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Abstract Human visual neurons rely on event-driven, energy-efficient spikes for communication, while silicon image sensors do not. The energy-budget mismatch between biological systems and machine vision technology has inspired the development of artificial visual neurons for use in spiking neural network (SNN). However, the lack of multiplexed data coding schemes reduces the ability of artificial visual neurons in SNN to emulate the visual perception ability of biological systems. Here, we present an artificial visual spiking neuron that enables rate and temporal fusion (RTF) coding of external visual information. The artificial neuron can code visual information at different spiking frequencies (rate coding) and enables precise and energy-efficient time-to-first-spike (TTFS) coding. This multiplexed sensory coding scheme could improve the computing capability and efficacy of artificial visual neurons. A hardware-based SNN with the RTF coding scheme exhibits good consistency with real-world ground truth data and achieves highly accurate steering and speed predictions for self-driving vehicles in complex conditions. The multiplexed RTF coding scheme demonstrates the feasibility of developing highly efficient spike-based neuromorphic hardware.

Abstract Background Transarterial chemoembolization (TACE) is the standard treatment for intermediate‐stage hepatocellular carcinoma (HCC). Given the lack of specific recommendations for conventional TACE (cTACE) and drug‐eluting bead TACE (DEB‐TACE) in patients having unresectable HCC with tumor infiltrating the common hepatic duct or the first‐order branch of the bile ducts (B1‐type bile duct invasion; B1‐BDI) after biliary drainage, we retrospectively compared the safety and efficacy of DEB‐TACE with cTACE in this patient population. Materials and Methods Using data from five tertiary medical centers (January 2017–December 2021), we compared complications, overall survival (OS), time to progression (TTP), and tumor response rate between patients having unresectable HCC with B1‐BDI who underwent DEB‐TACE or cTACE after successful biliary drainage. X‐tile software calculated the pre‐TACE total bilirubin (TBil) cutoff value, indicating optimal timing for sequential TACE after drainage. Propensity score matching (PSM) was performed. Results The study included 108 patients with unresectable HCC (B1‐BDI) who underwent DEB‐TACE and 114 who received cTACE as initial treatment. After PSM (n = 53 for each group), the DEB‐TACE group had a longer TTP (8.9 vs. 6.7 months, p = 0.038) and higher objective response rate (64.2% vs. 39.6%, p = 0.011) than did the cTACE group, although OS was comparable (16.7 vs. 15.3 months, p = 0.115). The DEB‐TACE group exhibited fewer post‐procedural increments in the mean albumin‐bilirubin score, TBil, and alanine aminotransferase (ALT), along with a significantly lower incidence of serious adverse events within 30 days (hepatic failure, ALT increase, and TBil increase) than the cTACE group (all p 99 μmol/L) had poorer OS in both groups (p

Abstract Background Manual therapy (MT) is frequently used in combination with management of osteoarthritis of the knee, but there is no consensus on the exact efficacy of this treatment strategy. The purpose of this systematic review and meta-analysis was to evaluate the pain relief and safety of MT for treatment of knee osteoarthritis (KOA). Methods Randomized controlled trials evaluating MT in patients with KOA in major English and Chinese journals were searched in the following databases: Wanfang, China Science and Technology Journal Database (VIP database), China National Knowledge Infrastructure (CNKI), PubMed, Embase, Web of Science, and the Cochrane Library databases through June 2023. The methodological quality and quality of evidence of the included studies were assessed using Cochrane’s risk-of-bias 2 (ROB 2) tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Data analysis was performed using Stata version 15.0 software. After use of Galbraith plots to exclude studies that could lead to heterogeneity, random effects models were used to analyze the remaining data and test the consistency of the findings. We used meta-regression to assess the effect of treatment period, patient age, and sex ratio on outcomes. Funnel plots and Egger’s test were used to evaluate publication bias. Sensitivity analyses were used to determine the reliability of the results. Results A total of 25 studies, with 2376 participants, were included in this review. The overall methodological quality of the included studies was limited. Our findings suggest that MT has a positive impact on pain relief outcomes in KOA patients. The meta-analysis showed that MT was superior to usual care (SMD = 2.04, 95% CI 0.94, 3.14, I 2 = 96.3%; low evidence quality) and exercise (SMD = 1.56, 95% CI 0.41, 2.71, I 2 = 96.3%; low evidence quality) for reducing pain. In terms of improvement in visual analogue scale (VAS) scores, MT treatment beyond 4 weeks (SMD = 1.56, 95% CI 0.41, 2.71, I 2 = 96.3%) may be superior to treatments less than or equal to 4 weeks (SMD = 1.24, 95% CI 0.56, 1.95, I 2 = 94.7%). No serious adverse events associated with MT were reported. Conclusions MT may be effective at reducing pain in patients with KOA and may be more effective after a 4-week treatment period. Compared with usual care and exercise therapy, MT may be superior at reducing KOA pain in the short term (9 weeks), but its long-term efficacy requires careful consideration of evidence-based outcomes. MT appears to be safe for KOA patients, though clinicians should inform patients of the potential risk of MT-related adverse events.

Accurately identifying vulnerable transmission lines in power system is paramount for averting cascading failures and guaranteeing the safety and stability of power grid operations. This paper introduces a vulnerability assessment method for transmission lines in power system, which incorporates network topology and system operational states. The enhanced degree index is used to assess the lines’ structural vulnerability. In order to evaluate the variations in power flow during regular system operation or following a failure, the improved power transfer distribution factor (PTDF) and line outage distribution factor (LODF) are used to build the line operational state vulnerability indices. To mitigate the limitations of a single assignment method, subjective indicator weights are determined using the hierarchical analysis method, while objective weights are calculated using the entropy value method. These weights are subsequently distributed using game theory. The effectiveness of the proposed method is verified through simulations on the IEEE 39-bus and IEEE 118-bus systems. The experimental results show that the proposed method has higher precision compared with other methods. And the new index can identify the vulnerable lines of the system, either due to their position in the network or by the power they transmit along the network.

Abstract Rapid mass transfer in solid-solid reactions is crucial for catalysis. Although phoretic nanoparticles offer potential for increased collision efficiency between solids, their implementation is hindered by limited interaction ranges. Here, we present a self-driven long-range electrophoresis of organic nanocrystals facilitated by a rationally designed photogenerated outer electric field (OEF) on their surface. Employing perylene-3,4,9,10-tetracarboxylic dianhydride (PTCDA) molecular nanocrystals as a model, we demonstrate that a directional OEF with an intensity of 13.6-0.4 kV m−1 across a range of 25–200 μm. This OEF-driven targeted electrophoresis of PTCDA nanocrystals onto the microplastic surface enhances the activity for subsequent decomposition of microplastics (196.8 mg h−1) into CO2 by solid-solid catalysis. As supported by operando characterizations and theoretical calculations, the OEF surrounds PTCDA nanocrystals initially, directing from the electron-rich (0 1 1) to the hole-rich $$(11\bar{2})$$ ( 11 2 ¯ ) surface. Upon surface charge modulation, the direction of OEF changes toward the solid substrate. The OEF-driven electrophoretic effect in organic nanocrystals with anisotropic charge enrichment characteristics indicates potential advancements in realizing effective solid-solid photocatalysis.

Introduction Hypertension and rising serum uric acid (sUA) played a pivotal role in the development of Chronic Kidney Disease (CKD). This study investigates the interactive effect of sUA and hypertension on CKD and identifies the optimal threshold of sUA among individuals with and without hypertension in the Chinese community population.Materials and methods The study included 4180 individuals aged 45–85 years, derived from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2015. Additionally, a hospital-based study enrolled subjects in the Department of Nephrology at Zhongshan Hospital, China from January 1, 2019, to December 31, 2021. The interaction effect analysis were used to assess the impact of sUA and hypertension on CKD. We also compared the distribution of sUA and the CKD risk in community populations, distinguishing between those with and without hypertension. For the hospital-based population, kidney injury was marked by a KIM-1 positive area.Results Our results indicate a higher prevalence of CKD in the community population with hypertension (10.2% vs. 3.9%, p

Study region: Tributaries of the Yellow River, Upper Fen River Basin, China. Study focus: The current research analyzed the streamflow changes resulting from interactions between climate and land use/cover (LULC) under Shared Socioeconomic Pathways (SSPs). The study utilized six General Circulation Models (GCMs) from Climate Model Intercomparison Project-6 (CMIP6) and the Land-Use Harmonization 2 (LUH2) dataset as forcing inputs for the Soil and Water Assessment Tool (SWAT) model. This study aims to quantitatively access the alone and combined effects of climate and LULC changes on future streamflow. New hydrologic insights for the region: The change in future streamflow under the combined effect of climate and LULC exceeded the change observed under the influence of climate or LULC alone in the Fenhe Reservoir Hydrological Station Control Basin (FRCB). The contributions were 72.5 % (SSP126), 73.1 % (SSP245), and 77.2 % (SSP585), respectively. Climate change showed a stronger correlation with future streamflow than LULC changes. Precipitation had the most direct effect on streamflow among the meteorological factors. The expansion of urban land contributes to an increase in streamflow in the source area and southwest tributaries of the FRCB to some extent. The future streamflow will gradually increase in mid-century (2045–2066) under low to high SSP. Adapting effective strategies for the FRCB, can be helpful in water resources planning and management.

Study region: China (excluding Hong Kong, Macao, and Taiwan). Study focus: Few studies have nationally evaluated China's spatiotemporal distribution of future runoff and per capita water resources (PCWR). Based on the SSP1-RCP2.6, SSP3-RCP7.0, and SSP5-RCP8.5 scenarios, the future runoff and PCWR in China under global warming levels of 1.5–4.5 °C are predicted. The calibrated Water and Energy Budget-based Distributed Hydrological Model with improved Snow physics for Global simulation (WEB-DHM-SG) was driven by the Inter-Sectoral Impact Model Intercomparison Project 3b (ISIMIP3b) protocol data to simulate runoff and future population data were used to predict the PCWR. Furthermore, the pre-industrial scenario was compared with future development scenarios to analyse the impact of human-induced climate change (HICC). New hydrological insights for the region: The average annual runoff would increase by 6.9–27.6 % nationally and increase in 28 provinces, whereas it would decrease in the other 3 provinces. Seasonal runoff decreased in winter but increased in the other three seasons. Runoff is affected by HICC by 4.1–30.0 %. The national average PCWR would change by −7.5 % to 20.4 %. Water shortage conditions might be further intensified in nine provinces but relatively alleviated in the other 22 provinces. Our results can provide scientific support for the future national and regional water planning and management in China.

Indoor Optical Wireless Communication (OWC) provides a promising solution for high-capacity, low-latency, and electromagnetic interference-resistant wireless communication. Over the past decade, there has been extensive research addressing key challenges in indoor OWC. This article provides an overview of the current development status, key technologies, and challenges faced in the field of indoor OWC. Furthermore, at the end of this overview, an experimental demonstration of an indoor non-line-of-sight (NLOS) OWC system utilizing a spatial light modulator (SLM) for beam steering is demonstrated, which is expected to inspire research on related technologies.

Introduction Non-pharmacological interventions play a crucial role in the management of non-specific chronic low back pain (NSCLBP). One prime example is Tuina, a traditional Chinese manual therapy that incorporates pressing, kneading and rubbing techniques to alleviate physical discomfort and enhance overall well-being. It serves as a widely used technique in China and other East Asian countries. However, the effectiveness and safety of Tuina for managing NSCLBP have not been substantiated through rigorous clinical research. We sought to carry out a randomised controlled trial with an open-label design, blinded assessors and parallel arms to assess the effectiveness and safety of Tuina as a treatment for NSCLBP. The trial aims to provide high-quality evidence regarding the efficacy and safety of Tuina in improving outcomes for patients with NSCLBP.Methods and analysis A total of 150 patients aged 18–60 years with NSCLBP will be recruited. Participants will be randomly assigned to one of the two groups. Both groups will receive standard health education. In addition, the treatment group will receive Tuina therapy, while the control group will participate in core stability exercises. Each group will undergo a total of 18 interventions over 6 weeks, with the interventions administered three times per week. The primary outcome measure is the patient’s pain intensity, assessed using the Numerical Rating Scale, at week 6 following randomisation. Secondary outcomes encompass disability (measured by the Roland-Morris Disability Questionnaire), quality of life (assessed using the EuroQoL-5 dimensions questionnaire), adverse emotions (evaluated with the Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia and Depression Anxiety Stress Scale), biomechanical outcomes, socioeconomic indicators (medication use, healthcare utilisation and absenteeism), patient satisfaction, treatment adherence and other relevant factors.The statistical analysis will follow the intention-to-treat principle. Two-way repeated measures analysis of variance will be used to compare the clinical data across different time points within both groups.Ethics and dissemination The study protocol has received approval from the Ethics Committee of Shuguang Hospital, Shanghai University of Traditional Chinese Medicine (2023-1366-133-01). All study participants will be required to give written informed consent. The findings of the study will be submitted to a peer-reviewed journal for publication and presented at scientific conferences. Additionally, the participants will receive copies of the results.Trial registration number ChiCTR2300076257.

Abstract Background Chronic kidney disease (CKD) is a global public health concern. Therefore, to provide timely intervention for non-hospitalized high-risk patients and rationally allocate limited clinical resources is important to mine the key factors when designing a CKD prediction model. Methods This study included data from 1,358 patients with CKD pathologically confirmed during the period from December 2017 to September 2020 at Zhongshan Hospital. A CKD prediction interpretation framework based on machine learning was proposed. From among 100 variables, 17 were selected for the model construction through a recursive feature elimination with logistic regression feature screening. Several machine learning classifiers, including extreme gradient boosting, gaussian-based naive bayes, a neural network, ridge regression, and linear model logistic regression (LR), were trained, and an ensemble model was developed to predict 24-hour urine protein. The detailed relationship between the risk of CKD progression and these predictors was determined using a global interpretation. A patient-specific analysis was conducted using a local interpretation. Results The results showed that LR achieved the best performance, with an area under the curve (AUC) of 0.850 in a single machine learning model. The ensemble model constructed using the voting integration method further improved the AUC to 0.856. The major predictors of moderate-to-severe severity included lower levels of 25-OH-vitamin, albumin, transferrin in males, and higher levels of cystatin C. Conclusions Compared with the clinical single kidney function evaluation indicators (eGFR, Scr), the machine learning model proposed in this study improved the prediction accuracy of CKD progression by 17.6% and 24.6%, respectively, and the AUC was improved by 0.250 and 0.236, respectively. Our framework can achieve a good predictive interpretation and provide effective clinical decision support.

Abstract Metal halide perovskites are promising for next-generation flexible photodetectors owing to their low-temperature solution processability, mechanical flexibility, and excellent photoelectric properties. However, the defects and notorious ion migration in polycrystalline metal halide perovskites often lead to high and unstable dark current, thus deteriorating their detection limit and long-term operations. Here, we propose an electrical field modulation strategy to significantly reduce the dark current of metal halide perovskites-based flexible photodetector more than 1000 times (from ~5 nA to ~5 pA). Meanwhile, ion migration in metal halide perovskites is effectively suppressed, and the metal halide perovskites-based flexible photodetector shows a long-term continuous operational stability (~8000 s) with low signal drift (~4.2 × 10−4 pA per second) and ultralow dark current drift (~1.3 × 10−5 pA per second). Benefitting from the electrical modulation strategy, a high signal-to-noise ratio wearable photoplethysmography sensor and an active-matrix photodetector array for weak light imaging are successfully demonstrated. This work offers a universal strategy to improve the performance of metal halide perovskites for wearable flexible photodetector and image sensor applications.

Abstract Background Tubulointerstitial lesions play a pivotal role in the progression of IgA nephropathy (IgAN). Elevated N-acetyl-beta-D-glucosaminidase (NAG) in urine is released from damaged proximal tubular epithelial cells (PTEC) and may serve as a biomarker of renal progression in diseases with tubulointerstitial involvement. Methods We evaluated the predictive value of urinary NAG (uNAG) for disease progression in 213 biopsy-proven primary IgAN patients from January 2018 to December 2019 at Zhongshan Hospital, Fudan University. We compared the results with those of serum cystatin C (sCysC). Results Increased uNAG and sCysC levels were associated with worse clinical and histological manifestations. Only uNAG level was independently associated with remission status after adjustment. Patients with high uNAG levels (> 22.32 U/g Cr) had a 4.32-fold greater risk of disease progression. The combination of baseline uNAG and clinical data may achieve satisfactory risk prediction in IgAN patients with relatively preserved renal function (eGFR ≥ 60 ml/min/1.73 m2, area under the curve [AUC] 0.760). Conclusion Our results suggest that uNAG is a promising biomarker for predicting IgAN remission status.

Cryoablation (CRA) and microwave ablation (MWA) are two main local treatments for hepatocellular carcinoma (HCC). However, which one is more curative and suitable for combining with immunotherapy is still controversial. Herein, CRA induced higher tumoral PD-L1 expression and more T cells infiltration, but less PD-L1highCD11b+ myeloid cells infiltration than MWA in HCC. Furthermore, CRA had better curative effect than MWA for anti-PD-L1 combination therapy in mouse models. Mechanistically, anti-PD-L1 antibody facilitated infiltration of CD8+ T cells by enhancing the secretion of CXCL9 from cDC1 cells after CRA therapy. On the other hand, anti-PD-L1 antibody promoted the infiltration of NK cells to eliminate PD-L1highCD11b+ myeloid cells by antibody-dependent cell-mediated cytotoxicity (ADCC) effect after CRA therapy. Both aspects relieved the immunosuppressive microenvironment after CRA therapy. Notably, the wild-type PD-L1 Avelumab (Bavencio), compared to the mutant PD-L1 atezolizumab (Tecentriq), was better at inducing the ADCC effect to target PD-L1highCD11b+ myeloid cells. Collectively, our study uncovered the novel insights that CRA showed superior curative effect than MWA in combining with anti-PD-L1 antibody by strengthening CTL/NK cell immune responses, which provided a strong rationale for combining CRA and PD-L1 blockade in the clinical treatment for HCC.

The high dark current of perovskite photodetectors hinders the full potential of perovskites as active material for X-ray detectors. Here, Jin et al. provide a strategy to reduce the dark current to zero and massively enhance the signal-to-noise ratio of perovskite X-ray detectors and photodetectors.

Abstract Aims To investigate the efficacy and safety of lenvatinib and idarubicin‐loaded drug‐eluting beads transarterial chemoembolization (IDADEB‐TACE) in primary advanced hepatocellular carcinoma (HCC). Methods This retrospective study included patients with primary advanced HCC who received either lenvatinib monotherapy or lenvatinib plus IDADEB‐TACE as first‐line treatment from September 2019 to September 2020 at three institutes. Overall survival (OS), time to progression (TTP), objective response rate (ORR), and adverse events were compared. Propensity score‐matching was used to reduce the influence of confounding factors on the outcomes. Results The study reviewed 118 patients who received lenvatinib plus IDADEB‐TACE (LIDA group) and 182 who received lenvatinib alone (LEN group). After propensity score‐matching, 78 pairs of patients remained. Compared to patients in the LEN group, those in the LIDA group had better post‐treatment ORR (57.7% vs. 25.6%, p

Abstract It is vital to acquire real‐time pH signals with high resolution as pH variation can reflect important information regarding health status and physiological environment. Field‐effect transistor (FET)‐based biosensors (bio‐FETs), a kind of potentiometric sensor, are being rapidly developed for pH detection due to their advantages of high sensitivity, low temperature dependence, and high portability. More importantly, the high scalability of bio‐FETs renders them applicable for achieving high spatial resolution in pH sensing. In this review paper, the design, operation principle, and critical characteristics of the FET‐based pH sensor are introduced. Then, the recent progress in pH mapping with FET sensor arrays, including static array where a sensor pixel is directly addressed by wiring, and active‐matrix array where a sensor pixel is accessed by additional switching FETs, is presented. Last, typical examples of pH sensor arrays in biomedical applications, such as health monitoring and DNA sequencing and elongation are presented.

IntroductionLumbar disc herniation, a chronic degenerative disease, is one of the major contributors to chronic low back pain and disability. Although many studies have been conducted in the past on brain function in chronic low back pain, most of these studies did not classify chronic low back pain (cLBP) patients according to their etiology. The lack of etiologic classification may lead to inconsistencies between findings, and the correlation between differences in brain activation and clinical symptoms in patients with cLBP was less studied in the past.MethodsIn this study, 36 lumbar disc herniation patients with chronic low back pain (LDHCP) and 36 healthy controls (HCs) were included to study brain activity abnormalities in LDHCP. Visual analogue scale (VAS), oswestry disability index (ODI), self-rating anxiety scale (SAS), self-rating depression scale (SDS) were used to assess clinical symptoms.ResultsThe results showed that LDHCP patients exhibited abnormally increased and diminished activation of brain regions compared to HCs. Correlation analysis showed that the amplitude of low frequency fluctuations (ALFF) in the left middle frontal gyrus is negatively correlated with SAS and VAS, while the right superior temporal gyrus is positively correlated with SAS and VAS, the dorsolateral left superior frontal gyrus and the right middle frontal gyrus are negatively correlated with VAS and SAS, respectively.ConclusionLDHCP patients have brain regions with abnormally increased and abnormally decreased activation compared to healthy controls. Furthermore, some of the abnormally activated brain regions were correlated with clinical pain or emotional symptoms.

The frequent start–stop scheme in the operation management of large pumping stations causes several problems, e.g., energy consumption and a potential safety hazard. We therefore established a mathematical model for the optimal operation of a large-scale pumping station considering the start-stop loss of machine. The objectives of the optimization model included electricity charges for a pumping station operation and the start-stop loss of a pumping station. The blade angle and start-stop scheme were taken into account as the double-decision variables, while the target water extraction (equality constraint), start-stop scheme, and power were the constraint conditions. A combination of an orthogonal experiment and a 0-1 integer programming algorithm was proposed to explore the optimal solution of the model. A real case of a single-unit pump station in China was applied to prove the effectiveness of the algorithm. The results showed that the optimization efficiency of the proposed algorithm was 4%–10% higher than that of the genetic algorithm. Additionally, the maximum optimization benefit was obtained when there were fewer than three start-stops during the operation process. The proposed algorithm provided a reference for similar complex nonlinear models. HIGHLIGHTS The start-stop loss of a pumping station was introduced to develop the optimization model.; A combination of an orthogonal experiment and a 0-1 integer programming algorithm was proposed.; The proposed algorithm could deal with the model with equality constraints.;

Abstract Background The risk of perioperative complications remains high in patients with intertrochanteric fractures. Immobilization after injury may predispose these patients to deep vein thrombosis (DVT) while waiting for surgery. The aims of this study were to determine the incidence of preoperative DVT in patients with intertrochanteric fractures and identify independent risk factors. Methods This retrospective study included patients with intertrochanteric fractures waiting for surgical interventions at our institution from June 2018 to December 2020. All patients received pharmacologic thromboprophylaxis after admission and ultrasound screening for DVT in both lower limbs before surgery. Demographic, clinical and laboratory data of these patients were collected to perform univariate analysis first. Subsequently, factors with a significant difference in univariate analysis were introduced into the multivariate logistic regression analysis to determine the independent risk factors for preoperative DVT. Results A total of 266 patients were enrolled in this study. Seventy-one patients (26.7%) developed DVTs before surgery. The majority of DVTs were distal types (91.5%). There were 40 patients with DVTs only in the affected limb, 7 patients with DVTs only in the unaffected limb, and 24 patients with DVTs in both lower limbs. Advanced age, female, prolonged period from injury to admission, combined cranial trauma, shorter thrombin time, increased level of D-dimer and lower level of albumin proved to be the independent risk factors for preoperative DVT. Conclusions We observed a high incidence of preoperative DVT in patients with intertrochanteric fractures. Identification of patients at high risk may improve the prevention and treatment of preoperative DVT in this population.

Simultaneous spatio-temporal description of tumor microvasculature, blood-brain barrier, and immune activity is pivotal to understanding the evolution mechanisms of highly aggressive glioblastoma, one of the most common primary brain tumors in adults. However, the existing intravital imaging modalities are still difficult to achieve it in one step. Here, we present a dual-scale multi-wavelength photoacoustic imaging approach cooperative with/without unique optical dyes to overcome this dilemma. Label-free photoacoustic imaging depicted the multiple heterogeneous features of neovascularization in tumor progression. In combination with classic Evans blue assay, the microelectromechanical system based photoacoustic microscopy enabled dynamic quantification of BBB dysfunction. Concurrently, using self-fabricated targeted protein probe (αCD11b-HSA@A1094) for tumor-associated myeloid cells, unparalleled imaging contrast of cells infiltration associated with tumor progression was visualized by differential photoacoustic imaging in the second near-infrared window at dual scale. Our photoacoustic imaging approach has great potential for tumor-immune microenvironment visualization to systematically reveal the tumor infiltration, heterogeneity, and metastasis in intracranial tumors.

Abstract Background We aimed to explore the association between long-term drinking behavior change patterns with hyperuricemia (HUA) in Chinese community adults. Methods This study was designed as a community-based unbalanced cohort study involving 4127 adults aged between 18 ~ 75 years, derived from the China Health and Nutrition Survey (CHNS) in 1997 and 2009. Drinking behavior change patterns were categorized into: never drinking, change to drinking, quitting drinking, and continued drinking. The alcoholism, type, and frequency of drinking were further categorized. We applied logistic regression models to explore the associations between drinking behavior change patterns and HUA. Results The average age of the participants was 54.6 (± 11.3) years and 47.8% were male. The overall prevalence of HUA was 15.5%. Drinking behavior change patterns of quitting (aOR 1.8; 95% CI 1.1 ~ 2.8) and continued drinking (aOR 2.0; 95% CI 1.3 ~ 3.0) were positively associated with high risks of HUA in the male participants. Early drinking behaviors such as liquor intake (aOR 1.8; 95% CI 1.4 ~ 2.5) and high consumption or frequency showed a positive correlation with HUA. Of note, heavy alcoholism (aOR 2.0; 95% CI 1.4 ~ 2.8) and daily drinking (aOR 2.5; 95% CI 1.7 ~ 3.6) had the highest risks of HUA. Furthermore, in the male participants, the association between early total alcohol intake and HUA was more pronounced at 18 standard drinks intake, with a stable increasing trend. In contrast, no statistical correlation was observed between the drinking behaviors and HUA in the female participants. Conclusions Drinking behavior change patterns of quitting and continued drinking are strongly associated with increased risks of HUA in males. The risks emanated from early drinking behaviors such as liquor drinking, high drinking frequency, and alcohol consumption. Although quitting drinking was associated with lower HUA risks compared to continued drinking, it still presented an undeniable risk for HUA.

Abstract Background Displaced patella fracture is commonly treated with open reduction and internal fixation (ORIF). Wound complications after surgery often lead to prolonged hospitalization and dissatisfaction of patients. Periarticular adiposity and swelling may be associated with wound complications. The purpose of this study is to determine the relationship between periarticular soft tissue thickness and wound complications after ORIF of patella fractures. Methods We retrospectively studied 237 patients undergoing ORIF for patella fractures from June 2017 to February 2021 at our institution. We established periarticular soft tissue thickness ratio (PSTTR) to evaluate soft tissue status on lateral knee X-ray radiographs. Univariate analysis was performed to identify the association between PSTTR and postoperative wound complication. A receiver-operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of PSTTR. Results The incidence of postoperative wound complication was 10.5%. Minor wound complication occurred in 24 patients, and major wound complication occurred in one patient. The average femoral PSTTR (fPSTTR) was 0.94 ± 0.17 and the average tibial PSTTR (tPSTTR) was 0.66 ± 0.16. fPSTTR proved to be associated with postoperative wound complication. In the ROC analysis of fPSTTR predicting postoperative wound complication, the area under curve (AUC) was 0.676, which indicated a moderate predictive value. Conclusions PSTTR was a feasible method to assess periarticular soft tissue. The increased fPSTTR was associated with wound complications after ORIF of patella fractures.

Objective: Females are more vulnerable to renal impairment (RI) in people living with HIV (PLWH), but few studies have examined sex disparity in the association of HIV serostatus with RI. Methods: In total, 2,101 PLWH on antiretroviral treatment (ART) and 4,202 HIV-negative people were selected and frequency matched in 1:2 ratio by sex and age categories. RI was defined as estimated glomerular filtration rate (eGFR)

Abstract Long non-coding RNAs (lncRNAs) regulate numerous biological processes involved in both development and carcinogenesis. Hippo-YAP/TAZ signaling, a critical pathway responsible for organ size control, is often dysregulated in a variety of cancers. However, the nature and function of YAP/TAZ-regulated lncRNAs during tumorigenesis remain largely unexplored. By profiling YAP/TAZ-regulated lncRNAs, we identified SFTA1P as a novel transcriptional target and a positive feedback regulator of YAP/TAZ signaling. Using non-small cell lung cancer (NSCLC) cell lines, we show that SFTA1P is transcriptionally activated by YAP/TAZ in a TEAD-dependent manner. Functionally, knockdown of SFTA1P in NSCLC cell lines inhibited proliferation, induced programmed cell death, and compromised their tumorigenic potential. Mechanistically, SFTA1P knockdown decreased TAZ protein abundance and consequently, the expression of YAP/TAZ transcriptional targets. We provide evidence that this phenomenon could potentially be mediated via its interaction with TAZ mRNA to regulate TAZ translation. Our results reveal SFTA1P as a positive feedback regulator of Hippo-YAP/TAZ signaling, which may serve as the molecular basis for lncRNA-based therapies against YAP/TAZ-driven cancers.

BackgroundThe burden of gout is increasing worldwide, which places a heavy burden on society and healthcare systems. This study investigates the independent effects of age, period, and cohort on the gout prevalence from 1990 to 2019 in China, compares these effects by gender and then predicts the future burden of gout over the next decade.MethodsThe data were obtained from the Global Burden of Disease (GBD) study in 2019. Joinpoint regression model was employed to calculate the annual percentage change (APC) in gout prevalence, and the age-period-cohort analysis was utilized to estimate the independent effects of age, period, and cohort. ARIMA model was extended to predict the gout epidemic in 2020–2029.ResultsIn 2019, there were 16.2 million cases of gout in China, with an age-standardized prevalence rate (ASPR) of 12.3‰ and 3.9‰ in men and women, respectively. During 1990–2019, the ASPR of gout was increasing significantly, with an average APC of 0.9%. The periods of 2014–2017 and 2001–2005 were “joinpoint” for men and women (APC: 6.3 and 5.6%). The age-period-cohort analyses revealed that the relative risk (RR) of developing gout increased with age, peaking at 70–74 years in men (RRage(70−74) = 162.9) and 75–79 years in women (RRage(75−79)=142.3). The period effect trended upward, with a more rapid increase in women (RRperiod(2019) = 2.31) than men (RRperiod(2019) = 2.23). The cohort effect generally peaked in the earlier cohort born in 1905–1909 for both sexes. Gout prevalence showed a strong positive correlation with the consumption of meat and aquatic products (rmeat = 0.966, raquaticproducts = 0.953). Within 2029, the ASPR of gout was projected to be 11.7‰ and 4.0‰ in men and women, respectively.ConclusionThe prevalence of gout is increasing at an alarming rate in China; thus, it is necessary to provide targeted health education, regular screening, and accessible urate-lowering therapy healthcare to prevent and protect against gout in China, particularly in older women.

Abstract Metal oxide thin-films transistors (TFTs) produced from solution-based printing techniques can lead to large-area electronics with low cost. However, the performance of current printed devices is inferior to those from vacuum-based methods due to poor film uniformity induced by the “coffee-ring” effect. Here, we report a novel approach to print high-performance indium tin oxide (ITO)-based TFTs and logic inverters by taking advantage of such notorious effect. ITO has high electrical conductivity and is generally used as an electrode material. However, by reducing the film thickness down to nanometers scale, the carrier concentration of ITO can be effectively reduced to enable new applications as active channels in transistors. The ultrathin (~10-nm-thick) ITO film in the center of the coffee-ring worked as semiconducting channels, while the thick ITO ridges (>18-nm-thick) served as the contact electrodes. The fully inkjet-printed ITO TFTs exhibited a high saturation mobility of 34.9 cm2 V−1 s−1 and a low subthreshold swing of 105 mV dec−1. In addition, the devices exhibited excellent electrical stability under positive bias illumination stress (PBIS, ΔV th = 0.31 V) and negative bias illuminaiton stress (NBIS, ΔV th = −0.29 V) after 10,000 s voltage bias tests. More remarkably, fully printed n-type metal–oxide–semiconductor (NMOS) inverter based on ITO TFTs exhibited an extremely high gain of 181 at a low-supply voltage of 3 V, promising for advanced electronics applications.

Abstract In view of the resonance phenomenon caused by LCL filter introduced by voltage pulse width modulation (PWM) rectifier as well as the inability of traditional PI adjustment to meet the needs of different load changes, this article proposed a segmented PI synergetic control strategy for the LCL filter rectifier based on the proportional‐integral manifold form synergetic control strategy. First of all, a synergetic controller based on the proportional‐integral manifold was constructed; secondly, particle swarm optimization was used to optimize PI parameters under different load conditions; thirdly, the optimized PI parameters were used to establish a segmented trigger database, taking load impedance as the trigger condition. The control strategy made full use of the LCL filter's ability to suppress higher harmonics and the PI adjustment is simple and fast under specific loads. The synergetic control theory has a lot of advantages, including chatter‐free, simple control ideas, easy implementation, etc. Simulation experiments verified that the control strategy could effectively reduce the harmonic content, avoid resonance phenomena and improve system stability, and it was characterized by high control accuracy and simple structure.

BackgroundCrescent formation indicates severe glomerular pathology, and hypothyroidism usually predicts poor prognosis for severe diseases. However, the relationship between thyroid function and the progression of chronic kidney disease (CKD) is unclear. This study analysed the prognostic predictive value of the serum free triiodothyronine (FT3) to free thyroxine (FT4) ratio and its correlation with renal function in patients with CKD with crescent formation.MethodsThis single-centre study included 162 CKD patients with glomerular crescents confirmed by renal pathology between March 2012 and December 2014. According to the first tertile (0.284) of FT3/FT4 ratio, the patients were divided into high and low FT3/FT4 ratio groups. Kaplan-Meier and Cox regression analyses were performed to evaluate the prognostic value of the FT3/FT4 ratio.ResultsThe age, haemoglobin, eGFR, urinary albumin-to-creatinine ratio, cardiac troponin T, N-terminal brain natriuretic peptide precursor, FT3, FT4, percentage of total crescents in non-globally sclerotic glomeruli, prevalences of hypertension, moderate to severe renal tubulopathy and crescentic nephritis, and proportion of patients receiving glucocorticoids and immunosuppressants were significantly different between high and low FT3/FT4 ratio groups (P < 0.05). Multivariate Cox regression analysis showed that when compared with patients with a high FT3/FT4 ratio (>0.284), those with intermediate and low FT3/FT4 ratios (≤0.284) had an increased risk of the long-term composite endpoint (P < 0.05 for various adjustment models).ConclusionsA low FT3/FT4 ratio is associated with increased mortality and worse outcome risk in CKD patients with crescent pathology.

High-resolution hydrological modeling is crucial for detecting extreme hydrological events and understanding fundamental terrestrial processes. However, spatial resolutions in current hydrological modeling studies have been mostly constrained to relatively coarse resolution (~10–100 km), and they therefore have a difficult time addressing flooding or drought issues with fine resolutions. In this study, a continental-scale high-resolution hydrological modeling framework (0.0625°, ~6 km) driven by remote sensing products was used to detect extreme hydrological event occurrences in China and evaluated based on the Variable Infiltration Capacity (VIC) model. The results showed that the developed model provided more detailed information than the coarser resolution models (a 0.25° and 1°), thereby capturing the timing, duration, and spatial extent of extreme hydrologic events regarding the 2012 Beijing flood and 2009/10 drought in Hai River Basin. Here, the total water storage changes were calculated based on the VIC model (−0.017 mm/year) and Gravity Recovery and Climate Experiment (GRACE) satellite (−0.203 mm/year) to reflect the water availability caused by climate change and anthropogenic factors. This study found that the 0.0625° dataset could capture detailed changes, thereby providing reliable information during occurrences of extreme hydrological events. The high-resolution model integrated with remote sensing products could be used for accurate evaluations of continental-scale extreme hydrological events and can be valuable in understanding its long-term occurrence and water resource security.

A new prototype of hybrid silk fibroin and sodium alginate (SF-SA) based osteogenic hydrogel scaffold with a concentration of 2.5% magnesium phosphate (MgP) based gel was prepared with the assistance of an extrusion-based three-dimensional (3D) printing machine in this study. To determine the optimum ratio of MgP-based gel in the hydrogel, a series of physical and biochemical experiments were performed to determine the proper concentration of MgP in two-dimensional hydrogel films, as well as the cell compatibility with these materials in sequence. The SF-SA hydrogel with 2.5wt% magnesium phosphate (SF-SA/MgP) stood out and then was used to fabricate 3D hydrogel scaffolds according to the consequences of the experiments, with SF-SA hydrogel as a control. Then the morphology and osteogenic activity of the scaffolds were further characterized by field emission scanning electron microscope (SEM), calcium mineralization staining, and reverse transcription-polymerase chain reaction (rt-PCR). The SF-SA/MgP hydrogel scaffold promoted the adhesion of rat mesenchymal stem cells with higher degrees of efficiency under dynamic culture conditions. After co-culturing in an osteogenic differentiation medium, cells seeded on SF-SA/MgP hydrogel scaffold were shown to have better performance on osteogenesis in the early stage than the control group. This work illustrates that the 3D structures of hybrid SF-SA/MgP hydrogel are promising headstones for osteogenic tissue engineering.

Abstract Memristors based neuromorphic devices can efficiently process complex information and fundamentally overcome the bottleneck of traditional computing based on von Neumann architecture. Meanwhile, natural biomaterials have attracted significant attention for biologically integrated electronic devices due to their excellent biocompatibility, mechanical flexibility, and controllable biodegradability. Thus, biomaterial‐based memristors may have a transformative impact on bridging electronic neuromorphic systems and biological systems. However, the working voltage in biological system is low, but the operation voltages of conventional memristors are high, violating the energy‐efficient biological system. Here, high‐performance silk fibroin‐based threshold switching (TS) memristors are demonstrated, which reveal an on‐current of 1 mA, a low threshold voltage (Vth) of 0.17 V, a high selectivity of 3 × 106, and a steep turn‐on slope of

Continuous drug monitoring is a promising alternative to current therapeutic drug monitoring strategies and has a strong potential to reshape our understanding of pharmacokinetic variability and to improve individualised therapy. This review highlights recent advances in biosensing technologies that support continuous drug monitoring in real time. We focus primarily on aptamer-based biosensors, wearable and implantable devices. Emphasis is given to the approaches employed in constructing biosensors. We pay attention to sensors’ biocompatibility, calibration performance, long-term characteristics stability and measurement quality. Last, we discuss the current challenges and issues to be addressed in continuous drug monitoring to make it a promising, future tool for individualised therapy. The ongoing efforts are expected to result in fully integrated implantable drug biosensing technology. Thus, we may anticipate an era of advanced healthcare in which wearable and implantable biochips will automatically adjust drug dosing in response to patient health conditions, thus enabling the management of diseases and enhancing individualised therapy.

Background In this study, we applied a composite index of neutrophil-lymphocyte * platelet ratio (NLPR), and explore the significance of the dynamics of perioperative NLPR in predicting cardiac surgery-associated acute kidney injury (CSA-AKI). Methods During July 1st and December 31th 2019, participants were prospectively derived from the ‘Zhongshan Cardiovascular Surgery Cohort’. NLPR was determined using neutrophil counts, lymphocyte and platelet count at the two-time points. Dose-response relationship analyses were applied to delineate the non-linear odds ratio (OR) of CSA-AKI in different NLPR levels. Then NLPRs were integrated into the generalized estimating equation (GEE) to predict the risk of AKI. Results Of 2449 patients receiving cardiovascular surgery, 838 (34.2%) cases developed CSA-AKI with stage 1 (n = 658, 26.9%), stage 2–3 (n = 180, 7.3%). Compared with non-AKI patients, both preoperative and postoperative NLPR were higher in AKI patients (1.1[0.8, 1.8] vs. 0.9[0.7,1.4], p 11.0 were more likely to develop AKI with an OR of 1.02. Integrating the dynamic NLPRs into the GEE model, we found that the AUC was 0.806(95% CI 0.793–0.819), which was significantly higher than the AUC without NLPR (0.799, p

Liquid fuel intermediates could be produced via aldol condensation reaction between furfural or 5-hydroxymethylfurfural (HMF) and acetone. It was found that iron-modified MCM-41 zeolite can be an effective Lewis acid catalyst for C—C bond formation via aldol condensation of furfural or HMF with acetone. The 4-(2-furyl)-3-buten-2-one and 1, 5-di-2-furanyl-1, 4-pentadien-3-one (FAc and F2Ac), or 1, 5-di-2-furanyl-1, 4-pentadien-3-one and 1, 5-bis[(5- hydroxlmethyl)-2-furanyl]-1, 4-pentadien-3-one (HAc and H2Ac), as two main condensation products of furfural with acetone or HMF with acetone, were observed. After 24 h at 160 °C, 86.9% conversion of furfural with 60.0% yield of the FAc as well as 7.5% yield of the F2Ac and 88.9% conversion of the HMF with 41.1% yield of the HAc as well as 3.5% yield of the H2Ac were achieved. Although furfural or HMF conversion was almost same after 24 h at 160 °C, iron-modified MCM-41 zeolite catalyst displayed an enhanced selectivity to condensation products of furfural with acetone. In addition, catalysts showed an improved selectivity to the F2Ac and H2Ac at higher reaction temperature. The reusability and regeneration studies showed that iron-modified MCM-41 zeolite catalyst could not be reused directly, but could be regenerated by calcination in air, and the catalytic performance of regenerated catalyst was acceptable.

IntroductionThe question of whether the increased burden of chronic kidney disease (CKD) is caused by the interaction of hyperuricemia and cardiovascular disease (CVD) risk factors or is accelerated by aging remains unresolved. The purpose of this study is to better understand the effect modification of hyperuricemia, cardiovascular risk, and age on CKD among the Chinese population.MethodsThis cross-sectional study of 8243 participants was derived from the China Health and Nutrition Survey (CHNS) in 2009. Inclusion criteria included age ≥18 years, non-pregnancy, and no history of high-protein diet prior to blood test. Demographics, comorbidities, health-related behaviors, and serum biomarkers were collected. Interaction association of hyperuricemia, CVD risk and age with CKD were analyzed using Logistic regression.ResultsCKD was detected in 359 (27.2%, 95% CI 24.8∼29.7%) of 1321 participants with hyperuricemia and 680 (9.8%, 95% CI 9.1∼10.5%) of 6,922 participants without hyperuricemia, and these patterns remained significant after controlling for age, gender, and Framingham risk score (adjusted odds ratio [aOR] 3.82, 95% CI 3.20∼4.57). We found a negative multiplicative interaction between hyperuricemia and CVD risk on CKD. The aOR in low-CVD risk groups was 5.51 (95% CI 4.03∼7.52), followed by medium-CVD risk groups (aOR: 3.64, 95% CI 2.61∼5.09) and high-CVD risk groups (aOR: 2.89, 95% CI 2.12∼3.96). CVD risk was less associated with CKD in hyperuricemia group (aOR: 0.92, 95% CI 0.68∼1.22) than in non-hyperuricemia group (aOR: 1.43, 95% CI 1.21∼1.70). Furthermore, hyperuricemia and age had a significant additive effect on CKD, with a synergy index of 2.26 (95% CI 1.45∼3.52). Coexisting with older age and hyperuricemia, the likelihood of developing CKD was higher than the sum of the two alone.ConclusionThe link between hyperuricemia and CKD begins at a young age and becomes stronger in the low CVD risk group. For young adults, early detection of hyperuricemia, routine CVD risk assessment, and timely intervention of modifiable factors are warranted.

Neurocognitive impairment (NCI) and gut microbiota dysbiosis are prevalent in patients with HIV infection. Docosahexanoic acid (DHA) supplementation may alleviate multiple neurocognitive diseases symptoms and plays important role in regulating gut microbiota. However, it is not known whether DHA algae oil supplements can alleviate neurocognitive impairment (NCI) and regulate gut microbiota and fecal metabolites. A randomized, double-blind, placebo-controlled trial was performed on 68 HIV-infected patients with NCI. Participants were randomized to receive a 3.15 g daily DHA algae oil supplement or placebo for 6 months. We collected blood and fecal samples from these patients before and after the trial. Mini mental state examination (MMSE) and neuropsychological tests (NP tests) were administered to assess the cognitive status of participants. The influence of DHA algae oil on the gut microbiota, fecal metabolomics, plasma proinflammatory, and oxidative stress factors was also investigated. There were no significant changes in NCI according to global diagnosis score (GDS) and MMSE score within the two groups, while patients receiving DHA had improvement in several blood lipids, pro-inflammatory and oxidative stress factors. The DHA supplement increased α-diversity indexes, increased abundances of Blautia, Bifidobacterium, Dorea, Lactobacillus, Faecalibacterium, Fusobacterium, and Agathobacter, and decreased abundances of Bacteroides and Prevotella_9. Furthermore, DHA supplement was correlated with improved fecal lipid metabolites as indicated by ceramides, bile acids, glycerophospholipids. In addition, the DHA supplement was associated with altered cholesterol metabolism and purine metabolism pathways. A daily supplement of DHA algae oil for 6 months has been shown to promote favorable transformations in gut microbiota, profiles of fecal metabolomic, and factors responsible for proinflammatory and oxidative stress, which might be beneficial for the prognosis of HIV-infected patients with NCI in the long-term.Clinical Trial Registrationhttps://clinicaltrials.gov/ct2/show/NCT04242004, identifier: NCT04242004.

Summary: Flexible biosensors have received intensive attention for real-time, non-invasive monitoring of cancer biomarkers. Highly sensitive tyrosinase biosensors, which are important for melanoma screening, remained a hurdle. Herein, high-performance tyrosinase-sensing field-effect transistor-based biosensors (bio-FETs) have been successfully achieved by self-assembling nanostructured tetrapeptide tryptophan–valine–phenylalanine–tyrosine (WVFY) on n-type metal oxide transistors. In the presence of target tyrosinase, the phenolic hydroxyl groups in WVFY are rapidly converted to benzoquinone with the consumption of protons, which could be detected potentiometrically by bio-FETs. As a result, the WVFY-modified bio-FETs exhibited an ultra-low detection limit of 1.9 fM and an optimal detection range of 10 fM to 1 nM toward tyrosinase sensing. Furthermore, flexible devices fabricated on ∼2.9-μm-thick polyimide (PI) substrates illustrated robust mechanical flexibility, which could be attached to human skin conformally. These achievements hold promise for wearable melanoma screening and provide designing guidelines for detecting other important cancer biomarkers with bio-FETs.

Abstract Background Variation in the relationship between education and health has been studied intensely over the past few decades. Although there is research on gender disparity and cohort variations in educational effect on health using samples from the U.S. and Europe, research about China’s is limited. Given the specific social changes in China, our study is designed to analyze the gender and cohort patterns in the education-health gradient. Method The latent growth-curve modeling was used to analyze the gender and cohort variations in the education gradient in self-rated health among Chinese respondents. The study employed longitudinal and nationally representative data from the Chinese Family Panel Studies from the years 2010 to 2016. Each cohort is specified according to their distinct periods of social change in China. Following the analysis, we used latent growth-curve model to illustrate gender and cohort differences in the age-graded education and health trajectories. Results Although Chinese men have reported to have better health than women in general, women reported 1.6 percentage points higher in self-reported health for each additional year of schooling compared to that of men (P

Background: There is limited evidence on the relationship between social isolation and renal outcomes. To address this gap, this study estimated the prospective relationship of social isolation with rapid kidney function decline and the development of chronic kidney disease (CKD) in middle-aged and elderly Chinese with normal kidney function.Methods: We analyzed data from 3,031 participants aged ≥ 45 years with baseline estimated glomerular filtration rates (eGFR) ≥ 60 ml/min/1.73 m2. All data were obtained from the 2011 and 2015 waves of the Chinese Longitudinal Study of Health and Retirement (CHARLS). eGFR was estimated based on a combination of serum creatinine and cystatin C. The primary outcome was rapid decline in renal function, as defined by an eGFR decrease of > 5 ml/min/1.73 m2 per year, while the secondary outcome was the development of CKD, as defined by an eGFR decrease to a level < 60 ml/min/1.73 m2.Results: During the follow-up of 4 years, 258 (8.5%) participants experienced a rapid decline in renal function, while 87 (2.9%) developed CKD. In the fully adjusted model, high social isolation was significantly related to an increased risk of experiencing a rapid decline in renal function (OR 1.805, 95% CI 1.310–2.487) and CKD onset (OR 1.842, 95% CI 1.084–3.129). Among the five components of social isolation, being unmarried, not participating in social activities, and living alone independently predicted declined renal function.Conclusions: Social isolation is significantly associated with the risk of rapid eGFR decline and CKD onset in middle-aged and older adults with normal kidney function in China.

IntroductionThe current study sought to explore the effect of baseline serum uric acid (SUA) on the risk of all-cause mortality among Chinese adults aged 45~75 years and to determine its interaction relationship with diabetes.MethodsThe study was designed as a community-based cohort of 4467 adults aged between 45~75 years included in a 6-years follow-up period from 2009 to 2015 years by the China Health and Nutrition Survey (CHNS). Baseline SUA levels were grouped into quartiles and its association on all-cause mortality was explored using multivariate Cox proportional hazards models. Stratified analyses were performed to explore the associations of SUA quartiles with all-cause mortality among diabetic and non-diabetic individuals.ResultsA total of 141 deaths (5.3 per 1000 person-years) were recorded During a follow-up of 26431 person-years. Out of the 141 deaths, 28 deaths (10.1 per 1000 person-years) were reported in the diabetic groups and 113 deaths (4.8 per 1000 person-years) were recorded in the non-diabetic group. An increased risk of all-cause mortality was observed for participants in the first and fourth quartiles compared with the second SUA quartile, (Q1 SUA: aHR=2.1, 95% CI 1.1~4.1; Q4 SUA: aHR=2.1, 95% CI 1.1~4.0). Stratification of participants by diabetes status showed a U-shaped association for non-diabetic individuals. Whereas, declined eGFR, rather than SUA, was an independent risk factor for all-cause mortality in diabetic individuals (aHR=0.7, 95% CI 0.6~1.0).ConclusionOur study proved that the prognostic role of SUA for predicting all-cause death might be regulated by diabetes. Both low and high SUA levels were associated with increased mortality, supporting a U-shaped association only in non-diabetic individuals. Whereas, renal dysfunction rather than SUA was an independent risk factor for all-cause mortality. Further studies should be conducted to determine the SUA levels at which intervention should be conducted and explore target follow-up strategies to prevent progression leading to poor prognosis.

Gut microbiota dysbiosis has been associated with many neurological diseases. However, how microbiota composition and metabolism relate to neurocognitive impairment (NCI) in HIV-infected individuals is largely unknown. In this study, a total of 102 HIV infected participants were classified into two groups—those with NCI and those without—using the global deficit score (GDS). Fecal samples were collected from the participants for 16S rRNA gene sequencing and untargeted metabolomics. The plasma level of 25 hydroxy-vitamin D (25(OH)D) was also evaluated. Although α-diversity and β-diversity were comparable, the HIV patients with NCI were significantly different from those without NCI in terms of abundance of several gut microbiota. The decreased abundance of butyrate-producing bacteria (BPB) and increased abundance of Klebsiella were related with NCI and carotid intima-media thickness (CIMT). Significant differences in fecal metabolites were also found between individuals with versus without NCI, including increased bile acids and bioactive lipids, decreased vitamin D, terpenoids, and resolvin D1 in the NCI group. Furthermore, the perturbed metabolic profile was closely related to BPB and Klebsiella. In addition, a low level of vitamin D was associated with NCI and CIMT. Both fecal and plasma vitamin D were positively correlated with BPB. Our results show that BPB and Klebsiella and the associated metabolites are associated with NCI in people with HIV. In addition, vitamin D, both in feces and blood, was associated with NCI and BPB, suggesting a protective effect of vitamin D on NCI.

The recent COVID-19 pandemic has caused tremendous damage to the social economy and people’s health. Some major issues fighting COVID-19 include early and accurate diagnosis and the shortage of ventilator machines for critical patients. In this manuscript, we describe a novel solution to deal with COVID-19: portable biosensing and wearable photoacoustic imaging for early and accurate diagnosis of infection and magnetic neuromodulation or minimally invasive electrical stimulation to replace traditional ventilation. The solution is a closed-loop system in that the three modules are integrated together and form a loop to cover all-phase strategies for fighting COVID-19. The proposed technique can guarantee ubiquitous and onsite detection, and an electrical hypoglossal stimulator can be more effective in helping severe patients and reducing complications caused by ventilators.

Background: HIV infection and normal aging share immune and inflammatory changes that result in premature aging and non-communicable diseases (NCDs), but the exact pathophysiology is not yet uncovered. We identified the common metabolic pathways underlying various NCDs in treated HIV infection. Methods: We performed untargeted metabolomics including 87 HIV-negative (–) normal controls (NCs), 87 HIV-positive (+) NCs, and 148 HIV+ subjects with only one type of NCDs, namely, subclinical carotid atherosclerosis, neurocognitive impairment (NCI), liver fibrosis (LF) and renal impairment. All HIV+ subjects were virally suppressed. Results: HIV+ patients presented widespread alterations in cellular metabolism compared to HIV– NCs. Glycerophospholipid (GPL) metabolism was the only one disturbed pathway presented in comparisons including HIV– NCs across age groups, HIV+ NCs across age groups, HIV+ NCs vs HIV– NCs and each of HIV+ NCDs vs HIV+ NCs. D-glutamine and D-glutamate metabolism and alanine-aspartate-glutamate metabolism were presented in comparisons between HIV+ NCs vs HIV– NCs, HIV+ LF or HIV+ NCI vs HIV+ NCs. Consistently, subsequent analysis identified a metabolomic fingerprint specific for HIV+ NCDs, containing 42 metabolites whose relative abundance showed either an upward (mainly GPL-derived lipid mediators) or a downward trend (mainly plasmalogen phosphatidylcholines, plasmalogen phosphatidylethanolamines, and glutamine) from HIV– NCs to HIV+ NCs and then HIV+ NCDs, reflecting a trend of increased oxidative stress. Interpretation: GPL metabolism emerges as the common metabolic disturbance linking HIV to NCDs, followed by glutamine and glutamate metabolism. Together, our data point to the aforementioned metabolisms and related metabolites as potential key targets in studying pathophysiology of NCDs in HIV infection and developing therapeutic interventions. Funding: China National Science and Technology Major Projects on Infectious Diseases, National Natural Science Foundation of China, Yi-wu Institute of Fudan University, and Shanghai Municipal Health and Family Planning Commission.

We designed an ultrasonic testing instrument that consisted of a single-chip microcomputer module, a digital display module, and an ultrasonic sensor module, which conveniently eliminated the troubles faced by the traditional Jolly’s scale. For comparison purpose, three linear springs’ stiffness factors were measured by Jolly’s scale and by our ultrasonic testing instrument. We found that our instrument could more conveniently and in real time display the distance values between the ultrasonic ranging module and the horizontal bottom plate when loading different weights. By processing these distance data, we found that our instrument was more convenient for obtaining the linear springs’ stiffness factors and that the results were more accurate than those of Jolly’s scale. This study verified that our instrument can accurately realize the performance of Jolly’s scale under diverse temperatures and humidity levels with high data reliability and perfect stability.

COVID-19 mortality is primarily driven by abnormal alveolar fluid metabolism of the lung, leading to fluid accumulation in the alveolar airspace. This condition is generally referred to as pulmonary edema and is a direct consequence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. There are multiple potential mechanisms leading to pulmonary edema in severe Coronavirus Disease (COVID-19) patients and understanding of those mechanisms may enable proper management of this condition. Here, we provide a perspective on abnormal lung humoral metabolism of pulmonary edema in COVID-19 patients, review the mechanisms by which pulmonary edema may be induced in COVID-19 patients, and propose putative drug targets that may be of use in treating COVID-19. Among the currently pursued therapeutic strategies against COVID-19, little attention has been paid to abnormal lung humoral metabolism. Perplexingly, successful balance of lung humoral metabolism may lead to the reduction of the number of COVID-19 death limiting the possibility of healthcare services with insufficient capacity to provide ventilator-assisted respiration.

Soil moisture (SM) plays an important role in regulating terrestrial–atmospheric water circulation and energy balance. Most of the existing studies have explored the dynamic patterns of SM based on experimental methods. However, the analysis of large-scale regions and long-term SM sequences was limited. Alternatively, satellite remote sensing data is a potential source for SM analysis for large-scale basins. Therefore, the SM data from the European Space Agency (ESA) Climate Change Initiative (CCI) from 2000 to 2015 is used in this paper to analyze the SM spatial-temporal changes in the Yellow River Basin (YRB). Further, the Normalized Difference Vegetation Index (NDVI) and meteorological data are used to explore the relationships between SM and NDVI, precipitation, air temperature, and wind speed, respectively. The results showed that the overall trend of SM in the YRB was decreasing from southeast to northwest during the past 16 years. The upper reaches of the YRB had shown a humid trend, with a value of 0.00047 m3·m−3·year−1, mainly due to the increase in precipitation; there was an obvious drought trend in the middle reaches of the YRB, especially in Shanxi Province and Henan Province, with a value of −0.00030 m3·m−3·year−1, which may be owed to vegetation greening increasing the soil evaporation. Overall, it is determined that the main factors influencing SM changes were NDVI and precipitation, followed by air temperature and wind speed. This study can provide a scientific basis for the spatial-temporal distribution characteristics and attributions of SM in the YRB over a long time series.

Studies of the element contents and isotopic characteristics of sulfide minerals from seafloor hydrothermal sulfide deposits are a significant method of investigating seawater-fluid mixing and fluid-rock and/or sediment interactions in hydrothermal systems. The seafloor hydrothermal sulfide ores from the Noho hydrothermal field (NHF) in the Okinawa Trough (OT) consist of pyrrhotite, isocubanite, sphalerite, galena, and amorphous silica. The Rh, Ag, Sb, and Tl contents mostly increase in galena as the fluid temperature decreases in the late ore-forming stage. In the sulfide minerals, the rare earth elements are mainly derived from the hydrothermal fluids, while the volcanic rocks and/or sediments are the sources of the sulfur and lead in the sulfide minerals. After the precipitation of galena, the redox state becomes oxidizing, and the pH value of the fluid increases, which is accompanied by the formation of amorphous silica. Finally, neither pyrite nor marcasite has been observed in association with pyrrhotite in the NHF sulfides, likely indicating that the amount of sulfur was limited in this hydrothermal system, and most of the residual Fe was incorporated into the sphalerite. This suggests that the later pyrite and/or marcasite precipitation in the seafloor hydrothermal sulfide deposit is controlled by the sulfur content of the fluid. Furthermore, it is possible to use hydrothermal sulfides and their inclusions to trace subseafloor fluid circulation processes.

Background Hyperuricemia (HUA) is becoming a global public health problem and associated with multiple diseases. Objective We conducted a systematic review to synthesize the pooled prevalence of HUA in mainland China and delineate its demographic, regional, and temporal trends over the past two decades. Methods Systematic literature searches of PubMed, SCOPUS, Web of Science, the China National Knowledge Infrastructure (CNKI), and the Wanfang digital database were conducted to screen studies published from 1 January 2000 to 31 August 2019, reporting the prevalence of HUA in mainland China. The search strings were (‘hyperuricemia’ OR ‘hyperuricaemia’ OR ‘uric acid’) AND (‘prevalence’ OR ‘epidemiology’) AND ‘China’. Article quality was appraised quantitatively from 11 items. Before formal meta-analysis, age-standardized prevalence was transformed. The random-effects model was applied to synthesize the pooled prevalence due to its high heterogeneity. Then we stratified the prevalence estimates by age, gender, area, nationality, and publication year for subgroup analysis. Results Totally 177 eligible studies with a whole population of 2,277,712 were included in the present meta-analysis. The pooled prevalence in mainland China was estimated at 16.4% (95% CI: 15.3%~17.6%). In studies with the onset age at 20 ~ 29 years old, males had a twice times higher HUA prevalence than females (21.5% vs. 8.9%). The prevalence of HUA was 13.7% (11.8%~15.7%) in people aged 15~ years old, 16.5% in 30~ (14.8%~18.4%), 17.9% in 40~ (16.4%~19.5%), 19.4% in 50~ (17.8%~21.0%), 20.5% in 60~ (18.8%~22.3%), and 24.9% in over 70 (22.9%~27.1%). Stratified by regions, southern (25.5%) and southwestern (21.2%) China shared the highest prevalence, and the lowest prevalence was observed in the northwest (12.6%). From 2001 to 2017, the prevalence estimates of HUA steadily climbed from 8.5% to 18.4% with minor fluctuations. Multiple regression revealed that HUA prevalence was positively correlated to the larger sample size, area, advanced onset age, and published year. Conclusions The last two decades witnessed the rapid growth prevalence of HUA in China. Early screening and personalized health education for HUA need to be given enough attention.