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Maodong Wu,1 Wenchao Yi,2 Qinglun Su,1 Yiming Huang,1 Qin Zhao,1,&ast; Shouguo Liu2,&ast; 1Department of Rehabilitation Medicine, The First Affiliated Hospital of Kangda College of Nanjing Medical University/The First People’s Hospital of Lianyungang, Lianyungang, 222000, People’s Republic of China; 2Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing, 210029, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Shouguo Liu, Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, 300 Guangzhou Road, Nanjing, Jiangsu Province, 210029, People’s Republic of China, Tel +86-13675155937, Email liushouguo2002@163.com Qin Zhao, Department of Rehabilitation Medicine, The First Affiliated Hospital of Kangda College of Nanjing Medical University/The First People’s Hospital of Lianyungang, No. 6 Zhenhua East Road, Lianyungang, 222000, People’s Republic of China, Tel +86-18961322279, Email zhaozihe@163.comPurpose: This study aims to examine the predictive value of Craniocervical Flexion Test (CCFT) scores in individuals with chronic non-specific neck pain (CNNP) and to identify factors that may affect CCFT scores.Methods: This case-control study included 73 patients with CNNP and 127 healthy controls. We assessed baseline information such as demographics, duration and frequency of CNNP onset, Neck Disability Index (NDI), and Visual Analog Scale (VAS) scores. All subjects were evaluated by the same rater for CCFT, maximal muscle strength, and endurance of the deep cervical flexors. Head and neck posture was measured using two-dimensional videography, capturing sagittal head angle (SHA), forward head angle (FHA), and protracted shoulder angle (PSA). The predictive capacity of CCFT for CNNP was evaluated using the ROC curve and area under the curve (AUC). Univariate and multivariate ordered logistic regression models were employed to analyze factors influencing CCFT scores.Results: The final analysis included 70 participants in the CNNP group and 123 in the control group. The CNNP group demonstrated lower CCFT scores, reduced maximal muscle strength, and decreased endurance of the deep cervical muscles (P< 0.05). Among maximum muscle strength, endurance, and CCFT scores, the latter exhibited the highest AUC. Univariate and multivariate ordered logistic regression analyses revealed that maximal muscle strength, muscle endurance, FHA, and lower NDI scores significantly increased the likelihood of higher CCFT scores (P< 0.05), while SHA significantly decreased this likelihood (P< 0.05).Conclusion: CCFT demonstrates good predictive value for CNNP, surpassing muscle strength and endurance. Maximal muscle strength, muscle endurance, FHA, and lower NDI scores were positive influencing factors for CCFT scores, whereas SHA was a negatively influencing factor.Plain Language Summary: As the population of patients with chronic non-specific neck pain (CNNP) increases, there is a growing clinical need for an assessment tool to predict the occurrence of CNNP. The Craniocervical Flexion Test (CCFT) is a widely used assessment tool for this condition and may be instrumental in identifying affected patients. However, the predictive value of CCFT for CNNP remains unclear, and no research has yet examined the factors that may influence CCFT scores in this context. To address this gap, we conducted a case-control study to investigate the predictive ability of CCFT for CNNP, and explore the factors that may affect CCFT scores. Our results indicated that CCFT has good predictive value for CNNP, with influencing factors including maximal muscle strength, muscle endurance, sagittal head angle, forward head angle, and the Neck Disability Index. Therefore, we suggest that CCFT has a good application value in the diagnosis and management of CNNP.Keywords: chronic non-specific neck pain, craniocervical flexion test, neck maximal muscle strength, neck muscle endurance, forward head angle

Jingxia Mao,1,2,&ast; Guibo Yang,1,3,&ast; Qin Su,1,4,&ast; Zhonghong Zeng,1 Jueying Lin,2 Lin Kong,3 Lidun Zhang,4 Lidan Liu,1 Yihua Yang,1 Hongbo Wu1 1Guangxi Reproductive Medical Center, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China; 2Department of Obstetrics, The Fifth Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China; 3Department of Obstetrics, The Maternity and Child Health Care of Guangxi Zhuang Autonomous Region, Nanning, People’s Republic of China; 4Department of Obstetrics, The First People’s Hospital of Yulin, Yulin, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hongbo Wu; Yihua Yang, Guangxi Reproductive Medical Center, The First Affiliated Hospital of Guangxi Medical University, Nanning, People’s Republic of China, Email 19587200@qq.com; workyyh@163.comObjective: To assess the safety and efficiency of in vitro fertilization/ intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) on maternal and neonatal perinatal outcomes in women (≥ 40y) with singleton pregnancies.Methods: This multi-center retrospective cohort study, carried out from January 2018 to June 2023, enrolled 1762 women (≥ 40y) with singleton pregnancies of at least 28 weeks. Participants were divided into two groups: the IVF/ICSI-ET group (204 cases) and the spontaneous conception (SC) group (1558 cases). After 1:2 propensity score matching (PSM), the two groups were compared for maternal and neonatal outcomes. The SC group (1558 cases) was further divided by age into the < 43 years group (1195 cases) and the ≥ 43 years group (363 cases) for subgroup analysis.Results: Adverse maternal and neonatal outcomes were comparable between the IVF/ICSI-ET group and the SC group, with a higher cesarean section rate (78% vs 67.5%, P =0.013), an increased maternal ICU admissions rate (5.5% vs 1.3%, P =0.008), and a lower birth defects rate (1.1% vs 4.6%, P =0.037) in the IVF/ICSI-ET group. Subgroup analysis showed that women aged ≥ 43 years had higher incidences of gestational diabetes, gestational hypertension, cesarean section, and neonatal asphyxia compared to women aged < 43 years.Conclusion: This study indicated IVF/ICSI-ET is relatively safe for women ≥ 40 years with singleton pregnancies. However, advanced maternal age deteriorated maternal and neonatal outcomes, and IVF/ICSI-ET further heightened the risk of cesarean section and maternal ICU admissions. Therefore, enhanced care and vigilance are crucial for women over 40 undergoing IVF/ICSI-ET.Keywords: in-vitro fertilization, intracytoplasmic sperm injection, advanced maternal age, maternal outcomes, neonatal outcomes

Mengjiao Song,1 Qiang Su,1 Lei Zhang2 1Department of The Second District of Intensive Care Medicine, Dongying People’s Hospital, Dongying, Shandong, People’s Republic of China; 2Department of Emergency Critical Care Medicine, Dongying People’s Hospital, Dongying, Shandong, People’s Republic of ChinaCorrespondence: Lei Zhang, Department of Emergency Critical Care Medicine, Dongying People’s Hospital, Nanyi Road NO. 317, Dongying, Shandong, 257091, People’s Republic of China, Tel +86-18554611031, Email Zhanglei8554zl@163.comObjective: To unveil the influence of norepinephrine (NE) combined with esmolol treatment on cardiac function, hemodynamics, inflammatory factor levels, and prognosis in patients with septic shock.Methods: Ninety-six patients with septic shock admitted to our hospital from January 2021 to June 2023 were retrospectively analyzed and divided into the control and observation groups according to the different treatment methods. The control group was treated with standard anti-infection and fluid resuscitation, followed by NE administration [with an infusion rate of 0.1– 0.5 μg/(kg-min)]. The observation group was treated with esmolol [starting pumping rate of 50 μg/(kg-min) and adjusting the pumping rate according to the target heart rate] in combination with the control group. Changes in hemodynamic parameters, including heart rate, mean arterial pressure, central venous pressure, cardiac index, stroke volume index, and systemic vascular resistance index, were monitored by pulse-indicating continuous cardiac output monitors before treatment (T0), 24h after treatment (T1), and 72h after treatment (T2); changes in cardiac function before and after 72h of treatment, indicators of inflammatory factors before and after treatment, and indicators of oxygenation metabolism were assessed; and adverse drug reactions during treatment were recorded in both groups.Results: NE combined with esmolol treatment improved the efficacy of patients with septic shock; was beneficial for the enhancement of blood perfusion in patients; improved the patient’s cardiac function, reduced myocardial injury, and suppressed the inflammatory response in patients; improved the oxygenation metabolism and the prognosis of patients; did not significantly increase the adverse drug reactions of patients and had a better safety profile.Conclusion: NE combined with esmolol treatment can improve the efficacy of patients with septic shock, improve their cardiac function and hemodynamic indices, reduce myocardial injury and inflammatory response, and have a better safety profile, which is conducive to improving patient prognosis and reducing mortality.Keywords: norepinephrine, esmolol, septic shock, cardiac function, hemodynamics, myocardial injury, inflammatory factor levels, prognosis

Yi Yang,1 Jingxian Wang,1 Qing Su,1 Jinhuan Yang,2,3 Zhiyuan Bo,2,3 Chongming Zheng,2,3 Yitong Xie,2,3 Kaiwen Chen,2,3 Juejin Wang,1 Gang Chen,2,3 Yi Wang1 1Department of Epidemiology and Biostatistics, School of Public Health, Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China; 2Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of China; 3Key Laboratory of Diagnosis and Treatment of Severe Hepato-Pancreatic Diseases of Zhejiang Province, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang Province, People’s Republic of ChinaCorrespondence: Yi Wang, Department of Epidemiology and Biostatistics, School of Public Health, Wenzhou Medical University, Nanliu Road, Chashan Street, Ouhai District, Wenzhou City, Zhejiang Province, 325035, People’s Republic of China, Fax +86(577)-86699-358, Email wang.yi@wmu.edu.cn Gang Chen, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village, Nanbaixiang Street, Ouhai District, Wenzhou City, Zhejiang Province, 325035, People’s Republic of China, Fax +86(577)-55579-555, Email chen.gang@wmu.edu.cnBackground: Primary liver cancer (PLC) is a fatal malignancy, sleep quality and gut microbiota were shown to be associated with PLC. However, the mechanism of how sleep quality affects PLC is unclear. This study aims to investigate the mediation/moderation effects of gut microbiota on sleep quality and the occurrence of PLC.Methods: The causality of sleep quality and the occurrence of PLC was detected through the Mendelian randomization (MR) analysis based on the data including 305,359 individuals (Finland Database) and 456,348 participants (UK Biobank). The primary method used for MR analysis was inverse-variance weighted analysis. Gut microbiota’ mediation/moderation effects were uncovered in the case–control study including 254 patients with PLC and 193 people with benign liver diseases through the mediation/moderation effect analyses. People’s sleep quality was evaluated through the Pittsburgh sleep quality index (PSQI).Results: Poor sleep quality could lead to PLC through the MR analysis (P = 0.026). The case–control study uncovered that Actinobacteria had mediation effects on the relationship between PSQI score, self-sleep quality, and the occurrence of PLC (P = 0.048, P = 0.046). Actinobacteria and Bifidobacterium could inhibit the development of PLC caused by short night sleep duration (P = 0.021, P = 0.022). Erysipelotrichales could weaken the influence of daytime dysfunction on PLC (P = 0.033). Roseburia modulated the contribution of nocturnal insomnia and poor sleep quality to PLC (P = 0.009, P = 0.017).Conclusion: Poor sleep quality was associated with PLC. Gut microbiota’ mediation/moderation effects on poor sleep quality and the occurrence of PLC prompted an insightful idea for the prevention of PLC.Keywords: primary liver cancer, sleep quality, gut microbiota, Mendelian randomization, mediation/moderation effect

The reduction of carbon dioxide (CO 2 ) by transition-metal oxides in the gas phase serves as a unique model system for understanding transition metal-based catalytic systems in CO 2 utilization. In this work, thermochemistry and reaction mechanisms attributed to the two-state reactivity scenario of CO 2 reduction by group 5 transition metal monoxide cations are extensively investigated using quantum chemical calculations. The interaction between the VO + cation with CO 2 exhibits an endothermic feature, whereas the reaction involving the TaO + cation showcases a more pronounced exothermic behavior than the NbO + cation, in accordance with previously reported reaction rates. Based on in-depth examinations of potential energy surfaces and spin-orbit couplings, it has been revealed that the reaction kinetics of CO 2 reduction to CO by the VO + cation is restricted not only by a significant energy barrier related to the singlet transition state, but also by the limited probability of intersystem crossing. For NbO + and TaO + cations, the spin inversion from triplet to singlet pathways becomes the rate-limiting step. The reaction with the TaO + cation represents a different case from typical two-state reactivity patterns, where the minimum energy crossing point submerged relative to the reactants level stands for the exclusive barrier. A considerably higher probability of intersystem crossing was identified for the reaction of the TaO + cation with CO 2 , elucidating the basis for the substantial increase in the rate constant compared to that of the NbO + cation.

Objectives: To evaluate the efficacy of low-intensity pulsed ultrasound (LIPUS) in orthodontic tooth movement (OTM) and orthodontically induced root resorption (OIRR) across animal and human studies., Materials and Methods: An electronic search in MEDLINE, Embase, Web of Science, Cochrane Library, National Knowledge Infrastructure, and Wanfang Database up to May 2024 identified 931 records screened using predefined PICOS criteria. 18 animal and 8 human studies met the inclusion criteria, with 12 suitable for meta-analysis. Methodological qualities for animal studies were assessed using the SYRCLE tool and ARRIVE guidelines. For clinical trials, the Cochrane RoB 2.0 tool and ROBINS-I were applied to evaluate the risk of bias in randomized clinical trials (RCTs) and controlled clinical trials (CCTs), respectively. Evidence quality was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, and quantitative analysis employed RevMan software with an inverse variance method and random effects models for all included studies., Results: Most animal and human studies had a high or unclear risk of bias. LIPUS significantly accelerated OTM in rats, showing increases of 0.08 mm (95% CI, 0.02 to 0.13; P = 0.006), 0.11 mm (95% CI, 0.04 to 0.17; P = 0.001), and 0.11 mm (95% CI, 0.06 to 0.16; P < 0.0001) on days 5, 7, and 14. In clinical trials, LIPUS reduced treatment duration with clear aligners by 352.07 days (95% CI, -524.81 to -179.34; P < 0.0001), but had no significant effect on OIRR (P > 0.05). GRADE analysis indicated very low evidence quality for both outcomes., Conclusions: LIPUS may accelerate OTM but shows weak evidence for alleviating OIRR. More well-designed studies with standardized methodology are needed., Clinical Relevance: LIPUS could benefit OTM acceleration, but its effect on OIRR remains inconclusive., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Drowning incidents present significant challenges for forensic investigators in determining the exact site of occurrence. Traditional forensic methods often rely on physical evidence and circumstantial clues, but the emerging field of forensic microbiology offers a promising avenue for enhancing precision and reliability in site inference. Our study investigates the application of microbiome analysis in inferring drowning sites, focusing on microbial diversity in water samples and lung tissues of drowned animals from different sites in the Northwest River. We utilized 16S rDNA sequencing to analyze microbial diversity in water samples and lung tissues, revealing distinct microbial signatures associated with drowning sites. Our findings highlight variations in species richness and diversity across different sampling points, indicating the influence of environmental factors on microbial community structure. Machine learning models trained on microbial data from lung tissues demonstrated high accuracy in predicting drowning sites, with cross-validation accuracy ranging from 83.53% ± 3.99% to 95.07% ± 3.17%. Notably, the Gradient Boosting Machine (GBM) method achieved a classification accuracy of 95.07% ± 3.17% for different sampling points at a submersion time of 1 day. Moreover, our cross-species site inference results revealed that utilizing data from drowned mice to predict the drowning sites of rabbits in location W5 achieved an accuracy of 72.22%. In conclusion, our study underscores the potential of microbiome analysis in forensic investigations of drowning incidents. By integrating microbial data with traditional forensic techniques, there is significant potential to enhance the reliability of scene inferences, thereby making substantial contributions to case investigations and judicial trials.IMPORTANCEBy employing advanced techniques like microbial profiling and machine learning, the study aims to enhance the accuracy of determining drowning sites, which is crucial for both legal proceedings. By analyzing microbial diversity in water samples and drowned animal lung tissues, the study sheds light on how environmental factors and victim-related variables influence microbial communities. The findings not only advance our understanding of forensic microbiology but also offer practical implications for improving investigative techniques in cases of drowning.

This study sought to explore the effects of passivator, leaf inhibitor, and their combination on cadmium （Cd）-contaminated farmland and to realize the safe utilization of cultivated land. Coconut shell biochar and calcium magnesium phosphate fertilizer were selected as soil passivators and foliar selenium fertilizer was used as a foliar inhibitor. The best combination was selected through a wheat-maize rotation experiment. The results showed that： ① The soil pH, organic matter content, and CEC could be improved to varying degrees by the application of passivators. ② The grain yield of wheat and maize increased to different degrees after the application of the passivator and foliar inhibitor. ③ The BFL treatment （biochar 1 800 kg·hm -2 +calcium magnesium phosphate 600 kg hm -2 + foliar inhibitor 3 L·hm -2 ） during the maize season had the best effect, which was significantly lower than that in CK by 13.85%. The effect of the BF treatment （biochar 1 800 kg·hm -2 + calcium magnesium phosphate 600 kg·hm -2 ） in wheat season was the best, which was significantly reduced by 11.21% compared with that in CK. ④ The BF treatment （biochar 1 800 kg·hm -2 + calcium magnesium phosphate 600 kg·hm -2 ） had the best effect on reducing Cd content in roots, straws, and grains of maize and wheat, reducing Cd content in roots of wheat and maize by 20.55% and 27.81%, Cd content in straws by 11.39% and 13.70%, and Cd content in grains by 48.97% and 50.44%, respectively. Therefore, considering all the indexes, the combination of passivators and foliar inhibitor, especially biochar combined with calcium magnesium phosphate fertilizer and biochar and calcium magnesium phosphate fertilizer combined with foliar inhibitor, could more effectively reduce the absorption, transport, and enrichment of Cd in maize and wheat and could be popularized and applied in safe use cultivated land.

Probiotics are increasingly considered as an alternative to antibiotics in developing environmentally sustainable aquaculture practices. Hybrid sturgeon (Acipenser baerii ♀ × Acipenser schrenckii ♂), a globally popular species valued for its nutritional content and caviar, has limited research on host-associated probiotics. In this study, we isolated and identified Bacillus subtilis and Bacillus amyloliquefaciens from healthy hybrid sturgeon and assessed their impact on growth, immunity, gut microbiota, and transcriptome following an 8-week feeding trial. The isolated strains demonstrated strong production of protease, amylase, lipase, and cellulase, along with broad-spectrum pathogen inhibition, including Aeromonas veronii, Aeromonas sobria, and Yersinia ruckeri. Supplementation with B. subtilis and B. amyloliquefaciens significantly improved growth performance and increased survival rates against A. veronii infection. Mechanistically, probiotics altered gut microbiota composition, enhancing digestive functions. Transcriptome analysis further revealed that probiotic supplementation boosted immune response and protein digestion and absorption. These findings suggest that B. subtilis and B. amyloliquefaciens are promising probiotic candidates for the hybrid sturgeon industry, offering effective protection against A. veronii infection., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2024. Published by Elsevier Ltd.)

Ion specificity is crucial for developing fluorescence probes. Using a recently reported optical sensor (BDA-1) of Zn 2+ as a representative, we carried out extensive quantum chemical calculations on its photophysical properties using density function theory. According to the calculated optimized geometries, excitation energies and transition oscillator strengths, the weak fluorescence of BDA-1 observed in experiments is attributed to the suppression of fluorescence emission by efficient internal conversion, rather than the previously proposed photoinduced electron transfer (PET) mechanism. With the addition of Zn 2+ or Cd 2+ ions, the tetradentate chelates [M:BDA-1 -H+ ] + (M=Zn, Cd) are produced. According to frontier molecular orbital and interfragment charge transfer analyses of these complexes, PET is preferentially confirmed to occur upon photo-excitation. Notably, as one coordination bond in the excited [Cd:BDA-1 -H+ ] + complex is significantly weakened in comparison to that of [Zn:BDA-1 -H+ ] + , their molecular orbital compositions in the S 1 state are completely different. As a result, absorption and radiation transitions of [Zn:BDA-1 -H+ ] + both have considerable oscillator strength, while fluorescence radiation from the excited [Cd:BDA-1 -H+ ] + is doubly suppressed. This difference causes that the fluorescence intensity of BDA-1 is sensitive to the addition of metal ions, and exhibits the zinc ion-specificity., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: As fundamental documents in clinical trials, clinical trial protocols are intended to ensure that trials are conducted according to the objectives set by researchers. The advent of large models with superior semantic performance compared to traditional models provides fresh perspectives for research recommendations in clinical trial protocols., Method: A clinical trial protocol recommendation system based on Large Language Models (LLMs) is proposed in this paper, combining GPT-4 and knowledge graph to assist in clinical trial protocol recommendations. Using knowledge graphs as an auxiliary tool, a finite set of clinical trial projects with similar features is identified. Subsequently, through the semantic capabilities of GPT-4, targeted recommendations are made to patients., Results: Experiments were conducted to compare GPT-4 and multiple models from the SBERT family that handle semantic similarity. The results indicate that GPT-4 is capable of better sorting clinical trial protocols based on similarity criteria and offering targeted recommendations to patients. Consequently, this capability meets the matching requirements between projects and patients and enhances the automation of clinical trial protocol recommendations. Additionally, in the future, personal factors of patients will be fully considered during the recommendation process to provide more accurate and personalized protocol recommendations., Conclusion: By integrating knowledge graphs and LLMs, a better understanding and processing of clinical trial protocol information can be achieved, enabling the recommendation of appropriate protocols for patients and enhancing both matching efficiency and accuracy. Furthermore, the application of this system contributes to the automation of clinical trial protocol recommendations, playing a crucial role in medical research institutions such as clinical trial research institutes and public health management departments. Additionally, it significantly aids in advancing the development of clinical trials and the medical field at large., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: QianMin SU reports financial support was provided by Shanghai Municipal Administration of Traditional Chinese Medicine Clinical Project. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Since lithium-sulfur (Li-S) batteries have high energy density and environmental friendliness, they have garnered a lot of attention as a new type of energy storage technology. However, the shuttle effect of lithium polysulfides (LiPSs) and low utilization of sulfur (S) in Li-S batteries reduce the cycle stability and energy efficiency and limit their practical application. Therefore, it is urgent to achieve simultaneous immobilization and conversion of LiPSs utilizing catalysts. Herein, a metal-organic framework (MOF)-derived MoC/WC@NC heterojunction is synthesized as a bidirectional catalyst for LiPSs in high-performance Li-S batteries. Experimental and theoretical calculations indicate that the catalyst is expected to improve the catalytic activity for reduction and oxidation reactions of LiPSs, thereby accelerating the kinetics of Li-S batteries. In conclusion, with the incorporation of the novel catalyst between the cathodes and separators in Li-S batteries, the assembled batteries demonstrate excellent rate performance, with an initial discharge capacity of 1752.1 mAh g -1 at 0.1 C, and a discharge-specific capacity of 783.2 mAh g -1 even at 2 C. More significantly, the coulombic efficiency stayed above 99% and the capacity of 589.1 mAh g -1 after 1000 cycles at 1 C with a decay rate of only 0.062% each cycle., (© 2024 Wiley‐VCH GmbH.)

Purpose: To evaluate the effects of ocular residual astigmatism (ORA) on refractive outcomes for patients with astigmatism after keratorefractive lenticule extraction (KLEx) and to identify the ratio of the ORA/manifest refractive cylinder at the corneal plane (MRC) resulting in a greater index of success (IOS)., Methods: In total, 892 right eyes that underwent KLEx surgery were included. Astigmatic changes were evaluated using Alpins' vector analysis. Surgical outcomes grouped by ORA/MRC and ORA were compared. In stage 1, eyes were divided into two groups with an ORA/MRC cutoff value of 1. In stage 2, patients with an ORA/MRC ratio of greater than 1 were divided into two groups: those with an ORA of 1.25 diopters (D) or greater and those with an ORA of less than 0.50 D. ORA/MRC thresholds leading to a high IOS were analyzed using receiver operating characteristic (ROC) curves., Results: In stage 1, the mean IOS was 0.13 and 0.21 for the low and high ORA/MRC groups, respectively ( P < .001). In stage 2, for high ORA/MRC, the IOS was significantly greater when the ORA was greater than 1.25 D than when the ORA was less than 0.50 D (0.27 versus 0.13, P < .001). ROC curves revealed that participants with an ORA/MRC ratio of greater than 1.8 were more likely to have a higher IOS ( P < .001)., Conclusions: Patients with a smaller ORA can obtain better correction results. An ORA/MRC ratio of greater than 1.8 may increase the risk of poor astigmatism correction with KLEx. The application of vector planning may improve the refractive outcomes of KLEx. [ J Refract Surg . 2024;40(12):e966-e973.] ., Competing Interests: Disclosure: The authors have disclosed no potential conflicts of interest, financial or otherwise.

This study aimed to evaluate the therapeutic properties of the traditional Chinese medicine Xuesanqi (XSQ, from the rhizome of Polygonum amplexicaule D. Don) in treating ulcerative colitis. We hypothesized that its many active components can alleviate symptoms of colitis by regulating the gut microbiota, its metabolites, and various signaling pathways. To test our hypotheses, we designed a DSS- induced colitis model in C57BL/6 male mice. Apparent metrics were evaluated in each group of mice and performed histological analysis of relevant tissues. The gut microbial composition was analyzed by 16S rRNA sequencing of bacteria. Simultaneously, the SCFAs content was detected by gas chromatography, inflammatory factor secretion was evaluated by ELISA or western-blot, the expression of tight junction protein and key proteins of the MAPK signaling pathway were analyzed by western-blot. Our result showed that the treatment with XSQ alleviated significant various symptoms such as weight loss, blood in stool, and shortening of colon. In addition, XSQ treatment restored the dysregulated gut microbiota in colitis mice, increased short chain fatty acids (SCFAs) and normalized the MAPK/ERK/JNK signaling pathways, promoted expression of tight junction protein Occludin, Claudin-1, and E-cadherin proteins. Furthermore, we also observed a dose-dependent pattern in these treatment responses. These findings demonstrated the active components of XSQ is a promising new treatment platform for ulcerative colitis., Competing Interests: Declarations. Ethics approval and consent to participate: All animal treatments were approved by the Animal Ethics Committee of South-Central Minzu University (2023-scuec-036). All institutional and national guidelines for the care and use of laboratory animals were followed. Competing interests: The authors declare no competing interest., (© 2024. The Author(s).)

Minimal change disease (MCD) is a universal primary glomerular disease contributing to nephrotic syndrome. Lon peptidase 1 (LONP1) has been suggested to protect podocytes from damage during the progression of MCD. Accordingly, our research further explored the specific mechanisms of LONP1. Initially, the expressions of TRPC6, p-ERK1/2, and LONP1 in the kidney tissues of MCD patients were detected by immunohistochemistry and Western blot. Human podocytes AB8/13 were serially subjected to transfection with shTRPC6/shNC, and 48-h treatment with 30 µg/ml puromycin aminonucleoside (PAN). The viability, apoptosis, and migration of AB8/13 cells were assessed by cell counting kit-8, flow cytometry, and transwell assays. The mRNA and protein expressions of LONP1 were downregulated while those of TRPC6 were upregulated in the kidney tissues of MCD patients. PAN induced podocyte injury and migration and inhibited LONP1 expression, whereas TRPC6 silencing did oppositely. The phosphorylation level of ERK1/2 was reduced in MCD samples, which was negatively associated with TRPC6 expression and positively associated with LONP1 expression. Furthermore, ERK phosphorylation agonist offset the effects of TRPC6 silencing on mitigating podocyte injury and migration as well as upregulating LONP1 expression. Collectively, TRPC6 knockdown-induced ERK1/2 inactivation can ameliorate podocyte injury in MCD by increasing the expression of LONP1.

It is crucial to recognize upper extremity fragility fractures as sentinel events that allow healthcare professionals the opportunity to identify and address underlying factors contributing to poor bone health, thereby reducing the risk of future fragility fractures. This study seeks to evaluate the extent of understanding and factors influencing osteoporosis in older adults with upper extremity fragility fractures, aiming to establish a foundation for enhancing their comprehension. A total of 1443 participants in 31 provinces were included in this study as survey subjects from September to November 2023. A general information questionnaire and an osteoporosis knowledge assessment tool were used for a cross-sectional survey. The univariate analysis and logistic regression were used to analyze the risk factors. The score of osteoporosis knowledge assessment tool of participants was 10.00 (7.00, 12.00), with only 24.95% scoring above 12 points. Being in an eastern hospital, suffering from chronic obstructive pulmonary disease, being diagnosed as severe osteoporosis, having bone mineral density testing, receiving osteoporosis health education, and receiving health education by phone were associated with higher knowledge of osteoporosis. The osteoporosis knowledge of older adults with upper extremity fragility fractures needs to be improved. To help the secondary prevention of osteoporosis, the standardized osteoporosis health education should be strengthened, and attention should be paid to key groups., (© 2024 John Wiley & Sons Australia, Ltd.)

Background: Early prediction of treatment efficacy can assist psychiatrists in optimizing personalized treatment strategies for drug-naïve schizophrenia patients. This study aimed to explore the predictive value of plasma concentrations of Interferon-γ (IFN-γ) and Neutrophil gelatinase-associated lipocalin (NGAL) in early treatment responses., Methods: We conducted a longitudinal study involving 125 drug-naïve schizophrenia patients and 75 healthy controls. Plasma samples were collected and analyzed at baseline and after 8 weeks of treatment. Based on treatment outcomes, patients were classified as Responders (R, n = 84) or Non-responders (NR, n = 41)., Results: At baseline, schizophrenia patients showed significantly lower IFN-γ and NGAL concentrations compared to healthy controls. NGAL levels were notably lower in the NR group compared to the R group. After treatment, both IFN-γ and NGAL concentrations increased in all patients, with a marked rise in IFN-γ levels. NGAL concentration negatively correlated with the positive factor at baseline, adjusting for confounders such as age, BMI, smoking, and duration of untreated illness. Logistic regression analysis identified lower baseline NGAL concentrations as a predictor of poor early treatment response., Conclusion: Pre-treatment plasma NGAL concentrations may serve as a potential biomarker for predicting early treatment response in drug-naïve Chinese Han schizophrenia patients. These findings highlight NGAL as a possible target for future therapeutic development in schizophrenia., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024. Published by Elsevier B.V.)

This study investigated the occurrence status, sources, and risk assessment of polycyclic aromatic hydrocarbons (PAHs) in sediments from three typical mangrove areas in Guangxi Province, China. Results showed that the PAH content in the three studied regions ranged from 39.76 ng·g -1 to 164.93 ng·g -1 , and the average concentration was 92.87 ng·g -1 . The PAHs that were detected were mainly 3-ring and 4-ring. The source of PAHs, as traced by the diagnostic ratio method and principal component analysis, was mainly from combustion. The toxicity risk assessment showed that the content of all PAHs was lower than the Effects Range Low (ERL), and the potential ecological risk was low. The toxicity equivalent (TEQ BaP ) content ranged from 4.75 ng·g -1 to 19.20 ng·g -1 , with an average of 12.08 ng·g -1 . Overall, the ecological risk of PAHs in mangrove sediments in Guangxi is considered low., Competing Interests: Declaration of competing interest All authors declare there are no conflicts of interest regarding the publication of this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Although quasi-2D Ruddlesden‒Popper (RP) perovskite exhibits advantages in stability, their photovoltaic performance are still inferior to 3D counterparts. Optimizing the buried interface of RP perovskite and suppress energetic losses can be a promising approach for enhancing efficiency and stability of inverted quasi-2D RP perovskite solar cells (PSCs). Among which, constructing polymer hole-transporting materials (HTMs) with defect passivation functions is of great significance for buried-interface engineering of inverted quasi-2D RP PSCs. Herein, by employing side-chain tailoring strategy to extend the π-conjugation and regulate functionality of side-chain groups, target polymer HTMs (PVCz-ThSMeTPA and PVCz-ThOMeTPA) with high mobility and multisite passivation functions are achieved. The presence of more sulfur atom-containing groups in side-chain endows PVCz-ThSMeTPA with increased intra/intermolecular interaction, appropriate energy level, and enhanced buried interfacial interactions with quasi-2D RP perovskite. The hole mobility of PVCz-ThSMeTPA is up to 9.20 × 10 -4 cm 2 V -1 S -1 . Furthermore, PVCz-ThSMeTPA as multifunctional polymer HTM with multiple chemical anchor sites for buried-interface engineering of quasi-2D PSCs can enable effective charge extraction, defects passivation, and perovskite crystallization modulation. Eventually, the PVCz-ThSMeTPA-based inverted quasi-2D PSC achieves a champion power conversion efficiency of 22.37%, which represents one of the highest power conversion efficiencies reported to date for quasi-2D RP PSCs., (© 2024 The Author(s). Advanced Science published by Wiley‐VCH GmbH.)

Background and Aim: To establish reference values for hyperuricemia (HUA) in children and adolescents., Methods and Results: The study enrolled 4807 students from "The Evaluation and Monitoring on School-based Nutrition and Growth in Shenzhen study." Utilizing quantile regression, associations between age, body mass index (BMI), pubertal stage, and serum uric acid (SUA) were examined, alongside the relationship between SUA and cardiovascular disease (CVD) risk factors. Reference values for SUA were explored using receiver operating characteristic analysis, considering sex and pubertal stage. The prevalence of HUA was 34.3 % for boys and 29 % for girls (using the adult HUA diagnostic criteria: >420 μmol/L for males, >360 μmol/L for females), increasing with higher BMI, age, and pubertal stage. Pubertal stage had the largest influence on SUA in boys, while nutritional status was the most significant factor affecting SUA in girls. Adjusting for age and pubertal stage, higher SUA levels correlated with an increased risk of CVD risk factors. Proposed reference values included >360 μmol/L for girls ages 6-17 years and prepubertal boys. For pubertal boys, reference values varied based on age: >392 μmol/L for ages 9-11 in early-middle puberty, >429 μmol/L for ages 12-14 in early-middle puberty, >478 μmol/L for ages 12-14 in late puberty, and >505 μmol/L for ages 15-17 in late puberty., Conclusions: Stratifying HUA reference values by pubertal stage, particularly for boys, is crucial. Long-term follow-up of individuals with high SUA levels may aid in refining SUA reference values., (Copyright © 2024 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Most patients with cancer are first diagnosed at an advanced disease stage, when tumors are already large and/or metastases are present. This circumstance has a negative impact on the prognosis and therapeutic effect of anticancer drugs. In this study, it is demonstrated that photosensitizer chlorin e6 and the photochemotherapy drug mitoxantrone self-assemble into relatively stable nanoassemblies (CM NAs) through hydrogen-bonding effect, π-π stacking, and hydrophobic interactions. Administration of CM NAs in combination with 660 nm laser irradiation shows chemotherapeutic, photothermal, and photodynamic effects, causing tumor cell apoptosis and pyroptosis and enabling noninvasive tumor ablation without compromising the surrounding normal tissue. More importantly, treatment with CM NAs increases tumor immunogenicity, leading to a strong and long-term antitumor immune response that eradicates large tumors and provides long-term protection against tumor recurrence on various tumor models., (© 2024 Wiley‐VCH GmbH.)

Non-small cell lung cancer (NSCLC) is a highly malignant tumor with a poor prognosis. Hypoxia conditions affect multiple cellular processes promoting the adaptation and progression of cancer cells via the activation of hypoxia-inducible factors (HIF) and subsequent transcription activation of their target genes. Preliminary studies have suggested that estrogen receptor β (ERβ) might play a promoting role in the progression of NSCLC. However, the precise mechanisms, particularly its connection to HIF-1α-mediated modulation under hypoxia, remain unclear. Our findings demonstrated that the overexpression of ERβ, not ERα, increased cell proliferation and inhibition of apoptosis in NSCLC cells and xenografts. Tissue microarray staining revealed a strong correlation between the protein expression of HIF-1α and ERβ. HIF-1α induced ERβ gene transcription and protein expression in CoCl 2 -induced hypoxia, 1% O 2 incubation, or HIF-1α overexpressing cells. ChIP identified HIF-1α binding to a hypoxia response element in the ESR2 promoter. The suppression of HIF-1α and ERβ both in vitro and in vivo effectively reduced the tumor growth, thus emphasizing the promising prospects of targeting HIF-1α and ERβ as a therapeutic approach for the treatment of NSCLC. KEY MESSAGES: ERβ, not ERα, increases cell proliferation and inhibition of apoptosis in NSCLC cells and xenografts. A strong correlation exists between the protein expression of HIF-1α and ERβ. HIF-1α induced ERβ gene transcription and protein expression in hypoxic cells via binding to HRE in the ESR2 promoter. The suppression of HIF-1α and ERβ both in vitro and in vivo effectively reduced the NSCLC tumor growth., Competing Interests: Declarations. Ethics approval and consent to participate: Animal experiments were performed in accordance with the Animals Care Committee Guidelines (XJTUAE2023-1593). Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

At present, pollution of gulf sediments with potentially toxic elements (PTEs) has become a prominent marine environmental problem. This study thoroughly investigated the occurrence, bioavailability, and probabilistic risk of PTEs in the surface sediments of the Beibu Gulf. The average total concentrations (mg/kg) were 8.03 for As, 0.06 for Cd, 52.73 for Cr, 9.86 for Cu, 0.04 for Hg, 18.70 for Ni, 27.77 for Pb and 59.80 for Zn, respectively. The positive matrix factorization model revealed that the PTE enrichment was primarily due to composite sources from aquaculture and fisheries activities, industrial and agricultural sources. Risk assessment code and correlation analysis indicated that Cd had the highest bioavailability, influenced by TOC and TP. The probabilistic risk assessment model estimated a 60.83 % probability that the mixed PTEs in the Beibu Gulf's surface sediments could have toxic effects on aquatic life. These findings underscore the impact of intensive human activities on PTE pollution and highlight the need for further research on PTE ecotoxicology and pollution control strategies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The simultaneous selection of antibiotic resistance genes (ARGs) induced by heavy metals and antibiotics has emerged as a growing environmental problem. This study investigated the combined effects of chromium (Cr(VI)) and antibiotics on the ARGs of Bacillus cereus SH-1. As Cr(VI) concentration increased, it triggered reactive oxygen species oxidative stress in SH-1, increased antioxidant enzyme activity, enhanced plasmid conjugative transfer, and reduced the efficiency of Cr(VI) removal by SH-1. Antibiotic resistance varied with increasing tetracycline and amoxicillin minimum inhibitory concentrations (MICs), whereas azithromycin and chloramphenicol MICs decreased with Cr(VI) induction. The overexpression of eight genes of the HAE-1 family of efflux pumps was detected using metagenomics and proteomics. Co-contamination with Cr(VI) and antibiotics has led to the emergence and spread of antibiotic-resistant bacteria. Therefore, resistance gene contamination resulting from Cr(VI)-polluted environments cannot be overlooked., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Although significant progress has been made in controlling emissions from stationary combustion sources in China over the past decade, understanding of condensable particulate matter (CPM) emissions from these sources and their impact on ambient PM 2.5 remains limited. In this study, we established the source profiles and emission inventories of CPM from coal-fired industrial boilers (CFIBs), coal-fired power plants (CFPPs), and iron and steel industry (ISIs) for the Yangtze River Delta (YRD) region of China; furthermore, the air quality model (Community Multiscale Air Quality, CMAQ) was used to evaluate the impact of CPM emissions from these three types of stationary combustion sources on ambient PM 2.5 during Feb. 2018, a month characterized by elevated PM 2.5 concentrations. The results indicated that CPM emissions from these three sources in the YRD region before and after the implementation of the ultra-low emissions (ULE) policy amounted to 109,839 and 43,338 tons, respectively, with particularly high emission intensity along the Yangtze River. The implementation of CFPPs ULE policy was shown to reduce the impact of CPM emissions from these three stationary sources on monthly PM 2.5 concentrations from 0.92 μg/m 3 to 0.41 μg/m 3 (with a maximum of 5.35 μg/m 3 ). This reduction exceeded the 0.31 μg/m 3 decrease in PM 2.5 concentrations resulting from the emission reductions of conventional pollutants (FPM, SO 2 and NOx). CPM emissions from these three stationary sources were found to increase the PM 2.5 by 0.68 μg/m 3 during pollution periods. The largest components of PM 2.5 contributed by CPM emissions from stationary combustion sources were sulfate, organic carbon, and nitrate, accounting for 21.4 %, 21.1 %, and 18.2 %, respectively. Particularly, contributions from CPM emissions to PM 2.5 varied by altitude, with a relatively large impact at altitudes between 220 and 460 m. Attention should be given to CPM emission control, with particular priority placed on implementing ULE measures for ISIs and CFIBs., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2024. Published by Elsevier B.V.)

Objectives: The aim of this study was to investigate the mechanism of itaconate's potential effect in diabetic kidney disease., Methods: Renal immune responsive gene 1 (IRG1) levels were measured in db/db mice and streptozotocin (STZ) + high-fat diet (HFD)-induced diabetic mice. Irg1 knockout mice were generated. db/db mice were treated with 4-octyl itaconate (4-OI, 50 mg/kg), a derivative of itaconate, for 4 weeks. Renal function and morphological changes were investigated. Ultrastructural alterations were determined by transmission electron microscopy., Results: Renal IRG1 levels were reduced in two diabetic models. STZ+HFD-treated Irg1 knockout mice exhibited aggravated renal tubular injury and worsened renal function. Treatment with 4-OI lowered urinary albumin-to-creatinine ratio and blood urea nitrogen levels, and restored renal histological changes in db/db mice. It improved mitochondrial damage, increased expressions of peroxisome-proliferator-activated receptor γ coactivator-1α (PGC-1α) and mitochondrial transcription factor A (TFAM) in the renal cortex of db/db mice. These were confirmed in vitro ; 4-OI improved high glucose-induced abnormal mitochondrial morphology and TFAM expression in HK-2 cells, effects that were inhibited by PGC-1α silencing. Moreover, 4-OI reduced the number of apoptotic cells in the renal cortex of db/db mice. Further study showed that 4-OI increased renal Nrf2 expression and decreased oxidative stress levels in db/db mice. In HK-2 cells, 4-OI decreased high glucose-induced mitochondrial ROS production, which was reversed by Nrf2 silencing. Nrf2 depletion also inhibited 4-OI-mediated regulation of PGC-1α, TFAM, and mitochondrial apoptotic protein expressions., Conclusions: 4-OI attenuates renal tubular injury in db/db mice by activating Nrf2 and promoting PGC-1α-mediated mitochondrial biogenesis.

Background: Cognitive impairment is a core feature of schizophrenia with unclear mechanisms, particularly neurocognition. The objective of this study was to investigate the association between duration of untreated psychosis (DUP) and neurocognition, as well as potential biological mechanisms., Methods: A total of 219 patients were recruited in this study. DUP was measured in years, reflecting the untreated period. Neurocognition was assessed by the MATRICS Consensus Cognitive Battery (MCCB). The plasma concentrations of three growth factors, vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor (BDNF), and epidermal Growth Factor (EGF) were detected by enzyme-linked immunosorbent assay in 128 patients. Multiple linear regression analysis was used to analyze the association between DUP, growth factors, and neurocognition., Results: Our findings showed that DUP was significantly negatively correlated with speed of processing and reasoning and problem-solving in all patients (N = 219, P < 0.05). Five years was defined as cut-off point for long and short DUP group in the present study. Only in the short DUP patients, DUP was strongly associated with visual learning and neurocognition (P < 0.05). In patients with growth factor (N = 128), DUP was independently associated with speed of processing, verbal learning, and neurocognition (P < 0.05). Further, plasma concentrations of VEGF, BDNF, and EGF were all significantly correlated with neurocognition (P < 0.05). Additionally, we found a potential trend of correlation between DUP and BDNF (P = 0.061)., Conclusion: Our study provides insights into a negative correlation between DUP and neurocognition, and BDNF may serve as a potential biological mechanism., Competing Interests: Declaration of competing interest The authors have no conflict of interest to report., (Copyright © 2024. Published by Elsevier B.V.)

For current image caption tasks used to encode region features and grid features Transformer-based encoders have become commonplace, because of their multi-head self-attention mechanism, the encoder can better capture the relationship between different regions in the image and contextual information. However, stacking Transformer blocks necessitates quadratic computation through self-attention to visual features, not only resulting in the computation of numerous redundant features but also significantly increasing computational overhead. This paper presents a novel Distilled Cross-Combination Transformer (DCCT) network. Technically, we first introduce a distillation cascade fusion encoder (DCFE), where a probabilistic sparse self-attention layer is used to filter out some redundant and distracting features that affect attention focus, aiming to obtain more refined visual features and enhance encoding efficiency. Next, we develop a parallel cross-fusion attention module (PCFA) that fully exploits the complementarity and correlation between grid and region features to better fuse the encoded dual visual features. Extensive experiments conducted on the MSCOCO dataset demonstrate that our proposed DCCT method achieves outstanding performance, rivaling current state-of-the-art approaches., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The dissolving pulp preparation from bleached kraft pulp while realizing the high-value application of hemicellulose fraction is of great significance for improving the overall economics of the process. This work proposed a two-step cascaded process of deep eutectic solvent (DES) pretreatment combined with mechanical refining for the co-production of dissolving pulp and arabinoxylan (AX) from bleached bamboo pulp. Results showed that using alkaline DES composed of quaternary ammonium hydroxide and urea prepared high-quality dissolving pulp (α-cellulose content of 97.7 %) while selectively extracting high-quality AX. The mechanical refining rapidly opened up the cellulose structure to increase its Fock reactivity to over 70.0 %. When 100 g bleached bamboo pulp was subjected to this technology route, the high yields of dissolving pulp (63.8 g) and AX (13.0 g) were respectively obtained. It was proposed that the tailored DES with different alkalinity could specifically produce dissolving pulp or AX which were more favorable for downstream application through distinct action pathways. The swelling effects of DES on the cellulose surface facilitated the subsequent mechanical fibrillation, allowing a synergistic enhancement of the reactivity. Thus, the integrated process provided a sustainable alternative for dissolving pulp upgrading while adding attractiveness by co-producing AX product stream., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Spiking Neural Networks (SNNs) are naturally suited to process sequence tasks such as NLP with low power, due to its brain-inspired spatio-temporal dynamics and spike-driven nature. Current SNNs employ "repeat coding" that re-enter all input tokens at each timestep, which fails to fully exploit temporal relationships between the tokens and introduces memory overhead. In this work, we align the number of input tokens with the timestep and refer to this input coding as "individual coding". To cope with the increase in training time for individual encoded SNNs due to the dramatic increase in timesteps, we design a Bidirectional Parallel Spiking Neuron (BPSN) with following features: First, BPSN supports spike parallel computing and effectively avoids the issue of uninterrupted firing; Second, BPSN excels in handling adaptive sequence length tasks, which is a capability that existing work does not have; Third, the fusion of bidirectional information enhances the temporal information modeling capabilities of SNNs; To validate the effectiveness of our BPSN, we present the SNN-BERT, a deep direct training SNN architecture based on the BERT model in NLP. Compared to prior repeat 4-timestep coding baseline, our method achieves a 6.46× reduction in energy consumption and a significant 16.1% improvement, raising the performance upper bound of the SNN domain on the GLUE dataset to 74.4%. Additionally, our method achieves 3.5× training acceleration and 3.8× training memory optimization. Compared with artificial neural networks of similar architecture, we obtain comparable performance but up to 22.5× energy efficiency. We would provide the codes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Autism spectrum disorder (ASD) is a complex neurodevelopmental condition that often coincides with gut dysbiosis. Studies show that alterations in gut microbiota influence brain function and could serve as diagnostic biomarkers and therapeutic targets. This forum article discusses the role of gut microbiota in ASD pathogenesis and its diagnostic and therapeutic potential., Competing Interests: Declaration of interests S.C.N. has served as an advisory board member for Pfizer, Ferring, Janssen, and Abbvie, and has received honoraria as a speaker for Ferring, Tillotts, Menarini, Janssen, Abbvie, and Takeda. S.C.N. has received research grants through her affiliated institutions from Olympus, Ferring, and Abbvie. S.C.N. is a founder member, non-executive director, non-executive scientific advisor, and shareholder of GenieBiome Ltd. S.C.N. receives patent royalties through her affiliated institutions. Q.S. is a Scientist (Diagnostics) of GenieBiome Ltd. Y.W., Q.S., and S.C.N. are named inventors of patent applications held by the CUHK and MagIC that cover the therapeutic and diagnostic use of microbiomes related to ASD., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background & Aims: Post-acute COVID-19 syndrome (PACS) is associated with sleep disturbance, but treatment options are limited. The etiology of PACS may be secondary to alterations in the gut microbiome. Here, we report the efficacy of fecal microbiota transplantation (FMT) in alleviating post-COVID insomnia symptoms in a nonrandomized, open-label prospective interventional study., Methods: Between September 22, 2022, and May 22, 2023, we recruited 60 PACS patients with insomnia defined as Insomnia Severity Index (ISI) ≥8 and assigned them to the FMT group (FMT at weeks 0, 2, 4, and 8; n = 30) or the control group (n = 30). The primary outcome was clinical remission defined by an ISI of <8 at 12 weeks. Secondary outcomes included changes in the Pittsburgh Sleep Quality Index, Generalized Anxiety Disorder-7 scale, Epworth Sleepiness Scale, Multidimensional Fatigue Inventory, blood cortisol and melatonin, and gut microbiome analysis on metagenomic sequencing., Results: At week 12, more patients in the FMT than the control group had insomnia remission (37.9% vs 10.0%; P = .018). The FMT group showed a decrease in ISI score (P < .0001), Pittsburgh Sleep Quality Index (P < .0001), Generalized Anxiety Disorder-7 scale (P = .0019), Epworth Sleepiness Scale (P = .0057), and blood cortisol concentration (P = .035) from baseline to week 12, but there was no significant change in the control group. There was enrichment of bacteria such as Gemmiger formicilis and depletion of microbial pathways producing menaquinol derivatives after FMT. The gut microbiome profile resembled that of the donor in FMT responders but not in nonresponders at week 12. There was no serious adverse event., Conclusions: This pilot study showed that FMT could be effective and safe in alleviating post-COVID insomnia, and further clinical trials are warranted., Clinicaltrials: gov, Number: NCT05556733., (Copyright © 2024 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Objective: This study aimed to systematically evaluate the effectiveness and safety of renal denervation (RDN) in managing heart failure with reduced ejection fraction (HFrEF)., Methods: A comprehensive search was done in multiple databases: Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP Database for Chinese Technical Periodicals. All clinical trials investigating RDN treatment for HFrEF through 15 March 2024 were gathered. The quality of the included studies was evaluated utilizing the Cochrane risk assessment tool. The pertinent data were gathered, and a meta-analysis was done using Review Manager 5.3, accompanied by sensitivity and publication bias analyses., Results: After applying the inclusion and exclusion criteria, eight randomized controlled trials (RCTs) were selected for analysis, encompassing 314 patients; 154 patients underwent RDN treatment during hospitalization, while 150 were randomized to the control group to receive medication therapy. The meta-analysis demonstrated that compared to medication therapy, RDN contributed to a 9.59% increase in left ventricular ejection fraction (LVEF) (95% CI: 7.92-11.27, Z  = 11.20, p  < 0.01); a decrease in brain natriuretic peptide (BNP) (95% CI: -364.19--191.75, Z  = 6.32, p  < 0.01); a decrease in N-terminal pro B-type natriuretic peptide (NT-proBNP) (95% CI: -1300.15--280.95, Z  = 3.04, p  < 0.01); a decrease in the New York Heart Association (NYHA) classification (95% CI: -1.58--0.34, Z  = 3.05, p  < 0.01); a 90.00-m increase in 6-min walk test (6MWT) (95% CI: 68.24-111.76, Z  = 8.11, p  < 0.01); a reduction of 4.05 mm in left ventricular end-diastolic diameter (LVEDD) (95% CI: -5.65--2.48, Z  = 5.05, p  < 0.01); a decrease of 4.60 heart beats·min -1 (95% CI: -8.83--0.38, Z  = 2.14, p  < 0.05); and a 4.67-mm reduction in left atrial diameter (LAD) (95% CI: -6.40--2.93, Z  = 5.27, p  < 0.01). Left ventricular end-systolic diameter (LVESD) and systolic/diastolic blood pressure (OSBP/ODBP) were similar between groups ( p  > 0.01). As the safety indicator, estimated glomerular filtration rate (eGFR) improved by 7.11 in the RDN group [ml/(min·1.73 m 2 )] (95% CI: 1.10-13.12, Z  = 2.32, p  < 0.05). LVEF, BNP, 6MWT, LVEDD, LAD and eGFR were meta-analyzed using a fixed-effects model, the other indicators a random-effects model., Conclusion: RDN significantly ameliorated cardiac function in HFrEF patients while exhibiting commendable safety.

Purpose: Brucella aneurysms are very rare but life-threatening, and a standard treatment approach has yet to be established. The current study aimed to assess the safety and efficacy of endovascular treatment for Brucella aneurysms., Materials and Methods: The clinical data of 15 Brucella aortic-iliac aneurysm patients who underwent endovascular repair at 2 hospitals from January 2012 to December 2021 were retrospectively collected and analyzed., Results: Fifteen patients (12 men and 3 women) with a mean age of 59.3 years were included. Fourteen patients (93.3%) had a history of exposure to animals (cattle and sheep). All patients had aortic or iliac pseudoaneurysms, 9 abdominal aortic aneurysms (AAAs), 4 iliac aneurysms, and 2 AAA combined with iliac aneurysms. Endovascular aneurysm repair (EVAR) was performed in all patients without conversion to open surgery. Six cases were treated for emergency surgery due to aneurysm rupture. The immediate technique success rate was 100%, with no postoperative death. Two cases had the iliac artery ruptured again after operation because of lack of antibiotic treatment and was given endovascular treatment again. Once brucellosis is diagnosed, antibiotic treatment with doxycycline and rifampicin was initiated for all the patients until 6 months after operation. All patients survived over a median follow-up period of 45 months. Follow-up computed tomography angiography showed that all stent grafts remained patent, with no endoleak., Conclusion: EVAR combined with antibiotics treatment is feasible, safe, and effective for Brucella aneurysms and represents a promising treatment option for these Brucella aneurysms., Clinical Impact: Brucella aneurysms are very rare but life-threatening, and a standard treatment approach has yet to be established. The traditional operation management strategy is surgical resection and debridement of the infected aneurysm and the surrounding tissues. However, open surgical management in these patients causes severe trauma with high surgical risks and mortality (13.3%-40%). We tried to treat Brucella aneurysms with endovascular therapy, and the technique success and survival rate of the operation reached 100%. EVAR combined with antibiotics treatment is feasible, safe, and effective for Brucella aneurysms and represents a promising treatment option for some mycotic aneurysms., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The significance of glomerular IgM deposit intensity in IgA Nephropathy (IgAN) remained ambiguous and requires further research. Patients with biopsy-proven IgAN in our hospital from January 2018 to May 2023 were recruited into this retrospective single-center study. Patients who presented with positive IgM deposit were included in IgM + cohort while patients with negative IgM deposit were included in IgM- cohort. Of the IgM+, patients whose IF intensity of IgM deposits exceeded 1+ formed IgM-H cohort while patients whose IF intensity of IgM deposits was equal to 1+ consisted IgM-L cohort. Pairwise comparisons were performed among these cohorts to determine clinical disparities, following the propensity score matching process. Among 982 IgAN patients, 539 patients presented with positive IgM deposit. The Kaplan-Meier analysis showed that the IgM deposit did not contribute adversely to the outcomes (eGFR decreased from the baseline ≥ 50% continuously or reached end-stage renal disease). However, the Cox regression analysis showed that increased intensity of IgM deposit was an independent risk factor ( p  = 0.03) in IgM+. The IgM-H exhibited more pronounced segmental glomerulosclerosis ( p  = 0.02) than the IgM-L, which may also be associated more directly with higher urine protein levels ( p  = 0.02). Moreover, our generalized linear mixed model demonstrated a remarkably higher urine albumin/creatinine ratio ( p  < 0.01) and serum creatinine ( p  = 0.04) levels as well as lower serum albumin ( p  < 0.01) level in IgM-H persistently during the 5-year follow-up. This study concluded that increased intensity of glomerular IgM deposits may contribute adversely to clinicopathologic presentation and outcome in those IgM + patients.

Objective: To analyze the epidemiological characteristics, clinical manifestations, antimicrobial resistance and develop a predictive model for severe pertussis spanning five years - before, during, and after the COVID-19 pandemic - in Shenzhen children's hospital in southern China, aiming to provide insights into the pandemic impact and control measures on the pertussis disease profile., Methods: Demographic, clinical, vaccination, and laboratory data were collected for patients who tested positive for pertussis by polymerase chain reaction and/or culture from January 1, 2019, to March 30, 2024. Analysis included changes in demographic and clinical features, indicators of severe cases, and resistance patterns over the study period., Results: During this period, 3963 patients were diagnosed, with 79 severe (PICU admitted) cases; 1433 isolates underwent antimicrobial susceptibility testing. In late 2023, pertussis cases began to increase. From 2019 to 2024, the proportion of cases among 4-6 year olds rose from 4.9 % to 28.6 %, and among 7-11 year olds from 0.7 % to 21.2 %. Macrolide resistance surged from 46.5 % in 2019 to 97.3 % in 2024, with 80 % of resistant hospitalized cases initially treated with macrolides. Clinical severity and co-infection increased post-pandemic, with a larger number of cases necessitating antibiotic changes and enhanced supportive care. Vaccination protected against severe disease. Indicators such as white blood cell count, lymphocyte to neutrophil ratio, platelet count, cyanosis and pneumonia predicted disease severity., Conclusions: Post-pandemic, pertussis cases shifted from infants to school-aged children, with increased clinical severity and high macrolide resistance. Urgent measures are needed to optimize vaccination schedules and develop management strategies addressing and changing epidemiological patterns., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)