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Purpose: Research on how much early phonemic awareness (PA) instruction is optimal has produced inconclusive answers. We conducted a nonlinear meta-analysis to estimate the optimal cumulative dosage of early PA instruction on PA outcomes with an associated maximum effect size in preschool through first-grade students. Method: Sixteen experimental and quasi-experimental primary studies (35 effect sizes) on PA instruction effectiveness that reported cumulative dosage data were included. There were 613 students in treatment and 542 students in control conditions (Mage= 5.20 years; SDage = 0.87). Results: The cumulative dosage response model took a concave parabolic form (an upside-down U shape). Specifically, PA instruction effects improved with increasing dosage up to 10.20 hours of instruction (dmax = 0.74), after which the effects declined. Moderator analyses revealed these results held for students at-risk for reading disabilities and basic PA skills instruction. Furthermore, moderator analyses showed that the dosage response curves exhibited a convex parabolic form (a U shape) in PA instruction with letters, with effects continually increasing after 16 hours of PA instruction. Discussion: Overall, our findings highlight the importance of planning the optimal cumulative dosage of early PA instruction in preschool through first-grade settings so that students acquire the PA and phonological-orthographic associations taught and show progress in learning to read.

Abstract Dementia represents a significant global health challenge, with early screening during the preclinical stage being crucial for effective management. Traditional diagnostic biomarkers for Alzheimer’s Disease, the most common form of dementia, are limited by cost and invasiveness. Mild cognitive impairment (MCI), a precursor to dementia, is currently identified through neuropsychological tests like the Montreal Cognitive Assessment (MoCA), which are not suitable for large-scale screening. Eye-tracking technology, capturing and quantifying eye movements related to cognitive behavior, has emerged as a promising tool for cognitive assessment. Subtle changes in eye movements could serve as early indicators of MCI. However, the interpretation of eye-tracking data is challenging. This study introduced a dementia screening tool, VR Eye-tracking Cognitive Assessment (VECA), using eye-tracking technology, machine learning, and virtual reality (VR) to offer a non-invasive, efficient alternative capable of large-scale deployment. VECA was conducted with 201 participants from Shenzhen Baoan Chronic Hospital, utilizing eye-tracking data captured via VR headsets to predict MoCA scores and classify cognitive impairment across different educational backgrounds. The support vector regression model employed demonstrated a high correlation (0.9) with MoCA scores, significantly outperforming baseline models. Furthermore, it established optimal cut-off scores for identifying cognitive impairment with notable sensitivity (88.5%) and specificity (83%). This study underscores VECA’s potential as a portable, efficient tool for early dementia screening, highlighting the benefits of integrating eye-tracking technology, machine learning, and VR in cognitive health assessments.

Abstract Background Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a rare cause of heart attack, which may not receive sufficient attention from patients during post-discharge treatment, especially among those with normal coronary angiography results. Case presentation We present the case of a 65-year-old woman who was readmitted to the hospital with ventricular septal rupture (VSR) complicated by ventricular aneurysm, occurring 2 weeks after myocardial infarction. During the initial admission, coronary angiography revealed normal coronary arteries, leading to a diagnosis of MINOCA. Epicardial coronary vasospasm or coronary embolism was considered as potential causes; however, the patient did not adhere to standardized treatment upon initial discharge. The delayed VSR led to a decline in cardiac function but did not result in severe hemodynamic impairment. Following correction of heart failure with medications, the patient underwent percutaneous VSR repair 19 days after diagnosis and was discharged with a favorable recovery. Conclusions The occurrence of delayed VSR complicated with ventricular aneurysm in patients with MINOCA is rare, highlighting the possibility of serious complications in MINOCA cases. Both cardioprotective therapies and cause-targeted therapies are essential in the management of patients with MINOCA.

Abstract Background Heart failure (HF), which is caused by cardiac overload and injury, is linked to significant mortality. Writers of RNA modification (WRMs) play a crucial role in the regulation of epigenetic processes involved in immune response and cardiovascular disease. However, the potential roles of these writers in the immunological milieu of HF remain unknown. Methods We comprehensively characterized the expressions of 28 WRMs using datasets GSE145154 and GSE141910 to map the cardiac immunological microenvironment in HF patients. Based on the expression of WRMs, the immunological cells in the datasets were scored. Results Single-cell transcriptomics analysis (GSE145154) revealed immunological dysregulation in HF as well as differential expression of WRMs in immunological cells from HF and non-HF (NHF) samples. WRM-scored immunological cells were positively correlated with the immunological response, and the high WRM score group exhibited elevated immunological cell infiltration. WRMs are involved in the differentiation of T cells and myeloid cells. WRM scores of T cell and myeloid cell subtypes were significantly reduced in the HF group compared to the NHF group. We identified a myogenesis-related resident macrophage population in the heart, Macro-MYL2, that was characterized by an increased expression of cardiomyocyte structural genes (MYL2, TNNI3, TNNC1, TCAP, and TNNT2) and was regulated by TRMT10C. Based on the WRM expression pattern, the transcriptomics data (GSE141910) identified two distinct clusters of HF samples, each with distinct functional enrichments and immunological characteristics. Conclusion Our study demonstrated a significant relationship between the WRMs and immunological microenvironment in HF, as well as a novel resident macrophage population, Macro-MYL2, characterized by myogenesis. These results provide a novel perspective on the underlying mechanisms and therapeutic targets for HF. Further experiments are required to validate the regulation of WRMs and Macro-MYL2 macrophage subtype in the cardiac immunological milieu.

Abstract Background and Objective Klotho is a protein that is closely related to human aging. Soluble Klotho (S-Klotho) is a circulating protein, and its level decreases in response to systemic inflammation. The relationship between the platelet/high-density lipoprotein cholesterol ratio (PHR), an emerging inflammatory index, and S-Klotho concentrations is still unclear. In addition, the mean platelet volume has been confirmed to have a significant negative association with S-Klotho concentrations, but the relationship between the platelet count (PC) and S-Klotho concentrations has not yet been reported. Methods Data from individuals who participated in the National Health and Nutrition Examination Survey (NHANES) during the five cycles from 2007 to 2016 were retrieved for analysis. Linear regression, two-piecewise linear regression, and restricted cubic spline (RCS) methods were used to analyze the associations of the PHR index and its components with S-Klotho concentrations. In addition, subgroup analysis and effect modification tests were conducted. Results A total of 11,123 participants (5463 men (48.17%)), with an average age of 56.2 years, were included. After full adjustment, the S-Klotho levels of participants in the highest quartile group of PHR (β: -51.19, 95% CI: -75.41 to -26.97, P

Abstract Nanozymes are promising antimicrobials, as they produce reactive oxygen species (ROS). However, the intrinsic lack of selectivity of ROS in distinguishing normal flora from pathogenic bacteria deprives nanozymes of the necessary selectivities of ideal antimicrobials. Herein, we exploit the physiological conditions of bacteria (high alkaline phosphatase (ALP) expression) using a novel CuO nanoparticle (NP) nanoenzyme system to initiate an ALP-activated ROS prodrug system for use in the on-demand precision killing of bacteria. The prodrug strategy involves using 2-phospho-L-ascorbic acid trisodium salt (AAP) that catalyzes the ALP in pathogenic bacteria to generate ascorbic acid (AA), which is converted by the CuO NPs, with intrinsic ascorbate oxidase- and peroxidase-like activities, to produce ROS. Notably, the prodrug system selectively kills Escherichia coli (pathogenic bacteria), with minimal influence on Staphylococcus hominis (non-pathogenic bacteria) due to their different levels of ALP expression. Compared to the CuO NPs/AA system, which generally depletes ROS during storage, CuO NPs/AAP exhibits a significantly higher stability without affecting its antibacterial activity. Furthermore, a rat model is used to indicate the applicability of the CuO NPs/AAP fibrin gel in wound disinfection in vivo with negligible side effects. This study reveals the therapeutic precision of this bifunctional tandem nanozyme platform against pathogenic bacteria in ALP-activated conditions.

Abstract Plastic pollution is an emerging environmental issue, with microplastics and nanoplastics raising health concerns due to bioaccumulation. This work explored the impact of polystyrene nanoparticle (PS-NPs) exposure during prepuberty on male reproductive function post maturation in rats. Rats were gavaged with PS-NPs (80 nm) at 0, 3, 6, 12 mg/kg/day from postnatal day 21 to 95. PS-NPs accumulated in the testes and reduced sperm quality, serum reproductive hormones, and testicular coefficients. HE staining showed impaired spermatogenesis. PS-NPs disrupted the blood-testis barrier (BTB) by decreasing junction proteins, inducing inflammation and apoptosis. Transcriptomics identified differentially expressed genes related to metabolism, lysosome, apoptosis, and TLR4 signaling. Molecular docking revealed Cordycepin could compete with polystyrene for binding to TLR4. Cordycepin alleviated oxidative stress and improved barrier function in PS-NPs treated Sertoli cells. In conclusion, prepubertal PS-NPs exposure induces long-term reproductive toxicity in male rats, likely by disrupting spermatogenesis through oxidative stress and BTB damage. Cordycepin could potentially antagonize this effect by targeting TLR4 and warrants further study as a protective agent. This study elucidates the mechanisms underlying reproductive toxicity of PS-NPs and explores therapeutic strategies.

Abstract Background Rating scales and linear indices of surface electromyography (sEMG) cannot quantify all neuromuscular conditions associated with ankle-foot dysfunction in hemiplegic patients. This study aimed to reveal potential neuromuscular conditions of ankle-foot dysfunction in hemiplegic patients by nonlinear network indices of sEMG. Methods Fourteen male patients with hemiplegia and 10 age- and sex-matched healthy male adults were recruited and tested in static standing position. The characteristics of the root mean square (RMS), median frequency (MF), and three nonlinear indices, the clustering coefficient (C), the average shortest path length (L), and the degree centrality (DC), of eight groups of muscles in bilateral calves were observed. Results Compared to those of the control group, the RMS of the medial gastrocnemius (MG), flexor digitorum longus (FDL), and extensor digitorum longus (EDL) on the affected side were significantly lower (P

Abstract Accurate diagnosis of white blood cells from cytopathological images is a crucial step in evaluating leukaemia. In recent years, image classification methods based on fully convolutional networks have drawn extensive attention and achieved competitive performance in medical image classification. In this paper, we propose a white blood cell classification network called ResNeXt-CC for cytopathological images. First, we transform cytopathological images from the RGB color space to the HSV color space so as to precisely extract the texture features, color changes and other details of white blood cells. Second, since cell classification primarily relies on distinguishing local characteristics, we design a cross-layer deep-feature fusion module to enhance our ability to extract discriminative information. Third, the efficient attention mechanism based on the ECANet module is used to promote the feature extraction capability of cell details. Finally, we combine the modified softmax loss function and the central loss function to train the network, thereby effectively addressing the problem of class imbalance and improving the network performance. The experimental results on the C-NMC 2019 dataset show that our proposed method manifests obvious advantages over the existing classification methods, including ResNet-50, Inception-V3, Densenet121, VGG16, Cross ViT, Token-to-Token ViT, Deep ViT, and simple ViT about 5.5–20.43% accuracy, 3.6–23.56% F1-score, 3.5–25.71% AUROC and 8.1–36.98% specificity, respectively.

Abstract Hailstorms, characterized by their intensity, are often accompanied by strong winds and heavy rain, posing significant destructive potential. Data indicate that the economic losses caused by hail to buildings, particularly solar panels, have been increasing annually. However, research on the hail resistance of photovoltaic panels has predominantly focused on the isolated effects of hail impacts and wind loads, neglecting the coupling effects between wind and hail. In this study, a device was designed to couple both wind and hail. The effects of turbulence, hail size, and velocity on hail impact behavior were systematically studied and quantified. A predictive formula for the peak load of hail impact on structures was established. The results indicate that the impact of turbulence on hail is significant. When turbulence intensity varies with hail velocity, hail impact force increases as turbulence decreases and hail velocity increases. When both turbulence and hail diameter vary, the impact force of smaller hailstones shows less variation with increasing turbulence. According to variance analysis, hail velocity is the most significant factor affecting hail impact, followed by hail diameter and finally turbulence. The regression equation is given by $$F = - 0.624I_{{\text{u}}} + 5116.25D + 7.85V_{hail} - 259.709$$ F = - 0.624 I u + 5116.25 D + 7.85 V hail - 259.709 , where $$F$$ F represents the peak impact force in Newtons (N), $$I_{{\text{u}}}$$ I u denotes the turbulence intensity, $$D$$ D is the hail diameter in meters (m), and $$V_{hail}$$ V hail is the hail velocity in meters per second (m/s).

Abstract The Hoek–Brown (H–B) criterion has found widespread application in numerous rock engineering projects. However, its efficacy is compromised by an underestimation of rock strength due to its neglect of the influence of the intermediate principal stress ( $$\sigma_{2}$$ σ 2 ). Experimental evidence underscores the significant impact of $$\sigma_{2}$$ σ 2 . Consequently, there exists an imperative to formulate a three-dimensional (3D) criterion. In this study, a new deviatoric function with two additional parameters ( $$k$$ k and $$A$$ A ) is developed firstly, which ensure compliance with the prerequisites of smoothness and convexity. In addition, the parameters $$k$$ k and $$A$$ A are bonded with the weakening effect of the Lode angle ( $$\theta_{\sigma }$$ θ σ ) and the strengthening effect of the mean stress ( $$\sigma_{m}$$ σ m ), respectively. Then a new 3D strength criterion for rocks is proposed by combining this new deviatoric function and the triaxial compression meridian function of the original H–B criterion. Four distinct sets of test data encompassing various rock types are employed to validate the proposed criterion. The results demonstrate that the proposed criterion adeptly captures the strength characteristics of the four rock types, providing a good depiction of failure surfaces within the 3D principal stress space. Comparative analyses involve the utilization of several existing 3D H–B criteria for strength predictions. The proposed criterion exhibits superior fitting performance for all the selected rocks.

The Anqing section of the Yangtze (Changjiang) River in Anhui Province, China, is one of the most important migratory routes and distribution of the highly valued diadromous estuarine tapertail anchovy Coilia nasus. In the past, this section has suffered a severe loss of C. nasus resources caused by human activities, especially overfishing and water pollution. Since 2019, a fishing ban policy for the species in the Yangtze River has been introduced in China for resource restoration. Otoliths are calcium carbonate structures, and otolith microchemistry can provide detailed life history information that can be used to compare habitat use between different saline water bodies. To study the habitat history of C. nasus in the Anqing section of the Yangtze River after the implementation of the fishing ban, we examined the microchemical characteristics (Sr and Ca) of otoliths from the long (previously named C. ectenes) and short maxillary (previously named C. brachygnathus) types of anchovy using electron probe X-ray microanalysis (EPMA). Line-transect analysis of Sr/Ca ratios suggested that the short maxillary type of C. nasus could be divided into two groups. The otolith Sr/Ca ratios (calculated and expressed as Sr/Ca ×1, 000) of one group were always < 3.0, indicating their freshwater residency. Those of the other group had phases of low (< 3.0, believed to be indicative of a freshwater habitat) and high values (> 3.0, believed to be indicative of a brackish or seawater habitat), indicating that anchovies not only have a freshwater habitat history with low salinity but also a brackish habitat history with high salinity. The latter group of anchovies were typically anadromous C. nasus, as the Sr/Ca ratio of the otoliths of C. nasus fluctuated significantly and coincided with variations between freshwater and estuarine brackish or seawater (i.e., anchovies experienced not only freshwater habitats but also brackish water habitats at different stages of their life history). The Sr content mapping of EPMA with different color patterns for freshwater (blue), brackish water (green-yellow) and seawater (red) habitats also confirmed the results obtained from the line-transect analysis. Our results demonstrated that the population composition of C. nasus in the Anqing section of the Yangtze river became complex, and there was coexistence of freshwater resident and anadromous C. nasus in the Anqing section of the Yangtze River in Anhui Province, China (i.e., freshwater resident and anadromous short maxillary and anadromous long maxillary type C. nasus). This phenomenon may suggest a restoration of C. nasus resource diversity after the implementation of the fishing ban in the Anqing section of the Yangtze River.

This umbrella review was conducted aiming to assess the association between genetic variations and the development of diabetic retinopathy (DR) by collecting and evaluating available systematic reviews and meta-analysis results. We evaluated the methodological quality using the Measurement Tool to Assess Systematic Reviews (AMSTAR) 2.0, estimated the summary effect size by using the random effects model and calculated the 95% prediction intervals (PIs). Evidence from the included meta-analyses was graded according to established criteria as follows: convincing, highly suggestive, suggestive, weak, or not significant. This umbrella review included 32 meta-analyses of 52 candidate SNPs. The 12 selected meta-analyses were rated as “high,” 2 studies were rated as “moderate,” 11 studies were graded as “low,” and the remaining 7 studies were graded as “critically low” in terms of methodological quality. Carriers of specific genotypes and alleles of the transcription Factor 7-like 2 C/T (TCF7L2 C/T) polymorphism (rs7903146, p < 0.001) might be more susceptible to the occurrence of DR in the homozygous and recessive models, and these associations were supported by “convincing” evidence. Significant associations were also found between interleukin-6 (IL-6) -174 G/C (rs1800795; p < 0.05) or vascular endothelial growth factor (VEGF) polymorphisms (rs2010963, rs699947, rs1570360, rs2010963, rs699947, rs2146323; all p values

Abstract Background Steroid-induced osteonecrosis of femoral head (SONFH) is a severe health risk, and this study aims to identify immune-related biomarkers and pathways associated with the disease through bioinformatics analysis and animal experiments. Method Using SONFH-related datasets obtained from the GEO database, we performed differential expression analysis and weighted gene co-expression network analysis (WGCNA) to extract SONFH-related genes. A protein-protein interaction (PPI) network was then constructed, and core sub-network genes were identified. Immune cell infiltration and clustering analysis of SONFH samples were performed to assess differences in immune cell populations. WGCNA analysis was used to identify module genes associated with immune cells, and hub genes were identified using machine learning. Internal and external validation along with animal experiments were conducted to confirm the differential expression of hub genes and infiltration of immune cells in SONFH. Results Differential expression analysis revealed 502 DEGs. WGCNA analysis identified a blue module closely related to SONFH, containing 1928 module genes. Intersection analysis between DEGs and blue module genes resulted in 453 intersecting genes. The PPI network and MCODE module identified 15 key targets enriched in various signaling pathways. Analysis of immune cell infiltration showed statistically significant differences in CD8 + t cells, monocytes, macrophages M2 and neutrophils between SONFH and control samples. Unsupervised clustering classified SONFH samples into two clusters (C1 and C2), which also exhibited significant differences in immune cell infiltration. The hub genes (ICAM1, NR3C1, and IKBKB) were further identified using WGCNA and machine learning analysis. Based on these hub genes, a clinical prediction model was constructed and validated internally and externally. Animal experiments confirmed the upregulation of hub genes in SONFH, with an associated increase in immune cell infiltration. Conclusion This study identified ICAM1, NR3C1, and IKBKB as potential immune-related biomarkers involved in immune cell infiltration of CD8 + t cells, monocytes, macrophages M2, neutrophils and other immune cells in the pathogenesis of SONFH. These biomarkers act through modulation of the chemokine signaling pathway, Toll-like receptor signaling pathway, and other pathways. These findings provide valuable insights into the disease mechanism of SONFH and may aid in future drug development efforts.

Abstract The high‐value utilization of blast furnace slag (BFS) and steel slag (SS) as a valuable resource in the field of carbon reduction represents a green revolution, and also is an indispensable path toward breaking through resource and environmental constraints and achieving high‐quality, sustainable development through solid waste utilization in the steel industry. Achieving resource recycling while harnessing the untapped latent energy of resources and exploring their carbon sequestration capabilities has become a crucial avenue for further valorization through waste utilization. BFS and SS discharged from iron‐making or steel‐making furnaces carry a significant amount of latent heat, especially the calcium oxide component in SS, which gives it a unique advantage in the field of comprehensive BFS and SS utilization and carbonation‐based SS utilization. This article discusses the current research status of low‐carbon‐waste‐heat utilization in the production of microcrystalline glass, cementitious materials, functional adsorbents, and other products through front‐end modification of molten BFS and SS. This report also provides an overview of carbon capture by utilizing BFS and SS, offering insights into the research directions for subsequent heat recovery, online quality adjustment, high‐value utilization, and carbon sequestration using BFS and SS in the steel industry.

Abstract Euglena gracilis (E. gracilis), pivotal in the study of photosynthesis, endosymbiosis, and chloroplast development, is also an industrial microalga for paramylon production. Despite its importance, E. gracilis genome exploration faces challenges due to its intricate nature. In this study, we achieved a chromosome-level de novo assembly (2.37 Gb) using Illumina, PacBio, Bionano, and Hi-C data. The assembly exhibited a contig N50 of 619 Kb and scaffold N50 of 1.12 Mb, indicating superior continuity. Approximately 99.83% of the genome was anchored to 46 chromosomes, revealing structural insights. Repetitive elements constituted 58.84% of the sequences. Functional annotations were assigned to 39,362 proteins, enhancing interpretative power. BUSCO analysis confirmed assembly completeness at 80.39%. This first high-quality E. gracilis genome offers insights for genetics and genomics studies, overcoming previous limitations. The impact extends to academic and industrial research, providing a foundational resource.

Abstract Erectile dysfunction (ED) is the most prevalent consequences in men with diabetes mellitus (DM). Recent studies demonstrates that neutrophil extracellular traps (NETs) play important roles in DM and its complications. Nevertheless, whether NETs are involved in ED remains unknown. This work intended to explore the role and mechanisms of NETs in ED in the context of DM. Here, we observed that NET generation and pyroptosis were promoted in DM rats with ED compared with controls. Mechanistically, NETs facilitated NLRP3 inflammasome activation and subsequently triggered pyroptosis under high glucose stress, ultimately leading to ED. Intriguingly, DNase I (a NET degrading agent) alleviated ED and corpus cavernosum injury in DM rats. Overall, NETs might induce ED in DM by promoting NLRP3-mediated pyroptosis in the corpus cavernosum.

Abstract Background Rabies is a fatal zoonotic disease whose pathogenesis has not been fully elucidated, and vaccination is the only effective method for protecting against rabies virus infection. Most inactivated vaccines are produced using Vero cells, which are African green monkey kidney cells, to achieve large-scale production. However, there is a potential carcinogenic risk due to nonhuman DNA contamination. Thus, replacing Vero cells with human diploid cells may be a safer strategy. In this study, we developed a novel 2BS cell-adapted rabies virus strain and analysed its sequence, virulence and immunogenicity to determine its application potential as a human diploid cell inactivated vaccine. Methods and results The 2BS cell-adapted rabies virus strain 2aG4-B40 was established by passage for 40 generations and selection of plaques in 2BS cells. RNA sequence analysis revealed that mutations in 2BS cell-adapted strains were not located at key sites that regulate the production of neutralizing antibodies or virulence in the aG strain (GQ412744.1). The gradual increase in virulence (remaining above 7.0 logLD50/ml from the 40th to 55th generation) and antigen further indicated that these mutations may increase the affinity of the adapted strains for human diploid cells. Identification tests revealed that the 2BS cell-adapted virus strain was neutralized by anti-rabies serum, with a neutralization index of 19,952. PrEP and PEP vaccination and the NIH test further indicated that the vaccine prepared with the 2aG4-B40 strain had high neutralizing antibody levels (2.24 to 46.67 IU/ml), immunogenicity (protection index 270) and potency (average 11.6 IU/ml). Conclusions In this study, a 2BS cell-adapted strain of the 2aG4 rabies virus was obtained by passage for 40 generations. The results of sequencing analysis and titre determination of the adapted strain showed that the mutations in the adaptive process are not located at key sequence regions of the virus, and these mutations may enhance the affinity of the adapted strain for human diploid cells. Moreover, vaccines made from the adapted strain 2aG4-B40 had high potency and immunogenicity and could be an ideal candidate rabies virus strain for inactivated vaccine preparation.

Abstract Pregnane X receptor (PXR) has been reported to regulate glycolipid metabolism. The dysfunction of intestinal barrier contributes to metabolic disorders. However, the role of intestinal PXR in metabolic diseases remains largely unknown. Here, we show that activation of PXR by tributyl citrate (TBC), an intestinal-selective PXR agonist, improves high fat diet (HFD)-induced obesity. The metabolic benefit of intestinal PXR activation is associated with upregulation of β-1,3 galactosyltransferase 5 (B3galt5). Our results reveal that B3galt5 mainly expresses in the intestine and is a direct PXR transcriptional target. B3galt5 knockout exacerbates HFD-induced obesity, insulin resistance and inflammation. Mechanistically, B3galt5 is essential to maintain the integrity of intestinal mucus barrier. B3galt5 ablation impairs the O-glycosylation of mucin2, destabilizes the mucus layer, and increases intestinal permeability. Furthermore, B3galt5 deficiency abolishes the beneficial effect of intestinal PXR activation on metabolic disorders. Our results suggest the intestinal-selective PXR activation regulates B3galt5 expression and maintains metabolic homeostasis, making it a potential therapeutic strategy in obesity.

Objective To investigate the clinical efficacy of disc repositioning surgery combined with orthodontic treatment in patients with temporomandibular disorder and facial asymmetry. Methods One patient who underwent disc repositioning surgery combined with orthodontic treatment for temporomandibular joint disorder and facial asymmetry was reported. Preoperatively, the patient had a skewed shape of the opening, mild pressure pain in the right preauricular region with left mandibular deviation, and a mismatch between the width of the upper and lower dental arches. In the arthrosurgery department, bilateral temporomandibular disc replacement and anchorage were performed through a transauricular incision, and an auxiliary splint was worn to stabilize the jaw position for 6 months. In the orthopedic department, maxillary skeletal expansion was used in combination with the multiloop edgewise archwire technique to reconstruct the occlusion after 16 months of orthodontic treatment. Results The deviation was corrected by wearing an occlusal splint for six months after joint repositioning and anchoring; moreover, the pain symptoms disappeared, and the cone beam CT examination showed that the bilateral temporomandibular joint space was uniformly enlarged, the lower alveolar ridge midline deviated to the right, the posterior regions of the teeth were bilaterally inverted, and the anterior region and the posterior region of the left side were open. The orthodontic treatment matched the width of the upper and lower dental arches and established the cuspal molar neutrality relationship and the normal overjet coverage of the anterior teeth; additionally, the mandibular position was not obviously skewed. A review of the results of the related literature shows that abnormal occlusal relationships, such as mismatched arch width and skewed occlusal plane, can cause adaptive mandibular deviation, which can lead to the occurrence of TMD. Temporomandibular joint disc anchorage with splint treatment can effectively improve maxillofacial deformity in young TMD patients. After the establishment of a stable, physiologically functional disc-condylar relationship, orthodontic treatment is required to remove the interfering factors to rebuild the occlusion, and long-term postoperative review and follow-up are needed. Conclusion In patients with TMD and mandibular accommodative deviation due to occlusal anomalies, establishing a normal disc-condylar relationship and eliminating occlusal interference through disc repositioning surgery combined with orthodontic treatment can effectively improve facial shape and establish a stable jaw position.

Understanding the effects of microwave irradiation and thermal treatment on the dynamic compression and fragmentation properties of rocks is essential to quantify energy consumption in rock engineering. In this study, Fangshan granite (FG) specimens were exposed to microwave irradiation and heat treatment. The damage of FG specimens induced by these two methods was compared using X-ray CT scanning and ultrasonic wave method. The temperatures of FG after microwave irradiation and thermal treatment were effectively evaluated using a newly proposed technique. A novelty method for precisely determining the geometric features of fragments is developed to estimate the fragmentation energy. Thus, the dynamic uniaxial compressive strength (UCS), the dynamic fragmentation characteristics, and the fragmentation energy of FG after these two pretreatment methods can be reasonably compared. The noticeable distinction of loading rate effect on the dynamic UCS of FG between these two pretreatment methods is first observed. A relationship is established between the dynamic UCS and the damage induced by microwave irradiation and heat treatment. Moreover, fragmentation energy fan analysis is introduced to accurately compare the fragmentation properties of FG after two pretreatment methods in dynamic compression tests.

Abstract The DC multi‐port converter's applications are increasing owing to its favourable features, including variable control mode, high power density, and bi‐directional power supply. On the other hand, the impedance interaction between each port of the electrolytic capacitor‐less DC multi‐port converter may generate an instability. To address the above mentioned problem, a method is proposed in this paper for reshaping the impedances of the energy storage converter by constructing a virtual impedance connected in parallel with the output impedance of the electrolytic capacitor‐less DC multi‐port converter. Furthermore, this paper introduces the stability criterion based on the unified impedance theory, which classifies a converter as either the bus current‐controlled converter or the bus voltage‐controlled converter. The proposed control approaches raise the magnitude of the output impedance of the electrolytic capacitor‐less DC multi‐port converter to satisfy the unified impedance theory criterion without modifying each port. The simulation results show that the proposed method is better than the traditional methods, and comprehensive experimental results are provided to validate the proposed methods.

Abstract Understanding the fluorescence resonance energy transfer (FRET) of metal nanoparticles at the atomic level has long been a challenge due to the lack of accurate systems with definite distance and orientation of molecules. Here we present the realization of achieving FRET between two atomically precise copper nanoclusters through cocrystallization-induced spatial confinement. In this study, we demonstrate the establishment of FRET in a cocrystallized Cu8(p-MBT)8(PPh3)4@Cu10(p-MBT)10(PPh3)4 system by exploiting the overlapping spectra between the excitation of the Cu10(p-MBT)10(PPh3)4 cluster and the emission of the Cu8(p-MBT)8(PPh3)4 cluster, combined with accurate control over the confined space between the two nanoclusters. Density functional theory is employed to provide deeper insights into the role of the distance and dipole orientations of molecules to illustrate the FRET procedure between two cluster molecules at the electronic structure level.

Abstract Background TTN is a complex gene with large genomic size and highly repetitive structure. Pathogenic variants in TTN have been reported to cause a range of skeletal muscle and cardiac disorders. Homozygous or compound heterozygous mutations tend to cause a wide spectrum of phenotypes with congenital or childhood onset. The onset and severity of the features were considered to be correlated with the types and location of the TTN variants. Methods Whole-exome sequencing was performed on three unrelated families presenting with fetal akinesia deformation sequence (FADS), mainly characterized by reduced fetal movements and limb contractures. Sanger sequencing was performed to confirm the variants. RT-PCR analysis was performed. Results TTN c.38,876–2 A > C, a meta transcript-only variant, with a second pathogenic or likely pathogenic variant in trans, was observed in five affected fetuses from the three families. Sanger sequencing showed that all the fetal variants were inherited from the parents. RT-PCR analysis showed two kinds of abnormal splicing, including intron 199 extension and skipping of 8 bases. Conclusions Here we report on three unrelated families presenting with FADS caused by four TTN variants. In addition, our study demonstrates that pathogenic meta transcript-only TTN variant can lead to defects which is recognizable prenatally in a recessive manner.

Abstract Tissue specificity is a fundamental property of an organ that affects numerous biological processes, including aging and longevity, and is regulated by the circadian clock. However, the distinction between circadian-affected tissue specificity and other tissue specificities remains poorly understood. Here, using multi-omics data on circadian rhythms in mice, we discovered that approximately 35% of tissue-specific genes are directly affected by circadian regulation. These circadian-affected tissue-specific genes have higher expression levels and are associated with metabolism in hepatocytes. They also exhibit specific features in long-reads sequencing data. Notably, these genes are associated with aging and longevity at both the gene level and at the network module level. The expression of these genes oscillates in response to caloric restricted feeding regimens, which have been demonstrated to promote longevity. In addition, aging and longevity genes are disrupted in various circadian disorders. Our study indicates that the modulation of circadian-affected tissue specificity is essential for understanding the circadian mechanisms that regulate aging and longevity at the genomic level.

Abstract Background Collagen (COL) genes, play a key role in tumor invasion and metastasis, are involved in tumor extracellular matrix (ECM)-receptor interactions and focal adhesion pathways. However, studies focusing on the diagnostic value of the COL4 family in stomach adenocarcinoma (STAD) are currently lacking. Methods The TCGA database was employed to retrieve the clinical features and RNA sequencing expression profiles of patients with STAD. We conducted an investigation to examine the expression disparities between STAD and adjacent normal tissues. Kaplan-Meier survival analysis was utilized to assess their prognostic significance, while Spearman correlation analysis was employed to determine their association with immune checkpoint genes and immunomodulatory molecules. Furthermore, GO and KEGG analyses were performed on the COL4s-related genes, revealing potential biological pathways through gene set enrichment analysis (GSEA). Subsequently, we explored the extent of immune infiltration of the COL4 family in STAD using the TIMER database. Lastly, the expression levels of the COL4 family in STAD were further validated through quantitative PCR (qPCR) and western blot techniques. Results The expression levels of COL4A1/2 were significantly upregulated, while COL4A5/6 were conspicuously downregulated in STAD. The survival analysis revealed that the upregulated COL4s indicated poorer overall survival, first progression and post-progression survival outcomes. Additionally, our findings demonstrated a positive correlation between the expressions of COL4A1/2/3/4 and the infiltration of immune cells, including CD8 + T cells, dendritic cells, macrophages, neutrophils and CD4 + T cells. Further correlation analysis uncovered a favorable association between the expression of COL4A1/2/3/4 and various crucial immunomodulatory molecules, immunological checkpoint molecules, and chemokines. Quantitative PCR analysis confirmed that the expression patterns of COL4A1/3/4/6 genes aligned with the finding from the TCGA database. However, gastric cancer cells exhibited downregulation of COL4A2. Consistently, the protein level of COL4A1 was elevated, whereas the protein level of COL4A2 was reduced in the gastric cancer cell lines. Conclusion COL4s could potentially serve as biomarkers for diagnosing and predicting the prognosis of STAD.

Abstract College students represent a burgeoning force in mass entrepreneurship, underscoring the critical need to nurture their entrepreneurial endeavors. This study adopts a quantitative method, surveying 33,660 Chinese college students engaged in entrepreneurial activities. It examines the impact of various entrepreneurial policies and regional entrepreneurship spirit on these students’ decision-making processes. The findings reveal a positive correlation between entrepreneurial policies and entrepreneurial decision-making among college students, with regional entrepreneurship spirit serving as a mediator. Gender influences the relationship between regional entrepreneurship spirit and entrepreneurial decision-making, primarily moderating the effects of supply-based and environmentally-oriented policies. Entrepreneurship must be deeply integrated within China’s unique social networks and informal institutional frameworks. The moderating influence of gender also highlights differing policy impacts among various student groups. This research contributes to the enhancement and understanding of the policy support mechanism’s effect on college students and underscores the necessity for precise implementation of entrepreneurship policies tailored to college students.

Abstract Hepatocellular carcinoma (HCC) is a common primary liver cancer with a high incidence and mortality. Members of the growth-arresting-specific 2 (GAS2) family are involved in various biological processes in human malignancies. To date, there is only a limited amount of information available about the expression profile and clinical importance of GAS2 family in HCC. In this study, we found that GAS2L1 and GAS2L3 were distinctly upregulated in HCC specimens compared to non-tumor specimens. Pan-cancer assays indicated that GAS2L1 and GAS2L3 were highly expressed in most cancers. The Pearson’s correlation revealed that the expressions of GAS2, GAS2L1 and GAS2L2 were negatively associated with methylation levels. Survival assays indicated that GAS2L1 and GAS2L3 were independent prognostic factors for HCC patients. Immune cell infiltration analysis revealed that GAS2, GAS2L1 and GAS2L3 were associated with several immune cells. Finally, we confirmed that GAS2L1 was highly expressed in HCC cells and its knockdown suppressed the proliferation of HCC cells. Taken together, our findings suggested the expression patterns and prognostic values of GAS2 members in HCC, providing insights for further study of the GAS2 family as sensitive diagnostic and prognostic markers for HCC.

Objective To analyze the ability of micro-implant nails placed in different locations in the posterior region to improve the hard and soft tissues of the labiodental region in patients with gummy smiles to provide a reference for clinicians. Methods This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. Thirty young female patients with anterior tooth protrusions and gummy smiles were included in the retrospective study; 18 patients had micro-implant nails implanted between the premolars (group A), and 12 patients had implant nails placed between the roots of the premolar and the molar and an intraoperatively placed rocking-chair archwire (group B). The preoperative and postoperative distances from the incisal end of the upper mesial incisors to the lower point of the upper lip (U1-Stms), the vertical distance from the incisal end of the upper mesial incisors to the palatal plane (U1-PP), the vertical distance from the point of the alveolar ridge to the palatal plane (Spr-PP), the distance from the incisal end of the upper mesial incisors to the point of the alveolar margin (U1-Spr), and the vertical distance from the point of the proximal middle buccal cusp of the maxillary first molar to the palatal plane of the maxillary first molar (U6-PP) were measured in the cephalometric lateral radiographs of the two groups; additionally, the amount of hard and soft tissues of the upper anterior region exposedduring smiling and the maximum amount of gingiva exposed during smiling were assessed from the smile photograph. Results After correction, the lip-dentition relationship improved significantly in both groups, with an average reduction of 2.6 mm in U1-Stms, 2.4 mm in U1-PP, 1.4 mm in Spr-PP, and 0.9 mm in U1-Spr in Group A. In group B, the U1-Stms was reduced by an average of 2.3 mm, the U1-PPs by an average of 1.6 mm, the Spr-PPs by 1.4 mm, and the U1-Spr by 0.2 mm. The difference between pre- and postoperative U6-PP in both groups was not significant (P>0.05). Group A had greater ∆U1-PP and ∆U1-Spr changes than group B(PP>0.05). The amount of soft and hard tissue exposed and maximum amount of gingiva exposed in the upper anterior region of the smile were reduced in 30 patients postoperatively, with group A having anaverage reduction of 70.19% of the preoperative amount of soft and hard tissue exposed in the upper anterior region and an average reduction of 24.12% of the preoperative maximum amount of gingiva exposed, and group B having an average reduction of 76.12% of the preoperative amount of hard and soft tissue exposed in the upper anterior region and an average reduction of 31.88% of the preoperative maximum gingiva exposed after the operation. The difference in the ratio between the two groups was not statistically significant (P>0.05). Conclusion For patients with proptosis and gummy smiles, placing micro-implant nails between the roots of maxillary premolars can effectively lead to retraction and intrusion of anterior teeth to improve the lip-dentition relationship and improve gummy smile, and placing micro-implant nails between the roots of the maxillary second premolar and the first molar together with the use of rocking chair arches can also achieve a good therapeutic effect.

Abstract Background Residual risk assessment for acute coronary syndrome (ACS) patients after sufficient medical management remains challenging. The usefulness of measuring high-sensitivity C-reactive protein (hsCRP) and remnant cholesterol (RC) in assessing the level of residual inflammation risk (RIR) and residual cholesterol risk (RCR) for risk stratification in these patients needs to be evaluated. Methods Patients admitted for ACS on statin treatment who underwent percutaneous coronary intervention (PCI) between March 2016 and March 2019 were enrolled in the analysis. The included patients were stratified based on the levels of hsCRP and RC during hospitalization. The primary outcome was ischemic events at 12 months, defined as a composite of cardiac death, myocardial infarction, or stroke. The secondary outcomes included 12-month all-cause death and cardiac death. Results Among the 5778 patients, the median hsCRP concentration was 2.60 mg/L and the median RC concentration was 24.98 mg/dL. The RIR was significantly associated with ischemic events (highest hsCRP tertile vs. lowest hsCRP tertile, adjusted hazard ratio [aHR]: 1.52, 95% confidence interval [CI]: 1.01–2.30, P = 0.046), cardiac death (aHR: 1.77, 95% CI:1.02–3.07, P = 0.0418) and all-cause death (aHR: 2.00, 95% CI: 1.24–3.24, P = 0.0048). The RCR was also significantly associated with these outcomes, with corresponding values for the highest tertile of RC were 1.81 (1.21–2.73, P = 0.0043), 2.76 (1.57–4.86, P = 0.0004), and 1.72 (1.09–2.73, P = 0.0208), respectively. The risks of ischemic events (aHR: 2.80, 95% CI: 1.75–4.49, P

Abstract Aims/Introduction Machine learning algorithms based on the artificial neural network (ANN), support vector machine, naive Bayesian or logistic regression model are commonly used to identify diabetes. This study investigated which approach performed the best and whether muscle strength provided any incremental benefit in identifying undiagnosed diabetes in Chinese adults. Methods This cross‐sectional study enrolled 4,482 eligible participants from eight provinces in China, who were randomly divided into the training dataset (n = 3,586) and the testing dataset (n = 896). Muscle strength was assessed by handgrip strength and the number of chair stands in the 30‐s chair stand test. An oral glucose tolerance test was used to ascertain undiagnosed diabetes. The areas under the curve (AUCs) were calculated accordingly and compared with each other. Results Of the included participants, 233 had newly diagnosed diabetes. All the four machine learning algorithms, which were developed based on nonlaboratory parameters, showed acceptable discriminative ability in identifying undiagnosed diabetes (all AUCs >0.70), with the ANN approach performing the best (AUC 0.806). Adding handgrip strength or the 30‐s chair stand test to this approach did not increase the AUC further (P = 0.39 and 0.26, respectively). Furthermore, compared with the New Chinese Diabetes Risk Score, the ANN approach showed a larger AUC in identifying undiagnosed diabetes (Pcomparison

Abstract Background Acute coronary syndrome due to coronary artery embolism in the setting of ascending aortic thrombus is an uncommon condition, even rarer when there is no aortic pathology such as aneurysm, severe atherosclerosis, aortic dissection, or thrombophilia (whether inherited or acquired). Case presentation We report a case of a 58-year-old male presented with acute chest pain, electrocardiogram showing non-ST-elevation acute coronary syndrome. The computed tomography angiography of coronary artery revealed a mural thrombus in the proximal part of ascending aorta, located above the left coronary artery ostium, without any aortic pathologies. With the exception of hypertension and cigarette smoking, no other risk factors were identified in this patient that may increase the risk of thrombosis. Given the life-threatening risk of interventional therapy and surgery, the patient determinedly opted for anticoagulant and dual antiplatelet therapy. Then he experienced the reoccurrence of chest pain after 6-day treatment, progressed to anterior and inferior ST-segment elevation myocardial infarction. Coronary artery embolism originating from the ascending aortic thrombus was suspected. Considering the hemodynamic instability of the patient, the medical treatment was continued and bridged to warfarin and aspirin after discharge. Follow-up computed tomography angiography at 6 months showed no obstruction in coronary artery and complete resolution of the thrombus. No thromboembolic events occurred henceforward. Conclusions Acute coronary syndrome could be a manifestation of secondary coronary embolism due to ascending aortic thrombus. Currently, there is no standardized guideline for the treatment of aortic mural thrombus, individualized treatment is recommended. When surgical therapy is not applicable for the patient, anticoagulation and dual antiplatelet treatment are alternative treatments that may successfully lead to the resolution of the aortic thrombus.

Abstract Background We describe a case in which bilateral optic nerve infiltration and leukemic retinopathy were the initial signs of disease relapse in a patient with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+-ALL) with central nervous system (CNS) involvement. Case presentation A 65-year-old Asian female with Ph+-ALL in complete remission presented at our institution with symptoms of visual disturbance, central scotoma and pain with eye movement in both eyes for a 1-month duration. Ophthalmic examination revealed remarkable optic disc swelling with multiple flame-shaped peripapillary hemorrhages, retinal venous dilation and retinal hemorrhages in both eyes. She was subsequently referred to the treating oncologist and diagnosed with Ph+-ALL relapse with multiple relapsed diseases involving the bone marrow and CNS. After intrathecal (IT) therapy, her visual acuity dramatically improved, and her leukemic infiltrates decreased. Conclusions To the best of our knowledge, this is the first case report of ALL relapse with CNS involvement presenting as bilateral optic nerve infiltration and leukemic retinopathy in an adult. Hence, we highlight the priority and sensitivity of ophthalmic examinations, as they are noninvasive methods for detecting leukemia relapse.

Abstract Histone deacetylase (HDAC) serves as a critical molecular regulator in the pathobiology of various malignancies and have garnered attention as a viable target for therapeutic intervention. A variety of HDAC inhibitors (HDACis) have been developed to target HDACs. Many preclinical studies have conclusively demonstrated the antitumor effects of HDACis, whether used as monotherapy or in combination treatments. On this basis, researchers have conducted various clinical studies to evaluate the potential of selective and pan-HDACis in clinical settings. In our work, we extensively summarized and organized current clinical trials, providing a comprehensive overview of the current clinical advancements in targeting HDAC therapy. Furthermore, we engaged in discussions about several clinical trials that did not yield positive outcomes, analyzing the factors that led to their lack of anticipated therapeutic effectiveness. Apart from the experimental design factors, issues such as toxicological side effects, tumor heterogeneity, and unexpected off-target effects also contributed to these less-than-expected results. These challenges have naturally become significant barriers to the application of HDACis. Despite these challenges, we believe that advancements in HDACi research and improvements in combination therapies will pave the way or lead to a broad and hopeful future in the treatment of solid tumors.

Abstract Down-polyethylene film material has been introduced for the first time as an excellent non-frame sound absorber, showing a distinctively outstanding performance. It contains down fiber adjacent to each other without firm connection in between, forming a structure of elastic fiber network. The unique structure has broadband response to sound wave, showing non-synchronous vibration in low and middle frequency and synchronous vibration in middle and high frequency. The broadband resonance in middle and high frequency allows the structure to achieve complete sound absorption in resonance frequency band. Moreover, down-polyethylene film material possesses forced vibration, corresponding sound absorption coefficient has been obtained based on vibration theory. The down-film sound absorption material has the characteristics of light weight, soft, environment-friendly, and has excellent broadband sound absorption performance.

Abstract This study elaborates on the design, fabrication, and data analysis details of SPEED, a recently proposed smartphone-based digital polymerase chain reaction (dPCR) device. The dPCR chips incorporate partition diameters ranging from 50 μm to 5 μm, and these partitions are organized into six distinct blocks to facilitate image processing. Due to the superior thermal conductivity of Si and its potential for mass production, the dPCR chips were fabricated on a Si substrate. A temperature control system based on a high-power density Peltier element and a preheating/cooling PCR protocol user interface shortening the thermal cycle time. The optical design employs four 470 nm light-emitting diodes as light sources, with filters and mirrors effectively managing the light emitted during PCR. An algorithm is utilized for image processing and illumination nonuniformity correction including conversion to a monochromatic format, partition identification, skew correction, and the generation of an image correction mask. We validated the device using a range of deoxyribonucleic acid targets, demonstrating its potential applicability across multiple fields. Therefore, we provide guidance and verification of the design and testing of the recently proposed SPEED device.

Abstract Background Previous evidence showed a possible link of dyslipidemia with bone health. Nevertheless, the correlation of remnant cholesterol (RC) with bone mineral density (BMD) has yet to be well investigated. This study investigated the association of RC with total spine BMD in general Americans. Methods This study explored the relationship of RC with total spine BMD in subjects aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) 2013–2018. After adjusting for covariates, multivariate linear regression and stratified analyses were conducted to determine the correlation of serum RC with total spine BMD in adult Americans. Restricted cubic spline (RCS) was applied to examine the nonlinear association of serum RC with total spine BMD. Results This study included 3815 individuals ≥ 20 years old, 1905 (49.93%) of whom were men and 1910 (50.07%) of whom were women. After adjusting for all covariates, the results showed a negative relationship of serum RC with total spine BMD (β= -0.024, 95% CI: -0.039, -0.010). The interaction tests of age, sex, race, and BMI showed no statistically significant effects on the association. The RCS also indicated a negative linear correlation of serum RC with total spine BMD (nonlinear P = 0.068, overall P

Background The most effective prevention strategy for atherosclerotic cardiovascular disease (ASCVD) is primary management, with the core measure of risk assessment. The existing prediction models for ASCVD for the elderly are not able to guide TCM primary management well. Therefore, it is necessary to integrate TCM elements into the development of prediction models to guide the primary management of ASCVD with combined traditional Chinese and western medicine. Objective To construct and validate the ASCVD prediction model for the elderly based on TCM constitution. Methods A total of 1 418 elderly people who underwent physical examination at Huayuan Street Community Health Service Center, Chentangzhuang Street Community Health Service Center, Xiangyang Road Street Community Health Service Center and Daqiuzhuang Town Central Health Center in 2017 were included as the study subjects. General data of the study subjects were collected and constitution identification was performed. The incidence of ASCVD (clinical outcome) was followed up from 2017 to 2022. The follow-up will end at 2022-11-30. The data of the subjects were randomly divided into a training set (n=1 127) and validation set (n=291) according to 8∶2. In the training set, the conventional ASCVD prediction model for the elderly (model 1) and the conventional ASCVD+constitution prediction model for the elderly (model 2) were constructed by using the forward stepwise method. The nomogram of ASCVD prediction model for the elderly based on TCM constitution was plotted. The calibration curve was plotted and the Hosmer-Lemeshow goodness of fit test was performed to determine the calibration of the model. The receiver operating characteristic curve was plotted and the area under the curve (AUC) was calculated to determine the discrimination of the model. AUC, Net Reclassification Index (NRI), Integrated Discrimination Improvement (IDI), and Decision Curve Analysis (DCA) were used to compare model 2 with model 1 to evaluate the improvement efficacy of model 2. Results There was no significant difference in the general data between the training set and validation set (P>0.05). The results of multivariate analysis showed that model 1 included 7 predictors of gender, age, waist circumference, systolic blood pressure, triacylglycerol (TG), BMI, systolic blood pressure×hypertension medication history. model 2 included 8 predictors of gender, age, waist circumference, systolic blood pressure, TG, BMI, systolic blood pressure×hypertension medication history, and constitution type. Hosmer-Lemeshow goodness-of-fit test showed good fit of model 2; Delong test results showed that AUC of model 2 was higher than that of model 1 (Z=2.741, P=0.006), NRI=0.511 (95%CI=0.359-0.663, P