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The purpose of this study was to verify the mediating role of depressive symptoms between excessive daytime sleepiness and suicidal ideation in college students. Of the 6944 participants, 2609 (37.6%) were male and 4335 (62.4%) were female. College students with excessive daytime sleepiness (p < 0.001) and those with depressive symptoms (p < 0.001) were more likely to have suicidal ideation. Moreover, both excessive daytime sleepiness (β = 0.14, 95% CI: 1.01–1.32) and depressive symptoms (β = 1.47, 95% CI: 3.80–5.00) were associated with suicidal ideation. The effect size of the mediating role of depressive symptoms in excessive daytime sleepiness to suicidal ideation was 50.41% for the entire sample, 58.33% for males, and 42.98% for females. Depressive symptoms partially mediated the relationship between excessive daytime sleepiness and suicidal ideation. The timely assessment of depressive symptoms in college students with excessive daytime sleepiness, and intervention, may reduce their risk of suicidal ideation.

Mobile social media are increasingly being used in education. They provide an effective way to address the imbalance between teaching supply and demand for older adults. However, few studies have investigated which factors contribute to older adults' intention to use mobile social media for learning. This study uses a sequential explanatory mixed method to investigate the factors impacting older Chinese adults' adoption of mobile social media for learning. Results of the quantitative phase indicated that Technology Anxiety (TA), Self-efficacy (SE), Previous Experience (PE), and Subjective Norm (SN) had significant effects on Perceived Usefulness (PU). TA, SE, PE, and Facilitating Conditions (FC) had significant effects on Perceived Ease of Use (PEU). PU and PEU are significant predictors of Behavioral Intention (BI), and PEU had a positive effect on PU. In the qualitative study, the significant effects of these extension factors on PU and/or PEU were investigated further. Perceptions and concerns about using mobile social media for learning were analyzed based on the participants' interview data. On the basis of these results, recommendations are made to promote the use of mobile social media for learning by older adults. Specifically, teachers and colleges should: (a) select appropriate social media applications and set up relevant courses, and (b) supply inexpensive network service and high-quality learning support service. These research results have important implications for academic researchers, senior college managers, and teachers.

Tuberous sclerosis complex (TSC) is associated with TSC1 or TSC2 gene mutations resulting in hyperactivation of the mTORC1 pathway. This mTORC1 activation is associated with abnormal tissue development and proliferation such that in the kidney there are both solid tumors and cystic lesions. This review summarizes recent advances in tuberous sclerosis complex nephrology and focuses on the genetics and cell biology of tuberous sclerosis complex renal disease, highlighting a role of extracellular vesicles and the innate immune system in disease pathogenesis.

Mating behavior is a critically important component of poultry reproduction. Here, a total of 135 geese were selected, specifically, Sichuan white geese (Anser cygnoides), Zhedong white geese (Anser cygnoides), and Hungarian geese (Anser anser) (300-day-old), and the mating behavior was monitored daily from 6:00 a.m. to 6:00 p.m. during the 20-day observation period. The results showed that the mating process included mounting, female cooperation, and successful copulation. Overall, the three breeds preferred mating on land. More than thirty percent of the mating time was primarily concentrated from 4:00 p.m. to 6:00 p.m. in domesticated geese from Anser cygnoides, the corresponding values for Sichuan white geese and Zhedong white geese were 32.0% and 33.3%, respectively. The mating of the Hungarian geese usually took place in the morning. In addition, the frequency of successful copulation of Sichuan white geese and Zhedong white geese were 2.31 and 1.94 times per day, significantly greater than that of Hungarian geese (0.89 times). Furthermore, a significant positive correlation between successful copulation and laying rates (r = 0.985) or fertilization rates (r = 0.992) was observed in Hungarian geese. Taken together, the mating behaviors among the different breeds were mainly reflected in time preference and successful copulation frequency.

Due to its rich nutritional value, yak milk is an important food source in the alpine pastoral areas. However, yaks have a low milk yield. The Hippo pathway participates in cell proliferation and organ development. We aimed to determine the regulatory mechanism of this pathway in yak mammary cells. A greater understanding of how the expression of its essential genes influence the reproductive cycle could lead to improvements in lactation performance. The expression levels of the key genes MST1, LATS1, YAP1, and TEAD1 were detected by quantitative real-time PCR, Western blotting, and immunohistochemistry during the growth, lactation, and dry periods (GP, LP and DP, respectively). The MST1 and LATS1 mRNA and protein expression level was highest during GP and lowest during LP. The YAP1 and TEAD1 mRNA and protein expression level decreased from GP to LP and DP. MST1 and LATS1 were expressed in the cytoplasm whereas YAP1 and TEAD1 were expressed in the nucleus and cytoplasm, respectively. The differential expression of MST1, LATS1, YAP1, and TEAD1 expression in the yak mammary gland during different developmental stages strongly suggests that they play an important role in the regulation of developmental functions under different physiological conditions.

Selenium (Se) is an emerging versatile player in medicinal chemistry. The incorporation of Se into small molecules and natural products could have multiple benefits. However, the lack of efficient methods for the synthesis of Se-containing chemical library has greatly hindered the development of seleno-medicinal chemistry. With the aim to address this issue, we proposed the development of "clickable selenylation" reactions, which can be used in the synthesis of Se-containing in situ library and DNA-encoded library (SeDEL), thereby quickly producing ultra-large collections of Se-containing compounds and boosting the development of seleno-medicinal chemistry. This research paradigm can be concluded as "clickable selenylation chemistry development→in situ library construction/SeDEL synthesis→phenotype- or target-based screening→seleno-hit compound".

Signage plays a crucial part in passengers’ wayfinding process. This research proposes a general method to optimize and evaluate different signage alternatives based on building information modeling (BIM), virtual reality (VR) technologies, and passengers’ wayfinding behaviors. A wayfinding experiment with 46 participants was conducted in a virtual environment. In this experiment, relevant measurements, including wayfinding time, wrong turns, and stopping and looking, were selected to describe wayfinding behaviors. The results showed that the evaluation outcome of the new integration information signage was better than that of the old one, with its wayfinding measurements decreasing to varying degrees. Overall, the new integration information-signage solution is more efficient in guiding passengers. Moreover, this general method of optimizing and evaluating signage alternatives with BIM and VR technologies is also suitable for other indoor spaces. Practitioner Summary: To evaluate the old and new integration information signage in transport hubs, a virtual reality experiment was conducted in this study based on the wayfinding theory and the TOPSIS comprehensive evaluation approach. The results showed that the new integration information signage solution was more efficient than the old one in guiding passengers.

ObjectiveTo identify factors associated with visual acuity regression following successful treatment of anisometropic amblyopia.Design and methodThis was a retrospective cohort study. Database records for 100 and 61 children with anisometropic amblyopia who met at least one criterion for successful treatment proposed by the Pediatric Eye Disease Investigator Group (PEDIG) and had at least 1 year of follow-up data available after the criterion was met were analyzed. The study sample was split into two groups, those who regressed within 1 year of successful treatment (no longer met any of the PEDIG criteria for successful treatment) and those who did not. A two-step analysis involving a least absolute shrinkage and selection operator (LASSO) regression and a logistic regression were used to identify predictor variables for increased risk of regression. A broad range of clinical, perceptual, and demographic variables were included in the analyses.ResultsSixty-eight (42.5%) children regressed within 1 year of successful treatment. Among the 27 predictor variables considered within the statistical modeling process, the three most important for predicting treatment regression were the extent of amblyopic eye visual acuity improvement, age at first hospital visit and sex. Specifically, lower risk of regression was associated with larger amblyopic eye visual acuity improvement with treatment, younger age at initiation of treatment and female sex.ConclusionPatients who received treatment at a younger age and responded well to treatment had a lower risk of treatment regression. This pattern of results suggests that early detection of amblyopia and strategies that enhance treatment adherence may reduce the risk of treatment regression. The higher risk of regression in boys than girls that we observed may reflect known sex differences in brain development and /or sex differences in environment within our sample of children from South China.

Drought is a major driver of interannual variability in the gross primary productivity (GPP) of global terrestrial ecosystems, and drought recovery time has been widely used to assess ecosystem responses to drought. However, the response of the carbon-water coupled cycle to drought, especially changes in the correlation between drought intensity and carbon-water coupling throughout the recovery time, remains unclear. In this study, the Yellow River Basin (YRB) located mostly in drylands was the study area. We assessed the correlation between the standardized water vapour pressure deficit (VPD) and the water use efficiency of ecosystems (WUEe) and water use efficiency of canopies (WUEc) every month with the drought recovery time of GPP. We found that the drought intensity in the middle reach of the YRB (MYRB) was greater and the drought recovery time was longer than those in the upper reach (UYRB) and lower reach (LYRB) during the period from 2003 to 2017. In terms of the correlation between drought intensity and carbon-water coupling, the greater the VPD was, the lower the WUEc. In addition, the correlation of WUEc with VPD was higher than that of WUEe in most areas of the YRB, especially in the LYRB. On the watershed level, the correlation between the two types of WUE and VPD increased gradually with the recovery time, while the correlation between WUEc and VPD (mostly negative) changed more than the correlation between WUEe and VPD (mostly positive). Therefore, the response of WUEc to meteorological drought should be given more attention, especially during the middle and late stages of drought, since it exhibited an opposite signal compared to that of WUEe during drought recovery.

The aim of this in vitro study was to evaluate the effect of three final irrigants, namely QMix, MTAD and EDTA, combined with three irrigation techniques, namely conventional needle irrigation (CNI), passive ultrasonic irrigation (PUI) and photon-induced photoacoustic streaming (PIPS), on smear layer removal, dentin mineral content and microhardness in oval-shaped canals. 130 decoronated premolars with single, oval root canals were equally divided into1 blank control group and 12 treatment groups (n=10) according to the final irrigation protocols. Roots in treatment groups were instrumented with ProTaper Gold to size F4 and subjected to final irrigation. Smear layer removal was assessed by using a four-level scoring system under an environmental scanning electron microscope. Energy dispersive X-ray spectroscopy was performed to measure the dentin mineral content. Dentin microhardness was measured by Knoop microhardness testing. Statistical analysis of the data was performed by using Kruskal-Wallis test, followed by Dunn’s post hoc test with Bonferroni correction. PUI- and PIPS-activated QMix and EDTA removed smear layer more effectively than MTAD groups (p

BackgroundHigh-flow nasal oxygenation (HFNO) has been suggested as an alternative oxygenation method during procedural sedation. This randomized, non-inferiority trial evaluated the safety and efficacy of HFNO compared with laryngeal mask airway (LMA) in pediatric ambulatory oral surgery under deep sedation.MethodsIn total, 120 children aged 2–7 years (weight: 10–30 kg) were equally assigned into two groups, namely, HFNO with propofol total intravenous anesthesia infusion (HFNO-IV) or LMA with propofol total intravenous anesthesia infusion (LMA-IV). The primary objective was to monitor carbon dioxide (CO2) accumulation during perioperative surgery. Secondary objectives included monitoring transcutaneous oxygen saturation, grade exposure to the surgical field, perioperative adverse events, or other events. The predefined non-inferiority margin was 7 mmHg. During the COVID-19 pandemic, a novel WeChat applet was implemented to gather follow-up data after discharge.ResultsNon-inferiority could be declared for HFNO relative to LMA (mean difference in transcutaneous CO2 (TcCO2) = −1.4 mmHg, 95% CI: −2.9, 0.1 mmHg; P > 0.05). The pre-surgical TcCO2 of the HFNO-IV group (45.4 ± 4.5 mmHg) was similar to that of the LMA-IV group (44.0 ± 3.5 mmHg), within the clinically acceptable normal range. All the children maintained SpO2 levels of >97%. The surgical field exposure score of the HFNO group was significantly better than that of the LMA group. There was no significant difference between the two groups regarding risk or adverse events.ConclusionHFNO was not inferior to LMA for maintaining oxygenation and ventilation in patients undergoing pediatric ambulatory oral surgery under deep sedation under strict isolation from the oral cavity to the upper airway.

BackgroundLeft ventricular hypertrophy (LVH) is a common cardiovascular complication among chronic kidney disease (CKD) patients. The present study aimed to identify major independent risk factors and determine their contribution and relationship to LVH development.MethodsClinical and echocardiographic data of 2002 pre-dialytic CKD patients were retrospectively collected. Independent risk factors for LVH were identified using univariable and multivariable logistic regression. Nomograms together with restricted cubic splines method were employed to explore the effect size and possible non-linear relationship with regard to LVH. A simplified predictive model was constructed and its predictive ability was validated to demonstrate to which extent the identified risk factors accounted for LVH risk.ResultsMultivariable logistic regression identified age, body mass index (BMI), systolic blood pressure (SBP), eGFR and hemoglobin as independent influencing factors for LVH. Nomogram revealed BMI, SBP and hemoglobin concentration as the most important risk factors. Impaired renal function only showed obvious risk for LVH when eGFR declined below 30 ml/min/1.73 m2. Significant threshold effects existed for blood pressure and obesity that the risks for LVH doubled when SBP exceeded 160 mmHg or BMI exceeded 30 kg/m2. The predictive model constructed performed well on both the training and validation cohort using calibration curve, ROC curve and AUC value, with AUC above 0.80 for both the training cohort and the validation cohort.ConclusionsWith the help of nomogram model, we identified five independent factors that explain a large proportion of LVH risk in CKD patients. Among them, major contribution to LVH development was resulted from comorbidities and complications of CKD (hypertension, anemia, obesity) rather than eGFR reduction per se. Non-linear relationship and threshold relationship between eGFR, blood pressure, obesity and LVH risk were also identified.

Purpose: To evaluate the efficacy and safety of different types of anesthesia (LA, LA with IVA, and GA) used during PKP.Patients and methods: A total of 150 patients of single-level OTLF were prospectively included in this study from February 2019 to February 2020. They were randomly divided into three groups of 50 patients each and treated with GA, LA, or LA with IVA. Severity of back pain was measured preoperatively, intraoperatively, and 1 h, 1 day, 1 month, and 1 year postoperatively using VAS scores. The ODI was administered and the AHVB on lateral thoracolumbar radiographs was measured preoperatively and at 1 month and 1 year postoperatively. The MMSE was administered at 1 and 7 days postoperatively to monitor for the development of POCD.Results: 131 patients completed the full postoperative follow-up schedule. The average duration of surgery in the LA group was slightly longer than the other two groups. The intraoperative VAS score of the LA+IVA group was significantly lower than that of the LA group. The MMSE scores at 1 day and 1 week postoperatively were significantly decreased only in the GA group. The incidence of POCD was 45% (18/40) at 1 day and 5% (2/40) and at 1 week postoperatively in the GA group, whereas POCD was not observed in the other two groups. The GA group had the highest incidence of anesthesia-related adverse reactions.Conclusion: IVA with ropivacaine can effectively reduce intraoperative and early postoperative pain, shorten the duration of surgery, reduce surgery-related complications.

BackgroundCurrent evidence on the relationship between carotenoids and chronic kidney disease (CKD) patients are limited and controversial.MethodsData were obtained from the Nutrition and Health Examination Survey (NHANES) database and the NHANES Linked Mortality File, both from a nationally representative sample. Dietary intake was assessed through 24-h dietary recall, and information was available both on dietary and serum α-carotene, β-carotene, β-cryptoxanthin, lycopene, and lutein/zeaxanthin (combined) through the NHANES cycles used. We used multivariable Cox proportional hazards regression models to estimate the risk for all-cause mortality associated with carotene intakes and serum levels, adjusting for potential confounding factors.ResultsOf the 6,095 CKD participants, 1,924 subjects died (mean follow-up time, 8.1 years). After eliminating all the confounding factors, we found that high levels of total carotene (HR = 0.85, 95% CI, 0.75-0.97, P = 0.011) intakes at baseline were significantly associated with a lower risk of death. And the serum concentrations of carotenoid were also showing that a-carotene (HR = 0.77, 95%CI, 0.65–0.92, P = 0.002), beta-cryptoxanthin (HR = 0.83, 95%CI, 0.70–0.98, P = 0.019), lycopene (HR = 0.77, 95% CI, 0.65–0.91, P = 0.002), and lutein + zeaxanthin (HR = 0.82, 95% CI, 0.70–0.96, P = 0.002) was significantly associated with decreased all-cause mortality of CKD patients. The associations remained similar in the sensitivity analyses.ConclusionFindings suggest that high-level carotene dietary intake and the serum concentration were associated with a lower risk of mortality in the CKD population.

The distribution equipment is core to intelligent distribution and directly determines the reliable operation of distribution networks. The primary and secondary integrated switchgear is an integration of the traditional primary switch, sensor, and secondary controlling terminal. It is influenced by temperature, pressure, electromagnetic interference, etc. To guarantee the quality of the primary and secondary integrated switchgear which is accessed to the power grid, the inspection outline of the primary and secondary integrated switchgear in the State Power Grid includes the structure and configuration, appearance inspection, insulation resistance test, power frequency voltage withstand test, and lightning impulse test.

Due to the limitation of hardware and software, the existing online monitoring system of distribution transformer has the defect of long response time. Therefore, the design of online monitoring system of distribution transformer based on cloud side end collaboration of Internet of Things is proposed. The online monitoring system of distribution transformer is designed based on the cloud side end collaborative concept of Internet of Things. The hardware unit is transformer data acquisition unit, microprocessor selection unit and wireless communication unit, and the software module is transformer data processing module, transformer monitoring and alarm module and communication protocol module. Through the design of hardware and software, the online monitoring system of transformer is realized. The reaction time of the design system is 0.98–1.44 s then the experimental results show that: compared with the existing system, the response time of the design system is shorter, which fully proves that the monitoring performance of the design system is better, and it is suitable for vigorously promoting and using.

Giant pandas consume different structural parts of bamboo (shoots, leaves and culms) during different seasons. Previous research showed different bamboo parts have varying nutritional content and that a long-term diet consisting of a single part of bamboo resulted in remarkable metabolic changes within captive giant pandas. However, the effects on the gut microbiome of giant pandas, as a result of a single bamboo part diet, have not been investigated. Here, we evaluated the changes in gut microbial communities based on single bamboo part diets and their potential implications by using 16S rRNA gene-based amplicon sequencing and metagenome shotgun sequencing. We found that the composition and function of the gut microbiome from captive giant pandas fed exclusively culms were significantly different from that of individuals fed shoots or leaves. During the culm feeding period, the gut microbiome showed strongest digestive capabilities for cellulose, hemicellulose and starch, and had the highest potential abilities for the biosynthesis of bile acids, fatty acids and amino acids. This suggests the microbiome aids in breaking down culm, which is more difficult for giant pandas to digest, as a means to compensate for the nutrient poor content of the culm. Genes related to fatty acid metabolism and tricarboxylic acid cycle enzymes were more abundant during the leaf stage diet than that in the shoot and culm stages. Thus, the microbiome may help giant pandas, which typically have low lipase levels, with fat digestion. These results illustrate that adaptive changes in the gut microbiome community and function may be an important mechanism to aid giant panda digestion when consuming different structural parts of bamboo. Supplementary Information The online version contains supplementary material available at 10.1007/s00284-021-02503-y.

We designed and synthesized a carboxylic acid-functionalized coumarin derivative sensor F3, which has a dual-channel response to CN− in DMSO/H2O (2:3, v/v) solution with a fluorescence detection limit of 3.09 × 10–8 M. After adding AcOH to F3-CN system, the fluorescence of the system recovered to its initial state, so F3 is a reversible fluorescence chemical sensor. Based on this, we applied it to the ultrasensitive IMPLICATION logic gate. In addition, we made a test strips that can be used to quickly and conveniently detect CN−. According to various characteristics and applications of F3, it can be concluded that sensor F3 is a promising sensor. The detection methods have strong anti-interference ability, convenient use, fast response speed and low detection limit.