Search

Objective This study examines the effectiveness of integrating problem-based learning (PBL) and situational teaching in laser-assisted ultrasound-guided radial artery puncture training to enhance students′ practical and clinical skills. Methods Forty anesthesiology residents from the First Hospital of Jilin University (2022 - 2023) were randomly assigned to traditional teaching (control group) (n = 18) or PBL with situational teaching (combined group) (n = 22) . The latter group engaged in problem-based scenarios. Assessments included the control knowledge and direct observation of procedural skills (DOPS) . Results The PBL combined group outperformed the control group in preparation, aseptic technique, and puncture skills (P < 0.05) . In Mini-CEX assessments, the combined group excelled in medical interview skills, humanistic care, clinical diagnosis, and overall clinical ability (P < 0.05). Survey results indicated higher agreement on improved clinical thinking and operational abilities in the combined group (P < 0.05). Conclusion This teaching mode is obviously better than the traditional teaching group, and it is leading in clinical ability and skill operation. Students have achieved remarkable teaching results in practice through this teaching mode.

Abstract Systems theory and complex science, especially knowledge of social–ecological interdependencies, are urgently needed in planning and decision-making on sustainable urban development due to the intensification of the contradiction between human development and nature conservation. Here, we present an analytical framework, the “social–ecological coupling trajectory”, that integrates the social–ecological coupling, multi-stability, causal feedbacks and sustainable management through understanding the evolution of the urban social–ecological system (SES). This framework is applied to a typical urban SES, i.e., China’s rapidly prosperous Pearl River Delta (PRD). Our results indicate that the SES evolution in the PRD is a phased process, which is accompanied by a continuous decline in major ecosystem services (ESs) and the disproportionate decline of ecological management performance. Further analysis shows that social and economic policies have a decisive role in driving the evolution of SES and the cumulative effect of sustained human interference is directly linked to the disproportionate increase in sustainability challenges. The findings of critical slowing down and evolution patterns of SES in the PRD may provide evidence for the threshold recognition and regime shift prediction in SES. In sum, this study expands the theoretical framework and empirical knowledge of SES evolution and provides a pathway for sustainable development of regions seeking prosperity from the social–ecological coupling perspective.

As the e-commerce landscape diversifies, suppliers are faced with the critical decision of how to effectively launch their products through e-commerce channels with varying business models. This study aims to explore the strategic considerations for a supplier launching products through two distinct e-commerce channels: one based on a direct sale model and the other on a reselling model. It builds a theoretical model to examine the supplier’s decision-making across three strategic options: a simultaneous launch through both channels, a sequential launch starting with the direct sale model followed by the reselling model, and vice versa. The equilibria of those options are derived through game analysis and further compared. The results reveal that for suppliers under a non-alliance pricing contract, a simultaneous product launch across both channels is the most advantageous approach. Conversely, in scenarios where an alliance pricing contract is in place, the optimal strategy shifts towards a sequential launch. The decision of which channel to ally with—whether the direct sale or the reselling model—hinges critically on the difference in service efficiency and the intensity of competition between the channels. This nuanced analysis highlights the importance of strategic flexibility and alignment with channel dynamics in maximizing product launch success in the evolving e-commerce environment.

Objectives: Numerous studies have established the role of inflammation in osteoarthritis (OA) progression, yet limited research explores the association between systemic inflammatory indicators and pre-diagnosis OA risk. This study aimed to investigate the association between peripheral inflammatory indicators and the risk of OA using data from the UK Biobank. Methods: The study analyzed data from 417,507 participants in the UK Biobank, including neutrophil count, lymphocyte count, monocyte count, platelet count, and C-reactive protein meter. Additionally, derived ratios such as NLR(neutrophils-lymphocytes ratio), PLR(Platelets-lymphocytes ratio), SII(systemic immune-inflammation index), and LMR (lymphocytes-monocytes ratio) were examined. Cox proportional hazards models and restricted cubic spline models were used to assess both linear and nonlinear associations. Results: Over a mean follow-up period of 12.7 years, a total of 49,509 OA events were identified. The findings revealed that CRP (HR:1.06, 95%CI:1.05–1.07), NLR (HR:1.02, 95%CI:1.01–1.03), PLR (HR:1.02, 95%CI:1.01–1.03), and SII (HR:1.03, 95%CI:1.01–1.04) were associated with an increased risk of OA, while LMR (HR:0.97, 95%CI:0.96–0.99) showed a significant negative correlation with OA risk. Subgroup analyses further emphasized that these associations were significant across most of the population. Although neutrophils, lymphocytes, monocytes, and platelets showed a nominal association with the risk of OA, the results were unreliable, especially for specific joint OA. Conclusion: The study provides evidence of a significant association between elevated peripheral inflammatory indicators and OA risk. These findings underscore the importance of low-grade chronic inflammation in OA development. The potential clinical utility of these indicators as early predictors of OA is suggested, warranting further exploration.

Objective To study the effect of case based teaching (CBL) method combined with situational simulation teaching(SST) method in anesthesia skill training teaching with students as the main body, typical cases as the support, teachers as the leading, and teachers as the leading. Methods A total of 24 trainees in the anesthesiology professional base of the First Hospital of Jilin University in 2022 were randomly divided into C group(accepted CBL) and SC group(accepted SST combined with CBL), with 12 doctors in each group. The differences in theoretical assessment, practical skill assessment and ability questionnaire survey after the completion of teaching training were compared between the two groups. Results There was no significant difference in general data between the two groups (P>0.05); SC group showed significantly higher scores of arterial puncture and central venous puncture in theoretical examination results and skill assessment compared with C group, and the difference was statistically significant (P0.05). Conclusion Compared with CBL alone, SST combined with CBL can significantly improve the evaluation results of arterial puncture and central venous puncture in theoretical and skill operation in anesthesia skill training teaching, and it is recommended to be popularized in practical anesthesiology teaching work.

Abstract The use of robots to augment human capabilities and assist in work has long been an aspiration. Robotics has been developing since the 1960s when the first industrial robot was introduced. As technology has advanced, robotic-assisted surgery has shown numerous advantages, including more precision, efficiency, minimal invasiveness, and safety than is possible with conventional techniques, which are research hotspots and cutting-edge trends. This article reviewed the history of medical robot development and seminal research papers about current research progress. Taking the autonomous dental implant robotic system as an example, the advantages and prospects of medical robotic systems would be discussed which would provide a reference for future research.

Macroscopic deformation and microscopic pores are the main defects affecting the comprehensive performance of laser powder bed fusion (LPBF) parts. The LPBF process involves highly coupled multiple physical mechanisms over a wide time scale, making it difficult to obtain strongly correlated defect characteristics and achieve online monitoring. Thus, this study proposes an acoustic-based macro–micro defect synchronous monitoring technology. It enables monitoring by analysing process information progressively from intra-layer to inter-layer. The research identifies that high energy density leads to deformation defects, with helical scan strategy energy fluctuations exacerbating deformation. A correlation between keyhole pores and high-frequency signal components allows quantitative pore analysis directly from acoustic signals. Furthermore, an intelligent diagnosis model (gn-Res_SC) is proposed, incorporating high-order information interaction and residual structure for in-depth process analysis. The model demonstrates superior performance with accuracy (90.70%), recall (90.70%) and F1-score (90.40%) in LPBF acoustic monitoring signal evaluation.

BackgroundConventional daytime monitoring in a single day may be influenced by factors such as motion artifacts and emotions, and continuous monitoring of nighttime heart rate variability (HRV) and respiration to assist in chronic obstructive pulmonary disease (COPD) diagnosis has not been reported yet. ObjectiveThe aim of this study was to explore and compare the effects of continuously monitored HRV, heart rate (HR), and respiration during night sleep on the remote diagnosis of COPD. MethodsWe recruited patients with different severities of COPD and healthy controls between January 2021 and November 2022. Vital signs such as HRV, HR, and respiration were recorded using noncontact bed sensors from 10 PM to 8 AM of the following day, and the recordings of each patient lasted for at least 30 days. We obtained statistical means of HRV, HR, and respiration over time periods of 7, 14, and 30 days by continuous monitoring. Additionally, the effects that the statistical means of HRV, HR, and respiration had on COPD diagnosis were evaluated at different times of recordings. ResultsIn this study, 146 individuals were enrolled: 37 patients with COPD in the case group and 109 participants in the control group. The median number of continuous night-sleep monitoring days per person was 56.5 (IQR 32.0-113.0) days. Using the features regarding the statistical means of HRV, HR, and respiration over 1, 7, 14, and 30 days, binary logistic regression classification of COPD yielded an accuracy, Youden index, and area under the receiver operating characteristic curve of 0.958, 0.904, and 0.989, respectively. The classification performance for COPD diagnosis was directionally proportional to the monitoring duration of vital signs at night. The importance of the features for diagnosis was determined by the statistical means of respiration, HRV, and HR, which followed the order of respiration > HRV > HR. Specifically, the statistical means of the duration of respiration rate faster than 21 times/min (RRF), high frequency band power of 0.15-0.40 Hz (HF), and respiration rate (RR) were identified as the top 3 most significant features for classification, corresponding to cutoff values of 0.1 minute, 1316.3 nU, and 16.3 times/min, respectively. ConclusionsContinuous monitoring of nocturnal vital signs has significant potential for the remote diagnosis of COPD. As the duration of night-sleep monitoring increased from 1 to 30 days, the statistical means of HRV, HR, and respiration showed a better reflection of an individual's health condition compared to monitoring the vital signs in a single day or night, and better was the classification performance for COPD diagnosis. Further, the statistical means of RRF, HF, and RR are crucial features for diagnosing COPD, demonstrating the importance of monitoring HRV and respiration during night sleep.

Tetrabromobisphenol A (TBBPA), a widely-used brominated flame retardant, has been revealed to exert endocrine disrupting effects and induce adipogenesis. Given the high structural similarities of TBBPA analogues and their increasing exposure risks, their effects on lipid metabolism are necessary to be explored. Herein, 9 representative TBBPA analogues were screened for their interference on 3T3-L1 preadipocyte adipogenesis, differentiation of C3H10T1/2 mesenchymal stem cells (MSCs) to brown adipocytes, and lipid accumulation of HepG2 cells. TBBPA bis(2-hydroxyethyl ether) (TBBPA-BHEE), TBBPA mono(2-hydroxyethyl ether) (TBBPA-MHEE), TBBPA bis(glycidyl ether) (TBBPA-BGE), and TBBPA mono(glycidyl ether) (TBBPA-MGE) were found to induce adipogenesis in 3T3-L1 preadipocytes to different extends, as evidenced by the upregulated intracellular lipid generation and expressions of adipogenesis-related biomarkers. TBBPA-BHEE exhibited a stronger obesogenic effect than did TBBPA. In contrast, the test chemicals had a weak impact on the differentiation process of C3H10T1/2 MSCs to brown adipocytes. As for hepatic lipid formation test, only TBBPA mono(allyl ether) (TBBPA-MAE) was found to significantly promote triglyceride (TG) accumulation in HepG2 cells, and the effective exposure concentration of the chemical under oleic acid (OA) co-exposure was lower than that without OA co-exposure. Collectively, TBBPA analogues may perturb lipid metabolism in multiple tissues, which varies with the test tissues. The findings highlight the potential health risks of this kind of emerging chemicals in inducing obesity, non-alcoholic fatty liver disease (NAFLD) and other lipid metabolism disorders, especially under the conditions in conjunction with high-fat diets.

Abstract Molecular knots, whose synthesis presents many challenges, can play important roles in protein structure and function as well as in useful molecular materials, whose properties depend on the size of the knotted structure. Here we report the synthesis by self-assembly of molecular trefoil metallaknot with formula [Au6{1,2-C6H4(OCH2CC)2}3{Ph2P(CH2)4PPh2}3], Au 6 , from three units of each of the components 1,2-C6H4(OCH2CCAu)2 and Ph2P(CH2)4PPh2. Structure determination by X-ray diffraction revealed that the chiral trefoil knot contains only 54 atoms in the backbone, so that Au 6 is the smallest and tightest molecular trefoil knot known to date.

The acoustic performance of ultrasonic transducer is directly determined by the coupling between the piezoelectric unit and the medium. At present, the coupling methods of the transducer are relatively single. In this work, a novel ultrasonic transducer coupling method based on pressureless sintering of nano-Ag is reported. The effects of sintering temperature on the micro-morphology and macro-porosity of nano-Ag sintered bulk (i.e. demoulded coupling layer) are systematically investigated. The transducers are design and fabricated by one-time pressureless sintering of nano-Ag paste. The influences of sintering temperature on acoustic performance of the transducers are analysed by experiments in detail. The results show that the number of the pores in the pressureless sintered bulk decrease with the sintering temperature, while the pores size gradually increase. From the perspective of acoustic impedance matching, silver materials have great advantages and universality as the coupling layer between most piezoelectric wafers and steel mediums. The coupling effect of sintered Ag could be improved by increasing the temperature. The best coupling effect could be obtained by sintering at 350 °C, at which the primary echo of the transducer has ideal waveform and bandwidth.

Abstract Improving three-dimensional (3D) localization precision is of paramount importance for super-resolution imaging. By properly engineering the point spread function (PSF), such as utilizing Laguerre–Gaussian (LG) modes and their superposition, the ultimate limits of 3D localization precision can be enhanced. However, achieving these limits is challenging, as it often involves complicated detection strategies and practical limitations. In this work, we rigorously derive the ultimate 3D localization limits of LG modes and their superposition, specifically rotation modes, in the multi-parameter estimation framework. Our findings reveal that a significant portion of the information required for achieving 3D super-localization of LG modes can be obtained through feasible intensity detection. Moreover, the 3D ultimate precision can be achieved when the azimuthal index l is zero. To provide a proof-of-principle demonstration, we develop an iterative maximum likelihood estimation (MLE) algorithm that converges to the 3D position of a point source, considering the pixelation and detector noise. The experimental implementation exhibits an improvement of up to two-fold in lateral localization precision and up to twenty-fold in axial localization precision when using LG modes compared to Gaussian mode. We also showcase the superior axial localization capability of the rotation mode within the near-focus region, effectively overcoming the limitations encountered by single LG modes. Notably, in the presence of realistic aberration, the algorithm robustly achieves the Cramér-Rao lower bound. Our findings provide valuable insights for evaluating and optimizing the achievable 3D localization precision, which will facilitate the advancements in super-resolution microscopy.

Abstract This study explored the potential association between age at menarche and the risks of gestational hypertension and preeclampsia in Chinese women. Data were sourced from the China‐US Collaborative Project for Neural Tube Defects Prevention, a large population‐based cohort study. Our study consisted of 209 411 women pre‐registered for pregnancy in two provinces in South China. Trained healthcare workers measured blood pressure at registration and recorded other pertinent health information. Using logistic regression, we assessed the correlations between age at menarche and the likelihood of developing gestational hypertension and preeclampsia, considering confounders such as maternal age, body mass index, ethnicity, parity, folic acid supplementation, education level, and occupation. The observed incidences for gestational hypertension and preeclampsia were 9.65% and 2.54%, respectively. The adjusted odds ratios (ORs) for gestational hypertension, based on age at menarche, were as follows: ≤13 years, 1.18 (95% confidence interval: 1.11–1.26); 14 years, 1.09 (1.04–1.15); 15 years, 1.11 (1.06–1.16); 16 years, 1.06 (1.01–1.12); and ≥17 years, 1.00 (reference; P for trend

Background: As emerging environmental contaminants, antibiotics pose potential threats to human health, in particular to pregnant women and infants. However, the potential harm of inadvertent antibiotic exposure (IAE) is often disregarded in light of the focus on intentional antibiotic use during pregnancy. Currently, little is known about the effects of IAE during pregnancy on fetal neural tube development. Methods: In this case-control study, we used questionnaire data from 855 subjects to investigate the effects of intentional antibiotic use in early pregnancy on neural tube defects (NTDs). Then we tested for placental antibiotics in mothers who had not intentionally used antibiotics, and the compounds were detected in 379 subjects; these were considered IAE cases. We assessed the association between IAE during pregnancy and fetal NTDs using both multivariable logistic and multi-pollutant exposure models. We also analyzed the correlation between maternal dietary habits and placental antibiotics to explore possible sources of IAE. Results: Only 50 of 855 participants (5.8%) intentionally used antibiotics and such use showed no significant association with NTD risk (odds ratio [OR] = 1.92, confidence interval [95%CI] = [0.66, 5.59]). However, 14 of 15 placental antibiotics were detected in 378 of 379 subjects (99.7%) and multivariable logistic analysis indicated that high levels of placental macrolides were significantly associated with increased NTD risk (4.42 [2.01–10.45]). Multi-pollutant exposure analysis suggested an increase in NTD risk with an increase in exposure to a mixture of placental antibiotics, among which macrolides were the most important contributor. In addition, the level of placental macrolides was positively correlated with the intake frequency of milk. Finally, mothers who drank river, well, or pond water had higher levels of placental macrolides than those who drank only tap water. Conclusions: Intentional antibiotic use during early pregnancy may not be associated with NTDs, while IAE during pregnancy is associated with higher NTD risk in offspring. Macrolides are crucial risk factors. Milk, and river, well, or pond water may be important sources of IAE.

Phthalates (PAEs) and polycyclic aromatic hydrocarbons (PAHs) are frequently detected in females of reproductive age. Many studies have found that environmental PAE and PAH levels are independent risk factors for gestational hypertension. However, exposure to both components is a more realistic scenario. To better assess the health effects of PAEs and PAHs in pregnant women, we explored the associations of exposure to both individual and combined PAEs and PAHs with gestational hypertension. This nested case–control study was a component of a prospective cohort study conducted in Beijing, China. We included 206 women with gestational hypertension and 214 pregnant controls. We used gas chromatography/tandem mass spectrometry (GC–MS/MS) to detect 8 PAEs and 13 PAHs in > 80 % of all collected hair samples. Multiple linear regression models were employed to test the individual associations between each component and gestational hypertension. A quantile-based g-computation (qgcomp) model and a weighted quantile sum (WQS) regression model were used to estimate whether exposure to both PAEs and PAHs increased the risk of gestational hypertension. The individual exposure analyses revealed that diethyl phthalate (DEP), diisobutyl phthalate (DIBP) (both PAEs), benzo(k)fluoranthene (BKF), anthracene, (ANT), and benzo(a)pyrene (BAP) (all PAHs) were positively associated with increased risk of gestational hypertension. In mixed-effect analyses, the qgcomp model indicated that co-exposure to PAEs and PAHs increased the risk of gestational hypertension (odds ratio = 2.01; 95 % confidence interval: 1.02, 3.94); this finding was verified by the WQS regression model. Our findings support earlier evidence that both PAEs and PAHs increase the risk of gestational hypertension, both individually and in combination. This suggests that reductions in exposure to endocrine system-disrupting chemicals such as PAEs and PAHs might reduce the risk of gestational hypertension.

Increasing evidences have revealed a close relationship between various environmental exposures and reproductive health. The real-world complex exposure scenario along with intricate interactions effects of these exposures has high demands of exposome-wide association studies for human risk assessment. With the development of exposomic studies, applying hair exposome to link environmental factors and reproductive health outcomes has obvious potential advantages. However, the reliability of utilizing hair to characterize exposome is always of high concern for researchers. In this review, we briefly summarized studies about the effects of environmental exposures on several typical reproductive health outcomes, described state-of-the-art situation of applying hair exposome for reproductive health risk assessment, elucidated the advantages (e.g., containing abundant exposure factors, low expenses for sampling, and tracing exposure history), and proposed the unsolved issues in this area. We also conducted a comprehensive discussion about the reliability of various hair biomarkers and primarily established the biomarker databases. Finally, a standardized framework on using hair exposome for reproductive health study was proposed to provide fundamental approach for future studies. We concluded that it is promising to apply hair exposome to evaluate the effects of the environmental factors on human reproductive health.

The migratory endoparasitic phytonematodes Bursaphelenchus xylophilus is the causal agent of pine wilt disease and causes significant economic damage to pine forests in China. Effectors play a key role in the successful parasitism of plants by phytonematodes. In this study, 210 genes obtained by transcriptomics analyses were found to be upregulated in B. xylophilus infecting Pinus massoniana that were not functionally annotated nor reported previously in B. xylophilus infecting P. thunbergii. Among these differentially expressed genes, a novel effector, BxICD1, that could induce cell death in the extracellular space of Nicotiana benthamiana was identified. BxICD1 was upregulated in the early stages of infection, as shown by RT-qPCR analyses. In situ hybridization analysis showed that BxICD1 was expressed in the esophageal gland of nematodes. The yeast signal sequence trap system indicated that BxICD1 possessed an N-terminal signal peptide with secretion functionality. Using an Agrobacterium-mediated transient expression system, it was demonstrated that the cell death-inducing activity of BxICD1 was dependent on N. benthamiana brassinosteroid-insensitive 1-associated kinase 1 (NbBAK1). Finally, BxICD1 contributed to B. xylophilus virulence and migration in host pine trees, as demonstrated by RNAi silencing assays. These findings indicate that BxICD1 both induces plant cell death and also contributes to nematode virulence and migration in P. massonian.

IntroductionSpontaneous preterm birth (SPB) is a significant cause of neonatal mortality, yet its etiology remains unclear. Cobalt, an essential trace element, might be a risk factor for SPB. This study aims to investigate the relationship between maternal serum cobalt concentration and SPB, and to clarify the role of blood lipids and fasting blood glucose (FBG) in this relationship.MethodsWe conducted a nested case-control study within the Beijing Birth Cohort Study. Serum samples were obtained from 222 pregnant women with SPB and 224 controls during the first (7–13 weeks of pregnancy) and third trimesters (32–42 weeks of pregnancy). Serum cobalt concentration was determined using inductively coupled plasma mass spectrometry (ICP-MS). Fasting blood glucose and lipids levels were detected using a fully automated biochemical immunoassay instrument. Logistic regression models and linear regression models were established to explore the association between serum cobalt concentration and the risk of SPB in pregnant women, and to test the mediating effect of fasting blood glucose (FBG) and lipids.ResultsWe found that the serum cobalt concentration in mothers with SPB and controls was similar in the first trimester, with values of 0.79 (0.58–1.10) ng/mL and 0.75 (0.51–1.07) ng/mL, respectively. However, in the third trimester, the cobalt concentration increased to 0.88 (0.59–1.14) ng/mL and 0.84 (0.52–1.19) ng/mL, respectively. In the logistic regression model, when considering the third trimester of pregnancy, after adjusting for ethnicity, pre-pregnancy body mass index (BMI), maternal age, education, income, and parity, it was observed that the medium level of cobalt concentration (0.63–1.07 ng/ml) had a negative correlation with the risk of SPB. The odds ratio (OR) was 0.56, with a 95% confidence interval of 0.34–0.90 ng/mL and a p-value of 0.02. This suggests that cobalt in this concentration range played a protective role against SPB. Additionally, it was found that FBG in the third trimester of pregnancy had a partial intermediary role, accounting for 9.12% of the association. However, no relationship between cobalt and SPB risk was found in the first trimester.ConclusionDuring the third trimester, intermediate levels of maternal cobalt appear to offer protection against SPB, with FBG playing a partial mediating role. To further clarify the optimal cobalt concentrations during pregnancy for different populations, a multi-center study with a larger sample size is necessary. Additionally, exploring the specific mechanism of FBG’s mediating role could provide valuable insights for improving the prevention of SPB.

Abstract Background Parental exposure to rare earth elements (REEs) could increase the risk of premature rupture of membranes, a major cause of spontaneous preterm birth (SPB). In addition, different subtypes of SPB, such as spontaneous preterm labor (SPL) and preterm premature rupture of membranes (PPROM), may have different susceptibility to environmental exposure. Therefore, we investigated the potential associations between REE exposure in different trimesters and SPB and its subtypes. Methods A nested case-control study was performed. We included 244 women with SPB as cases and 244 women with full-term delivery as controls. The plasma concentrations of light REEs were measured in the first and third trimesters. Logistic regression was used to analyze the associations between single REE levels and SPB, and Bayesian kernel machine regression (BKMR) was used to analyze the mixed-exposure effect. Results Exposure to light REEs was associated with SPB and its subtypes only in the third trimester. Specifically, the intermediate- and highest-tertile concentration groups of La and the highest-tertile concentration group of Sm were associated with an increased risk of SPL, with adjusted odds ratios (AORs) of 2.00 (95% CIs: 1.07–3.75), 1.87 (95% CIs: 1.01–3.44), and 1.82 (95% CIs: 1.00–3.30), respectively. The highest-tertile concentration group of Pr was associated with an increased risk of PPROM, with an AOR of 1.69 (95% CIs: 1.00–2.85). Similar results were also found in BKMR models. Conclusions La and Sm levels in plasma may be associated with the risk of SPL, and Pr levels in plasma may be associated with the risk of PPROM.

Abstract The accuracy assessment of land cover data is of significant value to accurately monitor and objectively reproduce spatio-temporal dynamic changes to land surface landscapes. In this study, the interpretation and applicability of CCI, MCD, and CGLS long time-series land cover data products for China were evaluated via consistency analysis and a confusion matrix system using NLUD-C periodic products as reference data. The results showed that CGLS had the highest overall accuracy, Kappa coefficient, and area consistency in the continuous time-series evaluation, followed by MCD, whereas CCI had the worst performance. For the accuracy assessment of subdivided land cover types, the three products could accurately describe the distribution of forest land in China with a high recognition level, but their recognition ability for water body and construction land was poor. Among the other types, CCI could better identify cropland, MCD for grassland, and CGLS for unused land. Based on these evaluation results and characteristics of the data products, we developed suitable selection schemes for users with different requirements.

Infant birth sizes are vital clinical parameters to predict poor growth and micronutrient deficiency in early life. However, their effects on childhood anemia remain unclear. We aimed to explore the associations between birth weight, crown–heel length, and head circumference with anemia in early childhood, as well as potential modification factors. This population-based prospective cohort study included 204,556 participants with singleton live births delivered at gestational ages of 28–42 weeks. A logistic regression model was used to estimate the associations of the measures of infant birth size and their Z-score with anemia under five years old. There were 26,802 (13.10%) children under five years old who were diagnosed has having anemia. Compared with children who did not have anemia, children who had anemia had a lower birth weight and smaller head circumference and a longer crown–heel length (all p-values < 0.05). After adjusting for confounders, not only birth weight (β coefficient, −0.008; 95% CI, −0.011–−0.004; p < 0.001) and head circumference (β coefficient, −0.004; 95% CI, −0.007–−0.001; p = 0.009), but also the related Z-scores were negatively associated with childhood anemia, while the trends for crown–heel length were the opposite. We further found significant interactions of folic acid use and maternal occupation with infant birth sizes. In conclusion, infants having abnormal sizes at birth are significantly associated with the risk for childhood anemia, which can be modified by folic acid use during pregnancy and maternal occupation.

A series of new monobactam sulfonates is continuously synthesized and evaluated for their antimicrobial efficacies against Gram-negative bacteria. Compound 33a (IMBZ18G) is highly effective in vitro and in vivo against clinically intractable multi-drug-resistant (MDR) Gram-negative strains, with a highly druglike nature. The checkerboard assay reveals its significant synergistic effect with β-lactamase inhibitor avibactam, and the MIC values against MDR enterobacteria were reduced up to 4–512 folds. X-ray co-crystal and chemoproteomic assays indicate that the anti-MDR bacteria effect of 33a results from the dual inhibition of the common PBP3 and some class A and C β-lactamases. Accordingly, preclinical studies of 33a alone and 33a‒avibactam combination as potential innovative candidates are actively going on, in the treatment of β-lactamase-producing MDR Gram-negative bacterial infections.

IntroductionPericonceptional use of multivitamins containing folic acid prevents external major birth defects, especially neural tube defects. We aimed to explore the effects of maternal folic acid supplementation alone on perinatal mortality with or without external major birth defects plus neural tube defects.MethodsFrom the China-US Collaborative Project for Neural Tube Defects Prevention, we identified 222, 303 singleton pregnancies with detailed information on periconceptional folic acid use, defined as folic acid supplementary before the last menstrual date until to the end of the first trimester. Perinatal mortality included stillbirths after 20 weeks’ gestation and early neonatal deaths within 7 days of delivery.ResultsAmong the fetuses or infants of women who did not take folic acid, the rate of perinatal mortality was 2.99% and 1.62% at least 20 weeks’ gestation in the northern and southern regions. Among the fetuses or infants of the women with periconceptional use of folic acid, the rates were 1.85% and 1.39% in the northern and southern region. The estimated relative risk for perinatal mortality [adjusted risk ratio (RR), 0.72; 95% confidence interval (CI), 0.61- 0.85], stillbirth (adjusted RR, 0.78; 95% CI, 0.64-0.96), early neonatal mortality (adjusted RR, 0.61; 95% CI, 0.45-0.82), and neonatal death (adjusted RR, 0.64; 95% CI, 0.49-0.83) in northern China was significantly decreased in association with periconceptional folic acid supplementation. Compared with northern, there was a lesser effect in southern China.ConclusionPericonceptional intake of 400μg folic acid daily reduces the overall risk perinatal mortality, as well as the risk from external major birth defects and neural tube defects, especially in northern China.

Abstract Nonalcoholic fatty liver disease (NAFLD) which is a leading cause of chronic liver diseases lacks effective treatment. Tamoxifen has been proven to be the first-line chemotherapy for several solid tumors in clinics, however, its therapeutic role in NAFLD has never been elucidated before. In vitro experiments, tamoxifen protected hepatocytes against sodium palmitate-induced lipotoxicity. In male and female mice fed with normal diets, continuous tamoxifen administration inhibited lipid accumulation in liver, and improved glucose and insulin intolerance. Short-term tamoxifen administration largely improved hepatic steatosis and insulin resistance, however, the phenotypes manifesting inflammation and fibrosis remained unchanged in abovementioned models. In addition, mRNA expressions of genes related to lipogenesis, inflammation, and fibrosis were downregulated by tamoxifen treatment. Moreover, the therapeutic effect of tamoxifen on NAFLD was not gender or ER dependent, as male and female mice with metabolic disorders shared no difference in response to tamoxifen and ER antagonist (fulvestrant) did not abolish its therapeutic effect as well. Mechanistically, RNA sequence of hepatocytes isolated from fatty liver revealed that JNK/MAPK signaling pathway was inactivated by tamoxifen. Pharmacological JNK activator (anisomycin) partially deprived the therapeutic role of tamoxifen in treating hepatic steatosis, proving tamoxifen improved NAFLD in a JNK/MAPK signaling-dependent manner.

Copper doping of atomically precise gold nanoclusters is a useful strategy to tune their chemical and physical properties, but Au–Cu nanocluster alloys tend to exhibit poor stability. Here, a [Au12Cu13(Ph3P)10I7](SbF6)2 cluster is prepared and shown to display enhanced stability and fluorescence in comparison to homonuclear cluster [Au25(PPh3)10Br7](SbF6)2, in addition to promising photocatalytic activity for methanol oxidation.

Meloidogyne javanica is one of the most widespread and economically important sedentary endoparasites. In this study, a comparative transcriptome analysis of M. javanica between pre-parasitic second-stage juveniles (Pre-J2) and parasitic juveniles (Par-J3/J4) was conducted. A total of 48,698 unigenes were obtained, of which 18,826 genes showed significant differences in expression (p < 0.05). In the differentially expressed genes (DEGs) from transcriptome data at Par-J3/J4 and Pre-J2, a large number of unigenes were annotated to the C-type lectin (CTL, Mg01965), the cathepsin L-like protease (Mi-cpl-1), the venom allergen-like protein (Mi-mps-1), Map-1 and the cellulase (endo-β-1,4-glucanase). Among seven types of lectins found in the DEGs, there were 10 CTLs. The regulatory roles of Mj-CTL-1, Mj-CTL-2 and Mj-CTL-3 in plant immune responses involved in the parasitism of M. javanica were investigated. The results revealed that Mj-CTL-2 could suppress programmed cell death (PCD) triggered by Gpa2/RBP-1 and inhibit the flg22-stimulated ROS burst. In situ hybridization and developmental expression analyses showed that Mj-CTL-2 was specifically expressed in the subventral gland of M. javanica, and its expression was up-regulated at Pre-J2 of the nematode. In addition, in planta silencing of Mj-CTL-2 substantially increased the plant resistance to M. javanica. Moreover, yeast co-transformation and bimolecular fluorescence complementation assay showed that Mj-CTL-2 specifically interacted with the Solanum lycopersicum catalase, SlCAT2. It was demonstrated that M. javanica could suppress the innate immunity of plants through the peroxide system, thereby promoting parasitism.

Abstract Plant PR10/Bet v1-like proteins are involved in defense against microbial pathogens, however, whether they participate in host defense against plant-parasitic animals including nematodes remains unknown. Here, according to the phylogeny, sequence-similarity, and secondary structure analyses, we found that the rice OsBet v1 protein and its homologs constitute a new subfamily of PR10/Bet v1-like protein. Reverse transcription-quantitative PCR assay showed that OsBet v1 was highly expressed in rice roots and induced by Meloidogyne graminicola infection. Using a transient expression assay in rice protoplasts, we demonstrated that OsBet v1 was localized in the cytoplasm and nucleus. Furthermore, CRISPR/Cas9-targeted mutagenesis of OsBet v1 significantly increased rice susceptibility to M. graminicola, but reduced rice plant height. In addition, the expression levels of two peroxidase genes (peroxidase 5 and peroxidase 56) were significantly down-regulated in OsBet v1 knockout mutants compared with those in wild-type rice plants. Taken together, this study identified a new PR10/Bet v1-like protein subfamily in plant and revealed the involvement of OsBet v1, a representative member of the subfamily, in rice growth and defense against M. graminicola. This provides a new insight into the role of plant PR10/Bet v1-like proteins in plant–nematode interactions.

Superconductivity at megabar pressures has recently attracted interest in the context of hydrides. Here, the authors demonstrate superconductivity up to 26 K at high pressure in elemental titanium, and further suggest that electron correlations contribute to the high T c.

Abstract Background Elevated intraocular pressure (IOP) is the main risk factor for glaucoma, which might cause the activation of astrocytes in optic nerve head. To determine the effect of mechanical stretch on the astrocytes, we investigated the changes in cell phenotype, proteins of interest and signaling pathways under biaxial stretch. Method The cultured astrocytes in rat optic nerve head were stretched biaxially by 10 and 17% for 24 h, respectively. Then, we detected the morphology, proliferation and apoptosis of the stretched cells, and performed proteomics analysis. Protein expression was analyzed by Isobaric tags for relative and absolute quantification (iTRAQ) mass spectrometry. Proteins of interest and signaling pathways were screened using Gene Ontology enrichment analysis and pathway enrichment analysis, and the results were verified by western blot and the gene-chip data from Gene Expression Omnibus (GEO) database. Result The results showed that rearrangement of the actin cytoskeleton in response to stimulation by mechanical stress and proliferation rate of astrocytes decreased under 10 and 17% stretch condition, while there was no significant difference on the apoptosis rate of astrocytes in both groups. In the iTRAQ quantitative experiment, there were 141 differential proteins in the 10% stretch group and 140 differential proteins in the 17% stretch group. These proteins include low-density lipoprotein receptor-related protein (LRP6), caspase recruitment domain family, member 10 (CARD10), thrombospondin 1 (THBS1) and tetraspanin (CD81). The western blot results of LRP6, THBS1 and CD81 were consistent with that of iTRAQ experiment. ANTXR2 and CARD10 were both differentially expressed in the mass spectrometry results and GEO database. We also screened out the signaling pathways associated with astrocyte activation, including Wnt/β–catenin pathway, NF-κB signaling pathway, PI3K-Akt signaling pathway, MAPK signaling pathway, Jak-STAT signaling pathway, ECM-receptor interaction, and transforming growth factor-β (TGF-β) signaling pathway. Conclusion Mechanical stimulation can induce changes in cell phenotype, some proteins and signaling pathways, which might be associated with astrocyte activation. These proteins and signaling pathways may help us have a better understanding on the activation of astrocytes and the role astrocyte activation played in glaucomatous optic neuropathy.

PurposeThough copy number variants (CNVs) have been suggested to play a significant role in inborn errors of immunity (IEI), the precise nature of this role remains largely unexplored. We sought to determine the diagnostic contribution of CNVs using genome-wide chromosomal microarray analysis (CMA) in children with IEI.MethodsWe performed exome sequencing (ES) and CMA for 332 unrelated pediatric probands referred for evaluation of IEI. The analysis included primary, secondary, and incidental findings.ResultsOf the 332 probands, 134 (40.4%) received molecular diagnoses. Of these, 116/134 (86.6%) were diagnosed by ES alone. An additional 15/134 (11.2%) were diagnosed by CMA alone, including two likely de novo changes. Three (2.2%) participants had diagnostic molecular findings from both ES and CMA, including two compound heterozygotes and one participant with two distinct diagnoses. Half of the participants with CMA contribution to diagnosis had CNVs in at least one non-immune gene, highlighting the clinical complexity of these cases. Overall, CMA contributed to 18/134 diagnoses (13.4%), increasing the overall diagnostic yield by 15.5% beyond ES alone.ConclusionPairing ES and CMA can provide a comprehensive evaluation to clarify the complex factors that contribute to both immune and non-immune phenotypes. Such a combined approach to genetic testing helps untangle complex phenotypes, not only by clarifying the differential diagnosis, but in some cases by identifying multiple diagnoses contributing to the overall clinical presentation.

The discovery of superconductivity in hydrides at critical temperature (T c) near room temperature receives intensive attentions. Here the authors report experimental synthesis and discovery of superconductivity with T c above 210 K in calcium superhydrides at 160–190 GPa.

Abstract Background Preterm delivery rate is a crucial public health indicator, yet reliable statistic is currently not available in China. In this systematic review and meta-analysis, we aimed to review studies on preterm delivery rate in China, explore sources of heterogeneity, and estimate the preterm delivery rate in China. Methods Published studies on preterm delivery rate in China since 2010 were electronically searched from PubMed, Embase, Web of Science, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Database, and complemented by manual search. Study selection, data extraction, and quality and bias assessment (using the Joanna Briggs Institute Critical Appraisal Checklist) were conducted by two reviewers independently. Random-effects meta-analysis was performed to estimate the pooled preterm delivery rate, and prespecified stratified analysis was conducted to explore sources of heterogeneity. Results The database search returned 4494 articles and manual search identified 10 additional studies. In total, 162 studies were eligible, of which 124 were hospital-based and 38 population-based. The pooled preterm delivery rate of hospital-based studies (7.2%; 95% CI: 6.9% to 7.6%) was significantly higher than that of population-based studies (4.9%; 95% CI: 4.5% to 5.4%) (P for subgroup difference

Background: Nausea and vomiting of pregnancy (NVP) is one of the most common pregnancy-associated symptoms, but little is known about the effects of passive smoking on this symptom. Passive smoking among women is widespread and severe in China due to the high proportion of men who smoke actively. The aim of this study is to examine the association between maternal passive smoking and severe NVP in early pregnancy among nonsmoking women in urban China. Methods: We collected information on passive smoking status and severe NVP in early pregnancy based on an ongoing prospective cohort study conducted from October 2017 to May 2019 in Beijing, China. We used multivariable logistic model to calculate adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) after controlling for confounding factors. Results: Among 3064 participants who were involved in the final analysis, 7.4% (n = 227) were passive smokers and 9.8% (n = 299) reported severe NVP. After adjusting for potential confounders, passive smoking conferred an increased risk of NVP (adjusted OR = 1.62, 95% CI: 1.08, 2.43). The frequency of exposure to second-hand smoke showed a positive relationship with the risk of severe NVP, and significant subgroup differences were also observed in stratified analyses by parity and education level. Conclusions: Our results suggested that maternal exposure to second-hand smoke remained to be a major public health problem in urban China, and that passive smoking during the first trimester may increase the risk of severe NVP among nonsmoking pregnant women. Measures should be taken to reduce the impact of second-hand smoke exposure on pregnant women.

In order to explore the endophytic fungi of Fagopyrum Mill and Avena sativa, Illumina Miseq high-throughput sequencing was used to analyze the community structure and diversity of endophytic fungi in leaves and roots of buckwheat and oat at the mature stage. The results of community structure showed that there were 205 operational taxonomic units (OTUs) in buckwheat roots and 181 OTUs in buckwheat leaves based on 97% sequence similarity level. There were 152 OTUs and 127 OTUs in the root and the leaf of oat, respectively. At the phylum level, Ascomycota and Basidiomycota were the dominant endophytic fungi in buckwheat roots and leaves, while Ascomycota was the dominant endophytic fungus in oat roots and leaves. Alpha diversity analysis showed that the Ace index, Chao index and Shannon index of buckwheat roots were higher than that of buckwheat leaves, and the three indices of oat roots were also higher than that of oat leaves, indicating that the richness and diversity of endophytic fungi community in roots were higher than that in leaves. Biomarkers were found by significant difference analysis in buckwheat and oat. The endophytic functional groups of buckwheat and oat were mainly distributed in Pathotroph and Saprotroph. The results of this study laid a foundation for fully exploiting the dominant endophytic fungal resources of buckwheat and oat and further developing microbial fertilizers.

Previous studies have found associations between chromium exposure and skin damage. However, few studies have focused on both chromium and skin aging. This study aimed to assess the degree of skin aging symptoms and estimate the relationship between hair chromium and skin aging among rural housewives. We recruited 405 subjects in Shanxi Province of northern China and analyzed 397 eligible hair samples with inductively coupled plasma–mass spectrometry (ICP–MS). The subjects’ skin aging symptoms were assessed with SCINEXA™ (SCore of INtrinsic and EXtrinsic skin Aging). After adjusting for age and other important covariates, the regression results showed more severe skin aging symptoms in women with a higher level of hair chromium and presented an increasing linear trend. Vegetables, fruits, and beans might be a source of chromium exposure. We concluded that skin aging might be positively associated with hair chromium. It is necessary to take measures to reduce chromium exposure to prevent skin aging.

Abstract Semiconductor nanowires (NWs) could simultaneously provide gain medium and optical cavity for performing nanoscale lasers with easy integration, ultracompact footprint, and low energy consumption. Here, we report III–V semiconductor NW lasers can also be used for self-frequency conversion to extend their output wavelengths, as a result of their non-centrosymmetric crystal structure and strongly localized optical field in the NWs. From a GaAs/In0.16Ga0.84As core/shell NW lasing at 1016 nm, an extra visible laser output at 508 nm is obtained via the process of second-harmonic generation, as confirmed by the far-field polarization dependence measurements and numerical modeling. From another NW laser with a larger diameter which supports multiple fundamental lasing wavelengths, multiple self-frequency-conversion lasing modes are observed due to second-harmonic generation and sum-frequency generation. The demonstrated self-frequency conversion of NW lasers opens an avenue for extending the working wavelengths of nanoscale lasers, even to the deep ultraviolet and THz range.

There is an urgent need to design and synthesize non-noble metal electrocatalysts (NNMEs) for the replacement of platinum-based electrocatalysts to enhance the sluggish oxygen reduction reaction (ORR) for Zn–air batteries and fuel cells. Herein, Fe-N,S-C materials were fabricated through two steps: first, reprecipitating hemin by adjusting the pH and, then, decorating it with melamine and cysteine in the presence of Zn2+. The resulting Fe-N,S-C-950 (Zn) was prepared after pyrolysis at 950 °C. Using this method, abundant iron-based active species with good dispersion were obtained. The fabrication of more micropores in Fe-N,S-C-950 (Zn) plays a positive role in the improvement of ORR activity. On comparison, Fe-N,S-C-950 (Zn) outperforms Fe-N,S-C-950 and Fe-N-C-950 (Zn) with respect to the ORR due to its larger specific surface area, porous structure, multiple iron-based active sites and N- and S-doped C. Fe-N,S-C-950 (Zn) achieves outstanding ORR performances, including a half-wave potential (E1/2) of 0.844 V and 0.715 V versus a reversible hydrogen electrode (RHE) in 0.1 M KOH and 0.1 M HClO4 solution, respectively. In addition, Fe-N,S-C-950 (Zn) shows an outstanding Zn–air battery performance with an open-circuit voltage (OCV) of 1.450 V and a peak power density of 121.9 mW cm−2, which is higher than that of 20 wt% Pt/C. As a result, the as-prepared electrocatalyst in this work shows the development of the Zn-assisted strategy combined with the assembly of porphyrins as NNMEs for the enhancement of the ORR in both alkaline and acidic solutions.

In order to solve the classification model's shortcomings, this study suggests a new trash classification model that is generated by altering the structure of the ResNet-50 network. The improvement is divided into two sections. The first section is to change the residual block. To filter the input features, the attention module is inserted into the residual block. Simultaneously, the downsampling process in the residual block is changed to decrease information loss. The second section is multi-scale feature fusion. To optimize feature usage, horizontal and vertical multi-scale feature fusion is integrated to the primary network structure. Because of the filtering and reuse of image features, the enhanced model can achieve higher classification performance than existing models for small data sets with few samples. The experimental results show that the modified model outperforms the original ResNet-50 model on the TrashNet dataset by 7.62% and is more robust. In the meanwhile, our model is more accurate than other advanced methods.

Abstract tRNA-derived fragments (tRFs) are new noncoding RNAs, and recent studies have shown that tRNAs and tRFs have important functions in cell metabolism via posttranscriptional regulation of gene expression. However, whether tRFs regulate cellular metabolism of the anterior cruciate ligament (ACL) remains elusive. The aim of this study was to investigate the role and action mechanism of tRFs in ACL cell metabolism. A tRF array was used to determine tRF expression profiles in different human ACL cells, and quantitative real-time polymerase chain reaction and fluorescence in situ hybridisation were used to determine TRF365 expression. ACL cells were transfected with a TRF365 mimic or a TRF365 inhibitor to determine whether TRF365 regulates IKBKB expression. A rescue experiment and dual-luciferase reporter assay were conducted to determine whether the 3′-untranslated region (UTR) of IKBKB has a TRF365-binding site. TRF365 was weakly expressed in osteoarthritis (OA) ACL and interleukin-1β-treated ACL cells. IKBKB was highly expressed in OA ACL and interleukin-1β-treated ACL cells; transfection with the TRF365 mimic suppressed IKBKB expression, whereas transfection with the TRF365 inhibitor had the opposite effect. A dual-luciferase reporter assay showed that TRF365 silenced the expression of IKBKB by binding to its 3′-UTR. Thus, TRF365 regulates the metabolism of ACL cells by targeting IKBKB. In summary, TRF365 may provide a new direction for the study of ACL degeneration and on the pathophysiological process of OA.

BackgroundThe Chinese government recently introduced a program to buy medical supplies in bulk to reduce the patient cost burden. For patients undergoing percutaneous coronary intervention (PCI), little is known about the effect on outcomes of this bulk-buy program.AimsThis study investigated whether the bulk-buy program to decrease the price of stents used in PCI affected clinical decision-making and outcomes.MethodsThis single-center study enrolled patients undergoing PCI from January 2020-December 2021. Prices decreased for stents on January 1, 2021, and balloons on March 1, 2021. Patients were grouped by surgical year as either before (2020) or after (2021) policy implementation. All clinical data were collected. To examine whether clinical decision-making for PCI was affected by the bulk-buy program, procedure appropriateness was analyzed using the 2017 appropriate use criteria (AUC). To assess outcomes, the rates of major adverse cardiac and cerebrovascular events (MACCE) and complications were compared between groups.ResultsStudy participants were 601 patients in 2020 (before bulk buying) and 699 patients in 2021 (after bulk buying). Results of analysis by AUC for procedure appropriateness were 74.5% appropriate, 21.6% may be appropriate, and 3.8% rarely appropriate in 2020, with no differences for patients who underwent PCI in 2021. Between-group comparisons showed MACCE rates of 0.5% in 2020 and 0.6% in 2021, whereas complication rates were 5.5% and 5.7%, respectively. No statistically significant differences were found between groups (p > 0.05).ConclusionThe bulk-buy program did not impact physician clinical decision-making or surgical outcomes for patients undergoing PCI.

PurposeTo investigate the micro-vascular changes in choroidal structures in patients with pre- and early-stage clinical diabetic retinopathy (DR) using wide-field Swept-Source Optical Coherence Tomography Angiography (SS-OCTA).MethodThis observational cross-sectional study included 131 eyes of 68 subjects that were divided into healthy controls (group 1, n = 46), pre-DR (group 2, n = 43), early-stage DR (group 3, n = 42) cohorts. All participants that underwent SS-OCTA examination were inpatients in the department of Ophthalmology and the department of Endocrinology, Qilu Hospital, Shandong University, and Department of Ophthalmology, Aier Eye Hospital, Jinan, from July 11, 2021 to March 17, 2022. The choroidal vascularity index (CVI), choroidal thickness (ChT) and central macular thickness (CMT) in the whole area (diameter of 12 mm) and concentric rings with different ranges (0–3, 3–6, 6–9, and 9–12 mm) were recorded and analyzed from the OCTA image.ResultCompared with healthy eyes, decreases in CVI and ChT were found in the eyes of patients with pre-or early-stage DR. The changes were more significant in the peripheral choroid, with the most prominent abnormalities in the 9-12mm area (P < 0.001). However, there was no obvious difference in the average CMT value. Furthermore, CVI and ChT were significantly correlated with the duration of diabetes in the range of 6–9 and 9–12 mm (Ps < 0.05; Correlation coefficient = -0.549, -0.395, respectively), with the strongest correlation (Ps < 0.01; Correlation coefficient = -0.597, -0.413, respectively) observed at 9–12 mm.ConclusionThe CVI and ChT values of diabetic patients are significantly lower than in healthy controls, especially in patients with early-stage DR. In addition, the peripheral choroidal capillaries are more susceptible to early DM-induced injury than in the central area.

Indoor air pollution may increase the risk for neural tube defects (NTDs) in Chinese rural populations. However, this association remains a subject of debate. We conducted a population-based case-control study of 222 NTD and 517 control mothers recruited between 2010 and 2016 in five rural areas in northern China. An indoor air pollution exposure evaluation index (IAPEEI) was used to evaluate mothers’ exposure to tobacco-sourced and coal-sourced indoor air pollution. Essential characteristics were collected using structured questionnaires within 10 days of delivery. We found that exposure to indoor air pollution (IAPEEI ≥ 1) can lead to 3.41 times the risk of conceiving NTD fetuses compared with the no-exposure group (IAPEEI = 0) (adjusted odds ratio and 95 % confidence interval: 3.41 [2.34–5.02]). The risk increased with increasing IAPEEI score, indicating a clear dose–response trend (P

Abstract Background Thorium is ubiquitous in the environment and its relationship with birth defects is still under discussion. This study aimed to investigate the associations of maternal exposure to thorium with risk of neural tube defects (NTDs) by using a case–control study, as well as the relationship between thorium exposure and the indoor air pollution from coal combustion. Methods This study was conducted in 11 local healthcare hospitals during 2003–2007 in Shanxi and Hebei provinces, China. A total of 774 mothers were included as participants who delivering 263 fetuses with NTDs including 123 with anencephaly, 115 with spina bifida, 18 with encephalocele, and 7 other NTD subtypes (cases), and 511 health fetuses without NTDs (controls). Their hair samples were collected as close as to the occipital posterior scalp, of which those grew from 3 months before to 3 months after conception was cut to measure the thorium concentration by inductively coupled plasma-mass spectrometry. Results We found a higher hair thorium concentration in the total NTD cases with 0.901 (0.588–1.382) ng/g hair [median (inter-quartile range)] than that in the controls with a value of 0.621 (0.334–1.058) ng/g hair. Similar results were found for the three concerned NTD subtypes. Maternal hair thorium concentration above its median of the controls was associated with an increased risk of the total NTDs with an adjusted odds ratio of 1.80 [95% confidence interval (CI), 1.23–2.63)] by adjusting for all confounders. There was obvious dose-response relationship between maternal hair thorium concentration and the risk of total NTDs, as well as their two subtypes (i.e. anencephaly and spina bifida). Maternal hair thorium concentration was positive associated with their exposure level to indoor air pollution from coal combustion during cooking. Conclusions Overall, our findings revealed that maternal periconceptional thorium exposure was associated with the risk of NTDs in North China. Reducing the coal usage in the household cooking activities may decrease maternal thorium exposure level. Graphical abstract

Active smoking has been a risk factor for insomnia, however, little is known about the effect of passive smoking on insomnia. Polycyclic aromatic hydrocarbons (PAHs) are potential contents in tobacco smoke. We aimed to investigate the association between passive smoking exposure and insomnia, plus the modification effects of single nucleotide polymorphisms (SNPs) related to PAHs metabolism. A cross-sectional study with 392 nonsmoking women was conducted in a rural area of Shanxi Province, China. A structured questionnaire was used to collect the information on passive smoking exposure, insomnia and other health-related factors via face-to-face interviews. We simultaneously collected participants’ hair samples to measure the concentrations of 26 PAHs. Whole blood samples were collected to test 9 SNPs related to PAHs metabolism. Logistic regression analysis was conducted to evaluate the association between passive smoking and insomnia, as well as the relation between passive smoking and PAHs concentrations. We further examined the potential interaction effects between passive smoking and SNPs on insomnia. 118 (30.1 %) were exposed to passive smoking and 128 (32.7 %) suffered from insomnia. Passive smoking nearly doubled the probability of insomnia with adjusted odds ratio and 95 % confidence interval of (1.99: 1.16, 3.39). Dose-response association between passive smoking and insomnia was observed by passive smoking frequency (P trend 70 %, no specific PAH was detected to be associated with passive smoking exposure after Bonferroni correction. The mutant genotypes of CYP1B1 (rs1056836), AHR (rs2066853), and AHRR (rs2292596) were detected to have synergetic effects with passive smoking on insomnia after multivariate adjustment. We found a positive association between passive smoking status and insomnia among nonsmoking women. This association could be modified by SNPs related to PAHs metabolism. PAHs might not be the environmentally potential mechanism involved in the insomnia caused by tobacco smoke exposure.

ObjectivesThe prognostic impact of marital status on malignant pleural mesothelioma (MPM) is not investigated. This paper probes into the relationship between the prognosis of MPM and marital status.Materials and methodsThe Surveillance, Epidemiology, and End Results (SEER) database of American had been applied to choose eligible patients over the 2004–2015 periods. Moreover, cancer-specific survival (CSS) and overall survival (OS) of unmarried and married groups were compared.ResultsA total of 3,997 patients in total had been identified, including 2,735 (68.43%) married patients. In comparison to unmarried patients, married ones tended to be younger, male, white, and received active treatment (surgery, chemotherapy, or radiotherapy). In addition, the 1, 3, and 5-year CSS rates were 44.40, 12.09, and 6.88% in married patients, while 35.75, 12.12, and 6.37% in unmarried group (p = 0.0014). At the same time, the 1, 3, and 5-year OS rates were 41.84, 10.56, and 5.91% in married patients, while 33.67, 10.44, and 4.93%, respectively, in the unmarried group (p < 0.0001). As revealed by the multivariate analysis results, the marital status was an independent favorable prognostic factor, in which the married groups showed better CSS [hazard ratio (HR): 0.870; 95% confidence interval (CI): 0.808–0.938; p < 0.001] as well as OS (HR: 0.871; 95% CI: 0.810–0.936; p < 0.001). According to the results of subgroup analysis, the CSS and OS survival of married groups were better than the unmarried groups in almost all the subgroups.ConclusionMarital status is an independent favorable prognostic indicator of MPM. Poor prognosis in unmarried patients is likely to be related to insufficient treatments and socioeconomic and psychosocial factors.

Background: Gastric cancer is one of the most important malignancies with poor prognosis. Ferroptosis and cuproptosis are newly discovered metal-dependent types of programmed cell death, which may directly affect the outcome of gastric cancer. Long noncoding RNAs (lncRNAs) can affect the prognosis of cancer with stable structures, which could be potential prognostic prediction factors for gastric cancer.Methods: Differentially expressed metal-dependent programmed cell death (PCD)-related lncRNAs were identified with DESeq2 and Pearson’s correlation analysis. Through GO and KEGG analyses and GSEA , we identified the potential effects of metal-dependent PCD-related lncRNAs on prognosis. Using Cox regression analysis with the LASSO method, we constructed a 12-lncRNA prognostic signature model. Also, we evaluated the prognostic efficiency with Kaplan–Meier (K-M) survival curve, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) methods. The sensitivities for antitumor drugs were then predicted with the pRRophetic method. Also, we discuss Chinese patent medicines and plant extracts that could induce metal-dependent programmed cell death.Results: We constructed a metal-dependent PCD-related lncRNA-gene co-expression network. Also, a metal-dependent PCD-related gastric cancer prognostic signature model including 12 lncRNAs was constructed. The K-M survival curve revealed a poor prognosis in the high-risk group. ROC curve analysis shows that the AUC of our model is 0.766, which is better than that of other published models. Moreover, the half-maximum inhibitory concentration (IC50) for dasatinib, lapatinib, sunitinib, cytarabine, saracatinib, and vinorelbine was much lower among the high-risk group.Conclusion: Our 12 metal-dependent PCD-related lncRNA prognostic signature model may improve the OS prediction for gastric cancer. The antitumor drug sensitivity analysis results may also be helpful for individualized chemotherapy regimen design.

The purpose of this paper is to explore how social influence (SI), which is disaggregated into subjective norms (SN), social image (SIM), and social identity (SID), predicts perceived usefulness (PU), perceived pleasure (PP), and continuance intention (CI) toward sports and fitness applications. The underlying context is the socialization and gamification of exercise during the Covid-19 pandemic. Based on the theory of SI and the technology acceptance model, a theoretical framework was built where PU and PP mediate the influence of SI on CI, and proposed hypotheses were tested. The responses of 296 Keep users (a popular sports and fitness application in China) to a questionnaire survey were analyzed. SN and SIM were found to have significant positive effects on SID; SID has significant positive effects on PU and PP; both PU and PP have significant positive effects on the CI of users; SID and PU positively and significantly mediate the relationship between SN/SIM and CI; PU positively and significantly mediates the SID-CI relationship. However, the role of PP in mediating the influence of SI on CI is non-significant. This paper deepens the current understanding of the mechanisms that influence the relationship between SI and CI under the context of socialization and gamification services.

Objective To investigate the impact of gestational hypertension and pre-eclampsia on preterm birth.Design The data were collected from the China–US Collaborative Project for Neural Tube Defect Prevention; this was a large population-based cohort study.Setting and participants We selected participants registered in two southern provinces, for whom we had exact information on gestational blood pressure and pregnancy outcomes, and who were not affected by chronic hypertension. In total, 200 103 participants were recruited from 1993 to 1995.Outcome measures Preterm birth was defined as a singleton pregnancy and birth before 37 gestational weeks.Results The incidences of gestational hypertension and pre-eclampsia were 5.47% and 5.44%, respectively, for women who gave birth at full term, and 5.63% and 7.33%, respectively, for those who gave birth preterm. After adjusting for potential confounders, the risk ratios (RRs) of preterm birth in women with gestational hypertension and pre-eclampsia were 1.04 (95% CI 0.98 to 1.11) and 1.39 (95% CI 1.25 to 1.55), respectively. The associations were stronger for early-onset (