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This paper constructed a mathematical model of ammonia-water nanofluid falling film generation outside the vertical tube, which considers the change of the film thickness of the falling film solution, the thermal convection along the film thickness direction and the physical properties of the solution. By solving the mathematical model, the temperature field and other elements of the liquid film were determined. The influence of the properties of the working fluid on the heat and mass transfer in the falling film process is investigated. According to the calculation results, a method of adding nanoparticles in the process of ammonia falling film generation is proposed. The simulation results showed that the heat efficiency of entire falling film process can be enhanced by adding an appropriate amount of Al2O3 nanoparticles. When the added Al2O3 nanoparticles are 1 vol.%, the coefficient of the heat transfer is increased by about 4%, and the mass transfer effect is also improved by about 12%. In brief, the establishment of this model aims to improve heat and mass transfer efficiency and promote the application and integration of low-grade waste heat or renewable energy technologies in built environment.

Soil microbial carbon use efficiency (CUE) refers to the efficiency of microorganisms in converting absorbed carbon into their own biomass carbon. Soil microbial CUE is a key parameter to understanding the soil carbon cycle. Biotic and abiotic factors are widely considered to be important factors influencing CUE. However, the related underlying mechanisms remain unclear. This review elaborates on the concept of soil microbial CUE and the various approaches used for its measurement. We reviewed the effects of various abiotic factors, such as temperature, soil moisture, pH, nutrient addition, and substrate type, and biotic factors, such as microbial community structure and diversity, on CUE. Finally, we discussed the focus areas that future studies need to further explore. We hope this review can provide a comprehensive understanding of the factors impacting soil microbial CUE, which is a fundamental step to improving soil carbon storage capacity.

Abstract Deep learning-based automated detection of insulator defects in electric power systems is a critical technological challenge, pivotal for ensuring reliability and efficiency in the global energy infrastructure. However, the effectiveness of the deep learning model is severely compromised by the scarcity of defective insulator samples. To tackle this problem, the present study proposes a style transfer approach utilizing an improved Star Generative Adversarial Network 2 (StarGAN2) model to generate artificial samples of faulty insulators, which adeptly synthesizes artificial faulty insulator samples on a one-to-many basis, markedly diminishing the necessity for extensive empirical data collection. Through the integration of identity loss, the proposed model ensures the fidelity of content and the preservation of critical defect semantics. Additionally, the proposed model incorporates a pre-trained Visual Geometry Group (VGG) network and perceptual loss, thus improving the quality of generated samples without additional artificial labeling. Finally, various experiments are conducted to assess the quality and authenticity of the generated samples and their impact on the detection model. The results demonstrate that StarGAN2 could generate realistic insulator defect samples and improve the performance of defect detection models.

Abstract Minimally invasive thermal therapy is a successful alternative treatment to surgery in solid tumors with high complete ablation rates, however, tumor recurrence remains a concern. Central memory CD8+ T cells (TCM) play important roles in protection from chronic infection and cancer. Here we find, by single-cell RNA analysis of human breast cancer samples, that although the memory phenotype of peripheral CD8+ T cells increases slightly after microwave ablation (MWA), the metabolism of peripheral CD8+ T cells remains unfavorable for memory phenotype. In mouse models, glycolysis inhibition by 2-deoxy-D-glucose (2DG) in combination with MWA results in long-term anti-tumor effect via enhancing differentiation of tumor-specific CD44hiCD62L+CD8+ TCM cells. Enhancement of CD8+ TCM cell differentiation determined by Stat-1, is dependent on the tumor-draining lymph nodes (TDLN) but takes place in peripheral blood, with metabolic remodeling of CD8+ T cells lasting the entire course of the the combination therapy. Importantly, in-vitro glycolysis inhibition in peripheral CD8+ T cells of patients with breast or liver tumors having been treated with MWA thrice leads to their differentiation into CD8+ TCM cells. Our work thus offers a potential strategy to avoid tumor recurrence following MWA therapy and lays down the proof-of-principle for future clinical trials.

Objective: To study the effects of astragalus polysaccharide (APS) on aplastic anaemia (AA) in mice through modulation of the upstream and downstream effectors of the Hippo pathway. Further, we investigated the underlying mechanisms of APS in the treatment of AA to provide possible therapeutic strategies and drugs for clinical use. Methods: BALB/c mice were subjected to 4 Gy X-ray irradiation and subsequently injected with lymphocytes from DBA/2 donor mice by using the tail vein to establish an AA mouse model. Next BALB/c mice were randomly divided into five groups: control (untreated), AA (model), and three APS remedy groups - LA (low-dose APS, 200 mg/kg), MA (medium-dose APS, 400 mg/kg), and HA (high-dose APS, 800 mg/kg). The mice were sacrificed after 14 d of continuous gavage with different doses of APS or saline, and the bone marrow, spleen and liver were obtained. The haematopoietic condition, apoptosis levels, and the expression of Large Tumour Suppressor 1/2 (LATS 1/2), transcriptional co-activator of activation (TCA) Yes-associated protein (YesAP), transcriptional enhancer of adherence domain (TEAD) protein, and Telomerase Reverse Transcriptase (TERT), were analysed. Results: Compared with control mice, mice in the AA group exhibited a reduction in peripheral blood cell counts, a significant decrease in the haematopoietic area, increased adipocyte infiltration, and overall haematopoietic failure, mirroring the clinical presentation of AA; After 14 days of treatment with different doses of APS, the APS-treated group, in comparison to the untreated AA group, showed an increase in peripheral blood cell counts (P

Abstract Enhanced oil recovery (EOR) by in situ formation of oil-in-water emulsion in heavy oil cold production technology has received growing interest from the petroleum industry. We present an experimental study of emulsification of model oils prepared by heavy oil and its functional group compositions dissolved into toluene brought into contact with a surfactant solution. The effects of functional group composition, emulsifier concentration, temperature, pH and stirring speed on the emulsification rate of heavy oil was investigated. A second-order kinetic model characterizing the temporal variation of conductivity during the emulsification has been established. The results show that acidic and amphoteric fractions exhibit higher interfacial activity, larger emulsification rate constant and faster emulsification rate. With the increase of emulsifier concentration, the emulsification rate constant increase to the maximum value at a concentration of 0.05 mol/L before decreasing. Temperature increase benefits the emulsification rate and the activation energy of the emulsification process is 40.28 kJ/mol. Higher pH and stirring speed indicate faster emulsification rate. The heterogeneity of emulsions limits the accuracy of dynamic characterization of the emulsification process and the determination method of emulsification rate has always been controversial. The conductivity method we proposed can effectively evaluates the emulsification kinetics. This paper provides theoretical guidance for an in-depth understanding of the mechanism and application of cold recovery technology for heavy oil.

Background In recent years, medically unexplained physical symptoms (MUPS) are widely concerned by domestic and foreign scholars. However, China started late in this field with relatively backward development. It is of significant importance for the promotion of MUPS field development in China to learn the researches on MUPS by international scholars. Objective To discusses the current status, research hotspots and development trends of MUPS internationally by using bibliometrics method. Methods The papers related to MUPS from inception to 2022-08-15 were searched based on Web of Science core collection databases from July to August in 2022. The bibliometric analysis was performed on the included papers in terms of publication volume trends and the distributions of authors, institutions and research areas after screening and data processing. CiteSpace 6.1R3 software was used to conduct visualization analysis on collaboration between countries or regions, document co-citation, keywords co-occurrence, keywords clustering, and keywords with bursts. Results A total of 1 615 papers were finally included, the number of annual publications in studies regarding MUPS showed an overall upward trend from 1985 to 2022, with the most rapid growth from 2014 to 2016. ROSMALEN J G M (43 papers), WITTHOFT M (41 papers) and RIEF W (31 papers) ranked the top three authors in terms of number of publications, and the total citations of the three scholars' papers also ranks in the top 10, with 954 times, 1 275 times and 1 339 times, respectively. The top three institutions in terms of number of publications were all from the UK, including University of London (143 papers), King's College London (95 papers) and University of Manchester (84 papers). The top three countries/regions in terms of number of publications were England (422 papers), the United States (341 papers), and Netherlands (268 papers), all of which cooperated closely with other countries. A total of 75 research areas were involved in all the literature, with most studies in psychiatry (605 papers). The literature co-citation network map includes 1 393 nodes and 6 108 connections, and the paper with the highest co-citation frequency was titled Somatoform Disorders and Medically Unexplained Symptoms in Primary Care. Except of "Medically unexplained symptoms", the top five keywords in terms of occurrence frequency were "primary care" (422 times), "somatoform disorder" (405 times), "somatization" (354 times), "prevalence" (217 times) and "depression" (211 times). A total of 12 clusters were obtained by keywords clustering analysis, reflecting in the subject category and epidemiological characteristics of MUPS, key subtypes of MUPS, main treatment methods and management of MUPS. Keyword with the highest intensity of burst was "somatic symptom disorder" "children" "bodily distress syndrome" "somatic symptom disorder" and "model" have burst in recent years and persisted till now. Conclusion At present, the publications of international studies regarding to MUPS show an upward stage, with research hotspots and trends mainly focus on the sutypes of MUPS with more researches, attention to juvenile groups and creation of effective communication models, correct evaluation and long-term management of MUPS, effectiveness of cognitive behavioral therapy for MUPS.

Surfactants are hailed as “industrial monosodium glutamate”, and are widely used as emulsifiers, demulsifiers, water treatment agents, etc., in the petroleum industry. However, due to the unidirectivity of conventional surfactants, the difficulty in demulsifying petroleum emulsions generated after emulsification with such surfactants increases sharply. Therefore, it is of great significance and application value to design and develop a novel switchable surfactant for oil exploitation. In this study, a CO2-switchable Gemini surfactant of N,N′-dimethyl-N,N′-didodecyl butylene diamine (DMDBA) was synthesized from 1, 4-dibromobutane, dodecylamine, formic acid, and formaldehyde. Then, the synthesized surfactant was structurally characterized by infrared (IR) spectroscopy, hydrogen nuclear magnetic resonance (1H NMR) spectroscopy, and electrospray ionization mass spectrometry (ESI-MS); the changes in conductivity and Zeta potential of DMDBA before and after CO2/N2 injection were also studied. The results show that DMDBA had a good CO2 response and cycle reversibility. The critical micelle concentration (CMC) of cationic surfactant obtained from DMDBA by injecting CO2 was 1.45 × 10−4 mol/L, the surface tension at CMC was 33.4 mN·m−1, and the contact angle with paraffin was less than 90°, indicating that it had a good surface activity and wettability. In addition, the kinetic law of the process of producing surfactant by injecting CO2 was studied, and it was found that the process was a second-order reaction. The influence of temperature and gas velocity on the reaction dynamics was explored. The calculated values from the equation were in good agreement with the measured values, with a correlation coefficient greater than 0.9950. The activation energy measured during the formation of surfactant was Ea = 91.16 kJ/mol.

The surface of calcined kaolinite particles underwent chemical modification using Vinyltriethoxysilane (VTMS) and 3-mercaptopropionic acid (3-MPA). The grafting ratio of VTMS on the calcined kaolinite surface was adjusted by varying its quantity. FT-IR analysis revealed the initial grafting of VTMS onto the kaolinite surface, resulting in the formation of a C=C reactive site on the surface. Subsequently, an olefin click reaction with 3-MPA occurred, leading to the effective grafting of 3-MPA onto the kaolinite surface and the formation of an efficient coating. Thermal analysis indicated that the optimal grafting level was achieved at a modifier content V:K ratio of 0.5. The estimated grafting ratio of the modifier on the kaolinite surface was approximately 40% when V:K was 0.5. Water contact angle and dispersion experiments demonstrated that the surface properties of kaolinite were effectively controlled by this modification approach. At V:K = 0.3, the modified kaolinite particles exhibited good dispersion in both polar and non-polar solvents. In polar solvents, the average particle size of modified kaolinite was below 1100 nm, while in non-polar solvents, it did not exceed 5000 nm. Considering all aspects, a V:K ratio of 0.3 is recommended. Further investigation into the impact of adding 3-MPA on the surface properties of modified kaolinite particles based on V:K = 0.3 revealed that the hydrophilicity of the modified particles could be enhanced. However, it is advised to keep the maximum M:V ratio (3-MPA to kaolinite) at 1.0.

In order to regulate the surface properties of calcined kaolinite for the purpose of achieving uniform distribution within various polar dispersion media, 3-aminopropyltriethoxysilane and phenyl glycidyl ether were employed to chemically modify calcined kaolinite. The grafting rate, surface properties, and dispersion properties of calcined kaolinite particles in different polar organic media were changed by varying the dosage of the modifiers. FT-IR analysis confirmed successful surface modification, while thermogravimetric analysis indicated a maximum graft coverage of 18.44 μmol/m2 for the modified particles. Contact angle measurements and particle size distribution analyses demonstrated the effective adjustment of surface characteristics by the modifiers. Specifically, at a mass ratio of 1.0 of modifier to kaolinite particles, the modified particles exhibited a contact angle of around 125°, achieving uniform dispersion in different polarity media. Particle size distribution ranged from 1600 nm to 2100 nm in cyclohexane and petroleum ether, and from 900 nm to 1200 nm in dioxane, ethyl acetate, and DMF, showcasing a significant improvement in dispersion performance compared to unmodified particles. Concurrently, to improve the mechanical properties of PBAT, modified particles were incorporated into the PBAT matrix, and the effect of modified particle addition on the tensile strength and fracture tensile rate of the composites was investigated. The optimal amount of modified particles is 6 wt.%~8 wt.%. This article aims at synthesizing modifier molecules containing different hydrophilic and hydrophobic groups to chemically graft onto the surface of calcined kaolinite. The hydrophilic and hydrophobic groups on the modified particles can adapt to dispersed systems of different polarities and achieve good distribution within them. The modified particles are added to PBAT to achieve good compatibility and enhance the mechanical properties of the composite material.

Abstract The telomerase RNA component (TERC) gene plays an important role in telomerase-dependent extension and maintenance of the telomeres. In the event of TERC haploinsufficiency, telomere length is often affected; this, in turn, can result in the development of progeria-related diseases such as aplastic anemia (AA) and congenital keratosis. Cell reprogramming can reverse the differentiation process and can, therefore, transform cells into pluripotent stem cells with stronger differentiation and self-renewal abilities; further, cell reprograming can also extend the telomere length of these cells, which may be crucial in the diagnosis and treatment of telomere depletion diseases such as AA. In this study, we summarized the effects of TERC haploid cell reprogramming on telomere length and the correlation between this alteration and the pathogenesis of AA; by investigating the role of cell reprogramming in AA, we aimed to identify novel diagnostic indicators and therapeutic strategies for patients with AA.

Abstract Glycosylation has been found to be altered in the brains of individuals with Alzheimer’s disease (AD). However, it is unknown which specific glycosylation-related pathways are altered in AD dementia. Using publicly available RNA-seq datasets covering seven brain regions and including 1724 samples, we identified glycosylation-related genes ubiquitously changed in individuals with AD. Several differentially expressed glycosyltransferases found by RNA-seq were confirmed by qPCR in a different set of human medial temporal cortex (MTC) samples (n = 20 AD vs. 20 controls). N-glycan-related changes predicted by expression changes in these glycosyltransferases were confirmed by mass spectrometry (MS)-based N-glycan analysis in the MTC (n = 9 AD vs. 6 controls). About 80% of glycosylation-related genes were differentially expressed in at least one brain region of AD participants (adjusted p-values

In challenging reservoirs where thermal recovery falls short, cold or chemical oil recovery methods are crucial. Spontaneous emulsification (SE), triggered by gentle disturbance, significantly enhances oil recovery. In elucidating SE mechanisms and kinetics, SE processes via direct contact between oil and aqueous phases without stirring were conducted. The effects of temperature, emulsifier concentration, pH, NaCl concentration, and the oil-to-water ratio on SE were investigated through droplet size analysis and turbidity measurements. Furthermore, the emulsification mechanism and derived emulsification kinetics based on turbidity data were obtained. The results underscore the feasibility of SE for oil–water systems, reducing viscous and capillary resistances without agitation. The emulsified oil mass increased with the temperature, pH, and aqueous-to-oil phase volume ratio while decreasing with the NaCl concentration. In this study, for GD-2 crude oil, the optimal emulsified oil amount occurred at a betaine surfactant (BetS-2) emulsifier concentration of 0.45%. Microscopic photo analysis indicated narrow particle size distributions and small droplets, which remained stable over time under various experimental conditions. A combined SE mechanism involving ultralow interfacial tension, interfacial turbulence due to Marangoni effects, and “diffusion and stranding” due to in situ emulsifier hydrophilicity, was speculated. Additionally, an analogous second-order kinetic equation for SE was proposed, indicating exceptional correlation with calculated and experimentally measured values. This study offers theoretical insight for enhancing oil recovery in chemical and cold production of heavy oil in oilfields.

High-density lipoproteins (HDLs) are key regulators of cellular cholesterol homeostasis but are functionally altered in many chronic diseases. The factors that cause HDL functional loss in chronic disease are not fully understood. It is also unknown what roles antioxidant carotenoids play in protecting HDL against functional loss. The aim of this study was to measure how various disease-associated chemical factors including exposure to (1) Cu2+ ions, (2) hypochlorous acid (HOCL), (3) hydrogen peroxide (H2O2), (4) sialidase, (5) glycosidase, (6) high glucose, (7) high fructose, and (8) acidic pH, and the carotenoid antioxidants (9) lutein and (10) zeaxanthin affect HDL functionality. We hypothesized that some of the modifications would have stronger impacts on HDL particle structure and function than others and that lutein and zeaxanthin would improve HDL function. HDL samples were isolated from generally healthy human plasma and incubated with the corresponding treatments listed above. Cholesterol efflux capacity (CEC), lecithin–cholesterol acyl transferase (LCAT) activity, and paraoxonase-1 (PON1) activity were measured in order to determine changes in HDL functionality. Median HDL particle diameter was increased by acidic pH treatment and reduced by HOCl, high glucose, high fructose, N-glycosidase, and lutein treatments. Acidic pH, oxidation, and fructosylation all reduced HDL CEC, whereas lutein, zeaxanthin, and sialidase treatment improved HDL CEC. LCAT activity was reduced by acidic pH, oxidation, high fructose treatments, and lutein. PON1 activity was reduced by sialidase, glycosidase, H2O2, and fructose and improved by zeaxanthin and lutein treatment. These results show that exposure to oxidizing agents, high fructose, and low pH directly impairs HDL functionality related to cholesterol efflux and particle maturation, whereas deglycosylation impairs HDL antioxidant capacity. On the other hand, the antioxidants lutein and zeaxanthin improve or preserve both HDL cholesterol efflux and antioxidant activity but have no effect on particle maturation.

Metastasis is the major cause of cancer-related death, and lymph node is the most common site of metastasis in breast cancer. However, the alterations that happen in tumor-draining lymph nodes (TDLNs) to form a premetastatic microenvironment are largely unknown. Here, we first report the dynamic changes in size and immune status of TDLNs before metastasis in breast cancer. With the progression of tumor, the TDLN is first enlarged and immune-activated at early stage that contains specific antitumor immunity against metastasis. The TDLN is then contracted and immunosuppressed at late stage before finally getting metastasized. Mechanistically, B and follicular helper T (Tfh) cells parallelly expand and contract to determine the size of TDLN. The activation status and specific antitumor immunity of CD8+ T cells in the TDLN are determined by interleukin-21 (IL-21) produced by Tfh cells, thus showing parallel changes. The turn from activated enlargement to suppressed contraction is due to the spontaneous contraction of germinal centers mediated by follicular regulatory T cells. On the basis of the B-Tfh-IL-21-CD8+ T cell axis, we prove that targeting the axis could activate TDLNs to resist metastasis. Together, our findings identify the dynamic alterations and regulatory mechanisms of premetastatic TDLNs of breast cancer and provide new strategies to inhibit lymph node metastasis.

Abstract Introduction Locoregional recurrent breast cancers have a poor prognosis. Little is known about the prognostic impact of immune microenvironment, and tertiary lymphoid structures (TLSs) in particular have not been reported. Thus, we aimed to characterize the immune microenvironment in locoregional recurrent breast tumors and to investigate its relationship with prognosis. Methods We retrospectively included 112 patients with locoregional recurrent breast cancer, and hematoxylin–eosin staining and immunohistochemical staining (CD3, CD4, CD8, CD19, CD38, and CD68) were performed on locoregional recurrent tumor samples. The association of immune cells and TLSs with progression‐free survival (PFS) were analyzed by survival analysis. Results We found more immune cells in the peritumor than stroma. After grouping according to estrogen receptor (ER) status, a low level of peritumoral CD3+ cells in ER+ subgroup (p = 0.015) and a low level of stromal CD68+ cells in ER− subgroup (p = 0.047) were both associated with longer PFS. TLSs were present in 68% of recurrent tumors, and CD68+ cells within TLSs were significantly associated with PFS as an independent prognostic factor (p = 0.035). TLSs and immune cells (CD3, CD38, and CD68) within TLSs were associated with longer PFS in ER− recurrent tumors (p = 0.044, p = 0.012, p = 0.050, p

Background Perioperative anxiety and emergence delirium (ED) in young children may cause a series of adverse events, which are worth investigating. Pharmacological treatments of anxiety and delirium remain uncertain, while non-pharmacological treatments lack personalization and pertinence.Aims The aim of study was to determine whether an individual cartoon video can alleviate perioperative anxiety and reduce ED in young children undergoing adenoidectomy and tonsillectomy.Methods Children between 3 and 7 years old undergoing adenoidectomy and tonsillectomy were randomly assigned to an individual cartoon video group (group V) or a control group (group C). In group V, an individual cartoon video of the child’ s own choice was played throughout the whole waiting, anaesthesia induction and recovery periods. The children in group C were contacted through verbal conversation. The primary outcomes were anxiety measured by the Modified Yale Preoperative Anxiety Scale and ED assessed by the Paediatric Anaesthesia Emergence Delirium (PAED) scale. The secondary outcomes included cooperation during induction, postoperative pain and adverse events.Results The incidence of anxiety were comparable in group V and group C at the holding area (T0) (26% vs 22%, p=0.323), but the incidence of anxiety of group V were significantly lower than those of group C at the time of entering the operating room (T1), during the induction of anaesthesia (T2) and leaving the post anaesthesia care unit (T6) (p

Abstract Hematopoietic stem cells (HSCs) are the common and essential precursors of all blood cells, including immune cells, and they are responsible for the lifelong maintenance and damage repair of blood tissue homeostasis. The vast majority (> 95%) of HSCs are in a resting state under physiological conditions and are only activated to play a functional role under stress conditions. This resting state affects their long-term survival and is also closely related to the lifelong maintenance of hematopoietic function; however, abnormal changes may also be an important factor leading to the decline of immune function in the body and the occurrence of diseases in various systems. While the importance of resting HSCs has attracted increasing research attention, our current understanding of this topic remains insufficient, and the direction of clinical targeted treatments is unclear. Here, we describe the functions of HSCs, analyze the regulatory mechanisms that affect their resting state, and discuss the relationship between resting HSCs and different diseases, with a view to providing guidance for the future clinical implementation of related targeted treatments.

The efficient and cost-effective suppression of atmospheric turbulence effects in free-space optical (FSO) communication poses a significant challenge. To address this challenge, a carrier frequency offset estimation (FOE) scheme based on frame-synchronous training sequence (FSTS) is proposed, which can be applied to spatial diversity polarization multiplexing (PM) coherent FSO communication system. The proposed scheme integrates the functions of frame synchronization (FS) and FOE by designing distinct training sequences for the X and Y polarizations. Specifically, the FOE scheme achieves high accuracy, wide range, low complexity, and multi-format versatility while maintaining FS accuracy. Simulation results for PM 4/16-quadrature amplitude modulation (QAM) demonstrate the feasibility and generality of the proposed scheme. Moreover, when combined with the spatial diversity reception under strong and weak turbulence conditions, the proposed algorithm exhibits higher receiver sensitivity compared to the conventional training sequence (TS)-based FOE algorithm. The advantages of this scheme make it highly promising for high-speed coherent FSO communications across multiple modulation formats.

BackgroundProlonged fasting, characterized by restricting caloric intake for 24 h or more, has garnered attention as a nutritional approach to improve lifespan and support healthy aging. Previous research from our group showed that a single bout of 36-h water-only fasting in humans resulted in a distinct metabolomic signature in plasma and increased levels of bioactive metabolites, which improved macrophage function and lifespan in C. elegans.ObjectiveThis secondary outcome analysis aimed to investigate changes in the plasma lipidome associated with prolonged fasting and explore any potential links with markers of cardiometabolic health and aging.MethodWe conducted a controlled pilot study with 20 male and female participants (mean age, 27.5 ± 4.4 years; mean BMI, 24.3 ± 3.1 kg/m2) in four metabolic states: (1) overnight fasted (baseline), (2) 2-h postprandial fed state (fed), (3) 36-h fasted state (fasted), and (4) 2-h postprandial refed state 12 h after the 36-h fast (refed). Plasma lipidomic profiles were analyzed using liquid chromatography and electrospray ionization mass spectrometry.ResultsSeveral lipid classes, including lysophosphatidylcholine (LPC), lysophosphatidylethanolamine (LPE), phosphatidylethanolamine, and triacylglycerol were significantly reduced in the 36-h fasted state, while free fatty acids, ceramides, and sphingomyelin were significantly increased compared to overnight fast and fed states (P

Abstract The development of high‐precision, non‐destructive, and three‐dimensional (3D) in situ imaging of micro‐scale damage inside polymers is extremely challenging. Recent reports suggest that 3D imaging technology based on micro‐CT technology causes irreversible damage to materials and is ineffective for many elastomeric materials. In this study, it is discovered that electrical trees inside silicone gel induced by an applied electric field can induce a self‐excited fluorescence effect. Based on this, high‐precision, non‐destructive, and 3D in situ fluorescence imaging of polymer damages is successfully achieved. Compared with the current methods, the fluorescence microscopic imaging method enables slicing of the sample in vivo with high‐precision operation, realizing the precise positioning of the damaged area. This pioneering discovery paves the way for high‐precision, non‐destructive, and 3D in situ imaging of polymer internal damage, which can solve the problem of internal damage imaging in insulating materials and precision instruments.

BackgroundThe current exploration of the tumor immune microenvironment is enthusiastic, but few studies explored the impact of angiogenesis on the immune microenvironment. Immunotherapy combined with anti-angiogenesis therapy has become one of the first-line treatment for lung adenocarcinoma. Our study aimed to explore the reasons for resistance of immunotherapy, and explore markers for immunotherapy combined with anti-angiogenesis therapy.MethodsFirst, by unsupervised clustering of 36 angiogenesis-related genes in lung adenocarcinoma patients from TCGA database, AGS1 and AGS2 groups were distinguished with significantly different clinical outcomes. Secondly, the immune microenvironment and metabolic characteristics were analyzed. Next, we used the GDSC and GEO database to analyze therapeutic responses. Then, through multivariate Cox regression, the hub gene: JAG1, significantly related to prognosis was selected, and further verified by multi-omics data. Finally, we validated that patient with high JAG1 expression had a low immune-infiltrating tumor microenvironment through single-cell transcriptomic data.ResultsCompared with the AGS1 group, AGS2 showed an immune “cold” phenotype with lower lymphocyte infiltration, and was associated with worse prognoses. At the same time, the immunosuppressive TGF-β response was significantly higher in AGS2. Furthermore, the glycolysis ability of the AGS2 was stronger than AGS1. The expression of JAG1 was significantly higher in the AGS2, and was significantly negatively correlated with the degree of immune infiltration, accompanying with higher glycolytic capacity. The above results indicate that patients with high expression of JAG1 may lead to immunosuppressive phenotype due to its strong glycolytic capacity, thus making immunotherapy resistance.ConclusionPatients with high expression of JAG1 enhanced glycolytic capacity was likely to cause suppressed immune microenvironment. JAG1 may be a marker for resistance of immunotherapy. Combining anti-angiogenesis therapy could be considered to improve the prognosis of those patients.

In this paper, a symmetric training sequence-based (STSB) carrier frequency offset estimation (FOE) scheme for coherent free-space optical (CFSO) communication is proposed. In the proposed technique, we exploit the training-sequence-based (TSB) carrier FOE algorithm to the CFSO communication system in the quadrature phase-shift keying (QPSK) modulation format. A symmetric training sequence, tailored to the carrier FOE algorithm for atmospheric turbulence channel, is formulated to accurately identify the correct temporal position of a data frame from received signals. Unlike the 4th power algorithm, the proposed algorithm requires only the identified training sequence and the symmetric sequence of the original training sequence in the FOE stage, performing a single multiplication to accurately remove the signal modulation phase. In this way, the proposed technique significantly improves the estimation accuracy. Furthermore, by avoiding the time-consuming 4th power operation, the proposed method reduces the computational complexity while expanding the FOE range. Therefore, when compared with existing algorithms, our proposed technique can achieve more accurate timing, a wider estimation range, and lower complexity. A 10-Gbps QPSK CFSO communication transmission experiment with different turbulence channels was carried out to validate the proposed technique and the improvement in receiver sensitivity.

When using distributed storage systems to store gridded remote sensing data in large, distributed clusters, most solutions utilize big table index storage strategies. However, in practice, the performance of big table index storage strategies degrades as scenarios become more complex, and the reasons for this phenomenon are analyzed in this paper. To improve the read and write performance of distributed gridded data storage, this paper proposes a storage strategy based on Ceph software. The strategy encapsulates remote sensing images in the form of objects through a metadata management strategy to achieve the spatiotemporal retrieval of gridded data, finding the cluster location of gridded data through hash-like calculations. The method can effectively achieve spatial operation support in the clustered database and at the same time enable fast random read and write of the gridded data. Random write and spatial query experiments proved the feasibility, effectiveness, and stability of this strategy. The experiments prove that the method has higher stability than, and that the average query time is 38% lower than that for, the large table index storage strategy, which greatly improves the storage and query efficiency of gridded images.

We previously introduced a three-stage design and associated end-of-stage analyses for allergen immunotherapy (AIT) trials. End-of-stage differences alone may not provide a fuller picture of Stages 2 and 3 effects because they may depend upon stage-specific durations. Therefore, we introduce an additional trend analysis to evaluate the difference in progression curves of two groups over the entire stage. Results from such analysis are used to inform persistence of end-of-stage benefit and thus provide evidence for stagewise effects beyond the study periods. We jointly apply end-of-stage and trend analyses to support the enhanced three-stage design to determine treatment response over time and sustained response to AIT. A simulation study was performed to illustrate the statistical properties (bias and power) of trend analyses under varying statistical missing mechanisms and effect sizes. The extent of bias depended on the missing mechanism and magnitude. Powers were largely driven by effect and sample sizes as well as pre-specified success margins, particularly of relative trend. As an illustration, assuming relative treatment differences of 25-30%, stagewise dropout rate of 15%, and parallel outcome progressions, a sample size of 200 per group may achieve 97% power to demonstrate a treatment effect and 53% power to demonstrate a sustained effect post-treatment. Trend analysis supplements the end-of-stage analysis to enhance the statistical claims of stagewise effects. Inferential statistics support our proposed trend analysis for evaluating benefits of AIT over time and inform clinical understanding and decisions.

Abstract High-density lipoprotein (HDL) particles have multiple beneficial and cardioprotective roles, yet our understanding of their full structural and functional repertoire is limited due to challenges in separating HDL particles from contaminating plasma proteins and other lipid-carrying particles that overlap HDL in size and/or density. Here we describe a method for isolating HDL particles using a combination of sequential flotation density ultracentrifugation and fast protein liquid chromatography with a size exclusion column. Purity was visualized by polyacrylamide gel electrophoresis and verified by proteomics, while size and structural integrity were confirmed by transmission electron microscopy. This HDL isolation method can be used to isolate a high yield of purified HDL from a low starting plasma volume for functional analyses. This method also enables investigators to select their specific HDL fraction of interest: from the least inclusive but highest purity HDL fraction eluting in the middle of the HDL peak, to pooling all of the fractions to capture the breadth of HDL particles in the original plasma sample. We show that certain proteins such as lecithin cholesterol acyltransferase (LCAT), phospholipid transfer protein (PLTP), and clusterin (CLUS) are enriched in large HDL particles whereas proteins such as alpha-2HS-glycoprotein (A2HSG), alpha-1 antitrypsin (A1AT), and vitamin D binding protein (VDBP) are enriched or found exclusively in small HDL particles.

BackgroundFor elderly patients with breast cancer, the treatment strategy is still controversial. In China, preoperative axillary lymph node needle biopsy is not widely used, resulting in many patients receiving axillary lymph node dissection (ALND) directly. Our study aims to determine whether local and systemic therapy can be safely de-escalated in elderly breast cancer.MethodsPatients aged ≥70 years were retrospectively enrolled from our institution’s medical records between May 2013 and July 2021. Groups were assigned according to local and systemic treatment regimens, and stratified analysis was performed by molecular subtypes. Univariate and multivariate survival analyses were used to compare the effects of different regimens on relapse-free survival (RFS).ResultsA total of 653 patients were enrolled for preliminary data analysis, and 563 patients were screened for survival analysis. The mean follow-up was 19 months (range, 1–82 months). Axillary lymph node metastases were pathologically confirmed in only 2.1% of cN0 cases and up to 97.1% of cN+ cases. In the aspect of breast surgery, RFS showed no significant difference between mastectomy and BCS group (p = 0.3078). As for axillary surgery, patients in the ALND group showed significantly better RFS than those in the sentinel lymph node biopsy (SLNB) group among pN0 patients (p = 0.0128). Among these cases, the proportion of cN+ in ALND was significantly higher than that in SLNB (6.4% vs. 0.4%, p = 0.002), which meant axillary lymph nodes (ALNs) of ALND patients were larger in imaging and more likely to be misdiagnosed as metastatic. With regard to adjuvant therapy, univariate and multivariate analyses showed that RFS in different comprehensive adjuvant regimens were similar especially among hormone receptor (HR)+/human epidermal growth factor receptor 2 (HER2)− subgroup where patients who did not receive any adjuvant therapy accounted for 15.7% (p > 0.05).ConclusionsIt is feasible to reduce some unnecessary local or systemic treatments for elderly breast cancer patients, especially in HR+/HER2− subtype. Multiple patient-related factors should be considered when making treatment plans.

Dietary fiber, a nutrient derived mainly from whole grains, vegetables, fruits, and legumes, is known to confer a number of health benefits, yet most Americans consume less than half of the daily recommended amount. Convenience and affordability are key factors determining the ability of individuals to incorporate fiber-rich foods into their diet, and many Americans struggle to access, afford, and prepare foods rich in fiber. The objective of this clinical study was to test the changes in microbial community composition, human metabolomics, and general health markers of a convenient, easy to use prebiotic supplement in generally healthy young participants consuming a diet low in fiber. Twenty healthy adults participated in this randomized, placebo-controlled, double-blind, crossover study which was registered at clinicaltrials.gov as NCT03785860. During the study participants consumed 12 g of a prebiotic fiber supplement and 12 g of placebo daily as a powder mixed with water as part of their habitual diet in randomized order for 4 weeks, with a 4-week washout between treatment arms. Fecal microbial DNA was extracted and sequenced by shallow shotgun sequencing on an Illumina NovaSeq. Plasma metabolites were detected using liquid chromatography–mass spectrometry with untargeted analysis. The phylum Actinobacteria, genus Bifidobacterium, and several Bifidobacterium species (B. bifidum, B. adolescentis, B. breve, B. catenulatum, and B. longum) significantly increased after prebiotic supplementation when compared to the placebo. The abundance of genes associated with the utilization of the prebiotic fiber ingredients (sacA, xfp, xpk) and the production of acetate (poxB, ackA) significantly changed with prebiotic supplementation. Additionally, the abundance of genes associated with the prebiotic utilization (xfp, xpk), acetate production (ackA), and choline to betaine oxidation (gbsB) were significantly correlated with changes in the abundance of the genus Bifidobacterium in the prebiotic group. Plasma concentrations of the bacterially produced metabolite indolepropionate significantly increased. The results of this study demonstrate that an easy to consume, low dose (12 g) of a prebiotic powder taken daily increases the abundance of beneficial bifidobacteria and the production of health-promoting bacteria-derived metabolites in healthy individuals with a habitual low-fiber diet.Clinical Trial Registrationwww.clinicaltrials.gov/, identifier: NCT03785860

Abstract Minimally invasive thermal therapies have been attempted in the treatment of breast cancer, and the immune response induced by these therapies has not been fully reported. A clinical trial is performed to determine the effect of microwave ablation (MWA) in the treatment of early‐stage breast cancer. The authors perform single‐cell RNA sequencing on peripheral blood mononuclear cells (PBMCs) from six patients before and after ablation. NK and CD8+T cells are activated by MWA of breast cancer, with the increased inhibitory signature of CD8+T cells but not dysfunctional. Enhanced co‐stimulatory signature of CD4+ T cells is observed and increased frequency of ICOS+CD4+ T cells after MWA is confirmed by flow cytometric analysis. After ablation, T‐cell clones expand with increased T‐cell receptor diversities. Activated antigen receptor‐mediated signaling pathways are found in B cells. Enhanced interactions between B cells and CD4+ T cells are found, indicating that B cells are important antigen‐presenting cells that initiate CD4+T cells in MWA‐induced immune response. Blockade of CTLA‐4 or PD‐1 of post‐MWA PBMCs show higher T‐cell activity than that of pre‐MWA PBMCs. This study provide global characteristics of MWA‐induced systemic immune response and pave a way for the identification of potential targets to improve the immune response.

The purpose of this study was to provide a new concept and technical method for the large-scale identification of industrial land and analyze the distribution characteristics of industrial land in China. The following research methods are employed using the point of interest data and random forest model based on data accessibility, this study selected 2015 data on Wuhan and Luoyang as training samples to identify the industrial land of China. Then, the proportion of industrial land in all 334 prefecture-level cities on the Chinese mainland was calculated, and the spatial pattern was analyzed. The results show that: 1) by comparing multiple experiments and robustness analysis, the optimal parameter setting of the random forest model is obtained. According to the test of actual industrial land distribution in Wuhan city and Luoyang city, the identification of industrial land in different scale cities by random forest model is accurate and effective. 2) From the perspective of spatial patterns, industrial land shows a “large aggregation and small scattering” distribution. 3) From the perspective of spatial distribution, the proportion of industrial land in these cities shows spatial aggregation. High–high aggregation areas were mainly distributed in North and Northeast China, and low–low aggregation areas were mainly located in West China. 4) From the perspective of related factors, industrial land was close to rivers, highways, and railway stations and had a relatively low correlation with the distribution of airports. Industrial land was located within approximately 10–60 km distance from the municipal government office. In terms of the proportion of industrial land, the proportion of industrial land is higher in the cities where the industrial land was closer to railway stations. However, when the industrial land in cities was closer to four other types of related factors (waters and lakes, major highways, airports, and municipal government stations), the share of industrial land is lower. In conclusion, the method based on the point of interest data and random forest model can accurately and effectively identify large-scale industrial land.

In recent decades, significant progress has been made in liver tissue engineering through the use of 3D bioprinting technology. This technology offers the ability to create personalized biological structures with precise geometric design capabilities. The complex and multifaceted nature of liver diseases underscores the need for advanced technologies to accurately mimic the physiological and mechanical characteristics, as well as organ-level functions, of liver tissue in vitro. Bioprinting stands out as a superior option over traditional two-dimensional cell culture models and animal models due to its stronger biomimetic advantages. Through the use of bioprinting, it is possible to create liver tissue with a level of structural and functional complexity that more closely resembles the real organ, allowing for more accurate disease modeling and drug testing. As a result, it is a promising tool for restoring and replacing damaged tissue and organs in the field of liver tissue engineering and drug research. This article aims to present a comprehensive overview of the progress made in liver tissue engineering using bioprinting technology to provide valuable insights for researchers. The paper provides a detailed account of the history of liver tissue engineering, highlights the current 3D bioprinting methods and bioinks that are widely used, and accentuates the importance of existing in vitro liver tissue models based on 3D bioprinting and their biomedical applications. Additionally, the article explores the challenges faced by 3D bioprinting and predicts future trends in the field. The progress of 3D bioprinting technology is poised to bring new approaches to printing liver tissue in vitro, while offering powerful tools for drug development, testing, liver disease modeling, transplantation, and regeneration, which hold great academic and practical significance.

In this paper, a low-complexity joint compensation scheme of carrier recovery (JCSCR) for coherent free-space optical (CFSO) communication is proposed. We applied the carrier recovery joint compensation approach to a CFSO communication system in the quadrature phase shift keying (QPSK) modulation format. A signal-preprocessing stage, which effectively avoided the repetitive operations found in traditional carrier recovery schemes, was proposed. Unlike in existing carrier recovery algorithms, the modulated phase of the received signal could be accurately removed using only the sum and subtraction of real absolute values in the signal-preprocessing stage, greatly reducing the complexity of the operation. Since this algorithm avoids the traditional fourth operation, the system’s complexity is reduced while additional noise generated by fourth cross-terms would be prevented and system noise immunity would be greatly enhanced. In addition, this algorithm uses joint compensation of phase errors in the final compensation stage, further reducing the complexity of the computation of the whole algorithmic scheme. A 10 Gbps QPSK CFSO communication transmission experiment was conducted in an atmospheric turbulence channel to verify the proposed technique and improvement in receiver sensitivity.

To solve the fault diagnosis difficulty of bearings with small data samples, a novel multi-information fusion vision transformer (ViT) model based on time–frequency representation (TFR) maps is proposed in this paper. The original vibration signal is decomposed into different scale sub-signals by the discrete wavelet transforms (DWTs), and the continuous wavelet transforms (CWTs) are used to transform these different scale sub-signals into time–frequency representation (TFR) maps, which are concatenated to input to the ViT model to diagnose the bearing fault. Through the multifaceted experiment analysis on the fault diagnosis of bearings with small data samples, the diagnosis results demonstrate that the proposed multi-information fusion ViT model can diagnose the fault of bearings with small data samples, with strong generalization and robustness; its average diagnosis accuracy achieved 99.85%, and it was superior to the other fault diagnosis methods, such as the multi-information fusion CNN, ViT model based on one-dimensional vibration signal, and ViT model based on the TFR of the original vibration signal.

Previous research on risk factors for obstructive heart defects (OHDs) focused on maternal and infant genetic variants, prenatal environmental exposures, and their potential interaction effects. Less is known about the role of paternal genetic variants or environmental exposures and risk of OHDs. We examined parent-of-origin effects in transmission of alleles in the folate, homocysteine, or transsulfuration pathway genes on OHD occurrence in offspring. We used data on 569 families of liveborn infants with OHDs born between October 1997 and August 2008 from the National Birth Defects Prevention Study to conduct a family-based case-only study. Maternal, paternal, and infant DNA were genotyped using an Illumina Golden Gate custom single nucleotide polymorphism (SNP) panel. Relative risks (RR), 95% confidence interval (CI), and likelihood ratio tests from log-linear models were used to estimate the parent-of-origin effect of 877 SNPs in 60 candidate genes in the folate, homocysteine, and transsulfuration pathways on the risk of OHDs. Bonferroni correction was applied for multiple testing. We identified 3 SNPs in the transsulfuration pathway and 1 SNP in the folate pathway that were statistically significant after Bonferroni correction. Among infants who inherited paternally-derived copies of the G allele for rs6812588 in the RFC1 gene, the G allele for rs1762430 in the MGMT gene, and the A allele for rs9296695 and rs4712023 in the GSTA3 gene, RRs for OHD were 0.11 (95% CI: 0.04, 0.29, P = 9.16x10-7), 0.30 (95% CI: 0.17, 0.53, P = 9.80x10-6), 0.34 (95% CI: 0.20, 0.57, P = 2.28x10-5), and 0.34 (95% CI: 0.20, 0.58, P = 3.77x10-5), respectively, compared to infants who inherited maternally-derived copies of the same alleles. We observed statistically significant decreased risk of OHDs among infants who inherited paternal gene variants involved in folate and transsulfuration pathways.

High-density lipoproteins (HDL) play a critical role in cholesterol homeostasis. Apolipoprotein E (APOE), particularly the E4 allele, is a significant risk factor for Alzheimer’s disease but is also a key HDL-associated protein involved in lipid transport in both the periphery and central nervous systems. The objective was to determine the influence of the APOE genotype on HDL function and size in the context of Alzheimer’s disease. HDL from 194 participants (non-demented controls, mild cognitive impairment, and Alzheimer’s disease dementia) were isolated from the plasma. The HDL cholesterol efflux capacity (CEC), lecithin-cholesterol acyltransferase (LCAT) activity, and particle diameter were measured. Neuropsychological test scores, clinical dementia rating, and magnetic resonance imaging scores were used to determine if cognition is associated with HDL function and size. HDL CEC and LCAT activity were reduced in APOE3E4 carriers compared to APOE3E3 carriers, regardless of diagnosis. In APOE3E3 carriers, CEC and LCAT activity were lower in patients. In APOE3E4 patients, the average particle size was lower. HDL LCAT activity and particle size were positively correlated with the neuropsychological scores and negatively correlated with the clinical dementia rating. We provide evidence for the first time of APOE genotype-specific alterations in HDL particles in Alzheimer’s disease and an association between HDL function, size, and cognitive function.

In order to improve the diagnosis accuracy and generalization of bearing faults, an integrated vision transformer (ViT) model based on wavelet transform and the soft voting method is proposed in this paper. Firstly, the discrete wavelet transform (DWT) was utilized to decompose the vibration signal into the subsignals in the different frequency bands, and then these different subsignals were transformed into a time–frequency representation (TFR) map by the continuous wavelet transform (CWT) method. Secondly, the TFR maps were input with respective to the multiple individual ViT models for preliminary diagnosis analysis. Finally, the final diagnosis decision was obtained by using the soft voting method to fuse all the preliminary diagnosis results. Through multifaceted diagnosis tests of rolling bearings on different datasets, the diagnosis results demonstrate that the proposed integrated ViT model based on the soft voting method can diagnose the different fault categories and fault severities of bearings accurately, and has a higher diagnostic accuracy and generalization ability by comparison analysis with integrated CNN and individual ViT.

The architecture model of the Internet of thing system is the primary foundation for the design and implementation of the Internet of thing system. This article discusses the method and practice of time automaton modeling and model checking for the architecture of the Internet of thing system from the state and time dimensions. This article introduces the theory and method of modeling using time automata. And then, combined with the actual need of the elderly health cabin Internet of thing system, a dynamic and fault-tolerant time automaton model is established through a relatively complete architecture modeling. The model checking method verifies that the designed Internet of thing system has no deadlock system activity, service correctness, and timeliness correctness. The results of modeling experiments and model validation show that the reference model of time automata Internet of thing architecture established in this article can better reflect the nature of interaction with the physical world, heterogeneity and large-scale, dynamic, and incompleteness of the Internet of thing system.

This study demonstrated that a homogeneous polysaccharide (HPS) extracted from Hawthorn exerted anti-cancer effects on colon cancer cells. Human colon cancer cell line HCT116 were treated with 125–1000 µg/mL HPS for 12 h and subsequent analysis was performed on proliferation and signaling pathways. HPS significantly inhibited proliferation of HCT116 cells when analyzed using WST-1 assay and immunofluorescence staining of Ki-67. Flow cytometric studies revealed that HPS could arrest the cell cycle in the S and G2/M phases and increase the rate of apoptosis. HPS downregulated the expression of Cyclin A1/D1/E1 and CDK-1/2. HPS induced apoptosis on HCT116 cells through upregulation of caspase3, 7, 8, 9 and Fas, FADD, TNF-R1, TRADD, upregulation of caspase3 protein was also observed. HPS has an anti-cancer potential in the treatment of human colon cancer which makes it a potential candidate in functional foods for cancer patients.

Gamma spectrum analysis is regarded as a fast, reliable and non-destructive technology on determining the type and intensity of radionuclides. It is widely used in nuclear physics research, geological exploration, environmental assessment. Under the certain condition (detector, electronic components and measuring environment), the data obtained by different unfolding algorithms have different results. The accuracy of qualitative and quantitative analysis of radionuclides is determined by gamma spectrum unfolding technique. This paper mainly analyzes the development and application of the gamma spectrum unfolding algorithms and technologies in denoising, background subtraction and overlapping peak separation, reviews the performances, results and highlights of the typical algorithms, discusses representative examples and proposes potential research directions. Keywords: Gamma spectrum, Unfolding algorithm, Denoising, Background subtraction, Overlapping peak separation

Sequentially randomized designs, more recently known as sequential multiple assignment randomized trial (SMART) designs, are widely used in biomedical research, particularly in clinical trials, to assess and compare the effects of various treatment sequences. In such designs, patients are initially randomized to one of the rst-stage therapies. Then patients meeting some criteria (e.g., no relapse of disease) participate in the second-stage randomization to one of the second-stage therapies. The advantage of such a design is that it allows the investigator to study various treatment sequences where the patients' second-stage therapies can be adjusted based on their responses to the rst-stage therapies. In the past few years, substantial improvement has been made in the statistical methods for analyzing the data from SMARTs. Much of the proposed statistical approaches focus on estimating and comparing the survival outcomes of treatment sequences embedded in the SMART designs. In this article, we introduce the R package DTR, which provides a set of functions that can be used to estimate and compare the effects of different treatment sequences on survival outcomes using the newly proposed statistical approaches. The proposed package is also illustrated using simulated data from SMARTs.

INTRODUCTION:In 2015, 11.9% of people with cystic fibrosis (CF) in the United States had osteopenia, 5.1% osteoporosis, and 0.3% experienced a fracture. Screening for CF-related bone disease starts in childhood, and dual energy x-ray absorptiometry (DXA) is the recommended method. It is unknown whether peripheral quantitative computed tomography (pQCT) can detect deficits earlier than DXA. This study compared pQCT and DXA scans in a group of pre-pubertal children with CF and healthy controls. METHODS:This was a cross-sectional study of children at Tanner stage 1. A pQCT scan of the radius at proximal and distal sites was performed plus a total body DXA scan. Serum C-reactive protein, interleukin-6 and tumor necrosis factor-alpha were also measured. RESULTS:A total of 34 subjects completed the study; 14 with CF and 20 controls. At the distal radius, pQCT showed a lower total bone mineral density (BMD) Z-score for the CF group (P = 0.01 and P = 0.03 for 2 different reference databases) compared to controls. At the proximal site, the polar strength-strain index was lower in the CF group (P = 0.017). Finally, the total body BMD Z-score by DXA was lower in the CF group, although it did not meet the definition of reduced bone density (P = 0.004). Biomarkers of inflammation were not different. CONCLUSIONS:In this group of pre-pubertal children with CF, measures of bone strength and density by both pQCT and DXA were reduced compared to healthy controls.

Objectives: This study aimed to determine if the presence of a pericardial effusion is associated with adverse outcomes among children admitted with juvenile idiopathic arthritis. Patients and methods: The multicenter, retrospective cohort study was conducted with 4,332 patients (1,554 males, 2,778 females; median age: 12 years; IQR, 7, 15 years) using the Pediatric Health Information System. Data from hospital admissions between January 1, 2004, and September 15, 2015, were obtained for patients with an International Disease Classification, Ninth Revision code for juvenile idiopathic arthritis. Pericardial effusion was the primary predictor variable; the outcomes of interest were length of stay, hospital costs, and readmission within 90 days. Multivariate models were created to evaluate associations between pericardial effusion and adverse outcomes. We also analyzed factors associated with increased odds of having pericardial effusion in juvenile idiopathic arthritis. Results: One hundred twenty (3%) patients had a code for pericardial effusion. Children with pericardial effusion had a longer median length of stay (7 days (IQR 3-12) vs. 3 days (IQR 2-6), p<0.001), higher median costs ($17,688 (IQR 8,657-40,623) vs. $8,456 (IQR 4,865-16,302), p<0.001), and greater rates of readmission (22% vs. 15%, p=0.045). Multivariate analysis demonstrated no significant association between pericardial effusion and outcomes of interest. Black race and male sex were associated with increased odds of having pericardial effusion. Conclusion: Pericardial effusion is rare among children admitted with juvenile idiopathic arthritis but is associated with significant morbidity; its presence may be a marker of disease severity. Black children and males admitted with juvenile idiopathic arthritis warrant special consideration and may benefit from screening echocardiography. [ABSTRACT FROM AUTHOR]

Objective: Obstructive sleep apnea (OSA) is a common sleep disorder in people with traumatic brain injury (TBI). Although sleep disturbances have been associated with an increased risk of suicide compared with the general population, the relationship between OSA and suicide risk after TBI is not well documented. In this study, we hypothesized that OSA diagnosis would predict suicide risk in veterans with TBI. Setting: Five Veterans Affairs (VA) Polytrauma Rehabilitation Centers. Participants: Participants were drawn from the VA TBI Model Systems study, with follow-up interviews at year 1 (n = 392), year 2 (n = 444), year 5 (n = 498), or year 10 (n = 252) post-TBI (7.8%-14.5% follow-up attrition). Design: This was a retrospective analysis from observational data using logistic regression with repeated measurements. Suicide ideation and suicide attempts were examined as outcomes at each follow-up to evaluate the relationship between OSA and suicide risk after adjusting for other risk factors determined a priori via literature review. Main Measures: Suicidal ideation (Patient Health Questionnaire-9 item 9), suicide attempt during the past year (self-reported), and OSA diagnosis (self-reported). Results: Contrary to study hypotheses, OSA diagnosis had no statistically significant association with suicide ideation or attempt after accounting for known predictors. However, greater depression symptoms, headache severity, and pre-TBI suicidal ideation and attempts predicted suicide risk at follow-up after accounting for other predictors. Conclusions: Results of this study did not support a relationship between OSA and suicide risk, possibly due to methodological limitations of OSA measurement. Future research on this topic should include objective measures of OSA severity and OSA treatment including adherence. Although suicide is a low base rate occurrence, the impact is disastrous and further research is needed to mitigate suicide risk. [ABSTRACT FROM AUTHOR]