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Abstract Background Acute kidney injury (AKI) is a common and serious condition, particularly among elderly patients. It is associated with high morbidity and mortality rates, further compounded by the need for continuous renal replacement therapy in severe cases. To improve clinical decision-making and patient management, there is a need for accurate prediction models that can identify patients at a high risk of mortality. Methods Data were extracted from the Dryad Digital Repository. Multivariate analysis was performed using least absolute shrinkage and selection operator (LASSO) logistic regression analysis to identify independent risk factors and construct a predictive nomogram for mortality within 28 days after continuous renal replacement therapy in elderly patients with acute kidney injury. The discrimination of the model was evaluated in the validation cohort using the area under the receiver operating characteristic curve (AUC), and calibration was evaluated using a calibration curve. The clinical utility of the model was assessed using decision curve analysis (DCA). Results A total of 606 participants were enrolled and randomly divided into two groups: a training cohort (n = 424) and a validation cohort (n = 182) in a 7:3 proportion. A risk prediction model was developed to identify independent predictors of 28-day mortality in elderly patients with AKI. The predictors included age, systolic blood pressure, creatinine, albumin, phosphorus, age-adjusted Charlson Comorbidity Index (CCI), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and sequential organ failure assessment (SOFA) score. These predictors were incorporated into a logistic model and presented in a user-friendly nomogram. In the validation cohort, the model demonstrated good predictive performance with an AUC of 0.799. The calibration curve showed that the model was well calibrated. Additionally, DCA revealed significant net benefits of the nomogram for clinical application. Conclusion The development of a nomogram for predicting 28-day mortality in elderly patients with AKI receiving continuous renal replacement therapy has the potential to improve prognostic accuracy and assist in clinical decision-making.

Pulmonary sarcomatoid carcinoma (PSC), a rare non-small cell lung cancer (NSCLC) subtype, poses diagnostic and treatment difficulties. Current research explores targeted therapies and immunotherapy to improve patient outcomes. This case report details a male patient diagnosed with PSC via pathology. Tests revealed high levels of PD-L1, a marker suggesting potential benefit from immune checkpoint inhibitors. However, despite bronchoscopic intervention, his advanced stage IIIB cancer (cT3N2bM0) progressed quickly, with progression-free survival (PFS) under 3 months. Following progression, the patient received tislelizumab (anti-PD-1 antibody) and anlotinib (an anti-angiogenic drug) as second-line therapy. This combination showed promise, achieving near-partial remission after the first cycle. Subsequent scans documented continued tumor shrinkage until the patient experienced fatal hemoptysis. This case highlights the potential benefits of combining tislelizumab with anlotinib for PSC. However, it also represents the first reported case of fatal hemoptysis with this specific treatment regimen. This finding emphasizes the need for increased awareness of this potential complication, especially in patients with centrally located PSC treated with anti-angiogenic agents like anlotinib.

Highlights MVOH/rGO cathode with dual defect of Mg2+ pre-intercalation defect (P-Mgd) and surface oxygen defect (Od) is prepared. The dual defect of Od and P-Mgd in MVOH/rGO lamellar structure effectively enhances Mg2+ migration kinetics, structural stability, and electronic conductivity. The Mg foil//MVOH/rGO full cell achieves an ultralong lifespan of 850 cycles at 0.1 A g−1 and powers an orange light-emitting diode.

Abstract Drought is more frequent and intensified due to global warming. Changed conditions in Beijing‐Tianjin–Hebei region which is drier and warmer than before, make it necessary to investigate various optimized irrigation schemes in the winter wheat production. In this study, the DSSAT–CERES‐Wheat model verified by field experimental data was applied to simulate the yield of winter wheat in Beijing–Tianjin–Hebei region from 2010 to 2069a under RCP8.5 climate scenario. The irrigation schemes were set up by adjusting the irrigation amount and irrigation structure to evaluate their adaptive capacity to climate change. The results showed that the regional average yield reduction rates of potential drought were 81.98% and 78.86% in 2010–2039a and 2040–2069a, which were higher in the north than that in the south. The yield reduction rate of potential drought increased with the decrease of irrigation amount, and the adaptive capacity declined with the decrease of irrigation amount, under the same irrigation structure. When 3‐9‐6 irrigation structure was applied, the regional averages of adaptive capacity to potential drought were 28.30%, 26.23%, and 22.22% in 2010–2039a, 29.00%, 26.67%, and 21.76% in 2040–2069a. The shortage of water resources caused by climate change and the possibility of drought limit the potential yield of winter wheat as high as 80% in this region. Priority shall be given to meeting the water demand in jointing stage and filling stage. Irrigation scheme of 3‐9‐6 structure with 180 mm irrigation amount shall be recommended and its adaptive capacity to climate change is the strongest in the near term and the medium‐term. Even if a further 20% reduction in irrigation is applied (144 mm), the dual goals of reducing yield loss and saving 8.28 × 108 t irrigation water per winter wheat season can be achieved.

Abstract Mg‐ion batteries (MIBs) are promising next‐generation secondary batteries, but suffer from sluggish Mg2+ migration kinetics and structural collapse of the cathode materials. Here, an H2O‐Mg2+ waltz‐like shuttle mechanism in the lamellar cathode, which is realized by the coordination, adaptive rotation and flipping, and co‐migration of lattice H2O molecules with inserted Mg2+, leading to the fast Mg2+ migration kinetics, is reported; after Mg2+ extraction, the lattice H2O molecules rearrange to stabilize the lamellar structure, eliminating structural collapse of the cathode. Consequently, the demo cathode of Mg0.75V10O24·nH2O (MVOH) exhibits a high capacity of 350 mAh g−1 at a current density of 50 mA g−1 and maintains a capacity of 70 mAh g−1 at 4 A g−1. The full aqueous MIB based on MVOH delivers an ultralong lifespan of 5000 cycles The reported waltz‐like shuttle mechanism of lattice H2O provides a novel strategy to develop high‐performance cathodes for MIBs as well as other multivalent‐ion batteries.

Abstract Objective To analyze recurrent factors in patients with clinical early-stage cervical cancer (ESCC) following hysterectomy and adjuvant radiotherapy. Methods We collected data from patients with ESCC, staged according to the 2009 Federation International of Gynecology and Obstetrics (FIGO) staging criteria, who underwent hysterectomy followed by adjuvant radiotherapy between 2012 and 2019. These patients were subsequently restaged using the 2018 FIGO criteria. Univariable and multivariable analyses, along with nomogram analyses, were conducted to explore factors associated with recurrence-free survival (RFS). Results A total of 310 patients met the inclusion criteria, with a median follow-up time of 46 months. Among them, 126 patients with ESCC were restaged to stage III C1 or III C2 after surgery due to lymph node metastasis (LNM) based on the 2018 FIGO staging criteria. Of these, 60 (19.3%) experienced relapse. The 1-, 3-, and 5-year RFS rates were 93.9%, 82.7%, and 79.3%, respectively. Multivariate analysis revealed that the number of positive lymph nodes (LNs), tumor diameter (TD) > 4 cm, and parametrial invasion (PI) were associated with recurrence. The nomogram indicated their predictive value for 3-year and 5-year RFS. Notably, the 5-year recurrence rate (RR) increased by 30.2% in patients with LNM, particularly those with ≥ 3 positive LNs (45.5%). Patients with stage III C2 exhibited a significantly higher RR than those with IIIC1 (56.5% vs. 24.3%, p 4 cm was 65.8%, significantly lower than for those with TD ≤ 4 cm (88.2%). Subgroup analysis revealed higher 5-year RRs in patients with stage III C2 than that in patients with III-C1 (56.5% vs. 24.3%, p 4 cm, and PI. Emphasis should be placed on the common high-risk factor of LNM association with recurrence after radical hysterectomy in ESCC.

Abstract Bone metastasis is of common occurrence in renal cell carcinoma with poor prognosis, but no optimal treatment approach has been established for bone metastatic renal cell carcinoma. To explore the potential therapeutic targets for bone metastatic renal cell carcinoma, we profile single cell transcriptomes of 6 primary renal cell carcinoma and 9 bone metastatic renal cell carcinoma. We also include scRNA-seq data of early-stage renal cell carcinoma, late-stage renal cell carcinoma, normal kidneys and healthy bone marrow samples in the study to better understand the bone metastasis niche. The molecular properties and dynamic changes of major cell lineages in bone metastatic environment of renal cell carcinoma are characterized. Bone metastatic renal cell carcinoma is associated with multifaceted immune deficiency together with cancer-associated fibroblasts, specifically appearance of macrophages exhibiting malignant and pro-angiogenic features. We also reveal the dominance of immune inhibitory T cells in the bone metastatic renal cell carcinoma which can be partially restored by the treatment. Trajectory analysis showes that myeloid-derived suppressor cells are progenitors of macrophages in the bone metastatic renal cell carcinoma while monocytes are their progenitors in primary tumors and healthy bone marrows. Additionally, the infiltration of immune inhibitory CD47 + T cells is observed in bone metastatic tumors, which may be a result of reduced phagocytosis by SIRPA-expressing macrophages in the bone microenvironment. Together, our results provide a systematic view of various cell types in bone metastatic renal cell carcinoma and suggest avenues for therapeutic solutions.

Abstract This study systematically analyzed the molecular mechanism and function of nuclear factor kappa B subunit 2 (NFKB2) in colorectal cancer (CRC) to investigate the potential of NFKB2 as a therapeutic target for CRC. Various experimental techniques, including RNA sequencing, proteome chip assays, and small molecule analysis, were used to obtain a deeper understanding of the regulation of NFKB2 in CRC. The results revealed that NFKB2 was upregulated in a significant proportion of patients with advanced hepatic metastasis of CRC. NFKB2 played an important role in promoting tumor growth through CD8+ T‐cell exhaustion. Moreover, NFKB2 directly interacted with signal transducer and activator of transcription 2 (STAT2), leading to increased phosphorylation of STAT2 and the upregulation of programmed death ligand 1 (PD‐L1). Applying a small molecule inhibitor of NFKB2 (Rg5) led to a reduction in PD‐L1 expression and improved response to programmed death‐1 blockade‐based immunotherapy. In conclusion, the facilitated NFKB2‐STAT2/PD‐L1 axis may suppress immune surveillance in CRC and targeting NFKB2 may enhance the efficacy of immunotherapeutic strategies. Our results provide novel insights into the molecular mechanisms underlying the contribution of NFKB2 in CRC immune escape.

BackgroundThe adoption of mobile health (mHealth) apps among older adults (>65 years) is rapidly increasing. However, use of such apps has not been fully effective in supporting people with dementia and their caregivers in their daily lives. This is mainly attributed to the heterogeneous quality of mHealth apps, highlighting the need for improved app quality in the development of dementia-related mHealth apps. ObjectiveThe aims of this study were (1) to assess the quality and content of mobile apps for dementia management and (2) to investigate the relationship between app quality and download numbers. MethodsWe reviewed dementia-related mHealth apps available in the Google Play Store and Apple App Store in Taiwan. The identified mobile apps were stratified according to a random sampling approach and evaluated by five independent reviewers with sufficient training and proficiency in the field of mHealth and the related health care sector. App quality was scored according to the user version of the Mobile Application Rating Scale. A correlation analysis was then performed between the app quality score and number of app downloads. ResultsAmong the 17 apps that were evaluated, only one was specifically designed to provide dementia-related education. The mean score for the overall app quality was 3.35 (SD 0.56), with the engagement (mean 3.04, SD 0.82) and information (mean 3.14, SD 0.88) sections of the scale receiving the lowest ratings. Our analyses showed clear differences between the top three– and bottom three–rated apps, particularly in the entertainment and interest subsections of the engagement category where the ratings ranged from 1.4 to 5. The top three apps had a common feature in their interface, which included memory, attention, focus, calculation, and speed-training games, whereas the apps that received lower ratings were found to be deficient in providing adequate information. Although there was a correlation between the number of downloads (5000 or more) and app quality (t15=4.087, P

BackgroundOral mucositis is a major complication for head and neck cancer (HNC) patients after radiotherapy or chemotherapy. A meta-analysis was performed to assess the efficacy of turmeric in the treatment of oral mucositis in HNC patients.MethodsRandomized controlled trials investigating our topic were included in the meta-analysis. The clinical outcomes considered were the severity of oral mucositis, pain level, and weight loss.ResultsA total of eight articles that met our inclusion criteria were included in our meta-analysis. At the 3-week follow-up visit, the turmeric group showed significantly lower grades of oral mucositis compared to the control group (p = 0.03). When compared to the placebo group, a significant difference in the degree of oral mucositis was observed at the 4-(p = 0.03) and 6-week (p < 0.00001) follow-up visits. No significant difference in pain levels was observed between the turmeric and control groups at any of the follow-up visits. However, a significant improvement in pain levels for the turmeric group when compared with the placebo group was observed only at the 6-week follow-up visit (p = 0.006). Interestingly, a significant improvement in pain levels was observed for the turmeric group at the 2-, 4-, 5-, and 6-week follow-up visits (p < 0.05) when compared to the non-placebo group. The turmeric group showed less weight loss than the control group at the final follow-up visit (p = 0.03).conclusionOur meta-analysis showed that using turmeric may be effective in improving both the severity of oral mucositis and pain levels in HNC patients who have received radiotherapy or radiochemotherapy. In addition, the turmeric group experienced less weight loss.

Raising attentions have focused on how to alleviate greenhouse gas (GHG) emissions from orchard system while simultaneously increase fruit production. Microalgae-based biofertilizer represents a promising resource for improving soil fertility and higher productivity. However, the effects of microalgae application more especially live microalgae on GHG emissions are understudied. In this study, fruit yield and quality, GHG emissions, as well as soil organic carbon and nitrogen fractions were examined in a hawthorn orchard, under the effects of live microalgae-based biofertilizer applied at three doses and two modes. Compared with conventional fertilization, microalgae improved hawthorn yield by 15.7%-29.6% with a maximal increment at medium dose by root application, and significantly increased soluble and reducing sugars contents at high dose. While microalgae did not increase GHG emissions except for nitrous oxide at high dose by root application, instead it significantly increased methane uptake by 1.5-2.3 times in root application. In addition, microalgae showed an increasing trend in soil organic carbon content, and significantly increased the contents of soil dissolved organic carbon and microbial biomass carbon, as well as soil ammonium nitrogen and dissolved organic nitrogen at medium dose with root application. Overall, the results indicated that the live microalgae could be used as a green biofertilizer for improving fruit yield without increasing GHG emissions intensity and the comprehensive greenhouse effect, in particular at medium dose with root application. We presume that if lowering chemical fertilizer rates, application of the live microalgae-based biofertilizer may help to reduce nitrous oxide emissions without compromising fruit yield and quality.

(1) Background: Early interventions may effectively reduce the risk of mental disorders in individuals with ultra-high risk. Specifying the health needs of individuals with ultra-high risk is crucial before the implementation of successful early intervention. This study aimed to explore the differences in lifestyles, mental risks, and physical indices among individuals with ultra-high risk, patients with schizophrenia, and healthy subjects. (2) Methods: A cross-section design applying seven questionnaires with physical examinations for 144 participants aged 13–45 years old was conducted in this study. The questionnaires included one about personal data, four on mental risks, and two for lifestyles. (3) Results: The individuals with ultra-high risk scored similarly in many dimensions as the patients with schizophrenia, but they displayed lower positive symptoms, lower negative symptoms, lower prodromal symptoms, higher interpersonal deficits, lower nutrition intake, and higher levels of exercise than the patients with schizophrenia. Female individuals with ultra-high risk had lower self-esteem, higher positive symptoms, lower nutrition intake, and higher exercise levels than male ones. (4) Conclusions: The study pinpointed specific health needs with interpersonal deficits, nutrition intake, and physical activity for the individuals with ultra-high risk. Future interventions targeted on improving social function, dietary pattern, and exercise will be beneficial.

Based on Sima and Lu’s system of the family Magnoliaceae, the genus Lirianthe Spach s. l. includes approximately 25 species, each with exceptional landscaping and horticultural or medical worth. Many of these plants are considered rare and are protected due to their endangered status. The limited knowledge of species within this genus and the absence of research on its chloroplast genome have greatly impeded studies on the relationship between its evolution and systematics. In this study, the chloroplast genomes of eight species from the genus Lirianthe were sequenced and analyzed, and their phylogenetic relationships with other genera of the family Magnoliaceae were also elucidated. The results showed that the chloroplast genome sizes of the eight Lirianthe species ranged from 159,548 to 159,833 bp. The genomes consisted of a large single-copy region, a small single-copy region, and a pair of inverted repeat sequences. The GC content was very similar across species. Gene annotation revealed that the chloroplast genomes contained 85 protein-coding genes, 37 tRNA genes, and 8 rRNA genes, totaling 130 genes. Codon usage analysis indicated that codon usage was highly conserved among the eight Lirianthe species. Repeat sequence analysis identified 42–49 microsatellite sequences, 16–18 tandem repeats, and 50 dispersed repeats, with microsatellite sequences being predominantly single-nucleotide repeats. DNA polymorphism analysis revealed 10 highly variable regions located in the large single-copy and small single-copy regions, among which rpl32-trnL, petA-psbJ, and trnH-psbA were the recommended candidate DNA barcodes for the genus Lirianthe species. The inverted repeat boundary regions show little variation between species and are generally conserved. The result of phylogenetic analysis confirmed that the genus Lirianthe s. l. is a monophyletic taxon and the most affinal to the genera, Talauma and Dugandiodendron, in Sima and Lu’s system and revealed that the genus Lirianthe s. s. is paraphyletic and the genus Talauma s. l. polyphyletic in Xia’s system, while Magnolia subsection Gwillimia is paraphyletic and subsection Blumiana polyphyletic in Figlar and Nooteboom’s system. Morphological studies found noticeable differences between Lirianthe species in aspects including leaf indumentum, stipule scars, floral orientation, tepal number, tepal texture, and fruit dehiscence. In summary, this study elucidated the chloroplast genome evolution within Lirianthe and laid a foundation for further systematic and taxonomic research on this genus.

Primary Sjögren’s syndrome (pSS) is a systemic autoimmune inflammatory disease mainly defined by T cell–dominated destruction of exocrine glands. Currently, CD8+ T cells are thought to be involved in the pathogenesis of pSS. However, the single-cell immune profiling of pSS and molecular signatures of pathogenic CD8+ T cells have not been well elucidated. Our multiomics investigation showed that both T cells and B cells, especially CD8+ T cells, were undergoing significant clonal expansion in pSS patients. TCR clonality analysis revealed that peripheral blood granzyme K+ (GZMK+) CXCR6+CD8+ T cells had higher a proportion of clones shared with CD69+CD103–CD8+ tissue-resident memory T (Trm) cells in labial glands in pSS. CD69+CD103–CD8+ Trm cells featured by high expression of GZMK were more active and cytotoxic in pSS compared with their CD103+ counterparts. Peripheral blood GZMK+CXCR6+CD8+ T cells with higher CD122 expression were increased and harbored a gene signature similar to Trm cells in pSS. Consistently, IL-15 was significantly elevated in pSS plasma and showed the capacity to promote differentiation of CD8+ T cells into GZMK+CXCR6+CD8+ T cells in a STAT5-dependent manner. In summary, we depicted the immune profile of pSS and further conducted comprehensive bioinformatics analysis and in vitro experimental investigations to characterize the pathogenic role and differentiation trajectory of CD8+ Trm cells in pSS.

Colloidal quantum dots (CQDs) are of great interest for photovoltaic (PV) technologies as they possess the benefits of solution-processability, size-tunability, and roll-to-roll manufacturability, as well as unique capabilities to harvest near-infrared (NIR) radiation. During the last decade, lab-scale CQD solar cells have achieved rapid improvement in the power conversion efficiency (PCE) from ∼1% to 18%, which will potentially exceed 20% in the next few years and approach the performance of other PV technologies, such as perovskite solar cells and organic solar cells. In the meanwhile, CQD solar cells exhibit long lifetimes either under shelf storage or continuous operation, making them highly attractive to industry. However, in order to meet the industrial requirements, mass production techniques are necessary to scale up the fabrication of those lab devices into large-area PV modules, such as roll-to-toll coating. This paper reviews the recent developments of large-area CQD solar cells with a focus on various fabrication methods and their principles. It covers the progress of typical large-area coating techniques, including spray coating, blade coating, dip coating, and slot-die coating. It also discusses next steps and new strategies to accomplish the ultimate goal of the low-cost large-area fabrication of CQD solar cells and emphasizes how artificial intelligence or machine learning could facilitate the developments of CQD solar cell research.

Abstract Background Behçet’s syndrome (BS) is a rare variant vasculitis which can involve the eyes and gastrointestinal systems. However, ocular involvement rarely overlaps with intestinal lesions. This study aimed to compare the clinical characteristics and laboratory parameters of ocular BS and intestinal BS patients in China and analyze the differences between two key phenotypes to verify the heterogeneous conditions in BS patients. Methods A retrospective analysis was used to collect the demographic data, clinical characteristics, endoscopic findings, and laboratory parameters from 135 ocular BS and 174 intestinal BS patients. The Mann-Whitney U test and Pearson chi-square or continuity correction was used to analyze the differences between two groups. Results Among 916 BS patients enrolled in this study, ocular BS and intestinal BS accounted for 14.74% (135 cases) and 19.00% (174 cases), respectively. Ocular and intestinal involvements overlapped in only 7 cases (0.76%). Male gender (74.8% vs. 51.1%, P=0.00), erythema nodosum (45.9% vs. 32.2%, P=0.01), and vascular involvement (6.7% vs. 1.7%, P=0.03) were more frequent in the ocular BS group compared with the intestinal BS group. On the contrary, hematologic involvement (7.5% vs. 0.0%, P=0.00) and fever (17.8% vs. 4.4%, P=0.00) were more frequent in the intestinal BS group compared with the ocular BS group. Additionally, the inflammation markers including ESR [26.5 (16.0–41.5) vs. 9.0 (5.0–15.0) mm/H, P=0.00], CRP [14.8 (4.8–33.0) vs. 4.1 (1.6–8.3) mg/L, P=0.00], serum amyloid A [27.4 (10.8–92.3) vs. 11.3 (6.0–24.0) mg/L, P=0.00], and interleukin 6 [8.4 (1.7–18.7) vs. 1.7 (1.5–3.2) pg/mL, P=0.00] were higher in the intestinal BS group than those in the ocular BS group, respectively. Conclusions Ocular BS was more prevalent in male patients and more likely to manifest with erythema nodosum and vascular involvement, while intestinal BS tends to have fever and hematologic disorders with higher inflammation markers. Ocular BS and intestinal BS are two distinct clinical phenotypes and very rarely overlapped.

This research investigates how fourth-instar larvae of the potato tuber moth, Phthorimaea operculella, respond to plant secondary metabolites (sucrose, glucose, nicotine, and tannic acid) both in terms of gustatory electrophysiology and feeding behavior. The objective is to establish a theoretical foundation for employing plant-derived compounds in potato tuber moth control. We employed single-sensillum recording techniques and dual-choice leaf disk assays to assess the gustatory electrophysiological responses and feeding preferences of these larvae towards the mentioned compounds. Sensory neurons responsive to sucrose, glucose, nicotine, and tannic acid were identified in the larvae’s medial and lateral sensilla styloconica. Neuronal activity was influenced by stimulus type and concentration. Notably, the two types of sensilla styloconica displayed distinct response patterns for sucrose and glucose while they had similar firing patterns towards nicotine and tannic acid. Sucrose and glucose significantly promoted larval feeding, while nicotine and tannic acid had significant inhibitory effects. These findings demonstrate that the medial and lateral sensilla styloconica house sensory neurons sensitive to both feeding stimulants and inhibitors, albeit with differing response profiles and sensitivities. This study suggests that sucrose and glucose are promising candidates for feeding stimulants, while nicotine and tannic acid show potential as effective feeding inhibitors of P. operculella larvae.

Abstract Activation of adipose tissue macrophages (ATMs) contributes to chronic inflammation and insulin resistance in obesity. However, the transcriptional regulatory machinery involved in ATM activation during the development of obesity is not fully understood. Here, we profiled the chromatin accessibility of blood monocytes and ATMs from obese and lean mice using assay for transposase-accessible chromatin sequencing (ATAC-seq). We found that monocytes and ATMs from obese and lean mice exhibited distinct chromatin accessibility status. There are distinct regulatory elements that are specifically associated with monocyte or ATM activation in obesity. We also discovered several transcription factors that may regulate monocyte and ATM activation in obese mice, specifically a predicted transcription factor named ETS translocation variant 5 (ETV5). The expression of ETV5 was significantly decreased in ATMs from obese mice and its downregulation was mediated by palmitate stimulation. The decrease in ETV5 expression resulted in macrophage activation. Our results also indicate that ETV5 suppresses endoplasmic reticulum (ER) stress and Il6 expression in macrophages. Our work delineates the changes in chromatin accessibility in monocytes and ATMs during obesity, and identifies ETV5 as a critical transcription factor suppressing ATM activation, suggesting its potential use as a therapeutic target in obesity-related chronic inflammation.

In the past decade, immunotherapy has been the most promising treatment for gastrointestinal tumors. But the low response rate and drug resistance remain major concerns. It is therefore imperative to develop adjuvant therapies to increase the effectiveness of immunotherapy and prevent drug resistance. Ginseng has been used in Traditional Chinese medicine as a natural immune booster for thousands of years. The active components of ginseng, ginsenosides, have played an essential role in tumor treatment for decades and are candidates for anti-tumor adjuvant therapy. They are hypothesized to cooperate with immunotherapy drugs to improve the curative effect and reduce tumor resistance and adverse reactions. This review summarizes the research into the use of ginsenosides in immunotherapy of gastrointestinal tumors and discusses potential future applications.

Androgen receptor (AR) is the principal molecule in prostate cancer (PCa) etiology and therapy. AR re‐activation still remains a major challenge during treatment of castration‐resistant prostate cancer (CRPC) tumors that relapse after castration therapies. Recent reports have indicated the enrichment of Ser81‐phosphorylated AR (pS81) in the nucleus of CRPC cells, and CDK1 and CDK9 as the kinases phosphorylating AR at S81. In the current study we showed that pS81 is preferentially localized in the nucleus in both rapid biopsy metastatic CRPC samples and PCa xenografts, and nuclear pS81 localization is correlated with AR transactivation in tumor xenografts. Chromatin immunoprecipitation (ChIP) analysis demonstrated an alignment of S81 phosphorylation and AR‐mediated transactivation with the chromatin locus openness. Moreover, pS81‐specific ChIP‐Seq showed a disproportional occupancy of pS81 on AR‐activated promoters, while 3C‐ChIP assays further indicated an enrichment of pS81 at the PSA enhancer‐promoter loop, a known AR activating hub. In the latter, CDK9 was shown to modulate the transactivation of the AR and RNA Pol II. Indeed, ChIP and re‐ChIP assays also confirmed that AR‐dependent activation of the PSA enhancer and promoter mediated by pS81 was coupled with activation of Pol II and the pTEFb complex. Mechanistically, we determined that CDK1 and CDK9 sustained the pS81 AR modification in the soluble and chromatin‐bound fractions of PCa cells, respectively. Finally, we demonstrated that CDK1 activity was maintained throughout the cell cycle, and that CDK1 inhibitors restored androgen sensitivity in CRPC tumor cells. Based on these findings, CDK1 and CDK9 could be targeted as pS81 kinases in patients with CRPC, either alone or in conjunction with direct AR antagonists.

Abstract Background Cellular communication is an essential feature of multicellular organisms. Binding of ligands to their homologous receptors, which activate specific cell signaling pathways, is a basic type of cellular communication and intimately linked to many degeneration processes leading to diseases. Main body This study reviewed the history of ligand-receptor and presents the databases which store ligand-receptor pairs. The recently applications and research tools of ligand-receptor interactions for cell communication at single cell level by using single cell RNA sequencing have been sorted out. Conclusion The summary of the advantages and disadvantages of analysis tools will greatly help researchers analyze cell communication at the single cell level. Learning cell communication based on ligand-receptor interactions by single cell RNA sequencing gives way to developing new target drugs and personalizing treatment.

Objective: To explore the mechanism by which the family with sequence similarity 83, member D (FAM83D)-mediated AKT/mTOR signaling pathway activation affects the proliferation and metastasis of glioma cells. Methods: FAM83D protein expression in glioma cells and tissues was detected by western blotting. Glioma U87 and U251 cells were selected and divided into the Mock, siNC, siFAM83D, FAM83D, MK2206 and FAM83D + MK2206 groups. Cell proliferation was assessed by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) and clone formation assays, while invasion and migration were evaluated by Transwell assays and wound healing tests. The protein expression of members of the AKT/mTOR pathway was determined via western blotting. Xenograft models were also established in nude mice to observe the in vivo effect of FAM83D on the growth of glioma. Results: FAM83D was upregulated in glioma patients, especially in those with Stage III-IV. In addition, cells treated with siFAM83D had significant downregulation of p-AKT/AKT and p-mTOR/mTOR, with decreased proliferation and colony numbers, as well as decreased invasion and migration compared to the Mock group. However, FAM83D overexpression could activate the Akt/mTOR pathway and promote the proliferation, invasion and migration of glioma cells. Moreover, treatment with MK2206, an inhibitor of AKT, reversed the promoting effect of FAM83D on the growth of glioma cells. The in vivo experiments demonstrated that silencing FAM83D could inhibit the in vivo growth of glioma cells Conclusion: FAM83D was upregulated in glioma and silencing FAM83D suppressed the proliferation, invasion and migration of glioma cells via inhibition of the AKT/mTOR pathway.

Abstract Renal cell cancer (RCC) is the most lethal of all the common urologic cancers and constitutes 2.2% of all malignancy diagnoses. The incidence of RCC has been steadily increasing in recent decades. The classic risk factors of RCC include smoking, hypertension, obesity, genetics, and genetic mutations. Recent studies also revealed that RCC was an immunogenic tumor and affected by host immune status. Among the pan‐cance, RCC presented with the highest degree of immune infiltration, indicating RCC patients might benefit from immunotherapy. A new immune classification of RCC has been developed by Su et al. based on tumor‐infiltrating lymphocytes to guide clinical practice. However, these studies mainly focus on biomarkers derived from tumor microenvironment (TME), the biomarkers based on peripheral blood samples to RCC have rarely been described. We collected peripheral blood samples from RCC patients and their matched healthy controls and detected the number of IL‐2 and IFN‐γ producing cells by implementing an enzyme‐linked immunospot (ELISPOT) assay. This is the first study to report blood‐based immune biomarkers for RCC using an ELISPOT assay. Our results suggested the frequency of IFN‐γ producing cells but not IL‐2 producing cells was associated with RCC risk. These findings warrant further validation in larger prospective studies.

BackgroundIdentifying a high-risk group of older people before surgical procedures is very important. The study aimed to explore the association between the age-adjusted Charlson comorbidity index (ACCI) and all-cause mortality and readmission among older Chinese surgical patients (age ≥65 years).MethodsA large-scale cohort study was performed in 25 general public hospitals from six different geographic regions of China. Trained registered nurses gathered data on clinical and sociodemographic characteristics. All-cause mortality was recorded when patients died during hospitalization or during the 90-day follow-up period. Readmission was also tracked from hospital discharge to the 90-day follow-up. The ACCI, in assessing comorbidities, was categorized into two groups (≥5 vs.

Objective To investigate the occurrence rate and risk factors of postoperative nausea and vomiting (PONV) in lung cancer patients following lobectomy and application of analgesic pumps. Methods This retrospective study reviewed clinical data from patients that had undergone lobectomy for lung cancer under general anaesthesia. The risk factors of PONV were analysed using binary logistic regression models. Results A total of 203 patients (97 females) were enrolled. The rate of PONV was 29.6% (60 of 203 patients) for all patients, 42.3% (41 of 97 patients) for female patients and 17.9% (19 of 106 patients) for male patients. Female patients undergoing thoracotomy (odds ratio [OR] 7.770, 95% confidence interval [CI] 1.747, 34.568) or having surgery durations ≥120 min (OR 4.493, 95% CI 1.502, 12.851) were significantly more susceptible to PONV. The risk of PONV in female patients that received postoperative dolasetron (100 mg, once a day) was significantly lower (OR 0.075, 95% CI 0.007, 0.834). For male patients, the risk of PONV was significantly lower in those with a body mass index ≥24 kg/m 2 (OR 0.166; 95% CI 0.035, 0.782). Conclusion Female and male patients have different risk factors for PONV following lobectomy for lung cancer and application of analgesic pumps.

Abstract Background Intestinal Behçet’s syndrome (BS) has high morbidity and mortality rates with serious complications. The purpose of this study was to investigate the clinical characteristics and laboratory parameters of intestinal and mucocutaneous BS patients and analyze the risk factors of intestinal involvement in BS patients. Methods A retrospective analysis was used to collect the demographic data and laboratory parameters from 97 intestinal and 154 mucocutaneous BS patients. Univariate and multivariate logistic regression analyses were used to investigate the risk factors of intestinal involvement in BS patients. Results The most common clinical manifestations of first onset in intestinal BS patients were oral ulceration (100.00%), followed by genital ulcers (62.89%) and erythema nodule (28.87%), gastrointestinal lesions (28.87%), pseudofolliculitis (25.77%), fever (17.53%), arthritis (16.49%), ocular involvement (5.15%), while the least common were vascular involvement (2.06%) and hematologic involvement involvement (2.06%). The most common intestinal segment involved in intestinal BS patients was terminal ileum (30.9%), followed by ileocecal (18.6%), colon (15.5%). By univariate logistic regression analysis, gender, age at hospitalization, age of disease onset, BDCAF, T-SPOT, fever, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), leukocyte, erythrocyte, hemoglobin (HGB), neutrophil-to-lymphocyte ratio, serum amyloid A, complement 3, albumin, total cholesterol, high-density lipoprotein and interleukin 6 (IL-6) were found all risk factors of intestinal involvement in BS patients (P 10 mg/L), HGB ( 7 pg/ml) were found the independent risk factors of intestinal involvement in BS patients (all P 10 mg/L), HGB ( 7 pg/ml) being observed, it may reminds that the presence of intestinal involvement in BS patients.

IntroductionThe burden of cancer-related mortality of common malignancies has been reported worldwide. However, whether bone cancer (BC), as a highly aggressive and heterogeneous group of rare cancers, followed a similar or distinct epidemiological pattern during such process remains largely unknown. We aimed to analyze the mortality and the temporal trends of BC in relation to gender, age, and premature death in Shanghai, China.MethodsWe conducted a population-based analysis of the mortality data of BC in Shanghai Pudong New Area (PNA) from 2005 to 2020. The epidemiological characteristics and long-term trends in crude mortality rates (CMRs), age-standardized mortality rates worldwide (ASMRWs), and rate of years of life lost (YLL) was analyzed using the Joinpoint regression program. The demographic and non-demographic factors affecting the mortality rate were evaluated by the decomposition method.ResultsThere are 519 BC-specific deaths accounting for 0.15% of all 336,823 deaths and 0.49% of cancer-specific death in PNA. The CMR and ASMRW of BC were 1.15/105 person-year and 0.61/105 person-year, respectively. The YLL due to premature death from BC was 6,539.39 years, with the age group of 60–69 years having the highest YLL of 1,440.79 years. The long-term trend of CMR, ASMRW, and YLL rate significantly decreased by −5.14%, −7.64%, and −7.27%, respectively, per year (all p < 0.05) in the past 16 years. However, the proportion of BC-specific death within the total cancer-specific death dropped to a plateau without further improvement since 2016, and a remarkable gender and age disparity was noticed in the observed reduction in mortality. Specifically, the elderly benefited less but accounted for a larger percentage of BC population in the last decades. Although the overall mortality of BC decreased, there was still a significant upward trend toward an increased mortality rate caused by the aging of the BC patients.ConclusionOur study provides novel insights on the epidemiological characteristics and longitudinal dynamics of BC in a fast urbanization and transitioning city. As a rare disease affecting all ages, the burden of BC among the elderly emerged to form an understudied and unmet medical need in an aging society.

The outbreak of COVID-19 in Wuhan began to spread rapidly in December 2019. It is highly infectious and widely spread. This article summarizes the care experience of one critically ill COVID-19 patient, including the strict implementation of protective measures, avoiding infection, precautions for high-risk caring of tracheal intubation, giving psychological care, improving the coordination, the importance of vital signs, food intake and excretion, and how to reduce the risk of infection during sample collection, as well as strengthening discharge guidance.

Edaravone (EDA) injection has been extensively applied in clinics for treating stroke. Nevertheless, the metabolite signatures and underlying mechanisms associated with EDA remain unclear, which deserve further elucidation for improving the accurate usage of EDA. Ischemia stroke was simulated by intraluminal occlusion of the right middle cerebral artery for 1 h, followed by reperfusion for 24 h in mice. Brain infarct size, neurological deficits, and lactate dehydrogenase (LDH) levels were improved by EDA. Significantly differential metabolites were screened with untargeted metabolomics by cross-comparisons with pre- and posttreatment of EDA under cerebral ischemia/reperfusion (I/R) injury. The possibly involved pathways, such as valine, leucine, and isoleucine biosynthesis, and phenylalanine, taurine, and hypotaurine metabolisms, were enriched with differential metabolites and relevant regulatory enzymes, respectively. The network of differential metabolites was constructed for the integral exhibition of metabolic characteristics. Targeted analysis of taurine, an important metabolic marker, was performed for further validation. The level of taurine decreased in the MCAO/R group and increased in the EDA group. The inhibition of EDA on cerebral endothelial cell apoptosis was confirmed by TdT-mediated dUTP nick-end labeling (TUNEL) stain. Cysteine sulfinic acid decarboxylase (CSAD), the rate-limiting enzyme of taurine generation, significantly increased along with inhibiting endothelial cell apoptosis after treatment of EDA. Thus, CSAD, as the possible new therapeutic target of EDA, was selected and validated by Western blot and immunofluorescence. Together, this study provided the metabolite signatures and identified CSAD as an unrecognized therapeutic intervention for EDA in the treatment of ischemic stroke via inhibiting brain endothelial cell apoptosis.

(1) Background: Empathetic communicative skills are the first step in establishing a good therapeutic relationship. The purpose of this study is to understand the effectiveness of improving the empathetic communicative skills applied to obtain accurate and precise information from patients via compound stimulus-drama in education. (2) Methods: A cross-sectional, one-group, pre- and post-test design was used for this study. In the two-day workshop, four clinical physiotherapists acted as tutors for the “Compound Stimulus-Drama in Education” module and assessed students’ performances. The Standard Patient Rating Scale (SPRS), Objective Structured Clinical Examination Scale (OSCES), Professional and Communication Self-Assessment Scale (PCSS), Patients’ Information (PI), and the Jefferson Scale of Empathy (JSE) were used to assess the students’ empathy scores and communication skills, before and after the course. (3) Results: Fifty-seven students participated in this study. The results showed that there were significant improvements in the SPRS, OSCES, PCSS, PI, and JSE (p < 0.05). Both the quantitative data and the participants’ reflection feedback suggest that this novel module was more helpful than traditional clinical practice courses for improving clinical empathy communication skills. (4) Conclusions: This study provided an innovative teaching model and assessment tools for learning clinic empathetic communicative skills in future education training.

Elevated atmospheric CO2 concentrations (eCO2) has become the main feature and cause of global change that could affect crop growth in many aspects, including physiological processes and morphological development in plants and nutrient cycling and nutrient uptake from the soil. Studying the responses of crop growth to different nitrogen (N) supply forms under elevated atmospheric CO2 concentrations can guide nutrient management strategies for agricultural production under future climate change scenarios. Few studies addressed the effect of eCO2 on N uptake and morphological development for plants. This study was conducted in the CO2-controlled light incubators based on the sand-pot incubation using wheat and maize as experimental plants. Six treatments were set with two different environmental CO2 concentrations (aCO2, 390 µmol mol−1; eCO2, 690 µmol mol−1) and three different N supply forms, including ammonium−N, nitrate−N and ammonium-nitrate with 1:1 ratio. The following results were obtained: (i) Wheat and maize seedlings, as nitrate-preferring crops, grew better under mixed N forms than under single N forms. For the single N supply treatment, seedlings with nitrate−N supply showed better growth than with ammonium. (ii) For wheat plants, seedlings with a single ammonium−N supply showed slender height and fewer tillers; seedlings with a single nitrate−N supply were characterized by slightly shorter plant height, more tillers, and higher aboveground biomass. (iii) Compared to the aCO2 group, wheat seedlings with the ammonium−N supply showed an increased maximum root length and a decreased carbon concentration in root exudates; wheat seedlings with a single nitrate−N supply under eCO2 showed a significant increase in biomass and a decreased carbon concentration in root exudates; wheat seedlings with a mixed N supply under eCO2 explored a significant increase in carbon concentration in root exudate and a relatively lower N concentration. (iv) For maize plants, seedlings with either single ammonium−N or nitrate−N supply did not show significant differences in most growing indices. Maize seedlings with a mixed N supply exhibited an increase in aboveground biomass and N concentration in root exudates compared to those with a single N supply. (v) Compared with the aCO2 group, maize seedlings with mixed N supply under eCO2 conditions exhibited significant increases in plant height, aboveground biomass, and N concentration in root exudates. Single ammonium−N supply was toxic to wheat and maize plants under eCO2 conditions. We recommend raising the ratio of ammonium-to-nitrate under mixed N supply to improve the coordination of carbon and N metabolism for efficient crop growth under climatic change conditions of elevated atmospheric CO2 concentration.

The health benefits of Vaccinium bracteatum are well recorded in ancient Chinese medical books and were also demonstrated by modern researches. However, the relationship between its beneficial functions and specific chemical constituents has not been fully characterized. This study investigated the bioactive small-molecule constituents in the leaves of V. bracteatum, which afforded 32 compounds including ten new ones (1–9) and ten pairs of enantiomers (9–18). Their structures with absolute configurations were elucidated by spectroscopic methods, especially nuclear magnetic resonance (NMR) and electronic circular dichroism (ECD) analyses, with 1–4 bearing a novel revolving-door shaped scaffold. While half-compounds exhibited decent antioxidant activity by scavenging 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals, all except 19 and 20 exerted significant capturing activity against diammonium 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonate) (ABTS) radicals. In addition, the new iridoids 1, 5, 6, and 7 exerted apparent neuroprotective activity toward PC12 cells, with 1 being comparable to the positive control, and selective compounds also displayed anti-diabetic and anti-inflammatory properties by inhibiting α-glucosidase and NO production, respectively. The current work revealed that the bioactive small-molecule constituents could be closely related to the functional food property of the title species.

Michelia balansae var. balansae (Aug. Candolle) Dandy is a timber and spices species in Magnoliaceae, native to China and Vietnam. In this paper, the complete chloroplast genome (cpDNA) and basic annotated information were reported and its phylogenetic relationship with other species in Magnoliaceae was analyzed. The size of chloroplast genome of M. balansae var. balansae is 160,134 bp, which exhibited a typical quadripartite structure comprising a large single-copy (LSC) region of 88,161 bp and a small single-copy (SSC) region of 18,845 bp separated by a pair identical inverted repeat regions (IRs) of 26,564 bp each. The chloroplast genome contains 131 genes, including 86 protein-coding genes (PCGs), 37 transfer RNA (tRNA) genes and 8 ribosomal RNA (rRNA) genes. The phylogenetic analysis indicated that M. balansae var. balansae is most affinal to M. montana and they form a nomophyletic group with other 14 Michelia species. This Michelia clade is sister to the Aromadendron clade with high support. All genera mentioned in this analysis are nomophyletic under the system of Magnoliaceae by Sima and Lu.

Introduction: COVID-19 has overloaded worldwide medical facilities, leaving some potentially high-risk patients trapped in outpatient clinics without sufficient treatment. However, there is still a lack of a simple and effective tool to identify these patients early.Methods: A retrospective cohort study was conducted to develop an early warning model for predicting the death risk of COVID-19. Seventy-five percent of the cases were used to construct the prediction model, and the remaining 25% were used to verify the prediction model based on data immediately available on admission.Results: From March 1, 2020, to April 16, 2020, a total of 4,711 COVID-19 patients were included in our study. The average age was 63.37 ± 16.70 years, of which 1,148 (24.37%) died. Finally, age, SpO2, body temperature (T), and mean arterial pressure (MAP) were selected for constructing the model by univariate analysis, multivariate analysis, and a review of the literature. We used five common methods for constructing the model and finally found that the full model had the best specificity and higher accuracy. The area under the ROC curve (AUC), specificity, sensitivity, and accuracy of full model in train cohort were, respectively, 0.798 (0.779, 0.816), 0.804, 0.656, and 0.768, and in the validation cohort were, respectively, 0.783 (0.751, 0.815), 0.800, 0.616, and 0.755. Visualization tools of the prediction model included a nomogram and an online dynamic nomogram (https://wanghai.shinyapps.io/dynnomapp/).Conclusion: We developed a prediction model that might aid in the early identification of COVID-19 patients with a high probability of mortality on admission. However, further research is required to determine whether this tool can be applied for outpatient or home-based COVID-19 patients.

Lirianthe hodgsonii is a tree species of Magnoliaceae as least concern. In the present paper, the complete chloroplast genome (cpDNA) and basic annotated information of L. hodgsonii were reported and its phylogenetic relationship with other species in Magnoliaceae was analyzed. The size of its complete cpDNA is 159,693 bp, with a typical quadripartite structure comprising a pair of inverted repeat (IR) regions of 26,546 bp, a large single-copy (LSC) region of 87,848 bp and a small single-copy (SSC) region of 18,753 bp. The genome contains 131 unique genes, including 86 protein-coding genes, 37 tRNA genes, and 8 rRNA genes. The phylogenetic analysis showed that L. hodgsonii is affinal to Lirianthe bidoupensis and they form a monophyletic group with other seven Lirianthe species. This Lirianthe clade is sister to the Dugandiodendron and Talauma clade with high support. All genera mentioned in this analysis are monophyletic under the system of Magnoliaceae by Sima and Lu.

Objective: Dementia is a progressive neurocognitive disorder that currently affects approximately 50 million people globally and causes a heavy burden for their families and societies. This study analyzed mobile apps for dementia care in different languages and during the COVID-19 pandemic. Methods: We searched PubMed, Cochrane Collaboration Central Register of Con-trolled Clinical Trials, Cochrane Systematic Reviews, Google Play Store, Apple App Store, and Huawei App Store for mobile applications for dementia care. The Mobile Application Rating Scale (MARS) was used to assess the quality of applications. Results: We included 99 apps for dementia care. No significant difference in MARS scores was noted between the two language apps (Overall MARS: English: 3.576 ± 0.580, Chinese: 3.569 ± 0.746, p = 0.962). In the subscale analysis, English apps had higher scores of perceived impact than Chinese apps but these were not significant (2.654 ± 1.372 vs. 2.000 ± 1.057, p = 0.061). (2) Applications during the COVID-19 pandemic had higher MARS scores than those before the COVID-19 pandemic but these were not significant (during the COVID-19 pandemic: 3.722 ± 0.416; before: 3.699 ± 0.615, p = 0.299). In the sub-scale analysis, apps during the COVID-19 pandemic had higher scores of engagement than apps before the COVID-19 pandemic but these were not significant (3.117 ± 0.594 vs. 2.698 ± 0.716, p = 0.068). Conclusions: Our results revealed that there is a minor but nonsignificant difference between different languages and during the COVID-19 pandemic. Further cooperation among dementia professionals, technology experts, and caregivers is warranted to provide evidence-based and user-friendly information to meet the needs of users.

Introduction Venous thromboembolism (VTE) occurs in up to 40%–80% of patients after hip and knee arthroplasty. Clinical decision-making aided by guidelines is the most effective strategy to reduce the burden of VTE. However, the quality of guidelines is dependent on the strength of their evidence base. The objective of this article is to critically evaluate the quality of VTE prevention guidelines and the strength of their recommendations in VTE prophylaxis in patients undergoing hip and knee arthroplasty.Methods Relevant literature up to 16 March 2020 was systematically searched. We searched databases such as Web of Science, PubMed, EMBASE, Cumulative Index of Nursing and Allied Health Literature, China National Knowledge Infrastructure and WanFang and nine guidelines repositories. The identified guidelines were appraised by two reviewers using the Appraisal of Guidelines for Research and Evaluation II and appraised the strength of their recommendations independently. Following quality assessment, a predesigned data collection form was used to extract the characteristics of the included guideline.Results We finally included 15 guidelines. Ten of the included guidelines were rated as ‘recommended’ or ‘recommended with modifications’. The standardised scores were relatively high in the domains of Clarity of Presentation, and Scope and Purpose. The lowest average standardised scores were observed in the domains of Applicability and Stakeholder Involvement. In reference to the domains of Rigour of Development and Editorial Independence, the standardised scores varied greatly between the guidelines. The agreement between the two appraisers is almost perfect (intraclass correlation coefficients higher than 0.80). A considerable proportion of the recommendations is based on low-quality or very-low-quality evidence or is even based on working group expert opinion.Conclusions In summary, the majority of the recommendations are based on low-quality evidence, and further confirmation is needed. Furthermore, guideline developers should pay more attention to methodological quality, especially in the Stakeholder Involvement domain and the Applicability domain.

BackgroundDepending on the renal function of patients and many other influencing factors, studies on vancomycin pharmacokinetics show significant inter- and intra-individual variability. The present study was conducted using a population pharmacokinetics method to investigate the pharmacokinetic parameters and identified their influencing covariates for intravenous vancomycin in adult kidney transplant recipients.MethodsThe drug monitoring data included 56 adult renal transplant recipients who received intravenous vancomycin as prophylactic medication. The analysis was performed by a population approach with NONMEM. Data were collected mainly during the first week after transplantation. Monitoring of vancomycin trough concentration in blood was initiated mainly 3–5 days after the initial administration.ResultsThe one-compartment open model was optimal and adequately described the data. Body weight (WT) and estimated glomerular filtration rate (GFR) were identified as significant covariates of the pharmacokinetic parameters CL and V of intravenous vancomycin in the kidney transplant patients. The typical values of vancomycin CL and V were 2.08 L h-1 and 63.2 L, respectively. A dosage strategy scheme according to model results was also designed.ConclusionBoth WT and GFR of the kidney transplant patients positively influence the pharmacokinetic parameters CL and V for intravenous vancomycin. Our population pharmacokinetic model provides a reference for vancomycin dosage adjustment in kidney transplant recipients.

The elevated atmospheric CO2 concentration (eCO2) is expected to increase the labile C input to the soil, which may stimulate microbial activity and soil N2O emissions derived from nitrification and denitrification. However, few studies studied the effect of eCO2 on N2O emissions from maize field under the free-air CO2 enrichment (FACE) conditions in the warm temperate zone. Here, we report a study conducted during the 12th summer maize season under long-term eCO2, aiming to investigate the effect of eCO2 on N2O emissions. Moreover, we tested zero and conventional N fertilization treatments, with maize being grown under either eCO2 or ambient CO2 (aCO2). We hypothesized that N2O emissions would be increased under eCO2 due to changes in soil labile C and mineral N derived from C-deposition, and that the increase would be larger when eCO2 was combined with conventional N fertilization. We also measured the activities of some soil extracellular enzymes, which could reflect soil C status. The results showed that, under eCO2, seasonal N2O and CO2 emissions increased by 12.4–15.6% (p < 0.1) and 13.8–18.5% (p < 0.05), respectively. N fertilization significantly increased the seasonal emissions of N2O and CO2 by 33.1–36.9% and 17.1–21.8%, respectively. Furthermore, the combination of eCO2 and N fertilization increased the intensity of soil N2O and CO2 emissions. The marginal significant increase in N2O emissions under eCO2 was mostly due to the lower soil water regime after fertilization in the study year. Dissolved organic C (DOC) and microbial biomass C (MBC) concentration showed a significant increase at most major stages, particularly at the tasseling stage during the summer maize growth period under eCO2. In contrast, soil mineral N showed a significant decrease under eCO2 particularly in the rhizospheric soils. The activities of C-related soil extracellular enzymes were significantly higher under eCO2, particularly at the tasseling stage, which coincided with concurrent increased DOC and MBC under eCO2. We conclude that eCO2 increases N2O emissions, and causes a higher increase when combined with N fertilization, but the increase extent of N2O emissions was influenced by environmental factors, especially by soil water, to a great extent. We highlighted the urgent need to monitor long-term N2O emissions and N2O production pathways in various hydrothermal regimes under eCO2.

Social stigma is inevitable for mentally ill patients, but how patients treat themselves is a priority for rehabilitation and an important buffer mechanism. This study thus aimed to measure the effectiveness of rehabilitation models for improving self-stigma. This quasi-experimental research design applied purposeful sampling. The participants (n = 250) were persons with mental illness who received rehabilitation treatment in central Taiwan. They were divided into community- (n = 170) and institution-based (n = 80) rehabilitation groups. The Internalized Stigma of Mental Illness Scale was evaluated at the time of recruitment, and a follow-up was conducted after 1 and 3 months. A generalized estimation equation was used in data analysis to measure whether self-stigma improved with the rehabilitation model and time, and to test the effect of different rehabilitation models on participants’ self-stigma improvement. The study found that the self-stigma of patients receiving CBR improved more than that of those receiving IBR when behavioral problems, education, OT level, sex, and first-time self-stigma were controlled. Returning to the community is the goal of rehabilitation for patients with mental illness, but IBR still dominates the rehabilitation model in Taiwan. Thus, it is necessary to continue promoting CBR plans for future mental health policies.

Cephalcia chuxiongica Xiao is one of the most dangerous defoliators of Pinus yunnanensis and other pine species in Yunnan province, resulting in serious losses. Its distinguishing characteristics are the females’ aggregation oviposition and larvae’s aggregation feeding. In order to explore the mechanism of aggregation oviposition in this sawfly, preliminary olfactory bioassay was conducted in laboratory. In in-cage choice tests, on average vast majority gravid females selected the shoots that had been loaded and oviposited by a ‘pioneer’ female. In one-choice tests in laboratory by a Y-tube olfactometer, the gravid females were attracted by the odors of eggs-carrying shoots (PE), shoots with one delivering female and her eggs (PGE), needles’ extract (NE), and fresh eggs’ eluent (EL); the virgin females were attracted by odors of fresh needles (P), PE, PGE, and NE, but repelled by odors of virgin and gravid females. In two-choice tests, the odors were tested in pairs for gravid females. When compared with odors of gravid females (G) or P, gravid females showed significantly more tendency to odors of PE or PGE. When given odors EL vs. NE, gravid females preferred the odors of NE, but they did not make obvious selection between G vs. P, and PE vs. PGE. Based on the results, our conjectures were: (1) Delivery female, as a pioneer, can summon her conspecific gravid females to aggregate in the same pine shoot; (2) Pine needles’ odors were attractive for both the virgin and gravid females; (3) Gravid females could be attracted by odors released by the pioneer gravid females; (4) The olfactory sensation of the females may be changed by mating.

(1) Background: The COVID-19 pandemic impacted education systems globally, and numerous strategies were used to transform education into online learning. Caring is recognized as a core competency in nursing; this competency is difficult to cultivate and measure. This study aimed to explore the effect of online team-based learning (TBL) on cultivating nursing students’ caring competency. (2) Method: A mix-methods study design with convenience sampling was used for this study. The intervention was online TBL with field observation. Quantitative data were collected by the modified Peer Caring Measurement (PCM) and analyzed using descriptive and inferential statistics. Qualitative data were collected by dialog in social media and analyzed by content analysis. (3) Result: Both the quantitative and qualitative data showed a significant increase in caring competency. A paired t-test of modified PCM showed significant improvement (p < 0.001), and female students had greater learning performances compared with male students in academic and affective dimensions. Three themes emerged, including that online TBL possesses remarkable benefits, students felt in charge of their learning, and changes in the students’ caring competency were revealed. (4) Conclusion: This online TBL strategy works well in teaching and fostering caring in an online environment among nursing students, which is necessary under COVID-19 restrictions.

Background: This paper explored the gender differences in the attitudes of parents toward taking care of their adult daughters or sons with schizophrenia, and focused on how parents define and think about the roles of their children, and how they cope with fulfilling the expected roles. Methods: Qualitative research design and purpose sampling were used to enroll parents who had adult patients with schizophrenia at a medical center in central Taiwan. Semi-structured in-depth interviews were conducted and content analysis was used to analyze the data. Results: Seven main themes emerged from the data provided by ten parents living with adult children with schizophrenia. Three themes that focused on gender difference are listed: parents continue to expect their sons with schizophrenia to carry on the family name; society as a whole expects males to be the “head of the family”; male family members are supposed to assume the responsibility of caring for siblings with schizophrenia. Conclusions: The results of the study could help clinical professionals to understand and have greater empathy with regard to the difficulties for families and the concerns of parents taking care of their children with schizophrenia in the specific context of Chinese culture, and to provide more efficient and responsive assistance.

ObjectivesThis study aimed to identify those at high risk of poor mental health among nursing students and to examine the relationships and consistency among five mental health assessments.DesignA cross-sectional design with purposive sampling was used. Four mental health screening tools plus previous mental health history/information were conducted during June 2015 to October 2016.SettingA nursing major university in Taiwan.ParticipantsA total of 2779 participants aged between 19 and 45 years were recruited.Main outcome measuresFive mental health risks were identified: increased risk for ultra-high risk, putative prepsychosis states, high trait anxiety, high state anxiety with genetic risk and depression.ResultsOut of the 3395 collected questionnaire, 2779 (82%) were found valid and included in the study. 612 (22%) of the participants were identified to be at mental health risk. 12 of them appeared positive in four, 79 in three, 148 in two and 373 in one of the adopted mental health screening tools. 69 participants had the experience of seeking medical help due to mental health issues, and 58% of them were identified to be at risk of mental health during the screening. Trait and state anxiety scored the highest in correlation analysis (r(2620)=0.76, p