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Accumulation of abnormal chondroitin sulfate (CS) chains in breast cancer tissue is correlated with poor prognosis. However, the biological functions of these CS chains in cancer progression remain largely unknown, impeding the development of targeted treatment focused on CS. Previous studies identified chondroitin polymerizing factor (CHPF; also known as chondroitin sulfate synthase 2) is the critical enzyme regulating CS accumulation in breast cancer tissue. We then assessed the association between CHPF‐associated proteoglycans (PGs) and signaling pathways in breast cancer datasets. The regulation between CHPF and syndecan 1 (SDC1) was examined at both the protein and RNA levels. Confocal microscopy and image flow cytometry were employed to quantify macropinocytosis. The effects of the 6‐O‐sulfated CS‐binding peptide (C6S‐p) on blocking CS functions were tested in vitro and in vivo. Results indicated that the expression of CHPF and SDC1 was tightly associated within primary breast cancer tissue, and high expression of both genes exacerbated patient prognosis. Transforming growth factor beta (TGF‐β) signaling was implicated in the regulation of CHPF and SDC1 in breast cancer cells. CHPF supported CS–SDC1 stabilization on the cell surface, modulating macropinocytotic activity in breast cancer cells under nutrient‐deprived conditions. Furthermore, C6S‐p demonstrated the ability to bind CS‐SDC1, increase SDC1 degradation, suppress macropinocytosis of breast cancer cells, and inhibit tumor growth in vivo. Although other PGs may also be involved in CHPF‐regulated breast cancer malignancy, this study provides the first evidence that a CS synthase participates in the regulation of macropinocytosis in cancer cells by supporting SDC1 expression on cancer cells.

Abstract Objective Expand genetic screening for atypical Type I sialidosis (ST‐1) could address its underdiagnosed in both progressive myoclonic ataxia (PMA) and ataxia patients. To evaluate the potential founder effect of mutation in the population. Methods We enrolled 231 patients with PMA or ataxia from the First Affiliated Hospital of Fujian Medical University. Through Whole Exome Sequencing and Sanger sequencing, we identified the causative gene in patients. Haplotype analysis was employed to explore a potential founder effect of the NEU1 c.544A>G mutation. Results A total of 31 patients from 23 unrelated families were genetically diagnosed with ST‐1. A significant 80.6% of these patients were homozygous for the c.544A>G mutation. We discovered six different NEU1 variants, including two novel mutations: c.951_968del and c.517T>G. The mean age of onset was 18.0 ± 7.1 years. The clinical spectrum of ST‐1 featured ataxia and myoclonus as the most common initial symptoms. Over 40% suffered from controlled generalized tonic–clonic seizures. Mobility and independence varied greatly across the cohort. Cherry‐red spots were rare, occurring in just 9.5% (2/21) of patients. Brain MRIs were typically unremarkable, except for two patients with unusual findings. EEGs showed diffuse paroxysmal activity in 17 patients. The c.544A>G mutation in NEU1 is a founder variant in Fujian, with a unique haplotype prevalent in East Asians. Interpretation ST‐1 should be suspected in patients with PMA or ataxia in Southeast China, even without macular cherry‐red spots and seizures, and the premier test could be a variant screening of the founder variant NEU1 c.544A>G.

Objective We assessed the contributions of B cell and T cell subsets to the disparate clinical outcomes in NZM.Baff−/− and NZM.Br3−/− mice. Methods We assessed in NZM wild‐type, NZM.Baff−/−, and NZM.Br3−/− mice numbers and percentages of B cells and subsets, T cells and subsets, and in vivo proliferation and survival of forkhead box P3 (Foxp3)+ cells by fluorescence‐activated cell sorting. Relationships between percentages of Foxp3+ cells and numbers of CD19+ and CD4+ cells were assessed by linear regressions. Results In each age and sex cohort, percentages and numbers of CD19+ cells were similar in NZM.Baff−/− and NZM.Br3−/− mice. Percentages of CD3+ and CD4+ cells were greater in NZM.Br3−/− than in NZM.Baff−/− mice, with the CD4 to CD3 cell ratios being greater in NZM.Br3−/− than in NZM.Baff−/− mice and percentages of Foxp3+ cells in NZM.Br3−/− mice being lower than in NZM.Baff−/− mice. Percentages of Foxp3+ cells correlated positively with CD19+ cells in NZM.Baff−/− mice but negatively in NZM.Br3−/− mice. In vivo proliferation and survival of Foxp3+ cells were lower in NZM.Baff−/− mice than in NZM.Br3−/− mice. Conclusion Differences between NZM.Baff−/− and NZM.Br3−/− mice in Foxp3+ cells and their relationships with CD19+ cells may have more to do with their divergent clinical outcomes than do differences in numbers of B cells. These unexpected findings suggest that B cell activating factor (BAFF)–B cell maturation antigen (BCMA) or BAFF–Transmembrane activator and calcium‐modulator and cyclophilin ligand interactor (TACI) interactions may help drive development of clinical systemic lupus erythematosus (SLE) even under conditions of considerable B cell depletion. Insufficient blocking of BAFF–BCMA and BAFF–TACI interactions may lie at the heart of incomplete clinical response to BAFF‐targeting agents in human SLE.

Abstract The introduction of cloud‐native technology has significantly changed the architecture of applications and the mechanism for the collaborative operation of components in power distribution edge computing terminals (PDECT). To develop an effective quantitative analysis tool for PDECT performance, the composition and characteristics of cloud‐native PDECT are studied, and the modelling and simulation of cloud‐native PDECT are proposed. Subsequently, modelling is implemented through the simulation software CloudSim, achieving the simulation of microservices, containers, declarative configuration, and container orchestration with the consideration of power distribution scenarios. Then, by the proposed simulation scenario module, various elements of the power distribution scenarios can be self‐defined. Finally, by demonstrating the principles and implementation mechanisms of the proposed modelling method and simulation tool, and comparing simulation results for different service time ranges, access devices, resource configurations of PDECT, request occurrence rates, and resource scheduling strategies, the validity and effectiveness of the proposed modelling method and simulation tool are verified.

Abstract This paper addresses the challenge of maximizing power capture from new energy sources, including coal, wind, solar, and hydroelectric power, which often lack sufficient inertia support. This deficiency can lead to frequency instability and cascading failures within the power system. A cooperative optimization model for the start‐up of multiple power supplies, designed to enhance the integration of new energy sources while maintaining system stability is proposed. The model incorporates primary frequency modulation and the intrinsic inertia support capabilities of self‐synchronous voltage source field stations, considering dynamic frequency constraints. Additionally, it employs new energy units with primary frequency modulation to provide inertia support during curtailment, particularly when conventional units cannot meet frequency standards due to existing constraints. Extensive simulations and comparative analyses demonstrate that the proposed model improves new energy utilization by up to 37.5% and reduces operational costs by approximately 16%, enhancing overall operational efficiency in high energy consumption scenarios.

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive cancer with a 5‐year survival rate of 7.2% in China. However, effective approaches for diagnosis of PDAC are limited. Tumor‐originating genomic and epigenomic aberration in circulating free DNA (cfDNA) have potential as liquid biopsy biomarkers for cancer diagnosis. Our study aims to assess the feasibility of cfDNA‐based liquid biopsy assay for PDAC diagnosis. In this study, we performed parallel genomic and epigenomic profiling of plasma cfDNA from Chinese PDAC patients and healthy individuals. Diagnostic models were built to distinguish PDAC patients from healthy individuals. Cancer‐specific changes in cfDNA methylation landscape were identified, and a diagnostic model based on six methylation markers achieved high sensitivity (88.7% for overall cases and 78.0% for stage I patients) and specificity (96.8%), outperforming the mutation‐based model significantly. Moreover, the combination of the methylation‐based model with carbohydrate antigen 19‐9 (CA19‐9) levels further improved the performance (sensitivity: 95.7% for overall cases and 95.5% for stage I patients; specificity: 93.3%). In conclusion, our findings suggest that both methylation‐based and integrated liquid biopsy assays hold promise as non‐invasive tools for detection of PDAC.

Abstract The human placenta is a vital organ, encompassing many distinct cell types, that maintains the growth and development of the fetus and is essential for substance exchange, defense, synthesis, and immunity. Abnormalities in placental cells can lead to various pregnancy complications, but the mechanisms remain largely unclear. Single‐cell and spatial transcriptomics technologies have been developed in recent years to demonstrate placental cell heterogeneity and spatial molecular localization. Here, we review and summarize the current literature, demonstrating these technologies and showing the heterogeneity of various placenta cells and cell–cell communication of normal human placenta, as well as placenta‐related diseases, such as preeclampsia, gestational diabetes mellitus, advanced maternal age, recurrent pregnancy loss, and placenta accreta spectrum disorders. Meanwhile, current weaknesses and future direction were discussed.

Abstract Universal neonatal hepatitis B virus (HBV) vaccination and the advent of direct‐acting antivirals (DAA) against hepatitis C virus (HCV) have reshaped the epidemiology of chronic liver diseases. However, some aspects of the management of chronic liver diseases remain unresolved. Nucleotide analogs can achieve sustained HBV DNA suppression but rarely lead to a functional cure. Despite the high efficacy of DAAs, successful antiviral therapy does not eliminate the risk of hepatocellular carcinoma (HCC), highlighted the need for cost‐effective identification of high‐risk populations for HCC surveillance and tailored HCC treatment strategies for these populations. The accessibility of high‐throughput genomic data has accelerated the development of precision medicine, and the emergence of artificial intelligence (AI) has led to a new era of precision medicine. AI can learn from complex, non‐linear data and identify hidden patterns within real‐world datasets. The combination of AI and multi‐omics approaches can facilitate disease diagnosis, biomarker discovery, and the prediction of treatment efficacy and prognosis. AI algorithms have been implemented in various aspects, including non‐invasive tests, predictive models, image diagnosis, and the interpretation of histopathology findings. AI can support clinicians in decision‐making, alleviate clinical burdens, and curtail healthcare expenses. In this review, we introduce the fundamental concepts of machine learning and review the role of AI in the management of chronic liver diseases.

Abstract As vehicular technology advances, intelligent vehicles generate numerous computation‐intensive tasks, challenging the computational resources of both the vehicles and the Internet of Vehicles (IoV). Traditional IoV struggles with fixed network structures and limited scalability, unable to meet the growing computational demands and next‐generation mobile communication technologies. In congested areas, near‐end Mobile Edge Computing (MEC) resources are often overtaxed, while far‐end MEC servers are underused, resulting in poor service quality. A novel network framework utilizing sixth‐generation mobile communication (6G) and digital twin technologies, combined with task migration, promises to alleviate these inefficiencies. To address these challenges, a task migration and re‐offloading model based on task attribute classification is introduced, employing a hybrid deep reinforcement learning (DRL) algorithm—Dueling Double Q Network DDPG (QDPG). This algorithm merges the strengths of the Deep Deterministic Policy Gradient (DDPG) and the Dueling Double Deep Q‐Network (D3QN), effectively handling continuous and discrete action domains to optimize task migration and re‐offloading in IoV. The inclusion of the Mini Batch K‐Means algorithm enhances learning efficiency and optimization in the DRL algorithm. Experimental results show that QDPG significantly boosts task efficiency and computational performance, providing a robust solution for resource allocation in IoV.

Abstract In view of the cost and reliability issues caused by mechanical position sensors, position sensorless control (PSC) of permanent magnet synchronous motors (PMSMs) has received widespread attention. A series of rotor position estimation (RPE) schemes have been developed, in which the phase‐locked loop (PLL) plays an important role. However, the conventional phase‐locked loops face two thorny issues, one is the degradation of RPE performance under motor acceleration and deceleration conditions, and the other is high noise sensitivity. To this end, an adaptive gain PLL (AG‐PLL) is proposed for PSC of PMSM drives. The gains of the loop filter in the proposed AG‐PLL are adaptively adjusted with the estimation error in order to find a compromise between the estimation performance under motor acceleration and deceleration conditions and the noise sensitivity. Moreover, the proposed scheme avoids increasing the order of the PLL, so its dynamic performance is also guaranteed. The proposed scheme is tested based on the hardware‐in‐the‐loop platform.

Abstract Owing to the widespread integration of renewable distributed energy resources (DERs), the system frequency stability has been jeopardized by the non‐inertial and stochastic units caused by power electronic devices. The integrated energy system (IES) that combines multi‐vector energy resources can provide energy compensation among sub‐systems in a coordinated fashion to further alleviate the volatility on the electric grid. Under the framework of IES, a virtual power plant (VPP) can aggregate multi‐entities and multi‐vector energy resources to participate in the frequency regulation service while pursuing profit maximization. A three‐stage optimal scheduling model of IES‐VPP that fully considers the cycle life of energy storage systems (ESSs), bidding strategies and revenue settlement has been proposed in this paper under the modified PJM frequency regulation market framework to motivate the aggregated resources to respond to the frequency regulation market actively. The simulation results under various scenarios have verified the feasibility and effectiveness of the proposed model through techno‐economic analysis, the advantages of IES‐VPP have been demonstrated compared with a single vector energy system.

Abstract Background The integration of 7 Tesla (7T) magnetic resonance imaging (MRI) with advanced multimodal artificial intelligence (AI) models represents a promising frontier in neuroimaging. The superior spatial resolution of 7TMRI provides detailed visualizations of brain structure, which are crucial forunderstanding complex central nervous system diseases and tumors. Concurrently, the application of multimodal AI to medical images enables interactive imaging‐based diagnostic conversation. Methods In this paper, we systematically investigate the capacity and feasibility of applying the existing advanced multimodal AI model ChatGPT‐4V to 7T MRI under the context of brain tumors. First, we test whether ChatGPT‐4V has knowledge about 7T MRI, and whether it can differentiate 7T MRI from 3T MRI. In addition, we explore whether ChatGPT‐4V can recognize different 7T MRI modalities and whether it can correctly offer diagnosis of tumors based on single or multiple modality 7T MRI. Results ChatGPT‐4V exhibited accuracy of 84.4% in 3T‐vs‐7T differentiation and accuracy of 78.9% in 7T modality recognition. Meanwhile, in a human evaluation with three clinical experts, ChatGPT obtained average scores of 9.27/20 in single modality‐based diagnosis and 21.25/25 in multiple modality‐based diagnosis. Our study indicates that single‐modality diagnosis and the interpretability of diagnostic decisions in clinical practice should be enhanced when ChatGPT‐4V is applied to 7T data. Conclusions In general, our analysis suggests that such integration has promise as a tool to improve the workflow of diagnostics in neurology, with a potentially transformative impact in the fields of medical image analysis and patient management.

Abstract Objective Human T‐cell leukemia virus type 1‐associated myelopathy (HAM) is a chronic, progressive, inflammatory disease with unclear pathogenesis and no effective treatments. We aimed to investigate a novel mechanistic theory and treat HAM patients with rituximab, which can deplete CD20+ B lymphocytes in circulation. Methods Single‐cell RNA sequencing (scRNA‐seq) data was analyzed to identify HTLV‐1‐associated B cells and their effect on T cells. An observational analysis of our HAM cohort was conducted to elucidate changes in the immunological microenvironment of these patients. Peripheral blood mononuclear cells (PBMC) from HAM patients were isolated to explore the efficacy of B cell depletion in vitro. To assess the effect of B‐cell depletion on HAM patients, eligible participants in our cohort received rituximab therapy (NCT04004819). Results ScRNA‐seq results suggest a significant effect of HTLV‐1‐associated B cells on T cells. Additionally, HTLV‐1 was found to infect B cells and depletion of B cells inhibited the proliferation of T cells. Number of B cells in HAM patients had positive correlation with the proviral load and infected cell counts. Depletion of B cells led to a reduction in HTLV‐1 proviral load in vitro. Furthermore, in clinical trial, 14 HAM patients were enrolled. Three patients (21.4%) who received rituximab failed to achieve remission, compared to 24 (85.7%) patients received any other therapy that failed to achieve remission. With a low level of circulating B cells, the proportion of Ki67‐positive cells in CD4+ T cells fell. Interpretation This study provided evidence that depleting B‐lymphocytes is an innovative strategy for treating patients with HAM and broadens the understanding of the role of B cells in infectious immunity.

Abstract Glaucoma poses a significant threat to vision, capable of causing irreversible damage and, in severe instances, leading to permanent blindness. Accurate optic cup (OC) and optic disc (OD) segmentation are essential in glaucoma screening. In this study, a novel OC and OD segmentation approach is proposed. Based on U‐Net, it is optimized by introducing cardinality dimensions. Moreover, attention gates are implemented to reinforce salient features while suppressing irrelevant information. Additionally, a convolutional block attention module (CBAM) is integrated into the decoder segment. This fusion hones in on effective information in both channel and spatial dimensions. Meanwhile, an image processing procedure is proposed for image normalization and enhancement. All of these increase the accuracy of the model. This model is evaluated on the ORIGA and REFUGE datasets, demonstrating the model's superiority in OC and OD segmentation compared to the state‐of‐the‐art methods. Additionally, after the proposed image processing, cup‐to‐disc ratio (CDR) prediction on a batch of 155 in‐house fundus images yields an absolute CDR error of 0.099, which is reduced by 0.04 compared to the case where only conventional processing was performed.

Abstract Cycling is increasingly promoted worldwide, but many urban areas lack satisfactory cycling environments. Assessing these environments is crucial, but existing methods face data challenges for large urban networks. This study proposes a data‐driven framework using dockless shared bicycle data to efficiently evaluate large‐scale cycling environments. First, critical cycling behaviour features that reflect cyclists’ perceptions are identified applying the fuzzy C‐means and random forest model. Then, a distribution‐oriented evaluation method is developed, ensuring the incorporation of cyclist heterogeneity and quantifying the quality differences among road segments by combining statistical analysis with a hierarchical clustering model. The evaluation framework is applied to Yangpu District, Shanghai, using Mobike data covering 114.9 km of cycling roads. Results show that indicators related to speed magnitude and fluctuation are critical, and an experimental study validates the effectiveness of the data‐driven feature extraction method. A minimum trajectory sample size of 260 is required to account for cyclist heterogeneity for one road segment to be evaluated. Further analysis of lower‐performing segments identifies vehicle‐bicycle separation, on‐street parking, and traffic volume as key influencing factors. The rationality of these findings further supports the reliability of the evaluation framework.

Abstract Background Although de novo metastatic breast cancer (dnMBC) is acknowledged as a heterogeneous disease, the current staging systems do not distinguish between patients within the M1 or stage IV category. This study aimed to refine the M1 category and prognostic staging for dnMBC to enhance prognosis prediction and guide the choice of locoregional treatment. Methods We selected patients with dnMBC from the SEER database (2010–2019), grouping them into training (N = 8048) and internal validation (N = 3450) cohorts randomly at a 7:3 ratio. An independent external validation cohort (N = 660) was enrolled from dnMBC patients (2010–2023) treated in three hospitals. Nomogram‐based risk stratification was employed to refine the M1 category and prognostic stage, incorporating T/N stage, histologic grade, subtypes, and the location and number of metastatic sites. Both internal and external validation sets were used for validation analyses. Results Brain, liver, or lung involvement and multiple metastases were independent prognostic factors for overall survival (OS). The nomogram‐based stratification effectively divided M1 stage into three groups: M1a (bone‐only involvement), M1b (liver or lung involvement only, with or without bone metastases), and M1c (brain metastasis or involvement of both liver and lung, regardless of other metastatic sites). Only subtype and M1 stage were included to define the final prognostic stage. Significant differences in OS were observed across M1 and prognostic subgroups. Patients with the M1c stage benefited less from primary tumor surgery in comparison with M1a stage. Conclusion Subdivision of the M1 and prognostic stage could serve as a supplement to the current staging guidelines for dnMBC and guide locoregional treatment.

Abstract Purpose This study aimed to report a newly developed, high‐fidelity synthetic simulator to simulate excision and primary anastomotic (EPA) bulbar urethroplasty and its clinical use for new practitioners in shortening the learning curve. Material and Methods The bulbar urethral anastomosis simulator consists of several standardized components created according to the actual size of the male patient. Interns, novice residents, and fellows inexperienced with urethral reconstruction (n = 10, 5, 5) from different medical centres were invited to participate in the training programme. Two reconstructive urology experts monitored each practice. Following the training, three kinds of validity testing were used to assess the simulator: face, content, and construct. In the intern group, the task performance in the first five training sessions and the last five training ones were compared using a self‐control approach. In the resident and fellow group, the real surgical data, including estimated blood loss, operative duration, and 6‐month post‐operative success rate of trainees after training, are plotted, which are compared with that of reconstructive urology experts (n = 5) included retrospectively to study the effectiveness of the simulator in shortening the learning curve. Results The overall mean satisfaction rate for the simulators was inspiring and evaluated by experts. In the intern group, significant improvement can be achieved through 10 training sessions (p

Objective The role of hypoalbuminemia throughout the course of chronic periprosthetic joint infection (PJI) remains poorly understood. This study aimed to determine the prevalence and risk factors of hypoalbuminemia in periprosthetic joint infection (PJI) patients and to explore the association between hypoalbuminemia and treatment outcomes. Methods This retrospective cohort study included 387 PJI cases who underwent two‐stage exchange arthroplasty between January 2007 and August 2020, of which 342 were reimplanted. The mean follow‐up period was 7.9 years. Multivariate logistic regression analyses were performed to identify risk factors for hypoalbuminemia and to assess the effect of hypoalbuminemia at 1st‐ and 2nd‐stage exchange on the treatment outcome. Furthermore, the impact of dynamic changes in hypoalbuminemia was investigated. Results The prevalence of hypoalbuminemia at 1st‐ and 2nd‐stage exchange was 22.2% and 4.7%, respectively. Patients with age ≥ 68 years and those with isolation of Staphylococcus aureus, Streptococcus, or Gram‐negative bacteria exhibited a higher risk of hypoalbuminemia. Hypoalbuminemia at 1st‐stage was significantly related to treatment failure (OR = 3.3), while hypoalbuminemia at 2nd‐stage raised the OR to 10.0. Patients with persistent hypoalbuminemia at both the 1st‐ and 2nd‐stage exchanges had a significantly higher rate of treatment failure than patients with hypoalbuminemia at the 1st‐stage but normal albumin levels at the 2nd‐stage exchange (55.6% vs 20.0%, p = 0.036). Conclusion One in five patients with chronic PJI exhibits hypoalbuminemia. Hypoalbuminemia is more likely to develop in patients of advanced age and those infected by specific highly virulent organisms. Also, our results highlight the close association between hypoalbuminemia and treatment outcomes.

Objective Many methods of acetabular reconstruction with total hip arthroplasty (THA) for Crowe type II and III adult developmental dysplasia of the hip (DDH) acetabular bone defect have been implemented clinically. However, there was no study comparing the results of integrated acetabular prosthesis (IAP) with bone grafting (BG). This study aims to investigate the efficacy of IAP and BG for acetabular reconstruction in Crowe type II and III DDH. Methods The clinical data of 45 patients with unilateral Crowe type II and III DDH who underwent THA from January 2020 to January 2023 were retrospectively analyzed. The patients were divided into two groups: 25 patients using 3D‐printed IAP (IAP group) and 20 patients using BG (BG group). The operation time and intraoperative blood loss were recorded. The clinical outcomes were assessed by Harris Hip Score (HHS) and full weight‐bearing time. The radiological outcomes were evaluated by the radiological examination. Accordingly, intraoperative and postoperative complications were observed as well. The data between the two groups were compared by independent sample t‐tests and the Mann–Whitney U rank sum test. Results There were no significant differences between the two groups in Harris Hip Score (HHS) (preoperative, 6 months postoperative, and the last follow‐up), leg length discrepancy (LLD), cup inclination, cup anteversion, vertical center of rotation (V‐COR), horizontal center of rotation (H‐COR) (p > 0.05). The mean HHS in the IAP group was higher than in the BG group at 1 and 3 months postoperative (p

Objective Arthrodesis, usage of metallic implants for internal fixation, is commonly employed as the primary treatment modality for Müller‐Weiss disease (MWD). Nevertheless, the efficacy of the current methods of fixation leaves room for improvement. Inadequate fixation strength and the risk of fixation failure are both critical concerns requiring attention. This study explored the clinical effects of implementing a modified fixation technique in talonavicular arthrodesis for the treatment of MWD. Methods A total of 14 cases diagnosed with MWD undergoing talonavicular (TN) arthrodesis from January 2021 toMarch 2023 were included in the retrospective study. The fixation method for fusion involved the use of screws, with additional support from the shape‐memory alloy (SMA) staple. Relevant clinical outcomes and complications were evaluated preoperatively and postoperatively. Paired‐samples t‐test was used for all data comparisons. Results Radiographic evidence confirmed solid fusion, and follow‐up evaluations showed satisfactory results in all cases. The American Orthopedic Foot and Ankle Society (AOFAS) scores were elevated from 32.21 ± 4.0 (range: 22–38) preoperatively to 86.5 ± 2.7 (range: 81–90) postoperatively (p

Objective The unclear clinical outcomes of two different zero‐profile implants with different number of screws in hybrid surgery restricts the choice of patient‐specific implants. This study aims to compare two different implants on its postoperative subsidence, motion stabilization and clinical outcomes. It also provides references to the most reasonable implant choice in fusion surgery. Methods This was a retrospective study. From February 2014 to March 2022, 173 patients who underwent hybrid surgery were included. Among them, 122 received surgery with a four screw implant, while 51 received a two screw implant. We analyzed the significance of patient‐specific factors, radiographic factors and clinical outcomes. The Wilcoxon rank sum test, t tests/analysis of variance (ANOVA) test and stepwise multivariate logistic regression were adopted for statistical analysis. Results No statistically significant difference was observed between the two screw and four screw groups in terms of immediate, middle, and long‐term stability and fusion rate (p > 0.05). However, the two screws group had higher FSU height subsidence at 3, 6, and 12 months postoperatively and higher rates of significant subsidence at three and 6 months postoperatively (p

Abstract Objective Vagus nerve stimulation (VNS) Therapy is routinely indicated for people with drug‐resistant epilepsy (DRE). We analyzed the baseline characteristics of individuals receiving the recently released VNS models and identified factors associated with early or late implantation. Methods The Comprehensive Outcomes Registry of subjects with Epilepsy (CORE‐VNS), a prospective observational study evaluating the clinical and psychosocial outcomes of VNS Therapy®, is following participants for up to 60 months after VNS implantation. In this analysis, we used Cox proportional hazards model to identify baseline characteristics associated with the time from diagnosis to first implantation. Results Of the 819 enrolled, 792 (96.7%) participants implanted with a VNS device were evaluated. 529 (64.6%) underwent the first implantation and 263 (32.1%) a re‐implantation. Participants' median age at first implant was 24 years; 492 (62.1%) were ≥18 years old and 166 (20.3%) were

Abstract Understanding how landscape structure and riparian vegetation impact bee diversity is important for maintaining pollination service in urban areas. We explored spatial and temporal variation of bee communities across land use types in a riparian zone of a mountainous megacity in 2018 and 2022, examined whether riparian vegetation functions as corridors that maintain gene flow of bee populations, and mapped pollination supply at the landscape scale. Pielou index was higher in 2018 than in 2022, while no significant differences in abundance, Shannon and richness index were observed. The abundance of bees and the Shannon index were significantly and positively correlated with the abundance of flowers on grassland and forested land, respectively, while both were negatively correlated with the area of the building. The genetic differentiation of the bee communities in the riparian zone was lower than those outside, indicating the function of the riparian vegetation corridor. The pollination supply varied significantly between regions, with medium to high degree of pollination supply distributed primarily in residual habitats and the surrounding urban green spaces, while low degree in the remaining areas. Our results stress the importance of maintaining the continuity of vegetation in riparian zones and increasing flower abundance, especially native plant species, for the conservation of bees in urban areas. Read the free Plain Language Summary for this article on the Journal blog.

Abstract Background Sarcopenia, the age‐related loss of muscle mass and function, brings multiple adverse outcomes including disability and death. Several sarcopenia consensuses have newly introduced the premorbid concept of possible sarcopenia and recommended early lifestyle interventions. Bidirectional transitions of premorbid states have been revealed in several chronic diseases yet not clarified in sarcopenia. This study aims to investigate the underlying transition patterns of sarcopenia states. Methods The study utilized three waves of data from a nationally representative survey, the China Health and Retirement Longitudinal Study (CHARLS), and included community‐dwelling individuals aged 60 years and older with at least two sarcopenia states assessments based on the Asian Working Group for Sarcopenia criteria 2019 (AWGS2019) between 2011 and 2015. The estimated transition intensity and probability between non‐sarcopenia, possible sarcopenia, sarcopenia, and death were investigated using multi‐stage Markov (MSM) models. Results The study comprised 4395 individuals (49.2% female, median age 67 years) with a total of 10 778 records of sarcopenia state assessment, and the mean follow‐up period was 3.29 years. A total of 24.5% of individuals with a current state of possible sarcopenia returned to non‐sarcopenia, 60.3% remained possible sarcopenia, 6.7% progressed to sarcopenia, and 8.5% died by the next follow‐up. The transition intensity of recovery to non‐sarcopenia (0.252, 95% CI 0.231–0.275) was 2.8 times greater than the deterioration to sarcopenia (0.090, 95% CI 0.080–0.100) for individuals with possible sarcopenia. For individuals with possible sarcopenia, the estimated probabilities of recovering to non‐sarcopenia, progressing to sarcopenia, and transitioning to death within a 1‐year observation were 0.181, 0.066, and 0.035, respectively. For individuals with sarcopenia, the estimated probabilities of recovering to non‐sarcopenia, recovering to possible sarcopenia, and transitioning to death within 1‐year observation were 0.016, 0.125, and 0.075, respectively. In covariables analysis, age, sex, body mass index, physical function impairment, smoking, hypertension, and diabetes are important factors influencing bidirectional transitions. Conclusions The findings highlight the bidirectional transitions of sarcopenia states among older adults and reveal a notable proportion of possible sarcopenia show potential for recovery in the natural course. Screening and intensifying interventions based on risk factors may facilitate a recovery transition.

Abstract Laser wireless energy transmission is a widely utilized method, yet its efficiency is constrained by a variety of factors. In order to improve the conversion efficiency of the receivers of the laser wireless power transmission (LWPT) system, the square elliptic hyperboloid (SEH) concentrating module designed for LWPT system receivers is developed. By analysing the I–V characteristic curves from the results of the experiments and employing non‐linear parameter regression, a corrected battery characteristic curve was derived within a specific laser irradiation range. On this basis, an optical–thermal–electric multi‐field coupling characteristic model was developed. The finite element method is used to simulate the multi‐field coupling characteristics and conversion efficiency of the receiving end under diverse working conditions (including different rotation angles and different divergence angles) of the concentrating photovoltaic module. Research shows: First, the larger the divergence half‐angle β of the laser beam, the more obvious the improvement of the effective optical efficiency of the system by the SEH concentrator. Second, the short‐circuit current and the maximum output power of the PV cell at the receiving end are significantly improved by the SEH concentrator, and the improvement effect is more obvious with the increase of the divergence angle and the rotation angle. Third, SEH concentrators did not significantly affect the fill factor of PV cells.

Objective Distal tibial deformities can significantly impact patients if left uncorrected, often leading to pain, alterations in gait, and the eventual development of post‐traumatic arthritis. The criteria for surgical correction in these patients continues to be a subject of debate, while supramalleolar osteotomy (SMO) is an effective method for correcting distal tibial deformities. The purpose of this study was to evaluate and compare the clinical results of SMO using internal fixation or using computer‐assisted hexapod external fixator in the treatment of distal tibial deformity. Methods A retrospective study was conducted on 290 patients who underwent SMO between June 2015 and January 2023. Forty‐four patients met the inclusion and exclusion criteria. Among the participants, 19 underwent SMO combined with a computer‐assisted hexapod external fixator, while 25 received SMO with plate and screw internal fixation. The tibial anterior surface (TAS) angle, tibial lateral surface (TLS) angle, the tibiotalar (TT) angle and the talocrural (TC) angle were assessed on weight‐bearing X‐ray films. Functional assessments were performed according to the American Orthopedic Foot and Ankle Society (AOFAS) ankle‐hindfoot score. Results The study followed patients for an average duration of 31.7 ± 15.3 months, with a range from 12 to 67 months. Successful bone union was achieved in all cases. For patients treated with the computer‐assisted hexapod external fixator, significant improvements were observed: the mean deviation in sagittal plane deformity parameters decreased from 14.3 ± 10.4 degrees preoperatively to 2.8 ± 3.8 degrees postoperatively (p

Objective Surgical technique in distraction osteogenesis for the treatment of brachymetatarsia can influence the final prognosis. However, there are currently no standardized guidelines for surgical procedures and complication management. The aim of this study is to investigate the effect of bone lengthening with external fixation by minimally invasive osteotomy based on Ilizarov technique in the treatment of congenital brachymetatarsia. Methods A retrospective study was conducted on patients with congenital brachymetatarsia treated by metatarsal lengthening, from June 2017 to December 2020. There were 11 patients with 17 shorted fourth metatarsals, including 10 females and 1 male, with age of 24.6 ± 4.5 years (16–31 years). Six patients were bilaterally involved. Orthofix external fixator mini track was installed through dorsal approach and the fourth MTP joints were temporarily fixed by Kirschner wire. Bone lengthening was performed after a minimally invasive osteotomy at the proximal metatarsals. American Orthopedic Foot and Ankle Society (AOFAS) lesser metatarsophalangeal‐interphalangeal (MTP‐IP) scores, metatarsal length, complications were recorded. Statistical comparison was performed using the paired t‐student test for pre‐ and postoperative AOFAS MTP‐IP scores. Results Patients were followed up for 55 ± 10.8 months. The mean length of the fourth metatarsal bone was 49.9 ± 2.9 mm preoperatively. The mean metatarsal shortage was 18.8 ± 3.1 mm. The mean lengthening achieved was 19.8 ± 3.3 mm, with a lengthening ratio of 39.7% ± 6.6%. The lengthened callus ossified completely at 3–4 months after operation. All patients were satisfied with the results of lengthening. The AOFAS scores were improved significantly from 83.7 ± 4.2 preoperatively to 93.2 ± 2.7 postoperatively (t = −10.27, p

Objectives The occurrence of infection in the ankle and hindfoot presents a formidable surgical challenge. Currently, there is a lack of consensus regarding its treatment strategies. The purpose of this study was to investigate the outcomes of one‐stage arthroscopic ankle and tibiotalocalcaneal (TTC) arthrodesis with external fixation in the treatment of septic ankle and hindfoot arthritis. Methods A retrospective consecutive case‐series study was conducted involving six patients diagnosed with acute or chronic septic ankle or hindfoot arthritis, who underwent operative intervention entailing thorough debridement, arthroscopically assisted one‐stage ankle or TTC fusion, and external fixation. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle‐hindfoot score and visual analog scale (VAS) pain score were determined preoperatively and at the final follow‐up. Demographic and clinical data, inclusive of perioperative and postoperative complications, were recorded. Comparisons of AOFAS ankle‐hindfoot score and VAS pain score between preoperative measures and those at the final follow‐up were conducted using paired t‐tests or paired Wilcoxon rank‐sum tests. Results The study cohort comprised two males and four females, with a mean age of 48.7 years (range, 26–75) at the time of surgical intervention. At the final follow‐up (mean, 26.5 months; range, 16–48), the AOFAS scores exhibited a significant improvement, ascending from an initial mean of 38.8 (range, 12–57) to 80.0 (range, 54–92) (p = 0.007). VAS scores indicated a substantial reduction in pain, decreasing from 6.5 (range, 4–9) to 0 (range, 0–5) (p = 0.046). All patients had achieved osseous consolidation, with a hindfoot infection control rate of 100%. Conclusion One‐stage arthroscopic ankle and TTC arthrodesis with external fixation is as an effective therapeutic choice for septic ankle or hindfoot arthritis. This approach yields favorable outcomes characterized by effective infection control, favorable osseous consolidation, and significant functional restoration of the affected limb.

Objective At present, due to the lack of early observation methods, the effect of the ‘accordion’ technique on the treatment of nonunion of the docking site varies greatly. In this study, color Doppler ultrasound was used to observe the docking site's local changes and investigate the relationship between local microenvironment changes and bone healing after the accordion technique. Methods 30 patients with tibial bone transport treated at the Department of Orthopedics, Second Hospital of Shanxi Medical University, from May 2018 to June 2022, were analyzed retrospectively. Paired‐sample t‐tests were used for data that conformed to a normal distribution, and paired rank‐sum tests were used for before‐and‐after comparisons that did not conform to a normal distribution. There were 26 males and 4 females, aged 47.3 ± 11.7 years. Before bone transport, the defect gap between tibial bone ends was 6.80 ± 3.61 cm. The steps of the accordion technique were as follows: compression for 7 days, ultrasonic study of the microenvironment at the docking site, distraction for 12 days, latency for 7 days, compression for 14 days, then static fixation and radiological study until complete bone healing. Ultrasound was used to detect the size of the hematoma after 7 days of pressure, and the changes in blood flow before and after the ‘accordion' operation. Results All patients were followed up for 11.9 ± 1.9 months. At the last follow‐up, 22 patients achieved bone healing at the docking site after the treatment of the ‘accordion’ technique. There was a linear negative correlation between the size of the hematoma and the time of bone healing at the docking site (r = −0.639, p

Abstract Lycium ruthenicum fruit (LRF) is a potential source of natural colorant in a wide pH range due to richness in monoacylated anthocyanin petanin. However, the yield of LRF largely lags behind the market demand in food industry. In this study, overexpressing LrAN2 (LrAN2OE), an anthocyanin activator in LRF, produced excessive acylated anthocyanins including petanin in L. ruthenicum callus (LRC). Physiological analysis indicates that LrAN2OE extensively orchestrate the redox homeostasis, including antioxidant enzymes system and antioxidants with low molecular weight. KEGG enrichment analysis indicates that LrAN2 hierarchically orchestrate the acylated anthocyanin biosynthesis in LRC at multi‐omics level, such as small RNAome, transcriptome, and metabolome. The anthocyanin yield of LrAN2OE callus cultured by 5% sucrose or glucose is significantly enhanced. Furthermore, the anthocyanin yield approach to 96.23 mg/g dry weight, approximately 3.5 folds of that in LRF, when LrAN2OE suspension cells are cultured in liquid MS medium supplement with 5% sucrose and 100 mM NaCl. Notably, anthocyanins extracted from LrAN2OE callus are stable in pH 1.0–2.0, pH 7.0, and pH 9.0, showing red or blue color within 30 days at 4°C. Our findings suggest that LrAN2 is perfect gene resource for metabolic engineering of acylated anthocyanins in LRC, a promising chassis producing acylated anthocyanins. Taken together, LRC metabolically engineered by LrAN2 is a potential source of natural food color, which facilitates to make up the shortfall of LRF as source of natural colorant in future food industry.

Abstract Emerging research has shown that lactic acid bacteria in the intestines of newborns play a beneficial role in the growth, immune function, and metabolism of infants after birth. In this study, four strains of Lactobacillus were isolated from fecal samples of newborns, and a safe Lactiplantibacillus plantarum ZFM518 (ZFM518) strain was obtained after the screening, which showed excellent antibacterial activity and adhesion potential. The strain exhibited excellent ability to survive in acidic environments, simulated gastric juice, and simulated intestinal environments, respectively. ZFM518 had a bacteriostatic zone of 31.12 ± 0.33 mm against Staphylococcus aureus, a hydrophobic rate of 76.97% ± 3.35%, and a survival activity of 96.54% ± 0.14% under a simulated intestinal fluid environment. Moreover, ZFM518 can produce up to 161.11 ± 9.67 ng/mL of folate. A genome‐wide investigation of ZFM518 revealed that the majority of its genes were involved in the metabolism of amino acids, carbohydrates, adhesion, immunological defense, and antibacterial activity. In addition, only one antibiotic resistance gene of the antimicrobial peptide was annotated. These results indicate that ZFM518 is a new strain with a strong comprehensive ability and probiotic potential. This study can provide practical support for screening potential probiotics from infant feces and provide a theoretical basis for developing probiotic resources.

Abstract Objective Despite successful recanalization following acute ischemic stroke, patients may have a poor prognosis. We investigated whether transcranial Doppler combined with quantitative electroencephalography can identify patients with a poor prognosis at an early stage. Methods Prospectively recruited patients with successful recanalization after endovascular treatment for acute ischemic stroke were assessed for prognosis at 90 days using the modified Rankin Scale. Clinical information and National Institute of Health Stroke Scale scores were recorded. Transcranial Doppler combined with quantitative electroencephalography was used to evaluate brain function. Results Of the 37 patients (63.5 ± 11.7 years) studied, 18 had a poor prognosis at 90 days (modified Rankin Scale >3). Multivariable analysis revealed that transcranial Doppler indicators of the pulsatility index of the unaffected side, quantitative electroencephalography indicators of the pairwise‐derived Brain Symmetry Index, and National Institute of Health Stroke Scale score were independent prognostic indicators. Modeling indicated that combining these independent predictors yielded superior accuracy and net clinical benefit to any single variable. With the final predictive model presented as a nomogram, internal validation by bootstrap resampling showed good discrimination with a concordance index of 0.961. The calibration curve displayed good agreement of predicted and actual probabilities. Interpretation The nomogram prediction model combining transcranial Doppler with quantitative electroencephalography and National Institute of Health Stroke Scale scores can provide guidance for individualized risk prediction in patients with acute ischemic stroke after revascularization.

Abstract Background Anaplastic lymphoma kinase (ALK) test in advanced non‐small cell lung cancer (NSCLC) can help physicians provide target therapies for patients harboring ALK gene rearrangement. This study aimed to investigate the real‐world test patterns and positive rates of ALK gene rearrangements in advanced NSCLC. Methods In this real‐world study (ChiCTR2000030266), patients with advanced NSCLC who underwent an ALK rearrangement test in 30 medical centers in China between October 1, 2018 and December 31, 2019 were retrospectively analyzed. Interpretation training was conducted before the study was initiated. Quality controls were performed at participating centers using immunohistochemistry (IHC)‐VENTANA‐D5F3. The positive ALK gene rearrangement rate and consistency rate were calculated. The associated clinicopathological characteristics of ALK gene rearrangement were investigated as well. Results The overall ALK gene rearrangement rate was 6.7% in 23,689 patients with advanced NSCLC and 8.2% in 17,436 patients with advanced lung adenocarcinoma. The quality control analysis of IHC‐VENTANA‐D5F3 revealed an intra‐hospital consistency rate of 98.2% (879/895) and an inter‐hospital consistency rate of 99.2% (646/651). IHC‐VENTANA‐D5F3 was used in 53.6%, real‐time polymerase chain reaction (RT‐PCR) in 25.4%, next‐generation sequencing (NGS) in 18.3%, and fluorescence in‐situ hybridization (FISH) in 15.9% in the adenocarcinoma subgroup. For specimens tested with multiple methods, the consistency rates confirmed by IHC‐VENTANA‐D5F3 were 98.0% (822/839) for FISH, 98.7% (1,222/1,238) for NGS, and 91.3% (146/160) for RT‐PCR. The overall ALK gene rearrangement rates were higher in females, patients of ≤ 35 years old, never smokers, tumor cellularity of > 50, and metastatic specimens used for testing in the total NSCLC population and adenocarcinoma subgroup (all P < 0.05). Conclusions This study highlights the real‐world variability and challenges of ALK test in advanced NSCLC, demonstrating a predominant use of IHC‐VENTANA‐D5F3 with high consistency and distinct clinicopathological features in ALK‐positive patients. These findings underscore the need for a consensus on optimal test practices and support the development of refined ALK test strategies to enhance diagnostic accuracy and therapeutic decision‐making in NSCLC.

Abstract Background Patients with non‐small cell lung cancer (NSCLC) with liver metastasis have a poor prognosis, and there are no reliable biomarkers for predicting disease progression. Currently, no recognized and reliable prediction model exists to anticipate liver metastasis in NSCLC, nor have the risk factors influencing its onset time been thoroughly explored. Methods This study conducted a retrospective analysis of 434 NSCLC patients from two hospitals to assess the association between the risk and timing of liver metastasis, as well as several variables. Results The patients were divided into two groups: those without liver metastasis and those with liver metastasis. We constructed a nomogram model for predicting liver metastasis in NSCLC, incorporating elements such as T stage, N stage, M stage, lack of past radical lung cancer surgery, and programmed death ligand 1 (PD‐L1) levels. Furthermore, NSCLC patients with wild‐type EGFR, no prior therapy with tyrosine kinase inhibitors (TKIs), and no prior radical lung cancer surgery showed an elevated risk of early liver metastasis. Conclusion In conclusion, the nomogram model developed in this study has the potential to become a simple, intuitive, and customizable clinical tool for assessing the risk of liver metastasis in NSCLC patients following validation. Furthermore, it provides a framework for investigating the timing of metachronous liver metastasis.

Abstract Salicylic acid (SA) plays an essential role in plant defense against biotrophic and semi‐biotrophic pathogens. Following pathogen recognition, SA biosynthesis dramatically increases at the infection site of the host plant. The manner in which pathogens sense and tolerate the onslaught of SA stress to survive in the plant following infection remains to be understood. The objective of this work was to determine how the model phytopathogen Xanthomonas campestris pv. campestris (Xcc) senses and effluxes SA during infection inside host plants. First, RNA‐Seq analysis identified an SA‐responsive operon Xcc4167–Xcc4171, encoding a MarR family transcription factor HepR and an RND (resistance‐nodulation‐cell division) family efflux pump HepABCD in Xcc. Electrophoretic mobility shift assays and DNase I footprint analysis revealed that HepR negatively regulated hepABCD expression by specifically binding to an AT‐rich region of the promoter of the hepRABCD operon, Phep. Second, isothermal titration calorimetry and further genetic analysis suggest that HepR is a novel SA sensor. SA binding released HepR from its cognate promoter Phep and then induced the expression of hepABCD. Third, the RND family efflux pump HepABCD was responsible for SA efflux. The hepRABCD cluster was also involved in the regulation of culture pH and quorum sensing signal diffusible signaling factor turnover. Finally, the hepRABCD cluster was transcribed during the XC1 infection of Chinese radish and was required for the full virulence of Xcc in Chinese radish and cabbage. These findings suggest that the ability of Xcc to co‐opt the plant defense signal SA to activate the multidrug efflux pump may have evolved to ensure Xcc survival and virulence in susceptible host plants.

Abstract Fzf1 is a Saccharomyces cerevisiae transcription factor containing five zinc fingers (ZFs). It regulates the expression of at least five downstream genes, including SSU1, YHB1, DDI2/3, and YNR064c, by recognizing a consensus sequence, CS2, found in these gene promoters. These gene products are involved in cellular responses to various chemical stresses. For example, SSU1 encodes a sodium sulfite efflux protein that confers sulfite resistance. However, the underlying molecular mechanism through which Fzf1 responds to chemical stress and coordinates target gene activation remains elusive. Interestingly, several mutations in the fourth ZF (ZF4) of Fzf1 have previously been reported to confer either sulfite resistance or elevated basal‐level expression of YHB1, indicating that ZF4 negatively impacts Fzf1 activity. Since ZF4 is dispensable for CS2 binding in vitro, we hypothesized that ZF4 is a negative regulator of Fzf1 and that chemically induced Fzf1‐regulated gene expression occurs via de‐repression. All five genes examined were cross‐induced by corresponding chemicals in an Fzf1‐dependent manner, and all three ZF4 mutations and a ZF4 deletion conferred increased basal‐level expression and SSU1‐dependent sulfite resistance. A ZF4 deletion did not alter the target DNA binding, consistent with the observed codominant phenotype. These observations collectively reveal that Fzf1 remains inactive by default at the target promoters and that its activation is at least partially achieved by self‐derepression through chemical modification and/or a conformational change.

ABSTRACT Importance Understanding the significance of motor skills in promoting physical fitness (PF) can offer valuable insights for devising comprehensive intervention and clinical rehabilitation programs for children with global developmental delay (GDD). However, it remains unclear whether fundamental motor skills (FMS) can improve the PF of children with GDD. Objective To investigate the correlation between FMS and PF in children with GDD. Methods A total of 180 children with GDD and 180 typically developing (TD) children aged 3–5 years were selected. All participants completed the Gesell Developmental Schedule, FMS, and PF tests at Beijing Children's Hospital between September 2022 and August 2023. Partial correlation and regression analyses were performed to examine the relationship between FMS and PF. Results Children with GDD had significantly lower FMS and PF scores compared to TD children (P < 0.05). No significant differences were found between males and females with GDD in FMS and PF score (P > 0.05). A more severe developmental delay was associated with lower FMS and PF scores. The correlation coefficients between individual FMS items and individual PF items, as well as the total PF score, ranged from 0.20 to 0.56. Regression analysis indicated that manual dexterity (β = 0.241, P = 0.029) and body balance (β = 0.399, P = 0.001) significantly predicted the total PF score. Interpretation In children with GDD, both FMS and PF are underdeveloped. Focusing on motor skills development is vital for promoting their PF.

Abstract Electric vehicles (EVs) and small photovoltaic (PV) installations advance residential power grids by lowering charging costs and fostering eco‐friendly operations. Yet, the variable nature of EV charging presents challenges to grid reliability. This research introduces a Monte Carlo‐based simulation for predicting EV charging loads and a systematic charging method that integrates a ‘green electricity’ pricing scheme with a joint optimization model for PV and EV management. By applying an improved ant lion optimizer (IALO) algorithm enriched with differential evolution features, an optimization strategy that markedly enhances grid performance is devised. In a park scenario, this ‘green electricity’ model reduced the mean square error of EV charging load by 11.82%, smoothed the power load curve, and improved grid stability. When compared with particle swarm optimization (PSO) and grey wolf optimizer (GWO) algorithms, the IALO algorithm boosted overall revenue by 16.8% and 12.8%, increased PV utilization by 162.3% and 37.1%, and significantly cut carbon emissions by 159.6% and 31.6%, respectively. These outcomes affirm the financial, environmental, and functional benefits of our proposed approach.

Abstract Autophagy can be classified as degradative and secretory based on distinct functions. The small GTPase proteins Rab8a and Rab37 are responsible for secretory autophagy‐mediated exocytosis of IL‐1β, insulin, and TIMP1 (tissue inhibitor of 54 metalloproteinase 1). Other Rab family members participating in secretory autophagy are poorly understood. Herein, we identified 26 overlapped Rab proteins in purified autophagosomes of mouse pancreatic β‐cell “Min‐6” and human lung cancer cell “CL1‐5‐Q89L” with high secretory autophagy tendency by LC–MS/MS proteomics analysis. Six Rab proteins (Rab8a, Rab11b, Rab27a, Rab35, Rab37, and Rab7a) were detected in autophagosomes of four cell lines, associating them with autophagy‐related vesicle trafficking. We used CL1‐5‐Q89L cell line model to evaluate the levels of Rab proteins colocalization with autophagy LC3 proteins and presence in purified autophagosomes. We found five Rab proteins (Rab8a, Rab11b, Rab27a, Rab35, and Rab37) are highly expressed in the autophagosome compared to the normal control by immunoblotting under active secretion conditions. However, only Rab8a, Rab35, and Rab37 showing high colocalization with LC3 protein by cofocal microscopy. Despite the discrepancy between the image and immunoblotting analysis, our data sustains the speculation that Rab8a, Rab11b, Rab27a, Rab35, and Rab37 are possibly associated with the secretory autophagy machinery. In contrast, Rab7a shows low colocalization with LC3 puncta and low level in the autophagosome, suggesting it regulates different vesicle trafficking machineries. Our findings open a new direction toward exploring the role of Rab proteins in secretory autophagy‐related cargo exocytosis and identifying the cargoes and effectors regulated by specific Rab proteins.

Abstract Autophagy is a self‐recycling machinery to maintain cellular homeostasis by degrading harmful materials in the cell. Autophagy‐related gene 5 (Atg5) is required for autophagosome maturation. However, the role of Atg5 in tumorigenesis under autophagy deficient conditions remains unclear. This study focused on the autophagy‐independent role of Atg5 and the underlying mechanism in tumorigenesis. We demonstrated that knockout of autophagy‐related genes including Atg5, Atg7, Atg9, and p62 in mouse embryonic fibroblast (MEF) cells consistently decreased cell proliferation and motility, implying that autophagy is required to maintain diverse cellular functions. An Atg7 knockout MEF (Atg7−/− MEF) cell line representing deprivation of autophagy function was used to clarify the role of Atg5 transgene in tumorigenesis. We found that Atg5‐overexpressed Atg7−/‐MEF (clone A) showed increased cell proliferation, colony formation, and migration under autophagy deficient conditions. Accordingly, rescuing the autophagy deficiency of clone A by overexpression of Atg7 gene shifts the role of Atg5 from pro‐tumor to anti‐tumor status, indicating the dual role of Atg5 in tumorigenesis. Notably, the xenograft mouse model showed that clone A of Atg5‐overexpressed Atg7−/− MEF cells induced temporal tumor formation, but could not prolong further tumor growth. Finally, biomechanical analysis disclosed increased Wnt5a secretion and p‐JNK expression along with decreased β‐catenin expression. In summary, Atg5 functions as a tumor suppressor to protect the cell under normal conditions. In contrast, Atg5 shifts to a pro‐tumor status under autophagy deprivation conditions.

Abstract Objective IRF2BPL mutation has been associated with a rare neurodevelopmental disorder with abnormal movements, including dystonia. However, the role of IRF2BPL in dystonia remains elusive. We aimed to investigate IRF2BPL mutations in a Taiwanese dystonia cohort. Methods A total of 300 unrelated patients with molecularly unassigned isolated (n = 256) or combined dystonia (n = 44) were enrolled between January 2015 and July 2023. The IRF2BPL variants were analyzed based on whole exome sequencing. The in silico prediction of the identified potential pathogenic variant was performed to predict its pathogenicity. We also compared the clinical and genetic features to previous literature reports. Results We identified one adolescent patient carrying a de novo heterozygous pathogenic variant of IRF2BPL, c.379C>T (p.Gln127Ter), who presented with generalized dystonia, developmental regression, and epilepsy (0.33% of our dystonia cohort). This variant resides within the polyglutamine (poly Q) domain before the first PEST sequence block of the IRF2BPL protein, remarkably truncating the protein structure. Combined with other patients with IRF2BPL mutations in the literature (n = 60), patients with variants in the poly Q domain have a higher rate of nonsense mutations (p

Abstract Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder with the increasing prevalence of a modern sedentary lifestyle. Wearable technology‐based physical activity interventions (WT‐BPAI) might provide a channel to improve diabetic self‐management. The study aimed to (1) evaluate the effectiveness of WT‐BPAI on PA levels, glycemic levels, and other outcomes (blood pressure [BP], body mass index [BMI], and serum lipid profile) in adults with T2DM, and (2) investigate the potential covariates affecting aforementioned outcomes. Eight databases were searched thoroughly using three steps from inception until January 16, 2024. The quality of the studies and overall evidence were evaluated. The package meta of the R software program version 4.3.1. was utilized for meta‐analyses, subgroup analyses, and meta‐regression analyses. A total of 19 randomized controlled trials (RCTs) were found. Meta‐analyses revealed that WT‐BPAI significantly increased 1583 steps per day and decreased systolic BP (SBP) by 2.46 mmHg. Subgroup and meta‐regression analyses found that function, duration of intervention, and age were significant covariates. According to the risk of bias version 2, more than half of the trials raised some concerns about the randomization process, deviations from the intended intervention, and missing outcome data. The certainty of the evidence was very low for all outcomes based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. WT‐BPAI can be considered a supplementary intervention to increase the steps per day and decrease SBP, especially when used for short periods in young adults with T2DM. However, we need more well‐designed research with long‐term outcomes.

ABSTRACT Background Long COVID symptoms (i.e., experiencing symptoms of COVID‐19 for 3 months post‐COVID‐19) affect individuals’ health and their quality of life (QoL). However, the pathways through which it does so are not fully known. Aim The present study examined the mediating roles of sleep quality, psychological distress, and self‐stigma in the associations between long COVID symptoms and QoL among individuals with mental illness. Method Individuals with mental illness (n = 333) were recruited from a psychiatric center in southern Taiwan to participate in the study. Data were collected regarding sleep quality, psychological distress, self‐stigma, and QoL. Independent t‐tests, Pearson correlations, and regression with Hayes’ Process Macro were used to compare groups, examine relationships, and parallel mediation models, respectively. Results Participants with long COVID symptoms had significantly worse sleep quality, psychological distress, physical QoL, and psychological QoL compared to those without symptoms. There were significant relationships between sleep quality, psychological distress, self‐stigma, and QoL. Sleep quality significantly mediated the associations between long COVID symptoms and physical and social QoL. Psychological distress significantly mediated the associations between long COVID symptoms and all domains of QoL, but not self‐stigma. Conclusion There are alternative pathways (e.g., sleep quality and psychological distress) through which long COVID symptoms may affect the QoL of individuals with mental illness. The findings suggest that individuals with long COVID symptoms have a higher chance of having poor QoL. Therefore, there may be the need for counseling and possible therapy for those who contract COVID‐19, especially among individuals who already have mental illness.

Abstract The factors that enable the coexistence of closely related species remain a major question in ecology, particularly in human‐disturbed habitats. The effects of anthropogenic disturbance and interspecific competition can exacerbate the decline in populations of competing species. The adoption of different strategies in responding to anthropogenic disturbances and competitive avoidances may create opportunities for competing species to coexist. However, few studies have explored how disturbance and competition interact to shape species coexistence. In this study, we conducted long‐term and large‐scale camera trap surveys comprising 540 sampling sites from 2017 to 2021 at Xishuangbanna, southwestern China, and deployed a spatiotemporal analysis framework to determine the effect of anthropogenic disturbances and competitive avoidances on the coexistence of three sympatric macaque species: Assamese macaque (Macaca assamensis; MA), northern pig‐tailed macaque (M. leonina; ML), and rhesus macaque (M. mulatta; MM). Macaque species exhibited diverse responses to different types of anthropogenic disturbances. The occurrence probability of MM was positively associated with distance to road and relative abundance of human occurrence, and negatively associated with distance to cropland, which reduces the likelihood of sympatry between MM and the other two species due to their opposing responses to road, cropland, and human occurrence. Conversely, the similar responses to road and cropland increase the sympatry between MA and ML. Three macaque species did not avoid each other through shifting space use or their overall daily activity pattern. However, they delayed using the shared site after other species used it to avoid confrontation. We provide evidence that (1) the spatial co‐occurrence pattern of sympatric macaque species was determined by anthropogenic disturbances rather than by competitive spatial avoidance and (2) fine‐scale temporary avoidance is the strategy to alleviate their interspecific competition. These results enhance our understanding of the underlying mechanisms leading to species coexistence of nonhuman primates in human‐disturbed habitats.

Abstract The mechanism and function of the expression of Schwann characteristics by nevus cells in the mature zone of the dermis are unknown. Early growth response 3 (EGR3) induces Schwann cell‐like differentiation of melanoma cells by simulating the process of nevus maturation, which leads to a strong phenotypic transformation of the cells, including the formation of long protrusions and a decrease in cell motility, proliferation, and melanin production. Meanwhile, EGR3 regulates the levels of myelin protein zero (MPZ) and collagen type I alpha 1 chain (COL1A1) through SRY‐box transcription factor 10 (SOX10)‐dependent and independent mechanisms, by binding to non‐strictly conserved motifs, respectively. Schwann cell‐like differentiation demonstrates significant benefits in both in vivo and clinical studies. Finally, a CD86‐P2A‐EGR3 recombinant mRNA vaccine is developed which leads to tumor control through forced cell differentiation and enhanced immune infiltration. Together, these data support further development of the recombinant mRNA as a treatment for cancer.

Background Left atrial (LA) fibrosis is a marker of atrial cardiomyopathy and has been reported to be associated with both atrial fibrillation and ischemic stroke. Elucidating this relationship is clinically important as LA fibrosis could serve as a surrogate biomarker of LA cardiomyopathy. The objective of this study is to investigate the association of LA fibrosis and embolic stroke of undetermined source (ESUS) using cardiac magnetic resonance imaging. Methods and Results Following an International Prospective Register of Systematic Reviews‐registered protocol, 3 blinded reviewers performed a systematic review for studies that quantified the degree of LA fibrosis in patients with ESUS as compared with healthy patients from inception to February 2024. A meta‐analysis was conducted in the mean difference. From 7 studies (705 patients), there was a significantly higher degree of LA fibrosis in patients with ESUS compared with healthy controls (MD, 5.71% [95% CI, 3.55%–7.87%], P

Abstract MicroRNAs (miRNAs) can regulate several physiological processes of cells after transcription, such as cell proliferation, differentiation, and apoptosis. In this study, we found that 500 μM of palmitic acid (PA) could significantly induce the apoptosis of porcine subcutaneous preadipocytes (p