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Background: Hepatitis B virus (HBV) infection is a common cause of liver-related morbidity and mortality. Evidence suggests that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) decrease liver fibrosis, an intermediate step between liver injury and hepatocellular carcinoma (HCC). Our aim was to investigate the association between the use of ACEIs and ARBs on incident HCC and liver-related mortality among patients with HBV infection. Methods: We conducted a population-based study on a new-user cohort of patients seen at 24 hospitals across China. We included adult patients with HBV infection who started ACEIs or ARBs (ACEIs/ARBs), or calcium channel blockers or thiazide diuretics (CCBs/THZs) from January 2012 to December 2022. The primary outcome was incident HCC; secondary outcomes were liver-related mortality and new-onset cirrhosis. We used propensity score matching and Cox proportional hazards regression to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) of study outcomes. Results: Among 32 692 eligible patients (median age 58 [interquartile range (IQR) 48-68] yr, and 18 804 male [57.5%]), we matched 9946 pairs of patients starting ACEIs/ARBs or CCBs/THZs. During a mean follow-up of 2.3 years, the incidence rate of HCC per 1000 person-years was 4.11 and 5.94 among patients who started ACEIs/ARBs and CCBs/THZs, respectively, in the matched cohort. Use of ACEIs/ARBs was associated with lower risks of incident HCC (HR 0.66, 95% CI 0.50-0.86), liver-related mortality (HR 0.77, 95% CI 0.64-0.93), and new-onset cirrhosis (HR 0.81, 95% CI 0.70-0.94). Interpretation: In this cohort of patients with HBV infection, new users of ACEIs/ ARBs had a lower risk of incident HCC, liver-related mortality, and new-onset cirrhosis than new users of CCBs/THZs., Chronic hepatitis B virus (HBV) infection is a global public health concern, affecting about 296 million people. (1,2) Despite recent advances in treatment--notably, tenofovir disoproxil fumarate and entecavir--HBV remains a [...]

This study explores energy-efficient KH₂PO₄ (KDP) preparation, examining its implications for sustainability, and offers insights on enhancement and benefits. For the first time, electrodialysis metathesis (EDM) process was considered as a potential technique for efficient conversion and cleaner production of KDP in this study. The effects of key operational parameters including applied voltage, initial feed concentration, concentration ratio, and volume ratio on the conversion performance of EDM were systematically investigated. The promising conditions were established with an applied voltage of 2.3 V per repeating unit, a concentration ratio of 0.5 M NH4Cl to 0.6 M KCl, and a critical 1.43-fold volume ratio, yielding a high-purity KDP solution of 96.65 % at 78.52 g/L with an energy consumption rate of 0.52 KWh/kg. An economic evaluation indicates a 15.4 % cost reduction compared to the market price, presenting the EDM process as a viable and leading technology for the production of high-purity KDP.

External field driven fluid manipulation, in particular electric field, offers the advantages of real-time control and exceptional flexibility, rendering it highly promising for applications in microfluidic devices, liquid separation and energy catalysis. However, it is still challenging for controlled liquid transport and fine control of droplet splitting. Herein, we demonstrate a strategy to achieve direction-controlled liquid transport and fine droplet splitting on an anisotropic groove-microstructured electrode surface viaan electrically switched asymmetric interface. The balance of asymmetric capillary force generated by microstructures and electro-capillary force is critical in determining directional liquid transport and fine droplet splitting. Asymmetric bubbles generated by liquid electrolysis form an asymmetric liquid–gas–solid interface and result in gradient liquid wetting behavior on the two neighboring electrode surfaces. The electric field further enhances the asymmetric wetting of a liquid droplet on the electrode surface, exhibiting electric field direction-dependent motion. Moreover, the groove-microstructured electrode surface can strengthen the liquid droplet anisotropic wetting and correspondingly refine the volume range of the splitting sub-droplet. Even unidirectional/bidirectional liquid droplet transport can be controlled in collaboration with the asymmetric groove-microstructure and electric field. Thus, this work provides a new route for liquid transport and droplet splitting, showing great potential in controllable separation, microreaction and microfluidic devices.

Zinc oxide (ZnO) varistor exhibiting excellent nonlinear volt-ampere characteristics, has now been widely applied to overvoltage protection in electrical equipment. However, the greater severity of AC ageing is a realistic issue facing the high-voltage gradient varistors used in ultra-high-voltage surge arresters. To some degree, silver (Ag) doping is effective in improving the performance of varistors. In spite of this, it remains necessary to explore its influence on the ageing process of varistors. In this study, an investigation is conducted into the microstructure, macroscopic electrical properties, and barrier potential of varistors with different Ag doping concentrations, so as to determine the optimal level of doping concentration required for improving the long-term stability of varistors. Furthermore, the mechanism of Ag+improving ageing resistance is accounted for in theory. The research results indicate the best anti-ageing performance is achieved at the doping concentration of 50 ppm.

Antioxidant play a crucial role in the prevention and treatment of diseases associated with oxidative stress. Curcumin (CUR), as a natural antioxidant, exhibits numerous therapeutic properties, including antioxidant, anti-inflammatory, antibacterial, and antitumor activities. However, its limited bioavailability and poor water solubility hinder its application as an effective antioxidant. In this study, a series of mesoporous silica nanomaterials with distinct morphologies, i.e., mesoporous silica nanoparticles (MSN) and mesoporous silica nanorods (MSR) were synthesized by a template–sediment–etching method. CUR was selected as a model drug and encapsulated into these nanomaterials to improve its bioavailability in vivo. The morphology and size distribution of MSN and MSR were determined through transmission electron microscopy (TEM) imaging and Zetasizer analysis. Fourier transform infrared spectroscopy (FTIR) spectra confirmed the successful encapsulation of CUR within these nanomaterials. Furthermore, these CUR-loaded silica nanomaterials, denoted as CUR@MSN and CUR@MSR, exhibited excellent DPPH and ABTS free radical scavenging activity in vitro. Furthermore, CUR@MSN and CUR@MSR also exhibited obvious in vivoantioxidant activity. This study opens up new avenues for the development of enhanced antioxidants through the utilization of mesoporous silica nanomaterials.

Silyl-phenanthroline (NN′Si) ligand ancillary iridium-catalyzed C(sp3)–H borylation is investigated theoretically. Density functional theory calculations clearly disclose that the (NN′Si)IrV(H)(Bpin)3(NN′Si = 6-[(di-tert-butylsilyl)methyl]-1,10-phenanthroline) complex is a resting state, and the (NN′Si)IrIII(Bpin)2complex serves as an active species in the catalytic cycle. The remarkably high activity of this type of a catalyst arises from the rapid reductive elimination of HBpin from (NN′Si)IrV(H)(Bpin)3to generate the active species (NN′Si)IrIII(Bpin)2. The silyl group plays a crucial role in accelerating the crucial hydride-migration elementary step, which allows the isomerization of the (NN′Si)IrV(R)(H)(Bpin)2intermediate to achieve the C(sp3)–B reductive elimination and afford the borylated product. Although C(sp3)–H borylation with HBpin is thermodynamically unfavorable, the Ir-dihydride intermediate (NN′Si)IrV(H)2(Bpin)2generated after product formation is slightly more stable than resting-state (NN′Si)IrV(H)(Bpin)3in this catalytic cycle, which is an important driving force for the HBpin reaction. Such success was not attained by many other traditional bidentate ligands. The unique regioselectivity of n-butyl ethyl ether and 2-methylheptane, induced by the NN′Si-pincer ligand, is well reproduced and the underlying reason for the selectivity is clearly elucidated.

In large-scale multiple-input multiple-output (U-MIMO) orthogonal frequency division multiplexing (OFDM) systems, the frequency domain channel exhibits non-stationarity, exacerbated by limited pilot positions which complicate channel estimation. This letter extends single-band channel estimation to multi-band scenarios, focusing on frequency domain non-stationary sub-6 GHz - millimeter-wave(mmWave) systems. A novel framework leveraging a multi-modal attention mechanism is proposed: it employs a multi-modal input network to extract sub-6 GHz channel details and fine-tune with limited mmWave data. An adaptive attention mechanism dynamically adjusts information weights, facilitating effective feature fusion for mmWave channel estimation. The algorithm’s reliability and effectiveness in non-stationary channel estimation are validated through theoretical analysis and numerical simulations in adaptive frequency domains.

Developing efficacious catalysts with superior Cl resistance and polychlorinated byproduct inhibition capability is crucial for realizing the environmentally friendly purification of chlorinated volatile organic compounds (CVOCs). Activating CVOC molecules and desorbing Cl species by modulating the metal–oxygen property is a promising strategy to fulfill these. Herein, a bifunctional CoRu/Al2O3catalyst with synergistic Co and Ru interactions (Ru–O–Co species) was rationally fabricated, which possesses abundant surface Co2+and Ruδ+sites and collaboratively facilitates the activation of lattice oxygen (O2–) and molecular oxygen (O2→ O2–→ O–), accelerating 1,2-dichloroethane (1,2-DCE) decomposition viathe reaction route of enolic species → aldehydes → carboxylate/carbonate. Furthermore, CoRu/Al2O3stimulates 1,2-DCE oxidation under humid conditions as H2O molecules can be easily activated to active *OH (potential oxidizing agent) over Ru species, accelerating C–Cl dissociation and Cl desorption and promoting the transformation of catecholate-type (C═O) species to easily oxidizable carboxylic acid (COOH) species, remarkably suppressing the formation of hazardous CCl4and CHCl2CH2Cl. This study provides critical insights into the development of bifunctional catalysts to synergistically activate surface oxygen species and H2O molecules for industrial CVOC stable and efficient elimination.

Miscarriage poses a significant threat to both maternal and fetal health. Its etiology remains unknown, and there are no established effective identification or prevention strategies. A low-oxygen environment in early pregnancy is a physiological necessity for embryonic and placental growth. Hypoxia-inducible factors are a family of classic hypoxia signaling molecules whose expression level may fluctuate abnormally because of an imbalance in oxygen levels. Its unusual fluctuations initiate multiple signaling pathways at the maternal womb. Hypoxia-inducible factors are a family of classic hypoxia-signaling molecules and immune tolerance. Notably, aberrant regulation of these processes may lead to miscarriage. This review aims to clarify how the hypoxia-inducible factor-1α mediates the aberrant regulation of biological processes, including autophagy, metabolic reprogramming, et al., and how these effects impact trophoblasts and other cells at the maternal-fetal interface. These findings provide new insights into potential therapeutic and preventive strategies for miscarriage.

The effects of fluctuations and disorder, which are substantially enhanced in reduced dimensionalities, can play a crucial role in producing non-trivial phases of matter such as vestigial orders characterized by a composite order parameter. However, fluctuation-driven magnetic phases in low dimensions have remained relatively unexplored. Here we demonstrate a phase transition from the zigzag antiferromagnetic order in the three-dimensional bulk to a Z3vestigial Potts nematicity in two-dimensional few-layer samples of van der Waals magnet NiPS3. Our spin relaxometry and optical spectroscopy measurements reveal that the spin fluctuations are enhanced over the gigahertz to terahertz range as the layer number of NiPS3reduces. Monte Carlo simulations corroborate the experimental finding of threefold rotational symmetry breaking but show that the translational symmetry is restored in thin layers of NiPS3. Therefore, our results show that strong quantum fluctuations can stabilize an unconventional magnetic phase after destroying a more conventional one.

• The modification mechanisms are mainly from surface energy and roughness. • The improvement of MS hydrophobicity is essential for oil-water separation. • The dip coating can be the easiest and most effective way for MS modification. Melamine sponge is a major concern for oil-water separation due to its lightweight, high porosity (> 99 %), cost-effectiveness, impressive mechanical properties, and chemical/thermal stability. However, its amphiphilic nature hinders selective oil absorption in water. Recent strategies to enhance hydrophobicity are reviewed, including synthetic methods and materials, with comprehensive explanations of the mechanisms driven by surface energy and roughness. Key performance indicators for MS in oil-water separation, including adsorption capacity, wettability, stability, emulsion separation, reversible wettability switching, flame retardancy, mechanical properties, and recyclability, are thoroughly discussed. In conclusion, this review provides insights into the future potential and direction of functional melamine sponges in oil-water separation. [Display omitted] [ABSTRACT FROM AUTHOR]

To develop novel fungicides for controlling postharvest fungal diseases in citrus fruits, 12 essential oil (EO)-based thiosemicarbazones compounds, termed hydrazine-carbothioamide, were prepared according to the condensation method. In vitroassays showed that compound 13j exhibited the strongest antifungal activity (minimum inhibitory concentration [MIC] = minimum fungicidal concentration [MFC] = 0.0125 mg/mL) against Penicillium digitatum. An in vivostudy revealed that 5 × MFC of compound 13j can effectively mitigate the green mold incidence of citrus fruit inoculated with P. digitatum, as well as fruit rot during natural storage, at a level comparable to that of the chemical fungicide prochloraz. Throughout this process, fruit quality was maintained. The hemolysis assay showed that these thiosemicarbazone compounds have good biocompatibility and that their safety is comparable to that of prochloraz. The antifungal activity of compound 13j was attributed to membrane damage, as confirmed using scanning electron microscopy (SEM), Calcofluor white (CFW) staining, propidium iodide (PI) staining, Fourier transform-infrared (FT-IR) spectroscopy, optical density (OD)260, and relative conductivity assays. Collectively, our results indicate that compound 13j can be used as an antifungal agent to control the postharvest decay of citrus fruits.

Zebrafish microinjection is widely used in vascular biology, neurology, and other research areas. The microinjection of zebrafish larvae is a complicated 3D task because zebrafish larvae are independent individuals with complex body structures compared with biological cells. In this study, we propose an automatic high-throughput injection system for zebrafish larvae under an optical inverted microscope. The proposed system combines the fixing device design, object detection, visual positioning, and 3D injection path planning to improve the survival rate of zebrafish after injection. Experimental results demonstrated the capability and efficiency of the proposed system, which achieved a success rate of 95.0% and a survival rate of 98.7% for zebrafish injection. The system can be applied to various biomedical and biochemical experiments. Note to Practitioners—Zebrafish larvae have long been an important model organism in neuroscience, biomedicine, and drug discovery. In various methods for external substance transportation into the zebrafish, microinjection is more efficient but also more difficult. At present, high-throughput injection of zebrafish larvae is mainly based on traditional manual operations. The injection speed and success rate of manual injection gradually decrease with the increase in zebrafish numbers. In this study, an automatic injection system is designed and implemented for high-throughput zebrafish larvae injection. We first use a simply designed mold to fix batch zebrafish larvae. Then we propose a coarse-fine two-step positioning method and perform a 3D injection path planning to achieve precise microinjection. The proposed injection system frees the operators from the repetitive and tedious injection work, providing technical support for the life science experiment.

Topological superconductors (TSCs) offer a promising avenue for delving into exotic states of matter and fundamental physics. We propose a strategy for realizing high transition temperatures (high-Tc) in TSCs by leveraging nontrivial topology alongside a high carrier density near the Fermi level in metal-doped borophenes. We identified 39 candidates with exceptional thermodynamic stability from thousands of Be-intercalated borophenes (Be1–xBx) via extensive structural searches. Seven candidates exhibit high carrier densities, with B7Be2B7emerging as a particularly promising candidate. This nanosheet displays both type-I and type-II Dirac fermions, indicative of Z2topological metals, thereby positioning it as an ideal platform for high-TcTSCs. The high-density π electrons of B7Be2B7originating from type-II Dirac fermions, coupled with the out-of-plane vibrations of B and Be atoms, significantly enhance the electron–phonon coupling (λ = 1.42), resulting in a substantially high-Tcof 31.5 K. These findings underscore the potential of metal-doped borophenes as a cutting-edge material platform for achieving high-TcTSCs.

Traditional treatments against advanced non-small cell lung cancer (NSCLC) with high morbidity and mortality continue to be dissatisfactory. Given this situation, there is an urgent requirement for alternative modalities that provide lower invasiveness, superior clinical effectiveness, and minimal adverse effects. The combination of photodynamic therapy (PDT) and immunotherapy gradually become a promising approach for high-grade malignant NSCLC. Nevertheless, owing to the absence of precise drug delivery techniques as well as the hypoxic and immunosuppressive characteristics of the tumor microenvironment (TME), the efficacy of this combination therapy approach is less than ideal. In this study, we construct a novel nanoplatform that indocyanine green (ICG), a photosensitizer, loads into hollow manganese dioxide (MnO2) nanospheres (NPs) (ICG@MnO2), and then encapsulated in PD-L1 monoclonal antibodies (anti-PD-L1) reprogrammed exosomes (named ICG@MnO2@Exo-anti-PD-L1), to effectively modulate the TME to oppose NSCLC by the synergy of PDT and immunotherapy modalities. The ICG@MnO2@Exo-anti-PD-L1 NPs are precisely delivered to the tumor sites by targeting specially PD-L1 highly expressed cancer cells to controllably release anti-PD-L1 in the acidic TME, thereby activating T cell response. Subsequently, upon endocytic uptake by cancer cells, MnO2catalyzes the conversion of H2O2to O2, thereby alleviating tumor hypoxia. Meanwhile, ICG further utilizes O2to produce singlet oxygen (1O2) to kill tumor cells under 808 nm near-infrared (NIR) irradiation. Furthermore, a high level of intratumoral H2O2reduces MnO2to Mn2+, which remodels the immune microenvironment by polarizing macrophages from M2 to M1, further driving T cells. Taken together, the current study suggests that the ICG@MnO2@Exo-anti-PD-L1 NPs could act as a novel drug delivery platform for achieving multimodal therapy in treating NSCLC.

The use of renewable rosin as a raw material to prepare rosin-based polymers with good properties had aroused great interest. This work used rosin as raw material and acid deep eutectic solvent [ZnCl2][FA]3(synthesized by zinc chloride (ZnCl2) and formic acid (FA)) as a catalyst for high conversion of rosin to polymerized rosin. [ZnCl2][FA]3possessed a suitable acid strength (457 mV), with both a Brønsted acid site and Lewis acid site, in which the Brønsted acid site could effectively promote the isomerization of rosin and the Lewis acid site could effectively promote the polymerization of rosin, so polymerized rosin with a high softening point (148.40 °C) and low acid value (125.23 mg KOH/g) was obtained under the following conditions: rosin = 15 g, mDES:mrosin= 30%, T= 110 °C, and t= 9 h. [ZnCl2][FA]3maintained good catalytic performance in all 5 cycles; on this basis, the green synthesis technology of polymerized rosin under the DES system was given and not only promoted the further application of polymerized rosin but also realized the high value-added utilization of renewable resource rosin. In addition, the formation mechanism of DES was systematically explained through DFT calculation, and the reaction mechanism of rosin polymerization over [ZnCl2][FA]3was explored, which could provide a theoretical basis for further research.

A biocompatible metal–organic framework (MOF), named HSTC-4, constructed using the flexible 4,4′-oxybis(benzoic acid) (OBA), was developed to enable efficient loading and controlled release of vitamin C (VC) through a combination of strategies involving ligand length, structure design, and metal selection. The kinetic product HSTC-4 demonstrates a propensity for transforming into the thermodynamically stable HSTC-5 under external stimuli, such as photoillumination and vacuum heating, as witnessed by single-crystal to single-crystal transformation. Density functional theory (DFT) calculations reveal that the VC guest molecules exhibit stronger binding affinity with HSTC-5 due to its narrower pores compared to HSTC-4, resulting in a slower release of VC from VC@HSTC-5. Furthermore, precise control over VC release can be achieved by introducing surface modifications involving SiO2onto the structure of VC@HSCT-5, while simultaneously adjusting environmental factors such as pH and temperature conditions. Preliminary cell culture experiments and cytotoxicity assays highlight the biocompatibility of HSTC-5, suggesting that it is a promising platform for sustained drug delivery and diverse biomedical applications.

The combination of infrared and visible videos aims to gather more comprehensive feature information from multiple sources and reach superior results on various practical tasks, such as detection and segmentation, over that of a single modality. However, most existing dual-modality object detection algorithms ignore the modal differences and fail to consider the correlation between feature extraction and fusion, which leads to incomplete extraction and inadequate fusion of dual-modality features. Hence, there raises an issue of how to preserve each unique modal feature and fully utilize the complementary infrared and visible information. Facing the above challenges, we propose a novel Differential Feature Awareness Network (DFANet) within antagonistic learning for infrared and visible object detection. The proposed model consists of an Antagonistic Feature Extraction with Divergence (AFED) module used to extract the differential infrared and visible features with unique information, and an Attention-based Differential Feature Fusion (ADFF) module used to fully fuse the extracted differential features. We conduct performance comparisons with existing state-of-the-art models on two benchmark datasets to represent the robustness and superiority of DFANet, and numerous ablation experiments to illustrate its effectiveness.

Hepatocellular carcinoma (HCC) is a serious complication of hepatic vena cava Budd-Chiari syndrome (HVC-BCS) that significantly reduces the survival time of patients. Our study aimed to analyze the prognostic factors influencing the survival of HVC-BCS patients with HCC and to develop a prognostic scoring system.

The aim of the present study was to evaluate the subgingival microbiome in patients with grade C molar‐incisor pattern periodontitis (C‐MIP) affecting the primary or permanent dentitions. DNA was isolated from subgingival biofilm samples from diseased and healthy sites from 45 C‐MIP patients and subjected to phylogenetic microarray analysis. C‐MIP sites were compared between children affected in the primary to those affected in the permanent dentitions. Within‐subject differences between C‐MIP‐affected sites and dentition‐matched healthy sites were also evaluated. C‐MIP sites of subjects affected in the primary dentition showed partially overlapping but distinct microbial communities from C‐MIP permanent dentition sites (p< 0.05). Differences were due to increased levels in primary C‐MIP sites of certain species of the genera Capnocytophaga and Leptotrichia, while C‐MIP permanent dentition sites showed higher prevalence of Filifactor alocis. Aggregatibacter actinomycetemcomitans(Aa) was among species seen in high prevalence and levels in both primary and permanent C‐MIP sites. Moreover, both permanent and primary C‐MIP sites showed distinct microbial communities when compared to dentition‐matched healthy sites in the same subject (p< 0.01). Primary and permanent teeth with C‐MIP showed a dysbiotic microbiome, with children affected in the primary dentition showing a distinct profile from those affected in the permanent dentition. However, Aawas enriched in both primary and permanent diseased sites, confirming that this microorganism is implicated in C‐MIP in both dentitions.

Acute kidney injury (AKI) is a common complication in patients supported by extracorporeal membrane oxygenation (ECMO). Vasoactive-Inotropic Score (VIS) serves as an indicator of the extent of cardiovascular drug support provided. Our objective is to assess the relationship between the VIS and ECMO-associated AKI (EAKI). This single-center retrospective study extracted adult patients treated with ECMO between August 2016 and September 2022 from an intensive care unit (ICU) in a university hospital. A total of 126 patients requiring ECMO support were included in the study, of which 76% developed AKI. Multivariate logistic regression analysis identified VIS-max Day1 (odds ratio [OR]: 1.025, 95% confidence interval [CI]: 1.007–1.044, p= 0.006), VIS-max Day2 (OR: 1.038, 95% CI: 1.007–1.069, p= 0.015), VIS-mean Day1 (OR: 1.048, 95% CI: 1.013–1.084, p= 0.007), and VIS-mean Day2 (OR: 1.059, 95% CI: 1.014–1.107, p= 0.010) as independent risk factors for EAKI. VIS-max Day1 showing the best predictive effect (Area under the receiver operating characteristic curve (AUROC): 0.80, sensitivity: 71.87%, specificity: 80.00%) for EAKI with a cutoff value of 33.33. Surprisingly, VIS-mean Day2 was also excellent at predicting 7 day mortality (AUROC: 0.77, sensitivity: 87.50%, specificity: 56.38%) with a cutoff value of 8.67. In conclusion, VIS could independently predict EAKI and 7 day mortality in patients with ECMO implantation, which may help clinicians to recognize the poor prognosis in time for early intervention.

Infectious diseases are a global public health problem, with emerging and re-emerging infectious diseases on the rise worldwide. Therefore, their prevention and treatment are still major challenges. Bile acids are common metabolites in both hosts and microorganisms that play a significant role in controlling the metabolism of lipids, glucose, and energy. Bile acids have historically been utilized as first-line, valuable therapeutic agents for related metabolic and hepatobiliary diseases. Notably, bile acids are the major active ingredients of cow bezoar and bear bile, which are commonly used traditional Chinese medicines (TCMs) with the therapeutic effects of clearing heat, detoxification, and relieving wind and spasm. In recent years, the promising performance of bile acids against infectious diseases has attracted attention from the scientific community. This paper reviews for the first time the biological activities, possible mechanisms, production routes, and potential applications of bile acids in the treatment and prevention of infectious diseases. Compared with previous reviews, we comprehensively summarize existing studies on the use of bile acids against infectious diseases caused by pathogenic microorganisms that are leading causes of global morbidity and mortality. In addition, to ensure a stable supply of bile acids at affordable prices, it is necessary to clarify the biosynthesis of bile acids in vivo, which will assist scientists in elucidating the accumulation of bile acids and discovering how to engineer various bile acids by means of chemosynthesis, biosynthesis, and chemoenzymatic synthesis. Finally, we explore the current challenges in the field and recommend a development strategy for bile-acid-based drugs and the sustainable production of bile acids. The presented studies suggest that bile acids are potential novel therapeutic agents for managing infectious diseases and can be artificially synthesized in a sustainable way.

Catalysts with isolated active sites have demonstrated preferable H2O2productivity via the 2e−oxygen reduction reaction, but their synthesis procedures are usually sophisticated, with only a few isolated sites generated. Here, we employ perovskite as a platform for facilely constructing isolated active sites with dense populations to produce H2O2. As a proof of concept, a silver niobate catalyst, where the Ag sites are isolated by the NbO6octahedra with an atomic distance (dAg–Ag) larger than 0.39 nm, is demonstrated to show outstanding H2O2productivity at both low and high currents. Combining theoretical calculations, chemical/electrochemical surface species tuning methods, and in situtransmission electron microscopy, the isolated Ag sites in AgNbO3are determined to be the active sites for the H2O2production. This study offers an initial exploration of the perovskite structure as a platform for constructing isolated active sites, paving the way for its potential application in more fields.

The use of antibiotics in animal production raises great public safety concerns; therefore, there is an urgent need for the development of substitutes for antibiotics. In recent decades, plant-derived feed additives have been widely investigated as antibiotic alternatives for use in animal health and production because they exert multiple biological functions and are less likely to induce resistance development. This review summarizes the research history and classification of phytogenic feed additives and their main functions, potential modes of action, influencing factors, and potential negative effects. Further, we highlight the challenges in developing sustainable, safe, and affordable plant-derived antibiotic alternatives for use in livestock production.

IMPORTANCE: Purinergic receptor P2Y12 (P2Y12) inhibitor monotherapy after a certain period of dual antiplatelet therapy (DAPT) may be an attractive option of maintenance antiplatelet treatment for patients undergoing percutaneous coronary intervention (PCI) who are at both high bleeding and ischemic risk (birisk). OBJECTIVE: To determine if extended P2Y12 inhibitor monotherapy with clopidogrel is superior to ongoing DAPT with aspirin and clopidogrel after 9 to 12 months of DAPT after PCI in birisk patients with acute coronary syndromes (ACS). DESIGN, SETTING, AND PARTICIPANTS: This was a multicenter, double-blind, placebo-controlled, randomized clinical trial including birisk patients with ACS who had completed 9 to 12 months of DAPT after drug-eluting stent implantation and were free from adverse events for at least 6 months at 101 China centers between February 2018 and December 2020. Study data were analyzed from April 2023 to May 2023. INTERVENTIONS: Patients were randomized either to clopidogrel plus placebo or clopidogrel plus aspirin for an additional 9 months. MAIN OUTCOMES AND MEASURES: The primary end point was Bleeding Academic Research Consortium (BARC) types 2, 3, or 5 bleeding 9 months after randomization. The key secondary end point was major adverse cardiac and cerebral events (MACCE; the composite of all-cause death, myocardial infarction, stroke or clinically driven revascularization). The primary end point was tested for superiority, and the MACCE end point was tested for sequential noninferiority and superiority. RESULTS: A total of 7758 patients (mean [SD] age, 64.8 [9.0] years; 4575 male [59.0%]) were included in this study. The primary end point of BARC types 2, 3, or 5 bleeding occurred in 95 of 3873 patients (2.5%) assigned to clopidogrel plus placebo and 127 of 3885 patients (3.3%) assigned to clopidogrel plus aspirin (hazard ratio [HR], 0.75; 95% CI, 0.57-0.97; difference, −0.8%; 95% CI, −1.6% to −0.1%; P = .03). The incidence of MACCE was 2.6% (101 of 3873 patients) in the clopidogrel plus placebo group and 3.5% (136 of 3885 patients) in the clopidogrel plus aspirin group (HR, 0.74; 95% CI, 0.57-0.96; difference, −0.9%; 95% CI, −1.7% to −0.1%; P &lt; .001 for noninferiority; P = .02 for superiority). CONCLUSIONS AND RELEVANCE: Among birisk patients with ACS who completed 9 to 12 months of DAPT after drug-eluting stent implantation and were free from adverse events for at least 6 months before randomization, an extended 9-month clopidogrel monotherapy regimen was superior to continuing DAPT with clopidogrel in reducing clinically relevant bleeding without increasing ischemic events. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03431142

The concentration of PM2.5has considerably reduced in recent years, but remains relatively high in China. In particular, the increasing contribution of organic compounds to PM2.5generates popular pressure for further reductions, resulting in an urgent need to study organic aerosol (OA). To investigate the molecular composition and source contribution of OA in the rural area of the Guanzhong Plain, Northwest China, PM2.5samples were collected during 3–23 August 2016 and 5–20 January 2017 and studied for more than 100 organic tracer compounds. The mean concentration of total measured organic compounds is 662 ± 296 ng/m3in summer and 3258 ± 1925 ng/m3in winter. Levoglucosan is the most abundant single compound found throughout the sampling period, which is a crucial tracer for biomass burning emissions, preliminary suggesting that biomass burning is an essential source of OA. In summer, organic compounds such as lipid compounds, sugar compounds, and polycyclic aromatic hydrocarbons (PAHs), more come from higher plants, wood burning, vehicle exhausts, plastic waste, and other direct emission sources. Oxygenated PAHs (OPAHs), nitrophenols, and phthalic acids more come from the atmosphere through the oxidation reaction of aromatic precursors, especially photochemical oxidation. However, in winter, most of the increases in concentrations of organic compounds are attributed to biomass burning. The analysis of a haze event (14–19 January 2017) during the winter sampling period shows that the increases in the concentration of organic compounds are unaccompanied by strong secondary formation under lower relative humidity (49.1% ± 13.5%). The main reason for the growth of OA in this haze event is the accumulation of primary OA (POA). The source apportionment by the positive matrix factorization (PMF) model shows that biomass burning (37.1%) is the primary source of OA in the rural regions of the Guanzhong Plain, especially in winter (40.6%). The contribution of secondary formation decreases from 26.0% in summer to 16.9% in winter, and the contribution of fossil fuel emissions is comparable across both seasons.

Herein, we demonstrate the progressive excited-state structural evolution of a flexible polycyclic π-skeleton by introducing a “rigid-flexible coupling” macrocyclization strategy to impose an ever-escalating constraint. Here, a series of compounds DPAC-RFn(n= 3, 5, 8, 9, 10, 11, 12, 15, 17) were prepared by cyclizing the molecule N,N′-diphenyl-dihydrodibenzo[a,c]-phenazine (DPAC) with a “rigid-flexible coupled” chain composed of a rigid phenyl ring and flexible alkyl chains of varying lengths. Although the absorption remains unchanged (around 350 nm), their emissions exhibit significant chain-length dependence. Nanosecond time-resolved measurements and theoretical calculation confirm the excited-state structural evolution of DPAC-RFnfrom bend–planar–twist conformers, correlating with successive emission distributions in the blue-green region (n= 3, 5, 8, 9, 470–500 nm), yellow-green region (n= 10, 11, 520–530 nm), and orange-red region (n= 12, 15, 17, 590–620 nm). This study explicitly reveals the excited-state structural diversity of flexible polycyclic π-skeleton derivatives and achieves a large-scale coverage in the emission colors, thereby implying the potential prospects for fundamental studies and practical applications.

Parkinson’s disease (PD) represents the second most widespread neurodegenerative disease, and early monitoring and diagnosis are urgent at present. Tyrosine hydroxylase (TH) is a key enzyme for producing dopamine, the levels of which can serve as an indicator for assessing the severity and progression of PD. This renders the specific detection and visualization of TH a strategically vital way to meet the above demands. However, a fluorescent probe for TH monitoring is still missing. Herein, three rationally designed wash-free ratiometric fluorescent probes were proposed. Among them, TH-1exhibited ideal photophysical properties and specific dual-channel bioimaging of TH activity in SH-SY5Y nerve cells. Moreover, the probe allowed for in vivoimaging of TH activity in zebrafish brain and living striatal slices of mice. Overall, the ratiometric fluorescent probe TH-1could serve as a potential tool for real-time monitoring of PD in complex biosystems.

Previous studies have shown that transfatty acids (TFA) are associated with several chronic diseases, the gut microbiota is directly influenced by dietary components and linked to chronic diseases. Our research investigated the effects of elaidic acid (EA), a typical TFA, on the gut microbiota to understand the underlying mechanisms of TFA-related chronic diseases. 16S rDNA gene sequencing on faecal samples from Sprague-Dawley rats were performed to explore the composition change of the gut microbiota by EA gavage for 4 weeks. The results showed that the intake of EA increased the abundance of well-documented harmful bacteria, such as Proteobacteria, Anaerotruncus, Oscillibacterand Desulfovibrionaceae. Plus, EA induced translocation of lipopolysaccharides (LPS) and the above pathogenic bacteria, disrupted the intestinal barrier, led to gut-liver axis derangement and TLR4 pathway activation in the liver. Overall, EA induced intestinal barrier damage and regulated TLR4-MyD88-NF-κB/MAPK pathways in the liver of SD rats, leading to the activation of NLRP3 inflammasome and inflammatory liver damage.

An environment-friendly solvent debinding process for polyoxymethylene (POM) for metal injection molding (MIM) is presented as an alternative to the traditional catalytic debinding method. This study investigated the influence of various acid solvents and debinding temperature. The optimal debinding parameters were 5 M nitric acid solution at 60 °C. Based on the calculation of effective diffusivity and activation energy, the solvent-debinding mechanism for POM is proposed. The removal of POM was controlled by three processes: dissolution, diffusion, and chemical reaction. The resulting final titanium parts have a high density of over 95% and an ultimate tensile strength of 406 MPa.

This paper proposes a longitudinal protection scheme utilizing empirical wavelet transform (EWT) for a through- type cophase traction direct power supply system, where both sides of a traction network line exhibit a distinctive boundary structure. This approach capitalizes on the boundary’s capacity to attenuate the high-frequency component of fault signals, resulting in a variation in the high-frequency transient energy ratio when faults occur inside or outside the line. During internal line faults, the high-frequency transient energy at the checkpoints located at both ends surpasses that of its neighboring lines. Conversely, for faults external to the line, the energy is lower compared to adjacent lines. EWT is employed to decompose the collected fault current signals, allowing access to the high-frequency transient energy. The longitudinal protection for the traction network line is established based on disparities between both ends of the traction network line and the high-frequency transient energy on either side of the boundary. Moreover, simulation verification through experimental results demonstrates the effectiveness of the proposed protection scheme across various initial fault angles, distances to faults, and fault transition resistances.

Uncontrolled hyperuricemia often leads to the development of hyperuricemic nephropathy (HN), characterized by excessive inflammation and oxidative stress. Piperine, a cinnamic acid alkaloid, possesses various pharmacological activities, such as antioxidant and anti-inflammatory effects. In this study, we intended to investigate the protective effects of piperine on adenine and potassium oxonate-induced HN mice and a uric-acid-induced injury model in renal tubular epithelial cells (mRTECs). We observed that treatment with piperine for 3 weeks significantly reduced serum uric acid levels and reversed kidney function impairment in mice with HN. Piperine (5 μM) alleviated uric acid-induced damage in mRTECs. Moreover, piperine inhibited transporter expression and dose-dependently inhibited the activity of both transporters. The results revealed that piperine regulated the AKT/mTOR signaling pathway both in vivoand in vitro. Overall, piperine inhibits URAT1/GLUT9 and ameliorates HN by inhibiting the AKT/mTOR pathway, making it a promising candidate for patients with HN.

Perovskite-type oxides (ABO3) possess beneficial cathode characteristics for solid oxide fuel cells because of quick oxide ion transport through the octahedral structures. However, mixed proton–electron conducting Co-free perovskites, which extend the electrode reactions from the electrolyte interface to the whole electrode, are still in urgent need of development. Herein, the hydration and proton kinetics in Ce-doped BaFeO3−δare explored by using first-principles calculations. In our study, we have defined two parameters to characterize the symmetry and investigate the formation and motion of protons in cathode materials of perovskite from the perspective of reaction thermodynamics and dynamics. The results demonstrated that Ce exhibited the most favorable equilibrium property at a low concentration of 12.5%, characterized by an oxygen vacancy formation energy of 0.55 eV, hydration energy of −1.06 eV, and a migration energy barrier of 0.15 eV, thereby facilitating the overall reaction process. The transition state calculation elucidates the influence of lattice distortion and lattice oxidation environment on proton migration. Specifically, a decrease in lattice distortion facilitates proton hydration and reduces proton migration. As lattice distortion increases, the energy barrier gradually rises from 0.076 to 0.4 eV. Moreover, in crystals with second-class symmetry, reducing lattice distortion is more favorable for promoting proton migration than increasing free volume. The reliability of the calculated parameters is validated through comparison with experimental and computational studies. This study provides a theoretical foundation for developing Co-free perovskite cathodes with triple conductivity through doping.

Reductive radical dearomatization N-alkyl quinoline quaternary ammonium salts to synthesize structurally complex and challenging polysubstituted benzo[d][1,3]oxazocines was first reported. The mechanism showed various allyl alcohols can be converted into alkyl radicals under reduction conditions of iron/silane. These radicals then nucleophilically attack the C4 site of N-alkyl quinoline quaternary ammonium salts, and intramolecular cyclization of the resulting intermediate generates the target product. This method not only produced a series of novel polysubstituted benzo[d][1,3]oxazocines but also prepared polycyclic benzo[d][1,3]oxazocines. Finally, this strategy made up for the lack of reductive radical reports on N-alkylquinolinium salts and also had the advantages of mild reaction conditions, wide substrate range, and novel product structure.

High-content screening (HCS) technology combines automated high-speed imaging hardware and single-cell quantitative analysis. It can greatly accelerate data acquisition in cellular fluorescence imaging and is a powerful research technique in traditional Chinese medicine (TCM). An increasing number of laboratories and platforms, including TCM laboratories, have begun utilizing HCS systems. However, this technology is still in its infancy in TCM research and there is a lack of sufficient experience with the associated concepts, instrument configurations, and analysis methods. To improve the understanding of HCS among researchers in the field of TCM, this paper summarizes the concept of HCS, software and hardware configuration, the overall research process, as well as common problems and related solutions of HCS in TCM research based on our team’s previous research experience, providing several research examples and an outlook on future perspectives, aiming to provide a technical guide for HCS in TCM research.

Wheat (Triticum aestivumL.) root‐associated microbes play an indispensable role in helping plants obtain phosphorus (P) from soil. However, the relationships among soil P content, wheat root‐associated microorganisms, and plants are still not fully understood. Therefore, revealing the effects of soil P content on the root‐associated microbes in different crop varieties at different growth stages is important for plant nutrient management. In this study, the variations of prokaryotic communities were investigated in the endosphere and rhizosphere of three wheat varieties growing in soils with different P content and at different growth stages. The key findings indicated that compartment niche and growth stage were the primary factors to shape wheat root‐associated prokaryotic community assembly under different soil P contents. Soil P content mainly affected the prokaryotic community in rhizosphere rather than in endosphere. The effects of soil P content on root‐associated prokaryotic communities in different wheat varieties were different and varied with the growth stage. Under low P treatment, there was greater variation in prokaryotic communities among varieties. In addition, compared with that in P‐deficient soil, wheat rhizosphere enriched more taxa and functions related to plant growth in the P‐sufficient soil. P‐efficient variety (ZGC) enriched more genera that were positively related to plant growth in P‐sufficient soil. This study comprehensively revealed the influences of soil P content on wheat root‐associated prokaryotic communities, and the relationships among soil P content, wheat root‐associated prokaryotic community, and plant. The effect of phosphorus (P) content on wheat root‐associated prokaryotic community depends on the growth stage and variety.Low P stress exacerbates community variation among varieties.P addition promotes the formation of mutually beneficial relationships between microorganisms and plants.P‐efficient variety enriches more potential beneficial genera in P‐sufficient soil.

To develop pure aluminum alloys with high conductivity and strength, Al-0.2Ce and Al-0.2Ce-0.1Y alloys were prepared by rolling and annealing processes in this study. The effects of trace rare earth elements on the strength and electrical conductivity of the pure aluminum alloys were investigated. It is revealed that the addition of Ce and Y to pure aluminum can effectively enhance the strength and electrical conductivity of the alloys. In Al-0.2Ce, the addition of Ce can effectively refine the grain size of α-Al, with an average grain size of 90.68 μm in the as-cast state. The grain size of the alloy is further reduced to 87.55 μm by the simultaneous addition of Y. The synergistic addition of Ce and Y changes the properties of the alloy. The addition of Ce and Y also produces the Al11Ce3and Al3Y second phases, which have coherent relationship with α-Al. The two-dimensional mismatch degree was calculated to be only 4.43% and 0.85%, respectively, which can provide a certain amount of nucleation substrate for α-Al in the incubation stage. The interfacial match between the L12structure of Al3Y and α-Al was calculated using first-principles simulations. The results indicate that Al3Y has a strong bonding effect with α-Al. Nanoscale second phases at grain boundaries can be effective in reducing resistivity due to dislocation motion. Nanoscale second phases with better matching interfaces to the substrate have no positive effect on the scattering motion of electrons.

Metallene materials with atomic thicknesses are receiving increasing attention in electrocatalysis due to ultrahigh surface areas and distinctive surface strain. However, the continuous strain regulation of metallene remains a grand challenge. Herein, taking advantage of autocatalytic reduction of Cu2+on biaxially strained, carbon-intercalated Ir metallene, we achieve control over the carbon extraction kinetics, enabling fine regulation of carbon intercalation concentration and continuous tuning of (111) in-plane (−2.0%–2.6%) and interplanar (3.5%–8.8%) strains over unprecedentedly wide ranges. Electrocatalysis measurements reveal the strain-dependent activity toward hydrogen evolution reaction (HER), where weakly strained Ir metallene (w-Ir metallene) with the smallest lattice constant presents the highest mass activity of 2.89 A mg–1Irat −0.02 V vs reversible hydrogen electrode (RHE). Theoretical calculations validated the pivotal role of lattice compression in optimizing H binding on carbon-intercalated Ir metallene surfaces by downshifting the d-band center, further highlighting the significance of strain engineering for boosted electrocatalysis.

A regioselective olefin hydrofunctionalization reaction of pavettine (4) with various nucleophiles was developed and used as the key step in the total syntheses of β-carboline natural products manzamine C (3), orthoscuticelline C (5), and quassidine S (6). In the 6-step total synthesis of manzamine C (3), an efficient two-step procedure, comprising a Wittig olefination reaction and a Fukuyama–Mitsunobu reaction, was devised for the synthesis of the N-macrocycle with a Z-olefin.

SATech-01 is an experimental satellite for space science exploration and on-orbit demonstration of advanced technologies. The satellite is equipped with 16 experimental payloads and supports multiple working modes to meet the observation requirements of various payloads. Due to the limitation of platform power supply and data storage systems, proposing reasonable mission planning schemes to improve scientific revenue of the payloads becomes a critical issue. In this article, we formulate the integrated task scheduling of SATech-01 as a multi-objective optimization problem and propose a novel Fair Integrated Scheduling with Proximal Policy Optimization (FIS-PPO) algorithm to solve it. We use multiple decision heads to generate decisions for each task and design the action mask to ensure the schedule meeting the platform constraints. Experimental results show that FIS-PPO could push the capability of the platform to the limit and improve the overall observation efficiency by 31.5% compared to rule-based plans currently used. Moreover, fairness is considered in the reward design and our method achieves much better performance in terms of equal task opportunities. Because of its low computational complexity, our task scheduling algorithm has the potential to be directly deployed on board for real-time task scheduling in future space projects.

As the first blockchain platform to support smart contracts, Ethereum has gained popularity and breeds various cybercrimes. Many phishing accounts on Ethereum take advantage of the blockchain’s anonymity to participate in illegal acts. To this end, to solve the transaction security problem caused by phishing accounts on Ethereum, this brief proposes a network embedding-based phishing account detection model. Firstly, we crawl the history of transactions from both labeled phishing and non-phishing accounts and use a new method to build these transactions as a transaction network, where each transaction edge is accompanied by additional transaction information for all source nodes of the target node. Then we propose a new random walk-based network embedding algorithm named bias2vec to obtain the embeddings of nodes as the feature inputs. Finally, we classify the accounts into phishing and non-phishing ones by different classifiers such as lightGBM and XGBoost. Experiments show that our proposed phishing account detection model achieves effective detection performance under different classifiers.

On the premise of considering the interests of insurance companies and reinsurance companies at the same time, this paper studies the investment and reinsurance game between them. Suppose that the compensation process faced by an insurance company is described by Brownian motion with drift. Insurance companies can purchase proportional reinsurance from reinsurance companies, and both companies can invest in a risk-free asset, a risky asset whose price process follows the constant elasticity of variance (CEV) model, and a defaultable bond. With the goal of maximizing the expected utility of weighted terminal wealth, the corresponding Hamilton–Jacobi–Bellman (HJB) equations are established and solved by using the principle of dynamic programming, and the analytical expressions of the equilibrium investment-reinsurance strategies of insurers and reinsurers are derived respectively. Finally, the influence of each model parameter on the equilibrium strategy is analyzed by numerical examples.

ABSTRACTStyrene-butadiene-styrene copolymer (SBS) modified asphalt is widely utilized in road construction. However, aging effect on SBS modified asphalt is still a serious problem that needs to be resolved. It has [...]

This study proposes a three-dimensional room transfer function (RTF) parameterization method based on multiple concentric planar circular arrays, which exhibits robustness to variations in the positions of both the receiver and source. According to the harmonic solution to the wave equation, the RTFs between two spherical regions (sound source and receiver) in a room can be expressed as a weighted sum of spherical harmonics, whose weight coefficients serve as the RTF parameters, which can be estimated by placing multiple concentric planar circular arrays composed of monopole-source pairs (MSPs) and multiple concentric planar circular arrays composed of omnidirectional-microphone pairs (OMPs) in respective source and receiver regions. We use MSP arrays to generate required outgoing soundfields originating from a source region. We derive a method to use OMP arrays to estimate RTF parameters that are concealed within the captured soundfield, which can be employed to reconstruct the RTF from any point in the source region to any point in the receiver region. The accuracy of the RTF parameterization method is validated through simulation testing.

Aging is a crucial cause of cognitive decline and a major risk factor for Alzheimer’s disease (AD); however, AD’s underlying molecular mechanisms remain unclear. Recently, tetraspanins have emerged as important modulators of synaptic function and memory. We demonstrate that the level of tetraspanin CD82 is upregulated in the brains of AD patients and middle-aged mice. In young adult mice, injection of AAV-CD82 to the hippocampus induced AD-like cognitive deficits and impairments in neuronal spine density. CD82 overexpression increased TRPM7 α-kinase cleavage via caspase-3 activation and induced Numb phosphorylation at Thr346 and Ser348 residues. CD82 overexpression promoted beta-amyloid peptide (Aβ) secretion which could be reversed by Numb T346S348 mutants. Importantly, hippocampus-related memory functions were improved in Cd82−/−mice. Taken together, our findings provide the evidence that links the elevated CD82-TRPM7-Numb signaling to age-related cognitive impairment.

Recent studies on sign language recognition (SLR) mainly focus on deaf individuals communicating with those who can hear. However, less attention has been given to enable hearing individuals to effectively communicate with the deaf, especially when they do not understand sign language (SL). To overcome this, we introduce SeqαGAN, a unique SL sequence generator. This tool is different from the standard variational autoencoder (VAE) + generative adversarial networks (GAN) model used commonly for creating images. Instead, our approach fuses conditional VAE and conditional GAN for generating sequences. SeqαGAN merges variational and adversarial learning to create versatile, recognizable data, which helps avoid mode collapse. The generated data could enhance SLR performance by supplementing existing resources. Tests on well-established SL datasets confirm the effectiveness of this new skeleton-based SLG model.

Abstract: Objectives: We aimed to investigate whether health-related quality of life (HRQOL) influences health service utilization and whether such influence exists independently in addition to socio-demographic and morbidity variables. Methods: A retrospective design was carried out among 737 primary care patients in mainland China. Health service utilization was measured by the number of monthly outpatient consultations and the annual hospitalization rate. HRQOL was measured by the SF-36. A clustered regression model was adopted throughout the analysis. Results: Lower HRQOL was associated with a higher utilization rate. Three out of the eight SF-36 subscales were associated with outpatient consultation, and additional two with inpatient consultation. One subscale of the SF-36 (mental health) was associated with an independent influence of 11.8% with outpatient consultation, and another subscale of the SF-36 (general health) was associated with an independent influence of 26.0% with inpatient consultation. Conclusions: Health service utilization increased significantly with decreasing HRQOL, and the independent influence of HRQOL on health service utilization was smaller than that of socio-demographic and morbidity variables among primary care patients in mainland China.

Erectile dysfunction ranks among the prevalent sexual disorders in men. Several studies have indicated a potential link between gut microbiota and erectile dysfunction. To validate this potential association, we were to screen statistical data from genome-wide association studies of gut microbiota and erectile dysfunction. pvalues of less than 1 × 10−5were set as the threshold for screening instrumental variables that were strongly associated with gut microbiota. At the same time, in order to obtain more convincing findings, we further excluded instrumental variables with possible chain imbalance, instrumental variables with the presence of palindromes, instrumental variables with F-statistics less than 10, and instrumental variables associated with risk factors for erectile dysfunction. Five methods including inverse-variance weighted method, weighted median method, weighted mode, Mendelian randomization egger method and Mendelian randomization pleiotropy residual sum and outlier test were then used to analyse the 2591 instrumental variables obtained from the screening. We identified correlations between six gut microbiota and the risk of erectile dysfunction. The genus Ruminococcaceae UCG-013 exhibited an inverse association with the risk of developing erectile dysfunction (0.79 (0.65–0.97), P= 0.0214). Conversely, the genus Tyzzerella3 (1.13 (1.02–1.26), P= 0.0225), genus Erysipelotrichaceae UCG-003 (1.18 (1.01–1.38), P= 0.0412), genus LachnospiraceaeNC2004group (1.19 (1.03–1.37), P= 0.0191), genus Oscillibacter (1.23 (1.08–1.41), P= 0.0022), and family Lachnospiraceae (1.26 (1.05–1.52), P= 0.0123) demonstrated positive associations with an increased risk of erectile dysfunction. These sensitivity analyses of the gut microbiota were consistent. This study demonstrated a possible causal relationship between gut microbiota and erectile dysfunction risk through Mendelian randomization analysis, providing new potential possibilities for the prevention and treatment of erectile dysfunction.