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Corneal transplantation is an effective treatment for corneal blindness, and it is the only hope for patients with corneal blindness. Cornea has no blood vessels and no lymphatic vessels, which is called immune privilege organ, so the success rate of corneal transplantation is significantly higher than that of other organ transplantation, but the rejection reaction after corneal transplantation is still the main reason for the failure of corneal transplantation. The directional movement of immune cells to lymphoid tissue and inflammatory sites is the mainly immune response after organ transplantation. And the regulatory T cells(Treg)play a key role in immune regulation, which can induce immune tolerance by regulating and inhibiting the activation of effector T cells and reduce the rejection reaction after corneal transplantation. In addition, this review also discussed the effectiveness of applying cordyceps sinensis extract FTY720 to enhance the function of Treg. Based on this, we briefly reviewed the sources, mechanism of action and treatment of Treg after corneal transplantation, so as to provide some reference for the subsequent clinical application transformation and basic research.

Objective To explore the safety and feasibility of the application of day surgery management model under enhanced recovery after surgery (ERAS) concept in patients undergoing gynecologic laparoscopic surgery. Methods A non-randomized concurrent control trial was conducted on the patients who underwent laparoscopic surgery in our department from January to August 2021. A total of 92 patients admitted on odd date were assigned into Ward B of our department and served as the control group, and another 96 patients hospitalized on even date were subjected into Ward A and served as the observation group. The control group was given the routine treatment schedule, including the relevant examinations after admission and general operation procedure during hospitalization. The observation group was under a day surgery management model based on the concept of ERAS, with aid of a day surgery team and optimized perioperative management measures, including pre-hospital rehabilitation, shortening water fasting before surgery, multi-mode analgesia, preventive antiemesis, intraoperative warmth, prevention of deep vein thrombosis, immediate postoperative eating and activity, and follow-up after discharge. Postoperative subjective comfort, intestinal function recovery, social and economic benefits, postoperative complications and inflammatory indicators were compared between the 2 groups. Results In 0~6, 7~12 and 13~24 h after operation, the scores of thirst, hunger, nausea, pain, abdominal distension and pharyngeal discomfort were significantly lower in the observation group than the control group (P < 0.01). The observation group had obviously shorter length of hospital stay and ealier bowel sound recovery and first anal exhaust than the control group (P < 0.01). No postoperative complication, such as fall, unplanned secondary operation or wound infection was observed in both groups. The postoperative inflammatory indicators, including procalcitonin (PCT), neutrophil percentage (Neu%) and white blood cell count (WBC) were all in the normal ranges in the 2 groups at 24 h and 3 and 7 d after surgery. Statistical differences were found in firstly postoperative mobilization, length of hospital stay, hospitalization cost and patient satisfaction between the 2 groups (P < 0.01). Conclusion ERAS-based day surgery management model has the advantages of shortening hospital stay, reducing medical costs, promoting postoperative rehabilitation, and improving the comfort and satisfaction in patients undergoing gynecologic laparoscopic surgery.

BackgroundType 2 diabetes mellitus is one of the most prevalent diseases， which imposes a heavy burden on patients' families and the society. Sleep disorders are recognized as risk factors for the development of diabetes， which may affect the onset and development of diabetes through neuro-endocrino-metabolic pathways， so identifying the factors responsible for the sleep quality of diabetic patients is of great importance in improving their sleep quality.ObjectiveTo investigate the relationship among fear of disease progression， executive function and sleep quality in patients with type 2 diabetes mellitus， so as to provide references for improvement of sleep quality in patients with type 2 diabetes mellitus.MethodsA sample of 197 patients with type 2 diabetes mellitus who were admitted to the Endocrinology Department of the Second Affiliated Hospital of the Air Force Military Medical University from January to May 2023 and met the criteria defined in the Guideline for the Prevention and Treatment of Type 2 Diabetes Mellitus in China （2020 edition） were consecutively selected. All subjects were assessed using Fear of Progression Questionnaire-Short Form （FoP-Q-SF）， Behavior Rating Inventory of Executive Function-Adult version （BRIEF-A） and Pittsburgh Sleep Quality Index （PSQI）. Then the Process macro for SPSS （Model 4） and Bootstrap technique were applied to examine the mediating effect of executive function on the relationship between fear of disease progression and sleep quality in patients with type 2 diabetes mellitus.Results①75 patients （38.07%） with type 2 diabetes mellitus were found to have sleep problems. ②PSQI score in patients with type 2 diabetes mellitus was positively correlated with FoP-Q-SF score and BRIEF-A score （r=0.159， 0.287， P

Abstract Background Insulin resistance (IR) induces hyperinsulinemia, which activates downstream signaling pathways such as the phosphatidylinositol-3-kinase/protein kinase B (PI3K/AKT) pathway, ultimately leading to abnormal proliferation and apoptosis of endometrial cells. This is thought to be a key pathogenic mechanism underlying the development of endometrial polyps (EP). This study aims to investigate the relationship between IR and the development of EP, the expression levels of downstream signaling molecules, including PI3K and AKT, and related laboratory parameters were examined. Methods A total of 100 patients who visited the gynecology outpatient clinic of Zhongda Hospital affiliated with Southeast University from May 2021 to March 2023 and were diagnosed with abnormal endometrial echoes by vaginal ultrasound and underwent hysteroscopic diagnostic curettage were enrolled in this study. General data and relevant hematological indicators were compared, and intraoperative specimens were obtained for pathological examination. Possible factors influencing the development of endometrial polyps were analyzed using Pearson correlation analysis and logistic regression analysis. Results In terms of body mass index, waist circumference, fasting insulin, insulin resistance index, serum total testosterone, and free testosterone index, women of childbearing age in the endometrial polyp group had higher values than those in the non-polyp group, while sex hormone-binding globulin in the endometrial polyp group was lower than that in the non-polyp group, and the differences were statistically significant (P

Abstract Side‐scan sonar is a lightweight acoustic sensor that is frequently deployed on autonomous underwater vehicles (AUVs) to provide high‐resolution seafloor images. However, using side‐scan images to perform simultaneous localization and mapping (SLAM) remains a challenge when there is a lack of 3D bathymetric information and discriminant features in the side‐scan images. To tackle this, the authors propose a feature‐based SLAM framework using side‐scan sonar, which is able to automatically detect and robustly match keypoints between paired side‐scan images. The authors then use the detected correspondences as constraints to optimise the AUV pose trajectory. The proposed method is evaluated on real data collected by a Hugin AUV, using as a ground truth reference both manually‐annotated keypoints and a 3D bathymetry mesh from multibeam echosounder (MBES). Experimental results demonstrate that this approach is able to reduce drifts from the dead‐reckoning system. The framework is made publicly available for the benefit of the community.

Abstract Central Nervous System (CNS) disorders represent a profound public health challenge that affects millions of people around the world. Diseases such as Alzheimer’s disease (AD), Parkinson’s disease (PD), and traumatic brain injury (TBI) exemplify the complexities and diversities that complicate their early detection and the development of effective treatments. Amid these challenges, the emergence of nanotechnology and extracellular vesicles (EVs) signals a new dawn for treating and diagnosing CNS ailments. EVs are cellularly derived lipid bilayer nanosized particles that are pivotal in intercellular communication within the CNS and have the potential to revolutionize targeted therapeutic delivery and the identification of novel biomarkers. Integrating EVs with nanotechnology amplifies their diagnostic and therapeutic capabilities, opening new avenues for managing CNS diseases. This review focuses on examining the fascinating interplay between EVs and nanotechnology in CNS theranostics. Through highlighting the remarkable advancements and unique methodologies, we aim to offer valuable perspectives on how these approaches can bring about a revolutionary change in disease management. The objective is to harness the distinctive attributes of EVs and nanotechnology to forge personalized, efficient interventions for CNS disorders, thereby providing a beacon of hope for affected individuals. In short, the confluence of EVs and nanotechnology heralds a promising frontier for targeted and impactful treatments against CNS diseases, which continue to pose significant public health challenges. By focusing on personalized and powerful diagnostic and therapeutic methods, we might improve the quality of patients.

IntroductionGenitourinary syndrome of menopause (GSM) describes the symptoms and signs resulting from the effect of estrogen deficiency on the female genitourinary tract, including genital, urinary, and sexual symptoms. However, besides estrogen deficiency, little is known about the etiology of GSM. The objective of this study was to investigate the effects of vaginal microbiota dysbiosis on the occurrence and development of GSM in perimenopausal and postmenopausal women.MethodsIn total, 96 women were enrolled in this cross-sectional study and clinical data were collected. GSM symptoms were divided into three types: genital, urological, and sexual symptoms. Full-length 16S rRNA gene sequencing using the third-generation PacBio sequencing technology was performed to analyze the vaginal microbiome using vaginal swabs of non-GSM and GSM women with different types of GSM symptoms. Live Lactobacillus Capsule for Vaginal Use (LLCVU) treatment was used to verify the effects of Lactobacillus on GSM symptoms.ResultsWe found that 83.58% (56/67) of women experienced GSM symptoms in the perimenopausal and postmenopausal stages. Among these women with GSM, 23.21% (13/56), 23.21% (13/56), and 53.57% (30/56) had one type, two types, and three types of GSM symptoms, respectively. The richness and diversity of vaginal microbiota gradually increased from reproductive to postmenopausal women. There were significant differences in vaginal microbial community among non-GSM women and GSM women with different types of symptoms. Lactobacillus was found to be negatively associated with the onset, severity, and type of GSM while some bacteria, such as Escherichia-shigella, Anaerococcus, Finegoldia, Enterococcus, Peptoniphilus_harei, and Streptococcus, were found to be positively associated with these aspects of GSM, and these bacteria were especially associated with the types of genital and sexual symptoms in GSM women. LLCVU significantly relieved genital symptoms and improved the sexual life of GSM women in shortterm observation.ConclusionsThe onset, severity, and type of GSM symptoms may be associated with changes in vaginal microbiota in perimenopausal and postmenopausal women. Vaginal microbiota dysbiosis probably contributes to the occurrence and development of GSMsymptoms, especially vaginal and sexual symptoms. Lactobacillus used in the vagina may be a possible option for non-hormonal treatment of GSM women with genital and sexual symptoms.Clinical Trial Registrationhttps://www.chictr.org.cn/indexEN.html, identifier ChiCTR2100044237.

BackgroundLacunes, a characteristic feature of cerebral small vessel disease (CSVD), are critical public health concerns, especially in the aging population. Traditional neuroimaging techniques often fall short in early lacune detection, prompting the need for more precise predictive models.MethodsIn this retrospective study, 587 patients from the Neurology Department of the Affiliated Hospital of Hebei University who underwent cranial MRI were assessed. A nomogram for predicting lacune incidence was developed using LASSO regression and binary logistic regression analysis for variable selection. The nomogram’s performance was quantitatively assessed using AUC-ROC, calibration plots, and decision curve analysis (DCA) in both training (n = 412) and testing (n = 175) cohorts.ResultsIndependent predictors identified included age, gender, history of stroke, carotid atherosclerosis, hypertension, creatinine, and homocysteine levels. The nomogram showed an AUC-ROC of 0.814 (95% CI: 0.791–0.870) for the training set and 0.805 (95% CI: 0.782–0.843) for the testing set. Calibration and DCA corroborated the model’s clinical value.ConclusionThis study introduces a clinically useful nomogram, derived from binary logistic regression, that significantly enhances the prediction of lacunes in patients undergoing brain MRI for various indications, potentially advancing early diagnosis and intervention. While promising, its retrospective design and single-center context are limitations that warrant further research, including multi-center validation.

Abstract Background Letrozole has been proven to be an effective method for inducing ovulation. However, little attention has been paid to whether the lead follicle size will affect the success rate of intrauterine insemination (IUI) with ovulation induction with alone letrozole. Therefore, we hope to investigate the effect of dominant follicle size on pregnancy outcomes on human chorionic gonadotropin (hCG) day of the first letrozole-IUI. Methods A retrospective cohort study design was employed. We included patients with anovulation or unexplained infertility undergoing first IUI treatment with letrozole for ovarian stimulation. According to the dominant follicle size measured on the day of hCG trigger, patients were divided into six groups (≤ 18 mm, 18.1–19.0 mm, 19.1–20.0 mm, 20.1–21.0 mm, 21.1–22.0 mm, > 22 mm). Logistic models were used for estimating the odds ratios (ORs) with their 95% confidence interval (CIs) for achieving a clinical pregnancy or a live birth. A restricted cubic spline was drawn to explore the nonlinear relationship between follicle size and IUI outcomes. Results A total of 763 patients underwent first letrozole-IUI cycles in our study. Fisher exact test showed significant differences among the six follicle-size groups in the rates of pregnancy, clinical pregnancy and live birth (P

Abstract Recent advancements in membrane-assisted seawater electrolysis powered by renewable energy offer a sustainable path to green hydrogen production. However, its large-scale implementation faces challenges due to slow power-to-hydrogen (P2H) conversion rates. Here we report a modular forward osmosis-water splitting (FOWS) system that integrates a thin-film composite FO membrane for water extraction with alkaline water electrolysis (AWE), denoted as FOWSAWE. This system generates high-purity hydrogen directly from wastewater at a rate of 448 Nm3 day−1 m− 2 of membrane area, over 14 times faster than the state-of-the-art practice, with specific energy consumption as low as 3.96 kWh Nm−3. The rapid hydrogen production rate results from the utilisation of 1 M potassium hydroxide as a draw solution to extract water from wastewater, and as the electrolyte of AWE to split water and produce hydrogen. The current system enables this through the use of a potassium hydroxide-tolerant and hydrophilic FO membrane. The established water-hydrogen balance model can be applied to design modular FO and AWE units to meet demands at various scales, from households to cities, and from different water sources. The FOWSAWE system is a sustainable and an economical approach for producing hydrogen at a record-high rate directly from wastewater, marking a significant leap in P2H practice.

The aryl hydrocarbon receptor (AHR) has been identified as a significant driver of tumorigenesis. However, its clinical significance in acute myeloid leukemia (AML) remains largely unclear. In this study, RNA-Seq data from AML patients (bone marrow samples from 173 newly diagnosed AML patients) obtained from the TCGA database, and normal human RNA-Seq data (bone marrow samples from 70 healthy individuals) obtained from the GTEX database are downloaded for external validation and complementarity. The data analysis reveals that the AHR signaling pathway is activated in AML patients. Furthermore, there is a correlation between the expressions of AHR and mitochondrial oxidative phosphorylation genes. In vitro experiments show that enhancing AHR expression in AML cells increases mitochondrial oxidative phosphorylation and induces resistance to cytarabine. Conversely, reducing AHR expression in AML cells decreases cytarabine resistance. These findings deepen our understanding of the AHR signaling pathway’s involvement in AML.

Background and aimThe deterioration in cognition of persons with dementia (PWD) makes their caregivers key players in their help-seeking process. This study aimed to identify the facilitators and barriers of help-seeking for persons with dementia in Asia from the perspective of their informal caregivers.MethodsA qualitative methodology was adopted in the current study. Twenty-nine informal caregivers of PWD in Singapore were interviewed between April 2019 and December 2020. All interviews were audio-recorded and transcribed verbatim for the analysis.ResultsThe transcripts were analyzed using inductive thematic analysis. The results revealed four major themes with 12 sub-themes, including (1) Barriers to diagnosis-seeking (i.e., lack of knowledge and awareness of dementia, emotional denial, resistance from PWD, and delays in the healthcare system); (2) Facilitators of diagnosis-seeking (i.e., synergy between awareness of dementia and an active diagnosis-seeking intention and incidental diagnosis resulting from seeking treatment for comorbid conditions); (3) Barriers to treatment-seeking (i.e., challenges from PWD and disease, challenges faced by caregivers when seeking treatment for PWD, and challenges imposed by the COVID-19 pandemic); (4) Facilitators of treatment-seeking (i.e., caregivers’ capabilities of handling PWD, cooperation/compliance from PWD, and an integrated care plan for PWD).ConclusionThe findings highlight the importance of raising public awareness, enabling health professionals to tailor psychosocial interventions better, and improving community support through dementia awareness and education.

IntroductionDementia and physical disability are serious problems faced by the aging population, and their occurrence and development interact.MethodsBased on data from a national cohort of Chinese people aged 60 years and above from the China Health and Retirement Longitudinal Survey from 2011 to 2018, we applied the group-based trajectory model to identify the heterogeneous trajectories of cognitive function and physical disability in participants with different physical disability levels. Next, multinomial logistic regression models were used to explore the factors affecting these trajectories.ResultsThe cognitive function trajectories of the Chinese older people could be divided into three characteristic groups: those who maintained the highest baseline level of cognitive function, those with a moderate baseline cognitive function and dramatic progression, and those with the worst baseline cognitive function and rapid–slow–rapid progression. The disability trajectories also fell into three characteristic groups: a consistently low baseline disability level, a low initial disability level with rapid development, and a high baseline disability level with rapid development. Compared with those free of physical disability at baseline, a greater proportion of participants who had physical disability at baseline experienced rapid cognitive deterioration. Education, income, type of medical insurance, gender, and marital status were instrumental in the progression of disability and cognitive decline in the participants.DiscussionWe suggest that the Chinese government, focusing on the central and western regions and rural areas, should develop education for the older people and increase their level of economic security to slow the rate of cognitive decline and disability among this age group. These could become important measures to cope with population aging.

Abstract Background Patients with DNA mismatch repair‐proficient/microsatellite stable (pMMR/MSS) colorectal cancer (CRC), which accounts for 85% of all CRC cases, display a poor respond to immune checkpoint inhibitors (i.e., anti‐PD‐1 antibodies). pMMR/MSS CRC patients with locally advanced cancers need effective combined therapies. Methods In this pilot study, we administered six preoperative doses of each 2‐week cycle of the anti‐PD‐1 antibody sintilimab (at a fixed dose of 200 mg), oxaliplatin, and 5‐FU/CF (mFOLFOX6) combined with five doses of bevacizumab (the number of doses was reduced to prevent surgical delays) to patients with cT4NxM0 colon or upper rectal cancers. And radical surgery was performed approximately 2 weeks after the last dose of neoadjuvant therapy. The primary endpoint was a pathologic complete response (pCR). We also evaluated major pathologic response (MPR, ≤10% residual viable tumor), radiological and pathological regression, safety, and tumor mutation burden (TMB), and tumor microenvironment (TME) characteristics. Results By the cutoff date (September 2023), 22 patients with cT4NxM0 pMMR/MSS colon or upper rectal cancers were enrolled and the median follow‐up was 24.7 months (IQR: 21.1–26.1). All patients underwent R0 surgical resection without treatment‐related surgical delays. pCR occurred in 12 of 22 resected tumors (54.5%) and MPR occurred in 18 of 22 (81.8%) patients. At the cutoff date, all patients were alive, and 21/22 were recurrence‐free. Treatment‐related adverse events of grade 3 or higher occurred in of 2/22 (9.1%) patients. Among the pCR tumors, two were found to harbor POLE mutations. The degree of pathological regression was significantly greater than that of radiological regression (p = 1.35 × 10−8). The number of CD3+/CD4+ cells in the tumor and stroma in pretreated biopsied tissues was markedly lower in pCR tumors than in non‐pCR tumors (p = 0.038 and p = 0.015, respectively). Conclusions Neoadjuvant sintilimab combined with bevacizumab and mFOLFOX6 was associated with few side effects, did not delay surgery, and led to pCR and non‐pCR in 54.5% and 81.8% of the cases, respectively. Downregulation of CD3/CD4 expression in the tumor and stroma is related to pCR. However, the molecular mechanisms underlying PD‐1 blockade‐enhanced targeted chemotherapy require further investigation.

BackgroundCerebral small vessel disease (CSVD) is a common neurodegenerative condition in the elderly, closely associated with cognitive impairment. Early identification of individuals with CSVD who are at a higher risk of developing cognitive impairment is crucial for timely intervention and improving patient outcomes.ObjectiveThe aim of this study is to construct a predictive model utilizing LASSO regression and binary logistic regression, with the objective of precisely forecasting the risk of cognitive impairment in patients with CSVD.MethodsThe study utilized LASSO regression for feature selection and logistic regression for model construction in a cohort of CSVD patients. The model’s validity was assessed through calibration curves and decision curve analysis (DCA).ResultsA nomogram was developed to predict cognitive impairment, incorporating hypertension, CSVD burden, apolipoprotein A1 (ApoA1) levels, and age. The model exhibited high accuracy with AUC values of 0.866 and 0.852 for the training and validation sets, respectively. Calibration curves confirmed the model’s reliability, and DCA highlighted its clinical utility. The model’s sensitivity and specificity were 75.3 and 79.7% for the training set, and 76.9 and 74.0% for the validation set.ConclusionThis study successfully demonstrates the application of machine learning in developing a reliable predictive model for cognitive impairment in CSVD. The model’s high accuracy and robust predictive capability provide a crucial tool for the early detection and intervention of cognitive impairment in patients with CSVD, potentially improving outcomes for this specific condition.

Anchoring noble metal sites through photo-reduction is an effective way to modulate charge distribution on photocatalytic interfaces, thereby enhancing photocatalytic performance. The irradiation field on the exposed surfaces of photocatalysts has an important influence on the morphology and distribution of noble metal sites. However, non-uniform light field derived from the scattering effects of particle-form photocatalysts hinders the well-distributed photo-deposition of noble metal sites. To address this challenge, we proposed a photo-deposition method utilizing the optical fiber coated with photocatalysts. TiO2 nanorod (NR) array was coated on the optical fiber to achieve a well-distributed irradiation filed across the NR array. This resulted in a concentration of the irradiation field primarily within the NR array, maintaining uniformly distributed light intensities throughout. Palladium (Pd) sites dominated by nanoclusters were well distributed on TiO2 NR array utilizing a photo-reduction method. These Pd sites functioned as electron acceptors, facilitating the effective separation and transfer of photo-generated carriers. Consequently, an highly active photocatalytic reaction interface was constructed, demonstrating the accumulation of a substantial concentration of holes and their efficient conversion into hydroxyl radicals (·OH). Notably, hydroxyl radicals with a concentration of 62.6 μM could be generated within 14.4 min. The construction of this efficient photocatalytic interface offers an optimal platform for accelerating photocatalytic reactions and enhancing photocatalytic efficiency.

In the research of sports injury prevention, the recognition of sports action plays an important role in the action recognition model and the prediction evaluation model. In view of the above problems, this paper constructs a new mathematical model through the idea of BP neural network. The model combines wearable technology and can improve the recognition accuracy of sports actions. The model uses the BP network classifier, which can be used in data. Processes such as feature extraction improve efficiency and reliability. In this paper, the algorithm simulation is carried out, and the experiments are carried out for three movements: running, running and static. The results show that for the recognition of running and running action, when the hidden layer node is 11, the BP neural network classifier shows the best recognition effect. For static motion, the recognition effect of each classifier is basically the same. This paper analyzes the wearable sports action recognition system, including perception layer, application layer and service layer, to realize the recognition and classification of sports actions, predict actions in advance and prevent sports injuries. Finally, this paper analyzes the causes of sports injury, puts forward specific measures to prevent sports injury, and further reduces sports injury events through wearable devices.

In order to clarify the pore structure and fractal characteristics of the deep continental shale of the Lower Wuerhe Formation in the central Junggar Basin， the Lower Wuerhe Formation shale in the Dongdaohaizi Sag was taken as the research object. On the basis of an in-depth analysis of shale minerals and geochemical characteristics， the pore structure characteristics of the Lower Wuerhe Formation shale were quantitatively characterized by using field emission scanning electron microscopy and low-temperature N2 adsorption experiments. The fractal dimension of shale pores was calculated based on the FHH model， and the relationships among TOC content， mineral composition， pore structure parameters， fractal dimension， and its geological significance were revealed. The results show that the Lower Wuerhe Formation shale mainly develops inorganic pores and micro-fractures， and the pore size distribution is multi-peak type， mostly parallel plate or narrow slit pores. The pore development of shale is controlled by TOC and the content of quartz， feldspar， and clay minerals， which results in significant differences and strong heterogeneity among pore structures. Shale pores of the Lower Wuerhe Formation in the study area have double fractal characteristics， in which the surface fractal dimension D1 varies from 2.452 2 to 2.594 8， with an average value of 2.540 9. The fractal dimension D2 of the structure ranges from 2.604 5 to 2.774 8， with an average of 2.705 6. TOC is negatively correlated with fractal dimension， while pore structure parameters （specific surface area and pore volume） and mineral composition （quartz， feldspar， and clay mineral content） are positively correlated with fractal dimension. An increase in the content of brittle minerals such as quartz， feldspar and clay minerals contributes to the development of micro- and nano-scale pores and micro-fractures. This results in an increase in specific surface area， pore volume， and fractal dimension. As pore heterogeneity strengthens， the complexity of the pore structure also increases.

This paper summarized the Nursing of a patient with post-stroke constipation of Qi-deficiency type treated by Baliao acupoints moxibustion and acupuncture combined with oral administration of Yiqi Runchang decoction. A comprehensive assessment of nursing risk was carried out before treatment. Traditional Chinese Medicine external treatment such as moxibustion and acupuncture at Baliao acupoints were performed to improve the recovery of intestinal function. The patient received oral administration of Yiqi Runchang decoction to regulate the body constitution. In addition, a prescription of drinking habits was administrated to promote defecation, and other interventions such as dietary guidance, exercise and emotion care were carried out to relieve the symptoms of Qi-deficiency syndromes. (本文总结灸八髎穴联合内服益气润肠中药汤剂治疗1例中风后气虚便秘患者的护理体会。在完善护理评估的基础上, 遵医嘱给予八髎穴艾灸、针灸等中医外治疗法, 以增强肠道蠕动, 缓解便秘; 给予益气润肠中药汤剂内服, 从根本上调理; 同时基于子午流注理论, 为患者开具饮水处方, 以软化粪便, 促进胃肠蠕动, 利于排便; 结合患者的疾病特点予以饮食调护、运动疗法和情志护理。经过10 d中医内服外用联合治疗以及辨证施护, 患者气虚便秘症状得到有效改善。)

Abstract Background Methadone maintenance treatment (MMT) has been implemented in China for nearly two decades, with a significant decrease in the number of participants in recent years. However, there is a lack of comprehensive research focusing on the long-term effectiveness in the context of this decline, especially from the perspectives of MMT participants themselves. This study aims to address this gap by examining the benefits and challenges experienced by long-term MMT participants in China, to uncover potential causes of the decrease in participant numbers and to improve the effectiveness of the program. Methods We conducted semi-structured interviews with 21 long-term MMT participants (treatment duration ≥ 5 years) recruited through purposive sampling from 6 MMT clinics in the Guangdong Province, China, between December 2021 and August 2022. Thematic analysis was employed to analyze the transcribed interviews. Two analysts independently coded the data, and a third researcher double-coded 20% of transcripts to ensure intercoder reliability. Results Overall, participants corroborated the notable decline in MMT participants during their long-term MMT, citing death, arrest, and self-perceived abstinence from heroin, as their perceived driving factors. They reported positive changes in their health, family relationships, and social functioning. However, they identified economic hardship as their greatest challenge associated with MMT, further exacerbated by other barriers including the conflict of clinic opening hours and working schedules, discrimination from employers, and COVID-19-related restrictions. Additionally, participants identified issues with dose adjustment and emergency treatment continuation. Conclusions This study outlines the overall improvement in the quality of life of long-term MMT participants. However, it highlights the need for official guidelines for dose adjustment and emergency treatment continuation as well as the provision of health education, job referrals, and flexibility of clinic opening times to facilitate the return to society receiving participants. Establishing a follow-up mechanism for those receiving MMT is also recommended to prevent relapses to heroin and other illicit substances.

Objective Conventional correction techniques were challenging and of high risk of neurological complications for the correction of severe and rigid kyphoscoliosis. A new technical note we developed and named as sequential correction, was used to treat severe and rigid kyphoscoliosis. The present study was to compare the clinical outcomes of sequential correction versus conventional correction for the treatment of severe and rigid kyphoscoliosis. Methods This is a respectively case–control study. Between January 2014 and December 2019, 36 adults underwent the surgical correction of severe and rigid kyphoscoliosis and were included in the present study. Among them, 20 adults underwent conventional correction, 16 adults underwent sequential correction. Major curve Cobb angle, kyphotic angle, coronal imbalance, and sagittal vertical axis were compared between two groups. The patient‐reported health‐related quality of life outcomes, including the Oswestry disability index score, and SRS‐22 questionnaire, were recorded. Independent samples t‐test, Mann–Whitney U test, and Wilcoxon signed‐rank test, were used to compare the differences between two groups according to the results of normal distribution test. Results In conventional correction group, the mean major curve Cobb angle was 122.50° preoperatively, 40.35° immediately after surgery, and 43.95° at final follow‐up postoperatively; the mean kyphotic angle was 97.45° preoperatively, 34.45° immediately after surgery, and 38.30° at final follow‐up postoperatively. In the sequential correction group, the mean major angle was 134.44° preoperatively, 44.56° immediately after surgery, and 46.25° at final follow‐up postoperatively; the mean kyphotic angle was 112.31° preoperatively, 39.00° immediately after surgery, and 40.38° at final follow‐up postoperatively. The mean major curve Cobb angle and kyphotic angle of both groups were improved significantly, while there were no significant differences between two groups (p > 0.001). Improved self‐reported quality of life scores were achieved postoperatively and at final follow‐up postoperatively, and there were no significant differences between the two groups. The total complication rate of the patients underwent conventional correction was 55%, and the total complication rate of the patients underwent sequential correction was 43.75%. The complication rate of the two groups showed no significant difference. Conclusions Sequential correction is an excellent and safe treatment for severe and rigid kyphoscoliosis in adults, with similar clinical outcomes with conventional correction. The total complication rate of the patients who underwent sequential correction was slightly lower than conventional correction.

Background: Evidence of modifying effect of various dietary patterns (DPs) on risk of type 2 diabetes (T2D) induced by long-term exposure to air pollution (AP) is still rather lacking, which therefore we aimed to explore in this study. Methods: We included 78,230 UK Biobank participants aged 40–70 years with at least 2 typical 24-hour dietary assessments and without baseline diabetes. The annual average concentration of particulate matter with diameter micrometers ≤2.5 (PM2.5) and ≤10 (PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOX) estimated by land use regression model was the alternative proxy of long-term AP exposure. Three well-known prior DPs such as Mediterranean diet (MED), dietary approaches to stop hypertension diet (DASH), and empirical dietary inflammatory pattern (EDIP), as well as three posterior DPs derived by the rank reduced regression model were used to capture participants’ dietary habits. Cox regression models were used to estimate AP-T2D and DP-T2D associations. Modifying effect of DPs on AP-T2D association was assessed using stratified analysis and heterogeneity test. Results: During a median follow-up 12.19 years, 1,693 participants developed T2D. PM2.5, PM10, NO2, and NOX significantly increased the T2D risk (P

The utilization of moving image feature extraction in sports teaching has garnered increasing attention. However, traditional feature extraction algorithms often struggle to meet the diverse and complex demands of moving images. To address this challenge, this paper proposes a multi-scale feature fusion algorithm aimed at improving feature extraction in moving images. The algorithm begins by decomposing the moving image into multiple scales, followed by extracting features from each scale using a feature extraction network. To obtain a more comprehensive and accurate feature representation, feature fusion technology is employed to merge the features from different scales. The proposed algorithm, based on multi-scale feature fusion, exhibits a significant improvement in both accuracy and stability when compared to traditional feature extraction algorithms. Byaccurately extracting and representing the crucial features within moving images, the algorithm contributes to an improved understanding of athletes' movements, enabling instructors to provide more targeted and insightful feedback. This algorithm effectively captures key features within the moving images, providing robust support for tasks such as movement analysis and skill evaluation in sports teaching.

Cancer and cardiovascular disease represent the two leading causes of morbidity and mortality worldwide. Women continue to enjoy a greater life expectancy than men. However, this comes at a cost with more women developing diabetes, hypertension and coronary artery disease as they age. These traditional cardiovascular risk factors not only increase their lifetime risk of heart failure but also their overall risk of cancer. In addition to this, many of the cancers with female preponderance are treated with potentially cardiotoxic therapies, adding to their increased risk of developing heart failure. As a result, we are faced with a higher risk population, potentially suffering from both cancer and heart failure simultaneously. This is of particular concern given the coexistence of heart failure and cancer can confer a worse prognosis than either a single diagnosis of heart failure or cancer alone. This review article explores the intersection of heart failure and cancer in women at multiple levels, including traditional cardiovascular risk factors, cardiovascular toxicity derived from antineoplastic and radiation therapy, shared pathophysiology and HF as an oncogenic process. This article further identifies opportunities and strategies for intervention and optimisation, whilst highlighting the need for contemporary guidelines to better inform clinical practice.

Objective To investigate the preoperative hope level of elderly patients with femoral neck fracture and analyze its influencing factors, so as to provide a practical basis for improving the preoperative hope level of elderly patients with femoral neck fracture and promoting postoperative rehabilitation. Methods A total of 206 cases of elderly patients with femoral neck fractures who were eligible for the surgical treatment were included as the research objects. The general information questionnaire, Herth Hope Index (HHI)Scale, General Self-Efficacy Scale(GSES) were analyzed. Results The total HHI score of 206 elderly patients with femoral neck fractures was (31.73+-9.68) points, and scores of each dimension were: positive attitude towards reality and the future (9.14+-1.10), taking positive actions (11.69+-5.36), maintaining close relationships with others (10.89+-3.22); Among them, 63 cases (30. 6%) were high hope levels, 131 cases (65. 6%) were medium hope levels, and 12 cases (3. 8%) were low hope levels. The results of multiple stepwise regression analysis showed that age, comorbidity index, economic status, housing status, and self-efficacy were significant predictors of the preoperative hope level of elderly patients with femoral neck fractures (p

Abstract Objective The present study is to evaluate the clinical outcomes of the sequential correction of severe and rigid kyphoscoliosis. Methods Between January 2014 and December 2020, 27 adults with severe and rigid kyphoscoliosis underwent sequential correction combined with posterior grade 4 or grade 5 spinal osteotomy. Radiological parameters, including the major curve Cobb angle, kyphotic angle, coronal imbalance, and sagittal vertical axis (SVA), were compared. Patient self-reported health-related quality of life (HRQOL) scores were used to evaluate clinical outcomes. Results The mean major curve Cobb angle improved from 134.30 ± 13.24° to 44.48 ± 9.34° immediately after surgery and to 46.11 ± 8.94° at the final follow-up. The mean kyphotic angle improved from 112.15 ± 20.28° to 38.63 ± 15.00° immediately after surgery and to 39.85 ± 14.92° at the final follow-up. The mean preoperative major curve Cobb angle of grade 5 spinal osteotomy group was higher than that of grade 4 spinal osteotomy group. Coronal imbalance and SVA slightly improved. The patient self-reported HRQOL scores improved postoperatively and at the final follow-up. Activity, appearance and total scores of the SRS-22 of the grade 5 spinal osteotomy group at the final follow-up were significantly better than those of the grade 4 spinal osteotomy group. Conclusions Sequential correction combined with posterior grade 4 or grade 5 spinal osteotomies is an excellent and safe treatment for severe and rigid kyphoscoliosis in adults. Sequential correction combined with posterior grade 5 spinal osteotomies can be used to correct severe and rigid kyphoscoliosis with higher major curve Cobb angle.

Abstract Background TORCH (Toxoplasma gondii [TOX], Cytomegalovirus [CMV], Rubella virus [RV], and Herpes simplex virus [HSV]) represents pathogens known to traverse the maternal-fetal barrier and cause severe neonatal anomalies. We aimed to assess the prevalence of preconception TOX, CMV, and RV infections among women with fertility desire in southern China, and identify related risk factors. Methods Data were obtained from a population-based cross-sectional study conducted as part of the National Free Preconception Health Examination Project. Women planning to conceive within the next 6 months in Guangdong Province were enrolled between 2014 and 2019. Information on sociodemographic, gynecological, and obstetric characteristics was collected. Sera were analyzed for TOX IgG, CMV IgG, and RV IgG antibodies using an enzyme-linked immunosorbent assay. Descriptive, univariate, and multivariate logistic regression analyses were performed to assess the association between TORCH infections and related factors. Results Among 2,409,137 participants, the prevalence of IgG antibodies for TOX, CMV, and RV was 3.20% (95% CI: 3.18–3.22%), 77.67% (95% CI: 77.62–77.71%) and 76.03% (95% CI: 75.98–76.07%), respectively. Of all participants, 141,047 women (5.85%, 95% CI:5.83–5.88%) reported a history of immunization for RV. Women living in the Pearl River Delta, a more developed region, have significantly lower vaccination rates than those living in other regions. The seropositivity of TOX IgG was highest among women aged 35 years and above, with primary or lower education levels, and rural registration. Factors such as being older, having a higher educational level, and being of other ethnicities were associated with a higher prevalence of naturally acquired CMV and RV infections. Women living in the Pearl River Delta showed a higher risk of TOX, CMV, and RV infections, with aORs of 2.21, 4.45, and 1.76, respectively. A history of pregnancy, gynecological diseases, and sexually transmitted infections were potentially associated with TORCH infections, but this association varied across pathogens. Conclusion The findings of this study update the baseline of preconception TORCH infections among women with fertility desire in southern China, helping to estimate the risk of congenital infection and guide the development and implementation of effective prevention measures for preconception TORCH infections.

Abstract The scaffold protein IRS-1 is an essential node in insulin/IGF signaling. It has long been recognized that the stability of IRS-1 is dependent on its endomembrane targeting. However, how IRS-1 targets the intracellular membrane, and what type of intracellular membrane is actually targeted, remains poorly understood. Here, we found that the phase separation-mediated IRS-1 puncta attached to endoplasmic reticulum (ER). VAPB, an ER-anchored protein that mediates tethers between ER and membranes of other organelles, was identified as a direct interacting partner of IRS-1. VAPB mainly binds active IRS-1 because IGF-1 enhanced the VAPB-IRS-1 association and replacing of the nine tyrosine residues of YXXM motifs disrupted the VAPB-IRS-1 association. We further delineated that the Y745 and Y746 residues in the FFAT-like motif of IRS-1 mediated the association with VAPB. Notably, VAPB targeted IRS-1 to the ER and subsequently maintained its stability. Consistently, ablation of VAPB in mice led to downregulation of IRS-1, suppression of insulin signaling, and glucose intolerance. The amyotrophic lateral sclerosis (ALS)-derived VAPB P56S mutant also impaired IRS-1 stability by interfering with the ER-tethering of IRS-1. Our findings thus revealed a previously unappreciated condensate-membrane contact (CMC), by which VAPB stabilizes the membraneless IRS-1 signalosome through targeting it to ER membrane.

In response to the environmental implications of the massive quantities of excavation soil generated by global urbanization and infrastructure development, recent research efforts have explored the repurposing of calcined excavation soils as sustainable supplementary cementitious materials (SCMs). As it is still at an early stage, current research lacks systematic analysis across diverse soil deposits regarding their reactivity and mechanical properties within cementitious binders, despite recognized geographical variability in kaolinite content. Through comprehensive experimentation with soils sourced from four major southern Chinese cities, this study presents a pioneering assessment of the compressive strength, pozzolanic reactivity (X-ray diffraction, Fourier-transform infrared spectroscopy, solid-state nuclear magnetic resonance), and microstructural development (mercury intrusion porosimetry, scanning electron microscopy) of mortars modified by various calcined excavation soils (up to 28 days curing). The experimental data suggest that soils with a kaolinite content above 53.39% produce mortars of equal or superior quality to plain cement mixes, primarily due to their refined pore structures, microstructural densification, and enhanced hydration reactions. The findings highlight kaolinite—specifically, aluminum content—as the principal indicator of excavation soil viability for SCM application, suggesting a promising avenue for sustainable construction practices.

Rapid urbanization in many cities has produced massive amounts of problematic excavation soil. The direct disposal of untreated excavation soil often leads to significant land use and severe environmental concerns. A sustainable solution is to transform the soil waste into high-quality nano-calcined excavation soil (NCES) for application as a substitute for cement in construction. However, research in this area is very limited. This study presents a systematic investigation of the nano-sized calcined soil materials from preparation to application in cementitious material. The influence of milling parameters, including the rotational speed, milling duration, ball diameter, and milling strategy, was investigated to produce NCES with various specific surface areas. The effect of NCES substitution (15 wt% of Portland cement) in cementitious materials was then examined for mechanical performance, hydration dynamics, hydration products, and microstructure. A cement mix with very fine NCES (specific surface area of 108.76 m2/g) showed a 29.7% enhancement in mechanical strength and refined pore structure while a cement mix with un-grounded calcined soil showed a mechanical loss in comparison to the Control specimen. Delayed and reduced heat release at an early age was observed in a cement paste mixed with NCES. The underlying mechanism was investigated. The results of this work will contribute to the high-quality application of excavation soil waste.

In response to the problems of no suitable constraint conditions in the optimization process of tooth profile modification of cycloidal pin wheel transmission, difficulty in determining the modification amount of cycloidal gear tooth profile in reverse engineering, and the inability to obtain the meshing interval when studying the characteristics of cycloidal pin wheel transmission, research has been conducted on the method for determining the meshing intervals of cycloidal gears. Firstly, the stiffness analysis is performed to determine the main components that affect the stiffness. Then, through the contact stiffness analysis of the key components, the torsional stiffness model of the needle roller bearing, the tapered roller bearing and the meshing point of the cycloid are established respectively.On this basis, the torsional stiffness equation of the cycloid with needle roller bearings, tapered roller bearings and with the torsion angle of the whole machine as variables is deduced.Finally, according to the continuity principle of meshing points, all the meshing intervals whose sum of torsional stiffness of meshing points is approximately equal to the torsional stiffness of cycloidal wheels are calculated, and according to the principle that the initial meshing point of cycloidal wheels does not change with the increase of load, the feasible meshing intervals under different loads are finally screened. The analysis results of this method are basically consistent with the actual situation, and there is no need to disassemble the reducer, which can provide necessary reference data for the design and optimization of cycloid pin gear transmission.

Objective To explore the efficacy and safety of CalliSpheres® drug-eluting beads trans-bronchial artery chemoembolization (DEB-BACE) . Methods A retrospective analysis was conducted on 45 patients with advanced primary lung cancer complicated with massive hemoptysis treated in Linyi Cancer Hospital from December 2019 to December 2021. All patients received bronchial artery embolization (BAE) and were divided into observation group (n=24) and control group (n=21) according to different embolization materials. DEB-BACE using CalliSpheres® drug-eluting beads loading 40-60 mg of epirubicin was performed in observation group, and BACE with 8Spheres® blank microspheres was given in control group. The control of hemoptysis, tumor response, the survival time and the related adverse reactions were observed and compared between two groups. Results There was no significant difference in hemostatic success rate between observation group and control group (87.5% vs 85.7%, P＞0.05) . The median duration of nonmassive hemoptysis in observation group was statistically longer than that in control group (96 days vs 50 days, P＜0.01) . At two months after embolization therapy, the objective response rate (83.3% vs 38.1%) in observation group were significantly higher than those in control group (P＜0.05) . The fever, chest tightness and chest pain related to the embolization treatment disappeared after symptomatic treatment in two groups, and there was no statistical difference in adverse reactions between two groups (P＞0.05) . No serious complications such as spinal cord injury and cerebral embolism occurred in two groups. By the end of September 30, 2022, the median overall survival in observation group (10 months) was statistically higher than that in control group (6 months) (P＜0.01) at a follow-up of 2-25 (9.97±5.41) month. Conclusion In the treatment of advanced lung cancer with massive hemoptysis, DEB-BACE can achieve higher tumor response rate, longer survival time without hemoptysis and total survival time compared with conventional BAE.

Abstract Adjuvant chemotherapy (ACT) is usually used to reduce the risk of disease relapse and improve survival for stage II/III colorectal cancer (CRC). However, only a subset of patients could benefit from ACT. Thus, there is an urgent need to identify improved biomarkers to predict survival and stratify patients to refine the selection of ACT. We used high-throughput proteomics to analyze tumor and adjacent normal tissues of stage II/III CRC patients with /without relapse to identify potential markers for predicting prognosis and benefit from ACT. The machine learning approach was applied to identify relapse-specific markers. Then the artificial intelligence (AI)-assisted multiplex IHC was performed to validate the prognostic value of the relapse-specific markers and construct a proteomic-derived classifier for stage II/III CRC using 3 markers, including FHL3, GGA1, TGFBI. The proteomics profiling-derived signature for stage II/III CRC (PS) not only shows good accuracy to classify patients into high and low risk of relapse and mortality in all three cohorts, but also works independently of clinicopathologic features. ACT was associated with improved disease-free survival (DFS) and overall survival (OS) in stage II (pN0) patients with high PS and pN2 patients with high PS. This study demonstrated the clinical significance of proteomic features, which serve as a valuable source for potential biomarkers. The PS classifier provides prognostic value for identifying patients at high risk of relapse and mortality and optimizes individualized treatment strategy by detecting patients who may benefit from ACT for survival.

Objective To investigate the team collaboration between volunteers with COVID-19 and nurses in makeshift hospital and provide strategies for the shortage of medical care in makeshift hospital. Methods A cross-sectional study was conducted in all volunteers and nurses of unit 4.1 in makeshift hospital built in Shanghai National Exhibition and Convention Center from April 7 to May 17 of 2022 via cluster sampling. The basic situation of volunteers and nurses and their team cooperation in actual work (including work foundation, publicity and education evaluation, work content and smoothness of working together) were investigated with a self-made questionnaire. Results Questionnaires of 112 volunteers and 50 nurses were valid. Among volunteers, men accounted for 75.91% of all volunteers, mainly aged 18~45 years (77.68%). Among nurses, women account for the 78.00% of all volunteers, mainly aged 18~45 years (92.00%). 88.39% of the volunteers joined the volunteer service based on their own wills, and 93.75% had a general knowledge of COVID-19 before being officially elected. More than 70% of volunteers and nurses believed that the pre-work education was detailed. For the pre-work evaluation, a larger proportion of nurses felt that the evaluation was relatively rough. More than 50% of volunteers and nurses believed that the daily tasks were necessary and easy. However, a larger proportion of nurses believed that volunteers were not required to participate in the epidemiological investigation (26.00% vs 12.50%, Chi-square=4.536, P=0.041) and nucleic acid sampling of new patients (44.00% vs 24.11%, Chi-square=6.484, P=0.016), and that it was more difficult for volunteers to deliver three meals (40.00% vs 8.04%, Chi-square=24.032, P < 0.001) and nucleic acid sampling (38.00% vs 14.29%, Chi-square=11.478, P=0.001). For the situation of working together, there was significant difference between volunteers and nurses in the item of whether the volunteers had extra and over workload or not(Fisher=22.257, P < 0.001). For other items, both volunteers and nurses believed that it was prompt to solve problems and get along well in work. Conclusion The team collaboration between volunteers and nurses in makeshift hospital is generally good, which effectively solves the problem of shortage of medical care.

BackgroundInformal caregivers of persons with dementia (PWD) often suffer adverse impacts on their mental health and require interventions for effective support. As they are often occupied with providing care, web-based interventions could be more convenient and efficient for them. However, there is currently a dearth of evidence-based mobile interventions to enhance the mental well-being of dementia caregivers locally, especially ones that are user-centered and culturally relevant. Hence, having designed an app based on feedback from local dementia caregivers, this study will evaluate the effectiveness of this mobile app in promoting the mental health of informal caregivers of PWD in Singapore.MethodsA pilot two-armed randomised controlled trial will be conducted on 60 informal caregivers of PWD recruited via convenience and snowball sampling. Thirty participants will be assigned to the intervention group, while another 30 will be in a waiting-list control group. Questionnaires will be administered at baseline and one month after, with the primary outcome being the difference in the change of depressive symptoms among the two groups.Statistical analysisPrimary analyses will follow the intention-to-treat principle and compare changes from baseline to the one-month follow-up time point relative to the control group. A repeated measures ANOVA will be conducted to examine differences between the groups over time.SignificanceTo our knowledge, this is the first study in Singapore that seeks to promote the mental health of informal dementia caregivers through a mobile-based intervention. The findings can inform the development and evaluation of future evidence-based digital interventions for local informal caregivers of PWD to address the gap in availability of such resources for them.Trial registrationClinicalTrials.gov (NCT05551533). Registration date: September 22, 2022.

The establishment of an industrial benefit distribution mechanism for reservoir migrants in water conservancy and hydropower projects is a crucial part. This paper establishes the logistic regression model with gradient descent by deriving the objective function and using the gradient descent method to solve its approximate solution. Then, the model is applied to predict the total income and total expenditure of reservoir migrants before and after agricultural resettlement and tertiary resettlement, and the criteria for benefit compensation distribution are given based on the comparison before and after relocation. In the case of agricultural resettlement, the average share of equal compensation in the first 5 years accounts for 54.67% of the predicted income, and the predicted average annual growth rate of net income per capita is 17.86% with a discount rate of 3.12%. In the tertiary placement case, the predicted growth rates of wage income in the first 5 years are 7.49%, 4.84%, 10.56%, and 1.15%, respectively, and the average annual growth rate of transfer income is 7.01%, and the average annual growth rate of government subsidies is 0.80%. The prediction accuracy of the logistic regression model based on gradient decline reached 84.14%, and the analysis of the distribution of industrial benefits for reservoir migrants was credible. To let the living standard of migrants recover and exceed the level of non-relocation as soon as possible, it is necessary to give migrants certain compensation for production and life recovery based on the living standard measurement index.

Few studies have delved into the effects of heatwaves on sleep duration loss among older adults. Our study examined correlations between heatwave exposure and sleep duration reductions in this demographic. Utilizing data of 7,240 older adults drawn from the China Health and Retirement Longitudinal Study (CHARLS) from 2015 to 2018, we assessed sleep duration differences between the baseline year (2015) and follow-up year (2018). Absolute reductions in sleep duration were defined as differences of ≥ 1, 1.5, or 2 h. Changes in sleep duration were categorized based on cut-offs of 5 and 8 h, including excessive decrease, moderate to short and persistent short sleep duration types. 12 heatwave definitions combining four thresholds (90th, 92.5th, 95th, and 97.5th percentiles of daily minimum temperature) and three durations (≥2, ≥3 and ≥ 4 days) were used. Heatwave exposure was determined by the difference in the number of 12 preceding months' heatwave days or events in 2015 and the number of 12 preceding months' heatwave days or events in 2018. The results showed that increased heatwave events (defined as ≥ P90th percentile & lasting three days) were associated with a higher likelihood of ≥ 1-hour sleep reduction and persistent short sleep duration. An increase in heatwave event (defined as ≥ P95th percentile & lasting three days) was linked to shifts from moderate to short sleep duration. For the association between an absolute reduction in sleep duration and heatwave exposure, while higher thresholds signified greater sleep reduction risks, the effect estimates of longer durations were not uniformly consistent. We observed that air pollution and green space modified the relationship between heatwaves and sleep duration. Females, urban residents, and individuals with chronic diseases were identified as vulnerable populations. This study found that increased heatwave exposure was associated with a higher risk of sleep duration loss in older adults.

Objective: Hepatic steatosis is a key initiating event in the pathogenesis of alcohol-associated liver disease (ALD), the most detrimental organ damage resulting from alcohol use disorder. However, the mechanisms by which alcohol induces steatosis remain incompletely understood. We have previously found that alcohol binging impairs brain insulin action, resulting in increased adipose tissue lipolysis by unrestraining sympathetic nervous system (SNS) outflow. Here, we examined whether an impaired brain–SNS–adipose tissue axis drives hepatic steatosis through unrestrained adipose tissue lipolysis and increased lipid flux to the liver. Methods: We examined the role of lipolysis, and the brain–SNS–adipose tissue axis and stress in alcohol induced hepatic triglyceride accumulation in a series of rodent models: pharmacological inhibition of the negative regulator of insulin signaling protein-tyrosine phosphatase 1β (PTP1b) in the rat brain, tyrosine hydroxylase (TH) knockout mice as a pharmacogenetic model of sympathectomy, adipocyte specific adipose triglyceride lipase (ATGL) knockout mice, wildtype (WT) mice treated with β3 adrenergic agonist or undergoing restraint stress. Results: Intracerebral administration of a PTP1b inhibitor, inhibition of adipose tissue lipolysis and reduction of sympathetic outflow ameliorated alcohol induced steatosis. Conversely, induction of adipose tissue lipolysis through β3 adrenergic agonism or by restraint stress worsened alcohol induced steatosis. Conclusions: Brain insulin resistance through upregulation of PTP1b, increased sympathetic activity, and unrestrained adipose tissue lipolysis are key drivers of alcoholic steatosis. Targeting these drivers of steatosis may provide effective therapeutic strategies to ameliorate ALD.

Recent advances in inverse-design approaches for discovering optical structures based on desired functional characteristics have reshaped the landscape of nanophotonic structures, where most studies have focused on how light interacts with nanophotonic structures only. When quantum emitters (QEs), such as atoms, molecules, and quantum dots, are introduced to couple to the nanophotonic structures, the light–matter interactions become much more complicated, forming a rapidly developing field – quantum nanophotonics. Typical quantum functional characteristics depend on the intrinsic properties of the QE and its electromagnetic environment created by the nanophotonic structures, commonly represented by a scalar quantity, local-density-of-states (LDOS). In this work, we introduce a generalized inverse-design framework in quantum nanophotonics by taking LDOS as the bridge to connect the nanophotonic structures and the quantum functional characteristics. We take a simple system consisting of QEs sitting on a single multilayer shell–metal–nanoparticle (SMNP) as an example, apply fully-connected neural networks to model the LDOS of SMNP, inversely design and optimize the geometry of the SMNP based on LDOS, and realize desirable quantum characteristics in two quantum nanophotonic problems: spontaneous emission and entanglement. Our work introduces deep learning to the quantum optics domain for advancing quantum device designs; and provides a new platform for practicing deep learning to design nanophotonic structures for complex problems without a direct link between structures and functional characteristics.

Combining the anomalies and environmental monitoring data of the early stage Beidou satellites, the space radiation environment spatial/temporal distribution and space radiation effect risk characteristics are analyzed, and the dynamic characteristics of space environmental factors, such as hot plasma, high-energy electron and solar proton are summarized. The systematic joint monitoring for surface charging, internal charging, single event effect and total dose effect with corresponding space environment factors is proposed. The detector types, measurement parameters range and engineering constraints are allocated, and the engineering application and scientific research of detection data are prospected.

Abstract Background Our study determined Multiple Mini-Interview (MMI) effectiveness in evaluating specific skill sets based on medical students’ performances during the undergraduate years and compared the academic performances of medical students who appeared for onsite/online MMI. Methods A retrospective study of 140 undergraduate medical students between 2016 and 2020 included data on age, gender, pre-university results, MMI scores, and examination results. Appropriate non-parametric tests were applied to compare the students’ MMI and academic performances. Results Ninety-eight students from cohorts 12 to 15 had an overall MMI score of 69.0(IQR: 65.0—73.2)/100 and an overall Cumulative Grade Point Average(GPA) of 3.64 (3.42—3.78)/5.0. Spearman’s correlation revealed a significantly positive relationship between MMI and cGPA (rho = 0.23) and GPA from the first 2 semesters (GPA1 rho = 0.25, GPA2 rho = 0.27). This observation was similar to that for station A in the first year (cGPA rho = 0.28, GPA1 rho = 0.34, GPA2 rho = 0.24), and in station B (GPA4 rho = 0.25) and D (GPA3 rho = 0.28, GPA4 rho = 0.24) in the second year. Of twenty-nine cohort16 students, 17(58.6%) underwent online and 12(41.4%) offline modes of MMI assessment, respectively. The overall median MMI score was 66.6(IQR: 58.6—71.6)/100, and the overall median cGPA was 3.45 (3.23—3.58)/5.0. When comparing the median marks of cohort16 groups, the online group scored significantly higher marks for station D than the offline group (p = 0.040). Conclusion Correspondence between MMI scores and cGPA predicted MMI scoring during student selection and entry process might ensure the success of their academic performance in medical school.

Objective To retrospectively evaluate the clinical efficacy and safety of brentuximab vedotin(BV) combined with chemotherapy in the treatment of malignant lymphoma. Methods We collected the data of 32 lymphoma patients with CD30-positive status, including 14 cases of Hodgkin's lymphomas, 2 cases of diffuse large B-cell lymphomas, and 16 cases of mature T/NK cell lymphomas. Chemotherapy combined with BV was administered to all patients for a minimum of two cycles. The efficacy of the treatment was evaluated according to Lugano criteria every two cycles. Results Complete response rate and overall response rate after four cycles of treatment were 22% and 50%, respectively. Sixteen cases (50.0%) had grades 1 and 2 toxicity, and 16 cases (50.0%) had grade 3 toxicity or higher. The most common adverse events were neutropenia (50.0%), pneumonia (46.9%), and anemia (43.8%). The most common grade 3 or higher adverse events were pneumonia (18.8%) and febrile neutropenia (12.5%). Four patients discontinued brentuximab vedotin because of severe adverse events. Conclusion BV is effective in treating relapsed and refractory CD30- positive Hodgkin's lymphoma and peripheral T-cell lymphoma, and its overall safety is acceptable.

Abstract Patients with internal carotid artery dissection (ICAD) usually report headache, neck pain, Horner's syndrome, and ischemic stroke. Because the posterior cranial nerve is involved, some patients may show different forms of posterior cranial nerve paralysis. There have been no reports of patients with ICAD showing repeated hiccups. Here, to help clinicians identify ICAD early and gain a better understanding of the atypical manifestations of the disease, we report an atypical case of recurrent hiccup symptoms caused by ICAD.

Clarify the value of ceramic containers used in tea packaging from the development process, study the impact of contemporary consumer culture, industrialization and globalization on ceramic tea packaging containers, discuss the orientation and development strategy of contemporary ceramic containers design applied to tea packaging.

ObjectiveTo investigate the willingness of middle school students to engage in medicine and its influencing factors during COVID-19 pandemic in Lanzhou， so as to provide references for the early career planning education on middle school students.MethodsConvenient sampling method was used to choose 1 795 middle school students from 5 schools in Lanzhou from July 21 to July 31， 2022 for this study where an online questionnaire survey was distributed to collect data. A self-compiled questionnaire was used to gather the general information， assess the willingness to engage in medicine and seek the underlying reasons. The psychological resilience level of students was assessed using Resilience Scale for Adolescents. Then multivariate Logistic regression analysis was conducted to screen the factors associated with the willingness of middle school students to engage in medicine.ResultsAfter the local outbreak of COVID-19 in Lanzhou， 835 （46.52%） middle school students demonstrated their willingness to engage in medicine， and the top three reasons for their willingness were being affected by medical staff during the pandemic （75.69%）， having interests in medical sciences （67.31%）， and the potential increase of attention to national medical development after the epidemic （43.23%）. Logistical regression analysis showed that female gender （OR=1.438， P

Abstract Background TORCH infections are the most common prenatal infections causing congenital malformation and infant mortality, especially in developing countries. Migrant women might be vulnerable to TORCH infections, but little is known about the association between migration-related characteristics and TORCH infection risk. This study aimed to investigate the impact of migrant status, migration distance, and the spouse’s migrant status on the TORCH epidemic among women of childbearing age. Methods Based on the National Free Preconception Health Examination Project, we analyzed a representative dataset of TORCH infections among women of childbearing age (15–49 years old) in Guangdong Province of China (2014–2019, n = 2,451,297). The past and/or recent infection status of TORCH infections (Toxoplasma gondii [TOX], Cytomegalovirus [CMV], and Rubella virus [RV]) were identified. Demographic and migration-related characteristics were collected. We thoroughly assessed the prevalence of TORCH infections in both migrant and native women and estimated adjusted odd ratios (aOR) for migration-related characteristics using multivariable logistic regression after adjusting the other sociodemographic factors. Results Among all 2,451,297 participants, 443,725 (18.1%) were migrant women. Migrant women presented a lower risk of past TOX infection (aOR: 0.89, 0.88–0.91) suggesting a healthy migrant effect (HME), but a higher risk of recent TOX infection (aOR: 1.88, 1.77–1.99), past CMV infection (aOR: 1.26, 1.25–1.28) and RV infection in natural ways (aOR: 1.05, 1.04–1.06). Compared with intra-provincial migrants, inter-provincial migrants had a lower past TOX infection (aOR: 0.88, 0.85–0.91), but a higher risk of recent TOX infection (aOR: 1.16, 1.05–1.27) and RV infection (aOR: 1.33, 1.31–1.36). In addition, having a migrant spouse was associated with a higher risk for all types of infection. Conclusion This study reported the association of migrant status and migration distance with TORCH infections, although the significance and directionality of these associations varied between pathogens. The spouse’s migrant status further amplified the infection risk for all types of pathogens. Our findings suggested interventions for preventing the spread of CMV and RV infection and new acquisition of TOX infection for migrants in southern China, to narrow the native-migrant health inequity and decrease the incidence of prenatal infections and related adverse outcomes.

BackgroundHysterosalpingography (HSG) is the most commonly applied tubal patency test in clinical practice. Although some studies have found an increased pregnancy rate after HSG, no studies to date have specifically characterized the effect of interval time between HSG and IUI on pregnancy outcome.ObjectivesTo investigate the effect of interval time between HSG and intrauterine insemination (IUI) on live birth rates of infertile patients.MethodsRetrospective cohort study. The reproductive medical record system was used to identify patients who completed ≥1 IUI cycle between January 2017 and October 2021. According to the interval time between HSG and IUI, patients were divided into three groups: 12 months interval group. The generalized estimating equation with Poisson distribution was used to estimate the risk ratios (RRs) and 95% confidence intervals (CIs) of different groups.ResultsA total of 413 patients completed 701 IUI cycles during the study period, 12 months interval group, 148 cycles. The live birth rate of 12 months group severally significantly decreased by 60% (adjusted RR = 0.40, 95% CI [0.19–1.40]). The cumulative clinical pregnancy and live birth rates of

Cervical artery dissection (CeAD), a special cerebrovascular disease and the main cause of stroke in young people, can present with ischemic stroke, headache, subarachnoid hemorrhage, and other symptoms, increasing the possibility of misdiagnosis. As a special class of non-coding RNAs, circRNAs are commonly found in organisms and can play regulatory roles in transcription and post-transcription processes, affecting gene expression.CircRNAs have reported to be associated with neurological diseases; however, their role in CeAD has not been discerned. In this study, we aimed to elucidate the pathophysiological changes in patients with CeAD and identify biomarkers. Peripheral blood mononuclear cells from patients with CeAD and healthy controls were sequenced using high-throughput sequencing. We detected 460 differently expressed circRNAs in patients with CeAD (p

BackgroundRecent researches have shown a correlation between the gut microbiota (GM) and various diseases. However, it remains uncertain whether the relationship between GM and benign prostatic hyperplasia (BPH) is causal.MethodsWe carried out a two-sample Mendelian randomization (MR) analysis, utilizing data from the most extensive GM-focused genome-wide association study by the MiBioGen consortium, with a sample size of 13,266. Data for BPH, encompassing 26,358 cases and 110,070 controls, were obtained from the R8 release of the FinnGen consortium. We employed multiple techniques, such as inverse variance weighted (IVW), constrained maximum likelihood and model averaging methods, maximum likelihood, MR-Pleiotropy RESidual Sum and Outlier (MRPRESSO),MR-Egger, and weighted median methods, to investigate the causal relationship between GM and BPH. To evaluate the heterogeneity among the instrumental variables, Cochran’s Q statistics were employed. Additionally, the presence of horizontal pleiotropy was assessed through the application of both MR-Egger and MR-PRESSO tests. The direction of causality was scrutinized for robustness using the MR-Steiger directionality test. A reverse MR analysis examined the GM previously linked to BPH through a causal relationship in the forward MR assessment.ResultsAccording to the analysis conducted using IVW,Eisenbergiella (odds ratio [OR]=0.92, 95% confidence interval [CI]: 0.85–0.99,P=0.022) and Ruminococcaceae (UCG009) (OR=0.88, 95% CI: 0.79–0.99, P=0.027) were found to reduce the risk of BPH, while Escherichia shigella (OR=1.19, 95% CI: 1.05–1.36, P=0.0082) appeared to increase it. The subsequent reverse MR analysis revealed that the three GM were not significantly influenced by BPH, and there was no noticeable heterogeneity or horizontal pleiotropy among the instrumental variables.Conclusion: These results indicated a causal relationship between Eisenbergiella, Ruminococcaceae (UCG009), and Escherichia shigella and BPH. Further randomized controlled trials are needed to explore more comprehensively the roles and operational mechanisms of these GM in relation to BPH.

Myocardial fibrosis, which is a common pathological manifestation of many cardiovascular diseases, is characterized by excessive proliferation, collagen deposition and abnormal distribution of extracellular matrix fibroblasts. In clinical practice, modern medicines, such as diuretic and β receptor blockers, and traditional Chinese medicines, such as salvia miltiorrhiza and safflower extract, have certain therapeutic effects on myocardial fibrosis. We reviewed some representative modern medicines and traditional Chinese medicines (TCMs) and their related molecular mechanisms for the treatment of myocardial fibrosis. These drugs alleviate myocardial fibrosis by affecting related signaling pathways and inhibiting myocardial fibrosis-related protein synthesis. This review will provide more references and help for the research and treatment of myocardial fibrosis.