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Abstract This study aimed to describe a novel sandwich technique of minimally invasive surgical implantation by using corneal stromal lenticules for corneal perforation. This prospective observational study included nine patients aged 23–79 years (mean, 54 ± 9) from Tianjin Eye Hospital. Corneal stromal lenticules with a central thickness of 120 μm were obtained from small incision lenticule extraction(SMILE). With the corneal perforation as the central point, an iris-repositor was used to manually create a mid-stromal pocket; the stromal lenticular button was gently inserted into the intrastromal pocket and flattened. The graft was sandwiched between the anterior and posterior corneal stromal pockets; the incision was closed using two sutures. The primary health outcome measured in this study was the logMAR best spectacle-visual acuity at 6 months postoperatively. Corneal perforation closure and anterior chamber formation occurred immediately after surgery. No epithelial implantation, infection, or allogeneic rejection was observed during the follow-up. No patients required a penetrating keratoplasty. Anterior segment optical coherence tomography revealed a mean thickness of the grafted tissue of 122 ± 21 μm, with a clear interface in all cases. Comparing the baseline and postoperative 6-month values, the mean logMAR best spectacle-corrected visual acuity was improved from 0.18 ± 0.12 to 0.52 ± 0.31 (P

Abstract Introduction Medical education, especially in ultrasound training, is undergoing significant changes. This study examines practical issues in ultrasound medical education, emphasizing state-of-the-art teaching methods, their effectiveness, and implementation challenges. Methods The study analyzed advancements in ultrasound education, including randomized controlled trials comparing peer-to-peer teaching with traditional faculty-led instruction. It evaluated the effectiveness of collaborative small-group training and group size impact in simulation-based training. The study also assessed practical training components outlined in the WFUMB Position Paper Part II. Results Findings indicate that peer-to-peer and collaborative small-group training are effective and cost-efficient. Group size did not significantly affect training outcomes. Key practical training elements, including early hands-on sessions and exposure to various equipment, substantially improved learning outcomes. Simulation tools like virtual reality (VR), augmented reality (AR), and phantoms were crucial for teaching standardized procedures and rare pathologies. Challenges identified include developing robust image acquisition skills, scarcity of qualified student tutors, and the need for reliable ultrasound skill assessment methods. Conclusion Integrating peer-to-peer teaching and advanced simulation technologies significantly advances ultrasound medical education. These methods enhance cognitive and psychomotor skills but also present challenges such as ensuring quality education and developing effective assessment methods. Future research should compare different simulation tools and establish objective ultrasound proficiency assessment criteria. Continual method evaluation and improvement are essential for effective and standardized ultrasound training, ultimately enhancing patient care and clinical outcomes.

Abstract Objective The present study endeavors to furnish an exhaustive review of the research advancements on solid tumors harboring RET rearrangement within the Chinese context, particularly emphasizing the examination of real-world therapeutic strategies and clinical outcomes observed in individuals diagnosed with advanced non-small cell lung cancer (NSCLC). The review delves into a critical assessment of the therapeutic efficacy of targeted RET inhibitors, while also scrutinizing the diverse array of treatment modalities employed in the Chinese patient population. Methods The study conducted a comprehensive review of the advancements made by Chinese scholars in the realm of RET driver genes. It delved into the analysis of the incidence of RET rearrangements in solid tumors, alongside an examination of the varied treatment paradigms and their current status within China. Utilizing the RECIST 1.1 criteria, the study evaluated the therapeutic efficacy achieved in RET-positive NSCLC patients undergoing diverse treatment modalities. Furthermore, treatment-related adverse events (TRAEs) were meticulously graded following the Common Terminology Criteria for Adverse Events (CTCAE). Results A retrospective, multi-center, real-world analysis was conducted, encompassing 64 patients diagnosed with pathologically confirmed RET rearrangement advanced non-small cell lung cancer (NSCLC) between December 2015 and November 2023. Notably, KIF5B-RET emerged as the most prevalent RET fusion partner, accounting for 59.4% of cases. Therapeutic interventions among these patients included specific targeted inhibitors such as Pralsetinib (48.4%), chemotherapy (34.3%), multi-target inhibitors (15.6%), and one case (1.6%) involving immunotherapy combined with anti-angiogenic therapy. In terms of progression-free survival (PFS), Pralsetinib monotherapy demonstrated a median PFS of 16.03 months, outperforming chemotherapy (2.87 months; p

Phosphoric acid, as a vital chemical raw material, holds an important position in the chemical industry. Its applications span across various sectors, determined largely by its purity. Low-purity phosphoric acid can be used in industrial and agricultural sectors, while high-purity phosphoric acid is essential for pharmaceuticals, food, electronics and other industries. The rising demand for batteries and semiconductors in recent years has led to increased requirements for phosphoric acid purity. There are two main methods for manufacturing phosphoric acid. The thermal method, while effective, is energy-intensive and environmentally unfriendly, conflicting with China’s green chemistry development goals. On the other hand, the phosphoric acid process, characterized by lower energy consumption, is more adept at handling China’s low-grade phosphate rock despite resulting in bulk and complex product impurities. Among various purification technologies, such as chemical precipitation, crystallization, electrodialysis, and ion exchange resin, the extraction method stands out. It offers environmental benefits, simple operation, and the capacity for large-scale production, marking it as a promising technique for phosphoric acid purification. This article summarizes in detail the research status of various extraction methods in recent years. It focuses on solvent extraction, aqueous two-phase extraction, reverse micelle extraction, ultrasonic-assisted extraction, and supercritical fluid extraction. It sorts out the solvent extraction method along with various extractants. The research on single extractants such as tri-n-butyl phosphate (TBP), methyl isobutyl ketone (MIBK), and n-octanol (NOA) has been primarily focused on identifying the optimal extraction conditions, including the O/A phase ratio, temperature, and air pressure. However, these single extractants typically target a single impurity, which limits their effectiveness in purifying phosphoric acid when multiple impurities are present. This limitation underscores the significant advantages of composite extractants in the purification process. Current research on composite extractants emphasizes determining the ideal proportion of extractants, often based on volume ratio, and establishing the optimal conditions for effective extraction. In addition to composite extractants, the development of new extractants offers promising solutions to the challenges posed by the low extraction efficiency of single extractants. Looking forward, the future of phosphoric acid extraction technology is poised for exciting developments: (1) The development of green composite extractants, alongside new extractants and materials combined with extractants, aims to achieve more efficient separation of impurities from phosphoric acid; (2) There is a growing interest in expanding research into the application of aqueous two-phase extraction and reverse micelle extraction for ion extraction, including the exploration of new aqueous phase systems; (3) The use of ultrasonic technology to accelerate the extraction process, coupled with studies on how supercritical fluids can improve the solubility and extraction efficiency of ions, represents another avenue for innovation. These advancements seek to reduce costs and explore specific application areas.

Abstract Background Primary electrical disorders (PEDs) are a group of cardiac rhythm abnormalities that occur in the absence of detectable structural heart disease and are a significant cause of sudden cardiac death (SCD). The initiation of cardiac muscle contraction and relaxation is orchestrated by the action potential (AP), generated through ionic changes across the membrane. Mutations in the AP-related gene CACNA2D1 have been identified as a causative factor for PED. Methods We recruited a Chinese family with a history of arrhythmia. The proband has experienced palpitations and chest tightness for over 40 years, with symptoms worsening over the past year. Whole exome sequencing (WES) was used to determine the genetic etiologies in this family. Results A novel heterozygous missense mutation (NM_000722.3: c.1685G > C;p.G562A) of CACNA2D1 gene was detected. Genotyping of the proband’s parents indicated that the arrhythmia phenotype in the proband was caused by a de novo mutation. Conclusions WES was utilized to explore the genetic etiology in a family with arrhythmia, leading to the identification of a novel mutation in the CACNA2D1 gene. This study not only expands the mutation spectrum of the CACNA2D1 gene but also contributes to genetic counseling and clinical diagnosis for this family.

Abstract Upregulation of vascular endothelial growth factor (VEGF) and enhanced angiogenesis have been implicated in the severe progression of age-related macular degeneration (AMD). Abnormal arachidonate 5-lipoxygenase (ALOX5) is associated with AMD pathogenesis. However, no reports have shown the causal role of ALOX5 in angiogenesis during AMD. In the present study, ARPE-19 cells were exposed to hypoxia, an inducer of VEGF expression. Potential proteins implicated in AMD progression were predicted using bioinformatics. RNA affinity antisense purification-mass spectrometry (RAP-MS) was applied to identify the binding proteins of ALOX5 3′UTR. Expression of ALOX5 and YTH N6-methyladenosine RNA-binding protein 1 (YTHDF1) was detected by qRT-PCR and western blotting. VEGF expression and secretion were assessed by immunofluorescence and ELISA, respectively. The chicken embryo chorioallantoic membrane (CAM) was used to analyze the effect of ALOX5 on angiogenesis. RNA stability was assayed using the Actinomycin D assay. The results show that hypoxia promoted cell growth and increased VEGF expression in ARPE-19 cells. ALOX5 was associated with AMD progression, and hypoxia upregulated ALOX5 expression in ARPE-19 cells. ALOX5 silencing reduced VEGF expression induced by hypoxia in ARPE-19 cells. Moreover, the conditioned medium of ALOX5-silenced ARPE-19 cells could suppress the viability and migration of HUVECs and diminish angiogenesis in the CAM. Furthermore, YTHDF1 was validated to bind to ALOX5 3′UTR, and YTHDF1 promoted ALOX5 expression by elevating the stability of ALOX5 mRNA. In conclusion, our findings demonstrate that YTHDF1-regulated ALOX5 increases VEGF expression in hypoxia-exposed ARPE-19 cells and enhances the viability, migration, and angiogenesis of vascular endothelial cells.

Abstract Background Sialidosis type 1 (ST-1) is a rare autosomal recessive disorder caused by mutation in the NEU1 gene. However, limited reports on ST-1 patients in the Chinese mainland are available. Methods This study reported the genetic and clinical characteristics of 10 ST-1 patients from southeastern China. A haplotype analysis was performed using 21 single nucleotide polymorphism (SNP) markers of 500 kb flanking the recurrent c.544 A > G in 8 families harboring the mutation. Furthermore, this study summarized and compared previously reported ST-1 patients from Taiwan and mainland China. Results Five mutations within NEU1 were found, including two novel ones c.557 A > G and c.799 C > T. The c.544 A > G mutation was most frequent and identified in 9 patients, 6 patients were homozygous for c.544 A > G. Haplotype analysis revealed a shared haplotype surrounding c.544 A > G was identified, suggesting a founder effect presenting in southeast Chinese population. Through detailed assessment, 52 ST-1 patients from 45 families from Taiwan and mainland China were included. Homozygous c.544 A > G was the most common genotype and found in 42.2% of the families, followed by the c.544 A > G/c.239 C > T compound genotype, which was observed in 22.2% of the families. ST-1 patients with the homozygous c.544 A > G mutation developed the disease at a later age and had a lower incidence of cherry-red spots significantly. Conclusion The results contribute to gaps in the clinical and genetic features of ST-1 patients in southeastern mainland China and provide a deeper understanding of this disease to reduce misdiagnosis.

Objective When urban rail transit line adopts the continuous co-phase power supply mode, a fault in the traction network may cause extended power outage due to the complexity and non-backup structure of the traction network. Therefore, it is necessary to optimize the segmental power supply scheme for the traction network. Method A segmental power supply scheme for the traction network applicable to the continuous co-phase power supply mode is proposed. Based on the topological characteristics of the segmental power supply of traction network, and combined with the coupling characteristics of vehicle-traction network, the identification methods of segmental short-circuit and neutral section short-circuit are proposed. The control schemes for these two fault scenarios are analyzed, and the self-healing process of the traction network under the above two fault scenarios is described, corresponding circuit breaker control schemes are formulated. In the case study of Guangzhou Metro Line 18, the correctness and reliability of the proposed segmental power supply scheme and the fault identification methods are verified by MATLAB/Simulink software simulation. Result & Conclusion The proposed method can effectively identify faulty segments. The circuit breaker control scheme for the traction network fault can provide reliable main protection for the segments and neutral sections, ensuring stable and efficient operation of the traction power supply system of Guangzhou Metro Line 18.

Abstract Background To assess the relationship between postoperative implantable collamer lens (ICL) vault and lens height obtained from two different measurements. Methods A retrospective case series study enrolled eyes with horizontally implanted ICL. Crystal lens rise (CLR) and the distance between STS plane and anterior crystalline lens surface (STSL) were measured in the horizontal and vertical directions using ultrasound biomicroscopy (UBM). We compared the differences in the parameters measured in both horizontal and vertical directions. The participants were categorized into three groups according to ciliary sulcus width (CSW) which is defined as the distance between the posterior angle of the iris and the anterior angle of the ciliary process: narrow CSW group (NSG); medium CSW group (MSG); and wide CSW group (WSG). The correlations between CLR/STSL and vault were examined in each of the three groups. Biased correlation analysis was used further to contrast the correlation between CLR/STSL and vault. Results This retrospective study included 223 myopic eyes. Vertical STSL (VSTSL) and vertical CLR (VCLR) exhibited significantly greater values compared to their horizontal counterparts (both P

Abstract Background Alagille syndrome (ALGS) is a multisystem genetic disorder frequently characterized by hepatic manifestations. This study analyzed the clinical, pathological, and molecular genetic features of ALGS to improve the efficiency of clinical diagnosis. Methods We retrospectively analyzed the clinical manifestations, pathological examination findings, and genetic testing results of 17 children diagnosed with ALGS based on the revised criteria and hospitalized at our center from January 2012 to January 2022. Results The clinical manifestations are as follows: Cholestasis (16/17, 94%), characteristic facies (15/17, 88%), heart disease (12/16, 75%), butterfly vertebrae (12/17, 71%) and posterior embryotoxon (7/12, 58%). Among the 15 patients who underwent liver pathology examination, 13 (87%) were found to have varying degrees of bile duct paucity. Genetic testing was performed on 15 children, and pathogenic variants of the jagged canonical Notch ligand 1 (JAG1) gene were identified in 13 individuals, including 4 novel variants. No pathogenic variant in the notch homolog 2 (NOTCH2) gene were identified, and 2 children exhibited none of the aforementioned gene pathogenic variants. The median follow-up duration was 7 years. Of the remaining 15 patients (excluding 2 lost to follow-up), 11 remained stable, 4 deteriorated, and no patient died during the follow-up period. Conclusions Among children diagnosed with ALGS, cholestasis stands as the most common feature. To minimize the risk of misdiagnosis, genetic testing should be performed on children exhibiting cholestasis, followed by the application of the revised diagnostic criteria for ALGS. While pharmacological therapy has shown effectiveness for ALGS patients, liver transplantation may be considered in instances of severe pruritus.

Abstract Proto-oncogenic MYC is frequently dysregulated in colorectal cancer (CRC). In the past decades, long noncoding RNAs (lncRNAs) have emerged as important regulators in cancers, acting as scaffolds, molecular decoys, post-transcriptional regulators, and others. Interestingly, lncRNAs are able to control MYC expression both at transcriptional and post-transcriptional levels. It is suggested that the reciprocal interaction of MYC and lncRNAs often occurs in CRC. MYC can affect the cell fate by promoting or inhibiting the transcription of some lncRNAs. At the same time, some lncRNAs can also affect MYC expression or transcriptional activity, and in turn decide the cell fate. In this review we summarized the current knowledge about the MYC and lncRNA axis, focusing on its mutual regulation, roles in CRC, and proposed potential therapeutic prospects for CRC treatment.

The phase equilibrium and mechanical behaviors of natural gas hydrate-bearing sediment are essential for gas recovery from hydrate reservoirs. In heating closed systems, the temperature-pressure path of hydrate-bearing sediment deviates from that of pure bulk hydrate, reflecting the porous media effect in phase equilibrium. A generalized phase equilibrium equation was established for hydrate-bearing sediments, which indicates that both capillary and osmotic pressures cause the phase equilibrium curve to shift leftward on the temperature-pressure plane. In contrast to bulk hydrate, hydrate-bearing sediment always contains a certain amount of unhydrated water, which keeps phase equilibrium with the hydrate within the hydrate stability field. With changes in temperature and pressure, a portion of pore hydrate and unhydrated water may transform into each other, affecting the shear strength of hydrate-bearing sediment. A shear strength model is proposed to consider not only hydrate saturation but also the change in temperature and pressure of hydrate-bearing sediment. The model is validated by experimental data with various hydrate saturation, temperature and pressure conditions. The deformation induced by partial dissociation was studied through depressurization tests under constant effective stress. The reduction in gas pressure within the hydrate stability field indeed caused sediment deformation. The dissociation-induced deformation can be reasonably estimated as the difference in volume between hydrate-bearing and hydrate-free sediments from the compression curves.

Abstract Prolonged ventricular repolarization has been associated with cardiovascular disease. We sought to investigate the association of prolonged ventricular repolarization with mild cognitive impairment (MCI) and the potential underlying neuropathological mechanisms in older adults. This cross-sectional study included 4328 dementia-free participants (age ≥ 65 years; 56.8% female) in the baseline examination of the Multidomain INterventions to delay dementia and Disability in rural China; of these, 989 undertook structural brain magnetic resonance imaging (MRI) scans. QT, QTc, JT, JTc, and QRS intervals were derived from 12-lead electrocardiograph. MCI, amnestic MCI (aMCI), and non-amnestic MCI (naMCI) were defined following the Petersen’s criteria. Volumes of gray matter (GM), white matter, cerebrospinal fluid, total white matter hyperintensities (WMH), periventricular WMH (PWMH), and deep WMH (DWMH) were automatically estimated. Data were analyzed using logistic and general linear regression models. Prolonged QT, QTc, JT, and JTc intervals were significantly associated with an increased likelihood of MCI and aMCI, but not naMCI (p

Abstract Giant hepatic cysts may lead to impaired liver function by compressing surrounding tissue, resulting in symptoms such as nausea or portal hypertension. Subharmonic‐aided pressure estimation (SHAPE) offers a noninvasive method for quantitatively estimating pressure and monitoring interstitial fluid pressure. A 55‐year‐old female patient with giant hepatic cysts was admitted to our hospital with elevated protein electrophoretic gamma levels, likely caused by compression of important liver vessels by the cysts. Before surgery, B‐mode ultrasound (BMUS) revealed multiple anechoic cystic lesions with thin, smooth walls in the right lobe. In SHAPE, the curve of the portal vein was lower than that of the hepatic vein, which is absolutely different from a healthy volunteer in our previous SHAPE study. It suggested that the patient may have had portal hypertension. Three days after laparoscopic fenestration and drainage of hepatic cysts, the size of the largest cyst had decreased on BMUS and protein electrophoretic gamma levels had normalized. While the curve of the portal vein remained lower than that of the hepatic vein, the difference between them had decreased compared to presurgery levels. SHAPE shows promise as a tool for noninvasively estimating portal hypertension and improving prognosis assessment in patients.

Abstract Chronic kidney disease (CKD) poses a significant global health dilemma, emerging from complex causes. Although our prior research has indicated that a deficiency in Reticulon-3 (RTN3) accelerates renal disease progression, a thorough examination of RTN3 on kidney function and pathology remains underexplored. To address this critical need, we generated Rtn3-null mice to study the consequences of RTN3 protein deficiency on CKD. Single-cell transcriptomic analyses were performed on 47,885 cells from the renal cortex of both healthy and Rtn3-null mice, enabling us to compare spatial architectures and expression profiles across 14 distinct cell types. Our analysis revealed that RTN3 deficiency leads to significant alterations in the spatial organization and gene expression profiles of renal cells, reflecting CKD pathology. Specifically, RTN3 deficiency was associated with Lars2 overexpression, which in turn caused mitochondrial dysfunction and increased reactive oxygen species levels. This shift induced a transition in renal epithelial cells from a functional state to a fibrogenic state, thus promoting renal fibrosis. Additionally, RTN3 deficiency was found to drive the endothelial-to-mesenchymal transition process and disrupt cell-cell communication, further exacerbating renal fibrosis. Immunohistochemistry and Western-Blot techniques were used to validate these observations, reinforcing the critical role of RTN3 in CKD pathogenesis. The deficiency of RTN3 protein in CKD leads to profound changes in cellular architecture and molecular profiles. Our work seeks to elevate the understanding of RTN3’s role in CKD’s narrative and position it as a promising therapeutic contender.

Abstract Parkinson’s disease (PD) is a progressive neurodegenerative disease characterized by mitochondrial dysfunction and accumulation of alpha-synuclein (α-Syn)-containing protein aggregates known as Lewy bodies (LB). Here, we investigated the entry of α-Syn into mitochondria to cause mitochondrial dysfunction and loss of cellular fitness in vivo. We show that α-Syn expressed in yeast and human cells is constitutively imported into mitochondria. In a transgenic mouse model, the level of endogenous α-Syn accumulation in mitochondria of dopaminergic neurons and microglia increases with age. The imported α-Syn is degraded by conserved mitochondrial proteases, most notably NLN and PITRM1 (Prd1 and Cym1 in yeast, respectively). α-Syn in the mitochondrial matrix that is not degraded interacts with respiratory chain complexes, leading to loss of mitochondrial DNA (mtDNA), mitochondrial membrane potential and cellular fitness decline. Importantly, enhancing mitochondrial proteolysis by increasing levels of specific proteases alleviated these defects in yeast, human cells, and a PD model of mouse primary neurons. Together, our results provide a direct link between α-synuclein-mediated cellular toxicity and its import into mitochondria and reveal potential therapeutic targets for the treatment of α-synucleinopathies.

ObjectiveThe role of informal social support in fostering active aging within the context of the “silver wave” is significant. This study investigated how such support influenced the mental health of older adults, with the goal of affirming its indispensable contribution to enhancing their psychological well-being.MethodsEmploying Principal Component Analysis (PCA) to construct the informal social support variable, this study rigorously analyzed the effects and underlying mechanisms of informal social support on mental health in older adults, utilizing data from the 2018 China Longitudinal Aging Social Survey (CLASS).ResultsInformal social support exerted a substantial positive influence on the mental health of older adults, particularly among younger, non-agricultural older adult populations who preferred cohabitation with their children. This form of support significantly enhanced mental well-being by elevating life satisfaction, improving access to medical services, and fostering active social engagement.ConclusionThis study elucidates the role of informal social support in bolstering the mental health of older adults. Future efforts should focus on fostering a supportive environment that enhances older adult care experiences, reforming the healthcare system to better meet the needs of the aging population, and promoting avenues for social engagement, thereby achieving a balanced integration of their emotional and physical care.

Abstract The purpose of this study was to investigate the relationship between circulating cytokines and liver function and prognosis of patients with advanced hepatocellular carcinoma (HCC) treated with radiotherapy combined with tislelizumab and anlotinib. The liver function indexes and pre-treatment levels of cytokines in 47 patients were measured by chemical method and flow cytometry. The median follow-up was 23.1 months. The objective response and the disease control rates were 46.8% and 68.1%, while overall survival (OS) and progression-free survival (PFS) were 12.6 and 11.4 months, respectively. Adverse events (2.1%) were grade 3–4. In addition to stage, intrahepatic metastasis and Child–Pugh score, pre-treatment interleukin-6 (IL-6) was the main cytokine affecting OS and PFS (p

Isothermal uniaxial compression experiments were performed in the temperature range of 340–460 °C and the deformation rate range of 0.001–1 s−1 to analyze the hot deformation behavior of the rapidly-solidified Al–Zn–Mg–Cu alloy in hot isostatic pressing state. A strain-compensated constitutive model was established to determine the flow stress in the alloy (based on the true stress-true strain data), and the average activation energy for the hot deformation was calculated as Q = ∼146 kJ/mol. The proposed model exhibited a high predictability with an average absolute relative error of 2.68% and a correlation coefficient of 0.99724. The processing map revealed that the alloy in the hot isostatic pressed state offers better workability than the spray-deposited alloy, and its optimal workable ranges at a strain of 0.78 are 370–390 °C/0.004–0.01 s−1 and 400–460 °C/0.005–0.06 s−1, respectively. The microstructural evolution shows that the main dynamic softening mechanism changes from dynamic recovery to continuous dynamic recrystallization with the increase in temperature and the decrease in strain rate.

Abstract Schizophrenia (SCZ), as a neurodevelopmental disorder and devastating disease, affects approximately 1% of the world population. Although numerous studies have attempted to elucidate the causes of SCZ occurrence, it is not clearly understood. Recently, the emerging roles of the gut microbiota in a range of brain disorders, including SCZ, have attracted much attention. While the molecular mechanism of gut microbiota in regulating the pathogenesis of SCZ is still lacking. Here, we first confirmed the difference of gut microbiome between SCZ patients and healthy controls, and then, we performed fecal microbiota transplantation (FMT) to clarify the roles of SCZ patients-derived microbiota in a specific pathogen free (SPF) mice model. 16 S rDNA sequencing confirmed that a significant difference of gut microbiome was present between two groups of FMT mice, which has a similar trend with the above human gut microbiome. Furthermore, we found that transplantation of fecal microbiota from SCZ patients into SPF mice was sufficient to induce schizophrenia-like (SCZ-like) symptoms, such as deficits in sociability and hyperactivity. Furthermore, the brains of mice colonized with SCZ microbiota displayed dysregulated transcript response and alternative splicing of SCZ-relevant genes. Moreover, 10 key genes were identified to be correlated with SCZ by an integrative transcriptome data analysis. Finally, 4 key genes were identified to be correlated with the 12 differential genera between two groups of FMT mice. Our results thus demonstrated that the gut microbiome might modify the transcriptomic profile in the brain, thereby modulating social behavior, and our present study can help better understand the link between gut microbiota and SCZ pathogenesis through the gut-brain axis.

Abstract Background ABCB4 gene-related cholestatic liver diseases have a wide spectrum of clinical and genetic variations. The correlation between genotype and clinical phenotype still unclear. This study retrospectively analyzed the clinical and pathological characteristics of 23 patients with ABCB4 gene-related cholestatic liver diseases. Next-generation sequencing was used to identify the genetic causes. Results The 23 included patients (15 children and 8 adults) were diagnosed as progressive familial intrahepatic cholestasis type 3 (PFIC3), drug-induced liver injury (DILI), cirrhosis cholestasis, cirrhosis, and mild liver fibrosis. Nineteen patients underwent liver pathological examination of the liver, exhibiting fibrosis, small bile duct hyperplasia, CK7(+), Cu(+), bile duct deletion, and cirrhosis. Thirty ABCB4 variants were identified, including 18 novel variants. Conclusion ABCB4 gene-related cholestatic liver diseases have a wide spectrum of clinical and genetic variations. Biallelic ABCB4 mutation carriers tended to severe PFIC3, which mostly occurs in children; while ABCB4 non-biallelic variants can lead to milder ICP, LACP, DILI or overlapping, mostly in adults. Thus, the ABCB4 genotype has a specific correlation with the phenotype, but there are exceptions. Non-biallelic null mutations can cause severe diseases. The mechanisms underlying this genetic phenotype require further investigation. Graphical Abstract

Abstract Background Thyroid nodule (TN) patients in China are subject to overdiagnosis and overtreatment. The implementation of existing technologies such as thyroid ultrasonography has indeed contributed to the improved diagnostic accuracy of TNs. However, a significant issue persists, where many patients undergo unnecessary biopsies, and patients with malignant thyroid nodules (MTNs) are advised to undergo surgery therapy. Methods This study included a total of 293 patients diagnosed with TNs. Differential methylation haplotype blocks (MHBs) in blood leukocytes between MTNs and benign thyroid nodules (BTNs) were detected using reduced representation bisulfite sequencing (RRBS). Subsequently, an artificial intelligence blood leukocyte DNA methylation (BLDM) model was designed to optimize the management and treatment of patients with TNs for more effective outcomes. Results The DNA methylation profiles of peripheral blood leukocytes exhibited distinctions between MTNs and BTNs. The BLDM model we developed for diagnosing TNs achieved an area under the curve (AUC) of 0.858 in the validation cohort and 0.863 in the independent test cohort. Its specificity reached 90.91% and 88.68% in the validation and independent test cohorts, respectively, outperforming the specificity of ultrasonography (43.64% in the validation cohort and 47.17% in the independent test cohort), albeit with a slightly lower sensitivity (83.33% in the validation cohort and 82.86% in the independent test cohort) compared to ultrasonography (97.62% in the validation cohort and 100.00% in the independent test cohort). The BLDM model could correctly identify 89.83% patients whose nodules were suspected malignant by ultrasonography but finally histological benign. In micronodules, the model displayed higher specificity (93.33% in the validation cohort and 92.00% in the independent test cohort) and accuracy (88.24% in the validation cohort and 87.50% in the independent test cohort) for diagnosing TNs. This performance surpassed the specificity and accuracy observed with ultrasonography. A TN diagnostic and treatment framework that prioritizes patients is provided, with fine-needle aspiration (FNA) biopsy performed only on patients with indications of MTNs in both BLDM and ultrasonography results, thus avoiding unnecessary biopsies. Conclusions This is the first study to demonstrate the potential of non-invasive blood leukocytes in diagnosing TNs, thereby making TN diagnosis and treatment more efficient in China.

Background and objective Lung cancer is a common malignant tumor of the lung. To explore the molecular mechanism of the occurrence and development of lung cancer is a hot topic in current research. Cyclic RNA D1 (CircCCND1) is highly expressed in lung cancer and may be a potential target for the treatment of lung cancer. The aim of this study was to investigate the effect of CircCCND1 on the malignant biological behaviors of lung cancer cells by regulating the miR-340-5p/transforming growth factor β-induced factor homeobox 1 (TGIF1) axis. Methods The expression of CircCCND1, miR-340-5p, and TGIF1 mRNA in human normal lung epithelial cells BEAS-2B and human lung cancer H446 cells were detected. H446 cells cultured in vitro were randomly divided into control group, CircCCND1 siRNA group, miR-340-5p mimics group, negative control group, and CircCCND1 siRNA+miR-340-5p inhibitor group. Cell proliferation, mitochondrial membrane potential, apoptosis, migration, and invasion were detected, and the expressions of CircCCND1, miR-340-5p, TGIF1 mRNA, BCL2-associated X protein (Bax), cleaved Caspase-3, N-cadherin, E-cadherin, and TGIF1 proteins in each group were detected. The targeting relationship of miR-340-5p with CircCCND1 and TGIF1 was verified. Results Compared with BEAS-2B cells, CircCCND1 and TGIF1 mRNA were increased in H446 cells, and miR-340-5p expression was decreased (P

Abstract Background The elimination of schistosomiasis remains a challenging task, with current measures primarily focused on the monitoring and control of Oncomelania hupensis (O. hupensis) snail, the sole intermediate host of Schistosome japonicum. Given the emerging, re-emerging, and persistent habitats of snails, understanding their genetic diversity might be essential for their successful monitoring and control. The aims of this study were to analyze the genetic diversity of Oncomelania hupensis robertsoni (O. h. robertsoni) using microsatellite DNA markers; and validate the applicability of previously identified microsatellite loci for O. hupensis in hilly regions. Methods A total of 17 populations of O. h. robertsoni from Yunnan Province in China were selected for analysis of genetic diversity using six microsatellite DNA polymorphic loci (P82, P84, T4-22, T5-11, T5-13, and T6-27). Results The number of alleles among populations ranged from 0 to 19, with an average of 5. The average ranges of expected (He) and observed (Ho) heterozygosity within populations were 0.506 to 0.761 and 0.443 to 0.792, respectively. The average fixation index within the population ranged from – 0.801 to 0.211. The average polymorphic information content (PIC) within the population ranged from 0.411 to 0.757, appearing to be polymorphic for all loci (all PIC > 0.5), except for P28 and P48. A total of 68 loci showed significant deviations from Hardy-Weinberg equilibrium (P < 0.05), and pairwise Fst values ranged from 0.051 to 0.379. The analysis of molecular variance indicated that 88% of the variation occurred within snail populations, whereas 12% occurred among snail populations. Phylogenetic trees and principal coordinate analysis revealed two distinct clusters within the snail population, corresponding to “Yunnan North” and “Yunnan South”. Conclusions O. h. robertsoni exhibited a relatively high level of genetic differentiation, with variation chiefly existing within snail populations. All snail in this region could be separated into two clusters. The microsatellite loci P82 and P84 might not be suitable for classification studies of O. hupensis in hilly regions. These findings provided important information for the monitoring and control of snail, and for further genetic diversity studies on snail populations. Graphical Abstract

Spiral ganglia neurons (SGNs) impairment can cause deafness. One important therapeutic approach involves utilizing stem cells to restore impaired auditory circuitry. Nevertheless, the inadequate implementation of research methodologies poses a challenge in accurately assessing the functionality of derived cells within the circuit. Here, we describe a novel method for converting human embryonic stem cells (hESCs) into otic neurons (ONs) and assess their functional connectivity using an optogenetic approach with cells or an organotypic slice of rat cochlear nucleus (CN) in coculture. Embryonic stem cell-derived otic neurons (eONs) exhibited SGN marker expression and generated functional synaptic connection when cocultured with cochlear nucleus neurons (CNNs). Synapsin 1 and VGLUT expression are found in the cochlear nucleus of brain slices, where eONs projected processes during the coculture of eONs and CN brain slices. Action potential spikes and I Na+ /I K+ of CNNs increased in tandem with light stimulations to eONs. These findings provide further evidence that eONs may be a candidate source to treat SGN-deafness.

Testicular choriocarcinoma is a relatively rare malignancy with a highly aggressive nature. Timely diagnosis and treatment can help prolong the survival of patients and even cure them. This case reports a 29-year-old male who presented to the clinic for a month with epigastric pain. On examination, a massive mass of approximately 9*10 cm could be palpated in the upper abdomen. When asked about his previous history, the patient only described a history of a right inguinal hernia that had been repaired 12 years earlier. The admission diagnosis was considered the retroperitoneal tumor, which was found to have metastasized to the liver and lungs after the completion of relevant tests. We then performed a CT-guided lune puncture biopsy on day 8 of admission. The biopsy pathology suggested metastatic cancer was considered. As the symptoms of tumor compression gradually worsened, we performed surgical treatment (retroperitoneal tumor resection + partial duodenal resection + enteroanastomosis) on day 13 of admission. The postoperative pathology was choriocarcinoma. We subsequently conducted a detailed inquiry with the patient’s family about his medical history and found a history of inguinal testicle. Through testicular ultrasound examination, it was preliminarily determined to be testicular choriocarcinoma (not yet pathologically confirmed). We wanted to start salvage chemotherapy as soon as possible after surgery. However, the patient’s postoperative condition was poor, with rapid progression of hepatopulmonary metastases and gradually increased thyrotoxicosis, and we started salvage chemotherapy (EP regimen: etoposide and cisplatin) on postoperative day 12. However, the patient was forced to stop due to a severe chemotherapy reaction and died of respiratory and cardiac arrest in the hospital. For male patients with retroperitoneal mass, the possibility of germ-cell neoplasm should first be excluded. By inquiring in detail about a history of cryptorchidism and in the initial days of hospitalization, testicular exploration, ultrasounds, and serum tumor markers (AFP, β-HCG) tests can be conducted to rule out the possibility of germ-cell neoplasm, thereby preventing misdiagnosis and treatment delays. If the clinical diagnosis is metastatic germ-cell tumor with severe symptoms of metastatic disease, surgery should never be used as the initial treatment.

Epidermoid cyst of the spleen is a rare disease, and relatively few cases were reported by literatures. Most published case reports provided inadequate information on the impact of splenic epidermoid cyst on tumor markers. A 32-year-old woman with a giant splenic epidermoid cyst was reported, for whom the serum concentration of a collection of tumor markers (CA19–9, CEA, CA125, CA242, and CA50) increased abruptly accompanied by left upper abdominal pain for 5 days. After comprehensive preoperative examination and multidisciplinary team discussion, we ruled out any concurrent malignancy and a laparoscopic total splenectomy was performed, during which the splenic cyst spontaneously ruptured unexpectedly. After surgery, the elevated serum tumor marker levels decreased sharply until reaching normal range 3 months later. Learning from the case, we conclude that interval monitoring of serum tumor markers is of critical value for patients with splenic epidermoid cyst. Abrupt elevation of tumor marker levels and abdominal pain may serve as signs of cyst rupture, which is strongly indicative of surgical intervention as soon as possible. Total removal of the splenic cyst is strongly suggested considering the recurrence and malignant potential of the splenic epidermoid cyst.

The World Federation of Ultrasound in Medicine and Biology (WFUMB) has started a series of position papers highlighting the role of ultrasound techniques for diagnosis, risk assessment and follow-up of incidental imaging findings. Gallbladder and biliary tree are among the most frequent anatomical localizations of incidental findings. A first part of the position paper on incidental findings of gallbladder and bile ducts was related to gallbladder polyps and other incidental findings of the gallbladder wall. Based on a description of normal findings, this second part addresses congenital anomalies and variations of the gallbladder and the biliary tree, asymptomatic bile duct dilatation and “silent” gallstones. Based on evidence on prevalence and outcome and with a special focus on ultrasound techniques, the position paper makes recommendations regarding diagnostic work-up, follow-up and treatment of these incidental findings.

Study region: Wuhan, China Study focus: In the context of intensifying human-water interactions under rapid urbanization, community perception has been demonstrated to significantly influence the coevolution trajectories of human-water system. This study employed a system dynamics (SD) model to simulate the human-water system coevolution processes at an urban scale. We incorporated the community sensitivity variable as one of the state variables within the SD model to investigate how community perceptions influence human decision-making and subsequently, the coevolution trajectories of the human-water system. Using Wuhan, a megacity, as a case study, we simulated the coevolution trajectories of the human-water system from 2001 to 2020 and predicted potential development trends across three scenarios for 2021–2050. Additionally, we examined the impact of community sensitivity on key variables to ascertain which policy actions could more significantly affect the coevolution of the human-water system. New hydrological insights for the region: The SD model, when integrated with community sensitivity, effectively simulates the coevolution of the human-water system and reflects the role of community perceptions. Between 2001 and 2020, urban water storage remained stable, while the evolution of water environment condition, domestic water use, and community sensitivity exhibited a U-shaped trend with distinct turning points. Productive water use consistently declined over this period, whereas the population size showed an S-shaped pattern, reflecting shifting demographic dynamics. Trends in each variable persisted across future scenarios, differing only in magnitude. Once economic development reaches a certain threshold, community sensitivity is anticipated to aid in restoring the water environment and halting its degradation. Implementing measures to control productive water use and improve the water environment condition could significantly contribute to the sustainable development of Wuhan City.

Summary: Background: Endovascular therapy (EVT) was demonstrated effective in acute large vessel occlusion (LVO) with large infarction. Revealing subgroups of patients who would or would not benefit from EVT will further inform patient selection for EVT. Methods: This post-hoc analysis of the ANGEL-ASPECT trial, a randomised controlled trial of 456 adult patients with acute anterior-circulation LVO and large infarction, defined by ASPECTS 3–5 or infarct core volume 70–100 mL, enrolled from 46 centres across China, between October 2, 2020 and May 18, 2022. Patients were randomly assigned (1:1) to receiving EVT and medical management or medical management alone. One patient withdrew consent, 455 patients were included in this post-hoc analysis and categorised into 4 subgroups by lower or higher NIHSS (< or ≥16) and smaller or larger infarct core (< or ≥70 mL). Those with lower NIHSS & smaller core, and higher NIHSS & larger core were considered clinical-radiological matched subgroups; otherwise clinical-radiological mismatched subgroups. Primary outcome was 90-day modified Rankin Scale (mRS). ANGEL-ASPECT is registered with ClinicalTrials.gov, NCT04551664. Findings: Overall, 139 (30.5%) patients had lower NIHSS & smaller core, 106 (23.3%) higher NIHSS & larger core, 130 (28.6%) higher NIHSS & smaller core, and 80 (17.6%) lower NIHSS & larger core. There was significant ordinal shift in the 90-day mRS toward a better outcome with EVT in clinical-radiological matched subgroups: lower NIHSS & smaller core (generalised OR, 1.76; 95% CI, 1.18–2.62; p = 0.01) and higher NIHSS & larger core (1.64; 1.06–2.54; 0.01); but not in the two clinical-radiological mismatched subgroups. Interpretation: Our findings suggested that in patients with anterior-circulation LVO and large infarction, EVT was associated with improved 90-day functional outcomes in those with matched clinical and radiological severities, but not in those with mismatched clinical and radiological severities. Simultaneous consideration of stroke severity and infarct core volume may inform patient selection for EVT. Funding: Unrestricted grants from industry [Covidien Healthcare International Trading (Shanghai), Johnson & Johnson MedTech, Genesis MedTech (Shanghai), and Shanghai HeartCare Medical Technology].

Abstract Crop residue cover plays a key role in the protection of black soil by covering the soil in the non-growing season against wind erosion and chopping for returning to the soil to increase organic matter in the future. Although there are some studies that have mapped the crop residue coverage by remote sensing technique, the results are mainly on a small scale, limiting the generalizability of the results. In this study, we present a novel corn residue coverage (CRC) dataset for Northeast China spanning the years 2013–2021. The aim of our dataset is to provide a basis to describe and monitor CRC for black soil protection. The accuracy of our estimation results was validated against previous studies and measured data, demonstrating high accuracy with a coefficient of determination (R2) of 0.7304 and root mean square error (RMSE) of 0.1247 between estimated and measured CRC in field campaigns. In addition, it is the first of its kind to offer the longest time series, enhancing its significance in long-term monitoring and analysis.

The field data acquisition of transient electromagnetic method is prone to jump due to various random disturbances. Wavelet denoising realizes data denoising by multi-scale decomposition, threshold setting and reconstruction of signal. In order to improve the data quality of TEM after wavelet denoising, a new wavelet denoising method based on the optimal threshold reference is proposed to improve the threshold selection method. Combined with the application of transient electromagnetic method in water-rich engineering, the noise reduction results of data under different threshold conditions are compared and analyzed, and the practical application effect of the proposed algorithm is discussed. The results show that the proposed method can further reduce the value of the induced electromotive force curve in the range of 1-4 ms, and make the whole period attenuation characteristics of the data more obvious. The smoke ring inversion results of the denoised data were analyzed, and three locations with relatively large electrical differences were explained, and the inversion results of the denoised data based on the optimal threshold reference were verified to be more accurate.

Abstract Noble metal materials have been identified as high efficiency catalysts for electrocatalytic reduction of nitrate, and the synthesis and manufacture of high catalytic activity and environmentally friendly catalysts of activating hydrogen for water purification applications is extremely attractive. In this work, the Pd–Cu single-atom catalysts (Pd–Cu-N-BC) were first prepared by direct growth of Pd–Cu single-atom on bamboo biochar by regulating the concentration of precursors and doping method, and then enhanced electrocatalytic reduction nitrate performance and N2 generation. The results showed that Pd–Cu-N-BC displayed excellent catalytic activity and reusability in electrocatalytic reduction nitrate with a low potential of 0.47 V vs. RHE (@10 mA cm−2). The maximum nitrate removal efficiency and N2 generation could reach about 100% and 72.32% within 180 min, respectively. The density functional theory (DFT) calculations confirmed that Cu atoms could catalyze the electrochemical reduction of nitrate to nitrite, and Pd atoms anchored in the nitrogen-doped biochar (N-BC) lattice could catalyze electrochemical reduction of nitrite to N2 involving the formation of hydrogen radical (H*). The characterization results of XANES showed that electronic synergistic effect between Pd and Cu single atoms significantly promotes the N2 production through hydrogenation while inhibiting the generation of byproducts, leading to significantly enhanced electrocatalytic reduction of nitrate to N2. Finally, Pd–Cu-N-BC was designed as a 3D particle electrode for enhanced electrocatalytic reduction of nitrate, exhibiting excellent stability and reusability, which could be considered as a suitable candidate for applications in the remediation of nitrate contamination. Graphical Abstract

Plant-mediated RNA interference (RNAi) has emerged as a promising technology for insect control. The green peach aphid, Myzus persicae, feeds on over 400 species of host plants. Brassica napus (rape) is the second most important oilseed crop worldwide. Myzus persicae is highly reproductive and causes severe damage to the rape plants due to its quite flexible life cycle. In this study, we tested the RNAi effects of transgenic rape plants on M. persicae. By in vitro feeding M. persicae with artificial diets containing double-stranded RNAs (dsRNAs) targeting seven aphid genes, we identified a new gene encoding the partitioning-defective protein 6 (Par6) as the most potent RNAi target. Tissue- and stage-expression analysis of Par6 suggested this gene is highly expressed in the embryo and adult stage of M. persicae. We next generated transgenic rape plants expressing dsPar6 by Agrobacterium-mediated transformation and obtained nine independent transgenic lines. Compared to wild-type control plants, transgenic rape lines expressing dsPar6 showed strong resistance to M. persicae. Feeding assays revealed that feeding transgenic rape plants to M. persicae significantly decreased MpPar6 expression and survival rate and impaired fecundity. Furthermore, we showed that the resistance levels to M. persicae are positively correlated with dsPar6 expression levels in transgenic rape plants. Our study demonstrates that transgenic rape plants expressing dsPar6 are efficiently protected from M. persicae. Interfering with the genes involved in embryo development could be the effective RNAi targets for controlling aphids and potentially other insect pests.

Abstract Background Exposure to general anesthesia influences neuronal functions during brain development. Recently, interneurons were found to be involved in developmental neurotoxicity by anesthetic exposure. But the underlying mechanism and long-term consequences remain elusive. Methods Pregnant mice received 2.5% sevoflurane for 6-h on gestational day 14.5. Pentylenetetrazole (PTZ)-induced seizure, anxiety- and depression-like behavior tests were performed in 30- and 60-day-old male offspring. Cortical interneurons were labeled using Rosa26-EYFP/-; Nkx2.1-Cre mice. Immunofluorescence and electrophysiology were performed to determine the cortical interneuron properties. Q-PCR and in situ hybridization (ISH) were performed for the potential mechanism, and the finding was further validated by in utero electroporation (IUE). Results In this study, we found that maternal sevoflurane exposure increased epilepsy susceptibility by using pentylenetetrazole (PTZ) induced-kindling models and enhanced anxiety- and depression-like behaviors in adolescent offspring. After sevoflurane exposure, the highly ordered cortical interneuron migration was disrupted in the fetal cortex. In addition, the resting membrane potentials of fast-spiking interneurons in the sevoflurane-treated group were more hyperpolarized in adolescence accompanied by an increase in inhibitory synapses. Both q-PCR and ISH indicated that CXCL12/CXCR4 signaling pathway downregulation might be a potential mechanism under sevoflurane developmental neurotoxicity which was further confirmed by IUE and behavioral tests. Although the above effects were obvious in adolescence, they did not persist into adulthood. Conclusions Our findings demonstrate that maternal anesthesia impairs interneuron migration through the CXCL12/CXCR4 signaling pathway, and influences the interneuron properties, leading to the increased epilepsy susceptibility in adolescent offspring. Our study provides a novel perspective on the developmental neurotoxicity of the mechanistic link between maternal use of general anesthesia and increased susceptibility to epilepsy.

Accurate land surface reflectance plays an important role in the accurate inversion of surface parameters, and atmospheric correction plays a decisive role in obtaining accurate reflectance. For GF-1 WFV and GF-6 WFV images, there are two major issues to be addressed, including the spectral differences between nadir with far off-nadir pixels and the spatial variability of atmospheric components for wide imaging. Therefore, this study focuses on these two issues using the Sensor Invariant Atmospheric Correction (SIAC) method. Our results reveal that the SIAC approach improves the correlation accuracy from 0.8868 to 0.9173 for GF-1 WFV image compared with Sentinel-2 reflectance, from 0.9530 to 0.9620 for GF-6 WFV image compared with the results using FLAASH model. For alleviating wide-swathed anisotropy, the directional imaging angle is calculated with the result ranging from 5.6450° to 33.7497°. Furthermore, the atmospheric components have been inversed pixel by pixel with obvious spatial variation. And the correlation of inversed aerosol optical thickness (AOT) and total column water vapor (TCWV) with a spatial resolution of 500 m TCWV with measured results of AERONET (AErosol RObotic NETwork) observation stations are 0.9175 and 0.4442, respectively. These results reveal that the atmospheric correction method works well, which is effective for the wide swath of Chinese GF-1 WFV and GF-6 WFV images on land.

Background: Ischemic cardiomyopathy (ICM) is a common condition that leads to left ventricular (LV) functional remodeling and poor prognosis. Extracorporeal membrane oxygenation (ECMO) can provide temporary circulatory support and facilitate percutaneous coronary intervention (PCI) in patients with ICM and hemodynamic instability. However, the impact of ECMO-assisted PCI on LV functional remodeling and clinical outcomes in ICM patients is unclear. Methods: We retrospectively analyzed 76 patients with ICM who underwent ECMO-assisted PCI at our institution between January 2013 and December 2022. We assessed the changes in LV functional remodeling using echocardiography at baseline and 12 months after the procedure. We also evaluated the incidence of major adverse cardiac and cerebrovascular events (MACCEs) and ECMO-related complications during hospitalization and at one-year follow-up. Results: The mean baseline left ventricular ejection fraction (LVEF) was 29.98 ± 2.65%. The rate of complete revascularization was 58%. The median duration of ECMO support was 38.99 hours. The most common ECMO-related complications were bleeding (8%) and lower extremity ischemia (5%). The one-year mortality rate was 30%. The overall freedom from MACCEs at 12 months was 59% (95% confidence interval (CI): 49–71%). LVEF increased significantly after the procedure from baseline to 6 months, yet decreased slightly at 12 months, although it was still higher than the baseline value. Wall motion score index (WMSI), end-diastolic volume index (EDVI), and end-systolic volume index (ESVI) decreased significantly from baseline to 12 months, indicating an improvement in LV function and a reduction in LV size. Conclusions: In a high-volume tertiary center with extensive experience in advanced heart failure therapies and a dedicated ECMO team, ECMO-assisted PCI demonstrated feasibility and safety in patients with ischemic cardiomyopathy. However, the rate of complete revascularization was modest at 58%. Despite the high-risk profile of the patients, ECMO-assisted PCI was associated with a significant improvement in LV functional remodeling and a favorable 12-month survival rate. Further prospective studies are needed to confirm these findings and to identify the optimal patient and device selection criteria for ECMO-assisted PCI.

The campus environment directly impacts college students’ psychological and emotional well-being, influencing their behavioral performance and the development of their personalities. Investigating the complex relationship between the campus spatial environment and students’ emotions is crucial for designing urban environments that support mental health. Using Yuelu Mountain National University Science and Technology City as a case study, this research developed a framework to analyze campus environment characteristics and emotional perception. The study quantitatively assessed emotional perceptions, examined the specific contributions of different campus environment elements to individual emotions, and created an emotion prediction map to explore these relationships in depth. The results indicate that “campus greenery” and “diversity” negatively affect “disappointment” and “depression”, while “sky views” positively impact “happiness” and “sense of security”. Additionally, “diversity” positively affects “relaxation”, and “campus greenery” and “diversity” have negative effects on “disappointment” and “depression”, with “diversity” having a particularly strong positive effect on “relaxation”. The pronounced spatial clustering of emotional perceptions on campus further underscores the significant influence of the campus environment on individual emotional experiences. As the first study to explore the mechanisms underlying the emotional perceptions of Chinese college students in relation to the campus environment, this research overcomes the limitations of traditional environmental assessment indicators by identifying campus environmental elements and psychological factors that better align with the psychological needs of college students. This provides a scientific basis for optimizing campus environments based on the emotional perceptions of students, thereby supporting mental health promotion and guiding campus environment construction. Moreover, the research methodology is broadly applicable. The integration of campus environment image data and deep learning offers a significant tool for assessing campus space and environmental perception, thereby enhancing human-centered environmental assessment and prediction while more accurately reflecting architectural space perception.

Cerebellar ataxia is an uncommon and atypical manifestation of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis, often accompanied by seizures, psychiatric symptoms, and cognitive deficits. Previous cases of isolated brainstem-cerebellar symptoms in patients with anti-NMDAR encephalitis have not been documented. This report presents a case of anti-NMDAR encephalitis in which the patient exhibited cerebellar ataxia, nystagmus, diplopia, positive bilateral pathological signs, and hemiparesthesia with no other accompanying symptoms or signs. The presence of positive CSF anti-NMDAR antibodies further supports the diagnosis. Other autoantibodies were excluded through the use of cell-based assays. Immunotherapy was subsequently administered, leading to a gradual recovery of the patient.

Summary: Background: Hospitals in China are classified into tiers (1, 2 or 3), with the largest (tier 3) having more equipment and specialist staff. Differential health insurance cost-sharing by hospital tier (lower deductibles and higher reimbursement rates in lower tiers) was introduced to reduce overcrowding in higher tier hospitals, promote use of lower tier hospitals, and limit escalating healthcare costs. However, little is known about the effects of differential cost-sharing in health insurance schemes on choice of hospital tiers. Methods: In a 9-year follow-up of a prospective study of 0.5 M adults from 10 areas in China, we examined the associations between differential health insurance cost-sharing and choice of hospital tiers for patients with a first hospitalisation for stroke or ischaemic heart disease (IHD) in 2009–2017. Analyses were performed separately in urban areas (stroke: n = 20,302; IHD: n = 19,283) and rural areas (stroke: n = 21,130; IHD: n = 17,890), using conditional logit models and adjusting for individual socioeconomic and health characteristics. Findings: About 64–68% of stroke and IHD cases in urban areas and 27–29% in rural areas chose tier 3 hospitals. In urban areas, higher reimbursement rates in each tier and lower tier 3 deductibles were associated with a greater likelihood of choosing their respective hospital tiers. In rural areas, the effects of cost-sharing were modest, suggesting a greater contribution of other factors. Higher socioeconomic status and greater disease severity were associated with a greater likelihood of seeking care in higher tier hospitals in urban and rural areas. Interpretation: Patient choice of hospital tiers for treatment of stroke and IHD in China was influenced by differential cost-sharing in urban areas, but not in rural areas. Further strategies are required to incentivise appropriate health seeking behaviour and promote more efficient hospital use. Funding: Wellcome Trust, Medical Research Council, British Heart Foundation, Cancer Research UK, Kadoorie Charitable Foundation, China Ministry of Science and Technology, and National Natural Science Foundation of China.

Wilson's disease (WD) is a genetic disorder that primarily leads to the pathological accumulation of copper (Cu) in the liver, causing an abnormal increase in reactive oxygen species (ROS). The prevailing clinical therapy for WD involves lifelong use of Cu chelation drugs to facilitate Cu excretion in patients. However, most available drugs exert severely side-effects due to their non-specific excretion of Cu, unsuitable for long-term use. In this study, we construct a prochelator that enables precise and controlled delivery of Cu chelator drugs to the liver in WD model, circumventing toxic side effects on other organs and normal tissues. This innovative prochelator rapidly releases the chelator and the fluorescent molecule methylene blue (MB) upon activation by ROS highly expressed in the liver of WD. The released chelator coordinates with Cu, efficiently aiding in Cu removal from the body and effectively inhibiting the pathological progression of WD.

Pacific Island countries have experienced periodic dengue, chikungunya and Zika outbreaks for decades. The prevention and control of these mosquito-borne diseases rely heavily on control of Aedes aegypti mosquitoes, which in most settings are the primary vector. Introgression of the intracellular bacterium Wolbachia pipientis (wMel strain) into Ae. aegypti populations reduces their vector competence and consequently lowers dengue incidence in the human population. Here we describe successful area-wide deployments of wMel-infected Ae. aegypti in Suva, Lautoka, Nadi (Fiji), Port Vila (Vanuatu) and South Tarawa (Kiribati). With community support, weekly releases of wMel-infected Ae. aegypti mosquitoes for between 2 to 5 months resulted in wMel introgression in nearly all locations. Long term monitoring confirmed a high, self-sustaining prevalence of wMel infecting mosquitoes in almost all deployment areas. Measurement of public health outcomes were disrupted by the Covid19 pandemic but are expected to emerge in the coming years.

Corn is the dominant crop planted in Northeast China, and its accurate and timely mapping is important for food security and agricultural management in China. However, the absence of enough labels is challenging for corn accurate mapping in a regional area using machine learning methods or deep learning methods. In this study, an efficient way of automatic labelling and mapping of corn planted areas by combining Global Ecosystem Dynamics Investigation (GEDI) data and Sentinel-2 images is proposed. We explore the height and vertical structure differences between corn and other crops derived from GEDI features and generate labels automatically by referencing crop type products and transferring models from historical years. The trained learning networks of automatic labelling from GEDI points and the trained decision trees of the Random Forest (RF) classifier can be transferred to corn mapping in arbitrary target years. The Sentinel-2 features are combined to perform wall-to-wall corn mapping using a random forest algorithm and GEDI-based labels. This approach is used to map corn planted areas in Northeast China from 2019 to 2022, and the classification results are validated using independent labels collected in field campaigns in 2023, published maps, and official statistics. Our classification results reveal that our proposed method achieves high accuracy and robustness with an average overall accuracy of 0.91 validated using testing labels from spatial-type stratified sampling. The correlation coefficient (R2) between our classified result with the official statistical data and published classification results reach 0.96 and 0.98, respectively. These results demonstrate the potential of GEDI data for automatic label collection for vegetation with height difference and provide a new approach for efficient crop mapping on a large-scale.

More than half of all cancers demonstrate aberrant c-Myc expression, making this arguably the most important human oncogene. Deregulated long non-coding RNAs (lncRNAs) are also commonly implicated in tumorigenesis, and some limited examples have been established where lncRNAs act as biological tuners of c-Myc expression and activity. Here, we demonstrate that the lncRNA denoted c-Myc Enhancing Factor (MEF) enjoys a cooperative relationship with c-Myc, both as a transcriptional target and driver of c-Myc expression. Mechanistically, MEF functions by binding to and stabilizing the expression of hnRNPK in colorectal cancer cells. The MEF-hnRNPK interaction serves to disrupt binding between hnRNPK and the E3 ubiquitin ligase TRIM25, which attenuates TRIM25-dependent hnRNPK ubiquitination and proteasomal destruction. In turn, the stabilization of hnRNPK through MEF enhances c-Myc expression by augmenting the translation c-Myc. Moreover, modulating the expression of MEF in shRNA-mediated knockdown and overexpression studies revealed that MEF expression is essential for colorectal cancer cell proliferation and survival, both in vitro and in vivo. From the clinical perspective, we show that MEF expression is differentially increased in colorectal cancer tissues compared to normal adjacent tissues. Further, correlations exist between MEF, c-Myc, and hnRNPK suggesting the MEF-c-Myc positive feedback loop is active in patients. Together these data demonstrate that MEF is a pivotal partner of the c-Myc network and propose MEF as a valuable therapeutic target for colorectal cancer.

Tintinnids (Ciliophora) are important microzooplankton grazers. In the Southern Ocean, they are found in the Antarctic Zone, Polar Front and Subantarctic Zone. The Antarctic Zone encompasses large gyres (Weddell Gyre and Ross Gyre) and the Antarctic Slope Current around the continent. The influence of these water masses on tintinnid communities has not been studied. This study investigated the tintinnid community structure in the Weddell and Cosmonaut seas in the summer of 2022. In the Weddell Gyre, tintinnid abundance was significantly lower in the interior than at the fronts. The dominant species differed between the east and west fronts: the proportion of Codonellopsis gaussi was high at the west front, whilst Laackmanniella naviculaefera, Salpingella sp. and Salpingella faurei showed high abundances at the east front. Tintinnid communities varied from inshore to offshore of the Cosmonaut Sea, possibly because of the influence from the Antarctic Slope Current and Antarctic Circumpolar Current. The Antarctic Slope Current was characterized by the occurrence of Cymatocylis drygalskii, whilst the Antarctic Circumpolar Current was characterized by Codonellopsis glacialis, Cymatocylis convallaria and Cy. calyciformis. We proposed that Cy. drygalskii can be used as an indicator of the Antarctic Slope Current. Moreover, we classify polymorphic C. gaussi into three types, in accordance with their loricae, and report their distribution characteristics in water masses. Our results contribute to a better understanding of tintinnid horizontal distribution in different parts of the Weddell Gyre and water masses and serve as a baseline for future studies of pelagic community responses to climate change in the Southern Ocean.

Abstract Purpose Older patients with acute type A aortic dissection (ATAAD) have higher risk of mortality than that of younger patients when a total arch reconstruction (TAR) is required. Triple-branched stent graft (TBSG) implantation is a novel technique for TAR. However, early outcomes of a TBSG implantation in older patients have not been reported. This study aimed to evaluate the early outcomes of the TBSG technique in older patients with ATAAD. Methods From February 2015 to December 2020, 640 patients who simultaneously underwent an emergent open aortic surgery and TBSG implantation for ATAAD were enrolled in this study. They were categorized into the younger (age ≤ 70 years old, n = 573) and older groups (age > 70 years, n = 67). Clinical data of all patients were retrospectively reviewed. Result The mean ages of the patients in the younger and older groups were 45.3 ± 9.6 years old and 73.5 ± 3.0 years old, respectively. Preoperative characteristics were similar between the two groups, except for weight and incidence of moderate or greater aortic regurgitation, which were lower in the older group than those in the younger group. Surgical procedure and duration (i.e., duration for cardiopulmonary bypass, aortic cross-clamp, selected cerebral perfusion, and total circulation arrest) were comparable between the two groups (p > 0.05). Patients in the older group had higher incidence of dialysis for acute kidney injury and longer ICU stay compared with those in the younger group. However, the incidences of 30-day mortality (5.1% in younger group vs. 7.5% in older group, p = 0.407) and other major complications (i.e., neurological adverse events) were similar between the two groups. Conclusion TBSG implantation for ATAAD resulted in an acceptable mortality rate in patients above 70 years old, thus, it could be a feasible surgical procedure to perform in older patients with ATAAD when a TAR is required.

Abstract Background Oncomelania hupensis is the sole intermediate host of Schistosoma japonicum. Its emergence and recurrence pose a constant challenge to the elimination of schistosomiasis in China. It is important to accurately predict the snail distribution for schistosomiasis prevention and control. Methods Data describing the distribution of O. hupensis in 2016 was obtained from the Yunnan Institute of Endemic Disease Control and Prevention. Eight machine learning algorithms, including eXtreme Gradient Boosting (XGB), support vector machine (SVM), random forest (RF), generalized boosting model (GBM), neural network (NN), classification and regression trees (CART), k-nearest neighbors (KNN), and generalized additive model (GAM), were employed to explore the impacts of climatic, geographical, and socioeconomic variables on the distribution of suitable areas for O. hupensis. Predictions of the distribution of suitable areas for O. hupensis were made for various periods (2030s, 2050s, and 2070s) under different climate scenarios (SSP126, SSP245, SSP370, and SSP585). Results The RF model exhibited the best performance (AUC: 0.991, sensitivity: 0.982, specificity: 0.995, kappa: 0.942) and the CART model performed the worst (AUC: 0.884, sensitivity: 0.922, specificity: 0.943, kappa: 0.829). Based on the RF model, the top six important variables were as follows: Bio15 (precipitation seasonality) (33.6%), average annual precipitation (25.2%), Bio2 (mean diurnal temperature range) (21.7%), Bio19 (precipitation of the coldest quarter) (14.5%), population density (13.5%), and night light index (11.1%). The results demonstrated that the overall suitable habitats for O. hupensis were predominantly distributed in the schistosomiasis-endemic areas located in northwestern Yunnan Province under the current climate situation and were predicted to expand north- and westward due to climate change. Conclusions This study showed that the prediction of the current distribution of O. hupensis corresponded well with the actual records. Furthermore, our study provided compelling evidence that the geographical distribution of snails was projected to expand toward the north and west of Yunnan Province in the coming decades, indicating that the distribution of snails is driven by climate factors. Our findings will be of great significance for formulating effective strategies for snail control. Graphical Abstract

In recent years, the power conversion efficiency of perovskite solar cells has increased rapidly. Perovskites can be prepared using simple and cost-effective solution methods. However, the perovskite films obtained are usually polycrystalline and contain numerous defects. Passivation of these defects is crucial for enhancing the performance of solar cells. Here, we report the use of propylamine hydroiodide (PAI) for defect passivation. We found that PAI can result in higher-efficiency cells by reducing the defects and suppressing non-radiative recombination. Consequently, n-i-p perovskite solar cells with a certificated efficiency of 21% were obtained. In addition, PAI exhibited excellent performance in p-i-n devices by serving as a buried interface layer, leading to an improved efficiency of 23%.

High-value resources beyond oil extraction for the olive industry need to be developed due to increased olive production. Soluble dietary fibers (SDFs) and olive proteins (OPIs) are important components of olives. However, the commercial production process partially damages OPIs’ emulsifying and foaming properties. Thus, the preparation of SDF-OPI complexes would help protect and even improve the emulsifying and foaming properties. The effects of pH and thermal–ultrasonic treatment on the complexation were explored, which showed that the SDF-OPI complexes prepared at pH 5 exhibited superior solubility (p < 0.05). SDF addition noticeably improved OPI thermal stability, emulsifying properties, and foaming properties. Moreover, the complexes prepared by thermal–ultrasonic treatment exhibited higher emulsion stability and lower emulsification activity than those prepared without thermal–ultrasonic treatment. In the acidic system, the electrostatic interaction was considered the main driving factor, assisted by the hydrophobic interaction. Additionally, after thermal–ultrasonic treatment, the covalent binding was observed by infrared spectroscopy. These results revealed the interaction mechanism between SDF and OPI, and the complexes significantly enhanced the functional properties of OPI. This study provides a reference for the high-value utilization of olives, thus broadening their potential uses in the food sector and beyond.