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Zhiwei Sun,1,* Xiangru Chen,1,* Fang Miao,2,* Na Meng,3 Keqiang Hu,1 Shaotang Xiong,4 Ximing Peng,1 Liya Ma,5 Chuchao Zhou,1 Yanqing Yang1 1Department of Plastic Surgery, Tongren Hospital of Wuhan University (Wuhan Third Hospital), Wuhan, 430060, People’s Republic of China; 2Department of Dermatology, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China; 3Department of Cardiovascular Medicine, Tongren Hospital of Wuhan University (Wuhan Third Hospital), Wuhan, 430060, People’s Republic of China; 4The Second People’s Hospital of China Three Gorges University·the Second People’s Hospital of Yichang, Hubei, People’s Republic of China; 5The Centre of Analysis and Measurement of Wuhan University, Wuhan University, Wuhan, 430072, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yanqing Yang; Chuchao Zhou, Email yangyq0106@163.com; chuchaozhou@163.comIntroduction: Graphene oxide (GO) nanoparticles have emerged as a compelling photothermal agent (PHTA) in the realm of photothermal antibacterial therapy, owing to their cost-effectiveness, facile synthesis, and remarkable photostability. Nevertheless, the therapeutic efficacy of GO nanoparticles is commonly hindered by their inherent drawback of low photothermal conversion efficiency (PCE).Methods: Herein, we engineer the Ag/GO-GelMA platform by growing the Ag on the surface of GO and encapsulating the Ag/GO nanoparticles into the GelMA hydrogels.Results: The resulting Ag/GO-GelMA platform demonstrates a significantly enhanced PCE (47.6%), surpassing that of pure GO (11.8%) by more than fourfold. As expected, the Ag/GO-GelMA platform, which was designed to integrate the benefits of Ag/GO nanoparticles (high PCE) and hydrogel (slowly releasing Ag+ to exert an inherent antibacterial effect), has been shown to exhibit exceptional antibacterial efficacy. Furthermore, transcriptome analyses demonstrated that the Ag/GO-GelMA platform could significantly down-regulate pathways linked to inflammation (the MAPK and PI3K-Akt pathways) and had the ability to promote cell migration.Discussion: Taken together, this study presents the design of a potent photothermal antibacterial platform (Ag/GO-GelMA) aimed at enhancing the healing of infectious wounds. The platform utilizes a handy method to enhance the PCE of GO, thereby making notable progress in the utilization of GO nano-PHTAs. Keywords: Ag/GO nanoparticles, photothermal therapy, photothermal conversion efficiency, hydrogel, infectious wound healing

Ni Meng, Xiaolong Cheng, Mengyao Sun, Yushan Zhang, Xueke Sun, Xifu Liu, Jing Chen Ministry of Education Key Laboratory of Molecular and Cellular Biology; Hebei Anti-Tumor Molecular Target Technology Innovation Center; Hebei Research Center of the Basic Discipline of Cell Biology; College of Life Science, Hebei Normal University, Shijiazhuang, 050024, People’s Republic of ChinaCorrespondence: Jing Chen; Xifu Liu, Email jingchen@hebtu.edu.cn; xfliu@hebtu.edu.cnIntroduction: The monkeypox (Mpox) virus epidemic presents a significant risk to global public health security. A35R, a crucial constituent of EEV, plays a pivotal role in virus transmission, serves as a vital target for vaccine development, and has potential for serological detection. Currently, there is a dearth of research on nanobodies targeting A35R. The purpose of this study is to identify specific nanobodies target A35R, so as to provide new antibody candidates for Mpox vaccine development and diagnostic kit development.Methods: Three nanobodies specific to the monkeypox virus protein A35R were screened from a naïve phage display library. After four rounds of panning, positive phage clones were identified by enzyme-linked immunosorbent assay (ELISA). Further, the nanobody fusion protein was constructed in pNFCG1-IgG1-Fc vector and expressed in HEK293F cells and purified by affinity chromatography. The specificity and affinity of the nanobodies were identified by ELISA. The binding kinetics of the VHH antibody to A35R were assessed via employment of a bio-layer interferometry (BLI) apparatus, thereby determining the nanobodies affinity.Results: The three purified nanobodies showed specific high-affinity binding MPXV A35R, of them, VHH-1 had the best antigen binding affinity (EC50 = 0.010 ug/mL). In addition, VHH-1 on Protein A biosensor can bind Mpox virus A35R, with an affinity constant of 54 nM as determined in BLI assay.Conclusion: In sum, we has obtained three nanobody strains against Mpox virus A35R with significant affinity and specificity, therefore laying an essential foundation for further research as well as the applications of diagnostic and therapeutic tools of Mpox virus.Keywords: monkeypox virus, A35R, nanobody, phage display library

Lin Sun,1,2,* Nan Meng,1,* Zecheng Wang,1 Jiaxin Hong,1 Yuqi Dai,1 Zhenyu Wang,1 Jing Wang,1,2 Xinan Jiao1,2 1Jiangsu Key Laboratory of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, People’s Republic of China; 2Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agrifood Safety and Quality, Ministry of Agriculture of China, Yangzhou University, Yangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jing Wang; Xinan Jiao, Email wj1231@yzu.edu.cn; jiao@yzu.edu.cnPurpose: Limited data are available on the prevalence and antimicrobial resistance of extended spectrum β-lactamase- (ESBL) and AmpC β-lactamase-producing Escherichia coli in stray dogs. We aimed to investigate the genomic characteristics of ESBL/AmpC-producing E. coli isolated from stray dogs sheltered in Yangzhou, China.Methods: We collected 156 samples including 115 fecal swabs, 35 kennel floor swabs, two breeder hand and shoe sole swabs, and four feed samples. The isolates were tested for resistance by antimicrobial susceptibility testing and further analyzed for cefotaxime-resistant E. coli isolates by whole genome sequencing.Results: We identified 80 cefotaxime-resistant E. coli isolates (51.3%), 59 isolates (73.8%) from feces and 21 (26.2%) from the environment. Whole-genome sequencing analysis showed that blaCTX-M-15 (n=30) and blaCTX-M-55 (n=29) were the most prevalent genotypes. Two isolates only carried the AmpC β-lactamase gene blaCMY-2; one isolate had a combination of AmpC β-lactamase gene blaDHA-1 and ESBL β-lactamase gene blaCTX-M-14. Other important resistance genes such as blaOXA-10, blaTEM-1B, blaTEM-135, blaTEM-106, tet(A), qnrS1, qnrB4, and oqxAB were also detected. The serotype combination was highly abundant, with O10:H25 predominating (n=12). Most cefotaxime-resistant E. coli isolates belonged to phylogroup A (62.5%, n=50), followed by phylogroup B1 (26.3%, n=21). Thirty different sequence types (STs) and 27 distinct plasmid replicons were identified, among which ST2325 (n=12) and IncFII (n=38) was the most frequent ST and plasmid, respectively. ESBL/AmpC-producing isolates were divided into four major clades; clade IV was the primary lineage containing 37 isolates from feces and 13 from the environment. Three high-risk E. coli clone ST23 strains and one ST10 strain belonged to clades III and IV, respectively.Conclusion: Our study provides a comprehensive overview of resistance profiles and genomic characteristics in ESBL/AmpC-producing E. coli and highlights the possible role of stray dogs as an antibiotic resistance gene reservoir.Keywords: Escherichia coli, ESBL/AmpC, stray dogs, antimicrobial resistance, whole genome sequencing

Lin Sun,1,2,* Guiling Li,3,4,* Nan Meng,1 Zhenyu Wang,1 Hanyun Wang,1 Jing Wang,1,2 Xinan Jiao1,2 1Jiangsu Key Laboratory of Zoonosis/Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, Jiangsu, People’s Republic of China; 2Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agrifood Safety and Quality, Ministry of Agriculture of China, Yangzhou University, Yangzhou, Jiangsu, People’s Republic of China; 3Department of Laboratory Medicine, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, People’s Republic of China; 4Clinical Testing Center, Northern Jiangsu People’s Hospital, Yangzhou, Jiangsu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jing Wang; Xinan Jiao, Email wj1231@yzu.edu.cn; jiao@yzu.edu.cnAbstract: Klebsiella quasipneumoniae isolate SBH035 was recovered from a patient in Jiangsu Province, China. The isolate showed resistance to ampicillin, cefazolin, cefotaxime, meropenem, ceftazidime–avibactam, and fosfomycin. The carbapenemase-encoding gene blaNDM-7 was identified, and whole genome sequencing analysis indicated that blaNDM-7 was located in an IncX3 plasmid with a conserved structure of IS 26-ΔcutA-tat-trpF-bleMBL-blaNDM-7-ISAba125-IS 3000-ΔTn2. To date, this is the first identification of a blaNDM-7-harboring IncX3 plasmid in ST196 K. quasipneumoniae from a patient in China. Greater attention to controlling the dissemination of IncX3 plasmids is needed owing to potential horizontal transfer via mobile genetic elements.Keywords: Klebsiella quasipneumoniae, ST196, carbapenem resistance, blaNDM-7, IncX3 plasmid

Dingtao Hu,1,* Nana Meng,2,* Xiaoqi Lou,1 Zhen Li,3 Ying Teng,3 Bizhi Tu,4 Yanfeng Zou,3 Fang Wang1 1Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 2Department of Quality Management Office, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China; 3Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China; 4Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China*These authors contributed equally to this workCorrespondence: Fang WangDepartment of Oncology, The First Affiliated Hospital of Anhui Medical University, 218Jixi Road, Hefei, 230022, Anhui, People’s Republic of ChinaTel +86055162923615Fax +86055162923615Email wangfangahmu@163.comYanfeng ZouDepartment of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81, Meishan Road, Shushan District, Hefei, 230032, Anhui, People’s Republic of ChinaEmail zouyanfeng2015@163.comBackground: Numerous studies on the E2F transcription factors have led to increasing insights that E2Fs could be an important driver of the formation and progression of many human cancers. Little is known about the function of distinct E2Fs in chromophobe renal cell carcinoma (chRCC).Methods: We utilized the UALCAN, GEPIA, Cancer Genome Atlas (TCGA) database, cBioPortal, Metascape, STRING, Cytoscape, GeneMANIA, TIMER, TISIDB, GSCALite, and MEXPRESS databases to investigate the transcription level, genetic alteration, methylation, and biological function of E2Fs in chRCC patients, and its association with the occurrence, progress, prognosis, and immune cell infiltration in patients with chRCC.Results: We found that E2F1/2/4/7/8 were more expressed in chRCC tissues than in normal tissues, while the expression of E2F5/6 was lower in the former than in the latter, and the expression levels of E2F1/2/4/5/6//7/8 were also associated with the histological parameters of chRCC, including T-stage and N-stage. Higher expression of E2F1/2/7/8 was found to be significantly correlated with worse overall survival (OS) in chRCC patients. Cox regression and time-dependent ROC analysis further suggested that E2F1/2 could be the potential independent biomarkers for chRCC prognosis. Besides, a moderate mutation rate of E2Fs (34%) was noticed in chRCC, and the genetic mutations in E2Fs were associated with poor survival of chRCC patients. We noticed that the expression of E2Fs was statistically correlated with the immune cell infiltration in chRCC. Moreover, we also found that the expression of E2F1 was significantly correlated with tumor-infiltrating lymphocytes and immunomodulators, E2F7 expression was associated with MHC molecules, and the expression of E2F1/8 was correlated to their methylation levels.Conclusion: Our results provide novel insights for selecting the prognostic biomarkers for chRCC and suggest that E2F1/2 could act as potential prognostic biomarkers for the survival of chRCC patients. However, more in-depth experiments are required to identify the underlying mechanisms and verify the clinical value of E2F1/2 in the prognosis of chRCC.Keywords: chromophobe renal cell carcinoma, E2Fs, prognosis, UALCAN, GEPIA

Cen Wei,1,* Huaqing Wei,2,* Xun Wu,3 Guangyao Nong,1 Chenglin Wu,4 Jinli Lee,5 Ning Meng,3 Dahai Yu,6 Jiping Su,7 Mengzhu Guo,6 Jiangyuan Qin,8 Xuemin Fan3 1ENT & HN Surgery Department, Wuming Hospital of Guangxi Medical University, Nanning 530199, People’s Republic of China; 2Department of Cardiology, Wuming Hospital of Guangxi Medical University, Nanning 530199, People’s Republic of China; 3Department of Maxillofacial Surgery, Guangxi Medical University College of Stomatology, Nanning 530021, People’s Republic of China; 4Department of ENT, Sixth Affiliated Hospital of Guangxi Medical University, Nanning 537000, People’s Republic of China; 5Department of Gastroenterology, 923 Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army, Nanning 530021, People’s Republic of China; 6Department of Stomatology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, People’s Republic of China; 7ENT & HN Surgery Department, The First Affiliated Hospital of Guangxi Medical University, Nanning 530199, People’s Republic of China; 8Department of Otolaryngology, Guangxi General Hospital of Chinses People’s Armed Police Force, Nanning 530000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xun WuDepartment of Maxillofacial Surgery, Guangxi Medical University College of Stomatology, No. 10 Shuangyong Road, Nanning City, Guangxi Province 530021, People’s Republic of ChinaEmail kc4704@163.comGuangyao NongENT & HN Surgery Department, Wuming Hospital of Guangxi Medical University, No. 26 Yongning Road Wuming District, Nanning City, Guangxi Province 530199, People’s Republic of ChinaTel +86 771-6023602Fax +86 771-6213919Email lmqvqaymlhn43@163.comObjective: The functions of lncRNA-IUR in laryngeal squamous cell carcinoma (LSCC) were investigated in this study.Methods: RT-qPCR and paired t-test were used to measure and compare expression levels of IUR, miR-24 and p53 in LSCC and non-tumor tissues. Human LSCC cell line UM-SCC-17A was used and transfected by pcDNA3.1 vector to overexpress IUR and miR-24. The transwell assay and wound healing assay illustrated the effect of overexpression of IUR or miR-24 in the cell invasion and migration of LSCC. Subcutaneous tumor model in nude mice was carried out to demonstrate the mechanism between IUR and miR-24 in regulating tumor growth.Results: We found that IUR was downregulated in LSCC. Low expression levels of IUR were correlated with the poor survival of LSCC patients. Overexpression experiments showed that overexpression of IUR led to increased, while overexpression of miR-24 led to decreased expression levels of p53 in LSCC cells. And bioinformatics analysis showed that IUR may sponge miR-24. Cell proliferation assay showed that overexpression of IUR and p53 led to decreased proliferation rate of LSCC cells, while overexpression of miR-24 led to increased proliferation rate of LSCC cells. We also illustrated that overexpression of IUR promoted cell migration and invasion while miR-24 had opposite effects. In addition, subcutaneous tumor model in nude mice showed that overexpression of miR-24 attenuated the effects of overexpression of IUR on the expression of p53 and cancer cell proliferation.Conclusion: IUR sponges miR-24 to upregulate p53 in LSCC, thereby inhibiting cancer cell proliferation.Keywords: laryngeal squamous cell carcinoma, IUR, miR-24, p53

Jian Rong,1,* Guimei Chen,1,* Xueqin Wang,2 Yanhong Ge,1 Nana Meng,1 Tingting Xie,1 Hong Ding1 1Department of Health Services Management, School of Health Management, Anhui Medical University, Hefei 230032, People’s Republic of China; 2Department of Medical Engineering, The Second Hospital of Anhui Medical University, Hefei 230601, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hong DingSchool of Health Management, Anhui Medical University, No. 81 Meishan Road, Hefei 230032, People’s Republic of ChinaTel +86 551 516 1220Fax +86 551 512 8754Email dinghong2003@126.comPurpose: We aimed to assess the current status of depressive symptoms and quality of life (QoL) among rural elderly in central China (Anhui Province) and explore their correlation and associated factors for depressive symptoms.Methods: A multi-stage random sampling method was used to obtain 3349 participants (aged ≥60): 1206 poor and 2143 non-poor. The 30-item Geriatric Depression Scale (GDS-30) and five-dimensional European quality of health scale (EQ-5D) were employed to evaluate depressive symptoms and QoL, respectively.Results: The prevalence of depressive symptoms was 52.9%, and that in the poor group (62.3%) was significantly higher than the non-poor group (47.6%). The GDS-30 score was 12.40 ± 7.089, and the poor group scored significantly higher (14.045 ± 6.929) than the non-poor group (11.472 ± 7.011). The EQ-5D score was 0.713 ± 0.186, and the poor group (0.668 ± 0.192) scored significantly lower than the non-poor group (0.738 ± 0.178). There was a significant negative correlation between depressive symptoms and QoL (r = −0.400, P-value

Abstract Background Ethical competency is important to head nurses’ transformational leadership, however, few researches have explored their correlation, Additionally, most studies used variable-oriented approach to examine ethical competence, without considering it as a multidimensional concept. This study aimed to identify the latent profiles of head nurses’ ethical competence and examine differences in transformational leadership across latent profiles. Methods Convenience sampling was used to recruit 329 head nurses from four tertiary hospitals in Changsha, Hunan province, China. This study collected data by using social-demographic survey, Ethical Competence Questionnaire, and Head Nurse’s Transformational Leadership Self-rating Scale between July and August 2023. Latent profile analysis (LPA) was employed to identify latent profiles of ethical competency. One-way ANOVA test and the Kruskal–Wallis test were used to compare the transformational leadership scores across latent profiles of ethical competency. Results The mean scores of ethical competence and transformational leadership were 4.045 ± 0.394 and 4.555 ± 0.419, respectively. This study identified three latent profiles of head nurses’ ethical competence, and those profiles labelled “low ethical competence” (n = 60, 18.2%), “moderate ethical competence” (n = 217, 66.0%) and “high ethical competence” (n = 52, 15.8%). The average score of transformational leadership was also statistically different (F = 26.446, p = 0.000) across the three profiles. Conclusion Our findings underscore the importance of tailoring interventions to address the varying profiles of ethical competence among head nurses. Enhancing ethical competence can strengthen transformational leadership, ultimately leading to improved patient outcomes and overall healthcare quality.

Abstract This study explores the interplay between Self-Determination (SDT), relatedness, and teaching presence and CoI’s presence (teaching, cognitive, and social) in the context of online educational settings within China. Specifically, the study employs the Partial Least Squares Structural Equation Modeling (PLS-SEM) to investigate the interaction between SDT (Self-Determination, relatedness, and competence) and the perceived learning outcomes (autonomy, competence, and perceived learning). The underlying structure of the study’s conceptual framework was analyzed through the measurement model and the discriminant validity assessment. The results show that cognitive presence, social presence, and teaching presence are significantly associated with autonomy, competence, relevance, and perceived learning. Moreover, cognitive presence and social presence can potentially augment cognitive processes, amplifying the mediating role of relatedness between cognitive presence and learning outcomes.

Abstract The integration of hippocampal oscillations during non-rapid eye movement (NREM) sleep is crucial for memory consolidation. However, how cardinal sleep oscillations bind across various subfields of the human hippocampus to promote information transfer and synaptic plasticity remains unclear. Using human intracranial recordings from 25 epilepsy patients, we find that hippocampal subfields, including DG/CA3, CA1, and SUB, all exhibit significant delta and spindle power during NREM sleep. The DG/CA3 displays strong coupling between delta and ripple oscillations with all the other hippocampal subfields. In contrast, the regions of CA1 and SUB exhibit more precise coordination, characterized by event-level triple coupling between delta, spindle, and ripple oscillations. Furthermore, we demonstrate that the synaptic plasticity within the hippocampal circuit, as indexed by delta-wave slope, is linearly modulated by spindle power. In contrast, ripples act as a binary switch that triggers a sudden increase in delta-wave slope. Overall, these results suggest that different subfields of the hippocampus regulate one another through diverse layers of sleep oscillation synchronization, collectively facilitating information processing and synaptic plasticity during NREM sleep.

With the development of regeneration technology, intentional replantation (IR) has gradually become the important treatment. Some affected teeth that are difficult to be cured by conventional methods, such as refractory periapical periodontitis, radicular groove and combined periodontal-endodontic lesions, can be preserved through IR. IR is effective in the treatment of teeth with severe periodontal destruction. This article reviews the historical development, clinical operation and influencing factors, and provides reference for exploring the treatment plan of IR for a single tooth with severe periodontal destruction and the preservation of patients’ natural dentition.

Abstract Aims Chronic liver disease (CLD) is increasingly recognized as a significant global public health threat, with morbidity and mortality rates remaining high. Evidence suggests that sarcopenia independently increases the risk of CLD and negatively impacts various clinical outcomes, including survival, quality of life, and the emergence of additional complications in patients with CLD. This study aimed to give a bibliometric analysis to examine the correlation between sarcopenia and CLD from a literature perspective. Methods To understand the structure of this research field, we employed VOSviewer. The research on the correlation between long‐term liver disease and sarcopenia was obtained from the Web of Science Core Collection. VOSviewer 1.6.19.0 was utilized to examine and illustrate these publications, encompassing yearly patterns in the domain, focal points of research, significant articles, authors, journals, and organizations. Moreover, according to the results of the cluster analysis of keywords, we further searched and classified related studies to discuss. Results This study provides a comprehensive analysis of current research trends, international collaboration models, fundamental understandings, key focus areas, and future research areas in the field of sarcopenia and CLD by reviewing publications from January 1, 2000 to December 31, 2023. Over the past 24 years, research in the field of sarcopenia and CLD has deepened, with a gradual increase in publications and citations from various countries, institutions, and authors. Keyword analysis of sarcopenia and CLD indicates that current research predominantly focuses on several key areas, including obesity, metabolic syndrome, hepatic steatosis, insulin resistance, inflammation, and nutrition therapy. Conclusion This study provided a visual representation of the current research on the correlation between CLD and sarcopenia, including publication trends, global collaboration patterns, and research hotspots. This research contributes significantly by summarizing and discussing current research trends in sarcopenia and CLD, offering valuable insights into the complex relationship, and highlighting research trends, collaborations, and future directions in clinical treatment.

Abstract Objectives Patients with traumatic brain injury (TBI) often suffer memory and cognitive impairments, and oxiracetam‐like drugs are considered to have a positive impact on these symptoms potentially. However, the efficacy and safety of L‐oxiracetam and oxiracetam in TBI patients have not been sufficiently investigated. Methods The study adopts a multicenter, randomized, double‐blind, parallel‐group, phase 3 clinical trial design in 74 centers across 51 hospitals in China. A total of 590 TBI patients meeting criteria will be randomly allocated into three groups in a 2:2:1 ratio: L‐oxiracetam group, oxiracetam group, and placebo group. The treatment period is 14 days, with a follow‐up period of 90 days. The primary outcome measure is the change in the Loewenstein Occupational Therapy Cognitive Assessment score at 90 days after treatment. Secondary outcomes include changes in other cognitive assessments, neurological function, activities of daily living, and safety assessments. Discussion There is no robust evidence to suggest that L‐oxiracetam and oxiracetam can enhance memory and cognitive function in patients with mild to moderate TBI. This study has the potential to answer this crucial clinical question. Trial registration chinadrugtrials.org.cn, identifier CTR20192539; ClinicalTrials.gov, identifier NCT04205565.

Abstract Aims Surveys and research on the applications of the hepatic venous pressure gradient (HVPG) are important for understanding the current status and future development of this technology in China. This article aimed to investigate the status of hepatic venous pressure gradient measurement in China in 2022. Methods We investigated the overall status of HVPG technology in China—including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications, and current challenges by using online questionnaire. By counting the number and percentages of cases of these results, we hope to clarify the current status of HVPG measurements in China. Results According to the survey, 85 hospitals in China used HVPG technology in 2022 distributed across 29 provinces. A total of 4989 HVPG measurements were performed in all of the surveyed hospitals in 2022, of which 2813 cases (56.4%) were measured alone. The average cost of HVPG measurement was 5646.8 ± 2327.9 CNY. Of the clinical teams who performed the measurements (sometimes multiple per hospital), 94.3% (82/87) used the balloon method, and the majority of the teams (72.4%, 63/87) used embolectomy catheters. Conclusions This survey clarified the clinical application status of HVPG in China and confirmed that some medical institutions in China have established a foundation for this technology. It is still necessary to continue promoting and popularizing this technology in the future.

Abstract Diabetes mellitus affected more than 500 million of people globally, with an annual mortality of 1.5 million directly attributable to diabetic complications. Oxidative stress, in particularly in post-prandial state, plays a vital role in the pathogenesis of the diabetic complications. However, oxidative status marker is generally poorly characterized and their mechanisms of action are not well understood. In this work, we proposed a new framework for deep characterization of oxidative stress in erythrocytes (and in urine) using home-built micro-scale NMR system. The dynamic of post-prandial oxidative status (against a wide variety of nutritional load) in individual was assessed based on the proposed oxidative status of the red blood cells, with respect to the traditional risk-factors such as urinary isoprostane, reveals new insights into our understanding of diabetes. This new method can be potentially important in drafting guidelines for sub-stratification of diabetes mellitus for clinical care and management.

The treatment of digestive system tumors presents challenges, particularly in immunotherapy, owing to the advanced immune tolerance of the digestive system. Nanomaterials have emerged as a promising approach for addressing these challenges. They provide targeted drug delivery, enhanced permeability, high bioavailability, and low toxicity. Additionally, nanomaterials target immunosuppressive cells and reshape the tumor immune microenvironment (TIME). Among the various cells in the TIME, tumor-associated macrophages (TAMs) are the most abundant and play a crucial role in tumor progression. Therefore, investigating the modulation of TAMs by nanomaterials for the treatment of digestive system tumors is of great significance. Here, we present a comprehensive review of the utilization of nanomaterials to modulate TAMs for the treatment of gastric cancer, colorectal cancer, hepatocellular carcinoma, and pancreatic cancer. We also investigated the underlying mechanisms by which nanomaterials modulate TAMs to treat tumors in the digestive system. Furthermore, this review summarizes the role of macrophage-derived nanomaterials in the treatment of digestive system tumors. Overall, this research offers valuable insights into the development of nanomaterials tailored for the treatment of digestive system tumors.

Objectives: The study aimed to investigate the relationship between blood pressure (BP) levels and mortality among critically ill older adults in the intensive care unit (ICU), establish optimal BP target for this population, and assess the mediating effect of severe malnutrition on BP-related mortality. Methods: Data were extracted from the Medical Information Mart for Intensive Care IV version 2.2 database, focusing on critically ill patients aged 80 years and older. The analysis included various BP parameters, such as systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP). Results: The study cohort comprised 14,660 critically ill patients, of whom 1558 (10.6 %) experienced ICU mortality and 2493 (17.0 %) experienced in-hospital mortality. Lower BP levels (SBP ≤ 112 mmHg; DBP ≤ 53 mmHg; MAP ≤65 mmHg), were associated with an increased risk of both ICU and in-hospital mortality. Notably, only reduced SBP levels were linked to a higher risk of 1-year mortality, with an adjusted hazard ratio 1.13 (95 % confidence interval 1.05 to 1.23). Additionally, severe malnutrition was identified as a mediator in the relationship between low BP levels and ICU mortality, with BP levels positively correlated with prognostic nutritional indexes. Conclusion: Among critically ill older adults, lower BP levels are significantly associated with higher risks of ICU and in-hospital mortality, while reduced SBP levels are linked to 1-year mortality. These findings emphasize the importance of assessing nutritional status in older ICU patients with low BP levels to potentially mitigate mortality risk.

Aims: The relationship between sarcopenia and cognitive impairment in older adults remains contentious. This study investigates this association and examines the long-term prognosis for individuals with both conditions. Methods: Utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014, this study focuses on the correlation between sarcopenia and cognitive impairment, as well as the extended prognosis for individuals managing these conditions. Results: The study cohort comprised 2890 participants, with 648 (22.4 %) diagnosed with sarcopenia. Multivariable logistic regression analysis identified a significant association between sarcopenia and an increased risk of cognitive impairment (adjusted odds ratio [aOR]: 1.68, 95 % confidence interval [CI]: 1.30–2.17). Over a median follow-up period of 48 months, 200 individuals (6.9 %) succumbed to cardiovascular and cerebrovascular diseases (CCVDs), including hypertension, congestive heart failure, coronary artery disease, and stroke, as well as Alzheimer's disease (AD). Participants had comorbid conditions such as CCVDs and diabetes mellitus. Kaplan–Meier survival analysis and the Cox proportional hazards model indicated that individuals with both sarcopenia and cognitive impairment had the highest mortality risk from CCVDs and AD (adjusted hazard ratio [aHR]: 2.73, 95 % CI: 1.48–5.02). Individuals with sarcopenia and comorbidities exhibited a higher mortality risk from CCVDs or AD compared to those without sarcopenia but with comorbidities (aHR: 2.71, 95 % CI: 1.37–5.37). Conclusion: Sarcopenia is independently associated with cognitive impairment. Older adults with both sarcopenia and cognitive impairment or concurrent comorbidities face increased mortality risks from CCVDs or AD compared to their healthy counterparts. Clinical implication: • Sarcopenia is associated with cognitive impairment. • Cognitive impairment and comorbidities increased the risk of mortality from CCVDs and AD for sarcopenia patients.

Abstract Objective This study examines the impact of parental migration on the psychological well‐being and development of left‐behind children (LBCs) in Zhejiang, China, within the broader context of the country's rural transformations and urban migration. It investigates how intellectual and relational engagement (RE), autonomy (AUT), competence (COM), and relatedness (RES) contribute to resilience (REL) and post‐traumatic growth (PTG) in these children, reflecting on the shift from viewing parental separation merely as a source of trauma to recognizing its potential to foster significant personal growth. Methods Utilizing a cross‐sectional design, the research was conducted in April and May 2023 with 1348 LBCs from a total sample of 4049 students inZhejiang. A two‐step random, stratified, cluster‐based sampling strategy was employed, and structural equation modeling was used to examine the hypothesized relationships among the constructs. Results The statistical analysis demonstrated significant positive effects of intellectual engagement (IE), AUT, COM, and RE on both REL and PTG (p .60) underscoring their importance. Notably, REL was found to moderate the relationships among RES, COM, and PTG, highlighting its critical role in the psychological adaptation of left‐behind children. Conclusion The study underscores the importance of nurturing intellectual and REs, AUT, and COM to enhance psychological REL and well‐being among LBAs. These elements are crucial for supporting the mental health and developmental needs of children facing the challenges of parental migration. The findings advocate for targeted interventions that can address the unique needs of this vulnerable population, emphasizing the potential for growth and adaptation despite adversities.

Metal-supported solid oxide fuel cell (MS-SOFC) is very promising for intermediate temperature solid oxide fuel cell (SOFC) due to better mechanical strength, low materials cost, and simplified stack assembling. However, the effects of metal support on the performance and temperature field of MS-SOFC is still necessary for further study. In this study, a three-dimensional multi-physical model is developed to investigate how the use of metal support influence the electrochemical performance and the temperature field of MS-SOFC with a ceria-based electrolyte. The multi-physical model fully considers the conservation equations of mass, momentum, and energy that are coupled with mass transport and electrochemical reactions. The wall temperature in the radiation model is calculated using a discrete method. It is found that the radiation heat flux accounts for 3.13 % of the total heat flux. More importantly, the temperature difference of MS-SOFC is 3.61 % lower than that of conventional anode-supported SOFC, leading to improved temperature uniformity and cell durability.

Background: Traumatic brain injury (TBI) is a common neurosurgical disease in emergency rooms with poor prognosis, imposing severe burdens on patients and their families. Evidence indicates that piracetam and compound porcine cerebroside and ganglioside injection (CPCGI) can improve cognitive levels in TBI patients to enhance functional prognosis, but there is still a research gap regarding the efficacy of CPCGI. This study aims to determine the effectiveness and safety of CPCGI in improving cognitive and functional outcomes in TBI patients. Methods: This study is a multicenter, randomized, parallel-group, double-blind trial aiming to recruit 900 adult patients with mild to moderate TBI. After providing informed consent, 600 patients will be randomly assigned to the CPCGI group (20 ml/d, for 14 days), and 300 patients will be randomized to the piracetam group as a control (20 ml/d, for 14 days), followed up for 3 months after treatment. The primary outcome is the change in the Montreal Cognitive Assessment (MoCA) score from baseline after 3 months. The main secondary outcome measures include Mini-Mental State Examination (MMSE) scores, Glasgow Outcome Scale-Extended (GOS-E), and the Barthel Index at 1 and 3 months. Discussion: This multi-center clinical trial aims to provide high-quality evidence on the efficacy and safety of CPCGI in improving cognitive and functional outcomes in mild to moderate TBI patients. Trial registration: ChiCTR2000040466, date of registration: November 28, 2020.

Proton exchange membrane (PEM) based electrochemical systems have the capability to operate in fuel cell (PEMFC) and water electrolyser (PEMWE) modes, enabling efficient hydrogen energy utilisation and green hydrogen production. In addition to the essential cell stacks, the system of PEMFC or PEMWE consists of four sub-systems for managing gas supply, power, thermal, and water, respectively. Due to the system's complexity, even a small fluctuation in a certain sub-system can result in an unexpected response, leading to a reduced performance and stability. To improve the system's robustness and responsiveness, considerable efforts have been dedicated to developing advanced control strategies. This paper comprehensively reviews various control strategies proposed in literature, revealing that traditional control methods are widely employed in PEMFC and PEMWE due to their simplicity, yet they suffer from limitations in accuracy. Conversely, advanced control methods offer high accuracy but are hindered by poor dynamic performance. This paper highlights the recent advancements in control strategies incorporating machine learning algorithms. Additionally, the paper provides a perspective on the future development of control strategies, suggesting that hybrid control methods should be used for future research to leverage the strength of both sides. Notably, it emphasises the role of artificial intelligence (AI) in advancing control strategies, demonstrating its significant potential in facilitating the transition from automation to autonomy.

Abstract A comprehensive understanding of the transient characteristics in solid oxide cells (SOCs) is crucial for advancing SOC technology in renewable energy storage and conversion. However, general formulas describing the relationship between SOC transients and multiple parameters remain elusive. Through comprehensive numerical analysis, we find that the thermal and gaseous response times of SOCs upon rapid electrical variations are on the order of two characteristic times (τ h and τ m), respectively. The gaseous response time is approximately 1τ m, and the thermal response time aligns with roughly 2τ h. These characteristic times represent the overall heat and mass transfer rates within the cell, and their mathematical relationships with various SOC design and operating parameters are revealed. Validation of τ h and τ m is achieved through comparison with an in-house experiment and existing literature data, achieving the same order of magnitude for a wide range of electrochemical cells, showcasing their potential use for characterizing transient behaviors in a wide range of electrochemical cells. Moreover, two examples are presented to demonstrate how these characteristic times can streamline SOC design and control without the need for complex numerical simulations, thus offering valuable insights and tools for enhancing the efficiency and durability of electrochemical cells.

Abstract Background The prevalence of burnout, depression, and anxiety among Chinese nurses was 34%, 55.5%, and 41.8% respectively. Mental health problems have significant impacts on their personal well-being, work performance, patient care quality, and the overall healthcare system. Mental health is influenced by factors at multiple levels and their interactions. Methods This was a descriptive qualitative study using phenomenological approach. We recruited a total of 48 nurses from a tertiary hospital in Changsha, Hunan Province, China. Data were collected through focus group interviews. Audio-recorded data were transcribed and inductively analysed. Results Four major themes with 13 subthemes were identified according to the social ecological model: (1) individual-level factors, including personality traits, sleep quality, workplace adaptability, and years of work experience; (2) interpersonal-level factors, encompassing interpersonal support and role conflict; (3) organization-level factors, such as organizational climate, organizational support, career plateau, and job control; and (4) social-level factors, which included compensation packages, social status, and legislative provision and policy. Conclusions Our study provides a nuanced understanding of the multifaceted factors influencing nurses’ mental health. Recognizing the interconnectedness of individual, interpersonal, organizational, and social elements is essential for developing targeted interventions and comprehensive strategies to promote and safeguard the mental well-being of nurses in clinical settings. Trial and protocol registration The larger study was registered with Chinese Clinical Trial Registry: ChiCTR2300072142 (05/06/2023) https://www.chictr.org.cn/showproj.html?proj=192676 . Reporting method This study is reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ).

Highlights A novel A/B-sites co-substitution strategy was introduced to enhance the performance and durability of Ruddlesden–Popper perovskite Sr3Fe2O7−δ (SF)-based air electrodes for reversible protonic ceramic cells (RePCCs). Simultaneous Sr-deficiency and Nb-substitution in SF result in Sr2.8Fe1.8Nb0.2O7−δ (D-SFN), offering improved structural stability under RePCC conditions by suppressing the formation of Sr3Fe2(OH)12 phase. The introduction of Sr-deficiency enhances oxygen vacancy concentration in D-SFN, promoting efficient oxygen transport within the material and contributing to excellent activity in RePCCs.

Abstract Background The diagnosis of primary small intestinal lymphoma (PSIL) is difficult. This study aimed to evaluate the clinical, radiological and endoscopic characteristics of PSIL and provide clue for diagnosis. Methods A total of 30 patients diagnosed with PSIL who underwent double balloon endoscopy (DBE) in the First Affiliated Hospital of Zhejiang University were retrospectively analyzed. Clinical, radiological and endoscopic data were collected. Univariate analysis was used to determine significant indicators for differentiating three main subtypes of PSIL. Cox regression analysis was performed to assess the risk factors for survival. Results In this study, 10 patients were pathologically diagnosed as diffuse large B-cell lymphoma (DLBCL), 11 were indolent B-cell lymphoma (BCL) and 9 were T-cell lymphoma (TCL). Compared with DLBCL patients, the body mass index (BMI) of TCL patients was significantly lower (p = 0.004). Meanwhile, compared with patients with DLBCL, the patients with indolent BCL had lower levels of C-reactive protein, lactate dehydrogenase (LDH), fibrinogen and D-Dimer (p = 0.004, p = 0.004, p = 0.006, and p = 0.002, respectively), and lower proportion of thicker intestinal wall and aneurysmal dilation in CT scan (p = 0.003 and p = 0.020, respectively). In terms of ulcer morphology, patients with DLBCL had significantly higher proportion of deep ulcers than patients with indolent BCL (p = 0.020, respectively). Cox regression analysis showed that drink (p = 0.034), concomitant colonic ulcers (p = 0.034) and elevated LDH (p = 0.043) are risk factors for mortality in patients with PSIL. Conclusions This study provides clinical characteristics of patients with PSIL. Thicker intestinal wall and aneurismal dilation detected on CT scan and deeper ulcer on DBE examination helps to establish a diagnosis of DLBCL.

Background Critically ill patients in the intensive care unit (ICU) often experience dysglycaemia. However, studies investigating the link between acute kidney injury (AKI) and dysglycaemia, especially in those with and without diabetes mellitus (DM), are limited.Methods We used the Medical Information Mart for Intensive Care IV database to investigate the association between AKI within 7 days of admission and subsequent dysglycaemia. The primary outcome was the occurrence of dysglycaemia (both hypoglycemia and hyperglycemia) after 7 days of ICU admission. Logistic regression analyzed the relationship between AKI and dysglycaemia, while a Cox proportional hazards model estimated the long-term mortality risk linked to the AKI combined with dysglycaemia.Results A cohort of 20,008 critically ill patients were included. The AKI group demonstrated a higher prevalence of dysglycaemia, compared to the non-AKI group. AKI patients had an increased risk of dysglycaemia (adjusted odds ratio [aOR] 1.53, 95% confidence interval [CI] 1.41–1.65), hypoglycemia (aOR 1.56, 95% CI 1.41–1.73), and hyperglycemia (aOR 1.53, 95% CI 1.41–1.66). In subgroup analysis, compared to DM patients, AKI showed higher risk of dysglycaemia in non-DM patients (aOR: 1.93 vs. 1.33, Pint

Microwave thermotherapy (MWTT), as a treatment for tumors, lacks specificity and requires sensitizers. Most reported microwave sensitizers are single metal-organic frameworks (MOFs), which must be loaded with ionic liquids to enhance the performance in MWTT. Meanwhile, MWTT is rarely combined with other treatment modalities. Here, we synthesized a novel Fe–Cu bimetallic organic framework FeCuMOF (FCM) by applying a hydrothermal method and further modified it with methyl polyethylene glycol (mPEG). The obtained FCM@PEG (FCMP) showed remarkable heating performance under low-power microwave irradiation; it also acted as a novel nanospheres enzyme to catalyze H2O2 decomposition, producing abundant reactive oxygen species (ROS) to deplete glutathione (GSH) and prevent ROS clearance from tumor cells during chemodynamic treatment. The FCMP was biodegradable and demonstrated excellent biocompatibility, allowing it to be readily metabolized without causing toxic effects. Finally, it was shown to act as a suitable agent for T2 magnetic resonance imaging (MRI) in vitro and in vivo. This new bimetallic nanostructure could successfully realize two tumor treatment modalities (MWTT and chemodynamic therapy) and dual imaging modes (T2 MRI and microwave thermal imaging). Our findings represent a breakthrough for integrating the diagnosis and treatment of tumors and provides a reference for developing new microwave sensitizers.

Abstract Background Cell‐free long RNAs in human plasma and extracellular vesicles (EVs) have shown promise as biomarkers in liquid biopsy, despite their fragmented nature. Methods To investigate these fragmented cell‐free RNAs (cfRNAs), we developed a cost‐effective cfRNA sequencing method called DETECTOR‐seq (depletion‐assisted multiplexed cell‐free total RNA sequencing). DETECTOR‐seq utilised a meticulously tailored set of customised guide RNAs to remove large amounts of unwanted RNAs (i.e., fragmented ribosomal and mitochondrial RNAs) in human plasma. Early barcoding strategy was implemented to reduce costs and minimise plasma requirements. Results Using DETECTOR‐seq, we conducted a comprehensive analysis of cell‐free transcriptomes in both whole human plasma and EVs. Our analysis revealed discernible distributions of RNA types in plasma and EVs. Plasma exhibited pronounced enrichment in structured circular RNAs, tRNAs, Y RNAs and viral RNAs, while EVs showed enrichment in messenger RNAs (mRNAs) and signal recognition particle RNAs (srpRNAs). Functional pathway analysis highlighted RNA splicing‐related ribonucleoproteins (RNPs) and antimicrobial humoral response genes in plasma, while EVs demonstrated enrichment in transcriptional activity, cell migration and antigen receptor‐mediated immune signals. Our study indicates the comparable potential of cfRNAs from whole plasma and EVs in distinguishing cancer patients (i.e., colorectal and lung cancer) from healthy donors. And microbial cfRNAs in plasma showed potential in classifying specific cancer types. Conclusions Our comprehensive analysis of total and EV cfRNAs in paired plasma samples provides valuable insights for determining the need for EV purification in cfRNA‐based studies. We envision the cost effectiveness and efficiency of DETECTOR‐seq will empower transcriptome‐wide investigations in the fields of cfRNAs and liquid biopsy. Keypoints DETECTOR‐seq (depletion‐assisted multiplexed cell‐free total RNA sequencing) enabled efficient and specific depletion of sequences derived from fragmented ribosomal and mitochondrial RNAs in plasma. Distinct human and microbial cell‐free RNA (cfRNA) signatures in whole Plasma versus extracellular vesicles (EVs) were revealed. Both Plasma and EV cfRNAs were capable of distinguishing cancer patients from normal individuals, while microbial RNAs in Plasma cfRNAs enabled better classification of cancer types than EV cfRNAs.

ObjectiveIn the past, the localization of seizure onset zone (SOZ) primarily relied on traditional EEG signal analysis methods. However, due to their limited spatial and temporal resolution, accurately pinpointing neural activity was challenging, thereby restricting their clinical applicability. Compared with traditional EEG signals, SEEG signals have superior spatial and temporal resolution, and can more accurately record neural activity near epileptic foci, making them better suited for studying SOZ. In addition, the traditional EEG signal analysis methods still have limitations, mainly focusing on the analysis of local signal features, while ignoring the complexity and interconnection of the overall brain network. How to more accurately locate SOZ is still not well resolved. The purpose of this study is to develop an effective positioning method for more accurate positioning.MethodTo overcome these limitations, this study proposed a model integrating brain functional network analysis with nonlinear dynamics. We utilized weighted phase lag index (WPLI) to construct brain functional network, epilepic network connectivity strength (ENCS) as the feature, and introduced persistence entropy (PE) for feature fusion, subsequently employing support vector machine (SVM) classification.ResultsThe proposed method was verified on the HUP-iEEG dataset, our solution identified the SOZ with 0.9440 accuracy, 0.9848 precision, 0.8974 recall rate, 0.9340 F1 score and 0.9697 area under the ROC curve across patients, which outperforms the existing approaches. It exhibits a 2.30 percentage point enhancement in localisation accuracy along with a 2.97 percentage points in AUC compared to others.ConclusionOur method consider the interactions between nodes in brain network connections, as well as the inherent nonlinear and non-stationary properties of neural signals, to be more robust.

The correlation between sports participation and psychological well-being is well-documented, revealing a complex interplay influenced by competition level and cultural context. This is particularly relevant in Korea, where the university sports culture significantly impacts student life. This study evaluates how competitive versus non-competitive sports affect Korean university students' psychological well-being using a quantitative approach with SmartPLS 4 for multi-group analysis. Findings reveal that competitive sports significantly enhance mental toughness and stress management through structured coping mechanisms and robust social support, improving coping strategy effectiveness by 34 % compared to non-competitive sports. Conversely, participants in non-competitive sports experience greater general well-being with a 40 % higher use of informal support. These insights suggest that university sports programs could benefit from targeted interventions incorporating specific coping strategies and social support frameworks tailored to the competitive context. This research underscores the need for precise stress management techniques and resilience-building exercises in sports curricula to optimize psychological well-being across different sports environments in Korean universities.

Abstract This study aimed to investigate the predictive factors of therapeutic efficacy for chronic subdural hematoma (CSDH) patients receiving atorvastatin combined with dexamethasone therapy by using clinical imaging characteristics in conjunction with computed tomography (CT) texture analysis (CTTA). Clinical imaging characteristics and CT texture parameters at admission were retrospectively investigated in 141 CSDH patients who received atorvastatin combined with dexamethasone therapy from June 2019 to December 2022. The patients were divided into a training set (n = 81) and a validation set (n = 60). Patients in the training data were divided into two groups based on the effectiveness of the treatment. Univariate and multivariate analyses were performed to assess the potential factors that could indicate the prognosis of CSDH patients in the training set. The receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of the significant factors in predicting the prognosis of CSDH patients and was validated using a validation set. The multivariate analysis showed that the hematoma density to brain parenchyma density ratio, singal min (minimum) and singal standard deviation of the pixel distribution histogram, and inhomogeneity were independent predictors for the prognosis of CSDH patients based on atorvastatin and dexamethasone therapy. The area under the ROC curve between the two groups was between 0.716 and 0.806. As determined by significant factors, the validation's accuracy range was 0.816 to 0.952. Clinical imaging characteristics in conjunction with CTTA could aid in distinguishing patients with CSDH who responded well to atorvastatin combined with dexamethasone.