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Abstract. Background:. The available evidence regarding the benefits of percutaneous coronary intervention (PCI) on patients receiving dialysis with coronary artery disease (CAD) is limited and inconsistent. This study aimed to evaluate the association between PCI and clinical outcomes as compared with medical therapy alone in patients undergoing dialysis with CAD in China. Methods:. This multicenter, retrospective study was conducted in 30 tertiary medical centers across 12 provinces in China from January 2015 to June 2021 to include patients on dialysis with CAD. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Secondary outcomes included all-cause death, the individual components of MACE, and Bleeding Academic Research Consortium criteria types 2, 3, or 5 bleeding. Multivariable Cox proportional hazard models were used to assess the association between PCI and outcomes. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were performed to account for potential between-group differences. Results:. Of the 1146 patients on dialysis with significant CAD, 821 (71.6%) underwent PCI. After a median follow-up of 23.0 months, PCI was associated with a 43.0% significantly lower risk for MACE (33.9% [n = 278] vs. 43.7% [n = 142]; adjusted hazards ratio 0.57, 95% confidence interval 0.45–0.71), along with a slightly increased risk for bleeding outcomes that did not reach statistical significance (11.1% vs. 8.3%; adjusted hazards ratio 1.31, 95% confidence interval, 0.82–2.11). Furthermore, PCI was associated with a significant reduction in all-cause and cardiovascular mortalities. Subgroup analysis did not modify the association of PCI with patient outcomes. These primary findings were consistent across IPTW, PSM, and competing risk analyses. Conclusion:. This study indicated that PCI in patients on dialysis with CAD was significantly associated with lower MACE and mortality when comparing with those with medical therapy alone, albeit with a slightly increased risk for bleeding events that did not reach statistical significance.

Spermatogonial cells are capable of transmitting genetic information to the next generation and have the potential for self-renewal. However, research on spermatogonial cells is generally limited by the paucity of cell surface markers, which are not universal among species. In this study, we developed a systematic screening strategy for germline regulatory pathways and spermatogonial surface markers in non-model organisms. This was achieved by combining weighted gene co-expression network analysis (WGCNA), differential expressed gene (DEG) overrepresentation analysis, and functional annotation. This strategy was employed to identify a spermatogonia-related module, which was found to be enriched with stem cell-related pathways in the scallop Patinopecten yessoensis. This module contained a transmembrane protein, fibroblast growth factor receptor (FGFR). A single copy of Fgfr (PyFgfr) was confirmed in the P. yessoensis genome, which exhibited the canonical functional domains of FGFRs. PyFgfr was universally expressed in multiple tissues, including the testis. The highest expression was observed at the resting stage of the testis, with exclusive localization in spermatogonia. To obtain antibodies that recognize the cell surface region, the extracellular domains of PyFGFR were used as an antigen to prepare antiserum. Western blotting, immunohistochemical, and immunofluorescent analyses demonstrated that the antiserum specifically detected PyFGFR in the spermatogonia. This study demonstrates the feasibility of this strategy for screening spermatogonial surface markers in the scallop. This approach will facilitate the culture and manipulation of spermatogonia in non-model organisms, which may contribute to genetic improvement in aquaculture.

Abstract Background Spermatogenesis is a complex process of cellular differentiation that commences with the division of spermatogonia stem cells, ultimately resulting in the production of functional spermatozoa. However, a substantial gap remains in our understanding of the molecular mechanisms and key driver genes that underpin this process, particularly in invertebrates. The dwarf surfclam (Mulinia lateralis) is considered an optimal bivalve model due to its relatively short generation time and ease of breeding in laboratory settings. Results In this study, over 4,600 testicular cells from various samples were employed to identify single-cell heterogeneity on a more comprehensive scale. The four germ cell populations (spermatogonia, primary spermatocytes, secondary spermatocytes, and round spermatids/spermatozoa) and three somatic populations (follicle cell, hemocyte, and nerve cell) were characterized. The four types of germ cells exhibited disparate cell cycle statuses and an uninterrupted developmental trajectory, progressing from spermatogonia to spermatids/spermatozoa. Pseudotime analysis indicates that gene expression, translation, ATP metabolic process, and microtubule-based process are involved in the transition of germ cell types. Weighted gene coexpression network analysis (WGCNA) identified four modules corresponding to the four types of germ cells, as well as key transcription factors (e.g., MYC, SREBF1, SOXH) that may play a critical role in these cell types. Furthermore, our findings revealed that there is extensive bidirectional communication between the somatic cells and the germline cells, including the FGF and TGF-β signaling pathways, as well as other ligand-receptor pairs, such as NTN1-NEO1 and PLG-PLGRKT. Conclusions This study provides a comprehensive single-cell transcriptome landscape of the gonad, which will contribute to the understanding of germ cell fate transition during spermatogenesis, and the development of germ cell manipulation technologies in mollusks.

Abstract Background Mild cognitive impairment (MCI) is prevalent in older adults with chronic pain, making early detection crucial for dementia prevention and healthy aging. This study aimed to determine MCI risk factors in older patients with chronic pain and to develop 9 machine learning models to identify MCI risk. Methods A total of 612 older patients with chronic pain were recruited between October 2023 and July 2024. Data collected included patients’ general information, cognitive function, pain level, depression, and sleep quality. The dataset was randomly divided into training set and testing set, and processed by Min-Max Normalization and SMOTETomek comprehensive sampling. SVM-RFE and LASSO regression were used for variable selection. We then developed machine learning models and interpreted them by SHAP. Results Age, education level, number of pain sites, pain duration, pain level, depression and sleep quality were risk factors of MCI in older patients with chronic pain. The Extreme Gradient Boosting (XGBoost) model performed best (AUC 0.925), with pain level, age, and depression as the most important variables. Conclusions We successfully developed 9 machine learning models to identify MCI risk. These models provide a tool for nurses to detect MCI risk early. We recommend that nurses integrate machine learning techniques into clinical nursing practice for managing MCI. However, these findings require validation with longitudinal data to confirm predictive validity for MCI progression.

Abstract Ethylene glycol, a widely used chemical, has a large global capacity exceeding 40 million tons per year. Nevertheless, its production is heavily reliant on fossil fuels, resulting in substantial CO2 emissions. Herein, we report an approach for electrochemically producing ethylene glycol from biomass glycerol. This process involves glycerol electrooxidation to glycolaldehyde at anode, which is subsequently electro-reduced to ethylene glycol at cathode. While the anode reaction has been reported, the cathode reaction remains a challenge. An electrodeposited electrode with metallic Cu catalyst enables us to achieve glycolaldehyde-to-ethylene glycol conversion with an exceptional faradaic efficiency of about 80%. Experimental and theoretical studies reveal that metallic Cu catalyst facilitates the C=O activation, promoting glycolaldehyde hydrogenation into ethylene glycol. We further assemble a zero-gap electrolyzer and demonstrate ethylene glycol electrosynthesis from glycerol to give a decent production rate of 1.32 mmol cm–2 h–1 under a 3.48 V cell voltage. The carbon intensity assessment based on a valid assumption reveals that our strategy may reduce CO2 emissions by over 80 million tons annually compared to conventional fossil fuel routes.

Abstract Background The high mortality rate of metastatic colorectal cancer (CRC) is primarily attributed to resistance to chemotherapy, where cancer stem cells (CSCs) play a crucial role. Deubiquitinating enzymes are essential regulators of CSC maintenance, making them potential targets for eliminating CSCs and overcoming chemotherapy resistance. This study aims to identify key deubiquitinating enzymes regulating CSCs and drug resistance of CRC. Methods RNA sequencing was performed to examine the mRNA expression of known deubiquitinating enzymes in CRC tissues from patients with alternate response to chemotherapy. Gain- and loss-of-function experiments were performed to evaluate the function of USP4 in regulation of stemness and drug sensitivity in CRC. High-throughput virtual screening and target management assays were conducted to identify small molecule inhibitor targeting USP4. Cell lines, organoids and animal models were used to evaluate the function of USP4 and its small molecule inhibitor in stemness and chemotherapy response. Results The expression of USP4 was significantly elevated in CRC samples from progressive disease (PD) or stable disease (SD) patients compared to partial response (PR) specimen. USP4 promoted stemness by stabilizing the β-catenin and Twist1 proteins in CRC cells. A natural small molecule product U4-I05 diminished the stem-like features of CSCs and enhanced their sensitivity to oxaliplatin and 5-fluorouracil by targeting inhibition of its deubiquitinating enzyme activity through binding the catalytic domain of USP4 (311 cysteine site) at nanomolar concentrations, triggering proteasome-mediated degradation of β-catenin and Twist1. Treatment with U4-I05 also inhibited tumor metastasis and extended survival in a genetically engineered CRC mouse model. Conclusions This study identifies U4-I05 as a USP4 inhibitor with significant therapeutic efficacy against CRC, offering a promising avenue for the development of new treatments targeting cancer stemness and chemotherapy resistance. Graphical abstract

Abstract Background PSMA PET/CT emerges as a pivotal technology in the diagnostic landscape of prostate cancer (PCa). It offers a suite of imaging interpretation criteria, notably the maximum standardized uptake value (SUVmax), the molecular imaging prostate-specific membrane antigen score (miPSMA score), and the PSMA reporting and data system (PSMA-RADS). Identifying the most valuable criteria for diagnosing PCa and standardizing imaging interpretation across various tracers is an unresolved question. Our study endeavors to pinpoint the most optimal criteria to enhance the precision of PCa diagnosis, encompassing clinically significant PCa (csPCa), by evaluating the consistency and diagnostic accuracy of these three criteria using two [18F]-labeled PSMA tracers. Method This retrospective analysis spans a five-year period, focusing on patients with clinically suspected or newly diagnosed, treatment-naïve PCa who underwent 18F-PSMA PET/CT. The study is bifurcated into two segments: 1.A direct comparison assessing the consistency in SUVmax, miPSMA scores, and PSMA-RADS among PSMA PET/CT tracers ([18F]DCFPyL and [18F]PSMA-1007) for prostate foci in 24 patients. 2. An analysis of the diagnostic accuracy of these three criteria for both PCa and csPCa across 55 [18F]DCFPyL and 65 [18F]PSMA-1007 PET/CT scans, respectively. Results 1.Our head-to-head study reveals that SUVmax and miPSMA score exhibit near-perfect consistency, with PSMA-RADS demonstrating substantial consistency. 2. The diagnostic accuracy ranking, considering both PCa and csPCa, stands as miPSMA score ≈ SUVmax > PSMA-RADS for [18F]DCFPyL PET/CT, contrasting with miPSMA score > SUVmax ≈ PSMA-RADS for [18F]PSMA-1007 PET/CT. Conclusion The miPSMA score outperforms SUVmax and PSMA-RADS in terms of inter-tracer consistency and diagnostic accuracy for the detection of PCa, including csPCa, when comparing [18F]DCFPyL and [18F]PSMA-1007 PET/CT scans. This underscores the miPSMA score’s potential as a robust criterion for PCa and csPCa diagnosis, holding substantial promise for refining clinical decision-making and patient management strategies. Clinical trial number not applicable.

Abstract Background Many studies have shown that using new technologies and medical equipment contributes to increasing health expenditure. Relatively less empirical studies have measured the impact of medical equipment on rising medical costs in China. Against this backdrop, we aim to examine whether the large-scale medical equipment deployment explains the increase in health expenditure. Methods Quasi-experimental research design with a difference-in-differences approach was adopted to explore whether an increase in the number of large-scale medical equipment impacts on outpatient and inpatient costs. Data were obtained from the 2011–2017 Health Financial Annals in Shaanxi province, China. Results The increase in the number of large-scale medical equipment by 1 — regardless of the initial configuration — resulted in the increase of the average cost per outpatient visit and the average cost per inpatient visit by 10.6% (p

Abstract The Eurasian avian-like (EA) H1N1 swine influenza virus (SIV) possesses the capacity to instigate the next influenza pandemic, owing to its heightened affinity for the human-type α-2,6 sialic acid (SA) receptor. Nevertheless, the molecular mechanisms underlying the switch in receptor binding preferences of EA H1N1 SIV remain elusive. In this study, we conduct a comprehensive genome-wide CRISPR/Cas9 knockout screen utilizing EA H1N1 SIV in porcine kidney cells. Knocking out the enzyme gamma glutamyl carboxylase (GGCX) reduces virus replication in vitro and in vivo by inhibiting the carboxylation modification of viral haemagglutinin (HA) and the adhesion of progeny viruses, ultimately impeding the replication of EA H1N1 SIV. Furthermore, GGCX is revealed to be the determinant of the D225E substitution of EA H1N1 SIV, and GGCX-medicated carboxylation modification of HA 225E contributes to the receptor binding adaption of EA H1N1 SIV to the α-2,6 SA receptor. Taken together, our CRISPR screen has elucidated a novel function of GGCX in the support of EA H1N1 SIV adaption for binding to α-2,6 SA receptor. Consequently, GGCX emerges as a prospective antiviral target against the infection and transmission of EA H1N1 SIV.

Abstract Boasting superior flexibility in beam manipulation and a simpler framework than traditional phased arrays, terahertz metasurface-based phased arrays show great promise for 5G-A/6G communication networks. Compared with the reflective reconfigurable intelligent surface (reflective RIS), the transmissive RIS (TRIS) offers more feasibility for transceiver multiplexing systems to meet the growing demand for high-performance beam tracking in terahertz communication and radar systems. However, the terahertz TRIS encounters greater challenges in phase shift, beam efficiency, and complex circuitry. Here, we propose a sub-terahertz TRIS based on the phase shift via Pancharatnam-Berry (PB) metasurface and self-on-off keying (OOK) modulation via Schottky diodes. The electrically reconfigurable unit cell consists of a column-wise phase resonator and a rectangular slot. An experimental retrieved equivalent lumped-element circuit model is implemented in joint field-circuit simulations and is validated by experiments. A fabricated prototype demonstrates excellent performance of TRIS with the minimum insertion loss of 2.8 dB for operational states, large bandwidth nearly covering the entire W-band for 1-bit phase shift, deep OOK amplitude modulation of 12 dB, and wide scanning range of ±60° with low specular transmission. We further implement an integrated platform combining high-speed beam steering and spatial-light modulation, verifying the point-to-point signal transmissions in different directions using the TRIS platform. The proposed TRIS with high-performance and cost-effective fabrication makes it a promising solution to terahertz minimalist communication systems, radar, and satellite communication systems.

The objective of this study was to investigate the feasibility of partially replacing NaCl with salty pig bone peptides (SPBP) in the production of low-NaCl sausages (LNS). The impact of varying proportions of SPBP replacing NaCl on sensory attributes, texture characteristics, color variation, pH, yield, moisture content, taste, and volatile profile was examined. The findings indicated that sausages supplemented with 1% NaCl+1% SPBP (1% LNS-SPBP) outperformed the control (supplemented with 2% NaCl) in terms of color, appearance, taste and flavor, while tissue structure was comparable to that of the control group. Additionally, 1% LNS-SPBP significantly enhanced the textural properties of LNS (P

In turbid water environments, conventional polari-metric imaging descattering methods usually rely on selecting a non-target background region as a substitute for global back-ground light information, leading to image clarity. By integrating polarization imaging with the dark channel prior (DCP) and fully utilizing the polarization information from the Stokes vector and the DCP, the interference of the target information in calculating the background information can be effectively eliminated. This method also enables accurate estimation of the global distribution for the degree of polarization (DoP) and the angle of polarization (AoP) of the backscattered light and eliminates the need for the complex process of background region selection. Experimental results with varying turbid water concentrations demonstrate the proposed method's effectiveness for target recovery in both underwater images with and without background regions. Compared with the conventional active polarization imaging model, our method improves image contrast by 47% in the strongly scattering environment.

Abstract Background The integration of traditional Chinese medicine (TCM) into emergency health systems in China serves as a model for global policy development and refining the inclusion of traditional medicine in health emergencies. Methods This study investigated 13 public health emergency policies related to TCM released by the Chinese central government from 2003–2023. A PMC(Policy Modeling Consistency) index model was developed combining ROSTCM text mining analysis software. The contents of these policy documents were quantitatively assessed using 10 first- and 40 s-level indicators. Results The content analysis results showed that current policies focus on emergency treatment, and that the State Administration of Traditional Chinese Medicine is the issuing authority of the main policies, most of which are issued in the form of a notice. The scoring results for the 13 policies showed that two, five, three, and three policies were rated as excellent, good, qualified, and unqualified, respectively. This indicates that the policy quality related to TCM use in emergency response was normally distributed and generally qualified, although room for further improvement exists; policies should follow the principles of science, reasonableness, and operability, and should be updated in a timely manner with continuous development of the governance period while focusing on the policy content, safeguards, and role measures. Conclusion Effective integration of traditional medicine into health emergency policies backed by state institutions is vital. This includes enforcing relevant laws and regulations, establishing multidisciplinary medical teams, and developing integrated medicine strategies that support clinical research and maximize the unique benefits of traditional medicine.

Abstract Background Internal migrants in China have long been at a disadvantage in terms of access to publicly financed services, as well as the utilization of public health services. The aim of the study was to examine inequities in the use of basic public health services between internal migrants and the local population and estimate the factors that contributed to inequity in use. Methods The data for this study was derived from the 2017 wave of the China Migrants Dynamic Survey. Basic public health services utilization was measured by the establishment of health records, health education and chronic disease management. We performed multivariable logistic regressions to examine inequities in the utilization of basic public health services between locals and internal migrants, and Oaxaca-Blinder decomposition was used to explore possible explanations for such inequities between the two groups. Results A total of 27,998 cases were included in the analysis. We found that the utilization rates for establishment of health records, health education and chronic disease management among internal migrants were 71.3%, 49.2% and 65.7% lower than their local counterparts, respectively. The decomposition results indicated that the inequities in the establishment of health records between locals and internal migrants were mainly explained by whether people had heard of the National Basic Public Health Services Program (NBPHSP) (17.67%) and by health insurance (5.99%). The contributors to the inequities in health education between locals and internal migrants were community involvement (14.71%) and whether people had heard of the NBPHSP (13.89%). The main factors contributing to the difference in utilization of chronic disease management between the two groups were whether people had heard of the NBPHSP (14.49%) and community involvement (8.43%). Conclusions To reduce inequities in the utilization of basic public health services between locals and internal migrants, measures need to be taken to improve knowledge about the basic public health services and to help migrants integrate into the local community.

Abstract Introduction This study protocol specifies the primary research line and theoretical framework of the 2023 Survey of the Psychology and Behavior of the Chinese Population. It aims to establish a consistent database of Chinese residents' psychological and behavioral surveys through multi‐center and large‐sample cross‐sectional surveys to provide robust data support for developing research in related fields. It will track the public's physical and psychological health more comprehensively and systematically. Methods The study was conducted from June 20, 2023 to August 31, 2023, using stratified and quota sampling methods. A total of 150 cities across 800 communities/villages were surveyed, selected from China (Despite extensive coordination, we have been unable to contact our counterparts in the Taiwan region of China to obtain relevant statistical data). The questionnaires were distributed to the public one‐on‐one and face‐to‐face by trained surveyors. The questionnaires included basic information about the individual, personal health status, basic information about the family, the social environment in which the individual lives, psychological condition scales, behavioral level scales, other scales, and attitudes towards topical social issues. Supervisors conducted quality control during the distribution process and returned questionnaires, logically checked and cleaned for data analysis. Discussion Data collection has been finished, and scientific outputs based on this data will support the development of health promotion strategies in China and globally. In the aftermath of the pandemic, it will guide policymakers and healthcare organizations to improve their existing policies and services to maximize the physical and mental health of the Chinese population. Trial Registration This study was filed in the National Health Security Information Platform (Record No.: MR‐37‐23‐017876) and officially registered in the China Clinical Trials Registry (Registration No.: ChiCTR2300072573).

ObjectiveTo explore the correlation between the nutritional and immunity score (NIS) based on prealbumin and T lymphocyte count and the prognosis of critically ill patients. MethodsA retrospective study was conducted involving patients from the intensive care unit of the First Affiliated Hospital of Zhengzhou University from September 2020 to August 2021. Patients’ basic information, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores within 24 hours of admission, and relevant biochemical indicators were collected. The primary endpoint was all-cause mortality within 28 days. The optimal cut-off values for prealbumin and T lymphocyte count related to mortality risk were determined using X-tile software. Patients were stratified according to these cut-off values and normal reference ranges, and the NIS was calculated. Univariate and multivariate Cox regression analyses were conducted to evaluate the relationship between NIS and mortality. ResultsThe optimal cut-off value for prealbumin was 110 mg/L, and for T lymphocyte count, it was 455/μL, with NIS scores ranging from 0 to 4. After adjusting for confounding factors, patients with NIS scores of 2 (HR＝1.87, 95%CI 1.19-2.94, P＝0.023), 3 (HR＝2.04, 95%CI 1.20-3.19, P＝0.007), and 4 (HR＝1.68, 95%CI 1.24-3.96, P＝0.005) showed a significantly increased risk of mortality. ConclusionsNIS≥2 is associated with an increased risk of death in critically ill patients. NIS can serve as an effective tool for early risk stratification and prognostic assessment in critically ill patients.