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Qingqing Zhang,1,2,&ast; Jing Zheng,1,&ast; Guoyu Wang,1,3 Suyun Jiang,1 Peng Gao,1 Si Sun,1 Xiangwei Ding,3 Yucheng Wu3 1Department of Pan-Vascular Management Center, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, People’s Republic of China; 2Department of Endocrinology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, People’s Republic of China; 3Department of Cardiology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yucheng Wu; Xiangwei Ding, Email 2567181759@qq.com; dingxw1208@126.comObjective: To determine the prevalence of Cardiovascular-Kidney-Metabolic (CKM) Syndrome and identify risk factors, including occupational factors, lifestyle factors and clinical measurements, and female-specific risk enhancers among healthcare workers in China.Methods: A cross-sectional study was conducted among healthcare workers at Taizhou People’s Hospital between April and May 2024. We collected data through surveys and laboratory results. Univariate and multivariate logistic regression analyses were performed to identify predictors of CKM syndrome and female-specific risk enhancers.Results: A total of 1110 participants were recruited (197 male; 913 female; mean age 34.8± 7.9). Almost 90% of male healthcare workers and 60% of female healthcare workers met the criteria for CKM syndrome (stage 1 or higher). Additionally, most male CKM syndrome patients were in stages 2– 3 (53.81%), while most female CKM syndrome patients were in stage 1 (35.82%). Multivariate logistic regression analysis revealed that, compared to those with over 20 years of work duration, a work duration of less than 10 years was a protective factor for CKM Syndrome. Additionally, more than 8 hours of sedentary time was identified as a risk factor compared to less than 2 hours (OR = 1.376, 95% CI 1.027– 1.844, P < 0.05). Receiver operating characteristic analysis showed that body mass index (BMI) was superior to fasting plasma glucose, glycated hemoglobin, triglycerides, and the triglyceride glucose product index in predicting CKM Syndrome, with area under the curve values of 0.884 vs 0.638, 0.708, 0.745, and 0.761, respectively (P < 0.05 for all). BMI was identified as an independent risk factor for female-specific risk enhancers.Conclusion: CKM syndrome is prevalent among healthcare workers in Chinese tertiary hospitals, with males generally presenting at more advanced stages than females. BMI is a key predictor of CKM syndrome and female-specific risk enhancers.Keywords: cardiovascular-kidney-metabolic syndrome, BMI, healthcare workers, triglyceride glucose product index

Abstract Purpose The objective of this study was to evaluate the feasibility of using Artificial Intelligence (AI) to measure the long-diameter of tumors for evaluating treatment response. Methods Our study included 48 patients with lung-specific target lesions and conducted 277 measurements. The radiologists recorded the long-diameter in axial imaging plane of the target lesions for each measurement. Meanwhile, AI software was utilized to measure the long-diameter in both the axial imaging plane and in three dimensions (3D). Statistical analyses including the Bland-Altman plot, Spearman correlation analysis, and paired t-test to ascertain the accuracy and reliability of our findings. Results The Bland-Altman plot showed that the AI measurements had a bias of -0.28 mm and had limits of agreement ranging from − 13.78 to 13.22 mm (P = 0.497), indicating agreement with the manual measurements. However, there was no agreement between the 3D measurements and the manual measurements, with P

Peng Gao,1 Yanshuo Wu,1 Xinhui Wu,1 Jing Bai,2 Kangkang Shen,1 Yanling Yin1 1Department of Critical Care Medicine, Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, People’s Republic of China; 2Department of Pharmacy, Fourth Hospital of Hebei Medical University, Shijiazhuang, 050000, People’s Republic of ChinaCorrespondence: Yanling Yin, Department of Critical Care Medicine,Fourth Hospital of Hebei Medical University, No. 12 Jiankang Road, Shijiazhuang City, Hebei Province, 050000, People’s Republic of China, Tel +86-13833467312, Email 47400548@hebmu.edu.cnObjective: To explore the effect of the Integrated Management Model of Doctor-Nurse-Pharmacist Collaboration on the Safety of Intravenous Therapy in Critically Ill Patients.Methods: 1587 patients who were hospitalized in the Intensive Care Department of the Fourth Hospital of Hebei Medical University in China from January 2021 to December 2022 were selected. 768 patients before the implementation of the integrated medical, nursing, and drug management model were selected as the control group, and 819 patients who implemented the integrated medical, nursing, and drug management model were selected as the observation group.Results: Compared with the control group, the incidence of drug compatibility contraindications in the observation group decreased from 3.5% to 1.5% (χ2=6.957 P=0.008), the central venous catheter (CVC) blockage rate decreased from 2.5% to 1.0% (χ2=5.249 P=0.022), the daily incidence of catheter related bloodstream infections decreased from (1.84 ± 2.17) to (0.91 ± 1.19)(t=6.988 P=0.015), and the incidence of peripheral venous treatment related complications decreased from 10.3% to 2.9% (χ2=16.663 P=0.000). Among them, the incidence of phlebitis decreased from 5% to 1.6% (χ2=4.817 P=0.028). The incidence of drug exudation decreased from 3.4% to 0.8% (χ 2=0.031 P=0.019). The incidence of extravasation has decreased from 2.5% to 0.4% (χ2=0.044 P=0.027). The differences were statistically significant (P< 0.05).Conclusion: The Integrated Management Model of Doctor-Nurse-Pharmacist Collaboration significantly reduced the incidence of catheter-related bloodstream infections (CRBSI), drug incompatibility, and other intravenous therapy-related complications, thereby enhancing the safety of intravenous therapy in critically ill patients.Keywords: severe patients, integration of doctor-nurse-pharmacist, intravenous treatment safety, complication

Objective To investigate the effects of terahertz (THz) radiation on mouse testicular tissue and its potential molecular mechanisms. Methods A total of 125 male C57BL/6J mice (6~8 weeks old) were randomly divided into control group and low-, medium- and high-radiation power groups. The mice of the latter 3 groups were exposed to THz radiation at a frequency of 2.5 T, with an average power density of 38, 115, or 318 mW/cm2, for 5 or 10 min. The detection time was immediately or 24 h after exposure. HE staining was used to observe pathological damage. ELISA was employed to detect the expression of inflammatory factors in testicular tissue. RNA-seq was utilized to detect the global changes of gene expression. The differentially expressed genes (DEGs) were screened and bioinformatics was used to cluster them. The screened genes were further analyzed with RT-qPCR to determine the time-dependent and dose-dependent relationships of the expression with THz exposure. Finally, sperm quality was evaluated morphologically using a microscope. Results Three doses of THz radiation exposure did not cause significant pathological damages to mouse testicular tissue. TNF-α expression was increased immediately after exposure at average power density of 115 mW/cm2 (P < 0.01), and the expression of IL-1β and TNF-α were both increased when the dose reached 318 mW/cm2 (P < 0.01). However, all the 3 factors returned to normal levels in 24 h after exposure. RNA-seq results showed that THz radiation exposure caused abnormal expression of 56 genes. Cluster analysis indicated that these DEGs were mainly enriched in immune and inflammatory responses, enzyme activity, sperm development and capacitation functions. Then for 5 selected key genes, Crisp1, Adam7, Ltf, Rnase9, and Bsph1, the expression of Crisp1 and Rnase9 was decreased immediately after exposure to 115 mW/cm2 THz radiation, the dose of 318 mW/cm2 resulted in obvious changes in the expression of the 5 genes (P < 0.05), and their expression returned to normal levels in 24 h after exposure. Morphological observation displayed that exposure to all the 3 doses of THz had no influence on sperm quality. Conclusion THz radiation exposure causes temporary inflammatory response in testicular tissue and abnormal expression of sperm functions-related genes. However, these changes return to normal 24 h after exposure, and additionally, do not impair sperm quality.

Asymmetric spin–orbit interaction (ASOI) breaks the limitations in conjugate symmetry of traditional geometric phase metasurfaces, bringing new opportunities for various applications such as spin-decoupled holography, imaging, and complex light field manipulation. Since anisotropy is a requirement for spin–orbit interactions, existing ASOI mainly relies on meta-atom with C1 and C2 symmetries, which usually suffer from an efficiency decrease caused by the propagation phase control through the structural size. Here, we demonstrate for the first time that ASOI can be realized in meta-atoms with rotational symmetry ≥3 by combining the generalized geometric phase with the propagation phase. Utilizing an all-metallic configuration, the average diffraction efficiency of the spin-decoupled beam deflector based on C3 meta-atoms reaches ∼84 % in the wavelength range of 9.3–10.6 μm, which is much higher than that of the commonly used C2 meta-atoms with the same period and height. This is because the anisotropy of the C3 metasurface originates from the lattice coupling effect, which is relatively insensitive to the propagation phase control through the meta-atom size. A spin-decoupled beam deflector and hologram meta-device were experimentally demonstrated and performed well over a broadband wavelength range. This work opens a new route for ASOI, which is significant for realizing high-efficiency and broadband spin-decoupled meta-devices.

Chunrong Zuo,1,2 Nor Shafrin Ahmad,2 Lyu Zeng,1 Xiaogang Zhou,3 Feifei Li,2,4 Wuman Hong,2 Ping Gao1 1School of Education, Huainan Normal University, Anhui, 232038, People’s Republic of China; 2School of Educational Studies, Universiti Sains Malaysia, Gelugor, Penang, 11800, Malaysia; 3College of Physical Education and Health Science, Zhejiang Normal University, Jinhua, 321000, People’s Republic of China; 4Department of Art, Shandong Agricultural University, Shandong, 271000, People’s Republic of ChinaCorrespondence: Nor Shafrin Ahmad, School of Educational Studies, Universiti Sains Malaysia, Gelugor, Penang, 11800, Malaysia, Tel +60 465 325 69, Email sham@usm.my Xiaogang Zhou, College of Physical Education and Health Science, Zhejiang Normal University, Jinhua, 321000, People’s Republic of China, Tel +86 183 2904 0923, Email brucechou123456@gmail.comBackground and Objective: The mental health of economically disadvantaged college students in China is notably inferior to that of their non-disadvantaged peers. As such, these students necessitate a broader spectrum of psychological support beyond mere financial assistance. Seligman’s PERMA theory has established a compelling association between social support and positive emotions with subjective well-being. However, there is a scarcity of research focusing on character strengths within this framework, particularly the mechanisms that underlie their relationship. Hence, this study aims to examine the relationship between character strengths and subjective well-being among Chinese impoverished college students, while also delving into the chain mediating roles of perceived social support and positive emotions.Methods: A convenience sampling method was employed to collect cross-sectional data from impoverished college students. Participants (N=336, Mean age=20.67) were assessed using four instruments: the Chinese Virtues Questionnaire (CVQ-96), the Perceived Social Support Scale (PSSS), the Positive and Negative Affect Scale (PANAS), and the Satisfaction with Life Scale (SWLS).Results: Character strengths, perceived social support, positive emotions, and subjective well-being were all significantly positively correlated with each other (p< 0.01). In addition, regression analysis indicated that character strengths positively predicted perceived social support (β=0.71, p< 0.001), positive emotions (β=0.44, p< 0.001), and subjective well-being (β=0.52, p< 0.001). Perceived social support positively predicted positive emotions (β=0.34, p< 0.001), and subjective well-being (β=0.44, p< 0.001). Positive emotions positively predicted subjective well-being (β=0.88, p< 0.001). Furthermore, chain mediation analysis revealed that character strengths influenced subjective well-being both directly and indirectly through perceived social support and positive emotions.Conclusion: Perceived social support and positive emotions play a chain mediating role between character strengths and subjective well-being among impoverished college students.Keywords: character strengths, perceived social support, positive emotions, subjective well-being, Chinese, impoverished college students

As a promising technique for 6G integrated sensing and communication, cooperative integrated sensing and communication (CoISAC) technology harnesses additional sensing information from various network nodes to overcome challenges of ISAC systems such as low sensing accuracy, non-line-of-sight path scenario, and limited sensing range. The current status of CoISAC technology was summarized and analyzed. A novel performance metric and two cooperative approaches were proposed. The challenges faced by CoISAC technology were analyzed, and the future development trend of CoISAC technology was forecasted.

Volatile components are one of the main active components of Ligusticum chuanxiong Hort and are important indicators for evaluating the medicinal quality of Ligusticum chuanxiong. To explore the effects of 60Co-γ irradiation on the volatile components of Ligusticum chuanxiong, the samples were treated with different irradiation doses, and the changes of the volatile components before and after irradiation were analyzed using an electronic nose combined with headspace solid-phase microextraction and gas chromatography-mass spectrometry. Principal component analysis (PCA), linear discriminant analysis (LDA), orthogonal partial least squares discriminant analysis (OPLS-DA), and cluster statistical analysis were used to elucidate changes in the volatile components of Ligusticum chuanxiong before and after irradiation. The electronic nose detection results and gas chromatography–mass spectrometry detection results indicated that ketone alkanes, alcohols, aldehydes, and ketones contributed to the odor of Ligusticum chuanxiong. Irradiation treatments at doses ≤10 kGy had no significant effect on the odor of Ligusticum chuanxiong. The results demonstrated that after irradiation at 0 kGy (control group), 3 kGy, 7 kGy, and 10 kGy, 60 compounds were identified in Ligusticum chuanxiong, including 23 hydrocarbons, 12 alcohols, 10 lipids, and 4 aldehydes or ketones, and 11 others. There were mainly 21 volatile substances that changed after irradiation, accounting for approximately 12.92% of the volatile components in Ligusticum chuanxiong; however, they were not the main volatile components of Ligusticum chuanxiong. No new compounds were identified in Ligusticum chuanxiong after irradiation treatment within a dose of 10 kGy. The results provide a theoretical basis and reference for the influence of 60Co-γ irradiation on the quality of Ligusticum chuanxiong samples and also lay a certain foundation for the application of irradiation in Ligusticum chuanxiong pieces and traditional Chinese medicine and simple preparation resources. The results indicate that the treatment of 60Co-γ irradiation on the Ligusticum chuanxiong samples with doses ˂10 kGy does not affect its main volatile components.

Pan Gao,1,&ast; Xinyu Li,1,&ast; Ziqiu He,1 Yifan Xu,2 Zhi Zhang1 1Department of Urology, Second People’s Hospital of Yichang, Second People’s Hospital of China Three Gorges University, Yichang, Hubei Province, People’s Republic of China; 2Department of Pathology, Second People’s Hospital of Yichang, Second People’s Hospital of China Three Gorges University, Yichang, Hubei Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhi Zhang, Department of Urology, Second People’s Hospital of Yichang, Second People’s Hospital of China Three Gorges University, 21 Xiling One Road, Yichang, Hubei Province, 443000, People’s Republic of China, Email 702032715@qq.comAbstract: Primary bladder large cell neuroendocrine carcinoma (LCNEC) is a rare, aggressive neoplasm with high recurrence rates and poor prognosis. Traditional management has heavily relied on radical cystectomy, which, despite its aggressiveness, often results in unsatisfactory outcomes. Emerging evidence suggests the potential for less invasive, bladder-sparing approaches, yet detailed reports and long-term outcomes remain scarce. We report a groundbreaking case of a 59-year-old male diagnosed with primary bladder LCNEC, managed through a pioneering bladder-sparing multimodal treatment. This novel strategy included transurethral resection followed by a tailored chemoradiation protocol, resulting in exceptional disease control and preservation of bladder function over a 20-month follow-up period, without evidence of recurrence. This case underscores the viability of bladder conservation strategies as a legitimate alternative to radical cystectomy for managing LCNEC, presenting a beacon of hope for patients wishing to preserve bladder functionality. It prompts a reevaluation of traditional treatment paradigms and advocates for further research into multimodal, organ-sparing approaches for this challenging malignancy.Keywords: LCNEC, bladder conservation, TURBT, secondary transurethral resection, EP regimen, radiotherapy

In order to investigate the microstructure uniformity and plasticity of hot-rolled 0Cr21A16 alloy sheet and im prove its high temperature and cold working characteristics， heat treatment tests and microstructure properties analysis were carried out at different temperatures. The microstructure and mechanical properties of 0Cr21Al6 alloy sheet before and after heat treatment were studied by optical microscopy， X-ray diffraction （XRD）， Gleeble high temperature thermal tensile test， scanning electron microscopy （SEM） and nanoindentation. The results show that the microstructure unifor mity of 0Cr21Al6 alloy sheet can be improved by heat treatment， and the average grain size is about 42 μm after holding at 960 ℃ for 6 min 40 s， and the overall grain size is relatively uniform and fine compared with at 940、980、1 000、1 020 ℃ heat treatment， the hardness and plasticity are the best combination， and the fracture toughness KIC is the best after 960 ℃ heat treatment. With the best comprehensive performance， it can effectively avoid the brittle fracture of materials in the production process. In addition， Gleeble test shows that the heat treatment temperature over 1 000 ℃ is no longer suitable for hot processing.

Abstract The safety performance and structural stiffness of a rim, which is the main load-bearing structure of the loader during operation, influence the overall performance, stability, and braking capabilities of the machine. In the industry, researchers are currently pursuing lightweight and high-strength rims as a primary objective. A low weight not only enhances machinery fuel efficiency but also aligns with societal demands for sustainable development, energy conservation, and emission reduction. In this article, multiobjective optimization analysis on rims composed of three different materials is performed, and the relationships between various optimization parameters and target parameters are established using the results of response surface construction. Multiobjective genetic algorithms are utilized to derive various optimization plans, which are subsequently evaluated through static analysis, fatigue analysis, and weight loss analysis. The final optimization plan is determined based on the calculation results while considering production costs. Field tests are conducted on the optimized rims under various working conditions to verify the test results, evaluate the reliability of the finite element analysis results, and confirm the safety of the optimized rim.

In China, the present implemented industrial wastewater discharge standards cannot objectively and correctly evaluate wastewater safety. The characteristics and application of the whole effluent toxicity evaluation methods at home and abroad were systematically summarized. The characteristics and application of whole effluent toxicity (WET), direct toxicity assessment (DTA), and whole effluent assessment (WEA) were emphatically discussed. The deficiencies of the comprehensive toxicity index system and evaluation methods of wastewater in China were analyzed. Reasonable suggestions on the establishment of the comprehensive toxicity methodology were proposed from aspects of species selection, experimental process and evaluation method. Finally, the actual situations of the characteristics of wastewater pollutants, discharge mode and environmental quality of receiving water should be considered as establishing comprehensive toxicity indices and evaluation methodology in line with Chinese national conditions.

Pan Gao,1,2 Xinyu Li,1,2 Ziqiu He,1,2 Hongbo Zhang,1,2 Zhi Zhang,1,2 Zonglai Liu1,2 1Department of Urology, Second People’s Hospital of Yichang, Yichang, Hubei Province, People’s Republic of China; 2Department of Urology, Second People’s Hospital of China Three Gorges University, Yichang, Hubei Province, People’s Republic of ChinaCorrespondence: Zonglai Liu, Department of Urology, Second People’s Hospital of Yichang, Second People’s Hospital of China Three Gorges University, 21 Xiling One Road, Yichang, 443000, Hubei Province, People’s Republic of China, Email 85538230@qq.comAbstract: Immune checkpoint inhibitors (ICI) have become a new hope for many patients with advanced cancer by blocking tumor immune escape. Bladder cancer is a common malignant tumor of the urinary tract epithelium that often relapses and metastasizes after surgery, chemotherapy, and radiotherapy. Immunotherapy has dramatically improved patient survival rates and clinical benefits as a new, potentially effective therapy. However, avoidance of various immune-related adverse events (irAEs) remains an implausible idea. ICI-induced myocarditis is different from viral myocarditis, and mortality is still high with the current treatment. We report the case of an 82-year-old female patient with ICI-induced fulminant myocarditis and myasthenia gravis. Although she actively accepted the current mainstream treatment for immune-related myocarditis and myasthenia, she died of heart and respiratory failure. Analyzing and reporting the patient’s disease development process and the changes in related indicators may help peers gain a deeper understanding of immune-related adverse events and reduce the mortality of immune-related myocarditis.Keywords: immune checkpoint inhibitors, immunotherapy, heart failure, multiple organs failure

Gear shifting mechanism is one of the most critical components in the shifting transmission system, and its performance directly affects the power performance and stability of the transmission system. In this study, the dynamic equations of the gear shifting mechanism of the two-stage planetary gear transmission system are established, and the influence of the external excitation frequency on the complex dynamic characteristics of the transmission system is studied. Through bifurcation diagram, time domain response diagram, phase diagram, Poincare section diagram and spectrum diagram, the chaotic vibration characteristics of the two-stage planetary gear transmission system are learned, and the stable vibration range of the external excitation frequency is obtained. The proportional differential control method is used to control the chaotic vibration of the gear shifting mechanism, and the chaotic vibration is adjusted to a stable single period vibration. The research results lay a foundation for improving the stability of the shift planetary transmission system.

Lawsonella clevelandensis is rare to associated with human infection, which may cause abscesses in abdominal cavity, liver, breast, and spine. Lawsonella clevelandensis is very difficult to be cultivated in regular manner; detection of 16S rRNA sequence is the main evidence for L. clevelandensis infection. The clinical manifestations of L. clevelandensis infection resemble other agents of Nocardia, Tuberculosis and non-tuberculous Mycobacterium (NTM) due to their morphologic similarities. Hidradenitis suppurativa (HS) is a chronic inflammatory disorder, which affects the intertriginous skin and is associated with numerous systemic comorbidities. HS eventually leads to severe pain, multiple abscesses, pus discharge, and irreversible tissue destruction. Lawsonella clevelandensis has not been reported to cause HS and systemic comorbidities. We presented the case of a 33-year-old male with widespread soft tissue infection and multiple abscesses secondary to HS (Hurley stage III) inducing septic shock caused by L. clevelandensis in China. He was diagnosed as HS and treated with intravenous antibiotic empirically. He developed multiple abscesses including lung and scrota. Bacterial and fungal cultures on blood and secretions from multiple skin lesions were all negative. Due to the misdiagnosis and progression of disease, the patient was transferred to intensive care unit, and he underwent drainage of the chest and right hemothorax removal under thoracoscopic. During the hospitalization, the patient developed septic shock and received mechanical ventilation. Computerized tomography (CT) scans revealed mediastinal emphysema, multiple subcutaneous emphysema, and severe pneumonia. Gene analysis of samples of incision and drainage of pus at the skin showed the rare infection of L. clevelandensis. Finally, the patients with recurrent soft tissue infections and multiple abscesses with negative microbiological culture results recovered after effective abscess drainage and antibiotic therapy. We suggested that NGS is a crucial supplementary diagnostic tool in individuals with recurrent skin infections and multiple abscesses, especially when conventional diagnostic methods are inconclusive.

Qingchen Li,1– 3,&ast; Xiaolin Xie,1,2,&ast; Jiasong Yang,1,2,4 Peng Gao,5 Wensheng Li1,2,4 1Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China; 2Shanghai Aier Eye Institute, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China; 3Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, 410011, People’s Republic of China; 4Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, 410015, People’s Republic of China; 5Department of Ophthalmology, Shanghai Tenth People’s Hospital of Tongji University, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Wensheng Li, Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, No. 83 Wuzhong Road, Xuhui District, Shanghai, 201103, People’s Republic of China, Email drlws@qq.comPurpose: To observe the outcome of bilateral femtosecond laser-assisted clear lens extraction with trifocal intraocular lens (IOL) implantation for presbyopia correction and evaluate its feasibility in early presbyopic adults.Methods: Prospective case series of eyes with clear crystalline lenses that underwent femtosecond laser-assisted lens extraction and trifocal IOL (Acrysof IQ PanOptix, Model TFNT00, Alcon) implantation between 2021 and 2023 were followed up for at least 3 months after surgery. Outcome measures included monocular uncorrected visual acuity at near (UNVA, 40 cm), intermediate (UIVA, 60 cm), and distance (UDVA, 5 m), monocular manifest refraction, corrected distance visual acuity (CDVA), defocus curve assessment, and spectacle independence at both near and distance.Results: A total of 60 eyes from 30 consecutive patients were included, and their mean age was 50.4± 6.5 years. After surgery, the mean UNVA (LogMAR) increased from 0.28± 0.16 to 0.08± 0.07, UIVA increased from 0.25± 0.12 to 0.09± 0.06, and UDVA increased from 0.27± 0.21 to 0.01± 0.08. The enhancements of UNVA, UIVA and UDVA were all significant (P < 0.05). The optometric results showed that the mean postoperative spherical equivalent (SE) was − 0.21± 0.24 D, and the mean postoperative CDVA (LogMAR) was − 0.00± 0.06. The preoperative spectacle independences at near and distance were 46.7% (14/30) and 56.7% (17/30), respectively, and both increased to 100% at 3 months after surgery.Conclusion: Satisfactory visual outcomes and safe surgical procedures were observed in this study, which demonstrate that bilateral femtosecond laser-assisted clear lens extraction with PanOptix IOL implantation could be a feasible approach for presbyopia correction in working-age Chinese patients.Keywords: presbyopia-correcting, clear lens extraction, refractive lens exchange, trifocal intraocular lens, refractive surgery

In case of emergency, evacuation signs play an important role in guiding people to evacuate safety exits in large space buildings. Large space buildings are characterized by high ceilings and large areas. In the existing legislation and standards, the height setting of evacuation signs is fixed, but the influence of height changes on the visibility of evacuation signs is very important. This study fully considers the relationship between the height setting change of evacuation signs and the visual range and puts forward a smart safety design strategy for evacuation signs. The smart safety design consists of two parts, one is the mathematical relationship between the height change of evacuation signs and the visual range of personnel, and the other is the integration of the application process of smart devices. Firstly, the visual range of two different sizes of evacuation signs placed at the height of 1.7 to 6 m was measured experimentally in China. The results showed that: (1) with an increase in the height of the evacuation signs, their viewing distance gradually decreased and the visual range was reduced; (2) the mathematical model of the change between the height and the visual range of evacuation signs was established; (3) the height of evacuation signs between 3 to 5 m agreed more with the visual habits of the people. Then, on this basis, the smart safety design method can use related mathematical models to set the evacuation signs at the optimal height based on the actual distance between people and evacuation signs, ensuring that people can see the signs the first time, thus providing evacuation guidance for evacuees and improving the safety of large space buildings.

The coal base electrodes and efficient coal base loaded cobalt electrodes (Co-CE) were prepared by pyrolysis method of low rank coal united activation method of KOH in order to develop more pores structures. The morphology of electrodes were characterized by Scanning electron microscopy, meanwhile, the type of elements were detected by energy dispersive spectroscopy (EDS). The electrochemical performance of electrodes were tested by cyclic voltammetry and electrochemical impedance spectroscopy. The lamella structures and pores were observed in microtopography of electrodes and the cobalt were successfully loaded in Co-CE from the EDS analysis. The operating conditions of processing time, current density, electrolyte concentration, pH and initial phenol concentration on this electrochemical system in single factor experiment were separately explored, correspondingly, the value was 180 min, 40 mA·cm−2, 0.01 mol·L−1, 2, 100 mg·L−1, and the phenol removal rate (R) were at the range of 47.64–67.84%. In the optimization experiment of JMP design, the removal rate could reach at 83.47%. The response surface methodology was employed for optimizing operation conditions to improve R. And the prediction model obtained for the response can be represented as: R = 66.5275 + 6.7311X 1 – 5.4197X 4 – 5.2303X 5 + 4.9555X 1 2 – 12.5219X 2 2 – 6.2912X 4 2 + 16.0937X 5 2 + 2.4109X 2 X 4 – 7.910X 3 X 4 – 3.0123X 3 X 5 – 2.183X 4 X 5. The optimized conditions were pH 3, 100 mg·L−1 of phenol concentration, 0.1 mol/L of electrolyte concentration, 35 mA/cm2 of current density, and 180 min of processing time. Meanwhile, the predicted R was 90.86%, the actual R of three parallel experiments were 91.2%, 89.3%, 91.05%, which were well consistent with the predicted value. Additionally, the degradation mechanism was proposed as that the adsorption in pore structures synergy electrocatalytic effect of Co-CE. Micro-electric fields formed in pores and the transition metal catalysis accelerated the transformation of cathode hydrogen peroxide to generate hydroxyl radical (·OH). Furthermore, the ·OH were produced both by cathode and anode which promoted the degradation of phenol. This high catalytic activity and low cost Co-CE is a kind of prospective electrode for electrochemical degradation of phenolic wastewater.

Compared with traditional methane sensors, metasurface methane sensors have advantages such as high sensitivity, stable performance, miniaturization, integration, and multi functional customizability. It better meets the application needs in complex environments such as coal mines. This paper proposes an all dielectric type metasurface methane sensor based on Fano resonance. The metasurface structure consists of periodic silicon nanostructures and SiO2 substrates, consisting of four square silicon ring nanostructures and a central silicon nanoblock. By changing the geometric parameters, the effect on the Fano resonance of the all dielectric metasurface structure is observed. The results show the following points. Considering the quality factor and modulation depth of the structure, the center distance of the square silicon ring should be 1000 nm, the inner edge length of the square silicon ring should be 100 nm, and the edge length of the silicon nanoblock should be 200 nm. At this time, the quality factor is 227.60, and the modulation depth is 99.98%, which is close to 100%. By coating methane gas sensing thin films within the metasurface structure to achieve sensing and detection functions, combined with the extremely narrow linewidth Fano resonance features and significant local field enhancement effect, high-precision detection of methane gas is achieved. The simulation results show that the sensitivity of the all dielectric metasurface sensor to methane volume fraction is −0.953 nm/%. The change in methane volume fraction is linearly related to the shift of the resonance peak, indicating good monitoring performance. The refractive index sensitivity of the all dielectric metasurface sensor is as high as 883.95 nm/RIU. The resonance peak offset is linearly related to the environmental refractive index increment, which can be used to detect changes in environmental refractive index.

“High-quality development” is an important objective for China’s current development projects. For the betterment of the current situation of the underdeveloped regions, high-quality development is necessary. The comprehensive index method is one of the most widely used methods for evaluating high-quality development works, and indicator weighting is its key and at the same time the most controversial step. Among many weighting methods, the entropy weighting method is widely applied due to its easier understandability and use. This article focuses on the problem of weight distortion when the entropy values of indicators are close to 1 and the improvements to this problem. To verify these improvements, this article deduces with mathematical analysis, the underlying assumptions of the problem and evaluates the level of high-quality development in Qinghai Province, which is assumed to be an appropriate example of the underdeveloped regions in western China. Our mathematical deductions demonstrate that these underlying assumptions do not theoretically exist. In addition, both the improved and the original methods have similar performances in practice or, more specifically, have shown an overall upward trend in the level of high-quality development in Qinghai Province. Because the “problem” is extremely stringent and difficult to reproduce, we conclude that further improvements on the entropy weighting method should not be a focus of future research. To address the subjectivity or objectivity issues of weighting, weightless methods may be of use and should be developed.

With the development of the Internet of Things, the rapid development of miniaturized self-powered electronic products and further micro-modulation greatly stimulate the urgent demand for microscale electrochemical energy storage devices. In each electrochemical energy storage device, the supercapacitor based on the plane pattern shape is highly compatible with modern electronic products in terms of functional features such as miniaturization and integration. In this work, the flexible 3D interdigital electrode symmetric micro capacitor was prepared by the combination of semiconductor preparation technology and electrophoresis printing technology, and the 3D printing was carried out by using oxygen enriched activated carbon ink. The 3D interdigital symmetric electrode was prepared by adjusting and optimizing the electric field strength, line width, number of printing layers and other parameters. The energy dispersive spectrometer (EDS), scanning electron microscopy(SEM), rheometer, electrochemical workstation and test system were used to characterize materials, pastes and microcapacitor devices, and to explore the influence of materials and pastes on the performance of 3D interdigital microcapacitor. The results that the 3D interdigital supercapacitor prepared by the combination of semiconductor and electrophoresis printing process has good performances, and its area capacitance can reach 22.3 mF·cm-2. In addition, the device can achieve 96% capacity retention after 2000 cycles through packaging optimization. This simple and controllable 3D jet printing technology provides an effective way to prepare advanced miniaturized electrochemical energy storage devices.

Abstract Pulmonary fibrosis (PF) is a severe chronic interstitial lung disease with high mortality, and there is currently a lack of definite and effective treatment methods. Studies have found that gentiopicroside, a secoiridoid glycoside compound derived from plants of the Gentiana genus, can significantly improve pulmonary inflammation and fibrosis lesions in mice with pulmonary fibrosis. However, the mechanism of its anti-fibrotic effect is unclear. Therefore, in this study, we employed network pharmacology's virtual computer technology to investigate the potential mechanism underlying the anti-pulmonary fibrosis effect of Gentianae Radix et Rhizome (Longdan in Chinese, GRR). Our findings offer valuable theoretical insights and serve as a guiding reference for future experimental investigations. A total of 10 active compounds and 920 drug-target proteins were identified from the TCMSP database. The compound-target-pathway-disease network showed that GRR could potentially treat PF by regulating the MDM2, ERBB2 and VEGFA, signaling pathways through its key targets, including AKT1, TNF, and MAPK1. The protein‒protein interaction network revealed that these targets had strong interactions with each other, indicating a potential synergistic effect of GRR in treating PF. The GO and KEGG enrichment analyses further supported the potential anti-pulmonary fibrosis mechanisms of GRR, including regulating the inflammatory response, ECM-receptor interaction, and TGF-beta signaling pathways. Our study provides a systematic analysis of the potential anti-pulmonary fibrosis mechanisms of GRR based on network pharmacology. These findings could contribute to the development of novel treatments for PF and provide a basis for further experimental studies.

Objective To investigate the effect of chloroquine (CQ) on proliferation, apoptosis and autophagy of human cervical cancer cell line HeLa and to preliminarily explore its mechanism of action. Methods HeLa cells were divided into control group and experimental groups: chloroquine-1 to chloroquine-5 groups (25,50,75,100, 150 μmol/L CQ respectively). The cells all were cultured for 24 and 48 h; CCK-8 and colony formation assays were used to detect cell proliferation; reactive oxygen species detection kit was used to detect intracellular ROS production; flow cytometry was used to detect apoptosis rate. The expression level of autophagy proteins p62, LC3 and Beclin1, apoptosis proteins Bax, Bcl-2 and PARP and PI3K/AKT/MDM2 pathway proteins was detected by protein immunoblotting. Results CQ inhibited cell proliferation in a time- and concentration-dependent manner (P＜0.01); CQ significantly inhibited cell autophagy, induced intracellular ROS production and induced apoptosis (P＜0.01). Compared with control group, CQ significantly inhibited the activation of PI3K/AKT/MDM2 signaling pathway (P＜0.05). Conclusions Chloroquine may inhibit the proliferation of HeLa cells and induce apoptosis through the PI3K/AKT/MDM2 pathway.

Diverse splicing types in nuclear and chloroplast genes of protist Euglena gracilis have been recognized for decades. However, the splicing machinery responsible for processing nuclear precursor messenger RNA introns, including trans-splicing of the 5′ terminal outron and spliced leader (SL) RNA, remains elusive. Here, we identify 166 spliceosomal protein genes and two snRNA genes from E. gracilis by performing bioinformatics analysis from a combination of next-generation and full-length transcriptomic RNA sequencing (RNAseq) data as well as draft genomic data. With the spliceosomal proteins we identified in hand, the insensitivity of E. gracilis to some splicing modulators is revealed at the sequence level. The prevalence of SL RNA-mediated trans-splicing is estimated to be more than 70% from our full-length RNAseq data. Finally, the splicing proteomes between E. gracilis and its three evolutionary cousins within the same Excavata group are compared. In conclusion, our study characterizes the spliceosomal components in E. gracilis and provides the molecular basis for further exploration of underlying splicing mechanisms.

Objective To analyze the prognosis and risk factors of acute tandem vertebrobasilar artery occlusion (VBO) after endovascular therapy (EVT). Methods This study used the patient data from the EVT for Acute Basilar Artery Occlusion Study (BASILAR), a national multicenter clinical registry study for endovascular treatment of acute basilar artery occlusion from January 2014 to May 2019. All patients received intravascular treatment and underwent a 90 d follow-up. According to the presence of vertebral artery and basilar artery occlusion, they were divided into vertebral basilar artery occlusion (VBO) group and acute basilar artery occlusion (BAO) group. Their baseline indicators were analyzed to explore the differences in prognosis and influencing factors between the 2 groups. Results A total of 647 eligible patients were included in this study, with a median age of 64 (56, 74) years, and 74.7% of them (483) were males. Among them, 560 patients had simple basilar artery occlusion and the other 87 had basilar artery occlusion combined with severe stenosis or occlusion of the vertebral artery. There were no significant differences in the 90-day good prognosis rate (defined as mRS score of 0~3) (P=0.090) and mortality rate (P=0.890) between the VBO group and the BAO group. For the patients in the VBO group, lower NIHSS score (OR=0.898, 95% CI: 0.845~0.954, P < 0.001), higher pc-ASPECTS score (OR=1.690, 95%CI: 1.117~2.557, P=0.010), and shorter puncture to recanalization time (OR=0.990, 95%CI: 0.980~1.000, P=0.047) were independent risk factors for 90-day good prognosis. Similarly, higher NIHSS score (OR=1.094, 95%CI: 1.033~1.159, P=0.002), lower pc-ASPECTS score (OR=0.622, 95%CI: 0.438~0.882, P=0.008) and longer puncture to recanalization time (OR=1.010, 95%CI: 1.001~1.019, P=0.040) were also predictive factors for 90-day mortality in these patients. Conclusion EVT is safe and effective for acute VBO, with a good short-term prognosis. NIHSS score, pc-ASPECTS score, and puncture to recanalization time are independent predictors for 90-day good prognosis in VBO patients, and are also predictors of 90-day mortality rate.

Objective To investigate the impact of exposure to 50 Hz magnetic field on transcription in Neuro2a/APP(695) cells. Methods Neuro2a/APP(695) cells were divided into radiation group and sham radiation group (n=3). The cells in the former group were exposed to 50 Hz magnetic field (1 mT, 4 h/d) for 3 consecutive days, and those from the latter group were only placed in the same coil system under the same conditions but without 50 Hz magnetic field. After exposure, all samples were collected to undergo standard procedures for transcriptome sequencing, including RNA extraction, data quality evaluation, and data analysis. Results There were 141 identified significant differentially expressed genes (DEGs) in Neuro2a/APP(695) cells after exposure, of which 129 were up-regulated and 12 were down-regulated. Gene Ontology (GO) enrichment analysis showed that the 62 up-regulated DEGs were involved in 432 significantly functional properties, of which 337 belong to biological processes, 16 to cellular components and 79 to molecular functions. While, the 3 down-regulated DEGs were involved in 275 significantly functional properties, of which 260 belonged to biological processes, 5 to cellular components and 10 to molecular functions. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis revealed that these DEGs may be involved in 20 differential KEGG pathways, including 2 down-regulated pathways and 18 up-regulated pathways. Conclusion Exposure to 50 Hz magnetic field may affect adhesion junction, Hippo signaling pathway, glycosaminoglycan biosynthesis-chondroitin sulfate/dermatan sulfate, protein digestion and absorption, mannose type O-glycan biosynthesis in Neuro2a/APP(695) cells, and these may be the main pathways that the exposure affects the cells.

【Objective】 Biochar amendment has been widely used to improve soil quality and remediate soil contamination. The objective of this paper is to elucidate the impact of its combination with brackish water irrigation on water flow and salt transport in saline-alkaline soils in the Yellow River Delta. 【Method】 The experiment was conducted using soil columns. Soil taken from the delta was amended with biochar of wheat or maize straw respectively. There were 10 treatments by applying 10 t/hm2 (X1) and 20 t/hm2 (X2) of wheat biochar (X1), or 10 t/hm2 (Y1) and 20 t/hm2 (Y2) of maize biochar. The control was irrigation with deionized water (CK). The concentration of the brackish water was 3 g/L. In each treatment, we measured the movement of water, salt and soil pH. 【Result】 Amending soil with biochar combined with brackish water irrigation improved soil infiltration capacity and water retention in the soil. The wheat straw biochar worked better in improving infiltration than the maize straw biochar. Biochar amendment combined with brackish water irrigation also facilitated salt leaching, reducing salt content in the soil by 7.3% to 10.44%, compared to the CK. Wheat straw biochar worked better in de-salinizing the soil than maize straw biochar, especially the X1 whose desalination rate was 53.74%. The addition of biochar combined with brackish water irrigation increased soil pH, albeit not significantly, especially the maize straw biochar in X2 which affects soil pH most. 【Conclusion】 Amending the soil with 10 t/hm2 of wheat straw biochar combined with brackish water irrigation was effective to improve the quality of the saline soils in the Yellow River Delta region. Results of this study provide guidance to sustainably utilize brackish water and biochar to improve productivity of the saline-alkaline soils in Yellow River delta and areas with similar conditions.

In atherosclerosis, macrophage-derived foam cell formation is considered to be a hallmark of the pathological process; this occurs via the uptake of modified lipoproteins. In the present study, we aim to determine the role of transaldolase in foam cell formation and atherogenesis and reveal the mechanisms underlying its role. Bone marrow-derived macrophages (BMDMs) isolated from mice successfully form foam cells after treatment with oxidized low-density lipoprotein (80 μg/mL). Elevated transaldolase levels in the foam cell model are assessed by quantitative polymerase chain reaction and western blot analysis. Transaldolase overexpression and knockdown in BMDMs are achieved via plasmid transfection and small interfering RNA technology, respectively. We find that transaldolase overexpression effectively attenuates, whereas transaldolase knockdown accelerates, macrophage-derived foam cell formation through the inhibition or activation of cholesterol uptake mediated by the scavenger receptor cluster of differentiation 36 (CD36) in a p38 mitogen-activated protein kinase (MAPK) signaling-dependent manner. Transaldolase-mediated glutathione (GSH) homeostasis is identified as the upstream regulator of p38 MAPK-mediated CD36-dependent cholesterol uptake in BMDMs. Transaldolase upregulates GSH production, thereby suppressing p38 activity and reducing the CD36 level, ultimately preventing foam cell formation and atherosclerosis. Thus, our findings indicate that the transaldolase-GSH-p38-CD36 axis may represent a promising therapeutic target for atherosclerosis.

Cellular senescence is a state of irreversible cellular growth arrest that occurs in response to various stresses. In addition to exiting the cell cycle, senescent cells undergo many phenotypic alterations, including metabolic reprogramming, chromatin rearrangement, and senescence-associated secretory phenotype (SASP) development. Furthermore, senescent cells can affect most physiological and pathological processes, such as physiological development; tissue homeostasis; tumour regression; and age-associated disease progression, including diabetes, atherosclerosis, Alzheimer’s disease, and hypertension. Although corresponding anti-senescence therapies are actively being explored for the treatment of age-associated diseases, the specific regulatory mechanisms of senescence remain unclear. N6-methyladenosine (m6A), a chemical modification commonly distributed in eukaryotic RNA, plays an important role in biological processes such as translation, shearing, and RNA transcription. Numerous studies have shown that m6A plays an important regulatory role in cellular senescence and aging-related disease. In this review, we systematically summarize the role of m6A modifications in cellular senescence with regard to oxidative stress, DNA damage, telomere alterations, and SASP development. Additionally, diabetes, atherosclerosis, and Alzheimer’s disease regulation via m6A-mediated cellular senescence is discussed. We further discuss the challenges and prospects of m6A in cellular senescence and age-associated diseases with the aim of providing rational strategies for the treatment of these age-associated diseases.

Yuxin Tan,1 Xiuyun Lin,1,2 Hui Chen,1 Min Xu,1 Yingying Tang,1 Pengfei Gao,1 Wei Ren,1 Di Zhang1 1Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of China; 2Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, People’s Republic of ChinaCorrespondence: Xiuyun Lin, Faculty of Psychology, Beijing Normal University, Beijing, 100875, People’s Republic of China, Email linxy@bnu.edu.cnIntroduction: During emergencies, individuals and communities often react in a variety of ways, including panic response. However, the study of panic response is limited due to narrow assessment tools that measure only one or two dimensions of human response (eg, physiology, cognition, emotion, and behavior). To address this limitation and to explore the risk and protective factors of panic response during the global spread of the Coronavirus Disease 2019 (COVID-19), the current study developed and evaluated the Panic Response Scale (PRS).Methods: Four samples were recruited for the following purposes: interview analysis (n = 26); item analysis and exploratory factor analysis (n = 604); confirmatory factor analysis and reliability analysis (n = 603); and retest reliability, validity analysis, and regression analysis (n = 349).Results: The PRS consists of 21 items with four subscales: Physical Discomfort, Anxious Fluster, Sensitive Depression, and Excessive Prevention. Each of these subscales demonstrated good internal consistency (rs > 0.73), test-retest reliability (rs > 0.77), criterion validity (r = 0.69, p < 0.01), and convergent validity (rs = 0.31– 0.65, p < 0.01). Regression analysis revealed significant predicting effects of COVID-19 knowledge and neuroticism on panic response. Additionally, cognitive reappraisal moderated the association between neuroticism and panic response.Discussion: Following a traumatic event, the PRS offers a potential tool for identifying individuals in need of mental health services. Moreover, during the COVID-19 pandemic, knowledge and neuroticism served as risk factors for heightened panic response, while cognitive reappraisal served as a protective factor for coping with panic response.Keywords: COVID-19, panic response, knowledge, neuroticism, cognitive reappraisal

Kaichen Zhang,&ast; Yihua Fan,&ast; Kunlan Long, Ying Lan, Peiyang Gao Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Peiyang Gao, Email gaopy930@126.comBackground: Interest in the application of deep learning (DL) in critical care medicine (CCM) is growing rapidly. However, comprehensive bibliometric research that analyze and measure the global literature is still lacking.Objective: The present study aimed to systematically evaluate the research hotspots and trends of DL in CCM worldwide based on the output of publications, cooperative relationships of research, citations, and the co-occurrence of keywords.Methods: A total of 1708 articles in all were obtained from Web of Science. Bibliometric analysis was performed by Bibliometrix package in R software (4.2.2), Microsoft Excel 2019, VOSviewer (1.6.18), and CiteSpace (5.8.R3).Results: The annual publications increased steeply in the past five years, accounting for 95.67% (1634/1708) of all the included literature. China and USA contributed to approximately 71.66% (1244/1708) of all publications. Seven of the top ten most productive organizations rank in the top 100 universities globally. Hot spots in research on the application of DL in CCM have focused on classifying disease phenotypes, predicting early signs of clinical deterioration, and forecasting disease progression, prognosis, and death. Convolutional neural networks, long and short-term memory networks, recurrent neural networks, transformer models, and attention mechanisms were all commonly used DL technologies.Conclusion: Hot spots in research on the application of DL in CCM have focused on classifying disease phenotypes, predicting early signs of clinical deterioration, and forecasting disease progression, prognosis, and death. Extensive collaborative research to improve the maturity and robustness of the model remains necessary to make DL-based model applications sufficiently compelling for conventional CCM practice.Keywords: hotspots, trends, deep learning, critical care medicine

To investigate the effect of group gliding formation on the hydrodynamic performance of manta rays, numerical simulations were used to investigate the drag, the lift and pressure distribution of multiple manta rays in tandem, triangular and diamond-shaped arrangements. The simulation results show that the leader manta ray at the head of the group always suffers the least drag, and in most cases, the companion manta ray at the tail of the group suffers the most drag. The pressure distribution in the flow field shows that the drag reduction effect mainly comes from the distribution of high pressure and low pressure zones among the individual rays in the cluster, the high pressure zone is beneficial to the manta rays at the front of the group, and under certain circumstances, the presence of low pressure zone generates forward suction to reduce the drag of the manta rays at the end of the group. It is found that when manta rays glide in "two in front and one at the back", four-body diamond, six-body tandem and six-body diamond arrangement, the average drag of the system can be reduced, which provides theoretical guidance for the formation of bionic vehicle groups.

To explore the metabolic pathways involved in oligosaccharide synthesis during the fruit development of Lycium barbarum, we investigated the differential expression of oligosaccharide synthesis-related proteins at different developmental stages of L. barbarum (S1—young fruit, S2—green fruit, S3—early yellowing, S4—late yellowing, and S5—full fruiting) using isobaric tags for relative and absolute quantitation (iTRAQ). A total of 1 799 differentially expressed proteins were identified, 133 of which were found to be associated with oligosaccharide metabolism by Gene Ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment. Oligosaccharide accumulation in L. barbarum fruits at the first three stages was mainly dependent on photosynthesis. Changes in the biosynthesis and metabolism of oligosaccharide were mainly related to the gene and protein expression of sucrose synthase (SS), sucrose phosphate synthase (SPS) and hexokinase (HK). At stages S4 and S5, oligosaccharide accumulation was achieved through the metabolism of starch and polysaccharide and the enzymes related to changes in the biosynthesis and metabolism of oligosaccharide included raffinose synthase, β-fructofuranosidase and endoglucanase. The gene expression of 10 oligosaccharide biosynthesis-related enzymes as detected by real-time polymerase chain reaction (PCR) was consistent with the proteomics results. This study provides a theoretical basis for further elucidating the mechanism of oligosaccharide biosynthesis and metabolism during the fruit development of L. barbarum.

Peng Gao,1 Hanwei Wu,2 Zhiguang Fan,3 Min Tao4 1Department of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, Jilin, People’s Republic of China; 2Department of Foreign Studies, Hunan Normal University, Changsha, Hunan, People’s Republic of China; 3Department of Psychology, School of Teacher Education, Shaoxing University, Shaoxing, Zhejiang, People’s Republic of China; 4Department of Education, Jilin International Studies University, Changchun, Jilin, People’s Republic of ChinaCorrespondence: Zhiguang Fan, Department of Teacher Education, Shaoxing University, No. 900, Chengnan Avenue, Shaoxing, Zhejiang, 312000, People’s Republic of China, Tel +86-0431-84924101, Fax +86 1 594-831-4623, Email fanyqm@126.comObjective: The present study aimed to probe the intergenerational transmission of intolerance of uncertainty (IU) and trust in physicians. Besides, through the actor-partner interdependence model (APIM), the predictive effect of parents’ IU on their own and their spouses’ trust in physicians was examined. A mediation model was further constructed to probe the mechanisms by which parents’ IU affects children’s trust in physicians.Methods: The Intolerance of Uncertainty Scale-12 (IUS-12) and the Wake Forest Physician Trust Scale (WFPTS) were employed to conduct the questionnaire survey among 384 families (each family with a father, mother, and one child).Results: IU and trust in physicians were found to be intergenerationally transmitted. The results of the APIM analyses showed that fathers’ total IUS-12 scores negatively predicted their own (β = − 0.419, p < 0.01) and mothers’ (β = − 0.235, p < 0.01) total WFPTS scores. Mothers’ total IUS-12 scores negatively predicted their own (β = − 0.353, p < 0.01) and fathers’ (β = − 0.138, p = 0.017) total WFPTS scores. The results of mediation analyses indicated that parents’ total WFPTS scores and children’s total IUS-12 scores mediated the effect of parents’ total IUS-12 scores on children’s total WFPTS scores.Conclusion: The public’s IU is a crucial influencing factor of their trust in physicians. Besides, the IU between couples and between parents and children could be mutually affected. On the one hand, husbands’ IU could affect their own and their wives’ trust in physicians, and vice versa. On the other hand, parents’ IU and trust in physicians could affect their children’s IU and trust in physicians, respectively.Keywords: intolerance of uncertainty, trust in physicians, intergenerational transmission, the actor-partner interdependence model, mediation analysis

Objective: To solve the problems of low accuracy, low efficiency, and strong manual dependence in existing milk protein detection methods. Methods: Based on hyperspectral imaging systems, proposed a combination of improved whale algorithm and Elman neural network for rapid and non-destructive detection of milk protein content. Optimized the whale algorithm through three aspects (chaotic mapping, adaptive convergence factor, and adaptive weight) to improve search accuracy, and optimized the Elman neural network parameters (weights and thresholds) after optimization. Analyzed the performance of the proposed non-destructive testing method through experimental analysis. Results: Compared with conventional detection methods, proposed method was optimal for multiple performance indicators in non-destructive testing of milk protein. The experimental method was optimal in multiple performance indicators for non-destructive testing of milk protein, with determination coefficient of 0.997 3, the root mean square error of 0.000 3, and the detection time of 1.56 seconds. Conclusion: The experimental method has high detection accuracy and efficiency.

This study investigates the integration of digital twin technology in the design of traditional cultural and creative products, addressing the challenges of innovation and efficiency in the cultural and creative industries. By employing digital twin network modeling, we develop an intelligent design method that digitally replicates and optimizes cultural products, enhancing design efficiency and innovation. Our approach involves digital modeling of traditional characteristics through preprocessing and feature extraction, followed by multi-scale design evolution experiments in a virtual environment. Results show a 30% improvement in design efficiency and increased product innovation and user satisfaction, demonstrating the method’s potential to revolutionize traditional product design while preserving cultural essence. This research contributes to the intelligent design of cultural and creative products and suggests new avenues for the cultural industry’s innovative growth.

Carbon pyrolysis is one of the essential ways to improve carbon energy utilization and reduce environmental pollution. The main product of carbon pyrolysis process is tar, and improving tar yield can not only increase the resource utilization efficiency, but also reduce the pollution to the environment. Therefore, this paper investigates the application of Ni/MgO catalyst in the pyrolysis process of bituminous coal. The experimental results show that Ni/MgO catalyst can effectively activate small molecule radicals and make them combine with prominent molecule radicals stably to improve the tar yield. Meanwhile, when it is under the pyrolysis gas environment, pyrolysis temperature reaches 570 ℃, gas flow rate is 375 ml/min, and the catalyst is selected to be filled in the upper layer, the activation effect of Ni/MgO catalyst is more prominent, and it can significantly increase the tar yield and the proportion of light oil. Ni/MgO catalyst had the best effect in tar yield increase compared to other catalysts, but the performance was average in fair oil percentage increase. The catalyst could also reduce the number of aliphatics in the tar and increase the proportion of non-aliphatics, improving the tar quality.

In the context of the comprehensive implementation of rural revitalization strategy, ecological protection and sustainable territorial spatial pattern are important elements of spatial planning and ecological civilization construction. With this as the starting point, this paper can use spatial analysis, hierarchical analysis, entropy method, integrated learning and other technical methods to divide the national spatial evaluation units under the MOLA model. Carry out spatial suitability evaluation of national land based on double constraints as well as spatial planning and design. The test results show that the villagers’ trust in the implementation of rural revitalization policies reached 78%, and most of them agree more with various policies on rural construction and development, which illustrates the necessity of territorial spatial planning in rural revitalization. The research data have good score validity when the observed variable of the questionnaire under the experimental test is greater than 0.4, which indicates the spatial planning layout under the proposed model. On the basis of mastering the current situation and problems facing rural revitalization, it not only proposes an effective path, but also scientifically adjusts and optimizes the space of rural areas, providing a boost to promote the construction and sustainable and healthy development of new rural areas.

Lejun Gao,1,&ast; Huaixin Mu,2,&ast; Yun Lin,1 Qingping Wen,1,3 Peng Gao1 1Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, Dalian, People’s Republic of China; 2Emergency Department, Shenyang Children’s Hospital, Shenyang, People’s Republic of China; 3Department of Anesthesiology, Dalian Medical University, Dalian, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Peng Gao; Qingping Wen, Department of Anesthesiology, First Affiliated Hospital of Dalian Medical University, NO. 222 Zhongshan Road, Dalian, 116011, People’s Republic of China, Tel/Fax +86 411 86110440, Email dalianpeople@163.com; dmuwqp@163.comAbstract: Postoperative pain is one of the most prevalent complications following surgery, and more than 47% of surgical patients endure postoperative discomfort worldwide. In Africa, due to resource shortages and other issues, postoperative pain is substantially more common when compared to developed countries. Severe postoperative pain has many negative effects, including possibly death, which can burden both individuals and society as a whole. Therefore, effectively controlling postoperative pain is becoming increasingly important. To enhance the effectiveness of future pain management, a thorough analysis of the current reasons for inadequate postoperative pain management is necessary. In this article, the present situations of occurring postoperative pain, children’s postoperative pain, and pain management in Africa are reviewed, based on relevant and recent literature. In particular, the reasons for inadequate postoperative pain management in Africa are detailed in this article from five perspectives: the inadequate assessment of postoperative pain, the knowledge gap among medical professionals, the patients’ misconceptions, the scarcity of resources, and the lack of medications. Additionally, we offer appropriate solutions following various factors.Keywords: Africa, postoperative pain, pain management, analgesia, pain in children, pain assessment

ObjectiveTo explore the mental health status and its influencing factors among middle school students in Xide County， Liangshan Yi Autonomous Prefecture， and to provide references for mental health interventions for local middle school students.MethodsUsing a cross-sectional study design， one junior middle school and one senior middle school in Xide County， Liangshan Prefecture， Sichuan Province， were randomly selected on September 16， 2021， and two classes per grade in each school involving 288 students were recruited. Subjects were assessed using Patients' Health Questionnaire Depression Scale-9 item （PHQ-9）， Generalized Anxiety Disorder Scale-7 item （GAD-7）， PTSD Checklist for DSM-5 （PCL-5）， Multidimensional Scale of Perceived Social Support （MSPSS） and UCLA Loneliness Scale （ULS-3）. Then the scores of above scales were compared among middle school students with different demographic characteristics， and binary Logistic regression analysis was conducted to screen the influencing factors of post-traumatic stress disorder (PTSD） symptoms.ResultsAmong the respondents， 17.71% （95% CI： 0.133~0.221）， 8.68% （95% CI： 0.054~0.120）， 2.78% （95% CI： 0.009~0.047） and 45.83% （95% CI： 0.400~0.516） were reported to have symptoms of depression， anxiety， PTSD and loneliness， respectively. Students in senior middle school scored lower on PCL-5 and ULS-3 than those in junior middle school ［（6.46±8.91） vs. （8.87±9.42）， t=2.202， P

Mengjie Chen,1,&ast; Kan Xu,2,&ast; Yuting He,1,&ast; Jianjun Jin,3 Ruolin Mao,1 Lei Gao,1 Yi Zhang,4 Gang Wang,5 Peng Gao,6 Min Xie,7 Chunfang Liu,8 Zhihong Chen1 1Department of Respiratory and Critical Care Medicine of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, People’s Republic of China; 2Geriatric Department of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, People’s Republic of China; 3Research Center of Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China; 4Air Liquide Holding Co., Ltd, Shanghai, People’s Republic of China; 5Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 6Department of Respiratory Medicine, The Second Affiliated Hospital of Jilin University, Changchun, People’s Republic of China; 7Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical 10 College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 8Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhihong Chen, Department of Respiratory and Critical Care Medicine of Zhongshan Hospital, No. 180 Fenglin Road, Shanghai, People’s Republic of China, Tel +86-21-64041990-2445, Fax +86-21-64187165, Email chen.zhihong@zs-hospital.sh.cn Chunfang Liu, Department of Laboratory Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, 12&num; Wlmq Road, Shanghai, People’s Republic of China, Email Chunfang_liu@fudan.edu.cnPurpose: The progression of an abnormal inflammatory response plays a crucial role in the lung function decline of chronic obstructive pulmonary disease (COPD) patients. Compared to serum biomarkers, inflammatory biomarkers in induced sputum would be a more reliable reflection of inflammatory processes in the airways.Patients and Methods: A total of 102 COPD participants were divided into a mild-to-moderate group (FEV1%pred≥ 50%, n=57) and a severe-to-very-severe group (FEV1%pred< 50%, n=45). We measured a series of inflammatory biomarkers in induced sputum and analyzed their association with lung function and SGRQ in COPD patients. To evaluate the relationship between inflammatory biomarkers and the inflammatory phenotype, we also analyzed the correlation between biomarkers and airway eosinophilic phenotype.Results: We found increased mRNA levels of MMP9, LTB4R, and A1AR and decreased levels of CC16 mRNA in induced sputum in the severe-to-very-severe group. After adjustment for age, sex and other biomarkers, CC16 mRNA expression was positively associated with FEV1%pred (r=0.516, p=0.004) and negatively correlated with SGRQ scores (r=− 0.3538, p=0.043). As previously known, decreased CC16 was related to the migration and aggregation of eosinophils in airway. It was also found that CC16 had a moderate negative correlation with the eosinophilic inflammation in airway (r=− 0.363, p=0.045) in our COPD patients.Conclusion: Low CC16 mRNA expression levels in induced sputum were associated with low FEV1%pred and a high SGRQ score in COPD patients. Sputum CC16 as a potential biomarker for predicting COPD severity in clinical practice might attribute to the involvement of CC16 in airway eosinophilic inflammation.Keywords: COPD, induced sputum, airway inflammation, biomarkers, lung function, CC16

The intracloud (IC) flashes can be classified into normal and inverted-polarity types according to their initial leader propagation directions. Due to the rare occurrence of inverted-polarity IC flashes with downward preliminary breakdown (PB) processes, the corresponding PB characteristics are much less understood than those in normal IC flashes.Based on the lightning data observed by a low-frequency lightning mapping system FALMA (fast antenna lightning mapping array) deployed in Ningxia, the characteristics of the PB process in 312 inverted-polarity IC flashes are statistically analyzed. The parameters of PB waveforms show that the arithmetical mean (AM) of the PB duration is 9.8 ms. The pulse shape is characterized by rise time, half-peak width, fall time, and pulse width, respectively, with AM values of 7.3 μs, 4.5 μs, 5.6 μs, and 24.7 μs. The pulse rate and pulse interval are 5.7 ms-1 and 169.2 μs.The statistical results for PB channels show that the inverted-polarity IC flashes are usually initiated at the AM altitude about 6.9 km, obviously higher than the initiation altitude of normal-polarity IC flashes. The difference indicates that there could be an inverted dipolar charge structure in the thunderclouds of Ningxia. The superposition of PB locations on the radar reflectivity suggests that these inverted IC flashes tend to be initiated in the region with radar echoes weaker than normal IC flashes (19.3 versus 27.8 dBZ). The vertical length and speed of PB channels are 2.0 km and 2.8×105 m·s-1.Furthermore, PB parameters show significant correlations with the initiation altitude. Specifically, both vertical speed and pulse rate decrease with the initiation altitude, and the correlation coefficients are -0.44 and -0.53, respectively. However, both PB durations and vertical distances show positive correlations with the initiation altitude, with the coefficients of 0.64 and 0.46, respectively.In general, the PB characteristics of inverted IC flashes present both similarities and differences to the PB processes in other flash types. It is believed more lightning observations in the northwest inland of China can facilitate the interpretation of these similarities and differences.

In recent years, with the development of minimally invasive instruments,equipment and the progress of surgical techniques, minimally invasive pancreatic surgery has entered an era of rapid development. Function-preserving laparoscopic resection of pancreatic head and duodenal papilla tumors including laparoscopic duodenum-preserving pancreatic head resection (LDPPHR), laparoscopic pancreatic head tumor enucleation and laparoscopic transduodenal ampullary resection(LTDAR) have also been used in clinical practice. However, the anatomy and surgical procedures are extremely complicated. Many surgeons lack the experience in this field. So far, these procedures have rarely used in clinical practice. In this article, we introduced the current status, problems and countermeasures of these surgical procedures, to promote the development of function-preserving laparoscopic pancreatic head and duodenal papilla tumor resection surgery.

Sprag-type overrunning clutches are widely used in aeroengines and the helicopter transmission system. The research on the contact properties of sprag-type overrunning clutches has important significance to the design of high reliability clutch. In order to study the effects of torque and coefficient of friction on the contact properties of sprag-type overrunning clutches, Hertz contact theory and finite element method are used to investigate the dynamic contact properties of sprag-type overrunning clutches. The results show that both rolling and sliding occur when friction is considered, the contact stress between sprags and races is elliptically distributed with a large eccentricity, the contact stress is distributed in the parabolic shape along the length of the sprags, maximum contact stress couldn't reflect the effects of torque on contact stress, the torque transmitted beyond the clutch is positively correlated with its torsion angle, the coefficient of friction doesn't affect the maximum contact stress and the torsion angle of the clutch, the coefficient of friction is nonlinear with the sliding distance and linear with the maximum friction stress.

Abstract Background China’s 35 largest cities, including Wuhan, are inhabited by approximately 18% of the Chinese population, and account for 40% energy consumption and greenhouse gas emissions. Wuhan is the only sub-provincial city in Central China and, as the eighth largest economy nationwide, has experienced a notable increase in energy consumption. However, major knowledge gaps exist in understanding the nexus of economic development and carbon footprint and their drivers in Wuhan. Methods We studied Wuhan for the evolutionary characteristics of its carbon footprint (CF), the decoupling relationship between economic development and CF, and the essential drivers of CF. Based on the CF model, we quantified the dynamic trends of CF, carbon carrying capacity, carbon deficit, and carbon deficit pressure index from 2001 to 2020. We also adopted a decoupling model to clarify the coupled dynamics among total CF, its accounts, and economic development. We used the partial least squares method to analyze the influencing factors of Wuhan’s CF and determine the main drivers. Results The CF of Wuhan increased from 36.01 million t CO2eq in 2001 to 70.07 million t CO2eq in 2020, a growth rate of 94.61%, which was much faster than that of the carbon carrying capacity. The energy consumption account (84.15%) far exceeded other accounts, and was mostly contributed by raw coal, coke, and crude oil. The carbon deficit pressure index fluctuated in the range of 8.44–6.74%, indicating that Wuhan was in the relief zone and the mild enhancement zone during 2001–2020. Around the same time, Wuhan was in a transition stage between weak and strong CF decoupling and economic growth. The main driving factor of CF growth was the urban per capita residential building area, while energy consumption per unit of GDP was responsible for the CF decline. Conclusions Our research highlights the interaction of urban ecological and economic systems, and that Wuhan’s CF changes were mainly affected by four factors: city size, economic development, social consumption, and technological progress. The findings are of realistic significance in promoting low-carbon urban development and improving the city’s sustainability, and the related policies can offer an excellent benchmark for other cities with similar challenges.

Zeli Xun,1,&ast; Pengfei Gao,2,3,&ast; Yanan Du,1 Xue Yan,3 Jingmin Yang,2– 4 Zhihua Wang1 1Department of Endocrinology, Xi’an Children’s Hospital, Shanxi, People’s Republic of China; 2State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, People’s Republic of China; 3Shanghai WeHealth Biomedical Technology Co, Ltd, Shanghai, People’s Republic of China; 4Key Laboratory of Birth Defects and Reproductive Health of National Health and Family Planning Commission (Chongqing Key Laboratory of Birth Defects and Reproductive Health, Chongqing Population and Family Planning, Science and Technology Research Institute), Chongqing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhihua Wang, Xi’an Children’s Hospital, Shanxi, 710002, People’s Republic of China, Email xasetyy@126.comAim: Mutations in the SLC12A3 gene have been reported to cause Gitelman syndrome (GS), characterized by hypokalemic metabolic alkalosis. The aim of this research is to investigate the genetic mutations and clinical features of patients with clinical suspicion of GS.Methods: Six families were enrolled. The symptoms, clinical examination, laboratory results, genotypes, and effect of mutations on mRNA splicing were analyzed. Genomic DNA was screened for gene variations using whole exome sequence and Sanger sequencing. DNA sequences were compared with reference sequences.Results: Genetic analysis revealed nine genetic variants of SLC12A3, including three novel heterozygous mutations (c.1096– 2A>G, c.1862A>G, and c.2747+4del) and six previously characterized mutations (c.965– 1_976delinsACCGAAAATTTT, c.506– 1G>A, c.602– 16G>A, c.533C >T, c.1456 G>A, and c.1108 G>C). Probands presented with the clinical syndrome of hypokalemia, increased plasma renin, hypocalciuria and hypokalemic alkalosis.Conclusion: These clinical manifestations and genotypes were consistent with the diagnostic criteria of GS. The study described the phenotypes and genotypes of six pedigrees involving GS patients, demonstrating the importance of SLC12A3 gene screening for GS. This study expands the mutation spectrum of SLC12A3 gene in GS.Keywords: SLC12A3, Gitelman syndrome, gene mutation, mRNA splicing, clinical characteristics