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Plant natural products (PNPs) exhibit a wide range of biological activities and have essential applications in various fields such as medicine, agriculture, and flavors. Given their natural limitations, the production of high-value PNPs using microbial cell factories has become an effective alternative in recent years. However, host metabolic burden caused by its massive accumulation has become one of the main challenges for efficient PNP production. Therefore, it is necessary to strengthen the transmembrane transport process of PNPs. This review introduces the discovery and mining of PNP transporters to directly mediate PNP transmembrane transportation both intracellularly and extracellularly. In addition to transporter engineering, this review also summarizes several auxiliary strategies (such as small molecules, environmental changes, and vesicles assisted transport) for strengthening PNP transportation. Finally, this review is concluded with the applications and future perspectives of transportation engineering in the construction and optimization of PNP microbial cell factories.

Abstract River ecosystems face challenges due to environmental degradation and alterations in flow and sediment transport resulting from climate change and other anthropogenic impacts. These changes may substantially affect river morphology, nutrient dynamics, wetland vegetation, aquatic habitats, and river ecological stability. This highlights the urgent need for systematic and quantitative studies on the interactions and feedback between changes in flow, sediment transport, and river ecology. In this study, we reviewed flow and sediment transport changes in major Chinese rivers, along with their resulting ecological impacts. We propose conducting eco‐fluvial dynamic studies, a potential solution that can guide the evaluation and restoration of ecological health impacted by physical processes. These studies can provide major benefits in balancing human and environmental needs in large river systems, which is crucial for the healthy and sustainable development of rivers.

Abstract Background Increasing studies focused on the efficacy of acupuncture on pregnancy outcomes in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization-embryo transfer (IVF-ET). However, debatable conclusions have been drawn from different randomized controlled trials (RCTs), which might be related to different doses of acupuncture. Objective To evaluate whether acupuncture has a dose-dependent effect on pregnancy outcomes in patients with PCOS undergoing IVF-ET in systematically reviewing. Methods Seven electronic databases were searched from inception to October 10th, 2024. The Cochrane Collaboration’s tool ROB 2.0 (ROB 2.0) provided an assessment for the risk of bias. The acupuncture dose was extracted, then categorized into high, medium, and low dose according to the scoring system results, the evidence was assessed by Slavin’s qualitative best-evidence synthesis approach in a rigours methodological way. Clinical pregnancy rate (CPR) was regarded as the primary outcome. Results A total of 953 subjects met the eligibility criteria in 12 RCTs were included, among which two studies were low dose, four were medium dose, and six were high dose. The overall quality of included studies was low, 50.00% (6/12) studies were low risk, 16.67% (2/12) studies were some concerns, and 33.33% (4/12) studies were high risk. Comparing the results, the consistent high-dose result among high-quality trials provides strong evidence for a positive correlation between high-dose acupuncture and pregnancy outcomes. Conclusion A trend indicates that higher acupuncture doses yield better outcomes for PCOS patients undergoing IVF-ET. Further confirmation through direct comparisons of different doses was needed. Trial registration The systematic review has been registered on PROSPERO ( https://www.crd.york.ac.uk/prospero/ ), and the registration number is CRD42023400187.

Abstract Activating mutations in NRAS account for 15–20% of melanoma, yet effective anti-NRAS therapies are still lacking. In this study, we unveil the casein kinase 1δ (CK1δ) as an uncharacterized regulator of oncogenic NRAS mutations, specifically Q61R and Q61K, which are the most prevalent NRAS mutations in melanoma. The genetic ablation or pharmacological inhibition of CK1δ markedly destabilizes NRAS mutants and suppresses their oncogenic functions. Moreover, we identify USP46 as a bona fide deubiquitinase of NRAS mutants. Mechanistically, CK1δ directly phosphorylates USP46 and activates its deubiquitinase activity towards NRAS mutants, thus promoting oncogenic NRAS-driven melanocyte malignant transformation and melanoma progression in vitro and in vivo. Our findings underscore the significance of the CK1δ-USP46 axis in stabilizing oncogenic NRAS mutants and provide preclinical evidence that targeting this axis holds promise as a therapeutic strategy for human melanoma harboring NRAS mutations.

Abstract Background Acute lung injury (ALI) is the most lethal disease associated with sepsis, and there is a lack of effective drug treatment. As the major cells of sepsis-induced ALI, macrophages polarize toward the proinflammatory M1 phenotype and secrete multiple inflammatory cytokines to accelerate the disease process through nuclear factor kappa-B (NF-κB) and NLR family pyrin domain containing 3 (NLRP3) inflammasome signaling pathways. Taraxerone, the main component of the Chinese medicinal Sedum, possesses numerous biological activities. However, uncertainty remains regarding the potential of taraxerone to protect against sepsis-induced ALI. This study aimed to investigate the effects and mechanisms of taraxerone against ALI. Methods An animal model for ALI was established by cecal ligation and puncture and treated with taraxerone via intraperitoneal administration. The protective effect of taraxerone on the lungs was analyzed using H&E staining, dihydroethidium staining, ELISA kits, cell counting, myeloperoxidase kit, malondialdehyde kit, glutathione kit, superoxide dismutase kit and flow cytometry. Western blotting, RT-PCR, flow cytometry, co-immunoprecipitation, and immunofluorescence were used to investigate the regulatory of taraxerone on SIRT1. Results Our study demonstrates for the first time that taraxerone can activate SIRT1 in macrophages, promoting SIRT1 activity. This activation inhibited the NF-κB signaling pathway primarily through the dephosphorylation and deacetylation of p65. Simultaneously, taraxerone disrupted the NLRP3 inflammasome signaling pathway, thereby alleviating M1 polarization of macrophages and mitigating sepsis-induced pulmonary inflammation and oxidative stress. In vivo, EX527 was used to validate the anti-inflammatory and anti-oxidative stress effects of taraxerone mediated by SIRT1. Conclusion SIRT1-mediated anti-inflammatory and anti-oxidative stress effects may be important targets for taraxerone in treating ALI.

Abstract Ground settlement prediction for highway subgrades is crucial in related engineering projects. When predicting the ground settlement, sparse sample data are often encountered in practice, which greatly affects the prediction accuracy. However, this has been seldom explored in previous studies. To resolve it, this paper proposes a regression Kriging (RK)—based method for ground settlement prediction with sparse data. Under the framework of RK, the stationarity of sample residual and trend structure are key factors for prediction accuracy. It is found that the use of Box–Cox transformation, which can help to achieve stationarity of sample residual, leads to significant increase of the prediction accuracy with sparse data. Specifically, the various evaluation metrics (i.e., root mean square error (RMSE), mean absolute error (MAE), mean arctangent absolute percent error (MAAPE) and scatter index (SCI)) are significantly decreased when the Box–Cox transformation is incorporated. In addition, the first-order polynomial trend structure is found to be more appropriate than those with higher orders for predicting settlements resulting from primary consolidation. Moreover, comparative study is conducted among the proposed RK method, classical prediction methods and back propagation neural network (BPNN). It is found that the evaluation metrics obtained by the RK method are significantly smaller than those obtained by the other methods, indicating its highest accuracy. By contrast, BPNN has the worst performance among the various methods, because the sparse data are inadequate to establish a satisfactory BPNN model.

Abstract Solid fuel combustion exposure is a leading global health risk factor, yet evidence on its effects, especially on vulnerable children, is sparse. This large-scale, multi-center prospective study aimed to address this gap by involving 9997 schoolchildren across China between 2013 and 2015. Here we show that lung function levels exhibited a marginally significant decline among children exposed to solid fuel usage. Specifically, FVC and FEV1 decreased by 21.2 mL (95% CI: −15.7, 58.1) and 24.1 mL (−8.4, 56.6), respectively. Additionally, PEF, FEF25 and FEF75 decreased by 25.7 mL/s (−46.5, 98.0), 32.7 mL/s (−42.7, 108.2), and 35.4 mL/s (−5.9, 76.7), respectively. Persistent exposure to solid fuel usage in children led to greater lung damage. Children with allergy history were more susceptible to solid fuel exposure. Our study highlights the adverse impact of solid fuel usage on children and the need to promote clean fuel usage for this vulnerable population.

Abstract Background Previous studies have established a positive link between nurse managers’ caring leadership and nurses’ work engagement, but the processes and conditions through which this leadership style influences positive work behaviors remain largely unexplored. To address this gap and contribute to the existing body of knowledge, we developed a chain-mediated effects model to elucidate the impact of caring leadership on nurses’ work engagement and the underlying mechanisms. In this model, we identified professional mission and affective organizational commitment as the mediating variables, offering a novel perspective on the relationship between caring leadership and work engagement. Methods A robust multi-center and large-sample cross-sectional survey was conducted, involving 2502 first-line nurses from six general tertiary hospitals across the eastern, central, and western regions of China. The data collection instruments included a comprehensive questionnaire covering demographic information, the caring leadership scale, the Chinese calling scale, the affective organizational commitment scale, and the Utrecht work engagement scale. Data were meticulously screened and analyzed, employing descriptive analysis to summarize the demographic information, correlation analysis to test the relationship among the variables, stepwise regression analysis to explore the mediating role of calling and affective organization commitment, and the bootstrap method to test the chain mediating effect. This rigorous methodology not only ensures the reliability and validity of research findings but also instills confidence in the robustness of this research. Results The results indicated a positive relationship among caring leadership, calling, affective organizational commitment, and nurses’ work engagement (p

Abstract The impact of the ketogenic diet (KD) on overall mortality and cardiovascular disease (CVD) mortality remains inconclusive.This study enrolled a total of 43,776 adults from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2018 to investigate the potential association between dietary ketogenic ratio (DKR) and both all-cause mortality as well as cardiovascular disease(CVD) mortality.Three models were established, and Cox proportional hazards regression analysis was employed to examine the correlation. Furthermore, a restricted cubic spline function was utilized to assess the non-linear relationship. In addition, subgroup analysis and sensitivity analysis were performed.In the adjusted Cox proportional hazards regression model, a significant inverse association was observed between DKR and all-cause mortality (HR = 0.76, 95% CI = 0.63–0.9, P = 0.003). However, no significant association with cardiovascular mortality was found (HR = 1.13; CI = 0.79–1.6; P = 0.504). Additionally, a restricted cubic spline(RCS) analysis demonstrated a linear relationship between DKR and all-cause mortality risk. In the adult population of the United States, adherence to a KD exhibits potential in reducing all-cause mortality risk while not posing an increased threat of CVD-related fatalities.

Abstract Background The recent Maternal Immune Activation (MIA) theory suggests maternal systemic inflammation may serve as a mediator in associations between prenatal maternal adversities and neurodevelopmental diseases in offspring. Given the co-exposure to multiple adversities may be experienced by pregnant person, it is unclear whether a quantitative index can be developed to characterize the inflammation related exposure level, and whether this index is associated with neurodevelopmental delays in offspring. Methods Based on Jiangsu Birth Cohort (JBC), a total of 3051 infants were included in the analysis. Inflammation related Prenatal Adversity Index (IPAI) was constructed using maternal data. Neurodevelopmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development, third edition, screening test in one year. Multivariate linear regression and Poisson regression model were performed to analyze the associations between IPAI and neurodevelopment in offspring. Results Compared with “low IPAI” group, offspring with “high IPAI” have lower scores of cognition, receptive communication, expressive communication, and fine motor. The adjusted β were − 0.23 (95%CI: -0.42, -0.04), -0.47 (95%CI: -0.66, -0.28), -0.30 (95%CI: -0.49, -0.11), and − 0.20 (95%CI: -0.33, -0.06). Additionally, the elevated risk for noncompetent development of cognition and receptive communication among “high IPAI” group was observed. The relative risk [RR] and 95% confidence interval [CI] were 1.35 (1.01, 1.69) and 1.37 (1.09, 1.72). Conclusions Our results revealed a significant association between higher IPAI and lower scores across cognition, receptive communication, expressive communication, and fine motor domains, and an increased risk of noncompetent development in the cognition and receptive communication domains.

Abstract Background The intricate interplay between genetics and immunology often dictates the host’s susceptibility to various diseases. This study explored the genetic causal relationship between natural killer (NK) cell-related traits and the risk of infection. Methods Single-nucleotide polymorphisms (SNPs) significantly associated with NK cell-related traits were selected as instrumental variables to estimate their genetic causal effects on infection. SNPs from a genome-wide association study (GWAS) on NK cell-related traits, including absolute cell counts, median fluorescence intensities reflecting surface antigen levels, and relative cell counts, were used as exposure instruments. Summary-level GWAS statistics of four phenotypes of infection were used as the outcome data. The exposure and outcome data were analyzed via the two-sample Mendelian randomization method. Results Each one standard deviation increase in the expression level of human leukocyte antigen (HLA)-DR on HLA-DR+ NK cells was associated with a lower risk of pneumonia (P

Abstract Objective This study aimed to develop and validate a nomogram for assessing the risk of nosocomial infections among obstetric inpatients, providing a valuable reference for predicting and mitigating the risk of postpartum infections. Methods A retrospective observational study was performed on a cohort of 28,608 obstetric patients admitted for childbirth between 2017 and 2022. Data from the year 2022, comprising 4,153 inpatients, were utilized for model validation. Univariable and multivariable stepwise logistic regression analyses were employed to identify the factors influencing nosocomial infections among obstetric inpatients. A nomogram was subsequently developed based on the final predictive model. The receiver operating characteristic (ROC) curve was utilized to calculate the area under the curve (AUC) to evaluate the predictive accuracy of the nomogram in both the training and validation datasets. Results The gestational weeks > = 37, prenatal anemia, prenatal hypoproteinemia, premature rupture of membranes (PROM), cesarean sction, operative delivery, adverse birth outcomes, length of hospitalization (days) > 5, CVC use and catheterization of ureter were included in the ultimate prediction model. The AUC of the nomogram was 0.828 (0.823, 0.833) in the training dataset and 0.855 (0.844, 0.865) in the validation dataset. Conclusion Through a large-scale retrospective study conducted in China, we developed and independently validated a nomogram to enable personalized postpartum infections risk estimates for obstetric inpatients. Its clinical application can facilitate early identification of high-risk groups, enabling timely infection prevention and control measures.

Abstract Background Thinning practices are useful measures in forest management and play an essential role in maintaining ecological stability. However, the effects of thinning on the soil properties and microbial community in large Chinese fir timber plantations remain unknown. The purpose of this study was to investigate the changes in soil physicochemical properties and microbial community composition in topsoil (0–20 cm) under six different intensities (i.e., 300 (R300), 450 (R450), 600 (R600), 750 (R750) and 900 (R900) trees per hectare and 1650 (R1650) as a control) in a large Chinese fir timber plantation. Results Compared with the CK treatment, thinning significantly altered the contents of soil organic carbon (SOC) and its fractions but not in a linear fashion; these indicators were highest in R900. In addition, thinning did not significantly affect the soil microbial community diversity indices but significantly affected the relative abundance of the core microbial community. Proteobacteria, Acidobacteria, and Actinobacteria were the dominant bacterial phyla; the relative abundances of Proteobacteria and Acidobacteria were highest in R900, and that of Actinobacteria was lowest in R900. The dominant fungal phyla were Ascomycota, Basidiomycota and Mucoromycota; the relative abundance of Ascomycota was lowest in R900, and that of Mucoromycota was highest in R900. The fungal microbial community composition was more sensitive than the bacterial community composition. The activity of the carbon-cycling genes was not linearly correlated with thinning, and the abundance of C-cycle genes was highest in R900. Conclusions These findings are important because they show that SOC and its fractions and the abundance of the soil microorganism community in large Chinese fir timber plantations can be significantly altered by thinning, thus affecting the capacity for carbon storage. These results may advance our understanding of how the density of large timber plantations could be modified to promote soil carbon storage.

Abstract Although there is an association between income status and concentration of perfluoroalkyl and polyfluoroalkyl substance (PFAS), the association remains uncertain in patients with hypertension, hyperlipidemia, and comorbidities. Data from the 2013–2016 National Health and Nutrition Examination Survey were analyzed. A total of 2665 adults were included, and the data included participants' serum PFAS (perfluorooctanoic acid [PFOA], perfluorononaic acid, perfluorodecanoic acid, perfluoroundecanoic acid, perfluorohexane sulfonic acid, and perfluorooctane sulfonic acid) levels and selected covariates. Multivariate linear regression models were used to examine the association between the ratio of family income to poverty (PIR) and individual serum PFAS concentrations in the hypertensive and/or hyperlipidemia groups after adjusting for covariates. The potential effects of sex and age on the results were explored using stratified analysis. A mediating effect model was used to explore the mediating effects of body mass index (BMI) and waist circumference on the association results. After adjusting for potential confounders, for hyperlipidemia and comorbidities (hypertension and hyperlipidemia), serum levels of multiple common PFAS increased by 0.09% (95%Confidence interval [CI] 0.02–0.15%) to 0.13% (95%CI 0.08–0.19%) and 0.10% (95%CI 0.02–0.17%) to 0.12% (95%CI 0.06–0.18%), respectively, with each 1% increase in PIR. The covariate model and stratified analyses results suggested the potential effects of different covariates such as age and sex, leading to changes in the statistical significance of the association results. BMI significantly mediated the effect of PIR on PFOA in hyperlipidemia (13%, P

As climate change worsens, it is becoming increasingly important to effectively harness and store energy from non-fossil fuels to reduce greenhouse gas emissions. The increasing adoption of various rechargeable batteries is being driven by advancements in non-fossil energy, the development of energy storage technology, and electrification in technological fields such as electric vehicles, photovoltaic thermal energy storage, and aerospace technology. However, the compact size of batteries leads to a significant increase in their internal energy density and temperature. Elevated heat flux and temperature not only limit battery performance but also reduce lifespan and pose safety risks to battery systems. The occurrence of thermal runaway under extreme conditions is a concern as it can result in battery combustion or even explosion. Thus, the implementation of efficient battery thermal management systems is essential. Besides traditional methods such as air cooling, phase change materials, and liquid cooling, in recent years, various novel thermal management technologies, including heat pipes, nanoparticle-enhanced phase change materials, and nanofluids, have been extensively explored. Among these emerging technologies, nanofluid battery thermal management systems have garnered attention due to their significant impact, minimal additional energy consumption, and cost-effectiveness compared with alternative approaches. These systems utilize nanofluids, which are liquids with uniformly dispersed nanoparticles. Nanoparticles can contain oxides such as alumina and titanium dioxide, metals such as silver and copper, and carbon-based materials such as carbon nanotube and nanodiamond. The application of nanoparticles results in an improvement in the thermal conductivity of fluids. Moreover, nanoparticles can also supply extra nuclei, improve surface wettability, and delay bubble coalescence while boiling. Thus, nanofluids can enhance heat transfer in both single-phase and two-phase flows. Given the enhancement of heat transfer, nanofluids exhibit significant potential in battery thermal management. Herein, a systematic review of the research progress on nanofluid battery thermal management systems is presented. First, the structure, working principle, and demands of battery thermal management are given. Afterward, the concept and classification of nanofluids are introduced. Subsequently, the fundamental properties of nanofluids, such as stability, viscosity, thermal conductivity, and electrical conductivity, are elucidated. The article further discusses the current research progress on nanofluid-based battery thermal management systems applied in lithium batteries, fuel cells, and photovoltaic batteries. Finally, some notable challenges associated with nanofluid battery thermal management systems and some future development directions on numerical and experimental research and industrial applications are outlined.

Abstract Alzheimer's disease is the predominant form of dementia, and disulfidptosis is the latest reported mode of cell death that impacts various disease processes. This study used bioinformatics to analyze genes associated with disulfidptosis in Alzheimer's disease comprehensively. Based on the public datasets, the differentially expressed genes associated with disulfidptosis were identified, and immune cell infiltration was investigated through correlation analysis. Subsequently, hub genes were determined by a randomforest model. A prediction model was constructed using logistic regression. In addition, the drug-target affinity was predicted by a graph neural network model, and the results were validated by molecular docking. Five hub genes (PPEF1, NEUROD6, VIP, NUPR1, and GEM) were identified. The gene set showed significant enrichment for AD-related pathways. The logistic regression model demonstrated an AUC of 0.952, with AUC values of 0.916 and 0.864 in validated datasets. The immune infiltration analysis revealed significant heterogeneity between the Alzheimer's disease and control groups. High-affinity drugs for hub genes were identified. Through our study, a disease prediction model was constructed using potential biomarkers, and drugs targeting the genes were predicted. These results contribute to further understanding of the molecular mechanisms underlying Alzheimer's disease.

ObjectiveIn order to address the issues of inconvenience, high medical costs, and lack of universality associated with traditional knee rehabilitation equipment, a portable intelligent wheelchair for knee rehabilitation was designed in this study. MethodsBased on the analysis of the knee joint’s structure and rehabilitation mechanisms, an electric pushrod-driven rehabilitation institution was developed. A multi-functional module was designed with a modular approach, and the control of the wheelchair body and each functional module was implemented using an STM32 single-chip microcomputer. A three-dimensional model was established using SolidWorks software. In conjunction with Adams and Ansys simulation software, kinematic and static analyses were conducted on the knee joint rehabilitation institution and its core components. A prototype was constructed to verify the equipment’s actual performance. ResultsAccording to the prototype testing, the actual range of motion for the knee joint swing rod is 15.1°~88.9°, the angular speed of the swing rod ranges from −7.9 to 8.1°/s, the angular acceleration of the swing rod varies from −4.2 to 1.6°/s², the thrust range of the electric pushrod is −82.6 to 153.1 N, and the maximum displacement of the load pedal is approximately 1.7 mm, with the leg support exhibiting a maximum deformation of about 1.5 mm. ConclusionThe intelligent knee joint rehabilitation wheelchair meets the designed functions and its actual performance aligns with the design criteria, thus validating the rationality and feasibility of the structural design.

Abstract Background Reactive astrocytes participate in various pathophysiology after subarachnoid hemorrhage (SAH), including neuroinflammation, glymphatic–lymphatic system dysfunction, brain edema, BBB disruption, and cell death. Astrocytes transform into two new reactive phenotypes with changed morphology, altered gene expression, and secretion profiles, termed detrimental A1 and beneficial A2. This study investigates the effect of 67LR activation by PEDF-34, a PEDF peptide, on neuroinflammation and astrocyte polarization after the experimental SAH. Methods A total of 318 male adult Sprague-Dawley rats were used in experiments in vivo, of which 272 rats were subjected to the endovascular perforation model of SAH and 46 rats underwent sham surgery. 67LR agonist (PEDF-34) was administrated intranasally 1 h after SAH. 67LR-specific inhibitor (NSC-47924) and STAT1 transcriptional activator (2-NP) were injected intracerebroventricularly 48 h before SAH. Short- and long-term neurological tests, brain water content, immunostaining, Nissl staining, western blot, and ELISA assay were performed. In experiments in vitro, primary astrocyte culture with hemoglobin (Hb) stimulation was used to mimic SAH. The expression of the PEDF-34/67LR signaling pathway and neuro-inflammatory cytokines were assessed using Western blot, ELISA, and immunohistochemistry assays both in vivo and in vitro. Results Endogenous PEDF and 67LR expressions were significantly reduced at 6 h after SAH. 67LR was expressed in astrocytes and neurons. Intranasal administration of PEDF-34 significantly reduced brain water content, pro-inflammatory cytokines, and short-term and long-term neurological deficits after SAH. The ratio of p-JNK/JNK and p-STAT1/STAT1 and the expression of CFB and C3 (A1 astrocytes marker), significantly decreased after PEDF-34 treatment, along with fewer expression of TNF-α and IL-1β at 24 h after SAH. However, 2-NP (STAT1 transcriptional activator) and NSC-47924 (67LR inhibitor) reversed the protective effects of PEDF-34 in vivo and in vitro by promoting A1 astrocyte polarization with increased inflammatory cytokines. Conclusion PEDF-34 activated 67LR, attenuating neuroinflammation and inhibiting astrocyte A1 polarization partly via the JNK/STAT1 pathway, suggesting that PEDF-34 might be a potential treatment for SAH patients. Graphical Abstract

Abstract Background Systemic inflammation markers have recently been identified as being associated with cardiac disorders. However, limited research has been conducted to estimate the pre-diagnostic associations between these markers and paroxysmal atrial fibrillation (PAF). Our aim is to identify potential biomarkers for early detection of PAF. Methods 91 participants in the PAF group and 97 participants in the non-PAF group were included in this study. We investigated the correlations between three systemic inflammation markers, namely the systemic immune inflammation index (SII), system inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI), and PAF. Results The proportion of patients with PAF gradually increased with increasing logSII, logSIRI, and logAISI tertiles. Compared to those in the lowest tertiles, the PAF risks in the highest logSII and logSIRI tertiles were 3.2-fold and 2.9-fold, respectively. Conversely, there was no significant correlation observed between logAISI and PAF risk within the highest tertile of logAISI. The restricted cubic splines (RCS) analysis revealed a non-linear relationship between the elevation of systemic inflammation markers and PAF risk. Specifically, the incidence of PAF is respectively increased by 56%, 95%, and 150% for each standard deviation increase in these variables. The ROC curve analysis of logSII, logSIRI and logAISI showed that they had AUC of 0.6, 0.7 and 0.6, respectively. It also demonstrated favorable sensitivity and specificity of these systemic inflammation markers in detecting the presence of PAF. Conclusions In conclusion, our study reveals significant positive correlations between SII, SIRI, and AISI with the incidence of PAF.

Abstract Excessive phosphorus (P) levels can disrupt nutrient balance in plants, adversely affecting growth. The molecular responses of Pennisetum species to high phosphorus stress remain poorly understood. This study examined two Pennisetum species, Pennisetum americanum × Pennisetum purpureum and Pennisetum americanum, under varying P concentrations (200, 600 and 1000 µmol·L− 1 KH2PO4) to elucidate transcriptomic alterations under high-P conditions. Our findings revealed that P. americanum exhibited stronger adaption to high-P stress compared to P. americanum× P. purpureum. Both species showed an increase in plant height and leaf P content under elevated P levels, with P. americanum demonstrating greater height and higher P content than P. americanum× P. purpureum. Transcriptomic analysis identified significant up- and down-regulation of key genes (e.g. SAUR, GH3, AHP, PIF4, PYL, GST, GPX, GSR, CAT, SOD1, CHS, ANR, P5CS and PsbO) involved in plant hormone signal transduction, glutathione metabolism, peroxisomes, flavonoid biosynthesis, amino acid biosynthesis and photosynthesis pathways. Compared with P. americanum× P. purpureum, P. americanum has more key genes in the KEGG pathway, and some genes have higher expression levels. These results contribute valuable insights into the molecular mechanisms governing high-P stress in Pennisetum species and offer implications for broader plant stress research.

BackgroundThe cardiovascular-kidney-metabolic index (CKMI), a novel functional indicator proposed in this study, aims to accurately reflect the functional status of the heart, kidneys, and metabolism. However, its ability to predict mortality risk in critically ill patients during their stay in the intensive care unit (ICU) remains uncertain. Therefore, this study aims to validate the correlation between the CKMI during hospitalization and all-cause mortality.MethodsThe study utilized the Medical Information Mart for Intensive Care IV 2.2 (MIMIC-IV) dataset for a retrospective analysis of cohorts. The cohorts were divided into quartiles based on CKMI index levels. The primary endpoint was all-cause mortality during ICU and hospital stay, while secondary endpoints included the duration of ICU stay and overall hospitalization period. We established Cox proportional hazards models and employed multivariable Cox regression analysis and restricted cubic spline (RCS) regression analysis to explore the relationship between CKMI index and all-cause mortality during hospitalization in critically ill patients. Additionally, subgroup analyses were conducted based on different subgroups.ResultsThe study enrolled 1,576 patients (male 60.79%). In-patient and ICU mortality was 11.55% and 6.73%. Multivariate COX regression analysis demonstrated a significant negative correlation between CKMI index and the risk of hospital death [HR, 0.26 (95% CI 0.07–0.93), P = 0.038] and ICU mortality [HR, 0.13 (95% CI 0.03–0.67), P = 0.014].RCS regression model revealed that in-hospital mortality (P-value =0.015, P-Nonlinear =0.459) and ICU mortality (P-value =0.029, P-Nonlinear =0.432) increased linearly with increasing CKMI index. Subgroup analysis confirmed consistent effect size and direction across different subgroups, ensuring stable results.ConclusionOur research findings suggest that a higher CKMI index is associated with a significant reduction in both in-hospital and ICU mortality among critically ill patients. Therefore, CKMI index emerges as a highly valuable prognostic indicator for predicting the risk of in-hospital death in this population. However, to strengthen the validity of these results, further validation through larger-scale prospective studies is imperative.

BackgroundBody Mass Index (BMI) and grip strength are potentially important risk factors for falls among the older adults. Currently, there is no consensus on the combined effects of grip strength and BMI on falls in the older adults, particularly among the Chinese older adults.ObjectiveTo investigate the incidence of falls among older adults in China and explore the association between BMI and grip strength and the risk of falls in older adults.MethodsData of participants over 60 in China Health and Retirement Longitudinal Study in 2011 and 2013 were collected. Sociodemographic variables, lifestyle, chronic disease status, history of falls and depression and cognitive status were obtained through the 2011 baseline questionnaire. Height, weight and grip strength were collected from a unified physical examination in 2011. Falls during the follow-up period were obtained through the follow-up questionnaire in 2013. Logistic regression was used to explore the association between BMI and grip strength and the risk of falls.ResultsThree thousand six hundred and eighty-five participants over 60 (67.14 ± 6.08) were included, with a fall incidence rate of 17.37%. The fall incidence rate in females (21.15%) was higher than that in male (13.46%). After adjusting covariates, high grip strength was associated with lower falls risks in general population (OR = 0.76; 95 CI: 0.630–0.923) and males (OR = 0.68; 95 CI: 0.503–0.919). Underweight was associated with lower falls risks in general population (OR = 0.77; 95 CI: 0.595–0.981) and females (OR = 0.69; 95 CI: 0.486–0.962) compared to the normal BMI group. Compared with the low grip strength group, females with high grip strength (OR = 0.54; 95 CI: 0.29–0.98) had a lower risk of falls in the underweight BMI group and males with high grip strength (OR = 0.63; 95 CI: 0.43–0.92) had lower risk of falls in the normal BMI group.ConclusionsHigh grip strength and underweight BMI are independently correlated with a lower fall risk, which varies between males and females.

Objective To investigate the risk factors of bladder neck contracture (BNC) after transurethral endoscopic surgery for benign prostatic hyperplasia (BPH), and to provide a reference basis for the clinic.Methods Clinical data of patients who underwent transurethral endoscopic surgery in our hospital from December 2019 to May 2023 were retrospectively collected. The incidence and risk factors of BNC after transurethral endoscopic surgery were analyzed by multivariate logistic regression analysis.Results A total of 420 cases were included in this study, of which 246 were treated with bipolar transurethral resection of the prostate (bTURP) and 174 with green light laser vaporization of the prostate (GL-PVP), and there was no statistically significant difference in the incidence of BNC when comparing these two types of operations. A total of 18 patients developed BNC after surgery, and the overall incidence of BNC was 4.29%. Multivariate logistic regression analysis showed that smaller preoperative prostate volume (p = 0.042), smoking history (p = 0.009), positive preoperative urine culture (p = 0.001), and prolonged postoperative catheterization days (p = 0.003) were independent risk factors of BNC.Conclusion Smaller preoperative prostate volume, smoking history, positive preoperative urine culture, and prolonged postoperative indwelling catheterisation were independent risk factors for BNC.

Background: The ketogenic diet (KD) is widely used for weight loss in obese individuals; however, its potential impact on hypertension risk remains uncertain. Methods: We used cross-sectional data from the 2007–2018 to National Health and Nutrition Examination Survey (NHANES) to investigate the association between the dietary ketogenic ratio (DKR) and hypertension prevalence. Dietary intake information was obtained through a comprehensive 24-h dietary recall interview. The DKR values were computed using a specialized formula. Multiple logistic regression analysis was employed to examine this association, whereas nonlinear relationships were assessed using restricted cubic splines. Inflection points were determined using two-piecewise linear regression analysis. Subgroup analyses based on age were also performed. Results: In a fully adjusted multivariate logistic regression model accounting for confounding variables, DKR was significantly associated with hypertension (OR, 1.24; 95 % CI: 1.00–1.53; P = 0.045). Moreover, individuals in the highest quartile of DKR exhibited a significantly elevated risk of hypertension compared with those in the lowest quartile (OR, 1.15; 95 % CI: 1.07–1.24; P

Recurrent opportunistic infections (OIs) in patients with severely immunosuppressed AIDS remain an unresolved medical challenge despite advancements in antiretroviral therapy (ART). To address this gap, we developed an HLA-mismatched allogeneic adoptive immune therapy (AAIT) specifically targeting this patient population. The safety and efficacy of this novel therapeutic approach were preliminarily confirmed in our phase 1 trial. Subsequently, a multicenter, open-label, controlled, phase 2a trial was conducted to evaluate the efficacy of AAIT in combination with ART compared with the conventional ART-only regimen. No difference in the incidence of adverse events (AEs) was observed between the two groups at the 96-week follow-up. AAIT treatment improved CD4+ T cell recovery at weeks 72 (P = 0.048) and 96 (P = 0.024) compared to the Control Group. Additionally, stratified analysis of patients in the AAIT Group showed that donor/recipient sex mismatch was significantly associated with the likelihood of patients achieving an immunological response (OR = 8.667; 95% CI, 2.010–37.377; P = 0.004). These findings suggest that AAIT serves as a promising adjunct therapy for improving the outcomes of patients with severely immunosuppressed AIDS. Further studies are needed to elucidate the immunological mechanisms underlying AAIT and identify the subpopulations that respond optimally to this therapeutic approach. This trial is registered at www.clinicaltrials.gov (NCT04098770).Trial registration: ClinicalTrials.gov identifier: NCT04098770.Trial registration: ClinicalTrials.gov identifier: NCT02651376.

ABSTRACTIn the past decades, the environment has changed drastically in China with rapid economic development. Lack of data, especially data with spatiotemporal information, has however hindered evaluating progress of environmental indicators in the global Sustainable Development Goal (SDG) framework. Here, we evaluate and explore geospatial information of 20 environmental SDG indicators from six SDGs in China from 2010 to 2020 using big data. We show China has improved rapidly in most of the 20 indicators, except for indicator 13.2.2 (CO2 emission). 63.5% of China’s land mass showed improved states for the SDG indicators. By 2020, four of the indicators were found to have achieved their 2030 targets. It is predicted from the existing data that 10 of the 20 indicators can achieve their targets smoothly by 2030, but two indicators will lag behind. We quantitatively show China’s progress towards the environmental SDG indicators, and put forward timelines and suggestions for policy makers.

Backgound Traumatic brain injury (TBI) is a severe neurological disorders, which invloving complicated molecular mechanisms, such as endoplasmic reticulum (ER) stress and ferroptosis. , However, the mechanism underlying TBI remains unclear. Objectives The Objective was to determine the effect of VPA on ER stress and ferroptosis, and affirm the relationship between ER stress and ferroptosis. Methods: The expression levels of GRP78, ATF6, CHOP and GPX4 in brain tissues were detected via western blot, histological staining, and immunofluorescence. The effect of VPA on ER stress and ferroptosis on OS cellswas evaluated in vitro and in vivo. Results In our study, we found that VPA suppressed ER stress after TBI by inhibiting the GRP78-ATF6-CHOP signaling pathway, which ameliorated ferroptosis by reversing the reduction of the ferroptosis protein GPX4. Furthermore, tissue defects, bleeding, and iron accumulation also reduced. Moreover, 4-phenylbutyric acid was used to further confirm our assumption. Conclusion VPA plays a neuroprotective role by inhibiting ER stress levels and subsequently inhibiting ferroptosis.

ObjectiveThis study aims to establish and evaluate a risk prediction model for coronary heart disease (CHD) in patients with primary Sjögren’s syndrome (pSS) based on peripheral blood levels of interleukin-6 (IL-6) and the percentage of regulatory T cells (Treg%). This model is intended to facilitate the timely identification of high-risk patients and the implementation of preventive measures.MethodsClinical data were collected from 120 pSS patients who visited the Second Hospital of Shanxi Medical University between November 2021 and September 2023. Patients were classified into pSS and pSS-CHD groups according to CHD diagnostic criteria. Peripheral blood lymphocyte subsets and cytokine levels were assessed using flow cytometry. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors, and a nomogram was constructed based on these factors. The model’s discriminatory ability, calibration, and clinical utility were evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis.ResultsThe univariate and multivariate logistic regression analyses identified several independent risk factors for CHD in pSS patients: erythrocyte sedimentation rate (ESR) (OR=1.10, P=0.019), triglycerides (TG) (OR=3.67, P=0.041), IL-6 (OR=1.29, P=0.048), and Treg% (OR=0.25, P=0.004). A nomogram incorporating these factors demonstrated an area under the curve (AUC) of 0.96, indicating excellent predictive performance, and showed good calibration (P=0.599), suggesting significant clinical applicability. Furthermore, Treg% exhibited a negative correlation with cholesterol (CHOL) and low-density lipoprotein cholesterol (LDL-C) levels, while IL-6 showed a positive correlation with CHOL and LDL-C levels. TG was positively correlated with C-reactive protein (CRP).ConclusionThis study successfully developed a risk prediction model based on peripheral blood IL-6 and Treg% levels, providing critical evidence for the early identification and personalized prevention of CHD in pSS patients, with potential clinical implications.

Articular cartilage has limited self-healing ability, resulting in injuries often evolving into osteoarthritis (OA), which poses a significant challenge in the medical field. Although some treatments exist to reduce pain and damage, there is a lack of effective means to promote cartilage regeneration. Reactive Oxygen Species (ROS) have been found to increase significantly in the OA micro-environment. They play a key role in biological systems by participating in cell signaling and maintaining cellular homeostasis. Abnormal ROS expression, caused by internal and external stimuli and tissue damage, leads to elevated levels of oxidative stress, inflammatory responses, cell damage, and impaired tissue repair. To prevent excessive ROS accumulation at injury sites, biological materials can be engineered to respond to the damaged microenvironment, release active components in an orderly manner, regulate ROS levels, reduce oxidative stress, and promote tissue regeneration. Hydrogels have garnered significant attention due to their excellent biocompatibility, tunable physicochemical properties, and drug delivery capabilities. Numerous antioxidant hydrogels have been developed and proven effective in alleviating oxidative stress. This paper discusses a comprehensive treatment strategy that combines antioxidant hydrogels with existing treatments for OA and explores the potential applications of antioxidant hydrogels in cartilage tissue engineering.

Chimeric antigen receptor T (CAR-T) cell therapy is a new treatment for cancers, but reports on curing immune-related skin diseases are limited. We report a case of successful CAR-T-cell therapy in a patient with refractory/relapsed diffuse large B-cell lymphoma (R/R DLBCL) who was incidentally cured of chronic generalized plaque psoriasis. The patient, a 65-year-old male who had a known history of psoriasis for 45 years, did not receive immunotherapy for psoriasis during this period. Imaging, molecular biology and immunology diagnostics confirmed DLBCL. After several weeks of standard-dose R-CHOP chemotherapy, the patient achieved partial remission, but according to CT, the patient relapsed, and there was no significant improvement in her psoriasis symptoms. Subsequently, the patient was enrolled in the CD19 CAR-T-cell therapy group. Four weeks after CAR-T-cell infusion, the patient’s abdominal pain disappeared, and there was a significant improvement in overall skin lesions. One year later, follow-up results indicated complete remission of R/R DLBCL (confirmed by PET-CT), with only minimal residual psoriatic skin lesions limited to the patient’s neck. The results of using CAR-T-cell therapy to achieve an incidental cure for psoriasis highlight the potential for exploring cell-based therapies for complex autoinflammatory skin diseases.

Gibberellin 20-oxidases (GA20oxs) are multifunctional enzymes involved in regulating gibberellin (GA) biosynthesis and controlling plant growth. We identified and characterized the GA20ox1 gene in a plant height mutant of Sophora davidii, referred to as SdGA20ox1. This gene was expressed in root, stem, and leaf tissues of the adult S. davidii plant height mutant, with the highest expression observed in the stem. The expression of SdGA20ox1 was regulated by various exogenous hormones. Overexpression of SdGA20ox1 in Arabidopsis resulted in significant elongation of hypocotyl and root length in seedlings, earlier flowering, smaller leaves, reduced leaf chlorophyll content, lighter leaf color, a significant increase in adult plant height, and other phenotypes. Additionally, transgenic plants exhibited a substantial increase in biologically active endogenous GAs (GA1, GA3, and GA4) content, indicating that overexpression of SdGA20ox1 accelerates plant growth and development. Using a yeast two-hybrid (Y2H) screen, we identified two SdGA20ox1-interacting proteins: the ethylene receptor EIN4 (11430582) and the rbcS (11416005) protein. These interactions suggest a potential regulatory mechanism for S. davidii growth. Our findings provide new insights into the role of SdGA20ox1 and its interacting proteins in regulating the growth and development of S. davidii.

Soil nematodes are the most abundant soil metazoans, occupying multiple trophic levels in the soil food web and playing an important role in soil function. Research on the biogeographic distribution patterns of soil nematode communities and their drivers has received greater attention. However, the distribution characteristics of soil nematode communities along the elevational gradient in the arid and semi-arid regions of Northwest China remain unclear. In this study, four elevational gradients (1750–1900, 1900–2100, 2100–2350 and 2350–2560 m) were established on Luoshan Mountain, Ningxia, an arid and semi-arid region in Northwest China, and soil nematodes in the soil layers of 0–10, 10–20 and 20–40 cm were investigated using the improved Baermann funnel method. The results revealed a monotonically decreasing trend in the total number of soil nematodes along the elevational gradient and soil layer depth, decreasing by 63.32% to 79.94% and 73.59% to 86.90%, respectively, while the interactions were not obvious. A total of 1487 soil nematodes belonging to 27 families and 32 genera were identified across the elevational gradient, with Helicotylenchus as the dominant genus, accounting for 10.43% of the total number of nematodes, and bacterivore nematodes as the main trophic groups, accounting for 32.39% to 52.55% of the relative abundance at each elevation, which increased with increasing elevation. Soil nematode community diversity, richness and maturity indices were relatively low at high elevation and decreased by 44.62%, 48% and 54.74%, respectively, with increasing soil layer depth at high elevations. Compared to low elevations, high-elevation soils experienced greater disturbance, reduced structural complexity and nutrient enrichment of the soil food web, and a shift in soil organic matter decomposition from bacterial to fungal pathways as elevation increased. Finally, redundancy analysis showed that soil pH, bulk density, soil moisture, soil organic carbon, available nitrogen, available phosphorus and available potassium were the main soil factors affecting the composition of soil nematode communities, which well explained the differences in nematode communities at different elevations and soil depths. This study can be used as basic information for further research on soil biota in this mountainous region, expanding our further understanding of the spatial ecology of soil nematodes in the arid and semi-arid mountain ecosystems.

The wound healing process involves communication among growth factors, cytokines, signaling pathways, and cells in the extracellular matrix, with growth factors acting as key regulators. Although stem cells can promote wound healing by secreting diverse growth factors, their therapeutic potential is hindered by poor survival and engraftment. Mimicking the stem cell-matrix interactions can improve stem cell survival, regulate their fate, and even enhance their paracrine effects. This study investigated the use of composite RGDmix hydrogel, which can support the survival and proliferation of human amniotic mesenchymal stem cells (hAMSCs), and effectively increase the expression of various growth factors, thereby promoting wound re-epithelialization, angiogenesis, and epidermal maturation. At last, the specific role of integrin αv and PI3K/AKT signaling pathways in the secretion of growth factors were examined by silencing them in vitro and in vivo. Results suggested that the RGDmix hydrogel improved the secretion of growth factors by hAMSCs through the RGDSP/integrin αv/PI3K/AKT axis, thereby enhancing the therapeutic effect in wound healing.

BackgroundAging, a significant public health issue, is associated with multiple concurrent chronic diseases and aging-related conditions (geriatric syndromes). ObjectiveThis study aims to investigate the impact of age and chronic conditions on geriatric syndromes and the intercorrelations between multiple geriatric syndromes and quality of life (QoL) in older adults (aged ≥65 years) at the population level. MethodsA large representative sample was randomly selected from a county in China, Feidong, with 17 towns and 811,867 residents. Multiple chronic conditions, geriatric syndromes (frailty, polypharmacy, and malnutrition), and QoL were assessed and compared. Associations of demographic information and chronic conditions with geriatric conditions and QoL in older adults were assessed using multivariable-adjusted logistic regression. Intercorrelations between age, multiple geriatric syndromes, and QoL were investigated using both correlation analysis and restricted cubic splines–based multivariable-adjusted dose-response analysis. ResultsOlder adults comprised 43.42% (3668/8447) of the entire study population. The prevalence of frailty, premalnutrition or malnutrition, polypharmacy, and impaired QoL (median age 73, IQR 69-78 years; 1871/3668, 51% men) was 8.26% (303/3668), 15.59% (572/3668), 3.22% (118/3668), and 10.8% (396/3668), respectively. Different age and sex subgroups mostly had similar prevalence of geriatric syndromes (except that frailty occurred more often with older age). Premalnutrition or malnutrition were associated with a lower frequency of obesity and a higher frequency of constipation, polypharmacy with a higher frequency of diabetes and constipation, frailty with a higher frequency of constipation and hernia, and impaired QoL with a higher frequency of hypertension, diabetes, physical disability, and constipation. Mini Nutritional Assessment–Short Form, Groningen Frailty Indicator, and EQ-5D-5L scores, as well as the number of medications used, mostly predicted each other and QoL. Impaired QoL was associated with a higher frequency of frailty, premalnutrition or malnutrition, and polypharmacy, and frailty with a higher frequency of premalnutrition or malnutrition and polypharmacy. At a 1.5-year follow-up, impaired QoL was linked to polypharmacy and frailty at baseline, premalnutrition or malnutrition and polypharmacy were associated with frailty at baseline, and frailty was linked to both premalnutrition or malnutrition and polypharmacy at baseline. Causal mediation analyses showed that frailty mediated the link between polypharmacy and worse QoL and that polypharmacy mediated the link between frailty and worse QoL. ConclusionsIn this large population-based study of older adults, multiple chronic conditions were associated with ≥1 of the investigated geriatric syndromes. Geriatric syndromes were mostly intercorrelated with, and well predictive of, each other and QoL; and causal relationships existed between geriatric syndromes and QoL, with other geriatric syndromes being mediators. The findings might be biased by residual confounding factors. It is important to perform personalized geriatric syndrome assessments stratified by chronic condition; active prevention of, or intervention for, any syndrome might help to reduce the others and improve QoL.

BackgroundAn increasing number of studies have turned their lens to the application of Artificial Intelligence (AI) in the diagnosis and treatment of colorectal cancer (CRC).ObjectiveTo clarify and visualize the basic situation, research hotspots, and development trends of AI in the diagnosis and treatment of CRC, and provide clues for research in the future.MethodsOn January 31, 2024, the Web of Science Core Collection (WoSCC) database was searched to screen and export the relevant research published during 2004-2023, and Cite Space, VoSviewer, Bibliometrix were used to visualize the number of publications, countries (regions), institutions, journals, authors, citations, keywords, etc.ResultsA total of 2715 pieces of literature were included. The number of publications grew slowly until the end of 2016, but rapidly after 2017, till to the peak of 798 in 2023. A total of 92 countries, 3997 organizations, and 15,667 authors were involved in this research. Chinese scholars released the highest number of publications, and the U.S. contributed the highest number of total citations. As to authors, MORI, YUICHI had the highest number of publications, and WANG, PU had the highest number of total citations. According to the analysis of citations and keywords, the current research hotspots are mainly related to “Colonoscopy”, “Polyp Segmentation”, “Digital Pathology”, “Radiomics”, “prognosis”.ConclusionResearch on the application of AI in the diagnosis and treatment of CRC has made significant progress and is flourishing across the world. Current research hotspots include AI-assisted early screening and diagnosis, pathology, and staging, and prognosis assessment, and future research is predicted to put weight on multimodal data fusion, personalized treatment, and drug development.

BackgroundWe conducted a large-scale epidemiological analysis to investigate the associations between systemic inflammation markers and heart failure (HF). Our aim is to identify potential biomarkers for early detection of HF.MethodsA cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey. We investigated the associations between five systemic inflammation markers (neutrophil to lymphocyte ratio [NLR], platelet to lymphocyte ratio [PLR], systemic immune inflammation index [SII], system inflammation response index [SIRI], and aggregate index of systemic inflammation [AISI]) and the risk of HF.ResultsThe prevalence rates of HF exhibited a gradual increase across increasing logNLR, logPLR, logSII, logSIRI, and logAISI tertiles. Compared to those in the highest tertiles of logNLR, logSII, logSIRI, and logAISI had a 1.579-fold, 1.341-fold, 1.956-fold, and 1.499-fold increased risk of HF compared to those in the lowest tertile respectively. Conversely, there was no significant correlation between logPLR and HF risk among subjects in the highest tertile. The restricted cubic splines (RCS) analysis revealed a non-linear relationship between the elevation of systemic inflammation markers and HF prevalence. Specifically, a per standard deviation increase in any of these variables is associated with a respective 45%, 29%, 28%, 44% and 29% increase in HF prevalence. The receiver operating characteristic (ROC) analysis demonstrated favorable sensitivity and specificity of these systemic inflammation markers in detecting the presence of HF.ConclusionOur cross-sectional study demonstrates significant positive correlations between the NLR, PLR, SII, SIRI, and AISI with the incidence of HF.