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BACKGROUND: Breast cancer is the most common malignant tumor in women. Early diagnosis of benign and malignant breast tumors is of great significance. OBJECTIVE: To retrospectively analyze the value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of Breast Imaging-Reporting and Data System (BI-RADS) 4a breast lesions less than 2 cm in diameter. METHODS: CEUS was performed for 143 breast masses less than 2 cm in diameter that were diagnosed as BI-RADS 4a by ultrasound and reclassified. Considering pathological diagnosis as the gold standard, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of reclassified lesions after CEUS for the diagnosis of benign and malignant masses were analyzed. RESULTS: BI-RADS 4a breast masses with a diameter less than 2 cm (n = 143) were confirmed by pathology; 103 and 40 were classified as benign and malignant, respectively. The sensitivity, specificity, PPV, and NPV of CEUS for the diagnosis were 90%, 86%, 72%, and 95%, respectively. The area under the receiver operating characteristic (ROC) curve of CEUS for the diagnosis of benign and malignant tumors after CEUS was 0.904. CONCLUSION: CEUS can help to improve the diagnostic accuracy of BI-RADS 4a masses with a diameter less than 2 cm.

With the rapid development of information technology, medical treatments are gradually transforming into digitalization and informatization. The diverse sources and scopes of the medical data are sensitive and significant. As important data assets, medical data are constantly being analyzed and mined. Because of the huge commercial value of medical data, the problems of privacy leakage exist in the centralized information system. They cannot adapt to complex medical environment. Most of the current authentication mechanisms use passwords for verification. It is not easy for users to remember all usernames and passwords. Based on these problems, we design single-sign-on (called SSO) authentication (Password Single-Sign-On Authentication scheme, PSSOA) and blockchain (Improved Cross-Blockchain based Privacy-Preserving Date Sharing scheme, ICPDS) fusion schemes. Users are verified by multiple identity servers in this scheme. Then identity servers issue authentication tokens with threshold manners. The protected identity servers regularly update their master secret shares to defend against malicious adversaries. &nbsp

Natural fish scales demonstrate outstanding mechanical efficiency owing to their elaborate architectures and thereby may serve as ideal prototypes for the architectural design of man-made materials. Here bioinspired magnesium composites with fish-scale-like orthogonal plywood and double-Bouligand architectures were developed by pressureless infiltration of a magnesium melt into the woven contextures of continuous titanium fibers. The composites exhibit enhanced strength and work-hardening ability compared to those estimated from a simple mixture of their constituents at ambient to elevated temperatures. In particular, the double-Bouligand architecture can effectively deflect cracking paths, alleviate strain localization, and adaptively reorient titanium fibers within the magnesium matrix during the deformation of the composite, representing a successful implementation of the property-optimizing mechanisms in fish scales. The strength of the composites, specifically the effect of their bioinspired architectures, was interpreted based on the adaptation of classical laminate theory. This study may offer a feasible approach for developing new bioinspired metal-matrix composites with improved performance and provide theoretical guidance for their architectural designs.

In this work, we find that room-temperature ferromagnetic order can be attained in a two-dimensional Mn–O metal–organic framework when it is hole doped by applying a few volts of gate voltage.

Model uncertainties and external disturbances present significant challenges for controlling fixed-wing unmanned aerial vehicles (UAVs). An adaptive smooth second-order time-varying nonsingular fast terminal sliding mode control method is proposed in this paper for attitude and airspeed control of fixed-wing UAVs with model uncertainties and external disturbances. This control method does not require information about the bounds of disturbances and can avoid overestimation of the control gains. A radial basis function neural network observer is designed to mitigate the influence caused by sudden disturbances. The convergence of the attitude and airspeed controllers is proven by using the Lyapunov stability theory. Simulation results demonstrate the effectiveness of the proposed method for controlling a six-degrees-of-freedom fixed-wing UAV.

CrCoNi-based medium- and high-entropy alloys display outstanding damage tolerance, especially at cryogenic temperatures. In this study, we examined the fracture toughness values of the equiatomic CrCoNi and CrMnFeCoNi alloys at 20 kelvin (K). We found exceptionally high crack-initiation fracture toughnesses of 262 and 459 megapascal-meters ½ (MPa·m ½ ) for CrMnFeCoNi and CrCoNi, respectively; CrCoNi displayed a crack-growth toughness exceeding 540 MPa·m ½ after 2.25 millimeters of stable cracking. Crack-tip deformation structures at 20 K are quite distinct from those at higher temperatures. They involve nucleation and restricted growth of stacking faults, fine nanotwins, and transformed epsilon martensite, with coherent interfaces that can promote both arrest and transmission of dislocations to generate strength and ductility. We believe that these alloys develop fracture resistance through a progressive synergy of deformation mechanisms, dislocation glide, stacking-fault formation, nanotwinning, and phase transformation, which act in concert to prolong strain hardening that simultaneously elevates strength and ductility, leading to exceptional toughness.

While the life expectancy of cancer survivors has substantially improved over time in the United States, the extent to which cancer patients are cured is not known. Population-level cure patterns are important indicators to quantify cancer survivorships. This population-based cohort study included 8978,721 cancer patients registered in the Surveillance, Epidemiology and End Results (SEER) databases between 1975 and 2018. The primary outcome was cure fractions. Five-year cure probability, time to cure and median survival time of uncured cases were also assessed. All four measures were calculated using flexible parametric models, according to 46 cancer sites, three summary stages, individual age and calendar year at diagnosis. In 2018, cure fractions ranged from 2.7% for distant liver cancer to 100.0% for localized/regional prostate cancer. Localized cancer had the highest cure fraction, followed by regional cancer and distant cancer. Except for localized breast cancer, older patients generally had lower cure fractions. There were 38 cancer site and stage combinations (31.2%) that achieved 95% of cure within 5 years. Median survival time of the uncured cases ranged from 0.3 years for distant liver cancer to 10.9 years for localized urinary bladder cancer. A total of 117 cancer site and stage combinations (93.6%) had increased cure fraction over time. A considerable proportion of cancer patients were cured at the population-level, and the cure patterns varied substantially across cancer site, stage and age at diagnosis. Increases in cure fractions over time likely reflected advances in cancer treatment and early detection.

Background: Uneven body-surface thermal distribution is a manifestation of hypoperfusion and can be quantified by infrared thermography. Our aim was to investigate whether body-surface thermal inhomogeneity could accurately evaluate the severity of patients at risk of hypoperfusion. Methods: This was a prospective cohort study in which infrared thermography images were taken from unilateral legs of critically ill patients at high risk of hypoperfusion in a cardiac surgical intensive care unit. For each patient, five body-surface thermal inhomogeneity parameters, including standard deviation (SD), kurtosis, skewness, entropy, and low-temperature area rate (LTAR), were calculated. Demographic, clinical, and thermal characteristics of deceased and living patients were compared. The risk of mortality and capillary refill time (CRT) were chosen as the primary outcome and benchmarking parameter for hypoperfusion, respectively. The area under the receiver operating characteristic curve (AUROC) was used to evaluate predictive accuracy. Results: Three hundred seventy-three patients were included, and 55 (14.7%) died during hospital stay. Of inhomogeneity parameters, SD (0.738) and LTAR (0.768) had similar AUROC to CRT (0.757) for assessing mortality risk. Besides, there was a tendency for LTAR (1%-3%-7%) and SD (0.81°C-0.88°C-0.94°C) to increase in normotensive, hypotensive, and shock patients. These thermal parameters are associated with CRT, lactate, and blood pressure. The AUROC of a combined prediction incorporating three thermal inhomogeneity parameters (SD, kurtosis, and entropy) was considerably higher at 0.866. Conclusions: Body-surface thermal inhomogeneity provided a noninvasive and accurate assessment of the severity of critically ill patients at high risk of hypoperfusion.

Depressed individuals experience deficits in emotional reactivity. One well-established theory is the Emotion Context Insensitivity (ECI) theory. To better understand impairments in emotional reactivity, we investigated whether the ECI theory is applicable to anticipatory, consummatory, and remembered affect, in both clinical and subclinical depression.Participants were divided into four groups: Major Depressive Disorder Group (MDD, N = 60), Control Group for MDD (ControlThe MDD group was more insensitive to both monetary reward and loss across most types of affect than was the control group. Compared with the controls, the SD group exhibited lower reactivity in anticipatory positive affect but enhanced reactivity in consummatory positive, anticipatory, and remembered negative affect.Emotional affect was evaluated by subjective ratings, which may lack objectivity. Additionally, laboratory settings and monetary rewards used in this study may cause the results less generalized to daily life and to other types of rewards.The pattern of emotional reactivity in the MDD group was partly consistent with the ECI theory, whereas the SD group showed greater arousal and instability of emotional reactions. These different patterns could facilitate the understanding of emotional reactivity and develop further treatments across the course of depression.

Background: Schizophrenia is a chronic and severe mental disorder. People with schizophrenia have transferred from hospital-based care to community-based care with the support of mental health legal policies. Challenges faced in the community should be emphasized. Limited qualitative studies have explored the challenges of living with schizophrenia. Aims: To explore the challenges of people living with schizophrenia in the community. Methods: A narrative method was used, including semi-structured, face-to-face interviews. Thematic analysis approach was used to analyze data. Results: Ten clients and their family members participated in the study. Analysis revealed three main themes related to their challenges in the community: deficits in self-management of illness; insufficient community mental health care; and the influence of policy. These challenges prevent those with schizophrenia from effectively managing their illness, returning to a productive role in society, and improving their quality of life. Conclusions: There are challenges in mental health rehabilitation and social reintegration of individuals with schizophrenia. There is a need for continuous community mental rehabilitation services, appropriate policy support, and the need to educate the public to reduce social bias and discrimination which allows individuals with schizophrenia to assume a productive role in the community.

Intestinal metabolites are attracting increasing interest, especially more and more studies have found they are closely related to diseases. Microbial fermentation of indigestible dietary fibers in the gut produces short chain fatty acids (SCFAs) as the main product. SCFAs can exert influences on the integrity of the intestinal epithelial and mucosal barrier, immune reactions, and the diversity of microbiota in humans. Thus, alteration in SCFAs may affect inflammatory bowel disease (IBD). In IBD, SCFAs are involved in the main pathogenic process and play an important role in the development of intestinal inflammation. Although many studies have proved that pretreatment with SCFAs can effectively ameliorate inflammation in the gut, the mechanisms are not fully understood. In this review, we describe the relationship between SCFAs and IBD from the aspects of defense barrier, immune effects, and microbial alterations. We also summarize the effects of SCFAs on comorbidities in IBD via the gut-brain, gut-liver, and gut-lung axis, and we give an overview of the prospects of their clinical application. A better understanding of the relevance of SCFAs in IBD may reveal novel targets for future study.

Qin-Yu Cai,1,2 Yin Yang,3 Yong-Heng Wang,1,2 Han-Lin Cui,1,2 Xue-Peng Wu,2 Kai-Mai Liao,1 Xin Luo,2,4 Tai-Hang Liu1,2 1Department of Bioinformatics, The School of Basic Medicine, Chongqing Medical University, Chongqing, People’s Republic of China; 2The Joint International Research Laboratory of Reproduction and Development, Ministry of Education, Chongqing Medical University, Chongqing, People’s Republic of China; 3Department of Infection Controlling Section, Women and Children’s Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 4Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Tai-Hang Liu; Xin Luo, Chongqing Medical University, Box 197, No. 1 Yixueyuan Road, Chongqing, 400016, People’s Republic of China, Tel +86 023 68485008, Fax +86 023 68485000, Email liuth@cqmu.edu.cn; lxcqmu@outlook.comObject: COVID-19 pandemic and worldwide quarantine seriously affected the physical and mental health of the general public. Our study aimed to investigate the effects of the COVID-19 quarantine on pregnancy outcomes among pregnant women with hypertensive disorders of pregnancy (HDP).Methods: This single-center retrospective cohort study collected complete clinical data of HDP patients with a history of home quarantine in The First Affiliated Hospital of Chongqing Medical University (Chongqing, China) in 2020 as well as the patients without home quarantine in 2018 and 2019. Then, the maternal and neonatal outcomes of two subtypes of HDP, gestational hypertension (GH) and preeclampsia/eclampsia (PE/E), were analyzed over the three years.Results: The incidence of HDP increased from 0.84% in 2018 and 0.51% in 2019 to 2.30% in 2020. The data suggested that home quarantine was associated with higher gestational weight gain, obesity rates, blood pressure, and uric acid among the patients with HDP in 2020. Furthermore, HDP patients with a history of home quarantine may have worse neonatal outcomes, including lower newborn weight, shorter body length, lower Apgar score, and higher risk of fetal growth restriction.Conclusion: Our results suggested that COVID-19 quarantine may be a risk factor for poor pregnancy outcomes in HDP patients. Lifestyle guidance and antenatal care may be necessary for HDP patients with home quarantine in an epidemic outbreak.Keywords: COVID-19, home quarantine, pregnancy outcomes, HDP, obesity

Objectives. Acupoint catgut embedding therapy has shown effectiveness in treating functional constipation; however, relevant, high-quality clinical evidence is scarce. This study aimed to systematically assess the effectiveness and safety of acupoint catgut embedding in treating poststroke constipation. Methods. Correlative randomized controlled trials were identified through a comprehensive literature search of PubMed, Cochrane Library/Cochrane Central Register of Controlled Trials, Web of Science, Embase, China National Knowledge Internet, Chinese Biomedical Literature Database, Wanfang, and VIP databases from inception until February 2022. Meta-analysis was performed using RevMan 5.3 software. Results. Fifteen trials involving 1084 patients were identified. The meta-analysis revealed that the acupoint catgut embedding group was significantly superior to the non-catgut embedding group with regard to the efficacy rate (RR = 1.27, 95% CI (1.19, 1.37), P < 0.05 ), the first defecation time (MD = −3.08, 95% CI (−4.53, −1.63), P < 0.05 ), the defecation sensation score (MD = −0.44, 95% CI (−0.61, −0.26), P < 0.05 ), the degree of difficulty in defecation (MD = −0.73, 95% CI (−1.10, −0.37), P < 0.05 ), the PAC-QOL scale score (MD = −10.06, 95% CI (−13.47, −6.64), P < 0.05 ), and the symptom integral (MD = −3.15, 95% CI (−3.60, −2.71), P < 0.05 ). However, there was no significant difference in the stool property score (MD = 0.06, 95% CI (−0.39, 0.50), P > 0.05 ) as well as the incidence of adverse reactions (RD = 0.01, 95% CI (−0.01, 0.03), P > 0.05 ) between the two groups. Conclusions. The results showed that acupoint catgut embedding is probably an effective and safe acupuncture treatment strategy for poststroke constipation. Nevertheless, more rigorously designed, standardized, large-sample, and multicenter randomized controlled designs are warranted to further verify the findings of this study.

Photocatalytic CO2 reduction to valuable hydrocarbon solar fuel is of great significance but still challenging. Strong CO2 enrichment ability and easily adjustable structures make metal-organic frameworks (MOFs) potential photocatalysts for CO2 conversion. Even though pure MOFs have the potential for photoreduction of CO2, the efficiency is still quite low due to rapid photogenerated electron–hole recombination and other drawbacks. In this work, graphene quantum dots (GQDs) were in situ encapsulated into highly stable MOFs via a solvothermal method for this challenging task. The GQDs@PCN-222 with encapsulated GQDs showed similar Powder X-ray Diffraction (PXRD) patterns to PCN-222, indicating the retained structure. The porous structure was also retained with a Brunauer–Emmett–Teller (BET) surface area of 2066 m2/g. After incorporation of GQDs, the shape of GQDs@PCN-222 particles remained, as revealed by the scanning electron microscope (SEM). As most of the GQDs were covered by thick PCN-222, it was hard to observe those GQDs using a transmission electron microscope (TEM) and a high-resolution transmission electron microscope (HRTEM) directly, the treatment of digested GQDs@PCN-222 particles by immersion in a 1 mM aqueous KOH solution can make the incorporated GQDs visible in TEM and HRTEM. The linker, deep purple porphyrins, make MOFs a highly visible light harvester up to 800 nm. The introduction of GQDs inside PCN-222 can effectively promote the spatial separation of the photogenerated electron–hole pairs during the photocatalytic process, which was proved by the transient photocurrent plot and photoluminescence emission spectra. Compared with pure PCN-222, the obtained GQDs@PCN-222 displayed dramatically enhanced CO production derived from CO2 photoreduction with 147.8 μmol/g/h in a 10 h period under visible light irradiation with triethanolamine (TEOA) as a sacrificial agent. This study demonstrated that the combination of GQDs and high light absorption MOFs provides a new platform for photocatalytic CO2 reduction.

Background: Many clinical studies have shown that patients with major depressive disorder (MDD) or obsessive-compulsive disorder (OCD) display evident cognitive deficits. However, little is known about the impact of these disorders on cognitive symptoms. Methods: This cross-sectional study was conducted with a convenience sampling method to distribute QR codes as an outpatient service. The Patient Health Questionnaire-9 (PHQ-9) assessed for depressive symptoms, and those with a total score ≥ 5 were selected for the analysis. A total of 218 outpatients with MDD were included. The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used for OCS. MDD patients with a Y-BOCS score ≥ 6 were classified as MDD with comorbid OCS (MDDOC). The Perceived Deficits Questionnaire-Depression (PDQ-D-5) was used to evaluate subjective cognitive symptoms. A multivariate analysis of covariance and regression models was performed to estimate the effects of OCS on cognitive symptoms. Results: There was no significant difference in cognitive symptoms between MDD alone and MDDOC patients (p＞0.05). In the MDDOC subgroup, both the Y-BOCS score and the subdomain (obsession/compulsion) had significant correlations with the PDQ-5 score (r=0.510, 0.504, 0.428, all p＜0.01, respectively). Further hierarchical regression analyses showed that OCS or the OCS subdomain (compulsion/obsession) contributed to cognitive symptoms (all p﹤0.05), even when controlling for depression severity (p＜0.001; p=0.032; p=0.012, respectively). Moreover,mediation anallysis indicated the ralation between PHQ-9 and subjective cognitive sympton was mediated by OCS. Conclusions: Our findings suggest there is no significant difference in cognitive symptoms between the MDD alone and the MDDOC groups. However, OCS or OCS subdomain may contribute to subjective cognitive symptoms in MDDOC patients. Notably, when controlling for the severity of depression, comorbid OCS aggravated cognition impairment in the MDDOC group.

Cr(VI) is one of the most toxic heavy metals, posing multiple threats to humans and ecosystems. Photoreduction of toxic Cr(VI) to para-toxic Cr(III) is one of the most effective ways to remove heavy metal chromium but is still challenging. Herein, Ti3C2/UiO-66-NH2 composites with different ratio of Ti3C2 were synthesized via an in situ solvothermal process and used for the enhanced photocatalytic removal of Cr(VI) for the first time. The UiO-66-NH2 nanoparticles were dispersed on the surface and slits of accordion-like Ti3C2 homogeneously. A strong interfacial interaction between Ti3C2 and UiO-66-NH2 was formed, which was indicated by the XPS. The Fermi level of the MXene cocatalyst is lower than UiO-66-NH2; thus, Ti3C2 can serve as the electron sink and accumulate photogenerated electrons from UiO-66-NH2 on its surface. A depletion layer was also formed due to the different Fermi levels of UiO-66-NH2 and Ti3C2, which prevents electrons from flowing back to UiO-66-NH. The strong interfacial interaction and formed depletion layer are beneficial for the following charge transfer from UiO-66-NH2 to Ti3C2 after light irradiation and for suppressing the photogenerated charge recombination. With suitable band positions and enhanced charge separation ability, Ti3C2/UiO-66-NH2 composites exhibited better photoreduction efficiency of Cr2O72− than pure Ti3C2 and UiO-66-NH2, with optimized samples reaching 100% in 40 min. The photoreduction kinetics of Cr2O72− by 2-T/U was also studied, with a photoreduction rate of 0.0871 min−1, which is about 2.6 times higher than that of the pure UiO-66-NH. This research provides a new type of efficient and environmentally friendly photocatalysts for the photoreduction of Cr2O72−.

Background Anti-programmed death 1/anti-programmed death ligand 1 (PD-1/PD-L1) combined with radiotherapy (RT) has a synergistic effect on systemic tumor control. A dissociated response (DR), characterized by some lesions shrinking and others growing, has been recognized with immune checkpoint inhibitor (ICI) monotherapy or combination therapy. The objective of this study was to assess the frequency and clinical benefit of DR in patients with advanced metastatic solid tumors receiving PD-1 inhibitors in combination with RT.Methods We conducted a single-center retrospective analysis of patients with advanced metastatic solid tumors receiving PD-1 inhibitor combined with RT at the Department of Radiotherapy & Oncology, The Second People's Hospital Affiliated with Soochow University. Treatment response was assessed for each measurable lesion according to the Response Evaluation Criteria in Solid Tumours (RECIST) v 1.1 guidelines. Patterns of response are divided into four groups: 1. DR; 2. uniform response; 3. uniform progression; 4. only stable lesions. The overall survival (OS) of different groups was compared using Kaplan-Meier methods and log-rank tests.Results Between March 2019 to July 2022, 93 patients were included. The median follow-up was 10.5 months (95% CI 8.8–12.1). The most common tumor types were lung cancer (19.8%), colorectal adenocarcinoma (17.2%), and esophageal cancer (10.8%). DR was observed in 22 (23.7%) patients. Patients with DR had significantly longer OS than patients who showed a uniform progression (13.5 months vs. 5.9 months; P = 0.012), of those who continued PD-1inhibitors in combination with RT or PD-1 inhibitors monotherapy (n = 12) experienced significantly prolonged OS (15.7 (95CI 3.5–27.9) vs. 8.2 (95%CI 5.6–10.8) months, P = 0.035) compared with patients who did not continue (n = 10).Conclusions DR is not uncommon (23.7%) in patients with advanced metastatic solid tumors treated with PD-1 inhibitors combined with RT and shows a relatively favorable prognosis. Some patients with DR may benefit from continued PD-1 inhibitor therapy in combination with RT or PD-1 inhibitor monotherapy and may have longer OS.

Bioinspired nacre-like structures are effective in toughening materials, yet are difficult to construct in magnesium-ceramic systems. Here, a set of magnesium-MAX phase composites with nacre-like lamellar and brick-and-mortar architectures are fabricated by pressureless infiltration of the magnesium melt into ice-templated Ti3AlC2 ceramic scaffolds. The structure and mechanical properties of the composites are elucidated with a special focus on the effects of the types of architectures (lamellar or brick-and-mortar) and matrices (pure magnesium or AZ91D alloy) on the toughening mechanisms. The nacre-like architectures are found to play a role in blunting the cracks via plastic deformation and microcracking, and shielding the cracks from applied stress by promoting crack deflection and uncracked-ligament bridging mechanisms. These composites achieve a good combination of specific strength and fracture toughness, which are superior to many other reported magnesium-ceramic and nacre-like metal-ceramic composite materials.

The extraordinary work hardening ability and fracture toughness of the face-centered cubic (fcc) high-entropy alloys render them ideal candidates for many structural applications. Here, the deformation and failure mechanisms of an equiatomic CrCoNi medium-entropyalloy (MEA) were investigated by powerful laser-driven shock experiments. Multiscale characterization demonstrates that profuse planar defects including stacking faults, nanotwins, and hexagonal nanolamella were generated during shock compression, forming a three-dimensional network. During shock release, the MEA fractured by strong tensile deformation and numerous voids was observed in the vicinity of the fracture plane. High defect populations, nanorecrystallization, and amorphization were found adjacent to these areas of localized deformation. Molecular dynamics simulations corroborate the experimental results and suggest that deformation-induced defects formed before void nucleation govern the geometry of void growth and delay their coalescence. Our results indicate that the CrCoNi-based alloys are impact resistant, damage tolerant, and potentially suitable in applications under extreme conditions.

Camellia crassicolumna (Theaceae) was described as an endemic species to southeastern Yunnan, China. In the most recent monograph of Camellia, seven names, including C. crispula, C. atrothea, C. makuanica, C. haaniensis, C. purpurea, C. rotundata, and C. crassicolumna var. shangbaensis, were listed as heterotypic synonyms of C. crassicolumna. Our examination of related specimens reveals that the statement ‘ovariis pilosis’ in the protologue of C. crassicolumna is incongruent with its type specimens whose ovaries are glabrous. The morphological traits of C. crassicolumna resemble C. kwangsiensis var. kwangnanica. Therefore, C. crassicolumna is reduced into C. kwangsiensis var. kwangnanica. The species status of C. crispula is reinstated with C. atrothea, C. makuanica, C. haaniensis, C. purpurea, C. rotundata, and C. crassicolumna var. shangbaensis treated as its heterotypic synonyms. A new combination, C. crispula var. multiplex, is proposed, and the lectotype of C. atrothea is designated here.

Purpose To compare the incidence profile of four major cancers in Australia by place of birth. Methods In this retrospective population-based cohort study, the analysis included 548,851 residents diagnosed with primary colorectum, lung, female breast, or prostate cancer during 2005–2014. Incidence rate ratio (IRR) and 95% confidence intervals (CI) were calculated for migrant groups relative to Australian-born. Results Compared with Australian-born residents, most migrant groups had significantly lower incidence rates for cancers of the colorectum, breast and prostate. The lowest rates of colorectal cancer were among males born in Central America (IRR = 0.46, 95% CI 0.29–0.74) and females born in Central Asia (IRR = 0.38, 95% CI 0.23–0.64). Males born in North-East Asia had the lowest rates of prostate cancer (IRR = 0.40, 95% CI 0.38–0.43) and females born in Central Asia had the lowest rates of breast cancer (IRR = 0.55, 95% CI 0.43–0.70). For lung cancer, several migrant groups had higher rates than Australian-born residents, with the highest rates among those from Melanesia (males IRR = 1.39, 95% CI 1.10–1.76; females IRR = 1.40, 95% CI 1.10–1.78). Conclusions This study describes cancer patterns among Australian migrants, which are potentially helpful in understanding the etiology of these cancers and guiding the implementation of culturally sensitive and safe prevention measures. The lower incidence rates observed for most migrant groups may be maintained with continued emphasis on supporting communities to minimize modifiable risk factors such as smoking and alcohol consumption and participation in organized cancer screening programmes. Additionally, culturally sensitive tobacco control measures should be targeted to migrant communities with high lung cancer incidence rates.

RNA viruses are diverse components of global ecosystems. The metagenomic identification of RNA viruses is currently limited to those with sequence similarity to known viruses, such that highly divergent viruses that comprise the "dark matter" of the virosphere remain challenging to detect. We developed a deep learning algorithm – LucaProt – to search for highly divergent RNA-dependent RNA polymerase (RdRP) sequences in 10,487 global meta-transcriptomes. LucaProt integrates both sequence and structural information to accurately and efficiently detect RdRP sequences. With this approach we identified 180,571 RNA viral species and 180 superclades (viral phyla/classes). This is the broadest diversity of RNA viruses described to date, including many viruses undetectable using BLAST or HMM approaches. The newly identified RNA viruses were present in diverse ecological niches, including the air, hot springs and hydrothermal vents, and both virus diversity and abundance varied substantially among ecological types. We also identified the longest RNA virus genome (nido-like) observed so far, at 47,250 nucleotides, and expanded the diversity of RNA bacteriophage to more than ten phyla/classes. This study marks the beginning of a new era of virus discovery, with the potential to redefine our understanding of the global virosphere and reshape our understanding of virus evolutionary history.

Objective To investigate the roles and clinical significance of tumor progression locus 2 (TPL2) and peptidyl-prolyl cis–trans isomerase 1 (Pin1) in the occurrence and development of breast invasive ductal carcinoma (IDC).Methods Immunohistochemistry was performed to detect the expression status of TPL2 and Pin1 in paraffin-embedded human breast tissues, which included normal breast tissues (Normal), fibrocystic changes (FCC), ductal carcinoma in situ (DCIS) and IDC. The roles of TPL2 and Pin1 in the development of IDC, as well as the correlation between their expression status and clinicopathological parameters, were analyzed.Results Compared with Normal and FCC groups, the overexpression rates of TPL2 and Pin1 were significantly increased in DCIS and IDC groups. The expression of TPL2 and Pin1 was positively correlated in DCIS and IDC groups. In the IDC group, Ki67 expression in the TPL2 overexpression group was significantly lower than that in the TPL2 low expression group. The TPL2 overexpression rate was significantly higher in IDC with histological grades 1–2 than that in IDC with histological grade 3. The TPL2 overexpression rate in IDC with TNM stage I was significantly higher than that in IDC with TNM stages II–III. The overexpression of Pin1 was positively correlated with the positive expression of estrogen receptor (ER) in the IDC group.Conclusions TPL2 and Pin1 may synergistically promote the occurrence and development of IDC, but TPL2 overexpression may be an early molecular event in IDC development. The prognosis of IDC patients with TPL2 overexpression may be better, suggesting that TPL2 overexpression may be a predictor of good prognosis in IDC. The detection of TPL2 expression in IDC tissues may be a key approach to evaluate the prognosis of IDC patients in the future.

BACKGROUND Osteoarthritis (OA) is the most common cause of adult activity limitation and a major cause of deformity in aging people, therefore gradually becomes a global public health issue. OBJECTIVE We here provide a comprehensive evaluation of the trends and cross-country inequalities of global OA burden over the last 30 years. METHODS The estimates and 95% uncertainty interval (UI) for incidence, prevalence, and disability-adjusted life-years (DALYs) of OA were extracted from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 as measures of OA burden. We described OA epidemiology at global, regional, and national levels, analyzed 1990-2019 trends in OA burden from overall, local, and multi-dimension scopes, decomposed OA DALYs, and quantified cross-country inequalities in OA DALYs. RESULTS GBD 2019 estimated 527,811,871 (95% UI: 478,667,549 to 584,793,491) prevalent cases, 41,467,542 (95% UI: 36,875,471 to 46,438,409) incident cases and 18,948,965 (95% UI:9,571,298 to 37,659,660) DALYs of OA occurred worldwide in 2019, with the highest cases in East Asia and highest age-standardized rate (ASR) in high-income North America. The global burden of OA increased overall from 1990 to 2019 with the fastest growth observed in the first decade of the 21st century, although there were variations in incidence, prevalence and DALYs of OA across countries. Decomposition analysis revealed that OA knee (62.78%), women (60.47%), and middle sociodemographic index (SDI) quintile region (32.35%) were responsible for the most significant DALYs, whose changes were primarily driven by population growth and aging. A significant increase in SDI-related inequalities was detected, and the gap in DALYs between the highest SDI countries and the lowest SDI countries increased from 179.5 (95% CI: 149.3 to 209.8) per 100,000 in 1990 to 341.9 (95% CI: 309.5 to 374.4) per 100,000 in 2019. CONCLUSIONS From 1990 to 2019, there was a significant increase in OA burden globally (particularly in OA knee burden), which was primarily driven by population growth and aging. Countries with high SDI shouldered disproportionately high OA burden, and the magnitude of the SDI-related inequalities across countries increased over time.

BackgroundWhile many high-income countries including Australia have successfully implemented a range of tobacco control policies, smoking remains the leading preventable cause of cancer death in Australia. We have projected Australian mortality rates for cancer types, which have been shown to have an established relationship with cigarette smoking and estimated numbers of cancer deaths attributable to smoking to 2044.MethodsCancer types were grouped according to the proportion of cases currently caused by smoking: 8%–30% and >30%. For each group, an age–period– cohort model or generalised linear model with cigarette smoking exposure as a covariate was selected based on the model fit statistics and validation using observed data. The smoking-attributable fraction (SAF) was calculated for each smoking-related cancer using Australian smoking prevalence data and published relative risks.ResultsDespite the decreasing mortality rates projected for the period 2015–2019 to 2040–2044 for both men and women, the overall number of smoking-related cancer deaths is estimated to increase by 28.7% for men and 35.8% for women: from 138 707 (77 839 men and 60 868 women) in 2015–2019 to 182 819 (100 153 men and 82 666 women) in 2040–2044. Over the period 2020–2044, there will be 254 583 cancer deaths (173 943 men and 80 640 women) directly attributable to smoking, with lung, larynx, oesophagus and oral (comprising lip, oral cavity and pharynx) cancers having the largest SAFs.InterpretationCigarette smoking will cause over 250 000 cancer deaths in Australia from 2020 to 2044. Continued efforts in tobacco control remain a public health priority, even in countries where smoking prevalence has substantially declined.