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Trivalent chromium (Cr(III)) can form stable soluble complexes with organic components, altering its adsorption properties in the water-soil environment. This increases the risk of Cr(III) migrating to deeper soils and transforming into toxic Cr(VI) due to the presence of manganese oxides in sediments. In this study, Citric Acid (CA) was selected as a representative organic ligand to prepare and characterize Cr(III)-CA complexes. The characteristics, mechanisms and environmental factors influencing the adsorption of Cr(III)-CA on porous media (silts and fine sands) were investigated in the study. The results show that Cr(III) coordinates with CA at a 1:1 molar ratio, forming stable and soluble Cr(III)-CA complexes. Compared to Cr(III) ions, the equilibrium adsorption capacity of Cr(III)-CA is an order of magnitude lower in silts and fine sands. The adsorption of Cr(III)-CA in silts and fine sands is dominated by chemical adsorption of monolayers, following the pseudo-second-order kinetic equation and the Langmuir isotherm adsorption model. Varying contents of clay minerals and iron-aluminum oxides prove to be the main causes of differences in adsorption capacity of Cr(III)-CA in silts and fine sands. Changes in solution pH affect the adsorption rate and capacity of Cr(III)-CA by altering its ionic form. The adsorption process is irreversible and only minimally influenced by ionic strength, suggesting that inner-sphere complexation serves as the dominant Cr(III)-CA adsorption mechanism.

ABSTRACT Carbapenem-resistant hypervirulent Klebsiella pneumoniae (CR-hvKP) strains present a significant global public health threat due to their high mortality rates. This study investigated the genomic characteristics of seven ST11-K1 CR-hvKP isolates harboring highly homologous KPC-2-encoding multidrug-resistance plasmids. The strains were isolated from a Chinese tertiary hospital between 2017 and 2020. Whole-genome sequencing and bioinformatic analysis revealed various antibiotic resistance genes (ARGs) and virulence determinants. The blaKPC-2-bearing plasmids that contain multiple antibiotic-resistance genes were also identified in these strains. ISfinder and Orifinder were applied to identify insertion sequences (IS) and conjugation-related factors among these blaKPC-2-bearing plasmids. The blaKPC-2 was highly consistent in seven blaKPC-2-bearing plasmids (ISKpn6-blaKPC-2-ISKpn27-ISYps3-IS26). In addition, we found a region composed of ISIR, Tn5393, and IS26. It was located upstream of the blaCTX-M-15 gene and presented in six blaKPC-2-bearing plasmids, with pCR-hvKP221-KPC-P3 as an exception. Conjugation experiments demonstrated the horizontal transfer of resistance plasmids pCR-hvKP128-KPC-P1 and pCR-hvKP132-KPC-P1 across species. Notably, pLVPK-like virulence plasmids carrying virulence gene clusters pCR-hvKP173-Vir-P1, and pCR-hvKP221-Vir-P1 were also detected. A fusional plasmid pCR-hvKP221-Vir-P2, which carries virulence gene clusters and ARGs, was also identified. Five CR-hvKP strains displayed enhanced biofilm formation and high virulence in vivo infection models. Phylogenetic and single nucleotide polymorphism (SNP) analyses indicated a close genetic relationship among the isolates, suggesting a subclade. These findings highlight the complex genetic profiles and potential transmission mechanisms of CR-hvKP strains.IMPORTANCEWe reported seven CR-hvKP strains all carried a highly homologous blaKPC-2 integrated IncFⅡ-resistant plasmid, and two strains harbored virulence plasmids. Conjugation experiments confirmed the transferability of these plasmids, indicating a potential for resistance spread. Phylogenetic analysis clarified the relationship among the CR-hvKP isolates. This study provides insights into the phenotypic and genomic characteristics of seven ST11-K1 CR-hvKP strains. The high prevalence and potential for local outbreaks emphasize the need for effective control measures.

Abstract Purpose The prognostic and predictive value of RAS mutations in patients with colorectal liver metastases (CRLM) who have undergone hepatectomy holds substantial importance. The present study aimed to investigate the impact of different RAS codon mutations on long‐term survival in CRLM patients. Methods A retrospective analysis was conducted on clinicopathological data from 399 CRLM patients with RAS mutations who underwent hepatectomy between January 2000 and December 2020. The RAS mutation gene status was assessed in KRAS codons (G12, G13, Q61, and A146) and NRAS codons (G12, G13, and Q61). Survival curves were generated using the Kaplan–Meier plotter and compared using the log‐rank test. Univariate and multivariate analyses were performed to analyze the clinicopathological data. Results In the entire cohort, patients with KRAS G12 mutations exhibited the most favorable prognosis (p = 0.018). Comparatively, patients harboring KRAS Q61 mutations experienced poorer overall survival (OS) with a median of 15 months versus 33 months (p = 0.011) when compared to those with KRAS G12 mutations. Moreover, patients with NRAS Q61 mutations also showed decreased OS with a median of 26 months versus 33 months (p = 0.020) in comparison to KRAS G12 mutation patients. The results of multivariate analysis showed that both KRAS Q61 mutation (HR 2.130; 95% CI 1.088–4.168; p = 0.027) and NRAS Q61 mutation (HR 2.877; 95% CI 1.398–5.922; p = 0.004) were independent influencing factors of OS. Based on all identified risk factors, patients with RAS mutation were divided into high‐risk and low‐risk groups. Notably, in the high‐risk group, the incorporation of postoperative chemotherapy was associated with longer OS, while it did not improve the survival of patients in the low‐risk group. Conclusions KRAS Q61 and NRAS Q61 mutations are promising predictors for OS in CRLM patients after hepatectomy. Postoperative chemotherapy may significantly benefit CRLM patients with RAS mutations, particularly those identified as high‐risk.

Nonalcoholic fatty liver disease (NAFLD) is marked by hepatic steatosis accompanied by an inflammatory response. At present, there are no approved therapeutic agents for NAFLD. Dendrobium Huoshanense polysaccharide (DHP), an active ingredient extracted from the stems of Dendrobium Huoshanense, and exerts a protective effect against liver injury. However, the therapeutic effects and mechanisms of action DHP against NAFLD remain unclear. DHP was extracted, characterized, and administered to mice in which NAFLD had been induced with a high-fat and high-fructose drinking (HFHF) diet. Our results showed that DHP used in this research exhibits the characteristic polysaccharide peak with a molecular weight of 179.935 kDa and is composed primarily of Man and Glc in a molar ratio of 68.97:31.03. DHP treatment greatly ameliorated NAFLD by significantly reducing lipid accumulation and the levels of liver function markers in HFHF-induced NAFLD mice, as evidenced by decreased serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol (TC) and total triglyceride (TG). Furthermore, DHP administration reduced hepatic steatosis, as shown by H&E and Oil red O staining. DHP also inhibited the Toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) signaling pathway expression, thereby reducing levels of hepatic proinflammatory cytokines. Besides, untargeted metabolomics further indicated that 49 metabolites were affected by DHP. These metabolites are strongly associated the metabolism of glycine, serine, threonine, nicotinate and nicotinamide, and arachidonic acid. In conclusion, DHP has a therapeutic effect against NAFLD, whose underlying mechanism may involve the modulation of TLR4/NF-κB, reduction of inflammation, and regulation of the metabolism of glycine, serine, threonine, nicotinate and nicotinamide metabolism, and arachidonic acid metabolism.

Abstract Objective The objective of this study is to explore the relationship between family communication, family violence, problematic internet use, anxiety, and depression and validate their potential mediating role. Methods The study population consisted of Chinese adolescents aged 12 to 18 years, and a cross-sectional survey was conducted in 2022. Structural equation models were constructed using AMOS 25.0 software to examine the factors that influence adolescent anxiety and depression and the mediating effects of problematic internet use and family violence. Results The results indicate that family communication was significantly and negatively related to family violence (β = -.494, p

AIM: To observe the clinical efficacy of Yishen Yanggan Mingmu formula combined with anti-vascular endothelial growth factor(VEGF)in the treatment of wet age-related macular degeneration(wARMD).METHODS: A total of 58 patients(58 eyes)with wARMD who were treated in Ningbo Eye Hospital from September 2020 to November 2022 were collected. They were divided into two groups according to randomized digital table: 29 patients(29 eyes)for the combination group and the other 29 patients(29 eyes)for the injection group. The injection group was only given intravitreal injection of conbercept; the combination group was orally administrated with Yishen Yanggan Mingmu formula combined with intravitreal injection of conbercept. The best corrected visual acuity(BCVA), central macular thickness(CMT)and the improvement of traditional Chinese medicine(TCM)syndromes after 3mo of treatment were observed and the clinical efficacy was evaluated.RESULTS: After 3mo of treatment, the total improved effective rate of the combination group(76%)was higher than the rate of the injection group(66%). After the treatment, the BCVA of the two groups was both higher than that before treatment(P

Background: Thromboelastogram (TEG) is an effective indicator that monitors the dynamic changes of blood coagulation in real-time. It still remains controversial about the performance and influence of coagulation at high altitude. The present study intends to describe comprehensively the clinical features of TEG in populations exposed to or transferring from high altitude. Methods: Two groups were recruited in the present study. Group A included young males who worked at high-altitude (4888 m or 5418 m) areas for some time, while Group B included young males who had recently returned from high-altitude (4888 m or 5418 m) areas. Medical examinations were performed using portable devices. Spearman's test was used to evaluate the correlations between thromboelastogram (TEG) variables and other variables. Logistic regression analysis was used to analyze the factors affecting various abnormal TEG variables. Results: A total of 51 adult males were included in the two groups. Significantly increased reaction time (R) and decreased maximum amplitude (MA) were found in group B (P

AIM: To introduce and evaluate the clinical efficacy of a new technique, the use of viscoelastic substances (VS) to close leaking sclerotomy in 23G microincision vitrectomy, and to observe its effect on the visual acuity and intraocular pressure (IOP) of patients. METHODS: Patients who underwent 23G vitrectomy in Ningbo Eye Hospital before the use of VS technique (June 2019 to September 2020) and after the use of VS technique (October 2020 to December 2021) were selected as the subjects of this study. The above cases underwent operation by the same surgeon and were retrospectively analyzed. VS technique was used as the alternative to suturing, in which a small amount of VS was injected at the leaking sclerotomy and then gently massaged to confirm leaking sclerotomy closure. RESULTS: A total of 174 eyes were covered in the study, including 84 eyes in the control group (before the use of VS technique) and 90 eyes in the VS technique group. The number of eyes that needed to be sutured decreased considerably from 42.9% in the control group to 3.3% in the VS technique group, and the proportion of subconjunctival hemorrhage at 1-2d after surgery decreased remarkably from 35.7% in the control group to 2.2% in the VS technique group. No substantial differences in the incidence of mean IOP and low IOP were found between 1-2 and 3-20d after surgery in the VS technique group. No major complications associated with VS technique were identified during the study. CONCLUSION: In 23G microincision vitrectomy, VS technique is a safe, simple, and effective method to close leaking sclerotomy.

AIM: To investigate whether nintedanib can inhibit pterygium cells through the fibroblast growth factor receptor 2 (FGFR2)/extracellular-signal-regulated kinase (ERK) pathway. METHODS: Human primary pterygium cells were cultured in vitro. After treatment with nintedanib, the cell morphology was observed under microscopy, the morphological changes of the nucleus were observed after DAPI staining, apoptosis was analyzed by Annexin-V FITC/PI double staining, and the changes of apoptosis-associated proteins were detected by Western blot. The binding ability of nintedanib to FGFR2 was predicted by molecular docking. Finally, by silencing FGFR2, we explored whether nintedanib inhibited FGFR2/ERK pathway. RESULTS: The results showed that nintedanib inhibited the growth of pterygium cells and caused nuclear pyknosis. The results of Annexin-VFITC/PI double staining showed that nintedanib was able to induce early and late apoptosis of pterygium cells, significantly increasing the expression of apoptosis-associated proteins Bax and cleaved-Caspase3 (P0.05). CONCLUSION: Nintedanib induces apoptosis of pterygium cells by inhibiting FGFR2/ERK pathway.

AIM: To investigate the effect of nasolacrimal duct packing combined with sodium hyaluronate gel injection in locating the nasal broken end in lacrimal canaliculus anastomosis which is difficult to find the broken end.METHODS:A total of 13 patients(13 eyes)with traumatic single lacrimal canaliculus rupture were treated in our hospital. RS lacrimal duct drainage tube was inserted into the lacrimal duct from intact lacrimal canaliculus to fill the nasolacrimal duct, then sodium hyaluronate gel was injected to make sodium hyaluronate gel overflow from the nasal broken end of fractured lacrimal canaliculus, which was used to locate the nasal broken end which was difficult to find and completed the lacrimal anastomosis operation.RESULTS: Among the patients with 13 eyes who were difficult to find the broken end, the nasolacrimal duct was filled with RS lacrimal duct drainage tube. After injection of sodium hyaluronate gel, the gel overflowed from the nasal broken end under direct vision of the microscope, and the lacrimal duct drainage tube was successfully inserted, and the success rate of finding the broken end was 100%. Thirteen eyes were extubated after being placed for 3mo, and then were followed up for 6mo. Among them, 9 eyes were cured, 3 eyes were markedly effective and 1 eye was ineffective. The cure rate was 69%, and the total effective rate was 92%.CONCLUSION: A new technique for rapid location of nasal broken end is proposed for patients in which are difficult to find the broken end. This method is simple to operate and requires a relatively low clinical experience. It is suitable for patients with different degrees of single lacrimal canaliculus rupture and can complete complex lacrimal canaliculus rupture anastomosis in a short time.

Diamide derivatives are biologically active molecules that have been widely applied in recent years in research on pesticides, especially insecticides. Using a simple and environmentally friendly scheme, a series of new diamide derivatives containing a trifluoromethylpyridine skeleton was designed, synthesized, and confirmed by 1H, 19F and 13C NMR, and HR-MS. Their insecticidal activities against Plutella xylostella and Helicoverpa armigera were measured and the relationship between structure and activity was investigated. Eight of the title compounds (D2, D5, D10, D21, D28, D29, D30 and D33) showed 100% activity against P. xylostella at 500 mg L–1. One compound, D33, still showed 100% activity against P. xylostella at 100 mg L–1 and had the lowest LC50 (lethal concentration 50%, 3.7 mg L–1) among the synthesized compounds. Molecular docking analysis revealed that D33 could be thoroughly embedded in the active pocket of the ryanodine receptor via hydrogen bonding in a manner similar to the commercial insecticide chlorantraniliprole.

Abstract Background Multiple liver metastases is considered a risk factor for overall survival of colorectal liver metastases patients (CRLM) after curative resection. However, whether the prognostic factors were constant in patients with various liver metastases (LM) numbers has not been adequately investigated. This retrospective study aimed to evaluate the changing of prognostic factors on overall survival (OS) in CRLM patients with various LM after curative resection. Methods Patients who underwent liver resection for CRLM between January 2000 and November 2020 were retrospectively studied. They were divided into three subgroups according to LM numbers by X-tile analysis. Multivariable analysis identified prognostic factors in each subgroup. Nomograms were built using different prognostic factors in three subgroups, respectively. Performance of the nomograms was assessed according to the concordance index (C-index) and calibration plots. The abilities of different scoring systems predicting OS were compared by calculating the area under the time-dependent receiver operating characteristic (ROC) curve (AUC). Results A total of 1095 patients were included. Multivariable analysis showed tumor number increasing was an independent risk factor. Patients were subsequently divided into 3 subgroups according to the number of LM by X-tile analysis, namely solitary (n = 375), 2–4 (n = 424), and ≥ 5 (n = 296). The 3-year and 5-year OS rates were 64.1% and 54.0% in solitary LM group, 58.1% and 41.7% in 2–4 LM group, and 50.9% and 32.0% in ≥ 5 LM group, respectively (p < 0.001). In multivariable analysis, RAS mutation was the only constant independent risk factor in all subgroups. The nomograms were built to predict survival based on independent factors in three subgroups. The C-index for OS prediction was 0.707 (95% CI 0.686–0.728) in the solitary LM group, 0.695 (95% CI 0.675–0.715) in the 2–4 LM group, and 0.687 (95% CI 0.664–0.710) in the ≥ 5 LM group. The time-dependent AUC values of nomograms developed using different risk factors after stratifying patients by tumor number were higher than the traditional scoring systems without patient stratification. Conclusions The prognostic factors varied among CRLM patients with different LM numbers. RAS mutation was the only constant risk factor. Building prediction models based on different prognostic factors improve patient stratification.

Understanding the complex interplay between the processes of mineral crystallization and the incorporation of trace elements, particularly in economically significant deposits like Carlin-type gold systems, is essential for unraveling geological processes. This study investigates the microscale to nanoscale texture and composition of weakly deformed arsenian pyrite from the Shangmanggang Carlintype Au deposit in Southwest China, employing advanced techniques such as scanning transmission electron microscopy and atom probe tomography. Trace element-rich oscillatory zones in the pyrite are characterized by ~30-nm-thick bands enriched in As, Au, and Cu. Cu, As, Sb, Pb, Hg, and Tl are distributed heterogeneously and form clusters and discontinuous planar features on the outer edge of As-rich oscillatory bands. Discontinuous planar features, nucleating from trace element-enriched clusters, are oriented approximately in line with the direction of epitaxial growth. The nanoscale epitaxial growth zones are likely the result of the incorporation of impurity defects coupled with diffusion-limited self-organization and fluctuations in fluid composition. Arsenic-induced lattice distortion facilitates surface adsorption of dopant trace metals, which leads to "unstructured" impurities (Sb, Pb, Hg, and Tl) clustering locally in misfit crystal defects. The transition from homogeneous element distribution in As-rich bands to clustered trace elements suggests a Stranski-Krastanov growth process. Discontinuous planar features may represent the propagation of crystal defects locally and the further incorporation of trace elements. Our study provides insights into the factors governing the heterogeneous incorporation of trace elements, particularly Au, into pyrite during epitaxial growth. [ABSTRACT FROM AUTHOR]

Abstract Epidemiological studies have indicated that natural disasters have important impacts on ischemic stroke. This study determined the associations between natural disasters and the incidence and prevalence of ischemic stroke at the global level. A 28-year ecological trend study was performed to estimate worldwide changes in the incidence and prevalence of ischemic stroke and their associations with natural disasters by analyzing data from 193 countries. Quantum geographic information system-based visualization and multivariable linear regression were used. Changes in the incidence and prevalence of ischemic stroke, as well as disaster occurrence, varied among the different regions over the past 28 years (p

Abstract Intravitreal anti-VEGF (anti-vascular endothelial growth factor) biologics have revolutionized the pharmacological management of chorioretinal diseases. However, the systemic adverse events such as stroke or bleeding are the concerns for many patients and physicians. The mechanism to develop these side effects are poorly understood. Consecutive 95 patients with retinal diseases were studied for their blood activated partial thromboplastin time (APTT), prothrombin time (PT), international normalized ratio (INR), and concentration of fibrinogen before and after intravitreal conbercept. Additionally, plasma nitric oxide (NO) and endothelin-1 (ET-1) were investigated on 38 of the 95 patients. Compared with the pre-injection, 4-week post-injection values of APTT and PT were increased by 0.582 s (p = 0.038, paired t test) and by 0.086 s (p = 0.080, paired t test; p = 0.0475, Sign test), respectively. At the same time, fibrinogen decreased by 0.048 g/L. Plasma levels of NO or ET-1 or VEGF did not significantly change from pre-injection levels. Our findings advanced the understanding of mechanism for systemic side effects associated with intravitreal anti-VEGF and emphasized paying more attention to higher risk of possible bleedings for patients following intravitreal conbercept.

ObjectiveThe present study was aimed at investigating the intelligence profiles and adaptive behaviors of children with high-functioning autism spectrum disorder (HFASD) and developmental speech and language disorders (DSLDs). We compared the similarities and differences of cognitive capabilities and adaptive functions and explored their correlations in the HFASD and DSLDs groups.Methods128 patients with HFASD, 111 patients with DSLDs and 114 typically developing (TD) children were enrolled into our study. Wechsler Intelligence Scale for Children-IV (WISC-IV) and Adaptive Behavior Assessment System-II (ABAS-II) were respectively applied to evaluate intelligence profiles and adaptive behaviors. Intelligence quotient (IQ) scores and adaptive functioning scores among the HFASD, DSLDs and TD groups were compared through one-way ANOVA. Pearson correlation coefficient was applied to examine the relationships between WISC indices and ABAS domains.ResultsOutcomes showed significantly poorer intelligence profiles and adaptive behaviors in HFASD and DSLDs groups. Both children with HFASD and DSLDs demonstrated impairments in verbal comprehension and executive functions. Processing speed and working memory were the predominant defects of children with HFASD and DSLDs in the field of executive functions, respectively. Whereas perceptual reasoning was a relative strength for them. Children with DSLDs had balanced scores of all the domains in ABAS-II; nevertheless, HFASD individuals demonstrated striking impairments in Social domain. Correlation analysis showed IQs of children with HFASD were positively correlated with all the domains and General Adaptive Composite (GAC) of ABAS-II. Additionally, IQs were positively correlated with Conceptual domain and GAC for children with DSLDs. Compared with DSLDs group, intelligence displayed stronger correlations with adaptive behaviors in HFASD group.ConclusionOur study expanded insights regarding intelligence profiles and adaptive behaviors of children with HFASD and DSLDs. Moreover, this study made breakthroughs in discovering positive correlations between IQs and adaptive functions in the two neurodevelopmental disorders.

Background. There are few studies comparing recurrences between endoscopic retrograde cholangiopancreatography (ERCP) and open choledochotomy (OCT). Aims. To compare the effect of different surgical methods on single and multiple recurrences of choledocholithiasis. Methods. A total of 1255 patients with choledocholithiasis who underwent ERCP or OCT were retrospectively studied. The recurrence of choledocholithiasis was calculated by the Kaplan–Meier method with the log-rank test. Multivariate analyses of recurrent choledocholithiasis were performed by introducing variables with P

Biotic and abiotic factors influence the formation of fungal–algal pairings in lichen symbiosis. However, the specific determinants of these associations, particularly when distantly related fungi are involved, remain poorly understood. In this study, we investigated the impact of different drivers on the association patterns between taxonomically diverse lichenized fungi and their trebouxioid symbiotic partners. We collected 200 samples from four biomes and identified 41 species of lichenized fungi, associating them with 16 species of trebouxioid green algae, of which 62% were previously unreported. The species identity of both the fungal and algal partners had the most significant effect on the outcome of the symbiosis, compared to abiotic factors like climatic variables and geographic distance. Some obviously specific associations were observed in the temperate zone; however, the nestedness value was lower in arid regions than in cold, polar, and temperate regions according to interaction network analysis. Cophylogenetic analyses revealed congruent phylogenies between trebouxioid algae and associated fungi, indicating a tendency to reject random associations. The main evolutionary mechanisms contributing to the observed phylogenetic patterns were “loss” and “failure to diverge” of the algal partners. This study broadens our knowledge of fungal–algal symbiotic patterns in view of Trebouxia-associated fungi.

BackgroundThe use of neoadjuvant chemotherapy (NAC) in resectable colorectal liver metastases (CRLM) patients is controversial. High-risk patients are more likely to benefit from NAC despite its hepatotoxic effects. Since patients with a high tumor burden receive NAC more frequently, previous retrospective studies have imbalanced baseline characteristics. The results of randomized controlled trials are still pending. This study aimed to assess the efficacy of NAC in resectable CRLM patients with high clinical risk scores (CRS) proposed by Fong et al. after balancing baseline characteristics by propensity score matching (PSM).MethodsResectable CRLM patients with high CRS (3-5) undergoing hepatectomy between January 2003 and May 2021 were retrospectively studied. Patients were divided into the NAC and the upfront surgery group. Survival outcomes and surgical outcomes were compared after PSM.ResultsThe current study included 322 patients with a median follow-up of 40 months. After one-to-two PSM, patients were matched into the upfront surgery group (n = 56) and the NAC group (n = 112). Baseline characteristics were balanced after matching. There was no difference in long-term progression-free survival (PFS), while overall survival (OS) from the initial diagnosis was improved in the NAC group (P = 0.048). Postoperative hospital stays were shorter in the NAC group (P = 0.020). Surgical outcomes were similar, including major hepatectomy rate, intraoperative ablation rate, blood loss, operative time, perioperative blood transfusion, positive surgical margin, and postoperative intensive care unit stay. In multivariable analysis, RAS mutation, maximum tumor diameter≥3cm, and no NAC were independent risk factors for OS. The 1-year PFS in the NAC group was improved, although it failed to reach a statistical difference (P = 0.064).ConclusionsNAC could improve OS in resectable CRLM patients with high CRS (3-5) and have a shorter postoperative hospital stay.

BackgroundEarly detection of children with autism spectrum disorder (ASD) and comorbid intellectual disability (ID) can help in individualized intervention. Appropriate assessment and diagnostic tools are lacking in primary care. This study aims to explore the applicability of machine learning (ML) methods in diagnosing ASD comorbid ID compared with traditional regression models.MethodFrom January 2017 to December 2021, 241 children with ASD, with an average age of 6.41 ± 1.96, diagnosed in the Developmental Behavior Department of the Children’s Hospital Affiliated with the Medical College of Zhejiang University were included in the analysis. This study trained the traditional diagnostic models of Logistic regression (LR), Support Vector Machine (SVM), and two ensemble learning algorithms [Random Forest (RF) and XGBoost]. Socio-demographic and behavioral observation data were used to distinguish whether autistic children had combined ID. The hyperparameters adjustment uses grid search and 10-fold validation. The Boruta method is used to select variables. The model’s performance was evaluated using discrimination, calibration, and decision curve analysis (DCA).ResultAmong 241 autistic children, 98 (40.66%) were ASD comorbid ID. The four diagnostic models can better distinguish whether autistic children are complicated with ID, and the accuracy of SVM is the highest (0.836); SVM and XGBoost have better accuracy (0.800, 0.838); LR has the best sensitivity (0.939), followed by SVM (0.952). Regarding specificity, SVM, RF, and XGBoost performed significantly higher than LR (0.355). The AUC of ML (SVM, 0.835 [95% CI: 0.747–0.944]; RF, 0.829 [95% CI: 0.738–0.920]; XGBoost, 0.845 [95% CI: 0.734–0.937]) is not different from traditional LR (0.858 [95% CI: 0.770–0.944]). Only SVM observed a good calibration degree. Regarding DCA, LR, and SVM have higher benefits in a wider threshold range.ConclusionCompared to the traditional regression model, ML model based on socio-demographic and behavioral observation data, especially SVM, has a better ability to distinguish whether autistic children are combined with ID.

Engineering Nanoparticles (ENPs)' superior characteristics of adsorption depends on their dispersion in the medium. In this study, multi-walled carbon nanotubes (nonmetal), iron nanoparticles and silver nanoparticles (metallic simple substance), and Nano-TiO2, Nano-Fe2O3 and Nano-ZnO (metal oxide) were selected and respectively added into pure water and aqueous solution with 1% Sodium dodecyl benzene sulfonate (SDBS) surfactant. The dispersion effects were compared by leaving the solutions standing at room temperature under ultrasound. The results show that the dispersion of iron nanoparticles is the lowestamong the six ENPs, and that of multi-walled carbon nanotubes (MWCTS) is the highest. Adding anionic surfactants (SDBS) can obviously improve the dispersion performance of ENPs. The concentration of solution decreases by only 5% in 10 daysafter adding 1% SDBS for ultrasonic dispersion.

Alcoholic liver disease (ALD) is a major worldwide chronic liver disease accompanied by hepatic inflammation, gut leakiness, and abnormal oxidative stress. Our previous study demonstrated substantial hepatoprotective activity of the active Poria cocos polysaccharide (PCP-1C). The present study explored whether PCP-1C protects against ALD among hepatic inflammation, gut leakiness, and abnormal oxidative stress. The results showed that PCP-1C significantly improved alcohol-induced liver injury by decreasing serum biochemical parameters, alleviating hepatic steatosis, and reducing lipid accumulation caused by ALD. Moreover, PCP-1C treatment reduced hepatic inflammation by inhibiting the toll-like receptor 4 (TLR4)/nuclear factor-kappa B (NF-κB) signaling pathway and also improved hepatocyte apoptosis by inhibiting the cytochrome P450 2E1 (CYP2E1)/reactive oxygen species (ROS)/mitogen-activated protein kinases (MAPKs) signaling pathway. Regarding intestinal protection, PCP-1C could repair the intestinal barrier and reduce lipopolysaccharide (LPS) leakage. Generally, PCP-1C exerts a positive therapeutic effect on ALD, which may play a pivotal of decreasing inflammatory factor release, inhibiting oxidative stress and apoptosis, and improving intestinal barrier injury.

Abstract Background To develop a nomogram for predicting the International Study Group of Liver Surgery (ISGLS) grade B/C posthepatectomy liver failure (PHLF) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients. Methods Patients initially treated with hepatectomy were included. Univariate regression analysis and stochastic forest algorithm were applied to extract the core indicators and reduce redundancy bias. The nomogram was then constructed by using multivariate logistic regression, and validated in internal and external cohorts, and a prospective clinical application. Results There were 900, 300 and 387 participants in training, internal and external validation cohorts, with the morbidity of grade B/C PHLF were 13.5, 11.0 and 20.2%, respectively. The nomogram was generated by integrating preoperative total bilirubin, platelet count, prealbumin, aspartate aminotransferase, prothrombin time and standard future liver remnant volume, then achieved good prediction performance in training (AUC = 0.868, 95%CI = 0.836–0.900), internal validation (AUC = 0.868, 95%CI = 0.811–0.926) and external validation cohorts (AUC = 0.820, 95%CI = 0.756–0.861), with well-fitted calibration curves. Negative predictive values were significantly higher than positive predictive values in training cohort (97.6% vs. 33.0%), internal validation cohort (97.4% vs. 25.9%) and external validation cohort (94.3% vs. 41.1%), respectively. Patients who had a nomogram score

Abstract Background Frailty is now seen as a significant factor in older people with diabetes, whose mortality and disability increased. This study aims to investigate the association between calf circumference (CC) with frailty in diabetic adults aged over 80 years. Methods A cross-sectional analysis was performed on the data of 426 diabetic adults aged over 80 years. On admission, demographic data and laboratory parameters were recorded. CC was measured on the lower right leg at the point of the maximal circumference. All participants accepted frailty assessments. Frailty was mainly defined using the Fried frailty phenotype criteria. Results The CC levels were significantly lower in the frail than the non-frail (26.7 ± 4.0 vs. 31.2 ± 4.0, P

Abstract In the chiral unitary approach, we have studied the single Cabibbo-suppressed decays $$\Lambda _c\rightarrow pK^+K^-$$ Λ c → p K + K - and $$\Lambda _c \rightarrow p \pi ^+\pi ^-$$ Λ c → p π + π - by taking into account the s-wave meson–meson interaction as well as the contributions from the intermediate vectors $$\phi $$ ϕ and $$\rho ^0$$ ρ 0 . Our theoretical results for the ratios of the branching fractions of $$\Lambda _c\rightarrow p {\bar{K}}^{*0}$$ Λ c → p K ¯ ∗ 0 and $$\Lambda _c\rightarrow p \omega $$ Λ c → p ω with respect to the one of $$\Lambda _c\rightarrow p \phi $$ Λ c → p ϕ are in agreement with the experimental data. Within the picture that the scalar resonances $$f_0(500)$$ f 0 ( 500 ) , $$f_0(980)$$ f 0 ( 980 ) , and $$a_0(980)$$ a 0 ( 980 ) are dynamically generated from the pseudoscalar-pseudoscalar interactions in s-wave, we have calculated the $$K^+K^-$$ K + K - and $$\pi ^+\pi ^-$$ π + π - invariant mass distributions respectively for the decays $$\Lambda _c\rightarrow pK^+K^-$$ Λ c → p K + K - and $$\Lambda _c\rightarrow p\pi ^+\pi ^-$$ Λ c → p π + π - . One can find a broad bump structure for the $$f_0(500)$$ f 0 ( 500 ) and a narrow peak for the $$f_0(980)$$ f 0 ( 980 ) in the $$\pi ^+\pi ^-$$ π + π - invariant mass distribution of the decay $$\Lambda _c\rightarrow p\pi ^+\pi ^-$$ Λ c → p π + π - . For the $$K^+K^-$$ K + K - invariant mass distribution, in addition to the narrow peak for the $$\phi $$ ϕ meson, there is an enhancement structure near the $$K^+K^-$$ K + K - threshold mainly due to the contribution from the $$f_0(980)$$ f 0 ( 980 ) . Both the $$\pi ^+\pi ^-$$ π + π - and $$K^+K^-$$ K + K - invariant mass distributions are compatible with the BESIII measurement. We encourage our experimental colleagues to measure these two decays, which would be helpful to understand the nature of the $$f_0(500)$$ f 0 ( 500 ) , $$f_0(980)$$ f 0 ( 980 ) , and $$a_0(980)$$ a 0 ( 980 ) .

Abstract Background Twin growth discordance was demonstrated to be a risk factor for adverse perinatal outcomes, and prenatal ultrasonographic methods were utilized to predict twin growth discordance to improve outcomes. The results currently reported are not consistent due to the poor unified parameters and gestational durations. Methods A total of 71 dichorionic twins with growth discordance and 346 dichorionic twins with normal growth were respectively included in the retrospective cohort study. The weight discordance of more than 25% was defined as a “growth discordant twin”. The clinical baseline information, maternal outcomes, twin birth weights and fetal growth parameters (which were measured by ultrasound) were compared between the two groups from early gestation to late gestation. Multiple logistic regression and receiver operating characteristic curves were adopted to evaluate the predictive value of the growth parameters. Results Compared with normal dichorionic twins, the clinical baseline conditions were similar in the twins those finally developed growth discordance. The fetal growth parameters and the deepest volume pocket of amniotic fluid in early and mid-pregnancy showed no obvious predictive values. The fetal growth parameters in late pregnancy showed predictive values, especially the discordance of estimated fetal weight (EFW) in the early third-trimester (P

Objectives：MiR-140 and DNAJC3-AS1 have been proven to play critical roles in cancer biology, while their participations in acute myeloid leukemia (AML) are unclear. This study aimed to explore the role of miR-140 and DNAJC3-AS1 in AML. Methods：Analysis of the expression of DNAJC3-AS1 and miR-140 was done with RT-qPCR. The role of DNAJC3-AS1 and miR-140 in the expression of each other was explored with overexpression assay. The direct interaction between DNAJC3-AS1 and miR-140 was analyzed with RNA pull-down assay. The subcellular location of DNAJC3-AS1 was explored with cellular subcellular fractionation assay. Cell proliferation analysis was done with BrdU assay. Results：AML patients showed increased expression of DNAJC3-AS1 and decreased expression of miR-140. DNAJC3-AS1 was detected in both nuclear and cytoplasm samples, and a direct interaction between DNAJC3-AS1 and miR-140 was observed. Discussion：Reduced expression of DNAJC3-AS1 was observed after miR-140 overexpression in AML cells. DNAJC3-AS1 increased cell proliferation and inhibited the role of miR-140 in suppressing cell proliferation. Conclusion：In conclusion, miR-140 may target DNAJC3-AS1 to suppress cell proliferation in AML.

Nonalcoholic fatty liver disease (NAFLD) is marked by hepatic steatosis accompanied by an inflammatory response. At present, there are no approved therapeutic agents for NAFLD. Dendrobium Huoshanense polysaccharide (DHP), an active ingredient extracted from the stems of Dendrobium Huoshanense, and exerts a protective effect against liver injury. However, the therapeutic effects and mechanisms of action DHP against NAFLD remain unclear. DHP was extracted, characterized, and administered to mice in which NAFLD had been induced with a high-fat and high-fructose drinking (HFHF) diet. Our results showed that DHP used in this research exhibits the characteristic polysaccharide peak with a molecular weight of 179.935 kDa and is composed primarily of Man and Glc in a molar ratio of 68.97:31.03. DHP treatment greatly ameliorated NAFLD by significantly reducing lipid accumulation and the levels of liver function markers in HFHF-induced NAFLD mice, as evidenced by decreased serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol (TC) and total triglyceride (TG). Furthermore, DHP administration reduced hepatic steatosis, as shown by H&E and Oil red O staining. DHP also inhibited the Toll-like receptor 4 (TLR4)/nuclear factor- kappa B (NF-κB) signaling pathway expression, thereby reducing levels of hepatic proinflammatory cytokines. Besides, untargeted metabolomics further indicated that 49 metabolites were affected by DHP. These metabolites are strongly associated the metabolism of glycine, serine, threonine, nicotinate and nicotinamide, and arachidonic acid. In conclusion, DHP has a therapeutic effect against NAFLD, whose underlying mechanism may involve the modulation of TLR4/NF-κB, reduction of inflammation, and regulation of the metabolism of glycine, serine, threonine, nicotinate and nicotinamide metabolism, and arachidonic acid metabolism. [ABSTRACT FROM AUTHOR]

Background: Recent studies have reported an association between natural disasters of various kinds and ischemic heart disease (IHD). We investigated the association between Disability-adjusted life years (DALYs) due to IHD and natural disasters and aimed to assess DALYs as a quantification of the burden of IHD related to natural disasters at the global level. Methods: Country-specific data of natural disaster impacts DALYs due to IHD and socioeconomic variables were obtained from open sources over the period of 1990–2013 and 2014–2017. A population-based trend ecological design was conducted to estimate the association between trends in DALYs and natural disasters (occurrence, casualties and total damage), adjusting for socioeconomic variables. Results: Most countries have experienced increases in natural disaster occurrences and decreases in DALYs during this study period. The unadjusted correlation analysis demonstrated a positive and significant correlation between DALYs and natural disasters for females and for both sexes (R = 0.163 and 0.146, p = 0.024 and 0.043), and a marginally significant correlation for males (R = 0.128, p = 0.076). After adjusting for socioeconomic variables, multiple linear regression demonstrated independent associations between the occurrence and DALYs due to IHD for males, females and both sexes (standardized coefficients = 0.192, 0.23 and 0.187, p = 0.016, 0.004 and 0.022). Conclusions: A weak but significantly positive association between natural disaster and IHD was confirmed and quantified at the global level by this DALY metric analysis. Adaptation strategies for natural disaster responses and IHD disease burden reduction need to be developed.

Deficiency of the DNA damage repair (DDR) signaling pathways is potentially responsible for genetic instability and oncogenesis in tumors, including colorectal cancer. However, the correlations of mutated DDR signaling pathways to the prognosis of colorectal cancer liver metastasis (CRLM) after resection and other clinical applications have not been fully investigated. Here, to test the potential correlation of mutated DDR pathways with survival and pre-operative chemotherapy responses, tumor tissues from 146 patients with CRLM were collected for next-generation sequencing with a 620-gene panel, including 68 genes in 7 DDR pathways, and clinical data were collected accordingly. The analyses revealed that 137 of 146 (93.8%) patients had at least one mutation in the DDR pathways. Mutations in BER, FA, HRR and MMR pathways were significantly correlated with worse overall survival than the wild-types (P < 0.05), and co-mutated DDR pathways showed even more significant correlations (P < 0.01). The number of mutated DDR pathways was also proved an independent stratifying factor of overall survival by Cox multivariable analysis with other clinical factors and biomarkers (hazard ratio = 9.14; 95% confidence interval, 1.21–68.9; P = 0.032). Additionally, mutated FA and MMR pathways were positively and negatively correlated with the response of oxaliplatin-based pre-operative chemotherapy (P = 0.0095 and 0.048, respectively). Mutated DDR signaling pathways can predict pre-operative chemotherapy response and post-operative survival in CRLM patients.

Background: Clinical trialists and clinicians have used a number of sleep quality measures to determine the outcomes of interventions to improve sleep and ameliorate the neurobehavioral consequences of sleep deprivation in critically ill patients, but findings have not always been consistent. To elucidate the source of these consistencies, an important consideration is responsiveness of existing sleep measures. The purpose of an evaluative measure is to describe a construct of interest in a specific population, and to measure the extent of change in the construct over time. This systematic literature review identified measures of sleep quality in critically ill adults hospitalized in the Intensive Care Unit (ICU), and assessed their measurement properties, strengths and weaknesses, clinical usefulness, and responsiveness. We also recommended modifications, including new technology, that may improve clinical usefulness and responsiveness of the measures in research and practice.Methods: CINAHAL, PubMed/Medline, and Cochrane Library were searched from January 1, 2000 to February 1, 2020 to identify studies that evaluated sleep quality in critically ill patients.Results: Sixty-two studies using polysomnography (PSG) and other electroencephalogram-based methods, actigraphy, clinician observation, or patient perception using questionnaires were identified and evaluated. Key recommendations are: standard criteria are needed for scoring PSG in ICU patients who often have atypical brain waves; studies are too few, samples sizes too small, and study duration too short for recommendations on electroencephalogram-based measures and actigraphy; use the Sleep Observation Tool for clinician observation of sleep; and use the Richards Campbell Sleep Questionnaire to measure patient perception of sleep.Conclusions: Measuring the impact of interventions to prevent sleep deprivation requires reliable and valid sleep measures, and investigators have made good progress developing, testing, and applying these measures in the ICU. We recommend future large, multi-site intervention studies that measure multiple dimensions of sleep, and provide additional evidence on instrument reliability, validity, feasibility and responsiveness. We also encourage testing new technologies to augment existing measures to improve their feasibility and accuracy.

Abstract Endocarpon species are key components of biological soil crusts. Phenotypic and systematic molecular analyses were carried out to identify samples of Endocarpon collected from the southeast edge of the Tengger Desert in China. These morphological and molecular analyses revealed two previously undescribed species that form highly supported independent monophyletic clades within Endocarpon. The new taxa were named Endocarpon deserticola sp. nov. and E. unifoliatum sp. nov. Furthermore, our results indicated that the newly developed protein coding markers adenylate kinase (ADK) and ubiquitin-conjugating enzyme h (UCEH) are useful for assessing species boundaries in phylogenic analyses.

Abstract Horizontal wells are commonly used in bottom water reservoirs, which can increase contact area between wellbores and reservoirs. There are many completion methods used to control cresting, among which variable density perforation is an effective one. It is difficult to evaluate well productivity and to analyze inflow profiles of horizontal wells with quantities of unevenly distributed perforations, which are characterized by different parameters. In this paper, fluid flow in each wellbore perforation, as well as the reservoir, was analyzed. A comprehensive model, coupling the fluid flow in the reservoir and the wellbore pressure drawdown, was developed based on potential functions and solved using the numerical discrete method. Then, a bottom water cresting model was established on the basis of the piston-like displacement principle. Finally, bottom water cresting parameters and factors influencing inflow profile were analyzed. A more systematic optimization method was proposed by introducing the concept of cumulative free-water production, which could maintain a balance (or then a balance is achieved) between stabilizing oil production and controlling bottom water cresting. Results show that the inflow profile is affected by the perforation distribution. Wells with denser perforation density at the toe end and thinner density at the heel end may obtain low production, but the water breakthrough time is delayed. Taking cumulative free-water production as a parameter to evaluate perforation strategies is advisable in bottom water reservoirs.

Abstract Purpose: To investigate the prognostic value of 17 platelet-based prognostic scores in patients with malignant hepatic tumors after TACE therapy. Methods: In total, 92 patients were divided into death group and survival group according to long-term follow-up results. The AUC was calculated to determine the optimal cut-off values for predicting prognosis. To determine better prognostic models, platelet-based models were analyzed separately after being showed as binary according to cut-off values. Cumulative survival rates of malignant hepatic tumors were calculated using Kaplan-Meier curves and differences were analyzed by the log-rank test. Univariate and multivariate analyses were performed to identify platelet-based prognostic scores associated with overall survival. Results: Univariate analysis showed that APGA, APRI, FIB-4, FibroQ, GUCI, King's score, Lok index, PAPAS, cirrhosis, number of tumors, vascular cancer embolus, AFP, ALP and APTT were significantly related to prognosis. A multivariate analysis showed that the APGA, number of tumors, ALP and APTT were independently associated with overall survival. Conclusion: This study showed that the APGA, a platelet-based prognostic score, was an independent marker of prognosis in patients with malignant hepatic tumors after TACE and was superior to the other platelet-based prognostic scores in terms of prognostic ability.