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In this paper, high cis-1,4 content hydroxyl-terminated polybutadiene (cis-HTPB) with different molecular weights was prepared through the oxidative cracking process using cis-butadiene rubber as raw material. Firstly, this article comprehensively compared the differences between cis-HTPB and conventional I-HTPB in terms of molecular weight distribution, functionality, viscosity, molecular polarity, and other physicochemical properties, which provided effective data support for its subsequent application. In addition, the reaction kinetics study showed that cis-HTPB with isocyanate curing agent has high reactivity, allowing it to be rapidly cured at low temperatures, and the cured elastomers had excellent mechanical properties, with tensile strength and elongation up to 1.89 MPa and 1100%, respectively. It was also found that cis-HTPB has extremely excellent low-temperature resistance, and the glass transition temperature (Tg) of its cured elastomer is as low as −101 °C. Based on the above studies, cis-HTPB is applied as a binder in composite solid propellants for the first time to investigate its practical performance, and the results indicated that cis-HTPB-based propellants have excellent process and mechanical properties.

Abstract Background Lipid management based on cardiovascular risk level is the cornerstone of primary prevention of coronary artery disease (CAD), while the accuracy and adherence of traditional cardiovascular risk stratification have been questioned. Prevention strategies based on imaging screening for atherosclerotic plaques are found to be more objective and adherent in recent studies. This trial aims to investigate the role of coronary computed tomography angiography (CCTA) in guiding the primary prevention of CAD in a randomized controlled design. Methods Approximately 3400 middle-aged asymptomatic community participants will be recruited and randomized in a 1:1 ratio to a traditional cardiovascular risk score-guided (usual care group) or CCTA-guided (CCTA group) strategy. Participants with cardiovascular disease, prior lipid-lowering therapy, CCTA contraindication, or serious diseases that affect life span will be excluded. The intervention strategy includes blood pressure, blood glucose, and lipid management and lifestyle modifications. Blood pressure and glucose targets and lifestyle modification recommendations keep the same in both strategies, while lipid management is personalized based on traditional risk level or CCTA results, respectively. The primary outcome is the proportion of participants taking lipid-lowering medication regularly at both 6 and 12 months. The secondary outcomes include the proportion of participants achieving low-density lipoprotein cholesterol lowering targets at 12 months, mean changes in lipid levels from baseline to 12 months, barriers to adherence, adverse reactions related to CCTA examination, and cardiovascular events. Discussion The study is the first randomized clinical trial to examine the effectiveness of a CCTA-guided versus a traditional risk score-guided primary prevention strategy in an asymptomatic community-based population. Trial registration ClinicalTrials.gov NCT05725096. Registered on 2 February 2023.

Abstract Dengue, an acute febrile disease transmitted by Aedes mosquitoes, is caused by the dengue virus (DENV), presenting a formidable challenge to global public health. By examining clues from ancient Chinese books and conducting a comprehensive review, this study elucidates the characteristics of potential dengue epidemics in China prior to 1978. This evidence indicates that China may not have experience dengue epidemics before 1840. During 1840–1949, however, it experienced a noticeable dengue occurrence and prevalence in the 1870s, 1920s, and 1940s. Then from 1949 to 1978, only sporadic reports were accounted. The disparity in the frequency of dengue occurrences across three time periods suggests that the persistent characteristic of dengue epidemics in China primarily arises from imported cases resulting from international exchanges, subsequently leading to local outbreaks influenced by global epidemic trend. This research offers a novel perspective on retrospectively examining the historical trajectory of dengue epidemics and provides valuable insights into exploration of DENV epidemic patterns. Graphical Abstract

ABSTRACTBackground Pneumococcal vaccines are effective in preventing pneumococcal diseases in adults. The evaluation of the antibodies persistence to the 23-valent pneumococcal polysaccharide vaccine (PPV23) could provide evidence on PPV23 revaccination.Research design and methods Adults aged ≥ 60 years were selected and vaccinated with PPV23 in Shanghai, and followed up for 5 years with blood samples collection of a 1-year interval. The geometric mean concentrations (GMC) of the IgG against 23 pneumococcal serotypes covered by PPV23 were detected using enzyme-linked immunosorbent assay. The antibodies to 23 pneumococcal serotypes among different groups was analyzed using statistical analysis.Results Overall, 517 participants completed all six visits over a 5-year period (2013–2018). The GMC of 23 serotypes in adults aged ≥ 60 years decreased slowly after PPV23 vaccination compared to baseline pre-vaccination (P

Abstract The traceability of groundwater nitrate pollution is crucial for controlling and managing polluted groundwater. This study integrates hydrochemistry, nitrate isotope (δ15N-NO3 − and δ18O-NO3 −), and self-organizing map (SOM) and end-member mixing (EMMTE) models to identify the sources and quantify the contributions of nitrate pollution to groundwater in an intensive agricultural region in the Sha River Basin in southwestern Henan Province. The results indicate that the NO3 −-N concentration in 74% (n = 39) of the groundwater samples exceeded the WHO standard of 10 mg/L. According to the results of EMMTE modeling, soil nitrogen (68.4%) was the main source of nitrate in Cluster-1, followed by manure and sewage (16.5%), chemical fertilizer (11.9%) and atmospheric deposition (3.3%). In Cluster-2, soil nitrogen (60.1%) was the main source of nitrate, with a significant increase in the contribution of manure and sewage (35.5%). The considerable contributions of soil nitrogen may be attributed to the high nitrogen fertilizer usage that accumulated in the soil in this traditional agricultural area. Moreover, it is apparent that most Cluster-2 sampling sites with high contributions of manure and sewage are located around residential land. Therefore, the arbitrary discharge and leaching of domestic sewage may be responsible for these results. Therefore, this study provides useful assistance for the continuous management and pollution control of groundwater in the Sha River Basin.

Abstract Background The strong invasiveness and rapid expansion of dengue virus (DENV) pose a great challenge to global public health. However, dengue epidemic patterns and mechanisms at a genetic scale, particularly in term of cross-border transmissions, remain poorly understood. Importation is considered as the primary driver of dengue outbreaks in China, and since 1990 a frequent occurrence of large outbreaks has been triggered by the imported cases and subsequently spread to the western and northern parts of China. Therefore, this study aims to systematically reveal the invasion and diffusion patterns of DENV-1 in Guangdong, China from 1990 to 2019. Methods These analyses were performed on 179 newly assembled genomes from indigenous dengue cases in Guangdong, China and 5152 E gene complete sequences recorded in Chinese mainland. The genetic population structure and epidemic patterns of DENV-1 circulating in Chinese mainland were characterized by phylogenetics, phylogeography, phylodynamics based on DENV-1 E-gene-based globally unified genotyping framework. Results Multiple serotypes of DENV were co-circulating in Chinese mainland, particularly in Guangdong and Yunnan provinces. A total of 189 transmission clusters in 38 clades belonging to 22 subgenotypes of genotype I, IV and V of DENV-1 were identified, with 7 Clades of Concern (COCs) responsible for the large outbreaks since 1990. The epidemic periodicity was inferred from the data to be approximately 3 years. Dengue transmission events mainly occurred from Great Mekong Subregion-China (GMS-China), Southeast Asia (SEA), South Asia Subcontinent (SASC), and Oceania (OCE) to coastal and land border cities respectively in southeastern and southwestern China. Specially, Guangzhou was found to be the most dominant receipting hub, where DENV-1 diffused to other cities within the province and even other parts of the country. Genome phylogeny combined with epidemiological investigation demonstrated a clear local consecutive transmission process of a 5C1 transmission cluster (5C1-CN4) of DENV-1 in Guangzhou from 2013 to 2015, while the two provinces of Guangdong and Yunnan played key roles in ongoing transition of dengue epidemic patterns. In contextualizing within Invasion Biology theories, we have proposed a derived three-stage model encompassing the stages of invasion, colonization, and dissemination, which is supposed to enhance our understanding of dengue spreading patterns. Conclusions This study demonstrates the invasion and diffusion process of DENV-1 in Chinese mainland within a global genotyping framework, characterizing the genetic diversities of viral populations, multiple sources of importation, and periodic dynamics of the epidemic. These findings highlight the potential ongoing transition trends from epidemic to endemic status offering a valuable insight into early warning, prevention and control of rapid spreading of dengue both in China and worldwide. Graphical Abstract

Abstract Environmental contamination by hexavalent chromium (Cr(VI)) and antibiotic drug residues pose significant challenges to public health and ecosystems. This study investigates the application of CoTiO3/BiVO4@MIL-Fe(53) (CT/BV@Fe-MOF) for the reduction of Cr(VI) and degradation of tetracycline (TCL) under visible light. After grafting an iron-based metal–organic framework MIL-Fe(53) on a modified CoTiO3/BiVO4 composite, the photogenerated electrons could easily be transferred from CoTiO3 to BiVO4/Fe-MOF species via interfacial charge transfer. UV–vis diffuse reflectance spectroscopy showed that charge carriers were formed in response to visible light absorption. The effect of different operating parameters, including catalyst load, pH, initial Cr(VI), and TCL concentration, was systematically evaluated during the photocatalytic process. The CT/BV@Fe-MOF composite exhibited 98.7% reduction efficiency in Cr(VI) (50 ppm) and 97.5% degradation efficiency towards TCL (30 ppm) within 90 min, resulting in a greater efficiency than the pristine CoTiO3, BiVO4, and Fe-MOF materials. The CT/BV@Fe-MOF composite displayed excellent stability over six cycles, highlighting its potential for practical applications. In addition, the plausible degradation pathway of TCL was evaluated using LC-ESI/MS analysis, while the TEST program was utilized to investigate the toxicity of the products generated during the degradation process.

ObjectiveTo evaluate the methodological, reporting and evidence quality of systematic reviews or meta-analyses of Janus kinases (JAK) inhibitors for the treatment of rheumatoid arthritis (RA).MethodsOur study systematically retrieved reviews from various databases, spanning from inception to June 2024. Two evaluators independently assessed the methodological, reporting, and evidence quality of each review using the AMSTAR-2 and PRIAMA2020 tools. The evidence quality was evaluated according to GRADE criteria. Six aspects were evaluated: publication year, study type, homogeneity, risk of publication bias, AMSTAR-2 methodology, and PRIAMA2020 reporting quality. Excel 2016 facilitated conversion of scores into radar plots.ResultsFollowing stringent selection criteria, a total of 18 relevant studies were identified. The AMSTAR-2 scores ranged from 4 to 13 points, with five studies rated as low quality and the remaining 13 as critically low quality. All studies encompassed populations, interventions, controls, and outcome measures, demonstrating commendable integrity. However, there is room for improvement in study protocol development and registration, comprehensive search strategies, inclusion and exclusion criteria, conflict of interest disclosure, and discussion of heterogeneity. PRIAMA2020 assessments ranged from 14.5 to 21 points, with two studies scoring below 15 points due to increased bias risk from data transformation and sensitivity analysis. Notably, all reviews (100%) adhered to PRIAMA2020 guidelines for certain items but none met all criteria. GRADE evaluation included 446 outcome measures, with 158 of moderate, 156 of low, and 132 of very low quality, indicating JAK inhibitors is effective in improving RA. According to radar chart, the average rank score was 13.13. One study achieved a balanced score across all dimensions, while 11 exceeded the average, five showed significant differences in PRIAMA2020 scores, and four in AMSTAR two scores.ConclusionDespite summarizing the efficacy and safety of JAK inhibitors in treating RA, the included studies exhibited poor methodological and reporting quality, along with low-quality evidence overall. Therefore, caution is warranted among decision-makers regarding the use of JAK inhibitors in RA treatment. Urgent requirements include high-quality, multicenter studies investigating JAK inhibitors for RA.Systematic Review registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier 413415.

Abstract In recent years, with the development of the new energy industry, the demand for cobalt as a raw material for power batteries has been increasing. However, China itself has a shortage of cobalt resources. Therefore, overcoming poor resource conditions and enhancing the international competitiveness of the cobalt industry have become urgent issues. This paper is based on global trade data on cobalt resources from 2007 to 2020. A panel regression model is constructed from the perspective of trade networks, and Entropy-Topsis is used to construct a comprehensive evaluation index system for the international competitiveness of critical nonferrous metals. This study empirically examines the impact of the trade network characteristics of cobalt resources on international competitiveness, assigns practical significance to trade network characteristic indicators, and analyses the overall competitiveness changes in the global cobalt industry chain and its upstream, midstream, and downstream sectors. The research findings reveal the following key points: (1) In recent years, the competitive focus of the cobalt industry chain in various countries has shifted from upstream and midstream to midstream and downstream, with increasingly fierce trade competition downstream, gradually tilting toward countries such as South Korea, Japan, and China. (2) Cobalt trade competition, which was initially characterized by competition among multiple countries, has gradually become more centralized and stable, with differences in the competitiveness of various countries occurring at different stages of the cobalt industry chain. (3) Network centrality and network heterogeneity both have a significant promoting effect on the international competitiveness of the industry, while network connectivity has a significant inhibitory effect on the improvement of international competitiveness.On this basis, the study also suggests some policy implications. The purpose of the study is to enhance the international competitiveness of China's cobalt industry from a trade perspective and to investigate the developments of cobalt trade between China and the rest of the world.

Abstract Background Diffuse large B-cell lymphomas (DLBCLs) display high molecular heterogeneity, but the International Prognostic Index (IPI) considers only clinical indicators and has not been updated to include molecular data. Therefore, we developed a widely applicable novel scoring system with molecular indicators screened by artificial intelligence (AI) that achieves accurate prognostic stratification and promotes individualized treatments. Methods We retrospectively enrolled a cohort of 401 patients with DLBCL from our hospital, covering the period from January 2015 to January 2019. We included 22 variables in our analysis and assigned them weights using the random survival forest method to establish a new predictive model combining bidirectional long-short term memory (Bi-LSTM) and logistic hazard techniques. We compared the predictive performance of our “molecular-contained prognostic model” (McPM) and the IPI. In addition, we developed a simplified version of the McPM (sMcPM) to enhance its practical applicability in clinical settings. We also demonstrated the improved risk stratification capabilities of the sMcPM. Results Our McPM showed superior predictive accuracy, as indicated by its high C-index and low integrated Brier score (IBS), for both overall survival (OS) and progression-free survival (PFS). The overall performance of the McPM was also better than that of the IPI based on receiver operating characteristic (ROC) curve fitting. We selected five key indicators, including extranodal involvement sites, lactate dehydrogenase (LDH), MYC gene status, absolute monocyte count (AMC), and platelet count (PLT) to establish the sMcPM, which is more suitable for clinical applications. The sMcPM showed similar OS results (P

Abstract Since the origin of life, temperatures on earth have fluctuated both on short and long time scales. How such changes affect the rate at which Darwinian evolution can bring forth new phenotypes remains unclear. On the one hand, high temperature may accelerate phenotypic evolution because it accelerates most biological processes. On the other hand, it may slow phenotypic evolution, because proteins are usually less stable at high temperatures and therefore less evolvable. Here, to test these hypotheses experimentally, we evolved a green fluorescent protein in E. coli towards the new phenotype of yellow fluorescence at different temperatures. Yellow fluorescence evolved most slowly at high temperature and most rapidly at low temperature, in contradiction to the first hypothesis. Using high-throughput population sequencing, protein engineering, and biochemical assays, we determined that this is due to the protein-destabilizing effect of neofunctionalizing mutations. Destabilization is highly detrimental at high temperature, where neofunctionalizing mutations cannot be tolerated. Their detrimental effects can be mitigated through excess stability at low temperature, leading to accelerated adaptive evolution. By modifying protein folding stability, temperature alters the accessibility of mutational paths towards high-fitness genotypes. Our observations have broad implications for our understanding of how temperature changes affect evolutionary adaptations and innovations.

Multiple studies have documented low human papillomavirus (HPV) vaccine uptake among Chinese girls. It remains crucial to determine the parental willingness to pay (WTP) HPV vaccine for girls. We conducted a cross-sectional study recruiting 3904 parents with girls aged 9–14 in Shanghai, China, employing an online questionnaire with a convenience sampling strategy. Parental WTP, both range of payment and estimated point value, were determined for themselves (or wives) and daughters. HPV vaccine uptake was 22.44% in mothers and 3.21% in daughters. Respondents favored WTP ≤ 1000 CNY/138 USD for themselves (or wives), whereas showed increasing WTP along with valency of HPV vaccine for daughters (2-valent: 68.62% ≤1000 CNY/138 USD; 4-valent: 56.27% 1001–2000 CNY/138–277 USD; 9-valent: 65.37% ≥2001 CNY/277 USD). Overall, respondents showed higher WTP for daughters (median 2000 CNY/277 USD; IQR 1000–3600 CNY/138–498 USD) than for themselves (2000 CNY/277 USD; 1000–3500 CNY/138–483 USD) or wives (2000 CNY/277 USD; 800–3000 CNY/110–414 USD) (each p

Abstract Background More than half of the global population lives in areas at risk of dengue (DENV) transmission. Developing an efficient risk prediction system can help curb dengue outbreaks, but multiple variables, including mosquito-based surveillance indicators, still constrain our understanding. Mosquito or oviposition positive index (MOI) has been utilized in field surveillance to monitor the wild population density of Aedes albopictus in Guangzhou since 2005. Methods Based on the mosquito surveillance data using Mosq-ovitrap collection and human landing collection (HLC) launched at 12 sites in Guangzhou from 2015 to 2017, we established a MOI-based model of the basic dengue reproduction number (R 0) using the classical Ross-Macdonald framework combined with a linear mixed-effects model. Results During the survey period, the mean MOI and adult mosquito density index (ADI) using HLC for Ae. albopictus were 12.96 ± 17.78 and 16.79 ± 55.92, respectively. The R 0 estimated from the daily ADI (ADID) showed a significant seasonal variation. A 10-unit increase in MOI was associated with 1.08-fold (95% CI 1.05, 1.11) ADID and an increase of 0.14 (95% CI 0.05, 0.23) in the logarithmic transformation of R 0. MOI-based R 0 of dengue varied by month and average monthly temperature. During the active period of Ae. albopictus from April to November in Guangzhou region, a high risk of dengue outbreak was predicted by the MOI-based R 0 model, especially from August to October, with the predicted R 0 > 1. Meanwhile, from December to March, the estimates of MOI-based R 0 were < 1. Conclusions The present study enriched our knowledge about mosquito-based surveillance indicators and indicated that the MOI of Ae. albopictus could be valuable for application in estimating the R 0 of dengue using a statistical model. The MOI-based R 0 model prediction of the risk of dengue transmission varied by month and temperature in Guangzhou. Our findings lay a foundation for further development of a complex efficient dengue risk prediction system. Graphical Abstract

Abstract Patients with residual nasopharyngeal carcinoma after receiving definitive treatment have poor prognoses. Although immune checkpoint therapies have achieved breakthroughs for treating recurrent and metastatic nasopharyngeal carcinoma, none of these strategies have been assessed for treating residual nasopharyngeal carcinoma. In this single-arm, phase 2 trial, we aimed to evaluate the antitumor efficacy and safety of toripalimab (anti-PD1 antibody) plus capecitabine in patients with residual nasopharyngeal carcinoma after definitive treatment (ChiCTR1900023710). Primary endpoint of this trial was the objective response rate assessed according to RECIST (version 1.1). Secondary endpoints included complete response rate, disease control rate, duration of response, progression-free survival, safety profile, and treatment compliance. Between June 1, 2020, and May 31, 2021, 23 patients were recruited and received six cycles of toripalimab plus capecitabine every 3 weeks. In efficacy analyses, 13 patients (56.5%) had complete response, and 9 patients (39.1%) had partial response, with an objective response rate of 95.7% (95% CI 78.1-99.9). The trial met its prespecified primary endpoint. In safety analyses, 21 of (91.3%) 23 patients had treatment-related adverse events. The most frequently reported adverse event was hand-foot syndrome (11 patients [47.8%]). The most common grade 3 adverse event was hand-foot syndrome (two patients [8.7%]). No grades 4-5 treatment-related adverse events were recorded. This phase 2 trial shows that combining toripalimab with capecitabine has promising antitumour activity and a manageable safety profile for patients with residual nasopharyngeal carcinoma.

BackgroundDigital radiography (DR) is a common and widely available examination. However, spinal DR cannot detect bone marrow edema, therefore, determining vertebral compression fractures (VCFs), especially fresh VCFs, remains challenging for clinicians.MethodsWe trained, validated, and externally tested the deep residual network (DRN) model that automated the detection and identification of fresh VCFs from spinal DR images. A total of 1,747 participants from five institutions were enrolled in this study and divided into the training cohort, validation cohort and external test cohorts (YHDH and BMUH cohorts). We evaluated the performance of DRN model based on the area under the receiver operating characteristic curve (AUC), feature attention maps, sensitivity, specificity, and accuracy. We compared it with five other deep learning models and validated and tested the model internally and externally and explored whether it remains highly accurate for an external test cohort. In addition, the influence of old VCFs on the performance of the DRN model was assessed.ResultsThe AUC was 0.99, 0.89, and 0.88 in the validation, YHDH, and BMUH cohorts, respectively, for the DRN model for detecting and discriminating fresh VCFs. The accuracies were 81.45% and 72.90%, sensitivities were 84.75% and 91.43%, and specificities were 80.25% and 63.89% in the YHDH and BMUH cohorts, respectively. The DRN model generated correct activation on the fresh VCFs and accurate peak responses on the area of the target vertebral body parts and demonstrated better feature representation learning and classification performance. The AUC was 0.90 (95% confidence interval [CI] 0.84–0.95) and 0.84 (95% CI 0.72–0.93) in the non-old VCFs and old VCFs groups, respectively, in the YHDH cohort (p = 0.067). The AUC was 0.89 (95% CI 0.84–0.94) and 0.85 (95% CI 0.72–0.95) in the non-old VCFs and old VCFs groups, respectively, in the BMUH cohort (p = 0.051).ConclusionIn present study, we developed the DRN model for automated diagnosis and identification of fresh VCFs from spinal DR images. The DRN model can provide interpretable attention maps to support the excellent prediction results, which is the key that most clinicians care about when using the model to assist decision-making.

Objectives: Stroke survivors frequently encounter physical complications. This study aimed to evaluate the impact of stroke on bone mineral density (BMD) and assess the risk of post-stroke osteoporosis or osteoporotic fractures. Design: Systematic review and meta-analysis. Setting and Participants: We systematically searched Medline, Embase, and the Cochrane Database of Systematic Reviews to identify longitudinal studies reporting the influence of stroke on BMD, osteoporosis, and osteoporotic fractures. Pooled analyses were performed utilizing random-effects models. Results: This study included 21 studies with 1,029,742 participants. The mean difference of BMD in the paretic femoral neck between follow-up and initial measurements was −0.07 g/cm2 (95% CI, −0.09 to −0.04), and −0.03 g/cm2 (95% CI, −0.05 to −0.01) in the non-paretic femoral neck. A follow-up length exceeding six months was associated with a more pronounced decrease compared to a follow-up of under six months (MD, −0.08; 95% CI, −0.11 to −0.05 vs MD, −0.04; 95% CI, −0.06 to −0.02; P = 0.03). No significant change in lumbar spine BMD was detected post-stroke (MD, −0.00; 95% CI, −0.03 to 0.02), nor was significant change observed in the non-paretic distal radius, proximal humerus, tibia, trochanter, and total hip. Stroke was not associated with an increased risk of osteoporosis or osteoporotic fractures (HR, 1.43; 95% CI, 0.95–2.13). Conclusion: Stroke survivors undergo significant BMD loss in paralyzed limbs, most notably in the femoral neck. However, BMD in the lumbar spine does not exhibit a significant decrease post-stroke. The risk of post-stroke osteoporosis or osteoporotic fractures should be interpreted with caution and needs further investigation.

Abstract Background Aedes albopictus is an invasive vector of serious Aedes-borne diseases of global concern. Habitat management remains a critical factor for establishing a cost-effective systematic strategy for sustainable vector control. However, the community-based characteristics of Ae. albopictus habitats in complex urbanization ecosystems are still not well understood. Methods A large-scale investigation of aquatic habitats, involving 12 sites selected as representative of four land use categories at three urbanization levels, was performed in Guangzhou, China during 2015–2017. The characteristics and dynamics of these Ae. albopictus habitats were assessed using habitat-type composition, habitat preference, diversity indexes and the Route index (RI), and the temporal patterns of these indexes were evaluated by locally weighted scatterplot smoothing models. The associations of RI with urbanization levels, land use categories and climatic variables were inferred using generalized additive mixed models. Results A total of 1994 potential habitats and 474 Ae. albopictus-positive habitats were inspected. The majority of these habitats were container-type habitats, with Ae. albopictus showing a particularly higher habitat preference for plastic containers, metal containers and ceramic vessels. Unexpectedly, some non-container-type habitats, especially ornamental ponds and surface water, were found to have fairly high Ae. albopictus positivity rates. Regarding habitats, the land use category residential and rural in Jiangpu (Conghua District, Guangzhou) had the highest number of Ae. albopictus habitats with the highest positive rates. The type diversity of total habitats (H-total) showed a quick increase from February to April and peaked in April, while the H-total of positive habitats (H-positive) and RIs peaked in May. RIs mainly increased with the monthly average daily mean temperature and monthly cumulative rainfall. We also observed the accumulation of diapause eggs in the winter and diapause termination in the following March. Conclusions Ecological heterogeneity of habitat preferences of Ae. albopictus was demonstrated in four land use categories at three urbanization levels. The results reveal diversified habitat-type compositions and significant seasonal variations, indicating an ongoing adaptation of Ae. albopictus to the urbanization ecosystem. H-positivity and RIs were inferred as affected by climatic variables and diapause behavior of Ae. albopictus, suggesting that an effective control of overwintering diapause eggs is crucial. Our findings lay a foundation for establishing a stratified systematic management strategy of Ae. albopictus habitats in cities that is expected to complement and improve community-based interventions and sustainable vector management. Graphical Abstract

A facile method, refluxing with hydrothermal process, was used to synthesize the fluorinated graphene sheets (FGS) with high F/C ratio. Then, the surface of aluminum hydride (AlH3) was coated with FGS by means of liquid self-assembly process. The structure and performance of FGS were characterized through fourier transform infrared spectra (FTIR), X-ray photoelectron spectroscopy (XPS), Raman spectroscopy, scanning electron microscopy (SEM), transmission electron microscope (TEM) and elemental analyzer. FTIR spectra show that the FGS have obvious absorption peak of CF bond. Raman spectra display many defects on FGS. XPS spectra and elemental analysis also prove the existence of CF bond, and the content of fluorine is more than 25%. From SEM photos we can see that FGS have thin layers with some curled wrinkles. TEM photos demonstrate intuitively the FGS has a few layers. At last, the aluminum hydride (AlH3) was coated with FGS by means of liquid self-assembly process, and AlH3 samples before and after treated were characterized through hydrogen content (H%) analysis, X-ray diffraction (XRD), FTIR, SEM and differential thermal analysis (DTA), ect. The results demonstrate that there is only a little FGS on the surface of AlH3, which won't affect the effective H% and release efficiency of hydrogen. AlH3@FGS also reduces the mechanical sensitivity of solid propellant with AlH3, which will remarkably promote the application of AlH3 in the novel high-energy solid propellant.

Rapeseed siliques easily shatter after ripening, resulting in a significant amount of grain loss, which delimits the development of rapeseed machine harvest. However, the effect of nitrogen (N) and density interaction on the characteristics of rape siliques and shattering resistance index is still vague. During the 2021–2022 and 2022–2023 growing seasons, we selected the Jiayou No. 5 rapeseed variety and set three N application levels (N1: 90 kg ha−1, N2: 180 kg ha−1, N3: 270 kg ha−1) and two density treatments (M1: 150,000 plants ha−1, M2: 300,000 plants ha−1) to research the effects of N and density interaction on morphological indexes, physiological indexes, shatter resistance index and yield of direct-seeding rapeseed siliques. The silique shatter resistance index, silique’s length, weight, moisture content, silique shell’s weight, thickness, lignin content, cellulose content and phenylalaninase (PAL) activity all increased first and then decreased with the increase in the N application rate; the N2 treatment increased by 18.38% and 26.92%, respectively, compared to the N1 and N3 treatments; 3.65%, 2.48%; 6.70%, 3.58%; 20.46%, 18.33%; 5.97%, 5.96%; 8.82%, 9.60%; 9.12%, 19.90%; 43.85%, 69%; 2.10%, 11.04%. Compared with the M1 treatment, the silique shatter resistance index, silique’s length, weight, moisture content, silique shell’s weight, thickness, lignin content, cellulose content and PAL activity were lower under M2 treatment. Correlation analysis demonstrated that the silique’s length, water content, silique shell’s weight, thickness, lignin content, cellulose content and PAL activity were significantly positively correlated with the silique shatter resistance index. Therefore, this study shows that N2M1 treatment can carry off synergy between silique shatter resistance and yield.

Abstract As the first safety barrier of nuclear reactors, zirconium alloy cladding tubes have attracted extensive attention because of its good mechanical properties. The strength and ductility of zirconium alloy are of great significance to the service process of cladding tubes, while brittle hydrides precipitate and thus deteriorate the overall performance. Based on the cohesive finite element method, the effects of cohesive strength, interfacial characteristics, and hydrides geometric characteristics on the strength and ductility of two-phase material (zirconium alloy with hydrides) are numerically simulated. The results show that the fracture behavior is significantly affected by the cohesive strength and that the overall strength and ductility are sensitive to the cohesive strength of the zirconium alloy. Furthermore, the interface is revealed to have prominent effects on the overall fracture behavior. When the cohesive strength and fracture energy of the interface are higher than those of the hydride phase, fracture initiates in the hydrides, which is consistent with the experimental phenomena. In addition, it is found that the number density and arrangement of hydrides play important roles in the overall strength and ductility. Our simulation provides theoretical support for the performance analysis of hydrogenated zirconium alloys during nuclear reactor operation.

Abstract Background The clinical presentation of adult-onset immunodeficiency with anti-interferon (IFN)-γ autoantibodies with intracellular pathogens can be highly variable, which can lead to misdiagnosis during the early stage of disease. Case presentation We report a complex case of a 54-year-old Chinese male who was human immunodeficiency virus-negative. He had a presence of anti-IFN-γ autoantibodies and suffered from various intracellular pathogenic infections. The patient was admitted to our hospital for the first time in July 2016 with severe pneumonia, and he experienced multiple pneumonia infections between 2017 and 2019. In March 2019, the patient was hospitalized due to pulmonary lesions and multiple-bone destruction. During hospitalization, the patient was confirmed to have disseminated Talaromyces marneffei infection and was successfully treated with antifungal therapy for 1 year. In June 2021, Mycobacterium kansasii infection was detected by positive culture and progressive bone destruction. A high concentration of anti-IFN-γ antibodies was observed in the patient’s serum. In addition, Listeria monocytogenes was isolated by blood culture, and the presence of L. monocytogenes in cerebrospinal fluid was confirmed by next-generation sequencing. Following anti-non-tuberculous mycobacteria (NTM) therapy and anti-bacterial therapy, the patient’s symptoms, pulmonary lesions, and bone destruction gradually improved. Conclusions Although the clinical presentation of adult-onset immunodeficiency with anti-IFN-γ autoantibodies can be highly variable, the diagnosis should be considered if patients suffer from unexplained repeated bacterial or opportunistic infections. Conventional and advanced molecular testing should be used, as needed, for microbiological diagnoses among this special immunodeficient population.

Abstract Objectives This study aimed to investigate the incidence, consequences, and predictors of serious chemotherapy‐induced thrombocytopenia (CIT) in nasopharyngeal carcinoma (NPC). Materials and Methods We retrospectively reviewed the clinical records of patients with NPC between 2013 and 2015. Multivariate Cox proportional hazards regression model and propensity score matching were used to estimate the effect of serious CIT on overall survival. Univariate and multivariate logistic regression analyses were applied to identify the predictors of serious CIT. Results and Conclusion The incidence of serious CIT was 5.21% in patients with NPC. Patients who experienced serious thrombocytopenia had a worse long‐term prognosis, while the difference in short‐term survival rate was slight. Chemotherapy regimens of gemcitabine and platinum, 5‐fluorouracil and platinum, taxane and platinum, serum potassium ion concentration, serum lactate dehydrogenase levels, platelet count, red blood cell count, and estimated glomerular filtration rate were predictors of serious CIT.

Abstract Background Internal fixation for rib fractures has been widely carried out worldwide, and its surgical efficacy has been recognized. However, there is still controversy about whether implant materials need to be removed. At present, the research on this topic is still lacking at home and abroad. Therefore, in this study, the patients undergoing removal of internal fixation for rib fractures in our department within one year were followed up, to statistically analyze implant-related complications, postoperative complications and postoperative remission rate. Methods A retrospective analysis was conducted on 143 patients undergoing removal of internal fixation for rib fractures from 2020 to 2021 in our center. The implant-related complications, postoperative complications and postoperative remission rate of patients with internal fixation were analyzed. Results In this study, a total of 143 patients underwent removal of internal fixation, among which 73 suffered from preoperative implant-related complications (foreign-body sensation, pain, wound numbness, sense of tightness, screw slippage, chest tightness, implant rejection), and 70 had no post operative discomfort but asked for removal of internal fixation. The average interval between rib fixation and removal was 17 ± 9.00 (months), and the average number of removed materials was 5.29 ± 2.42. Postoperative complications included wound infection (n = 1) and pulmonary embolism (n = 1). of the 73 patients with preoperative implant-related complications, the mean postoperative remission rate was 82%. Among the 70 patients without preoperative discomfort, the proportion of discomforts after removal was 10%. No perioperative death occurred. Conclusion For patients with internal fixation for rib fractures, removal of internal fixation can be considered in the case of implant-related complications after surgery. The corresponding symptoms can be relieved after removal. The removal presents low complication rate, and high safety and reliability. For patients without obvious symptoms, it is safe to retain the internal fixation in the body. For the asymptomatic patients who ask for removal of internal fixation, the possible risk of complications should be fully informed before removal.

Abstract Background Dysregulation of lipid metabolism is closely associated with cancer progression. The study aimed to establish a prognostic model to predict distant metastasis-free survival (DMFS) in patients with nasopharyngeal carcinoma (NPC), based on lipidomics. Methods The plasma lipid profiles of 179 patients with locoregionally advanced NPC (LANPC) were measured and quantified using widely targeted quantitative lipidomics. Then, patients were randomly split into the training (125 patients, 69.8%) and validation (54 patients, 30.2%) sets. To identify distant metastasis-associated lipids, univariate Cox regression was applied to the training set (P

The family of two-dimensional MA2Z4 heterostructures has received increasing attention in recent years. To investigate the structural stability, electrical structure, optical characteristics, and thermal properties (M = Ti, Zr, and Hf) of MSi2N4/WSi2N4, we have carried out first-principles calculations. The dynamic stability of MSi2N4/WSi2N4 (M = Ti, Zr, and Hf) is confirmed by phonon spectrum analysis. ZrSi2N4/WSi2N4 and HfSi2N4/WSi2N4 have indirect band type with bandgap of 0.37 eV and 0.34 eV, respectively, while TiSi2N4/WSi2N4 exhibits metallic property. At room temperature (300 K), the relative thermal values (CV) of MSi2N4/WSi2N4 (M = Ti, Zr and Hf) vary between 100 and 212.5 JK-1mol−1. Moreover, ZrSi2N4/WSi2N4 and HfSi2N4/WSi2N4 have light absorption qualities below 12 % in both the Ultraviolet and Infrared areas. The MSi2N4/WSi2N4 materials (where M = Ti, Zr, and Hf) exhibit exceptional characteristics, positioning them as promising candidates for applications in thermoelectric and nanoelectronic fields.

Malignant melanoma (MM) is a malignant tumor associated with high mortality rates and propensity for metastasis. Despite advancement in treatment, the incidence of MM continue to rise globally. GPR168, also known as MrgprF, is a MAS related GPR family member. The low expression of GPR168 has also been reported in many malignant tumors including MM. In the study, the statistical analysis from The Cancer Genome Atlas (TCGA) revealed a significant down regulation of GPR168 in melanoma compared to normal melanocytes, underscoring its importance in MM. The aim of the present study is to investigate the affect of GPR168 overexpression and elucidate its molecular mechanisms in MM cells. In addition, we used mouse melanoma B16-F10 cell line and xenograph tumor model to explore the function of GPR168 in melanoma. Our findings demonstrate that GPR168 overexpression could inhibit B16-F10 cell proliferation, migration, and xenografts tumor growth. Further, mechanistic studies revealed that GPR168 affected B16-F10 progress through Akt signal pathway with the decreased expression of p-Akt, p-GSK-3β, β-catenin, Myc, CyclinD1 and CDK4. In order to validate these findings, a rescue experiment was formulated employing GPR168 polyclonal antibody (Anti-GPR168 pAbs) to block GPR168 functionality. The addition of Anti-GPR168 pAbs into the culture medium restored both cell proliferation and migration. In conclusion, the overexpression of GPR168 in mouse melanoma B16-F10 cells suppressed proliferation and migration through the Akt signaling pathway. These findings collectively propose GPR168 as a promising novel tumor suppressor in MM, suggesting its potential as a therapeutic target in future interventions.

Abstract Albeit nanozymes‐based tumor catalytic therapy (NCT) relies on endogenous chemical reactions that could achieve tumor microenvironment (TME)‐specialized reactive oxygen species (ROS) production, the unsatisfactory catalytic activity of nanozymes accompanied by complex TME poses a barrier to the therapeutic effect of NCT. Herein, a one‐step in situ synthesis strategy is reported to construct ternary Ru/TiO2−x@TiCN heterojunctions through oxidative conversion of TiCN nanosheets (NSs) to TiO2−x NSs and reductive deposition of Ru3+ to Ru nanoparticles. The narrow bandgap and existence of heterojunctions enhance the ultrasound‐activated ROS generation of Ru/TiO2−x@TiCN because of the accelerated electron transfer and inhibits electron–hole pair recombination. The augmented ROS production efficiency is achieved by Ru/TiO2−x@TiCN with triple enzyme‐like activities, which amplifies the ROS levels in a cascade manner through the catalytic decomposition of endogenous H2O2 to relieve hypoxia and heterojunction‐mediated NCT, as well as depletion of overexpressed glutathione. The satisfactory therapeutic effects of Ru/TiO2−x@TiCN heterojunctions are achieved through synergetic sonodynamic therapy and NCT, which achieve the complete elimination of tumors without recurrence. This strategy highlights the potential of in situ synthesis of semiconductor heterojunctions as enhanced sonosensitizers and nanozymes for efficient tumor therapy.

Summary: Background: Cabozantinib is approved for previously treated advanced hepatocellular carcinoma (aHCC) and has been investigated in gastric cancer (GC) and gastroesophageal junction adenocarcinoma (GEJ). Atezolizumab plus bevacizumab is approved for unresectable or metastatic HCC untreated with prior systemic therapy. We evaluated efficacy and safety of cabozantinib plus atezolizumab in aHCC previously untreated with systemic anticancer therapy or previously treated GC/GEJ. Methods: COSMIC-021 (ClinicalTrials.gov, NCT03170960) is an open-label, phase 1b study in solid tumours with a dose-escalation stage followed by tumour-specific expansion cohorts, including aHCC (cohort 14) and GC/GEJ (cohort 15). Eligible patients were aged ≥18 years with measurable locally advanced, metastatic, or recurrent disease per RECIST version 1.1. Patients received oral cabozantinib 40 mg daily and intravenous atezolizumab 1200 mg once every 3 weeks until progressive disease or unacceptable toxicity. The primary endpoint was investigator-assessed objective response rate per RECIST version 1.1. Findings: Patients were screened between February 14, 2019, and May 7, 2020, and 61 (30 aHCC, 31 GC/GEJ) were enrolled and received at least one dose of study treatment. Median duration of follow-up was 31.2 months (IQR 28.5–32.7) for aHCC and 30.4 months (28.7–31.9) for GC/GEJ. Objective response rate was 13% (4/30, 95% CI 4–31) for aHCC and 0% (95% CI 0–11) for GC/GEJ. Six (20%) aHCC patients and three (10%) GC/GEJ patients had treatment-related adverse events resulting in discontinuation of either study drug. Interpretation: Cabozantinib plus atezolizumab had clinical activity with a manageable safety profile in aHCC previously untreated with systemic anticancer therapy. Clinical activity of cabozantinib plus atezolizumab was minimal in previously treated GC/GEJ. Funding: Exelixis, Inc., Alameda, CA, USA.

Summary: It is imperative to optimally utilize virtues and obviate defects of fully automated analysis and expert knowledge in new paradigms of healthcare. We present a deep learning-based semiautomated workflow (RAINMAN) with 12,809 follow-up scans among 2,172 patients with treated nasopharyngeal carcinoma from three centers (ChiCTR.org.cn, Chi-CTR2200056595). A boost of diagnostic performance and reduced workload was observed in RAINMAN compared with the original manual interpretations (internal vs. external: sensitivity, 2.5% [p = 0.500] vs. 3.2% [p = 0.031]; specificity, 2.9% [p

Abstract Background To develop and validate a predictive nomogram for tumor residue 3–6 months after treatment based on postradiotherapy plasma Epstein–Barr virus (EBV) deoxyribonucleic acid (DNA), clinical stage, and radiotherapy (RT) dose in patients with stage II–IVA nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT). Methods In this retrospective study, 1050 eligible patients with stage II–IVA NPC, who completed curative IMRT and underwent pretreatment and postradiotherapy (-7 to +28 days after IMRT) EBV DNA testing, were enrolled from 2012 to 2017. The prognostic value of the residue was explored using Cox regression analysis in patients (n=1050). A nomogram for predicting tumor residues after 3–6 months was developed using logistic regression analyses in the development cohort (n=736) and validated in an internal cohort (n=314). Results Tumor residue was an independent inferior prognostic factor for 5-year overall survival, progression-free survival, locoregional recurrence-free survival and distant metastasis-free survival (all P

Abstract We conducted a matched retrospective cohort study of two cohorts to estimate inactivated vaccine effectiveness (VE) and its comparative effectiveness of booster dose among older people in Shanghai. Cohort 1 consisted of a vaccinated group (≥1 dose) and an unvaccinated group (3,317,475 pairs), and cohort 2 consisted of a booster vaccinated group and a fully vaccinated group (2,084,721 pairs). The Kaplan–Meier method and Cox regression models were used to estimate risk and hazard ratios (HRs) study outcomes. For cohort 1, the overall estimated VEs of ≥1 dose of inactivated vaccine against SARS-CoV-2 infection, severe/critical Covid-19, and Covid-19 related death were 24.7% (95%CI 23.7%−25.7%), 86.6% (83.1%−89.4%), and 93.2% (88.0%−96.1%), respectively. Subset analysis showed that the booster vaccination provided greatest protection. For cohort 2, compared with full vaccination, relative VEs of booster dose against corresponding outcome were 16.3% (14.4%−17.9%), 60.5% (37.8%−74.9%), and 81.7% (17.5%−95.9%). Here we show, although under the scenario of persistent dynamic zero-Covid policy and non-pharmaceutical interventions, promoting high uptake of the full vaccination series and booster dose among older adults is critically important. Timely vaccination with the booster dose provided effective protection against Covid-19 outcomes.

Abstract Background Induction chemotherapy (IC) and concurrent chemoradiotherapy (CCRT) is the standard of care for locoregionally advanced nasopharyngeal carcinoma (LA‐NPC). This intensive treatment regimen increases acute toxicities, which could negatively impact patients' nutritional status. We conducted this prospective, multicentre trial to investigate the effects of IC and CCRT on nutritional status in LA‐NPC patients, so as to provide evidence for further study of nutritional intervention, which was registered in ClinicalTrials.gov (NCT02575547). Methods Patients with biopsy‐proven NPC and planned for IC + CCRT were recruited. IC entailed two cycles of 3‐weekly docetaxel 75 mg/m2 and cisplatin 75 mg/m2; CCRT entailed two to three cycles of 3‐weekly cisplatin 100 mg/m2 depending on the duration of radiotherapy. Nutritional status and quality of life (QoL) were assessed pre‐IC, post‐cycles one and two of IC, W4 and W7 of CCRT. Primary endpoint was the cumulative proportion of ≥ 5.0% weight loss (WL5.0) by the end of treatment (W7‐CCRT). Secondary endpoints included body mass index, NRS2002 and PG‐SGA scores, QoL, hypoalbuminaemia, treatment compliance, acute and late toxicities and survivals. The associations between primary and secondary endpoints were also evaluated. Results One hundred and seventy‐one patients were enrolled. Median follow‐up was 67.4 (IQR: 64.1–71.2) months. 97.7% (167/171) patients completed two cycles of IC, and 87.7% (150/171) completed at least two cycles of concurrent chemotherapy; all, except one patient (0.6%), completed IMRT. WL was minimal during IC (median of 0.0%), but increased sharply at W4‐CCRT (median of 4.0% [IQR: 0.0–7.0%]) and peaked at W7‐CCRT (median of 8.5% [IQR: 4.1–11.7%]). 71.9% (123/171) of patients recorded a WL5.0 by W7‐CCRT, which was associated with a higher malnutrition risk (NRS2002 ≥ 3 points: 87.7% [WL ≥ 5.0%] vs 58.7% [WL

Abstract The integration of human-centric approaches has gained more attention recently due to more automated systems being introduced into our built environments (buildings, roads, vehicles, etc.), which requires a correct understanding of how humans perceive such systems and respond to them. This paper introduces an Immersive Virtual Environment-based method to evaluate the infrastructure design with psycho-physiological and behavioral responses from the vulnerable road users, especially for pedestrians. A case study of pedestrian mid-block crossings with three crossing infrastructure designs (painted crosswalk, crosswalk with flashing beacons, and a smartphone app for connected vehicles) are tested. Results from 51 participants indicate there are differences between the subjective and objective measurement. A higher subjective safety rating is reported for the flashing beacon design, while the psychophysiological and behavioral data indicate that the flashing beacon and smartphone app are similar in terms of crossing behaviors, eye tracking measurements, and heart rate. In addition, the smartphone app scenario appears to have a lower stress level as indicated by eye tracking data, although many participants do not have prior experience with it. Suggestions are made for the implementation of new technologies, which can increase public acceptance of new technologies and pedestrian safety in the future.

Geopolymer concrete (GPC) represents an innovative green and low-carbon construction material, offering a viable alternative to ordinary Portland cement concrete (OPC) in building applications. However, existing studies tend to overlook the recyclability aspect of GPC for future use. Various structural applications necessitate the use of concrete with distinct strength characteristics. The recyclability of the parent concrete is influenced by these varying strengths. This study examined the recycling potential of GPC across a spectrum of strength grades (40, 60, 80, and 100 MPa, marked as C40, C60, C80, and C100) when subjected to freeze–thaw conditions. Recycling 5–16 mm recycled geopolymer coarse aggregate (RGAs) from GPC prepared from 5 to 16 mm natural coarse aggregates (NAs). The cementitious material comprised 60% metakaolin and 40% slag, with natural gravel serving as the NAs, and the alkali activator consisting of sodium hydroxide solution and sodium silicate solution. The strength of the GPC was modulated by altering the Na/Al ratio. After 350 freeze–thaw cycles, the GPC specimens underwent crushing, washing, and sieving to produce RGAs. Subsequently, their physical properties (apparent density, water absorption, crushing index, and attached mortar content and microstructure (microhardness, SEM, and XRD) were thoroughly examined. The findings indicated that GPC with strength grades of C100, C80, and C60 were capable of enduring 350 freeze–thaw cycles, in contrast to C40, which did not withstand these conditions. RGAs derived from GPC of strength grades C100 and C80 complied with the criteria for Class II recycled aggregates, whereas RGAs produced from GPC of strength grade C60 aligned with the Class III level. A higher-strength grade in the parent concrete correlated with enhanced performance characteristics in the resulting recycled aggregates.

The time-varying gravity field models derived from the Gravity Recovery and Climate Experiment (GRACE) satellite mission suffer from pronounced longitudinal stripe errors in the spatial domain. A potential way to mitigate such errors is to combine GRACE data with observations from other sources. In this study, we investigate the impacts on GRACE monthly gravity field solutions of incorporating the GPS data collected by the Gravity Field and Steady-State Ocean Circulation Explorer (GOCE) mission. To that end, we produce GRACE/GOCE combined monthly gravity field solutions through combination on the normal equation level and compare them with the GRACE-only solutions, for which we have considered the state-of-the-art ITSG-Grace2018 solutions. Analysis in the spectral domain reveals that the combined solutions have a notably lower noise level beyond degree 30, with cumulative errors up to degree 96 being reduced by 31%. A comparison of the formal errors reveals that the addition of GOCE GPS data mainly improves (near-) sectorial coefficients and resonant orders, which cannot be well determined by GRACE alone. In the spatial domain, we also observe a significant reduction by at least 30% in the noise of recovered mass changes after incorporating the GOCE GPS data. Furthermore, the signal-to-noise ratios of mass changes over 180 large river basins were improved by 8–20% (dependent on the applied Gaussian filter radius). These results demonstrate that the GOCE GPS data can augment the GRACE monthly gravity field solutions and support a future GOCE-type mission for tracking more accurate time-varying gravity fields.

To rationally evaluate the seismic damage of RC structures comprehensively and multi-dimensionally, a damage index calculation method is proposed. This is a macroscopic global seismic damage model that considers torsional damage, damage in two perpendicular horizontal directions, as well as the overall damage, based on the modal characteristics of the three-dimensional structure and the multi-mode damage model. Formulas are derived, and the steps for damage evaluation are summarized. To better illustrate the results of the proposed method, an example of an asymmetric 6-story frame-shear wall structure is built using the OpenSees program. Thirteen ground motions are selected for incremental dynamic analysis. The structure’s damage indexes are evaluated according to the proposed method and compared with the corresponding structural responses, He et al.’s index, and the Final Softening index. The results demonstrate that the proposed method can fully reflect the macroscopic damage state of the structure from different perspectives. Additionally, the results show that, despite the ground motion only acting in the y-direction, the structure exhibits responses and damage in both the x-direction and the torsional direction. The overall damage to the structure is primarily controlled by the torsional damage, attributed to the asymmetric arrangement of shear walls. The torsional effect is the key factor leading to the failure of asymmetric structures during earthquakes. Therefore, ensuring the torsional strength of the structure is crucial during the structural design process.

Complexes associated with strong electrostatic interactions constitute a valuable method to construct tough hydrogels, but current systems are either unstable in saline environments or lead to relatively soft matrices. Herein, a class of acid‐base complex (ABC) hydrogels made from poly(2‐(dimethylamino)ethyl methacrylate) and glassy poly(methacrylic acid) (PMA) is reported. The tough hydrogels are prepared via a dialysis‐free process and maintain their structure in saline solutions. Results indicate that the glassy feature of PMA endows the ABC hydrogels with high moduli (227 MPa), typical yielding points (3 MPa), and moderate stretchability (300% strain). The glassy backbones (PMA chains) are stiff at low temperatures, and would be melted at high temperatures, which bring about interesting shape‐memory effects and inverse memory‐forgetting behaviors. These results may inspire a simple but powerful strategy to design innovative hydrogel materials.

Recently, the two-dimensional MA2Z4 family with a seven-atom layer structure (experimentally synthesized a MoSi2N4 monolayer), which has good stability and exhibits semiconductivity, providing a platform for photocatalytic hydrolysis studies of two-dimensional polyatomic layer materials. In this work, we systematically investigated the thermal stability, dynamical stability, mechanical stability, electronic properties, and HER performance of the MX2N4 systems (M = Ti, Zr; X = Si, Ge). All monolayers exhibit excellent hydrogen evolution reaction (HER) performance (The Gibbs free energy (ΔGH*) of TiSi2N4; ZrSi2N4; ZrGe2N4 are 0.11 eV; 0.05 eV; −0.03 eV, respectively) and meet the thermodynamic requirements of OER for photocatalytic. Furthermore, the effects of biaxial strain and pH value on ZrGe2N4 monolayer photocatalytic hydrolysis performance were studied. ZrGe2N4 monolayer with 1% compression strain has well HER performance (ΔGH∗=0.21eV) under light conditions (Ue = 0.04 eV, pH = 0), and the photocatalytic oxidation process of water can take place spontaneously under light conditions and pH ≥ 7. In addition, the ZrGe2N4 monolayer also has excellent absorption in the visible range (high absorption coefficients over 105 cm−1). Undoubtedly, the potential applications and properties of MX2N4 monolayers in the fields of electrocatalysis and photocatalysis are poised to expand significantly. These findings hold great promise and are expected to offer valuable insights for experimental research in these areas.

Multilabel learning goes beyond standard supervised learning models by associating a sample with more than one class label. Among the many techniques developed in the last decade to handle multilabel learning best approaches are those harnessing the power of ensembles and deep learners. This work proposes merging both methods by combining a set of gated recurrent units, temporal convolutional neural networks, and long short-term memory networks trained with variants of the Adam optimization approach. We examine many Adam variants, each fundamentally based on the difference between present and past gradients, with step size adjusted for each parameter. We also combine Incorporating Multiple Clustering Centers and a bootstrap-aggregated decision trees ensemble, which is shown to further boost classification performance. In addition, we provide an ablation study for assessing the performance improvement that each module of our ensemble produces. Multiple experiments on a large set of datasets representing a wide variety of multilabel tasks demonstrate the robustness of our best ensemble, which is shown to outperform the state-of-the-art.

Abstract Background To explore the short‐ and long‐term outcomes in patients with nasopharyngeal carcinoma (NPC) with magnetic resonance imaging (MRI)‐detected residual disease at 3 months post‐treatment who received intervention either promptly (0 month) or following observation (after an additional 3 months). Methods A total of 272 patients with residual disease at 3 months post‐treatment (observation [observation for additional 3 months]: 122, intervention [prompt intervention]: 150) were analyzed. Univariate and multivariate analyses were performed to examine the survival. Adverse events were analyzed in all patients. Results Patients in the observation group had a lower 3‐year overall survival (77.1% vs. 85.2%), progression‐free survival (10.2% vs. 18.1%), and locoregional relapse‐free survival (10.2% vs. 20.6%) (all p

Lowering the Pt loading while maintaining high fuel-cell performance is an important but difficult task. Here the authors report modified polymers with intrinsic microporosity as binder for preferential retention of phosphoric acid in the catalyst layer, which offers great opportunities to lower the catalyst loading for high-temperature proton exchange membrane fuel cell.

Abstract Background Limited data are available on the effectiveness of inactivated and Ad5-nCoV COVID-19 vaccines in real-world use—especially against Omicron variants in SARS-CoV-2 infection-naïve population. Methods A matched case-control study was conducted among people aged ≥ 3 years between 2 December 2021 and 13 May 2022. Cases were SARS-CoV-2-infected individuals, individuals with severe/critical COVID-19, or COVID-19-related deaths. Controls were selected from consecutively test-negative individuals at the same time as cases were diagnosed and were exact-matched on year-of-age, gender, birthplace, illness onset date, and residential district in ratios of 1:1 with infected individuals and 4:1 with severe/critical COVID-19 and COVID-19-related death. Additionally, two subsets were constructed to analyze separate vaccine effectiveness (VE) of inactivated vaccines (subset 1) and Ad5-vectored vaccine (subset 2) against each of the three outcomes. Results Our study included 612,597 documented SARS-CoV-2 infections, among which 1485 progressed to severe or critical illness and 568 died. Administering COVID-19 vaccines provided limited protection against SARS-CoV-2 infection across all age groups (overall VE: 16.0%, 95% CI: 15.1–17.0%) but high protection against severe/critical illness (88.6%, 85.8–90.8%) and COVID-19-related death (91.6%, 86.8–94.6%). In subset 1, inactivated vaccine showed 16.3% (15.4–17.2%) effective against infection, 88.6% (85.8–90.9%) effective against severe/critical COVIID-19, and 91.7% (86.9–94.7%) against COVID-19 death. Booster vaccination with inactivated vaccines enhanced protection against severe COVID-19 (92.7%, 90.1–94.6%) and COVID-19 death (95.9%, 91.4–98.1%). Inactivated VE against infection began to wane 12 weeks after the last dose, but two and three doses sustained high protection levels (> 80%) against severe/critical illness and death, while subset 2 showed Ad5-vectored vaccine was 13.2% (10.9–15.5%) effective against infection and 77.9% (15.6–94.2%) effective against severe/critical COVIID-19. Conclusions Our real-world study found high and durable two- and three-dose inactivated VE against Omicron-associated severe/critical illness and death across all age groups, but lower effectiveness against Omicron infection, which reinforces the critical importance of full-series vaccination and timely booster dose administration for all eligible individuals.

Abstract Background Dengue is the fastest spreading arboviral disease, posing great challenges on global public health. A reproduceable and comparable global genotyping framework for contextualizing spatiotemporal epidemiological data of dengue virus (DENV) is essential for research studies and collaborative surveillance. Methods Targeting DENV-1 spreading prominently in recent decades, by reconciling all qualified complete E gene sequences of 5003 DENV-1 strains with epidemiological information from 78 epidemic countries/areas ranging from 1944 to 2018, we established and characterized a unified global high-resolution genotyping framework using phylogenetics, population genetics, phylogeography, and phylodynamics. Results The defined framework was discriminated with three hierarchical layers of genotype, subgenotype and clade with respective mean pairwise distances 2–6%, 0.8–2%, and ≤ 0.8%. The global epidemic patterns of DENV-1 showed strong geographic constraints representing stratified spatial-genetic epidemic pairs of Continent-Genotype, Region-Subgenotype and Nation-Clade, thereby identifying 12 epidemic regions which prospectively facilitates the region-based coordination. The increasing cross-transmission trends were also demonstrated. The traditional endemic countries such as Thailand, Vietnam and Indonesia displayed as persisting dominant source centers, while the emerging epidemic countries such as China, Australia, and the USA, where dengue outbreaks were frequently triggered by importation, showed a growing trend of DENV-1 diffusion. The probably hidden epidemics were found especially in Africa and India. Then, our framework can be utilized in an accurate stratified coordinated surveillance based on the defined viral population compositions. Thereby it is prospectively valuable for further hampering the ongoing transition process of epidemic to endemic, addressing the issue of inadequate monitoring, and warning us to be concerned about the cross-national, cross-regional, and cross-continental diffusions of dengue, which can potentially trigger large epidemics. Conclusions The framework and its utilization in quantitatively assessing DENV-1 epidemics has laid a foundation and re-unveiled the urgency for establishing a stratified coordinated surveillance platform for blocking global spreading of dengue. This framework is also expected to bridge classical DENV-1 genotyping with genomic epidemiology and risk modeling. We will promote it to the public and update it periodically. Graphical Abstract

Introduction: There has been a lack of treatments available to lower the frequency of recurrent aphthous ulcers (RAUs) until now. Total glucosides of paeony (TGP) is a botanical drug extracted from the dried roots of Paeonia lactiflora Pall. [Ranunculaceae; Paeoniae Radix Alba]. This study aims to evaluate the efficacy and safety of TGP in the treatment of RAU.Methods: This study was registered with the Chinese Clinical Trial Registry (ChiCTR1900025623). Patients were randomly assigned to the TGP or placebo group and treated with 1.8 g/day for 24 weeks. Participants were observed for a total of 36 weeks and were asked to record ulcer severity, medication, and adverse reactions in the form of diaries or apps every day. The primary outcome was the monthly ulcer-free interval.Results: A total of 79 individuals were enrolled, with 40 assigned to the TGP group and 39 to the placebo group. The dropout rate was 18.18%. In the TGP group, the monthly ulcer-free interval was significantly longer than baseline (median, 9.6 days) since weeks 13–24 (median, 18.5 days) (p < 0.05), and after discontinuation, it was further prolonged (median, 24.7 days) than in weeks 13–24 (p < 0.05). In addition, the monthly ulcer-free interval was longer in the TGP group than in the placebo group (median, 15.9 days) at weeks 25—36 (p < 0.001). There were better improvements in the monthly number of ulcers and monthly area of ulcers, and visual analog scoring in the TGP group at weeks 25—36 (p < 0.001).Conclusion: TGP had a good long-term therapeutic effect on RAU with frequent occurrence.Systematic Review Registration:www.chictr.org.cn, identifier ChiCTR1900025623.

Recent advancements of virtual reality (VR) technology (such as the HTC Vive or Oculus Quest) have opened the door for lower cost and lower risk methods to study pedestrians’ behavior and perception of safety, offering a higher degree of data resolution and level of realism compared to previous pedestrian simulators. This research aims to address the lack of research conducted to compare pedestrian midblock crossing behavior within VR simulators against naturalistic, real-world behavior, as well as provide a low-risk framework for conducting these analyses. In addition to comparing pedestrian crossing speeds and gap acceptance in the replica virtual environment, post-experiment questionnaires also asked participants about their perception of realism in the virtual environment. Chi-squared analysis showed no statistically significant differences in the gap acceptance distribution nor median accepted gap size (real-world = 8.05sec, VR = 8.20sec, p = 0.358), indicating similar gap size acceptance between environments. Logistic regression analysis showed similarity with respect to the rate at which participants’ decision to cross or not changes, indicating consistent and naturalistic decision-making processes between the environments. Furthermore, experiment results showed no significant difference in the means (real-world = 3.32mph, VR = 3.52mph, p = 0.138) and medians of crossing speeds (real-world = 3.28mph, VR = 3.43mph, p = 0.358) in either environment and no difference in crossing speed variance. Additionally, survey results showed that subjects felt their sense of movement and risk inside the simulator were realistic and reported high levels of immersion. Through the use of a low-risk and time-efficient study framework, this paper demonstrates the efficacy of VR simulation for use in replicating naturalistic pedestrian crossing behavior in immersive virtual environments modeled after real-world locations.