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Aims: The relationship between the incidence of major cardiovascular diseases (CVDs) and estimated glucose disposal rate (eGDR), a proxy measurement for insulin resistance (IR), is not well understood in the general population. The predictive value of eGDR and other proxies of IR for CVD incidents have not been examined in previous studies. This study aimed to investigate the association between eGDR and various CVD events, including myocardial infarction (MI), heart failure (HF), atrial fibrillation (AF) and ischemic stroke. Additionally, the predictive values of eGDR, triglyceride-glucose (TyG) index, TyG-waist circumference (WC), TyG-body mass index (BMI), TyG-waist-to-height ratio (WHtR), triglyceride (TG)-to-high density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C) and the metabolic score for insulin resistance (METS-IR) for CVD events were compared., Methods: The study population was extracted from the UK Biobank, and the CVD events were documented by linking to hospital records. Cox proportional hazards model and the restricted cubic spline model were used to assess the association between eGDR and the risk of CVDs with adjustment for potential confounders. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) were used to compare the predictive values of eGDR, TyG, TyG-WC, TyG-BMI, TyG-WHtR, TG/HDL-C and METS-IR., Results: A total of 360 953 participants were included in this study. During a median follow-up of 13.8 years, 12 698 MI, 10 360 HF, 23 638 AF and 6512 ischemic stroke events were documented. Compared with participants in the lowest quartile category of eGDR, those in the highest quartile category had the adjusted hazard ratio (HR) and 95% confidence interval (CI) of 0.59 (0.51-0.67) for MI, 0.66 (0.56-0.76) for HF, 0.88 (0.80-0.98) for AF and 0.73 (0.61-0.89) for ischemic stroke. eGDR outperformed TyG, TyG-WC, TyG-BMI, TyG-WHtR, TG/HDL-C and METS-IR in terms of predicting MI (AUC: 0.661), HF (AUC: 0.690), AF (AUC: 0.653) and ischemic stroke (AUC: 0.646)., Conclusions: eGDR was inversely associated with the incidence of MI, HF, AF and ischemic stroke in the general population. eGDR could serve as a more valuable predictive indicator than TyG, TyG-WC, TyG-BMI, TyG-WHtR, TG/HDL-C and METS-IR for CVD events in clinical practice., (© 2025 John Wiley & Sons Ltd.)

Objective: To evaluate the efficacy and safety of acupuncture as a supplementary treatment for mild to moderate depression in hemodialysis patients., Method: This multicenter, randomized, controlled, single-masked trial included 64 hemodialysis patients aged 18-75 divided into two groups. One group received genuine acupuncture, while the other received sham acupuncture over 12 weeks. The primary outcome measure was Hamilton Depression Scale (HAMD) scores; an inclusion criterion was HAMD scores of 10-23. Secondary outcomes included life quality improvements and changes in biochemical markers, such as serum albumin and hemoglobin levels. To assess the predictive effects of acupuncture treatment and biochemical parameters on depressive symptoms, a multivariable linear regression analysis was conducted., Results: Following acupuncture treatment, HAMD scores significantly decreased, quality of life scores improved, and biochemical indicators (serum albumin, hemoglobin, transferrin, and total protein levels) showed some improvement, indicating the effectiveness of acupuncture in alleviating depressive symptoms and enhancing overall health in hemodialysis patients. Multivariable regression analysis showed that acupuncture treatment (P = 0.004) and serum albumin levels (P = 0.03) were significant predictors of improvement in depressive symptoms, with an adjusted R 2 of 0.45, indicating that the model explained 45 % of the variance in symptom improvement. Other biochemical indicators, such as hemoglobin, transferrin, and total protein, did not show significant predictive effects (P > 0.05). No serious adverse events were observed during the treatment., Conclusion: Acupuncture is a safe and effective adjunct therapy for alleviating mild to moderate depression in hemodialysis patients. Acupuncture treatment and certain biochemical indicators (such as serum albumin) have significant predictive value for improving depressive symptoms., Competing Interests: Declaration of competing interest The author declares no conflict of interest., (Copyright © 2025 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Anxiety in patients undergoing colonoscopy may also result in adverse effects, including altered vital signs such as elevated heart rate and blood pressure, exacerbation of symptoms like bloating and gastrointestinal discomfort, a decline in cooperation and satisfaction, and even colonoscopy failure. However, limited studies have explored the level of anxiety, factors that influence it, and its specific causes., Methods: A cross-sectional study was conducted, recruiting 825 patients undergoing colonoscopy in Hunan Province between January and July 2023 using stratified sampling. The Spielberger State-Trait Anxiety Inventory (STAI), a self-designed demographic characteristics questionnaire, and a colonoscopy patient anxiety influencing factor questionnaire were used. The data were analyzed in SPSS (version 26) using Mann-Whitney U, Kruskal-Wallis, and multiple regression analysis tests., Results: The final study included 825 participants, of whom 19.8% exhibited mild anxiety, 37.0% exhibited moderate anxiety, and 43.2% exhibited severe anxiety. The results indicated that insomnia (β=-0.080, p = 0.013), no comorbidities (β=-0.147, p < 0.001), not smoking or drinking (β=-0.158, p < 0.001), and poor health (moderate: β=-0.183, p < 0.001; poor: β=-0.164, p < 0.001) were negatively associated with anxiety levels. In contrast, marital status (β = 0.177, p < 0.001), education level (β = 0.204, p < 0.001), age (β = 0.114, p = 0.007), medical insurance (Basic Medical Insurance for Urban Residents β = 0.204, p < 0.001; Commercial medical insurance: β = 0.112, p < 0.001), care provided by relatives (β = 0.102, p = 0.002), diarrhoea (β = 0.089, p = 0.005), occupation (farmers: β = 0.099, p = 0.009; self-employed: β = 0.082, p = 0.014), and paternal upbringing (β = 0.067, p = 0.034) were positively correlated with anxiety. Several factors had a greater impact on the anxiety level of the patients: education level (β = 0.204), health status (moderate: β=-0.183; not good: β=-0.164), and marital status (β = 0.177). It probably because higher education levels may increase awareness of potential risks associated with colonoscopy, contributing to greater anxiety. The five common reasons for anxiety included the presence of bloody faeces, enemas, need for further treatment, lack of timely feedback from the physician, lack of an accurate diagnosis., Conclusion: The level of anxiety experienced by patients during the colonoscopy phase was more severe and should be alleviated with targeted interventions based on the cause of anxiety, such as pre-procedural counseling, patient education materials, and enhanced communication with healthcare providers., Competing Interests: Declarations. Ethics approval and consent to participate: This study was approved by Hengyang Medical School, University of South China (NO.4502101003887). All participants will be required to provide written informed consent, for more details see the supplementary materials. Overall, the entire methods in this study were performed in accordance with international and national ethical guidelines and regulations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

The preparation of UiO-66@CdTe@AuNPs composites is presented for the first time, which function as a photoelectrochemical (PEC) sensing matrix and are conjugated to a three-way junction (TWJ). We propose an antibody-based specific recognition-induced neighbor-joining reaction that initiates the assembly of two molecularly designed nucleic acid enzymes (MNAzymes), to release an oligonucleotide that hydrolyzes TWJ through the mechanism of a toehold-mediated strand displacement reaction (TSDR). Subsequently, a hybridization chain reaction application (HRCA)-based dendrimer is formed, which immobilizes a large number of quantum dots to generate a burst effect that reduces the photocurrent signal. As anticipated, the developed PEC biosensor showed excellent analytical performance for both m 6 A-RNA and m 5 C-RNA, with detection limits of 0.309 fM and 6.918 aM, respectively. The successful fabrication of this ultrasensitive and simultaneous PEC biosensor provides new insights for epigenetic research and the bioassay, mechanism investigation and clinical diagnosis of diseases associated with RNA methylation., Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Metallic Bi is a classic metal-type anode material characterized by its high volume-specific capacity (3785 mA h cm -3 ) and theoretical specific capacity (386 mA h g -1 ). However, during the charge and discharge processes of the battery, Bi undergoes significant volume expansion and contraction, which leads to a notable decline in battery performance. In this work, to suppress the volume expansion of bismuth and enhance battery performance and stability, a Bi-metal-organic-framework (Bi-MOF) is utilized as a precursor and combined with an organic polymerization coating process, followed by calcination, to obtain a double-carbon-coated lamellar structure (Bi/C@C Ppy ). The coated carbon layers inhibit the agglomeration of Bi particles and mitigate volume changes during charge-discharge cycles. After 100 cycles at 0.1 A g -1 , Bi/C@C Ppy maintains a specific capacity of 526.4 mA h g -1 . Even after 900 extended cycles, it retains a specific capacity of 255.6 mA h g -1 at 0.5 A g -1 . In situ XRD is employed to analyze the Li + storage mechanism. Furthermore, a full cell with Li 1.2 Ni 0.13 Co 0.13 Mn 0.64 O 2 as the cathode and a Bi/C@C Ppy -based anode achieves a capacity of 104.3 mA h g -1 after 100 cycles at a current density of 0.05 A g -1 . This approach provides valuable insights into the precise structural design and preparation of high-performance rechargeable battery alloy negative electrode materials.

Polymer self-assembly offers an important route to construct well-defined nanostructures. However, it remains challenging to assemble polymers into vertically oriented nanostructures. Here, we use a seed-induced confinement self-assembly strategy to construct vertically aligned semiconducting nanobrushes from polyfluorene-based polymers on conductive substrates. Mechanism studies elucidate that the immobilized seeds on the substrate initiate the vertical growth of nanobrushes, and supercritical drying as well as the rigid charged coronas collectively contribute to retaining the vertical architecture. This process enables nanobrushes with ∼40× higher charge mobilities than their bulk film counterparts. Thus, inverted organic solar cells using the nanobrushes as the electron transporting layer (ETL) exhibit a record power conversion efficiency of 18.51% as a result of increased ETL texturing and the ETL-active layer interface favoring electron extraction. Moreover, our approach also enables the uniform growth of nanobrushes on a nanoporous photoanode (bismuth vanadate) for photoelectrochemical water splitting, improving catalyst distribution and electron transfer. Our work presents a feasible approach to fabricating challenging vertical polymer nanostructures, thereby unlocking the tremendous potential of conjugated polymers in optoelectronic applications.

The development of high-performance all-solid-state lithium-sulfur batteries (ASSLSBs) has garnered considerable attention due to their potential for high energy density and enhanced safety. However, significant challenges such as poor cycling stability, interface incompatibility, and reaction kinetics hinder severely their practical application. In this work, an all-in-one sulfur/cobalt disulfide (S/CoS 2 ) composite cathode is proposed by integrating sulfur and homogenized cobalt disulfide (CoS 2 ) as the sulfur-based cathode materials with the sulfide solid electrolyte (Li 6 PS 5 Cl) through ball milling. This strategy combines the homogenization effect and catalytic effect of CoS 2 to improve the interfacial compatibility and reaction kinetics of the sulfur-based cathode, thereby reducing interfacial resistance and enhancing overall battery performance. It is confirmed that the introduction of homogenized CoS 2 can significantly improve interfacial lithium-ion transport, enhancing the rate performance. More importantly, it promotes the conversion of S to Li 2 S, improving the utilization rate and reaction kinetics of the ASSLSBs. The S/CoS 2 cathode delivers an impressive initial discharge capacity of 1584 mA h g -1 with a capacity utilization of 99% at a current density of 0.25 mA cm -2 and maintains 915 mA h g -1 after 100 cycles. Even at 1.28 mA cm -2 , the cathode exhibits a specific capacity of 474 mA h g -1 . This all-in-one strategy provides valuable insights into the design of next-generation ASSLSBs and holds significant potential for future energy storage technologies.

This study investigates the application of decellularized tissue matrices (DSCM) hydrogels functionalized with extracellular vesicles (EVs) derived from mesenchymal stromal cells (MSCs) for spinal cord injury (SCI) treatment. The primary focus is on how these composites influence macrophage reprogramming and neural stem cell (NSC) differentiation by modulating Slamf9 expression. MSC-derived EVs were successfully isolated, and DSCM hydrogels were prepared from porcine spinal cords. The composite material, EVs derived from MSCs (DSCM@EVs), was constructed and applied to a mouse SCI model, showing significant enhancement in NSC differentiation and axonal growth, thereby alleviating SCI. Bioinformatics and in vitro cell experiments revealed that DSCM@EVs promote the reprogramming of M1 macrophages to the M2 phenotype, reducing inflammatory responses and facilitating NSC differentiation. RNA-seq analysis identified Slamf9 as a key regulatory gene, with its suppression linked to the observed therapeutic effects. This novel approach demonstrates the potential of DSCM@EVs in SCI repair by modulating the inflammatory environment and promoting neural regeneration, offering a promising strategy for treating SCI and potentially other inflammatory neurological disorders., Competing Interests: Declarations. Ethical approval: All animal experiments were approved by the Animal Ethics Committee. The study does not involve any clinical ethics considerations. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Loss-of-function (LOF) pathogenic variants in KCNQ1 encoding a cardiac potassium channel predispose to sudden cardiac death in type 1 congenital long QT syndrome (LQT1). To determine the spectrum of molecular mechanisms responsible for this life-threatening condition, we used an integrative approach to determine the biophysical, functional, and trafficking properties of 61 KCNQ1 variants distributed throughout all domains of the channel. Impaired trafficking to the plasma membrane was the most common cause of LOF across all channel domains, often but not always coinciding with protein instability. However, many LOF variants, particularly in transmembrane domains, trafficked normally, but when coexpressed with KCNE1 exhibited impaired conductance, altered voltage dependence, or abnormal gating kinetics, highlighting diverse pathogenic mechanisms. This indicates a need for personalized treatment approaches for LQT1. Use of our data to benchmark variant pathogenicity prediction methods demonstrated that prediction accuracy depends on the exact mechanism of pathogenicity associated with a given variant., Competing Interests: Competing interests statement:Alfred George serves on the Scientific Advisory Board of Tevard Biosciences. Alfred George received grant funding from Biohaven Pharmaceuticals.

The utilization of ferroelectric polarization-assisted photoelectrochemical (PEC) systems holds huge promise for solving the issue of high recombination of photogenerated electron-hole pairs. Monitoring their intricate charge-transfer process can offer profound insights into the advancement of highly active photoelectrodes. In this work, the hydrothermally synthesized titanium dioxide nanorod arrays (TiO 2 NRAs) are subjected to in situ etching to introduce oxygen vacancies (Ov), and subsequently loaded with barium titanate (BaTiO 3 , BTO) nanoparticles to form a ferroelectric polarization effect-assisted type-II heterojunction. The resulting Ov-TiO 2 /BTO demonstrates an ultrahigh photocurrent of 102 μA and outstanding stability over 7200 s, far surpassing majority of recently reported PEC photoanodes operating at a bias voltage of 0 V (vs Ag/AgCl). Notably, the photoinduced charge transfer in ferroelectric Ov-TiO 2 /BTO was monitored at the microscale by advanced scanning photoelectrochemical microscopy (SPECM). As a showcase, the aptamer-coupled self-powered PEC biosensor for kanamycin presents excellent sensitivity and good anti-interference ability. This study not only elucidates the intrinsic mechanism of the synergistic amplification of photoelectric signals by oxygen vacancies and ferroelectric heterojunctions but also provides a reliable platform for the ultrasensitive detection of biological molecules.

Background: To evaluate the correlation between atrial fibrillation (AF) burden and two-dimensional LA (left atrium) longitudinal reservoir strain (LARS) to explore the potential clinical utility of this novel parameter in patients with AF., Methods: This cross-sectional study was conducted at the cardiac electrophysiology clinic of a tertiary centre by consecutively enrolling patients with non-valvular AF. The AF burden was evaluated using 14-day patch-based electrocardiography and defined as the percentage of time spent in AF during a 14-day monitoring period. High and low AF burdens were defined based on the median 14-day AF burden. Echocardiographic measurements, including the longitudinal strain of the LA, were performed in all patients., Results: Among 267 patients, LARS was successfully performed in 221 (age 63 ± 11 years, male 71%, paroxysmal AF 71%). After adjusting for age, diabetes mellitus, congestive heart failure, estimated glomerular filtration rate, low-density lipoprotein level, left ventricular ejection fraction, LA dimension, and LA volume in multivariable linear regression analysis, low LARS remained a significant predictor of AF burden in addition to N-terminal pro-B-type natriuretic peptide and sex. Receiver operating curve analysis demonstrated that the best cut-off value for LARS to predict high AF burden (above median 10.49%) was 21.5%, with 75% sensitivity and 83% specificity., Conclusions: LARS is associated with the AF burden in patients with AF. Further studies are needed to determine the role of routine LARS measurements in such patients., Competing Interests: Declaration of competing interest None., (Copyright © 2025 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)

Space cooling and heating consume huge energy resources globally, while existing cooling/heating equipment can only address indoor temperature control. In this work, we report a multifunctional layered Janus-coated fabric (JCF) with radiative cooling/solar heating/Joule heating, which can utilize space and the sun as a source of cooling and heating. By adjusting the reflectivity, emissivity, and absorptivity of the coating, the fabric performs a thermal management function in a complex and changeable environment without consuming energy. In cooling mode, the cooling layer achieves a high solar reflectivity of 96% and an infrared emissivity of 96%, resulting in a 3.1 °C reduction in ambient temperature without any convective shielding. In addition, it reduces temperatures by 1.6 °C on human arms and by 5.1 °C inside houses, respectively. In the heating mode, the heating layer demonstrates excellent light-to-heat conversion efficiency under direct sunlight, achieving a 13.3 °C radiation warming ability, 16 °C heating effect on the surface of the arm, and a 12.8 °C temperature increase in the house. Furthermore, when switched to active heating for temperature regulation, JCF exhibits fast electrical response, high-efficiency electrical heat conversion capability, and stable electrical heat circulation capability. Building energy simulations indicate that widespread deployment of JCF across China could lead to a reduction in cooling and heating energy consumption by more than 25 MJ/m 2 in 80% of cities. This multifunctional Janus-coated fabric not only provides a viable engineering path for the practical application of radiative heat management technology but also demonstrates its potential applications in human thermal comfort, smart wearable and building energy efficiency.

Cancer stem cells (CSCs) are significant factors in the treatment resistance and recurrence of glioblastoma. Chromobox protein homolog 7 (CBX7) can inhibit the progression of various tumors, but its impact on the stem cell-like properties of glioblastoma cells remains unclear. Clinically, low levels of CBX7 are associated with poor prognosis and increased distant metastasis in glioblastoma patients, and this low expression is caused by methylation of the CBX7 promoter. Our current research indicates that CBX7 plays a key role in suppressing the stem-like phenotype of glioblastoma. In this study, through bioinformatics analysis, we found that CBX7 is the most significantly downregulated member of the CBX family in glioblastoma and is closely associated with the stem-like phenotype of glioblastoma cells. We show that CBX7 promotes the degradation of myosin heavy chain 9 (MYH9) protein through the ubiquitin-proteasome pathway via the polycomb repressive complex 1 (PRC1) and suppresses the stem-like phenotype of glioblastoma cells by inhibiting the nuclear factor kappa-B (NF-κB) signaling pathway. Furthermore, overexpression of MYH9 in glioblastoma cells reverses the inhibitory effects of CBX7 on migration, proliferation, invasion, and stemness of glioblastoma cells. In summary, CBX7 acts as a tumor suppressor by inhibiting the stem cell-like characteristics of glioblastoma. The CBX7-MYH9-NF-κB signaling axis may serve as a potential therapeutic target for glioblastoma., Competing Interests: Competing interests: The authors declare no competing interests. Ethics approval: The study was approved by the Institutional Ethics Committee of Wuxi People’s Hospital of Nanjing Medical University at the commencement of the study., (© 2025. The Author(s).)

Key Message: Flavonoid 3'-hydroxylase synthesis gene-GHCYP706A7, enhanced cotton resistance to alkali stress by scavenging ROS to regulate anthocyanin synthesis. Anthocyanins are a class of flavonoids that play a significant role in mediating plant responses to adverse environmental conditions. Flavonoid 3'-hydroxylase (F3'H), a member of the cytochrome P-450 (CYP) family, is a pivotal enzyme involved in the biosynthesis of anthocyanins. The present study identified 398 CYPs in the Gossypium hirsutum genome, of which GHCYP706A7 was responsible for F3'H synthesis and its ability to respond to alkaline stress. GHCYP706A7 suppression through virus-induced gene silencing (VIGS) diminished tolerance to alkali stress in cotton, evidenced by significantly reduced anthocyanin synthesis, markedly decreased antioxidant capacity, notable increases in reactive oxygen species, severe cellular damage, and observably decreased stomatal opening. The cumulative effects of these physiological disruptions ultimately manifest in cotton wilting and fresh weight decline. These findings lay a foundation for further investigations into the role of CYPs in regulating anthocyanin synthesis and responding to alkali stress., Competing Interests: Declarations. Conflict of interest: The authors have not disclosed any competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Astrocytes regulate synaptic transmission in healthy and pathological conditions, but their involvement in modulating synaptic transmission in chronic pain is unknown. Our study demonstrates that astrocytes in the anterior cingulate cortex (ACC) exhibit abnormal calcium signals and induce the release of glutamate in male mice. This leads to an elevation in extracellular glutamate concentration, activation of presynaptic kainate receptors, and an increase in synaptic transmission following neuropathic pain. We discovered that the abnormal calcium signals are caused by the reappearance of metabotropic glutamate receptor type 5 (mGluR5) in astrocytes in male mice. Importantly, when we specifically inhibit the Gq pathway using iβARK and reduce the expression of mGluR5 in astrocytes through shRNA, we observe a restoration of astrocytic calcium activity, normalization of synaptic transmission and extracellular concentration of glutamate, and improvement in mechanical allodynia in male mice. Furthermore, the activation of astrocytes through chemogenetics results in an overabundance of excitatory synaptic transmission, exacerbating mechanical allodynia in mice with neuropathic pain, but not in sham-operated male mice. In summary, our findings suggest that the abnormal calcium signaling in astrocytes, mediated by mGluR5, plays a crucial role in enhancing synaptic transmission in ACC and contributing to mechanical allodynia in male mice., Competing Interests: Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Aggregate signatures are excellent in simultaneously verifying the validity of multiple signatures, which renders them highly suitable for bandwidth-constrained environments. The certificateless public key system is among the most advanced public key cryptosystems at present. Scholars have combined their advantages to develop certificateless aggregate signature schemes, which are applicable to the secure communication of Vehicular Ad-hoc Networks (VANETs). Recently, Cahyadi E F et al. put forward a certificateless aggregate signature scheme specifically designed for use in VANETs. Regrettably, through our strict security analysis, we discovered at least two major vulnerabilities in the signature scheme: a public key replacement attack and a malicious KGC (Key Generation Center) attack. To tackle these vulnerabilities, our article not only presents the methods of these attacks but also explores the fundamental reasons for their feasibility. Additionally, we propose specific improvement measures and show that the enhanced scheme retains its security under the random oracle model. The stability of the improved scheme depends on the computational complexity of the Diffie-Hellman problem. Finally, a comprehensive assessment involving security, computational cost, communicational cost, and calculational efficiency overhead highlights the excellent performance of our proposed solution., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Li et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The N6-methyladenosine (m6A) demethylase ALKBH5 is the only other identified m6A eraser except for FTO, and dysregulated ALKBH5 functions were closely associated with leukemogenesis. However, the development of ALKBH5 inhibitors is slow compared to FTO inhibitors. Inspired by a non-catalytic C200-covalent strategy, a series of maleimide derivatives were designed and synthesized as potent and covalent ALKBH5 inhibitors in this work. The analog 18l exhibited excellent inhibitory effects on ALKBH5 (IC50 = 0.62 μM), and exerted a strong antiproliferative effect on NB4 cells with IC50 of 0.63 μM. The Kd value of 18l binding to ALKBH5 was 804 nM, while no binding was observed with FTO. This result indicated that 18l was a highly selective inhibitor of ALKBH5 rather than FTO. Additionally, proteomic experiments showed that 18l directly targeted ALKBH5 in cells and altered m6A levels on mRNA, blocked the related downstream signal pathways, promoted differentiation, and induced apoptosis. Furthermore, 18l exerted excellent in vivo antitumor activity with TGITV values of 66.3% at 1 mg/kg in NB4 tumor xenograft models., (© 2025 Wiley‐VCH GmbH.)

Though cholinesterase-based method could detect two types of pesticides (organophosphorus and carbamate), they had weak sensing on sulfonylurea pesticides. In our previous work, the peroxidase-like reaction system of nanozyme - H 2 O 2 - TMB showed selective detection of sulfonylurea pesticides, but the single-signal output sensing platform was easily affected by complex matrix background, cross-contamination and human error. Therefore, this work used colorimetric, photothermal, and fluorescent signals of the nanozyme reaction as sensing units for the detection of pesticides. This is the first time that photothermal signals have been used to construct a sensor array. When the concentration of interfering substances was 25 times that of pesticides, the method was still unaffected and had excellent selectivity and anti-interference performance. Meanwhile, a concentration-independent differentiation mode was established based on the K-nearest neighbor (KNN) algorithm. The pesticides were detected and distinguished with 100% accuracy. This work contributed to the detection of sulfonylurea pesticides in complex environmental/food matrices, bridging the gap of existing pesticide detection methods and providing an effective method for food safety detection., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier B.V. All rights reserved.)

Phenylalanine (Phe), an aromatic amino acid, is a key precursor of flavonoids, which are crucial for plant growth and development. Arogenate dehydratase (ADT) catalyzes the final step in Phe biosynthesis. This study identified eleven ADT genes in G. hirsutum, twelve in G. barbadense, six in G. arboreum, and six in G. raimondii. Among them, GhADT5 exhibited the highest upregulation under alkali stress. Silencing GhADT5 using virus-induced gene silencing (VIGS) reduced cotton tolerance to alkali stress. GhADT5 silencing also led to decreased plant phenylalanine content, total flavonoid content, and activities of superoxide dismutase (SOD), catalase (CAT), and peroxidase (POD). These reductions caused intracellular accumulation of Malondialdehyde (MDA) and reactive oxygen species (ROS). This oxidative damage ultimately reduced tolerance to alkali stress. In addition, silenced plants displayed reduced stomatal aperture, cellular deformation, and irregular intercellular breaks in the leaf epidermis. In summary, these findings suggest that GhADT5 may enhance resistance to alkali stress by regulating enzymatic and non-enzymatic antioxidant systems. This study highlights the role of GhADT5 under alkali stress and provides novel insights for breeding cotton varieties with improved stress tolerance., Competing Interests: Declarations. Ethical approval and consent to participate: All the cotton materials were collected from the Institute of Cotton Research, Chinese Academy of Agricultural Sciences, which are publicly and available for non-commercial purpose. All experimental studies on plants were complied with relevant institutional, national, and international guidelines and legislation. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Sexual reproduction and recruitment enhance the genetic diversity and evolution of reef-building corals for population recovery and coral reef conservation under climate change. However, new recruits are vulnerable to physical changes and the mechanisms of symbiosis establishment remain poorly understood. Here, Dipsastraea veroni , a broadcast spawning hermaphrodite reef-building coral, was subjected to settlement and juvenile growth in flow-through in situ seawater at 27.93 ± 0.96°C. Symbiosis of Symbiodiniaceae, bacteria, and/or archaea by horizontal acquisition and/or hypothetical vertical transmission through the mucus with symbionts from the parent appears to be a heritable process of selection and adaptation in D. veroni at the egg, larva, juvenile (5 days post settlement, d p.s. and 32 d p.s.) stages. Symbiodiniaceae was dominated by the genera Cladocopium , Durusdinium , Symbiodinium, with increasing relative abundance of Durusdinium at 5 d p.s. and Symbiodinium at 32 d p.s. Mixed acquisition of the dominant phyla Pseudomonadota, Bacteroidota, Cyanobacteriota, Bacillota, Planctomycetota, and Actinomycetota in egg, larva, and/or juvenile showed a winnowing and regulated bacterial diversity and dynamics, resulting in stage-abundant orders Pseudomonadales and Bacillales in egg and Rhodobacterales, Rhodospirillales, Cyanobacteria, and Cyanobacteriales in larva and/or juvenile. The photoautotrophic Chloroflexales, Cyanobacteriales, and Chlorobiales were abundant in adults. The stable archaeal community contained predominant Crenarchaeota, Halobacterota, Nanoarchaeia Thermoplasmatota, and eight rare phyla, with increased relative abundance of the genera Bathyarchaeota , Candidatus&#95;Nitrosopumilus , Candidatus&#95;Nitrocosmicus , Nitrosarchaeum , Candidatus&#95;Nitrosotenuis , Candidatus&#95;Nitrosopelagicus , Cenarchaeum , Haladaptatus , Halogranum , Halolamina, and Woesearchaeales and GW2011-AR15 in juveniles. All results revealed flexible symbiotic mechanisms in D. veroni during early ontogeny for coral survival and evolution.IMPORTANCEFlexible symbioses of Symbiodiniaceae, bacteria, and archaea appear to be a heritable process of selection and adaptation in Dipsastraea veroni in the field, benefiting early coral development and facilitating coral population recovery and reef conversation., Competing Interests: The authors declare no conflict of interest.

Background: Palmar midcarpal instability (PMCI) is often neglected in diagnosis and lacks a gold standard treatment. It is primarily associated with dorsal radiocarpal (DRC) ligament insufficiency. We used a combined approach of arthroscopic thermal capsular shrinkage and open DRC ligament suture tensioning for symptomatic PMCI and present our outcomes. Methods: From 2018 to 2022, nine PMCI patients (mean age: 32 years) underwent this treatment. The mean symptom duration was 15.3 months, with a mean follow-up of 16.8 months. Outcomes were measured by wrist ROM, grip strength, VAS for pain, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and modified Mayo Wrist scores. Results: All patients showed significant improvement in pain, grip strength and function, with maintained radiocarpal stability at final follow-up. Although wrist ROM showed mild limitation after surgery, all patients returned to their previous work and activities. Conclusions: This approach may provide an effective and less aggressive treatment for PMCI. Level of Evidence: Level IV (Therapeutic).

Nonspecific interactions are ubiquitous and important in biology; however, they are rarely valued or employed in the field of clinical disease diagnosis. Relying on nonspecific cross-interactions, sensor arrays have shown great potential in distinguishing mixtures or nuanced compounds. However, developing generic strategies for constructing effective arrays tailored to compositionally complicated and highly individualized clinical biospecimens remains challenging. Here, we introduce a combinatorial chemistry-screened array strategy, leveraging four-component Ugi reactions to achieve the rapid synthesis of hundreds of structurally diverse sensing elements. Moreover, effective sensor arrays can thus be built by rapidly screening sensors against diverse analytes. Next, we demonstrate the practical applicability of this array by clinical sperm quality assessment, given the current lack of well-established clinical rapid detection techniques. A library of 192 structurally diverse sensor elements was synthesized. Following screening, a pruned 14-element array was successfully constructed, achieving 94.2% accuracy in distinguishing between healthy individuals and four types of abnormal sperm samples from patients within 1 min. This universal strategy avoids complex sensor design and greatly improves the efficiency of sensor array construction, offering a new way of designing effective arrays.

The antiviral agent, amantadine, is widely present in marine ecosystems and poses a significant threat to marine organisms. However, studies on the toxicity of amantadine across the full life cycle of the brown alga Laminaria japonica, particularly during the microscopic gametophyte stage, remain lacking. A comprehensive approach combing biochemical analyses and multi-omics techniques was employed to investigate the mechanisms underlying amantadine-induced toxicity in L. japonica gametophytes. The development rate of algal cells was less than 3 % from 10 3 to 10 7 ng/L of amantadine. In total, 1049 differentially expressed genes and 215-231 differential metabolites were detected, with the majority involved in amino acid, lipid, and carbohydrate metabolism. Integrated analysis showed that alginate biosynthesis and glycerophospholipid metabolism were affected, suggesting damage to the cell wall and membrane structure. Key genes (e.g., SOD2) and metabolites (e.g., arachidonic acid and α-linolenic acid), associated with the antioxidant system and arachidonic acid metabolism, were identified, leading to oxidative stress in the algae. Furthermore, the downregulation of genes and metabolites involved in porphyrin metabolism, photosynthesis, carbon fixation, glycolysis, and the pentose phosphate pathway may inhibit ATP supply and NADPH generation, negatively affecting metabolic processes and inhibiting algal cell growth. In contrast to disrupting protein synthesis in juvenile sporophytes, amantadine primarily interferes with photosynthesis and carbohydrate metabolism in gametophytes. These findings offer new insights into the mechanisms by which amantadine impedes the growth and metabolism of algae throughout their life cycle in aquatic ecosystems., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier B.V. All rights reserved.)

Cuproptosis, a distinct cell death pathway, has been integrated into nanomedicine for disease theranostics. However, current nanosystems inducing cuproptosis rely on exogenous toxic copper ions, limiting the scope of biomaterials. Developing nanoplatforms that induce cuproptosis without exogenous copper holds substantial promise. Here, we engineered a two-dimensional iron (Fe) single-atom-doped molybdenum disulfide (MoS 2 ) piezocatalyst (Fe-MoS 2 ) for tumor therapy. Incorporating single Fe atoms enhances MoS 2 piezoelectric polarization via charge redistribution and modulates Fe and Mo oxidation states, enabling multifaceted enzymatic activities, including peroxidase-, glutathione oxidase-, oxidase-, and catalase-like activities. Upon ultrasound stimulation, the Fe-MoS 2 nanocatalyst generates reactive oxygen species and depletes glutathione via synergistic piezocatalytic and enzyocatalytic effects, disrupting copper ion homeostasis and inducing cuproptosis, concurrently triggering ferroptosis and ferritinophagy, which collectively enhances tumor suppression. This study represents the first paradigm to introduce a copper-free piezocatalyst for initiating cuproptosis, substantially advancing the applications of cuproptosis in tumor therapy.

Background and Purpose: Epilepsy, a globally prevalent neurological disorder, necessitates precise identification of the epileptogenic zone (EZ) for effective surgical management. While the individual utilities of FDG PET and FMZ PET have been demonstrated, their combined efficacy in localizing the epileptogenic zone remains underexplored. We aim to improve the non-invasive prediction of epileptogenic zone (EZ) in temporal lobe epilepsy (TLE) by combining FDG PET and FMZ PET with statistical feature extraction and machine learning., Materials and Methods: This study included 20 drug-resistant unilateral TLE patients (14 mesial TLE, 6 lateral TLE), and two control groups (N=29 for FDG, N=20 for FMZ). EZ of each patient was confirmed by post-surgical pathology, and one-year follow-up, while propagation zone (PZ) and non-involved zone (NIZ) were derived from the epileptogenicity index based on presurgical stereo-encephalography (SEEG) monitoring. Whole brain PET scans were obtained with dual tracers [ 18 F]FDG and [ 18 F]FMZ on separate days, from which standard uptake value ratio (SUVR) was calculated by global mean scaling. Low-order statistical parameters of SUVRs and t-maps derived against control groups were extracted. Additionally, fused FDG and FMZ features were created using arithmetic operations. Spearman correlation was used to investigate the associations between FDG and FMZ, while multiple linear regression analysis was used to explore the interaction effects of imaging features in predicting epileptogenicity. Crafted imaging features were used to train logistic regression models to predict EZ, whose performance was evaluated using 10-fold cross-validation at ROI-level, and leave-one-patient-out cross-validation at patient-level., Results: FDG SUVR significantly decreased in EZ and PZ compared to NIZ, while FMZ SUVR in EZ significantly differed from PZ. Interaction effects were found between FDG and FMZ in their prediction of epileptogenicity. Fusion of FDG and FMZ provided the best prediction model with an area under the curve (AUC) of 0.86 [0.84-0.87] for EZ vs. NIZ and an AUC of 0.79 [0.77-0.81] for EZ vs. PZ, eliminating 100% false positives in 50% of patients, and ≥80% FPs in 90% patients at patient level., Conclusions: Combined FDG and FMZ offer a promising avenue for non-invasive localization of the epileptogenic zone in TLE, potentially refining surgical planning., Abbreviations: AUC = Area under the curve; EI = Epileptogenicity index; EZ = Epileptogenic zone; FMZ = Flumazenil; GABA A = Gamma-aminobutyric acid type A; NIZ = Non-involved zone; PZ = Propagation zone; SEEG = Stereo-electroencephalography; SUVR = Standard uptake value ratio; TLE = Temporal lobe epilepsy., Competing Interests: The authors declare no conflicts of interest related to the content of this article., (© 2025 by American Journal of Neuroradiology.)

Microplastics (MPs) are alarming social issues owing to their detrimental influences on both ecology and human health. Although MPs retained in low-trophic organisms are assumed to be transferred to high-trophic organisms via the food chain, concrete knowledge about the physical-chemical alterations of MPs via trophic transfer and the impact of trophic-transferred MPs on organisms remains scarce. Here, we established a three-tiered (microalgae-mussel-crab) trophic-transfer model to systematically investigate the bio-accumulation and distribution of polyethylene MPs (PE-MPs, 10-45 μm), and subsequent induction of antioxidant defenses in marine organisms with pivotal ecological and economic status at each trophic level. Results demonstrated that microalgae's growth and quality as feeds were hampered due to attachment to PE-MPs, whose physical-chemical properties were hence altered. This affected the intake and occurrence of PE-MPs in mussels, where PE-MPs were initially fragmentized. Following mussel-crab transfer, further fragmented PE-MPs in crabs resulted in stronger internalization and active internal transport among tissues. Despite successful antioxidation observed in both consumers, severer stress was posed on tissues in charge of metabolism and detoxification, leading to serious DNA damage. Overall, hierarchical fragmentation can increase internalization and bio-transportation of MPs via trophic transfer leading to longer retention and stronger capacity across biological barriers, which is speculated to pose further risks to higher-trophic organisms (e.g., humans)., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier B.V. All rights reserved.)

Irritable bowel syndrome (IBS) is a globally prevalent functional gastrointestinal disorder frequently misdiagnosed due to overlapping symptoms with other diseases. Currently, there are no rapid and effective diagnostic or therapeutic approaches for IBS. Despite this, low-FODMAP diets (LFDs) have become a major dietary intervention strategy for symptom relief. However, detecting FODMAPs usually relies on chromatographic techniques, which are costly and time-consuming, making it difficult to apply in real-time detection. In this study, we introduce the first dual-functional sensor array capable of rapidly diagnosing IBS and identifying low-FODMAP diets. This six-element array was constructed using nitrophenylboronic acid-modified poly(ethylenimine) coupled with coumarins through dynamic borate ester bonds across a range of pH conditions. Optimized by diverse machine learning algorithms, with the multilayer perceptron (MLP) algorithm proving optimal, the array enabled the simultaneous identification of 12 intestinal bacteria with 99.2% accuracy and the detection of mouse fecal specimens with varying degrees of IBS with 99.8% accuracy within seconds. Furthermore, it allowed for the detection of various FODMAP levels in commercially purchased, brand-named, and differently processed soy milk. The array demonstrates potential for use in both the clinical diagnosis of IBS and the guiding of low-FODMAP diets for patients.

Diabetes-associated neurodegeneration may result from increased oxidative stress in the brain under hyperglycemic conditions, which leads to neuronal cell death. The current study employs the neuroblastoma cell line SH-SY5Y and db/db mouse model of diabetes maintained on a high-fat diet to investigate the neuroprotective effects of the primary functional components of mulberry (Morus alba Linn) leaf extract (MLE), chlorogenic acid (CGA), and neochlorogenic acid (NCGA). CGA and NCGA demonstrated the ability to enhance the activities of the antioxidant enzymes superoxide dismutase and glutathione peroxidase, and attenuate inflammation via regulating nuclear factor erythroid 2-related factor 2 (Nrf2), nuclear factor-κB (NFκB), and inflammatory cytokines, thereby protecting SH-SY5Y cells from oxidative damage induced by palmitic acid and high glucose. CGA and NCGA were found to decrease the expression of proinflammatory proteins α-synuclein and amyloid-β (Aβ). In addition, CGA and NCGA treatments increased the expression of tyrosine hydroxylase (TH) and brain-derived neurotrophic factor (BDNF). Furthermore, MLE supplementation in the animal model resulted in decreased levels of α-synuclein and Aβ concomitant with an elevated expression of TH. These experimental findings suggest that the neuroprotective effects of CGA and NCGA may be mediated via three pathways: reducing oxidative stress, decreasing neuronal inflammation, and enhancing BDNF expression.

As they became the dominant gene therapy platform, lipid nanoparticles (LNPs) experienced nearly all their innovation in varying the structure of individual molecules in LNPs. This ignored control of the spatial arrangement of molecules, which is suboptimal because supramolecular structure determines function in biology. To control LNPs' supramolecular structure, we introduce multi-stage-mixing (MSM) to successively add different molecules to LNPs. We first utilize MSM to create a core-then-shell (CTS) synthesis. CTS-LNPs display a clear core-shell structure, vastly lower frequency of LNPs containing no detectable mRNA, and improved mRNA-LNP expression. With DNA-loaded LNPs, which for decades lagged behind mRNA-LNPs due to low expression, CTS improved DNA-LNPs' protein expression by 2-3 orders of magnitude, bringing it within range of mRNA-LNPs. These results show that supramolecular arrangement is critical to LNP performance and can be controlled by mixing methodology. Further, MSM/CTS have finally made DNA-LNPs into a practical platform for long-term gene expression.

Minimizing energy loss is crucial for breaking through the efficiency bottleneck of organic solar cells (OSCs). The main mechanism of energy loss can be attributed to non-radiative recombination energy loss (ΔE nr ) that occurs due to exciton-vibration coupling. To tackle this challenge, tuning intramolecular noncovalent interactions is strategically utilized to tailor novel fused ring electron acceptors (FREAs). Upon comprehensive analysis of both theoretical and experimental results, this approach can effectively enhance molecular rigidity, suppress structural relaxation, reduce exciton reorganization energy, and weakens exciton-vibration coupling strength. Consequently, the binary OSC device based on Y-SeSe, which features dual strong intramolecular Se ⋅ ⋅ ⋅ O noncovalent interactions, achieves an outstanding power conversion efficiency (PCE) of 19.49 %, accompanied by an extremely small ΔE nr of 0.184 eV, much lower than those of Y-SS and Y-SSe based devices with weaker intramolecular noncovalent interactions. These achievements not only set an efficiency record for selenium-containing OSCs, but also mark the lowest reported ΔE nr value among high-performance binary devices. Furthermore, the ternary blend device showcases a remarkable PCE of 20.51 %, one of the highest PCEs for single-junction OSCs. This work demonstrates the effectiveness of intramolecular noncovalent interactions in suppressing exciton-vibration coupling, thereby achieving low-energy-loss and high-efficiency OSCs., (© 2024 Wiley-VCH GmbH.)

Background: The liver undergoes significant hemodynamic changes during surgery, transplantation, or cirrhosis with portal hypertension(PH). The hepatic artery buffer response(HABR), which compensates for reduced portal venous flow by increasing hepatic artery(HA) flow, is hypothesized to induce pathological portal tract remodeling. This study investigates the molecular mechanisms underlying this process., Methods: PH was induced in Sprague-Dawley rats via partial portal vein ligation(PPVL). Structural evaluation(microCT), immune cell profiling, hemodynamic measurements, and transcriptomic analysis in macrophages(Mϕ) from sham or PPVL rats were conducted., Results: MicroCT revealed decreased portal vein flow and increased HA flow correlated with portal pressure(r=0.799, p<0.01). A 2-fold increase in portal tract fibrosis(p<0.001) was observed with increased α-SMA+ myofibroblasts in PPVL rats. CD68+ Mϕ peaked at 10 days post-PPVL, and their depletion significantly reduced fibrosis(p<0.001), indicating critical roles of Mϕ in portal tract remodeling. VCAM-1 was elevated in HA endothelium and portal fibroblasts (PFs); VCAM-1 neutralization reduced collagen accumulation(p<0.05), CD68+ Mϕ(46.3%, p<0.01), and CD3+ T cells(18%, p<0.05). Mϕ-conditioned medium increased VCAM-1 in PFs(8-fold, p<0.001) and enhanced PF migration, while VCAM-1 knockdown reduced this effect (p<0.01). Single-cell RNA sequencing data(GSE171904) and RNA-FISH revealed increased interactions between osteopontin (Spp1)+ Mϕ and PFs, with Spp1+ Mϕ driving fibrosis. Spp1 knockdown in Mϕ co-culture reduced PF fibrogenic markers, while recombinant Spp1 upregulated Col1a1, Fn1, and Acta2 expression in PFs., Conclusion: Increased VCAM-1 in arterial endothelial cells and PFs facilitates the recruitment of Spp1+ Mϕ, which drive HA flow-mediated vascular remodeling and portal tract fibrosis. These findings highlight arterial flow-induced fibrosis as a key mechanism in PH, potentially contributing to disease progression and decompensation., Synopsis: Liver hemodynamic changes in portal hypertension drive extracellular matrix accumulation and portal tract remodeling via Spp1+ macrophages. This study highlights how altered blood flow induces fibrosis, and its potential role in decompensation, and identifies therapeutic targets for advanced liver disease.

Background: Osteoarthritis (OA) is the most prevalent joint disorder globally, causing a substantial and increasing socioeconomic burden. Kojic acid (KA) presented potential biological roles in regulating inflammation and autophagy, which was implicated in OA progression. However, its role in chondrocytes and OA has not been reported. To do so, this study aims to explore the chondroprotective effect of KA and elucidate its regulatory mechanisms., Methods: IL-1β in vitro was used to induce OA-like phenotypes. Cell viability was measured by cell counting kit-8 assay. RT-qPCR, western blotting, as well as immunofluorescence staining were used to assess protein and RNA expression of inflammatory (COX2 and iNOS), catabolic (MMP13 and MMP3), anabolic (collagen II, aggrecan and SOX9), and signaling pathways factors. Destabilized medial meniscus (DMM) surgery was adopted to build OA model in vivo. After consecutive 8 weeks of intra-articular injection of KA, X-ray, μ-CT, histological staining, as well as immunohistochemistry staining were adopted to evaluate effects of KA on articular cartilage in vivo., Results: KA did not affect chondrocyte viability. KA notably elevated anabolic factors expression, simultaneously, inhibited catabolic and inflammatory factors expression in vitro. Mechanistically, KA significantly suppressed the activated NF-κB and PI3K/AKT/mTOR signaling pathways. Moreover, impaired autophagy was restored by KA. Inhibition of autophagy by 3-MA diminished the chondroprotective effect of KA. Intra-articular injection of KA can significantly alleviate DMM-induced cartilage damage in vivo., Conclusion: Collectively, our work is the first to demonstrate that KA can alleviate osteoarthritis by attenuatinginflammationand restoring impaired autophagy through regulating relevant signaling pathways. This in vivo and in vitro study provides strong evidence supportingKA as a novel and valuable approach for treating OA., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Author(s). Published by Elsevier B.V. All rights reserved.)

Purpose: This study aims to develop an autonomous robotic ultrasound scanning system (auto-RUSS) pipeline, comparing its reproducibility and observer consistency in image analysis with physicians of varying levels of expertise., Design/methodology/approach: An auto-RUSS was engineered using a 7-degree-of-freedom robotic arm, with real-time regulation based on force control and ultrasound visual servoing. Two phantoms were employed for the human-machine comparative experiment, involving three groups: auto-RUSS, non-expert (4 junior physicians), and expert (4 senior physicians). This setup enabled comprehensive assessment of reproducibility in contact force, image acquisition, image measurement and AI-assisted classification. Radiological feature variability was measured using the coefficient of variation (COV), while performance and reproducibility assessments utilized mean and standard deviation (SD)., Findings: The auto-RUSS had the potential to reduce operator-dependent variability in ultrasound examinations, offering enhanced repeatability and consistency across multiple dimensions including probe contact force, images acquisition, image measurement, and diagnostic model performance., Originality/value: In this paper, an autonomous robotic ultrasound scanning system (auto-RUSS) pipeline was proposed. Through comprehensive human-machine comparison experiments, the auto-RUSS was shown to effectively improve the reproducibility of ultrasound images and minimize human-induced variability., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Lin, Li, Ruan, Ke, Zhang, Huang, Wu, Cheng, Tong, Hu, He, Lu, Lin, Kuang, Lu, Chen, Huang and Wang.)

Objectives: To evaluate the placental vascular architecture using MV Flow™ imaging for analyzing vascular distribution per region of biological tissue in isolated congenital heart diseases (CHD), CHD associated with extracardiac malformations (EXM) and normal pregnancies, and to explore the relationship of fetal Doppler flow parameters and growth to placental perfusion in these conditions., Methods: Placental microvascular structure was assessed using MV-Flow™ in a total of 227 normal fetuses and 139 with CHD; fetuses with gestational age ranging from 11 to 41 weeks were included. Placental vascular indices (VI MV %) was acquired at three different segments of each placenta (upper, middle, and lower regions). Doppler pulsatility indices of fetal umbilical artery (UA), middle cerebral artery (MCA), ductus venosus (DV), uterine artery (UtA), and cerebroplacental ratio were measured in both normal and CHD groups. The CHD group was divided into two subgroup based on whether it is associated with EXM., Results: Compared to the control group, the CHD with EXM group exhibited a significantly lower VI MV % for the upper, middle, and lower regions of the placenta (P = .005; P = .018; P = .039, respectively). In the total CHD group, VI MV % decreased in the middle segment of placenta in the 2nd trimester compared to the control group. But the VI MV % of upper and middle segments decreased in the 3rd trimester. Both subgroups, EXM and isolated CHD, showed similar distribution of gestational weeks. Doppler vascular indices were significantly different compared to normal in the total CHD group for UA-pulse index (PI), DV-PI, right UtA-PI, and left UtA-PI, with similar differences from normal for the CHD with EXM group. DV-PI was the only significantly different Doppler vascular parameter for the isolated CHD group compared to normal., Conclusions: For the first time, MV-Flow™ imaging demonstrated reduced placental vascularity in fetuses with CHD and ECM and in fetuses with isolated CHD in the 3rd trimester of pregnancy. Application of MV-Flow™ as part of serial fetal echocardiographic surveillance in cases of CHD may allow for better understanding of the development of placental abnormalities., (© 2025 American Institute of Ultrasound in Medicine.)

Objective: To investigate whole-brain microstructural changes in amyotrophic lateral sclerosis (ALS) using soma and neurite density imaging (SANDI), a novel multicompartment model of diffusion-weighted imaging that estimates apparent soma and neurite density., Methods: This study consists of 41 healthy controls and 43 patients with ALS, whose diffusion-weighted data were acquired. The SANDI-derived (including signal fractions of soma (f soma ), neurite (f neurite ), and extra-cellular space (f extra )) and diffusion tensor imaging (DTI)-derived metrics were obtained. Voxel-based analyses were performed to evaluate intergroup differences and the correlation of SANDI and DTI metrics with clinical parameters., Results: In ALS patients, f neurite reduction involved both gray matter (primarily the bilateral precentral gyri, supplementary motor area, medial frontal gyrus, anterior cingulate cortex, inferior frontal gyrus, orbital gyrus, paracentral lobule, postcentral gyrus, middle cingulate cortex, hippocampus and parahippocampal gyrus, and insula, and left anterior parts of the temporal lobe) and white matter (primarily the bilateral corticospinal tract, body of corpus callosum, and brainstem) (P <0.05 after false discovery rate correction). The f extra increment showed a similar spatial distribution in ALS patients. Interestingly, the decreased f soma in ALS primarily located in gray matter; while, the increased f soma primarily involved white matter. The spatial distribution of f neurite /f extra /f soma changes was larger than that detected by conventional DTI metrics, and the f neurite /f extra /f soma were correlated with disease severity., Conclusions: SANDI may serve as a clinically relevant model, superior to conventional DTI, for characterizing microstructural impairments such as neurite degeneration and soma alteration in ALS., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025. Published by Elsevier B.V.)

To develop a deep learning model using transfer learning for automatic detection and segmentation of neck lymph nodes (LNs) in computed tomography (CT) images, the study included 11,013 annotated LNs with a short-axis diameter ≥ 3 mm from 626 head and neck cancer patients across four hospitals. The nnUNet model was used as a baseline, pre-trained on a large-scale head and neck dataset, and then fine-tuned with 4,729 LNs from hospital A for detection and segmentation. Validation was conducted on an internal testing cohort (ITC A) and three external testing cohorts (ETCs B, C, and D), with 1684 and 4600 LNs, respectively. Detection was evaluated via sensitivity, positive predictive value (PPV), and false positive rate per case (FP/vol), while segmentation was assessed using the Dice similarity coefficient (DSC) and Hausdorff distance (HD95). For detection, the sensitivity, PPV, and FP/vol in ITC A were 54.6%, 69.0%, and 3.4, respectively. In ETCs, the sensitivity ranged from 45.7% at 3.9 FP/vol to 63.5% at 5.8 FP/vol. Segmentation achieved a mean DSC of 0.72 in ITC A and 0.72 to 0.74 in ETCs, as well as a mean HD95 of 3.78 mm in ITC A and 2.73 mm to 2.85 mm in ETCs. No significant sensitivity difference was found between contrast-enhanced and unenhanced CT images (p = 0.502) or repeated CT images (p = 0.815) during adaptive radiotherapy. The model's segmentation accuracy was comparable to that of experienced oncologists. The model shows promise in automatically detecting and segmenting neck LNs in CT images, potentially reducing oncologists' segmentation workload., Competing Interests: Competing interests: The authors have no competing interests. Informed consent: Due to the retrospective nature of the study, the Ethics Committee for Medical Research of Sichuan Cancer Hospital waived the need of obtaining informed consent., (© 2024. The Author(s).)

Benchmarking electricity consumption of wastewater treatment plants (WWTPs) is fundamental for sustainable wastewater management, as these facilities have a concomitant electricity-intensive nature along with their pollutant removal and resource recovery functions. Due to the challenge of characterizing influent water quality using traditional methods, satisfactory benchmarks have long been elusive. To overcome the complexity of wastewater compositions, an unsupervised machine learning algorithm, spectral clustering, is introduced to analyze 2,576 WWTPs across China, effectively characterizing influent quality as a single variable and contributing to robust benchmarks with 75 % of the fittings achieving coefficients of determination (R 2 ) >0.85. The benchmarks are established with four critical parameters influencing electricity consumption: scale, influent quality, discharge standard and treatment process. Regional variations of the four parameters and their effects on regional WWTP electricity consumption are elaborated. Results indicate that the overall influent concentration characterized by spectral clustering is the major influencing factor of regional WWTP annual average electricity consumption per unit of volume (UEC). The findings not only enhance understanding of WWTP electricity consumption patterns and provide a scalable model for wider application, but also demonstrate a novel methodology for addressing multi-variable problems., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2025 The Author(s).)

Gold (Au) nanoclustersare promising photocatalysts for biomedicine, sensing, and environmental remediation. However, the short carrier lifetime, inherent instability, and unclear charge transfer mechanism hinder their application. Herein, the Au nanoclusters decorated with three different isomers of o-Aminophenol, m-Aminophenol, and p-Aminophenol are synthesized, namely o-Au, m-Au, and p-Au, which achieve efficient hydrogen peroxide (H 2 O 2 ) photoproduction through two-step one-electron oxygen reduction reaction (ORR). The interfacial kinetics for the photocatalytic process in this system are investigated in detail, in which, the isomer-effects of aminophenol decorated in Au nanoclusters are definitely elucidated by combining transient photovoltage (TPV), transient potential scanning (TPS), and photo-induced current (TPC) tests. The reaction pathway of o-Au, m-Au, and p-Au is confirmed to be the same through TPC. Although the conduction band values of o-Au, m-Au, and p-Au are essentially the same under working conditions, the values of surface effective charges (n e ) for both m-Au and p-Au are higher than that of o-Au. In addition, m-Au has a stronger adsorption capacity for O 2 and a faster ORR rate. Thus, the m-Au manifests the highest photocatalytic activity for the H 2 O 2 photoproduction. This work shows a new way for the in-situ study on charge distribution and transfer on photocatalysts., (© 2025 Wiley‐VCH GmbH.)

Objectives: This study aimed to explore the long-term impacts of exposure to earthquake in adolescence on later-life cognitive function in China., Methods: Data were from the 2015 China Health and Retirement Longitudinal Study (CHARLS). Our analytical sample comprised 4394 participants aged 49 to 78 from two birth cohorts born between 1937 and 1966: exposed cohort during adolescence (born between 1952 and 1966), and non-exposed cohort during adolescence (born between 1937 and 1951). We defined earthquake exposure as the exposure severity of the 1976 Great Tangshan Earthquake (GTE). We selected community environmental characteristics as our key moderators. A difference-in-differences (DID) method was employed to estimate the long-term impact of the GTE on later-life cognitive function., Results: We found that exposure to the earthquake during adolescence resulted in higher scores of later-life cognitive function (for males: β = 2.18; 95% CI: 0.70-3.66; for females: β = 1.22; 95% CI: 0.11-2.33). For males, this impact was moderated by community environmental characteristics including the old-age allowance program (β = 3.07; 95% CI: 1.94-4.19) and the condition of basic community infrastructures (β = 1.52; 95% CI: 0.84-2.19)., Conclusions: Our study supports the post-traumatic growth theory. This finding suggest that individuals with early-life traumatic exposure need to be focused on. Additionally, improving the conditions of community infrastructures and establishing a community environment with comfort and security may be pretty important for promoting cognitive function and post-traumatic growth., Competing Interests: Declarations. Ethical approval: All procedures involving human subjects were approved by the Peking University Ethical Review Committee (IRB00001052–11015). All of the respondents involved in the study provided written informed consent before their participation in this study. All methods in this study were performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Competing interests: The authors have no conflicts of interest to declare for this study., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Background: Obstructive sleep apnea (OSA) is common after stroke. Still, routine screening of OSA with polysomnography (PSG) is often unfeasible in clinical practice, primarily because of how limited resources are and the physical condition of patients. In this study, we used several artificial intelligence techniques to predict moderate-to-severe OSA and identify its features in patients with acute ischemic stroke., Methods: A total of 146 patients with acute ischemic stroke underwent PSG screening for OSA. Their baseline demographic characteristics, including age, sex, body mass index (BMI), Epworth Sleepiness Scale (ESS) score, and stroke risk factors, were recorded. Logistic regression analysis was conducted to identify significant features associated with moderate-to-severe OSA in patients with stroke. These significant features were used with six machine learning and ensemble learning algorithms, namely decision tree, support vector machine, random forest, extreme gradient boosting (XGBoost), adaptive boosting (AdaBoost), and gradient boosting, to compare the performance of several predictive models., Results: Multivariate logistic regression analysis revealed that age, sex, BMI, neck circumference, and ESS score were significantly associated with the presence of moderate-to-severe OSA. According to the machine learning and ensemble learning results, the XGBoost model achieved the highest performance, with an area under the receiver operating characteristic curve of 0.89 and an accuracy and F1 score of 0.80., Conclusion: This study identified key factors contributing to moderate-to-severe OSA in patients with ischemic stroke. The XGBoost model exhibited high predictive performance, indicating it has potential as a supporting tool for decision-making in health-care settings., Competing Interests: Declaration of competing interest The authors declare no financial and non-financial competing interests., (Copyright © 2024. Published by Elsevier Inc.)

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths worldwide. Due to the poor therapeutic efficacy of CRC treatments and poor prognosis of the disease, effective treatment strategies are urgently needed. As long-term proteotoxic stress is a major cause of cell death, agents that induce proteotoxic stress offer a promising strategy for cancer intervention. Thiostrepton is a natural antibiotic derived from the Streptomyces genus. In the present study, we found that thiostrepton triggered apoptosis, reduced the migration of CRC cells, and inhibited xenograft tumour growth in vivo. Mechanistically, thiostrepton reduced proteasome activity; induced the aggregation of ubiquitinated proteins; caused endoplasmic reticulum (ER) stress, which was characterized by increased protein levels of GRP78, ATF4, P-eIF2α, and CHOP and cytosolic calcium release; and ultimately resulted in cell death. Thiostrepton-related changes in cell survival and cell migration, as well as mechanistical processes, were almost completely reversed by treatment with the antioxidant N-acetylcysteine (NAC), suggesting that the mechanism is dependent on reactive oxygen species (ROS). These results demonstrated that thiostrepton induced apoptosis and inhibited migration through ROS-induced ER stress and proteotoxic stress in colorectal cancer., Competing Interests: Declaration of competing interest The authors declare no competing interests., (Copyright © 2025 Elsevier Inc. All rights reserved.)

Purpose: This study aimed to explore symptom clusters and the inter-relationship of symptoms in esophageal cancer (EC) patients during the first week after surgery., Methods: A cross-sectional survey across multiple centers was carried out using the EORTCQLQ-OES18. Patients with esophageal cancer within a week post-surgery were recruited from the "Be Resilient to Cancer" project in Guangdong, Hunan, and Sichuan provinces between January and September 2024. Exploratory factor analysis with a priori algorithm was used to identify symptom clusters and network analysis was employed to recognize the relationship among core and bridge symptoms., Results: The sample consisted of 501 patients with esophageal cancer, who were predominantly male (83%), married (93%) and 57% were ≥60 years. Three symptom clusters were identified: "reflux-pain", "eating", and "dysphagia-dry mouth". Acid or bile coming up (support = 40.1%, confidence = 1, lift = 2.53), eating difficulties (support = 40.1%, confidence = 0.990, lift = 2.408) and dry mouth (support = 42.9%, confidence = 0.808, lift = 1.298) were marked as sentinel symptoms for these clusters, respectively. Acid indigestion or heartburn was identified as the core symptom (EI = 1.142 without covariates and EI = 1.153 with covariates), and dry mouth served as the bridge symptoms (EI = 0.63 and EI = 0.656)., Conclusions: Addressing acid or bile coming up, eating difficulties, dry mouth are imperative to help relief symptom burden at the cluster level. Furthermore, targeting acid indigestion and heartburn are crucial to break the chains among different symptom clusters., Competing Interests: Declaration of competing interest The authors declare no potential conflicts of interest in the research, authorship, and/or publication of this article., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

Electrocatalytic carbon dioxide reduction into high-value chemicals is one of the important solutions to the greenhouse effect and energy crisis. However, the slow kinetic process of eight electrons requires the development of efficient catalysts to improve the yields. Single atom catalysts (SACs) with high activity and selectivity have become an emerging research frontier in the field of heterogeneous catalysis. Herein, a catalyst comprised of Cu single atoms loaded on carbon substrate (Cu-NC) is developed for highly selective electrocatalytic reduction of CO 2 to methane (CH 4 ). The optimal catalyst (Cu-NC-1-4) exhibits a faradaic efficiency (FE) of over 50 % for CH 4 within a wide potential window from -1.3 V to -1.8 V (vs. RHE) and the highest FE of CH 4 is up to 67.22 % at -1.6 V (vs. RHE). Meanwhile, the product selectivity of CH 4 among all the carbon products reaches 93.00 %, and the activity decay can be negligible via the 70-hour-stability-test. The existence of atomic dispersed Cu-N 3 sites was verified by high-angle annular dark field scanning transmission electron microscopy (HAADF-STEM) and X-ray absorption near edge structure (XANES). Density functional theory (DFT) calculations show that the effective adsorption of the key intermediate *CO on Cu-N 3 sites prompts the generation of CH 4 ., (© 2024 Wiley-VCH GmbH.)

To investigate the impact of vaccines on sociodemographic characteristics, clinical profiles, and outcomes of SARS-CoV-2 infection among healthcare workers in South China during the period of Omicron variant dominance, a retrospective, analytical cross-sectional study was conducted. The findings revealed that while full vaccination could not prevent Omicron variant infection efficiently (26.51% uninfected vs 14.29% uninfected between vaccinated and unvaccinated participants, p = 0.506), it did substantially reduce the length of viral clearance significantly (p < 0.05), potentially facilitating quicker patient recovery. Unvaccination was found to be an independent risk factor for slow clearance when a linear regression analysis model was used (Coefficient: -3.516; 95% CI: -6.425 to -0.607; p = 0.020). Therefore, all eligible individuals should be fully vaccinated to get prepared for a potential wave of epidemic in the future., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Herd immunity through mass vaccination is an effective method for preventing infectious diseases. However, the emerging SARS-CoV-2 variants, with their frequent mutations, largely evade the immune response and protection induced by COVID-19 vaccines. Here, we designed messenger RNAs encoding mutant epitopes of the spike protein shared among various COVID-19 variants. These mRNAs were encapsulated in lipid nanoparticles to formulate a vaccine named 'mPANVAX@COVID'. Post-vaccination, this approach elicited effective immunity against multiple SARS-CoV-2 variants, including Delta and Omicron, and demonstrated good safety. This study suggests a novel direction for the design of broadly protective vaccines., Competing Interests: Declaration of competing interest There are declarations of no competing financial interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder affecting multiple systems, characterized by the development of harmful autoantibodies and immune complexes that lead to damage in organs and tissues. Chinese medicine (CM) plays a role in mitigating complications, enhancing treatment effectiveness, and reducing toxicity of concurrent medications, and ensuring a safe pregnancy. However, CM mainly solves the disease comprehensively through multi-target and multi-channel regulation process, therefore, its treatment mechanism is often complicated, involving many molecular links. This review introduces the research progress of pathogenesis of SLE from the aspects of genetics, epigenetics, innate immunity and acquired immunity, and then discusses the molecular mechanism and target of single Chinese herbal medicine and prescription that are commonly used and effective in clinic to treat SLE., Competing Interests: Conflict of Interest. The authors declare no conflict of interest., (© 2024. The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: Osteoarthritis (OA) is a prevalent degenerative joint condition. Among OA patients, depressive symptoms are the most frequent psychiatric disorder, negatively impacting both prognosis and quality of life. This study analyzed the independent factors associated with the development of depressive symptoms in patients with OA and constructed a nomogram to assess the risk of developing depressive symptoms., Methods: An analysis was conducted on data from 2093 OA patients in the NHANES database, covering 2007 to 2014. A training set and a validation set were randomly assigned to participants in a 7:3 ratio. Variables significantly associated with depressive symptoms in OA patients were identified using the least absolute shrinkage and selection operator (LASSO) and multivariable logistic regression analyses and nomograms were constructed. Its performance and clinical relevance were assessed using receiver operating characteristic (ROC) curves, C indices, calibration curves, and decision curves., Results: Among the 2093 OA patients, 357 were assessed as having depressive symptoms. There are eight independent relevant factors, which are gender, age, poverty-to-income ratio (PIR), race, educational attainment, smoking status, diabetes, and sleep disorder. The AUC values of the training and validation sets were 0.718 (95 %CI: 0.683-0.752) and 0.733 (95 %CI: 0.678-0.788). Calibration and decision curve analyses showed that this nomogram exhibits high accuracy, good discrimination, and potential clinical benefits on both training and validation sets., Conclusions: We screened to obtain factors associated with depressive symptoms in patients with OA. Dynamic nomograms enable the combination of individual relevant factors for better assessing and managing high-risk OA groups., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Despite the success of antiretroviral therapy (ART) in suppressing HIV-1 replication, some people living with HIV-1 (PLWH) fail to achieve an optimal recovery of CD4 T cells, and precise metabolic regulation underlying immune recovery remained poorly understood., Methods: In this cross-sectional study, mass spectrometry was used for quantitative analysis of plasma metabolome and lipidome in 24 treatment-naïve PLWH (TNs), 33 immunological responders (IRs), 35 immunological non-responders (INRs), and 16 healthy controls (HCs). The data were analyzed using the Mann-Whitney U-test, Kruskal-Wallis test, Spearman correlation, and LASSO regression analysis., Results: Significant metabolic dysregulation was observed in TNs, IRs and INRs compared to HCs. In TNs, metabolomic analysis revealed increased levels of 3-hydroxyoctanoic acid, 3-oxododecanoic acid, 5-hydroxy-L-tryptophan, 5-hydroxyindoleacetic acid, L-kynurenine, oleoylcarnitine, and pseudouridine that were positively correlated with CD8 T cell activation and inflammation-related markers, and decreased levels of phosphorylcholine, ribothymidine, and thymine that were negatively correlated. Notably, 3-hydroxyoctanoic acid and thymine were consistently associated with CD4 T cell counts and inflammation-related markers in PLWH, regardless of ART. Pathway analysis uncovered the biosynthesis of unsaturated fatty acids as the major dysregulated pathway in TNs, IRs, and INRs, while primary bile acid biosynthesis was the dysregulated pathway specifically in INRs. Lipidomic analysis indicated higher plasma triacylglycerols, free fatty acids, ceramide, and monosialodihexosyl gangliosides (GM3) in TNs, IRs, and INRs compared to HCs. Pathway enrichment and differential correlation analyses underscore perturbed systemic lipid metabolism in treatment response to ART, possibly mediated by host-commensal metabolic interactions. Ultimately, we identified two panels, one consisting of 9 metabolites and another of 8 lipids, that can effectively distinguish INRs from IRs., Conclusions: Metabolic aberrations induced by chronic HIV-1 infection persist and do not recover with ART. Abnormal primary bile acid biosynthesis pathway and levels of DHA-containing lipids are closely associated with CD4 T cell recovery. These finding provide new intervention targets to achieve better immune recovery in PLWH., Competing Interests: Declarations. Ethics approval and consent to participate: This study was approved by Ethics Committee of the Fifth Medical Centre of PLA General Hospital (ky-2021–7-6–1), and conducted in accordance with the principles contained within the Declaration of Helsinki. All participants provided written informed consent before enrollment. Competing interests: The authors have declared no conflict of interest., (© 2025. The Author(s).)

Background: To investigate the effects of personalized DiaBetes TEXT messaging combined with Peer Support Education (DB-TEXT+ PSE) on clinical outcomes in patients with type 2 diabetes., Methods: An assessor-blinded, three-arm randomized controlled trial recruited 84 participants between December 2022 and July 2023. Participants were randomly assigned to a DB-TEXT + PSE group, a DB-TEXT group, or a professional education program (PEP) group. Primary outcomes included glycated hemoglobin (HbA 1c ), fasting blood glucose (FBG) levels, and clinical remission rates, whereas secondary outcomes measured lipid profiles, fatigue, sleep quality, depression, and quality of life (QoL). Outcomes were assessed at baseline (T0), three months (T1), and six months (T2) postintervention., Results: Relative to PEP, personalized DB-TEXT + PSE and DB-TEXT alone led to significantly reduced HbA 1c levels at T1 and decreased FBG levels at T1 and T2. Type 2 diabetes remission was achieved by 35.7% and 50% of the participants in the DB-TEXT + PSE group, by 17.9% and 25% in the DB-TEXT group, and by 3.7% and 3.7% in the PEP group at T1 and T2, respectively. Relative to the PEP, DB-TEXT + PSE led to significantly reduced TC levels, diastolic blood pressure (DBP), and systolic blood pressure (SBP) and improved sleep quality and QoL over time., Conclusions: Personalized DB-TEXT + PSE is more effective at enhancing clinical outcomes, reducing fatigue, improving sleep quality, and improving quality of life in patients with type 2 diabetes than DB-TEXT alone and PEPs are. Educators can incorporate personalized DB-TEXT + PSE as a component of diabetes education programs and thereby integrate digital interventions and supplementary programs., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.