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Abstract Background Patients in the intensive care unit (ICU) are highly susceptible to malnutrition, and while enteral nutrition via nasogastric tube is the preferred method, there is a risk of inadvertent reflux and aspiration. Therefore, clinicians have turned to nasointestinal tubes (NET) for enteral nutrition as an alternative option. But the precise localization of NET presents an ongoing challenge. We proposed an innovative approach to provide a valuable reference for clinicians involved in NET placement. Method Data were obtained retrospectively from the medical records of adult patients with a high risk of aspiration or gastric feeding intolerance who had a NET placed in the ICU of Zhejiang Provincial People’s Hospital between October 1, 2017, and October 1, 2023. The collected data were subjected to statistical analysis using SPSS and R software. Result There were 494 patients who met the inclusion and exclusion criteria. The first-pass success rate was 81.4% (n = 402). The success of a patient’s initial NET placement was found to be associated with Angle SPC and Distance CP, as determined by univariate analysis (25.6 ± 16.7° vs. 41.9 ± 18.0°, P

IntroductionHyperarousal has been a significant pathophysiological theory related to insomnia disorder (ID), characterized by excessive cortical activation and abnormal electroencephalogram (EEG) power during daytime or sleep. However, there is currently insufficient attention to the EEG power during rapid eye movement (REM) sleep and different stages of non-rapid eye movement (NREM) sleep. Additionally, whether the abnormal sleep EEG power in ID patients can be restored by repetitive transcranial magnetic stimulation (rTMS) remains unclear.Methods> Data of 26 ID patients and 26 healthy controls (HCs) were included in the current observational study. The comparisons of relative power between patients and HCs at baseline in each band of each sleep stage and the changes in patients before and after rTMS treatment were performed. The correlations between relative power and behavioral measures of the patients were also investigated.ResultsAbnormalities in sleep EEG relative power in the delta, beta and gamma bands of the patients were observed in NREM2, NREM3 and REM sleep. Correlations were identified between relative power and behavioral measures in ID group, primarily encompassing sleep efficiency, sleep onset latency and depression scores. Post-treatment improvements in relative power of the delta and beta band were observed in NREM2 sleep.DiscussionThe relative power of sleep EEG exhibited a significant correlation with sleep measures in ID patients, and demonstrated notable differences from HCs across the delta, beta, and gamma frequency bands. Furthermore, our findings suggest that rTMS treatment may partially ameliorate relative power abnormalities in patients with ID.

Background: Enteral nutrition administered via the nasointestinal tube (NET) is a prevalent nutritional modality among critically ill patients, and abdominal radiographs hold significant value in accurately ascertaining the precise positioning of the NET subsequent to its placement. Therefore, we propose an innovative approach to construct a clinical prediction model based on NET's configuration within the gastrointestinal tract in abdominal radiography. This model aims to enhance the accuracy of determining the position of NETs after their placement. Methods: Patients admitted to the intensive care unit of Zhejiang Provincial People's Hospital between October 2017 and October 2021 were included to constitute the training cohort for retrospective analysis, and nomogram was constructed. Consecutively enrolled patients admitted to the same hospital from October 2021 to October 2023 were included as the validation cohort. The training cohort underwent a univariate analysis initially, followed by a multivariate logistic regression approach to analyze and identify the most appropriate model. Subsequently, nomogram was generated along with receiver operator characteristic curves, calibration curves, and decision curves for both the training and validation cohorts to evaluate the predictive performance of the model. Results: The training and validation cohorts comprised 574 and 249 patients, respectively, with successful tube placement observed in 60.1 % and 76.3 % of patients, correspondingly. The predictors incorporated in the prediction maps encompass the “C-shape,” the height of “inverse C-shape,” showing the duodenojejunal flexure, and the location of the head end of the NET. The model demonstrated excellent predictive efficacy, achieving an AUC of 0.883 (95 % CI 0.855–0.911) and good calibration. Furthermore, when applied to the validation cohort, the nomogram exhibited strong discrimination with an AUC of 0.815 (95 % CI 0.750–0.880) and good calibration. Conclusion: The combination of abdominal radiography and NET's configuration within the gastrointestinal tract enables accurate determination of NET placement in critically ill patients.

ObjectiveThe objective of this study is to assess the viability of utilizing radiomics for predicting the treatment response of lung cancer brain metastases (LCBM) to whole-brain radiotherapy (WBRT) combined with temozolomide (TMZ).MethodsFifty-three patients diagnosed with LCBM and undergoing WBRT combined with TMZ were enrolled. Patients were divided into responsive and non-responsive groups based on the RANO-BM criteria. Radiomic features were extracted from contrast-enhanced the whole brain tissue CT images. Feature selection was performed using t-tests, Pearson correlation coefficients, and Least Absolute Shrinkage And Selection (LASSO) regression. Logistic regression was employed to construct the radiomics model, which was then integrated with clinical data to develop the nomogram model. Model performance was evaluated using receiver operating characteristic (ROC) curves, and clinical utility was assessed using decision curve analysis (DCA).ResultsA total of 1834 radiomic features were extracted from each patient's images, and 3 features with predictive value were selected. Both the radiomics and nomogram models exhibited satisfactory predictive performance and clinical utility, with the nomogram model demonstrating superior predictive value. The ROC analysis revealed that the AUC of the radiomics model in the training and testing sets were 0.776 and 0.767, respectively, while the AUC of the nomogram model were 0.799 and 0.833, respectively. DCA curves demonstrated that both models provided benefits to patients across various thresholds.ConclusionRadiomic-defined image biomarkers can effectively predict the treatment response of WBRT combined with TMZ in patients with LCBM, offering potential to optimize treatment decisions for this condition.

Abstract Due to the rising need for clean and renewable energy, green materials including biochar are becoming increasingly popular in the field of energy storage and conversion. However, the lack of highly active and stable electrode materials hinders the development of stable energy supplies and efficient hydrogen production devices. Herein, we fabricated stable, conductive, and multifunctional chitosan microspheres by a facile emulsion crosslinking solution growth and hydrothermal sulphuration methods as multifunctional electrodes for overall water splitting driven by supercapacitors. This material possessed three-dimensional layered conductors with favorable heterojunction interface, ample hollow and porous structures. It presented remarkably enhanced electrochemical and catalytic activity for both supercapacitors and overall water electrolysis. The asymmetric supercapacitors based on chitosan biochar microsphere achieved high specific capacitance (260.9 F g−1 at 1 A g−1) and high energy density (81.5W h kg−1) at a power density of 978.4 W kg−1. The chitosan biochar microsphere as an electrode for electrolyze only required a low cell voltage of 1.49 V to reach a current density of 10 mA cm−2, and achieved excellent stability with 30 h continuous test at 20 mA cm−2. Then, we assembled a coupled energy storage device and hydrogen production system, the SCs as a backup power source availably guaranteed the continuous operation of overall water electrolysis. Our study provides valuable perspectives into the practical design of both integrated biochar-based electrode materials and coupled energy storage devices with energy conversion and storage in practical. Graphical Abstract

Abstract Background The rapid global emergence and spread of carbapenem-resistant Gram-negative bacilli (CR-GNB) is recognized as a major public health concern, and there are currently few effective treatments for CR-GNB infection. The aim of this study was to investigate the clinical characteristics and outcomes of patients with CR-GNB infections treated with ceftazidime/avibactam (CAZ/AVI) combined with colistin from October 2019 to February 2023 in China. Methods A total of 31 patients with CR-GNB infections were retrospectively identified using the electronic medical record system of Zhejiang Provincial People's Hospital. Results Thirty-one patients were treated with CAZ/AVI combined with colistin. Respiratory tract infections (87%) were most common. The common drug-resistant bacteria encompass Klebsiella pneumonia (54.8%), Acinetobacter baumannii (29.0%), and Pseudomonas aeruginosa (16.1%). The 30-day mortality rate was 29.0%, and the 7-day microbial clearance rate was 64.5%. The inflammatory marker CRP changes, but not PCT and WBC, were statistically significant on days 7 and 14 after combination therapy. There were seven patients developing acute renal injury (AKI) after combination therapy and treating with continuous renal replacement therapy (CRRT). Two patients developed diarrhea. Conclusion The combination of CAZ/AVI and colistin has potential efficacy in patients with CR-GNB infection, but more studies are needed to determine whether it can reduce 30-day mortality rates and increase 7-day microbial clearance. At the same time, the adverse reactions of combination therapy should not be ignored.

Glioblastoma multiforme, a highly aggressive and lethal brain tumor, is a substantial clinical challenge and a focus of increasing concern globally. Hematological toxicity and drug resistance of first-line drugs underscore the necessity for new anti-glioma drug development. Here, 43 anthracenyl skeleton compounds as p53 activator XI-011 analogs were designed, synthesized, and evaluated for their cytotoxic effects. Five compounds (13d, 13e, 14a, 14b, and 14n) exhibited good anti-glioma activity against U87 cells, with IC50 values lower than 2 μM. Notably, 13e showed the best anti-glioma activity, with an IC50 value up to 0.53 μM, providing a promising lead compound for new anti-glioma drug development. Mechanistic analyses showed that 13e suppressed the MDM4 protein expression, upregulated the p53 protein level, and induced cell cycle arrest at G2/M phase and apoptosis based on Western blot and flow cytometry assays.

Solenopsis invicta Buren (Hymenoptera: Formicidae), a red imported fire ant that originated from South America, is a worldwide invasive pest. This study investigated the efficacy of the newly designed baited trap to detect red imported fire ants, Solenopsis invicta Buren, under field conditions in China. Among the five food lures tested for red imported fire ants, the ants preferred ham sausage and fish powder, followed by mixed powder (50% fish powder + 50% black soldier fly powder) and black soldier fly powder. These lures were compared to sugar water (control) to determine their efficacy in trapping red imported fire ants. Field data revealed that the ham sausage powder trap was more efficient than the fish powder trap based on its ability to trap more red imported fire ants under field conditions and ease of use. Thus, it was concluded that the baited traps are efficient for longterm red imported fire ants monitoring.

OBJECTIVE: May–Thurner syndrome (MTS) is a common cause of lower-extremity deep venous thrombosis (DVT). Stenting is effective in the treatment of MTS; however, there are still complications that may affect the patency of the stent. In addition, the long-term efficacy of stenting remains uncertain. This retrospective study investigated the efficacy and prognosis of endovascular treatment of acute proximal DVT with MTS. MATERIALS AND METHODS: Between June 2014 and December 2017, 122 patients with acute symptomatic proximal DVT at our hospital underwent endovascular surgery. The clinical data of the patients were retrospectively collected including follow-up information. The analysis used the generalized additive mixed model and Kaplan–Meier curves (log-rank test). RESULTS: Of the 122 patients, 75 underwent only catheter-directed thrombolysis (CDT), and 47 underwent CDT with stent placement. Characteristics such as age (P = 0.630 ) and gender (P = 0.842) did not show significant differences between the two groups. The freedom from target lesion revascularization did not show significant differences between the two groups (P = 0.82). There were no significant differences between the two groups in the Venous Clinical Severity Score and Villalta Score. CONCLUSIONS: Endovascular treatment of acute lower limb DVT with MTS has good overall efficacy. In young patients with DVT caused by multiple factors besides MTS, prolonged anticoagulation and close follow-up may be more appropriate than primary stenting after thrombus clearance and significant relief of lower limb symptoms.

Endovascular treatment is widely used for treating the subclavian artery pseudoaneurysm (SAP) because of its small trauma, fast recovery, exact effect, and low incidence of complications. However, when the systemic disease or infection that causes SAP is in the active phase, treatment of the primary disease is more critical. Surgical intervention should be performed after systemic symptoms have been controlled unless the situation is particularly critical. We introduced two cases of SAP caused by brucellosis and Behcet's disease and discussed the course of treatment.

Abstract Background and objectives: Bloodstream infection (BSI) is a life-threatening condition in critically ill patients, but pathogen quantification techniques during treatment are laborious. This study aimed to explore the impact of monitoring pathogen DNA load changes and polymicrobial infection in blood by droplet digital polymerase chain reaction (ddPCR) on the prognosis of patients with BSIs. Methods This prospective case series study was conducted in the general intensive care unit of the Zhejiang Provincial People’s Hospital and included patients with BSIs from May 2020 to January 2021. Pathogens DNA load and presence of polymicrobial BSIs were dynamically monitored by ddPCR. Results Sixteen patients with BSIs proven by blood culture were recruited (87.5% men; mean age, 69.3 ± 13.7 years). All pathogens identified by blood culture were Gram-negative bacteria, among which seven were multidrug-resistant strains. The 28-day mortality rate was 62.5%. Compared to the 28-day survivors, the non-survivors were older (P = 0.04), had higher pathogen DNA load on the second (day 3–4) and third (day 6–7) ddPCR assay (P

Abstract Ewing sarcoma (ES) is a rare disease that lacks a prognostic prediction model. This study aims to develop a nomogram and risk classification system for estimating the probability of overall survival (OS) of patients with ES. The clinicopathological data of ES were collected from the Surveillance, Epidemiology and Final Results (SEER) database from 2010 to 2018. The primary cohort was randomly assigned to the training set and the validation set. Univariate and multiple Cox proportional hazard analyses based on the training set were performed to identify independent prognostic factors. A nomogram was established to generate individualized predictions of 3- and 5-year OS and evaluated by the concordance index (C-index), the receiver operating characteristic curve (ROC), the calibration curve, the integrated discrimination improvement (IDI) and the net reclassification improvement (NRI). Based on the scores calculated with the nomogram, ES patients were divided into three risk groups to predict their survival. A total of 935 patients were identified, and a nomogram consisting of 6 variables was established. The model provided better C-indices of OS (0.788). The validity of the Cox model assumptions was evaluated through the Schönfeld test and deviance residual. The ROC, calibration curve, IDI and NRI indicated that the nomogram exhibited good performance. A risk classification system was built to classify the risk group of ES patients. The nomogram compares favourably and accurately to the traditional SEER tumour staging systems, and risk stratification provides a more convenient and effective tool for clinicians to optimize treatment options.

The influence of the maritime environment such as water currents, water depth, and traffic separation rules should be considered when conducting ship path planning. Additionally, the maneuverability constraints of the ship play a crucial role in navigation. Addressing the limitations of the traditional A-star algorithm in ship path planning, this paper proposes an improved A-star algorithm. Specifically, this paper examines the factors influencing ship navigation safety, and develops a risk model that takes into account water currents, water depth, and obstacles. The goal is to mitigate the total risk of ship collisions and grounding. Secondly, a traffic model is designed to ensure that the planned path adheres to the traffic separation rules and reduces the risk of collision with incoming ships. Then, a turning model and smoothing method are designed to make the generated path easy to track and control for the ship. To validate the effectiveness of the proposed A-star ship path-planning algorithm, three cases are studied in simulations and representative operational scenarios. The results of the cases demonstrate that the proposed A-star ship path-planning algorithm can better control the distance to obstacles, effectively avoid shallow water areas, and comply with traffic separation rules. The safety level of the path is effectively improved.

Rheumatoid arthritis (RA) is a chronic progressive autoimmune disease. Despite the wide use of conventional synthetic, targeted and biologic disease modifying anti-rheumatic drugs (DMARDs) to control its radiological progress, nearly all DMARDs are immunologically non-selective and do not address the underlying immunological mechanisms of RA. Patients with RA often need to take various DMARDs long-term or even lifelong and thus, face increased risks of infection, tumor and other adverse reactions. It is logical to modulate the immune disorders and restore immune balance in patients with RA by restoring immune tolerance. Indeed, approaches based on stem cell transplantation, tolerogenic dendritic cells (tolDCs), and antigen-based tolerogenic vaccination are under active investigation, and some have already transformed from wet bench research to clinical investigation during the last decade. Among them, clinical trials on stem cell therapy, especially mesenchymal stem cells (MSCs) transplantation are most investigated and followed by tolDCs in RA patients. On the other hand, despite active laboratory investigations on the use of RA-specific peptide-/protein-based tolerogenic vaccines for T cell, clinical studies on RA patients are much limited. Overall, the preliminary results of these clinical studies are promising and encouraging, demonstrating their safety and effectiveness in the rebalancing of T cell subsets; particular, the recovery of RA-specific Treg with increasing anti-inflammatory cytokines and reduced proinflammatory cytokines. Future studies should focus on the optimization of transplanted stem cells, the preparation of tolDCs, and tolerogenic vaccines with RA-specific protein or peptide, including their dosage, course, and route of administration with well-coordinated multi-center randomized clinical control researches. With the progress of experimental and clinical studies, generating and restoring RA-specific immune tolerance may bring revolutionary changes to the clinical management of RA in the near future.

Lasiodiplodia sp. is a typical opportunistic plant pathogen, which can also be classified as an endophytic fungus. In this study, the genome of a jasmonic-acid-producing Lasiodiplodia iranensis DWH-2 was sequenced and analyzed to understand its application value. The results showed that the L. iranensis DWH-2 genome was 43.01 Mb in size with a GC content of 54.82%. A total of 11,224 coding genes were predicted, among which 4776 genes were annotated based on Gene Ontology. Furthermore, the core genes involved in the pathogenicity of the genus Lasiodiplodia were determined for the first time based on pathogen–host interactions. Eight Carbohydrate-Active enzymes (CAZymes) genes related to 1,3-β-glucan synthesis were annotated based on the CAZy database and three relatively complete known biosynthetic gene clusters were identified based on the Antibiotics and Secondary Metabolites Analysis Shell database, which were associated with the synthesis of 1,3,6,8-tetrahydroxynaphthalene, dimethylcoprogen, and (R)-melanin. Moreover, eight genes associated with jasmonic acid synthesis were detected in pathways related to lipid metabolism. These findings fill the gap in the genomic data of high jasmonate-producing strains.

In order to explore the stress and strain characteristics around the corner of reinforced earth retaining wall, a certain engineering example was selected as a study case, and a 3D numerical model was established. After that, the stress-strain characteristics of the corners and the inherent mechanics principle were analyzed. The results show that the corners of the reinforced earth retaining wall are more prone to deformation and damage. The spatial shape of the potential fracture surface at the corner appears the shape of “circle chair”, which intersects with two wall surfaces. As for the distribution of grid tensile stress, the corner with “X” shape is completely different from the flat parts paralleling to the wall surface; The horizontal deformation of the corners occurs in both directions of the vertical and parallel walls, while the straight portions are only horizontally deformed in the direction of the vertical wall. There is a transition between the corner and the straight line, and the extent of the transition is related to the range of potential deformation and damage.

Considering that the modification parameters and performance parameters of gear are affected by various influencing factors during manufacturing and operation process， a robust modification design method for EMU transmission gears based on improved tolerance model and fuzzy theory is proposed. The controllable and uncontrollable factors in gear robust modification are firstly determined， and then the sample points are obtained by combining orthogonal experimental design and Romax motion simulation. The polynomial response surface model is used to fit the response surface function of peak-to-peak value of transmission error. On this basis， the fuzzy theory is introduced， the mathematical model of gear modification robust optimization is established based on improved tolerance model， the NSGA-III algorithm is used to find the optimal solution， and the comparison with other modification schemes is completed. Finally， the simulation verification of each modification scheme is carried out. The results show that the robust modification result based on the improved tolerance model is better than the traditional tolerance model. Considering the influence of fuzzy factors in the design of gear robust modification based on the improved tolerance model， it is not only improves the offset load condition of the tooth surface， but also improves the robustness and rationality of the modification results.

In this work, a fuzzy design optimization-based fatigue reliability analysis technique is addressed to obtain the optimal fatigue reliability of the structures with random parameters under the minimum fluctuation of fatigue life. The challenge of the problem lies in uncertainties involved from both structural parameters and loads, which renders the fatigue reliability becoming the primary problem to be considered in evaluating structural performance. In order to obtain the optimal fatigue reliability, the optimal mathematical models aiming at the mass and fatigue life of welding robots are constructed respectively, and the genetic particle swarm optimization algorithm and radial basis function neural network (GAPSO-RBFNN) based surrogate model is then presented. Moreover, fuzzy constraints are introduced into the optimization model, and the improved non-dominated sorting genetic algorithm (INSGA-III) optimization strategy is proposed to solve it, which can effectively reduce the workload by increasing the diversity of Pareto solutions during the iterative process. Finally, the optimized structure combined with numerical simulation method is adopted to analyze the fatigue reliability. After analysis steps are given in detail, a practical welding robot structure is presented to demonstrate the validity and reasonability of the developed methodology.

Abstract The relatively long turnaround time and low sensitivity of traditional blood culture‐based diagnosis may delay effective antibiotic therapy for patients with bloodstream infections (BSIs). A rapid and sensitive pathogen detection method is urgently required to reduce the morbidity and mortality associated with BSIs. Acinetobacter baumannii and Klebsiella pneumoniae are two major microorganisms that cause BSIs. Here we report a novel droplet digital polymerase chain reaction (ddPCR) assay that can detect A. baumannii and K. pneumoniae in blood samples within 4 h, with a specificity of 100% for each strain and a limit of detection at 0.93 copies/μl for A. baumannii and 0.27 copies/μl for K. pneumoniae. Clinical validation of 170 patients with suspected BSIs showed that compared to blood cultures that detected four (2.4%) A. baumannii cases and seven (4.1%) K. pneumoniae cases, ddPCR detected 23 (13.5%) A. baumannii cases, 26 (15.3%) K. pneumoniae cases, and four (2.4%) co‐infection cases, including the 11 cases detected via blood culture. In addition, patients who tested positive via ddPCR alone (n = 42) had significantly lower serum concentrations of procalcitonin and lactate, SOFA and APACHE II scores, and 28‐day mortality than those reported positive via both blood culture and ddPCR (n = 11), suggesting that patients with less severe symptoms can potentially benefit from ddPCR‐based diagnosis. In conclusion, our study suggests that ddPCR represents a sensitive and rapid method for identifying causal pathogens in blood samples and guiding treatment decisions in the early stages of BSIs.

Endovascular interventional therapy is the first choice for the treatment of the traumatic arteriovenous fistula (AVF) because of its small trauma, fast recovery, exact effect, and low incidence of complications. However, surgery is still an important option for patients with contraindications to endovascular treatment or failure of endovascular treatment. We present the case of a 64-year-old male who was carried out with traumatic AVF and given endovascular treatment in other hospital 10 years ago. However, AVF did not disappear after surgery, and symptoms of venous hypertension such as lower limb swelling and ulcers appeared. We removed the stent and repaired the AVF with opening surgery. AVF did not recur after 1-year follow-up.

Salmonella aortitis accounts for approximately 40% of all infectious aortitis. Superficial femoral artery aneurysm infected by Salmonella typhi has rarely been reported. The study reported a 71-year-old Chinese woman with a previous history of nephrotic syndrome and long-term oral hormone therapy, who was admitted to the hospital with a gradually increasing pulsatile mass in the right thigh and pain. After admission, computed tomography angiography revealed rupture and bleeding of an aneurysm in the middle and lower segment of the right superficial femoral artery (SFA). The aneurysm of the SFA was satisfactorily isolated by the covered stent. The bacterial culture of the secretion from the punctured mass showed the S. typhi infection. Based on the results of the drug sensitivity test, the patient received anti-infective treatment for 4 weeks. The patient recovered well after 1-year follow-up.

Cadmium (Cd) is a ubiquitous environmental pollutant of increasing worldwide concern to both humans and animals. Selenium yeast (Se-Y) is an organic selenium source that has been shown an advantage in antagonizing Cd-induced liver necroptosis in chicken. Herein, we described the discovery path of Se-Y antagonism in Cd-induced renal necroptosis in chicken through targeting miR-26a-5p/PTEN/PI3K/AKT signaling pathway. We set up four groups of chickens at random: control group (0.5 mg/kg Na2SeO3), Se-Y group (0.5 mg/kg Se-Y), Se-Y+Cd group (0.5 mg/kg Se-Y and 150 mg/kg CdCl2) and Cd group (150 mg/kg CdCl2 and 0.5 mg/kg Na2SeO3). Interestingly, we found Se-Y, but not Na2SeO3, significantly blocked Cd accumulation in the kidney and alleviated Cd-induced necroptosis through inhibiting the expression of RIP1, RIP3 and MLKL. Se-Y, activated miR-26a-5p expression, thereby down-regulated the expression of PTEN, resulting in the up-regulation of PI3K/AKT signaling pathway and the inhibition of oxidative stress in both Se-Y and Cd treated chickens. Besides that, Se-Y could also specifically reduce the expression levels of heat shock protein 60 (HSP60), HSP70 and HSP90 in Se-Y and Cd co-treated chickens. Taken together, our results showed that Se-Y has an added value to antagonize Cd-induced necroptosis in chicken kidney by regulating the miR-26a-5p/PTEN/PI3K/AKT signaling pathway and HSPs, indicating that Se-Y could serve as an effective antagonist on Cd-induced renal necroptosis in chickens.

Background: Loss of control over drug intake occurring in drug addiction is believed to result from disruption of reward circuits, including reduced responsiveness to natural rewards (e.g., monetary, sex) and heightened responsiveness to drug reward. Yet few studies have assessed reward deficiency and related brain responses in abstinent heroin users with opioid use disorder, and less is known whether the brain responses can predict cue-induced craving changes following by prolonged abstinence. Method: 31 heroin users (age: 44.13±7.68 years, male: 18 (58%), duration of abstinence: 85.2 ± 52.5 days) were enrolled at a mandatory detoxification center. By employing a cue-reactivity paradigm including three types of cues (drug, sexual, neutral), brain regional activations and circuit-level functional coupling were extracted. Among the 31 heroin users, 15 were followed up longitudinally to assess cue induced craving changes in the ensuing 6 months. Results: One way analysis of variance results showed that heroin users have differential brain activations to the three cues (neutral, drug and sexual) in the left dorsolateral prefrontal cortex (DLPFC), insula, orbiotofrontal cortex (OFC) and the bilateral thalamus. Drug cue induced greater activations in left DLPFC, insula and OFC compared to sexual cue. The psychophysiological interactions (PPI) analysis revealed negative couplings of the left DLPFC and the left OFC, bilateral thalamus, putamen in heroin users during drug cue exposure. In the 6-month follow-up study, both drug cue induced activation of the left DLPFC and the functional coupling of the left DLPFC-bilateral thalamus at baseline was correlated with craving reductions, which were not found for sexual cues. Conclusion: Our preliminary study provided novel evidence for the reward deficiency theory of opioid use disorder. Our findings also have clinical implications, as drug cue induced activation of the left DLPFC and functional coupling of left DLPFC-bilateral thalamus may be potential neuroimaging markers for craving changes during prolonged abstinence. Evidently, the findings in the current preliminary study should be confirmed by large sample size in the future.

Metagenomic next-generation sequencing (mNGS) and droplet digital PCR (ddPCR) have recently demonstrated a great potential for pathogen detection. However, few studies have been undertaken to compare these two nucleic acid detection methods for identifying pathogens in patients with bloodstream infections (BSIs). This prospective study was thus conducted to compare these two methods for diagnostic applications in a clinical setting for critically ill patients with suspected BSIs. Upon suspicion of BSIs, whole blood samples were simultaneously drawn for ddPCR covering 20 common isolated pathogens and four antimicrobial resistance (AMR) genes, mNGS, and blood culture. Then, a head-to-head comparison was performed between ddPCR and mNGS. A total of 60 episodes of suspected BSIs were investigated in 45 critically ill patients, and ddPCR was positive in 50 (83.3%), mNGS in 41 (68.3%, not including viruses), and blood culture in 10 (16.7%) episodes. Of the 10 positive blood cultures, nine were concordantly identified by both mNGS and ddPCR methods. The head-to-head comparison showed that ddPCR was more rapid (~4 h vs. ~2 days) and sensitive (88 vs. 53 detectable pathogens) than mNGS within the detection range of ddPCR, while mNGS detected a broader range of pathogens (126 vs. 88 detectable pathogens, including viruses) than ddPCR. In addition, a total of 17 AMR genes, including 14 blaKPC and 3 mecA genes, were exclusively identified by ddPCR. Based on their respective limitations and strengths, the ddPCR method is more useful for rapid detection of common isolated pathogens as well as AMR genes in critically ill patients with suspected BSI, whereas mNGS testing is more appropriate for the diagnosis of BSI where classic microbiological or molecular diagnostic approaches fail to identify causative pathogens.

Deep clustering technique is a state-of-the-art deep learning-based method for multi-talker speaker-independent speech separation. It solves the label ambiguity problem by mapping time-frequency (TF) bins of the mixed spectrogram to an embedding space, and assigning contrastive embedding vectors to different TF regions in order to predict the mask of the target spectrogram of each speaker. The original deep clustering transforms the speech into the TF domain through a short-time Fourier transform (STFT). Since the frequency component of STFT is linear, while the frequency distribution of human auditory system is nonlinear. Therefore, we propose to use constant Q transform (CQT) instead of STFT to achieve a better simulation of the frequency resolving power of the human auditory system. The ideal upper bound of signal-to-distortion (SDR) of CQT based deep clustering is higher than that based on STFT. In the same experimental setting on WSJ0-mix2 corpus, we gave a detail description in selecting meta-parameters of CQT for speech separation, and finally the SDR improvements of this method achieved about 1dB better performance than the original deep clustering.

The automatic identification of multiship encounter is a vital criterion for ship collision avoidance and intelligent maritime safety surveillance. However, the parameters of ship encounter identification in the existing studies are fixed, and the methods are weak to give an automatic and visual performance in the multiship encounter identification. In order to fix the existed gap, this paper proposed a novel adaptive visual analytics framework for automatic multiship encounter identification based on density-based spatial clustering of applications with noise (DBSCAN) and visual analytics by adjusting the parameters of ship encounter adaptively. The DBSCAN clustering method was applied to detect the clusters of encounter ships and filter out the nonencounter ship, and the distribution and density of the encounter ship had been visualized on the nautical chart to give a better perception of ships’ behavior with a potentially high navigational risk. The framework had been designed and developed using DBSCAN and visual analytics, and the effectiveness was evaluated and validated by adjusting different parameters of multiship encounter within the Southwest waters of Zhoushan Island, China. The results showed that the proposed framework had a good performance in the visual identification of multiship encounter within confined waters, which could assist the ship collision avoidance and intelligent maritime surveillance system.

Three kinds of derivative carboxymethyl cellulose (DCMC) materials, CMC-Na, CMC-K, and CMC-NH4, were prepared from cotton straw fiber. Their chemical structure, film morphology, water retention, biodegradability, and growth promotion were investigated with infrared spectroscopy (IR), scanning electron microscope (SEM), and field experiments. The results showed that the infrared absorption peaks of the three materials were similar. It was observed that the DCMC materials could form films after being sprayed at the amount of 4.00 g/m2 and 12.00 g/m2, and the film thickness was showed in the order of CMC-K, CMC-NH4, and CMC-Na. The largest water holding capacity increased significantly after DCMC was sprayed on the soil. The water retention of CMC-Na, CMC-K, and CMC-NH4 increased by 47.74%, 72.85%, and 61.40% severally while sprayed with 12.00 g/m2 compared to the control group (CK), and the water retention rate increased with 6.93, 9.75, and 8.67 times, respectively, on the seventh day. The total number of soil microorganisms increased with the DCMC materials being sprayed; the number in the upper layer increased by 92.31%, 123.08%, and 138.46%, respectively, compared with CK. When the three materials were used to the cornfield at the amount of 100.00 kg/hm2, the corn yield increased by 33.11%, 70.93%, and 50.60%, respectively. The DCMC materials, as the sole carbon source, could be degraded by soil microorganisms. The nutrient elements such as NH4+ in the materials could further promote the growth of microorganisms and crops. This study might provide a new way to apply straw-based DCMC in soil water retention, soil amendment, and high value-added transformation of straws in arid areas.

lncRNAs play important roles in lipopolysaccharide- (LPS-) induced acute lung injury. But the mechanism still needs further research. In the present study, we investigate the functional role of the lncRNA-SNHG14/miR-223-3p/Foxo3a pathway in LPS-induced ALI and tried to confirm its regulatory effect on autophagy. Transcriptomic profile changes were identified by RNA-seq in LPS-treated alveolar type II epithelial cells. The expression changes of lncRNA-SNHG14/miR-223-3p/Foxo3a were confirmed using qRT-PCR and west blot. The binding relationship of lncRNA-SNHG14/miR-223-3p/and miR-223-3p/Foxo3a was verified using dual-luciferase reporter, RNA immunoprecipitation, and RNA pull-down assays. Using gain-of-function or loss-of-function approaches, the effect of lncRNA-SNHG14/miR-223-3p/Foxo3a was investigated in LPS-induced acute lung injury mice model and in vitro. Increasing of lncRNA-SNHG14 and Foxo3a with reducing miR-223-3p was found in LPS-treated A549 cells and lung tissue collected from the LPS-induced ALI model. lncRNA-SNHG14 inhibited miR-223-3p but promoted Foxo3a expression as a ceRNA. Artificially changes of lncRNA-SNHG14/miR-223-3p/Foxo3a pathway promoted or protected cell injury from LPS in vivo and in vitro. Autophagy activity could be influenced by lncRNA-SNHG14/miR-223-3p/Foxo3a pathway in cells with or without LPS treatment. In conclusion, aberrant expression changes of lncRNA-SNHG14 participated alveolar type II epithelial cell injury and acute lung injury induced by LPS through regulating autophagy. One underlying mechanism is that lncRNA-SNHG14 regulated autophagy by controlling miR-223-3p/Foxo3a as a ceRNA. It suggested that lncRNA-SNHG14 may serve as a potential therapeutic target for patients with sepsis-induced ALI.

Background: Insomnia disorder (ID) is a prevalent sleep disorder, which seriously affects people's daily life and was found to be associated with increased frequency of sleep stage shifts. Previous findings had revealed the critical role of the nucleus accumbens (NAc) in sleep-wake transition. However, the neuroimaging studies of the NAc in patients with ID have been rare. We hypothesized that structural and functional abnormalities of the NAc would be implicated in ID. Methods: Twenty-six ID patients and 36 matched healthy controls (HC) were included in the current study. The volumes and corresponding resting-state functional connectivity (RSFC) of the bilateral NAc were compared between the two groups. The abnormal RSFC in ID were then correlated with Pittsburgh Sleep Quality Index (PSQI). Results: Compared with HC, ID patients showed significantly increased volume of right NAc. Several brain regions showed increased RSFC with the NAc in ID patients, such as medial prefrontal cortex (mPFC), anterior cingulate cortex (ACC), caudate and putamen. Meanwhile, the occipital gyrus and temporal gyrus showed decreased RSFC with the NAc. Additionally, the increased RSFC strength between bilateral NAc and left mPFC was significant correlated with PSQI scores in ID patients. Conclusion: Dysfunctions of the NAc-mPFC circuit were found in ID patients, which were associated with sleep quality measured by PSQI. The two patterns of increase and decrease of RSFC in ID patients observed in our study may reflect the state of hyperarousal and potential impairment of cognitive function in the patients, respectively. It is hoped that our study focusing on NAc-mPFC circuits could provide new insights for the neural mechanisms of ID and potential novel therapeutic targets for treatment of ID patients.

Open surgical or percutaneous endovascular (EVAR) intervention is the only approved treatment for abdominal aortic aneurysm (AAA). Novel targeted therapy and companion diagnostic are needed. Our study aimed to investigate the expression of myeloid related protein 8/14 (MRP8/14) in AAA and explore whether MRP8/14 can be a biomarker and therapeutic target for AAA. The serum levels of MRP8/14 and inflammatory factors including TNF-α, IL-1β, and IL-6 were increased in 20 human AAA patients compared to healthy people by ELISA assay. The mRNA and protein expressions of MRPs in AAA tissues of AAA patient were significantly elevated when compared with the levels in adjacent non-aneurysmal aortic segments in AAA patients. through PCR and western blot analysis. Correlation analysis and receiver operating characteristic (ROC) curve analysis confirmed that MRP8/14 was secreted into the serum and possessed the potential diagnostic value. Rat AAA models established by perfusion porcine pancreatic elastase and murine macrophage RAW264.7 cells were used to evaluate the mechanisms of MRP8/14 after treatment with antibodies. Similarly, MRP8, MRP14, and MRP8/14 were highly expressed in rat AAA model, while the administrations of antibodies of MRPs significantly reversed the improvement expressions of MRP8 and MRP14. In RAW264.7 cells, MRPs especially for MRP8/14 obviously increased the levels of MMP-2 and MMP-9. Under MRP8/14 stimulation, the antibodies of MRPs recovered the expressions of MMP-2 and MMP-9. Anti MRP8/14 antibody exhibited the strongest effect in the experiments. Our results indicated that MRP8/14 was associated with AAA presence and progression and could be considered as a biomarker for AAA diagnose. Anti MRP8/14 can be a potential therapeutic target for treatment of AAA.

A renewable and superior intrinsic thermal-resistant cellulose-based nonwoven was explored as lithium-ion battery separator via phase separation mechanism. Herein, we sparked a robust strategy for improving the flammability of cellulose, namely DOPO- Cinnamoyl Cellulose (DCC) with intrinsic flame retardant was obtained via the incorporation of 9,10-dihydro-9-oxa-10-phosphaphenanthrene-10-oxide (DOPO) and Cinnamoyl Chloride attached on the backbone of cellulose. It demonstrates that the heat release rate and total heat release significantly reduced. Meanwhile the membrane displayed excellent self-extinction. Additionally, after the DCC membrane assembled into lithium battery, under the optimum formulation situation, the electrochemical properties established that the LIBs showed superior electrochemical performance compared with PP separator. The interface impedance of DCC separator was less than 300 Ω, which was much smaller than that of commercial separator of 410 Ω. After 50 cycles, the battery with DCC-0.11 separator retained 84.2% of its initial discharge capacity, which was higher than the commercial polypropylene separator with the numeric of 79.1%. In sum, this novel, environmental friendly and intrinsic DOPO-Cinnamic flame-retardant cellulose based separator can be considered as an expectant candidate for lithium ion battery separator with high performance.

As an important class of reversible deactivation radical polymerization (RDRP), reversible addition fragmentation chain transfer (RAFT) polymerization has attracted great attention attributed to its facile and flexible features to prepare well-defined polymers with different complex structures. In addition, the combination of RAFT with click chemistry provides more effective strategies to fabricate advanced functional materials. In this work, a series of temperature responsive tetra-arm telechelic poly(N-isopropylacrylamide)s (PNIPAs) with propargyl end groups were prepared for the first time through RAFT and subsequent aminolysis/Michael addition modification. The temperature sensitivities of their aqueous solutions were researched via turbidity measurement. It was found that the phase transition temperature of obtained PNIPAs increased with their molecular weights ascribed to their distinctions in the hydrophobic/hydrophilic balance. Subsequently, β-cyclodextrin (β-CD) functionalized with azide moieties was used to crosslink the prepared propargyl-terminated tetra-arm PNIPAs through click chemistry, fabricating corresponding hydrogels with thermoresponse. Similar to their precursors, the hydrogels demonstrated the same dependence of volume phase transition temperature (VPTT) on their molecular weights. In addition, the incorporation of β-CD and the residual groups besides crosslinking may provide a platform for imparting additional functions such as inclusion and adsorption as well as further functionalization.

Acute gastrointestinal injury (AGI) is common in mechanically ventilated (MV) patients, but the potential association between ventilatory pressure parameters and AGI grade and their impact on mortality remains unclear. This study aimed to explore the association between ventilatory pressure parameters and AGI grade, and their interaction on all-cause mortality in MV patients. This study was a secondary analysis of a multicenter, prospective, observational study that enrolled adult patients with an expected duration of mechanical ventilation ≥ 48 h from 14 general intensive care units in Zhejiang Province between March and August 2014. The AGI grade was assessed daily on the basis of gastrointestinal symptoms, intra-abdominal pressures, and feeding intolerance in the first week of admission to the ICU. This study included 331 patients (69.2% men; mean age, 64.6 ± 18.9 years). Multivariate regression analysis showed that plateau pressure (Pplat) (OR 1.044, 95% CI 1.009-1.081, P = 0.013), serum creatinine (OR 1.003, 95% CI 1.001-1.006, P = 0.042) and APACHE II score (OR 1.035, 95% CI 1.021-1.072, P = 0.045) were independently associated with global AGI grade III/IV within 7 days of ICU admission. Moreover, global AGI grade (HR 2.228, 95% CI 1.561-3.182, P < 0.001), serum creatinine (HR 1.002, 95% CI 1.001-1.003, P = 0.012) and APACHE II score (HR 1.039, 95% CI 1.015-1.063, P = 0.001) were independently associated with 60-day mortality. In addition, there were significant (P int  ≤ 0.028) interactions of Pplat and DP with AGI grade in relation to 60-days mortality, whereas no interaction (P int  = 0.061) between PEEP and AGI grade on 60-days mortality was observed. In the presence of Pplat ≥ 19 cmH 2 O, the patients with AGI grade III/IV had 60-day mortality rate of 72.2%, significantly higher than those with AGI grade I/II (48.7%, P = 0.018), whereas there were no significant differences (27.9% vs. 33.7%, P = 0.39) in 60-days mortality between AGI grade I/II and III/IV among the patients with Pplat < 19 cmH 2 O. In comparison with Pplat, DP had a similar interaction (P int  = 0.028) with AGI grade on 60-day mortality. Ventilatory pressure parameters (Pplat and DP) are independent risk factors of AGI grade III/IV. Pplat and DP interact with AGI grade on 60-days mortality, highlighting the importance of optimizing ventilatory pressure parameters to improve gastrointestinal function and survival outcomes of MV patients.Trial registration: ChiCTR-OCS-13003824., (© 2024. The Author(s).)