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Objective: The objective of this study was to develop a deep learning-andradiomics- based ultrasound nomogram for the evaluation of axillary lymph node (ALN) metastasis risk in breast cancer patients = 75 years. Methods: The study enrolled breast cancer patients = 75 years who underwent either sentinel lymph node biopsy or ALN dissection at Fudan University Shanghai Cancer Center. DenseNet-201 was employed as the base model, and it was trained using the Adam optimizer and cross-entropy loss function to extract deep learning (DL) features from ultrasound images. Additionally, radiomics features were extracted from ultrasound images utilizing the Pyradiomics tool, and a Rad-Score (RS) was calculated employing the Lasso regression algorithm. A stepwise multivariable logistic regression analysis was conducted in the training set to establish a prediction model for lymph node metastasis, which was subsequently validated in the validation set. Evaluation metrics included area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and F1-score. The calibration of the model's performance and its clinical prediction accuracy were assessed using calibration curves and decision curves respectively. Furthermore, integrated discrimination improvement and net reclassification improvement were utilized to quantify enhancements in RS. Results: Histological grade, axillary ultrasound, and RS were identified as independent risk factors for predicting lymph node metastasis. The integration of the RS into the clinical prediction model significantly improved its predictive performance, with an AUC of 0.937 in the training set, surpassing both the clinical model and the RS model alone. In the validation set, the integrated model also outperformed other models with AUCs of 0.906, 0.744, and 0.890 for the integrated model, clinical model, and RS model respectively. Experimental results demonstrated that this study's integrated prediction model could enhance both accuracy and generalizability. Conclusion: The DL and radiomics-based model exhibited remarkable accuracy and reliability in predicting ALN status among breast cancer patients = 75 years, thereby contributing to the enhancement of personalized treatment strategies' efficacy and improvement of patients' quality of life. [ABSTRACT FROM AUTHOR]

To address the consumption and security of color images for transmission and storage, a cross-channel color image encryption scheme based on a discrete memristive coupled neuron model and DWT compression is designed in this article. Firstly, the dynamics of the discrete memristive coupled neuron system are analyzed and found to possess the hyperchaotic phenomenon, which provides sufficient security for the encryption scheme. Secondly, the color image processed by discrete wavelet transform (DWT) has a quarter of the previous capacity. Then, the color image is combined with a Hash function, and the resulting Hash sequence is given the initial value of the hyperchaotic system. Next, a particle swarm foraging algorithm (PSFA) is designed to better disrupt the correlation in the RGB channel. Finally, a complementary DNA coding rule is implemented for the further encryption of color images. Simulation results show that even with DWT lossy compression, the recovered image can be clearly seen. The performance analysis illustrates that under the hyperchaotic system, the proposed encryption algorithm brings higher security for color images. [ABSTRACT FROM AUTHOR]

Main conclusion: The post-transcriptional gene regulatory pathway and small RNA pathway play important roles in regulating the rapid and long-term response of Rhododendron moulmainense to high-temperature stress. The Rhododendron plays an important role in maintaining ecological balance. However, it is difficult to domesticate for use in urban ecosystems due to their strict optimum growth temperature condition, and its evolution and adaptation are little known. Here, we combined transcriptome and small RNAome to reveal the rapid response and long-term adaptability regulation strategies in Rhododendron moulmainense under high-temperature stress. The post-transcriptional gene regulatory pathway plays important roles in stress response, in which the protein folding pathway is rapidly induced at 4 h after heat stress, and alternative splicing plays an important role in regulating gene expression at 7 days after heat stress. The chloroplasts oxidative damage is the main factor inhibiting photosynthesis efficiency. Through WGCNA analysis, we identified gene association patterns and potential key regulatory genes responsible for maintaining the ROS steady-state under heat stress. Finally, we found that the sRNA synthesis pathway is induced under heat stress. Combined with small RNAome, we found that more miRNAs are significantly changed under long-term heat stress. Furthermore, MYBs might play a central role in target gene interaction network of differentially expressed miRNAs in R. moulmainense under heat stress. MYBs are closely related to ABA, consistently, ABA synthesis and signaling pathways are significantly inhibited, and the change in stomatal aperture is not obvious under heat stress. Taken together, we gained valuable insights into the transplantation and long-term conservation domestication of Rhododendron, and provide genetic resources for genetic modification and molecular breeding to improve heat resistance in Rhododendron. [ABSTRACT FROM AUTHOR]

To improve the salient region security and transmission efficiency of remote sensing images, a multiple remote sensing image (MRSIs) encryption scheme based on saliency extraction and magic cube circular motion is proposed in this paper. The scheme provides two tiers of privacy protection for salient regions (airport locations) in remote sensing images. First, a 4D improved discrete tabu learning neuron (4D-IDTLN) chaotic system is proposed. The analysis of phase diagrams, the Lyapunov exponents (LEs) spectrum and bifurcation diagrams of the system show that the system exhibits rich dynamic behaviors. Second, the salient regions of remote sensing images are classified and extracted via knowledge-oriented saliency (KOS) and vision-oriented saliency (VOS) techniques to create a mask contour positioning model (MCPM) for the salient regions, which is then encrypted. Then, the MRSIs are fused into a cube, which is encrypted using magic cube circular motion and chaotic sequences and further encrypted using closed-loop diffusion. Finally, the security of the proposed encryption scheme is evaluated. The results indicate that the scheme provides higher security and better transmission efficiency for MRSIs. [ABSTRACT FROM AUTHOR]

The n-octane hydroconversion catalysts were prepared by the impregnation of nanosized HZSM-5 with ammonium heptamolybdate or phosphomolybdic acid (PMA) precursors and were characterised by SEM, BET, FT-IR, UV–Vis, XRD, Py-IR and NH3-TPD. The hydroconversion of n-octane over a little phosphorus doping on the n-octane hydroconversion activity of MoO3/ZSM-5 catalysts has been investigated in order to obtain light isomers, alkanes and aromatic products with high octane number. In particular, the use of PMA increases the ability of aromatization and producing light iso-alkanes for nanosized HZSM-5 zeolites. The yield of total aromatics and i/n ratio over PMA-based MoO3/ZSM-5 catalysts reached 31.7 and 3.3 after 10 h of continuous reaction, respectively. When 0.2 wt% of phosphorus is added to the catalyst prepared from heptamolybdate, the activity is suppressed. A mixture of monoclinic β-MoO3 and orthorhombic α-MoO3 favors increasing aromatization performance over nanosized HZSM-5 zeolites, and orthorhombic α-MoO3 is beneficial to the production of light iso-alkanes. It could be attributed to the difference between orthorhombic α-MoO3 and monoclinic β-MoO3 as well as the structural dissimilarity between the two phases on nanosized HZSM-5 zeolites. The improved activity of n-octane hydroconversion over these catalysts and the mechanism of hydroconversion is discussed. [ABSTRACT FROM AUTHOR]

Background: Alzheimer's disease (AD) is the most common form of dementia, progressively impairing cognitive abilities. While neuroimaging studies have revealed functional abnormalities in AD, how these relate to aberrant neuronal circuit mechanisms remains unclear. Using magnetoencephalography imaging we documented abnormal local neural synchrony patterns in patients with AD. To identify global abnormal biophysical mechanisms underlying the spatial and spectral electrophysiological patterns in AD, we estimated the parameters of a biophysical spectral graph model (SGM). Methods: SGM is an analytic neural mass model that describes how long-range fiber projections in the brain mediate the excitatory and inhibitory activity of local neuronal subpopulations. Unlike other coupled neuronal mass models, the SGM is linear, available in closed-form, and parameterized by a small set of biophysical interpretable global parameters. This facilitates their rapid and unambiguous inference which we performed here on a well-characterized clinical population of patients with AD (N = 88, age = 62.73 +/- 8.64 years) and a cohort of age-matched controls (N = 88, age = 65.07 +/- 9.92 years). Results: Patients with AD showed significantly elevated long-range excitatory neuronal time scales, local excitatory neuronal time scales and local inhibitory neural synaptic strength. The long-range excitatory time scale had a larger effect size, compared to local excitatory time scale and inhibitory synaptic strength and contributed highest for the accurate classification of patients with AD from controls. Furthermore, increased long-range time scale was associated with greater deficits in global cognition. Conclusions: These results demonstrate that long-range excitatory time scale of neuronal activity, despite being a global measure, is a key determinant in the local spectral signatures and cognition in the human brain, and how it might be a parsimonious factor underlying altered neuronal activity in AD. Our findings provide new insights into mechanistic links between abnormal local spectral signatures and global connectivity measures in AD. [ABSTRACT FROM AUTHOR]

This document provides a summary of a special issue in the journal "Electronics" that focuses on the effects of radiation on advanced electronic devices and circuits. The articles cover various topics, including the impact of radiation on specific devices and the development of evaluation methods and strategies for enhancing radiation resistance. The research aims to improve the reliability and performance of electronic systems in space applications. The second edition of the special issue will explore emerging technologies, fault-tolerant computing architectures, nanoscale effects, and the role of machine learning and artificial intelligence. [Extracted from the article]

Background: Copper oxide nanoparticles (CuO NPs) exhibit antitumor activity; however, their potential as an antiangiogenesis agent is unknown. Materials & methods: The antiangiogenesis properties of CuO NPs were evaluated in vitro and in vivo and the underlying mechanism was examined using RNA sequencing and metabolomic analyses. Results: CuO NPs inhibited endothelial cell function in vitro. They also mitigated retinal vasculature development and alleviated pathological retinal angiogenesis in vivo. RNA sequencing and metabolomic analyses revealed that CuO NPs disrupt the tricarboxylic acid cycle and induce cuproptosis, which was further supported by evaluating cuproptosis-related metabolites and proteins. Conclusion: CuO NPs may be an effective antiangiogenic agent for the treatment of retinal angiogenesis. We demonstrated that CuO nanoparticles (NPs) exhibit significant antiangiogenic properties in vitro and in vivo. The combined analysis of metabolomics and RNA sequencing revealed that CuO NPs disrupt the TCA cycle pathway, ultimately leading to cuproptosis. [ABSTRACT FROM AUTHOR]

Background: The rise of linezolid resistance has been widely observed both in clinical and non-clinical settings. However, there were still data gaps regarding the comprehensive prevalence and interconnections of linezolid resistance genes across various niches. Results: We screened for potential linezolid resistance gene reservoirs in the intestines of both humans and animals, in meat samples, as well as in water sources. A total of 796 bacteria strains out of 1538 non-duplicated samples were identified to be positive for at least one linezolid resistance gene, optrA, poxtA, cfr, and cfr(D). The prevalence of optrA reached 100% (95% CI 96.3–100%) in the intestines of pigs, followed by fish, ducks, and chicken at 77.5% (95% CI 67.2–85.3%), 62.0% (95% CI 52.2–70.9%), and 61.0% (95% CI 51.2–70.0%), respectively. The meat and water samples presented prevalences of 80.0% (95% CI 70.6–87.0%) and 38.0% (95% CI 25.9–51.9%), respectively. The unreported prevalence of the cfr(D) gene was also relatively higher at 13.0% (95% CI 7.8–21.0%) and 19.0% (95% CI 10.9–25.6%) for the feces samples of ducks and pigs, respectively. Enterococci were the predominant hosts for all genes, while several non-enterococcal species were also identified. Phylogenetic analysis revealed a significant genetic distance among linezolid resistance gene reservoirs, with polyclonal structures observed in strains within the same niche. Similar genetic arrays harboring assorted insertion sequences or transposons were shared by reservoirs displaying heterogeneous backgrounds, though large diversity in the genetic environment of linezolid resistance genes was also observed. Conclusions: The linezolid resistance genes were widespread among various niches. The horizontal transfer played a crucial role in driving the circulation of linezolid resistance reservoirs at the human-animal-environment interfaces. 96S1xiBHwsMdUXcKCqEsW5 Video Abstract [ABSTRACT FROM AUTHOR]

Background: Pleomorphic adenoma (PA), often with the benign-like imaging appearances similar to Warthin tumor (WT), however, is a potentially malignant tumor with a high recurrence rate. It is worse that pathological fine-needle aspiration cytology (FNAC) is difficult to distinguish PA and WT for inexperienced pathologists. This study employed deep learning (DL) technology, which effectively utilized ultrasound images, to provide a reliable approach for discriminating PA from WT. Methods: 488 surgically confirmed patients, including 266 with PA and 222 with WT, were enrolled in this study. Two experienced ultrasound physicians independently evaluated all images to differentiate between PA and WT. The diagnostic performance of preoperative FNAC was also evaluated. During the DL study, all ultrasound images were randomly divided into training (70%), validation (20%), and test (10%) sets. Furthermore, ultrasound images that could not be diagnosed by FNAC were also randomly allocated to training (60%), validation (20%), and test (20%) sets. Five DL models were developed to classify ultrasound images as PA or WT. The robustness of these models was assessed using five-fold cross-validation. The Gradient-weighted Class Activation Mapping (Grad-CAM) technique was employed to visualize the region of interest in the DL models. Results: In Grad-CAM analysis, the DL models accurately identified the mass as the region of interest. The area under the receiver operating characteristic curve (AUROC) of the two ultrasound physicians were 0.351 and 0.598, and FNAC achieved an AUROC of only 0.721. Meanwhile, for DL models, the AUROC value for discriminating between PA and WT in the test set was from 0.828 to 0.908. ResNet50 demonstrated the optimal performance with an AUROC of 0.908, an accuracy of 0.833, a sensitivity of 0.736, and a specificity of 0.904. In the test set of cases that FNAC failed to provide a diagnosis, DenseNet121 demonstrated the optimal performance with an AUROC of 0.897, an accuracy of 0.806, a sensitivity of 0.789, and a specificity of 0.824. Conclusion: For the discrimination of PA and WT, DL models are superior to ultrasound and FNAC, thereby facilitating surgeons in making informed decisions regarding the most appropriate surgical approach. [ABSTRACT FROM AUTHOR]

We have performed a systematical study of the eclectic flavor group ∆(27) ⋊ S3 which is the extension of the traditional flavor symmetry ∆(27) by the finite modular symmetry S3. Consistency between ∆(27) and S3 requires that the eight nontrivial singlet representations of ∆(27) should be arranged into four reducible doublets. The modular transformation matrices are determined for various ∆(27) multiplets, and the CP-like symmetry compatible with ∆(27) ⋊ S3 are discussed. We study the general form of the Kähler potential and superpotential invariant under ∆(27) ⋊ S3, and the corresponding fermion mass matrices are presented. We propose a bottom-up model for lepton masses and mixing based on ∆(27) ⋊ S3, a numerical analysis is performed and the experimental data can be accommodated. [ABSTRACT FROM AUTHOR]

The advancement of biomaterials with antimicrobial and wound healing properties continues to present challenges. Macrophages are recognized for their significant role in the repair of infection-related wounds. However, the interaction between biomaterials and macrophages remains complex and requires further investigation. In this research, we propose a new sequential immunomodulation method to enhance and expedite wound healing by leveraging the immune properties of bacteria-related wounds, utilizing a novel mixed hydrogel dressing. The hydrogel matrix is derived from porcine acellular dermal matrix (PADM) and is loaded with a new type of bioactive glass nanoparticles (MBG) doped with magnesium (Mg-MBG) and loaded with Curcumin (Cur). This hybrid hydrogel demonstrates controlled release of Cur, effectively eradicating bacterial infection in the early stage of wound infection, and the subsequent release of Mg ions (Mg2+) synergistically inhibits the activation of inflammation-related pathways (such as MAPK pathway, NF-κB pathway, TNF-α pathway, etc.), suppressing the inflammatory response caused by infection. Therefore, this innovative hydrogel can safely and effectively expedite wound healing during infection. Our design strategy explores novel immunomodulatory biomaterials, offering a fresh approach to tackle current clinical challenges associated with wound infection treatment. [ABSTRACT FROM AUTHOR]

In the process of rotating machinery fault diagnosis (RMFD), the lack of feature conditions leads to the problem of low accuracy of traditional rule-based reasoning methods FD. This paper proposed a knowledge graph (KG)-driven device FD method and applied it to RMFD. First, we proposed a multi-level KG construction method to get multi-source data based on each level and analyzed the levels that affected the system state. A single-level KG was constructed through data features, and a multilevel KG with a stereostructure was built using a multi-source data fusion model as data support for FD. Second, we proposed an approach based on multilevel KG and Bayes theory to detect the system state and located the source of faults by combining the KG reasoning based on relational paths, then used the relationships between the structures of rotating mechanical equipment for fault cause reasoning and used the KG as a knowledge base for a reason using machine learning. Finally, the proposed method was validated using a steelworks motor as an example and compared with other ways, such as rule-based FD. The results show that under the condition of missing input features, the accuracy of the proposed method reaches 91.1%, which is significantly higher than other methods and effectively solves the problem of low diagnostic accuracy. [ABSTRACT FROM AUTHOR]

The freshness of vegetable soybean (VS) is an important indicator for quality evaluation. Currently, deep learning-based image recognition technology provides a fast, efficient, and low-cost method for analyzing the freshness of food. The RGB (red, green, and blue) image recognition technology is widely used in the study of food appearance evaluation. In addition, the hyperspectral image has outstanding performance in predicting the nutrient content of samples. However, there are few reports on the research of classification models based on the fusion data of these two sources of images. We collected RGB and hyperspectral images at four different storage times of VS. The ENVI software was adopted to extract the hyperspectral information, and the RGB images were reconstructed based on the downsampling technology. Then, the one-dimensional hyperspectral data was transformed into a two-dimensional space, which allows it to be overlaid and concatenated with the RGB image data in the channel direction, thereby generating fused data. Compared with four commonly used machine learning models, the deep learning model ResNet18 has higher classification accuracy and computational efficiency. Based on the above results, a novel classification model named ResNet-R &H, which is based on the residual networks (ResNet) structure and incorporates the fusion data of RGB and hyperspectral images, was proposed. The ResNet-R &H can achieve a testing accuracy of 97.6%, which demonstrates a significant enhancement of 4.0% and 7.2% compared to the distinct utilization of hyperspectral data and RGB data, respectively. Overall, this research is significant in providing a unique, efficient, and more accurate classification approach in evaluating the freshness of vegetable soybean. The method proposed in this study can provide a theoretical reference for classifying the freshness of fruits and vegetables to improve classification accuracy and reduce human error and variability. [ABSTRACT FROM AUTHOR]

Introduction: The dynamic HIV/AIDS epidemic significantly impacts China, particularly affecting injection drug users (IDUs), former plasma donors (FPDs), men who have sex with men (MSM), and those engaging in high-risk heterosexual behavior (HRHB). This study specifically focuses on identifying the risk factors and influences that drive the spread of HIV among these population groups by performing a comprehensive analysis of contact histories of individuals diagnosed with HIV. Methods: Data for this research were gathered from China's HIV/AIDS Comprehensive Response Information Management System (CRIMS). Contact histories were described using bar and venn diagram. Trend in engaging in HBRB among MSM were identify potential change using the Cochran-Armitage test. Logistic regression was employed to analyze the factors influencing HBRB in MSM. Results: From 1989 through to 2022, a total of 1,457,218 individuals aged 15 years or older in China, who reported being infected with HIV, indicated they had one or more types of contact histories including injecting drug use, male homosexual behavior, commercial plasma donation, and high-risk heterosexual behavior. Among these, 97.0% reported a single type of contact history, while 3.0% reported having multiple contact histories. Of those with multiple contact histories, 98.0% (42,258 individuals) had engaged in HRHB. Among all HIV-infected IDUs, MSM, and FPDs, their respective proportions of engagement in HRHB were 11.8%, 5.7% and 6.2%. Prior to 2012, most were reported to be IDUs; however, subsequent to this, most reported being MSM. Factors that heightened the risk of engaging in HRHB among HIV-infected MSM included being of age between 25–34 years [adjusted odds ratio (AOR) = 1.29] or 35–44 years (AOR = 1.22), marital status such as being married (AOR = 1.23) or being divorced/widowed (AOR = 1.17), belonging to an ethnic minority (AOR = 1.29), receiving diagnosis in hospitals (AOR = 1.81), residing in rural areas (AOR = 1.12), among others. However, the risk of HRHB decreased when age ≥ 55 years (55–64 years: AOR = 0.82; ≥ 65 years: AOR = 0.64). Conclusion: The potential for HIV transmission among diverse populations is substantial. As such, it is imperative that strategies are implemented to mitigate the propagation of HIV to the general populace via heterosexual intercourse. [ABSTRACT FROM AUTHOR]

Carbapenem is one of the few available drugs to treat multidrug-resistance Gram-negative bacteria infections. Recently, the plasmid-mediated spread of the carbapenem resistance gene blaNDM poses a significant threat to public health, requiring global monitoring and surveillance. Here, we used both short-read (n = 2461) and long-read (n = 546) sequencing data to characterize the global distribution of blaNDM. We analyzed the replicon type of blaNDM-positive plasmids and found that the dominant plasmid type was different in diverse geographical locations. Although blaNDM gene has been transferred across diverse countries, its genetic backgrounds are highly conserved, and the mobile genetic element ISAba125, IS5, and IS26 may play an important role in the mobilization of blaNDM. A significant association was observed between host origin and gene presence/deletion variation on IncX3 plasmid, which may be a key factor in the bacterial adaption to diverse hosts. In this study, we analyzed the diversity, distribution and transmission of blaNDM-positive plasmids from a global perspective, and emphasize the importance of plasmid analysis for understanding the evolution and adaptation of blaNDM-positive plasmids and their co-evolution with bacterial genomes (resistome). [ABSTRACT FROM AUTHOR]

Background: Ultrasound plays a critical role in the early screening and diagnosis of cancers. Although deep neural networks have been widely investigated in the computer‐aided diagnosis (CAD) of different medical images, diverse ultrasound devices, and image modalities pose challenges for clinical applications, especially in the recognition of thyroid nodules having various shapes and sizes. More generalized and extensible methods need to be developed for the cross‐devices recognition of thyroid nodules. Purpose: In this work, a semi‐supervised graph convolutional deep learning framework is proposed for the domain adaptative recognition of thyroid nodules across several ultrasound devices. A deep classification network, trained on a source domain with a specific device, can be transferred to recognize thyroid nodules on the target domain with other devices, using only few manual annotated ultrasound images. Methods: This study presents a semi‐supervised graph‐convolutional‐network‐based domain adaptation framework, namely Semi‐GCNs‐DA. Based on the ResNet backbone, it is extended in three aspects for domain adaptation, that is, graph convolutional networks (GCNs) for the connection construction between source and target domains, semi‐supervised GCNs for accurate target domain recognition, and pseudo labels for unlabeled target domains. Data were collected from 1498 patients comprising 12 108 images with or without thyroid nodules under three different ultrasound devices. Accuracy, Sensitivity and Specificity were used for the performance evaluation. Results: The proposed method was validated on six groups of data for a single source domain adaptation task, the mean Accuracy was 0.9719 ± 0.0023, 0.9928 ± 0.0022, 0.9353 ± 0.0105, 0.8727 ± 0.0021, 0.7596 ± 0.0045, 0.8482 ± 0.0092, which achieved better performance in comparison with the state‐of‐the‐art. The proposed method was also validated on three groups of multiple source domain adaptation tasks. In particular, when using X60 and HS50 as the source domain data, and H60 as the target domain, it can achieve the Accuracy of 0.8829 ± 0.0079, Sensitivity of 0.9757 ± 0.0001, and Specificity of 0.7894 ± 0.0164. Ablation experiments also demonstrated the effectiveness of the proposed modules. Conclusion: The developed Semi‐GCNs‐DA framework can effectively recognize thyroid nodules on different ultrasound devices. The developed semi‐supervised GCNs can be further extended to the domain adaptation problems for other modalities of medical images. [ABSTRACT FROM AUTHOR]

Blood vessels play a role in osteogenesis and osteoporosis; however, the role of vascular metabolism in these processes remains unclear. The present study finds that ovariectomized mice exhibit reduced blood vessel density in the bone and reduced expression of the endothelial glycolytic regulator pyruvate kinase M2 (PKM2). Endothelial cell (EC)‐specific deletion of Pkm2 impairs osteogenesis and worsens osteoporosis in mice. This is attributed to the impaired ability of bone mesenchymal stem cells (BMSCs) to differentiate into osteoblasts. Mechanistically, EC‐specific deletion of Pkm2 reduces serum lactate levels secreted by ECs, which affect histone lactylation in BMSCs. Using joint CUT&Tag and RNA sequencing analyses, collagen type I alpha 2 chain (COL1A2), cartilage oligomeric matrix protein (COMP), ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1), and transcription factor 7 like 2 (TCF7L2) as osteogenic genes regulated by histone H3K18la lactylation are identified. PKM2 overexpression in ECs, lactate addition, and exercise restore the phenotype of endothelial PKM2‐deficient mice. Furthermore, serum metabolomics indicate that patients with osteoporosis have relatively low lactate levels. Additionally, histone lactylation and related osteogenic genes of BMSCs are downregulated in patients with osteoporosis. In conclusion, glycolysis in ECs fuels BMSC differentiation into osteoblasts through histone lactylation, and exercise partially ameliorates osteoporosis by increasing serum lactate levels. [ABSTRACT FROM AUTHOR]

China's comprehensive primary healthcare (PHC) reforms since 2009 aimed to deliver accessible, efficient, equitable and high-quality healthcare services. However, knowledge on the system-wide effectiveness of these reforms is limited. This systematic review synthesizes evidence on the reforms' health and health system impacts. In 13 August 2022, international databases and three Chinese databases were searched for randomized controlled trials, quasi-experimental studies and controlled before-after studies. Included studies assessed large-scale PHC policies since 2009; had a temporal comparator and a control group and assessed impacts on expenditures, utilization, care quality and health outcomes. Study quality was assessed using Risk of Bias In Non-randomized Studies of Interventions, and results were synthesized narratively. From 49 174 identified records, 42 studies were included—all with quasi-experimental designs, except for one randomized control trial. Nine studies were assessed as at low risk of bias. Only five low- to moderate-quality studies assessed the comprehensive reforms as a whole and found associated increases in health service utilization, whilst the other 37 studies examined single-component policies. The National Essential Medicine Policy (N  = 15) and financing reforms (N  = 11) were the most studied policies, whilst policies on primary care provision (i.e. family physician policy and the National Essential Public Health Services) were poorly evaluated. The PHC reforms were associated with increased primary care utilization (N  = 17) and improved health outcomes in people with non-communicable diseases (N  = 8). Evidence on healthcare costs was unclear, and impacts on patients' financial burden and care quality were understudied. Some studies showed disadvantaged regions and groups that accrued greater benefits (N  = 8). China's comprehensive PHC reforms have made some progress in achieving their policy objectives including increasing primary care utilization, improving some health outcomes and reducing health inequalities. However, China's health system remains largely hospital-centric and further PHC strengthening is needed to advance universal health coverage. [ABSTRACT FROM AUTHOR]

Grass carp reovirus (GCRV), one of the most serious pathogens threatening grass carp (Ctenopharyngodon idella), can lead to grass carp hemorrhagic disease (GCHD). Currently, GCRV can be divided into three genotypes, but the comparison of their pathogenic mechanisms and the host responses remain unclear. In this study, we utilized the Ctenopharyngodon idella kidney (CIK) model infected with GCRV to conduct comparative studies on the three genotypes. We observed a cytopathic effect (CPE) in the GCRV-I and GCRV-III groups, whereas the GCRV-II group did not show any CPE. Moreover, a consistent trend in the mRNA expression levels of antiviral-related genes across all experimental groups of CIK cells was detected via qPCR and further explored through RNA-seq analysis. Importantly, GO/KEGG enrichment analysis showed that GCRV-I, -II, and -III could all activate the immune response in CIK cells, but GCRV-II induced more intense immune responses. Intriguingly, transcriptomic analysis revealed a widespread down-regulation of metabolism processes such as steroid biosynthesis, butanoate metabolism, and N-Glycan biosynthesis in infected CIK cells. Overall, our results reveal the CIK cells showed unique responses in immunity and metabolism in the three genotypes of GCRV infection. These results provide a theoretical basis for understanding the pathogenesis and prevention and control methods of GCRV. [ABSTRACT FROM AUTHOR]

Habitat fragmentation is altering species interactions worldwide. However, the mechanisms underlying the response of network specialization to habitat fragmentation remain unknown, especially for multi-trophic interactions. We here collected a large dataset consisting of 2670 observations of tri-trophic interactions among plants, sap-sucking aphids and honeydew-collecting ants on 18 forested islands in the Thousand Island Lake, China. For each island, we constructed an antagonistic plant–aphid and a mutualistic aphid–ant network, and tested how network specialization varied with island area and isolation. We found that both networks exhibited higher specialization on smaller islands, while only aphid–ant networks had increased specialization on more isolated islands. Variations in network specialization among islands was primarily driven by species turnover, which was interlinked across trophic levels as fragmentation increased the specialization of both antagonistic and mutualistic networks through bottom-up effects via plant and aphid communities. These findings reveal that species on small and isolated islands display higher specialization mainly due to effects of fragmentation on species turnover, with behavioural changes causing interaction rewiring playing only a minor role. Our study highlights the significance of adopting a multi-trophic perspective when exploring patterns and processes in structuring ecological networks in fragmented landscapes. [ABSTRACT FROM AUTHOR]

Habitat fragmentation is altering species interactions worldwide. However, the mechanisms underlying the response of network specialization to habitat fragmentation remain unknown, especially for multi-trophic interactions. We here collected a large dataset consisting of 2670 observations of tri-trophic interactions among plants, sap-sucking aphids and honeydew-collecting ants on 18 forested islands in the Thousand Island Lake, China. For each island, we constructed an antagonistic plant–aphid and a mutualistic aphid–ant network, and tested how network specialization varied with island area and isolation. We found that both networks exhibited higher specialization on smaller islands, while only aphid–ant networks had increased specialization on more isolated islands. Variations in network specialization among islands was primarily driven by species turnover, which was interlinked across trophic levels as fragmentation increased the specialization of both antagonistic and mutualistic networks through bottom-up effects via plant and aphid communities. These findings reveal that species on small and isolated islands display higher specialization mainly due to effects of fragmentation on species turnover, with behavioural changes causing interaction rewiring playing only a minor role. Our study highlights the significance of adopting a multi-trophic perspective when exploring patterns and processes in structuring ecological networks in fragmented landscapes. [ABSTRACT FROM AUTHOR]

Hydrophobic conjugated polymers have poor ionic transport property, so hydrophilic side chains are often grafted for their application as organic electrochemical transistors (OECTs). However, this modification lowers their charge transport ability. Here, an ionic gel interfacial layer is applied to improve the ionic transport while retaining the charge transport ability of the polymers. By using the ionic gels comprising gel matrix and ionic liquids as the interfacial layers, the hydrophobic polymer achieves the OECT feature with high transconductance, low threshold voltage, high current on/off ratio, short switching time, and high operational stability. The working mechanism is also revealed. Moreover, the OECT performance can be tuned by varying the types and ratios of ionic gels. With the proposed ionic gel strategy, OECTs can be effectively realized with hydrophobic conjugated polymers. [ABSTRACT FROM AUTHOR]

Hydrophobic conjugated polymers have poor ionic transport property, so hydrophilic side chains are often grafted for their application as organic electrochemical transistors (OECTs). However, this modification lowers their charge transport ability. Here, an ionic gel interfacial layer is applied to improve the ionic transport while retaining the charge transport ability of the polymers. By using the ionic gels comprising gel matrix and ionic liquids as the interfacial layers, the hydrophobic polymer achieves the OECT feature with high transconductance, low threshold voltage, high current on/off ratio, short switching time, and high operational stability. The working mechanism is also revealed. Moreover, the OECT performance can be tuned by varying the types and ratios of ionic gels. With the proposed ionic gel strategy, OECTs can be effectively realized with hydrophobic conjugated polymers. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is one of the most common progressive neurodegenerative diseases associated with the degradation of memory and cognitive ability. Current pharmacotherapies show little therapeutic effect in AD treatment and still cannot prevent the pathological progression of AD. Deep brain stimulation (DBS) has shown to enhance memory in morbid obese, epilepsy and traumatic brain injury patients, and cognition in Parkinson's disease (PD) patients deteriorates during DBS off. Some relevant animal studies and clinical trials have been carried out to discuss the DBS treatment for AD. Reviewing the fornix trials, no unified conclusion has been reached about the clinical benefits of DBS in AD, and the dementia ratings scale has not been effectively improved in the long term. However, some patients have presented promising results, such as improved glucose metabolism, increased connectivity in cognition‐related brain regions and even elevated cognitive function rating scale scores. The fornix plays an important regulatory role in memory, attention, and emotion through its complex fibre projection to cognition‐related structures, making it a promising target for DBS for AD treatment. Moreover, the current stereotaxic technique and various evaluation methods have provided references for the operator to select accurate stimulation points. Related adverse events and relatively higher costs in DBS have been emphasized. In this article, we summarize and update the research progression on fornix DBS in AD and seek to provide a reliable reference for subsequent experimental studies on DBS treatment of AD. [ABSTRACT FROM AUTHOR]

Due to the excellent heat transfer performance, spray cooling is widely used for heat removal of high-heat-flux electronic devices. In this study, the influence of spray characteristics on spray cooling heat transfer is tested experimentally, where both water and 4% ethanol-water mixture are used as the working fluid. The Sauter mean diameter and droplet number distributions are measured by the Particle/Droplet Imaging Analysis system, and the fluid volumetric flux distributions are measured by the self-designed Precision Mobile Experiment Bench. The results show that the heat transfer efficiency of the 4% ethanol-water mixture is superior to that of water. Especially, the critical heat flux is about twofold that of water for the Spray A nozzle. For a fixed nozzle, the Sauter mean diameter of the 4% ethanol-water mixture is smaller, while the fluid volumetric flux shows an increase under the same conditions. Small Sauter mean diameter and large fluid volumetric flux can induce more droplets to entrain bubbles. Then the mechanisms of improved spray cooling heat transfer are analyzed based on the spray characteristics measurement results. It is revealed that the Sauter mean diameter and mean fluid volumetric flux exert joint influence on the heat transfer efficiency, and the mean fluid volumetric flux has an obvious effect between different nozzles. Two dimensionless heat flux correlations are proposed for the single-phase and nucleate boiling regimes with mean absolute errors of 15.56% and 14.68%, respectively. Highlights: Sauter mean diameter of 4 vol.% ethanol-water is smaller than water, but the fluid volumetric flux is higher than water. Small Sauter mean diameter and large fluid volumetric flux induce more droplets generating entrained bubbles, which can enhance the heat transfer performance. Fluid volumetric flux is predominant in improving heat transfer performance, especially in the nucleate boiling regime. Spray characteristics have an obvious influence on the critical heat flux. Dimensionless heat flux is correlated with characteristic numbers integrating Sauter mean diameter and fluid volumetric flux. [ABSTRACT FROM AUTHOR]

Rabies is a serious public health problem in Asia and Africa. Approximately 99% of cases result from a bite by an infected dog. The high rabies risk countries are generally characterized by rapid urbanization; however, the prevalence and risk factors for rabies in urban dogs in developing countries remain unclear. Beijing, the capital of China, has been undergoing rapid urbanization, and implemented compulsory rabies immunization for dogs on October 1, 2014. We evaluated the effects of this immunization policy and investigated the dynamics and determinants of the spread of dog rabies virus (RABV) in Beijing. Between 2013 and 2018, the positive rate of rabies in biting dogs declined significantly; 79.6% of these were stray dogs. Reconstructed spatiotemporal diffusion for RABV presents a more central distribution within Beijing and a surrounding dissemination of virus lineage toward suburban areas, indicating that rabies is self-sustaining in Beijing. Continuous RABV phylogeographic reconstructions and logistic regression analysis of rabies cases revealed that rabies tended to remain in commercial areas, high-rise residences, demolition areas, and high-GDP, high-population and high-accessibility areas. Demolition areas, where many residents have abandoned their pets, are recognized as high-risk areas for rabies. Our findings reveal that the implementation of the immunization policy in Beijing has been effective in prevention and control of canine rabies, and because the prevalence of canine rabies results from multiple factors, emphasize the important role of multi-sectoral cooperation in rabies prevention and control. [ABSTRACT FROM AUTHOR]

KRAS mutation is the most frequent type of genetic mutation in non‐small cell lung cancer (NSCLC), especially in lung adenocarcinoma. However, KRAS mutation can affect many biological processes and the mechanisms underlying KRAS mutation‐mediate carcinogenesis in NSCLC have not been fully understood. In this research, we found that KRASG12C mutation was associated with the upregulation of T‐LAK cell‐originated protein kinase (TOPK), which is a well‐known serine/threonine MAPK‐like protein kinase implicated in tumorigenesis. The overexpression of TOPK significantly promoted the malignant phenotype of A549 cells, and TOPK silencing impaired the malignant phenotype with KRASG12C mutation. Moreover, we demonstrated that TOPK level was regulated by MAPK/ERK signalling and the transcription factor Elk1. TOPK was also found to promote the activation of NF‐κB signalling in A549 cells with KRASG12C mutation via facilitating the phosphorylation of TAK1. In the in vivo tumorigenesis model, the administration of TOPK inhibitor OTS514 enhanced the anticancer effect of 5‐FU, and the combinatory use of OTS514 and KRASG12C inhibitor AMG510 showed synergistic anti‐tumour effect. These results suggest that KRAS‐TOPK axis contributes to the progression of NSCLC and targeting this axis could synergize with anticancer effect of the existing chemotherapeutics. [ABSTRACT FROM AUTHOR]

The human intestinal tract is considered the most important reservoir of the opportunistic pathogens, including Pseudomonas aeruginosa, which is often overlooked but critical due to its antimicrobial resistance and virulence. Public health interventions to control this pathogen require a comprehensive understanding of its epidemiology and genomics. In the current study, we identified P. aeruginosa strains from 2,605 fecal samples collected between 2021 to 2022. Among these samples, 574 were from ICU inpatients in Zhejiang province, while 2,031 were obtained from healthy individuals residing in ten different provinces in China. The prevalence of P. aeruginosa intestinal carriage was found to be higher in ICU inpatients (10.28%, 95% CI: 7.79%–12.76%) than that in healthy individuals (3.99%, 81/2,031, 95% CI: 3.14%–4.84%). Similarly, the prevalence of carbapenem-resistant P. aeruginosa (CRPA) was higher in ICU inpatients (32.2%) compared to healthy individuals (7.41%). The population structure analysis of our isolates revealed a predominantly non-clonal distribution, with 41 distinct sequence types identified among 59 P. aeruginosa isolates from ICU inpatients and 38 different STs among 81 P. aeruginosa isolates from healthy individuals. These findings suggest that the individual acquisition of P. aeruginosa is more frequent than patient-to-patient transmission, as evidenced by the polyclonal population structure. Antimicrobial susceptibility testing and genome analysis indicated that P. aeruginosa strains from ICU inpatients exhibited significantly higher resistance rates to most antimicrobials and harbored a greater number of acquired resistance genes compared to strains from healthy individuals. Notably, in ICU inpatients, we identified three isolates of ST463, all of which shared the conserved Tn3-TnpR-ISKpn8-blaKPC-ISKpn6 genetic context. Additionally, five isolates carrying the qacE gene were also identified, these findings suggest that small-scale transmission events may still occur within the ICU setting, posing significant challenges for clinical management. With regard to virulence factors, we observed similar profiles between the two groups, except for phzA2, phzB2, and pilA, which were statistically higher in isolates from healthy individuals. This may be because the accumulating resistance mutations in ICU-derived P. aeruginosa are linked to a decrease in virulence. [ABSTRACT FROM AUTHOR]

Purpose: The detection of human epidermal growth factor receptor 2 (HER2) expression status is essential to determining the chemotherapy regimen for breast cancer patients and to improving their prognosis. We developed a deep learning radiomics (DLR) model combining time-frequency domain features of ultrasound (US) video of breast lesions with clinical parameters for predicting HER2 expression status. Patients and Methods: Data for this research was obtained from 807 breast cancer patients who visited from February 2019 to July 2020. Ultimately, 445 patients were included in the study. Pre-operative breast ultrasound examination videos were collected and split into a training set and a test set. Building a training set of DLR models combining time-frequency domain features and clinical features of ultrasound video of breast lesions based on the training set data to predict HER2 expression status. Test the performance of the model using test set data. The final models integrated with different classifiers are compared, and the best performing model is finally selected. Results: The best diagnostic performance in predicting HER2 expression status is provided by an Extreme Gradient Boosting (XGBoost)-based time-frequency domain feature classifier combined with a logistic regression (LR)-based clinical parameter classifier of clinical parameters combined DLR, particularly with a high specificity of 0.917. The area under the receiver operating characteristic curve (AUC) for the test cohort was 0.810. Conclusion: Our study provides a non-invasive imaging biomarker to predict HER2 expression status in breast cancer patients. [ABSTRACT FROM AUTHOR]

Aiming at the problem that it is difficult to accurately detect the position and magnitude of pitch angle deviation (PAD) fault of wind turbine (WT) in operation at the same time, this paper proposes a novel multi-parameter synergy mechanism based on a double threshold judgment method combined with power spectral density analysis. First, the influence of different PADs of a single blade on the time domain information of WT parameters under different turbulent wind speeds is discussed. Second, according to the changing rule of three blade parameters caused by the single blade PAD, the double threshold judgment method is introduced to determine the faulty blade and the direction of PAD. Third, this paper put forward the concept of characteristic frequency power ratio. Based on the characteristic frequency of the power spectrum, a method is proposed to determine the magnitude of PAD. Finally, a complete set of fault detection and identification flow for single blade PAD was established. This detection strategy is more accurate and faster than the traditional methods and does not need to add additional data acquisition equipment in the wind power generation system. [ABSTRACT FROM AUTHOR]

In modern large-scale wind farms, power loss caused by the wake effect is more than 30%, and active yaw control can greatly reduce the influence of the wake effect by deflecting the wind turbine's wake. The yawed wind turbine's wake characteristics are complex, and a deep comprehension of a yawed turbine's wake is necessary. The actuator line method combined with URANS (unsteady Reynold-averaged Navier–Stokes equations) is used to study the yawed wind turbine's wake characteristics in this paper. Compared with an un-yawed wind turbine, a yawed one has two main characteristics, deflection and deformation. With an increasing yaw angle, turbine wake shows an increasing deflection. The results indicated that deflection at different height was different, the wake profile showed the biggest deflection at about the hub height, while the smallest deflection existed at the top and bottom of the yawed turbine's wake. This can be visually demonstrated by the evolution of a kidney-shape velocity distribution at the vertical cross-section. Two-dimensional and three-dimensional presentations of velocity deficit distributions are presented in this paper. The evolution of an irregular kidney-shape distribution is discussed in this paper. It is formed by the momentum exchange caused by the counter-rotating vortex pair. The results indicated that the counter-rotating vortex pair was composed of the streamwise vortex flux brought by the tip vortex. Furthermore, when the wind turbine rotated clockwise and yawed clockwise, the negative vorticity of counter-rotating vortex first appeared in the upper left position. [ABSTRACT FROM AUTHOR]

The Kähler potentials of modular symmetry models receive unsuppressed contributions which may be controlled by a flavor symmetry, where the combination of the two symmetry types is referred to as eclectic flavor symmetry. After briefly reviewing the consistency conditions of eclectic flavor symmetry models, including those with generalised (g)CP, we perform a comprehensive bottom-up study of eclectic flavor symmetry models based on Ω(1) ≅ ∆(27) ⋊ T′, consisting of the flavor symmetry ∆(27) in a semi-direct product with the modular symmetry T′. The modular transformations of different ∆(27) multiplets are given by solving the consistency condition. The eight nontrivial singlets of ∆(27) are related by T′ modular symmetry, and they have to be present or absent simultaneously in any Ω(1) model. The most general forms of the superpotential and Kähler potential invariant under Ω(1) are discussed, and the corresponding fermion mass matrices are presented. Based on the eclectic flavor group Ω(1), two concrete lepton models which can successfully describe the experimental data of lepton masses and mixing parameters are constructed. For the two models without gCP, all six mixing parameters vary in small regions. A nearly maximal atmospheric mixing angle θ23 and Dirac CP phase δCP are obtained in the first model. After considering the compatible gCP symmetry and the assumption of R τ = 0 in the first model, the μ − τ reflection symmetry is preserved in the charged lepton diagonal basis. As a consequence, the atmospheric mixing angle and Dirac CP phase are predicted to be maximal, and two Majorana CP phases are predicted to be π. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is the second leading cause of cancer death worldwide. Opportunistic colonoscopy may be beneficial in reducing the incidence of CRC by detecting its precursors. Aim: To determine the risk of colorectal adenomas in a population who underwent opportunistic colonoscopy, and demonstrate the need for opportunistic colonoscopy. Methods: A questionnaire was distributed to patients who underwent colonoscopy in the First Affiliated Hospital of Zhejiang Chinese Medical University from December 2021 to January 2022. The patients were divided into two groups, the opportunistic colonoscopy group who underwent a health examination including colonoscopy without intestinal symptoms due to other diseases, and the non-opportunistic group. The risk of adenomas and influence factors were analyzed. Results: Patients who underwent opportunistic colonoscopy had a similar risk to the non-opportunistic group, in terms of overall polyps (40.8% vs. 40.5%, P = 0.919), adenomas (25.8% vs. 27.6%, P = 0.581), advanced adenomas (8.7% vs. 8.6%, P = 0.902) and CRC (0.6% vs. 1.2%, P = 0.473). Patients with colorectal polyps and adenomas in the opportunistic colonoscopy group were younger (P = 0.004). There was no difference in the detection rate of polyps between patients who underwent colonoscopy as part of a health examination and those who underwent colonoscopy for other reasons. In patients with intestinal symptoms, abnormal intestinal motility and changes in stool characteristics were frequent (P = 0.014). Conclusion: The risk of overall colonic polyps, advanced adenomas in healthy people undergoing opportunistic colonoscopy no less than that in the patients with intestinal symptoms, positive FOBT, abnormal tumor markers, and who accepted re-colonoscopy after polypectomy. Our study indicates that more attention should be paid to the population without intestinal symptoms, especially smokers and those older than 40 years. [ABSTRACT FROM AUTHOR]

Background: To estimate crude mortality, excess mortality, and standardized mortality rates (SMR) among people living with HIV (PLHIV) initiating highly active antiretroviral therapy (HAART) in Luzhou, China 2006–2020, and assess associated factors. Methods: PLHIV initiating HAART in the HIV/AIDS Comprehensive Response Information Management System (CRIMS) in Luzhou, China 2006–2020 were included in the retrospective cohort study. The crude mortality, excess mortality, and SMR were estimated. Multivariable Poisson regression model was used for analyzing risk factors associated with excess mortality rates. Results: The median age among 11,468 PLHIV initiating HAART was 54.5 years (IQR:43.1–65.2). The excess mortality rate decreased from 1.8 deaths/100 person-years (95% confidence interval [CI]:1.4–2.4) in 2006–2011 to 0.8 deaths/100 person-years (95%CI:0.7–0.9) in 2016–2020. SMR decreased from 5.4 deaths/100 person-years (95%CI:4.3–6.8) to 1.7 deaths/100 person-years (95%CI:1.5–1.8). Males had greater excess mortality with the eHR of 1.6 (95%CI:1.2–2.1) than females. PLHIV with CD4 counts ≥ 500 cells/μL had the eHR of 0.3 (95%CI:0.2–0.5) in comparison to those with CD4 counts < 200 cells/μL. PLHIV with WHO clinical stages III/IV had greater excess mortality with the eHR of 1.4 (95%CI:1.1–1.8). PLHIV with time from diagnosis to HAART initiation ≤ 3 months had the eHR of 0.7 (95%CI:0.5–0.9) compared to those with time ≥ 12 months. PLHIV with initial HAART regimens unchanged and viral suppression had the eHR of 1.9 (95%CI:1.4–2.6) and 0.1 (95%CI:0.0–0.1), respectively. Conclusions: The excess mortality and SMR among PLHIV initiating HAART in Luzhou, China decreased substantially from 2006 to 2020, but the mortality rate among PLHIV was still higher than general population. PLHIV who were male, with baseline CD4 counts less than 200 cells/μL, WHO clinical stages III/IV, time from diagnosis to HAART initiation ≥ 12 months, initial HAART regimens unchanged, and virological failure had a greater risk of excess deaths. Early and efficient HAART would be significant in reducing excess mortality among PLHIV. [ABSTRACT FROM AUTHOR]

Background: OXA-232-producing Klebsiella pneumoniae was first identified in China in 2016, and its clonal transmission was reported in 2019. However, there are no prevalence and genotypic surveillance data available for OXA-232 in China. Therefore, we investigated the trends and characteristics of OXA-232 type carbapenemase in Zhejiang Province, China from 2018 to 2021. Methods: A total of 3278 samples from 1666 patients in the intensive care units were collected from hospitals in Zhejiang Province from 2018 to 2021. Carbapenem-resistant isolates were initially selected by China Blue agar plates supplemented with 0.3 μg/ml meropenem, and further analyzed by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry identification, immune colloidal gold technique, conjugation experiment, antimicrobial susceptibility testing and whole genome sequencing. Results: A total of 79 OXA-producing strains were recovered, with the prevalence increased from 1.8% [95% confidence interval (CI): 0.7–3.7%] in 2018 to 6.0% (95% CI: 4.4–7.9%) in 2021. Seventy-eight strains produced OXA-232 and one produced OXA-181. The blaOXA-232 gene in all strains was located in a 6141-bp ColKP3-type non-conjugative plasmid and the blaOXA-181 gene was located in a 51,391-bp ColKP3/IncX3-type non-conjugative plasmid. The blaOXA-232-producing K. pneumoniae was dominated (75/76) by isolates of sequence type 15 (ST15) that differed by less than 80 SNPs. All OXA-producing strains (100%, 95% CI: 95.4–100.0%) were multidrug-resistant. Conclusions: From 2018 to 2021, OXA-232 is the most prevalent OXA-48-like derivative in Zhejiang Province, and ST15 K. pneumoniae isolates belonging to the same clone are the major carriers. The transmission of ColKP3-type plasmid to E. coli highlighted that understanding the transmission mechanism is of great importance to delay or arrest the propagation of OXA-232 to other species. [ABSTRACT FROM AUTHOR]

Objective To analyze the epidemic characteristics of coronavirus disease 2019 (COVID-19) cases aged 60 years or older during the outbreak epidemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant in Sanya City, Hainan Province, August-September 2022, and to provide scientific and effective basis for formulating strategies for the prevention and treatment of COVID-19 in the elderly in the future. Methods The data of 1 785 COVID-19 cases aged ≥60 years reported from August 1 to September 8, 2022 in Sanya City, and 537 local COVID-19 inpatients aged ≥ 60 years treated in Sanya Central Hospital were collected and analyzed using WPS Office 2018 software for data cleaning, database assistance, and drawing, and SPSS 22.0 software was used to statistically describe and analyze the counting data. Results A total of 1 785 local COVID-19 cases aged ≥60 years were reported in China's Disease Prevention and Control Information System, including 1 509 confirmed cases (84.54%) and 276 asymptomatic cases (15.46%). Of the confirmed cases, 1 448 were mild cases (95.96%), 40 were common cases (2.65%), 10 were severe cases (0.66%), and 11 were critical cases (0.73%), and no deaths were reported. The ratio of male to female was 0.88:1. The youngest was 60 years old, the oldest age was 107 years old, with a median age of 67 years old. Most of them (1 559 cases, 87.34%) were non-social employed personnel. Among them, 952 (53.33%) were from Tianya District and 733 (41.06%) from Jiyang District. Among the 537 COVID-19 elderly infected patients hospitalized in Sanya Central Hospital, infected patients with underlying diseases accounted for 287 (53.45%) cases of hypertension, diabetes and other types of basic diseases (chronic kidney disease, hyperlipidemia, chronic gastritis, gastric ulcer, etc.), and there were serious infections. Conclusions Most of the elderly infected with Omicron variants were mild cases with few symptoms, but the elderly infected with Omicron variants were difficult to recover or even worsen the condition due to old age and underlying diseases. Therefore, by analyzing the various aspects of elderly infected cases, scientific and effective basis can be provided to prevent and control the epidemic situation in the future, and reduce the occurrence of severe, critical and death cases of COVID-19 in the elderly. [ABSTRACT FROM AUTHOR]

Objectives To characterize the pharmacokinetics (PK) of polymyxin B in Chinese critically ill patients. The factors significantly affecting PK parameters are identified, and a limited sampling strategy for therapeutic drug monitoring of polymyxin B is explored. Methods Thirty patients (212 samples) were included in a population PK analysis. A limited sampling strategy was developed using Bayesian estimation, multiple linear regression and modified integral equations. Non-linear mixed-effects models were developed using Phoenix NLME software. Results A two-compartment population PK model was used to describe polymyxin B PK. Population estimates of the volumes of central compartment distribution (V) and peripheral compartment distribution (V2), central compartment clearance (CL) and intercompartmental clearance (Q) were 7.857 L, 12.668 L, 1.672 L/h and 7.009 L/h. Continuous renal replacement therapy (CRRT) significantly affected CL, and body weight significantly affected CL and Q. The AUC0-12h of polymyxin B in patients with CRRT was significantly lower than in patients without CRRT. CL and Q increased with increasing body weight. A limited sampling strategy was suggested using a two-sample scheme with plasma at 0.5h and 8h after the end of infusion (C0.5 and C8) for therapeutic drug monitoring in the clinic. Conclusions A dosing regimen should be based on body weight and the application of CRRT. A two-sample strategy for therapeutic drug monitoring could facilitate individualized treatment with polymyxin B in critically ill patients. [ABSTRACT FROM AUTHOR]

Problem: Preeclampsia (PE) is the main factor threatening the life of primipara. Defective migration and invasion of trophoblast cells was one of the causes of PE. Circ_0111277 had been reported to be related to the development of PE, but the mechanism of its effect on trophoblast cells needed further study. Method of Study: The expression of circ_0111277, microRNA‐188‐3p (miR‐188‐3p) and grainyhead‐like 2 (GRHL2) mRNA were detected by quantitative real‐time polymerase chain reaction (qRT‐PCR). Cell Counting Kit‐8 (CCK‐8) assay, 5‐Ethynyl‐20‐deoxyuridine (EdU) and colony formation assay were used to examine cell proliferation ability. Tube formation and transwell assay were performed to assess the angiogenesis and metastasis ability of cells. Western blot was applied to measure the levels of epithelial‐mesenchymal transition (EMT)‐related proteins (E‐cadherin and Vimentin) and GRHL2 protein. The relationship between miR‐188‐3p and circ_0111277 or GRHL2 was verified by the dual luciferase reporter experiment. Results: Circ_0111277 and GRHL2 were elevated, and miR‐188‐3p was declined in PE patients. Overexpression of circ_0111277 could inhibit the proliferation, angiogenesis, migration, invasion and EMT of trophoblast cells (HTR‐8/Svneo). Circ_0111277 was the molecular sponge of miR‐188‐3p. MiR‐188‐3p up‐regulation could reduce the inhibition of HTR‐8/Svneo cell growth caused by overexpression of circ_0111277. GRHL2 was a target gene of miR‐188‐3p, and GRHL2 silencing relieved the adverse effects of miR‐188‐3p inhibitors on HTR‐8/Svneo. In general, circ_0111277 up‐regulated GRHL2 expression through sponge miR‐188‐3p. Conclusion: Highly expressed circ_0111277 up‐regulated the expression of GRHL2 through sponge miR‐188‐3p, thereby inhibiting trophoblast cells function, which suggested a new molecular mechanism for the pathogenesis of PE. [ABSTRACT FROM AUTHOR]

Carbapenem-resistant Enterobacterales (CRE) are increasingly recognized as an urgent public health concern. The rapid and accurate identification of carbapenemases could provide insights into antimicrobial therapy and infection control. In this study, we evaluated the efficacy of three different methods, including the NG-test Carba 5, colloidal gold immunoassay (CGI) test, and Xpert Carba-R assay, for the rapid detection of five carbapenemases (KPC, NDM, IMP, OXA-48, and VIM). A total of 207 Gram-negative strains collected from patients and hospital sewages were tested. The presence or absence of carbapenemase genes in the whole-genome sequences was used as the gold standard for evaluating the accuracy of the above-mentioned three methods. Among the 192 strains carrying only one carbapenemase gene, the accuracies of the NG-Test Carba 5, CGI test, and Xpert Carba-R were 96.88% (95% CI, 93.01–98.72%), 96.88% (95% CI, 93.01–98.72%), and 97.92% (95% CI, 94.41–99.33%), respectively. Xpert Carba-R was able to detect all 13 types of KPC variants, including KPC-2, KPC-3, KPC-25, KPC-33, KPC-35, KPC-51, KPC-52, KPC-71, KPC-76, KPC-77, KPC-78, KPC-93, and KPC-123, with a detection sensitivity of 100.00% (95% CI, 96.50–100.00%), a specificity of 100.00% (95% CI, 92.38–100.00%), and a κ index of 1.00. For IMP, Carba 5 was superior to the other two methods, with a sensitivity of 100% (95% CI, 71.66–100.00%), a specificity of 100% (95% CI, 97.38–100.00%), and a κ index of 1.00. For the remaining 15 strains carrying two or three kinds of carbapenemase genes, Carba 5 performed the best, which accurately identified all the target genes, followed by Xpert Carba-R (12/15, 80.00%) and the CGI test (10/15, 66.67%). Therefore, all three assays demonstrated reliable performances in carbapenemase detection, and Xpert Carba-R should be recommended for the detection of KPC variants, especially for patients at a high risk of infections caused by ceftazidime/avibactam-resistant strains. IMPORTANCE: CRE was listed as one of the top three pathogens that are in critical need of new antibiotics by the WHO. The rapid and accurate identification of carbapenemases is important for antimicrobial therapy and infection control. In recent years, new beta-lactam/beta-lactamase inhibitor combinations such as ceftazidime/avibactam (CZA) have been approved by the Food and Drug Administration (FDA) to cope with CRE challenges. CZA was effective against class A, class C, and some class D enzymes such as OXA-48-like. However, CZA-resistant KPC variants emerged at an alarming speed, which posed a new challenge for the accurate identification of KPC variants. In this study, we evaluated the performance of two lateral flow immunochromatographic assays, namely, NG-test Carba 5 and the CGI test, and the automated real-time quantitative PCR Xpert Carba-R in the rapid detection of carbapenemases. Notably, 13 types of KPC variants were enrolled in this study, which covered most KPC variants discovered in China. Carba-R was superior to NG-teat Carba 5 and the CGI test; it was able to detect all of the included KPC variants, including KPC-2, KPC-3, KPC-25, KPC-33, KPC-35, KPC-51, KPC-52, KPC-71, KPC-76, KPC-77, KPC-78, KPC-93, and KPC-123. [ABSTRACT FROM AUTHOR]

First identified as a new circovirus in Hunan Province in China in 2019, porcine circovirus (PCV4) is now widely detected in other Chinese provinces and South Korea. In recent years, the virus has threatened pig health and operations in the pig industry. Hence, early PCV4 detection and regular surveillance are required to control the spread of infection and prevent collateral damage to the industry. Due to PCV4 being difficult to isolate in vitro, molecular detection methods, such as conventional PCR and real-time PCR, and serological assays are currently the main methods used for the detection of PCV4 infection. However, they are time-consuming, labor-intensive, and complex and require professional personnel. To facilitate rapid pen-side PCV4 diagnoses, we used clustered regularly interspaced short palindromic repeats (CRISPR) and Cas13a technology to develop a quick testing kit. Five recombinase-aided amplification (RPA) primer sets were designed based on the conserved PCV4-Cap gene nucleotide region, which were used to determine several key lateral flow strip (LFD) characteristics (sensitivity, specificity, and accuracy). The results showed that the RPA-Cas13a-LFD reaction could detect PCV4 within 1.5 h in genomic DNA harboring a minimum of a single copy. Furthermore, the assay showed good specificity and absence of cross-reactivity with PCV2, PCV3, or other porcine viruses. When we tested 15 clinical samples, a high accuracy was also recorded. Therefore, we successfully developed a detection assay that was simple, fast, accurate, and suitable for on-site PCV4 testing. [ABSTRACT FROM AUTHOR]

With the large-scale development of wind turbines, large flexible blades bear heavier loads. In the actual rotating work of blades, the coupling of structural deformation and motion produces a dynamic stiffening effect and spin softening effect, which affects the dynamic characteristics of blades. In this study, the finite element method is used to model the NREL 5MW blade, and the dynamic stiffening and spin softening effects are investigated using the modal analysis. The influence of rotating effects on the blade's natural frequency is revealed. It is concluded that the effect of dynamic stiffening is more significant than that of spin softening, and the comprehensive result of the two effects is not simply the superposition of them but presents obvious nonlinearity. [ABSTRACT FROM AUTHOR]

Onshore wind turbines are primarily installed in high-altitude areas with good wind energy resources. However, in winter, the blades are easy to ice, which will seriously impact their aerodynamic performance, as well as the power and service life of the wind turbine. Therefore, it is of great practical significance to predict wind turbine blade icing in advance and take measures to eliminate the adverse effects of icing. Along these lines, three approaches to supervisory control and data acquisition (SCADA) data feature selection were summarized in this work. The problems of imbalance between positive and negative sample datasets, the underutilization of SCADA data time series information, the scarcity of high-quality labeled data, and weak model generalization capabilities faced by data-driven approaches in wind turbine blade icing detection, were reviewed. Finally, some future trends in data-driven approaches were discussed. Our work provides guidance for the use of technical means in the actual detection of wind turbine blades. In addition, it also gives some insights to the further research of fault diagnosis technology. [ABSTRACT FROM AUTHOR]

In this study, we focus on the Multi-robot Coverage Path Planning (MCPP) problem for maritime Search And Rescue (SAR) missions using a multiple Autonomous Underwater Vehicle (AUV) system, with the ultimate purpose of efficiently and accurately discovering the target from sonar images taken by Side-Scan Sonar (SSS) mounted on the AUVs. Considering the specificities of real maritime SAR projects, we propose a novel MCPP method, in which the MCPP problem is transformed into two sub-problems: Area partitioning and single-AUV coverage path planning. The structure of the task area is first defined using Morse decomposition of the spike pattern. The area partitioning problem is then formulated as an AUV ordering problem, which is solved by developing a customized backtracking method to balance the workload and to avoid segmentation of the possible target area. As for the single-AUV coverage path planning problem, the SAR-A* method is adopted, which generates a path that preferentially visits the possible target areas and reduces the number of turns to guarantee the high quality of the resulting sonar images. Simulation results demonstrate that the proposed method can maintain the workload balance and significantly improve the efficiency and accuracy of discovering the target. Moreover, our experimental results indicate that the proposed method is practical and the mentioned specificities are useful for discovering targets. [ABSTRACT FROM AUTHOR]