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Abstract Background This study sought to explore the clinical relevance of the associations of serum levels of advanced glycation end products (AGEs), soluble receptor for AGEs (sRAGE), and thioredoxin-interacting protein (TXNIP) with the renal fat fraction (RFF) in individuals with type 2 diabetes mellitus (T2DM). Methods A total of 133 patients with T2DM were enrolled in the study. RFF, which represents the renal fat level, was determined utilizing Dixon magnetic resonance imaging (MRI). Serum levels of AGEs, sRAGE, TXNIP, and other biochemical parameters were measured in patients who fasted. Results RFF in T2DM patients was positively correlated with the fasting levels of C-peptide (CP), triglycerides (TG), AGEs, TXNIP, and sRAGE (P

Abstract Background Malassezia restricta, a lipophilic and lipodependent yeast belonging to the basidiomycetes group, is an opportunistic fungal pathogen associated with various skin diseases, including seborrheic dermatitis and dandruff. Typically, Malassezia infection in neonates manifests as fungemia or hematogenous dissemination to the bone or lungs. However, vertebral osteomyelitis caused by these fungi is rarely reported owing to non-specific clinical presentations and laboratory/imaging findings. The Pathogen Metagenomics Sequencing (PMseq) technique enables direct high-throughput sequencing of infected specimens, facilitating the rapid and accurate detection of all microorganisms in clinical samples through comprehensive reports. Case presentation A 52-year-old male was admitted to our hospital on July 20, 2022 with a 3-month history of ambulatory difficulties and localized low back pain. Magnetic Resonance Imaging (MRI) examination of the spinal column revealed irregular bone destruction affecting the L2, L3, and L5 vertebral bodies. Additionally, low T1 and high T2 intensity lesions were observed at the intervertebral discs between L3 and L5. The presumptive diagnosis of tuberculous spondylitis was made based on the imaging findings, despite negative results in all mycobacterium tests. However, the patient exhibited no improvement after receiving regular anti-tuberculosis treatment for 3 months. Subsequent MRI revealed an expansive abnormal signal within the vertebral body, leading to progressive bone destruction. The absence of spinal tuberculosis or other infective microorganisms was confirmed through culture from blood and pathological tissue from the L4 vertebral body. Subsequently, PMseq was performed on the specimens, revealing M. restricta as the predominant pathogen with the highest relative abundance value. The pathological examination revealed the presence of fungal mycelium in the L4 vertebral body, with positive findings on periodic Schiff-methenamine and periodic acid-Schiff staining. The anti-tuberculosis treatment was discontinued, and an antifungal combination of fluconazole and voriconazole was administered. All symptoms were resolved after 7 consecutive months of treatment, and the patient was able to ambulate autonomously. Vertebral lesions were reduced on MRI during the 13-month follow-up. Conclusions M. restricta is not a commonly recognized pathogen associated with infectious vertebral osteomyelitis. However, PMseq can aid in diagnosis, timely treatment, and decision making for some non-specific infectious diseases.

Abstract Background Plant microbiota contributes to plant growth and health, including enhancing plant resistance to various diseases. Despite remarkable progress in understanding diseases resistance in plants, the precise role of rhizosphere microbiota in enhancing watermelon resistance against soil-borne diseases remains unclear. Here, we constructed a synthetic community (SynCom) of 16 core bacterial strains obtained from the rhizosphere of grafted watermelon plants. We further simplified SynCom and investigated the role of bacteria with synergistic interactions in promoting plant growth through a simple synthetic community. Results Our results demonstrated that the SynCom significantly enhanced the growth and disease resistance of ungrafted watermelon grown in non-sterile soil. Furthermore, analysis of the amplicon and metagenome data revealed the pivotal role of Pseudomonas in enhancing plant health, as evidenced by a significant increase in the relative abundance and biofilm-forming pathways of Pseudomonas post-SynCom inoculation. Based on in vitro co-culture experiments and bacterial metabolomic analysis, we selected Pseudomonas along with seven other members of the SynCom that exhibited synergistic effects with Pseudomonas. It enabled us to further refine the initially constructed SynCom into a simplified SynCom comprising the eight selected bacterial species. Notably, the plant-promoting effects of simplified SynCom were similar to those of the initial SynCom. Furthermore, the simplified SynCom protected plants through synergistic effects of bacteria. Conclusions Our findings suggest that the SynCom proliferate in the rhizosphere and mitigate soil-borne diseases through microbial synergistic interactions, highlighting the potential of synergistic effects between microorganisms in enhancing plant health. This study provides a novel insight into using the functional SynCom as a promising solution for sustainable agriculture. Video Abstract

Background/purpose: The pathophysiology of burning mouth syndrome (BMS), although considered a multifactorial etiology including psychological factors, is still not well understood. Hence, this study aimed to investigate the potential usage of salivary and serum biomarkers, including brain-derived neurotrophic factor (BDNF), interferon-gamma (IFN-γ), interleukin-1beta (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-α), in diagnosing BMS and their correlations with anxiety/depression. Materials and methods: 45 BMS patients and 14 healthy volunteers were enrolled. The patients were divided into BMS with anxiety/depression group and BMS without anxiety/depression group according to the scores of the Zung Self-rating Anxiety Scale (SAS) and Zung Self-rating Depression Scale (SDS). Additionally, concentrations of BDNF, IFN-γ, IL-1β, IL-6, IL-8, and TNF-α in saliva and those in serum among the patients and healthy volunteers were assessed by multiplex assay using Luminex 200TM system and Enzyme-linked immunosorbent assay (ELISA), respectively. Results: Among all the serum biomarkers, only BDNF showed a statistically significant decrease in the patients than the healthy volunteers (P

Mycoplasma pneumoniae is the primary pathogen causing community-acquired pneumonia in children, accounting for approximately 10%–40% of cases. It can lead to various extrapulmonary complications, including acute pancreatitis, which has been reported in approximately 30 cases to date. Here, we report a 4-year-old girl who presented with fever, cough, and elevated levels of M. pneumoniae IgM antibodies, followed by the onset of abdominal pain, elevated lipase, and elevated blood and urine amylase. Abdominal CT implied diffuse inflammation of the pancreas. Serum inflammatory cytokines, such as interleukin (IL)-2, IL-6, IL-17A, tumor necrosis factor, and interferon-gamma, were elevated. After excluding other causes, it was determined that M. pneumoniae infection was the cause of her acute pancreatitis. She was treated with macrolides and glucocorticoids and ultimately made a full recovery. Therefore, acute pancreatitis should be included in the differential diagnosis for patients with M. pneumoniae infection who present with abdominal pain. Inflammatory cytokines may play a role in mediating pancreatic damage.

The potential adverse effects of problematic internet use (PIU) on individuals’ offline personalities have been a significant concern in internet psychology. This study aimed to investigate the negative effects of PIU on shyness and the mediating role of self-regulation, as well as the moderating role of social comparison orientation. A total of 1,322 adolescents from China participated in the survey. The results indicated that: (1) PIU positively predicted shyness; (2) self-regulation partially mediated the relationship between PIU and shyness; (3) social comparison orientation moderated the mediation effect, specifically buffering the negative prediction of PIU on self-regulation, but exacerbating the negative predictive effect of self-regulation on shyness. The findings explored and verified the psychosocial effects of the internet, contributing to a deeper understanding of how PIU affects individual personality traits and offering insights into its role in broader social behavior patterns.

During the critical period of personality shaping and self-development, adolescents face unique challenges and opportunities. This study, based on Cognitive-Behavioral Theory, explored the relationship between shyness and self-consistency and congruence (hereinafter referred to as SCC), as well as its underlying mechanisms. Through a questionnaire survey on shyness, social comparison orientation, self-focused attention, and SCC among 984 adolescents, the results revealed that (1) Adolescent shyness negatively predicted SCC. (2) Social comparison orientation partially mediated the relationship between shyness and SCC. (3) Self-focused attention moderated the direct pathway of this mediation process, where a high level of self-focused attention exacerbated the negative impact of shyness on SCC. These findings offered a new perspective on understanding SCC and underscored the importance of addressing the information processing mechanisms of social comparison orientation and self-focused attention among shy adolescents in interventions aimed at promoting their psychological harmony and healthy growth.

Abstract Background Clinical and experimental studies have shown that the myocardial inflammatory response during pathological events varies between males and females. However, the cellular and molecular mechanisms of these sex differences remain elusive. CD73/adenosine axis has been linked to anti-inflammatory responses, but its sex-specific cardioprotective role is unclear. The present study aimed to investigate whether the CD73/adenosine axis elicits sex-dependent cardioprotection during metabolic changes and myocarditis induced by hypobaric hypoxia. Methods For 7 days, male and female mice received daily injections of the CD73 inhibitor adenosine 5′- (α, β-methylene) diphosphate (APCP) 10 mg/kg/day while they were kept under normobaric normoxic and hypobaric hypoxic conditions. We evaluated the effects of hypobaric hypoxia on the CD73/adenosine axis, myocardial hypertrophy, and cardiac electrical activity and function. In addition, metabolic homeostasis and immunoregulation were investigated to clarify the sex-dependent cardioprotection of the CD73/adenosine axis. Results Hypobaric hypoxia-induced cardiac dysfunction and adverse remodeling were more pronounced in male mice. Also, male mice had hyperactivity of the CD73/adenosine axis, which aggravated myocarditis and metabolic shift compared to female mice. In addition, CD73 inhibition triggered prostatic acid phosphatase ectonucleotidase enzymatic activity to sustain adenosine overproduction in male mice but not in female mice. Moreover, dual inhibition prostatic acid phosphatase and CD73 enzymatic activities in male mice moderated adenosine content, alleviating glycolytic shift and proinflammatory response. Conclusion The CD73/adenosine axis confers a sex-dependent cardioprotection. In addition, extracellular adenosine production in the hearts of male mice is influenced by prostatic acid phosphatase and tissue nonspecific alkaline phosphatase.

Abstract Purpose The effectiveness of anastrozole for breast cancer prevention has been demonstrated. The objective of this study was to evaluate the cost-effectiveness of anastrozole for the prevention of breast cancer in women with a high risk of breast cancer and to determine whether anastrozole for the primary prevention of breast cancer can improve the quality of life of women and save health-care resources. Methods A decision-analytic model was used to assess the costs and effects of anastrozole prevention versus no prevention among women with a high risk of breast cancer. The key parameters of probability were derived from the IBIS-II trial, and the cost and health outcome data were derived from published literature. Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated for the two strategies,One-way and probabilistic sensitivity analyses were performed. Results In the base case, the incremental cost per QALY of anastrozole prevention was £125,705.38/QALY in the first 5 years compared with no prevention in the UK, above the threshold of WTP (£3,000/QALY),and in the 12-year period, the ICER was £8,313.45/QALY, less than WTP. For the US third-party payer, ICER was $134,232.13/QALY in the first 5 years and $8,843.30/QALY in the 12 years, both less than the WTP threshold ($150,000/QALY). Conclusion In the UK and US, anastrozole may be a cost-effective strategy for the prevention of breast cancer in high-risk postmenopausal women. Moreover, the longer the cycle of the model, the higher the acceptability. The results of this study may provide a scientific reference for decision-making for clinicians, patients, and national medical and health care government departments.

China’s rural residential photovoltaic system has been greatly developed in recent years. However, most existing researches, are difficult to reflect the real development situation of the whole system. This study systematically sorts out the results in related fields through the literature review, aiming to clarify the current situation of applications and benefits of photovoltaic technology. The results show that currently the photovoltaic power generation technology is relatively mature and widely applied, and passive photovoltaic technology can play a greater role in reducing energy consumption in rural residential buildings in China. However, the development of photothermal and photovoltaic combined with other energy technologies, as well as the integration between photovoltaic technology and buildings are relatively lagging behind. Besides, the life cycle analysis and evaluation of photovoltaic system has not been established. In view of opportunities and challenges, this study prospects two future development directions. Firstly, the system coupling of photovoltaic technology should be strengthened, especially between the joint supply subsystems, between the active and passive technologies, and between photovoltaic technology and buildings. Secondly, the rationality of photovoltaic technology evaluation should be ensured, particularly to cover the three aspects of economy, ecology and society on the whole life cycle dimension.

A multi-modal feature based motion emotion analysis model based on a fusion deep learning model is proposed for the problem of analyzing the motion emotions of participants in the joint exercise quality expansion task. This model involves three major modalities: EEG signals, peripheral physiological signals, and facial expression signals, and processes and fuses the information of these three main modalities to achieve the effect of processing multi-dimensional motor emotional information. At the same time, this study introduces the design concept of residual networks, using self attention modules and multi head mutual attention modules to process different modal features. The results showed that the combination of peripheral physiological modality and facial expression modality had the highest accuracy among the three modality combinations, with an accuracy rate of 88.8 %. The feature fusion method based on the cascaded residual attention mechanism module has better accuracy and F1 Score performance than other methods. In addition, different emotional states can be effectively identified and distinguished in these three modalities, indicating that the model has a wide range of possibilities in practical applications.

Background: Circulating tumor cell (CTC) counting may be a useful non-invasive biomarker that helps patients choose first-line treatment options. Nevertheless, the cost of CTC inspection may impose an economic burden on patients, necessitating the simultaneous consideration of both its clinical effectiveness and cost. We evaluated the cost-effectiveness of CTC count-guided chemotherapy and endocrine therapy as first-line therapy for HR+/HER2-metastatic breast cancer (MBC) from the perspective of US payers. Methods: Based on the STIC CTC trial, a Markov model was constructed for three health states, and health outcomes were measured in quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were performed to assess the robustness of the incremental cost per QALY. Results: The base-case analysis revealed that CTC count-driven treatment was associated with improved effectiveness by 0.07 QALYs and increased the overall cost by $9187.05 compared with clinician-driven first-line treatment choices, leading to an ICER of $138 354.15 per QALY. One-way sensitivity analysis indicated that the model was most sensitive to the cost of treatment for neutropenia and the utility for PFS; probability sensitivity analysis indicated that CTC count-driven treatment choices would be considered the cost-effective option at a willingness-to-pay threshold of $150 000 per QALY. Conclusions: The findings of this cost-effectiveness analysis suggest that, at the current price of CTC enumeration, choosing first-line treatment options based on CTC count is a cost-effectiveness approach for treating patients with HR+/HER2- MBC in the US.

Abstract Background The present study is intended to examine the multiple mediating roles of sleep quality and depression in the relationship between psychological resilience and quality of life in middle-aged and older adults hospitalized with chronic diseases. Methods From October 2, 2021, to February 27, 2022, a questionnaire survey was conducted using a multistage stratified sampling method among 339 middle-aged and older adults (45 years and over) hospitalized with chronic diseases. These participants were recruited from a hospital in Zhejiang Province, China. The questionnaire included the Aged Cumulative Disease Rating Scale, the Psychological Resilience Scale, the Pittsburgh Sleep Quality Index Scale, the Depression Scale, and the Quality-of-Life Scale. A descriptive analysis was performed to characterize the sample. Linear regression was utilized to evaluate the relationship between psychological resilience and quality of life. Amos 24.0 was used to analyze the multiple mediated effects of sleep quality and depression. Results Psychological resilience exerted a remarkable direct effect on the quality of life in middle-aged and older adults hospitalized with chronic diseases (β = 0.239, 95% CI = 0.125–0.354), which represented 52.98% of the total effect. Through three significantly mediated pathways indirectly affect the quality of life: (1) through the sleep quality pathway (β = 0.115, 95% CI = 0.056–0.201), which represented 25.39% of the total effect; (2) through the depression pathway (β = 0. 060, 95% CI = 0.023–0.114), which represented 13.24% of the total effect; and (3) through both the sleep quality and depression pathway (β = 0. 038, 95% CI = 0.019–0.074), which represented 8.39% of the total effect. The total mediating effect was 47.02%. Conclusions Sleep quality and depression mediate the relationship between psychological resilience and quality of life in middle-aged and older adults hospitalized with chronic diseases. Therefore, healthcare professionals and stakeholders should be concerned about the sleep status and mental health of middle-aged and older adults hospitalized with chronic diseases, strengthen their attention to psychological resilience, and provide interventions and treatment measures for hospitalized patients who have sleep problems and depressive tendencies.

Background/Aims The impact of coronavirus disease 2019 (COVID-19) on the management of colorectal cancer (CRC) may worse in elderly population, as almost all COVID-19 deaths occurred in the elderly patients. This study aimed to evaluate the impact of COVID-19 on CRC management in the elderly population. Methods The numbers of patients who underwent colonoscopy, who visited hospitals or operated for CRC in 2020 and 2021 (COVID-19 era) were compared with those in 2019, according to 3 age groups (≥70 years, 50–69 years, and ≤49 years), based on the nationwide, population-based database (2019–2021) in South Korea. Results The annual volumes of colonoscopy and hospital visits for CRC in 2020 were more significantly declined in the old age group than in the young age group (both P

Abstract With advances in tissue engineering and bioelectronics, flexible electronic hydrogels that allow conformal tissue integration, online precision diagnosis, and simultaneous tissue regeneration are expected to be the next-generation platform for the treatment of myocardial infarction. Here, we report a functionalized polyaniline-based chronological adhesive hydrogel patch (CAHP) that achieves spatiotemporally selective and conformal embedded integration with a moist and dynamic epicardium surface. Significantly, CAHP has high adhesion toughness, rapid self-healing ability, and enhanced electrochemical performance, facilitating sensitive sensing of cardiac mechanophysiology-mediated microdeformations and simultaneous improvement of myocardial fibrosis-induced electrophysiology. As a result, the flexible CAHP platform monitors diastolic-systolic amplitude and rhythm in the infarcted myocardium online while effectively inhibiting ventricular remodeling, promoting vascular regeneration, and improving electrophysiological function through electrocoupling therapy. Therefore, this diagnostic and therapeutic integration provides a promising monitorable treatment protocol for cardiac disease.

The study determined the impacts of dietary fermented residues’ (FBR) inclusion on growth, nutrient utilization, carcass characteristics, and meat properties in fattening pigs. Seventy-two robust pigs were randomly assigned to two experimental groups (Duroc × Landrace × Yorkshire, thirty-six pigs each). Each group was subjected to a 52-day trial, during which they received either a corn–soybean meal-based diet or diet enhanced with a 10% addition of FBR. Consequently, adding 10% FBR caused a significant decrease in the digestive utilization of crude dietary components in fattening pigs (p < 0.05) but showed no significant impact on the growth performance. Additionally, FBR inclusion increased the marbling scores (p < 0.05) and total antioxidant functions (p < 0.05) of muscle tissues, indicating improved meat quality. Gender affected backfat depth, with barrows showing thicker backfat depth. In conclusion, dietary supplementation with 10% FBR in finishing pigs influenced the meat quality by improving the marbling score and antioxidant performance while reducing digestibility without compromising growth performance.

Abstract Background The N6‐methyladenosine (m6A) dynamics in the progression of intervertebral disc (IVD) aging remain largely unknown. This study aimed to explore the distribution and pattern of m6A modification in nucleus pulpous (NP) tissues of rats at different ages. Methods Histological staining and MRI were performed to evaluate the degeneration of IVD. The expression of m6A modifiers was analyzed using qRT‐PCR and western blot. Subsequently, methylated RNA immunoprecipitation next generation sequencing and RNA‐seq were conducted to identify differences in m6A methylome and transcriptome of NP tissues. Results Compared to 2‐month‐old rats, we found significant changes in the global m6A level and the expression of Mettl3 and FTO in NP tissues from 20‐month‐old rats. During the progression of NP aging, there were 1126 persistently differentially m6A peaks within 931 genes, and 51 persistently differentially expressed genes. GO and KEGG analyses showed that these m6A peaks and m6A modified genes were mainly engaged in the biological processes and pathways of intervertebral disc degermation (IDD), such as extracellular matrix metabolism, angiogenesis, inflammatory response, mTOR and AMPK signaling pathways. Meanwhile, conjoint analyses and Venn diagram revealed a total of 405 aging related genes contained significant methylation and expression levels in 20‐month‐old rats in contrast to 2‐month‐old and 10‐month‐old rats. Moreover, it was found that four aging related genes with hypermethylated modification including BUB1, CA12, Adamts1, and Adamts4 depicted differentially expressed at protein level, of which BUB1 and CA12 were decreased, while Adamts1 and Adamts4 were increased during the progression of NP aging. Conclusion Collectively, this study elucidated the distribution and pattern of m6A modification during the aging of IVD. Furthermore, the m6A modified genes were involved in the IDD related biological processes and pathways. These findings may provide novel insights into the mechanisms and therapies of IDD from the perspective of aging.

ObjectiveTo explore the effect of varying numbers of embryo washings prior to blastocyst formation in non-invasive preimplantation chromosome screening (NICS) on the accuracy of NICS results.MethodsIn this study, 68 blastocysts from preimplantation genetic testing (PGT)-assisted pregnancy were collected at our institution. On the fourth day of embryo culture, the embryos were transferred to a new medium for blastocyst culture and were washed either three times (NICS1 group) or ten times (NICS2 group). A trophectoderm (TE) biopsy was performed on the blastocysts, and the corresponding embryo culture media were collected for whole genome amplification (WGA) and high-throughput sequencing.ResultsThe success rate of WGA was 100% (TE biopsy), 76.7% (NICS1 group), and 89.5% (NICS2 group). The success rate of WGA in embryo medium on days 5 and 6 of culture was 75.0% (33/44) and 100% (24/24), respectively. Using TE as the gold standard, the karyotype concordance rate between the results of the NICS1 and NICS2 groups’ embryo culture medium samples and TE results was 43.5% (10/23) and 73.5% (25/34), respectively. The sensitivity and specificity of detecting chromosomal abnormalities were higher in the NICS2 group than in the NICS1 group when TE was used (83.3% vs 60.0%; 62.5% vs 30.8%, respectively). The false-positive rate and false-negative rate (i.e., misdiagnosis rate and missed diagnosis rate, respectively) were lower in the NICS2 group than in the NICS1 group (37.5% vs 69.2%; 16.7% vs 40.0%, respectively).ConclusionThe NICS yielded favorable results after ten washings of the embryos. These findings provide a novel method for lowering the amount of cell-free DNA contamination from non-embryonic sources in the medium used for embryo development, optimizing the sampling procedure and improving the accuracy of the NICS test.

Academic procrastination is a common concern among adolescents, but the correlation between shyness and academic procrastination and the internal mechanisms have not yet been thoroughly investigated. Based on a questionnaire survey with 1,279 Chinese middle school students, this study examined the effect of shyness on academic procrastination and its underlying mechanism of self-regulation and self-focused attention. Results revealed that: (1) shyness significantly predicted academic procrastination. (2) Self-regulation mediated the relationship between shyness and academic procrastination. (3) Self-focused attention played a moderating role in the first half of this mediation process. Specifically, higher level of self-focused attention strengthened the predictive effect of shyness on self-regulation. These results underscored the latent risks and protective factors associated with shyness, self-regulation, and self-focused attention in adolescent academic procrastination. In future research and interventions, attention may be directed towards improving individual internal factors to assist adolescents in effectively addressing issues related to academic procrastination.

The Polycomb Repressive Complex 2 (PRC2) methylates H3K27 to regulate development and cell fate by transcriptional silencing. Alteration of PRC2 is associated with various cancers. Here, we show that mouse Kdm1a deletion causes a dramatic reduction of PRC2 proteins, whereas mouse null mutation of L3mbtl3 or Dcaf5 results in PRC2 accumulation and increased H3K27 trimethylation. The catalytic subunit of PRC2, EZH2, is methylated at lysine 20 (K20), promoting EZH2 proteolysis by L3MBTL3 and the CLR4DCAF5 ubiquitin ligase. KDM1A (LSD1) demethylates the methylated K20 to stabilize EZH2. K20 methylation is inhibited by AKT-mediated phosphorylation of serine 21 in EZH2. Mouse Ezh2K20R/K20R mutants develop hepatosplenomegaly associated with high GFI1B expression, and Ezh2K20R/K20R mutant bone marrows expand hematopoietic stem cells and downstream hematopoietic populations. Our studies reveal that EZH2 is regulated by methylation-dependent proteolysis, which is negatively controlled by AKT-mediated S21 phosphorylation to establish a methylation-phosphorylation switch to regulate the PRC2 activity and hematopoiesis.

IntroductionThe study aimed to evaluate the effect of mydriasis on macular and peripapillary metrics with swept-source optical coherence tomography angiography (SS-OCTA) in healthy subjects.MethodsThirty-five healthy subjects were included. The macular region was scanned by the 3×3mm mode and 6×6mm mode, and the peripapillary region was scanned by the 4.5×4.5mm mode on both eyes with SS-OCTA before and after mydriasis. Macular and peripapillary metrics, including retinal vessel density (VD) and fundus thickness were measured by the built-in program. Data of the right eye were analyzed.ResultsThe signal strength of the scans was comparable before and after mydriasis (all P>0.05). There were no significant differences in foveal avascular zone (FAZ) parameters and retinal VD of most sectors in both macular and peripapillary areas (all P>0.05). Choroidal thickness was decreased, outer and whole retinal thickness was increased in most of the macular sectors after mydriasis (all P

[This corrects the article DOI: 10.1371/journal.pone.0255795.].

Abstract Objective: To determine whether the Chinese heart-healthy diet (Sichuan cuisine version) (CHH diet-SC) was more expensive than the conventional Sichuan diet and explore the food groups and nutrients that mainly affected the cost of CHH diet-SC. Design: Cost analysis of 4-week intervention diets in the Sichuan center representing southwestern China in the CHH diet study. Setting: A multicentre, parallel-group, single-blind, randomised feeding trial evaluating the efficacy of lowering blood pressure with the cuisine-based CHH diet. Participants: Totally, fifty-three participants with hypertension aged 25–75 years in the Sichuan center were randomised into the control group (n 26) or the CHH diet-SC group (n 27). Results: The CHH diet-SC was more expensive than the control diet (¥27·87 ± 2·41 v. ¥25·18 ± 2·79 equals $3·90 ± 0·34 v. $3·52 ± 0·39, P < 0·001), and the incremental cost-effectiveness ratio for a 1-mm Hg systolic blood pressure reduction was ¥9·12 ($1·28). Intakes and the cost of seafood, dairy products, fruits, soybeans and nuts, whole grains and mixed beans were higher for the CHH diet-SC than for the control diet (P < 0·001). Intakes of vitamin B1, vitamin B6, vitamin C, Mg and phosphorus were positively correlated with the cost (P < 0·05). Conclusions: The CHH diet-SC costs more than the conventional Sichuan diet, partly due to the high cost of specific food groups. Positive correlations between the intakes of vitamin B1, vitamin B6, vitamin C, Mg, phosphorus and the dietary cost could be a direction to adjust the composition within the food groups to reduce the cost of the CHH diet-SC.

ObjectiveThis study aims to investigate the relationship between exposure to air pollution and adverse meteorological factors, and the risk of osteoporosis.MethodsWe diagnosed osteoporosis by assessing bone mineral density through Dual-Energy X-ray absorptiometry in 2,361 participants from Jiangsu, China. Additionally, we conducted physical examinations, blood tests, and questionnaires. We evaluated pollution exposure levels using grid data, considering various lag periods (ranging from one to five years) based on participants’ addresses. We utilized logistic regression analysis, adjusted for temperature, humidity, and individual factors, to examine the connections between osteoporosis and seven air pollutants: PM₁, PM₂.₅, PM₁₀, SO₂, NO₂, CO, and O₃. We assessed the robustness of our study through two-pollutant models and distributed lag non-linear models (DLNM) and explored susceptibility using stratified analyses.ResultsIn Jiangsu, China, the prevalence of osteoporosis among individuals aged 40 and above was found to be 15.1%. A consistent association was observed between osteoporosis and the five-year average exposure to most pollutants, including PM₂.₅, PM₁₀, CO, and O₃. The effects of PM₁₀ and CO remained stable even after adjusting for the presence of a second pollutant. However, the levels of PM₁ and PM₂.₅ were significantly influenced by O₃ levels. Individuals aged 60 and above, those with a BMI of 25 or higher, and males were found to be more susceptible to the effects of air pollution. Interestingly, males showed a significantly higher susceptibility to PM₁ and PM₂.₅ compared to females. This study provides valuable insights into the long-term effects of air pollution on osteoporosis risk among the adult population in China.ConclusionThis study indicates a potential association between air pollutants and osteoporosis, particularly with long-term exposure. The risk of osteoporosis induced by air pollution is found to be higher in individuals aged 60 and above, those with a BMI greater than 25, and males. These findings underscore the need for further research and public health interventions to mitigate the impact of air pollution on bone health.

Osteoarthritis (OA) is a highly prevalent age-related musculoskeletal disorder that typically results in chronic pain and disability. OA is a multifactorial disease, with increased oxidative stress, dysregulated inflammatory response, and impaired matrix metabolism contributing to its onset and progression. The neurohormone melatonin, primarily synthesized by the pineal gland, has emerged as a promising therapeutic agent for OA due to its potential to alleviate inflammation, oxidative stress, and chondrocyte death with minimal adverse effects. The present review provides a comprehensive summary of the current understanding regarding melatonin as a promising pharmaceutical agent for the treatment of OA, along with an exploration of various delivery systems that can be utilized for melatonin administration. These findings may provide novel therapeutic strategies and targets for inhibiting the advancement of OA.

Osteosarcoma (OS) is a malignant tumor originating from mesenchymal tissue. Pulmonary metastasis is usually present upon initial diagnosis, and metastasis is the primary factor affecting the poor prognosis of patients with OS. Current research shows that the ability to regulate the cellular microenvironment is essential for preventing the distant metastasis of OS, and anoxic microenvironments are important features of solid tumors. During hypoxia, hypoxia-inducible factor-1α (HIF-1α) expression levels and stability increase. Increased HIF-1α promotes tumor vascular remodeling, epithelial-mesenchymal transformation (EMT), and OS cells invasiveness; this leads to distant metastasis of OS cells. HIF-1α plays an essential role in the mechanisms of OS metastasis. In order to develop precise prognostic indicators and potential therapeutic targets for OS treatment, this review examines the molecular mechanisms of HIF-1α in the distant metastasis of OS cells; the signal transduction pathways mediated by HIF-1α are also discussed.

Detecting and localizing standing dead trees (SDTs) is crucial for effective forest management and conservation. Due to challenges posed by mountainous terrain and road conditions, conducting a swift and comprehensive survey of SDTs through traditional manual inventory methods is considerably difficult. In recent years, advancements in deep learning and remote sensing technology have facilitated real-time and efficient detection of dead trees. Nevertheless, challenges persist in identifying individual dead trees in airborne remote sensing images, attributed to factors such as small target size, mutual occlusion and complex backgrounds. These aspects collectively contribute to the increased difficulty of detecting dead trees at a single-tree scale. To address this issue, the paper introduces an improved You Only Look Once version 7 (YOLOv7) model that incorporates the Simple Parameter-Free Attention Module (SimAM), an unparameterized attention mechanism. This improvement aims to enhance the network’s feature extraction capabilities and increase the model’s sensitivity to small target dead trees. To validate the superiority of SimAM_YOLOv7, we compared it with four widely adopted attention mechanisms. Additionally, a method to enhance model robustness is presented, involving the replacement of the Complete Intersection over Union (CIoU) loss in the original YOLOv7 model with the Wise-IoU (WIoU) loss function. Following these, we evaluated detection accuracy using a self-developed dataset of SDTs in forests. The results indicate that the improved YOLOv7 model can effectively identify dead trees in airborne remote sensing images, achieving precision, recall and mAP@0.5 values of 94.31%, 93.13% and 98.03%, respectively. These values are 3.67%, 2.28% and 1.56% higher than those of the original YOLOv7 model. This improvement model provides a convenient solution for forest management.

BackgroundWhile China's primary health care (PHC) system covers all citizens, the use of medical services supplied by primary health institutions (PHIs) is not at ideal levels. This study explored the impact of socioeconomic status (SES) on residents' first choice of medical services provided by PHIs.MethodsThis community-based, cross-sectional study was conducted in Jiangsu Province, China, from October 2021 to March 2022. A custom-designed questionnaire was used to evaluate 4,257 adults, of whom 1,417 chose to visit a doctor when they were sick. Logistic regression was used to test the relationships among SES, other variables and the choice of medical services, and interaction effects were explored.ResultsA total of 1,417 subjects were included in this study (48.7% female; mean age 44.41 ± 17.1 years). The results showed that older age (p < 0.01), rural residence (p < 0.01), a preference for part-time medical experts in PHIs (p < 0.01), and lack of coverage by basic medical insurance (p < 0.05) were associated with the first choice to use PHIs. In the multiple logistic regression model, SES was not associated with the first choice of medical services supplied by PHIs (p > 0.05), but it interacted with three variables from the Commission on Social Determinants of Health Framework (material circumstances, behaviors and biological factors, and psychosocial factors).ConclusionVulnerable individuals who are the target visitors to PHIs are older, live in rural areas, and suffer from chronic diseases. SES, as a single factor, did not impact whether medical services at PHIs were preferred, but it mediated relationships with other factors.

Early fire detection is essential for preventing catastrophic events, and fire detectors play a critical role in ensuring fire safety. Among the various types of fire detectors, photoelectric smoke detectors are widely used because of their ability to detect smoke at an early stage. The present study investigates the effects of changes in flow directions and inlet size on the smoke detection ability of a photoelectric smoke detector by conducting computational fluid dynamics (CFD) simulations. The results indicated that when the flow direction changes, the components in the optical chamber may hinder the smoke inflow and increase the detector activation time. Moreover, the smoke inlet size was found to affect the carbon monoxide concentration inside the chamber. The velocity magnitude distributions confirmed the correlation between the smoke velocity in the labyrinth structures entering the optical chamber and the detection ability of the smoke detector. These findings suggested that when optimizing the performance of a smoke detector, flow direction, inlet size, and amount of smoke introduced into the optical chamber should be considered. The current study suggested the modified design of the smoke detector to have superior detection ability in both directions compared to the base case in terms of activation time.

Abstract In order to reveal the dynamic mechanical properties of resin-molded parts prepared from photosensitive resin composition at different temperatures, four typical service temperatures (26 °C, 50 °C, 70 °C and 90 °C) were selected, and the mechanical properties of photosensitive resin specimens under quasi-static and high strain rate (1200 s−1, 1500 s−1 and 1800 s−1) loading were tested by universal material testing machine and split Hopkinson pressure bar (SHPB) experimental device. The stress–strain data of the material were obtained. Results show that the stress of photosensitive resin specimens decreases with the increase of temperature under quasi-static and high strain rate loading conditions, reflecting a certain temperature softening effect. Two typical stages of strain softening and strain hardening exist in the quasi-static compression process of the specimens at room temperature, while the specimens only exhibit strain hardening at 50 °C, 70 °C and 90 °C. Under dynamic loading, the elastic modulus, peak stress and peak strain of the photosensitive resin increase with the increase of the strain rate, reflecting an obvious effect of strain rate strengthening. The nonlinear thermo-viscoelastic constitutive model can better describe the mechanical behavior of the material under high strain rates and service temperatures, and the experimental values are in good agreement with the fitted values of the model. The results can provide theoretical model and method support for the design and development of resin-based materials and the optimization of their mechanical properties.

The ketogenic diet (KD) and regular exercise (EX) are both capable of orchestrating circadian metabolism homeostasis during losing weight. However, the combined effects of these two factors on circadian metabolism remain poorly understood. To determine if the combined treatment yields a superimposed physiological phenotype, we measured weight loss, white adipose, the respiratory exchange ratio (RER), heat production, and activity parameters in individual and combined treatment groups. Surprisingly, none of these metrics displayed a cumulative effect when administered in the combined treatment approach. Additionally, we investigated the impact of combination therapy on molecular homeostasis through using high-throughput liver transcriptomic approaches. The results revealed that individual and combined treatments can reprogram the circadian rhythm; yet, the combined group exhibited a minimum quantity of cyclic transcript genes. Noteworthy, the amplitude of 24 h circadian expression genes was not significantly increased in the combination treatment, indicating that the combined approach has non-overlapping effects on maintenance peripheral metabolism homeostasis. This may be due to the liver requiring less ketogenic and gluconeogenic potential during metabolic processes. This research suggests that combined treatment may have adverse effects on the body’s homeostasis and provide crucial insights for the homeostatic health of athletes or individuals who wish to lose weight.

In this study, the effects of soil conditioners on the growth and development of melons and the rhizosphere soil environment were explored. The optimal amount of added soil conditioner was screened to solve the practical production problems of high-quality and high-yield thin-skinned melon. The melon variety “Da Shetou” was used as the material. Under the conditions of conventional fertilization and cultivation technology management, different soil conditioners were set up for potted melons. The effects of Pastoral soil (CK), 95% Pastoral soil + 5% volcanic ash soil conditioner (KT1), 85% Pastoral soil + 15% volcanic ash soil conditioner (KT2), 75% Pastoral soil + 25% volcanic ash soil conditioner (KT3), 65% Pastoral soil + 35% volcanic ash soil conditioner (KT4), and 55% Pastoral soil + 45% volcanic ash soil conditioner (KT5) on melon yield, quality, and rhizosphere soil characteristics were investigated. The soil microbial community was analyzed using Illumina MiSeq technology. Compared to CK, KT1, KT3, KT4, and KT5, the KT2 treatment could improve the single fruit yield of melon, increasing it by 4.35%, 2.48%, 2.31%, 5.92%, and 2.92%. Meanwhile, the highest contents of soluble protein, soluble solid, and soluble sugar in the KT2 treatment were 1.89 mg·100 g−1, 16.35%, and 46.44 mg·g−1, which were significantly higher than those in the control treatment. The contents of organic matter, total nitrogen, alkali-soluble nitrogen, nitrate nitrogen, ammonium nitrogen, available potassium, and available phosphorus in melon rhizosphere soil were the highest in the KT2 treatment. Through Alpha diversity analysis, it was found that the Chao1 index, Shannon index, and ACE index were significantly higher in the KT1 treatment than in the control, while, among all groups, the Simpson index and coverage were not significantly different. The dominant bacteria in the six treated samples were mainly Actinobacteriota, Proteobacteria, Cyanobacteria, Chloroflexi, Acidobacteria, Bacteroidetes, Myxomycota, Firmicutes, Gemmatimonadota, Verrucomicrobia, and Planctomycetes, which accounted for 96.59~97.63% of the relative abundance of all bacterial groups. Through redundancy analysis (RDA), it was found that the organic matter, electrical conductivity, available phosphorus, and nitrate nitrogen of melon rhizosphere soil were the dominant factors of bacterial community change at the dominant genus level. In summary, 15% ash soil conditioner applied on melon was the selected treatment to provide a theoretical reference for the application of soil conditioner in facility cultivation.

Poly(9,9-di-n-octylfluorene) (PFO) is a promising material for polymer light-emitting diodes (PLEDs) due to its advantageous properties. To enhance its electron transporting capabilities, diblock polymers were synthesized by attaching polystyrene (PSt) chains of varying lengths to one end of the PFO molecule. In a comparative study with PFO homopolymer, the diblock polymers maintained similar thermal properties, absorption spectra, and photoluminescent stability, while exhibiting slightly deeper lowest unoccupied molecular orbital (LUMO) levels and higher crystallinity. Notably, diblock polymers with shorter polystyrene blocks demonstrated higher electron mobility than the PFO homopolymer and diblock polymers with excessively long polystyrene blocks. These findings suggest that the optimal chain length of the polystyrene block is crucial for maximizing electron mobility, thus offering valuable insights for designing high-performance PLED materials.

Welding stands as a critical focus for the intelligent and digital transformation of the machinery industry, with automated laser welding playing a pivotal role in the sector’s technological advancement. The management of welding deformation in such operations is fundamental, relying on advanced analysis and prediction methods. The endeavor to accurately analyze welding deformation in practical applications is compounded by the interplay of numerous variables, a pronounced coupling effect among these factors, and a reliance on expert intuition. Thus, effective deformation control in automated laser welding operations necessitates the gathering of pre-test laser welding data to develop a predictive approach that accurately reflects real-world conditions and is characterized by improved reliability and stability. To address the technological evolution in automated laser welding, a predictive model based on neural network technology is proposed to map the intricate relationship between process variables and the resulting deformation. At the heart of this approach is the formulation of a predictive model utilizing a back-propagation neural network (BP), with an emphasis on four essential welding parameters: speed, peak power, duty cycle, and defocusing amount. The model’s predictive accuracy is then honed through the application of the whale optimization algorithm (WOA) and the differential evolutionary (DE) algorithm. Finally, extensive testing in an automated laser welding experimental setup is conducted to validate the accuracy and reliability of the proposed prediction model. It is demonstrated through these experiments that the deformation prediction model, enhanced by the DEWOA-BP neural network, accurately forecasts the relationship between laser welding parameters and the induced deformation, maintaining a prediction error margin of ±0.1mm. The model is employed to fulfill the requirements for a pre-welding quality evaluation, thereby facilitating a more calculated and informed approach to welding operations. This method of intelligent prediction is not only crucial for the intelligent transformation of laser welding but also holds significant implications for traditional machining technologies such as milling, grinding, and spraying. It offers innovative ideas and methods that are pivotal for the industrial revolution and technological advancement of the traditional machining industry.

Undesirable meteorological conditions are typical aviation flight safety threats. Although most meteorological radar and flight augmentation computers have avionic system wind shear alarms, the preferred approach is that pilots avoid unsafe wind shear events. Therefore, effective pilot competency evaluations are needed to assess pilots’ abilities to deal with these events. This study developed a wind shear operation competency model that includes observable behavior indicators, sub-task decomposition, and competency check items. An adapted competency model and a quantitative data-driven competency evaluation criteria optimization method were then developed using three-dimensional competency feature modeling, after which wind shear simulation flight training data were used to verify the effectiveness of the proposed method. The competency assessment grades were significantly correlated with the results from experienced examiners with a 93.33% evaluation accuracy. The proposed quantitative data-driven competency assessment method can provide effective pilot competency assessments for a range of aviation meteorological threats.

The effects of dried tea residues on the nutritional parameters and fermentation quality, microbial community, and in vitro digestibility of alfalfa silage were investigated. In this study, dried tea residues generated from five different processing techniques (green tea, G; black tea, B; white tea, W; Pu’er raw tea, Z; Pu’er ripe tea, D) were added at two addition levels (5% and 10% fresh weight (FW)) to alfalfa and fermented for 90 days. The results showed that the tea residues increased the crude protein (CP) content (Z10: 23.85%), true protein nitrogen (TPN) content, DPPH, and ABST radical scavenging capacity, total antioxidant capacity (T-AOC), and in vitro dry matter digestibility (IVDMD) of the alfalfa silage. Moreover, the pH, ammonia-N (NH3-N) content, and acetic acid (AA) content decreased (p < 0.05). The effects of tea residues were promoted on these indicators with increasing tea residue addition. In addition, this study revealed that the influence of dried tea residues on the nutritional quality of alfalfa silage was greater than that on fermentation quality. Based on the nutrient composition, the addition of B or G to alfalfa silage can improve its silage quality, and these tea byproducts have the potential to be used as silage additives.

Anaerobic ammonium oxidation (ANAMMOX) has emerged as a promising sustainable nitrogen removal technology that offers significant advantages over conventional nitrification–denitrification processes, such as reduced energy consumption, a 60% reduction in oxygen demand, and a 90% reduction in sludge production. However, the practical application of ANAMMOX is hindered by several challenges, including the slow growth of ANAMMOX bacteria, long start-up periods, and high sensitivity to environmental disturbances. Recent studies have highlighted the crucial role of extracellular polymeric substances (EPSs) in the formation, activity, and stability of ANAMMOX biofilms and granules. An EPS is a complex mixture of high-molecular-weight polymers secreted by microorganisms, mainly composed of polysaccharides, proteins, nucleic acids, and lipids. The diverse physicochemical properties and functional groups of EPSs enable them to serve as a structural scaffold, protective barrier, sorption site, electron shuttle, and nutrient source for ANAMMOX bacteria. This review aims to provide an overview of the latest research progress on harnessing the potential of EPSs to enhance the ANAMMOX process. The characteristics, compositions, and extraction methods of ANAMMOX-derived EPSs are summarized. The mechanisms of how EPSs facilitate the enrichment, immobilization, aggregation, and adaptation of ANAMMOX bacteria are elucidated. The strategies and effects of EPS supplementation on improving the performance and robustness of ANAMMOX reactors under various stresses are critically reviewed. The challenges and future perspectives of the EPS-mediated optimization of the ANAMMOX process are also discussed. This review sheds new light on exploiting EPSs as a renewable bioresource to develop more efficient and stable ANAMMOX applications for sustainable wastewater treatment.

Abstract Purpose Our study was to investigate the correlation correlation between FDG uptake and PD-L1 expression of liver metastasis in patients with colon cancer, and to determine the value of FDG-PET in predicting PD-L1 expression in liver metastasis of colon cancer. Methods A total of 72 patients with confirmed liver metastasis of colon cancer were included in this retrospective study. The PD-L1 expression and immune cell infiltrating of tumors were determined through immunohistochemistry staining. The SUVmax of liver metastasis lesions were assessed using 18 F-FDG PET/CT. The correlation between PD-L1 expression and the clinicopathological were evaluated by the Cox proportional hazards model and the Kaplan-Meier survival analysis. Results PD-L1 expression was significantly correlated with FDG uptake (SUVmax), tumor size, differentiation, survival and cytotoxic T cells infiltration in liver metastasis of colon cancer (P

Abstract Hepatoma-derived growth factor (HDGF) expression is associated with poor prognosis in non-small cell lung cancer (NSCLC); however, whether HDGF affects gefitinib resistance in NSCLC remains unknown. This study aimed to explore the role of HDGF in gefitinib resistance in NSCLC and to discover the underlying mechanisms. Stable HDGF knockout or overexpression cell lines were generated to perform experiments in vitro and in vivo. HDGF concentrations were determined using an ELISA kit. HDGF overexpression exacerbated the malignant phenotype of NSCLC cells, while HDGF knockdown exerted the opposite effects. Furthermore, PC-9 cells, which were initially gefitinib-sensitive, became resistant to gefitinib treatment after HDGF overexpression, whereas HDGF knockdown enhanced gefitinib sensitivity in H1975 cells, which were initially gefitinib-resistant. Higher levels of HDGF in plasma or tumor tissue also indicated gefitinib resistance. The effects of HDGF on promoting the gefitinib resistance were largely attenuated by MK2206 (Akt inhibitor) or U0126 (ERK inhibitor). Mechanistically, gefitinib treatment provoked HDGF expression and activated the Akt and ERK pathways, which were independent of EGFR phosphorylation. In summary, HDGF contributes to gefitinib resistance by activating the Akt and ERK signaling pathways. The higher HDGF levels may predict poor efficacy for TKI treatment, thus it has the potential to serve as a new target for overcoming tyrosine kinase inhibitor resistance in combating NSCLC.

Abstract Energy drinks, often advertised as dietary supplements that enhance physical and mental performance, have gained increasing popularity among adolescents and athletes. Several studies on individual ingredients such as caffeine or taurine have reported either adverse or favorable influences on myogenic differentiation, a key process in muscle regeneration to repair microtears after an intense workout session. However, the impact of different energy drinks with various formulas on muscle differentiation has never been reported. This study aims to examine the in vitro effects of various energy drink brands on myogenic differentiation. Murine C2C12 myoblast cells were induced to differentiate into myotubes in the presence of one of eight energy drinks at varying dilutions. A dose-dependent inhibition of myotube formation was observed for all energy drinks, supported by reduced percentage of MHC-positive nuclei and fusion index. Moreover, expression of myogenic regulatory factor MyoG and differentiation marker MCK were also decreased. Furthermore, given the variation in formulas of different energy drinks, there were remarkable differences in the differentiation and fusion of myotubes between energy drinks. This is the first study to investigate the impact of various energy drinks on myogenic differentiation and our results suggest an inhibitory effect of energy drinks in muscle regeneration.

Few studies have examined the mechanisms linking motivated behavior and reward–punishment stimuli in shy individuals. This study was designed to probe these mechanisms by examining shy and non-shy college student responses to both monetary rewards and penalties in the Iowa Gambling Task (IGT). Specifically, out of the 280 undergraduates surveyed in East China, 45 participants (18 boys) identified as shy and 45 (19 boys) identified as non-shy based on their shyness questionnaire scores were selected to participate in the IGT. Results revealed that shy participants selected favorable low-risk seeking decks (deck C) more frequently and adverse high-risk seeking decks (deck B) less frequently and were more inclined to change deck selection after incurring a net loss. Furthermore, the net score of shy students was higher than that of nonshy students. Results demonstrated that shy people were the winners of IGT games, indicating that they are more likely to exhibit risk-averse behaviors when making decisions. The results are discussed from the perspective of the decision-making style and practical implications of shy individuals.

ObjectiveNocardia is clinically rare but highly pathogenic in clinical practice. Due to the lack of Nocardia screening methods, Nocardia is often missed in diagnosis, leading to worsening the condition. Therefore, this paper proposes a Nocardia screening method based on neural networks, aiming at quick Nocardia detection in sputum specimens with low costs and thereby reducing the missed diagnosis rate.MethodsFirstly, sputum specimens were collected from patients who were infected with Nocardia, and a part of the specimens were mixed with new sputum specimens from patients without Nocardia infection to enhance the data diversity. Secondly, the specimens were converted into smears with Gram staining. Images were captured under a microscope and subsequently annotated by experts, creating two datasets. Thirdly, each dataset was divided into three subsets: the training set, the validation set and the test set. The training and validation sets were used for training networks, while the test set was used for evaluating the effeteness of the trained networks. Finally, a neural network model was trained on this dataset, with an image of Gram-stained sputum smear as input, this model determines the presence and locations of Nocardia instances within the image.ResultsAfter training, the detection network was evaluated on two datasets, resulting in classification accuracies of 97.3% and 98.3%, respectively. This network can identify Nocardia instances in about 24 milliseconds per image on a personal computer. The detection metrics of mAP50 on both datasets were 0.780 and 0.841, respectively.ConclusionThe Nocardia screening method can accurately and efficiently determine whether Nocardia exists in the images of Gram-stained sputum smears. Additionally, it can precisely locate the Nocardia instances, assisting doctors in confirming the presence of Nocardia.

Pest and disease damage to forests cannot be underestimated, so it is essential to detect diseased trees in time and take measures to stop their spread. The detection of discoloration standing trees is one of the important means to effectively control the spread of pests and diseases. In the visible wavelength range, early infected trees do not show significant color changes, which poses a challenge for early detection and is only suitable for monitoring middle and late discolor trees. The spectral resolution of hyperspectral restricts the improvement of its spatial resolution, and there are phenomena of different spectral of the same and foreign objects in the same spectrum, which affect the detection results. In this paper, the method of hyperspectral and CCD image fusion is used to achieve high-precision detection of discoloration standing trees. This paper proposes an improved algorithm MSGF-GLP, which uses multi-scale detail boosting and MTF filter to refine high-resolution data. By combining guided filtering with hyperspectral images, the spatial detail difference is enhanced, and the injection gain is interpolated into the difference of each band, so as to obtain high-resolution and high-quality hyperspectral images. This research is based on hyperspectral and CCD data obtained from LiCHy, Chinese Academy of Forestry, Maoershan Experimental Forest Farm, Shangzhi City, Heilongjiang Province. The evaluation framework is used to compare with the other five fusion algorithms to verify the good effect of the proposed method, which can effectively preserve the canopy spectrum and improve the spatial details. The fusion results of forestry remote sensing data were analyzed using the vegetation Normalized Difference Water Index and Plant Senescence Reflectance Index. The fused results can be used to distinguish the difference between discoloration trees and healthy trees by the multispectral vegetation index. The research results can provide good technical support for the practical application of forest remote sensing data fusion, and lay the foundation for promoting the scientific, automatic and intelligent forestry control.

Abstract Background This study explored the specialty preferences of China-educated international medical students (IMSs), who are mainly from low- and middle-income countries (LMICs) and constitute a potential medical workforce both for their home countries and foreign countries, and the influence of migration intentions on their specialty preferences. Methods A cross-sectional, questionnaire-based survey was conducted at 5 universities in China. The questionnaire link was distributed electronically among the IMSs at the 5 universities via emails. The questionnaire enquired IMSs’ demographic information, migration intentions and their specialty preferences. The Chi-square test was applied to determine the influence of the respondent’s gender, intention to practise in the home country and intention to practise in a high-income country on their specialty choices. The Chi-square test was also applied to determine the influence of the respondent’s gender, year of study and country of origin on their preferences for generalist-orientated or non-generalist orientated specialties. Results Altogether, 452 IMSs returned their responses, yielding a response rate of 64.1%. Approximately half of the IMSs planned to not return to their home country. The most selected specialty was general surgery and the least selected specialty was physical medicine and rehabilitation. No significant differences were evident in most specialty preferences between those who intended to return home and those who intended to stay abroad. Among the IMSs having intentions of returning to their home country, male students tended to choose a generalist-orientated specialty, while female students tended to choose a non-generalist-orientated specialty. Conclusion China-educated IMSs could play important roles in the primary care services as well as other shortage specialties both for their home countries or foreign countries. Therefore, it is recommended that governments in these countries plan migration and recruitment policies that cater for these studying-abroad medical students from LMICs, especially in this challenging time during the COVID-19 pandemic.

Abstract Background STIL centriolar assembly protein (STIL) is a cytoplasmic protein implicated in cellular growth and proliferation as well as chromosomal stability, which abnormal condition affected tumor immunity and tumor progression. However, the role of STIL in the biological mechanism of hepatocellular carcinoma (HCC) remains unclear. Methods Comprehensive bioinformatic approaches, in vitro functional assays, and validation were conducted to elucidate the oncogenic value of STIL in HCC. Results In the present study, we found that STIL may serve as an independent prognostic indicator and a potential oncogene in HCC. Gene set enrichment analysis (GSEA), and Gene set variation analysis (GSVA) showed that upregulated expression of STIL was positively associated with pathways enriched in the cell cycle and DNA damage response. Subsequently, we identified several non-coding RNAs (ncRNAs) accounting for the upregulation of STIL expression using a combination of in silico bioinformatics approaches (including expression analysis, correlation analysis, and survival analysis). Finally, CCNT2-AS1/SNHG1-has-miR-204-5p-STIL axis was screened out as the most potential upstream ncRNA-related pathway of STIL in HCC. Moreover, STIL expression is highly associated with the infiltration of immune cells, the expression of immune checkpoints, as well as the survival benefit of immunotherapy/chemotherapy. Conclusions Our study discloses that ncRNAs-mediated overexpression of STIL independently predicted poor prognosis and correlated with the efficacy of PD-1-targeted immunotherapy in HCC.

Abstract Background In recent years, stroke has become the second leading cause of death worldwide, and the incidence and mortality of ischemic stroke have increased significantly. This study mainly aimed to explore the experiences and needs of older adults at different stages of cerebral infarction based on the chronic illness trajectory theory. Methods Data were collected from 22 older adults experiencing the onset, acute, and stable stages of stroke through semi‐structured interviews and were analyzed using Colaizzi's descriptive phenomenological approach. Results Multiple themes and subthemes emerged on the experiences and needs of older adults at different stages of cerebral infarction based on the three dimensions of the long‐term disease trajectory theory: illness‐related work, biographical work, and everyday life work. Seven themes were extracted for illness‐related work, six for biographical work, and eight for everyday life work. Discussions The treatment, nursing, and rehabilitation of cerebral infarction are complex. This study indicated that patients after cerebral infarction have different experiences and needs for illness‐related work. They also have distinctive and dynamically changing demands for biographical work and everyday life work. Conclusions The experiences and needs of older patients with cerebral infarction changed dynamically at different stages of the disease. Healthcare professionals should develop effective interventions targeting these needs at various disease stages, provide patients with continuous support to shape their disease trajectories, and maintain patients' stability.

Abstract Background In a rapidly changing healthcare environment, Self-directed learning (SDL) ability is recognized as a crucial condition for nursing students and nurse to deal with severe challenges positively. Developing SDL ability is becoming more and more important among nursing students. SDL is related to nursing students enhancing their own knowledge, skills and maintaining lifelong learning. This study is aim at translating the Self-directed Learning Instrument (SDLI) into Chinese and verify its reliability and validity among nursing students. Methods The study adopted a cross-sectional design and the multistage sampling design. The SDLI was translated into Chinese, and the reliability and validity of the scale were tested among 975 nursing students. Results The Cronbach’s α value of the Chinese version of SDLI was 0.916. The split-half reliability coefficient was 0.829, and the retest coefficient was 0.884. The content validity index of the scale was 0.95. Furthermore, the four-factors model was obtained by using exploratory factor analysis, explaining 55.418% variance, and the communalities of the items ranged from 0.401 to 0.664. With modified confirmatory factor analysis, the fit indices were chi-square/degree of freedom (CMIN/DF) = 2.285, the comparative fit index (CFI) = 0.947, and the tucker lewis index (TLI) was 0.938. And, the model fitting indexes were all in the acceptable range and confirmatory factor analysis indicated that the model fit the SDLI well. Conclusion The Chinese version of SDLI has good validity and reliability among nursing students. It can be used to measure the SDL ability of nursing students in China.

Abstract Background During myocardial damage, the sex hormone estrogen and CD73, the main enzyme that converts AMP into adenosine, are cardioprotective molecules. However, it is unclear how these two molecules work together to provide cardioprotection. The current study aimed to elucidate the interaction between estrogen and CD73 under chronic stress. Methods Ovariectomy and SHAM operations were done on FVB wild-type (WT) female mice. Two weeks after the operation, the mice were treated with daily isoproterenol (10 mg/kg/day) injections for 14 days. The effect of E2 on relevant cardiac injury biomarkers (BNP, ANP), myocardial morphology (cardiomyocyte surface area), electrocardiography, CD73 protein expression and activity, and macrophage (CD86 + and CD206 +) infiltrations were assessed. In vitro, H9C2 cells were treated with 1 nM of estrogen and 10 mM APCP (CD73 inhibitor α, β-methylene adenosine-5'-diphosphate), 10 µM isoproterenol and 20 µm LY294002 (PI3K inhibitor) for 24 h and western blot was done to elucidate the mechanism behind the effect of estrogen on the CD73/adenosine axis. Results Estrogen deficiency during chronic catecholamine stress caused myocardial injury, thereby triggering the hyperactivity of the CD73/adenosine axis, which aggravated myocarditis, adverse remodeling, and arrhythmias. However, estrogen normalizes CD73/Adenosine axis via the upregulation of PI3K/Akt pathways to prevent adverse outcomes during stress. In vivo results showed that the inhibition of PI3K significantly decreased PI3K/Akt pathways while upregulating the CD73/adenosine axis and apoptosis. Conclusion Estrogen’s pleiotropy cardioprotection mechanism during stress includes its normalization of the CD73/Adenosine axis via the PI3K/Akt pathway. Video Abstract

Lysine methylation is a major post-translational protein modification that occurs in both histones and non-histone proteins. Emerging studies show that the methylated lysine residues in non-histone proteins provide a proteolytic signal for ubiquitin-dependent proteolysis. The SET7 (SETD7) methyltransferase specifically transfers a methyl group from S-Adenosyl methionine to a specific lysine residue located in a methylation degron motif of a protein substrate to mark the methylated protein for ubiquitin-dependent proteolysis. LSD1 (Kdm1a) serves as a demethylase to dynamically remove the methyl group from the modified protein. The methylated lysine residue is specifically recognized by L3MBTL3, a methyl-lysine reader that contains the malignant brain tumor domain, to target the methylated proteins for proteolysis by the CRL4DCAF5 ubiquitin ligase complex. The methylated lysine residues are also recognized by PHF20L1 to protect the methylated proteins from proteolysis. The lysine methylation-mediated proteolysis regulates embryonic development, maintains pluripotency and self-renewal of embryonic stem cells and other stem cells such as neural stem cells and hematopoietic stem cells, and controls other biological processes. Dysregulation of the lysine methylation-dependent proteolysis is associated with various diseases, including cancers. Characterization of lysine methylation should reveal novel insights into how development and related diseases are regulated.