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Abstract Climate change destabilizes the symbiosis between corals and Symbiodiniaceae. The effects of ocean acidification and warming on critical aspects of coral survical such as symbiotic interactions (i.e., carbon and nitrogen assimilation and exchange) during the planula larval stage remain understudied. By combining physiological and stable isotope techniques, here we show that photosynthesis and carbon and nitrogen assimilation (H13CO3 − and 15NH4 +) in Pocillopora damicornis coral larvae is enhanced under acidification (1000 µatm) and elevated temperature (32 °C). Larvae maintain high survival and settlement rates under these treatment conditions with no observed decline in symbiont densities or signs of bleaching. Acidification and elevated temperature both enhance the net and gross photosynthesis of Symbiodiniaceae. This enhances light respiration and elevates C:N ratios within the holobiont. The increased carbon availability is primarily reflected in the 13C enrichment of the host, indicating a greater contribution of the algal symbionts to the host metabolism. We propose that this enhanced mutualistic symbiotic nutrient cycling may bolster coral larvae’s resistance to future ocean conditions. This research broadens our understanding of the early life stages of corals by emphasizing the significance of symbiotic interactions beyond those of adult corals.

Abstract Erectile dysfunction (ED) is a prevalent type of sexual dysfunction, and continuous monitoring of penile tumescence and rigidity during spontaneous nocturnal erections is crucial for its diagnosis and classification. However, the current clinical standard device, limited by its active mechanical load, is bulky and nonwearable and strongly interferes with erections, which compromises both monitoring reliability and patient compliance. Here, we report a wearable adaptive rigidity monitoring (WARM) system that employs a measurement principle without active loads, allowing for the assessment of penile tumescence and rigidity through a specifically designed elastic dual-ring sensor. The dual-ring sensor, comprising two strain-sensing rings with distinct elastic moduli, provides high resolution (0.1%), robust mechanical and electrical stability (sustaining over 1000 cycles), and strong interference resistance. An integrated flexible printed circuit (FPC) collects and processes sensing signals, which are then transmitted to the host computer via Bluetooth for ED assessment. Additionally, we validated the WARM system against the clinical standard device using both a penile model and healthy volunteers, achieving high consistency. Furthermore, the system facilitates the continuous evaluation of penile erections during nocturnal tumescence tests with concurrent sleep monitoring, demonstrating its ability to minimize interference with nocturnal erections. In conclusion, the WARM system offers a fully integrated, wearable solution for continuous, precise, and patient-friendly measurement of penile tumescence and rigidity, potentially providing more reliable and accessible outcomes than existing technologies. Erectile dysfunction (ED) is a prevalent sexual dysfunction, and continuous monitoring of penile tumescence and rigidity during spontaneous nocturnal erections is crucial for its diagnosis and classification. However, the current clinical standard device, limited by its active mechanical load, is bulky, nonwearable, and creates pronounced interference with erections, which compromises both monitoring reliability and patient compliance. Here, we report a wearable adaptive rigidity monitoring (WARM) system (Fig. 1a) that employs a measurement principle without active loads (Fig. 1b), allowing for the assessment of penile tumescence and rigidity through a specifically designed elastic dual-ring sensor. The dual-ring sensor, comprising two strain-sensing rings with distinct elastic moduli, provides high resolution (0.1%), robust mechanical and electrical stability (sustaining over 1000 cycles), and strong interference resistance. Additionally, we validate the WARM system against the clinical standard device using both a penile model and healthy volunteers, achieving high consistency. Furthermore, the system facilitates the continuous evaluation of penile erections during nocturnal tumescence tests, with concurrent sleep monitoring, demonstrating its ability to minimize interference with nocturnal erections (Fig. 1c). In conclusion, the WARM system offers a fully integrated, wearable solution for continuous, precise, and patient-friendly measurement of penile tumescence and rigidity, potentially providing more reliable and accessible outcomes than those from existing technologies.

Abstract Inflammatory bowel disease (IBD) is a chronic and recurrent inflammatory disease of the gastrointestinal tract, including two subtypes: Crohn’s disease (CD) and ulcerative colitis (UC). Metabolic disorders are important factors in the development of IBD. However, the evidence for the causal relationship between blood metabolites and IBD remains limited. A two-sample MR analysis was applied to evaluate relationships between 486 blood metabolites and IBD. The inverse variance weighted method was chosen as the primary MR analysis method. False discovery rate correction was used to control for false positives in multiple testing. Following complementary and sensitivity analyses were conducted using methods such as weight median, MR-egger, weighted mode, simple mode, Cochran Q test, and MR-PRESSO. Moreover, we performed replication, meta-analysis, Steiger test, and linkage disequilibrium score regression to enhance the robustness of the results. Additionally, we performed metabolic pathway analysis to identify potential metabolic pathways. As a result, we identified four significant causal associations between four blood metabolites and two IBD subtypes. Specifically, one metabolite was identified as being associated with the development of CD (mannose: odds ratio (OR) = 0.19, 95% confidence interval (CI) 0.08–0.43, P = 8.54 × 10–5). Three metabolites were identified as being associated with the development of UC (arachidonate (20:4n6): OR = 0.18, 95% CI 0.11–0.30, P = 2.09 × 10–11; 1, 5-anhydroglucitol: OR = 2.21, 95% CI 1.47–3.34, P = 1.50 × 10–4; 2-stearoylglycerophosphocholine: OR = 2.66, 95% CI 1.53–4.63, P = 5.30 × 10–4). The findings of our study suggested that the identified metabolites and metabolic pathways can be considered as useful circulating metabolic biomarkers for the screening and prevention of IBD in clinical practice, as well as candidate molecules for future mechanism exploration and drug target selection.

Coral reefs are severely threatened by global and local disturbances that can shift reefs from coral to algal dominance. Coral-macroalgae competition is expected to exacerbate coral decline as the interactions increase in frequency. Whereas numerous studies over the last decade have aimed to characterize the interactions and impacts on coral growth and physiology, the underlying mechanisms remain controversial. This study tested the impact of different macroalgal species, densities, and contact status with corals on the physiological response of corals in Sanya Reefs. The results revealed that direct contact with increasing densities of fleshy macroalgae had a negative impact on the photosynthesis, growth rate, and tissue biomass of the two common corals. However, calcified macroalgae did not significantly affect the corals, regardless of whether there was direct contact or not. Under the same conditions, Acropora intermedia appeared to be more susceptible to fleshy macroalgae compared to Porites lutea. This suggested that different corals varied in their susceptibility to various macroalgae. Additionally, the results of the generalized linear mixed model revealed that macroalgal species and contact status with corals were the most important predictors of the impacts of macroalgae on corals, and macroalgal density was another nonnegligible parameter. Overall, macroalgae may have caused a potential functional shift in the composition of coral assemblages on the Sanya reefs by further reducing the already depauperate reef-building coral populations. The negative impacts of macroalgae in Sanya Reefs may serve as an early warning that the persistence of the invaluable ecological functions provided by coral reefs will be increasingly threatened throughout the South China Sea. Our findings could contribute to improving the scientific and effective management practices, fostering sustainable coral reef development in China and beyond.

Abstract Coastal darkening is emerging as a global threat to fringing reefs. While some reef‐building corals exhibit resistance to low‐light environments, the mechanisms behind this resistance, particularly the role of coral hosts, remain inadequately understood. Here, we investigated variations in underwater photosynthetically active radiation (PAR) and employed the Bayesian stable isotope mixing model (MixSIAR) to estimate the contributions of autotrophic (i.e., dissolved inorganic matter, DIM) and heterotrophic sources (i.e., particulate organic matter, POM, and dissolved organic matter, DOM) to the nutrition of the reef coral Galaxea fascicularis on the Luhuitou turbid reef in the northern South China Sea. Our findings revealed that the heterotrophic contribution to coral nutrition increased to 58.5% with decreasing PAR and that the heterotrophic contribution was significantly negatively correlated with δ13C difference between host and symbiont (δ13Ch–s). Moreover, we observed significant seasonal variations in the respective contributions of POM and DOM to coral nutrition, linked to the sources of these nutrients, demonstrating that G. fascicularis can selectively ingest POM and DOM based on their bioavailability to enhance its heterotrophic contribution. This heterotrophic plasticity improved the low‐light resistance of G. fascicularis and contributed to its prominence within coral communities. However, with a low‐light threshold of approximately 3.73% of the surface PAR for G. fascicularis, our results underscore the need for effective strategies to mitigate low‐light conditions on nearshore turbid reefs. In summary, our study highlights the critical role of heterotrophic plasticity in coral responses to natural low‐light environments, suggesting that some reef‐building corals with such plasticity could become dominant or resilient species in the context of coastal darkening.

Clubroot caused by Plasmodiophora brassicae is a devastating disease of Cruciferous crops. Developing cultivars with clubroot resistance (CR) is the most effective control measure. For the two major Brassica vegetable species B. rapa and B. oleracea, several commercial cultivars with unclear CR pedigrees have been intensively used as CR donors in breeding. However, the continuous occurrence of CR-breaking makes the CR pedigree underlying these cultivars one of the breeders' most urgent concerns. The complex intraspecific diversity of these two major Brassica vegetables has also limited the applicability of CR markers in different breeding programs. Here we first traced the pedigree underlying two kinds of CR that have been widely applied in breeding by linkage and introgression analyses based on public resequencing data. In B. rapa, a major locus CRzi8 underlying the CR of the commercial CR donor ‘DegaoCR117’ was identified. CRzi8 was further shown to have been introgressed from turnip (B. rapa ssp. rapifera) and that it carried a potential functional allele of Crr1a. The turnip introgression carried CRbc, sharing the same coding sequence with the CRb that was also identified from chromosome C07 of B. oleracea CR cultivars with different morphotypes. Within natural populations, variation analysis of linkage intervals of CRzi8, PbBa8.1, CRb, and CRbc yielded easily resolved InDel markers (> 20 bp) for these fundamental CR genes. The specificity of these markers was tested in diverse cultivars panels, and each exhibited high reliability in breeding. Our research demonstrates the value of the practice of applying resequencing big data to solve urgent concerns in breeding programs.

Improving the geo-hazard meteorological risk warning capabilities is an important component of the comprehensive prevention system for geological disasters. Since 2003, Sichuan Province has been carrying out geo-hazard meteorological risk warning work. Building on the previous foundation, research has been focused on the analysis and establishment of warning models, system design and implementation, and graded warning operation modes since 2019. A geo-hazard warning model library, an integrated geological disaster meteorological risk warning interconnection system at the provincial, municipal, and county levels, and a graded warning mechanism have been created. We have achieved closed-loop management of interconnection and graded early warning based on integrated platform such as rainfall data transmission, early warning model analysis and calculation, and early warning information release in province, cities, and counties. This has solved the three problems of lack of technology, capacity, and funding in cities and counties, as well as the interference caused by multiple early warning information releases on grassroots levels. In 2023, 86% of the successful risk avoidance cases in Sichuan Province were affected by meteorological risk warning, effectively reducing casualties and property losses caused by geo-hazard.

Abstract Exciton–polaritons (polaritons) resulting from the strong exciton–photon interaction stimulates the development of novel low-threshold coherent light sources to circumvent the ever-increasing energy demands of optical communications1–3. Polaritons from bound states in the continuum (BICs) are promising for Bose–Einstein condensation owing to their theoretically infinite quality factors, which provide prolonged lifetimes and benefit the polariton accumulations4–7. However, BIC polariton condensation remains limited to cryogenic temperatures ascribed to the small exciton binding energies of conventional material platforms. Herein, we demonstrated room-temperature BIC polariton condensation in perovskite photonic crystal lattices. BIC polariton condensation was demonstrated at the vicinity of the saddle point of polariton dispersion that generates directional vortex beam emission with long-range coherence. We also explore the peculiar switching effect among the miniaturized BIC polariton modes through effective polariton−polariton scattering. Our work paves the way for the practical implementation of BIC polariton condensates for integrated photonic and topological circuits.

High temperature stress is one of the major environmental factors that affect the growth and development of plants. Although WRKY transcription factors play a critical role in stress responses, there are few studies on the regulation of heat stress by WRKY transcription factors, especially in tomato. Here, we identified a group I WRKY transcription factor, SlWRKY3, involved in thermotolerance in tomato. First, SlWRKY3 was induced and upregulated under heat stress. Accordingly, overexpression of SlWRKY3 led to an increase, whereas knock-out of SlWRKY3 resulted in decreased tolerance to heat stress. Overexpression of SlWRKY3 accumulated less reactive oxygen species (ROS), whereas knock-out of SlWRKY3 accumulated more ROS under heat stress. This indicated that SlWRKY3 positively regulates heat stress in tomato. In addition, SlWRKY3 activated the expression of a range of abiotic stress-responsive genes involved in ROS scavenging, such as a SlGRXS1 gene cluster. Further analysis showed that SlWRKY3 can bind to the promoters of the SlGRXS1 gene cluster and activate their expression. Collectively, these results imply that SlWRKY3 is a positive regulator of thermotolerance through direct binding to the promoters of the SlGRXS1 gene cluster and activating their expression and ROS scavenging.

Background: Mitochondrial DNA plays a crucial role in the pathophysiology of autoimmune diseases (ADs). However, the association between mitochondrial DNA copy number (mtDNA-CN) and ADs risk is controversial. In this study, Mendelian randomization (MR) analysis and meta-analysis were performed using three sets of independent instrumental variables (IVs) to investigate the potential association between mtDNA-CN and 20 types of ADs. Methods: The three sets of IVs were drawn primarily from participants in the UK Biobank and the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium using different methods. Outcome data for ADs were investigated using summary statistics from the FinnGen cohort. The potential causal associations were assessed using inverse-variance weighting (IVW), MR-Egger, and weighted median methods. Sensitivity analysis and the Steiger test were used to verify the robustness of the MR estimates. In addition, a meta-analysis was conducted to pool the results from three IV groups. Results: Overall, genetically predicted mtDNA-CN was not associated with ADs risk (OR = 1.046, 95 % CI: 0.964–1.135, P = 0.283). However, subgroup analyses showed positive causal associations of mtDNA-CN with autoimmune hypothyroidism (OR = 1.133, 95 % CI: 1.016–1.262, P = 0.024) and rheumatoid arthritis (OR = 1.219, 95 % CI: 1.028–1.445, P = 0.023). In contrast, there was no causal association between mtDNA-CN and atopic dermatitis as well as psoriasis, ulcerative colitis, adult-onset Still disease, type1 diabetes, Crohn disease, sarcoidosis, ankylosing spondylitis, multiple sclerosis, autoimmune hyperthyroidism, primary sclerosing cholangitis, systemic lupus erythematosus, systemic sclerosis, alopecia areata, myasthenia gravis, Guillain-Barre syndrome, dermatopolymyositis, and vitiligo. Conclusions: This MR analysis showed mtDNA-CN is causally associated with an increased risk of autoimmune hypothyroidism and rheumatoid arthritis at the genetic level. The findings have important implications for the use of mtDNA-CN as a biomarker for risk assessment of autoimmune hypothyroidism and rheumatoid arthritis in clinical practice.

AbstractObjectives To evaluate the efficacy of a novel approach to achieve the optimal penile erection during the penile doppler ultrasound (PDU) examination, which was oral sildenafil combined alprostadil injection.Materials and Methods A total of 60 ED patients were enrolled in our prospective study, and they were randomly assigned to two group with different PDU order. The approaches assisted the PDU included two models, mode A meaning injection of 15 μg alprostadil and model B meaning oral sildenafil 100 mg plus injection of 15 μg alprostadil. The PDU parameters were measured continuously before induced erection, and 5, 10, 15, 20, 25 min.Results Each group included 30 ED patients with similar clinical characteristics. After pooling the results together, the PSV, EDV, and RI were all improved significantly, when adding the oral sildenafil administration to assist PDU. Also, the clinical response of oral sildenafil administration plus alprostadil injection was better than that in alprostadil injection alone (p = 0.016). The arterial ED were decreased from 31.67% to 15.00% with the P value 0.031, and the mixed ED was also decreased statistically (23.33% vs 8.33%, p = 0.024).Conclusion Oral sildenafil administration plus alprostadil injection could improve the diagnostic accuracy of PDU.

Abstract Background Severe bacterial infections can trigger acute lung injury (ALI) and acute respiratory distress syndrome, with bacterial pathogen‐associated molecular patterns (PAMPs) exacerbating the inflammatory response, particularly in COVID‐19 patients. Cyclic‐di‐GMP (CDG), one of the PAMPs, is synthesized by various Gram‐positve and Gram‐negative bacteria. Previous studies mainly focused on the inflammatory responses triggered by intracellular bacteria‐released CDG. However, how extracellular CDG, which is released by bacterial autolysis or rupture, activates the inflammatory response remains unclear. Methods The interaction between extracellular CDG and myeloid differentiation protein 2 (MD2) was investigated using in vivo and in vitro models. MD2 blockade was achieved using specific inhibitor and genetic knockout mice. Site‐directed mutagenesis, co‐immunoprecipitation, SPR and Bis‐ANS displacement assays were used to identify the potential binding sites of MD2 on CDG. Results Our data show that extracellular CDG directly interacts with MD2, leading to activation of the TLR4 signalling pathway and lung injury. Specific inhibitors or genetic knockout of MD2 in mice significantly alleviated CDG‐induced lung injury. Moreover, isoleucine residues at positions 80 and 94, along with phenylalanine at position 121, are essential for the binding of MD2 to CDG. Conclusion These results reveal that extracellular CDG induces lung injury through direct interaction with MD2 and activation of the TLR4 signalling pathway, providing valuable insights into bacteria‐induced ALI mechanisms and new therapeutic approaches for the treatment of bacterial co‐infection in COVID‐19 patients.

IntroductionThe digital financial inclusion (DFI) provides opportunities to improve the relative capacity to pay for healthcare services by rural residents who are usually underserved by traditional finance in China. This paper provides empirical evidence on how the development of DFI affects the healthcare expenditure disparities between urban and rural residents.MethodsWe employed the fixed effects model and instrumental variable method to estimate the impact of DFI on the Theil index of urban–rural disparities in healthcare expenditures, using panel data from 31 provinces (2011 ~ 2020) in China. We further adopted a moderating effect model to test whether the intensity of the impact would vary depending on the level of local government health expenditures.ResultsThe results suggest a negative association between the development level of DFI and the urban–rural healthcare expenditure disparities in China. For every 1% increase in the DFI index, the Theil index of urban–rural disparities in healthcare expenditures would fall by 0.0013. After changing the measurement method for the dependent variable and adjusting the sample, the results remain robust. Moreover, the result of the moderating effect model indicates that, a high level of government health expenditures is conducive to the impact of DFI.DiscussionOur research reveals that DFI plays an important role in bridging the urban–rural gap in healthcare expenditures. This finding provides new information for addressing the issue of urban–rural healthcare inequality in China. Chinese government needs to accelerate the construction of digital infrastructure and increase the penetration rate of digital tools in rural areas to promote the beneficial effects of DFI. Additionally, it is also necessary for local government to address the unbalanced allocation of medical resources between urban and rural areas, especially the shortage of rural human resources.

BackgroundErectile dysfunction (ED) is a very common condition among adult men and its prevalence increases with age. The ankle-brachial blood pressure index (ABPI) is a noninvasive tool used to assess peripheral vascular disease (PAD) and vascular stiffness. However, the association between ABPI and ED is unclear. We aimed to explore the association between ABPI and ED in the US population.MethodsOur study used data from two separate National Health and Nutrition Examination Survey (NHANES) datasets (2001-2002 and 2003-2004). Survey-weighted logistic regression models were used to explore the association between ABPI as a continuous variable and quartiles with ED. We further assessed the association between ABPI and ED using restricted cubic regression while selecting ABPI thresholds using two-piecewise Cox regression models. In addition, we performed subgroup analyses stratified by BMI, race, marital status, diabetes, and hypertension.Main outcome measureABPI was calculated by dividing the mean systolic blood pressure at the ankle by the mean systolic blood pressure at the arm.ResultsFinally, 2089 participants were enrolled in this study, including 750 (35.90%) ED patients and 1339 (64.10%) participants without ED. After adjusting for all confounding covariates, logistic regression analyses showed a significant association between ABPI and ED (OR=0.19; 95% CI, 0.06-0.56, P=0.01); with ABPI as a categorical variable, compared with the lowest quartile, the OR and 95% CI for the second quartile were 0.58 (0.34-0.97; P = 0.04).Besides, splines indicated that there was an L-shaped relationship between ABPI levels and the risk of ED. Piecewise Cox regression demonstrated the inflection point at 1.14, below which the OR for ED was 0.06 (0.02-0.20; P < 0.001), and above which the OR was 2.79 (0.17-4.53; P = 0.469).ConclusionIn our study, lower ABPI was independently associated with ED risk. In addition, the lowest ABPI level associated with ED risk was 1.14, below this level, lower ABPI was associated with higher ED risk.

Observation of coral spawning times is valuable to detect spawning patterns and identify the potential mechanisms behind coral reproduction. Although large amount of data on global coral spawning records have become available over the past decades, information on coral spawning in the northern South China Sea remains scarce. In this study, we investigated the spawning patterns of scleractinian corals in Luhuitou fringing reef, Hainan Island, China, from 2009 to 2021 in relation to lunar cycles (month and day). The spawning times of 22 coral species from five genera (Acropora, Montipora, Platygyra, Dipsastraea, and Galaxea) within three families (Acroporidae, Merulinidae, and Euphylliidae) were recorded, with spawning occurring from lunar February to May 2009–2021. Recorded spawning events started at a period of increasing seawater temperature. Acropora, the most documented genus, spawned between lunar February and April, but primarily in lunar March. Importantly, the spawning time of Acropora was delayed for one lunar month in 2016 most likely due to a rapid decrease in monthly mean seawater temperature in lunar February. Spawning lunar days before, on or after full moon of corals in the Luhuitou Reef, including those of the Acropora species, were highly variable between years even for the same species. No predictable pattern of spawning times can thus be detected. Nonetheless, our results fill up an information gap on coral spawning patterns in the northern South China Sea that may be useful for further understanding of the reproductive biology of scleractinian corals throughout the Indo–West Pacific.

Objectives: Killer cell lectin like receptor G1 (KLRG1) is identified as a co-inhibitory receptor for NK cells and antigen-experienced T cells. The role of KLRG1 in immune regulation in patients with non-small cell lung cancer (NSCLC) remains poorly understood. Materials and Methods: We measured the proportion and immune function of KLRG1+CD8+ T cells derived from peripheral blood in patients with NSCLC by flow cytometry. Besides, using data from the gene expression profiles and single-cell sequencing, we explored the expression and immune role of KLRG1 in tumor tissues of patients with NSCLC. We further determined the prognostic value of KLRG1 in terms of overall survival (OS) in NSCLC patients. Results: We found that the proportion of KLRG1+CD8+T cells in peripheral blood significantly increased in patients with NSCLC as compared to those with benign pulmonary nodules and healthy donors. Peripheral KLRG1+CD8+T cell proportion was increased in elder subjects compared to that in younger ones, implying an immunosenescence phenotype. Moreover, the KLRG1+CD8+T cell levels were positively correlated with tumor size and TNM stage in the NSCLC cohort. In vitro stimulation experiments demonstrated that the KLRG1+CD8+T cells from peripheral blood expressed higher levels of Granzyme B and perforin than the KLRG1−CD8+ T cells. However, single-cell RNA sequencing data revealed that the KLRG1+CD8+ T cells were less infiltrated in tumor microenvironment and exhibited impaired cytotoxicity. The KLRG1 gene expression levels were significantly lower in tumor tissues than that in normal lung tissues, and were inversely correlated with CDH1 expression levels. Moreover, higher expression of CDH1 in tumor tissues predicted worse overall survival only in patients with KLRG1-high expression, but not in the KLRG1-low subset. Conclusion: This study demonstrates that KLRG1+CD8+T cells were associated with tumor immune evasion in NSCLC and suggests KLRG1 as a potential immunotherapy target.

Objective To compare the diagnostic values of transperineal and transrectal ultrasound-guided prostate puncture for prostate cancer in patients with gray / sub-gray zone of prostate-specific antigen （PSA）. Methods A total of 110 samples were collected from patients with PSA≤20 ng/mL who underwent transperineal and transrectal ultrasound-guided prostate puncture. All patients were divided into two groups according to different patterns of prostate puncture. The detection rates of prostate cancer and CsPCa of patients with PSA in the gray/ sub-gray zone were compared between two different puncture methods. Surgical conditions and degree of pain were compared between two groups，including operation time，bleeding，intra-operative and post-operative VAS pain scores. The incidence of complications was also compared between two groups，including pain，fever and hematuria，etc. The probability of complications was assessed in two groups. Results The detection rate of prostate cancer in the transperineal ultrasound-guided prostate puncture was higher than that in the transrectal prostate puncture （P<0.05）. Further subgroup analyses showed no statistical significance in the detection rates of prostate cancer in patients with PSA gray zone between two groups （P>0.05），but patients with PSA sub-gray zone in the transperineal ultrasound-guided prostate puncture group had a higher detection rate （P<0.05）. PSA sub-gray zone CsPCa in the PSA sub-gray zone accounted for a higher proportion of patients with positive puncture than that in the PSA gray zone （P<0.05）. There was no significant difference between two different puncture methods in terms of puncture time，bleeding，degree of pain and incidence of complications （all P>0.05）. Conclusions For patients with PSA gray zone，there is no significant difference in the detection rate of prostate cancer between two modalities. Nevertheless，for patients with PSA between 10-20 ng/mL sub-gray zone，transperineal ultrasound-guided prostate puncture yields better diagnostic and application value compared with transrectal ultrasound-guided prostate puncture.

The formation and evolution characteristics of fracture surface is one of the key points in anti-inclined layered slope research, and it is also the basis of stability evaluation as well as engineering design and treatment. In this study, the stress and deformation parameters of the slope are obtained by using the indoor large-scale geotechnical centrifuge. At the same time, combined with the PFC numerical simulation results, the formation and evolution process and characteristics of the slope fracture surface are displayed: firstly, the compression shear crack is generated and extends to the middle and lower part of the slope, and the compression shear zone of the slope is divided; secondly, the developments of cracks toward to the middle and upper part of the slope, and with the initial formation of fracture surface, the deep slope body is bent; finally, the shallow cracks are completely connected to form a complete fracture surface Ⅰ from the top to the foot of the slope. The middle and upper parts of the internal potential fracture surface (Ⅱ, Ⅲ) are approximately parallel to the slope surface, and the lower parts are merged gradually at the foot of the slope. While the potential fracture surface Ⅳ at the boundary between the stable compression area and the bending area is stepped. At the same time, there are three secondary fracture surfaces in the shallow layer of the slope. The formation mechanism of the fracture surface is revealed that the deformation and failure of the slope causes the differential stress of the rock stratum due to the action of gravity. Under the action of compression shear, tension shear and bending, the crack initiates and expands from the tip of the prefabricated crack, and finally penetrates to form the fracture surface. Therefore, gravity is the internal reason, and the structural characteristics of slope are the basic conditions. The research results provide a basis for further research and practice of anti-inclined layered slope.

Objective: Existing methods for automated coronary artery branch labeling in cardiac CT angiography face two limitations: 1) inability to model overall correlation of branches, since differences between branches cannot be captured directly. 2) a serious class imbalance between main and side branches. Methods and procedures: Inspired by the application of Transformer in sequence data, we propose a topological Transformer network (TTN), which solves the vessel branch labeling from a novel perspective of sequence labeling learning. TTN detects differences between branches by establishing their overall correlation. A topological encoding that represents the positions of vessel segments in the artery tree, is proposed to assist the model in classifying branches. Also, a segment-depth loss is introduced to solve the class imbalance between main and side branches. Results: On a dataset with 325 CCTA, our method obtains the best overall result on all branches, the best result on side branches, and a competitive result on main branches. Conclusion: TTN solves two limitations in existing methods perfectly, thus achieving the best result in coronary artery branch labeling task. It is the first Transformer based vessel branch labeling method and is notably different from previous methods. Clinical impact: This Pre-Clinical Research can be integrated into a computer-aided diagnosis system to generate cardiovascular disease diagnosis report, assisting clinicians in locating the atherosclerotic plaques.

Several methods have been applied to measure healthcare accessibility, ie, the Euclidean distance, the network distance, and the transport time based on speed limits. However, these methods generally produce less accurate estimates than actual measurements. This research proposed a method to estimate historical healthcare accessibility more accurately by using taxi Global Positioning System (GPS) traces. The proposed method’s advantages were evaluated vis a case study using acute myocardial infarction (AMI) cases in Beijing in 2008. Comparative analyses of the new measure and three conventionally used measures suggested that the median estimated transport time to the closest hospital with percutaneous coronary intervention (PCI) capability for AMI patients was 5.72 minutes by the taxi GPS trace-based measure, 2.42 minutes by the network distance-based measure, 2.28 minutes by the speed limit-based measure, 1.73 minutes by the Euclidean distance-based measure; and the estimated proportion of patients who lived within 5 minutes of a PCI-capable hospital was 38.17%, 89.20%, 92.52%, 95.05%, respectively. The three conventionally used measures underestimated the travel time cost and overestimated the percentage of patients with timely access to healthcare facilities. In addition, the new measure more accurately identifies the areas with low or high access to healthcare facilities. The taxi GPS trace-based accessibility measure provides a promising start for more accurately estimating accessibility to healthcare facilities, increasing the use of medical records in studying the effects of historical healthcare accessibility on health outcomes, and evaluating how accessibility to healthcare changes over time.

The surging accumulation of trajectory data has yielded invaluable insights into urban systems, but it has also presented challenges for data storage and management systems. In response, specialized storage systems based on non-relational databases have been developed to support large data quantities in distributed approaches. However, these systems often utilize storage by point or storage by trajectory methods, both of which have drawbacks. In this study, we evaluate the effectiveness of segmented trajectory data storage with HBase optimizations for spatio-temporal queries. We develop a prototype system that includes trajectory segmentation, serialization, and spatio-temporal indexing and apply it to taxi trajectory data in Beijing. Our findings indicate that the segmented system provides enhanced query speed and reduced memory usage compared to the Geomesa system.

Summary: Exhausted CD8+ T cells (Texs) are characterized by the expression of various inhibitory receptors (IRs), whereas the functional attributes of these co-expressed IRs remain limited. Here, we systematically characterized the diversity of IR co-expression patterns in Texs from both human oropharyngeal squamous cell carcinoma (OPSCC) tissues and syngeneic OPSCC model. Nearly 60% of the Texs population co-expressed two or more IRs, and the number of co-expressed IRs was positively associated with superior exhaustion and cytotoxicity phenotypes. In OPSCC patients, programmed cell death-1 (PD-1) blockade significantly enhanced PDCD1-based co-expression with other IR genes, whereas dual blockades of PD-1 and cytotoxic T lymphocyte-associated protein 4 (CTLA-4) significantly upregulated CTLA4-based co-expression with other IR genes. Collectively, our findings demonstrate that highly diverse IR co-expression is a leading feature of Texs and represents their functional states, which might provide essential clues for the rational selection of immune checkpoint inhibitors in treating OPSCC.

Abstract The triboelectric nanogenerator (TENG) reflects a prospering field, that uses Maxwell's displacement current as the driving force to transform mechanical energy into electricity. Based on the law of energy conservation, many theoretical models of TENGs are proposed to provide a detailed insight into how energy flows and transformation in the energy harvesting system, while ignoring a hidden but extremely important point about TENG's momentum transfer and conservation. Here a series of analysis is presented for the momentum transfer and conservation in TENGs based on Maxwell equations and stress tensor. Using a time‐dependent 3D mathematical model, it is elaborated that how the time‐ and spatial‐dependent momentum current is influenced by the field and the dielectric materials, demonstrating that momentum is overall conserved for a TENG. In other words, the TENG device can not only convert mechanical energy into electricity, but it is also able to transfer momentum. Momentum transfer is another important characteristic of TENGs, and finally, the essential differences and similarities among the momentum transfer, energy transfer, and energy transformation in TENGs are systematically discussed. This study will certainly serve as a new starting point for exploring momentum transfer and conservation in the TENG momentum transfer system.

Abstract Osteoporosis is a prevalent bone disease with multigene involved, and the molecular mechanisms of its pathogenesis are not entirely understood. This study aims to identify novel key genes involved in osteoporosis to discover potential pharmacological targets. We analyzed three microarray datasets and identified four differentially expressed genes. The LASSO model indicated that RNA-binding motif protein 5 (RBM5) is associated with osteoporosis and is a potential drug target. We conducted the Spearman correlation analysis and found 52 genes that were significantly related to RBM5. Enrichment analysis showed that these genes were primarily involved in RNA splicing and osteoclast differentiation pathways. By using lentivirus-based shRNA, we successfully knocked down RBM5 expression in RAW264.7 cell line, which showed that RBM5 knockdown significantly impaired their differentiation potential to mature osteoclasts and significantly inhibited bone-resorbing activity. RT-qPCR analyses revealed the expression of osteoclastogenesis marker genes was downregulated along with RBM5 expression. These findings suggest that RBM5 plays a crucial role in the pathogenesis of osteoporosis and provides a new potential pharmacological target.

Abstract Background Few studies were conducted to explore the association between sleep quality and nocturnal erection. Here, we intended to explore the association between sleep quality and nocturnal erection monitor when conducting nocturnal erection monitor. All erectile dysfunction (ED) patients underwent sleep monitors using Fitbit Charge 2™ (Fitbit Inc.) and nocturnal penile tumescence and rigidity (NPTR) monitors using RigiScan® (GOTOP medical, Inc., USA) for two nights. Subsequently, the patients were divided into two groups: Group A included patients who experienced effective erections only on the second night, while Group B included patients who had effective erections on both nights. To explore the associations between NPTR parameters and sleep parameters, a comparative analysis was performed between Group A and Group B for both nights. Results Finally, our study included 103 participants, with 47 patients in Group A and 56 patients in Group B. Notably, the Group A patients showed significant improvements in NPTR parameters on the second night compared to the first night. Conversely, the NPTR parameters on Group B of the second night did not demonstrate a superior outcome when compared to the second night of Group A. Interestingly, it was found that only the disparities in sleep parameters accounted for the variation in NPTR parameters between the two groups on the first night. After correlation and ROC analysis, we identified the rapid eye movement (REM) sleep time and wake after sleep onset (WASO) time monitoring by the Fitbit Charge 2 as the primary parameters for predicting abnormal NPTR results in the first night. Conclusions Therefore, our study strongly suggests a close association between sleep parameters and NPTR parameters. It emphasizes the importance of incorporating sleep monitoring alongside nocturnal erection monitoring to enhance the reliability of the NPTR results.

Abstract Background Immense attention has been given to the outcome of COVID-19 infection. However, comprehensive studies based on large populational cohort with long-term follow-up are still lacking. This study aimed to investigate the risk of various short-term comorbidities (within one month) and long-term sequelae (above one month) after COVID-19 infection. Methods In this large prospective cohort study with 14 months follow-up information based on UK biobank, we included 16,776 COVID-19-positive participants and 58,281 COVID-19-negative participants matched for comparison. The risk of each comorbidity and sequela was evaluated by multivariable logistic regression analysis and presented as hazard ratio (HR) and 95% confidence interval (95% CI). Results COVID-19-positive individuals had a higher risk of 47 types of comorbidities within one month following COVID-19 infection, especially those who were older, male, overweight/obese, ever-smoked, with more pre-existing comorbidities and hospitalized. About 70.37% of COVID-19 patients with comorbidities had more than one co-occurring comorbidities. Additionally, only 6 high-risk sequelae were observed after one month of COVID-19 infection, and the incidence was relatively low (

The construction of community elderly care facilities (CECF) is pivotal for promoting healthy aging and “aging in place” for older people. This study focuses on the low utilization rates of community elderly care facilities in the Dongcheng and Xicheng Districts, core areas of Beijing. The explainable machine learning method is used to analyze data across three dimensions: the elderly’s individual attributes, characteristics of the community elderly care station (CECS), and features of the built environment around CECS and subdistrict, to identify the important factors that influence the usage frequency of overall CECS and its different functional spaces, and also the correlation between factors and usage frequency of CECS. It shows that the most important factors are the features of CSCF, including the degree of space acceptance and satisfaction with services provided, which influence the usage frequency of nine functional spaces (R2 ≥ 0.68) and overall (R2 = 0.56). In addition, older people’s individual factors, such as age and physical condition, significantly influence the usage of specific spaces such as rehabilitation therapy rooms and assistive bathing rooms. The influence of built environment characteristics is relatively low, with factors such as the density of bus stations and housing prices within the subdistrict and the mean distance from CECF to the nearest subway stations being more important. These findings provide a reference for the construction of indoor environments, management of service quality, and optimal site selection for future community elderly care facilities.