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This article discusses a case of Purtscher-like retinopathy (PLR) in a 61-year-old woman with diffuse cutaneous systemic scleroderma. The patient presented with slightly blurred vision and was diagnosed with bilateral PLR upon ophthalmologic examination. Fundus photography and ultra-widefield OCT-angiography revealed multiple cotton-wool spots, Purtscher flecken, and intraretinal hemorrhages. The patient received plasma exchange and symptomatic therapy but unfortunately passed away 10 days later due to refractory heart failure and cardiogenic shock. PLR is a rare occlusive microangiopathy associated with systemic conditions, and this case adds to the limited number of reported cases associated with systemic scleroderma. [Extracted from the article]

Cu2MgSnS4 (CMTS) nanoparticles are successfully prepared via a solvothermal approach. X-ray diffraction (XRD) and Raman reveal that pure zinc-blende CMTS phase is obtained. Scanning electron microscopy (SEM) shows that CMTS nanoparticles exhibit microsphere structure. The band gap of as-obtained CMTS nanoparticles is calculated to be 1.68eV, indicating a potential candidate for tandem solar cells. The degradation rate of methylene blue (MB) with under visible-light irradiation is about 87%, indicating that CMTS can be useful for effective visible-light photocatalyst. [ABSTRACT FROM AUTHOR]

The phylum Gemmatimonadota is widespread but rarely cultured and, in fact, there are only six described species isolated from soil, freshwater, and wastewater treatment. However, no isolates of Gemmatimonadota from marine environment have been described; thus, little is known about the physiology and metabolism of members of the marine lineages. In this study, four novel facultatively anaerobic bacterial strains belonging to Gemmatimonadota were isolated from marine sediments collected from Xiaoshi Island in Weihai, China, using an aerobic enrichment method. The integrated results of phylogenetic and phenotypic characteristics supported that these four strains represent one novel species in a novel genus, for which the name Gaopeijia maritima gen. nov., sp. nov. is proposed, as the first representative of novel taxa, Gaopeijiales ord. nov., Gaopeijiaceae fam. nov. in the class Longimicrobiia. Gaopeijiales was detected in 22,884 out of 95,549 amplicon data sets, mainly from soil. However, the highest mean relative abundances were in sponge (0.7%) and marine sediment (0.35%), showing salt-related character. Most of the Gaopeijiales subgroups potentially belong to the rare bacterial biosphere. The aerobic enrichment in this study could significantly increase the relative abundance of Gaopeijiales (from 0.37% to 2.6%). Furthermore, the metabolic capabilities inferred from high-quality representative Gaopeijiales genomes/MAGs suggest that this group primarily performs chemoorganoheterotrophic metabolism with facultatively anaerobic characteristics and possesses various secondary metabolite biosynthesis gene clusters (BGCs), mirroring those observed in the four novel strains.IMPORTANCEDespite rapid advances in molecular and sequencing technologies, obtaining pure cultures remains a crucial research goal in microbiology, as it is essential for a deeper understanding of microbial metabolism. Gemmatimonadota is a widespread but rarely cultured bacterial phylum. Currently, there are only six cultured strains of this interesting group, all isolated from non-marine environments. Little is known about the physiology and metabolism of members of the marine lineages. Here we isolated and characterized four novel marine strains, and proposed a new order Gaopeijiales within Gemmatimonadota . Furthermore, the global distribution, environmental preference, and metabolic potential of Gaopeijiales are analyzed using public data. Our work enriches the resources available for the under-represented phylum Gemmatimonadota and provides insights into the physiological and metabolic characteristics of the marine lineage ( Gaopeijiales ) through culturology and omics.

Life depends on a conserved set of chemical energy currencies that are relics of early biochemistry. One of these is ATP, a molecule that, when paired with a divalent metal ion such as Mg 2+ , can be hydrolyzed to support numerous cellular and molecular processes. Despite its centrality to extant biochemistry, it is unclear whether ATP supported the function of ancient enzymes. We investigate the evolutionary necessity of ATP by experimentally reconstructing an ancestral variant of the N 2 -reducing enzyme nitrogenase. The Proterozoic ancestor is predicted to be ~540-2,300 million years old, post-dating the Great Oxidation Event. Growth rates under nitrogen-fixing conditions are ~80% of those of wild type in Azotobacter vinelandii . In the extant enzyme, the hydrolysis of two MgATP is coupled to electron transfer to support substrate reduction. The ancestor has a strict requirement for ATP with no other nucleotide triphosphate analogs (GTP, ITP, and UTP) supporting activity. Alternative divalent metal ions (Fe 2+ , Co 2+ , and Mn 2+ ) support activity with ATP but with diminished activities compared to Mg 2+ , similar to the extant enzyme. Additionally, it is shown that the ancestor has an identical efficiency in ATP hydrolyzed per electron transferred to the extant of two. Our results provide direct laboratory evidence of ATP usage by an ancient enzyme.IMPORTANCELife depends on energy-carrying molecules to power many sustaining processes. There is evidence that these molecules may predate the rise of life on Earth, but how and when these dependencies formed is unknown. The resurrection of ancient enzymes provides a unique tool to probe the enzyme's function and usage of energy-carrying molecules, shedding light on their biochemical origins. Through experimental reconstruction, this research investigates the ancestral dependence of a nitrogen-fixing enzyme on the energy carrier ATP, a requirement for function in the modern enzyme. We show that the resurrected ancestor does not have generalist nucleotide specificity. Rather, the ancestor has a strict requirement for ATP, like the modern enzyme, with similar function and efficiency. The findings elucidate the early-evolved necessity of energy-yielding molecules, delineating their role in ancient biochemical processes. Ultimately, these insights contribute to unraveling the intricate tapestry of evolutionary biology and the origins of life-sustaining dependencies., Competing Interests: The authors declare no conflict of interest.

Objective: To analyze the current situation of myopia and its related factors among primary school students in a certain district of Beijing City in 2022, and provide a basis for the risk assessment of myopia among primary school students. Method: In June 2022, a cluster sampling method was used to include 376 third-grade students from a primary school in a certain district of Beijing. A questionnaire survey was conducted to collect basic information about students, including eye usage habits, reading and writing postures, and parents' myopia conditions. The examination of students' distant visual acuity and refractive status was performed. A multivariate logistic regression model was used to analyze the related factors of myopia occurrence. Results: The age of 376 primary school students was (8.87±0.417) years old, with 48.40% (182) being male. A total of 196 myopia cases were identified, with a myopia rate of 52.13%. The results of the multivariate logistic regression model analysis showed that students who sometimes read while lying down ( OR =2.003, 95% CI : 1.128-3.555), often read while lying down ( OR =18.853, 95% CI : 4.512-78.778), had outdoor activity time less than 120 minutes per day ( OR =4.937, 95% CI : 2.4464-9.892), were engaged in indoor break activities ( OR =4.995, 95% CI : 2.773-8.996), performed eye exercises less than once per day ( OR =8.710, 95% CI : 4.464-16.995), had a reading distance from the book less than 30 cm ( OR =5.098, 95% CI : 2.410-10.787), occasionally maintained a fist distance from the edge of the desk ( OR =1.918, 95% CI : 1.086-3.385), and had high school desks and tables ( OR =5.325, 95% CI : 1.465-19.359) could have a higher risk of myopia occurrence, compared with those who never read while lying down, had outdoor activity time more than 120 minutes per day, maintained outdoor break activities, performed eye exercises more than once per day, had a reading distance from the book more than 30 cm, always maintained a fist distance from the edge of the desk, and had short school desks and tables. Conclusion: The incidence rate of myopia among primary school students in a certain district of Beijing City. in 2022 is relatively high. The occurrence of myopia is related to insufficient outdoor activity time and poor eye usage habits.

Objective: To explore the application value of a novel separated magnetic-controlled forceps in transumbilical single-incision laparoscopic cholecystectomy (SILC). Methods: This is a prospective case series study. Data from patients who underwent SILC at the Department of General Surgery, the Second Affiliated Hospital of Air Force Medical University from March to August 2023 were prospectively collected, based on inclusion and exclusion criteria. All patients underwent cholecystectomy assisted by a novel separated magnetic-controlled forceps. Surgical time, intraoperative blood loss, the need for additional incisions during surgery, and the length of hospital stay were recorded to assess surgical difficulty and effectiveness. Postoperative pain scores and complications were documented to evaluate the safety of the procedure. The collaboration experience of the surgeon and assistant was evaluated using a 5-point Likert scale to assess the feasibility of this surgical approach. Informed consent was obtained from all patients in accordance with medical ethical regulations. Patients were followed up through outpatient visits or telephone calls, with follow-up at 7 days and 1 month after surgery, and evaluation of incisional scar healing and completion of satisfaction questionnaires. Follow-up was conducted until September 30, 2023. Results: A total of 45 patients were included in the study,including 19 males and 26 females,aged (42.7±4.2)years(range:32 to 61 years). The difficulty of the operation was evaluated as grade 1 or 2 in 38 cases(84.4%) and grade 3 in 7 cases(15.6%). Operation time was (37.3±5.3) minutes(range: 25 to 80 minutes),and intraoperative blood loss( M (IQR)) was 17.8(35.0) ml (range:10 to 60 ml). All surgical procedures proceeded smoothly without intraoperative incidents, and the overall satisfaction of the surgeon and assistants was high. All patients underwent successful day surgery management and were discharged within 48 hours of hospitalization. The postoperative pain scores at 1, 7, and 30 days were 3 (4), 1 (3), and 0 (2), respectively. The follow-up time was 5.0(2.2) weeks (range: 3 to 7 weeks), with no occurrence of grade 3 to 4 adverse reactions, and the patients were satisfied with the cosmetic effect of the umbilical incision. Conclusions: The novel separated magnetic-controlled forceps can be applied in transumbilical SILC. It has the advantages of convenient operation, and patients are satisfied with the surgical results.

Dimethacrylate-based chemistries feature extensively as resin monomers in dental resin-based materials due to their distinguished overall performance. However, challenges endure, encompassing inadequate mechanical attributes, volumetric shrinkage, and estrogenicity. Herein, we first synthesized a novel resin monomer, 9-armed starburst polyurethane acrylate (NPUA), via the grafting-onto approach. Compared to the primary commercial dental monomer 2,2-bis [p-(2'-hydroxy-3'-methacryloxypropoxy) phenyl] propane (Bis-GMA) (with a viscosity of 1,174 ± 3 Pa·s and volumetric shrinkage of 4.7% ± 0.1%), the NPUA monomer achieves the lower viscosity (158 ± 1 Pa·s), volumetric shrinkage (2.5% ± 0.1%), and cytotoxicity ( P < 0.05). The NPUA-based resins exhibit the higher flexural strength, flexural modulus, hardness, and hydrophobicity and lower volumetric shrinkage, water absorption, and solubility compared to the Bis-GMA (70 wt%)/TEGDMA (30 wt%) resins. The NPUA-based composites exhibit significantly higher flexural strength, flexural modulus, and hardness and lower volumetric shrinkage (171.4 ± 3.0 MPa, 12.6 ± 0.5 GPa, 2.0 ± 0.2 GPa, and 3.4% ± 0.2%, respectively) compared to the Bis-GMA group (120.3 ± 4.7 MPa, 9.4 ± 0.7 GPa, 1.5 ± 0.1 GPa, and 4.7% ± 0.2%, respectively; P < 0.05). This work presents a viable avenue for augmenting the physicochemical attributes of dental resins., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: Randomized controlled trials (RCT) usually have strict implementation criteria. The included subjects' characteristics of the conditions for the intervention implementation are quite different from the actual clinical environment, resulting in discrepancies between the risk-benefit of interventions in actual clinical use and the risk-benefit shown in RCT. Therefore, some methods are needed to enhance the extrapolation of RCT results to evaluate the real effects of drugs in real people and clinical practice settings. Methods: Six databases (PubMed, Embase, Web of Science, CNKI, Wanfang Data, and VIP) were searched up to 31 st December 2022 with detailed search strategies. A scoping review method was used to integrate and qualitatively describe the included literature inductively. Results: A total of 12 articles were included. Three methods in the included literature focused on: ①improving the design of traditional RCT to increase population representation; ②combining RCT Data with real-world data (RWD) for analysis;③calibrating RCT results according to real-world patient characteristics. Conclusions: Improving the design of RCT to enhance the population representation can improve the extrapolation of the results of RCT. Combining RCT data with RWD can give full play to the advantages of data from different sources; the results of the RCT were calibrated against real-world population characteristics so that the effects of interventions in real-world patient populations can be predicted.

Surgical treatment is one of the most important forms of treatment in patients with gallbladder cancer. With the development of minimally invasive technology, the feasibility, safety and efficacy of minimally invasive approaches such as laparoscopic or robotic-assisted radical cholecystectomy for gallbladder cancer have received continuous attention.For patients with an early T-stage (Tis or T1a), laparoscopic simple cholecystectomy is safe and economical, with a good prognosis for postoperative patients, and it has been widely accepted and performed. Radical resection of advanced gallbladder cancer requires resection of the gallbladder, its liver bed, and other neighboring invaded organs, as well as clearance of regional lymph nodes, which requires experienced gallbladder cancer treatment teams to strictly grasp the indications, select appropriate patients, and formulate a good surgical strategy to ensure the therapeutic effect. Meanwhile, robot-assisted radical resection for gallbladder cancer has been performed in a few centers and shows good clinical potential, but more high-quality studies are needed to further evaluate its value in gallbladder cancer treatment.

Objective: To investigate the causal relationship between intestinal flora and benign biliary diseases by genome-wide Mendelian randomization. Methods: This is a retrospective observational study. The data from the genome-wide association study of the gut microbiota from 18 340 samples from the MiBioGen consortium were selected as the exposure group,and the data from the genome-wide association study of biliary tract diseases were obtained from the FinnGen consortium R8 as the outcome group. There were 1 491 cases of primary sclerosing cholangitis,32 894 cases of cholelithiasis,3 770 cases of acalculous cholecystitis,and 34 461 cases of cholecystitis. Single nucleotide polymorphisms were screened as instrumental variables,and the Mendelian randomization method was used to infer the causal relationship between exposures and outcomes. The inverse variance weighting method (IVW) was used as the main basis, supplemented by heterogeneity,pleiotropy and sensitivity tests. Results: Coprococcus 2 was associated with a reduced risk of cholelithiasis (IVW OR =0.88,95% CI :0.80 to 0.97, P =0.012) and cholecystitis (IVW OR =0.88,95% CI :0.80 to 0.97, P =0.011). Coprococcus 3 was associated with cholelithiasis (IVW OR =1.15,95% CI :1.02 to 1.30, P =0.019) and acalculous cholecystitis(IVW OR =1.48, 95% CI : 1.08 to 2.04, P =0.016) and cholecystitis (IVW OR =1.17, 95% CI : 1.02 to 1.33, P =0.020). Peptococcus was associated with an increased risk of cholelithiasis (IVW OR =1.08, 95% CI :1.02 to 1.13, P =0.005) and cholecystitis (IVW CI =1.07, 95% CI :1.02 to 1.13, P =0.010). Clostridiumsensustricto 1 was associated with an increased risk of cholelithiasis (IVW OR =1.16,95% CI :1.02 to 1.31, P =0.020) and cholecystitis (IVW OR =1.16, 95% CI :1.03 to 1.30, P =0.015). Eubacterium hallii was associated with an increased risk of primary sclerosing cholangitis (IVW OR =1.43, 95% CI : 1.03 to 1.99, P =0.033). Eubacterium ruminantium (IVW OR =0.87, 95% CI : 0.76 to 1.00, P =0.043) and Methanobrevibacter (IVW OR =0.81, 95% CI : 0.68 to 0.98, P =0.027) were associated with a reduced risk of acalculous cholecystitis. Conclusions: Eight intestinal bacterial genera maybe play pathogenic roles in benign biliary diseases. Eubacterium hallii can increase the risk of primary sclerosing cholangitis. Peptococcus and Clostridiumsensustricto 1 can increase the risk of cholelithiasis and generalized cholecystitis. Coprococcus 3 have multiple correlations with biliary stones and inflammation.

Objective: Differences between randomized controlled trial (RCT) results and real world study (RWS) results may not represent a true efficacy-effectiveness gap because efficacy-effectiveness gap estimates may be biased when RWS and RCT differ significantly in study design or when there is bias in RWS result estimation. Secondly, when there is an efficacy- effectiveness gap, it should not treat every patient the same way but assess the real-world factors influencing the intervention's effectiveness and identify the subgroup likely to achieve the desired effect. Methods: Six databases (PubMed, Embase, Web of Science, CNKI, Wanfang Data, and VIP) were searched up to 31 st December 2022 with detailed search strategies. A scoping review method was used to integrate and qualitatively describe the included literature inductively. Results: Ten articles were included to discuss how to use the RCT research protocol as a template to develop the corresponding RWS research protocol. Moreover, based on correctly estimating the efficacy-effectiveness gap, evaluate the intervention effect in the patient subgroup to confirm the subgroup that can achieve the expected benefit-risk ratio to bridge the efficacy-effectiveness gap. Conclusion: Using real-world data to simulate key features of randomized controlled clinical trial study design can improve the authenticity and effectiveness of study results and bridge the efficacy-effectiveness gap.

Chronic non-communicable diseases (NCDs) have become diseases that seriously threaten the health and quality of life of the Chinese population, and also become a major public health problem affecting the national economic and social development. With the intensification of China's population aging, the economic burden caused by NCDs will further increase. More and more evidence has shown that NCDs could be prevented, and the prevention and control of NCDs have been considered as a core task of building a healthy China. Therefore, precise personalized nutrition and the prevention of NCDs from the age of zero, which is called the "Double Zero Strategy", would provide a well-consolidated basis for body tissue structure, and prevention of NCDs should also begin at age zero, and then extend to the first 1 000 days of life. The "Double Zero Strategy" preventive intervention can improve the nutritional status, balance diet and nutrition, and increase physical activity among children, adolescents, adults, and the elderly, all of which can reduce the risk of chronic disease, disability, and death. Therefore, launching the "Double Zero Strategy" for full life cycle prevention will help to achieve China's health goals in the new era, and provide more comprehensive measures and plans for implementing the goal of a healthy China.