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Objective: To investigate the potential efficacy and safety of Lutai Danshen Baishao granules (LDBG) for treating female melasma associated with kidney deficiency and blood stasis patterns. Methods: A randomized, double-blind, placebo-controlled trial was conducted at the Third Central Hospital of Tianjin, China from March to December 2023. A total of 110 female patients with melasma linked to kidney deficiency and blood stasis were enrolled and treated with either LDBG or a placebo twice daily for 60 days. Efficacy was assessed through measures such as the total melasma area, reduced melasma area, reduction rate of melasma area, melasma color score, Melasma Area and Severity Index (MASI) score, and traditional Chinese medicine (TCM) symptom score scale. Safety assessments included routine blood and biochemical tests. Results: Participants in both groups were aged 52–63 years, with no significant differences. After the 2-month intervention, the total melasma area decreased in both groups; however, a greater reduction was observed in the test group [462.50 mm2 (12.81%) vs. 100.00 mm2 (3.11%), P

Abstract The H2-evolution kinetics play a pivotal role in governing the photocatalytic hydrogen-evolution process. However, achieving precise regulation of the H-adsorption and H-desorption equilibrium (Hads/Hdes) still remains a great challenge. Herein, we propose a fine-tuning d-p hybridization strategy to precisely optimize the Hads/Hdes kinetics in a Ni-B x modified CdS photocatalyst (Ni-B x /CdS). X-ray absorption fine-structure spectroscopy and theoretical calculations reveal that increasing B-atom amount in the Ni-B x cocatalyst gradually strengthens the d-p orbital interaction between Ni3d and B2p , resulting in a consecutive d-band broadening and controllable d-band center on Ni active sites. The above consecutive d-band optimization allows for precise modulation of the Hads/Hdes dynamics in the Ni-B x /CdS, ultimately demonstrating a remarkable H2-evolution activity of 13.4 mmol g-1 h-1 (AQE = 56.1 %). The femtosecond transient absorption spectroscopy further confirms the rapid electron-transfer dynamics in the Ni-B x /CdS photocatalyst. This work provides insights into the optimal design of prospective H2-evolution catalysts.

Abstract Background Head and neck squamous cell carcinoma (HNSCC) is a very aggressive disease characterized by a heterogeneous tumor immune microenvironment (TIME). Tumor-associated macrophages (TAMs) constitute the major innate immune population in the TIME where they facilitate crucial regulatory processes that participate in malignant tumor progression. SPP1 + macrophages (SPP1 + Macs) are found in many cancers, but their effects on HNSCC remain unknown. This study aimed to identify and validate the role and function of SPP1 + Macs in the malignant progression of HNSCC. Methods In this study, we applied single-cell RNA sequencing (scRNA-seq) analyses of paired tumor and normal tissues from 5 HNSCC patients to identify tumor-specific SPP1 + Macs. RT-qPCR and multiplex immunohistochemical and multiplex immunofluorescence staining were used to verify the presence of SPP1 + Macs in the clinical samples. Gene set variation analysis suggested that SPP1 + Macs were actively involved in cytokine production. Thus, we constructed SPP1-OE macrophages and SPP1-KD macrophages (both differentiated from THP-1 cells), performed a Luminex liquid suspension chip detection assay to detect differential cytokines, and further assessed their biological functions and mechanisms in several HNSCC cell lines and adjacent macrophages. An in vivo experiment was used to verify the function of SPP1 + Macs in HNSCC progression. Results The scRNA-seq results revealed that myeloid cells were heterogeneous and strongly correlated with tumor cells in the TIME in HNSCC and identified tumor-specific SPP1 + Macs, which were positively correlated with poor prognosis of HNSCC patients. Gene set variation analysis (GSVA) suggested that SPP1 + Macs were actively involved in cytokine production. Luminex liquid suspension chip detection assay indicated that SPP1 + Mac-derived TNF-α and IL-1β played important roles. Both in vitro and in vivo experiments and the use of VGX-1027, an inhibitor of macrophage-derived TNF-α and IL-1β, confirmed that SPP1 + Mac-derived TNF-α and IL-1β promoted HNSCC progression by supporting tumor cell proliferation and migration. Mechanistically, we found that TNF-α and IL-1β were upregulated due to NF-kappa B signaling pathway activation in SPP1 + Macs. Moreover, SPP1 + Mac-derived TNF-α and IL-1β promoted the expression of OPN in both tumor cells and other adjacent macrophages through different signaling pathways. Conclusions SPP1 + Macs increase the secretion of TNF-α and IL-1β via the NF-kappa B pathway to promote HNSCC cell proliferation, and TNF-α and IL-1β in turn upregulate the expression of OPN in tumor cells and macrophages; thus, SPP1 + Macs may be a candidate target through which antitumor efficacy can be enhanced.

Abstract Background Jointly analyzing multiple phenotype/traits may increase power in genetic association studies by aggregating weak genetic effects. The chance that at least one phenotype is missing increases exponentially as the number of phenotype increases especially for a real dataset. It is a common practice to discard individuals with missing phenotype or phenotype with a large proportion of missing values. Such a discarding method may lead to a loss of power or even an insufficient sample size for analysis. To our knowledge, many existing phenotype imputing methods are built on multivariate normal assumptions for analysis. Violation of these assumptions may lead to inflated type I errors or even loss of power in some cases. To overcome these limitations, we propose a novel phenotype imputation method based on a new Gaussian copula model with three different loss functions to address the issue of missing phenotype. Results In a variety of simulations and a real genetic association study for lung function, we show that our method outperforms existing methods and can also increase the power of the association test when compared to other comparable phenotype imputation methods. The proposed method is implemented in an R package available at https://github.com/jane-zizhen-zhao/CopulaPhenoImpute1.0 Conclusions We propose a novel phenotype imputation method with a new Gaussian copula model based on three loss functions. Results of the simulation studies and real data analyses illustrate that the proposed method outperforms comparable methods.

Abstract With the population ages, many patients are unable to receive comprehensive care, leading to an increase in hazardous incidents, particularly falls occurring after getting out of bed. To address this issue, this paper proposes a method for recognizing bed-exit intentions using an array air spring mattress. The method integrates convolutional neural networks with feature point matching techniques to identify both global and local features of the array air spring. For global features, a one-dimensional focal loss convolutional neural network (1D-FLCNN) model is employed to classify eight internal pressure time series and determine bed-exit status based on global features. For local features, the distribution matrix and feature point matrix of the internal pressure features are extracted to represent the spatial distribution of bed-exit postures. Euclidean distance is utilized to measure the similarity between these matrices and match bed-exit postures. Finally, the recognition results from both feature types are combined using a logical OR operation to produce the final result. Experimental validation confirms that the proposed method greatly improves the anti-interference capability and effectively avoids the problem of non-recognition due to body position and external environment.

Abstract The rapid recombination of photoinduced charge carriers in semiconductors fundamentally limits their application in photocatalysis. Herein, we report that a superlattice interface and S-scheme heterojunction based on Mn0.5Cd0.5S nanorods can significantly promote ultrafast charge separation and transfer. Specifically, the axially distributed zinc blende/wurtzite superlattice interfaces in Mn0.5Cd0.5S nanorods can redistribute photoinduced charge carriers more effectively when boosted by homogeneous internal electric fields and promotes bulk separation. Accordingly, S-scheme heterojunctions between the Mn0.5Cd0.5S nanorods and MnWO4 nanoparticles can further accelerate the surface separation of charge carriers via a heterogeneous internal electric field. Subsequent capture of the photoelectrons by adsorbed H2O is as fast as several picoseconds which results in a photocatalytic H2 evolution rate of 54.4 mmol·g−1·h−1 without any cocatalyst under simulated solar irradiation. The yields are increased by a factor of ~5 times relative to control samples and an apparent quantum efficiency of 63.1% at 420 nm is measured. This work provides a protocol for designing synergistic interface structure for efficient photocatalysis.

Abstract Aims The molecular signatures in epicardial adipose tissue (EAT) that contribute to the pathogenesis of heart failure with preserved ejection fraction (HFpEF) are poorly characterized. In this study, we sought to elucidate molecular signatures including genetic transcripts and long non‐coding RNAs (lncRNAs) in EAT that might modulate HFpEF development. Methods RNA sequencing (RNA‐seq) was performed to identify differentially expressed lncRNAs and mRNAs in EAT samples from patients with HFpEF (n = 5) and without HF (control, n = 5) who underwent coronary artery bypass grafting. The sequencing results were validated using quantitative real‐time PCR (qRT‐PCR). Bioinformatics analysis (Gene Ontology and Kyoto Encyclopedia of Genes and Genomes) of differentially expressed RNAs was performed to predict enriched functions. Results HFpEF patients had higher EAT thickness and NT‐proBNP levels than the control group. A total of 64 471 transcripts were detected including 35 395 protein‐coding sequences, corresponding to 16 854 genes in EAT. RNA‐seq identified a total of 741 dysregulated mRNA transcripts (394 up‐regulated and 347 down‐regulated) and 334 differentially expressed lncRNA transcripts (222 up‐regulated and 112 down‐regulated) in the HFpEF group compared with the control group (P

Abstract Lung Cancer remains the leading cause of cancer deaths in the USA and worldwide. Non-small cell lung cancer (NSCLC) harbors high transcriptomic intratumor heterogeneity (RNA-ITH) that limits the reproducibility of expression-based prognostic models. In this study, we used multiregional RNA-seq data (880 tumor samples from 350 individuals) from both public (TRACERx) and internal (MDAMPLC) cohorts to investigate the effect of RNA-ITH on prognosis in localized NSCLC at the gene, signature, and tumor microenvironment levels. At the gene level, the maximal expression of hazardous genes (expression negatively associated with survival) but the minimal expression of protective genes (expression positively associated with survival) across different regions within a tumor were more prognostic than the average expression. Following that, we examined whether multiregional expression profiling can improve the performance of prognostic signatures. We investigated 11 gene signatures collected from previous publications and one signature developed in this study. For all of them, the prognostic prediction accuracy can be significantly improved by converting the regional expression of signature genes into sample-specific expression with a simple function—taking the maximal expression of hazardous genes and the minimal expression of protective genes. In the tumor microenvironment, we found a similar rule also seems applicable to immune ITH. We calculated the infiltration levels of major immune cell types in each region of a sample based on expression deconvolution. Prognostic analysis indicated that the region with the lowest infiltration level of protective or highest infiltration level of hazardous immune cells determined the prognosis of NSCLC patients. Our study highlighted the impact of RNA-ITH on the prognostication of NSCLC, which should be taken into consideration to optimize the design and application of expression-based prognostic biomarkers and models. Multiregional assays have the great potential to significantly improve their applications to prognostic stratification.

Abstract ERBB2 (HER2) represents a newly recognized actionable oncogenic driver in non-small cell lung cancer (NSCLC), with approved targeted therapy available. Understanding the landscape of ERBB2 alterations and co-occurring mutations is essential for guiding treatment decisions. We conducted an analysis involving 3000 NSCLC patients with all types of ERBB2 alterations, drawn from two extensive retrospective cohorts: 1281 from Geneplus (Chinese) and 1719 from Guardant360 (the United States, US). The incidence of all types of ERBB2 alterations was found to be 5.6% in the Chinese group and 5.2% in the US group. In both cohorts, among oncogenic alterations of ERBB2, exon 20 insertion Y772_A775dupYVMA was the most frequent alteration (58% vs 41.6% in the Chinese vs the US), followed by G776delinsVC/LC/VV/IC (10.7% vs 9.7%), and S310X (10.5% vs 15.4%). EGFR ex20 insertions were identified in the A767-V774 region, whereas ERBB2 ex20 insertions were observed in the Y772-P780 region. Notably, EGFR ex20 insertions exhibited greater insertion diversity. Clinical characteristics of EGFR and ERBB2 ex20 NSCLC were similar, characterized by low tumor mutation burden (TMB), a predominant never-smoker population, and a majority of lung adenocarcinoma cases.

Abstract The wearable exoskeleton system is a typical strongly coupled human–robotic system. Human–robotic is the environment for each other. The two support each other and compete with each other. Achieving high human–robotic compatibility is the most critical technology for wearable systems. Full structural compatibility can improve the intrinsic safety of the exoskeleton, and precise intention understanding and motion control can improve the comfort of the exoskeleton. This paper first designs a physiologically functional bionic lower limb exoskeleton based on the study of bone and joint functional anatomy and analyzes the drive mapping model of the dual closed-loop four-link knee joint. Secondly, an exoskeleton dual closed-loop controller composed of a position inner loop and a force outer loop is designed. The inner loop of the controller adopts the PID control algorithm, and the outer loop adopts the adaptive admittance control algorithm based on human–robot interaction force (HRI). The controller can adaptively adjust the admittance parameters according to the HRI to respond to dynamic changes in the mechanical and physical parameters of the human–robot system, thereby improving control compliance and the wearing comfort of the exoskeleton system. Finally, we built a joint simulation experiment platform based on SolidWorks/Simulink to conduct virtual prototype simulation experiments and recruited volunteers to wear rehabilitation exoskeletons to conduct related control experiments. Experimental results show that the designed physiologically functional bionic exoskeleton and adaptive admittance controller can significantly improve the accuracy of human–robotic joint motion tracking, effectively reducing human–machine interaction forces and improving the comfort and safety of the wearer. This paper proposes a dual-closed loop four-link knee joint exoskeleton and a variable admittance control method based on HRI, which provides a new method for the design and control of exoskeletons with high compatibility.

Objective: To investigate the efficacy and safety of Liqingtong (LQT) granules in patients with dampness-heat hyperuricemia. Methods: A randomized, double-blind, placebo-controlled pilot trial was conducted at the 983rd Hospital of the Joint Logistic Support Force of the People's Liberation Army from March 15, 2023, to August 10, 2023. In total, 119 participants were enrolled in this trial, and participants were given either LQT granules or placebo for 60 days based on a health education. The primary outcome was serum uric acid (SUA) level, and the secondary outcome was the traditional Chinese medicine (TCM) symptom score, measured on days 0, 30, and 60. Safety indicators, including liver function, kidney function, blood routine, glucose, blood lipid, blood pressure, and heart rate were tested on days 0 and 60 of the trial. The data were analyzed using Prism 9 software, and the significance level was set at P

Abstract The authors propose Point'n Move, a method that achieves interactive scene object manipulation with exposed region inpainting. Interactivity here further comes from intuitive object selection and real‐time editing. To achieve this, Gaussian Splatting Radiance Field is adopted as the scene representation and its explicit nature and speed advantage are fully leveraged. Its explicit representation formulation allows to devise a 2D prompt points to 3D masks dual‐stage self‐prompting segmentation algorithm, perform mask refinement and merging, minimize changes, and provide good initialization for scene inpainting and perform editing in real‐time without per‐editing training; all lead to superior quality and performance. The method was tested by editing both forward‐facing and 360 scenes. The method is also compared against existing methods, showing superior quality despite being more capable and having a speed advantage.

Abstract Small cell lung cancer (SCLC) is an aggressive pulmonary neuroendocrine malignancy featured by cold tumor immune microenvironment (TIME), limited benefit from immunotherapy, and poor survival. The spatial heterogeneity of TIME significantly associated with anti-tumor immunity has not been systemically studied in SCLC. We performed ultra-high-plex Digital Spatial Profiling on 132 tissue microarray cores from 44 treatment-naive limited-stage SCLC tumors. Incorporating single-cell RNA-sequencing data from a local cohort and published SCLC data, we established a spatial proteo-transcriptomic landscape covering over 18,000 genes and 60 key immuno-oncology proteins that participate in signaling pathways affecting tumorigenesis, immune regulation, and cancer metabolism across 3 pathologically defined spatial compartments (pan-CK-positive tumor nest; CD45/CD3-positive tumor stroma; para-tumor). Our study depicted the spatial transcriptomic and proteomic TIME architecture of SCLC, indicating clear intra-tumor heterogeneity dictated via canonical neuroendocrine subtyping markers; revealed the enrichment of innate immune cells and functionally impaired B cells in tumor nest and suggested potentially important immunoregulatory roles of monocytes/macrophages. We identified RE1 silencing factor (REST) as a potential biomarker for SCLC associated with low neuroendocrine features, more active anti-tumor immunity, and prolonged survival.

Abstract The spatial arrangement of immune cells within the tumor microenvironment (TME) and their interactions play critical roles in the initiation and development of cancer. Several advanced technologies such as imaging mass cytometry (IMC) providing the immunological landscape of the TME with single-cell resolution. In this study, we develop a new method to quantify the spatial proximity between different cell types based on single-cell spatial data. Using this method on IMC data from 416 lung adenocarcinoma patients, we show that the proximity between different cell types is more correlated with patient prognosis compared to the traditional features such immune cell density and fractions. Consistent with previous reports, our results validate that proximity of T helper (Th) and B cells to cancer cells is associated with survival benefits. More importantly, we discover that the proximity of M2 macrophages to multiple immune cells is associated with poor prognosis. When Th/B cells are stratified into M2-distal and M2-proximal, the abundance of the former but not the latter category of Th/B cells is correlated with enhanced patient survival. Additionally, the abundance of M2-distal and M2-proximal cytotoxic T cells (Tc) is respectively associated with good and poor prognosis. Our results indicate that the prognostic effect of Th, Tc, and B cells in the tumor microenvironment is modulated by the nearby M2 macrophages. The proposed new method proposed can be readily applied to all single-cell spatial data for revealing functional impact of immune cell interactions.

Absrtact: In order to solve the problem that the two-way flow of power and information between user nodes and service nodes in the smart grid poses a huge threat to the privacy and security of user data, and at the same time, the limitation of the power bureau's computing resources also brings users response delay, service quality degradation and other problems, the author proposes the application of edge computing technology in smart grid data security. Combining with edge computing technology, the author proposes a proxy blind signcryption scheme based on certificateless without bilinear mapping. By blinding the power and information, the signcrypter can not know the specific power consumption information of the user, so as to ensure the data privacy and security of the user. Implement forward security using proxy key update mechanism and perform batch verification of user signature ciphertext. The experimental results indicate that: The total running time required for executing proxy authorization and verification, proxy key generation, signature and decryption algorithms in this scheme is 5.617 ms, with a ciphertext length of 80 Bytes. Compared with other existing literature, the maximum reduction is 85.6 % and 86 %, respectively. Conclusion: This scheme is more suitable for protecting data security and privacy in the data transmission process of smart grids due to its lower running time and communication cost.

Introduction: Racial and ethnic disparities in the presentation and outcomes of lung cancer are widely known. To evaluate potential factors contributing to these observations, we measured systemic immune parameters in Black and White patients with lung cancer. Methods: Patients scheduled to receive cancer immunotherapy were enrolled in a multi-institutional prospective biospecimen collection registry. Clinical and demographic information were obtained from electronic medical records. Pretreatment peripheral blood samples were collected and analyzed for cytokines using a multiplex panel and for immune cell populations using mass cytometry. Differences between Black and White patients were determined and corrected for multiple comparisons. Results: A total of 187 patients with NSCLC (Black, 19; White, 168) were included in the analysis. Compared with White patients, Black patients had greater comorbidity (median Charlson Comorbidity Index 5 versus 3; p = 0.04) and were more likely to have received previous chemotherapy (79% versus 47%; p = 0.03). Black patients had significantly lower levels of CCL23 and CCL27 and significantly higher levels of CCL8, CXCL1, CCL26, CCL25, CCL1, IL-1b, CXCL16, and IFN-γ (all p < 0.05, false discovery rate < 0.1). Black patients also exhibited greater populations of nonclassical CD16+ monocytes, NKT-like cells, CD4+ cells, CD38+ monocytes, and CD57+ gamma delta T cells (all p < 0.05). Conclusions: Black and White patients with lung cancer exhibit several differences in immune parameters, with Black patients exhibiting greater levels of numerous proinflammatory cytokines and cell populations. The etiology and clinical significance of these differences warrant further evaluation.

Abstract Safety concerns and uncontrollable dendrite growths have severely impeded the advancement of lithium‐metal batteries. Herein, a safe deep‐eutectic‐polymer electrolyte with built‐in thermal shutdown capability is proposed by utilizing hydrophobic association of methylcellulose within a novel deep‐eutectic‐solvent. Specifically, at elevated temperatures, methylcellulose chains aggregate to form dense polymer networks due to hydrophobic association and break the solvation structure equilibrium inside the deep‐eutectic system through encapsulating Li+ in polymer matrix, leading to quick solidification of the electrolyte. The solidified electrolyte obstructs Li+ transports and terminates electrochemical processes, protecting LMBs from unstoppable exothermic chain reactions. The accelerating rate calorimeter tests of 1 Ah pouch cells demonstrate that the as‐prepared electrolyte significantly improves the onset self‐heating temperature from 73 °C for conventional electrolytes to 172 °C and prolongs the thermal runaway waiting time more than 20 hours. More impressively, benefiting from its favorable electrochemical performance, this polymer electrolyte enables LiNi0.8Mn0.1Co0.1O2||Li batteries to retain 92% capacity over 200 cycles and LiFePO4||Li batteries to maintain 90% capacity after 500 cycles. This research paves a promising avenue for enhancing both the safety and electrochemical performance of high‐energy‐density LMBs.

Introduction Despite significant successes, immune checkpoint blockade fails to achieve clinical responses in a significant proportion of patients, predictive markers for responses are imperfect and immune-related adverse events (irAEs) are unpredictable. We used T-cell receptor (TCR) sequencing to systematically analyze prospectively collected patient blood samples from a randomized clinical trial of dual immune checkpoint inhibitor therapy to evaluate changes in the T-cell repertoire and their association with response and irAEs.Methods Patients with immunotherapy-naïve metastatic non-small cell lung cancer (NSCLC) were treated with ipilimumab and nivolumab according to trial protocol (LONESTAR, NCT03391869). Blood samples were systematically obtained at baseline (n=107), after 12 weeks of ipilimumab and nivolumab (n=91), and at the time of grade ≥2 irAEs (n=77). For analysis of T-cell repertoire, we performed immunoSEQ to assess the complementary determining region 3β region of the TCR involved in antigen binding.Results A total of 250 samples from 119 patients were analyzed. Patients who had a response to therapy exhibited greater T-cell diversity at baseline. Interestingly, patients with irAEs demonstrated lower T-cell richness at the time of toxicity compared with those without irAEs.Conclusion Our study highlights the potential impact of peripheral blood T-cell repertoire on clinical response and toxicities from the combination of ipilimumab and nivolumab in patients with metastatic NSCLC. These findings suggest that analysis of peripheral blood T-cell repertoire may help to guide patient selection for treatment with ipilimumab and nivolumab.Trial registration number NCT03391869.

Prefabricated container houses have been widely used in recent decades, particularly at construction sites. To improve their energy efficiency, the thermal deficiencies of a typical prefab container house were firstly analyzed using infrared thermography. Detailed measurements of the thermal behavior of its envelope were conducted, focusing on thermal bridges, air infiltration rates, and window solar heat gains. The energy consumption from various sources were then calculated based on the measured data. It showed that there were thermal bridges near the joint of the walls and the panels. The reserved space for rainwater pipes and cables, as well as the panel connecting seams, were inadequately insulated, resulting in higher surface temperatures and heat fluxes compared to the adjacent walls. The energy consumption from the windows, the thermal bridges and air infiltration accounted for around 50 % of the total energy consumption. The thermal bridge insulation structures could reduce more than 60 % and around 40 % energy consumptions of the corners and the seams. The external louvers could reduce around 40 % energy consumption of the windows. After the energy-saving retrofit, the total energy consumption of the prefab house was reduced by approximately 25.9 %.

Abstract Traumatic cervical spinal cord injury (TCSCI) often causes varying degrees of motor dysfunction, common assessed by the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), in association with the American Spinal Injury Association (ASIA) Impairment Scale. Accurate prediction of motor function recovery is extremely important for formulating effective diagnosis, therapeutic and rehabilitation programs. The aim of this study is to investigate the validity of a novel nested ensemble algorithm that uses the very early ASIA motor score (AMS) of ISNCSCI examination to predict motor function recovery 6 months after injury in TCSCI patients. This retrospective study included complete data of 315 TCSCI patients. The dataset consisting of the first AMS at ≤ 24 h post-injury and follow-up AMS at 6 months post-injury was divided into a training set (80%) and a test set (20%). The nested ensemble algorithm was established in a two-stage manner. Support Vector Classification (SVC), Adaboost, Weak-learner and Dummy were used in the first stage, and Adaboost was selected as second-stage model. The prediction results of the first stage models were uploaded into second-stage model to obtain the final prediction results. The model performance was evaluated using precision, recall, accuracy, F1 score, and confusion matrix. The nested ensemble algorithm was applied to predict motor function recovery of TCSCI, achieving an accuracy of 80.6%, a F1 score of 80.6%, and balancing sensitivity and specificity. The confusion matrix showed few false-negative rate, which has crucial practical implications for prognostic prediction of TCSCI. This novel nested ensemble algorithm, simply based on very early AMS, provides a useful tool for predicting motor function recovery 6 months after TCSCI, which is graded in gradients that progressively improve the accuracy and reliability of the prediction, demonstrating a strong potential of ensemble learning to personalize and optimize the rehabilitation and care of TCSCI patients.

Abstract Constructing S-scheme heterojunctions proves proficient in achieving the spatial separation of potent photogenerated charge carriers for their participation in photoreactions. Nonetheless, the restricted contact areas between two phases within S-scheme heterostructures lead to inefficient interfacial charge transport, resulting in low photocatalytic efficiency from a kinetic perspective. Here, In2O3/Nb2O5 S-scheme heterojunctions are fabricated through a straightforward one-step electrospinning technique, enabling intimate contact between the two phases and thereby fostering ultrafast interfacial electron transfer (

Abstract Background Around the world, there is a high incidence of gastric ulcers. YS, an extract from the Chinese herb Albizzia chinensis (Osbeck) Merr, has potential therapeutic applications for gastrointestinal diseases. Here we elucidated the protective effect and underlying mechanism of action of YS on gastric ulcer in rats injured by ethanol. Methods The ethanol‐induced gastric ulcer rat model was used to assess the protective effect of YS. A pathological examination of gastric tissue was performed by H&E staining. GES‐1 cells damaged by hydrogen peroxide were used to simulate oxidative damage in gastric mucosal epithelial cells. Endogenous NRF2 was knocked down using small interfering RNA. Immunoprecipitation was used to detect ubiquitination of NRF2. Co‐immunoprecipitation was used to detect the NRF2–Keap1 interaction. Results YS (10 and 30 mg/kg, i.g.) significantly reduced the ulcer index, decreased MDA level, and increased SOD and GSH levels in gastric tissues damaged by ethanol. YS promoted NRF2 translocation from cytoplasm to nucleus and enhanced the NQO1 and HO‐1 expression levels in injured rat gastric tissue. In addition, YS regulated NQO1 and HO‐1 via NRF2 in H2O2‐induced oxidative injured GES‐1 cells. Further studies on the underlying mechanism indicated that YS reduced the interaction between NRF2 and Keap1 and decreased ubiquitylation of NRF2, thereby increasing its stability and expression of downstream factors. NRF2 knockdown abolished the effect of YS on MDA and SOD in GES‐1 cells treated with H2O2. Conclusion YS reduced the NRF2–Keap1 interaction, promoting NRF2 translocation into the nucleus, which increasing the transcription and translation of NQO1 and HO‐1 and improved the antioxidant capacity of rat stomach.

Cooperative coupling of hydrogen peroxide (H2O2) photosynthesis with organic pollutant degradation is promising strategy applied in chemical synthesis and environmental protection. Nonetheless, the photocatalytic performance is limited by sluggish photogenerated carrier separation and limited redox potentials. Herein, an S-scheme heterojunction was constructed by assembling the TiO2 nanoparticles and a Schiff-base COF together. The formed S-scheme TiO2/COF heterojunction can efficiently produce H2O2 and degrade Rhodamine B (RhB) synchronously. The S-scheme charge transfer mechanism in TiO2/COF composite is well unveiled by in situ irradiated X-ray photoelectron spectroscopy and DFT calculation. The femtosecond transient absorption spectra reveal the superior charge migration at interface between TiO2 and COF. The designed TiO2/COF composite shows drastically enhanced H2O2 yield of 1326 μmol·g−1·h−1 in RhB solution, and the AQY value of 4.11% under 420 nm monochromatic light irradiation is achieved. Meanwhile, 100% of RhB degraded under light irradiation for 40 min with TiO2/TD COF as photocatalyst. This work exemplifies a promising approach to design COF-based S-scheme heterojunction with ameliorative photocatalytic performance for simultaneous organic pollutants degradation and H2O2 production.

Objectives To explore influencing factors for postoperative urinary retention (POUR) in cervical cancer patients and construct and validate a POUR prediction model.Design A prospective cohort study.Setting A large tertiary hospital specialised in child and maternal healthcare in Southwest China.Participants 1101 patients undergoing cervical cancer surgery at our hospital were enrolled in the analytic cohort between 1 July 2022 and 31 July 2023. Another 205 patients were enrolled in the external validation cohort between 1 August 2023 and 31 October 2023. Demographics and disease-related information were collected to construct a risk prediction model by logistic regression. Univariate analyses and a multivariate logistic regression analysis were conducted to determine possible influencing factors. The discrimination and accuracy of the model were assessed by the area under the curve (AUC) and the concordance index, respectively.Results Univariate analysis identified duration of surgery, intraoperative bleeding, presence of diabetes, hypertension, ureteral adhesion, wound healing classification, preoperative radio/chemotherapy, category of Body Mass Index, history of urinary diseases, history of caesarean section, postoperative urinary infection and use of analgesia pumps as potential influencing factors (p

ProblemSinonasal squamous cell carcinoma (SNSCC) and sinonasal lymphoma (SNL) lack distinct clinical manifestations and traditional imaging characteristics, complicating the accurate differentiation between these tumors and the selection of appropriate treatment strategies. Consequently, there is an urgent need for a method that can precisely distinguish between these tumors preoperatively to formulate suitable treatment plans for patients.MethodsThis study aims to construct and validate ML and DL feature models based on Dynamic Contrast-Enhanced (DCE) imaging and to evaluate the clinical value of a radiomics and deep learning (DL) feature fusion model in differentiating between SNSCC and SNL. This study performed a retrospective analysis on the preoperative axial DCE-T1WI MRI images of 90 patients diagnosed with sinonasal tumors, comprising 50 cases of SNSCC and 40 cases of SNL. Data were randomly divided into a training set and a validation set at a 7:3 ratio, and radiomic features were extracted. Concurrently, deep learning features were derived using the optimally pre-trained DL model and integrated with manually extracted radiomic features. Feature sets were selected through independent samples t-test, Mann-Whitney U-test, Pearson correlation coefficient and LASSO regression. Three conventional machine learning (CML) models and three DL models were established, and all radiomic and DL features were merged to create three pre-fusion machine learning models (DLR). Additionally, a post-fusion model (DLRN) was constructed by combining radiomic scores and DL scores. Quantitative metrics such as area under the curve (AUC), sensitivity, and accuracy were employed to identify the optimal feature set and classifier. Furthermore, a deep learning-radiomics nomogram (DLRN) was developed as a clinical decision-support tool.ResultsThe feature fusion model of radiomics and DL has higher accuracy in distinguishing SNSCC from SNL than CML or DL alone. The ExtraTrees model based on DLR fusion features of DCE-T1WI had an AUC value of 0.995 in the training set and 0.939 in the validation set.The DLRN model based on the fusion of predictive scores had an AUC value of 0.995 in the training set and 0.911 in the validation set.The DLRN model based on the fusion of predictive scores had an AUC value of 0.995 in the training set and 0.911 in the validation set.ConclusionThis study, by constructing a feature integration model combining radiomics and deep learning (DL), has demonstrated strong predictive capabilities in the preoperative non-invasive diagnosis of SNSCC and SNL, offering valuable information for tailoring personalized treatment plans for patients.

ObjectiveTo explore the effectiveness of a machine learning-based multiparametric MRI radiomics nomogram for predicting the WHO/ISUP nuclear grading of clear cell renal cell carcinoma (ccRCC) before surgery.MethodsData from 86 patients who underwent preoperative renal MRI scans (both plain and enhanced) and were confirmed to have ccRCC were retrospectively collected. Based on the 2016 WHO/ISUP grading standards, patients were divided into a low-grade group (Grade I and II) and a high-grade group (Grade III and IV), and randomly split into training and testing sets at a 7:3 ratio. Radiomics features were extracted from FS-T2WI, DWI, and CE-T1WI sequences. Optimal features were selected using the Mann-Whitney U test, Spearman correlation analysis, and the least absolute shrinkage and selection operator (LASSO). Five machine learning classifiers—logistic regression (LR), naive bayes (NB), k-nearest neighbors (KNN), adaptive boosting (AdaBoost), and multilayer perceptron (MLP)—were used to build models to predict ccRCC WHO/ISUP nuclear grading. The model with the highest area under the curve (AUC) in the testing set was chosen as the best radiomics model. Independent clinical risk factors were identified using univariate and multivariate logistic regression to create a clinical model, which was combined with radiomics score (rad-score) to develop a nomogram. The model’s effectiveness was assessed using the receiver operating characteristic (ROC) curve, its calibration was evaluated using a calibration curve, and its clinical utility was analyzed using decision curve analysis.ResultsSix radiomics features were ultimately selected. The MLP classifier showed the highest diagnostic performance in the testing set (AUC=0.933). Corticomedullary enhancement level (P=0.020) and renal vein invasion (P=0.011) were identified as independent risk factors for predicting the WHO/ISUP nuclear classification and were included in the nomogram with the rad-score. The ROC curves indicated that the nomogram model had strong diagnostic performance, with AUC values of 0.964 in the training set and 0.933 in the testing set.ConclusionThe machine learning-based multiparametric MRI radiomics nomogram provides a highly predictive, non-invasive tool for preoperative prediction of WHO/ISUP nuclear grading in patients with ccRCC.

Background Neoadjuvant immune checkpoint inhibitors (ICIs) have improved survival outcomes compared with chemotherapy in resectable non-small cell lung cancer (NSCLC). However, the impact of actionable genomic alterations (AGAs) on the efficacy of neoadjuvant ICIs remains unclear. We report the influence of AGAs on treatment failure (TF) in patients with resectable NSCLC treated with neoadjuvant ICIs.Methods Tumor molecular profiles were obtained from patients with stage I–IIIA resectable NSCLC (American Joint Committee on Cancer seventh edition) treated with either neoadjuvant nivolumab (N, n=23) or nivolumab+ipilimumab (NI, n=21) followed by surgery in a previously reported phase-2 randomized study (NCT03158129). TF was defined as any progression of primary lung cancer after neoadjuvant ICI therapy in patients without surgery, radiographic and/or biopsy-proven primary lung cancer recurrence after surgery, or death from possibly treatment-related complications or from primary lung cancer since randomization. Tumors with AGAs (n=12) were compared with tumors without AGAs and non-profiled squamous cell carcinomas (non-AGAs+NP SCC, n=20).Results With a median follow-up of 60.2 months, the overall TF rate was 34.1% (15/44). Tumor molecular profiling was retrospectively obtained in 47.7% (21/44) of patients and select AGAs were identified in 12 patients: 5 epidermal growth factor receptor (EGFR), 2 KRAS, 1 ERBB2, and 1 BRAF mutations, 2 anaplastic lymphoma kinase (ALK) and 1 RET fusions. The median time to TF in patients with AGAs was 24.7 months (95% CI: 12.6 to 40.4), compared with not reached (95% CI: not evaluable (NE)–NE) in the non-AGAs+NP SCC group. The TF risk was higher in AGAs (HR: 5.51, 95% CI: 1.68 to 18.1), and lower in former/current smokers (HR: 0.24, 95% CI: 0.08 to 0.75). The odds of major pathological response were 4.71 (95% CI: 0.49 to 45.2) times higher in the non-AGAs+NP SCC group, and the median percentage of residual viable tumor was 72.5% in AGAs compared with 33.0% in non-AGS+NP SCC tumors.Conclusions Patients with NSCLC harboring select AGAs, including EGFR and ALK alterations, have a higher risk for TF, shorter median time to TF, and diminished pathological regression after neoadjuvant ICIs. The suboptimal efficacy of neoadjuvant chemotherapy-sparing, ICI-based regimens in this patient subset underscores the importance of tumor molecular testing prior to initiation of neoadjuvant ICI therapy in patients with resectable NSCLC.

Feedback-insensitive Quantum Dot (QD) comb lasers hold significant promise for integrated dense wavelength division multiplexing photonic systems due to their ability to generate multiple wavelengths and operate without bulky isolators, facilitating the development of high-density and large-scale photonic integrated circuits. In this study, we investigated the optical feedback (OFB) influence of the InAs/GaAs QD comb laser from various perspectives. Our findings reveal that the comb laser exhibits a stable locking region with consistent optical spectra across a range of OFB strengths (−45 to −10 dB). Furthermore, under a high OFB strength of −10 dB, there is a notable 40 dB suppression of relative intensity noise in the low-frequency range (below 1 GHz). Transmission experiments demonstrate clear eye openings at 25 Gbps using a bit pattern of 231-1 pseudorandom binary sequence. Remarkably, the bit error rates decrease by five orders of magnitude under −10 dB OFB. These results indicate the ultra-robustness of 100 GHz grid QD comb laser, which exhibits great transmission enhancement under a strong OFB of −10 dB.

Introduction: Responses to first-line programmed cell death protein 1 inhibition vary among patients with metastatic NSCLC and a programmed death-ligand 1 (PD-L1) tumor proportion score (TPS) greater than or equal to 50%. We previously reported improved clinical outcomes to first-line programmed cell death protein 1 inhibition in patients with metastatic NSCLC with a PD-L1 TPS of greater than or equal to 90% versus 50% to 89% in a pilot study. Here, we report the three-year survival with first-line pembrolizumab and cemiplimab in two large independent cohorts of patients with PD-L1 TPS greater than or equal to 90% versus 50% to 89% and characterize genomic and immunophenotypic differences between these PD-L1 expression groups, which were largely unknown. Methods: We analyzed three-year outcomes of the following two independent cohorts: (1) a multicenter cohort of patients from four academic centers in the United States treated with pembrolizumab and (2) EMPOWER-Lung 1, randomized, phase III trial comparing first-line cemiplimab with chemotherapy. Tumor genomic profiling and multiplexed immunofluorescence were performed to evaluate genomic and immunophenotypic correlates of very high PD-L1 expression. Results: At three years of follow-up, progression-free survival (hazard ratio [HR], 0.69; p < 0.001) and overall survival (HR, 0.70; p < 0.01) to first-line commercial pembrolizumab were significantly improved in patients with a PD-L1 TPS greater than or equal to 90% versus 50% to 89%. In the EMPOWER-Lung 1, patients assigned to the cemiplimab arm with a PD-L1 TPS greater than or equal to 90% also had significant improvements in progression-free survival (HR, 0.53; p < 0.0001) and overall survival (HR, 0.63; p = 0.007) compared with those with a PD-L1 of 50% to 89%. Tumor genomic profiling of 553 NSCLC samples revealed that mutations in STK11 and SMARCA4 were significantly more frequent in tumors with a PD-L1 TPS of 50% to 89% compared with those with a PD-L1 TPS greater than or equal to 90% (Q < 0.15), whereas BRCA2 was enriched in NSCLC samples with a PD-L1 TPS greater than or equal to 90% (Q < 0.15). Multiplexed immunofluorescence on 93 NSCLC samples identified higher intratumoral CD8+PD1+ T cells (p = 0.02) in tumors with PD-L1 TPS greater than or equal to 90% versus 50% to 89%. Conclusion: Pembrolizumab and cemiplimab were found to have long-term survival benefit and favorable genomic and immunophenotypic profile in patients with advanced NSCLC with PD-L1 TPS greater than or equal to 90% compared with TPS 50% to 89%.

We are concerned with the existence and concentration of multi-bump solutions for the nonlinear Kirchhoff equation $ \begin{eqnarray*} -\left ( \varepsilon ^{2}a+\varepsilon b\displaystyle {\int}_{\mathbb{R}^{3} }\left | \nabla v \right | ^{2} \mathrm {d} x \right )\Delta v+\lambda v = K(x)\left | v \right |^{2\sigma }v,\,\,\,x\in\mathbb{R}^3 \end{eqnarray*} $ with an $ L^{2} $-constraint in the $ L^{2} $-subcritical case $ \sigma\in\left(0, \, \frac{2}{3}\right) $ and the $ L^{2} $-supercritical case $ \sigma\in\left(\frac{2}{3}, \, 2 \right). $ Here $ \lambda \in \mathbb{R} $ appears as a Lagrange multiplier, $ \varepsilon $ is a small positive parameter and $ K > 0 $ possesses several local maximum points. By employing the variational gluing method and the penalization technique, we prove the existence of multi-bump solutions that are concentrated at local maximum points of $ K $ for the problem above.

Abstract While we recognize the prognostic importance of clinicopathological measures and circulating tumor DNA (ctDNA), the independent contribution of quantitative image markers to prognosis in non-small cell lung cancer (NSCLC) remains underexplored. In our multi-institutional study of 394 NSCLC patients, we utilize pre-treatment computed tomography (CT) and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) to establish a habitat imaging framework for assessing regional heterogeneity within individual tumors. This framework identifies three PET/CT subtypes, which maintain prognostic value after adjusting for clinicopathologic risk factors including tumor volume. Additionally, these subtypes complement ctDNA in predicting disease recurrence. Radiogenomics analysis unveil the molecular underpinnings of these imaging subtypes, highlighting downregulation in interferon alpha and gamma pathways in the high-risk subtype. In summary, our study demonstrates that these habitat imaging subtypes effectively stratify NSCLC patients based on their risk levels for disease recurrence after initial curative surgery or radiotherapy, providing valuable insights for personalized treatment approaches.

Abstract The pressing demand for sustainable energy storage solutions has spurred the burgeoning development of aqueous zinc batteries. However, kinetics-sluggish Zn2+ as the dominant charge carriers in cathodes leads to suboptimal charge-storage capacity and durability of aqueous zinc batteries. Here, we discover that an ultrathin two-dimensional polyimine membrane, featured by dual ion-transport nanochannels and rich proton-conduction groups, facilitates rapid and selective proton passing. Subsequently, a distinctive electrochemistry transition shifting from sluggish Zn2+-dominated to fast-kinetics H+-dominated Faradic reactions is achieved for high-mass-loading cathodes by using the polyimine membrane as an interfacial coating. Notably, the NaV3O8·1.5H2O cathode (10 mg cm−2) with this interfacial coating exhibits an ultrahigh areal capacity of 4.5 mAh cm−2 and a state-of-the-art energy density of 33.8 Wh m−2, along with apparently enhanced cycling stability. Additionally, we showcase the applicability of the interfacial proton-selective coating to different cathodes and aqueous electrolytes, validating its universality for developing reliable aqueous batteries.

Abstract The kinematic equivalent model of an existing ankle-rehabilitation robot is inconsistent with the anatomical structure of the human ankle, which influences the rehabilitation effect. Therefore, this study equates the human ankle to the UR model and proposes a novel three degrees of freedom (3-DOF) generalized spherical parallel mechanism for ankle rehabilitation. The parallel mechanism has two spherical centers corresponding to the rotation centers of tibiotalar and subtalar joints. Using screw theory, the mobility of the parallel mechanism, which meets the requirements of the human ankle, is analyzed. The inverse kinematics are presented, and singularities are identified based on the Jacobian matrix. The workspaces of the parallel mechanism are obtained through the search method and compared with the motion range of the human ankle, which shows that the parallel mechanism can meet the motion demand of ankle rehabilitation. Additionally, based on the motion-force transmissibility, the performance atlases are plotted in the parameter optimal design space, and the optimum parameter is obtained according to the demands of practical applications. The results show that the parallel mechanism can meet the motion requirements of ankle rehabilitation and has excellent kinematic performance in its rehabilitation range, which provides a theoretical basis for the prototype design and experimental verification.

Abstract A reliable, efficient and electrically-pumped Si-based laser is considered as the main challenge to achieve the integration of all key building blocks with silicon photonics. Despite the impressive advances that have been made in developing 1.3-μm Si-based quantum dot (QD) lasers, extending the wavelength window to the widely used 1.55-μm telecommunication region remains difficult. In this study, we develop a novel photonic integration method of epitaxial growth of III-V on a wafer-scale InP-on-Si (100) (InPOS) heterogeneous substrate fabricated by the ion-cutting technique to realize integrated lasers on Si substrate. This ion-cutting plus epitaxial growth approach decouples the correlated root causes of many detrimental dislocations during heteroepitaxial growth, namely lattice and domain mismatches. Using this approach, we achieved state-of-the-art performance of the electrically-pumped, continuous-wave (CW) 1.55-µm Si-based laser with a room-temperature threshold current density of 0.65 kA/cm−2, and output power exceeding 155 mW per facet without facet coating in CW mode. CW lasing at 120 °C and pulsed lasing at over 130 °C were achieved. This generic approach is also applied to other material systems to provide better performance and more functionalities for photonics and microelectronics.

Surface structures and microstructures are of vital importance to the wetting behaviors and mechanical robustness of non-wetting surfaces. In this work, yttrium oxide coatings with different surface structures and microstructures were deposited via the solution precursor plasma spray (SPPS) process, powder plasma spray (PPS) process, and a newly-developed mesh shielding PPS process. The SPPS coatings showed porous microstructures and hierarchical surface structures, and thereby presented superhydrophobic behaviors. The PPS coatings showed dense lamellar microstructures and relatively flat surface topographies, resulting in mildly hydrophobic behaviors. The PPS coatings exhibited much higher mechanical robustness and more stable hydrophobicity under physical damage as compared to the SPPS coatings. The coatings deposited via the mesh shielding PPS process showed unique surface structures of conical pillars, endowing the coating with excellent hydrophobicity and high mechanical robustness. The conical-structured coatings showed quasi-superhydrophobic behaviors, and maintained relatively consistent hydrophobicity after abrasion. The effects of the microstructures and surface structures on the wetting behaviors and mechanical robustness of different coatings were comparatively investigated. The effects of the microstructures and surface structures on the wetting behaviors and mechanical robustness of different coatings were comparatively investigated. The change of wetting behaviors of coatings after different treatments was elaborated by correlating with the surface compositions. The work showed the wetting behaviors and mechanical robustness can be manipulated by tailoring the microstructures and surface structures in plasma spray processes.

Abstract Background Corneal neovascularization (CoNV) threatens vision by disrupting corneal avascularity, however, current treatments, including pharmacotherapy and surgery, are hindered by limitations in efficacy and adverse effects. Minocycline, known for its anti-inflammatory properties, could suppress CoNV but faces challenges in effective delivery due to the cornea's unique structure. Therefore, in this study a novel drug delivery system using minocycline-loaded nano-hydroxyapatite/poly (lactic-co-glycolic acid) (nHAP/PLGA) nanoparticles was developed to improve treatment outcomes for CoNV. Results Ultra-small nHAP was synthesized using high gravity technology, then encapsulated in PLGA by a double emulsion method to form nHAP/PLGA microspheres, attenuating the acidic by-products of PLGA degradation. The MINO@PLGA nanocomplex, featuring sustained release and permeation properties, demonstrated an efficient delivery system for minocycline that significantly inhibited the CoNV area in an alkali-burn model without exhibiting apparent cytotoxicity. On day 14, the in vivo microscope examination and ex vivo CD31 staining corroborated the inhibition of neovascularization, with the significantly smaller CoNV area (29.40% ± 6.55%) in the MINO@PLGA Tid group (three times daily) than that of the control group (86.81% ± 15.71%), the MINO group (72.42% ± 30.15%), and the PLGA group (86.87% ± 14.94%) (p

ABSTRACT: As a highly infectious and contagious pathogen in chickens, infectious bronchitis virus (IBV) is currently grouped into nine genotypes (GI to GIX). However, the classification of serotypes of IBV is still not clear. In this study, 270 field strains of IBV were isolated from dead or diseased chicken flocks in eastern and southern China during January 2021 to April 2023. These isolated IBV strains could be classified into 2 genotypes, GI (including 5 lineages GI-1, GI-13, GI-19, GI-22, and GI-28) and GVI based on the complete S1 sequence. Further analysis showed that the GI-19, GI-13, GI-22, GI-28, and GVI were the dominant genotypes with the proportions of 61.48, 8.89, 8.89, 7.78, and 8.89% respectively, and the homology of S1 protein of these isolates ranged from 86.85 to 100% in GI-19, 92.22 to 100% in GI-13, 83.1 to 100% in GI-22, 94.81 to 100% in GI-28 and 90.0 to 99.8% in GVI, respectively. Moreover, cross-neutralization test with sera revealed that these isolates in GI-19 lineage could be classified into at least 3 serotypes according to the antigenic relationship. In addition, structure assay using PyMOL indicated that one mutation such as S120 in receptor binding site (RBD) of GI-19 might alter the antigenicity and conformation of S protein of IBV. Overall, our data demonstrate that not only multiple genotypes, but also multiple serotypes in a single genotype or lineage have been co-circulated in eastern and southern China, providing novel insights into the molecular evolution of the antigenicity of IBV and highlighting the significance of the selection of the dominant isolate for vaccine development in IBV endemic region.

IntroductionImproving photosynthetic use efficiency in dryland agroecosystems to sustain high agricultural yields is a key responsibility for ensuring food security.MethodsThis study was conducted in the regions on the semiarid Loess Plateau of China during 2018–2020. Dryland maize of Xianyu 335 comprised four modes: basic yield input (CK, plastic film mulching, 37500 plant.ha-1 of plant density and unfertilized), farmer input (FP, plastic film mulching, 45000 plant.ha-1 of plant density and inorganic nitrogen(N) and phosphate(P) fertilizer were 150kg.ha-1 and 90kg.ha-1), high yield and high-efficiency input (HH, full plastic-film mulching on double furrow, 67500 plant.ha-1 of plant density and N, P and organic manure(M) fertilizer were 230kg.ha-1, 140kg.ha-1 and 1500kg.ha-1), and super high yield input (SH, full plastic-film mulching on double furrow, 9000 plant.ha-1 of plant density and N, P and organic M fertilizer were 300kg.ha-1, 180kg.ha-1 and 7500kg.ha-1). The effects of different cultivation modes on yield, WUE, net photosynthetic rate(Pn), leaf area index(LAI), chlorophyll index(SPAD value) and root index were studied.ResultsThe results showed that the value average of yield and WUE for CK were 7790kg and 17480kg.ha-1 in three years. SH, HH and FP cultivation modes of yield and WUE was significant higher compared with CK cultivation mode (P

IntroductionThe purpose of this study was to investigate the predictive factors of atrial fibrillation (AF) recurrence in patients after first-time radiofrequency catheter ablation (RFCA) and to develop a nomogram predictive model that can provide valuable information for determining the ablation strategy.MethodsIn total, 500 patients who had received first-time RFCA for AF were retrospectively enrolled in the study. The patients were divided into a training cohort (n = 300) and a validation cohort (n = 200) randomly at a 6:4 ratio. Lasso and multivariate logistic regression analyses were used to screen the predictors for AF recurrence during a 2-year follow-up. The C-index and a calibration plot were used to detect the discriminative ability and calibration of the nomogram. The performance of the nomogram was assessed compared with the APPLE score, CAAP-AF score, and MB-LATER score using the receiver operating characteristic (ROC) curve, decision curve analysis (DCA), integrated discrimination index (IDI), and net reclassification index (NRI).ResultsA total of 78 patients experienced the recurrence of AF after first-time RFCA in the training cohort. The six strongest predictors for AF recurrence in the training cohort were persistent AF, duration of AF, left atrial diameter (LAD), estimated glomerular filtration rate (eGFR), N-terminal pro-brain natriuretic peptide (NT-proBNP), and autoantibody against M2-muscarinic receptor (anti-M2-R). Based on the above six variables, a nomogram prediction model was constructed with a C-index of 0.862 (95% CI, 0.815–0.909), while the C-index was 0.831 (95% CI, 0.771–0.890) in the validation cohort. DCA showed that this nomogram had greater net benefits compared with other models. Furthermore, the nomogram showed a noticeable improvement in predictive performance, sensitivity, and reclassification for AF recurrence compared with the APPLE score, CAAP-AF score, or MB-LATER score.ConclusionWe established a novel predictive tool for AF recurrence after the first-time RFCA during a 2-year follow-up period that could accurately predict individual AF recurrence.

Bacterial infections and inadequate tissue regeneration capacity are prevalent issues in diabetic wounds, impeding the healing process. To solve these problems, a biomimetic hydrogel combined with bacterial cellulose (BC), recombinant human collagen type III (RHC), and ε-poly-L-Lysine (EPL) is fabricated by stepwise co-assembly technology. Owing to the RHC and EPL modifications of BC, the biomimetic hydrogel exhibited antibacterial effects and promoted fibroblast proliferation and angiogenesis, which accelerated the healing of diabetic wounds. Biomimetic hydrogels exhibit good mechanical properties and excellent water absorption, that can protect wounds and provide a moist environment. In addition, in vitro studies have shown that the hydrogels exhibit excellent antibacterial activity and biocompatibility. In vivo studies on diabetic wound healing have shown that biomimetic hydrogels can promote angiogenesis, accelerate collagen deposition, and re-epithelialize wound sites to promote wound healing. This study provides a new and promising strategy for the treatment of diabetic wounds.

The bilateral teleoperation system is susceptible to model parameter uncertainty and unknown disturbances in both the master and slave manipulators, resulting in instability and inaccuracies in the force and position tracking performance. To address these issues, a novel nonlinear model reference adaptive impedance controller has been designed to achieve coordinated force and position synchronization of dual manipulators. The adaptive control laws, based on sliding mode functions, have been designed to compensate for the uncertainty of the manipulator model. Furthermore, an adaptive estimation law has been employed to appraise the unknown upper bound of external disturbances. This ensures that the closed-loop model parameters of the dual manipulator converge to the reference impedance model respectively. Simultaneously, it enables the position error between the reference model response and the end-effector task space position to asymptotically converge to zero. To verify the effectiveness of the proposed controller, simulations have been conducted on the MATLAB platform and experiments on a single degree of freedom teleoperation system have been performed. The results demonstrate that the controller exhibits strong robustness and has the capability of force-position tracking ability.

The electromagnetic transient overvoltage in the substation is an important factor that affects the life of insulation equipment. For evaluate the economy and reliability of the insulation design of substation equipment, it is necessary to study and analyze the actual measured overvoltage waveforms in the substation. In this paper, firstly, the 3018 pieces of overvoltage data monitored in the 220 kV substation from 2018 to 2019 are preprocessed to obtain the required overvoltage waveform. Next, by analyzing and classifying the overvoltage data, four typical overvoltage waveforms suffered by the insulation equipment in the substation are extracted. Combined with the IEC60060 standard, the time parameters of the overvoltage waveform are selected and defined: wave-front time (Tf), half-value time (Thalf), main oscillation frequency (f), and attenuation constant (α). Further, statistical analysis is performed on the parameters of each waveform. The distribution law, distribution characteristics and distribution range of the parameters are obtained. Finally, the parameters of four typical overvoltage waveforms are summarized and compared, the cumulative distribution functions are obtained. This results can guide and optimize the insulation design of the insulation equipment in the substation, reduce design errors. It provide data support for the economy and reliability of insulation design.

BackgroundIncreasing evidence suggests a correlation between intestinal microbiota and the gut-brain axis; however, the causal relationship between gut microbiota and postpartum depression (PPD) remains unclear.MethodsIn this study, a two-sample Mendelian randomization (MR) design was employed to analyze the GWAS data of gut microorganisms from the Mibiogen database and PPD data from the UK biobank. Various statistical methods, including inverse variance weighted, MR-Egger, weighted median, weighted model, and MR-PRESSO, were utilized to investigate the causal relationship between gut microbiota and PPD. Additionally, sensitivity analysis was conducted to assess the robustness of the findings.ResultsThrough MR analysis, it was found that phylum Actinobacteria (P=0.014, OR=0.971, 95% CI=0.948-0.994) and genus Holdemanella (P=0.023, OR=0.979, 95% CI=0.961-0.997) have protective effects on PPD, while the other two unknown genera, genus Unknown Ids 2001 (P=0.025, OR=0.972,95% CI=0.947-0.996), and genus Unknown Ids 2755 (P=0.012, OR=0.977, 95% CI=0.959-0.995) also has a protective effect on PPD. The sensitivity analysis results indicate that there is no heterogeneity or horizontal pleiotropy.ConclusionThis study has identified a causal association between Actinomycetota, Holdemanella, and PDD through MR analysis. These findings offer significant contributions to the development of personalized treatment approaches for PPD, encompassing interventions such as dietary modifications or microbiome interventions.

Nasopharyngeal carcinoma with bone marrow metastasis presents a rare and challenging clinical scenario associated with exceedingly poor prognosis. While standard treatment regimens offer limited efficacy and tolerability in such cases, individualized approaches are increasingly necessary. We present the case of a 64-year-old male diagnosed with recurrent nonkeratinizing undifferentiated nasopharyngeal carcinoma with extensive bone marrow metastasis (rTxN0M1). Treatment was initiated with immunotherapy-based combination therapy, consisting of pembrolizumab and low-dose cisplatin, which resulted in an initial response. Subsequently, there was a transition to standard-dose nab-paclitaxel-cisplatin chemotherapy in combination with pembrolizumab, followed by maintenance therapy with pembrolizumab plus fruquintinib. The patient achieved a sustained response with renormalization of tumor markers, imaging findings, and bone biopsies, resulting in complete remission. This case highlights the successful management of nasopharyngeal carcinoma with extensive bone marrow metastasis through an individualized treatment approach incorporating immunotherapy.

Abstract Tumor mutational burden (TMB) and T‐cell receptor (TCR) might predict the response to immunotherapy in patients with non–small cell lung cancer (NSCLC). However, the predictive value of the combination of TMB and TCR was not clear. Targeted DNA and TCR sequencing were performed on tumor biopsy specimens. We combined TMB and TCR diversity into a TMB‐and‐TCR (TMR) score using logistic regression. In total, 38 patients with advanced NSCLC were divided into a discovery set (n = 17) and validation set (n = 21). A higher TMR score was associated with better response and longer progression‐free survival to immunotherapy in both the discovery set and validation set. The performance of TMR score was confirmed in the two external validation cohorts of 225 NSCLC patients and 306 NSCLC patients. Tumors with higher TMR scores were more likely to combine with LRP1B gene mutation (p = 0.027) and top 1% CDR3 sequences (p = 0.001). Furthermore, LRP1B allele frequency was negatively correlated with the top 1% CDR3 sequences (r = –0.55, p = 0.033) and positively correlated with tumor shrinkage (r = 0.68, p = 0.007). The TMR score could serve as a potential predictive biomarker for the response to immunotherapy in advanced NSCLC.

Abstract Livestock constitute the world’s largest anthropogenic source of methane (CH4), providing high-protein food to humans but also causing notable climate risks. With rapid urbanization and increasing income levels in China, the livestock sector will face even higher emission pressures, which could jeopardize China’s carbon neutrality target. To formulate targeted methane reduction measures, it is crucial to estimate historical and current emissions on fine geographical scales, considering the high spatial heterogeneity and temporal variability of livestock emissions. However, there is currently a lack of time-series data on city-level livestock methane emissions in China, despite the flourishing livestock industry and large amount of meat consumed. In this study, we constructed a city-level livestock methane emission inventory with dynamic spatial-temporal emission factors considering biological, management, and environmental factors from 2010 to 2020 in China. This inventory could serve as a basic database for related research and future methane mitigation policy formulation, given the population boom and dietary changes.

Abstract Despite the central role of human leukocyte antigen class I (HLA-I) in tumor neoantigen presentation, quantitative determination of presentation capacity remains elusive. Based on a pooled pan-cancer genomic dataset of 885 patients treated with immune checkpoint inhibitors (ICIs), we developed a score integrating the binding affinity of neoantigens to HLA-I, as well as HLA-I allele divergence, termed the HLA tumor-Antigen Presentation Score (HAPS). Patients with a high HAPS were more likely to experience survival benefit following ICI treatment. Analysis of the tumor microenvironment indicated that the antigen presentation pathway was enriched in patients with a high HAPS. Finally, we built a neural network incorporating factors associated with neoantigen production, presentation, and recognition, which exhibited potential for differentiating cancer patients likely to benefit from ICIs. Our findings highlight the clinical utility of evaluating HLA-I tumor antigen presentation capacity and describe how ICI response may depend on HLA-mediated immunity.

Abstract Background Few evidence-based prediction models have been developed for predicting major adverse cardiovascular and cerebrovascular events (MACCE) in patients aged 65 years or older undergoing noncardiac surgery. In this study, we aimed to analyze the risk factors for perioperative MACCE in patients aged 65 years or older undergoing noncardiac surgery and construct a prediction model. Methods In this nested case–control study, a total of 342 Chinese patients who were aged ≥ 65 years and underwent medium- or high-risk noncardiac surgery in our hospital were included. There were 84 cases with MACCE (the MACCE group) and 258 without MACCE (the control group). Univariable logistic regression analysis was performed to identify the risk factors for MACCE. Least absolute shrinkage and selection operator (LASSO) regression was used to screen the variables. Nomogram was constructed using the selected variables. Machine learning methods, including Decision Tree, XGBoost, Support Vector Machine, K-nearest Neighbor, and Neural network, was used to establish, validate, and compare the performance of different prediction models. Results A prediction model based on nine variables, including age ≥ 85 years, history of ischemic chest pain, symptoms of decompensated heart failure, high-risk surgery, intraoperative minimum systolic blood pressure, postoperative systolic blood pressure, Cr levels over 2.0 mg/dL, left ventricular ejection fraction, and perioperative blood transfusion, was constructed. This LASSO logistic regression model showed good discriminatory ability to predict MACCE (area under the curve = 0.89; 95% confidence interval, 0.818 – 0.963) and fit to the test set (Hosmer–Lemeshow, χ2 = 7.4053, P = 0.4936). The decision curve analysis showed a positive net benefit of the new model. Compared with logistic regression model, the XGBoost model showed better prediction ability (area under the curve = 0.903). A preoperative prediction model based on five variables, including age ≥ 85 years, symptoms of decompensated heart failure, ischemic chest pain, high-risk type of surgery and Cr levels over 2.0 mg/dL was also constructed. This model showed good discriminatory ability to predict MACCE before surgery (area under the curve = 0.720 [95% CI, 0.591–0.848]. Both models compared with the modified RCRI score had improvement in reclassification. Conclusion By analyzing Chinese patients aged ≥ 65 years undergoing medium- or high-risk noncardiac surgery, the risk factors for perioperative MACCE were identified. Then, simple prediction models were constructed and validated, which showed good prediction performance and may be used as a decision-making assistant tool for clinicians. These findings provide a basis for preventing and improving the perioperative management of MACCE.

Abstract Aiming at the problem that the existing ankle rehabilitation robot is difficult to fully fit the complex motion of human ankle joint and has poor human-machine motion compatibility, an equivalent series mechanism model that is highly matched with the actual bone structure of the human ankle joint is proposed and mapped into a parallel rehabilitation mechanism. The parallel rehabilitation mechanism has two virtual motion centers (VMCs), which can simulate the complex motion of the ankle joint, adapt to the individual differences of various patients, and can meet the rehabilitation needs of both left and right feet of patients. Firstly, based on the motion properties and physiological structure of the human ankle joint, the mapping relationship between the rehabilitation mechanism and ankle joint is determined, and the series equivalent model of the ankle joint is established. According to the kinematic and constraint properties of the ankle equivalent model, the configuration design of the parallel ankle rehabilitation robot is carried out. Secondly, according to the intersecting motion planes theory, the full-cycle mobility of the mechanism is proved, and the continuous axis of the mechanism is judged based on the constraint power and its derivative. Then, the kinematics of the parallel ankle rehabilitation robot is analyzed. Finally, based on the OpenSim biomechanical software, a human-machine coupling rehabilitation simulation model is established to evaluate the rehabilitation effect, which lays the foundation for the formulation of a rehabilitation strategy for the later prototype.