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Introduction Our objective was to examine the factors associated with the serum angiopoietin-2/angiopoietin-1 (Angpt-2/Angpt-1) ratio in peritoneal dialysis (PD) patients and to investigate the association between Angpt-2/Angpt-1 ratio and cardiovascular and all-cause mortality.Methods Patients on PD who were prevalent between January 2014 and April 2015 in the center of Renji Hospital were enrolled. At the time of enrollment, serum and dialysate samples were collected to detect biochemical parameters, serum angiopoietin-2 and angiopoietin-1 levels. Patients were dichotomized into two groups according to a median of Angpt-2/Angpt-1 ratio and followed up prospectively until the end of the study.Results A total of 325 patients were enrolled, including 168 males (51.7%) with a mean age of 56.9 ± 14.2 years and a median PD duration of 32.4 (9.8-55.9) months. Multiple linear regression showed pulse pressure (β = 0.206, p .05).Conclusions High Angpt-2/Angpt-1 ratio is an independent risk factor for cardiovascular and all-cause mortality in PD patients.

ABSTRACTThe gut microbiota and Short-chain fatty acids (SCFAs) can influence the progression of diseases, yet the role of these factors on gastric cancer (GC) remains uncertain. In this work, the analysis of the gut microbiota composition and SCFA content in the blood and feces of both healthy individuals and GC patients indicated that significant reductions in the abundance of intestinal bacteria involved in SCFA production were observed in GC patients compared with the controls. ABX mice transplanted with fecal microbiota from GC patients developed more tumors during the induction of GC and had lower levels of butyric acid. Supplementation of butyrate during the induction of gastric cancer along with H. pylori and N-methyl-N-nitrosourea (MNU) in WT in GPR109A−/−mice resulted in fewer tumors and more IFN-γ+ CD8+ T cells, but this effect was significantly weakened after knockout of GPR109A. Furthermore, In vitro GC cells and co-cultured CD8+ T cells or CAR-Claudin 18.2+ CD8+ T cells, as well as in vivo tumor-bearing studies, have indicated that butyrate enhanced the killing function of CD8+ T cells or CAR-Claudin 18.2+ CD8+ T cells against GC cells through G protein-coupled receptor 109A (GPR109A) and homologous domain protein homologous box (HOPX). Together, these data highlighted that the restoration of gut microbial butyrate enhanced CD8+ T cell cytotoxicity via GPR109A/HOPX, thus inhibiting GC carcinogenesis, which suggests a novel theoretical foundation for GC management against GC.

Introduction Heart failure with preserved ejection fraction (HFpEF) is a prevalent comorbidity among patients with end-stage kidney disease. Although sodium-glucose cotransporter 2 inhibitors are validated in treating heart failure and ameliorating left ventricular hypertrophy among non-dialysis patients, the effects on dialysis patients are unknown. We previously investigated the pharmacokinetics of henagliflozin in patients undergoing haemodialysis (HD) or peritoneal dialysis (PD) and clarified its safety.Methods and analysis This multicentre, randomised, double-blind, placebo-controlled trial is being conducted at three hospitals in Shanghai, China. A target of 108 HD or PD patients with HFpEF are randomly allocated to treatment group (henagliflozin 5 mg/day in addition to standard therapy) or control group (placebo with standard therapy) at a ratio of 1:1. All subjects will be followed up for 24 weeks. The primary outcome is change in echocardiography-measured left ventricular mass index. The secondary interests include changes in left atrial volume index, E/e’, e’ and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Intergroup comparisons of change in echocardiography-related outcomes from baseline to 24 weeks are based on a linear regression model adjusted for baseline values (analysis of covariance), and repeated measure analysis of variance with Bonferroni adjustment is employed for comparison of change in NT-proBNP. Subgroup analyses of the primary and secondary outcomes are conducted to determine whether the effect of henagliflozin varies according to dialysis modality. The χ2 method is used to compare the occurrence of adverse events and severe adverse events.Ethics and dissemination This trial has been approved by the Ethics Committee of Renji Hospital, School of Medicine, Shanghai Jiao Tong University (LY2023-127-B). All participants provide written informed consent before screening. The results of the trial will be disclosed completely in international peer-reviewed journals. Both positive and negative results will be reported.Trial registration number ChiCTR2300073169.

In recent years, there has been significant progress in the use of organic–inorganic hybrid perovskites for photovoltaic applications. Engineering the compositions and/or morphology of perovskites has become the most effective method to address the challenges related to photovoltaic efficiency and stability. Herein, an amino‐functionalized covalent organic framework (NH2‐COF) as a precursor additive to modulate the crystallization of perovskites is incorporated. The NH2‐COF is found to decrease the defect concentration, reduce the nonradiative recombination within the perovskite layer, and further promote carrier transport. Correspondingly, the solar cells based on the NH2‐COF‐modified perovskites deliver a champion power conversion efficiency of 22.13% with a fill factor of 0.773 under AM 1.5G 100 mW cm−2 illumination. Furthermore, the device retains approximately 81% of its initial efficiency after 1000 h of aging under ambient conditions at a temperature of 30 °C and relative humidity ranging from 45% to 55%. It is believed that this work would provide a facile and efficient strategy to prepare high‐quality perovskite films for efficient and stable solar cells.

The global demand for protein is on an upward trajectory, and peanut protein powder has emerged as a significant player, owing to its affordability and high quality, with great future market potential. However, the industry currently lacks efficient methods for rapid quality testing. This research paper addressed this gap by introducing a portable device with employed near-infrared spectroscopy (NIR) to quickly assess the quality of peanut protein powder. The principal component analysis (PCA), partial least squares (PLS), and generalized regression neural network (GRNN) methods were used to construct the model to further enhance the accuracy and efficiency of the device. The results demonstrated that the newly established NIR method with PLS and GRNN analysis simultaneously predicted the fat, protein, and moisture of peanut protein powder. The GRNN model showed better predictive performance than the PLS model, the correlation coefficient in calibration (Rcal) of the fat, the protein, and the moisture of peanut protein powder were 0.995, 0.990, and 0.990, respectively, and the residual prediction deviation (RPD) were 10.82, 10.03, and 8.41, respectively. The findings unveiled that the portable NIR spectroscopic equipment combined with the GRNN method achieved rapid quantitative analysis of peanut protein powder. This advancement holds a significant application of this device for the industry, potentially revolutionizing quality testing procedures and ensuring the consistent delivery of high-quality products to fulfil consumer desires.

Sunflower seeds, oil, and protein powder are rich in nutritional value, but the quality of different varieties of sunflower seeds is quite different, and the comprehensive comparative analysis characteristics of edible and oil sunflower seeds are still unclear. The comprehensive analysis and comparison of the raw material indicators, physicochemical properties, and processing characteristics of four edible and four oil sunflower seed varieties were investigated. The results showed that the engineering properties, texture characteristics, single-cell structure, and oil, protein, and starch granule distribution were different between edible and oil sunflower seeds. The composition of fatty acids and amino acids was different among edible, oil sunflower seeds and different varieties. The oleic acid (18.72~79.30%) and linoleic acid (10.11~51.72%) were the main fatty acids in sunflower seed oil, and in amino acid composition, the highest content was glutamic acid (8.88~11.86 g/100 g), followed by aspartic acid (3.92~4.86 g/100 g) and arginine (4.03~4.80 g/100 g). Sunflower meal proteins were dominated by 11S globulin and 2S albumin, and the secondary structure was dominated by β-folding, with -SH and S-S varying greatly among different varieties. Sunflower meal proteins vary widely in terms of functional properties among different varieties, and specialized quality screening was necessary. This study provided a reference and theoretical support for understanding sunflower seeds to further promote the processing and utilization of sunflower seeds.

Gastric cancer (GC) is a serious disease with high morbidity and mortality rates worldwide. Chemotherapy plays a key role in GC treatment, while inevitable drug resistance and systematic side effects hinder its clinical application. Fenton chemistry-based chemodynamic therapy (CDT) has been used as a strategy for cancer ferroptosis, and the CDT efficiency could be enhanced by photothermal therapy (PTT). With the trend of treatment and diagnosis integration, the combination of magnetic resonance imaging (MRI) and CDT/PTT exhibits enormous progress. Herein, we constructed a platform based on PEGylated manganese-containing polydopamine (PDA) nanoparticles, named as PEG-PDA@Mn (PP@Mn) NPs. The PP@Mn NPs were stable and globular. Furthermore, they demonstrated near-infrared (NIR)-triggered PTT and Fenton-like reaction-based CDT effects and T1-weighted MRI capabilities. According to in vitro studies, the PP@Mn NPs trigger ferroptosis in cancer cells by producing abundant reactive oxygen species (ROS) via a Fenton-like reaction combined with PTT. Furthermore, in vivo studies showed that, under MRI guidance, the PP@Mn NPs combined with the PTT at the tumor region, have CDT anti-tumor effect. In conclusion, the PP@Mn NPs could provide an effective strategy for CDT/PTT synergistic ferroptosis therapy for GC.

Summary: Most gastric cancer (GC) patients with early stage often have no lymph node (LN) metastases, while LN metastases appear in the advanced stage. However, there are some patients who present with early stage LN metastases and no LN metastases in the advanced stage. To explore the deeper molecular mechanisms involved, we collected clinical samples from early and advanced stage GC with and without LN metastases, as well as metastatic lymph nodes. Herein, we identified a key target, HOXA11, that was upregulated in GC tissues and closely associated with lymphatic metastases. HOXA11 transcriptionally regulates TGFβ1 expression and activates the TGFβ1/Smad2 pathway, which not only promotes EMT development but also induces VEGF-C secretion and lymphangiogenesis. These findings provide a plausible mechanism for HOXA11-modulated tumor in lymphatic metastasis and suggest that HOXA11 may represent a potential therapeutic target for clinical intervention in LN-metastatic gastric cancer.

Background: Hemodialysis patients have a high risk of severe/critical COVID-19 and related high mortality, but nirmatrelvir/ritonavir is not recommended for hemodialysis patients with COVID-19 infection because of lack of evidence of safety.Objectives: Our study aims to evaluate the minimum plasma concentration (Cmin) of nirmatrelvir and its safety of different doses of nirmatrelvir/ritonavir in hemodialysis patients with mild COVID-19.Method: This was a prospective, two step, nonrandomized, open-label study. Participants were treated with nirmatrelvir 150 mg or 300 mg once a day (another 75 mg or 150 mg supplied after hemodialysis) and ritonavir 100 mg twice daily for 5 days, respectively. The primary outcome was the safety of nirmatrelvir/ritonavir, including the Cmin of nirmatrelvir and the number of adverse events (AE). The secondary outcome was the time of viral elimination in hemodialysis patients.Results: Adverse events were happened in 3 and 7 participants in the step 1 and step 2 group, respectively (p = 0.025). Among them, 2 and 6 participants were identified as drug-related adverse events (p = 0.054). No SAE or liver function damage happened. The Cmin of nirmatrelvir in step 1 and step 2 group were 5,294.65 ± 2,370.59 ng/mL and 7,675.67 ± 2,745.22 ng/mL (p = 0.125). The Cmin of the control group was 2,274.10 ± 1,347.25 ng/mL (p = 0.001 compared to step 2 and p = 0.059 compared to step 1). Compared to hemodialysis patients without nirmatrelvir/ritonavir, there were no statistical differences in overall viral elimination time (p = 0.232).Conclusion: In our study, two doses of nirmatrelvir/ritonavir appeared to be excessive for hemodialysis patients. Although all of the patients tolerated 5-day administration, nearly half of the patients experienced drug-related adverse events. In addition, the medication group did not show a significant advantage in the time of viral elimination.

Abstract Assisted PD is used as an alternative option for the growing group of frail, older ESKD patients unable to perform their own PD. This study was undertaken to investigate the outcomes of assisted PD in older patients by comparing assisted PD patients with self-care PD patients. This study included all patients aged 70 and above who started on PD in our hospital from 2009 to 2018. Patients were followed up until death, PD cessation or to the end of the study (December 31, 2019). Risk factors associated with mortality, peritonitis and technique failure were evaluated using both cause-specific hazards and subdistribution hazards models. 180 patients were enrolled, including 106 (58.9%) males with a median age of 77.5 (77.2–81.2) years. Among the 180 patients, 62 patients (34.4%) were assisted. Patients on assisted PD group were older, more likely to be female, more prevalent in DM and CVD, with a higher Charlson score than patients undergoing self-care PD (P all

Since deterministic prediction errors of wind power cannot be avoided, probabilistic prediction can adequately describe the uncertainty of wind power and, thus, provide further guidance to dispatching authorities for decision making. Current probabilistic prediction methods for wind power are still incomplete in mining its physical variation process. Therefore, this study constructs a new framework for short-term wind power probabilistic forecasting considering the spatio-temporal dependence of errors by mining the spatio-temporal characteristics of historical wind power data and numerical weather forecasts at numerical weather prediction (NWP). First, the deterministic prediction results are obtained by an improved deep belief network (DBN); then, a multi-location NWP is introduced to propose a multi-level error scenario partitioning method considering the spatio-temporal dependence property. Finally, a new error sample set is formed by reconstructing the kernel density estimation method to adapt the model, and the short-term wind power probability prediction at different confidence levels is carried out. It is, thus, concluded that the effectiveness of the overall framework under the probabilistic prediction considering spatio-temporal dependence is verified in a wind farm in Jilin, China, and the prediction accuracy is effectively and significantly improved compared with the same confidence level, and the coverage of the evaluation index prediction interval is improved by 1.23, 0.72, and 0.80%, and the average bandwidth of the prediction interval is reduced by 2.14, 1.40, and 0.63%, which confirms the proposed effectiveness and feasibility of the method.

IntroductionUF insufficiency is a major limitation in PD efficiency and sustainability. Our study object to investigate the efficacy of intraperitoneal inflammation marker, IL-6 level as a predictor of UF insufficiency in continuous ambulatory peritoneal dialysis (CAPD) patients.MethodsStable prevalent CAPD patients were enrolled in this prospective study. IL-6 concentration in the overnight effluent was determined and expressed as the IL-6 appearance rate (IL-6 AR). Patients were divided into two groups according to the median of IL-6 AR and prospectively followed up until death, transfer to permanent HD, recovery of renal function, kidney transplantation, transfer to other centers, lost to follow-up or to the end of study (January 31, 2021). Factors associated with UF capacity as well as dialysate IL-6 AR were assessed by multivariable linear regression. Cox proportional hazards model was used to examine the association between dialysate IL-6 AR and UF insufficiency.ResultsA total of 291 PD patients were enrolled, including 148 males (51%) with a mean age of 56.6 ± 14.1 years and a median PD duration of 33.4 (12.7–57.5) months. No correlation was found between dialysate IL-6 AR and UF capacity at baseline. PD duration was found positively correlated with baseline dialysate IL-6 AR, while 24h urine volume was negatively correlated with baseline dialysate IL-6 AR (P < 0.05). By the end of study, UF insufficiency was observed in 56 (19.2%) patients. Patients in the high IL-6 AR group showed a significantly inferior UF insufficiency-free survival when compared with their counterparts in the low IL-6 AR group (P = 0.001). In the multivariate Cox regression analysis, after adjusting for DM, previous peritonitis episode and 24h urine volume, higher baseline dialysate IL-6 AR (HR 3.639, 95% CI 1.776–7.456, P = 0.002) were associated with an increased risk of UF insufficiency. The area under the ROC curve (AUC) for baseline IL-6 AR to predict UF insufficiency was 0.663 (95% CI, 0.580–0.746; P < 0.001).ConclusionOur study suggested that the dialysate IL-6 AR could be a potential predictor of UF insufficiency in patients undergoing PD.

Selective laser melting (SLM), as a revolutionary technology for metal manufacturing, attracts tremendous attention because it can produce complex components to benefit the customised production. Here we report that additively manufactured 304L austenitic stainless steel (SS) with low stacking fault energy (SFE) show superior fatigue resistance than its conventional counterparts due to the unique heterogeneous microstructure despite containing relatively high porosity. A series of detailed microstructural characterisations were applied to systematically disclose the fatigue enhancement mechanism of additively manufactured parts. Direct evidence is offered to show the obvious progressive work hardening and strain rate hardening caused by the heterogeneous microstructure during cyclic deformation, thus enhancing the fatigue crack initiation resistance. The microstructural results reveal that the cellular substructure plays a decisive role in regulating the dislocation motion during cyclic deformation, resulting in the intergranular fatigue cracking along HAGBs rather than twin boundaries.

IntroductionAssociation of peritoneal protein clearance (Pcl) with outcomes in patients with peritoneal dialysis (PD) is uncertain. Thus, we aimed to investigate its impact on cardiovascular events and all-cause mortality in patients with PD and factors associated with Pcl.MethodsPrevalent patients with PD from January 2014 to April 2015 in the center of Renji Hospital were enrolled. At the time of enrollment, serum and dialysate samples were collected to detect biochemical parameters and Angiopoietin-2-Tie2 system cytokines. Mass transfer area coefficient of creatinine (MTACcr) and Pcl were calculated. Patients were dichotomized into two groups by the median Pcl level (68.5 ml/day) and were followed up prospectively until the end of the study (1 October 2018).ResultsA total of 318 patients with PD [51.2% men, mean age 56.7 ± 14.3 y, median PD duration 31.5 (12.1–57.2) months] were enrolled. Among them, 25.7% were comorbid with diabetes and 28.6% had a history of cardiovascular disease (CVD). After being followed up for up to 43.9 (24.2–50.3) months, 63 had developed cardiovascular events, and 81 patients were died. Among them, the high Pcl group had occurred 39 cardiovascular events and 51 deaths, and the low Pcl group had 24 cardiovascular events and 30 deaths. Kaplan-Meier analysis showed that both the occurrence of cardiovascular events and all-cause mortality were increased in patients with high Pcl. However, after adjusting for important confounders and serum Angiopoietin-2 (Angpt-2) level, Pcl was still an independent risk factor for cardiovascular events [hazard ratio (HR) = 1.006 (1.000–1.012), p = 0.038] but not mortality. On multivariate regression analysis, serum albumin, MTACcr, and body mass index (BMI) were found to be independently associated with Pcl.ConclusionHigh Pcl is an independent risk factor for cardiovascular events but not all-cause mortality. The prediction of cardiovascular events by Pcl was independent of serum Angpt-2.

Wind power forecasting, to a certain extent, will transform the random fluctuation of wind power output into a known situation, which is one of the effective approaches to deal with large-scale wind power integrated into power grid. Due to the use of only historical data and the lack of new information, the accuracy of ultra-short-term wind power prediction (WPP) is still not satisfactory. Therefore, a combined prediction method based on the day-ahead Numerical Weather Prediction (NWP) location technology is proposed. Firstly, the time points with low forecasting accuracy of rolling WPP are approximately located by the NWP information and time windows, and then the hybrid approach combined with neural network and persistence method is presented to predict the future wind power output. The results of the case study show that compared with other classical prediction methods, this method can effectively improve the ultra-short-term prediction accuracy of wind power and verify the effectiveness of the proposed method.

Background: Cerebrovascular and cardiovascular diseases contribute substantially to the mortality of end-stage renal disease patients. We sought to combine pulse wave velocity (PWV) with galectin-3 to predict the mortality and cerebrovascular and cardiovascular events in hemodialysis patients.Methods and Results: End-stage renal disease patients who underwent stable hemodialysis were screened for inclusion. Patients with preexisting cardiovascular and cerebrovascular diseases were excluded. The primary endpoint was a composite of all-cause mortality and major adverse cerebrovascular and cardiovascular events. Receiver operating characteristic curve analysis was used to determine the optimal cutoffs to dichotomize PWV and galectin-3. The study population was then stratified into four groups based on these cutoffs. Both univariable and multivariable Cox regression analyses were performed to estimate the hazard ratio and 95% confidence interval (CI) for clinical factors. Model performance was compared among models with or without PWV and galectin-3. A total of 284 patients were enrolled. During a median follow-up of 31 months, 57 patients (20.1%) reached the primary endpoint. The optimal cutoffs for PWV and galectin-3 were 7.9 m/s and 30.5 ng/ml, respectively. In the multivariable regression analysis, the high PWV–high galectin-3 group was associated with a 3-fold increased risk of all-cause mortality and major adverse cerebrovascular and cardiovascular events (hazard ratio = 3.19, 95% CI: 1.05–9.66, p = 0.04) compared with the low PWV–low galectin-3 group. The combination of PWV and galectin-3 was associated with improved model discrimination, calibration, and reclassification.Conclusions: The combination of PWV and galectin-3 can be used to predict mortality and cerebral and cardiovascular complications in hemodialysis patients.

Abstract As one of promising clean and low-emission energy, wind power is being rapidly developed in China. However, it faces serious problem of wind curtailment, particularly in northeast China, where combined heat and power (CHP) units cover a large proportion of the district heat supply. Due to the inherent strong coupling between the power and the heat load, the operational flexibility of CHP units is severely restricted in winter to meet the heat supply demand, which imparts considerable stress on the wind power connection to the grid. To promote the integration of wind power and enhance the flexibility of CHP units, this paper presented a method of heat and power load dispatching by exploring the energy storage ability of electric heating boilers and district heating systems. The optimization results indicate that the proposed method can integrate additional wind power into the grid and reduce the coal consumption of CHP units over the optimized period. Furthermore, the thermal inertia of a district heating system is found to contribute more to the reduction of coal consumption, whereas the electric heating boilers contribute to lower wind curtailment.

To investigate the long-term outcomes of peritoneal dialysis (PD) patients with diabetes as primary renal disease and patients with diabetes as a comorbid condition.All diabetic patients who commenced PD between January 1, 1995 and June 30, 2012 at Ren Ji Hospital, China were included. Patients were divided into diabetic nephropathy group (DN group) and non-diabetic nephropathy group (NDN group) according to their diagnosis of primary renal disease at the initiation of PD. They were followed until death, cessation of PD, transferred to other centers or to the end of study (June 30, 2013). Outcomes were analyzed by Kaplan-Meier method and Cox regression models.A total of 163 diabetic patients were enrolled in the study, including 121 (74.2%) in DN group and 42 (25.8%) in NDN group. The 1-, 2-, 3- and 5-year patient survival rates were 89%, 78%, 66% and 51% for DN group, and 85%, 63%, 53% and 25% for NDN group, respectively. Kaplan-Meier analysis showed that patients in NDN group had a worse patient survival compared with DN group (log rank 4.830, P=0.028). Patients in NDN group had a marginally shorter peritonitis-free period (log rank 3.297, P=0.069), however, there was no significant difference in technique survival (log rank 0.040, P=0.841). Multivariate Cox regression analysis showed that older age (HR 1.047, 95% CI 1.022-1.073, p

In this paper, the statistical properties and fatigue life estimations of 0.44% carbon steel at different tempering temperatures are presented. The specimens were austenized at 900 °C for 10 min, quenched in water, tempered at different temperatures, and then machined to the design geometry and average surface roughness of Ra = 0.4 μm. The effect of tempering temperature on the fatigue life of 0.44% carbon steel was investigated using 75 fatigue tests, divided into three groups at temperatures 500 °C, 600 °C, and 700 °C. S–N and P–S–N curves were established. Two methods of estimating the mean fatigue life are presented. One is based on dislocation dipole accumulation and Paris’ law; another is based on the kriging model. Six more fatigue tests were carried out to validate the presented methods. Test results showed that the first method is superior to the second in terms of estimating accuracy from the validation datum. However, the second method could estimate the mean fatigue life of quenched and tempered 0.44% carbon steel with an average surface roughness of Ra = 0.4 μm when the tempering temperature was set to a value other than 500 °C, 600 °C, or 700 °C, with no additional fatigue test needed.