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Background: Avoidance of colonoscopy is often associated with fear, embarrassment, and disgust aroused in screening procedures. However, each emotion can be linked to different challenges faced by patients. More research is needed to evaluate and address the causes of these respective emotions. Aim: The purpose of this study was to develop and assess the scales of three negative emotions (i.e., fear, embarrassment, and disgust) caused by specific issues in colonoscopy screening. Method: The measurement items were developed based on multiple common barriers in colonoscopy screening procedures. An online sample of 232 adults aged 45-75 was recruited from Amazon Mechanical Turk to test the scales. Explorative and confirmatory factor analyses were conducted to validate the measurement models. Results: Psychometric evidence demonstrated the factor structures of three negative emotions. Each emotional factor was caused by unique combinations of barriers in the preparation, screening, and recovery stages of colonoscopy. Most of the emotional factors were associated with attitudes and screening intention. Conclusion: This study showed different dimensions of negative emotions and their underlying causes in colonoscopy. These findings will help assess specific causes of negative emotions in colonoscopy and develop effective interventions to improve screening uptake.

Introduction: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease typically characterized by chronic airway inflammation, with emerging evidence highlighting the driving role of cellular senescence-related lung aging. Accelerated lung aging and inflammation mutually reinforce each other, creating a detrimental cycle that contributes to disease progression. Growth arrest and DNA damage-inducible (GADD45) family has been reported to involve in multiple biological processes, including inflammation and senescence. However, the role of GADD45 family in COPD remains elusive. Objectives: To investigate the role and mechanism of GADD45 family in COPD pathogenesis. Methods: Expressions of GADD45 family were evaluated by bioinformatic analysis combined with detections in clinical specimens. The effects of GADD45B on inflammation and senescence were investigated via constructing cell model with siRNA transfection or overexpression lentivirus infection and animal model with Gadd45b knockout. Targeted bisulfite sequencing was performed to probe the influence of DNA methylation in GADD45B expression in COPD. Results: GADD45B expression was significantly increased in COPD patients and strongly associated with lung function, whereas other family members presented no changes. GADD45B upregulation was confirmed in mice exposed by cigarette smoke (CS) and HBE cells treated by CS extract as well. Moreover, experiments involving bidirectional modulation of GADD45B expression in HBE cells further substantiated its positive regulatory role in inflammatory response and cellular senescence. Mechanically, GADD45B-facilitated inflammation was directly mediated by p38 phosphorylation, while GADD45B interacted with FOS to promote cellular senescence in a p38 phosphorylation-independent manner. Furthermore, Gadd45b deficiency remarkably alleviated inflammation and senescence of lungs in CS-exposed mice, as well as improved emphysema and lung function. Eventually, in vivo and vitro experiments demonstrated that GADD45B overexpression was partially mediated by CS-induced DNA hypomethylation. Conclusion: Our findings have shed light on the impact of GADD45B in the pathogenesis of COPD, thereby offering a promising target for intervention in clinical settings.

The pivotal role of color imagery analysis and activation has been insufficiently explored in the realm of historic heritage conservation. This study addresses this issue by introducing a comprehensive methodological framework that encompasses acquisition, analysis, activation, and application of color information based on the NCD (Nippon Color & Design) color system, an innovative color semantic quantification theory. Utilizing the venerable Yuelu Academy (from A.D. 976) as a case study, color imagery analysis methods across diverse spatial scales have been summarized. Subsequently, these results are applied to activate the surrounding environment color, as well as its cultural souvenirs. The methodologies outlined herein hold profound significance in addressing challenges concerning visual color continuity in the preservation of historic architectural landscapes, offering innovative perspectives.

Abstract Background Discs large homolog 2 (DLG2) has been implicated in cancer development, yet its role in cervical cancer remains unclear. This study aims to explore the regulatory mechanism of DLG2 in cervical cancer and its clinical implications. Methods Quantitative reverse transcription polymerase chain reaction and western blotting assays were employed to detect RNA and protein expression, respectively. Colony formation assay, 5-Ethynyl-2’-deoxyuridine assay, flow cytometry, and transwell assays were conducted for cell functional analysis. A xenograft mouse model assay was performed to analyze tumor tumorigenesis in vivo. m6A RNA immunoprecipitation assay was used to analyze the association of METTL3 and DLG2. Results DLG2 was underexpressed in cervical cancer tissues and cells. Elevating DLG2 levels significantly suppressed cervical cancer cell proliferation, migration, and invasion, while promoting apoptosis. Additionally, DLG2 overexpression led to the deactivation of the Hippo/YAP signaling pathway. In vivo, DLG2 overexpression was shown to reduce tumor formation. We also discovered that METTL3 destabilized DLG2 mRNA through an m6A-dependent mechanism. Moreover, lowering DLG2 expression mitigated the effects of METTL3 silencing on cervical cancer cell malignancy. Conclusion DLG2 acted as a tumor suppressor in cervical cancer by inhibiting the Hippo/YAP signaling pathway. The METTL3-dependent regulation of DLG2 mRNA stability could be a critical factor in cervical cancer progression.

Growing evidence has linked extreme temperature with neuropsychiatric disorders under climate warming with frequent extreme heat events over the past decades, while cognitive performance in relation to heat exposure remains largely unstudied, particularly in populations at high vulnerability to climate risks (e.g., China). Based on five survey waves of a nationwide dynamic cohort (2011–2020), we analyzed 47,825 cognitive test records from 14,729 respondents aged 45+ years across 126 Chinese cities. Global cognitive performance and its two dimensions (episodic memory and mental status) was measured using standardized questionnaires. Temperature exposure prior to cognitive tests was assessed using both average temperatures and heat days exceeding predefined temperature thresholds. Linear mixed-effects models were utilized to examine the relationship between high temperature exposure and cognitive function. This study revealed consistent evidence for heat-related declines in global cognitive performance and episodic memory across multiple exposure-window analyses, while robust associations were observed solely during prolonged exposure periods (more than 90 d) for mental status. For each 1-°C rise in annual mean temperature within 1 year prior to investigation, cognitive scores declined by 0.058 (95% CI: −0.079, −0.037) points for global performance, 0.033 (95% CI: −0.048, −0.018) points for episodic memory, and 0.025 (95% CI: −0.038, −0.013) points for mental status, respectively. Similar findings were seen in analyses using heat exposure days defined by multiple temperature percentiles, linking per 10-d increase in heat duration to reduced global cognitive scores ranging from −0.142 (95% CI: −0.214, −0.070) to −0.168 (95% CI: −0.254, −0.082). Despite varied evidence by heat exposure metrics and cognitive dimensions, stratified analyses suggested possibly higher susceptibility among females, less-educated, and urban-dwelling residents to heat-related cognitive impairment. These results provided suggestive evidence for the role of exposure to heat in triggering cognitive impairment in middle-aged and older individuals. This finding may be crucial in developing public health strategies for managing climate change risks of neurobehavioral disorders in a healthy aging society.

For many years, oil and natural gas geochemistry has been key to hydrocarbon exploration and exploitation in offshore China. Onshore oil fields have been thoroughly explored and exploited and have now entered the later stages of development. However, the oil and gas resources in the offshore basin of China are still abundant, and they have been relatively little explored, so they will be the main growth target for oil and gas production in the future. China has made many breakthroughs in offshore oil exploration in recent years. A large condensate field—Bozhong 19-6—has been discovered in the Bozhong Depression. Its main source rock is associated with algal blooming in the third member of the Shahejie Formation. The Baodao 21-1 gas field in the Qiongdongnan Basin shows clear signs of receiving terrestrial organic matter from the Yacheng and Lingshui formations. The first ultra-deep water and ultra-shallow gas, found in the Lingshui 36-1 gas field in the Qiongdongnan Basin, has thermogenetic and biogenetic origins. Well WY-1 in the Weixinan Depression marked the initiation of offshore shale oil exploration. Its sweet interval consists of two stable oil shale beds developed at the base and the top of the second member of the Liushagang Formation. However, samples from offshore exploration are often severely contaminated, and the corresponding data can be seriously distorted, which yields fewer core and more cutting samples. Therefore, it is necessary to thoroughly screen test data and to apply decontamination treatment and data correction to contaminated samples. The success rate of offshore exploration usually relies on the accurate prediction of source kitchens. Reservoir geochemistry thus has great significance for the future, as source input geochemical information can be used to trace materials backwards, and source kitchens can be predicted, when geochemistry is combined with enrichment and development models of source rocks and geophysical data.

Abstract Purpose To evaluate the utility of apparent diffusion coefficient (ADC) values of extraocular muscles (EOMs) in differentiating activity of thyroid eye disease (TED). Method Forty-two TED patients who underwent diffusion tensor imaging(DTI) were retrospectively enrolled in this study, including 29 patients in analysis group and 13 patients in validation group. The mean, maximum and minimum ADC value of each EOM were regarded as ADCmean, ADCmax and ADCmin. The difference between ADCmax and ADCmin was regarded as △ADC. The correlations between ADCmean or △ADC of each EOM and clinical activity score (CAS) were assessed. Results In analysis group, ADCmean differed between active and inactive eyes and positively correlated with CAS in IR (P 0.05). While △ADC differed between two groups and negatively correlated with CAS in all EOMs (all P

Nonalcoholic fatty liver disease (NAFLD) is an escalating global health issue, leading to liver fat accumulation, inflammation, fibrosis, and potential liver failure. In our preliminary network pharmacological study, it was hypothesized that Pedalitin (PED), a flavonoid found in black sesame plants, might exhibit protective effects against NAFLD. However, the effects and mechanisms of PED underlying its action on NAFLD are not yet fully understood. This study aimed to explore the potential effects and mechanisms of PED on NAFLD using a combination of network pharmacology, molecular docking, and the LO2 cell model. Potential targets for PED and NAFLD were predicted through public databases. Protein-protein interaction (PPI) networks were constructed, and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed. Molecular docking was used to predict the target genes that could bind to PED. In vitro experiments using the LO2 cell model indicated that PED significantly reduced TG level (p ​

Abstract Introduction The COVID-19 pandemic overwhelmed health systems, resulting in a surge in excess deaths. This study clustered countries based on excess mortality to understand their response to the pandemic and the influence of various factors on excess mortality within each cluster. Materials and Methods This ecological study is part of the COVID-19 MORtality (C-MOR) Consortium. Mortality data were gathered from 21 countries and were previously used to calculate weekly all-cause excess mortality. Thirty exposure variables were considered in five categories as factors potentially associated with excess mortality: population factors, health care resources, socioeconomic factors, air pollution, and COVID-19 policy. Estimation of Latent Class Linear Mixed Model (LCMM) was used to cluster countries based on response trajectory and Generalized Linear Mixture Model (GLMM) for each cluster was run separately. Results Using LCMM, two clusters were reached. Among 21 countries, Brazil, the USA, Georgia, and Poland were assigned to a separate cluster, with the mean of excess mortality z-score in 2020 and 2021 around 4.4, compared to 1.5 for all other countries assigned to the second cluster. In both clusters the population incidence of COVID-19 had the greatest positive relationship with excess mortality while interactions between the incidence of COVID-19, fully vaccinated people, and stringency index were negatively associated with excess mortality. Moreover, governmental variables (government revenue and government effectiveness) were the most protective against excess mortality. Conclusion This study highlighted that clustering countries based on excess mortality can provide insights to gain a broader understanding of countries' responses to the pandemic and their effectiveness.

Abstract Silicon photonics enables the construction of chip-scale spectrometers, in which those using a single tunable interferometer provide a simple and cost-effective solution. Among various tuning mechanisms, electrostatic MEMS reconfiguration stands out as an ideal candidate, given its high tuning efficiency and ultra-low power consumption. Nonetheless, MEMS devices face significant noise challenges arising from their susceptible minuscule components, adversely impacting spectral resolution. Here, we propose a distinct paradigm of spectrometers through synergizing an easily-fabricated MEMS-reconfigurable low-loss waveguide coupler on a silicon photonic chip and a convolutional autoencoder denoising (CAED) mechanism. The spectrometer offers a 300 nm bandwidth and a reconstruction resolution of 0.3 nm in a noise-free condition. In a noisy environment with a signal-to-noise ratio as low as 30 dB, the reconstruction resolution of the interferograms processed by the CAED exhibits an enhancement from 1.2 to 0.4 nm, approaching the noise-free value. Our technology is envisaged to provide a powerful and cost-effective solution for applications requiring accurate, broadband, and energy-efficient spectral analysis.

[Introduction] The realization of "dual carbon" goals in the construction of a new power system necessitates the transformation of existing thermal power plants to accommodate peak load operations. The safety of thermal power units during flexible operation is a critical element for enhancing the overall stability of the power system. Air preheater is the key auxiliary equipment that affects the wide-load operation capacity of thermal power units. This paper addresses the challenges associated with flue gas temperature fluctuations and blockage and corrosion induced by excessive ammonia injection. It is very important to develop a real-time assessment and safety status monitoring model for dust and blockage of rotary air preheaters. [Method] Based on the big data of wide-load operation monitoring of 600 MW and 350 MW units in central China, the paper developed a model for air preheater blockage assessment based on approximation of the resistance coefficients in the case of various time scales. Furthermore, the flue gas temperature at the outlet of the air preheater and the cold end working temperature were used as monitoring indicators to count the proportion of parameters exceeding the limit in multiple load sections of the unit. [Result] The results show that, at a peak regulation load of 39%, there is approximately a 20% probability of temperature exceedance. In addition, the independent calculation of the blockage risk based on the two indicators may result in a certain degree of underestimation of its degradation rate compared to the calculation based on a joint distribution. Besides, with the verification of data from the two units, the method can quantify the short-term (within the soot-blowing cycle) and mid-and-long term evolution of the air preheater blockage. [Conclusion] This assessment strategy applies to other equipment and systems in thermal power plants, such as SCR denitrification systems and coal mills, providing a quantitative assessment of safety risks during peak load operation. It guides thermal power units to efficiently and stably cooperate with the new power system in dispatching.

Abstract Background The integration of multi-omics data through deep learning has greatly improved cancer subtype classification, particularly in feature learning and multi-omics data integration. However, key challenges remain in embedding sample structure information into the feature space and designing flexible integration strategies. Results We propose MoAGL-SA, an adaptive multi-omics integration method based on graph learning and self-attention, to address these challenges. First, patient relationship graphs are generated from each omics dataset using graph learning. Next, three-layer graph convolutional networks are employed to extract omic-specific graph embeddings. Self-attention is then used to focus on the most relevant omics, adaptively assigning weights to different graph embeddings for multi-omics integration. Finally, cancer subtypes are classified using a softmax classifier. Conclusions Experimental results show that MoAGL-SA outperforms several popular algorithms on datasets for breast invasive carcinoma, kidney renal papillary cell carcinoma, and kidney renal clear cell carcinoma. Additionally, MoAGL-SA successfully identifies key biomarkers for breast invasive carcinoma.

Global inland surface water bodies such as lakes and reservoirs, important components of the hydrosphere and ecosphere, are increasingly affected by climate change. Generating bathymetric volume-area-height (BVAH) curves for global inland surface water bodies can enhance our understanding of their topography and climate impacts. However, accurately quantifying the topographic patterns of these water bodies remains challenging due to the difficulties in collecting comprehensive bathymetric data. Therefore, we collected and processed over 2000 bathymetric maps of global water bodies from over 50 different data sources and then developed the BVAH model. Finally, the BVAH hydrological curves of 16671 global inland surface water bodies (larger than 10 km2) were generated. The results include but are not limited to (1) For most targeted water bodies, area (A) and volume (V) exhibit significant power function relationships with surface heights (H), with optimal power values quantified as 1.42 for A and 2.42 for V. (2) The BVAH model outperforms GLOBathy in estimating area and volume changes, achieving higher correlation coefficients (CC) of approximately 0.962 for the area and 0.991 for volume, and demonstrating lower percentages of root mean squared errors (PRMSE) around 10.9% for the area and 4.8% for volume. (3) In the case study of the Xizang Plateau and various large global reservoirs, the BVAH curve database can capture dynamic volume changes. As a unified simulation of the bathymetric topographical patterns, our bathymetric dataset and corresponding BVAH curve database have great potential to contribute to effective water resource management and ecological conservation efforts worldwide.

Abstract The efficacy and safety of venetoclax in newly diagnosed pediatric acute myeloid leukemia (AML) are not well-established as they are in adults. Children newly diagnosed with AML were recommended for induction therapy with venetoclax and chemotherapy or hypomethylating agents (HMAs) as per for the ChiCTR1900027146 trial. Venetoclax was administered at a consistent dose of 200 mg/m2/day for 28 days, with adjustments when used concurrently with azoles. The study measured both the remission rates and the safety assessments of venetoclax. We enrolled 45 newly diagnosed pediatric patients with AML. The complete remission rates were 94.7% in the low/middle-risk group and 80.8% in the high-risk group; MRD-negative rates were 52.6% and 38.5% in the low/middle-risk group and high-risk group, respectively. Venetoclax based combination therapy was well tolerated by the majority of patients. The median duration of venetoclax dosing was 18 days (range 9–28), with hematological toxicity and infection being the most common adverse events. Venetoclax-based induction regimens demonstrated a high response rate and safety profile in newly diagnosed pediatric AML cases. This underscores the significance of venetoclax as a viable treatment option for untreated AML, extending beyond its role as salvage therapy for refractory/relapsed AML.

Abstract The gut microbiome primarily generates short-chain fatty acids (SCFAs) by fermenting dietary fibers. Though previous studies have linked SCFAs to blood pressure, there remains a lack of research on the relationship between SCFAs levels in the serum of elderly individuals and blood pressure. Based on this, we investigated the associations of serum SCFAs with blood pressure in Chinese older adults in a cross-sectional study. In this report, we recruited 1013 older adults over 60 years of age from June to September 2016 in Lu 'an City, China. Using Ultra High Performance Liquid Chromatography-Quadrupole-Exactive-Orbitrap-Mass Spectrometry (UHPLC-QE-Orbitrap MS), we measured the level of various SCFAs, including acetic acid (AA), propanoic acid (PA), butyric acid (BA), isobutyric acid (iso-BA), valeric acid (VA), isovaleric acid (iso-VA), and caproic acid (CA), in serum samples collected from Chinese elderly adults. The study recruited 1013 older adults in total. Multiple logistic regression analysis shows that AA (OR = 0.696, 95%CI: 0.501–0.966) and VA (OR = 0.713, 95%CI: 0.516–0.985) are negatively associated with hypertension. Linear regression analysis shows a negative correlation between AA (β = -3.89, 95% CI: -7.12 – -0.66) and the systolic blood pressure (SBP) levels, and a significant negative association between iso-VA (β = -2.11, 95% CI: -3.94 – -0.29) and diastolic blood pressure (DBP) levels. Whether in unadjusted or adjusted linear regression models, we all observe significant positive associations between CA and blood pressure levels. In the Bayesian kernel-machine regression (BKMR) models, the trends between the mixture of SCFAs and hypertension, SBP are inverse, but not significant; we also observe a significant negative correlation between AA and SBP, and a significant negative association between iso-VA and DBP levels, while CA is significantly positively correlated with SBP and DBP. Collectively, our results advocate for considering SCFA as a potential intervention to lower blood pressure, and especially AA may be a possible target for research. This may provide new perspectives for understanding the role of SCFAs in hypertension.

Purpose – The purpose of this study is to address the deficiency in safety monitoring technology for 27.5 kV high-voltage cables within the railway traction power supply by analyzing the grounding methods employed in high-speed railways and developing an effective monitoring solution. Design/methodology/approach – Through establishing a mathematical model of induced potential in the cable sheath and analyzing its influencing factors, the principle of grounding current monitoring is proposed. Furthermore, the accuracy of data collection and alarm function of the monitoring equipment were verified through laboratory simulation experiments. Finally, through practical application in the traction substation of the railway bureau on site, a large amount of data were collected to verify the stability and reliability of the monitoring system in actual environments. Findings – The experimental results show that the designed monitoring system can effectively monitor the grounding current of high-voltage cables and respond promptly to changes in cable insulation status. The system performs excellently in terms of data collection accuracy, real-time performance and reliability of alarm functions. In addition, the on-site trial results further confirm the accuracy and reliability of the monitoring system in practical applications, providing strong technical support for the safe operation of high-speed railway traction power supply systems. Originality/value – This study innovatively develops a 27.5kV high-voltage cable grounding current monitoring system, which provides a new technical means for evaluating the insulation status of cables by accurately measuring the grounding current. The design, experimental verification and application of this system in high-speed railway traction power supply systems have demonstrated significant academic value and practical significance, contributing innovative solutions to the field of railway power supply safety monitoring.

Abstract Exploring the optimization of communication strategies for animation films in the context of cross-cultural communication, this research integrates the Internet of Things (IoT) and convolutional networks. The research constructs a collaborative filtering (CF) movie recommendation model based on a graph convolutional neural network (GCN) and investigates its application in cross-cultural communication. The fusion of IoT and convolutional networks in movie communication is also analyzed, and the effectiveness of the proposed GCN-CF model is validated through comparative experiments. The results indicate that, compared to other models, the GCN-CF model achieves the lowest Root Mean Square Error (RMSE) on the MovieLens 100 K and MovieLens 1 M datasets, with values of 0.8762 and 0.8275, respectively. Compared to traditional models, the GCN-CF model exhibits significantly superior performance in terms of RMSE, with reductions ranging from 0.6 to 5.2%, highlighting its heightened detection accuracy and overall performance. Moreover, the performance of the GCN-CF model is enhanced after introducing attention mechanisms and auxiliary information on both datasets, showing an improvement of 0.4% compared to the scenario without these additions. This data demonstrates the effectiveness of attention mechanisms and auxiliary information. Finally, the research presents an animation film communication strategy based on IoT and convolutional networks, offering novel insights for film production and communication, along with positive implications for cultural exchange and the advancement of the global media industry.

Abstract Mosquitoes are the most common disease vectors worldwide. In coastal cities, the spread, activity, and longevity of vector mosquitoes are influenced by environmental factors such as temperature, humidity, and rainfall, which affect their geographic distribution, biting rates, and lifespan. We examined mosquito abundance and species composition before and after Hurricane Irma in Miami, Dade County, Florida, and identified which mosquito species predominated post-Hurricane Irma. Our results showed that mosquito populations increased post-Hurricane Irma: 7.3 and 8.0 times more mosquitoes were captured in 2017 than at baseline, 2016 and 2018 respectively. Warmer temperatures accelerated larval development, resulting in faster emergence of adult mosquitoes. In BG-Sentinel traps, primary species like Ae. tortills, Cx. nigripalpus, and Cx. quinquefasciatus dominated the post-Hurricane Irma period. Secondary vectors that dominated post-Hurricane Irma include An. atropos, An. crucians, An. quadrimaculatus, Cx. erraticus, and Ps. columbiae. After Hurricane Irma, the surge in mosquito populations in Miami, Florida heightened disease risk. To mitigate and prevent future risks, we must enhance surveillance, raise public awareness, and implement targeted vector control measures.

Abstract Using data from the 2019 China Household Finance Survey (CHFS), this paper explores the impact of digital inclusive finance on the entrepreneurial performance of returning rural migrants. The study first finds that digital inclusive finance can enhance the entrepreneurial performance of returning rural migrants. Second, it significantly improves entrepreneurial performance in three dimensions: the degree of digitization in inclusive finance, the depth of digital financial usage, and the breadth of digital financial coverage. Third, farmers’ digital participation, digital usage, and the extent of digital usage are crucial pathways through which digital inclusive finance influences their entrepreneurial performance. Fourth, the impact of digital inclusive finance on entrepreneurial performance varies according to different types of migration, duration of migration, scale of entrepreneurship, educational attainment, and credit access channels. The findings of this study help validate the real effects of digital inclusive finance on entrepreneurial outcomes in rural populations.

Blended synchronous learning enables online learners to participate in class activities from geographically separated sites. Due to various challenges, however, online learners are often harder to be engaged and their engagement levels are lower than that of classroom counterparts. This review summarized and synthesized the challenges that led to the low engagement of online learners and the strategies applied to address the challenges and, thus, increased learner engagement in the empirical studies published in recent years. A total of 33 articles were systematically selected and analyzed. By following the constant comparative analysis approach, this article categorized the challenges into four main themes: (1) inadequate online learner-instructor interactions, (2) insufficient online learner-classroom learner interactions, (3) limited online learner-content interactions, and (4) technological constraints. Meanwhile, this article grouped the strategies into five main themes: (1) initiating frequent interactions, (2) letting online learners play active roles, (3) applying continuous assessment, (4) optimizing technological conditions, and (5) professional development. This article further compared subchallenges and substrategies to identify, which strategies could effectively address each challenge. Implications for instructors, learners, and administrators are discussed, and future research areas are suggested.

How does studying in the United States affect Chinese doctoral engineering graduates' career decisions? The present study is based on semi-structured interviews with 16 Chinese engineering graduates who completed their doctorates in the United States, focusing on two critical aspects of their career decisions: returning to China and pursuing academic careers. First, the findings categorise Chinese doctoral engineering graduates into four types based on intention to return to China: fresh returnees, advanced returnees, hesitant stayers and resolute stayers. Second, the findings describe the reasons why they pursued academic or non-academic careers. In particular, the study explores how the graduates' learning experiences during their doctoral study in the United States affected them in terms of the research field, industry experiences, information gained and expectations about working conditions. In the decision process, it was important for doctoral students to adopt positive and open attitudes and exercise self-agency to identify the most appropriate directions for their careers. The study has contributions to the agency theory in career decision-making and social implications for international doctoral students to navigate the career decision process after completing doctoral programmes abroad.

ObjectiveThis study aims to discuss the dose-response relationship between the Life's Essential 8 (LE8) score and chronic obstructive pulmonary disease (COPD).MethodsWe screened data from the National Health and Nutrition Examination Survey (NHANES) database for the years 2007–2018. Logistics regression analysis and subgroup analysis were used to explore the relationship between cardiovascular health (CVH) and COPD based on the LE8 score. Additionally, restricted cubic spline (RCS) plots were drawn to visually display the dose-response relationship.ResultsA total of 12,517 participants were included, of which 835 had COPD. After multivariable adjustment, the LE8 score was found to be linearly and inversely associated with the risk of developing COPD. A similar relationship was observed in the scores for health behavior factors, whereas the relationship was weaker for health factors. The RCS plots visually demonstrated the aforementioned dose-response relationship. Moreover, subgroup analyses showed that this relationship remained robust across different groups.ConclusionLE8 scores are inversely and linearly associated with the risk of developing COPD. Higher LE8 scores can reduce the risk of developing COPD in individuals over 40 years old, especially concerning health behavior factors.

Introduction Small-cell lung cancer (SCLC) is a highly malignant neuroendocrine tumour, and concurrent chemoradiotherapy is the current recommended treatment for limited-stage SCLC. However, the overall survival (OS) of patients with SCLC remains poor. Therefore, improving the survival of patients with SCLC and benefitting more patients are urgent clinical requirements. Immunotherapy has achieved good efficacy in extensive-stage SCLC and non-SCLC. However, the use of neoadjuvant immunotherapy in limited-stage SCLC is unknown but promising. To this end, we plan to conduct a study on adebrelimab in combination with chemotherapy for the neoadjuvant treatment of limited-stage SCLC.Methods and analysis This will be a single-arm, prospective study. The primary endpoint of this study will be a pathological complete remission rate. The secondary endpoints will be a major pathological response, objective response rate, event-free survival, OS, R0 resection rate, safety and potential predictive biomarker parameters related to efficacy in peripheral blood samples, including minimal residual disease, circulating tumour cells and cluster of differentiation (CD) 4/CD8. This study will enrol 28 patients.Ethics and dissemination This study was approved by the Biomedical Ethics Review Committee of West China Hospital, Sichuan University, on 1 August 2023 (grant number 2023[987]). The version of this study protocol is V7.0. The patients have been enrolled since September 2023. This study will conclude in January 2026, and the results will be presented to peer-reviewed medical journals and international scientific conferences in 2027. This study will provide important data on whether neoadjuvant treatment with adebrelimab combined with chemotherapy is clinically beneficial in patients with limited-stage SCLC.(Prospective study of neoadjuvant adebrelimab combined with chemotherapy in limited-stage SCLC; Chinese Clinical Trial Registry (ChiCTR), www.chictr.org.cn/; Number, ChiCTR2300074591.)Trial registration number ChiCTR2300074591

Objectives: To examine the association between physical activity (PA) and leisure-time sedentary time and cardiovascular disease (CVD). Methods: This cross-sectional study used baseline data from the Regional Ethnic Cohort Study in Northwest China from June 2018 to May 2019. PA and leisure-time sedentary time were self-reported. Logistic regression models analyzed the association of PA and leisure-time sedentary time with CVD prevalence individually and jointly. Restricted cubic spline analyses assessed dose-response relationships. Isotemporal substitution models were used to investigate substituting leisure-time sedentary time, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) with CVD prevalence. Results: The prevalence of CVD was 31.8 %. Compared to the lowest quartile, participants in the highest quartile of total PA had a 32 % lower CVD prevalence (odds ratio [OR]: 0.68, 95 % confidence interval [CI]: 0.62–0.74; P for trend

Geographical accessibility is important for promoting health equity, and calculating it requires the locations of all existing healthcare facilities in a region. Authoritative location data collected by governments is accurate but mostly not publicly available, while point-of-interest (POI) data from online sources, such as Baidu Maps and AutoNavi Maps are easily accessible. However, the accuracy of the latter has not been thoroughly analyzed. Taking Baotou, a medium-sized city in China, as aneample, we assessed the suitability of using POI data for measuring geographic accessibility to healthcare facilities.We computedthe difference of geographic accessibility calculated based on POI data and that on authoritative data.Logistic regression and a multiple linear regression model was applied to identify factors related to the consistency between the two data sources. Compared to authoritative data, POI data exhibited discrepancies, with completeness of 54.9% and accuracy of 63.7%. Geographic accessibility calculated based on both data showed similar patterns, with good consistency for hospitals and in urban areas. However, large differences (>30 minutes) were shown in rural areas for primary healthcare facilities. The differences were small regarding to population- weighted average accessibility (with slight underestimation of 3.07 minutes) and population coverage across various levels of accessibility (with differences less than 1% of the population) for the entire area. In conclusion, POI data can be considered foruse in both urban areas and at the level of entire city; however, awareness should be raised in rural areas.

Abstract Objective This study analyzed the causes of sphenoid sinus (SS) infection (SSI) following endoscopic transsphenoidal skull base surgery and determined appropriate treatment methods. Methods This study included 31 cases of secondary SSI following the endoscopic transsphenoidal approach (ETSA; SSI group) and 246 cases without SSI (non‐SSI group). Data collected included post‐ETSA pathological results, types of artificial skull base reconstruction materials, and SS patency. For the SSI group, data included time from ETSA to symptom onset, endoscopic and imaging findings, intraoperative conditions during the second surgery, and changes in visual analog scale (VAS) scores. Results The incidence of secondary SSI was 11.19%. In the SSI group, 26 patients (83.87%) reported headaches, and 24 (77.42%) had stenosis or closure of the SS ostium (SSO). The non‐SSI group reported no symptoms, and 236 patients (95.93%) had well‐opened SSOs. Centripetal hyperosteogeny (CHO) in the SS walls was observed in 20 patients (64.5%) in the SSI group. Absorbable materials were used in five cases (16.13%) and 215 cases (87.40%) in the SSI and non‐SSI groups, respectively, while non‐absorbable materials were used in 24 cases (77.42%) and 20 cases (8.13%), respectively. SSI risk was 9.42 times higher with non‐absorbable synthetic materials. VAS scores for SSI symptoms and Lund–Kennedy scores significantly decreased at 3 and 12 months post‐second surgery. Conclusion Secondary SSI after ETSA can cause persistent symptoms. Non‐absorbable synthetic repair materials should be avoided to prevent secondary SSI. Extended sphenoidectomy and removal of artificial materials can lead to rapid resolution of SSI symptoms. Level of Evidence 4.

Abstract Colorectal adenomas (CRAs) represent precancerous lesions that precede the development of colorectal cancer (CRC). Regular monitoring of CRAs can hinder the progression into carcinoma. To explore the utility of tissue DNA and circulating cell‐free DNA (cfDNA) in early diagnosis of CRC, we retrospectively sequenced paired tissue and plasma samples from 85 patients with conventional CRAs. The genetic alterations identified were compared with those from 78 stage‐I CRC patients (CRC‐I) in the ChangKang project. Within the CRA cohort, we pinpointed 12 genes, notably APC, KRAS, and SOX9, that exhibited significant mutated rates in tissue. Patients harboring KMT2C and KMT2D mutations displayed persistent polyps. By comparing with the mutational profiles of metastatic CRC plasma samples, we found that ZNF717 was exclusively mutated in CRAs, while KMT2C and KMT2D mutations were detected in both CRA and CRC. The presence of cfDNA mutations in plasma was validated through polymerase chain reaction, enhancing the feasibility of using cfDNA mutations for early CRC screening. Compared with CRC‐I, CRAs exhibited a reduced frequency of TP53 and PIK3CA somatic mutations and underwent non‐neutral evolution more often. We established a random forest model based on 15 characteristic genes to distinguish CRA and CRC, achieving an area under the curve of 0.89. Through this endeavor, we identified two novel genes, CNTNAP5 and GATA6, implicated in CRC carcinogenesis. Overall, our findings reveal convincing biomarkers markers for detecting CRAs with a propensity for CRC development, highlighting the importance of early genetic screening in CRC prevention.

Pain after surgery causes significant suffering. Opioid analgesics cause severe side effects and accidental death. Therefore, there is an urgent need to develop non-opioid therapies for managing post-surgical pain. Local application of Clarix Flo (FLO), a human amniotic membrane (AM) product, attenuated established post-surgical pain hypersensitivity without exhibiting known side effects of opioid use in mice. This effect was achieved through direct inhibition of nociceptive dorsal root ganglion (DRG) neurons via CD44-dependent pathways. We further purified the major matrix component, the heavy chain-hyaluronic acid/pentraxin 3 (HC-HA/PTX3) from human AM that has greater purity and water solubility than FLO. HC-HA/PTX3 replicated FLO-induced neuronal and pain inhibition. Mechanistically, HC-HA/PTX3-induced cytoskeleton rearrangements to inhibit sodium current and high-voltage activated calcium current on nociceptive DRG neurons, suggesting it is a key bioactive component mediating pain relief. Collectively, our findings highlight the potential of naturally derived biologics from human birth tissues as an effective non-opioid treatment for post-surgical pain. Moreover, we unravel the underlying neuronal mechanisms of pain inhibition induced by FLO and HC-HA/PTX3.

BackgroundBronchopulmonary Dysplasia (BPD) is a chronic lung disease affecting preterm infants, with limited prevention and treatment options. Inhaled Nitric Oxide (iNO) is sometimes used to treat Persistent Pulmonary Hypertension of the Newborn (PPHN) and Hypoxemic Respiratory Failure (HRF), and its impact on BPD development remains debated.ObjectiveTo assess whether iNO-related factors are potential contributors to the development of BPD Grade Ⅱ-Ⅲ in very premature infants (VPI) diagnosed with PPHN or HRF at birth using Propensity Score Matching (PSM).MethodsWe conducted a retrospective cohort study of infants born at 22–32 weeks gestation with PPHN or HRF, treated with iNO for over 3 h. PSM matched groups by gestational age, birth weight, and gender, etc. Multivariate logistic regression evaluated the association between iNO treatment and BPD outcomes to identify influencing factors, while Restricted Cubic Spline (RCS) and mediation analysis examined iNO dose effects and potential mediators like mechanical ventilation time and oxygenation index (OI).ResultsA higher initial iNO dose was significantly associated with a reduced risk of BPD Grade Ⅱ-Ⅲ (adjusted OR = 0.68, 95% CI: 0.52–0.89, p < 0.01). Additionally, administration of iNO within the first 7 days of life was identified as an important influencing factor No significant mediation effects were observed for factors such as mechanical ventilation time and OI.ConclusionA higher initial iNO dose within the first 7 days was associated with a reduced risk of BPD Grade Ⅱ-Ⅲ in VPI with PPHN or HRF.

In the current study the metabolic response of peanut root exudates to Sclerotium rolfsii Sacc. infection was analyzed in plant-pathogen interaction systems. The analytical methodology employed in this study entailed the utilization of ultra-high-performance liquid chromatography coupled with tandem quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS) in relation to metabolomics. The experimental findings have demonstrated that pathogen infection induces significant variations in both the composition and abundance of peanut root exudates. A total of 322 metabolites were identified in peanut root exudates, among which 19 metabolites showed significant differences under pathogen infection. The results of the orthogonal partial least squares score discriminant analysis (OPLS) and hierarchical cluster analysis (HCA) plots clearly demonstrated that the metabolic profiling effectively distinguished between peanut plants inoculated with S. rolfsii Sacc. and the healthy control plants that were not inoculated. Pathogen infection is associated with five metabolic pathways, the most correlated being arginine and proline metabolism and ABC transporters.

Renal fibrosis is a long-term and progressively worsening condition that impacts kidney function during aging and in the context of chronic kidney disease (CKD). CKD and renal fibrosis affect approximately 10% of the global population and are prevalent in about half of individuals over the age of 70. Despite ongoing research, the mechanisms underlying renal fibrosis are still not well understood, and there is currently a lack of effective treatments available. In the present study, we demonstrated a significant increase of circPWWP2A in renal tubular cells both in vivo and in vitro models of renal fibrosis. Suppressing circPWWP2A has the potential to reduce mitochondrial dysfunction and the production of mitochondrial reactive oxygen species (mtROS), ultimately leading to the inhibition of renal fibrosis. Whereas, supplementation of circPWWP2A led to more serve mitochondrial dysfunction, mtROS production and renal fibrosis. Mechanistically, we found the expression of circPWWP2A was negatively correlated with the expression of miR-182. And we further confirmed miR-182 was the direct target of circPWWP2A by dual-luciferase reporter assay and RIP assay. Then, we found miR-182 suppressed the expression of ROCK1 in both in vitro and in vivo models of renal fibrosis. Luciferase microRNA target reporter assay further indicated ROCK1 as a direct target of miR-182. Knockdown of ROCK1 inhibits renal fibrosis and mitochondrial dysfunction, suggesting ROCK1 not only served as an injurious role in mitochondrial homeostasis but also a pro-fibrotic factor in CKD. Taking together, our findings suggest that circPWWP2A may promote renal interstitial fibrosis by modulating miR-182/ROCK1-mediated mitochondrial dysfunction.

Background Primary pulmonary diffuse large B-cell lymphoma (PP-DLBCL) is a rare extranodal non-Hodgkin's lymphoma (EN-NHL). Its prognosis as an aggressive lymphoma is abysmal, and predictive models are still lacking.Methods We screened patients diagnosed with PP-DLBCL between 2010 and 2019 from the Surveillance, Epidemiology, and End Results (SEER) database. Then, univariate and multivariate COX regression analyses were used to identify independent risk factors affecting patient prognosis. Finally, a novel nomogram was constructed and the model was evaluated by looking at three dimensions.Results A total of 831 patients were included in this study. Most of the patients were elderly (526 (63.8%)) and female (428 (51.9%)). The included patients were randomized in a 7:3 ratio into a training group (577 (70%)) and a validation group (248 (30%)). We concluded that the independent risk factors of prognosis were age, extrapulmonary metastasis, radiotherapy, chemotherapy, and surgical intervention. The results of receiver operating characteristic curves, calibration curves, and decision curve analysis in the training and validation groups confirmed that the risk prediction nomogram could accurately predict the survival of PP-DLBCL.Conclusion This study is the first large population-based clinical data study on PP-DLBCL. A novel predictive model about prognosis has been developed to help clinical decision-making.

Aiming at the hidden danger of information security caused by the lack of medical big data information security firewall, this paper proposes a security privacy protection method for hospital big data based on hybrid encryption algorithm. First, collect hospital big data including hospital medical business system, mobile wearable devices and big health data; Secondly, use byte changes to compress hospital big data to achieve safe transmission of hospital big data; Then, the hospital sender uses the AES session key to encrypt the hospital big data and the ECC public key to encrypt the AES session key, uses SHA-1 to calculate the hash value of the medical big data, and uses the ECC public key to sign the hash value; The hospital receiver uses the ECC private key to verify the signature, and decrypts the AES session key using the ECC private key. After the AES session key decrypts, the hospital big data, the hospital big data security privacy protection is completed. The experimental results show that the method is superior to conventional ECC algorithm or RSA and AES hybrid encryption algorithm in terms of encryption and decryption time and security strength. The average correlation coefficient of encrypted hospital big data is only 0.0576, and the RL curve value is low and gentle. The encrypted data has good scrambling effect and low privacy leakage probability, which ensures the confidentiality and integrity of medical data in the transmission process.

Abstract Previous studies in small samples have identified inconsistent cortical abnormalities in major depressive disorder (MDD). Despite genetic influences on MDD and the brain, it is unclear how genetic risk for MDD is translated into spatially patterned cortical vulnerability. Here, we initially examined voxel-wise differences in cortical function and structure using the largest multi-modal MRI data from 1660 MDD patients and 1341 controls. Combined with the Allen Human Brain Atlas, we then adopted transcription-neuroimaging spatial correlation and the newly developed ensemble-based gene category enrichment analysis to identify gene categories with expression related to cortical changes in MDD. Results showed that patients had relatively circumscribed impairments in local functional properties and broadly distributed disruptions in global functional connectivity, consistently characterized by hyper-function in associative areas and hypo-function in primary regions. Moreover, the local functional alterations were correlated with genes enriched for biological functions related to MDD in general (e.g., endoplasmic reticulum stress, mitogen-activated protein kinase, histone acetylation, and DNA methylation); and the global functional connectivity changes were associated with not only MDD-general, but also brain-relevant genes (e.g., neuron, synapse, axon, glial cell, and neurotransmitters). Our findings may provide important insights into the transcriptomic signatures of regional cortical vulnerability to MDD.

Abstract Abdominal adhesions manifests following abdominal infections triggered by intestinal fistulas. The severity of such adhesions depends on the extent of fiber deposition and peritoneal fibrinolysis following peritoneal injury, which may be influenced by sustained inflammation within the abdominal cavity. In this regard, the visceral-to-subcutaneous fat area (VFA/SFA) ratio has been implicated as a potential marker of inflammation. This study aimed to explore the relationship between VFA/SFA and abdominal adhesions. This multicenter study was conducted across four tertiary institutions and involved patients who had undergone definitive surgery (DS) for intestinal fistula from January 2009 and October 2023. The presence of abdominal adhesions was determined intraoperatively. VFA/SFA was investigated as a potential risk factor for severe adhesions. The study comprised 414 patients with a median age of 50 [interquartile range (IQR) 35–66] years and a median body mass index of 20.0 (IQR 19.2–22.4) kg/m2, including 231 males with a median VFA/SFA of 1.0 (IQR 0.7–1.2) and 183 females a median VFA/SFA of 0.8 (0.6–1.1). VFA/SFA was associated with severe abdominal adhesions in males [odds ratio (OR) = 3.34, 95% CI 1.14–9.80, p = 0.03] and females (OR = 2.99, 95% CI 1.05–8.53, p = 0.04). J-shaped association between VFA/SFA ratio and severe adhesions was revealed in both sex. The increasing trend can be revealed when OR more than 0.8, and 0.6 in males and females respectively. Preoperative VFA/SFA demonstrates predictive value for statues of severe abdominal adhesions in DS for anastomotic fistula after small intestine resection.

The Gaoligong Mountains are characterized by large variations in elevation and topography, which support high levels of biodiversity and endemism that remain largely understudied. Herein, based on the integration of morphological comparisons and phylogenetic reconstruction, we describe a new species of Rhacophorus from the northern Gaoligong Mountains, Yunnan Province, China. The new species, Rhacophorus dulongensis sp. nov., is morphologically distinguishable from its congeners based on the differences in body size, head length, tibia length, snout and tongue shape, toe webbing formula and coloration, ventral skin texture and coloration, dorsal pattern and coloration, body macroglands, iris coloration, and pattern of markings on flanks. Phylogenetically, it differs from its congeners by uncorrected p-distances of >4.8% for the 16S rRNA gene fragment. Rhacophorus dulongensis sp. nov. is likely to be found in Myanmar, considering its type locality lies close to the China-Myanmar border. The phylogenetic analysis revealed that the “widespread” species, R. rhodopus, is a species complex and a composite of five distinct lineages. The results revealed that R. napoensis is also found in Vietnam, making it a new country record for Vietnam. Interestingly, R. dulongensis sp. nov. likely breeds in bamboo, a hidden behavioral characteristic that makes them easy to overlook. Given the ongoing habitat loss and degradation in the region, further biological exploration is urgently needed in the Gaoligong Mountains as a biodiversity reservoir.

Abstract Background Job burnout is a prevalent and emerging challenge in the primary medical system, causing mass turnover, especially of primary medical staff. Little attention has been paid to the different dimensions of job burnout (emotional exhaustion, personality disintegration, and reduced sense of achievement), which may hinder efforts to tackle high turnover intention among primary medical staff. From the perspective of conservation of resources theory, social support and psychological capital are basic resources with potential to diminish job burnout and thus lower turnover intention. However, there is insufficient research evidence on the relationships between social support, psychological capital, and the three dimensions of job burnout within the primary medical system. Objectives Focusing on primary medical staff, this study conducts a path analysis to examine the correlations between two types of resources (social support and psychological capital) and the three dimensions of job burnout, and to test the impact of the latter on turnover intention. Based on the results, effective management strategies to improve the work stability of primary medical staff are proposed. Methods Multi-stage cluster random sampling was used to select participants in Anhui Province, China. Data were collected using a self-administered questionnaire containing measures of the main variables and demographic questions. In total, 1132 valid questionnaires were returned by primary medical staff. Structural equation modeling was used for path analysis of the data. Results Social support was negatively associated with emotional exhaustion (β = − 0.088, P = 0.020), personality disintegration (β = − 0.235, P

Energy security and the “dual carbon” goals are impacting the global energy industry and supply chains, presenting some urgent needs for the secure, efficient, and green low-carbon transformation of energy and power systems in China. To ensure energy security, the coal-fired power plant will remain an important support for electricity supply security and the integration of renewable energy for a considerable period into the future in China. To achieve carbon neutrality, the energy system is gradually shifting from primarily relying on fossil fuels to primarily relying on renewable energy. However, the intermittency, randomness, and volatility of renewable energy make power system regulation more challenging, highlighting the issues of system balance and security. In this context, the zero-carbon fuels such as ammonia play an indispensable role in dealing with the intermittency of renewable energy. They can serve as carriers for long-term and large-scale energy storage to facilitate the large-scale integration of renewable energy and can also be flexibly used directly in power equipment such as boilers to replace fossil fuels. However, due to the differences in physical and chemical properties between zero-carbon fuels and fossil fuels, some challenges arise in the widespread utilization of ammonia fuel, such as poor flame stability and the generation of nitrogen oxides during combustion. Therefore, based on the feasibility, economy and necessity of ammoniac-coal co-combustion, this paper comprehensively reviews the chemical reaction kinetics, combustion characteristics (ignition, steady combustion) and pollutants characteristics (NOx, fly ash particles and soot) of ammoniac-coal co-combustion, and discusses the scaling laws of burner based on the dimensionless number. The efficient and stable combustion control strategy of existing industrial grade ammonia-coal burners is discussed in detail. The C—N fuel separation, air staged and their joint control technology can effectively reduce NOx emissions. In the future, artificial intelligence, big data and digital twin and other information technologies are integrated. It is expected to provide a scientific support and path reference for the research and development of the next generation of new green power generation system oriented to the dual carbon strategy from the source.

Observed soil moisture and precipitation as well as GLDAS and CMFD reanalysis data are used to analyze the spatial and temporal distribution and variation trend in the Loess Plateau region.Regression analysis， Granger causality test and singular value decomposition （SVD） are used to study the relationship between soil moisture and precipitation， and to analyze the temporal scale and spatial range of the influence of initial soil moisture on subsequent precipitation.The results show that the explained variance of the regression analysis of soil moisture and subsequent 1~2 months precipitation on the Loess Plateau is relatively high， with larger values in the summer and fall seasons （July， August， September， and October）.That the correlation between soil moisture and the subsequent 21 days of precipitation in different regions of the Loess Plateau （zones I， II， and III） is more frequent and concentrated than that in the whole region.This indicates that soil moisture on the Loess Plateau is heterogeneous so that a larger lagged precipitation time scale is just suitable for analysis at larger spatial scales.The Granger causality test shows that the initial soil moisture in the fall （October and November） across the Loess Plateau has a significant effect on the precipitation in the following 1 or 2 months， and the soil moisture in August also has a significant effect on the precipitation in October in Area III， which is consistent with the results of the regression analysis.The result of the SVD decomposition shows that from 1979 to 2014， when soils in the central， northern， and eastern parts of the Loess Plateau are wetter in July， the precipitation in the western and northern margins of the plateau is accordingly more in August.A wetter soil in the eastern part of the plateau in September means more precipitation in the western part of the plateau， as well as some parts of the northern and southern parts of the plateau， in October.The significant correlation between soil moisture and precipitation has fewer overlapping regions， suggesting spatial and temporal asymmetry in the influence of soil moisture on precipitation on the Loess Plateau.