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Abstract Background The growing body of research on kidney disease in children has identified a broad spectrum of genetic etiologies. Methods We conducted a prospective study to evaluate the efficacy of an optimized genetic test and subclinical changes in a real-world context before kidney transplantation. All cases involved recipients under the age of 18 who underwent whole exome sequencing (ES) between 2013 and 2022. Results The study population included 244 children, with a median age of 13.1 years at transplantation. ES provided a molecular genetic diagnosis in 114 (46.7%) probands with monogenic variants in 15 known disease-causing genes. ES confirmed the suspected clinical diagnosis in 74/244 (30.3%) cases and revised the pre-exome clinical diagnoses in 40/244 (16.4%) cases. ES also established a specific underlying cause for kidney failure for 19 patients who had previously had an unknown etiology. Genetic diagnosis influenced clinical management in 88 recipients (36.1%), facilitated genetic counseling for 18 families (7.4%), and enabled comprehensive assessment of living donor candidates in 35 cases (14.3%). Conclusions Genetic diagnosis provides critical insights into the pathogenesis of kidney disease, optimizes clinical strategies concerning risk assessment of living donors, and enhances disease surveillance of recipients.

Abstract Background This study aims to (1) determine the reliability and validity of the interRAI Chinese Self-reported Carer Needs (SCaN) assessment among informal Chinese caregivers of older adults, (2) identify predictors of caregiving distress in Asian regions with long-standing Confucian values of filial piety and family responsibility. Methods This cross-sectional study recruited 531 informal Chinese caregivers of older adults in Hong Kong, Shanghai, Taiwan, and Singapore. The scale reliability was examined using Cronbach’s alphas (α) and McDonald’s omega coefficient (ω). The concurrent validity and discriminant validity were assessed using Spearman rank correlations (rho). To examine the predictors of caregiving distress among informal caregivers of older adults, we employed hierarchical linear regression analyses informed by the Model of Carer Stress and Burden and categorized the predictors into six domains. Results Results revealed good internal consistency reliability (α = 0.83–0.96) and concurrent validity (rho = 0.45–0.74) of the interRAI Chinese SCaN assessment. Hierarchical linear regression analysis revealed that entering the background factors, primary stressors, secondary stressors, appraisal, and exacerbating factors all significantly enhanced the model’s predictability, indicating that the source of caregiving distress is multidimensional. In the full model, caregivers with longer informal care time, lack of support from family and friends, have unmet needs, experience role overload, have sleep problems, and low IADL functioning are at a higher risk of caregiving distress. Conclusions The interRAI Chinese SCaN Assessment was found to be a reliable and valid tool among the Chinese informal caregivers of older adults. It would be useful for determining family caregivers’ strengths, needs, and challenges, and tailoring interventions that address the potentially modifiable factors associated with caregiving distress and maximize support. Healthcare providers working in home and community settings should be aware of the early identification of caregiving distress and routine assessment of their needs and empower them to continue taking care of their needs and providing adequate care to the care recipient.

Abstract. Background:. Growth retardation is a common complication of chronic kidney disease in children, which can be partially relieved after renal transplantation. This study aimed to develop and validate a predictive model for growth patterns of children with end-stage renal disease (ESRD) after kidney transplantation using machine learning algorithms based on genomic and clinical variables. Methods:. A retrospective cohort of 110 children who received kidney transplants between May 2013 and September 2021 at the First Affiliated Hospital of Zhengzhou University were recruited for whole-exome sequencing (WES), and another 39 children who underwent transplant from October 2021 to March 2022 were enrolled for external validation. Based on previous studies, we comprehensively collected 729 height-related single-nucleotide polymorphisms (SNPs) in exon regions. Seven machine learning algorithms and 10-fold cross-validation analysis were employed for model construction. Results:. The 110 children were divided into two groups according to change in height-for-age Z-score. After univariate analysis, age and 19 SNPs were incorporated into the model and validated. The random forest model showed the best prediction efficacy with an accuracy of 0.8125 and an area under curve (AUC) of 0.924, and also performed well in the external validation cohort (accuracy, 0.7949; AUC, 0.796). Conclusions:. A model with good performance for predicting post-transplant growth patterns in children based on SNPs and clinical variables was constructed and validated using machine learning algorithms. The model is expected to guide clinicians in the management of children after renal transplantation, including the use of growth hormone, glucocorticoid withdrawal, and nutritional supplementation, to alleviate growth retardation in children with ESRD.

B4C/Inconel 625 composite coatings were successfully prepared on 20 pipeline steel by laser cladding, in which B4C ceramic was selected as reinforcement phase to improve the microstructure and corrosion property of Inconel 625 coating. The laser cladding parameters were optimized and the effect of B4C content and B4C particle sizes on the microstructure and properties of B4C/Inconel 625 composite coatings were studied in detail. With increasing liner energy density and decreasing powder feeding speed, the crack ratio of the composite coatings reduces. NiB phase forms due to the in-situ reaction of B4C with Ni element in Inconel 625, and a thin layer of planar crystal also forms at the coating/substrate interface. As the addition of B4C content ranged 5 wt.%∼10 wt.% and the particle sizes ranged 10 μm–60 μm, the quantities of equiaxed crystals increase obviously and the coarse columnar crystals are also refined, which contributes to the improved microhardness and corrosion resistance of the B4C/Inconel 625 composite coatings. When the B4C content is 10 wt.% and particle size is 10 μm, the maximum microhardness of the composite coating is about 567HV0.2, which is 241.2% to that of Inconel 625 coating. The optimal corrosion resistance of B4C/Inconel 625 composite coatings is obtained when the B4C content is 5 wt.% and particle size is 60 μm.

The tasseling stage of maize, as a critical period of maize cultivation, is essential for predicting maize yield and understanding the normal condition of maize growth. However, the branches overlap each other during the growth of maize seedlings and cannot be used as an identifying feature. However, during the tasseling stage, its apical ear blooms and has distinctive features that can be used as an identifying feature. However, the sizes of the maize tassels are small, the background is complex, and the existing network has obvious recognition errors. Therefore, in this paper, unmanned aerial vehicle (UAV) RGB images and an improved YOLOv8 target detection network are used to enhance the recognition accuracy of maize tassels. In the new network, a microscale target detection head is added to increase the ability to perceive small-sized maize tassels; In addition, Spatial Pyramid Pooling—Fast (SPPF) is replaced by the Spatial Pyramid Pooling with Efficient Layer Aggregation Network (SPPELAN) in the backbone network part to connect different levels of detailed features and semantic information. Moreover, a dual-attention module synthesized by GAM-CBAM is added to the neck part to reduce the loss of features of maize tassels, thus improving the network’s detection ability. We also labeled the new maize tassels dataset in VOC format as the training and validation of the network model. In the final model testing results, the new network model’s precision reached 93.6% and recall reached 92.5%, which was an improvement of 2.8–12.6 percentage points and 3.6–15.2 percentage points compared to the mAP50 and F1-score values of other models. From the experimental results, it is shown that the improved YOLOv8 network, with high performance and robustness in small-sized maize tassel recognition, can accurately recognize maize tassels in UAV images, which provides technical support for automated counting, accurate cultivation, and large-scale intelligent cultivation of maize seedlings.

Conducting end-to-end analysis of 5G service quality is the focus of operators to improve 5G user perception.Technical solutions such as rule engine, AI competency center, and intelligent scheduling were adopted to build a “fifth order closed-loop autonomous process” covering quality difference identification, quality difference definition, closed-loop management, effect analysis, and model iteration related to 5G service quality analysis.The process can make up for the shortage of the traditional end-to-end analysis of service quality that highly relies on solidified expert rules.According to this process, the end-to-end analysis scheme of 5G service quality of self-intelligent network was studied and practiced, achieving efficient autonomous collaboration and ensuring the perception of 5G service users.

Abstract Background Informal caregivers of older patients often neglect their self-care, despite the mental and physical health effects of caregiving. Randomized controlled trials (RCTs) on self-care interventions for informal caregivers are lacking, making it difficult to determine effective strategies. This systematic review explored the definition and categories of self-care RCTs for informal caregivers and a meta-analysis was conducted to determine the effectiveness of these interventions. Methods Seven databases (Scopus, Web of Science, MEDLINE, PubMed, ProQuest, CINAHL, and Embase) were searched for articles in English reporting on self-care intervention outcomes for informal caregivers of patients aged 60 years or older. Standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated using a random-effects model. Subgroup, sensitivity, and publication bias analyses were conducted. Results Eighteen studies were included in the systematic review, of which fifteen studies were included in the meta-analysis. RCTs lacked a clear definition of self-care, mainly focused on promoting physical and mental health and individual capacity, and neglected disease prevention. The interventions focused on self-management for health and individual agency, with less attention on health literacy, decision-making capacity, self-monitoring for health status, and linkage to the health system. Meta-analysis results showed that RCTs had a small effect on reducing anxiety (SMD = -0.142, 95% CI [-0.302, 0.017], p = .081) but a significant effect on reducing depression (SMD = -0.214, 95% CI [-0.353, -0.076], p = .002). Country and type of caregiver significantly contributed to the effect of reducing caregivers’ depression in subgroup analysis. Conclusions Studies on caregiver-centered self-care interventions are limited, resulting in a lack of a clear definition and comprehensive intervention. RCTs indicated a small effect on informal caregivers’ mental health, and interventions should consider both mental and physical health. More evidence is needed on the effectiveness of self-care interventions for informal caregivers’ anxiety and physical health.

Cylindrical shell structures have excellent structural properties and load-bearing capacities in fields such as aerospace, marine engineering, and nuclear power. However, under high-pressure conditions, cylindrical shells are prone to cracking due to impact, corrosion, and fatigue, leading to a reduction in structural strength or failure. This paper proposes a static modeling method for damaged liquid-filled cylindrical shells based on the extended finite element method (XFEM). It investigated the impact of different initial crack angles on the crack propagation path and failure process of liquid-filled cylindrical shells, overcoming the difficulties of accurately simulating stress concentration at crack tips and discontinuities in the propagation path encountered in traditional finite element methods. Additionally, based on fluid-structure interaction theory, a dynamic model for damaged liquid-filled cylindrical shells was established, analyzing the changes in pressure and flow state of the fluid during crack propagation. Experimental results showed that although the initial crack angle had a slight effect on the crack propagation path, the crack ultimately extended along both sides of the main axis of the cylindrical shell. When the initial crack angle was 0°, the crack propagation path was more likely to form a through-crack, with the highest penetration rate, whereas when the initial crack angle was 75°, the crack propagation speed was slower. After fluid entered the cylindrical shell, it spurted along the crack propagation path, forming a wave crest at the initial ejection position.

The proteolysis targeting chimeras (PROTACs) technology has been rapidly developed since its birth in 2001, attracting rapidly growing attention of scientific institutes and pharmaceutical companies. At present, a variety of small molecule PROTACs have entered the clinical trial. However, as small molecule PROTACs flourish, non-small molecule PROTACs (NSM-PROTACs) such as peptide PROTACs, nucleic acid PROTACs and antibody PROTACs have also advanced considerably over recent years, exhibiting the unique characters beyond the small molecule PROTACs. Here, we briefly introduce the types of NSM-PROTACs, describe the advantages of NSM-PROTACs, and summarize the development of NSM-PROTACs so far in detail. We hope this article could not only provide useful insights into NSM-PROTACs, but also expand the research interest of NSM-PROTACs.

Abstract Background This study aims to determine the clinical value of contrast enhanced ultrasound (CEUS) for fine-needle aspiration (FNA) of high inadequate risky thyroid nodules. Methods During April 2018 and April 2021, consecutive 3748 thyroid nodules underwent FNA were retrospectively analyzed. CEUS guided FNA (CEUS-FNA) was applied in 115 nodules with high inadequate risk in Lingnan Campus. Ten nodules underwent CEUS-FNA presented non-enhancing, and would be further analyzed independently. Other 105 partial or total enhancing nodules were included as CEUS-FNA group, and 210 nodules with high inadequate risk in Tianhe Campus were match as the US-FNA control group. FNA specimens were collected for liquid-based preparation. Cytological results were classified following the Bethesda System for Reporting Thyroid Cytopathology. Results The overall FNA specimen inadequate rate in our center was 6.6%. All of the ten non-enhancing nodules under CEUS have an inadequate result in cytopathological analyzes. The subsequent postoperative pathology and follow-up ultrasonography showed the non-enhancing nodules were benign or stable without further malignant features. Total specimen inadequate rate of high inadequate risk thyroid nodules in CEUS-FNA group was significantly lower than US-FNA group (6.7% vs. 16.7%, P = 0.014). Further stratified analyzed shown that FNA under US guidance, the inadequate rates in cystic, predominantly cystic, predominantly solid and solid sub-groups were 28.1%, 17.1%, 10.0% and 9.2% (P = 0.019). In contrast, the inadequate rates in cystic, predominantly cystic, predominantly solid and solid sub-groups were 7.4%, 6.7%, 5.6% and 6.7% (P = 0.996) in CEUS-FNA group. Conclusions CEUS can improve the specimen adequacy of FNA in high inadequate risk thyroid nodules by avoiding unnecessary FNAs of the non-enhancing nodules, and accurately locating the viable tissue and precise guidance in real-time. CEUS is a recommend modality for FNA guidance of high inadequate risk thyroid nodules.

BackgroundRadiofrequency ablation (RFA) has been widely applied in patients with benign thyroid nodules (BTNs), and complete ablation in a single-session treatment brings great benefits to patients. While how the ablation should be planned and performed to achieve complete ablation in a single-session treatment in large BTNs remains unknown.PurposeTo determine a more suitable ablation strategy for sufficient treatment in a single-session treatment.Materials and MethodsThis retrospective study included 108 BTNs receiving RFA treatment. These patients were divided into two groups: group A using one insertion point with a fan-shaped overlapping mode and group B using multiple insertion points with a novel parallel overlapping mode. All the treatments used a hydrodissection approach and moving-shot technique. Contrast-enhanced ultrasonography (CEUS) was used to guide the supplementary ablation. Follow-ups were performed at 1, 3, 6 and 12 months. The rates of supplementary ablation, initial ablation ratio (IAR), the rates of complete ablation (CAR), treatment effects and complications between the two groups were compared.ResultsThe group B had larger treated nodules (10.2ml vs 6.4ml, P

Background Radiofrequency ablation (RFA) has been recommended as the treatment for benign thyroid nodules (BTNs) by some guidelines. However, detailed follow-up instructions for thyroid function about the timing and affected populations after RFA are lacked due to insufficient researches. This 12-month prospective study aimed to evaluate the incidence and risk factors of thyroid dysfunction at different time points after RFA, especially within 1 week that previous studies didn’t concern. Methods Seventy-five euthyroid patients who underwent RFA for symptomatic BTNs were enrolled (ChiCTR-INR-16007884). The incidence of thyroid dysfunction within 1 week, at 1, 6, and 12 months after RFA was evaluated. The risk factors for different types of thyroid dysfunction in the different terms were further analyzed. Results Within 1 week after RFA, the incidence of thyroid dysfunction was as high as 36.00% unexpectedly, and only overt thyrotoxicosis and subclinical thyrotoxicosis occurred, which were significantly associated with the low-normal baseline thyrotropin (TSH) level (p = 0.001) and high ablation volume ratio (p = 0.008). From 1 to 12 months (the long term), the incidence dropped significantly and remained low (8.00–12.00%); and thyroid dysfunction presented as overt thyrotoxicosis, subclinical thyrotoxicosis, and subclinical hypothyroidism. The long-term thyrotoxicosis group had more cases with diabetes and lower baseline TSH levels. The long-term subclinical hypothyroidism group had more cases with positive thyroid peroxidase antibodies, higher baseline TSH levels, and higher ablation volume ratios. Conclusions After the RFA of BTNs, thyroid dysfunction was more likely to occur within 1 week and in populations with risk factors.

With the increasing demand for privacy protection in the blockchain, the universal zero-knowledge proof protocol has been developed and widely used. Because hash function is an important cryptographic primitive in a blockchain, the zero-knowledge proof of hash preimage has a wide range of application scenarios. However, it is hard to implement it due to the transformation of efficiency and execution complexity. Currently, there are only zero-knowledge proof circuits of some widely used hash functions that have been implemented, such as SHA256. SM3 is a Chinese hash function standard published by the Chinese Commercial Cryptography Administration Office for the use of electronic authentication service systems, and hence might be used in several cryptographic applications in China. As the national cryptographic hash function standard, the zero-knowledge proof circuit of SM3 (Chinese Commercial Cryptography) has not been implemented. Therefore, this paper analyzed the SM3 algorithm process, designed a new layered circuit structure, and implemented the SM3 hash preimage zero-knowledge proof circuit with a circuit size reduced by half compared to the automatic generator. Moreover, we proposed several extended practical protocols based on the SM3 zero-knowledge proof circuit, which is widely used in blockchain.

The title compound, C20H28O4 [systematic name: (4bS,8aS,10S)-3,10-dihydroxy-2-isopropyl-4b,8,8-trimethyl-4b,5,6,7,8,8a,9,10-octahydrophenanthrene-1,4-dione], is an abietane-type diterpene, which was isolated from Taxodium ascendens (B.). The compound crystallizes in the chiral space group P21, but it was not possible to determine the absolute structure of the molecule in the crystal by resonant scattering. The molecular structure is stabilized by two intramolecular O—H...O hydrogen bonds, enclosing S(5) and S(6) ring motifs. In the crystal, molecules are linked by O—H...O and C—H...O hydrogen bonds, forming chains along the [010] direction. The crystal structure of the 10R stereoisomer of the title compound, isolated from the roots of Premna obtusifolia (Verbenaceae), has been reported. It crystallized in the chiral space group P212121, and the absolute structure was determined as (4bS,8aS,10R), by resonant scattering using Cu Kα radiation [Razak et al. (2010). Acta Cryst. E66, o1566–o1567].

Cardiography is an indispensable element of health care. However, the accessibility of at-home cardiac monitoring is limited by device complexity, accuracy, and cost. We have developed a real-time algorithm for heart rate monitoring and beat detection implemented in a custom-built, affordable system. These measurements were processed from seismocardiography (SCG) and gyrocardiography (GCG) signals recorded at the sternum, with concurrent electrocardiography (ECG) used as a reference. Our system demonstrated the feasibility of non-invasive electro-mechanical cardiac monitoring on supine, stationary subjects at a cost of $100, and with the SCG−GCG and ECG algorithms decoupled as standalone measurements. Testing was performed on 25 subjects in the supine position when relaxed, and when recovering from physical exercise, to record 23,984 cardiac cycles at heart rates in the range of 36−140 bpm. The correlation between the two measurements had r2 coefficients of 0.9783 and 0.9982 for normal (averaged) and instantaneous (beat identification) heart rates, respectively. At a sampling frequency of 250 Hz, the average computational time required was 0.088 s per measurement cycle, indicating the maximum refresh rate. A combined SCG and GCG measurement was found to improve accuracy due to fundamentally different noise rejection criteria in the mutually orthogonal signals. The speed, accuracy, and simplicity of our system validated its potential as a real-time, non-invasive, and affordable solution for outpatient cardiac monitoring in situations with negligible motion artifact.