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Abstract Background To evaluate the changes of retinal and choroidal microvascular including the superficial retinal capillary plexus (SCP), deep retinal capillary plexus (DCP), choriocapillaris (CC), and central retinal thickness (CRT) in high myopic eyes after the implantable collamer lens with a central hole (ICL V4c) implantation using optical coherence tomography angiography (OCTA). Methods This retrospective study included 30 eyes of 30 patients (14 males and 16 females) who underwent ICL V4c implantation in Tianjin Aier Eye Hospital from October 2022 to May 2023. Uncorrected distant visual acuity (UDVA), best corrected distance visual acuity (BDVA), intraocular pressure (IOP), spherical equivalent (SE), axial length (AL), and optical coherence tomography angiography (OCTA) were measured and assessed before surgery, and 1 week, 1 month, and 3 months after surgery. OCTA was used to image and measure several key indicators: the foveal avascular zone (FAZ), vascular density (VD) of the SCP and DCP, blood flow density (BD) of the CC, and CRT. All measurement data were obtained utilizing the instrument’s proprietary software, ensuring accuracy and consistency. Results UDVA were significant improvements at the 1 week, 1 month, and 3 months after ICL V4c implantation surgery. BDVA, FAZ, and CRT maintained stable, however, IOP was higher at 1 week and 3 months post-operation compared to 1-month post-operation. The statistically significant difference was identified within the S3, S7, and S9 of SCP at each time point before and after the surgery (P 1 = 0.004; P 2 = 0.014; P 3 = 0.037). However, paired analyses showed that there was a significant decrease in VD of S3 at 1 week after ICL V4c implantation surgery (P 0.05), and the increase in VD of the S7 region at 1 month after ICL V4c implantation, which is significant compared to 1 week post-surgery, but not compared to preoperative levels. An overall comparison of the BD of the CC (2 mm) at each time point showed a statistically significant difference (P = 0.029). Conclusion ICL V4c implantation offers a safe and efficient therapy to the high myopic patients. However, the retinal and choroidal microvascular changes need to be paid attention to in post-ICL implantation patients.

Abstract Background 5-Aminolevulinic acid (ALA) recently received much attention due to its potential application in many fields such as medicine, nutrition and agriculture. Metabolic engineering is an efficient strategy to improve microbial production of 5-ALA. Results In this study, an ALA production strain of Escherichia coli was constructed by rational metabolic engineering and stepwise improvement. A metabolic strategy to produce ALA directly from glucose in this recombinant E. coli via both C4 and C5 pathways was applied herein. The expression of a modified hemA RS gene and rational metabolic engineering by gene knockouts significantly improved ALA production from 765.9 to 2056.1 mg/L. Next, we tried to improve ALA production by RGMS-directed evolution of eamA gene. After RGMS, the ALA yield of strain A2-ASK reached 2471.3 mg/L in flask. Then, we aimed to improve the oxidation resistance of cells by overexpressing sodB and katE genes and ALA yield reached 2703.8 mg/L. A final attempt is to replace original promoter of hemB gene in genome with a weaker one to decrease its expression. After 24 h cultivation, a high ALA yield of 19.02 g/L was achieved by 108-ASK in a 5 L fermenter. Conclusions These results suggested that an industrially competitive strain can be efficiently developed by metabolic engineering based on combined rational modification and optimization of gene expression.

AIM: To analysis of research hotspots and trends on the application of premium intraocular lens (PIOLs) in the past 2 decades. METHODS: The literature search was performed on the Web of Science and included PIOLs studies published between January 2000 and December 2022. The retrieved literature was collated and analyzed by R-tool's Bibliometrix package, CitNetExplorer, CiteSpace and other software. RESULTS: A total of 1801 articles about PIOLs were obtained, most of which were published in Spain and the United States. The organization that published the most articles was the University of Valencia in Spain. Alió JL, and Montés-Micó R, from Spain were the most influential authors in this field. The Journal of Cataract and Refractive Surgery and Journal of Refractive Surgery were the core journals for this field; the top 10 cited articles mainly focus on postoperative satisfaction with multifocal intraocular lens (IOLs) and postoperative results of toric IOLs. Through the keyword analysis, we found that trifocal IOLs, astigmatism and extended depth of focus (EDoF) IOLs are the most discussed topics at present, and the importance of astigmatism and the clinical application of the new generation of PIOLs are the emerging research trends. CONCLUSION: Bibliometric analysis can effectively help to identify multilevel concerns in PIOLs research and the prevailing research trends in the realm of PIOLs encompass the adoption of EDoF IOLs, trifocal IOLs, and their respective Toric models.

Benefits from the powerful local modeling capability of deep convolutional neural networks (CNNs), remote-sensing image change detection (CD) has made significant progress. In recent years, the rise of transformers has further driven improvements in global feature extraction for bitemporal remote-sensing images. Some prior efforts have tried to integrate CNN and transformer, but they suffer from the limitation of inefficiently aggregating local features and contextual information. Besides, they struggle to refine change boundaries and exhibit inferior performance in detecting multiscale and subtle changes. To tackle these interrelated problems, we propose a difference-enhanced pyramid pooling dynamic sparse attention network (DPDANet) for CD, which integrates the potential of CNN and pyramid pooling dynamic sparse attention (PDSA) mechanism. Specifically, a pretrained EfficientNetV2-S network is first used to extract multilevel local fine-grained features. Then, a global semantic enhancement network based on well-designed PDSA mechanism is proposed to extract rich global contextual information. The proposed difference enhancement module combines long short-term memory and deformable convolution to emphasize relevant and irrelevant changes, capturing precise boundary details of the changing region. A decoder is then employed for step-by-step upsampling of encoded features, with skip connections between local multiscale features and globally enhanced features. Expensive experiments on four public CD datasets demonstrate that DPDANet outperforms state-of-the-art methods by reducing missed detections and false detections and achieving more accurate boundaries of the changing area.

Bartter syndrome (BS, OMIM #601678) is a rare inherited salt-losing tubulopathy characterized by hypokalemia metabolic alkalosis with secondary renin-angiotensin-aldosterone system activation. As reported, BS type 1 is generally presented prenatal and neonatal period, and symptoms usually appear before and after birth or in infancy, accompanied by severe salt loss, whilst kidney function remains mostly normal. In this study, we report a case of BS type 1 with childhood onset and proteinuria and renal impairment. The child was born preterm due to hyperamniotic fluid, but there were no apparent symptoms after birth until the age of 3 when the child began to present with polydipsia, polyuria and increased nocturnal uria. At the age of 5, she had elevated serum creatinine level and proteinuria. After admission, she was diagnosed with chronic tubulointerstitial disease and stage 2 chronic kidney disease(CKD). According to the chloride clearance test, the abnormal function of medullary thick ascending limb Henle′s loop, was confirmed and BS type 1 was diagnosed by gene sequencing. After active management of complications, kidney function of the child improved. In the long-term follow-up, the urinary protein amount of the child still increased, eGFR slowly decreased, and the child was currently in the CKD2 stage. Children with prenatal BS may not present typical clinical manifestations immediately after birth until the onset of relevant clinical symptoms in childhood. BS type 1 patients may have renal impairment, which needs to be identified in time. Clinical differentiation diagnosis between BS and Gitelman syndrome can be made by chloride clearance tests. Early diagnosis and treatment are critical to improve prognosis.

The nonlinear mechanical properties of ballasted tracks along railways result in complex dynamics of the vehicle–track systems. Employing localized characterization of ballast and a simplified model might underestimate the vehicle–track system’s dynamical responses and safety. This paper presents a new dynamical stiffness model of railway ballast by incorporating the ballast’s time-varying, nonlinear viscoelastic, and elastoplastic properties. The new nonlinear stiffness model is a versatile tool that comprehensively characterizes the ballast characteristics of displacement-dependent stiffness, frequency-dependent stiffness, hysteresis, and time/space-varying features. These features, widely reported in previous experimental research, can now be effectively understood. Conventionally, to characterize time/space-varying characteristics of ballast along the track, ground-penetrating radar (GPR) has been used as the most efficient approach to survey railway networks quickly and to infer track dynamical properties. Aiming to improve the present technique for characterizing time/space-varying properties of ballast stiffness by using a GPR signal, the adaptive optimal kernel time–frequency representation (AOKTFR) method is used to process a typical GPR signal from a railway ballast scanning. It is found that the results of AOKTFR exhibit a clear time-varying pattern and precise frequency modulation. In contrast, the conventional time–frequency methods failed to give a clear time-varying pattern. The results illustrate that AOKTFR is a practical approach for processing the time-varying nonlinear signal of GPR and correlating it with the time-varying nonlinear stiffness of ballast.

We propose a compound control framework to improve the path tracking accuracy of a four-wheel independent steering and driving (4WISD) vehicle in complex environments. The framework consists of a deep reinforcement learning (DRL)-based auxiliary controller and a dual-layer controller. Samples in the 4WISD vehicle control framework have the issues of skewness and sparsity, which makes it difficult for the DRL to converge. We propose a group intelligent experience replay (GER) mechanism that non-dominantly sorts the samples in the experience buffer, which facilitates within-group and between-group collaboration to achieve a balance between exploration and exploitation. To address the generalization problem in the complex nonlinear dynamics of 4WISD vehicles, we propose an actor-critic architecture based on the method of two-stream information bottleneck (TIB). The TIB method is used to remove redundant information and extract high-dimensional features from the samples, thereby reducing generalization errors. To alleviate the overfitting of DRL to known data caused by IB, the reverse information bottleneck (RIB) alters the optimization objective of IB, preserving the discriminative features that are highly correlated with actions and improving the generalization ability of DRL. The proposed method significantly improves the convergence and generalization capabilities of DRL, while effectively enhancing the path tracking accuracy of 4WISD vehicles in high-speed, large-curvature, and complex environments.

Dry age-related macular degeneration (AMD) is one of the main diseases that causes blindness in humans, and the number of cases is increasing yearly. However, effective treatments are unavailable, and arbutin (ARB) has been reported to have antioxidant, anti-inflammatory, and anti-aging effects in other age-related diseases. However, whether ARB can be used to treat dry AMD remains unknown. To explore the therapeutic potential and molecular mechanism of arbutin in the treatment of dry AMD. MTT assays, reactive oxygen species (ROS) production assays, flow cytometry assays, qPCR and western blotting were used to assess the impact of ARB on human RPECs induced by H2O2. A transcriptome sequencing assay was used to further explore how ARB acts on human RPECs treated with H2O2. Hematoxylin and eosin (H&E) staining and total antioxidant capacity (T-AOC) assays were used to observe the impact of ARB on mouse retina induced by sodium iodate. ARB counteracted the H2O2-induced reduction in human RPECs viability, ARB reversed H2O2-induced cellular ROS production by increasing the expression of antioxidant-related genes and proteins, ARB also reversed H2O2-induced cell apoptosis by altering the expression of apoptosis-related genes and proteins. Transcriptome sequencing and western blotting showed that ARB reduced ERK1/2 and P-38 phosphorylation to prevent H2O2-induced oxidation damage. The in vivo experiments demonstrated that ARB protected against retinal morphology injury in mice, increased serum T-AOC levels and increased antioxidant oxidase gene expression levels in the mouse retina induced by sodium iodate. We concluded that ARB reversed the H2O2-induced decrease in human RPECs viability through the inhibition of ROS production and apoptosis. The ERK1/2 and P38 MAPK signaling pathways may mediate this process. ARB maintained retinal morphology, increased serum T-AOC level and improved the expression of antioxidant oxidase genes in mice.

Phylogenetic methods have long been used in biology and more recently have been extended to other fields—for example, linguistics and technology—to study evolutionary histories. Galaxies also have an evolutionary history and fall within this broad phylogenetic framework. Under the hypothesis that chemical abundances can be used as a proxy for the interstellar medium’s DNA, phylogenetic methods allow us to reconstruct hierarchical similarities and differences among stars—essentially, a tree of evolutionary relationships and thus history. In this work, we apply phylogenetic methods to a simulated disk galaxy obtained with a chemodynamical code to test the approach. We found that at least 100 stellar particles are required to reliably portray the evolutionary history of a selected stellar population in this simulation, and that the overall evolutionary history is reliably preserved when the typical uncertainties in the chemical abundances are smaller than 0.08 dex. The results show that the shapes of the trees are strongly affected by the age–metallicity relation, as well as the star formation history of the galaxy. We found that regions with low star formation rates produce shorter trees than regions with high star formation rates. Our analysis demonstrates that phylogenetic methods can shed light on the process of galaxy evolution.

Aiming at the abuse of gaseous substances such as nitrous oxide (N2O), the detection method based on the combination of quantum cascade laser and wavelength modulation technology can detect the concentration of nitrous oxide exhumed by users, and realize the rapid on-site identification of users. Aiming at the measurement error caused by laser light intensity jitter, a digital phase-locked amplifier for trace N2O gas detection is proposed. The laser light stress modulator is integrated in the phase-locked amplifier. When the mercury cadmium telluride detector receives the absorbed light intensity signal, the first and second harmonics are demodulated in FPGA at the same time, and the second harmonics are normalized to avoid the influence of light intensity jitter on the measurement. The performance of the detection system is evaluated by using the phase-locked amplifier. The mass flow controller is used to set different concentrations of N2O gas. When the laser modulation frequency is 5 kHz, the linear fitting degree between the normalized second harmonic peak value and the N2O gas concentration is 0.992 1. The detection system detection limit is evaluated using Allan variance. When the system integration time is 0.1 s, the detection limit of N2O gas is 17.7 x 10-9 ; when the integration time is 6.3 s, the detection limit of N2O gas reached its lowest value of 8.9x10-9. The phase-locked amplifier has the advantages of high integration, fast detection speed and high signal-to-noise ratio, and is suitable for the field rapid detection of trace N2O gas. [ABSTRACT FROM AUTHOR]

Off-axis integrated cavity output spectroscopy (OA-ICOS) has attracted much interest because it potentially allows highly sensitive field measurements with robust optical alignment. In this paper, a novel instrument that employs a high-finesse optical cavity as an absorption cell has been developed for sensitive measurements of multi-component gases N2O, H2O and CO in the atmosphere based on a mid-infrared quantum cascade laser (QCL) and OA-ICOS. In order to improve the energy utilization and increase the signal-to-noise ratio (SNR) of the signal, a new type of optical path structure of the laser re-injection method is adopted. Furthermore, the system performance can be effectively improved by using a new intervention method of injecting radio frequency (RF) white noise into a laser driver to suppress cavity mode noise and combining the wavelength modulation method (WMS). We compared the sensitivity of the second harmonic signal demodulation between the re-injection method and the standard OA-ICOS, and the SNR increased by 2.68 times compared to the latter. Analysis of the spectral measurements with Allan variance indicates that within an integration time of 1 s, the measurement accuracy of N2O, H2O, and CO is 6.71 ppb, 13.945 ppm, and 1.81 ppb, respectively, and within an integration time of 820 s, the measurement accuracy of N2O, H2O, and CO can be further improved to 1.26 ppb, 2.089 ppm, and 172 ppt, respectively. Our approach represents an underlying analytical method that provides guidelines for monitoring of representative gases in the atmosphere, industrial processes, emergency safety, etc. [ABSTRACT FROM AUTHOR]

This study aimed to explore the effects of thinning years on the water holding capacity of litter layer and soil layer in Chinese fir forest, thus to provide a scientific basis for evaluating the response of water conservation function of Chinese fir forest to thinning. In Jingning County, southwest Zhejiang Province, the Chinese fir forest with thinning for 1 year, 3 years, 8 years and unthinning was selected as the research object, and the litter and soil samples were collected. Then, the moisture content, water holding capacity, soil bulk density, non-capillary porosity of litter were analyzed and measured, and the relevant indexes were calculated. The results showed that there was no significant difference in the litter stock on hand of Chinese fir forest among different thinning years (P>0.05). The relationship between litter water holding capacity, water holding rate and water immersion time was in accordance with logarithmic function and power function, respectively. The maximum water holding capacity, maximum retention rate and effective retention rate of litter layer in Chinese fir forest with thinning for 8 years were significantly higher than those in the unthinned forest (P<0.05). The maximum water holding capacity and effective retention rate of litter layer in Chinese fir forest with thinning for 3 years and 8 years were significantly higher than those in unthinned forest (P<0.05). After thinning for 8 years, the soil bulk density of 0-10 cm soil layer in Chinese fir forest was significantly decreased (P<0.05), the non-capillary porosity was significantly increased, and the non-capillary water holding capacity was significantly increased by 22.4% (P<0.05). However, there was no significant effect on the related indicators of soil water storage performance in 10-30 cm soil layer (P>0.05). In conclusion, the water conservation function of litter layer and soil layer in Chinese fir forest was enhanced with the extension of thinning years. [ABSTRACT FROM AUTHOR]

In this study, a π-shaped main beam with typical geometric characteristic parameters was selected for conducting wind tunnel tests, and the characteristics of the buffeting force were measured. Based on the measured results, numerical expansion research was conducted using the narrowband synthetic random flow generation (NSRFG) turbulent inlet method, and a grid strategy was provided. By changing the geometric characteristic parameters of the π-shaped girder, a comparative study was conducted using proper orthogonal decomposition (POD) and dynamic mode decomposition (DMD) methods, revealing the influence of cross-sectional geometric characteristic parameters on the buffeting force characteristics and analyzing their mechanism of action. The results indicate that the inlet wind parameters of the NSRFG need to be adapted to the grid size. The grid filter size at the front end of the model should be smaller than 0.193 of the along-wind turbulence integral scale, which can then be used to solve for 80% of the turbulent kinetic energy. The smaller the aspect ratio is, the larger the buffeting force spectrum is, and the smaller the opening ratio is, the smaller the buffeting force spectrum is. The opening ratio strongly influences the buffeting lift spectrum, and the aspect ratio strongly influences the buffeting drag spectrum. The POD decomposition indicates that the geometric characteristic parameters affect the shape, strength, position, and direction of vortices at the section opening. DMD decomposition indicates that geometric feature parameters affect the frequency and growth rate of dominant modes as well as the directionality and regularity of vortex distribution. [ABSTRACT FROM AUTHOR]

Laser peen forming (LPF) is an appealing technique for forming metal sheets using high-energy, short-duration laser pulses. The deformation of the target metal plate is closely related to the magnitude and distribution of laser-induced residual stress. Consequently, the relationship between process parameters and residual stress is worth researching. In this research, two process parameters in LPF, laser energy and coverage ratio (spot distance essentially), and one workpiece parameter, plate thickness, were examined through an element method (FEM) of multiple square-spot laser shock peening (SSLSP). Corresponding experiments of SSLSP on aluminum alloy 2024-T351 test blocks were conducted, together with an X-ray diffraction (XRD) residual stress measurement and a surface morphology observation. The FEM simulation and experimental results show that congested laser spots had a significant influence on the magnitude of compressive residual stress; higher laser energy was beneficial to the depth of the compressive stress layer but could decrease its magnitude. Therefore, for better forming ability, higher laser energy and a higher coverage ratio are beneficial; for surface strengthening, laser energy should not be too large, and the coverage ratio should be larger than 100% to ensure that the residual stress on the treated surface is compressive, resulting in better surface integrity.

Abstract Background The cotton whitefly (Bemisia tabaci) is a major global pest, causing significant crop damage through viral infestation and feeding. Traditional B. tabaci recognition relies on human eyes, which requires a large amount of work and high labor costs. The pests overlapping generations, high reproductive capacity, small size, and migratory behavior present challenges for the real-time monitoring and early warning systems. This study aims to develop an efficient, high-throughput automated system for detection of the cotton whiteflies. In this work, a novel tool for cotton whitefly fast identification and quantification was developed based on deep learning-based model. This approach enhances the effectiveness of B. tabaci control by facilitating earlier detection of its establishment in cotton, thereby allowing for a quicker implementation of management strategies. Results We compiled a dataset of 1200 annotated images of whiteflies on cotton leaves, augmented using techniques like flipping and rotation. We modified the YOLO v8s model by replacing the C2f module with the Swin-Transformer and introducing a P2 structure in the Head, achieving a precision of 0.87, mAP50 of 0.92, and F1 score of 0.88 through ablation studies. Additionally, we employed SAHI for image preprocessing and integrated the whitefly detection algorithm on a Raspberry Pi, and developed a GUI-based visual interface. Our preliminary analysis revealed a higher density of whiteflies on cotton leaves in the afternoon and the middle-top, middle, and middle-down plant sections. Conclusion Utilizing the enhanced YOLO v8s deep learning model, we have achieved precise detection and counting of whiteflies, enabling its application on hardware devices like the Raspberry Pi. This approach is highly suitable for research requiring accurate quantification of cotton whiteflies, including phenotypic analyses. Future work will focus on deploying such equipment in large fields to manage whitefly infestations.

Abstract Background Macrophage-based cell therapy is promising in solid tumors, but the efficient acquisition of macrophages remains a challenge. Induced pluripotent stem cell (iPSC)-induced macrophages are a valuable source, but time-consuming and costly. The application of reprogramming technologies allows for the generation of macrophages from somatic cells, thereby facilitating the advancement of cell-based therapies for numerous malignant diseases. Methods The composition of CD45+ myeloid-like cell complex (MCC) and induced macrophage (iMac) were analyzed by flow cytometry and single-cell RNA sequencing. The engraftment capacity of CD45+ MCC was evaluated by two transplantation assays. Regulation of c-Myc on MafB was evaluated by ChIP-qPCR and promoter reporter and dual luciferase assays. The phenotype and phagocytosis of iMac were explored by flow cytometry and immunofluorescence. Leukemia, breast cancer, and patient-derived tumor xenograft models were used to explore the anti-tumor function of iMac. Results Here we report on the establishment of a novel methodology allowing for reprogramming fibroblasts into functional macrophages with phagocytic activity by c-Myc overexpression. Fibroblasts with ectopic expression of c-Myc in iPSC medium rapidly generated CD45+ MCC intermediates with engraftment capacity as well as the repopulation of distinct hematopoietic compartments. MCC intermediates were stably maintained in iPSC medium and continuously generated functional and highly pure iMac just by M-CSF cytokine stimulation. Single-cell transcriptomic analysis of MCC intermediates revealed that c-Myc up-regulated the expression of MafB, a major regulator of macrophage differentiation, to promote macrophage differentiation. Characterization of the iMac activity showed NF-κB signaling activation and a pro-inflammatory phenotype. iMac cells displayed significantly increased in vivo persistence and inhibition of tumor progression in leukemia, breast cancer, and patient-derived tumor xenograft models. Conclusions Our findings demonstrate that c-Myc alone is enough to reprogram fibroblasts into functional macrophages, supporting that c-Myc reprogramming strategy of fibroblasts can help circumvent long-standing obstacles to gaining “off-the-shelf” macrophages for anti-cancer immunotherapy.

Abstract Recent years have witnessed notable advancements in medical image segmentation through deep convolutional neural networks. However, a notable limitation lies in the local operation of convolution, which hinders the ability to fully exploit global semantic information. To overcome the challenges prevalent in medical image segmentation, the feature ensemble network with multi‐scale atrous transformer is proposed. At the core of the approach lies the multi‐scale contextual integration module, which is based on the multi‐scale atrous transformer and facilitates contextual integration of multi‐level features. To extract discriminative fine‐grained features of the target region, a hybrid attention mechanism that synergistically combines spatial and channel attention, thereby sharpening the model's focus on crucial target information within high‐level features, is incorporated. Additionally, the channel‐aware feature reconstruction module is introduced as an innovative component engineered to tackle feature similarity issues across different categories. This module performs feature reconstruction based on channel perception, effectively widening the feature gap between categories and enhancing the segmentation capability. It is worth mentioning that our approach surpasses the state‐of‐the‐art method using three benchmark datasets in medical image segmentation.

Current analysis of fragile bronzes mainly relies on the research of two-dimensional aspects such as sample cross-sections and surfaces while typically utilizing optical and electronic microscopy, Raman spectroscopy, and X-ray fluorescence spectroscopy (XRF). As a fast and nondestructive testing method, computer tomography (CT) can be used to characterize and detect the internal structures, corrosion conditions, and corrosion distribution of bronzes. This study used the CT imaging results of fragile bronzes to analyze, locate, and measure corrosion in fragile bronzes quickly and accurately, thus providing strong support for corrosion evaluation and protection research of fragile bronzes. The results verified the value and application prospects of CT technology in the protection of cultural relics.

Abstract. Background:. Pulmonary embolism (PE) is a severe and acute cardiovascular syndrome with high mortality among patients with autoimmune inflammatory rheumatic diseases (AIIRDs). Accurate prediction and timely intervention play a pivotal role in enhancing survival rates. However, there is a notable scarcity of practical early prediction and risk assessment systems of PE in patients with AIIRD. Methods:. In the training cohort, 60 AIIRD with PE cases and 180 age-, gender-, and disease-matched AIIRD non-PE cases were identified from 7254 AIIRD cases in Tongji Hospital from 2014 to 2022. Univariable logistic regression (LR) and least absolute shrinkage and selection operator (LASSO) were used to select the clinical features for further training with machine learning (ML) methods, including random forest (RF), support vector machines (SVM), neural network (NN), logistic regression (LR), gradient boosted decision tree (GBDT), classification and regression trees (CART), and C5.0 models. The performances of these models were subsequently validated using a multicenter validation cohort. Results:. In the training cohort, 24 and 13 clinical features were selected by univariable LR and LASSO strategies, respectively. The five ML models (RF, SVM, NN, LR, and GBDT) showed promising performances, with an area under the receiver operating characteristic (ROC) curve (AUC) of 0.962–1.000 in the training cohort and 0.969–0.999 in the validation cohort. CART and C5.0 models achieved AUCs of 0.850 and 0.932, respectively, in the training cohort. Using D-dimer as a pre-screening index, the refined C5.0 model achieved an AUC exceeding 0.948 in the training cohort and an AUC above 0.925 in the validation cohort. These results markedly outperformed the use of D-dimer levels alone. Conclusion:. ML-based models are proven to be precise for predicting the onset of PE in patients with AIIRD exhibiting clinical suspicion of PE. Trial Registration:. Chictr.org.cn: ChiCTR2200059599.

Abstract Objective Based on the Omaha problem classification system, a sensitivity outcome index system for home nursing of elderly liver transplant patients was established. Methods Through a comprehensive literature review and rigorous application of the Delphi method, a panel of 20 experts completed two rounds of effective letter consultation to obtain expert consensus opinions. The contents of indicators were determined based on this process, and the analytic hierarchy process was employed to confirm the weightage assigned to each indicator. Consequently, we established a sensitivity outcome index system for home care in elderly liver transplant patients. Results The effective recovery rate of the questionnaire in two rounds of expert consultation was 100%, and the proportion of experts who gave opinions was 55% and 15%, respectively, indicating that the experts were highly active. The expert authority coefficients were calculated as 0.904 and 0.905, respectively, indicating a high degree of expert authority. In the second round, Kendall’s coordination coefficients for primary, secondary, and tertiary indicators were determined to be 0.419, 0.418, and 0.394 (P

We investigated the effect of different fat sources on growth performance and intestinal health in weaned piglets. A total of 72 21-day-old weaned piglets were divided into 3 groups the CON group with 2.5% soybean oil, TRE1 with 2.5% emulsified balanced oil powder and TRE2 with 2.5% emulsified coconut oil powder. These two experimental oil powders were emulsified with the emulsifier (lysophospholipid). The average daily feed intake in TRE1 was significantly higher than that in CON (P < 0.05). The apparent total tract digestibility (ATTD) of ash in TRE1 was significantly higher than that in CON (P < 0.05). Compared with CON, TRE1 tended to improve ATTD of dry matter (P = 0.075), serum triglyceride (P = 0.062) and serum-free fatty acids (P = 0.090). The jejunal villus width of piglets in TRE1 and TRE2 was significantly increased (P < 0.05) and the duodenal crypt depth was significantly decreased (P < 0.05). Compared with CON, TRE1 significantly increased the mRNA expression levels of jejunal Occludin, Claudin-1 and ZO-1 (P < 0.05). From the results of the present study, we concluded that dietary supplementation of 2.5% emulsified balanced oil powder has more obvious effects on enhancing the growth performance of weaned piglets by improving lipid metabolism, intestinal tissue development and barrier function.

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders related to adrenal steroid biosynthesis, and mainly caused by mutations in the CYP21A2 gene encoding 21-hydroxylase. Adrenal tumors are common in CAH, but functional adrenal tumors are rare. Here, we report a 17-year-old female with virilized external genitalia and primary amenorrhea, accompanied by a right adrenal tumor. Her 17-OHP level was normal, cortisol and androgen levels were significantly elevated, and the tumor pathology showed adrenal cortical adenoma. Gene testing for CYP21A2 showed c.518T > A in exon 4 and c.29313C > G in intron 2. The possibility of untreated classic CAH with 21-OH deficiency causing functional adrenal cortical adenoma should be considered. When clinical diagnosis highly considers CAH and cannot rule out the influence of functional adrenal tumors’ secretion function on 17-OHP, gene mutation analysis should be performed.

IntroductionAggressive behaviors in the online gaming world are frequent and have far-reaching negative effects.MethodTo explore the factors and mechanisms of aggressive in games, we surveyed 945 university students using a framework of social dominance orientation, online disinhibition, moral disengagement, and aggression in gaming, and examined the moderating role of gender traits.ResultsWe found no direct relationship between online disinhibition and aggression in gaming; however, through the mediating role of moral disengagement, online disinhibition indirectly affected aggression in gaming behavior and enhanced social dominance orientation. Social dominance orientation predicted both moral disengagement and aggression in gaming behaviors, and the mediating effect of moral disengagement was confirmed through the indirect influence of moral disengagement on aggression in gaming behavior. Moreover, the moral disengagement mechanism significantly predicted aggression in gaming behavior. Furthermore, femininity and androgyny moderated both social dominance orientation toward moral disengagement and aggression in gaming, while masculinity and androgyny moderated the path from online disinhibition to social dominance orientation. Regarding the path from moral disengagement to aggression, all gender trait moderations were significant.DiscussionThis study reveals the role of the moral disengagement mechanism in the process of game-related aggression, providing theoretical support for the explanation of aggressive behavior, which applies to players of any gender. Moreover, this study confirms the moderating role of gender. Unlike biological sex, gender traits are malleable; androgynous traits offer greater adaptability in various environments. Thus, prevention and intervention efforts against online aggression should include strengthening moral education and properly guiding and fostering androgynous gender traits.

The tumor suppressor p53 is a transcription factor involved in a variety of crucial cellular functions, including cell cycle arrest, DNA repair and apoptosis. Still, a growing number of studies indicate that p53 plays multiple roles in spermatogenesis, as well as in the occurrence and development of male infertility. The representative functions of p53 in spermatogenesis include the proliferation of spermatogonial stem cells (SSCs), spermatogonial differentiation, spontaneous apoptosis, and DNA damage repair. p53 is involved in various male infertility-related diseases. Innovative therapeutic strategies targeting p53 have emerged in recent years. This review focuses on the role of p53 in spermatogenesis and male infertility and analyses the possible underlying mechanism involved. All these conclusions may provide a new perspective on drug intervention targeting p53 for male infertility treatment.

Abstract Background Chronic kidney disease (CKD) is a significant public health concern, and patient self-management is an effective approach to manage the condition. Mobile applications have been used as tools to assist in improving patient self-management, but their effectiveness in long-term outpatient follow-up management of patients with CKD remains to be validated. This study aimed to investigate whether using a mobile application combined with traditional outpatient follow-up can improve health outcomes of patients with CKD . Methods This retrospective cohort study recruited CKD patients with stage 1–5 who were not receiving renal replacement therapy from a CKD management center. Two groups were established: the APP + outpatient follow-up group and the traditional outpatient follow-up group. Baseline data was collected from January 2015 to December 2019, followed by a three-year long-term follow-up until December 2022. Laboratory data, all-cause mortality, and renal replacement treatment were then collected and compared between the two groups. Results 5326 patients were included in the study, including 2492 in the APP + outpatient group and 2834 in the traditional outpatient group. After IPTW virtualization matching, the final matched the APP + outpatient group consisted of 2489 cases (IQR, 33–55) and 2850 (IQR, 33–55) in the traditional outpatient group. By the end of the study, it was observed that the laboratory data of Phosphorus, Sodium, Triglyceride, Hemoglobin showed significant improvements, Furthermore the APP + outpatient group demonstrated superior results compared to the traditional outpatient group (P

Abstract Objective This study aims to evaluate the feasibility and applicability of an online cervical cancer screening program using a website as the public platform and self-collected HPV testing as the primary screening method. Methods A website (mcareu.com) was developed to facilitate the online cervical cancer screening program by Peking University Shenzhen Hospital (PUSH). Women in Shenzhen could register for participation on the website by providing essential demographic data. Sampling kits and specimens were delivered through regular logistics. Eligible women collected vaginal samples by themselves using the provided kits and in referring of the graphic guidance. The specimens were tested for HPV at PUSH or a reference lab, and the results were accessible on the website through participants' personal accounts. Participants who tested positive for high-risk HPV were scheduled for colposcopy and biopsies. The demographic and social background data of the eligible participants were analyzed to evaluate the feasibility and applicability of the online screening approach. Results A total of 1712 applicants registered for participation, with 99.9% (1710/1712) completing registration with full data. The analysis included 1560 applicants aged 30–59, with an average age of 41.1 (± 7.6) years. Among them, 83.3% (1299/1560) provided self-collected samples for testing. Age-group analysis revealed an overall sample provision rate (SPR) exceeded 80% in all age groups. A significant difference in SPR was observed only between the 30–34 and 45–49 age groups (p

Chemicals are commonly dosed in sewer systems to reduce the emission of hydrogen sulfide (H2S) and methane (CH4), incurring high costs and environmental concerns. Nitrite dosing is a promising approach as nitrite can be produced from urine wastewater, which is a feasible integrated water management strategy. However, nitrite dosing usually requires strict conditions, e.g., relatively high nitrite concentration (e.g., ∼200 mg N/L) and acidic environment, to inhibit microorganisms. In contrast to “microbial inhibition”, this study proposes “microbial utilization” concept, i.e., utilizing nitrite as a substrate for H2S and CH4 consumption in sewer. In a laboratory-scale sewer reactor, nitrite at a relatively low concentrations of 25–48 mg N/L was continuously dosed. Two nitrite-dependent microbial utilization processes, i.e., nitrite-dependent anaerobic methane oxidation (n-DAMO) and microbial sulfide oxidation, successfully occurred in conjunction with nitrite reduction. The occurrence of both processes achieved a 58 % reduction in dissolved methane and over 90 % sulfide removal in the sewer reactor, with microbial activities measured as 15.6 mg CH4/(L·h) and 29.4 mg S/(L·h), respectively. High copy numbers of n-DAMO bacteria and sulfide-oxidizing bacteria (SOB) were detected in both sewer biofilms and sediments. Mechanism analysis confirmed that the dosed nitrite at a relatively low level did not cause the inhibition of sulfidogenic process due to the downward migration of activity zones in sewer sediments. Therefore, the proposed “microbial utilization” concept offers a new alternative for simultaneous removal of sulfide and methane in sewers.

Background: More than half the domestic population in China were infected with COVID-19 in two months after ending “zero-infection policy”, which severely overwhelmed frontline healthcare providers with stress and fear. However, there is no study to date investigating the associations between nurses' fear of pandemic and cyberchondria. This study aimed to 1) investigate the correlations between fear pandemic and cyberchondria among frontline nurses, and 2) discover its potential mechanism. Methods: A cross-sectional sample of frontline nurses (N = 8161) was recruited from 98 hospitals across China in February 2023. Participants were invited to complete an online, self-rated standardized questionnaire focused on pandemic fear, alexithymia, psychological distress, and cyberchondria. Environmental, clinical and socioeconomic information were collected for adjustment while conducting chain mediation analysis. Results: When other covariates were controlled, it was found that fear of the pandemic significantly contributed to cyberchondria (b = 0.58, 95%CI [0.56, 0.60], p

IntroductionFeeding bamboo powder is a kind of fiber raw material mainly composed of insoluble dietary fiber (IDF). In this study, IDF-based rice husk meal and feeding bamboo powder were used to compare the effects of bamboo fiber on fecal microflora and the performance of lactating sows and their offspring piglets.MethodsThirty healthy crossbred gilts (Yorkshire × Landrace) at day 105 of gestation were randomly allocated into three groups: CON, TRE1 supplemented with 2% BBF1 (feeding bamboo powder), and TRE2 supplemented with 2% BBF2 (99% feeding bamboo powder +1% bamboo fiber polymer material). The reproductive performance, serum indexes, and fecal microbiota of sows and piglets were analyzed. The results showed that, compared with CON, the average feed intake of sows in TRE1 during the second week of lactation was significantly increased by 21.96% (p

Objective This study endeavors to introduce the statistical process control (SPC) method to analyze the quality control index concerning red blood cells in additive solution with leukocytes reduced, with the aspiration to advance the effective utilization of blood quality control data, thereby providing empirical foundations for the continual enhancement of blood quality. Methods Between 2020 and 2022, test data pertaining to the quality control index of red blood cells in additive solution with leukocytes reduced were amassed from six blood stations in Chongqing area. Utilizing Minitab software, the SPC analysis was carried out, p-control charts were delineated, the non-conformance rates of each quality control index along with their 95% confidence intervals were computed, as well as the Process Capability Index (Z value). Results In accordance with the Whole Blood and Blood Components Quality Requirements, the appraisal of the quality control indexes for red blood cells in additive solution with leukocytes reduced manifested a conformity rate of 100% for appearance, end-of-storage hemolysis rate and sterility test. Nonetheless, the conformity rates for volume, hemoglobin, hematocrit and residual leukocytes did not attain 100%, albeit all were ≥75%. Through the employment of binomial distribution-based p-control charts, the controlled state of the production process was discerned. Although the overarching conformity rate satisfied the national standard stipulations, it was discerned that there were out-of-control points concerning volume, hemoglobin, hematocrit, and residual leukocytes across different institutions, exhibiting palpable trends. The non-conformance rates of all quality control indexes were less than 25%, yet at a 95% confidence level, the residual leukocyte counts from institutions B, C, E, and F did not adhere to the stipulations (exceeding 25%). By architecting the ability evaluation index Z value for count data process capability analysis, it was unveiled that the volume of institution E, the hematocrit of institutions B, C, and F, and the residual leukocytes Z values of all six blood collection and supply institutions were below 2, hinting at avenues for amelioration. Conclusion The SPC method anchored in binomial distribution exhibits substantial application merit in blood component quality management, facilitating real-time surveillance of blood collection, preparation, and storage procedures.