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Abstract Close vital signs monitoring is crucial for the clinical management of patients with dengue. We investigated performance of a non-invasive wearable utilising photoplethysmography (PPG), to provide real-time risk prediction in hospitalised individuals. We performed a prospective observational clinical study in Vietnam between January 2020 and October 2022: 153 patients were included in analyses, providing 1353 h of PPG data. Using a multi-modal transformer approach, 10-min PPG waveform segments and basic clinical data (age, sex, clinical features on admission) were used as features to continuously forecast clinical state 2 h ahead. Prediction of low-risk states (17,939/80,843; 22.1%), defined by NEWS2 and mSOFA

This study examines a cooperative non-orthogonal multiple access (NOMA) network utilizing an energy-constrained unmanned aerial vehicle (UAV) relay (UAVR) to expand coverage and improve network throughput. In order to provide energy to the UAVR, we consider the hybrid simultaneous wireless information and power transmission (SWIPT) method, which allows the UAVR to harvest energy from the source (i.e., sink node) signal. Herein, a hybrid time switching (TS)-based and power splitting (PS)-based relaying scheme is applied to improve the UAVR’s energy harvesting (EH) efficiency and the system performance. Given this context, we derive the closed-form expression of the outage probability (OP) for the sensors to evaluate the network performance. Based on the achieved analytical results, we apply the bat algorithm optimization (BAO) method to determine the optimal working point (as a fraction of received power and power allocation coefficients, and the 3-D positions of the UAVR) for the system such that the OP is minimized. The numerical analysis indicates that BAO is effective in both exploring and exploiting solutions, making it a suitable choice for similar non-convex optimization problems in continuous search spaces for cooperative NOMA IoT networks.

Abstract Industrial green and low-carbon transformation plays a crucial role in China’s efforts to achieve its Carbon peaking and Carbon neutrality objectives. The implementation of environmental regulation policies is a key institutional framework that facilitates this transformation. Therefore, it is of great importance to explore the impact and interplay of these policies on industrial green and low-carbon transformation to foster high-quality economic development. This study categorizes environmental regulation policy instruments into three types: command-type, investment-type, and expense-type. Using industrial panel data from 30 provinces in China spanning the period from 1997 to 2021, both theoretical analysis and empirical testing are conducted to investigate the effects of these different policy instruments on industrial green and low-carbon transformation. The benchmark regression results show that the impact of command-type environmental regulation and investment-type environmental regulation on industrial green and low-carbon transformation shows an inverted U-shaped feature of rising first and then declining. The impact of cost-based environmental regulation on industrial green and low-carbon transformation shows a U-shaped feature of decreasing first and then increasing. The coupling of command-type environmental regulation and investment-type environmental regulation, command-type environmental regulation and expense-type environmental regulation, and the coupling of the three kinds of environmental regulation can promote industrial green and low-carbon transformation. The mechanism test results show that the impact of formal environmental regulation on industrial green and low-carbon transformation has a transmission mode of “formal environmental regulation–green technology innovation path–green and low-carbon transformation.”

Background and Study Aim. The physical development of high school students is often hindered by the limitations of traditional physical education programs, which may not fully engage students or promote balanced physical growth. In light of these concerns, the need to explore alternative educational models that can enhance students' physical development has become evident. The purpose of this article is to evaluate the potential effectiveness of a physical education curriculum following the Sports Club model in improving the physical development of high school students. Material and Methods. A total of 84 female 10th-grade students participated in the study. They were divided into two groups: an experimental group of 42 students following the Sports Club model and a control group of 42 students following the current physical education curriculum. The experiment lasted for 17 weeks. Both groups completed initial and final physical fitness tests. These tests included the 30-second sit-up test (to assess core strength), the 30-meter sprint test (to measure speed), the 4 × 10-meter shuttle run test (to evaluate agility), the standing long jump test (to measure explosive leg power), and the 5-minute running field test (to assess endurance). Results. The female students in the experimental group demonstrated greater physical development compared to the control group in all five assessment tests. The experimental group showed the most significant improvement in the 30-second sit-up test, with a growth rate of 26.71%. The lowest growth was observed in the 5-minute running field test, at 9.92%. In contrast, the control group showed its highest improvement in the 30-second sit-up test, with a growth rate of 9.44%. However, there was minimal to no improvement in the 4 × 10-meter shuttle run and the 5-minute running field test for the control group. Conclusions. The Sports Club model improved students' physical fitness more effectively compared to the current curriculum, offering greater benefits in all tested areas. It is recommended that teachers further integrate and refine the implementation of the Sports Club model in future physical education programs to enhance teaching effectiveness.

Abstract The inorganic biopolymer polyphosphate (polyP) occurs in all domains of life and affects myriad cellular processes. A longstanding observation is polyP’s frequent proximity to chromatin, and, in many bacteria, its occurrence as magnesium (Mg2+)-enriched condensates embedded in the nucleoid region, particularly in response to stress. The physical basis of the interaction between polyP, DNA and Mg2+, and the resulting effects on the organization of the nucleoid and polyP condensates, remain poorly understood. Here, using a minimal system of polyP, Mg2+, and DNA, we find that DNA can form shells around polyP-Mg2+ condensates. These shells show reentrant behavior, that is, they form within a window of Mg2+ concentrations, representing a tunable architecture with potential relevance in other multicomponent condensates. This surface association tunes condensate size and DNA morphology in a manner dependent on DNA length and concentration, even at DNA concentrations orders of magnitude lower than found in the cell. Our work also highlights the remarkable capacity of two primordial inorganic species to organize DNA.

Abstract Acute kidney injury (AKI) presents a significant clinical challenge due to its rapid progression to kidney failure, resulting in serious complications such as electrolyte imbalances, fluid overload, and the potential need for renal replacement therapy. Early detection and prediction of AKI can improve patient outcomes through timely interventions. This review was conducted as a narrative literature review, aiming to explore state-of-the-art models for early detection and prediction of AKI. We conducted a comprehensive review of findings from various studies, highlighting their strengths, limitations, and practical considerations for implementation in healthcare settings. We highlight the potential benefits and challenges of their integration into routine clinical care and emphasize the importance of establishing robust early-detection systems before the introduction of artificial intelligence (AI)-assisted prediction models. Advances in AI for AKI detection and prediction are examined, addressing their clinical applicability, challenges, and opportunities for routine implementation.

Abstract Development of new vaccines tailored for difficult-to-target diseases is hampered by a lack of diverse adjuvants for human use, and none of the currently available adjuvants induce Th17 cells. Here, we develop a liposomal adjuvant, CAF®10b, that incorporates Mincle and Toll-like receptor 9 agonists. In parallel mouse and non-human primate studies comparing to CAF® adjuvants already in clinical trials, we report species-specific effects of adjuvant composition on the quality and magnitude of the responses. When combined with antigen, CAF®10b induces Th1 and Th17 responses and protection against a pulmonary infection with Mycobacterium tuberculosis in mice. In non-human primates, CAF®10b induces higher Th1 responses and robust Th17 responses detectable after six months, and systemic and pulmonary Th1 and Th17 recall responses, in a sterile model of local recall. Overall, CAF®10b drives robust memory antibody, Th1 and Th17 vaccine-responses via a non-mucosal immunization route across both rodent and primate species.

Abstract Purpose This study aimed to evaluate the clinical efficacy of applying real-time dynamic navigation (RDN) in the extraction of deep horizontal mandibular impacted third molars, hypothesizing that RDN reduces surgical time and minimizes the risk of injury to adjacent anatomical structures. Methods A prospective study was conducted on 160 patients aged between 18 and 37 years with deep horizontal impaction of the mandibular third molar. The participants were randomly assigned to either the experimental group (receiving RDN-assisted extractions) or the control group (undergoing traditional extraction methods). Preoperative planning utilized cone beam computed tomography (CBCT) and Mimics software for the accurate localization and segmentation of impacted teeth. Parametric data were analysed via an independent t test for intergroup comparisons, and significance was set to p

Yan-Shan Duan, Yi-Ran Wang, Bin-Yan Li, Zi-Tong Fu, Jian-Feng Tu, Hang Zhou, Yu Wang, Li-Qiong Wang, Cun-Zhi Liu International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, People’s Republic of ChinaCorrespondence: Li-Qiong Wang; Cun-Zhi Liu, International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, No. 11, Bei San Huan Dong Lu, Beijing, Chaoyang District, 100029, People’s Republic of China, Email lcz623780@126.com; wangliqiongwork@163.comObjective: To evaluate the reporting quality of randomized controlled trials (RCT) of acupuncture for knee osteoarthritis and explore factors associated with the reporting.Study Design and Setting: Eight databases were searched from inception to August 2024 to assess the quality of acupuncture for knee osteoarthritis RCTs based on the CONSORT, the STRICTA, and the CONSORT-Outcomes. We performed regression analyses on pre-specified study characteristics to explore factors associated with reporting quality.Results: One hundred and seventy-four RCTs were evaluated by 69 items from 3 checklists. Seventeen of 37 items on the CONSORT were under-reported (reported in less than 20% of RCTs), and the weakest reported item was why the trial ended or was stopped (0%). Four of 17 items on the STRICTA were under-reported, and the weakest reported item was the number of needle insertions per subject per session (9.2%). Eight of 17 items on the CONSORT-Outcomes were under-reported, and the weakest reported item was identifying any outcomes that were not pre-specified in a trial registry or trial protocol (0.6%). RCT locations include countries other than China, published in English, or funded were more likely to have better reporting.Conclusion: RCTs of acupuncture for knee osteoarthritis need to focus more on reporting details of acupuncture interventions, the reporting of protocol amendment, and the complete reporting of outcome-related content. Journals should encourage authors to adhere strictly to reporting guidelines, which is necessary to improve the quality of reporting, which is very important for Chinese journals.Keywords: randomized controlled trials, acupuncture, knee osteoarthritis, CONSORT, STRICTA, outcomes

Abstract Background Breast screening recommendation based on individual risk assessment is emerging as an alternative approach to improve compliance and efficiency to detect breast cancer (BC) early. In Vietnam, prior knowledge to stratify risk based on genetic factors is currently lacking. Methods This study recruited 892 BC patients and 735 healthy Vietnamese women from 2016 to 2021. DNA from blood samples of BC patients was first analyzed for pathogenic variants associated with hereditary breast and ovarian cancer syndrome (HBOC). For patients with no HBOC and healthy participants, DNA was genotyped for 398 BC susceptibility single-nucleotide polymorphism (SNPs) by next-generation sequencing to identify significantly associated SNPs and construct a polygenic risk score (PRS). Results The prevalence of HBOC predisposition gene mutations in Vietnamese women with BC was 5.4%. HBOC cases were significantly younger and enriched in the age group of 20–39 years old. In patients with no HBOC, we found 36 SNPs significantly associated with BC that were mostly similar to other Asian ethnicities; 34 of them were used to build a PRS model achieving an area under the receiver operating characteristics curve of 0.61 (95% CI: 0.56–0.68). Women in the top 1% PRS percentile had an odds ratio of 5.09 (95% CI: 3.10–7.86) while those in the bottom 1% had an odds ratio of 0.21 (95% CI: 0.09–0.39) to develop BC. Conclusions This study provides the first large datasets for HBOC gene analysis, BC susceptibility SNP association testing, and PRS modeling for Vietnamese women. Together, these data could aid the development of personalized BC screening recommendations for women in Vietnam.

Abstract To addresse the problem of poor detection accuracy or even false detection of wildlife caused by rainy environment at night. In this paper, a wildlife target detection algorithm based on improved YOLOX-s network is proposed. Our algorithm comprises the MobileViT-Pooling module, the Dynamic Head module, and the Focal-IoU module.First, the MobileViT-Pooling module is introduced.It is based on the MobileViT attention mechanism, which uses a spatial pooling operator with no parameters as a token mixer module to reduce the number of network parameters. This module performs feature extraction on three feature layers of the backbone network output respectively, senses the global information and strengthens the weight of the effective information. Second, the Dynamic Head module is used on the downstream task of network detection, which fuses the information of scale sensing, spatial sensing, and task sensing and improves the representation ability of the target detection head. Lastly, the Focal idea is utilized to improve the IoU loss function, which balances the learning of high and low quality IoU for the network. Experimental results reveal that our algorithm achieves a notable performance boost with mAP@0.5 reaching 87.8% (an improvement of 7.9%) and mAP@0.5:0.95 reaching 62.0% (an improvement of 5.3%). This advancement significantly augments the night-time wildlife detection accuracy under rainy conditions, concurrently diminishing false detections in such challenging environments.

Abstract Purpose This review primarily discusses the current research advance of predictive biomarkers for melanoma immunotherapy. The aim of the present review is to summarize the biomarkers and evaluate the advantages and disadvantages. Methods All reference can be found through Pubmed. This review mainly focuses on three main directions: tumor-related factors, host factors, and the tumor microenvironment. In the end, there exhibits some unusual aspects of predictive biomarkers and forecasts the future model. Results The mainsteam of predictive biomarkers focuses on PD-L1, TMB, gene mutations, immune cells, IDO1, LDH, tertiary lymphoid structures (TLS), HLA-DR, tumor-associated macrophages (TAMs), tumor-infiltrating lymphocytes (TILs), and Extracellular vesicles (EVs). Conclusion The current research advance of predictive biomarkers for melanoma immunotherapy can be mainly divided into three parts: tumor-related factors, host factors, and the tumor microenvironment. The predictive biomarkers include PD-L1, TMB, gene mutations, immune cells, IDO1, LDH, TLS, HLA-DR, TAMs, TILs, and EVs. A model based on multiple biomarkers is expected to become the answer to predicting prognosis.

Xiao Chen,* Yuanhe Fan,* Hongliang Tu,* Jie Chen Department of Orthopedics, The First People’s Hospital of Neijiang, Neijiang, Sichuan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiao Chen, Department of Orthopedics, The First People’s Hospital of Neijiang, Neijiang, Sichuan, People’s Republic of China, Email 342918992@qq.comObjective: Postoperative delirium (POD) commonly occurs in elderly individuals following hip fracture surgery, with unclear pathophysiological mechanism. Inflammation is a known factor affecting the onset of delirium. The current work aimed to examine the associations of preoperative immune inflammation-related indicators with POD occurrence in elderly cases following hip fracture surgery.Methods: The current retrospective cohort study included 437 elderly cases administered hip fracture surgery from January 2018 to December 2023. The clinicodemographic data and laboratory findings of all cases were retrospectively analyzed. Immune inflammation-related indicators were assessed, eg, MLR, NLR and PLR, as well as SII and SIRI. The bootstrap method was employed to assign cases at 7:3 to the training (48 and 258 cases in the POD and no-POD groups, respectively) and internal validation (13 and 118 cases in the POD and no-POD groups, respectively) cohorts. Next, LASSO, univariable and multivariable logistic regression analyses were applied to determine risk factors in the training cohort, based on which a nomogram model was built. The obtained nomogram was examined for accuracy by calibration plot analysis. Finally, the nomogram’s clinical value was assessed by decision curve analysis (DCA), followed by internal validation based on the training cohort.Results: Of all 437 cases, 61 developed POD, indicating a POD incidence of 13.96%. LASSO regression and multivariable analyses revealed preoperative SIRI independently predicted POD in the training cohort. The developed nomogram had an area under the curve (AUC) of 0.991 (95% CI 0.983~0.998) in the training cohort versus 0.986 (95% CI 0.966~1.000) in the validation cohort. Calibration curve analysis revealed nomogram-predicted and actual probabilities were in line. DCA demonstrated the novel nomogram could confer net benefits for POD prediction in elderly cases administered hip fracture surgery.Conclusion: The immune inflammation-related indicators SIRI could predict POD in elderly cases following hip fracture surgery.Keywords: postoperative delirium, hip fracture, elderly, immune inflammation related indicators, nomogram

Kaidi Zhao,1,* Yang Zhao,2,* Ao Guo,1 Shengxiang Xiao,1 Chen Tu1 1Department of Dermatology, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710004, People’s Republic of China; 2National & Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710004, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chen Tu; Shengxiang Xiao, Email tuchen2023@126.com; xiao_sx@163.comBackground: Psoriasis is a chronic inflammatory skin disease, and its etiology is still unclear. There is increasing evidence suggesting that microorganisms may trigger psoriasis. However, the relationship between psoriasis and oral microbiota remains poorly understood. Our aim is to identify differences in the composition and diversity of the oral microbiota between patients with psoriasis and healthy controls, and to discover oral microbial markers for assessing the severity of psoriasis.Methods: This study recruited 20 psoriasis patients and 20 healthy individuals, collecting their saliva to analyze the composition of the oral microbiota in psoriasis patients. We employed 16S rRNA sequencing technology and utilized various methods for oral microbiome analysis, including the Shannon Index, Gini-Simpson Index, Principal Coordinates Analysis (PCoA), non-metric multidimensional scaling (NMDS), Linear discriminant analysis Effect Size (LEfSe), Wilcoxon test, and Spearman’s rank correlation.Results: The results showed that the alpha diversity of oral microbiota was higher in psoriasis patients. The relative abundances of certain bacterial taxa differed between psoriasis and healthy individuals, including Prevotella, Prevotella 7 and Porphyromonas gingivalis, which are increased in psoriasis. We also found a positive correlation between Alloprevotella, Porphyromonas, and Neisseria with the severity of psoriasis, while Veillonella showed a negative correlation.Conclusion: In summary, this study found significant changes in the composition of the oral microbiota in patients with psoriasis. Some oral bacteria are associated with psoriasis severity. It provides a new perspective on the relationship between the oral microbiota and psoriasis.Keywords: psoriasis, oral microbiota, dysbiosis, comorbidity, 16s rRNA

Effective management of malignant tumor-induced bone defects remains challenging due to severe systemic side effects, substantial tumor recurrence, and long-lasting bone reconstruction post tumor resection. Magnesium and its alloys have recently emerged in clinics as orthopedics implantable metals but mostly restricted to mechanical devices. Here, by deposition of calcium-based bilayer coating on the surface, a Mg-based composite implant platform is developed with tailored degradation characteristics, simultaneously integrated with chemotherapeutic (Taxol) loading capacity. The delicate modulation of Mg degradation occurring in aqueous environment is observed to play dual roles, not only in eliciting desirable osteoinductivity, but allows for modification of tumor microenvironment (TME) owing to the continuous release of degradation products. Specifically, the sustainable H2 evolution and Ca2+ from the implant is distinguished to cooperate with local Taxol delivery to achieve superior antineoplastic activity through activating Cyt-c pathway to induce mitochondrial dysfunction, which in turn leads to significant tumor-growth inhibition in vivo. In addition, the local chemotherapeutic delivery of the implant minimizes toxicity and side effects, but markedly fosters osteogenesis and bone repair with appropriate structure degradation in rat femoral defect model. Taken together, a promising intraosseous administration strategy with biodegradable Mg-based implants to facilitate tumor-associated bone defect is proposed.

Artificial zeolite was used as an adsorbent to treat sewage with low C/N from an expressway service area. The effect of zeolite dosage on nitrogen removal from sewage was investigated. The factors affecting the adsorption effect of NH3-N by artificial zeolite were discussed by orthogonal experiments. The mechanism of NH3-N removal by artificial zeolite was discussed by means of adsorption kinetics and thermodynamics, specific surface area analysis (BET) and scanning electron microscopy (SEM). The results showed that artificial zeolite could significantly remove NH3-N and TN in sewage in a short time, and could effectively increase the C/N of sewage. After 24 h reaction, 40 g/L artificial zeolite could reduce NH3-N and TN in sewage to (13.45±0.39) mg/L and (19.23±0.21) mg/L, with the removal rates of (91.14±0.32)% and (87.12±0.10)%, respectively. Meanwhile, the C/N increased from 1.30±0.01 to 5.47±0.07. The orthogonal experiments showed that the effect of various factors on nitrogen removal of artificial zeolite was as follows: zeolite dosage>aeration volume>initial concentration of NH3-N. The adsorption process of NH3-N by artificial zeolite conformed to the quasi-secondary reaction kinetic model (R2=0.990), and the adsorption was a heat-absorbing process. The efficient removal of NH3-N by artificial zeolite was mainly due to its large specific surface area (493.23 m2/g) and its mesoporous pores with a wide distribution range. After adsorption, the particles on zeolite surface became smooth, compact and reduced in number.

The semiconductor industry wastewater is complex due to it contains large amount of pollutants such as heavy metals, toxic cyanide, fluoride, nitrogen, and phosphorus, etc. Meanwhile, the poor biodegradability and low C/N makes it difficult to directly use biological methods for treatment. The sewage treatment plant in a certain high-tech industrial park adopts the treatment process of “grille+aeration sedimentation tank+high-efficiency sedimentation tank+advanced A2/O+MBR+disinfection tank”. The changes of influent and effluent water quality during the actual operation for 5 months were explored. The results showed that the treatment process had a good removal effect on pollutants. During operation, pollutants such as suspended solids, COD, NH4+-N, TN, TP, and fluoride in effluent were maintained below 4, 26, 1, 8, 0.1, and 1.5 mg/L, respectively, which always met the first level class A standards of Discharge Standard of Pollutants for Municipal Wastewater Treatment Plant (GB 18918-2002). In addition, the electricity cost of water treatment was about 0.536 yuan/m3, the chemicals cost was about 0.220 yuan/m3, and the direct operating cost was about 0.756 yuan/m3.

Abstract Background Breast cancer is a major health concern worldwide, especially in Vietnam. This study aimed to explore women’s motivation for and factors related to breast cancer screening. Methods A mixed-methods study was conducted in Danang, Vietnam, using a convergent parallel approach. This study utilized both quantitative and qualitative methods to gather the data. The quantitative approach involved surveys to assess motivation levels and related factors, including demographic information and experience with breast cancer screening. In-depth qualitative interviews were used to gain deeper insights into participants' perspectives and experiences related to breast cancer screening. Results The average motivation score for breast cancer screening was moderate (3.55 ± 0.55). Ethnicity, regular health check-ups, family history of breast cancer, receiving information about breast cancer, and women’s health issues have direct relationships with breast cancer screening motivation. According to the qualitative data, three categories emerged: intrinsic motivation, external motivation/internalization, and amotivation. The individual, and sociocultural environmental factors impacted screening motivation. Conclusions This study highlights the motivations behind breast cancer screening among women. Healthcare providers could use these findings to improve screening policies and guidelines and encourage more women to undergo regular screening, ultimately reducing the incidence of breast cancer in the community.

Chan Li,1,2,* Chen Zhu,3,* Genghong Tu,4,* Zhijie Chen,1 Zhixian Mo,1,5 Chaohua Luo1,5 1School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, People’s Republic of China; 2School of Life Sciences, Guangzhou University, Guangzhou, People’s Republic of China; 3The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, People’s Republic of China; 4Department of Sports Medicine, Guangzhou Sport University, Guangzhou, Guangdong, People’s Republic of China; 5Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhixian Mo, Mo; Chaohua, Luo, School of Traditional Chinese Medicine, Southern Medical University, 1023-1063 Shatai South Road, Guangzhou, 510515, People’s Republic of China, Tel +020-61648261 ; +020-61648244, Email cherrymo@fimmu.com; 120557369@qq.comObjects: Ketamine is a drug of abuse worldwide and current treatments for ketamine abuse are inadequate. It is an urgent need to develop novel anti-addictive strategy. Since gut microbiota plays a crucial role in drug abuse, the present study investigates the impact and mechanisms of the gut microbiota in addictive behaviors induced by ketamine addiction.Methods: Conditioned place preference (CPP) was employed to assess addiction, followed by 16S rRNA gene sequencing to elucidate alterations in the gut microbiota. Furthermore, qRT-PCR, ELISA, and immunohistochemistry were conducted to evaluate the expression levels of crucial genes and proteins associated with the gut-brain axis. Additionally, we investigated whether ketamine addiction is regulated through the gut microbiota by orally administering antibiotics to establish pseudo-germ-free mice.Results: We found that repeated ketamine administration (20 mg/kg) induced CPP and significantly altered gut microbiota diversity and composition, as revealed by 16S rRNA gene sequencing. Compared to the control group, ketamine exposure exhibited differences in the relative abundance of 5 microbial families, with 4 (Lachnospiraceae, Ruminococcaceae, Desulfovibrionaceae and Family-XIII) showing increases, while one (Prevotellaceae) displayed a decrease. At the genus level, five genera were upregulated, while one was downregulated. Furthermore, COG analysis revealed significant differences in protein functionality between the two groups. Additionally, axis series studies showed that ketamine dependence reduced levels of tight junction proteins, GABA and GABRA1, while increasing BDNF and 5-HT. Moreover, an oral antibiotic cocktail simulating pseudo germ-free conditions in mice did not enhance the addictive behavior induced by ketamine.Conclusion: Our study supports the hypothesis that ketamine-induced CPP is mediated through the gut microbiota. The present study provides new insights into improvement of efficient strategy for addiction treatment.Keywords: ketamine abuse, BDNF, GABRA1, gut microbiota, gut-brain axis

Abstract Background To formulate effective strategies for antimicrobial stewardship (AMS) in primary care, it is crucial to gain a thorough understanding of factors influencing prescribers' behavior within the context. This qualitative study utilizes the Theoretical Domains Framework (TDF) to uncover these influential factors. Methods We conducted a qualitative study using in-depth interviews and focus group discussions with primary care workers in two provinces in rural Vietnam. Data analysis employed a combined inductive and deductive approach, with the deductive aspect grounded in the TDF. Results Thirty-eight doctors, doctor associates, and pharmacists participated in twenty-two interviews and two focus group discussions. We identified sixteen themes, directly mapping onto seven TDF domains: knowledge, skills, behavioral regulation, environmental context and resources, social influences, social/professional role and identity, and optimism. Factors driving unnecessary prescription of antibiotics include low awareness of antimicrobial resistance (AMR), diagnostic uncertainty, prescription-based reimbursement policy, inadequate medication supplies, insufficient financing, patients’ perception of health insurance medication as an entitlement, and maintaining doctor-patient relationships. Potential factors facilitating AMS activities include time availability for in-person patient consultation, experience in health communication, and willingness to take action against AMR. Conclusion Utilizing the TDF to systematically analyze and present behavioral determinants offers a structured foundation for designing impactful AMS interventions in primary care. The findings underscore the importance of not only enhancing knowledge and skills but also implementing environmental restructuring, regulation, and enablement measures to effectively tackle unnecessary antibiotic prescribing in this context.

Abstract Background Patient navigators, whose value has become increasingly apparent, still face significant challenges, including a lack of support, funding, and recognition. These challenges have been exacerbated in the wake of COVID‐19 pandemic. Methods This study explored the potential use of artificial intelligence (AI) in patient navigation. Data were collected through structured surveys and individual interviews with patient navigators from a variety of institutions and professional backgrounds. The data were analyzed to understand the current state of patient navigation, identify existing gaps, and suggest best practices for the future. Results The findings showed that patient navigators (a) have diverse backgrounds and responsibilities, (b) lack technology support for their work, (c) are at risk for burnout, with the extent varying based on the level of technical support received, and (d) report significant overlap between current barriers and those that could potentially be addressed with AI‐driven technologies. Conclusion A novel intervention, that is enabled by AI and other technologies and tailored to individual needs, has the potential to reduce burnout, increase capacity, and help ensure the sustainability of patient navigation and other areas of healthcare. By addressing the specific needs of individual patients, this type of intervention could help improve the overall effectiveness of patient navigation and support the long‐term sustainability of the role.

Qingquan Wei, Xianghong Tu, Qinghua Qiu, Li Wang Department of Ophthalmology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of ChinaCorrespondence: Qinghua Qiu; Li Wang, Department of Ophthalmology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 Xianxia West Road, Shanghai, 200336, People’s Republic of China, Email QQH4948@shtrhospital.com; WL1249@shtrhospital.comPurpose: The objective of this study was to ascertain metabolic biomarkers and investigate the metabolic alterations associated with aqueous humor (AH) in wet age-related macular degeneration (AMD).Methods: AH samples were collected from a total of 20 participants, including 10 individuals diagnosed with wet AMD and 10 individuals undergoing cataract surgery, serving as the control group. Metabolomics analysis was performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) to identify and quantify metabolites.Results: A total of 155 metabolites were identified in the AH samples. Among them, 10 metabolites emerged as potential biomarkers capable of differentiating patients with wet AMD from the control group. In the AH of wet AMD patients, there was increased expression of Cardiolipin (CL) (72:5), Diglyceride (DG) (18:3_18:2), DG (36:5e) and Triglyceride (TG) (24:7), while the expression of Ceramides (Cer) (d32:0), Cer (d34:0), Cer (d36:0), Monogalactosyldiacylglycerol (MGDG) (16:1_18:3), Sphingosine (SPH) (d18:0) and TG (16:0_10:4_16:0) was down regulated.Conclusion: Through metabolomics analysis of AH, this study successfully uncovered valuable metabolic biomarkers linked to wet AMD. These findings contribute to a more comprehensive understanding of the pathogenesis of wet AMD and offer potential avenues for the development of innovative treatment strategies for this condition.Keywords: metabolomic, wet age-related macular degeneration, aqueous humor

Yanye Tu,1 Hui Gao,1 Rongqing Zhao,1 Jiliang Yan,1 Diyu Wu2 1Clinical Laboratory of Ningbo Medical Centre Lihuili Hospital, Ningbo University, Ningbo, Zhejiang Province, People’s Republic of China; 2School of Laboratory Medicine and Life Science, Wenzhou Medical University, Wenzhou, People’s Republic of ChinaCorrespondence: Hui Gao, Email gaoh711@126.comObjective: This study aims to investigate the association between antimicrobial resistance genes and virulence factors in ST11 and non-ST11 types of CR-KP in bloodstream infections in the intensive care unit, providing a theoretical basis for infection control and clinical diagnosis and treatment.Methods: From January 2021 to June 2023, samples of Klebsiella pneumoniae from bloodstream infections were collected at our hospital, focusing on those resistant to carbapenems. The resistance genes, housekeeping genes, and virulence genes were identified through PCR and analyzed using the GrapeTree software to perform MLST-based minimum spanning tree typing.Results: Among the 85 CR-KP cases, 61.18% were of the ST11 type, predominantly of the KL64 capsular type; non-ST11 types were mainly ST15, accounting for 25.88%, predominantly of the KL5 capsular type. The carriage rates of virulence genes such as rmpA2, entB, silS, kpn, iucA, peg-344, and terB were significantly higher in the ST11 group than in the non-ST11 group. The primary carbapenemase identified was class A enzyme blaKPC-2, with a higher carriage rate in the ST11 group. Drug susceptibility tests showed that the resistance rates for cefepime, ertapenem, nitrofurantoin, amikacin, and gentamicin were also higher in the ST11 group, consistent with the resistance genotype findings.Conclusion: The study reveals that ST11 type CR-KP in intensive care unit bloodstream infections exhibits stronger resistance and higher virulence compared to non-ST11 types, posing significant challenges to clinical treatment. Thus, strict control over the use of carbapenem antibiotics is essential to prevent the spread of resistant plasmids.Keywords: intensive care unit, bloodstream infections, ST11 CR-KP, Non-ST11 CR-KP, resistance genes, virulence genes

The marine red alga, Gracilaria eucheumatoides, is economically significant for its agar production and pharmacologically active compounds. This study reveals its complete mitochondrial genome (mitogenome), sequenced using Illumina’s next-generation technology. The mitogenome is a 25,909 bp circular molecule with a G + C content of 27.21%, comprising 24 protein-coding genes, two ribosomal RNA genes, 24 transfer RNA genes, and one open reading frame (ORF) with an unidentified function. Both gene structure and composition are highly conserved within Gracilaria. The phylogenetic analyses fully support a close relationship of G. eucheumatoides with other Gracilaria species, as well as its sister relationship with G. urvillei. This mitogenome sequencing effort of G. eucheumatoides provides crucial data for future phylogenetic research on marine red algae.

Yingying Tu,1 Wenwen Du,2 Yuanyuan Pan,2 Xiaozhen Zhang,1 Yunchang Mo,2 Caixia Sun,1 Junlu Wang2 1Nursing Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of China; 2Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, People’s Republic of ChinaCorrespondence: Junlu Wang, Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, South Baixiang Street, Ouhai District, Wenzhou City, Zhejiang, 325000, People’s Republic of China, Email wangjunlu973@163.comBackground: Postoperative high-activity delirium (PDHA) manifests as a high alertness, restlessness, hallucinations, and delusions. Occurrence of PDHA represents an increased risk of poor prognosis for patients.Objective: To establish and validate a nomogram prediction model for high-activity delirium after non-cardiac surgery in a post-anesthesia care unit (PACU).Methods: This study retrospectively enrolled adult patients who underwent non-cardiac surgery and were observed in the PACU as training data. Patients were divided into PDHA (199 patients) and non-PDHA (396 patients) groups. Patients’ general data, preoperative indicators, intraoperative conditions, and postoperative PACU conditions were collected. The risk factors for PDHA were identified using univariate and multivariate logistic regression analyses. A predictive column chart was created using R language. Adult patients who underwent non-cardiac surgery and entered the PACU for observation were randomly selected as the validation set data (198 cases) for model performance validation.Results: The incidence rate of adult PDHA in the PACU was 0.275%. Sex, age, smoking history, low preoperative albumin level, Society of Anesthesiologists (ASA) classification, anesthesia duration, and postoperative PACU pain score were independent risk factors for hyperactive delirium in PACU adults. In this study, an adult PACU PDHA nomogram prediction model was developed. The training dataset verified that the ROC curve (area under the curve) and 95% confidence interval (95% CI) were 0.936 (0.917– 0.955). The ROC curve of the validation data row showed that the area under the curve and 95% CI were 0.926 (0.885– 0.967).Conclusion: The nomogram predictive model for PACU adult high-activity delirium constructed in this study showed good predictive performance. This model could enable the visualization and graphical prediction of adult high-activity delirium occurrence after PACU, which has clinical value.Keywords: post anesthesia care unit, PACU, delirium, risk factor, nomograms

Inflammatory bowel disease (IBD) is a group of chronic, non-specific inflammatory diseases of the gastrointestinal tract including primarily Crohn’s disease and ulcerative colitis, which are affected by multiple factors. Periodontitis is a type of disease characterized by plaque biofilm as the initiating factor and chronic destruction of alveolar bone via resorption. An increasing number of studies have reported a correlation between periodontitis and IBD, but the relationship between the two remains unclear. In this study, we explore the internal relationships between the two diseases from three dimensions, including epidemiological, biological, and associated treatment evidence. Based on epidemiological evidence, periodontitis was found to be associated with an increased risk of IBD, which also affects periodontal health, although the bidirectional correlation needs to be further studied by expanding the number of data sources. From the biological evidence, both clinical studies and animal experiments show that IBD and periodontitis are interconnected. Based on evidence from association therapy, drugs that are beneficial for the treatment of IBD are also effective in the prevention and treatment of periodontitis. In addition, drugs that are good for improving periodontitis can also significantly alleviate IBD. The interaction mechanism between IBD and periodontitis includes the microbial pathway and the immunization route. The microbial pathway refers to the increase in the probability of intestinal tract ectopic colonization by oral bacteria transmitted through the mouth-gut axis or blood, resulting from the increase in the proportion of opportunistic pathogens in the oral cavity of patients with periodontitis and the influence of IBD on the secretion of gastric juice and the balance of intestinal flora. These microorganisms further aggravate IBD inflammation by releasing virulence factors, destroying the intestinal mucosal barrier, and triggering inflammatory responses. In periodontitis, adaptive immunity is activated in the mouth, leading to the production of a large number of immune cells, including Th17 containing the intestinal homing marker α4β7 integrin on their surface. Increased ligand expression of α4β7 integrin in the intestinal mucosa of patients with IBD accelerates oral Th17 cell transfer to the intestine, thereby worsening intestinal inflammation. In parallel, the abnormal expression of cytokines, such as TNF-α, IL-1β, IL-10, IL-6, IL-21, soluble CD40 ligand (sCD40L), IL-23, and INF-γ, in the oral cavity of patients with IBD was observed, suggesting that IBD may affect periodontitis through immunity. These cytokines represent targets for the treatment of both diseases and provide a research direction for their prevention and treatment in the future.

The global burden of skin diseases affects over 3 billion individuals, posing important public health challenges worldwide, with profound impacts in both high-income and low-income and middle-income countries. These challenges are exacerbated by widespread disparities in access to dermatologic care and the prevalence of misinformation. This article, derived from the Skin and Digital Summit at the International Master Course on Aging Science critically evaluates how digital technologies such as artificial intelligence, teledermatology, and large language models can bridge these access gaps. It explores practical applications and case studies demonstrating the impact of these technologies in various settings, with a particular focus on adapting solutions to meet the diverse needs of low-income and middle-income countries. In addition, the narrative highlights the ongoing conversation within the dermatologic community about the role of digital advances in health care, emphasizing that this discussion is dynamic and the one that is continuously evolving. Dermatologists play an essential role in this transition, integrating digital tools into mainstream care to complement a patient-centered, culturally sensitive approach. The article advocates for a globally coordinated digital response that not only addresses current disparities in skin health care but also promotes equitable access to digital health resources, making dermatologic care more representative of all skin types and accessible worldwide.

Isobutylene polymerization was studied with the rare-earth metal scandium cationic complexes as catalysts and molecular weight and its distribution, and glass transition temperature of polyisobutylene were investigated by screening the catalyst system, adjusting the ratio of monomer to catalyst and regulating the reaction temperature and time. The results showed that the constrained-geometry-configuration scandium dialkyl catalyst which had relatively smaller steric hindrance had the highest catalytic activity for isobutylene polymerization among 5 kinds of rare-earth metal scandium cationic catalysts. The higher mole ratio of monomer isobutylene to catalyst was, the higher number-average relative molecular weight the resulting polymer had. The lower reaction temperature was, the higher numbe-average relative molecular weight of the polymer was, however, when the reaction temperature was below -60 ℃, the number-average relative molecular weight of the polymer decreased significantly. The reaction time had little effect on the change of the number-average relative molecular weight of the polymer. In addition, the polymerization reaction temperature and time had no significant effect on the glass transition temperature of polyisobutylene.

DC circuit breakers， as one of the vital devices for fault clearance in DC power systems， significantly influence the secure and stable operation of the system. Given the problem that most circuit breakers lack fault current limiting capability and are comparably expensive， this paper proposes a design for a capacitive high voltage DC circuit breaker incorporating a current limiting function. By utilizing the charging and discharging characteristics of capacitors， current limiting reactors and lightning arresters can be switched， significantly reducing the peak value of fault current. The extensively used IGBTs in conventional DC circuit breakers are replaced by capacitors， effectively reducing the cost while retaining the current cutout capability. A single-ended equivalent model is developed using PSCAD/EMTDC software， and simulation is conducted. The simulation results show that， compared with traditional high-voltage DC circuit breakers， the proposed scheme reduces the peak value of fault current and shortens the fault isolation time. It demonstrates pleasing performance.

Abstract Background This study evaluated the impact of the tax increase in January 2019 on changes in intention to quit and the effect of cigarette prices on quit attempts and successful quitting among male cigarette smokers in Vietnam. Methods Data were derived from the ITC project in Vietnam, which included 1585 adult smokers at baseline (Wave 1, Aug-Oct 2018) followed up to waves 2 (Sep-Nov 2019) and 3 (Sep-Dec 2020). Generalized estimating equations regression was performed to estimate changes in the intention to quit. Multiple logistic regression analysis was used to evaluate the cigarette price of a cigarette pack in relation to quit attempts and successful quitting. Results The increase in cigarette tax in 2019 did not significantly increase the likelihood of the intention to quit. After the tax increase, 63.6% of participants who smoked made a quit attempt, and 27.6% successfully quit smoking in the follow-up waves. However, the price of a cigarette pack was not significantly associated with quit attempts and successful quitting. The study did not observe a significant impact of cigarette prices on quit attempts and successful quitting in all subgroups of household income. Factors associated with quit attempts included the number of cigarettes smoked and the intention to quit, while those associated with successful quitting included age, dual use of cigarettes and other tobacco products, and the intention to quit. Conclusion Current cigarette prices were not associated with cessation behaviors even within the lowest household income group. Therefore, a sharp rise in cigarette tax is required to incentivize smokers to quit smoking.

Investigating natural-inspired applications is a perennially appealing subject for scientists. The current increase in the speed of natural-origin structure growth may be linked to their superior mechanical properties and environmental resilience. Biological composite structures with helicoidal schemes and designs have remarkable capacities to absorb impact energy and withstand damage. However, there is a dearth of extensive study on the influence of fiber redirection and reorientation inside the matrix of a helicoid structure on its mechanical performance and reactivity. The present study aimed to explore the static and transient responses of a bio-inspired helicoid laminated composite (B-iHLC) shell under the influence of an explosive load using an isomorphic method. The structural integrity of the shell is maintained by a viscoelastic basis known as the Pasternak foundation, which encompasses two coefficients of stiffness and one coefficient of damping. The equilibrium equations governing shell dynamics are obtained by using Hamilton's principle and including the modified first-order shear theory, therefore obviating the need to employ a shear correction factor. The paper's model and approach are validated by doing numerical comparisons with respected publications. The findings of this study may be used in the construction of military and civilian infrastructure in situations when the structure is subjected to severe stresses that might potentially result in catastrophic collapse. The findings of this paper serve as the foundation for several other issues, including geometric optimization and the dynamic response of similar mechanical structures.

6061 aluminum alloys with different aging states were prepared by rotational friction extrusion （RFE）. The effect of RFE on the microstructure and mechanical properties of 6061 aluminum alloys with different aging states was investigated. The results show that the refractory AlFeMnSi phase of 6061 aluminum alloys can be broken by using RFE， resulting in the fine and uniform distribution of the AlFeMnSi phase in the alloy. Under the combined effects of frictional heat and deformation during RFE processing， the pre-precipitated coarse Mg2Si phase is dissolved and re-precipitated， resulting in that the pre-precipitated coarse Mg2Si phase has no effect on the particle stimulated nucleation （PSN） mechanism in the dynamic recrystallization of the material. Therefore， the size of grain exhibits negligible change by RFE. RFE reduces the strength of as-quenched 6061 aluminum alloys， while the strength of 6061 aluminum alloys with a long-term aging state can be increased by RFE. However， there are holes inside the material processed by RFE， which reduce the elongation of the alloys.

Introduction: COVID-19 poses risks and leads to complications for vulnerable populations, including children. Unreported cases of COVID-19 among children hinder our understanding of the true disease burden. In this study, we aimed to investigate the proportion of children who report no prior infection to SARS-CoV-2 but who nevertheless exhibit serological evidence of prior infection. Methods: Between November 2022 and February 2023, we recruited children and adolescents under 19 years of age who lacked a prior history of SARS-CoV-2 infection. Participants underwent SARS-CoV-2 antibody testing to assess the presence of IgG antibodies specific to nucleocapsid (N) and spike (S) proteins. Demographic and contact information were also collected. Results: Among 260 COVID-19-free children, the overall anti-N antibody positivity rate, which varied across age groups (4%–25%), was 9.2% (24/260). Contact with individuals who were positive for COVID-19, particularly the children's mothers, significantly increased the likelihood of antibody positivity. The median age of the 34 children who remained unvaccinated against COVID-19 was lower than that of the children who were vaccinated (6.5 vs. 9 years; p

Objective As the core function of urban rail transit brake control devices, the structural principle design of pressure control is crucial for the brake control system. High-frequency switching solenoid valve pressure control method is the mainstream control approach, studying its structural characteristics is particularly important for enhancing the reliability of brake control devices. Method By analyzing different configurations of solenoid valves, the basic structures of five high-frequency switching solenoid valve pressure control methods are identified, including series exhaust, series pressure-holding, parallel exhaust, parallel pressure-holding, and parallel inflation. Their characteristics and applicable scenarios based on their failure modes are summarized. Result & Conclusion According to T/CAMET 04004.4—2018 ′Brake systems of urban rail vehicles Part 4: Technical specification of brake control units′, the exhaust-type pressure control structure is suitable for normal braking air circuits, while pressure-holding and inflation-type pressure control structures are suitable for emergency braking air circuits. The series pressure control structure maintains output pressure stability better than the parallel pressure control structure does, whereas the parallel pressure control structure has a faster inflation rate compared to the series pressure control structure. When designing the pressure control structure of brake control devices, it is essential to comprehensively consider factors such as the target pressure control accuracy, inflation and exhaust rate requirements, and solenoid valve control strategies, and to configure the chamber volume and pipeline diameter appropriately.

Cheryl Lin,1 Alejandra Mella-Velazquez,1 Wendy E Braund,2 Pikuei Tu1 1Policy and Organizational Management Program, Duke University, Durham, NC, USA; 2Pennsylvania Department of Health, Harrisburg, PA, USACorrespondence: Pikuei Tu, Email Pikuei.tu@duke.eduPurpose: Hispanics, the largest minority in America, have increased risk of several medical issues and face noteworthy health disparities. This study compares care-seeking behaviors and choice experience among Hispanics, Asians, Blacks, and Whites, considering SES (income, education, and insurance status) and across five healthcare provider (HCP) types. Concurrent analysis provides a comprehensive view of how and where inequity manifests in healthcare.Methods: A cross-sectional online survey assessed 1485 adults (Hispanic=314, Asian=313, Black=316, White=542, recruited through a panel agency) of the frequency of visiting primary care providers, dentists, optometrists, gynecologists, and specialists for chronic conditions. Participants also rated the importance of self-selecting a HCP and difficulty in finding one.Results: Whites visited each HCP most regularly. Compared to Asians, more Hispanics saw specialists regularly (45.1% vs 56.5%, p=0.042), and Blacks saw dentists less (47.0% vs 38.3%, p=0.028) and gynecologists more often (21.2% vs 33.1%, p=0.024). No other frequency differences were observed among minorities. Low-income participants across four races saw dentists and gynecologists with comparable infrequency. Hispanics and Asians assigned similarly significantly lower self-choice importance and experienced more difficulty relative to Whites or Blacks. Participants with lower income or education visited HCPs less regularly yet perceived the same choice importance as higher-SES peers (p> 0.05). Notably, discrepancies in visit frequency between Whites and minorities were more pronounced in higher-SES than lower-SES group. Differences in experiencing care-seeking difficulty were associated with income (p=0.029) and insurance type (p=0.009) but not education (p> 0.05).Conclusion: Higher income and education increase healthcare utilization; however, racial disparities persist, particularly among higher-SES groups. Despite similarities among minorities, the extent of disparities varied by SES and provider type. The findings help explain evident inequity in healthcare access and health outcomes. Tailored patient education, culturally-specific navigation support, and more inclusive services are needed to address barriers faced by minorities and disadvantaged populations.Keywords: healthcare access, minority, equity, health behavior, patient preference, decision-making

Background Post-stroke cognitive impairment (PSCI) can significantly limit the recovery of stroke patients at all stages and lead to a decline in activity participation and quality of life. Objective Based on the concept of full-cycle rehabilitation in stroke, by investigating the incidence of PSCI, to analyzed the differences of PSCI in different age and disease period and its potential influencing factors. Methods Stroke patients were hospitalized in the rehabilitation departments of 27 hospitals in different regions of China from October 2022 to July 2023 using simple random sampling method for cross-sectional analysis. A total of 402 patients were finally included according to the study criteria, and categorized into the young and middle-aged group (18-64 years old, n=234) and the elderly group (≥65 years old, n=168) according to the criteria of the National Bureau of Statistics of China, and the patients were also categorized into the acute-phase group (1-7 d, n=25), subacute-phase group (8-180 d, n=338), and the chronic-phase group (>180 d, n=39) according to the International Stroke Rehabilitation Alliance. Baseline information on patients was collected through interviews, assessments, and an electronic case system. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), and subscores and total scores were calculated for each cognitive domain. Using the National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Fugl-Meyer Assessment-Lower Extremity (FMA-LE), Berg Balance Scale (BBS), Modified Barthel Index (MBI), Hospital Anxiety Scale (HADS-A), and the Hospital Depression Scale (HADS-D) were used to assess the disease conditions and physical functioning of the patients. Spearman's rank correlation analysis was used to investigate the correlation between cognitive function levels and other clinical indicators at different ages and different stages of disease. Results The prevalence of PSCI in stroke patients was 76.4% (307/402), including 81.0% (136/168) in elderly patients and 73.1% (171/234) in young and middle-aged patients; the prevalence of PSCI in stroke patients was 56.0% (14/25) in the acute phase, 78.4% (265/338) in the subacute phase, and 71.8% (28/39) in the chronic phase. The results of grouping by age and disease period showed that the elderly group had lower visuospatial and executive function, attention, numeracy, delayed recall scores and total MoCA scores than those in the young and middle-aged group (P

Antibiotic-resistant bacteria are becoming more common due to the overuse of antibiotics in aquaculture. Alternative antibiotic solutions are fascinating and under the consideration in many countries. This study's objective was to isolate and identify certain actinomycete isolates with inhibitory action against the hemorrhagic disease-causing Aeromonas hydrophila in intensively cultivated catfish. This investigation isolated ten actinomycete isolates from sediment and water samples of catfish ponds in Vinh Long province. Using the diffusion well method, the study identified all isolates with antogonisttic activity against A. hydrophila. In particular, two isolates, BCA1.2 and BCA1.5, presented the highest inhibitory activity with inhibitory diameter zones of 11±1.0 mm and 10±1.0 mm, respectively. Two actinomycete isolates, BCA1.2 and BCA1.5, had their growth affected by pH, temperature, and NaCl. The findings revealed that two of these isolates showed optimum growth in a pH range of 7.0–8.0 and at 37°C. Two isolates, BCA1.2 and BCA1.5, survived well on medium containing a high salt concentration of NaCl ranging from 3% to 7% and were able to utilize different sources of carbon. They produced a wide range of hydrolytic extracellular enzymes, such as cellulase, amylase, protease, lipase, and chitinase. Isolates BCA1.2 and BCA1.5 were identified as Streptomyces based on morphological, cultural, physiological, and biochemical characteristics and 16S rRNA gene sequencing.

Currently, research and practice on roadway floor heave mainly explore the deformation mechanism and control technology of roadway floor. The mechanical analysis of floor before and after roof cutting and pressure relief in gob-side entry retaining is not comprehensive. In order to solve the above problem, mechanical models of the surrounding rock and floor of the roadway before and after roof cutting are constructed based on the features of coal partition failure. The effects of solid coal, roadway support, and goaf on the floor are analyzed. The analytical solutions for the floor heave of the roadway before and after roof cutting are obtained. The conclusion is drawn that the elastic-plastic zone of the coal wall beside the roadway, the support structure of the roadway, and the load on the floor of the subsidence zone jointly affect the magnitude of the roadway floor heave. Numerical simulation is used to verify the features of rock mass failure, stress distribution, and changes in floor heave in gob-side entry retaining before and after roof cutting and pressure relief. The results show that roof cutting and pressure relief technology can effectively reduce the damage area on the solid coal side and top of the roadway, and maintain the stability of the roadway rock mass structure. The maximum stress of the roadway floor, the resistance of the roadway side support, and the amount of roadway floor heave all decrease, with an average decrease of 25.78%, 56.14%, and 54.07%, respectively. The on-site application results show that the amount of floor heave of thick hard top in gob-side entry retaining is reduced from 709.345 1 mm to 320.965 8 mm. The roof cutting and pressure relief technology can optimize the stress structure of the surrounding rock of the roadway, suppress the floor heave of the roadway, and effectively improve the floor damage.

Objective To investigate the changes of retinal nerve fiber layer (RNFL) thickness and superficial vascular density in patients with Parkinson's disease (PD), and analyze the correlation between the changes and disease severity. Methods Total 43 patients (76 eyes) with PD admitted to the Affiliated Hospital of North Sichuan Medical College from June 2021 to March 2022, and 45 patients (90 eyes) with normal neurological and visual functions from their family members were recruited as the control group. Optical coherence tomography angiography (OCTA) was used to measure RNFL thickness, retinal blood vessel length density and perfusion density, and the area and circumference of foveal avascular zone (FAZ). Disease severity was evaluated by modified Hoehn - Yahr staging, and motor function was evaluated by Unified Parkinson's Disease Rating Scale Ⅲ (UPDRS Ⅲ) in PD group. Pearson and partial correlation analyses were used to investigate the correlation between retinal parameters and PD severity. Results Comparison of OCTA related parameters between the 2 groups: RNFL thickness (t = - 6.424, P = 0.000), central length density (t = - 3.629, P = 0.000), inner ring length density (Z = - 2.846, P = 0.004) and central perfusion density (Z = - 2.703, P = 0.007) in the PD group were lower than those in the control group. Correlation analysis showed that RNFL thickness was negatively correlated with UPDRSⅢ score (r = - 0.625, P = 0.000). Conclusions RNFL thickness may be a potential indicator for early diagnosis and evaluation of the severity of PD.

Time-frequency domain reflection (TFDR) method has the advantages of maturity, convenience and high resolution, so it is widely applied to locate defects in various cables. To ensure the fracture defect of the instrumentation and control (I&C) cable can be effectively discriminated and precisely located in nuclear power plant (NPP), an improved TFDR method is proposed by intervening thermal stress in this paper. Subsequently, different degrees of fracture defects are simulated in a 50-meter multi-core I&C cable, and traditional TFDR and improved TFDR methods are used for detection and verification. Comparing the detection results of both, the peak localization of improved TFDR method for weak defect fracture is improved to 0.2, which is 2.5 times of the traditional TFDR method, and the localization error rate is less than 2.5%. Compared to the traditional TFDR method, improved TFDR method utilizes the thermal stress fluctuation variance curve as the basis for defect identification, the identification power of weak fracture defects can be substantially improved. The original localization distance can be corrected to improves the accuracy of weak fracture damage in improved TFDR method. So the effective identification and localization of weak defects can be further achieved in improved TFDR method.

Abstract In thermoelectric, phase interface engineering proves effective in reducing the lattice thermal conductivity via interface scattering and amplifying the density-of-states effective mass by energy filtering. However, the indiscriminate introduction of phase interfaces inevitably leads to diminished carrier mobility. Moreover, relying on a singular energy barrier is insufficient for comprehensive filtration of low-energy carriers throughout the entire temperature range. Addressing these challenges, we advocate the establishment of a composite phase interface using atomic layer deposition (ALD) technology. This design aims to effectively decouple the interrelated thermoelectric parameters in ZrNiSn. The engineered coherent dual-interface energy barriers substantially enhance the density-of-states effective mass across the entire temperature spectrum while preser carrier mobility. Simultaneously, the strong interface scattering on phonons is crucial for curtailing lattice thermal conductivity. Consequently, a 40-cycles TiO2 coating on ZrNi1.03Sn0.99Sb0.01 achieves an unprecedented zT value of 1.3 at 873 K. These findings deepen the understanding of coherent composite-phase interface engineering.

Abstract Exploration of metastable phases holds profound implications for functional materials. Herein, we engineer the metastable phase to enhance the thermoelectric performance of germanium selenide (GeSe) through tailoring the chemical bonding mechanism. Initially, AgInTe2 alloying fosters a transition from stable orthorhombic to metastable rhombohedral phase in GeSe by substantially promoting p‐state electron bonding to form metavalent bonding (MVB). Besides, extra Pb is employed to prevent a transition into a stable hexagonal phase at elevated temperatures by moderately enhancing the degree of MVB. The stabilization of the metastable rhombohedral phase generates an optimized bandgap, sharpened valence band edge, and stimulative band convergence compared to stable phases. This leads to decent carrier concentration, improved carrier mobility, and enhanced density‐of‐state effective mass, culminating in a superior power factor. Moreover, lattice thermal conductivity is suppressed by pronounced lattice anharmonicity, low sound velocity, and strong phonon scattering induced by multiple defects. Consequently, a maximum zT of 1.0 at 773 K is achieved in (Ge0.98Pb0.02Se)0.875(AgInTe2)0.125, resulting in a maximum energy conversion efficiency of 4.90% under the temperature difference of 500 K. This work underscores the significance of regulating MVB to stabilize metastable phases in chalcogenides.

Fangyuan Kuang,1,2 Yang Gao,3 Qingyun Zhou,4 Chenying Lu,3 Qiaomei Lin,4 Abdullah Al Mamun,5 Junle Pan,6 Shuibo Shi,7 Chaoyong Tu,4,* Chuxiao Shao2,* 1School of Medicine, Shaoxing University, Shaoxing, Zhejiang, 312000, People’s Republic of China; 2Department of Hepatopancreatobiliary Surgery, People Hospital of Lishui, The Sixth Affiliated Hospital of Wenzhou Medical University, The First Affiliated Hospital of Lishui University, Lishui, Zhejiang, 323000, People’s Republic of China; 3Department of Radiology, the Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, 323000, People’s Republic of China; 4Department of Hepatopancreatobiliary Surgery, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, 323000, People’s Republic of China; 5Key Laboratory of Joint Diagnosis and Treatment of Chronic Liver Disease and Liver Cancer of Lishui, The Sixth Affiliated Hospital of Wenzhou Medical University, Lishui People’s Hospital, Lishui, Zhejiang, 323000, People’s Republic of China; 6First Academy of Clinical Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, 325000, People’s Republic of China; 7The First Clinical Medical College of Nanchang University, Nanchang City, Jiangxi, 330000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chaoyong Tu, Department of Hepatopancreatobiliary Surgery, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, Zhejiang, 323000, People’s Republic of China, Email tcy7409@163.comBackground: A limited number of studies have examined the use of radiomics to predict 3-year overall survival (OS) after hepatectomy in patients with hepatocellular carcinoma (HCC). This study develops 3-year OS prediction models for HCC patients after liver resection using MRI radiomics and clinicopathological factors.Materials and Methods: A retrospective analysis of 141 patients who underwent surgical resection of HCC was performed. Patients were randomized into two set: the training set (n=98) and the validation set (n=43) including the survival groups (n=111) and non-survival groups (n=30) based on 3-year survival after hepatectomy. Furthermore, x2 or Fisher’s exact test, univariate and multivariate logistic regression analyses were conducted to determine independent clinicopathological risk factors associated with 3-year OS. 1688 quantitative imaging features were extracted from preoperative T2-weighted imaging (T2WI) and contrast-enhanced magnetic resonance imaging (CE-MRI) of arterial phase (AP), portal venous phases (PVP)and delay period (DP). The features were selected using the variance threshold method, the select K best method and the least absolute shrinkage and selection operator (LASSO) algorithm. By using Bernoulli Naive Bayes (BernoulliNB) and Multinomial Naive Bayes (MultinomialNB) classifiers, we constructed models based on the independent clinicopathological factors and Rad-scores. To determine the best model, receiver operating characteristics (ROC) and Delong’s test were used. Moreover, calibration curves were used to determine the calibration ability of the model, while decision curve analysis (DCA) was implemented to evaluate its clinical benefit.Results: The fusion model showed excellent prediction precision with AUC of 0.910 and 0.846 in training and validation set and revealed significant diagnostic accuracy and value in the calibration curve and DCA analysis.Conclusion: Nomograms based on MRI radiomics and clinicopathological factors have significant predictive value for 3-year OS after hepatectomy and can be used for risk classification.Keywords: hepatocellular carcinoma, hepatectomy, MRI radiomics

Abstract Background Oxford Nanopore provides high throughput sequencing platforms able to reconstruct complete bacterial genomes with 99.95% accuracy. However, even small levels of error can obscure the phylogenetic relationships between closely related isolates. Polishing tools have been developed to correct these errors, but it is uncertain if they obtain the accuracy needed for the high-resolution source tracking of foodborne illness outbreaks. Results We tested 132 combinations of assembly and short- and long-read polishing tools to assess their accuracy for reconstructing the genome sequences of 15 highly similar Salmonella enterica serovar Newport isolates from a 2020 onion outbreak. While long-read polishing alone improved accuracy, near perfect accuracy (99.9999% accuracy or ~ 5 nucleotide errors across the 4.8 Mbp genome, excluding low confidence regions) was only obtained by pipelines that combined both long- and short-read polishing tools. Notably, medaka was a more accurate and efficient long-read polisher than Racon. Among short-read polishers, NextPolish showed the highest accuracy, but Pilon, Polypolish, and POLCA performed similarly. Among the 5 best performing pipelines, polishing with medaka followed by NextPolish was the most common combination. Importantly, the order of polishing tools mattered i.e., using less accurate tools after more accurate ones introduced errors. Indels in homopolymers and repetitive regions, where the short reads could not be uniquely mapped, remained the most challenging errors to correct. Conclusions Short reads are still needed to correct errors in nanopore sequenced assemblies to obtain the accuracy required for source tracking investigations. Our granular assessment of the performance of the polishing pipelines allowed us to suggest best practices for tool users and areas for improvement for tool developers.

Objective To study the influence of air springs on maglev train system as one of the components, and solve the problem of deteriorated suspension performance in maglev train system due to the influence of air springs, the mechanism research and simulation analysis of the above problem are carried out. Method First, a maglev model without air springs is built, and based on this, a control algorithm is designed. According to the performance indicators of the maglev system, the optimal control parameters are designed. After determining the control algorithm and optimal control parameters, the influence of air springs is considered in the maglev system model to study the influence of air spring stiffness on maglev suspension performance. The performance of the maglev system is simulated using MATLAB software. During the simulation process, the air spring stiffness is changed without changing the control parameters, and the changes in maglev suspension performance are observed. When the maglev suspension performance deteriorates, the optimal suspension performance is maintained through optimizing control parameters. Result & Conclusion Simulation results show that the air spring stiffness is within a certain range, and the greater the stiffness, the less conducive to the maglev system stability. When the air spring stiffness increases, increasing the stiffness and damping of the control system appropriately is beneficial for the stability of the maglev system.

Background: Lung cancer, the most commonly diagnosed cancer globally, has the highest incidence and mortality rates in Taiwan. It can be divided into two types. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of lung cancers, which is further divided into adenocarcinoma, squamous cell carcinoma, and large cell lung cancer accounting for approximately 40%, 25%, and 15% of NSCLC cases, respectively. Small cell lung cancer accounts for approximately 15% of lung cancers. Early systemic therapy NSCLC was based on chemotherapy, and immunotherapy is currently under development. Fucoidan, from brown seaweed extracts, shows promise in mitigating radiation-induced lung fibrosis in animal studies, suggesting its potential as an adjuvant for radiation therapy-related lung fibrosis in lung cancer patients. However, the clinical utility of such adjuvant therapy in lung cancer treatment remains uncertain. The purpose of this study was to investigate the effects of oral administration of oligo-fucoidan on the survival rate, quality of life, and immunity of patients with lung cancer. Methods: Subjects with Non-small cell lung cancer aged between 20 and 80 were collected from outpatient clinics, divided into control group (n = 7): conventional therapy and fucoidan group (n = 13): received conventional therapy+ oral supplementation of oligo-fucoidan (550 mg × 4 tablets). Data were collected before the study, at weeks 4, 12, and 24 during the study, and to collect 20 ml of peripheral blood, for analysis biochemical data, liver and kidney function, lymphocyte population, inflammation cytokines, and using EORTC QLQ-C30 questionnaire to assess quality of life. Results: The survival rates of the subjects in the control and fucoidan groups were 20% and 28.6%, respectively. During the study, patients in the fucoidan group experienced a better quality of life than those in the control group, but this difference lacked statistical significance. Oligo-fucoidan increases the CD19 lymphocyte population. The patients in the fucoidan group also had Lower inflammatory cytokine. Conclusion: Oligo-fucoidan holds promise as an adjuvant therapy to enhance the survival rate, quality of life, and immune function in patients with lung cancer.

Abstract Obesity shapes anti-tumor immunity through lipid metabolism; however, the mechanisms underlying how colorectal cancer (CRC) cells utilize lipids to suppress anti-tumor immunity remain unclear. Here, we show that tumor cell-intrinsic ATP6V0A1 drives exogenous cholesterol-induced immunosuppression in CRC. ATP6V0A1 facilitates cholesterol absorption in CRC cells through RAB guanine nucleotide exchange factor 1 (RABGEF1)-dependent endosome maturation, leading to cholesterol accumulation within the endoplasmic reticulum and elevated production of 24-hydroxycholesterol (24-OHC). ATP6V0A1-induced 24-OHC upregulates TGF-β1 by activating the liver X receptor (LXR) signaling. Subsequently, the release of TGF-β1 into the tumor microenvironment by CRC cells activates the SMAD3 pathway in memory CD8+ T cells, ultimately suppressing their anti-tumor activities. Moreover, we identify daclatasvir, a clinically used anti-hepatitis C virus (HCV) drug, as an ATP6V0A1 inhibitor that can effectively enhance the memory CD8+ T cell activity and suppress tumor growth in CRC. These findings shed light on the potential for ATP6V0A1-targeted immunotherapy in CRC.

Background: Selecting embryos with the highest implantation potential is crucial for in vitro fertilization (IVF) success.Both the timing of blastulation, day 5 (D5) or D6, and the embryo quality have been suggested as influentialfactors in determining the clinical outcome of single euploid blastocyst transfers. However, evidence supporting thesuperiority of D5 over D6 blastocysts remains inconclusive. The aim of this study was to compare clinical outcomesfollowing the transfer of euploid blastocysts with different quality and timing of blastulation.Materials and Methods: A retrospective cohort study was conducted at our Assisted Reproductive Center, analyzingthe outcome of 774 transfers with D5 euploids and 155 transfers with D6 euploids performed between January 2019and February 2022.Results: The live birth rate was significantly lower in the euploid D6 group compared to the euploid D5 group (38.71vs.55.04%, P=0.001). The outcome was significantly influenced by the quality of the embryos. Live birth rates were 62.14and 53.61% following transfers of D5 and D6 excellent embryos respectively, 45.18 and 32.21% following transfer ofD5 and D6 good embryos but only 28.64 and 19.32% following transfer of D5 and D6 fair embryos. The outcome differencewas statistically significant across embryo quality categories (P=0.001). The adjusted risk ratios (RR) of clinicaloutcomes indicated that excellent euploid D5 embryos consistently outperformed other types of embryo quality.Conclusion: The timing of blastulation and embryo quality are crucial factors in determining the success of singleeuploid blastocyst transfers. Excellent euploid D5 transfers yielded superior clinical outcomes, providing valuableinsights for IVF teams and patients when selecting embryos to be transferred.