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Zhibao Mi,1 Dimitri Novitzky,2 Joseph F Collins,1 David KC Cooper3 1Cooperative Studies Program Coordinating Center, VA Maryland Health Care Systems, Perry Point, MD, USA; 2Department of Cardiothoracic Surgery, University of South Florida, Tampa, FL, USA; 3Thomas E Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA Abstract: The management of brain-dead organ donors is complex. The use of inotropic agents and replacement of depleted hormones (hormonal replacement therapy) is crucial for successful multiple organ procurement, yet the optimal hormonal replacement has not been identified, and the statistical adjustment to determine the best selection is not trivial. Traditional pair-wise comparisons between every pair of treatments, and multiple comparisons to all (MCA), are statistically conservative. Hsu’s multiple comparisons with the best (MCB) – adapted from the Dunnett’s multiple comparisons with control (MCC) – has been used for selecting the best treatment based on continuous variables. We selected the best hormonal replacement modality for successful multiple organ procurement using a two-step approach. First, we estimated the predicted margins by constructing generalized linear models (GLM) or generalized linear mixed models (GLMM), and then we applied the multiple comparison methods to identify the best hormonal replacement modality given that the testing of hormonal replacement modalities is independent. Based on 10-year data from the United Network for Organ Sharing (UNOS), among 16 hormonal replacement modalities, and using the 95% simultaneous confidence intervals, we found that the combination of thyroid hormone, a corticosteroid, antidiuretic hormone, and insulin was the best modality for multiple organ procurement for transplantation. Keywords: best treatment selection, brain-dead organ donors, hormonal replacement, multiple binary endpoints, organ procurement, multiple comparisons

Improving the stability of semiconductor materials is one of the major challenges for sustainable and economic photoelectrochemical water splitting. N-terminated GaN nanostructures have emerged as a practical protective layer for conventional high efficiency but unstable Si and III-V photoelectrodes due to their near-perfect conduction band-alignment, which enables efficient extraction of photo-generated electrons, and N-terminated surfaces, which protects against chemical and photo-corrosion. Here, we demonstrate that Pt-decorated GaN nanostructures on an n+-p Si photocathode can exhibit an ultrahigh stability of 3000 h (i.e., over 500 days for usable sunlight ∼5.5 h per day) at a large photocurrent density (>35 mA cm-2) in three-electrode configuration under AM 1.5G one-sun illumination. The measured applied bias photon-to-current efficiency of 11.9%, with an excellent onset potential of ∼0.56 V vs. RHE, is one of the highest values reported for a Si photocathode under AM 1.5G one-sun illumination. This study provides a paradigm shift for the design and development of semiconductor photoelectrodes for PEC water splitting: stability is no longer limited by the light absorber, but rather by co-catalyst particles.

In this paper, we introduced a method to measure grain rotation of nanomaterials under external stress using a high pressure diamond anvil cell and the Laue microdiffraction technique at a synchrotron facility. We used tungsten carbide marker crystals to investigate grain rotation activities of 3 and 500 nm nickel media. Our results show that the grain rotation of 3 and 500 nm nickel nanocrystals increase with pressure and finally rotation of 500 nm nickel tends to stop at a lower pressure/stress level than 3 nm nickel. 3 nm nickel nanocrystals show a higher rotation magnitude than 500 nm nickel nanocrystals. Our measurements show an effective method to study the grain rotation of nanomaterials especially in ultrafine nanocrystals.

Pressure-induced phase transformation and fluorescent properties of ErF3 were investigated here using in-situ synchrotron X-ray diffraction and photoluminescence up to 32.1 GPa at room temperature. Results showed that ErF3 underwent a reversible pressure-induced phase transition from the β-YF3-type to the fluocerite LaF3-type at 9.8 GPa. The bulk moduli B0 for low- and high-pressure phases were determined to be 130 and 208 GPa, respectively. Photoluminescencent studies showed that new emission lines belonging to the transition of 2H11/2→4I15/2, 4S3/2→4I15/2, and 4F9/2→4I15/2 appeared during phase transition, suggesting pressure-induced electronic band splitting. Remarkably, significant pressure-induced enhancement of photoluminescence was observed, which was attributed to lattice distortion of the material under high pressure.

Abstract Transthoracic echocardiography (TTE) is widely recognized as one of the principal modalities for diagnosing tricuspid regurgitation (TR). The diagnostic procedures associated with conventional methods are intricate and labor-intensive, with human errors leading to measurement variability, with outcomes critically dependent on the operators’ diagnostic expertise. In this study, we present an innovative assessment methodology for evaluating TR severity utilizing an end-to-end deep learning system. This deep learning system comprises a segmentation model of single cardiac cycle TR continuous wave (CW) Doppler spectra and a classification model of the spectra, trained on the TR CW Doppler spectra from a cohort of 11,654 patients. The efficacy of this intelligent assessment methodology was validated on 1500 internal cases and 573 external cases. The receiver operating characteristic (ROC) curves of the internal validation results indicate that the deep learning system achieved the areas under curve (AUCs) of 0.88, 0.84, and 0.89 for mild, moderate, and severe TR, respectively. The ROC curves of the external validation results demonstrate that the system attained the AUCs of 0.86, 0.79, and 0.87 for mild, moderate, and severe TR, respectively. Our study results confirm the feasibility and efficacy of this novel intelligent assessment method for TR severity.

Nano-Y2O3-dispersion strengthened CoCrFeNi high entropy alloys are fabricated via mechanical alloying and spark plasma sintering using high purity elemental powders or pre-alloyed CoCrFeNi powder. All the alloys show an FCC matrix incorporated by small amount of BCC Cr-rich segregations, whose brittle nature is detrimental to the mechanical properties of the alloys. It has been found that using pre-alloyed powder significantly suppresses the formation of the Cr-rich phase, and its size and volume fraction can be further reduced by increasing the rotation speed of ball-milling during mechanical alloying. Besides, the grain refinement is also achieved under a higher rotation speed. Y2O3 nanoparticles with a number density of 1.8 × 1022 m−3 and an average diameter of 11.0 ± 7.3 nm are uniformly distributed in the alloy that produced from pre-alloyed powder under the rotation speed of 350 rpm during ball-milling. These Y2O3 nanoparticles share coherent interface with the FCC matrix, indicating the in-situ precipitation mechanism. Due to a good combination of grain boundary strengthening, dislocation strengthening and precipitation strengthening, this ODS high entropy alloy possesses a yield strength of 1281 MPa at room temperature.

In the era of increasingly advanced Earth Observation (EO) technologies, extracting pertinent information (such as water-bodies) from the Earth’s surface has become a crucial task. Deep Learning, especially via pre-trained models, currently offers a highly promising approach for the semantic segmentation of Remote Sensing Imagery (RSI). However, effectively adapting these pre-trained models to RSI tasks remains challenging. Typically, these models undergo fine-tuning for specialized tasks, involving modifications to their parameters or structure of the original architecture, which may impact their inherent generalization capabilities. Furthermore, robust pre-trained models on nature images are not specifically designed for RSI, presenting challenges in their direct application to RSI tasks. To alleviate these problems, our study introduces a light-weight Enhanced Semantic-positional Feature Fusion Network (ESFFNet), leveraging diverse pre-trained image encoders alongside extensive EO data. The proposed method begins by leveraging pre-trained encoders, specifically Vision Transformer (ViT)-based and Convolutional Neural Network (CNN)-based models, to extract deep semantic and precise positional features respectively, without additional training. Following this, we introduce the Enhanced Semantic-positional Feature Fusion Module (ESFFM). This module adeptly merges semantic features derived from the ViT-based encoder with spatial features extracted from the CNN-based encoder. Such integration is realized via multi-scale feature fusion, local and long-distance feature integration, and dense connectivity strategies, leading to a robust feature representation. Finally, the Primary Segmentation-guided Fine Extraction Module (PSFEM) further bolsters the precision of remote sensing image segmentation. Collectively, these two modules constitute our light-weight decoder, with a parameter size of less than 4 M. Our approach is evaluated on two distinct water-body datasets, indicating superiority over other leading segmentation techniques. In addition, our method also demonstrates exemplary efficacy in diverse remote sensing segmentation tasks, such as building extraction and land cover classification. The source codes will be available at https://github.com/zhilyzhang/ESFFNet.

Objectives: The guidelines recommend fractional flow reserve-guided coronary artery bypass grafting (CABG) during primary valve surgery without evidence. Quantitative flow ratio (QFR) is a novel coronary angiography (CAG)-based fractional flow reserve measurement. We aimed to compare the early clinical outcomes between QFR-guided and CAG-guided CABG in these patients. Methods: This observational study screened all 2081 patients admitted to our institution for elective primary mitral and/or aortic valve surgery from January 2017 to September 2020. Of them, all 188 patients with comorbid coronary artery lesions (visual estimated stenosis ≥50%) were included. Sixty-nine patients with QFR analysis received bypasses only for lesions with QFR ≤0.80 (QFR-guided group). The remaining 119 patients without QFR analysis received bypasses for all stenosis ≥50% (CAG-guided group). Propensity overlap weighting was used to neutralize the intergroup imbalance. The primary end point was major adverse cardiovascular events. Results: After propensity score weighting, the baseline characteristics were comparable. Concomitant coronary artery bypass grafting was performed 58.1% versus 100% in the QFR-guided and CAG-guided groups, respectively. The mean number of grafts was significantly lower in QFR-guided group than in the CAG-guided group (0.9 ± 0.7 vs 1.6 ± 0.5 [P

Abstract Background To clarify the fat attenuation index (FAI) change trend of peri-saphenous vein graft (SVG) and determine the association between FAI and graft disease progression based on CCTA images. Methods Patients with venous coronary artery bypass grafts (CABGs) were consecutively enrolled in this retrospective study. In study 1, 72 patients who had undergone 1, 3, and 5 years of CCTA examinations without graft occlusion were recruited, and generalized estimation equation was used to analyze the peri-SVG FAI change trend over time. In study 2, 42 patients with graft disease progression and 84 patients as controls were propensity score-matched. Generalized linear mixed model and continuous net reclassification improvement (NRI) were used for assessing the associations with graft disease progression. Multivariable Cox regression analysis was used for assessing risk factors predicting cardiac events. Results In study 1, both the FAI of proximal right coronary artery and SVG decreased over time. In study 2, the 1-year CTA-derived FAI of grafts and graft anastomosis were independent indicators of graft disease progression at the 3-year CCTA follow-up (graft: odds ratio [OR] = 1.106; 95% confidence interval [CI] = 1.030–1.188, P = 0.006; graft anastomosis: OR = 1.170, 95% CI = 1.091–1.254, P

Abstract Background The rumen microbiome plays an essential role in maintaining ruminants’ growth and performance even under extreme environmental conditions, however, which factors influence rumen microbiome stability when ruminants are reared in such habitats throughout the year is unclear. Hence, the rumen microbiome of yak (less domesticated) and cattle (domesticated) reared on the Qinghai-Tibetan Plateau through the year were assessed to evaluate temporal changes in their composition, function, and stability. Results Rumen fermentation characteristics and pH significantly shifted across seasons in both cattle and yak, but the patterns differed between the two ruminant species. Ruminal enzyme activity varied with season, and production of xylanase and cellulase was greater in yak compared to cattle in both fall and winter. The rumen bacterial community varied with season in both yak and cattle, with higher alpha diversity and similarity (beta diversity) in yak than cattle. The diversity indices of eukaryotic community did not change with season in both ruminant species, but higher similarity was observed in yak. In addition, the similarity of rumen microbiome functional community was higher in yak than cattle across seasons. Moreover, yak rumen microbiome encoded more genes (GH2 and GH3) related to cellulose and hemicellulose degradation compared to cattle, and a new enzyme family (GH160) gene involved in oligosaccharides was uniquely detected in yak rumen. The season affected microbiome attenuation and buffering values (stability), with higher buffering value in yak rumen microbiome than cattle. Positive correlations between antimicrobial resistance gene (dfrF) and CAZyme family (GH113) and microbiome stability were identified in yak, but such relationship was negatively correlated in cattle. Conclusions The findings of the potential of cellulose degradation, the relationship between rumen microbial stability and the abundance of functional genes varied differently across seasons and between yak and cattle provide insight into the mechanisms that may underpin their divergent adaptation patterns to the harsh climate of the Qinghai-Tibetan Plateau. These results lay a solid foundation for developing strategies to maintain and improve rumen microbiome stability and dig out the potential candidates for manufacturing lignocellulolytic enzymes in the yak rumen to enhance ruminants’ performance under extreme environmental conditions.

In this paper, we introduced a new contraction principle via altering distance and $ C $-class functions with rational forms which extends and generalizes the existing version provided by Hasan Ranjbar et al. [H. Ranjbar, A. Niknam, A fixed point theorem in Hilbert $ C^\ast $-modules, Korean J. Math., 30 (2022), 297–304]. Specifically, the rational forms involved in the contraction condition we presented involve the $ p $-th power of the displacements which can exceed the second power mentioned in Hasan Ranjbar et al.'s paper. Moreover, we also proved a fixed point theorem for this type of contraction in the Hilbert $ C^\ast $-module. Some adequate examples were provided to support our results. As an application, we applied our result to prove the existence of a unique solution to an integral equation and a second-order $ (p, q) $-difference equation with integral boundary value conditions.

Abstract Objective To evaluate the clinical efficacy of Langenlianqiao (LGLQ) oral liquid treatment and provide a reference basis for the clincal treatment of coronavirus disease 2019 (COVID-19). Design An experimental clinical study was conducted on three groups with confirmed diagnoses of COVID-19. Site This study was conducted at Changde Hospital. Participants A total of 253 patients were enrolled in this study. Methods The patients were divided into the LGLQ treatment group (100 cases), the Lianhuaqingwen (LHQW) treatment group (100 cases) and the placebo control group (53 cases), according to the treatment each group received. The occurrence of major clinical symptoms, the duration of symptom disappearance, the number of days in hospitalisation and the duration of infection were compared among the three groups. Results Compared with the placebo control group (10.0 [1.2] d, 9.4 [1.3] d), the duration of infection and hospitalisation effectively decreased in the LGLQ group (6.8 [0.6] d, 7.4 [0.8] d) and the LHQW group (6.8 [1.0] d, 7.3 [1.0] d). Furthermore, the incidence of fatigue in the LGLQ group (4.0%) was lower compared to the LHQW group (14.0%) and the placebo control group (15.1%), but this difference was not statistically significant (P = 0.580 for LGLQ vs. LHQW, P = 0.246 for LGLQ vs. placebo). In the treatment of cough, the LGLQ group showed a significantly different effect compared to both the LHQW group (P = 0.014) and the placebo group (P = 0.016). Additionally, for dry cough specifically, LHQW was effective in reducing its incidence compared to the placebo control group (P 0.05). Conclusions Compared with the placebo control group, the LGLQ group showed an improvement in the clinical symptoms of COVID-19 and a decrease in the duration of hospitalisation and infection, which confirmed that the LGLQ treatment had the same antiviral effect as the LHQW treatment. This may provide in-depth insights for antiviral therapy research.

Abstract Background Acute myeloid leukemia (AML) is a genetically heterogeneous disease in which glutamine (Gln) contributes to AML progression. Therefore, this study aimed to identify potential prognostic biomarkers for AML based on Gln metabolism-related genes. Methods Gln-related genes that were differentially expressed between Cancer Genome Atlas-based AML and normal samples were analyzed using the limma package. Univariate, least absolute shrinkage, selection operators, and stepwise Cox regression analyses were used to identify prognostic signatures. Risk score-based prognostic and nomogram models were constructed to predict the prognostic risk of AML. Subsequently, consistent cluster analysis was performed to stratify patients into different subtypes, and subtype-related module genes were screened using weighted gene co-expression network analysis. Results Through a series of regression analyses, HGF, ANGPTL3, MB, F2, CALR, EIF4EBP1, EPHX1, and PDHA1 were identified as potential prognostic biomarkers of AML. Prognostic and nomogram models constructed based on these genes could significantly differentiate between high- and low-risk AML with high predictive accuracy. The eight-signature also stratified patients with AML into two subtypes, among which Cluster 2 was prone to a high risk of AML prognosis. These two clusters exhibited different immune profiles. Of the subtype-related module genes, the HOXA and HOXB family genes may be genetic features of AML subtypes. Conclusion Eight Gln metabolism-related genes were identified as potential biomarkers of AML to predict prognostic risk. The molecular subtypes clustered by these genes enabled prognostic risk stratification.

Abstract Purpose The characteristic of RENT3B in cancer remains ambiguous. We aimed to study the relationship between RENT3B and immune infiltration in liver hepatocellular carcinoma (LIHC) and lung squamous cell carcinoma (LUSC). Patients and methods We investigated the expression levels of RENT3B using ONCOMINE and TIMER databases, and assessed the interrelationship between RENT3B expression and survival using PrognoScan, GEPIA, and Kaplan–Meier plotter. Additionally, we examined the association between RENT3B and immune cells in the tumor microenvironment (TME), as well as markers of immune cells, using TIMER. Subsequently, we performed prognostic analysis based on the expression level of RENT3B within specific immune cell subgroups. Furthermore, we evaluated the promoter methylation profile of RENT3B between tumor and normal tissues in LIHC and LUSC using the DNMIVD database. Results RENT3B exhibited increased levels in both in LIHC and LUSC. High RENT3B expression was associated with unfavorable prognosis in LIHC, whereas it indicated a beneficial prognosis in LUSC. In LIHC, the expression of RENT3B positively correlated with immune infiltration levels of B cells, CD4 + T cells, CD8 + T cells, neutrophils, macrophages, and dendritic cells. However, in LUSC, the expression of RENT3B showed a negative correlation with immune infiltration levels of B cells, CD8 + T cells, neutrophils, macrophages, and dendritic cells. RENT3B exhibited positive correlations with 42 immune markers in LIHC, while it displayed negative associations with 10 immune markers in LUSC. Despite variations in immune cell enrichment and reduction subgroups, high RENT3B expression consistently indicated poor prognosis in LIHC, whereas it remained favorable in LUSC. Additionally, there were no significant differences observed in RENT3B promoter methylation between tumor and normal tissues in both LIHC and LUSC. Conclusion RENT3B can affect the overall tumor prognosis and is associated with immune infiltration, especially in LIHC and LUSC. Consequently, RENT3B can become a prognostic biomarker for LIHC and LUSC.

In this paper, a seismic and vibration reduction measure of subway station is developed by setting a segmented isolation layer between the sidewall of structure and the diaphragm wall. The segmented isolation layer consists of a rigid layer and a flexible layer. The rigid layer is installed at the joint section between the structural sidewall and slab, and the flexible layer is installed at the remaining sections. A diaphragm wall-segmented isolation layer-subway station structure system is constructed. Seismic and vibration control performance of the diaphragm wall-segmented isolation layer-subway station structure system is evaluated by the detailed numerical analysis. Firstly, a three-dimensional nonlinear time-history analysis is carried out to study the seismic response of the station structure by considering the effect of different earthquake motions and stiffness of segmented isolation layer. Subsequently, the vibration response of site under training loading is also studied by considering the influence of different train velocities and stiffness of the segmented isolation layer. Numerical results demonstrate that the diaphragm wall-segmented isolation layer-subway station structure system can not only effectively reduce the lateral deformation of station structure, but also reduce the tensile damage of the roof slab. On the other hand, the developed reduction measure can also significantly reduce the vertical peak displacements of site under training loading.

Abstract The development of intracerebral hemorrhage (ICH) is a dynamic process and intervention during the acute phase of ICH is critical for subsequent recovery. Therefore, it is crucial to screen potential signature genes and therapeutic target genes in the acute phase of ICH. In this study, based on the results of mRNA sequencing in mouse ICH and mRNA sequencing of human ICH from online databases, top five potential signature genes after ICH, Tyrobp, Itgb2, Tlr2, Ptprc and Itgam, were screened. Quantitative PCR results showed higher mRNA expression of Tyrobp, Itgb2, Tlr2, Ptprc, and Itgam in the 1-, 3- and 5-day mouse ICH groups compared to the sham-operated group. Immune infiltration correlation analysis shows that the top-ranked signature gene, Tyrobp, is negatively correlated with M2 macrophages and plasma cells, and Western blot analysis shows higher expression of the Tyrobp protein in the 1-, 3-, and 5-day mouse ICH groups compared to the sham-operated group. Furthermore, immunohistochemistry revealed that TYROBP protein expression was significantly higher in human ICH tissues than in normal brain tissues. Our results suggest that Tyrobp is a signature gene in the acute phase of ICH and may be a potential target for the treatment of the acute phase of ICH.

Abstract Severe PM2.5 pollution threatens public health in India. Atmospheric stagnation traps emitted pollutants, worsening their health impacts. Global warming is anticipated to alter future stagnation patterns, impacting the effectiveness of air quality policies. Here, we develop a region-specific index that characterizes meteorological conditions driving stagnation and associated PM2.5 increases. Applying this index to an ensemble of climate models and global warming scenarios, we find that future stagnation changes result from both global CO2-driven circulation changes and local aerosol-driven meteorological responses. By 2100, we project an increase in winter stagnation in the Indo-Gangetic Plain (IGP) of 7 ± 3 days that leads to an increase in PM2.5 of ~7 ug/m3 in a high-warming and high-aerosol scenario. However, annual stagnation occurrences decrease across most of India. Thus, stringent air quality regulations in the IGP during winters will be critical to reduce surface PM2.5 concentrations as climate warms. Such regulations will directly improve air quality while reducing future stagnation occurrences, providing additional air quality benefits.

Abstract Background Rapid sequence intubation (RSI) have been shown to be effective in preventing reflux aspiration in patients with a full stomach during anaesthesia induction and endotracheal intubation. However, there is currently no standardized operation protocol or anaesthesia induction drug standard for RSI. Furthermore, there is a lack of evidence regarding the use of RSI in patients older than 65. In this study, we aimed to investigate the cardiovascular effects of different doses of alfentanil combined with propofol and etomidate during RSI in elderly patients aged 65–80 years. Methods A total of 96 patients aged 65–80 years who underwent general anaesthesia with tracheal intubation were selected for this study. The patients were randomly assigned to one of four groups using a random number table. Group A patients received an induction dose of 10 µg/kg alfentanil, group B patients received 15 µg/kg alfentanil, group C patients received 20 µg/kg alfentanil, and group D patients received 25 µg/kg alfentanil. Heart rate (HR), mean arterial pressure (MAP), cardiac index (CI), and ejection fraction (EF) were measured at three time points: 5 min before anaesthesia induction (T0), 1 min after endotracheal intubation (T1), and 5 min after endotracheal intubation (T2). Concurrently, 4 ml of arterial blood was collected from patients at three time points, and the concentrations of norepinephrine (NE) and cortisol (Cor) in plasma were detected. Occurrences of hypertension, hypotension, bradycardia and tachycardia during anesthesia induction to 5 min after tracheal intubation were noted. Results Compared with T0, the HR, MAP, NE and Cor concentrations in group A and group B were increased at the T1 and T2 time points, CI and EF values were decreased (P 0.05). Additionally, they were not significant in group D at the T1 time point (P > 0.05), but decreased at the T2 time point (P

Abstract Background Inadequate nerve regeneration and an inhibitory local microenvironment are major obstacles to the repair of spinal cord injury (SCI). The activation and differentiation fate regulation of endogenous neural stem cells (NSCs) represent one of the most promising repair approaches. Metformin has been extensively studied for its antioxidative, anti-inflammatory, anti-aging, and autophagy-regulating properties in central nervous system diseases. However, the effects of metformin on endogenous NSCs remains to be elucidated. Methods The proliferation and differentiation abilities of NSCs were evaluated using CCK-8 assay, EdU/Ki67 staining and immunofluorescence staining. Changes in the expression of key proteins related to ferroptosis in NSCs were detected using Western Blot and immunofluorescence staining. The levels of reactive oxygen species, glutathione and tissue iron were measured using corresponding assay kits. Changes in mitochondrial morphology and membrane potential were observed using transmission electron microscopy and JC-1 fluorescence probe. Locomotor function recovery after SCI in rats was assessed through BBB score, LSS score, CatWalk gait analysis, and electrophysiological testing. The expression of the AMPK pathway was examined using Western Blot. Results Metformin promoted the proliferation and neuronal differentiation of NSCs both in vitro and in vivo. Furthermore, a ferroptosis model of NSCs using erastin treatment was established in vitro, and metformin treatment could reverse the changes in the expression of key ferroptosis-related proteins, increase glutathione synthesis, reduce reactive oxygen species production and improve mitochondrial membrane potential and morphology. Moreover, metformin administration improved locomotor function recovery and histological outcomes following SCI in rats. Notably, all the above beneficial effects of metformin were completely abolished upon addition of compound C, a specific inhibitor of AMP-activated protein kinase (AMPK). Conclusion Metformin, driven by canonical AMPK-dependent regulation, promotes proliferation and neuronal differentiation of endogenous NSCs while inhibiting ferroptosis, thereby facilitating recovery of locomotor function following SCI. Our study further elucidates the protective mechanism of metformin in SCI, providing new mechanistic insights for its candidacy as a therapeutic agent for SCI.

ObjectiveTo understand the correlation between hepatitis C virus (HCV) antibodies and HCV RNA viral load in HIV co-infected individuals and to provide a basis for predicting HCV RNA based on HCV antibody detection. MethodsThe blood samples and relevant data were collected from 979 HIV-infected individuals with HCV antibody detection at the Yunnan Provincial Infectious Disease Hospital from November 2022 to March 2023. HCV antibodies were detected by enzyme-linked immunosorbent assay (ELISA), and HCV RNA was measured by real-time reverse transcription-PCR (qRT-PCR). T-test and chi-squared test were used for data analysis. ResultsAmong all participants, 17.9% (n = 176) were HCV antibody positive, and the positive rates were 17.1% (n = 110) and 19.6% (n = 66) for male and female participants, respectively. The rate of HCV antibody positivity was associated with age (χ2 = 107.662, P < 0.001), with the highest rate of 29.6% in participants aged 41 – 60 years and the lowest rate of 0% in participants younger than 20 years. Among participants who were HCV antibody positive, the HCV RNA positivity rate was 46.6%, with positive rates of 50.0% and 40.9% in male and female participants, respectively, and the positive rate was not related to age (P > 0.05). Spearman rank correlation analysis showed a positive correlation between HCV RNA positivity and HCV antibody levels (r = 0.237, P < 0.05). Receiver operating characteristic (ROC) curve analysis showed that an HCV antibody level ≥ 16.78 (signal to cutoff ratio, S/CO) indicated HCV RNA positivity. ConclusionThe rate of HCV antibody positivity was high in the HIV-infected population and positively correlated with HCV RNA levels, with an S/CO value of 16.78 being an optimal threshold for predicting HCV RNA positivity, which could be used in the diagnosis and management of patients co-infected with HIV and HCV.

Bear bile has been a valuable and effective medicinal material in traditional Chinese medicine (TCM) for over 13 centuries. However, the current practice of obtaining it through bear farming is under scrutiny for its adverse impact on bear welfare. Here, we present a new approach for creating artificial bear bile (ABB) as a high-quality and sustainable alternative to natural bear bile. This study addresses the scientific challenges of creating bear bile alternatives through interdisciplinary collaborations across various fields, including resources, chemistry, biology, medicine, pharmacology, and TCM. A comprehensive efficacy assessment system that bridges the gap between TCM and modern medical terminology has been established, allowing for the systematic screening of therapeutic constituents. Through the utilization of chemical synthesis and enzyme engineering technologies, our research has achieved the environmentally friendly, large-scale production of bear bile therapeutic compounds, as well as the optimization and recomposition of ABB formulations. The resulting ABB not only closely resembles natural bear bile in its composition but also offers advantages such as consistent product quality, availability of raw materials, and independence from threatened or wild resources. Comprehensive preclinical efficacy evaluations have demonstrated the equivalence of the therapeutic effects from ABB and those from commercially available drained bear bile (DBB). Furthermore, preclinical toxicological assessment and phase I clinical trials show that the safety of ABB is on par with that of the currently used DBB. This innovative strategy can serve as a new research paradigm for developing alternatives for other endangered TCMs, thereby strengthening the integrity and sustainability of TCM.

Abstract High-voltage transmission lines are susceptible targets for lightning strikes. It is an interesting topic how the trip event of transmission line is related to the area, location, and intensity of thunderstorms occurring at that time and that place. Based on total lightning observation containing intra-cloud and cloud-to-ground lightning, and transmission line trip information from relaying system of power system, 8 thunderstorms associated with the lightning strike trip of local transmission lines were selected in the Pearl River Delta (PRD) region. Analysis was conducted on the total lightning activity of each thunderstorm process, including the characteristics of total lightning counts and density, followed by the variations in total lightning activity before and after lightning strike trips. Further, our investigation encompassed the spatial and temporal evolution, charge structure, and kinematic parameters of thunderstorms. It was revealed that almost all lightning trips in this area emerged in close proximity to bodies of water, accompanied by a discernible reduction in thunderstorm cloud altitude during line trip occurrences. This paper aims to enhance the understanding of total lightning and thunderstorm activity behavior, thereby providing valuable insights for lightning disaster prevention and mitigation in the meteorological bureau and power system.

Background and aim: Hepatitis B virus (HBV)-related gestational acute-on-chronic liver failure (ACLF) is a severe condition with limited treatment options. This study aimed to evaluate the efficacy and ideal timing of plasma exchange and continuous renal replacement therapy (CRRT) in managing pregnant women with HBV-related ACLF. Methods: This study retrospectively analyzed 51 eligible patients with HBV-related gestational ACLF between 2009 and 2020. Patients admitted to the study were divided into a conventional treatment group and a new treatment group according to whether they received the new management protocol, which included more aggressive plasma exchange (PE) and CRRT strategies. All 19 pregnant women with hepatic encephalopathy (HE) were divided into an early treatment group and a non-early treatment group according to whether PE therapy was initiated within three days. Our study had two primary objectives. Firstly, we aimed to evaluate the impact of PE and CRRT on puerperal survival. Secondly, we sought to assess the effects of early PE and CRRT regimens on puerperal survival in women with HE. Results: The levels of total bilirubin on the second day postpartum (D3), the third day postpartum (D4), and the fifth day postpartum (D6) were significantly lower in the new treatment group compared to the conventional treatment group (P = 0.02, 0.01, and 0.02, respectively). The ALT of D3 was significantly elevated in the new treatment group compared to the conventional treatment group (P = 0.02). The incidence of HE overall increased from prenatal to postpartum D4, peaked on D4, and then gradually decreased from the fourth day postpartum (D5) （P = 0.027）. The first week after delivery revealed a significant difference in survival rate between the two groups, the conventional treatment group had statistically higher mortality rates compared to the new treatment group (P = 0.002). Similarly, the entire puerperal period mortality rate of the conventional treatment group was statistically higher than the new treatment group (P = 0.002). Moreover, among all patients with HE, the non-early treatment group showed significantly higher puerperal mortality rates compared to the early treatment group (P = 0.006). Conclusions: Early PE and CRRT conducted within three days post-childbirth, enhance puerperal prognosis for HBV-related gestational ACLF.

The precast composite reinforced concrete wall with the advantages of fewer joints, superior impermeability and rapid construction provides an efficient and environmental friendly alternative in the construction of underground utility tunnels in the last few years. To investigate the seismic performance of precast concrete composite walls of utility tunnels with grouting-sleeve connection under out-of-plane loads, a series of quasi-static cyclic tests were performed on the full-scale sidewall specimens with different axial compression ratios in this study. The experimental results including the failure modes, crack distributions, and the influence of different connections on the out-of-plane seismic performance of precast concrete composite wall were carefully examined and compared with those from the cyclic tests of the cast-in-place sidewalls of the utility tunnel. The test results show that the seismic performance of the precast concrete composite sidewall specimen, such as the hysteresis curves, the ultimate bearing capacity, stiffness degradation pattern and the ductility ratio, is basically the same as that of the cast-in-place specimen, indicating that the seismic performance of the prefabricated structure is equivalent to that of the cast-in-place structure. Moreover, the grouting-sleeves of the joints can effectively transfer the reinforcement stress until the failure of the precast concrete composite sidewall specimens, which exhibits excellent out-of-plane ductility and serviceability.