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A new species of the genus Boulenophrys is described from the coastal hills of eastern Fujian Province, China. The new taxon can be distinguished from all recognized congeners by a combination of discrete morphological character state differences and genetic divergences in the combined mitochondrial 16S + CO1 genes. We also provide a map showing the distribution pattern of Boulenophrys species in Fujian and a provincial-specific key, which will aid their conservation by helping the local authorities accurately identify species during field identifications and data collection efforts.

[Objective] The study aims to investigate the growth and physiological characteristics of Arnebia guttata along the altitudinal gradients, in order to understand its ecological adaptation mechanism under different habitat conditions and provide a theoretical basis for the conservation and utilization of the wild resources of A . guttata. [Methods] A . guttata in Wushi County in northwestern Tarim Basin was chosen as the research subject. The leaf morphology, growth indicators, photosynthetic pigments, proline, soluble osmoregulatory substances, malondialdehyde content, and the activities of antioxidant enzyme were measured at five different altitudinal sites (1 155, 1 227, 1 332, 1 533, 2 137 m). [Results] The plant height, aboveground biomass, total biomass, leaf area, specific leaf area, and the content of chlorophyll a and chlorophyll b of A . guttata were the highest at the lowest altitude (1 155 m) and decreased with increasing altitude, reaching the lowest at 2 137 m. Among them, plant height, aboveground biomass, and leaf area were decreased by 22.89%, 31.77%, and 26.58%, respectively. The minimum value of specific leaf mass, root/shoot ratio, and carotenoid content, carotenoid/chlorophyll ratio, malondialdehyde, proline, soluble sugar, and ascorbate peroxidase and peroxidase enzyme activity of A . guttata were at 1 155 m, and increased with increasing altitude, reaching the maximum at 2 137 m. [Conclusion] The environmental condition of lower altitude is conducive to the growth and biomass accumulation of A . guttata in Wushi County. As altitude rises, the physiological stress on A . guttata becomes intensified, which adapts to the harsh environment to increase the soluble osmotic substances and the activity of antioxidant enzymes.

Abstract Background This systematic review and meta-analysis aimed to investigate the differences in hallux valgus angle (HVA), intermetatarsal angle (IMA), American Orthopedic Foot and Ankle Society (AOFAS) scores, and complication rates between chevron osteotomy and scarf osteotomy for correcting hallux valgus. Methods Two investigators independently searched for randomized controlled trials (RCTs) published from 2007 to 2018 on PubMed, Web of Science, and Cochrane Library databases. Next, chevron and scarf osteotomies were compared for their postoperative outcomes using HVA, IMA, and AOFAS scores and their complication rates. Meta-analysis was performed using Review Manager (version 5.3). Results Six RCTs—comprising 507 feet, of which 261 and 246 underwent chevron and scarf osteotomies, respectively—were included. The meta-analysis revealed that chevron osteotomy led to significantly smaller postoperative HVAs than scarf osteotomy (weighted mean difference [WMD] = -1.94, 95% CI = − 2.65 to − 1.29, P

Abstract Background Prior research has highlighted the synergistic impact of protein supplementation on muscle function post‐exercise in adults; however, evidence supporting the combined effects were less robust and inconsistent on those with protein insufficiency. This investigation aims to explore efficacy of protein‐enriched soup coupled with exercise on muscle health and metabolism in middle‐aged and older adults with suboptimal protein intake. Methods An open‐label, 12‐week, randomized controlled trial involving participants with insufficient protein intake (

Background The association between nonalcoholic fatty liver disease and cardiovascular disease is firmly established, yet the association between noninvasive liver fibrosis scores and cardiovascular events remains a topic of uncertainty. Our study aimed to explore the association between liver fibrosis and heart failure. Methods and Results The data set was from the National Health and Nutrition Examination Survey 2011 to 2018. Advanced hepatic fibrosis risk was assessed through 3 noninvasive liver fibrosis scores: Fibrosis‐4 score (FIB‐4), the nonalcoholic fatty liver disease fibrosis score (NFS), and the aspartate aminotransferase to platelet ratio index (APRI). We included 19 695 eligible participants. The national prevalence of advanced liver fibrosis risk in the United States was 4.20%, 8.06%, and 0.35% as determined by FIB‐4, NFS, and APRI scores, respectively. Weighted logistic regression analysis revealed significant associations between advanced liver fibrosis risk and the prevalence of heart failure (continuous variables, FIB‐4: odds ratio [OR], 1.15 [95% CI, 1.07–1.23]; NFS: OR, 1.42 [95% CI, 1.23–1.64]; APRI: OR, 1.44 [95% CI, 1.15–1.81]). When the scores were assessed as categorical variables, the results were still significant (FIB‐4 ≥2.67 versus FIB‐4

Background: Elevated circulatory phosphate levels are linked to age-related muscle dysfunction, yet the mechanisms remain unclear. This study investigated the hypothesis that inflammation plays a role in connecting elevated phosphate levels to muscular dysfunction in middle-aged and older individuals and explored potential sex-based differences in these associations. Methods: The study, based on the I-Lan Longitudinal Aging Study Cohort, analyzed individuals' serum phosphate and hsCRP levels. Sex-specific analyses explored links between circulatory phosphate, inflammation, and muscle profiles (mass, handgrip strength, and walking speed). The study also examined potential mediation or synergistic effects of inflammation in the circulatory phosphate-muscle relationship. Results: The study included 2006 participants (mean age: 65.5 ± 6.5 years; 49.8 % men). Women exhibited higher circulatory phosphate levels than men. Linear analyses revealed that higher phosphate levels were significantly associated with weaker handgrip strength but not with reduced muscle mass in both men and women. In women, circulatory phosphate was not associated with inflammation (hsCRP levels), while in men, higher phosphate levels were significantly associated with higher hsCRP levels. In men, a synergistic effect was observed, where the combination of high hsCRP and elevated phosphate levels had a more pronounced impact on reducing handgrip strength than either factor alone. Conclusions: This study highlights a sex-specific association of inflammation in the mechanisms of hyperphosphatemia-related muscle weakness. The findings emphasize the importance of managing both hyperphosphatemia and chronic inflammation to mitigate their collective impact on muscle function, particularly in older men. Addressing these factors is crucial for promoting muscle health in later life.

Objectives: To develop an intrinsic capacity (IC) score and to investigate the association between IC transition with overall and cause-specific mortality, incident disability and healthcare utilization. Design: Retrospective cohort study Setting and participants: Data from 1852 respondents aged ≥ 65 years who completed the 1999 and 2003 surveys of the Taiwan Longitudinal Study on Aging were analyzed. Measurements: Transitions of IC score were categorized into three groups: (1) Improved IC (IC2003−1999 >0), (2) Stable IC (IC2003−1999 = 0), (3) Worsened IC (IC2003−1999

Abstract Background Studies have suggested that blood circulating phytosterols, plant-derived sterols analogous to cholesterol, were associated with blood lipid levels and the risk of Alzheimer’s disease (AD) and Parkinson’s disease (PD). This Mendelian randomization (MR) study is performed to determine the causal effect of circulating phytosterols on AD and PD and evaluate the mediation effect of blood lipids. Methods Leveraging genome-wide association studies summary-level data for phytosterols, blood lipids, AD, and PD, univariable and multivariable MR (MVMR) analyses were conducted. Four types of phytosterols (brassicasterol, campesterol, sitosterol, and stigmasterol), three blood lipids parameters (high-density lipoprotein cholesterol [HDL-C], non-HDL-C, and triglyceride), two datasets for AD and PD were used. Inverse-variance weighted method was applied as the primary analysis, and false discovery rate method was used for adjustment of multiple comparisons. Results Using the largest AD dataset, genetically proxied higher levels of stigmasterol (OR = 0.593, 95%CI = 0.431–0.817, P = 0.004) and sitosterol (OR = 0.864, 95%CI = 0.791–0.943, P = 0.004) significantly correlated with a lower risk of AD. No significant associations were observed between all four types of phytosterols levels and PD. MVMR estimates showed that the above causal associations were missing after integrating the blood lipids as exposures. Sensitivity analyses confirmed the robustness of these associations, with no evidence of pleiotropy and heterogeneity. Conclusion The study supports a potential beneficial role of blood stigmasterol and sitosterol in reducing the risk of AD, but not PD, which is dependent on modulating blood lipids. These insights highlight circulating stigmasterol and sitosterol as possible biomarkers and therapeutic targets for AD.

Background: Sarcopenia and intrinsic capacity (IC) declines pose significant challenges to healthy aging, particularly in the rapidly growing octogenarian population. This study aimed to elucidate the relationship between sarcopenia and declines in IC across multiple cohorts of community-dwelling older adults. Methods: Data from four Taiwanese cohorts were analyzed. Sarcopenia was diagnosed based on the Asian Working Group for Sarcopenia (AWGS) 2019 criteria (algorithm 1: categorized as either having possible sarcopenia or not (robust); algorithm 2: categorized as robust, possible sarcopenia or sarcopenia). IC was operationalized using the World Health Organization's Integrated Care for Older People (ICOPE) framework (step 1 and step 2), encompassing six domains: locomotion, vitality, vision, hearing, cognition, and psychological well-being. Multivariable logistic regression models were adopted to assess the association between sarcopenia and IC decline. Results: Among 599 octogenarians (median age 82.2 years, 54.8% male), the prevalence of possible sarcopenia (algorithm 1) was 64.6%. When adopting algorithm 2, the prevalence of possible sarcopenia and sarcopenia was 46,2% and 32.1%, respectively. After adjusting for covariates, participants with possible sarcopenia or sarcopenia (algorithm 2) were more likely to exhibit declines in vitality (ICOPE Step 1: possible sarcopenia aOR 3.65, sarcopenia aOR 4.74; ICOPE Step 2: possible sarcopenia aOR 5.11, sarcopenia aOR 14.77) and cognition (ICOPE Step 1: possible sarcopenia aOR 2.40, sarcopenia aOR 2.12; ICOPE Step 2: possible sarcopenia aOR 2.02, sarcopenia aOR 2.51) compared to robust individuals. Conclusions: This study underscores the robust association between sarcopenia and declines in vitality and cognition among octogenarians, highlighting the importance of sarcopenia screening and management in promoting healthy longevity in this vulnerable population.

Abstract Chronic diseases often lead to metabolic disorders, causing anabolic resistance and increased energy consumption, which result in cachexia. Cachexia, in turn, can lead to major clinical consequences such as impaired quality of life, shortened life expectancy, and increased healthcare expenditure. Existing international diagnostic criteria for cachexia employ thresholds derived from Western populations, which may not apply to Asians due to differing body compositions. To address this issue, the Asian Working Group for Cachexia (AWGC) was initiated. The AWGC comprises experts in cachexia research and clinical practice from various Asian countries and aims to develop a consensus on diagnostic criteria and significant clinical outcomes for cachexia in Asia. The AWGC, composed of experts in cachexia research and clinical practice from several Asian countries, undertook three‐round Delphi surveys and five meetings to reach a consensus. Discussions were held on etiological diseases, essential diagnostic items for cachexia, including subjective and objective symptoms and biomarkers, and significant clinical outcomes. The consensus highlighted the importance of multiple diagnostic factors for cachexia, including chronic diseases, either or both weight loss or low body mass index, and at least one of the following: anorexia, decreased grip strength (5 mg/L [0.5 mg/dL]). The AWGC proposed a significant weight change of 2% or more over a 3–6 month period and suggested a tentative cut‐off value of 21 kg/m2 for low body mass index in diagnosing cachexia. Critical clinical outcomes were determined to be mortality, quality of life as assessed by tools such as EQ‐5D or the Functional Assessment of Anorexia/Cachexia Therapy, and functional status as measured by the Clinical Frailty Scale or Barthel Index, with significant emphasis on patient‐reported outcomes. The AWGC consensus offers a comprehensive definition and user‐friendly diagnostic criteria for cachexia, tailored specifically for Asian populations. This consensus is set to stimulate future research and enhance the multidisciplinary approach to managing cachexia. With plans to develop further guidelines for the optimal treatment, prevention, and care of cachexia in Asians, the AWGC criteria are expected to drive research across chronic co‐morbidities and cancer in Asia, leading to future refinement of diagnostic criteria.

A longstanding quest in material science has been the development of superhydrophobic coating based on a single material, without the requirement of fluorination or silane treatment. In this work, the micro-arc oxidation (MAO) coating as transition layer can effectively enhance the bonding force of the superhydrophobic coating. The semiconductor@metal organic frameworks (MOFs) core-shell structure was synthesized by a simple self-templating method, and obtained ZnO@2-methylimidazole zinc salt (ZIF-8) nanorods array on magnesium (Mg) alloy. ZnO nanorods not only act as the template but also provide Zn2+ for ZIF-8. In addition, we proved that the ligand concentration, synthesis time and temperature are the keys to the preparation of ZnO@ZIF-8 nanorods. As we expect, the ZnO@ZIF-8 nanorods array can trap air in the gaps to form an air layer, and the coating exhibits superhydrophobic properties (154.81°). Excitingly, ZnO@ZIF-8 nanorods array shown a superhydrophobic property, without the requirement of fluorination or silane treatment. The results shown that the coating has good chemical stability and self-cleaning performance. Meanwhile, the corrosion resistance has been significantly improved, Rct was increased from 1.044×103 to 1.414×106 Ω/cm2 and Icorr was reduced from 4.275×10−5 to 5.611×10−9 A/cm2. Therefore, the semiconductor@MOFs core-shell structure has broad application prospects in anti-corrosion.

Objective To study the effect of triptolide(TPL)combined with chemotherapy drug doxorubicin(DOX)on apoptosis of human breast cancer cell line MCF-7 and its molecular mechanism. Methods MCF-7 cells were treated with triptolide and different concentrations of doxorubicin alone or in combination. Cell viability was analyzed by CCK-8 method with the combination index calculated. Cell proliferation was detected by plate cloning formation assay. Cell apoptosis and cell cycle were detected by flow cytometry. The expressions of apoptosis-related proteins Bcl-2, Bax, cleaved caspase-3 and proteins in PI3K/AKT signaling pathway were analyzed by Western blot. Results Triptolide combined with different concentrations of doxorubicin significantly inhibited cell proliferation as compared with the doxorubicin group alone after incubation for 24, 48 and 72 hours(P＜0.05). The clone formation was restrained and the cell apoptosis rate was significantly higher(P＜0.01). The expressions of Bax and cleaved caspase-3 was up-regulated, and the expressions of Bcl-2, p-PI3K, p-AKT was down-regulated(P＜0.05). The cells were blocked in S phase after combination treatment of the two drugs(P＜0.05). Conclusions The combination of triptolide and doxorubicin significantly increases the sensitivity of MCF-7 cells to doxorubicin and promotes the apoptosis of cells, which might be related to the inhibition of PI3K/AKT signaling pathway.

The Three-River Headwaters (TRH) region in the Tibetan Plateau is vulnerable to climate change; changes in summer (June–August) precipitation have a significant impact on water security and sustainability in both local and downstream areas. However, the changes in summer precipitation of different intensities over the TRH region, along with their influencing factors, remain unclear. In this study, we used observational and ERA5 reanalysis data and employed a precipitation categorization and water vapor budget analysis to quantify the categorized precipitation variations and investigate their possible linkages with the water vapor budget. Our results showed an increasing trend in summer precipitation at a rate of 0.9 mm per year (p

Mg alloys are considered the most promising engineering materials because of their unique properties. However, the uncontrolled corrosion rate of these alloys limits their applications. Therefore, in this study, a micro-arc oxidation layer was used as a transition layer to “directly” grow a zinc-based metal-organic framework (MOF) composite coating on the surface of a Mg alloy (AZ91D). Herein, the two zeolitic imidazolate framework (ZIF-8) coatings with different morphologies were separately prepared by homologous metal oxide induction and a one-step in-situ growth method. The superhydrophobic composite coating showed strong hydrophobicity and self-cleaning properties, which could prevent the penetration of water and corrosive ions (Cl−) into the surface of AZ91D. Electrochemical tests demonstrated that the super-hydrophobic composite coatings greatly enhanced the corrosion resistance of AZ91D, and the corrosion current density decreased from 10−5 to 10−9 A/cm2. These results indicate that the ZIF-8 coatings are beneficial for improving the hydrophobicity and enhancing the corrosion resistance of Mg alloys. Therefore, MOF composite coatings provide a new strategy that can be used to prepare multifunctional anticorrosion coatings on metal substrates.

To improve estimating accuracy in the traditional mean rank or median rank estimation method, an improved mean rank is proposed in the correction principle of rank estimation function as the cumulative distribution function of samples by adjusting the applicable points of natural mean rank. Then a least squares estimation is performed by directly fitting the cumulative distribution function. Based on the hypothesis of Weibull distribution under small sample, the parameter estimations under different ranks are calculated by Monte Carlo simulation. The results indicate that the relative error on calculating scale parameter using the improved mean rank method for the Weibull distribution with different parameters is less than 9.5% under the condition of sample size not less than 4. Furthermore, the relative error on calculating mean time between failures using the improved mean rank method is less than 8.7%, while the relative errors using traditional methods are higher than 16%. From calculated results, proposed method can effectively improve the parameter estimation accuracy for Weibull distribution.

To solve the problems of complex calculation and weak applicability of the traditional interval estimation methods such as Weibull distribution with the different parameters, a simple interval estimation method suitable to the conditions of multi-parameters was proposed. Through the expression of Weibull distribution, the pivotal-variable obeying chi-square distribution was obtained and the degrees of freedom were modified. Combined with the point estimation results from maximum likelihood estimation and the empirical estimation shape parameter in the Weibull distribution, the interval estimation method of two parameters in Weibull distribution was established. The confidence of proposed interval estimation method was verified by Monte Carlo simulation, and the applicability of the method on different parameters was also analyzed. Furthermore, comparisons with the results computed from traditional least square and maximum likelihood estimation methods were carried out by using simulation. Simulation results indicated that the modified pivotal-variable method has simple calculation process and small deviation from predefined nominal confidence with the different parameters. Therefore, it can be concluded that proposed method executes the more effective estimation than the traditional methods.

BackgroundDementia development is a complex process in which the occurrence and sequential relationships of different diseases or conditions may construct specific patterns leading to incident dementia. ObjectiveThis study aimed to identify patterns of disease or symptom clusters and their sequences prior to incident dementia using a novel approach incorporating machine learning methods. MethodsUsing Taiwan’s National Health Insurance Research Database, data from 15,700 older people with dementia and 15,700 nondementia controls matched on age, sex, and index year (n=10,466, 67% for the training data set and n=5234, 33% for the testing data set) were retrieved for analysis. Using machine learning methods to capture specific hierarchical disease triplet clusters prior to dementia, we designed a study algorithm with four steps: (1) data preprocessing, (2) disease or symptom pathway selection, (3) model construction and optimization, and (4) data visualization. ResultsAmong 15,700 identified older people with dementia, 10,466 and 5234 subjects were randomly assigned to the training and testing data sets, and 6215 hierarchical disease triplet clusters with positive correlations with dementia onset were identified. We subsequently generated 19,438 features to construct prediction models, and the model with the best performance was support vector machine (SVM) with the by-group LASSO (least absolute shrinkage and selection operator) regression method (total corresponding features=2513; accuracy=0.615; sensitivity=0.607; specificity=0.622; positive predictive value=0.612; negative predictive value=0.619; area under the curve=0.639). In total, this study captured 49 hierarchical disease triplet clusters related to dementia development, and the most characteristic patterns leading to incident dementia started with cardiovascular conditions (mainly hypertension), cerebrovascular disease, mobility disorders, or infections, followed by neuropsychiatric conditions. ConclusionsDementia development in the real world is an intricate process involving various diseases or conditions, their co-occurrence, and sequential relationships. Using a machine learning approach, we identified 49 hierarchical disease triplet clusters with leading roles (cardio- or cerebrovascular disease) and supporting roles (mental conditions, locomotion difficulties, infections, and nonspecific neurological conditions) in dementia development. Further studies using data from other countries are needed to validate the prediction algorithms for dementia development, allowing the development of comprehensive strategies to prevent or care for dementia in the real world.

The J-TEXT capability is enhanced compared to two years ago with several upgrades of its diagnostics and the increase of electron cyclotron resonance heating (ECRH) power to 1 MW. With the application of electron cyclotron wave (ECW), the ECW assisted plasma startup is achieved; the tearing mode is suppressed; the toroidal injection of 300 kW ECW drives around 24 kA current; fast electrons are generated with toroidal injected ECW and the runaway current conversion efficiency increases with ECRH power. The mode coupling between 2/1 and 3/1 modes are extensively studied. The coupled 2/1 and 3/1 modes usually lead to major disruption. Their coupling can be either suppressed or avoided by external resonant magnetic perturbation fields and hence avoids the major disruption. It is also found that the 2/1 threshold of external field is significantly reduced by a pre-excited 3/1 mode, which can be either a locked island or an external kink mode. The disruption control is studied by developing prediction methods capable of cross tokamak application and by new mitigation methods, such as the biased electrode or electromagnetic pellet injector. The high-density operation and related disruptions are studied from various aspects. Approaching the density limit, the collapse of the edge shear layer is observed and such collapse can be prevented by applying edge biasing, leading to an increased density limit. The density limit is also observed to increase, if the plasma is operated in the poloidal divertor configuration or the plasma purity is increased by increasing the pre-filled gas pressure or ECRH power during the start-up phase.

Abstract Purpose The purpose was to explore the effect of drug-eluting beads transarterial chemoembolization (DEB-TACE) on down-staging in unresectable liver cancer patients. Methods A total of 180 patients with PHC treated by TACE were retrospectively analyzed. These included 80 cases in the DEB-TACE group and 100 cases in the cTACE group. Of these, 56 had complete clinical data (DEB-TACE: 24, cTACE: 32), and 23 patients received hepatectomy after TACE as a down-staging therapy (DEB-TACE: 15, cTACE: 8). Data (including clinical characteristics, clinical efficacy, tumor response, tumor diameters, residual liver volume, and liver function indexes before and after TACE, RFS, OS, and complications were collected and compared. Treatment response was evaluated at 1 month after TACE. Tumor diameter was evaluated by abdominal computed tomography scan. The residual liver volume was evaluated by IQQA liver system, and relapse-free survival (RFS) and overall survival (OS) were calculated by Kaplan–Meier curves. Results The conversion rate in DEB-TACE group was higher than cTACE group (18.8% vs 8%, p = 0.032). In DEB-TACE group, 17 patients achieved objective response rate (ORR) which was higher than cTACE group (70.8% vs 34.4%, p = 0.007). The tumor necrosis rate was higher in DEB-TACE group, but there was no significant difference between the two groups (p = 0.053). Tumor diameter was decreased after TACE compared to before TACE (DEB-TACE: 9.4 ± 3.3 vs. 5.4 ± 3.5 cm, p = 0.003; cTACE: 9.7 ± 2.6 vs. 6.9 ± 2.2, p = 0.036). As to residual liver volume, it was increased after TACE compared to before TACE (1066.2 cm3 vs. 1180.3 cm3, p = 0.007) in DEB-TACE group, while there was no significant difference in cTACE group (1046.4 cm3 vs. 1170 cm3, p = 0.339) compared by paired-sample t-test, but there was no significant difference before and after TACE when compared by unpaired-sample t-test (p > 0.05). After TACE at 1 month, the AFP level in the DEB-TACE group was significantly lower than that in the cTACE group (p = 0.003). For survival, the median RFS was 26.0 months in DEB-TACE group and 15 months in cTACE group; there was significant difference between the two groups (p = 0.0465). As to OS, the median OS in DEB-TACE group was higher than that in cTACE group, but there was no significant difference between the two groups (p = 0.165). For safety profiles, in terms of liver function and adverse events, there was no significant difference between the two groups. Conclusion Compared with cTACE, DEB-TACE might be a more efficient and safety down-staging treatment in unresectable liver cancer patients.