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Engineering rock mass often involves bedding planes and U-shaped defects. Under the combined influence of bedding planes and defects, the fracture mode of engineering rock mass is more complicated. To better understand the failure law of U-shaped defects in rock mass with bedding planes and better control or predict the crack propagation morphology, three-point bending tests were conducted on semicircular disk specimens with U-shaped notches under three different notch radii. The load variation law, different stages of the load–displacement curve, and fracture characteristics of specimens under five bedding angles were analyzed. Then, numerical models of semicircular three-point bending tests were established in particle flow code 2D (PFC2D). The influence of notch radius and bedding angle on the failure path of semicircular specimens was simulated and analyzed, and the three failure modes were verified again. In addition, the stress at the notch tip of the model was monitored by the measurement circle in the discrete-element method, and the fracture toughness of the model specimen was calculated, which provides a new calculation idea for fracture toughness. The research results help us more comprehensively understand the mechanical behavior and failure characteristics of layered rock mass with notch under external load. [ABSTRACT FROM AUTHOR]

Extreme rainfall, also known as heavy rainfall or intense precipitation, is a weather event characterized by a significant amount of rainfall within a short period. This study analyzes the trends in extreme precipitation indices at 17 stations in four main regions in Cambodia—the Tonle Sap, coastal, Mekong Delta, and Upper Mekong regions—between 1991 and 2021. Analyzing the data with RClimDex v1.9 reveals diverse spatial and temporal variations. The statistical analysis of the extreme rainfall indices in Cambodia from 1991 to 2021 reveals significant trends. In the Tonle Sap region, consecutive dry days (CDDs) increased at most stations, except Battabang, Kampong Thmar, and Pursat, while consecutive wet days (CWDs) increased at most stations. These trends align with rising temperatures and reduced forest cover. In the coastal region, particularly at the Krong Khemarak Phummin station, most rainfall indices increased, with a slope value of 89.94 mm/year. The extreme rainfall indices max. 1-day precipitation (RX1day) and max. 5-day precipitation (RX5day) also increased, suggesting higher precipitation on days exceeding the 95th (R95p) and 99th percentiles (R99p). The Kampot station showed a significant increase in CDDs, indicating a heightened drought risk. In the Mekong Delta, the Prey Veng station recorded a decrease in the CDDs slope value by −4.892 days/year, indicating potential drought risks. The Stung Treng station, which is the only station in Upper Mekong, showed a decreasing trend in CDDs with a slope value of −1.183 days/year, indicating a risk of extreme events. These findings underscore the complex interplay between climate change, land use, and rainfall patterns in Cambodia. [ABSTRACT FROM AUTHOR]

This study aimed to enhance flood forecasting accuracy in the Liangfeng River basin, a small karst watershed in Southern China, by incorporating the Available Reservoir Capacity of Karst (ARCK) into the HEC-HMS model. This region is often threatened by floods during the rainy season, so an accurate flood forecast can help decision-makers better manage rivers. As a crucial influencing factor on karstic runoff, ARCK is often overlooked in hydrological models. The seasonal and volatile nature of ARCK makes the direct computation of its specific values challenging. In this study, a virtual reservoir for each sub-basin (total of 17) was introduced into the model to simulate the storage and release of ARCK-induced runoff phenomena. Simulations via the enhanced model for rainfall events with significant fluctuations in water levels during 2021–2022 revealed that the Nash–Sutcliffe efficiency coefficient (NSE) of the average simulation accuracy was improved by more than 34%. Normally, rainfalls (even heavy precipitations) during the dry season either do not generate runoff or cause negligible fluctuations in flow rates due to long intervals. Conversely, relatively frequent rainfall events (even light ones) during the wet season result in substantial runoff. Based on this observation, three distinct types of karstic reservoirs with different retaining/releasing capacities were defined, reflecting variations in both the frequency and volume of runoff during both seasons. As a real-time environmental variable, ARCK exhibits higher and lower values during the dry and rainy seasons, respectively, and we can better avoid the risk of flooding according to its special effects. [ABSTRACT FROM AUTHOR]

Aims Rabson-Mendenhall syndrome (RMS) is a rare autosomal, recessive disorder characterized by severe insulin resistance due to mutations in the insulin receptor (INSR) gene. This study aims to analyze the clinical features and gene mutations in RMS, which have not been extensively studied. Methods PubMed, Embase, the China National Knowledge Infrastructure, and Wanfang were searched for "Rabson-Mendenhall syndrome" or "Black acanthosis hirsutism insulin resistance syndrome." Results A total of 42 cases from 33 articles were included. The body mass index ranged from 18.50 to 20.00 kg/m2 with an average of 16.00 kg/m2. There were no overweight (25.00∼29.90 kg/m2) or obese (≥30.00 kg/m2) patients. Acanthosis was present in 29 cases (29/42, 69.05%); growth retardation in 25 cases (25/42, 59.52%); dental anomalies including absence of teeth, crowding, and malocclusion in 23 cases (23/42, 54.76%); and hirsutism in 17 cases (17/42, 40.48%). The average glycosylated hemoglobin was 9.35%, and the average fasting blood-glucose was 8.44 mmol/L; the mean fasting insulin was 349.96 μIU/mL, and the average fasting C-peptide was 6.00 ng/mL. Diabetes was reported in 25 cases (25/33, 75.76%) all of which were diagnosed before 23 years old. All 42 patients had recorded gene mutations, with 22 patients (22/42, 52.38%) having ≥ 2 mutations and 20 cases (20/42, 47.62%) having only 1 mutation. No statistical differences were found in clinical features and laboratory parameters between patients with different mutations. Conclusion The study indicates that RMS should be considered in young patients with hyperinsulinemia, hyperglycemia with low weight, acanthosis nigricans, growth retardation, dental anomalies, and hirsutism. [ABSTRACT FROM AUTHOR]

Background/aim: Efficient discharge for stroke patients is crucial but challenging. The study aimed to develop early predictive models to explore which patient characteristics and variables significantly influence the discharge planning of patients, based on the data available within 24 h of admission. Design: Prospective observational study. Methods: A prospective cohort was conducted at a university hospital with 523 patients hospitalised for stroke. We built and trained six different machine learning (ML) models, followed by testing and tuning those models to find the best‐suited predictor for discharge disposition, dichotomized into home and non‐home. To evaluate the accuracy, reliability and interpretability of the best‐performing models, we identified and analysed the features that had the greatest impact on the predictions. Results: In total, 523 patients met the inclusion criteria, with a mean age of 61 years. Of the patients with stroke, 30.01% had non‐home discharge. Our model predicting non‐home discharge achieved an area under the receiver operating characteristic curve of 0.95 and a precision of 0.776. After threshold was moved, the model had a recall of 0.809. Top 10 variables by importance were National Institutes of Health Stroke Scale (NIHSS) score, family income, Barthel index (BI) score, FRAIL score, fall risk, pressure injury risk, feeding method, depression, age and dysphagia. Conclusion: The ML model identified higher NIHSS, BI, and FRAIL, family income, higher fall risk, pressure injury risk, older age, tube feeding, depression and dysphagia as the top 10 strongest risk predictors in identifying patients who required non‐home discharge to higher levels of care. Modern ML techniques can support timely and appropriate clinical decision‐making. Relevance to Clinical Practice: This study illustrates the characteristics and risk factors of non‐home discharge in patients with stroke, potentially contributing to the improvement of the discharge process. Reporting Method: STROBE guidelines. [ABSTRACT FROM AUTHOR]

Understanding tax avoidance becomes a matter of significant interest as it is not just a financial problem but also an organizational ethical and integrity issue. This paper investigates the influence of the board chair's early-life famine experience on corporate tax avoidance in China. We find a negative association between board chairs' famine experience and tax avoidance. Our channel tests confirm that the two perspectives of "ethical altruism" and "risk aversion" explain this negative association. Further, the effect of the famine experience on tax avoidance is more pronounced in firms whose board chairs had the famine experience in their early childhood or adolescent years, suggesting that experiences in the childhood and adolescent periods have a greater 'imprint' on human behavior. Our study fills a critical gap in tax research by directly linking board chair life experiences to corporate tax practices, suggesting that early-life experience is an important determinant of tax behavior. [ABSTRACT FROM AUTHOR]

In the vitamin C microbial fermentation system, oxidative stress limits the growth and 2‐keto‐l‐gulonic acid (2‐KLG, the precursor of vitamin C) production of Ketogulonicigenium vulgare. Most Bacillus strains, as helper strains, have been reported to release key biomolecules to reduce oxidative stress and promote the growth and 2‐KLG production of K. vulgare. To understand the specific mechanism by which the helper strain and K. vulgare interact to reduce oxidative stress, a novel helper strain, Rhodotorula mucilaginosa A8, was used to construct a consortium in the co‐culture fermentation system. Based on the activities of the antioxidant enzymes and quantitative polymerase chain reaction (qPCR) analysis, R. mucilaginosa A8 could reduce oxidative stress and increase 2‐KLG production in K. vulgare by upregulating antioxidant enzyme activities and related gene‐expression levels. In addition, the carotenoids of R. mucilaginosa promoted 2‐KLG production in K. vulgare. Coculture of R. mucilaginosa with K. vulgare increased the yield of carotenoids. This study suggested that helper strains with the ability to reduce oxidative stress in K. vulgare would likely act as potential helper strains for facilitating 2‐KLG biosynthesis. This work could provide a theoretical basis for the search for potential helper strains for vitamin C microbial fermentation and for the construction of synthetic microbial communities to produce valuable products. [ABSTRACT FROM AUTHOR]

Renal fibrosis contributes to chronic renal failure and a decline in the quality of life. Bushen Huoxue (BSHX) formula is a Traditional Chinese Medicine used to treat chronic renal failure. However, its mechanisms of action remain unclear. In this study, a rat model of renal fibrosis was constructed by 5/6 nephrectomy in vivo, and histopathological changes were analyzed using hematoxylin-eosin and Masson's trichrome staining. Angiotensin II (Ang II) was used to establish an in vitro renal fibrosis cell model in vitro. Pyroptosis was measured using flow cytometry. Related markers of fibrosis and NOD-like receptor protein 3 (NLRP3) inflammasome activation were measured using western blotting and enzyme-linked immunosorbent assay. Treatment with BSHX (0.25, 0.5, and 1 g/kg) significantly inhibited renal fibrosis and damage in 5/6 nephrectomized rats and simultaneously reduced oxidative stress and NLRP3 inflammasome activation. Similarly, BSHX treatment reduced the levels of hydroxyproline, transforming growth factor-β, matrix metalloproteinase 2, and matrix metalloproteinase 9 and inactivated the Smad2/3 signaling pathway in Ang II-treated HK-2 cells. Our data also showed that treatment with BSHX reduced NLRP3 inflammasome activation and pyroptosis in Ang II-treated HK-2 cells. Moreover, fibrosis and pyroptosis in HK-2 cells induced by NLRP3 overexpression were reduced by treatment with BSHX. BSHX significantly reduced renal fibrosis and pyroptosis, and its mechanism was mainly associated with the inhibition of reactive oxygen species (ROS)/NLRP3-mediated inflammasome activation. [ABSTRACT FROM AUTHOR]

Background: Stroke patients with dysphagia and family caregivers will experience multiple transitions during the whole process of the disease and various nursing needs will be generated. There is a lack of knowledge about their experiences at different transition stages. Thus, we aimed to explore the transition experiences of patients with post stroke dysphagia and family caregivers from admission to discharge home. Methods: A semi-structured interview based on Meleis's transition theory was used during hospitalization and telephone follow-up interviews were conducted in the first, third, and sixth month after the diagnosis of dysphagia. Interview transcripts were analyzed using the conventional content analysis method. Results: A total of 17 participants enrolled in the first face-to-face interview, 16 participants took part in the first month's telephone follow-up interview, 14 participants in the third month, and 12 participants in the sixth month. The transition experiences of patients with post stroke dysphagia and family caregivers could be summarized into three themes: (1)transition from onset to admission; (2)transition from discharge to other rehabilitation institutions; and (3)transition from discharge to home. Each theme had identified interrelated subthemes. Conclusions: The experiences of patients with post stroke dysphagia and family caregivers during transition are a dynamic process with enormous challenges in each phase. Collaboration with health care professionals, follow-up support after discharge, and available community and social support should be integrated into transitional nursing to help patients facilitate their transition. [ABSTRACT FROM AUTHOR]

Objective: To review the effectiveness of different physical therapies for acute and sub-acute low back pain supported by evidence, and create clinical recommendations and expert consensus for physiotherapists on clinical prescriptions. Data sources: A systematic search was conducted in PubMed and the Cochrane Library for studies published within the previous 15 years. Review methods: Systematic review and meta-analysis, randomized controlled trials assessing patients with acute and sub-acute low back pain were included. Two reviewers independently screened relevant studies using the same inclusion criteria. The Physiotherapy Evidence Database and the Assessment of Multiple Systematic Reviews tool were used to grade the quality assessment of randomized controlled trials and systematic reviews, respectively. The final recommendation grades were based on the consensus discussion results of the Delphi of 22 international experts. Results: Twenty-one systematic reviews and 21 randomized controlled trials were included. Spinal manipulative therapy and low-level laser therapy are recommended for acute low back pain. Core stability exercise/motor control, spinal manipulative therapy, and massage can be used to treat sub-acute low back pain. Conclusions: The consensus statements provided medical staff with appliable recommendations of physical therapy for acute and sub-acute low back pain. This consensus statement will require regular updates after 5–10 years. [ABSTRACT FROM AUTHOR]

Background: Asians bear a heavier burden of chronic kidney disease (CKD), a common comorbidity of type 2 diabetes mellitus (T2DM), than non‐Asians. Nonsteroidal mineralocorticoid receptor antagonists (MRAs) have garnered attention for their potential advantages in renal outcomes. Nevertheless, the impact on diverse ethnic groups remains unknown. Methods: The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang database, and clinical trial registries were searched through August 2023 with the following keywords: nonsteroidal MRAs (finerenone, apararenone, esaxerenone, AZD9977, KBP‐5074), CKD, T2DM, and randomized controlled trial (RCT). A random effects model was used to calculate overall effect sizes. Results: Seven RCTs with 14 997 participants were enrolled. Nonsteroidal MRAs reduced urinary albumin to creatinine ratio (UACR) significantly more in Asians than non‐Asians: (weighted mean difference [WMD], −0.59, 95% CI, −0.73 to −0.45, p <.01) vs (WMD, −0.29, 95% CI, −0.32 to −0.27, p <.01), respectively. The average decline of estimated glomerular filtration rate (eGFR) was similar in Asians and non‐Asians (p >.05). Regarding systolic blood pressure (SBP), nonsteroidal MRAs had a better antihypertension performance in Asians (WMD, −5.12, 95% CI, −5.84 to −4.41, p <.01) compared to non‐Asians (WMD, −3.64, 95% CI, −4.38 to −2.89, p <.01). A higher incidence of hyperkalemia and eGFR decrease ≥30% was found in Asians than non‐Asians (p <.01). Conclusions: Nonsteroidal MRAs exhibited significant renal benefits by decreasing UACR and lowering SBP in Asian than that of non‐Asian patients with CKD and T2DM, without increase of adverse events except hyperkalemia and eGFR decrease ≥30%. [ABSTRACT FROM AUTHOR]

In engineering practice, layered rock masses often display obvious anisotropy while deforming and failing, and the failure mode directly impacts the engineering construction stability. In this study, the fracture failure load, fracture toughness, crack deflection angle, and failure mode of a layered rock mass under different fracture modes were analyzed by utilizing improved asymmetric semi-circular disc specimens. According to the constitutive model of transversely isotropic materials, the maximum tensile stress (MTS), maximum energy release rate (MERR), and maximum strain energy density (MSED) calculation formulas were modified, and the calculation formulas of the three prediction criteria under anisotropic materials were derived. The calculation results were compared with the experimental results. The results show that the fracture toughness and crack deflection angle were significantly affected by the weak bedding plane. As a result of applying the MTS criterion, the results are closer to the experimental results, providing a solid foundation for engineering deformation, failure, and fracture analyses. [ABSTRACT FROM AUTHOR]

Introduction: Tirzepatide is a novel hypoglycemic agent for type 2 diabetes mellitus (T2DM). However, the pathophysiology of T2DM in Asians is different from that in non-Asians, and there is no evidence to explain the differences in the efficacy and safety of tirzepatide between different races. Methods: A literature search was conducted in China National Knowledge Infrastructure (CNKI), PubMed, Cochrane Library, Clinical Trials.gov, and Embase databases for clinical studies of tirzepatide for T2DM. The data extraction process was done independently by two authors. All analyses were performed using STATA 14.0 software and Review Manager 5.3 software. Results: A total of 2118 patients with T2DM from 6 studies were involved, with doses of tirzepatide ranging from 5 to 15 mg administered subcutaneously once weekly. The results showed that compared with control/placebo, tirzepatide was more effective in decreasing fasting blood glucose (FBG) in non-Asians than in Asians, and 10 mg rather than 15 mg was the optimal dose to decrease FBG. Similarly, non-Asians were more effective than Asians in improving glycated hemoglobin (HbA1c). Asians were significantly more effective than non-Asians in reducing body weight and ≥ 5% weight loss. In terms of adverse events, the incidence of gastrointestinal adverse events was higher in Asians than in non-Asians at the same dose, while the incidence of metabolic and nutrition disorders was higher in non-Asians than in Asians. Conclusion: Tirzepatide is a novel agent for the treatment of diabetes and has different efficacy in Asians and non-Asians. Asians were more likely to experience weight loss and gastrointestinal adverse events, whereas non-Asians were more likely to have better glycemic control and more metabolic and nutritional disorders. Trial Registration: PROSPERO registration no. CRD42023489588. [ABSTRACT FROM AUTHOR]

The high-quality waveguide structure in the Dy 3 + -doped Y3Al5O 1 2 transparent ceramic is of significance for the application of integrated micro-light elements. However, there have been no reports on the preparation of optical waveguides by ion implantation in the Dy 3 + -doped Y3Al5O 1 2 transparent ceramic. The work reports on the formation of optical planar waveguides by using the proton implantation in the Dy 3 + -doped Y3Al5O 1 2 transparent ceramic. The acceleration energy and the dose of the protons are 400 keV and 8 × 1 0 1 6 ions/cm2, respectively. The structure of the fabricated waveguide is captured with the high-res/mag images by a metallurgical microscope. The dark-mode spectrum and the refractive index distribution are gained by the prism coupling system and the RCM software, respectively. The measurement and simulation of the near-field intensity distribution indicate the propagation of light field in the waveguide. The results are of potential to the compact devices in the photonics. [ABSTRACT FROM AUTHOR]

Background: Proximal tubular cells (PTCs) play a critical role in the progression of diabetic kidney disease (DKD). As one of important progenitor markers, CD133 was reported to indicate the regeneration of dedifferentiated PTCs in acute kidney disease. However, its role in chronic DKD is unclear. Therefore, we aimed to investigate the expression patterns and elucidate its functional significance of CD133 in DKD. Methods: Data mining was employed to illustrate the expression and molecular function of CD133 in PTCs in human DKD. Subsequently, rat models representing various stages of DKD progression were established. The expression of CD133 was confirmed in DKD rats, as well as in human PTCs (HK-2 cells) and rat PTCs (NRK-52E cells) exposed to high glucose. The immunofluorescence and flow cytometry techniques were utilized to determine the expression patterns of CD133, utilizing proliferative and injury indicators. After overexpression or knockdown of CD133 in HK-2 cells, the cell proliferation and apoptosis were detected by EdU assay, real-time cell analysis and flow analysis. Additionally, the evaluation of epithelial, progenitor cell, and apoptotic indices was performed through western blot and quantitative RT-PCR analyses. Results: The expression of CD133 was notably elevated in both human and rat PTCs in DKD, and this expression increased as DKD progressed. CD133 was found to be co-expressed with CD24, KIM-1, SOX9, and PCNA, suggesting that CD133+ cells were damaged and associated with proliferation. In terms of functionality, the knockdown of CD133 resulted in a significant reduction in proliferation and an increase in apoptosis in HK-2 cells compared to the high glucose stimulus group. Conversely, the overexpression of CD133 significantly mitigated high glucose-induced cell apoptosis, but had no impact on cellular proliferation. Furthermore, the Nephroseq database provided additional evidence to support the correlation between CD133 expression and the progression of DKD. Analysis of single-cell RNA-sequencing data revealed that CD133+ PTCs potentially play a role in the advancement of DKD through multiple mechanisms, including heat damage, cell microtubule stabilization, cell growth inhibition and tumor necrosis factor-mediated signaling pathway. Conclusion: Our study demonstrates that the upregulation of CD133 is linked to cellular proliferation and protects PTC from apoptosis in DKD and high glucose induced PTC injury. We propose that heightened CD133 expression may facilitate cellular self-protective responses during the initial stages of high glucose exposure. However, its sustained increase is associated with the pathological progression of DKD. In conclusion, CD133 exhibits dual roles in the advancement of DKD, necessitating further investigation. [ABSTRACT FROM AUTHOR]

Field investigations and back analyses were conducted on a rockfall hazard. The flexible barrier protection system constructed along the roadside was damaged by the rockfall impact and lost its mitigation ability. Vital physical characteristics such as rockfall trajectory and kinetic energy were presumed based on the data from the aerial survey and the slope digital model. A numerical model, including slope, rockfalls, and flexible barrier, was created and thus the impacting process was reproduced. It demonstrates that the impact kinetic energy of the rockfall is only around 40 % of its design protection energy. The improper connections of members are the leading causes of damage, which prevent the flexible barrier from producing significant deformation and reduce its capacity to absorb impact force. The damage can be avoided by changing the connections of the members to improve the ability of the nets and ropes to slide and deform. The calculation results indicate that the impact resistance of the optimized model is 3 times better than the actual project. The findings can be used as a guide when designing a flexible protection system that performs better. [ABSTRACT FROM AUTHOR]

Aim: Achondroplasia is the most common of the skeletal dysplasias that cause fatal and disabling growth and developmental disorders in children, and is caused by a mutation in the fibroblast growth factor receptor, type 3 gene(FGFR3). This study aims to analyse the clinical characteristics and gene mutations of ACH to accurately determine whether a patient has ACH and to raise public awareness of the disease. Methods: The database of Pubmed, Cochrane Library, Wanfang and CNKI were searched with terms of "Achondroplasias" or "Skeleton-Skin-Brain Syndrome" or "Skeleton Skin Brain Syndrome" or "ACH" and "Receptor, Fibroblast Growth Factor, Type 3" or "FGFR3". Results: Finally, four hundred and sixty-seven patients with different FGFR3 mutations were enrolled. Of the 138 patients with available gender information, 55(55/138, 40%) were female and 83(83/138, 60%) were male. Among the patients with available family history, 47(47/385, 12%) had a family history and 338(338/385, 88%) patients were sporadic. The age of the patients ranged from newborn babies to 36 years old. The mean age of their fathers was 37 ± 7 years (range 31–53 years). Patients came from 12 countries and 2 continents, with the majority being Asian (383/432, 89%), followed by European (49/432, 11%). Short stature with shortened arms and legs was found in 112(112/112) patients, the abnormalities of macrocephaly in 94(94/112) patients, frontal bossing in 89(89/112) patients, genu valgum in 64(64/112) patients and trident hand were found in 51(51/112) patients. The most common mutation was p.Gly380Arg of the FGFR3 gene, which contained two different base changes, c.1138G > A and c.1138G > C. Ten rare pathogenic mutations were found, including c.831A > C, c.1031C > G, c.1043C > G, c.375G > T, c.1133A > G, c.1130T > G, c.833A > G, c.649A > T, c.1180A > T and c.970_971insTCTCCT. Conclusion: ACH was caused by FGFR3 gene mutation, and c.1138G > A was the most common mutation type. This study demonstrates the feasibility of molecular genetic testing for the early detection of ACH in adolescents with short stature, trident hand, frontal bossing, macrocephaly and genu valgum. [ABSTRACT FROM AUTHOR]

Purpose: Proximal tubular epithelial cell (PTEC) is vulnerable to injury in diabetic kidney disease (DKD) due to high energy expenditure. The injured PTECs-derived profibrotic factors are thought to be driving forces in tubulointerstitial fibrosis (TIF) as they activate surrounding fibroblasts. However, the mechanisms remain unclear.Methods: The diabetes with uninephrectomy (DKD) rats were used to evaluated renal histological changes and the expression of Claudin-2 by immunofluorescence staining. Then, Claudin-2 expression in PTECs were modulated and subsequently determined the proliferation and activation of fibroblasts by building a transwell co-culture system in normal glucose (NG)or high glucose (HG) condition.Results: Decreased expression of Claudin-2 in PTECs accompanied by tight junction disruption and increased interstitial fibrosis, were detected in DKD rats. In vitro, downregulated Claudin-2 in PTECs promoted proliferation and activation of fibroblasts, which coincided with elevated expression of profibrotic connective tissue growth factor (CTGF) in PTECs. Silenced CTGF inhibited the profibrotic of PTECs via Claudin-2 inhibition. Fibroblasts co-cultured with PTECs transitioned more to myofibroblasts and generated extracellular matrix (ECM) significantly in response to high glucose (HG) stimulation whereas overexpression of Claudin-2 in PTECs reversed the above results. Upregulating CTGF disrupted the beneficial anti-fibrosis effects obtained by overexpression of Claudin-2 in HG condition.Conclusion: Our study suggested that Claudin-2 in PTECs, a key mediator of paracellular cation and water transport, promotes the activation and proliferation of surrounding fibroblasts significantly via CTGF in a paracrine manner. [ABSTRACT FROM AUTHOR]

Purpose: Thyroid dysfunction is the most common immune-related adverse event during anti-programmed cell death 1 (anti-PD-1) therapy. In this study, we monitored patients with advanced malignant tumors who received anti-PD-1 therapy to observe the characteristic of anti-PD-1 therapy-induced thyroid dysfunction and its correlation with prognosis. Methods: Patients with advanced carcinoma treated with anti-PD-1 therapy were evaluated for thyroid function at baseline and after treatment initiation from August 2020 to March 2022. Seventy-three patients were finally included in the study. Results: Among these patients, 19 (26.03%) developed thyroid dysfunction after receiving anti-PD-1 therapy. Primary hypothyroidism and thyrotoxicosis were the most common clinical manifestation. Anti-PD-1-induced thyroid dysfunction occurred 63 (26–131) days after administration; thyrotoxicosis appeared earlier than primary hypothyroidism. In Kaplan–Meier survival analysis, the progression-free survival (PFS) of the thyroid dysfunction group was better than that of the no thyroid dysfunction group (227 (95% confidence interval (CI) 50.85–403.15) days vs 164 (95% CI 77.76–250.24) days, p = 0.026). Male patients had better PFS than female patients (213 (95% CI 157.74–268.26) days vs 74 (95% CI 41.23–106.77) days, p = 0.031). In cox proportional hazards regression model, anti-PD-1-induced thyroid dysfunction remained an independent predictor of better PFS (hazard ratio (HR) = 0.339(0.136–0.848), p = 0.021). Conclusion: Thyroid dysfunction is a common immune-related adverse events in advanced cancer patients treated with anti-PD-1 therapy and predicts a better prognosis. Trial registration: This study was retrospectively registered with Trial ClinicalTrials.gov (NCT05593744) on October 25, 2022. [ABSTRACT FROM AUTHOR]

Drawing on the notions of transmedia storytelling and engagement, this study investigates how practitioners engage with the process of producing and consuming boys' love (BL) audio dramas, the trans-directional communication and interaction between producers and consumers in the transmedia BL subcultural space, and the implications of their engagement for counterculture. We contribute to the growing field of BL studies by providing insights into how practitioners can stimulate these cultural productions as a part of gender–sexuality-related counterculture in the new media space of audio dramas. We argue that the engagement of BL audio drama producers and consumers ('prosumers') features the sense of countering the predominant heteronormativity in China by producing explicit homosexual romance, actively expanding the story elements transmedially, and bringing queer members into the BL audio drama community. In this way, built by both producers and consumers together, the BL audio drama community is no longer a female-only area, but becomes a more inclusive 'third' space constituted by people with diverse sexual identities and orientations. Given its knowledge, perspectives, and experiences, the BL audio drama community, as a countercultural group, has a certain potential to bridge the divide between the female-led BL subculture and the larger queer community. [ABSTRACT FROM AUTHOR]

Background: The association between the total bilirubin/albumin (B/A) and the all-cause mortality of critically ill patients with acute kidney injury (AKI) remains unclear. This retrospective study aimed to investigate the relationship between B/A ratio and mortality in patients with AKI. Methods: The clinical data of AKI patients in the Medical Information Mart for Intensive Care III (MIMIC-III) database were retrospectively analyzed. Patients were divided into the low and high B/A groups (B/A ≤ 0.25 and B/A > 0.25, respectively). The primary outcome was 28-day all-cause mortality, and the secondary outcomes were 60-day, 1-year and 4-year all-cause mortality. Kaplan–Meier survival curves and Cox proportional risk models were constructed to evaluate the effect of B/A on survival outcomes. Results: The 28-day mortality rates were 18.00% and 25.10% in the low and high B/A groups, respectively (P < 0.001). The Kaplan–Meier analysis showed that patients with higher B/A values had higher all-cause mortality risk (log-rank P < 0.0001). The multivariate Cox proportional risk analysis showed that B/A was an independent risk predictor for death at 28 days, 60 days, 1 year, and 4 years. Conclusion: B/A is an independent risk factor for increased mortality in patients with AKI and may be used as a predictor of clinical outcomes in AKI. [ABSTRACT FROM AUTHOR]

Mazdutide is a once-weekly glucagon-like peptide-1 (GLP-1) and glucagon receptor dual agonist. We evaluated the efficacy and safety of 24-week treatment of mazdutide up to 6 mg in Chinese overweight adults or adults with obesity, as an interim analysis of a randomised, two-part (low doses up to 6 mg and high dose of 9 mg), double-blind, placebo-controlled phase 2 trial (ClinicalTrials.gov, NCT04904913). Overweight adults (body-mass index [BMI] ≥24 kg/m2) accompanied by hyperphagia and/or at least one obesity-related comorbidity or adults with obesity (BMI ≥ 28 kg/m2) were randomly assigned (3:1:3:1:3:1) to once-weekly mazdutide 3 mg, 4.5 mg, 6 mg or matching placebo at 20 hospitals in China. The primary endpoint was the percentage change from baseline to week 24 in body weight. A total of 248 participants were randomised to mazdutide 3 mg (n = 62), 4.5 mg (n = 63), 6 mg (n = 61) or placebo (n = 62). The mean percentage changes from baseline to week 24 in body weight were −6.7% (SE 0.7) with mazdutide 3 mg, −10.4% (0.7) with 4.5 mg, −11.3% (0.7) with 6 mg and 1.0% (0.7) with placebo, with treatment difference versus placebo ranging from −7.7% to −12.3% (all p < 0.0001). All mazdutide doses were well tolerated and the most common adverse events included diarrhoea, nausea and upper respiratory tract infection. In summary, in Chinese overweight adults or adults with obesity, 24-week treatment with mazdutide up to 6 mg was safe and led to robust and clinically meaningful body weight reduction.Mazdutide is a once-weekly glucagon-like peptide-1 (GLP-1) and glucagon receptor dual agonist. Here, the authors show mazdutide was well tolerated over 24 weeks and demonstrated significant and clinically meaningful body weight loss, compared with placebo, in Chinese overweight adults or adults with obesity. [ABSTRACT FROM AUTHOR]

AZ91 alloy reinforced by carbon nanotubes coated with MgO ( AZ91-MgO@CNTs) was prepared by powder metallurgy, hot extrusion and T4 treatment. The influences of MgO@CNTs content and load on the friction and wear property, surface wear morphology and debris topography of AZ91-MgO@CNTs composites were investigated under the dry sliding friction. The results show that MgO@CNTs can improve the wear properties of AZ91-MgO@CNTs. With increasing the content of MgO@CNTs, the strengthening effect of the wear properties of the composite increases and then decreases. Compared with AZ91- CNTs, AZ91-MgO@CNTs has smaller friction coefficient and lower abrasion loss, indicating that the MgO@CNTs is better than CNTs to improve the wear properties of AZ91 alloy. The main wear mechanism of AZ91-MgO@CNTs is abrasive wear under the load of 10 N. When the load is 50 N, there are three wear mechanisms appeared: abrasive wear, oxidation wear and adhesive wear. [ABSTRACT FROM AUTHOR]

Aims: Diabetic kidney disease (DKD) is a severe microvascular complication frequently associated with type 1 and type 2 diabetes mellitus. The objective of this work was to evaluate the relevance of PI3K/Akt pathway polymorphisms and DKD susceptibility by a meta‐analysis. Methods: Case–control studies related to the relationship between PI3K/Akt pathway polymorphisms and DKD risk were searched from Pubmed, Embase, Cochrane Library, SINOMED, CNKI, and Wanfang databases. Statistical analysis and heterogeneity test were conducted by Review Manager 5.4. Results: Totally, 52 eligible studies were enrolled, including seven single nucleotide polymorphisms (SNPs) for four genes in the PI3K/AKT pathway (GNB3: rs5443; eNOS: rs1799983, rs869109213, rs2070744; IL‐6: rs1800795, rs1800796; TNFα: rs1800629). The "M" allele of eNOS rs1799983 was related to the increased risk of DKD under random effects model, especially in Asian population (Overall:M vs. W: I2 = 75%, OR = 1.29, 95%CI 1.07–1.56; MM + WM vs. WW: I2 = 75%, OR = 1.50, 95%CI 1.21–1.86). The "M" allele of eNOS rs869109213 was implicated with higher prevalence of DKD under random effects model, especially in Asian population (Overall:M vs. W: I2 = 63%, OR = 1.43, 95%CI 1.22–1.68; MM + WM vs. WW: I2 = 50%, OR = 1.36, 95%CI 1.16–1.58; MM vs. WM + WW: I2 = 59%, OR = 2.20, 95%CI 1.41–3.43). The "M" allele of eNOS rs2070744 was implicated with higher prevalence of DKD under random effects model, especially in Indian population (Overall: M vs. W: I2 = 47%, OR = 1.35, 95%CI 1.15–1.59; MM + WM vs. WW: I2 = 45%, OR = 1.32, 95%CI 1.07–1.62; MM vs. WM + WW: I2 = 65%, OR = 2.29, 95%CI 1.39–3.77). The "M" allele of IL‐6 rs1800796 was predominately associated with higher DKD risks under random effects model, especially in Asian population (Overall: M versus W: I2 = 23%, OR = 1.49, 95%CI 1.21–1.84; MM + WM vs. WW: I2 = 1%, OR = 1.43, 95%CI 1.15–1.77; MM + WM vs. WW: I2 = 71%, OR = 2.77, 95%CI 1.09–7.06). Conclusions: This meta‐analysis indicated that polymorphisms in the PI3K/Akt pathway in eNOS rs1799983, rs869109213, rs2070744, and IL‐6 rs1800796 were related to the increased risk of DKD. [ABSTRACT FROM AUTHOR]

Hereditary spherocytosis (HS) is a common, hereditary hemolytic anemia (HHA) that is attributed to the disturbance of five erythrocyte membrane proteins. HS is also common in Guangxi, China. Target region capture high-throughput sequencing technology was used to analyze genetic mutations found in HS patients. Pedigree analysis was also performed, in some cases, to provide an optimized approach for the etiological diagnosis of complex, hereditary hemolytic anemia. Blood samples from the probands and their families were assessed by laboratory tests, target region capture high-throughput sequencing technology, and Sanger sequencing. We detected 79 HS patients from 37 unrelated families. The mutations observed in these patients were found mainly in four HS-related genes. These included SLC4A1, which was mutated in 31.65% of patients (25/79), SPTA1 (30.78% (24/79)), EPB42 (6.33% (5/79)), and SPTB (5.06% (4/79)). Composite genotype was observed in 26.58% (21/79) of patients and included mutations in two or more HS-related genes or mutations in HS-related genes combined with thalassemia or G6PD deficiency. No significant differences in clinical symptoms were found among patients of various genotypes except total bilirubin. Mean reticulocyte volume (MRV) and mean sphered cell volume (MSCV) of the composite genotype were significantly different from other groups. A total of 28 mutation types were found in HS-related genes. Using high-throughput sequencing technology, we also found some cases that had been misdiagnosed. MRV and MSCV are more significant in compound mutations as sensitive determinants of HS. High-throughput sequencing technology can be used to provide a more effective etiological diagnostic method for HS, with high efficiency and specificity. [ABSTRACT FROM AUTHOR]

This paper investigates the impact of the Shanghai–Hong Kong Stock Connect (SHSC) scheme on voluntary corporate social responsibility (CSR) disclosure in China. Using a difference‐in‐differences (DiD) design, we find that companies that participate in the SHSC scheme are more inclined to voluntarily issue CSR reports. This effect is more pronounced for companies that have limited access to international markets and those with weak corporate governance. Additional analyses show that SHSC‐connected firms also produce higher quality CSR reports and achieve a better CSR performance. Our findings imply that capital market liberalisation promotes voluntary corporate disclosure for investors. [ABSTRACT FROM AUTHOR]

In this work, the three spectroscopic parameters of the Dy:LPS were calculated as follows: 2.0902 × 10−20 cm2, 0.2469 × 10−20 cm2, and 0.4597 × 10−20 cm2, according to the Judd–Ofelt theory. Then, a planar waveguide was fabricated on the Dy:LPS by the proton implantation with an energy of 400 keV and a dose of 8 × 1016 ions/cm2. The dark-mode spectrum was obtained by the prism coupling method. Correspondingly, the refractive index profile of the waveguide structure was reconstructed by the RCM. The mode profile of the waveguide was investigated by the end-face coupling technique. The results suggest that the Dy:LPS crystal and its waveguide structure have potential applications in integrated optics, especially in the fabrication of solid-state waveguide lasers. [ABSTRACT FROM AUTHOR]

The aim of this study is to appraise the potential of calcium sulfoaluminate (CSA) cement-based grouts in simulated permafrost environments. The hydration and performance of CSA cement-based grouts cured in cold environments (10, 0, and −10 °C) are investigated using a combination of tests, including temperature recording, X-ray diffraction (XRD) tests, thermogravimetric analysis (TGA), and unconfined compressive strength (UCS) tests. The recorded temperature shows a rapid increase in temperature at the early stage in all the samples. Meanwhile, results of the TGA and XRD tests show the generation of a significant quantity of hydration products, which indicates the rapid hydration of CSA cement-based grouts at the early stage at low temperatures. Consequently, the CSA cement-based grouts exhibit remarkably high early strength. The UCS values of the samples cured for 2 h at −10, 0, and 10 °C are 6.5, 12.0, and 12.3 MPa, respectively. The UCS of the grouts cured at −10, 0, and 10 °C increases continuously with age and ultimately reached 14.9, 19.0, and 30.6 MPa at 28 d, respectively. The findings show that the strength of grouts fabricated using CSA cement can develop rapidly in cold environments, thus rendering them promising for permafrost applications. [ABSTRACT FROM AUTHOR]

Background: Diabetic kidney disease (DKD) has mainly been considered as a glomerular disease. Our previous study showed that the progression of DKD was highly correlated with the dysfunction of renal proximal tubular cells. Fermented Cordyceps sinensis (CS), a substitute for natural CS, is a prominent herb widely used in China, and has exhibited excellent efficacy on DKD. However, the underlying mechanisms remain poorly understood. Methods: The database analysis was used to identify the main therapeutic targets and pathways of CS involved in DKD treatment. Next, the protective effects of fermented CS on high glucose (HG, 30 mM) induced HK-2 cell injury was validated through cell proliferation and apoptosis assay, including CCK-8, EdU and TUNEL. Finally, quantitative real‑time PCR (qRT-PCR) and western blotting were used to verify key target genes. Results: Our results revealed that 9 main targets (RELA, JNK1, PTEN, VEGFA, EGF, ERK2, CASP3, AKT1, MMP9) were recognized as key therapeutic targets with excellent binding affinity screened by database analysis and molecular docking. The biological processes were identified by Gene Ontology (GO) enrichment, which appeared mainly involved in the positive regulation of cell proliferation as well as the negative regulation of apoptosis. The verification experiments in vitro revealed that fermented CS significantly attenuated the HG-induced cytotoxicity and apoptosis, and promoted the proliferation of HK-2 cells. Moreover, fermented CS significantly downregulated the expressions of Bax, Caspase-3, VEGFA, P-AKT and P-ERK, and upregulated the expression of PTEN compared with that of HG group. Conclusion: Our results demonstrate that the fermented CS has nephroprotective effects significantly, which functions via promoting proliferation and inhibiting apoptosis of renal proximal tubular cells, likely by targeting Caspase-3, Bax, VEGFA and PTEN. Furthermore, AKT and ERK signaling pathway may be the critical mechanisms underlying the efficacy of fermented CS in DKD treatment. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the efficacy and safety of janagliflozin in Chinese patients with type 2 diabetes (T2D) inadequately controlled with metformin monotherapy. Materials and methods: This multicentre phase 3 trial included a 24‐week, randomized, double‐blind, placebo‐controlled period, followed by a 28‐week extension period. Patients (N = 421) with HbA1c of 7.0% or higher and 10.5% or less were randomized (1:1:1) to receive once‐daily placebo, janagliflozin 25 or 50 mg. After the 24‐week treatment period, patients on placebo were re‐randomized (1:1) to janagliflozin 25 or 50 mg for the additional 28‐week treatment, whereas patients on janagliflozin maintained the same therapy. The primary endpoint was the change from baseline in HbA1c to week 24. Results: At week 24, the placebo‐adjusted least squares mean changes of HbA1c were –0.58% and –0.58% with janagliflozin 25 and 50 mg, respectively (P <.0001 for both). The proportion of patients achieving HbA1c less than 7.0% was higher with janagliflozin 25 and 50 mg compared with placebo (41.8%, 41.7% and 28.0%, respectively). Both janagliflozin doses provided significant reductions in fasting plasma glucose, 2‐hour postprandial glucose, body weight and systolic blood pressure, and improvements in high‐density lipoprotein cholesterol and insulin sensitivity compared with placebo (P <.05 for all). The trends in improvement of these variables were retained during the 28‐week extension period. No severe hypoglycaemia occurred throughout the whole 52‐week treatment. Conclusions: Janagliflozin 25 or 50 mg once‐daily added to metformin therapy significantly improved glycaemic control, reduced body weight and systolic blood pressure, improved high‐density lipoprotein cholesterol and insulin sensitivity, and was generally well‐tolerated by Chinese T2D patients who had poor glycaemic control with metformin monotherapy. [ABSTRACT FROM AUTHOR]

A two-dimensional waveguide is the building block in integrated photonic circuits. In this work, the 5.0 MeV oxygen ion implantation at a dose of 5. 0 × 1 0 1 4 ions/cm2 was carried out on the fused silica glass for the formation of the planar waveguide. Then, a femtosecond laser was employed to ablate the ion-implanted surface at a speed of 200 μ m/s for the construction of the ridge waveguide. The energy depositions of the oxygen ion implantation into the fused silica glass were simulated by the SRIM 2013. The microscopic morphology of the ridge waveguide was photographed by a Nikon microscope. The near-field intensity distributions of the ridge waveguide at 532 nm and 976 nm were measured by using the end-face coupling system. The ion-implanted and femtosecond-ablated ridge waveguide on the fused silica glass has the potential as a photonic device for integrated optical systems at the visible and near-infrared bands. [ABSTRACT FROM AUTHOR]

The pathogenic mechanism of diabetic kidney disease (DKD) is involved in various functions; however, its inadequate characterisation limits the availability of effective treatments. Tubular damage is closely correlated with renal function and is thought to be the main contributor to the injury observed in early DKD. Programed cell death (PCD) occurs during the biological development of the living body. Accumulating evidence has clarified the fundamental role of abnormalities in tubular PCD during DKD pathogenesis. Among PCD types, classical apoptosis, autophagic cell death, and pyroptosis are the most studied and will be the focus of this review. Our review aims to elucidate the current knowledge of the mechanism of DKD and the potential therapeutic potential of drugs targeting tubular PCD pathways in DKD. [ABSTRACT FROM AUTHOR]

Audits of internal control over financial reporting (ICFR) are typically "integrated" with the audit of the financial statements (FSs)—both audits are conducted by the same audit firm, which designs procedures to satisfy the objectives of both audits simultaneously. A common assumption is that integrating the two audits is more effective and efficient than performing them separately. However, this assumption has not been tested empirically. Using a sample of Chinese companies that employ different audit firms for their FS and ICFR audits (i.e., nonintegrated auditors), we find evidence that challenges this assumption. Specifically, we find ICFR audit quality is higher for nonintegrated audits compared to integrated audits. Moreover, total audit fees are lower for nonintegrated audits, despite higher ICFR audit fees. [ABSTRACT FROM AUTHOR]

We analyzed the characteristics of main karstic/non-karst reaches of the Lijiang River to uncover the causes behind different flood behaviors by providing a better understanding of the flood formation. Having 63 years of rainfall-runoff data and applying the HEC-HMS model, geo/hydrological features were investigated. The available reservoir capacity of karts (ARCK) was included through soil moisture accounting loss data to assess its impact. In particular, the expected instantaneous peak discharge rates/times were found largely imbalanced with generated unit hydrographs. Moreover, significant gaps among the floods' features for different subbasins in terms of required peak modifications (2-4 times larger for mid-upstream, respectively) were mainly associated with the unique karst structure and initial condition due to various ARCK in rainy/dry seasons. Besides, notable dissimilarities between the wedge/prism storage volumes and the hydrograph's wave traveling/receding time were observed owing to the geomorphological conditions. Although the contribution rates of drivers in karst flood formation cannot be quantitively modeled, based on our results the ARCK emerged to play a substantial role on the forecasted results, comparatively. Our results suggest that since ARCK varies, taking it into account (as initial abstraction) results in a more reliable estimation. This was underpinned by the results in which the unmodified simulations had a qualified rate of 52% accuracy on average and increased to 67.5% after the ARCK inclusion. This work adds to the body of evidence illustrating that in karst hydrology, ignoring the situational circumstances in modeling might lead to inaccuracies in flood forecasting for such dynamic watersheds. [ABSTRACT FROM AUTHOR]

Hypoxia can cause Epithelial–mesenchymal transition (EMT) in renal tubular cells, and in turn, renal fibrosis. We tested the expression of TRIM46, a member of tripartite motif-containing (TRIM) family proteins, and mesenchymal markers under hypoxia. Our results showed that hypoxia significantly enhanced expression of TRIM46 in HK2 human renal proximal tubular epithelial cells. Our data further showed that hypoxia led to upregulated expression of mesenchymal markers including α-smooth muscle actin, vimentin, and Snail, and downregulated expression of epithelial marker E-cadherin, coupled with an increased abundance of nuclear β-catenin. However, such effects were reversed when TRIM46 expression was knocked down. TRIM46 overexpression had similar effects as hypoxia exposure, and such effects were reversed when cells were treated with XAV-939, a selective inhibitor for β-catenin. Furthermore, we found that TRIM46 promoted ubiquitination and proteasomal degradation of Axin1 protein, a robust negative regulator of Wnt/β-catenin signaling activity. Finally, increased TRIM46 coupled with decreased Axin1 was observed in a rat renal fibrosis model. These data suggest a novel mechanism contributing to EMT that mediates hypoxia-induced renal fibrosis. Our results suggest that selectively inhibiting this pathway that activates fibrosis in human kidney may lead to development of a novel therapeutic approach for managing this disease. [ABSTRACT FROM AUTHOR]

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and metformin are both widely accepted anti-hyperglycemic agents. However, there is still no systematic review evaluating the cardiovascular benefits and risk of infections of SGLT2i versus metformin. To make that clear, we designed this study. Public databases, including the Cochrane library database, PubMed, and Embase were searched for randomized clinical trials (RCTs) fitting the inclusion criteria. Two reviewers extracted the data and appraised the study quality independently. Thirteen RCTs enrolling 4189 patients were eligible for this analysis. Our results showed that compared with metformin, SGLT2i increased the risk of genitourinary tract infections (p < 0.00001). Further subgroup analysis suggested that the occurrence of urinary tract infections (UTI) was not statistically significant (p = 0.18), but the incidence of reproductive tract infections (RTI) was significantly increased in patients in the SGLT2i group compared with that in the metformin group (p < 0.00001). In addition, SGLT2i markedly decreased the levels of cardiovascular risk factor, including body weight, blood pressure, and triglyceride level, and significantly increased the HDL-cholesterol level (p < 0.00001) in patients versus that of metformin. For type 2 diabetes patients with obesity, SGLT2i was associated with more significant reductions in weight and blood pressure compared to metformin without an increased risk of genitourinary infections, and the reduction in fasting plasma glucose was superior in the SGLT2i group; the decrease in HbA1c was similar in both groups. Additionally, no significant publication bias was seen. Based on these findings, SGLT2i provided the similar antihyperglycemic effects, additional cardiovascular benefits, and a potential RTI risk compared with that of metformin. Our results indicate that SGLT2i is a good choice for those patients with metformin intolerance or resistance. [ABSTRACT FROM AUTHOR]

The aim of this study was to apply biochemical parameters to Onychostoma barbatulum to understand whether Wuling Farm activities have caused organic pollution from xenoestrogens to flow into surrounding streams and thereby affected area aquatic ecosystems. Individuals of the Taiwan shovel-jaw carp (O. barbatulum) were collected by fyke netting in the Cijiawan, Kaoshan, and Yusheng Rivers in the protected area of Shei-Pa National Park and in the Ikawan River outside the protected areas from 4–5 June 2015 to 20–21 September 2015. The collected male individuals of O. barbatulum were divided into two groups. In the first group monooxygenase (Mon) activity, glutathione S-transferase (GST) activity, and vitellogenin (VTG) concentration in the liver were measured right after they were captured. Those in the second group were acclimated for 14 days and then exposed to 0 (control) or 10 ng/L 17β-estradiol for 10 days and then measured for changes in Mon, GST, and VTG in their livers. The value of VTG concentrations in O. barbatulum individuals collected from the Ikawan River was 2.12 ± 1.62 μg PO42+/g protein, which was the highest among all samples, followed by those collected from the Yusheng River (0.78 ± 1.00 μg PO42+/g protein). Individuals collected from the Yusheng River had the highest liver Mon activity (4.16 ± 1.08△A650/30 min/g protein) and the highest GST activity (1.58 ± 1.13 △A340/20 min/g protein), followed by those from the Ikawan River (Mon: 3.63 ± 1.13 △A650/30 min/g protein; GST: 1.24 ± 0.73 △A340/20 min/g protein). Comprehensive analyses showed that Mon and GST activities and VTG concentrations in livers measured right after being collected were lower than individuals exposed to 10 ng 17β-estradiol/L in the laboratory. Induced VTG concentrations were 9.87 ± 0.89 μg PO42+/g protein, Mon activity 8.02 ± 1.74 △A650/30 min/g protein, and GST activity 3.24 ± 0.62 △A340/20 min/g protein, indicating that farming activities have not significantly affected these aquatic organisms. However, pollution sources are still releasing pollutants containing xenoestrogens into the Yusheng River and Ikawan River. The impact of xenoestrogens is worthy of continuous long-term follow-up monitoring. [ABSTRACT FROM AUTHOR]

Objective: To investigate a previously uncharacterized function of Sijunzi Decoction (SJZD) in inhibition of gastric cancer stem cells (GCSCs). Methods: MKN74 and MKN45, two CD44 positive gastric cancer cell lines with stem cell properties were used. The cells were divided into 2 groups. Treatment group was treated with SJZD (1–5 mg/mL) for indicated time (48 h–14 days). The control group was treated with equal volume of phosphate buffered saline. Cell Counting Assay Kit-8 were used to measure cell viability. Spheroid colony formation and GCSCs marker expression were performed to determine GCSCs stemness. Cell fractionation and chromatin immunoprecipitation assays were used to assess the distribution and DNA-binding activity of β-catenin after SJZD treatment, respectively. Results: SJZD treatment repressed cell growth and induced apoptosis in MKN74 and MKN45 cell lines (P<0.05). Moreover, SJZD dramatically inhibited formation of spheroid colony and expression of GCSC markers in GC cells (P<0.05). Mechanistically, SJZD reduced nuclear accumulation and DNA binding activity of β-catenin (P<0.05), the key regulator for maintaining CSC stemness. Conclusion: SJZD inhibits GCSCs by attenuating the transcriptional activity of β-catenin. [ABSTRACT FROM AUTHOR]

Aims: Maturity-onset diabetes of the young type 5 (MODY5), a rare disease, is very easy to be misdiagnosed as type 2 diabetes. To get better understanding of the disease, we analyzed the clinical characteristics and gene mutations of MODY5. Methods: PubMed, Cochrane, the China National Knowledge Infrastructure, and Wanfang were searched with the following search terms: "MODY5" OR "HNF1B maturity-onset diabetes of the young" OR "maturity-onset diabetes of the young type 5" OR "renal cysts and diabetes syndrome". Clinical characteristics and gene mutations of MODY5 were analyzed. The demography, clinical characteristics, and blood indicators of patients were described utilizing simple summary statistics. Variables were analyzed by t-test, Wilcoxon signed rank test, and Fisher exact test. Spearman's correlation analysis was used for bi-variate analysis. All tests were two-sided, and a p -value < 0.05 was considered statistically significant. Statistical analysis was performed using the Statistical Package for the Social Sciences version 26 for Windows (SPSS). Results: A total of 48 literatures were included in this study, including 61 eligible patients and 4 different mutations. Of the 39 patients with available body weight index, 15 (38.46%) were underweight, 21 (53.85%) were normal weight and 3 (7.69%) were overweight or obese. Of the 38 patients with available family history, 25 (65.79%) reported a family history of diabetes. Of the 34 patients with available age of diabetes diagnosis, the median age of diabetes diagnosis was 16.00 years old and 88.24% (30/34) of patients were under 25 years old when they were first diagnosed with diabetes. Renal cysts were presented in 72.41%, hypomagnesemia in 91.67%, and pancreatic dysplasia in 71.88% of the patients. Patients with hepatocyte nuclear factor 1B (HNF1B) deletion had lower serum magnesium, serum creatinine, and higher eGFR than patients with other gene mutations, and the difference was statistically significant. Conclusions: The young onset of diabetes with low or normal BMI, renal cysts, hypomagnesemia, and pancreatic dysplasia should be recommended to genetic testing in order to differentiate MODY5 from other types of diabetes earlier. [ABSTRACT FROM AUTHOR]

This paper presents an analysis methodology for composite sandwich panel 90° closeout with multi-layered non-uniform facesheets and core. A detailed 2D finite element model was constructed to model honeycomb core through the thickness as well as simulate top and bottom facesheets and the transition region. 2D equivalent material properties of the facesheets are calculated based on classical lamination theory. Elemental stresses of core are used to calculate failure index and margin of safety for various loading conditions based on tension/compression and shear interaction theory. Facesheet strength is checked by interlaminar shear and tension interaction equation with the utilization of failure index. Theoretical failure modes and critical locations obtained from this approach are compared with structural testing of specimens. The predicted failure loads, deflection, facesheet load ratio, and strains are in good agreement with test data. The methodology is verified to be a simple, efficient, and reliable method for the analysis of composite sandwich closeout structures. [ABSTRACT FROM AUTHOR]

Purpose: The correlation of abnormal glucose metabolism and thyroid carcinoma, especially the aggressiveness of thyroid cancer, still remains controversial. We conducted this study to investigate the relationship between abnormal glucose metabolism parameters and differentiated thyroid carcinoma (DTC) in the Chinese population. Materials and Methods: The study was designed as a hospital-based case–control study and was approved by the Ethics Committee of our hospital and registered in the Clinical Trial Protocol Registration and Results System (Registration code: NCT 03006289). From January 1, 2018 to June 30, 2021, a total of 377 DTC patients were enrolled in the study. Demographic and general characteristics, details of thyroid surgery and histopathological results, hematological test indicators were collected. Glucose metabolism parameters were calculated. Variables were analyzed by t-test, ANOVA, chi-squared analysis and Fisher's exact test. Pearson bi-variate correlation and Spearman's correlation analysis were used for bi-variate analysis. Results: More than 40% of patients with DTC were multifocality, more than half were extra-glandular invasion, and nearly 85% complied by lymph node metastasis. The prevalence of diabetes mellitus (DM) was about 10.08% in DTC patients. It was found that the proportion of postprandial 2 h blood glucose ≥11.1mmol/L and HbA1c ≥6.5% was significantly higher than the known proportion of DM (17.8%, 16.7% vs. 10.08%). Additionally, 87.3% of the DTC patients in this study had varying degrees of insulin resistance. Further analysis found that higher T staging was associated with higher levels of area under curve of C-peptide (P = 0.029), insulin sensitivity index (P = 0.012) and C-peptide sensitivity index (P = 0.016). A delayed peak of insulin secretion was found to be positive related with capsule invasion (r = 0.206, P = 0.004). In patients without a DM history, homeostasis model assessment of insulin resistance (P = 0.017), insulin sensitivity index (P = 0.019) and C-peptide sensitivity index (P = 0.020) were statistic associated with T staging. Also, the glucose metabolism parameter at 3-hour after a meal was related to a larger number of metastatic lymph nodes. Conclusion: Abnormal glucose metabolism, namely, DM, hyperinsulinemia and insulin resistance, were significantly associated with the carcinogensis and aggressiveness of DTC. [ABSTRACT FROM AUTHOR]

This work reports on the fabrication and characterization of a K9 glass planar waveguide structure. The helium ion implantation was employed to form the waveguide on the K9 glass. The choices of the energy of 0.4 MeV and the dose of 6. 0 × 1 0 1 6 ions/cm2 were conducted by the SRIM 2013. The m -line spectroscopy and the modal profile of the He + -irradiated K9 glass waveguide were performed by the prism-coupling system and the end-face coupling technique at 0.6328 μ m, which suggests the capability of light propagation. The He + -implanted K9 glass waveguides can serve as potential candidates for advanced integrated optoelectronic devices. [ABSTRACT FROM AUTHOR]

In this work, a one-dimensional waveguide is formed by virtue of the helium ion implantation in the oxyfluoride glass (OFG). The energy and the fluence of the ion implantation are 0.4 MeV and 6. 0 × 1 0 1 4 He + ⋅ mm − 2 , respectively. The m-line curve with the effective refractive indices of the modes was recorded by using the prism coupling system. The energy loss distribution and the refractive index profile were calculated by the stopping and range of ions into matter (SRIM)-2013 and the RCM, respectively. The light modal profile was measured by the end-facet coupling system. It suggests that the He + -ion implanted OFG waveguides have the potential to act as integrated photonic devices. [ABSTRACT FROM AUTHOR]

A significant prognostic value of 24h dRDW was found in the anemia patients for 1-year all-cause mortality, but not in the non-anemia patients. (Table 3) The anemia patients with a higher 24h dRDW had a higher mortality rate than those with a lower 24h dRDW; the adjusted HRs and 95% CIs (quintile 4 and quintile 5 vs quintile 1) were 2.243 (1.732, 2.905) and 4.070 (3.203, 5.171), respectively (Table 3). Anemia patients with a higher 24h dRDW had a higher mortality rate than those with a lower 24h dRDW, implying an association between myocardial dysfunction and these hematologic abnormalities. In the stratified analysis, a significant prognostic value of 24h dRDW was found in the anemia patients for 1-year all-cause mortality, but not in the non-anemia patients. [Extracted from the article]

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