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The aggregate-matrix interfacial transition zone (ITZ) is known as the weakest link in recycled concrete. Cellulose nanofiber (CNF), as a green and renewable nano-reinforcement material, proven effective in modifying the mechanical properties of cementitious composites, is considered for incorporation into recycled concrete for the first time. This study investigates the effect of CNF addition on the microstructure characterization and nano-mechanical behavior of ITZs in recycled concrete. The elastic modulus distribution and 2D microstructure topology of the old/new aggregate-matrix interfaces are characterized through statistic nanoindentation technique for different CNF dosages. The results show that the width of the new ITZ is between 40 μm and 60 μm, while the width of the old ITZ is between 30 μm and 50 μm. The old ITZ has better mechanical properties than the new ITZ, where a remarkable low elastic modulus area at the new ITZ is observed. The incorporation of an appropriate amount of CNF can significantly improve the nano-properties of the new ITZ due to the increased hydration degree of cement particles at the recycled aggregate-matrix interface. Moreover, a dense network structure around the cement hydration products is formed with improved compactness, resulting in an increase in the overall mechanical strength of the recycled aggregate concrete material. The research outcome provides a viable solution for improving the performance of concrete containing recycled aggregates and urges the green and sustainable development in concrete industry.

Abstract Background The government has rapidly promoted the privatisation of healthcare to improve systemic performance, based on the theory that markets improve efficiency. This study aims to measure the efficiency of private hospitals following their expansion and venture into the medical tourism industry through extensive governmental support. Methods Inpatient utilisation of 101 private, non-specialised hospitals in Malaysia in 2014 and 2018 from the Health Informatics Centre, Ministry of Health Malaysia database was studied using paired samples t-test, analysis of variance (ANOVA), and the Pabón‐Lasso model. Results Better quantitative performance was found among larger hospitals, those with hospital accreditation, and those participating in medical tourism activities. There is a scale effect of efficiency between smaller and larger hospitals. However, when compared within respective size categories, Category 1 (small hospitals with less than 100 beds) has the highest percentage of efficient hospitals (39.3 per cent in 2014 and 35.7 per cent in 2018 in Sector 3 of the Pabón Lasso graphs). Conclusion This study has found that a higher bed occupancy rate (BOR) and longer average length of stay (ALoS) are associated with larger private hospitals, hospital accreditation, and participation in medical tourism activities in Malaysia. There is a need to expedite strategic hospitals partnership for resource optimisation and capacity pooling towards producing better performance.

Abstract The passivation and depassivation characteristics of Super 13Cr stainless steel were examined under a range of oxygen partial pressures within a high-temperature (120 ℃) and high-pressure (3 MPa) CO2 atmosphere. We performed comprehensive electrochemical assessments, encompassing open-circuit potential monitoring, electrochemical impedance spectroscopy, and linear polarization resistance analysis, to evaluate the corrosion resistance and passive film stability. The results demonstrate that the addition of low O2 partial pressures enhanced the stability of the passive film, while higher O2 levels led to the loss of the passivation properties of Super 13Cr stainless steel. The study elucidates the pivotal role of oxygen in the corrosion mechanisms affecting Super 13Cr stainless steel, presenting valuable data to enhance for integrity management in severe environmental conditions.

Abstract Background DNA metabarcoding applies high-throughput sequencing approaches to generate numerous DNA barcodes from mixed sample pools for mass species identification and community characterisation. To date, however, most metabarcoding studies employ second-generation sequencing platforms like Illumina, which are limited by short read lengths and longer turnaround times. While third-generation platforms such as the MinION (Oxford Nanopore Technologies) can sequence longer reads and even in real-time, application of these platforms for metabarcoding has remained limited possibly due to the relatively high read error rates as well as the paucity of specialised software for processing such reads. Results We show that this is no longer the case by performing nanopore-based, cytochrome c oxidase subunit I (COI) metabarcoding on 34 zooplankton bulk samples, and benchmarking the results against conventional Illumina MiSeq sequencing. Nanopore R10.3 sequencing chemistry and super accurate (SUP) basecalling model reduced raw read error rates to ~ 4%, and consensus calling with amplicon_sorter (without further error correction) generated metabarcodes that were ≤ 1% erroneous. Although Illumina recovered a higher number of molecular operational taxonomic units (MOTUs) than nanopore sequencing (589 vs. 471), we found no significant differences in the zooplankton communities inferred between the sequencing platforms. Importantly, 406 of 444 (91.4%) shared MOTUs between Illumina and nanopore were also found to be free of indel errors, and 85% of the zooplankton richness could be recovered after just 12–15 h of sequencing. Conclusion Our results demonstrate that nanopore sequencing can generate metabarcodes with Illumina-like accuracy, and we are the first study to show that nanopore metabarcodes are almost always indel-free. We also show that nanopore metabarcoding is viable for characterising species-rich communities rapidly, and that the same ecological conclusions can be obtained regardless of the sequencing platform used. Collectively, our study inspires confidence in nanopore sequencing and paves the way for greater utilisation of nanopore technology in various metabarcoding applications.

The Lower Shihezi Formation of the Upper Paleozoic at the northeastern margin of the Ordos Basin develops widely distributed thick massive and multilayer gas reservoirs. How to formulate an effective development policy is a difficult and hot spot. In this article, reservoir characteristics and production capacity influencing factors of the tight gas sandstone in Lower Shihezi Formation in this area are systematically studied, and optimization schemes of development measures for massive and multilayer gas reservoirs are proposed. The results show that the petrophysical characteristics of the small pore–mesopore type gas reservoir in the target layer are the best, with the average porosity, permeability, and coordination number of 7.6%, 0.74 mD, and 3.3, respectively. Thick sand body, high structural position, good petrophysical properties, and high drilling rate of sandstone are all conducive to drilling high production gas wells. Development policies for massive and multilayer gas reservoirs have been formulated: (1) the preferred well type for massive gas reservoir is vertical well + horizontal well, while the preferred well type for multilayer gas reservoir is horizontal well + stepped horizontal well; (2) the reasonable horizontal segment length of massive gas reservoir is 1,000 m, and the reasonable horizontal segment length of multilayer gas reservoir is 1,250 m; (3) similar to massive and multilayer gas reservoirs, the more the fracture stages, the higher the cumulative gas production, and the optimal fracture stage number of both gas reservoirs is 8; (4) the optimal fracture half-length and the angle between the fracture and the horizontal section are 140 m and 90°, respectively; and (5) the reasonable well spacing of vertical wells is 600 m and that of horizontal wells is 750 m. The development policy proposed in this study is suitable for the efficient development of complex tight sandstone gas reservoirs in similar areas.

Abstract Objective The early identification and diagnosis of transplant-associated thrombotic microangiopathy (TA-TMA) are essential yet difficult in patients underwent hematopoietic stem cell transplantation (HSCT). To develop an evidence-based, nurse-leading early warning model for TA-TMA, and implement the healthcare quality review and improvement project. Methods This study was a mixed-methods, before-and-after study. The early warning model was developed based on quality evidence from literature search. The healthcare quality review and improvement project mainly included baseline investigation of nurse, improvement action and effectiveness evaluation. The awareness and knowledge of early parameter of TA-TMA among nurses and the prognosis of patients underwent HSCT were compared before and after the improvement. Results A total of 1 guideline, 1 evidence synthesis, 4 expert consensuses, 10 literature reviews, 2 diagnostic studies, and 9 case series were included in the best evidence. The early warning model including warning period, high-risk characteristics and early manifestation of TA-TMA was developed. The improvement action, including staff training and assessment, suspected TA-TMA identification and patient education, was implemented. The awareness and knowledge rate of early parameter of TA-TMA among nurses significantly improved after improvement action (100% vs. 26.7%, P

Abstract Background Few studies have been conducted on treating temporomandibular disorders (TMDs) with new digital occlusal splints, which has increasingly attracted wide attention. Methods To evaluate the clinical efficacy and quality of life (QoL) of Kovacs digital occlusal splint (KDOS) treatment in patients with TMD. Materials and methods Eighty-nine patients with TMD who were treated using KDOS were analyzed. The patients were divided into three groups according to the Wilkes stage. The clinical symptoms and QoL scores of the patients in each group were recorded before and at least three months after treatment, and the data were statistically analyzed and compared. The relationships between the disease severity, sex, age, and level of QoL before treatment and improvement in the clinical symptoms were analyzed using binary logistic regression. Results The mean age and follow-up period of the patients were 28.0 ± 10.4 years and 4.9 ± 2.1 months, respectively. After KDOS treatment, the improvement rates of joint noise and pain were 80.4% and 69.8%, respectively. Additionally, the patients’ maximum mouth opening and global QoL mean scores significantly improved compared to those before treatment (p

Abstract Acute lung injury (ALI) is a life threatening disease in critically ill patients, and characterized by excessive reactive oxygen species (ROS) and inflammatory factors levels in the lung. Multiple evidences suggest that nanozyme with diversified catalytic capabilities plays a vital role in this fatal lung injury. At present, we developed a novel class of polydopamine (PDA) coated cerium dioxide (CeO2) nanozyme (Ce@P) that acts as the potent ROS scavenger for scavenging intracellular ROS and suppressing inflammatory responses against ALI. Herein, we aimed to identify that Ce@P combining with NIR irradiation could further strengthen its ROS scavenging capacity. Specifically, NIR triggered Ce@P exhibited the most potent antioxidant and anti-inflammatory behaviors in lipopolysaccharide (LPS) induced macrophages through decreasing the intracellular ROS levels, down-regulating the levels of TNF-α, IL-1β and IL-6, up-regulating the level of antioxidant cytokine (SOD-2), inducing M2 directional polarization (CD206 up-regulation), and increasing the expression level of HSP70. Besides, we performed intravenous (IV) injection of Ce@P in LPS induced ALI rat model, and found that it significantly accumulated in the lung tissue for 6 h after injection. It was also observed that Ce@P + NIR presented the superior behaviors of decreasing lung inflammation, alleviating diffuse alveolar damage, as well as promoting lung tissue repair. All in all, it has developed the strategy of using Ce@P combining with NIR irradiation for the synergistic enhanced treatment of ALI, which can serve as a promising therapeutic strategy for the clinical treatment of ROS derived diseases as well.

ABSTRACT The objective of the study was to ascertain an optimal Helicobacter pylori diagnostic strategy using population-level laboratory data comparing the performance of serology against urea breath test (UBT). H. pylori diagnostic test results for serology and UBT from two laboratories over a 12-year period (2006–20017) were extracted, linked, and analyzed. A subset of this population underwent both methods of testing within days of each other, enabling a direct comparison of the two methods. The average prevalence of H. pylori positivity was 21.3% by serology and 17.5% by UBT. There were 2,612 individuals who had serology performed first, followed by UBT within 14 days. For this subset, the sensitivity of serology compared with UBT was 96.5% with a specificity of 79.2%. The negative predictive value for serology was 98.4%. Contrary to various recent clinical guidelines, the data show that serology still has utility as a sensitive enough test to be used as an initial H. pylori screening test in a lower prevalence population. Negative serology can be used with confidence to rule out active infection, whereas a positive serology could be followed up with a UBT or a similar performing test such as stool antigen to differentiate active from past infection. For population-based diagnostic recommendations, such a strategy may be ideal since serology generally costs less than UBT and may be combined with a blood draw being done for other diagnostic tests. Continuing to offer serology increases options for patients and may provide economic benefits for single-payer health care systems or health maintenance organizations.IMPORTANCEThis study compares the performance of serology with urea breath test in the diagnosis of Helicobacter pylori in a population-level data set and mimics a head-to-head direct comparison as the study population had both tests performed within 2 weeks of each other. This provides new information supporting the use of serology in a diagnostic algorithm. There are several instances where serology could be preferable to patients to rule out disease, despite some guidelines suggesting serology should not be used.

ObjectivesNon-invasive vagus nerve stimulation (nVNS) is an emerging neuromodulation technique in recent years, which plays a role in nervous system diseases, psychiatric diseases, and autoimmune diseases. However, there is currently no comprehensive analysis of all the literature published in this field. Therefore, in this article, a bibliometric analysis will be conducted on all the literature published in the field of nVNS in the past 20 years.MethodsAll articles and reviews published in this field from 2004 to 2023 were extracted from the WOS core database. VOSviewer 1.6.18.0, Scimago Graphica, CiteSpace 6.2.R2, and Excel 2021 were used to analyze the number of publications, participating countries, institutions, authors, references, and research hotspots in this field.ResultsA total of 843 articles were included in the bibliometric analysis of nVNS. Over the past 20 years, the number of publications in this field has gradually increased, reaching a peak in 2023. The United States and China ranked top two in terms of publication volume, and institutions from these two countries also ranked high in terms of publication volume, citation count, and collaboration intensity. Rong Peijing is the author with the most publications, while Bashar W Badran is the most cited author. Articles in the field of nVNS were most frequently published in Frontiers in Neuroscience, while Brain Stimulation had the most citations. Currently, research hotspots in nVNS mainly focus on its application in diseases and related mechanisms.ConclusionWe conducted a comprehensive analysis of the field of nVNS, clarifying the previous research directions, which is helpful to expand its indications and promote clinical application.

To evaluate the plan quality and robustness of volumetric modulated arc therapy (VMAT) and intensity modulated radiation therapy (IMRT) for breast cancer, 50 patients, including 25 patients who received radiotherapy after breast-conserving surgery (BCR) and 25 patients who received postmastectomy radiotherapy (PRT), were selected for this study. Nominal VMAT and IMRT plans were generated for each patient on Eclipse treatment planning system (version 15.6). The dosimetric metrics, dose distribution, gamma passing rate, and delivery time were compared. In addition, 12 uncertainty plans with plan isocenter uncertainty and CT density uncertainty were recalculated based on the nominal plans for each patient. The dose volume histogram (DVH) band width (DVHBW) was adopted to quantify the plan robustness of the nominal plans for the perturbed scenarios in this study. For BCR, the dosimetric metrics except planning target volume (PTV) conformal index (CI) and ipsilateral lung V 5 were not statistically different for IMRT and VMAT plans. PTV CI of VMAT plans was better than that of IMRT plans (VMAT: 0.923 ± 0.024, IMRT: 0.855 ± 0.032, p = 0.003). The ipsilateral lung V 5 of VMAT plan was higher than that of IMRT plan (VMAT: 42.4% ± 2.8%, IMRT: 40.5% ± 4.0%, p = 0.045). The VMAT plans save more than 1.20 min compared to the IMRT plans (VMAT: 0.87 min, IMRT: 2.08 min, p < 0.001). The gamma passing rates of VMAT plans were better than those of IMRT plans (3 mm/3%, VMAT: 99.7% ± 0.2%, IMRT: 99.4% ± 0.4%, p < 0.001; 2 mm/2%, VMAT: 97.2% ± 1.0%, IMRT: 96.9% ± 0.6%, p = 0.108). For PRT, the dosimetric metrics of VMAT plans, including PTV D mean, homogeneity index (HI), CI, and D max of spinal cord, were significantly better than those of IMRT plans. The VMAT plans save more than 45% time compared with IMRT plans (VMAT: 1.54 min, IMRT: 2.81 min, p < 0.001). The difference in gamma passing rates between VMAT plans and IMRT plans was not statistically significant. For the plan robustness, the DVHBW of VMAT plans and IMRT plans for BCR were 2.09% ± 0.23% and 2.98% ± 0.40%, respectively (p < 0.05). For PRT, the DVHBW of VMAT plans was significantly better than those of IMRT plans (VMAT: 3.05% ± 0.26%, IMRT: 3.57% ± 0.27%, p < 0.05). The results show that the dosimetric metrics of VMAT plans were comparable to those of IMRT plans. More importantly, the VMAT plans had excited dose distribution and fast execution efficiency. The plan robustness of VMAT plans were superior.

Aiming at the demand of electric cinch and release priority function of high-end vehicle door latches, a cam swing linkage and spring linkage combined mechanism is proposed, and a combined mechanism of double cam single swing linkage and spring four bar mechanism is constructed. Combined with the characteristics of limiting blocks, contact states, cam intermittent movement, profile abrupt change and other components, it can realize three motion modes of flexible and adaptive rolling, rigid pushing, avoiding and releasing, and switch among them. Embedded into the ratchet and pawl locking mechanism, the combined mechanism is transformed into electric cinch and release branches, corresponding to the three working conditions of the vehicle door latch: electric cinch, manual or power release and reset, and cinch branch reset. Based on the corresponding driving modes and motion boundary conditions, the compatible function of the cinch motion and the existing branches in the latch, the release priority function, and the half-lock release function in the case of the cinch pinch are studied and analyzed. The mechanism and the drive are embedded in the door latch for simulation, and the contact force between the release cam and the swing linkage, the swing linkage and the ratchet, and the ratchet and the paw are studied in all working conditions. The time of the mechanism to realize each function matches the design requirements of the vehicle door latch, the time of the electric cinch process is 420.97 ms, the reset time is 29.03 ms, and the manual release time is 622 ms.

Abstract Background The deep sea represents the largest marine ecosystem, driving global-scale biogeochemical cycles. Microorganisms are the most abundant biological entities and play a vital role in the cycling of organic matter in such ecosystems. The primary food source for abyssal biota is the sedimentation of particulate organic polymers. However, our knowledge of the specific biopolymers available to deep-sea microbes remains largely incomplete. One crucial rate-limiting step in organic matter cycling is the depolymerization of particulate organic polymers facilitated by extracellular enzymes (EEs). Therefore, the investigation of active EEs and the microbes responsible for their production is a top priority to better understand the key nutrient sources for deep-sea microbes. Results In this study, we conducted analyses of extracellular enzymatic activities (EEAs), metagenomics, and metatranscriptomics from seawater samples of 50–9305 m from the Mariana Trench. While a diverse array of microbial groups was identified throughout the water column, only a few exhibited high levels of transcriptional activities. Notably, microbial populations actively transcribing EE genes involved in biopolymer processing in the abyssopelagic (4700 m) and hadopelagic zones (9305 m) were primarily associated with the class Actinobacteria. These microbes actively transcribed genes coding for enzymes such as cutinase, laccase, and xyloglucanase which are capable of degrading phytoplankton polysaccharides as well as GH23 peptidoglycan lyases and M23 peptidases which have the capacity to break down peptidoglycan. Consequently, corresponding enzyme activities including glycosidases, esterase, and peptidases can be detected in the deep ocean. Furthermore, cell-specific EEAs increased at 9305 m compared to 4700 m, indicating extracellular enzymes play a more significant role in nutrient cycling in the deeper regions of the Mariana Trench. Conclusions Transcriptomic analyses have shed light on the predominant microbial population actively participating in organic matter cycling in the deep-sea environment of the Mariana Trench. The categories of active EEs suggest that the complex phytoplankton polysaccharides (e.g., cutin, lignin, and hemicellulose) and microbial peptidoglycans serve as the primary nutrient sources available to deep-sea microbes. The high cell-specific EEA observed in the hadal zone underscores the robust polymer-degrading capacities of hadal microbes even in the face of the challenging conditions they encounter in this extreme environment. These findings provide valuable new insights into the sources of nutrition, the key microbes, and the EEs crucial for biopolymer degradation in the deep seawater of the Mariana Trench. Video Abstract

Abstract Background Post-stroke cognitive impairment (PSCI) is the focus and difficulty of poststroke rehabilitation intervention with an incidence of up to 61%, which may be related to the deterioration of cerebrovascular function. Computer-aided cognitive training (CACT) can improve cognitive function through scientific training targeting activated brain regions, becoming a popular training method in recent years. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, can regulate the cerebral vascular nerve function, and has an effect on the rehabilitation of cognitive dysfunction after stroke. This study examined the effectiveness of both CACT and tDCS on cognitive and cerebrovascular function after stroke, and explored whether CACT combined with tDCS was more effective. Methods A total of 72 patients with PSCI were randomly divided into the conventional cognitive training (CCT) group (n = 18), tDCS group (n = 18), CACT group (n = 18), and CACT combined with tDCS group (n = 18). Patients in each group received corresponding 20-minute treatment 15 times a week for 3 consecutive weeks. Montreal Cognitive Assessment (MoCA) and the Instrumental Activities of Daily Living Scale (IADL) were used to assess patients’ cognitive function and the activities of daily living ability. Transcranial Doppler ultrasound (TCD) was used to assess cerebrovascular function, including cerebral blood flow velocity (CBFV), pulse index (PI), and breath holding index (BHI). These outcome measures were measured before and after treatment. Results Compared with those at baseline, both the MoCA and IADL scores significantly increased after treatment (P

Propeller propulsion technology plays an important role in aviation field. Composite materials have the characteristics of high specific strength，high specific modulus，high damping，designability and so on. The use of composite material propeller blades can further improve the performance of propeller in terms of mass reduction efficiency，propulsion efficiency，corrosion resistance，noise reduction. Composite material propeller blades have become the general trend. Based on aircraft propeller blades and rotor blades，this paper aims to perform a brief review of the research achievements of aviation composite propeller blades at home and abroad，classifies and expounds the material systems，structural design and molding processes of aviation propellers. The key technical problems and the simulation research on manufacturing process of propeller at home and abroad are summarized. Finally，the future development direction of domestic composite propellers from the aspects of improving the material system，optimizing the structure design，deepening the process research and strengthening the engineering application of numerical simulation technology are concluded.

Abstract Background Chronic neck pain (CNP) is a common public health problem that affects daily living activities and quality of life. There is biomechanical interdependence between the neck and scapula. Studies have shown that shoulder blade function might be related to chronic neck pain. We therefore evaluated the effects of scapular targeted therapy on neck pain and function in patients with CNP. Methods Databases, including MEDLINE (via PubMed), EMBASE (via Ovid), Ovid, Web of Science, and Scopus, were systematically searched for randomized controlled trials published in English investigating treatment of the scapula for CNP before July 16, 2023. Results A total of 313 participants were included from 8 RCTs. Compared with those in the control group, the intervention in the scapular treatment group exhibited greater improvement in pain intensity (standardized mean difference (SMD) = 2.55; 95% CI = 0.97 to 4.13; P = 0.002), with moderate evidence. Subgroup analysis for pain intensity revealed a significant difference between the sexes, with only the female population (SMD = 6.23, 95% CI = 4.80 to 7.65) showing better outcomes than those with both sexes (SMD = 1.07, 95% CI = 0.57 to 1.56) (p

Abstract Natural fluctuations in cardiac activity modulate brain activity associated with sensory stimuli, as well as perceptual decisions about low magnitude, near-threshold stimuli. However, little is known about the relationship between fluctuations in heart activity and other internal representations. Here we investigate whether the cardiac cycle relates to learning-related internal representations – absolute and signed prediction errors. We combined machine learning techniques with electroencephalography with both simple, direct indices of task performance and computational model-derived indices of learning. Our results demonstrate that just as people are more sensitive to low magnitude, near-threshold sensory stimuli in certain cardiac phases, so are they more sensitive to low magnitude absolute prediction errors in the same cycles. However, this occurs even when the low magnitude prediction errors are associated with clearly suprathreshold sensory events. In addition, participants exhibiting stronger differences in their prediction error representations between cardiac cycles exhibited higher learning rates and greater task accuracy.

Aiming at the configuration problem of amphibious assault ship formation in submarine defense, a circle model of submarine torpedo limit range is established from the analysis of submarine threat to formation. Through model analysis and simulation calculation, it is concluded that amphibious assault ships should be positioned in the later position of threat circle center, and the optimal position calculation model is given. Based on the model of submarine threat range and threat range and the model of submarine defense range of warning ships, the optimal allocation method of escort forces is given, which provides a reference for the submarine defense of amphibious assault ship formation at sea.

Purposes The high-value utilization of coal gangue has attracted attention, and the activation and action of coal-bearing kaolin have great significance value for utilization of coal gangue. Methods The thermal activation parameters of kaolinite in coal gangue were optimized by orthogonal test, and the compressive strength and microstructure of paste consisting of cement and metakaolin formed under the optimal activation conditions were studied. Findings The experimental results show that the optimum thermal activation conditions of metakaolin are calcination temperature 800 ℃, holding time 2 h, and grinding fineness of 2.82 μm. Calcination temperature has the greatest influence on the activity of metakaolin, followed by grinding fineness and holding time. By using metakaolin instead of 20% (mass fraction) cement, the compressive strength of cement paste at all curing ages, especially in the early age, can be improved effectively. XRD and SEM test results show that the pozzolanic reaction of metakaolin consumes a lot of calcium hydroxide, and forms calcium silicate hydrate with lower calcium-silicon ratio and denses structure.

Abstract Background The existing respiratory fit test panels (RFTPs) are based on Bivariate and Principal Component Analysis (PCA) which utilise American and Chinese head and facial dimensions. As RFTPs based on local facial anthropometric data for Malaysia are not available, this study was conducted with the aim to develop new RFTPs using Malaysian data. Methodology A cross-sectional study was conducted across Malaysia among 3,324 participants of the study of National Health and Morbidity Survey 2020 aged 18 and above. Ten head and facial dimensions were measured. Face length and face width were used to construct bivariate facial panel, whereas the scores from the first two PCA were used to develop the PCA panel. Results This study showed that Malaysians have the widest upper limit for facial width. It also found that three factors could be reduced from the PCA analysis. However only 2 factors were selected with PCA 1 representing head and facial size and PCA 2 representing facial shape. Our bivariate panel could accommodate 95.0% of population, while our PCA panel accommodated 95.6%. Conclusion This was the first study to use Malaysian head and facial anthropometry data to create bivariate and PCA panels. Respirators constructed using these panels are likely to fit ≥ 95.0% of Malaysia’s population.

Objective: Carbon nanoparticle (CNP)-guided sentinel lymph node biopsy (SLNB) has been extensively adopted as a cost-effective and highly efficient method for tracing malignant tumors except for those associated with vulvar cancer. The current study aimed to validate the feasibility and efficacy of CNPs in tracking sentinel lymph nodes (SLNs) in patients with early vulvar cancer. Methods: We retrospectively reviewed patients with vulvar cancer at our institution from January 2016 to April 2022 who were pathologically diagnosed and underwent SLNB or inguinofemoral lymphadenectomy (IFLND). CNPs were the only lymphatic tracer used in SLNB. Patient demographics, perioperative outcomes and follow-up results, including overall survival (OS) and progression-free survival (PFS), were compared between the SLNB and IFLND groups. Results: Data from 52 patients were collected and investigated. Forty groins of 22 patients who underwent SLNB with CNP tracing were included. Black-stained SLNs were detected in 32 groins of 19 patients, and the rates of CNP detection by patient and by groin were 86.4 % and 80 %, respectively. Patients who underwent SLNB had better perioperative outcomes than those who underwent IFLND in certain aspects (groin drainage rate: 41.2 % and 80 %, respectively, p

BackgroundFrontotemporal dementia (FTD) is a neurodegenerative disease with clinical, pathological, and genetic heterogeneity. FTD is receiving increasing attention because it is the second leading cause of early-onset dementia after Alzheimer’s disease. This study aimed to analyse the research trends and hotspots of FTD from 2000 to 2022 using bibliometrics.MethodsPapers related to FTD from 2000 to 2020 were systematically searched through the Web of Science Core Collection (WOSCC). Citespace and Vosviewer software were used to visually analyse the retrieved data of countries/regions, institutions, journals, authors, references, and keywords. Microsoft Excel was used to generate the annual publications and growth trends.ResultsThere were 10,227 papers included in the bibliometric analysis. The annual publication output on FTD has increased significantly from 2000 to 2022, with papers published in 934 academic journals and 87 countries/regions. The Journal of Alzheimer’s Disease was the most popular, with 488 papers about FTD. The most productive countries/regions, institutions, and authors are the United States (n = 4,037), the University of California San Francisco (n = 687), and Miller, Bruce L. (n = 427), respectively. The article by Katya Rascovsky and her colleagues published on Brain in 2011 was the most cocited paper, with 625 citations. The research hotspots in this field were the clinical diagnostic criteria, subdivision, and pathological mechanism of FTD, such as tau protein, chromosome 17, progranulin, TDP-43, and C9orf72.ConclusionThe future research direction is based on biomarkers and pathological mechanisms to diagnose and differential diagnose FTD from the aspects of behavior, neuropathology, neuroimaging, and serum markers.

ObjectiveThis study aimed to explore whether famine exposure during early life are associated with a high risk of Type 2 Diabetes Mellitus (T2DM) in adulthood and the role of socioeconomic status (SES) on this effect.Materials and methodsWe conducted a secondary data analysis based on data from a cross-sectional survey, collected 3,355 participants born between January 1, 1941 and December 31, 1966. Participants were categorized into four groups based on their date of birth, unexposed (individuals born in 1963–1966), infant exposed (individuals born in 1959–1962), childhood exposed (individuals born in 1949–1958), and adolescent exposed (born in 1941–1948). The association of famine exposure with T2DM risk in adults and conducted separately in plain area and mountain area was assessed using logistics regression model.Result22.35% of participants were diagnosed with T2DM, of which 43.47% were from the childhood famine-exposed group, representing the highest proportion among all subgroups (p

Abstract Regulated cell death (RCD) plays a fundamental role in placental development and tissue homeostasis. Placental development relies upon effective implantation and invasion of the maternal decidua by the trophoblast and an immune tolerant environment maintained by various cells at the maternal-fetal interface. Although cell death in the placenta can affect fetal development and even cause pregnancy-related diseases, accumulating evidence has revealed that several regulated cell death were found at the maternal-fetal interface under physiological or pathological conditions, the exact types of cell death and the precise molecular mechanisms remain elusive. In this review, we summarized the apoptosis, necroptosis and autophagy play both promoting and inhibiting roles in the differentiation, invasion of trophoblast, remodeling of the uterine spiral artery and decidualization, whereas ferroptosis and pyroptosis have adverse effects. RCD serves as a mode of communication between different cells to better maintain the maternal-fetal interface microenvironment. Maintaining the balance of RCD at the maternal-fetal interface is of utmost importance for the development of the placenta, establishment of an immune microenvironment, and prevention of pregnancy disorders. In addition, we also revealed an association between abnormal expression of key molecules in different types of RCD and pregnancy-related diseases, which may yield significant insights into the pathogenesis and treatment of pregnancy-related complications.

Abstract The pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has had a profound impact on the global health and economy. While mass vaccination for herd immunity is effective, emerging SARS-CoV-2 variants can evade spike protein-based COVID-19 vaccines. In this study, we develop a new immunization strategy by utilizing a nanocarrier, dendritic mesoporous silica nanoparticle (DMSN), to deliver the receptor-binding domain (RBD) and conserved T-cell epitope peptides (DMSN-P-R), aiming to activate both humoral and cellular immune responses in the host. The synthesized DMSN had good uniformity and dispersion and showed a strong ability to load the RBD and peptide antigens, enhancing their uptake by antigen-presenting cells (APCs) and promoting antigen delivery to lymph nodes. The DMSN-P-R vaccine elicited potent humoral immunity, characterized by highly specific RBD antibodies. Neutralization tests demonstrated significant antibody-mediated neutralizing activity against live SARS-CoV-2. Crucially, the DMSN-P-R vaccine also induced robust T-cell responses that were specifically stimulated by the RBD and conserved T-cell epitope peptides of SARS-CoV-2. The DMSN demonstrated excellent biocompatibility and biosafety in vitro and in vivo, along with degradability. Our study introduces a promising vaccine strategy that utilizes nanocarriers to deliver a range of antigens, effectively enhancing both humoral and cellular immune responses to prevent virus transmission.

To standardize the market conduct of electricity sales companies and elevate the power market management level， it is essential to conduct a credit evaluation of these companies. Therefore， based on Box-plot and orthogonalization methods， a credit evaluation model based on an enhanced discrete Hopfield neural network （DHNN） is proposed. Firstly， factors influencing the credit levels of electricity sales companies are analyzed， and a credit evaluation index system， which includes 11 indicators such as basic information， foundational management， contract management， and transaction management， is established. The weights for these indicators are determined using the Delphi method. Secondly， outliers in the indicators of electricity sales companies are addressed to derive optimal credit scores， enabling an objective assessment of their credit levels. Finally， the feasibility of the proposed model is verified through case studies. The results indicate that the model can objectively and accurately evaluate the credit levels of electricity sales companies.

Abstract Background COVID-19-induced acute respiratory distress syndrome (ARDS) can result in tissue damage and multiple organ dysfunction, especially in kidney transplant recipients (KTRs) receiving immunosuppressive drugs. Presently, single-cell research on COVID-19-induced ARDS is considerably advanced, yet knowledge about ARDS in KTRs is still constrained. Methods Single-cell RNA sequencing (scRNA-seq) analysis was performed to construct a comprehensive single-cell immune landscape of the peripheral blood mononuclear cells (PBMCs) of eight patients with COVID-19-induced ARDS, five KTRs with COVID-19-induced ARDS, and five healthy individuals. Subsequently, we conducted a comprehensive bioinformatics analysis, including cell clustering, enrichment analysis, trajectory analysis, gene regulatory network analysis, and cell–cell interaction analysis, to investigate the heterogeneity of the immune microenvironment in KTRs with ARDS. Result Our study revealed that KTRs exhibit significant heterogeneity with COVID-19-induced ARDS compared with those of other individuals, with significant reductions in T cells, as well as an abnormal proliferation of B cells and monocytes. In the context of dual influences from immunosuppression and viral infection, KTRs exhibited more specific plasma cells, along with significant enrichment of dysfunctional GZMB and XAF1 double-positive effector T cells and IFI27-positive monocytes. Additionally, robust communication existed among T cells and monocytes in cytokine signaling. These effects impede the process of immune reconstitution in KTR patients. Conclusion Our findings suggest that KTRs with COVID-19-induced ARDS show elevated antibody levels, impaired T cell differentiation, and dysregulation of innate immunity. In summary, this study provides a theoretical foundation for a comprehensive understanding of COVID-19-induced ARDS in KTRs.

Abstract Glutathione synthetase (GSS) catalyzes the final step in the synthesis of glutathione (GSH), a well-established antioxidant. Research on the specific roles of the Gss gene during spermatogenesis remains limited due to the intricate structure of testis. In this study, we identified pachytene spermatocytes as the primary site of GSS expression and generated a mouse model with postnatal deletion of Gss using Stra8-Cre (S8) to investigate the role of GSS in germ cells. The impact of Gss knockout on reducing male fertility is age-dependent and caused by ferroptosis in the testis. The 2-month-old S8/Gss −/− male mice exhibited normal fertility, due to a compensatory increase in GPX4, which prevented the accumulation of ROS. With aging, there was a decline in GPX4 and an increase in ALOX15 levels observed in 8-month-old S8/Gss −/− mice, resulting in the accumulation of ROS, lipid peroxidation, and ultimately testicular ferroptosis. We found that testicular ferroptosis did not affect spermatogonia, but caused meiosis disruption and acrosome heterotopia. Then the resulting aberrant sperm showed lower concentration and abnormal morphology, leading to reduced fertility. Furthermore, these injuries could be functionally rescued by inhibiting ferroptosis through intraperitoneal injection of GSH or Fer-1. In summary, Gss in germ cells play a crucial role in the resistance to oxidative stress injury in aged mice. Our findings deepen the understanding of ferroptosis during spermatogenesis and suggest that inhibiting ferroptosis may be a potential strategy for the treatment of male infertility.

In Singapore, 10 captive lions tested positive for SARS-CoV-2 by real-time PCR. Genomic analyses of nanopore sequencing confirmed human-to-animal transmission of the SARS-CoV-2 Delta variant. Viral genomes from the lions and zookeeper shared a unique spike protein substitution, S:A1016V. Widespread SARS-CoV-2 transmission among humans can increase the likelihood of anthroponosis.

Although phase change materials (PCMs) exhibit effective performance in the thermal management of lithium-ion batteries (LIBs), their development is limited by low thermal conductivity and susceptibility to leakage during the solid–liquid phase transition. To address these challenges and enhance thermal management capabilities, this study introduces a novel composite phase change material (CPCM) synthesized by physically mixing paraffin (PA), expanded graphite (EG), and bacterial cellulose (BC). The thermal performance of CPCMs with varying BC proportions is evaluated, and their impact on temperature control in battery thermal management systems (BTMS) is assessed. The results show that the addition of EG and BC significantly improves the thermal conductivity of the CPCM, reaching a value of 1.39 W·m−1·K−1. This also enhances the uniformity of temperature distribution within the battery module and reduces CPCM leakage. By comparing temperature variations within the battery module under different operating conditions, it was found that the intricate network structure of the CPCM promotes uniform temperature distribution, effectively mitigating temperature rise. Consequently, the maximum temperature and maximum temperature difference within the battery module were maintained below 47 °C and 4 °C, respectively. Compared to a system without phase change material at a 3C discharge rate, the maximum cell temperature, maximum module temperature, and maximum temperature difference were reduced by 32.38%, 26.92%, and 34.94%, respectively. These findings provide valuable insights for the design and optimization of BTMS.

Frequent soil erosion disasters in the middle reaches of the Yellow River (MRYR) have a profound effect on the sediment load of the river. This paper addresses the intertwined effects of human activities and climate change on river runoff and sediment load. Therefore, runoff and sediment loads from hydrological stations along the main and tributary rivers within the MRYR were used. The Mann–Kendall (M–K) trend test and the double mass curve analysis, among other analytical tools, were used to examine the erosion patterns of these rivers from 1950 to 2022, as well as the main factors driving these changes. The results showed that the runoff depth of the Yan River tended to decrease, and there was a significant decrease in the mainstream and nine other tributaries, with a significant decrease in the sediment transport modulus for both the mainstream and tributaries. In the main river, human activities contributed between 69.99% and 94.69% to the runoff and between 88.52% and 98.49% to the sediment load, while in the tributaries, the contribution of human activities was greater. The annual runoff and annual sediment load in the MRYR showed a decreasing trend, with a discernible impact of human activities. The results of this research are of great significance for erosion control and the restoration of the ecological balance in the Yellow River Basin.

Introduction: IL4I1, also known as Interleukin-4-induced gene 1, is an enzyme that can modulate the immune system by acting as a L-amino acid oxidase. Nevertheless, a precise understanding of the correlation of IL4I1 with immunological features and immunotherapy efficacy in bladder cancer (BLCA) remains incomplete.Methods: We analyzed RNA sequencing data from the Cancer Genome Atlas (TCGA) to investigate the immune function and prognostic importance of IL4I1 across different cancer types. We further examined the TCGA-BLCA cohort for correlations between IL4I1 and various immunological characteristics of tumor microenvironment (TME), such as cancer immune cycle, immune cell infiltration, immune checkpoint expression and T cell inflamed score. Validation was conducted using two independent cohort, GSE48075 and E-MTAB-4321. Finally, RNA sequencing data from the IMvigor210 cohort and immunohistochemistry assays were employed to validate the predictive value of IL4I1 for the TME and immunotherapy efficacy.Results: In our findings, a positive correlation was observed between IL4I1 expression and immunomodulators expression, immune cell infiltration, the cancer immune cycle, and T cell inflamed score in BLCA, suggesting a significant link to the inflamed TME. In addition, studies have shown that IL4I1 elevated levels of individuals tend to be more performance for basal subtype and exhibit enhanced response rates to diverse treatment modalities, specifically immunotherapy. Clinical data from the IMvigor 210 cohort confirmed a higher rate of response to immunotherapy and better survival benefits in patients with high IL4I1 expression.Discussion: To summarize, our research showed that elevated IL4I1 levels are indicative of an inflamed TME, the basal subtype, and a more favorable response to various treatment methods, especially immune checkpoint blockade therapy in BLCA.

Background and objectiveIt remains uncertain if the addition of Saccharomyces boulardii (S. boulardii) to bismuth quadruple therapy (BQT) recommended in the current guidelines can enhance the Helicobacter pylori (H. pylori) eradication rate and decrease the incidence of adverse events. We therefore conducted a meta-analysis of randomized controlled trials (RCTs) to address this issue.MethodsWe performed comprehensive searches in PubMed, Embase, Web of Science, and Cochrane library databases from the inception of the databases through to November 1, 2023. A meta-analysis was conducted to determine the pooled relative risk (RR) with 95% confidence intervals (CI) using a random-effects model. We utilized the revised Cochrane Risk of Bias Tool to assess the risk of bias of included studies.ResultsA total of six RCTs (1,404 patients) included in this meta-analysis. The results of the intention-to-treat analysis showed that the combination of S. boulardii with BQT had a higher eradication rate than BQT alone (87.0% versus 83.3%), with a pooled RR of 1.05 (95% CI: 1.00–1.10, p = 0.03). In the per-protocol analysis, however, there was no statistical significance between the two groups in the eradication rate (93.7% versus 91.0%, RR = 1.03, 95% CI: 1.00–1.06, p = 0.07). The combination of S. boulardii and BQT had a significantly lower rate of overall adverse events (22% vs. 39%, RR = 0.56, 95% CI: 0.44–0.70, p

Complex microgrid structures and time-varying conditions, among other factors, cause problems in the mechanical modeling of microgrids, making model-based controller optimization difficult. Therefore, this study proposed a secondary frequency adaptive control strategy based on parameter identification, which uses an online parameter identification method to identify the parameters in the microgrid in real-time. The identified parameters are then used in the secondary frequency adaptive controller to optimize the real-time controller performance. The proposed method realizes adaptive optimization of the controller in the microgrid operation state and is applied to a microgrid with unknown parameters to adjust the controller parameters. Finally, a simulation experiment was conducted to verify the model accuracy and the frequency regulation effect of the proposed adaptive control strategy

Meningiomas are extra-axial neoplasms that originate from the arachnoid cap cells located on the inner surface of the meninges. Approximately 36% of central nervous system tumors are meningiomas. Based on earlier findings to be benign in most cases, they are categorized as slow-growing tumors that form gradually over time. Meningiomas are usually asymptomatic and discovered inadvertently. They rarely present with immediate clinical symptoms or abrupt hemorrhagic strokes. However, tumor hemorrhage can be fatal in high-grade meningiomas, particularly those with vascularization. We describe a 58-year-old man who was hospitalized after experiencing an unexpectedly acute headache. The right cerebellar hemisphere and vermis cerebellar hemorrhage were detected on computed tomography (CT), and the cerebellar hemorrhage was explained by a diagnosis of hypertension. When additional analysis of the patient’s chest CT indicated lung mass lesions, we assumed that the lung cancer had spread to the brain. However, the pathological outcomes of a guided definite pulmonary aspiration biopsy, in conjunction with resection of the cerebellar tumor, suggested a subtentorial meningioma with ruptured hemorrhage and pulmonary meningioma metastasis. The patient was transferred to a hospital closer to home for ongoing follow-up and, after 2 months, he had recovered well.

Abstract Objective Drug‐induced side effects, particularly serious adverse events (SAEs), often affect cancer patients enrolled in clinical trials. However, little is known about anxiety and depression in cancer patients who experienced SAEs. This study evaluated the prevalence of anxiety and depression in cancer patients enrolled in clinical trials who experienced SAEs and explored the risk factors. Methods A multi‐center, cross‐sectional survey was conducted in hospitals affiliated with the University of Science and Technology of China from December 2021 to November 2022. A total of 112 cancer patients who experienced SAEs while enrolled in clinical trials, and who completed the informed consent process and study questionnaires, were included in the final analysis. Results The rate of moderate–severe depression in cancer patients was 38.4% and that of moderate–severe anxiety was 13.4%. Among the patients who had moderate–severe anxiety, 93.3% had concurrent moderate–severe depression. Lower cognitive function and lower global quality of life were risk factors for depression in cancer patients who experienced SAEs. Pain, low emotional function, low global quality of life, and a high Impact of Events Scale score were risk factors for anxiety. Conclusions Cancer patients enrolled in a clinical trial who experienced SAEs tended to be anxious and depressed, particularly the latter. These results indicate the need to evaluate anxiety and depression, and mental health treatment among cancer patients with SAEs in clinical trials.

In the context of promoting the integration of smart cities, the pace of construction of smart chemical parks is gradually accelerating.Since accidents in China’s chemical industry have occurred frequently in recent years, causing great damage and loss to public safety, improving the safety management and emergency response capability of chemical parks is an urgent need to be solved.For this kind of safety problems, this paper proposed a game patrol strategy for hazardous gas leakage in chemical parks.Firstly, the convective diffusion model was used to describe the process of hazardous gas leakage.Secondly, game theory was introduced to model the confrontation process between the attacking and defending parties in the patrol problem, and the response time of the defenders to a safety incident was correlated with its benefit.Then, a multilinear programming-based GGC algorithm was proposed to solve this game model.Finally, the gains of the game model in this paper were compared with the other two basic methods in the scenarios of three real chemical park case with different sizes.The results show that the model can effectively improve the gains of the defender and reduce the gains of the attacker.

In order to obtain polyurethane elastomer (PUE) for reducing the vibration and noisy in deep-water environments, toluene diisocyanate (TDI), polypropylene glycol 2000 (PPG2000) and triethanolamine (TEA) were selected as raw materials, and the effects of hard segment content, R value and synthesis route on damping property and compression modulus of PUE were explored. Results reveal that the tanδ of PUE could be decreased with the increase of hard segment content, while the compression modulus increases. With the increase of R value, Tg increases, the compression modulus first increases and then decreases, reaching a peak when R=2. The prepolymer process and one-step process have little effect on the tanδ, but the compression modulus of PUE synthesized by prepolymer process is obviously greater than that of one-step process, which is more in line with the requirements of high damping/strong pressure resistance. It was observed that the compression modulus of PUE can be effectively improved by increasing the stiffness of molecular chain, the degree of hydrogen bonding and the uniformity of hard segment micro region distribution, but for damping property have a negative impact.

Lithium-ion batteries (LIBs) are extensively utilized in electric vehicles (EVs), energy storage systems, and related fields due to their superior performance and high energy density. However, battery-related incidents, particularly fires, are increasingly common. This paper aims to first summarize the flame behavior of LIBs and then thoroughly examine the factors influencing this behavior. Based on these factors, methods for suppressing LIB flames are identified. The factors affecting flame behavior are categorized into two groups: internal and external. The paper then reviews the flame behavior within battery modules, particularly in confined spaces, from both experimental and simulation perspectives. Furthermore, methods for suppressing battery flames are classified into active and passive techniques, allowing for a more comprehensive analysis of their effectiveness. The paper concludes with a summary and outlook, offering new insights for future research and contributing to the development of safer and more efficient battery systems.

In ventilation systems of metal mines, the real-time measurement of the airflow field and a reduction in pollutants are necessary for clean environmental management and human health. However, the limited quantitative data and expensive detection technology hinder the accurate assessment of mine ventilation effectiveness and safety status. Therefore, we propose a new method for constructing a mine intelligent ventilation system with a global scheme, which can realize the intelligent prediction of unknown points in the mine ventilation system by measuring the airflow parameters of multiple known points. Firstly, the nodal wind pressure method combined with the Hardy–Cross iterative algorithm is used to solve the mine ventilation network, and the airflow parameters under normal operation and extreme working conditions are simulated, based on which an intelligent ventilation training database is established. Secondly, we compared the airflow parameter prediction ability of three different machine learning models with different neural network models based on the collected small-sample airflow field dataset of a mine roadway. Finally, the depth learning method is optimized to build the intelligent algorithm model of the mine ventilation system, and a large number of three-dimensional simulation data and field measurement data of the mine ventilation system are used to train the model repeatedly to realize the intelligent perception of air flow parameters of a metal mine ventilation network and the construction of an intelligent ventilation system. The results show that the maximum error of a single airflow measurement point is 1.24%, the maximum overall error is 3.25%, and the overall average error is 0.51%. The intelligent algorithm has a good model training effect and high precision and can meet the requirements of the research and application of this project. Through case analysis, this method can predict the airflow parameters of any position underground and realize the real-time control of mine safety.

Emergence of newer variants of SARS-CoV-2 underscores the need for effective antivirals to complement the vaccination program in managing COVID-19. The multi-functional papain-like protease (PLpro) of SARS-CoV-2 is an essential viral protein that not only regulates the viral replication but also modulates the host immune system, making it a promising therapeutic target. To this end, we developed an in vitro interferon stimulating gene 15 (ISG15)-based Förster resonance energy transfer (FRET) assay and screened the National Cancer Institute (NCI) Diversity Set VI compound library, which comprises 1584 small molecules. Subsequently, we assessed the PLpro enzymatic activity in the presence of screened molecules. We identified three potential PLpro inhibitors, namely, NSC338106, 651084, and 679525, with IC50 values in the range from 3.3 to 6.0 µM. These molecules demonstrated in vitro inhibition of the enzyme activity and exhibited antiviral activity against SARS-CoV-2, with EC50 values ranging from 0.4 to 4.6 µM. The molecular docking of all three small molecules to PLpro suggested their specificity towards the enzyme’s active site. Overall, our study contributes promising prospects for further developing potential antivirals to combat SARS-CoV-2 infection.

In today’s society, there is an urgent need to help users better access information that they are interested in, as there is an increasing amount of news and messages available with the development of the Internet. Many existing methods involve directly inputting text into a pre-trained model, which limits the effectiveness of text feature extraction. The personalized news recommendation model discussed in this article is a model that can enhance feature extraction from news articles. It consists of a candidate news module, a historically accessed news module, and an access prediction module. Using news titles that accurately summarize news content, a model with double multi-head attention mechanisms and double residual structures (DDM) is utilized to better capture the features of news articles historically accessed by users, thereby achieving an improved recommendation functionality. The candidate news module aims to help the model learn representations of news that users are likely to select from the news titles. The user historical click news module primarily serves to enable the model to learn personalized representations of users from news they have previously browsed. The model has been tested on MIND-small. The AUC reached 0.6665, the MRR reached 0.3205, the nDCG@5 reached 0.3532, and the nDCG@10 reached 0.4158. The results indicate this model has achieved good results in the downstream tasks of preprocessing news-title texts.

Flexible DC technology has revolutionary significance in flexibly solving the problem of high proportion of new energy consumption. Due to the vulnerability of high-ratio power electronic equipment and the difficulty in extracting fault information, traditional line protection schemes can no longer be reliably adapted to the flexible DC transmission system. A rapid protection scheme for flexible DC transmission lines based on voltage traveling wave steepness is proposed in this paper. By analyzing the transient characteristics of DC line faults, and utilizing the differences in the steepness and polarity of fault voltage traveling waves on both sides of the current-limiting reactor, the range of effective transient information extraction is increased, and the fault identification inside or outside the region is realized. The faults are classificated by utilizing the significant difference in the degree of voltage traveling wave variation between the faulty and sound poles. Lightning interference is considered and a rapid identification method is proposed by using its initial change characteristics. Finally, the performance of the protection scheme under various influencing factors is verified by simulation, which can identify faults quickly and reliably and has good sensitivity and anti-interference ability.

Abstract Background Most studies in advanced care settings reported that the increasing workload increases the work-life imbalance and harms the mental health of health workers. The COVID-19 Pandemic's tracing, testing, treatment, and mass vaccination also have multiplied the primary healthcare workers' workload. Nevertheless, studies on primary care workers are scarce. This study aimed to investigate how the COVID-19-related work-life balance impact stress on primary healthcare workers in the third years of the pandemic. Methods The study was a cross-sectional, web-based survey conducted on primary healthcare workers in Kediri Regency, Indonesia, with the highest Omicron case surge worldwide. It was conducted right after the surge between July and August 2022, the third year of the COVID-19 pandemic hit Indonesia. Under coordination with the local government health officials, primary healthcare workers were invited to participate in an online survey. The respondents were asked to evaluate their sociodemography, work conditions, personal life, and perceived stress (using the Perceived Stress Scale) during the pandemic. Their work-life balance was evaluated using the Work/Non-work Interference and Enhancement Scale. We used several hierarchical linear regression models to determine which variables contribute to work stress among primary healthcare workers. Results Sociodemographic characteristics, including gender, age, marital status, years of professional experience, and educational level, were not significantly associated with stress levels among our respondents. Separately, work conditions and personal life variables did not associate with stress levels. However, primary healthcare workers' work and personal lives interfere with each other during the pandemic and are associated with their higher stress. Conclusion During the pandemic, the work life of primary health workers interferes with their personal life more than the interference of personal life on their work life. At the same time, the work life's enhancement on the personal life and vice versa were lower than its interference. Those conditions are associated with higher perceived stress of primary health workers.

Objectives: The aim of this study was to investigate the prognostic value of reclassified new type III monomicrobial gram-negative necrotizing fasciitis (NF) and the microbial factors associated with an increased risk of mortality. Methods: This study included 235 NF cases treated at National Taiwan University Hospital. We compared the mortality risk of NF caused by different causal microorganisms and examined the bacterial virulence genes profile and antimicrobial susceptibility pattern associated with an increase in mortality risk. Results: Type III NF (n = 68) had a mortality risk two-fold higher than type I (polymicrobial, n = 64) or type II (monomicrobial gram-positive, n = 79) NF (42.6% vs 23.4% or 19.0%, P = 0.019 and 0.002, respectively). Mortality differed by causal microorganism (Escherichia coli [61.5%], Klebsiella pneumoniae [40.0%], Aeromonas hydrophila [37.5%], Vibrio vulnificus [25.0%], polymicrobial [23.4%], group A streptococci [16.7%], and Staphylococcus aureus [16.2%], in decreasing rank, P

Objective To investigate the mechanism of hypoxia-induced free iron reduction in mouse pulmonary artery smooth muscle cells (PASMCs) and its role in the proliferation of PASMCs and pulmonary vascular remodeling. Methods ① Primary mouse PASMCs were cultured and divided into normoxic group(C), normoxic ferric ammonium citrate group (C+FAC), normoxic rapamycin group (C+R), hypoxic group (H), hypoxic ferric ammonium citrate group (H+FAC) and hypoxic rapamycin group (H+R). The C, C+FAC and C+R groups were incubated in normoxic (21% O2) enviroment for 48 h. The H, H+FAC and H+R groups were incubated in hypoxic (1% O2) environment for 48 h. The C+FAC and H+FAC groups were treated with ferrous ammonium citrate (FAC), and the C+R and H+R groups were treated with rapamycin (R). Cell proliferation was detected with CCK-8 assay and EdU proliferation assay. The content of intracellular free iron was measured by FerroOrange staining. The protein levels of iron regulatory proteins (IRPs), transferrin receptor (TFR), ferroportin (FPN) and ferritin heavy chain (FTH) were detected with Western blotting. ②Twenty-four C57/BL6N mice (male, 6 weeks old, weighting 18~22 g) were divided into normoxic group (C-4W), normoxic high-iron diet group (C+HID-4W), hypoxic group (H-4W) and hypoxic high-iron diet group (H+HID-4W) (n=6). The H-4W and H+HID-4W groups were placed in a low-pressure hypoxic environment at a simulated altitude of 5 000 m for 4 weeks. Right heart function, right ventricular systolic pressure, and pulmonary vascular remodeling in each group were observed and measured. Results Compared with C group, significantly enhanced proliferation (P < 0.01), reduced intracellular free iron content (P < 0.01), and up-regulated protein level of FTH were observed in the PASMCs of H group (P < 0.01). Compared with H group, the free iron content was obviously increased (P < 0.01) and cell proliferation was decreased in H+FAC group (P < 0.01). The H+R group had notably increased free iron content (P < 0.01), decreased cell proliferation (P < 0.05), and reduced protein level of FTH when compared with H group (P < 0.05). Compared with H-4W group, the mice in the H+HID-4W group showed significantly improved right heart function (P < 0.01), lower right ventricular systolic pressure (P < 0.05), reduced right heart hypertrophy (P < 0.01), and inhibited pulmonary artery thickening (P < 0.01). Conclusion Hypoxia mediates the reduction of free iron by inhibiting the ferritinophagy pathway, and thus promotes the proliferation of PASMCs and pulmonary artery remodeling.

BackgroundIn May–June 2023, an unprecedented outbreak of human respiratory syncytial virus (HRSV) infections occurred in a kindergarten, Zhejiang Province, China. National, provincial, and local public health officials investigated the cause of the outbreak and instituted actions to control its spread.MethodsWe interviewed patients with the respiratory symptoms by questionnaire. Respiratory samples were screened for six respiratory pathogens by real-time quantitative polymerase chain reaction (RT-PCR). The confirmed cases were further sequenced of G gene to confirm the HRSV genotype. A phylogenetic tree was reconstructed by maximum likelihood method.ResultsOf the 103 children in the kindergarten, 45 were classified as suspected cases, and 25 cases were confirmed by RT-PCR. All confirmed cases were identified from half of classes. 36% (9/25) were admitted to hospital, none died. The attack rate was 53.19%. The median ages of suspected and confirmed cases were 32.7 months and 35.8 months, respectively. Nine of 27 confirmed cases lived in one community. Only two-family clusters among 88 household contacts were HRSV positive. A total of 18 of the G gene were obtained from the confirmed cases. Phylogenetic analyses revealed that 16 of the sequences belonged to the HRSV B/BA9 genotype, and the other 2 sequences belonged to the HRSV A/ON1 genotype. The school were closed on June 9 and the outbreak ended on June 15.ConclusionThese findings suggest the need for an increased awareness of HRSV coinfections outbreak in the kindergarten, when HRSV resurges in the community after COVID-19 pandemic.