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Abstract The linear ubiquitin chain assembly complex (LUBAC) mediates the linear ubiquitination of various proteins and is involved in NF-κB signaling and immune regulation. However, the function and mechanism of linear ubiquitination in regulating oncogenic signaling and tumor growth have remained poorly understood. Herein, we identified Gli proteins, key transcription factors in the Hedgehog (Hh) signaling pathway, as novel substrates of LUBAC. Linear ubiquitination stabilizes Gli proteins, leading to the noncanonical activation of Hh signaling in CRC cells. Furthermore, LUBAC facilitates tumor growth in CRC cells. Additionally, elevated expression of LUBAC components in CRC tissues was observed, and higher expression levels of these components correlated with poor prognosis in CRC patients. Interestingly, inhibition of LUBAC using either a small molecule agonist or RNA silencing specifically suppressed cell growth in CRC cells but had no effect on normal intestinal cells. Taken together, aberrant expression of LUBAC components activates Hh signaling noncanonically by mediating linear ubiquitination, promoting tumor growth in CRC, demonstrating the novel function of linear ubiquitination in regulating the protein stability of its substrates and highlighting the potential of targeting LUBAC as a therapeutic strategy in CRC.

Abstract Severe acute pancreatitis (SAP) begins with premature activation of enzymes, promoted by the immune system, triggering a potential systemic inflammatory response that leads to organ failure with increased mortality and a bleak prognosis. Interleukin-22 (IL-22) is a cytokine that may have a significant role in SAP. IL-22, a member of the IL-10 cytokine family, has garnered growing interest owing to its potential tissue-protective properties. Recently, emerging research has revealed its specific effects on pancreatic diseases, particularly SAP. This paper provides a review of the latest knowledge on the role of IL-22 and its viability as a therapeutic target in SAP.

Abstract Identifying potential prognostic factors of CSM patients could improve doctors’ clinical decision-making ability. The study retrospectively collected the baseline data of population characteristics, clinical symptoms, physical examination, neurological function and quality of life scores of patients with CSM based on the clinical big data research platform. The modified Japanese Orthopedic Association (mJOA) score and SF-36 score from the short-term follow-up data were entered into the cluster analysis to characterize postoperative residual symptoms and quality of life. Four clusters were yielded representing different patterns of residual symptoms and quality of patients’ life. Patients in cluster 2 (mJOA RR 55.8%) and cluster 4 (mJOA RR 55.8%) were substantially improved and had better quality of life. The influencing factors for the better prognosis of patients in cluster 2 were young age (50.1 ± 11.8), low incidence of disabling claudication (5.0%) and pathological signs (63.0%), and good preoperative SF36-physiological function score (73.1 ± 24.0) and mJOA socre (13.7 ± 2.8); and in cluster 4 the main influencing factor was low incidence of neck and shoulder pain (11.7%). We preliminarily verified the reliability of the clustering results with the long-term follow-up data and identified the preoperative features that were helpful to predict the prognosis of the patients. This study provided reference and research basis for further study with a larger sample data, extracting more patient features, selecting more follow-up nodes, and improving clustering algorithm.

ABSTRACTContinuous emergence of new variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), enhanced transmissibility, significant immune escape, and waning immunity call for booster vaccination. We evaluated the safety, immunogenicity, and efficacy of heterologous booster with a SARS-CoV-2 mRNA vaccine SYS6006 versus an active control vaccine in a randomized, open-label, active-controlled phase 3 trial in healthy adults aged 18 years or more who had received two or three doses of SARS-CoV-2 inactivated vaccine in China. The trial started in December 2022 and lasted for 6 months. The participants were randomized (overall ratio: 3:1) to receive one dose of SYS6006 (N = 2999) or an ancestral receptor binding region-based, alum-adjuvanted recombinant protein SARS-CoV-2 vaccine (N = 1000), including 520 participants in an immunogenicity subgroup. SYS6006 boosting showed good safety profiles with most AEs being grade 1 or 2, and induced robust wild-type and Omicron BA.5 neutralizing antibody response on Days 14 and 28, demonstrating immunogenicity superiority versus the control vaccine and meeting the primary objective. The relative vaccine efficacy against COVID-19 of any severity was 51.6% (95% CI, 35.5–63.7) for any variant, 66.8% (48.6–78.5) for BA.5, and 37.7% (2.4–60.3) for XBB, from Day 7 through Month 6. In the vaccinated and infected hybrid immune participants, the relative vaccine efficacy was 68.4% (31.1–85.5) against COVID-19 of any severity caused by a second infection. All COVID-19 cases were mild. SYS6006 heterologous boosting demonstrated good safety, superior immunogenicity and high efficacy against BA.5-associated COVID-19, and protected against XBB-associated COVID-19, particularly in the hybrid immune population.Trial registration: Chinese Clinical Trial Registry: ChiCTR2200066941

Abstract Background Evidence-based nursing (EBN) intervention is a nursing approach that uses credible scientific research findings as evidence, in conjunction with patient needs, to provide personalized nursing care tailored to the specific needs of patients. EBN has been widely applied in clinical practice and has achieved remarkable results. However, there are limited studies evaluating the efficacy of EBN on cognitive impairment, psychological disorders, and quality of life in stroke patients. This study aims to explore the clinical effects of the EBN, which we call “two-heart” nursing mode on cognitive function, limb function, mental state, and quality of life of stroke patients. Methods A total of 92 stroke patients were divided into two groups: the traditional group (n = 46) and the two-heart group (n = 46). The traditional group received conventional nursing care, while the two-heart group received the double-heart nursing mode in addition to conventional nursing care. The cognitive function, limb function, living ability, mental state, quality of life, and nursing satisfaction of both groups were compared. Results The cognitive function in the two-heart group (26.81 ± 3.15 points) was better than the traditional group (23.61 ± 3.74 points; P = 001); limb function in the two-heart group (86.16 ± 6.73 points) was improved compared to the traditional group (79.57 ± 5.19 points; P = 0.002), and the living ability of patients in the two-heart group (68.53 ± 5.87 points) was superior to the traditional group (60.79 ± 5.96 points; P = 0.003). Similarly, the quality of life of patients in the two-heart group (81.13 ± 6.69 points) was higher than the traditional group (70.78 ± 6.63 points; P = 0.003), and the mental state of patients in the two-heart group (43.61 ± 4.13 points, 43.19 ± 4.16 points) was better than that in the traditional group (50.59 ± 3.76 points, 51.49 ± 4.43 points; P = 0.003). However, the nursing satisfaction score in the two-heart group (97.83%) was slightly higher than the traditional group (95.65%; P = 0.068). Conclusions The two-heart nursing mode can improve cognitive function, limb function, and mental state, as well as enhance the quality of life of stroke patients. This approach is worthy of clinical promotion and application.

Study Design Single‐center, retrospective study. Objective Hemivertebra resection is the only treatment option for congenital cervical scoliosis (CCS). However, this procedure is complex and technically demanding. It often requires a considerably long operation, and there is substantial intraoperative bleeding. Therefore, we have attempted to treat CCS with a concave side distraction comprising a three‐dimensional (3D) printed titanium cage. The purpose of this study is to evaluate the safety and efficacy of this technique for the treatment of patients with CCS. Methods A series of 22 patients with CCS who underwent a concave side distraction technique between 2019 and 2021 were retrospectively reviewed and analyzed. Radiological measurements included the Cobb angle of the distraction segments, the kyphosis angle, the range of movement, and the distraction correction angle. Student's t‐test and Spearman correlation analysis were used for statistical analysis. p

A single nitrogen-vacancy (NV) center in a diamond can be used as a nanoscale sensor for magnetic field, electric field or nuclear spins. Due to its low photon detection efficiency, such sensing processes often take a long time, suffering from an electron spin resonance (ESR) frequency fluctuation induced by the time-varying thermal perturbations noise. Thus, suppressing the thermal noise is the fundamental way to enhance single-sensor performance, which is typically achieved by utilizing a thermal control protocol with a complicated and highly costly apparatus if a millikelvin-level stabilization is required. Here, we analyze the real-time thermal drift and utilize an active way to alternately track the single-spin ESR frequency drift in the experiment. Using this method, we achieve a temperature stabilization effect equivalent to sub-millikelvin (0.8 mK) level with no extra environmental thermal control, and the spin-state readout contrast is significantly improved in long-lasting experiments. This method holds broad applicability for NV-based single-spin experiments and harbors the potential for prospective expansion into diverse nanoscale quantum sensing domains.

This study first employed ultrasonic-assisted fermentation of seaweed foot material with Lactiplantibacillus plantarum to produce Porphyra yezoensis sauce. The aim was to examine L. plantarum's growth and metabolism of nutritional components at different growth stages under low- (133.99 W/L) and high-ultrasonic power densities (169.17 W/L). After 24-h fermentation, L. plantarum exhibited a 21.32 % increase in the sonicated P. yezoensis sauce at 133.99 W/L and the logarithmic growth phase compared to that at 169.17 W/L. In addition, compared to the non-sonicated sauce, total phenolic and flavonoid contents increased by around 58 % and 27 % in sonicated sauce at 133.99 W/L, reaching 92.38 mg GEA/g DW and 111.08 mg RE/g DW, respectively. Principal Component Analysis (PCA) of the evaluation criteria for different fermentation stages under 133.99 W/L power ultrasonication revealed that the P. yezoensis sauce generated more phenolic compounds and exhibited stronger antioxidant capabilities in the sonicated sample at the logarithmic phase of L. plantarum. Compared to the traditional treated P. yezoensis sauce, the content of free amino acids was significantly increased in sonicated sauce, especially for logarithmic phase. Finally, GC-IMS analysis demonstrated that the ultrasonication at logarithmic phase released more volatile compounds compared to the non-sonicated sauce. This led to a reduction in the fishy odour of the Porphyra yezoensis sauce and an improved release of favourable flavour compounds.

Abstract Background The purpose of this study was to investigate the relationship between the size and duration of asymptomatic subchorionic hematoma and pregnancy outcomes in women with singleton pregnancies. Methods This was a retrospective study that enrolled 701 singleton pregnant women who were diagnosed with asymptomatic subchorionic hematoma by ultrasound at 5–10 gestational weeks. The control group recruited 640 normal pregnant women without subchorionic hematoma who were matched with subchorionic hematoma group on baseline characteristics. The pregnancy outcomes were compared between the two groups, and the associations of the size and duration of subchorionic hematoma with pregnancy outcomes were analyzed by logistic regression model. Results Compared with the normal pregnancy group, the incidence of, gestational diabetes mellitus, gestational thrombocytopenia, placenta adhesion, fetal growth restriction, macrosomia in subchorionic hematoma group were higher (all P

Climate change has caused more frequent instances of extreme climatic events around the world, being an influential factor on the occurrence of wildfires in China on large scale. However, the impact of changes in extreme climate on the occurrence of wildfires in different climate zones remains unclear. In the present study, 26 extreme climate indices were selected to analyze the thereof relationship with wildfire occurrences from 2005 to 2018 in different regions of China. Wildfires in China primarily occur in the south, with a measurable presence in the north. On an annual scale, the wildfire occurrences in southwestern China show stronger correlations with mean temperature than extreme temperature indices, but show stronger correlations with extreme precipitation indices than the total precipitation. On the contrary, the wildfire occurrences in southeastern China show stronger correlations with the total precipitation than extreme precipitation indices, but show stronger correlations with extreme temperature indices than the mean temperature. In Northeast China, wildfires show a more significant correlation with mean temperature than with any extreme climate indices, indicating a minimal impact from extreme climatic conditions. The fire-climate relationships in the main fire season (January-April) are similar to those in the annual scale. The wildfire occurrences in the southwestern, south-central, and southeastern China, which are located in the same latitudes, were affected by extreme climate indices of different types and on different time scales. Furthermore, we recommend that consecutive dry days (CDD) and diurnal temperature range (DTR) should be considered first when studying the relationship between wildfire occurrence and extreme climate in southwestern and southeastern China respectively.

Land-sea coordination (LSC) is the key to deepening ecological governance and ensuring the ecological security in the Guangdong-Hong Kong-Macao Greater Bay Area (GBA). From the perspective of the human-land-sea giant system, terrestrial and marine environment, terrestrial and marine resources, terrestrial and marine disasters, as well as human socio-economic driving force, pressures and responses are included in the evaluation system of the ecological security of the terrestrial subsystem and the marine subsystem. Using an instrumental variable quantile model, structural equation model and system dynamics model, this study tested the mutual influence of land-sea ecological security in the GBA, as well as its underlying mechanism. The results are summarized as follows: 1) There is a clear non-linear mutualistic symbiosis relationship between the terrestrial subsystem and marine subsystem, while the marine subsystem is influenced by the terrestrial subsystem more significantly; 2) The increasingly scarce terrestrial resources of the GBA cannot provide strong support for turning the GBA into a world-class bay area; however, marine resources effectively offset the shortage of terrestrial resources, the needs of terrestrial socio-economic development provide a core driving force for the marine economy; 3) Ecological problems in the GBA are rooted in the land; the terrestrial socio-economic pressure has unidirectional negative influence on the marine ecology; the terrestrial environment is significantly inferior to the marine environment, and the negative influence on the fostering of terrestrial resources and marine environment is gradually emerging; 4) Marine ecological pressure is mainly rooted in the pollution discharge from terrestrial socio-economic development, but is scarcely related to marine economic development; 5) Owing to the differences in political systems, legal systems and cultural contexts between Guangdong, Hong Kong and Macao, the effectiveness of land-sea ecological governance is not yet significant. Hence, it is advisable to develop an efficient cross-border coordinated governance system, further deepen the land-sea integrated environmental governance, resource conservation, economic transformation and social response across the GBA, build a high-quality land and marine ecological community in accordance with higher standards.

Radial growth of trees can result in opposite wood (OW) and compression wood (CW) due to the varying impact of stem mechanical stress, such as that caused by gravity or wind. Previous research has identified higher xylem production in CW compared to OW. Yet, it remains unclear whether the difference in the number of xylem cells between OW and CW results from differences in growth rate or the duration of xylem cells. In this study, we collected wood microcores on a weekly basis from March 2019 to January 2020 in Pinus massoniana Lamb. located on a steep slope. Our objective was to compare the dynamic of cambial activity and resulting cellular anatomical parameters between OW and CW in a humid subtropical environment. Our results showed that the xylem phenology of OW and CW was generally consistent with the xylem cell division process beginning in early March and ceasing in November. The last latewood cell completed its differentiation at the end of December. The response of wood formation dynamics to climate was consistent in both OW and CW. Moreover, both wood types exhibited a limited development of the enlargement phase due to the heat and drought during the summer. The rate of cell division was responsible for 90.7% of the variability in the number of xylem cells. The CW xylem obtained a larger number of cells by increasing the rate of cell division and displayed thinner earlywood cells with larger lumens than OW cells. Our findings showed that the xylem of conifer species responds to mechanical stress by accelerating the cell division rate. As a result, we suggest calculating the ratio between OW and CW widths to reconstruct wind stress changes rather than calculating the residuals used in the current study.

Spring precipitation in southeastern China and Bengal, occurring during the transitional phase from winter to summer monsoons, serves as a critical window into the dynamics of large-scale circulations and the subsequent summer monsoon. While many studies have analyzed spring precipitation in southeastern China and Bengal, their interconnections and implications for the summer monsoon have remained relatively under explored. We utilized the Empirical Orthogonal Function of spring precipitation to reveal Synchronous Spring Precipitation (SSP) in southeastern China and Bengal. This synchronicity is bridged by the East Asian Subtropical Jet (EASJ) that extends from Bengal to southeastern China. The EASJ was predominantly correlated with precipitation in southeastern China prior to the 1990s, while it developed a more profound connection with precipitation in Bengal after the 1990s. Notably, SSP anomalies occurred during the developing phase of the El Niño-Southern Oscillation (ENSO). The predictive capacity of SSP for the Indian summer monsoon (ISM) amplifies during periods of the intensified SSP-ENSO correlations and positive phase of the North Pacific Meridional Mode. Tree-ring based reconstructions spanning the past two centuries further corroborate the persistent linkages among the SSP, ISM, and ENSO. Our research sheds light on the intricate interplay of these factors and their significance in understanding and predicting the monsoon dynamics in the region.

Obesity has been associated with the development of 13 different types of cancers, including breast cancer. Evidence has indicated that cancer-associated adipocytes promote the proliferation, invasion, and metastasis of cancer. However, the mechanisms that link CAAs to the progression of obesity-related cancer are still unknown. Here, we found the mature adipocytes in the visceral fat of HFD-fed mice have a CAAs phenotype but the stromal vascular fraction of the visceral fat has not. Importantly, we found the derivate of the potent PPARγ antagonist GW9662, BZ26 inhibited the reprogramming of mature adipocytes in the visceral fat of HFD-fed mice into CAA-like cells and inhibited the proliferation and invasion of obesity-related breast cancer. Further study found that it mediated the browning of visceral, subcutaneous and perirenal fat and attenuated inflammation of adipose tissue and metabolic disorders. For the mechanism, we found that BZ26 bound and inhibited PPARγ by acting as a new modulator. Therefore, BZ26 serves as a novel modulator of PPARγ activity, that is, capable of inhibiting obesity-related breast cancer progression by inhibiting of CAA-like cell formation, suggesting that inhibiting the reprogramming of mature adipocytes into CAAs or CAA-like cells may be a potential therapeutic strategy for obesity-related cancer treatment.

Objective To report concave-side distraction technique to treat congenital cervical scoliosis in lower cervical and cervicothoracic spine. To evaluate and compare clinical and radiographic results of this procedure with classic hemivertebra resection procedure. Methods This study reviewed 29 patients in last 13 years. These patients were divided into convex-side resection group (group R) and concave-side distraction group (group D). Radiographic assessment was based on parameter changes preoperatively, postoperatively and at last follow-up. Demographic data, surgical data and complications were also evaluated and compared between the 2 groups. Results In group R, mean age was 8.9 ± 3.3 years and follow-up was 46 ± 18 months. Operation time and blood loss averaged 500 ± 100 minutes, 703 ± 367 mL. In group D, mean age was 9.9 ± 2.8 years and follow-up was 34 ± 14 months. Operation time and blood loss averaged 501 ± 112 minutes, 374 ± 181 mL. Structural Cobb angle was corrected from 29.4° ± 12.5° to 5.3° (2.1°–18.1°) (p = 0.001) and 33.7° ± 14.1° to 12.8° ± 11.4° (p < 0.001) in groups R and D. Compensatory Cobb angle had a spontaneous correction rate of 59.6% (40.0%–80.8%) and 59.7% ± 23.0% in groups R and D. Mandibular incline, clavicle angle and spine coronal balance were significantly improved at last follow-up in both groups. All correction rates were not statistically different between groups. However, group D had significant less blood loss (p < 0.001) and operation time (p = 0.004) per vertebra than group R. Seven patients developed C5 nerve root palsy and recovered by 6 months of follow-up. Conclusion Both surgical procedures are safe and effective in correcting congenital cervical scoliosis. But concave-side distraction technique has less blood loss and time-consuming during surgery, which provides a better option for the treatment of congenital cervical scoliosis.

Abstract Adult tendons heal via fibrovascular scarring with inferior biomechanical properties. Mohawk (Mkx) emerged as a pivotal actor in tenolineage commitment. However, its precise function in tendinopathy remains poorly understood. This study investigates the cellular and molecular mechanisms underlying Mkx’ role in fibrovascular healing. Human samples were collected to test fibrovascular markers. We then performed RNAseq on Mkx−/− mice compared to their wild type littermates to decipher Mkx regulome. We therefore sought to reproduce TSPCs transition to myofibroblasts in-vitro by over-expressing MyoD and followed by phenotypic and experimental cells’ characterization using microscopy, qRT-PCR, flow cytometry sorting, presto-blue cell viability assay and immunofluorescence. Two different in vivo models were used to assess the effect of the MyoD-expressing myofibroblasts: transplantation in the dorsal area of immunodeficient mice and in an adult Achilles tendon injury model. To prevent angiofibrosis, we tested the molecule Xav939 and proceeded with histological stainings, q-RT PCR transcriptional quantification of angifibrotic markers, mechanical tests, and immunofluorescence. Tendinopathy samples showed fibrovascular healing with decreased tenolineage phenotype. Transcriptomic analysis of Mkx−/− tendons revealed myofibroblast-associated biological processes. Over-expression of MyoD in WT tendon stem progenitor cells (TSPCs) gave rise to myofibroblasts reprogramming in-vitro and fibrovascular scarring in-vivo. MKX directly binds to MyoD promoter and underlies global regulative processes related to angiogenesis and Wnt signaling pathway. Blocking Wnt signaling with the small molecule Xav393 resulted in higher histological and biomechanical properties. Taken together, our data provide the first in vivo and in-vitro evidence of tendon stem progenitor cells to myofibroblasts transition and show improved tendon healing via angiofibrosis modulation, thus opening potential therapeutic avenues to treat tendinopathy patients.

Abstract Rho GTPases play an essential role in many cellular processes, including cell cycle progress, cell motility, invasion, migration, and transformation. Several studies indicated that the dysregulation of Rho GTPase signaling is closely related to tumorigenesis. Rho GEFs considered being positive regulators of Rho GTPase, promoting the dissociation of Rho protein from GDP and binding to GTP, thus activating the downstream signaling pathway. Herein, we demonstrated that ARHGEF3, a member of the Rho GEFs family, played an important role in non-small cell lung cancer (NSCLC). We found that ARHGEF3 was highly expressed in non-small cell lung cancer and facilitated cancer cell proliferation of NSCLC cells in vitro and in vivo. Further studies demonstrated that ARHGEF3 enhanced the protein homeostasis of ATP-citrate lyase (ACLY) by reducing its acetylation on Lys17 and Lys86, leading to the dissociation between ACLY and its E3 ligase-NEDD4. Interestingly, this function of ARHGEF3 on the protein homeostasis of ACLY was independent of its GEF activity. Taken together, our findings uncover a novel function of ARHGEF3, suggesting that ARHGEF3 is a promising therapeutic target in non-small cell lung cancer.

Abstract Background Glycogen-Interacting Protein 1 (GNIP1), an E3 ligase, is a member of the tripartite motif (TRIM) family proteins. Current studies on GNIP1 mainly focus on glycogen metabolism. However, the function and molecular mechanisms of GNIP1 in regulating autophagy still remains unclear. This study aimed to investigate the regulatory mechanism of GNIP1 in regulating autophagy in non-small cell lung cancer (NSCLC). Methods Crystal violet staining assays were used to evaluate the ability of cell growth and proliferation. Transwell and scratch wound healing assays were used to evaluate the cell migration ability. The protein expressions were measured by western blot and immunohistochemistry. Co-immunoprecipitation assays determined the protein–protein interactions. The in vivo effect of GNIP1 on tumor growth was determined by xenograft assay. Results We found that GNIP1 was overexpressed in tumor tissues and the expression level of GNIP1 was related to the poor prognosis and the survival time of NSCLC patients. In non-small cell lung cancer (NSCLC), GNIP1 increased proliferation and migration of cancer cells by promoting autophagy. Mechanistic studies indicated that GNIP1, as a scaffold protein, recruited BECN1 and LC3B to promote the formation of autophagosomes. Besides, GNIP1 mediated the degradation of 14-3-3ζ, the negative regulator of VPS34 complex, thus promoting autophagy. Overexpressing GNIP1 promoted tumorigenesis and enhanced autophagy in xenograft models. Conclusion GNIP1 promotes proliferation and migration of NSCLC cells through mediating autophagy, which provides theoretical basis for targeting GNIP1 as anti-cancer drugs. Video Abstract

Magnetic resonance is a fundamental method to manipulate qubits in spin-based quantum information processing. In such areas, the functionality of fast frequency sweeping is required to determine the resonance of the system. We provide a hardware-synchronized sweeping microwave source with a minimal latency in the sub-μs level based on the direct digital synthesizer technique. The output frequency can be up-converted to match the requirement for particular applications. We demonstrate this module in an optically detected magnetic resonance experiment for a nitrogen-vacancy center, and the spectrum is obtained much faster than conventional schemes with high resolution. Comparing with commercial vector signal generators, our module is highly integrated on a single board with a limited area, especially suitable for engineering of quantum sensors and devices in the future.

The tree-ring fire scar stands as a pivotal proxy for reconstructing historical wildfire occurrences, providing invaluable context for comprehending contemporary wildfire activities during the Anthropocene era. Precise identification of fire scars often necessitates sampling complete tree disks. Yet, stringent forest resource protection policies limit such collection in certain regions, thus curtailing the application of tree-ring-based fire reconstruction. While current methods based on tree-ring cores can ascertain the age range of fire events, pinpointing the exact year remains challenging. In this study, we propose a novel approach for detecting fire occurrence years by recognizing abrupt shifts in the tree-ring geometric center (TRGC). This method entails extracting a minimum of three tree-ring cores from the uninjured side of the tree and in proximity to the fire scar. We validated this method’s efficacy using samples from Transbaikal of Russia, in northeastern Asia, where fire years have already been documented. Our results show that this method accurately identified the fire year in nine fire scars with a 67 percent probability of exact agreement with the actual fire year. It is noteworthy that this method particularly excels in cases of trees with a single fire scar. We recommend employing the traditional method of collecting tree-ring cores near the fire scar to establish the age range of the fire scar. Subsequently, within this determined range, we suggest detecting the shifts in the TRGC to accurately pinpoint the exact year of the fire scar.

Abstract Background The effect of dairy products intake on breast cancer (BC) is highly controversial. This study aims to investigate the relationship between dairy intake and BC incidence. Methods A search was carried out in PubMed, EBSCO, Web of Science, and Cochrane Library databases before January 2021. The primary objective was the risk of BC and intake of dairy products were exposure variables. Results The meta-analysis comprised 36 articles with 1,019,232 participants. Total dairy products have a protective effect on female population (hazard ratio (HR) =0.95, 95% confidence interval (CI) =0.91–0.99, p = 0.019), especially for estrogen receptor-positive (ER+) (HR = 0.79, p = 0.002) and progesterone receptor-positive (PR+) BC (HR = 0.75, p = 0.027). For ER+/PR+ BC, there is a trend of protection, but it has not reached statistical significance (HR = 0.92, p = 0.075). Fermented dairy products can reduce BC risk in postmenopausal population (HR = 0.96, 95%CI = 0.93–0.99, p = 0.021), but have no protective effect on premenopausal population (HR = 0.98, 95%CI = 0.94–1.03, p = 0.52). Non-fermented dairy products have no significant effect on BC occurrence (p > 0.05). High-fat dairy products are harmful to women, without statistical difference (HR = 1.06, 95%CI = 1.00–1.13, p = 0.066). On the contrary, low-fat dairy products can protect the premenopausal population (HR = 0.94, 95%CI = 0.89–1.00, p = 0.048). Conclusion The intake of dairy products can overall reduce BC risk in the female population, but different dairy products have varying effects on different BC subtypes and menopausal status.

BackgroundPreeclampsia (PE) is a specific hypertensive disorder in pregnancy. Lead (Pb) is a heavy metal that affects women's reproductive health. However, it is unclear whether lead exposure during can predispose maternal risk of developing preeclampsia. This systematic review and meta-analysis study aimed to explore the association.MethodsWe searched studies from three databases (PubMed, Web of Science, Embase). Only case-control, cross-sectional, and cohort studies reporting maternal blood lead levels (BLL) and PE were included from database inception to 31st July 2022. Pregnant women with blood lead levels measured were eligible. Those healthy pregnant women who did not develop preeclampsia were assessed as comparators. Letters, comments, case reports, and reviews were excluded. Newcastle-Ottawa Scale (NOS) and its adaptive form were applied for assessment. The random-effects method (REM) was applied to calculate the standardized mean difference (SMD) with a 95% confidence interval (CI). Stata 16.0 and RevMan 5.3 were the software used for data extraction and analysis.Results25 studies out of 1,808 articles made the finalist for systematic reviews, of which 21 underwent further quantity analysis. A total of 1,533 preeclamptic women and 10,998 healthy pregnant controls were included in the meta-analysis. The overall result revealed that maternal lead exposure was significantly higher in women with preeclampsia (SMD: 1.06, 95% CI 0.69, 1.43); (I2 = 96.40%; P = 0.000).ConclusionThis study demonstrates that maternal lead exposure is associated with preeclampsia during pregnancy. The association is present even in low blood lead levels. The conclusion should be taken seriously and women should avoid unexpected exposure to a lead-containing environment as much as possible.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=347220, identifier: CRD42022347220.

BackgroundDiabetes mellitus (DM) is a global health problem, and it has become a shocking threat in the contemporary era. The objective of this study was to analyze the safety of sotagliflozin in patients with DM systematically and intuitively.MethodsOn November 15, 2021, literature retrieval was performed on PubMed, Web of Science, EBSCO, and Cochrane libraries. The meta-analysis results included genital mycotic infection, related-to-acidosis events, and other related adverse events, including diarrhea, severe nocturnal hypoglycemia event, and volume depletion. In addition, a subgroup analysis was also conducted based on different doses of sotagliflozin. Moreover, the patient-treated years analyzed in the study were 12 weeks, 24 weeks, and 52 weeks, respectively, for type 1 diabetes, and were 12 weeks, 22 weeks, and 52 weeks, respectively, for type 2 diabetes.ResultsThe results of this meta-analysis illustrated that sotagliflozin could increase the risk of genital mycotic infection for patients with T1D and T2D (RR: 3.49, 95% Cl: 2.54-4.79, p < 0.001; RR: 2.83, 95% Cl: 2.04-3.93, p < 0.001; respectively). In addition, the subgroup analysis showed that the drug doses that could increase the risk of genital mycotic infection were 400 mg and 200 mg (RR: 3.63, 95% Cl: 2.46-5.36, p < 0.001; RR: 3.21, 95% Cl: 1.84-5.62, p < 0.001; respectively) in T1D. Moreover, sotagliflozin could increase the risk of events related to acidosis in the patients of T1D, including acidosis-related adverse events, positively adjudicated diabetic ketoacidosis, acidosis-related event, and diabetic ketoacidosis (RR: 7.49, 95% Cl: 3.20-17.52, p < 0.001; RR: 6.05, 95% Cl: 2.56-14.30, p < 0.001; RR: 4.83, 95% Cl: 3.13-7.45, p < 0.001; RR: 8.12, 95% Cl: 3.06-21.52, p < 0.001; respectively). In the patients of T2D, sotagliflozin could not increase the risk of DKA (RR: 1.30, 95% Cl: 0.34-4.99, p = 0.70). About serious of acidosis-related adverse events, positively adjudicated diabetic ketoacidosis (DKA) and acidosis-related event, the included studies were not reported for T2D patients. As for the other related adverse events, sotagliflozin was found to be a risk factor for diarrhea and volume depletion in T1D patients (RR: 1.44, 95% Cl: 1.09-1.90, p = 0.01; RR: 2.50, 95% Cl: 1.33-4.69, p < 0.01; respectively) and T2D patients (RR: 1.44, 95% Cl: 1.26-1.64, p < 0.001; RR: 1.25, 95% Cl: 1.07-1.45, p < 0.01; respectively).ConclusionsThis meta-analysis showed that the adverse events of sotagliflozin were tolerable to patients with DM, in terms of the incidence of genital mycotic infection, related-to-acidosis events, diarrhea, volume depletion, and severe nocturnal hypoglycemia events. In addition, the subgroup analysis of sotagliflozin dosage is considered to have great clinical significance for future guidance of sotagliflozin application in patients with DM.

Abstract Laboratory experiments have revealed the meteorological sensitivity of the coronavirus disease 2019 (COVID‐19) virus. However, no consensus has been reached about how outdoor meteorological conditions modulate the virus transmission as it is also constrained by non‐meteorological conditions. Here, we identify the outbreak's evolution stage, constrained least by non‐meteorological conditions, by searching the maximum correlation coefficient between the ultraviolet flux and the growth rate of cumulative confirmed cases at the country level. At this least‐constrained stage, the cumulative cases count around 1300–3200, and the count's daily growth rate correlates with the ultraviolet flux and temperature significantly (correlation coefficients r = −0.54 ± 0.09 and −0.39 ± 0.10 at p

Little research has been reported on evaluating the safety of the fixation construct in cervical kyphosis correction. In this study, we proposed a principal-strain criterion to evaluate the safety of the fixation construct and validated the modeling method against a retrospective case of anterior cervical discectomy fusion (ACDF). From C2 to T2 vertebra bodies, fixation instruments were reconstructed and positioned as per postoperative computed tomography (CT) scans. Head weight (HW) and various moments estimated from isometric strength data were imposed onto the C2. The postoperative stability of non-surgical segments, deformations surrounding the screw trajectories, and contact slipping on zygapophysial joints were analyzed. The model was validated against the reality that the patient had a good fusion and deformity correction. The ACDF restricted the range of motions (ROMs) of cervical segments and lent stability to vertebra fusion, no failure was found in the finite element (FE) model of cervical vertebrae. The deformation surrounding the screw trajectories were concentrated to the lateral sides of trajectories, recommending that the shape of the anterior cervical plate conforming to the curvature of the vertebra and screws fully inserted into vertebrae reduced the deformation concentration around the screw trajectories.

The snow cover extent (SCE) on the southeastern Tibet Plateau (SETP) has an important impact on the dynamics of the East Asian winter monsoon and the runoff changes of the first and third largest rivers in Asia, namely, the Yangtze River and the Yarlung Zangbo River. Unfortunately, the shortness of instrumental SCE data of a few decades limits our ability to understand its long-term variability before the industrial era. Here, we developed Abies faxoniana tree-ring total ring width (TRW), early-wood width (EWW), and late-wood width (LWW) chronologies for the past four centuries at Little Qamdo Village (XQDV), Markam County, on the SETP. The most significant positive correlation (r = 0.62, p < 0.01) was found between the EWW chronology and SCE from March to May (SCE3–5). The SCE would affect the onset of the growing season through soil moisture, restricting the early-wood growth of trees. Thus, we presented a reconstruction of SCE3–5via EWW chronology since AD 1660 for SETP. We observed two abrupt changes from low to high around the years 1685 and 1998 for our reconstructed SCE3–5. In addition, we found that the positive anomalies of the reconstructed SCE3–5 after 1988 cohered with the distinct increase of the East Asian winter monsoon.

Due to its obvious advantages in processing big data and image information, the combination of artificial intelligence and medical care may profoundly change medical practice and promote the gradual transition from traditional clinical care to precision medicine mode. In this artical, we reviewed the relevant literatures and found that artificial intelligence was widely used in spine surgery. The application scenarios included etiology, diagnosis, treatment, postoperative prognosis and decision support systems of spinal diseases. The shift to artificial intelligence model in medicine constantly improved the level of doctors' diagnosis and treatment and the development of orthopedics.

Current scholarship tends to see temporality as a problem or challenge to be overcome in communication on social media (as in “context collapse” and “time collapse”). Drawing on in-depth interviews of Chinese users of a digital writing function (bullet comments) on a major video-sharing platform, we aim to expand current research and deepen understandings of temporality and digital writing. We offer a broader, more positive conceptualization of time on social media by highlighting an alternative set of time-related practices and experiences, mediated by bullet comments. Following recent studies of individuals’ making and experiencing of time in media-saturated societies, our article investigates Chinese social media users’ diverse time-sensitive practices and multi-dimensional temporal experiences. We outline their creative practices from the bottom up, which make use of the distinct technological design of bullet comments. Four interrelated themes in their temporal experiences are analyzed and the similarities and differences with the Deleuzian concept of “crystal of time” explained. Overall, we demonstrate the semiotic power of digital writing in facilitating new meaning-making practices, producing multi-layered mediated temporalities, and affording multisensory, enriching, bonding experiences. The significance and implications of this study for future studies are discussed, in view of the expansion of bullet comments to Chinese mainstream, commercial platforms.

Abstract Background The prognosis of pancreatic cancer (PC) is extremely poor, and most patients with metastatic PC still receive palliative care. Here, we report the efficacy and safety of FOLFIRINOX (oxaliplatin, irinotecan, leucovorin, 5-fluorouracil) in the treatment of metastatic PC. Methods We searched PubMed, Web of Science, EBSCO, and Cochrane library databases for articles that described efficacy and safety of FOLFIRINOX in patients with metastatic PC, from January 1996 to July 2020. The primary outcomes targeted included overall survival (OS) and progression-free survival (PFS). Results We found that FOLFIRINOX could directly improve OS rate of patients with metastatic PC (HR 0.76, 95% Cl 0.67–0.86, p0.05). The main adverse events (AEs) targeted hematological toxicity and the gastrointestinal system, and included febrile neutropenia, a reduction in white blood cells and appetite, as well as diarrhea. Conclusion These findings indicated that FOLFIRINOX has potential benefits for the prognosis of patients with metastatic PC. Furthermore, there is no difference between the regimen of FOLFIRINOX and nab-paclitaxel + gemcitabine in this study. The application of FOLFIRINOX should be according to the actual situation of the patients and the experience of the doctors. Graphical abstract

Breast invasive carcinoma (BRCA) is a carcinoma with a fairly high incidence, and the therapeutic schedules are generally surgery and chemotherapy. However, chemotherapeutic drugs tend to produce serious toxic side effects, which lead to the cessation of treatment. Therefore, it is imperative to develop treatment strategies that are more effective and have fewer side effects at the genetic level. Centromeric protein W (CENPW) is an oncogene that plays an important part in nucleosome assembly. To date, no studies have reported the prognostic significance of CENPW in breast carcinoma. In this study, we verified that CENPW expression is up-regulated in breast carcinoma and positively associated with the level of immune cell infiltration. The clinicopathological characteristics further suggest that CENPW expression is correlated with a worse prognosis of breast carcinoma. Interestingly, the CENPW mutation contributes to the poor prognosis. Next, we discovered that the genes interacting with CENPW are mainly concentrated in the cell cycle pathway, and CENPW is co-expressed with CDCA7, which is also highly expressed in breast carcinoma and leads to a worse prognosis. Our subsequent studies verified that knockdown of CENPW significantly inhibits the proliferation and migration of breast carcinoma cells and promotes their apoptosis rate. Notably, inhibition of CEMPW sensitizes breast cancer cells to chemotherapeutic drugs that have been found to induce cell cycle arrest. In summary, these results provide extensive data and experimental evidence that CENPW can serve as a novel predictor of breast cancer and may act as a prospective therapeutic target.

BackgroundRecently, there have been some reports on surgical treatment for Klippel–Feil syndrome, but the prevalence and risk factors of surgery have not been well evaluated. This study sought to find the prevalence and potential risk factors of surgical treatment.MethodsA retrospective radiographic review of 718 Klippel–Feil syndrome patients seen at Peking University Third Hospital from January 2010 to October 2017 was performed. Parameters included age, gender, deformity, cervical instability, Samartzis classification, and surgical treatment. Based on the surgical treatment they received, patients were divided into a surgery group and a non-surgery group. Prevalence and possible risk factors of surgical treatment were assessed.ResultsA total of 718 Klippel–Feil syndrome patients, including 327 men and 391 women, with an average age of 46.8 years were enrolled. According to the Samartzis classification scheme, 621 cases (86.5%) were classified as type I, 48 cases (6.7%) were classified as type II, and 49 cases (6.8%) were classified as type III, respectively. The most commonly fused segments were C2–3 (54.9%) and C5–6 (9.3%). Of all 718 patients, 133 (18.5%) patients underwent surgical treatment, mainly via the posterior approach (69.9%). The clinical factors included age, gender, deformity, instability, and Samartzis classification. Men were more likely to require surgical treatment (p

Miscarriage poses a significant threat to pregnant women globally. Recurrent miscarriages or potential poor embryonic development indicated by early drops in serum human chorionic gonadotrophin (hCG) are even more catastrophic for pregnant women. However, these patients receive either individualized medical intervention supported by limited evidence or no treatment at all. In this study, we report ten patients who shared at least one episode of an early decline of hCG in the first trimester and were treated with compassionate use of tumor necrosis factor-alpha inhibitor (TNFi). They were then followed up regularly with caution. Their hCG trajectory all resumed a normal pattern within one week and the obstetric outcomes were promising. No adverse fetal, neonatal, or maternal health issues have been observed. This case series supports current safety evidence of TNFi and provides new insight into its use in pregnancy when the embryo is in danger. Further well-designed clinical trials should be carried out to consolidate the evidence.

PurposeTo study the clinical application value of Modified Buzhong Yiqi Decoction in the treatment of female stress urinary incontinence (SUI).MethodsA total of 103 female patients with SUI were included in this study, 13 were lost to follow-up, and the final number of studies was 90. General information about the patients, including age, years of menopause, body mass index (BMI), reproductive history, chronic respiratory disease, hypertension, and diabetes, were recorded. All the patients were treated with Modified Buzhong Yiqi Decoction alone for 4 weeks. The Patient Global Impression of Improvement (PGI-I), the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICI-QSF) and 72-h voiding diary were used to evaluate the patients' subjective symptoms and urinary incontinence degree before treatment, 1 month after treatment and 1 year after treatment, the efficacy and efficacy-related factors of Modified Buzhong Yiqi Decoction in the treatment of female SUI were analyzed.ResultsOne month after Modified Buzhong Yiqi Decoction treatment, compared with before treatment, the PGI-I questionnaire was very much better (68.89%), much better (8.89%), a little better (12.33%), no change (8.89%), the ICI-QSF score decreased (P < 0.05), and 72-h urine leakage frequency decreased (P < 0.05); One year after treatment compared with before treatment, the PGI-I questionnaire was very much better (40.00%), much better (17.78%), a little better (12.22%), no change (30.00%), the ICI-QSF score decreased (P < 0.05), and 72-h urine leakage frequency decreased (P < 0.05); and 1 year after treatment compared with 1 month after treatment, the ratio of very much better at 1 year after treatment was significantly decreased (P < 0.05), the score of the ICI-QSF was significantly increased (P < 0.05), and 72-h urine leakage frequency was significantly increased (P < 0.05). The correlation analysis showed that the efficacy at 1 month after treatment was negatively correlated with the severity of SUI and chronic respiratory diseases, but was not significantly correlated with age, menopause status, BMI, number of pregnancies, and number of births. The efficacy at 1 year after treatment was negatively correlated with the severity of SUI, chronic respiratory disease, age, and number of births and was positively correlated with BMI, but not significantly correlated with menopause status and number of pregnancies.ConclusionModified Buzhong Yiqi Decoction can effectively treat SUI in women. The efficacy is related to the severity of SUI and chronic abdominal hypertension, but the long-term efficacy decreases.

Multi-modality imaging constitutes a foundation of precision medicine, especially in oncology where reliable and rapid imaging techniques are needed in order to insure adequate diagnosis and treatment. In cervical cancer, precision oncology requires the acquisition of 18F-labelled 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET), magnetic resonance (MR), and computed tomography (CT) images. Thereafter, images are co-registered to derive electron density attributes required for FDG-PET attenuation correction and radiation therapy planning. Nevertheless, this traditional approach is subject to MR-CT registration defects, expands treatment expenses, and increases the patient's radiation exposure. To overcome these disadvantages, we propose a new framework for cross-modality image synthesis which we apply on MR-CT image translation for cervical cancer diagnosis and treatment. The framework is based on a conditional generative adversarial network (cGAN) and illustrates a novel tactic that addresses, simplistically but efficiently, the paradigm of vanishing gradient vs. feature extraction in deep learning. Its contributions are summarized as follows: 1) The approach-termed sU-cGAN- uses, for the first time, a shallow U-Net (sU-Net) with an encoder/decoder depth of 2 as generator; 2) sU-cGAN's input is the same MR sequence that is used for radiological diagnosis, i.e. T2-weighted, Turbo Spin Echo Single Shot (TSE-SSH) MR images; 3) Despite limited training data and a single input channel approach, sU-cGAN outperforms other state of the art deep learning methods and enables accurate synthetic CT (sCT) generation. In conclusion, the suggested framework should be studied further in the clinical settings. Moreover, the sU-Net model is worth exploring in other computer vision tasks.

Specialized services and management must understand students' behavioral patterns in a timely and accurate manner. Based on these patterns, we can make targeted rules, especially for unexpected patterns. To perform this type of work, a questionnaire method is usually used to collect data and analyze students' behavioral states. However, the effectiveness of this method is greatly influenced by the timeliness and validity of the feedback data. To address this problem, we propose an unsupervised ensemble clustering framework to use student behavioral data to discover behavioral patterns. Because the behavioral data produced by students on campus are available in real time without intentional bias, clustering analysis can be relatively efficient and reliable. The proposed framework extracts behavior features from the two perspectives of statistics and entropy and then combines density-based spatial clustering of applications with noise (DBSCAN) and k-means algorithms to discover behavioral patterns. To evaluate the performance of the proposed framework, we carry out experiments on six types of behavioral data produced by undergraduates in a university in Beijing and analyze the relationships between different behavioral patterns and students' grade point averages (GPAs). The results show that the framework can not only detect anomalous behavioral patterns but also find mainstream patterns. The findings from this research can assist student-related departments in providing better services and management, such as psychological consulting and academic guidance.

Bisphenol A (BPA) is a major component of polycarbonate plastics and epoxy resins. While many studies have investigated the effect BPA exposure has upon changes in gut microbial communities, the influence of gut microbiota on an organism’s ability to metabolize BPA remains comparatively unexplored. To remedy this, in this study, Sprague Dawley rats were intermittently (i.e., at a 7-day interval) or continuously dosed with 500 μg BPA/kg bw/day for 28 days, via oral gavage. In the rats which underwent the 7-day interval BPA exposure, neither their metabolism of BPA nor their gut microbiota structure changed greatly with dosing time. In contrast, following continuous BPA exposure, the relative level of Firmicutes and Proteobacteria in the rats’ guts significantly increased, and the alpha diversity of the rats’ gut bacteria was greatly reduced. Meanwhile, the mean proportion of BPA sulfate to total BPA in rat blood was gradually decreased from 30 (on day 1) to 7.4% (by day 28). After 28 days of continuous exposure, the mean proportion of BPA glucuronide to total BPA in the rats’ urine elevated from 70 to 81%, and in the rats’ feces the mean proportion of BPA gradually decreased from 83 to 65%. Under continuous BPA exposure, the abundances of 27, 25, and 24 gut microbial genera were significantly correlated with the proportion of BPA or its metabolites in the rats’ blood, urine, and feces, respectively. Overall, this study principally aimed to demonstrate that continuous BPA exposure disrupted the rats’ gut microbiota communities, which in turn altered the rats’ metabolism of BPA. These findings contribute to the better understanding of the metabolism of BPA in humans.

Abstract Purpose The purpose of this study was to explore the clinical features, risk factors, and outcomes of mixed Candida albicans/bacterial bloodstream infections (mixed-CA/B-BSIs) compared with monomicrobial Candida albicans bloodstream infection (mono-CA-BSI) in adult patients in China. Methods All hospitalized adults with Candida albicans bloodstream infection (CA-BSI) were recruited for this retrospective observational study from January 1, 2013, to December 31, 2018. Results Of the 117 patients with CA-BSI, 24 patients (20.5%) had mixed-CA/B-BSIs. The most common copathogens were coagulase-negative Staphylococcus (CNS) (24.0%), followed by Klebsiella pneumoniae (20.0%) and Staphylococcus aureus (16.0%). In the multivariable analysis, a prior ICU stay > 2 days (adjusted odds ratio [OR], 7.445; 95% confidence interval [CI], 1.152–48.132) was an independent risk factor for mixed-CA/B-BSIs. Compared with patients with mono-CA-BSI, patients with mixed-CA/B-BSIs had a prolonged length of mechanical ventilation [17.5 (4.5, 34.8) vs. 3.0 (0.0, 24.5), p = 0.019] and prolonged length of ICU stay [22.0 (14.3, 42.2) vs. 8.0 (0.0, 31.5), p = 0.010]; however, mortality was not significantly different. Conclusions There was a high rate of mixed-CA/B-BSIs cases among CA-BSI cases, and CNS was the predominant coexisting species. A prior ICU stay > 2 days was an independent risk factor for mixed -CA/B-BSIs. Although there was no difference in mortality, the outcomes of patients with mixed -CA/B-BSIs, including prolonged length of mechanical ventilation and prolonged length of ICU stay, were worse than those with mono-CA-BSI; this deserves further attention from clinicians.

Abstract Background This study aimed to investigate the predictive value of the D-dimer level for venous thromboembolism (VTE) events during puerperium of women age at 35 years or older, as well as to identify other risk factors associated with the occurrence of VTE. Methods It was a prospective observational cohort study, from January 2014 to December 2018, which involved 12,451 women age 35 or older who delivered at least 28 weeks of gestation at Women’s Hospital of Zhejiang University, School of Medicine. The maternal and fetal demographic characteristics, pregnancy complications, imaging finding and results of laboratory test within postpartum 24 h including D-dimer level, platelet counts and fibrinogen level were collected for analyses. Results 30(2.4‰) women were identified as VTE, including 1 pulmonary embolism event and 29 deep venous thrombosis events. The receiver operating characteristic (ROC) curve analysis suggested the best cutoff point for D-dimer level within postpartum 24 h of women age 35 or older was 5.545 mg/L, with a specificity of 70.0% and a sensitivity of 75.4%. Besides, there was no statistical correlation between platelet counts and VTE, as well as between fibrinogen level and VTE. On multivariate analysis, D-dimer≥5.50 mg/L (OR = 5.874, 95%CI: 2.678–12.886) and emergency cesarean section (OR = 11.965, 95%CI: 2.732–52.401) were independently associated with VTE in puerperium of women age 35 or older. Conclusions We concluded that D-dimer≥5.50 mg/L was an independent predictor of VTE in puerperium with maternal age 35 or older and D-dimer testing was a necessary examination for perinatal women.

Abstract Background The aim of this study is to investigate the reliability, validity, and responsiveness of JOACMEQ for CSM patients in mainland China. Methods A retrospective review was performed on 91 patients with CSM in our hospital from March 2015 to June 2015. Patients completed the JOACMEQ, the mJOA and the SF-36 questionnaires during the process. Cronbach's α was used to evaluate the internal consistency reliability, and test–retest reliability was checked. An exploratory factor analysis was used to determine the correlations among the JOACMEQ questions and the construct validity. The concurrent validity was assessed by Spearman correlation coefficient. The internal responsiveness was determined by effect sizes and standardized response means. External responsiveness was determined by the area under the receiver operating characteristic curve on the basis of the Youden Index. Results The mean age of patients was 57.61 years old. The mean follow-up was 24 months. JOACMEQ showed a good internal consistency (Cronbach's α, 0.897). Test–retest reliability showing good result (Pearson's correlation, 0.695–0.905). Our data were amenable to factor analysis (KMO = 0.816, Bartlett's test, χ2(45) = 1199.99, p

Background: With the onset of the coronavirus disease 2019 (COVID-19) pandemic at the beginning of 2020, all non-essential medical treatments were suspended, including fertility treatments. As a unique group in society, patients with infertility may be more sensitive and vulnerable in the face of pressure and crisis. However, to the best of our knowledge, there have been no reports on the influence of postponed fertility treatment on the sexual health of infertile patients owing to COVID-19. Therefore, this study aimed to investigate whether postponed fertility treatment resulting from COVID-19 affects the sexual health of patients with infertility.Methods: A total of 1,442 participants were included for analysis in this large-scale study. Those with postponed fertility treatment were categorised as group A (n = 474), whereas those whose fertility treatment was not delayed were in group B (n = 968). The sexual health and psychological well-being were compared between the two groups.Results: The total Female Sexual Function Index score and five domains of female sexual function (arousal ability, vaginal lubrication, orgasm, satisfaction, and coital pain) were significantly lower in group A than those in group B (p < 0.05). The International Index of Erectile Dysfunction score and Premature Ejaculation Diagnostic Tool score were significantly higher in group A than those in group B (p < 0.05).Conclusions: Delaying fertility treatment obviously affects patients' sexual and mental health. Through a structural equation model, we observed that postponed fertility treatment mediates sexual health by regulating psychological distress and couple relationship quality.

Monitoring cambial activity is important for a better understanding of the mechanisms governing xylem growth responses to climate change, providing a scientific basis for tree-ring-based climate reconstructions and projections about tree growth under future climate scenarios. It plays an even more important role in investigating evergreen tree growth in regions with less distinct seasonal cycles. Subtropical evergreen forests have been studied in recent years for their sensitivity to climate change, but it remains unclear how xylem growth is driven by subtropical climates. To further understand the climate-growth response strategies of subtropical conifers, we micro-cored Cryptomeria fortunei and Cunninghamia lanceolata weekly in 2016 and 2017 at the humid subtropical Gushan Mountain in southeastern China. Our weekly growth monitoring showed that the vegetation periods of these two species were both approximately 2–3 months longer than trees in temperate and boreal forests. The growth of C. fortunei in 2016 and 2017 and C. lanceolata in 2017 showed a bimodal pattern of xylogenesis, which was induced by summer drought. The results also indicated that the earlier end of the xylem formation was related to the yearly drought stress. These findings provide more specific information about tree growth and evidence of how climate influences wood production at the cellular level in subtropical regions.

Hydroclimatic change across China has received considerable attention due to its vital significance for regional ecosystem stability and economic development, yet the spatiotemporal dynamics of its nonlinear trends and complexity have not been fully understood. Herein, the spatiotemporal evolution of Dai’s self-calibrating Palmer drought severity index (scPDSI) trends in China during the period from 1951 to 2014 is diagnosed using the ensemble empirical mode decomposition (EEMD) method. A persistent and noticeable drying has been identified in North and Northeastern China (NNEC) since the 1950s. Significant wetting in the north of the Tibetan Plateau (TP) and the south of the western parts of Northwestern China (WNWC) started sporadically at first and accelerated until around 1980. A slight wetting trend was found in Southwest China (SC) before 1990, followed by the occurrence of a dramatic drying trend over the following decades. In addition, we have found that the scPDSI variations in WNWC and the TP are more complex than those in NNEC and SC based on our application of Higuchi’s fractal dimension (HFD) analysis, which may be related to complex circulation patterns and diverse geomorphic features.

MCrAlY (M = Ni or/and Co) coatings have played an indispensable role in the high-temperature protection system for key components of aero-engines due to their excellent high-temperature oxidation and hot corrosion resistance. Nanoindentation is a useful and highly efficient method for characterizing the nanomechanical properties of materials. The rich information reflecting materials can be gained by load-displacement curves. In addition to common parameters such as elastic modulus and nanohardness, the indentation work and creep property at room temperature can also be extracted. Herein, nanomechanical properties of NiCoCrAlYCe coatings using high-velocity oxygen-fuel (HVOF) spraying were investigated systematically by nanoindentation. The microstructure of as-sprayed NiCoCrAlYCe coatings present mono-modal distribution. Results of nanoindentation reveal that the elastic modulus and nanohardness of NiCoCrAlYCe coatings are 121.08 ± 10.04 GPa and 6.09 ± 0.86 Gpa, respectively. Furthermore, the indentation work of coatings was also characterized. The elastic indentation work is 10.322 ± 0.721 nJ, and the plastic indentation work is 22.665 ± 1.702 nJ. The ratio of the plastic work to the total work of deformation during indentation is 0.687 ± 0.024, which can predict excellent wear resistance for NiCoCrAlYCe coatings. Meanwhile, the strain rate sensitivity determined by nanoindentation is 0.007 ± 0.001 at room temperature. These results can provide prediction of erosion resistance for MCrAlY coatings.

Tree-ring latewood is a key proxy for the reconstruction of climate, especially for temperature. The mechanisms of latewood formation and its responses to climates remain uncertain. Given that the tree-ring latewood of the taproot is absent belowground under conditions of low temperature gradients, we thus hypothesize that low diurnal temperature ranges (DTRs) may be one determining factor for latewood production. To evaluate this hypothesis, we designed experimental investigations by adding heat-protecting layers to the trunks of Pinus massoniana Lamb. to lower DTRs and simulate the environmental conditions underground in the Fuzhou area of humid subtropical China (HSC). We found that a decreased DTR induces a significant decline in latewood cell thickness and a slight reduction in latewood cell number and latewood density. DTRs played an important role in the formation of tree-ring width (TRW) and latewood width (LWW) rather than precipitation. Our study highlighted the effects of DTRs on tree growth and wood anatomical changes and provided a possible explanation for the “divergence problem” in dendroclimatology.

Uncontrollable bleeding is a major problem in surgery and after trauma. Here the authors design a photo-reactive adhesive that mimics the composition of connective tissue and is able to stop high pressure bleeding within half a minute.

Abstract Introduction Taxis play an important role among public transport modes in China, but there has been very little in-depth research regarding taxi drivers’ crash risk. Thus, this study aimed to develop a quantitative method to predict taxi drivers’ crash risk and identify contributory factors. Methods Nine hundred fourty-eight professional taxi drivers in Xi’an, China completed an anonymous, structured face-to-face questionnaire reporting their demographic information, work-related stress, daily risky driving behaviors, and crash experience within the 3 years prior to the survey. A Negative-Binomial regression model was used to predict the risk of personal injury collisions for taxi drivers. Results Drivers’ 7 risky driving behaviors (e.g., disregarding red lights, speeding, aggressive driving, driving while sleepy or fatigued, etc.) were significantly and positively related to the risk of personal injury collisions, while driver’s parking at will to pick up/drop off passengers was not a significant predictor of such risk for taxi drivers. Furthermore, driver’s sociodemographic characteristics and level of occupational workload were not found to be significantly correlated with the personal injury crash risk. Conclusions Risk traits appear to peak among male taxi drivers who drive more hours per day, pay high management fees, and frequently engage in risky behaviors while driving. These findings provide implications to design potentially useful policy initiatives as well as targeted safety promotion programs to prevent road crashes involving professional taxi drivers.

The purpose of our study was to evaluate pregnancy outcomes of women with antiphospholipid antibodies (aPL) positivity and assess risk factors associated with adverse pregnancy outcomes. Pregnant women with aPL positivity were enrolled prospectively in China from January 2017 to March 2020. Treatment of low-dose aspirin and low molecular weight heparin were given. Pregnancy outcomes and coagulation function were recorded and compared with normal pregnancies. Multivariable logistic regression was performed to identify risk factors associated to intrauterine growth restriction (IUGR). 270 pregnant women, including 44 diagnosed as Antiphospholipid syndrome (APS), 91 as non-criteria APS (NCAPS) and 135 normal cases as control, were enrolled in the study. The live birth rate in aPL carriers and APS group was 97% and 95.5%, respectively. Adverse pregnancy outcomes did not show significant difference between aPL carriers and normal pregnancies, and between APS and NCAPS, except for IUGR. The incidence of IUGR was significantly higher in aPL carriers than normal pregnancies, and in APS patients than NCAPS (P < 0.05). After controlling for age, in vitro fertilization (IVF), pregnancy losses related to APS and treatment, anticardiolipin (aCL) positivity was the only variable significantly associated with IUGR, with an adjusted odds ratio of 4.601 (95% CI, 1.205-17.573). Better pregnant outcomes of aPL positive women, include APS and NCAPS, were achieved in our study with treatment based on low-dose aspirin (LDA) plus low molecular weight heparin (LMWH). The incidence of IUGR was still higher in them, and aCL positivity was the only one risk factor associated with IUGR.

The East Asian summer monsoon (EASM) exhibits considerable decadal variations since the late 20th century. Efforts to examine long-term behaviors and dynamics of the EASM are impeded largely due to the shortness of instrumental meteorological records. So far, reconstructions of the EASM with annual resolution from its core regions remain limited. We conduct the first 200-year robust EASM reconstruction based on tree-ring cellulose δ18O records derived from Pinus massoniana trees growing in the middle Yangtze River basin, one of the core EASM areas. The δ18O chronology accounts for 46.2% of the actual variation in an index of the EASM from 1948 to 2014. The reconstructed EASM indicates that the monsoon intensity was below average before the 1950s, peaked in the 1950s-1970s, and then began to decline. The reconstructed EASM is negatively correlated with the El Niño-Southern Oscillation (ENSO), but this teleconnection is dynamic through time, i.e. enhanced (reduced) ENSO variability coheres with strong (weak) EASM-ENSO connections. In addition, despite high ENSO variability since the 1980s, the EASM-ENSO relationship weakened possibly due to anthropogenic impact, particularly aerosol emissions.

Background: Polycystic ovary syndrome (PCOS) is a major endocrine and metabolic disorder with heterogeneous manifestations and complex etiology. As a leading cause of anovulatory infertility, the molecular diversity of the follicular microenvironment has not been fully elucidated. The aim of the present study was to investigate the follicular fluid proteomic profiles of overweight/obese and normal-weight women with PCOS, to identify novel molecular mechanisms underlying PCOS and to determine the effect of obesity on the follicular fluid protein profiles.Methods: Follicular fluid samples were collected from 3 different groups: overweight/obese PCOS patients (n = 29), normal-weight PCOS patients (n = 29), and normo-ovulatory controls (n = 29). We used a quantitative approach with tandem mass tag labeling and liquid chromatography tandem mass spectrometry to identify the differentially expressed proteins. Differential abundance of four selected proteins was confirmed by ELISA. Gene Set Enrichment Analysis was also conducted to further explore our findings. Furthermore, we compared the clinical, hormonal, and biochemical characteristics of overweight/obese and normal-weight patients with PCOS to determine the effects of obesity.Results: A total of 1,153 proteins were identified, of which 41 and 19 proteins were differentially expressed in the overweight/obese PCOS group vs. the control group, and in the normal-weight PCOS group vs. the control group, respectively. Bioinformatics analyses showed that the inflammatory, immunological, and metabolic-related biological processes were co-enriched in both subgroups of PCOS. Apolipoprotein A-II, complement C5, fetuin-B, and stromal cell-derived factor 1 were found to be involved in various processes and were validated using the ELISA analysis. From clinical features and proteomic data, obesity was found to worsen follicular development disturbances in PCOS.Conclusion: In this proteomic study, a panel of proteins were found differentially expressed in the follicular fluid of PCOS. Inflammatory, immunological, and metabolic abnormalities were identified inside the intra-follicular environment, which could be aggravated by obesity. The identified proteins were correlated with follicular growth and may be considered as candidate biomarkers as well as therapeutic targets of PCOS.