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Abstract Endoscopic submucosal dissection (ESD) of fibrotic colorectal lesions is difficult and has a high complication rate. There are only a few reports on the utility of orthodontic rubber band (ORB) traction in reducing the difficulty of this procedure. This study aimed to investigate the risk factors for perforation when applying ORB traction during ESD of fibrotic colorectal lesions. We continuously collected the clinical data of 119 patients with fibrotic colorectal lesions who underwent ESD with ORB and clip traction between January 2019 and January 2024. Possible risk factors for perforation were analyzed. The median ORB-ESD operative time was 40 (IQR 28–62) min, and the en bloc and R0 resection rates were 94.1% and 84.0%, respectively. Perforation occurred in 16 of 119 patients (13.4%). The lesion size, lesion at the right half of the colon or across an intestinal plica, the degree of fibrosis, operation time, and the surgeon’s experience were associated with perforation during ORB-ESD (P

Abstract Background Hereditary spherocytosis (HS, MIM#612641) is one of the most common hereditary hemolytic disorders. This study aimed to confirm a novel variant’s pathogenicity and reveal a patient’s genetic etiology. Methods The clinical data of a patient with HS who underwent genetic sequencing at the Children’s Hospital of Chongqing Medical University were reviewed retrospectively. In silico prediction and in vitro minigene splicing reporter system were then conducted on the detected variant to analyze its intramolecular impact. A summary of the literature related to HS due to SPTB gene variants was also presented. Results A novel variant (c.301–2 A > G) in the SPTB gene (NM_001024858.4) was identified in the proband. Using Sanger sequencing, we conclusively confirmed that the inheritance of the variant could not be traced to the biological parents. The in vitro minigene assay revealed three different transcripts derived from the c.301–2 A > G variant: r.301_474del, r.301_306delCCAAAG, and r.301-1_301-57ins. Through a literature review, patients with HS who had been genotypically validated were summarized and the SPTB gene variant profile was mapped. Conclusion We identified a splicing variant of the SPTB gene, thus confirming its aberrant translation. The novel variant was the probable genetic etiology of the proband with HS. Our findings expanded the variant spectrum of the SPTB gene, thus improving the understanding of the associated hereditary hemolytic disorders from a clinical and molecular perspective and contributing to the foundation of genetic counseling and diagnosis.

Abstract Background In recent years, there has been a growing trend in the utilization of observational studies that make use of routinely collected healthcare data (RCD). These studies rely on algorithms to identify specific health conditions (e.g. diabetes or sepsis) for statistical analyses. However, there has been substantial variation in the algorithm development and validation, leading to frequently suboptimal performance and posing a significant threat to the validity of study findings. Unfortunately, these issues are often overlooked. Methods We systematically developed guidance for the development, validation, and evaluation of algorithms designed to identify health status (DEVELOP-RCD). Our initial efforts involved conducting both a narrative review and a systematic review of published studies on the concepts and methodological issues related to algorithm development, validation, and evaluation. Subsequently, we conducted an empirical study on an algorithm for identifying sepsis. Based on these findings, we formulated specific workflow and recommendations for algorithm development, validation, and evaluation within the guidance. Finally, the guidance underwent independent review by a panel of 20 external experts who then convened a consensus meeting to finalize it. Results A standardized workflow for algorithm development, validation, and evaluation was established. Guided by specific health status considerations, the workflow comprises four integrated steps: assessing an existing algorithm’s suitability for the target health status; developing a new algorithm using recommended methods; validating the algorithm using prescribed performance measures; and evaluating the impact of the algorithm on study results. Additionally, 13 good practice recommendations were formulated with detailed explanations. Furthermore, a practical study on sepsis identification was included to demonstrate the application of this guidance. Conclusions The establishment of guidance is intended to aid researchers and clinicians in the appropriate and accurate development and application of algorithms for identifying health status from RCD. This guidance has the potential to enhance the credibility of findings from observational studies involving RCD.

Abstract Chromosome rearrangements may distort 3D chromatin architectures and thus change gene regulation, yet how 3D chromatin structures evolve in insects is largely unknown. Here, we obtain chromosome-level genomes for four butterfly species, Graphium cloanthus, Graphium sarpedon, Graphium eurypylus with 2n = 30, 40, and 60, respectively, and Papilio bianor with 2n = 60. Together with large-scale Hi-C data, we find that inter-chromosome rearrangements very rarely disrupted the pre-existing 3D chromatin structure of ancestral chromosomes. However, some intra-chromosome rearrangements changed 3D chromatin structures compared to the ancestral configuration. We find that new TADs and subTADs have emerged across the rearrangement sites where their adjacent compartments exhibit uniform types. Two intra-chromosome rearrangements altered Rel and lft regulation, potentially contributing to wing patterning differentiation and host plant choice. Notably, butterflies exhibited chromatin loops between Hox gene cluster ANT-C and BX-C, unlike Drosophila. Our CRISPR-Cas9 experiments in butterflies confirm that knocking out the CTCF binding site of the loops in BX-C affected the phenotypes regulated by Antp in ANT-C, resulting in legless larva. Our results reveal evolutionary patterns of insect 3D chromatin structures and provide evidence that 3D chromatin structure changes can play important roles in the evolution of traits.

Abstract Background Many factors contribute to quality of life (QoL) in patients with schizophrenia, yet limited research examined these factors in patients in China. This cross-sectional study explores subjective QoL and its associated factors in patients. Methods The QoL was assessed using the Schizophrenia Quality of Life Scale (SQLS). Clinical symptoms were evaluated using the Brief Psychiatric Rating Scale (BPRS) and seven factors were extracted. Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder Scale (GAD-7) were used to assess depression and anxiety. Cognitive impairment was assessed using the Ascertain Dementia 8 (AD8). The Treatment Emergent Symptom Scale (TESS) and Rating Scale for Extrapyramidal Side Effects (RSESE) were used to evaluate the side effects of medications. Results We recruited 270 patients (male:142,52.6%, mean age:41.9 ± 9.4 years). Positive correlations were observed between SQLS and its subdomains with the total score of BPRS, PHQ-9, GAD-7, AD8, TESS, and RSESE (all P

Abstract Neuroinflammation caused by microglia and other immune cells plays pivotal role in cerebral ischemia/reperfusion injury and recovery. Modulating microglial polarization or Treg/Th17 balance from pro-inflammatory phenotype to anti-inflammatory phenotype are promising strategies for the treatment of cerebral ischemia. Curcumol has potential to fight against oxidative stress and inflammation, but whether it has protective effect in cerebral ischemia is uncertain. In the present study, cerebral ischemia was induced in C57BL/6 mice via middle cerebral artery occlusion (MCAO). MCAO mice were treated with curcumol for 7 days, then post-stroke ischemic injury, neurological deficits, microglial polarization and brain leukocyte infiltration were evaluated by TTC staining, behavioural tests, flow cytometry, western blot and immunofluorescence. We found that poststroke administration of curcumol reduced infarct volume, attenuated neuronal damage and inflammation, and improved motor function recovery of MCAO mice. Curcumol skewed microglial polarization toward anti-inflammatory phenotype in MCAO mice in vivo or after oxygen-glucose deprivation and reoxygenation (OGD/R) in vitro. In addition, curcumol reduced local T cell infiltration in ischemic brain of MCAO mice and impaired Treg/Th17 balance. Curcumol inhibited ROS production and regulated Nrf2/HO-1 and NF-κB signaling in microglia. Finally, inhibiting Nrf2/HO-1 signaling or activating NF-κB signaling abrogated the influence of curcumol on microglial polarization. In conclusion, curcumol treatment reduced brain damage and neuroinflammation via modulating anti-inflammatory microglial polarization and Treg/Th17 balance through Nrf2/HO-1 and NF-κB signaling. Curcumol might be a promising treatment strategy for stroke patients.

Mpox is a zoonotic infectious disease caused by the mpox virus (MPXV). Historically, the majority of mpox cases have been documented in Central Africa. However, since May 2022, there has been a notable rise in reported cases from regions beyond Africa. Currently, over 110 countries spanning Europe, North America, South America, Asia, and other territories have reported mpox infections. This report details a case involving a patient who identifies as a man who has sex with men (MSM) and is concurrently infected with MPXV, human immunodeficiency virus type 1 (HIV-1), Pneumocystis jiroveci, as well as extensively drug-resistant tuberculosis (XDR-TB). This patient had also received a vaccination for smallpox in the past. Additionally, we provide photographic documentation charting the progression of dermatological manifestations associated with mpox. This case highlights the significance of sexual intercourse as a crucial mode of transmission for mpox. The rapid and widespread dissemination of the MPXV across various regions, especially among MSM communities, underscores the importance of enhancing preventive education efforts targeted at high-risk populations.

Abstract The cryopreservation and transplantation of ovarian tissue underscore its paramount importance in safeguarding reproductive capacity and ameliorating reproductive disorders. However, challenges persist in ovarian tissue cryopreservation and transplantation (OTC-T), including the risk of tissue damage and dysfunction. Consequently, there has been a compelling exploration into the realm of nanoregulators to refine and enhance these procedures. This review embarks on a meticulous examination of the intricate anatomical structure of the ovary and its microenvironment, thereby establishing a robust groundwork for the development of nanomodulators. It systematically categorizes nanoregulators and delves deeply into their functions and mechanisms, meticulously tailored for optimizing ovarian tissue cryopreservation and transplantation. Furthermore, the review imparts valuable insights into the practical applications and obstacles encountered in clinical settings associated with OTC-T. Moreover, the review advocates for the utilization of microbially derived nanomodulators as a potent therapeutic intervention in ovarian tissue cryopreservation. The progression of these approaches holds the promise of seamlessly integrating nanoregulators into OTC-T practices, thereby heralding a new era of expansive applications and auspicious prospects in this pivotal domain. Graphical Abstract

In this work, the effect of tungsten inert gas (TIG) remelting on the microstructure, mechanical properties, and corrosion resistance of 5052 aluminum alloy joints produced by metal inert gas (MIG) welding is investigated. The results indicate that after TIG remelting of MIG welds, the proportion of dendrites increases in the remelted weld zone (WZ), porosity decreases by 76.9%, and the Fe elements in the second phase become coarser and more segregated. In contrast, the Mg elements form a solid solution with a decreased degree of segregation. In addition, the average grain size of the remelted structure decreases, while the proportion of sub-grain boundaries (SGBs) and the kernel average misorientation (KAM) values increase. Moreover, the heat-affected zone (HAZ) widens, and the grains become coarser. An increase of 4.5% in tensile strength and 20.0% in elongation was observed in the TIG-remelted joints after TIG remelting. Electrochemical and immersion tests on the TIG-remelted microstructure showed reduced corrosion resistance. Electrochemical tests mainly exhibited galvanic corrosion, resulting in the formation of pits. The types of corrosions observed in the immersion test differ from those in the electrochemical test, primarily exhibiting exfoliation corrosion and pitting corrosion. A higher geometric dislocation density (ρGND) in the structure increases the susceptibility to corrosion.

A large-scale fine-grained Mg-Gd-Y-Zn-Zr alloy plate with high strength and ductility was successfully prepared by multi-pass friction stir processing (MFSP) technology in this work. The structure of grains and long period stacking ordered (LPSO) phase were characterized, and the mechanical properties uniformity was investigated. Moreover, a quantitative relationship between the microstructure and tensile yield strength was established. The results showed that the grains in the processed zone (PZ) and interfacial zone (IZ) were refined from 50 µm to 3 µm and 4 µm, respectively, and numerous original LPSO phases were broken. In IZ, some block-shaped 18R LPSO phases were transformed into needle-like 14H LPSO phases due to stacking faults and the short-range diffusion of solute atoms. The severe shear deformation in the form of kinetic energy caused profuse stacking fault to be generated and move rapidly, greatly increasing the transformation rate of LPSO phase. After MFSP, the ultimate tensile strength, yield strength and elongation to failure of the large-scale plate were 367 MPa, 305 MPa and 18.0% respectively. Grain refinement and LPSO phase strengthening were the major strengthening mechanisms for the MFSP sample. In particularly, the strength of IZ was comparable to that of PZ because the strength contribution of the 14H LPSO phase offsets the lack of grain refinement strengthening in IZ. This result opposes the widely accepted notion that IZ is a weak region in MFSP-prepared large-scale fine-grained plate.

We report the first record of Amolops truongi Pham, Pham, Ngo, Sung, Ziegler & Le, 2023 from China, based on four specimens collected in Yunnan Huanglianshan National Nature Reserve. This species was previously known only from the type locality in north-western Vietnam. Morphologically, the specimens from China correspond to the original description of A. truongi with a few variations and, phylogenetically, they are clustered with the type specimens of A. truongi from Vietnam with strong support. In this study, we also provide an updated diagnosis of this species combining the original description and new data.

Selenium (Se)-enriched Brassica napus L. is a valuable organic Se supplement. In this study, the fermentation broth enriched with organic Se (FFS) was prepared using Lactobacillus plantarum to ferment the substrate of Se-enriched Brassica napus L. Significant increases were observed after fermentation in total sugars, reducing sugars, soluble proteins, total phenolic content (TPC), and total flavonoid content (TFC). The organic Se was retained at a concentration of 54.75 ​mg/g in the freeze-dried sample. Principal component analysis and cluster analysis showed good separation between the FFS and unfermented (FS) groups. Fragrant 2-ethyloxetane had the highest content among all volatiles, while sinapine had the highest content among all phenolic compounds. The fermentation process showed remarkable improvement in the abundance and concentration of volatile compounds and phenolic contents, making FFS exhibit strong antioxidant activity and inhibitory capacity against α-glucosidase activity. The bioaccessibility of phenolic compounds was significantly greater in FFS compared to FS. ADMET analysis revealed that the majority of phenolic compounds contained in FFS did not exhibit mutagenicity toxicity, hepatotoxicity, skin sensitization, or blood-brain barrier penetration, indicating a favorable level of biosafety. Overall, our study provides a new insight into the further utilization of Se-enriched Brassica napus L. in foods.

Abstract The Patient-Reported Outcomes Measurement Information System 29-item Profile version 2.1 (PROMIS-29 V2.1) is a widely utilized self-reported instrument for assessing health outcomes from the patients’ perspectives. This study aimed to evaluate the psychometric properties of the PROMIS-29 V2.1 Chinese version among patients with hematological malignancy. Conducted as a cross-sectional, this research was approved by the Medical Ethical Committee of the Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (registration number QTJC2022002-EC-1). We employed convenience sampling to enroll eligible patients with hematological malignancy from four tertiary hospitals in Tianjin, Shandong, Jiangsu, and Anhui province in China between June and August 2023. Participants were asked to complete a socio-demographic information questionnaire, the PROMIS-29 V2.1, and the Functional Assessment of Cancer Therapy-General (FACT-G). We assessed the reliability, ceiling and floor effects, structural, convergent discriminant and criterion validity of the PROMIS-29 V2.1. A total of 354 patients with a mean age of 46.93 years was included in the final analysis. The reliability of the PROMIS-29 V2.1 was affirmed, with Cronbach’s α for the domains ranging from 0.787 to 0.968. Except sleep disturbance, the other six domains had ceiling effects, which were seen on physical function (26.0%), anxiety (37.0%), depression (40.4%), fatigue (18.4%), social roles (18.9%) and pain interference (43.2%), respectively. Criterion validity was supported by significant correlations between the PROMIS-29 V2.1 and FACT-G scores, as determined by the Spearman correlation test (P

Abstract Sexual dysfunction is common in males with chronic kidney disease (CKD), but yet the prevalence and specific relationship between CKD and sexual dysfunction, especially premature ejaculation (PE), remain to be investigated in China; This study aims to examine the prevalence and association between CKD and sexual dysfunction in male patients in China; In this cross-sectional, non-interventional, observational study conducted at a single center. 72 male patients with CKD were enrolled. Data collection included socio-demographic information, assessments via the 5-item version of the International Index of Erectile Function (IIEF-5), the Chinese version of the Premature Ejaculation Diagnostic Tool, the Patient Health Quentionnnaire-9 and the General Anxiety Disorder-7. Data analysis was performed using R version 3.5.2 and SPSS software version 25.0; Among the 72 CKD patients, 56.9% experienced erectile dysfunction and 29.2% had PE. Various factors including estimated Glomerular Filtration Rate, Albumin-to-Creatinine Ratio, psychological aspects, medication use were found to be associated with sexual dysfunction in these CKD patients; Sexual dysfunction is prevalent in males with CKD and is, influenced by multiple factors. It is important for clinicians to focus on sexual dysfunction in this patient group and further investigate its underlying mechanisms.

Abstract Organic room temperature phosphorescence (RTP) has significant potential in various applications of information storage, anti-counterfeiting, and bio-imaging. However, achieving robust organic RTP emission of the single-component system is challenging to overcome the restriction of the crystalline state or other rigid environments with cautious treatment. Herein, we report a single-component system with robust persistent RTP emission in various aggregated forms, such as crystal, fine powder, and even amorphous states. Our experimental data reveal that the vigorous RTP emissions rely on their tight dimers based on strong and large-overlap π-π interactions between polycyclic aromatic hydrocarbon (PAH) groups. The dimer structure can offer not only excitons in low energy levels for visible-light excited red long-lived RTP but also suppression of the nonradiative decays even in an amorphous state for good resistance of RTP to heat (up to 70 °C) or water. Furthermore, we demonstrate the water-dispersible nanoparticle with persistent RTP over 600 nm and a lifetime of 0.22 s for visible-light excited cellular and in-vivo imaging, prepared through the common microemulsion approach without overcaution for nanocrystal formation.

Abstract Although papillary thyroid cancer (PTC) has a good prognosis, its recurrence rate is high and remains a core concern in the clinic. Molecular factors contributing to different recurrence risks (RRs) remain poorly defined. Here, we perform an integrative proteogenomic and metabolomic characterization of 102 Chinese PTC patients with different RRs. Genomic profiling reveals that mutations in MUC16 and TERT promoter as well as multiple gene fusions like NCOA4-RET are enriched by the high RR. Integrative multi-omics analyses further describe the multi-dimensional characteristics of PTC, especially in metabolism pathways, and delineate dominated molecular patterns of different RRs. Moreover, the PTC patients are clustered into four subtypes (CS1: low RR and BRAF-like; CS2: high RR and metabolism type, worst prognosis; CS3: high RR and immune type, better prognosis; CS4: high RR and BRAF-like) based on the omics data. Notably, the subtypes display significant differences considering BRAF and TERT promoter mutations, metabolism and immune pathway profiles, epithelial cell compositions, and various clinical factors (especially RRs and prognosis) as well as druggable targets. This study can provide insights into the complex molecular characteristics of PTC recurrences and help promote early diagnosis and precision treatment of recurrent PTC.

Abstract This study assesses the effect of stone content on the stability of soil–rock mixture slopes and the dynamics of ensuing large displacement landslides using a material point strength reduction method. This method evaluates structural stability by incrementally decreasing material strength parameters. The author created four distinct soil–rock mixture slope models with varying stone contents yet consistent stone size distributions through digital image processing. The initial conditions were established by linearly ramping up the gravity in fixed proportionate steps until the full value was attained. Stability was monitored until a sudden shift in displacement marked the onset of instability. Upon destabilization, the author employed the material point method to reconstruct the landslide dynamics. Due to the substantial computational requirements, the author developed a high-performance GPU-based framework for the material point method, prioritizing the parallelization of the MPM algorithm and the optimization of data structures and memory allocation to exploit GPU parallel processing capabilities. Our results demonstrate a clear positive correlation between stone content and slope stability; increasing stone content from 10 to 20% improved the safety factor from 1.9 to 2.4, and further increments to 30% and 40% ensured comprehensive stability. This study not only sheds light on slope stability and the mechanics of landslides but also underscores the effectiveness of GPU-accelerated methods in handling complex geotechnical simulations.

The BDI is a barometer of maritime trade, and the shipping trade network may graphically reflect trade pattern evolution. Because commerce influences freight prices, it is worthwhile to consider the influence of maritime network characteristics on freight rates. To begin, this article constructs maritime networks using AIS data and displays the dry bulk trade trend in the period following the pandemic. This will assist shipowners and laypeople in comprehending the evolution of dry bulk maritime commerce in the post-pandemic age. Second, the PVAR model is implemented in this work to investigate the connection between the trade in shipping mode and freight prices. The empirical study demonstrated that shipowners ought to devote more attention to port linkages, particularly significant ports in the maritime network in the years following the pandemic.

Abstract Background Definitive concurrent chemoradiotherapy (dCCRT) is the gold standard for the treatment of locally advanced esophageal squamous cell carcinoma (ESCC). However, the potential benefits of consolidation chemotherapy after dCCRT in patients with esophageal cancer remain debatable. Prospective randomized controlled trials comparing the outcomes of dCCRT with or without consolidation chemotherapy in patients with ESCC are lacking. In this study, we aim to generate evidence regarding consolidation chemotherapy efficacy in patients with locally advanced, inoperable ESCC. Methods This is a multicenter, prospective, open-label, phase-III randomized controlled trial comparing non-inferiority of dCCRT alone to consolidation chemotherapy following dCCRT. In total, 600 patients will be enrolled and randomly assigned in a 1:1 ratio to receive either consolidation chemotherapy after dCCRT (Arm A) or dCCRT alone (Arm B). Overall survival will be the primary endpoint, whereas progression-free survival, locoregional progression-free survival, distant metastasis-free survival, and treatment-related toxicity will be the secondary endpoints. Discussion This study aid in further understanding the effects of consolidation chemotherapy after dCCRT in patients with locally advanced, inoperable ESCC. Trial registration ChiCTR1800017646.

Abstract Background Expanding new nurse training and education is a priority for nursing educators as well as a critical initiative to stabilize the nursing workforce. Given that there is currently no standardized program for the training of new nurses in China, we investigated the effectiveness of the bridge-in, objective, pre-assessment, participatory learning, post-assessment, and summary model combined with case-based learning ((BOPPPS-CBL) for the standardized training of new nurses. Methods The mixed method approach with explanatory sequential (quantitative-qualitative) method was used. A questionnaire was used to compare the impact of the BOPPPS-CBL model and the Traditional Learning Model (TLM) on the core competencies of 185 new nurses for two years of standardized training. Quantitative data were analyzed using SPSS 22.0. Focus group interviews were used with four groups of new nurses and perceptions of BOPPPS-CBL training were recorded. Qualitative data were analyzed thematically. Results According to the quantitative data, more new nurses agreed that the BOPPPS-CBL model stimulated their learning and improved their core nursing competencies than the TLM. The BOPPPS-CBL group outperformed the TLM group on theoretical knowledge tests. Qualitative data revealed that 87.5% of new nurses agreed on the value of BOPPPS-CBL training, and three themes were extracted: (1) role promotion; (2) formation of new thinking to solve clinical problems; and (3) suggestions for improvement. Conclusion BOPPPS-CBL training had a significant impact on improving new nurses’ core competencies and promoting the transition of new nurses to clinical practice nurses in China. The study recommends BOPPPS-CBL training as an effective teaching model for the standardized training and education of new nurses.

Monoterpenoids are typically present in the secretory tissues of higher plants, and their biosynthesis is catalyzed by the action of monoterpene synthases (MTSs). However, the knowledge about these enzymes is restricted in a few plant species. MTSs are responsible for the complex cyclization of monoterpene precursors, resulting in the production of diverse monoterpene products. These enzymatic reactions are considered exceptionally complex in nature. Therefore, it is crucial to understand the catalytic mechanism of MTSs to elucidate their ability to produce diverse or specific monoterpenoid products. In our study, we analyzed thirteen genomes of Dipterocarpaceae and identified 38 MTSs that generate a variety of monoterpene products. By focusing on four MTSs with different product spectra and analyzing the formation mechanism of acyclic, monocyclic and bicyclic products in MTSs, we observed that even a single amino acid mutation can change the specificity and diversity of MTS products, which is due to the synergistic effect between the shape of the active cavity and the stabilization of carbon-positive intermediates that the mutation changing. Notably, residues N340, I448, and phosphoric acid groups were found to be significant contributors to the stabilization of intermediate terpinyl and pinene cations. Alterations in these residues, either directly or indirectly, can impact the synthesis of single monoterpenes or their mixtures. By revealing the role of key residues in the catalytic process and establishing the interaction model between specific residues and complex monoterpenes in MTSs, it will be possible to reasonably design and engineer different catalytic activities into existing MTSs, laying a foundation for the artificial design and industrial application of MTSs.

Abstract The duck gastrointestinal tract (GIT) harbors an abundance of microorganisms that play an important role in duck health and production. Here, we constructed the first relatively comprehensive duck gut microbial gene catalog (24 million genes) and 4437 metagenome‐assembled genomes using 375 GIT metagenomic samples from four different duck breeds across five intestinal segments under two distinct rearing conditions. We further characterized the intestinal region‐specific microbial taxonomy and their assigned functions, as well as the temporal development and maturation of the duck gut microbiome. Our metagenomic analysis revealed the similarity within the microbiota of the foregut and hindgut compartments, but distinctive taxonomic and functional differences between distinct intestinal segments. In addition, we found a significant shift in the microbiota composition of newly hatched ducks (3 days), followed by increased diversity and enhanced stability across growth stages (14, 42, and 70 days), indicating that the intestinal microbiota develops into a relatively mature and stable community as the host duck matures. Comparing the impact of different rearing conditions (with and without water) on duck cecal microbiota communities and functions, we found that the bacterial capacity for lipopolysaccharide biosynthesis was significantly increased in ducks that had free access to water, leading to the accumulation of pathogenic bacteria and antibiotic‐resistance genes. Taken together, our findings expand the understanding of the microbiome signatures linked to intestinal regional, temporal development, and rearing conditions in ducks, which highlight the significant impact of microbiota on poultry health and production.

In this study, a trisodium citrate (TSC)-assisted hydrothermal method is utilized to prepare three-dimensional hydroxyapatite (3D HA). Understanding the role of TSC in the preparation of 3D HA crystals may provide valuable methods to design advanced biomaterials. As one of the indexes of solution supersaturation, the initial pH (ipH) value can not only directly affect the nucleation rate, but also affect the growth of HA crystals. In this work, the effect of the ipH on the microstructure, particle size distribution, and specific surface area of the 3D HA is explored. Results showed that the morphology of 3D HA transformed from a bundle to a dumbbell ball and then a dumbbell with an increase in the ipH. A corresponding mechanism of such a structural evolution was proposed, providing inspiration for the fabrication of innovative 3D HA structures with enhanced biological functionality and performance.

Objective: Intrathecal drug delivery systems (IDDS) have been clinically applied to treat refractory cancer-related pain for years. In this study, we demonstrate the current clinical practice and outcomes of IDDS for cancer pain management over a 3-year period at a single tertiary medical center in China. Methods: Patients who received IDDS implantation for cancer-related pain from 2021 to 2023 were identified. The electronic medical records of all eligible patients were retrospectively reviewed for study data including baseline characteristics, IDDS variables and postoperative clinical outcomes. Results: A total of 96 consecutive individuals were identified for analysis and complete follow-up information was available in 72 patients with a follow-up rate of 75 %. Patients were 49.0 % female with a mean age of 62 ± 10 years. The top five cancer types in IDDS population were lung (34.4 %), colorectal (17.7 %), pancreatic (11.5 %), breast (5.2 %) and liver (4.2 %) cancer. The median duration from cancer diagnosis to IDDS implantation was 24 months (interquartile range [IQR] 12–48 months) and from pain onset to IDDS implantation was 6 months (IQR 2–12 months). In addition, the median oral morphine equivalents (OME) daily dose was 290 mg (IQR 100–632 mg). Mean NRS was 7.5 ± 0.8 before implantation and decreased to an average of 3.0 ± 1.1 after IDDS (p

Multiple myeloma (MM) is the most prevalent malignant monoclonal disease of plasma cells. There is mounting evidence that interactions with the bone marrow (BM) niche are essential for the differentiation, proliferation, survival, migration, and treatment resistance of myeloma cells. For this reason, gaining a deeper comprehension of how BM microenvironment compartments interact with myeloma cells may inspire new therapeutic ideas that enhance patient outcomes. This review will concentrate on the most recent findings regarding the mechanisms of interaction between microenvironment and MM and highlight research on treatment targeting the BM niche.

As the most widely distributed scavenger birds on the Qinghai-Tibetan Plateau, Himalayan vultures (Gyps himalayensis) feed on the carcasses of various wild and domestic animals, facing the dual selection pressure of pathogens and antibiotics and are suitable biological sentinel species for monitoring antibiotic resistance genes (ARGs). This study used metagenomic sequencing to comparatively investigate the ARGs and mobile genetic elements (MGEs) of wild and captive Himalayan vultures. Overall, the resistome of Himalayan vultures contained 414 ARG subtypes resistant to 20 ARG types, with abundances ranging from 0.01 to 1,493.60 ppm. The most abundant resistance type was beta-lactam (175 subtypes), followed by multidrug resistance genes with 68 subtypes. Decreases in the abundance of macrolide-lincosamide-streptogramin (MLS) resistance genes were observed in the wild group compared with the zoo group. A total of 75 genera (five phyla) of bacteria were predicted to be the hosts of ARGs in Himalayan vultures, and the clinical (102 ARGs) and high-risk ARGs (35 Rank I and 56 Rank II ARGs) were also analyzed. Among these ARGs, twenty-two clinical ARGs, nine Rank I ARG subtypes, sixteen Rank II ARG subtypes were found to differ significantly between the two groups. Five types of MGEs (128 subtypes) were found in Himalayan vultures. Plasmids (62 subtypes) and transposases (44 subtypes) were found to be the main MGE types. Efflux pump and antibiotic deactivation were the main resistance mechanisms of ARGs in Himalayan vultures. Decreases in the abundance of cellular protection were identified in wild Himalayan vultures compared with the captive Himalayan vultures. Procrustes analysis and the co-occurrence networks analysis revealed different patterns of correlations among gut microbes, ARGs, and MGEs in wild and captive Himalayan vultures. This study is the first step in describing the characterization of the ARGs in the gut of Himalayan vultures and highlights the need to pay more attention to scavenging birds.

BackgroundDelivery systems based on albumin nanoparticles (NPs) have recently garnered substantial interest in anti-tumor drug development. However, systematic bibliometric analyses in this field remain lacking. This study aimed to analyze the current research status, hotspots, and frontiers in the application of albumin NPs in the field of oncology from a bibliometric perspective.MethodsUsing the Web of Science Core Collection (WOSCC) as the data source, retrieved articles were analyzed using software, such as VOSviewer 1.6.18 and CiteSpace 6.1.6, and the relevant visualization maps were plotted.ResultsFrom 1 January 2000, to 15 April 2024, 2,262 institutions from 67 countries/regions published 1,624 articles related to the application of albumin NPs in the field of oncology. The USA was a leader in this field and held a formidable academic reputation. The most productive institution was the Chinese Academy of Sciences. The most productive author was Youn YS, whereas Kratz F was the most frequently co-cited author. The most productive journal was the International Journal of Nanomedicine, whereas the Journal of Controlled Release was the most co-cited journal. Future research hotspots and frontiers included “rapid and convenient synthesis methods predominated by self-assembly,” “surface modification,” “construction of multifunctional NPs for theranostics,” “research on natural active ingredients mainly based on phenolic compounds,” “combination therapy,” and “clinical applications.”ConclusionBased on our bibliometric analysis and summary, we obtained an overview of the research on albumin NPs in the field of oncology, identified the most influential countries, institutions, authors, journals, and citations, and discussed the current research hotspots and frontiers in this field. Our study may serve as an important reference for future research in this field.

Abstract Introduction Fatigue is a common symptom that negatively affects the outcomes and functions of rheumatoid arthritis (RA) patients. This study aimed to assess the fatigue by two scales and validate their consistency, also to comprehensively evaluate fatigue‐related risk factors in RA patients. Methods In this case–control study, the fatigue of 160 RA patients and 60 healthy controls was evaluated by the Bristol Rheumatoid Arthritis Fatigue Multi‐Dimensional Questionnaire (BRAF‐MDQ) and the Chinese version of the Brief Fatigue Inventory (BFI‐C). The 28‐joint disease activity score using erythrocyte sedimentation rate of RA patients was assessed. Results The BRAF‐MDQ and BFI‐C scores were elevated in RA patients versus healthy controls (all p

Abstract Objective To investigate the prognostic factors of patients with anti‐melanoma differentiation‐associated gene 5 (MDA5) positive clinically amyopathic dermatomyositis (CADM) and interstitial lung disease (ILD). Methods A retrospective analysis was conducted on clinical data of 125 patients with anti‐MDA5 + CADM‐ILD collected from 10 branches in eastern China between December 2014 and December 2022. Prognostic factors were analyzed using χ2 test, Log‐rank test, COX and logistic regression analysis. Results In this cohort, 125 anti‐MDA5 + CADM‐ILD patients exhibited a rapidly progressive interstitial lung disease (RPILD) incidence of 37.6%, and an overall mortality rate of 24.8%. One patient was lost to follow‐up. After diagnosis of RPILD, a mortality rate of 53.2% occurred in patients died within 3 months, and that of 5.6% appeared in those who survived for more than 3 months. Multiple factor analysis revealed that C‐reactive protein (CRP) ≥ 10 mg/L (p = 0.01) and recombinant human tripartite motif containing 21 (Ro52) (+) (p = 0.003) were associated with a higher risk of RPILD in anti‐MDA5 + CADM‐ILD patients; CRP ≥ 10 mg/L (p = 0.018) and the presence of RPILD (p = 0.003) were identified as the factors influencing survival time in these patients, while arthritis was the protective factor (p = 0.016). Conclusion Patients with anti‐MDA5 + CADM‐ILD will have a higher mortality rate, and the initial 3 months after diagnosis of RPILD is considered the risk window for the dismal prognosis. Patients with CRP ≥ 10 mg/L, Ro52 (+) and RPILD may be related to a shorter survival time, while patients complicated with arthritis may present with relatively mild conditions.

BackgroundThe integrity of the lateral wall in femoral intertrochanteric fractures significantly impacts fracture stability and internal fixation. In this study, we compared the outcomes of treating intertrochanteric fractures with lateral wall involvement using the ortho-bridge system (OBS) combined with proximal femoral nail antirotation (PFNA) versus simple PFNA from a biomechanical perspective.MethodsFinite-element models of femoral intertrochanteric fractures with lateral wall involvement were subjected to fixation with OBS combined with PFNA and simple PFNA. Von Mises stress measurements and corresponding displacement assessments for each component of the model, including the proximal femur and lateral wall, were used to evaluate the biomechanical effects of OBS fixation on bone and intramedullary nail stability.ResultsUsing PFNA alone to fix intertrochanteric fractures with lateral wall involvement resulted in von Mises stress levels on the lateral wall exceeding safe stress tolerances for bone growth. OBS fixation significantly reduced stress on the lateral wall of the femur and minimized the stress on each part of the intramedullary nail, reducing the overall displacement.ConclusionIn cases of intertrochanteric fractures with lateral wall involvement, PFNA fixation alone may compromise the biomechanical integrity of the lateral femoral wall, increasing the risk of postoperative complications. The addition of OBS to PFNA significantly reduces stress on the lateral femoral wall. Consequently, OBS should be considered for lateral wall fixation when managing intertrochanteric fractures combined with lateral wall fractures.

ObjectiveTo explore the insight, treatment attitude, and related influencing factors of hospitalized elderly patients suffering from major depression.MethodsA total of 141 hospitalized elderly patients with depression were selected as the research objects. Insight was evaluated by the total score of the Insight and Treatment Attitude questionnaire (ITAQ). The data collected included sociodemographic characteristics, psychiatric symptoms, delirium status, social functioning, social support, suicide risk, and cognitive function.ResultsThe sample included 74.5% of female patients, and the mean age was 67.53 (sd=7.19) years. The influencing factors of inpatients with depression included alcohol consumption, length of hospitalization, admission types, and the main caregivers (P

BackgroundThis study was aimed at investigating the dynamics of lipids and the effect of TAF on the lipid profile of patients including fatty liver disease in CHB patients.MethodsThe data of TC, LDL-c, HDL-c, TG, and TC/HDL ratio were collected at baseline, 24 weeks, 48 weeks, 72 weeks, and 96 weeks. CHB patients with fatty liver at baseline were further analyzed in a subgroup.ResultsA total of 137 CHB patients treated with TAF were enrolled in this study. During 96 weeks of TAF treatment, there was no significant change in TC, LDL-c, HDL-c, and TG level (P > 0.05). The TC/HDL-c ratio was increased with no significant change (+0.24, P > 0.05). In CHB patients with fatty liver (n = 48), TC, LDL-c, and TC/HDL-c ratio increased gradually during TAF treatment, TG levels increased to 146.63 mg/dL at 48 weeks (P = 0.057) and then decreased, but there was still no significant change compared with the baseline level by 96 weeks (P > 0.05).ConclusionTAF treatment had a low effect on the lipid profile of CHB patients over the course of 96 weeks, and it was safe even in patients with fatty liver.Clinical trial registration[https://www.chictr.org.cn/showproj.html?proj=65123], identifier [ChiCTR2000041005].

Histamine is a biogenic amine with various physiological functions. However, excessive consumption of histamine can lead to various symptoms, and pose a threat to human lives. A ratiometric fluorescent test strip for visual detection of histamine was developed based on CB-Ni2+@CDs probes. As the concentration of histamine increases, the test strips exhibit a transition in fluorescence signal from yellow-green to blue. The RGB values were extracted from the images, and used for quantitative analysis of histamine. The method had a linear range of 0–1.0 mM, with a detection limit of 0.086 mM. The test strips were employed for the detection of histamine, and the recovery rate was found to be in the range of 88.3% to 104.69%, indicating a high level of accuracy. The uniqueness of the test strips lies in their ability to be produced simply by mixing CB, Ni2+ on a suitable polyvinyl alcohol/wood cellulose fiber substrate.

Hydrogen (H2) sensors with excellent performance play an important role in the safety application of H2 energy. Among current H2 detection technologies, surface acoustic wave (SAW) based H2 sensors attract more attention due to their features of high sensitivity, fast response, mico-nano scale and excellent stability, which was composed of a SAW sensing chip and sensing materials depositing along the acoustic wave propagation path, and utilizing the coupling mechanism of force-acoustic-electric multiple physical fields. Here we review the SAW H2 sensor, focusing on the H2 sensing materials, SAW sensing mechanisms, sensing devices, sensing circuits, and development status. And prospects were made for its development trends and challenges.

Abstract B-cell maturation antigen (BCMA), expressed in plasmablasts and plasma cells, could serve as a promising therapeutic target for autoimmune diseases. We reported here chimeric antigen receptor (CAR) T cells targeting BCMA in two patients with highly relapsed and refractory myasthenia gravis (one with AChR-IgG, and one with MuSk-IgG). Both patients exhibited favorable safety profiles and persistent clinical improvements over 18 months. Reconstitution of B-cell lineages with sustained reduced pathogenic autoantibodies might underlie the therapeutic efficacy. To identify the possible mechanisms underlying the therapeutic efficacy of CAR-T cells in these patients, longitudinal single-cell RNA and TCR sequencing was conducted on serial blood samples post infusion as well as their matching infusion products. By tracking the temporal evolution of CAR-T phenotypes, we demonstrated that proliferating cytotoxic-like CD8 clones were the main effectors in autoimmunity, whereas compromised cytotoxic and proliferation signature and profound mitochondrial dysfunction in CD8+ Te cells before infusion and subsequently defect CAR-T cells after manufacture might explain their characteristics in these patients. Our findings may guide future studies to improve CAR T-cell immunotherapy in autoimmune diseases.

Abstract Acceleration of tooth movement during orthodontic treatment is challenging, with osteoclast-mediated bone resorption on the compressive side being the rate-limiting step. Recent studies have demonstrated that mechanoreceptors on the surface of monocytes/macrophages, especially adhesion G protein-coupled receptors (aGPCRs), play important roles in force sensing. However, its role in the regulation of osteoclast differentiation remains unclear. Herein, through single-cell analysis, we revealed that CD97, a novel mechanosensitive aGPCR, was expressed in macrophages. Compression upregulated CD97 expression and inhibited osteoclast differentiation; while knockdown of CD97 partially rescued osteoclast differentiation. It suggests that CD97 may be an important mechanosensitive receptor during osteoclast differentiation. RNA sequencing analysis showed that the Rap1a/ERK signalling pathway mediates the effects of CD97 on osteoclast differentiation under compression. Consistently, we clarified that administration of the Rap1a inhibitor GGTI298 increased osteoclast activity, thereby accelerating tooth movement. In conclusion, our results indicate that CD97 suppresses osteoclast differentiation through the Rap1a/ERK signalling pathway under orthodontic compressive force.

Abstract The capacity to identify small amounts of pathogens in real samples is extremely useful. Herein, we proposed a sensitive platform for detecting pathogens using cyclic DNA nanostructure@AuNP tags (CDNA) and a cascade primer exchange reaction (cPER). This platform employs wheat germ agglutinin-modified Fe3O4@Au magnetic nanoparticles (WMRs) to bind the E. coli O157:H7, and then triggers the cPER to generate branched DNA products for CDNA tag hybridization with high stability and amplified SERS signals. It can identify target pathogens as low as 1.91 CFU/mL and discriminate E. coli O157:H7 in complex samples such as water, milk, and serum, demonstrating comparable or greater sensitivity and accuracy than traditional qPCR. Moreover, the developed platform can detect low levels of E. coli O157:H7 in mouse serum, allowing the discrimination of mice with early-stage infection. Thus, this platform holds promise for food analysis and early infection diagnosis.

Abstract Background and aims Metformin has been reported to inhibit the occurrence and development of colorectal cancer (CRC) by mediating changes in intestinal flora. Studies have also indicated that the occurence of familial adenomatous polyposis (FAP) may also be associated with changes in the intestinal flora. Therefore, we investigated the efficacy and safety of metformin in treating FAP and the association with intestinal flora. Results Compared with the baseline, the mean number and load of polyps in the areas of nanocarbon labeling and postoperative residuals in the test group were lower than those in the placebo group, while the diversity of intestinal flora species was increased. At the genus level, the relative abundance of g_Ruminococcus in the test group was lower than that at baseline, whereas the relative abundance of g_Lactobacillus was higher. These changes were statistically significant (P

[Objective] As a special form of space utilization for vehicle base, sunken metro vehicle base faces greater risk in flood control and drainage. However, currently there are no available specifications and standards in this regard in China. Therefore, it is necessary to conduct in-depth research on the flood control and drainage design capacity of sunken vehicle base, clarify the relevant content in specification and standards to provide design reference for such projects. [Method] Relying on the Qianyin Parking Lot project of Ningbo Metro Line 5, the design requirements in existing specifications and standards for flood control and drainage are analyzed, as well as the flood prevention and control scheme of the sunken vehicle base. The flood control and drainage design schemes for different areas in sunken foundation pit are compared and analyzed according to 50-year and 100-year rainstorm return periods. [Result & Conclusion] The sunken vehicle base should adopt ′reliable measures for waterlogging prevention and drainage′ to meet the basic requirements in this regard. In terms of flood control, the flood wall top elevation of sunken vehicle base and the pavement elevation at entry/exit should be higher than the 100-year flood level plus the safety height, and the height difference between the flood wall and the surrounding ground should be higher than the plot waterlogged level under 100-year rainstorm return period condition. In terms of drainage, the principle of ′high water and high drainage′ should be adopted for the drainage of the cover roof area over sunken foundation pit. The roof drainage capacity should be designed according to 100-year rainstorm return period, and the water should be directly discharged out of the foundation pit through gravity flow. The open area in the pit adopts pumping and drainage method, and the total drainage capacity of the rainwater pump station is designed according to 100-year rainstorm return period.

In recent years, the steady-state visual evoked potentials (SSVEP) based brain control method has been employed to help people with disabilities because of its advantages of high information transmission rate and low training time. However, the existing SSVEP brain control methods cannot adapt to dynamic or unstructured environments. Moreover, the recognition accuracy from the conventional decoding algorithm still needs to improve. To address the above problems, this study proposed a steady-state hybrid visual evoked potentials (SSHVEP) paradigm using the grasping targets in their environment to improve the connection between the subjects’ and their dynamic environments. Moreover, a novel EEG decoding method, using the multivariate variational mode decomposition (MVMD) algorithm for adaptive sub-band division and convolutional neural network (CNN) for target recognition, was applied to improve the decoding accuracy of the SSHVEPs. 18 subjects participated in the offline and online experiments. The offline accuracy across 18 subjects by the 9-target SSHVEP paradigm was up to $95.41~\pm ~2.70$ %, which is a 5.80% improvement compared to the conventional algorithm. To further validate the performance of the proposed method, the brain-controlled grasping robot system using the SSHVEP paradigm was built. The average accuracy reached $93.21~\pm ~10.18$ % for the online experiment. All the experimental results demonstrated the effectiveness of the brain-computer interaction method based on the SSHVEP paradigm and the MVMD combined CNN algorithm studied in this paper.

Abstract Long-term monitoring of environmental warfare agengts is a challenge for chemical gas sensors. To address this issue, we developed a 433 MHz passive wireless surface acoustic wave (WSAW) gas sensor for dimethyl methylphosphonate (DMMP) detection. This WSAW gas sensor includes a YZ lithium niobate (LiNbO3) substrate with metallic interdigital transducers (IDTs) etched on it, and an antenna was placed near the IDT. A DMMP-sensitive viscoelastic polymer fluoroalcoholpolysiloxane (SXFA) film was prepared on a LiNbO3 substrate, and mode modeling coupling was used to optimize the design parameters. The sensor can function properly in an environments between −30 °C and 100 °C with humidity less than 60% RH. When the wireless transmission distance was within the range of 0–90 cm, the sensor noise increased with distance, and the stability was less than 32°/h. While optimizing the film thickness of SXFA, a relationship was observed between sensor sensitivity and film thickness. When the film thickness of SXFA reached 450 nm, the optimal value was reached. At a distance of 20 cm between the transmitting and receiving antennas, DMMP was detected at different concentrations with the developed WSAW gas sensor. The lower detection limit of DMMP was 0.48 mg/m3, the sensitivity of the sensor was 4.63°/(mg/m3), and repeatable performance of the sensor was confirmed.

Abstract Interferon therapy is the most effective treatment for achieving clinical cure in chronic hepatitis B (CHB) patients. However, the treatment outcomes of interferon therapy are uncertain, multiple side effects can occur during treatment, and the treatment is expensive. Although these characteristics may affect patients’ quality of life, research examining this topic is limited. We used a cross-sectional design to examine 100 CHB patients receiving interferon, 100 receiving nucleoside/nucleotide analogues, and 87 receiving non-antiviral treatment. Characteristic information, the Hepatitis B Quality of Life Instrument, Connor Davidson Resilience Scale, and Work Productivity and Activity Impairment Questionnaire were used to collect information. We found that quality of life in the interferon treatment group was higher than that in the non-antiviral treatment and nucleoside/nucleotide analogue treatment groups (p

AbstractMelochia corchorifolia Linnaeus, 1753, is a weedy tropical plant of the Sterculiaceae family and has medicinal value. We sequenced the complete chloroplast genome of M. corchorifolia using Illumina high-throughput sequencing and examined phylogenetic relationships with closely related species. The assembled chloroplast genome of M. corchorifolia was 163,693 bp long and contained a pair of inverted repeats of 29,729 bp, separated by a large single-copy sequence of 84,350 bp and a small single-copy region of 19,885 bp. A total of 136 genes were annotated across the entire chloroplast genome, including 37 transfer RNA, 8 ribosomal RNA, and 91 protein-coding genes. The GC content of the complete cp genome was 37.27%. The phylogenetic tree indicated that M. corchorifolia is closely related to Melochia pyramidata (Malvaceae). These results would provide useful information for future phylogenetic, taxonomic, and evolutionary studies on Sterculiaceae and Malvaceae.

In order to analyze and predict the performance of mechanical structure and system, the tangential contact of solid-liquid interface under normal and tangential loads is studied, and the tangential stiffness model of rough surfaces is established by analyzing various contact states of the asperity under normal elastic-plastic deformation and tangential stick-slip. Based on the contact model of closed oil pits based on the influence of rough surfaces, on the basis of fully considering the influence of gradual application of load on the number of closed oil pit, and then changing the load distribution of solid-liquid interface, a liquid tangential stiffness model is established. The tangential stiffness of solid-liquid interface is obtained by two parts in parallel. Through simulation and experimental analysis, the effects of normal load, deformation and lubricant viscosity on the tangential stiffness of solid-liquid interface are revealed, and the tangential stiffness with or without lubricating medium is compared and analyzed. The results show that the tangential stiffness of solid-liquid interface and solid-solid interface increases nonlinearly with the increase of normal load and deformation. Due to the contribution of liquid stiffness, the tangential stiffness of solid-liquid interface is always slightly higher than that of solid-solid interface. The greater the viscosity of the lubricating medium, the greater the tangential stiffness of the solid-liquid interface. At low load, liquid contact is dominant, and the tangential stiffness of solid-liquid interface is low. Under moderate and heavy loads, the solid contact is dominant, and the tangential stiffness of the solid-liquid interface increases rapidly. Therefore, the tangential contact stiffness of the solid-liquid interface in mixed lubrication can be effectively improved by increasing the normal load and increasing the viscosity of the lubricating medium.

Circumaortic left renal vein with additional retroaortic limb is a rare anatomic variant. We encountered two cases in our practice with additional retroaortic limb draining into hemiazygos and IVC respectively. We focus on discussing the clinical relevance and surgical implications of such variants.

The high-intensity mining of coal face in the Ordos gas-coal overlapping area can easily lead to the failure of shallowly buried oil & gas pipelines. It is of great significance to clarify the time series of the pipeline failure during the advancing process of the panel in this area for the accurate maintenance and parameter optimization of the gathering and transmission pipelines. Firstly, the theoretical algorithm of volume strain (VS) is proposed through theoretical analysis. Then, a new method for failure damage discrimination in the tensile and compressive states locally is respectively constructed by the volume strain limit. Next, the deformation and volumetric strain of the pipeline in the axial and circumferential directions were analyzed by numerical simulation, and the time series law of buried pipeline damage was clarified. At the same time, the numerical results are compared and analyzed with the monitoring data and theoretical results to verify the reasonableness and accuracy of the experimental results. The results show that the volumetric strain limits in tension and compression are, for example, 0.42% and −0.31% for a 508 mm diameter gas transmission pipe. The deformation of the pipeline is smaller than that of the overburden during the process of panel advancing, and the deformation between them is non-synergistic. The closer the panel is to the pipeline, the greater the degree of non-synergistic. In the axial direction, the deformation curves of the tubes are funnel-shaped. The ellipticity of the tube decreases as the distance between the tube and the panel decreases, and the mathematical relationship between them can be expressed as an exponential function. The volume strain between the inflection points of the pipeline is always less than 0, and the VS from the inflection point to the end is always greater than 0. Furthermore, the volume strain of the pipe is symmetrical to the left and right about the position of the center of the subsidence. The volume strain distribution at the bottom and top of the pipe is not symmetrical, and the absolute value of the volume strain at the top is always greater than that at the bottom at the same axial position. The failure profiles at the top and bottom of the pipeline are shown as “∩” and “∪”, and at the same axial position show “S”. The location and pattern of axial damage of the pipeline: compression damage at the bottom center, and tensile damage at the bottom two ends. The panel is gradually approaching the pipeline process, the failure from the center to the inflection point and from the end to the inflection point of the pipeline is successively generated, and the center is earlier than that at both ends, and the top is earlier than the bottom. At the same time, the failure of the pipeline ring is the transfer from 270° to 180°, where 330°-150° is the most vulnerable to damage orientation, and the minimum deformation is the transfer from 120° to 0°. Finally, the reliability of the results was verified by the deformation, the ellipticity, the shear stress of the pipe, and the ground settlement. The research results further clarify the orientation and time series rule of pipeline failure, which is conducive to the precise maintenance and efficient construction of pipeline projects and provides a reference for promoting the coordinated mining of oil-gas-coal resources.

Abstract Background In the era of antiretroviral therapy (ART), central nervous system (CNS) complications in patients with human immunodeficiency virus (HIV) infection are sometimes associated with cerebrospinal fluid (CSF) viral escape. Here, we reported a case of persistent CNS viral escape with recurrent symptomatic encephalitis, which had ultimate stabilization achieved by a combination of ART adjustment and corticosteroids. Case presentation A 27-year-old man with HIV infection complained of recurrent headaches during the last year. His magnetic resonance imaging (MRI) presented diffused bilateral white matter lesions, and laboratory tests confirmed elevated CSF protein level, lymphocytic pleocytosis, and detectable CSF HIV RNA (774 copies/mL). Plasma HIV RNA was well suppressed with tenofovir, lamivudine, and lopinavir/ritonavir. Prednisone 60 mg once daily was initiated to reduce intracranial inflammation, followed by a good clinical response, with CSF HIV RNA still detectable (31.1 copies/mL). During the gradual tapering of prednisone, his headache relapsed, and booming viral loads were detected in both CSF (4580 copies/mL) and plasma (340 copies/mL) with consistent drug-resistant mutations. Thereupon, prednisone was resumed and the ART regimen was switched to zidovudine, lamivudine, and dolutegravir according to drug resistance tests. Persistent clinical recovery of symptoms, neuroimaging, and laboratory abnormalities were observed in the follow-up visits. Conclusion CSF and plasma HIV RNA and further drug resistance tests should be monitored in HIV-infected patients with neurologic symptoms, as opportunistic infections or tumors can be ruled out. ART optimization using a sensitive regimen may be crucial for addressing CSF viral escape and the related encephalitis.

Abstract Background The clinical characteristics of early-onset type 2 diabetes (T2D) patients are not fully understood. To address this gap, we conducted a cohort study to evaluate clinical characteristics and disease burden in the new-onset T2D population, especially regarding the progression of diseases. Methods This cohort study was conducted using a population-based database. Patients who were diagnosed with T2D were identified from the database and were classified into early- (age