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Direct seawater electrolysis is a promising technology within the carbon-neutral energy framework, leveraging renewable resources such as solar, tidal, and wind energy to generate hydrogen and oxygen without competing with the demand for pure water. High-selectivity, high-efficiency, and corrosion-resistant multifunctional electrocatalysts are essential for practical applications, yet producing stable and efficient catalysts under harsh conditions remains a significant challenge. This review systematically summarizes recent advancements in advanced electrocatalysts for seawater splitting, focusing on their multifunctional designs for selectivity and chlorine corrosion resistance. We analyze the fundamental principles and mechanisms of seawater electrocatalytic reactions, discuss the challenges, and provide a detailed overview of the progress in nanostructures, alloys, multi-metallic systems, atomic dispersion, interface engineering, and functional modifications. Continuous research and innovation aim to develop efficient, eco-friendly seawater electrolysis systems, promoting hydrogen energy application, addressing efficiency and stability challenges, reducing costs, and achieving commercial viability.

The corrosion behaviors of three bridge steels in a real tropical marine environment for 2 years were studied. One weathering steel (WS) was designed with higher levels of nickel, copper, and molybdenum compared to the other. These two kinds of WSs and one kind of ordinary high-strength low-alloy steel (Q345qe) were compared under two conditions (marine atmospheric zone and marine immersion zone at Sanya Marine Environmental Test Station). The morphology, corrosion rate, and corrosion product analysis of the steels were performed through SEM, XPS, FTIR and other characterization methods. The results demonstrated that weathering steels facilitate the densification of the corrosion product layer due to the addition of alloying elements Cr, Ni, and Cu, promoting rust nucleation and enhancing the compactness of the protective layer. However, in an immersion environment, the extensive erosion by chloride ions renders the benefits of WS ineffective.

The corrosion behaviors of two bridge steels (Q345q and Q500q) under simulated ultraviolet irradiation and a wet–dry alternating (UVWD) environment were studied. Weight loss measurement, stereomicroscope observation, SEM, XRD, and electrochemical impedance spectroscopy (EIS) were performed to investigate the influence of the coupled environment. The results revealed that the corrosion rates of Q345q and Q500q were significantly accelerated by the synergistic effect of UV light exposure and alternating wet–dry conditions. Numerous voids and cracks could be observed throughout the thickened rust layers, enabling the corrosive substances to easily penetrate through the rust layer. Q500q exhibited better corrosion resistance than Q345q due to the addition of Mo, Cr, and Ni as corrosion-resistant elements, which tended to transform the rust layer into α-FeOOH rather than γ-FeOOH during later stages of corrosion.

Inland waterway transport is considered a critical component of sustainable maritime transportation and is subject to strict legal regulations on fuel quality. However, crew members often prefer cheaper, inferior fuels for economic reasons, making government inspections crucial. To address this issue, we formulate the ship selection and inspection scheduling problem into an integer programming model under a multi-inspector and multi-location scenario, alongside a more compact symmetry-eliminated model. The two models are developed based on ship itinerary information and inspection resources, aiming to maximize the total weight of the inspected ships. Driven by the unique property of the problem, a customized heuristic algorithm is also designed to solve the problem. Numerical experiments are conducted using the ships sailing on the Yangtze River as a case study. The results show that, from the perspective of the computation time, the compact model is 102.07 times faster than the original model. Compared with the optimal objectives value, the gap of the solution provided by our heuristic algorithm is 0.37% on average. Meanwhile, our algorithm is 877.19 times faster than the original model, demonstrating the outstanding performance of the proposed algorithm in solving efficiency.

Vitamin D, a crucial fat-soluble vitamin, is primarily synthesized in the skin upon exposure to ultraviolet radiation and is widely recognized as a bone-associated hormone. However, recent scientific advancements have unveiled its intricate association with gut health. The intestinal barrier serves as a vital component, safeguarding the intestinal milieu and maintaining overall homeostasis. Deficiencies in vitamin D have been implicated in altering the gut microbiome composition, compromising the integrity of the intestinal mucosal barrier, and predisposing individuals to various intestinal pathologies. Vitamin D exerts its regulatory function by binding to vitamin D receptors (VDR) present in immune cells, thereby modulating the production of pro-inflammatory cytokines and influencing the intestinal barrier function. Notably, numerous studies have reported lower serum vitamin D levels among patients suffering from intestinal diseases, including inflammatory bowel disease, irritable bowel syndrome, and celiac disease, highlighting the growing significance of vitamin D in gut health maintenance. This comprehensive review delves into the latest advancements in understanding the mechanistic role of vitamin D in modulating the gut microbiome and intestinal barrier function, emphasizing its pivotal role in immune regulation. Furthermore, we consolidate and present relevant findings pertaining to the therapeutic potential of vitamin D in the management of intestinal diseases.

Deep learning-based sheep face recognition improves the efficiency and effectiveness of individual sheep recognition and provides technical support for the development of intelligent livestock farming. However, frequent changes within the flock and variations in facial features in different views significantly affect the practical application of sheep face recognition. In this study, we proposed the Li-SheepFaceNet, a method for open-set sheep face recognition in multi-view. Specifically, we employed the Seesaw block to construct a lightweight model called SheepFaceNet, which significantly improves both performance and efficiency. To enhance the convergence and performance of low-dimensional embedded feature learning, we used Li-ArcFace as the loss function. The Li-SheepFaceNet achieves an open-set recognition accuracy of 96.13% on a self-built dataset containing 3801 multi-view face images of 212 Ujumqin sheep, which surpasses other open-set sheep face recognition methods. To evaluate the robustness and generalization of our approach, we conducted performance testing on a publicly available dataset, achieving a recognition accuracy of 93.33%. Deploying Li-SheepFaceNet on an open-set sheep face recognition system enables the rapid and accurate identification of individual sheep, thereby accelerating the development of intelligent sheep farming.

Acute cardiovascular events result from clots caused by the rupture and erosion of atherosclerotic plaques. This paper aimed to produce a functional biomimetic hydrogel of the neointimal layer of the atherosclerotic plaque that can support thrombogenesis upon exposure to human blood. A biomimetic hydrogel of the neointima was produced by culturing THP-1-derived foam cells within 3D collagen hydrogels in the presence or absence of atorvastatin. Prothrombin time and platelet aggregation onset were measured after exposure of the neointimal models to platelet-poor plasma and washed platelet suspensions prepared from blood of healthy, medication-free volunteers. Activity of the extrinsic coagulation pathway was measured using the fluorogenic substrate SN-17. Foam cell formation was observed following preincubation of the neointimal biomimetic hydrogels with oxidized LDL, and this was inhibited by pretreatment with atorvastatin. The neointimal biomimetic hydrogel was able to trigger platelet aggregation and blood coagulation upon exposure to human blood products. Atorvastatin pretreatment of the neointimal biomimetic layer significantly reduced its pro-aggregatory and pro-coagulant properties. In the future, this 3D neointimal biomimetic hydrogel can be incorporated as an additional layer within our current thrombus-on-a-chip model to permit the study of atherosclerosis development and the screening of anti-thrombotic drugs as an alternative to current animal models.

The aryl hydrocarbon receptor (AhR) is a transcription factor that regulates the immune system through complicated transcriptional programs. Genistein, an AhR ligand, exhibits anti-inflammatory properties. However, its role in modulating immune responses via the AhR signaling pathway remains unclear. In this study, 360 male Arbor Acre broilers (1-day-old) were fed a basal diet supplemented with 40 or 80 mg/kg genistein and infected with or without Clostridium perfringens (Cp). Our results demonstrated that genistein ameliorated Cp-induced intestinal damage, as reflected by the reduced intestinal lesion scores and improved intestinal morphology and feed-to-gain ratio. Moreover, genistein increased intestinal sIgA, TGF-β, and IL-10, along with elevated serum IgG, IgA, and lysozyme levels. Genistein improved intestinal AhR and cytochrome P450 family 1 subfamily A member 1 (CYP1A1) protein levels and AhR+ cell numbers in Cp-challenged broilers. The increased number of AhR+CD163+ cells in the jejunum suggested a potential association between genistein-induced AhR activation and anti-inflammatory effects mediated through M2 macrophage polarization. In IL-4-treated RAW264.7 cells, genistein increased the levels of AhR, CYP1A1, CD163, and arginase (Arg)-1 proteins, as well as IL-10 mRNA levels. This increase was attenuated by the AhR antagonist CH223191. In summary, genistein activated the AhR signaling pathway in M2 macrophages, which enhanced the secretion of anti-inflammatory cytokines and attenuated intestinal damage in Cp-infected broilers Cp.

Due to the advantages of coastal areas in the fields of agriculture, transport, and fishing, increasingly more people are moving to these areas. Sea level information is important for these people to survive after extreme sea level events. With the recent improvements in computing and storage capacities, image analysis as a new measuring method is being rapidly developed and widely applied. In this paper, a multi-camera-based sea level height measuring system was built along Japan’s coast and a deep-learning-based stereo matching method has been proposed for this system to complete 3D measurements. In this system, cameras are set with long base distances to ensure the long-distance monitoring system’s precision, which causes a huge difference between the fields of view of the left and right cameras. Since most common network structures complete stereo matching by depth-wise cross-correlation between left and right images, they rely too much on the high-quality rectification of two images and fail on our long-distance sea surface images. We established a feature detection and matching network to realize sea wave extraction and sparse stereo matching for the system. Based on our previous result using the traditional method, the initial disparity was computed to reduce the search range of stereo matching. A training set with 785 pairs of sea surface images and 10,172 pairs of well-matched sea wave images was constructed to supervise the network. The experimental results verified that the proposed method can realize sea wave extraction and mask generation. It can also realize sparse matching of sea surface images regardless of poor rectification.

The spatial shifts and vulnerability assessments of ecological niches for trees will offer fresh perspectives for sustainable development and preservation of forests, particularly within the framework of rapid climate change. Betula luminifera is a fast-growing native timber plantation species in China, but the natural resources have been severely damaged. Here, a comprehensive habitat suitability model (including ten niche-based GIS modeling algorithms) was developed that integrates three types of environmental factors, namely, climatic, soil, and ultraviolet variables, to assess the species contemporary and future distribution of suitable habitats across China. Our results suggest that the habitats of B. luminifera generally occur in subtropical areas (about 1.52 × 106 km2). However, the growth of B. luminifera is profoundly shaped by the nuances of its local environment, the most reasonable niche spaces are only 1.15 × 106 km2 when limiting ecological factors (soil and ultraviolet) are considered, generally considered as the core production region. Furthermore, it is anticipated that species-suitable habitats will decrease by 10 and 8% with climate change in the 2050s and 2070s, respectively. Our study provided a clear understanding of species-suitable habitat distribution and identified the reasons why other niche spaces are unsuitable in the future, which can warn against artificial cultivation and conservation planning.

Quick response and high sensitivity are equally important for the practical application of gas sensors. In this study, we introduced polyoxometalates (POMs) into a classical ternary metal oxide CuBi2O4 for the first time by convenient electrospinning and prepared a group of heater-type gas sensors by using CuBi2O4/PW12 composite nanofibers. The sensor performances to formaldehyde gas were explored. The results proved that the gas-sensing response of the CuBi2O4/PW12 (PW12 = H3PW12O40·xH2O) composite sensor to 100 ppm formaldehyde gas was increased to 6.68, which was 3.92 times greater than the sensing capacity of the pure CuBi2O4 sensor. Simultaneously, the sensor exhibited a highly rapid response/recovery time of only 1/2 s, which is significantly faster than performances of CuBi2O4 gas sensors reported in the past literature. The cause of the improvement of the sensing performance was assessed via mechanism study, and it was found that the introduction of PW12 into the sensor contributed to its enhanced performance. It was found that PW12, as an electron acceptor, increased carrier mobility and reduced electron–hole recombination, thus contributing to enhanced gas-sensing properties. Moreover, other gas-sensing parameters such as selectivity, humidity resistance, repeatability, long-term stability were investigated. Hence, this study contributed to the literature on the development of polyoxometalates-based gas sensors.

After implantation, complex and highly specialized molecular events render functionally distinct organ formation, whereas how the epigenome shapes organ-specific development remains to be fully elucidated. Here, nano-hmC-Seal, RNA bisulfite sequencing (RNA-BisSeq), and RNA sequencing (RNA-Seq) were performed, and the first multilayer landscapes of DNA 5-hydroxymethylcytosine (5hmC) and RNA 5-methylcytosine (m5C) epigenomes were obtained in the heart, kidney, liver, and lung of the human foetuses at 13–28 weeks with 123 samples in total. We identified 70,091 and 503 organ- and stage-specific differentially hydroxymethylated regions (DhMRs) and m5C-modified mRNAs, respectively. The key transcription factors (TFs), T-box transcription factor 20 (TBX20), paired box 8 (PAX8), krueppel-like factor 1 (KLF1), transcription factor 21 (TCF21), and CCAAT enhancer binding protein beta (CEBPB), specifically contribute to the formation of distinct organs at different stages. Additionally, 5hmC-enriched Alu elements may participate in the regulation of expression of TF-targeted genes. Our integrated studies reveal a putative essential link between DNA modification and RNA methylation, and illustrate the epigenetic maps during human foetal organogenesis, which provide a foundation for for an in-depth understanding of the epigenetic mechanisms underlying early development and birth defects.

The unicellular green alga Chlamydomonas reinhardtii (hereafter Chlamydomonas) possesses both plant and animal attributes, and it is an ideal model organism for studying fundamental processes such as photosynthesis, sexual reproduction, and life cycle. N6-methyladenosine (m6A) is the most prevalent mRNA modification, and it plays important roles during sexual reproduction in animals and plants. However, the pattern and function of m6A modification during the sexual reproduction of Chlamydomonas remain unknown. Here, we performed transcriptome and methylated RNA immunoprecipitation sequencing (MeRIP-seq) analyses on six samples from different stages during sexual reproduction of the Chlamydomonas life cycle. The results show that m6A modification frequently occurs at the main motif of DRAC (D = G/A/U, R = A/G) in Chlamydomonas mRNAs. Moreover, m6A peaks in Chlamydomonas mRNAs are mainly enriched in the 3′ untranslated regions (3′UTRs) and negatively correlated with the abundance of transcripts at each stage. In particular, there is a significant negative correlation between the expression levels and the m6A levels of genes involved in the microtubule-associated pathway, indicating that m6A modification influences the sexual reproduction and the life cycle of Chlamydomonas by regulating microtubule-based movement. In summary, our findings are the first to demonstrate the distribution and the functions of m6A modification in Chlamydomonas mRNAs and provide new evolutionary insights into m6A modification in the process of sexual reproduction in other plant organisms.

Abstract Background The accumulation of α-synuclein (α-syn), an essential step in PD development and progression, is observed not only in neurons but also in glia, including astrocytes. The mechanisms regulating astrocytic α-syn level and aggregation remain unclear. More recently, it has been demonstrated that a part of α-syn spreading occurs through extracellular vesicles (EVs), although it is unknown whether this process is involved in astrocytes of PD. It is known, however, that EVs derived from the central nervous system exist in the blood and are extensively explored as biomarkers for PD and other neurodegenerative disorders. Methods Primary astrocytes were transfected with A53T α-syn plasmid or exposed to α-syn aggregates. The level of astrocyte-derived EVs (AEVs) was assessed by nanoparticle tracking analysis and immunofluorescence. The lysosomal function was evaluated by Cathepsin assays, immunofluorescence for levels of Lamp1 and Lamp2, and LysoTracker Red staining. The Apogee assays were optimized to measure the GLT-1+ AEVs in clinical cohorts of 106 PD, 47 multiple system atrophy (MSA), and 103 healthy control (HC) to test the potential of plasma AEVs as a biomarker to differentiate PD from other forms of parkinsonism. Results The number of AEVs significantly increased in primary astrocytes with α-syn deposition. The mechanism of increased AEVs was partially attributed to lysosomal dysfunction. The number of α-syn-carrying AEVs was significantly higher in patients with PD than in HC and MSA. The integrative model combining AEVs with total and aggregated α-syn exhibited efficient diagnostic power in differentiating PD from HC with an AUC of 0.915, and from MSA with an AUC of 0.877. Conclusions Pathological α-syn deposition could increase the astrocytic secretion of EVs, possibly through α-syn-induced lysosomal dysfunction. The α-syn-containing AEVs in the peripheral blood may be an effective biomarker for clinical diagnosis or differential diagnosis of PD.

Abstract Background Changes in vascular function are closely associated with the development of cardiovascular disease (CVD). Pulse wave velocity (PWV) is a potential indicator of vascular dysfunction; it allows noninvasive assessment of arterial stiffness. Currently, evidence for the effects of different classes of antidiabetic drugs on arterial stiffness remains limited. In this study, a network meta‐analysis (NMA) was performed to explore the associations between changes in arterial stiffness and first‐line antidiabetic drugs by evaluating PWV in patients with different metabolic abnormalities. Methods We systematically searched several electronic databases for randomized controlled trials (RCTs) published from inception until 25 August 2022, without language restrictions. The primary outcome was the change in PWV (ΔPWV) in all included studies; subgroup analysis was performed for patients with abnormal glucose metabolism, including prediabetes and diabetes mellitus. NMA was performed to calculate the mean differences (MDs) with 95% confidence intervals (CIs) as effect sizes to evaluate the ΔPWV. Results Among the 2257 candidate articles identified in the initial search, 18 RCTs were eventually included in the analysis. In all studies, two classes of new antidiabetic drugs, glucagon‐like peptide‐1 receptor (GLP‐1R) agonists and sSodium‐glucose co‐transporter 2 (SGLT‐2) inhibitors, improved arterial stiffness by decreasing PWV compared with placebo (MD = −1.11, 95% CI: −1.94 to 0.28) and (MD = −0.76, 95% CI: −1.45 to −0.08). A conventional antidiabetic drug, metformin, also showed similar efficacy compared with placebo (MD = −0.73, 95% CI: −1.33 to −0.12). Finally, in subgroup studies of patients with abnormal glucose metabolism diseases, GLP‐1R agonists (MD = −1.06, 95% CI: −2.05 to −0.10) significantly decreased PWV compared with placebo. Conclusion Three classes of antidiabetic drugs—GLP‐1R agonists, SGLT‐2 inhibitors, and metformin—have the potential to improve arterial stiffness. Among the six classes of antidiabetic drugs analyzed, GLP‐1R agonists constitute the only class of drugs that improves arterial stiffness in patients with abnormal glucose metabolism diseases.

Abstract Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder with high morbidity and mortality. The current study aims to explore the role of Cullin-associated and neddylation-dissociated protein 1 (CAND1) in the development of NAFLD and the underlying mechanisms. CAND1 is reduced in the liver of NAFLD male patients and high fat diet (HFD)-fed male mice. CAND1 alleviates palmitate (PA) induced lipid accumulation in vitro. Hepatocyte-specific knockout of CAND1 exacerbates HFD-induced liver injury in HFD-fed male mice, while hepatocyte-specific knockin of CAND1 ameliorates these pathological changes. Mechanistically, deficiency of CAND1 enhances the assembly of Cullin1, F-box only protein 42 (FBXO42) and acetyl-CoA acyltransferase 2 (ACAA2) complexes, and thus promotes the ubiquitinated degradation of ACAA2. ACAA2 overexpression abolishes the exacerbated effects of CAND1 deficiency on NAFLD. Additionally, androgen receptor binds to the −187 to −2000 promoter region of CAND1. Collectively, CAND1 mitigates NAFLD by inhibiting Cullin1/FBXO42 mediated ACAA2 degradation.

Cui and Zhong (2019), (Computational Statistics & Data Analysis, 139, 117–133) proposed a test based on the mean variance (MV) index to test independence between a categorical random variable Y with R categories and a continuous random variable X. They ingeniously proved the asymptotic normality of the MV test statistic when R diverges to infinity, which brings many merits to the MV test, including making it more convenient for independence testing when R is large. This paper considers a new test called the integral Pearson chi-square (IPC) test, whose test statistic can be viewed as a modified MV test statistic. A central limit theorem of the martingale difference is used to show that the asymptotic null distribution of the standardized IPC test statistic when R is diverging is also a normal distribution, rendering the IPC test sharing many merits with the MV test. As an application of such a theoretical finding, the IPC test is extended to test independence between continuous random variables. The finite sample performance of the proposed test is assessed by Monte Carlo simulations, and a real data example is presented for illustration.

Abstract Background Headache disorders are major contributors to disability in adolescents and young adults worldwide. We aimed to analyze global trends in the burden of migraine and tension-type headache in 10 to 24-year-olds from 1990 to 2019. Methods Data were obtained from the Global Burden of Disease Study (GBD) 2019 to examine trends in incidence, prevalence, and disability-adjusted life years (DALYs) for migraine and tension-type headache in adolescents and young adults by location, age, sex and sociodemographic index (SDI). Joinpoint regression analyzed trends and identified years of significant change. Results Globally, migraine and tension-type headache incidence, prevalence, and DALYs increased from 1990 to 2019, though with some fluctuations. The highest growth in migraine incidence occurred in males and individuals aged 10-14, while for tension-type headache incidence, it was observed in males and individuals aged 20-24. Prevalence and DALYs were highest for both disorders in females and those aged 20–24 years. Incidence increased fastest in East Asia for migraine and tension-type headache. For migraine, Tropical Latin America had the fastest increase in prevalence and DALYs. East Asia had the fastest increase in prevalence of tension-type headache, while North Africa and the Middle East had the highest growth in DALYs. Some high-income countries such as Singapore, Norway, and Iran (Islamic Republic of) demonstrated fast increases, while a few countries including Qatar, Thailand and Ethiopia decreased. Conclusions The incidence, prevalence and disability from migraine and tension-type headache are rising in adolescents and young adults, especially in males, older youth and middle SDI populations. The increasing trends highlight the need for targeted interventions focused on prevention and control in priority populations. Continued monitoring of trends can help identify strategies to promote headache health and reduce the life-course impacts of headache disorders globally.

Abstract Background DNA methyltransferase 3A (DNMT3A) is frequently mutated in acute myeloid leukemia (AML) with Arg882His (R882H) as the hotspot mutation. It has been reported that DNMT3A mutation plays a key role in leukemogenesis through hypomethylation of some target genes associated with cell growth and differentiation. In this study, we investigated the function of DNMT3A R882H in the malignant progression of AML by regulating metabolic reprogramming. Methods Ultra-High Performance Liquid Chromatography–High Resolution Tandem Mass Spectrometry (UHPLC-HRMS/MS) was used to detect metabolites in the serum of mice harboring Dnmt3a R878H mutation and the wild-type Dnmt3a. Methylated DNA Immunoprecipitation Sequencing (MeDIP-seq) and RNA sequencing (RNA-seq) were used to analyze the levels of DNA methylation and mRNA expression of genes in mouse Gr1+ bone marrow cells respectively. The TCGA and GO databases were used to analyze the differential genes between human samples carrying the DNMT3A R882 mutation and the wild-type DNMT3A. Co-immunoprecipitation and immunoblotting were used to illustrate the binding levels of Cyclins-CDKs and CDK inhibitors including CDKN1A and CDKN1B. Flow cytometry was used to analyze the cell differentiation, division, apoptosis and cell cycle. The effect of NAMPT inhibition on leukemia was evaluated by using in vivo fluorescence imaging in NOG mouse model bearing OCI-AML3 cells. Results DNMT3A mutation caused high expression of nicotinamide phosphoribosyltransferase (NAMPT), a key enzyme in the nicotinamide adenine dinucleotide (NAD) salvage synthetic pathway, through DNA hypomethylation, and finally led to abnormal nicotinamide (NAM) metabolism and NAD synthesis. The NAM-NAD metabolic abnormalities caused accelerated cell cycle progression. Inhibition of NAMPT can reduce the binding degree between Cyclins-CDKs, and increase the binding interaction of the CDK inhibitors with Cyclins-CDKs complexes. Moreover, cells with high expression of NAMPT were more sensitive to the NAMPT inhibitor FK866 with a lower IC50. The inhibition of NAMPT can remarkably extend the survival time of tumor-bearing mice and reduce the infiltration of tumor cells. Conclusions Taken together, our data showed that DNMT3A mutation caused NAMPT overexpression to induce the reprogramming of NAM-NAD metabolism and contribute to abnormal proliferation, which provided a potential direction for targeted therapy at the metabolic level in AML with DNMT3A mutation.

Abstract Objective The aim of this study was to investigate the incidence of chromosome anomalies in different types of congenital gastrointestinal obstruction and assess pregnancy outcomes of fetuses with congenital gastrointestinal obstruction. Methods A total of 64 cases with gastrointestinal obstruction between January 2014 and December 2020 were enrolled in this study. They were divided into three groups according to sonographic images. Group A: isolated upper gastrointestinal obstruction; Group B: isolated lower gastrointestinal obstruction; Group C: non-isolated gastrointestinal obstruction. The rate of chromosome anomalies in different groups was calculated. Pregnant women with amniocentesis were followed up by medical records and telephone. The follow-up included pregnancy outcomes and development of the live born infants. Result From January 2014 to December 2020, there were 64 fetus with congenital gastrointestinal obstruction underwent chromosome microarray analysis(CMA), the overall detection rate of CMA testing was 14.1%(9/64). The detection rate of Group A, B and C were 16.2%, 0 and 25.0% respectively. 9 fetuses with abnormal CMA results were all terminated. Among 55 fetuses with normal chromosomes, 10(18.2%) fetuses were not found to have any gastrointestinal obstruction after birth. 17(30.9%) fetuses were diagnosed with gastrointestinal obstruction and underwent surgical treatment after birth, one of which had lower gastrointestinal obstruction combined with biliary obstruction and died due to liver cirrhosis. 11(20.0%) pregnancy were terminated due to multiple abnormalities. 5(9.1%) fetuses were intrauterine death. 3(5.5%) fetuses were neonatal deaths. 9(16.4%) fetuses were lost to follow-up. Conclusion It is crucial to understand whether the gastrointestinal tract abnormality is isolated or associated to other findings. The risk of chromosomal abnormalities in fetuses with isolated lower gastrointestinal obstruction is lower than upper gastrointestinal obstruction. While genetic abnormalities excluded, a promising prognosis is expected for fetuses with congenital gastrointestinal obstruction.

Currently, implant-associated bacterial infections account for most hospital-acquired infections in patients suffering from bone fractures or defects. Poor osseointegration and aggravated osteolysis remain great challenges for the success of implants in infectious scenarios. Consequently, developing an effective surface modification strategy for implants is urgently needed. Here, a novel nanoplatform (GO/Ga) consisting of graphene oxide (GO) and gallium nanoparticles (GaNPs) was reported, followed by investigations of its in vitro antibacterial activity and potential bacterium inactivation mechanisms, cytocompatibility and regulatory actions on osteoblastogenesis and osteoclastogenesis. In addition, the possible molecular mechanisms underlying the regulatory effects of GO/Ga nanocomposites on osteoblast differentiation and osteoclast formation were clarified. Moreover, an in vivo infectious microenvironment was established in a rat model of implant-related femoral osteomyelitis to determine the therapeutic efficacy and biosafety of GO/Ga nanocomposites. Our results indicate that GO/Ga nanocomposites with excellent antibacterial potency have evident osteogenic potential and inhibitory effects on osteoclast differentiation by modulating the BMP/Smad, MAPK and NF-κB signaling pathways. The in vivo experiments revealed that the administration of GO/Ga nanocomposites significantly inhibited bone infections, reduced osteolysis, promoted osseointegration located in implant-bone interfaces, and resulted in satisfactory biocompatibility. In summary, this synergistic therapeutic system could accelerate the bone healing process in implant-associated infections and can significantly guide the future surface modification of implants used in bacteria-infected environments.

Abstract Objective Homocysteine (HCY) has been associated with carotid plaque in cross-sectional studies, but the prospective relationship between HCY and incident carotid plaque has not been well established. The purpose of this study was to investigate the association between HCY and incidence of novel carotid plaque in a Chinese community-based population without pre-existing carotid atherosclerosis and to assess the additive effect of HCY and low-density lipoprotein cholesterol (LDL-C) on the incidence of novel plaque. Methods: At baseline, we measured HCY and other risk factors in subjects aged ≥ 40 years. All participants underwent carotid ultrasound examinations at baseline and after an average of 6.8 years of follow-up. Incidence of plaque was identified if plaque was absent at baseline, but plaque was detected at the end of follow-up. A total of 474 subjects were included in the analysis. Results: The incidence of novel carotid plaque was 24.47%. Multivariate regression analyses showed that HCY was independently associated with a 1.05-fold-higher likelihood for incident novel plaque (adjusted odds ratio [OR] = 1.05, 95% confidence interval [CI]: 1.01–1.09, P = 0.008). Using tertile 1 and tertile 2 for reference, the top HCY tertile (T3) showed a 2.28-fold-higher likelihood for incident plaque (adjusted OR = 2.28, 95%CI: 1.33–3.93, P = 0.002). The combination of HCY T3 and LDL-C ≥ 3.4 mmol/L had the highest risk for novel plaque formation (adjusted OR = 3.63, 95%CI: 1.67–7.85, P = 0.001) compared to those without either condition. In the LDL-C ≥ 3.4 mmol/L subgroup, HCY was significantly associated with incidence of plaque (adjusted OR = 1.16, 95%CI: 1.04–1.28, P = 0.005, P-interaction = 0.023). Conclusion: In the Chinese community-based population, HCY was independently associated with the incidence of novel carotid plaque. There were additive effect between HCY and LDL-C on the incidence of plaque, the highest risk was observed in individuals with both high HCY levels and LDL-C ≥ 3.4 mmol/L. Our findings suggest that HCY may be a potential target for preventing the incidence of carotid plaque, particularly in individuals with elevated LDL-C levels.

Abstract Background Clostridioides difficile (C. difficile) is the major pathogen causing antibiotic-associated diarrhea. There are a variety of symptoms associated with C. difficile infection (CDI) in adults, including self-limiting diarrhea, pseudomembranous colitis, toxic megacolon, septic shock, and even death from the infection. However, the infant’s intestine appears to be completely resistant to the effects of C. difficile toxins A and B with rare development of clinical symptoms. Case presentation In this study, we reported a 1-month-old girl with CDI who was born with neonatal hypoglycemia and necrotizing enterocolitis. Her symptom of diarrhea occurred after extensive use of broad-spectrum antibiotics during hospitalization and was accompanied by elevated white blood cell, platelet, and C-reactive protein levels, and repeated routine stool examinations were abnormal. She was recovered by norvancomycin (an analogue of vancomycin) and probiotic treatment. The results of 16 S rRNA gene sequencing also demonstrated the recovery of intestinal microbiota with the enrichment of Firmicutes and Lactobacillus. Conclusions Based on the literature review and this case report, clinicians should also pay attention to diarrhea caused by C. difficile in infants and young children. More strong evidence is needed to explain the true prevalence of CDI in this population and to better understand the C. difficile-associated diarrhea in infants.

Abstract Background Since hepatitis B surface antigen (HBsAg) loss is rarely achieved with nucleos(t)ide analog (NA) treatment, most patients require life-long NA treatment. Previous studies have shown that some patients remain virologically responsive even after NA cessation. However, there is still controversy surrounding whether NA discontinuation increases the HBsAg loss rate. Therefore, this study aimed to assess the cumulative rate of HBsAg loss and identify the predictors of HBsAg loss after NA discontinuation. Methods This multicenter prospective study included HBV e antigen (HBeAg)-positive patients without cirrhosis from 12 hospitals in China who met the inclusion criteria. The enrolled patients stopped NA and were followed up with clinical and laboratory assessments every 3 months for 24 months after NA cessation or until clinical relapse (CR) occurred. Results Overall, 158 patients were classified into two groups. Group A included patients with HBsAg positivity at NA cessation (n = 139), and Group B included patients with HBsAg negativity at NA cessation (n = 19). In Group A, the 12-month and 24-month cumulative rates of HBsAg loss were4.3%and 9.4%, respectively. End of treatment (EOT) HBsAg (hazard ratio (HR) = 0.152, P

Abstract Background An accurate assessment of teaching needs is necessary to ensure targeted teacher training programs are developed and implemented to improve teaching outcomes. The assessment of teaching needs from different perspectives helps to identify teaching needs more accurately. Therefore, based on the different perspectives of teachers and students, this study aimed to identify and evaluate the needs of community practice teachers by measuring discrepancies between perceived teaching importance and actual teaching performance, with a focus on the influencing factors. Methods A survey was circulated to 220 teachers in 36 community health service centers and 695 students in 6 medical schools in Southwest China. The participants anonymously completed the teacher or student version of the Chinese version of the Teacher Teaching Needs Questionnaire, which is predominantly used to assess the teaching needs of teachers. Both versions of the questionnaire include 27 items, covering 3 dimensions (including teaching skills, teaching environments, and teaching contents). The ordinal logistic regression was conducted to explore the factors that influenced teaching needs. Results The teachers and students produced overall self-evaluated teaching needs scores of 0.61 and 0.62 respectively. The teachers from provincial capital cities and low-educated teachers had teaching needs that are lower (OR = 0.641,95% CI: 0.461–0.902, OR = 15.352, 95% CI: 1.253–26.815, separately). Teachers with 10 years of experience. Compared with teachers who self-evaluated their teaching outcomes as poor, those who reported extremely excellent (OR = 0.362, 95% CI: 0.220–0.701), excellent (OR = 0.638, 95% CI: 0.426–1.102), and ordinary (OR = 0.714, 95% CI: 0.508–1.034) teaching outcomes had lower teaching needs. Compared with teachers who self-evaluated their teaching abilities as poor, those who reported extremely excellent (OR = 0.536, 95% CI: 0.313–0.934), excellent (OR = 0.805, 95% CI: 0.518–1.269), and ordinary (OR = 0.737, 95% CI: 0.413–1.322) teaching abilities had lower teaching needs. Conclusions Greater assistance should be provided to teachers with lower levels of education, fewer than three years of teaching experience, and who are located in non-capital cities, as these individuals require additional efforts to strengthen competencies. The education department should pay more attention to teacher feedback on practical outcomes and teaching abilities, as this can be used to devise the best teacher development plans. Trial registration Not applicable.

Abstract Background Implantable Collamer Lens (ICL) surgery has been proven to be a safe, effective, and predictable method for correcting myopia and myopic astigmatism. However, predicting the vault and ideal ICL size remains technically challenging. Despite the growing use of artificial intelligence (AI) in ophthalmology, no AI studies have provided available choices of different instruments and combinations for further vault and size predictions. This study aimed to fill this gap and predict post-operative vault and appropriate ICL size utilizing the comparison of numerous AI algorithms, stacking ensemble learning, and data from various ophthalmic devices and combinations. Results This retrospective and cross-sectional study included 1941 eyes of 1941 patients from Zhongshan Ophthalmic Center. For both vault prediction and ICL size selection, the combination containing Pentacam, Sirius, and UBM demonstrated the best results in test sets [R 2 = 0.499 (95% CI 0.470–0.528), mean absolute error = 130.655 (95% CI 128.949–132.111), accuracy = 0.895 (95% CI 0.883–0.907), AUC = 0.928 (95% CI 0.916–0.941)]. Sulcus-to-sulcus (STS), a parameter from UBM, ranked among the top five significant contributors to both post-operative vault and optimal ICL size prediction, consistently outperforming white-to-white (WTW). Moreover, dual-device combinations or single-device parameters could also effectively predict vault and ideal ICL size, and excellent ICL selection prediction was achievable using only UBM parameters. Conclusions Strategies based on multiple machine learning algorithms for different ophthalmic devices and combinations are applicable for vault predicting and ICL sizing, potentially improving the safety of the ICL implantation. Moreover, our findings emphasize the crucial role of UBM in the perioperative period of ICL surgery, as it provides key STS measurements that outperformed WTW measurements in predicting post-operative vault and optimal ICL size, highlighting its potential to enhance ICL implantation safety and accuracy.

Abstract Background Copy-number variants (CNVs) drive many neurodevelopmental-related disorders. Although many neurodevelopmental-related CNVs can give rise to widespread phenotypes, it is necessary to identify the major genes contributing to phenotypic presentation. Copy-number variations in chromosome 6, such as independent 6p deletion and 6p duplication, have been reported in several live-born infants and present widespread abnormalities such as intellectual disability, growth deficiency, developmental delay, and multiple dysmorphic facial features. However, a contiguous deletion and duplication in chromosome 6p regions have been reported in only a few cases. Case presentation In this study, we reported the first duplication of chromosome band 6p25.3–p22.3 with deletion of 6p25.3 in a pedigree. This is the first case reported involving CNVs in these chromosomal regions. In this pedigree, we reported a 1-year-old boy with maternal 6p25-pter duplication characterized by chromosome karyotype. Further analysis using CNV-seq revealed a 20.88-Mb duplication at 6p25.3-p22.3 associated with a contiguous 0.66-Mb 6p25.3 deletion. Whole exome sequencing confirmed the deletion/duplication and identified no pathogenic or likely pathogenic variants related with the patient´s phenotype. The proband presented abnormal growth, developmental delay, skeletal dysplasia, hearing loss, and dysmorphic facial features. Additionally, he presented recurrent infection after birth. CNV-seq using the proband´s parental samples showed that the deletion/duplication was inherited from the proband´s mother, who exhibited a similar phenotype to the proband. When compared with other cases, this proband and his mother presented a new clinical finding: forearm bone dysplasia. The major candidate genes contributing to recurrent infection, eye development, hearing loss features, neurodevelopmental development, and congenital bone dysplasia were further discussed. Conclusions Our results showed a new clinical finding of a contiguous deletion and duplication in chromosome 6p regions and suggested candidate genes associated with phenotypic features, such as FOXC1, SERPINB6, NRN1, TUBB2A, IRF4, and RIPK1.

Abstract Background Diabetic kidney disease (DKD) is a severe complication of diabetes. Currently, no effective measures are available to reduce the risk of DKD progression. This study aimed to establish a weighted risk model to determine DKD progression and provide effective treatment strategies. Methods This was a hospital-based, cross-sectional study. A total of 1104 patients with DKD were included in this study. The random forest method was used to develop weighted risk models to assess DKD progression. Receiver operating characteristic curves were used to validate the models and calculate the optimal cutoff values for important risk factors. Results We developed potent weighted risk models to evaluate DKD progression. The top six risk factors for DKD progression to chronic kidney disease were hemoglobin, hemoglobin A1c (HbA1c), serum uric acid (SUA), plasma fibrinogen, serum albumin, and neutrophil percentage. The top six risk factors for determining DKD progression to dialysis were hemoglobin, HbA1c, neutrophil percentage, serum albumin, duration of diabetes, and plasma fibrinogen level. Furthermore, the optimal cutoff values of hemoglobin and HbA1c for determining DKD progression were 112 g/L and 7.2%, respectively. Conclusion We developed potent weighted risk models for DKD progression that can be employed to formulate precise therapeutic strategies. Monitoring and controlling combined risk factors and prioritizing interventions for key risk factors may help reduce the risk of DKD progression.

Abstract Background Non-small cell lung cancer (NSCLC) with HER2 mutation has entered into the era of targeted therapy. However, both anti-HER2 antibody–drug conjugates (ADCs) and tyrosine kinase inhibitors (TKIs) showed moderate objective response rate (ORR) and median progression-free survival (PFS). The aim of this study was to investigate the molecular features of responders to pyrotinib in advanced NSCLC with HER2 mutation. Methods Patients from our two previous phase II trials were pooled analyzed. Their circulating tumor DNA (ctDNA) were detected by next-generation sequencing (NGS) panels, and the correlation with the efficacy of pyrotinib was investigated. Results This pooled analysis included 75 patients, and 50 of them with baseline plasma samples were finally enrolled with a median age of 57 years old. The overall ORR and median PFS were 28% and 7.0 months respectively. Biomarker analysis showed that 5 patients were ctDNA nonshedding. Patients with TP53 wild type were significantly associated with higher disease control rate (97.1%vs. 68.8%, p = 0.010), PFS (median 8.4 vs. 2.8 months, p = 0.001) and overall survival (OS, median 26.7 vs. 10.4 months, p

Abstract Whole-body regeneration of planarians is a natural wonder but how it occurs remains elusive. It requires coordinated responses from each cell in the remaining tissue with spatial awareness to regenerate new cells and missing body parts. While previous studies identified new genes essential to regeneration, a more efficient screening approach that can identify regeneration-associated genes in the spatial context is needed. Here, we present a comprehensive three-dimensional spatiotemporal transcriptomic landscape of planarian regeneration. We describe a pluripotent neoblast subtype, and show that depletion of its marker gene makes planarians more susceptible to sub-lethal radiation. Furthermore, we identified spatial gene expression modules essential for tissue development. Functional analysis of hub genes in spatial modules, such as plk1, shows their important roles in regeneration. Our three-dimensional transcriptomic atlas provides a powerful tool for deciphering regeneration and identifying homeostasis-related genes, and provides a publicly available online spatiotemporal analysis resource for planarian regeneration research.

Ammonia is highly toxic to aquatic organisms and has become a consistent pollutant in intensive fish farming conditions. Dihydroartemisinin (DhA) has potential value in the treatment of ammonia poisoning in aquaculture. However, the application investigation of DhA is insufficient in the field of aquaculture. In the present study, 540 zebrafish with an average body weight of (1.00 ± 0.01) g were randomly assigned into 9 groups. The zebrafish were fed a basal diet supplemented with or without 0.25% or 0.5% DhA for 1 week. The zebrafish were then exposed to water supplemented with or without 40 or 80 mg/L ammonium acetate (NH4AC) for 4 days. The results showed that dietary supplementation with 0.5% DhA attenuated mortality and ammonia accumulation in zebrafish exposed to 80 mg/L NH4AC. In addition, the alleviative effects of 0.5% DhA were associated with enhanced mRNA levels for ammonia transporter (Rhesus-associated glycoprotein, Rh family C glycoprotein 1, Na+/K+-ATPase, carbonic anhydrase), anti-inflammatory cytokines (transforming growth factor β), as well as the down-regulation of mRNA expression of inflammatory factors (interleukin 1β), hypoxia-inducible factors (hypoxia-inducible factor 1 αb, hypoxia-inducible factor 2α), and protein abundances of autophagy (autophagy-related gene 5, BCL-2-interacting myosin-like coiled-coil protein-1, microtubule-associated protein 1 light chain 3 Ⅱ, cathepsin B, cathepsin L). Taken together, DhA has great potential in aquaculture as a defence against ammonia toxicity.

Objectives Radiofrequency catheter ablation is the first-line treatment for idiopathic premature ventricular complexes (PVCs) and ventricular tachycardias (VTs). However, the outcomes were less compared among the categories. The study aims to assess the effectiveness and safety of catheter ablation for idiopathic PVC/VTs in a single high-volume centre, using the right ventricular outflow tract (RVOT) as a reference.Design Retrospective cohort study.Setting Patient data were collected from a tertiary hospital in Guizhou, China.Participants Between September 2013 and September 2022, 1028 patients (male: 41.3%; age: 46.5±15.6 years) who underwent the first catheter ablation for idiopathic monomorphic PVC/VTs were enrolled.Outcome measures Acute success, procedure-related complications, and long-term recurrence were assessed. Antiarrhythmic drugs (AADs) were not administrated after procedures unless recurrence was identified.Results The overall acute success rate was 90.3%, with 368 patients (35.8%) experiencing left ventricular PVC/VTs. No cases of third-degree atrioventricular block or death were reported. Complications were more common in patients with left ventricular PVC/VTs than those with right-sided ones (4.6% vs 0.1%, p

Introduction: The bileaflet valves found in collecting lymphatic vessels and some veins are essential for maintaining a unidirectional flow, which is important for lymphatic and venous function. Under an adverse pressure gradient, the two leaflets tightly overlap to prevent backflow. Valves are proposed to share four main stages of development, based on images obtained from randomly oriented valves in fixed mouse embryos, with the best structural views obtained from larger venous valves. It is not known at what stage lymphatic valves (LVs) become functional (e.g., able to oppose backflow), although a requirement for stage 4 is presumed.Methods: To gain an insight into this sequence of events for LVs, we used Prox1CreERT2:Foxo1fl/fl mice and Foxc2CreERT2:Foxo1fl/fl mouse models, in which deletion of the valve repressor factor Foxo1 promotes the development of new LVs in adult lymphatic vessels. Both strains also contained a Prox1eGFP reporter to image the lymphatic endothelium. Mesenteric collecting lymphatic vessels were dissected, cannulated, and pressurized for ex vivo tests of valve function. LVs at various stages (1–4 and intermediate) were identified in multi-valve segments, which were subsequently shortened to perform the backleak test on single valves. The GFP signal was then imaged at high magnification using a confocal microscope. Z-stack reconstructions enabled 1:1 comparisons of LV morphology with a quantitative measurement of back leak.Results: As expected, LVs of stages 1–3 were completely leaky in response to outflow pressure elevation. Stage 4 valves were generally not leaky, but valve integrity depended on the Cre line used to induce new valve formation. A high percentage of valves at leaflet an intermediate stage (3.5), in which there was an insertion of a second commissure, but without proper luminal alignment, effectively resisted back leak when the outflow pressure was increased.Discussion: Our findings represent the first 3D images of developing lymphatic valves and indicate that valves become competent between stages 3 and 4 of development.

Water-related ecosystem services (WES) critical to anthropogenic-related water security are being severely degraded, primarily due to climate and land-use change. Clarifying future trends in WES (i.e., water yield and water purification services) will contribute to water resource sustainability. However, most existing studies are single case studies and rarely consider the combined impacts of climate change and land-use change on ecosystem services, resulting in patterns that cannot be adequately summarized. In this study, the “Annual Water Yield” module of the InVEST model was used to estimate water yield and the “Nutrient Delivery Ratio” module was used to analyze water purification services. In order to compare the impacts of different natural conditions and geographic locations on water ecosystem services, 17 typical watersheds throughout China were selected as study areas. Coupled scenarios were also considered when setting climate and land-use scenarios to predict prospective (2020–2100) evolutionary trends in WES. The response of WES under different scenarios was also assessed. Results show that climate change is more likely to affect water yield services than water purification services. The impact of land use on water purification services is more pronounced than its impact on water yield services. Climate change contributed > 90 % to water yields in 15 out of the 17 watersheds, contributed 79.4 % in the Hei River watershed, while only contributing 11.2 % in the Yarkant River watershed. The influence of climate change on total nitrogen (TN) output in eight of the watersheds was greater than that of land-use change, especially in the Min River and Mintuo River watersheds, for which the contribution was > 95 %. Furthermore, water purification services in nine of the watersheds were more affected by land-use change, especially in the Dongting Lake and Hei River watersheds, for which the contribution was > 95 %. The aim of this study is to assist in the planning of sound water resource measures while developing sustainable management strategies to help relevant water resource sectors cope with prospective risks and challenges.

ObjectiveMost brain function assessments for disorders of consciousness (DOC) utilized quantified characteristics, measured only once, ignoring the variation of patients' brain states. The study aims to investigate the brain activities of patients with DOC from a new perspective: variability of a large timescale functional network.MethodsForty-nine patients were enrolled in this study and performed a 1-week behavioral assessment. Subsequently, each patient received electroencephalography (EEG) recordings five times daily at 2-h intervals. Functional connectivity and networks were measured by weighted phase lag index and complex network parameters (characteristic path length, cluster coefficient, and betweenness centrality). The relative coefficient of variation (CV) of network parameters was measured to evaluate functional network variability.ResultsFunctional networks of patients with vegetative state/unresponsive wakefulness syndrome (VS/UWS) showed significantly higher segregation (characteristic path length) and lower centrality (betweenness centrality) than emerging from the minimal conscious state (EMCS) and minimal conscious state (MCS), as well as lower integration (cluster coefficient) than MCS. The functional networks of VS/UWS patients consistently presented the highest variability in segregation and integration (i.e., highest CV values of characteristic path length and cluster coefficient) on a larger time scale than MCS and EMCS. Moreover, the CV values of characteristic path length and cluster coefficient showed a significant inverse correlation with the Coma Recovery Scale-Revised scores (CRS-R). The CV values of network betweenness centrality, particularly of the cento-parietal region, showed a positive correlation with the CRS-R.ConclusionThe functional networks of VS/UWS patients present the most invariant segregation and integration but divergent centrality on the large time scale networks than MCS and EMCS.SignificanceThe variations observed within large timescale functional networks significantly correlate with the degree of consciousness impairment. This finding augments our understanding of the neurophysiological mechanisms underpinning disorders of consciousness.

This study aimed to explore the immunomodulatory activity of Dendrobium officinale leaf polysaccharide (DOLP) in both immunosuppressed and normal mice. The data showed that DOLP significantly reversed thymic and splenic damage in immunosuppressed mice, regulated their peripheral blood cells (PLT, etc.), immune-related cytokines (TNF-α, INF-γ and IL-6) and immunoglobulins (IgA, IgG and IgM) production, and increased the relative abundance of beneficial bacteria (Lactobacillus and Bifidobacterium, etc.) while decreased that of pathogenic bacteria (Desulfovibrio, etc.). In normal mice, DOLP significantly increased immune-related cytokines (TNF-α, INF-γ, and IL-6), gut microbiota diversity, and the relative abundance of beneficial bacteria (unclassified_f_Lachnospiraceae_NK4A136_group, etc.). The results indicated that DOLP could exert immune modulating effects both on immunosuppressed mice and normal mice by modulating immune parameters and gut microbiota. These findings provide new insights into the immune-modulating effects of DOLP and a solid basis for the thorough utilization of DOLP.

Individuals frequently encounter dilemmas in which they must choose between smaller, immediate gains and larger, delayed rewards; this phenomenon is known as intertemporal choice. The present study analyzed the interplay of trait and state self-control and time perception tendencies (time overestimation vs. time underestimation) and how it influences the rates of selecting immediate options in both gain and loss situations by conducting an intertemporal choice task. Experiment 1 was used to explore the impact of trait self-control and time perception on intertemporal choices within gain and loss situations. In Experiment 2, the e-crossing task was used to induce self-control resource depletion in participants and to investigate the impact of self-control resources and time perception on intertemporal choices in gain and loss situations. The results indicate that (1) compared with the high-self-control group, the low-self-control group exhibited a greater tendency to choose immediate options. Additionally, the high time estimation group was more likely to opt for immediate choices than the low time estimation group was. Furthermore, participants were more likely to select immediate options in the loss situation than in the gain situation. (2) In the gain situation, the high time estimation group was more likely to choose immediate options than was the low time estimation group. However, in the loss situation, the difference between the two groups was nonsignificant. (3) Time perception and gain–loss situations exerted a moderating mediating effect on the impact of self-control resources on intertemporal choices. These findings shed light on the influence of both self-control abilities and self-control resources on intertemporal choices. They provide valuable insights into intertemporal decision behaviors across diverse contexts and indicate the need for rational analysis based on one’s current state to mitigate cognitive biases to ensure individuals can maximize benefits in their daily lives.

Objectives Examining fear of cancer recurrence (FCR) among breast cancer survivors and their spouses, and the protective effect of family resilience on FCR among couples affected by breast cancer.Design Cross-sectional survey design.Setting Ten general grade IIIa (>500 beds) hospitals in southwest China.Participants Overall, 392 early breast cancer survivors and their spousal caregivers (N=392) were recruited from cancer centres in hospitals.Primary and secondary outcome measures Spouses’ and survivors’ FCR were the primary outcome measures. Family resilience and perceived stress were the secondary outcome measures. Using a convenience sampling method, we collected data on-site using paper questionnaires. The Chinese version of the Family Resilience Assessment Scale, Perceived Stress Scale, Fear of Progression Questionnaire Short Form and Fear of Progression Questionnaire-Short Form for spouses were used to evaluate the outcomes.Results The model accounted for 66.3% and 53.6% of the variance in spouses’ FCR and survivors’ FCR, respectively. Family resilience directly negatively affected perceived stress and spouses’ and survivors’ FCR (β=−0.22; β=−0.13; β=−0.19). Perceived stress was a partial mediator of the association between family resilience and survivors’ FCR (β=−0.070; 95% CI :−0.151 to –0.022). Spouses’ FCR partially mediated the association between family resilience and survivors’ FCR (β=−0.048; 95% CI= −0.092 to –0.015). Perceived stress and spouses’ FCR played a significant chain-mediated role between family resilience and survivors’ FCR (β=−0.061; 95% CI: −0.119 to –0.022).Conclusions Family-centred approaches to reducing survivors’ perceived stress can improve the psychological well-being of couples affected by breast cancer and ultimately reduce FCR. Medical staff should consider the psychological feelings of survivors and their spousal caregivers when devising the intervention plan, which should address the families’ potential and mobilise family and community resources for increasing family resilience.

Advances in neuroimaging techniques during the past few decades have captured impaired functional brain activity in migraine disorders, yet the molecular mechanisms accounting for its alterations in migraine remain largely unknown. A total of 27 patients with episodic migraine (EM) and 30 matched healthy controls (HCs) underwent resting-state functional and structural magnetic resonance imaging (MRI) scans. Regional homogeneity (ReHo), low-frequency fluctuations (ALFF), and fractional amplitude of low-frequency fluctuations (fALFF) of fMRI were compared between the two groups. Based on the Allen Human Brain Atlas and risk genes in migraine, we identified gene expression profiles associated with ReHo alterations in EM. Compared with HCs, patients with EM showed increased ReHo in the left orbital part of the superior frontal gyrus (P < 0.05, cluster-level FWE-corrected). The expression profiles of 16 genes were significantly correlated with ReHo alterations in EM (P < 0.05/5,013, Bonferroni corrected). These genes were mainly enriched for transcription regulation, synaptic transmission, energy metabolism, and migraine disorders. Furthermore, the neural activation was positively correlated with Hamilton Rating Scale for Anxiety (HAMA) scores. To test the stability of our results, we repeated our procedure by using ALFF and fALFF and found these results had a high degree of consistency. Overall, these findings not only demonstrated that regional brain activity was increased in patients with EM, which was associated with emotional regulation but also provided new insights into the genetic mechanisms underlying these changes in migraine.

Summary: Background: Frail elderly patients with newly diagnosed multiple myeloma (NDMM) have inferior survival and less benefit from high-dose therapies. This prospective study aimed to investigate the efficacy, safety, and quality of life (QoL) of induction treatment of ixazomib/lenalidomide/dexamethasone (IRd) and ixazomib/pegylated liposomal doxorubicin/dexamethasone (IDd) followed by ixazomib/dexamethasone (Id) maintenance therapy in frail, elderly patients with NDMM. Methods: From July 2019 to December 2021, this non-randomized concurrent controlled clinical study enrolled 120 NDMM patients aged ≥65 years with frailty defined by the International Myeloma Working Group (IMWG) frailty score or Mayo geriatric scoring system. The enrolled patients received 6–8 cycles of IRd or IDd followed by Id maintenance therapy for a minimum of 2 years at the discretion of physicians based on patient's clinical characteristics (chiCTR1900024917). Findings: The median age was 71 years and 55% of the patients were males. The overall response rate (ORR) was 82% and 77%, complete response (CR) rate was 25% and 12% for IRd and IDd groups, respectively. The difference in ORR of the Idd group minus the IRd group was −5.36% (95% CI: −18.9% to 8.19%), indicating that the ORR of the IDd group was neither inferior nor non-inferior to the IRd group. After a median follow-up of 34.3 months, the median progression-free survival (PFS) was 21.6 and 13.9 months, OS was not reached and 29.2 months in IRd and IDd groups, respectively. 28 and 33 patients discontinued induction therapy, 20 and 19 discontinued maintenance therapy in IRd and IDd groups, respectively. Cumulative Grade 3 or higher hematological adverse events (AEs) occurred in 10 of the 60 patients (17%) and non-hematological AEs occurred in 15 of the 60 patients (25%) in the IRd group, while 13 of the 60 patients (22%) and 21 of the 60 patients (35%) in the IDd group. Patients were observed with clinically significant improvement in QoL when compared with that at baseline in both IRd and IDd groups by evaluation per cycle (P

This study explores the potential medicinal properties of Bletilla striata fibrous roots by comparing their active ingredient contents and antioxidant activity with those in tubers. The study further examines the effects of growth age and origin on the distribution characteristics of medicinal properties in fibrous roots and identifies biomarkers that distinguish these characteristics. The Δ E value of fibrous roots significantly increases with age and is significantly influenced by origin; both the age and origin also significantly affect militarine content and antioxidant activity; a positive correlation exists between appearance quality, active ingredients, and antioxidant activity. The total phenolic content and antioxidant activity of fibrous roots significantly exceed those of tubers. The militarine content in both 1-year-old and 2-year-old fibrous roots complies with the 2020 edition of the Chinese Pharmacopoeia, suggesting that the fibrous roots possess medicinal potential. Additionally, this study demonstrates that the OPLS-DA model can differentiate 1-year-old and non-1-year-old fibrous roots of Bletilla striata and distinguish between their origin.

Background. Liver injury related to heatstroke plays a pivotal role in secondary multiorgan damage and is a direct cause of mortality in affected patients of heatstroke. This study was designed to identify independent risk factors associated with liver injury in heatstroke and to construct a clinically applicable predictive model. Methods. We conducted a retrospective analysis of 188 patients diagnosed with heatstroke, treated in the emergency departments of eight medical institutions from July 1, 2022, to September 30, 2023. Patients were categorized into a liver injury group (n = 80) and a nonliver injury group (n = 108), based on liver function indices recorded during hospitalization. Lasso regression was employed for variable refinement, while multifactorial logistic regression was utilized to identify independent risk factors for liver injury in heatstroke and to construct a nomogram model. The model’s efficacy was evaluated using the C-index, calibration curves, and decision curve analysis, examining its discriminative ability, calibration, and clinical utility. Results. The nomogram included predictive factors such as the Glasgow score, absolute lymphocyte count, lactate dehydrogenase levels, and creatine kinase isoenzyme. The model showed high accuracy and discriminative capability. The C-index was 0.852 (95% CI 0.80–0.905) with a calibration index of 0.843. Decision curve analysis revealed significant clinical applicability for this nomogram. Conclusion. The study identified four key independent risk factors for liver injury in heatstroke patients. The constructed nomogram, based on the four clinical indicators, demonstrated robust predictive accuracy, discriminative power, and clinical relevance.

Background In digital medicine, human activity recognition (HAR) can be used to track and assess a patient's progress throughout rehabilitation, enhancing the quality of life for the elderly and the disabled. Methods A patch-type flexible sensor that integrated dynamic electrocardiogram (ECG) and acceleration signal (ACC) was used to record the signals of the various behavioral activities of 20 healthy volunteers and 25 patients with pneumoconiosis. Seven HAR tasks were then carried out on the data using four different deep learning methods (CNN, LSTM, CNN–LSTM and GRU). Results When ECG and ACC were obtained simultaneously, the overall accuracy rates of HAR for healthy group were 0.9371, 0.8829, 0.9843 and 0.9486 by the CNN, LSTM, CNN–LSTM and GRU models, respectively. In contrast, the overall accuracy rates of HAR for the pneumoconiosis patients’ group were 0.8850, 0.7975, 0.9425 and 0.8525 by the four corresponding models. The accuracy of HAR for both groups using all four models is higher than when only ACC signal is detected. Conclusion The addition of the ECG signal significantly improves HAR outcomes in the group of healthy individuals, while having relatively less enhancing effects on the group of patients with pneumoconiosis. When ECG and ACC signals were combined, the increase in HAR accuracy was notable compared to cases where no ECG data was provided. These results suggest that the combination of ACC and ECG data can represent a novel method for the clinical application of HAR.

IntroductionThe panicle fertilization strategy for japonica and indica rice under wheat straw return (SR) has not been updated, especially on the elaboration of their impacts on spikelet differentiation and degeneration. This study aimed to verify the hypothesis that SR increases spikelet number by reducing spikelet degeneration and to explore the possibility of simplifying panicle fertilization.MethodsIn three consecutive years, four varieties of japonica and indica rice were field-grown in Yangzhou, Jiangsu Province, China. Six panicle fertilization rates and split treatments were applied to SR and no straw return (NR) conditions.ResultsThe results showed that SR promoted rice yield significantly by 3.77%, and the highest yields were obtained under the T2 (split panicle fertilization at the panicle initiation (PI) and spikelet primordium differentiation (SPD) stages) and T1 (panicle fertilization only at the PI stage) treatments, for indica and japonica rice, respectively. Correlation and path analysis revealed that the number of spikelets per panicle was the most attributable to yield variation. SR significantly increased the concentration of alkali hydrolyzable N in the soil 40 days after rice transplantation, significantly increased the nitrogen accumulation per stem (NA) during the SPD-pollen mother cell meiosis (PMC) stage, and increased the brassinosteroids level in the young panicles at the PMC stage. SR also reduced the degeneration rate of spikelets (DRS) and increased the number of surviving spikelets (NSS). The dry matter accumulation per stem was more important to increasing the NA in japonica rice at the PMC stage, whereas NA was more affected by the N content than the dry matter accumulation in indica rice. In japonica rice, panicle N application once only at the PI stage combined with the N released from SR was enough to improve the plant N content, reduce the DRS, and increase the NSS. For indica rice, split application of N panicle fertilization at both the PI and SPD stages was still necessary to achieve a maximum NSS.DiscussionIn conclusion, under wheat SR practice, panicle fertilization could be simplified to once in japonica rice with a significant yield increase, whereas equal splits might still be optimal for indica rice.

Ferulic acid (FA) and ferulic acid methyl ester (FAM) are important phenolic compounds in Baijiu. In this study, the interaction of FA and FAM with human serum albumin (HSA) and lysozyme (LZM) was investigated using multispectral methods and molecular dynamics simulation. FA and FAM could interact with HSA and LZM, changing the conformation and hydrophilicity of the protein. The quenching mechanisms of FA-HSA, FA-LZM, FAM-HSA, and FAM-LZM were all static-quenching. In the FA-HSA, FAM-HSA, and FA-LZM systems, the interaction forces were mainly hydrophobic interactions and hydrogen bonding. In the FAM-LZM system, the interaction forces were mainly hydrophobic interactions, hydrogen bonding, and van der Waals force. Common metal ions such as K+, Ca2+, Cu2+, Mg2+, and Mn2+ could affect the binding ability of FA and FAM to HSA and LZM. Moreover, FA and FAM could increase the stability of HSA and LZM, and the protein bound to FA/FAM was more stable than the free protein. FA and FAM had varying degrees of impact on the physiological activities of HSA and LZM. This study provides relevant information on the interactions and metabolic mechanisms of FA and its derivatives with endogenous proteins.

AimsThe current study aims to investigate the consistency between the surveyees’ self-reported disease diagnosis and clinical assessment of eight major chronic conditions using community-based survey data collected in Xi’an, China in 2017. With a focus on under-reporting patients, we aim to explore its magnitude and associated factors, to provide an important basis for disease surveillance, health assessment and resource allocation, and public health decision-making and services.MethodsQuestionnaires were administered to collect self-reported chronic condition prevalence among the study participants, while physical examinations and laboratory tests were conducted for clinical assessment. For each of the eight chronic conditions, the sensitivity, specificity, under-reporting, over-reporting, and agreement were calculated. Log-binomial regression analysis was employed to identify potential factors that may influence the consistency of chronic condition reporting.ResultsA total of 2,272 participants were included in the analysis. Four out of the eight chronic conditions displayed under-reporting exceeding 50%. The highest under-reporting was observed for goiter [85.93, 95% confidence interval (CI): 85.25–86.62%], hyperuricemia (83.94, 95% CI: 83.22–84.66%), and thyroid nodules (72.89, 95% CI: 72.02–73.76%). Log-binomial regression analysis indicated that senior age and high BMI were potential factors associated with the under-reporting of chronic condition status in the study population.ConclusionThe self-reported disease diagnosis by respondents and clinical assessment data exhibit significant inconsistency for all eight chronic conditions. Large proportions of patients with multiple chronic conditions were under-reported in Xi’an, China. Combining relevant potential factors, targeted health screenings for high-risk populations might be an effective method for identifying under-reporting patients.

BackgroundNon-suicidal self-injury (NSSI) is a highly prevalent behavioral problem among depression adolescent patients that can result in numerous adverse outcomes. This study endeavors to bridge this knowledge gap by creating a comprehensive model that incorporates multiple aspects of NSSI to accurately evaluate its risk in adolescents with depression, thereby enhancing our ability to prevent and address this challenging issue.MethodUsing a cross-sectional design, we recruited 302 adolescents with depressive disorders who visited or were hospitalized at Shandong Mental Health Center from December 2021 to June 2022. The participants completed several self-report questionnaires, including the Chinese version of the Internet Addiction Test, the Pittsburgh Sleep Quality Index questionnaire, the Defeat Scale, the Social Avoidance and Distress Scale and the Children’s Depression Inventory. Logistic regression analysis was performed to identify the diagnostic factors, which were further used to establish clinical risk assessment models. A receiver operating characteristic curve (ROC) to identify the best model. An external validating team was introduced to verify the assessing efficiency.ResultsBased on a logistic regression analysis, three variables have been identified as significant risk factors. Specifically, adolescents with depression who experience low self-esteem, internet use, or suffer from sleep disturbance face an increased risk of NSSI. An integrated risk index for NSSI exhibits excellent accuracy in identifying depressed adolescents at risk of NSSI (area under the curve = 0.86, sensitivity = 0.88, specificity = 0.69). In the validation cohort, the identification performance remains strong (area under the curve = 0.84, sensitivity = 0.72, specificity = 0.81).ConclusionThis study highlighted the role of self-esteem, internet use and sleep disturbance in the development of NSSI. The risk index diagnosing NSSI onset may help to guide the design and application of novel interventions to minimize this risky behavior in future depressed adolescents.

ABSTRACT: The objective of this study was to investigate the preventive effects and mechanisms of genistein (GEN) on production performance and metabolic disorders in broilers under chronic heat stress (HS). A total of 120 male 3-wk-old Ross broilers were randomly assigned to 5 groups: a thermoneutral zone (TN) group maintained at normal temperature (21°C ± 1°C daily), an HS group subjected to cyclic high temperature (32°C ± 1°C for 8 h daily), and 3 groups exposed to HS with varying doses of GEN (50, 100, or 150 mg/kg diet). The experimental period lasted for 3 wk. Here, HS led to a decline in growth performance parameters and hormone secretion disorders (P < 0.05), which were improved by 100 and 150 mg/kg GEN treatment (P < 0.05). Moreover, the HS-induced increases in the liver index (P < 0.01) and abdominal fat rate (P < 0.05) were attenuated by 150 mg/kg GEN (P < 0.05). The HS-induced excessive lipid accumulation in the liver and serum (P < 0.01) was ameliorated after 100 and 150 mg/kg GEN treatment (P < 0.05). Furthermore, the HS-induced decreases in lipolysis-related mRNA levels and increases in lipid synthesis-related mRNA levels in the liver (P < 0.01) were effectively blunted after 100 and 150 mg/kg GEN treatment (P < 0.05). Importantly, the HS-stimulated hepatic mitochondrial energetic dysfunction and decreases in the mRNA or protein levels of peroxisome proliferator-activated receptor-gamma coactivator 1α (PGC-1α), nuclear respiratory factor 1, and mitochondrial transcription factor A in the liver were ameliorated by 150 mg/kg GEN (P < 0.05). Moreover, 50 to 150 mg/kg GEN treatment resulted in a significant increase in the mRNA or protein levels of G protein-coupled estrogen receptor (GPR30), AMP-activated protein kinase (AMPK) α1, phosphorylated AMPKα, and phosphorylated acetyl-CoA carboxylase α. Collectively, GEN alleviated metabolic disorders and hepatic mitochondrial energetic dysfunction under HS, possibly through the activation of GPR30-AMPM-PGC-1α pathways. These data provide a sufficient basis for GEN as an additive to alleviate HS in broilers.

AbstractBackground Erector spinae plane block is a promising strategy for pain management in some settings. However, the effectiveness of erector spinae plane block versus caudal block in pediatric inguinal hernia repair has yet to be formally investigated.Methods One hundred and two patients aged 2–5 years undergoing unilateral open inguinal hernia repair randomly received unilateral erector spinae plane block (0.2% ropivacaine 0.5 mL kg−1), caudal block (0.2% ropivacaine 1 mL kg−1), or no block. The primary outcome was time to the first rescue analgesia, defined as the interval from the end of surgery to the Face, Legs, Activity, Cry, and Consolability scale greater than three. Secondary outcomes included the number of patients requiring rescue analgesia, the area under the curve of pain scores over time, satisfaction of guardians, and adverse events.Results The median time to the first rescue analgesia was longer in the erector spinae plane block group than in the caudal block group [10.0 h (interquartile range, 6.6–24.0 h) vs. 5.0 h (interquartile range, 2.9–7.3 h); p