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Zhiru Xiu,1 Yiquan Li,1 Jinbo Fang,1 Jicheng Han,1 Shanzhi Li,1 Yaru Li,1,2 Xia Yang,1 Gaojie Song,3 Yue Li,1 Ningyi Jin,1,4,5 Yilong Zhu,1 Guangze Zhu,1 Lili Sun,6 Xiao Li1,4,7 1Academician Workstation of Jilin Province, Changchun University of Chinese Medicine, Changchun, People’s Republic of China; 2Medical College, Yanbian University, Yanji, People’s Republic of China; 3Medical College, Jiujiang· University, Jiujiang, People’s Republic of China; 4Changchun Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Changchun, People’s Republic of China; 5Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, People’s Republic of China; 6Department of Head and Neck Surgery, Tumor Hospital of Jilin Province, Changchun, People’s Republic of China; 7College of Life Sciences, Shandong Normal University, Jinan, People’s Republic of ChinaCorrespondence: Lili Sun; Xiao Li, Boshuo Road, 1035, Jingyue Economic & Technological Development Zone, Changchun, Jilin, 130122, People’s Republic of China, Tel +86-431-86985923, Fax +86-431-87985861, Email skylee6226@163.com; linjiaxiaoya@163.comObjective: To explore the effects of Esculetin on liver cancer and explore potential mechanisms of Esculetin-inducing cells death.Methods: Esculetin’s effects on the proliferation, migration and apoptosis of HUH7 and HCCLM3 cells were detected by using CCK8, crystal violet staining, wound healing, TranswellTM and Annexin V-FITC/PI. Flow cytometry, fluorescence staining, Western blot, T-AOC, DPPH radical scavenging assay, hydroxyl radical’s inhibitory capability and GSH test were used to examine the esculetin’s effects on the ROS level, the oxidation-related substances and proteins’ expression in hepatoma cells. In vivo experiment was performed by xenograft model. Ferrostatin-1 was used to determine the death way of hepatoma cells induced by esculetin. Live cell probe, Western blot, Fe2+ content, MDA, HE staining, Prussian blue staining and immunohistochemistry were used to examine the ferritinophagy-related phenomenon induced by esculetin in hepatoma cells. The relationship between esculetin and NCOA4-mediated ferritinophagy was confirmed through gene silence and overexpression, immunofluorescence staining and Western blot.Results: Esculetin suppressed the proliferation, migration and apoptosis of HUH7 and HCCLM3 cells significantly, influenced the oxidative stress level, altered the autophagy and iron metabolism levels in cells, and produced a ferritinophagy-related phenomena. Esculetin increased the levels of cellular lipid peroxidation and reactive oxygen species. In vivo, esculetin could decrease tumour volume, promote LC3 and NCOA4 expressions, suppresse hydroxyl radical‘s inhibiting capacity and GSH, increase Fe2+ and MDA levels, decrease antioxidant proteins expression in tumour tissue. In addition, Esculetin could also increase the iron deposition of tumour tissues, promote ferritinophagy, and induce tumours’ ferroptosis.Conclusion: Esculetin has an inhibitory effect on liver cancer in vivo and in vitro through triggering NCOA4 pathway-mediation ferritinophagy.Keywords: esculetin, ferritinophagy, liver cancer, anti-tumour, NCOA4

Abstract Dental and maxillofacial diseases are always accompanied by complicated hard and soft tissue defects, involving bone, teeth, blood vessels and nerves, which are difficult to repair and severely affect the life quality of patients. Recently, extracellular vesicles (EVs) secreted by all types of cells and extracted from body fluids have gained more attention as potential solutions for tissue regeneration due to their special physiological characteristics and intrinsic signaling molecules. Compared to stem cells, EVs present lower immunogenicity and tumorigenicity, cause fewer ethical problems, and have higher stability. Thus, EV therapy may have a broad clinical application in regenerative dentistry. Herein, we reviewed the currently available literature regarding the functional roles of EVs in oral and maxillofacial tissue regeneration, including in maxilla and mandible bone, periodontal tissues, temporomandibular joint cartilage, dental hard tissues, peripheral nerves and soft tissues. We also summarized the underlying mechanisms of actions of EVs and their delivery strategies for dental tissue regeneration. This review would provide helpful guidelines and valuable insights into the emerging potential of EVs in future research and clinical applications in regenerative dentistry.

Abstract The advent of polyadenosine diphosphate ribose polymerase inhibitors (PARPi) has brought about significant changes in the field of ovarian cancer treatment. However, in 2022, Rucaparib, Olaparib, and Niraparib, had their marketing approval revoked for third-line and subsequent therapies due to an increased potential for adverse events. Consequently, the exploration of new treatment modalities remains imperative. Recently, the integration of PARPi with immune checkpoint inhibitors (ICIs) has emerged as a potential remedy option within the context of ovarian cancer. This article offers a comprehensive examination of the mechanisms and applications of PARPi and ICIs in the treatment of ovarian cancer. It synthesizes the existing evidence supporting their combined use and discusses key considerations that merit attention in ongoing development efforts.

Abstract While photo-cross-linking (PXL) with alkyl diazirines can provide stringent distance restraints and offer insights into protein structures, unambiguous identification of cross-linked residues hinders data interpretation to the same level that has been achieved with chemical cross-linking (CXL). We address this challenge by developing an in-line system with systematic modulation of light intensity and irradiation time, which allows for a quantitative evaluation of diazirine photolysis and photo-reaction mechanism. Our results reveal a two-step pathway with mainly sequential generation of diazo and carbene intermediates. Diazo intermediate preferentially targets buried polar residues, many of which are inaccessible with known CXL probes for their limited reactivity. Moreover, we demonstrate that tuning light intensity and duration enhances selectivity towards polar residues by biasing diazo-mediated cross-linking reactions over carbene ones. This mechanistic dissection unlocks the full potential of PXL, paving the way for accurate distance mapping against protein structures and ultimately, unveiling protein dynamic behaviors.

Abstract Sepsis, a life-threatening condition caused by infection, is characterized by the dysregulation of immune responses and activation of monocytes. Plac8, a protein, has been implicated in various inflammatory conditions. This study aimed to investigate the effect of Plac8 upregulation on monocyte proliferation and activation in sepsis patients. Peripheral blood samples were collected from healthy individuals and sepsis patients. Monocytes were stimulated with lipopolysaccharide (LPS) to create an in vitro sepsis model, while a murine sepsis model was established using cecal ligation and puncture (CLP). The levels of monocyte markers, proliferation index (PI), and pro-inflammatory cytokines were assessed using flow cytometry and qPCR, respectively. Plac8 and phosphorylated ERK protein levels were determined by western blot, and TNF-α, IL-6, and IL-10 levels were quantified using ELISA. The CCK-8 assay was used to evaluate PBMC proliferation and activation. The results showed that Plac8 was highly expressed in sepsis models, promoting the survival, proliferation, and activation of monocytes. Plac8 upregulation activated the ERK pathway, leading to increased phosphorylation of ERK protein and elevated levels of CD14, CD16, TNF-α, IL-6, Plac8, and IL-10. In sepsis mice, Plac8 overexpression similarly activated the ERK pathway and promoted the survival, proliferation, and activation of monocytes. In conclusion, the upregulation of Plac8 enhances the activation of the ERK pathway and promotes monocyte proliferation and activation in sepsis patients.

Abstract Background The anatomic structure of the anterior chamber (AC) helps to explain differences in refractive status in school-aged children and is closely associated with primary angle closure (PAC). The aim of this study was to quantify and analyze the anterior chamber and angle (ACA) characteristics in Chinese children with different refractive status by swept-source optical coherence tomography (SS-OCT). Methods In a cross-sectional observational study, 383 children from two primary schools in Shandong Province, China, underwent a complete ophthalmic examination. First, the anterior chamber depth (ACD), anterior chamber width (ACW), angle-opening distance (AOD), and trabecular-iris space area (TISA) were evaluated automatically using a CASIA2 imaging device. AOD and TISA were measured at 500, 750 μm nasal (N1 and N2, respectively), and temporal (T1 and T2, respectively) to the scleral spur (SS). Cycloplegic refraction and axial length (AL) were then measured. According to spherical equivalent refraction (SER), the children were assigned to hyperopic (SER > 0.50D), emmetropic (-0.50D

Abstract Previous studies have indicated a link between neutrophil to lymphocyte ratio (NLR) and impaired fasting glucose (IFG), but the findings have been disputed. By conducting a real-world follow-up study, we can monitor the development of diseases and confirm the connection between NLR and IFG. A total of 1168 patients without IFG or T2DM were followed up for six years. At baseline, participants' NLR levels, fasting plasma glucose and other clinical characteristics were recorded. During the follow-up period, NLR levels and the prevalence of IFG were recorded. Ultimately, 45 individuals were lost to follow-up, leaving 1,123 participants for analysis. Using Group-Based Trajectory Modeling (GBTM), the sample was divided into three groups. The prevalence of IFG in the three groups was 12.1%, 19.4%, and 20.85%, respectively. Compared with the low-level NLR group, the hazard ratio of IFG in the moderate-level NLR group and high-level NLR group were 1.628 (1.109–2.390) and 1.575 (1.001–2.497), respectively. There was a significant interaction effect of BMI and NLR on the risk of IFG (P

Both increased plant density and wide seedling strip planting (WSP) can improve wheat grain yield. However, whether and how greater gains in grain yield can be achieved by combining WSP with an increased plant density is unclear. In this study, two winter wheat cultivars were subjected to three plant densities (lower, normal, and higher) and two planting patterns (conventional planting [CP] and WSP). The effects of plant density, planting pattern, and their combination on the solar radiation interception and conversion, biomass accumulation, harvest index, and grain yield were investigated. In response to an increase in plant density from lower to higher and a shift from CP to WSP and their combination, grain yield increased by 15.43 %, 10.85 % and 27.62 % for cultivar Taimai198, and by 13.13 %, 8.31 % and 22.41 % for Shannong30, respectively. The larger increases in grain yield were mainly ascribed to enhanced dry matter production, in particular after anthesis with no variation or a slight decline in the harvest index. The higher plant density was the dominant driver of the enhanced radiation interception, whereas WSP was mainly responsible for ameliorating the reduction in radiation use efficiency (RUE) caused by the higher plant density. The combined effects of these two management practices in increasing grain yield were much greater than the independent effects of a shift from CP to WSP or an increase in plant density. Optimizing the planting method may thus be a promising option for further improving grain yield of a densely planted wheat population by increasing the RUE.

BackgroundHigh altitude cerebral edema (HACE) is a condition where the central nervous system experiences severe impairment as a result of sudden oxygen deprivation at high elevations. At present, effective measures for preventing and treating this condition are still lacking. Eleutheroside B (EB), the primary natural active compound found in the Eleutheroside senticosus, has demonstrated various biological functions. It has also shown significant potential in addressing acute mountain sickness and various neurological disorders. However, additional investigation is required to explore the potential protective effects and its underlying mechanisms of EB on HACE.MethodsThe male rats received pre-treatment with either vehicle, EB 100 mg/kg or 50 mg/kg, Dexamethasone 4 mg/kg, or coumermycin A1 100 μg/kg. To simulate the hypobaric hypoxia environment at a plateau of 6,000 m, a hypobaric hypoxia chamber was utilized. The therapeutic effects of EB were assessed through measurements of brain water content, histopathological observation, and evaluation of oxidative stress and inflammatory factors using immunofluorescence and ELISA. Furthermore, molecular docking, molecular dynamics simulation and Western blot were employed to clarify its molecular mechanism. Through these analyses, the underlying mechanism by which EB on HACE was identified.ResultsPre-treatment with EB demonstrated a significant protective effect against HACE by effectively reducing brain water content, down-regulating HIF-1α and AQP4 protein expression induced by hypoxia and reversing pathological changes in brain tissue and neuron damage. Compared to the group treated with HACE alone, the group pre-treated with EB showed a significant reduction in levels of ROS and MDA, as well as an increase in GSH. In addition, pre-treatment with EB led to a significant decrease in the levels of IL-1β, IL-6, and TNF-α. Molecular docking and dynamics simulations indicated that EB has a strong binding affinity to the JAK2/STAT3 signaling pathway. Western blot further confirmed that EB significantly downregulated the expression of JAK2/STAT3 related proteins in the brain tissue of HACE rats. Additionally, coumermycin A1, an agonist of the JAK2, reversed the anti-oxidative stress and neuroinflammation against HACE of EB.ConclusionEB exerts its antioxidant stress and anti-neuroinflammatory effects by inhibiting the JAK2/STAT3 signaling pathway in a rat HACE model.

High-altitude pulmonary edema (HAPE) is a potentially fatal condition that occurs when exposed to high-altitude hypoxia environments. Currently, there is no effective treatment for HAPE, and available interventions focus on providing relief. Notoginsenoside R1 (NGR1), a major active constituent of Panax notoginseng (Burkill) F.H.Chen (sānqī), has demonstrated heart and lung-protective effects under hypobaric hypoxia. However, there is a lack of clarity regarding the precise mechanisms that underlie the protective effects of NGR1 against inflammation. In this study, a rat model of HAPE was developed to assess the effect of NGR1 on this pathology. High-altitude hypoxia corresponding to 6000 m altitude was simulated with a hypobaric chamber. We found that NGR1 dose-dependently alleviated pulmonary oxidative stress damage and inflammatory response, and prevented acid-base balance disruption. In addition, NGR1 restored the expression levels of hypoxia-inducible factor-1 alpha, vascular endothelial growth factor, and aquaporin protein-5, correlated with the development of pulmonary edema induced by hypobaric hypoxia. Furthermore, NGR1 pre-treatment remarkably mitigated NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome-induced pyroptosis, and this effect was partially counteracted by the use of an NLRP3 agonist. Thus, NGR1 may exert a lung-protective effect against HAPE by ameliorating hypoxia-induced lung edema, oxidative damage, and inflammation through inhibition of the NLRP3/Caspase-1/ GSDMD signaling pathway.

IntroductionPorcine circovirus type 2 (PCV2) and Porcine epidemic diarrhea virus (PEDV) are highly prevalent in Sichuan, significantly affecting the swine industry’s development. PCV2, known for its immunosuppressive effects, can compromise pigs’ immune systems, while PEDV typically causes diarrhea in piglets, leading to high mortality rates. Despite their impact, recent studies on the epidemiology and genetic diversity of PCV2 and PEDV within Sichuan Province remain limited.MethodsThis study examines clinical samples from 352 diarrheal piglets across 63 pig farms in 17 regions of Sichuan Province, revealing positivity rates of 42.33% (149/352) for PCV2 and 50.28% (177/352) for PEDV, with a co-infection rate of 27.56% (97/352). Notably, the highest positivity rates were observed in Ziyang for PCV2 at 61.90% (13/21), and in Meishan for PEDV at 73.81% (31/42), both regions also reported the highest co-infection rates of 47.62%.Results and discussionSeasonal analysis indicated that PEDV infections peaked during winter, whereas PCV2 showed no significant seasonal trends. Phylogenetic analysis identified 14 PCV2 strains, categorizing 2 as PCV2b (14.29%), 10 as PCV2d (71.43%), and 2 as PCV2e (14.29%). Among the 16 PEDV strains, 2 were classified as G1a (12.5%) and 14 as G2a (87.5%), with PCV2d and PEDV G2a identified as the predominant strains in the region. The study also highlights a high mutation rate at the antigenic sites of both viruses, potentially affecting vaccine efficacy. These findings underscore the need for ongoing surveillance and vaccine development tailored to the prevalent strains to improve control measures within the province.

ObjectiveBirth defect of any type is undesirable and often pose a negative impact on the health and development of the newborn. Birth defects surveillance with datasets from surveillance health-related programs are useful to predict the pattern of birth defects and take preventive measures. In this study, the total prevalence, perinatal prevalence, and livebirth prevalence of birth defects were compared.MethodsData were obtained from the Birth Defects Surveillance System in Hunan Province, China, 2016–2020. The total prevalence is the number of birth defects (including livebirths, stillbirths, and selective terminations of pregnancy) per 1,000 births (including livebirths and stillbirths). The perinatal prevalence is the number of birth defects (between 28 weeks gestation and 7 days postpartum) per 1,000 births. The livebirth prevalence is the number of liveborn birth defects per 1,000 births (unit: ‰). Underestimated proportion (unit: %) is the reduction level of perinatal prevalence or livebirth prevalence compared to the total prevalence. Prevalence with 95% confidence intervals (CI) was calculated using the log-binomial method. Chi-square tests (χ2) were used to examine if significant differences existed in prevalence or underestimated proportion between different groups.ResultsA total of 847,755 births were included in this study, and 23,420 birth defects were identified, including 14,459 (61.74%) birth defects with gestational age > =28 weeks, and 11,465 (48.95%) birth defects in livebirths. The total prevalence, perinatal prevalence, and livebirth prevalence of birth defects were 27.63‰ (95%CI, 27.27–27.98), 17.06‰ (95%CI, 16.78–17.33), and 13.52‰ (95%CI, 13.28–13.77), respectively, and significant differences existed between them (χ2 = 4798.55, p 0.05).ConclusionThe total prevalence and livebirth prevalence of birth defects in Hunan Province, China, was not well studied. A systematic study was conducted to compare the total prevalence, perinatal prevalence, and livebirth prevalence of birth defects. The study reveals that significant differences existed between the total prevalence, perinatal prevalence, and livebirth prevalence of birth defects (including many specific defects), and year, sex, residence, and maternal age had significant impacts on it. The outcomes of the study will help to take preventive measures for birth defects as well as benefit the people involving public health and policymakers to improve the current scenario.

Niobium carbide (NbC) is often used as a reinforcing phase to improve the mechanical properties of composite coatings, but its low thermal conductivity makes the flow of molten pool poor, and the cladding layer is prone to defects such as non-fusion and slag inclusion. Therefore, in this paper, Ni60–NbC composite coatings with different NbC content were prepared by laser cladding technology, and the 10 vol% graphene-20 vol% NbC-70 vol% Ni60 composite coatings were prepared under the optimal NbC component. The effects of the addition of NbC and graphene on the microstructure and microhardness of the coating were systematically discussed. The results show that the microhardness of 20 vol% NbC composite coating is increased from 680.1 HV to 882.9 HV compared with Ni60 coating without NbC.The composite coating with both NbC and graphene has a microhardness of up to 1048HV, which is 18% higher than the composite coating with only 20 vol% NbC. The mechanism is that the addition of graphene promotes the formation of chromium carbide (Cr23C6, Cr7C3) and increases the fluidity of the molten pool, which causes small niobium carbide particles to dissolve and recondense to form large particles. Large niobium carbide particles and chromium carbide jointly inhibit the excessive growth of other grains. This study provides a new idea for laser cladding of nickel-based composite coatings.

Abstract Background Patients with Turner syndrome (TS) face an increased risk of developing aortic dilatation (AD), but diagnosing AD in children presents greater complexity compared to adults. This study aimed to investigate the application of various assessment indicators of AD in Chinese children and adolescents with TS. Methods This study included TS patients admitted to Shenzhen Children’s Hospital from 2017 to 2022. Cardiovascular lesions were diagnosed by experienced radiologists. Patients without structural heart disease were divided into different body surface area groups, then the Chinese TS population Z-score (CHTSZ-score) of the ascending aorta was calculated and compared with other indicators such as aortic size index (ASI), ratio of the ascending to descending aortic diameter (A/D ratio), and TSZ-score (Quezada’s method). Results A total of 115 TS patients were included, with an average age of 10.0 ± 3.7 years. The incidences of the three most serious cardiovascular complications were 9.6% (AD), 10.4% (coarctation of the aorta, CoA), and 7.0% (bicuspid aortic valve, BAV), respectively. The proportion of developing AD in TS patients aged ≥ 10 years was higher than that in those

Abstract Background This study aimed to explore the association of the second birth delivery mode and interval with maternal pelvic floor changes. Methods This prospective cohort study included women who had a first delivery and were in weeks 36–41 of a subsequent pregnancy at Panzhihua Central Hospital between July 2017 and June 2018. The primary outcomes of the study were the hiatus area at 6 months postpartum and bladder neck (mm) at rest and during a maximum Valsalva maneuver. Results There were 112 women with vaginal delivery and 182 with Cesarean section. The hiatus area and hiatus circumference decreased at all time points (all P

Porcine reproductive and respiratory syndrome virus (PRRSV) causes a highly contagious disease that threatens the global swine industry. Recent studies have focused on the damage that PRRSV causes to the reproductive system of male pigs, although pathological research is lacking. Therefore, we examined the pathogenic mechanisms in male piglets infected with PRRSV. Gross and histopathological changes indicated that PRRSV affected the entire reproductive system, as confirmed via immunohistochemical analysis. PRRSV infected Sertoli cells and spermatogonia. To test the new hypothesis that PRRSV infection in piglets impairs blood – testis barrier (BTB) development, we investigated the pathology of PRRSV damage in the BTB. PRRSV infection significantly decreased the quantity and proliferative capacity of Sertoli cells constituting the BTB. Zonula occludens-1 and β-catenin were downregulated in cell – cell junctions. Transcriptome analysis revealed that several crucial genes and signalling pathways involved in the growth and development of Leydig cells, Sertoli cells, and tight junctions in the testes were downregulated. Apoptosis, necroptosis, inflammatory, and oxidative stress-related pathways were activated, whereas hormone secretion-related pathways were inhibited. Many Sertoli cells and spermatogonia underwent apoptosis during early differentiation. Infected piglets exhibited disrupted androgen secretion, leading to significantly reduced testosterone and anti-Müllerian hormone levels. A cytokine storm occurred, notably upregulating cytokines such as tumour necrosis factor-α and interleukin-6. Markers of oxidative-stress damage (i.e. H2O2, malondialdehyde, and glutathione) were upregulated, whereas antioxidant-enzyme activities (i.e. superoxide dismutase, total antioxidant capacity, and catalase) were downregulated. Our results demonstrated that PRRSV infected multiple organs in the male reproductive system, which impaired growth in the BTB.

Background: Stigma is among the most prevalent and disturbing consequences of being infertile among women, yet it remains unknown whether fertility stigma is affected by irrational parenthood cognitions (IPC). The current study aimed to assess IPC, infertility stigma, and their interrelationship among a group of Chinese women referred to an infertility center in Changsha, Hunan, China. Methods: A cross-sectional study was conducted among 376 women seeking treatment for infertility in Changsha City, China. Pearson correlation test was used to explore the association between IPC and infertility stigma, while multivariate linear regression was used to explore the independent influencing factors of infertility stigma. Results: Participants had a mean score of 42.41 ± 13.03 for IPC and 62.89 ± 24.50 for ISS. IPC was highly correlated with infertility stigma with a large effect size (r = 0.55, p

Transformer oil plays the role of heat dissipation and insulation in power transformers, and its electrical and thermal characteristics are directly related to the stable operation of the transformer. At the same time, it is important to master the electric–thermal characteristics of transformer oil for transformer state evaluation, latent fault prediction, and maintenance planning. Based on this, the gas production rule and electrical characteristics of transformer oil under accelerated aging are studied in this paper. First, the experimental platform for power transformer aging is established to accelerate the aging of power transformers. Second, the accelerated aging transformer oil is taken as the research object, and the power frequency, DC, lightning, and gas chromatography are measured and analyzed. Finally, a transformer oil aging evaluation model is established, which takes into account four factors: carbon and oxygen gas factors in transformers, life loss factors calculated by hotspot temperature, hydrocarbon gas factors dissolved in transformer oil, and oil quality factors, and conducts aging evaluation. The conclusion shows that the T parameter proposed in this paper can effectively evaluate the quality of transformer oil. When T is less than or equal to 0.6, there is no aging of the oil. When T is greater than 0.6 and less than 1, the transformer oil has been aging, but it is not manifested. Those are parameters whose chromatography and breakdown voltage are not far beyond the IEEE standard. When T = 1, the aging of oil with significant changes in gas content and breakdown voltage can be observed. When T is greater than 1, the oil has undergone serious aging.

Confocal laser scanning microscopy is one of the most widely used tools for high-resolution imaging of biological cells. However, the imaging resolution of conventional confocal technology is limited by diffraction, and more complex optical principles and expensive optical-mechanical structures are usually required to improve the resolution. This study proposed a deep residual neural network algorithm that can effectively improve the imaging resolution of the confocal microscopy in real time. The reliability and real-time performance of the algorithm were verified through imaging experiments on different biological structures, and an imaging resolution of less than 120 nm was achieved in a more cost-effective manner. This study contributes to the real-time improvement of the imaging resolution of confocal microscopy and expands the application scenarios of confocal microscopy in biological imaging.

Background: While prehabilitation (pre surgical exercise) effectively prevents postoperative pulmonary complications (PPCs), its cost-effectiveness in valve heart disease (VHD) remains unexplored. This study aims to evaluate the cost-effectiveness of a three-day prehabilitation program for reducing PPCs and improving quality adjusted life years (QALYs) in Chinese VHD patients. Methods: A cost-effectiveness analysis was conducted alongside a randomized controlled trial featuring concealed allocation, blinded evaluators, and an intention-to-treat analysis. In total, 165 patients scheduled for elective heart valve surgery at West China Hospital were randomized into intervention and control groups. The intervention group participated in a three-day prehabilitation exercise program supervised by a physiotherapist while the control group received only standard preoperative education. Postoperative hospital costs were audited through the Hospital Information System, and the EuroQol five-dimensional questionnaire was used to provide a 12-month estimation of QALY. Cost and effect differences were calculated through the bootstrapping method, with results presented in cost-effectiveness planes, alongside the associated cost-effectiveness acceptability curve (CEAC). All costs were denominated in Chinese Yuan (CNY) at an average exchange rate of 6.73 CNY per US dollar in 2022. Results: There were no statistically significant differences in postoperative hospital costs (8484 versus 9615 CNY, 95% CI –2403 to 140) or in the estimated QALYs (0.909 versus 0.898, 95% CI –0.013 to 0.034) between the intervention and control groups. However, costs for antibiotics (339 versus 667 CNY, 95% CI –605 to –51), nursing (1021 versus 1200 CNY, 95% CI –330 to –28), and electrocardiograph monitoring (685 versus 929 CNY, 95% CI –421 to –67) were significantly lower in the intervention group than in the control group. The CEAC indicated that the prehabilitation program has a 92.6% and 93% probability of being cost-effective in preventing PPCs and improving QALYs without incurring additional costs. Conclusions: While the three-day prehabilitation program did not significantly improve health-related quality of life, it led to a reduction in postoperative hospital resource utilization. Furthermore, it showed a high probability of being cost-effective in both preventing PPCs and improving QALYs in Chinese patients undergoing valve surgery. Clinical Registration Number: This trial is registered in the Chinese Clinical Trial Registry (URL: https://www.chictr.org.cn/) with the registration identifier ChiCTR2000039671.

Salt stress is a well-known abiotic constraint that hampers crop productivity, affecting more than 424 million hectares of topsoil worldwide. Applying plant growth regulators externally has proven effective in enhancing crop resilience to salt stress. Previous metabolomics studies revealed an accumulation of Valine-Threonine-Isoleucine-Aspartic acid (VTID) in salt-stressed maize seedlings, suggesting its potential to assist maize adaptation to salt stress. To explore the effectiveness of VTID in enhancing salt tolerance in maize, 10 nM VTID was applied to salt-stressed maize seedlings. The results showed a remarkable 152.29% increase in plant height and a 122.40% increase in fresh weight compared to salt-stressed seedlings. Moreover, the addition of VTID enhanced the activity of antioxidant enzymes, specifically superoxide dismutase (SOD) and catalase (CAT), while reducing the level of malondialdehyde (MDA), a marker of oxidative stress. Additionally, VTID supplementation resulted in a significant increase in osmoregulatory substances such as proline. Metabolomic analysis revealed substantial changes in the metabolite profile of maize seedlings when treated with VTID during salt stress. Differential metabolites (DMs) analysis revealed that the identified DMs primarily belonged to lipids and lipid-like molecules. The receiver operating characteristic curve and linear regression analysis determined a correlation between isodolichantoside and the height of maize seedlings under salt-stress conditions. In conclusion, these findings validate that VTID effectively regulates tolerance in maize seedlings and offers valuable insights into the potential of short peptides for mitigating salt stress.

BackgroundClinical notes contain contextualized information beyond structured data related to patients’ past and current health status. ObjectiveThis study aimed to design a multimodal deep learning approach to improve the evaluation precision of hospital outcomes for heart failure (HF) using admission clinical notes and easily collected tabular data. MethodsData for the development and validation of the multimodal model were retrospectively derived from 3 open-access US databases, including the Medical Information Mart for Intensive Care III v1.4 (MIMIC-III) and MIMIC-IV v1.0, collected from a teaching hospital from 2001 to 2019, and the eICU Collaborative Research Database v1.2, collected from 208 hospitals from 2014 to 2015. The study cohorts consisted of all patients with critical HF. The clinical notes, including chief complaint, history of present illness, physical examination, medical history, and admission medication, as well as clinical variables recorded in electronic health records, were analyzed. We developed a deep learning mortality prediction model for in-hospital patients, which underwent complete internal, prospective, and external evaluation. The Integrated Gradients and SHapley Additive exPlanations (SHAP) methods were used to analyze the importance of risk factors. ResultsThe study included 9989 (16.4%) patients in the development set, 2497 (14.1%) patients in the internal validation set, 1896 (18.3%) in the prospective validation set, and 7432 (15%) patients in the external validation set. The area under the receiver operating characteristic curve of the models was 0.838 (95% CI 0.827-0.851), 0.849 (95% CI 0.841-0.856), and 0.767 (95% CI 0.762-0.772), for the internal, prospective, and external validation sets, respectively. The area under the receiver operating characteristic curve of the multimodal model outperformed that of the unimodal models in all test sets, and tabular data contributed to higher discrimination. The medical history and physical examination were more useful than other factors in early assessments. ConclusionsThe multimodal deep learning model for combining admission notes and clinical tabular data showed promising efficacy as a potentially novel method in evaluating the risk of mortality in patients with HF, providing more accurate and timely decision support.

Groundwater drought is distinctive comparing with other droughts, featuring high concealment, long duration, and obvious hysteresis. It may have significant negative effects on agriculture, eco-environment, and social economy sectors. Therefore, investigating the temporal and spatial characteristics of groundwater drought and its driving factors is meaningful for monitoring and assessing the risks of groundwater shortage. In this study, a groundwater drought index based on groundwater storage anomalies (GWSAs) derived from GRACE satellites was developed to detect and analyze drought events. The spatiotemporal variations and trends of historical groundwater droughts from 2002 to 2021 in the North China Plain were evaluated. In addition, the correlations between groundwater drought and meteorological and agricultural drought were analyzed by the detrended cross-correlation analysis. The results indicated that (1) the standardized groundwater storage anomaly index (SGSAI) could better identify and characterize groundwater drought by eliminating the spatial heterogeneity of GWSAs; (2) from 2002 to 2021, the intensity, frequency, duration, and area of groundwater drought showed an increasing trend; (3) groundwater drought had an obvious hysteresis (>9 months) to meteorological drought and the correlation between groundwater drought and meteorological drought increased, while the relationship with agricultural drought decreased; (4) long-term overexploitation of groundwater resources might be the main driving factor for the exacerbating groundwater drought in this area.

ObjectivesProlonged intubation (PI) is a frequently encountered severe complication among patients following cardiac surgery (CS). Solely concentrating on preoperative data, devoid of sufficient consideration for the ongoing impact of surgical, anesthetic, and cardiopulmonary bypass procedures on subsequent respiratory system function, could potentially compromise the predictive accuracy of disease prognosis. In response to this challenge, we formulated and externally validated an intelligible prediction model tailored for CS patients, leveraging both preoperative information and early intensive care unit (ICU) data to facilitate early prophylaxis for PI.MethodsWe conducted a retrospective cohort study, analyzing adult patients who underwent CS and utilizing data from two publicly available ICU databases, namely, the Medical Information Mart for Intensive Care and the eICU Collaborative Research Database. PI was defined as necessitating intubation for over 24 h. The predictive model was constructed using multivariable logistic regression. External validation of the model's predictive performance was conducted, and the findings were elucidated through visualization techniques.ResultsThe incidence rates of PI in the training, testing, and external validation cohorts were 11.8%, 12.1%, and 17.5%, respectively. We identified 11 predictive factors associated with PI following CS: plateau pressure [odds ratio (OR), 1.133; 95% confidence interval (CI), 1.111–1.157], lactate level (OR, 1.131; 95% CI, 1.067–1.2), Charlson Comorbidity Index (OR, 1.166; 95% CI, 1.115–1.219), Sequential Organ Failure Assessment score (OR, 1.096; 95% CI, 1.061–1.132), central venous pressure (OR, 1.052; 95% CI, 1.033–1.073), anion gap (OR, 1.075; 95% CI, 1.043–1.107), positive end-expiratory pressure (OR, 1.087; 95% CI, 1.047–1.129), vasopressor usage (OR, 1.521; 95% CI, 1.23–1.879), Visual Analog Scale score (OR, 0.928; 95% CI, 0.893–0.964), pH value (OR, 0.757; 95% CI, 0.629–0.913), and blood urea nitrogen level (OR, 1.011; 95% CI, 1.003–1.02). The model exhibited an area under the receiver operating characteristic curve (AUROC) of 0.853 (95% CI, 0.840–0.865) in the training cohort, 0.867 (95% CI, 0.853–0.882) in the testing cohort, and 0.704 (95% CI, 0.679–0.727) in the external validation cohort.ConclusionsThrough multicenter internal and external validation, our model, which integrates early ICU data and preoperative information, exhibited outstanding discriminative capability. This integration allows for the accurate assessment of PI risk in the initial phases following CS, facilitating timely interventions to mitigate adverse outcomes.

For the detections of typical faults gases, namely NO2 and O3, in the air insulated switchgears (AIS), we purpose Au- and B-embedded graphene (Au- and B-graphene) as promising sensing material using the first-principles theory. We firstly investigate the Au- and B-embedding behavior on the graphene, and find that both Au and B atoms are chemical stably adsorbed on the vacancy-defected graphene; in the gas adsorbed systems, it is found that NO2 and O3 adsorptions on Au-graphene are identified as chemisorption, while those on B-graphene are physisorption. The electronic properties of Au- and B-graphene in the gas adsorptions indicate the resistance-type sensing potential of Au-graphene upon O3 as well as that of B-graphene upon NO2. Besides, Au-graphene is a promising WF-based gas sensor upon NO2 and O3. The findings in this work uncover the strong potentials of Au- and B-graphene for detections of the NO2 and O3 in AIS, which gives the guidance to explore novel graphene-based gas sensors for applications in the power system.

The converter transformer is an electrical equipment with a symmetrical structure. Due to its symmetry, the ground current should be small when the core is grounded at one point. The research and analysis of grounding currents in the converter transformer can effectively help staff to judge the working state of the converter transformer. Therefore, it is very meaningful to study the calculation problem of the grounding current under the multi-point grounding state. First of all, a homogenization modeling method considering the characteristics material of the core silicon steel sheet is proposed; secondly, on this basis, the finite element simulation model of multi-point grounding of the core of the converter transformer is established and simulated; then a multi-point grounding test was conducted using the shrinkage model of the converter transformer to verify the finite element simulation results; the final consequence show that the homogenization modeling method can effectively calculate the grounding current at multi-grounding.

Power system stabilizer (PSS) is widely used to improve power system stability. The current parameter coordination optimization method is easy to fall into the local optimization, to solve the problem and find the optimal parameter combination of PSS, the sample screening method based on the similarity index of power system state (SIPSS) and BP neural network is proposed for global optimization parameters of PSS. The SIPSS screening method uses a similar metric index of the grid state variable as the criterion to screen out the required samples. The BP neural network fits the predicted and expected values of the minimum damping ratio of the system after random fluctuations of PSS parameters under various operating modes to minimize the mean square deviation by fitting the streamlined training samples. Firstly, the SIPSS-BP neural network model is obtained by analyzing the mapping relationship between generator power, node power, branch power, and minimum damping ratio. Then, the sensitivity of the PSS parameters damping ratio is calculated, and the PSS parameter optimization model is established. The optimal adjustment of the PSS parameter is obtained, and the minimum damping ratio is modified to improve the system’s stability. Finally, the minimum damping ratio after correction is obtained. The test results of the SIPSS-BP network with the IEEE 3-machines and 9-nodes show that the method can achieve good prediction accuracy, the parameter optimization effect of PSS can be remarkable, and the stability of the power system has been greatly improved.

This study investigates the growth tolerance mechanisms of Chlorella pyrenoidosa to 3-fluorophenol and its removal efficiency by algal cells. Our results indicate that C. pyrenoidosa can tolerate up to 100 mg/L of 3-fluorophenol, exhibiting a significant hormesis effect characterized by initial inhibition followed by promotion of growth. In C. pyrenoidosa cells, the activities of superoxide dismutase (SOD) and catalase (CAT), as well as the levels of malondialdehyde (MDA) and reactive oxygen species (ROS), were higher than or comparable to the control group. Metabolic analysis revealed that the 3-fluorophenol treatment activated pathways, such as glycerol phospholipid metabolism, autophagy, glycosylphosphatidylinositol (GPI)-anchored protein biosynthesis, and phenylpropanoid biosynthesis, contributed to the stabilization of cell membrane structures and enhanced cell repair capacity. After 240 h of treatment, over 50% of 3-fluorophenol was removed by algal cells, primarily through adsorption. Thus, C. pyrenoidosa shows potential as an effective biosorbent for the bioremediation of 3-fluorophenol.