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Shaojie Bi,1 Juan Zhang,1 Ning Wei,2 Qingbo Zhou,3,4 Chunyan Wang3 1Department of Cardiology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China; 2Department of Information Center, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China; 3Department of Geriatrics, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of China; 4School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, People’s Republic of ChinaCorrespondence: Chunyan Wang, Email 201062013735@email.sdu.edu.cnIntroduction: Anemia, characterized by low hemoglobin or erythrocyte levels, is a significant global health issue with severe implications for public health. Recent studies have explored the potential link between anemia and 25-hydroxyvitamin D [25(OH)D], yet the precise mechanisms remain unclear. This study aims to clarify the possible causal relationship between 25(OH)D levels and anemia risk.Methods: We conducted a comprehensive investigation combining observational and Mendelian randomization (MR) analyses. The observational study included detailed demographic, comorbidities, and laboratory data collected from 7160 hospitalized patients in China. For the MR analysis, genetic polymorphisms were utilized to assess causal effects.Results: Observational analysis revealed an inverse relationship between 25(OH)D levels and the risk of anemia, with stratified analysis indicating a nonlinear association and a threshold of 48.716 nmol/L. The MR analysis confirmed a protective causal relationship between higher 25(OH)D levels and a reduced risk of anemia. Bidirectional MR analysis found no evidence that anemia influences 25(OH)D levels.Discussion: This study provides strong evidence of a causal link between increased 25(OH)D levels and a lower incidence of anemia. The findings highlight the potential role of vitamin D in anemia prevention, supporting the need for further research into vitamin D supplementation as a strategy to reduce anemia risk.Conclusion: Our findings support the hypothesis that higher 25(OH)D levels are causally associated with a reduced risk of anemia, suggesting vitamin D’s potential role in anemia prevention and public health strategies.Keywords: anemia, 25-hydroxyvitamin D, Mendelian randomization

Jing Yang, Chengsen Shu, Xianfu Shang, Hao Xu, Ning Wei Department of Interventional Radiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221006, People’s Republic of ChinaCorrespondence: Ning Wei, Email weiningjieru2006@163.comPurpose: This study aimed to investigate the prognostic value of systemic immune-inflammation index (SII) in patients with extrahepatic cholangiocarcinoma (EHCC) treated by percutaneous transhepatic biliary stenting (PTBS) combined with 125I seed intracavitary irradiation and further develop a predictive model related to SII.Methods: A total of 145 patients with EHCC who received PTBS combined with 125I seed implantation were retrospectively analyzed. The optimal cut-off value of SII was identified by receiver operating characteristic (ROC) curve analysis. Kaplan–Meier curves and Cox regression were applied to estimate the prognostic value of SII and identify other significant factors of overall survival (OS). Additionally, a novel nomogram was constructed. The concordance index (C-index), calibration plots and decision curve analysis were used to evaluate the performance of the nomogram model.Results: The optimal cut-off value for preoperative SII of 890.2 stratified the patients into High-SII (H-SII) and Low-SII (L-SII) groups. Univariate and multivariate analyses demonstrated that SII was an independent factor for OS. We also found that better therapeutic effect could be obtained with combined postoperative chemotherapy (P < 0.001). Moreover, we revealed that elevated preoperative CA19-9 (P = 0.038) and TBIL level (P = 0.024) were reason for poor prognosis of EHCC. A well-discriminated and calibrated nomogram was developed to predict the 1-year and 2-year OS of EHCC (C-index: 0.709).Conclusion: The SII may be a feasible and convenient prognosis predictor for EHCC. The comprehensive nomogram based on SII presented in this study is a promising model for predicting OS in EHCC patients after PTBS combined with 125I seed intracavitary irradiation.Keywords: extrahepatic cholangiocarcinoma, biliary stenting, 125I seed, systemic immune-inflammation index, nomogram

The future Sixth-Generation (6G) wireless systems are expected to encounter emerging services with diverse requirements. In this paper, 6G network resource orchestration is optimized to support customized network slicing of services, and place network functions generated by heterogeneous devices into available resources. This is a combinatorial optimization problem that is solved by developing a Particle Swarm Optimization (PSO) based scheduling strategy with enhanced inertia weight, particle variation, and nonlinear learning factor, thereby balancing the local and global solutions and improving the convergence speed to globally near-optimal solutions. Simulations show that the method improves the convergence speed and the utilization of network resources compared with other variants of PSO.

Abstract In recent years, under the background of exam-oriented physical education reform, the government has issued a lot of physical education documents and policies. As a result, many schools have made fundamental changes in physical education activities. These policies are mainly aimed at getting young people to be more active and autonomous in school sports. This requires physical education training teachers must adhere to the people-oriented, student-oriented, so as to highlight the subject status of students. Based on this, students should establish a good sports values and ethics and form a good habit of lifelong sports, so as to further promote the sustainable development of youth sports activities. Based on the ecological theory of sustainable development as the background, this study constructs a unified theory of Unified Theory of Acceptance and Use of Technology (UTAUT) model for the sustainable training and development of youth skating sports training institutions. This study selects the youth skating sports training institutions in Beijing, China as the investigation object, covering small, medium and large institutions of different sizes, and analyzes based on the statistical data in 2023 and the results of field research. The results show that the application of this model not only increases the willingness of youth skating training institutions to continue to participate by 3.66%, but also promotes the diversified development of youth skating training. In addition, this study also discusses the environmental protection measures implemented in the process of skating training to ensure that the training activities are sustainable while reducing the impact on the environment, so as to build a sustainable development of the new ecology of skating sports training.

BackgroundCurrently， there has been a gradual increase in the incidence of mental diseases， becoming a problem that has attracted great concern of the general public. Zhuhai is a core city of the Guangdong-Hong Kong-Macao Greater Bay Area， and the local government have attached great importance to the mental health of residents. The systematic study on the mental health has focused largely on pregnant women and medical workers， yet few are on the adult residents.ObjectiveTo investigate the prevalence and its influencing factors of anxiety and depression among adult residents in Zhuhai， so as to provide references for formulating targeted psychological intervention strategies.MethodsFrom September 1 to December 1， 2021， a cohort of 5 600 permanent residents aged 18 years and above in Zhuhai were selected through multistage sampling. All participants were subjected to complete Patients' Health Questionnaire Depression Scale-9 item （PHQ-9）， Generalized Anxiety Disorder Scale-7 item （GAD-7） and National Mental Health Literacy Questionnaire based on Wenjuanxing software. Then Logistic regression was employed to identify the factors associated with anxiety and depression among the residents.ResultsAmong the 5 600 residents， depressive symptoms were detected in 842 （15.04%） residents and anxiety symptoms in 579 （10.34%） residents. Logistic regression analysis yielded that female gender （OR=1.488）， living in Doumen district （OR=1.942）， junior college/undergraduate level （OR=3.602）， postgraduate and above （OR=5.904）， irregular meal pattern （OR=3.320）， comorbid chronic diseases （OR=3.244）， disqualification of self-assessment （OR=3.414） and disqualification of mental health skill （OR=2.131） were risk factors for depression symptoms， whereas age ≥25 years old （of all age groups OR20 000 yuan （OR=0.438） and exercising ≥3 times a week （OR=0.431） were protective factors for depression symptoms. Age of 25~34 years old （OR=2.051）， living in Jinwan district （OR=1.729） or Doumen district （OR=1.901）， junior college/undergraduate level （OR=2.955）， postgraduate and above （OR=6.662）， irregular meal pattern （OR=2.741）， comorbid chronic diseases （OR=3.535）， disqualification of self-assessment （OR=3.325） and disqualification of mental health skill （OR=1.838） were risk factors for anxiety symptoms， while monthly per capita income of 6 001~9 000 yuan （OR=0.665） and exercising ≥3 times a week （OR=0.572） were protective factors for anxiety symptoms.ConclusionThe mental health status of adult residents in Zhuhai is affected by various factors， including gender， age， region of residence， education level， meal pattern， exercise frequency and chronic diseases. ［Funded by 2023 Zhuhai Medical Research Project （number， 2220009000227）］

Abstract Background The association of body mass index (BMI) with survival outcomes in patients with advanced non-small cell lung cancer (NSCLC) treated with first-line chemotherapy, immunotherapy, or chemoimmunotherapy is controversial. We aimed to investigate these associations, including associations in male and female patients specifically, in a multicenter cohort study. Methods We retrospectively analyzed data from seven cohorts comprising 7021 advanced non-small cell lung cancer patients who received chemotherapy (three cohorts), immunotherapy (two cohorts), and chemoimmunotherapy (two cohorts) from five data sources, including a de-identified nationwide (US-based) NSCLC clinico-genomic database and two randomized, double-blind, phase 3 clinical trials. BMI was categorized as underweight, normal weight, overweight, or obese. Underweight patients were excluded because of their small proportion. The primary endpoints were the associations between BMI and progression-free survival (PFS) and overall survival (OS) stratified by treatment type and sex, which were assessed using Kaplan–Meier methods and adjusted Cox modeling. Meta-analyses were performed to combine the adjusted hazard ratios. Results In the pooled analysis, obesity was significantly associated with improved OS in patients receiving chemotherapy (hazard ratios [HR] = 0.84, 95% confidence interval (CI) 0.76–0.93), but there was no association with PFS (HR = 0.91, 95% CI 0.82–1.02). The association of BMI with OS for patients receiving chemotherapy differed by sex, with an inverse association in men (HR = 0.74, 95% CI 0.64–0.84), but no association observed in women (HR = 0.96, 95% CI 0.81–1.13, Pinteraction = 0.018). No impact of BMI on OS or PFS was detected in patients receiving immunotherapy or chemoimmunotherapy. Obese patients had the lowest level of tumor mutational burden, similar level of programmed death-ligand 1 expression and ESTIMATE scores. Conclusions Obesity may be associated with an increased overall survival among male patients treated with chemotherapy, whereas not associated with the outcomes in patients treated with immunotherapy or chemoimmunotherapy.

Abstract The photothermal conversion properties of tellurium (Te) nanoparticles have been extensively investigated, rendering them a promising candidate for tumor photothermal therapy. However, there is still room for improvement in the development of efficient Te-based drug delivery systems. Here, Te nanoparticles are mineralized with bioactive molecules within attenuated Salmonella (S-Te), which are subsequently taken up by macrophages (RAW264.7) to construct a double-camouflaged delivery platform (RS-Te). Remarkably, RS-Te retains superior photothermal properties under near-infrared irradiation. The mineralization process eliminates bacterial proliferation potential, thereby mitigating the risk of excessive bacterial growth in vivo. Furthermore, the uptake of bacteria by macrophages not only polarizes them into M1 macrophages to induce an anti-tumor immune response but also circumvents any adverse effects caused by complex antigens on the bacterial surface. The results show that RS-Te can effectively accumulate and retain in tumors. RS-Te-mediated photothermal immunotherapy largely promotes the maturation of dendritic cells and priming of cytotoxic T cells induced by near-infrared laser irradiation. Moreover, RS-Te can switch the activation of macrophages from an immunosuppressive M2 phenotype to a more inflammatory M1 state. The double-camouflaged delivery system may offer highly efficient and safe cancer treatment.

Objective The objective of this experiment was to determine the standard ileal digestibility (SID) of amino acid (AA) in 10 different sources of wheat bran fed to broilers and establish the SID AA prediction based on the chemical composition. Methods A total of 660 1-day-old broilers were randomly divided into 11 treatments with 6 replicates of 10 chickens each. Diets included 10 semi-purified mash diets and 1 nitrogen-free diet. Titanium dioxide (TiO2) 0.50% was used as an indigestible index. On day 13, 6 chickens from each replicate were selected for slaughter to collect ileal contents. On day 28, 4 chickens from each replicate were selected for slaughter to collect ileal contents. Results Results showed that the coefficient of variation of the conventional nutrients (except for gross energy, and dry matter) and all AAs was greater than 8.00%. The average SID of essential AA in wheat bran for 13-day-old broilers was 37.24% and the average SID of nonessential AA was 42.02%; the average SID of essential AA for 28-day-old broilers was 67.13% and the average SID of nonessential AA was 69.51%. A correlation was observed (p

Abstract In food circular economy, the utilization of food manufacturing side streams (FMSS) offers significant potential instead of being discarded. However, reincorporating FMSS into the food value chain raises food safety concerns due to potential food hazards. This perspective explores food safety risks associated with circular management of FMSS by using a ‘Quad-Modal hazard dynamic’ approach with case studies. Future research and advancements in food safety control strategies are also discussed.

Objective: To investigate whether angiotensin II type 1 receptor (AGTR1 A1166C) gene polymorphism was associated with the effectiveness of valsartan monotherapy in Chinese patients with essential hypertension. Methods: This retrospective analysis included 198 patients (⩾18 years of age) who received valsartan monotherapy (80 mg/day) for newly developed essential hypertension at the authors’ center between January 1, 2020 and December 31, 2023. Genotyping for AGTR1 A1166C gene polymorphism was done by polymerase chain reaction (PCR)-melting curve analysis of genomic DNA from peripheral blood samples. A dominant genetic model for AGTR1 A1166C (AA genotype versus AC + CC genotype) was used. Multivariate regression analysis of baseline variables and AGTR1 polymorphism was conducted to identify predictors of target blood pressure attainment (

The network autoregressive model is a super high-dimensional time series model that can fully explain social relationships. This model can fully reflect the complex relationships in reality. Therefore, it plays a vital role in detecting the inflection point problem of this network autoregressive model for economics and finance. In this paper, we proposed the change-point problem of detecting network autoregressive models using empirical likelihood statistics based on the expected error term of the switching rule being 0, using the empirical likelihood method. Moreover, the asymptotic null distribution of the proposed empirical likelihood statistic was investigated. Simulation studies based on different settings were considered, and the results showed that the power of test statistics is significant. In the end, the Chinese stock market was investigated to demonstrate the significance of the proposed method.

In order to investigate the influence of X-ray irradiation dose on the germination and storage quality of coloured potatoes, this study took the coloured potatoes Yellow Rose 3, Purple Rose 3, Red Rose 5 and common potatoes as test materials, and treated them with 5 MeV electron-beam rotary target X-rays at 0, 100, 300 and 500 Gy. The treated potatoes were stored at room temperature (20±2) ℃ with a relative humidity of 80%~90%. In order to study the influence of X-ray irradiation on the appearance, nutritional quality and fresh-keeping effects of potatoes, parameter changes of germination rate, weight loss rate, hardness, VC content, dry matter content and respiration intensity during the storage period were analyzed. The results showed that X-ray irradiation treatment reduced the respiratory intensity of potatoes in the mid to late storage period and decreased the weight loss, hardness decline and loss of VC content during storage. Compared with control group, 100 Gy irradiation treated Yellow Rose 3, Purple Rose 3, Red Rose 5 and common potatoes reduced the weight loss rate by 12.76%, 5.31%, 6.05% and 1.43%, respectively, the degree of decrease in hardness at the end of the storage period compared with the beginning of storage period was reduced by 12.98%, 6.40%, 8.34% and 7.13%, respectively, and the rate of loss of VC content was reduced by 17.71%, 22.80%, 13.52% and 14.65%, respectively. Four varieties of potatoes did not sprout even after storage for more than 240 days after receiving different doses of X-rays. A low dose of 100 Gy of X-ray irradiation treatment could achieve an optimal sprout inhibition effect. Moreover, it delayed weight loss and hardness decline more effectively than 300 and 500 Gy. This dose could be recommended as the dose for irradiation preservation of coloured and ordinary potatoes in industrial applications. This research provides a theoretical basis and technical guidance for the application of X-ray irradiation technology in the storage and preservation of coloured potatoes.

Abstract Objective This study aimed to investigate the critical role of MDSCs in CRC immune suppression, focusing on the CSF1R and JAK/STAT3 signaling axis. Additionally, it assessed the therapeutic efficacy of LNCs@CSF1R siRNA and anti-PD-1 in combination. Methods Single-cell transcriptome sequencing data from CRC and adjacent normal tissues identified MDSC-related differentially expressed genes. RNA-seq analysis comprehensively profiled MDSC gene expression in murine CRC tumors. LNCs@CSF1R siRNA nanocarriers effectively targeted and inhibited CSF1R. Flow cytometry quantified changes in MDSC surface markers post-CSF1R inhibition. RNA-seq and pathway enrichment analyses revealed the impact of CSF1R on MDSC metabolism and signaling. The effect of CSF1R inhibition on the JAK/STAT3 signaling axis was validated using Colivelin and metabolic assessments. Glucose and fatty acid uptake were measured via fluorescence-based flow cytometry. The efficacy of LNCs@CSF1R siRNA and anti-PD-1, alone and in combination, was evaluated in a murine CRC model with extensive tumor section analyses. Results CSF1R played a significant role in MDSC-mediated immune suppression. LNCs@CSF1R siRNA nanocarriers effectively targeted MDSCs and inhibited CSF1R. CSF1R regulated MDSC fatty acid metabolism and immune suppression through the JAK/STAT3 signaling axis. Inhibition of CSF1R reduced STAT3 activation and target gene expression, which was rescued by Colivelin. Combined treatment with LNCs@CSF1R siRNA and anti-PD-1 significantly slowed tumor growth and reduced MDSC abundance within CRC tumors. Conclusion CSF1R via the JAK/STAT3 axis critically regulates MDSCs, particularly in fatty acid metabolism and immune suppression. Combined therapy with LNCs@CSF1R siRNA and anti-PD-1 enhances therapeutic efficacy in a murine CRC model, providing a strong foundation for future clinical applications.

Aiming at the deficiencies presented by the traditional methods of highway project investment evaluation, the proposed highway investment evaluation method was based on system dynamics. First, we constructed an evaluation index system from profitability, solvency, and risk resistance and clarified the positive and negative causality within the investment evaluation system of highway projects; second, we determined the boundaries of the system dynamics model and divided it into six sub-systems, namely, income, cash flow, investment evaluation, profit, cost, investment and financing, and liabilities; and then, we established the system dynamics model of highway investment evaluation based on the sub-systems. The model made up for the limitations of the traditional discounted cash flow method; finally, taking the China's Yunnan Province an Expressway project as an example, using VENSIM software simulation, we get the evaluation results of the system dynamics model and make a comparative analysis with the discounted cash flow method, which showed that the calculation inaccuracies of the NPV and other financial indicators were in a reasonable range, and the evaluation method had strong operability and practicability. The system dynamics investment evaluation model provided a systematic, intuitive, whole-process investment evaluation method, which provided a theoretical basis for the analysis and decision-making of the investment effect of highway projects.

Abstract KDM6A (lysine demethylase 6A) has been reported to undergo inactivating mutations in colorectal cancer, but its function in the progression of colorectal cancer has not been evaluated using animal models of colorectal cancer. In this study, we found that knocking out KDM6A expression in mouse intestinal epithelium increased the length of villus and crypt, promoting the development of AOM (azoxymethane)/DSS (dextran sulfate sodium salt)-induced colorectal cancer. On the other hand, knocking down KDM6A expression promoted the growth of colorectal cancer cells. In molecular mechanism studies, we found that KDM6A interacts with HIF-1α; knocking down KDM6A promotes the binding of HIF-1α to the LDHA promoter, thereby promoting LDHA expression and lactate production, enhancing glycolysis. Knocking down LDHA reversed the malignant phenotype caused by KDM6A expression loss. In summary, this study using animal models revealed that KDM6A loss promotes the progression of colorectal cancer through reprogramming the metabolism of the colorectal cancer cells, suggesting that restoring the function of KDM6A is likely to be one of the strategies for colorectal cancer treatment.

BackgroundThis study aimed to explore the mechanism of action of DiWuYangGan (DWYG) capsule in improving Immunological non-responder (INR) by analyzing the active ingredients of DWYG.MethodsThe study employed a randomized, controlled, double-blind, single-simulation method. Patients were randomly divided into control and trial groups and treated with the primal highly effective antiretroviral therapy. To demonstrate the effect of DWYG on INR, patients in the control group were administered simulated DWYG, whereas patients in the trial group were administered DWYG capsules (ChiCTR1900024673). The chemical composition of DWYG was analyzed using ultra-performance liquid chromatography-high-resolution mass spectrometry. Potential targets of DWYG in the treatment of INR were identified and predicted using network pharmacology and molecular docking. The molecular mechanisms underlying the effects of DWYG were validated using a peripheral blood monocyte model.ResultsThe CD4:CD8 ratio in the trial group was significantly higher than that in the control group (p < 0.01). A total of 210 DWYG compounds were identified and network pharmacology revealed 182 potential therapeutic targets for DWYG and INR. The results of Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses showed that the toll-like receptor signaling pathway is one of the key pathways. This study demonstrated that DWYG reduced the expression level of TLR4 and the levels of IL-2, IL-10, and TNF-α, which are important cytokines involved in the immune response.ConclusionThe efficacy of DWYG in the treatment of INR confirmed the potential practical components of DWYG. Moreover, the results of network pharmacology and experimental validation showed that DWYG could restore the immune function of acquired immune deficiency syndrome patients by inhibiting the expression of TLR4 and related signaling pathways and the overactivation of immune function.Clinical Trial Registration:https://www.chictr.org.cn/index.html, identifier ChiCTR1900024673.

ABSTRACT: This study aimed to investigate the effects of baicalin and chlorogenic acid (BC) on growth performance, intestinal barrier function, antioxidant capacity, intestinal microbiota, and mucosal metabolism in broilers. A total of 720 twenty-one-day-old broilers were randomly allocated into 3 groups, with 6 replicates per group and 40 chickens per replicate. They were fed a basal diet (Con group) or a basal diet supplemented with 250 or 400 mg/kg BC (BC250 and BC400 groups) for 40 consecutive days. The results revealed that 250 mg/kg BC significantly increased 60-d body weight and average daily gain during 39 to 60 d (P < 0.05). Furthermore, Supplementation with 250 mg/kg BC improved the antioxidant capacity and immunity of broilers, as evidenced by increased (P < 0.05) superoxide dismutase and decreased (P < 0.05) malondialdehyde levels in serum and ileum, as well as increased (P < 0.05) immunoglobulin G levels. Supplementation with 250 mg/kg BC enhanced intestinal development by improving intestinal morphology and promoting the proliferation of intestinal crypts. Moreover, Supplementation with 250 mg/kg BC improved (P < 0.05) intestinal permeability, up-regulated (P < 0.05) the expression of tight junction-related genes (Occludin and ZO-1), and down-regulated (P < 0.05) the expression of pro-inflammatory genes (IL-2, IL-8, and IFN-γ). 16S rRNA sequencing revealed significant enrichment of Microbacteriaceae, Micromonosporaceae, Anaerovoracaceae, and Coriobacteriaceae in the BC250 group. Metabolomics showed that 250 mg/kg BC up-regulated the lysosome, foxo signaling pathway, glycosylphosphatidylinositol (GPI)-anchor biosynthesis, and oxidative phosphorylation pathways, while down-regulating the biosynthesis of cofactors pathway. In conclusion, supplementing diets with 250 mg/kg BC is recommended to modulate intestinal microbiota, mucosal metabolism, and antioxidant capacity, thereby improving broiler growth performance and intestinal health.

Background Microangiogenesis and lymphangiogenesis are essential for tumor growth in the tumor microenvironment, contributing to tumor invasion and metastasis. Limited literature exists on these processes in esophageal squamous cell carcinoma (ESCC). Therefore, the purpose of this study is to explore the impacts of microangiogenesis and lymphangiogenesis on the occurrence, progression, and prognosis assessment of ESCC. Methods Surgical specimens and paraffin-embedded human tissues were procured from ESCC patients, encompassing 100 ESCC tissues and 100 cancer-adjacent normal (CAN) tissues. CD34 and D2-40 were utilized as markers for microvessel endothelial cells and lymphatic vessel endothelial cells, respectively. Microvascular density (MVD) and lymphatic vessel density (LVD) were evaluated through immunohistochemical quantification. Results We found that tumor tissues in ESCC patients had significantly higher MVD and LVD than cancer-adjacent normal (CAN) tissues. High MVD and LVD were associated with lymph node metastasis and advanced tumor clinical stages. Additionally, both high MVD and high LVD were strongly linked to poorer prognosis among cancer patients. Furthermore, a positive correlation was found between high MVD and high LVD (p < 0.05). The presence of these markers individually indicated a worse prognosis, with their combined assessment showcasing enhanced prognostic value. Conclusions Overall, the increased MVD and LVD indicates higher invasion and metastasis of ESCC, closely correlating with unfavorablefor poor prognosis of ESCC patients.

Abstract Background The 9th edition of the TNM Classification for lung cancer delineates M1c into two subcategories: M1c1 (Multiple extrathoracic lesions within a single organ system) and M1c2 (Multiple extrathoracic lesions involving multiple organ systems). Existing research indicates that patients with lung cancer in stage M1c1 exhibit superior overall survival compared to those in stage M1c2. The primary frontline therapy for patients with advanced non‐small cell lung cancer (NSCLC), lacking driver gene mutations, involves the use of immune checkpoint inhibitors (ICIs) combined with chemotherapy. Nevertheless, a dearth of evidence exists regarding potential survival disparities between NSCLC patients with M1c1 and M1c2 undergoing first‐line immune‐chemotherapy, and reliable biomarkers for predicting treatment outcomes are elusive. Serum metabolic profiles may elucidate distinct prognostic mechanisms, necessitating the identification of divergent metabolites in M1c1 and M1c2 undergoing combination therapy. This study seeks to scrutinize survival discrepancies between various metastatic patterns (M1c1 and M1c2) and pinpoint metabolites associated with treatment outcomes in NSCLC patients undergoing first‐line ICIs combined with chemotherapy. Method In this study, 33 NSCLC patients lacking driver gene mutations diagnosed with M1c1, and 22 similarly diagnosed with M1c2 according to the 9th edition of TNM Classification, were enrolled. These patients received first‐line PD‐1 inhibitor plus chemotherapy. The relationship between metastatic patterns and progression‐free survival (PFS) in patients undergoing combination therapy was analyzed using univariate and multivariate Cox regression models. Serum samples were obtained from all patients before treatment initiation for untargeted metabolomics analysis, aiming to identify differential metabolites. Results In the univariate analysis of PFS, NSCLC patients in M1c1 receiving first‐line PD‐1 inhibitor plus chemotherapy exhibited an extended PFS (HR = 0.49, 95% CI, 0.27–0.88, p = 0.017). In multivariate PFS analyses, these M1c1 patients receiving first‐line PD‐1 inhibitor plus chemotherapy also demonstrated prolonged PFS (HR = 0.45, 95% CI, 0.22–0.92, p = 0.028). The serum metabolic profiles of M1c1 and M1c2 undergoing first‐line PD‐1 inhibitors plus chemotherapy displayed notable distinctions. In comparison to M1c1 patients, M1c2 patients exhibited alterations in various pathways pretreatment, including platelet activation, linoleic acid metabolism, and the VEGF signaling pathway. Diminished levels of lipid‐associated metabolites (diacylglycerol, sphingomyelin) were correlated with adverse outcomes. Conclusion NSCLC patients in M1c1, devoid of driver gene mutations, receiving first‐line PD‐1 inhibitors combined with chemotherapy, experienced superior outcomes compared to M1c2 patients. Moreover, metabolomic profiles strongly correlated with the prognosis of these patients, and M1c2 patients with unfavorable outcomes manifested distinct changes in metabolic pathways before treatment. These changes predominantly involved alterations in lipid metabolism, such as decreased diacylglycerol and sphingomyelin, which may impact tumor migration and invasion.

Abstract Nonlinear transport is a unique functionality of noncentrosymmetric systems, which reflects profound physics, such as spin-orbit interaction, superconductivity and band geometry. However, it remains highly challenging to enhance the nonreciprocal transport for promising rectification devices. Here, we observe a light-induced giant enhancement of nonreciprocal transport at the superconducting and epitaxial CaZrO3/KTaO3 (111) interfaces. The nonreciprocal transport coefficient undergoes a giant increase with three orders of magnitude up to 105 A−1 T−1. Furthermore, a strong Rashba spin-orbit coupling effective field of 14.7 T is achieved with abundant high-mobility photocarriers under ultraviolet illumination, which accounts for the giant enhancement of nonreciprocal transport coefficient. Our first-principles calculations further disclose the stronger Rashba spin-orbit coupling strength and the longer relaxation time in the photocarrier excitation process, bridging the light-property quantitative relationship. Our work provides an alternative pathway to boost nonreciprocal transport in noncentrosymmetric systems and facilitates the promising applications in opto-rectification devices and spin-orbitronic devices.

The paper assesses the moderating role of firm age in the relationship between financial constraints, as measured by the KZ index, and the WW index on three alternative measures of firm growth (Asset growth, ROA, and ROE) in the ASEAN–6 region. This study employs a sample of ASEAN–6 listed firms over the period 2009–2019 using Fixed Effects and the System GMM model. Firm age is found to interact positively with financial constraints in their effects on firm growth. The negative impact of financial constraints on firm growth is less severe with older age firms.

Abstract Nonlinear transport enabled by symmetry breaking in quantum materials has aroused considerable interest in condensed matter physics and interdisciplinary electronics. However, achieving a nonlinear optical response in centrosymmetric Dirac semimetals via defect engineering has remained a challenge. Here, we observe the helicity dependent terahertz emission in Dirac semimetal PtTe2 thin films via the circular photogalvanic effect under normal incidence. This is activated by a controllable out-of-plane Te-vacancy defect gradient, which we unambiguously evidence with electron ptychography. The defect gradient lowers the symmetry, which not only induces the band spin splitting but also generates the giant Berry curvature dipole responsible for the circular photogalvanic effect. We demonstrate that the THz emission can be manipulated by the Te-vacancy defect concentration. Furthermore, the temperature evolution of the THz emission features a minimum in the THz amplitude due to carrier compensation. Our work provides a universal strategy for symmetry breaking in centrosymmetric Dirac materials for efficient nonlinear transport.

Educational inequalities in all-cause mortality have been observed for decades. However, the underlying biological mechanisms are not well known. We aimed to assess the role of DNA methylation changes in blood captured by epigenetic clocks in explaining these inequalities. Data were from 8 prospective population-based cohort studies, representing 13 021 participants. First, educational inequalities and their portion explained by Horvath DNAmAge, Hannum DNAmAge, DNAmPhenoAge, and DNAmGrimAge epigenetic clocks were assessed in each cohort via counterfactual-based mediation models, on both absolute (hazard difference) and relative (hazard ratio) scales, and by sex. Second, estimates from each cohort were pooled through a random effect meta-analysis model. Men with low education had excess mortality from all causes of 57 deaths per 10 000 person-years (95% confidence interval [CI]: 38, 76) compared with their more advantaged counterparts. For women, the excess mortality was 4 deaths per 10 000 person-years (95% CI: -11, 19). On the relative scale, educational inequalities corresponded to hazard ratios of 1.33 (95% CI: 1.12, 1.57) for men and 1.15 (95% CI: 0.96, 1.37) for women. DNAmGrimAge accounted for the largest proportion, approximately 50%, of the educational inequalities for men, while the proportion was negligible for women. Most of this mediation was explained by differential effects of unhealthy lifestyles and morbidities of the World Health Organization (WHO) risk factors for premature mortality. These results support DNA methylation-based epigenetic aging as a signature of educational inequalities in life expectancy emphasizing the need for policies to address the unequal social distribution of these WHO risk factors. [ABSTRACT FROM AUTHOR]

IntroductionThe detection rate of benign thyroid nodules is increasing every year, with some affected patients experiencing symptoms. Ultrasound-guided thermal ablation can reduce the volume of nodules to alleviate symptoms. As the degree and speed of lesion absorption vary greatly between individuals, an effective model to predict curative effect after ablation is lacking. This study aims to predict the efficacy of ultrasound-guided thermal ablation for benign thyroid nodules using machine learning and explain the characteristics affecting the nodule volume reduction ratio (VRR).DesignProspective studyPatientsThe clinical and ultrasonic characteristics of patients who underwent ultrasound-guided thermal ablation of benign thyroid nodules at our hospital between January 2020 and January 2023 were recorded.MeasurementsSix machine learning models (logistic regression, support vector machine, decision tree, random forest, eXtreme Gradient Boosting [XGBoost], and Light Gradient Boosting Machine [LGBM]) were constructed to predict efficacy; the effectiveness of each model was evaluated, and the optimal model selected. SHapley Additive exPlanations (SHAP) was used to visualize the decision process of the optimal model and analyze the characteristics affecting the VRR.ResultsIn total, 518 benign thyroid nodules were included: 356 in the satisfactory group (VRR ≥70% 1 year after operation) and 162 in the unsatisfactory group. The optimal XGBoost model predicted satisfactory efficacy with 78.9% accuracy, 88.8% precision, 79.8% recall rate, an F1 value of 0.84 F1, and an area under the curve of 0.86. The top five characteristics that affected VRRs were the proportion of solid components < 20%, initial nodule volume, blood flow score, peripheral blood flow pattern, and proportion of solid components 50–80%.ConclusionsThe models, based on interpretable machine learning, predicted the VRR after thermal ablation for benign thyroid nodules, which provided a reference for preoperative treatment decisions.

Background and PurposeThe risk of skin injuries in space is increasing with longer space missions and a growing astronaut population. This highlights the importance of understanding the adverse effects of weightlessness on wound healing. The objective of this research was to examine the therapeutic potential of Low-Level Light Therapy (LLLT) on skin healing processes under simulated microgravity (SMG) conditions and uncover the underlying molecular mechanisms, thus providing innovative solutions and a sound theoretical basis for space skin injuries.MethodsHindlimb unloading (HU) mice models were used to simulate weightlessness conditions, with or without a complete management of LLLT for 14 days. A systematic testing consisting of HE, Masson and immunohistochemical staining was performed against the standardized mouse tissue specimens. In vitro assessment of cellular biological functions under SMG conditions was carried out in the rotation system of culture (RSOC) using HaCaT and NIH3T3 cell-lines.ResultsUnder SMG conditions, LLLT significantly reduced skin wound area in HU mice, especially on Days 10 (p < 0.001), accompanied by increased collagen deposition and elevated levels of Ki67 and CD31. Moreover, LLLT showed impressive anti-inflammatory effects represented by the reduced in pro-inflammatory markers including LY6G, F4/80 and CD86, as well as the decreased levels of IL-1β, IL-6 and TNF-α. Conversely, an elevation in the anti-inflammatory marker CD206 was observed. By employing bioinformatics technology, we further found the PI3K/AKT signaling was prominent in the KEGG pathway analysis and CCR2 acted as a hub gene in the interaction network. Therefore, we demonstrated that LLLT could enhance the phosphorylation of PI3K/AKT and reduce CCR2 expression under SMG conditions, while CCR2 knockdown promoted the phosphorylation of PI3K/AKT, suggesting an important role of CCR2/PI3K/AKT signal axis in LLLT-accelerated wound healing under SMG conditions.ConclusionLLLT induced activation of the PI3K/AKT signaling pathway through suppression of CCR2 expression, which significantly enhanced skin wound healing under SMG conditions.s.