Search

Abstract Background Cannabis use has been increasing among older adults in Canada, particularly during the COVID-19 pandemic. This study aims to examine the association between loneliness and cannabis use among older Canadians during the pandemic. Methods Quantitative data analyses were performed based on 2,020 participants aged 55 years and older from the Canadian Perspectives Survey Series 6, 2021: Substance Use and Stigma During the Pandemic. Results This study found that participants who used cannabis in the 30 days before the survey reported significantly higher loneliness scores than those who never used cannabis after adjusting social-demographic, social interaction, and pandemic-related factors. Participants who kept using cannabis during the pandemic also reported significantly higher loneliness scores than those who never used cannabis. Conclusion The findings about the correlation between cannabis use and greater loneliness contribute to the discourse on potential health and wellbeing harms of cannabis use among older adults.

Abstract Background Individuals who have experienced severe traumatic events are estimated to have a post-traumatic stress disorder (PTSD) prevalence rate ranging from 10 to 50%, while those not affected by trauma exposure are often considered to possess psychological resilience. However, the neural mechanisms underlying the development of PTSD, especially resilience after trauma, remain unclear. This study aims to investigate changes of cortical morphometric similarity network (MSN) in PTSD and trauma-exposed healthy individuals (TEHI), as well as the associated molecular alterations in gene expression, providing potential targets for the prevention and intervention of PTSD. Methods We recruited PTSD patients and TEHI who had experienced severe earthquakes, and healthy controls who had not experienced earthquakes. We identified alterations in the whole-brain MSN changes in PTSD and TEHI, and established associations between these changes and brain-wide gene expression patterns from the Allen Human Brain Atlas microarray dataset using partial least squares regression. Results At the neuroimaging level, we found not only trauma-susceptible changes in TEHI same as those in PTSD, but also unique neurobiological alterations to counteract the deleterious impact of severe trauma. We identified 1444 and 2214 genes transcriptionally related to MSN changes in PTSD and TEHI, respectively. Functional enrichment analysis of weighted gene expression for PTSD and TEHI revealed distinct enrichments in Gene Ontology biological processes and Kyoto Encyclopedia of Genes and Genomes pathways. Furthermore, gene expression profiles of astrocytes, excitatory neurons, and microglial cells are highly related to MSN abnormalities in PTSD. Conclusions The formation of resilience may be by an active compensatory process of the brain. The combination of macroscopic neuroimaging changes and microscopic human brain transcriptomics could offer a more direct and in-depth understanding of the pathogenesis of PTSD and psychological resilience, shedding light on new targets for the prevention and treatment of PTSD.

Abstract Background Informal caregivers of older adults play a vital role in improving the degree to which older adults access community and healthcare services in a seamless and timely manner. They are fulfilling important navigation and support roles for their older care recipients. However, there is still little knowledge of the most significant facilitators and barriers to effective and efficient system navigation among caregivers. This paper aims to fill these knowledge gaps through investigation of the key factors (i.e., social capital/cohesion, caregiving supports, and utilization factors) affecting navigation difficulties faced by informal caregivers of older adults. Methods The Behavioural-Ecological Framework of Healthcare Access and Navigation (BEAN) model is used to frame the study. Using the General Social Survey on Caregiving and Care Receiving 2018, we analyzed 2,733 informal caregivers whose primary care recipients were aged 65 or older. Hierarchical logistic regression was conducted to identify the relationship between system navigation difficulties among informal caregivers and four sequentially ordered blocks of predictors: (1) sociodemographic (2), social capital/cohesion (3), caregiving supports, and (4) healthcare demand. Results The fully adjusted model showed that the probability of reporting navigation difficulties was lower for caregivers with social capital/cohesion compared to those without social capital/cohesion. In comparison, the probability of reporting navigation difficulties was higher among caregivers with caregiving support and among caregivers whose care receivers use a higher amount of health service use. Several sociodemographic covariates were also identified. Conclusion Our findings support certain aspects of the BEAN model. This study extends our understanding of potential facilitators and barriers that informal caregivers of older adults face while navigating complex community and health systems. There is a need to implement coordinated schemes and health policies especially for older adults with mental/neurological issues to address the challenges of their caregivers given the specific vulnerability identified in this study. The need for further research using different approaches to examine the disproportionate impact of COVID-19 on caregivers’ system navigation experience is crucial.

Abstract Objective Multimorbidity is recognized as a serious health condition faced by a majority of older adults. Research investigating adaptive responses to multimorbidity, termed multimorbidity resilience, has been growing. This paper examines protective and risk factors, with a focus on health behaviours, socio-economic resources, and social support using an established measure of resilience (Connor-Davidson Resilience Scale) among older adults, focusing on older persons with two or more concurrent chronic conditions. Methods Using Baseline (2011–2015), Follow-up One (2015–2018), and Follow-up Two (2018–2021) data from the Comprehensive Cohort of the Canadian Longitudinal Study on Aging, we tested hypotheses using 13,064 participants aged 65 years and older, who completed all waves and reported two or more of 27 chronic conditions, for the full sample of multimorbid individuals and three multimorbidity clusters: Cardiovascular/Metabolic, Musculoskeletal, and Mental Health. Associations between protective and risk factors and resilience were examined using linear regression to model the Connor-Davidson resilience scale, adjusting for illness context and social determinants of health. Results Among all multimorbid individuals, the strongest associations with resilience were found for higher self-rated health, greater sleep satisfaction, better appetite, higher household income, more relatives and friends, being overweight (compared to normal weight), fewer housing problems, and fewer skipped meals. Weaker associations were found for non-smokers, less alcohol consumption, less pain, sedentary behaviour, being non-married (compared to married), and among Canadian born (compared to foreign). The analyses for the three multimorbidity clusters were largely replicated for the three multimorbidity clusters, but with some nuances depending on the cluster. Discussion This research provides confirmatory evidence for several protective and risk factors affecting the ability to cope and recover from multimorbidity adversity among older adults. There are consistent patterns for the multimorbidity disease clusters, but some distinct relationships arise that are worthy of attention. The implications of the findings for modifiable health behaviours and socio-economic factors are discussed for their public health and clinical relevance.

The Jingyang–Weinan Fault that Xi’an Metro Line 10 crosses is a Holocene active fault, and its future stick-slip earthquakes and coseismic dislocations pose a potential threat to the metro line. To reveal the deformation and stratum stress characteristics of the site caused by the stick-slip seismic and coseismic dislocations of the Jingyang–Weinan Fault zone, based on the Jingyang–Weinan fault zone crossed by Xi’an Metro Line 10, the geomechanical model of the fault zone site coseismic dislocations and stick-slip seismic was established, and the numerical simulation analysis of the stratum deformation and stress field characteristics of fault zone site was carried out considering different dislocation amounts and seismic intensity. The results show that under the coseismic dislocation, the stress reduction and strengthening zones appear in the hanging wall and footwall near the fault zone, and the site presents an inverse “S” shaped differential settlement failure. The differential displacement peaks at the fault zone, and the plastic zone is concentrated here. The deformation range and plastic zone of the hanging wall are 1.67 times and 2.50 times more than that of the footwall, respectively. The displacement and differential deformation of the site near the fault zone reach the peak value under the stick-slip earthquake. The influence range of the site displacement during the large earthquake is approximately 6.50 times more than that during the medium earthquake. It has a typical magnification effect on the hanging wall, and the displacement decreases linearly far away from the fault zone. The amplification factor of peak surface acceleration (PGA) in the large earthquake is 1.14 times more than that in the medium earthquake. The site shows “V” shear failure; the plastic zones of hanging wall and footwall in the large earthquake is about 1.40 times and 1.00 times larger than that in the medium earthquake, respectively. This study can provide a scientific basis for the seismic fortification of Xi’an Metro Line lines crossing the Jingyang–Weinan fault zone.

Abstract Streamflow in source region of Yellow River (SRYR) matters with regard to the adjacent and downstream water resources. Intraseasonal oscillation (ISO) in the streamflow in SRYR is of great significance to the sub-seasonal prediction of streamflow in SRYR, but is unknown. Here, we first report a 30–60-day ISO in the streamflow in SRYR, which is regulated by the atmospheric 30–60-day ISO at mid-high latitude over North Eurasia. The 30–60-day ISO in atmosphere is featured by a Rossby wavetrain, and the wave energy propagates southward onto the TP, which causes anomalous wind response over TP. The leading anomalous high (low) with anti-cyclonic (cyclonic) wind anomalies over the TP favors dry (wet) air in lower troposphere in SRYR, via enhancing the water vapor divergence (convergence). Dry (wet) air always results in strong (weak) evaporation from the Yellow River, which causes the later streamflow valley (peak) and thereby the 30–60-day ISO in the streamflow in SRYR.

Abstract In recent years, the widespread adoption of wireless sensor networks (WSN) has resulted in the growing integration of the internet of things (IoT). However, WSN encounters limitations related to energy and sensor node lifespan, making the development of an efficient routing protocol a critical concern. Cluster technology offers a promising solution to this challenge. This study introduces a novel cluster routing protocol for WSN. The system selects cluster heads and relay nodes utilizing the multi-strategy fusion snake optimizer (MSSO) and employs the minimum spanning tree algorithm for inter-cluster routing planning, thereby extending the system’s lifecycle and conserving network energy. In pursuit of an optimal clustering scheme, the paper also introduces tactics involving dynamic parameter updating, adaptive alpha mutation, and bi-directional search optimization within MSSO. These techniques significantly increase the algorithm convergence speed and expand the available search space. Furthermore, a novel efficient clustering routing model for WSN is presented. The model generates different objective functions for selecting cluster heads and relay nodes, considering factors such as location, energy, base station distance, intra-cluster compactness, inter-cluster separation, and other relevant criteria. When selecting cluster heads, the fuzzy c-means (FCM) algorithm is integrated into MSSO to improve the optimization performance of the algorithm. When planning inter-cluster routing, the next hop node is selected for the relay node based on distance, residual energy, and direction.The experimental results demonstrate that the proposed protocol reduces energy consumption by at least 26.64% compared to other cluster routing protocols including LEACH, ESO, EEWC, GWO, and EECHS-ISSADE. Additionally, it increases the network lifetime of WSN by at least 25.84%, extends the stable period by at least 52.43%, and boosts the network throughput by at least 40.99%.

BackgroundAs a minimally invasive approach to treating congenital heart disease (CHD), the application of the right subaxillary small incision (RSSI) has been developing fast in its indication spectrum. However, RSSI's use is still quite challenging for the surgical treatment of the low-age and low-weight infant patient group.ObjectivesTo investigate the safety and efficacy of performing RSSI surgery, treating CHD for infants with low-age and low-weight.MethodsBetween March 2010 and April 2023, Low-age (≤6 months) and low-weight (≤5 kg) infants with ventricular or atrial septal defect (ASD) as the main diagnosis were retrospectively included in this study. The infants were divided into the RSSI group and the median sternotomy (MS) group. Preoperative conditions, general surgical conditions, perioperative and postoperative outcomes, and long-term follow-up results were compared between the 2 groups.ResultsThe study included 783 cases. Of these, 434 were operated with MS, and 349 were operated with RSSI. A1:1 matched MS group (282 cases) and RSSI group (282 cases) were obtained after performing propensity score matching (PSM). Analysis of the 2 groups after PSM showed the differences in residual ASD/VSD, peak airway pressure, fraction of inspired oxygen/partial pressure of oxygen (PaO2/FiO2), and partial pressure of carbon dioxide (PaCO2) before return to the intensive care unit (ICU) and extubation were not statistically significant between groups, whereas mechanical ventilation time (P

Objective This study aims to assess the accuracy and stability of smartwatches in predicting acute mountain sickness (AMS). Methods In locations exceeding an altitude of 2500 m, a cohort of 42 subjects had their Lake Louise AMS self-assessment score, blood oxygen saturation (SpO 2 ), heart rate, and perfusion index measured using smartwatches, with the data seamlessly conveyed to the Huawei Cloud. Results A significant decrease in SpO 2 was observed in individuals positive for AMS compared to those negative ( p

Background: Pegylated liposomal doxorubicin (PLD), epirubicin and pirarubicin are the main anthracyclines widely used in China. PLD demonstrates therapeutic response comparable to epirubicin and pirarubicin in neoadjuvant chemotherapy (NAC) of breast cancer. Objectives: The objectives of our study were to retrospectively assess the real-world effectiveness and prognostic characteristics of PLD as NAC for HR ⩽ 10%/human epidermal growth factor receptor 2 (HER2)-negative breast cancer. Design: This was a retrospective study. Methods: Our study enrolled patients with HR ⩽ 10%/HER2-negative breast cancer who received PLD-, epirubicin- or pirarubicin-based NAC from three centres in Hunan Province, China, between 2015 and 2022. We employed inverse probability of treatment weighting to balance the differences in patients’ characteristics among the PLD, epirubicin, and pirarubicin groups. The endpoints were pathological complete response (pCR), event-free survival (EFS), and overall survival (OS). Results: A total of 267 patients were included. After NAC, the pCR rates in PLD group were superior to epirubicin group (PLD, 34.1%; epirubicin, 20.8%, p = 0.038). The differences in EFS (log-rank p = 0.99) and OS (log-rank p = 0.33) among the three groups were not statistically significant. Among the three groups, non-pCR patients had worse EFS than pCR patients (log-rank p = 0.014). For patients with pCR, the differences in EFS (log-rank p = 0.47) and OS (log-rank p = 0.38) were not statistically significant among the three groups, and the EFS (log-rank p = 0.59) and OS (log-rank p = 0.14) of non-pCR patients in the PLD group were similar to those in the epirubicin and pirarubicin groups. Conclusion: PLD had a similar therapeutic response and prognosis compared to epirubicin or pirarubicin in NAC for patients with HR ⩽ 10%/HER2 negative breast cancer, which means that PLD represents a potential NAC option.

IntroductionMultiple linked single nucleotide polymorphisms (SNPs) have shown potential in personal identification and mixture detection. However, the limited number of marker and sequencing errors have obstructed accurate DNA typing.MethodsTo develop more candidate loci, the diversity value (D-value) was introduced as a new parameter for screening the novel polymorphic multiple linked-SNP markers, referred to as multi-SNP. In this study, a “FD Multi-SNP Mixture Kit” comprising 567 multi-SNPs was developed for mixture detection. Additionally, a new computational error correction method was applied as a quality control approach for sequencing data.ResultsThe results demonstrated higher typing success rates than the conventional CE typing method. For single-source DNA, approximately 70–80 loci were detected with a DNA input of 0.009765625 ng. More than 65% of the minor alleles were distinguishable at 1 ng DNA with a frequency of 0.5% in 2- to 4-person mixtures.ConclusionThis study offers a polymorphic and high-resolution detection method for DNA genotyping and complex mixture detection, providing an alternative strategy for addressing challenging mixed DNA traces.

Abstract Purpose To summarize and analyze the safety and efficacy of a Y-shape Sigma stent loaded with I125 in patients with inoperable malignant main airway obstruction. Methods This study was approved by the Institutional Ethics Committee, and a written informed consent was obtained from each participant. A Y-shape Sigma stent loaded with I125 was placed under vision from rigid bronchoscopy. The primary endpoint was alleviation of symptoms and improvement of Karnofsky Performance Status (KPS) score, and the secondary endpoint was complications and technical success. Results From November 2018 through June 2023, total 33 patients with malignant airway obstruction were palliatively treated by installing Y-shape Sigma stents loaded with I125. The airway lumen was immediately restored and the average airway opening significantly increased to 70 ± 9.4% after the procedure from baseline 30.2 ± 10.5% (p

Objective Breast-conserving therapy (BCT) includes breast-conserving surgery (BCS) combined with radiation therapy (RT). RT plays a crucial role in improving the prognosis of patients who undergo BCS. However, obesity is a potential risk factor for resistance to radiation. The aim of this study was to evaluate any difference in the long-term prognosis of patients with early stage breast cancer and obesity treated with BCT or total mastectomy (TM).Design, setting and participants This was a retrospective cohort study involving 1125 patients diagnosed with early stage breast cancer and obesity at the Shanghai Cancer Center of Fudan University from 2013 to 2016.Outcome measures Obesity in the Chinese population was defined as a body mass index ≥28 kg/m2. Surgical options included BCT and TM. The primary survival outcomes were overall survival (OS), disease-free survival (DFS) and recurrence-free survival (RFS). Inverse probability of treatment weighting (IPTW) was used to control for the impact of confounding factors on prognosis.Results The median follow-up times in the BCT group and TM group without postoperative RT were 51.1 months (IQR of 40.6–68.1 months) and 61.8 months (IQR of 46.5–76.7 months), respectively. After IPTW, the baseline data were balanced. Compared with those in the TM cohort, patients in the whole IPTW cohort in the BCT cohort had worse DFS (HR 4.280, 95% CI 2.180 to 8.400; p

ObjectiveExperienced 3 years of pandemic-induced home life, in the post-epidemic period, preschoolers in China are falling short of the World Health Organization’s standards for screen time and outdoor activities. This notably impacts their physical well-being. The study aims to probe the associations between screen time, outdoor activities, and the physical health of preschoolers, offering insights to shape interventions targeting myopia and obesity prevention in children.MethodsA cross-sectional study was conducted in Guangdong Province, involving a representative sample of 23,992 preschoolers and their caregivers recruited through proportional stratified cluster sampling. Data collection utilized the Chinese Early Human Capability Index (CHeHCI, eHCi), a questionnaire on children’s media use in daily family life, and Body Mass Index (BMI). Linear regression and binary logistic regression models were employed to analyze the impact of screen time and outdoor activity duration on the physical health of preschoolers.ResultsIn the high family socioeconomic status (SES) group, children had significantly less screen time compared to those in the medium and low SES groups. Outdoor activity time varied significantly based on SES, with higher SES linked to extended outdoor engagement. Additionally, children’s eHCi health dimension score exhibited significant SES-related differences, showcasing higher scores for children in higher SES groups. In terms of gender differences, boys dedicated significantly more time to outdoor activities than girls, yet boys had a notably higher overweight rate. Furthermore, girls demonstrated better health outcomes based on eHCi health scores. A significant association emerged between overweight and screen time in children with high SES, indicating that prolonged screen time was linked to a higher likelihood of overweight based on BMI. Additionally, a substantial negative correlation was observed between children’s eHCi health dimension score and screen time. Furthermore, children’s outdoor activity time exhibited a significant positive correlation with eHCi health dimension score. Regression analysis revealed that screen time could significantly negatively predict children’s physical health score, while outdoor activity time could significantly positively predict children’s eHCi physical health score.ConclusionThe current study highlights that family SES, age, and gender play pivotal roles in influencing preschoolers’ screen time and outdoor activity duration, with family SES being particularly influential. Higher family SES correlates with reduced screen time, increased outdoor activity, and elevated health levels among children. Importantly, children’s screen time negatively predicts their health status, while outdoor time positively predicts their health status.

Summary: Glioblastoma (GBM) is characterized by aggressive growth, invasiveness, and poor prognosis. Elucidating the molecular mechanisms underlying GBM is crucial. This study explores the role of Sm-like protein 14 homolog A (LSM14A) in GBM. Bioinformatics and clinical tissue samples analysis demonstrated that overexpression of LSM14A in GBM correlates with poorer prognosis. CCK8, EdU, colony formation, and transwell assays revealed that LSM14A promotes proliferation, migration, and invasion in GBM in vitro. In vivo mouse xenograft models confirmed the results of the in vitro experiments. The mechanism of LSM14A modulating GBM cell proliferation was investigated using mass spectrometry, co-immunoprecipitation (coIP), protein half-life, and methylated RNA immunoprecipitation (MeRIP) analyses. The findings indicate that during the G1/S phase, LSM14A stabilizes DDX5 in the cytoplasm, regulating CDK4 and P21 levels. Furthermore, METTL1 modulates LSM14A expression via mRNA m7G methylation. Altogether, our work highlights the METTL1-LSM14A-DDX5 pathway as a potential therapeutic target in GBM.

One of the critical technologies to ensure cyberspace security is network traffic anomaly detection, which detects malicious attacks by analyzing and identifying network traffic behavior. The rapid development of the network has led to explosive growth in network traffic, which seriously impacts the user's information security. Researchers have delved into intrusion detection as an active defense technology to address this challenge. However, traditional machine learning methods struggle to capture complex threats and attack patterns when dealing with large-scale network data. In contrast, deep learning methods have the advantages of automatically extracting features from network traffic data and strong generalization capabilities. Aiming to enhance the ability of network anomaly traffic detection, this paper proposes a network traffic anomaly detection based on Deep Residual Shrinkage Network (DRSN), namely ''GSOOA-1DDRSN''. This method uses an improved Osprey optimization algorithm to select the most relevant and essential features in network traffic, reducing the features' dimensionality. For better detection performance of network traffic anomalies, a one-dimensional deep residual shrinkage network (1DDRSN) is designed as a classifier. Validation is performed using the NSL-KDD and UNSW-NB15 datasets and compared with other methods. The experimental results show that GSOOA-1DDRSN has improved multi-classification accuracy, precision, recall, and F1 Score by approximately 2 % and 3 %, respectively, compared to the 1DDRSN model on two datasets. Additionally, it reduces the time computation costs by 20 % and 30 % on these datasets. Furthermore, compared to other models, GSOOA-1DDRSN offers superior classification accuracy and effectively reduces the number of features.

Abstract Research on amateur mountaineers is scarce, and this study aims to delve into the emotional experiences of ten amateur mountaineers during their ascent using the "Befindlichkeitsskala" (BFS) and Lake Louise Acute Mountain Sickness scoring system (LLS). These subjects were exposed to altitudes of 3140 m, 4300 m, and 5276 m, respectively. We found that LLS scores were negatively correlated with positive emotions (β = −27.54, p

The terahertz range, as a type of electromagnetic wave with wavelengths between microwaves and the infrared band, has the characteristics of penetration, low energy and a stable absorption spectrum of specific substances, and is widely used in non-destructive testing, human security inspections, biological tissue diagnoses and military detection. In particular, terahertz wave 3D imaging technology can detect the internal information of the target of detection, and it has become the focus of current research. This study carried out research on 3D reconstruction and object detection algorithms based on terahertz images. In view of the problem that the MVS (Multi-ViewStereo) series of 3D reconstruction algorithms ignore the context information between the cost layers and have unsatisfactory reconstruction effects when used on complex regions, an improved MVSNet 3D reconstruction algorithm FCTMVSNet(Feature and Cost Transformer Depth Inference for Unstructured Multi-view Stereo) based on Transformer is proposed here. A structured object recognition algorithm was designed to provide theoretical support for subsequent terahertz image-based object detection algorithms.

Abstract Background The long-term impact of COVID-19-associated public health interventions on zoonotic and vector-borne infectious diseases (ZVBs) remains uncertain. This study sought to examine the changes in ZVBs in China during the COVID-19 pandemic and predict their future trends. Methods Monthly incidents of seven ZVBs (Hemorrhagic fever with renal syndrome [HFRS], Rabies, Dengue fever [DF], Human brucellosis [HB], Leptospirosis, Malaria, and Schistosomiasis) were gathered from January 2004 to July 2023. An autoregressive fractionally integrated moving average (ARFIMA) by incorporating the COVID-19-associated public health intervention variables was developed to evaluate the long-term effectiveness of interventions and forecast ZVBs epidemics from August 2023 to December 2025. Results Over the study period, there were 1,599,647 ZVBs incidents. HFRS and rabies exhibited declining trends, HB showed an upward trajectory, while the others remained relatively stable. The ARFIMA, incorporating a pulse pattern, estimated the average monthly number of changes of − 83 (95% confidence interval [CI] − 353–189) cases, − 3 (95% CI − 33–29) cases, − 468 (95% CI − 1531–597) cases, 2191 (95% CI 1056–3326) cases, 7 (95% CI − 24–38) cases, − 84 (95% CI – 222–55) cases, and − 214 (95% CI − 1036–608) cases for HFRS, rabies, DF, HB, leptospirosis, malaria, and schistosomiasis, respectively, although these changes were not statistically significant besides HB. ARFIMA predicted a decrease in HB cases between August 2023 and December 2025, while indicating a relative plateau for the others. Conclusions China's dynamic zero COVID-19 strategy may have exerted a lasting influence on HFRS, rabies, DF, malaria, and schistosomiasis, beyond immediate consequences, but not affect HB and leptospirosis. ARFIMA emerges as a potent tool for intervention analysis, providing valuable insights into the sustained effectiveness of interventions. Consequently, the application of ARFIMA contributes to informed decision-making, the design of effective interventions, and advancements across various fields.

Abstract Background Sentinel lymph node biopsy (SLNB) is a common choice for axillary surgery in patients with early‐stage breast cancer (BC) who have clinically negative lymph nodes. Most research indicates that obesity is a prognostic factor for BC patients, but studies assessing its association with the rate of positive sentinel lymph nodes (SLN) and the prognosis of patients with early BC undergoing SLNB are limited. Methods Between 2013 and 2016, 7062 early‐stage BC patients from the Shanghai Cancer Center of Fudan University were included. Based on the Chinese Body Mass Index (BMI) classification standards, the patients were divided into three groups as follows: normal weight, overweight, and obese. Propensity score matching analysis was used to balance the baseline characteristics of the participants. Logistic regression analysis was used to determine the association between obesity and positive SLN rate. Cox regression analysis was used to investigate whether obesity was an independent prognostic factor for early‐stage BC patients who had undergone SLNB. Results No significant association was observed between obesity and positive SLN rate in early‐stage BC patients who had undergone SLNB. However, multivariate analysis revealed that compared to patients with normal BMI, the overall survival (hazard ratio (HR) 2.240, 95% confidence interval (CI) 1.27–3.95, p = 0.005) and disease‐free survival (HR 1.750, 95% CI 1.16–2.62, p = 0.007) were poorer in patients with high BMI. Conclusion Obesity is an independent prognostic factor for early‐stage BC patients who undergo SLNB; however, it does not affect the positive SLN rate.

IntroductionThe use of online follow-up services (OFUS) is becoming an increasingly important supplement to hospital care. Through OFUS, patients can find their doctors in online health communities (OHCs) and receive remote medical follow-ups after hospital treatment. However, the rate of effective use of OFUS by current patients is still low, and there is an urgent need for research to investigate the online information factors that affect patients' effective use of OFUS.MethodsBased on the elaboration likelihood model (ELM) of persuasion and an analysis of a panel dataset including 3,672 doctors in a leading OHC in China, this study explores how online information from doctors' knowledge contributions and patient feedback influences patients' effective use of OFUS.ResultsThe results show that both doctors' knowledge contributions and patient feedback positively influence patients' effective use of OFUS. Doctors' paid knowledge contributions and patients' paid feedback have stronger persuasive effects than doctors' free knowledge contributions and patients' free feedback, respectively. Moreover, there is a substitutional relationship between doctors' paid and free knowledge contributions and between patients' paid and free feedback in influencing patients' effective use of OFUS.DiscussionThe findings of this study suggest that OHC platforms and healthcare providers should account not only for the persuasive effects of doctors' knowledge contributions and patient feedback but also for influential differences and relationships between the types of doctors' knowledge contributions and patient feedback to better persuade patients to effectively use OFUS.

ObjectiveHormone receptor (HR)-low/HER2-negative breast cancers (BCs) are more likely to be basal-like BCs, with similar molecular features and gene expression profiles to HR-negative (estrogen receptor

The Resource for Coronavirus 2019 (RCoV19) is an open-access information resource dedicated to providing valuable data on the genomes, mutations, and variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this updated implementation of RCoV19, we have made significant improvements and advancements over the previous version. Firstly, we have implemented a highly refined genome data curation model. This model now features an automated integration pipeline and optimized curation rules, enabling efficient daily updates of data in RCoV19. Secondly, we have developed a global and regional lineage evolution monitoring platform, alongside an outbreak risk pre-warning system. These additions provide a comprehensive understanding of SARS-CoV-2 evolution and transmission patterns, enabling better preparedness and response strategies. Thirdly, we have developed a powerful interactive mutation spectrum comparison module. This module allows users to compare and analyze mutation patterns, assisting in the detection of potential new lineages. Furthermore, we have incorporated a comprehensive knowledgebase on mutation effects. This knowledgebase serves as a valuable resource for retrieving information on the functional implications of specific mutations. In summary, RCoV19 serves as a vital scientific resource, providing access to valuable data, relevant information, and technical support in the global fight against COVID-19. The complete contents of RCoV19 are available to the public at https://ngdc.cncb.ac.cn/ncov/.

Abstract To explore the clinical role of QPRT in breast cancer. The gene expression, methylation levels and prognostic value of QPRT in breast cancer was analyzed using TCGA data. Validation was performed using the data from GEO dataset and TNMPLOT database. Meta analysis method was used to pool the survival data for QPRT. The predictive values of QPRT for different drugs were retrieved from the ROC plot. The expression differences of QPRT in acquired drug-resistant and sensitive cell lines were analyzed using GEO datasets. GO and KEGG enrichment analysis were conducted for those genes which were highly co-expressed with QPRT in tissue based on TCGA data and which changed after QPRT knockdown. Timer2.0 was utilized to explore the correlation between QPRT and immune cells infiltration, and the Human Protein Atlas was used to analyse QPRT’s single-cell sequencing data across different human tissues. The expression of QPRT in different types of macrophages, and the expression of QPRT were analysed after coculturing HER2+ breast cancer cells with macrophages. Additionally, TargetScan, Comparative Toxicogenomics and the connectivity map were used to research miRNAs and drugs that could regulate QPRT expression. Cytoscape was used to map the interaction networks between QPRT and other proteins. QPRT was highly expressed in breast cancer tissue and highly expressed in HER2+ breast cancer patients (P

One of the challenging issues that hinders the application of single-walled carbon nanotubes (SWCNTs) is the poor solubility and the inevitable formation of bundles. Efforts still need to be made towards solving the problem. Herein, we report a non-covalent strategy to disperse aggregated SWCNTs by aromatic cyclic Schiff bases assisted by ultrasonic techniques. The aromatic cyclic Schiff base (OMM) was synthesized via Schiff base reactions, and the molecular structure was determined by ATR-FT-IR, solid-state 13C-NMR, and HRMS. Although the yielded product showed poor solubility in aqueous solution and organic solvents, it could interact with and disperse the aggregated SWCNTs in dimethyl formamide (DMF) under the condition of ultrasound. UV-vis-NIR, FL, Raman spectra, AFM, and TEM, along with computer simulations, provide evidence for the interactions between OMM molecules and SWCNTs and the dispersion thereof. The semiconductive (7,5), (8,6), (12,1), and (9,7)-SWCNTs expressed a preference for dissolution. The capability of dispersion is contributed by π-π, C-H·π, and lone pair (lp)·π interactions between OMM and SWCNTs based on the simulated results. The present non-covalent strategy could provide inspiration for preparing organic cyclic compounds as dispersants for SWCNTs and then facilitate their further utilization.

This is an essay in the field of mineral processing engineering. Aiming at the problem of difficult recovery of ultrafine ilmenite from a concentrator in Panzhihua-Xichang Area, a comparative study of flotation process was carried out. Using direct flotation, desliming flotation, "centrifugal-flotation", "superconducting flotation", "strong magnetic flotation", "suspension vibration-flotation" and other beneficiation processes, the test results show that: direct flotation and desliming flotation processes can not obtain titanium concentrate products with TiO2 grade greater than 46%. Suspension vibration and high intensity magnetic separation can obtain higher grade preenriched concentrate, which is conducive to the subsequent flotation operation. Centrifugation and superconductivity can obtain higher recovery of preenriched concentrate, which can ensure the effective recovery of ilmenite. But considering that superconducting preenrichment technology industry implementation investment is large, there is no mature industrial case at present; The high intensity magnetic separation and suspended vibration preconcentration process are easy to be industrialized, but the single processing capacity of the suspended vibration separator is limited. Therefore, the optimal flotation process was finally determined to be "strong magnetic flotation", which could obtain the index of titanium concentrate grade of 46.62%, recovery rate of 58.32% in open flotation operation and recovery rate of 43.78% in the whole process.

This is an essay in the field of mineral processing engineering. A low-grade fluorite ore is mainly composed of fluorite (28.85%), calcite (43.26%), quartz (12.01%) and feldspar (10.28%). Through detailed beneficiation test research，using acidized water glass and modified carbohydrate EM-318 as calcite inhibitors and using plant-based fatty acid soap EM-OL3 as fluorite collector,the fluorite concentrate with a grade of 97.59% and recovery of 90.98 % was obtained by the flowsheet of "-0.074 mm accounting for 65%, two roughings, one scavenging, and eight cleanings ". This experimental study shows that the combination of modified carbohydrate EM-318 and plant based fatty acid soap EM-OL3 as fluorite collector can efficiently separate fluorite from calcite,

To study the influence of grain arrangement on the surface profile of the workpiece, a mathematical model and its corresponding analytical algorithm of pyramidal abrasive belt grinding were established. The roughness value was simulated and predicted with Abaqus software. Grinding tests were carried out on the robot grinding system platform with pyramidal abrasive belt, and the surface profile were inspected and then compared with the simulation. The results show that the simulated roughness and the measured values have similar variation trend with good consistency, where the error is within 0.03 μm and the maximum error rate is 16.6%. The theoretical simulation and test results remain consistent, indicating that the model could be used to predict the surface roughness of workpiece ground with pyramidal abrasive belt.

Objective Informal caregivers are playing a vital role in improving the degree to which older adults access community and healthcare systems in a more seamless and timely manner, thereby fulfilling their complex needs. It is critical to understand their experiences and perspectives while navigating these systems. This review aimed to identify and organise the research findings on the roles and experiences of informal caregivers of older adults while navigating community and healthcare systems.Design This scoping review was undertaken according to the Joanna Briggs Institute’s Reviewer manual. Four databases were used: AgeLine, PsycINFO, CINAHL and Medline to capture literature with a focus on informal caregivers whose care recipients are aged 55 years or older. Articles were included if they focused on examining the experience, perspective and/or role of informal caregivers in providing care for their older care recipients, while articles were excluded if they only focused on healthcare professionals or older adults.Results A total of 24 studies were identified that met the study inclusion criteria. This review elucidated the roles of caregivers as a primary system navigator and as an advocate for older adults. Numerous challenges/barriers in system navigation were uncovered, such as lack of consistency in fragmented systems, as well as facilitators, including interface/coordination roles. Finally, recommendations for better system navigation such as caregiver engagement and integration of continuity of care services were identified.Conclusion The need to raise the visibility of the roles and experiences of informal caregivers in system navigation was highlighted. Further research needs to focus on implementing interventions for informal caregivers incorporating a care coordinator to fill the care gap within community and healthcare systems. This review has the potential to foster greater integration of community and healthcare systems.

Surface wave tomography is a widely used geophysical method to measuring seismic velocity and anisotropy in the crust and upper mantle. This paper briefly reviewed the history of surface wave tomography, and summarized the principles and advantages of multiple surface wave tomography methods (i.e., two-station method, two-plane-wave method, Eikonal and Helmholtz surface wave tomography, ambient noise tomography, and direct surface wave tomography). The theory and application of the two-station method are straightforward, but this method requires the earthquake and seismic stations to be located in the same great circle. This restriction results in a low lateral resolution phase velocity map for regions where stations are sparse and deployment times short. The two-plane-wave method can overcome the effect of scattering and multipathing of seismic wave propagation on phase velocity dispersions, but this method requires high-quality surface wave waveforms and is usually suitable for regional seismic networks. The Eikonal and Helmholtz surface wave tomography can directly compute the phase velocities and azimuthal anisotropy straightforwardly without any processes of forward modeling and inversion, but this method is limitedly suitable for high-density and orderly seismic arrays. In comparison to the Eikonal surface wave tomography method, the Helmholtz surface wave tomography approach analyzes both the phase and amplitude of the waveform and can produce better results. Ambient noise tomography can obtain high-resolution crustal structure without seismic events. However, this method is difficult to obtain long-period phase velocities, resulting in a lack of constraints on the mantle and lithosphere structure. Direct surface wave tomography can obtain the shear-wave velocity and azimuthal anisotropy from dispersive curves without the inversion process of phase velocity maps. We conducted detailed comparisons of the phase velocity maps at the short-intermediate periods (20～40 s) previously obtained from these surface wave tomography methods in the central-northern, northeastern and southern Tibetan Plateau. The comparisons demonstrated that the Rayleigh and Love wave phase velocity maps from different tomography methods show highly consistency in velocity variation patterns at same periods. The results show that the plateau's interior by characterized with low-velocities in phase velocity maps at intermediate and long periods, whereas relatively high velocities dominate adjacent regions, such as the Qaidam Basin and Sichuan Basin. These features indicate that the Tibetan Plateau's mid-lower crust and upper mantle tend to be weaker and easily deform during the northward movement of the Indian plateau and the barrier of the strong blocks (e.g., the Qaidam Basin and the Alashan Platform). The short periods phase velocity maps (i.e., 20～40 s) reveal that the mid-lower crustal flow of the Tibetan Plateau escapes southward surrounding the weakening zones (i.e., the Red River Fault and the Xianshui River Fault) due to the barrier of the strong Chuandian tectonic block. The Qilian Orogen also shows low velocities in the phase velocity maps at the short-intermediate periods, which is likely due to thermal anomaly with localized mantle upwelling. It is noteworthy that the Rayleigh-wave and Love-wave phase velocities at different period ranges (e.g., 4～200 s) can be obtained via incorporating earthquake surface wave tomography and ambient noise tomography. Those phase velocities can be used as input to inverting three-dimensional shear wave velocities and radial anisotropy models simultaneously. This paper envisions that integrating higher-mode earthquake surface wave tomography, adjoint tomography, and joint inversion could obtain higher resolution and more reliable crustal and upper mantle structures.

Abstract The Yinggehai Basin (YB) in the northwest of the South China Sea (SCS) has preserved the complete evolution of the Red River Fault (RRF), whose motion over time has largely contributed to shaping the current tectonic framework of the southeastern Tibetan Plateau and Indochina Block. Here we, for the first time, image the RRF, crustal architecture, and crust‐mantle boundary (i.e., Moho) in detail under the YB from two high‐resolution 40‐km‐depth seismic reflection pre‐stack migration profiles. Our seismic reflection images provide direct seismic evidence to support a deep‐penetrating RRF, most likely crosscutting the Moho. In this sense, the RRF was a large‐scale shear zone, along with the clockwise rotation of the Indochina Block, to accommodate the Indochina Block extrusion during Oligocene‐early Miocene and form the YB. We highlight that the material extrusion along deep‐penetrating faults dominated the Tibetan Plateau deformation in response to the India‐Asia collision at an early stage.

Abstract Background Metastasis is the predominant cause of mortality in patients with breast cancer. Long noncoding RNAs (lncRNAs) have been shown to drive important phenotypes in tumors, including invasion and metastasis. However, the lncRNAs involved in metastasis and their molecular and cellular mechanisms are still largely unknown. Methods The transcriptional and posttranscriptional processing of LINC00478-associated cytoplasmic RNA (LacRNA) was determined by RT-qPCR, semiquantitative PCR and 5′/3′ RACE. Paired-guide CRISPR/cas9 and CRISPR/dead-Cas9 systems was used to knock out or activate the expression of LacRNA. Cell migration and invasion assay was performed to confirm the phenotype of LacRNA. Tail vein model and mammary fat pad model were used for in vivo study. The LacRNA-PHB2-cMyc axis were screened and validated by RNA pulldown, mass spectrometry, RNA immunoprecipitation and RNA-seq assays. Results Here, we identified a novel cytoplasmic lncRNA, LacRNA (LINC00478-associated cytoplasmic RNA), derived from nucleus-located lncRNA LINC00478. The nascent transcript of LINC00478 full-length (LINC00478_FL) was cleaved and polyadenylated, simultaneously yielding 5′ ends stable expressing LacRNA, which is released into the cytoplasm, and long 3′ ends of nuclear-retained lncRNA. LINC00478_3′RNA was rapidly degraded. LacRNA significantly inhibited breast cancer invasion and metastasis in vitro and in vivo. Mechanistically, LacRNA physically interacted with the PHB domain of PHB2 through its 61–140-nt region. This specific binding affected the formation of the autophagy degradation complex of PHB2 and LC3, delaying the degradation of the PHB2 protein. Unexpectedly, LacRNA specifically interacted with PHB2, recruited c-Myc and promoted c-Myc ubiquitination and degradation. The negatively regulation of Myc signaling ultimately inhibited breast cancer metastasis. Furthermore, LacRNA and LacRNA-mediated c-Myc signaling downregulation are significantly associated with good clinical outcomes, take advantage of these factors we constructed a prognostic predict model. Conclusion Therefore, our findings propose LacRNA as a potential prognostic biomarker and a new therapeutic strategy.

Abstract Background With the increasing morbidity and mortality of preeclampsia (PE), it has posed a huge challenge to public health. Previous studies have reported endoplasmic reticulum (ER) stress could contribute to trophoblastic dysfunction which was associated with the N6-methyladenosine (m6A) modification by methyltransferase-like 3 (METTL3), resulting in PE. However, little was known about the relationship between METTL3 and ER stress in PE. Thus, in vitro and in vivo studies were performed to clarify the mechanism about how METTL3 affects the trophoblasts under ER stress in PE and to explore a therapeutic approach for PE. Methods An ER stress model in HTR-8/SVneo cells and a preeclamptic rat model were used to study the mechanism and explore a therapeutic approach for PE. Western blot, immunohistochemistry, quantitative reverse transcription-polymerase chain reaction (qRT-PCR), and methylated RNA immunoprecipitation (MeRIP)-qPCR were performed to detect the protein, RNA, and methylated transmembrane BAX inhibitor motif containing 6 (TMBIM6) expression levels. The m6A colorimetric and mRNA stability assays were used to measure the m6A levels and TMBIM6 stability, respectively. Short hairpin RNAs (shRNAs) were used to knockdown METTL3 and YTH N6-methyladenosine RNA binding protein 2 (YTHDF2). Flow cytometry and Transwell assays were performed to evaluate the apoptosis and invasion abilities of trophoblasts. Results Upregulated METTL3 and m6A levels and downregulated TMBIM6 levels were observed in preeclamptic placentas under ER stress. The ER stress model was successfully constructed, and knockdown of METTL3 had a beneficial effect on HTR-8/SVneo cells under ER stress as it decreased the levels of methylated TMBIM6 mRNA. Moreover, overexpression of TMBIM6 was beneficial to HTR-8/SVneo cells under ER stress as it could neutralize the harmful effects of METTL3 overexpression. Similar to the knockdown of METTL3, downregulation of YTHDF2 expression resulted in the increased expression and mRNA stability of TMBIM6. Finally, improved systemic symptoms as well as protected placentas and fetuses were demonstrated in vivo. Conclusions METTL3/YTHDF2/TMBIM6 axis exerts a significant role in trophoblast dysfunction resulting in PE while inhibiting METTL3 may provide a novel therapeutic approach for PE.

Terahertz waves, positioned between microwaves and infrared in the electromagnetic spectrum, are distinguished by their exceptional penetration capabilities, minimal energy requirements, and consistent absorption profiles for specific substances. Their versatility in applications such as non-destructive evaluation, human security scans, and biological diagnostics has propelled them to the forefront of scientific inquiry. However, existing terahertz equipment poses limitations in terms of compromised resolution, diffraction-induced blurring, and degradation of clarity due to texture overlaps. Consequently, numerous multi-view 3D reconstruction algorithms struggle to produce high-quality results with terahertz imagery. To address these challenges—particularly the scarcity of terahertz datasets and texture conflation—we integrated X-ray images from the DTU dataset with our collected terahertz projections. By observing inconsistent texture projections in multi-view terahertz images resulting from angle shifts, we developed DETransMVSnet—a state-of-the-art multi-view 3D reconstruction approach based on the Multi-Scale Deep Equilibrium Layer (MDEQ) paradigm. Leveraging equilibrium layers within homography-projected feature maps enables us to extract masks that differentiate different layers within a scene. The Intra-Attention and Mask-Attention Blocks further refine feature selection by preserving relevant terahertz details while suppressing disruptive background elements. As evidence of its effectiveness, DETransMVSnet achieves comparable performance to conventional algorithms on the DTU dataset but notably outperforms them when applied to terahertz datasets by successfully reconstructing images where previous methods have failed.

Enantioenriched N-alkylindole compounds, in which nitrogen is bound to a stereogenic sp3 carbon, are target molecules in the fields of biological, medicinal, and organic chemistry. Here the authors show a nickel-catalyzed C-C coupling protocol to synthesize these molecules from N-indolylsubstituted alkenes.

Abstract Studying the evolution history of the southwest summer monsoon (SSM) throughout geological time, particularly during its strongest period in the Holocene, can improve our understanding of its variation and driving mechanisms, and even help predict future climate changes, due to its significant social and economic implications. Here, we reconstructed the history of chemical weathering intensity since the Last Glacial Maximum (LGM) based on clay mineral proxies [(illite/smectite)/(illite + chlorite) and illite crystallinity] obtained from Qionghai Lake sediments and examined its response to paleoclimate and SSM. Our findings indicate that the intensity of chemical weathering generally aligned with changes in paleoclimate, exhibiting strong chemical weathering intensity during warm and humid climate conditions. In addition, the intensity of chemical weathering basically tracks the evolution of the SSM since the LGM. Our results support the view that the highest SSM intensity occurred during the early‐middle Holocene, followed by gradual weakening during the late Holocene, with Northern Hemisphere summer insolation being the primary driver of the SSM evolution. The variations of the SSM and the corresponding intensity of chemical weathering were also influenced by the cumulative effects of glacier boundary conditions, North Atlantic climate fluctuations, and Intertropical Convergence Zone migrations.

ABSTRACT Carryover contamination during amplicon sequencing workflow (AMP-Seq) put the accuracy of the high-throughput detection for pathogens at risk. The purpose of this study is to develop a carryover contaminations-controlled AMP-Seq (ccAMP-Seq) workflow to enable accurate qualitative and quantitative detection for pathogens. By using the AMP-Seq workflow to detect SARS-CoV-2, Aerosols, reagents and pipettes were identified as potential sources of contaminations and ccAMP-Seq was then developed. ccAMP-Seq used filter tips and physically isolation of experimental steps to avoid cross contamination, synthetic DNA spike-ins to compete with contaminations and quantify SARS-CoV-2, dUTP/uracil DNA glycosylase system to digest the carryover contaminations, and a new data analysis procedure to remove the sequencing reads from contaminations. Compared to AMP-Seq, the contamination level of ccAMP-Seq was at least 22-folds lower and the detection limit was also about an order of magnitude lower—as low as one copy/reaction. By testing the dilution series of SARS-CoV-2 nucleic acid standard, ccAMP-Seq showed 100% sensitivity and specificity. The high sensitivity of ccAMP-Seq was further confirmed by the detection of SARS-CoV-2 from 62 clinical samples. The consistency between qPCR and ccAMP-Seq was 100% for all the 53 qPCR-positive clinical samples. Seven qPCR-negative clinical samples were found to be positive by ccAMP-Seq, which was confirmed by extra qPCR tests on subsequent samples from the same patients. This study presents a carryover contamination-controlled, accurate qualitative and quantitative amplicon sequencing workflow that addresses the critical problem of pathogen detection for infectious diseases. IMPORTANCE Accuracy, a key indicator of pathogen detection technology, is compromised by carryover contamination in the amplicon sequencing workflow. Taking the detection of SARS-CoV-2 as case, this study presents a new carryover contamination-controlled amplicon sequencing workflow. The new workflow significantly reduces the degree of contamination in the workflow, thereby significantly improving the accuracy and sensitivity of the SARS-CoV-2 detection and empowering the ability of quantitative detection. More importantly, the use of the new workflow is simple and economical. Therefore, the results of this study can be easily applied to other microorganism, which has great significance for improving the detection level of microorganism.

SuperBIT was a 0.5 m near-UV to near-infrared wide-field telescope that launched on a NASA superpressure balloon into the stratosphere from New Zealand for a 45-night flight. SuperBIT acquired multiband images of galaxy clusters to study the properties of dark matter using weak gravitational lensing. We provide an overview of the instrument and its various subsystems. We then present the instrument performance from the flight, including the telescope and image stabilization system, the optical system, the power system, and the thermal system. SuperBIT successfully met the instrument’s technical requirements, achieving a telescope pointing stability of 0.″34 ± 0.″10, a focal plane image stability of 0.″055 ± 0.″027, and a point-spread function FWHM of ∼0.″35 over 5-minute exposures throughout the 45-night flight. The telescope achieved a near-diffraction-limited point-spread function in all three science bands ( u , b , and g ). SuperBIT served as a pathfinder to the GigaBIT observatory, which will be a 1.34 m near-UV to near-infrared balloon-borne telescope.

Abstract Background Performance evaluation is vital for IRB operations. As the number of IRBs and their responsibilities in reviewing and supervising clinical research grow in China, there is a significant need to evaluate their performances. To date, little research has examined IRB performance within China. The aim of this study was to ascertain the perspectives and experiences of IRB employees and researchers to (1) understand the current status of IRBs; (2) compare collected results with those of other countries; and (3) identify shortcomings to improve IRB performance. Methods This study was conducted in China from October 2020 to September 2021, using an online survey with the IRB-researcher assessment tool-Chinese version. Results 757 respondents were included in the analysis and classified into IRB employees, researchers, or those who are both IRB employees and researchers. Overall, the score for an ideal IRB was significantly higher than that of an actual IRB. Compared to the US National Validation study, Chinese participants and American participants both agree and differ in their perspectives on the most and least important ideal items. Conclusion This investigation provides a benchmark of the perceived performance of actual IRBs in China. IRBs in China can be precisely adjusted by targeting identified areas of weakness to improve their performances.

Abstract Background Wheat-dependent exercise-induced anaphylaxis (WDEIA) is a serious and potentially life-threatening form of wheat allergy. Further episodes can only be prevented by avoiding wheat ingestion or avoiding exercise after wheat intake. Anaphylaxis may recur in some patients post-diagnosis. This study aimed to analyze the clinical features and management/outcomes of WDEIA in China. Methods We retrospectively analyzed the clinical characteristics, and laboratory testing of 197 patients with WDEIA. After diagnosis, the patients were followed up as outpatients to evaluate dietary/exercise choice and clinical outcomes. Results Among the 197 WDEIA patients (median age, 37 years), 53.8% were male and 28.4% had other allergic disorders. The median duration of anaphylaxis before diagnosis was 16 months. Significant delays in diagnosis (> 1 years) were recorded in 52.7% of the patients, which has not decreased by years (P = 0.064). Exercise (83.8%), alcohol (12.2%), and nonsteroidal anti-inflammatory drugs (7.1%) were the most common cofactors. The most common clinical features were urticaria (100%), loss of consciousness (82.7%), dyspnea (50.8%), and hypotension (47.2%). Of the 197 eligible patients, 155 responded (78.7%), and 124 (80.0%) of which had no anaphylaxis post-diagnosis. A wheat-free diet prevented future anaphylaxis in 91.7% of the patients, followed by the avoidance of wheat combined with exercise (87%) and reduced wheat intake combined with exercise avoidance (80.5%). Conclusion The diagnosis of WDEIA is frequently delayed. Therefore, when patients present with unexplained anaphylaxis, the possibility of WDEIA should be considered. A wheat-free diet or avoiding wheat combined with exercise or reduced wheat combined with exercise avoidance helps to significantly reduce the onset of future anaphylaxis. However, approximately one-fifth of patients continue to experience anaphylaxis post-diagnosis. Thus, these patients must always carry epinephrine autoinjectors.

Purpose: Neoadjuvant therapy (NAT) is considered the standard of care for patients with HER2-positive breast cancer (BC). However, there is no proven survival benefit of NAT compared to adjuvant therapy for the survival of patients with early-stage HER2-positive BC. This study aimed to compare the prognosis of HER2-positive BC patients treated with NAT to that of patients treated with adjuvant therapy. Methods: This was a single-center real-world retrospective study. This study analyzed the disease-free survival (DFS) and overall survival (OS) of 538 HER2-positive BC patients treated with neoadjuvant therapy and 2684 patients treated with adjuvant therapy at Fudan University Shanghai Cancer Center (FUSCC) between 2012 and 2016. Patients with a clinical tumor size (cT) ≤5 cm or >5 cm were matched using the propensity score matching (PSM) method to prevent selection bias. Results: After PSM, among patients with cT ≤ 5 cm, there was no significant difference in DFS (P = 0.08) or OS (P = 0.11) between the two groups. The analysis of survival outcomes of patients treated with neoadjuvant and adjuvant therapy in the different chemotherapy subgroups yielded consistent results. According to multivariate analysis, lymph node status and response to NAT showed independent prognostic value for OS and DFS. Among patients with cT > 5 cm, the DFS (P = 0.25) and OS (P = 0.57) of patients treated with NAT were similar to those of patients treated with adjuvant therapy after PSM. Conclusion: We confirmed the equivalent effects of adjuvant therapy and NAT in HER2-positive BC patients. Neoadjuvant therapy should be used for patients with HER2-positive BC.

Estrogen receptor‐positive and human epidermal growth factor receptor 2‐negative (ER+HER2−) breast cancer accounts for ~ 60–70% of all cases of invasive breast carcinoma. High‐grade ER+HER2− tumors respond poorly to endocrine therapy. In this study, we systematically analyzed clinical and multi‐omics data to find potential strategies for personalized therapy of patients with high‐grade ER+HER2− disease. Six different cohorts were analyzed, for which multi‐omics data were available. Grade III ER+HER2− cases harbored higher proportions of large tumor size (> 5 cm), lymph node metastasis, chemotherapy use, and luminal B subtypes defined by PAM50, as compared with grade I/II tumors. DNA methylation (HM450) data and methylation‐specific PCR indicated that the cg18629132 locus in the MKI67 promoter was hypermethylated in grade I/II cases and normal tissue, but hypomethylated in grade III cases or triple‐negative breast cancer, resulting in higher expression of MKI67. Mutations in ESR1 and TP53 were detected in post‐endocrine treatment metastatic samples at a higher rate than in treatment‐naive tumors in grade III cases. We identified 42 and 20 focal copy number events in nonmetastatic and metastatic high‐grade ER+HER2− cases, respectively, with either MYC or MDM2 amplification representing an independent prognostic event in grade III cases. Transcriptional profiling within grade III tumors highlighted ER signaling downregulation and upregulation of immune‐related pathways in non‐luminal‐like tumors defined by PAM50. Recursive partitioning analysis was employed to construct a decision tree of an endocrine‐resistant subgroup (GATA3‐negative and AGR‐negative) of two genes that was validated by immunohistochemistry in a Chinese cohort. All together, these data suggest that grade III ER+HER2− tumors have distinct clinical and molecular characteristics compared with low‐grade tumors, particularly in cases with non‐luminal‐like biology. Due to the dismal prognosis in this group, clinical trials are warranted to test the efficacy of potential novel therapies.

The bionic flapping wing aircraft realizes flight by imitating the structure and flapping mode of birds. In this paper, a three-dimensional composite motion aerodynamic analysis model of a bionic flapping wing is established. The diverting field and flapping wing grid are divided up using dynamic hybrid grid technology. The flow field of the flapping wing is analyzed by solving the Navier–Stokes (N–S) equation combined with the Boussinesq hypothesis. The lift of the flapping wing under different flutter frequencies and incoming wind speeds is studied under the asymmetric flutter condition. In order to verify the accuracy of the aerodynamic simulation results, a flapping-wing shrinking-ratio model prototype is made, and low-speed wind tunnel experiments are carried out to test the changes in the flight lift of the wing at different flutter frequencies and angles of attack. A comparative analysis of the wind tunnel experiment and the aerodynamic simulation results shows that when the flapping frequency (1–5 Hz) and incoming wind speed (1–5 m/s) increase, the lift force generated by the wing flapping increases. Due to the deviation between the experimental sample airfoil area and the simulated airfoil area, as well as the wing-driven fuselage vibration during the experiment, a sensor error is produced, resulting in a deviation of about 1 N between the experimental result curve and the simulation result curve. However, the aerodynamic characteristics obtained from the aerodynamic simulation analysis are basically consistent with the aerodynamic change law measured in the wind tunnel experiment.

The convergent subduction zones and the divergent spreading ridges are essential tectonic units that are widely distributed in the South China Sea and the surrounding regions, governing the regional tectonic evolution. Subduction-spreading interaction may be present between these two tectonic units, especially when they are located adjacent. Quantitative study of subduction-spreading interaction remains insufficient. Using 2D thermomechanical numeric modeling, we systematically study subduction-spreading interaction with particular attention paid on the influence of lower plate spreading versus upper plate spreading on subduction development. Our modeling results provide the following findings. (1) Intensive interaction is present between the adjacently located spreading center and subduction zone through plate motion and mantle convection, and positive feedback is present between these two units, i.e., spreading promotes subduction and vise verse. (2) The location of spreading center either on the upper or lower plate facilitates the formation of passive and active subduction, respectively, and the offset distance between the two units affects the intensity of subduction-spreading interaction. (3) Subduction-spreading interaction may be widely present in the South China Sea and the surrounding regions, where multiple subduction zones and spreading centers distribute adjacently in the present and evolved episodically in the past.

Background: Wheat-induced anaphylaxis (WIA) is a serious and potentially life-threatening wheat allergy, more common in adults than in children. Little is known about the differences in clinical profiles in WIA among patients of various ages in China. Methods: We analyzed data retrospectively from an allergy department in a tertiary hospital that included 248 patients (208 adults and 40 children and adolescents) with a history of WIA. Results: We found that alcohol was more frequent in patients aged ≥50 years [older adults] (19.0%, 4/21) than in those aged 12–17 years [adolescents] (0%, 0/33; p = 0.019). The frequency of NSAID use in older adults (42.9%, 9/21) was significantly higher than that in adolescents (0%, 0/33; p

Abstract Trends of precipitation over the Tibetan Plateau (TP) are characterized by a north‐south dipole pattern, and the role of local mesoscale systems, TP vortices (TPVs), remains ambiguous. This work reports that the north‐south dipole pattern trends in the TPVs‐associated precipitation have experienced an interdecadal shift in the last two decades, that is, increases in northern TP and decreases in southern TP first and then varies opposite trends, which greatly contributes to the similar interdecadal shift in TP precipitation trends. Furthermore, the causes of changes in TPV frequency are explored from the perspective of lower troposphere conditions. We find that the lower‐level winds, that is, zonal winds over the TP and meridional winds across the northwestern TP boundary, are responsible for the regionally different variations in TPV frequency. The variations in Indian Ocean Dipole are suggested to contribute to the changes in lower‐level winds over the TP.

IntroductionBiological soil crusts (BSCs) constitute a substantial portion of primary production in dryland ecosystems. They successionally mature to deliver a series of ecosystem services. Bacteria, as an important community in BSCs, play critical roles in maintaining the structure and functions of BSCs. However, the process by which bacterial diversity and community are altered with BSC development is not fully understood.MethodsIn this study, amplicons sequencing was used to investigate bacterial diversity and community compositions across five developmental stages of BSCs (bare sand, microbial crusts, algae crusts, lichen crusts, and moss crusts) and their relationship with environmental variables in the Gonghe basin sandy land in Qinghai-Tibet Plateau, northwestern China.ResultsThe results showed that Proteobacteria, Actinobacteria, Cyanobacteria, Acidobacteria, Bacteroidetes, and Firmicutes were predominant in different developmental stages of BSCs, accounting for more than 77% of the total relative abundance. The phyla of Acidobacteria and Bacteroidetes were abundant in this region. With BSC development, bacterial diversity significantly increased, and the taxonomic community composition significantly altered. The relative abundance of copiotrophic bacteria, such as Actinobacteria, Acidobacteria, Bacteroidetes, Verrucomicrobia, Planctomycetes, and Gemmatimonadetes significantly increased, whereas the relative abundance of oligotrophic bacteria, such as Proteobacteria and Firmicutes significantly decreased. The relative abundance of Cyanobacteria in the algae crusts was significantly higher than that in the other developmental stages (p

Delamination or convective thinning could cause large-scale and complete removal of the mantle lithosphere under orogens. However, geological and geophysical observations suggest that patched removal of the mantle lithosphere has occurred in some orogens, such as the northeastern Tibetan Plateau, the central Tianshan, and the central Andes. Dislocation-creep-induced strain localization cannot promote effective removal of the mantle lithosphere to the Moho on a small-scale. Recent rheological studies propose that dislocation-accommodated grain boundary sliding (DisGBS) may dominate upper mantle deformation. DisGBS could make the lower lithospheric mantle rheologically weaker than dry olivine. With 2-D high-resolution thermo-mechanical modeling, we systematically investigated the conditions for the initiation of small-scale lithospheric thinning under orogens and explored the minimum range of removal of the mantle lithosphere. The numerical results indicate that classic convective drip cannot effectively thin the mantle lithosphere to the Moho on a small-scale. In contrast, small-scale thinning can be induced by lithospheric heterogeneity with DisGBS and plasticity. The rheological heterogeneity can be verified by magmatism and metasomatism under the central Andes and orogens between terranes under the northeastern Tibetan Plateau or in Tianshan.

Abstract Diabetic cardiomyopathy (DCM) is a serious cardiac complication of diabetes that currently lacks specific treatment. The cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) signaling pathway has been suggested to contribute to the pathogenesis of cardiovascular diseases. However, whether cGAS-STING is involved in the development of DCM has not been established. Our study aimed to determine the role of cGAS-STING in the initiation of nucleotide-binding oligomerization domain-like receptor pyrin domain containing 3 (NLRP3) inflammasome-induced cardiac pyroptosis and chronic inflammation during the pathogenesis of DCM. C57BL/6J mice were preinjected with adeno-associated virus 9 (AAV9) intravenously via the tail vein to specifically knock down myocardial STING. After four weeks, mice with myocardium-specific knockdown of STING received injections of streptozotocin (STZ; 50 mg/kg) and a high-fat diet to induce diabetes. Measurements included echocardiography, immunohistochemical analyses, wheat germ agglutinin (WGA) staining, and western blotting. Here, we showed that the cGAS-STING signaling pathway was activated in diabetic hearts, which was indicated by the increased phosphorylation of TANK-binding kinase 1 (TBK1) and interferon (IFN) regulatory factor 3 (IRF3), leading to the activation of the NLRP3 inflammasome in the hearts of diabetic mice and proinflammatory cytokine release into serum. Moreover, STING knockdown via adeno-associated virus-9 (AAV9) in diabetic mouse heart alleviated cardiac pyroptosis and the inflammatory response, prevented diabetes-induced hypertrophy, and restored cardiac function. Mechanistically, we showed that palmitic acid (PA)-induced lipotoxicity impairs mitochondrial homeostasis, producing excessive mitochondrial reactive oxygen species (mtROS), which results in oxidative damage to mitochondrial DNA (mtDNA) and its release into the cytoplasm while switching on cGAS-STING-mediated pyroptosis in cardiomyocytes, thereby worsening the progression of diabetic cardiomyopathy. Our study demonstrated that activation of the cGAS-STING pathway caused by mitochondrial oxidative damage and mtDNA escape induced by free fatty acids promoted pyroptosis and proinflammatory responses in cardiomyocytes in a NLRP3 inflammasome-dependent manner, thus promoting myocardial hypertrophy during the progression of DCM.

In April 2023, the superBIT telescope was lifted to the Earth’s stratosphere by a helium-filled super-pressure balloon to acquire astronomical imaging from above (99.5% of) the Earth’s atmosphere. It was launched from New Zealand and then, for 40 days, circumnavigated the globe five times at a latitude 40 to 50 degrees south. Attached to the telescope were four “drs” (Data Recovery System) capsules containing 5 TB solid state data storage, plus a gnss receiver, Iridium transmitter, and parachute. Data from the telescope were copied to these, and two were dropped over Argentina. They drifted 61 km horizontally while they descended 32 km, but we predicted their descent vectors within 2.4 km: in this location, the discrepancy appears irreducible below ∼2 km because of high speed, gusty winds and local topography. The capsules then reported their own locations within a few metres. We recovered the capsules and successfully retrieved all of superBIT’s data despite the telescope itself being later destroyed on landing.