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BackgroundBone marrow aspiration and biopsy remain the gold standard for the diagnosis of hematological diseases despite the development of flow cytometry (FCM) and molecular and gene analyses. However, the interpretation of the results is laborious and operator dependent. Furthermore, the obtained results exhibit inter- and intravariations among specialists. Therefore, it is important to develop a more objective and automated analysis system. Several deep learning models have been developed and applied in medical image analysis but not in the field of hematological histology, especially for bone marrow smear applications. ObjectiveThe aim of this study was to develop a deep learning model (BMSNet) for assisting hematologists in the interpretation of bone marrow smears for faster diagnosis and disease monitoring. MethodsFrom January 1, 2016, to December 31, 2018, 122 bone marrow smears were photographed and divided into a development cohort (N=42), a validation cohort (N=70), and a competition cohort (N=10). The development cohort included 17,319 annotated cells from 291 high-resolution photos. In total, 20 photos were taken for each patient in the validation cohort and the competition cohort. This study included eight annotation categories: erythroid, blasts, myeloid, lymphoid, plasma cells, monocyte, megakaryocyte, and unable to identify. BMSNet is a convolutional neural network with the YOLO v3 architecture, which detects and classifies single cells in a single model. Six visiting staff members participated in a human-machine competition, and the results from the FCM were regarded as the ground truth. ResultsIn the development cohort, according to 6-fold cross-validation, the average precision of the bounding box prediction without consideration of the classification is 67.4%. After removing the bounding box prediction error, the precision and recall of BMSNet were similar to those of the hematologists in most categories. In detecting more than 5% of blasts in the validation cohort, the area under the curve (AUC) of BMSNet (0.948) was higher than the AUC of the hematologists (0.929) but lower than the AUC of the pathologists (0.985). In detecting more than 20% of blasts, the AUCs of the hematologists (0.981) and pathologists (0.980) were similar and were higher than the AUC of BMSNet (0.942). Further analysis showed that the performance difference could be attributed to the myelodysplastic syndrome cases. In the competition cohort, the mean value of the correlations between BMSNet and FCM was 0.960, and the mean values of the correlations between the visiting staff and FCM ranged between 0.952 and 0.990. ConclusionsOur deep learning model can assist hematologists in interpreting bone marrow smears by facilitating and accelerating the detection of hematopoietic cells. However, a detailed morphological interpretation still requires trained hematologists.

BackgroundThe detection of dyskalemias—hypokalemia and hyperkalemia—currently depends on laboratory tests. Since cardiac tissue is very sensitive to dyskalemia, electrocardiography (ECG) may be able to uncover clinically important dyskalemias before laboratory results. ObjectiveOur study aimed to develop a deep-learning model, ECG12Net, to detect dyskalemias based on ECG presentations and to evaluate the logic and performance of this model. MethodsSpanning from May 2011 to December 2016, 66,321 ECG records with corresponding serum potassium (K+) concentrations were obtained from 40,180 patients admitted to the emergency department. ECG12Net is an 82-layer convolutional neural network that estimates serum K+ concentration. Six clinicians—three emergency physicians and three cardiologists—participated in human-machine competition. Sensitivity, specificity, and balance accuracy were used to evaluate the performance of ECG12Net with that of these physicians. ResultsIn a human-machine competition including 300 ECGs of different serum K+ concentrations, the area under the curve for detecting hypokalemia and hyperkalemia with ECG12Net was 0.926 and 0.958, respectively, which was significantly better than that of our best clinicians. Moreover, in detecting hypokalemia and hyperkalemia, the sensitivities were 96.7% and 83.3%, respectively, and the specificities were 93.3% and 97.8%, respectively. In a test set including 13,222 ECGs, ECG12Net had a similar performance in terms of sensitivity for severe hypokalemia (95.6%) and severe hyperkalemia (84.5%), with a mean absolute error of 0.531. The specificities for detecting hypokalemia and hyperkalemia were 81.6% and 96.0%, respectively. ConclusionsA deep-learning model based on a 12-lead ECG may help physicians promptly recognize severe dyskalemias and thereby potentially reduce cardiac events.

Didymocarpus pingyuanensis, endemic to the Danxia landscape in Pingyuan County, Guangdong, China, is described and illustrated here. This species can be distinguished from other members of Didymocarpus sect. Heteroboea by its calyx deeply 5-lobed to about three quarters of its length. The phylogenetic position of the new species within Didymocarpus was examined using nuclear ribosomal internal transcribed spacer (ITS) sequences. Based on phylogenetics analysis and morphological evidence, we propose two new combinations, elevating the two varieties to species level, namely D. yinzhengii and D. gamosepalus.

[C8H11N3O4], monoclinic, P21/c (no. 14), a = 4.5811(16) Å, b = 19.734(7) Å, c = 11.812(4) Å, β = 101.181(11)°, V = 1047.6(6) Å3, Z = 4, Rgt (F) = 0.0742, wRref (F 2) = 0.1176, T = 296(2) K.

Oreocharis leveilleana Fedde was collected in Ta-pin in 1910 and published in 1911. The collected location was verified within western Luodian County, Guizhou Province, China. However, there have been no records of the species’ collection for more than 100 years since then. After extensive investigations by our research team on the type locality and its surrounding areas, we found that it is widely distributed in western Luodian County and eastern Wangmo County, Guizhou Province, China. During further research on the original literature, type specimens and type locality of O. leveilleana, the taxonomic position of O. leveilleana, which was once treated as a synonym of O. auricula (S.Moore) C.B.Clarke, was found to have a taxonomic problem. Through morphological research combined with geographical distribution analysis, it has been determined that it should belong to the genus Petrocodon Hance and it is the same species as P. coccineus (C.Y.Wu ex H.W.Li) Yin Z.Wang. According to the regulations and suggestions of the 2018 "International Code of Nomenclature for Algae, Fungi, and Plants (Shenzhen Code)", we propose and confirm a new combination – Petrocodon leveilleanus (Fedde) X.X.Bai & F.Wen and treat P. coccineus as a synonym of the new combination. Due to its unique bright red flowers within Petrocodon, its original Chinese name has been retained.

Abstract Background Recent evidence has demonstrated that abnormal expression and regulation of circular RNA (circRNAs) are involved in the occurrence and development of a variety of tumors. The aim of this study was to investigate the effects of circ_PPAPDC1A in Osimertinib resistance in NSCLC. Methods Human circRNAs microarray analysis was conducted to identify differentially expressed (DE) circRNAs in Osimertinib-acquired resistance tissues of NSCLC. The effect of circ_PPAPDC1A on cell proliferation, invasion, migration, and apoptosis was assessed in both in vitro and in vivo. Dual-luciferase reporter assay, RT-qPCR, Western-blot, and rescue assay were employed to confirm the interaction between circ_PPAPDC1A/miR-30a-3p/IGF1R axis. Results The results revealed that circ_PPAPDC1A was significantly upregulated in Osimertinib acquired resistance tissues of NSCLC. circ_PPAPDC1A reduced the sensitivity of PC9 and HCC827 cells to Osimertinib and promoted cell proliferation, invasion, migration, while inhibiting apoptosis in Osimertinib-resistant PC9/OR and HCC829/OR cells, both in vitro and in vivo. Silencing circ_PPAPDC1A partially reversed Osimertinib resistance. Additionally, circ_PPAPDC1A acted as a competing endogenous RNA (ceRNA) by targeting miR-30a-3p, and Insulin-like Growth Factor 1 Receptor (IGF1R) was identified as a functional gene for miR-30a-3p in NSCLC. Furthermore, the results confirmed that circ_PPAPDC1A/miR-30a-3p/IGF1R axis plays a role in activating the PI3K/AKT/mTOR signaling pathway in NSCLC with Osimertinib resistance. Conclusions Therefore, for the first time we identified that circ_PPAPDC1A was significantly upregulated and exerts an oncogenic role in NSCLC with Osimertinib resistance by sponging miR-30a-3p to active IGF1R/PI3K/AKT/mTOR pathway. circ_PPAPDC1A may serve as a novel diagnostic biomarker and therapeutic target for NSCLC patients with Osimertinib resistance. Graphical Abstract

The 16-item Physical Resilience Instrument for Older Adults (PRIFOR) has good clinimetric properties; however, a shortened PRIFOR would greatly enhance physical resilience measurements in clinical settings. The current analysis aimed to reduce the number of PRIFOR while maintaining its clinimetric properties, emphasizing on its factor structure and convergent validity. A longitudinal study was conducted among 863 patients aged 65 years or older. Four PRIFOR items with high factor loadings were selected to generate the short version of PRIFOR (PRIFOR-4). The PRIFOR-4 was found to have a unidimensional structure (comparative fit index = 0.999; Tucker-Lewis index = 0.998 in the confirmatory factor analysis results) with good convergent validity with various external measures (absolute r = 0.109–0.597; p-values

In order to study the combustion characteristics of glass fiber/phenolic resin composites, a conical calorimeter was used to explore the combustion characteristics of glass fiber/phenolic resin composites in an aircraft frame under different thermal radiation intensities, and the fire hazard of the materials was evaluated by evaluation index, and the limiting oxygen index at different temperatures was explored by combining the high temperature oxygen index meter. The test results show that when the ambient temperature increases from 20 °C to 220 °C, the limiting oxygen index first increases from 86.6 % to 93.7 %, and then decreases to 84.4 %. The oxygen consumption and CO2 release increase with the increase of thermal radiation intensity during combustion, and the release of CO decreases with the increase of thermal radiation. The heat release rate curve of the test material has only 1 enhancement peak. The heat radiation intensity increased from 50 kW/m2 to 70 kW/m2, and the peak heat release rate of the test material combustion increased from 64.7 kW/m2 to 100.7 kW/m2. The rate of mass loss of materials accelerates with the increase of thermal radiation intensity; As the intensity of thermal radiation increases, the fire hazard of the material increases.

Introduction: Nurses undertaking air ambulance service encounter environmental, equipment, and personnel limitations during their work. Moreover, they must cope with various types of injuries and illnesses, as well as changes in patient conditions. These factors pose a significant pressure on nurses. Currently, there is a lack of qualitative research on the experiences of nurses performing air ambulance tasks. The purpose of this study is to explore the experiences of nurses undertaking air ambulance service, with a focus on capturing their personal perceptions regarding this field of work. Methods: Twelve nurses were selected using purposive sampling, and semi-structured interviews were conducted to collect data. Content analysis was used to analyze the data. Results: The analysis identified three major themes: "Ambiguous and risky emergency missions," "Challenges during air transfer," and "Nurses’ personal limitations.” Eight categories were formulated within these themes, including "Mission uncertainty," “Urgency of medical conditions," “Hazards at high altitude," "Cabin environment limitations," "Inadequate equipment," "Incomprehensive operating mechanisms," "Physical discomfort," and "Recognition of professional shortcomings." Conclusions: Improving the performance and well-being of nurses engaged in air ambulance services necessitates the implementation of a psychological adaptation program. This includes the utilization of psychological stress assessment tools or engaging in role-playing activities. Successful patient rescues demand the establishment of comprehensive standard operating procedures, involving an interprofessional team. Supporting nurses in adeptly managing challenges during air ambulance services requires an expanded scope of education and training, facilitated through initiatives like situational simulation and similar approaches.

Abstract The global diagnosis rate and mortality of gastric cancer (GC) are among the highest. Ferroptosis and iron-metabolism have a profound impact on tumor development and are closely linked to cancer treatment and patient’s prognosis. In this study, we identified six PRDEGs (prognostic ferroptosis- and iron metabolism-related differentially expressed genes) using LASSO-penalized Cox regression analysis. The TCGA cohort was used to establish a prognostic risk model, which allowed us to categorize GC patients into the high- and the low-risk groups based on the median value of the risk scores. Our study demonstrated that patients in the low-risk group had a higher probability of survival compared to those in the high-risk group. Furthermore, the low-risk group exhibited a higher tumor mutation burden (TMB) and a longer 5-year survival period when compared to the high-risk group. In summary, the prognostic risk model, based on the six genes associated with ferroptosis and iron-metabolism, performs well in predicting the prognosis of GC patients.

Objective To explore the impacts of Xingnaojing Injection plus ulinastatin plus continuous renal replacement therapy （CRRT） on efficacy, immune function and hemodynamics of septic patients complicated with acute kidney injury （AKI）. Methods From May 1, 2019 to May 31, 2022, 104 septic patients complicated with AKI were selected and randomized into two groups of observation （n = 52） and control （n = 52）. Control group received ulinastatin plus CRRT. And observation group had Xingnaojing injection on the basis of control group. Physiological status was evaluated by APACHE Ⅱ score; the levels of T lymphocyte subsets （CD4+/CD8+） were measured by flow cytometry before and after treatment and ratio of CD4+/CD8+ was calculated; the levels of immunoglobulin IgA, IgM and IgG were measured by one-way immunodiffusion before and after treatment; central venous pressure （CVP）, mean arterial pressure （MAP） and heart rate （HR） were monitored with an electronic monitor before and after treatment; in addition, efficacies, changes of APACHE Ⅱ score, CD4+ and CD8+ levels, CD4+/CD8+, IgA/M/G, CVP, MAP and HR were compared between two groups. Results The efficacy of observation group was significantly higher than that of control group （90.39% vs 73.08%, χ2 = 5.216, P = 0.022）. APACHE Ⅱ score of observation and control group declined markedly after treatment [（20.57 ± 3.72） points, （19.74 ± 3.51） points vs （9.67 ± 2.24） points, （13.84 ± 3.11） points] （P＜0.05） and APACHE Ⅱ score of observation group was significantly lower than that of control group after treatment （P＜0.05）. CD4+ level [（30.73 ± 6.54）%, （29.46 ± 6.28）% vs （35.82 ± 6.59）%, （32.65 ± 6.74）%] and CD4+/CD8+ [（1.10 ± 0.24）, （1.12 ± 0.26） vs （1.84±0.31）、（1.52±0.29）] spiked obviously after treatment in observation and control groups. CD8+ level declined markedly [（27.94 ± 5.75）%, （26.30 ± 5.54）% vs （19.48 ± 4.21）%, （21.45 ± 4.54）%] （P＜0.05）.After treatment, the levels of CD4+ and CD4+/CD8+ were significantly higher in observation group than those in control group; CD8+ level was significantly lower than that in control group （P＜0.05）. The levels of IgA [（1.32 ± 0.31） g/L, （1.28 ± 0.29） g/L vs （1.96 ± 0.48） g/L, （1.63 ± 0.42）g/L], IgM [（0.95 ± 0.31） g/L, （0.91 ± 0.28） g/L vs （1.96 ± 0.51） g/L, （1.37 ± 0.36） g/L] and IgG [（5.82 ± 0.81） g/L, （5.77 ± 0.76） g/L vs （9.75 ± 1.43） g/L, （7.32 ± 1.24） g/L] in observation and control groups were significant after treatment. After treatment, the levels of IgA, IgM and IgG were significantly higher in observation group than those in control group （P＜0.05）. The levels of CVP [（6.47 ± 1.24） mmH2O, （6.42 ± 1.21） mmH2O vs （12.83 ± 2.85） mmH2O, （9.54 ± 2.32） mmH2O] and MAP [（56.53 ± 5.34） mmHg, （55.87 ± 5.21） mmHg vs （87.27 ± 6.83） mmHg, （71.92 ± 6.42） mmHg, 1 mmHg = 0.133 kPa] spiked markedly in observation and control groups after treatment. HR declined markedly [（117.56 ± 12.65） beat/min, （115.73 ± 12.57） beat/min vs （83.41 ± 8.73） beat/min, （98.65 ± 10.51） beat/min] （P＜0.05）. After treatment, CVP and MAP levels were significantly higher in observation group than those in control group and HR was significantly lower than that in control group （P＜0.05）. The levels of urea nitrogen [（10.38 ± 2.31） mmol/L, （10.42 ± 2.34） mmol/L vs （14.22 ± 3.34） mmol/L, （19.14±5.27） mmol/L] and serum creatinine [（125.87 ± 26.57） μmol/L, （125.76 ± 25.68） μmol/L vs （183.55 ± 36.81） μmol/L, （241.26 ± 42.79） μmol/L] spiked obviously （P＜0.05）. After treatment, the levels of urea nitrogen and blood creatinine were significantly lower in observation group than those in control group （P＜0.05）. Conclusions Xingnaojing injection combined with ulinastatin and continuous renal replacement therapy are effective in treating patients with sepsis complicated with AKI, which can effectively improve the immune function and hemodynamics of patients, and alleviate the condition of patients.

Background:. As long-term, regular aesthetic botulinum neurotoxin A (BoNT-A) use becomes more commonplace, it is vital to understand real-world risk factors and impact of BoNT-A immunoresistance. The first Aesthetic Council on Ethical Use of Neurotoxin Delivery panel discussed issues relating to BoNT-A immunoresistance from the health care professionals’ (HCPs’) perspective. Understanding the implications of BoNT-A immunoresistance from the aesthetic patient’s viewpoint allows HCPs to better support patients throughout their aesthetic treatment journey. Methods:. A real-world consumer study surveyed 363 experienced aesthetic BoNT-A recipients across six Asia-Pacific territories. The survey mapped participants’ BoNT-A aesthetic treatment journey and characterized awareness and attitudes relating to BoNT-A immunoresistance and treatment implications. At the second Aesthetic Council on Ethical use of Neurotoxin Delivery meeting, panelists discussed survey findings and developed consensus statements relating to the impact of BoNT-A immunoresistance on the aesthetic treatment journey. Results:. Aesthetic BoNT-A patients’ depth of knowledge about BoNT-A immunoresistance remains low, and risk/benefit communications need to be more lay-friendly. The initial consultation is the most important touchpoint for HCPs to raise awareness of BoNT-A immunoresistance as a potential side effect considering increased risk with repeated high-dose treatments. HCPs should be cognizant of differences across BoNT-A formulations due to the presence of certain excipients and pharmacologically unnecessary components that can increase immunogenicity. Standardized screening for clinical signs of secondary nonresponse and a framework for diagnosing and managing immunoresistance-related secondary nonresponse were proposed. Conclusion:. These insights can help patients and HCPs make informed treatment decisions to achieve desired aesthetic outcomes while preserving future treatment options with BoNT-A.

BackgroundFinding individuals with drug-resistant tuberculosis (DR-TB) is important to control the pandemic and improve patient clinical outcomes. To our knowledge, systematic reviews assessing the effectiveness, cost-effectiveness, acceptability, and feasibility of different DR-TB case-finding strategies to inform research, policy, and practice, have not been conducted and the scope of primary research is unknown. ObjectiveWe therefore assessed the available literature on DR-TB case-finding strategies. MethodsWe looked at systematic reviews, trials, qualitative studies, diagnostic test accuracy studies, and other primary research that sought to improve DR-TB case detection specifically. We excluded studies that included patients seeking care for tuberculosis (TB) symptoms, patients already diagnosed with TB, or were laboratory-based. We searched the academic databases of MEDLINE, Embase, The Cochrane Library, Africa-Wide Information, CINAHL (Cumulated Index to Nursing and Allied Health Literature), Epistemonikos, and PROSPERO (The International Prospective Register of Systematic Reviews) using no language or date restrictions. We screened titles, abstracts, and full-text articles in duplicate. Data extraction and analyses were carried out in Excel (Microsoft Corp). ResultsWe screened 3646 titles and abstracts and 236 full-text articles. We identified 6 systematic reviews and 61 primary studies. Five reviews described the yield of contact investigation and focused on household contacts, airline contacts, comparison between drug-susceptible tuberculosis and DR-TB contacts, and concordance of DR-TB profiles between index cases and contacts. One review compared universal versus selective drug resistance testing. Primary studies described (1) 34 contact investigations, (2) 17 outbreak investigations, (3) 3 airline contact investigations, (4) 5 epidemiological analyses, (5) 1 public-private partnership program, and (6) an e-registry program. Primary studies were all descriptive and included cross-sectional and retrospective reviews of program data. No trials were identified. Data extraction from contact investigations was difficult due to incomplete reporting of relevant information. ConclusionsExisting descriptive reviews can be updated, but there is a dearth of knowledge on the effectiveness, cost-effectiveness, acceptability, and feasibility of DR-TB case-finding strategies to inform policy and practice. There is also a need for standardization of terminology, design, and reporting of DR-TB case-finding studies.

Background: Patterns of physical activity and sedentary behavior among postmenopausal women are not well characterized. Objectives: To describe the patterns of accelerometer-assessed physical activity and sedentary behavior among postmenopausal women. Design: Cross-sectional study. Methods: Women 63–97 years (n = 6126) wore an ActiGraph GT3X + accelerometer on their hip for 1 week. Latent class analysis was used to classify women by patterns of percent of wake time in physical activity and sedentary behavior over the week. Results: On average, participants spent two-thirds of their day in sedentary behavior (62.3%), 21.1% in light low, 11.0% in light high, and 5.6% in moderate-to-vigorous physical activity. Five classes emerged for each single-component model for sedentary behavior and light low, light high, and moderate-to-vigorous physical activity. Six classes emerged for the multi-component model that simultaneously considered the four behaviors together. Conclusion: Unique profiles were identified in both single- and multi-component models that can provide new insights into habitual patterns of physical activity and sedentary behavior among postmenopausal women. Implications: The multi-component approach can contribute to refining public health guidelines that integrate recommendations for both enhancing age-appropriate physical activity levels and reducing time spent in sedentary behavior.

Abstract Optical frequency combs provide a powerful tool for precise measurement of the optical frequency, holding significant importance in fields such as spectroscopy, optical communication and optical clock. The frequency stability of the comb line determines the precision of the frequency measurement, but the delicate interplay between high precision, low power consumption and integration still needs to be optimized. To this aim, here we demonstrate a frequency measurement scheme based on a fully stabilized electro-optic comb, in which the pump laser frequency and repetition rate are independently locked to the atomic transition and microwave signal. The measurement precision of the demonstrated wavemeter can reach sub-kHz-level, and the parallel measurement of multiple wavelengths can be performed. Therefore, by combining the technical scheme reported here with advanced integrated functional devices, our system is expected to provide a feasible solution for chip-scale frequency precision measurement and reference.

A new lithophytic species, Paraboea zunyiensis T.Deng, F.Wen & R.B.Zhang (Gesneriaceae), inhabiting Karst rocks in northern Guizhou, China, is introduced and depicted in this study. It bears a resemblance to P. crassifolia (Hemsl.) B.L. Burtt, yet is distinguishable by its shorter filaments and staminodes, triangular ovate calyx segments, and ovaries surpassing the styles in length. Moreover, the phylogenetic tree constructed from nuclear DNA (ITS) and plastid DNA (trnL-F) data firmly support the differentiation of this novel species from P. crassifolia.

为提高蛋白基Pickering乳液稳定性，采用美拉德反应制备乳清分离蛋白（WPI）-葡聚糖（Dex）接枝物，然后利用该接枝物制得蛋白基固体颗粒，再与中链甘油三酯制备Pickering乳液，考察WPI-Dex接枝物对蛋白基固体颗粒乳化活性、乳化稳定性和蛋白基Pickering乳液乳析指数的影响，以及Pickering乳液在不同pH、加热温度、贮藏时间下粒径的变化。结果表明：扫描电镜观察到共价接枝Dex将WPI形貌结构由球状转变为片状，十二烷基硫酸钠-聚丙烯酰胺凝胶电泳证实干法美拉德反应成功制备了WPI-Dex接枝物；与WPI相比，WPI-Dex接枝物的乳化活性和乳化稳定性分别增加了57.8%和138.5%；WPI和WPI-Dex接枝物Pickering乳液贮藏30 d时的乳析指数分别为52.3%和36.0%，WPI-Dex接枝物使Pickering乳液的乳析稳定性提高了31.2%；WPI-Dex接枝物Pickering乳液具有良好的pH稳定性、热稳定性和贮藏稳定性。综上，蛋白质糖基化接枝修饰是提高天然蛋白质Pickering乳液稳定性的有效方法。In order to improve the stability of protein-based Pickering emulsion, Maillard reaction was used to prepare the whey protein isolate(WPI)-dextran(Dex) conjugate. The WPI-Dex conjugate was used to prepare protein-based solid particles, and then Pickering emulsion was prepared with medium-chain triglyceride. The effects of the WPI-Dex conjugate on the emulsification activity, emulsion stability of protein-base solid particles and creaming index of Pickering emulsion were investigated, as well as the change of diameter of Pickering emulsion under different pH, heating temperature and storage time. The results showed that scanning electron microscopy (SEM) observed the covalently grafted Dex transformed the morphologic structure of WPI from globular to flake. The WPI-Dex conjugate was successfully prepared by the dry state Maillard reaction, which was confirmed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Compared with WPI, the emulsification activity and emulsion stability of WPI-Dex conjugate increased by 57.8% and 138.5%, respectively. The creaming indexes of WPI and WPI-Dex conjugate Pickering emulsion stored for 30 d were 52.3% and 36.0%, respectively, and the creaming stability of WPI-Dex conjugate Pickering emulsion increased by 31.2%. WPI-Dex conjugate Pickering emulsion had good pH stability, thermal stability and storage stability. In conclusion, the glycosylation graft modification of protein is an effective method to improve the stability of natural protein Pickering emulsions.

Didymocarpus subpalmatinervis W.T.Wang was shown to be conspecific with Petrocodon lithophilus Y.M.Shui, W.H.Chen & Mich.Möller, by checking original literature, examining specimens, tracing specimen collecting history, and conducting field surveys. The results show morphological characteristics and geographical distribution overlaps between these two species. The transfer of Didymocarpus subpalmatinervis to Petrocodon as a new combination with Petrocodon subpalmatinervis (W.T.Wang) F.Wen & Z.L.Li is proposed here, and P. lithophilus is synonymized with P. subpalmatinervis. Color photographs and essential information are also provided, including a detailed comparison of description, distribution, habitat, and the proposed IUCN conservation status.

The construction of community elderly care facilities (CECF) is pivotal for promoting healthy aging and “aging in place” for older people. This study focuses on the low utilization rates of community elderly care facilities in the Dongcheng and Xicheng Districts, core areas of Beijing. The explainable machine learning method is used to analyze data across three dimensions: the elderly’s individual attributes, characteristics of the community elderly care station (CECS), and features of the built environment around CECS and subdistrict, to identify the important factors that influence the usage frequency of overall CECS and its different functional spaces, and also the correlation between factors and usage frequency of CECS. It shows that the most important factors are the features of CSCF, including the degree of space acceptance and satisfaction with services provided, which influence the usage frequency of nine functional spaces (R2 ≥ 0.68) and overall (R2 = 0.56). In addition, older people’s individual factors, such as age and physical condition, significantly influence the usage of specific spaces such as rehabilitation therapy rooms and assistive bathing rooms. The influence of built environment characteristics is relatively low, with factors such as the density of bus stations and housing prices within the subdistrict and the mean distance from CECF to the nearest subway stations being more important. These findings provide a reference for the construction of indoor environments, management of service quality, and optimal site selection for future community elderly care facilities.

(1) Background: Bifidobacterium plays a pivotal role within the gut microbiota, significantly affecting host health through its abundance and composition in the intestine. Factors such as age, gender, and living environment exert considerable influence on the gut microbiota, yet scant attention has been directed towards understanding the specific effects of these factors on the Bifidobacterium population. Therefore, this study focused on 98 adult fecal samples to conduct absolute and relative quantitative analyses of bifidobacteria. (2) Methods: Using droplet digital PCR and the PacBio Sequel II sequencing platform, this study sought to determine the influence of various factors, including living environment, age, and BMI, on the absolute content and biodiversity of intestinal bifidobacteria. (3) Results: Quantitative results indicated that the bifidobacteria content in the intestinal tract ranged from 106 to 109 CFU/g. Notably, the number of bifidobacteria in the intestinal tract of the school population surpassed that of the off-campus population significantly (p = 0.003). Additionally, the group of young people exhibited a significantly higher count of bifidobacteria than the middle-aged and elderly groups (p = 0.041). The normal-weight group displayed a significantly higher bifidobacteria count than the obese group (p = 0.027). Further analysis of the relative abundance of bifidobacteria under different influencing factors revealed that the living environment emerged as the primary factor affecting the intestinal bifidobacteria structure (p = 0.046, R2 = 2.411). Moreover, the diversity of bifidobacteria in the intestinal tract of college students surpassed that in the out-of-school population (p = 0.034). This was characterized by a notable increase in 11 strains, including B. longum, B. bifidum, and B. pseudolongum, in the intestinal tract of college students, forming a more intricate intestinal bifidobacteria interaction network. (4) Conclusions: In summary, this study elucidated the principal factors affecting intestinal bifidobacteria and delineated their characteristics of intestinal bifidobacteria in diverse populations. By enriching the theory surrounding gut microbiota and health, this study provides essential data support for further investigations into the intricate dynamics of the gut microbiota.

Petrocodon Hance is one of the famous ornamental flowers, but most of them are assessed as extremely dangerous (CR), or at least above vulnerable (VU) due to climate turbulence and strong interference of human activities. To reconstruct the temporal and spatial changes of the potential suitable areas of Petrocodon since the last interglacial period, and explore the response of the suitable areas to environmental changes, which provided theoretical guidance for the origin of Petrocodon, the study of geographical differentiation, the conservation of unique germplasm resources in China, and the development and utilization of gardens. In this paper, combined with 120 distribution records and 17 environmental variables, the optimal MaxEnt model and geographic information technology (ArcGIS) were used to simulate the suitable areas and distribution pattern of Petrocodon in China and Indo-China Peninsula. Based on stepwise multiple linear regression analysis, redundancy analysis and Monte-Carlo test, the dominant variables affecting the current geographical distribution of Petrocodon were evaluated. The results were as follows: (1) The prediction accuracy of the optimized MaxEnt model was high, and the AUC value was greater than 0.96. The potential suitable areas of Petrocodon for the present distribution are continuous from Southwest China to North Vietnam, scattered in central and southern China and blocky in North Myanmar, of which the South Yunnan-Guizhou Plateau in China was the most suitable. (2) The environmental variables which restrict the geographical distribution of Petrocodon included precipitation of the driest month (bio14), precipitation of the warmest quarter (bio18), precipitation of the wettest quarter (bio16), SD of the temperature seasonality (bio4), min temperature of the coldest month (bio6) and altitude (alt). (3) Under the climate change scenario, the expansion and contraction areas of the suitable habitat of Petrocodon were located in the north and northeast of the current potential distribution area, which were sensitive areas susceptible to climate change. During the last interglacial period, the suitable area of Petrocodon expanded on a large scale, but there was almost no suitable distribution area of Petrocodon in the dry and cold environment during the last glacial maximum. After that, with the aggravation of climate warming, the suitable habitats of Petrocodon increased rapidly to high latitudes, while the suitable habitat in low latitudes decreased. (4) The centroid position of the suitable area for Petrocodon migrated northwards from Yongfu County, Guangxi (110.10° E, 24.69° N) to Chengbu County, Hunan (110.29° E, 26.05° N). To sum up, global warming has a positive impact on the potential distribution area of Petrocodon, but extreme warming will cause the suitable habitat of Petrocodon to shrink, and the niche of Petrocodon will narrow. Southwest China to North Vietnam, which has the advantage of mature karst landform, may be its main refuge.

There are a lot of endemic and narrowly distributed species in Gesneriaceae in China’s higher plants, 805 known species (including infraspecies, the same below), belong to 45 genera, before December 31st, 2021, and mainly found from Southwest toward South China. Apart from a few species, most species in China are specifically turned the certain micro-habitats so that they are easily influenced becoming endangered status by the own and external factors. For better understanding the endangered risks of known species of Gesneriaceae in China, we re-assessed the IUCN red list categories of China’s Gesneriaceae taxa, then calculated and analyzed the data based on consulting relevant literature, collecting the endangered data of new reported taxa in recent years, and coupling with detailed field investigations for Gesneriaceae in China. At the same time, relied on Gesneriad Committee of China Wild Plant Conservation Association, National Gesneriaceae Germplasm Resources Bank of GXIB and Gesneriad Conservation Center of China, we first created and formulated a new mode for the conservation of China’s Gesneriaceae plants, which executed simultaneously new taxa discoveries and formal publications, assessments of the taxon’s endangered status, immediately launching conservation programs and new horticultural variety cultivations. Analysis results demonstrate that it is necessary to enhance the attention degree of protection of Gesneriaceae biodiversity by relevant government departments. Thus, we suggest: (1) To further strengthen the understanding for the urgency of protection of China's Gesneriaceae germplasm resource; (2) To conduct series of researches about rescuing conservation, ex & in-situ conservation, re-introduction in similar habitats and development for those groups in CR & EN categories; (3) To promote the development of breeding of new horticultural varieties of Gesneriaceae. All are the important base and essential precondition of Gesneriaceae biodiversity conservation.

Primulina jiulianshanensis F.Wen & G.L.Xu, a new species of Gesneriaceae from Jiulianshan National Nature Reserve of Jiangxi Province, China, is described and illustrated here. Molecular evidence showed it was sister to P. wenii Jian Li & L.J.Yan, while the morphological observation found clear differences between them, petiole, both sides of leaf blades, adaxial surface of the calyx lobes, corolla inside toward the bottom, bract margins covered glandular-pubescent hairs in P. jiulianshanensis (vs. no glandular-pubescent hairs in P. wenii); lateral bracts 4–9 × ca. 2 mm, the central one 2–5 × 1–1.5 mm, adaxially glabrous but sparsely pubescent at apex (vs. lateral bracts 14–16 × 2.5–3.0 mm, the central one 10–12 × 1.3–1.6 mm, all adaxially pubescent); calyx lobes 8–11 × ca. 2 mm, each side with several brown serrate teeth at apex (vs. 14–15 × ca. 2.5 mm, margin entire); filaments and staminodes sparsely yellow glandular-puberulent (vs. white, glabrous).

Background and aim: Gastric cancer (GC) is a common malignant tumor worldwide. Modified Gui-shao-liu-jun-zi decoction (mGSLJZ) is a clinically effective traditional Chinese medicine (TCM) compound in GC treatment. This study aimed to analyze main chemical substances of mGSLJZ and investigate active ingredients and molecular mechanism of mGSLJZ against GC. Experimental procedure: HPLC-Q-TOF-MS/MS was used to analyze chemical substances of mGSLJZ, and potential active ingredients were screened from TCMSP. The target set of mGSLJZ for GC was obtained based on SwissTargetPrediction. The PPI network was constructed to screen out core targets. GO and KEGG enrichment analyses were conducted to identify BPs, CCs, MFs and pathways. The ''active ingredient-core target-pathway'' regulatory network was constructed to obtain core substances. Subsequently, Oncomine, Proteinatlas and molecular docking were performed to validate these findings. The cell experiments were conducted to confirm the anti-GC effects of mGLSJZ. Results and conclusion: Forty-one potential active ingredients were filtered out from 120 chemical substances in mGSLJZ, including various organic acids and flavonoids. The top 10 key targets, 20 related pathways and 6 core medicinal substances were obtained based on network pharmacology analysis. Molecular docking results indicated that the core substances and key targets had good binding activities. The cell experiments validated that mGSLJZ and the core substances inhibited the proliferation in multiple GC cells and that mGLSJZ restrained the migration of GC. Meanwhile, the top 5 targets and top 2 pathways were verified. The rescue experiments demonstrated that mGSLJZ suppressed the proliferation and migration of GC through the PI3K/AKT/HIF-1 pathway.

Petrocodon wui F.Wen & R.B.Zhang (Gesneriaceae), a typically lithophyte occurring in the Danxia areas of north-western Guizhou, China, is described and illustrated as new to science. The new species shows overall similarity with P. chishuiensis Z.B.Xin, F.Wen & S.B.Zhou, which is also its sister species, based on molecular evidence. The new species can be distinguished from P. chishuiensis by the elongated rhizome, the relatively long indumentum on the peduncle, the shape, size and indumentum of calyx lobes, the location of the stamens in the corolla tube and the shape, size and indumentum of the stigma. We provide a diagnosis, detailed description, photographic images and a table with taxonomic notes to distinguish several other morphologically similar Petrocodon species.

In the digital era, web applications have become a prevalent tool for businesses. As the number of web applications continues to grow, they become enticing targets for malicious actors seeking to exploit potential security vulnerabilities. Organizations face constant risks associated with vulnerabilities in their web-based software systems, which can result in data breaches, service disruptions, and a loss of trust. Consequently, organizations require an effective and efficient approach to assess and analyze the security of acquired web-based software, ensuring sufficient confidence in its utilization. This research aims to enhance the quantitative evaluation and analysis of web application security through a model-based approach. We focus on integrating the Open Web Application Security Project's (OWASP) Application Security Verification Standard (ASVS) into a structured and analyzable metamodel. This model aims to effectively assess the security levels of web applications while offering valuable insights into their strengths and weaknesses. By combining the ASVS with a comprehensive framework, we aim to provide a robust methodology for evaluating and analyzing web application security.

The global problem of petroleum contamination in soils seriously threatens environmental safety and human health. Current studies have successfully demonstrated the feasibility of bioelectrokinetic and bioelectrochemical remediation of petroleum-contaminated soils due to their easy implementation, environmental benignity, and enhanced removal efficiency compared to bioremediation. This paper reviewed recent progress and development associated with bioelectrokinetic and bioelectrochemical remediation of petroleum-contaminated soils. The working principles, removal efficiencies, affecting factors, and constraints of the two technologies were thoroughly summarized and discussed. The potentials, challenges, and future perspectives were also deliberated to shed light on how to overcome the barriers and realize widespread implementation on large scales of these two technologies.

Quantum sensors based on NV centers in diamond are well established, however the sensitivity of detection of high-frequency radio signals has been limited. Here the authors use nanoscale field-focusing to enhance sensitivity and demonstrate ranging for GHz radio signals in an interferometer set-up.

Aeschynanthus smaragdinus F.Wen & J.Q.Qin, a new species of Gesneriaceae from the monsoon rain forest in Mangbang township, Tengchong City, Yunnan Province, China, is described and illustrated here. It morphologically resembles A. chiritoides C.B.Clarke in size, shape and hairs on the leaf blades. But it can easily be distinguished from the latter by the green corolla limb with brownish-red to maroon lower lobes. At the same time, the hairs of the pedicel and calyx lobes, the length of the staminode and the size of the seed grain can also help distinguish both. It is provisionally assessed as Data Deficient (DD), according to the IUCN Red List Categories and Criteria, because field surveys for this new taxon have not been completed.

Microchirita minor (Gesneriaceae), a new species from the limestone area in Son La Province, north-western Vietnam, is described here. The new species resembles M. hamosa, but it differs by the combination of corolla tube shape, stamens number and the length of pistil. Detailed morphological description, together with photographic plates, information on phenology, distribution, ecology and preliminary conservation status of the new species are presented.

Oreocharis polyneura, a new species from southern Yunnan, China, is described and illustrated. It is morphologically similar to O. rhytidophylla by having more obvious lateral veins forming a crosslinked network on the adaxial surface of leaf blades, but can be distinguished by having more lateral veins (12–15 pairs vs. 7–9 pairs) of leaf blades, shorter corolla tubes (the length ratio of corolla tube to corolla lobes = 1.2–2.9 vs. 3.4–6) and shorter pistils (6–8 mm long vs. 27–30 mm long). In addition, a detailed morphological description, a photographic illustration, the distribution and phenology of the new species are presented.

Abstract Hexagonal boron nitride (hBN) has recently been demonstrated to contain optically polarized and detected electron spins that can be utilized for implementing qubits and quantum sensors in nanolayered-devices. Understanding the coherent dynamics of microwave driven spins in hBN is of crucial importance for advancing these emerging new technologies. Here, we demonstrate and study the Rabi oscillation and related phenomena of a negatively charged boron vacancy (V $${}_{{{{{{{{\rm{B}}}}}}}}}^{-}$$ B − ) spin ensemble in hBN. We report on different dynamics of the V $${}_{{{{{{{{\rm{B}}}}}}}}}^{-}$$ B − spins at weak and strong magnetic fields. In the former case the defect behaves like a single electron spin system, while in the latter case it behaves like a multi-spin system exhibiting multiple-frequency dynamical oscillation as beat in the Ramsey fringes. We also carry out theoretical simulations for the spin dynamics of V $${}_{{{{{{{{\rm{B}}}}}}}}}^{-}$$ B − and reveal that the nuclear spins can be driven via the strong electron nuclear coupling existing in V $${}_{{{{{{{{\rm{B}}}}}}}}}^{-}$$ B − center, which can be modulated by the magnetic field and microwave field.

Abstract Background The drug resistance of tumor stem cells is an obstacle in gastric cancer (GC) treatment and the high expression of ABC transporters is a classic reason for drug resistance. This study aimed to construct a reliable GC drug-resistant stem cell model and explore the inhibitory effect and mechanism of Yi-qi-hua-yu-jie-du medicated serum (YQHY) on the drug resistance of GC stem cells based on ABC transporters. Methods The tumor stemness biomarker CD44 was primary identification from WGCNA. The magnetic-activated cell sorting (MACS) method was used to separate CD44( +)BGC823/5-Fu (BGC823/5–Fu-CSCs) cells and the stemness characteristics were verified from multiple dimensions. Then, the drug resistance index and expression of ABC transporter genes MDR1 and MRP1 were detected in CD44(−)/CD44(+) cells. The inhibition and apoptosis rates of the cells administrated with YQHY or/and 5-Fu were calculated to confirm that YQHY can suppress the drug resistance of BGC823/5-Fu-CSCs. Afterwards, the effects of YQHY on the expression of MDR1 and MRP1 and the activation of the PI3K/Akt/Nrf2 pathway were observed. Finally, under the administration of IGF-1 (the activator of PI3K/Akt pathway) and Nrf2 siRNA, the mechanism of YQHY on reversing the drug resistance of BGC823/5–Fu-CSCs through inhibiting the expression of MDR1 and MRP1 via PI3K/Akt/Nrf2 was verified. Results CD44 was a reliable GC stemness biomarker and can be applied to construct the drug-resistant GC stem cell model CD44(+)BGC823/5-Fu. The growth rate, cell proliferation index, soft agar colony formation, expression of stemness specific genes and tumorigenesis ability of CD44(+)BGC823/5-Fu cells were significantly higher than those of CD44(−)BGC823/5-Fu cells. BGC823/5–Fu-CSCs exhibited strong drug resistance to 5-Fu and high expression of ABC transporter genes MDR1 and MRP1 compared to CD44(-) cells. YQHY increased the inhibition and apoptosis rates to efficiently inhibit the drug resistance of BGC823/5–Fu-CSCs. Meanwhile, it suppressed the expression of MDR1 and MRP1 and restrained the activation of PI3K/Akt/Nrf2 signaling pathway. Finally, it was found that IGF-1 partially restored the activation of PI3K/Akt/Nrf2 pathway, alleviated the inhibition of MDR1 and MRP1, blocked the proliferation-inhibitory and apoptosis-promotion effects. YQHY and si-Nrf2 synergistically suppressed the MDR1/MRP1 expression and the drug resistance of BGC823/5–Fu-CSCs. Conclusions CD44 was a reliable GC stemness biomarker, and the high expression of ABC transporter genes MDR1 and MRP1 was an important feature of drug-resistant stem cells. YQHY inhibited the MDR1 and MRP1 expression via PI3K/Akt/Nrf2 pathway, thus reversing the drug resistance of BGC823/5–Fu-CSCs.

A new species of Oreocharis, O. guangwushanensis from the Sichuan Province of south-western China, is described and illustrated here. This new species has a pink corolla that is different from other species of Oreocharis in southwest China and, although it is morphologically similar to O. ronganensis and O. reticuliflora, it has significant differences in the colour and shape of the corolla, the apex of the corolla limb, shape and indumentum of the filaments and a shorter pistil. A detailed description, colour photographs, distribution and habitat, as well as the IUCN conservation status, are also provided.

Abstract Bismuth-based materials (e.g., metallic, oxides and subcarbonate) are emerged as promising electrocatalysts for converting CO2 to formate. However, Bio-based electrocatalysts possess high overpotentials, while bismuth oxides and subcarbonate encounter stability issues. This work is designated to exemplify that the operando synthesis can be an effective means to enhance the stability of electrocatalysts under operando CO2RR conditions. A synthetic approach is developed to electrochemically convert BiOCl into Cl-containing subcarbonate (Bi2O2(CO3) x Cl y ) under operando CO2RR conditions. The systematic operando spectroscopic studies depict that BiOCl is converted to Bi2O2(CO3) x Cl y via a cathodic potential-promoted anion-exchange process. The operando synthesized Bi2O2(CO3) x Cl y can tolerate − 1.0 V versus RHE, while for the wet-chemistry synthesized pure Bi2O2CO3, the formation of metallic Bio occurs at − 0.6 V versus RHE. At − 0.8 V versus RHE, Bi2O2(CO3) x Cl y can readily attain a FEHCOO- of 97.9%, much higher than that of the pure Bi2O2CO3 (81.3%). DFT calculations indicate that differing from the pure Bi2O2CO3-catalyzed CO2RR, where formate is formed via a *OCHO intermediate step that requires a high energy input energy of 2.69 eV to proceed, the formation of HCOO− over Bi2O2(CO3) x Cl y has proceeded via a *COOH intermediate step that only requires low energy input of 2.56 eV.

Primulina nana C.Xiong, W.C.Chou & F.Wen, a new species of Gesneriaceae from limestone areas of Guangxi, China, is described and illustrated here. It morphologically resembles P. yangshuoensis Y.G.Wei & F.Wen in papillose leaf surface, but can be easily distinguished from the latter by noting a combination of characteristics, especially in its leaf blades, leaf blade indumentum characteristic, calyx lobes, corolla and the disc. We found only one population at the type locality, about 200 mature individuals. According to the IUCN Red List Categories and Criteria (Version 3.1), the new species is provisionally assessed as Critically Endangered (CR).

Abstract Background Indwelling urethral catheters are widely used in clinical settings. Catheter-associated urinary tract infection has been recognized as a common adverse event in older patients. However, noninfectious complications are almost 5 times as common as infectious complications, and insufficient attention has been given to noninfectious complications. Given this importance, a novel intervention related to removing unnecessary catheters in a timely manner to promote, after removal, the recovery of self-voiding function is herein developed to reduce infectious and noninfectious complications associated with indwelling urethral catheters in hospitalized older patients. Methods A quasi-experimental study design was adopted. Patients aged 65 and older who had a urinary catheter placed within 24 h of hospital admission were included. All patients were allocated into either an intervention group, in which the novel intervention developed in the study was implemented, or a control group, who received care as usual. The outcomes of this study were to evaluate whether the novel intervention reduced the incidence of the following: catheter-associated urinary tract infections, catheter-associated noninfectious complications, decline in activities of daily living, and new nursing home admissions. Results Of 106 hospitalized older patients who consented to participate, 92 completed follow-up until discharge, including 49 in the control group and 43 in the intervention group. The patients in the intervention group were significantly older than those in the control group [83.72 ± 9.18 vs. 80.26 ± 7.66, p = 0.038], and no differences were found between the groups in other demographics or present health conditions. Multivariable logistic regression analysis showed that the control group was more likely to develop noninfectious complications [adjusted odds ratio: 3.01, 95% confidence interval: 1.32–6.81] and a decline in ADLs [adjusted odds ratio: 11.20, 95% confidence interval: 3.68–34.00]. Conclusions A novel intervention can be effective as a means of reducing noninfectious complications associated with indwelling urethral catheters in hospitalized older patients. This approach will help to standardize urethral catheter care, and it highlights the fact that health care professionals can play a crucial role in preventing harm from urethral catheters.

It is difficult to identify and locate the defects quickly when the long cable line cross-bonded box has defects such as grounding,water inflow and three-phase sequence error. Aiming at three types of typical defects of cross-bonded box,a cross-bonded model of long cable lines is established to analyze the amplitude and phase change rule of circulation under the defects. Then,the curve fitting of the ratio of circulation at both ends and the scatter data of defect box number are carried out to obtain the defect location formulas. Finally,it is verified by an example. The results show that the circulation amplitude of the defective phase increases and the non-defective phase is normal when the ground is grounded inside the box. When the phase sequence is wrong,the amplitude of two-phase circulation increases obviously,and the amplitude of the other phase circulation is smaller. When the tank is filled with water,the circulation amplitude of each phase increases and is basically equal. The fitting degree of the positioning formula is about 0.96,and the range of defect box number can be determined through the example verification. The proposed method is not affected by the change of wire core current and ground resistance,and can provide reference for the defect identification and location of long cable line cross-bonded box.

Abstract The formation of gastric cancer (GC) is a complicated process involving multiple factors and multiple steps. The tumor–immune microenvironment is essential for the growth of GC and affects the prognosis of patients. We performed multiple machine learning algorithms to identify immunophenotypes and immunological characteristics in GC patients’ information from the TCGA database and extracted immune genes relevance of the GC immune microenvironment. C-X-C motif chemokine receptor 4 (CXCR4), belongs to the C-X-C chemokine receptor family, which can promote the invasion and migration of tumor cells. CXCR4 expression is significantly correlated to metastasis and the worse prognosis. In this work, we assessed the condition of immune cells and identified the connection between CXCR4 and GC immune microenvironment, as well as the signaling pathways that mediate the immune responses involved in CXCR4. The work showed the risk scores generated by CXCR4-related immunomodulators could distinguish risk groups consisting of differential expression genes and could use for the personalized prognosis prediction. The findings suggested that CXCR4 is involved in tumor immunity of GC, and CXCR4 is considered as a potential prognostic biomarker and immunotherapy target of GC. The prognostic immune markers from CXCR4-associated immunomodulators can independently predict the overall survival of GC.

Abstract Aims Suicidal acts may cluster in time and space and lead to community concerns about further imitative suicidal episodes. Although suicide clusters have been researched in previous studies, less is known about the clustering of non-fatal suicidal behaviour (self-harm). Furthermore, most previous studies used crude temporal and spatial information, e.g., numbers aggregated by month and residence area, for cluster detection analysis. This study aimed to (i) identify space–time clusters of self-harm and suicide using daily incidence data and exact address and (ii) investigate the characteristics of cluster-related suicidal acts. Methods Data on emergency department presentations for self-harm and suicide deaths in Taipei City and New Taipei City, Taiwan, were used in this study. In all-age and age-specific analyses, self-harm and suicide clusters were identified using space–time permutation scan statistics. A cut-off of 0.10 for the p value was used to identify possible clusters. Logistic regression was used to investigate the characteristics associated with cluster-related episodes. Results A total of 5,291 self-harm episodes and 1,406 suicides in Taipei City (2004–2006) and 20,531 self-harm episodes and 2,329 suicides in New Taipei City (2012–2016) were included in the analysis. In the two cities, two self-harm clusters (n [number of self-harm episodes or suicide deaths in the cluster] = 4 and 8 in Taipei City), four suicide clusters (n = 3 in Taipei City and n = 4, 11 and 4 in New Taipei City) and two self-harm and suicide combined clusters (n = 4 in Taipei City and n = 8 in New Taipei City) were identified. Space–time clusters of self-harm, suicide, and self-harm and suicide combined accounted for 0.05%, 0.59%, and 0.08% of the respective groups of suicidal acts. Cluster-related episodes of self-harm and suicide were more likely to be male (adjusted odds ratio [aOR] = 2.22, 95% confidence interval [CI] 1.26, 3.89) and young people aged 10–29 years (aOR = 2.72, 95% CI 1.43, 5.21) than their cluster-unrelated counterparts. Conclusions Space–time clusters of self-harm, suicide, and self-harm and suicide combined accounted for a relatively small proportion of suicidal acts and were associated with some sex/age characteristics. Focusing on suicide deaths alone may underestimate the size of some clusters and/or lead to some clusters being overlooked. Future research could consider combining self-harm and suicide data and use social connection information to investigate possible clusters of suicidal acts.

BackgroundAnlotinib may boost the efficacy of pancreatic cancer (PC) treatment if timely added to the GS regimen (Gemcitabine, Tegafur-gimeracil-oteracil potassium); however, no data has been published. This study evaluated the safety and efficacy of anlotinib in combination with the GS regimen(hereafter referred to as the A+GS regimen) in the first-line treatment of patients with unresectable or metastatic PC.MethodsPatients with unresectable or metastatic PC treated at Yueyang Central Hospital and Yueyang People’s Hospital between October 2018 and June 2022 were enrolled in this retrospective real-world investigation. Treatment efficacy was evaluated based on the overall survival (OS), progression-free survival (PFS), disease control rate (DCR), and objective response rate (ORR), while the treatment safety was assessed by the frequency of major adverse events (AEs).ResultsSeventy-one patients were included in this study, 41 in the GS group and 30 in the A+GS group. The A+GS group had a longer mPFS than the GS group (12.0 months (95% CI, 6.0–18.0) and 6.0 months (95% CI, 3.0–8.1)), respectively (P = 0.005). mOS was longer in the GS+A group) when compared with the GS group (17.0 months (95%CI, 14.0–20.0) and 10.0 months (95% CI, 7.5–12.5)), respectively (P = 0.018). The GS+A group had higher ORR (50.0% vs 26.8%, P = 0.045) and DCR (83.3% vs 58.5%, P = 0.026). Furthermore, there were no grade 4-5 AEs and no treatment-related deaths, and no discernible increase in AEs in the GS+A group when compared with the GS group.ConclusionThe A+GS regimen therapy holds great promise in managing treatment-naive advanced PC, except that future prospective studies with larger sample sizes and multiple centers are required to determine its efficacy and safety.

While maintaining information over a delay of time, working memory (WM) also allows individuals to prepare the mnemonic contents for prospective utilisation. However, it remains unclear whether the expectation of the time of WM test could modulate neural responses during the retention interval of WM and subsequent performance. Here, we investigated whether temporal expectations based on the variability of delay duration can modulate 9–13 Hz alpha oscillations during WM retention and whether the expectation-induced alpha activity was associated with WM performance. Participants performed a retro-cueing WM task with magnetoencephalography (MEG) (Experiment 1) and a standard WM task with electroencephalography (EEG) (Experiment 2). The expectation of the timing of the WM test was manipulated by the temporal structure of the tasks with small or large variability in the delay durations. We showed that alpha oscillations during retention interval and WM performance varied with duration variability in both of the MEG and EEG experiments. The novel finding was greater alpha-power attenuation over the left frontal and parietal regions during WM retention when the duration variability was small and the test onset was predictable, compared to when the duration variability was large and the test onset was less predictable. Importantly, we observed a positive relationship in variability difference between the response benefit and alpha-power attenuation in the left posterior parietal regions at both MEG-source and EEG-electrode levels. Finally, we confirmed the behavioural benefit when a condition with a fixed delay-duration was included in a behavioural experiment (Experiment 3). When conjoined, the delay duration enables individuals to anticipate when the relevant information would be put to work, and alpha oscillations track the anticipatory states during WM maintenance.

Oreocharis phuongii, a new species of Gesneriaceae from central Vietnam, is described and illustrated here. The new species is most similar to O. longifolia by sharing peduncles up to 22 cm long, bracts 2, zygomorphic, yellow flowers with tubular corolla, stamens 4 with two pairs of coherent anthers and capsules up to 6 cm long. It mainly differs from the latter by the combination of some morphological characters of leaves (shape, base, apex and margin), size of calyx lobes, indumentum of corolla tube and inner surface of three lower corolla lobes. Detailed morphological description together with colour illustration, information on phenology, distribution, ecology, preliminarily conservation status of the new species and comparison with its similar species are also presented.

Abstract Background Physical resilience is known to minimize the adverse outcomes of health stressors for older people. However, validated instruments that assess physical resilience in older adults are rare. Therefore, we aimed to validate the Physical Resilience Instrument for Older Adults (PRIFOR) to fill the literature gap. Methods Content analysis with content validity was first carried out to generate relevant items assessing physical resilience for older adults, and 19 items were developed. Psychometric evaluation of the 19 items was then tested on 200 older adults (mean [SD] age = 76.4 [6.6] years; 51.0% women) for item properties, factor structure, item fit, internal consistency, criterion-related validity, and known-group validity. Results All 19 items had satisfactory item properties, as they were normally distributed (skewness = -1.03 to 0.38; kurtosis = -1.05 to 0.32). However, two items were removed due to substantial ceiling effects. The retained 17 items were embedded in three factors as suggested by the exploratory factor analysis (EFA) results. All items except one had satisfactory item fit statistics in Rasch model; thus, the unidimensionality was supported for the three factors on 16 items. The retained 16 items showed promising properties in known-group validity, criterion-related validity, and internal consistency (α = 0.94). Conclusions The 16-item PRIFOR exhibits good psychometric properties. Using this instrument to measure physical resilience would be beneficial to identify factors that could protect older people from negative health consequence. With the use of the PRIFOR, intervention effects could also be evaluated. It is helpful to strengthen resilience and thereby facilitate successful aging.

Actinostephanus, a new genus from southern China, is described and colorfully illustrated with a single species, A. enpingensis. This new genus is morphologically most similar to Boeica and Leptoboea, nevertheless, it can be easily distinguished from the latter two by the following characteristics, such as leaves in whorls of three, all closely clustered at the top; corolla bowl-shaped, 5-lobed, actinomorphic; capsule hard, oblong-ovoid, short, 3–4 mm long, densely appressed villous, wrapped by persistent densely pubescent calyx lobes, style persistent. The new genus and related genera were sequenced using the next-generation sequencing technique. The whole plastid genome of the new genus is 154, 315 – 154, 344 bp in length. We reconstructed phylogenetic trees using the dataset of 80 encoded protein genes of the whole plastid genome from 47 accessions based on ML and BI analyses. The result revealed that the new genus was recovering in a polytomy including Boeica, Rhynchotechum, and Leptoboea with strong support, congruent to the morphological evidence. A global conservation assessment was also performed and classifies A. enpingensis as Least Concern (LC). In addition, after a review of recently described species of Gesneriaceae, we propose that plant enthusiasts, especially Gesneriad fans, have been playing an increasingly important role in the process of new taxa-discoveries.

The sensitivity of practical solid quantum sensing can be boosted up by increasing the number of probes. However, the effects of spin dephasing caused by inhomogeneous broadening and imperfect quantum control can reduce the fidelity of quantum control and the sensitivity of quantum sensing with the dense ensemble of probes, such as nitrogen-vacancy (NV) centers in diamond. Here, we present a robust and effective composite-pulse for high fidelity operation against inhomogeneous broadening and control errors via optimized modulation of the control field. Such a composite-pulse was verified on NV center to keep high fidelity quantum control up to a spectrum detuning as large as 110% of Rabi frequency. The sensitivity of the magnetometer with NV center ensemble was experimentally improved by a factor of 4, comparing to dynamical decoupling with a normal rectangular pulse. Our work marks an important step towards high trustworthy ultra-sensitive quantum sensing with imperfect quantum control in practical applications. The used principle is universal and not restricted to NV center ensemble magnetometer.

Aging is a biological process that leads to the progressive deterioration and loss of physiological functions in the human body and results in an increase in morbidity and mortality, and aging-related disease is a major global problem that poses a serious threat to public health. Polysaccharides have been shown to delay aging by reducing oxidative damage, suppressing inflammatory responses, and modulating intestinal microbiota. Our previous studies have shown that polysaccharide CPP-1 extracted from the root of Codonopsis pilosula possesses noticeable anti-oxidant activity in vitro. Thus, in our study, we tested the anti-aging effect of CPP-1 in naturally aging mice (in vivo). Eighteen C57/BL mice (48-week-old, male) were divided into a control group, high-dose CPP-1 group (20 mg/mL), and low-dose CPP-1 group (10 mg/mL). We discovered that CPP-1 can exert a reparative effect on aging stress in the intestine and liver, including alleviating inflammation and oxidative damage. We revealed that CPP-1 supplementation improved the intestinal microbiota composition and repaired the intestinal barrier in the gut. Furthermore, CPP-1 was proved to modulate lipid metabolism and repair hepatocyte injury in the liver by influencing the enterohepatic axis associated with the intestinal microbiota. Therefore, we concluded that CPP-1 prevents and alleviates oxidative stress and inflammatory responses in the intestine and liver of aging mice by modulating the intestinal microbiota-related gut–liver axis to delay aging.

Nonequilibrium thermodynamics provides a general framework for understanding nonequilibrium processes, particularly in small systems that are typically far from equilibrium and dominated by fluctuations. However, the experimental investigation of nonequilibrium thermodynamics remains challenging due to the lack of approaches to precisely manipulate nonequilibrium states and dynamics. Here, by shaping the effective potential of energy, we propose a general method to construct a nonequilibrium steady state (NESS) with arbitrary energy distribution. Using a well-designed energy-dependent feedback damping, the dynamics of an optically levitated nanoparticle in vacuum is manipulated and driven into a NESS with the desired energy distribution. Based on this approach, a phonon laser state is constructed with an ultra-narrow linewidth of 6.40µHz. Such an arbitrary NESS construction method provides an approach to manipulating the dynamics processes of micromechanical systems and paves the way for the systematic study of nonequilibrium dynamics in interdisciplinary research fields.

Abstract In this study, through employing the mixed‐ligand synthesis method, a novel coordination polymer (CP) containing Cu(II) has been synthesized in success with the reaction of 4‐bmbpd and Cu(NO3)2·3H2O in the presence of auxiliary polycarboxylate ligand 1,3,5‐H3BTC under hydrothermal conditions, and the chemical formula of this compound is [Cu(4‐bmbpd)(1,3,5‐HBTC)]·2H2O (1) (1,3,5‐H3BTC is 1,3,5‐benzenetricarboxylic acid and 4‐bmbpd is N,N′‐bis(4‐methylenepyridin‐4‐yl)‐1,4‐benzenedicarboxamide). The assessment of its prevention and predictive nursing activity on the hypothermia during laparoscopic cholecystectomy operation was conducted and the corresponding mechanism was studied simultaneously. The molecular docking simulation helps for identifying that the carboxylate group and the amide group form multiple H‐bonds with respect to the active sites within the docking pocket of the target protein.

Paraboea (Gesneriaceae) distributed in the karst areas of South and Southwest China and Southeast Asia, is an ideal genus to study the phylogeny and adaptive evolution of karst plants. In this study, the complete chloroplast genomes of twelve Paraboea species were sequenced and analyzed. Twelve chloroplast genomes ranged in size from 153166 to 154245 bp. Each chloroplast genome had a typical quartile structure, and relatively conserved type and number of gene components, including 131 genes which are composed of 87 protein coding genes, 36 transfer RNAs and 8 ribosomal RNAs. A total of 600 simple sequence repeats and 389 non-overlapped sequence repeats were obtained from the twelve Paraboea chloroplast genomes. We found ten divergent regions (trnH-GUG-psbA, trnM-CAU, trnC-GCA, atpF-atpH, ycf1, trnK-UUU-rps16, rps15, petL, trnS-GCU-trnR-UCU and psaJ-rpl33) among the 12 Paraboea species to be potential molecular markers. In the phylogenetic tree of 31 Gesneriaceae plants including twelve Paraboea species, all Paraboea species clustered in a clade and confirmed the monophyly of Paraboea. Nine genes with positive selection sites were detected, most of which were related to photosynthesis and protein synthesis, and might played crucial roles in the adaptability of Paraboea to diverse karst environments. These findings are valuable for further study of the phylogeny and karst adaptability of Gesneriaceae plants.