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Background Fibrinogen (FIB) is often elevated in children with Henoch Schonlein purpuric nephritis (HSPN), but the correlation between FIB and renal lesions has been less studied. Objective To explore the correlation between FIB in children with HSPN and the International Study Group on Pediatric Kidney Disease (ISKDC) pathology grading and micropathological changes in parts of renal units, and to clarify whether FIB can assess the severity of renal injury in children with HSPN. Methods In total, 922 children with HSPN who were hospitalized in the First Affiliated Hospital of Henan University of Chinese Medicine in the pediatric nephrology ward and underwent kidney biopsy at the same time from December 2017 to December 2022 were collected, and the clinical information, FIB and renal pathological information during renal biopsy were summarized, and based on the FIB level, the children were categorized into group A (low) 4.98 g/L. The correlation between FIB and ISKDC pathological grades, glomerular mesangial hyperplasia ratio, the crescentic bodies ratio and the nature of the glomerular lesions from acute to chronic was investigated by Spearman rank correlation analysis, and the prediction of FIB on the micropathological changes of renal units was analyzed by the subject's work characteristic (ROC) curve. Results Among 922 children with HSPN who had undergone renal biopsy, the FIB was (3.48±1.01) g/L. 113 cases in group A had a low FIB rate of 12.26%; 734 cases in group B had a standardized FIB rate of 79.61%; and 75 cases in group C had a high FIB rate of 8.13%. The ISKDC pathology classification was type Ⅱa in 173 cases (18.76%), type Ⅱb in 29 cases (3.15%), 466 cases (50.54%) of type Ⅲa, 232 cases (25.16%) of type Ⅲb, and 22 cases (2.39%) of type Ⅳ and above (including 2 cases of type Ⅳa, 18 cases of type Ⅳb, and 2 cases of type Ⅴ). The results of the Spearman's rank correlation analysis showed that the FIB and the grouping of the FIB of the children with HSPN were positively related to the renal pathology ISKDC grading (rs=0.146, P

In the context of rural revitalization and carbon peaking and carbon neutrality goals， a model of township micro-energy network is established. Firstly， the mathematical models of garbage power generation and biogas production from anaerobic digestion of sludge are built in view of the characteristics of energy in rural areas. An electric vehicle load prediction model is established considering the development of rural transportation industry and tourism. Secondly， the carbon emissions from farming， breeding， and purchased energy are modeled， and the carbon reduction from domestic waste treatment， biogas export， and electric vehicle are also considered to illustrate the carbon emission characteristics from production and living in rural areas. Finally， with the lowest energy cost and lowest carbon emission of the township micro-energy network as the objective functions， the multi-objective optimization problem is solved using the normal boundary intersection （NBI） and the TOPSIS. The optimal energy consumption decision of the township under the premise of economy and low carbon is obtained through specific cases. The role of energy equipment with rural characteristics is analyzed to provide a theoretical basis for promoting the construction of zero-carbon villages.

During the Cultural Revolution, millions of youths, workers, intellectuals, and cadres were separated from their families and mobilized to work in distant places according to the needs of the state. For these families, the transition to the post-Mao era was experienced not as an epochal change but as a family reunion often delayed by specific institutional constraints. The constant friction between families' strategies to reunite and the bureaucratic logic specific to local contexts led to a sense of victimhood and a turn to domestic life and hope in children as the new sacred in life. By examining the processes of family reunion told in three sets of family letters, this article explores "transitional frictions," defined as the conflicts and tensions arising from different speeds of institutional change during a rapid transition, as a ubiquitous phenomenon in the post-Mao transition. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to externally validate a predictive score for fracture-related infections, establishing generalizability for absolute and relative risk of infection in the setting of orthopedic fracture surgery. Materials and Methods: This was a retrospective, case-control study performed at a level I academic trauma center that included 147 patients with fracture-related infection in the study group and 300 control patients. We analyzed the same 8 independent predictors of fracture-related infection cited by a previous study. We then used the area under the receiver operating characteristics curve (AUC) to compare the derivation and validation cohorts. The validation and derivation cohorts were then compared by grouping patients into 4 strata of Wise score groups. This allowed for comparison of AUC and risk of fracture-related infection in our institution with those in the previously studied institution. Results: The resulting data yielded an AUC (0.74) nearly identical to that of the previously studied institution. It was also found that the relative risk of infection correlated with the Wise score in the same way the initial model did with the absolute risks being similar. Conclusion: The previous predictive model was externally validated and shown to be generalizable to a different patient population. The relative risk of a fracture-related infection can be determined using this scoring model preoperatively with the goal of aiding in patient counseling and surgical decision-making, giving a quantitative value to patient risk factors. [Orthopedics. 2024;47(5):e268–e272.] [ABSTRACT FROM AUTHOR]

Context Recurrent spontaneous abortion (RSA) is defined as the loss of 2 or more consecutive intrauterine pregnancies with the same sexual partner in the first trimester. Despite its significance, the etiology and underlying mechanisms of RSA remain elusive. Defective decidualization is proposed as one of the potential causes of RSA, with abnormal decidualization leading to disturbances in trophoblast invasion function. Objective To assess the role of bone morphogenetic protein 4 (BMP4) in decidualization and RSA. Methods Decidual samples were collected from both RSA patients and healthy controls to assess BMP4 expression. In vitro cell experiments utilized the hESC cell line to investigate the impact of BMP4 on decidualization and associated aging, as well as its role in the maternal-fetal interface communication. Subsequently, a spontaneous abortion mouse model was established to evaluate embryo resorption rates and BMP4 expression levels. Results Our study identified a significant downregulation of BMP4 expression in the decidua of RSA patients compared to the normal control group. In vitro, BMP4 knockdown resulted in inadequate decidualization and inhibited associated aging processes. Mechanistically, BMP4 was implicated in the regulation of FOXO1 expression, thereby influencing decidualization and aging. Furthermore, loss of BMP4 hindered trophoblast migration and invasion via FOXO1 modulation. Additionally, BMP4 downregulation was observed in RSA mice. Conclusion Our findings highlighted the downregulation of BMP4 in both RSA patients and mice. BMP4 in human endometrial stromal cells was shown to modulate decidualization by regulating FOXO1 expression. Loss of BMP4 may contribute to the pathogenesis of RSA, suggesting potential avenues for abortion prevention strategies. [ABSTRACT FROM AUTHOR]

Background The purpose of this study was to evaluate the correlation and consistency between urine protein/creatinine ratio (UPCR) and 24-h urine protein (24HUPr) in children, and to determine cutoff values of UPCR relative to 24HUPr at 100 mg/m.sup.2/d ([greater than or equal to] 100 mg/m.sup.2/d as pathological proteinuria) and 1000 mg/m.sup.2/d ([greater than or equal to] 1000 mg/m.sup.2/d as nephrotic-range proteinuria). Methods Three hundred sixty-six children were enrolled, including 81 controls, 109 with Henoch-Schönlein purpura nephritis, 167 with nephrotic syndrome, 5 with IgA nephropathy, and 4 with lupus nephritis. Patients were divided into three groups: normal group; non-nephrotic-range proteinuria group; nephrotic-range proteinuria group. The cutoff values of UPCR in predicting the different levels of proteinuria were determined using ROC curve analysis. Results UPCR was positively correlated with 24HUPr (r = 0.915, p 95% spots of UPCR and 24HUPr were within 95% confidence intervals. Relative to 24HUPr at 100 mg/m.sup.2/d, the cutoff value of UPCR (0.18 g/g Cr) had the highest sensitivity (94%) and specificity (98.8%) which is close to 0.2 g/g Cr as proposed by the American College of Rheumatology. Relative to 24HUPr at 1000 mg/m.sup.2/d, the cutoff value of UPCR (2.09 g/g Cr) had the highest sensitivity (92.1%) and specificity (92.1%) which is close to the 2.0 g/g Cr proposed in KDIGO guidelines. Conclusions UPCR showed strong correlation and consistency with 24HUPr for evaluating levels of proteinuria in children. UPCR < 0.2 g/g Cr can be considered a criterion for normal-range proteinuria. Instead of 24HUPr [greater than or equal to] 1000 mg/m.sup.2/d, UPCR [greater than or equal to] 2.0 g/g Cr can be considered a criterion for nephrotic-range proteinuria or nephrotic syndrome in children., Author(s): Yanjie Huang [sup.1] , Xiaoqing Yang [sup.2] , Yanan Zhang [sup.1] , Shangsai Yue [sup.1] , Xiaofeng Mei [sup.2] , Liangliang Bi [sup.2] , Wensheng Zhai [sup.1] , Xianqing [...]