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Objective To explore the risk factors for platelet transfusion refractoriness(PTR)in patients with hematological disorders, construct a prediction model and validate the model efficacy. Methods Patients with hematological disorders who received platelet transfusion therapy in the Chengdu Second People′s Hospital from December 2021 to December 2022 were retrospectively included to judge the effectiveness of platelet transfusion and screened for risk factors by univariate and multivariate logistic regression. A prediction model for PTR was constructed using receiver operating characteristic(ROC) curve, calibration curve and decision curve(DCA) to assess the differentiation, calibration and clinical value of the model, respectively. Results A total of 334 hematological patients were included, including 168 males and 176 females, with a PTR incidence of 40.4%. Univariate and multivariate logistic regression analysis showed that platelet transfusion volume, erythrocyte transfusion volume, and neutrophil ratio were risk factors for PTR(P

Abstract Recent observational studies suggest that gut microorganisms are involved in the onset and development of coronavirus disease 2019 (COVID-19), but the potential causal relationship behind them remains unclear. Exposure data were derived from the MiBioGen consortium, encompassing 211 gut microbiota (n = 18,340). The outcome data were sourced from the COVID-19 host genetics initiative (round 7), including COVID-19 severity (n = 1,086,211), hospitalization (n = 2,095,324), and susceptibility (n = 2,597,856). First, a two-sample Mendelian randomization (TSMR) was performed to investigate the causal effect between gut microbiota and COVID-19 outcomes. Second, a two-step MR was used to explore the potential mediators and underlying mechanisms. Third, several sensitivity analyses were performed to verify the robustness of the results. Five gut microbes were found to have a potential causality with COVID-19 severity, namely Betaproteobacteria (beta = 0.096, p = 0.034), Christensenellaceae (beta = -0.092, p = 0.023), Adlercreutzia (beta = 0.072, p = 0.048), Coprococcus 1 (beta = 0.089, p = 0.032), Eisenbergiella (beta = 0.064, p = 0.024). Seven gut microbes were found to have a potential causality with COVID-19 hospitalization, namely Victivallaceae (beta = 0.037, p = 0.028), Actinomyces (beta = 0.047, p = 0.046), Coprococcus 2 (beta = -0.061, p = 0.031), Dorea (beta = 0.067, p = 0.016), Peptococcus (beta = -0.035, p = 0.049), Rikenellaceae RC9 gut group (beta = 0.034, p = 0.018), and Proteobacteria (beta = -0.069, p = 0.035). Two gut microbes were found to have a potential causality with COVID-19 susceptibility, namely Holdemanella (beta = -0.024, p = 0.023) and Lachnospiraceae FCS020 group (beta = 0.026, p = 0.027). Multi-omics mediation analyses indicate that numerous plasma proteins, metabolites, and immune factors are critical mediators linking gut microbiota with COVID-19 outcomes. Sensitivity analysis suggested no significant heterogeneity or pleiotropy. These findings revealed the causal correlation and potential mechanism between gut microbiota and COVID-19 outcomes, which may improve our understanding of the gut-lung axis in the etiology and pathology of COVID-19 in the future.

Abstract Cognitive functions, including attention and working memory, have been recognized to be associated with tone processing. However, it remains unclear how these cognitive functions might modulate the process of tone merging. In Macau Cantonese, three pairs of tones are currently undergoing or have completed merging, exhibiting different rates and ranges of merging within the speech community, providing a valuable opportunity to investigate this issue. Through a perception task, a production task, and a series of cognitive function tasks, we examined differences in cognitive performances among individuals distinguishing different tone pairs and explored the correlations between various indices of tone processing and cognitive functions. The results revealed that the completed merging of the T2–T5 pair showed no significant correlation with cognitive functions in perception and production. The T3–T6 pair, with an intermediate merging speed, exhibited a significant positive correlation between cognitive functions and both their perception and production. In contrast, the T4–T6 pair, characterized by a slower merging speed, showed a correlation only in the perception modality. Our findings suggested that cognitive functions affect tones at different stages of the merging process, influencing their perception and production in distinct ways. The results provide a novel perspective on the origin of tonal variation and the relationship between perception and production.

Objective To explore the predictive value of combined thromboelastography(TEG), coagulation index and platelet parameters in evaluating the risk of thrombosis in patients with chronic venous insufficiency(CVI). Methods A total of 359 patients with CVI were enrolled in our hospital from November 2020 to March 2022, and divided into VTE group and non-VTE group according to the occurrence of venous thromboembolism (VTE).The baseline characteristics of the two groups and the value of combined TEG, coagulation index and platelet parameters in predicting the risk of VTE in patients with CVI were analyzed. The risk factors were screened by univariate logistic regression analysis, and the prediction model was constructed by multivariate logistic regression. The performance of the model was evaluated by area under the curve (AUC) and sensitivity specificity. Results Compared with the non-VTE group, the R value (3.27±0.71 vs 3.87±1.16, P

Abstract Background Chicken coccidiosis is a protozoan disease that leads to considerable economic losses in the poultry industry. Live oocyst vaccination is currently the most effective measure for the prevention of coccidiosis. However, it provides limited protection with several drawbacks, such as poor immunological protection and potential reversion to virulence. Therefore, the development of effective and safe vaccines against chicken coccidiosis is still urgently needed. Methods In this study, a novel oral vaccine against Eimeria tenella was developed by constructing a recombinant Lactobacillus plantarum (NC8) strain expressing the E. tenella RON2 protein. We administered recombinant L. plantarum orally at 3, 4 and 5 days of age and again at 17, 18 and 19 days of age. Meanwhile, each chick in the commercial vaccine group was immunized with 3 × 102 live oocysts of coccidia. A total of 5 × 104 sporulated oocysts of E. tenella were inoculated in each chicken at 30 days. Then, the immunoprotection effect was evaluated after E. tenella infection. Results The results showed that the proportion of CD4+ and CD8+ T cells, the proliferative ability of spleen lymphocytes, inflammatory cytokine levels and specific antibody titers of chicks immunized with recombinant L. plantarum were significantly increased (P

Abstract Background The oncological outcomes of fertility-sparing surgery (FSS) compared to radical surgery (RS) in patients with stage I epithelial ovarian cancer (EOC) remain a subject of debate. We evaluated the risk ratios (RRs) for outcomes in patients with stage I EOC who underwent FSS versus RS. Methods We conducted a systematic search of PubMed, Web of Science, and Embase for articles published up to November 29, 2023. Studies that did not involve surgical procedures or included pregnant patients were excluded. We calculated the RRs for disease-free survival, overall survival, and recurrence rate. The quality of the included studies was assessed using the Cochrane Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool. The meta-analysis was registered on PROSPERO (CRD42024546460). Results From the 5,529 potentially relevant articles, we identified 83 articles for initial screening and included 12 articles in the final meta-analysis, encompassing 2,906 patients with epithelial ovarian cancer. There were no significant differences between the two groups in disease-free survival (RR [95% confidence interval {CI}], 0.90 [0.51, 1.58]; P = 0.71), overall survival (RR [95% CI], 0.74 [0.53, 1.03]; P = 0.07), and recurrence rate (RR [95% CI], 1.10 [0.69, 1.76]; P = 0.68). In sensitivity analyses, the significant difference was observed only for overall survival (before exclusion: RR [95% CI], 0.74 [0.53–1.03], P = 0.07; after exclusion: RR [95% CI], 0.70 [0.50–0.99]; P = 0.04). Conclusions This is the first and only individual patient data meta-analysis comparing disease-free survival, overall survival, and recurrence rate of patients with early-stage epithelial ovarian cancer undergoing FSS and RS. FSS was associated with similar disease-free survival and risk of recurrence as RS. We hypothesized that the decreased overall survival in the FSS group could not be attributed to distant metastases from epithelial ovarian cancer.

Abstract Background Early identification of high-risk individuals with cisplatin-induced nephrotoxicity (CIN) is crucial for avoiding CIN and improving prognosis. In this study, we developed and validated a CIN prediction model based on general clinical data, laboratory indications, and genetic features of lung cancer patients before chemotherapy. Methods We retrospectively included 696 lung cancer patients using platinum chemotherapy regimens from June 2019 to June 2021 as the traing set to construct a predictive model using Absolute shrinkage and selection operator (LASSO) regression, cross validation, and Akaike’s information criterion (AIC) to select important variables. We prospectively selected 283 independent lung cancer patients from July 2021 to December 2022 as the test set to evaluate the model’s performance. Results The prediction model showed good discrimination and calibration, with AUCs of 0.9217 and 0.8288, sensitivity of 79.89% and 45.07%, specificity of 94.48% and 94.81%, in the training and test sets respectively. Clinical decision curve analysis suggested that the model has value for clinical use when the risk threshold ranges between 0.1 and 0.9. Precision-Recall (PR) curve shown in recall interval from 0.5 to 0.75: precision gradually declines with increasing Recall, up to 0.9. Conclusions Predictive models based on laboratory and demographic variables can serve as a beneficial complementary tool for identifying high-risk populations with CIN.

Background Preoperative evaluation of femoral anteversion to predict postoperative stem anteversion aids the selection of an appropriate prosthesis and optimizes the combined anteversion in total hip arthroplasty (THA) for developmental dysplasia of the hip (DDH). The conventional prediction methods are based on the femoral anteversion measurement at the location of the femoral head and/or neck. However, varied differences between femoral anteversion and postoperative stem anteversion were demonstrated. This study investigated the predictive role of a new method based on the principle of sagittal three‐point fixation. Methods From January 2017 to December 2018, a total of 133 DDH hips that underwent THA were retrospectively analyzed. There were 76 Crowe type I, 27 type II, and 30 type III hips. The single‐wedge stem was used in 49 hips, and the double‐wedge stem was used in 84 hips. Preoperative native femoral anteversion at the femoral head–neck junction, anterior cortex anteversion at 2 levels of the lesser trochanter, posterior cortex anteversion at 5 levels of the femoral neck, and postoperative stem anteversion were measured using two‐dimensional computed tomography. Predictive anteversion by the new method was calculated as the average anteversion formed by the anterior cortex at the lesser trochanter and the posterior cortex at the femoral neck. Results For hips with different neck heights, different Crowe types, different stem types, or different femoral anteversions, native femoral anteversion showed widely varied differences and correlations with stem anteversion, with differences ranging from −1.27 ± 8.33° to −13.67 ± 9.47° and correlations ranging from 0.122 (p = 0.705, no correlation) to 0.813. Predictive anteversion formed by the anterior cortex at the lesser trochanter proximal base and posterior cortex 10 mm above the lesser trochanter proximal base showed no significant difference with stem anteversion, with less varied differences (0.92 ± 7.52°) and good to excellent correlations (r = 0.826). Conclusion Adopting our new method, predictive anteversion, measured as the average anteversion of the anterior cortex at the lesser trochanter proximal base and posterior cortex 10 mm above the lesser trochanter proximal base, predicted postoperative stem anteversion more reliably than native femoral anteversion.

The application of platelet-rich plasma (PRP) in wound repair is progressively garnering attention. However, certain patients, owing to relative or absolute contraindications, encounter impediments in the acquisition or application of autologous PRP. The utilization of homologous allogeneic PRP, sourced through rigorous donor selection and standardized preparation methodologies, as a substitute for autologous PRP, may hold favorable implications for such individuals. This article endeavors to succinctly delineate and forecast the mechanisms, advantages, limitations, efficacy and safety of allogeneic PRP in the context of wound healing, furnishing a foundation for its implementation in wound repair.

Abstract Background Epidemiological evidence links a close correlation between long-term exposure to air pollutants and autoimmune diseases, while the causality remained unknown. Methods Two-sample Mendelian randomization (TSMR) was used to investigate the role of PM10, PM2.5, NO2, and NOX (N = 423,796–456,380) in 15 autoimmune diseases (N = 14,890–314,995) using data from large European GWASs including UKB, FINNGEN, IMSGC, and IPSCSG. Multivariable Mendelian randomization (MVMR) was conducted to investigate the direct effect of each air pollutant and the mediating role of common factors, including body mass index (BMI), alcohol consumption, smoking status, and household income. Transcriptome-wide association studies (TWAS), two-step MR, and colocalization analyses were performed to explore underlying mechanisms between air pollution and autoimmune diseases. Results In TSMR, after correction of multiple testing, hypothyroidism was causally associated with higher exposure to NO2 [odds ratio (OR): 1.37, p = 9.08 × 10–4] and NOX [OR: 1.34, p = 2.86 × 10–3], ulcerative colitis (UC) was causally associated with higher exposure to NOX [OR: 2.24, p = 1.23 × 10–2] and PM2.5 [OR: 2.60, p = 5.96 × 10–3], rheumatoid arthritis was causally associated with higher exposure to NOX [OR: 1.72, p = 1.50 × 10–2], systemic lupus erythematosus was causally associated with higher exposure to NOX [OR: 4.92, p = 6.89 × 10–3], celiac disease was causally associated with lower exposure to NOX [OR: 0.14, p = 6.74 × 10–4] and PM2.5 [OR: 0.17, p = 3.18 × 10–3]. The risky effects of PM2.5 on UC remained significant in MVMR analyses after adjusting for other air pollutants. MVMR revealed several common mediators between air pollutants and autoimmune diseases. Transcriptional analysis identified specific gene transcripts and pathways interconnecting air pollutants and autoimmune diseases. Two-step MR revealed that POR, HSPA1B, and BRD2 might mediate from air pollutants to autoimmune diseases. POR pQTL (rs59882870, PPH4=1.00) strongly colocalized with autoimmune diseases. Conclusion This research underscores the necessity of rigorous air pollutant surveillance within public health studies to curb the prevalence of autoimmune diseases. Graphical abstract (Built by the Biorender)

Highlights The boosted heterogeneous interfaces in titanium nitride (TiN) nanotube/polydimethylsiloxane (PDMS) composite contributed to strong polarization loss relaxation ability. The TiN nanotubes/PDMS composite possessed both good impedance matching behavior and strong dielectric loss ability in wide temperature spectrum. The TiN nanotubes/PDMS composite exhibited excellent EMWA performances (effective absorption bandwidth value of 3.23 GHz and minimum reflection loss value of − 44.15 dB) at the varied temperature from 298 to 573 K.

Background: The increasing prevalence of kidney diseases has become a significant public health issue, with a global prevalence exceeding 10%. In order to accurately identify biochemical changes and treatment outcomes associated with kidney diseases, novel methods targeting specific genes have been discovered. Among these genes, leucine-rich α-2 glycoprotein 1 (LRG1) has been identified to function as a multifunctional pathogenic signaling molecule in multiple diseases, including kidney diseases. This study aims to provide a comprehensive overview of the current evidence regarding the roles of LRG1 in different types of kidney diseases. Summary: Based on a comprehensive review, it was found that LRG1 was upregulated in the urine, serum, or renal tissues of patients or experimental animal models with multiple kidney diseases, such as diabetic nephropathy, kidney injury, IgA nephropathy, chronic kidney diseases, clear cell renal cell carcinoma, end-stage renal disease, canine leishmaniosis-induced kidney disease, kidney fibrosis, and aristolochic acid nephropathy. Mechanistically, the role of LRG1 in kidney diseases is believed to be detrimental, potentially through its regulation of various genes and signaling cascades, i.e., fibronectin 1, GPR56, vascular endothelial growth factor (VEGF), VEGFR-2, death receptor 5, GDF15, HIF-1α, SPP1, activin receptor-like kinase 1-Smad1/5/8, NLRP3-IL-1b, and transforming growth factor β pathway. Key Messages: Further research is needed to fully comprehend the molecular mechanisms by which LRG1 contributes to the pathogenesis and pathophysiology of kidney diseases. It is anticipated that targeted treatments focusing on LRG1 will be utilized in clinical trials and implemented in clinical practice in the future.

BackgroundThe prognostic significance of Treg and Th17 cells, as well as their ratio (Th17/Treg), in cervical cancer remains a topic of debate. Our study aimed to clarify their association with patient survival and clinical outcomes in cervical cancer through a comprehensive meta-analysis.Materials and methodsWe conducted a comprehensive search in PubMed, Embase, and Web of Science to identify eligible studies. Studies related to cervical cancer and involving Treg cells or Th17 cells were included. For prognostic analysis, we collected Hazard Ratio values of patient survival. For studies focusing on clinical characteristics, we selected mean and standard deviation values for further analysis. This study was registered at PROSPERO (ID:CRD42024546507).ResultsOut of the 2949 records initially retrieved, we ultimately included 21 studies in our analysis. High levels of Treg cells were found to be correlated with shorter survival in patients with cervical cancer. Subgroup analysis revealed that the prognostic effect of Treg cells on cervical cancer was not influenced by their source or definition. However, analyses of different survival measures indicated that only Overall Survival showed a correlation with Treg cell levels. Additionally, Treg cells were associated with clinical staging. High-grade Th17 cells were associated with lymphatic metastases and advanced clinical stage. The Th17/Treg ratio was found to be elevated in both cervical intraepithelial neoplasia and cervical cancer patients compared to controls.DiscussionDespite limitations such as heterogeneity among selected studies and inadequate subgroup analyses, our study contributes to a deeper understanding of the significance of Treg cells in the onset and progression of cervical cancer. It also provides valuable insights for future research in immunotherapy.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024546507.

BackgroundCerebral radiation necrosis (RN), a severe complication of stereotactic radiotherapy (SRT), has been shown to significantly decrease patient survival time and quality of life. The purpose of this study was to analyze whether bevacizumab can prevent or reduce the occurrence of SRT-induced cerebral RN in non-small cell lung cancer (NSCLC) patients with brain metastases.Materials and methodsWe retrospectively reviewed the clinical records of NSCLC patients with brain metastases from March 2013 to June 2023 who were treated with SRT. Patients were divided into two groups: those in the bevacizumab group received SRT with four cycles of bevacizumab, and patients in the control group received SRT only. Inverse probability of treatment weighting (IPTW) was performed based on a multinomial propensity score model to balance the baseline characteristics. The chi-square test was used. A Cox model was used to evaluate overall survival (OS).ResultsA total of 80 patients were enrolled, namely, 28 patients in the bevacizumab group and 52 patients in the control group. The possibility of developing cerebral RN and/or symptomatic edema (RN/SE) was significantly decreased in patients treated with bevacizumab compared to those who did not receive bevacizumab before IPTW (p=0.036) and after IPTW (p=0.015) according to chi-square analysis. The IPTW-adjusted median OS was 47.7 months (95% CI 27.4-80.8) for patients in the bevacizumab group and 44.1 months (95% CI 36.7-68.0) (p=0.364) for patients in the control group.ConclusionThe application of bevacizumab concurrent with SRT may prevent or reduce the occurrence of cerebral RN in NSCLC patients with brain metastases.

IntroductionThis investigation leverages advanced machine learning (ML) techniques to dissect the complex relationship between heavy metal exposure and its impacts on osteoarthritis (OA) and rheumatoid arthritis (RA). Utilizing a comprehensive dataset from the National Health and Nutrition Examination Survey (NHANES) spanning from 2003 to 2020, this study aims to elucidate the roles specific heavy metals play in the incidence and differentiation of OA and RA.MethodsEmploying a phased ML strategy that encompasses a range of methodologies, including LASSO regression and SHapley Additive exPlanations (SHAP), our analytical framework integrates demographic, laboratory, and questionnaire data. Thirteen distinct ML models were applied across seven methodologies to enhance the predictability and interpretability of clinical outcomes. Each phase of model development was meticulously designed to progressively refine the algorithm’s performance.ResultsThe results reveal significant associations between certain heavy metals and an increased risk of arthritis. The phased ML approach enabled the precise identification of key predictors and their contributions to disease outcomes.DiscussionThese findings offer new insights into potential pathways for early detection, prevention, and management strategies for arthritis associated with environmental exposures. By improving the interpretability of ML models, this research provides a potent tool for clinicians and researchers, facilitating a deeper understanding of the environmental determinants of arthritis.

Abstract Background Definitive concurrent chemoradiotherapy (dCCRT) is the gold standard for the treatment of locally advanced esophageal squamous cell carcinoma (ESCC). However, the potential benefits of consolidation chemotherapy after dCCRT in patients with esophageal cancer remain debatable. Prospective randomized controlled trials comparing the outcomes of dCCRT with or without consolidation chemotherapy in patients with ESCC are lacking. In this study, we aim to generate evidence regarding consolidation chemotherapy efficacy in patients with locally advanced, inoperable ESCC. Methods This is a multicenter, prospective, open-label, phase-III randomized controlled trial comparing non-inferiority of dCCRT alone to consolidation chemotherapy following dCCRT. In total, 600 patients will be enrolled and randomly assigned in a 1:1 ratio to receive either consolidation chemotherapy after dCCRT (Arm A) or dCCRT alone (Arm B). Overall survival will be the primary endpoint, whereas progression-free survival, locoregional progression-free survival, distant metastasis-free survival, and treatment-related toxicity will be the secondary endpoints. Discussion This study aid in further understanding the effects of consolidation chemotherapy after dCCRT in patients with locally advanced, inoperable ESCC. Trial registration ChiCTR1800017646.

The fried food in fast food is deeply loved by consumers. However, with the increasing concern about the safety of volatile methylsiloxanes, the residue of oligomer monomer of methylsiloxanes from defoamer PDMS in fried food needs to be studied urgently. In this study, an efficient and sensitive method for the determination of methylsiloxane oligomers in fried chicken and French fries was established using QuEChERS-gas chromatography-tandem mass spectrometry (GC-MS/MS). A total of 33 fried chickens and 30 French fries purchased from fast food restaurants were analyzed and a preliminary exposure assessment using a point assessment method was carried out. The results showed that octamethyl cyclotetrasiloxane (D4)~hexamethyldisiloxane (D18) and decamethyl tetrasiloxane (L4)~triaconta methyltetradecasiloxane (L14) were detected, and the median total content of methylsiloxane oligomers in fried chicken (514.61 ng·g−1) was higher than that in French fries (83.4 ng·g−1). The estimated daily intake (EDI) of methylsiloxanes (molecular weight

This paper proposes a novel dual-vector model predictive control (DV-MPC) method applied to modular multilevel converter(MMC). The traditional predictive control method generally aims to minimize the output current tracking error at the next sampling instant, while the proposed method minimizes the total harmonic distortion (THD) of the output current by quantifying the relationship between the THD and the output current trajectory within the next sampling period. The control of the circulating current is achieved by selecting proper total number of inserted submodules (SMs) in the upper and lower arms. By selecting appropriate SMs to insert or bypass, the voltage balance between submodules within the arm is fulfilled. This method accomplishes multiple control objectives without the need for cumbersome weighting factor design. At the same time, the adopted preselection method and total number of SMs selection method effectively reduce the calculation burden. Simulation and experimental results verify the superiority of the proposed method.

The mechanical properties of basalt fiber-reinforced polymer (BFRP) concrete structures in corrosive environments are largely dependent on the bonding performance between the BFRP reinforcement and concrete. An accurate and convenient method for calculating the bonding strength is crucial for engineering design. However, experimental methods and existing empirical models are insufficient to encompass the intricate interdependencies among the bonding factors. This study proposed a machine learning (ML)-based bonding strength prediction method, which utilizes random forests (RF) and adaptive boosting (AdaBoost) algorithms to predict the interfacial bond strength of BFRP reinforcement in corroded concrete. The model was trained on a dataset of 355 samples, effectively quantifying the relationships between the BFRP reinforcement parameters, concrete parameters, corrosion factors, and bonding strength. The performance of the two algorithms was evaluated using R2, RMSE, and MAE indicators, and the prediction results were explained using the SHAP method. The results show that the predicted results of the machine learning model are highly consistent with the experimental results, with the AdaBoost model achieving an R2 of 0.925 on the test set, demonstrating high predictive performance. Among the various factors, the corrosion factor has the most significant impact on bonding strength, followed by concrete compressive strength and BFRP bar yield strength. Ultimately, the model was juxtaposed against traditional empirical formulas, affirming its efficacy and dependability. The research presents a novel approach to predicting bond strength in corroded BFRP bar-concrete systems.

Introdução: A pandemia teve um impacto amplo e duradouro na comunidade de Macau, o que motivou muitos académicos a explorar esses efeitos sob diversas perspetivas. Na nossa visão, teria um significado especial conduzir um estudo sob a perspetiva da paisagem linguística. Objetivo: Investigar como a pandemia de COVID-19 tem tido impacto na paisagem linguística de Macau. Métodos: A nossa investigação foi essencialmente um estudo quantitativo por meio de uma análise comparativa de dados específicos recolhidos antes e durante a pandemia. Resultados: Os resultados mostraram que a diversidade linguística em Macau se mantinha, em paralelo ao aumento da predominância da língua materna chinesa da maioria dos habitantes. As organizações e instituições não governamentais foram menos afetadas pela política linguística na disseminação de mensagens relacionadas com a pandemia. Conclusão: A paisagem linguística de Macau transformou-se concomitantemente com as mudanças provocadas pela pandemia, nomeadamente na estrutura demográfica da comunidade local.

This study proposes a novel colorimetric method based on the ultraviolet/visible spectrophotometry-colorimetric method (UV/Vis-CM) for detecting and quantifying total triterpenoids in traditional Chinese medicine. By incorporating the colourants 2-hydroxy-5-methylbenzaldehyde and concentrated sulfuric acid, triterpenoid compounds colour development became more sensitive, and the detection accuracy was significantly improved. 2-hydroxy-5-methylbenzaldehyde and concentrated sulfuric acid were incorporated in a 1:3 vol ratio at room temperature to react with the total triterpenes for 25 min, incorporated to an ice bath for 5 min, and then detected at the optimal absorption wavelength. The accuracy and reliability of this method were verified by comparison with high-performance liquid chromatography and four other colorimetric methods. Additionally, this approach has the advantages of not requiring heating during operation, high sensitivity, short usage time, low solvent usage, and low equipment costs. This study not only offers a reliable method for detecting total triterpenes in traditional Chinese medicine but also offers a rapid detection tool for on-site testing and large-scale screening, laying a foundation for the modernization of traditional Chinese medicine research, quality control, and drug development.

Periprosthetic osteolysis (PPO) is the most common cause of joint arthroplasty failure. Its progression involves both biological and mechanical factors. Osteoclastogenesis induced by wear from debris-cell interactions, ultimately leading to excessive bone erosion, is considered the primary cause of PPO; therefore, targeting osteoclasts is a promising treatment approach. Currently available drugs have various side effects and limitations. Artemisinic acid (ArA) is a sesquiterpene isolated from the traditional herb Artemisia annua L. that has various pharmacological effects, such as antimalarial, anti-inflammatory, and antioxidant activities. Therefore, this study was aimed at investigating the effect of ArA on osteoclast formation and bone resorption function in vitro, as well as wear particle-induced osteolysis in vivo, and to explore its molecular mechanism of action. Here, we report that ArA inhibits RANKL-stimulated osteoclast formation and function. Mechanistically, ArA suppresses intracellular reactive oxygen species levels by activating the antioxidant response via nuclear factor erythroid-2-related factor 2 (Nrf2) pathway upregulation. It also inhibits the mitogen-activated kinases (MAPK) and nuclear factor-κB (NF-κB) pathways, as well as the transcription and expression of NFATc1 and c-Fos. In vivo experiments demonstrated that ArA reduces osteoclast formation and alleviates titanium particle-induced calvarial osteolysis. Collectively, our study highlights that ArA, with its osteoprotective and antioxidant effects, is a promising therapeutic agent for preventing and treating PPO and other osteoclast-mediated osteolytic diseases.

Abstract Background Nickel-Titanium shape-memory sawtooth-arm embracing clamps (SSECs) have been used in revision total hip arthroplasties (rTHAs) to protect stem stability. This study was to introduce this technique and report its mid to long-term clinical and radiographic outcomes. Methods We retrospectively reviewed all patients implanted with SSECs in our department from January 2008 to December 2015. 41 patients (41 hips) were finally included. Radiographs and Harris hip scores (HHS) were collected. Radiographs were blindly analyzed for evidence of loosening, subsidence and stress shielding. HHS were compared to previous records by student’s t tests. The average follow-up period was 9.3 years. Results All stems were stably fixed with no signs of loosening. The mean stem subsidence was 0.9 mm (range, 0 to 3 mm). Only one patient (2.4%) demonstrated the fourth degree of stress shielding, with the others none or minor bone resorption. The mean HHS at the final follow-up was 84.2 (range, 81 to 91), which was improved from 17.4 (range, 0 to 37) before surgery. No implant failures or re-revisions occurred. Dislocation occurred in 1 case during the follow-up period. Conclusions The SSEC protected stem fixation and achieved favorable clinical and radiographic outcomes in this 9-year follow-up study. It offered an additional extramedullary fixation option for surgeons to choose from in treating complex femoral revision arthroplasties.

Background: Total joint arthroplasty (TJA) is an orthopedic procedure commonly used to treat damaged joints. Despite the efficacy of TJA, postoperative complications, including aseptic prosthesis loosening and infections, are common. Moreover, the effects of individual genetic susceptibility and modifiable risk factors on these complications are unclear. This study analyzed these effects to enhance patient prognosis and postoperative management. Methods: We conducted an extensive genome-wide association study (GWAS) and Mendelian randomization (MR) study using UK Biobank data. The cohort included 2964 patients with mechanical complications post-TJA, 957 with periprosthetic joint infection (PJI), and a control group of 398,708 individuals. Genetic loci associated with postoperative complications were identified by a GWAS analysis, and the causal relationships of 11 modifiable risk factors with complications were assessed using MR. Results: The GWAS analysis identified nine loci associated with post-TJA complications. Two loci near the PPP1R3B and RBM26 genes were significantly linked to mechanical complications and PJI, respectively. The MR analysis demonstrated that body mass index was positively associated with the risk of mechanical complications (odds ratio [OR]: 1.42; p < 0.001). Higher educational attainment was associated with a decreased risk of mechanical complications (OR: 0.55; p < 0.001) and PJI (OR: 0.43; p = 0.001). Type 2 diabetes was suggestively associated with mechanical complications (OR, 1.18, p = 0.02), and hypertension was suggestively associated with PJI (OR, 1.41, p = 0.008). Other lifestyle factors, including smoking and alcohol consumption, were not causally related to postoperative complications. Conclusions: The genetic loci near PPP1R3B and RBM26 influenced the risk of post-TJA mechanical complications and infections, respectively. The effects of genetic and modifiable risk factors, including body mass index and educational attainment, underscore the need to perform personalized preoperative assessments and the postoperative management of surgical patients. These results indicate that integrating genetic screening and lifestyle interventions into patient care can improve the outcomes of TJA and patient quality of life.

The precise recognition of entire classroom meta-actions is a crucial challenge for the tailored adaptive interpretation of student behavior, given the intricacy of these actions. This paper proposes a Dynamic Position Embedding-based Model for Student Classroom Complete Meta-Action Recognition (DPE-SAR) based on the Video Swin Transformer. The model utilizes a dynamic positional embedding technique to perform conditional positional encoding. Additionally, it incorporates a deep convolutional network to improve the parsing ability of the spatial structure of meta-actions. The full attention mechanism of ViT3D is used to extract the potential spatial features of actions and capture the global spatial–temporal information of meta-actions. The proposed model exhibits exceptional performance compared to baseline models in action recognition as observed in evaluations on public datasets and smart classroom meta-action recognition datasets. The experimental results confirm the superiority of the model in meta-action recognition.

Introduction: Ischemic stroke is the second most common chronic disease worldwide and is associated with high morbidity and mortality. Thromboembolism and platelet aggregation are the most characteristic features of stroke. Other than aspirin, no standard, accepted, or effective treatment for acute ischemic stroke has been established. Consequently, it is essential to identify novel therapeutic compounds for this condition.Methods: In this study, novel ozagrel/paeonol-containing codrugs were synthesized and characterized using 1H-NMR, 13C-NMR, and mass spectroscopy. Their antiplatelet aggregation activity was evaluated, with compound PNC3 found to exhibit the best effect. Subsequently, studies were conducted to assess its neuroprotective effect, pharmacokinetic properties and model its binding mode to P2Y12 and TXA2, two proteins critical for platelet aggregation.Results: The results indicated that PNC3 has good bioavailability and exerts protective effects against oxygen-glucose deprivation injury in PC12 cells. Molecular docking analysis further demonstrated that the compound interacts with residues located in the active binding sites of the target proteins.Conclusion: The codrugs synthesized in this study display promising pharmacological activities and have the potential for development as an oral formulation.

Abstract A series of carbon nitride (CN) materials represented by graphitic carbon nitride (g‐C3N4) have been widely used in bioimaging, biosensing, and other fields in recent years due to their nontoxicity, low cost, and high luminescent quantum efficiency. What is more attractive is that the luminescent properties such as wavelength and intensity can be regulated by controlling the structure at the molecular level. Hence, it is time to summarize the related research on CN structural evolution and make a prospect on future developments. In this review, we first summarize the research history and multiple structural evolution of CN. Then, the progress of improving the luminescence performance of CN through structural evolution was discussed. Significantly, the relationship between CN structure evolution and energy conversion in the forms of photoluminescence, chemiluminescence, and electrochemiluminescence was reviewed. Finally, key challenges and opportunities such as nanoscale dispersion strategy, luminous efficiency improving methods, standardization evaluation, and macroscopic preparation of CN are highlighted.

Microorganisms are important members of seagrass bed ecosystems and play a crucial role in maintaining the health of seagrasses and the ecological functions of the ecosystem. In this study, we systematically quantified the assembly processes of microbial communities in fragmented seagrass beds and examined their correlation with environmental factors. Concurrently, we explored the relative contributions of species replacement and richness differences to the taxonomic and functional β-diversity of microbial communities, investigated the potential interrelation between these components, and assessed the explanatory power of environmental factors. The results suggest that stochastic processes dominate community assembly. Taxonomic β-diversity differences are governed by species replacement, while for functional β-diversity, the contribution of richness differences slightly outweighs that of replacement processes. A weak but significant correlation (p < 0.05) exists between the two components of β-diversity in taxonomy and functionality, with almost no observed significant correlation with environmental factors. This implies significant differences in taxonomy, but functional convergence and redundancy within microbial communities. Environmental factors are insufficient to explain the β-diversity differences. In conclusion, the assembly of microbial communities in fragmented seagrass beds is governed by stochastic processes. The patterns of taxonomic and functional β-diversity provide new insights and evidence for a better understanding of these stochastic assembly rules. This has important implications for the conservation and management of fragmented seagrass beds.

Source and mask optimization is a critical technique for further resolution enhancement in immersion lithography systems, wherein the optimal illumination source shape is widely generated by the micromirror array. Accordingly, the accurate achievement of the allocated angles of micromirrors is a key prerequisite for the implementation of arbitrary illumination patterns. In this paper, we propose an angle monitor to ensure the high-precision tilting of thousands of biaxial micromirrors. As one of the critical modules for closed-loop control of the two-dimensional micromirror array, the online monitor feeds the monitored high-precision tilt angle back to the processing system. The angle monitor mainly consists of the spot scanning module and the angle detection module. Among them, an f-θ lens and a Fourier transform lens with satisfied performances are designed and evaluated by CODE V. Furthermore, a galvanometer and the designed f-θ lens are adopted for the generation of the spot array irradiated on the electrostatic actuated mirrors. Meanwhile, the designed Fourier transform lenses are employed to detect the corresponding tilt angles. In addition, the performance of the proposed system is identified by simulations and experiments individually. It is demonstrated that the monitorable biaxial tilt range of the system is (−2.5°, +2.5°) with a repeatability of better than 0.005°. The large-format micromirror array can be monitored completely without optical cross-talk. Through the device, a 16 × 16 micromirror array is monitored, where the initial angle with no bias voltage applied is captured and the voltage–angle relation for individual micromirrors is obtained. In general, the proposed system can be utilized in the illumination system, providing an efficient and reliable method for complex source shape generation.

Objective To explore the effectiveness of PDCA (Plan-Do-Check-Act Cycle Management) in clinical emergency blood management. Methods The data of emergency blood-using cases from January 2021 to June 2022 in each clinical department of our hospital were collected to observe the blood matching time, blood retrieving time, and emergency bloodusing rate. They were divided into PDCA experimental group (Experimental group, July to December 2021, n=287), pre-PDCA experimental group (Control group 1, January to June 2021, n=516) and post-PDCA experimental cessation group (Control group 2, January to June 2022, n=277). Subgroup analysis was performed according to different departments, which were Internal Medicine Department, Surgery Depatment, and ICU. The situation of non-emergency blood use occupying emergency lanes in the pre-implementation period was continuously improved using PDCA, and the differences in blood matching time, blood retrieving time, and emergency blood-using rate among the three groups were compared and analyzed by Kruskal-Wallis test and chi-square test. Results The blood matching time and blood retrieving time (M, min) in the experimental group, control group 1 and control group 2 were 19.00 vs 45.50 vs 23.00 and 22.00 vs 44.00 vs 25.00, respectively (P< 0.05), and were 19.00 vs 47.00 vs 24.00 and 23.00 vs 56.00 vs 30. 50 in Internal Medicine Department, 18.00 vs 57.50 vs 14.00 and 32.00 vs 41.00 vs 24.00 in Surgery Department, 20.00 vs 42.00 vs 23.00 and 16.50 vs 34.00 vs 12.50 in ICU (P

This article presents a vibration model of neighboring rolling parts that takes into account non-smooth symmetric collisions. This model was used to examine the motion state of the rolling element and the collision force between nearby rolling elements. It also determined the motion posture and overall collision form of the rolling element after setting the functional slot. Afterwards, the level of disorderly movement and the structure of the moving object were examined and confirmed through the use of a phase diagram of the motion system in relation to zero symmetry, the Lyapunov exponent, and a platform for measuring irregular vibrations in the bearing. This work aims to clarify the factors that contribute to the persistent chaotic state of rolling elements in bearing vibration.

Abstract Background Medial meniscal posterior root tear (MMPRTs) is a common lesion of the knee joint, and repair surgery is a well-established treatment option. However, patients with obvious varus alignment are at an increased risk for MMPRT and can suffer from a greater degree of medial meniscus extrusion, which leads to the development of osteoarthritis following repair. The efficacy of high tibial osteotomy (HTO) as a means of correcting this malformation, and its potential benefits for MMPRT repair, remains unclear. Purpose To explore whether HTO influenced the outcome of MMPRT repair in clinical scores and radiological findings. Study design Systematic review. Methods According to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines, we searched PubMed, Embase, Web of Science, and the Cochrane Library databases for studies reporting the outcomes of MMPRT repair and extracted data about characteristics of patients, clinical functional scores and radiologic outcomes. One reviewer extracted the data and 2 reviewers assessed the risk of bias and performed a synthesis of the evidence. Articles were eligible if they reported the results of MMPRT repair with exact mechanical axis (registered in the International Prospective Register of Systematic Reviews, CRD42021292057). Results Fifteen studies with 625 cases of high methodological quality were identified. Eleven studies were assigned to the MMPRT repair group (M) with 478 cases performing MMPRT repair only, and others belonged to the MMPRT repair and HTO group (M and T) performing HTO and MMPRT repair. Most of the studies had significantly improved clinical outcome scores, especially in M groups. And the radiologic outcomes showed that the osteoarthritis deteriorated in both groups with similar degree in about 2-year follow-up. Conclusion HTO is a useful supplement in treating MMPRT patients with severe osteoarthritis and the clinical and radiological outcomes were similar with MMPRT repair alone. Which would be better for patients’ prognosis generally, performing MMPRT repair alone or a combination of HTO and MMPRT repair, was still controversial. We suggested taking K-L grade into account. Large-scale randomized control studies were called for in the future to help make better clinical decisions. Level of evidence III

Abstract Background Despite receiving orthokeratology (ortho-k), the efficacy of retarding ocular elongation during myopia varies among myopic children. The current study aimed to investigate the early changes of choroidal vasculature at one month after ortho-k treatment and its association with one-year ocular elongation, as well as the role of such choroidal responses in predicting the one-year control efficacy of ortho-k treatment. Methods A prospective cohort study was conducted in myopic children treated with ortho-k. Myopic children aged between 8 and 12 years who were willing to wear ortho-k lenses were recruited consecutively from the Eye Hospital of Wenzhou Medical University. Subfoveal choroidal thickness (SFCT), submacular total choroidal luminal area (LA), stromal area (SA), choroidal vascularity index (CVI), choriocapillaris flow deficit (CcFD) were evaluated by optical coherence tomography (OCT) and OCT angiography over a one-year period. Results Fifty eyes from 50 participants (24 males) who finished one-year follow-ups as scheduled were included, with a mean age of 10.31 ± 1.45 years. The one-year ocular elongation was 0.19 ± 0.17 mm. The LA (0.03 ± 0.07 mm2), SA (0.02 ± 0.05 mm2) increased proportionally after one-month of ortho-k wear (both P

Abstract Circular RNA HIPK3 (circHIPK3) mediates the progression of multiple cancers, including bladder cancer, by regulating cell migration, autophagy and epithelial mesenchymal transition. However, the mechanism by which circHIPK3 regulates autophagy in bladder cancer cells remains unclear. Autophagy is a common self-protection mechanism in eukaryotic cells and is essential for cell survival and death regulation. However, it is unclear whether circHIPK3 affects the level of autophagy in bladder cancer through binding proteins, and the potential regulatory mechanism is unknown. Here, we found that circHIPK3 levels were significantly lower and autophagy-related proteins were significantly upregulated in bladder cancer cells and tissues compared to normal controls. CircHIPK3 downregulation promoted bladder cancer cell proliferation, while circHIPK3 overexpression inhibited proliferation. CircHIPK3 overexpression significantly suppressed autophagy in bladder cancer cells. Overexpression of circHIPK3 did not affect VCP protein expression but inhibited the VCP/Beclin 1 interaction. VCP also stabilized Beclin 1 and promoted autophagy in bladder cancer cells by downregulating ataxin-3. Thus, circHIPK3 may play an important role in bladder cancer by inhibiting VCP-mediated autophagy.

Abstract An optimal meeting point query is used to determine a location in a spatial region to build a new facility that minimizes the sum of the (weighted) road distances from all clients. This problem has been studied in previous work with the assumption that all clients and facilities reside in Euclidean space or along road networks. However, due to the limitations of geographic information system technologies, it is difficult to return an exact geographic location to answer the optimal meeting point query based on a set of arbitrary coordinates. This issue results in various problems, such as positioning and measurement errors, in practical use. In this paper, it is aimed to identify the optimal meeting point in road networks for clients and facilities residing in non‐Euclidean spaces. Two efficient heuristic solutions are proposed based on approximate and adaptive query processing techniques by using randomized adaptive search and random direction search methods, respectively, to rapidly converge to the global optimum in the geographic coordinate system. Extensive experiments based on real datasets demonstrate that our proposed method achieves a 32.11% improvement over the state‐of‐the‐art approach.

Static security analysis (SSA) is a significant measure to verify the secure and stable operation of power grids. However, it is too time-consuming to perform SSA for interconnected networks due to the scale of network. Therefore, the equivalent-based method attracts attention due to simplifying the external networks (uninteresting networks). However, existing equivalent methods are not suitable for SSA, which are based on the assumption that the topology of internal networks is invariant. This paper proposes a novel static network equivalent method for SSA in interconnected networks. The proposed method can adaptively and precisely preserve the impact of external networks on topology changes of internal networks. Specifically, based on the sensitivity consistency of tie-line power, the equivalent nodal admittance matrix is derived for the external networks. The parameters for the obtained equivalent networks are obtained by least square model with Kirchhoff and necessary logistic constraints to achieve the optimal equivalence accuracy. The accuracy and practicability of proposed method are verified by using IEEE 39-bus system and IEEE 118-bus system.

Abstract The objective of this multicenter, single‐arm trial (ChiCTR1900022293) was to explore the efficacy and safety of neoadjuvant therapy with epirubicin, cyclophosphamide, and pyrotinib followed by docetaxel, trastuzumab, and pyrotinib (ECPy‐THPy) in the treatment of patients with stage II–III HER2‐positive breast cancer. The present study enrolled patients with stage II–III HER2‐positive breast cancer. Epirubicin and cyclophosphamide were administrated for four 21‐day cycles, followed by four cycles of docetaxel and trastuzumab. Pyrotinib was taken orally once per day throughout the treatment period. The primary endpoint was total pathological complete response (tpCR, ypT0/is ypN0) rate in the modified intention‐to‐treat (mITT) population. In total, 175 patients were included. The tpCR rate was 68.6% (95% CI, 60.7–75.8%), while the objective response rate was 89.1%. In the post‐hoc subgroup analysis, no association between clinical characteristics and the tpCR rate was observed. The most common grade ≥3 adverse events were diarrhea (54.3%), followed by white blood cell count decreased (5.1%), and neutrophil count decreased (4.6%). In conclusion, the neoadjuvant regimen with ECPy‐THPy showed promising pathological response and clinical benefits with an acceptable safety profile in patients with stage II–III HER2‐positive breast cancer.

IntroductionEpstein-Barr virus (EBV) infection in humans is associated with a wide range of diseases including malignancies of different origins, most prominently B cells. Several EBV latent genes are thought to act together in B cell immortalization, but a minimal set of EBV genes sufficient for transformation remains to be identified.MethodsHere, we addressed this question by transducing human peripheral B cells from EBV-negative donors with retrovirus expressing the latent EBV genes encoding Latent Membrane Protein (LMP) 1 and 2A and Epstein-Barr Nuclear Antigen (EBNA) 2.ResultsLMP1 together with EBNA2, but not LMP1 alone or in combination with LMP2A was able to transform human primary B cells. LMP1/EBNA2-immortalized cell lines shared surface markers with EBV-transformed lymphoblastoid cell lines (LCLs). They showed sustained growth for more than 60 days, albeit at a lower growth rate than EBV-transformed LCLs. LMP1/EBNA2-immortalized cell lines generated tumors when transplanted subcutaneously into severely immunodeficient NOG mice. ConclusionOur results identify a minimal set of EBV proteins sufficient for B cell transformation.

ObjectivesEpidemiological studies suggested a potential connection between education and autoimmune disorders. This study investigated the possible cause-and-effect relationship using a Mendelian randomization approach.MethodsWe explored the causality between four education traits (n = 257,841~1,131,881) and 22 autoimmune diseases. The mediating role of smoking (632,802 individuals), BMI (681,275 individuals), alcohol (335,394 individuals), and income (397,751 individuals) was also investigated. Transcriptome-wide association study (TWAS) and enriched signaling pathways analysis were used to investigate the underlying biological mechanisms.ResultsEspecially, higher cognitive performance was protective for psoriasis (odds ratio (OR) = 0.69, 95% confidence interval (CI) = 0.60-0.79, p = 6.12×10-8), rheumatoid arthritis (RA) (OR = 0.75, 95% CI = 0.67-0.83, p = 4.62×10-6), and hypothyroidism (OR = 0.83, 95% CI = 0.77-0.90, p = 9.82×10-6). Higher levels of educational attainment decreased risks of psoriasis (OR = 0.61, 95% CI = 0.52-0.72, p = 1.12×10-9), RA (OR = 0.68, 95% CI = 0.59-0.79, p = 1.56×10-7), and hypothyroidism (OR = 0.80, 95% CI = 0.72-0.88, p = 5.00×10-6). The completion of highest-level math class genetically downregulates the incidence of psoriasis (OR = 0.66, 95% CI = 0.58-0.76, p = 2.47×10-9), RA (OR = 0.71, 95% CI = 0.63-0.81, p = 5.28×10-8), and hypothyroidism (OR = 0.85, 95% CI = 0.79-0.92, p = 8.88×10-5). Higher self-reported math ability showed protective effects on Crohn’s disease (CD) (OR = 0.67, 95% CI = 0.55-0.81, p = 4.96×10-5), RA (OR = 0.76, 95% CI = 0.67-0.87, p = 5.21×10-5), and psoriasis (OR = 0.76, 95% CI = 0.65-0.88, p = 4.08×10-4). Protein modification and localization, response to arsenic-containing substances may participate in the genetic association of cognitive performance on UC, RA, psoriasis, and hypothyroidism. According to mediation analyses, BMI, smoking, and income served as significant mediators in the causal connection between educational traits and autoimmune diseases.ConclusionHigher levels of education-related factors have a protective effect on the risk of several autoimmune disorders. Reducing smoking and BMI and promoting income equality can mitigate health risks associated with low education levels.

With the continuous expansion of the lithium-ion battery market, the collection and recycling of spent lithium-ion batteries have gradually become a concern for researchers. In this research, based on the hydrometallurgical recovery process of spent lithium-ion batteries, an efficient and continuous synthesis process of industrial lithium carbonate was developed in a microreactor system. The effects of initial concentration of lithium solution, temperature and washing conditions on recovery rate of Li and product purity were investigated, and the optimal conditions of synthesis were obtained. Compared with the semi-batch method, the microreactor system had excellent mass and heat transfer characteristics. The product had good microscopic properties, uniform particle size distribution, and the recovery rate of Li reached 94.8 % with the purity of Li2CO3 reached 99.4 %, meeting the national standard of China for industrial grade lithium carbonate. The particle size distribution of the synthesized lithium carbonate was 6.2

AbstractThe presence of institutional investors in a firm’s ownership structure is often associated with improved corporate governance practices and increased focus on long-term sustainable value creation. This study investigates whether the presence of institutional investors and a strong CSR performance act as deterrents to large shareholder expropriation, which refers to the misuse of controlling power by large shareholders to extract personal benefits at the expense of minority shareholders. Empirical analysis yields several key findings. First, institutional investor site visits exhibit a significant negative association with large shareholder expropriation, implying that heightened institutional investor engagement through site visits is linked to improved corporate governance and a reduced propensity for opportunistic actions by large shareholders. Second, CSR plays a mediating role, elucidating that institutional investor engagement not only directly impacts governance but also indirectly shapes large shareholder behavior through CSR. Third, institutional ownership moderates the site visits-expropriation relationship, underscoring the significance of ownership structure in governance dynamics. This study contributes to the existing literature by offering empirical evidence of how institutional investor engagement, mediated by CSR, can curtail large shareholder expropriation. These findings expand comprehension of the mechanisms through which institutional investors bolster governance and emphasize the need to consider ownership structure when analyzing governance dynamics. The implications of this study are multifaceted. Firms can enhance corporate governance by fostering engagement with institutional investors, leading to improved CSR practices and reduced risks of large shareholder expropriation. Policymakers should recognize the importance of institutional ownership and investor involvement when crafting governance regulations, as these elements strengthen governance mechanisms.

ObjectiveObservational evidence reported that air pollution is a significant risk element for numerous health problems, such as obesity and coronavirus disease 2019 (COVID-19), but their causal relationship is currently unknown. Our objective was to probe the causal relationship between air pollution, obesity, and COVID-19 and to explore whether obesity mediates this association.MethodsWe obtained instrumental variables strongly correlated to air pollutants [PM2.5, nitrogen dioxide (NO2) and nitrogen oxides (NOx)], 9 obesity-related traits (abdominal subcutaneous adipose tissue volume, waist-to-hip ratio, body mass index, hip circumference, waist circumference, obesity class 1-3, visceral adipose tissue volume), and COVID-19 phenotypes (susceptibility, hospitalization, severity) from public genome-wide association studies. We used clinical and genetic data from different public biological databases and performed analysis by two-sample and two-step Mendelian randomization.ResultsPM2.5 genetically correlated with 5 obesity-related traits, which obesity class 1 was most affected (beta = 0.38, 95% CI = 0.11 - 0.65, p = 6.31E-3). NO2 genetically correlated with 3 obesity-related traits, which obesity class 1 was also most affected (beta = 0.33, 95% CI = 0.055 - 0.61, p = 1.90E-2). NOx genetically correlated with 7 obesity-related traits, which obesity class 3 was most affected (beta = 1.16, 95% CI = 0.42-1.90, p = 2.10E-3). Almost all the obesity-related traits genetically increased the risks for COVID-19 phenotypes. Among them, body mass index, waist circumference, hip circumference, waist-to-hip ratio, and obesity class 1 and 2 mediated the effects of air pollutants on COVID-19 risks (p < 0.05). However, no direct causal relationship was observed between air pollution and COVID-19.ConclusionOur study suggested that exposure to heavy air pollutants causally increased risks for obesity. Besides, obesity causally increased the risks for COVID-19 phenotypes. Attention needs to be paid to weight status for the population who suffer from heavy air pollution, as they are more likely to be susceptible and vulnerable to COVID-19.

Abstract Background Aspirin is a commonly used antipyretic, analgesic, and anti-inflammatory drug. Numerous researches have demonstrated that aspirin exerts multiple biological effects on bone metabolism. However, its spatiotemporal roles remain controversial according to the specific therapeutic doses used for different clinical conditions, and the detailed mechanisms have not been fully elucidated. Hence, in the present study, we aimed to identify the dual effects of different aspirin dosages on osteoclastic activity and osteoblastic bone formation in vitro and in vivo. Methods The effects of varying doses of aspirin on osteoclast and osteoblast differentiation were evaluated in vitro. The underlying molecular mechanisms were detected using quantitative real-time polymerase chain reaction, western blotting, and immunofluorescence techniques. An ovariectomized rat osteoporosis model was used to assess the bone-protective effects of aspirin in vivo. Results Aspirin dose-dependently suppressed RANKL-induced osteoclasts differentiation and bone resorption in vitro and reduced the expression of osteoclastic marker genes, including TRAP, cathepsin K, and CTR. Further molecular analysis revealed that aspirin impaired the RANKL-induced NF-κB and MAPK signaling pathways and prevented the nuclear translocation of the NF-κB p65 subunit. Low-dose aspirin promoted osteogenic differentiation, whereas these effects were attenuated when high-dose aspirin was administered. Both low and high doses of aspirin prevented bone loss in an ovariectomized rat osteoporosis model in vivo. Conclusion Aspirin inhibits RANKL-induced osteoclastogenesis and promotes osteogenesis in a dual regulatory manner, thus preventing bone loss in vivo. These data indicate that aspirin has potential applications in the prevention and treatment of osteopenia.

Smart membranes with responsive wettability show promise for controllably separating oil/water mixtures but it remains challenging to fabricate responsive and stable scalable membranes. Here, the authors develop a capillary force-driven self-assembling strategy to construct a scalable and stable CO2-responsive membrane for the smart separation of various oil/water systems.

Objective To observe the effect of platelet transfusion in inpatients with haematological diseases, analyze the possible causes of platelet transfusion refractoriness (PTR), in order to further improve the efficacy of platelet transfusion. Methods A total of 310 patients with blood disease in our hospital from August 2020 to November 2021 who received platelet transfusion were retrospectively analyzed. Possible influencing factors of platelet transfusion, including gender, age, platelet preservation time, number of platelet transfusions, complication and red blood cell product transfusion were analyzed. Results Patients were divided into effective group and refractory group according to percentage platelet recovery (PPR) and corrected count increment (CCI). PTR was defined as PPR

Performing in-situ diagnosis is a crucial task during routine inspections of high-power converter systems, such as mine hoist. This paper presents an on-board offline condition assessment method for bond wire degradation of high-power IGBT modules within three-level neutral-point clamped (3L-NPC) converter. This method is based on the increment of the on-state voltage $V_{\mathrm {on}}$ during series short-circuit (SSC). The SSC is formed by the conduction of the IGBT modules to be tested and the external constant current switch (CCS). In CCS circuits, a PI-controlled gate drive circuit is employed to achieve high constant short-circuit current and maintain the stability of the $V_{\mathrm {on}}$ . The improved $V_{\mathrm {on}}$ detection circuit takes the decrement of charging time $t_{\mathrm {cp}}$ of the capacitor as the parameter for aging assessment. It simplifies the data processing of $V_{\mathrm {on}}$ , while increasing the aging sensitivity. To validate the effectiveness of this method in practical applications, a single-phase 3L-NPC experimental platform was built to simulate the aging state of IGBTs by cutting off the bonding wires. The feasibility of the detection circuit, the influence of short-circuit current and ambient temperature on $t_{\mathrm {cp}}$ , and the reliability of the CCS circuit are analyzed in detail.

The application of the Z-source/quasi-Z-source inverter exacerbates the hazard of common mode voltage in motor drives or photovoltaic systems. The existing reduced common-mode voltage pulse width modulation (RCMV-PWM) technique applied to the Z-source/quasi-Z-source inverter has solved the problem of common mode voltage suppression to a certain extent, but its switching losses have not been optimized. In this paper, the existing Active zero-state PWM (AZSPWM) and remote state PWM (RSPWM) strategies in quasi-Z-source inverters are analyzed, and a new switching loss optimized common mode reduction modulation strategy is proposed. This algorithm does not change the original common-mode voltage suppression effect, while reducing the number of switching times in a switching period, thereby reducing the switching losses. By optimizing the shoot-through vector insertion method, the current stress of the switching device is reduced. The proposed modulation strategy does not affect the operating range and boost factor of the quasi-Z-source inverter OPWM strategy. The simulation results show that when the output power is 1kw, the proposed strategy can improve efficiency by at least 1% compared to the odd PWM(OPWM) strategy. Finally, A low-power test platform is built to verify the loss optimization effect.

(1) Background: the utilization of fast-growing trees for phytoremediation in heavy-metal-contaminated soil is increasingly recognized as an effective remediation method. Nitrogen (N) fertilizer enhances plant tolerance to heavy metals, yet the impact of various N levels and ammonium (NH4+-N)/nitrate (NO3−-N) ratios on the remediation of cadmium (Cd) and lead (Pb) by trees remains unclear. (2) Methods: the efficiency of Salix linearistipularis in remediating Cd- and Pb-contaminated soil was investigated using a pot experiment with three N levels (60, 120, 200 kg hm−1 year−1) and five NH4+-N/NO3−-N ratios (6/0, 4/2, 3/3, 2/4, 0/6) employed, resulting in 16 treatments including a control. (3) Results: the levels and ratios of NH4+-N/NO3−-N significantly affected the Cd and Pb uptake by S. linearistipularis. The highest increases in Cd and Pb in S. linearistipularis were observed for the N120-6/0 treatment, which increased by 104.36% and 95.23%, respectively. In addition, in the N120-6/0 treatment, the stem and leaf bioconcentration factors of Cd were significantly enhanced by 28.66% and 40.11%, respectively. Structural equation modeling revealed that the uptake of Cd and Pb was predominantly influenced by plant traits (biomass and root traits) rather than soil properties. (4) Conclusions: Our findings highlight the potential of the NH4+-N/NO3−-N ratio to regulate plant traits, thereby improving the phytoremediation efficiency of heavy-metal-contaminated soil.