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Background Ambulatory care sensitive conditions (ACSCs) are illnesses that can be prevented from resulting in hospitalization with timely and effective ambulatory care. As the global emphasis on improving healthcare service quality and efficiency increases, understanding the evolution and research trends of ACSCs becomes increasingly vital. Objective To analyze the research hotspots, frontiers, and trends in the field of ACSCs over the past 30 years. Methods The English literature related to ACSCs published in the Web of Science was searched in March 2023. CiteSpace was utilized to perform a visualization analysis of the publication year, authors, research institutions, keywords and references extracted from the identified articles. The time frame was set from 1992 to 2023, with each time segment spanning five years. The network node correlation strength was determined using the "Cosine" algorithm. For the analysis, "Author" "Institution" and "Keyword" were selected as nodes, resulting in knowledge maps that illustrate co-occurrence among authors, institutions, and keywords. Results From an initial pool of 1 701 articles, 1 698 were ultimately selected for analysis by CiteSpace. Research focusing on ACSCs had generally shown an upward trend in recent years. The top three prolific institutions were Harvard University [81 articles (4.77%) ], University of California [63 articles (3.71%) ] and University of Michigan [47 articles (2.77%) ]. Eight topic clusters were derived from keyword cluster mapping, namely "nursing home""public health""primary care""integrated care""impact""potentially avoidable hospitalizations""management", and "performance". Citation analysis showed that highly cited studies in this field focused on the status of avoidable hospitalizations, influencing factors, healthcare relationships, and reduction strategies. Conclusion Over the past 30 years, research in the field of ACSCs has rapidly progressed and is extensively utilized by major developed nations worldwide to evaluate and improve healthcare services. However, there is a lack of cross-regional collaboration among researchers and institutions, and research interests continually evolve. The main themes include the significance and policy implications of ACSCs and hospitalization for ambulatory care sensitive conditions (ACSH), influencing factors, practical applications, and policy insights. Domestic exploration of these crucial areas is insufficient and requires more attention in the future.

Abstract Background The initiation time and formula for supplemental parenteral nutrition after surgery require optimization, especially in older patients undergoing major gastrointestinal surgery. This study aimed to assess the effect of early supplementation with a branched-chain amino acid (BCAA)-enriched formula (BAF) on short-term postoperative outcomes in older patients undergoing gastric surgery. Methods This single-center, prospective, double-blinded, randomized clinical trial was conducted from March 10, 2020, to September 15, 2022. Patients aged 65–80 years with gastric cancer scheduled for curative resection were assessed for eligibility and randomly allocated to a high-proportion BCAA (HBCAA) (early supplementation with the BAF) or control (routine nutrition) group. The primary outcome was the standardized length of hospital stay (LOS). Results A total of 150 patients were randomized. Thirteen patients were excluded due to the resection of other organs, presence of metastasis, or withdrawal of consent. Finally, we included 70 and 67 patients in the HBCAA and control groups, respectively (mean age: 70.5 ± 4.2 years; 96 men [70.1%]). The standardized LOS was significantly shorter in the treatment group than in the control group (median [interquartile range]: 8.0 [7.8, 8.0] vs. 8.5 [8.0, 9.0] days; mean difference, 0.38; 95% confidence interval [CI], 0.02–0.74 days; P

This study assessed the quality characteristics juice and processing suitability of six varieties of large-fruited sea buckthorn juice from Xinjiang using gas chromatography-ion mobility spectroscopy (GC-IMS) and multivariate physicochemical analysis combined with correlation and principal component analysis. The varieties included five large-fruited sea buckthorn types, namely SQH, ZYH, GR, WCF, and XY, along with one mixed-fruited variety (HG). The results indicated that ZYH exhibited the highest b* and c, as well as contents for total phenols (0.9 mg/mL), vitamin E (63.14 μg/g), vitamin C (69.61 mg/100 g), DPPH (97.13%), ABTS+ free radical scavenging capabilities (61.99%) , and FRAP antioxidant capacity (0.85 μmol Trolox/mL). XY sea buckthorn juice showed the highest juice yield (56.43%) and total flavonoid content (8.55 mg/mL). Correlation analysis revealed a significant positive correlation (P

Hydrogen energy, with its abundant reserves, green and low-carbon characteristic, high energy density, diverse sources, and wide applications, is gradually becoming an important carrier in the global energy transformation and development. In this paper, the off-grid wind power hydrogen production system is considered as the research object, and the operating characteristics of a proton exchange membrane (PEM) electrolysis cell, including underload, overload, variable load, and start- stop are analyzed. On this basis, the characteristic extraction of wind power output data after noise reduction is carried out, and then the self-organizing mapping neural network algorithm is used for clustering to extract typical wind power output scenarios and perform weight distribution based on the statistical probability. The trend and fluctuation components are superimposed to generate the typical operating conditions of an off-grid PEM electrolytic hydrogen production system. The historical output data of an actual wind farm are used for the case study, and the results confirm the feasibility of the method proposed in this study for obtaining the typical conditions of off-grid wind power hydrogen production. The results provide a basis for studying the dynamic operation characteristics of PEM electrolytic hydrogen production systems, and the performance degradation mechanism of PEM electrolysis cells under fluctuating inputs.

Objective: To investigate the potential role of the regulator of G protein signaling 20 (RGS20) in radioresistance of non-small cell lung cancer (NSCLC). Methods: A total of 35 lung adenocarcinoma (LUAD) patients from The Cancer Genome Atlas (TCGA), who underwent radiotherapy, were enrolled and divided into radiosensitive (n ​= ​16) and radioresistant (n ​= ​19) groups based on clinical prognosis. The expression and prognosis of RGS20 were analyzed by Gene Expression Profiling Interactive Analysis (GEPIA) database. A radioresistant cell line (A549R) was constructed by irradiating A549 ​cells with 6 ​Gy X-rays for 10 fractions. Cell survival was measured by colony formation assay. The regulatory effect of RGS20 on pyroptosis were verified by LDH release and Western blot assay, and the underlying mechanism was investigated by transfecting RGS20 siRNA and applying a GSDMD inhibitor). Results: A total of 2,181 differentially expressed genes (DEGs) were identified by analyzing the data of radiosensitive and radioresistant individuals from the TCGA-LUAD dataset. These DEGs were enriched in G alpha (z) signalling events analyzed by Reactome database. RGS20 exhibited significant upregulation among the DEGs, and its higher expression predicted poor prognosis in LUAD patients. In vitro, the expression of RGS20 protein was increased by irradiation in A549 ​cells, whereas it remained at much high levels in A549R cells regardless of irradiation. After irradiation, the expressions of pyroptosis-related proteins were significantly increased in A549 cells (P ＜ 0.05), with no significant changes were observed in A549R cells. Treatment with LDC7559 significantly reduced LDH release (P ＜ 0.01) and improved the survival rate of irradiated A549 cells (P ＜ 0.01). Furthermore, knockdown of RGS20 gene in A549R cells significantly increased LDH release (P ＜ 0.001) and enhanced radiosensitivity (P ＜ 0.01), while LDC7559 administration reversed LDH release (P ＜0.01) and radiation-induced cell death increased by siRGS20 (P ＜0.05). Meantime, the increased expression level of GSDMD-NT was observed in A549 and A549R cells transfected with siRGS20 (P ＜ 0.05). Conclusion: RGS20 contributes to the radioresistance of NSCLC cells, which might be a potential target for NSCLC radiotherapy.

Objective Shield tunneling may cause displacement and deformation of the nearby viaduct foundation and reduce its bearing capacity. Therefore, the deformation effect caused by shield tunnel closely side-passing viaduct foundation is studied based on an actual project. Method Relying on the project of Hefei Metro Line 5 in which the shield tunnel passes the pile foundation of the viaduct on the side, a three-dimensional numerical model is established to analyze the horizontal displacement,the longitudinal displacement and the settlement pattern of the pile foundation caused by shield construction. Result & Conclusion The research results show that the horizontal displacement at the pile bottom presents dynamic changes of leaving, approaching and leaving the tunnel. The horizontal displacement of the pile body is similar to a C shape flexture curve. The displacement increases first and then decreases along with the pile depths, and the extreme value is located at the pile depth of 9~10 m. The longitudinal displacement at the pile bottom （parallel to the tunnel axis） shows a bimodal curve. After the shield passing the pile foundation, the pile body undergoes longitudinal deformation in the opposite direction of the excavation. After the shield passing through the pile foundation for 12m and further, the horizontal displacement of the pile body in longitudinal direction rebounds, indicating that the influence of shield tunneling on the longitudinal deformation of the pile foundation is reversible to a certain extent. The settlement of the pile foundation presents a steep trend. The closer the pile foundation at the same side is to the tunnel, the greater the settlement. Moreover, the excavation of the far side tunnel will cause secondary settlement of the pile top. The maximum settlement occurs at the bottom of the No.4 pile foundation, and the settlement value is 4.94 mm.

Abstract This study examines tuberculosis (TB) incidence among students in Jilin Province, China, focusing on spatial, temporal, and demographic dynamics in areas of social inequality. Variation in incidence rate of TB was analyzed using the joinpoint regression method. Spatial analyses techniques included the global and local Moran indices and Getis-Ord Gi* analysis. Demographic changes in new cases were analyzed descriptively, and the Geodetector method measured the influence of risk factors on student TB incidence. The analysis revealed a declining trend in TB cases, particularly among male students. TB incidence showed geographical heterogeneity, with lower rates in underdeveloped rural areas compared to urban regions. Significant spatial correlations were observed, with high-high clusters forming in central Jilin Province. Hotspots of student TB transmission were primarily concentrated in the southwestern and central regions from 2008 to 2018. Socio-economic factors exhibited nonlinear enhancement effects on incidence rates, with a dominant bifactor effect. High-risk zones were predominantly located in urban centers, with university and high school students showing higher incidences than other educational stages. The study revealed economic determinants as being especially important in affecting TB incidence among students, with these factors having nonlinear interacting effects on student TB incidence.

Background: Real-world vaccine effectiveness following the third dose of vaccination against SARS-CoV-2 remains less investigated among people with HIV (PWH). Methods: PWH receiving the third dose of BNT162b2 and mRNA-1273 (either 50- or 100-μg) were enrolled. Participants were followed for 180 days until the fourth dose of COVID-19 vaccination, SARS-CoV-2 infection, seroconversion of anti-nucleocapsid IgG, death, or loss to follow-up. Anti-spike IgG was determined every 1–3 months. Results: Of 1427 participants undergoing the third-dose COVID-19 vaccination, 632 (44.3%) received 100-μg mRNA-1273, 467 (32.8%) 50-μg mRNA-1273, and 328 (23.0%) BNT162b2 vaccine and the respective rate of SARS-CoV-2 infection or seroconversion of anti-nucleocapsid IgG was 246.1, 280.8 and 245.2 per 1000 person-months of follow-up (log-rank test, p = 0.28). Factors associated with achieving anti-S IgG titers >1047 BAU/mL included CD4 count 200 copies/mL (aOR, 0.27; 95% CI, 0.09–0.80), having achieved anti-spike IgG >141 BAU/mL within 3 months after primary vaccination (aOR, 3.69; 95% CI, 2.68–5.07), receiving BNT162b2 vaccine as the third dose (aOR, 0.20; 95% CI, 0.10–0.41; reference, 100-μg mRNA-1273), and having previously received two doses of mRNA vaccine in primary vaccination (aOR, 2.46; 95% CI, 1,75-3.45; reference, no exposure to mRNA vaccine). Conclusions: PWH receiving different types of the third dose of COVID-19 vaccine showed similar vaccine effectiveness against SARS-CoV-2 infection. An additional dose with 100-μg mRNA-1273 could generate a higher antibody response than with 50-μg mRNA-1273 and BNT162b2 vaccine.

There are many important and interesting academic competitions that attract an increasing number of students. However, traditional student team building methods usually have strong randomness or involve only some first-class students. To choose more suitable students to compose a team and improve students' abilities overall, a competition-oriented student team building method is proposed. This would not only lead to better competition results by choosing more suitable students and teams but also improve the overall involvement of students in considering education fairness. First, a Big Data platform is constructed to collect students' various behavior data. Based on that, a competition with a six-tuple attribute and a student with a six-tuple attribute are modeled. Then, a corresponding utility function is designed for each attribute in the student model to denote the student's utility in this attribute for attending a competition. Furthermore, a team utility function is developed for each team to denote the utilities of all involved students. A team building utility function is also developed to denote the utilities of all involved teams. Second, a multiple-objective particle swarm optimization algorithm with dimension by dimension improvement is proposed to build appropriate teams to optimize team building utility maximization and education fairness simultaneously. Finally, extensive experimental results demonstrate that the overall performance of our proposed team building method not only has better performance in terms of team utility and student ability than other current methods, but also has better performance in terms of hyper volume and inverted generational distance than other optimization algorithms.

Non-small-cell lung cancer (NSCLC) represents a predominant histological subtype of lung cancer, characterized by high incidence and mortality rates. Despite significant advancements in therapeutic strategies and a deeper understanding of targeted therapies in recent years, tumor resistance remains an inevitable challenge, leading to poor prognostic outcomes. Several studies have indicated that sphingosine kinase 1 (SPHK1) plays a regulatory role in epidermal growth factor receptor (EGFR) signaling, and its elevated expression may be associated with resistance to EGFR tyrosine kinase inhibitors (EGFR-TKIs). Furthermore, the catalytic product of SPHK1, sphingosine 1-phosphate (S1P), along with its receptor, sphingosine 1-phosphate receptor 3 (S1PR3), plays a regulatory role in the function of the EGFR. However, the specific effects of the SPHK1/S1P/S1PR3 axis on EGFR in NSCLC, as well as the combined effects of SPHK1/S1P/S1PR3 inhibitors with the EGFR-TKI gefitinib, remain to be elucidated. In the present study, we investigated the correlation between SPHK1 expression levels and the survival rates of NSCLC patients, the relationship between SPHK1 or S1PR3 and EGFR, and the impact of SPHK1 expression on the half-maximal inhibitory concentration (IC50) of gefitinib in NSCLC. In A549 cells, the phosphorylation of EGFR was significantly reduced following SPHK1 knockdown. Utilizing SPHK1/S1P/S1PR3 inhibitors, namely PF543, TY52156, and FTY720, we established that the SPHK1/S1P/S1PR3 axis modulates EGFR activation in NSCLC. Furthermore, these signaling inhibitors enhanced the anti-proliferative efficacy of the EGFR-TKI gefitinib. RNA sequencing analysis revealed substantial alterations in 85 differentially expressed genes in NSCLC cells treated with the combination of FTY720 and gefitinib. These genes were predominantly associated with pathways such as axon guidance, microRNAs in cancer, and the JAK-STAT signaling pathway, among others. Overall, targeting the SPHK1/S1P/S1PR3 signaling pathway represents a promising therapeutic strategy to enhance gefitinib sensitivity in NSCLC.

ABSTRACTDigital twin railway is a pivotal foundation for the intelligent construction and maintenance of railway engineering projects within extensive open spaces. Its essence is the integrated representation and association management of multi-granularity spatiotemporal data, executable analysis models, and professional knowledge. These elements are characterized by the prominent characteristics of multi-source, heterogeneity, and massive volume. However, current decentralized and independent management strategies often neglect the dynamic coupling relationships between them, and numerous multi-path joins and conversion aggregation operations exist across various spatial scale applications. Consequently, this results in challenges such as the inability to dynamically couple data-model-knowledge and conduct global association retrieval, thereby limiting the potential for real-time analysis and intelligent application capabilities. To address these problems, we first constructed a tripartite graph model ([Formula: see text]) that explicitly associates temporal, spatial, and interactive relationships. Subsequently, an association management architecture was proposed, accompanied by a global association graph index ([Formula: see text]) and a global-local indexing mechanism. Finally, a prototype system for railway data-model-knowledge association management was developed. The effectiveness of the distributed association management method was demonstrated by employing a case study of high-temperature safety risk analysis in railway tunnel engineering with multi-physics field coupling.

IntroductionCircular RNA CDR1as/ciRS-7 has been reported to function as an oncogenic regulator in various cancers. However, the prognostic value of CDR1as/ciRS-7 expression in solid tumors remains unclear. Herein, we conducted an updated meta-analysis to investigate the association between CDR1as/ciRS-7 expression and clinical outcomes in solid tumors.MethodsA systematic search was performed through the PubMed, EMBASE, Web of Science, and Ovid databases for eligible studies on clinical values of CDR1as/ciRS-7 in solid tumors. The pooled hazard ratios (HRs) or odd ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the correlation between CDR1as/ciRS-7 and clinical outcomes.ResultsA total of 2424 patients from 17 studies between 2017 and 2023 were included. The results suggested that elevated CDR1as/ciRS-7 expression predicted a poor overall survival (OS) for 12 types of solid tumors (HR=1.93, 95% CI: 1.43-2.60, P

BackgroundAlthough several studies linked the sugary beverages to chronic kidney disease (CKD), the role of different types of sugary beverages in the development of CKD remained inconsistent. This study aimed to examine the associations of sugar-sweetened beverages (SSBs), artificially-sweetened beverages (ASBs), and natural juices (NJs) with CKD risk, and assess the extent to which the associations were mediated through metabolic syndrome (MetS).MethodsThis is a prospective analysis of 191,956 participants from the UK Biobank. Participants with information on beverage consumption and no history of CKD at recruitment were included. Daily consumptions of SSBs, ASBs and NJs were measured via 24-h dietary recall. Cox models were fitted to calculate the hazard ratios (HRs) and confidence intervals (CIs) of sugary beverages intakes on CKD risk. The causal mediation analyses were conducted to investigate whether MetS explained the observed associations.ResultsWe documented 4,983 CKD cases over a median of 10.63 years follow-up. Higher consumption of SSBs and ASBs (>1 units/d compared with none) was associated with an elevated risk of CKD (HR: 1.45; 95% CI: 1.30–1.61, P-trend < 0.001 for SSBs and 1.52, 95% CI: 1.36–1.70 for ASBs). In contrast, we observed a J-shaped association between NJs and CKD with the with lowest risk at 0–1 unit/day (0–1 unit/d vs. 0, HR 0.86; 95% CI 0.81–0.91). The proportions of the observed association of higher intakes of SSBs and ASB with CKD mediated by MetS were 12.5 and 18.0%, respectively.ConclusionsHigher intakes of ASBs and SSBs were positively associated with the development of CKD, while moderate consumption of NJs was inversely associated with CKD risk. More intensified policy efforts are warranted to reduce intake of SSBs and ASBs for CKD prevention.

Abstract Background Kawasaki disease (KD) is a pyretic ailment predominantly observed in children aged below 5 years. There is currently a dearth of precise markers for timely identification of incomplete Kawasaki disease (IKD). It is imperative to develop updated, comprehensive, and evidence-based guidelines to effectively direct clinical practice. Methods The guideline development group comprised individuals with diverse expertise in both content and methodology and carried out an extensive exploration of the following digital repositories: CNKI, VIP, Wanfang Data, UpToDate, BMJ, Clinical Evidence, National Guideline Clearinghouse, Joanna Briggs Institute Library, Cochrane Library, and PubMed. The entire period from the establishment of these databases until January 1, 2024 was covered. To evaluate IKD, systematic reviews and randomised controlled trials were assessed using the risk of prejudice instrument specified in the Cochrane Handbook, along with the evidence robustness framework established by the GRADE group. The recommendations were formulated based on the findings, considering the evidence strength. After several iterations of expert consensus, the relevant professional committees in China endorsed the ultimate guideline. Results These guidelines address clinical questions regarding the classification and definition of KD, diagnosis of IKD, treatment during the acute phase of IKD, and follow-up of IKD. Conclusions To provide healthcare professionals with guidance and decision-making bases for the diagnosis and treatment of IKD in China, 13 recommendations were formulated based on expert consensus and evidence of best practices.

Background: The RECOVERY trial demonstrated that the use of dexamethasone is associated with a 36% lower 28-day mortality in hospitalized patients with COVID-19 on invasive mechanical ventilation. Nevertheless, the optimal timing to start dexamethasone remains uncertain. Methods: We conducted a quasi-experimental study at National Taiwan University Hospital (Taipei, Taiwan) using propensity score matching to simulate a randomized controlled trial to receive or not to receive early dexamethasone (6 mg/day) during the first 7 days following the onset of symptoms. Treatment was standard protocol-based, except for the timing to start dexamethasone, which was left to physicians’ decision. The primary outcome is 28-day mortality. Secondary outcomes include secondary infection within 60 days and fulfilling the criteria of de-isolation within 20 days. Results: A total of 377 patients with COVID-19 were enrolled. Early dexamethasone did not decrease 28-day mortality in all patients (adjusted odds ratio [aOR], 1.03; 95% confidence interval [CI], 0.97–1.10) or in patients who required O2 for severe/critical disease at admission (aOR, 1.05; 95%CI, 0.94–1.18); but is associated with a 24% increase in superinfection in all patients (aOR, 1.24; 95% CI, 1.12–1.37) and a 23% increase in superinfection in patients of O2 for several/critical disease at admission (aOR, 1.23; 95% CI, 1.02–1.47). Moreover, early dexamethasone is associated with a 42% increase in likelihood of delayed clearance of SARS-CoV-2 virus (adjusted hazard ratio, 1.42; 95% CI, 1.01–1.98). Conclusion: An early start of dexamethasone (within 7 days after the onset of symptoms) could be harmful to hospitalized patients with COVID-19.

Abstract This study aims to refine clinical designs within clear aligner therapy, exploring the appropriate ratio of anterior tooth retraction to intrusion under maximum anchorage. Using a three-dimensional finite element model and evaluating 19 load scenarios with first premolar extraction, the research identifies the optimal force angle for anterior tooth retraction as 45 to 55°. For clinical planning, it is recommended to design a retraction of 0.19 mm combined with an intrusion of 0.16 mm to achieve anterior tooth retraction. This investigation is crucial for enhancing understanding of biomechanical principles in clear aligner orthodontics, offering significant insights for effective treatments.

AIM: To explore the effects of hepatocyte growth factor (HGF) on retinal pigment epithelium (RPE) cell behaviors. METHODS: The human adult retinal pigment epithelial cell line-19 (ARPE-19) were treated by HGF or mesenchymal-epithelial transition factor (MET) inhibitor SU11274 in vitro. Cell viability was detected by a Cell Counting Kit-8 assay. Cell proliferation and motility was detected by a bromodeoxyuridine incorporation assay and a wound healing assay, respectively. The expression levels of MET, phosphorylated MET, protein kinase B (AKT), and phosphorylated AKT proteins were determined by Western blot assay. The MET and phosphorylated MET proteins were also determined by immunofluorescence assay. RESULTS: HGF increased ARPE-19 cells' viability, proliferation and migration, and induced an increase of phosphorylated MET and phosphorylated AKT proteins. SU11274 significantly reduced cell viability, proliferation, and migration and decreased the expression of MET and AKT proteins. SU11274 suppressed HGF-induced increase of viability, proliferation, and migration in ARPE-19 cells. Additionally, SU11274 also blocked HGF-induced phosphorylation of MET and AKT proteins. CONCLUSION: HGF enhances cellular viability, proliferation, and migration in RPE cells through the MET/AKT signaling pathway, whereas this enhancement is suppressed by the MET inhibitor SU11274. HGF-induced MET/AKT signaling might be a vital contributor of RPE cells survival.

Abstract Background Fruquintinib is a highly selective inhibitor of vascular endothelial growth factor receptor (VEGFR). Currently, there are no reported cases of fruquintinib causing kidney-restrictive thrombotic microangiopathy (TMA) in the available Chinese and foreign literature. Case presentation In this case report, we presented a 73-year-old patient receiving fruquintinib for metastatic colon cancer, manifesting abundant proteinuria, in which kidney-restrictive TMA was also diagnosed through renal biopsy. As far as we were concerned, this was the frst reported in terms of fruquintinib-induced kidney-restrictive TMA confrmed by renal biopsy. Conclusion This case indicates that fruquintinib may result in kidney-restrictive TMA, which is a rare but life-threatening complication of cancer treatment drug. Therefore, regular monitoring of proteinuria and blood pressure is imperative for all patients undergoing anti-VEGF drug therapy. And renal biopsy should be promptly conducted to facilitate early detection of thrombotic microangiopathy.

"Objective To investigate the clinical diagnostic efficacy of color Doppler ultrasound (CDU) combined with serum carbohydrate antigen (CA) 125, cysteine-rich protein 61 (CYR61) and insulin-like growth factor-1 (IGF-1) for breast cancer. Methods Eighty six female breast cancer patients treated in Hanyang Hospital Affiliated to Wuhan University of Science and Technology from January 2021 to December 2023 were included in the breast cancer group, and 86 female benign breast disease patients treated in the same period were included in the benign group for retrospective analysis. CDU and serum CA125, CYR61, IGF-1 were detected in both groups. The CDU characteristics and serum CA125, CYR61 and IGF-1 levels of patients in the two groups, and those of breast cancer patients with different TNM grades were analyzed. ROC curve was used to analyze the diagnostic efficacy of CDU, serum CA125, CYR61 and IGF-1 for breast cancer alone and in combination. Results Compared with benign group, the proportions of unclear boundaries, irregular morphology, microcalcification, uneven internal echo, and high-grade blood flow signals, as well as resistance index (RI), pulsatility index (PI), and peak systolic velocity (PSV) values in breast cancer group were higher (P＜0.05）.The levels of serum CA125, CYR61, and IGF-1 all increased in breast cancer group compared to benign group (P＜0.01). ROC curve analysis showed that the area under the curve (AUC) of CDU, serum CA125, CYR61, IGF-1 and their combined diagnosis of breast cancer were 0.874, 0.832, 0.849, 0.806 and 0.962, respectively，with the highest AUC, specificity (95.29%) and sensitivity (93.86%) in combined diagnosis of four indexes. Conclusion CDU combined with serum CA125, CYR61 and IGF-1 has a high clinical value in the diagnosis of breast cancer."

Energy systems are currently undergoing a transformation towards new paradigms characterized by decarbonization, decentralization, democratization, and digitalization. In this evolving context, energy blockchain, aiming to enhance efficiency, transparency, and security, emerges as an integrated technological solution designed to address the diverse challenges in this field. Data security is essential for the reliable and efficient functioning of energy blockchain. The pressing need to address challenges related to secure data storage, effective data management, and efficient data utilization is increasingly vital. This paper offers a comprehensive survey of academic discourse on energy blockchain data security over the past five years, adopting an all-encompassing perspective that spans data storage, management, and utilization. Our work systematically evaluates and contrasts the strengths and weaknesses of various research methodologies. Additionally, this paper proposes an integrated hierarchical on-chain and off-chain security energy blockchain architecture, specifically designed to meet the complex security requirements of multi-blockchain business environments. Concludingly, this paper identifies key directions for future research, particularly in advancing the integration of storage, management, and utilization of energy blockchain data security.

Abstract Effective watershed management hinges on understanding water sources and pollution origins. In the Hangbu Watershed of Chaohu Lake, China, we analyze pollution source patterns and propose an adaptive strategy. This adaptive strategy is defined as a flexible and dynamic approach that adjusts management practices and policies in response to evolving environmental conditions and emerging data on pollution sources. The analysis includes examining the trends, periodicity, and mutagenicity of pollution sources. The results demonstrated substantial variations in sources, with nitrogen and phosphorus. The adaptive approach enables prioritizing crucial pollution sources, with farmland identified as a significant contributor under varying conditions. Specific pollution sources with growth trends and control robustness have been recognized as vital contributors, even though their contributions to the nitrogen and phosphorus flux at the watershed outlets may not be the most prominent. The results of this study could guide the sustainable management of watersheds.

Abstract Background and aims Epidemiological evidence suggests that the phenotype of glutathione S-transferase mu 1 (GSTM1), a hepatic high-expressed phase II detoxification enzyme, is closely associated with the incidence of alcohol-related liver disease (ALD). However, whether and how hepatic GSTM1 determines the development of ALD is largely unclear. This study was designed to elucidate the role and potential mechanism(s) of hepatic GSTM1 in the pathological process of ALD. Methods GSTM1 was detected in the liver of various ALD mice models and cultured hepatocytes. Liver-specific GSTM1 or/and micro (miR)-743a-3p deficiency mice were generated by adenoassociated virus-8 delivered shRNA, respectively. The potential signal pathways involving in alcohol-regulated GSTM1 and GSTM1-associated ALD were explored via both genetic manipulation and pharmacological approaches. Results GSTM1 was significantly upregulated in both chronic alcohol-induced mice liver and ethanol-exposed murine primary hepatocytes. Alcohol-reduced miR-743a-3p directly contributed to the upregulation of GSTM1, since liver specific silencing miR-743a-3p enhanced GSTM1 and miR-743a-3p loss protected alcohol-induced liver dysfunctions, which was significantly blocked by GSTM1 knockdown. GSTM1 loss robustly aggravated alcohol-induced hepatic steatosis, oxidative stress, inflammation, and early fibrotic-like changes, which was associated with the activation of apoptosis signal-regulating kinase 1 (ASK1), c-Jun N-terminal kinase (JNK), and p38. GSTM1 antagonized ASK1 phosphorylation and its downstream JNK/p38 signaling pathway upon chronic alcohol consumption via binding with ASK1. ASK1 blockage significantly rescued hepatic GSTM1 loss-enhanced disorders in alcohol-fed mice liver. Conclusions Chronic alcohol consumption-induced upregulation of GSTM1 in the liver provides a feedback protection against hepatic steatosis and liver injury by counteracting ASK1 activation. Down-regulation of miR-743a-3p improves alcohol intake-induced hepatic steatosis and liver injury via direct targeting on GSTM1. The miR-743a-3p–GSTM1 axis functions as an innate protective pathway to defend the early stage of ALD. Graphical Abstract