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In carbonate soils, soil inorganic carbon (SIC) dissolves and releases CO2 due to exogenous application of nitrogen fertilizer, which makes the soil an important carbon source. Application of the nitrification inhibitor 3,4-dimethylpyrazole phosphate (DMPP) is likely to be an effective measure to alleviate SIC dissolution. A 5-year field experiment was conducted to observe SIC dynamics under three treatments: No N fertilizer (CK), N fertilizer (NF), and N fertilizer combined with DMPP (N + NI). Soil samples were collected from 0 to 20, 20–40, 40–60, 60–80, and 80–100 cm in depth, and soil organic carbon (SOC), SIC, total carbon (TC), total nitrogen (TN), and carbon isotope composition (δ13C) of the soil were analyzed. The proportion of pedogenic carbonate (PIC) in SIC was estimated using an isotopic mass balance equation. Results showed that: (1) compared with the application of N only, DMPP had no significant effect on SOC content and δ13CSOC in the 0–100 cm soil profile; (2) the application of N fertilizer significantly reduced the SIC content by 10.0 g·kg−1 (58.3 %) in the 0–80 cm soil profile. In the 0–20, 20–40, and 60–80 cm soil layers, the SIC content was reduced by 2.9, 1.9, and 3.8 g·kg−1, respectively. However, the SIC content significantly increased by 3.2 g·kg−1 (58.9 %) in the 80–100 cm soil layer. DMPP application significantly increased the SIC content in the 0–20 and 20–40 cm soil layers by 1.3 g·kg−1 (50.9 %) and 1.2 g·kg−1 (48.2 %), respectively; (3) DMPP combined with N significantly alleviated PIC dissolution in the 0–40 cm soil layers and increased PIC stock in 0–100 cm soil by 6.2 Mg·ha−1 (64.6 %). Applying DMPP to farmland soil containing carbonate significantly alleviated the dissolution of N fertilizer on PIC, which may decrease CO2 emissions in the field.

Objective The Gudui-Nanliang spring basin located in southern Shanxi Province is a complex karst water system with the coexistence of deep and shallow circulation, the transformation of cold and hot water, and multistage discharge. Due to long-term unreasonable exploitation and utilization, a series of geological environment problems related to karst groundwater have emerged in the spring basin. The present study aims to propose an ecological restoration and planning scheme for the spring basin by discussing in detail the status of karst groundwater-related environmental problems and their causes. Methods Based on a hydrogeological survey, this paper comprehensively employs a variety of methods, including comparative analysis of groundwater flow field, hydrogeochemical and isotopic analysis, and evaluation of karst water resources. Results The results show that due to the superimposed effects of climate change and human activities, Gudui Spring, Nanliang spring, and Haitou spring cut off the flow in 1999, 1992, and 2002, respectively, and the average decline rate of the regional groundwater level from 2013 to 2021 reaches 2.53 m/a. The results of hydrochemical and isotopic analysis indicate that the recharge to the karst groundwater of porous groundwater from unconsolidated deposits through leakage and surface water from Sanquan Reservoir through seepage cannot be ignored. The proportion of karst water samples worse than the water quality standard of class Ⅲ in the spring basin increased from 62.5% in 2014 to 81.25% in 2021. The range of 0.904 km2 of the spring source area can be subdivided into core protection zone, general protection zone and reservoir storage zone. Ecological protection and restoration planning should be carried out considering the differences between the three zones. Conclusion The results of the study can provide a basis for the comprehensive management of groundwater overexploitation areas in Shanxi Province and the ecological restoration and protection of Gudui spring basin.

Abstract Background The purpose of current retrospective study was to explore the outcomes of using the adductor magnus tendon to reconstruct the medial patellofemoral ligament in the treatment of recurrent patellar dislocation in children. Method Thirty-two children with recurrent patellar dislocation were selected. Sixteen cases in the conservative group, seven males and nine females, with an average age of 11.81 ± 1.28 years; sixteen cases in the surgical group, eight males and eight females, with an average age of 11.56 ± 1.15 years. All patients had no surgery history. The IS index (> 1.2), Q angle (> 20°) and tibial tubercle–femoral trochlear groove (TT–TG) distance (> 20 mm) were measured by X-ray and MRI. The conservative group was treated with closed reduction and a brace, and the surgical group received surgical treatment. Two years after surgery, congruence angle (CA) (− 6° to 6°) and lateral patellofemoral angle (LPFA) (7.7°–18.7°) were measured by X-ray image and all children were evaluated based on Kujala and Lysholm scores. The re-dislocation rate was recorded. Analysis was performed by t test and chi-square with the statistical SPSS software. P 0.05). Patients in the two groups were followed up for 2 years in average. Among the 16 cases in the conservative group, 7 cases (43.75%) had recurrence of patellar dislocation, while none of recurrence in the surgical group (P

Abstract Background Since the connection between muscle atrophy and vitamin D and estradiol status ambiguous, this study was thus conducted to determine whether low skeletal muscle mass (SMM) in middle-aged and elderly women was affected by estradiol and vitamin D levels together. Methods Baseline data from a sub-cohort of the China Northwest Natural Population Cohort: Ningxia Project (CNC-NX) were analyzed. Serum 25-hydroxyvitamin D (25(OH) D) and estradiol were measured by chemiluminescence immunoassay analyzer. Bivariate logistic regression and multiplicative interaction analyses were used to assess the impact of estradiol level and vitamin D status on low SMM, as well as the combined impact of estradiol and low vitamin D status on low SMM. Results A total of 287 (9.49%) participants had low SMM, which had lower levels of estradiol and vitamin D concentration than normal SMM group. While, after adjusting the confounding variables, these correlations were maintained in estradiol Q1, Q2, Q3 and vitamin D Q1. Furthermore, the significant combined effect of the highest quartile of estradiol concentrations and non-vitamin D deficiency, and interactions between vitamin D Q1 and estradiol Q2, vitamin D Q1 and estradiol Q3, vitamin D Q2 and estradiol Q1, vitamin D Q3 and estradiol Q3 on low SMM were stably reflected (P for interaction

Abstract Objectives This study aimed to explore the differences in anchorage strength and histomorphometric changes in orthodontic miniscrews between adult and adolescent beagles. Material and method Six adult beagles and six young beagles were used as experimental subjects, and eight miniscrews were symmetrically placed in the posterior mandible of each dog. Measurement of the displacement (mm) of two adjacent miniscrews after load application was performed to compare the anchorage strength between the adult and adolescent groups. Three intravital bone fluorochromes (oxytetracycline, calcein green, xylenol orange) were administered postoperatively to mark the active bone-forming surface. Subsequently, the mineral apposition rate and bone-implant contact ratio were measured for dynamic and static histomorphometry. Finally, the expression levels of the RANKL/OPG ratio were evaluated by immunohistochemistry. Results The average displacement of miniscrews in the adult group was significantly less than that in the adolescent group after load application. For histomorphometry analysis, the mineral exposure rate in the adolescent group was higher than that in the adult group with or without force application. In addition, more fractures and new bone formation but deceased bone-implant contact ratios were observed in the adolescent group than in the adult group. The ratio of RANKL/OPG expression increased more in the adolescent group than in the adult group. Conclusion Miniscrews do not remain in the same position as skeletal anchors, and the amount of displacement was higher in adolescent group than that in adult group, reflecting the weaker anchorage strength of miniscrews in adolescents due to the higher bone turnover rate and active bone remodelling. Therefore, it is feasible to apply orthodontic loading to the miniscrews in adult patients earlier, even immediately, but it is recommended to wait a period for the adolescents.

Introduction: Gastric cancer (GC)is the third leading cause of cancer-related deaths in China and immunotherapy emerging as a revolutionary treatment for GC recently. Tumor mutational burden (TMB) is a predictive biomarker of immunotherapy in multiple cancers. However, the prognostic significance and subtype of TMB in GC is not fully understood. Objectives: This study aims to evaluate the prognostic value of TMB in Chinese GC and further classify TMB-high GC (GCTMB-H) patients combing with mutational signatures. Methods: Genomic profiling of 435 cancer-gene panel was performed using 206 GC samples from Chinese people. Actionable genetic alterations were compared across all the samples to generate actionable subtyping. The prognostic value of TMB in Chinese GC was evaluated. Mutational signatures were analyzed on TMB-H subtype to stratify the prognosis of TMB. Transcriptomic analysis was applied to compare the distributed immunocytes among different subtypes. Results: 88.3% (182/206) of GC samples had at least one mutation, while 45.1% (93/206) had at least one somatic copy number alteration (SCNA). 29.6% (61/206) of GC samples were TMB-H, including 13 MSI-H and 48 MSS tumors. According to distinct genetic alteration profiles of 69 actionable genes, we classified GC samples into eight molecular subtypes, including TMB-H, ERBB2 amplified, ATM mutated, BRCA2 mutated, CDKN2A/B deleted, PI3KCA mutated, KRAS mutated, and less-mutated subtype. TMB-H subtype presented a remarkable immune-activated phenotype as determined by transcriptomic analysis that was further validated in the TCGA GC cohort. GCTMB-H patients exhibited significantly better survival (P = 0.047). But Signature 1-high GCTMB-H patients had relatively worse prognosis (P = 0.0209, HR = 2.571) than Signature 1-low GCTMB-H patients from Chinese GC cohort, also validated in TCGA GC cohort, presenting highly activated carbohydrate, fatty acid or lipid metabolism. Conclusion: The Signature 1-high GCTMB-H could be a marker of poor prognosis and is associated with metabolism disorder.

Abdominal aortic aneurysm (AAA) is a progressive aortic dilatation, causing ∼80% mortality upon rupture. Currently, there is no approved drug therapy for AAA. Surgical repairs are invasive and risky and thus not recommended to patients with small AAAs which, however, account for ∼90% of the newly diagnosed cases. It is therefore a compelling unmet clinical need to discover effective non-invasive strategies to prevent or slow down AAA progression. We contend that the first AAA drug therapy will only arise through discoveries of both effective drug targets and innovative delivery methods. There is substantial evidence that degenerative smooth muscle cells (SMCs) orchestrate AAA pathogenesis and progression. In this study, we made an exciting finding that PERK, the endoplasmic reticulum (ER) stress Protein Kinase R-like ER Kinase, is a potent driver of SMC degeneration and hence a potential therapeutic target. Indeed, local knockdown of PERK in elastase-challenged aorta significantly attenuated AAA lesions in vivo. In parallel, we also conceived a biomimetic nanocluster (NC) design uniquely tailored to AAA-targeting drug delivery. This NC demonstrated excellent AAA homing via a platelet-derived biomembrane coating; and when loaded with a selective PERK inhibitor (PERKi, GSK2656157), the NC therapy conferred remarkable benefits in both preventing aneurysm development and halting the progression of pre-existing aneurysmal lesions in two distinct rodent models of AAA. In summary, our current study not only establishes a new intervention target for mitigating SMC degeneration and aneurysmal pathogenesis, but also provides a powerful tool to facilitate the development of effective drug therapy of AAA.

Abstract Background This systematic review and meta-analysis aimed to study the evidence on the efficacy and safety of omitting axillary lymph node dissection (ALND) for patients with clinically node-negative but sentinel lymph node (SLN)-positive breast cancer using all the available evidence. Methods The Embase, Medline, and Cochrane Library databases were searched through February 25, 2023. Original trials that compared only the sentinel lymph node biopsy (SLNB) with ALND as the control group for patients with clinically node-negative but SLN-positive breast cancer were included. The primary outcomes were axillary recurrence rate, total recurrence rate, disease-free survival (DFS), and overall survival (OS). Meta-analyses were performed to compare the odds ratio (OR) in rates and the hazard ratios (HR) in time-to-event outcomes between both interventions. Based on different study designs, tools in the revised Cochrane risk of bias tool were used for randomized trials and the risk of bias in nonrandomized studies of interventions to assess the risk of bias for each included article. Funnel plots and Egger's test were used for the publication’s bias assessment. Results In total, 30 reports from 26 studies were included in the systematic review (9 reports of RCTs, 21 reports of retrospective cohort studies). According to our analysis, omitting ALND in patients with clinically node-negative but SLN-positive breast cancer had a similar axillary recurrence rate (OR = 0.95, 95% confidence interval (CI): 0.76–1.20), DFS (HR = 1.02, 95% CI: 0.89–1.16), and OS (HR = 0.97, 95% CI: 0.92–1.03), but caused a significantly lower incidence of adverse events and benefited in locoregional recurrence rate (OR = 0.76, 95% CI: 0.59–0.97) compared with ALND. Conclusion For patients with clinically node-negative but SLN-positive breast cancer (no matter the number of the positive SLN), this review showed that SLNB alone had a similar axillary recurrence rate, DFS, and OS, but caused a significantly lower incidence of adverse events and showed a benefit for the locoregional recurrence compared with ALND. An OS benefit was found in the Macro subset that used SLNB alone versus complete ALND. Therefore, omitting ALND is feasible in this setting. Trial registration CRD 42023397963

(1) Background: Sophora subprostrate, is the dried root and rhizome of Sophora tonkinensis Gagnep. Sophora subprostrate polysaccharide (SSP1) was extracted from Sophora subprostrate, which has shown good anti-inflammatory and antioxidant effects. Previous studies showed SSP1 could modulate inflammatory damage induced by porcine circovirus type 2 (PCV2) in murine splenic lymphocytes, but the specific regulatory mechanism is unclear. (2) Methods: Whole transcriptome analysis was used to characterize the differentially expressed mRNA, lncRNA, and miRNA in PCV2-infected cells and SSP1-treated infected cells. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and other analyses were used to screen for key inflammation-related differentially expressed genes. The sequencing results were verified by RT-qPCR, and western blot was used to verify the key protein in main enriched signal pathways. (3) Results: SSP1 can regulate inflammation-related gene changes induced by PCV2, and its interventional mechanism is mainly involved in the key differential miRNA including miR-7032-y, miR-328-y, and miR-484-z. These inflammation-related genes were mainly enriched in the TNF signal pathway and NF-κB signal pathway, and SSP1 could significantly inhibit the protein expression levels of p-IκB, p-p65, TNF-α, IRF1, GBP2 and p-SAMHD1 to alleviate inflammatory damage. (4) Conclusions: The mechanism of SSP1 regulating PCV2-induced murine splenic lymphocyte inflammation was explored from a whole transcriptome perspective, which provides a theoretical basis for the practical application of SSP1.

Abstract Rituximab, a chimeric anti-CD20 monoclonal antibody, is an effective treatment for nephrotic syndrome. Hypokalemia is a rare adverse reaction among patients treated with rituximab although there have been extensive reports of acute and chronic adverse events with the administration of rituximab. We herein report two cases of symptomatic hypokalemia after intravenous rituximab administration in our center, to help health professionals consider the possibility of acute hypokalemia after rituximab administration, monitor potassium timely and develop an appropriate treatment plan.

Abstract Background Although artificial intelligence systems that diagnosis among different conditions from medical images are long term aims, specific goals for automation of human-labor, time-consuming tasks are not only feasible but equally important. Acute conditions that require quantitative metrics, such as acute ischemic strokes, can greatly benefit by the consistency, objectiveness, and accessibility of automated radiological reports. Methods We used 1,878 annotated brain MRIs to generate a fully automated system that outputs radiological reports in addition to the infarct volume, 3D digital infarct mask, and the feature vector of anatomical regions affected by the acute infarct. This system is associated to a deep-learning algorithm for segmentation of the ischemic core and to parcellation schemes defining arterial territories and classically-identified anatomical brain structures. Results Here we show that the performance of our system to generate radiological reports was comparable to that of an expert evaluator. The weight of the components of the feature vectors that supported the prediction of the reports, as well as the prediction probabilities are outputted, making the pre-trained models behind our system interpretable. The system is publicly available, runs in real time, in local computers, with minimal computational requirements, and it is readily useful for non-expert users. It supports large-scale processing of new and legacy data, enabling clinical and translational research. Conclusion: The generation of reports indicates that our fully automated system is able to extract quantitative, objective, structured, and personalized information from stroke MRIs.

Introduction: Male infertility is a multifactorial pathological condition and may be a harbinger of future health. Phthalates are ubiquitous environmental contaminants that have been implicated in the global decline in male fertility. Among them, di-(2-ethylhexyl) phthalate (DEHP) is the most prevalently used. Lycopene (LYC) is a possible preventive and therapeutic agent for male infertility owing to its antioxidant properties. The blood-testis barrier (BTB) is formed between Sertoli cells where it creates a unique microenvironment for spermatogenesis. Objectives: We hypothesize that phthalate caused male infertility and LYC plays an important role in phthalate-induced male fertility disorders. Methods: Hematoxylin-eosin (H&E) staining, ultrastructure observation, and fluorescence microscopy were used to examine the morphological changes. RNA-Seq, and western blotting were conducted to detect gene and protein levels. Routine testing for sperm morphology and sperm-egg binding assay were conducted to examine the morphological structure and function of sperm. Cell scratch assay and transepithelial electrical resistance (TER) were used to detect cell migration capacity and barrier integrity. Results: In vivo experiments, we showed that LYC prevented DEHP-induced impairment of BTB integrity, which provided a guarantee for the smooth progress of spermatogenesis. LYC improved DEHP-induced change in sperm parameters and fertilization ability. Subsequent in vitro experiments, LYC alleviated MEHP-induced disruption of intercellular junctions in mouse Spermatogonia cells (GC-1 cells) and mouse Sertoli cells (TM4 cells). In MEHP-induced BTB impairment models of Sertoli cells, treatment with LYC or overexpressing connexin-43 (Cx43) promoted cell migration capacity and normalized BTB integrity. Cx43 knockdown inhibited cell migration capacity and perturbed BTB reassembly in LYC preventing DEHP-induced BTB impairment. Conclusion: Our study provides evidence for the role of LYC in phthalates-induced spermatogenic disorders and points to Cx43 as a potential target for male fertility.

Wheat embryo globulin (WEG) has been proven to possess multiple biological activities, including antioxidative properties, immunomodulatory, and so on. Aged mouse model were established by subcutaneous injection of D-galactose (D-gal), and the effects of WEG on learning, memory, and antioxidant capacity in aging mice were explored through behavioural tests and antioxidant enzyme activities determination. Compared with the Model group, WEG improved the percentage of the platform quadrant, increased the number of crossing platforms, and enhanced the identification indexs. WEG also increased total antioxidant capacity (T-AOC), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) activities in the liver and brains of aging mice, and reduced malondialdehyde (MDA) content. Pathological observations indicated that WEG protected against damage to brain in D-gal-induced aging mice. These results effectively revealed that WEG not only improved the abilities of learning and memory, and the cognitive impairment, but also delayed the aging process of the D-gal-induced mice.

Photocatalytic technology, which is regarded as a green route to transform solar energy into chemical fuels, plays an important role in the fields of energy and environmental protection. An emerging S-scheme heterojunction with the tightly coupled interface, whose photocatalytic efficiency exceeds those of conventional type II and Z-scheme photocatalysts, has received much attention due to its rapid charge carrier separation and strong redox capacity. This review provides a systematic description of S-scheme heterojunction in the photocatalysis, including its development, reaction mechanisms, preparation, and characterization methods. In addition, S-scheme photocatalysts for CO2 reduction are described in detail by categorizing them as 0D/1D, 0D/2D, 0D/3D, 2D/2D, and 2D/3D. Finally, some defects of S-scheme heterojunctions are pointed out, and the future development of S-scheme heterojunctions is proposed.

Absent in melanoma 2 (AIM2), a key component of the IFI20X/IFI16 (PYHIN) protein family, is characterized as a DNA sensor to detect cytosolic bacteria and DNA viruses. However, little is known about its immunological role during pathogenic Clostridium perfringens (C. perfringens) infection, an extracellular bacterial pathogen. In a pathogenic C. perfringens gas gangrene model, Aim2−/− mice are more susceptible to pathogenic C. perfringens soft tissue infection, revealing the importance of AIM2 in host protection. Notably, Aim2 deficiency leads to a defect in bacterial killing and clearance. Our in vivo and in vitro findings further establish that inflammasome signaling is impaired in the absence of Aim2 in response to pathogenic C. perfringens. Mechanistically, inflammasome signaling downstream of active AIM2 promotes pathogen control. Importantly, pathogenic C. perfringens-derived genomic DNA triggers inflammasome signaling activation in an AIM2-dependent manner. Thus, these observations uncover a central role for AIM2 in host defense and triggering innate immunity to combat pathogenic C. perfringens infections.

Crater detection can provide valuable information for humans to explore the topography and understand the history of extraterrestrial planets. Due to the significantly varying scenario distributions, existing detection models trained on known labelled crater datasets are hardly effective when applied to new unlabelled planets. To address this issue, we propose a two-stage adaptive network (TAN) for semi-supervised cross-domain crater detection. Our network is built on the YOLOv5 detector, where a series of strategies are employed to enhance its cross-domain generalisation ability. In the first stage, we propose an attention-based scale-adaptive fusion (ASAF) strategy to handle objects with significant scale variances. Furthermore, we propose a smoothing hard example mining (SHEM) loss function to address the issue of overfitting on hard examples. In the second stage, we propose a sort-based pseudo-labelling fine-tuning (SPF) strategy for semi-supervised learning to mitigate the distributional differences between source and target domains. For both stages, we employ weak or strong image augmentation to suit different cross-domain tasks. Experimental results on benchmark datasets demonstrate that the proposed network can enhance domain adaptation ability for crater detection under varying scenario distributions.

Objective: The objective of this study is to compare the differences in effective connectivity within the default mode network (DMN) subsystems between patients with Parkinson’s disease with mild cognitive impairment (PD-MCI) and patients with Parkinson’s disease with normal cognition (PD-CN). The mechanisms underlying DMN dysfunction in PD-MCI patients and its association with clinical cognitive function in PD-MCI are aimed to be investigated. Methods: The spectral dynamic causal model (spDCM) was employed to analyze the effective connectivity of functional magnetic resonance imaging (fMRI) data in the resting state for the DMN subsystems, which include the medial prefrontal cortex (MPFC), posterior cingulate cortex (PCC), left and right angular gyrus (LAG, RAG) in 23 PD-MCI and 22 PD-CN patients, respectively. The effective connectivity values of DMN subsystems in the two groups were statistically analyzed using a two-sample t-test. The Spearman correlation analysis was used to test the correlation between the effective connectivity values of the subsystems with significant differences between the two groups and the clinical cognitive function (as measured by Montreal Cognitive Assessment Scale (MoCA) score). Results: Statistical analysis revealed significant differences in the effective connections of MPFC-LAG and LAG-PCC between the two patient groups (MPFC-LAG: t = –2.993, p < 0.05; LAG-PCC: t = 2.174, p < 0.05). Conclusions: The study findings suggest that abnormal strength and direction of effective connections between DMN subsystems are found in PD-MCI patients.

In order to study the hydration absorption behaviors and characteristics of sandstone in Mogao Grottoes in China, the pressure-less hydration absorption experiment on the outcrop porous sandstone of Mogao Grottoes was carried out by using the self-developed real-time monitoring experimental system. The hydration absorption was measured and the curve of hydration absorption with time was drawn. At the same time, the digital image correlation method (DIC) was used to measure the full-field deformation, and the speckle pattern of the sample was analyzed using Match ID, and the displacement field and strain field of the sandstone sample at different hydration absorption moments were computed. Moreover, the sparse area and dense area of sandstone are used as regions of interest (ROI) for DIC analysis. According to the test results, it is concluded that the hydration absorption of sandstone increases rapidly in the initial stage, and gradually tends to be stable with the change of time. This corresponds well with the deformation characteristics of sandstone analyzed using DIC. In the initial stage, the deformation of sandstone increases rapidly. With the change in time, the deformation of sandstone samples gradually slows down. When the hydration adsorption reaches saturation, the sandstone continues to deform for a period of time before stopping hydration absorption. The results of the mercury injection test and the XRD test show that the porosity of the sparse area is larger than that of the dense area and the particle content of the dense area is lower. When the sandstone is saturated with water, the liquid is immersed in the pores between the solid particles, which makes the sparse area more prone to stress concentration, and the deformation in the sparse area is larger. Therefore, when analyzing the hydration absorption deformation of sandstone, the porosity should be considered.

In this paper, I examine the iconography, religious function and text–image relationship of one of the earliest illustrations of the apocryphal Visualization Sūtra, namely, the mural painting on the left (south) wall of Cave 20 at the Toyok Grottoes in Turfan created in the late sixth century. I study this mural with a structuralist approach to situate it within the overall pictorial program of the cave temple. I argue that this wall painting was designed as a set of visual and verbal cues to assist the meditating monks in situ to separately visualize the different individual visions constituting the “Thirteen Visualizations” taught in the sutra, excluding the five visions directly related to the Amitāyus Triad, namely, the eighth, ninth, tenth, eleventh and thirteenth visualizations. These five visualizations were likely facilitated by icons of the Amitāyus Triad placed in the center of the cave. The meditators started from the contemplations of the impure represented on the right (north) wall as preparatory practices to eliminate their sins, improve their karma and thereby enhance their spiritual purity to a level appropriate for performing the Pure Land visualizations. They then turned to the left wall to perform the Pure Land visualizations represented there that end with the twelfth visualization: imagining oneself being reborn in Sukhāvatī. Continuing from the twelfth visualization, the meditators facing the rear wall entered the Western Pure Land via the lotus ponds represented on the rear wall while in a state of meditational concentration.

Abstract The authors conducted an observational study to explore the association between body fat composition and the risk of hyperhomocysteinemia (HHcy) and their combined effect on the risk of developing cardiovascular disease (CVD). Adults aged 18–74 years from the Northwest China Natural Population Cohort: Ningxia Project (CNC‐NX) were recruited in this study. Association between body fat composition and HHcy was evaluated by logistic regression model. Restricted cubic spline was used to find nonlinear association. The impact of the interaction between HHcy and body fat composition on CVD was evaluated using the addition interaction model and mediation effect model. In total, 16 419 participants were included in this research. Body fat percentage, visceral fat level, and abdominal fat thickness were positively associated with overall HHcy (p for trend

Abstract Background As the population ages, chronic non-communicable diseases (NCDs) multimorbidity has emerged as a major public health issue globally. This study examines ethnic disparities in prevalence of NCDs and its multimorbidity among rural southwest Chinese older adults. Methods A cross-sectional survey was conducted in rural southwest population aged ≥ 60 years consisting of 5,642 consenting participants of Han and three ethnic minority groups (Dai, Ha Ni, and Bai). Information about participants’ demographic characteristics and lifestyle behaviors was obtained using a standard questionnaire. Anthropometric measurements including height, weight, and waist circumference, fasting blood sugar and blood pressure measurement, as well as post-bronchodilator spirometry test were recorded for each participant. Results The age-standardized prevalence of five common chronic NCDs– hypertension, diabetes, coronary heart disease (CHD), stroke, chronic obstructive pulmonary disease (COPD) – and its multimorbidity was 72.8%, 15.9%, 4.0%, 10.0%, 9.8%, and 27.6%, respectively. Bai participants had both the highest overall and sex-specific prevalence rates of hypertension, diabetes, stroke, and COPD, whereas Han participants had the highest rates of CHD (P

High-speed health trains have the advantages of large rescue volume, strong continuous operation capability, and medical treatment on the way. It is the best transport platform for large-scale medical transfer tasks. To solve the problem of space limitations and the vehicle formation of high-speed health trains, a new method of space layout design and evaluation of high-speed health trains based on improved systematic layout planning (SLP) was proposed. First, SLP was improved, and the relationship between functional carriages was reasonably marshaled using the improved SLP. Then, according to the space constraints of high-speed trains and the requirements of the man–machine environment, the space layout of the vehicles was designed, and 3ds MAX software was used to visualize the designed layout structure. Finally, the static and dynamic simulation effects and adaptability of the design scheme were evaluated using the digital virtual simulation software JACK. The design scheme can meet the requirements of human–computer interaction efficiency. Compared with previous studies, the results of this study reflect the superiority and rationality of the design in functional configuration, space utilization, medical treatment, and injury-carrying capacity. The results of this study can provide theoretical support for the formation of high-speed health trains, and provide a reference for the research and development of such trains. It has certain practical application value.

This paper proposes a functional carriage design and an evaluation index system to improve the operational efficiency of high-speed medical trains. Hierarchical task analysis and human-machine-environment analysis were applied to model the transfer task and the functional modules of the medical train. The functional module configuration was obtained by performing a correlation analysis between the task and function. The relationship between carriages was elucidated by analysing material, personnel and information flow, and an optimal grouping diagram was obtained. Based on this design method, an innovative 6-carriage grouping design scheme was proposed. A functional evaluation index system for the carriage design was constructed, and the 6-carriage design was compared with the conventional 8-carriage design to verify the usability of the design method. The results showed that the 6-carriage high-speed trains can be flexibly configured to suit the changing task environment and are generally better than the 8-carriage design. This study provides theoretical and methodological support for constructing efficient and rational functional carriages for high-speed medical trains.

Abstract Uterine clear cell carcinoma (UCCC) is a relatively rare endometrial cancer. There is limited information on its prognosis. This study aimed to develop a predictive model predicting the cancer-specific survival (CSS) of UCCC patients based on data from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2018. A total of 2329 patients initially diagnosed with UCCC were included in this study. Patients were randomized into training and validation cohorts (7:3). Multivariate Cox regression analysis identified that age, tumor size, SEER stage, surgery, number of lymph nodes detected, lymph node metastasis, radiotherapy and chemotherapy were independent prognostic factors for CSS. Based on these factors, a nomogram for predicting the prognosis of UCCC patients was constructed. The nomogram was validated using concordance index (C-index), calibration curves, and decision curve analyses (DCA). The C-index of the nomograms in the training and validation sets are 0.778 and 0.765, respectively. Calibration curves showed good consistency of CSS between actual observations and nomogram predictions, and DCA showed that the nomogram has great clinical utility. In conclusion, a prognostic nomogram was firstly established for predicting the CSS of UCCC patients, which can help clinicians make personalized prognostic predictions and provide accurate treatment recommendations.

This work presented a new PEG modified calix[4]arene stationary phase (C4A-PEG-2PTSC) for gas chromatographic (GC) separations. The statically coated C4A-PEG-2PTSC column exhibited moderate polarity and column efficiency of 2224 plates m-1 determined by 1-octanol at 120 oC. The results showed that the C4A-PEG-2PTSC column exhibited the good separation performance for various types of analytes containing halogenated benzenes, benzaldehydes, phenols, alcohols, anilines isomers and showed the different retention behavior with the comparative columns. Importantly, it showed the better separation capacity of toluidine and xylidine isomers than commercial HP-35 column. Moreover, it was applied in practical sample analysis to detect the content of isomer impurities. This work exhibited the good application potential of C4A-PEG-2PTSC stationary phase in GC analyses.

BackgroundThe contribution of long-term ambient PM2.5 exposure to hypertension should not be ignored. However, the conclusions of whether dietary factors play a role in regulating PM2.5-related hypertension are still inconsistent. ObjectiveTo explore the correlation between long-term exposure to ambient PM2.5 and blood pressure indicators (systolic blood pressure, diastolic blood pressure, mean arterial pressure, and pulse pressure) in adults in Ningxia and a potential moderating effect of dietary factors. MethodsA set of cross-sectional survey data from March, 2013 to May, 2018 was retrieved from the China Northwest Cohort-Ningxia, and the average ambient PM2.5 concentration in the previous three years was also collected to estimate the long-term exposure of the participants. Binary logistic regression model was used to validate the correlation between long-term exposure to ambient PM2.5 and hypertension in Ningxia, and linear model was used to study the correlation between long-term exposure to ambient PM2.5 and blood pressure indicators (systolic blood pressure, diastolic blood pressure, mean arterial pressure and pulse pressure), and to explore the influence of dietary factors on ambient PM2.5-related hypertension. ResultsA total of 11470 participants were included in the study, 42.2% male and 57.8% female. The three-year average ambient PM2.5 concentration before the baseline survey was 37.0 μg·m−3. Each 1 μg·m−3 increase in ambient PM2.5 was associated with an increased risk of hypertension (OR=1.111, 95%CI: 1.097, 1.125), and increased systolic blood pressure, diastolic blood pressure, mean arterial pressure, and pulse pressure by 0.886 (95%CI: 0.783, 0.990), 0.570 (95%CI: 0.500, 0.641), 0.676 (95%CI: 0.600, 0.751), and 0.316 (95%CI: 0.243, 0.389) mmHg, respectively. The stratified analysis showed that the OR and 95%CI of hypertension were 1.171 (1.097, 1.254), 1.117 (1.064, 1.174), and 1.160 (1.116, 1.207) respectively for each 1 μg·m−3 increased in PM2.5 with low frequency of vegetable and fruit consumption and salty taste respectively. The OR and 95%CI of hypertension were decreased when the moderate and high frequency of vegetable and fruit intake and moderate and light taste applied, the values were 1.091 (1.062, 1.121) and 1.114 (1.097, 1.131), 1.105 (1.082, 1.129) and 1.111 (1.092, 1.13), 1.115 (1.090, 1.140) and 1.102 (1.083, 1.121) respectively. Compared with low frequency of vegetable and fruit intake and salty taste, the increase degree of ambient PM2.5 related systolic blood pressure, diastolic blood pressure, mean arterial pressure and pulse pressure also decreased in middle and high frequency of vegetable and fruit intake and moderate and light taste. ConclusionLong-term exposure to ambient PM2.5 is significantly associated with increased risks of hypertension and blood pressure in Ningxia area. Increasing the frequency of vegetable and fruit intake and decreasing salty taste may reduce the effect of ambient PM2.5 on hypertension and blood pressure.

Abstract Background We report a patient with a novel c.737 C > T variant (p.Ser246Leu) of the TPM3 gene presenting with adult-onset distal myopathy. Case presentation A 35-year-old Chinese male patient presented with a history of progressive finger weakness. Physical examination revealed differential finger extension weakness, together with predominant finger abduction, elbow flexion, ankle dorsiflexion and toe extension weakness. Muscle MRI showed disproportionate fatty infiltration of the glutei, sartorius and extensor digitorum longus muscles without significant wasting. Muscle biopsy and ultrastructural examination showed a non-specific myopathic pattern without nemaline or cap inclusions. Genetic sequencing revealed a novel heterozygous p.Ser246Leu variant (c.737C>T) of the TPM3 gene which is predicted to be pathogenic. This variant is located in the area of the TPM3 gene where the protein product interacts with actin at position Asp25 of actin. Mutations of TPM3 in these loci have been shown to alter the sensitivity of thin filaments to the influx of calcium ions. Conclusion This report further expands the phenotypic spectrum of myopathies associated with TPM3 mutations, as mutations in TPM3 had not previously been reported with adult-onset distal myopathy. We also discuss the interpretation of variants of unknown significance in patients with TPM3 mutations and summarise the typical muscle MRI findings of patients with TPM3 mutations.

Abstract Background Rheumatoid arthritis (RA) is a chronic, systemic autoimmune inflammatory disease, the pathogenesis of which is not clear. Clinical remission, or decreased disease activity, is the aim of treatment for RA. However, our understanding of disease activity is inadequate, and clinical remission rates for RA are generally poor. In this study, we used multi-omics profiling to study potential alterations in rheumatoid arthritis with different disease activity levels. Methods Fecal and plasma samples from 131 rheumatoid arthritis (RA) patients and 50 healthy subjects were collected for 16S rRNA sequencing, internally transcribed spacer (ITS) sequencing, and liquid chromatography-tandem mass spectrometry (LC–MS/MS). The PBMCS were also collected for RNA sequencing and whole exome sequencing (WES). The disease groups, based on 28 joints and ESR (DAS28), were divided into DAS28L, DAS28M, and DAS28H groups. Three random forest models were constructed and verified with an external validation cohort of 93 subjects. Results Our findings revealed significant alterations in plasma metabolites and gut microbiota in RA patients with different disease activities. Moreover, plasma metabolites, especially lipid metabolites, demonstrated a significant correlation with the DAS28 score and also associations with gut bacteria and fungi. KEGG pathway enrichment analysis of plasma metabolites and RNA sequencing data demonstrated alterations in the lipid metabolic pathway in RA progression. Whole exome sequencing (WES) results have shown that non-synonymous single nucleotide variants (nsSNV) of the HLA-DRB1 and HLA-DRB5 gene locus were associated with the disease activity of RA. Furthermore, we developed a disease classifier based on plasma metabolites and gut microbiota that effectively discriminated RA patients with different disease activity in both the discovery cohort and the external validation cohort. Conclusion Overall, our multi-omics analysis confirmed that RA patients with different disease activity were altered in plasma metabolites, gut microbiota composition, transcript levels, and DNA. Our study identified the relationship between gut microbiota and plasma metabolites and RA disease activity, which may provide a novel therapeutic direction for improving the clinical remission rate of RA.

The properties of steel are affected by the non-metallic inclusions. It is critical to control the morphology of inclusions for producing the high-quality steel. However, due to the morphology of inclusions is complex and diverse, it is difficult to reveal the real morphology of inclusions by using the traditional two-dimensional (2D) observation method, and making it hard to quantitatively analyze the size and morphology of inclusions. In this study, the three-dimensional (3D) morphology of the alumina clusters in steel samples was observed by using the X-ray Micro-CT in the beamline of BL16U2 at Shanghai Synchrotron Radiation Facility (SSRF). Avizo software was used to reconstruct the 3D morphology of the alumina clusters, which intuitively shows the actual morphology of alumina clusters. The accuracy of 2D and 3D observation methods is discussed based on the stereological analysis of individual alumina cluster. A series of parameters were defined to characterize the morphological characteristics of the alumina clusters based the 3D observation. The fractal theory was introduced to quantitatively describe the morphological of alumina clusters. In the current study, the 2D fractal dimension of alumina clusters was determined as 1.64. The complexity of 3D morphology of alumina clusters was analyzed by 3D fractal dimension and shape factor. The current work provides an effective method for quantitative description of the morphology and spatial distribution of inclusions, which provides an important reference for effective control of alumina inclusions.

Urban intertunnel weaving (UIW) section is a special type of weaving section, where various lane-changing behaviours occur. To gain insight into the lane-changing behaviour in the UIW section, in this paper we attempt to analyse the decision feature and model the behaviour from the lane-changing point selection perspective. Based on field-collected lane-changing trajectory data, the lane-changing behaviours are divided into four types. Random forest method is applied to analyse the influencing factors of choice of lane-changing point. Moreover, a support vector machine model is adopted to perform decision behaviour modelling. Results reveal that there are significant differences in the influencing factors for different lane-changing types and different positions in the UIW segment. The three most important factor types are object vehicle status, current-lane rear vehicle status and target-lane rear vehicle status. The precision of the choice of lane-changing point models is at least 82%. The proposed method could reveal the detailed features of the lane-changing point selection behaviour in the UIW section and also provide a feasible choice of lane-changing point model.

This article focuses on achieving fixed-time synchronization (FxTS) of nonlinear coupled memristive neural networks (NCMMN) with time delays. We propose a novel integrable sliding-mode manifold (SMM) and develop two control strategies (chattering or non-chattering) to achieve FxTS. By selecting appropriate parameters, some criteria are established to force the dynamics of NCMMN to reach the designed SMM within a fixed time and remain on it thereafter. Additionally, they provide estimations for the settling time (TST). the validity of our results is demonstrated through several numerical examples.

Abstract Background Multifocal (MF) and multicentric (MC) breast cancer cases have been increasingly diagnosed owing to the extensive use of improved preoperative breast imaging. The current tumor‐node‐metastasis staging system uses the dimension of the largest tumor and recommends reporting the pathological features of the largest tumor in MF/MC breast cancers. Aim This study aimed to explore whether the largest or aggregate dimensions of MF and MC breast cancers can better predict tumor behavior. We also attempted to study the histological and biological heterogeneities of separate foci in MF and MC breast cancers to determine whether it was necessary to examine each lesion. Methods We retrospectively analyzed 121 patients with MF/MC (103 with MF and 18 with MC) breast cancers and 484 patients with unifocal breast cancer who were treated at the First Affiliated Hospital of Nanjing Medical University. Two methods were used to record the T stage (using the dimensions of the largest lesion and aggregate dimensions of all lesions). The histological grade, immunohistochemical parameters, and molecular subtypes of the largest lesion and other lesions in MF/MC breast cancers were studied to assess intertumoral heterogeneity. Results The use of aggregate dimensions upstaged 63 patients with MF/MC breast cancers to a more advanced stage and removed the independent effect of cancer multiplicity on lymph node positivity compared with the use of the largest dimension. Mismatches were found in the pathological type (9.9%), histological grade (4.1%), and molecular subtype (8.3%) among different foci. Conclusion The tendency of MF/MC breast tumors to metastasize may be related to tumor load, which can be better predicted by the aggregate dimensions of all foci. The use of the current staging systems may require further evaluation and modification. Intertumoral heterogeneity indicates the necessity for pathological and immunohistochemical assessments of each lesion in patients with MF/MC breast cancers.

Abstract Background Neutrophils have a critical role in the pathogenesis of rheumatoid arthritis (RA) with immune system dysfunction. However, the molecular mechanisms of this process mediated by neutrophils still remain elusive. The purpose of the present study is to identify hub genes in neutrophils for diagnosis and treatment of RA utilizing publicly available datasets. Methods Gene expression profiles were downloaded from the Gene Expression Omnibus, and batch-corrected and normalized expression data were obtained using the ComBat package. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis were used to conduct significantly functional analysis and crucial pathways. The resulting co-expression genes modules and hub genes were generated based on the weighted gene co-expression network analysis and visualization by Cytoscape. Flow cytometry was conducted to detect reactive oxygen species (ROS) levels in neutrophils. Results Neutrophils underwent transcriptional changes in synovial fluid (SF) of RA patients, different from peripheral blood of healthy controls or patients with RA. Especially, glycolysis, HIF-1 signaling, NADH metabolism, and oxidative stress were affected. These hub genes were strongly linked with classical glycolysis-related genes (ENO1, GAPDH, and PKM) responsible for ROS production. The antioxidant enzyme glutathione peroxidase 3 (GPX3), a ROS scavenger, was first identified as a hub gene in RA neutrophils. Neutrophils from patients with autoinflammatory and autoimmune diseases had markedly enhanced ROS levels, most notably in RA SF. Conclusion This research recognized hub genes and explored the characteristics of neutrophils in RA. Our findings suggest that the novel hub gene GPX3 is involved in the neutrophil-driven oxidative stress-mediated pathogenesis of RA. It has the potency to be a target for neutrophil-directed RA therapy.

Abstract Background Mycoplasma hominis infection is common in urinary tract. 18F-FDG-PET/CT is a valuable tool for tumor and infection diagnosis. Few studies have shown the 18F-FDG-PET/CT images after mycoplasma infection. Case presentation Here we described a case of Waldenstrom macroglobulinemia with thickened bladder wall. The 18F-FDG-PET/CT showed the SUVmax up to 36.1 mimicking bladder cancer. The results of histopathological examination and metagenomic sequencing of the blood and urinary revealed the Mycoplasma hominis infection. Conclusion The full consideration should be given to the possibility of infection besides tumor in lesions with high SUV value in 18F-FDG-PET/CT, especially in immunodeficiency patients.

Abstract This study aimed to explore the substance basis and mechanisms of Shen-qi-wang-mo Granule (SQWMG), a traditional Chinese medicine prescription that had been clinically utilized to treat retinal vein occlusion (RVO) for 38 years. Components in SQWMG were analyzed by UPLC-Triple-TOF/MS and a total of 63 components were identified with ganoderic acids (GA) being the largest proportion. Potential targets of active components were retrieved from SwissTargetPrediction. RVO-related targets were acquired from related disease databases. Core targets of SQWMG against RVO were acquired by overlapping the above targets. The 66 components (including 5 isomers) and 169 targets were obtained and concluded into a component-target network. Together with biological enrichment analysis of targets, it revealed the crucial role of the “PI3K-Akt signaling pathway”, “MAPK signaling pathway” and their downstream factor iNOS and TNF-α. The 20 key targets of SQWMG in treating RVO were acquired from the network and pathway analysis. The effects of SQWMG on targets and pathways were validated by molecular docking based on AutoDock Vina and qPCR experiment. The molecular docking showed great affinity for these components and targets, especially on ganoderic acids (GA) and alisols (AS), which were both triterpenoids and qPCR exhibited remarkably reduced inflammatory factor gene expression through regulation of these two pathways. Finally, the key components were also identified from rat serum after treatment of SQWMG.

With the advancement of China’s “carbon neutrality” process, the carbon emission quotas of various types of users have gradually tightened, “carbon responsibility” has attracted widespread attention, and the “high/low carbon area” is divided from the perspective of the user side, and the analysis of “carbon responsibility” is conducive to building a flexible and reasonable response mechanism that promotes carbon reduction demand, and revitalizes the carbon reduction potential of the user side. Based on the theory of carbon emission flow, considering the generator output power transfer distribution factor, The emergence of the proportional sharing principle and electrical dissection theory solves the problem of load-side electricity consumption sources. The emerging carbon emission stream theory, which is both applicable to power systems and consistent with the proportional sharing principle, is used as a basis to further delineate high/low carbon areas. By tracing from the load side to the power side, we can determine the power consumption attributes of the load side, differentiate between high-carbon and low-carbon power users, divide the typical areas of high-carbon and low-carbon power, the levy carbon tax on high-carbon power, change the power consumption habits of the load side to achieve effective demand response, and complete the low-carbon planning of the power system from the load side. the carbon emission flow distribution factor model is established, a method of dividing the high and low carbon area of the power system is proposed, and the effectiveness of the proposed method is verified by the IEEE30 node system.

Background: Emerging data have supported the immunostimulatory role of radiotherapy, which could exert a synergistic effect with immune checkpoint inhibitors (ICIs). With proven effective but suboptimal effect of ICI and chemotherapy in triple-negative breast cancer (TNBC), we designed a pilot study to explore the efficacy and safety of neoadjuvant stereotactic body radiotherapy (SBRT) plus adebrelimab and chemotherapy in TNBC patients. Methods: Treatment-naïve TNBC patients received two cycles of intravenous adebrelimab (20 mg/kg, every 3 weeks), and SBRT (24 Gy/3 f, every other day) started at the second cycle, then followed by six cycles of adebrelimab plus nab-paclitaxel (125 mg/m² on days 1 and 8) and carboplatin (area under the curve 6 mg/mL per min on day 1) every 3 weeks. The surgery was performed within 3–5 weeks after the end of neoadjuvant therapy. Primary endpoint was pathological complete response (pCR, ypT0/is ypN0). Secondary endpoints included objective response rate (ORR), residual cancer burden (RCB) 0-I, and safety. Results: 13 patients were enrolled and received at least one dose of therapy. 10 (76.9%) patients completed SBRT and were included in efficacy analysis. 90% (9/10) of patients achieved pCR, both RCB 0-I and ORR reached 100% with three patients achieved complete remission. Adverse events (AEs) of all-grade and grade 3–4 occurred in 92.3% and 53.8%, respectively. One (7.7%) patient had treatment-related serious AEs. No radiation-related dermatitis or death occurred. Conclusions: Adding SBRT to adebrelimab and neoadjuvant chemotherapy led to a substantial proportion of pCR with acceptable toxicities, supporting further exploration of this combination in TNBC patients. Funding: None. Clinical trial number: NCT05132790.

Aqueous Zn-organic batteries (AZOBs) stand out in the family of aqueous Zn devices due to high theoretical capacity, tunable structures, sustainable resources, and low cost of organic hosts. However, the development of advanced AZOBs faces numerous issues and challenges, including, poor conductivity, low actual capacity, serve molecular dissolution, and unsatisfying energy density. Herein, we summarize an overview of various organic materials as the inserted ion hosts. In addition to categorizing organic compounds based on their functional groups, this report also covers the latest developments in organic cathodes and their energy storage mechanisms. Furthermore, strategies for advanced Zn-organic devices are suggested with regard to structural design and important battery metrics. Moreover, challenges and perspectives are finally discussed from the point of view of full batteries. We hope this review can provide a valuable evaluation of commercial Zn-organic batteries and spur new insights toward a greener energy world.

Background Since most infants are usually discharged before age 48–72 hours, peak bilirubin levels will almost always occur after discharge. Parents may be the first to observe the onset of jaundice after discharge, but visual assessment is unreliable. The jaundice colour card (JCard) is a low-cost icterometer designed for the assessment of neonatal jaundice. The objective of this study was to evaluate parental use of JCard to detect jaundice in neonates.Methods We conducted a multicentre, prospective, observational cohort study in nine sites across China. A total of 1161 newborns ≥35 weeks of gestation were enrolled in the study. Measurements of total serum bilirubin (TSB) levels were based on clinical indications. The JCard measurements by parents and paediatricians were compared with the TSB.Results JCard values of parents and paediatricians were correlated with TSB (r=0.754 and 0.788, respectively). The parents’ and paediatricians’ JCard values 9 had sensitivities of 95.2% vs 97.6% and specificities of 84.5% vs 71.7% for identifying neonates with TSB ≥153.9 µmol/L. The parents’ and paediatricians’ JCard values 15 had sensitivities of 79.9% vs 89.0% and specificities of 66.7% vs 64.9% for identifying neonates with TSB ≥256.5 µmol/L. Areas under the receiver operating characteristic curves of parents for identifying TSB ≥119.7, ≥153.9, ≥205.2, and ≥256.5 µmol/L were 0.967, 0.960, 0.915, and 0.813, respectively, and those of paediatricians were 0.966, 0.961, 0.926 and 0.840, respectively. The intraclass correlation coefficient was 0.933 between parents and paediatricians.Conclusion The JCard can be used to classify different levels of bilirubin, but it is less accurate with high bilirubin levels. The JCard diagnostic performance of parents was slightly lower than that of paediatricians.

Abstract Topological transition metal dichalcogenides (TMDCs) have attracted much attention due to their potential applications in spintronics and quantum computations. In this work, the structural and electronic properties of topological TMDCs candidate ZrTe2 are systematically investigated under high pressure. A pressure‐induced Lifshitz transition is evidenced by the change of charge carrier type as well as the Fermi surface. Superconductivity is observed at around 8.3 GPa without structural phase transition. A typical dome‐shape phase diagram is obtained with the maximum Tc of 5.6 K for ZrTe2. Furthermore, the theoretical calculations suggest the presence of multiple pressure‐induced topological quantum phase transitions, which coexists with emergence of superconductivity. The results demonstrate that ZrTe2 with nontrivial topology of electronic states displays new ground states upon compression.

Reversible data hiding (RDH) has been generally utilized in copyright protection and content integrity authentication for multimedia. In general, many typical RDH schemes are based on grayscale images. Considering that color images are widely employed in daily life, color image based RDH should be significantly concerned. Recently, color image based RDH is rare and those schemes are mostly empirically designed, which means that embedding capacity is manually allocated between different channels (such as RGB channels). In addition, most existing algorithms only focus on designing effective prediction methods to utilize the correlation in each channel, which means that the correlation between different channels is insufficiently employed and thus the algorithm performance is limited. Therefore, in this paper, the correlation between those different channels is sufficiently considered and an adaptive capacity allocation framework is proposed instead of empirical schemes. Moreover, the construction of a new synchronous histogram associated with the above-mentioned capacity allocation algorithm is proposed to further improve its performance. Experimental results demonstrate the superiority of the proposed scheme compared with other state-of-the-art ones.

Oxidative stress (OS) plays a pivotal role in the pathogenesis of spinal cord injury (SCI), yet its underlying mechanisms remain elusive. In this study, we explored the OS phenotype in a rat model of SCI. Subsequently, comprehensive bioinformatic analyses were conducted on microarray data pertaining to SCI (GSE45006). Notably, KEGG enrichment analysis revealed a pronounced enrichment of pivotal pathways, namely MAPK, FoxO, Apoptosis, NF-κB, TNF, HIF-1, and Chemokine across distinct phases of SCI. Furthermore, GO enrichment analysis highlighted the significance of biological processes including response to hypoxia, response to decrease oxygen levels, response to reactive oxygen species, cellular response to oxidative stress, reactive oxygen species metabolic process, and regulation of neuron death in the context of OS following SCI. Notably, our study underscores the prominence of nine genes, namely Itgb1, Itgam, Fn1, Icam1, Cd44, Cxcr4, Ptprc, Tlr4, and Tlr2 as OS key genes in SCI, consistently expressed in both the acute phase (1, 3, 7 days) and sub-acute phase (14 days). Subsequently, the relative mRNA expression of these key genes in different time points (1, 3, 7, 14 days) post-SCI. Finally, leveraging the DsigDB database, we predicted ten potential compounds potentially targeting OS and facilitating the repair of SCI, thus providing novel insights into the mechanisms underlying OS and identifying potential therapeutic targets for SCI.

Acquired aplastic anemia (AA) is a bone marrow failure (BMF) disease, characterized by fatty bone marrow (BM) and BM hypocellularity resulted from auto-immune dysregulated T cells-mediated destruction of BM haemopoietic stem cells (HPSC). The objective of this study was to investigate potential therapeutic effect of irisin, a molecule involved in adipose tissue transition, on AA mouse model. Our results showed that the concentration of irisin in serum was lower in AA patients than in healthy controls, suggesting a role of irisin in the pathogenesis of AA. In the AA mice, irisin administration prolonged the survival rate, prevented or attenuated peripheral pancytopenia, and preserved HPSC in the BM. Moreover, irisin also markedly reduced BM adipogenesis. In vitro results showed that irisin increased both cell proliferation and colony numbers of HPSC. Furthermore, our results demonstrated that irisin upregulated the expression of mitochondrial ATPase Inhibitory Factor 1 (IF1) in HPSC, inhibited the activation of mitochondrial fission protein (DRP1) and enhanced aerobic glycolysis. Taken together, our findings indicate novel roles of irisin in the pathogenesis of AA, and in the protection of HPSC through stimulation of proliferation and regulation of mitochondria function, which provides a proof-of-concept for the application of irisin in AA therapy.

Cardiovascular risk models developed may have limitations when applied to rural Chinese. This study validated and compared the Framingham Risk Score (FRS) and Prediction for Atherosclerotic Cardiovascular Disease Risk in China (PAR) models in predicting 10-year risk of coronary heart disease (CHD) in a rural cohort in Ningxia, China from 2008 to 2019. The FRS and PAR models were validated by estimating predicted events, C index, calibration χ2 and plots. 1381 adults without CHD at baseline were followed up for 9.75 years on average. 168 CHD cases were observed. The FRS and PAR underestimated CHD events by 22 % and 46 % for the total population, while overestimated for males by 152 % and 78 %, respectively. The C index was slightly higher for PAR than FRS. Both models showed weak calibration with chi-square values above 20 (p

The purpose of this work was to investigate the deterioration mechanism of an optimized Al2O3–MgO refractory castable during industrial trials. After structural optimization, the average corrosion rate of every cycle deceased to 0.29 mm/cycle from 0.46 mm/cycle. Corroded microstructure of the optimized Al2O3–MgAl2O4 refractory castable after server 195 cycles was explored. It was indicated that the structural optimization led to an approximate 36% improvement in corrosion resistance than that of comparison one. An adhered slag layer comprising of (Fe, Mg)Al2O4 spinel was observed on the refractory's surface. Iron beans and iron/manganese oxides mainly occurred in the reaction layer, and several penetrating cracks occurred at the corroded interface which would cause potential structural spalling for refractory lining. Based on the observed microstructural characteristics, a corrosion mechanism of refractory lining in a commercial ladle was proposed.

Introduction Atopic dermatitis (AD) exhibits difference in immune polarization between Caucasians and Asian races due to which an evaluation of the efficacy and safety of Pimecrolimus (PIM) in Asian population is called for. The current study addresses the need via a sub-group analysis of the PETITE study (NCT00120523) to evaluate the safety and efficacy of PIM in Chinese infants. Materials and methods Patients with AD (≥3 months–

AbstractObjective To compare the clinical efficacy of High intensity-focused ultrasound(HIFU) for different types of adenomyosis classified by magnetic resonance imaging (MRI).Methods A total of 227 patients with adenomyosis who underwent HIFU treatment in Suining Central Hospital from January 2014 to December 2019 were included. Based on the preoperative pelvic MRI examination and Kishi isometric classification method, the patients were divided into 4 types according to the location of lesions. There were 82 cases of type I (endogenous type), 75 cases of type II (exogenous type), 34 cases of type III (nodular type), and 36 cases of type IV (heterogeneous type). The results of HIFU treatment for four types of adenomyosis and intraoperative adverse effects were analyzed. The changes of lesion size, dysmenorrhea, and menstrual volume were analyzed at 3 and 6 months after the operation.Result (1) adverse effects: All patients successfully accepted HIFU treatment under sedation and analgesia. Grade A adverse effects occurred in 51 cases (22.47%) and grade B adverse effects in 3 cases (1.32%). The incidence of adverse effects in type I–IV patients was 21.95%, 22.66%, 23.53%, and 30.56%, respectively. There was no significant difference in the incidence of grade A and B adverse effects in all types, and no grade C–F adverse effects occurred. (2) Ablation effect: The ablation rate of type III(nodular type)patients was (74.7 ± 20.3) %, which was significantly higher than that of the other three types (p

Objectives This study aimed to analyse trends in the prevalence and economic burden of hypertension and its socioeconomic disparities in rural southwestern China.Design Two repeated cross-sectional studies were conducted to collect interview and health examination data among individuals aged ≥35 years in rural Yunnan Province, China.Setting Three rural areas of Yunnan, China.Participants We invited 8187 consenting participants in 2010–2011 and 7572 consenting participants in 2020–2021 to undergo interviews and health examinations.Results The standardised prevalence of hypertension significantly increased from 26.1% in 2011 to 40.4% in 2021 (p

Choriocarcinoma is an exceptionally aggressive trophoblastic cell tumor that that typically originates in gonadal tissues, with rare occurrences outside the gonads, including the mediastinum, retroperitoneum, and intracranial sites. However, it rarely occurs in the stomach. Herein, we presented a case of primary gastric choriocarcinoma in a 27-year-old female patient who found multiple liver masses detected during physical examination, accompanied by remarkably elevated human chorionic gonadotropin levels. The 18F-FDG PET/CT scan suggested ring-shaped intense uptake masses located in the gastric sinus and liver, and no significance in the pelvic region. Final histopathology indicated primary choriocarcinoma of the stomach. This case illustrates that 18F-FDG PET/CT is an essential imaging technique for the clinical diagnosis and stage of primary choriocarcinoma.

BackgroundBrain functional connectivity analysis of resting-state functional magnetic resonance imaging (fMRI) data is typically performed in a standardized template space assuming consistency of connections across subjects. Analysis methods can come in the form of one-edge-at-a-time analyses or dimension reduction/decomposition methods. Common to these approaches is an assumption that brain regions are functionally aligned across subjects; however, it is known that this functional alignment assumption is often violated.MethodsIn this paper, we use subject-level regression models to explain intra-subject variability in connectivity. Covariates can include factors such as geographic distance between two pairs of brain regions, whether the two regions are symmetrically opposite (homotopic), and whether the two regions are members of the same functional network. Additionally, a covariate for each brain region can be included, to account for the possibility that some regions have consistently higher or lower connectivity. This style of analysis allows us to characterize the fraction of variation explained by each type of covariate. Additionally, comparisons across subjects can then be made using the fitted connectivity regression models, offering a more parsimonious alternative to edge-at-a-time approaches.ResultsWe apply our approach to Human Connectome Project data on 268 regions of interest (ROIs), grouped into eight functional networks. We find that a high proportion of variation is explained by region covariates and network membership covariates, while geographic distance and homotopy have high relative importance after adjusting for the number of predictors. We also find that the degree of data repeatability using our connectivity regression model—which uses only partial location information about pairs of ROI's—is comparably as high as the repeatability obtained using full location information.DiscussionWhile our analysis uses data that have been transformed into a common template-space, we also envision the method being useful in multi-atlas registration settings, where subject data remains in its own geometry and templates are warped instead. These results suggest the tantalizing possibility that fMRI connectivity analysis can be performed in subject-space, using less aggressive registration, such as simple affine transformations, multi-atlas subject-space registration, or perhaps even no registration whatsoever.