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Abstract Purpose To evaluate the impact of exercise-based cardiac rehabilitation (CR) on the cardiopulmonary function and prognosis in post-percutaneous coronary intervention (PCI) patients with ST elevation myocardial infarction (STEMI) in extremely cold regions of China. Methods This retrospective study included 2,162 patients diagnosed with STEMI who were treated at five medical centers in extremely cold regions of China, between January 2020 and December 2023. All included patients underwent emergency coronary angiography and PCI. Based on whether they received exercise-based CR, patients were divided into a CR group and a non-CR group. To adjust for variations in initial risk factors and baseline characteristics between patients who underwent CR or not, we employed the propensity score matching. Each patient was matched in a 1:1 ratio with replacement. Patients who either participated in CR or did not, but could not be adequately matched, were excluded from the study population. Patient information between the two groups was systematically compared in hospital and at follow-up. Results The rate of heart failure, re-hospitalization, and ventricular arrhythmia in CR group was significantly lower than that in non-CR group. The left ventricular ejection fraction (LVEF) measured by echocardiography in CR group were significantly higher than those in non-CR group. The cardiopulmonary test indicators for patients in CR group showed significant improvement over one year, including Power, HR, VCO₂, VO₂, VE, VD/VT, PetCO₂, CHO, CO, and SV, all with statistical significance. Multivariate COX regression analysis showed that CR was independently associated with heart failure in follow up. Conclusion Exercise-based CR effectively improves the recovery of cardiac function and prognosis in post-PCI patients with STEMI in extremely cold regions of China. Graphical Abstract

In this work, a foam composed of helical carbon nanofiber arrays was successfully synthesized via chemical vapor deposition. By controlling synthesis parameters including the synthesising temperature and gas flow rate, carbon nanofibers with straight, kinked, and spring-like morphologies were obtained. Adjusting the precursor feed led to the formation of foams with well-ordered carbon nanofiber structures. The nanofibers exhibit diameters ranging from 98 to 175 nm and lengths extending to the centimetre scale. Experimental results confirm that these fibers are organic carbon nanofibers, attributed to low-temperature catalytic synthesis. Structural characterization reveals that the catalyst assumes a regular polyhedral shape and becomes embedded within the fibers, which symmetrically grow from both faces of the catalyst. Structural analysis indicate that the carbon nanofibers are hollow, multi-walled structures with numerous defects. The resulting foam demonstrates porous, along with excellent elasticity and high mechanical strength.

Abstract Studies on triaxial contact stresses and asphalt pavement rutting are of great significance for traffic safety and the durability of the asphalt pavement. Our new approach considers more evaluating indicators by investigating compressive creep, vertical, and longitudinal permanent deformation to analyse asphalt pavement rutting under triaxial contact stress during typical driving conditions. For this purpose, firstly sophisticated three-dimensional finite element models encompassing the truck-bus tire and asphalt pavement temperature are developed. Secondly, a comparative analysis was conducted by collating the predicted deformations obtained through finite element analysis with the deformations measured in laboratory experiments using specialized sensors. Finally, the rutting analysis process under triaxial contact stresses during typical driving conditions is established. The results show asphalt pavement exhibits different temperature gradient changes between daytime and nighttime during the summer season. The longitudinal contact stress under braking condition has a significant impact on the longitudinal permanent deformation and compressive creep of asphalt pavement, especially, the longitudinal permanent deformation of the feature points in the middle layer exhibits the most pronounced sensitivity to this contact stress. In addition, the maximal compressive creep is observed at the top of the middle layer, although the characteristic positions for the maximum values of positive and negative creep differ. The proposed new method is beneficial for improving the accuracy and comprehensiveness of asphalt pavement rutting analysis.

Abstract Lactate produced during ischemia-reperfusion injury is known to promote lactylation of proteins, which play controversial roles. By analyzing the lactylomes and proteomes of mouse myocardium during ischemia-reperfusion injury using mass spectrometry, we show that both Serpina3k protein expression and its lactylation at lysine 351 are increased upon reperfusion. Both Serpina3k and its human homolog, SERPINA3, are abundantly expressed in cardiac fibroblasts, but not in cardiomyocytes. Biochemically, lactylation of Serpina3k enhances protein stability. Using Serpina3k knockout mice and mice overexpressing its lactylation-deficient mutant, we find that Serpina3k protects from cardiac injury in a lysine 351 lactylation-dependent manner. Mechanistically, ischemia-reperfusion-stimulated fibroblasts secrete Serpina3k/SERPINA3, and protect cardiomyocytes from reperfusion-induced apoptosis in a paracrine fashion, partially through the activation of cardioprotective reperfusion injury salvage kinase and survivor activating factor enhancement pathways. Our results demonstrate the pivotal role of protein lactylation in cardiac ischemia-reperfusion injury, which may hold therapeutic value.

Abstract The rapid growth of electric vehicles (EVs) in China challenges raw material demand. This study evaluates the impact of recycling and reusing EV batteries on reducing material demand and carbon emissions. Integrating a national-level vehicle stock turnover model with life-cycle carbon emission assessment, we found that replacing nickel-cobalt-manganese batteries with lithium iron phosphate batteries with battery recycling can reduce lithium, cobalt, and nickel demand between 2021 and 2060 by up to 7.8 million tons (Mt) (67%), 12.4 Mt (96%), and 37.2 Mt (93%), respectively, significantly decreasing reliance on import. Moreover, battery recycling coupled with reuse can reduce carbon emissions by up to 6,532-6,864 Mt (36.0-37.9%), depending on four recycling methods employed. However, this reuse strategy delays battery recycling and risks lithium supply shortage, necessitating trade-offs between carbon reduction and material supply. Future technologies, such as lithium-sulfur and all-solid-state batteries, despite their energy efficiency, might exacerbate lithium shortage, underscoring the crucial need for increased lithium supply.

Abstract Background Displaced tibial tubercle (TT) fractures in adolescents are typically treated with open reduction and internal fixation. While metallic screw (MS) fixation provides strong stability, it often results in a high incidence of postoperative screw head protrusion or irritation, leading to additional removal surgery. Bioabsorbable screw (BS) fixation presents an alternative that may avoid these issues, though its stability has not yet been extensively documented in the literature. This study aims to compare the efficacy of BS versus MS in the fixation of TT fractures. Methods A retrospective analysis was conducted on adolescent patients with TT fractures who underwent surgical treatment from September 2015 to September 2023. Patients were divided into two groups based on the fixation method: The BS group and the MS group. Data collected included patient demographics, fracture details, treatment strategies, radiological and clinical rehabilitation outcomes, and postoperative complications. Knee joint function was evaluated using the Lysholm and Tegner scores. Statistical analysis was performed to identify differences between the variables of the two groups. Results A total of 30 patients with 32 fractures were included, with 15 fractures in the BS group and 17 in the MS group. The average follow-up period was 42.1 (range: 12.0-109.5) months. The demographic characteristics, fracture details, and treatment strategies were comparable between the two groups. No significant differences were observed between the groups in fracture healing time, time to return to pre-injury activities, or knee joint function as assessed by the Lysholm and Tegner scores at the final follow-up. However, compared with the MS group, the BS group showed a shorter time to regain full range of motion (ROM) in the knee joint and experienced lower rates of postoperative hardware irritation and joint stiffness. Conclusions Both BS and MS fixations are safe and effective for treating adolescent TT fractures. BS fixation has the advantages of avoiding hardware irritation, facilitating earlier recovery of knee joint ROM, reducing the incidence of joint stiffness, and eliminating the need for additional removal surgery. Clinical trial number Not applicable.

Objective: Osteoarthritis (OA) is a progressive joint disease characterized by degeneration and destruction of articular cartilage. Arctiin (ARC) has been shown in many studies to have potential anti-inflammatory, anti-apoptotic, and antioxidant effects in various diseases. However, the mechanism by which ARC exerts its protective effects in OA is not fully understood. Here, we explore the mechanism by which ARC plays its protective role in OA. Materials and Methods: Mouse chondrocytes were isolated and characterized through toluidine blue staining and collagen II immunofluorescence labeling. A mouse-based experimental model was developed to induce chondrocyte inflammation through Interleukin-1β (IL-1β). Subsequently, ARC was administered in various doses to mitigate this inflammation. Techniques such as biochemical assays, Enzyme-linked immunosorbent assay, quantitative real-time polymerase chain reaction (qRT-PCR), Western blotting, and immunofluorescence labeling were employed to detect changes in nitric oxide (NO), lactate dehydrogenase (LDH), inflammatory markers, and components of the cartilage matrix in chondrocytes. RNA-sequencing (RNA-seq) was utilized to explore variations in gene expression among chondrocytes across different groups. The genes and signaling pathways that were identified underwent analysis through Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment studies. Validation of gene and protein expression was carried out using qRT-PCR, Western blotting, and cellular flow cytometry, based on the results from sequencing. Furthermore, Safranin-O fast green staining and immunohistochemistry staining were performed on slices of the mice knee joint to evaluate the OA Research Society International score, alterations in the cartilage matrix, and levels of apoptosis-related proteins at sites of knee cartilage damage in an arthritis model induced by monosodium iodoacetate (MIA) and physical activity. Results: It was found that ARC effectively inhibits the production of IL-1β-induced chondrocytes’ inducible NO synthase, cyclooxygenase-2, NO, LDH, IL-6, and tumor necrosis factor-α. ARC exhibited a dose-dependent effect on chondrocytes by reducing IL-1β-induced matrix metalloproteinase-3 (MMP-3) and a disintegrin and metalloproteinase with thrombospondin motifs-5 levels while increasing Aggrecan levels. RNA-seq and bioinformatics analysis revealed that ARC’s therapeutic effects involve apoptotic signaling pathways through the downregulation of Bcl-2-associated X protein (Bax) and caspase-3 expression and the upregulation of B-cell lymphoma-2 (Bcl-2) expression in IL-1β-induced chondrocytes. ARC significantly raised the levels of aggrecan and Bcl-2 and decreased the levels of MMP-3, Bax, and caspase-3 in an arthritis model induced by MIA and movement. Conclusions: Through RNA-seq, in vitro cell assays, and in vivo experiments, this research established the link between apoptosis and inflammation in the progression of OA and confirmed the protective effects of ARC on chondrocytes and its key targets. This highlights ARC’s therapeutic potential and its role in the development of treatments for OA.

Abstract Background Functional mitral regurgitation (MR) is a common form of mitral valve dysfunction that often persists even after surgical intervention, requiring reoperation in some cases. To advance our understanding of the pathogenesis of functional MR, it is crucial to characterize the cellular composition of the mitral valve leaflet and identify molecular changes in each cell subtype within the mitral valves of MR patients. Therefore, we aimed to comprehensively examine the cellular and molecular components of mitral valves in patients with MR. Methods We conducted a single-cell RNA sequencing (scRNA-seq) analysis of mitral valve leaflets extracted from six patients who underwent heart transplantation. The cohort comprised three individuals with moderate-to-severe functional MR (MR group) and three non-diseased controls (NC group). Bioinformatics was applied to identify cell types, delineate cell functions, and explore cellular developmental trajectories and interactions. Key findings from the scRNA-seq analysis were validated using pathological staining to visualize key markers in the mitral valve leaflets. Additionally, in vitro experiments with human primary valvular endothelial cells were conducted to further support our results. Results Our study revealed that valve interstitial cells are critical for adaptive valve remodelling, as they secrete extracellular matrix proteins and promote fibrosis. We discovered an abnormal decrease in a subpopulation of FABP4 (fatty acid binding protein 4)-positive proliferating valvular endothelial cells. The trajectory analysis identifies this subcluster as the origin of VECs. Immunohistochemistry on the expanded cohort showed a reduction of FABP4-positive VECs in patients with functional MR. Intervention experiments with primary cells indicated that FABP4 promotes proliferation and migration in mitral valve VECs and enhances TGFβ-induced differentiation. Conclusions Our study presented a comprehensive assessment of the mitral valve cellular landscape of patients with MR and sheds light on the molecular changes occurring in human mitral valves during functional MR. We found a notable reduction in the proliferating endothelial cell subpopulation of valve leaflets, and FABP4 was identified as one of their markers. Therefore, FABP4 positive VECs served as proliferating endothelial cells relates to functional mitral regurgitation. These VECs exhibited high proliferative and differentiative properties. Their reduction was associated with the occurrence of functional MR.

Abstract Background To analyze the safety and efficacy of microsurgical subinguinal varicocelectomy(MSV) performed with and without preservation of all testicular arteries and lymphatic system. Methods All of the 98 patients with varicocele who underwent MSV were included in the analysis. Fifty-eight male patients surgically underwent MSV with preservation of all testicular arteries and lymphatic system(Group 1). The other 40 male patients surgically underwent MSV with preservation of a single testicular artery, while the remaining vascular bundle sparing the vas deferens with its vessels was then isolated"en bloc,” ligated and cut(Group 2). Operative time, semen parameters and complications were then compared. Results Mean operative time for Group 1 was significantly longer than that of Group 2(90.26 ± 21.69 min vs. 79.30 ± 19.58 min, P = 0.01). Visual analogue pain scale (VAS) decreased significantly in both groups. Group 1 experienced a decrease from a median of 5 (interquartile range, IQR: 4 ~ 6) to 1 (IQR: 0 ~ 2), P

Acid mine drainage has always been of global concern, primarily due to its low pH, high concentration of heavy metals and toxic substances, and serious impact on the surrounding environment and ecology of mines. However, the research progress and hotspots in this field of acid mine drainage processing are still unclear. To better understand the research hotspots and trends of acid mine drainage processing from 2004 to 2023, we used CiteSpace bibliometric software to visually analyze 1142 English-language research articles and reviews from the Web of Science core database. Results indicated that this field has received increas-ing attention from researchers worldwide, especially since 2017. The USA and China stand out as major contributors, yet their international collaboration doesn't match South Africa robust partnerships. Strengthening cooperation with other nations should be a priority for both the USA and China. The University of Quebec and University of South Africa were the most production institution. Vhahangwele Masindi from South Africa was the most active author. The top two core journals in this field were Science of the Total Environment and Water Re-search. Additionally, through keyword co-occurrence, clustering, and burst analysis, it is evi-dent that research on heavy metal mechanisms and resource recovery will be the future re-search hotspots in this field of acid mine drainage. This study provides researchers with an opportunity to understand the hotspots and trends in acid mine drainage research from a bibliometric perspective, and serves as a reference for future studies.

Abstract Coal gangue, as a byproduct of coal mining and washing, has experienced a significant surge in production due to escalating energy demands. The extensive accumulation of coal gangue has resulted in significant challenges, including resource wastage and severe environmental contamination. To better understanding of the current research landscape, hotspots, and emerging trends in the comprehensive utilization of coal gangue, we employed the CiteSpace bibliometric software to visually analyze 200 articles published in the Web of Science Core Collection from 2004 to 2023. The majority of these publications (85%) were published between 2019 and 2023, with most originating from China. This study used cooperative network analysis to examine and synthesize the contributions of different institutions and scholars on the research examining the comprehensive utilization of coal gangue. By employing advanced techniques such as keyword co-occurrence and cluster analysis, our study delves into dynamic research hotspots in this field over different time periods. Through trend and current situation analyses, future research directions for the comprehensive utilization of coal gangue are proposed, with the aim of inspiring relevant research and guiding future policy formulation.

Piezoelectric ceramics provide high strain and large driving forces in actuators. A large electrostrain can be realized by the introduction of point defects such as vacancies, interstitial defects, and substitution defects. With Mn doping, a significant increase in the reversible electrostrain from 0.05% to 0.17% could be achieved in potassium niobite lead-free piezoelectric ceramics. The origins of the large electrostrain were analyzed via in situ X-ray diffraction (XRD) under an electric field. The electrostrain and other typical electrical properties of the samples were measured at various temperatures, which enabled the ceramics to perform under a very wide temperature range, such as −80–130 °C for the 0.5 mol% Mn-doped sample with low dielectric loss (≤ 0.02). More importantly, combined with characterizations of the defect behavior by thermally stimulated depolarization current (TSDC), the failure mechanisms of electrostrain in a high-temperature environment could be revealed, which was associated with synergistic damage to the defects caused by the electric field and high temperature. The results can provide good ideas and a basis for the design of piezoelectric materials with good electrostrain stability over a wide temperature range.

Abstract Background Little is known about the role of D-dimer (DD) on the prognosis of patients undergoing coronary endarterectomy (CE) combined with coronary artery bypass grafting (CABG). Methods A total of 371 patients undergoing CE with CABG between January 2018 and July 2022 were retrospectively enrolled. The primary endpoint was the perioperative major adverse cardiovascular and cerebrovascular events (MACCE). Univariate logistic regression was performed to detect the relationship between preoperative DD level and the occurrence of perioperative MACCE. Receiver operating characteristics method was applied to determine the optimal cut-off threshold, while the multivariable logistic regression analysis was used to adjust the potential confounders. Results Univariate logistic regression revealed that preoperative DD level was associated with increased risk of perioperative MACCE. The optimal cut-off for DD was 0.235 µg/ml. More patients in the high DD group suffered from perioperative MACCE than the low DD group (13.2% vs. 3.9%, P = 0.004), even after multiple adjustment (odds ratio [OR]: 2.93, 95% confidence interval [CI]: 1.07–8.04, P = 0.036) in the multivariable logistic analysis. The occurrence of perioperative myocardial infarction was also much higher in high DD group (3.1% vs. 11.2%, P = 0.013). Conclusions In conclusion, high preoperative DD levels might predict an increased risk of perioperative adverse events after CE with CABG.

Abstract Background: The collection of substantial amounts of electroencephalogram (EEG) data is typically time-consuming and labor-intensive, which adversely impacts the development of decoding models with strong generalizability, particularly when the available data is limited. Utilizing sufficient EEG data from other subjects to aid in modeling the target subject presents a potential solution, commonly referred to as domain adaptation. Most current domain adaptation techniques for EEG decoding primarily focus on learning shared feature representations through domain alignment strategies. Since the domain shift cannot be completely removed, target EEG samples located near the edge of clusters are also susceptible to misclassification. Methods: We propose a novel adaptive deep feature representation (ADFR) framework to improve the cross-subject EEG classification performance through learning transferable EEG feature representations. Specifically, we first minimize the distribution discrepancy between the source and target domains by employing maximum mean discrepancy (MMD) regularization, which aids in learning the shared feature representations. We then utilize the instance-based discriminative feature learning (IDFL) regularization to make the learned feature representations more discriminative. Finally, the entropy minimization (EM) regularization is further integrated to adjust the classifier to pass through the low-density region between clusters. The synergistic learning between above regularizations during the training process enhances EEG decoding performance across subjects. Results: The effectiveness of the ADFR framework was evaluated on two public motor imagery (MI)-based EEG datasets: BCI Competition III dataset 4a and BCI Competition IV dataset 2a. In terms of average accuracy, ADFR achieved improvements of 3.0% and 2.1%, respectively, over the state-of-the-art methods on these datasets. Conclusions: The promising results highlight the effectiveness of the ADFR algorithm for EEG decoding and show its potential for practical applications.

Abstract This study is to analyse the failure patterns and long-term survival after stereotactic body radiotherapy (SBRT) in patients with T1-3N0M0 inoperable non-small cell lung cancer (NSCLC). Early-stage NSCLC patitents who received SBRT at Zhejiang Cancer Hospital from January 2012 to September 2018 were retrospectively analyzed. The primary endpoint were the patterns of disease progression, which were divided into local recurrence, regional failure, and distant metastasis. Kaplan-Meier method survival analysis was used to calculate overall survival (OS), progression-free survival (PFS). Cox model was used for univariate analysis and multivariate analysis. A total of 215 patients with 224 lesions were enrolled. After the median follow-up time of 50.8 months (1.0-117.9 months), 76 (35.3%) patients progressed, with regional progression occurring in 4 cases (1.8%), local and local-regional progression in 17 cases (7.9%), various distant metastases developing in 55 cases (25.6%). The OS rates at 1, 3, and 5 years were 97.1%, 80.9%, and 63.8%, respectively, with a median OS of 92.2 months (95%CI, 61.5-122.9 months). The PFS rates at 1, 3, and 5 years were 87.5%, 65.9%, and 50.8%, respectively, with a median PFS of 62.2 months (95% CI, 45.0-59.4 months). There was no significant difference in OS (P = 0.832) and PFS (P = 0.672) between the two groups with or without pathology. Multivariate analysis showed that BED and patient age were independent prognostic factors affecting early-stage lung cancer survival (all P

Objective Hip fracture (HF) has been described as the “last fracture of life” in the elderly, so the assessment of HF risk is extremely important. Currently, few studies have examined the relationship between imaging data from chest computed tomography (CT) and HF. This study demonstrated that pectoral muscle index (PMI) and vertebral body attenuation values could predict HF, aiming to opportunistically assess the risk of HF in patients without bone mineral density (BMD) based on chest CT for other diseases. Methods In the retrospective study, 800 participants who had both BMD and chest CT were enrolled from January 2021 to January 2024. After exclusion, 472 patients were finally enrolled, divided into the healthy control (HC) group and the HF group. Clinical data were collected, and differences between the two groups were compared. A predictive model was constructed based on the PMI and CT value of the fourth thoracic vertebra (T4HU) by logistic regression analysis, and the predictive effect of the model was analyzed by using the receiver operating characteristic (ROC) curve. Finally, the clinical utility of the model was analyzed using decision curve analysis (DCA) and clinical impact curves. Results Both PMI and T4HU were lower in the HF group than in the HC group (p

Purpose: To explore the clinical characteristics of pediatric pelvic fracturs caused by traffic accidents and to analyze the accompanying injuries and complications. Methods: A total of 222 cases involved traffic accidents was enrolled in this case-control study. The data of children with pelvic fractures caused by traffic accidents who were admitted to our hospital from January 2006 to December 2021 were analyzed retrospectively. Sex, age, Tile classification, abbreviated injury scale score, injury severity score, mortality, and accompanying injuries were studied. The ANOVA was used for measurement data, and the non-parametric rank sum test was used for non-normally distributed data. The Fisher's exact probability method was used for the count data. Results: Of all enrolled cases, 140 are boys and 82 are girls, including 144 cases aged < 6 years, 65 aged between 6 and 12 years, and 13 aged > 12 years. Depending on the injury mechanism, there are 15 cases involving pedestrians vs. motorcycles (PVM), 91 cases involving pedestrians vs. passenger cars (PVC), 78 cases involving pedestrians vs. commercial vehicles (PVV), and 38 cases involving motor vehicles vs. motor vehicles (MVM). Associated injuries are reported in 198 cases (89.2%), primarily involving the abdomen injury in 144 cases (64.9%), and lower limb injury in 99 cases (44.6%). PVV injury involves longer hospital stay (p = 0.004). Intensive care unit admission rate is significantly higher in the MVM group than in other groups (p = 0.004). Head injury (p = 0.001) and face injury (p = 0.037) are more common in the MVM group, whereas abdominal injury (p = 0.048) and lower limb injury (p = 0.037) are more common in the PVV group. In the MVM group, the brain injury (p = 0.004) and femoral neck injury (p = 0.044) are more common. In the PVM group, the mediastinum (p = 0.004), ear (p = 0.009), lumbar vertebrae (p = 0.008), and spinal cord (p = 0.011) are the most vulnerable regions, while in the PVV group, the perineum (p 12 years have higher pelvic abbreviated injury scale scores (p = 0.019). There are significant differences in the classification of pelvic fractures among children < 6, 6 – 12, and > 12 years of age, with Tile C being more likely to occur in children > 12 years of age (p = 0.033). Children aged > 12 years are more likely to sustain injuries to the spleen (p = 0.022), kidneys (p = 0.019), pancreas (p

The Gravity Recovery and Climate Experiment (GRACE) and GRACE Follow-On (GRACE-FO) missions have enabled consistent production of monthly gravity field solutions by international institutes, contributing to the International Centre for Global Earth Models. Each institute employs distinct processing strategies, yielding varied estimates of terrestrial water storage (TWS). In this study, we employ statistical collocation techniques (Total assessment ratio, TAR) to assess and compare the performance of GRACE TWS data products (2003.03 ~ 2014.03) and GRACE-FO TWS data (2018.06 ~ 2022.11). For GRACE TWS, the TAR values are as follows: COST-G (0.15), ITSG (0.83), APM-SYSU (0.85), CSR (0.91), JPL (0.93), GFZ (0.94), Tongji (0.96), HUST (1.08), SUST (1.18), CNES (1.37), and AIUB (1.41). Similarly, for GRACE-FO TWS, the TAR values are COST-G (0.15), JPL (0.81), ITSG (0.96), CSR (0.97), GFZ (1.06), and CNES (1.41). Furthermore, our comparison across basin sizes and climatic regions reveals that COST-G exhibits lower uncertainty and larger signal-to-noise ratios in TWS, making it particularly noteworthy for its utility. Conversely, other single solutions that depict long-term trends and annual amplitudes demonstrate comparable values across various basin sizes, climatic regions, and specific areas.

Hydrotalcite-like materials (OSA-LDH) were prepared used oil shale ash (OSA), which came from a thermal power plant area, as the main raw material. The characterization results of X-ray diffraction (XRD), scanning electron microscope (SEM), transmission electron microscope (TEM), and thermogravimetric-differential scanning calorimetry (TG-DSC) showed that the prepared samples were mesoporous materials in a crystal state and were layered and contained lattice oxygen and a large number of surface hydroxyl groups. The adsorption property of the prepared samples was confirmed and evaluated by adsorption experiments with Pb2+ as the target pollutant. The adsorption process was in accord with the Langmuir isothermal adsorption equation, and the adsorption data fitted perfectly with the pseudo-second kinetic equation. The saturated adsorption capacity for Pb2+ was 120.92 mg·g−1 at a temperature of 298 K and initial concentration of 300 mg·L−1. The main adsorption mechanisms of OSA-LDH for Pb2+ were chemical bond cooperation and electrostatic bond cooperation. This paper aimed to not only prepare an economical and effective adsorbent to remove heavy metal ions from the solution but also provide a new path for the treatment and utilization of OSA so as to realize efficient waste resource utilization.

[Objective] To investigate the characteristics of lesions and clinical features of keloids. [Methods] This study included a total of 395 patients with keloids who were diagnosed and treated at the Dermatology Department of the Second Hospital of Hebei Medical University between October 2022 and October 2023. Patients′ general information, characteristics of onset and treatment history were analyzed. [Results] The male-to-female ratio was 1∶1.04. The peak onset age was between 19~28 years old. The chest (48.35%) and shoulders/back (22.28%) were the two most commonly affected areas. One hundred sixty-two (41.01%) patients had single lesion on single site. Patients with a family history of keloids accounted for 4.30%. Among the 395 patients, 74.94% of the patients had not received any treatments, while 25.06% had a history of treatment prior to visiting our clinic. Twelve patients had received multiple or combination modality treatments, and 87 patients had received single modality treatment. Patients who had received previous treatments experienced recurrence. [Conclusions] Keloids primarily affect young individuals, predominantly on the chest and shoulders/back, and mostly present as single lesion on one body site. There are no significant differences in onset sites, clinical classification and lesion sizes between genders. Genetic factors can affect the development of keloids. Patients with keloids are often treated with local drug injection, surgical resection, and other methods. But the recurrence rate is high, indicating a challenge in the treatment of keloids.

Abstract Background Sphingosine-1-phosphate receptor 1 (S1PR1) is considered to be closely related to a variety of malignant tumors, but the role and mechanism of S1PR1 in lung adenocarcinoma are not fully understood. In this study, we aim to explore the role and downstream signaling pathways of S1PR1 in the malignant biological functions of lung adenocarcinoma (LUAD). Methods Bioinformatics analysis, RT-qPCR, western blot and immunohistochemistry (IHC) were was used to investigate the expression of S1PR1 in LUAD. The prognosis of S1PR1 was also analyzed. CCK-8 assay, colony formation assay, scratch assay, transwell migration and invasion assay, cell adhesion assay were performed to examine the effect of S1PR1 on LUAD. RNA sequencing was employed to analyze the DEGs in LUAD cells overexpressing S1PR1. Enrichment pathway analysis using KEGG, GO, and GSEA was conducted to predict potential signaling pathways and downstream targets. chromatin immunoprecipitation (ChIP) and dual luciferase reporter assay were performed to verify the direct regulation between FOXA1 and the target genes. Then FOXA1 overexpression were performed to functional rescue experiments. miRNA-30c-5p was identified as a microRNA regulating FOXA1 by dual luciferase reporter assay. The downstream signaling pathways of S1PR1 was detected to clarify the specific pathways to regulates miR-30c-5p. Results S1PR1 is significantly decreased in LUAD and is positively correlated with the prognosis. Overexpression of S1PR1 inhibits the proliferation, migration, invasion and adhesion function of LUAD cells by suppressing the expression of COL5A1, MMP1, and SERPINE1. FOXA1 is a key transcription factor regulating the expression of MMP1, COL5A1 and SERPINE1. S1PR1 inhibits the expression of FOXA1 through p-STAT1/miR-30c-5p, thereby suppressing the malignant function of LUAD cells. Conclusions The expression of S1PR1 is downregulated in LUAD, which is positively correlated with prognosis. S1PR1 regulates the malignant function of LUAD cells by inhibiting the expression of COL5A1, MMP1 and SERPINE1 through the p-STAT1/miR-30c-5p/FOXA1 signaling pathway.

Intelligent electromagnetic interference (EMI) shielding materials with adaptively adjustable structure and performance under external stimuli hold great potential in developing new generation of intelligent EMI shielding materials. In this review, the latest and most impressive works of advanced materials for stimulus-responsive EMI shielding are highly focused on. Based on stimulating sources, the smart EMI materials are discussed in five categories: mechanical-, temperature-, electrical-, humidity-responsive and others. The key information, including structural design principle, EMI behavior, and structure-function relationship, is extracted and well organized with profundity and easy-to-understand approach. What’s more, the merit and demerit are revealed by comparison. Finally, a profound comment on the stimulus-responsive EMI materials as well as challenges are proposed, and the future directions are forecasted. Schematic illustration for stimulus-responsive EMI shielding, including mechanical-responsive (top left) (Reproduced with permission. Copyright 2021, Elsevier), temperature-responsive (top right) (Reproduced with permission. Copyright 2021, Elsevier; Reproduced with permission. Copyright 2022, The Authors, Elsevier), electrical-responsive (bottom right) (Reproduced with permission, Copyright 2015 Springer Nature), humidity-responsive (bottom) (Reproduced with permission. Copyright 2018, Elsevier), and others (bottom left) (Reproduced with permission. Copyright 2022, American Chemical Society; Reproduced with permission. Copyright 2020, Wiley-VCH).

Abstract Focusing solely on enhancing the resilience of power systems at a systemic level would lead to a significant underestimation of the actual impact of extreme disasters. Equally vital is the assurance of livelihood security amidst such extreme conditions, which is crucial for the development of a truly resilient power system. Hence, this paper attempts to incorporate quantifiable metrics assessing public safety impacts into resilience enhancement works, thereby guiding the precise allocation of funds. Considering that the residents' intuitive feelings are the most direct reflection of the severity of the disaster, this paper employs the modified prospect theory to formulate functions representing residents' psychological risk perception and risk‐taking willingness to tolerate risks during disruptions in power, gas, and water supplies. Meanwhile, in order to accurately calculate the energy loss duration for each residential customer, a resilience enhancement method for post‐disaster collaborative dispatch of electricity‐gas‐water systems is proposed. With the objective of minimizing the public safety and economic impact of disasters, the optimal multi‐source collaborative emergency restoration strategy is developed. The significant necessity and efficiency of the proposed strategy are verified with exhaustive case studies. Numerical results evince the resilience enhancement by considering the livelihood security in the post‐disaster restoration stage.

Research vessels are typically equipped with multiple receivers for positioning and attitude measurement; however, there is no data interaction or model fusion to implement the Precise Point Positioning (PPP) for these receivers. Therefore, a Constrained PPP (CPPP) is established by using the baseline length and tropospheric constraints of two receivers to improve the vessel’s remote marine positioning performance. Based on two integrated Real-Time Kinematic (RTK) receivers, marine experiments are conducted at a distance of 300–600 km from land. Compared to the ground environment, the Root Mean Square error (RMS) of the multipath and the STandard Deviation (STD) of the carrier-to-noise ratio in the marine environment are increased by 2.87 and 2.6 times, respectively. The length constraints reduce the RMS of positioning in the East, North, and Up (ENU) directions by about 0.053 (67%), 0.020 (34%), and 0.054 m (34%), respectively, and also rapidly recover positioning after interruptions, achieving positioning with errors in the ENU-directions of 10, 15, and 20 cm, respectively, within 3 minutes. When the baseline length and tropospheric constraints are combined, with or without the addition of the Zenith Wet Delay bias (dZWD), the average STD can be reduced by about 0.060 m (43%) and the accuracy of the up-positioning can be significantly improved. The correlation of dZWD to the up-positioning deviation of du=−2.161*dZWD is obtained by simulation. Since the acquisition of dZWD depends on the PPP accuracy, it is recommended that dZWD be set to compensate for unmodeled receiver errors when the STD of the up-positioning is superior to 0.06 m.

Abstract Current research on the dynamics and vibrations of geared rotor systems primarily focuses on deterministic models. However, uncertainties inevitably exist in the gear system, which cause uncertainties in system parameters and subsequently influence the accurate evaluation of system dynamic behavior. In this study, a dynamic model of a geared rotor system with mixed parameters and model uncertainties is proposed. Initially, the dynamic model of the geared rotor-bearing system with deterministic parameters is established using a finite element method. Subsequently, a nonparametric method is introduced to model the hybrid uncertainties in the dynamic model. Deviation coefficients and dispersion parameters are used to reflect the levels of parameter and model uncertainty. For example, the study evaluates the effects of uncertain bearing and mesh stiffness on the vibration responses of a geared rotor system. The results demonstrate that the influence of uncertainty varies among different model types. Model uncertainties have a more significant than parametric uncertainties, whereas hybrid uncertainties increase the nonlinearities and complexities of the system’s dynamic responses. These findings provide valuable insights into understanding the dynamic behavior of geared system with hybrid uncertainties.

The fine modeling of the lunar gravity field is a fundamental task for establishing lunar altitude references, conducting research on lunar interior structure, and other scientific endeavors. The lunar gravity field model constructed solely based on spacecraft orbit data has limited spatial resolution, making it challenging to meet the demands of fine gravity field research. The acquisition of high-resolution terrain models presents new opportunities for the study of precise lunar gravity fields. This paper reviews the current status and advancements in fine lunar gravity field modeling, including research efforts and evaluation methods for global lunar gravity field models, principles and technologies for fine gravity field modeling, as well as related research outcomes. On this basis, this paper systematically summarizes the key theoretical issues and technical challenges in the theory of lunar gravity field modeling based on high-resolution terrain models. These include data updating, error correction in high-frequency gravity field modeling, calculation efficiency, and the series divergence problem in spherical harmonic analysis. In addition, future research directions are discussed. This work will provide references for gravity field research on the Moon and other terrestrial planets.

Abstract Diabetic retinopathy (DR) is the most prevalent cause of preventable vision loss worldwide, imposing a significant economic and medical burden on society today, of which early identification is the cornerstones of the management. The diagnosis and severity grading of DR rely on scales based on clinical visualized features, but lack detailed quantitative parameters. Retinal non-perfusion area (NPA) is a pathogenic characteristic of DR that symbolizes retinal hypoxia conditions, and was found to be intimately associated with disease progression, prognosis, and management. However, the practical value of NPA is constrained since it appears on fundus fluorescein angiography (FFA) as distributed, irregularly shaped, darker plaques that are challenging to measure manually. In this study, we propose a deep learning-based method, NPA-Net, for accurate and automatic segmentation of NPAs from FFA images acquired in clinical practice. NPA-Net uses the U-net structure as the basic backbone, which has an encoder-decoder model structure. To enhance the recognition performance of the model for NPA, we adaptively incorporate multi-scale features and contextual information in feature learning and design three modules: Adaptive Encoder Feature Fusion (AEFF) module, Multilayer Deep Supervised Loss, and Atrous Spatial Pyramid Pooling (ASPP) module, which enhance the recognition ability of the model for NPAs of different sizes from different perspectives. We conducted extensive experiments on a clinical dataset with 163 eyes with NPAs manually annotated by ophthalmologists, and NPA-Net achieved better segmentation performance compared to other existing methods with an area under the receiver operating characteristic curve (AUC) of 0.9752, accuracy of 0.9431, sensitivity of 0.8794, specificity of 0.9459, IOU of 0.3876 and Dice of 0.5686. This new automatic segmentation model is useful for identifying NPA in clinical practice, generating quantitative parameters that can be useful for further research as well as guiding DR detection, grading severity, treatment planning, and prognosis.

Abstract Implant-related infections pose significant challenges to orthopedic surgeries due to the high risk of severe complications. The widespread use of bioactive prostheses in joint replacements, featuring roughened surfaces and tight integration with the bone marrow cavity, has facilitated bacterial proliferation and complicated treatment. Developing antibacterial coatings for orthopedic implants has been a key research focus in recent years to address this critical issue. Researchers have designed coatings using various materials and antibacterial strategies. In this study, we fabricated 3D-printed porous titanium rods, incorporated vancomycin-loaded mPEG750-b-PCL2500 gel, and coated them with a PCL layer. We then evaluated the antibacterial efficacy through both in vitro and in vivo experiments. Our coating passively inhibits bacterial biofilm formation and actively controls antibiotic release in response to bacterial growth, providing a practical solution for proactive and sustained infection control. This study utilized 3D printing technology to produce porous titanium rod implants simulating bioactive joint prostheses. The porous structure of the titanium rods was used to load a thermoresponsive gel, mPEG750-b-PCL2500 (PEG: polyethylene glycol; PCL: polycaprolactone), serving as a novel drug delivery system carrying vancomycin for controlled antibiotic release. The assembly was then covered with a PCL membrane that inhibits bacterial biofilm formation early in infection and degrades when exposed to lipase solutions, mimicking enzymatic activity during bacterial infections. This setup provides infection-responsive protection and promotes drug release. We investigated the coating’s controlled release, antibacterial capability, and biocompatibility through in vitro experiments. We established a Staphylococcus aureus infection model in rabbits, implanting titanium rods in the femoral medullary cavity. We evaluated the efficacy and safety of the composite coating in preventing implant-related infections using imaging, hematology, and pathology. In vitro experiments demonstrated that the PCL membrane stably protects encapsulated vancomycin during PBS immersion. The PCL membrane rapidly degraded at a lipase concentration of 0.2 mg/mL. The mPEG750-b-PCL2500 gel ensured stable and sustained vancomycin release, inhibiting bacterial growth. We investigated the antibacterial effect of the 3D-printed titanium material, coated with PCL and loaded with mPEG750-b-PCL2500 hydrogel, using a rabbit Staphylococcus aureus infection model. Imaging, hematology, and histopathology confirmed that our composite antibacterial coating exhibited excellent antibacterial effects and infection prevention, with good safety in trials. Our results indicate that the composite antibacterial coating effectively protects vancomycin in the hydrogel from premature release in the absence of bacterial infection. The outer PCL membrane inhibits bacterial growth and prevents biofilm formation. Upon contact with bacterial lipase, the PCL membrane rapidly degrades, releasing vancomycin for antibacterial action. The mPEG750-b-PCL2500 gel provides stable and sustained vancomycin release, prolonging its antibacterial effects. Our composite antibacterial coating demonstrates promising potential for clinical application.

Abstract It is crucial to precisely calculate temperature utilizing thermal models, which require the determination of thermal parameters that optimally align model outcomes with experimental data. In many instances, the refinement of these models is undertaken within space instruments. This paper introduces an optimization methodology for thermal network models, with the objective of enhancing the accuracy of temperature predictions for aerial cameras. The investigation of internal convective heat transfer coefficients for both cylindrical and planar structures provides an estimation of convective thermal parameters. Based on the identification of thermally sensitive parameters and the reliability evaluation of transient temperature data through the Monte-Carlo simulation, the genetic algorithm is employed to search for global optimal parameter values that minimize the root mean square error (RMSE) between calculated and measured node temperatures. As a result, the optimized model shows significantly improved accuracy in temperature prediction, attaining an RMSE of 1.07 ℃ and reducing the maximum relative error between predicted and experimental results from 33.8 to 3.1%. Furthermore, the flight simulation and thermal control experiments validate the robustness of the optimized model, demonstrating that discrepancies between the observed and predicted temperatures are within 2 °C after re-correcting the external convection heat transfer coefficient value.

IntroductionThe fundamental step in microbiological detection is the preparation of culture medium. The reliability and accuracy of microbiological assay heavily relies on this step. Currently in China, the most recognized standard method for such medium evaluation is ISO 11133-2014. However, this method requires highly complicated biosafety management, detailed standard strains record-keeping and substantial working time.Methods and resultsBacterial tablet is considered to be a novel strategy for bacteria culture medium evaluation. The filter membrane as a carrier ensures uniform cell dispersion, forming a singular colony that can facilitate counting. We examined the viability and storage durability of vacuum freeze-dried bacterial tablets using a filter membrane as a carrier and utilized the results to evaluate culture medium. We found that the recipe GBSS (Glycerinum, Brain Heart Infusion, Sucrose, Sodium Glutamate) showed the highest survival rate for Escherichia coli in vacuum freeze-drying. As a qualified medium, the productivity of target bacterium should be greater than 0.7. A comparison of freeze-dried bacterial tablet method with ISO 11133-2014 quantitative method showed the sensitivity and specificity of this novel method were 94.1% and 88.9% respectively. The results suggested that vacuum freeze-dried bacterial tablet method had high conformity when compared to ISO 11133-2014 quantitative method (χ2 = 0.25, p > 0.05; Kappa = 0.75).DiscussionHence, vacuum freeze-drying method is an integral part of preservation of bacterial strains and the preparation of related biological products. In conclusion, we have developed a novel and effective disposable product for estimating efficiency of the culture medium.

Ursodeoxycholic acid (UDCA) can be used as a drug to treat various liver and bile diseases. Currently, the biological synthesis of UDCA is predominantly conducted via a two-step enzymatic process in which synthesis is catalyzed by 7α-hydroxysteroid dehydrogenase (7α-HSDH) and 7β-hydroxysteroid dehydrogenase (7β-HSDH) in succession, utilizing chenodeoxycholic acid (CDCA) as the substrate. In this study, an engineered Escherichia coli (E. coli) strain, designated UCA23, was constructed. This strain coexpressed four enzymes under the control of three independent T7 promoters: lactate dehydrogenase (LDH) derived from Lactobacillus delbrueckii, glucose dehydrogenase (GDH) derived from Priestia megaterium, 7α-HSDH derived from E. coli, and 7β-HSDH derived from Ruminococcus torques, enabling the whole-cell catalytic synthesis of UDCA from CDCA. This study systematically optimized the reaction parameters, including temperature, pH, and the addition of organic solvents and surfactants, for the whole-cell catalytic synthesis of UDCA by UCA23, and at the 2 L level, a UDCA conversion rate of 99% was achieved with 100 mM CDCA in 2 h, which is the highest level of conversion of a high-concentration CDCA substrate reported to date.

PurposeTo investigate the clinical features of necrotizing enterocolitis-associated intestinal perforation (NEC-IP) in neonates with different gestational ages (GAs). Furthermore, we also want to identify the risk factors of poor prognosis for these patients.MethodsThe retrospective study of patients with NEC-IP was conducted with basic information, comorbidity, intraoperative findings, related treatment, and prognosis. According to the GA, patients were divided into three groups: early (GA: 28–

Abstract Hydrogen gas (H2) therapy, recognized for its inherent biosafety, holds significant promise as an anti‐cancer strategy. However, the efficacy of H2 treatment modalities is compromised by their reliance on systemic gas administration or chemical reactions generation, which suffers from low efficiency, poor targeting, and suboptimal utilization. In this study, living therapeutics are employed using photosynthetic bacteria Rhodobacter sphaeroides for in situ H2 production combined with near‐infrared (NIR) mediated photothermal therapy. Living R. sphaeroides exhibits strong absorption in the NIR spectrum, effectively converting light energy into thermal energy while concurrently generating H2. This dual functionality facilitates the targeted induction of tumor cell death and substantially reduces collateral damage to adjacent normal tissues. The findings reveal that integrating hydrogen therapy with photothermal effects, mediated through photosynthetic bacteria, provides a robust, dual‐modality approach that enhances the overall efficacy of tumor treatments. This living therapeutic strategy not only leverages the therapeutic potential of both hydrogen and photothermal therapeutic modalities but also protects healthy tissues, marking a significant advancement in cancer therapy techniques.

BackgroundPrimary hypertension (PH) poses significant risks to children and adolescents. Few prediction models for the risk of PH in children and adolescents currently exist, posing a challenge for doctors in making informed clinical decisions. ObjectiveThis study aimed to investigate the incidence and risk factors of PH in Chinese children and adolescents. It also aimed to establish and validate a nomogram-based model for predicting the next year’s PH risk. MethodsA training cohort (n=3938, between January 1, 2008, and December 31, 2020) and a validation cohort (n=1269, between January 1, 2021, and July 1, 2023) were established for model training and validation. An independent cohort of 576 individuals was established for external validation of the model. The result of the least absolute shrinkage and selection operator regression technique was used to select the optimal predictive features, and multivariate logistic regression to construct the nomogram. The performance of the nomogram underwent assessment and validation through the area under the receiver operating characteristic curve, concordance index, calibration curves, decision curve analysis, clinical impact curves, and sensitivity analysis. ResultsThe PH risk factors that we have ultimately identified include gender (odds ratio [OR] 3.34, 95% CI 2.88 to 3.86; P

Abstract Low‐temperature energy harvest, delivery, and utilization pose significant challenges for thermal management in extreme environments owing to heat loss during transport and difficulty in temperature control. Herein, we propose a light‐driven photo‐energy delivery device with a series of photo‐responsive alkoxy‐grafted azobenzene‐based phase‐change materials (a‐g‐Azo PCMs). These a‐g‐Azo PCMs store and release crystallization and isomerization enthalpies, reaching a high energy density of 380.76 J/g even at a low temperature of −63.92 °C. On this basis, we fabricate a novel three‐branch light‐driven microfluidic control device for distributed energy recycling that achieves light absorption, energy storage, controlled movement, and selective release cyclically over a wide range of temperatures. The a‐g‐Azo PCMs move remote‐controllably in the microfluidic device at an average velocity of 0.11–0.53 cm/s owing to the asymmetric thermal expansion effect controlled by the temperature difference. During movement, the optically triggered heat release of a‐g‐Azo PCMs achieves a temperature difference of 6.6 °C even at a low temperature of −40 °C. These results provide a new technology for energy harvest, delivery, and utilization in low‐temperature environments via a remote manipulator.

Introduction Elderly stable chronic obstructive pulmonary disease (COPD) patients frequently experience walking dysfunction. Research indicates that balance training holds promise for enhancing walking stability in these individuals, whereas respiratory therapy (RT) can enhance walking endurance effectively. However, existing balance training regimens tailored for COPD are intricate and lack specificity, and the impact of combined RT on patients’ walking function remains uncertain. This study aims to assess the influence of core training (CT) integrated with RT on walking function among elderly stable COPD patients.Methods and analysis This randomised, assessment-blinded, routine rehabilitation-controlled trial will be carried out at the Department of Respiratory and Critical Care Rehabilitation, the Second Rehabilitation Hospital of Shanghai. A total of 42 elderly patients diagnosed with stable COPD will be randomly allocated to either the study group (SG) or the control group in a 1:1 ratio. Both groups will undergo 6 weeks of standard rehabilitation training. Additionally, patients in the SG will receive CT based on RT. The primary outcome of the study is the 6 min walk test. Secondary outcomes encompass ultrasound indicators of the diaphragm and multifidus, pulmonary function tests, Berg balance scale test, trunk impairment scale test, COPD assessment test and St. George’s Respiratory Questionnaire.Ethics and dissemination Ethical approval was obtained from the Ethics Committee of the Second Rehabilitation Hospital of Shanghai (2023-01-01, see online supplemental file 1). All patients will provide written informed consent before participation. The results of the trial are intended for publication in a peer-reviewed journal.Trial registration number ChiCTR2400080276.

ObjectiveThis study compared the value of different systemic immune-inflammatory markers for evaluating coronary collateralization (CC) in patients with type 2 diabetes mellitus (T2DM) and chronic total occlusion (CTO).MethodsSystemic immune-inflammation index (SII), systemic inflammation response index (SIRI) and pan-immune-inflammation value (PIV) were calculated at admission in 1409 T2DM patients with CTO. The degree of coronary collaterals was estimated using the Rentrop scoring system and categorized into poor (Rentrop score 0 or 1) or good (Rentrop score 2 or 3) CC. The predictors of poor CC were determined by multivariate regression analysis, and the diagnostic potential of these indexes was analyzed by Receiver Operating Characteristic (ROC) curves.ResultsSII, SIRI and PIV levels increased stepwise across Rentrop score 0–3, with significantly higher levels in patients with poor CC than in those with good CC (P

Change detection (CD) is a meaningful and challenging task for remote sensing (RS) image analysis. Deep learning (DL) based methods have shown great potential in change detection tasks, there are still two problems with existing deep learning methods such as CNN and Transformer: (1) They do not target different depths to extract global semantics in the network; (2) The increase in network depth will lead to uncertainty in the edge pixels of changing targets and the absence of small targets. First, to address this challenge and address these issues, this work proposes a global pyramid aggregation UNet3+ (GPA-UNet3+) change detection model, that uses UNet3+ as the backbone network and connects the encoder and decoder with a pyramid structure. Secondly, a Global Atrous Spatial Pooling Pyramid Module (GASPPM) is proposed. Refined features at different depths and aggregated them to enhance the network’s ability to extract global semantics. Finally, the Edge Enhancement Channel Attention Module (EECAM) is specifically proposed to alleviate the edge pixel uncertainty and spatial position information loss caused by the increase in network depth. Multiple experiments are conducted on two common change detection datasets and a real dataset. Extensive experimental results show that the proposed method outperforms other state-of-the-art methods, achieving the highest F1-score of 90.95%, 95.31%, and 88.32% on the LEVIR-CD dataset, SVCD dataset and Shizuishan Mining Area dataset, respectively.

BackgroundNutritional problem after surgery for Hirschprung’s disease (HSCR) was not optimistic. This study aimed to analyze the risk factors of postoperative undernutrition for patients with HSCR and establish a scoring system for predicting postoperative undernutrition.MethodsRetrospective review of 341 patients with HSCR who received Laparoscopic-assisted pull-through surgery in a tertiary-level pediatric hospital was conducted with assessments of clinical data. Univariate/multivariate Logistic regression analysis was used to identify independent factors of postoperative undernutrition, and establish a scoring system for predicting postoperative nutritional status based on the sum of adjusted odds ratios (ORs).ResultsThe postoperative undernutrition of 341 patients with HSCR was 29.9%. Multivariate Logistic regression analysis showed that non-breast feeding (mixed: OR = 6.116, artificial: OR = 12.00), preoperative undernutrition (risk of malnutrition: OR = 7.951, malnutrition: OR = 8.985), non-parental caregivers (OR = 3.164), long-segment HSCR (OR = 12.820), postoperative complications within 30 days (grade 1 ~ 2: OR = 2.924, Grade 3 ~ 4: OR = 6.249), and surgery for other systemic malformation (OR = 5.503) were risk factors for postoperative undernutrition (all p

ObjectiveThis study aims to investigate the psychological distress and its influencing factors in patients with biliary tract malignant tumors, alongside the development of a predictive model.MethodsA total of 219 patients diagnosed with biliary tract malignant tumors who were admitted to the Department of Liver Surgery at Fudan University Shanghai Cancer Center from July 2021 to May 2023, were selected using a convenience sampling method. Research tools involve psychological distress management screening tools, a demographic questionnaire, self-rating anxiety and depression scales, and the Chinese version of the Memorial Symptom Assessment Scale. Bootstrap method was utilized for repeated sampling to identify relevant factors influencing psychological distress in biliary tract cancer patients. The R software was employed to create a nomogram model, and the model’s accuracy and predictive performance were assessed using the receiver operating characteristic curve (ROC) and the Hosmer-Lemeshow test.ResultsThe average score of psychological distress among the 219 patients was (3.91 ± 2.44), with a psychological distress detection rate of 54.8%. Regression model results indicated that factors such as the presence of distant metastasis, comorbidity with other major diseases, poor sleep quality, anxiety, and severity of anxiety and depression were the primary influencers of psychological distress.ConclusionThe detection rate of psychological distress in patients with biliary tract malignant tumors is notably high. The predictive model constructed in this study exhibits good predictive efficacy and clinical value, providing valuable reference for healthcare professionals in developing targeted intervention strategies.

Nitrogen is one of the most important macronutrients for plant growth and timely estimation of canopy nitrogen content (CNC) is crucial for agricultural applications. Remote sensing has emerged as an important tool to quantify CNC using either empirically or physically based methods. Most empirical methods use chlorophyll related spectral indices and are dependent on the relationship between nitrogen and chlorophyll, which varies with vegetation types and growth stages. In contrast, physically based methods use the full-range reflectance data and retrieve CNC from coupled leaf and canopy radiative transfer models (such as PROSPECT-PRO + 4SAIL, PROSAIL-PRO). However, the subtle absorption features of nitrogen and protein in fresh leaves hinder the accurate estimation of CNC. Therefore, this study proposed an efficient and mechanistic framework to estimate CNC (PROSAIL-NAM) by coupling PROSAIL-PRO with a nitrogen allocation model, which divided the total nitrogen into non-photosynthetic nitrogen (NPN) and photosynthetic nitrogen (PN). At the canopy level, PN and NPN are assumed to be proportional to canopy chlorophyll content (CCC) and canopy dry matter content (CDM), respectively. The PROSAIL-PRO model was first used to estimate CCC and CDM, and then the resulting CCC and CDM were fed to the nitrogen allocation model to estimate CNC. The estimation accuracy of CNC was assessed with six diverse datasets: four from field crop experiments across geographic sites, one from multiple ecosystems, and one from a satellite-ground joint experiment. Our results showed that satisfactory estimations of CNC were obtained when CCC and CDM were estimated using a model inversion method (RMSE = 0.54–1.56 g/m2) and a hybrid retrieval method (RMSE = 0.49–2.25 g/m2). The model inversion method was comparable with the hybrid retrieval method for ground platforms, but performed better for airborne and satellite platforms. In addition, the traditional protein-nitrogen conversion model obtained CNC from the canopy protein content and led to clear overestimations of CNC with RMSE > 1.95 g/m2. This study represents a first attempt to develop a robust approach by coupling PROSAIL-PRO with a nitrogen allocation model for accurate estimation of CNC across geographic sites, ecosystems, and platforms. These finding will advance the monitoring of CNC from regional to global scales.

Influenced by various geophysical factors, gravity and bathymetry exhibit significant correlations only at certain intermediate wavelengths. In this study, a deep neural network (DNN) combined with multi-source gravity data was used to recovery the intermediate wavelength (15–160 km) depth in the Sea of Japan (37–42°N, 130–138°E), to analyze the contributions of different gravity data to the bathymetric model. Subsequently, the gravity anomaly (GA), vertical gravity gradient (VGG), and vertical deflection were used as training data with a suitable DNN framework and designed training strategy. Evaluation results show that: the precision of the final DNN training models at test points surpasses that of the topo_25.1 model by 13 to 14 m; the TC1 model, with GA, VGG, and vertical deflection, is optimal, and the accuracy is 7.2 m higher than that of the (gravity geology method) GGM model on check cruises. The three types of gravity data can complement and constrain each other. In addition, predicting depths at intermediate wavelengths with significant coherence, as opposed to directly predicting absolute depths, results in higher accuracy by 20–30 m at test points, and an improvement of approximately 10 m in check accuracy.

Abstract. Background:. Long non-coding RNAs (lncRNAs) plays an important role in the progression of gastric cancer (GC). Their involvement ranges from genetic regulation to cancer progression. However, the mechanistic roles of RP11-789C1.1 in GC are not fully understood. Methods:. We identified the expression of lncRNA RP11-789C1.1 in GC tissues and cell lines by real-time fluorescent quantitative polymerase chain reaction. A series of functional experiments revealed the effect of RP11-789C1.1 on the proliferation of GC cells. In vivo experiments verified the effect of RP11-789C1.1 on the biological behavior of a GC cell line. RNA pull-down unveiled RP11-789C1.1 interacting proteins. Western blot analysis indicated the downstream pathway changes of RP11-789C1.1, and an oxaliplatin dosing experiment disclosed the influence of RP11-789C1.1 on the drug sensitivity of oxaliplatin. Results:. Our results demonstrated that RP11-789C1.1 inhibited the proliferation of GC cells and promoted the apoptosis of GC cells. Mechanistically, RP11-789C1.1 inhibited checkpoint kinase 1 (CHK1) phosphorylation by binding ataxia-telangiectasia mutated and Rad3 related (ATR), a serine/threonine-specific protein kinase, promoted GC apoptosis, and mediated oxaliplatin sensitivity. Conclusion:. In general, we discovered a tumor suppressor molecule RP11-789C1.1 and confirmed its mechanism of action, providing a theoretical basis for targeted GC therapy.

The hands and face are the most important parts for expressing sign language morphemes in sign language videos. However, we find that existing Continuous Sign Language Recognition (CSLR) methods lack the mining of hand and face information in visual backbones or use expensive and time-consuming external extractors to explore this information. In addition, the signs have different lengths, whereas previous CSLR methods typically use a fixed-length window to segment the video to capture sequential features and then perform global temporal modeling, which disturbs the perception of complete signs. In this study, we propose a Multi-Scale Context-Aware network (MSCA-Net) to solve the aforementioned problems. Our MSCA-Net contains two main modules: (1) Multi-Scale Motion Attention (MSMA), which uses the differences among frames to perceive information of the hands and face in multiple spatial scales, replacing the heavy feature extractors; and (2) Multi-Scale Temporal Modeling (MSTM), which explores crucial temporal information in the sign language video from different temporal scales. We conduct extensive experiments using three widely used sign language datasets, i.e., RWTH-PHOENIX-Weather-2014, RWTH-PHOENIX-Weather-2014T, and CSL-Daily. The proposed MSCA-Net achieve state-of-the-art performance, demonstrating the effectiveness of our approach.

Abstract Purpose This study investigated the clinical and functional outcomes of children with distal both-bone forearm fractures treated by fixation of the radius only compared to fixation of both the radius and ulna. Methods A total of 71 patients from two centres with distal both-bone forearm fractures (30 in the ulna-yes group, 41 in the ulna-no group) who underwent closed reduction and percutaneous pinning treatment were retrospectively analysed. Operation duration, number of fluoroscopic exposures, loss of reduction rate and angulation based on radiographic assessment were compared between the two groups. Evaluation of wrist function including Gartland-Werley Score and Mayo Wrist Score were compared at the last follow-up. Results Ulna angulation upon bone healing on the posteroanterior and the lateral plane of ulna-no group (6.11 ± 1.56°; 6.51 ± 1.69°) was significantly greater than that of ulna-yes group (4.49 ± 1.30°; 5.05 ± 2.18°) (p 0.05). At last follow-up, no significant difference was found between the Gartland-Werley Scores of the ulna-yes group (1.83 ± 3.25, range: 0–16) and ulna-no group (1.85 ± 2.72, range: 0-11.5) (p > 0.05). No significant difference was found between the Mayo Wrist Scores of the ulna-yes group (92.60 ± 6.20) and ulna-no group (92.15 ± 7.58) (p > 0.05). Conclusions For distal both-bone forearm fractures in children, fixation of only the radius appears to be a viable method with equivalent clinical outcomes compared to fixation of both the radius and ulna.

Abstract Background With Primary Health Care (PHC) being a cornerstone of accessible, affordable, and effective healthcare worldwide, its efficiency, especially in developing countries like China, is crucial for achieving Universal Health Coverage (UHC). This study evaluates the efficiency of PHC systems in a southwest China municipality post-healthcare reform, identifying factors influencing efficiency and proposing strategies for improvement. Methods Utilising a 10-year provincial panel dataset, this study employs an enhanced Data Envelopment Analysis (DEA) model integrating Slack-Based Measure (SBM) and Directional Distance Function (DDF) with the Global Malmquist-Luenberger (GML) index for efficiency evaluation. Tobit regression analysis identifies efficiency determinants within the context of China’s healthcare reforms, focusing on horizontal integration, fiscal spending, urbanisation rates, and workforce optimisation. Results The study reveals a slight decline in PHC system efficiency across the municipality from 2009 to 2018. However, the highest-performing county achieved a 2.36% increase in Total Factor Productivity (TFP), demonstrating the potential of horizontal integration reforms and strategic fiscal investments in enhancing PHC efficiency. However, an increase in nurse density per 1,000 population negatively correlated with efficiency, indicating the need for a balanced approach to workforce expansion. Conclusions Horizontal integration reforms, along with targeted fiscal inputs and urbanisation, are key to improving PHC efficiency in underdeveloped regions. The study underscores the importance of optimising workforce allocation and skillsets over mere expansion, providing valuable insights for policymakers aiming to strengthen PHC systems toward achieving UHC in China and similar contexts.

Abstract Background Increasing evidence suggested that immune abnormalities involved in the pathophysiology of schizophrenia. However, the relationship between immunity and clinical features has not been clarified. The aim of this study was to measure the plasma levels of tumor necrosis factor alpha (TNF-α) and soluble TNF-α receptor 1 (sTNF-α R1) and to investigate their association with agitation in first episode patients with schizophrenia (FEPS). Methods The plasma TNF-α and sTNF-α R1 levels were measured using sandwich enzyme-linked immunosorbent assay (ELISA) in the FEPS with (n = 36) and without agitation (n = 49) symptoms, and healthy controls (HCs, n = 54). The psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS), and the agitation symptoms were evaluated by the PANSS excitatory component (PANSS-EC). Results The plasma TNF-α levels in patients with and without agitation symptoms were significantly higher than those in HCs. The patients with agitation had significantly higher plasma TNF-α levels compared to the patients without agitation. There were no significant differences in the sTNF-α R1 levels among the three groups. Furthermore, the plasma TNF-α levels were positively correlated with the PANSS total score, Positive and General psychopathological subscores, and PANSS-EC score in the FEPS, but the relationships were not found for the plasma sTNF-α R1 levels. Conclusions These results suggested that TNF-α might play an important role in the onset and development of agitation symptoms of schizophrenia.

Abstract Background Cardiac arrest after coronary artery bypass grafting (CABG) is a serious complication with low survival rate. The prognosis of patients with cardiac arrest in the general ward is worse than that in the intensive care unit (ICU) because of the delayed and poor rescue conditions. Methods This retrospective study included patients who experienced cardiac arrest after CABG surgery between January 2010 and December 2019 at the Fuwai Hospital. Differences in cardiac arrest between the ICU and the general ward were compared. The patients were divided into shockable and non-shockable rhythm groups, and the differences between the two groups were compared. Finally, we proposed a management protocol for cardiac arrest in the general ward. Results We retrospectively analyzed 41,450 patients who underwent CABG only, of whom 231 (0.56%) experienced cardiac arrest post-surgery in the ICU (185/231) or in the general ward (46/231). The rescue success rate and 30-day survival rate of the patients with cardiac arrest in the general ward were 76.1% (35/46) and 58.7% (27/46), respectively. The incidence of the different arrhythmia types of cardiac arrest in the general ward compared with that in the ICU was different (P = 0.010). The 30-day survival rate of the non-shockable rhythm group was 31.8% (7/22), which was worse than that of the shockable rhythm group (83.3% [20/24]; P = 0.001). Kaplan–Meier survival analysis showed that the prognosis of the non-shockable group was poor (P

Abstract Background The timing of surgical intervention for Hirschsprung’s disease (HSCR) has been a topic of continued discussion. The objective of this study was to evaluate the significance of age at surgery in the management of HSCR by conducting a comparative analysis of the correlation between surgical age and midterm outcomes. Methods We conducted a retrospective analysis of children with HSCR who underwent one-stage laparoscopic assisted pull-through surgery with modified Swenson technology at our hospital between 2015 and 2019. The study population was stratified into two groups based on surgical age: patients who underwent surgery within a period of less than 3 months and those who underwent surgery between 3 and 12 months. The basic conditions, complications at 3–7 years after surgery, anal function (Rintala scale) and quality of life (PedsQLTM4.0) were compared between the groups. Results A total of 235 children (196 males and 39 females) were included in the study. No statistically significant differences in postoperative bowel function (P = 0.968) or quality of life (P = 0.32) were found between the two groups. However, there was a significant reduction in the incidence of Hirschsprung-associated enterocolitis (HAEC) among individuals under the age of three months prior to undergoing surgical intervention (69.1%) compared to the incidence observed postsurgery (30.9%). This difference was statistically significant (P