of 6.43 for the 33 PHERPs. The PMC-Surface analysis highlighted that the top three scoring indicators were policy openness, policy structure, and policy area. In contrast, the lowest-scoring indicators were policy timeliness, issuing agency, and incentive measures. Conclusions The study demonstrates was generally good. However, significant variability was observed in the scores of individual indicators across different policies. These findings provide valuable insights into the strengths and weaknesses of PHERPs and offer a reference for optimizing policy design and implementation.

Abstract Background The prevalence of mental health problems among college students, both domestically and internationally, has emerged as a significant public health concern. College students are in a period of transition to independent living. Adopting a healthy lifestyle can have advantageous effects on their overall well-being. Thus, this study aimed to investigate the impact of healthy lifestyle choices on mental health problems among college students in China. Methods We conducted a cross-sectional online survey of college students from 2021 to 2023 at a university in Wuhan (N = 1826) using the cluster sampling method. We employed Chi-square tests and binary logistic regression to evaluate the association between healthy lifestyle choices and mental health and identify other influencing factors. Results A total of 969 (53.1%) students met standard criteria for poor mental health. Multiple analysis revealed that personal characteristics including female (1.280[1.035—1.582]), obesity (2.015[1.278—3.175]), general or poor health status (1.738[1.380—2.188]; 4.265[1.125—16.165]), occasionally attending health knowledge lectures or paying attention to health books and information (1.376[1.055—1.795]), healthy lifestyle choices including occasionally or seldom eating breakfast (1.393[1.105—1.757]; 1.825[1.287—2.587]), occasionally or seldom getting enough sleep (2.800[2.179—3.597]; 3.544[2.209—5.685]), a poor or very poor irregular schedule (1.792[1.222—2.628]; 3.619[1.380—9.486]), seldom or no physical exercise (1.395[1.053—1.847]; 1.377[1.066—1.779]), and often smoking (3.320[1.281—8.604]) were identified as significant predictors of poor mental health. Conclusion The prevalence of poor mental health among college students was high. A few types of healthy lifestyles, such as a lack of health knowledge and physical exercise, seldom eating breakfast, not getting enough sleep, an irregular schedule, and chronic smoking were closely related to abnormal psychological health symptoms. Interventions such as health education knowledge lectures and regular exercise programs should be given to college students to improve their mental health.

Abstract Background Lack of motivation and behavioral abnormalities are the hallmarks of postpartum depression (PPD). Severe uterine contractions during labor are pain triggers for psychiatric disorders, including PPD in women during the puerperium. Creating biomarkers to monitor PPD may help in its early detection and treatment. It has been suggested that uterine contraction-induced labor pain plays a role in the emergence of this syndrome. Therefore, abnormal electroencephalography (EEG) patterns during the first stage of labor may provide useful information. Here, we propose that aberrant EEG patterns caused by painful uterine contractions may be predictive markers for PPD. Methods This study is a single-centre prospective cohort planned for 331 parturients for vaginal delivery in the maternity ward of Zhujiang Hospital from 2022 to 2023. At baseline, online or paper-based questionnaires, including the Edinburgh Postnatal Depression Scale (EPDS) and demographic data, will be collected when the parturient is admitted to labor. EEG, electrocardiography (ECG) and electrohysterography (EHG) signals will be monitored and recorded during the first stage of labor in the ward. Follow-up will be taken at the postpartum timepoints of day 3, day 42, and 3, 6 and 12 months, respectively. Power spectral density and functional connections will be quantified. The connections between PPD severity and EEG measurements as a function of time will be assessed using linear mixed-effects models. Maternal age, parity, and whether oxytocin is used during labor, all have an impact on the incidence of PPD, hence a stratified analysis will be carried out. Discussion We expect EEG changes caused by painful uterine contractions in the first labor may predict early PPD. The results from this study may act as a predictor for the development of PPD which may enhance long-term quality of life for the parturient and her offspring. Trial registration. Name of registry: EEG Alterations of Uterine Contractions in the First Stage of Labor Predicting PPD. Trial registration number: NCT05217251; registration date on the ClinicalTrial.gov platform: February, 1/2022.

Federated learning (FL) is a distributed machine learning paradigm for edge cloud computing. FL can facilitate data-driven decision-making in tactical scenarios, effectively addressing both data volume and infrastructure challenges in edge environments. However, the diversity of clients in edge cloud computing presents significant challenges for FL. Personalized federated learning (pFL) received considerable attention in recent years. One example of pFL involves exploiting the global and local information in the local model. Current pFL algorithms experience limitations such as slow convergence speed, catastrophic forgetting, and poor performance in complex tasks, which still have significant shortcomings compared to the centralized learning. To achieve high pFL performance, we propose FedCLCC: Federated Contrastive Learning and Conditional Computing. The core of FedCLCC is the use of contrastive learning and conditional computing. Contrastive learning determines the feature representation similarity to adjust the local model. Conditional computing separates the global and local information and feeds it to their corresponding heads for global and local handling. Our comprehensive experiments demonstrate that FedCLCC outperforms other state-of-the-art FL algorithms.

Acarospora alba, A. indistincta, A. sharnoffii, and A. tejonensis are described from California. Sarcogyne fasciculata is described from California and New Mexico. Sarcogyne coeruleonigricans is reported new for California. Sarcogyne lapponica is recognized as a synonym of Acarospora lapponica, its basionym. We report 127 described species of Acarosporaceae for North America. We verified 62 species of Acarosporaceae from California.

Abstract Background KRAS-G12C inhibitors mark a notable advancement in targeted cancer therapies, yet identifying predictive biomarkers for treatment efficacy and resistance remains essential for optimizing clinical outcomes. Methods This systematic meta-analysis synthesized studies available through September 2024 across PubMed, Cochrane Library, SpringerLink, and Embase. Using CRISPR/Cas9 technology, this study generated cells with KEAP1 and STK11 knockouts, and utilized lentiviral vectors to overexpress PD-L1. Cellular sensitivity to KRAS-G12C inhibitors—AMG510, MRTX849, and JAB-21822—was evaluated through CCK-8 assays. Comprehensive bioinformatics analyses on stably transfected cell lines were conducted to elucidate pathways mediating resistance. Results Analysis of 13 studies involving 1132 patients highlighted the significant efficacy of KRAS-G12C inhibitor monotherapy, particularly among elderly and female patients. Treatment response was notably affected by liver and brain metastases, with KEAP1 mutations identified as a primary negative prognostic factor, closely associated with early resistance to treatment. Validation studies in NCI-H358 cells showed a marked increase in IC50 values for AMG510, MRTX849, and JAB-21822 after KEAP1 knockout (P

Abstract Background Sepsis-induced acute lung injury (ALI) is a severe clinical condition accompanied with high mortality. Tangeretin, which is widely found in citrus fruits, has been reported to exert antioxidant and anti-inflammatory properties. However, whether tangeretin protects against sepsis-induced ALI and the potential mechanisms remain unclear. Methods We established an ALI model via intraperitoneally injected with 5 mg/kg lipopolysaccharides (LPS) for 12 h. Tangeretin was applied intraperitoneally 30 min before LPS treatment. Dexamethasone (Dex) was used as a positive control. Hematoxylin and eosin (HE) staining and protein content in bronchoalveolar lavage fluid (BALF) were determined to detect the degree of lung injury. RNA-seq was also applied to explore the effect of tangeretin on ALI. In vitro, RAW264.7 were treated with Nrf2 siRNA, the expression of ferroptosis-associated biomarkers, including glutathione peroxidase 4 (GPX4) and prostaglandin-endoperoxide synthase 2 (PTGS2) were assessed. Glutathione (GSH), malondialdehyde (MDA) levels, reactive oxygen species (ROS) and inflammatory factors were also determined both in vivo and in vitro. Furthermore, mice were treated with an Nrf2 inhibitor (ML385) to verify the mechanism of tangeretin in inhibiting sepsis-induced lung injury and ferroptosis. Data were analyzed using one way analysis of variance or two-tailed unpaired t tests. Results Our study demonstrated that tangeretin significantly alleviated lung injury, reversed the LPS-induced reduction in GPX4 and GSH, and mitigates the elevation of PTGS2 and MDA levels. Tangeretin also reduced 4-HNE and iron levels. Besides, the levels of LPS-stimulated inflammatory factors IL-6, IL-1β and TNF-α were also decreased by tangeretin. RNA-seq and bioinformatics analysis demonstrated that tangeretin inhibited inflammatory response. Mechanistically, we identified that tangeretin inhibited the GPX4-dependent lipid peroxidation through activation of Nrf2. The silence of Nrf2 abolished the inhibitory effect of tangeretin on oxidative stress, inflammatory response and ferroptosis in RAW264.7 cells. Additionally, all the protective effects of tangeretin on ALI were abolished in Nrf2 inhibitor-treated mice. Conclusion We identified that ferroptosis as a critical mechanism contributing to sepsis-induced ALI. Tangeretin, a promising therapeutic candidate, effectively mitigates ALI through inhibiting ferroptosis via upregulating Nrf2 signaling pathway.

Abstract Nitrate (NO3 −) leaching from nitrogen (N) fertilized soils is a significant global concern, affecting both the environment and public health. However, substantial uncertainties and variabilities in NO3 − leaching factors (LFs) among regions or crops impede accurate assessments of NO3 − leaching. Here we synthesize 2500 field observations worldwide and show that LFs vary by an order of magnitude across regions and crops, primarily driven by hydroclimatic and edaphic conditions rather than N fertilizer management. Global cropland NO3 − leaching from synthetic N fertilization, calculated through spatially explicit (15.4, 14.8–16.1 Tg N yr–1) and crop-specific (12.9, 11.0–14.8 Tg N yr–1) LFs, is 41% lower than the Intergovernmental Panel on Climate Change Tier 1 global inventory. Over 47% of this leaching is concentrated in China, India, and the United States, with maize, wheat, rice and vegetables accounting for nearly half of it. Improved regional and crop-specific LFs will provide a benchmark for NO3 − leaching abatement by pinpointing potential global hotspots.

Abstract Air pollution, especially particulate matter (PM), is one of the most common risk factors for global burden of disease. However, its effect on the risk of digestive diseases is unclear. Herein, we attempt to explore this issue by reviewing the existing evidence from published meta-analyses. We conducted a systematic literature search to identify all relevant meta-analyses regarding the association of air pollution with digestive diseases, and summarize their major findings. We assessed the methodological quality and evidence quality of the included meta-analyses using the AMSTAR-2 and GRADE tools, respectively, and the overlap of primary studies was assessed by the GROOVE tool. Nine meta-analyses were included in our analysis, containing 43 primary studies with high overlap. In the included meta-analyses, the methodological quality was from critically low to moderate, and the evidence quality was from very low to moderate. The exposure was primarily PM2.5. Seven, four, and one meta-analysis investigated the effect of air pollution on liver diseases, gastrointestinal diseases, and pancreatic diseases, respectively. PM2.5 exposure was significantly associated with liver dysfunction, chronic liver diseases, liver cancer, and colorectal cancer, but not oesophagus cancer, gastric cancer, or pancreatic cancer. Based on very low to moderate quality evidence from meta-analyses, PM2.5 exposure may contribute to the development of some digestive diseases, especially liver diseases.

Abstract Background Ischemic stroke, accounting for 85% of stroke cases, leads to severe disabilities and increased mortality. Its global incidence rose by 87.55% from 1990 to 2019, posing significant health and economic burdens. The BRICS-plus nations—Brazil, Russia, India, China, South Africa, and five others—represent a large global population, presenting unique public health challenges. This study aims to evaluate the epidemiological trends and variations in the burden of ischemic stroke across BRICS-plus nations in a timely manner. Methods Data on the number, all-age rate, age-standardized rate, and relative change in ischemic stroke disability-adjusted life years (DALYs) from 1992 to 2021 within BRICS-plus were obtained from the Global Burden of Disease Study (GBD) 2021. Relationships between the DALYs rate and the Socio-demographic Index (SDI) were evaluated using Pearson correlation analyses. Additionally, age-period-cohort modeling was employed to estimate net drift, local drift, age, period, and cohort effects over the past three decades. Results From 1992 to 2021, total DALYs due to ischemic stroke increased by 47.14%, while the age-standardized DALYs rate decreased by 33.79%. All BRICS-plus countries exhibited a declining trend in the age-standardized DALYs rate over the past three decades. Egypt reported the highest age-standardized DALYs rate (2,462.60 per 100,000 population) in 2021, whereas the most substantial reduction of 59.37% was observed in Brazil. The annual net drift in the ischemic stroke DALYs rate ranged from -3.04% for Brazil to -0.48% for Egypt among the ten countries. A significant positive correlation was observed between the DALYs rate of ischemic stroke and SDI values. Countries exhibited similar age effect patterns, with an increasing risk of DALYs rate with advancing age. Period and cohort effects highlighted declines in observed nations, indicating improved ischemic stroke management strategies. Conclusion The burden of ischemic stroke showed an overall declining trend across the BRICS-plus from 1992 to 2021, but persistent health inequalities between these countries were driven by socioeconomic disparities. Furthermore, it emphasizes the necessity for targeted interventions across age, period, and cohort dimensions to address the distinct challenges posed by ischemic stroke in these rapidly developing countries.

The immobilization of heavy metals using microbes presents an environmentally friendly approach, utilizing local indigenous microbes for remediating heavy metal-contaminated soils and improving soil environmental quality. Microbially induced carbonate precipitation (MICP), particularly through urea hydrolysis, is a typical biomineralization process in nature that has gained considerable attention. Sporosarcina pasteurii, a popular indigenous urease-producing bacterium, is especially effective in hydrolyzing urea. This study examines the effects of calcium ion (Ca2+) addition, cadmium ion (Cd2+) concentration, and curing time on the characteristics of cadmium-contaminated soil solidified by acclimatized Sporosarcina pasteurii. Various tests, including toxicity leaching, unconfined compressive strength, soil column leaching, cadmium speciation analysis, and microanalysis, were conducted to evaluate these effects. The results indicate that Ca2+ significantly affects the leaching behavior of Cd2+ in the contaminated soil after solidification. Without Ca2+, the lowest Cd2+ leaching concentration (0.42–5.64 mg·L‒1) was observed at a urea concentration of 0.5 mol·L‒1. When Ca2+ was added, the Cd2+ leaching concentration slightly increased, but optimal solidification efficiency was achieved when urea and Ca2+ concentrations were 0.5 mol·L‒1. As curing time increased, the compressive strength of the solidified soil also improved, while Cd2+ leaching concentration decreased. The presence of Ca2+ further enhanced soil solidification over time. Higher Cd2+concentrations led to reduced compressive strength and increased leaching concentration. However, the addition of Ca2+ enhanced the solidification effect on cadmium-contaminated soil. At a curing time of 28 d, for a Cd2+ concentration of 100 mg·kg‒1, the unconfined compressive strength of samples with Ca2+ reached 312 kPa, a 33.3% increase compared to 234 kPa without Ca2+. For a Cd2+ concentration of 1600 mg·kg‒1, the unconfined compressive strength with Ca2+ reached 269 kPa, representing a 57.3% increase compared to samples without Ca2+, and the leaching concentration decreased by 15.4%. After leaching tests over 15 days using a geoenvironmental osmosis system revealed that the Cd2+ concentration in the leachate from samples with Ca2+ remained consistently lower than those without Ca2+. After solidification, weak acid-extracted cadmium in the contaminated soil transformed into reducible and residual forms. The addition of Ca2+ further reduced the proportion of weak acid-extractable cadmium, thereby reducing Cd2+ mobility. The calcium carbonate generated by the MICP reaction cements adjacent soil particles, thereby improving overall soil stability. Cadmium ions in the contaminated soil are immobilized by calcium carbonate through coprecipitation, forming stable compounds that reduce Cd2+ migration and bioavailability. This effectively alleviates soil heavy metal pollution. Overall, the results of this study will offer significant theoretical insight and technical innovations, holding profound implications for ecosystems, society, and the economy.

Lung cancer is a leading cause of cancer-related mortality worldwide, profoundly affecting patients' quality of life. Patient-reported outcomes (PROs) provide essential insights from the patients' perspective, a crucial aspect often overlooked by traditional clinical outcomes. This review synthesizes research on the role of PROs in lung cancer surgery to enhance patient care and outcomes. We conducted a comprehensive literature search across PubMed, Scopus, and Web of Science up to March 2024, using terms such as ''lung cancer,'' ''Patient Reported Outcome,'' ''lobectomy,'' ''segmentectomy,'' and ''lung surgery.'' The criteria included original studies on lung cancer patients who underwent surgical treatment and reported on PROs. After screening and removing duplicates, reviews, non-English articles, and irrelevant studies, 36 research articles were selected, supported by an additional 53 publications, totaling 89 references. The findings highlight the utility of PROs in assessing post-surgical outcomes, informing clinical decisions, and facilitating patient-centered care. However, challenges in standardization, patient burden, and integration into clinical workflows remain, underscoring the need for further research and methodological refinement. PROs are indispensable for understanding the quality-of-life post-surgery and enhancing communication and decision-making in clinical practice. Their integration into routine care is vital for a holistic approach to lung cancer treatment, promising significant improvements in patient outcomes and quality of care.

Abstract Inorganic plastic semiconductors play a crucial role in the realm of flexible electronics. In this study, we present a cost-effective plastic thermoelectric semimetal magnesium bismuthide (α-Mg3Bi2), exhibiting remarkable thermoelectric performance. Bulk single-crystalline α-Mg3Bi2 exhibits considerable plastic deformation at room temperature, allowing for the fabrication of intricate shapes such as the letters “SUSTECH” and a flexible chain. Transmission electron microscopy, time-of-flight neutron diffraction, and chemical bonding theoretic analyses elucidate that the plasticity of α-Mg3Bi2 stems from the helical dislocation-driven interlayer slip, small-sized Mg atoms induced weak interlayer Mg-Bi bonds, and low modulus of intralayer Mg2Bi2 2- networks. Moreover, we achieve a power factor value of up to 26.2 µW cm-1 K-2 along the c-axis at room temperature in an n-type α-Mg3Bi2 crystal. Our out-of-plane flexible thermoelectric generator exhibit a normalized power density of 8.1 μW cm-2 K-2 with a temperature difference of 7.3 K. This high-performance plastic thermoelectric semimetal promises to advance the field of flexible and deformable electronics.

Abstract To investigate the anti-inflammatory effects of collagen peptides, collagen peptides from cod skin were prepared to assess their in vitro anti-inflammatory effects and in vivo efficacy against ulcerative colitis. The results show that collagen peptides demonstrated anti-inflammatory effects by inhibiting the secretion of pro-inflammatory cytokines and reducing oxidative stress in vitro. In vivo, collagen peptides significantly reduced colonic tissue damage, modulated serum cytokine balance, increased the expression of tight junction proteins ZO-1, Occludin, and Claudin-1 in colon tissue, enhanced the abundance of beneficial bacteria while reducing harmful bacteria, and restored microbial balance. In addition, collagen peptides ameliorated colitis in vivo by inhibiting the phosphorylation of NF-κB p65, IκBα and p38 MAPK in the NF-κB/MAPK signaling pathway. Based on these findings, collagen peptides could serve as potential therapeutic agents for managing ulcerative colitis.

Abstract Background Mental health is an important aspect of adolescents’ development and well-being. Mental health problems, such as depression, anxiety, non-suicidal self-injury, suicide ideation, and suicide attempt, are recognized to be interconnected and to occur often. Research has found that aggression is connected to a variety of mental health problems. However, there’s limited knowledge about the patterns of how depression, anxiety, non-suicidal self-injury, suicide ideation, and suicide attempt co-occur, and only few studies describe their association with aggression and sex differences. Methods A cross-sectional study that involved 18,555 Chinese adolescents was performed to explore the mental health latent classes and the relationship with aggression. Results The results showed four latent classes of mental health problems: low-symptom class (70.8%), self-harm class (9.1%), emotional symptom class (13.4%), and high-symptom class (6.7%). A significant co-occurrence between depression, anxiety, non-suicidal self-injury, suicide ideation, and suicide attempt was found in the high-symptom class. Notably, higher levels of adolescent aggression were associated with comorbid moderate to high mental health problems. Similar four latent classes and associations were found across sexes. Conclusions The present study emphasized the heterogeneity of mental health problems and revealed their co-occurrence patterns. Aggression levels are associated with the latent classes in adolescents, with the most pronounced association observed in the high-symptom class. Preventing aggression could contribute to reducing the severity and co-occurring patterns of mental health problems among adolescents.

Abstract The number of patients with bone defects caused by trauma and diseases has been increasing year by year. The treatment of bone defects remains a major challenge in clinical practice. Bone scaffolds are increasingly favored for repairing bones, with triply periodic minimal surface (TPMS) scaffolds emerging as a popular option due to their superior performance. The aim of this review is to highlight the crucial influence of pore structure on the properties of TPMS bone scaffolds, offering important insights for their innovation and production. It briefly examines various elements that influence the properties of TPMS bone scaffolds, such as pore shape, porosity, pore diameter, and curvature. By analyzing these elements, this review serves as a valuable reference for upcoming research and practical implementations in the field of bone tissue engineering. Graphical Abstract

Abstract Objective Given the changes in trends of cannabis use (e.g., product types), this study examined latent classes of young adult use and associations with use-related outcomes. Methods We analyzed 2023 survey data among 4,031 US young adults (Mage=26.29, 59.4% female, 19.0% Hispanic, 13.5% Black, 13.6% Asian). Among those reporting past-month use (48.8%), latent class analysis (LCA) indicators included: days used (1–5; 6–20; 21–30), use/day (1; 2–4; ≥5), and type usually used (herb/flower; edibles; oils/vape; concentrates/other). Multivariable regressions examined class in relation to problematic use, quitting-related factors, and mental health, controlling for sociodemographics and state non-medical cannabis laws. Results LCA identified 4 classes of cannabis use frequency and types used: ‘infrequent-herb/edibles’ (41.4%), ‘frequent-herb’ (16.8%), ‘moderate-herb’ (28.0%), and ‘moderate-oil/other’ (13.8%). In multivariable analyses (referent group: ‘moderate-herb’ class), ‘frequent-herb’ reported less problematic use (B=-0.18, 95%CI=-0.30, -0.07), while ‘moderate-oil/other’ reported greater (B = 0.39, 95%CI = 0.27, 0.51). ‘Infrequent-herb/edibles’ had lower odds of driving post-use of cannabis (aOR = 0.28, 95%CI = 0.22, 0.37) and cannabis/alcohol (aOR = 0.52, 95%CI = 0.35, 0.76), whereas ‘frequent-herb’ (aOR = 1.52, 95%CI = 1.02, 2.28) and ‘moderate-oil/other’ (aOR = 3.98, 95%CI = 2.72, 5.82) reported greater odds of driving post-cannabis/alcohol use. ‘Moderate-oil/other’ reported higher quitting importance (B = 0.59, 95%CI = 0.17, 1.01), while ‘frequent-herb’ reported lower (B=-0.33, 95%CI=-0.99, -0.18). ‘Infrequent-herb/edibles’ reported higher quitting confidence (B = 0.56, 95%CI = 0.20, 0.92), whereas ‘frequent-herb’ (B=-1.01, 95%CI=-1.45, -0.57) and ‘moderate-oil/other’ (B=-1.27, 95%CI=-1.74, -0.81) reported lower. ‘Infrequent-herb/edibles’ reported fewer mental health symptoms (B=-0.55, 95%CI=-0.93, -0.17), while ‘moderate-oil/other’ reported more (B = 1.03, 95%CI = 0.53, 1.52). Conclusions Preventing frequent and moderate use of cannabis, particularly of oils/concentrates, is crucial given the potential negative implications for problematic use, quitting, and mental health.

Abstract Abnormalities of carbohydrate antigen 19 − 9 (CA19-9) are common in patients with type 2 diabetes mellitus (T2DM), and in some patients, CA19-9 returns to normal level after glycemic control. The aim of this study was to investigate the factors associated with CA19-9 levels in patients with T2DM and the associated influences on the degree of reduction of CA19-9 levels after antidiabetic therapy (AT). This study was an observational cross-sectional study. A total of 213 patients with T2DM were enrolled in this study, of whom 105 with abnormal CA19-9 and 108 with normal CA19-9. Socio-demographic information, complete blood counts, biochemical indicators, thyroid function indicators, and CA19-9 level were collected separately for each subject. Levels of glycosylated hemoglobin, type A1C (HbA1c), fasting blood glucose (FBG) were significantly higher in T2DM patients with abnormal CA19-9 compared to patients with normal CA19-9 (both FDR

Abstract The rapid urbanization has led to the loss of natural spaces and a subsequent disconnection between humans and nature, negatively affecting residents’ well-being and environmental awareness. There is a a growing interest in leveraging technology to address this gap in Human-Computer Interaction. This article introduces GoChirp, an AI-powered wearable device for enhancing nature relatedness within urban landscapes. By utilizing machine learning algorithms, GoChirp recognizes bird sounds in the environment and provides haptic feedback that mimics the bird flapping, directing users’ attention to avian life and fostering a heightened awareness and connection to nature. To evaluate GoChirp, we conducted a week-long field study with 36 urban participants divided into two groups: an experimental group using GoChirp and a control group using a dummy device. We used pre- and post-study questionnaires to assess changes in participants’ nature relatedness. Additional questionnaires and semi-structured interviews were employed to evaluate the device’s usability and user experience. The results suggest that AI-powered wearables like GoChirp, have the potential to augment individual’s sensory and cognitive capabilities, enabling a deeper connection with the natural environment. This could further enhance users’ well-being and potentially foster a greater sense of responsibility towards the natural environment, leading to mutual benefits between humans and nature.

Abstract The quality of bowel preparation is an important factor in the success of colonoscopy. However, multiple influencing factors that function together can lead to inadequate bowel preparation. The main objective of this study was to explore the specific factors that affect the quality of bowel preparation, with the goal of deriving and validating a predictive model for inadequate bowel preparation in Chinese outpatients. A prospective observational study. We conducted a prospective study in a tertiary hospital in Zhejiang Province that included elective colonoscopy outpatients treated between December 15, 2022 and August 12, 2023. Clinical data related to the patient characteristics and patient bowel preparation were collected to analyze the risk factors of inadequate bowel preparation in outpatients. The quality of bowel preparation was assessed by using the Boston bowel preparation scale (BBPS). Inadequate bowel preparation was defined as a total BBPS score of 5 h (OR = 2.471, 95% CI: 1.814–3.366) were independent risk factors. We derived a model to identify patients with inadequate cleansing by using data from patients in the derivation cohort and tested it in the validation cohort. The area under the curve (AUC) was 0.704 (95% CI: 0.667–0.741), with a calibration value of p = 0.632 in the derivation cohort. Bootstrap cross-validation showed a good model calibration condition. For the validation cohort, the AUC was 0.704 (95% CI: 0.628–0.779), and the calibration value was p = 0.376. We identified the influencing factors of outpatient bowel cleansing that are associated with patient clinical characteristics and bowel preparation-related behaviors. A model was constructed and validated to identify patients who were at high risk of inadequate bowel preparation by using six simple variables, which included male sex, diabetes, constipation, history of colorectal surgery, a high fiber diet used at 24 h prior to examination, and PC > 5 h. The clinical decision curve showed that the constructed prediction model has some clinical utility based on results from the derivation cohort and validation cohort.

Abstract Monotherapy with anti-programmed cell death protein 1 (PD-1) monoclonal antibody has been approved for the treatment of advanced non-small cell lung cancer with positive programmed cell death-ligand 1 (PD-L1) expression and oncogene wild type, which revealed survival benefit compared with chemotherapy. Nevertheless, certain patients develop rapid progression on anti-PD-1 inhibitor monotherapy. This novel pattern is called hyperprogressive disease (HPD), and the underlying mechanism and molecular characteristics still leaves not clear. Here, we reported two heavily pretreated advanced lung adenocarcinoma cases with HER2 exon 20 insertion who presented HPD after two cycles of anti-PD-1 inhibitor sintilimab monotherapy, and they both carried co-alterations in the PI3K/AKT/mTOR and cell cycle signaling pathway. We speculated that HER2 exon 20 insertion might be viewed as a potential biomarker to avoid single-agent immunotherapy in certain patients with driver mutations, or timely guide proper treatment strategies.

Abstract Background The individualized prediction and discrimination of precancerous lesions of gastric cancer (PLGC) is critical for the early prevention of gastric cancer (GC). However, accurate non-invasive methods for distinguishing between PLGC and GC are currently lacking. This study therefore aimed to develop a risk prediction model by machine learning and deep learning techniques to aid the early diagnosis of GC. Methods In this study, a total of 2229 subjects were recruited from nine tertiary hospitals between October 2022 and November 2023. We designed a comprehensive questionnaire, identified statistically significant factors, and created a web-based column chart. Then, a risk prediction model was subsequently developed by machine learning techniques. In addition, a tongue image-based risk prediction model was established by deep learning algorithms. Results Based on logistic regression analysis, a dynamic web-based nomogram was developed and it is freely accessible at: https://yz6677.shinyapps.io/GC67/ . Then, the prediction model was established using ten different machine learning algorithms and the Random Forest (RF) model achieved the highest accuracy at 85.65%. According with the predictive results, the top 10 key risk factors were age, traditional Chinese medicine (TCM) constitution type, tongue coating color, tongue color, irregular meals, pickled food, greasy fur, over-hot eating habit, anxiety and sleep onset latency. These factors are all significant risk indicators for the progression of PLGC patients to GC patients. Subsequently, the Swin Transformer architecture was used to develop a tongue image-based model for predicting the risk for progression of PLGC. The verification set showed an accuracy of 73.33% and an area under curve (AUC) greater than 0.8 across all models. Conclusions Our study developed machine learning and deep learning-based models for predicting the risk for progression of PLGC to GC, which will offer the assistance to determine the high-risk patients from PLGC and improve the early diagnosis of GC. Graphical Abstract

Abstract Background Chromosomal inversions are underappreciated causes of rare diseases given their detection, resolution, and clinical interpretation remain challenging. Heterozygous mutations in the MEIS2 gene cause an autosomal dominant syndrome characterized by intellectual disability, cleft palate, congenital heart defect, and facial dysmorphism at variable severity and penetrance. Case presentation Herein, we report a Chinese girl with intellectual disability, developmental delay, and congenital heart defect, in whom G-banded karyotype analysis identified a de novo paracentric inversion 46,XX, inv(15)(q15q26.1) and other conventional approaches including chromosomal microarray analysis and whole exome sequencing were failed to detect any pathologic variants that can explain the phenotypes of the proband. Subsequently, long-read Nanopore sequencing was directly conducted and defined the breakpoint position of the inversion, disrupting the MEIS2 gene at intron 8. These breakpoints were also confirmed by Sanger sequencing. Conclusions In conclusion, we report the first chromosomal inversion disrupting the MEIS2 gene, which was fine-mapped by long read Nanopore sequencing. Our data not only expand the clinical spectrum of MEIS2-caused syndromic developmental delay, but also illustrate the value of long-read sequencing in elucidating the precise genetic etiology of patients with relatively nonspecific clinical findings and chromosomal inversion that are beyond the resolution of conventional approaches.

Abstract Background Pulmonary space-occupying lesions are typical chronic pulmonary diseases that contribute significantly to healthcare resource use and impose a large disease burden in China. A time-series ecological trend study was conducted to investigate the associations between environmental factors and hospitalizations for pulmonary space-occupying lesions in North of China from 2014 to 2022. Methods The DLNM was used to quantify the association of environmental factors with lung cancer admissions. The heating-, age-, gender-, malignancy-specific effects were further estimated to identify the susceptible groups. Results During the study period, fluctuations in air pollutants and climate conditions closely mirrored changes in hospitalizations for pulmonary space-occupying lesions. Totally, the distributed lag surface showed clear positive associations between pulmonary tumor hospitalization and PM2.5 (RRlag30: 1.000912; 95%CI: 1.000076, 1.00175), PM10 (RRlag30: 1.002246; 95%CI: 1.000474, 1.004021), SO2 (RRlag30: 1.002714; 95%CI: 1.001071, 1.004414), CO (RRlag30: 1.002231; 95%CI: 1.000592, 1.003873). Additionally, the associations between air pollutants and hospitalizations for pulmonary space-occupying lesions were significantly stronger during the heating season. Population aged 65 or older, females and those diagnosed with malignancies were more vulnerable for the risk of pulmonary space-occupying lesions diseases due to air pollution exposure. Conclusions The present study illustrated risk and burden for pulmonary space-occupying lesions hospitalization associated with air pollution, especially among population aged ≥ 65, or female.

Dynamic cross-linked networks (DCNs) endow thermoset rubber with self-healability and recyclability to extend its lifetime and alleviate environmental pollution. However, the contradiction between high self-healing and mechanical properties in DCNs rubber is always difficult to be resolved. Herein, we used boronic ester (BO) and Diels-Alder dynamic covalent bonds (DA) to synthesize polybutadiene-based dual networks rubber (PB-BO-DA) via thiol-ene reaction. This approach achieved a tensile strength of 16.46 MPa and 99% self-healing efficiency, facilitated by extensive intermolecular interactions (π-π packing and N-B coordination) and fully dynamic cross-linking. In addition, multiple dynamic cross-linked networks (MDCNs) polybutadiene-based rubber also show excellent shape memory ability and recyclability. This strategy might open a helpful pathway to fabricate intelligent multifunctional polymers with high strength and high self-healing efficiency.

Abstract Background The purpose of this study was to analysis the nostril symmetry and nasal stability following secondary rhinoplasty performed with either nasal septal cartilage implantation (G1) or simple alar cartilage suspension and internal fixation (G2) in patients with unilateral secondary cleft nasal deformity. Methods Nostril and alar symmetry were analyzed retrospectively in 13 consecutive patients in G1 and 17 in G2. Assessment of three indexes was first performed using photogrammetric measurements of photographs at pre-operation(T1), 7 days after repair (T2), and at least 6 months after repair (T3). The ratio of the cleft side to the noncleft side for nostril width, nostril height and alar height were used to assess symmetry. Changes in the mean ratios of the cleft side to the noncleft side at three different time points for three parameters were used to assess stability. Results In both groups, the alar height was improved after operation and remained stable in the follow-up period. The nostril width significantly decreased in G1 and G2, remaining consistent in the follow-up for G1 but increasing in G2. The nostril height significantly increased in G1 and stabilized during the follow-up, while it decreased after operation and remained so throughout the follow-up for G2. Conclusion Both techniques can maintain stability more than six months after surgery, except for the nostril width with simple alar cartilage suspension and internal fixation technique. The nasal septal cartilage implantation technique may have advantages in improving the nasal symmetry of the nostril width and height.

Abstract X-linked lymphoproliferative disease (XLP) is a rare primary immunodeficiency with susceptibility and vulnerability to Epstein-Barr virus (EBV) infection. Most patients were diagnosed in early childhood and do not survive into adulthood. Here we reported an adult-onset XLP patient presenting with fever, dyspnea, and pulmonary nodules, mimicking respiratory infection at disease onset. Diagnosis was made based on whole-exon sequencing and pedigree analysis. Chest CT showed bilateral nodular lesions partially responsive to steroid therapy. The symptoms were managed with high-dose steroid, together with broad-spectrum anti-infective treatment for mixed secondary opportunistic infections. Pathology studies revealed non-Langerhans histiocytosis and T cell infiltration in lungs. Our case highlights the importance of genetic sequencing in managing young patients with unexplained infection and potential immuno-deficiency. We also added to the understanding of XLP by carrying detailed investigation into the pulmonary lesions.

Abstract Background Poa pratensis is a predominant cool-season turfgrass utilized in urban landscaping and ecological management. It is extensively employed in turf construction and in the regulation of ecological environments. However, it is susceptible to powdery mildew, a prevalent disease in humid regions. Currently, the primary control measure for powdery mildew involves the application of pesticides, a practice that is both costly and environmentally detrimental. Developing superior disease-resistant cultivars represents a more cost-effective and sustainable strategy for managing turfgrass diseases. Furthermore, an in-depth investigation into the response mechanisms of P. pratensis to powdery mildew infection could significantly advance research on the identification of disease resistance genes and the molecular breeding of resistant varieties. Results In this study, we first assessed the disease incidence across various disease-resistant P. pratensis cultivars and subsequently examined alterations in their in vivo redox states. We employed isobaric tags for relative and absolute quantification (iTRAQ) proteomics alongside non-targeted metabolomics to elucidate the response mechanisms of P. pratensis to powdery mildew invasion. A comprehensive analysis of the shared KEGG pathways among differentially abundant proteins (DAPs) and differentially enriched metabolites (DEMs) led to the identification of four common KEGG pathways. Notably, the phenylpropanoid biosynthesis pathway, enriched in both examined P. pratensis cultivars, was selected for further investigation. This analysis indicated that lignin biosynthesis plays a crucial role in the response of P. pratensis to powdery mildew infection. Conclusions The findings of this study enhance our understanding of the mechanisms underlying powdery mildew resistance in P. pratensis and serve as a valuable reference for the selection of powdery mildew-resistant cultivars, as well as for the identification and application of associated disease resistance genes. Clinical trial number Not applicable.

Abstract A low‐profile circularly polarised (CP) metasurface antenna is proposed, utilising characteristic mode analysis (CMA). The antenna design features a two‐layer laminated substrate, a 4×4 Butterfly‐shaped metasurface, a rectangular slot, an irregular transmission line, and a ground plane. The metasurface is analysed using mode significance (MS), characteristic angle (CA), and characteristic current to determine the resonance bandwidth and CA resonance points, which exhibit a near 90° difference. At the intersection of the two MS modes, their CAs differ by nearly 90°, and their far‐field radiation directions align, indicating the potential for achieving circular polarisation at the desired frequency. The integration of the metasurface with the slot antenna is simulated to validate the CMA findings. Additionally, the CP bandwidth is enhanced by modifying the transmission line branches. Measurement of the fabricated antenna reveals an impedance bandwidth (IBW) of 27.4%, a 3‐dB axial ratio bandwidth (ARBW) of 10.1%, and a peak gain of 6.9 dBic at 4.4 GHz. Compared to the design without branches, IBW and ARBW have increased by 10% and 7.3%, respectively.

Abstract The rapid development of electric vehicles (EVs) has made the construction and service capability evaluation of EV charging and battery swapping stations (CBSSs) more important. A comprehensive evaluation indicator system for the service capability evaluation of EV‐CBSSs is established, meticulously outlining the critical aspects of operational efficiency, economy, convenience, and reliability, each with multiple indicators for thorough assessment. To address the shortcomings of individual evaluation methods in evaluating the service capability of EV‐CBSSs, the game theory‐based combination weighting (GTCW) method is adopted, which integrates the advantages of the analytic hierarchy process method, entropy weight method, and grey relation analysis method. Specifically, the weights for each indicator are obtained separately using these three evaluation methods, and then combined using the GTCW method to calculate the final weights. In case studies, the service capability for each EV‐CBSS is calculated and compared between these three individual methods and the proposed GTCW method. Simulation results validate that the proposed evaluation indicator system and GTCW method can offer a more comprehensive evaluation of the service capability for EV‐CBSSs, providing guiding suggestions for future construction plans.

Scenario planning is a powerful tool for cities to navigate uncertainties and mitigate the impacts of adverse scenarios by projecting future outcomes based on present-day decisions. This approach is becoming increasingly important given the growing call for building resilient cities to face adverse future scenarios posed by emerging disruptive technologies and climate change. However, conventional scenario planning practices predominantly rely on expert knowledge and judgment, which may be limited in accounting for the complexity of future scenarios. Therefore, we explored the potential integration of artificial intelligence (AI) techniques to assist scenario planning practices. We synthesized related studies from various disciplines (e.g., engineering, computer science, and urban planning) to identify the potential applications of AI in the three key components of scenario planning: plan generation, scenario generation, and plan evaluation. We then discuss the challenges and possible solutions for integrating AI into the scenario planning process and highlight the critical role of planning experts in this process. We conclude by outlining future research opportunities in this context. Ultimately, this study contributes to the advancement of scenario planning practices and aids the creation of more resilient cities that can thrive in an uncertain future.

Abstract Background A new era in minimally invasive surgery has been ushered in by Leonardo’s robot surgical system, but the safety and effectiveness in cervical cancer is lake of evidence. This study aimed to compare the safety, effectiveness, and cost-effectiveness of robot-assisted laparoscopic radical hysterectomy (RRH) and conventional laparoscopic radical hysterectomy (LRH) in patients with cervical cancer. Methods Patients with cervical cancer who had radical surgery at the first affiliated Hospital of Chongqing Medical University between January 2017 and June 2022 were enrolled. Patients in the LRH and RRH groups were matched 1:1 using propensity score matching (PSM), all patients were followed up to September 2023, cancer recurrence occurred or death, whichever came first. Results 522 cervical cancer patients were enrolled in this study, 261 of whom were in the LRH group and 261 of whom were in the RRH group. Univariate analysis showed that the RRH group had less intraoperative blood loss, shorter operation time and hospital stay, lower incidence of composite complications and urinary retention, but had higher hospitalization costs. Multivariate Logistic regression analysis showed that LRH was an independent protective factor for composite complications (OR 1.531; 95%CI,1.022 to 2.295; P = .039). Cox regression analysis with cancer recurrence as the endpoint showed that LRH (HR 0.320; 95%CI,0.255 to 0.401; P

Abstract The gut microbiota is a complex and dynamic ecosystem that plays a crucial role in human health and disease, including obesity, diabetes, cardiovascular diseases, neurodegenerative diseases, inflammatory bowel disease, and cancer. Chronic inflammation is a common feature of these diseases and is closely related to angiogenesis (the process of forming new blood vessels), which is often dysregulated in pathological conditions. Inflammation potentially acts as a central mediator. This abstract aims to elucidate the connection between the gut microbiota and angiogenesis in various diseases. The gut microbiota influences angiogenesis through various mechanisms, including the production of metabolites that directly or indirectly affect vascularization. For example, short-chain fatty acids (SCFAs) such as butyrate, propionate, and acetate are known to regulate immune responses and inflammation, thereby affecting angiogenesis. In the context of cardiovascular diseases, the gut microbiota promotes atherosclerosis and vascular dysfunction by producing trimethylamine N-oxide (TMAO) and other metabolites that promote inflammation and endothelial dysfunction. Similarly, in neurodegenerative diseases, the gut microbiota may influence neuroinflammation and the integrity of the blood–brain barrier, thereby affecting angiogenesis. In cases of fractures and wound healing, the gut microbiota promotes angiogenesis by activating inflammatory responses and immune effects, facilitating the healing of tissue damage. In cancer, the gut microbiota can either inhibit or promote tumor growth and angiogenesis, depending on the specific bacterial composition and their metabolites. For instance, some bacteria can activate inflammasomes, leading to the production of inflammatory factors that alter the tumor immune microenvironment and activate angiogenesis-related signaling pathways, affecting tumor angiogenesis and metastasis. Some bacteria can directly interact with tumor cells, activating angiogenesis-related signaling pathways. Diet, as a modifiable factor, significantly influences angiogenesis through diet-derived microbial metabolites. Diet can rapidly alter the composition of the microbiota and its metabolic activity, thereby changing the concentration of microbial-derived metabolites and profoundly affecting the host's immune response and angiogenesis. For example, a high animal protein diet promotes the production of pro-atherogenic metabolites like TMAO, activating inflammatory pathways and interfering with platelet function, which is associated with the severity of coronary artery plaques, peripheral artery disease, and cardiovascular diseases. A diet rich in dietary fiber promotes the production of SCFAs, which act as ligands for cell surface or intracellular receptors, regulating various biological processes, including inflammation, tissue homeostasis, and immune responses, thereby influencing angiogenesis. In summary, the role of the gut microbiota in angiogenesis is multifaceted, playing an important role in disease progression by affecting various biological processes such as inflammation, immune responses, and multiple signaling pathways. Diet-derived microbial metabolites play a crucial role in linking the gut microbiota and angiogenesis. Understanding the complex interactions between diet, the gut microbiota, and angiogenesis has the potential to uncover novel therapeutic targets for managing these conditions. Therefore, interventions targeting the gut microbiota and its metabolites, such as through fecal microbiota transplantation (FMT) and the application of probiotics to alter the composition of the gut microbiota and enhance the production of beneficial metabolites, present a promising therapeutic strategy.

Abstract The gut microbiota alterations interact with the pathogenesis and progression of chronic kidney disease (CKD). Probiotics have received wide attention as a potential management in CKD. We investigated the effects of Lactobacillus paracasei N1115 (LP N1115) on intestinal microbiota and related short-chain fatty acids (SCFAs) in end stage kidney disease patients on peritoneal dialysis (PD) in a single-center, prospective, randomized, double-blind, placebo-controlled study. The patients were randomly allocated into two groups. The intervention group (n = 38, PR group) was given the probiotics (two bags) containing fructooligosaccharide (FOS) (additive amount > 80%), maltosaccharin, and LP N1115 (additive amount > 3 × 1010 CFU/bag) every day whereas the control group (n = 19, PL group) received placebo (two bags) containing only pregelatinized starch and lactose, both for 12 weeks. In addition to collecting fecal samples for 16S rRNA gene high-throughput sequencing and SCFAs analysis, gastrointestinal (GI) symptoms were also assessed at baseline and after the intervention. Probiotics administration caused significant changes in the composition of gut microbiota, as indicated by increased abundance of beneficial bacteria (Firmicutes), decreased Bacteroidetes, and opportunistic pathogens (Fusobacterium, Bilophila) (p 0.05). In addition, probiotics administration could effectively reduce GI symptoms, particularly in dyspepsia and constipation (p

Abstract Rolling bearings of the vibration exciter are prone to failure due to long-term high amplitude alternating impact loads, causing economic losses and threatening production safety. The heavy environmental noise during the operation of the vibration exciter and the high vibration level generated by the eccentric block make the weak bearing fault features submerged and difficult to extract. Teager–Kaiser energy operator is a popular method for extracting bearing fault features. However, it has poor noise-robustness and low accuracy of frequency estimation of the exciter with heavy noise and multiple disturbances. Therefore, three enhanced energy operators—symmetric higher-order analytical energy operator (SHAEO), multi-resolution symmetric difference energy operator (MSDAEO), and symmetric higher-order frequency weighted energy operator (SHFWEO) have been introduced. This paper compares and studies the three energy operators through theoretical analysis and vibration exciter bearing fault diagnosis experiments. The results show that MSDAEO has the most outstanding noise robustness, but has the minimum effect on improving the signal-to-interference ratio (SIR) of the signal among the three energy operators. SHFWEO has the most prominent performance on improving SIR but is sensitive to the signal energy. SHAEO can increase the amplitude of the signal, and its ability to improve signal SIR is higher than MSDAEO but lower than SHFWEO. Its ability to improve signal SNR is the weakest among the three. Finally, the characteristics of preprocessing methods that can be jointly used by the three energy operators in different application scenarios are presented.

Abstract The proliferation of multi-platform network information has expanded communication channels for users, enabling the integration and dissemination of information across both Social Networking Services (SNS)-type app and Instant Message (IM)-type app. With the intensification of convergent communication, some users in the two types of apps show active alternation in spreading information to each other’s platforms. The study of the evolution trend of information in different platforms is of great practical significance for the mastery of the communication law. This study synthesizes the following three points: (1) The information in SNS-type app diffuses from key nodes with more followers to ordinary nodes, showing the characteristics of heterogeneous network with radial and explosive propagation. (2) The information in IM-type app mainly depends on the “relationship chain” diffusion, showing the characteristics of homogeneous network with gradual and multi-cluster propagation. (3) SNS-type apps and IM-type apps with some users showing coupled propagation characteristics. Therefore, this study constructs the heterogeneous-homogeneous asymmetric coupling two-layer network information propagation dynamics model. The propagation threshold R0 and the stability of the model are derived theoretically. Real network data sets are used to simulate the platform fusion. Numerical simulations confirm the rationality of the propagation threshold and perform changes analyses of parameters, such as the degree of cross-circulation of platforms, users’ tendency of multi-platform expression, and changes in users’ behaviors towards information dissemination. Simulation results reveal that promoting platform integration can improve communication efficiency in the real world. Dual-platform communication by IM-platform spreaders substantially contributes to the growth in the number of SNS-platform spreaders. The higher the level of disinterest in dual-platform spreaders, the more likely it is to inhibit the growth of spreaders and removers, with IM-type app demonstrating more pronounced effects.

Abstract Objective A key component of determining that a patient-reported outcome (PRO) measure is fit-for-purpose is to ensure that respondents understand its instructions and items. Any modification to a measure should be evaluated for relevance and understandability. The objective of the study was to assess comprehension of the adapted Urticaria Activity Score (UAS) questionnaire among adolescents aged populations with chronic spontaneous urticaria (CSU) and the modification to UAS question 2 to include patient-friendly terminology “wheals (hives).” A patient guidance document for completing the adapted UAS was also examined. Methods A non-interventional, cross-sectional, qualitative study involving hybrid concept elicitation and cognitive interviews was conducted among adults and adolescents with CSU. Eligibility included clinician confirmation of CSU and experience of itch and hives for ≥ 6 weeks. Study participants were recruited from US clinical sites and online CSU patient communities. Telephone interviews were conducted using a semi-structured interview guide. Participants reviewed the UAS and provided their input on the UAS guidance document. Results Twenty-two interviews were conducted (seven adolescents and 15 adults; mean age 34 ± 18 years, 64% female, 77% White, 77% non-Hispanic, and 59% moderate to severe CSU symptoms). All participants (n = 22/22, 100%) stated that the adapted UAS was clear and “easy” to understand. For the adapted UAS “wheals (hives)” item, several participants were unfamiliar with the term “wheals,” but the term “hives” was well understood by US participants. Most participants reported that it was “easy” or “not difficult” to count and recall the number of hives they had over the past 24 h. Participants found the adapted UAS guidance document “helpful” and “easy to understand” for determining and counting hives in a 24-hour period. Suggestions for improving the guide included adding a picture to aid in counting hives. Conclusions Itch and hives are important symptoms of CSU. Results support the content validity of an adapted UAS as a daily measure of severity of itch and hives and provided valuable suggestions for improving its patient guidance, which can be used in future clinical trials involving adults and adolescents ≥ 12 years old with CSU to assess the severity of itch and hives.

Abstract Background The therapeutic efficacy and prognosis of various tumors can be assessed using the systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI). Despite their potential, no studies have investigated the prognostic value of the combined SII-PNI score for outcomes in patients with extensive small cell lung cancer (ES-SCLC) treated with chemotherapy and immune checkpoint inhibitors (ICIs). Materials and methods Our study retrospectively examined 213 ES-SCLC patients treated with chemotherapy and ICIs across two institutions. The patients were divided into three groups based on their SII-PNI scores. Cox regression analysis was employed to identify independent prognostic factors. A nomogram was constructed based on these independent factors. With 1000 repeated samples, the bootstrap method was used to validate the nomogram model internally. The model’s performance was assessed using calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). Result Before and after chemotherapy with immune checkpoint inhibitors (ICIs), SII was significantly higher in the PD group compared with the PR group (both p

Abstract Background Primary liver cancer, particularly hepatocellular carcinoma, is one of the most common gastrointestinal cancers. An increasing number of studies indicate that nanomaterials play a significant role in the diagnosis and treatment of liver cancer. However, despite the extensive and diverse research on nanomaterials and liver cancer, bibliometric studies in this field have not yet been reported. This study aims to comprehensively evaluate the application prospects and development trends of nanomaterials in primary liver cancer over the past 20 years. By elucidating the current state of research on liver cancer, we intend to provide valuable reference information for researchers in this field. Methods We conducted a comprehensive search of the Web of Science Core Collection for publications related to liver cancer and nanomaterials from January 1, 2004, to December 31, 2023. Relevant literature was selected based on specific inclusion and exclusion criteria. These selected publications were subsequently analyzed using CiteSpace, VOSviewer, and the R package "bibliometrix" to identify trends, influential countries, institutions, authors, journals, and research hotspots in this field. Results This study included a total of 1641 publications, with an annual growth rate of 25.45%. China and the United States are leading in this field, accounting for 67.46% and 11.27% of the total publications, respectively. The Chinese Academy of Sciences and Shao D are the most cited institution and author, respectively. The International Journal of Nanomedicine is the most influential journal in this field, while Biomaterials is the most highly cited and co-cited journal. Research hotspots mainly focus on improving drug delivery efficiency, inducing cancer cell apoptosis, photodynamic therapy, photothermal therapy, and combination treatments. Emerging research directions include the tumor microenvironment, polyethylene glycol, and immunogenic cell death. Conclusion The results of this study indicate that the application of nanomaterials in the field of liver cancer is gradually becoming a significant research area, with a focus on improving drug delivery efficiency, enhancing therapeutic efficacy, and reducing side effects.

Abstract Background The influence of the glucagon-like peptide-1 receptor (GLP-1R) on bone metabolism is well-established. However, it has been observed that single nucleotide polymorphisms (SNPs) in the GLP-1R gene can partially affect its function. Therefore, this study aims to investigate the association between SNPs in the GLP-1R gene and postmenopausal osteoporosis (PMOP) within the Chinese Han population. Methods This study employed a cross-sectional case–control design, recruiting a total of 152 participants, including 76 patients with osteoporosis (OP) (case group) and 76 healthy individuals (control group). Seven tag SNPs of GLP-1R were selected from the National Center of Biotechnology Information and Genome Variation Server. The association between GLP-1R polymorphisms and PMOP risk was assessed using different genetic models and haplotypes, while also exploring SNP-SNP and SNP-environment interactions. Results Our results showed that minor alleles A at rs3765468, A at rs3765467 and G at rs4714210 showed significant associations with an increased risk of OP. Individuals with rs3765468 AG-AA genotype and rs3765467 AG-AA genotype exhibited a significantly higher risk of PMOP. Moreover, haplotype analysis revealed a significant association of the GACACA haplotype on PMOP risk (P = 0.033). Additionally, a multiplicative interaction was observed between rs3765468 and rs3765467 that was associated with an increased risk of PMOP (P interaction = 0.012). Conclusions Specific SNPs in the GLP-1R gene were linked to an increased risk of PMOP. This study improves our understanding of the genetic basis of PMOP in this population and suggests that genetic screening can identify individuals at risk for developing PMOP, enabling early prevention.

Abstract Background New mothers frequently encounter postpartum depression, anxiety, and stress symptoms, which pose challenges in diagnosis and treatment owing to their intricate interplay. This study employs network analysis to explore the interconnections between these symptoms and identify potential intervention points. Methods The study was carried out from December 2023 to June 2024 at the postpartum clinics of three representative tertiary hospitals in Nantong City. The participants were mothers undergoing their 42-day postpartum check-up. Participants completed the Edinburgh Postnatal Depression Scale (EPDS), the Depression, Anxiety, and Stress Scales (DASS-21), and the Maternal postpartum stress scale (MPSS). The R language was used to construct the network. Network analysis was also carried out to explore the network structure, centrality indices (strength, closeness, betweenness, and expected influence), and the stability of the network. Results A total of 625 women were included. The resulting network indicates a close interconnection between communities associated with depression, anxiety, and stress. As assessed on the centrality index, “I have felt sad or miserable” (EPDS-8), “Baby’s irregular patterns of daily sleep” (MPSS-9), “lack of time for myself” (MPSS-19), “I have been so unhappy that I have been crying” (EPDS-4), and “Physical appearance after childbirth” (MPSS-20) are the five most important nodes of these three network structures. High network stability (> 0.7). Conclusion Postpartum-specific stress symptoms play a significant role in the network of postpartum depression, anxiety, and stress, and identifying the central symptoms of depression, anxiety, and stress can provide a scientific basis for the development of precise interventions. Clinical trial number Not Applicable.