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In this paper, the differences in the wetting mechanisms of lignite dust and silica dust were investigated using molecular dynamics simulations and quantum chemical methods. A water-surfactant-lignite coal dust/silica dust model was constructed and the interaction energy, radial distribution function (RDF), mean square displacement (MSD), self-diffusion coefficient (D) and relative number density among the components within 100 ps after equilibrium were investigated by molecular dynamics simulations. The results show that the interaction energy and self-diffusion coefficient between cetyl trimethyl ammonium bromide(CTAB) solution and lignite molecules are larger and the peak value of relative number density is higher compared to silica dust; by comparing the electrostatic potential of lignite dust with that of silica dust, the magnitude of the potential difference of SiO2 varies widely, which shows that the size of the potential difference between the dust surface and water molecules due to active agent adsorption is one of the factors affecting the difference in surface wettability, but the functional groups in lignite increase the intermolecular interactions and play a significant role in the wetting process.

BackgroundTo evaluate the effects of curing modes on the micro-tensile bond strength and durability of 6 different dual curing resin cements to dentin.Methods84 human molars were divided into 7 groups (n = 12), and were further distributed into two subgroups according to the two curing modes: light-curing (L) and self-curing (D) (n = 6). The 6 dual-cured resin cements were: DU (Duolink, Bisco), TC (TheraCem, Bisco), MS (Multilink Speed, Ivoclar), N3 (Nexus 3 Universal, Kerr), R2 (RelyX U200, 3M) and RU (RelyX Ultimate, 3M). The universal adhesives were: All Bond Universal (Bisco); Adhesive Universal Vivapen (Ivoclar); Optibond Versa Adhesive (Kerr); Scotch Bond Universal Adhesive (3M). RU was placed directly on processed adhesive layer without light-curing, set as group 7. Micro-tensile bond strength test was carried out after 37°C water storage for 24 h, 3 months and 6 months, respectively. Three-way ANOVA and Games-Howell test were performed by SPSS 19.0 (α = 0.05).ResultsThe Three-way ANOVA indicated that bonding performance was significantly affected by curing mode (p = 0.000, F = 1,237.510), resin cement (p = 0.000, F = 59.507) and storage time (p = 0.000, F = 97.888). The interaction of these three factors was significant (p = 0.017, F = 2.071).ConclusionThe bonding strength and durability of dual curing resin cements were significantly improved by light-curing process. In addition, the bonding strength of resin cements with different experimental condition was material depended. Among all tested resin cements, N3 exhibits the most favorable outcomes.Clinical RelevanceA dual curing procedure is recommended in clinical application. Among all tested resin cements, N3 exhibits the most favorable outcomes.

Echinacoside, a principal active compound derived from Cistanche deserticola Ma, is recognized in traditional Chinese medicine for its anti-aging, immunomodulatory, endocrine-regulating, and neuroprotective properties. However, the specific neuroprotective mechanisms of echinacoside remain largely unclear. This study aims to investigate whether the neuroprotective effects of echinacoside in a mouse model of Parkinson's disease (PD) are mediated through the Nrf2/HO-1 signaling pathway by mitigating inflammatory responses. Mice were divided into four groups: control, model, positive control, and echinacoside-treated groups. PD mouse model was induced through intraperitoneal injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) over the course of one week, followed by three weeks of oral administration of echinacoside. The results demonstrated that echinacoside significantly improved motor function impairments caused by MPTP in PD mice. Immunohistochemical analysis revealed that echinacoside enhanced the expression of tyrosine hydroxylase in the substantia nigra of PD mice. Furthermore, assays of inflammatory cytokines indicated that echinacoside effectively reduced the levels of IL-6 and TNF-α in brain tissues. Western blot analysis further confirmed that echinacoside intervention upregulated the expression of Nrf2 and HO-1 in the brain tissues of PD mice. These findings suggest that echinacoside exerts neuroprotective effects in the PD mouse model, likely through the activation of the Nrf2/HO-1 signaling pathway. Therefore, echinacoside may be considered a potential therapeutic strategy for the treatment of PD.

This study aims to investigate the distribution patterns of bird species in urban built-up areas and their impact factors from multiple dimensions, including spatiotemporal distribution, environmental changes, and anthropogenic disturbances, as well as overall distribution and local hotspots. Leveraging geographic distribution data of 383 bird species from 70 families and 21 orders, the study recorded dynamic changes in bird distribution within urban built-up areas characterized by highly heterogeneous core areas and suburban areas. It examined species distribution across different seasons and land cover types, evaluated population fluctuations based on migratory behaviors, and assessed the relative abundance of bird families and species in hotspot areas. Additionally, this study employed three tree-based machine learning algorithms—Decision Tree (DT), Random Forest (RF), and Extreme Gradient Boosting (XGBoost)—to investigate the influence of environmental factors on bird species distribution within urban built-up areas. The findings showed that, temporally, the number of observed bird species in the study area peaked in May and September, while the lowest numbers of species (54.83 %) and individuals (5.45 %) were recorded during the high-temperature period from June to August. Spatially, (1) woodlands, including stable mature forests, unstable juvenile forests, and sparse vegetation, recorded the highest frequencies of bird observations (2,053 times), bird species (369 species), and bird individuals (38,623 individuals); (2) comprehensive parks, where bird species demonstrated higher adaptability to anthropogenic disturbances, experienced a more significant decline in species richness compared to country parks; and (3) the number of bird species in hotspot areas located in the core areas, which developed earlier, has decreased annually, while the number of species in suburban areas, which developed later, has increased annually. In terms of impact factors, water area (WA), point of interest kernel density (DPOI), relative humidity (RH), green space area (GSA), and nighttime light pollution (NL) were identified as the five most important environmental factors affecting bird species richness. These results suggest that although birds exhibit some adaptability to environmental changes and anthropogenic disturbances, species distribution remains significantly impacted. This research aims to provide a planning framework for future urban development that promotes biodiversity and adaptability, thereby bolstering the resilience of urban ecosystems.

Summary: Background: Over 500,000 new cases are diagnosed with papillary thyroid cancer (PTC) globally per year, of whom the vast majority are in the low-risk stratification. Although thyroid-stimulating hormone (TSH) suppression is traditionally recommended for all postoperative PTCs in current guidelines, its necessity remains highly controversial in low-risk patients. Since relevant recommendations in current guidelines are still empirical, we aim to provide a direct, large-scale, real-world evidence. Methods: This large-scale real-world retrospective study included 11,140 low-risk PTC patients from two Chinese large-volume centers (Fudan University Shanghai Cancer Center [FUSCC] and Cancer Hospital of Chinese Academy of Medical Sciences [CH-CAMS]) treated from January 1, 2000 to June 30, 2022. The mean TSH level was calculated based on postoperative serum TSH values during follow-up. The primary outcome was the association between postoperative TSH level and structural recurrence assessed by Kaplan–Meier, log-rank, multivariate Cox regression analyses and equivalence testing by Two One-Sided Tests (TOST) procedure. Propensity score matching (PSM) was used to adjust for confounders among groups. Findings: A total of 11,140 patients with low-risk PTC were included with a median follow-up of 70 months. Based on the mean TSH level, we classified these patients into ≤0.5 (n = 1,504, 13.5%), (0.5–1] (n = 4,336, 38.9%), (1–2] (n = 4,285, 38.5%), (2–3] (n = 704, 6.3%) and >3 (n = 311, 2.8%) mU/L groups. After PSM adjusting for age, sex, T and N stage, 8991 patients were included in further analysis, for whom the log-rank analyses showed no significant differences between any two groups (all P > 0.05) in recurrence-free survival (RFS), locoregional recurrence-free survival (LRRFS) and distant metastasis-free survival (DMFS), and suppressed TSH was not associated with tumor recurrence in the multivariate Cox analysis (TSH > 2 group vs TSH ≤ 2 group: HR = 1.30, 95% CI = 0.85–2.01, P = 0.23). Furthermore, the TOST equivalence tests showed that tumor recurrence status of any two TSH groups were statistically comparable (all Bonferroni-corrected P values

This paper proposes a biogas-wind-solar-hydrogen multi-microgrid system to address the issues of poor economy and reliability, as well as the waste of wind and solar energy, in single energy-based isolated microgrid systems. The study considers the coupling constraints of multiple time scales and establishes a dynamic economic dispatch model. Furthermore, a consensus-based distributed dynamic economic dispatch strategy is proposed. To tackle the challenge of unified economic dispatch caused by the interaction among multiple microgrids in the joint operation of the biogas-wind-solar-hydrogen multi-microgrid system, a microgrid selfishness impact model and elimination strategy are developed. Simulation results demonstrate the effectiveness and superiority of the proposed distributed dynamic economic dispatch strategy considering individual selfishness in the biogas-wind-solar-hydrogen multi-microgrid system.

BackgroundNumerous studies have developed or validated prediction models to estimate the likelihood of postoperative pneumonia (POP) in esophageal cancer (EC) patients. The quality of these models and the evaluation of their applicability to clinical practice and future research remains unknown. This study systematically evaluated the risk of bias and applicability of risk prediction models for developing POP in patients undergoing esophageal cancer surgery.MethodsPubMed, Embase, Web of Science, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), WanFang Database and Chinese Biomedical Literature Database were searched from inception to March 12, 2024. Two investigators independently screened the literature and extracted data. The Prediction Model Risk of Bias Assessment Tool (PROBAST) checklist was employed to evaluate both the risk of bias and applicability.ResultA total of 14 studies involving 23 models were included. These studies were mainly published between 2014 and 2023. The applicability of all studies was good. However, all studies exhibited a high risk of bias, primarily attributed to inappropriate data sources, insufficient sample size, irrational treatment of variables and missing data, and lack of model validation. The incidence of POP in patients undergoing esophageal cancer surgery ranged from 14.60% to 39.26%. The most frequently used predictors were smoking, age, chronic obstructive pulmonary disease(COPD), diabetes mellitus, and methods of thoracotomy. Inter-model discrimination ranged from 0.627 to 0.850, sensitivity ranged between 60.7% and 84.0%, and specificity ranged from 59.1% to 83.9%.ConclusionIn all included studies, good discrimination was reported for risk prediction models for POP in patients undergoing esophageal cancer surgery, indicating stable model performance. However, according to the PROBAST checklist, all studies had a high risk of bias. Future studies should use the predictive model assessment tool to improve study design and develop new models with larger samples and multicenter external validation.Systematic review registrationhttps://www.crd.york.ac.uk/prospero, identifier CRD42024527085.

Abstract Purpose The pathways underpinning suicide ideation (SI) and certain physical and psychological factors in patients with advanced breast cancer remain unclear. This study develops and validates a mediation model that delineates the associations between several multidimensional variables and SI in Chinese patients with advanced breast cancer. Methods Patients with advanced breast cancer (n = 509) were recruited as study participants from 10 regional cancer centers across China from August 2019 to December 2020. Participants were required to complete five questionnaires using an electronic patient-reported outcomes (ePRO) system: 9 item- Patient Health Questionnaire (PHQ-9), Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), 5-level EQ-5D (EQ-5D-5L), and MD Anderson Symptom Inventory (MDASI). Risk factors for SI were identified using multivariable logistic regression, and inputted into serial multiple mediation models to elucidate the pathways linking the risk factors to SI. Results SI prevalence was 22.8% (116/509). After adjusting for covariates, depression (odds ratio [OR] = 1.384), emotional distress (OR = 1.107), upset (OR = 0.842), and forgetfulness (OR = 1.236) were identified as significant independent risk factors (all p

Abstract Diabetic retinopathy (DR) is the most frequent microvascular complication of diabetes mellitus, however, its underlying biological mechanisms remain poorly understood. We examined single nucleotide polymorphisms linked to 486 blood metabolites through extensive genome-wide association studies conducted on individuals of European ancestry. The FinnGen Biobank database served as a reference to define DR. Two-sample MR analysis was conducted to reveal the association between the levels of genetically predicted circulating metabolites and the susceptibility to DR. To validate the robustness of the obtained findings, sensitivity analyses with weighted median, weighted mode, and MR-Egger were conducted. 1-oleoylglycerophosphoethanolamine (odds ratio [OR] (OR per one standard deviation [SD] increase) = 0.414; 95% confidence interval [CI] 0.292–0.587; P = 7.613E−07, PFDR = 6.849E−06), pyroglutamine (OR per one SD increase = 0.414; 95% confidence interval [CI] 0.292–0.587; P = 8.31E−04, PFDR = 0.007), phenyllactate (PLA) (OR per one SD increase = 0.591; 95% confidence interval [CI] 0.418–0.836; P = 0.003, PFDR = 0.026), metoprolol acid metabolite (OR per one SD increase = 0.978; 95% confidence interval [CI] 0.962–0.993; P = 0.005, PFDR = 0.042), 10-undecenoate (OR per one SD increase = 0.788; 95% confidence interval [CI] 0.667–0.932; P = 0.005, PFDR = 0.049), erythritol (OR per one SD increase = 0.691; 95% confidence interval [CI] 0.513–0.932; P = 0.015, PFDR = 0.034), 1-stearoylglycerophosphoethanolamine (OR per one SD increase = 0.636; 95% confidence interval [CI] 0.431–0.937; P = 0.022, PFDR = 0.099), 1-arachidonoylglycerophosphoethanolamine (OR per one SD increase = 0.636; 95% confidence interval [CI] 0.431–0.937; P = 0.030, PFDR = 0.099) showed a significant causal relationship with DR and could have protective effects. stachydrine (OR per one SD increase = 1.146; 95% confidence interval [CI] 1.066–1.233; P = 2.270E−04, PFDR = 0.002), butyrylcarnitine (OR per one SD increase = 1.117; 95% confidence interval [CI] 1.023–1.219; P = 0.014, PFDR = 0.062), 5-oxoproline (OR per one SD increase = 1.569; 95% confidence interval [CI] 1.056–2.335; P = 0.026, PFDR = 0.082), and kynurenine (OR = 1.623; 95% CI 1.042–2.526; P = 0.041, PFDR = 0.097) were significantly associated with an increased risk of DR. This study identified metabolites have the potential to be considered prospective compounds for investigating the underlying mechanisms of DR and for selecting appropriate drug targets.

Abstract Background Little is understood about the association between psychosomatic symptoms and advanced cancer among older Chinese patients. Methods This secondary analysis was part of a multicenter cross-sectional study based on an electronic patient-reported outcome platform. Patients with advanced cancer were included between August 2019 and December 2020 in China. Participants (over 60 years) completed the MD Anderson Symptom Inventory (MDASI) and Hospital Anxiety and Depression Scale (HADS) to measure symptom burden. Network analysis was also conducted to investigate the network structure, centrality indices (strength, closeness, and betweenness) and network stability. Results A total of 1022 patients with a mean age of 66 (60–88) years were included; 727 (71.1%) were males, and 295 (28.9%) were females. A total of 64.9% of older patients with advanced cancer had one or more symptoms, and up to 80% had anxiety and depression. The generated network indicated that the physical symptoms, anxiety and depression symptom communities were well connected with each other. Based on an evaluation of the centrality indices, ‘distress/feeling upset’ (MDASI 5) appears to be a structurally important node in all three networks, and ‘I lost interest in my own appearance’ (HADS-D4) had the lowest centrality indices. The network stability was relatively high (> 0.7). Conclusion The symptom burden remains high in older patients with advanced cancer in China. Psychosomatic symptoms are highly interactive and often present as comorbidities. This network can be used to provide targeted interventions to optimize symptom management in older patients with advanced cancer in China. Trial registration Chinese Clinical Trial Registry (ChiCTR1900024957), registered on 06/12/2020.

As China’s financial markets become increasingly integrated and the carbon market undergoes financialization, the impact of carbon emission price fluctuations on financial markets has emerged as a key area of systemic risk research. This study employs the Generalized AutoRegressive Conditional Heteroskedasticity (GARCH) model and the optimal Copula function to investigate the dynamic correlation between carbon prices and China’s financial markets. Building on this, the Monte Carlo simulation and Copula CoVaR models are used to explore the spillover effects of carbon price volatility on China’s financial markets. The findings reveal the following: (1) Carbon price fluctuations generate spillover effects on all financial markets, but the intensity varies across different markets. The foreign exchange market experiences the strongest spillover effect, followed by the bond market, while the stock and money markets are relatively less affected. (2) The optimal Copula functions differ between the carbon market and China’s financial markets, indicating heterogeneous characteristics across regional markets. (3) There is a degree of interdependence between the carbon market and various sub-markets in China’s financial system. The carbon market has the strongest positive correlation with the commodity market and a relatively high negative correlation with the real estate market. These findings underscore the importance of integrating carbon price volatility into financial risk management frameworks. For policymakers, it highlights the need to consider market stability measures when crafting carbon emission regulations. Market managers can leverage these insights to develop strategies that mitigate risk spillover effects, while investors can use this analysis to inform their portfolio diversification and risk assessment processes.

Abstract Objectives Patients with advanced colorectal cancer (CRC) have multiple concurrent physical and psychological symptoms. This study aimed to explore the relationship between anxiety, depression, and symptom burden in advanced CRC. Methods A multicenter cross‐sectional study was conducted in 10 cancer centers from geographically and economically diverse sites in China. A total of 454 patients with advanced CRC completed the Hospital Anxiety and Depression Scale and the MD Anderson Symptom Inventory. Multiple regression analysis was applied to explore the relationship between anxiety, depression and symptom burden. Results About one‐third of the patients showed symptoms of anxiety or depression. Patients with anxiety or depression reported significantly higher symptom burden than those without (p

Abstract Background Patients diagnosed with advanced stage cancer face an elevated risk of suicide. We aimed to develop a suicidal ideation (SI) risk prediction model in patients with advanced cancer for early warning of their SI and facilitate suicide prevention in this population. Patients and Methods We consecutively enrolled patients with multiple types of advanced cancers from 10 cancer institutes in China from August 2019 to December 2020. Demographic characteristics, clinicopathological data, and clinical treatment history were extracted from medical records. Symptom burden, psychological status, and SI were assessed using the MD Anderson Symptom Inventory (MDASI), Hospital Anxiety and Depression Scale (HADS), and Patient Health Questionnaire‐9 (PHQ‐9), respectively. A multivariable logistic regression model was employed to establish the model structure. Results In total, 2814 participants were included in the final analysis. Nine predictors including age, sex, number of household members, history of previous chemotherapy, history of previous surgery, MDASI score, HADS‐A score, HADS‐D score, and life satisfaction were retained in the final SI prediction model. The model achieved an area under the curve (AUC) of 0.85 (95% confidential interval: 0.82–0.87), with AUCs ranging from 0.75 to 0.95 across 10 hospitals and higher than 0.83 for all cancer types. Conclusion This study built an easy‐to‐use, good‐performance predictive model for SI. Implementation of this model could facilitate the incorporation of psychosocial support for suicide prevention into the standard care of patients with advanced cancer.

Summary: Strong evidence from human genetic studies associates the thousand and one amino acid kinase 1 (TAOK1) gene with autism spectrum disorder (ASD). In this work, we discovered a de novo frameshifting mutation in TAOK1 within a Chinese ASD cohort. We found that Taok1 haploinsufficiency induces autistic-like behaviors in mice. Importantly, we observed a significant enrichment of Taok1 in the dorsal raphe nucleus (DRN). The haploinsufficiency of Taok1 considerably restrained the activation of DRN neurons during social interactions, leading to the aberrant phosphorylation of numerous proteins. Intriguingly, the genetic deletion of Taok1 in VGlut3-positive neurons of DRN resulted in mice exhibiting autistic-like behaviors. Ultimately, reintroducing wild-type Taok1, but not its kinase-dead variant, into the DRN of adult mice effectively mitigated the autistic-like behaviors associated with Taok1 haploinsufficiency. This work suggests that Taok1, through its influence in the DRN, regulates social interaction behaviors, providing critical insights into the etiology of ASD.

ObjectiveWe conducted this cross-sectional study to explore the mediating and predicting role of somatic symptom disorder (SSD) between psychological measures and quality of life (QOL) among Chinese breast cancer patients.MethodsBreast cancer patients were recruited from three clinics in Beijing. Screening tools included the Patient Health Questionnaire-15 (PHQ-15), the Patient Health Questionnaire-9 (PHQ-9), the General Anxiety Disorder-7 scale (GAD-7), the Health Anxiety Scale (Whiteley Index-8, WI-8), the Somatic Symptom Disorder B-Criteria Scale (SSD-12), the Fear of Cancer Recurrence scale (FCR-4), the Brief Illness Perception Questionnaire (BIPQ-8), and the Functional Assessment of Cancer Therapy-Breast (FACT-B). Chi-square tests, nonparametric tests, mediating effect analysis, and linear regression analysis were used for the data analysis.ResultsAmong the 264 participants, 25.0% were screened positive for SSD. The patients with screened positive SSD had a lower performance status, and a greater number of patients with screened positive SSD received traditional Chinese medicine (TCM) (p

Abstract Hydrothermal H2S is an important energy source for hydrothermal ecosystems. However, it is difficult to obtain accurate hydrogen sulfide concentrations in high‐temperature hydrothermal fluids because they are highly susceptible to oxidation and compositional variability with mixing. In this study, a new in situ approach for measuring H2S, HS− and pH in hydrothermal fluids was developed and applied to the detections of Okinawa Trough hydrothermal activities. The in situ total H2S concentrations in the Jade and Biwako fluids were determined to be 31.4 and 76.7 mmol/kg, respectively. The in situ measured pH of the Jade fluids was determined to be 6.3, which has exceeded that of a neutral fluid at a specific temperature and pressure, indicating that the pH of Jade fluids is weakly alkaline. The pH transition of hydrothermal fluids from alkaline to acidic may be attributed to the thermal decomposition of organic matter and sulfide precipitation.

Objective: The purpose of this systematic review and meta-analysis was to evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) on pregnancy outcomes in women undergoing in vitro fertilization-embryo transfer (IVF-ET), in order to provide evidence-based medical support.Methods: We searched the Cochrane Library, Embase, PubMed, Web of Science, SinoMed, and CNKI for relevant randomized controlled trials (RCTs) from inception to 31 May 2022, using the search terms “transcutaneous electrical acupoint stimulation,” “TEAS,” “in vitro fertilization-embryo transfer,” “IVF-ET,” “randomized controlled trial,” and “clinical trials.” The experimental group was treated with TEAS or combined with ovulation-inducing medication, and the control group was treated with mock TEAS (mTEAS), ovulation-inducing medication, or no intervention. The main outcome was the clinical pregnancy rate. Secondary outcomes were the embryo implantation rate, live birth rate, biochemical pregnancy rate, and number of oocytes retrieved. Stata15.1 software was used for data summary and analysis.Results: This review involved 15 RCTs and 4,281 participants. TEAS were superior to the control group for improving the clinical pregnancy rate [RR: 1.29, 95% CI: 1.19 to 1.40; p < 0.001; I2 = 23.0%], embryo implantation rate [RR: 1.43, 95% CI: 1.22 to 1.69; p < 0.001; I2 = 35.9%], live birth rate [RR: 1.33, 95% CI: 1.14 to 1.54; p < 0.001; I2 = 47.3%], and biochemical pregnancy rate [RR: 1.15, 95% CI: 1.05 to 1.26; p = 0.003; I2 = 49.1%], without significant heterogeneity. TEAS had no statistically significant effect on the number of oocytes retrieved as compared with the control group, and the heterogeneity was high [SMD: 0.34, 95% CI: -0.04 to 0.72; p = 0.081; I2 = 77.6%]. We performed subgroup analysis based on the sample size, interventions and intervention time-point. The results showed that the sample size had no effect on the results. There was no significant difference between TEAS and ovulation-inducing medication in the clinical pregnancy rate or the embryo implantation rate. In addition, TEAS did not significantly increase the embryo implantation rate or the live birth rate, compared with no intervention. In terms of safety, mild allergic symptoms were found in both the experimental group and the control group.Conclusion: In general, existing evidence supports the potential value of TEAS as an adjunctive treatment for improving pregnancy outcomes. High-quality, large-sample RCTs are needed to further support this conclusion.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=334892, identifier PROSPERO CRD42022334892.

Background: At present, a number of systematic reviews (SRs) on Xuebijing injection (a patent in China) in the treatment of acute pancreatitis (AP) or severe acute pancreatitis (SAP) have been published. However, the quality of evidence is uneven and has not been comprehensively evaluated.Aim: We evaluated the efficacy of Xuebijing injection for AP/SAP through an overview of SR, and to provide a scientific basis for its effectiveness and safety.Methods: We searched Cochrane Library, Embase, PubMed, SinoMed, CNKI, Wanfang, and VIP comprehensively. The retrieval period from inception to 30 November 2021, and the two reviewers independently complete the literature retrieval, data extraction and evaluation. The Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) and the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) were used to evaluate the methodological quality and reporting quality of the SRs, respectively. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to evaluate the quality grading of outcomes and the risk of bias in SRs was evaluated by ROBIS Tool. Finally, the RCTs involved in SRs were synthesized. Stata15.1 was used for quantitative analysis of total effectiveness rate, time until relief of abdominal pain, time until relief of abdominal distension, and serum amylase level.Results: Nine eligible SRs were included, including 92 RCTs and 6,837 participants. The quality of SRs was relatively good, and the manuscript structures were relatively complete. However, the methodological quality of SRs was low or critically low. RoB rated 5 SRs as low risk of bias and 4 SRs as high risk of bias. In GRADE, a total of 47 results were included in the 9 SRs, of which 5 results (10.64%) were moderate quality, 22 results (46.81%) were low quality, and 20 results (42.55%) were very low quality. The results of data synthesis showed that Xuebijing injection combined treatment increased the total effectiveness rate of AP patients (RR = 1.19, 95% CI 1.17–1.23, p < 0.0001), and there was no heterogeneity between studies (I2 = 0.0%, p = 0.589). Compared with the control group, Xuebijing injection group shortened the abdominal pain and distension relief time in AP patients (WMD = −1.69, 95% CI −1.88–−1.50, p < 0.0001; WMD = −1.48, 95% CI −1.74–−1.23, p < 0.0001), with high heterogeneity (I2 = 84.3%, p = 0.000; I2 = 72.2%, p = 0.000). Serum amylase level was also reduced (WMD = −2.06, 95% CI −2.47–−1.64, p < 0.0001), with significant heterogeneity (I2 = 71.6%, p = 0.000). A total of one SR reported adverse drug reaction (ADR), no ADRs were observed in the control group.Conclusion: Although the quality of the evidence is not high, it can still reflect the clinical value of Xuebijing injection as an analgesic and anti-inflammatory traditional Chinese medicine in the treatment of AP/SAP. Therefore, future clinical studies should focus on the long-term efficacy and adverse reactions of drugs.Systematic Review Registration: (website), identifier (registration number).

Abstract A recently developed energy flux diagnosis scheme, which incorporates a smooth connection between the tropical and subtropical zones, is used in the present study to investigate vertically propagating waves in the tropical Indian Ocean (IO) based on the result of a linear, continuously stratified ocean model driven by climatological wind forcing. This extended diagnosis reveals deep-reaching eastward energy fluxes at the equator which develop four times per year and are associated with equatorial Kelvin waves (KWs) generated by semiannual winds. The authors find that the downward transfer of wave energy is particularly deep in the southern Bay of Bengal (SBoB). This downward flux is attributed to off-equatorial Rossby waves and appears four times per year, maximizing its amplitude during November–December. Southwesterly winds in the Arabian Sea intensify eastward energy flux of KWs at mid-depth, which maximizes in amplitude in August. This is contrastive to KW energy flux at the surface which peaks in May. These mid-depth equatorial KW packets subsequently arrive at the eastern boundary of the IO and are diffracted poleward to produce downward energy flux in November and December detected in the SBoB.

Heavy metals often coexist in contaminated environmental media, and competition between heavy metals for adsorption sites influences the absorption capacity of biochar. In this study, the adsorption mechanism of pyrolytically modified wood ear mushroom sticks (250, 450, and 650 °C) as a new bio-adsorbent for single-ion and mixed-ion solutions Cd2+ and Pb2+ Biochar adsorption experiments showed that the adsorption abilities of Cd2+ and Pb2+ increased with increasing WMBC (wood ear mushroom sticks biochar) pyrolysis temperature. According to the Langmuir model, the maximum adsorption capacity of Cd2+ and Pb2+increased with higher pyrolysis temperature, being 29.84, 39.08, 46.16 mg·g−1and 124.3, 186.8, 234.2 mg·g−1, respectively for three different pyrolysis temperatures 250, 450, and 650 °C. WMBC exhibited a stronger adsorption ability for Pb2+ than for Cd2+. Competition between the two heavy metals severely inhibited the adsorption of Cd2+. Based on X-ray diffraction (XRD), scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM-EDS), and Fourier transform infrared spectroscopy (FTIR) analyses, the dominant interaction mechanisms were determined to be complexation, ion exchange, precipitation, and C–π interaction. The results suggest WMBC shows promise as a novel, cheap, and effective adsorbent that can be used to remove both Cd2+ and Pb2+ pollutants from environmental media.

Wheat stripe rust is an important foliar disease that affects the wheat yield globally. Breeding for resistant wheat varieties is one of the most economically and environmentally effective ways to control this disease. The common wheat (Triticum aestivum L.) cultivar “Pascal” exhibited susceptibility to stripe rust at the seedling stage but it showed high resistance to stripe rust at the adult plant stage over 20 years in Gansu, a hotspot of the disease in northwestern China. To understand the genetic mechanism of stripe rust resistance in this cultivar, a 55K SNP array was used to analyze the two parents and the 220 recombinant inbred lines (RILs) derived from the cross of “Huixianhong” × “Pascal.” We detected three new stripe rust adult plant resistance (APR) quantitative trait locus (QTL) contributed by Pascal, viz. QYr.gaas-1AL, QYr.gaas-3DL, and QYr.gaas-5AS, using the inclusive composite interval mapping method. They were flanked by SNP markers AX-111218361—AX-110577861, AX-111460455—AX-108798599, and AX-111523523—AX-110028503, respectively, and explained the phenotypic variation ranging from 11.0 to 23.1%. Bulked segregant exome capture sequencing (BSE-Seq) was used for fine mapping of QYr.gaas-1AL and selection of candidate genes, TraesCS1A02G313700, TraesCS1A02G313800, and TraesCS1A02G314900 for QYr.gaas-1AL. KASP markers BSE-1A-12 and HXPA-3D for QYr.gaas-1AL and QYr.gaas-3DL were developed for breeders to develop durable stripe rust-resistant wheat varieties.

ObjectiveDiabetic retinopathy (DR) is a common diabetic microvascular complication and a major cause of acquired vision loss. Finding effective biomarkers for the early identification and diagnosis of DR is crucial. This study aimed to comprehensively evaluate the accuracy of microRNAs (miRNAs) in the diagnosis of DR via a meta-analysis of previously published diagnostic studies. This study has been registered on the PROSPERO website, with the number CRD42022323238.MethodsWe searched PubMed, Cochrane Library, Embase, Web of Science, China Wanfang database, and China Knowledge Network database to identify relevant articles published from the time of database creation to April 10, 2022. Stata 14.0 software was used to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic ratio (DOR), and area under the summary receiver operating characteristic (ROC) curve to assess the accuracy of miRNAs in the diagnosis of DR. Heterogeneity between studies was assessed using Cochran-Q test and I2 statistic for quantitative analysis. The random-effect model was selected due to significant heterogeneity. Subgroup analysis and regression analysis were also performed to determine the potential sources of heterogeneity.ResultsWe included 25 articles detailing 52 studies with 1987 patients with DR and 1771 non-DR controls. The findings demonstrated overall sensitivity (0.82, 95% CI: 0.78 ~ 0.85), specificity (0.84, 95% CI: 0.81 ~ 0.86), PLR (5.0, 95% CI: 4.2 ~ 5.9), NLR (0.22, 95% CI: 0.18 ~ 0.26), and the area under the summary ROC curve (0.90, 95% CI: 0.87 ~ 0.92). Furthermore, we performed subgroup analysis and found that panels of multiple miRNAs could enhance the pooled sensitivity (sensitivity, specificity, and AUC values were 0.89, 0.87, and 0.94, respectively).ConclusionThe meta-analysis showed that miRNAs can be used as potential diagnostic markers for DR, with high accuracy of diagnoses observed with the detection of miRNAs in plasma and serum.

BackgroundPatients with cancer experience multiple symptoms related to cancer, cancer treatment, and the procedures involved in cancer care; however, many patients with pain, depression, and fatigue, especially those outside the hospital, receive inadequate treatment for their symptoms. Using an electronic patient-reported outcome (ePRO) platform to conduct symptom management follow-up in outpatients with advanced cancer could be a novel and potentially effective approach. However, empirical evidence describing in detail the preparation and implementation courses in a real setting is needed. ObjectiveThe purpose of this paper was to describe the implementation process and evaluation of an ePRO platform that facilitates symptom management for patients with cancer, share our experiences and the problems we encountered during the process of implementation, and share the solutions we identified for those problems. Moreover, we tested the feasibility, safety, and efficacy of the ePRO platform. MethodsThis was a real-world, ongoing, longitudinal, single-center, prospective study with a total of 7 follow-ups conducted within 4 weeks after the first visit to the symptom management clinic (on days 1, 3, 7, 10, 14, 21, and 28). Participants were encouraged to complete scales for physical symptoms (pain, fatigue, and shortness of breath), cognitive symptoms (memory problems and impaired concentration), and affective symptoms (especially depression and anxiety) during follow-up. The design and function of the ePRO-doctor client and ePRO-patient client, the patient-reported outcome (PRO) scales used in the study, and the strategies to promote symptom tracking have been described. Moreover, the training and evaluation for research assistants have been presented. The efficacy of the ePRO platform was assessed with a comparison of the baseline and 4-week outcomes on the MD Anderson Symptom Inventory. ResultsUsing the ePRO platform for symptom management follow-ups in advanced cancer patients was associated with a high completion rate (72.7%-86.4%) and a low drop-off rate (23.6%). The ePRO platform sent 293 alert notifications to both patients and doctors, which promoted patient security. The short and sharp PRO tool selection, user-friendly interface, automatic reminder notifications and alerts, and multiple dimensional training were essential components for the preparation and implementation of the ePRO system. The results showed significant improvements in the mean scores of pain, fatigue, and numbness from baseline to day 28 (P=.02, P=.02, and P

BackgroundPrimary tumor of the inferior vena cava is a rare tumor, which arises from the smooth muscle of vascular walls. Surgery appears the only curative treatment. However, the optimal surgical methods and surgical management are not well-studied. In this article, we reviewed the successful treatment experience of patients in our center who had resection of primary tumor of the inferior vena cava and reviewed the relevant literature.MethodsFour cases of patients who undergoing initial resection of primary tumors of the inferior vena cava from September 2017 to August 2021 in the Second Affiliated Hospital of Nanchang University were screened and followed up. They were discussed and cases reported in this field were reviewed.ResultsAmong the four patients, three of them were female. The median age of the disease is 53.75 years (range 45–60 years). After surgical treatment, tumors were removed in all patients, and some patients had reconstruction of inferior vena cava. There were no disease-specific deaths, no serious complications, and no recurrence during follow-up in these cases.ConclusionsCareful preoperative examination, correct surgical treatment methods, and multidisciplinary collaboration can lead to safe and successful operations, which improve the survival rate of patients.

The LCL-type dual active bridge (LCL-DAB) DC-DC converter is a promising part for DC micro-grids due to its high voltage gain and low bridge current, but the issues of backflow power elimination and transient response optimization deserve attention in its operation. In this article, a virtual direct current control (VDCC) method of the LCL-DAB converter for fast transient response and no backflow power is proposed, which can eliminate the backflow power and improve the transient response against the input voltage and load disturbances. With dual-phase-shift (DPS) modulation scheme, the voltage-current characteristics are first analyzed using the phasor method. The small-signal mathematic model of the LCL-DAB converter is then established. The power characteristic is derived so the design regions of no backflow power can be graphed. On this basis, an appropriate outer phase shift ratio can be estimated to ensure a wide range of no backflow power operation. Moreover, a virtual voltage is generated to compensate in the control loop, thus the transient response against disturbances of the LCL-DAB converter can be improved under no backflow power. Simulation and prototype experimental results are presented to verify the feasibility of the proposed VDCC method.

Due to their toxicity, non-biodegradability, and biological amplification in the food chain, heavy metal accumulation in humans via the consumption of fishes has become a problem. In this study, we analyzed the concentrations of six trace metals (Cd, Cr, Cu, Ni, Pb, Zn) in 12 marine fish species collected from Liaodong Bay, China, from 2015 to 2020, to understand the pollution status of the bay and evaluate the impact of fish consumption on human health. In addition, 5 fish species with the potential to serve as bioindicators of metal contamination were identified. In general, the average concentrations were Zn > Pb ≈ Cr > Ni ≈ Cu > Cd. There were significant differences in the concentrations in the muscle tissues of fish with different feeding strategies. The total target hazard quotient values of some fish were greater than 1 in 2015, suggesting that people were susceptible to high health risks. The year 2017 had the lowest values, which suggests that metal pollution in Liaodong Bay may have been decreasing at that time. Monitoring of metal concentrations in marine fish from Liaodong Bay warrants more study.

Long-term exposure to low polycyclic aromatic hydrocarbon (PAH) concentration may ave detrimental effects, including changing platelet indices. Effects of chronic exposure to low PAH concentrations have been evaluated in cross-sectional, but not in longitudinal studies, to date. We aimed to assess the effects of long-term exposure to the low-concentration PAHs on alterations in platelet indices in the Chinese population. During 2014-2017, we enrolled 222 participants who had lived in a village in northern China, 1-2 km downwind from a coal plant, for more than 25 years, but who were not employed by the plant or related businesses. During three follow-ups, annually in June, demographic information and urine and blood samples were collected. Eight PAHs were tested: namely 2-hydroxynaphthalene, 1-hydroxynaphthalene, 2-hydroxyfluorene, 9-hydroxyfluorene (9-OHFlu), 2-hydroxyphenanthrene (2-OHPh), 1-hydroxyphenanthrene (1-OHPh), 1-hydroxypyrene (1-OHP), and 3-hydroxybenzo [a] pyrene. Five platelet indices were measured: platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), platelet crit, and the platelet-large cell ratio. Generalized mixed and generalized linear mixed models were used to estimate correlations between eight urinary PAH metabolites and platelet indices. Model 1 assessed whether these correlations varied over time. Models 2 and 3 adjusted for additional personal information and personal habits. We found the following significant correlations: 2-OHPh (Model1 β1 = 18.06, Model2 β2 = 18.54, Model β3 = 18.54), 1-OHPh (β1 = 16.43, β2 = 17.42, β3 = 17.42), 1-OHP(β1 = 13.93, β2 = 14.03, β3 = 14.03) with PLT, as well as 9-OHFlu with PDW and MPV (odds ratio or Model3 ORPDW[95%CI] = 1.64[1.3-2.06], ORMPV[95%CI] = 1.33[1.19-1.48]). Long-term exposure to low concentrations of PAHs, indicated by2-OHPh, 1-OHPh, 1-OHP, and 9-OHFlu, as urinary biomarkers, affects PLT, PDW, and MPV. 9-OHFlu increased both PDW and MPV after elimination of the effects of other PAH exposure modes.

Background: Clinical evidence suggests that acupuncture is effective for relieving abdominal pain and distension in acute pancreatitis (AP). However, there is a lack of systematic reviews and meta-analyses that provide high-quality evidence of the efficacy and safety of acupuncture in this context.Aim: To assess the efficacy and safety of acupuncture for relieving abdominal pain and distension in AP.Methods: We searched the PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang, VIP, and China Biomedical Literature databases. Randomized controlled trials of acupuncture plus routine treatment (RT) vs. RT alone or RT plus sham/placebo acupuncture were included. Primary outcomes included total effectiveness rate, VAS scores for abdominal pain and distension, and time until relief of abdominal pain and distension. Secondary outcomes included time until recovery of bowel sound, time until first defecation, length of hospital stay, and APACHE II score.Results: Nineteen eligible original studies (n = 1,503) were included. The results showed that acupuncture in combination with RT had a significant advantage in terms of increasing the total effectiveness rate [risk ratio: 1.15; 95% confidence interval (CI): 1.06–1.24; P = 0.001]. Acupuncture also reduced the VAS score for abdominal pain [weighted mean difference (WMD): −1.45; 95% CI: −1.71 to −1.19; P < 0.0001] and the VAS score for abdominal distension (WMD: −0.71; 95% CI: −1.04 to −0.37; P < 0.0001) in patients with AP. Other results also showed the efficacy of acupuncture. One study reported adverse events after acupuncture.Conclusion: Acupuncture in combination with RT has a better effect than RT alone for relieving abdominal pain and distension in AP. More rigorous studies are needed to confirm this result.Systematic Review Registration: PROSPERO CRD42019147503 (https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=147503).

The LLC-type resonant dual-active-bridge (LLC-DAB) DC-DC converter with a high voltage gain, high power density, and low backflow power has attracted increasing attention in recent years. However, its soft-switching and backflow power problems are still not solved, so the improvements to these problems are studied in this paper. Based on the dual phase shift (DPS) modulation method, the operating characteristics are analyzed, and a soft-switching and no backflow power modulation curve is established based on the voltage-current time-domain characteristics. On this basis, a soft-switching and no backflow power optimized control method based on DPS modulation is proposed to achieve soft-switching operation and eliminate backflow power. Due to the complex time-domain characteristics of the resonant tank voltage and current, the relationship between the phase shift ratios is fitted and optimized with this method based on the soft-switching and no backflow power characteristic curve, and the optimized results of the phase shift ratio under different operating conditions are obtained. The simulation results indicate that the soft-switching operation of the LLC-DAB converter can be achieved with the optimized control method proposed in this paper, and the backflow power is effectively eliminated.

With global warming, previous studies have found nonuniformity responses of precipitation because of regional differences. However, climate change affects the mean, extreme, and data structure of precipitation. Quantile regression, which can reflect every part of the trends of data, was used to detect responses of each part of precipitation in China. The V2.0 dataset of daily precipitation grid data (0.5° × 0.5°) from 1961 to 2020 in China was used as practical observation data. Daily precipitation in 2015–2100 from the China Model BCC-CSM2-MR of scenarios SSP2-4.5 and SSP5-8.5 were chosen as future climate changes with moderate and high radiative forcing, respectively. On the basis of the sign consistency of the slope coefficients with quantile regression, the results of quantiles q = 0.3, 0.5, 0.7 and 0.9 were selected to represent low, median, high and flood precipitation, respectively. Precipitation in four seasons was separately analyzed to observe seasonal characteristics in China. For the observation data, precipitation had obviously different responses in the low and high percentiles and was present in mainly spring and summer. In spring, in the middle and lower Yangtze Plains, the low and median precipitation increased, whereas the high and flood precipitation significantly decreased. In summer, Heilongjiang Province and northern Inner Mongolia showed decreasing trends in the low quantile and increasing trends in the high quantile, indicating a completely opposite trend adjustment. These regions deserve more attention. However, obviously different responses in low and high percentiles were not so evident in future climate changes. Self-consistency in model data may weaken the heteroscedastic characteristics of precipitation.

Background: Excessive supraventricular ectopic activity (ESVEA) is correlated with the development of atrial fibrillation (AF) and is frequently observed in ischemic stroke patients. This meta-analysis aims to summarize the evidence on the association between ESVEA and the risk of AF and stroke. Methods: PubMed and Embase databases were systematically searched to identify all publications providing relevant data from inception to 23 August 2022. Hazard ratio (HR) and 95% confidence interval (CI) were pooled using fixed-effect or random-effect models. Results: We included 23,272 participants from 20 studies. Pooled results showed that ESVEA was associated with an increased risk of AF in the general population (HR: 2.57; 95% CI 2.16–3.05), increased risk of AF in ischemic stroke patients (HR: 2.91; 95% CI 1.80–4.69), new-onset ischemic stroke (HR: 1.91; 95% CI 1.30–2.79), and all-cause mortality (HR: 1.41; 95% CI 1.24–1.59). Pooled analysis indicated that ESVEA was not associated with recurrent ischemic stroke/transient ischemic attack (TIA) (HR: 1.24; 95% CI 0.91–1.67). Conclusions: ESVEA is associated with AF, new-onset ischemic stroke, and all-cause mortality.

Purpose: Death anxiety is commonly experienced by individuals with advanced cancer who have a limited life expectancy. The Death and Dying Distress Scale (DADDS) is a validated measure that was created to capture this experience; but no Chinese version is available to date. We conducted a cross-sectional study to explore the psychometric properties of a Chinese version DADDS (DADDS-C) and address prevalence of death anxiety among patients with advanced cancer.Methods: Patients with advanced cancer were recruited from Peking University Cancer Hospital. Measures administered included: DADDS-C, Patient Health Questionnaire (PHQ-9), General Anxiety Disorder-7(GAD-7), Quality of Life at End of Life in Cancer (QUAL-EC), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-sp). McDonald's Omega, Cronbach's alpha, Exploratory Factor Analysis and Confirmatory Factor Analysis were used to test DADDS-C's reliability and validity. Logistic regression analysis was used to identify risk factors for death anxiety.Results: Of 300 patients approached, 256 (85%) provided informed consent and completed the questionnaires. Of these participants, 43 (16.8%) had moderate death anxiety based on scores of ≥45 on the DADDS-C. Three factors (feeling shortness of time, dying and death distress, being a burden to others) explained 71.643% of shared variation with factor loadings ranging from 0.629 to 0.822. Cronbach's alpha was 0.939; Omega total was 0.959. DADDS-C had acceptable convergent and discriminant validity. Logistic regression analysis indicated that two factors (better relationship with healthcare providers and preparation for end of life) protected patients from death anxiety.Conclusion: DADDS-C is a valid tool for measuring death anxiety in Chinese patients with advanced cancer. The presence of at least moderate death anxiety in a substantial minority of these patients calls for screening for this symptom and for more routine psychological interventions to alleviate and prevent such distress in this population.

Introduction An electronic Patient-Reported Outcome (ePRO) platform is needed for implementing evidence-based symptom management in outpatients with advanced cancer. We describe the overall protocol and the methodology for measuring symptom burden, to provide critical parameters needed to implement symptom management on the ePRO platform.Methods and analysis The study focusses on patients with advanced lung cancer, stomach cancer, oesophagus cancer, liver cancer, colorectal cancer or breast cancer. The primary outcome is the change of symptom burden. MD Anderson Symptom Inventory, and other PRO instruments (Insomnia Severity Index, Hospital Anxiety and Depression Scale, 9-item Patient Health Questionnaire and EuroQol-5 dimensions-5 levels version) were used. The secondary outcomes include feasibility of using ePRO, symptom-related quality of life, reasons for no improvement of symptoms, defining frequency of PRO assessments and cut-points, items for screening and management of comorbidity and satisfaction with ePRO platform in patients and health providers. After initial outpatient visit for baseline assessment, ePRO system will automatically send follow-up notification seven times over 4 weeks to patients. The characteristics and changing trajectory of symptoms of patients will be described. Parameters for using PROs, such as optimal time points for follow-up and cut-off point for alert will be determined. The feasibility of ePRO platform to track the changes of target symptoms in outpatients will be evaluated.Ethics and dissemination The study protocol and related documents were approved by the Institutional Research Board (IRB) of Peking University Cancer Hospital on 13 February 2019 (2019YJZ07). The results of this study will be disseminated through academic workshops, peer-reviewed publications and conferences.Trial registration number ChiCTR1900023560.

Objectives The aim of this study was to explore perspectives and reasoning of medical staff from Class A tertiary hospitals about the factors hindering and facilitating the uptake and use of clinical practice guidelines (CPGs) during medical procedures.Design Mixed-method research study to collect and analyse both quantitative and qualitative data.Setting Class A tertiary hospitals in China.Participants The inclusion criteria for the questionnaire survey and qualitative research were (1) medical practitioners and (2) years of practice: above 5 years in a tertiary hospital.Methods Questionnaires were distributed to medical staff in 11 cities to collect quantitative data. Frequency and ranking of barriers and enablers were analysed. Spearman correlations were computed to explore the correlation between years of practice, professional title ranking and educational background with self-reported guideline adherence. Using a constructivist grounded theory method, qualitative data were generated via in-depth face-to-face interviews with Chinese medical practitioners.Results A total of 359 medical practitioners were surveyed and 32 medical practitioners interviewed in 11 cities. Higher frequency and higher ranking of barriers all converged on ‘lack of access’, ‘less convenient’, ‘lack of applicability’ and ‘lack of evidence from Chinese sample’. Higher frequency and higher ranking of enablers converged on ‘Short formats presentation’, ‘Utilisation of various media’, ‘Information visualisation’ and ‘Linking to patient electronic medical records’. There were no relationships between characteristics of respondents with self-reported adherence. This research produced a theoretical understanding of the experience of medical practitioners when using guidelines. Themes identified were as follows: existing intrinsic flaws in guidelines, deficient or incomplete system mechanism and being ambiguous.Conclusion Our findings provide a comprehensive and culturally sensitive perspective in understanding guideline implementation in China. Strategies addressing those barriers should be further discussed and researched in the future.

Background: Diabetic retinopathy (DR) is a common diabetes complication and was considered as the major cause of blindness among young adults. MiRNAs are a group of small non-coding RNAs regulating the expression of target genes and have been reported to be associated with the development of DR in a variety of molecular mechanisms. In this study, we aimed to identify miRNAs that are differentially expressed (DE) in the serum of DR patients.Methods: We recruited 21 type 2 diabetes mellitus (T2DM) inpatients of Chinese Han ancestry, consisting of 10 non-proliferative DR patients (DR group) and 11 non-DR T2DM patients (NDR group). MiRNA was extracted from fasting peripheral serum and quantified by RNA-seq. The expression levels of miRNA were evaluated and compared between the two groups, with adjustments made for age differences. The validated target genes of miRNAs were subjected to a pathway analysis. We also constructed a weighted polygenic risk score using the DE miRNA and evaluated its predictive power.Results: Five miRNAs were DE between DR and NDR groups (p-Value ≤ 0.01, LFC ≥ 2 or LFC ≤-2). These included miR-4448, miR-338-3p, miR-190a-5p, miR-485-5p, and miR-9-5p. In total, these miRNAs were validated to regulate 55 target genes. Four target genes were found to overlap with the NAD metabolism, sirtuin, and aging pathway, which was thought to control the vascular growth and morphogenesis. The predictive power of our polygenic risk score was apparently high (AUC = 0.909). However, it needs to be interpreted with caution.Conclusion: In this study, we discovered novel DR-specific miRNAs in human serum samples. These circulating miRNAs may represent the pathological changes in the retina in response to diabetes and may serve as non-invasive biomarkers for early DR risk prediction.

Two improved designs of wideband dual polarization antennas for base station. The first design is the crossed dipoles for the frequency bands 1695–2695 MHz. The presented shape of crossed dipole provides a low level of crosspolarization, VSWR better than 1.4, the isolation between polarizations is better than –33 dB and the beam width in the horizontal plane is 65±4 degrees. The second design is the square dipole in the frequency range 690–960 MHz provides the beam width in the horizontal plane 60±5 degrees, E-plane 58±3 degrees, H-plane 64±3 degrees, the isolation between polarizations better than –35dB.