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Abstract Background Recently, deep learning has been increasingly applied in the field of dentistry. The aim of this study is to develop a model for the automatic segmentation, numbering, and state assessment of teeth on panoramic radiographs. Methods We created a dual-labeled dataset on panoramic radiographs for training, incorporating both numbering and state labels. We then developed a fusion model that combines a YOLOv9-e instance segmentation model with an EfficientNetv2-l classification model. The instance segmentation model is used for tooth segmentation and numbering, whereas the classification model is used for state evaluation. The final prediction results integrate tooth position, numbering, and state information. The model’s output includes result visualization and automatic report generation. Results Precision, Recall, mAP50 (mean Average Precision), and mAP50-95 for the tooth instance segmentation task are 0.989, 0.955, 0.975, and 0.840, respectively. Precision, Recall, Specificity, and F1 Score for the tooth classification task are 0.943, 0.933, 0.985, and 0.936, respectively. Conclusions This fusion model is the first to integrate automatic dental segmentation, numbering, and state assessment. It provides highly accurate results, including detailed visualizations and automated report generation.

Abstract Background Cosmetic surgery has a profound impact on health and other aspects. As a means of enhancing physical attractiveness, it is increasingly being considered by female college students in China. However, current knowledge about the determinants of cosmetic surgery consideration among Chinese female college students still needs to be improved due to the lack of systematic perspectives and large-scale representative data sets. This study aimed to contribute to the literature in these two aspects. Methods We framed cosmetic surgery consideration as a function of two broad sets of determinants: socio-cultural and labor-economic. We used data from a large, nationally representative sample of female college students in China (N = 6658, mean age = 20.3 years). Results In terms of socio-cultural oriented factors, we found that family socioeconomic status, peers' cosmetic surgery practices, and media exposure were positively associated with the likelihood of considering cosmetic surgery. In terms of labor-economic oriented factors, we found that self-rated physical appearance, higher grades, and expected income after graduation were positively associated with a higher likelihood of considering cosmetic surgery. Conclusions These findings suggest that the decision-making process for cosmetic surgery among Chinese female college students goes beyond personal factors and is significantly influenced by structural factors.

Abstract Background Preliminary evidence demonstrates that visit-to-visit systolic blood pressure (SBP) variability is a prognostic factor of TBI. However, literature regarding the impact of initial blood pressure management on the outcomes of TBI patients is limited. We aimed to further validate the clinical significance of BPV on the prognostic outcomes of patients with TBI. Methods We performed the analysis by using individual patient-level data acquired from the eICU-CRD, which collected 200,859 ICU admissions of 139,367 patients in 2014 and 2015 from 208 US hospitals. Adult patients with traumatic intraparenchymal hemorrhage or contusion were included. The primary outcome was in-hospital mortality and the secondary outcome was discharge-home rate. Blood pressure variability (BPV) was calculated according to standard criteria: at least six measurements were taken in the first 24 h (hyperacute group) and 36 over days 2–7 (acute group). We estimated the associations between BPV and outcomes with logistic and proportional odds regression models. The key parameter for BPV was standard deviation (SD) of SBP, categorized into quintiles. We also calculated the average real variability (ARV), as well as maximum, minimum, and mean SBP for comparison in our analysis. Results We studied 1486 patients in the hyperacute group and 857 in the acute group. SD of SBP had a significant association with the in-hospital mortality for both the hyperacute group (highest quintile adjusted OR 2.28 95% CI 1.18–4.42; ptrend

Abstract Introduction Although heparin has been widely used in clinical practice, its effect on mortality in sepsis is still controversial. This study aimed to investigate the effectiveness of heparin in septic patients. Methods Adult septic patients were identified from the Medical Information Mart for Intensive Care (MIMIC)-IV 2.0 database, which contains patients admitted to intensive care units (ICUs) at the Beth Israel Deaconess Medical Centre from 2008 to 2019. Propensity score matching (PSM) was employed to adjust for the baseline differences in the probability to receive heparin or not. The marginal structural cox model (MSCM) was used to account for both baseline and time-dependent covariates. Group-based trajectory modelling (GBTM) was performed to identify activated partial thromboplastin time (APTT) trajectory groups, and patient outcomes were compared between the heparin- and non-heparin groups in each phenotype. Results A total of 9940 septic patients were enrolled in the study, including 1690 (17%) in the heparin group. By PSM, significant benefit in terms of mortality was observed among the heparin group (HR = 0.82; 95% CI 0.71–0.94; p = 0.004). Similar findings were replicated with the MSCM analysis (HR = 0.66; 95% CI 0.44–0.98; p = 0.038). In the GBTM analysis, three APTT trajectory groups were identified: “normal” (n = 8236; 82.8%); “medium high” (n = 1358; 13.7%); and “high” (n = 346; 13.5%). Heparin therapy was associated with a reduced mortality (HR, 0.59; 95% CI, 0.41–0.84; p = 0.003) in patients with the medium high APTT level [51.7 s (interquartile range, 40.1–64.3)]. Conclusions Heparin therapy was associated with improved outcome in septic patients, and it showed significant survival benefit in patients achieved the medium high APTT phenotype.

Lung cancer as a molecularly and histologically high heterogonous disease, there is an urgent need to predict lung cancer patients' responses to anti-cancer treatment, and patient-derived organoids (PDOs) have been recognized as a valuable platform for preclinical drug screening. In this study, we successfully established 26 PDO lines from various subtypes of lung cancers including benign tumor, adenocarcinoma, squamous cell carcinoma, adenosquamous carcinoma, large-cell carcinoma, and small-cell carcinoma. These PDOs were shown to retain the major genomic and histological characteristics of primary tumors and remain stable during long-term culture. With the help of targeted genomic sequencing, we found that lung cancer that harbors METN375S mutation is selectively sensitive to afatinib, and a combination of afatinib and gemcitabine induced synthetic lethality in PDO and mini-PDX models. In summary, our findings demonstrate the potential of PDO in predicting lung cancer drug response, and reveal a promising strategy for METN375S mutant lung cancer treatment.

Metal tolerance protein (MTP) is a cation transporter that plays an important role in tolerance to heavy metal stress. However, thus far, there has been no genome-wide investigation of the MTP gene family in Quercus plants. Quercus dentata is one of the main constructive species of forest in northern China. It has strong tolerance to a variety of heavy metal stresses. In this study, 25 MTPs were identified from the Q. dentata genome and classified into three subfamilies and seven groups according to their sequence characteristics and phylogenetic relationships. Both tandem and segmental duplication events contributed to the expansion of the QdMTP gene family. Interestingly, all 10 tandem duplication events contributed to the expansion of the Mn-CDF subfamily. The expression of Mn-CDF subfamily members in different organs and tissues of Q. dentata was different, and they responded differently to manganese, iron, zinc and cadmium stress treatments. QdMTP10.7, a member of the Mn-CDF subfamily, enhanced yeast growth under manganese, zinc and iron stresses. The subcellular localization in tobacco leaf epidermis cells showed that QdMTP10.7 was located in vacuoles. These data generated from this study provide an important foundation to elucidate the biological roles of QdMTP genes related to heavy metal tolerance in Q. dentata.

Abstract Phasing down fossil fuels is crucial for climate mitigation. Even though 80–90% of fossil fuels are used to provide energy, their use as feedstock to produce plastics, fertilizers, and chemicals, is associated with substantial CO2 emissions. However, our understanding of hard-to-abate chemical production remains limited. Here we developed a chemical process-based material flow model to investigate the non-energy use of fossil fuels and CO2 emissions in China. Results show in 2017, the chemical industry used 0.18 Gt of coal, 88.8 Mt of crude oil, and 12.9 Mt of natural gas as feedstock, constituting 5%, 15%, and 7% of China’s respective total use. Coal-fed production of methanol, ammonia, and PVCs contributes to 0.27 Gt CO2 emissions ( ~ 3% of China’s emissions). As China seeks to balance high CO2 emissions of coal-fed production with import dependence on oil and gas, improving energy efficiency and coupling green hydrogen emerges as attractive alternatives for decarbonization.

Abstract Background Acute pancreatitis (AP) has heterogeneous clinical features, and identifying clinically relevant sub-phenotypes is useful. We aimed to identify novel sub-phenotypes in hospitalized AP patients using longitudinal total serum calcium (TSC) trajectories. Methods AP patients had at least two TSC measurements during the first 24 h of hospitalization in the US-based critical care database (Medical Information Mart for Intensive Care-III (MIMIC-III) and MIMIC-IV were included. Group-based trajectory modeling was used to identify calcium trajectory phenotypes, and patient characteristics and treatment outcomes were compared between the phenotypes. Results A total of 4518 admissions were included in the analysis. Four TSC trajectory groups were identified: “Very low TSC, slow resolvers” (n = 65; 1.4% of the cohort); “Moderately low TSC” (n = 559; 12.4%); “Stable normal-calcium” (n = 3875; 85.8%); and “Fluctuating high TSC” (n = 19; 0.4%). The “Very low TSC, slow resolvers” had the lowest initial, maximum, minimum, and mean TSC, and highest SOFA score, creatinine and glucose level. In contrast, the “Stable normal-calcium” had the fewest ICU admission, antibiotic use, intubation and renal replace treatment. In adjusted analysis, significantly higher in-hospital mortality was noted among “Very low TSC, slow resolvers” (odds ratio [OR], 7.2; 95% CI, 3.7 to 14.0), “moderately low TSC” (OR, 5.0; 95% CI, 3.8 to 6.7), and “Fluctuating high TSC” (OR, 5.6; 95% CI, 1.5 to 20.6) compared with the “Stable normal-calcium” group. Conclusions We identified four novel sub-phenotypes of patients with AP, with significant variability in clinical outcomes. Not only the absolute TSC levels but also their trajectories were significantly associated with in-hospital mortality.

This paper proposes a high-precision attitude cooperative control strategy for three spacecraft in space gravitational wave detection. Firstly, based on the layout of optical components on the spacecraft and factors such as external interference and model uncertainty, a relative attitude model based on the Euler angle is constructed for the characteristics of small angle motion in differential wavefront sensing mode. Secondly, aiming at the cooperative control problem of multi drag-free attitude control system after the laser link capture between two spacecraft is completed, an attitude control method based on consensus mode cooperative control strategy is proposed. It combines local neighbourhood error from star sensing and differential wavefront sensing with an adaptive controller for equilateral triangle configuration control. Additionally, a cooperative control strategy based on laser measurement information is established to improve control accuracy by avoiding star sensors with low accuracy. Simulation results indicate that the control accuracy of the consistency mode and its sub-mode laser measurement mode is superior to the master-slave and cyclic modes, achieving better than 5×10−6 rad. The laser measurement mode demonstrates the highest accuracy, with relative attitude control accuracy reaching 1.5×10−7 rad, meeting the requirements for space gravitational wave detection.

Introduction Heart failure with preserved ejection fraction (HFpEF) is a prevalent comorbidity among patients with end-stage kidney disease. Although sodium-glucose cotransporter 2 inhibitors are validated in treating heart failure and ameliorating left ventricular hypertrophy among non-dialysis patients, the effects on dialysis patients are unknown. We previously investigated the pharmacokinetics of henagliflozin in patients undergoing haemodialysis (HD) or peritoneal dialysis (PD) and clarified its safety.Methods and analysis This multicentre, randomised, double-blind, placebo-controlled trial is being conducted at three hospitals in Shanghai, China. A target of 108 HD or PD patients with HFpEF are randomly allocated to treatment group (henagliflozin 5 mg/day in addition to standard therapy) or control group (placebo with standard therapy) at a ratio of 1:1. All subjects will be followed up for 24 weeks. The primary outcome is change in echocardiography-measured left ventricular mass index. The secondary interests include changes in left atrial volume index, E/e’, e’ and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Intergroup comparisons of change in echocardiography-related outcomes from baseline to 24 weeks are based on a linear regression model adjusted for baseline values (analysis of covariance), and repeated measure analysis of variance with Bonferroni adjustment is employed for comparison of change in NT-proBNP. Subgroup analyses of the primary and secondary outcomes are conducted to determine whether the effect of henagliflozin varies according to dialysis modality. The χ2 method is used to compare the occurrence of adverse events and severe adverse events.Ethics and dissemination This trial has been approved by the Ethics Committee of Renji Hospital, School of Medicine, Shanghai Jiao Tong University (LY2023-127-B). All participants provide written informed consent before screening. The results of the trial will be disclosed completely in international peer-reviewed journals. Both positive and negative results will be reported.Trial registration number ChiCTR2300073169.

ObjectivesTo assess the comparative efficacy of neoadjuvant chemotherapy followed by surgery (NACT+S) versus concurrent chemoradiotherapy (CCRT) for patients with cervical cancer stages IB2 to IIB.MethodAn exhaustive literature search was conducted up to November 2023 in databases including PubMed, Embase, Web of Science, and the Cochrane Library, focusing on disease-free survival (DFS) and overall survival (OS). Data were analyzed using STATA version 15.ResultsThe meta-analysis included data from two randomized controlled trials and eight retrospective cohort studies, totaling 2,879 patients with stages IB2 to IIB cervical cancer. Pooled data showed no significant difference in OS [hazard ratio (HR) 0.71, 95% confidence interval (CI): 0.51 to 1.00, p = 0.052] and DFS (HR 0.65, 95% CI: 0.38 to 1.14, p = 0.132) between NACT+S and CCRT. Subgroup analysis revealed that NACT+S provided a better OS in Asian populations, retrospective cohort studies, TP regimen chemotherapy, and multivariate analysis.ConclusionThe findings indicate that CCRT and NACT+S are comparably effective for treating cervical cancer stages IB2 to IIB. Notably, in specific subgroups such as Asian patients and those receiving the TP regimen, NACT+S appears to enhance OS.

The aim of this study was to explore the formation of volatile lipid oxidation products by the lipoxygenase (LOX)-hydroperoxide lyase (HPL)-mediated pathway in oat, barley and soy bean. LOX activity was found only in barley and soy bean samples, but the lipase and HPL activity was detected in all samples. HPL showed particularly high activity with 13-hydroperoxides, while the activity was quite low when using 9-hydroperoxides, especially in the oat and barley. The optimum pH for HPL in different samples was similar, i.e., pH 6–7. In this condition, the volatile compounds formed dramatically with aldehydes and furans as the dominant products. Furthermore, a remarkable enzymatic degradation of lipids occurred during the preparation of food models with highly refined rapeseed oil (RO) and rapeseed oil fatty acid (ROFA) emulsions, where the ROFAs were more prone to oxidation than RO. This study shows the significance of lipid-degrading enzymes in plant-food flavour formation.

Emotion recognition is an important part of human-computer interaction and human communication information is multi-model. Despite advancements in emotion recognition models, certain challenges persist. The first problem (Problem 1) pertains to the predominant focus in existing research on mining the interaction information between modes and the context information in the dialogue process but neglects to mine the role information between multi-model states and context information in the dialogue process. The second problem (Problem 2) is in the context information of the dialogue where the information is not completely transmitted in a temporal structure. Aiming at these two problems, we propose a multi-model fusion dialogue graph attention network (MM DialogueGAT). To solve the problem 1, the bidirectional GRU mechanism is used to extract the information from each model. In the multi-model information fusion problem, different model configurations and different combinations use the cross-model multi-head attention mechanism to establish a multi-head attention layer. Text, video and audio information are used as the main and auxiliary modes for information fusion. To solve the problem 2, in the temporal context information extraction problem, the GAT graph structure is used to capture the context information in the mode. The results show that our model achieves good results using the IMEOCAP datasets.

When earthquakes occur in high-mountain areas during the winter season, the epicentral region is often covered by a snow layer, which can be either thin or thick. The presence of snow and/or ice layers affects the detection of thermal anomalies associated with seismic signals. Taking into account the penetration capabilities of microwaves, microwave brightness temperature data were analyzed by using the index of microwave radiation anomaly to study the response of the epicentral region associated with two recent strong earthquakes in Central Asia, which occurred in snow-covered mountainous areas. Increased microwave radiation was observed within one week prior to the earthquakes. By conducting a comparative analysis of different frequencies and a comprehensive examination of meteorological parameters, we distinguished anomalies caused by tectonic activity from those induced by atmospheric water vapor. A robustness analysis from the periods of seismic tranquility and seismic disturbance has been conducted to validate our results. Our findings suggest that regions with less snow cover or shallow snow depth may exhibit high sensitivity to seismic microwave radiation anomalies in high-altitude mountainous areas during the cold season, which can be detected through passive microwave remote sensing. Combined with a further analysis from microwave polarization difference index and distribution of regional lithology, we proposed that the theory of positive holes may be the dominant mechanism for enhanced microwave radiation.

Compared with ground-based gravitational wave detection, space-based gravitational wave detection has become a research hotspot because of its abundant wave sources. However, how to reliably transmit the detection data, obtained by the space gravitational wave detector, back to the ground station from a distance of 105 kilometers is a huge challenge. In this paper, the visibility analysis and link budget are carried out for the data transmission of gravitational wave detection in geocentric orbit space, and a high real-time data transmission scheme is provided to support the mHz band gravitational wave detection. In more detail, we firstly establish a theoretical model for visibility analysis and link budget based on spacecraft dynamics model and communication link model. Secondly, through visibility simulation and calculation, we obtained the average communication time per day, and found that the Zhuhai station has a more uniform distribution of communication time compared with other ground stations. Subsequently, the link budget model indicates that link performance is largely determined by various gains and attenuations during the link process, which are related to the link working frequency band and resource allocation. Comparing the differences on gain and attenuation between X-band and Ka-band, we design an X-band communication scheme with the transmission rate of 1Mbps and bit error rate of 10−5. The calculation results also show that the communication scheme has a C/N₀ margin of 4.10 dB, which meets the data transmission requirements of TianQin. Finally, the research shows that compared with the heliocentric orbit of LISA, the geocentric orbit of TianQin has obvious advantages in transmission delay, communication time and real-time performance of data transmission, avoiding the antenna pointing issues and is more conducive to the multi-messenger detection of large astronomical events.

Background: The roles of both parents’ and children’s educational expectations in shaping adolescent depressive symptoms have increasingly been discussed, yet in a separate manner. To date, few studies have associated parent–child mismatch in educational expectations with depressive symptoms, and less is known about the variation in the association across gender (male vs. female), educational level (primary vs. secondary), and region status (urban vs. rural) in the Chinese educational setting. Methods: Respondents were from a nationally representative sample of adolescent students in China (sample size: 1844; age range: 10–15 years). Parent–child mismatch in educational expectations included three categories: (1) “match”, (2) “mismatch—parent higher”, and (3) “mismatch—parent lower”. Regression analysis with inverse propensity-score weighting was employed to estimate the effect of parent–child mismatch as to educational expectations on depressive symptoms, and stratified analysis was used to examine the variation of the effect by gender, educational level, and region. Results: Compared with the “match” group, the “mismatch—parent higher” group had significantly higher levels of depressive symptoms. Furthermore, the pattern remained consistent between boys and girls, but differed significantly by adolescents’ educational level and region status. Specifically, the pattern was more pronounced in the primary school and urban subsamples. Conclusions: Findings in this study indicated that educators and policymakers can develop tailored strategies to alleviate depressive symptoms among the “mismatch—parent higher” group, and especially for those children from primary schools and urban areas.

Background: Lung adenocarcinoma is the most common source of brain metastasis (BM), resulting in significant morbidity and mortality. We aimed to identify patients with high BM risk who possibly benefit from brain-penetrant drugs, prophylactic cranial irradiation, or close brain magnetic resonance imaging surveillance. Methods: Metastatic lung adenocarcinoma patients with extracranial tumor samples profiled by a next-generation sequencing panel targeting 425 tumor-related genes were retrospectively enrolled between February 2008 and July 2021. We compared BM and non-BM patients’ genomic and clinical features and studied their associations with BM risk. Two external cohorts were used for result validation and molecular mechanisms investigation, respectively. Results: We included 174 eligible patients, including 90 having developed BM by the end of follow-up. Age≤60, EGFR activating mutations, and high-level apolipoprotein B mRNA editing enzyme, catalytic polypeptide-like (APOBEC) mutational signatures were associated with elevated BM risk. Similar findings in BM-free survival were obtained by fitting Fine-Gray subdistribution hazard models addressing competing risks. Increased BM risk related to APOBEC mutational signatures was validated in an external cohort (N = 440). RNA sequencing data analyses performed in another external cohort (N = 230) revealed that expressions of metastasis-related pathways such as transforming growth factor (TGF)β and epithelial-mesenchymal transition (EMT) were upregulated in the patients with high-level APOBEC mutational signatures. Conclusion: APOBEC mutational signatures related to upregulated TGFβ and EMT, could serve as an independent risk factor for BM and BM-free survival in metastatic lung adenocarcinoma patients. Further investigations are warranted to tailor personalized treatments to improve the susceptible patient's outcomes.

Abstract Chronic diabetic wounds are a serious complication of diabetes and often result in limb amputations and confer high mortality rates. The proinflammatory secretome in the wound perpetuates defective neovascularization and contributes to dysregulated tissue repair. This study aims to design a gelatin methacrylamide (GelMA) hydrogel to sustained the release of grancalcin‐neutralizing antibody (GCA‐NAb) and evaluate it as a potential scaffold to promote diabetic wound healing. Results show that the expression of grancalcin(GCA), a protein secreted by bone marrow‐derived immune cells, is elevated in the wound sites of individuals and animals with diabetic ulcers. Genetic inhibition of grancalcin expression accelerates vascularization and healing in an animal model. Mechanistic studies show that grancalcin binds to transient receptor potential melastatin 8(TRPM8) and partially inactivates its downstream signaling pathways, thereby impairing angiogenesis in vitro and ex vivo. Systemic or topical administration of a GCA‐NAb accelerate wound repair in mice with diabetes. The data suggest that GCA is a potential therapeutic target for the treatment of diabetic ulcers.

Abstract Background Nasopharyngeal carcinoma (NPC) is more common in men aged 40 to 59, and radiotherapy is an effective treatment. Nasopharyngeal lymphoma (NPL) is rare, and the coexistence of nasopharyngeal mantle cell lymphoma (MCL) and NPC is even rarer. A collision tumor is a rare type of tumor that refers to two or more different tumors occurring in the same organ. No reports to date have described a collision tumor of NPC and MCL occurring within the same nasopharyngeal mass. We herein report the successful treatment of a unique case of synchronous coexistence of NPC and MCL occurring in the nasopharynx of a Chinese man. Case presentation A 58-year-old man presented with a 5-month history of swallowing discomfort. Biopsy was performed under nasopharyngeal endoscopy, and histopathology revealed NPC. Magnetic resonance imaging revealed lesions in the nasopharynx, oropharynx, and tonsils, as well as enlarged lymph nodes in the parotid gland, posterior ear, and neck. This may be a synchronous dual primary tumor coexisting with NPC and NPL. Pathology consultation confirmed that the biopsy specimen of the nasopharynx was a collision tumor of NPC and MCL. Positron emission tomography computed tomography (PET-CT) revealed thickening of the posterior wall of the nasopharynx, which was considered NPC with lymphoma. The enlargement of the pharyngeal lymph ring and multiple hypermetabolic lymph nodes were evaluated as lymphoma infiltration. The patient received two courses of R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) followed by head and neck radiotherapy. At the time of this writing, he had remained alive without recurrence for 61 months since the initial treatment and was still undergoing follow-up. Conclusions It is very important to correctly recognize collision tumors. Magnetic resonance imaging helps identify different components of collision tumors. Pathological examination helps to confirm the diagnosis. Histological examination reveals different components, and PET-CT can help determine the extent of the lesion. Dose-adjusted chemotherapy combined with radiotherapy may have promising herapeutic effects, but additional case studies are needed to confirm.

(1) Background: The benefits of weight management are widely recognized, and prolonged fasting duration has become a common method for weight control. The suitability of time-restricted eating (TRE) for elderly individuals remains controversial. This study aims to examine the correlation between fasting duration and mortality within a nationally representative cohort of elderly individuals in the United States. (2) Methods: Data were extracted from a prospective cohort study conducted as part of the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Participants aged over 60 with complete data on dietary intake and mortality follow-up information were included. Fasting duration was assessed using two 24 h dietary recalls. All the participants were categorized into fasting duration quartiles. Mortality outcomes were ascertained through the National Death Index. Cox proportional hazards regression models were utilized to analyze the association between fasting duration and mortality. (3) Results: The final analysis included 10,561 elderly participants (mean age 69.89, 45.58% male). Individuals with the longest fasting duration (over 12.38 h) had a significantly higher risk of CVD mortality compared to those with a normal fasting duration (10.58–12.38 h). This elevated CVD mortality risk was particularly pronounced in males, individuals over 70 years old, and non-shift workers. A non-linear relationship was observed between fasting duration and all-cause mortality and CVD mortality. (4) Conclusions: Prolonged fasting periods are associated with a higher risk of CVD mortality in the elderly population, although this correlation is not evident for all-cause, cancer, or other-cause mortality. A fasting duration of 11.49 h correlates with the lowest mortality risk. Additionally, elderly individuals with the shortest fasting duration exhibit elevated hazard ratios for both cancer and other-cause mortality. As with any health intervention, clinicians should exercise caution when recommending a fasting regimen that is personalized to the health condition of people who are older. Further research through randomized controlled trials should be conducted to comprehensively investigate the impact of TRE on mortality.

The mechanical properties and serviceability of the alloy fabricated by laser powder bed fusion (L-PBF) additive manufacturing (AM) strongly depend on the phase composition and microstructure, which are affected by the thermal condition of the process, such us cooling rate. In this study, AlCrFe2Ni2 medium entropy alloy (MEA) was fabricated by L-PBF under varying cooling rate via changing process parameters. The phase transformation, microstructure and mechanical properties were experimentally investigated using X-ray diffraction (XRD), scanning transmission electron microscopy (TEM), scanning electron microscope (SEM) and electron backscatter diffraction (EBSD). The cooling rate was numerically calculated using a well-tested multi-physic thermal fluid model. The results showed that cooling rate had a significant effect on phase composition, microstructure and mechanical properties. The as-built MEA with lower cooling rate showed a nano-size structure composed of BCC and ordered B2 phases and a higher yield strength of 2055 MPa. While for the higher cooling rate, the as-built MEA showed a homogeneous structure consisted of single ordered B2 phase and a lower yield strength of 1544 MPa. The threshold value of cooling rate for phase transformation was between 4.9 × 106 K/s and 6.0 × 106 K/s. Through the strengthening mechanism analysis, it was crucial to achieve the nano-size dual-phase microstructure by manipulating cooling for obtaininng desirable mechanical properties in L-PBF AMed AlCrFe2Ni2 MEA.

IntroductionFerula is a traditional, edible, and important medicinal plant with high economic value. The distinction between edible and non-edible Ferula remains unclear.MethodsIn this study, headspace solid-phase microextraction coupled to gas chromatography-mass spectrometry (HS-SPME/GC-MS) and ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) non-targeted metabolomics techniques were used to systematically and comprehensively analyse secondary metabolites in the leaves and roots of four species of Ferula, considering their edibility.ResultsA total of 166 leaf volatile organic compounds (VOCs) and 1,079 root metabolites were identified. Additionally, 42 potential VOCs and 62 differential root metabolites were screened to distinguish between edible and non-edible Ferula. Twelve volatile metabolites were specific to F. feurlaeoides, and eight compounds were specific to the three edible Ferula species. The results showed that compounds containing sulphur, aldehydes, and ketones, which produce pungent odours, were the primary sources of the strong odour of Ferula. The root differential metabolites include 13 categories, among which the high concentration group is organic acids, amino acids, terpenoids and fatty acids. The bioactive metabolites and VOCs in the roots exhibited species-specific characteristics. VOCs with various odors were linked to the distribution of root metabolites in both edible and non-edible Ferula plants. The screened root markers may contribute to the formation of characteristic VOCs.DiscussionThis study identified the difference in flavour between edible and non-edible Ferula plants and, for the first time, demonstrated the contribution of the efficacy of Ferula root to the unique flavour of the above-ground parts of Ferula. These results provide a theoretical basis for selecting Ferula for consumption and help evaluate the quality of different species of Ferula. Our findings may facilitate food processing and the further development of Ferula.

Bidirectional communication between the gut microbiota and the brain has sparked interest in exploring the link between mobile phone addiction (MPA) and sleep disorders (SD) in microbiome research. However, investigating the role of gut microbiota in this relationship using animal models presents challenges due to the unique nature of MPA, and human research in this area is scarce. We recruited 99 healthy college students to evaluate the gut microbiome using 16S rRNA gene amplicon sequencing and assess MPA and SD at baseline and after a two-month follow-up. Multiple covariate-adjusted statistical models, including linear regression, permutational multivariate analysis of variance and so on, were employed to determine microbiome associations with MPA at baseline and changes in SD at follow-up. Our findings revealed negative associations between MPA and three alpha diversity metrics, along with alterations in bacterial composition. MPA showed negative associations with the relative abundance of Bacteroidetes, while displaying positive associations with Actinobacteria and Bifidobacteriales. Conversely, Actinobacteria exhibited a negative association with increased SD. This study has established a significant link between MPA and a decrease in the alpha diversity of the gut microbiota. Actinobacteria was associated with MPA and SD, respectively. Additional investigation is needed to fully comprehend the relationship between comorbid behavioral disorders and the gut microbiota.

17β-Estradiol (E2) is a common environmental endocrine and excessive estrogen will disturb the endocrine balance of human body and lead to diseases because of its accumulation in human body. The main aim of this study is to determine the trace amount of E2 in various foods. Based on aptamer specific recognition, DNA walker molecular machine and Exonuclease III-assisted dual cycle signal amplification technology, a fluorescent aptamer sensor was constructed and applied to the detection of 17β-estradiol. Atomic force microscopy (AFM) and polyacrylamide gel electrophoresis (PAGE) were used to verify the feasibility of DNA walker participating in the reaction. Under the optimal conditions, 17β-estradiol concentration showed a good linear relationship with fluorescence in the range of 5.0 × 10−10–1.8 × 10−8 M, and the detection limit was 5.6 × 10−11 M. The fluorescent aptamer sensor established in this study has good selectivity, simple operation and good specificity, and the results of its application in the determination of milk samples are satisfactory. Research findings revealed that the E2 concentration in water and milk is less than the safe limits, indicating the foods in the market are safe and can be consumed. Though the foods are safe in present content, the health risk still exists because of continuous intake of trace E2.

All around the world, salt stress has severely restricted plant development. Cotton is one of the most important cash crops, but the saline soil negatively influences the quality and output of plants. Strigolactones (SLs) is a new type of phytohormone that plays an important role in the development of plants. However, the underlying mechanism of how SLs alleviate the high salinity stress is unclear in cotton. In this research, we observed that exogenous 10 μΜ GR24 (a synthetic analog of SLs) significantly alleviated the salt stress (200 mM NaCl) in the hydroponically planted seedlings. Under salt stress, the contents of proline, O2− malondialdehyde, and hydrogen peroxide were greatly decreased by 48.40%, 45.57%, 31.03%, and 35.52%. Combined with transcriptome analysis and corresponding verification, it was figured out that with the application of exogenous GR24, the genes encoding antioxidant enzymes, chlorophyll biosynthesis, and photosynthesis system were significantly up-regulated, while the activities of antioxidant enzymes, the content of chlorophyll, and the efficiency of photosynthesis were also significantly improved under salt stress in cotton seedlings. Thus, the exogenous application of SLs could enhance the salt tolerance of cotton seedlings, which displayed its great potential for cotton production in salinized land.

AbstractBackground Although current guidelines didn’t support the routine use of furosemide in oliguric acute kidney injury (AKI) management, some patients may benefit from furosemide administration at an early stage. We aimed to develop an explainable machine learning (ML) model to differentiate between furosemide-responsive (FR) and furosemide-unresponsive (FU) oliguric AKI.Methods From Medical Information Mart for Intensive Care-IV (MIMIC-IV) and eICU Collaborative Research Database (eICU-CRD), oliguric AKI patients with urine output (UO) < 0.5 ml/kg/h for the first 6 h after ICU admission and furosemide infusion ≥ 40 mg in the following 6 h were retrospectively selected. The MIMIC-IV cohort was used in training a XGBoost model to predict UO > 0.65 ml/kg/h during 6–24 h succeeding the initial 6 h for assessing oliguria, and it was validated in the eICU-CRD cohort. We compared the predictive performance of the XGBoost model with the traditional logistic regression and other ML models.Results 6897 patients were included in the MIMIC-IV training cohort, with 2235 patients in the eICU-CRD validation cohort. The XGBoost model showed an AUC of 0.97 (95% CI: 0.96–0.98) for differentiating FR and FU oliguric AKI. It outperformed the logistic regression and other ML models in correctly predicting furosemide diuretic response, achieved 92.43% sensitivity (95% CI: 90.88–93.73%) and 95.12% specificity (95% CI: 93.51–96.3%).Conclusion A boosted ensemble algorithm can be used to accurately differentiate between patients who would and would not respond to furosemide in oliguric AKI. By making the model explainable, clinicians would be able to better understand the reasoning behind the prediction outcome and make individualized treatment.

Abstract Background Maternal systemic lupus erythematosus (SLE) is at greater risk of pregnancy complications and is associated with increased risk of preterm delivery. However hardly any study has looked at the influence of SLE on the outcomes of preterm infants. This study aimed to explore the influence of SLE on the outcomes of preterm infants. Methods In this retrospective cohort study, preterm infants born to mothers with SLE from Shanghai Children’s Medical Center during 2012 to 2021 were enrolled. Infants were excluded if they were died during hospitalization or has major congenital anomalies and neonatal lupus. Exposure was defined as mother diagnosed SLE before or during pregnancy. Maternal SLE group was matched with Non-SLE group by gestational age, birth weight and gender. Clinical data has been extracted from patients’ records and registered. Major morbidities of premature and biochemical parameters in the two groups were compared using multiple logistic regression. Results One hundred preterm infants born to 95 mothers with SLE were finally enrolled. The mean (standard deviation) of gestational age and birth weight were 33.09 (7.28) weeks and 1768.50 (423.56) g respectively. There was no significant difference in major morbidities between SLE group and non-SLE group. Compared with non-SLE group, SLE off-spring had significantly lower leukocytes, neutrophiles after birth, neutrophils and platlet in one week (mean difference: -2.825, -2.001, -0.842, -45.469, respectively). Among SLE group, lower birth weight and smaller gestational age were observed in SLE mothers with disease active during pregnancy, kidney involved, blood system involved and not taking Aspirin during pregnancy. In the multivariable logistic regression analysis, exposure to aspirin during pregnancy reduced the risk of very preterm birth and increased the incidence of survive without major morbidities among preterm infants born to SLE mothers. Conclusion Born to mothers with SLE may not increase the risk of major premature morbidities, but the hematologic profile of SLE preterm infants may be different from preterm infants born to women without SLE. The outcome of SLE preterm infants is associated with maternal SLE status and may benefit from maternal aspirin administration.

Rodents, such as those that feed on plants and nest in plant roots, can significantly affect the growth and development of desert plants. The aim of this study was to investigate the effects of Rhombomys opimus disturbance on the photosynthetic characteristics and nutrient status of Haloxylon ammodendron at different growth stages in the Gurbantunggut Desert. The effects of great gerbil disturbance on the photosynthetic characteristics of H. ammodendron at different growth stages were investigated by measuring the gas exchange parameters, instantaneous water use efficiency, and chlorophyll fluorescence parameters of H. ammodendron at different ages (young, middle, and adult) under the disturbance of great gerbils. The soil nutrients in the assimilated branches and rhizosphere of H. ammodendron at different growth stages were tracked to reveal the relationship between the H. ammodendron nutrient content and gerbil disturbance. The results showed that great gerbil disturbance decreased the organic carbon content in the rhizosphere soil of adult H. ammodendron and increased the total nitrogen content in the rhizosphere soil and the nitrogen and potassium contents in the assimilated branches at each growth stage. The net photosynthetic rate and instantaneous water use efficiency of H. ammodendron decreased at each growth stage, and the maximum photochemical efficiency and non-photochemical quenching parameters of the young H. ammodendron decreased. However, the actual photochemical efficiency and photochemical parameters of the middle H. ammodendron increased. It was concluded that the disturbance of great gerbils decreased the photosynthetic capacity of H. ammodendron and increased the content of total nitrogen in the soil and nitrogen and potassium in the plant. This study revealed that the Gurbantunggut Desert great gerbil and H. ammodendron do not have a simple predation relationship. It laid a foundation for the study of the moderate disturbance threshold and better use of the mutually beneficial relationship between the two.

Soil salinization poses a threat to the sustainability of agricultural production and has become a global issue. Cotton is an important cash crop and plays an important role in economic development. Salt stress has been harming the yield and quality of many crops, including cotton, for many years. In recent years, soil salinization has been increasing. It is crucial to study the mechanism of cotton salt tolerance and explore diversified materials and methods to alleviate the salt stress of cotton for the development of the cotton industry. Nanoparticles (NPs) are an effective means to alleviate salt stress. In this study, zinc oxide NPs (ZnO NPs) were sprayed on cotton leaves with the aim of investigating the intrinsic mechanism of NPs to alleviate salt stress in cotton. The results show that the foliar spraying of ZnO NPs significantly alleviated the negative effects of salt stress on hydroponic cotton seedlings, including the improvement of above-ground and root dry and fresh weight, leaf area, seedling height, and stem diameter. In addition, ZnO NPs can significantly improve the salt-induced oxidative stress by reducing the levels of MDA, H2O2, and O2− and increasing the activities of major antioxidant enzymes, such as superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT). Furthermore, RNA-seq showed that the foliar spraying of ZnO NPs could induce the expressions of CNGC, NHX2, AHA3, HAK17, and other genes, and reduce the expression of SKOR, combined with the CBL-CIPK pathway, which alleviated the toxic effect of excessive Na+ and reduced the loss of excessive K+ so that the Na+/K+ ratio was stabilized. In summary, our results indicate that the foliar application of ZnO NPs can alleviate high salt stress in cotton by adjusting the Na+/K+ ratio and regulating antioxidative ability. This provides a new strategy for alleviating the salt stress of cotton and other crops, which is conducive to the development of agriculture.

Abstract Pathogenic CD8+ T cells are pivotal contributors to the onset of systemic lupus erythematosus (SLE). Erucic acid (EA) has been proven to have anti‐inflammatory activity. However, the capacity of EA to regulate pathogenic CD8+ T cells in the context of pregnancy complicated with SLE (pSLE) remains unclear. In our investigation, we observed augmented CD8+ T cell effector function juxtaposed with diminished EA levels in pSLE patients relative to healthy pregnant controls. Significantly, plasma EA levels exhibited a negative correlation with the severity of pSLE‐associated complications. In blood from patients with pSLE, EA inhibited the effector function of CD8+ T cells, concurrently dampening the maintenance of stem cell‐like memory CD8+ T cells. Mechanistically, EA orchestrated the inhibition of CD8+ T cell effector function by impeding signal transducer and activator of transcription 3 phosphorylation and promoting ferroptosis. Moreover, EA supplementation in pregnant MRL/lpr mice manifested as the attenuation of uterine CD8+ T cell effector function, culminating in the mitigation of placental pathological damage. Our findings uncover the immune response modulatory effects of EA upon pathogenic CD8+ cells, thereby unveiling new perspectives for therapeutic strategies targeting pSLE patients.

The Al–Si coatings are commonly used for hot-press-forming (HPF) steel to prevent oxidation in the automobile industry. However, due to the presence of Al–Si coating, undesirable intermetallic compounds are easily formed in the welds of HPF steel. In this work, an environment-friendly and effective nanosecond pulsed laser cleaning process was used to remove the Al–Si coating, and HPF steel with varying thicknesses of coatings was prepared for laser welding. The microstructure and mechanical properties of laser welded HPF steel with different thicknesses of coatings were further investigated. The results showed that there was a threshold of power to remove the Al–Si coatings in the laser cleaning process. The reduced thickness of coatings not only could improve the stability of the welding process due to the diminishing of metal vapor generated by coating ablation, but also decrease the content of the Fe–Al phase in the welded joint, which is detrimental to weld performance. The tensile strength and cupping test pass rate of weld joints gradually increased with the decreasing thickness of coatings to 5 μm. After that, the Al–Si coating almost had no effect on the mechanical properties of the laser weld joints. The laser weld joint with 5 μm-thick of Al–Si coating showed, a tensile strength of 1435.05 MPa, a microhardness of 488.38 HV and a pass rate of 100% for the cupping test.

A catastrophic earthquake (magnitude Mw 7.2) occurred on 14 August 2021 in Haiti. Sea surface temperature (SST) and sea potential temperature (SPT) observed from satellites show pronounced changes prior to the main earthquake event. The changes are observed near the epicenter and the boundary of the Caribbean Plate. Here we have carried out a detailed analysis of ocean, atmosphere and land surface parameters (sea water salinity, chlorophyll-a, latent energy flux, sensible heat flux, specific humidity, air temperature, methane and land surface temperature) using multiple satellite data to understand the possible mechanism of sea temperature changes. The strong coupling among these geophysical and geochemical parameters has been found within 2-week prior to the 2021 Haiti Mw 7.2 earthquake due to the interaction between ocean/land and atmosphere during the last phase of earthquake preparation period caused by the tectonic movement. The spatiotemporal distribution pattern of anomalies is discussed in view of the focal mechanism of the earthquake event.

Abstract As a high-temperature thermoelectric (TE) material, ZnO offers advantages of non-toxicity, chemical stability, and oxidation resistance, and shows considerable promise as a true ready-to-use module under air conditions. However, poor electrical conductivity and high thermal conductivity severely hinder its application. Carbon nanotubes (CNTs) are often used as a reinforcing phase in composites, but it is difficult to achieve uniform dispersion of CNTs due to van der Waals forces. Herein, we developed an effective in-situ growth strategy of homogeneous CNTs on ZnO nanoparticles by exploiting the chemical vapor deposition (CVD) technology, in order to improve their electrical conductivity and mechanical properties, as well as reducing the thermal conductivity. Meanwhile, magnetic nickel (Ni) nanoparticles are introduced as catalysts for promoting the formation of CNTs, which can also enhance the electrical and thermal transportation of ZnO matrices. Notably, the electrical conductivity of ZnO is significantly boosted from 26 to 79 S·cm−1 due to the formation of dense and uniform conductive CNT networks. The lattice thermal conductivity (κ L) is obviously declined by the intensification of phonon scattering, resulting from the abundant grain boundaries and interfaces in ZnO-CNT composites. Importantly, the maximum dimensionless figure of merit (zT) of 0.04 at 800 K is obtained in 2.0% Ni-CNTs/ZnO, which is three times larger than that of CNTs/ZnO prepared by traditional ultrasonic method. In addition, the mechanical properties of composites including Vickers hardness (HV) and fracture toughness (K IC) are also reinforced. This work provides a valuable reference for dispersing nano-phases in TE materials to enhance both TE and mechanical properties.

Wire-based additive manufacturing (AM) shows a promising prospect in fabricating large-scale titanium aerospace components at a high deposition rate and low cost. The currently used wire-based AM processes commonly utilize a lateral feeding method with an acute angle to form a deposit, which reduces the flexibility and increases the difficulty of control in making complex components. In this work, a novel coaxial laser metal wire deposition (LMWD) process was used to fabricate the most widely used titanium alloy, Ti6Al4V. The coaxial wire feeding was achieved by a coaxial laser head through a vertically fed wire surrounded by an annular shape beam at focal plane. The surface quality, microstructure and mechanical properties of the deposited Ti6Al4V were examined. To show the characteristic of the coaxial LMWD process, conventional lateral LMWD was also conducted for comparison. The deposited Ti6Al4V wall showed a high surface quality and a microstructure with a mix of equiaxed β grains and columnar prior-β grains rather than coarse prior-β grains. The refined microstructure resulted in a low anisotropy in mechanical properties. The mechanism of the equiaxed β grains formation was also discussed. The combined effect of the reduced thermal gradient and the heterogeneous nucleation from the coaxial wire feeding played an important role in determining the refined microstructures in coaxial LMWD.

Myocardial fibrosis, a common pathophysiological consequence of various cardiovascular diseases, is characterized by fibroblast activation and excessive deposition of extracellular matrix (ECM) collagen. Accumulating evidence indicates that myocardial fibrosis contributes to ventricular stiffness, systolic and diastolic dysfunction, and ultimately leads to the development of heart failure (HF). Early detection and targeted treatment of myocardial fibrosis is critical to reverse ventricular remodeling and improve clinical outcomes in patients with cardiovascular diseases. However, despite considerable progresses made in understanding molecular mechanisms of myocardial fibrosis, non-invasive imaging to assess myocardial fibrosis and guide clinical treatment is still not widely available, limiting the development of innovative treatment strategies. This review summarizes recent progresses of imaging modalities for detecting myocardial fibrosis, with a focus on nuclear medicine, echocardiography and cardiac magnetic resonance (CMR).

Transition metal sulfides have excellent electrochemical performance and show great potential for improving the energy density of asymmetric supercapacitors. This study demonstrates a two-step synthesis technique and highlights the enhanced energy storage efficiency of ZnS-NiS2 composite materials for asymmetric supercapacitors. The composite materials of ZnS nanosheets and NiS2 nanocrystals are characterized by a rough surface and spherical shape. The sample with the optimal ratio (ZnS-NiS2-1:7) exhibits a maximum specific capacitance of 1467.9 F g−1 (550.5 C g−1) at 1 A g−1. The specific capacitance of the ZnS-NiS2-1:7 sample is 26.1% higher compared to the pure NiS2 sample. Furthermore, the assembled ZnS-NiS2-1:7//AC device shows a high specific capacitance of 127.8 F g−1 (217.3 C g−1) at 1 A g−1 and an energy density of 51.3 Wh kg−1 at a power density of 820.8 W kg−1. The ZnS-NiS2-1:7 sample has exceptional energy storage capability on its own, but it can also be composited with graphene to further increase the specific capacitance (1681.0 F g−1 at 1 A g−1), suggesting promising prospects for the ZnS-NiS2-based composite material in the future.

Abstract Background Sodium selenite (SSE) has been reported to exert anti-tumor effects in several cancer cells. However, the underlying mechanisms in renal cancer are yet to be elucidated. The effects of SSE on the proliferation, metastasis, and apoptosis of renal cancer cells, as well as its mechanism, were investigated in this study. Methods ACHN and 786-O renal cancer cells were treated with different concentrations of SSE, MTT, and colony formation assays were used to detect the proliferation ability of cells. The migration of cells was detected using scratch-wound-healing and transwell-migration assays. The effect of SSE on apoptosis was assessed by AnnexinV-FITC/PI double staining. Besides, Western blotting was employed to detect the protein-expression level and elucidate the underlying pathways. We also made subcutaneous xenografts in athymic mice to verify the effect of SSE on tumor growth in vivo. Results Our results demonstrated that treatment with SSE resulted in significant inhibition of cell proliferation and migration. Flow cytometry and Western blot confirmed that SSE induced apoptosis via the endogenous apoptotic pathway. We also confirmed that SSE treatment causes an increase in intracellular reactive oxygen species (ROS) levels, resulting in the inhibition of nuclear transcription factor-κB (NF-κB) signaling. Modulation of the ROS level by the chemical inhibitor N-acetyl-cysteine reversed the effect of SSE on cells. Similarly, subcutaneous xenografts in athymic mice models showed that SSE inhibits tumor growth in vivo. Conclusion These results indicate that SSE inhibits proliferation and migration and induces apoptosis via ROS mediated inhibition of NF-κB signaling in renal cancer cells.

Abstract Machine learning algorithms are a natural fit for printing fully dense superior metallic parts since 3D printing embodies digital technology like no other manufacturing process. Since traditional machine learning needs a large volume of reliable historical data to optimize many printing variables, the algorithm is augmented with human intelligence derived from the rich knowledge base of metallurgy and physics-based models. The augmentation improves the computational efficiency and makes the problem tractable by enabling the algorithm to use a small set of data. We provide a verifiable quantitative index for achieving fully dense superior parts, facilitate material selection, uncover the hierarchy of important variables that affect the density, and present easy-to-use visual process maps. These findings can improve the quality consistency of 3D printed parts that now limit their greater industrial adaptation. The approach used here can be applied to solve other problems of 3D printing and beyond.

Abstract Background Understanding the trends and causes to the burden of maternal deaths is a key requirement to further reduce the maternal mortality ratio (MMR), and devise targeted intervention policy. We aimed to evaluate the spatiotemporal trends of MMRs and cause patterns across the 34 provinces of China during 1990–2017. Methods Using data from the Global Burden of Disease Study 2017, we calculated the levels and trends of total maternal deaths and MMR due to ten different causes through Bayesian multivariable regression model for pregnancies aged 10–54 years, and assessed the age and regional distribution over time. Results China has experienced fast decline in MMR, dropped from 95.2 (87.8–102.3) in 1990 to 13.6 (12.5–15.0) in 2017, with an annualised rate of decline of 7.0%. In 1990, the range of MMRs in mainland China was 31.1 in Shanghai, to 323.4 in Tibet. Almost all provinces showed remarkable decline in the last two decades. However, spatial heterogeneity in levels and trends still existed. The annualised rate of decline across provinces from 1990 to 2017 ranged from 0.54% to 10.14%. Decline accelerated between 2005 and 2017 compared with between 1990 and 2005. In 2017, the lowest MMR was 4.2 in Zhejiang; the highest was still in Tibet, but had fallen to 82.7, dropped by 74.4%. MMR was highest in the 40–49 years age group in both 1990 and 2017. In 2017, haemorrhage and hypertensive disorders were the leading two specific causes for maternal deaths. Conclusions MMRs have declined rapidly and universally across the provinces of China. Setting of associated interventions in the future will need careful consideration of provinces that still have MMR significantly higher than the national mean level.

Abstract To investigate the effect of initial dynamic eccentricity on the rotor winding turn‐to‐turn short circuit (RWISC) in a large synchronous condenser, this paper uses the study object of a 300 MVar dual water intercooler condenser. Firstly, the air gap flux density characteristics, unbalanced magnetic pull (UMP) and stator circulating current of the condenser under single and compound faults are derived theoretically. Then, a phase‐modulated field‐circuit coupling model is constructed using Anosoft software. It is used to simulate and analyse the condenser. Finally, the operation of the condenser was simulated with the SDF‐9 experimental setup, and the correctness of the theoretical derivation and simulation analysis was verified. The results show that the initial dynamic eccentricity of the condenser has a cutting effect on the fault characteristics generated by the RWISC. The 2nd harmonic of air gap flux density and stator circulating current and the fundamental wave of UMP decrease and increase with eccentricity. This study can provide theoretical guidance to eliminate disturbing factors to improve the accuracy of RWISC diagnosis in large synchronous condensers.

Lead (Pb), cadmium (Cd) and total mercury (THg) are toxic heavy metals (THMs) that are widely present in the environment and can cause substantial health problems. However, previous risk assessment studies have rarely focused on the elderly population and have usually targeted a single heavy metal, which might underestimate the long-term accumulative and synergistic effects of THMs in humans. Based on the food frequency questionnaire and inductively coupled plasma mass spectrometry, this study assessed external and internal exposures to Pb, Cd and THg in 1747 elderly people in Shanghai. Probabilistic risk assessment with the relative potential factor (RPF) model was used to assess the neurotoxicity and nephrotoxicity risks of combined THMs exposures. The mean external exposures of Pb, Cd and THg in Shanghai elderly were 46.8, 27.2 and 4.9 μg/day, respectively. Plant-based foods are the main source of Pb and THg exposure, while Cd is mainly from animal-based foods. The mean concentrations of Pb, Cd and THg were 23.3, 1.1 and 2.3 μg/L in the whole blood, and 6.2, 1.0 and 2.0 μg/L in the morning urine, respectively. Combined exposure to THMs leading to 10.0 % and 7.1 % of Shanghai elderly at risk of neurotoxicity and nephrotoxicity. The results of this study have important implications for understanding the profiles of Pb, Cd and THg exposure in the elderly living in Shanghai and provide data support for risk assessment and control of nephrotoxicity and neurotoxicity from combined THMs exposure in the elderly.

Abstract Introduction and objectives The aging population is expected to reach 2 billion by 2050, but the impact of somatic symptom disorder (SSD) on the elderly has been insufficiently addressed. We aimed to clarify the prevalence of SSD in China and to identify physical and psychological differences between the elderly and non-elderly. Methods In this prospective multi-center study, 9020 participants aged (2206 non-elderly adults and 6814 elderly adults) from 105 communities of Shanghai were included (Assessment of Somatic Symptom in Chinese Community-Dwelling People, clinical trial number NCT04815863, registered on 06/12/2020). The Somatic Symptom Scale-China (SSS-CN) questionnaire was used to measure SSD. Depressive and anxiety disorders were assessed by the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Results The prevalence of SSD in the elderly was higher than that in the non-elderly (63.2% vs. 45.3%). The elderly suffered more severe SSD (20.4% moderate and severe in elderly vs. 12.0% in non-elderly) and are 1.560 times more likely to have the disorder (95%CI: 1.399–1.739; p

The study of drug side effects is a significant task in drug discovery. Candidate drugs with unaccepted side effects must be eliminated to prevent risks for both patients and pharmaceutical companies. Thus, all side effects for any candidate drug should be determined. However, this task, which is carried out through traditional experiments, is time-consuming and expensive. Building computational methods has been increasingly used for the identification of drug side effects. In the present study, a new path-based method was proposed to determine drug side effects. A heterogeneous network was built to perform such method, which defined drugs and side effects as nodes. For any drug and side effect, the proposed path-based method determined all paths with limited length that connects them and further evaluated the association between them based on these paths. The strong association indicates that the drug has a side effect with a high probability. By using two types of jackknife test, the method yielded good performance and was superior to some other network-based methods. Furthermore, the effects of one parameter in the method and heterogeneous network was analyzed.

Hydrogen leakage and explosion accidents have obvious dangers, ambiguity of accident information, and urgency of decision-making time. These characteristics bring challenges to the optimization of emergency alternatives for such accidents. Effective emergency decision making is crucial to mitigating the consequences of accidents and minimizing losses and can provide a vital reference for emergency management in the field of hydrogen energy. An improved VIKOR emergency alternatives optimization method is proposed based on the combination of hesitant triangular fuzzy set (HTFS) and the cumulative prospect theory (CPT), termed the HTFS-CPT-VIKOR method. This method adopts the hesitant triangular fuzzy number to represent the decision information on the alternatives under the influence of multi-attributes, constructs alternatives evaluation indicators, and solves the indicator weights by using the deviation method. Based on CPT, positive and negative ideal points were used as reference points to construct the prospect matrix, which then utilized the VIKOR method to optimize the emergency alternatives for hydrogen leakage and explosion accidents. Taking an accident at a hydrogen refueling station as an example, the effectiveness and rationality of the HTFS-CPT-VIKOR method were verified by comparing with the existing three methods and conducting parameter sensitivity analysis. Research results show that the HTFS-CPT-VIKOR method effectively captures the limited psychological behavior characteristics of decision makers and enhances their ability to identify, filter, and judge ambiguous information, making the decision-making alternatives more in line with the actual environment, which provided strong support for the optimization of emergency alternatives for hydrogen leakage and explosion accidents.

Gas protection is a crucial part of quality control in laser welding, especially for titanium alloy, which oxidizes easily at high temperatures. Substantial experiments concerning shielding gas characteristics in the welding process have been implemented. However, the common analysis conducted is simplistic and lacks a theoretical basis. This paper presented an investigation of the shielding gas behaviors based on numerical simulation and a titanium alloy laser welding experiment. The numerical model was established and validated by experiment. Subsequently, the temperature field and gas flow fields were calculated. By combining the two fields, the threshold temperature of gas protection was determined, and the influence of shielding gas parameters on the protection effect was examined. The results revealed that the protection of the high-temperature zone was primarily influenced by the nozzle height, nozzle inner diameter, and nozzle angle, while the plasma suppression effect was mainly correlated with the nozzle inner diameter and gas flow rate. These initial findings provide scientific guidance for the better quality production of laser beam welded components made of not only titanium alloy but also other metallic materials.

The 6D pose estimation using RGBD images plays a pivotal role in robotics applications. At present, after obtaining the RGB and depth modality information, most methods directly concatenate them without considering information interactions. This leads to the low accuracy of 6D pose estimation in occlusion and illumination changes. To solve this problem, we propose a new method to fuse RGB and depth modality features. Our method effectively uses individual information contained within each RGBD image modality and fully integrates cross-modality interactive information. Specifically, we transform depth images into point clouds, applying the PointNet++ network to extract point cloud features; RGB image features are extracted by CNNs and attention mechanisms are added to obtain context information within the single modality; then, we propose a cross-modality feature fusion module (CFFM) to obtain the cross-modality information, and introduce a feature contribution weight training module (CWTM) to allocate the different contributions of the two modalities to the target task. Finally, the result of 6D object pose estimation is obtained by the final cross-modality fusion feature. By enabling information interactions within and between modalities, the integration of the two modalities is maximized. Furthermore, considering the contribution of each modality enhances the overall robustness of the model. Our experiments indicate that the accuracy rate of our method on the LineMOD dataset can reach 96.9%, on average, using the ADD (-S) metric, while on the YCB-Video dataset, it can reach 94.7% using the ADD-S AUC metric and 96.5% using the ADD-S score (

The interaction between lake water and groundwater is of great significance to the rational development and utilization of water resources. In this paper, based on temperature tracer principle, two methods including of the analytical method and numerical simulation method are used to comprehensively study the interaction between lake water and groundwater with a buried depth of 0-0.4 meters at the lake bed in the beach of Maowusu Lake Basin. In addition, compared with the result by hydrodynamic method. The results show that from May 20 to 28, 2018, the vertical seepage velocity between lake water and groundwater is 2×10-7-1×10-6 m/s, and the seepage velocity at the buried depth is 0.4 m is greater than that at the buried depth of 0.2 m. Precipitation have a certain impact on the results of analytic method, and there is a certain lag in the seepage velocity at the buried depth of 0.4 m. Without less rainfall interference, the results of numerical method and hydrodynamic method are of good agreement, furthermore the results of the three methods are in the same order of magnitude. At the same time, the volume heat capacity and porosity of lake bed sediments have great influence on the results. In the study of interaction between lake water and groundwater in semi-arid areas, numerical simulation is much better choice when the monitoring data are collected completely.

Background and aimCardiotoxicity has become the most common cause of non-cancer death among breast cancer patients. Pyrotinib, a tyrosine kinase inhibitor targeting HER2, has been successfully used to treat breast cancer patients but has also resulted in less well-understood cardiotoxicity. This prospective, controlled, open-label, observational trial was designed to characterize pyrotinib’s cardiac impacts in the neoadjuvant setting for patients with HER2-positive early or locally advanced breast cancer.Patients and methodsThe EARLY-MYO-BC study will prospectively enroll HER2-positive breast cancer patients who are scheduled to receive four cycles of neoadjuvant therapy with pyrotinib or pertuzumab added to trastuzumab before radical breast cancer surgery. Patients will undergo comprehensive cardiac assessment before and after neoadjuvant therapy, including laboratory measures, electrocardiography, transthoracic echocardiography, cardiopulmonary exercise testing (CPET), and cardiac magnetic resonance (CMR). To test the non-inferiority of pyrotinib plus trastuzumab therapy to pertuzumab plus trastuzumab therapy in terms of cardiac safety, the primary endpoint will be assessed by the relative change in global longitudinal strain from baseline to completion of neoadjuvant therapy by echocardiography. The secondary endpoints include myocardial diffuse fibrosis (by T1-derived extracellular volume), myocardial edema (by T2 mapping), cardiac volumetric assessment by CMR, diastolic function (by left ventricular volume, left atrial volume, E/A, and E/E’) by echocardiography, and exercise capacity by CPET.DiscussionThis study will comprehensively assess the impacts of pyrotinib on myocardial structural, function, and tissue characteristics, and, furthermore, will determine whether pyrotinib plus trastuzumab is a reasonable dual HER2 blockade regimen with regard to cardiac safety. Results may provide information in selecting an appropriate anti-HER2 treatment for HER2-positive breast cancer.Clinical trial registrationhttps://clinicaltrials.gov/, identifier NCT04510532