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Abstract Background Adolescents in their school-age period undergo rapid changes in various aspects, such as physiological development, academic pressure, and interpersonal relationships, constitute a high-risk group for depression. Parental educational involvement, as a critical family variable, influences not only children’s academic achievement but also their psychological well-being. However, previous research has shown significant discrepancies regarding the relationship between parental educational involvement and adolescent depressive symptoms. Methods To elucidate the overall strength of the association between parental educational involvement and adolescent depressive symptoms, this study systematically searched Web of Science, Medline, PubMed, CNKI, and other Chinese and English databases. A meta-analysis was conducted on 22 selected studies encompassing 36 effect sizes and involving 390,094 participants. Results The results revealed a moderate negative correlation between parental educational involvement and adolescent depressive symptoms (r = -0.200, 95% CI [-0.26, -0.14]). Additionally, the relationship between parental educational involvement and adolescent depressive symptoms was found to be moderated by factors such as adolescent age, grade level and the reporter of parental educational involvement. However, it was not influenced by the female ratio or cultural background. Conclusions This study offers the inaugural comprehensive assessment of the relationship between parental educational involvement and adolescent depressive symptoms, with variations observed across different ages, grade levels, and reporter of parental educational involvement.

Abstract The detection of defects on the copper chain in the production process of tobacco cutters is crucial for ensuring product quality. Traditional defect detection methods often rely on spatial domain image analysis, which not only has a large computational load but also performs poorly in handling high‐frequency noise and complex backgrounds. To address this issue, this paper proposes a novel neural network model based on frequency domain analysis, called frequency domain attention network. This network first utilizes discrete cosine transform to transform the image from the spatial domain to the frequency domain, effectively reducing computational complexity and improving processing speed. Subsequently, through the innovative frequency domain attention module, the network automatically identifies and enhances key discriminative features in the frequency domain, thereby strengthening the model's ability to identify defects. Finally, the frequency domain attention map, after feature extraction and integration, is inputted into the coupling detection head to achieve high‐precision defect detection. The experimental results show that our method outperforms the SOTA method with an increase of 0.03 in AP and 21 in FPS.

Aimed at the new application scenario of laser, a test platform was established to study the coating material da-mage features induced by the interaction of the Ma=6 tangential air flow and the continuous laser irradiation. The laser-damaged characteristics of the coating materials in still air and Ma=6 ground-simulated airflows, as well as the corresponding interference flow structures, were presented. Compared with the laser-irradiation ablation phenomenon of the coating materials in still air, the laser-induced damage characteristics of coating materials are significantly different in hypersonic tangential airflows. Under the interaction of hypersonic airflows, the coating materials show a larger damage area when the laser power is low, while the coating materials form deeper ablation pits when the laser power is high. Due to the disturbance from the material ablation, flow patterns similar to those produced by a thermal jet or small protrusion are formed around the ablative structure of coating materials. This phenomenon, in turn, affects the ablation of coating materials, producing a strong coupling phenomenon between hypersonic flow and laser ablation. The results can provide important guidance for engineering applications.

The quest for clean, efficient engine technologies is imperative in reducing transportation’s environmental impact. Hydrogen, as a zero-emission fuel, offers significant potential for internal combustion engines but faces challenges such as optimizing engine performance and longevity. Water injection is proposed as a solution, yet its effects on engine performance require thorough investigation. This study bridges the knowledge gap by examining various water injection ratios (WIRs) and their impact on engine performance, focusing on the balance between power output and engine longevity. We identified the existence of an optimum WIR (e.g., 10% in this study), which provides peak performance with minimal adverse effects on engine performance and health. Computational simulations of a single-cylinder engine revealed how WIRs influence in-cylinder temperature, pressure, and IMEP, emphasizing the nuanced benefits of water injection. Additionally, our analysis of turbulence, through TKE and dissipation rate, deepens the understanding of combustion and fuel efficiency in hydrogen engines. This research provides valuable guidance for optimizing engine operations and paves the way for advanced water injection systems in hydrogen engines, marking a significant step towards cleaner engine technology.

Although lignin improves the strength and modulus of soil, it is less active when unmodified, and it exhibits more limited effects on soils in combination with traditional Ca-based curing agents. Lignin-solidified soil also exhibits deficiencies, such as poor durability under dry–wet cycling conditions, and thus, the amelioration effect is limited. This study investigated the enhancement of cement-solidified soil using hydroxylated lignin with sodium silicate and quicklime used as activators to improve the engineering performance and durability of the treated soil. Using respective cement, sodium silicate, quicklime, and lignin contents of 7%, 0.4%, 0.2%, and 0.2% with respect to the dry mass of the slag soil, the strength and cohesion of the composite-solidified soil were 1.5 times those of cement-solidified soil, whereas the internal friction angle increased by 5.1°. At a solidifying age of 14 d, the penetration resistance almost doubled, indicating a significant improvement in the bearing capacity of the soil. The results suggest that modified lignin-based admixtures may significantly enhance the performance of cement-solidified soil. The cement curing admixture used in this study provides theoretical and technological support for curing agent preparation and the utilization of slag.

Building sustainable and affordable transport systems is a key issue for social development and sustainable urban expansion. The study used dynamic ordinary least squares (DOLS) and fully modified ordinary least squares (FMOLS) to examine the impact of transport infrastructure investment on environmental degradation in China, Japan, and South Korea over the period 1995–2020 and the validity of the EKC hypothesis. The results show that GDP has a significant positive effect, and GDP2 and GDP3 have significant adverse effects on environmental degradation, respectively. These results confirm the validity of the inverted U shaped EKC hypothesis in selected Asian countries. Road infrastructure investment has a significant positive effect, while railway infrastructure investment has a significant adverse effect on environmental degradation. Air infrastructure investment and trade opening have a progressive and statistically significant impact on environmental pollution. Modern rail systems that run on electricity are considered less polluting, so the share of rail infrastructure investment in the transport mix can help build sustainable and safe transport systems at the city Centre and intercity levels and reduce emissions in Asian countries. Moreover, strict enforcement of the prevailing environmental conditions of trade agreements should be encouraged to reduce the increasing impact of free trade on environmental pollution.

High enthalpy stagnation gas can be converted into hypervelocity flow through the contraction—expansion nozzle. The enthalpy flow in the nozzle can be divided into three regions: an equilibrium region, a non-equilibrium region, and a frozen region. The stagnation gas with a total enthalpy of 13.4 MJ/kg is used to analyze the thermochemical non-equilibrium effects. At the selected conditions, the effects of a conical nozzle under different expansion angles of the expansion section, curvature radius of the throat, throat radius, and convergence angle of the convergent section are investigated. Based on the Spalart–Allmaras one-equation turbulence model with the Catris–Aupiox compressibility correction, a multi-block solver for axisymmetric compressible Navier–Stokes equations is applied to simulate the thermochemical non-equilibrium flow in several high enthalpy conical nozzles. The multi-species two-temperature equation is employed in the calculation. The results reveal three interesting characteristics: Firstly, the thermochemical non-equilibrium effects are sensitive to the maximum expansion angle and throat radius but not to the radius of throat curvature and contraction angle. Secondly, as the maximum expansion angle decreases and the throat radius increases, the flow approaches equilibrium state. When the maximum expansion angle decreases from 12° to 4°, the freezing temperature decreases from 2623 K to 2018 K. When the throat diameter increased from 10 mm to 30 mm, the freezing temperature decreased from 2442 K to 2140 K. Finally, the maximum expansion angle and throat radius not only affect the position of the freezing point but also the flow field parameters, such as temperature, Mach number, and species mass fraction.

Abstract Background The primary aim of this study was to observe the effect of 5-ALA-mediated photodynamic therapy on oral squamous cell carcinoma in vitro. Methods SCC25 cells were divided into the observation group and the blank control group. Different concentrations of 5-ALA and SCC25 cells were co-incubated for different times, and the concentration of protoporphyrin IX was detected by flow cytometry. SCC25 cells were divided into the 5-ALA group (100 mg/L), the laser irradiation group alone, the 5-ALA plus laser irradiation group, and the blank control group (0 mg/L 5-ALA), and the methyl thiazolyl tetrazolium (MTT) solution method was used (each group was incubated for 4, 8 and 12 h in turn). The cell survival rate was calculated. Using annexin V-fluorescein isothiocyanate/propidium iodide method, the apoptosis of SCC25 cells was detected by flow cytometry. Results The level of protoporphyrin IX in SCC25 cells increased with increased concentrations of 5-ALA and length of incubation. However, after 12 h, protoporphyrin IX level in SCC25 cells was gradually stabilized, and similar effect was obtained with 100 mg/L or more 5-ALA, indicating that the level of protoporphyrin IX in SCC25 cells was determined by 5-ALA concentration and incubation time. 5-ALA plus laser irradiation exerted an inhibitory effect on the growth of SCC25 cells, which was highly associated with drug dose and incubation time. Compared with the control group, laser irradiation alone or 5-ALA alone had no effect on the apoptosis of SCC25 cells. Different concentrations of 5-ALA combined with laser irradiation showed a remarkable effect of apoptosis, and a higher apoptosis rate was seen with higher drug concentrations. Conclusion 5-ALA-mediated photodynamic therapy affects the growth of SCC25 cells in vitro, which may provide a new idea for the clinical treatment of oral squamous cell carcinoma.

Abstract The high enthalpy nozzle converts the high enthalpy stagnation gas into the hypervelocity free flow. The flow region of the high enthalpy nozzle consists of three parts: an equilibrium region upstream of the throat, a non-equilibrium region near the throat, and a frozen region downstream of the throat. Here we propose to consider the thermochemical non-equilibrium scale effects in the high enthalpy nozzle. By numerically solving axisymmetric compressible Navier-Stokes equations coupling with Park’s two-temperature model, the fully non-equilibrium solution is employed throughout the entire nozzle. Calculations are performed at different stagnation conditions with the different absolute scales and expansion ratio. The results of this study are twofold. Firstly, as the absolute scale and expansion ratio increase, the freezing position is delayed, and the flow approaches equilibrium. Secondly, the vibrational temperature and Mach number decrease with the increase in the nozzle scale and expansion ratio, while the speed of sound, static pressure, and translational temperature increase as the nozzle scale and expansion ratio increase.

This paper presents the design and process of two highly sensitive sensors working in the terahertz band. The sensors comprise the quartz substrate, medium, reflection plate, and metal resonant layer with a symmetrical single-slot patch array. The devices help study the electrically induced permittivity of two liquid crystals in different frequency bands and at different voltages, and the experimental data verify that both liquid crystals have a large birefringence. Based on experimental results, the sensitivity of the fabricated sensor is 47.03 GHz/RIU in the frequency range 90–140 GHz. Similarly, the other fabricated sensor has a sensitivity of 112.47 GHz/RIU in the frequency range 325–500 GHz. The results show that both sensors have superior sensing properties and potential applications in biological and chemical liquid sensing.

In this work, the tensile responses of 3D woven quartz fiber silica matrix composites were experimentally and numerically investigated. The ceramic composites reinforced by 3D layer-to-layer angle interlock woven preforms were manufactured and tested under warp direction tension. A numerical method is proposed to model the mechanical response of the ceramic composites under tension. The method is based on a mesoscopic single layer unit cell for the composites, using a progressive damage analysis approach to account for damage evolution. The predicted results are compared with experimental data, and good agreement in the stress–strain response up to the ultimate tensile strength of the composites is obtained. It has been demonstrated that the proposed numerical model based on a simple single layer unit cell is both efficient and effective in characterization of the mechanical behavior of the 3D layer-to-layer woven ceramic composites.

It is well-known that the quantum efficiency (QE) of inverted AlGaInP solar cells is less than that of upright ones, and the mechanism has not been well-explained. In this paper, a Si-doped AlInP window layer, compared with an emitter layer, is revealed to be one more important factor that decreases QE. It is noted that the quality of a heavily Si-doped AlInP window layer would decrease and further deteriorate subsequent active layers. An optimization strategy of a Si-doped AlInP window layer is proposed, which proves effective through time-resolved photoluminescence measurements (TRPL) of double heterojunctions. Inverted 2.1 eV AlGaInP solar cells with an improved AlInP window layer are fabricated. A 60 mV Voc increment is achieved with a remarkable enhancement of the fill factor from 0.789 to 0.827. An enhanced QE of 10% to 20% is achieved at short-wavelength and the peak IQE rises from 83.3% to 88.2%, which presents a nearly identical IQE compared with the upright reference. Further optimization in GaAs homojunction sub-cells is performed by introducing an n-GaInP/p-GaAs heterojunction structure, which decreases the recombination loss in the emitter caused by a poor AlInP window layer. The optimized structure significantly improves the Voc of the inverted GaAs-based T-3J solar cells to 3830 mV, boosting the efficiency of SBT five-junction solar cells to 35.61% under AM0 illumination.

Radiation-induced defects are responsible for solar cell degradation. The effects of radiation and annealing on the defects of a GaAs/Ge solar cell are modeled and analyzed in this paper. The electrical performance and spectral response of solar cells irradiated with 150 keV proton are examined. Then, thermal annealing was carried out at 120°C. We found that the proportion of defect recovery after annealing decreases with increasing irradiation fluence. The minority carrier lifetime increases with decreasing defect concentration, which means that the electrical performance of the solar cell is improved. We calculated the defect concentration and minority carrier lifetime with numerical simulation and modeled an improved annealing kinetic equation with experimental results.

In this article, we present a study of the equivalent dielectric constant of two nematic liquid crystals (LCs) with different thicknesses, in the region from 90 to 140 GHz. The equivalent dielectric constant of the LCs was measured using a frequency selective surface (FSS). The LC-based tunable FSS with 22 × 25 unit cells was printed on a quartz substrate with an area of 4 × 4 cm2 and a thickness of 480 µm; the LC layer with thicknesses ranging from 30 to 100 µm acted as a substrate. The FSS featured a maximum frequency-shifting range of 8.15 GHz and 30 µm-thick LC layers with mutually orthogonal rubbing directions were deposited on it. The results show that the initial equivalent dielectric constant of the LC layer increased with the LC layer thickness, while the saturation-equivalent dielectric constant remained almost constant. This work provides LC parameters that can be useful for the design of LC-based devices in the millimeter and terahertz ranges.

In this paper, we demonstrate a frequency shifter at 780 nm based on an X-cut Z -propagating lithium niobate waveguide platform with an isotropic orientation. The electro-optic effect modulates the signal with traveling-wave configuration. The frequency-shifting device emulates a rotating half-wave plate when it converts left circular polarized input light to right circular polarized output light and changes the original optical frequency by its modulation frequency. We characterize the device by conducting the polarization conversion experiment and achieve the frequency shift at up to 2 GHz and more than 20 dB extinction ratio. The device needs 30 dBm RF power to perform a frequency shift with high extinction ratio. With the same device, we also demonstrate optical isolation with 18.5 dB extinction ratio.

It is highly desired that synthesis of photothermal agents with near-infrared (NIR) absorption, excellent photostability, and high photothermal conversion efficiency are essential for potential applications. In this work, three (D-A) conjugated polymers (PBABDF-BDTT, PBABDF-BT, and PBABDF-TVT) based on aza-heterocycle, bis(2-oxo-7-azaindolin-3-ylidene)benzodifurandione (BABDF) as the strong acceptor, and benzodithiophene-thiophene (BDTT), bithiophene (BT), and thiophene-vinylene-thiophene (TVT) as the donors, were designed and synthesized. The conjugated polymers showed significant absorption in the NIR region and a maximum absorption peak at 808 nm by adjusting the donor and acceptor units. Their photothermal properties were also investigated by using poly(ethylene glycol)-block-poly(hexyl ethylene phosphate) (mPEG-b-PHEP) to stabilize the conjugated polymers. Photoexcited conjugated polymer (PBABDF-TVT) nanoparticles underwent non-radiative decay when subjected to single-wavelength NIR light irradiation, leading to an excellent photothermal conversion efficiency of 40.7%. This work indicated the aza-heterocycle BABDF can be a useful building block for constructing D-A conjugated polymer with high conversion efficiency.

In the previous work, two new nematic liquid crystal (NLC) mixtures, E7-2 and S200-2, were produced by adding eight LC monomers to two commercial LCs S200 and E7, respectively. At λ = 589 nm, the birefringence (Δn) characteristics of the two LC nematic mixtures E7-2 (Δn = 0.260) and S200-2 (Δn = 0.298) are greater than those of the commercial LC E7 (Δn = 0.224) and S200 (Δn = 0.266). The properties (TN-I, ε//, Δɛ, K11, and K33) of these four NLCs were measured. A double-layer metal loop arrays modulation structure based on metamaterial (MM) metal−dielectric−metal (MDM) was designed and fabricated for use in the THz frequency range. The results show that the LC mixtures E7-2 and S200-2 have greater modulation depth (MD) and less modulation insertion loss (IL) than E7 and S200 at THz frequencies. The results show that LC mixtures have significant potential for designing active tunable LC-based devices in the THz and visible light range.

An electrically tuned phase shifter based on the single slot unit cell and liquid crystal for a reconfigurable reflectarray antenna was presented. The simulation and measured results obtained at the F-band were used to demonstrate that the dielectric properties of a nematic state liquid crystal could be exploited to realize a slot unit cell phase shifter for the reconfigurable reflectarrays antennas. By reducing the inhomogeneous of the external electric field in the liquid crystal layer, a lower control voltage and improved model accuracy was obtained. In the experiments test, the achieved saturation bias voltage (10 V) was smaller than the previously reported structure, and the phase shift of the reflectarray greater than 300° was achieved in the frequency range 121.5⁻126 GHz. The maximum phase shift of 306° occurred at 124.5 GHz.

This paper introduces a tunable metamaterial absorber (MA) based on polymer network liquid crystal (PNLC) in the terahertz (THz) frequency band. Under the optimal polymerization condition, through electrical control of the orientation of the PNLC embedded in the frequency selective surface, the resonant frequency of the absorber can be tuned from 416.5 to 405.0 GHz, corresponding to fractional frequency bandwidth of 2.8%. The experimental results show that the proposed MA based on the PNLC offers an adjustment time of 10 ms and recovery time of 85 ms, which is significantly faster than the tunable metamaterial devices based on conventional nematic liquid crystal (LC).

We present a wideband metamaterial (MM) filter based on a metal-dielectric-metal (MDM) structure. The proposed structure consists of a quartz dielectric substrate and two metallic square-loop arrays, which were deposited on both surfaces of the substrate. The performance of the proposed design was numerically simulated by considering the angle of incidence. The surface current and electric field distributions were calculated for the two resonant frequencies to examine the intrinsic mechanism of the proposed filter. The transmittance of the structure for various oblique angles of incidence was also analyzed. It is generally challenging to completely align the two metallic layers due to limitations in the manufacturing process. Hence, the influence of periodic misalignment on wave propagation was studied. Furthermore, a prototype of the proposed structure was fabricated and the transmission spectra were measured. Simulation and experimental results reveal that our proposed filter can achieve wideband transmission in the F-band. This work is valuable for the design of broadband filters in millimeter and terahertz waves.

We previously demonstrated vast expansion of hypoxic areas in the leukemic microenvironment and provided a rationale for using hypoxia-activated prodrugs. PR104 is a phosphate ester that is rapidly hydrolyzed in vivo to the corresponding alcohol PR-104A and further reduced to the amine and hydroxyl-amine nitrogen mustards that induce DNA cross-linking in hypoxic cells under low oxygen concentrations. In this phase I/II study, patients with relapsed/refractory acute myeloid leukemia (n=40) after 1 or 2 prior treatments or acute lymphoblastic leukemia (n=10) after any number of prior treatments received PR104; dose ranged from 1.1 to 4 g/m2. The most common treatment-related grade 3/4 adverse events were myelosuppression (anemia 62%, neutropenia 50%, thrombocytopenia 46%), febrile neutropenia (40%), infection (24%), and enterocolitis (14%). Ten of 31 patients with acute myeloid leukemia (32%) and 2 of 10 patients with acute lymphoblastic leukemia (20%) who received 3 g/m2 or 4 g/m2 had a response (complete response, n=1; complete response without platelet recovery, n=5; morphological leukemia-free state, n=6). The extent of hypoxia was evaluated by the hypoxia tracer pimonidazole administered prior to a bone marrow biopsy and by immunohistochemical assessments of hypoxia-inducible factor alpha and carbonic anhydrase IX. A high fraction of leukemic cells expressed these markers, and PR104 administration resulted in measurable decrease of the proportions of hypoxic cells. These findings indicate that hypoxia is a prevalent feature of the leukemic microenvironment and that targeting hypoxia with hypoxia-activated prodrugs warrants further evaluation in acute leukemia. The trial is registered at clinicaltrials.gov identifier: 01037556.

To meet the requirements for rapid tumor growth, a complex array of non-neoplastic cells are recruited to the tumor microenvironment. These cells facilitate tumor development by providing matrices, cytokines, growth factors, as well as vascular networks for nutrient and waste exchange, however their precise origins remain unclear. Through multicolored tissue transplant procedures; we have quantitatively determined the contribution of bone marrow-derived and adipose-derived cells to stromal populations within syngeneic ovarian and breast murine tumors. Our results indicate that subpopulations of tumor-associated fibroblasts (TAFs) are recruited from two distinct sources. The majority of fibroblast specific protein (FSP) positive and fibroblast activation protein (FAP) positive TAFs originate from mesenchymal stem/stromal cells (MSC) located in bone marrow sources, whereas most vascular and fibrovascular stroma (pericytes, α-SMA(+) myofibroblasts, and endothelial cells) originates from neighboring adipose tissue. These results highlight the capacity for tumors to utilize multiple sources of structural cells in a systematic and discriminative manner.

Recent studies indicate that interactions between leukemia cells and the bone marrow (BM) microenvironment promote leukemia cell survival and confer resistance to anti-leukemic drugs. There is evidence that BM microenvironment contains hypoxic areas that confer survival advantage to hematopoietic cells. In the present study we investigated whether hypoxia in leukemic BM contributes to the protective role of the BM microenvironment. We observed a marked expansion of hypoxic BM areas in immunodeficient mice engrafted with acute lymphoblastic leukemia (ALL) cells. Consistent with this finding, we found that hypoxia promotes chemoresistance in various ALL derived cell lines. These findings suggest to employ hypoxia-activated prodrugs to eliminate leukemia cells within hypoxic niches. Using several xenograft models, we demonstrated that administration of the hypoxia-activated dinitrobenzamide mustard, PR-104 prolonged survival and decreased leukemia burden of immune-deficient mice injected with primary acute lymphoblastic leukemia cells. Together, these findings strongly suggest that targeting hypoxia in leukemic BM is feasible and may significantly improve leukemia therapy.

Abstract Background Renal calculi are one of the most frequent diseases in urology, and percutaneous nephrolithotomy (PCNL) being the gold standard for treating renal calculi larger than 2 cm. However, traditional rigid nephroscope cannot bend, presents significant limitations during PCNL. This study aims to develop a novel digital flexible nephroscope for PCNL and verify its safety and efficacy using 3D printed models and ex vivo porcine kidney models, providing new equipment for PCNL. Methods Based on the determined technical parameters, the novel digital flexible nephroscope was manufactured. First, 3D-printed model and ex vivo porcine kidney models were utilized to simulate the PCNL procedures. Then, the traditional rigid nephroscope and the novel digital flexible nephroscope were utilized to simulate the PCNL procedures on 10 ex vivo porcine kidneys for comparison. We observed and recorded the renal calyces visualized and accessed by both the traditional rigid nephroscope and the novel digital flexible nephroscope. Results In both the 3D printing and ex vivo porcine kidney models, the novel percutaneous digital flexible nephroscope smoothly entered the renal collecting system through the percutaneous renal tract. It freely changed angles to reach most target calyces, demonstrating significant advantages over the traditional rigid nephroscope. Conclusion The successful development of the novel percutaneous digital flexible nephroscope allows it to be used either independently or as an adjunct in complex stone cases, providing more effective and safer surgical equipment for percutaneous nephrolithotomy.

Abstract Background The teaching of critical care medicine is a very important task, especially during the COVID-19 pandemic. The understanding of critical care parameters is the foundation and core, which is conducive to the formation of clinical thinking. This study is to evaluate the training effect of teaching of critical care parameters based on an online platform, and explore the teaching methods of critical care medicine that can help to cultivate trainees’ clinical thinking and practical ability. Methods Questionnaires were released before and after the training through the official new media platform “Yisheng” application (APP) of China Medical Tribune involving 1109 participants. The trainees who filled in the questionnaire in APP and received training were randomly selected as the investigated population. Statistical description and analysis were carried out using SPSS 20.0 and Excel 2020. Results The trainees were mainly attending physicians in tertiary hospitals and above. Among all critical care parameters, trainees paid more attention to critical hemodynamics, respiratory mechanics, severity of illness scoring systems, critical ultrasound, and critical hemofiltration. The degree of satisfaction with the courses was high, especially the course of critical hemodynamics was scored the highest. The trainees believed that the course contents were of great help to clinical work. However, no significant difference was found in the trainees’ understanding or cognition of the connotation of the parameters before and after the training. Conclusion Teaching of critical care parameters based on an online platform is conducive to improving and consolidating the clinical care ability of trainees. However, it is still necessary to strengthen the cultivation of clinical thinking in critical care. In the future, the integration of theory with practice must be strengthened in clinical practice, ultimately achieving the homogeneous diagnosis and treatment of patients with critical illness.

Objectives The routine teaching mode of diabetes mellitus (DM) is divided into various sub-majors of medical laboratory, which is not conducive to clinical laboratory physicians quickly mastering relevant knowledge. A novel DM laboratory testing pathway is established to improve teaching efficiency and enhance the effects of talent cultivation in laboratory medicine. Methods The guidelines and expert consensuses of DM were gathered from professional websites and databases. The clinical laboratory diagnostic pathway was formulated, and the questionnaire and mutual evaluation were used to evaluate the teaching effectiveness of 8-year undergraduate students enrolled in 2018 and enrolled in 2019, respectively. Results Clinical laboratory physicians developed and approved the DM clinical laboratory diagnostic pathway, which included the entire process of DM diagnosis and differential diagnosis, drug selection, treatment impact monitoring, prognosis evaluation, etc. The results of the questionnaires showed that, in comparison to the teaching mode used with the students enrolled in 2018 and enrolled in 2019, the percentages of more improvement and significant improvement were significantly increased ( P

ABSTRACTMitochondrial dysfunction leading to overproduction of oxygen free radicals is an important event in the development of Alzheimer's disease. Tetrahydroxy stilbene glycoside (TSG) is one of the main effective components of Polygonum multiflorum and has a certain free radical scavenging effect. We synthesized tetrahydroxy stilbene glycoside derivatives (Mito-TSGs) that can cross the mitochondrial membrane and may provide effective protection against Alzheimer's disease. This experiment investigates the protective mechanism of tetrahydroxy stilbene glycoside derivatives against mitochondrial free radical damage and apoptosis in APP695V717I transgenic model mice. The experimental subjects were healthy 3-month-old APP695V717I transgenic model mice, while C57BL/6J mice of the same age and genetic background served as controls. The results demonstrated that the tetrahydroxy stilbene glycoside derivatives significantly improved mouse behavioral performance. It also led to a decrease in the levels of H2O2, NO, MDA, and LD, along with an increase in LDH activity and in the antioxidant enzyme activity of SOD, CAT, and GSH-Px. Moreover, it elevated the mitochondrial membrane potential, decreased the gene and protein expression of Caspase-3 and Bax, and increased the gene and protein expression of Bcl-2. Notably, the effectiveness of tetrahydroxy stilbene glycoside derivatives was superior to that of traditional tetrahydroxy stilbene glycoside.

G-quadruplex stabilizers, including CX-5461, exhibit synthetic lethality with loss of BRCA1/2 in preclinical models. Here the authors report the results of a phase I study of CX-5461 in patients with solid tumors enriched for DNA-repair deficiencies.

BackgroundAs one of the most prevalent genitourinary cancers, bladder cancer (BLCA) is associated with high morbidity and mortality. Currently, limited indicators are available for early detection and diagnosis of bladder cancer, and there is a lack of specific biomarkers for evaluating the prognosis of BLCA patients. This study aims to identify critical genes that affect bladder cancer immunity to improve the diagnosis and prognosis of bladder cancer and to identify new biomarkers and targets for immunotherapy.MethodsTwo GEO datasets were used to screen differentially expressed genes (DEGs). The STRING database was used to construct a protein-protein interaction network of DEGs, and plug-in APP CytoHubba in Cytoscape was used to identify critical genes in the network. GO and KEGG analyses explored the functions and pathways of differential gene enrichment. We used GEPIA to validate the expression of differential genes, their impact on patient survival, and their relationship to clinicopathological parameters. Additionally, hub genes were verified using qRT-PCR and Western blotting. Immune infiltration analysis and multiple immunohistochemistry reveal the impact of Hub genes on the tumor microenvironment.ResultWe screened out 259 differential genes, and identified 10 key hub genes by the degree algorithm. Four genes (ACTA2, FLNA, TAGLN, and TPM1) were associated with overall or disease-free survival in BLCA patients and were significantly associated with clinical parameters. We experimentally confirmed that the mRNA and protein levels of these four genes were significantly decreased in bladder cancer cells. Immunoassays revealed that these four genes affect immune cell infiltration in the tumor microenvironment; they increased the polarization of M2 macrophages.ConclusionThese four genes affect the tumor microenvironment of bladder cancer, provide a new direction for tumor immunotherapy, and have significant potential in the diagnosis and prognosis of bladder cancer.

Background: Prostate cancer (PC) is one of the most commonly diagnosed cancer in men worldwide. Epithelial-mesenchymal transition (EMT) is considered to play a crucial role in the development of the metastatic castration-resistant prostate cancer, which causes the majority of the death cases in PC. Golgi membrane protein 1 (GOLM1) is highly expressed in PC and has been identified as a driver factor for EMT in various cancers. However, its biological functions and underlying mechanisms remain ambiguous in PC. Method: GOLM1 expression level of PC was detected by Western blot and immunohistochemistry analyses. To investigate GOLM1 functions in cancer cells, we overexpressed and knocked down GOLM1 in different prostate cancer cell lines. Transwell assay and wound healing assay were used to determine the role of GOLM1 in cell EMT, such as migration and invasion abilities. TGF-β1/Smad2 signaling pathway downstream of GOLM1 was detected by Western blot and Transwell assay. Result: GOLM1 expression is up-regulated in PC and correlated with a worse prognosis. GOLM1 promotes the abilities of migration and invasion in PC cell lines (DU145 and LNCaP). Furthermore, TGF-β1/Smad2 signaling is positively regulated by GOLM1 to facilitate EMT in PC, whereas this role can be restored by TGF-β1 after GOLM1 knockdown or be abrogated by p-Smad inhibitor SB431542. Conclusion: GOLM1 is significantly upregulated in PC and acts as a critical oncogene by promoting PC cell EMT process by activating TGF-β1/Smad2 signaling pathway. Therefore, GOLM1 has the potential to be a biomarker for PC diagnosis and to predict the prognosis of PC patients. It is of great significance to seek effective and specific inhibitor of GOLM1 for PC treatment as well.

Abstract Background Hospital and ICU structural factors are key factors affecting the quality of care as well as ICU patient outcomes. However, the data from China are scarce. This study was designed to investigate how differences in patient outcomes are associated with differences in hospital and ICU structure variables in China throughout 2019. Methods This was a multicenter observational study. Data from a total of 2820 hospitals were collected using the National Clinical Improvement System Data that reports ICU information in China. Data collection consisted of a) information on the hospital and ICU structural factors, including the hospital type, number of beds, staffing, among others, and b) ICU patient outcomes, including the mortality rate as well as the incidence of ventilator-associated pneumonia (VAP), catheter-related bloodstream infections (CRBSIs), and catheter-associated urinary tract infections (CAUTIs). Generalized linear mixed models were used to analyse the association between hospital and ICU structural factors and patient outcomes. Results The median ICU patient mortality was 8.02% (3.78%, 14.35%), and the incidences of VAP, CRBSI, and CAUTI were 5.58 (1.55, 11.67) per 1000 ventilator days, 0.63 (0, 2.01) per 1000 catheter days, and 1.42 (0.37, 3.40) per 1000 catheter days, respectively. Mortality was significantly lower in public hospitals (β = − 0.018 (− 0.031, − 0.005), p = 0.006), hospitals with an ICU-to-hospital bed percentage of more than 2% (β = − 0.027 (− 0.034, -0.019), p

Quantitative photoacoustic tomography (QPAT) is a valuable tool in characterizing ovarian lesions for accurate diagnosis. However, accurately reconstructing a lesion’s optical absorption distributions from photoacoustic signals measured with multiple wavelengths is challenging because it involves an ill-posed inverse problem with three unknowns: the Grüneisen parameter (Γ), the absorption distribution, and the optical fluence (ϕ). Here, we propose a novel ultrasound-enhanced Unet model (US-Unet) that reconstructs optical absorption distribution from PAT data. A pre-trained ResNet-18 extracts the US features typically identified as morphologies of suspicious ovarian lesions, and a Unet is implemented to reconstruct optical absorption coefficient maps, using the initial pressure and US features extracted by ResNet-18. To test this US-Unet model, we calculated the blood oxygenation saturation values and total hemoglobin concentrations from 655 regions of interest (ROIs) (421 benign, 200 malignant, and 34 borderline ROIs) obtained from clinical images of 35 patients with ovarian/adnexal lesions. A logistic regression model was used to compute the ROC, the area under the ROC curve (AUC) was 0.94, and the accuracy was 0.89. To the best of our knowledge, this is the first study to reconstruct quantitative PAT with PA signals and US-based structural features.

COVID-19 is a critical public health threat, but molecular characterizations of patients’ immunity is still lacking. Here the authors collected blood from patients with various disease severity, and prefiltered to exclude selected comorbidity, to obtain genomic, transcriptomic, proteomic, metabolomic and lipidomic profiles to report a trans-omics landscape.

Dynamic characteristics of the asymmetric rotor system supported in axial-grooved gas-lubricated bearings are studied. In order to solve nonlinear dynamic response of rotor system effectively, a hybrid numerical model is established by coupling the motion equation of rotor with the rational function model of the gas film forces. The rational function model of the gas film forces of gas-lubricated bearing is established based on vector fitting theory. By using the hybrid numerical model, the repeated calculations of the unsteady Reynolds equation and gas film forces are avoided; the continuous rotor trajectory and the dynamic gas film forces can be calculated simultaneously; and for the rotor system supported in the same bearings, the computing cost can be saved effectively. The nonlinear dynamic responses of asymmetric rotor system supported in axial-grooved gas-lubricated bearings are investigated by trajectory diagrams, frequency spectrum, Poincaré maps, and time series. The bifurcations are analyzed by the bifurcation diagrams with different rotating speeds and mass eccentricities. The dynamic behaviors of the asymmetric rotor system appear complex nonlinear dynamic phenomenon and specific bifurcation characteristics.

Background: Adult critically ill patients are prone to complications when receiving enteral nutrition, including feeding intolerance. Although abdominal massage is an effective intervention, its effects on enteral nutrition complications in adult critically ill patients are controversial. Objective: To summarize and evaluate the effect of abdominal massage on enteral nutrition complications in adult critically ill patients. Methods: We searched databases (e.g., PubMed, the Cochrane Library, Embase, and Web of Science) from inception until November 2020 for relevant studies published in English. The methodological quality of selected studies was assessed with the Cochrane Risk of Bias 2.0 tool. And we used of PRISMA 2020 guidelines. The meta-analysis results were reported as mean difference (MD) and events, and the heterogeneity of the studies was evaluated using I2. Results: Seven studies including 472 participants (aged≥18 years) met the inclusion criteria. The mean gastric residual volume (GRV) (MD=−42.41, 95% confidence interval [CI]: −71.43, −13.39; P = 0.004) and incidence of abdominal distension (odds ratio [OR]=0.08, 95%CI: 0.03, 0.19; P

Objectives: This study aimed to investigate the effect of nurse-led, goal-directed lung physiotherapy (GDLPT) on the prognosis of older patients with sepsis caused by pneumonia in the intensive care unit.Methods: We conducted a prospective, two-phase (before-and-after) study over 3 years called the GDLPT study. All patients received standard lung therapy for sepsis caused by pneumonia and patients in phase 2 also received GDLPT. In this study, 253 older patients (age ≥ 65 years) with sepsis and pneumonia were retrospectively analyzed. The main outcome was 28 day mortality.Results: Among 742 patients with sepsis, 253 older patients with pneumonia were divided into the control group and the treatment group. Patients in the treatment group had a significantly shorter duration of mechanical ventilation [5 (4, 6) vs. 5 (4, 8) days; P = 0.045], and a lower risk of intensive care unit (ICU) mortality [14.5% (24/166) vs. 28.7% (25/87); P = 0.008] and 28 day mortality [15.1% (25/166) vs. 31% (27/87); P = 0.005] compared with those in the control group. GDLPT was an independent risk factor for 28 day mortality [odds ratio (OR), 0.379; 95% confidence interval (CI), 0.187–0.766; P = 0.007].Conclusions: Nurse-led GDLPT shortens the duration of mechanical ventilation, decreases ICU and 28-day mortality, and improves the prognosis of older patients with sepsis and pneumonia in the ICU.

In this paper, we propose our observation, analysis, and alleviation method of the beat frequency fluctuation in short-cavity dual-polarization distributed Bragg reflector (DBR) fiber grating laser sensor in time and frequency domain. According to our observation, beat frequency fluctuation varies from 8 to 800 kHz under different pump power. Research shows frequency domain beat signal linewidth broadening aggravates beat frequency fluctuation due to time domain irregular self-pulsation effect. By introducing self-injection into laser cavity as an auxiliary pump laser with a circulator, self-pulsation effect in DBR fiber laser sensor can be greatly suppressed, resulting in the compression of frequency domain beat signal linewidth as well as the stabilization of beat frequency fluctuation. Experimental results demonstrate that beat frequency fluctuation can be greatly reduced from 800 to 8 kHz within 1 h through self-injection, which is significant for high-accurate sensing.

As a renewable energy source, wind energy harvesting provides a desirable solution to address the environmental concerns associated with energy production to satisfy the increasingly global demand. Over the years, the penetration of wind turbines has experienced a rapid growth, however, the impacts of turbine noise correspondingly become a major concern in wind energy harvesting. Recent studies indicate that the noise emitted by turbine operating could increase the risk of nuisance, which might further affect the well-being of local residents. However, the main factors affecting turbine noise assessment and to what extent they contribute to the assessment are still unclear. In this study, a survey-based approach is developed to identify these major factors and to explore the interactions between the factors and assessment results. Principal component analysis method was adapted to extract key factors; followed by reliability assessment, validity analysis, descriptive assessment, and correlation analysis were conducted to test the robust of the proposed methodology, as well as to examine the interactions between variables. Regression analysis was finally employed to measure the impacts on results contributed by the key factors. Findings of this study indicate that key factors including physical conditions, control capacity, and subjective opinions are of significant impact on residents’ response to wind turbine noise, while the factor of subjective opinions contributes predominately to the assessment results. Further validations also indicate that the proposed approach is robust and can be extensively applied in survey-based assessments for other fields.

Background Cardiac hypertrophy has been recognized as an important independent risk factor for the development of heart failure and increases the risk of cardiac morbidity and mortality. A disintegrin and metalloprotease 23 (ADAM23), a member of ADAM family, is involved in cancer and neuronal differentiation. Although ADAM23 is expressed in the heart, the role of ADAM23 in the heart and in cardiac diseases remains unknown. Methods and Results We observed that ADAM23 expression is decreased in both failing human hearts and hypertrophic mice hearts. Cardiac‐specific conditional ADAM23‐knockout mice significantly exhibited exacerbated cardiac hypertrophy, fibrosis, and dysfunction, whereas transgenic mice overexpressing ADAM23 in the heart exhibited reduced cardiac hypertrophy in response to pressure overload. Consistent results were also observed in angiotensin II‐induced neonatal rat cardiomyocyte hypertrophy. Mechanistically, ADAM23 exerts anti‐hypertrophic effects by specifically targeting the focal adhesion kinase‐protein kinase B (FAK‐AKT) signaling cascade. Focal adhesion kinase inactivation by inhibitor (PF‐562271) greatly reversed the detrimental effects in ADAM23‐knockout mice subjected to aortic banding. Conclusion Altogether, we identified ADAM23 as a negative regulator of cardiac hypertrophy through inhibiting focal adhesion kinase‐protein kinase B signaling pathway, which could be a promising therapeutic target for this malady.

MiR-139-5p has been reported to be overexpressed in many types of cancers, but its role in bladder cancer has not been elucidated yet. Here, we report that miR-139-5p functions as a tumor suppressor in bladder cancer and inhibits the cancer stem cell self-renewal by targeting Bmi1 directly. We found that miR-139-5p expression was significantly downregulated in the bladder cancer specimens compared with that in adjacent normal tissues. In vitro, restoration of miR-139-5p expression significantly inhibited the proliferation of bladder cancer cells. Mechanism analysis revealed that miR-139-5p could decrease Bmi1 protein levels by binding to the 3′ untranslated region of Bmi1 messenger RNA. Stem cell–related proteins such as c-MYC, NANOG, OCT4, and KLF4 and signaling pathways such as Wnt signaling were suppressed by restoration of miR-139-5p in bladder cancer cells. In addition, miR-139-5p expression also blocked self-renewal of bladder cancer stem cells by inhibiting Bmi1. In summary, our study supports that miR-139-5p acts as a tumor suppressor in bladder cancer development and suppresses cancer stem cell property of bladder cancer. Our study also suggests that miR-139-5p has the potential to be used as a therapeutic molecule for bladder cancer treatment.

Background and purpose: Placental site trophoblastic tumor (PSTT) is a rare type of malignant tumor. Because of its unique mode of invasion in the uterus and its insensitivity to chemotherapy, total hysterectomy is the primary recommendation. The purpose of this study was to investigate the feasibility and safety of conservative surgical treatment in patients with stage Ⅰ PSTT. Methods: The patients with stage Ⅰ PSTT admitted to Obstetrics and Gynecology Hospital of Fudan University from January 2015 to December 2021 were included, and those published on Pubmed and China National Knowledge Infrastructure (CNKI) from January 1990 to December 2021 were searched with the keywords of “placental site trophoblastic tumor” and “case”, “placental trophoblastic tumor” and “case” respectively. The clinicopathological data of the patients were collected and retrospectively analyzed. Results: A total of 10 cases admitted to Obstetrics and Gynecology Hospital of Fudan University were enrolled. The median age was 27 years. The most common symptom was irregular vaginal bleeding (70.0%). The median time of interval since antecedent pregnancy (ISAP) was 14.5 months. The median level of β-human chorionic gonadotrophin (β-hCG) was 124.51 mU/mL, and the diameter of the focus was 0.8-8.0 cm. All 10 patients admitted to Obstetrics and Gynecology Hospital of Fudan University achieved complete remission after initial treatment. The average follow-up time was 48.1 months and there was no recurrence. Three patients became pregnant naturally after treatment, including 2 cases of full-term pregnancy and delivery and 1 case of induced abortion because of unplanned pregnancy. Literature review of PSTT cases showed similar clinicopathological distribution and disease outcome. Conclusion: Conservative surgery could be an alternative choice for selected patients with stage Ⅰ PSTT, but more research is needed to provide evidence.

Head and neck squamous cell carcinoma (HNSCC) is a solid tumor with high morbidity. In recent years, traditional treatment methods, such as surgery, chemotherapy, and radiotherapy, are going through a bottleneck period, and therefore, new treatment methods are urgently needed to improve the prognosis of patients. Immunotherapy is an emerging treatment method for tumor in recent years, and immune checkpoint inhibitors (ICIs) have been widely used in the clinical treatment of HNSCC and other tumors with a marked clinical effect. This article summarizes the research advances in ICIs in the treatment of HNSCC and the effect of ICIs combined with radiotherapy and/or chemotherapy and elaborates on the adverse reactions of ICI the-rapy, in order to find the best paradigm of immunotherapy for HNSCC patients.