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Here we propose a foveated image transmission and compensation strategy with a rendering compression step, a re‐compression step and a decompression step. It is realized and tested on an FPGA‐based headset tester equipped with a high‐accuracy eye tracking system. Past human factors engineering experiments are reviewed and used to determine the proper boundaries for thefoveation zone division. [ABSTRACT FROM AUTHOR]

Abstract The mitochondrial malic enzyme 2 (ME2), which is frequently elevated during carcinogenesis and may be a target for cancer therapy, catalyzes the conversion of malate to pyruvate. The processes controlling ME2 activity, however, remain largely unclear. In this work, we show that human hepatocellular carcinoma (HCC) tissues contain high levels of ME2 and that the methylation of ME2 stimulates the growth and migration of HCC cells. Furthermore, we observed that ME2 interacts with protein arginine methyltransferase 1 (PRMT1) and that ME2 enzymatic activity is activated by mutation of ME2 at lysine 67. Mitochondrial respiration was markedly increased by activated ME2, which promoted cell division and carcinogenesis. Furthermore, a negative prognosis for patients was strongly linked with the expression levels of PRMT1 and ME2 R67K in HCC tissues. These findings imply that hepatocellular carcinoma growth is aided by PRMT1-mediated ME2 methylation, that is an essential signaling event that cancer cells need to continue mitochondrial respiration.

Abstract Background Rare infectious diseases of poverty (rIDPs) involve more than hundreds of tropical diseases, which dominantly affect people living in impoverished and marginalized regions and fail to be prioritized in the global health agenda. The neglect of rIDPs could impede the progress toward sustainable development. This study aimed to estimate the disease burden of rIDPs in 2021, which would be pivotal for setting intervention priorities and mobilizing resources globally. Methods Leveraging data from the Global Burden of Disease Study 2021, the study reported both numbers and age-standardized rates of prevalence, mortality, disability-adjusted life-years (DALYs), years lived with disability, and years of life lost of rIDPs with corresponding 95% uncertainty intervals (UIs) at global, regional, and national levels. The temporal trends between 1990 and 2021 were assessed by the joinpoint regression analysis. A Bayesian age-period-cohort model was used to project the disease burden for 2050. Results In 2021, there were 103.76 million (95% UI: 102.13, 105.44 million) global population suffered from rIDPs with an age-standardized DALY rate of 58.44 per 100,000 population (95% UI: 42.92, 77.26 per 100,000 population). From 1990 to 2021, the age-standardized DALY rates showed an average annual percentage change of − 0.16% (95% confidence interval: − 0.22, − 0.11%). Higher age-standardized DALY rates were dominated in sub-Saharan Africa (126.35 per 100,000 population, 95% UI: 91.04, 161.73 per 100,000 population), South Asia (80.80 per 100,000 population, 95% UI: 57.31, 114.10 per 100,000 population), and countries with a low socio-demographic index. There was age heterogeneity in the DALY rates of rIDPs, with the population aged under 15 years being the most predominant. Females aged 15–49 years had four-times higher age-standardized DALY rates of rIDPs than males in the same age. The projections indicated a slight reduction in the disease burden of rIDPs by 2050. Conclusions There has been a slight reduction in the disease burden of rIDPs over the past three decades. Given that rIDPs mainly affect populations in impoverished regions, targeted health strategies and resource allocation are in great demand for these populations to further control rIDPs and end poverty in all its forms everywhere. Graphical Abstract

Abstract Background Second-trimester miscarriage is a common adverse pregnancy outcome that imposes substantial economic and psychological pressures on both the physical and mental well-being of patients and their families. Currently, there is a scarcity of research on predictive models for the risk of second-trimester miscarriage. Methods Clinical data were retrospectively collected from patients who were in the second trimester of pregnancy (between 14+0 and 27+6 weeks gestation), whose main diagnosis was “threatened abortion” and who were hospitalized at the Women and Children’s Hospital of Ningbo University from January 2020 to October 2023. Following preliminary data processing, the patient cohort was randomly stratified into a training cohort and a validation cohort at proportions of 70% and 30%, respectively. The Boruta algorithm and multifactor analysis were used to refine feature factors and determine the optimal features linked to second-trimester miscarriages. The imbalanced dataset from the training cohort was rectified by applying the SMOTE oversampling approach. Seven machine-learning models were built and subjected to a comprehensive analysis to validate and evaluate their predictive capabilities. Through this rigorous assessment, the optimal model was selected. Shapley additive explanations (SHAP) were generated to provide insights into the model’s predictions, and a visual representation of the predictive model was built. Results A total of 2006 patients were included in the study; 395 (19.69%) of them had second-trimester miscarriages. XGBoost was shown to be the optimal model after a comparison of seven different models utilizing metrics such as accuracy, precision, recall, the F1 score, precision-recall average precision, the receiver operating characteristic-area under the curve, decision curve analysis, and the calibration curve. The most significant feature was cervical length, and the top ten features of second-trimester miscarriage were found using the SHAP technique based on relevance rankings. Conclusion The risk of a second-trimester miscarriage can be accurately predicted by the visual risk prediction model, which is based on the machine learning mentioned above.

ObjectiveAir-independent propulsion (AIP) submarines carry huge quantities of liquid oxygen. However, in the liquid oxygen combustion process, the cold energy is not usually recovered, and there are criticisms concerning CO2 removal in the confined space of a submarine. Aiming at the two major pain points that have long plagued AIP submarines, this paper proposes an integrated solution that organically combines the recovery and utilization of cold energy from liquid oxygen with the removal of CO2 . Method Liquid oxygen can be used as a cold energy source to process the cabin air. According to the different phase transition temperature characteristics of each air component, the CO2 in the air is frozen (condensed) and separated under normal pressure. ResultsThis study uses quantitative data analysis to show that the energy stored in liquid oxygen can basically meet the cold energy demand for freezing the CO2 produced by the crew's respiratory metabolism within the self-sustaining capacity of the submarine, and proposes a three-level workflow and implementation plan. ConclusionThe technical solution proposed in this paper can recycle 5% of cold energy from liquid oxygen, which conforms to the idea of the comprehensive integration of energy saving and noise reduction, and the full integration of overall resources. As such, it can be used for air purification and CO2 removal in confined spaces such as submarines, submersibles and deep-sea space stations powered by AIP systems.

Objective Urban rail transit project construction involves numerous management objects, complex processes and technical requirements. The imperfect standardized management system leads to frequent construction quality and safety problems. Therefore, it is necessary to carry out management standardization research. Method In combination with the standardized management practice of Shanghai Rail Transit Line 15 construction management, the standardization methods for total factor management behaviors such as technology, quality, safety, risk, progress and civilized construction in the entire cycle of preliminary preparation, construction and completion acceptance are studied. A construction management standardization system with a three-tier architecture covering basic management behaviors, professional behaviors and supporting standards is established. A series of standardized management process, system, technical basis as well as standardized document and smart terminal are formed. Result & Conclusion Engineering practice proves that the proposed standardization management method can effectively promote the institutionalization and scientific process of engineering management, and guide urban rail transit engineering to achieve the construction goals of high efficiency, high quality and safety.

C23H14Cl4N6O4, triclinic, P1̄ (no. 2), a = 9.044(2) Å, b = 11.340(2) Å, c = 11.812(3) Å, α = 95.470(17)°, β = 105.46(2)°, γ = 90.084(18)°, V = 1161.8(5) Å3, Z = 2, Rgt(F) = 0.0914, wRref(F2) = 0.2547, T = 296 K.

ObjectiveTo analyze the effect of diagnosis related group(DRG) reform in 2022 and its impact on patients in different departments, and create a policy environment that promotes the implementation of DRG.MethodsThe data of this study were collected from the database of discharge records of secondary and tertiary hospitals in Beijing, including 1 603 989 discharge records of urban employee medical insurance inpatients. This study constructed a difference in difference model and used the event study method to test the parallel trend assumption. Firstly, the hospital-month level aggregated data was used to analyze the effects of DRG reform on inpatient cost per admission, average length of stay, proportion of patients with 30-day read-mission, proportion of patients with 60-day readmission and the proportion of patients admitted through outpatients. Then, the aggregated monthly data of the departments of internal medicine, surgery, obstetrics and gynecology and oncology were used to further analyze the influence of DRG reform on the utilization of inpatient services in different departments.ResultsDRG reform reduced the inpatient cost per admission by about 9.79% and the length of stay per admission by about 5.35%, but had no significant effect on readmission risk and the proportion of patients admitted through outpatients. It reduced the inpatient cost per admission in the departments of internal medicine, surgery and obstetrics and gynecology, and reduced the length of stay per admission of inpatients in the departments of internal medicine and surgery. However, the reform had no significant effect on the readmission risk and the proportion of patients admitted through outpatients for all the four departments.ConclusionsThe DRG reform in Beijing reduced the inpatient cost per admission, but it is necessary to regularly monitor the medical behavior and pay more attention to the role of other payment methods in making up for the deficiencies of DRG. The impact of DRG reform on different departments is varied, so appropriate supportive policies should be formulated to secure the beneficial development of DRG reform.

Pure Mg has advantages of low density， good shock absorption performance and good biocompatibility， but its strength is low. Alloying is an important method to modify microstructure and properties of pure Mg. Sn has characteristics of low melting point， high eutectic temperature with Mg， high solid solubility in Mg， stable chemical properties and large output， which is appropriate to be an alloying element. The effects of alloying element Sn on microstructures and properties of Mg alloys were reviewed in this paper. Sn enriches at the front of the solid-liquid interface， dissolves in Mg matrix， reduces the ratio of critical resolved shear stress value of the pyramidal plane to that of the basal plane， and elevates the electric potential of Mg matrix. Mg2Sn precipitates can hinder dislocation and grain boundary movement， and form galvanic corrosion cells with Mg matrix. Therefore， effects of Sn addition include grain refinement， age hardening and strengthening， improving plasticity， accelerating or reducing corrosion rate， enhancing discharge efficiency and discharge potential. At present， the main problems restricting the development of Mg-Sn alloys are slow aging， low hardness and strength. In the future， endeavors should be made to develop rapidly age-hardenable Mg-Sn alloys with high strengths， wrought Sn-containing Mg alloys with good ductility， and Sn-containing structural-functional Mg alloys.

C21H21MnN6O6S, monoclinic, P21/c (no. 14), a = 13.093(3) Å, b = 23.810(5) Å, c = 7.9852(17) Å, β = 106.882(4)°, V = 2,382.1(9) Å3, Z = 4, Rgt(F) = 0.0498, wRref(F2) = 0.1299, T = 296(2) K.

With high melting point, high hardness, high thermal conductivity, excellent electrical conductivity, and high temperature oxidation resistance, the TiB2 ceramic has been applied in the fields of aerospace, machinery manufacturing, metal smelting, electronic information, and so on. However, the high-end manufacturing application of TiB2 ceramic has been limited by the low relative density and the difficulty of machine-processing. The densification of TiB2 ceramic could be improved by doping modification, adding sintering additives, optimizing sintering process, and so on, which significantly improves the mechanical properties. The research progress of high-performance TiB2 ceramic in terms of composition design and sintering processing was reviewed in this paper. The applications of TiB2 ceramic were also prospected on precision tools, bulletproof armor, and cathode tools.

Stress， as an adaptive response of the organism to internal and external environmental stimuli， may have detrimental effects on health when excessively or continuously activated， particularly on contributing the occurrence and progression of cardiovascular diseases. Therefore， this paper comprehensively reviews the relationship between stress and cardiovascular diseases from four aspects： epidemiology， pathophysiological mechanisms， stress-related cardiovascular diseases and advances in the treatment， aiming to provide references for prevention， early diagnosis and effective intervention of cardiovascular diseases in clinical practice. ［Funded by Beijing Natural Science Foundation （number， 2108000050）］

Cigarette draw resistance and filter pressure drop are both critical physical indicators for the tobacco industry, which use testing equipment to measure the two parameters. Pressure drop standards are used as transfer standards to ensure the accuracy and reliability of the testing equipment. Pressure drop standards are generally cylindrical rods having a certain number of parallel capillaries. To address the issue of how to design and fabricate pressure drop standards quickly and conveniently, this paper proposes a design method for pressure drop standards based on structural parameters. The method uses a mathematical model of the internal airflow of the standard including the entrance effect into a circular capillary and uses an iterative calculation algorithm accordingly. By iterative calculation, the structural parameters of the pressure drop standard, namely, diameter and length of the capillaries, were obtained, along with the relationship between the draw resistance of the standard and the flow rate in each capillary. The accuracy of the mathematical model was validated by comparing and analyzing the experimental and theoretical draw resistance of standards with different structural parameters. The experimental results showed that the relative error between the measured draw resistance and the calculated draw resistance was below 8%, which proves the reliability and validity of the mathematical model, and provides theoretical support for the design and fabrication of pressure drop standards.

Abstract Aging is identified as a significant risk factor for severe coronavirus disease-2019 (COVID-19), often resulting in profound lung damage and mortality. Yet, the biological relationship between aging, aging-related comorbidities, and COVID-19 remains incompletely understood. This study aimed to elucidate the age-related COVID19 pathogenesis using an Hutchinson-Gilford progeria syndrome (HGPS) mouse model, a premature aging disease model, with humanized ACE2 receptors. Pathological features were compared between young, aged, and HGPS hACE2 mice following SARS-CoV-2 challenge. We demonstrated that young mice display robust interferon response and antiviral activity, whereas this response is attenuated in aged mice. Viral infection in aged mice results in severe respiratory tract hemorrhage, likely contributing a higher mortality rate. In contrast, HGPS hACE2 mice exhibit milder disease manifestations characterized by minor immune cell infiltration and dysregulation of multiple metabolic processes. Comprehensive transcriptome analysis revealed both shared and unique gene expression dynamics among different mouse groups. Collectively, our studies evaluated the impact of SARS-CoV-2 infection on progeroid syndromes using a HGPS hACE2 mouse model, which holds promise as a useful tool for investigating COVID-19 pathogenesis in individuals with premature aging.

[H2(C12H10N4)]2+·2(NO3)−, monoclinic, P21/c (no. 14), a = 3.6937(3) Å, b = 15.5641(10) Å, c = 12.3322(8) Å, β = 93.201(7)°, V = 707.86(9) Å3, Z = 2, R gt(F) = 0.0377, wR ref(F 2) = 0.1076, T = 298.15 K.

[CuC12H10N4]⋅[CuCl2], triclinic, P1̄ (no. 2), a = 4.2957(9) Å, b = 8.718(2) Å, c = 9.878(3) Å, α = 67.58(2)°, β = 78.97(2)°, γ = 80.043(19)°, V = 333.63(15) Å3, Z = 1, Rgt (F) = 0.0360, wRref (F 2) = 0.0998, T = 296 K.

The rational utilization of the complementarity between new energy sources can smooth out the fluctuation of their power output, and the consideration of complementarity in new energy planning can make the new energy planning layout more rational. Based on this, the paper considers the complementarity of new energy outputs and investigates the optimal planning method of new energy system taking into account the source-load matching. The positive correlation between new energy output and load is utilized to maintain the dynamic balance between new energy output and load. Firstly, based on the idea of source-load matching, an equalization index describing the degree of closeness between the new energy output and the load, and a consistency index describing the degree of positive correlation between the new energy output and the baseline load output are proposed. Then, a multi-region new energy optimization planning model considering the source-load matching is established, and a constraint on the equilibrium degree of the new energy output and the load matching is introduced to ensure the consistency of the change characteristics of the two. Finally, a case study is conducted to analyze the power grids of four regions in the northern part of China. The results show that the new energy optimization planning considering the source-load matching can consider the new energy consumption rate and penetration rate comprehensively, and provide a solution for the new energy planning layout considering the complementarity of new energy output.

Abstract Background The excessive application of chemical fertilizers in the cultivation of Astragalus mongholicus Bunge results in a reduction in the quality of the medicinal plant and compromises the sustainable productivity of the soil. PGPB inoculant is a hot topic in ecological agriculture research. In the cultivation of Astragalus mongholicus, the screened nitrogen-fixing bacteria can promote plant growth, however, whether it can promote the accumulation of main bioactive components remains unknown. In this study, mixed inoculants containing 5 strains of growth promoting bacteria (Rhizobium T16 , Sinorhizobium T21 , Bacillus J1 , Bacillus G4 and Arthrobacter J2) were used in the field experiment. The metabolic substances in the root tissues of Astragalus mongholicus were identified during the harvest period by non-targeted metabolomics method, and the differential metabolites between groups were identified by statistical analysis. Meanwhile, high-throughput sequencing was performed to analyze the changes of rhizosphere soil and endophytic microbial community structure after mixed microbial treatment. Results The results of non-targeted metabolism indicated a significant increase in the levels of 26 metabolites after treatment including 13 flavonoids, 3 saponins and 10 other components. The contents of three plant hormones (abscisic acid, salicylic acid and spermidine) also increased after treatment, which presumed to play an important role in regulating plant growth and metabolism. Studies on endosphere and rhizosphere bacterial communities showed that Rhzobiaceae, Micromonosporaceae, and Hypomicrobiaceae in endophytic, and Oxalobactereae in rhizosphere were significantly increased after treatment. These findings suggest their potential importance in plant growth promotion and secondary metabolism regulation. Conclusions This finding provides a basis for developing nitrogen-fixing bacteria fertilizer and improving the ecological planting efficiency of Astragalus mongholicus.

Abstract Background Hepatic controlled attenuation parameter (CAP) is a novel marker for quantifying hepatic fat accumulation. Insulin resistance (IR) plays a major role in the pathogenesis and natural history of hepatic steatosis. This study aimed to investigate the possible relationship between CAP value and IR. Methods This study included a total of 420 patients with overweight or obesity who came to the obesity clinic at Tianjin Union Medical Center. Vibration-controlled transient elastography examination was conducted to detect CAP and liver stiffness measurement (LSM) values. Body composition, including visceral fat area (VFA), and body fat mass (BFM), was evaluated by the direct segmental multi-frequency bioelectrical impedance analysis (BIA). The associations between CAP value, body mass index (BMI), VFA, BFM and homeostasis model assessment of insulin resistance (HOMA-IR) were analyzed. Results CAP value was positively associated with HOMA-IR (r = 0.568, P 0.05). Conclusions Hepatic CAP value is more remarkably than other obesity markers associated with HOMA-IR in individuals with overweight or obesity, regardless of age, BMI, LSM, hypertension, and sex.

Abstract Background The available evidence presented inconsistencies and inconclusive findings regarding the associations between co-existing asthma and mortality among COVID-19 patients. The objective of the current study is to investigate the relationship between asthma and severe outcomes after SARS-CoV-2 Omicron infection in an infection-naïve population. Methods A retrospective cohort study using propensity score matching was conducted. The COVID-19 patients requiring hospitalisation in Hong Kong from January 1, 2022, to November 13, 2022, an Omicron-predominated period, were identified. Severe clinical outcomes were defined as ICU admission and inpatient death after the first positive PCR results as well as a composite outcome of both. Results Of the 74,396 hospitalised COVID-19 patients admitted, 1,290 asthma patients and 18,641 non-asthma patients were included in the matched cohort. The rates of death and the composite outcome were 15·3% and 17·2%, respectively, among the non-asthma patients,12·2% and 13·6%, respectively, among the asthma patients, with adjusted hazard ratios equal to 0·775 (95% CI: 0·660–0·909) and 0·770 (95% CI: 0·662–0·895), respectively. The negative association was more apparent in the elderly and female groups. Asthma remained a factor that lowered the risk of disease severity even though the patients were not fully vaccinated with at least two doses. Conclusions We used real-world data to demonstrate that asthma was not a risk factor for COVID-19 severity of the infections of Omicron variant, even though the patients were not fully vaccinated.

Platinum group metals (PGMs) are indispensable for the automobile, petrochemical, energy, and national defense industries. However, the mineral resources of PGMs are extremely scarce in China, and the contradiction is prominent between the supply and demand of the resources. Therefore, recycling PGMs becomes an important measure to ensure the safe supply of PGMs and support the high-quality development of related industries. This study analyzes the supply and application of PGMs, clarifies the supply and demand trend of the PGMs market, and sorts out the recycling technologies of PGMs. The hydrometallurgical process includes cyanidation as well as hydrogen chloride combined oxidant method. The pyrometallurgical process includes capture by lead,copper, matte, and iron. The research and application of the pyro-hydro-metallurgical recycling process for PGMs are elaborated from the aspects of the roasting-leaching, iron capture-acid leaching, and low-temperature iron capture-electrolysis-centrifugal extraction processes. The low-temperature iron capture-electrolysis-centrifugal extraction process follows the research idea of low-temperatureiron capture. Through the design of slags with a low melting point, the iron capture temperature is reduced from beyond 1800 ℃ to around 1400 ℃. The enriched Fe-PGM alloy is further enriched by electrolysis, and Pd, Pt, and Rh are successively obtained through centrifugal extraction and purification, realizing the short-process separation and purification of PGMs. This process has the advantages of green, high efficiency, and low cost. Focusing on the high-quality development of the PGM recycling industry, we propose the following suggestions: (1) conducting basic research and technical breakthroughs centering the entire process of PGM enrichment, separation and purification, as well as pollution prevention and control; (2) accelerating the construction of a full-chain standards system for PGM recycling and a green and low-carbon industrial ecological environment; and (3) improving the Internet Plus capabilities through the entire business links to realize the intellectualization of the whole recycling-processing-reuse process.

Abstract Background Mild cognitive impairment has received widespread attention as a high-risk population for Alzheimer’s disease, and many studies have developed or validated predictive models to assess it. However, the performance of the model development remains unknown. Objective The objective of this review was to provide an overview of prediction models for the risk of Alzheimer’s disease dementia in older adults with mild cognitive impairment. Method PubMed, EMBASE, Web of Science, and MEDLINE were systematically searched up to October 19, 2023. We included cohort studies in which risk prediction models for Alzheimer’s disease dementia in older adults with mild cognitive impairment were developed or validated. The Predictive Model Risk of Bias Assessment Tool (PROBAST) was employed to assess model bias and applicability. Random-effects models combined model AUCs and calculated (approximate) 95% prediction intervals for estimations. Heterogeneity across studies was evaluated using the I 2 statistic, and subgroup analyses were conducted to investigate sources of heterogeneity. Additionally, funnel plot analysis was utilized to identify publication bias. Results The analysis included 16 studies involving 9290 participants. Frequency analysis of predictors showed that 14 appeared at least twice and more, with age, functional activities questionnaire, and Mini-mental State Examination scores of cognitive functioning being the most common predictors. From the studies, only two models were externally validated. Eleven studies ultimately used machine learning, and four used traditional modelling methods. However, we found that in many of the studies, there were problems with insufficient sample sizes, missing important methodological information, lack of model presentation, and all of the models were rated as having a high or unclear risk of bias. The average AUC of the 15 best-developed predictive models was 0.87 (95% CI: 0.83, 0.90). Discussion Most published predictive modelling studies are deficient in rigour, resulting in a high risk of bias. Upcoming research should concentrate on enhancing methodological rigour and conducting external validation of models predicting Alzheimer’s disease dementia. We also emphasize the importance of following the scientific method and transparent reporting to improve the accuracy, generalizability and reproducibility of study results. Registration This systematic review was registered in PROSPERO (Registration ID: CRD42023468780).

Despite most COVID-19 infections being asymptomatic, mainland China had a high increase in symptomatic cases at the end of 2022. In this study, we examine China's sudden COVID-19 symptomatic surge using a conceptual SIR-based model. Our model considers the epidemiological characteristics of SARS-CoV-2, particularly variolation, from non-pharmaceutical intervention (facial masking and social distance), demography, and disease mortality in mainland China. The increase in symptomatic proportions in China may be attributable to (1) higher sensitivity and vulnerability during winter and (2) enhanced viral inhalation due to spikes in SARS-CoV-2 infections (high transmissibility). These two reasons could explain China's high symptomatic proportion of COVID-19 in December 2022. Our study, therefore, can serve as a decision-support tool to enhance SARS-CoV-2 prevention and control efforts. Thus, we highlight that facemask-induced variolation could potentially reduces transmissibility rather than severity in infected individuals. However, further investigation is required to understand the variolation effect on disease severity.

Human fibroblast cells (BJ cells) were used in vitro to study the skin-care effects of fish swim bladder oligopeptides (FSBOP). Wound healing results showed that cell migration was significantly enhanced in cells treated with 0.5 % FSBOP (P

With the increasing integration of renewable energy sources and the presence of numerous controllable loads such as electric vehicles and energy storage in the modern power system, higher nonlinearities and uncertainty both sources and loads are introduced. These factors pose challenges in achieving fast and accurate emergency frequency control. Therefore, this paper addresses the issue of dual source-load uncertainties in power system and presents an optimization strategy based on the Soft Actor Critic (SAC) algorithm that involves the participation of controllable loads in emergency frequency control. Firstly, the spatio-temporal uncertainties of wind farm power output on power supply side and power demand on the load side are described using Weibull and normal probability distributions, respectively. Secondly, an improved Markov Decision Process (MDP) model for emergency frequency control is established, which considers the characteristics of the dual source-load uncertainties. Finally, an optimization of the SAC algorithm is conducted based on Deep Reinforcement Learning (DRL), aiming to achieve rapid system frequency recovery and minimize the cost of removing controllable loads. The presented approach in the paper enhances the emergency frequency control strategy for uncertain power systems and effectively addresses the issue of source-load uncertainty compounded by fault power shortages.

Chlamydia pneumoniae (C. pneumoniae) is a specialized intracellular parasitic pathogen capable of causing pneumonia, sinusitis, bronchitis, and other respiratory diseases, which pose significant public health challenges. Therefore, rapid, accurate, and sensitive diagnosis is crucial for the prevention and treatment of respiratory diseases caused by C. pneumoniae. In this study, we combined enzymatic recombination amplification (ERA) with the clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein (Cas) 12a system (CRISPR/Cas12a) to develop a dual detection platform termed the Cpn-ERA-CRISPR/Cas12a dual system. This system integrates both the ERA-CRISPR/Cas12a fluorescence system and the ERA-CRISPR/Cas12a lateral flow system. Detection results can be measured using a fluorescence detector or observed with the naked eye on lateral flow strips. The fluorescence system and the lateral flow system detect C. pneumoniae in 30 minutes and 15 minutes, respectively. This dual system exhibits no cross-reactivity with the other seven pathogens, demonstrating high specificity, and achieves a sensitivity of 100 copies/µL. Additionally, the Cpn-ERA-CRISPR/Cas12a dual system was employed to analyze 39 clinical samples, comprising 19 positive and 20 negative samples. The detection rate for positive samples was 100%, with no positive results in the negative samples, indicating a high level of concordance with qPCR results. In summary, the Cpn-ERA-CRISPR/Cas12a dual system represents a novel tool for diagnosing C. pneumoniae and holds promising application potential in grassroots community hospitals.

ObjectivePneumonia is a common clinical condition primarily treated with antibiotics and organ support. Exploring the pathogenesis to identify therapeutic targets may aid in the adjunct treatment of pneumonia and improve survival rates.MethodsTranscriptomic data from peripheral blood of 183 pneumonia patients were analyzed using Gene Set Variation Analysis (GSVA) and univariate Cox regression analysis to identify signaling pathways associated with pneumonia mortality. A pneumonia mouse model was established via airway injection of Klebsiella pneumoniae, and pathway-specific blockers were administered via tail vein infusion to assess whether the identified signaling pathways impact the mortality in pneumonia.ResultsThe combination of GSVA and Cox analysis revealed 17 signaling pathways significantly associated with 28-day mortality in pneumonia patients (P < 0.05). Notably, the RIG-I-like receptor signaling pathway exhibited the highest hazard ratio of 2.501 with a 95% confidence interval of [1.223–5.114]. Infusion of RIG012 via the tail vein effectively inhibited the RIG-I-like receptor signaling pathway, significantly ameliorated lung injury in pneumonia mice, reduced pulmonary inflammatory responses, and showed a trend toward improved survival rates.ConclusionRIG012 may represent a novel adjunctive therapeutic agent for pneumonia.

BackgroundAs individuals age, they commonly experience reduced physical activity and cognitive decline. While evidence, there is limited trajectory research on their concurrent progression and interrelation in individuals over 55 years old.MethodsThe data was collected from 5,765 individuals aged over 55 years who participated in the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2020. Physical activity was measured by IPAQ, cognitive function by episodic memory, and mental intactness score. Separate sets of group-based trajectory models were fitted to identify physical activity trajectories and cognitive function trajectories. Multivariate logistic regression was used to estimate the association between baseline characteristics and each set of trajectories. Group-based dual trajectory modeling (GBDTM) was applied to quantify these associations.ResultsGBDTM identified three distinct trajectory groups for physical activity and cognitive outcomes. The physical activity trajectories were classified as “Persistently low physical activity” (74.2%), “Decreasing physical activity” (13.7%), and “Rising physical activity” (12.1%). Similarly, cognitive function trajectories were categorized as “Persistently low cognitive function” (22.2%), “Persistently moderate cognitive function” (37.9%), and “Persistently high cognitive function” (39.9%). Notably, 15.6% of participants followed the trajectories of “Persistently low physical activity” and “Persistently low cognitive function.” The presence of a severe decline in physical activity was associated with an increased likelihood of poor cognitive function and vice versa. Age, sex, education, residential status, BMI, and visual impairment were identified as significant predictors for physical activity and cognitive decline.ConclusionThis study found that the GBDTM can determine the consistent trajectories of physical activity and cognitive function trajectories that persistently decline in individuals over 55 years. Analyses of predictive factors can be instrumental in promoting physical activity and delaying cognitive decline.

BackgroundOlder adults with cognitive impairment can experience poor oral health due to reduced self-care ability, yet the impact of various oral health indicators on the cognitive ability remains unclear. We investigated the relationship between oral health indicators and mild cognitive impairment (MCI) in older adults.MethodsA cross-sectional study of 234 older adults aged 65 years or over was performed form January to March 2023 at health screening departments of hospitals. This study used the Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Activities of Daily Living (ADL), Clinical Dementia Rating (CDR), and Hachinski Ischemic Score (HIS) to measure MCI. Two qualified dentists performed clinical oral examinations (number of teeth lost, dental caries, removable dentures, periodontitis). The other oral health status was measured by subjective assessment questionnaires, and the oral health-related quality of life (OHRQoL) was assessed by Geriatric Oral Health Assessment Index (GOHAI).ResultsOf the 234 older adults, 166 had MCI and 68 had normal cognitive ability. The univariate analyses revealed that older adults with poor oral health indicators of dental caries, mastication ability, oral and maxillofacial pain, self-perceived oral health status and OHRQoL had lower cognitive levels. The stepwise logistic regression analysis observed that higher education level (OR = 0.06, 95%CI = 0.007, 0.567) and OHRQoL score (OR = 0.92, 95%CI = 0.878, 0.963) were negatively associated with the presence of MCI. The area under the ROC curve (AUC) of MCI was 0.675 (95% CI: 0.600, 0.749) with a low sensitivity of 41.6% and a moderate specificity of 86.8%.ConclusionOHRQoL was found to be associated with MCI, implying that OHRQoL may be important in cognitive decline. The GOHAI scale can be used to more easily assess the oral health of older adults, which is important for the timely detection of poor oral status to delay cognitive decline.

Abstract Background Uncontrolled inflammation caused by macrophages and monocytes plays a crucial role in worsening acute respiratory distress syndrome (ARDS). Previous studies have highlighted the importance of IFIH1 in regulating macrophage polarisation in ARDS triggered by pneumonia. However, the mechanisms by which IFIH1 is activated in ARDS remain unclear. Methods In this study, we utilised multiomics sequencing and molecular interaction experiments to explore the molecular mechanisms underlying IFIH1 activation in ARDS. Through the use of conditional gene knockout mice and primary cells, we demonstrated the significant role of these mechanisms in the development of ARDS. Additionally, we validated the associations between these mechanisms and ARDS by quantitative PCR analysis of CD14+ cells obtained from the peripheral blood of 140 ARDS patients. Results Our investigation revealed that lipopolysaccharide, a critical component derived from Gram‐negative bacteria, activated IFIH1 by upregulating a novel transcript known as IFIH1‐binding RNA1 (IBR1) in monocytes and macrophages. Specifically, as an endogenous double‐stranded RNA, IBR1 bind to the helicase domain of IFIH1 because of its unique double‐stranded structure. Deletion of IBR1 significantly reduced the activation of IFIH1, M1 polarisation of macrophages, and inflammatory lung injury in ARDS. Moreover, IBR1 directly induced M1 polarisation of macrophages and ARDS, whereas deletion of IFIH1 inhibited IBR1‐induced macrophage M1 polarisation and inflammatory lung injury. Importantly, we observed a notable increase in IBR1 expression in ARDS patients with pneumonia caused by Gram‐negative bacteria. Furthermore, we demonstrated that the delivery of IFIH1 mutants through exosomes effectively counteracted IBR1, thereby reducing pulmonary inflammation and alleviating lung injury. Conclusions This study revealed a novel mechanism involving IBR1, an endogenous double‐stranded RNA (dsRNA) that binds to IFIH1, shedding light on the complex process of macrophage polarisation in ARDS. The administration of IFIH1 variants has the potential to eliminate pulmonary dsRNA and alleviate inflammatory lung injury in ARDS. Highlights In monocytes and macrophages, the endogenous double‐stranded RNA, IFIH1‐binding RNA 1 (IBR1), binds to the helicase domain of IFIH1 because of its unique double‐stranded structure. IBR1 plays a significant role in macrophage polarisation and the development of acute respiratory distress syndrome (ARDS) induced by Gram‐negative bacteria or lipopolysaccharide (LPS). Administration of IFIH1 variants has potential for eliminating pulmonary IBR1 and reducing inflammatory lung injury in ARDS patients.

Abstract The demand for miniaturized and integrated multifunctional devices drives the progression of high‐performance infrared photodetectors for diverse applications, including remote sensing, air defense, and communications, among others. Nonetheless, infrared photodetectors that rely solely on single low‐dimensional materials often face challenges due to the limited absorption cross‐section and suboptimal carrier mobility, which can impair sensitivity and prolong response times. Here, through experimental validation is demonstrated, precise control over energy band alignment in a type‐II van der Waals heterojunction, comprising vertically stacked 2D Ta2NiSe5 and the topological insulator Bi2Se3, where the configuration enables polarization‐sensitive, wide‐spectral‐range photodetection. Experimental evaluations at room temperature reveal that the device exhibits a self‐powered responsivity of 0.48 A·W−1, a specific directivity of 3.8 × 1011 cm·Hz1/2·W−1, a response time of 151 µs, and a polarization ratio of 2.83. The stable and rapid photoresponse of the device underpins the utility in infrared‐coded communication and dual‐channel imaging, showing the substantial potential of the detector. These findings articulate a systematic approach to developing miniaturized, multifunctional room‐temperature infrared detectors with superior performance metrics and enhanced capabilities for multi‐information acquisition.

IntroductionOsteoporosis-induced changes in bone structure and composition significantly reduce bone strength, particularly in the human proximal femur. This study examines how these changes affect the mechanical performance of trabecular bone to enhance diagnosis, prevention, and treatment strategies.MethodsA proximal femur sample was scanned using micro-CT at 40 μm resolution. Five regions of interest were selected within the femoral head, femoral neck, and greater trochanter. Structural models simulating various stages of osteoporosis were created using image processing software. Micro-finite element analysis evaluated the mechanical properties of trabecular bone under different conditions of structural deterioration and tissue-level elastic modulus variations. The combined effects of structural deterioration and tissue-level mechanical properties on trabecular bone mechanical performance were further analyzed.ResultsThe mechanical performance of trabecular bone generally follows a power-law relationship with its microstructural characteristics. However, in any specific region, the apparent mechanical properties linearly decrease with structural deterioration. The femoral neck and greater trochanter are more sensitive to structural deterioration than the femoral head. A 5% bone mass loss in the femoral head led to a 7% reduction in mechanical performance, while the femoral neck experienced a 12% loss. Increasing tissue-level elastic modulus improved mechanical performance, partially offsetting bone mass reduction effects.ConclusionTrabecular bone in low bone mass regions is more affected by bone mass loss. Structural deterioration primarily reduces bone strength, but improvements in tissue-level properties can mitigate this effect, especially in early osteoporosis. Targeted assessments and interventions are crucial for effective management. Future research should explore heterogeneous deterioration models to better understand osteoporosis progression.

Background: Limited evidence exists regarding the association between ozone exposure and adverse sperm quality. We aimed to assess the association between ozone exposure and sperm quality, and identify susceptible exposure windows. Methods: We recruited 32,541 men aged between 22 and 65 years old attending an infertility clinic in Wuhan, Hubei Province, China from 2014 to 2020. Ozone data were obtained from a satellite-based spatiotemporal model. Generalized linear models were used to estimate the association between ozone exposure and sperm quality parameters, including sperm concentration, sperm count, sperm total motility, and sperm progressive motility during the entire stage of sperm development (0–90 days before ejaculation) and three crucial stages (0–9 days, 10–14 days and 70–90 days before ejaculation). Stratified analyses were performed to evaluate whether associations varied by age, body mass index, and education levels. Results: The final analysis included 27,854 adult men. A 10 μg/m3 increase in ozone concentrations during the entire stage of sperm development was associated with a −4.17 % (95 % CI: −4.78 %, −3.57 %) decrease in sperm concentration, −6.54 % (95 % CI: −8.03 %, −5.60 %) decrease in sperm count, −0.50 % (95 % CI: −0.66 %, −0.34 %) decrease in sperm total motility, and −0.07 % (95 % CI: −0.22 %, 0.09 %) decrease in sperm progressive motility. The associations were stronger during 70–90 days before ejaculation and among men with middle school and lower education for sperm concentration. Conclusions: Ozone exposure was associated with decreased sperm quality among Chinese adult men attending an infertility clinic. These results suggest that ozone may be a risk factor contributing to decreased sperm quality in Chinese men.

Patients with infections in the department of critical care medicine have complex sources and diverse sites of infection, which may be associated with multiple pathogenic bacteria and have a high rate of drug resistance, posing a significant challenge to clinical diagnosis and treatment. Infections in the department of critical care medicine can be divided into two types: hospital acquired infections and non-hospital acquired infections, with significant differences in clinical characteristics between the two. This article discusses the relevant concepts, risk factors, pathogenesis, and common characteristics of severe infections such as bloodstream infections, pulmonary infections, intra-abdominal infections, and intracranial infections, as well as diagnostic and treatment plans and prevention and control strategies from the perspectives of hospital acquired and non-hospital acquired infections, aiming to provide valuable guidance for the clinical management of critically ill patients.

Objective To explore the effect of physical exercise on semen quality in order to provide basic data and theoretical basis for the improvement of male reproductive health. Methods A cross-sectional study was conducted on 1 059 males who visited the Reproductive Medicine Center of Shandong Maternal and Child Health Hospital for medical treatment and physical examination during July 2022 and April 2023. Their demographic data and physical exercise data were surveyed with questionnaires. Total sperm count, sperm concentration, total sperm motility, forward movement and normal sperm morphology were analyzed with computer aided analysis. Logistic regression model and multiple linear regression model were applied to analyze the effects of physical exercise on semen quality. Results After adjustment for confounding factors such as age, body mass index, alcohol consumption and smoking, logistic regression analysis showed that the risk of abnormal semen quality was increased in patients with moderate and heavy exercise intensity (OR=2.103, OR=2.229). Compared with the participants with physical exercise ≤10 min per session, those with >20 min per session had a lower risk of abnormal semen quality (OR=0.357, 0.256, 0.289 for exercise time for >20~30, >30~60, >60 min, respectively). There was no statistical significance between physical exercise frequency and semen quality (P>0.05). The participants having exercise well were at a lower risk for abnormal semen quality (OR=0.711). Multiple linear regression analysis revealed that the frequency of physical exercise was an influencing factor of sperm concentration (β=7.474, 95%CI: 4.800~10.149, P

Abstract Background As SARS-CoV-2 Omicron variants circulating globally since 2022, assessing the transmission characteristics, and the protection of vaccines against emerging Omicron variants among children and adolescents are needed for guiding the control and vaccination policies. Methods We conducted a retrospective cohort study for SARS-CoV-2 infections and close contacts aged

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

Hydrogen isotopes, such as protium(H), deuterium(D), and tritium(T), are widely used in medical treatment, nuclear energy, national defense, and other fields. Under the background of the "double carbon" target with carbon peak and carbon neutralization, deuterium-tritium fusion energy is considered to be an important energy strategy in China. However, the relative abundance of deuterium and tritium in nature is extremely low, and it is of great significance to separate hydrogen isotopes economically and effectively. This paper presents the research on water hydrogen isotope separation technology. Firstly, the methods and the principles of hydrogen isotope separation in water are summarized. Then, two perspectives of separation methods were reviewed. From the perspective of engineering application, the electrolysis, distillation and chemical exchange method are focused. From the perspective of laboratory research and development, the membrane separation method and porous material adsorption method are focused. Finally, the separation factors and energy consumption of typical separation technologies are compared. Moreover, to provide a certain reference for the water hydrogen isotope separation technology, several future research directions are prospected.

【Background and Objective】 Organic mulch involves covering the soil surface with organic materials. While it has been recognized as an environmentally friendly method for reusing organic waste, improper mulching with organic wastes might degrade soil structure, hinder vegetation growth, and lead to environmental pollution. This paper is to investigate the alterations in soil hydraulic properties resulting from various garden waste mulches. 【Method】 The study is based on incubation. Garden wastes including grass clippings, tree leaves, tree branches, and branch-leaf mixtures are used to mulch the soil surface at a thickness ranging from 3 to 9 cm. The incubation lasts 21 months, after which we measure soil moisture content, bulk soil density, soil porosity, soil aeration, water holding capacity, and soil hydraulic conductivity. Their variations with the garden waste types and the mulching depth are analyzed. 【Result】 ① Mulching with all garden waste types increases soil hydraulic properties, albeit the improvement depends on the waste types and mulching thickness. ② Compared to without mulch, mulching reduces soil bulk density significantly by 5.6%-13.6%, increases the maximum soil water holding capacity by 31.9%-108.2%, capillary water holding capacity by 36.7%-114.2%, field water holding capacity by 64.1%-149.8%, and drainage capacity by 38.2%-67.1%. ③ Comprehensive evaluation reveals that those that were effective for improving hydraulic properties of soil are: 9 cm tree leaves, 9 cm grass clippings, 9 cm branch leaves, 6 cm grass clippings, mixture of 6 cm branch leaves and 9 cm tree branches. 【Conclusion】 Mulching soil with garden wastes can increase soil porosity and drainage capacity, thereby improving water-holding capacity of the soil. However, care needs to be taken in selecting waste types and mulching thicknesses in practical application in order to optimize mulching benefits.

Skatole, a strong fecal odor substance, is generated through microbial degradation of tryptophan in the animal hindgut. It easily accumulates in adipose tissue and affects meat quality. In this study, the effect of mulberry leaf supplementation on skatole in finishing pigs was studied. In a 35-day trial, 20 finishing pigs (barrows and gilts) were fed with a basal diet or basal diet with 6% mulberry leaves. Growth performance of the pigs (n = 10) was automatically recorded by a performance-testing feeder system and 8 pigs in each treatment were slaughtered and sampled for the remaining tests. Skatole and short-chain fatty acids were detected using HPLC and gas chromatography, respectively. Fecal microbiota were analyzed using 16S rRNA gene sequencing. The metabolomics analysis of feces and serum was performed with UHPLC-MS/MS. The major cytochrome P450 (CYP) enzymes that catalyze skatole degradation in the liver were tested by using RT-PCR and Western blot. Effects of major bioactive compounds in mulberry leaves on the CYP genes were verified in the hepatic cell line HepG2 in an in vitro test (n = 3). In finishing pigs, mulberry leaf supplementation had no significant effect on the average daily gain, average daily feed intake, and feed conversion ratio (P > 0.05), but reduced skatole levels in feces, serum, and backfat (P

Asymmetric gears are a new type of involute gears with different pressure angles on each side of a gear tooth. Gear tooth profile parameters have a great influence on the performance of a gear pair, such as its tooth profile shape, motion characteristics, bearing capacity, transmission efficiency, dynamic characteristics and so on. Asymmetric tooth geometry formulas based upon a rack-type tool are derived following Litvin's vector approach. Then a precise calculation model for meshing stiffness of asymmetric gear is proposed and validated to be effective by comparing with a finite element model separately. Further, the influence of cutting tool tip fillet radius, gear pressure angle and contact ratio on gear meshing stiffness is quantified parametrically. The research results indicate that gear meshing stiffness can be improved effectively with the increase of pressure angle and cutting tool fillet radius. The influence of the pressure angle is relatively greater. With the increase of the pressure angle, not only will the thickness of tooth root increase, which is beneficial to improve the bearing capacity of the gear, but also the thickness of tooth tip and contact ratio will decrease, which is prone to evoke tooth tip fractures. In asymmetric tooth profile design, it is suggesting that the involute pressure angles are set according to actual working conditions.

Abstract Influenza virus continuously evolves to escape human adaptive immunity and generates seasonal epidemics. Therefore, influenza vaccine strains need to be updated annually for the upcoming flu season to ensure vaccine effectiveness. We develop a computational approach, beth-1, to forecast virus evolution and select representative virus for influenza vaccine. The method involves modelling site-wise mutation fitness. Informed by virus genome and population sero-positivity, we calibrate transition time of mutations and project the fitness landscape to future time, based on which beth-1 selects the optimal vaccine strain. In season-to-season prediction in historical data for the influenza A pH1N1 and H3N2 viruses, beth-1 demonstrates superior genetic matching compared to existing approaches. In prospective validations, the model shows superior or non-inferior genetic matching and neutralization against circulating virus in mice immunization experiments compared to the current vaccine. The method offers a promising and ready-to-use tool to facilitate vaccine strain selection for the influenza virus through capturing heterogeneous evolutionary dynamics over genome space-time and linking molecular variants to population immune response.

Background and aimsTo analyze the effect of oral metformin on changes in gut microbiota characteristics and metabolite composition in normal weight type 2 diabetic patients.MethodsT2DM patients in the cross-sectional study were given metformin for 12 weeks. Patients with unmedicated T2DM were used as a control group to observe the metrics of T2DM patients treated with metformin regimen. 16S rDNA high-throughput gene sequencing of fecal gut microbiota of the study subjects was performed by llumina NovaSeq6000 platform. Targeted macro-metabolomics was performed on 14 cases of each of the gut microbiota metabolites of the study subjects using UPLC-MS/MS technology. Correlations between the characteristics of the gut microbiota and its metabolites, basic human parameters, glycolipid metabolism indicators, and inflammatory factors were analyzed using spearman analysis.ResultsGlycolipid metabolism indexes and inflammatory factors were higher in normal-weight T2DM patients than in the healthy population (P0.05), and the differences in β-diversity were statistically significant (P

Objectives To estimate the association between the transition to daylight saving time and the risks of all cause and cause specific mortality in the US.Design Nationwide time series observational study based on weekly data.Setting US state level mortality data from the National Center for Health Statistics, with death counts from 50 US states and the District of Columbia, from the start of 2015 to the end of 2019.Population 13 912 837 reported deaths in the US.Main outcome measures Weekly counts of mortality for any cause, and for Alzheimer's disease, dementia, circulatory diseases, malignant neoplasms, and respiratory diseases.Results During the study period, 13 912 837 deaths were reported. The analysis found no evidence of an association between the transition to spring daylight saving time (when clocks are set forward by one hour on the second Sunday of March) and the risk of all cause mortality during the first eight weeks after the transition (rate ratio 1.003, 95% confidence interval 0.987 to 1.020). Autumn daylight saving time is defined in this study as the time when the clocks are set back by one hour (ie, return to standard time) on the first Sunday of November. Evidence indicating a substantial decrease in the risk of all cause mortality during the first eight weeks after the transition to autumn daylight saving time (0.974, 0.958 to 0.990). Overall, when considering the transition to both spring and autumn daylight saving time, no evidence of any effect of daylight saving time on all cause mortality was found (0.988, 0.972 to 1.005). These patterns of changes in mortality rates associated with transition to daylight saving time were consistent for Alzheimer's disease, dementia, circulatory diseases, malignant neoplasms, and respiratory diseases. The protective effect of the transition to autumn daylight saving time on the risk of mortality was more pronounced in elderly people aged ≥75 years, in the non-Hispanic white population, and in those residing in the eastern time zone.Conclusions In this study, transition to daylight saving time was found to affect mortality patterns in the US, but an association with additional deaths overall was not found. These findings might inform the ongoing debate on the policy of shifting daylight saving time.

Objective: Powerful adjuvant strategies are required to improve the survival of patients with completely resected stage ΙΙΙA non-small cell lung cancer (NSCLC). We aimed to compare the efficacy of traditional Chinese medicine (TCM) treatment versus observation after adjuvant chemotherapy in these patients. Methods: Eligible patients were randomized 1:1 to receive either oral decoctions based on Qi-Yin syndrome differentiation (TCM group) or observation (observation group). The intervention lasted for 12 months. The primary endpoint was 1-year disease-free survival (DFS). Secondary endpoints were DFS, quality of life, regulatory T cells (Tregs), and cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) on the surface of Tregs in peripheral blood. We used EORTC QLQ-LC43 to evaluate quality of life. Results: Between Apr 29, 2019, and Nov 11, 2021, 75 patients were randomly assigned to oral decoctions based on Qi-Yin syndrome differentiation (n = 38) or observation (n = 37). The full analysis set included 35 patients in the TCM group and 35 in the observation group. After a median follow-up of 24.2 months, oral decoctions based on Qi-Yin syndrome differentiation improved DFS compared with observation (HR 0.378, 95% CI: 0.157-0.912; P = .03). One-year DFS was 82.1% in the TCM group and 61.9% in the observation group ( P = .06). Three months after randomization, scores of total health, role function, emotional function, and social function in the TCM group were higher than those in the observation group ( P

This study presented a narrative review of the six latest sets of guidelines on physical activity for children and adolescents from Australia, Canada, China, the United Kingdom, the United States and WHO, and analysed the history of the development of the guidelines; the policy context in which the guidelines were developed; and the main subjects of the guidelines. The core elements of the latest guidelines were identified and compared, including frequency, intensity, duration (time), and type of physical activity, assessment intensity of physical activity, and risk prevention for physical activity participation. There is an urgent need for obtaining the latest scientific evidence to support and update the contents of the Chinese guidelines. We therefore make the following recommendations for future revisions of the Chinese guidelines based on the findings of this study: (1) to update the recommended frequency, intensity, duration, and type of physical activities that meet the needs for Chinese children and adolescents; (2) to update the methods for assessing physical activity intensity, and identifying and managing the risk factors in participating in physical activity; and (3) to incorporate analyses and reviews of school physical education curriculum for effectively achieving the adequate levels of physical activity.

BackgroundThe tumor growth rate and tumor volume doubling time are crucial parameters in diagnosing and managing lung lesions. Pulmonary sarcomatoid carcinoma (PSC) is a unique and highly malignant subtype of lung cancer, with limited documentation on its growth feature. This article aims to address the gap in knowledge regarding a PSC’s growth patterns by describing the characteristics of a confirmed case using computed tomography, thereby enhancing the understanding of this rare disease.Case presentationA 79-year-old man was transferred to our center presenting with a mild cough, blood-tinged sputum, and a malignant nodule in the left upper lobe. Chest CT revealed a solid nodule in the left upper lobe. A follow-up CT ten days later showed a significant increase in the size of the nodule, accompanied by ground-glass opacity in the surrounding lung. The rapid preoperative growth of the nodule suggested a non-neoplastic lesion, and intraoperative frozen pathology also considered the possibility of tuberculosis. Subsequently, a left upper apical-posterior segment (S1 + 2) resection was performed. Postoperative tumor pathology confirmed the diagnosis of pulmonary sarcomatoid carcinoma with extensive giant cell carcinoma and necrosis. Immunohistochemistry indicated approximately 60% PD-L1 positive and genetic testing revealed a MET mutation. The patient was discharged with oral crizotinib targeted therapy, and his condition remained stable postoperatively. The patient is currently undergoing regular follow-up at our hospital, with no evidence of distant metastasis or recurrence.ConclusionPulmonary sarcomatoid carcinoma can exhibit rapid tumor growth on imaging, and PSC should be considered in the differential diagnosis for lesions that present with a fast growth rate. Timely and appropriate treatment for PSC may lead to a good prognosis.

The energy industry, acutely sensitive to geopolitical shifts due to the Russia-Ukraine conflict, experiences sustained disturbances in global energy markets, reshaping global energy supply dynamics and significantly influencing global trade patterns. Utilizing static and dynamic GARCH-Copula models, this study elucidates the dependency between energy markets and related assets. The Copula function, when compared with the multivariate GARCH model, demonstrates distinct advantages, notably in delineating joint asset distributions, capturing market dependence's nonlinear traits, and highlighting robust tail correlation structures. Beyond the average inter-market dependence, its tail correlation offers a vital perspective on market risk. This research delves into the temporal and structural variations in interdependence between energy markets and related assets. It probes potential structural breakpoints in dynamic interdependence and pinpoints their occurrences. By focusing on the Russia-Ukraine conflict, this study offers a holistic view of the changing interplay between the energy market and other asset categories, providing pivotal insights for investor portfolio optimization, regulatory oversight, and risk mitigation. Moreover, employing wavelet analysis, this study examines the frequency domain traits of the interdependency between energy markets and associated assets. As frequency wanes, market price fluctuations become less pronounced. The continuous wavelet power spectrum indicates that price variations are predominantly mid to high frequency. Cross-wavelet transform results suggest that correlations between energy markets and related assets are more influenced by short-term perturbations than enduring shifts.