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ObjectiveTo describe the lipid metabolic profile of different patients with coronavirus disease 2019 (COVID-19) and contribute new evidence on the progression and severity prediction of COVID-19.MethodsThis case–control study was conducted in Peking University Third Hospital, China. The laboratory-confirmed COVID-19 patients aged ≥18 years old and diagnosed as pneumonia from December 2022 to January 2023 were included. Serum lipids were detected. The discrimination ability was calculated with the area under the curve (AUC). A random forest (RF) model was conducted to determine the significance of different lipids.ResultsTotally, 44 COVID-19 patients were enrolled with 16 mild and 28 severe patients. The top 5 super classes were triacylglycerols (TAG, 55.9%), phosphatidylethanolamines (PE, 10.9%), phosphatidylcholines (PC, 6.8%), diacylglycerols (DAG, 5.9%) and free fatty acids (FFA, 3.6%) among the 778 detected lipids from the serum of COVID-19 patients. Certain lipids, especially lysophosphatidylcholines (LPCs), turned to have significant correlations with certain immune/cytokine indexes. Reduced level of LPC 20:0 was observed in severe patients particularly in acute stage. The AUC of LPC 20:0 reached 0.940 in discriminating mild and severe patients and 0.807 in discriminating acute and recovery stages in the severe patients. The results of RF models also suggested the significance of LPCs in predicting the severity and progression of COVID-19.ConclusionLipids probably have the potential to differentiate and forecast the severity, progression, and clinical outcomes of COVID-19 patients, with implications for immune/inflammatory responses. LPC 20:0 might be a potential target in predicting the progression and outcome and the treatment of COVID-19.

Abstract Background Soil microbiome is an important part of the forest ecosystem and participates in forest ecological restoration and reconstruction. Niche differentiation with respect to resources is a prominent hypothesis to account for the maintenance of species diversity in forest ecosystems. Resource-based niche differentiation has driven ecological specialization. Plants influence soil microbial diversity and distribution by affecting the soil environment. However, with the change in plant population type, whether the distribution of soil microbes is random or follows an ecologically specialized manner remains to be further studied. We characterized the soil microbiome (bacteria and fungi) in different plant populations to assess the effects of phytophysiognomy on the distribution patterns of soil microbial communities in a temperate forest in China. Results Our results showed that the distribution of most soil microbes in different types of plant populations is not random but specialized in these temperate forests. The distribution patterns of bacteria and fungi were related to the composition of plant communities. Fungal species (32%) showed higher specialization than bacterial species (15%) for different types of plant populations. Light was the main driving factor of the fungal community, and soil physicochemical factors were the main driving factor of the bacterial community. Conclusion These findings suggest that ecological specialization is important in maintaining local diversity in soil microbial communities in this forest. Fungi are more specialized than bacteria in the face of changes in plant population types. Changes in plant community composition could have important effects on soil microbial communities by potentially influencing the stability and stress resistance of forest ecosystems.

Recent studies have shown that the use of mesenchymal stem/stromal cells (MSCs) may be a promising strategy for treating spinal cord injury (SCI). This study aimed to explore the effectiveness of human umbilical cord-derived MSCs (hUC-MSCs) with different administration routes and dosages on SCI rats. Following T10-spinal cord contusion in Sprague-Dawley rats (N = 60), three different dosages of hUC-MSCs were intrathecally injected into rats (SCI-ITH) after 24 h. Intravenous injection of hUC-MSCs (SCI-i.v.) and methylprednisolone reagent (SCI-PC) were used as positive controls (N = 10/group). A SCI control group without treatment and a sham operation group were injected with Multiple Electrolyte Injection solution. The locomotor function was assessed by Basso Beattie Bresnahan (BBB) rating score, magnetic resonance imaging (MRI), histopathology, and immunofluorescence. ELISA was conducted to further analyze the nerve injury and inflammation in the rat SCI model. Following SCI, BBB scores were significantly lower in the SCI groups compared with the sham operation group, but all the treated groups showed the recovery of hind-limb motor function, and rats receiving the high-dose intrathecal injection of hUC-MSCs (SCI-ITH-H) showed improved outcomes compared with rats in hUC-MSCs i.v. and positive control groups. Magnetic resonance imaging revealed significant edema and spinal cord lesion in the SCI groups, and significant recovery was observed in the medium and high-dose hUC-MSCs ITH groups. Histopathological staining showed that the necrotic area in spinal cord tissue was significantly reduced in the hUC-MSCs ITH-H group, and the immunofluorescence staining confirmed the neuroprotection effect of hUC-MSCs infused on SCI rats. The increase of inflammatory cytokines was repressed in hUC-MSCs ITH-H group. Our results confirmed that hUC-MSC administered via intrathecal injection has dose-dependent neuroprotection effect in SCI rats.

Abstract We aimed to determine disseminated intravascular coagulation (DIC)-associated organ failure and underlying diseases based on data from three ICU wards in tertiary hospitals in China from 2008 to 2016. The diagnosis of DIC was confirmed by an International Society of Thrombosis and Hemostasis score greater than or equal to 5. The maternal outcomes included the changes in organ function 24 h after ICU admission. The durations of hospital stay and ICU stay were recorded as secondary outcomes. Among 297 ICU admissions (median Sequential Organ Failure Assessment score, 4) for obstetric diseases, there were 87 DIC cases, with an estimated DIC incidence of 87 per 87,580 deliveries. Postpartum hemorrhage was the leading disease associated with DIC (71, 81.6%), followed by hypertensive disorders (27, 31.0%), sepsis (15, 17.2%), acute fatty liver of pregnancy (11, 12.6%) and amniotic fluid embolism (10, 11.5%). Compared with patients without DIC, those with DIC had higher rates of multiple organ dysfunction syndrome/death (27.6% vs 4.8%, p = 0.000), organ failure (36.8% vs 24.3%, p = 0.029), among which organ failure included acute renal failure (32.2% vs 10.0%, p = 0.000), respiratory failure (16.1% vs 8.6%, p = 0.057), disturbance of consciousness (12.6% vs 2.4%, p = 0.000) and DIC group also had higher rates of massive transfusion (52.9% vs 21.9%, p = 0.000), hysterectomy (32.2% vs 15.7%, p = 0.001), longer ICU (4 days vs 2 days, p = 0.000) and hospital stays (14 days vs 11 days, p = 0.005). DIC and amniotic fluid embolism were independent risk factors for organ failure in patients admitted to the ICU. Postpartum hemorrhage was the leading cause of DIC associated organ failure in obstetrics admitted to the ICU. The control of obstetric bleeding in a timely manner may improve obstetric prognoses.

Vertisols are clayey soils with a high potential for improving production. Therefore, understanding the impact of tillage and fertilization on soil physicochemical properties and microbial community is essential for improving the vertisols with a high montmorillonite and smectite clay content. A 3-year field experiment was conducted to compare the effects of different tillage and fertilization practices at three depths of the vertisol under the wheat–maize cropping system in the North China Plain. The experimental treatments included rotary tillage without fertilization (R-CK), rotary tillage with chemical nitrogen (N), phosphorus (P), and potassium (K) fertilization (R-NPK), R-NPK plus biochar (R-NPKB), deep tillage without fertilization (D-CK), deep tillage with chemical N, P, and K fertilization (D-NPK), and D-NPK plus biochar (D-NPKB). The results showed that D-NPKB significantly improved winter wheat and summer maize yields by 14.4 and 3.8%, respectively, compared with R-NPK. The nitrate (NO3––N) content of the deeper soil layer in D-NPKB was significantly higher than that in D-NPK. Meanwhile, biochar application increased the pH in the three layers. Compared with R-NPK, D-NPKB significantly increased the average content of available phosphorus (AP), soil organic carbon (SOC), and total nitrogen (TN) by 73.7, 18.5, and 19.0%, respectively. Meanwhile, Gaiellale, Sphingomonadaceae, and Nocardioidaceae were the predominant bacteria at the family level across all treatments, with a total relative proportion ranging from 14.1 to 23.6%. In addition, the abundance of Bacillaceae in deep tillage was 9.4% higher in the 20–30-cm soil layer than that in rotary tillage. Furthermore, the correlation analysis revealed a significant positive correlation between crop yield and chemical factors such as NO3––N and the abundances of Gaiellalea, Sphingomonadaceae, and Nocardioidaceae. The findings collectively indicated that deep tillage combined with biochar application could increase the soil nutrients and modify the bacterial structure in the deeper soil layer and therefore will be beneficial for improving the productivity of the vertisols.

Soil microbes play a crucial role in a forest ecosystem. However, whether the distribution of bacteria and fungi in different forest succession stages is random or following ecological specialization remains to be further studied. In the present study, we characterized soil bacterial and fungal communities to determine their distribution preference, with different succession communities in a temperate mountain forest. The Kruskal–Wallis method was used to analyze structural differences between bacterial and fungal communities in different succession processes. The specificity of soil microbial distribution in a secondary forest was studied by network analysis. The torus-translation test was used to analyze the species distribution preference of soil microbes in different succession stages. Results showed that the species composition of soil bacteria and fungi differed significantly in different succession processes. The modularity index of fungi (0.227) was higher than that of bacteria (0.080). Fungi (54.47%) had specific preferences than bacteria (49.95%) with regard to forests in different succession stages. Our work suggests that the distribution pattern of most soil microbes in a temperate mountain forest was not random but specialized in temperate mountain forests. Different microbes showed different distribution preferences. Fungi were more sensitive than bacteria during secondary succession in a temperate mountain forest. In addition, microbe–environment relations varied during secondary succession. Our results provided new insight into the mechanism through which complex soil microbial communities responded to changes in forest community succession.

Background: The role of sodium bicarbonate therapy (SBT) remains controversial. This study aimed to investigate whether hemodynamic status before SBT contributed to the heterogeneous outcomes associated with SBT in acute critically ill patients.Methods: We obtained data from patients with metabolic acidosis from the Medical Information Mart for Intensive Care (MIMIC)-III database. Propensity score matching (PSM) was applied to match the SBT group with the control group. Logistic regression and Cox regression were used to analyze a composite of newly “developed or exacerbated organ dysfunction” (d/eOD) within 7 days of ICU admission and 28-day mortality associated with SBT for metabolic acidosis.Results: A total of 1,765 patients with metabolic acidosis were enrolled, and 332 pairs obtained by PSM were applied to the final analyses in the study. An increased incidence of newly d/eOD was observed in the SB group compared with the control group (54.8 vs. 44.6%, p < 0.01). Multivariable logistic regression indicated that the adjusted OR of SBT for this composite outcome was no longer significant [OR (95% CI): 1.39 (0.9, 1.85); p = 0.164]. This effect of SBT did not change with the quintiles stratified by pH. Interestingly, SBT was associated with an increased risk of the composite of newly d/eOD in the subgroup of patients with worsening hemodynamics before SBT [adjusted OR (95% CI): 3.6 (1.84, 7.22), p < 0.001]. Moreover, the risk potential for this composite of outcomes was significantly increased in patients characterized by both worsening [adjusted OR (95% CI): 2.91 (1.54, 5.47), p < 0.001] and unchanged hemodynamics [adjusted OR (95% CI): 1.94 (1.01, 3.72), p = 0.046] compared to patients with improved hemodynamics before SBT. Our study failed to demonstrate an association between SBT and 28-day mortality in acute critically ill patients with metabolic acidosis.Conclusions: Our findings did not demonstrate an association between SBT and outcomes in critically ill patients with metabolic acidosis. However, patients with either worsening or unchanged hemodynamic status in initial resuscitation had a significantly higher risk potential of newly d/eOD subsequent to SBT.

Forests in different disturbance regimes provide diverse microhabitats for species growth. However, whether the species distribution of wood plant is random or follows ecological specialization among forests in different disturbance regimes remains to be elucidated. In this study, four 1 hm2 (100 m × 100 m) forest dynamic monitoring plots in different disturbance regimes of forests were randomly selected in a temperate deciduous broad-leaved forest. We examined the specificity of woody plants to forests through network analysis. Torus-translation test was used to analyze the species distribution preference of woody plants to forests in different disturbance regimes. The specialization index of woody plants was 0.3126, and that of shrubs (51.01%) was higher than that of trees (25.16%). Moreover, 66.67% (38/57) of woody plants were associated with different forests. More shrub species (70.00%) had specific preferences than tree species (45.95%) with respect to forests in different disturbance regimes. Our findings suggest that the distribution of woody plants among forests with different disturbance regimes is not random but is specialized. Different woody plants show different community preferences in different disturbance regimes of forests. Shrubs show higher specialization than trees in different disturbance regimes of forests.

Diversified community types provide different microhabitats for plant growth. However, whether the distribution of species is random distribution or ecological specialization within different plant community types remains to be elucidated. Here, five 1 ha (100 m × 100 m) plots with different communities were established in a temperate forest. We examined community structure differences by non-metric multidimensional scaling and betadisper test, analyzed the species–community relationships by correlation network approach, and then the examined distribution preferences of woody plant species by torus-translation test. Results showed that the abundance, richness, and species composition of woody plants exhibited significant differences among the five communities. The specialization index showed that 42.83% of the species had the characteristics of distribution specialization for different communities. The torus-translation test showed that 85 species (86.74%) were positively associated with specific community. Our findings suggested that the distribution of woody plants species among different plant community types is not random but specialization. Different woody plant species have distinct specific preferences among various plant community types in temperate mountain forest. These findings provide new insights into the biodiversity conservation of woody plant species in temperate deciduous broad-leaved forests and indicate the potential importance of community partitioning for the maintenance of woody plant diversity.

Abstract Rechargeable batteries with high durability over wide temperature is needed in aerospace and submarine fields. Unfortunately, Current battery technologies suffer from limited operating temperatures due to the rapid performance decay at extreme temperatures. A major challenge for wide-temperature electrolyte design lies in restricting the parasitic reactions at elevated temperatures while improving the reaction kinetics at low temperatures. Here, we demonstrate a temperature-adaptive electrolyte design by regulating the dipole-dipole interactions at various temperatures to simultaneously address the issues at both elevated and subzero temperatures. This approach prevents electrolyte degradation while endowing it with the ability to undergo adaptive changes as temperature varies. Such electrolyte favors to form solvation structure with high thermal stability with rising temperatures and transits to one that prevents salt precipitation at lower temperatures. This ensures stably within a wide temperature range of ‒60 −55 °C. This temperature-adaptive electrolyte opens an avenue for wide-temperature electrolyte design, highlighting the significance of dipole-dipole interactions in regulating solvation structures.

Abstract This study aims to investigate the potential relationships between the systemic immune-inflammation index (SII) and body mass index (BMI), waist circumference, and the prevalence of obesity. A cross-sectional analysis was conducted on 7,645 individuals aged 20 and above from the NHANES 2017–2020. Multivariate linear regression analyses were conducted to evaluate the association of the logarithmically transformed SII (lgSII) with BMI and waist circumference. Additionally, multivariable logistic regression was utilized to explore the relationship between lgSII and the prevalence of obesity. Fitted smoothing curves and threshold-effect analysis were applied to elucidate nonlinear relationships. In the fully adjusted model, a positive relationship was observed between lgSII and BMI, waist circumference, and obesity prevalence (β = 3.13, 95% CI 2.10–4.16; β = 7.81, 95% CI 5.50–10.13; OR = 1.44, 95% CI 1.12–1.86). The variables of gender, age, race, education, marital status, poverty income ratio (PIR), energy intake, sleep disorder, smoking status, and alcohol use did not significantly modify the positive association between lgSII and obesity. However, physical activity appeared to influence the positive correlation between lgSII and obesity. Using a two-segment linear regression model, an inverted U-shaped relationship was observed between lgSII and both BMI and waist circumference. Furthermore, lgSII demonstrated a linear positive correlation with obesity prevalence. When stratified by physical activity, lgSII showed a non-significant negative correlation with obesity in the physically active group. Our findings underscore a robust association between the logarithmically transformed SII and BMI, waist circumference, and the prevalence of obesity.

Abstract Background Whole exome sequencing (WES) has been recommended to investigate the genetic cause of fetal structural anomalies. In this retrospective study, we aimed to evaluate the diagnostic yield of WES in our cohort of families with pregnancy loss or termination of pregnancy due to structural anomalies. Methods As aneuploidy, triploidy and copy number variations (CNVs) could be detected by exome-based CNV analysis, only WES is performed in this study. And the results of 375 cases assessed by WES were analyzed. Results The overall detection rate was 32.3% (121/375), including aneuploidy and triploidy (7.5%, 28/375), CNVs (5.1%, 19/375) and single-nucleotide variants (SNVs) /insertions or deletions (Indels) (19.7%, 74/375). Among these, the diagnostic yield for likely pathogenic (LP) or pathogenic (P) CNVs is 4.8% (18/375), and the diagnostic yield for LP or P SNVs/Indels is 15.2% (57/375). And an additional 4.8% (18/375) of cases had CNVs or SNVs/Indels classified as variants of uncertain significance (VUS) with potential clinical significance. Conclusions Our findings expand the known mutation spectrum of genetic variants related to fetal abnormalities, increase our understanding of prenatal phenotypes, and enable more accurate counseling of recurrence risk for future pregnancies.

To investigate the effect of multidisciplinary team (MDT)-based nutritional management approach on the perioperative nutrition care of gastric cancer patients. A total of 120 patients who underwent radical gastrectomy for gastric cancer from November 2021 to October 2023 were retrospectively enrolled. The participants were divided into two groups: the control group (n = 60), comprising patients who underwent surgery from November 2021 to October 2022, and the observation group (n = 60), including patients who had their surgery from November 2022 to October 2023. While the control group received standard care, the observation group was administered an MDT-based nutritional management protocol in addition to the standard care. Perioperative nutritional status, postoperative gastrointestinal function parameters, gastrointestinal feeding intolerance and quality of life were compared between the two groups. Results indicated a marked improvement in the perioperative nutritional status, postoperative gastrointestinal function, and quality of life in the observation group compared to the control group (p < 0.05). Furthermore, the incidence rate of gastrointestinal feeding intolerance in the observation group was significantly lower than that in the control group, with the differences achieving statistical significance (p < 0.05). The findings suggest that the MDT nutrition management mode can improve the nutritional status of patients, promote the rehabilitation of gastrointestinal function and quality of life, and reduce the incidence of gastrointestinal feeding intolerance, which is worthy of promotion in clinical practice.

Abstract Objectives Metabolic dysfunction-associated fatty liver disease (MAFLD), a globally prevalent disease, is closely linked to insulin resistance (IR). Physical activity (PA) is closely linked to both MAFLD and IR. We aim to explore the dose–response relationship between metabolic score for IR (METS-IR)/homeostasis model assessment of IR (HOMA-IR) and MAFLD, and investigate the relationship between PA, IR and MAFLD. Methods Participants from the NHANES study were included in this cross-section study. Logistic regression and the receiver operating characteristic were used to assess the predictive performance of METS-IR/HOMA-IR for MAFLD. Restrictive cubic splines were performed to visualize their dose–response relationship. Decision tree analysis was used to identify high-risk populations of MAFLD. PA’s mediating effect in the association between METS-IR/HOMA-IR and MAFLD was also examined. Results Of all 1,313 participants, 693 had MAFLD (52.78%). There were a positive association between METS-IR (OR = 1.162, 95% CI = 1.126–1.199) and HOMA-IR (OR = 1.630, 95% CI = 1.431–1.856) and MAFLD risk. The AUCs of the METS-IR and HOMA-IR were 0.831 (0.809, 0.853) and 0.767 (0.741, 0.791), respectively, with significantly different predictive performance (P

Objective The Pingbei slope belt is one of the key zones for the exploration of lithologic reservoirs in the Xihu Depression. However, the exploration process was inhibited by issues of small thickness and significant lateral variation of sand-bodies. Therefore, research on the tectonic-sedimentary response, including the stratigraphic development patterns, deposition center evolution, and sand-body distribution mechanisms in different tectonic units, is urgently needed. Methods Integrating the newly obtained well drilling, well logging, and high-resolution 3D seismic data, a high-precision sequence stratigraphic framework was established and the third-order sequences and systems tracts were analysed in the Pinghu Formation of the Pingbei slope belt. Results Based on differences in palaeogeomorphology and fault systems, the tectonic-sedimentary units of the Pingbei slope zone were classified. Differences in fault styles, stratigraphic contact relationships, and sedimentary filling patterns under different sequence stratigraphic architectures were analysed in various tectonic units. Additionally, the controlling factors and models of sand-body distribution in various sequence stratigraphic architectures were discussed. Conclusion This study revealed that the Pingbei slope zone can be divided into four types of sequence stratigraphic architectures: steep fault slope, opposite fault step, reversal step fault, and forward step fault. The sequence stratigraphic architectures that were controlled by factors of sediment supply, fault activity, palaeogeomorphic, and base-level cycles generated four sand-body distribution models. Research on the differences in sequence configurations and sand-body distribution models in different tectonic units is important for promoting the exploration of lithological reservoirs in the Pingbei slope belt of the Xihu Depression.

Abstract The microRNAs (miRNAs) of their hosts play an important role in regulating both the innate and adaptive immune responses to Cryptosporidium parvum infection. The mechanisms of autophagy and apoptosis are important components of the defense system against C. parvum infection. In this study, we investigate the role of miRNA-199a-3p in regulating MTOR-mediated autophagy and apoptosis in HCT-8 cells induced by C. parvum. The expression of miR-199a-3p increased at 3, 6 and 12 hours postinfection (hpi) but decreased at 24 and 48 hpi. The upregulation of miR-199a-3p promoted autophagy and apoptosis and limited the parasite burden in HCT-8 cells after C. parvum infection. The downregulation of miR-199a-3p inhibited the autophagy and apoptosis induced by C. parvum and enhanced the parasite burden in HCT-8 cells. A luciferase reporter showed that MTOR was a target gene of miR-199a-3p. Suppressed expression of MTOR by small interfering RNA (siRNA) promoted autophagy and apoptosis and limited C. parvum burden in HCT-8 cells. Co-transfection with miR-199a-3p inhibitor or si-mTOR revealed that miR-199a-3p regulates autophagy and apoptosis in HCT-8 cells through MTOR, to resist C. parvum infection. In conclusion, intestinal epithelial cells defend against C. parvum infection by regulating their autophagy and apoptosis through the miR-199a-3p-MTOR axis.

Abstract Introduction Declining physical activity among university students has become a concern, with increasingly poor dietary behaviors and other unfavorable factors having an impact on the occurrence of psychological symptoms. Previous studies have analyzed the association between moderate-to-vigorous physical activity (MVPA) and psychological symptoms, but few studies have investigated the association between soy product consumption and these symptoms. In addition, the associations between physical activity and soy product consumption with psychological symptoms have not been investigated. Methods In this study, 7267 university students from different regions of China were surveyed regarding physical activity, soy product consumption, and psychological symptoms. Binary logistic regression was used to analyze the associations among MVPA, soy product consumption, and psychological symptoms. A generalized linear model (GLM) was applied to further analyze the associations of MVPA and soy product consumption with psychological symptoms in this population. Results The detection rate of psychological symptoms among Chinese university students was 17.9%, with the rate among female students (18.9%) higher than that among male students (16.6%). The proportion of university students with MVPA 60 min/d was 76.1%, 19.3%, and 4.6%, respectively, and the proportion with soy product consumption ≤ 2 times/wk, 3–5 times/wk, and ≥ 5 times/wk was 25.8%, 42.4%, and 31.7%, respectively. The GLM showed that compared with university students who had MVPA 60 min/d and soy product consumption ≥ 6 times/week (OR = 0.198, 95% CI: 0.100–0.393, P 60 min/d and soy product consumption 3–5 times/week (OR = 0.221, 95% CI: 0.102–0.479, P

Abstract Background Pulmonary hypertension (PH) is a progressive disease characterized by pulmonary vascular remodeling. Increasing evidence indicates that endothelial-to-mesenchymal transition (EndMT) in pulmonary artery endothelial cells (PAECs) is a pivotal trigger initiating this remodeling. However, the regulatory mechanisms underlying EndMT in PH are still not fully understood. Methods Cytokine-induced hPAECs were assessed using RNA methylation quantification, qRT-PCR, and western blotting to determine the involvement of N6-methyladenosine (m6A) methylation in EndMT. Lentivirus-mediated silencing, overexpression, tube formation, and wound healing assays were utilized to investigate the function of METTL3 in EndMT. Endothelial-specific gene knockout, hemodynamic measurement, and immunostaining were performed to explore the roles of METTL3 in pulmonary vascular remodeling and PH. RNA-seq, RNA Immunoprecipitation-based qPCR, mRNA stability assay, m6A mutation, and dual-luciferase assays were employed to elucidate the mechanisms of RNA methylation in EndMT. Results The global levels of m6A and METTL3 expression were found to decrease in TNF-α- and TGF-β1-induced EndMT in human PAECs (hPAECs). METTL3 inhibition led to reduced endothelial markers (CD31 and VE-cadherin) and increased mesenchymal markers (SM22 and N-cadherin) as well as EndMT-related transcription factors (Snail, Zeb1, Zeb2, and Slug). The endothelial-specific knockout of Mettl3 promoted EndMT and exacerbated pulmonary vascular remodeling and hypoxia-induced PH (HPH) in mice. Mechanistically, METTL3-mediated m6A modification of kruppel-like factor 2 (KLF2) plays a crucial role in the EndMT process. KLF2 overexpression increased CD31 and VE-cadherin levels while decreasing SM22, N-cadherin, and EndMT-related transcription factors, thereby mitigating EndMT in PH. Mutations in the m6A site of KLF2 mRNA compromise KLF2 expression, subsequently diminishing its protective effect against EndMT. Furthermore, KLF2 modulates SM22 expression through direct binding to its promoter. Conclusions Our findings unveil a novel METTL3/KLF2 pathway critical for protecting hPAECs against EndMT, highlighting a promising avenue for therapeutic investigation in PH.

Breast cancer is rare in men and is managed using strategies similar to those for breast cancer in women. This study retrospectively analyzed the clinicopathological features, treatment, and survival of male breast cancer (MBC). A total of 66 patients with MBC admitted into Xijing Hospital from August 2006 to March 2024 were reviewed. Data were collected from patients’ hospital records and breast cancer database of Xijing Hospital. The incidence of MBC tended to increase from 2018, with affected individuals being older than those with female breast cancer (FBC). The most common histological type of MBC was invasive carcinoma, with positive hormone receptor status. A total of 62 (93.9%) patients with MBC underwent modified radical mastectomy. Chemotherapy was administered to 39 (59.1%) patients, while endocrine therapy was received by 14 patients (21.2%) and radiotherapy by nine patients (13.6%). Survival analysis indicated that the median overall survival (OS) of patients with MBC was 46.7 months (0.9–184.8 months). As of the latest data, 58 patients (87.9%) with MBC are alive. Factors significantly associated with survival included age (χ 2 = 3.856, p = .050), estrogen receptor (χ 2 = 10.427, p = .005), molecular types (χ 2 = 10.641, p = .031), P63 (χ 2 = 2.631, p

A mixed epithelial and stromal tumor of the seminal vesicle gland is an uncommon neoplasm characterized by a dual population of epithelial and stromal cells. In this case report, we present a 59-year-old male patient who presented with a large, 10 cm mass in the left seminal vesicle, which was preliminarily suspected to be a malignant tumor of the seminal vesicle based on magnetic resonance imaging findings. Histopathological evaluation, however, revealed a tumor with biphasic epithelial–mesenchymal differentiation, predominantly displaying mesenchymal characteristics. The epithelium and stroma displayed papillary and foliar structures, respectively. The epithelial cells were bland, arranged in either single or multi-layered cuboidal patterns, and the stromal cells were spindle shaped with a sparse distribution. The patient experienced a favorable postoperative outcome. The diagnosis of mixed epithelial and stromal tumor is challenging based on clinical and imaging findings alone, and definitive diagnosis relies on pathological examination. This case report addresses a rare presentation of low-grade mixed epithelial and stromal tumor in the seminal vesicle gland and aims to expand the understanding of this entity by reviewing the relevant literature.

Bird invasion will reduce the yield of high-value crops, which threatens the healthy development of agricultural economy. Sonic bird repellent has the advantages of large range, no time and geographical restrictions, and low cost, which has attracted people’s attention in the field of agriculture. At present, there are few studies on the application of sonic bird repellents in pear orchards to minimize economic losses and prolong the adaptive capacity of birds. In this paper, a sound wave bird repellent system based on computer vision is designed, which combines deep learning target recognition technology to accurately identify birds and drive them away. The neural network model that can recognize birds is first trained and deployed to the server. Live video is captured by an installed webcam, and the sonic bird repellent is powered by an ESP-8266 relay switch. In a pear orchard, two experimental areas were divided into two experimental areas to test the designed sonic bird repellent device, and the number of bad fruits pecked by birds was used as an indicator to evaluate the bird repelling effect. The results showed that the pear pecked fruit rate was 6.03% in the pear orchard area that used the acoustic bird repeller based on computer recognition, 7.29% in the pear orchard area of the control group that used the acoustic bird repeller with continuous operation, and 13.07% in the pear orchard area that did not use any bird repellent device. While acoustic bird repellers based on computer vision can be more effective at repelling birds, they can be used in combination with methods such as fruit bags to reduce the economic damage caused by birds.

Objective: Traumatic brain injury (TBI) is among the leading causes of death and disability globally. Identifying and assessing the risk of in-hospital mortality in traumatic brain injury patients at an early stage is challenging. This study aimed to develop a model for predicting in-hospital mortality in TBI patients using prehospital data from China. Methods: We retrospectively included traumatic brain injury patients who sustained injuries due to external forces and were treated by pre-hospital emergency medical services (EMS) at a tertiary hospital. Data from the pre-hospital emergency database were analyzed, including demographics, trauma mechanisms, comorbidities, vital signs, clinical symptoms, and trauma scores. Eligible patients were randomly divided into a training set (241 cases) and a validation set (104 cases) at a 7:3 ratio. Least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression were employed to identify independent risk factors. Analyzed the discrimination, calibration, and net benefit of the nomogram across both groups. Results: 17.40 % (42/241) of TBI patients died in the hospital in the training set, while 18.30 % (19/104) in the validation set. After analysis, chest trauma (odds ratio [OR] = 4.556, 95 % confidence interval [CI] = 1.861–11.152, P = 0.001), vomiting (OR = 2.944, 95%CI = 1.194–7.258, P = 0.019), systolic blood pressure (OR = 0.939, 95%CI = 0.913–0.966, P

As a common cardiovascular disease (CVD), Arrhythmia refers to any abnormality in the origin, frequency, rhythm, conduction velocity, timing, pathway, sequence, or other aspect of cardiac impulses, and it is one of the common cardiovascular diseases in clinical practice. At present, various ion channel blockers are used for treatment of arrhythmia that include Na+ ion channel blockers, K+ ion channel blockers and Ca2+ ion channel blockers. While these drugs offer benefits, they have led to a gradual increase in drug-related adverse reactions across various systems. As a result, the quest for safe and effective antiarrhythmic drugs is pressing. Recent years have seen some advancements in the treatment of ventricular arrhythmias using traditional Chinese medicine(TCM). The theory of Luobing in TCM has proposed a new drug intervention strategy of ''fast and slow treatment, integrated regulation'' leading to a shift in mindset from ''antiarrhythmic'' to ''rhythm-regulating''. Guided by this theory, the development of Shen Song Yang Xin Capsules (SSYX) has involved various Chinese medicinal ingredients that comprehensively regulate the myocardial electrophysiological mechanism, exerting antiarrhythmic effects on multiple ion channels and non-ion channels. Similarly, in clinical studies, evidence-based research has confirmed that SSYX combined with conventional antiarrhythmic drugs can more effectively reduce the occurrence of arrhythmias. Therefore, this article provides a comprehensive review of the composition and mechanisms of action, pharmacological components, network pharmacology analysis, and clinical applications of SSYX guided by the theory of Luobing, aiming to offer valuable insights for improved clinical management of arrhythmias and related research.

ABSTRACT: This study determined metabolizable energy (ME) and developed ME prediction equations for broilers based on chemical composition of soybean meal (SBM) and rapeseed meal (RSM) using a 2 × 10 factorial arrangement of age (11 to 14 or 25 to 28 d of age) and 10 sources of each ingredient. Each treatment contained 6 replicates of 8 broilers. The ME values were determined by total collection of feces and urine. Principal components analysis (PCA) of the chemical composition clearly revealed distinct differences in SBM and RSM based on a principal components (PC) score plot. The nitrogen-corrected apparent metabolizable energy (AMEn) of SBM was higher in broilers from 25 to 28 than 11 to 14 d of age (P = 0.013). Interactions between broiler age and ingredient source affected apparent metabolizable energy (AME) of SBM and ME of RSM (P < 0.05). The ME of SBM in 11 to 14 and 25 to 28-day-old broilers were estimated by crude protein (CP) content (R2≥ 0.782; SEP ≤ 83 kcal/kg DM; P < 0.001). The AME and AMEn of RSM in 11 to 14-day-old broilers were estimated by ether extract (EE), ash and acid detergent fiber (ADF) (R2 = 0.897, SEP = 106 kcal/kg DM; P = 0.002), and by EE and ash (R2 = 0.885, SEP = 98 kcal/kg DM; P = 0.001), respectively. The AME and AMEn of RSM in 25 to 28-day-old broilers were estimated by ash and ADF (R2 = 0.925, SEP = 104 kcal/kg DM; P < 0.001) and by ash and neutral detergent fiber (NDF) (R2 = 0.921, SEP = 91 kcal/kg DM; P < 0.001), respectively. These results indicate that ME of these 2 plant protein ingredients are affected interactively by chemical composition and age of broilers. This study developed robust, age-specific prediction equations of ME for broilers based on chemical composition for SBM and RSM. Overall, ME values can be predicted from CP content for SBM, or EE, ash, ADF, and NDF for RSM.

Abstract Accurate identification and localization of multiple abnormalities are crucial steps in the interpretation of chest X-rays (CXRs); however, the lack of a large CXR dataset with bounding boxes severely constrains accurate localization research based on deep learning. We created a large CXR dataset named CXR-AL14, containing 165,988 CXRs and 253,844 bounding boxes. On the basis of this dataset, a deep-learning-based framework was developed to identify and localize 14 common abnormalities and calculate the cardiothoracic ratio (CTR) simultaneously. The mean average precision values obtained by the model for 14 abnormalities reached 0.572-0.631 with an intersection-over-union threshold of 0.5, and the intraclass correlation coefficient of the CTR algorithm exceeded 0.95 on the held-out, multicentre and prospective test datasets. This framework shows an excellent performance, good generalization ability and strong clinical applicability, which is superior to senior radiologists and suitable for routine clinical settings.

Abstract Background Extragonadal germ cell tumors originating from the prostate are exceptionally rare. To the best of our knowledge, there have been no reported cases of mixed germ cell tumors in individuals with 46 XX disorder of sex development. In this study, we conducted a comprehensive analysis using whole genome sequencing to investigate the clinicopathological and molecular genetic characteristics of a submitted case, with the objective of elucidating its underlying pathogenesis. Case presentation A 40-year-old male patient was diagnosed with a combination of 46, XX disorder of sex development and a primary prostate mixed germ cell tumor with yolk sac tumor and teratoma components. Whole-genome sequencing revealed that the tumor cells had a high somatic mutational load. Analysis of genomic structural variations and copy number variants confirmed the patient's karyotype as 46, XX (SRY +). Additionally, the patient exhibited short stature, small bilateral testes, slightly enlarged breasts, elevated serum alpha-fetoprotein concentrations, elevated follicle-stimulating hormone and luteinizing hormone levels, and low testosterone levels. Discussion A case of 46, XX disorder of sex development, along with a primary prostatic mixed germ cell tumor, was diagnosed. This diagnosis has contributed to advancing our understanding of the genetic and phenotypic profile of the disease and may provide some insights for its treatment.

Porous asphalt (PA) have attracted considerable interest due to their functional advantages such as significant water permeability and noise attenuation properties. Nevertheless, its vulnerability to damage significantly hinders its widespread application. Therefore, this paper aims to investigate the damage characteristics of PA's high- and low-temperature performance under the coupled effects of moisture and temperature. Firstly, Hamburg Wheel-Tracking Test (HWTT) and three-point bending tests were conducted on PA under different coupling conditions. Subsequently, its damage characteristics were analyzed using the three-stage permanent deformation model, logistic model, and two-way analysis of variance (ANOVA) method. The findings indicate that under dry conditions, PA-13 exhibits a linear decrease in rutting resistance within the temperature range of 40–60 °C, followed by a significant decrease at 70 °C. During immersion in water, PA-13 undergoes a second and third-stage rutting evolution process, with an accelerated creep rate observed at 70°C. High temperatures exacerbate the viscoelastic damage of PA-13, while multi-field coupling promotes the simultaneous occurrence of viscoelastic damage and stripping damage. Furthemore, the results of the two-way ANOVA indicate that moisture has a more significant impact on high-temperature performance damage. In addition, in a dry environment, the low-temperature crack resistance of PA-13 deteriorates with decreasing temperature, but there is little difference at −20 °C and −30 °C. This is attributed to PA-13 exhibiting flexible cracking at 0 °C and −10 °C, while undergoing brittle cracking at −20 °C and −30 °C. Additionally, the coupled effect of temperature and moisture reduces the damage tolerance of PA-13 and accelerates its cracking process. The results of the two-way ANOVA indicate that both low temperature and treatment methods have a statistically significant impact on low-temperature performance, with treatment methods having a higher degree of influence. The findings of this paper contribute to an in-depth understanding of the damage mechanism of PA-13.

ObjectiveAlthough the impact of the variants of COVID-19 on the general population is diminishing, there is still a certain mortality rate for severe and critically ill patients, especially for the elderly with comorbidities. The present study investigated whether the D-dimer to albumin ratio (DAR) can predict the severity of illness and mortality in COVID-19 patients.MethodsA total of 1,993 patients with COVID-19 were retrospectively reviewed and the association of DAR with severe or critical illness or death during hospitalization was analyzed. The area under the ROC curve was used to screen the best indicators, Chi-square test, rank sum test, and univariate and multivariate binary logistic regression analysis were used to calculate the mean value of difference and adjusted odds ratio (aORs) with their 95% CI, and finally, survival was analyzed using Kaplan–Meier (KM) curves.ResultsAmong 1,993 patients with COVID-19, 13.4% were severely ill, and the mortality rate was 2.3%. The area under the curve (AUC) using DAR to predict severe and critically ill patients was higher than that using other parameters. The best cut-off value of DAR was 21 in the ROC with a sensitivity of 83.1% and a specificity of 68.7%. After adjusting age, gender, comorbidities, and treatment, the binary logistic regression analysis showed that elevated DAR was an independent risk factor for severely ill and mortality of COVID-19 patients. The KM curve suggested that patients with a higher DAR was associated with worse survival. The negative predictive value of DAR (21) for adverse prognosis and death was 95.98 and 99.84%, respectively, with a sensitivity of 80.9 and 95.65%, respectively.ConclusionThe DAR may be an important predictor for severe illness and mortality in COVID-19 patients.

Broccoli, a cruciferous vegetable, has a unique indeterminate inflorescence structure known as curds. It is the main edible organ of broccoli and has a rich nutritional value and health benefits. However, the formation and development mechanism of the curd is still not well understood. In the present study, the shoot apical meristem (SAM) stage and three different development stages of curd (formation stage (FS), expansion stage (ES), and maturation stage (MS)) were identified and subjected to transcriptome sequencing to uncover the potential genes and regulatory networks involved in curd formation and development. The results indicated that the genes associated with the development of SAM such as BolAP1A, BolAP1C, BolCAL, and BolAGL6 play an important role in the abnormal differentiation of the curd apical buds. The genes, BolFRI, BolbHLH89, BolKAN4, BolAGL12, and BolAGL24, displayed significantly differential expression patterns in curd development may function in the regulation of the transition from inflorescence meristem (IM) to floral meristem (FM). Moreover, gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of the differentially expressed genes (DEGs) indicate that phytohormones, such as auxin (AUX), gibberellins (GA), and abscisic acid (ABA) also play an important role in SAM proliferation and the transition from SAM to IM. In addition, the genes regulating photosynthetic reaction (BolLHCA1, BolLHCB1, BolPsbO, etc.) have a key involvement in the differentiation of secondary IMs during curd expansion. The genes associated with the metabolism of starch and sucrose (e.g., BolSPS4, BolBAM4) were significantly upregulated at the MS should contribute to the maturation of the curd. These findings provide new insights into the potential key regulatory factors and metabolic pathways involved in the formation and development of broccoli curds.

ABSTRACT: Enterococcus faecium (E. faecium) is an alternative to antibiotics, while the probiotic effect of short-term application in mature broiler chickens remains unclear. In the current study, 48 Arbor Acres male broilers were chosen to investigate the effects of E. faecium on growth performance, the gut microbiome and intestinal health during the finishing period. Forty-eight birds were randomly allocated to 4 treatment groups that were fed a corn-soybean meal basal diet (Con), a basal diet supplemented with 1 g/kg amoxicillin (ABX), 5×106 CFU/g encapsulated E. faecium (cEF), or 5×106 CFU/g uncoated E. faecium (EF) from d 33 to 42. The results showed that 10 d of antibiotic treatment decreased the growth performance of the broilers (P < 0.05). The feed conversion ratio of the cEF and EF groups were lower than that of the Con group by 0.13 and 0.07, respectively (P > 0.05). The abundance of viable ileal and cecal E. faecium in the cEF group was greater than that in the EF group (P < 0.05), and both groups were markedly greater than those in the Con and ABX groups (P < 0.05). The ABX treatment decreased the Shannon and Chao1 indices of the cecal microbiota, while the dietary E. faecium treatment resulted in significant differences in the β diversity of the ileal and cecal microbiota (P < 0.05). Mantel correlation revealed that the ileal microbiota at the genus level was significantly correlated with the growth performance of broilers, with Lactobacillus, Bacillus and Escherichia-Shigella showing positive and strong correlations (P < 0.05). In the ileum, the crypt depth was lower in the cEF group than in the Con group, but the villi height-to-crypt depth ratio was greater in the cEF group than in the other groups (P = 0.037). However, the expression of the ZO-2 and Occludin genes was downregulated in the E. faecium-fed birds (P < 0.05). In the cecum, the acetate, butyrate and total SCFA levels were greater in the EF group (P < 0.05), while the propionate, isobutyrate and isovalerate levels were lower in the ABX group (P < 0.05). In summary, 10 d of dietary supplementation with E. faecium markedly increased colonization in mature broilers and potentially improved growth performance by modulating the ileal microbiota. Encapsulation techniques could enable a slow release of E. faecium in the intestine, thereby reducing the negative impacts of rapid expansion of E. faecium on the intestinal epithelium.

Objective This study investigated the correlation between uncertainty stress (US) and depression among healthcare professionals (HCPs) in China.Design, settings and participants A cross-sectional online survey was conducted by recruiting HCPs from three provinces in China (central, eastern and western) through purposive sampling between 29 September 2022 and 18 January 2023. US was measured using the Life Stress Questionnaire and depression was measured using the Patient Health Questionnaire-9. In total, 2976 questionnaires were deemed valid.Primary and secondary outcome This study examined the prevalence of US and depression among HCPs in China; the correlating sociodemographic traits; and the correlation between US and depression.Results The prevalence of US and depression among HCPs in China was 26.54% (790 out of 2976) and 71.63% (2132 out of 2976). Binary logistic analysis revealed that individuals with graduate degrees (OR: 1.83; 95% CI 1.07 to 3.11; p

This study aimed to convert wastes generated during the extraction of oil from Camellia oleifera seeds, including the fruit shell (COFS) and seed cake (COSC), into fermentable feedstocks using pretreatment and enzymatic hydrolysis processes. The application of a green acid catalyst in the thermochemical pretreatment of the COFS and COSC mixture yielded the highest sugar of 28 g/L. Solid-state fermentation (SSF) was conducted on-site using various waste biomass substrates to produce enzymes for the saccharification process. This study found that COFS was the ideal substrate for generating SSF enzymes capable of breaking down lignocellulosic biomass. A novel enzymatic hydrolysis strategy was developed to minimize water consumption and enhance substrate utilization efficiency. By fine-tuning the enzymatic hydrolysis process, an additional sugar of 20.58 g/L was achieved using thermochemically pretreated solid residues and SSF enzymes. Standard techniques were used to analyze the raw materials, residual solids, and hydrolysates to assess the efficiency of each processing step. In general, the use of SSF enzymes and green pretreatment methods, reduction of water consumption in the process, and implementation of an efficient biomass utilization approach, enhance the overall efficiency and eco-friendliness of this study.

Abstract Currently, there are three main shortcomings in meteorological drought indices: first, they rely on historical climate probability functions; second, the timescale used in calculations has a certain degree of subjectivity; third, the same index value may correspond to vastly different levels of actual drought in different climate types of regions. The purpose of this article is to establish a meteorological drought index that does not rely on historical meteorological element probability functions. Through theoretical derivation, four drought‐level maintenance lines are established on the cumulative precipitation‐cumulative water surface evaporation coordinate plane, and the coordinate quadrant is divided into five drought‐level areas. Through forward daily rolling accumulation, the maximum distance point is selected from the dynamically changing coordinate points to determine the corresponding cumulative precipitation and cumulative evaporation. The meteorological drought index is established by the distance from the selected coordinate point to each drought‐level maintenance line. Using daily precipitation and evaporation data from meteorological observation stations, the index is calculated based on the established meteorological drought index model, and compared with actual drought evolution and drought disaster records. The results show that the index can capture the development of drought well, and its changes are very consistent with drought disaster records. The index is of great significance for drought monitoring or assessment, and can provide guidance for water resource allocation, crop layout, and urban planning. Furthermore, it can also provide a way of thinking that does not rely on historical element probabilities for future drought research.

IntroductionUlcerative colitis (UC) is marked by recurring inflammation. Existing treatments are ineffective and may have toxic side effects. Thus, new therapeutic agents are urgently needed. We studied the botanical formula “Li-Hong Tang (LHT)", which contains two main ingredients, Salvia plebeia R. Br and Rhodiola crenulata (Hook. f. et Thoms.) H. Ohba. In this study, we aimed to identify the effects of LHT on UC and explore its potential mechanism.MethodsLHT was analyzed using a mass spectrometer (MS). DSS at a dose of 2.5% was utilized to develop UC in mice. The administered groups received low, medium, and high dosages (0.32 g/kg, 0.64 g/kg, and 1.28 g/kg) of LHT and the positive medication, sulfasalazine (0.2 g/kg), respectively. Body weight, disease activity index (DAI) score, colon length, spleen index, serum myeloperoxidase (MPO), nitric oxide (NO), superoxide dismutase (SOD) and inflammatory factor concentrations were monitored. The expression of NRF2 and HO-1 in colonic tissues was evaluated by immunohistochemistry. 16S rDNA sequencing was employed to investigate alterations in the gut microbiota of the mice, aiming to elucidate the extent of LHT’s impact.ResultsLHT may ameliorate DSS-induced colitis in mice by lowering inflammation, reducing oxidative stress, restoring the intestinal barrier, and influencing the NRF2/HO-1 pathway. Moreover, LHT treatment exhibited a regulatory effect on the gut microbiota, characterized by elevated levels of Patescibacteria, Verrucomicrobiota, Candidatus_Saccharimonas, Lactobacillus, and Ligilactobacillus levels while decreasing Oscillibacter and Colidextribacter levels. Further study indicated that MPO, NO, and inflammatory factors were positively correlated with Oscillibacter, Colidextribacter, Escherichia-Shigella, Anaerostines, and negatively with Lactobacillus, Clostridiales_unclassified, Candidatus_Saccharimonas, and Patescibacteria. Furthermore, colony network analysis revealed that Lactobacillus was negatively associated with Oscillibacter and Colidextribacter, whereas Oscillibacter was positively related to Colidextribacter.ConclusionLHT protects against DSS-induced mice by inhibiting the inflammatory response, oxidative stress, and mucosal injury. The protective role may involve regulating the NRF2/HO-1 signaling pathway and gut microbiota.

BackgroundAcute myocardial infarction (AMI) is one of the most severe cardiovascular diseases and is associated with a high risk of in-hospital mortality. However, the current deep learning models for in-hospital mortality prediction lack interpretability. ObjectiveThis study aims to establish an explainable deep learning model to provide individualized in-hospital mortality prediction and risk factor assessment for patients with AMI. MethodsIn this retrospective multicenter study, we used data for consecutive patients hospitalized with AMI from the Chongqing University Central Hospital between July 2016 and December 2022 and the Electronic Intensive Care Unit Collaborative Research Database. These patients were randomly divided into training (7668/10,955, 70%) and internal test (3287/10,955, 30%) data sets. In addition, data of patients with AMI from the Medical Information Mart for Intensive Care database were used for external validation. Deep learning models were used to predict in-hospital mortality in patients with AMI, and they were compared with linear and tree-based models. The Shapley Additive Explanations method was used to explain the model with the highest area under the receiver operating characteristic curve in both the internal test and external validation data sets to quantify and visualize the features that drive predictions. ResultsA total of 10,955 patients with AMI who were admitted to Chongqing University Central Hospital or included in the Electronic Intensive Care Unit Collaborative Research Database were randomly divided into a training data set of 7668 (70%) patients and an internal test data set of 3287 (30%) patients. A total of 9355 patients from the Medical Information Mart for Intensive Care database were included for independent external validation. In-hospital mortality occurred in 8.74% (670/7668), 8.73% (287/3287), and 9.12% (853/9355) of the patients in the training, internal test, and external validation cohorts, respectively. The Self-Attention and Intersample Attention Transformer model performed best in both the internal test data set and the external validation data set among the 9 prediction models, with the highest area under the receiver operating characteristic curve of 0.86 (95% CI 0.84-0.88) and 0.85 (95% CI 0.84-0.87), respectively. Older age, high heart rate, and low body temperature were the 3 most important predictors of increased mortality, according to the explanations of the Self-Attention and Intersample Attention Transformer model. ConclusionsThe explainable deep learning model that we developed could provide estimates of mortality and visual contribution of the features to the prediction for a patient with AMI. The explanations suggested that older age, unstable vital signs, and metabolic disorders may increase the risk of mortality in patients with AMI.

Abstract Infection by Helicobacter pylori, a prevalent global pathogen, currently requires antibiotic-based treatments, which often lead to antimicrobial resistance and gut microbiota dysbiosis. Here, we develop a non-antibiotic approach using sonodynamic therapy mediated by a lecithin bilayer-coated poly(lactic-co-glycolic) nanoparticle preloaded with verteporfin, Ver-PLGA@Lecithin, in conjunction with localized ultrasound exposure of a dosage permissible for ultrasound medical devices. This study reveals dual functionality of Ver-PLGA@Lecithin. It effectively neutralizes vacuolating cytotoxin A, a key virulence factor secreted by H. pylori, even in the absence of ultrasound. When coupled with ultrasound exposure, it inactivates H. pylori by generating reactive oxygen species, offering a potential solution to overcome antimicrobial resistance. In female mouse models bearing H. pylori infection, this sonodynamic therapy performs comparably to the standard triple therapy in reducing gastric infection. Significantly, unlike the antibiotic treatments, the sonodynamic therapy does not negatively disrupt gut microbiota, with the only major impact being upregulation of Lactobacillus, which is a bacterium widely used in yogurt products and probiotics. This study presents a promising alternative to the current antibiotic-based therapies for H. pylori infection, offering a reduced risk of antimicrobial resistance and minimal disturbance to the gut microbiota.

This is an essay in the field of mineral processing engineering. Through micro-flotation experiment, contact Angle test, Zeta potential test, Adsorption measurements and infrared spectrum analysis, the effects of alendronate sodium on the flotation behavior of fluorite and calcite were studied, and the adsorption mechanism of alendronate sodium on the surface of two kinds of minerals was investigated. Micro-flotation experiment results show that when only sodium oleate is added, fluorite and calcite have good floatability in the pH range of 7~12 and are difficult to separate. The floatability of fluorite and calcite is different when sodium alendronate is added, and the flotation separation of fluorite and calcite can be realized. The results of contact Angle test, Zeta potential test, adsorption capacity test and infrared spectrum analysis showed that the adsorption amount of sodium alendronate on fluorite surface was less, which had little effect on its surface wettability, while the adsorption amount on calcite surface was larger, which had a greater effect on its surface wettability. Two phosphate groups in sodium alendronate bind with calcium atoms on the surface of calcite, which hindered the adsorption of oleic acid molecules on the surface of calcite, thus inhibiting the calcite.