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Abstract This study conducts push-out tests on eight geopolymer concrete filled steel tube column specimens with varying design parameters to evaluate the effects of steel tube wall thickness, concrete strength, and the presence of welded longitudinal ribs on the bond-slip performance at the interface between geopolymer concrete and steel tube. The study analyzes the influence mechanism of chemical bonding force, mechanical bite force, and friction resistance on bond strength and a three-stage bond-slip constitutive relationship is established. The results indicate that steel tube strain increases with height, with significant strain observed at the welding structure and the fixed end of the steel tube. The length-to-diameter ratio, diameter-to-thickness ratio, concrete strength, and construction measures of the steel tube are identified as key factors in enhancing interfacial bonding performance. The presence of welded longitudinal ribs on the inner wall of the steel tube significantly improves the interface bonding. The calculated bond strength ratios, compared with the test results, fall within an 11% margin, demonstrating good agreement.

Abstract Background The neonatal outcomes across different percentiles of birth weight for gestational age are still unclear. Methods This retrospective cohort study was conducted within 57 tertiary hospitals participating in the Chinese Neonatal Network (CHNN) from 25 provinces throughout China. Infants with gestational age (GA) 24+0-31+6 weeks who were admitted within 7 days after birth were included. The composite outcome was defined as mortality or any one of neonatal major morbidities, including necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD), severe intraventricular hemorrhage (IVH), cystic periventricular leukomalacia (cPVL), severe retinopathy of prematurity (ROP), and sepsis. Multivariable logistic regressions using generalized estimating equation approach were conducted. Results A total of 8380 infants were included with a mean GA of 30 (28–31) weeks. Of these, 1373 (16.5%) were born at less than 28 weeks, while 6997 (83.5%) had a GA between 28 and 32 weeks. Our analysis indicated that the risk of composite outcomes was negatively associated with birth weight for gestational age, and compared to the reference group, the multiple-adjusted ORs (95%CI) of composite outcomes were 4.89 (3.51–6.81) and 2.16 (1.77–2.63) for infants with birth weight for gestational less than 10th percentile and 10th -30th percentile, respectively. The ORs (95%CI) of mortality, NEC, BPD, severe ROP, and sepsis in infants with birth weight for gestational age at 10th-30th percentile were 1.94 (1.56–2.41), 1.08 (0.79–1.47), 2.48 (2.03–3.04), 2.35 (1.63–3.39), and 1.39 (1.10–1.77), respectively. Conclusion Our study suggested that the risk of adverse neonatal outcomes increased significantly when the birth weight for gestational age was below the 30th percentile. Regular monitoring and early intervention are crucial for these high-risk infants.

Abstract The power industry’s low carbon transition is pivotal for achieving carbon reduction and sustainable development. This study uses the super epsilon-based measurement (Super-EBM) model and the Malmquist index to evaluate the power industry’s low carbon transition efficiency using data from 30 provinces in China from 2010 to 2020, and utilizes the Tobit model to comprehensively analyze the factors affecting the low carbon transition of power industry. In addition, this paper examines the spatial differences in the power industry's low carbon transition efficiency as well as its distributional characteristics and dynamic evolutionary patterns. Conclusion is drawn as follows this paper analyzes the regional differences, spatial distribution characteristics and dynamic evolutionary trends of the power industry’s low carbon transition. The main conclusions are as follows: (1) The power industry’s low carbon transition efficiency in China shows an uptrend, with the western China region having the highest overall level of efficiency, greater fluctuations in the central China region, and more stability in the eastern China region, technological progress is a central factor in increasing total factor productivity, the efficiency of the power industry’s low carbon transition is positively influenced by the electricity prices, and negatively influenced by the energy structure, environmental regulations and economic structure; (2) the Intraregional differences and hypervariable density are the main reasons sources of the overall differences in the efficiency of the power industry’s low carbon transition; Intraregional differences in the eastern, central, and western China regions are decreasing year by year, but the efficiency of the power industry’s low carbon transition in the western China region is still distributed in a multipolar way; (3) The dynamic evolutionary trends of the efficiency distribution of the low carbon transition in power industry is influenced by the type of spatial lag in the neighboring area. Where areas with low efficiency makes it difficult to achieve short-term leapfrog development, and areas with a cluster of high-efficiency provinces are prone to “Siphon Effect”. The findings provide a theoretical basis for promoting the efficiency of the power industry's low carbon transition and coordinating the strategic adjustment of economic and environmental green development.

Abstract Integrating genomics and histology for cancer prognosis demonstrates promise. Here, we develop a multi-classifier system integrating a lncRNA-based classifier, a deep learning whole-slide-image-based classifier, and a clinicopathological classifier to accurately predict post-surgery localized (stage I–III) papillary renal cell carcinoma (pRCC) recurrence. The multi-classifier system demonstrates significantly higher predictive accuracy for recurrence-free survival (RFS) compared to the three single classifiers alone in the training set and in both validation sets (C-index 0.831-0.858 vs. 0.642-0.777, p

Abstract Recently, a robust steganographic algorithm that achieves errorless robustness against JPEG recompression has been proposed. The method employs a lattice embedding scheme and utilizes the syndrome-trellis code (STC) for practical embedding. However, we have noticed that errorless robust embedding with STC may encounter failures due to modifications on wet coefficients, especially when a high quality factor is used by the compression channel. To solve this problem, we have discovered that using steganographic polar code (SPC) for embedding has better performance in avoiding modifications on wet coefficients. In this paper, we conduct theoretical analysis to prove the better performance of SPC in wet paper embedding. We establish the condition of avoiding modifications on wet coefficients, followed by presenting a recursive calculation method for determining the distribution of columns in the generator matrix of SPC. The findings reveal that SPC can avoid modifications on wet coefficients under a larger number of wet coefficients compared with STC, and therefore we propose a better errorless robust embedding method employing SPC. The experimental results demonstrate that under close security performance, the proposed method achieves a higher success rate compared with embedding with STC. Specifically, when the quality factor of the compressor is 95 and the payload size is 0.4 bpnzac, our method achieves a success rate of 99.85%, surpassing the 91.95% success rate of the embedding with STC.

Abstract The causal relationship between Packed red blood cell (RBC) transfusion and necrotizing enterocolitis (NEC) remains uncertain. This study aims to provide an exploration of transfusion and NEC in very preterm infants. Using data from the Chinese Neonatal Network cohort study between 2019 and 2021, the analysis focused on very preterm infants (with a birth weight of

Chlorophyll-a (Chl a) is an important indicator of algal biomass frequently used to evaluate the severity of cultural eutrophication. Identifying the key covariates of Chl a concentrations is essential to understand the mechanisms that drive eutrophication and to develop forecasting tools that guide the restoration process. In this study, we present a novel ensemble modeling framework founded upon the complementary features of Random Forest (RF) and Generalized Additive modeling (GAMs). A series of RF models are first developed to forecast Chl a concentrations based on the antecedent values of a multitude of environmental predictors. GAMs are then used to explore the presence of non-linearities in the seasonal relationships between Chl a and the identified predictors. The optimal RF models using a 0–8 day time lag displayed high predictive skills with adjusted R2 values consistently above 0.80. Analyses of the RF models revealed that the modulating factors of Chl a display significant seasonality. Dissolved oxygen (DO) and turbidity were the key covariates of Chl a in the spring, while the water level fluctuations predominantly regulated phytoplankton biomass in the summer and winter. The occurrence and severity of algal blooms in the summer and autumn were associated with threshold levels of 0.06 and 1.50 mg/L for total phosphorus (TP) and total nitrogen (TN) concentrations, respectively. These results reveal the potential of the introduced modeling framework to shed light on the regulatory factors of algal biomass as well as to establish real-time predictions in the Nanji wetland waters of Poyang Lake.

Abstract Analyzing blood lipid and bile acid profile changes in colorectal cancer (CRC) patients. Evaluating the integrated model's diagnostic significance for CRC. Ninety-one individuals with colorectal cancer (CRC group) and 120 healthy volunteers (HC group) were selected for comparison. Serum levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and apolipoproteins (Apo) A1, ApoA2, ApoB, ApoC2, and ApoC3 were measured using immunoturbidimetric and colorimetric methods. Additionally, LC–MS/MS was employed to detect fifteen bile acids in the serum, along with six tumor markers: carcinoembryonic antigen (CEA), carbohydrate antigens (CA) 125, CA19-9, CA242, CA50, and CA72-4. Group comparisons utilized independent sample t-tests and Mann–Whitney U tests. A binary logistic regression algorithm was applied to fit the indicators and establish a screening model; the diagnostic accuracy of individual Indicators and the model was analyzed using receiver operating characteristic (ROC) curves. The CRC group showed significantly lower levels in eight serum lipid indicators and eleven bile acids compared to the HC group (P

Abstract Recently, innate immunity and inflammation were recognized as the key factors for acute kidney injury (AKI) caused by sepsis, which is closely related to high mortality. Stimulator of interferon genes (STING) has emerged as a critical component of innate immune and inflammatory responses. However, the role of STING in the pathogenesis of septic AKI remains unclear. This study demonstrated that the STING was significantly activated in tubular cells induced by lipopolysaccharide (LPS) in vivo and in vitro. Tubule-specific STING knockout attenuated LPS-induced renal dysfunction and pathological changes. Mechanistically, the STING pathway promotes NOD-like receptor protein 3 (NLRP3) activation. STING triggers endoplasmic reticulum (ER) stress to induce mitochondrial reactive oxygen species (mtROS) overproduction, enhancing thioredoxin-interacting protein activation and association with NLRP3. Eventually, the NLRP3 inflammasome leads to tubular cell inflammation and pyroptosis. This study revealed the STING-regulated network and further identified the STING/ER stress/mtROS/NLRP3 inflammasome axis as an emerging pathway contributing to tubular damage in LPS-induced AKI. Hence, targeting STING may be a promising therapeutic strategy for preventing septic AKI.

Water level is crucial to the growth and development of wetland plants, in order to study the physiological and ecological responses of Pomatogeton crispus under different water levels, in the study, P. crispus were placed under 50 cm (control) and 60–135 cm water levels following a 15 cm gap gradient for 60 days in a simulation experiment. The results showed that: (1) As the water level gradient increased, the plant height, leaf number and biomass of P. crispus showed a trend of increasing and then decreasing. (2) The concentrations of chlorophyll a (Chl-a), chlorophyll b (Chl-b), chlorophyll a + b (Chl a + b) and carotenoids (Car) showed a multi-peak increasing trend with increasing water level, with the maximum values occurring in the 135 cm water level group. (3) The antioxidant enzymes of P. crispus showed a fluctuating upward trend with increasing water level, and the higher the water level the greater the difference within the group, and rooting activity of P. crispus was significantly increased under elevated water level conditions. (4) The P. crispus grows best in the water level range of 105 ∼ 120 cm, and the growth indexes such as the number of leaves and biomass all reach higher values in the water level of 105 ∼ 120 cm, If the water level is too high or too low, it has an effect on the growth and development of P. crispus.

ABSTRACTUrinary tract infections (UTIs) are among the most common late-onset infections in preterm infants, characterized by nonspecific symptoms and a pathogenic spectrum that diverges from that of term infants and older children, which present unique diagnostic and therapeutic challenges. Existing data on the role of gut microbiota in UTI pathogenesis in this demographic are limited. This study aims to investigate alterations in gut microbiota and fecal calprotectin levels and their association with the development of UTIs in hospitalized preterm infants. A longitudinal case-control study was conducted involving preterm infants admitted between January 2018 and October 2020. Fecal samples were collected weekly and analyzed for microbial profiles and calprotectin levels. Propensity score matching, accounting for key perinatal factors including age and antibiotic use, was utilized to match samples from UTI-diagnosed infants to those from non-UTI counterparts. Among the 151 preterm infants studied, 53 were diagnosed with a UTI, predominantly caused by Enterobacteriaceae (79.3%) and Enterococcaceae (19.0%). Infants with UTIs showed a significantly higher abundance of these families compared to non-UTI infants, for both Gram-negative and positive pathogens, respectively. Notably, there was a significant pre-UTI increase in the abundance of pathogen-specific taxa in infants later diagnosed with UTIs, offering high predictive value for early detection. Shotgun metagenomic sequencing further confirmed the dominance of specific pathogenic species pre-UTI and revealed altered virulence factor profiles associated with Klebsiella aerogenes and Escherichia coli infections. Additionally, a decline in fecal calprotectin levels was observed preceding UTI onset, particularly in cases involving Enterobacteriaceae. The observed pathogen-specific alterations in the gut microbiota preceding UTI onset offer novel insight into the UTI pathogenesis and promising early biomarkers for UTIs in preterm infants, potentially enhancing the timely management of this common infection. However, further validation in larger cohorts is essential to confirm these findings.

Nicotine is the primary addictive component of cigarette smoke and is associated with various smoking-related diseases. However, recent research has revealed its broader cognitive-enhancing and anti-inflammatory properties, suggesting its potential therapeutic applications in several conditions. This review aims to examine the double-edged nature of nicotine, encompassing its positive and negative effects. We provide a concise overview of the physiochemical properties and pharmacology of nicotine, including insights into nicotine receptors. Therefore, the article is divided into two main sections: toxicity and therapeutic potential. We comprehensively explored nicotine-related diseases, focusing on specific signaling pathways and the underlying mechanisms that contribute to its effects. Furthermore, we addressed the current research challenges and future development perspectives. This review aims to inspire future researchers to explore the full medical potential of nicotine, which holds significant promise for the clinical management of specific diseases.

Satellite communication and terrestrial mobile communication have strong complemented co-benefits.Satellite Internet is the hot spot supporting current industrial development and an important part of the future 6G network.Global coverage requires interstellar networking, but inter-satellite communication bandwidth requirements and the instability brought by the free space channel pose new challenges to the space bearer network.Inter-satellite communication technologies and link interface technologies were compared and analyzed.An optical transport network (OTN) carrier network solution based on inter-satellite laser was proposed, which could fully leverage the advantages of the maturities and the economies of the scaled ground optical communication.It constructs a satellite-terrestrial integrated network with strong cost-efectivity, compatibility, and scalability.Finally, the technological directions and evolutions of the inter-satellite laser communication were discussed, and suggestions for industrial development in China were proposed.

Abstract Background Human milk fortifier (HMF) composition has been optimized recently. But clinical evidence of its safety and efficacy is limited in Chinese population. The aim of this study was to evaluate effects of a new HMF in growth, nutritional status, feeding intolerance, and major morbidities among very preterm (VPT) or very low birth weight (VLBW) infants in China. Methods VPT/VLBW infants admitted from March 2020 to April 2021 were prospectively included in the experimental (new HMF, nHMF) group, who received a new powdered HMF as a breast milk feeding supplement during hospitalization. Infants in the control group (cHMF) admitted from January 2018 to December 2019, were retrospective included, and matched with nHMF group infants for gestational age and birth weight. They received other kinds of commercially available HMFs. Weight gain velocity, concentrations of nutritional biomarkers, incidence of major morbidities, and measures of feeding intolerance were compared between the two groups. Results Demographic and clinical characteristics of infants in nHMF and cHMF groups were comparable. Weight gain velocity had no significant difference between the nHMF (14.0 ± 3.5 g/kg/d) and the cHMF group (14.2 ± 3.8 g/kg/d; P = 0.46). Incidence of morbidities, including necrotizing enterocolitis, bronchopulmonary dysplasia, retinopathy of prematurity, culture-confirmed sepsis, and feeding intolerance during hospitalization between nHMF and cHMF, were similar (all P-values > 0.05). The time to achieve full enteral feeding [13.5 (10, 21) days] in the nHMF group was significantly shorter than that in the cHMF group [17 (12, 23) days, HR = 0.67, 95%CI: 0.49, 0.92; P = 0.01]. Compared with cHMF group, the decrease of blood urea nitrogen level over time in nHMF group was smaller (β = 0.6, 95%CI:0.1, 1.0; P = 0.01). Conclusions The new HMF can promote growth of preterm infants effectively without increasing the incidence of major morbidity and feeding intolerance. It can be used feasible in Chinese VPT/VLBW infants. Trial registration This study was registered on ClinicalTrials.gov (NCT04283799).

Abstract Background In China, ~1,072,100 small for gestational age (SGA) births occur annually. These SGA newborns are a high-risk population of developmental delay. Our study aimed to evaluate the genetic profile of SGA newborns in the newborn intensive care unit (NICU) and establish a prognosis prediction model by combining clinical and genetic factors. Methods A cohort of 723 SGA and 1317 appropriate for gestational age (AGA) newborns were recruited between June 2018 and June 2020. Clinical exome sequencing was performed for each newborn. The gene-based rare-variant collapsing analyses and the gene burden test were applied to identify the risk genes for SGA and SGA with poor prognosis. The Gradient Boosting Machine framework was used to generate two models to predict the prognosis of SGA. The performance of two models were validated with an independent cohort of 115 SGA newborns without genetic diagnosis from July 2020 to April 2022. All newborns in this study were recruited through the China Neonatal Genomes Project (CNGP) and were hospitalized in NICU, Children’s Hospital of Fudan University, Shanghai, China. Results Among the 723 SGA newborns, 88(12.2%) received genetic diagnosis, including 42(47.7%) with monogenic diseases and 46(52.3%) with chromosomal abnormalities. SGA with genetic diagnosis showed higher rates in severe SGA(54.5% vs. 41.9%, P=0.0025) than SGA without genetic diagnosis. SGA with chromosomal abnormalities showed higher incidences of physical and neurodevelopmental delay compared to those with monogenic diseases (45.7% vs. 19.0%, P=0.012). We filtered out 3 genes (ITGB4, TXNRD2, RRM2B) as potential causative genes for SGA and 1 gene (ADIPOQ) as potential causative gene for SGA with poor prognosis. The model integrating clinical and genetic factors demonstrated a higher area under the receiver operating characteristic curve (AUC) over the model based solely on clinical factors in both the SGA-model generation dataset (AUC=0.9[95% confidence interval 0.84–0.96] vs. AUC=0.74 [0.64–0.84]; P=0.00196) and the independent SGA-validation dataset (AUC=0.76 [0.6–0.93] vs. AUC=0.53[0.29–0.76]; P=0.0117). Conclusion SGA newborns in NICU presented with roughly equal proportions of monogenic and chromosomal abnormalities. Chromosomal disorders were associated with poorer prognosis. The rare-variant collapsing analyses studies have the ability to identify potential causative factors associated with growth and development. The SGA prognosis prediction model integrating genetic and clinical factors outperformed that relying solely on clinical factors. The application of genetic sequencing in hospitalized SGA newborns may improve early genetic diagnosis and prognosis prediction.

The traditional organic and inorganic solvents used for polysaccharide extraction generally have long extraction time, large solvent consumption, low extraction efficiency and certain pollution problems, and the exploration of new safe solvents has become a hot issue in polysaccharide extraction. As an emerging green solvent, low eutectic solvent (DES) has a variety of solvent characteristics that traditional organic solvents do not possess, and has been widely used in the field of plant polysaccharide extraction in recent years. In this paper, the composition, main properties, synthesis method and important factors affecting the properties of DES are reviewed, and the progress of the application of DES in the extraction of plant polysaccharides such as tea polysaccharides, herbal polysaccharides and peel pectin are summarized.Compared with traditional water and acid-base extraction, the extraction conditions of DES are relatively mild and the energy consumption is lower. The extracted plant polysaccharides have higher extraction rate and purity, and the biological activity and biocompleteness of polysaccharides are better. The limitations and potentials of DES in plant polysaccharide extraction are further elaborated, aiming to provide ideas and theoretical references for the research related to the extraction of plant polysaccharides by DES.

IntroductionThe use of controlled-release nitrogen (N) fertilizers has been shown to improve yield and N-use efficiency (NUE) in mechanical transplanted rice. However, the fertilizer requirements for mechanical direct-seeding rice differ from those for mechanical transplanted rice. The effects of controlled-release fertilizers on yield, NUE, and quality in mechanical direct-seeding rice are still unknown.MethodsHybrid indica rice varieties Yixiangyou 2115 and Fyou 498 were used as test materials, and slow-mixed N fertilizer (120 kg hm-2) as a base (N1), N1+urea-N (30 kg hm-2) once as a base (N2), N1+urea-N (30 kg hm-2) topdressing at the tillering stage (N3), N1+urea-N (30 kg hm-2) topdressing at the booting stage (N4) four N fertilizer management to study their impact on the yield, NUE and quality of mechanical direct-seeding rice.Results and discussionCompared with Yixiangyou 2115, Fyou 498 significantly increased photosynthetic potential, population growth rate, root vigor, and N transport rate by 3.34–23.88%. This increase further resulted in a significant improvement in the yield and NUE of urea-N topdressing by 1.73–5.95 kg kg-1. However, Fyou 498 showed a significant decrease in the head rice rate and taste value by 3.34–7.67%. All varieties were treated with N4 that significantly increase photosynthetic potential and population growth rate by 15.41–62.72%, reduce the decay rate of root vigor by 5.01–21.39%, promote the N transport amount in stem-sheaths (leaves) by 13.54–59.96%, and then significantly increase the yields by 4.45–20.98% and NUE of urea-N topdressing by 5.20–45.56 kg kg-1. Moreover, the rice processing and taste values were optimized using this model. Correlation analysis revealed to achieve synergistic enhancement of high-yield, high-quality, and high-NUE in rice, it is crucial to focus on increasing photosynthetic potential, population growth rate, and promoting leaf N transport. Specifically, increasing the contribution rate of N transport in stem-sheaths is the most important. These findings offer an effective N management strategy for 4R nutrient stewardship (right source, right method, right rate and right timing) of mechanical direct-seeding hybrid indica rice.

The massive consumption of fossil energy has resulted in high CO2 emissions, posing a formidable challenge to global sustainable economic development (SED). As countries endeavor to shift from fossil to clean energy sources to achieve SED, research on the impact of clean energy is scarce, and quantitative analysis is lacking. This study measured China's SED and used a spatial econometric model to examine the impact of clean energy consumption and production on SED across 30 provinces in China from 2008 to 2020. Results show that (1) China's SED exhibits significant positive spatial autocorrelation characteristics, forming a “point-to-area” development pattern. (2) Clean energy consumption, production, and consumption structure all contribute to the promotion of SED in the region and have positive spatial spillover effects. (3) A considerable regional disparity exists in the spatial impact of clean energy on SED. The eastern and central regions have significant positive spatial spillover effects, whereas the western region is opposite. Notably, the estimated coefficient of the spatial Durbin model is relatively small, reflecting China's ongoing transition to clean energy and its limited role in promoting economic sustainability. Joint efforts and differentiated policies are essential to develop clean energy and sustainable economic.

Permanent basic farmland plays an important role in stabilizing agricultural production and ensuring national food security. Therefore, it is necessary to reasonably delineate and control permanent basic farmland. This article is based on the idea of classifying the quality of cultivated land resources, combined with the rules for the delineation of permanent basic farmland, and from the perspective of the synergy of “suitability-connectivity-stability” of cultivated land, a indicator system is constructed. Application of suitability, connectivity, and stability evaluation methods. Taking Zhangshu City, Jiangxi Province as an example, the status of cultivated land resources is comprehensively evaluated, and permanent basic farmland is optimized and graded for protection. The results show that: (1) the arable land in Zhangshu City is mainly of medium suitability, medium continuity and high stability. (2) Zhangshu City is divided into 43218.80 hm2 of permanent basic farmland, accounting for 79.35% of the total area of cultivated land. (3) Control and partition permanent basic farmland into three categories: core protected areas for permanent basic farmland, quality improvement areas, and key transformation areas. The above results indicate that this evaluation has a supportive role in supporting the spatial optimization and hierarchical management of permanent basic farmland, and is of great significance for the unified management of natural resources.

Abstract Background TFE3 immunohistochemistry (TFE3‐IHC) is controversial in the diagnosis of TFE3‐rearranged renal cell carcinoma (TFE3‐rearranged RCC). This study is to investigate the accuracy and sensitivity of IHC and establish a predictive model to diagnose TFE3‐rearranged RCC. Methods Retrospective analysis was performed by collecting IHC and fluorescence in situ hybridization (FISH) results from 228 patients. IHC results were evaluated using three scoring systems. Scoring system 1 is graded based on nuclear staining intensity, scoring system 2 is graded based on the percentage of stained tumor cell nuclei, and scoring system 3 is graded based on both the nuclear staining intensity and the percentage. We collected patients' IHC results and clinical information. Important variables were screened based on univariate logistic regression analysis. Then, independent risk factors were established through multivariate logistic regression, and a nomogram model was constructed. The model was validated in internal test set and external validation set. The receiver operating characteristic curve (ROC curve), calibration curve, and decision curve analysis (DCA) were generated to assess discriminative ability of the model. Results The accuracy of IHC based on three scoring systems were 0.829, 0.772, and 0.807, respectively. The model included four factors including age, gender, lymph node metastasis and IHC results. Area under the curve (AUC) values were 0.935 for the training set, 0.934 for the internal test set, 0.933 for all 228 patients, and 0.916 for the external validation set. Conclusions TFE3 IHC has high accuracy in the diagnosis of TFE3‐rearranged RCC. Clinical information such as age and lymph node metastasis are independent risk factors, which can be used as a supplement to the results of TFE3 IHC. This study confirms the value of IHC in the diagnosis of TFE3‐rearranged RCC. The accuracy of the diagnosis can be improved by incorporating IHC with other clinical risk factors.

Abstract This multicenter retrospective study was conducted to explore the effects of different courses and durations of invasive mechanical ventilation (MV) on the respiratory outcomes of very low birth weight infants (VLBWI) in China. The population for this study consisted of infants with birth weight less than 1500 g needing at least 1 course of invasive MV and admitted to the neonatal intensive care units affiliated with the Chinese Neonatal Network within 6 h of life from January 1st, 2019 to December 31st, 2020. Univariate and multivariate logistic regression analyses were performed to evaluate associations between invasive MV and respiratory outcomes. Adjusted odds ratios (ORs) were computed with the effects of potential confounders. (1) Among the 3183 VLBWs with a history of at least one course of invasive MV, 3155 (99.1%) met inclusion criteria and were assessed for the primary outcome. Most infants received one course (76.8%) and a shorter duration of invasive MV (62.16% with ventilation for 7 days or less). (2) In terms of the incidence of all bronchopulmonary dysplasia (BPD) (mild, moderate, and severe BPD), there were no significant differences between different invasive MV courses [For 2 courses, adjusted OR = 1.11 (0.88, 1.39); For 3 courses or more, adjusted OR = 1.07 (0.72, 1.60)]. But, with the duration of invasive MV prolonging, the OR of BPD increased [8–21 days, adjusted OR = 1.98 (1.59, 2.45); 22–35 days, adjusted OR = 4.37 (3.17, 6.03); ≥ 36 days, adjusted OR = 18.44 (10.98, 30.99)]. Concerning severe BPD, the OR increased not only with the course of invasive MV but also with the duration of invasive MV [For 2 courses, adjusted OR = 2.17 (1.07, 4.40); For 3 courses or more, adjusted OR = 2.59 (1.02, 6.61). 8–21 days, adjusted OR = 8.42 (3.22, 22.01); 22–35 days, adjusted OR = 27.82 (9.08, 85.22); ≥ 36 days, adjusted OR = 616.45 (195.79, > 999.999)]. (3) When the interaction effect between invasive MV duration and invasive MV course was considered, it was found that there were no interactive effects in BPD and severe BPD. Greater than or equal to three courses would increase the chance of severe BPD, death, and the requirement of home oxygen therapy. Compared with distinct courses of invasive MV, a longer duration of invasive MV (> 7 days) has a greater effect on the risk of BPD, severe BPD, death, and the requirement of home oxygen therapy.

The objective of this study was to assess the relationship of ACS with neonatal outcomes among very preterm infants born to mothers with clinical chorioamnionitis in China. This was a multicenter retrospective cohort study. Study participants included infants born at

Abstract Background Nerve compression symptoms and spinal instability, resulting from spinal metastases, significantly impact the quality of life for patients. A 3D-printed vertebral body is considered an effective approach to reconstruct bone defects following en bloc resection of spinal tumors. The advantage of this method lies in its customized shape and innermost porous structure, which promotes bone ingrowth and leads to reduced postoperative complications. Objective The purpose of this study is to assess the effectiveness of 3D-printed auto-stable artificial vertebrae in the en bloc resection and reconstruction of thoracolumbar metastases. Methods This study included patients who underwent en bloc resection of thoracolumbar metastases based on the Weinstein-Boriani-Biagini surgical staging system, between January 2019 and April 2021. The patients were divided into two groups: the observation group, which was reconstructed using 3D-printed auto-stable vertebral bodies, and the control group, treated with titanium cages and allograft bone. Evaluation criteria for the patients included assessment of implant subsidence, instrumentation-related complications, VAS score, and Frankel grading of spinal cord injury. Results The median follow-up period was 21.8 months (range 12–38 months). Among the patients, 10 received a customized 3D-printed artificial vertebral body, while the remaining 10 received a titanium cage. The observation group showed significantly lower operation time, intraoperative blood loss, and postoperative drainage compared to the control group (P

Objective: To explore the characteristics of plasma metabolites, feces gut microbiota and the crosstalk between gut microbiota and host metabolism in patients with acute ischemic stroke and phlegm-heat pattern (AIS-PHP). Methods: The metabolic and microbiome profiles of 20 AIS-PHP patients and 20 healthy controls (HCs) were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based metabolomics and 16s rDNA sequencing, respectively. The covariation between LC-MS/MS-based metabolite data and 16s rDNA sequence data was presented. Results: Distinct alterations in the plasma metabolic phenotype of AIS-PHP patients were found, in which 16 metabolites differed significantly between the AIS-PHP patients and the HCs. These metabolites represented 17 different metabolic pathways, including amino acid metabolism, lipid metabolism, and nucleotide metabolism. Additionally, significant alterations of gut microbiota composition and taxon were revealed at the phylum level between the AIS-PHP patients and the HCs. In AIS-PHP, Bacteroidetes, Firmicutes, and Proteobacteria dominated. Moreover, some microbes that differed between the 2 groups manifested a sole association with certain metabolites, such as the connection between Bacteroides and inosine and between Lachnospiraceae_unclassified and hypoxanthine. Conclusion: The present study preliminarily investigated the metabolomic and gut microbiome characteristics of AIS-PHP patient indicators. The link between metabolic and microbial dysbiosis in AIS-PHP sheds new light on the function of gut microbiota and associated metabolomics in the pathogenesis of the disease.

Objective: We aimed to investigate the clinical and genetic risk factors associated with neonatal severe unconjugated hyperbilirubinemia.Methods: This was a retrospective, 1:1 matched, case–control study. We included 614 neonates diagnosed with severe unconjugated hyperbilirubinemia (serum total bilirubin level ≥425 μmol/L or serum total bilirubin concentration that met exchange transfusion criteria) from the China Neonatal Genomes Project in Children’s Hospital of Fudan University. Clinical exome sequencing data were analyzed using a data analysis pipeline of Children’s Hospital of Fudan University. The factors associated with severe unconjugated hyperbilirubinemia were assessed using univariable and multivariable logistic regression analyses. Interaction analyses were examined between clinical and genetic risk factors.Results: ABO/Rh incompatibility hemolysis (odds ratio [OR] 3.36, 95% confidence interval [CI] 2.32–4.86), extravascular hemorrhage (OR 2.95, 95% CI 2.24–3.89), weight loss (OR 5.46, 95% CI 2.88–10.36), exclusive breastmilk feeding (OR 3.56, 95% CI 2.71–4.68), and the homozygous mutant of UGT1A1 211G>A (OR 2.35, 95% CI 1.54–3.59) were all identified as factors significantly associated with severe unconjugated hyperbilirubinemia. The presence of UGT1A1 211G>A mildly increased the risk of severe unconjugated hyperbilirubinemia caused by ABO/Rh incompatibility hemolysis (OR 3.98, 95% CI 2.19–7.23), although the effect is not statistically significant.Conclusion: ABO/Rh incompatibility hemolysis, extravascular hemorrhage, weight loss, exclusive breastmilk feeding, and the homozygous mutant of UGT1A1 211G>A were found to be risk factors for severe unconjugated hyperbilirubinemia. Clinical factors remain the most crucial and preventable determinants in managing severe unconjugated hyperbilirubinemia, with a minimal genetic contribution. The establishment of preconception care practices and the reinforcement of screening for the aforementioned risk factors are essential steps for preventing severe unconjugated hyperbilirubinemia.

Summary: Background: The optimal treatment strategy for patent ductus arteriosus (PDA) in extremely preterm infants is currently highly controversial. This study aimed to evaluate the association between PDA treatment and short-term outcomes among extremely preterm infants. Methods: This cohort study included all extremely preterm infants (≤27 and 6/7 weeks) who were admitted to hospitals participating in the Chinese Neonatal Network from January 2019 to December 2021, and were diagnosed to have PDA by echocardiogram. PDA treatment was defined as medical treatment and/or surgical ligation of PDA during hospitalization. Short-term outcomes included death, bronchopulmonary dysplasia (BPD), death/BPD, retinopathy of prematurity, necrotizing enterocolitis, and severe brain injury. Multivariate logistic regression was used to evaluate the association between PDA treatment and outcomes. Subgroup analysis were performed among infants with different respiratory support on 3 and 7 days of life. Findings: A total of 2494 extremely preterm infants with the diagnosis of PDA were enrolled, of which 1299 (52.1%) received PDA treatment. PDA treatment was significantly associated with lower risk of death (adjusted odds ratio, 0.48; 95% confidence interval, 0.38–0.60). The decreased risk of death was accompanied by increased risk of BPD and death/BPD. In subgroup analysis according to respiratory support, PDA treatment was associated with lower risk of death among infants who required invasive ventilation. However, the beneficial effect on death was not significant among infants who did not require invasive ventilation. Interpretation: PDA treatment was associated with reduced mortality in extremely preterm infants, but this beneficial effect was mainly present among infants who required invasive ventilation. Funding: This study was funded by the Shanghai Science and Technology Commission's Scientific and Technological Innovation Action Plan (21Y21900800) and the Canadian Institutes of Health Research (CTP87518).

Primary carnitine deficiency (PCD) caused by pathogenic variants in the solute carrier family 22 member 5 (SLC22A5) gene is a rare autosomal recessive disease that results in defective fatty acid oxidation. PCD can be detected through tandem mass spectrometry (MS/MS), but transplacental transport of free carnitine from mothers may cause false negatives or positives during newborn screening (NBS). This study aimed to analyze the genetic characteristics of SLC22A5 and estimate the prevalence of PCD in the Chinese population, providing useful information for NBS and genetic counseling. We manually curated SLC22A5 pathogenic or likely pathogenic (P/LP) variants according to the American College of Medical Genetics and Genomics (ACMG) guidelines and identified 128 P/LP variants. Based on the China Neonatal Genomes Project (CNGP), the estimated PCD prevalence was 1:17,456, which was higher than that in other populations. The genotype–phenotype association analysis showed that patients carrying homozygous c.760C>T and c.844C>T were more likely to present cardiomyopathy, whereas those carrying homozygous c.1400C>G were more likely to be asymptomatic (all p-values < 0.05). We found that there was no significant difference in initial C0 concentrations between patients and carriers, but there was a significant difference in the second-tier screening of C0 concentration between them (p-value < 0.05). We established a cost-effective variant panel containing 10 high-frequency sites and developed a screening algorithm incorporating gene panels with MS/MS, which could rescue one more patient who was undetected from MS/MS. In conclusion, the prevalence of PCD in the Chinese population is relatively high. The combination of conventional NBS with genetic sequencing is suggested for early diagnosis of PCD.

Abstract Background Carbapenem-resistant gram-negative bacilli (CR-GNB) have been increasingly reported in China. However, dynamic monitoring data on molecular epidemiology of CR-GNB are limited in pediatric patients. Results 300 CR-GNB isolates (200 Carbapenem-resistant K. pneumoniae (CRKP), 50 carbapenem-resistant A.baumannii (CRAB) and 50 carbapenem-resistant P. aeruginosa (CRPA)) were investigated. The predominant carbapenemase gene was bla NDM−1 (73%) and bla KPC−2 (65%) in neonates and non-neonates. Meanwhile, the predominant STs were ST11 (54%) in neonates and ST17 (27.0%) and ST278 (20.0%) in non-neonates. Notably, a shift in the dominant sequence type of CRKP infections from ST17 /ST278-NDM-1 to ST11-KPC-2 was observed during the years 2017–2021 and KPC-KP showed relatively higher resistance to aminoglycosides and quinolones than NDM-KP.Bla OXA−23 was isolated from all the CRAB isolates while only one isolate expressing bla BIC and 2 isolates expressing bla VIM−2 were found in CRPA isolates. ST195 (22.0%) and ST244 (24.0%) were the most common in CRAB and CRPA isolates and all the STs of CRAB belonged to CC92 while CRPA presents ST types with diversity distribution. Conclusion CRKP showed different molecular phenotypes in neonates and non-neonates and was changing dynamically and high-risk clone of ST11 KPC-KP should be paid more attention. Most CRKP and CRAB strains shared the same CCs, suggesting that intrahospital transmission may occur, and large-scale screening and more effective measures are urgently needed.

Abstract. Background:. Significant brain volume deviation is an essential phenotype in children with neurodevelopmental delay (NDD), but its genetic basis has not been fully characterized. This study attempted to analyze the genetic factors associated with significant whole-brain deviation volume (WBDV). Methods:. We established a reference curve based on 4222 subjects ranging in age from the first postnatal day to 18 years. We recruited only NDD patients without acquired etiologies or positive genetic results. Cranial magnetic resonance imaging (MRI) and clinical exome sequencing (2742 genes) data were acquired. A genetic burden test was performed, and the results were compared between patients with and without significant WBDV. Literature review analyses and BrainSpan analysis based on the human brain developmental transcriptome were performed to detect the potential role of genetic risk factors in human brain development. Results:. We recruited a total of 253 NDD patients. Among them, 26 had significantly decreased WBDV (+2 SDs). NDD patients with significant WBDV had higher rates of motor development delay (49.8% [106/213] vs. 75.0% [30/40], P = 0.003) than patients without significant WBDV. Genetic burden analyses found 30 genes with an increased allele frequency of rare variants in patients with significant WBDV. Analyses of the literature further demonstrated that these genes were not randomly identified: burden genes were more related to the brain development than background genes (P = 1.656e–9). In seven human brain regions related to motor development, we observed burden genes had higher expression before 37-week gestational age than postnatal stages. Functional analyses found that burden genes were enriched in embryonic brain development, with positive regulation of synaptic growth at the neuromuscular junction, positive regulation of deoxyribonucleic acid templated transcription, and response to hormone, and these genes were shown to be expressed in neural progenitors. Based on single cell sequencing analyses, we found TUBB2B gene had elevated expression levels in neural progenitor cells, interneuron, and excitatory neuron and SOX15 had high expression in interneuron and excitatory neuron. Conclusion:. Idiopathic NDD patients with significant brain volume changes detected by MRI had an increased prevalence of motor development delay, which could be explained by the genetic differences characterized herein.

Abstract. Background:. Antenatal corticosteroids (ACS) can significantly improve the outcomes of preterm infants. This study aimed to describe the ACS use rates among preterm infants admitted to Chinese neonatal intensive care units (NICU) and to explore perinatal factors associated with ACS use, using the largest contemporary cohort of very preterm infants in China. Methods:. This cross-sectional study enrolled all infants born at 24+0 to 31+6 weeks and admitted to 57 NICUs of the Chinese Neonatal Network from January 1st, 2019 to December 30th, 2019. The ACS administration was defined as at least one dose of dexamethasone and betamethasone given before delivery. Multiple logistic regressions were applied to determine the association between perinatal factors and ACS usage. Results:. A total of 7828 infants were enrolled, among which 6103 (78.0%) infants received ACS. ACS use rates increased with increasing gestational age (GA), from 177/259 (68.3%) at 24 to 25 weeks’ gestation to 3120/3960 (78.8%) at 30 to 31 weeks’ gestation. Among infants exposed to ACS, 2999 of 6103 (49.1%) infants received a single complete course, and 33.4% (2039/6103) infants received a partial course. ACS use rates varied from 30.2% to 100% among different hospitals. Multivariate regression showed that increasing GA, born in hospital (inborn), increasing maternal age, maternal hypertension and premature rupture of membranes were associated with higher likelihood to receive ACS. Conclusions:. The use rate of ACS remained low for infants at 24 to 31 weeks’ gestation admitted to Chinese NICUs, with fewer infants receiving a complete course. The use rates varied significantly among different hospitals. Efforts are urgently needed to propose improvement measures and thus improve the usage of ACS.

Abstract Background In most areas of China, mothers typically do not participate in early care of preterm infants in NICU. This study aims to examine the early experience of mothers of preterm infants participating in skin-to-skin contact combined with non-nutritive comfort sucking in China. Methods This qualitative research study used one-on-one, face-to-face, semi-structured in-depth interviews. Eighteen mothers who participated in early skin-to-skin contact combined with non-nutritive comfort sucking were interviewed in the NICU of a tertiary children’s hospital in Shanghai between July and December 2020. Their experiences were analyzed using the inductive topic analysis method. Results Five themes about skin-to-skin contact combined with non-nutritive comfort sucking were identified, including alleviation of maternal anxiety and fear during mother infant separation, reshaping the maternal role, promotion of active breast pumping, enhances the mother’s willingness to actively breast feed and building the maternal confidence in baby care. Conclusion Skin-to-skin contact combined with non-nutritive comfort sucking in the NICU can not only enhance the identity and responsibility of the mother’s role, but also provide non-nutritive sucking experience for promoting the establishment of oral feeding in preterm infants.

Oxidative stress increases the apoptosis of intestinal epithelial cells and impairs intestinal epithelial cell renewal, which further promotes intestinal barrier dysfunction and even death. Extensive evidence supports that resveratrol and apigenin have antioxidant, anti-inflammatory, and antiproliferative properties. Here, we investigated the ability of these two compounds to alleviate diquat-induced jejunal oxidative stress and morphological injury, using the duck as a model, as well as the effects of apigenin on oxidative stress induced by H2O2 in immortalized duck intestinal epithelial cells (IDECs). Ducks were randomly assigned to the following four groups, with five replicates: a control (CON) group, a diquat-challenged (DIQ) group, a resveratrol (500 mg/kg) + diquat (RES) group, and an apigenin (500 mg/kg) + diquat (API) group. We found that serum catalase (CAT) activity and total antioxidant capacity (T-AOC) markedly reduced in the RES and API groups as compared to the DIQ group (p < 0.05); moreover, serum S superoxide dismutase (SOD) levels increased significantly in the API group as compared to the DIQ group (p < 0.05). In jejunal mucosa, the malondialdehyde (MDA) content in the RES and API groups decreased more than that in the DIQ group (p < 0.05). In addition, the jejunal expression levels of the NRF2 and GCLM genes in the RES and API groups increased notably compared with those in the DIQ group (p < 0.05); meanwhile, CAT activity in the RES and API groups was markedly elevated compared with that in the CON group (p < 0.05). In IDECs, apigenin significantly restrained the H2O2-mediated increase in MDA content and decrease in CAT levels (p < 0.05). Furthermore, apigenin increased the protein expression of p-NRF2, NRF2, p-AKT, and p-P38; downregulated that of cleaved caspase-3 and cleaved caspase-9; and reduced the ratio of Bax/Bcl-2 in H2O2-treated IDECs (p < 0.05). In conclusion, resveratrol and apigenin can be used as natural feed additives to protect against jejunal oxidative stress in ducks.

Bifidobacterium longum is a common probiotic; both viable and heat-inactivated Bifidobacterium longum have many probiotic effects, such as anticancer effects. But some mechanisms of anticancer effects are still unclear, especially for heat-inactivated probiotics. In this study, we analyzed the effects of viable and heat-inactivated Bifidobacterium longum D42 on human colon cancer cells (HT-29). Cell proliferation, membrane permeability and apoptosis were detected by using the CCK-8 method, LDH method and Annexin V-FITC/PI kits. The ROS level and mitochondrial membrane potential were examined using the fluorescent probes DCFH-DA and JC-1. Real-time fluorescence quantitative PCR (RT-qPCR) and Western blot were used to detect the expression of mitochondrial apoptosis pathway genes and proteins. The results showed that viable and heat-inactivated Bifidobacterium longum D42 at concentrations of 1 × 106 CFU/mL significantly inhibited the proliferation of and increased the level of LDH release of HT-29 colon cancer cells. We found that they could increase the apoptosis rate of HT-29 cells. Moreover, they could also induce apoptosis by inducing cells to produce ROS and destroying the mitochondrial membrane potential of cells. Further studies found that they could increase the mRNA transcription and protein expression levels of the Caspase-3, Caspase-9 and Bax genes in cells, and reduce the mRNA transcription and protein expression levels of the Bcl-2 gene. In summary, our findings revealed that viable and heat-inactivated Bifidobacterium longum D42 have inhibitory effects on proliferation and promote the apoptosis of human colon cancer cells, and also have certain adjuvant drug therapeutic effects and have potential application value in the adjuvant treatment of colon cancer.

In recent years, deepfake videos have been abused to create fake news, which threaten the integrity of digital videos. Although existing detection methods leveraged cumbersome neural networks to achieve promising detection performance, they cannot be deployed in resource-constrained scenarios. To overcome this limitation, we propose a novel model compression framework based on joint distillation for deepfake detection, which includes a pre-training stage and a knowledge transfer stage. In the pre-training stage, a teacher network is trained with sufficient labeled samples. Then, in the knowledge transfer stage, a lightweight student network is constructed by considering dimension alignment. To transfer forensics knowledge comprehensively, a joint distillation loss is designed, including cross-entropy loss, knowledge distillation loss, and gradient-guided feature distillation loss. For feature distillation, feature maps from both shallow and deep layers are utilized to calculate channel-wise mean square error weighted by gradient information for transferring knowledge of forensics features adaptively. Besides, a decayed teaching strategy is constructed to adjust the importance of feature distillation, which aims at mitigating the risk of negative transfer. Extensive experiments show that student networks obtained by our model compression method can achieve competitive detection performance and outstanding efficiency by distinctly reducing computational costs compared against state-of-the-art methods.

Sialic acid-binding immunoglobulin-like lectin (Siglec)-8 is a sialoside-binding receptor expressed by eosinophils and mast cells that exhibits priming status- and cell type-dependent inhibitory activity. On eosinophils that have been primed with IL-5, GM-CSF, or IL-33, antibody ligation of Siglec-8 induces cell death through a pathway involving the β2 integrin-dependent generation of reactive oxygen species (ROS) via NADPH oxidase. In contrast, Siglec-8 engagement on mast cells inhibits cellular activation and mediator release but reportedly does not impact cell viability. The differences in responses between cytokine-primed and unprimed eosinophils, and between eosinophils and mast cells, to Siglec-8 ligation are not understood. We previously found that Siglec-8 binds to sialylated ligands present on the surface of the same cell (so-called cis ligands), preventing Siglec-8 ligand binding in trans. However, the functional relevance of these cis ligands has not been elucidated. We therefore explored the potential influence of cis ligands of Siglec-8 on both eosinophils and mast cells. De-sialylation using exogenous sialidase profoundly altered the consequences of Siglec-8 antibody engagement on both cell types, eliminating the need for cytokine priming of eosinophils to facilitate cell death and enabling Siglec-8–dependent mast cell death without impacting anti–Siglec-8 antibody binding. The cell death process licensed by de-sialylation resembled that characterized in IL-5–primed eosinophils, including CD11b upregulation, ROS production, and the activities of Syk, PI3K, and PLC. These results implicate cis ligands in restraining Siglec-8 function on eosinophils and mast cells and reveal a promising approach to the selective depletion of mast cells in patients with mast cell-mediated diseases.

Abstract Background In the treatment of unstable atlas fractures using the combined anterior–posterior approach or the posterior monoaxial screw-rod system, factors such as severe trauma or complex surgical procedures still need to be improved despite the favourable reduction effect. This research described and evaluated a new technique for the treatment of unstable atlas fracture using a self-designed lateral mass screw-plate system. Methods A total of 10 patients with unstable atlas fractures using this new screw-plate system from January 2019 to December 2021 were retrospectively reviewed. All patients underwent posterior open reduction and internal fixation (ORIF) with a self-designed screw-plate system. The medical records and radiographs before and after surgery were noted. Preoperative and postoperative CT scans were used to determine the type of fracture and evaluate the reduction of fracture. Results All 10 patients were successfully operated with this new system, with an average follow-up of 16.7 ± 9.6 months. A total of 10 plates were placed, and all 20 screws were inserted into the atlas lateral masses. The mean operating time was 108.7 ± 20.1 min and the average estimated blood loss was 98.0 ± 41.3 ml. The lateral mass displacement (LMD) averaged 7.1 ± 1.9 mm before surgery and almost achieved satisfactory reduction after surgery. All the fractures achieved bony healing without reduction loss or implant failure. No complications (vertebral artery injury, neurologic deficit, or wound infection) occurred in these 10 patients. At the final follow-up, the anterior atlantodens interval (AADI) was 2.3 ± 0.8 mm and the visual analog scale (VAS) was 0.6 ± 0.7 on average. All patients preserved almost full range of motion of the upper cervical spine and achieved a good clinical outcome at the last follow-up. Conclusions Posterior osteosynthesis with this new screw-plate system can provide a new therapeutic strategy for unstable atlas fractures with simple and almost satisfactory reduction.

Abstract Background The prevalence of preterm birth has been rising, and there is a paucity of nationwide data on the perinatal characteristics and neonatal outcomes of twin deliveries of very preterm infants (VPIs) in China. This study compared the perinatal characteristics and outcomes of singletons and twins admitted to neonatal intensive care units (NICUs) in China. Methods The study population comprised all infants born before 32 weeks in the Chinese Neonatal Network (CHNN) between January 2019 and December 2019. Three-level and population-average generalized estimating equation (GEE)/alternating logistic regression (ALR) models were used to determine the association of twins with neonatal morbidities and the use of NICU resources. Results During the study period, there were 6634 (71.2%) singletons and 2680 (28.8%) twins, with mean birth weights of 1333.70 g and 1294.63 g, respectively. Twins were significantly more likely to be delivered by caesarean section (p

Abstract Background In mice, liver fibrosis is the most serious pathologic change during Schistosoma japonicum (S. japonicum) infection. Schistosomiasis is mainly characterized by schistosome egg-induced granulomatous fibrosis. Hepatic stellate cells (HSCs) are mainly responsible for the net accumulation of collagens and fibrosis formation in the liver. Activated HSCs regulated by transforming growth factor-β1 (TGF-β1)/Smad signaling have emerged as the critical regulatory pathway in hepatitis virus or carbon tetrachloride-induced liver fibrosis. However, the detailed mechanism of HSC activation in schistosome-induced liver fibrosis is poorly understood. Methods Schistosoma japonicum-induced murine models and a control group were generated by abdominal infection with 15 (± 1) cercariae. The purity of cultured primary HSCs was evaluated by immunocytochemistry. The histopathological changes in the livers of infected mice were estimated by hematoxylin–eosin and Masson staining. Dynamic expression of pro-fibrotic molecules and microRNAs was detected by real-time quantitative PCR (RT-qPCR). Mainly members involved in the TGF-β1/Smad signaling pathway were examined via RT-qPCR and Western blot. Results The egg-induced granulomatous inflammation formed at 4 weeks post-infection (wpi) and developed progressively. Alpha-smooth muscle actin (α-SMA), collagen I, collagen III, TGF-β1, Smad2, Smad3, and Smad4 showed a significant increase in mitochondrial RNA (mRNA) and protein expression compared with the control group at 7 and 9 weeks post-infection (wpi), while an opposite effect on Smad7 was observed. In addition, the mRNA expression of microRNA-21 (miRNA-21) was significantly increased at 7 wpi, and the mRNA expression of miRNA-454 was decreased starting from 4 wpi. Conclusion Our present findings revealed that HSCs regulated by the TGF-β1/Smad signaling pathway play an important role in liver fibrosis in S. japonicum-infected mice, which may provide proof of concept for liver fibrosis in schistosomiasis. Graphical Abstract

To study the response of the Vallisneria natans morphological and physiology to water level change, seedlings were placed in a submerged condition at depths ranging from 50 cm to 135 cm and set the rising and declining water levels respectively (0.2 cm/d, 0.5 cm/d, 0.8 cm/d, 1.1 cm/d, 1.4 cm/d, 1.7 cm/d). After 50 days of simulation experiment, we observed the effects on plant height, the number of blades, root activity, biomass, chlorophyll a (Chl a), chlorophyll b (Chl b), chlorophyll (a + b) (Chl a + b), carotenoid (Car), soluble protein (SP) and soluble sugar (SS) of V. natans under different water level change rates. The results showed that (1) plant height and the number of blades showed an overall upward trend under the condition of high-rate water level change, while the low-rate change of water level showed a trend of first rising and then decreasing. (2) the root activity of 0.5–1.7 cm/d groups increased with the test time at rising water level, and the declining water level showed a trend of increasing and then decreasing. The total biomass showed an upward trend with the extension of the test time. (3) Chl a, Chl b, Chl (a + b), and Car showed a multi-peak downward trend with the extension of the test time. (4) the response of SP and SS to the test time showed a trend of first increase and then decrease with water level changes. In conclusion, our study demonstrates that the morphological and physiology of V. natans could adapt to water level changes, but it could be stressed if the water level exceeded the suitable range.

Purpose – The purposes of this research are to study the theory and method of multi-attribute index system design and establish a set of systematic, standardized, scientific index systems for the design optimization and inspection process. The research may form the basis for a rational, comprehensive evaluation and provide the most effective way of improving the quality of management decision-making. It is of practical significance to improve the rationality and reliability of the index system and provide standardized, scientific reference standards and theoretical guidance for the design and construction of the index system. Design/methodology/approach – Using modern methods such as complex networks and machine learning, a system for the quality diagnosis of index data and the classification and stratification of index systems is designed. This guarantees the quality of the index data, realizes the scientific classification and stratification of the index system, reduces the subjectivity and randomness of the design of the index system, enhances its objectivity and rationality and lays a solid foundation for the optimal design of the index system. Findings – Based on the ideas of statistics, system theory, machine learning and data mining, the focus in the present research is on “data quality diagnosis” and “index classification and stratification” and clarifying the classification standards and data quality characteristics of index data; a data-quality diagnosis system of “data review – data cleaning – data conversion – data inspection” is established. Using a decision tree, explanatory structural model, cluster analysis, K-means clustering and other methods, classification and hierarchical method system of indicators is designed to reduce the redundancy of indicator data and improve the quality of the data used. Finally, the scientific and standardized classification and hierarchical design of the index system can be realized. Originality/value – The innovative contributions and research value of the paper are reflected in three aspects. First, a method system for index data quality diagnosis is designed, and multi-source data fusion technology is adopted to ensure the quality of multi-source, heterogeneous and mixed-frequency data of the index system. The second is to design a systematic quality-inspection process for missing data based on the systematic thinking of the whole and the individual. Aiming at the accuracy, reliability, and feasibility of the patched data, a quality-inspection method of patched data based on inversion thought and a unified representation method of data fusion based on a tensor model are proposed. The third is to use the modern method of unsupervised learning to classify and stratify the index system, which reduces the subjectivity and randomness of the design of the index system and enhances its objectivity and rationality.

Abstract Background Intensive care is of great significance for very low birth weight infants (VLBWI). The Yangtze River Delta is the most ecomonically developed area in China. However, there are few data on the care practices and survival of VLBWI in this region. Objectives To investigate the prevalence, care practices and motality of VLBWI in Yangtze River Delta in China. Methods A multi-center retrospective investigation study was conducted at five tertiary hospitals within the Yangtze River Delta in China from January to December 2017. Clinical data included the general characteristics of the infants and the mothers, clinical prognosis, care practices in NICUs was collected by trained research members. Results During the study period, 1059 VLBWIs were included. Infants with birth weight

As a green and clean source of energy, natural gas plays an indispensable role in changing the energy structure and reducing greenhouse gas emissions. In this context, forecasting natural gas production becomes particularly important. In China, natural gas production has obvious seasonal and cyclical characteristics. To this end, a grey prediction model combined with particle swarm optimization (PSO) is proposed: the PSO-based data grouping grey model with a fractional order accumulation (PSO-FDGGM (1,1)). The traditional grey model has shortcomings such as low prediction accuracy and poor adaptability, and its application is limited. Compared with the traditional grey models, this model can be used to predict time series with seasonal characteristics, and the prediction accuracy is higher. Based on the data grouping-based grey modelling method (DGGM (1,1)), this model introduces the modeling method of the grey system model with the fractional order accumulation (FGM (1,1)), that is, combining data grouping with fractional accumulation, and using PSO to optimize fractional-order parameters, which improves the performance and adaptability of the model. In order to verify the effectiveness of the model, the model is compared with the traditional grey model (GM (1,1)), FGM (1,1) model, DGGM (1,1) model, autoregressive comprehensive moving average (ARIMA) model and the PSO-based grey forecasting model (PSOGM (1,1)). The mean absolute percent errors (MAPEs) of the comparison model in the test set are 7.46%, 9.28%, 4.38%, 8.60% and 5.97% respectively, while that of PSO-FDGGM (1,1) model is only 3.19%. The results show that PSO-FDGGM (1,1) has good adaptability and prediction accuracy for seasonally fluctuating sequences. In order to further verify the effectiveness and applicability of PSO-FDGGM (1,1), this paper adopts two ways: adjusting the parameters of PSO algorithm in the new model and applying the new model to the prediction of solar power generation, and the empirical results show that the new model is effective in forecasting seasonal data. Finally, the new model is used to predict the quarterly production of natural gas in China from the third quarter of 2021 to the second quarter of 2024. The forecast results can provide a basis for formulating natural gas production plans and environmental policies.

Selective activation of C–H bonds is a key challenge in organic reactions. Here, the authors achieve the selective activation of four quasi-equivalent C–H bonds, leading to the formation of N-doped graphene nanoribbons with partial corannulene motifs.

Summary: Background: Improved markers for predicting recurrence are needed to stratify patients with localised (stage I–III) renal cell carcinoma after surgery for selection of adjuvant therapy. We developed a novel assay integrating three modalities—clinical, genomic, and histopathological—to improve the predictive accuracy for localised renal cell carcinoma recurrence. Methods: In this retrospective analysis and validation study, we developed a histopathological whole-slide image (WSI)-based score using deep learning allied to digital scanning of conventional haematoxylin and eosin-stained tumour tissue sections, to predict tumour recurrence in a development dataset of 651 patients with distinctly good or poor disease outcome. The six single nucleotide polymorphism-based score, which was detected in paraffin-embedded tumour tissue samples, and the Leibovich score, which was established using clinicopathological risk factors, were combined with the WSI-based score to construct a multimodal recurrence score in the training dataset of 1125 patients. The multimodal recurrence score was validated in 1625 patients from the independent validation dataset and 418 patients from The Cancer Genome Atlas set. The primary outcome measured was the recurrence-free interval (RFI). Findings: The multimodal recurrence score had significantly higher predictive accuracy than the three single-modal scores and clinicopathological risk factors, and it precisely predicted the RFI of patients in the training and two validation datasets (areas under the curve at 5 years: 0·825–0·876 vs 0·608–0·793; p

AbstractIn order to investigate the effects of water level changes on the growth and physiology of Arundo donax var. versicolor and to understand its adaptive mechanisms to water level fluctuations, this study was conducted. A. donax var. versicolor was selected as the experimental species, and a dual-pot method was employed to simulate both rising and falling water level conditions. The study analyzed morphological characteristics (plant height, stem diameter, leaf traits, root traits), biomass, and photosynthetic features (chlorophyll a, chlorophyll b, chlorophyll a + b, carotenoids) of A. donax var. versicolor under these two water level conditions. The results revealed that (1) under the condition of rising water level, the morphological characteristics and chlorophyll content showed an overall trend of increasing initially and then decreasing with the increase of the rate. The growth rate of 0.2–0.4 cm/d groups were better, while exceeding its tolerance range led to a decrease in photosynthetic pigment content and even cell inactivation. (2) falling water level were more complex, with plant height, stem diameter, leaf length, leaf width, and leaf area being higher in the 0.8–1 cm/d groups, but values for leaf number and root characteristics were lower. This suggests that moderate stress can promote the growth of A. donax var. versicolor, but in the later stages, it can lead to leaf yellowing, root shrinkage, and even death.

AbstractThe growth, development, distribution, and dynamic processes of wetland plants are altered by water level fluctuations, which can even have an impact on the structure and stability of wetland ecosystems. In this research, the experiment was conducted to investigate the plasticity difference and adaptability of Artemisia selengensis under special hydrological situations by simulating three types of water levels (rising, falling, and stable). The results showed that (1) The suitable water level for the growth of A. selengensis was 0 cm-15 cm, i.e. the tolerance threshold was 15 cm. When the flooding depth was lower than 15 cm, both plant height and biomass increased with the duration of the experiment. The growth was inhibited when the flooding depth was higher than 15 cm. A. selengensis in the 20 cm-30 cm water level gradient group at the stable water level responded to flooding stress by reducing aboveground biomass and increasing belowground biomass. (2) Among the 12 physiological traits of A. selengensis, PPI was distributed between 0.036-0.785, antioxidant enzymes (SOD, CAT, POD), soluble sugars and superoxide anion plasticity changes were the most sensitive, and photosynthetic pigment plasticity changes were insensitive. The coefficients of variation were distributed between 0.156-0.657, with higher coefficients of variation for antioxidant enzymes and soluble sugars (CV > 0.2), while the rest of the traits were stable. A. selengensis was most suitable for growth and reproduction when the flooding depth was below 15 cm. A. selengensis responds to flooding stress mainly by adjusting morphological plasticity and biomass allocation to various organs and regulating physiological plasticities such as antioxidant enzymes, soluble sugars, and superoxide anions.

AbstractWater level plays an important role in the growth and development of wetland plants. To study the ecological responses of the growth and physiology of Triarrhena lularioriparia under different water levels, seedlings were used as the study materials and in 13 water level gradient treatment groups, −67, −54, −42, −34, −29, −16, −3.5, 10, 20, 30, 40, 50, 60 cm. The results showed that (1) the plant height, leaf number and root activity of T. lularioriparia first increased and then decreased with the increment of the water level gradient, and the highest values appeared at a water level of approximately 0 cm; (2) the concentrations of chlorophyll a (Chl a), chlorophyll b (Chl b), chlorophyll (a + b) (Chl a + b) and biomass first increased and then decreased with the increment of the water level gradient. The malondialdehyde (MDA) and antioxidant enzyme concentrations of T. lularioriparia first increased and then decreased, and both reached their maximums at a water level of approximately 20 cm. The soluble protein decreased and then increased with the change in the water level gradient and reached its lowest value at 31 cm; soluble protein increased slightly at 30–40 cm but showed a stable trend after the waterlogging depth exceeded 40 cm. (3) The water level ecological amplitude of T. lularioriparia was [−38.62, 41.07 cm], and the optimum water level ecological amplitude was [−11.04, 20.15 cm]. This study demonstrates that T. lularioriparia could adapt to drought and flooding stress to a certain extent, but it could be stressed if the water level exceeded the suitable range.

Background Nonresolving inflammation is a major driver of disease and needs to be taken seriously. Hypoxia-inducible factor (HIF) is closely associated with inflammation. Hypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHIs), as stabilizers of HIF, have recently been reported to have the ability to block inflammation. We used MK8617, a novel HIF-PHI, to study its effect on macrophage inflammation and to explore its possible mechanisms. Methods Cell viability after MK8617 and lipopolysaccharide (LPS) addition was assessed by Cell Counting Kit-8 (CCK8) to find the appropriate drug concentration. MK8617 pretreated or unpretreated cells were then stimulated with LPS to induce macrophage polarization and inflammation. Inflammatory indicators in cells were assessed by real-time quantitative reverse-transcription polymerase chain reaction (qRT-PCR), western blot (WB) and immunofluorescence (IF). The level of uridine diphosphate glucose (UDPG) in the cell supernatant was measured by ELISA. Purinergic G protein-coupled receptor P2Y14, as well as hypoxia-inducible factor-1α (HIF-1α) and glycogen synthase 1 (GYS1) were detected by qRT-PCR and WB. After UDPG inhibition with glycogen phosphorylase inhibitor (GPI) or knockdown of HIF-1α and GYS1 with lentivirus, P2Y14 and inflammatory indexes of macrophages were detected by qRT-PCR and WB. Results MK8617 reduced LPS-induced release of pro-inflammatory factors as well as UDPG secretion and P2Y14 expression. UDPG upregulated P2Y14 and inflammatory indicators, while inhibition of UDPG suppressed LPS-induced inflammation. In addition, HIF-1α directly regulated GYS1, which encoded glycogen synthase, an enzyme that mediated the synthesis of glycogen by UDPG, thereby affecting UDPG secretion. Knockdown of HIF-1α and GYS1 disrupted the anti-inflammatory effect of MK8617. Conclusions Our study demonstrated the role of MK8617 in macrophage inflammation and revealed that its mechanism of action may be related to the HIF-1α/GYS1/UDPG/P2Y14 pathway, providing new therapeutic ideas for the study of inflammation.

Abstract Background The administration of antenatal corticosteroids (ACS) to women who are at risk of preterm birth has been proven to reduce not only the mortality, but also the major morbidities of the preterm infants. The rate of ACS and the risk factors associated with ACS use in Chinese population is unclear. This study aimed to investigate the rate of ACS use and the associated perinatal factors in the tertiary maternal centers of China. Methods Data for this retrospective observational study came from a clinical database of preterm infants established by REIN-EPIQ trial. All infants born at