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A 66-year-old female patient presenting with dysphagia was diagnosed with stage IV unresectable gastric cancer (cTxN+M1). Multiple liver metastases were identified. The patient subsequently underwent five courses of chemotherapy and immunotherapy, including the capecitabine plus oxaliplatin (XELOX) regimen combined with tislelizumab. After fifth course treatment, it was confirmed that the liver metastases had completely disappeared and the primary tumor had significantly reduced in size. Consequently, a laparoscopy was performed, revealing a retraction-like response in the primary tumor and no obvious metastases in the abdominal cavity. Subsequently, a radical total gastrectomy was carried out through open abdominal surgery. Pathological analysis showed no remaining cancer or lymph node metastases, and the tumor regression was classified as grade 0. The patient has been now receiving additional chemotherapy and immunotherapy to manage any potential residual metastases. This case illustrated the rare and significant impact of combining chemotherapy with tislelizumab, transitioning the treatment approach from palliative to curative. It highlighted the critical role of immunotherapy in managing advanced gastric cancer with liver metastases.

Background: The global prevalence of violence against children is alarmingly high, with millions facing violent discipline and physical punishment. In Mongolia, domestic violence-related criminal offenses have sharply increased, with a 46.92% surge in the first quarter of 2020 compared to 2019., Objective: This study aimed to estimate the prevalence of and identify factors associated with physical punishment and/or psychological aggression experienced by children under 5 years old from their caregivers., Methods: We used data from the nationally representative 2018 MICS6 dataset. To examine the association between independent and dependent variables, we used multilevel Poisson regression because it provides a better estimate and is more interpretable when the prevalence is relatively high., Results: The prevalence of psychological aggression was reported at 32.3% and physical punishment at 31.6%, including severe forms. Nonviolent techniques were common, with 77.5% exclusively using nonviolent discipline. Psychological aggression was more likely to occur in older children (3 and 4 years old) and in households with Buddhist heads. Additionally, 3-year-olds are more likely to experience physical punishment compared to 2-year-olds., Conclusion: These findings underscore the need for targeted policy interventions, including age-sensitive parental education programs and religious and cultural sensitivity measures. Comprehensive educational and awareness programs are essential to foster a culture of nonviolence across all educational levels, highlighting the need for context-specific policies to safeguard the well-being of children in Mongolia.

Background: In low- and middle-income countries, the double burden of malnutrition is prevalent. Many countries in Africa are currently confronted with overweight and obesity, particularly among women, coupled with an increase in the prevalence of non-communicable diseases., Objective: This study examines trends in overweight and obesity among Ethiopian women of reproductive age from 2005 to 2016, and identifies associated factors., Methods: We used three consecutive datasets from 2005 ( n  = 14070), 2011 ( n  = 16515), and 2016 ( n  = 15683) demographic health survey years. Multilevel logistic regression was used to identify the determinant factors among individual- and cluster-level variables., Results: The prevalence of overweight and obesity among reproductive women in Ethiopia increased steadily from 6.09% in 2005 to 8.54% in 2011, and 10.16% in 2016. However, mixed patterns were observed among the regions of the country. We found that age, education, living in urban areas, and living in a rich community are associated with becoming overweight and obese. For instance, the odds of becoming overweight and obese among women aged 35-49 were higher than those among women aged 15-24 (odds ratio [OR] = 3.62, 95% Confidence Interval [CI]:2.64-4.97). Women who completed secondary school have higher odds than those without formal education (OR = 1.64, 95% CI:1.19-2.26)., Conclusion: To our knowledge, this is the first study to investigate trends in the nationwide prevalence of overweight and obesity and the associated factors among Ethiopian women. This study warrants further follow-up research to identify the pathways between overweight and obesity and their probable factors.

Myocardial ischemia-reperfusion injury (MIRI) is a complex pathological process that results from the restoration of blood flow to ischemic myocardium, leading to a series of detrimental effects including oxidative stress and inflammation. Stachyose, a naturally occurring oligosaccharide found in traditional Chinese medicinal herbs, has been suggested to possess therapeutic properties against various pathological conditions. However, its impact on MIRI and the underlying mechanisms have not been fully elucidated. In this study, we aimed to investigate the therapeutic effects of stachyose on MIRI and to uncover the molecular mechanisms involved. Using both in vivo and in vitro models of MIRI, we evaluated the effects of stachyose on cardiac function and cell death pathways. Our results indicate that stachyose significantly improves cardiac function and reduces infarct size in MIRI mice. Mechanistically, stachyose modulates the ferroptotic pathway in cardiomyocytes by upregulating the expression of glutathione peroxidase 4 (GPX4) and reducing lipid peroxides and iron levels. Additionally, stachyose inhibits the pyroptotic pathway in macrophages by downregulating the expression of NLRP3, gasdermin D (GSMD-N), and cleaved-caspase-1, leading to decreased levels of proinflammatory cytokines interleukin (IL)-1β and IL-18. This study demonstrates that stachyose exerts a protective effect against MIRI by targeting both ferroptosis and pyroptosis pathways, suggesting its potential as a novel therapeutic agent for the treatment of MIRI. Further research is warranted to explore the detailed mechanisms and therapeutic potential of stachyose in clinical settings., 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 Elsevier B.V. All rights reserved.)

Microcystis aeruginosa (M. aeruginosa) blooms and microplastics pollution have been major global water pollution concern in lakes and reservoirs. In this study, the behaviour of M. aeruginosa-microplastic composite pollutants in inorganic coagulant (PACl) and organic coagulant (HTCC) treatment was investigated. Results showed that, in coagulation stage, the dissolved extracellular polymers secreted by M. aeruginosa could promote the adhesion of microplastics to algae, so as to combine them into the algal flocs, thus improving the sedimentation and removal efficiency of microplastics. On the other hand, whilst microplastics increased the size of algal flocs in PACl coagulation and improved algal removal efficiency, they had the opposite effect on HTCC coagulation. And the removal of algal metabolites including microcystins were improved by the presence of microplastics. In sludge storage stage, the oxidative and mechanical damage effects of microplastics promoted the rupture of M. aeruginosa cells in PACl sludge but not in HTCC sludge, which mean more potential risks in recycling of PACl sludge water. Besides, microplastics promoted the proliferation of beneficial bacteria such as Poterioochromonas and Coccomyxa, which contributed to the control of sludge pollution., 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. Published by Elsevier B.V.)

Background: IgA vasculitis (IgAV), previously known as Henoch-Schönlein purpura, is an IgA-mediated systemic small vessel vasculitis that tends to be more severe in adults than in children. Early diagnosis of IgAV involving the gastrointestinal tract remains difficult, especially in patients who present with gastrointestinal symptoms before purpura. This study aims to systematically analyze the abdominal imaging and endoscopic features of adult patients with abdominal IgAV, providing assistance to clinicians in the early recognition of this condition., Patients and Methods: This multicenter retrospective study was conducted in three large tertiary hospitals in China from January 2017 to January 2024. A total of 108 adult patients with abdominal IgAV, who had complete abdominal imaging and/or endoscopy results, were enrolled. The clinical manifestations, abdominal imaging findings, endoscopic characteristics, and serological indicators of the patients were analyzed., Results: The median age of the patients was 40 years (IQR: 26-55), with a male-to-female ratio of 2:1. Acute abdominal pain was the most common presenting symptom (100 patients, 92.59%). Bowel wall thickening was the most frequent finding on abdominal imaging (50/86 patients, 58.14%). Gastrointestinal endoscopy showed findings of congestion and erosion (32/67 patients, 47.76%), and erosion with ulcers (21/67 patients, 31.34%). Among patients with both imaging and endoscopic results, the duodenum (28/51 patients, 54.90%) and ileum (28/51 patients, 54.90%) were the most commonly affected sites. Laboratory findings revealed elevated white blood cell count (WBC), neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), D-dimer and fibrinogen levels, along with decreased albumin level. Comparing patients with gastrointestinal symptoms versus purpura as the initial symptom, those with gastrointestinal symptoms had higher levels of WBC ( p  < 0.05) and NLR ( p  < 0.01)., Conclusions: The most common symptom in adult abdominal IgAV patients is acute abdominal pain. In the early stage of the disease, most patients exhibit elevated levels of WBC, NLR, CRP, D-dimer, and fibrinogen, along with decreased albumin level. The duodenum and ileum are the most commonly affected sites. By integrating these findings, clinicians can identify abdominal IgAV patients earlier and more accurately.

Background: Accurate detection of lymph node metastasis (LNM) is crucial for determining the tumor stage, selecting optimal treatment, and estimating the prognosis for cervical cancer. This study aimed to assess the diagnostic efficacy of multimodal diffusion-weighted imaging (DWI) and morphological parameters alone or in combination, for detecting LNM in cervical cancer., Methods: In this prospective study, we enrolled consecutive cervical cancer patients who received multimodal DWI (conventional DWI, intravoxel incoherent motion DWI, and diffusion kurtosis imaging) before treatment from June 2022 to June 2023. The largest lymph node (LN) observed on each side on imaging was matched with that detected on pathology to improve the accuracy of LN matching. Comparison of the diffusion and morphological parameters of LNs and the primary tumor between the positive and negative LN groups. A combined diagnostic model was constructed using multivariate logistic regression, and the diagnostic performance was evaluated using receiver operating characteristic curves., Results: A total of 93 cervical cancer patients were enrolled: 35 with LNM (48 positive LNs were collected), and 58 without LNM (116 negative LNs were collected). The area under the curve (AUC) values for the apparent diffusion coefficient, diffusion coefficient, mean diffusivity, mean kurtosis, long-axis diameter, short-axis diameter of LNs, and the largest primary tumor diameter were 0.716, 0.720, 0.716, 0.723, 0.726, 0.798, and 0.744, respectively. Independent risk factors included the diffusion coefficient, mean kurtosis, short-axis diameter of LNs, and the largest primary tumor diameter. The AUC value of the combined model based on the independent risk factors was 0.920, superior to the AUC values of all the parameters mentioned above., Conclusion: Combining multimodal DWI and morphological parameters improved the diagnostic efficacy for detecting cervical cancer LNM than using either alone., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Rehmannia glutinosa produces many phenylethanoid glycoside (PhG) compounds, including salidroside, which not only possesses various biological activities but also is a core precursor of some medicinal PhGs, so it is very important to elucidate the species' salidroside biosynthesis pathway to enhance the production of salidroside and its derivations. Although some plant copper-containing amine oxidases (CuAOs), phenylacetaldehyde reductases (PARs) and UDP-glucose glucosyltransferases (UGTs) are thought to be vital catalytic enzymes involved in the downstream salidroside biosynthesis pathways, to date, none of these proteins or the associated genes in R. glutinosa have been characterized. To verify a postulated R. glutinosa salidroside biosynthetic pathway starting from tyrosine, this study identified and characterized a set of R. glutinosa genes encoding RgCuAO, RgPAR and RgUGT enzymes for salidroside biosynthesis. The functional activities of these proteins were tested in vitro by heterologous expression of these genes in Escherichia coli, confirming these catalytic abilities in these corresponding reaction steps of the biosynthetic pathway. Importantly, four enzyme-encoding genes (including the previously reported RgTyDC2 encoding tyrosine decarboxylase and the RgCuAO1, RgPAR1 and RgUGT2 genes) were cointegrated into Saccharomyces cerevisiae to reconstitute the R. glutinosa salidroside biosynthetic pathway, achieving an engineered strain that produced salidroside and validating these enzymes' catalytic functions. This study elucidates the complete R. glutinosa salidroside biosynthesis pathway from tyrosine metabolism in S. cerevisiae, establishing a basic platform for the efficient production of salidroside and its derivatives., 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 Elsevier B.V. All rights reserved.)

Microplastics (MPs) and heavy metals widely coexist in agricultural soils, posing significant risks to soil-plant ecosystems. This study explores the effects of five common MPs-polyethylene (PE), polypropylene (PP), polyvinyl chloride (PVC), polystyrene (PS), and polylactic acid (PLA)-and environmental-simulating microplastics (EMPs), composed based on the composition of local MPs in agricultural soils, on the bioavailability and phytotoxicity of Cd and Cr in soils. Pot experiments demonstrated that MPs, particularly PE and EMPs at a 5 % dosage, markedly decreased soil pH, water-holding capacity, and soil organic carbon content. This decrease in pH led to enhanced Cd and Cr mobility and bioavailability, especially with PE and EMPs increasing Cr bioavailability in 15 cm depth soil by up to 43.9 % and 37.8 %, respectively. In soils with 2.1 mg/kg of Cd and 390 mg/kg of Cr, both 1 % and 5 % doses of MPs inhibited wheat growth while enhancing the uptake and translocation of Cd and Cr in wheat. Notably, PE, PS, PLA, and EMPs exposure significantly elevated levels of oxidative stress markers (SOD, POD, CAT, and MDA) in wheat. These findings highlight the importance of further research on the combined impacts of MPs and heavy metals on soil health and plant safety., 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 Elsevier B.V. All rights reserved.)

The tri-trophic interaction of plants, insect herbivores, and entomoviruses is an important topic in ecology and pest control. The susceptibility of insect herbivores to entomoviruses (e.g., nucleopolyhedroviruses) is influenced by host plants; however, the role of plant secondary metabolites in determining such susceptibility is poorly understood. Metabolomic analyses of Brassica oleracea, Glycine max, and Ipomoea aquatica plants, which differ in how they affect the susceptibility of Spodoptera exigua to nucleopolyhedroviruses among 14 plants, suggested that the plant secondary metabolites genistein, kaempferol, quercitrin, and coumarin play a role in influencing nucleopolyhedroviruses susceptibility. Subsequently, transcriptomic analysis of caterpillars, treated with nucleopolyhedroviruses alone or with one of these four phenolics, identified four genes (CYP340K4, CXE18, GSTe, and GSTe1) that were significantly downregulated by the phenolics. Functional characterization of these genes suggested that their downregulation significantly increased larval sensitivity to nucleopolyhedroviruses and altered aspects of the immune response. Our findings provide new insight into the role of plant defense metabolites in influencing the interactions between insect herbivores and entomopathogens and identify plant secondary metabolites as potential synergists of viral agents for the control of agricultural pests., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Organismal communities associated with coral reefs, particularly invertebrates and microbes, play crucial roles in ecosystem maintenance and coral health. Here, we characterized the organismal composition of a healthy, non-urbanized reef (Site A) and a degraded, urbanized reef (Site B) in the Gulf of Eilat/Aqaba, Red Sea to assess its impact on coral health and physiology. Biomimetically designed terracotta tiles were conditioned for 6 months at both sites, then reciprocally transplanted, and scleractinian coral species, Acropora eurystoma and Stylophora pistillata, were attached for an additional 6 months. After 12 months, tiles from Site A transplanted to Site B exhibited greater invertebrate richness and diversity than Site B's original tiles (via Cytochrome c. Oxidase subunit I metabarcoding). Key bacteria from the healthy reef were more prevalent on Site A tiles and on the tiles transplanted to Site B (via 16S rRNA gene sequencing). Corals originally from Site B attached to transplanted healthy tiles (Site A) showed higher photochemical capacity, increased endosymbionts, and reduced physiological stress, measured by total antioxidant capacity and an integrated biomarker response. Our findings demonstrate the successful transfer of organismal communities between reefs, highlighting the potential benefits of healthy reef-associated invertebrates and microbes on coral physiology and their implications for reef restoration strategies., Competing Interests: Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Many heavy metals pose significant threats to the environment and human health. Traditional methods for detecting heavy metals are often limited by complex procedures, high costs, and challenges in field monitoring. Carbon quantum dots (CQDs), a novel class of fluorescent carbon nanomaterials, have garnered significant interest due to their excellent biocompatibility, low cost, and minimal toxicity. This paper reviews the primary synthesis methods, luminescence mechanisms, and fluorescence quenching mechanisms of CQDs, as well as their recent applications in detecting heavy metals. In heavy metal sensing applications, the simplest hydrothermal method is commonly employed for the one-step synthesis and surface modification of CQDs. Various green reagents and biomass materials, such as citric acid, glutathione, orange peel, and bagasse, can be used for CQDs' preparation. Quantum confinement effects and surface defects give CQDs their distinctive luminescence properties, enabling the detection of heavy metals through fluorescence quenching or enhancement. Additionally, CQDs can be applied in biological imaging and smart detection, and when combined with adsorption materials, they can offer multifunctional capabilities. This review also discusses the future development prospects of CQDs., 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 Elsevier B.V. All rights reserved.)

In recent decades, global aquaculture has expanded rapidly, raising concerns about coastal environmental degradation due to unregulated or poorly regulated discharge of aquaculture tailwater. Despite the crucial role of dissolved organic matter (DOM) in biogeochemical processes and aquatic biodiversity, the influence of aquaculture type on the molecular characteristics of DOM remains largely unexplored. Herein, this study investigated the variations in chemical and spectroscopic properties as well as molecular characteristics and composition of DOM across different aquaculture types including crustacean, fish and shellfish. Our findings revealed notable differences in DOM quantities among different aquaculture types, with crustacean and fish aquaculture water containing higher DOM amount compared to shellfish aquaculture water. This disparity can be attributed to the more frequent formulated feeds of crustacean and fish in contrast to shellfish aquaculture. Furthermore, distinct differences were also observed in the characteristics and composition of DOM among the different aquaculture waters. Specifically, DOM in shellfish aquaculture water exhibited a higher abundance of unsaturated and reduced molecules as well as increased aromaticity compared to the other two aquaculture waters. Conversely, DOM from fish aquaculture water showed a greater contribution from terrestrial origin characterized by elevated levels of plant-based components such as lignin-like and tannin-like compounds. Interestingly, DOM from shellfish aquaculture water contained lower levels of microbial-derived components such as lipid-like and protein-like compounds, likely due to reduced microorganism populations resulting from lower nutrients availability and higher salinity. Overall, these significant variations in characteristics and composition of DOM underscore the potential impacts of aquaculture type on the DOM biogeochemical cycle and the environmental quality 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 © 2024 Elsevier Ltd. All rights reserved.)

Xanthan gum, produced by the aerobic fermentation of carbohydrates by Xanthomonas campestris, is a significant natural and industrial biopolymer known for its exceptional properties. Enhancing the yield of xanthan gum production remains a critical challenge. This study employed atmospheric and room temperature plasma (ARTP) technology to induce mutagenesis in X. campestris, resulting in a high-yielding strain, X20. The X20 mutant exhibited a substantial increase in xanthan gum yield, ranging from 13.3 % to 30.0 % over the starting strain across NaCl concentrations of 0, 6.0, and 8.0 g/L, along with improved viscosity and molecular weight. In the whole genome of X20 mutant, a total of 80 variant sites differing from the reference genome were identified, involving 76 mutated genes. Among these, 19 were missense mutations primarily associated with the two-component system. Transcriptome analysis highlighted their role in enhancing flagellar movement, biofilm formation, and metabolic synthesis, thereby elevating the capability of the mutant strain in xanthan gum production. This study demonstrates the potential of ARTP as an effective tool for microbial mutagenesis breeding, providing theoretical guidance for future studies on the synthesis regulation of xanthan gum and the engineering modification of X. campestris., 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 Elsevier B.V. All rights reserved.)

Background: Play is an indispensable and meaningful activity in children's daily life. Research has shown that autistic children often exhibit differences in play development. The core traits of autism, such as distinct patterns in social interaction and communication, focused interests, and repetitive behaviors, frequently manifest in their play. Therefore, play may serve as an insightful measure of these differences. Unlike previous studies focusing on play behaviors only, we explored other behaviors associated with autism during free play, and constructed a clinical prediction model for effectively screening autistic children., Methods: Participants, including 123 autistic children and 123 neurotypical children aged 1-6 years, engaged in a 1.5-min free play with fixed toys, which was videotaped. A novel behavior-coding scheme was used to code these videos for 19 autistic behaviors, including play. The coding details of the 19 behaviors were then converted and expanded to 81 digital behavior indicators, including counts, duration, and proportion., Results: The autistic children showed less functional play and imaginative play and reduced social communication and interactions, such as eye contact, facial expressions, and vocalizations, compared to the neurotypical children during free play. Furthermore, 5 behavioral indicators were selected for the prediction model through stepwise logistic regression, including 1 on socially oriented vocalizations and 4 on count and duration of functional play. The receiver operating characteristic (ROC) curve revealed a good prediction performance with an area under the curve (AUC) of 0.826, a sensitivity of 85.4%, and a specificity of 68.3%., Conclusion: Our findings highlight differences in play performance and social communication and interactions during free play among autistic children. Based on these findings, we constructed a good clinical prediction model, which might be a potential digital tool used by clinicians to effectively screen autistic children., Competing Interests: Declarations Ethics approval and consent to participate All methods were carried out in accordance with the guidelines and recommendations specified within the Helsinki declaration. The procedure was approved by the Ethics Committee of Peking University Sixth Hospital (approval no. 2021-71), and written informed consent was obtained from the parents/legal guardians of all participants before enrolling in this study. Consent for publication Not applicable. Competing interests The authors (Z.M., Y.J., JH.C., Y.G., X.L., and J.L.) declare that there were two patent applications related to this research (No. 202310300588.1 and No. 202310315701.3). Q.L., R.H., X.S., JL.C., and T.Y. have no conflicts of interest with regard to the content of this manuscript., (© 2024. The Author(s).)

A new dammarane-type triterpenoid saponin, suanzaoside A ( 1 ) along with one known analogue 3- O -[ α -L-rhamnopyranosyl(1→2)- α -L-arabinopyranosyl-]-30- O -[ β -D-glucopyranosyl-(1→2)- β -D-glucopyranosyl]-3 β ,25,30-trihydroxy-16-one-20 R ,24 R -epoxydammarane ( 2 ), were isolated from the leaves of sour jujube. The structure of these isolated compounds was elucidated by HRESIMS, 1D and 2D NMR spectroscopy, and literature comparison. In addition, the anti-inflammatory activities were further tested in LPS-induced RAW264.7 macrophage.

Currently, water treatment usually requires additional light illumination or oxidants for the degradation of organic pollutants, which increases the costs and is not conducive to practical application. In this study, carbon vacancy-modified Fe-N-C single-atom catalysts (Cv-Fe-N-C SACs) were prepared through one simple acid-etching and pyrolysis process. Interestingly, we found that Cv-Fe-N-C SACs could degrade organic pollutants without any external assistance (such as oxidants or light illumination). The Cv-Fe-N-C SACs could remove over 99% of Rhodamine B (RhB) within 10 min at room temperature. The degradation of organic pollutants with the Cv-Fe-N-C SACs was attributed to their ability to activate dissolved oxygen for producing superoxide (O 2 ˙ - ). In addition, the catalysts showed high activity over a broad pH range (3-11) and held rather good stability after 5 recycles. This study proved that the Cv-Fe-N-C SACs are highly efficient catalysts for degrading organic pollutants. These catalysts have the potential to make sewage treatment more efficient and less expensive.

Experimental Acupuncture and Moxibustion, as an interdisciplinary course, integrates traditional acupuncture and moxibustion with modern science. It is an important way for cultivating students' scientific thinking and innovation. The teaching group of Experimental Acupuncture and Moxibustion in Shandong university of TCM developed the content of courses under the guidance of talent construction of "emerging medicine discipline", aiming to cultivate the talents for the upright and innovation of acupuncture and moxibustion, and being abide to the advanced teaching concepts of students' cognitive law and outcome based education. Base on teaching design, teaching mode, curriculum ideological and political development, and teaching evaluation, a series of new measures have been implemented, e.g. "two-line, three-stage and eight-step measures", "six dimensions and five combinations" and "five combinations and three measure gauges". Through practice and exploration, the students' satisfaction, the innovation and creativity, and teaching ability of teachers have been enhanced. These reforms could provide the new approach to the development of the first-class courses related to traditional Chinese medicine.

Objective: To systematically evaluate the efficacy and safety of norepinephrine in the treatment of septic shock., Methods: Literature retrieval of eligible randomized controlled trials (RCTs) on norepinephrine in the treatment of septic shock was performed in three English databases including PubMed, Web of Science, and Medline from database establishment to October 1, 2023. The Cochrane risk bias tool was used to evaluate the quality of the included literature. RevMan 5.3 software was used for meta-analysis., Results: A total of 14 RCTs were included in this study, and the risk of bias was low. Our meta-analysis showed that the norepinephrine group had significantly better outcomes in reducing the 28-day mortality rate (RR = 0.92; 95% CI, 0.86 ~ 0.99; P = 0.03), the incidence of arrhythmia (RR = 0.54; 95% CI, 0.45 ~ 0.64; P < 0.0001), and the length of stay in intensive care unit (ICU) (MD =  - 1.03; 95% CI, - 1.85 to approximately - 0.21; P = 0.01) than those of the control group. However, there were no statistically significant differences in in-hospital mortality rate (RR = 0.97; 95% CI, 0.90 ~ 1.04; P = 0.4), the 90-day mortality rate (RR = 1.07; 95% CI, 0.97 ~ 1.18; P = 0.15), length of hospital stay (MD = 0.03; 95% CI, - 1.13 ~ 1.18; P = 0.96), and the rate of achieving target MAP (RR = 1.27; 95% CI, 0.72 ~ 2.26; P = 0.41) between the norepinephrine group and the control group., Conclusion: Norepinephrine has the advantages of improving 28-day mortality, shortening ICU hospitalization time, and reducing the incidence of arrhythmia. It is a more effective choice for the treatment of septic shock than other vasopressors, and the incidence of arrhythmia is low., (© 2024. The Author(s).)

Introduction: Childhood-onset asthma is a chronic respiratory disease that profoundly impacts patients, their families, and healthcare systems. This study explores the lived experiences, challenges, and perceptions of mothers in managing asthma, controlling symptoms, and maintaining the quality of life for their children with asthma in Palestine., Methods: A qualitative descriptive design through semi-structured interviews was used in this study. Purposive sampling was used to identify mothers who have children with severe uncontrolled asthma in the four public hospitals with pediatric units in the West Bank, Palestine. Mothers of children with scored below 15 on the asthma control test were included in the study. The data were analyzed using an analytical framework following a thematic analysis through the NVivo 11., Results: A total of 20 mothers participated in interviews wherein they delineated the most important challenges negatively affecting asthma management from mothers' perspectives. These challenges encompassed frequent emergency room visits, improper medication administration practices, and limitations in physical activity. The mothers expressed concerns regarding asthma control, including anxieties concerning the chronicity of the illness, adverse effects of medications, and susceptibility to weather fluctuations. The main themes that emerged from the data included reduced quality of life for the child, parental responsibility for monitoring triggers, symptoms, and medications, challenges in asthma management, apprehensions regarding asthma control, and strategies for enhancing asthma management., Conclusion: This study emphasizes the pressing need for targeted interventions to address asthma management, environmental triggers, and psychosocial disruptions related to asthma in children with asthma to enhance the quality of life and asthma control. This study highlights the importance of developing strategies that provide mothers with the appropriate information and tools to navigate the complexities of caring for a child with asthma., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Angiogenesis refers to the process of forming a new network of blood vessels from existing ones through the migration, proliferation, and differentiation of endothelial cells. This process is crucial for the growth and spread of solid tumors, particularly once the tumor volume exceeds 2 mm 3 , as the newly formed vascular network provides essential oxygen, nutrients, and growth factors to the tumor. Anti-angiogenesis therapy has become one of the commonly used targeted treatments for cancer in clinical practice. Bevacizumab, the first anti-angiogenesis drug, has been widely applied in the treatment of various solid tumors. However, due to acquired resistance, its efficacy is typically sustained for only 1 to 2 years. Despite the relative genomic stability of endothelial cells, which makes resistance less likely, various types of resistance phenomena have been observed in clinical practice, indicating that resistance to anti-angiogenic therapy remains a challenging research area. This review focuses on the latest advances in the mechanisms of resistance to anti-angiogenic therapy in tumors and explores new prospects for anti-tumor angiogenesis treatment, in order to provide strong theoretical support and guidance for clinical practice.

Objectives: This study aimed to examine the relationship between measures of kidney function and impaired lung function in individuals with diabetes and to assess all-cause mortality risk associated with having chronic kidney disease (CKD) and or impaired lung function., Design: Cross-sectional and retrospective cohort study., Setting: The National Health and Nutrition Examination Survey 2007-2012., Participants: A total of 10 809 participants aged over 20 years were included in this study: 9503 with normal spirometry, 951 with preserved ratio impaired spirometry (PRISm) and 355 with variable obstruction (VO)., Exposure and Outcome Measures: Kidney function measures, including estimated glomerular filtration rate (eGFR) and urinary albumin to creatinine ratio (UACR), were considered exposure variables. PRISm and VO were outcome variables. PRISm was defined as a forced expiratory volume in 1 s (FEV1)<80% predicted and an FEV1/forced vital capacity (FVC) ratio≥0.7, while VO was defined as an FEV1/FVC ratio <0.7 prebronchodilator and ≥0.7 postbronchodilator. In the cross-sectional analysis, multivariate logistic regression models were used to assess the relationship between kidney function measures and spirometry findings. In the retrospective cohort analysis, Cox proportional hazards models were employed to evaluate the impact of having PRISm or VO, combined with CKD, on all-cause mortality., Results: An increase in UACR was significantly associated with higher odds of PRISm (OR (95% CI)=1.10 (1.01, 1.21), p=0.03). Additionally, eGFR <60 was associated with the odds of variable obstructive lung function (OR (95% CI)=1.72 (1.07, 2.74), p=0.03) compared with eGFR >60. After adjustments, an increase in UACR was associated with higher odds of PRISm in individuals with diabetes (OR (95% CI)=1.21 (1.08, 1.36), p=0.002), and UACR ≥300 mg/g significantly increased odds of having PRISm in idividuals with diabetes (OR (95% CI)=2.34 (1.23, 4.47), p=0.01). During a mean follow-up of 12.3 years, 10 500 deaths occurred. In the diabetic group, compared with normal spirometry without CKD, those with both PRISm and CKD had a significantly increased risk of all-cause mortality (HR (95% CI)=3.46 (1.94, 6.16), p<0.0001)., Conclusion: An elevated UACR and albuminuria were linked to a higher risk of PRISm. Our study emphasises that kidney and lung function are correlated. Further research is necessary to confirm our findings., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The relationship of hypoglycemic drugs, inflammatory proteins and gallbladder diseases remain unknown., Methods: Four hypoglycemic drugs were selected as exposure: glucagon-like peptide-1 receptor agonists (GLP-1RA), dipeptidyl peptidase-4 inhibitors (DPP-4i), sodium-glucose cotransporter 2 inhibitors (SGLT-2i), and metformin. The outcome were two gallbladder diseases: cholecystitis and cholelithiasis. Mendelian Randomization (MR) was employed to determine the association between hypoglycemic drugs and gallbladder diseases., Results: DPP-4i and SGLT-2i had no effect on cholecystitis and cholelithiasis. However, a causal relationship was found between inhibition of ETFDH gene, a target of metformin expressed in cultured fibroblasts, and cholelithiasis (OR: 0.84, 95 %CI: (0.72,0.97), p = 0.021), as well as between GLP1R expression in the brain caudate basal ganglia and cholecystitis (OR: 1.29, 95 %CI: (1.11,1.49), p = 0.001). The effect of ETFDH inhibition on cholelithiasis through Interleukin-10 receptor subunit beta (IL-10RB) levels and Neurotrophin-3 (NT-3) levels, with a mediated proportion of 8 % and 8 %, respectively., Conclusion: Metformin plays a protective role in cholelithiasis, while GLP-1RA have a harmful effect on the risk of cholecystitis. Metformin may reduce the risk of cholelithiasis by modulating the levels of Neurotrophin-3 (NT-3) and Interleukin-10 receptor subunit beta (IL-10RB). Further clinical and mechanistic studies are required to confirm these findings., 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 B.V. All rights reserved.)

Forest transformation can markedly impact soil greenhouse gas emissions and soil environmental factors. Due to increasing labor costs and declining bamboo prices, the abandonment of Moso bamboo forests is sharply escalating in recent years, which weakens the carbon sequestration capacity and decreases the ecological function of forests. To improve the ecological quality of abandoned Moso bamboo forests, transformations of abandoned bamboo forests have occurred. However, the impact of such transformations on N 2 O emissions remains elusive. To bridge the knowledge gap, we conducted a 23-month field experiment to compare the effects of various forest management practices on soil N 2 O emissions and soil environmental factors in abandoned Moso bamboo forests in subtropical China. These practices included uncut abandonment as a control, intensive management, three intensities (light, moderate, and heavy) of strip clear-cutting with replanting local tree species, and clear-cutting with replanting transformation. During the experimental period, the mean soil N 2 O flux in abandoned Moso bamboo forests was 13.2 ± 0.1 μg m -2 h -1 , representing a 44% reduction compared to intensive management forests. In comparison to the uncut control, light, moderate, and heavy strip clear-cutting and clear-cutting transformations increased soil N 2 O emission rates by 20%, 43%, 64%, and 94%, respectively. Soil temperature (69-71%), labile C (2-6%) and N (3-8%) were the main factors that explain N 2 O emissions following the transformation of abandoned Moso bamboo forests. Additionally, replanting could decrease soil N 2 O emissions by increasing the contribution of soil moisture. Overall, the light strip clear-cutting transformation is suggested to convert abandoned Moso bamboo forests to mitigate N 2 O emissions., 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 Elsevier Ltd. All rights reserved.)

This study investigates the efficacy of a novel tissue-engineered scaffold for nerve repair and functional reconstruction following injury. Utilizing stable jet electrospinning, we fabricated aligned ultrafine fibers from dopamine and poly(L-lactic acid) (PLLA), further developing a biomimetic, oriented, and electroactive scaffold comprising poly(pyrrole) (PPy), polydopamine (PDA), and PLLA through dual in situ polymerizations. The scaffold demonstrated enhanced cell adhesion and reactive oxygen species (ROS) scavenging capabilities and promoted the differentiation of mesenchymal stem cells (MSCs) into Schwann-like cells, essential for nerve regeneration. In vivo assessments revealed significant peripheral nerve regeneration in 10 mm sciatic nerve defects in rats, with observations made 12 weeks post-transplantation. This included facilitated myelination and increased muscle density on the injured side, leading to improved motor function recovery. Our results suggest that the aligned PPy/PDA/PLLA fibrous scaffold offers a promising approach for promoting the differentiation of MSCs into Schwann-like cells conducive to nerve regeneration and represents a significant advancement in nerve repair technologies. This study provides a foundational basis for future research into tissue-engineered solutions for nerve damage, potentially impacting clinical strategies for nerve reconstruction., 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 Elsevier B.V. All rights reserved.)

Background: Visceral hypersensitivity is considered the core pathophysiological mechanism that causes abdominal pain in patients with irritable bowel syndrome (IBS). Fungal dysbiosis has been proved to contribute to visceral hypersensitivity in IBS patients. However, the underlying mechanisms for Dectin-1, a major fungal recognition receptor, in visceral hypersensitivity are poorly understood. This study aimed to explore the role of Dectin-1 in visceral hypersensitivity and elucidate the impact of Dectin-1 activity on the function of transient receptor potential vanilloid type 1 (TRPV1)., Methods: Visceral hypersensitivity model was established by the intracolonic administration of 0.1 mL TNBS (130 μg/mL in 30% ethanol) in the male mice. Fluconazole and nystatin were used as fungicides. Laminarin, a Dectin-1 antagonist and gene knockout (Clec7a -/- ) mice were used to interrupt the function of Dectin-1. Colorectal distension-electromyogram recording was performed to assess visceral sensitivity. Immunostaining experiment was performed to determine the localization of Dectin-1 in dorsal root ganglion (DRG) neurons. Calcium imaging study was performed to assay TRPV1-mediated calcium influx in acutely dissociated DRG neurons., Results: Pretreatment with fungicides, administration of laminarin or genetic deletion of Clec7a alleviated TNBS-induced visceral hypersensitivity in male mice. The expression of Dectin-1 was upregulated in the DRG and colon of TNBS-treated mice. Colocalization of Dectin-1 and TRPV1 was observed in DRG neurons. Importantly, pretreatment with curdlan, a Dectin-1 agonist, increased TRPV1-mediated calcium influx., Conclusions: Dectin-1 contributes to visceral hypersensitivity in IBS or in inflammatory bowel disease in remission and activation of Dectin-1 induces TRPV1 sensitization., Significance Statement: This work provides direct evidence for the functional regulation of TRPV1 channel by Dectin-1 activity, proposing a new mechanism underlying TRPV1 sensitization. Control of intestinal fungi might be beneficial for the treatment of refractory abdominal pain in patients with IBS or IBD in remission., (© 2024 European Pain Federation ‐ EFIC ®.)

Peptide glucagon-like peptide-1 receptor agonists (GLP-1RAs) are effective drugs for treating type 2 diabetes (T2DM) and have been proven to benefit the heart and kidney. Apart from oral semaglutide, which does not require injection, other peptide GLP-1RAs need to be subcutaneously administered. However, oral semaglutide also faces significant challenges, such as low bioavailability and frequent gastrointestinal discomfort. Thus, it is imperative that advanced oral strategies for peptide GLP-1RAs need to be explored. This review mainly compares the current advantages and disadvantages of various oral delivery strategies for peptide GLP-1RAs in the developmental stage and discusses the latest research progress of peptide GLP-1RAs, providing a useful guide for the development of new oral peptide GLP-1RA drugs., 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. Published by Elsevier Inc.)

The aim of the study was to explore the clinical efficacy of bisphosphonates in patients with osteoporosis in diabetes patients by meta-analysis. Six databases were systematically searched from inception to January 30,2023. Studies evaluating the treatment of diabetic osteoporosis with bisphosphonates were included. Key outcome measures, such as bone mineral density (BMD), bone metabolism markers, pain improvement, and safety assessments, were extracted and analyzed. STATA MP V17.0 was used to calculate the combined effect size. After searching Chinese and English databases, 15 studies met the inclusion criteria of this study. The results of the meta-analysis showed that the BMD of patients with osteoporosis in diabetes increased significantly after bisphosphonate treatment, and the lumbar BMD increased by 0.08 g/cm² (95% CI: 0.05-0.11). Femoral neck BMD increased by 0.06 g/cm² (95% CI: 0.01-0.11); Ward's triangle BMD increased 0.07 g/cm² (95% CI: 0.04-0.09); and trochanter BMD increased by 0.06 g/cm² (95% CI: 0.04-0.08). In addition, bone alkaline phosphatase increased 1.95 μg/l (95% CI: 1.18-2.72), while serum tartrate-resistant acid phosphatase-5b decreased 1.28 U/l (95% CI: -1.81-0.75). Moreover, improvements in pain were statistically significant. The effects of bisphosphonates on osteocalcin (MD: -0.07; 95% CI: -1.12-1.25), serum calcium (MD: 0.01; 95% CI: -0.03-0.04), serum phosphorus (MD: 0.04; 95% CI: -0.03-0.10) and medication safety (OR: 1.75; 95% CI: 1.29-2.37) were not statistically significant. Bisphosphonates have a significant positive effect on bone mineral density and bone metabolism in patients with osteoporosis in diabetes and have good safety., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Aqueous nickel-ion batteries (ANIBs) as an emerging energy storage device attracted much attention owing to their multielectron redox reaction and dendrite-free Ni anode, yet their development is hindered by the divalent properties of Ni 2+ and the lack of suitable cathode materials. Herein, a hydrated iron vanadate (Fe 2 V 3 O 10.5 ∙1.5H 2 O, FOH) with a preferred orientation along the (200) plane is innovatively proposed and used as cathode material for ANIBs. The FOH cathode exhibits a remarkable capacity of 129.3 mAh g -1 at 50 mA g -1 and a super-high capacity retention of 95% at 500 mA g -1 after 700 cycles. The desirable Ni 2+ storage capacity of FOH can be attributed to the preferentially oriented and tunnel structures, which offer abundant reaction active planes and a broad Ni 2+ diffusion path, the abundant vacancies and high specific surface area further increase ion storage sites and accelerate ion diffusion in the FOH lattice. Furthermore, the Ni 2+ storage mechanism and structural evolution in the FOH cathode are explored through ex situ XRD, ex situ Raman, ex situ XPS and other ex situ characteristics. This work opens a new way for designing novel cathode materials to promote the development of ANIBs., (© 2024 Wiley‐VCH GmbH.)

Background: Left ventricular assist devices (LVADs) are well-established for treating end-stage heart failure, but this therapy is only available to Chinese patients in recent years. The CH-VAD is the first used fully magnetically levitated pump in China. This study reports the long-term outcomes of a cohort supported by the CH-VAD for the first time., Methods: From June 2017 to August 2023, 50 consecutive patients received CH-VAD implantation in Fuwai Hospital. Clinical data were collected and retrospectively analyzed., Results: Baseline characteristics included a mean age of 47.9 ± 13.9 years, 90% male, and 26% ischemic etiology. The Interagency Registry for Mechanically Assisted Circulatory Support profile revealed 12% profile 1, 56% profile 2, 26% profile 3, and 6% profile 4. The mean support duration was 868 ± 630 days (range 33 days-6.4 years). Kaplan-Meier survival rate was 93% (95% CI, 79-98) at 1 year, 93% (95% CI, 79-98) at 2 years, and 89% (95% CI, 71-96) at 3 years. Forty patients (80%) currently remain on support, 3 were bridged to recovery, 2 received transplants, and 5 expired during support. Major adverse events (AEs) included right heart failure (10%), surgical-related bleeding (8%), arrhythmia (8%), and driveline infection (16%). Major hemocompatibility-related AEs were limited to 3 nondisabling strokes and 1 gastrointestinal bleeding. No major device malfunction occurred during the follow-up period., Conclusions: The largest single-center experience with the leading LVAD in China shows high survival with low complication rates, demonstrating that CH-VAD is safe and efficient in providing long-term support for patients with end-stage heart failure., (Copyright © 2024 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.)

Background: Despite the positive effect of early post-cardiac surgery exercises, the concern of safety issues is high, indicating the need for standardized and quantitative mobility indicators to enhance early mobilization monitoring in the intensive care unit while ensuring patient safety. This study aimed to compare the safety and efficacy of quantitative phase I exercise versus usual care in patients who have undergone cardiac surgery., Methods: In this non-randomized, single-blind trial, patients following on-pump cardiac surgery were allocated to either quantitative exercise (intervention group, n=114) or usual care (control group, n=114) based on their willingness. Continuous cycling ergometer was used for intervention, and the peak power was recorded for setting next exercise intensity. Noninvasive cardiac output monitoring during exercise was used for safety management. Patients received one time per day, seven sessions in total., Results: Two-way repeated-measure analysis of variance demonstrated significant group and test time difference for forced expiratory volume in 1 s (FEV1) (P=0.01), maximum expiratory pressure (MEP) (P=0.02), peak expiratory flow (PEF) rate (P=0.045), and 6-minute walking distance (6MWD) (P=0.001); more improvement of 6MWD in intervention group (P<0.001). Intervention group showed significant post-test improvements except FEV1/forced vital capacity (FVC). Post-test differences between groups were observed in FEV1 (P=0.02), FVC (P=0.02), MEP (P=0.02), 6MWD (P<0.001), and △6MWD (P<0.001). Analysis of covariance with smoking as covariate showed consistent results. Postoperative stay in intensive-care unit in the intervention group [mean ± standard deviation (SD), 3.0±1.3] was shorter than that in the control group (mean ± SD, 3.5±2.2) (P=0.03)., Conclusions: Quantitative phase I exercise applied to patients following cardiopulmonary bypass is safe and recovers respiratory and physical capacity more quickly., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-24-753/coif). The authors have no conflicts of interest to declare, (2024 AME Publishing Company. All rights reserved.)

Phenolic allelochemicals from root exudates dominate rhizosphere formation, lead to autotoxicity in plants subjected to continuous monoculture (CM) stress and induce the emergence of replant disease. However, the regulatory mechanisms governing the transport of phenolics from plant roots to the rhizosphere remain poorly understood. A potential phenolic efflux transporter from Rehmannia glutinosa , designated RgMATE35, has been preliminarily characterized. The objective of this study was to elucidate the molecular function of RgMATE35 in the secretion of phenolics and to investigate its role in the development of plant replant disease using quantitative real-time PCR (qRT-PCR), genetic transformation, HPLC-Q-TOF-MS and other analytical techniques. A tissue expression pattern analysis of RgMATE35 revealed that it is highly expressed in plant roots. Transient expression analysis confirmed the localization of the protein in plasma membranes. An assessment of the transport activity of RgMATE35 in Xenopus oocytes indicated that it plays a role in facilitating the efflux of labeled ferulic acid ([ 2 H 3 ]-FA) and trans- p -coumaric acid [ 2 H 6 ]- p CA. The results of functional studies in R. glutinosa demonstrated that RgMATE35 positively mediates the secretion of FA and p CA from plant roots into the rhizosphere. A molecular and physiological analysis of RgMATE35 transgenic plants subjected to CM stress revealed that the overexpression or repression of RgMATE35 resulted in notable changes in the degree of autotoxic injury in plants. These findings demonstrate that RgMATE35 plays a positive role in the development of replant disease through the secretion of phenolic acids from plant roots. They also provide a fundamental framework for elucidating the molecular regulatory mechanism through which MATEs regulate replant disease through the root secretion of allelochemicals.

Background: Leaves are important sites for photosynthesis and can convert inorganic substances into organic matter. Photosynthetic performance is an important factor affecting crop yield. Leaf colour is closely related to photosynthesis, and leaf colour mutants are considered an ideal material for studying photosynthesis., Results: We obtained a yellow-green leaf mutant jym165, using ethyl methane sulfonate (EMS) mutagenesis. Physiological and biochemical analyses indicated that the contents of chlorophyll a, chlorophyll b, carotenoids, and total chlorophyll in the jym165 mutant decreased significantly compared with those in Jiyu47 (JY47). The abnormal chloroplast development of jym165 led to a decrease in net photosynthetic rate and starch content compared with that of JY47. However, quality traits analysis showed that the sum of oil and protein contents in jym165 was higher than that in JY47. In addition, the regional yield (seed spacing: 5 cm) of jym165 increased by 2.42% compared with that of JY47 under high planting density. Comparative transcriptome analysis showed that the yellow-green leaf phenotype was closely related to photosynthesis and starch and sugar metabolism pathways. Genetic analysis suggests that the yellow-green leaf phenotype is controlled by a single recessive nuclear gene. Using Mutmap sequencing, the candidate regions related of leaf colour was narrowed to 3.44 Mb on Chr 10., Conclusions: Abnormal chloroplast development in yellow-green mutants leads to a decrease in the photosynthetic pigment content and net photosynthetic rate, which affects the soybean photosynthesis pathway and starch and sugar metabolism pathways. Moreover, it has the potentiality to increase soybean yield under dense planting conditions. This study provides a useful reference for studying the molecular mechanisms underlying photosynthesis in soybean., (© 2024. The Author(s).)

Planar tetracoordinate fluorine (ptF) species are very exotic and scarce due to high electronegativity of fluorine. Herein we report the ternary square ptF cluster, D 4 h FK 4 H 4 - , which is composed of a F center, a square K 4 ring, and four outer H bridges. It is a true global minimum (GM) structure and possesses good dynamic stability. Bonding analyses indicate that there are four lone pairs for the central F atom, along with four K-H-K three-center two-electron (3c-2e) σ bonds for the peripheral K 4 H 4 ligand ring. The stability of ptF is dominated by multicenter ionic bonds rather than the supposed σ aromaticity of the system. Excitingly, it is a pseudohalogen anion with the VDE 3.57 eV at the CCSD(T) level. The merge of ptF with pseudohalogen anion character makes the FK 4 H 4 - cluster an exotic species, which will motivate theoretical and experimental studies on novel ptF species as well as superhalogens.

We isolated peripheral blood mononuclear cells (PBMCs) from a healthy female donor, and successfully converted into induced pluripotent stem cells (iPSCs) by using non-integrating episomal vectors. These iPSCs displayed a normal karyotype, expressed markers of pluripotency, and showed the capacity to differentiate into three germ layers in vitro, which could be utilized for future research endeavors., 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. Published by Elsevier B.V.)

In this study, the gelatine-polyphenol microgels with dual cryoprotective roles were constructed by regulating the ratio of gelatin to tea polyphenols (1:50-1:250). The physicochemical attributes, ice recrystallization inhibition ability of microgels, and their dosage effects (1 %, 2.5 % and 4 %, w/w) on surimi were investigated. The results indicated that increased gelatin caused the reduced size and enhanced viscosity of microgels. Except for high viscosity and antioxidant activity, the GP-5 group also showed great IRI ability with minimum size distribution (125-214 μm 2 ) of ice crystals. Furthermore, 2.5 G group and S group had a comparable TVB-N (3.81, 4.34 mg/100 g), TBARS (1.18, 1.32 mg/kg), sulfhydryl contents (29.52, 25.48 μmol/g) and Ca 2+ -ATPase activity (0.44, 0.36 μmolPi/gprot/h). Compared to uneven free water distribution of control group, S and 2.5 G group show more even immobilized-water distribution. Thereafter, the dual cryoprotective functions of microgels in surimi offer valuable insights for the development of effective antifreeze agents., 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. Published by Elsevier Ltd.)

A stable solid-electrolyte interphase (SEI) is crucial for cycling reversibility of Na-ion batteries by mitigating continuous side reactions. So far, the severe SEI dissolution leads to low Coulombic efficiency (CE) and short cycle life. Meanwhile, the quantified relationship between SEI components and their solubility remains unclear. In this work, we establish the direct correlation between SEI components and SEI solubility, and quantify that the solubility of organic-rich SEI is 3.26 times of inorganic-rich SEI. We further propose a feasible strategy to preform inorganic-rich insoluble SEI and demonstrate a practical hard carbon (HC)||NaMn 0.33 Fe 0.33 Ni 0.33 O 2 full cell in a commercial electrolyte of 1 M NaPF 6 in propylene carbonate (PC) with 80.0 % capacity retention for 900 cycles, and achieve a record-high average CE of 99.95 % for a practical Na-ion full cell. This study provides an effective strategy of preforming insoluble SEI to suppress its dissolution towards highly reversible Na-ion batteries., (© 2024 Wiley-VCH GmbH.)

Background: Epidemiologic studies have shown that patients with acute exacerbation of COPD (AECOPD) suffer from morbidity and mortality from venous thromboembolism (VTE) and poor diagnosis. Von Willebrand factor (vWF) and plasminogen activator inhibitor type-1 (PAI-1) are frequently investigated in COPD as crucial parameters for coagulation and fibrinolysis. Nevertheless, the role of vWF and PAI-1 in AECOPD needs further exploration., Objective: We sought to evaluate the hypercoagulability in AECOPD and investigate the association of plasma vWF and PAI-1 with occurrence and exacerbation risk of AECOPD patients., Methods: Fifty-seven AECOPD patients and 34 control subjects were enrolled in our study. The concentrations of plasma vWF and PAI-1 antigens were measured by ELISA kit. Independent samples t -test or Wilcoxon rank sum test was applied for group comparison. Spearman correlation analysis, subject work curve (ROC) analysis, and Logistic regression were used to evaluate the role of the plasma vWF and PAI-1 in AECOPD., Results: We observed increased vWF (770.15 ± 325.52 vs 327.62 ± 210.97 ng/mL, P < 0.001) and PAI-1 (0.47 vs 0.17 ng/mL, P < 0.001) levels in AECOPD patients compared with control subjects. Both vWF and PAI-1 are closely related to COPD (vWF: AUC = 0.8741, P < 0.001; PAI-1: AUC = 0.8222, P < 0.001). Moreover, elevated vWF could be an independent risk factor for COPD (OR = 1.01, 95% CI: 1.00-1.01, P = 0.01). We also discovered higher plasma levels of vWF and PAI-1 in the COPD "E" group in contract to "AB" group (vWF: 966.29 ± 251.18 vs 552.21 ± 253.28, P < 0.0001; PAI-1: 1.02 vs 0.38, P = 0.003). And vWF levels increased with increasing COPD exacerbation risk, moreover, plasma vWF positively related with patients' CAT scores and SGRQ scores. In addition, plasma vWF and PAI-1 correlated with each other in total participants and AECOPD subgroup analysis., Conclusion: This study demonstrated that AECOPD patients have a prothrombotic state, as demonstrated by vWF and PAI-1 levels in plasma compared with those in control subjects, and the prothrombotic state increases with increasing COPD exacerbation risk., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Jin et al.)

In this paper, composite adsorbent was prepared from biochar and Mg-MOF-74 by in-situ growth method to investigate regeneration mechanism. The effects of O 2 and temperature on regeneration characteristics were investigated by CO 2 adsorption properties and characterization techniques, and the optimal regeneration conditions were determined. Regeneration mechanism of adsorbent was revealed by adsorption kinetics and elemental valence analysis. The related wave function parameters were calculated based on DFT to reveal the repair mechanism of the failed oxidation sites from the microscopic level. The mechanism of CO 2 adsorption by the repaired oxidation sites was explored based on the regenerated adsorption configuration. It was found that the regeneration performance of the adsorbent exhibited a trend of increasing and then decreasing with the increase of O 2 concentration and temperature, and the optimal regeneration conditions were determined to be 5 % O 2 concentration and 200 °C. At optimal regeneration conditions, a synergistic interaction between O 2 and poly-metals was generated to enhance the adsorbent polarity. O 2 also reacted with the adsorbent in a redox reaction to produce new oxygen-containing functional groups and cause pore expansion, the mass transfer and diffusion was enhanced. The oxidation site adsorbed O 2 to undergo electron rearrangement and release the adsorbed CO 2 . Due to the nature of common orbital hybridization between metals, the metals underwent conjugation and synergistic effects with O 2 to form tetrahedral co-coordination structures with lower energies. The electron density and electric field effects of the system were enhanced. The former enhanced interaction with CO 2 to form carbonate. The latter increased the activity of the neighboring N atom, which in turn generated a stable ring structure with carbonate, and CO 2 adsorption was enhanced., 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 Elsevier B.V. All rights reserved.)

Accurate runoff forecasting is of great significance for water resource allocation flood control and disaster reduction. However, due to the inherent strong randomness of runoff sequences, this task faces significant challenges. To address this challenge, this study proposes a new SMGformer runoff forecast model. The model integrates Seasonal and Trend decomposition using Loess (STL), Informer's Encoder layer, Bidirectional Gated Recurrent Unit (BiGRU), and Multi-head self-attention (MHSA). Firstly, in response to the nonlinear and non-stationary characteristics of the runoff sequence, the STL decomposition is used to extract the runoff sequence's trend, period, and residual terms, and a multi-feature set based on 'sequence-sequence' is constructed as the input of the model, providing a foundation for subsequent models to capture the evolution of runoff. The key features of the input set are then captured using the Informer's Encoder layer. Next, the BiGRU layer is used to learn the temporal information of these features. To further optimize the output of the BiGRU layer, the MHSA mechanism is introduced to emphasize the impact of important information. Finally, accurate runoff forecasting is achieved by transforming the output of the MHSA layer through the Fully connected layer. To verify the effectiveness of the proposed model, monthly runoff data from two hydrological stations in China are selected, and eight models are constructed to compare the performance of the proposed model. The results show that compared with the Informer model, the 1th step MAE of the SMGformer model decreases by 42.2% and 36.6%, respectively; RMSE decreases by 37.9% and 43.6% respectively; NSE increases from 0.936 to 0.975 and from 0.487 to 0.837, respectively. In addition, the KGE of the SMGformer model at the 3th step are 0.960 and 0.805, both of which can maintain above 0.8. Therefore, the model can accurately capture key information in the monthly runoff sequence and extend the effective forecast period of the model., (© 2024. The Author(s).)

Asymmetric synthesis of derivatives of spiro[indoline-3,4-pyrrolo[3,4-b]pyridines] were first developed through the organocatalytic cascade of Knoevenagel/Michael/cyclization reactions using a quinidine-derived squaramide. Under the optimized conditions, the three-component reactions of isatins, cyanoacetates, and 3-aminomaleimides yield the desired heterocycle-fused spirooxindoles in good yields (78-91 %) with 53 %-99 % enantiomeric excess (ee). Notably, this reaction enables a broad substrate scope under mild conditions and provides a convenient method for the enantioselective construction of diverse spirooxindoles combined with dihydropyridine and maleimide skeletons, which has great potential for the construction of new bioactive chemical entities., (© 2024 Wiley-VCH GmbH.)

Background: The increasing incidence and high mortality rate of Candida glabrata infection in ICU patients is an important issue. Therefore, it is imperative to investigate the antifungal susceptibility profiles and epidemiological characteristics in local regions., Methods: Herein, antifungal susceptibility testing was conducted to determine the minimum inhibitory concentrations (MICs) of eight antifungal drugs. Multilocus sequence typing (MLST) was used to study the strain genotype, geographical distribution, and susceptibility to antifungal agents among C. glabrata isolates. The mechanism of echinocandin resistance was explored by sequencing the FKS1 and FKS2 genes (encoding 1,3-β-D-glucan synthases) of echinocandin-resistant C. glabrata strains. Moreover, we further investigated the clinical manifestations and the various risk factors of patients infected with C. glabrata in the ICU., Results: We selected 234 C . glabrata isolates from 234 patients in the ICU randomly for the follow-up study. Cross-resistance was found among the ICU C. glabrata isolates. Analysis using MLST showed that the genetic diversity among the C. glabrata isolates was low. Furthermore, sequence type showed no correlation with the antifungal resistance profiles, but was associated with geographical distribution. We also revealed novel mutations in FKS1 (S629P) and FKS2 (W1497stop) that mediated high-level echinocandin resistance (MIC >8 µg/mL). More than 14 days' stay in ICU (P=0.007), Acute Physiology and Chronic Health Evaluation II (APACHE-II) score (P=0.024), prior antifungal exposure (P=0.039) and lung disease (P=0.036) were significantly associated with antifungal resistant/non-wild-type C. glabrata infection., Conclusion: Our study shed light on the antifungal susceptibility, molecular epidemiology, and clinical risk factors of C. glabrata in the ICU of a Chinese Tertiary Hospital. Importantly, we revealed the molecular mechanism of echinocandin resistance. These results highlight the significance of continued surveillance in ICUs and provide data support for the treatment of C. glabrata in clinics., 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 © 2024 Huang, Lv, Song, Zhao, Liu, Wang and Xiang.)

Background: The mortality rate of COVID-19 patients with critical symptoms is reported to be 40.5%. Early identification of patients with poor progression in the critical cohort is essential to timely clinical intervention and reduction of mortality. Although older age, chronic diseases, have been recognized as risk factors for COVID-19 mortality, we still lack an accurate prediction method for every patient. This study aimed to delve into the cell-free DNA fragmentomics of critically ill patients, and develop new promising biomarkers for identifying the patients with high mortality risk., Methods: We utilized whole genome sequencing on the plasma cell-free DNA (cfDNA) from 33 COVID-19 patients with critical symptoms, whose outcomes were classified as survival (n = 16) and death (n = 17). Mitochondrial DNA (mtDNA) abundance and fragmentomic properties of cfDNA, including size profiles, ends motif and promoter coverages were interrogated and compared between survival and death groups., Results: Significantly decreased abundance (~ 76% reduction) and dramatically shorter fragment size of cell-free mtDNA were observed in deceased patients. Likewise, the deceased patients exhibited distinct end-motif patterns of cfDNA with an enhanced preference for "CC" started motifs, which are related to the activity of nuclease DNASE1L3. Several dysregulated genes involved in the COVID-19 progression-related pathways were further inferred from promoter coverages. These informative cfDNA features enabled a high PPV of 83.3% in predicting deceased patients in the critical cohort., Conclusion: The dysregulated biological processes observed in COVID-19 patients with fatal outcomes may contribute to abnormal release and modifications of plasma cfDNA. Our findings provided the feasibility of plasma cfDNA as a promising biomarker in the prognosis prediction in critically ill COVID-19 patients in clinical practice., (© 2024. The Author(s).)

Background: Pectus excavatum (PE) is the most common chest wall deformity, characterized by an insidious onset, gradual progression, and challenges in early diagnosis. It is often accompanied by emaciation and distinctive metabolic traits, which may provide valuable insights into its internal physiological and biochemical mechanisms. Our study attempted to screen out biomarkers by identifying the metabolic characteristics of PE, and the results provide a scientific basis for the early diagnosis of PE., Methods: Untargeted metabolomic and lipidomic analyses using liquid chromatography-mass spectrometry was conducted on serum samples obtained from 20 patients diagnosed with PE and 30 healthy case-controls. Principal component analysis and partial least squares discriminant analysis were employed to assess the quality of the metabolic profiling and delineate the metabolic differences between the PE and healthy cohorts. Receiver operating characteristic analysis was conducted to evaluate the predictive accuracy of the selected biomarkers. Pathway analysis of the dysregulated metabolites was utilized to elucidate the underlying pathological pathways., Results: Fourteen metabolites and seven lipids were found to be differentially expressed between patients with PE and healthy controls. Indole-3-acetaldehyde showed potential as a biomarker for PE, with an area under the curve value of 0.94, making it effective in distinguishing patients with PE. Pathway analysis revealed enrichment of several pathological pathways, such as valine, leucine, and isoleucine biosynthesis; sphingolipid metabolism; glycine, serine, and threonine metabolism; and glycerophospholipid metabolism., Conclusions: In our study, we employed a multiomics approach to comprehensively examine dysregulated serological molecules in PE patients, and the analyses revealed potential biomarkers for early diagnosis and provided information for pathological studies., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tp.amegroups.com/article/view/10.21037/tp-24-288/coif). The authors have no conflicts of interest to declare., (2024 AME Publishing Company. All rights reserved.)

Intraspinal cold abscesses caused by macrolide-resistant Mycoplasma pneumoniae in patients with X-linked agammaglobulinemia have not yet been described to our knowledge. Here we describe a patient with X-linked agammaglobulinemia who developed an intraspinal cold abscess caused by macrolide-resistant M. pneumoniae . Genetic analysis revealed a hemizygous c.1566 + 1G > C (IVS15 + 1G > C) mutation in BTK gene. The patient showed relatively naive T cells and a significant proliferative defect., Competing Interests: The authors have no funding or conflicts of interest to disclose., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Due to the advantages of high stiffness, high precision, high load capacity and large workspace, hybrid robots are applicable to drilling and milling of complicated components with large sizes, for instance car panels. However, the difficulty in establishing an exact dynamic model and external disturbances affect the high accuracy control directly, which will decrease the machining accuracy and thereby affect the machining quality and efficiency of the system. Sliding mode control is an effective approach for high-order nonlinear dynamic systems since that it is very insensitive to disturbances and parameter variations. However, chattering may exist in traditional sliding mode control with fixed parameters, which results from a constant approaching speed. Besides, the approaching speed will affect the chattering strength directly. To solve these problems, a modified sliding mode controller with self-adaptive parameters is proposed to enhance the trajectory-tracking performance of a 5-degree-of-freedom hybrid robot. Firstly, the kinematic model of the robot is established. Then adopting the principle of virtual work, a rigid dynamic model of the robot is built. Based on the built dynamic model, a modified sliding mode control method is developed, of which the approaching speed is dependent on the system state. Finally, the sliding mode controller with self-adaptive parameters is created for a hybrid robot. The proposed sliding mode controller can achieve a rapid approaching speed and suppress chattering simultaneously. Simulation results demonstrate that the proposed modified sliding mode controller can achieve a comparatively accurate and smooth trajectory, which owns good robustness to external disturbances., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The global health threat posed by carbapenem-resistant Klebsiella pneumoniae (CRKP) is exacerbated by the limited availability of effective treatments. Bacteriophages are promising alternatives to conventional antimicrobial agents. However, current phage databases are limited. Thus, identifying and characterizing new phages could provide biological options for the treatment of multi-drug resistant bacterial infections. Here, we report the characterization of a novel lytic phage, vB&#95;KpnP&#95;23, isolated from hospital sewage. This phage exhibited potent activity against carbapenemase-producing CRKP strains and was characterised by an icosahedral head, a retractable tail, and a genome comprising 40,987 base pairs, with a G + C content of 51 %. Capable of targeting and lysing nine different capsule types (K-types) of CRKP, including the clinically relevant ST11-K64, it demonstrated both high bacteriolytic efficiency and stability in various environmental contexts. Crucially, vB&#95;KpnP&#95;23 lacks virulence factors, antimicrobial resistance genes, or tRNA, aligning with the key criteria for therapeutic application. In vitro evaluation of phage-antibiotic combinations revealed a significant synergistic effect between vB&#95;KpnP&#95;23 and meropenem, levofloxacin, or amikacin. This synergy could lead to an 8-fold reduction in the minimum inhibitory concentration (MIC), suggesting that integrated treatments combining this phage with the aforementioned antibiotics may substantially enhance drug effectiveness. This approach not only extends the clinical utility of these antibiotics but also presents a strategic advance in combating antibiotic resistance. Specifically, it underscores the potential of phage-antibiotic combinations as a powerful tool in the treatment of infections caused by CRKP, offering a promising avenue to mitigate the public health challenges of antibiotic-resistant pathogens., 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 B.V. All rights reserved.)

Liquid-liquid phase separation (LLPS) regulates many biological processes including RNA metabolism, chromatin rearrangement, and signal transduction. Aberrant LLPS potentially leads to serious diseases. Therefore, the identification of the LLPS proteins is crucial. Traditionally, biochemistry-based methods for identifying LLPS proteins are costly, time-consuming, and laborious. In contrast, artificial intelligence-based approaches are fast and cost-effective and can be a better alternative to biochemistry-based methods. Previous research methods employed word2vec in conjunction with machine learning or deep learning algorithms. Although word2vec captures word semantics and relationships, it might not be effective in capturing features relevant to protein classification, like physicochemical properties, evolutionary relationships, or structural features. Additionally, other studies often focused on a limited set of features for model training, including planar π contact frequency, pi-pi, and β-pairing propensities. To overcome such shortcomings, this study first constructed a reliable dataset containing 1206 protein sequences, including 603 LLPS and 603 non-LLPS protein sequences. Then a computational model was proposed to efficiently identify the LLPS proteins by perceiving semantic information of protein sequences directly; using an ESM2-36 pre-trained model based on transformer architecture in conjunction with a convolutional neural network. The model could achieve an accuracy of 85.68% and 89.67%, respectively on training data and test data, surpassing the accuracy of previous studies. The performance demonstrates the potential of our computational methods as efficient alternatives for identifying LLPS proteins., 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 Elsevier B.V. All rights reserved.)