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Irritable bowel syndrome with diarrhea (IBS-D) is a common and chronic gastrointestinal disorder that is characterized by abdominal discomfort and occasional diarrhea. The pathogenesis of IBS-D is thought to be related to a combination of factors, including psychological stress, abnormal muscle contractions, and inflammation and disorder of the gut microbiome. However, there is still a lack of comprehensive analysis of the logical regulatory correlation among these factors. In this study, we found that stress induced hyperproduction of xanthine and altered the abundance and metabolic characteristics of Lactobacillus murinus in the gut. Lactobacillus murinus -derived spermidine suppressed the basal expression of type I interferon (IFN)-α in plasmacytoid dendritic cells by inhibiting the K63-linked polyubiquitination of TRAF3. The reduction in IFN-α unrestricted the contractile function of colonic smooth muscle cells, resulting in an increase in bowel movement. Our findings provided a theoretical basis for the pathological mechanism of, and new drug targets for, stress-exposed IBS-D. [Display omitted] • Stress-induced xanthine upregulation in CD4+ T cells drives IBS-D symptoms • IFN-α deficiency in plasmacytoid dendritic cells contributes to IBS-D • AdorA2B receptor inhibition attenuates stress-induced IBS-D responses • Lactobacillus murinus -derived spermidine directly triggers visceral hypersensitivity Zhang et al. revealed that stress triggers irritable bowel syndrome with diarrhea by raising systemic purine levels, which stimulates the proliferation of Lactobacillus in the gut and leads to spermidine accumulation. Spermidine inhibits the expression of IFN-α in plasmacytoid dendritic cells, ultimately impairing smooth muscle cell contraction and resulting in intestinal spasms. [ABSTRACT FROM AUTHOR]

In contrast to younger adult populations, clinical practice guidelines state that there is no difference in long-term functional outcomes in surgically versus nonoperatively treated distal radius fractures in patients ≥65 years old. In this study, we asked the following questions: (1) has treatment for distal radius fractures in younger and older adult populations changed over time? (2) What patient and surgeon factors are associated with treatment trends? Using a national administrative claims database, we identified patients aged ≥18 years with isolated, closed distal radius fractures, subdivided by age (18–64 years, ≥65 years old). We characterized the proportion of patients who underwent open reduction and internal fixation (ORIF) over time. We stratified our analysis by surgeon subspecialty, region, and mean area income. Changes in ORIF utilization over time were evaluated using linear regression models. The proportion of distal radius ORIF, including in patients aged ≥65 years, increased from 10.4% in 2012 to 15.1% in 2020. Of the ORIF procedures performed, hand surgeons accounted for an increasing proportion over time, with a corresponding decrease in those performed by general orthopedic surgeons. The proportion of ORIF increased over time in all US regions, with the largest rate of increase in the Midwest for patients aged ≥65 years and Northeast for patients aged 18–64 years. Patients living in areas with mean family income ≥$65,000 were more likely to undergo ORIF. The proportion of distal radius ORIF including in older adult populations is increasing in all US regions, and an increasing proportion is performed by hand surgeons. Further analysis of the drivers of these trends is warranted, given the rising incidence of surgical treatment in older patients, which could reflect evolving patient activity demands and suggest a need to further evaluate conventional treatment algorithms based on age. [ABSTRACT FROM AUTHOR]

[Display omitted] • RAMs played a pivotal role in resolving inflammation during LPS and/or E.coli -induced ARDS. • RvD1 promoted RAM self-renewal and phagocytosis in an ALX/MAPK14/S100A8/A9-dependent manner. • Plasma RvD1 and S100A8/A9 levels were negatively correlated, and associated with the outcome of sepsis-induced ARDS. Acute respiratory distress syndrome (ARDS) is a pulmonary inflammatory process primarily caused by sepsis. The resolution of inflammation is an active process involving the endogenous biosynthesis of specialized pro-resolving mediators, including resolvin D1 (RvD1). Resident alveolar macrophages (RAMs) maintain pulmonary homeostasis and play a key role in the resolution phase. However, the role of RAMs in promoting the resolution of inflammation by RvD1 is unclear. Here, we investigated the mechanisms of RvD1 on regulating RAMs to promote the resolution of ARDS. Mice were administered lipopolysaccharide and/or Escherichia coli via aerosol inhalation to establish a self-limited ARDS model. Then, RvD1 was administered at the peak inflammatory response. RAMs self-renewal was measured by flow cytometry, RAM phagocytosis was measured by two-photon fluorescence imaging. In addition, plasma was collected from intensive care unit patients on days 0–2, 3–5, and 6–9 to measure RvD1 and S100A8/A9 levels using triple quadrupole/linear ion trap mass spectrometry. RAMs were found to play a pivotal role in resolving inflammation during ARDS, and RvD1 enhanced RAM proliferation and phagocytosis, which was abrogated by a lipoxin A4 receptor (ALX, RvD1 receptor) inhibitor. Both primary RAMs transfected with rS100A8/A9 and/or S100A8/A9 siRNA and S100A9-/- mice (also deficient in S100A8 function) showed higher turnover and phagocytic function, indicating that RvD1 exerted its effects on RAMs by inhibiting S100A8/A9 production in the resolution phase. RvD1 reduced S100A8/A9 and its upstream MAPK14 levels in vivo and in vitro. Finally, in the patients, RvD1 levels were lower, but S100A8/A9 levels were higher. We propose that RvD1 improved RAM self-renewal and phagocytosis via the ALX/MAPK14/S100A8/A9 signaling pathway. Plasma RvD1 and S100A8/A9 levels were negatively correlated, and associated with the outcome of sepsis-induced ARDS. [ABSTRACT FROM AUTHOR]

This article researches the issue of robust non-fragile hybrid control for delayed uncertain singular impulsive jump systems (USIMJSs). The key aim is to design non-fragile hybrid state feedback controllers (including a non-fragile normal state feedback controller and a non-fragile impulsive state feedback controller), which are insensitive to the uncertainties of gains of controllers and can provide sufficient tuning margins. The non-fragile normal state feedback controller can eliminate the internal impulses and overcome the external disturbances; the non-fragile impulsive state feedback controller can suppress the interference of external unstable impulses and restrain the instantaneous jumps caused by Markovian modes switching. By introducing impulse instant-dependent auxiliary functions, the improved impulse-time-dependent Lyapunov–Krasovskii functional is constructed, which can capture the information of the impulse instants and Markovian jump modes. Novel criteria of robust admissibilization for delayed USIMJSs are acquired under linear matrix inequalities framework. Lastly, the effectiveness of the derived algorithm and designed method is confirmed by simulation examples including a direct current motor-controlled inverted pendulum device and a Quarter-Car active suspension model. • The non-fragile hybrid state feedback controllers (NFHSFC, including a NSFC and an ISFC) are designed. • The impulse instant-dependent auxiliary functions are introduced to construct the improved L–K functional. • The proposed NFHSFC method is more universal, regularity and non-impulsiveness need not be assumed in advance. [ABSTRACT FROM AUTHOR]

Facial symmetry enhances attractiveness, with various therapies available to improve it. However, trends in facial asymmetry remain unclear. This study evaluates the differences between specific facial regions using 3D scanning to guide clinical treatment. The 3dMD face™ system (3dMD Ltd, USA) scanned the faces of 88 participants. Geomagic Wrap 2021 analyzed the left and right sides. Differences in the eyebrow peaks, eyebrow tails, eye ends, and mouth corners were evaluated. Several participants showed a drooping right side of the face in the eyebrow peaks, eyebrow tails, eye ends, mouth corners, tubercula mentale, and mandibular margin positions. A higher proportion had deeper left nasolabial folds and marionette lines, whereas several others had deeper right tear ducts and lateral chin depressions. Several participants exhibited prominent right forehead and parotid masseter region, with prominent left temporal and cheek regions. 3D scanning effectively assesses facial asymmetry in clinical practice. Research indicates significant differences in asymmetry between the facial regions. Evaluating these differences pre-treatment can guide the selection of therapeutic methods to improve facial asymmetry. 3 (Diagnostic). [ABSTRACT FROM AUTHOR]

G protein-coupled receptors (GPCRs) mediate most cellular responses to hormones, neurotransmitters, and environmental stimulants. However, whether GPCRs participate in tissue homeostasis through ferroptosis remains unclear. Here we identify that GPR56/ADGRG1 renders cells resistant to ferroptosis and deficiency of GPR56 exacerbates ferroptosis-mediated liver injury induced by doxorubicin (DOX) or ischemia-reperfusion (IR). Mechanistically, GPR56 decreases the abundance of phospholipids containing free polyunsaturated fatty acids (PUFAs) by promoting endocytosis-lysosomal degradation of CD36. By screening a panel of steroid hormones, we identified that 17α-hydroxypregnenolone (17-OH PREG) acts as an agonist of GPR56 to antagonize ferroptosis and efficiently attenuates liver injury before or after insult. Moreover, disease-associated GPR56 mutants were unresponsive to 17-OH PREG activation and insufficient to defend against ferroptosis. Together, our findings uncover that 17-OH PREG-GPR56 axis-mediated signal transduction works as a new anti-ferroptotic pathway to maintain liver homeostasis, providing novel insights into the potential therapy for liver injury. [Display omitted] • GPR56 is a potent ferroptosis suppressor • GPR56 remodels lipid metabolism to defend against ferroptosis via downregulating CD36 • Identification of 17-OH PREG as a potent agonist of GPR56 to inhibit ferroptosis • Targeting the GPR56-17-OH PREG-CD36 axis is beneficial for ferroptosis-induced liver injury Lin et al. found that adhesion GPCR family member GPR56 remodels CD36-mediated lipid metabolism to defend against ferroptosis. They also identified that 17-OH PREG acts as the endogenous agonist of GPR56 to suppress ferroptosis. Targeting the GPR56-17-OH PREG-CD36 axis efficiently alleviated ferroptosis-induced liver injury. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is a chronic autoimmune condition characterized by inflammatory activity with distinct rhythmic fluctuations. However, the precise mechanisms governing these inflammatory rhythms remain elusive. Here, we explore the interaction between dietary patterns, gut microbiota diurnal oscillations, and the rhythmicity of RA in both collagen-induced arthritis (CIA) mice and patients with RA and highlight the significance of dietary timing in modulating RA inflammatory rhythms linked to gut microbiota. Specifically, we discovered that Parabacteroides distasonis (P. distasonis) uses β-glucosidase (β-GC) to release glycitein (GLY) from the diet in response to daily nutritional cues, influencing RA inflammatory rhythms dependent on the sirtuin 5-nuclear factor-κB (SIRT5-NF-κB) axis. Notably, we validated the daily fluctuations of P. distasonis- β-GC-GLY in patients with RA through continuous sampling across day-night cycles. These findings underscore the crucial role of dietary timing in RA rhythmicity and propose potential clinical implications for novel therapeutic strategies to alleviate arthritis. [Display omitted] • RA exhibits rhythmic inflammatory activity influenced by dietary patterns • Nutritional cues significantly modulate RA inflammatory fluctuations via gut microbiota • P. distasonis utilizes β-glucosidase to release glycitein to inhibit the SIRT5-NF-κB axis • Continuous sampling validates fluctuations of P. distasonis -β-GC-GLY in RA patients Ma et al. demonstrate that dietary timing modulates rheumatoid arthritis inflammatory rhythms by inducing diurnal oscillations in gut microbiota. Particularly, Parabacteroides distasonis utilizes β-glucosidase to release glycitein, which mitigates RA inflammation via the SIRT5-NF-κB axis. [ABSTRACT FROM AUTHOR]

To observe the cases of superior laryngeal nerve injury along with summarizing and analyzing its clinical characteristics. A total of 14 patients with unilateral superior laryngeal nerve injury (SLN) diagnosed by laryngeal electromyography (LEMG) in our department from 2018 to 2020 were collected as SLN injury group. A total of 14 healthy subjects with normal laryngeal electromyography were recruited as normal group matched by age and sex. The etiology and LEMG of the SLN injury group were analyzed, and the video stroboscopic manifestations of SLN injury group and normal group were compared to see the characteristic video stroboscopic manifestations of SLN injury. The most common causes of SLN injury were surgery and idiopathic etiology. Compared with normal group, the most frequent video stroboscopic manifestations of SLN injury group were vocal fold dyskinesia. Abnormal video stroboscopic manifestations occurred in normal group except larynx deviation, epiglottic petiole deviation, and dyskinesia. There was a significant difference between the two groups in various abnormal video stroboscopic manifestations (P < 0.05). Time limit widening was the most common manifestation of LEMG. Vocal fold dyskinesia was a prominent finding in SLN injury, laryngeal deviation and epiglottic petiole deviation were relative specific signs of SLN injury. Vocal fold bowing combined with shortening will contribute to the diagnosis of SLN injury. There were no specific diagnostic signs for SLN injury, clinicians need further LEMG for a firm diagnosis. [ABSTRACT FROM AUTHOR]

Rapid turnover of the intestinal epithelium is a critical strategy to balance the uptake of nutrients and defend against environmental insults, whereas inappropriate death promotes the spread of inflammation. PPAR α is highly expressed in the small intestine and regulates the absorption of dietary lipids. However, as a key mediator of inflammation, the impact of intestinal PPAR α signaling on cell death pathways is unknown. Here, we show that Pparα deficiency of intestinal epithelium up-regulates necroptosis signals, disrupts the gut vascular barrier, and promotes LPS translocation into the liver. Intestinal Pparα deficiency drives age-related hepatic steatosis and aggravates hepatic fibrosis induced by a high-fat plus high-sucrose diet (HFHS). PPAR α levels correlate with TRIM38 and MLKL in the human ileum. Inhibition of PPAR α up-regulates necroptosis signals in the intestinal organoids triggered by TNF- α and LPS stimuli via TRIM38/TRIF and CREB3L3/MLKL pathways. Butyric acid ameliorates hepatic steatosis induced by intestinal Pparα deficiency through the inhibition of necroptosis. Our data suggest that intestinal PPAR α is essential for the maintenance of microenvironmental homeostasis and the spread of inflammation via the gut–liver axis. Pparα deficiency in the ileum epithelium up-regulates necroptosis signals via TRIM38/TRIF and CREB3L3/MLKL pathways, leading to hepatic steatosis through the spread of gut-derived endotoxin. [Display omitted] [ABSTRACT FROM AUTHOR]

Periodontitis suffer from inflammation-induced destruction of periodontal tissues, resulting in the serious loss of alveolar bone. Controlling inflammation and promoting bone regeneration are two crucial aspects for periodontitis-related alveolar bone defect treatment. Herein, we developed a hierarchically structured nanofibrous scaffold with a nano-embossed sheath and a bone morphogenetic protein 2-loaded core to match the periodontitis-specific features that spatiotemporally modulated the osteoimmune environment and promoted periodontal bone regeneration. We investigated the potential of this unique scaffold to treat periodontitis-related alveolar bone defects in vivo and in vitro. The results demonstrated that the hierarchically structured scaffold effectively reduced the inflammatory levels in macrophages and enhanced the osteogenic potential of bone mesenchymal stem cells in an inflammatory microenvironment. Moreover, in vivo experiments revealed that the hierarchically structured scaffold significantly ameliorated inflammation in the periodontium and inhibited alveolar bone resorption. Notably, the hierarchically structured scaffold also exhibited a prolonged effect on promoting alveolar bone regeneration. These findings highlight the significant therapeutic potential of hierarchically structured nanofibrous scaffolds for the treatment of periodontitis, and their promising role in the field of periodontal tissue regeneration. We present a novel hierarchically structured nanofibrous scaffold of coupling topological and biomolecular signals for precise spatiotemporal modulation of the osteoimmune micro-environment. Specifically, the scaffold was engineered via coaxial electrospinning of the poly(ε-caprolactone) sheath and a BMP-2/polyvinyl alcohol core, followed by surface-directed epitaxial crystallization to generate cyclic nano-lamellar embossment on the sheath. With this unique hierarchical structure, the cyclic nano-lamellar sheath provided a direct nano-topographical cue to alleviate the osteoimmune environment, and the stepwise release of BMP-2 from the core provided a biological cue for bone regeneration. This research underscores the potential of hierarchically structured nanofibrous scaffolds as a promising therapeutic approach for periodontal tissue regeneration and highlights their role in advancing periodontal tissue engineering. [Display omitted] [ABSTRACT FROM AUTHOR]

To explore the influencing factors of syncope in patients after plastic surgery, establish a syncope risk prediction model, and verify its accuracy. A total of 265 patients undergoing craniomaxillofacial surgery were included and divided into a syncope group and non-syncope group. Multivariate logistic regression analysis was used to screen for risk factors of syncope, and R language was used to establish a risk prediction nomogram of syncope in craniomaxillofacial surgery patients. The Hosmer-Lemeshow goodness-of-fit test was used to evaluate the fit of the model, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of the model. Syncope occurred in 87 of 265 patients (32.8%), and no syncope occurred in 178 patients (67.8%). Multivariate logistic regression analysis revealed statistical differences in age, orthostatic heart rate, orthostatic diastolic blood pressure, syncope history, weight loss history, and medication history between the 2 groups (P < 0.05). A nomogram was constructed for predicting the risk of syncope after craniomaxillofacial surgery, and the Hosmer-Lemeshow goodness-of-fit test proved that the nomogram fitted well (P = 0.431). The results of ROC curve analysis showed that the alignment graph model had high prediction accuracy; the area under the curve was 0.886 (95% confidence interval, 0.8381–0.9332). Evaluating the risk of syncope after craniomaxillofacial surgery is helpful and provides guidance for the formulation of preventive strategies. [ABSTRACT FROM AUTHOR]

Statistical analysis of the time-to-event scenarios commonly involves the use of the exponential and Rayleigh distributions. However, the exponential distribution is constrained by its constant failure rate, while the Rayleigh distribution exhibits a growing (or increasing) failure rate. The linear failure rate distribution provides a broader perspective by encompassing both of these distributions, including the possibility of a non-increasing hazard function. In this paper, a new distribution is introduced, which could be considered as one of the major modifications to the linear failure rate distribution, known as the weighted linear failure rate distribution. The model proposed illustrates both monotonic and a known non-monotonic failure rate. This paper extensively explores the characteristics of the proposed distribution. It presents the maximum likelihood estimates for the unknown parameters and includes a simulation study. The analysis focuses on three real data sets obtained from the fields of musical education and engineering. By employing three decisive tools, it is observed that the current distribution provides a superior fit in comparison to several other widely recognized distributions. [ABSTRACT FROM AUTHOR]

Postoperative use of oral prednisone to augment the effect of multimodal pain regimens after total knee arthroplasty (TKA) has increased in popularity. However, data on the risks of its utilization, especially as it relates to infection, have been lacking. We tested the null hypothesis that perioperative prednisone use is not associated with the incidence of surgical and medical complications after TKA. Using a national administrative claims database, we identified 949,555 patients undergoing primary TKA. We excluded patients who filled oral prednisone prescriptions within 90 days prior to surgery or between 90 and 364 days after surgery. Patients who had acute prednisone use were defined as those who filled prednisone prescriptions only within 30 days after surgery. Outcomes consisted of surgical and medical complications after TKA. Multivariable logistic regression models were used to evaluate the association between acute prednisone use and complications, adjusting for age, sex, region, insurance plan, and Elixhauser comorbidities. Patients in the acute prednisone cohort had greater adjusted odds of subsequent manipulation under anesthesia (adjusted odds ratio [OR] = 1.23 [95% confidence interval {CI}: 1.09 to 1.38]; P <.001) and lysis of adhesions (adjusted OR = 1.58 [95% CI: 1.02 to 2.33]; P =.03) compared to patients who did not have acute prednisone use. Patients who had acute prednisone use also had greater adjusted odds of acute kidney injury (adjusted OR = 1.47 [95% CI: 1.25 to 1.71]; P <.001) and pneumonia (adjusted OR = 4.04 [95% CI: 3.53 to 4.59]; P <.001). There was no increased incidence of infection. Prednisone use shortly following TKA may be associated with a higher incidence of certain surgical and medical complications, but without increased risk for infection. However, given these risks, the optimal patient profile for postoperative prednisone use remains to be defined. [ABSTRACT FROM AUTHOR]

To investigate the relationship and potential pathways between metal(loid) exposure and the risk of polycystic ovary syndrome (PCOS) in women of childbearing age. This case-control study included 200 patients with PCOS (cases) and 896 non-PCOS controls with the age of 25–37 years. The concentrations of 29 metal(loid)s in the follicular fluid (FF) and clinical indicators in the serum were measured in all participants. Logistic regression analysis and mediation analysis were conducted to evaluate the associations between metal(loid) exposure and PCOS risk and investigate the possible roles of clinical indicators, respectively. Logistic regression analysis revealed an association between high copper levels in FF and increased PCOS risk (highest vs. lowest quartile: adjusted odds ratio = 2.94, 95% confidence interval: 1.83–4.72). A high luteinizing hormone/follicle-stimulating hormone ratio and elevated levels of testosterone and anti-Müllerian hormone (AMH) were strongly associated with increased PCOS risk induced by high copper exposure. The mediation analysis indicated a mediating effect of AMH in the association between copper exposure and PCOS risk. Copper may affect PCOS risk through the hypothalamic–pituitary–ovarian axis, mediated by AMH. Copper exposure and internal AMH levels are important indicators for early warning of PCOS development. [ABSTRACT FROM AUTHOR]

The criteria for determining the acceptability of total knee replacement (TKR) radiographs are not established in current clinical practice. In TKR patients, the implant components replaced the anatomical landmarks, making it more difficult for radiographers to determine the degree of rotation. This study aims to establish an acceptable range of knee rotation for TKR radiographs. Rejected TKR radiographs (199 AP and 186 lateral) were analysed retrospectively. Radiographers objectively measured rotation on the radiographs. A subset of 46 AP and 46 lateral radiographs were rated by orthopaedic surgeons for rotation and diagnostic value. Inter-rater reliability (IRR) of radiographic measurements and surgeons' ratings were analysed using Bland–Altman and Cohen's kappa, respectively. Spearman's rank-order correlation and Receiver Operator Characteristic analyses were used to determine the correlation and diagnostic performance of the radiographic measurements against the surgeon's ratings. Strong IRR was observed for the radiographic measurements. Only slight to fair agreement was observed for the surgeons' rotation and diagnostic value ratings of the radiographs. Moderate to strong correlation was observed between the radiographic measurements and the surgeons' ratings. The radiographic measurements provided acceptable to excellent discrimination of acceptable and unacceptable radiographs. The acceptable range of measured rotation for usability was AP: 0–5.29 mm and lateral: 0–6.01 mm. The proposed measurement methods and the established rotation range could potentially be used by radiographers in clinical practice to determine the acceptability of TKR radiographs. Follow-up studies could investigate uncommon knee implants and seek consensus across different institutions on the acceptable degree of rotation. The proposed method suggests that accepting radiographs within the threshold (AP: 5.29 mm, lateral: 6.01 mm) reduces repeated examination and radiation exposure and improves imaging efficiency. [ABSTRACT FROM AUTHOR]

Biomaterials with osteoinductivity are widely used for bone defect repair due to their unique structures and functions. Machine learning (ML) is pivotal in analyzing osteoinductivity and accelerating new material design. However, challenges include creating a comprehensive database of osteoinductive materials and dealing with low-quality, disparate data. As a standard for evaluating the osteoinductivity of biomaterials, ectopic ossification has been used. This paper compiles research findings from the past thirty years, resulting in a robust database validated by experts. To tackle issues of limited data samples, missing data, and high-dimensional sparsity, a data enhancement strategy is developed. This approach achieved an area under the curve (AUC) of 0.921, a precision of 0.839, and a recall of 0.833. Model interpretation identified key factors such as porosity, bone morphogenetic protein-2 (BMP-2), and hydroxyapatite (HA) proportion as crucial determinants of outcomes. Optimizing pore structure and material composition through partial dependence plot (PDP) analysis led to a new bone area ratio of 14.7 ± 7 % in animal experiments, surpassing the database average of 10.97 %. This highlights the significant potential of ML in the development and design of osteoinductive materials. This study leverages machine learning to analyze osteoinductive biomaterials, addressing challenges in database creation and data quality. Our data enhancement strategy significantly improved model performance. By optimizing pore structure and material composition, we increased new bone formation rates, showcasing the vast potential of machine learning in biomaterial design. [Display omitted] [ABSTRACT FROM AUTHOR]

Cell volume as a characteristic of changes in response to external environmental cues has been shown to control the fate of stem cells. However, its influence on macrophage behavior and macrophage-mediated inflammatory responses have rarely been explored. Herein, through mediating the volume of macrophages by adding polyethylene glycol (PEG), we demonstrated the feasibility of fine-tuning cell volume to regulate macrophage polarization towards anti-inflammatory phenotypes, thereby enabling to reverse macrophage-mediated inflammation response. Specifically, lower the volume of primary macrophages can induce both resting macrophages (M0) and stimulated pro-inflammatory macrophages (M1) to up-regulate the expression of anti-inflammatory factors and down-regulate pro-inflammatory factors. Further mechanistic investigation revealed that macrophage polarization resulting from changing cell volume might be mediated by JAK/STAT signaling pathway evidenced by the transcription sequencing analysis. We further propose to apply this strategy for the treatment of arthritis via direct introduction of PEG into the joint cavity to modulate synovial macrophage-related inflammation. Our preliminary results verified the credibility and effectiveness of this treatment evidenced by the significant inhibition of cartilage destruction and synovitis at early stage. In general, our results suggest that cell volume can be a biophysical regulatory factor to control macrophage polarization and potentially medicate inflammatory response, thereby providing a potential facile and effective therapy for modulating macrophage mediated inflammatory responses. Cell volume has recently been recognized as a significantly important biophysical signal in regulating cellular functionalities and even steering cell fate. Herein, through mediating the volume of macrophages by adding polyethylene glycol (PEG), we demonstrated the feasibility of fine-tuning cell volume to induce M1 pro-inflammatory macrophages to polarize towards anti-inflammatory M2 phenotype, and this immunomodulatory effect may be mediated by the JAK/STAT signaling pathway. We also proposed the feasible applications of this PEG-induced volume regulation approach towards the treatment of osteoarthritis (OA), wherein our preliminary results implied an effective alleviation of early synovitis. Our study on macrophage polarization mediated by cell volume may open up new pathways for immune regulation through microenvironmental biophysical clues. [Display omitted] [ABSTRACT FROM AUTHOR]

To observe the laryngeal CT and strobe laryngoscopy signs of unilateral vocal fold hypomobility (UVFHM) in patients with well-closed glottises in the horizontal plane. A retrospective analysis was performed on 18 subjects with well-closed glottises in the horizontal plane using strobe laryngoscopy, 9 patients diagnosed with unilateral vocal fold hypomobility with an unknown etiology were enrolled in the UVFHM group, and 9 healthy matched subjects with symmetrical bilateral vocal fold movement were enrolled in the control group. Vertical plane distances of bilateral vocal folds and three-dimensional structural parameters of vocal folds were measured through laryngeal CT. Glottic insufficiency in the vertical plane and reflux findings scores (RFS) were assessed under laryngeal CT and strobe laryngoscopy. Reflux symptom index (RSI) were collected. SPSS25.0 software was used for statistical analysis. The height differences in vertical plane and thicknesses of bilateral vocal folds in the UVFHM group were larger than those in the control (P < 0.05), while the length, width and subglottic convergence angle of the vocal folds were not statistically significant between the two groups (P > 0.05). In the UVFHM group, laryngeal CT showed that 77.78% of patients (7/9) had glottic insufficiency in the vertical plane, with height differences ranging from 0.3 to 1.9 mm and a mean of 0.76mm. However, strobe laryngoscopy showed that 33.33% (3/9) had glottic insufficiency in the vertical plane. The proportion of patients with glottic insufficiency in vertical plane in the UVFHM group was significantly higher than that in the control group (P < 0.05). RSI and RFS scores of the UVFHM group were higher than those of the control group (P < 0.05). Glottic insufficiency in the vertical plane often occurred in patients with UVFHM with an unknown cause of hoarseness, so the presence of glottic insufficiency in the vertical plane should be considered when hoarseness is detected by clinicians. Laryngeal dynamic CT can enhance the diagnostic rate compared to strobe laryngoscopy. Unexplained UVFHM patients have higher RSI and RFS compared to control subjects, warranting further research about the relationship between UVFHM and laryngopharyngeal reflux. [ABSTRACT FROM AUTHOR]

Presently, the clinical treatment of intervertebral disc degeneration (IVDD) remains challenging, but the strategy of simultaneously overcoming the overactive inflammation and restoring the anabolic/catabolic balance of the extracellular matrix (ECM) in the nucleus pulposus (NP) has become an effective way to alleviate IVDD. IL-1ra, a natural antagonist against IL-1β, can mitigate inflammation and promote regeneration in IVDD. Chondroitin sulfate (CS), an important component of the NP, can promote ECM synthesis and delay IVDD. Thus, these were chosen and integrated into functionalized microspheres to achieve their synergistic effects. First, CS-functionalized microspheres (GelMA-CS) with porous microstructure, good monodispersion, and about 200 µm diameter were efficiently and productively fabricated using microfluidic technology. After lyophilization, the microspheres with good local injection and tissue retention served as the loading platform for IL-1ra and achieved sustained release. In in vitro experiments, the IL-1ra-loaded microspheres exhibited good cytocompatibility and efficacy in inhibiting the inflammatory response of NP cells induced by lipopolysaccharide (LPS) and promoting the secretion of ECM. In in vivo experiments, the microspheres showed good histocompatibility, and local, minimally invasive injection of the IL-1ra-loaded microspheres could reduce inflammation, maintain the height of the intervertebral disc (IVD) and the water content of NP close to about 70 % in the sham group, and retain the integrated IVD structure. In summary, the GelMA-CS microspheres served as an effective loading platform for IL-1ra, eliminated inflammation through the controlled release of IL-1ra, and promoted ECM synthesis via CS to delay IVDD, thereby providing a promising intervention strategy for IVDD. The strategy of simultaneously overcoming the overactive inflammation and restoring the anabolic/catabolic balance of the extracellular matrix (ECM) in nucleus pulposus (NP) has shown great potential prospects for alleviating intervertebral disc degeneration (IVDD). From the perspective of clinical translation, this study developed chondroitin sulfate functionalized microspheres to act as the effective delivery platform of IL-1ra, a natural antagonist of interleukin-1β. The IL-1ra loading microspheres (GelMA-CS-IL-1ra) showed good biocompatibility, good injection with tissue retention, and synergistic effects of inhibiting the inflammatory response induced by lipopolysaccharide and promoting the secretion of ECM in NPCs. In vivo , they also showed the beneficial effect of reducing the inflammatory response, maintaining the height of the intervertebral disc and the water content of the NP, and preserving the integrity of the intervertebral disc structure after only one injection. All demonstrated that the GelMA-CS-IL-1ra microspheres would have great promise for the minimally invasive treatment of IVDD. [Display omitted] [ABSTRACT FROM AUTHOR]

Real-time adaptation of thoracic radiation plans is compelling because offline adaptive experiences show that tumor volumes and lung anatomy can change during therapy. We present and analyze a novel adaptive-on-demand (AOD) workflow combining online adaptive radiation therapy (o-ART) on the ETHOS system with image guided radiation therapy delivery on a Halcyon unit for conventional fractionated radiation therapy of locally advanced lung cancer (LALC). We analyzed 26 patients with LALC treated with the AOD workflow, adapting weekly. We timed segments of the workflow to evaluate efficiency in a real-world clinic. Target coverage and organ at risk (OAR) doses were compared between adaptive plans (ADP) and nonadaptive scheduled plans (SCH). Planning robustness was evaluated by the frequency of preplanning goals achieved in ADP plans, stratified by tumor volume change. The AOD workflow was achievable within 30 minutes for most radiation fractions. Over the course of therapy, we observed an average 26.6% ± 23.3% reduction in internal target volume (ITV). Despite these changes, with o-ART, ITV and planning target volume (PTV) coverage (V100%) was 99.2% and 93.9% for all members of the cohort, respectively. This represented a 2.9% and 6.8% improvement over nonadaptive plans (P <.05), respectively. For tumors that grew >10%, V100% was 93.1% for o-ART and 76.4% for nonadaptive plans, representing a median 17.2% improvement in the PTV coverage (P <.05). In these plans, critical OAR constraints were met 94.1% of the time, whereas in nonadaptive plans, this figure was 81.9%. This represented reductions of 1.32 Gy, 1.34 Gy, or 1.75 Gy in the heart, esophagus, and lung, respectively. The effect was larger when tumors had shrunk more than 10%. Regardless of tumor volume alterations, the PTV/ITV coverage was achieved for all adaptive plans. Exceptional cases, where dose constraints were not met, were due to large initial tumor volumes or tumor growth. The AOD workflow is efficient and robust in responding to anatomic changes in LALC patients, providing dosimetric advantages over standard therapy. Weekly adaptation was adequate to keep pace with changes. This approach is a feasible alternative to conventional offline replanning workflows for managing anatomy changes in LALC radiation therapy. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine if adverse social determinants of health (SDOH) are associated with differential complication rates following surgical fixation of distal radius fractures and assess which SDOH domain (economic, educational, social, health care, or environmental) is most associated with postoperative complications. Using a national administrative claims database, we conducted a retrospective cohort analysis of patients undergoing open treatment for an isolated distal radius fracture between 2010 and 2020. Patients were stratified based on the presence/absence of at least one SDOH code and propensity score matched to create two cohorts balanced by age, sex (male or female), insurance type, and comorbidities. Social determinants of health examined included economic, educational, social, health care, and environmental factors. Multivariable logistic regression analyses were performed to assess the isolated effect of SDOH on 90-day and 1-year complication rates. After propensity matching, 57,025 patients in the adverse SDOH cohort and 57,025 patients in the control cohort were included. Patients facing an adverse SDOH were significantly more likely to experience 90-day complications, including emergency department visits (Odds ratio (OR): 3.18 [95% confidence interval (CI): 3.07–3.29]), infection (OR: 2.37 [95% CI: 2.12–2.66]), wound dehiscence (OR: 2.06 [95% CI: 1.72–2.49]), and 1-year complications, including complex regional pain syndrome (OR: 1.35 [95% CI: 1.15–1.58]), malunion/nonunion (OR: 1.18 [95% CI: 1.08–1.29]), and hardware removal (OR: 1.13 [95% CI: 1.07–1.20]). Additionally, patients facing an adverse SDOH had a significantly increased risk of 90-day complications, regardless of fracture severity, and patients with economic and social challenges had the highest odds of both 90-day and 1-year postoperative complications. Social determinants of health are associated with increased complications following distal radius fracture fixation, even when controlling for demographic and clinical factors. We recommend routine screening for adverse SDOH and inclusion of SDOH data into health records to not only inform quality improvement initiatives and risk adjustment for outcome-based quality measurements but also to allow providers to begin to discuss and address such barriers during the perioperative period. Prognosis II. [ABSTRACT FROM AUTHOR]

This study proposes an Hadoop-based improved Apriori algorithm (IM Apriori) that optimizes the efficiency of data processing by reducing the set of candidate items and the time to calculate support. The improved algorithm solves two major bottlenecks in traditional Apriori algorithms: scanning databases frequently and generating a large number of candidate sets. Specific improvements include adopting new database mapping methods, avoiding repeatedly scanning the database, further pruning frequent and candidate sets, and calculating support using overlapping strategies to achieve efficient data processing. To verify the performance of the improved algorithm, simulation experiments were conducted on the Hadoop platform and compared with the traditional Apriori algorithm, BITXOR algorithm and several other association analysis algorithms. The experimental results show that the improved IM Apriori algorithm is better than the traditional and other improved algorithms in terms of efficiency and performance, which significantly reduces the number of database scans and alleviates the input / output bottleneck problem. Through this study, we prove the application potential of cloud computing based and improved data mining algorithm in medical data analysis, and improve the efficiency and accuracy of medical data mining. [ABSTRACT FROM AUTHOR]

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Chin prosthesis implantation, a cosmetic procedure to correct chin asymmetry, depression, or retraction, is generally safe and simple. However, its long-term effects on surrounding tissues are a concern. This study aimed to use three-dimensional (3D) scanning to classify the mentalis muscle shapes and assess the impact of prosthesis implantation on these muscles. This study evaluated 450 eligible female participants. Using three-dimensional imaging, data on the types, thickness, width, and length of the left and right mentalis muscles were collected and summarized. The impact of chin prosthesis on these muscle dimensions was assessed using analysis of variance, and the effect on muscle type was determined using χ 2 test. Chin implant placement affected the mentalis muscles, resulting in increased length, thickness, and width. The subjects' mentalis muscles were categorized into 3 types and divided into 7 subtypes. χ 2 test results indicated that implantation influences the classification of these muscles. Recognizing how implant placement affects the mentalis muscle can guide the development of treatments to mitigate these changes. Additionally, understanding the muscle's morphology enables more precise treatment approaches for patients. [ABSTRACT FROM AUTHOR]

"Y-shaped" airway stents have been widely used in the treatment of airway diseases, especially airway stenosis, due to their excellent flexibility. However, the current research on the flexibility of "Y-shaped" airway stents is still blank, limiting the possibility of improving the performance of stents in complex clinical disease. This study aimed to establish multi-dimensional evaluation of the flexibility of a novel segmented "Y-shaped" airway stent and two kinds of conventional stents. We evaluated the flexibility of the segmented stent, wholly knitted stent, and silicone stent by in vitro mechanical testing and finite element analysis methods. That is, the bending force and spring-back force of three kinds of stent were measured in left–right, anterior-posterior and longitudinal directions. The torque of the stents in torsion-recovery test of branches of stent was also executed. Finite element analysis was performed to evaluate the change of diameter. According to the detection, the bending force and spring-back force of the branch of the segmented stent during left–right and anterior-posterior compression, and the torque during torsion and recovery were lower than those of the other two stents. In finite element analysis, the diameter change of the segmented stent was minimal among the three stents. The flexibility of the segmented "Y-shaped" airway stent was better than that of the conventional "Y-shaped" airway stents, indicating that it has better adaptability and resistance to compression when implanted in the body. [ABSTRACT FROM AUTHOR]

[Display omitted] • We examine how the introduction of AI affects enterprise environmental performance. • The application of AI can reduce the pollution emission level of enterprises. • Improving labor substitution can improve enterprise environmental performance. • Improving technological innovation can improve firm environmental performance. • The use of AI has a different impact on different enterprises. The progress of artificial intelligence (AI) technology is an important way to solve the problem of global sustainable development. This paper discusses how AI, as a new scientific force, affects the pollution reduction of enterprises from a micro perspective. In this paper, the robot data provided by the International Federation of Robotics and pollution data of industrial enterprises in China are used for empirical analysis to test the effect of AI on pollution performance of enterprises. The results show that the application of AI can reduce enterprise emissions through technological innovation effect and labor substitution effect, and this result remains robust after sample substitution and variable substitution. Further heterogeneity analysis shows that AI has a more significant impact on enterprises in big cities and southern cities, as well as large enterprises, old enterprises and non-technology-intensive enterprises. The research results of this paper provide an effective reference for solving how to achieve green and sustainable development of artificial intelligence applications. [ABSTRACT FROM AUTHOR]

Inconel 718 represents a large portion of high-temperature metals in key industries, where the machining-induced surface integrity is quite important. As the different grain size results in various densities of grain boundaries in the deformed area, the surface integrity can be significantly affected. This paper studies the effect of workpiece grain size on machining-induced surface integrity when cutting Inconel 718. Workpiece materials with fine or coarse grain features are prepared with various heat treatment methods. Orthogonal cutting experiments are conducted with uncoated carbide tools under different cutting speeds (20 - 100 m/min). The cutting force results indicate that Inconel 718 with larger grain size will cause lower cutting forces and the percentage reduction approximately ranges from 20 % to 33 %. An interesting phenomenon is found that the workpiece with coarse grains exhibits large-scale geometrical defects due to tearing within the grains at low cutting speed (v c = 20 m/min). This phenomenon can be diminished if the cutting speed v c is increased to 60 m/min. In addition, the subsurface deformation layer is reduced with decreasing workpiece grain size due to the barrier effect of grain boundary on plastic deformation. [ABSTRACT FROM AUTHOR]

Breast phyllodes tumor (PT) is a rare fibroepithelial neoplasm with potential malignant behavior. Long non-coding RNAs (lncRNAs) play multifaceted roles in various cancers, but their involvement in breast PT remains largely unexplored. In this study, microarray was leveraged for the first time to investigate the role of lncRNA in PT. We identified lncRNA ZFPM2-AS1 was significantly upregulated in malignant PT, and its overexpression endowed PT with high tumor grade and adverse prognosis. Furthermore, we elucidated that ZFPM2-AS1 promotes the proliferation, migration, and invasion of malignant PT in vitro. Targeting ZFPM2-AS1 through nanomaterial-mediated siRNA delivery in patient-derived xenograft (PDX) model could effectively inhibit tumor progression in vivo. Mechanistically, our findings showed that ZFPM2-AS1 is competitively bound to CDC42, inhibiting ACK1 and STAT1 activation, thereby launching the transcription of TNFRSF19. In conclusion, our study provides evidence that ZFPM2-AS1 plays a pivotal role in the pathogenesis of breast PT, and suggests that ZFPM2-AS1 could serve as a prognostic indicator for patients with PT as well as a promising novel therapeutic target. ZFPM2-AS1 is competitively bound to CDC42, inhibiting ACK1 and STAT1 activation and launching the transcription of TNFRSF19, thereby promoting the proliferation, migration, and invasion of malignant breast phyllodes tumor. [Display omitted] [ABSTRACT FROM AUTHOR]

Multifunctional therapeutics have emerged as a solution to the constraints imposed by drugs with singular or insufficient therapeutic effects. The primary challenge is to integrate diverse pharmacophores within a single-molecule framework. To address this, we introduced DeepSA, a novel edit-based generative framework that utilizes deep simulated annealing for the modification of articaine, a well-known local anesthetic. DeepSA integrates deep neural networks into metaheuristics, effectively constraining molecular space during compound generation. This framework employs a sophisticated objective function that accounts for scaffold preservation, anti-inflammatory properties, and covalent constraints. Through a sequence of local editing to navigate the molecular space, DeepSA successfully identified AT-17 , a derivative exhibiting potent analgesic properties and significant anti-inflammatory activity in various animal models. Mechanistic insights into AT-17 revealed its dual mode of action: selective inhibition of Na V 1.7 and 1.8 channels, contributing to its prolonged local anesthetic effects, and suppression of inflammatory mediators via modulation of the NLRP3 inflammasome pathway. These findings not only highlight the efficacy of AT-17 as a multifunctional drug candidate but also highlight the potential of DeepSA in facilitating AI-enhanced drug discovery, particularly within stringent chemical constraints. DeepSA is a novel molecular generation framework that uses deep-simulated annealing for structural modifications. AT-17 , selected based on DeepSA, shows significant efficacy in relieving oral pain, providing long-acting local anesthesia and anti-inflammation. [Display omitted] [ABSTRACT FROM AUTHOR]

Stroke patients commonly face challenges during magnetic resonance imaging (MRI) examinations due to involuntary movements. This study aims to overcome these challenges by utilizing multiple overlapping-echo detachment (MOLED) quantitative technology. Through this technology, we also seek to detect microstructural changes of the normal-appearing corticospinal tract (NA-CST) in subacute-chronic stroke patients. 79 patients underwent 3.0 T MRI scans, including routine scans and MOLED technique. A deep learning network was utilized for image reconstruction, and the accuracy, reliability, and resistance to motion of the MOLED technique were validated on phantoms and volunteers. Subsequently, we assessed motor dysfunction severity, ischemic lesion volume, T 2 values of the bilateral NA-CST, and the T 2 ratio (rT 2) between the ipsilesional and contralesional NA-CST in patients. The MOLED technique showed high accuracy (P < 0.001) and excellent repeatability, with a mean coefficient of variation (CoV) of 1.11%. It provided reliable quantitative results even under head movement, with a mean difference (Mean diff) = 0.28% and a standard deviation difference (SD diff) = 1.34%. Additionally, the T 2 value of the ipsilesional NA-CST was significantly higher than contralesional side (P < 0.001), and a positive correlation was observed between rT 2 and the severity of motor dysfunction (r s = 0.575, P < 0.001). Furthermore, rT 2 successfully predicted post-stroke motor impairment, with an area under the curve (AUC) was 0.883. The MOLED technique offers significant advantages for quantitatively imaging stroke patients with involuntary movements. Additionally, T 2 mapping from MOLED can detect microstructural changes in the NA-CST, potentially aiding in monitoring stroke-induced motor impairment. [ABSTRACT FROM AUTHOR]

To assess the value of a multiparametric magnetic resonance imaging (MRI)-based model integrating radiomics features with clinical and MRI semantic features for preoperative evaluation of tumor budding (TB) in rectal cancer. A total of 120 patients with pathologically confirmed rectal cancer were retrospectively analyzed. The patients were randomized into training and validation cohorts in a 6:4 ratio. Radiomics features were extracted and selected from preoperative T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and contrast-enhanced T1-weighted imaging (T1CE) sequences, after which the corresponding radiomics score (RS) was calculated, and the radiomics models (T2WI model, DWI model, and T1CE model) were constructed. Logistic regression analysis was selected to develop a combined model integrated RS T2WI , RS DWI , RS T1CE , and clinical and MRI semantic features. The efficacy of each model in diagnosing TB grade was observed by the receiver operating characteristic (ROC) curve. Decision curve analysis (DCA) was used to assess the clinical benefits of the models. Seven features were extracted and selected from each T2WI, DWI, and T1CE sequence to calculate the corresponding RS and construct the corresponding radiomics model. MRI reported N stage was an independent risk factor for TB. The area under the ROC curve of the combined model was 0.961 and 0.891 in the training and validation cohorts, respectively. The combined model showed better performance than the other models. DCA showed that the net benefit of the combined model was better than that of the other models in the vast majority of threshold probabilities. A combined model integrating radiomics features and MRI semantic features allows for noninvasive preoperative evaluation of TB grading in patients with rectal cancer. [ABSTRACT FROM AUTHOR]

To investigate if higher baseline physical activity levels are associated with less β-amyloid burden and whether the ApoE4 genotype moderates this association cross-sectionally and longitudinally. Prospective cohort study. 204 cognitively normal older adults (74.5 ± 6.6 years; 26 % ApoE4-carrier) were analyzed. Baseline physical activity was measured using the Minnesota Physical Activity Questionnaire. Brain β-amyloid burden was measured with positron emission tomography using 11C-labeled Pittsburgh compound. A subsample of 128 participants underwent longitudinal positron emission tomography (2.0 ± 0.9 scans over 5 ± 3 years). Statistical analysis was run according to physical activity (high/low group) and the ApoE4 genotype (carrier/noncarrier). The ApoE4 genotype moderated the relationship between physical activity and β-amyloid, such that low physical activity had a greater impact on β-amyloid deposition in ApoE4-carriers than noncarriers. This ApoE4 × physical activity effect on brain β-amyloid deposition was also observed when all available β-amyloid scan timepoints were included in the model. β-amyloid deposition increased over time (p < 0.001), and ApoE4-carriers had disproportionately greater β-amyloid accumulation than ApoE4-noncarriers. The lower physical activity group had marginally greater β-amyloid accumulation than the higher physical activity group (p = 0.099), but there was no significant ApoE4 effect on β-amyloid accumulation. Low physical activity in combination with the ApoE4-carrier genotype is associated with increased β-amyloid burden, suggesting that ApoE4 moderates the effect of physical activity on β-amyloid load. However, this effect was insufficient for baseline physical activity to modulate the change in β-amyloid accumulation over time. [ABSTRACT FROM AUTHOR]

Cachexia is prevalent in cancer patients. The conventional diagnostic criteria for cachexia are often based on Western evidence, lacking consensus for Asian populations. This study aims to compare Asian Working Group for Cachexia (AWGC) criteria with Fearon's criteria, assessing their differences in population characteristics and prognostic impact. The clinical data of patients who underwent radical gastrectomy between 2013 and 2019 were prospectively collected. Cachexia diagnosis involves the utilization of either AWGC criteria and the previous international consensus proposed by Fearon et al. A scoring model is established based on the optional criteria according to the AWGC criteria. Univariate and multivariate logistic and Cox regression analysis were conducted to determine the independent effect factors for postoperative complications and overall survival. In a total of 1330 patients, 461 met AWGC cachexia criteria and 311 met Fearon's criteria. Excluding 262 overlapping cases, those diagnosed solely with AWGC-cachexia had higher age and lower BMI, albumin, hemoglobin, and handgrip strength compared to those by Fearon's criteria alone. AWGC-cachexia independently increased the risk of postoperative complications, whereas Fearon's criteria did not. Patients with AWGC-cachexia also exhibited shorter overall survival than Fearon's criteria. The AWGC-based cachexia grading system effectively stratifies the risks of postoperative complications and mortality. The AWGC criteria is more effective in diagnosing cancer cachexia in the Asian population and provide better prognostic indicators. [ABSTRACT FROM AUTHOR]

Amidst pressing global needs for environmental protection and sustainable development, the international community expects corporations to play a vital role, balancing profit pursuits with environmental responsibility. As the world's second-largest economy and a manufacturing giant, China's environmental governance and corporate models become a research centerpiece. Using the panel data of Chinese A-share heavy polluting industry listed companies from 2013 to 2020, and adopting the Linear-In-Means Model, this paper proposes for the first time that the corporate environmental financial integration is significantly influenced by the peer enterprises. Further research finds that: 1) Peer effect is more significant in private enterprises than state-owned enterprises. 2)The peer effect of environmental pollution integration of heavily polluting enterprises is sticky, mainly reflected in the effect of focus enterprises following peer enterprises to reduce their own environmental financial integration is stronger than the effect of following peer enterprises to upgrade synchronously. And this kind of stickiness is more significant in private enterprises. 3) The institutional pressure has a role in promoting the peer effect of enterprise environmental financial integration, and more significant in state-owned enterprises. Delving into the dynamics of Chinese enterprises in environmental management and financial strategies serves not only to excavate lessons from China's experience but also contributes to the global reservoir of wisdom on environmental protection and green development. [ABSTRACT FROM AUTHOR]

Among music majors with only 18 months of training, supraglottal activities and aerodynamic parameters were studied to facilitate understanding of the influence of voice training on characteristics of voice production. Twenty-three students at the Xiamen Music School were examined over the course of 18 months of singing training. Only 17 students completed all data collection sessions. All students had no previous voice training and were confirmed to be without organic voice disorders by a laryngologist but did present with supraglottal compression. Strobolaryngoscopy and aerodynamic assessment were performed every 6 months. Using the laryngoscopic images, anterior-posterior (A-P) compression and medial-lateral compression were analyzed. Aerodynamic assessment was carried out to measure maximum phonation time, phonation threshold flow, glottal resistance, subglottal pressure, phonation threshold pressure, and vocal efficiency. From these measurements, the mean was calculated along with a measurement of reliability. One-way ANOVA with Bonferroni post hoc test was used to evaluate the results between subjects at different time points. Kendall's W test was completed to assure consistency between and within laryngologists. Referring to the Strobolaryngoscopy Evaluation Rating Form, 4 of the 17 students had decreased A-P compression scores in the second measurement compared to the first (from 2.24 ± 0.20 to 2.12 ± 0.17, P = 0.100). After completion of the program, 6 of the 17 students' anterior-posterior compression scores further improved from the second measurement (from 2.12 ± 0.17 to 1.71 ± 0.17, P = 0.600). The A-P compression scores showed a gradual downward trend and was overall statistically significant (P = 0.004). In addition, there was an improvement of maximum phonation time (P ​ ​= 0.016). Professional voice training can improve the supraglottal activities and maximum phonation time. These parameters have potential to be used for voice training evaluation and screening. [ABSTRACT FROM AUTHOR]

Obeticholic acid (OCA), a farnesoid X receptor (FXR) agonist with favorable effects on fatty and glucose metabolism, has been considered the leading candidate drug for nonalcoholic steatohepatitis (NASH) treatment. However, its limited effectiveness in resolving liver fibrosis and lipotoxicity-induced cell death remains a major drawback. Ferroptosis, a newly recognized form of cell death characterized by uncontrolled lipid peroxidation, is involved in the progression of NASH. Nitric oxide (NO) is a versatile biological molecule that can degrade extracellular matrix. In this study, we developed a PEGylated thiolated hollow mesoporous silica nanoparticles (MSN) loaded with OCA, as well as a ferroptosis inhibitor liproxsatin-1 and a NO donor S -nitrosothiol (ONL@MSN). Biochemical analyses, histology, multiplexed flow cytometry, bulk-tissue RNA sequencing, and fecal 16S ribosomal RNA sequencing were utilized to evaluate the effects of the combined nanoparticle (ONL@MSN) in a mouse NASH model. Compared with the OCA-loaded nanoparticles (O@MSN), ONL@MSN not only protected against hepatic steatosis but also greatly ameliorated fibrosis and ferroptosis. ONL@MSN also displayed enhanced therapeutic actions on the maintenance of intrahepatic macrophages/monocytes homeostasis, inhibition of immune response/lipid peroxidation, and correction of microbiota dysbiosis. These findings present a promising synergistic nanotherapeutic strategy for the treatment of NASH by simultaneously targeting FXR, ferroptosis, and fibrosis. The PEGylated and thiolated hollow mesoporous silica nanoparticles (MSN), loaded with OCA, S -nitrosothiol, and liproxstatin-1, exhibit potent therapeutic action against NASH by simultaneously targeting FXR, ferroptosis, and fibrosis. [Display omitted] [ABSTRACT FROM AUTHOR]

Pressure injuries (PIs) are one of the leading potentially preventable hospital-acquired complications associated with prolonged hospital length, poor quality of life and financial burden. The relationship between body mass index (BMI) and PIs occurrence is controversial. The aim of this study was to further examine relationships between BMI and PIs occurrence in hospitalized patients. A multi-center prospective study. 39 hospitals located in northwest China from April 2021 to July 2023. 175,960 hospitalized patients aged over 18 years were enrolled, and 170,800 patients were included in the final analysis. BMI and clinical characteristics were assessed at baseline. PIs assessment were performed by trained nurses, with data recorded for the presence, the location and stage of each PI. For staging PIs, the National Pressure Ulcer Advisory Panel（NPUAP） staging system were used. The multivariate logistic regressions analysis and restricted cubic splines (RCS) models were used to explore associations between BMI and PIs, adjusting for potential confounders. Of 175,960 participants, 5160 were excluded from analyses. The multivariate logistic regression model identified a positive relationship between under-weight BMI and risk of PIs occurrence (OR = 1.60, 95% CI:1.18–2.17). We also found U shaped association between BMI and PIs occurrence (non-linear P < 0.001). BMI less than 23 kg/m2 significantly increased risk of PIs, and there was a tendency to increase risk of PIs at BMI higher than 30 kg/m2. We stratified participants by sex to further investigate their association and found the risk of PIs increases substantially in women at BMI below 17 kg/m2 and in men at BMI below 23 kg/m2. The present study indicated that there was an approximate U shaped relationship between BMI and PIs occurrence, and this association was potentially different between men and women. • Pressure injuries (PIs) are one of the leading potentially preventable adverse events in the hospital. • Early identification of hospitalized patients at risk of PIs can lead to early and precise intervention. • The relationship between body mass index (BMI) and PIs occurrence is controversial. • There was an approximate U shaped relationship between BMI and PIs occurrence. • The relationships between BMI and PIs occurrence was potentially different between men and women. [ABSTRACT FROM AUTHOR]

Subarachnoid hemorrhage (SAH) is primarily attributed to the rupture of intracranial aneurysms and is associated with a high incidence of disability and mortality. SAH disrupts the blood‒brain barrier, leading to the release of iron ions from blood within the subarachnoid space, subsequently inducing neuronal ferroptosis. A recently discovered protein, known as ferroptosis suppressor protein 1 (FSP1), exerts anti-ferroptotic effects by facilitating the conversion of oxidative coenzyme Q 10 (CoQ10) to its reduced form, which effectively scavenges reactive oxygen radicals and mitigates iron-induced ferroptosis. In our investigation, we observed an increase in FSP1 levels following SAH. However, the depletion of CoQ10 caused by SAH hindered the biological function of FSP1. Therefore, we created neuron-targeted liposomal CoQ10 by introducing the neuron-targeting peptide Tet1 onto the surface of liposomal CoQ10. Our objective was to determine whether this formulation could activate the FSP1 system and subsequently inhibit neuronal ferroptosis. Our findings revealed that neuron-targeted liposomal CoQ10 effectively localized to neurons at the lesion site after SAH. Furthermore, it facilitated the upregulation of FSP1, reduced the accumulation of malondialdehyde and reactive oxygen species, inhibited neuronal ferroptosis, and exerted neuroprotective effects both in vitro and in vivo. Our study provides evidence that supplementation with CoQ10 can effectively activate the FSP1 system. Additionally, we developed a neuron-targeted liposomal CoQ10 formulation that can be selectively delivered to neurons at the site of SAH. This innovative approach represents a promising therapeutic strategy for neuronal ferroptosis following SAH. Subarachnoid hemorrhage (SAH) is primarily attributed to the rupture of intracranial aneurysms and is associated with a high incidence of disability and mortality. Ferroptosis suppressor protein 1 (FSP1), exerts anti-ferroptotic effects by facilitating the conversion of oxidative coenzyme Q 10 (CoQ10) to its reduced form, which effectively scavenges reactive oxygen radicals and mitigates iron-induced ferroptosis. In our investigation, we observed an increase in FSP1 levels following SAH. However, the depletion of CoQ10 caused by SAH hindered the biological function of FSP1. Therefore, we created neuron-targeted liposomal CoQ10. We find that it effectively localized to neurons at the lesion site after SAH and activated the FSP1/CoQ10 system. This innovative approach represents a promising therapeutic strategy for neuronal ferroptosis following SAH and other central nervous system diseases characterized by disruption of the blood-brain barrier. [Display omitted] [ABSTRACT FROM AUTHOR]

To accurately identify the high-risk pathological factors of pulmonary nodules, our study constructed a model combined with clinical features, radiomics features, and deep transfer learning features to predict high-risk pathological pulmonary nodules. The study cohort consisted of 469 cases of lung adenocarcinoma patients, divided into a training cohort (n = 400) and an external validation cohort (n = 69). We obtained computed tomography (CT) semantic features and clinical characteristics, as well as extracted radiomics and deep transfer learning (DTL) features from the CT images. Selected features were used for constructing prediction models using the logistic regression (LR) algorithm. The performance of the models was evaluated through metrics including the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, calibration curve, and decision curve analysis. The clinical model achieved an AUC of 0.774 (95% CI: 0.728–0.821) in the training cohort and 0.762 (95% confidence interval [CI]: 0.650–0.873) in the external validation cohort. The radiomics model demonstrated an AUC of 0.847 (95% CI: 0.810–0.884) in the training cohort and 0.800 (95% CI: 0.693–0.907) in the external validation cohort. The radiomics-DTL (Rad-DTL) model showed an AUC of 0.871 (95% CI: 0.838–0.905) in the training cohort and 0.806 (95% CI: 0.698–0.914) in the external validation cohort. The proposed combined model yielded AUC values of 0.872 and 0.814 in the training and external validation cohorts, respectively. The combined model demonstrated superiority over both the clinical model and the Rad-DTL model. There were no statistically significant differences observed in the comparison between the combined model incorporating clinical features and the Rad-DTL model. Decision curve analysis (DCA) indicated that the models provided a net benefit in predicting high-risk pathologic pulmonary nodules. Rad-DTL signature is a potential biomarker for predicting high-risk pathologic pulmonary nodules using preoperative CT, determining the appropriate surgical strategy, and guiding the extent of resection. [ABSTRACT FROM AUTHOR]

Despite advances in risk-stratified treatment strategies for children with medulloblastoma (MB), the prognosis for MB with short-term recurrence is extremely poor, and there is still a lack of evaluation of short-term recurrence risk or short-term survival. This study aimed to construct and validate a radiomics model for predicting the outcome of MB based on preoperative multiparametric magnetic resonance images (MRIs) and to provide an objective for clinical decision-making. The clinical and imaging data of 64 patients with MB admitted to Shenzhen Children's Hospital from December 2012 to December 2021 and confirmed by pathology were retrospectively collected. According to the 18-month progression-free survival, the cases were classified into a good prognosis group and a poor prognosis group, and all cases were divided into training group (70%) and validation group (30%) randomly. Radiomics features were extracted from MRI of each child. The consistency test, t -test, and the least absolute shrinkage and selection operator were used for feature selection. The support vector machine (SVM) and receiver operator characteristic were used to evaluate the distinguishing ability of the selected features to the prognostic groups. RAD score was calculated based on the selected features. The clinical characteristics and RAD score were included in the multivariate logistic regression, and prediction models were constructed by screening out independent influences. The radiomics nomogram was constructed, and its clinical significance was evaluated. A total of 1930 radiomic features were extracted from the images of each patient, and 11 features were included in the construction of radiomics score after selected. The area under the curve (AUC) values of the SVM model in the training and validation groups were 0.946 and 0.797, respectively. The radiomics nomogram was constructed based on the training cohort, and the AUC values in the training group and the validation group were 0.926 and 0.835, respectively. The results of clinical decision curve analysis showed that a good net benefit could be obtained from the nomogram. The radiomics nomogram established based on MRI can be used as a noninvasive predictive tool to evaluate the prognosis of children with MB, which is expected to help neurosurgeons better conduct preoperative planning and patient follow-up management. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the feasibility and accuracy of a combined virtual surgical planning (VPS) and short-segment drilling guides (SSDGs) workflow for the treatment of complex mandibular fractures. Consecutive patients with complex mandibular fractures underwent treatment using the VPS and SSDGs workflow from August 2020 to April 2022. Various mandibular landmarks were compared between the preoperative virtual surgical plan and postoperative data, including condylar distance (CoD), mandibular angle width (GoL-GoR), GoMeGo angle (∠GoL-Me-GoR), the difference in mandibular angles between the left and right sides (Δ∠Co-Go-Me), and the difference in length between the left and right mandibular body (ΔGo-Me). Additionally, preoperative preparation time and surgical duration were retrospectively analyzed and compared to conventional surgery. All 14 consecutive patients with complex mandibular fractures achieved successful reduction using the VPS and SSDGs workflow. Three-dimensional comparison revealed a mean deviation distance of 0.91 ± 0.50 mm and a root-mean-square deviation of 1.75 ± 0.47 mm between the preoperative designed mandible model and the postoperative mandible model. The percentage of points with deviation distances less than 2 mm, 1 mm, and 0.5 mm between preoperative and postoperative models were 78.47 ± 8.87 %, 60.02 ± 14.28 %, and 38.64 ± 15.48 %, respectively. There were no significant differences observed in CoD, GoL-GoR, ∠GoL-Me-GoR, Δ∠Co-Go-Me, and ΔGo-Me between preoperative virtual surgical planning and postoperative measurements. Furthermore, no significant differences were found in the injury-to-surgery interval, admission-to-surgery interval, and surgical duration between the workflow and conventional surgery. The combined VPS and SSDGs workflow proved to be an accurate and feasible method for treating complex mandibular fractures. It offers advantages such as minimal preoperative preparation time and the ability to precise transfer screw positions of the pre-bent reconstruction plate during surgery. This approach is particularly suitable for managing complex mandibular fractures. This study assessed the feasibility and accuracy of a combined virtual surgical planning (VPS) and short-segment drilling guides (SSDGs) workflow for treating complex mandibular fractures. From August 2020 to April 2022, 14 consecutive patients with complex mandibular fractures underwent treatment using this workflow. Various mandibular landmarks were compared between the preoperative virtual surgical plan and postoperative data, along with analysis of preoperative preparation time and surgical duration in comparison to conventional surgery.Three-dimensional comparison revealed a mean deviation distance of 0.91 ± 0.50 mm and a root-mean-square deviation of 1.75 ± 0.47 mm between the VSP mandible model and the postoperative mandible model. The percentage of points with deviation distances less than 2 mm, 1 mm, and 0.5 mm between preoperative and postoperative models were 78.47 ± 8.87 %, 60.02 ± 14.28 %, and 38.64 ± 15.48 %, respectively. Additionally, the workflow did not differ significantly from conventional surgery in terms of the injury-to-surgery interval, admission-to-surgery interval, and surgical duration.The combined VPS and SSDGs workflow demonstrated its accuracy and feasibility for treating complex mandibular fractures. It offered benefits such as reduced preoperative preparation time and precise transfer of screw positions during surgery. This approach proves particularly suitable for managing complex mandibular fractures. [ABSTRACT FROM AUTHOR]