Search

Lung cancer (LC) is considered to have the highest mortality rate around the world. Because there are no early diagnostic signs or efficient clinical alternatives, distal metastasis and increasing numbers of recurrences are a challenge in the clinical management of LC. Long non-coding RNAs (lncRNAs) have recently been recognized as a critical regulator involved in the progression and treatment response to LC. The Wnt/β-catenin pathway has been shown to influence LC occurrence and progress. Therefore, discovering connections between Wnt signaling pathway and lncRNAs may offer new therapeutic targets for improving LC treatment and management. In this review, the purpose of this article is to present possible therapeutic approaches by reviewing particular relationships, key processes, and molecules associated to the beginning and development of LC.

A single-row pile dam is a type of rigid debris flow barrier structure. In order to reveal the mutual interaction effects between debris flow and a single-row pile dam and the distribution law of debris flow impact forces, an analysis of the correlation between debris flow density, characteristic particle size, and relative pile spacing (the ratio of pile gap size to debris flow characteristic particle diameter) and debris flow impact forces was conducted to obtain dimensionless parameters related to debris flow impact force and climbing height. These parameters were verified through flume model experiments to provide theoretical support for the engineering design of single-row pile dams. The results show that the impact force of the debris flow on the pile dam is mainly affected by the flow velocity, debris flow density, and relative pile spacing. The dimensionless parameters are introduced, and the semi-empirical expression of the impact load coefficient is established. The impact pressure coefficient of debris flow is classified into two categories, and the calculation model of impact load of a single-row pile dam is constructed. The research results can provide a theoretical basis and technical parameters for designing a single-row pile dam.

Background: Orthostatic intolerance (OI) is the inability to tolerate orthostatic stress during any postural change. The etiology of OI varies, and methods to obtain a specific diagnosis and plan appropriate treatment are important. The tools available within the Chinese context to swiftly identify orthostatic intolerance syndrome (OIS) are currently limited. Methods: Patients with OI symptoms were included in this study and categorized into two groups based on the results of the supine-to-stand test. Those with abnormal test results were assigned to the OIS group, while those with normal test results were placed in the non-OIS group. We evaluated the internal consistency and predictive value of the Chinese Orthostatic Discriminant and Severity Scale (ODSS) by comparing patients’ scores with their physiological measurements collected during orthostatic stress tests and the results of other available questionnaires, including the orthostatic Symptom Questionnaire and Orthostatic Grading Scale (OGS). Results: Patients with OIS scored significantly higher on all three questionnaires and showed significant differences in autonomic responses during orthostatic stress tests compared with non-OIS patients. Receiver operating characteristic curve analysis showed that the orthostatic score from the ODSS had moderate predictive value for the supine test (area under the curve [AUC] = 0.754). Further subgroup analysis revealed that the orthostatic score from the ODSS had uniquely high specificity and sensitivity for identifying patients with orthostatic hypotension with abnormal cerebral blood flow (OH–U, AUC = 0.919). Conclusions: We conclude that the Chinese version of the ODSS has sufficient reliability and validity to distinguish patients with OIS and could possibly be used as a diagnostic tool for OH–U patients. Thus, the Chinese ODSS offers a beneficial screening tool for quickly assessing whether patients have OIS that requires further clinical assessment.

Chimeric antigen receptor T (CAR-T) cell therapy targeting T cell tumors still faces many challenges, one of which is its fratricide due to the target gene expressed on CAR-T cells. Despite this, these CAR-T cells can be expanded in vitro by extending the culture time and effectively eliminating malignant T cells. However, the mechanisms underlying CAR-T cell survival in cell subpopulations, the molecules involved, and their regulation are still unknown. We performed single-cell transcriptome profiling to investigate the fratricidal CAR-T products (CD26 CAR-Ts and CD44v6 CAR-Ts) targeting T cells, taking CD19 CAR-Ts targeting B cells from the same donor as a control. Compared with CD19 CAR-Ts, fratricidal CAR-T cells exhibit no unique cell subpopulation, but have more exhausted T cells, fewer cytotoxic T cells, and more T cell receptor (TCR) clonal amplification. Furthermore, we observed that fratricidal CAR-T cell survival was accompanied by target gene expression. Gene expression results suggest that fratricidal CAR-T cells may downregulate their human leukocyte antigen (HLA) molecules to evade T cell recognition. Single-cell regulatory network analysis and suppression experiments revealed that exhaustion mediated by critical regulatory factors may contribute to fratricidal CAR-T cell survival. Together, these data provide valuable and first-time insights into the survival of fratricidal CAR-T cells.

Conditioning is an important step in harvesting alfalfa hay, as squeezing and bending alfalfa stems can break down the stem fibers and accelerate the drying rate of alfalfa. The quality of alfalfa hay is directly affected by the conditioning effect. The finite element method (FEM) can quantitatively analyze the interaction relationship between alfalfa and conditioning rollers, which is of great significance for improving conditioning effects and optimizing conditioning systems. The accuracy of material engineering parameters directly affects the simulation results. Due to the small diameter and thin stem wall of alfalfa, some of its material parameters are difficult to measure or have low measurement accuracy. Based on this background, this study proposed a method for calibrating the finite element parameters of thin-walled plant stems. By conducting radial tensile, shear, bending, and radial compression tests on alfalfa stems and combining with the constitutive relationship of the material, the range of engineering parameters for the stems was preliminarily obtained. By conducting a Plackett–Burman experiment, the parameters that affect the maximum shearing force of stems were determined, including Poisson’s ratio in the isotropic plane, radial elastic modulus, and the sliding friction coefficient between the alfalfa stem and steel plate. By conducting the steepest ascent experiment and Box–Behnken experiment, the optimal values of Poisson’s ratio, radial elastic modulus, and sliding friction coefficient were obtained to be 0.42, 28.66 MPa, and 0.60, respectively. Finally, the double-shear experiment, radial compression experiment, and conditioning experiment were used to evaluate the accuracy of the parameters. The results showed that the average relative error between the maximum shear and the measured value was 0.88%, and the average relative error between the maximum radial contact force and the measured value was 2.13%. In the conditioning experiment, the load curve showed the same trend as the measured curve, and the simulation results could demonstrate the stress process and failure mode of alfalfa stems. The modeling and calibration method can effectively predict the stress and failure of alfalfa during conditioning.

Even though long-term immunosuppressant drugs (ISD) are employed to inhibit immune system activity, enhancing graft functionality and patient survival in solid organ transplantation (SOT), these transplants often lead to immune complications, with post-transplant autoimmune diseases of the central nervous system (CNS) being uncommon. Here, we detail the case of a 66-year-old woman who underwent a renal transplantation 8 months prior, who was admitted with subacute onset of encephalomyelitis, accompanied by headaches, paraplegia, weakness, vomiting, and abdominal pain, with a positive COVID-19 nasopharyngeal swab test 1 month before admission. MRI scans of the brain revealed multiple lesions in the white matter of the bilateral deep frontal lobe, the left temporal lobe and insula lobe. Additionally, there were multiple short segment lesions in the spinal cord and subdural hematoma at T1, T6-T7 posterior. The serum revealed a positive result for GlyR-IgG. Following the administration of corticosteroid and intravenous immunoglobulin, there was a significant improvement in the patient’s symptoms within 2 weeks, and her brain MRI showed a reduction in the lesion. Despite its rarity, we believe this to be the inaugural documentation of anti-GlyR encephalomyelitis occurring during renal transplantation. A full panel of antibodies for autoimmune encephalomyelitis is the key leading to the diagnosis.

Background and aimsDementia imposes a heavy burden on society and families, therefore, effective drug treatments, exploring and preventing factors associated with dementia, are paramount. To provide reference points for the best frequency of physical exercise (physical exercise), we investigated the association between frequency of PE and cognition in Chinese old adults.Methods16,181 Chinese participants aged 65 years or older were included in this study. Associations between PE and cognition were estimated multivariate logistic and linear regression analyses. Associations were further investigated across dementia subtypes (Alzheimer dementia, vascular dementia, and other types of dementia). Subgroup analyses were performed in different age groups, in populations with and without stroke, and those with and without hypertension.ResultsPE associated with dementia after adjusting for full covariates (OR: 0.5414, 95% CI: 0.4536–0.6491, p

In recent years, countries around the world have been placing increasing emphasis on energy saving and emission reduction. As part of the energy system, integrated energy stations play an important role in the low-carbon transition of the energy sector. However, most of the existing studies on carbon emissions from integrated energy stations focus on the operation phase or a single module within it and lack analysis and prediction of carbon emissions from all phases of the integrated energy station. In this paper, based on the perspective of life cycle assessment, system dynamics is used to establish a life cycle carbon emission model for integrated energy stations from four phases: production & materialization, construction, operation & maintenance, and disposal & recycling. This paper takes wind power integrated energy stations as an example, simulates the characteristics of the life cycle carbon emissions of integrated energy stations, and identifies the key factors affecting the carbon emissions. The simulation results show that the carbon emissions of the integrated energy station are mainly concentrated in the production and operation of the energy station, and the increase in the service life of the energy station will not have a significant impact on the total carbon emissions. This paper provides the theoretical guidance and decision-making basis for the formulation of low-carbon emission reduction measures for integrated energy stations.

With the increasing shortage of water resources and the aggravation of water pollution, solar-driven interfacial steam generation (SISG) technology has garnered considerable attention because of its low energy consumption, simple operation, and environmental friendliness. The popular multi-layer SISG evaporator is composed of two basic structures: a photothermal layer and a support layer. Herein, the support layer underlies the photothermal layer and carries out thermal management, supports the photothermal layer, and transports water to the evaporation interface to improve the stability of the evaporator. While most research focuses on the photothermal layer, the support layer is typically viewed as a supporting object for the photothermal layer. This review focuses on the support layer, which is relatively neglected in evaporator development. It summarizes existing progress in the field of multi-layer interface evaporators, based on various polymers and biomaterials, along with their advantages and disadvantages. Specifically, mainly polymer-based support layers are reviewed, including polymer foams, gels, and their corresponding functional materials, while biomaterial support layers, including natural plants, carbonized biomaterials, and other innovation biomaterials are not. Additionally, the corresponding structure design strategies for the support layer were also involved. It was found that the selection and optimal design of the substrate also played an important role in the efficient operation of the whole steam generation system. Their evolution and refinement are vital for advancing the sustainability and effectiveness of interfacial evaporation technology. The corresponding potential future research direction and application prospects of support layer materials are carefully presented to enable effective responses to global water challenges.

Plasma seed pretreatment is an important means to rapidly improve seed quality. The studies on plasma-generating devices suitable for continuous seed pretreatment at atmospheric pressure have been relatively limited. Gliding arc discharge can generate atmospheric pressure plasma at room temperature, which provides a new way to use plasma to treat seeds at ambient temperature and pressure. By analyzing the influence of structural characteristics, such as gliding arc electrode shape, discharge distance, and electrode opening angle on plasma distribution, a plasma seed treatment method based on negative pressure guidance was proposed, and the electrode structure was optimized. The results show that the reasonable matching of electrode structure parameters can improve the gliding arc guiding ability of the discharge electrode. Comparing the three electrode shapes, it was found that the triangular electrode had the best gliding arc guiding ability, and it had the potential to further increase the plasma size with the increase in the electrode size. The discharge distance and electrode opening angle had a significant impact on the gliding arc guiding ability of the discharge electrode. When the discharge distance was 15 mm and the electrode opening angle was 76°, the structure parameters of the plasma seed treatment electrode were matched with each other, and the best processing capacity was achieved. After 10 s of gliding arc plasma treatment with the optimized triangular electrode structure, the seed germination rate and germination index of Leymus chinensis ((Trin.) Tzvel) increased by 33.3% and 13.8%. This study provides a theoretical basis for the design and optimization of gliding arc electrode structures and serves as a reference for the research and development of plasma generators for continuous seed treatment at atmospheric pressure.

Quinone imines are important derivatives of quinones with a wide range of applications in organic synthesis and the pharmaceutical industry. The attack of nucleophilic reagents on quinone imines tends to lead to aromatization of the quinone skeleton, resulting in both the high reactivity and the unique reactivity of quinone imines. The extreme value of quinone imines in the construction of nitrogen- or oxygen-containing heterocycles has attracted widespread attention, and remarkable advances have been reported recently. This review provides an overview of the application of quinone imines in the synthesis of cyclic compounds via the domino annulation reaction.

To analyze the interaction between the surface soil and the soil-contacting component (65 Mn) in the camellia oleifera forest planting area in Changsha City, Hunan, China, in this study, we conducted discrete element calibration using physical and simulation tests. The chosen contact model was Hertz–Mindlin with JKR cohesion, with the soil repose angle as the response variable. The repose angle of the soil was determined to be 36.03° based on the physical tests. The significant influencing factors of the repose angle determined based on the Plackett–Burman test were the soil–soil recovery coefficient, soil–soil rolling friction coefficient, soil-65 Mn static friction coefficient, and surface energy of soil for the JKR model. A regression model for the repose angle was developed using the Box–Behnken response surface optimization method to identify the best parameter combination. The optimal parameter combination for the JKR model was determined as follows: surface energy of soil: 0.400, soil–soil rolling friction coefficient: 0.040, soil-65 Mn static friction coefficient: 0.404, and soil–soil recovery coefficient: 0.522. The calibrated discrete element parameters were validated through experiments on the repose angle and steel rod insertion. The results indicated that the relative errors obtained from the two verification methods were 2.44% and 1.71%, respectively. This research offers fundamental insights for understanding the interaction between soil and soil-contacting components and optimizing their design.

CFD offers advantages over wind tunnel experiments in the prediction and optimization of building wind environment; however, the computational costs associated with optimizing architectural wind environment remain a challenge. In this study, an approach that combines deep learning techniques with CFD simulations is proposed for the prediction and optimization of the architectural wind environment efficiently. A dataset of wind field is constructed using CFD simulation, considering various wind directions, wind speeds, and building spacing. Subsequently, a U-net deep learning model is trained as a surrogate model to rapidly predict the architectural wind field under different conditions. The results indicate that the model can accurately predict the wind field in buildings. The prediction time of building wind field is only 1/900 of that of CFD simulations, making it a viable surrogate model for wind environment optimization. Furthermore, considering all the building layouts and inflow conditions examined in this study, the maximum and minimum uniform wind speed area ratios Auni are 0.84 and 0.13, respectively. Under a single inflow speed, the maximum improvement in the Auni is 0.4, with an improvement rate of 48%. The results demonstrate the effectiveness of the proposed method as an efficient approach for optimizing architectural wind environment.

An efficient dearomative (3 + 2) cycloaddition of para-quinamines and 2-nitrobenzofurans has been developed. This reaction proceeds smoothly under mild conditions and affords a series of benzofuro[3,2-b]indol-3-one derivatives in good to excellent yields (up to 98%) with perfect diastereoselectivities (all cases > 20:1 dr). The scale-up synthesis and versatile derivatizations demonstrate the potential synthetic application of the protocol. A plausible reaction mechanism is also proposed to account for the observed reaction process. This work represents the first instance of the N-triggered dearomative (3 + 2) cycloaddition of 2-nitrobenzofurans.

Abstract Background Autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy is a recently identified recurrent meningoencephalomyelitis with GFAP immunoglobulin G presence in the serum or cerebrospinal fluid (CSF) as a specific biomarker. GFAP astrocytopathy is closely associated with the occurrence of some tumors and often coexists with other antibodies, such as the N-methyl-D-aspartate receptor and aquaporin-4 antibodies. However, GFAP astrocytopathy complicated by central nervous system infection is rare. Case presentation Here, we present the case of a patient admitted to a local hospital due to a prominent fever and cough. The patient had a 1-month history of headaches before admission that were not considered serious at the time. Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid revealed a high sequence number of Legionella pneumophila and a few mycobacteria. His cough and fever improved significantly after antibiotic treatment. Still, a slight headache remained. Subsequently, his condition worsened, and he visited our hospital with a disturbance of consciousness. Mycobacterium tuberculosis was detected with mNGS of the CSF, while the CSF and serum were also positive for GFAP antibodies. Following anti-tuberculosis and steroid therapy, the patient’s symptoms improved, and he tested negative for the GFAP antibody. Conclusion This is the first reported case of GFAP astrocytopathy complicated by tuberculous meningoencephalitis. Due to overlaps in the clinical manifestations of the two diseases, GFAP astrocytopathy is sometimes misdiagnosed as tuberculous meningoencephalitis. Therefore, in addition to ensuring careful identification of the two diseases, clinicians need to be aware of their possible co-existence.

Hollow-core anti-resonant fibers (HC-ANF) have the advantages of low scattering loss, wide bandwidth and simplicity of preparation, but are sensitive to bend, which limits their practical applications. On the contrary, hollow-core photonic bandgap (HC-PBGF) fibers have lower confinement loss and more robust bending characteristic, but exhibit unavoidable high scattering loss, influence of surface modes and stricter manufacturing processes. In this article, a novel hollow-core hybrid cladding fiber (HC-HBCF) which consists of anti-resonant circular tubes of inner cladding and periodically arranged air holes of outer cladding is proposed and investigated numerically. The results show that combining the claddings of antiresonance and photonic bandgap guidance mechanisms can effectively reduce the mode confinement loss by five and six orders of magnitude compared to the fibers with two claddings alone respectively. The proposed HC-HBCF exhibits similar excellent low scattering loss and spectral flatness as the single-tube anti-resonant fiber. Specifically, the proposed HC-HBCF exhibits the confinement loss of 5 × 10−5 dB/km at 1550 nm and a total loss of 0.1 dB/km from 1430 nm to 1770 nm. Meanwhile, the hybrid cladding fiber has an outstanding bending property with a bending loss of 0.16 dB/km at a small bending radius of 2 cm. The mode properties of HC-HBCF are also calculated and analyzed, indicating that the hybrid cladding fiber has a unique potential in controlling modal content.

Abstract Although tyrosine kinase inhibitors (TKIs) improve the prognosis of chronic myeloid leukemia (CML) patients, resistance to TKIs and residual leukemia stem cells (LSCs) inevitably become the bottleneck of cure. Therefore, we need to explore novel treatment strategies based on conventional treatment strategies. Our previous study found that CML cell senescence may be one of the main factors to achieve clinical cure of CML. Studies have shown that lipid metabolism plays a key role in cellular senescence. Here, we found that long-chain acyl-CoA synthetase 1 (ACSL1) was significantly up-regulated in senescent CML cells. Furthermore, we demonstrated that overexpression of ACSL1 induces senescence and inhibits cell growth in K562 cells by altering cell cycle progression, and enhances the proliferation-inhibiting effect of imatinib. Overexpression of ACSL1 enhances imatinib-induced tumorigenic decline in K562 cells in vivo. Knockdown of ACSL1 reverses imatinib-induced senescence in K562 cells. Mechanistically, overexpression of ACSL1 induced senescence in K562 cells via the SIRT1/p53/p21 axis. Collectively, our study showed that ACSL1 promotes imatinib-induced K562 cells senescence and tumor growth by regulating SIRT1/p53/p21 pathway. The ACSL1/SIRT1/p53 signal axis is a novel mechanism of cell senescence in CML and a new potential target for eradication of CML LSCs.

Highlights There are significant sex differences in Chinese population with cognitive impairment in Lewy body disease. Women were more common in dementia with Lewy bodies and mild cognitive impairment with Lewy bodies cases, had more frequent and severe neuropsychiatric symptoms, and poorer cognition than men. Men predominant in Parkinson’s disease with mild cognitive impairment and Parkinson’s disease with dementia cases, and performed more frequent RBD and parkinsonism than women. Dementia with Lewy bodies vs. Parkinson’s disease with dementia, and mild cognitive impairment with Lewy bodies vs. Parkinson’s disease with mild cognitive impairment are distinct disease forms and should not be confused.

To investigate the impact of different cutter structures on the crushing effect of forage stalks at various rotational speeds, this study designed five types of crushing cutters. The effects of cutter structure and rotational speed on the crushing effect of the forage crusher were examined using the discrete element method, a single-factor test. An orthogonal test was conducted, with the percentage of bond breakage as the evaluation index, and tool type and tool speed as influencing factors. The results of the orthogonal test were analyzed using range analysis. The findings revealed that the quality of alfalfa stalk crushing varied depending on the crushing structure and rotational speed. Within a certain rotational speed range, the crushing effect improved as the rotational speed increased. However, beyond a certain value, the improvement in the crushing effect became slower. Notably, the hob-type crushing structure exhibited the best crushing effect at 2400 r/min.

The R&D Building of Zhanjiang Bay Laboratory is a high-rise structure with multiple irregular items exceeding the specification limit, employing a steel frame-shear wall structural system. The outer frame consists of square steel tube concrete columns and solid-web steel beams, while the core shear wall uses a double steel plate concrete composite shear wall. This paper employs the architectural structural calculation software YJK-EP to perform a dynamic elastic-plastic time-history analysis under rare earthquake action. The shear and bending resistance of the shear wall at the maximum shear force and bending moment are checked to meet the requirements of the “Technical Specifications for Concrete Structures of High-rise Buildings”. The maximum inter-story displacement angle meets the requirements of the “Code for Seismic Design of Buildings”. The double steel plate concrete composite shear wall Wall-1, connected to a large-span and heavy-load transfer truss, was verified under significant seismic action using the ABAQUS software. The results indicate that Wall-1 can meet the design target requirements under major earthquake conditions. Finally, a dynamic nonlinear analysis method was employed using MIDAS-GEN software to study the structure’s anti-progressive collapse performance. The results show that under seven different scenarios, the maximum rotational angle of the remaining structural horizontal members is 2.02°, far less than the limit set by GSA, indicating that a progressive collapse did not occur. In the scenario where the corner column is removed, both the maximum shear and bending moment values for Wall-1 are far below its shear and bending resistance capacities, satisfying the load-bearing requirements. The removal of the corner column has a significant impact on the displacement of the columns on the same level nearby, with the peak displacement change rate reaching 702.65%.

α-Substituted-7-azaindoline amides and α,β-unsaturated 7-azaindoline amides have emerged as new versatile synthons for various metal-catalyzed and organic-catalyzed asymmetric reactions, which have attracted much attention from chemists. In this review, the progress of research on 7-azaindoline amides in the asymmetric aldol reaction, the Mannich reaction, the conjugate addition, the 1,3-dipole cycloaddition, the Michael/aldol cascade reaction, aminomethylation and the Michael addition-initiated ring-closure reaction is discussed. The α-substituted-7-azaindoline amides, as nucleophiles, are classified according to the type of α-substituted group, whereas the α,β-unsaturated 7-azaindoline amides, as electrophiles, are classified according to the type of reaction.

Geotechnical control engineering is widely used in the treatment of debris flow disasters, and the damage degree of the engineering will have a certain impact on the functionality of the engineering. It affects the continuous exertion of benefits. This paper selects geotechnical control engineering of 18 debris flow gullies in Wenchuan area as the research objects, combined with field investigation, the damage degree of control engineering was evaluated. The system of evaluation index is generally divided into two factors: check dam factor and drainage channel factor. The secondary evaluation indexes are refined, including the damage degree of dam foundation, the damage degree of dam abutment, the damage degree of dam body, scouring degree of foundation, structural impact degree and slope thrust degree. The fuzzy comprehensive evaluation method is used to construct the judgment matrix and membership function, and the damage degree is divided into four grades: excellent, good, medium and poor. The evaluation results show that except for Banzi gully and Dengxi gully, the damage grades of other debris flow control engineering are good or excellent, and the evaluation results are consistent with the field investigation.

BackgroundThe objective of this study was to explore whether longitudinal changes in skeletal muscle mass, from hospital admission to 3 weeks post-trauma, are associated with poor prognosis and nutritional intake in acutely hospitalized patients with abdominal trauma.MethodsA single-center retrospective observational review was conducted on 103 patients with abdominal trauma admitted to the Affiliated Jinling Hospital, Medical School of Nanjing University between January 2010 and April 2020. Skeletal muscle mass was assessed by abdominal computed tomography (CT) performed within 14 days before surgery and on post-trauma days 1–3 (week 0), 7–10 (week 1), 14–17 (week 2), and 21–24 (week 3). The skeletal muscle index (SMI) at L3, change in SMI per day (ΔSMI/day), and percent change in SMI per day (ΔSMI/day [%]) were calculated. The receiver-operating characteristic (ROC) curve was used to evaluate the discriminatory performance of ΔSMI/day (%) for mortality. Linear correlation analysis was used to evaluate the associations between ΔSMI/day (%) and daily caloric or protein intake.ResultsAmong the included patients, there were 91 males and 12 females (mean age ± standard deviation 43.74 ± 15.53 years). ΔSMI4-1/d (%) had a ROC-area under the curve of 0.747 (p = 0.048) and a cut-off value of −0.032 for overall mortality. There were significant positive correlations between ΔSMI4-1/d (%) and daily caloric intake and protein intake (Y = 0.0007501*X – 1.397, R2 = 0.282, R = 0.531, p 1.2 g/kg/d in weeks 3 and 1–3 post-trauma.ConclusionLoss of skeletal muscle mass is associated with poor prognosis and nutritional intake in patients admitted to hospital with abdominal trauma.

BackgroundCD44v6 chimeric antigen receptor T (CD44v6 CAR-T) cells demonstrate strong anti-tumor ability and safety in acute myeloid leukemia (AML). However, the expression of CD44v6 on T cells leads to transient fratricide and exhaustion of CD44v6 CAR-T cells, which affect the application of CD44v6 CAR-T. The exhaustion and function of T cells and CD44v6 expression of AML cells are associated with DNA methylation. Hypomethylating agents (HAMs) decitabine (Dec) and azacitidine (Aza) have been widely used to treat AML. Therefore, there may be synergy between CD44v6 CAR-T cells and HAMs in the treatment of AML.MethodsCD44v6 CAR-T cells pretreated with Dec or Aza were co-cultured with CD44v6+ AML cells. Dec or aza pretreated AML cells were co-cultured with CD44v6 CAR-T cells. The cytotoxicity, exhaustion, differentiation and transduction efficiency of CAR-T cells, and CD44v6 expression and apoptosis in AML cells were detected by flow cytometry. The subcutaneous tumor models were used to evaluate the anti-tumor effect of CD44v6 CAR-T cells combined with Dec in vivo. The effects of Dec or Aza on gene expression profile of CD44v6 CAR-T cells were analyzed by RNA-seq.ResultsOur results revealed that Dec and Aza improved the function of CD44v6 CAR-T cells through increasing the absolute output of CAR+ cells and persistence, promoting activation and memory phenotype of CD44v6 CAR-T cells, and Dec had a more pronounced effect. Dec and Aza promoted the apoptosis of AML cells, particularly with DNA methyltransferase 3A (DNMT3A) mutation. Dec and Aza also enhanced the CD44v6 CAR-T response to AML by upregulating CD44v6 expression of AML cells regardless of FMS-like tyrosine kinase 3 (FLT3) or DNMT3A mutations. The combination of Dec or Aza pretreated CD44v6 CAR-T with pretreated AML cells demonstrated the most potent anti-tumor ability against AML.ConclusionDec or Aza in combination with CD44v6 CAR-T cells is a promising combination therapy for AML patients.

Objectives The aims of the study were to assess the management of low-density lipoprotein cholesterol (LDL-C) and the goal achievement, as well as to investigate the association between baseline LDL-C level, lipid-lowering treatment (LLT), and stroke recurrence in patients with ischaemic stroke or transient ischaemic attack (TIA).Design Our study was a post hoc analysis of the Third China National Stroke Registry (CNSR-III).Setting We derived data from the CNSR-III - a nationwide clinical registry of ischaemic stroke and TIA based on 201 participating hospitals in mainland China.Participants 15,166 patients were included in this study with demographic characteristics, etiology, imaging, and biological markers from August 2015 to March 2018.Primary and secondary outcome measures The primary outcome was a new stroke, LDL-C goal (LDL-C

Abstract Oral bacteria directly affect the disease status of dental caries and periodontal diseases. The dynamic oral microbiota cooperates with the host to reflect the information and status of immunity and metabolism through two-way communication along the oral cavity and the systemic organs. The oral cavity is one of the most important interaction windows between the human body and the environment. The microenvironment at different sites in the oral cavity has different microbial compositions and is regulated by complex signaling, hosts, and external environmental factors. These processes may affect or reflect human health because certain health states seem to be related to the composition of oral bacteria, and the destruction of the microbial community is related to systemic diseases. In this review, we discussed emerging and exciting evidence of complex and important connections between the oral microbes and multiple human systemic diseases, and the possible contribution of the oral microorganisms to systemic diseases. This review aims to enhance the interest to oral microbes on the whole human body, and also improve clinician’s understanding of the role of oral microbes in systemic diseases. Microbial research in dentistry potentially enhances our knowledge of the pathogenic mechanisms of oral diseases, and at the same time, continuous advances in this frontier field may lead to a tangible impact on human health.

Confronting the pressing challenge of freshwater scarcity, polymeric membrane-based water treatment technology has emerged as an essential and effective approach. Poly(arylene ether)s (PAEs) polymers, a class of high-performance engineering thermoplastics, have garnered attention in recent decades as promising membrane materials for advanced water treatment approaches. The PAE-Based membranes are employed to resist the shortages of most common polymeric membranes, such as chemical instability, structural damage, membrane fouling, and shortened lifespan when deployed in harsh environments, owing to their excellent comprehensive performance. This article presents the advancements in the research of several typical PAEs, including poly(ether ether ketone) (PEEK), polyethersulfone (PES), and poly(arylene ether nitrile) (PEN). Techniques for membrane formation, modification strategies, and applications in water treatment have been reviewed. The applications encompass processes for oil/water separation, desalination, and wastewater treatment, which involve the removal of heavy metal ions, dyes, oils, and other organic pollutants. The commendable performance of these membranes has been summarized in terms of corrosion resistance, high-temperature resistance, anti-fouling properties, and durability in challenging environments. In addition, several recommendations for further research aimed at developing efficient and robust PAE-based membranes are proposed.

Outstanding high-temperature resistance, thermal stability, and dielectric properties are fundamental for dielectric materials used in harsh environments. Herein, TiO2 nanoparticles are decorated on the surface of BN nanosheets by internal crosslinking between polydopamine (PDA) and polyethyleneimine (PEI), forming three-dimensional novel nanohybrids with a rough surface. Then, an ether nitrile (PEN) matrix is introduced into the polyarylene to form polymer-based nanocomposite dielectric films. Meanwhile, the structure and micromorphology of the newly prepared nanohybrids, as well as the dielectric and thermal properties of PEN nanocomposites, are investigated in detail. The results indicate that TiO2 nanoparticles tightly attach to the surface of BN, creating a new nanohybrid that significantly enhances the comprehensive performance of PEN nanocomposites. Specifically, compared to pure PEN, the nanocomposite film with a nanofiller content of 40 wt% exhibited an 8 °C improvement in the glass transition temperature (Tg) and a 162% enhancement in the dielectric constant at 1 kHz. Moreover, the dielectric constant–temperature coefficient of the nanocomposite films remained below 5.1 × 10−4 °C−1 within the temperature range of 25–160 °C, demonstrating excellent thermal resistance. This work offers a method for preparing highly thermal-resistant dielectric nanocomposites suitable for application in elevated temperature environments.

Exploring the properties of magnetic metal on the semiconductor surface is of great significance for the application of magnetic recording materials. Herein, DFT calculations are carried out to explore the properties of the iron–silicon interface structures (nFe/DASF) formed by depositing n Fe atoms on the reconstructed Si(111)-(7×7) surface (DASF). The stable nFe/DASF structures are studied in the cases of the adsorption and permeation of Fe atoms on the DASF. In both cases, Fe atoms are not very dispersed and prefer binding with Si atoms rather than the adsorbed Fe atoms, because the Fe-Si interaction is stronger than the Fe-Fe interaction. As the n value increases, the average binding energy (Eb_ave) of Fe generally firstly becomes more negative and then becomes less negative, with the presence of a 7Fe wheel as a stable geometry on the upmost surface. The presence of the 7Fe wheel is attributed to the enhanced Fe-Si interaction in this wheel compared to other geometries. CO adsorption occurs at the central Fe site of the 7Fe wheel which is greatly influenced by the surrounding Si atoms but is little influenced by the additional Fe atoms in the interlayer.

After Wenchuan earthquake, many large debris flow have occur in Banzi Gully. Especially in 2019, the "8·20" debris flow caused serious damage to the roads，bridges and villages in the gully mouth, mail river was seriously squeeaed to the other side and there is a big risk of blocking the river in the future. Based on the field investigation and comprehensive analysis of the basic characteristics and formation conditions of the debris flow, the characteristics of river blockage are analyzed, the parameters of river blockage under different debris flow frequency are calculated, and the possible impact of dam-breaking flood under each frequency on Miansi Town is predicted. The results show that debris flow with frequencies of 2%, 5% and 10% are less likely to cause river blockage of Min River, and if there was a river blocking event , the town of Miansi would not be exposed to dam-breaking flood. The debris flow with a frequency of 1% are likely to cause river blockage. The debris flow material with a volume of 57.38×104 m3 can reach the Min River to form a dam with a height of about 51.61 m. Under the action of the main river flood (1890.0 m3/s), the dam will be broken, and the peak flow rate of the flood was 5935.49 m3/s, which dropped to 2312.25 m3/s while arrive at Miansi Town. Since the flood depth (4.00 m) is higher than the height of the protective embankment (3.5 m), the flood is likely to damage the houses near the protective embankment of Miansi Town.This paper provided a reference for the analysis of the characteristics of large-scale debris flow blockage in the future, as well as the possible impact of the collapse flood on downstream towns.

The abrupt termination of periodic structures in hollow-core photonic bandgap fiber (HC-PBF) cladding introduces surface modes (SMs). This results in a high loss and small available bandwidth. This has become an important factor that restricts the development of HC-PBFs. For many years, there has been a lack of clear understanding of SMs. In this study, SMs were considered the main body of research. First, a pure HC-PBF platform was constructed to systematically observe the SMs inside the bandgap. The core wall was used as a control variable to achieve precise control of the SMs. The SMs are divided into two categories: fundamental and high-order SMs. We named the SMs and studied their characteristics, including the mode field shape, coupling bandwidth, and coupling speed. The coupling characteristics of SMs with different core diameters were compared and analyzed. Further, we compared the model with actual fiber to prove the practicality of the theoretical analysis. This study will deepen our understanding of HC-PBF and will have a positive impact on its development.

Metal-based nanomaterials with shifting or mixed redox states have been widely applied for combating against bacteria-infected diseases by virtue of their peroxidase (POD)-like catalytic activity. Herein, a polyoxometalate-based heterojunction (GdP5W30@WS2) with shifting or mixed redox states (W6+/W5+) is devised to achieve boosted reactive oxygen species (ROS) generation by near-infrared (NIR) laser-facilitated W6+/W5+ redox cycling for accelerated bacteria-infected wound healing. On the one hand, under the exposure to NIR laser, WS2 as electron donor could be stimulated to transfer electrons to GdP5W30, which promotes the reduction from W6+ to W5+ active sites on the surface of the GdP5W30. Consequently, the regenerated W5+ active sites could catalyze endogenous overexpressed H2O2 to persistently generate ROS, which displays enhanced POD-like catalytic activity for chemodynamic therapy (CDT) by NIR-driven photocatalytic W6+/W5+ redox cycling. Moreover, GdP5W30@WS2 also displays favorable glutathione (GSH)-activated photothermal performance by W6+-triggered GSH exhaustion for sufficient ROS generation, thereby facilitating the synergistic therapeutic efficiency of photothermal therapy (PTT) and CDT. We expect that the present work will promote the development of the heterojunction with shifting or mixed redox states for biofilm elimination based on NIR-facilitated enzyme-like catalytic activity, which may act as a candidate for BME-activated synergistic therapy.

Chimeric antigen receptor T-cell (CAR-T-cell) therapy has been well researched to date because of its ability to target malignant tumor cells. The most common CAR-T cells are CD19 CAR-T cells, which play a large role in B-cell leukemia treatment. However, most CAR-T cells are associated with relapse after clinical treatment, so the quality and persistence of CAR-T cells need to be improved. With continuous optimization, there have been four generations of CARs and each generation of CARs has better quality and durability than the previous generation. In addition, it is important to increase the proportion of memory cells in CAR-T cells. Studies have shown that an immunosuppressive tumor microenvironment (TME) can lead to dysfunction of CAR-T cells, resulting in decreased cell proliferation and poor persistence. Thus, overcoming the challenges of immunosuppressive molecules and targeting cytokines in the TME can also improve CAR-T cell persistence. In this paper, we explored how to improve the durability of CAR-T cell therapy by improving the structure of CARs, increasing the proportion of memory CAR-T cells and improving the TME.

Background: Severe pneumonia is one of the common acute diseases caused by pathogenic microorganism infection, especially by pathogenic bacteria, leading to sepsis with a high morbidity and mortality rate. However, the existing bacteria cultivation method cannot satisfy current clinical needs requiring rapid identification of bacteria strain for antibiotic selection. Therefore, developing a sensitive liquid biopsy system demonstrates the enormous value of detecting pathogenic bacterium species in pneumonia patients. Methods: In this study, we developed a tool named Species-Specific Bacterial Detector (SSBD, pronounce as ‘speed’) for detecting selected bacterium. Newly designed diagnostic tools combining specific DNA-tag screened by our algorithm and CRISPR/Cas12a, which were first tested in the lab to confirm the accuracy, followed by validating its specificity and sensitivity via applying on bronchoalveolar lavage fluid (BALF) from pneumonia patients. In the validation I stage, we compared the SSBD results with traditional cultivation results. In the validation II stage, a randomized and controlled clinical trial was completed at the ICU of Nanjing Drum Tower Hospital to evaluate the benefit SSBD brought to the treatment. Results: In the validation stage I, 77 BALF samples were tested, and SSBD could identify designated organisms in 4 hr with almost 100% sensitivity and over 87% specific rate. In validation stage II, the SSBD results were obtained in 4 hr, leading to better APACHE II scores (p=0.0035, ANOVA test). Based on the results acquired by SSBD, cultivation results could deviate from the real pathogenic situation with polymicrobial infections. In addition, nosocomial infections were found widely in ICU, which should deserve more attention. Conclusions: SSBD was confirmed to be a powerful tool for severe pneumonia diagnosis in ICU with high accuracy. Funding: National Natural Science Foundation of China. The National Key Scientific Instrument and Equipment Development Project. Project number: 81927808. Clinical trial number: This study was registered at https://clinicaltrials.gov/ (NCT04178382).

BackgroundTo curb the spread of the coronavirus disease 2019 (COVID-19) epidemic, the Chinese government shut down Wuhan city from January 23rd to April 8th, 2020. The COVID-19 epidemic not only leads to widespread illness but also affects the diagnosis and treatment of hematopoietic stem-cell transplant (HSCT) recipients.ObjectiveTo investigate the medical-seeking pattern and daily behavior changes in Hubei Province during the COVID-19 epidemic in Hubei Province during the lockdown.MethodsWe conducted a multicenter, cross-sectional, web-based investigation among 325 HSCT recipients by online questionnaires in Hubei Province during the COVID-19 epidemic.ResultsA total of 145 complete responses were collected both before and during the epidemic questionnaires. The participants from pre-epidemic group preferred to go to hospital (68.29%) when they experienced influenza-like symptoms. The majority of the patients elected to take oral drugs by themselves (40%) or consulted their attending physicians online or by telephone during the lockdown (23.33%). 64.83% had difficulties in purchasing drugs during the lockdown, which was significantly higher than the proportion of the pre-epidemic group (24.83%) (P < 0.05). The participants preferred to purchase drugs online (23.40%) and decrease or withdraw drugs (18.09%) during the epidemic. The number of participants received regular re-examinations during the epidemic decreased sharply. The proportion of wearing masks and isolating themselves at home increased significantly during the epidemic. No statistic difference was observed in the incidence of graft-versus-host disease (GVHD)complications in participants between the during the epidemic group and the pre-epidemic group. In our study, six patients were confirmed to have COVID-19, and half of them died due to COVID-19-related complications.ConclusionThe medical-seeking pattern and daily behavior of HSCT recipients changed during the lockdown; the methods of self-protection, online consultation and drug delivery can help patients receive necessary follow-up and reduce the occurrence of COVID-19.

The application of intracellular and extracellular Epstein–Barr virus (EBV) DNA in allogeneic hematopoietic stem cell transplantation (allo-HSCT) has been poorly characterized. We conducted a combined prospective-retrospective study of 300 patients who underwent allo-HSCT between 2016 to 2019 in our center and monitored for EBV DNA within the first year after HSCT. Combining the optimal cut-off value of EBV DNA load (7.3×104 copies/106 cells) in peripheral blood mononuclear cells (PBMCs) and qualitative detection in plasma (400 copies/mL) allowed for the better differentiation of EBV-related posttransplant lymphoproliferative disorders (EBV-PTLD), with increased sensitivity (100%) and specificity (86%), and provided the effective risk stratification of EBV DNA level according to their impact on transplant outcomes. By multivariate analysis, patients with intermediate-level of EBV DNA load (low EBV DNA load in PBMCs or high load in PBMCs but negative in plasma) was associated with superior overall survival (HR 1.92, 95% CI 1.03-3.57, p=0.039) and lower transplant-related mortality (HR 3.35, 95% CI 1.31-8.58, p=0.012) compared to those with high-level (high load in PBMCs and positive in plasma). Notably, high EBV-level group had poor reconstitution of CD4+ and CD8+T cells, and both low and high EBV-level groups showed abnormally increase in IL-10 level within one year. Additionally, patients with peak EBV DNA load in PBMCs during 3-12 months had a higher incidence of chronic graft versus host disease (GVHD) than those within 3 months post transplantation (17.4% vs 13.7%, p=0.029). Collectively, EBV DNA in PBMCs can synergistically predict the risk of EBV-PTLD and GVHD. The intermediate-level of EBV DNA presented in plasma and PBMCs might contribute to a better reconstitution of T cells associated with favorable prognosis of allo-HSCT.

Abstract Background Chimeric antigen receptor T‐cell (CAR‐T) therapy for acute myeloid leukaemia (AML) has thus far been elusive, in part due to target restriction and phenotypic heterogeneity of AML cells. Mutations of the FMS‐like tyrosine kinase 3 (FLT3) and DNA methyltransferase 3A (DNMT3A) genes are common driver mutations that present with a poor prognosis in AML patients. We found that AML patients with FLT3 or DNMT3A mutations had higher expression of CD44 isoform 6 (CD44v6) compared to normal specimens. Therefore, we intended to demonstrate CD44v6 could be a specific option for AML with FLT3 or DNMT3A mutations. Methods Internal tandem duplication (ITD) mutations of FLT3 (FLT3/ITD) knock‐in clone and DNMT3A‐R882H mutant clones of SKM‐1 cells were generated using CRISPR/Cas9 and lentiviral transfection, respectively. CD44v6 CAR‐T cells were constructed by transfecting T cells with lentivirus containing CD44v6 CAR. CD44v6 expression in AML cell lines, AML patients and healthy donors was evaluated by flow cytometry. DNA methylation assays were used to analyse the mechanisms of FLT3 and DNMT3A mutations affecting CD44v6 expression. Results Aberrant overexpression of CD44v6 was observed in AML cell lines with FLT3 or DNMT3A mutations compared to the wild‐type SKM‐1 or K562 cells. AML patients with FLT3 or DNMT3A mutations had higher expression of CD44v6 compared to normal specimens. Then we constructed CD44v6 CAR‐T cells and found that CD44v6 CAR‐T specifically lysed CD44v6+ cells, accompanied by cytokines release. No significant killing effect was observed from CD44v6‐ AML cells and normal cells after co‐culture with CD44v6 CAR‐T. These results were also observed in vivo. Furthermore, we found that FLT3 or DNMT3A mutations induced CD44v6 overexpression by downregulating the CpG methylation of CD44 promoter. Conclusions Collectively, CD44v6 is a promising target of CAR‐T for AML patients with FLT3 or DNMT3A mutations.

To determine the influence of graft composition in haplo-HSCT, we summarized the long-term consequences of 251 consecutive transplantations from haploidentical donors. For donor-recipient HLA3/6-matched setting, 125 cases used G-CSF-mobilized BM and PBSCs mixtures, while 126 cases only used G-CSF-mobilized PBSCs in HLA4/6-matched transplantation. On the one hand, we wanted to explore the effect of harvests (CD34+ cells and TNCs dosages) on transplantation outcome in the context of haplo-HSCT no matter HLA4/6 or HLA3/6-matched setting. On the other hand, for patients using G-CSF-mobilized BM and PBSCs combination in HLA3/6-matched setting, we attempted to analyze whether TNCs or CD34+ cells from G-CSF-mobilized BM or G-CSF-mobilized PBSCs play the most paramount role on transplantation prognosis. Collectively, patients with hematologic malignancies receiving G-CSF-primed BM and PBSCs harvests had comparable consequences with patients only receiving G-CSF-mobilized PBSCs. Moreover, when divided all patients averagely according to the total amount of transfused nucleated cells, 3-year TRM of the intermediate group (13.06-18.05×108/kg) was only 4.9%, which was remarkably reduced when compared to lower and higher groups with corresponding values 18.3%, 19.6% (P=0.026). The 3-year probabilities of OS and DFS of this intermediate group were 72.6% and 66.5%, which were slightly improved than the lower and higher groups. Most importantly, these data suggest that the transfused nucleated cells from G-CSF-primed BM above than 5.20×108/kg could achieve remarkably lower TRM in haplo-HSCT receiving G-CSF-mobilized BM and PBSCs harvests. These encouraging results suggested that we could improve the efficacy of haplo-HSCT by adjusting the component and relative ratio of transfused graft cells. Nevertheless, the above findings should be confirmed in a randomized prospective comparative research with adequate follow-up.

Pre-sowing treatment of seeds by plasma can improve seed vigor and promote seed germination and growth. To solve the problems of low processing volume and uneven treatment in plasma seed treatment devices, according to the process scheme of medium-blocking discharge plasma seed treatment, a medium-blocking discharge vibration-uniform material plasma seed treatment device was designed, the structure and working principle of the vibration-uniform material device were systematically analyzed, and the mathematical model of seed force was established. According to electromagnetic vibration theory, the seed sorting and conveying principles were analyzed in the lower trough, and the relevant parameters were selected and calculated. Using EDEM discrete element simulation software, a numerical simulation of alfalfa seed feeding and vibration-uniform material process was carried out. A three-factor, three-level orthogonal test was established. The results showed that the vibration amplitude and groove shape significantly affected the coefficient of variation of seed uniformity on the groove during the seed feeding and vibration-uniform material processes, and the groove wheel speed had a certain effect on the coefficient of variation of uniformity. The main order of factors affecting the uniformity of seed spreading was vibration amplitude B > notch shape C > speed A. The optimal speed was 35 r/min, the optimal notch shape was circular, and the optimal vibration amplitude was 0.55 mm.

In this research, a metal-free diastereoselective formal 1,3-dipolar cycloaddition of N-2,2,2-trifluoroethylisatin ketimines and cyclopentene-1,3-diones which can efficiently lead to the desymmetrization of cyclopentene-1,3-diones is developed. With the developed protocol, a series of tetracyclic spirooxindoles containing pyrrolidine and cyclopentane subunits can be smoothly obtained with good results (up to 99% yield and 91:9 dr). Furthermore, the methodology can be extended to trifluoromethyl-substituted iminomalonate, and the corresponding formal [3+2] cycloaddition reaction affords bicyclic heterocycles containing fused pyrrolidine and cyclopentane moieties in moderate yields with >20:1 dr. The synthetic potential of the methodology is demonstrated by the scale-up experiment and by versatile transformations of the products.

An unprecedented N-alkylation of 3-nitroindoles with para-quinone methides was developed for the first time. Using potassium carbonate as the base, a wide range of structurally diverse N-diarylmethylindole derivatives were obtained with moderated to good yields via the protection group migration/aza-1,6-Michael addition sequences. The reaction process was also demonstrated by control experiments. Different from the previous advances where 3-nitrodoles served as electrophiles trapping by various nucleophiles, the reaction herein is featured that 3-nitrodoles is defined with latent N-centered nucleophiles to react with ortho-hydrophenyl p-QMs for construction of various N-diarylmethylindoles.

The growth of Achnatherum splendens (A. splendens) inhibits the growth of dominant grassland herbaceous species, resulting in a loss of grassland biomass and a worsening of the grassland ecological environment. Therefore, it is crucial to identify the dynamic development of A. splendens adequately. This study intended to offer a transformer-based A. splendens detection model named YOLO-Sp through ground-based visible spectrum proximal sensing images. YOLO-Sp achieved 98.4% and 95.4% AP values in object detection and image segmentation for A. splendens, respectively, outperforming previous SOTA algorithms. The research indicated that Transformer had great potential for monitoring A. splendens. Under identical training settings, the AP value of YOLO-Sp was greater by more than 5% than that of YOLOv5. The model’s average accuracy was 98.6% in trials conducted at genuine test sites. The experiment revealed that factors such as the amount of light, the degree of grass growth, and the camera resolution would affect the detection accuracy. This study could contribute to the monitoring and assessing grass plant biomass in grasslands.

BackgroundPost-stroke dementia (PSD) has adverse effects on the quality of work and life in elderly stroke survivors. There are inconsistent results on the impacts of blood pressure control on the risk of PSD in people aged 65 years and above.ObjectiveThis study was performed to explore whether poorly-controlled blood pressure was associated with an increasing risk of PSD.MethodsThe study population was enrolled from cross-sectional research conducted in 106 communities of rural northern China. In Phase I, a total of 7,448 people aged ≥65 years, including 830 with stroke history, completed a questionnaire, a physical examination, and a cognitive assessment. Phase II further confirmed the diagnosis of PSD. Well-controlled blood pressure was defined as an average systolic blood pressure of

Drainage channels are widely used for discharging debris flows into deposition basins or rivers. However, the current drainage channel designs for guiding rapid debris flows downstream do not account for the variations of the gullies’ gradient and debris flow energy. In this study, we evaluated the performance of different step-baffle geometries (square, triangle, and trapezoid) in regulating debris flows. Specifically, their effects on the flow patterns, sediment transport, energy dissipation, and impact pressure are investigated using flume experiments. Results here showed that the square baffles promote highly turbulent flows which in turn result in the highest lift height relative to the triangular and trapezoidal baffles. Maximum sediment interception and highest energy dissipation are obtained using the trapezoidal baffle, whereas the triangular baffle exhibits minimal solid interception and the lowest energy dissipation. Trapezoidal baffles generally experience the greatest impact forces relative to both square and triangular baffles. However, when only the first baffle in the channel is considered, it is the square baffles that experience the largest impact forces. The present work improves the understanding of the effectiveness of step-baffle drainage channels in mitigating debris flows.

ObjectiveThis study aims to explore the feasibility, safety, and effectiveness of home exercise prehabilitation on a new social platform for remote guidance to optimize the physical function of patients with end-stage renal disease awaiting kidney transplantation and provide scientific guidance on home prehabilitation exercises for patients awaiting kidney transplantation.MethodsThe subjects of this randomized clinical trial were randomly divided into the test and control groups. The control group maintained their exercise habits, while the trial group was given a 12-week personalized home prehabilitation exercise prescription (aerobic exercise + functional resistance exercise + flexibility exercise) on a new social platform with remote guidance. The participants’ physical and cardiorespiratory fitness, quality of life, and psychological functioning were assessed before and after the intervention. The 6-min walk test (6MWT) walking distance and its percentage of attainment, the handgrip, the 5 repetition-sit-to-stand test, and the 4-m gait speed were used as primary outcome indicators, while the Short Form Health Survey SF-36 (health survey summary table) and the Hospital Anxiety and Depression scale were used as the secondary outcome indicators.ResultsAfter 12 weeks of intervention, the changes in the 6MWT measured distance (+ 44.9 ± 40.2, P = 0.001) and the percentage of 6MWT measured distance achieved (+ 6.8 ± 5.7, P = 0.001), the handgrip (+ 2.7 ± 4.3, P = 0.028), the 5-sit-to-stand test (−1.1 ± 1.4, P = 0.005), and the 4-m walking speed (−0.3 ± 0.4, P < 0.001) of the test group (n = 21) improved significantly. In the control group (n = 16), the changes in the 6MWT measured distance (−13.1 ± 57.2), the 6MWT measured distance attainment percentage (−2.1 ± 9.1), the handgrip (−0.1 ± 2.5), the 5-sit-to-stand test value (0.6 ± 2.2), and the 4-m walking speed (0.2 ± 0.5) showed no significant difference. No significant improvement in anxiety, depression, and SF-36 was noted in both the test and control groups.ConclusionThe remote coaching of home exercise pre-habilitation on a new social platform significantly improves the physical and cardiopulmonary fitness of patients with end-stage renal disease awaiting kidney transplantation. This treatment is safe and feasible in this population.

Abstract Background Lewy body dementia (LBD), consisting of dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD), is the second most common type of neurodegenerative dementia in older people. The current study aimed to investigate the clinical characteristics of LBD in Chinese memory clinics. Methods A total of 8405 dementia medical records were reviewed, revealing 455 patients with LBD. Demographic data, neuropsychological scores, and the scale for Medial Temporal lobe Atrophy (MTA) were then analyzed from nine memory clinics in the China Lewy Body Disease Collaborative Alliance. Results The clinical proportion of LBD among the subjects and among all dementia types was 5.4% (4.9–5.9%) and 7.3% (6.7–8.0%), respectively, with a mean onset age of 68.6 ± 8.4 years. Patients with DLB comprised 5.6% (n = 348, age of onset 69.1 ± 8.3), while PDD comprised 1.7% (n = 107, age of onset 66.7 ± 8.8) of all dementia cases. There were slightly more males than females with DLB (n = 177, 50.9%) and PDD (n = 62, 57.9%). Patients with DLB had a poorer performance compared to those with PDD on the MMSE (16.8 ± 7.1 vs. 19.5 ± 5.7, p = 0.001), the MoCA (11.4 ± 6.6 vs. 14.0 ± 5.8, p

Chimeric antigen receptor T cell (CAR-T) therapy in hematologic malignancies has made great progress, but there are still some problems. First, T cells from tumor patients show an exhaustion phenotype; thus, the persistence and function of the CAR-Ts are poor, and achieving a satisfactory curative effect is difficult. Second, some patients initially respond well but quickly develop antigen-negative tumor recurrence. Thirdly, CAR-T treatment is not effective in some patients and is accompanied by severe side effects, such as cytokine release syndrome (CRS) and neurotoxicity. The solution to these problems is to reduce the toxicity and enhance the efficacy of CAR-T therapy. In this paper, we describe various strategies for reducing the toxicity and enhancing the efficacy of CAR-T therapy in hematological malignancies. In the first section, strategies for modifying CAR-Ts using gene-editing technologies or combining them with other anti-tumor drugs to enhance the efficacy of CAR-T therapy are introduced. The second section describes some methods in which the design and construction of CAR-Ts differ from the conventional process. The aim of these methods is to enhance the anti-tumor activity of CAR-Ts and prevent tumor recurrence. The third section describes modifying the CAR structure or installing safety switches to radically reduce CAR-T toxicity or regulating inflammatory cytokines to control the symptoms of CAR-T-associated toxicity. Together, the knowledge summarized herein will aid in designing better-suited and safer CAR-T treatment strategies.

[3 + 2] Cycloaddition reactions of heteroaromatic N-ylides with electron-deficient olefins have been developed. The heteroaromatic N-ylides, in situ generated from N-phenacylbenzothiazolium bromides, can smoothly react with maleimides under very mild conditions, affording fused polycyclic octahydropyrrolo[3,4-c]pyrroles in good-to-excellent isolated yields. This reaction concept could also be extended to 3-trifluoroethylidene oxindoles and benzylidenemalononitriles as electron-deficient olefins for accessing highly functionalized polyheterocyclic compounds. A gram-scale experiment was also carried out to verify the practicability of the methodology.