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Abstract Paired immunoglobin-like type 2 receptor beta (PILRB) mainly plays a crucial role in regulating innate immunity, but whether PILRB is involved in cancer is poorly understood. Here, we report that PILRB potentiates the PI3K/AKT pathway to drive gastric tumorigenesis by binding and stabilizing IRS4, which could hyperactivate the PI3K/AKT pathway. Firstly, the levels of PILRB are upregulated in human gastric cancer (GC) specimens and associated with poor prognosis in patients with GC. In addition, our data show that PILRB promotes cell proliferation, colony formation, cell migration and invasion in GC cells in vitro and in vivo. Mechanistically, PILRB recruits the deubiquitination enzymes OTUB1 to IRS4 and relieves K48-linked ubiquitination of IRS4, protecting IRS4 protein from proteasomal-mediated degradation and subsequent activation of the PI3K/AKT pathway. Importantly, the levels of PILRB are positively correlated with IRS4 in GC specimens. Meanwhile, we also found that PILRB reprogrammed cholesterol metabolism by altering ABCA1 and SCARB1 expression levels, and PILRB-expression confers GC cell resistance to statin treatment. Taken together, our findings illustrate that the oncogenic role of PILRB in gastric tumorigenesis, providing new insights into the regulation of PI3K/AKT signaling in GC and establishing PILRB as a biomarker for simvastatin therapy resistance in GC.

Abstract Background Loneliness and social isolation have been found to be associated with various health-related outcomes. Our study aimed to evaluate the association of loneliness and social isolation with the risk of glaucoma. Methods A total of 373,330 participants from the UK Biobank without glaucoma at recruitment were included in this study. Self-reported questionnaires were used to define loneliness and social isolation. Incident glaucoma events were identified by hospital inpatient admissions and self-reported data. COX proportional hazards models adjusted for sociodemographic, lifestyle, and health-related factors were used to estimate hazard ratios (HRs) and 95% CIs. Results During a median follow-up of 13.1 (interquartile range: 12.3–13.9) years, 6,489 participants developed glaucoma. After adjusting for confounding factors, loneliness (yes vs. no: adjusted HR: 1.16; 95% CI: 1.04–1.30; P = 0.009) and social isolation (yes vs. no: adjusted HR: 1.08; 95% CI: 1.01–1.16; P = 0.033) were associated with an increased risk of glaucoma. Conclusions In this population-based prospective cohort study, loneliness and social isolation were associated with a higher risk of glaucoma.

Abstract Background Limited studies have investigated the correlation between fat distribution and the risk of diabetic retinopathy (DR) in the general population with diabetes. The relationship between obesity and DR remains inconclusive, possibly due to using simple anthropometric measures to define obesity. This study investigates the relationships between the android-to-gynoid fat ratio (A/G ratio, measured using dual-energy X-ray absorptiometry) and DR within the US population with diabetes. Methods The study used a population-based, cross-sectional approach based on the 2003–2006 and 2011–2018 data of the National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression analyses were performed on participants with diabetes to evaluate the contribution of body mass index (BMI), waist-to-height ratio (WHtR), and A/G ratio to the prevalence of DR. Results The prevalence of DR was 22.2, 21.2, and 17.6% among participants with A/G ratios

Abstract Background Many factors contribute to quality of life (QoL) in patients with schizophrenia, yet limited research examined these factors in patients in China. This cross-sectional study explores subjective QoL and its associated factors in patients. Methods The QoL was assessed using the Schizophrenia Quality of Life Scale (SQLS). Clinical symptoms were evaluated using the Brief Psychiatric Rating Scale (BPRS) and seven factors were extracted. Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder Scale (GAD-7) were used to assess depression and anxiety. Cognitive impairment was assessed using the Ascertain Dementia 8 (AD8). The Treatment Emergent Symptom Scale (TESS) and Rating Scale for Extrapyramidal Side Effects (RSESE) were used to evaluate the side effects of medications. Results We recruited 270 patients (male:142,52.6%, mean age:41.9 ± 9.4 years). Positive correlations were observed between SQLS and its subdomains with the total score of BPRS, PHQ-9, GAD-7, AD8, TESS, and RSESE (all P

Abstract Photodetection has attracted significant attention for information transmission. While the implementation relies primarily on the photonic detectors, they are predominantly constrained by the intrinsic bandgap of active materials. On the other hand, photothermoelectric (PTE) detectors have garnered substantial research interest for their promising capabilities in broadband detection, owing to the self-driven photovoltages induced by the temperature differences. To get higher performances, it is crucial to localize light and heat energies for efficient conversion. However, there is limited research on the energy conversion in PTE detectors at micro/nano scale. In this study, we have achieved a two-order-of-magnitude enhancement in photovoltage responsivity in the self-rolled tubular tellurium (Te) photodetector with PTE effect. Under illumination, the tubular device demonstrates a maximum photovoltage responsivity of 252.13 V W−1 and a large detectivity of 1.48 × 1011 Jones. We disclose the mechanism of the PTE conversion in the tubular structure with the assistance of theoretical simulation. In addition, the device exhibits excellent performances in wide-angle and polarization-dependent detection. This work presents an approach to remarkably improve the performance of photodetector by concentrating light and corresponding heat generated, and the proposed self-rolled devices thus hold remarkable promises for next-generation on-chip photodetection.

Abstract The second-order nonlinear Hall effect (NLHE) in non-centrosymmetric materials has recently drawn intense interest, since its inherent rectification could enable various device applications such as energy harvesting and wireless charging. However, previously reported NLHE systems normally suffer from relatively small Hall voltage outputs and/or low working temperatures. In this study, we report the observation of a pronounced NLHE in tellurium (Te) thin flakes at room temperature. Benefiting from the semiconductor nature of Te, the obtained nonlinear response can be readily enhanced through electrostatic gating, leading to a second-harmonic output at 300 K up to 2.8 mV. By utilizing such a giant NLHE, we further demonstrate the potential of Te as a wireless Hall rectifier within the radiofrequency range, which is manifested by the remarkable and tunable rectification effect also at room temperature. Extrinsic scattering is then revealed to be the dominant mechanism for the NLHE in Te, with symmetry breaking on the surface playing a key role. As a simple elemental semiconductor, Te provides an appealing platform to advance our understanding of nonlinear transport in solids and to develop NLHE-based electronic devices.

Abstract The aim of this study was to develop a real-time risk prediction model for extrauterine growth retardation (EUGR). A total of 2514 very preterm infants were allocated into a training set and an external validation set. The most appropriate independent variables were screened using univariate analysis and Lasso regression with tenfold cross-validation, while the prediction model was designed using binary multivariate logistic regression. A visualization of the risk variables was created using a nomogram, while the calibration plot and receiver operating characteristic (ROC) curves were used to calibrate the prediction model. Clinical efficacy was assessed using the decision curve analysis (DCA) curves. Eight optimal predictors that namely birth weight, small for gestation age (SGA), hypertensive disease complicating pregnancy (HDCP), gestational diabetes mellitus (GDM), multiple births, cumulative duration of fasting, growth velocity and postnatal corticosteroids were introduced into the logistic regression equation to construct the EUGR prediction model. The area under the ROC curve of the training set and the external verification set was 83.1% and 84.6%, respectively. The calibration curve indicate that the model fits well. The DCA curve shows that the risk threshold for clinical application is 0–95% in both set. Introducing Birth weight, SGA, HDCP, GDM, Multiple births, Cumulative duration of fasting, Growth velocity and Postnatal corticosteroids into the nomogram increased its usefulness for predicting EUGR risk in very preterm infants.

The deep surrounding rock is usually in the true triaxial stress state, and previous constitutive models based on the understanding of uniaxial and conventional triaxial test results have difficulty characterizing the degradation and fracture process of rock ductile–brittle failure under true triaxial stress state. Therefore, this study conducted a series of true triaxial tests to obtain the understanding of the ductile–brittle behaviour of rock, and then combined the test results and the Mogi–Coulomb strength criterion, and proposed calculation methods for the elastic modulus E, cohesion c and internal friction angle φ and the evolution functions of E, c and φ of rock under true triaxial stresses. With the decreasing of the minimum principal stress σ3 or increasing of the intermediate principal stress σ2, the marble post-peak stress drop rate gradually increases, the ductility gradually weakens, and the brittleness significantly strengthens. The calculation method and evolution function of rock E, c and φ under true triaxial stress were proposed. E decreased at first and then tended to remain stable with the increasing of equivalent plastic strain increment dεp. c and φ slowly increased at first and then rapidly decreased. With a method of parameter degradation rate to realize post-peak stress drop rate to reflect the ductile–brittle characteristics, a new three-dimensional ductile–brittle deterioration mechanical model (3DBDM) was established. The proposed model can accurately characterize the influence of σ2 and σ3 on mechanical parameters, the ductile–brittle behaviour of rock under true triaxial stresses, and the asymmetric failure characteristics of surrounding rock after excavation of deep underground engineering. The proposed model can be reduced to elastic–perfectly plastic, elastic–brittle, cohesion weakening friction strengthening (CWFS), Mohr–Coulomb, and Drucker–Prager models.

BackgroundCircadian rhythms impact metabolism and the therapeutic effects of drugs. The purpose of this study was to determine the association between PER and CRY polymorphisms and caffeine citrate treatment response in infants with apnea of prematurity.MethodsA total of 221 preterm infants of gestational age 0.05). Infants in the non-response groups had a higher incidence of moderate and severe bronchopulmonary dysplasia (BPD) (P = 0.043), retinopathy of prematurity (ROP) (P = 0.035), and invasive ventilation (P = 0.027), and their duration of oxygen use (P = 0.041) was longer. When corrected for false discovery rate, the PER3 rs228669 recessive model (PFDR = 0.045) and the over-dominant model (PFDR = 0.045) were both associated with caffeine citrate treatment response. Preterm infants with the rs228669 CC genotype had a significantly lower rate of caffeine citrate non-response in the recessive model (OR = 0.28, 95% CI = 0.12–0.66), which was significantly higher in preterm infants with the CT genotype in the over-dominant model (OR = 4.18, 95% CI = 1.64–10.66). GMDR analysis revealed an interaction between the PER and CRY genes (P

Background: Allergic rhinitis (AR) is a pervasive global health issue, and currently, there is a scarcity of targeted drug therapies available. This study aims to identify potential druggable target genes for AR using Mendelian randomization (MR) analysis. Methods: MR analysis was conducted to assess the causal effect of expression quantitative trait loci (eQTL) in the blood on AR. Data on AR were collected from 2 datasets: FinnGen(R9) (11,009 cases and 359,149 controls) and UK Biobank (25,486 cases and 87,097 controls). Colocalization analysis was utilized to assess the common causal genetic variations between the identified drug target genes and AR. We also employed available genome-wide association studies (GWAS) data to gauge the impact of druggable genes on AR biomarkers and other allergic diseases. Results: This study employs MR to analyze the relationship between 3410 druggable genes and AR. After Bonferroni correction, 10 genes were found to be significantly associated with AR risk (P 0.8), highlighting their importance as potential therapeutic targets for AR. The CFL1 gene showed a causal link with levels of thymic stromal lymphopoietin (TSLP), eosinophil count, and interleukin-13 (IL-13) (P = 0.016, 7.45E-16, 0.00091, respectively). EFEMP2 was also causally related to eosinophil count, IL-13, and interleukin-17 (IL-17) (P = 0.00012, 0.00091, 0.032, respectively). PheWAS analysis revealed significant associations of CFL1 with asthma, whereas EFEMP2 showed associations with both asthma and eczema. Protein-Protein Interaction (PPI) network analysis further unveiled the direct interactions of EFEMP2 and CFL1 with proteins related to immune regulation and inflammatory responses, with 77.64% of the network consisting of direct bindings, indicating their key roles in modulating AR-related immune and inflammatory responses. Notably, there was an 8.01% significant correlation between immune-related pathways and genes involved in inflammatory responses. Conclusion: These genes present notable associations with AR biomarkers and other autoimmune diseases, offering valuable targets for developing new AR therapies.

Identifying damaged areas after earthquakes is essential for emergency rescue and rebuilding efforts. Remote sensing image change detection can facilitate these tasks by analyzing features differences between bitemporal/multi-temporal optical images. However, the existing methods still face challenges due to the unpredictable timing, locations, and magnitudes of earthquakes. Firstly, the spectral features of optical images vary over time, making it difficult to differentiate actual damage from areas appearing damaged due to spectral noise. Secondly, variations in earthquake characteristics can cause different types and scales of damage, from individual buildings in urban areas to extensive landslides in mountain areas. Overcoming these variations to establish capabilities for detecting multiple types of damage is also critical. To tackle these challenges, this study introduces a change detection network based on the decoupling of context-structural features (referred to as CSDNet). CSDNet uses a CNN-transformer architecture and decouples image features into structural and context branches through a feature difference extractor. Subsequently, the structural branch extracts reliable features through multi-scale consistency feature fusion, ensuring robust damage detection across multiple scales. Context branch facilitates long-range supervision and reduces the impacts of pseudo-changes through partial feature exchange between bitemporal images. Furthermore, to enhance CSDNet’s adaptability across different scenarios and explore CSDNet’s potential for solving multiple tasks within a unified framework, an adaptive module has been designed to dynamically fuse structural and context features. Experiments were conducted on two representative tasks: individual building damage with partial rebuilding and large-scale landslides, to investigate CSDNet’s capabilities. As a result, CSDNet achieved F1-Scores of 92.2% and 90.2% on the two tasks respectively, indicating the effectiveness of CSDNet.

The far-field microdynamic disturbance caused by the excavation of deep mineral resources and underground engineering can induce surrounding rock damage in high-stress conditions and even lead to disasters. However, the mechanical properties and damage/fracture evolution mechanisms of deep rock induced by microdynamic disturbance under three-dimensional stress states are unclear. Therefore, a true triaxial multilevel disturbance test method is proposed, which can completely simulate natural geostress, excavation stress redistribution (such as stress unloading, concentration and rotation), and subsequently the microdynamic disturbance triggering damaged rock failure. Based on a dynamic true triaxial test platform, true triaxial microdynamic disturbance tests under different frequency and amplitudes were carried out on monzogabbro. The results show that increasing amplitude or decreasing frequency diminishes the failure strength of monzogabbro. Deformation modulus gradually decreases during disturbance failure. As frequency and amplitude increase, the degradation rate of deformation modulus decreases slightly, disturbance dissipated energy increases significantly, and disturbance deformation anisotropy strengthens obviously. A damage model has been proposed to quantitatively characterize the disturbance-induced damage evolution at different frequency and amplitude under true triaxial stress. Before disturbance failure, the micro-tensile crack mechanism is dominant, and the micro-shear crack mechanism increases significantly at failure. With the increase of amplitude and frequency, the micro-shear crack mechanism increases. When approaching disturbance failure, the acoustic emission fractal dimension changes from a stable value to local large oscillation, and finally increases sharply to a high value at failure. Finally, the disturbance-induced failure mechanism of surrounding rock in deep engineering is clearly elucidated.

Abstract Background Necrotizing enterocolitis (NEC) is a serious gastrointestinal disease, primarily affects preterm newborns and occurs after 7 days of life (late-onset NEC, LO-NEC). Unfortunately, over the past several decades, not much progress has been made in its treatment or prevention. This study aimed to analyze the risk factors for LO-NEC, and the impact of LO-NEC on short-term outcomes in very preterm infants (VPIs) with a focus on nutrition and different onset times. Method Clinical data of VPIs were retrospectively collected from 28 hospitals in seven different regions of China from September 2019 to December 2020. A total of 2509 enrolled VPIs were divided into 2 groups: the LO-NEC group and non-LO-NEC group. The LO-NEC group was divided into 2 subgroups based on the onset time: LO-NEC occurring between 8 ~ 14d group and LO-NEC occurring after 14d group. Clinical characteristics, nutritional status, and the short-term clinical outcomes were analyzed and compared among these groups. Results Compared with the non-LO-NEC group, the LO-NEC group had a higher proportion of anemia, blood transfusion, and invasive mechanical ventilation (IMV) treatments before NEC; the LO-NEC group infants had a longer fasting time, required longer duration to achieve the target total caloric intake (110 kcal/kg) and regain birthweight, and showed slower weight growth velocity; the cumulative dose of the medium-chain and long-chain triglyceride (MCT/LCT) emulsion intake in the first week after birth was higher and breastfeeding rate was lower. Additionally, similar results including a higher proportion of IMV, lower breastfeeding rate, more MCT/LCT emulsion intake, slower growth velocity were also found in the LO-NEC group occurring between 8 ~ 14d when compared to the LO-NEC group occurring after 14 d (all (P

Abstract Background The relationship between integrated lifestyles, mental status and their impact on overall well-being has attracted considerable attention. This study aimed to evaluate the association between lifestyle factors, depression and diabetic retinopathy (DR) in adults aged 18–64 years. Methods A cohort of 3482 participants diagnosed with diabetes was drawn from the National Health and Nutrition Examination Survey (NHANES) spanning the years 1999–2018. DR was defined based on self-reported diabetic retinopathy diagnoses by professional physicians, relying on Diabetes Interview Questionnaires. Subgroup analysis was employed to assess lifestyle and psychological factors between participants with DR and those without, both overall and stratified by diabetic duration. Continuous variables were analyzed using the student’s t test, while weighted Rao-Scott χ2 test were employed for categorical variables to compare characteristics among the groups. Results Of the 3482 participants, 767 were diagnosed with diabetic retinopathy, yielding a weighted DR prevalence of 20.8%. Patients with DR exhibited a higher prevalence of heavy drinking, depression, sleep deprivation, and insufficient physical activity compared to those without DR. Furthermore, multivariable logistic regression analysis revealed that sleeping less than 5 h (OR = 3.18, 95%CI: 2.04–4.95, p

Mechanical excavation, blasting, adjacent rockburst and fracture slip that occur during mining excavation impose dynamic loads on the rock mass, leading to further fracture of damaged surrounding rock in three-dimensional high-stress and even causing disasters. Therefore, a novel complex true triaxial static-dynamic combined loading method reflecting underground excavation damage and then frequent intermittent disturbance failure is proposed. True triaxial static compression and intermittent disturbance tests are carried out on monzogabbro. The effects of intermediate principal stress and amplitude on the strength characteristics, deformation characteristics, failure characteristics, and precursors of monzogabbro are analyzed, intermediate principal stress and amplitude increase monzogabbro strength and tensile fracture mechanism. Rapid increases in microseismic parameters during rock loading can be precursors for intermittent rock disturbance. Based on the experimental result, the new damage fractional elements and method with considering crack initiation stress and crack unstable stress as initiation and acceleration condition of intermittent disturbance irreversible deformation are proposed. A novel three-dimensional disturbance fractional deterioration model considering the intermediate principal stress effect and intermittent disturbance damage effect is established, and the model predicted results align well with the experimental results. The sensitivity of stress states and model parameters is further explored, and the intermittent disturbance behaviors at different f are predicted. This study provides valuable theoretical bases for the stability analysis of deep mining engineering under dynamic loads.

Background Diabetic vascular complications share common pathophysiological mechanisms, but the relationship between diabetes‐related macrovascular complications (MacroVCs) and incident diabetic microvascular complications remains unclear. We aimed to investigate the impact of MacroVCs on the risk of microvascular complications. Methods and Results There were 1518 participants with type 1 diabetes (T1D) and 20 802 participants with type 2 diabetes from the UK Biobank included in this longitudinal cohort study. MacroVCs were defined by the presence of macrovascular diseases diagnosed after diabetes at recruitment, including coronary heart disease, peripheral artery disease, stroke, and ≥2 MacroVCs. The primary outcome was incident microvascular complications, a composite of diabetic retinopathy, diabetic kidney disease, and diabetic neuropathy. During a median (interquartile range) follow‐up of 11.61 (5.84–13.12) years and 12.2 (9.50–13.18) years, 596 (39.3%) and 4113 (19.8%) participants developed a primary outcome in T1D and type 2 diabetes, respectively. After full adjustment for conventional risk factors, Cox regression models showed significant associations between individual as well as cumulative MacroVCs and the primary outcome, except for coronary heart disease in T1D (T1D: diabetes coronary heart disease: 1.25 [0.98–1.60]; diabetes peripheral artery disease: 3.00 [1.86–4.84]; diabetes stroke: 1.71 [1.08–2.72]; ≥2: 2.57 [1.66–3.99]; type 2 diabetes: diabetes coronary heart disease: 1.59 [1.38–1.82]; diabetes peripheral artery disease: 1.60 [1.01–2.54]; diabetes stroke: 1.50 [1.13–1.99]; ≥2: 2.66 [1.92–3.68]). Subgroup analysis showed that strict glycemic (glycated hemoglobin

Ischemia/reperfusion (I/R) injury following myocardial infarction is a major cause of cardiomyocyte death and impaired cardiac function. Although clinical data show that metformin is effective in repairing cardiac I/R injury, its efficacy is hindered by non-specific targeting during administration, a short half-life, frequent dosing, and potential adverse effects on the liver and kidneys. In recent years, injectable hydrogels have shown substantial potential in overcoming drug delivery challenges and treating myocardial infarction. To this end, we developed a natural polymer hydrogel system comprising methacryloylated chitosan and methacryloylated gelatin modified with polyaniline conductive derivatives. In vitro studies demonstrated that the optimized hydrogel exhibited excellent injectability, biocompatibility, biodegradability, suitable mechanical properties, and electrical conductivity. Incorporating metformin into this hydrogel significantly extended the administration cycle, mitigated mitochondrial damage, decreased abnormal ROS production, and enhanced cardiomyocyte function. Animal experiments indicated that the metformin/hydrogel system reduced arrhythmia incidence, infarct size, and improved cardiac mitochondrial and overall cardiac function, promoting myocardial repair in I/R injury. Overall, the metformin-loaded conductive hydrogel system effectively mitigates mitochondrial oxidative damage and improves cardiomyocyte function, thereby offering a theoretical foundation for the potential application of metformin in cardioprotection.

Objectives This study aims to explore the lived experience of young adults with life-limiting conditions (YALLC) and how they perceive and navigate adulthood, to identify challenges and opportunities for improved care and support.Methods A qualitative study using interpretative phenomenological analysis to understand how young adults who survived childhood serious illness make sense of current circumstances. Seven YALLC with different diagnoses ranging from 19 to 39 years were recruited through purposive sampling in a specialist paediatric palliative care service/adult hospice. In-depth, semistructured interviews were conducted, and verbatim transcripts analysed iteratively.Results Four major themes emerged: (1) living with limitations and in limbo—compressed timelines and confusion, triggered by dissonance between age-expected versus developmentally appropriate aspirations and goals; (2) experiencing identity crises, confronting existential concerns and chasing the elusive goal of enduring connection—struggle between public versus self-identities, including issues around self-worth and purpose; (3) striving for autonomy while tolerating interdependence/codependence—tensions arising from their desire for independence against the need to rely on others and (4) accepting and appreciating LLC as integral to one’s existence—demonstrating adaptability, creativity and resilience. Themes highlight a complex interplay of push-pull factors encountered by YALLC at multiple levels as they strive for a normative or negotiated life course.Conclusion YALLC face an intricate web of physical, psychoemotional, social and financial challenges compounded by underlying, persistent or progressive illnesses. Contextual understanding and identified gaps from this study will guide affirmative strategies to improve quality of life among a growing cohort.

Registration of multi-modal remote sensing images (MRSI) is crucial for unlocking the full potential of heterogeneous remote sensing imagery. However, achieving accurate registration among MRSI is challenging due to the trade-off between geometric invariance and matching accuracy, caused by differences in signal-to-noise ratio and nonlinear radiometric distortion (NRD) arising from varying imaging mechanisms. To tackle the challenge, this paper proposes a lightweight and hybrid feature-guided registration algorithm for MRSI called the hybrid registration algorithm based on multi-dimensional oriented self-similarity features (MOSS). MOSS leverages the advantages of multi-dimensional oriented self-similarity features to progressively enhance registration performance. In the hybrid feature coarse matching stage, oriented self-similarity features are extracted from MRSI, and their directional information is utilized for feature description to estimate the initial affine transformation. The fine matching under multi-dimensional oriented self-similarity features stage takes the outputs of the coarse matching stage to perform a template-like matching process. To evaluate the performance of MOSS, comprehensive experiments are conducted using six different combinations of MRSI, and seven state-of-the-art registration algorithms are selected for comparison. The experimental results demonstrate that MOSS outperforms the compared methods, with the number of correct matches being at least about 1.6 times higher than the comparison methods. Moreover, MOSS exhibits the lowest root mean square error across all experiments, with an average RMSE of 1.86 pixels, achieving an RMSE within 2 pixels. This highlights its effectiveness in achieving precise alignment and robust registration of MRSI.

Cancer remains a significant global health issue, despite advances in screening and treatment. While existing tumor treatment protocols such as surgery, chemotherapy, radiotherapy, targeted therapy, and immunotherapy have proven effective in enhancing the prognosis for some patients, these treatments do not benefit all patients. Consequently, certain types of cancer continue to exhibit a relatively low 5-year survival rate. Therefore, the pursuit of novel tumor intervention strategies may help improve the current effectiveness of tumor treatment. Over the past few decades, numerous species of protozoa and their components have exhibited anti-tumor potential via immune and non-immune mechanisms. This discovery introduces a new research direction for the development of new and effective cancer treatments. Through in vitro experiments and studies involving tumor-bearing mice, the anti-tumor ability of Toxoplasma gondii, Plasmodium, Trypanosoma cruzi, and other protozoa have unveiled diverse mechanisms by which protozoa combat cancer, demonstrating encouraging prospects for their application. In this review, we summarize the anti-tumor ability and anti-tumor mechanisms of various protozoa and explore the potential for their clinical development and application.

Abstract Zinc‐bromine batteries (ZBBs) have recently gained significant attention as inexpensive and safer alternatives to potentially flammable lithium‐ion batteries. Zn metal is relatively stable in aqueous electrolytes, making ZBBs safer and easier to handle. However, Zn metal anodes are still affected by several issues, including dendrite growth, Zn dissolution, and the crossover of Br species from cathodes to corrode anodes, resulting in self‐discharge and fast performance fading. Similarly, Br2 undergoes sluggish redox reactions on cathodes, which brings several issues such as poor reaction kinetics, the highly corrosive nature of Br species leading to corrosion of separators and poisoning of anodes, and the volatile nature of Br species causing increased internal pressures, etc. These issues are compounded in flowless ZBB configuration as no fresh electrolyte is available to provide extra/fresh reaction species. In this review, the factors controlling the performance of ZBBs in flow and flowless configurations are thoroughly reviewed, along with the status of ZBBs in the commercial sector. The review also summarizes various novel methodologies to mitigate these challenges and presents research areas for future studies. In summary, this review will offer a perspective on the historical evolution, recent advancements, and prospects of ZBBs.

Intervertebral disc (IVD) degeneration (IDD) is a worldwide spinal degenerative disease. Low back pain (LBP) is frequently caused by a variety of conditions brought on by IDD, including IVD herniation and spinal stenosis, etc. These conditions bring substantial physical and psychological pressure and economic burden to patients. IDD is closely tied with the structural or functional changes of the IVD tissue and can be caused by various complex factors like senescence, genetics, and trauma. The IVD dysfunction and structural changes can result from extracellular matrix (ECM) degradation, differentiation, inflammation, oxidative stress, mechanical stress, and senescence of IVD cells. At present, the treatment of IDD is basically to alleviate the symptoms, but not from the pathophysiological changes of IVD. Interestingly, the p38 mitogen-activated protein kinase (p38 MAPK) signaling pathway is involved in many processes of IDD, including inflammation, ECM degradation, apoptosis, senescence, proliferation, oxidative stress, and autophagy. These activities in degenerated IVD tissue are closely relevant to the development trend of IDD. Hence, the p38 MAPK signaling pathway may be a fitting curative target for IDD. In order to better understand the pathophysiological alterations of the intervertebral disc tissue during IDD and offer potential paths for targeted treatments for intervertebral disc degeneration, this article reviews the purpose of the p38 MAPK signaling pathway in IDD.

Summary: Background: The pathology of keloid and especially the roles of bacteria on it were not well understood. Methods: In this study, multi-omics analyses including microbiome, metaproteomics, metabolomic, single-cell transcriptome and cell-derived xenograft (CDX) mice model were used to explore the roles of bacteria on keloid disease. Findings: We found that the types of bacteria are significantly different between keloid and healthy skin. The 16S rRNA sequencing and metaproteomics showed that more catalase (CAT) negative bacteria, Clostridium and Roseburia existed in keloid compared with the adjacent healthy skin. In addition, protein mass spectrometry shows that CAT is one of the differentially expressed proteins (DEPs). Overexpression of CAT inhibited the proliferation, migration and invasion of keloid fibroblasts, and these characteristics were opposite when CAT was knocked down. Furthermore, the CDX model showed that Clostridium butyricum promote the growth of patient's keloid fibroblasts in BALB/c female nude mice, while CAT positive bacteria Bacillus subtilis inhibited it. Single-cell RNA sequencing verified that oxidative stress was up-regulated and CAT was down-regulated in mesenchymal-like fibroblasts of keloid. Interpretation: In conclusion, our findings suggest that bacteria and CAT contribute to keloid disease. Funding: A full list of funding bodies that contributed to this study can be found in the Acknowledgements section.

Abstract Background To analyze the real-world growth pattern of very premature infants (VPI) with small for gestational age (SGA) after birth by using the ΔZ value of weight at discharge. Methods The clinical data were collected from 28 hospitals in China from September 2019 to December 2020. They were divided into the EUGR(Extrauterine Growth Restriction) and the non-EUGR group according to the criterion of ΔZ value of weight at discharge

Abstract In this paper, we propose a scheme for autonomous exploration in unknown environments using a mobile robot. To reduce the storage consumption and speed up the search of frontiers, we propose a wave-features-based rapidly exploring random tree method, which can inhibit or promote the growth of sampling trees regionally. Then, we prune the frontiers with mean shift algorithm and use the pruned frontiers for decision-making. To avoid the repeated exploration, we develop a decision making method with consistency assessment, in which the status of the robot and frontiers are explicitly encoded and modeled as a fixed start open traveling salesman problem (FSOTSP). Furthermore, a re-decision mechanism is build to reduce the extra computing cost. Simulations and real-world experiments show the significant improvement of the proposed scheme.

Since the surrounding rocks of underground tunnels are frequently suffered from the dynamic disturbance of mechanical percussion drilling and explosive blasting, it is significantly meaningful to investigate the mechanical properties and failure behaviors of rock material with a tunnel-shaped opening under dynamic loads. In this work, seven groups of prismatic samples, including the intact samples and the samples with a circular opening of three kinds of diameters, a square opening, a horseshoe-shaped opening and a D-shaped opening, were prepared for dynamic compressive loading. The results show that the prismatic specimens satisfy the stress uniformity condition in impact tests using SHPB testing system with a bar diameter of 50 mm. The weakening effects of the existed openings on the dynamic compressive strength, elastic modulus and peak strain of rocks are closely associated with the size and shape of opening and the loading direction. Based on the energy parameters of the samples, the dissipated energy density of each group of samples can be solved. The failure degree of the samples characterized by dissipated energy density and fractal dimension are in good agreement. Besides, the failure mode of the intact specimen belongs to splitting tensile failure, while that of the pre-holed specimens can be classified as shear-dominated failure due to the coalescence of the openings and the shear cracks occurring along the diagonals of the specimens. The test results provide some insights into the mechanical behavior of rock materials under dynamic loads and lay an important theoretical foundation for support design and rock disaster prevention of underground tunnel.

Liquid hydrogen is one of the high-quality energy carriers, but a large leak of liquid hydrogen can pose significant safety risks. Understanding its diffusion law after accidental leakage is an important issue for the safe utilization of hydrogen energy. In this paper, a series of open-space large-volume liquid hydrogen release experiments are performed to observe the evolution of visible clouds during the release, and an array of hydrogen concentration sensors is set up to monitor the fluctuation in hydrogen concentration at different locations. Based on the experimental conditions, the diffusion of hydrogen clouds in the atmosphere under different release hole diameters and different ground materials is compared. The results show that with the release of liquid hydrogen, the white visible cloud formed by air condensation or solidification is generated rapidly and spread widely, and the visible cloud is most obvious near the ground. With the termination of liquid hydrogen release, solid air is deposited on the ground, and the visible clouds gradually shrink from the far field to the release source. Hydrogen concentration fluctuations in the far field in the case of the cobblestone ground are more dependent on spontaneous diffusion by the hydrogen concentration gradient. In addition, compared with the concrete ground, the cobblestone ground has greater resistance to liquid hydrogen extension; the diffusion of hydrogen clouds to the far field lags. The rapid increase stage of hydrogen concentration at N8 in Test 7 lags about 3 s behind N12 in Test 6, N3 lags about 7.5 s behind N1, and N16 lags about 8.25 s behind N14. The near-source space is prone to high-concentration hydrogen clouds. The duration of the high-concentration hydrogen cloud at N12 is about 15 s, which is twice as long as the duration at N8, increasing the safety risk of the near-source space.

A new method based on a digital twin is proposed for fault diagnosis, in order to compensate for the shortcomings of the existing methods for fault diagnosis modeling, including the single fault type, low similarity, and poor visual effect of state monitoring. First, a fault diagnosis test platform is established to analyze faults under constant and variable speed conditions. Then, the obtained data are integrated into the Unity3D platform to realize online diagnosis and updated with real-time working status data. Finally, an industrial test of the digital twin model is conducted, allowing for its comparison with other advanced methods in order to verify its accuracy and application feasibility. It was found that the accuracy of the proposed method for the entire reducer was 99.5%, higher than that of other methods based on individual components (e.g., 93.5% for bearings, 96.3% for gear shafts, and 92.6% for shells).

Following a loss of coolant accident (LOCA), prestressing concrete containment vessels (PCCVs) may experience high thermal load as well as internal pressure. The high temperature stress would increase the risk of premature damage to the containment, which reduces the safety margin during the increasing internal pressure. However, current investigations cannot clearly address the issues of thermal-pressure coupling effect on damage propagation and thus safety of the containment. Thus, this paper offers three simple and powerful damage parameters to differentiate the severity of damage of the containment. Moreover, despite of the temperature action severely threatening the pressure performance of the containment, the research regarding the improvement of the resistant performance of the containment is quite scarce. Therefore, in this paper, a comprehensive comparison of damage propagation and mechanism between conventional and fiber-reinforced concrete (FRC) containments is performed. The effects of fiber characteristics parameters on damage propagation of structures following the LOCA are also specifically revealed. It is found that the proposed damage indices can properly indicate state of damage in the containment body and the addition of fiber can be used to obviously mitigate the damage propagation in PCCV considering the thermal-pressure coupling.

Abstract Background The thermotolerant yeast is beneficial in terms of efficiency improvement of processes and reduction of costs, while Saccharomyces cerevisiae does not efficiently grow and ferment at high-temperature conditions. The sterol composition alteration from ergosterol to fecosterol in the cell membrane of S. cerevisiae affects the thermotolerant capability. Results In this study, S. cerevisiae ERG5, ERG4, and ERG3 were knocked out using the CRISPR–Cas9 approach to impact the gene expression involved in ergosterol synthesis. The highest thermotolerant strain was S. cerevisiae ERG5ΔERG4ΔERG3Δ, which produced 22.1 g/L ethanol at 37 °C using the initial glucose concentration of 50 g/L with an increase by 9.4% compared with the wild type (20.2 g/L). The ethanol concentration of 9.4 g/L was produced at 42 ℃, which was 2.85-fold of the wild-type strain (3.3 g/L). The molecular mechanism of engineered S. cerevisiae at the RNA level was analyzed using the transcriptomics method. The simultaneous deletion of S. cerevisiae ERG5, ERG4, and ERG3 caused 278 up-regulated genes and 1892 down-regulated genes in comparison with the wild-type strain. KEGG pathway analysis indicated that the up-regulated genes relevant to ergosterol metabolism were ERG1, ERG11, and ERG5, while the down-regulated genes were ERG9 and ERG26. S. cerevisiae ERG5ΔERG4ΔERG3Δ produced 41.6 g/L of ethanol at 37 °C with 107.7 g/L of corn liquefied glucose as carbon source. Conclusion Simultaneous deletion of ERG5, ERG4, and ERG3 resulted in the thermotolerance improvement of S. cerevisiae ERG5ΔERG4ΔERG3Δ with cell viability improvement by 1.19-fold at 42 °C via modification of steroid metabolic pathway. S. cerevisiae ERG5ΔERG4ΔERG3Δ could effectively produce ethanol at 37 °C using corn liquefied glucose as carbon source. Therefore, S. cerevisiae ERG5ΔERG4ΔERG3Δ had potential in ethanol production at a large scale under supra-optimal temperature.

Rechargeable aqueous zinc-ion batteries (AZIBs) have attracted interest in serving as large-scale electrochemical energy storage devices because of their high energy storage capacity, low cost, outstanding operational safety, and superior environmental friendliness. In the past two decades, enormous efforts have been devoted to all components of AZIBs, including cathode materials, Zn anodes, and electrolytes. This brief review first outlines the challenges of realizing practical ZIBs for cathodes, anodes, and electrolytes. Then, we focus on recent representative and promising electrolyte addictive studies. We further present our perspectives on critical issues to be addressed to enable practical AZIBs.

Abstract With rapid developments in the field of very large‐scale integrated circuits, heat dissipation has emerged as a significant factor that restricts the high‐density integration of chips. Due to their high thermal conductivity and low thermal expansion coefficient, diamond/Cu composites have attracted considerable attention as a promising thermal management material. In this study, a surface tungsten carbide gradient layer coating of diamond particles has been realized using comprehensive magnetron sputtering technology and a heat treatment process. Diamond/Cu composites were prepared using high‐temperature and high‐pressure technology. The results show that, by adjusting the heat treatment process, tungsten carbide and di‐tungsten carbide are generated by an in situ reaction at the tungsten–diamond interface, and W–WC–W2C gradient layer‐coated diamond particles were obtained. The diamond/Cu composites were sintered by high‐temperature and high‐pressure technology, and the density of surface‐modified diamond/Cu composites was less than 4 g cm−3. The W–WC–W2C@diamond/Cu composites have a thermal diffusivity as high as 331 mm2 s−1, and their thermal expansion coefficient is as low as 1.76 × 10−6 K−1. The interface coherent structure of the gradient layer‐coated diamond/copper composite can effectively improve the interface heat transport efficiency.

Particulate organic carbon (POC) is an essential component of the carbon pump within marine organisms. Exploring estimation methods for POC holds substantial significance for understanding the marine carbon cycle. In this study, we investigated the spatial heterogeneity of 30 factors and POC concentrations using geodetector to account for nonlinearity, diversity, and complexity. Ultimately, 20 factors including sea surface temperature, sea surface salinity, and chlorophyll-a were selected as modeling variables. Six machine learning models—backpropagation neural network, convolutional neural network, attention-based neural network, random forest (RF), adaptive boosting, and extreme gradient boosting were used to compare their performance. The results indicate that among the six machine learning algorithms, RF exhibits the strongest performance, with a root mean square error of 0.11 [log(mg/m3)] and an average percentage deviation of 2.73%. Global annual average sea surface POC concentrations were estimated for 2007 and compared to NASA’s POC product. The outcomes indicate that the RF model-based estimation method displays enhanced accuracy in estimating POC concentrations within intricate coastal environments, while the backpropagation neural network performed better in estimating POC concentrations in open ocean areas. Leveraging the RF model, global sea surface POC concentrations were estimated for the years 2007 through 2016, enabling a spatiotemporal analysis. The analysis unveils heightened POC concentrations in coastal regions and lower levels in open ocean areas. Furthermore, POC concentrations were greater in high-latitude regions compared to mid and low latitude counterparts. In conclusion, the global sea surface POC product in this study exhibits heightened spatial resolution and improved data completeness in contrast to other products. It enhances the accuracy of conventional POC estimation methods, particularly within coastal regions.

PurposeTo investigate the prevalence of diabetic retinopathy (DR) and vision-threatening DR (VTDR) in patients with type 2 diabetes mellitus (T2DM) stratified by the duration of diabetes and to identify the clinical variations and risk factors for VTDR occurring at different stages of T2DM.MethodsThis was a retrospective comparative study. Patients were divided into short- (≤3 years), intermediate- (3–7 years), and long-duration (>7 years) groups. All patients were followed-up for DR and VTDR development. Risk factors were explored using logistic regression analysis.ResultsA total of,2961 patients were included; among them, 1,036 (35.0%) patients developed DR, and 293 (9.9%) had VTDR. The frequency of VTDR in patients who developed DR in the short-duration group was significantly higher than that in the intermediate-duration group (25.7% vs. 15.0%; p = 0.019), but comparable with that of the long-duration group (25.7% vs. 31.8%; p = 0.138). Patients who developed VTDR within the first 3 years of T2DM were more likely to have a family history of diabetes (p = 0.024), had higher glycated hemoglobin (p = 0.025), were males (p = 0.042), and were notably older at the onset of diabetes (p

Endothelial dysfunction is a critical and initiating factor of the vascular complications of diabetes. Inflammation plays an important role in endothelial dysfunction regulated by epigenetic modifications. N6-methyladenosine (m6A) is one of the most prevalent epigenetic modifications in eukaryotic cells. In this research, we identified an m6A demethylase, fat mass and obesity-associated protein (FTO), as an essential epitranscriptomic regulator in diabetes-induced vascular endothelial dysfunction. We showed that enhanced FTO reduced the global level of m6A in hyperglycemia. FTO knockdown in endothelial cells (ECs) resulted in less inflammation and compromised ability of migration and tube formation. Compared with EC Ftofl/fl diabetic mice, EC-specific Fto-deficient (EC FtoΔ/Δ) diabetic mice displayed less retinal vascular leakage and acellular capillary formation. Furthermore, methylated RNA immunoprecipitation sequencing (MeRIP-Seq) combined with RNA-Seq indicated that Tnip1 served as a downstream target of FTO. Luciferase activity assays and RNA pull-down demonstrated that FTO repressed TNIP1 mRNA expression by erasing its m6A methylation. In addition, TNIP1 depletion activated NF-κB and other inflammatory factors, which aggravated retinal vascular leakage and acellular capillary formation, while sustained expression of Tnip1 by intravitreal injection of adeno-associated virus alleviated endothelial impairments. These findings suggest that the FTO-TNIP1-NF-κB network provides potential targets to treat diabetic vascular complications.

Excellent biocompatibility, mechanical properties, chemical stability, and elastic modulus close to bone tissue make polyetheretherketone (PEEK) a promising orthopedic implant material. However, biological inertness has hindered the clinical applications of PEEK. The immune responses and inflammatory reactions after implantation would interfere with the osteogenic process. Eventually, the proliferation of fibrous tissue and the formation of fibrous capsules would result in a loose connection between PEEK and bone, leading to implantation failure. Previous studies focused on improving the osteogenic properties and antibacterial ability of PEEK with various modification techniques. However, few studies have been conducted on the immunomodulatory capacity of PEEK. New clinical applications and advances in processing technology, research, and reports on the immunomodulatory capacity of PEEK have received increasing attention in recent years. Researchers have designed numerous modification techniques, including drug delivery systems, surface chemical modifications, and surface porous treatments, to modulate the post-implantation immune response to address the regulatory factors of the mechanism. These studies provide essential ideas and technical preconditions for the development and research of the next generation of PEEK biological implant materials. This paper summarizes the mechanism by which the immune response after PEEK implantation leads to fibrous capsule formation; it also focuses on modification techniques to improve the anti-inflammatory and immunomodulatory abilities of PEEK. We also discuss the limitations of the existing modification techniques and present the corresponding future perspectives.

Highlights The CuaAgm1Bim2In/CuI bilayer films are prepared simultaneously in situ by a one-step low-temperature gas-solid phase diffusion induced elemental reaction without spin coating. A new type of CuaAgm1Bim2In photovoltaic material was originally designed to reduce the bandgap of this class of materials from 2.06 to 1.78 eV by breaking the restriction of double perovskite structure with a ratio of Ag:Bi = 1:1. The power conversion efficiency (PCE) of solar cell with a structure of FTO/TiO2/CuaAgm1Bim2In/CuI/carbon reached 2.76%, which is the highest PCE for CuaAgm1Bim2In absorbers.

Abstract Background To investigate the prevalence and predictors of retinal breaks reopening after vitrectomy with air tamponade in rhegmatogenous retinal detachment (RRD). Methods A retrospective cohort study was conducted in Shanghai General Hospital. Chart review was performed among 1715 patients with primary RRD who received pars plana vitrectomy (PPV) with air tamponade as initial management. Patients were followed up for recurrence. The clinical features of the eyes with retinal breaks reopening were recorded. Logistic regression was constructed to investigate the predictors for breaks reopening. Results A total of 137 (7.99%) patients had recurrent retinal detachment after PPV with air tamponade. The causes of surgery failure included new or missed retinal breaks (48.9%), reopening of original tears (43.8%) and proliferative vitreoretinopathy (7.3%). The median time to recurrence for the patients with breaks reopening was 18.0 days. Multivariate logistic regression indicated that the presence of retinal break(s) ≥ 1.5 disc diameters (DD) (odds ratio [OR]: 2.68, 95% confidence interval [CI]: 11.04–6.92, P = 0.041), and shorter period for restricted activities (OR: 0.94, 95% CI: 0.89–0.99, P = 0.020) were the independent predictors for breaks reopening. Conclusions Breaks reopening is an important cause for retinal redetachment after PPV with air tamponade in primary RRD. The first 2–4 weeks after surgery is the “risk period” for breaks reopening. Special attention should be paid for patients with retinal break(s) ≥ 1.5 DD. A prolonged period for restricted activities is recommended.

Deep convolutional neural networks have gotten a lot of press in the last several years, especially in domains like computer vision and remote sensing (RS). However, achieving superior performance with deep networks highly depends on a massive number of accurately labeled training samples. In real-world applications, gathering a large number of labeled samples is time consuming and labor intensive, especially for pixel-level data annotation. This dearth of labels in land-cover classification is especially pressing in the RS domain because high-precision high-quality labeled samples are extremely difficult to acquire, but unlabeled data are readily available. In this study, we offer a new semisupervised deep semantic labeling framework for the semantic segmentation of high-resolution RS images to take advantage of the limited amount of labeled examples and numerous unlabeled samples. Our model uses transformation consistency regularization to encourage consistent network predictions under different random transformations or perturbations. We try three different transforms to compute the consistency loss and analyze their performance. Then, we present a deep semisupervised semantic labeling technique by using a hybrid transformation consistency regularization. A weighted sum of losses, which contains a supervised term computed on labeled samples and an unsupervised regularization term computed on unlabeled data, may be used to update the network parameters in our technique. Our comprehensive experiments on two RS datasets confirmed that the suggested approach utilized latent information from unlabeled samples to obtain more precise predictions and outperformed existing semisupervised algorithms in terms of performance. Our experiments further demonstrated that our semisupervised semantic labeling strategy has the potential to partially tackle the problem of limited labeled samples for high-resolution RS image land-cover segmentation.

Abstract Background Infants with rule-out infections are responsible for the majority of empirical antibiotics treatment (EAT) in neonatal intensive care units (NICUs), particularly very preterm infants (VPIs). Antibiotic overuse has been linked to adverse outcomes. There is a paucity of data on the association between EAT and clinical outcomes (containing the nutritional outcomes) of VPIs without infection-related morbidities. Methods Clinical data of VPIs admitted in 28 hospitals in 20 provinces of China from September 2019 to December 2020 were collected. EAT of VPIs was calculated as the number of days with initial usage in the first week after birth, and then categorized into 3 groups (antibiotic exposure: none, 1-4 days, and > 4 days). Clinical characteristics, nutritional status , and the short-term clinical outcomes among 3 groups were compared and analyzed. Results In total, 1834 VPIs without infection-related morbidities in the first postnatal week were enrolled, including 152 cases (8.3%) without antibiotics, 374 cases (20.4%) with EAT ≤4 days and 1308 cases (71.3%) with EAT > 4 days. After adjusting for the confounding variables, longer duration of EAT was associated with decreased weight growth velocity and increased duration of reach of full enteral feeding in EAT > 4 days group (aβ: -4.83, 95% CI: − 6.12 ~ − 3.53; aβ: 2.77, 95% CI: 0.25 ~ 5.87, respectively) than those receiving no antibiotics. In addition, the risk of feeding intolerance (FI) in EAT > 4 days group was 4 times higher than that in non-antibiotic group (aOR: 4.14, 95%CI: 1.49 ~ 13.56) and 1.8 times higher than that in EAT ≤4 days group (aOR: 1.82, 95%CI: 1.08 ~ 3.17). EAT > 4 days was also a risk factor for greater than or equal to stage 2 necrotizing enterocolitis (NEC) than those who did not receive antibiotics (aOR: 7.68, 95%CI: 1.14 ~ 54.75) and those who received EAT ≤4 days antibiotics (aOR: 5.42, 95%CI: 1.94 ~ 14.80). Conclusions The EAT rate among uninfected VPIs was high in Chinese NICUs. Prolonged antibiotic exposure was associated with decreased weight growth velocity, longer duration of reach of full enteral feeding, increased risk of feeding intolerance and NEC ≥ stage 2. Future stewardship interventions to reduce EAT use should be designed and implemented.

Abstract Background Mass screening and treatment (MSAT) for malaria elimination lacks an ideal diagnostic tool to allow sensitive and affordable test of the target population in the field. This study evaluated whether Capture and Ligation Probe-PCR (CLIP-PCR) could be used in a field MSAT in Laiza City, Myanmar. Methods On day 0, two dried blood spots were collected from each participant. On day 1, all samples were screened for Plasmodium in a 20 m2 laboratory with workbench, a biosafety cabinet, a refrigerator, a benchtop shaking incubator and a qPCR machine, by four technicians using CLIP-PCR with sample pooling, at a health clinic of the Chinese bordering town of Nabang. On day 2, all positives were followed up and treated. Results Of 15,038 persons (65% of the total population) screened, 204 (1.36%) were CLIP-PCR positives. Among them, 188, 14, and 2 were infected with Plasmodium vivax, Plasmodium falciparum, and P. vivax/P. falciparum mix, respectively. The testing capacity was 538 persons/day, with a cost of US$0.92 /person. The proportion of submicroscopic infection was 64.7%. All positive individuals received treatment within 72 h after blood collection. Conclusion Using CLIP-PCR in MSAT in low transmission settings can support the malaria elimination efforts in the China-Myanmar border region.

Introduction Benign gastric outlet obstruction (BGOO) severely impacts the quality of life of patients. The main treatment methods for BGOO include surgery and endoscopy, but both have significant drawbacks. Therefore, this study aims to explore the safety and efficacy of a new technique, to develop a new option for treating BGOO.Methods and analysis This is an ongoing prospective, single-centre, single-blind randomised controlled trial. The study will be conducted from January 2022 to December 2025, and 50 patients will be enrolled. The participants will be randomly assigned in a 1:1 ratio to either the experimental (stomach-partitioning gastrojejunostomy with distal selective vagotomy) or control groups (conventional gastrojejunostomy with highly selective vagotomy). We will collect baseline characteristics, laboratory tests, auxiliary examinations, operation, postoperative conditions and follow-up data. Follow-up will last for 3 years. The main outcome is the incidence of delayed gastric emptying within 30 days after surgery. Secondary outcomes include the efficacy indicator (consisting of serum gastrin level, pepsinogen level, 13C breath test, gastrointestinal quality of life index, operation time, blood loss and postoperative recovery), a safety evaluation index (consisting of complications and mortality within 30 days after surgery) and follow-up data (consisting of the incidence of primary ulcer progression in 3 years after surgery, and the gastroscopy results in 1 and 3 years after surgery).Ethics and dissemination This study was approved by the Ethics Committee of Beijing Friendship Hospital, Capital Medical University (no. 2021-P2-274-02). The study conformed to the provisions of the Declaration of Helsinki (as revised in 2013). Written informed consent will be obtained prior to study enrolment. The results of this study will be published in peer-reviewed publications.Trial registration number ChiCTR2100052197.

This paper presents an experimental investigation on the damage characteristics and microstructures of hybrid fiber reinforced concrete (HFRC) subjected to the freeze-thaw（F-T）cycles and compound- salt attack. The effect of steel fiber content and steel-polypropylene fiber hybridization on the apparent morphology, mass loss, relative dynamic elastic modulus (RDEM), mechanical strengths in terms of compressive and flexural strengths were studied. The damage mechanism was explored based on an analysis of pore structures of specimens. The results showed that the F-T cycle has adverse effect on the physical and mechanical properties of specimens. The addition of fibers alleviates the damage degree of concrete, and the fiber hybridization shows more pronounced effect. Results from the porosity analysis indicate the pore sizes of 1.2HFRC are mainly distributed within 40 nm and those of OC are within 60 nm. The volume of larger pore size of 1.2HFRC increases less than the others after salt F-T cycles. Finally, based on Weibull distribution function, evolution equations for the salt-frozen damage of HFRC are developed by a combination of strength attenuation and RDEM degradation. The research results provide theoretical basis and reference for the practical application and building maintenance of fiber reinforced concrete.

Background: The incidence of extrauterine growth retardation (EUGR) varies considerably in different countries due to the distinct definitions and inclusion criteria of individual studies. Most studies included small for gestational age (SGA) very preterm infants (VPIs), resulting in a higher incidence of EUGR. Experts have suggested the accurate definition of “EUGR” in SGA infants is not “true EUGR”. The postnatal growth curve of multiple premature births also differs from that of singletons. As far as we know, there is no study about relationship between singleton-non-SGA preterm infants and EUGR. Objectives: To analyze the factors influencing EUGR among VPIs who were singleton-non-SGA in China. Methods: A prospective-multicenter study was conducted in 28 hospitals distributed through China from September 2019 to December 2020. The clinical data on singleton-non-SGA among VPIs were divided into EUGR group (n = 692) and non-EUGR group (n = 912). Results: Compared to non-EUGR group, the mean gestational age (GA), mean birth weight (BW) and percentage of BW in Fenton curve in EUGR group were lower (P < 0.001 for all). The incidence of EUGR among distinct GA groups (classifications of GA < 28weeks, 28–28+6 weeks, 29–29+6 weeks, 30–30+6 weeks and 31–31+6 weeks) and distinct BW groups (classifications of BW

Abstract The multiple reignitions of vacuum circuit braker (VCB) while switching off the shunt reactor in an offshore wind farm (OWF) would produce a high overvoltage. The post‐arc process of ion movement in the vacuum interrupter is analysed. Considering the sheath growth and ion concentration variation, the expression for dielectric recovery strength inside the VCB interrupter is derived. A novel VCB model is implemented in the environment of electromagnetic transient programme based on the new reignition criterion. Then, the switching overvoltage is computed and analysed in detail. For the OWF with high rising rate of transient recovery voltage, the sheath growth must be considered in the VCB model; otherwise, the overvoltage may be underestimated. Using resistor–capacitor (RC) snubber, a new installation scheme is proposed to suppress the overvoltage in the OWF. The results indicate that the proposed scheme can not only reduce the peak and steepness of overvoltage but also damp the high‐frequency oscillation. It would not affect the steady‐state operation of OWF. Besides, the capacitor of RC snubber normally does not bear the electric stress, and its life expectancy would be greatly enhanced.

Abstract Background Home-based palliative care (HPC) is considered to moderate the problem of rising healthcare utilization of cancer patients at end-of-life. Reports however suggest a proportion of HPC patients continue to experience high care intensity. Little is known about differential trajectories of healthcare utilization in patients on HPC. Thus, we aimed to uncover the heterogeneity of healthcare utilization trajectories in HPC patients and identify predictors of each utilization pattern. Methods This is a cohort study of adult cancer patients referred by Singapore Health Services to HCA Hospice Service who died between 1st January 2018 and 31st March 2020. We used patient-level data to capture predisposing, enabling, and need factors for healthcare utilization. Group-based multi-trajectory modelling was applied to identify trajectories for healthcare utilization based on the composite outcome of emergency department (ED) visits, hospitalization, and outpatient visits. Results A total of 1572 cancer patients received HPC (median age, 71 years; interquartile range, 62–80 years; 51.1% female). We found three distinct trajectory groups: group 1 (31.9% of cohort) with persistently low frequencies of healthcare utilization, group 2 (44.1%) with persistently high frequencies, and group 3 (24.0%) that begin with moderate frequencies, which dropped over the next 9 months before increasing in the last 3 months. Predisposing (age, advance care plan completion, and care preferences), enabling (no medical subsidy, primary decision maker), and need factors (cancer type, comorbidity burden and performance status) were significantly associated with group membership. High symptom needs increased ED visits and hospitalizations in all three groups (ED visits, group 1–3: incidence rate ratio [IRR] 1.74–6.85; hospitalizations, group 1–3: IRR 1.69–6.60). High home visit intensity reduced outpatient visits in all three groups (group 1–3 IRR 0.54–0.84), while it contributed to reduction of ED visits (IRR 0.40; 95% CI 0.25–0.62) and hospitalizations (IRR 0.37; 95% CI 0.24–0.58) in group 2. Conclusions This study on HPC patients highlights three healthcare utilization trajectories with implications for targeted interventions. Future efforts could include improving advance care plan completion, supporting care preferences in the community, proactive interventions among symptomatic high-risk patients, and stratification of home visit intensity.

Intervertebral disc degeneration (IDD) causes a variety of signs and symptoms, such as low back pain (LBP), intervertebral disc herniation, and spinal stenosis, which contribute to high social and economic costs. IDD results from many factors, including genetic factors, aging, mechanical injury, malnutrition, and so on. The pathological changes of IDD are mainly composed of the senescence and apoptosis of nucleus pulposus cells (NPCs), the progressive degeneration of extracellular matrix (ECM), the fibrosis of annulus fibrosus (AF), and the inflammatory response. At present, IDD can be treated by conservative treatment and surgical treatment based on patients' symptoms. However, all of these can only release the pain but cannot reverse IDD and reconstruct the mechanical function of the spine. The latest research is moving towards the field of biotherapy. Mesenchymal stem cells (MSCs) are regard as the potential therapy of IDD because of their ability to self‐renew and differentiate into a variety of tissues. Moreover, the non‐coding RNAs (ncRNAs) are found to regulate many vital processes in IDD. There have been many successes in the in vitro and animal studies of using biotherapy to treat IDD, but how to transform the experimental data to real therapy which can apply to humans is still a challenge. This article mainly reviews the treatment strategies and research progress of IDD and indicates that there are many problems that need to be solved if the new biotherapy is to be applied to clinical treatment of IDD. This will provide reference and guidance for clinical treatment and research direction of IDD.

Abstract Background Healthcare professionals play a key role in interacting with children who have a parent with a life-limiting illness. While playing such a role can be challenging, not much is known about how such interactions impact these professionals and affect their ability to render support. Methods Four databases were searched with the intention to conduct a qualitative systematic review. Articles were selected based on pre-determined inclusion and exclusion criteria. Their quality was assessed using the tool "Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields”. Findings were analysed using thematic analysis techniques outlined by Thomas and Harden as well as Sandelowski and Barroso. Review was registered with the Review Registry database. Results Three themes emerged – healthcare professionals’ discomfort; their assumptions and actions; and potentiating workplace factors. The discomfort had several dimensions: fear of making a situation worse, concern of not being able to cope with emotionally charged situations, and internal conflict that arose when their values clashed with family dynamics. Conclusion Healthcare professionals’ sense of discomfort was very pronounced. This discomfort, together with their assumptions, could impact their ability to support children. The organisation played an important role, which was reflected in the work culture, workflow and ability to collaborate with other agencies involved in supporting children. The discomfort was mitigated by having more professional experience, workplace support systems and training on communicating with children. It was apparent that the individual professional did not work alone when supporting children but alongside others within an organisation. As such, issues raised in this review will benefit from multi-faceted solutions.

Atmospheric pressure gas–liquid discharge plasma has garnered considerable attention for its efficacy in wastewater contaminant removal. This study utilized atmospheric oxygen gas–liquid discharge plasma for the treatment of ammonia nitrogen wastewater. The effect of applied voltage on the treatment of ammonia nitrogen wastewater by gas–liquid discharge plasma was discussed, and the potential reaction mechanism was elucidated. As the applied voltage increased from 9 kV to 17 kV, the ammonia nitrogen removal efficiency rose from 49.45% to 99.04%, with an N2 selectivity of 87.72%. The mechanism of ammonia nitrogen degradation by gas–liquid discharge plasma under different applied voltages was deduced through electrical characteristic analysis, emission spectrum diagnosis, and further measurement of the concentration of active species in the gas–liquid two-phase system. The degradation of ammonia nitrogen by gas–liquid discharge plasma primarily relies on the generation of active species in the liquid phase after plasma–gas interactions, rather than direct plasma effects. Increasing the applied voltage leads to changes in discharge morphology, higher energy input, elevated electron excitation temperatures, enhanced collisions, a decrease in plasma electron density, and an increase in rotational temperatures. The change in the plasma state enhances the gas–liquid transfer process and increases the concentration of H2O2, O3, and, ⋅OH in the liquid phase. Ultimately, the efficient removal of ammonia nitrogen from wastewater is achieved.