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Few studies have investigated tobacco use among people with disabilities living in low- and middle-income countries (LMICs). We aimed to examine current tobacco use among men and women with disabilities using Demographic and Health Survey (DHS) data from 9 LMICs. We considered a respondent currently use tobacco products if they reported current use of any combustible/smoked tobacco products or smokeless tobacco products. We performed secondary analyses of DHS data from 2016-2021 collected in Haiti, Mali, Mauritania, Nigeria, Pakistan, Rwanda, South Africa, Timor-Leste, and Uganda. We examined marginal effects in logistic regression to calculate the adjusted prevalence and adjusted prevalence differences of tobacco use by disability status, controlling for selected sociodemographic characteristics. The adjusted prevalence of current use of tobacco products among women with a moderate/severe disability, mild disability, and no disability varied across countries, with medians of 1.9% (range = 0.1% [Mali] to 11.3% [Pakistan]), 3.2% (range = 0.9% [Nigeria] to 13.3% [South Africa]), and 2.3% (range = 0.5% [Nigeria] to 8.9% [South Africa]), respectively. For men with moderate/severe disability, the median adjusted prevalence for current use of tobacco products was 18.8% (range = 8.9% [Rwanda] to 55.0% [Timor-Leste]). The median prevalences of current use of tobacco products for men with mild disability and no disability were similar to those with moderate/severe disability, at 16.5% and 15.9%, respectively. Current tobacco product use among people with disabilities varied for countries included in our study; however, with few exceptions, current tobacco product use was similar across disability status groups. Additional research is warranted to determine whether our findings extend beyond the nine countries assessed here. It is important to consider the needs of people with disabilities in tobacco prevention, control, and cessation efforts so that this substantial population can benefit equitably from such programs, interventions, or policies.

We propose a method based on the Hilbert–Huang transform (HHT) to recover the high-energy waveform of low-frequency quasiperiodic oscillations (QPOs). Based on the method, we successfully obtain the modulation of the phase-folded light curve above 170 keV using the QPO phase reconstructed at lower energies in MAXI J1535–571 with Insight-HXMT observations. A comprehensive simulation study is conducted to demonstrate that such modulation indeed originates from the QPO. Thus, the highest energies turn out to significantly exceed the upper limit of ∼100 keV for QPOs reported previously using the Fourier method, marking the first opportunity to study QPO properties above 100 keV in this source. Detailed analyses of these high-energy QPO profiles reveal different QPO properties between the 30–100 and 100–200 keV energy ranges: the phase lag remains relatively stable, and the amplitude slightly increases below ∼100 keV, whereas above this threshold, soft phase lags and a decrease in amplitude are observed. Given the reports of a hard-tail detection in broad spectroscopy, we propose that the newly discovered QPO properties above 100 keV are dominated by the hard-tail component, possibly stemming from a relativistic jet. Our findings also indicate a strong correlation between the QPOs originating from the jet and corona, supporting the scenario of jet–corona coupling precession. We emphasize that our proposed HHT-based method can serve as an efficient manner in expanding the high-energy band for studying QPOs, thereby enhancing our understanding of their origin.

Although low-frequency quasiperiodic oscillations (LFQPOs) are commonly detected in the X-ray light curves of accreting black hole X-ray binaries, their origin still remains elusive. In this study, we conduct phase-resolved spectroscopy in a broad energy band for LFQPOs in MAXI J1820+070 during its 2018 outburst, utilizing Insight-HXMT observations. By employing the Hilbert–Huang transform method, we extract the intrinsic quasiperiodic oscillation (QPO) variability, and obtain the corresponding instantaneous amplitude, phase, and frequency functions for each data point. With well-defined phases, we construct QPO waveforms and phase-resolved spectra. By comparing the phase-folded waveform with that obtained from the Fourier method, we find that phase folding on the phase of the QPO fundamental frequency leads to a slight reduction in the contribution of the harmonic component. This suggests that the phase difference between QPO harmonics exhibits time variability. Phase-resolved spectral analysis reveals strong concurrent modulations of the spectral index and flux across the bright hard state. The modulation of the spectral index could potentially be explained by both the corona and jet precession models, with the latter requiring efficient acceleration within the jet. Furthermore, significant modulations in the reflection fraction are detected exclusively during the later stages of the bright hard state. These findings provide support for the geometric origin of LFQPOs and offer valuable insights into the evolution of the accretion geometry during the outburst in MAXI J1820+070.

We present a systematic analysis of type C quasiperiodic oscillation (QPO) observations of H1743-322 throughout the Rossi X-ray Timing Explorer era. We find that, while different outbursts have significant flux differences, they show consistent positive correlations between the QPO fractional rms amplitude and nonthermal fraction of the emission, which indicate an independence of the intrinsic QPO rms on individual outburst brightnesses in H1743-322. However, the dependence of the QPO rms on frequency is different between the outburst rise and decay phases, where the QPO fractional rms of the decay phase is significantly lower than that of the rise phase at low frequencies. The spectral analysis also reveals different ranges of coronal temperature between the two outburst stages. A semiquantitative analysis shows that the Lense–Thirring precession model could be responsible for the QPO rms differences, requiring a variable coronal geometric shape. However, the variable-Comptonization model could also account for the findings. The fact that the rms differences and the hysteresis traces in the hardness–intensity diagram accompany each other indicates a connection between the two phenomena. By correlating the findings with QPO phase lags and the quasi-simultaneous radio flux previously published, we propose there could be corona-jet transitions in H1743-322 similar to those that have been recently reported in GRS 1915+105.

Objective Evaluation of the efficacy and safety of guselkumab, a human monoclonal antibody targeting the interleukin-23p19 subunit, in patients with psoriatic arthritis (PsA) through 1 year.Methods Adults who met ClASsification criteria for Psoriatic ARthritis, with active disease (≥3 swollen and ≥3 tender joints; C reactive protein ≥0.3 mg/dL) despite standard treatment (31% previously received ≤2 tumour necrosis factor inhibitors (TNFi)), were randomised (1:1:1) to guselkumab 100 mg every 4 weeks (Q4W); guselkumab 100 mg at Week0, Week4, then Q8W; or placebo with cross-over to guselkumab 100 mg Q4W at Week24 (PBO→Q4W) through Week48. Clinical efficacy through Week52 (employing non-responder imputation) and adverse events (AEs) through Week60 were evaluated.Results Of 381 treated patients, 90% completed the study. Numerical increases in the proportions of patients achieving ≥20% improvement in ACR criteria (ACR20) were observed post-Week24, reaching 73% (94/128) and 60% (76/127) for Q4W-randomised and Q8W-randomised patients, respectively, by Week52. Proportions of patients achieving ACR50/ACR70/skin responses and minimal/very low disease activity were maintained, as were improvements in physical function and health-related quality of life, through Week52 in guselkumab-randomised patients. Response to guselkumab was maintained in both TNFi-naïve and TNFi-experienced patients. Serious AEs and serious infections occurred in similar proportions of guselkumab Q4W-randomised (3% and 0%) and Q8W-randomised (6% and 2%) patients through Week60, with no new safety concerns versus observations through Week24. No guselkumab-treated patient and two patients receiving placebo died; no study participant developed opportunistic infection or inflammatory bowel disease.Conclusion Guselkumab provided sustained improvement across multiple clinical manifestations of PsA, maintaining a favourable benefit-risk profile, through 1 year regardless of prior TNFi exposure.

Mechanisms through which anesthetics disrupt neuronal activity are incompletely understood. In order to study anesthetic mechanisms in the intact brain, tight control over anesthetic pharmacology in a genetically and neurophysiologically accessible animal model is essential. Here, we developed a pharmacokinetic model that quantitatively describes propofol distribution into and elimination out of the brain. To develop the model, we used jugular venous catheters to infuse propofol in mice and measured propofol concentration in serial timed brain and blood samples using high performance liquid chromatography (HPLC). We then used adaptive fitting procedures to find parameters of a three compartment pharmacokinetic model such that all measurements collected in the blood and in the brain across different infusion schemes are fit by a single model. The purpose of the model was to develop target controlled infusion (TCI) capable of maintaining constant brain propofol concentration at the desired level. We validated the model for two different targeted concentrations in independent cohorts of experiments not used for model fitting. The predictions made by the model were unbiased, and the measured brain concentration was indistinguishable from the targeted concentration. We also verified that at the targeted concentration, state of anesthesia evidenced by slowing of the electroencephalogram and behavioral unresponsiveness was attained. Thus, we developed a useful tool for performing experiments necessitating use of anesthetics and for the investigation of mechanisms of action of propofol in mice.

Peripheral T cell lymphoma (PTCL) is a heterogeneous malignancy with poor response to current therapeutic strategies and incompletely characterized genetics. We conducted whole exome sequencing of matched PTCL and non-malignant samples from 12 patients, spanning 8 subtypes, to identify potential oncogenic mutations in PTCL. Analysis of the mutations identified using computational algorithms, CHASM, PolyPhen2, PROVEAN, and MutationAssessor to predict the impact of these mutations on protein function and PTCL tumorigenesis, revealed 104 somatic mutations that were selected as high impact by all four algorithms. Our analysis identified recurrent somatic missense or nonsense mutations in 70 genes, 9 of which contained mutations predicted significant by all 4 algorithms: ATM, RUNX1T1, WDR17, NTRK3, TP53, TRMT12, CACNA2D1, INTS8, and KCNH8. We observed somatic mutations in ATM (ataxia telangiectasia-mutated) in 5 out of the 12 samples and mutations in the common gamma chain (γc) signaling pathway (JAK3, IL2RG, STAT5B) in 3 samples, all of which also harbored mutations in ATM. Our findings contribute insights into the genetics of PTCL and suggest a relationship between γc signaling and ATM in T cell malignancy.

ObjectiveEvaluate the efficacy and safety of ustekinumab, an anti-interleukin-12/23 p40 antibody, in a phase 3, randomised, placebo-controlled study of patients with active systemic lupus erythematosus (SLE) despite receiving standard-of-care.MethodsActive SLE patients (SLE Disease Activity Index 2000 (SLEDAI-2K) ≥6 during screening and SLEDAI-2K ≥4 for clinical features at week 0) despite receiving oral glucocorticoids, antimalarials, or immunomodulatory drugs were randomised (3:2) to receive ustekinumab (intravenous infusion ~6 mg/kg at week 0, followed by subcutaneous injections of ustekinumab 90 mg at week 8 and every 8 weeks) or placebo through week 48. The primary endpoint was SLE Responder Index (SRI)-4 at week 52, and major secondary endpoints included time to flare through week 52 and SRI-4 at week 24.ResultsAt baseline, 516 patients were randomised to placebo (n=208) or ustekinumab (n=308). Following the planned interim analysis, the sponsor discontinued the study due to lack of efficacy but no safety concerns. Efficacy analyses included 289 patients (placebo, n=116; ustekinumab, n=173) who completed or would have had a week 52 visit at study discontinuation. At week 52, 44% of ustekinumab patients and 56% of placebo patients had an SRI-4 response; there were no appreciable differences between the treatment groups in the major secondary endpoints. Through week 52, 28% of ustekinumab patients and 32% of placebo patients had a British Isles Lupus Assessment Group flare, with a mean time to first flare of 204.7 and 200.4 days, respectively. Through week 52, 70% of ustekinumab patients and 74% of placebo patients had ≥1 adverse event.ConclusionsUstekinumab did not demonstrate superiority over placebo in this population of adults with active SLE; adverse events were consistent with the known safety profile of ustekinumab.Trial registration numberNCT03517722.

Abstract Congestive heart failure (CHF) is a complex clinical syndrome that significantly impacts patient outcomes, especially in critically ill patients admitted to intensive care units (ICUs). The aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT), has also been reported as a risk factor of cardiovascular diseases. However, few studies investigated the correlations between the AST/ALT ratio and ICU mortality in critically ill patients with CHF. This study investigates the association between the baseline AST/ALT ratio measured within the first 24 h of ICU admission and 28-day ICU all-cause mortality in critically ill patients with CHF. This retrospective cohort study included 4869 critically ill patients with CHF from the eICU Collaborative Research Database. Patients were categorized into tertiles based on their AST/ALT ratio: Tertile 1 (0.13–0.97), Tertile 2 (0.97–1.50), and Tertile 3 (1.50–5.89). Univariate and multivariate Cox proportional hazards regression models were used to evaluate the association between the AST/ALT ratio and 28-day ICU all-cause mortality. Nonlinear threshold effects and subgroup analyses were conducted to assess the robustness of the findings. Kaplan-Meier survival curves were generated to compare survival probabilities across tertiles. Participants with higher AST/ALT ratios were older, had higher illness severity, and experienced worse clinical outcomes. In univariate analysis, the AST/ALT ratio was significantly associated with 28-day ICU mortality (HR: 1.24, 95% CI 1.13–1.37, P

This study evaluated the effects of feeding a microbial-derived antioxidant diet (MA) for 56 days on the growth performance of Eriocheir sinensis, as well as on digestive and metabolic enzyme activity and antioxidant capacity under ammonia stress (400 mg/L ammonia nitrogen for 48 h). The weight gain at 28d and the specific growth rate at 56ds for crabs in the MA group were significantly higher than those in the control diet (C) group (p

To solve the problem of poor thermal stability of the current D-allulose 3-epimerase (DAEase), the ancestor sequences of DAEase with different catalytic domains were reconstructed by big data mining, reasonable modification and ancestor sequence reconstruction (ASR) strategy under the guidance of phylogenetic information. The expression vectors of the ancestor sequences were constructed, and DAEase A13 with significantly enhanced thermal stability was screened by recombinant expression and molecular docking, and its enzymatic properties were characterized. In addition, the molecular mechanism of thermal stability enhancement of DAEase A13 was revealed based on structural analysis and molecular dynamics. The results showed that the half-life of A13 constructed based on ASR strategy could reach 8.4 h at 70 ℃, indicating that its thermal stability was significantly enhanced compared with that of wild-type (WT) enzyme. The maximum conversion rate of A13 reached 31%, indicating that the catalytic activity of A13 was slightly higher than that of WT enzyme. The structural and molecular dynamics analysis revealed that the increase in hydrogen bonding and hydrophobic interaction in ASR A13 was the main factor responsible for maintaining the stability of the enzyme's molecular structure at high temperatures. The results showed that ASR strategy could modify DAEases to enhance the stability, activity or hybridity, which could provide superior biocatalyst sources for various industrial applications of functional sugars.

Abstract The health-related quality of life (HRQOL) of college students is not promising and needs to be improved through effective interventions. This study aimed to investigate the associations of nutrition literacy (NL) with HRQOL and anxiety among college students, and to identify the role of anxiety in the relationship between NL and HRQOL. The cross-sectional survey was conducted via the “Wenjuanxing” platform from September to November 2023. The Food and Nutrition Literacy Questionnaire (FNLQ), the Generalized Anxiety Disorder (GAD-7) diagnostic tool and the SF-12 scale were used to assess NL, anxiety, and HRQOL, respectively. Logistic regression models, mediation analysis, additive and multiplicative interaction analyses were used. 2066 college students participated in the analysis. After adjusting for potential confounders, we found that college students with higher NL had higher HRQOL (OR = 2.52, 95% CI: 2.09–3.03, p

Abstract Background Adequate sleep and rest are essential for patient recovery; however, lack of sleep has become a common problem faced by Chinese patients during hospital stays. Reduced sleep is often associated with a higher risk of disease progression and is strongly associated with increased hospital stay. However, there is no specific tool in China to assess short-term insomnia caused by hospitalization. This study aimed to translate the Hospital-acquired Insomnia Scale (HAIS) into Chinese, test its applicability to Chinese inpatients through reliability and validity indicators, and investigate the potential influencing factors of hospital-acquired insomnia. Methods Psychometric analysis from a sample of 679 hospitalized patients to whom the HAIS questionnaire was applied. The structural validity was assessed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and the content validity of the scale was assessed using the content validity index. Cronbach’s alpha coefficient, split-half reliability and test–retest reliability were calculated to evaluate the internal consistency of the scale. Multiple stepwise linear regression analysis was conducted to determine the potential correlates of hospital-acquired insomnia. Results EFA supported a four-factor structure with factor loadings for all dimensions greater than 0.40. CFA showed good indicators of model fit. The content validity index of the scale was 0.94. the Cronbach’s alpha of the scale was 0.915, the split-half reliability coefficient was 0.819, and the retest reliability was 0.844. Gender, age, total hours of sleep during the night, medical insurance, length of hospital stay, perceived stress level, and perceptions about sleep explained 46.2% of the variance in hospital-acquired insomnia. Conclusion The Chinese version of HAIS has good psychometric characteristics and is an effective instrument for evaluating hospital-acquired insomnia. In addition, hospital-acquired insomnia is more common in women, of younger age, less than 5 h of sleep a night, without medical insurance, stressed, and patients with more misconceptions about sleep.

Abstract Background We aimed to evaluate the predictors for early and interim culture conversion within 2 months and 6 months of treatment in multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) patients in China. Methods This study included adult MDR/RR-TB patients with a positive baseline sputum culture from 8 institutions located in different cities in China from May 2018 to January 2022. We mainly used logistic regression model to derive possible predictors of early and interim culture conversion. Results A total of 813 patients were enrolled and 28.5% of them received multidrug-resistant treatment regimens containing bedaquiline. Of these, 362 (44.5%) patients experienced culture conversion within 2 months of treatment, and 649 (79.8%) within 6 months. The results of the multivariable logistic regression analysis revealed that acid-fast bacilli smear positive (adjusted odds ratio [aOR] = 1.637, 95% confidence interval [CI] = 1.197–2.238), cavities (aOR = 1.539, 95% CI = 1.132–2.092), bilateral disease (aOR = 1.638, 95% CI = 1.183–2.269), and viral hepatitis (aOR = 2.585, 95% CI = 1.189–5.622) were identified as risk factors for early culture un-conversion within 2 months of treatment. Additionally, smoking history (aOR = 2.197, 95% CI = 1.475–3.273), previous treatment for tuberculosis (aOR = 1.909, 95% CI = 1.282–2.844), bilateral disease (aOR = 2.201, 95% CI = 1.369–3.537), viral hepatitis (aOR = 2.329, 95% CI = 1.094–4.962) were identified as risk factors for interim culture un-conversion within 6 months of treatment, while patients with regimen containing bedaquiline (aOR = 0.310, 95% CI = 0.191–0.502) was a protective factor. Conclusions A history of smoking, a baseline sputum AFB smear positive, lung cavities, bilateral disease, previous anti-tuberculosis treatment, or a comorbidity of viral hepatitis can be used as the predictors for early and interim culture un-conversion in MDR/RR-TB patients, while bedaquiline was a protective factor .

Abstract Objective This study aims to assess the levels of social support, fear of disease progression (FOP) and health promotion behaviors in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), and to examine the associations between FOP, social support, and health promotion behaviors in OSAHS patients, with a focus on exploring the mediating role of social support. The findings aim to provide insights for enhancing health promotion behaviors among OSAHS patients in China and to offer a theoretical foundation for healthcare professionals in devising intervention strategies to promote health behaviors in individuals with OSAHS. Methods This cross-sectional study included 307 patients diagnosed with OSAHS in Jinzhou City, Liaoning province. The survey instruments utilized included the Demographic Characteristics Questionnaire, Social Support Rating Scale (SSRS), Fear of Disease Progression Scale (Fop-Q-SF), and Health-Promoting Lifestyle Scale (HPLP II). Pearson correlation analysis was employed to assess correlations, while multiple linear regression and structural equation modeling were utilized to explore potential mediation effects. Results In the OSAHS patient population, FOP (r=-0.55, p

Abstract Listeria monocytogenes is an important foodborne pathogen known for causing listeriosis. To gain insights into the pathogenicity, genetic characterization, and evolution of various Listeria species, in vitro cell adhesion and invasion ability assays and whole-genome sequencing were performed using four Listeria strains isolated from livestock and poultry slaughterhouses. The four Listeria strains exhibited adhesion and invasion abilities in Caco-2 and RAW264.7 cells. Pathogenic Liv1-1 and Lm2-20 had higher adhesion ability, but non-pathogenic Lin4-99 was more invasive than Lm2-20 (p

Abstract Acute myocardial infarction (AMI) is a leading cause of morbidity and mortality worldwide. Early identification of high-risk patients is crucial for timely interventions and improved outcomes. The lactate/albumin ratio (LAR) has been suggest as a significant correlate for assessing the risk of mortality in critically ill patients. This study aimed to utilize the American eICU Collaborative Research Database to explore the association between baseline LAR and all-cause mortality within 28 days in ICU of critically ill patients diagnosed with AMI. We conducted a retrospective cohort study of 989 AMI patients from the eICU Collaborative Research Database. Patients were included based on ICD-9 code 410 and the universal definition of AMI. LAR was calculated as the ratio of baseline lactate to albumin levels within the first 24 h of ICU admission. The outcome was all-cause mortality within 28 days after ICU admission. Multivariable logistic regression models were used to evaluate the independent association between LAR and the risk of death, adjusting for potential confounders including demographics, comorbidities, vital signs, and laboratory parameters. Subgroup analyses and nonlinear modeling were performed to further explore the relationship. Of the 989 AMI patients, 171 (17.3%) died within 28 days after ICU admission. Patients who died had significantly higher LAR compared to survivors (1.66 vs. 0.96, p

Abstract Background Chronic insomnia disorder is a common sleep disorder. Previous studies have reported increased demand for anesthetics in patients with chronic insomnia disorder. However, few studies have investigated the effective dose of dexmedetomidine for sedation in patients with chronic insomnia disorder. We aimed to determine the 95% effective dose of dexmedetomidine to induce adequate sedation in patients with chronic insomnia disorder. Methods This is a biased coin design up-and-down sequential allocation trial in patients aged 18–65 years with chronic insomnia disorder (n = 60). The dose of dexmedetomidine for the subsequent patient was determined based on the response of the previous patient, with an interval of 0.1 µg/kg. Sedation was assessed using the bispectral index. The 95% effective dose was calculated using isotonic regression. Results The 95% effective dose of dexmedetomidine to induce adequate sedation in patients with chronic insomnia disorder was 1.75 (95% confidence interval, 1.70–1.94) µg/kg. Four patients (6.7%) experienced bradycardia and no other adverse events were observed during the study. Conclusions The 95% effective dose of dexmedetomidine to induce adequate sedation in patients with chronic insomnia disorder was 1.75 µg/kg. Trials registration Chinese Clinical Trial Registry (ChiCTR2200063212); first registered 01/09 /2022.

Abstract Background Evolutionary radiation is widely recognized as a mode of species diversification, but the drivers of the rapid diversification of fungi remain largely unknown. Here, we used Amanitaceae, one of the most diverse families of macro-fungi, to investigate the mechanism underlying its diversification. Results The ancestral state of the nutritional modes was assessed based on phylogenies obtained from fragments of 36 single-copy genes and stable isotope analyses of carbon and nitrogen. Moreover, a number of time-, trait-, and paleotemperature-dependent models were employed to investigate if the acquisition of ectomycorrhizal (ECM) symbiosis and climate changes promoted the diversification of Amanitaceae. The results indicate that the evolution of ECM symbiosis has a single evolutionary origin in Amanitaceae. The earliest increase in diversification coincided with the acquisition of the ECM symbiosis with angiosperms in the middle Cretaceous. The recent explosive diversification was primarily triggered by the host-plant switches from angiosperms to the mixed forests dominated by Fagaceae, Salicaceae, and Pinaceae or to Pinaceae. Conclusions Our study provides a good example of integrating phylogeny, nutritional mode evolution, and ecological analyses for deciphering the mechanisms underlying fungal evolutionary diversification. This study also provides new insights into how the transition to ECM symbiosis has driven the diversification of fungi.

Abstract Background We aimed to explore the association of socioeconomic status (SES) and life’s essential 8 (LE8) with cardiovascular disease (CVD) and all-cause mortality in north China. Methods A total of 91,365 adults from the Kailuan study were included in this study. Comprehensive individual SES, mainly including monthly household income, education, Occupation position, and community environment, was confirmed by latent class analysis. Furthermore, the mediation and combination effects of SES and LE8 on CVD and all-cause mortality were further assessed. The Cox regression model was conducted to estimate HRs and 95% CI. Results During about 13 years of follow-up, 7,646 cardiovascular events and 11,749 deaths were recorded. Relative to the high SES, there were decreased risks of CVD [HR (95% CI): 1.57(1.43–1.72)] and high all-cause death [HR (95% CI): 1.43(1.31–1.53)] in the low SES. The associations between SES and CVD [Mediation % (95% CI): 22.3 (16.4–30.4)] and mortality [Mediation % (95% CI): 10.1 (7.1–14.0)] were partially mediated by LE8 when comparing medium SES to high SES. Meanwhile, relative to high LE8, the elevated risk of death [HR (95% CI): 1.72(1.56–1.89)], and incident CVD [HR (95% CI): 3.34(2.91–3.83)] were detected in low LE8. Compared to participants who had the high SES and LE8, participants who had both the low SES and LE8 further increased the risk of CVD [HR (95% CI): 7.76(5.21–11.55)] and all-cause mortality [HR (95% CI): 2.80(2.19–3.58)]. Conclusion Low SES was related to a higher risk of CVD and mortality in low- and middle-income countries, which was partially mediated by LE8.

Abstract Background Larch is an important timber tree species. The traditional methods of tree genetic breeding have been progressing slowly. It is necessary to carry out gene function analysis and genetically modified breeding research. The NAC transcription factor family is a plant-specific transcription factor family with various biological functions, as shown in recent research. However, there are few studies on the NAC gene among gymnosperm coniferous species. Results LoNAC3 with complete cds was identified and isolated from the cDNA of Larix olgensis based on transcriptome data. The cDNA length of LoNAC3 is 1185 bp, encoding 394 amino acids, with a conserved NAM domain located at the N-terminus, and subcellular localization in the nucleus. The results of real-time quantitative PCR analysis showed that at different growth stages and in different tissues of L. olgensis, the relative expression level of LoNAC3 was highest in the needles. After drought, salt, alkali stress and hormone treatment, expression was induced to different degrees. The expression level of LoNAC3 was significantly increased under drought and salt conditions. The relative expression level changed under methyl jasmonate (MeJA) and abscisic acid (ABA) treatment. By observing the phenotype of overexpressed LoNAC3 tobacco, it was found that overexpressed tobacco is shorter and blooms earlier than wild-type tobacco. Under abiotic stress, LoNAC3 overexpressed tobacco has lower germination rates and poorer growth status. Transgenic tobacco under stress treatment has a higher malondialdehyde (MDA) content than wild-type tobacco, while peroxidase (POD) activity is lower than wild-type tobacco. Conclusions Through the analysis of LoNAC3 sequence and promoter expression, it can be concluded that LoNAC3 is involved in the drought and salt stress response processes of L. olgensis, and is induced by ABA and MeJA expression. Overexpression of LoNAC3 leads to stunted tobacco growth and negatively regulates its tolerance to drought and salt stress through the reactive oxygen species pathway. The preliminary analysis of the expression pattern and function of the LoNAC3 can provide a theoretical basis and high-quality materials for genetic improvement of larch in later stages.

Background The incidence density of metabolic dysfunction-associated fatty liver disease (MAFLD) and the effect of a healthy lifestyle on the risk of MAFLD remain unknown. We evaluated the prevalence and incidence density of MAFLD and investigated the association between healthy lifestyle and the risk of MAFLD. Methods A cross-sectional analysis was conducted on 37,422 participants to explore the prevalence of MAFLD. A cohort analysis of 18,964 individuals was conducted to identify the incidence of MAFLD, as well as the association between healthy lifestyle and MAFLD. Cox proportional hazards regression was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) with adjustments for confounding factors. Results The prevalence of MAFLD, non-alcoholic fatty liver disease, and their comorbidities were 30.38%, 28.09%, and 26.13%, respectively. After approximately 70 thousand person-years of follow-up, the incidence densities of the three conditions were 61.03, 55.49, and 51.64 per 1,000 person-years, respectively. Adherence to an overall healthy lifestyle was associated with a 19% decreased risk of MAFLD (HR, 0.81; 95% CI, 0.72 to 0.92), and the effects were modified by baseline age, sex, and body mass index (BMI). Subgroup analyses revealed that younger participants, men, and those with a lower BMI experienced more significant beneficial effects from healthy lifestyle. Conclusion Our results highlight the beneficial effect of adherence to a healthy lifestyle on the prevention of MAFLD. Health management for improving dietary intake, physical activity, and smoking and drinking habits are critical to improving MAFLD.

Abstract Computer-aided diagnosis has been slow to develop in the field of oral ulcers. One of the major reasons for this is the lack of publicly available datasets. However, oral ulcers have cancerous lesions and their mortality rate is high. The ability to recognize oral ulcers at an early stage in a timely and effective manner is a very critical issue. In recent years, although there exists a small group of researchers working on these, the datasets are private. Therefore to address this challenge, in this paper a multi-tasking oral ulcer dataset (Autooral) containing two major tasks of lesion segmentation and classification is proposed and made publicly available. To the best of our knowledge, we are the first team to make publicly available an oral ulcer dataset with multi-tasking. In addition, we propose a novel modeling framework, HF-UNet, for segmenting oral ulcer lesion regions. Specifically, the proposed high-order focus interaction module (HFblock) performs acquisition of global properties and focus for acquisition of local properties through high-order attention. The proposed lesion localization module (LL-M) employs a novel hybrid sobel filter, which improves the recognition of ulcer edges. Experimental results on the proposed Autooral dataset show that our proposed HF-UNet segmentation of oral ulcers achieves a DSC value of about 0.80 and the inference memory occupies only 2029 MB. The proposed method guarantees a low running load while maintaining a high-performance segmentation capability. The proposed Autooral dataset and code are available from https://github.com/wurenkai/HF-UNet-and-Autooral-dataset .

Abstract Wetlands are the largest and most uncertain biological source of atmospheric methane, with hydrological fluctuations exacerbating this uncertainty. Here we critically explore the complex relationship between hydrological fluctuations and methane emissions in wetlands by integrating observations from 31 FLUXNET wetland sites with a comprehensive literature review. We present the prevalence and patterns of water table fluctuations and their contribution to uncertainty in methane fluxes. We also highlight key pathways through which these fluctuations affect methane production and emission, such as soil redox heterogeneity, changes in substrate availability and alternative electron acceptor pool, the contribution of different methane transport pathways, and the non-linear responses of community structure and activity of methanogens and methanotrophs to hydrological fluctuations. This review aims to improve the accuracy of wetland methane emission reports by carefully assessing biogeochemical kinetics under hydrological fluctuations.

In borehole monitoring for deep displacement, the abrupt characteristics of inclinometer curves are the key basis for identifying the sliding surface. Previous studies have summarized several types of inclinometer curve patterns that exhibit significant sliding surface signals, including “B” “D”and “r” types. For “D” type inclinometer curves, the convex point of the curve is typically used as the position of the sliding surface. However, this method is susceptible to the influence of observation points spacing and coordinate observation scales, which can result in an unclear definition of the sliding surface position and uncertain numerical values. To overcome these drawbacks and improve the accuracy of sliding surface identification in inclinometer curves, a generalized model of landslides composed of “sliding body” “sliding interval” and “immovable body” was developed based on the variation characteristics of the “D” type inclinometer curve. A mechanical strut model subjected to external loads was established based on the different flexural rigidity of the three members, and the deformation characteristics of soil at different depths during landslide movement were analyzed in depth. The study found that the sliding surface of “D” curve does not entirely penetrate, leading to continuous soil deformation along the depth direction without abrupt change. The demarcation point of the positive and negative bending moments in the mechanical model is a location where the horizontal displacement of deformation curve is the largest, which can reflect the real deformation characteristics of the landslide and the position of the sliding surface. By converted the accumulated soil displacement into relative displacement, the “D” type inclinometer curve is transformed into “S” type relative displacement-depth curve, and the inflection point of the “S” type curve is close to the position of the sliding surface. By extracting the average relative displacement of soil at different depths during the monitoring period and calculating the depth value of the inflection point in the “S” type segment by using the cubic spline interpolation method, the position of the sliding surface can be determined more accurately, which can greatly improve the reliability and accuracy of deep displacement monitoring and has significant practical value.

Abstract Purpose To investigate the repeatability and reproducibility of a new method for centration analysis after small incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK (FS-LASIK). Methods This study comprised 29 eyes treated with SMILE and 24 with FS-LASIK. Decentrations were analyzed using tangential and pachymetry difference maps respectively. Both difference maps were generated with a Scheimpflug tomographer (Pentacam) for each eye, using preoperative and 3-month postoperative scans. Repeatability and reproducibility were evaluated by calculating the intraclass correlation coefficient (ICC), within-subject standard deviation (Sw), and coefficient of repeatability (CR). Results ICC, Sw, and CR showed good to excellent repeatability in locating the coordinates of the optical zone (OZ) center on both maps, with values ranging from 0.84 to 0.96, 0.03 to 0.13, and 0.08 to 0.36 respectively. The repeatability of the total decentration from the preoperative corneal vertex on the tangential curvature difference maps( $$d_{TC}$$ d TC ) and the pachymetry difference maps( $$d_{PC}$$ d PC ) were moderate and good, respectively. The ICC, Sw, and CR of $$d_{TC}$$ d TC were 0.63, 0.09, and 0.25, respectively. The ICC, Sw, and CR of $$d_{PC}$$ d PC were 0.77, 0.10, and 0.28, respectively. The reproducibility of the OZ center measurements was excellent for the tangential difference maps (ICC $$\ge 0.97$$ ≥ 0.97 ) and good for the pachymetry difference maps (ICC $$\ge$$ ≥ 0.86). ICC, Sw, and CR showed excellent reproducibility of $$d_{TC}$$ d TC , with values of 0.95, 0.03, and 0.08, respectively. ICC, Sw, and CR showed good reproducibility of $$d_{PC}$$ d PC , with values of 0.89, 0.06, and 0.17, respectively. Conclusion The centration analysis method used in this study showed good to excellent repeatability and reproducibility in locating the coordinates of the center of the OZ on the tangential and pachymetry difference maps.

Abstract Nitrous acid (HONO), a key precursor of hydroxyl radicals (OH), is one of the factors affecting atmospheric chemistry and air quality. Currently, the proposed sources of HONO are not able to fully explain observed HONO concentrations. In this study, a comprehensive field observation of HONO was conducted in the autumn of 2021 in urban Beijing. The box model using a default Master Chemical Mechanism (MCM) was unable to reproduce the observed HONO concentrations with a normalized mean bias (NMB) of −92.8%. The NMB improved to −46.1% after the inclusion of seven additional HONO formation pathways. Several factors like vehicle emission factor (1.23%) and nocturnal NO2 heterogeneous uptake coefficient on the ground surface (8.25 × 10−6) were calculated based on observational data. The enhancement factor for nocturnal NO2 heterogeneous conversion was established as a function of relative humidity (RH) and incorporated into the model, which compensated for the missing nocturnal HONO sources and well-reproduced the observed HONO concentrations, with an NMB of −5.1%. The major source of HONO at night was found to be the heterogeneous reaction of NO2 on the ground surface, contributing up to 85.6%. During the daytime, it was the homogeneous reaction of NO with OH, accounting for 41.8%. The daytime primary source of OH was mainly the photolysis of HONO, which constituted 73.6% and therefore promoted the formation of secondary pollutants and exacerbated haze events.

Abstract Magma evolution toward a caldera-forming eruption remains uncertain in many cases owing to the lack of successive volcanic records before catastrophic eruptions. Here we take an approach to this issue by analyzing a submarine core sampled near Kikai Caldera, southern Japan, which has recorded two caldera-forming eruptions at 95 and 7.3 ka and small eruptions between them. Discovery of mafic glass fragments in the submarine deposits of the 95-ka eruption, which had not been recognized in subaerial outcrops, implies the involvement of mafic magma in felsic magma-driven caldera-forming eruption. Inter-caldera volcanic activity resumed with binary mafic and felsic magma extrusions but then shifted to eruptions predominated by felsic magmas. In the final stage preceding the 7.3-ka caldera-forming eruption, the most felsic composition did not appear in glass fragments. We suggest that this period was the phase of felsic melt accumulation to grow a magma reservoir toward the next catastrophic eruption.

Abstract Background Chinese cherry [Cerasus pseudocerasus (Lindl.) G.Don] (syn. Prunus pseudocerasus Lindl.) is an economically important fruiting cherry species with a diverse range of attractive colors, spanning from the lightest yellow to the darkest black purple. However, the MYB transcription factors involved in anthocyanin biosynthesis underlying fruit color variation in Chinese cherry remain unknown. Results In this study, we characterized the R2R3-MYB gene family of Chinese cherry by genome-wide identification and compared it with those of 10 Rosaceae relatives and Arabidopsis thaliana. A total of 1490 R2R3-MYBs were classified into 43 subfamilies, which included 29 subfamilies containing both Rosaceae MYBs and AtMYBs. One subfamily (S45) contained only Rosaceae MYBs, while three subfamilies (S12, S75, and S77) contained only AtMYBs. The variation in gene numbers within identical subfamilies among different species and the absence of certain subfamilies in some species indicated the species-specific expansion within MYB gene family in Chinese cherry and its relatives. Segmental and tandem duplication events primarily contributed to the expansion of Chinese cherry R2R3-CpMYBs. The duplicated gene pairs underwent purifying selection during evolution after duplication events. Phylogenetic relationships and transcript profiling revealed that CpMYB10 and CpMYB4 are involved in the regulation of anthocyanin biosynthesis in Chinese cherry fruits. Expression patterns, transient overexpression and VIGS results confirmed that CpMYB10 promotes anthocyanin accumulation in the fruit skin, while CpMYB4 acts as a repressor, inhibiting anthocyanin biosynthesis of Chinese cherry. Conclusions This study provides a comprehensive and systematic analysis of R2R3-MYB gene family in Chinese cherry and Rosaceae relatives, and identifies two regulators, CpMYB10 and CpMYB4, involved in anthocyanin biosynthesis in Chinese cherry. These results help to develop and utilize the potential functions of anthocyanins in Chinese cherry.

Abstract We retrospectively investigated the correlation between the spinal cord compression angle and increased signal intensity (ISI) in 118 patients with ossification of the posterior longitudinal ligament (OPLL). Patients were analyzed based on the presence and shape of ISI on magnetic resonance imaging. Various indicators, including the spinal cord compression angle, were measured through imaging examinations. Spearman’s correlation and logistic regression were used for analyses. Significant positive correlations were observed between the ISI grade and the spinal cord compression angle, maximum spinal canal occupying rate, cervical range of motion, and segmental range of motion. The spinal cord compression ratio and Japanese Orthopaedic Association (JOA) score were negatively correlated with the ISI grade. Regression analysis revealed that the spinal cord compression angle and JOA scores were independent factors that significantly influenced ISI grade. The odds ratio of ISI was 3.858 (95% confidence interval: 0.974–15.278) when comparing the highest and lowest quartiles of the spinal cord compression angle. Patients with a spinal cord compression angle > 35° had more severe imaging manifestations. Thus, a spinal cord compression angle > 35° could serve as a significant indicator of OPLL severity, and greater attention should be focused on treating patients with larger spinal cord compression angles.

Highlights Site-selective superassembly was used to synthesize a nanorobot with bionic rod-shaped head/hollow tail structure, exhibiting strong photothermal effect, high drug loading capacity, precise and controlled drug release, and excellent motility. Injectable regenerated silk fibroin (RSF) nanofibril hydrogels were developed via simple sonication, offering significant production, structural, and performance advantages. Nanorobot/thrombin (Thr)/RSF nanofibril hydrogels reduced intraoperative bleeding of hepatocellular carcinoma (HCC) spinal metastasis, provided starvation embolization, and prevented post-surgery recurrence. Nanorobot/Thr/RSF nanofibril hydrogels inhibited blood supply to residual tumors and reduced neovascularization, inhibiting post-surgery HCC spinal metastasis recurrence.

Abstract Background Frailty, defined as a phenotype of decreased physiological reserves and diminished ability to respond to stressors, has been linked to the development of chronic diseases. Epidemiological evidence connecting frailty to non‐alcoholic fatty liver disease (NAFLD) and cirrhosis risks remain sparse. We aimed to assess the longitudinal associations of frailty with the risks of severe NAFLD and cirrhosis in middle‐aged to older adults and further explore the modification role of genetic risk on these associations. Methods This study included a total of 398 386 participants from the UK Biobank. Incident cases of severe NAFLD and cirrhosis were ascertained through linked hospital records and death registries. Frailty status was assessed by a modified version of the frailty phenotype, encompassing five key components: weight loss, tiredness, physical activity, gait speed, and grip strength. Participants were classified as pre‐frailty if they met one or two of these criteria, and as frailty if they met three or more. Genetic predisposition to NAFLD and cirrhosis was estimated by genetic risk score (GRS) and further categorized into high, intermediate, and low genetic risk levels according to tertiles of GRSs. Cox proportional hazards regression model was employed to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for their associations. Results The mean (standard deviation) age of the study population was 56.6 (8.03) years. 214 408 (53.8%) of the participants was female; 14 924 (3.75%) of participants met the criteria for frailty, 170 498 (42.8%) for pre‐frailty, and 212 964 (53.5%) for non‐frailty. Over a median follow‐up of 12.0 years, we documented 4439 incident severe NAFLD and 3323 incident cirrhosis cases, respectively. Compared with non‐frailty, both pre‐frailty (HR: 1.50; 95% CI: 1.40–1.60) and frailty (HR: 1.98; 95% CI: 1.77–2.21) were associated with increased risk of NAFLD. Similar associations were observed for cirrhosis, the corresponding HRs (95% CIs) for non‐frailty, pre‐frailty, and frailty were 1.00 (reference), 1.29 (1.20, 1.38), and 1.90 (1.66, 2.18). Such associations were consistent across all genetic risk levels, with no observed interactions between frailty and GRSs (all P for interactions ≥0.10). Compared with participants with frailty and a low level of genetic risk, the greatest risk increasement in developing severe NAFLD (HR: 3.36; 95% CI: 2.83–3.99) and cirrhosis (HR: 2.81; 95% CI: 2.29–3.44) was both observed in those with frailty and a high level of genetic risk. Conclusions Our findings indicate that frailty is a significant predictor of severe NAFLD and cirrhosis, irrespective of genetic predisposition.