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Shenghao Zhang,1,* Jiahui Ma,1,* Yilei Ma,1,* Jia Yi,1 Beier Wang,2 Hanbing Wang,3 Qinsi Yang,4 Kun Zhang,5 Xiaoqing Yan,6 Da Sun,1,7 Jinfeng You8 1Institute of Life Sciences & Biomedical Collaborative Innovation Center of Zhejiang Province, Wenzhou University, Wenzhou, 325035, People’s Republic of China; 2Department of Hepatobiliary-Pancreatic Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China; 3Department of Biotechnology, The University of Hong Kong, Hong Kong SAR, 999077, People’s Republic of China; 4Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, 325000, People’s Republic of China; 5Chongqing Municipality Clinical Research Center for Endocrinology and Metabolic Diseases, Chongqing University Three Gorges Hospital, Chongqing, 404000, People’s Republic of China; 6The Chinese-American Research Institute for Diabetic Complications, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, People’s Republic of China; 7Department of Endocrinology, Yiwu Central Hospital, The Affiliated Yiwu hospital of Wenzhou Medical University, Yiwu, 322000, People’s Republic of China; 8Department of Obstetrics, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, 324000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jinfeng You; Da Sun, Email Jincancanyjf@163.com; sunday@wzu.edu.cnBackground: Diabetes Mellitus (DM) is a substantial health concern worldwide, and its incidence is progressively escalating. Conventional pharmacological interventions frequently entail undesirable side effects, and while probiotics offer benefits, they are hindered by constraints such as diminished stability and effectiveness within the gastrointestinal milieu. Given these complications, the advent of bioengineered probiotics is a promising alternative for DM management.Aim of Review: The objective of this review is to provide an exhaustive synthesis of the most recent studies on the use of engineered probiotics in the management of DM. This study aimed to clarify the mechanisms through which these probiotics function, evaluate their clinical effectiveness, and enhance public awareness of their prospective advantages in the treatment of DM.Key Scientific Concepts of Review: Scholarly critiques have explored diverse methodologies of probiotic engineering, including physical alteration, bioenrichment, and genetic manipulation. These techniques augment the therapeutic potency of probiotics by ameliorating gut microbiota, fortifying the intestinal barrier, modulating metabolic pathways, and regulating immune responses. Such advancements have established engineered probiotics as a credible therapeutic strategy for DM, potentially providing enhanced results compared to conventional treatments. Keywords: engineered probiotics, diabetes mellitus, gut microbiota, genetic engineering, therapeutic efficacy

Qian Song,1,2,* Kaili Zheng,1,2,* Zixia Ding,1,2 Zhengmiao Miao,1,2 Zhaoxia Liu,1,2 Ming Cheng,3 Jinyao Yi1,2,4 1Medical Psychological Center, the Second Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 2Medical Psychological Institute, Central South University, Changsha, People’s Republic of China; 3Department of Clinical Psychology, Hunan Brain Hospital, Changsha, People’s Republic of China; 4National Clinical Research Center for Mental Disorders, Changsha, 410011, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jinyao Yi, Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China, Email jinyaoyi@csu.edu.cnBackground: There exist four short forms of the Social Interaction Anxiety Scale (SIAS): 10-item version (SIAS-10), 6-item version by Peters et al (SIAS-6P), 6-item version by Fergus et al (SIAS-6F), and 5-item version (SIAS-5). This study aims to comprehensively examine the psychometric properties of the SIAS-10, SIAS-6P, SIAS-6F, and SIAS-5 and to determine which one performs relatively better in Chinese population.Methods: This study enrolled 733 Chinese college students. The unidimensionality of the SIAS-10, SIAS-6P, SIAS-6F, SIAS-5 was examined using Confirmatory Factor Analysis (CFA). Multi-Group CFA was further adopted to assess measurement equivalence across gender. Internal consistency reliability and criteria-related validity were also evaluated. Additionally, the measurement performance of the SIAS-10, SIAS-6P, SIAS-6F, and SIAS-5 was assessed with Item Response Theory (IRT), which estimated the discrimination parameter and the Item Characteristic Curve (ICC) for each item.Results: Except for the SIAS-5, the SIAS-10, SIAS-6P, and SIAS-6F displayed a good-fit to the one-factor model. Furthermore, the SIAS-10 achieved strict equivalence across gender while other versions did not. The SIAS-10, SIAS-6P, SIAS-6F and SIAS-5 all had acceptable internal consistency and significant correlations with criteria scales. The IRT results showed that the SIAS-10 included more items with higher discrimination and peaked ICCs (indicating more informative), whereas the SIAS-6P included more items with lower discrimination and flat ICCs (indicating less informative).Conclusion: For assessing social anxiety in Chinese under constrained conditions, the SIAS-10 is recommended to clinicians for it measuring equivalently across gender, reflecting the relevant criteria variables well, and discriminating various levels of social anxiety sensitively.Keywords: social anxiety, psychometric properties, measurement equivalence, item response theory, Chinese

Luyao Liu,1 Wang Xiao,2 Chaojie Zhang,1 Peizhi Fan,1 Jie Zeng,1 Jianing Yi1 1Department of Breast and Thyroid Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, People’s Republic of China; 2Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, People’s Republic of ChinaCorrespondence: Jianing Yi; Jie Zeng, Department of Breast and Thyroid Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, 61 Jiefang West Road, Changsha, Hunan, 410005, People’s Republic of China, Tel +8613007436234 ; +8613974837749, Email yijianing@hunnu.edu.cn; zengjie227@hunnu.edu.cnBackground: Breast cancer (BC) continues to pose a substantial challenge to global health, necessitating an enhanced understanding of its fundamental mechanisms. Among its various pathological classifications, breast invasive carcinoma (BRCA) is the most prevalent. The role of the transcription factor forkhead box P3 (FOXP3), associated with regulatory T cells, in BRCA’s diagnosis and prognosis remains insufficiently explored, despite its recognized importance.Methods: We examined the mRNA expression profile of FOXP3 in BRCA patients, assessing its correlation with disease detection, patient survival, immune checkpoint alterations, and response to anticancer drugs.Results: Our analysis revealed significantly elevated FOXP3 mRNA levels in BRCA patients, with a 95.7% accuracy for BRCA detection based on the area under the curve. High FOXP3 mRNA levels were positively correlated with overall survival and showed significant associations with CTLA4, CD274, PDCD1, TMB, and immune cell infiltration status. Furthermore, FOXP3 mRNA expression was linked to the efficacy of anticancer drugs and the tumor inflammation signature.Discussion: These findings suggest that FOXP3 serves as a promising biomarker for BRCA, offering valuable insights into its diagnosis and prognosis. The correlation between FOXP3 expression and immune checkpoint alterations, along with its predictive value for treatment response, underscores its potential in guiding therapeutic strategies.Conclusion: FOXP3 stands out as an influential factor in BRCA, highlighting its diagnostic accuracy and prognostic value. Its association with immune responses and treatment efficacy opens new avenues for research and clinical applications, positioning FOXP3 as a vital target for further investigation in BRCA management.Keywords: breast cancer, FOXP3, regulatory T cells, immune checkpoint alterations, anticancer drugs response, immune cell infiltration

Haibang Pan,1,&ast; Tianming Wang,1,2,&ast; Ying Che,3,4 Xiaoli Li,1,5 Yan Cui,1 Quanxin Chen,1 Zhihang Wu,1 Jianfeng Yi,1 Bo Wang3 1First School of Clinical Medicine, Gansu University of Chinese Medicine, Lanzhou, People’s Republic of China; 2Gansu Provincial Key Laboratory of Traditional Chinese Medicine Recipe Mining and Innovation Transformation, Gansu Province New Production of Traditional Chinese Medicine Product Creation Engineering Laboratory, Lanzhou, People’s Republic of China; 3School of Nursing, Gansu University of Chinese Medicine, Lanzhou, People’s Republic of China; 4Research Ward, Gansu Provincial People’s Hospital, Lanzhou, People’s Republic of China; 5Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Bo Wang; Jianfeng Yi, Email wbbphb@gszy.edu.cn; yijf02@163.comIntroduction: Skin and soft tissue infection (SSTI) is a frequently encountered clinical disease, and Sanhuang ointment, a traditional Chinese medicine, is used to treat it. However, the pharmacological effect of Sanhuang ointment on SSTI and its underlying mechanism remains unclear. Here, we investigate the protective effect of Sanhuang ointment on Methicillin-resistant Staphylococcus aureus (MRSA) infection in the skin and soft tissues and the underlying mechanism by network pharmacological analysis, followed by in vivo experimental validation.Methods: Via network pharmacology, the active components and disease targets of Sanhuang ointment were screened and intersected for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. A rat model of skin and soft tissue infection was established, and pathological features were observed. Large, medium, and small-dose groups (1 g, 0.5 g, and 0.25 g/animal, with the total amount of Vaseline, dispensed 1 g/animal) of Sanhuang ointment were prepared and Mupirocin ointment was used as a positive control (0.5 g/animal, with the total amount of Vaseline, dispensed 1 g/animal). The expressions of key proteins of the IL-17/NF-κB signaling pathway and downstream inflammatory factors were analyzed by histomorphological analysis, enzyme-linked immunosorbent assay, polymerase chain reaction, and Western blotting.Results: In all, 119 active components and 275 target genes of Sanhuang ointment were identified and intersected with MRSA infection-related genes via network pharmacology analysis, and 34 target genes of Sanhuang ointment were found to be involved in skin and soft tissue infections with MRSA. Sanhuang ointment (1 g/mouse) could effectively ameliorate histopathological changes and significantly inhibit the expression of key proteins involved in the IL-17/NF-κB signaling pathway and downstream inflammatory factors (p < 0.05).Conclusion: Sanhuang ointment has a protective effect on MRSA infection and inhibits inflammation by inhibiting the IL-17/NF-κB signaling pathway. Our findings are important for the secondary development and new drug development of Sanhuang ointment.Plain Language Summary: Sanhuang ointment can significantly inhibit inflammatory response after skin and soft tissue infection with MRSA.Sanhuang ointment may inhibit the inflammatory response induced by MRSA in the skin and soft tissue infections by targeting the IL-17/NF-κB signaling pathway.We study the active components and mechanism of action of Sanhuang ointment on MRSA infection through network pharmacology.Keywords: Sanhuang ointment, MRSA, SSTI, network pharmacology, IL-17, NF-κB

Junlan Tan,1,2 Jian Yi,2,3 Xianya Cao,1,2 Feiying Wang,2,4 Silin Xie,2,4 Aiguo Dai2,4,5 1School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, 410208, People’s Republic of China; 2Hunan Provincial Key Laboratory of Vascular Biology and Translational Medicine, Changsha, Hunan, 410208, People’s Republic of China; 3The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, 410021, People’s Republic of China; 4Department of Respiratory Diseases, School of Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, 410208, People’s Republic of China; 5Department of Respiratory Medicine, the First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, 410021, People’s Republic of ChinaCorrespondence: Aiguo Dai, Department of Respiratory Diseases, School of Medicine, Hunan University of Chinese Medicine, 300 Xueshi Road, Hanpu Science and Education District, Changsha, Hunan, 410208, People’s Republic of China, Tel +86-731-88458128, Fax +86-731-88458111, Email daiaiguo@hnucm.edu.cnAbstract: Respiratory diseases are an emerging public health concern, that pose a risk to the global community. There, it is essential to establish effective treatments to reduce the global burden of respiratory diseases. Astragaloside IV (AS-IV) is a natural saponin isolated from Radix astragali (Huangqi in Chinese) used for thousands of years in Chinese medicine. This compound has become increasingly popular due to its potential anti-inflammatory, antioxidant, and anticancer properties. In the last decade, accumulated evidence has indicated the AS-IV protective effect against respiratory diseases. This article presents a current understanding of AS-IV roles and mechanisms in combatting respiratory diseases. The ability of the agent to suppress oxidative stress, cell proliferation, and epithelial-mesenchymal transition (EMT), to attenuate inflammatory responses, and modulate programmed cell death (PCD) will be discussed. This review highlights the current challenges in respiratory diseases and recommendations to improve disease management.Keywords: astragaloside IV, Radix astragali, respiratory diseases, oxidative stress, inflammatory responses

Yanyan Ma,1,&ast; Ying Cao,2,&ast; Hong Gao,3 Rui Tong,1 Jing Yi,3 Zhongwei Zhang,1 Rui Chen,1 Zhijun Pan1 1School of Anesthesia, Guizhou Medical University, Guiyang, People’s Republic of China; 2Department of Anesthesiology, The Second People’s Hospital of Guiyang, Guiyang, People’s Republic of China; 3Department of Anesthesiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Hong Gao, Department of Anesthesiology, The Affiliated Hospital of Guizhou Medical University, No. 9 Beijing Road, Guiyang, People’s Republic of China, Email 2169617@qq.com; anesth@qq.comPurpose: This study investigated the effect of exosomes derived from sevoflurane-treated cardiac fibroblasts (Sev-CFs-Exo) on reperfusion arrhythmias (RA), ventricular conduction, and myocardial ischemia-reperfusion injury (MIRI).Methods: Primary cardiac fibroblasts (CFs) were isolated from the hearts of neonatal rats and identified by morphology and immunofluorescence. Exosomes were isolated from CFs at passages 2– 3 after they had been treated with 2.5% sevoflurane for an hour and cultivated for 24– 48 hours. The control group was CFs that did not receive any treatment. The hypothermic global ischemia-reperfusion injury model was established using the Langendorff perfusion technique following injection with exosomes through the caudal vein. Multi-electrode array (MEA) mapping was used to investigate the changes in RA and ventricular conduction in isolated hearts. Western blots and immunofluorescence were used to examine the relative expression and location of connexin 43 (Cx43). In addition, the MIRI was evaluated with triphenyl tetrazolium chloride and Hematoxylin-Eosin staining.Results: The primary CFs had a variety of morphologies, no spontaneous pulsation, and were vimentin-positive, which confirmed their successful isolation. Sev-CFs-Exo increased the heart rate (HR) at reperfusion for 15 minutes (T2) and 30 minutes (T3) and lowered the score and duration of RA and the time for restoration of heartbeat in reperfusion. Meanwhile, Sev-CFs-Exo increased conduction velocity (CV), decreased absolute inhomogeneity (P5-95) and inhomogeneity index (P5-95/P50) at T2 and T3, as well as promoted the recovery of HR, CV, P5-95 and P5-95/P50 after hypothermic global ischemia-reperfusion injury. Furthermore, Sev-CFs-Exo raised expression and reduced lateralization of Cx43, and improved myocardial infarct sizes and cellular necrosis. However, while cardiac fibroblast-derived exosomes (CFs-Exo) showed similar cardioprotective effects, the outcomes were not as significant.Conclusion: Sevoflurane reduces the risk of RA and improves ventricular conduction and MIRI by CFs-Exo, and this may be driven by the expression and location of Cx43.Keywords: anesthetic, extracellular vesicles, arrhythmia, electrophysiology, electrical mapping, connexin 43, Cx43

Sofia V Krylova, Sara Glickman, Ali Kalam, Katherine Chemakin, Joseph Yi, Linda Forrester, Priti Mishall, Adi Pinkas Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, 10461, USACorrespondence: Adi Pinkas, Department of Pathology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, F620S, Bronx, NY, 10461, USA, Email adi.pinkas@einsteinmed.eduAbstract: The thoracic cavity contains vital cardiovascular and pulmonary structures. Few congenital anatomical variations in the bronchial tree and pulmonary vasculature have been reported. Understanding such variants is crucial during surgical procedures that involve the thorax. During routine dissection of an 89-year-old male cadaver as part of a first-year anatomy course, an anomaly of the bronchial tree was discovered. The left lung hilum was notable for the pulmonary artery being posterior to the mainstem bronchus. The case report describes normal lung development and anatomy and the significance of this novel variation in which has not been previously described in the literature.Keywords: pulmonary artery, bronchus, lung, pulmonary vein, thoracic region

Zixia Ding,1,2,&ast; Qian Song,1,2,&ast; Jun Chu,1,2 Tao Zou,3 Kaili Zheng,1,2 Zhaoxia Liu,1,2 Wanrong Peng,1,2 Jinyao Yi1,2,4 1Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 2Medical Psychology Institution, Central South University, Changsha, Hunan, 410011, People’s Republic of China; 3Department of Psychiatry, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, 550004, People’s Republic of China; 4National Clinical Research Center for Mental Disorders, Changsha, Hunan, 410011, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jinyao Yi, Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People’s Republic of China, Email jinyaoyi@csu.edu.cnBackground: The present study investigated the applicability of the Cognitive Emotion Regulation Questionnaire (CERQ) in the Chinese community elderly and explored the influence of cognitive emotion regulation strategies on late-life depression.Methods: A total of 367 community elderly aged 60– 94 were deemed eligible and completed CERQ, the Perceived Stress Scale-10, the Geriatric Depression Questionnaire-15, and the State Anxiety Inventory. Confirmatory factor analysis was adopted to verify the 9-factor structure of CERQ. Cronbach’s α coefficient, Ω coefficient and split-half reliability were used to test the internal consistency of CERQ. Pearson correlations among scores of CERQ and other scales were calculated to examine its convergent validity. In addition, a structural equation model was used to further examine the effect of cognitive emotion regulation strategies on the association between perceived stress and late-life depression.Results: All the fitting indexes of CERQ’s 9-factor model met the criterion (χ2/df= 2.26, CFI= 0.916, TLI= 0.904, RMSEA= 0.052). For the total score of CERQ, the Cronbach’s α coefficient and Ω coefficient were both 0.90, and the split-half reliability was 0.74. For the nine subscales, the α coefficients ranged from 0.66 to 0.88, and the Ω coefficients ranged from 0.69 to 0.88. Significant positive correlations were found between the maladaptive dimension of CERQ and other scales (all p < 0.001). The maladaptive emotion regulation strategies indirectly affected the effect of perceived stress on late-life depression (effect size was 21.57%).Conclusion: With good reliability and factor validity, the CERQ showed good applicability in the Chinese elderly population. The influence of perceived stress on depression in the elderly was mediated by maladaptive emotion regulation strategies.Keywords: cognitive emotion regulation, late-life depression, perceived stress, psychometric properties, mediating effect

The Stimulator of Interferon Genes (STING) pathway initiates potent immune responses upon recognition of DNA. To initiate signaling, serine 365 (S365) in the C-terminal tail (CTT) of STING is phosphorylated, leading to induction of type I interferons (IFNs). Additionally, evolutionary conserved responses such as autophagy also occur downstream of STING, but their relative importance during in vivo infections remains unclear. Here we report that mice harboring a serine 365-to-alanine (S365A) mutation in STING are unexpectedly resistant to Herpes Simplex Virus (HSV)-1, despite lacking STING-induced type I IFN responses. By contrast, resistance to HSV-1 is abolished in mice lacking the STING CTT, suggesting that the STING CTT initiates protective responses against HSV-1, independently of type I IFNs. Interestingly, we find that STING-induced autophagy is a CTT- and TBK1-dependent but IRF3-independent process that is conserved in the STING S365A mice. Thus, interferon-independent functions of STING mediate STING-dependent antiviral responses in vivo.

Pan Su,1 Jindong Yi,1 Xiuwen Chen,2 Yao Xiao3– 5 1Teaching and Research Section of Clinical Nursing, Emergency Department, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 2Teaching and Research Section of Clinical Nursing, Department of Operating Room, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 3Department of General Surgery, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 4International Joint Research Center of Minimally Invasive Endoscopic Technology Equipment & Standards, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 5National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People’s Republic of ChinaCorrespondence: Yao Xiao; Xiuwen Chen, Email yaoxiao@csu.edu.cn; chenxiuwen2020@163.comBackground: The importance of psychological resilience that people show in coping with stress and adversity is prominent, but few studies have used rigorous bibliometric tools to analyze the knowledge structure and distribution of psychological resilience research.Objective: The purpose of this study was to sort out and summarize the previous studies on psychological resilience by using bibliometrics. Specifically, the time distribution of psychological resilience research was determined by publication trend, the power distribution was determined by the distribution of countries, authors, institutions and journals, the hot research spots were analyzed according to the results of keyword cluster analysis, and the research frontier was explored according to the results of burst keywords.Methods: CiteSpace5.8.R3 was used to analyze the literatures on psychological resilience collected in Web of Science core Collection database from January 1, 2010, to June 16, 2022.Results: A total of 8462 literatures were included after screening. Research on psychological resilience has been on the rise in recent years. The United States had made a high contribution in this field. Robert H Pietrzak, George A Bonanno, Connor KM and others were highly influential. J Pers Soc Psychol has the highest citation frequency and centrality. The research hot spots focus on five aspects: study on psychological resilience related to COVID-19 pandemic, influencing factors of psychological resilience, psychological resilience related to PTSD, study on psychological resilience of special population, and the molecular biology and genetic basis of psychological resilience. Psychological resilience related to COVID-19 pandemic was the most cutting-edge research aspect.Conclusion: The current situation and trend of psychological resilience research were found in this study, which may be used to identify more hot issues and explore new research directions in this field.Keywords: psychological resilience, CiteSpace, hot spots, visualization

Lei Yang,1,2 Weimin Dang,2,3 Xin Yu,1,2 Yi He,4,5 Chuan Shi,1,2 Jialong Yi,1,2 Lu Gao,6 Siheng Li,7 Tianhang Zhou,1,2 Yantao Ma1,2 1Department of Clinical Research, Peking University Sixth Hospital (Institute of Mental Health), Beijing, People’s Republic of China; 2NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, People’s Republic of China; 3The Division of Medical Affairs, Peking University Sixth Hospital (Institute of Mental Health), Beijing, People’s Republic of China; 4Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing, People’s Republic of China; 5Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, Beijing, People’s Republic of China; 6Department of Stomatology, Beijing Children’s Hospital, Capital Medical University, Beijing, People’s Republic of China; 7Department of Neurology, Peking University First Hospital, Beijing, People’s Republic of ChinaCorrespondence: Xin Yu, Peking University Sixth Hospital, No. 51 Hua Yuan Bei Road, Haidian District, Beijing, 100191, People’s Republic of China, Tel +86 13718747842, Fax +86-10-62026310, Email yuxin@bjmu.edu.cnIntroduction: Processed betel quid product chewing is a public health problem in areca non-plant areas in China. However, there is no valid instrument to screen for betel quid use disorder (BQUD) in mainland China. We developed a self-administered screening test for betel quid use disorders (SST-BQUD) and tested its reliability and validity in a sample of betel quid chewers (BQCers) in Hunan, China.Methods: Items of SST-BQUD were selected from the test results of an item pool, which includes 52 questions related to the psycho-social and behavioral presentations of BQUD. All participants, in a self-administered manner, completed the item pool. A subsample completed the re-test one week later. Two psychiatrists interviewed all participants to ascertain the presence of BQUD. The receiver Operating Characteristic curve was used to determine the best cut-off value to discriminate BQUD.Results: One hundred and twelve BQCers were recruited. Based on the statistical analysis of receiver operating characteristic (ROC) curves, 14 yes/no questions were selected for SST-BQUD. As indicated by Cronbach’s α coefficient, the internal consistency was 0.876. The area under the curve of SST-BQUD was 0.881, representing a satisfactory diagnostic value. The one-week re-test reliability test was 0.771 (P< 0.001), suggesting good stability over time. The optimal cut-off score for BQUD screening was six, with a sensitivity of 0.921 and a specificity of 0.716, implying the satisfactory accuracy of SST-BQUD to screen for BQUD.Conclusion: The standard version of SST-BQUD consists of 14 items. The total score of SST-BQUD was the sum of affirmative answers, with higher scores denoting a more severe BQUD symptom. If one answered six or more times “yes” to these 14 questions, they can be classified with BQUD. The SST-BQUD is a valid screening method for BQUD among BQCers in betel quid processed area.Keywords: betel quid use disorders, screener, development, validity, diagnostic test

Ping Yang,1,2 Chao Liu,3 Zhenchao Wu,2 Jiajia Zheng,4 Juan Yi,1 Nan Wu,2 Zhangli Wu,1,2 Ming Lu,2,3 Liyan Cui,4,&ast; Ning Shen1– 3,&ast; 1Institute of Medical Technology, Peking University Health Science Center, Beijing, People’s Republic of China; 2Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, People’s Republic of China; 3Department of Infectious Diseases, Peking University Third Hospital, Beijing, People’s Republic of China; 4Department of Laboratory Medicine, Peking University Third Hospital, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Liyan Cui; Ning Shen, Email cliyan@163.com; shenningputh@163.comPurpose: This study aimed to identify the clinical outcomes, microbiological features and risk factors for difficult-to-treat resistance (DTR) Klebsiella pneumoniae (Kp) infection.Materials and Methods: A retrospective study was conducted at Peking University Third Hospital from January 2020 to March 2021. DTR was defined as resistance to ≥ 1 carbapenem, ≥ 1 extended-spectrum cephalosporin, and ≥ 1 fluoroquinolone. Hypervirulent Kp (HvKp) was defined as peg-344-, iroB-, iucA-, rmpA-, or rmpA2-positive. Clinical data were collected. Antimicrobial susceptibility testing and string tests were performed to determine resistance and hypermucoviscosity phenotype. Whole genome sequencing was performed to analyze the sequence type (ST), capsular serotypes, resistance and virulence genes. Risk factors for 30-day mortality were analyzed.Results: Fifty DTR-Kp (50.0%) strains were identified among 100 patients. Compared to non-DTR-Kp group, a significant number of patients with DTR-Kp infection experienced ICU admission (44.0% versus 10.0%, P< 0.001) and mechanical ventilation after Kp detection (26.0% versus 10.0%, P=0.037). Notably, the percentage of hvKp among the DTR-Kp isolates increased consistently over the 15 months evaluated. Most DTR-Kp strains belonged to ST11 (82.0%), followed by ST15 (12.0%), ST86 (2.0%), ST996 (2.0%), and ST3157 (2.0%). DTR-Kp isolates possessed various resistance genes, such as blaKPC-2, blaTEM-1D and fosA3 (90.0%, 80.0% and 72.0%, respectively). Importantly, the yersiniabactin genes were significantly clustered in DTR group (48/50, 96.0%). The 30-day mortality was significantly higher in patients with DTR-Kp infection than non-DTR-Kp group (38.0% versus 8.2%, P=0.001). DTR-Kp infection (odds ratio [OR] = 4.196) was an independent risk factor for the 30-day mortality of Kp-infected patients. Additionally, cerebrovascular disease (OR = 2.780) and Charlson comorbidity index (OR= 1.584) were independent risk factors for DTR-Kp infections.Conclusion: DTR-hvKp is rapidly emerging. The DTR-Kp strains harbored various resistance genes and high rates of yersiniabactin siderophore genes. DTR-Kp infection was an independent risk factor for mortality, suggesting that enhanced awareness essential.Keywords: Klebsiella pneumoniae, difficult-to-treat resistance, mortality, risk factor

Chirality characterizes an object that is not identical to its mirror image. In condensed matter physics, Fermions have been demonstrated to obtain chirality through structural and time-reversal symmetry breaking. These systems display unconventional electronic transport phenomena such as the quantum Hall effect and Weyl semimetals. However, for bosonic collective excitations in atomic lattices, chirality was only theoretically predicted and has never been observed. We experimentally show that phonons can exhibit intrinsic chirality in monolayer tungsten diselenide, whose lattice breaks the inversion symmetry and enables inequivalent electronic K and -K valley states. The time-reversal symmetry is also broken when we selectively excite the valley polarized holes by circularly polarized light. Brillouin-zone-boundary phonons are then optically created by the indirect infrared absorption through the hole-phonon interactions. The unidirectional intervalley transfer of holes ensures that only the phonon modes in one valley are excited. We found that such photons are chiral through the transient infrared circular dichroism, which proves the valley phonons responsible to the indirect absorption has non-zero pseudo-angular momentum. From the spectrum we further deduce the energy transferred to the phonons that agrees with both the first principle calculation and the double-resonance Raman spectroscopy. The chiral phonons have significant implications for electron-phonon coupling in solids, lattice-driven topological states, and energy efficient information processing.

Although prior studies have broadly examined the external economic consequences of corporate green innovation (GI) strategies, whether and how GI strategies influence firms' internal operations is underexplored. To fill this significant gap, we investigate the effect of GI initiatives on firm human capital structure, as represented by the ratio of salesmen (RSE) and accountants (RAE) to total employees. A higher RSE (RAE) plausibly indicates an enhanced position of salesmen (accountants) in human capital and greater importance that firms attach to their crucial role in improving marketing (reporting). Consistent with GI enhancing consumer purchase willingness, we find that GI lowers RSE. In line with GI reducing financing constraints and firms' emphasis on high-quality financial reporting, we record that GI decreases RAE. Moreover, such inhibitory effects become stronger when stakeholders' recognition of GI strategies grows, or when firms ex-ante rely more on marketing (reporting) functions of salesmen (accountants). [ABSTRACT FROM AUTHOR]

A graphene sulfide framework (GSF) is designed and synthesized via a hybridization of graphene and organic compounds for use in electrodes for high-performance Li-ion batteries (LIB). This electrode material is devoid of transition metal and features a layered framework structure that is constructed by the formation of covalent disulfide bonds between organic linker molecules and graphene sheets. This structure capitalizes on the advantageous properties of each of the components in an electrochemical reaction. The structures of GSFs are characterized by Cs-corrected transmission electron microscopy (Cs-TEM), field emission scanning electron microscopy (FE-SEM), and X-ray diffraction (XRD). Depending on current density, the GSF electrodes exhibit two different types of electrochemical behavior during Li incorporation/extraction process, indicating the involvement of multiple Li-incorporation mechanisms. Various types of dithiol organics as linker components are incorporated in the GSF to evaluate the effect of length or structure on the electrochemical properties. The linker-dependent Li storage mechanism is explained based on the results of differential capacity analyses and electrochemical impedance spectroscopy (EIS). The GSF proposed in this study shows promise as an electrode material for a high-performance energy-storage system that is inexpensive and free of transition metals.

Hao Yu,1,2 Jie Yi,1 Ya-ling Dou,1 Yu Chen,1 Ling-jun Kong,1 Jie Wu1 1Department of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, People’s Republic of China; 2Department of Laboratory Medicine, Beijing Hepingli Hospital, Beijing, People’s Republic of ChinaCorrespondence: Jie WuDepartment of Laboratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing, Dongcheng District, Beijing, 100730, People’s Republic of ChinaTel +86 106 915 9701Email wujie_pumch@163.comObjective: Human papillomavirus (HPV) infection, especially with high-risk HPV (HR-HPV) genotypes, is closely associated with cervical cancer. This study aimed to observe the epidemiological characteristics of HPV infection among healthy women in Beijing, China.Materials and Methods: Cervical specimens were collected from 29,436 healthy women, who underwent health check-ups in Peking Union Medical College Hospital between 2016 and 2019. A commercial kit was used for the detection of 15 HR-HPV and two low-risk HPV (LR-HPV) genotypes.Results: A total of 3586 (12.18%) participants tested positive for HPV, 3467 of which were infected with HR-HPVs. The most prevalent genotypes were HPV52, 58, 16, 51, and 56. Moreover, while infection with a single genotype (9.84%) was more prevalent, HPV16+52 was the most common combination in those infected with multiple HPVs. Furthermore, the highest infection rate among age groups was in women aged < 25 years (20.92%). No significant difference in the prevalence was observed from 2016 to 2019. However, HPV incidence in Beijing was significantly different than that in all other areas in China, except for Zhengzhou (p < 0.05).Conclusion: Our findings could serve as potential reference for better understanding of the epidemiological characteristics of HPV infection in Beijing.Keywords: human papillomavirus, cervical cancer, prevalence, genotype

Miao Chen,1,2 Weimin Lin,1 Jianru Yi,1,2 Zhihe Zhao1,2 1State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, People’s Republic of China; 2Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, People’s Republic of ChinaCorrespondence: Jianru Yi; Zhihe Zhao Tel +86-28-85503040; +86-28-85503645Email jianruyi@scu.edu.cn; zhzhao@scu.edu.cnPurpose: Genetic factors in type 2 diabetes (T2D) pathogenesis have been widely explored by the genome-wide association studies (GWAS), identifying a great amount of susceptibility loci. With the development of high-resolution sequencing, the N(6)-methyladenosine (m6A) RNA modification has been proved to be affected by genetic variation. In this study, we identified the T2D-associated m6A-SNPs from T2D GWAS data and explored the underlying mechanism of the pathogenesis of T2D.Methods: We examined the association of m6A-SNPs with T2D among large-scale T2D GWAS summary statistics and further performed multi-omics integrated analysis to explore the potential role of the identified m6A-SNPs in T2D pathogenesis.Results: Among the 15,124 T2D-associated m6A-SNPs, 71 of them reach the genome-wide significant threshold (5.0e-05). The leading SNP rs4993986 (C>G), which is located near the m6A modification site at the 3ʹ end of the HLA-DQB1 transcript, is expected to participate in the pathogenesis of T2D by influencing m6A modification to regulate the HLA-DQB1 expression.Conclusion: The current study has suggested a potential correlation between m6A-SNPs and T2D pathogenesis and also provided new insights into the pathogenic mechanism of the T2D susceptibility loci identified by GWAS.Keywords: type 2 diabetes, single nucleotide polymorphism, epigenetics, m6A, genome-wide association study