Search

Abstract Background Distal tibial fractures represent common lower limb injuries, frequently accompanied by significant soft tissue damage. The optimal surgical approach for managing these fractures remains a topic of considerable debate. The aim of this study was to perform a comparative analysis of the outcomes associated with retrograde intramedullary tibial nails (RTN) and minimally invasive plate osteosynthesis (MIPO) in the context of treating extra-articular distal tibial fractures. Methods A retrospective review was conducted on a cohort of 48 patients who sustained extra-articular distal tibial fractures between December 2019 and December 2021. Patients underwent either RTN or MIPO procedures. Various parameters, including operative duration, intraoperative fluoroscopy exposure, time to union, duration until full weight-bearing, American Orthopedic Foot and Ankle Society (AOFAS) scores, and complications, were recorded and compared between the two treatment groups. Results No statistically significant differences were observed in operative duration, time to union, angulation of the distal tibial coronal plane, or AOFAS scores between the RTN and MIPO groups. However, the RTN group had a higher average number of intraoperative fluoroscopy images (8.2 ± 2.3) compared to the MIPO group (4.1 ± 2.0). The RTN group demonstrated shorter average hospital stays (7.1 ± 1.4 days) and a quicker return to full weight-bearing (9.9 ± 1.3 weeks), which were significantly superior to the MIPO group (9.0 ± 2.0 days and 11.5 ± 1.5 weeks, respectively). In terms of complications, the RTN group had one case of superficial infection, whereas the MIPO group exhibited two cases of delayed union and nonunion, two occurrences of deep infection, and an additional three cases of superficial infection. Conclusions Both RTN and MIPO are effective treatment options for extra-articular distal tibial fractures. However, RTN may offer superior outcomes in terms of decreased inpatient needs, faster return to full weight-bearing capacity, and a lower rate of complications.

Abstract Objective This study aimed to describe the clinical and genetic characteristics of Chinese patients with congenital fibrosis of the extraocular muscles (CFEOM), and to evaluate the phenotype–genotype correlations in these patients. Methods This was a retrospective study. Patients with CFEOM underwent detailed ophthalmic examinations and magnetic resonance imaging (MRI). Panel-based next-generation sequencing was performed to identify pathogenic variants of disease-causing genes. Results Sixty-two patients with CFEOM were recruited into this study. Thirty-nine patients were diagnosed with CFEOM1 and 23 with CFEOM3. Forty-nine of the 62 patients with CFEOM carried either KIF21A (41/49) or TUBB3 variants (8/49). Six known missense variants in the KIF21A and TUBB3 genes, and a novel variant (c.3906T > A, p.D1302E) in the KIF21A gene were detected. Most patients with CFEOM1 carrying the KIF21A mutation displayed isolated CFEOM, whereas patients with CFEOM3 carrying the TUBB3 mutation had a wide range of clinical manifestations, either CFEOM alone or syndromes. Nystagmus was also present in 12 patients with CFEOM. Furthermore, the MRI findings varied, ranging from attenuation of the extraocular muscles to dysgenesis of the cranial nerves and brain structure. Conclusions The novel variants identified in this study will further expand the spectrum of pathogenic variants in CFEOM-related genes. However, no phenotype–genotype correlations were established because of the diversity of the clinical characteristics of these patients.

Background Cerebral infarction is a disorder of blood supply to the local brain tissue area caused by various causes. Tongnao Decoction is approved and used in Jiangsu Province Hospital of Chinese Medicine for the treatment of cerebral infarction. However, the specific mechanisms underlying its action remain unclear. Objective To explain the mechanism of Tongnao Decoction in the treatment of cerebral infarction through network pharmacology and clinical trails. Methods From January 2019 to June 2020, a total of 199 patients with cerebral infarction admitted to Jiangsu Province Hospital of Chinese Medicine were included in the clinical study. and divided into the control group (97 cases) and experimental group (102 cases) according to the method of random number table. Both groups received standardized treatment for stable cerebral infarction, and the experimental group was treated with Tongnao Decoction. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the degree of functional impairment caused by stroke, and the modified Rankin Scale (mRS) was used to assess the recovery of neurological function for both groups before treatment and at 2 weeks of treatment. The chemical compounds of Tongnao Decoction were screened from TCMSP and literature, and those with bioavailability (OB) ≥30% and drug-like properties (DL) ≥0.18 requirements were selected to find the active ingredient of the prescription. OMIM and GeneCards databases were used to analyze the molecular targets of Tongnao Decoction for the treatment of cerebral infarction. After screening the common targets, Cytoscape software, String database were used to plot the network of compounds and target proteins, construct protein-protein interaction (PPI) network, gene ontology (GO) function, and Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway enrichment analysis, respectively. Molecular docking experiments were finally performed to identify the main active ingredients of Tongnao Decoction for the treatment of cerebral infarction. Results After treatment, the scores of NIHSS and mRS in the experimental group were lower than those in the control group (P

Highlights A novel organohydrogel-based multimodal e-skin with excellent sensing performance for temperature, humidity, pressure, proximity, and NO2 is proposed for the first time, showing powerful sensing capabilities beyond natural skin. The developed multimodal e-skin exhibited extraordinary sensing performance at room temperature, including fast pressure response time (0.2 s), high temperature sensitivity (9.38% °C-1), a wide range of humidity response (22%–98% RH), high NO2 sensitivity (254% ppm-1), a low detection limit (11.1 ppb NO2) and the abilities to sense the proximity of objects accurately, which are yet achieved by previous e-skins. The multimodal e-skin was combined with the deep neural network algorithm and wireless alarm circuit to achieve zero-error classification of different objects and rapid response to NOx leak incidents, proving the feasibility of the e-skin-assisted rescue robot for post-earthquake rescue.

Abstract Callosobruchus maculatus is one of the most competitive stored grain pests, which causes a great loss to agricultural economy. However, due to an inadequacy of high-quality reference genome, the molecular mechanisms for olfactory and hypoxic adaptations to stored environments are unknown and require to be revealed urgently, which will contribute to the detection and prevention of the invasive pests C. maculatus. Here, we presented a high-quality chromosome-level genome of C. maculatus based on Illumina, Nanopore and Hi-C sequencing data. The total size was 1.2 Gb, and 65.17% (797.47 Mb) of it was identified to be repeat sequences. Among assembled chromosomes, chromosome 10 was considered the X chromosome according to the evidence of reads coverage and homologous genes among species. The current version of high-quality genome provides preferable data resources for the adaptive evolution research of C. maculatus.

Abstract Circular RNAs are an unusual class of single-stranded RNAs whose ends are covalently linked via back-splicing. Due to their versatility, the need to express circular RNAs in vivo and in vitro has increased. Efforts have been made to efficiently and precisely synthesize circular RNAs. However, a review on the optimization of the processes of circular RNA design, synthesis, and delivery is lacking. Our review highlights the multifaceted aspects considered when producing optimal circular RNAs and summarizes the available options for each step of exogenous circular RNA design and synthesis, including circularization strategies. Additionally, this review describes several potential applications of circular RNAs.

Based on new data from cores, drilling and logging, combined with extensive rock and mineral testing analysis, a systematic analysis is conducted on the characteristics, diagenesis types, genesis and controlling factors of deep to ultra-deep abnormally high porosity clastic rock reservoirs in the Oligocene Linhe Formation in the Hetao Basin. The reservoir space of the deep to ultra-deep clastic rock reservoirs in the Linhe Formation is mainly primary pores, and the coupling of three favorable diagenetic elements, namely the rock fabric with strong compaction resistance, weak thermal compaction diagenetic dynamic field, and diagenetic environment with weak fluid compaction-weak cementation, is conducive to the preservation of primary pores. The Linhe Formation clastic rocks have a superior preexisting material composition, with an average total content of 90% for quartz, feldspar, and rigid rock fragments, and strong resistance to compaction. The geothermal gradient in Linhe Depression in the range of (2.0–2.6) °C/100 m is low, and together with the burial history of long-term shallow burial and late rapid deep burial, it forms a weak thermal compaction diagenetic dynamic field environment. The diagenetic environment of the saline lake basin is characterized by weak fluid compaction. At the same time, the paleosalinity has zoning characteristics, and weak cementation in low salinity areas is conducive to the preservation of primary pores. The hydrodynamic conditions of sedimentation, salinity differentiation of ancient water in saline lake basins, and sand body thickness jointly control the distribution of high-quality reservoirs in the Linhe Formation.

Abstract Background Neuromyelitis Optica Spectrum Disorder (NMOSD) is an inflammatory autoimmune disease with high risk of recurrence and disability, the treatment goal is a recurrence free state. Area postrema (AP) is one of the most common involved area of NMOSD, which may have a particular significance in the pathogenesis of NMOSD and clinical heterogeneity. Our study is to investigate the clinical and recurrent characteristics AP onset NMOSD patients. Methods A retrospective study was done in a cohort of 166 AQP4-IgG seropositive NMOSD patients which were identified by the 2015 IPND criteria. The patients were divided into AP onset (APO-NMOSD) group and non-AP onset (NAPO-NMOSD) group based on the initial episode location. Clinical features and recurrence differences of two groups were compared. Results The APO-NMOSD group and NAPO-NMOSD group had a population ratio of 24:142. APO-NMOSD patients were younger (34.6y VS 42.3y, P = 0.013), had lower EDSS at first episode (0.7 VS 4.2, p = 0.028) and last follow up (1.9 VS 3.3, p = 0.001), more likely to have multi-core lesions at the first attack (33.3% VS 9.2%, P = 0.001). Also, they had a higher annual recurrence rate (0.4 ± 0.28 VS 0.19 ± 0.25, P = 0.012). In natural course NMOSD patients without immunotherapy, APO-NMSOD had a shorter time of first relapse (P

Non-degradable polymers cause serious environmental pollution problem, such as the widely-used while unrecyclable coatings which significantly affect the overall degradation performance of products. It is imperative and attractive to develop biodegradable functional coatings. Herein, we proposed a novel strategy to successfully prepare biodegradable, thermoplastic and hydrophobic coatings with high transparence and biosafety by weakening the interchain interactions between cellulose chain. The natural cellulose and cinnamic acid were as raw materials. Via reducing the degree of polymerization (DP) of cellulose and regulating the degree of substitution (DS) of cinnamate moiety, the obtained cellulose cinnamate (CC) exhibited not only the thermal flow behavior but also good biodegradability, which solves the conflict between the thermoplasticity and biodegradability in cellulose-based materials. The glass transition temperature (Tg) and thermal flow temperature (Tf) of the CC could be adjusted in a range of 150–200 °C and 180–210 °C, respectively. The CC with DS

Congenital hypogonadotropic hypogonadism (CHH) is a rare genetic disorder, resulting from impaired production, secretion, or action of gonadotropin-releasing hormone (GnRH). Variants of the KISS1R gene can result in CHH. Herein we describe a Chinese boy with CHH, caused by a novel, compound heterozygous variant in KISS1R. A male infant presented to the pediatric urological surgeon at three months of age for micropenis. Laboratory investigations done at this time revealed low levels of serum gonadotropins and testosterone, suggesting a lack of minipuberty. Topical application of dihydrotestosterone gel was recommended, but the parents refused treatment. The child was brought to our hospital at 3.3 years of age for the same complaint. A diagnosis of CHH was considered, and next generation sequencing revealed a compound heterozygous variant including a novel c.182C>A (p.S61*) and a c.418C>T (p.R140C) in KISS1R. We describe a novel compound heterozygous variant in the KISS1R in a boy with CHH, born to non-consanguineous Chinese parents. This report adds to the spectrum of variants in KISS1R seen in children with CHH.

Abstract Background Congenital stationary night blindness (CSNB) is an inherited retinal disorder. Most of patients have myopia. This study aims to describe the clinical and genetic characteristics of fifty-nine patients with CSNB and investigate myopic progression under genetic cause. Results Sixty-five variants were detected in the 59 CSNB patients, including 32 novel and 33 reported variants. The most frequently involved genes were NYX, CACNA1F, and TRPM1. Myopia (96.61%, 57/59) was the most common clinical finding, followed by nystagmus (62.71%, 37/59), strabismus (52.54%, 31/59), and nyctalopia (49.15%, 29/59). An average SE of -7.73 ± 3.37 D progressed to -9.14 ± 2.09 D in NYX patients with myopia, from − 2.24 ± 1.53 D to -4.42 ± 1.43 D in those with CACNA1F, and from − 5.21 ± 2.89 D to -9.24 ± 3.16 D in those with TRPM1 during the 3-year follow-up; the TRPM1 group showed the most rapid progression. Conclusions High myopia and strabismus are distinct clinical features of CSNB that are helpful for diagnosis. The novel variants identified in this study will further expand the knowledge of variants in CSNB and help explore the molecular mechanisms of CSNB.

ObjectiveDifficulties in emotion regulation (DERs) can contribute to disordered eating behavior in children and adolescents with type 1 diabetes (T1D), although it is unknown how DERs may affect eating behavior in these children and adolescents. This study examined the relationship between disordered eating behaviors and emotion regulation in children and adolescents with T1D.MethodsFor this cross-sectional study, 128 patients (aged 8–16 years) were recruited to complete the Diabetes Eating Problem Survey-Revised (DEPS-R) and Difficulties in Emotion Regulation Scale (DERs).ResultsThe mean age of the 128 patients (99 females) who completed the DEPS-R was 11.63 ± 2.27 years. The participants' mean DEPS-R score was 17.78 ± 8.56 points. Of the total sample, 61 participants' scores surpassed the established threshold, resulting in a DEPS-R positivity rate of 47.66%. The participants' mean total DERS score was 72.3 ± 21.15 points, and it was found that children and adolescents with T1D who had a positive DEPS-R screening result had significant differences in emotional regulation and that eating behavior disorders were positively correlated with emotional regulation and all dimensions scores.ConclusionsThe prevalence of disordered eating behavior is high among children and adolescents with T1D. DERs are related to disordered eating behavior in children and adolescents with T1D. The novel finding that DERs may be a predictor of eating problems lends preliminary support for the inclusion of DERs in future risk models and as a potential target for intervention.

Summary: The serine/threonine phosphatase calcineurin is a component of the T cell receptor (TCR) signalosome, where it promotes T cell activation by dephosphorylating LckS59. Using small interfering RNA (siRNA)-mediated knockdown and CRISPR-Cas9-targeted genetic disruption of the calcineurin A chain α and β isoforms, we find that calcineurin also functions as an adaptor in TCR-signaled human T cells. Unlike inhibition of its phosphatase activity, in the absence of calcineurin A, TCR signaling results in attenuated actin rearrangement, markedly reduced TCR-Lck microcluster formation and recruitment of the adaptor RhoH, and diminished phosphorylation of critical targets downstream of Lck such as TCRζ and ZAP-70. Reconstitution of deficient T cells with either calcineurin Aα or Aβ restores TCR microcluster formation and signaling, as does reconstitution with a phosphatase-inactive Aα chain. These results assign a non-enzymatic adaptor function to calcineurin in the formation and stabilization of a functional TCR signaling complex.

The monolithically integrated self-driven photoelectric detector (PD) with the light-emitting diode (LED) epitaxial structure completely relies on the built-in electric field in the multi-quantum wells region to separate the photogenerated carriers. Here, we propose a novel superlattices–electron barrier layer structure to expand the potential field region and enhance the detection capability of the integrated PD. The PD exhibits a record-breaking photo-to-dark current ratio of 5.14 × 107, responsivity of 110.3 A/W, and specific detectivity of 2.2 × 1013 Jones at 0 V bias, respectively. A clear open-eyed diagram of the monolithically integrated chip, including the PD, LED, and waveguide, is realized under a high-speed communication rate of 150 Mbps. The obtained transient response (rise/decay) time of 2.16/2.28 ns also illustrates the outstanding transient response capability of the integrated chip. The on-chip optical communication system is built to achieve the practical video signals transmission application, which is a formidable contender for the core module of future large-scale photonic integrated circuits.

Background: Severe fever with thrombocytopenia syndrome (SFTS) is spreading rapidly in Asia. The pathway of SFTS virus shedding from patient and specific use of personal protective equipments (PPEs) against viral transmission have rarely been reported. The study was to determine SFTS virus (SFTSV) shedding pattern from the respiratory, digestive and urinary tract to outside in patients. Methods: Patients were divided into mild and severe groups in three sentinel hospitals for SFTS in Anhui province from April 2020 to October 2022. SFTSV level from blood, throat swabs, fecal/anal swabs, urine and bedside environment swabs of SFTS patients were detected by qRT-PCR. Specific PPEs were applied in healthcare workers contacting with the patients who had oropharyngeal virus shedding and hemorrhagic signs. Results: A total of 189 SFTSV-confirmed patients were included in the study, 54 patients died (case fatality rate, 28.57 %). Positive SFTSV in throat swabs (T-SFTSV), fecal/anal swabs (F-SFTSV) and urine (U-SFTSV) were detected in 121 (64.02 %), 91 (48.15 %) and 65 (34.4 %) severely ill patients, respectively. The levels of T-SFTSV, F-SFTSV and U-SFTSV were positively correlated with the load of SFTSV in blood. We firstly revealed that SFTSV positive rate of throat swabs were correlated with occurrence of pneumonia and case fatality rate of patients (P

Diagenetic physical simulation is a reliable means to study patterns of pore evolution and variations of physical properties, however, the current compaction model is mostly based on sandstone, and there is a lack of quantitative compaction and porosity reduction studies for more complex rock fabrics. In order to simulate the continuous change of intergranular porosity in the reservoir under compaction during the diagenesis of buried sedimentary strata, a self-designed diagenesis simulation experimental system was adopted. Using different modern sediment samples, the simulation experiment of mechanical compaction of glutenite was carried out. The experiment shows that during the process of mechanical compaction of glutenite, the change of porosity with depth is segmented, and there is a good logarithmic relationship between depth and porosity in the process of diagenetic compaction. The larger the grain size in the reservoir rock, the better the pore preservation capacity; When the sand particles fill the pores among gravel, stable secondary support structure formed by gravel and sand grades can effectively take over the bearing pressure, and when the sand-grade particle content is about 30%, the pressure-bearing capacity is the strongest; Intergranular heterobase filling is greater in samples with high heterobase content, high heterobasic content is not favourable to the preservation of primary pores. This study provides favorable experimental support for the preservation mechanism of deep clastic reservoir pores, and has important theoretical and practical significance for oil and gas exploration in the study area. The use of simulation experiment provides a useful idea for the evaluation and prediction of reservoirs and the search for favorable reservoir development zones in the future.

Summary: Blood microbiome signatures in patients with type 1 diabetes (T1D) remain unclear. We profile blood microbiome using 16S rRNA gene sequencing in 77 controls and 64 children with new-onset T1D, and compared it with the gut and oral microbiomes. The blood microbiome of patients with T1D is characterized by increased diversity and perturbed microbial features, with a significant increase in potentially pathogenic bacteria compared with controls. Thirty-six representative genera of blood microbiome were identified by random forest analysis, providing strong discriminatory power for T1D with an AUC of 0.82. PICRUSt analysis suggested that bacteria capable of inducing inflammation were more likely to enter the bloodstream in T1D. The overlap of the gut and oral microbiome with the blood microbiome implied potential translocation of bacteria from the gut and oral cavity to the bloodstream. Our study raised the necessity of further mechanistic investigations into the roles of blood microbiome in T1D.

BackgroundA high-fat diet (HFD) contributes to various metabolic disorders and obesity, which are major contributors to cardiovascular disease. As an essential regulator for heart homeostasis, cardiac resident macrophages may go awry and contribute to cardiac pathophysiology upon HFD. Thus, to better understand how HFD induced cardiac dysfunction, this study intends to explore the transcriptional and functional changes in cardiac resident macrophages of HFD mice.MethodsC57BL/6J female mice that were 6 weeks old were fed with HFD or normal chow diet (NCD) for 16 weeks. After an evaluation of cardiac functions by echocardiography, mouse hearts were harvested and cardiac resident CCR2- macrophages were sorted, followed by Smart sequencing. Bioinformatics analysis including GO, KEGG, and GSEA analyses were employed to elucidate transcriptional and functional changes.ResultsHyperlipidemia and obesity were observed easily upon HFD. The mouse hearts also displayed more severe fibrosis and diastolic dysfunction in HFD mice. Smart sequencing and functional analysis revealed metabolic dysfunctions, especially lipid-related genes and pathways. Besides this, antigen-presentation-related gene such as Ctsf and inflammation, particularly for NF-κB signaling and complement cascades, underwent drastic changes in cardiac resident macrophages. GO cellular compartment analysis was also performed and showed specific organelle enrichment trends of the involved genes.ConclusionDysregulated metabolism intertwines with inflammation in cardiac resident macrophages upon HFD feeding in mice, and further research on crosstalk among organelles could shed more light on potential mechanisms.

Microplastic (MP) pollution has become a global environmental issue, and increasing concern has been raised about its impact on human health. Current studies on the toxic effects and mechanisms of MPs have mostly been conducted in animal models or in vitro cell cultures, which have limitations regarding inter-species differences or stimulation of cellular functions. Organoid technology derived from human pluripotent or adult stem cells has broader prospects for predicting the potential health risks of MPs to humans. Herein, we reviewed the current application advancements and opportunities for different organoids, including brain, retinal, intestinal, liver, and lung organoids, to assess the human health risks of MPs. Organoid techniques accurately simulate the complex processes of MPs and reflect phenotypes related to diseases caused by MPs such as liver fibrosis, neurodegeneration, impaired intestinal barrier and cardiac hypertrophy. Future perspectives were also proposed for technological innovation in human risk assessment of MPs using organoids, including extending the lifespan of organoids to assess the chronic toxicity of MPs, and reconstructing multi-organ interactions to explore their potential in studying the microbiome-gut-brain axis effect of MPs.

Abstract The theories for substrate recognition in enzyme catalysis have evolved from lock-key to induced fit, then conformational selection, and conformational selection followed by induced fit. However, the prevalence and consensus of these theories require further examination. Here we use cryogenic electron microscopy and African swine fever virus type 2 topoisomerase (AsfvTop2) to demonstrate substrate binding theories in a joint and ordered manner: catalytic selection by the enzyme, conformational selection by the substrates, then induced fit. The apo-AsfvTop2 pre-exists in six conformers that comply with the two-gate mechanism directing DNA passage and release in the Top2 catalytic cycle. The structures of AsfvTop2-DNA-inhibitor complexes show that substantial induced-fit changes occur locally from the closed apo-conformer that however is too far-fetched for the open apo-conformer. Furthermore, the ATPase domain of AsfvTop2 in the MgAMP-PNP-bound crystal structures coexist in reduced and oxidized forms involving a disulfide bond, which can regulate the AsfvTop2 function.

Abstract Senescence of vascular smooth muscle cells (VSMCs) contributes to aging-related cardiovascular diseases by promoting arterial remodelling and stiffness. Ferroptosis is a novel type of regulated cell death associated with lipid oxidation. Here, we show that pro-ferroptosis signaling drives VSMCs senescence to accelerate vascular NAD+ loss, remodelling and aging. Pro-ferroptotic signaling is triggered in senescent VSMCs and arteries of aged mice. Furthermore, the activation of pro-ferroptotic signaling in VSMCs not only induces NAD+ loss and senescence but also promotes the release of a pro-senescent secretome. Pharmacological or genetic inhibition of pro-ferroptosis signaling, ameliorates VSMCs senescence, reduces vascular stiffness and retards the progression of abdominal aortic aneurysm in mice. Mechanistically, we revealed that inhibition of pro-ferroptotic signaling facilitates the nuclear-cytoplasmic shuttling of proliferator-activated receptor-γ and, thereby impeding nuclear receptor coactivator 4-ferrtin complex-centric ferritinophagy. Finally, the activated pro-ferroptotic signaling correlates with arterial stiffness in a human proof-of-concept study. These findings have significant implications for future therapeutic strategies aiming to eliminate vascular ferroptosis in senescence- or aging-associated cardiovascular diseases.

Background: There is limited literature guiding the prescribing of direct oral anticoagulants (DOACs) early after cardiac surgery as this population has been excluded from landmark randomized controlled trials. This study aims to determine the rate of in-hospital DOAC use compared with warfarin early after cardiac surgery, evaluate factors associated with DOAC use, determine difference in postoperative length of stay, and characterize bleeding events. Methods: A retrospective cohort study was conducted in adult patients with indications for anticoagulation and receiving either a DOAC or warfarin after cardiac surgery during their index hospitalization. Patients were excluded if they had any contraindications to DOAC use. The primary outcome was the proportion of patients discharged on a DOAC compared with warfarin. Results: Of included 210 patients, 30% received DOACs and 70% received warfarin on discharge. The most common DOAC used was apixaban (74.6%), and median postoperative day of initiation was 5 days. Patients receiving DOACs were older (70.8 vs 68.0 years), had less valvular heart disease (38.1% vs 63.9%), were more likely to be on DOACs preoperatively (50.8% vs 31.3%), and were more likely to have undergone coronary artery bypass graft alone (54.0% vs 24.5%) compared with those on warfarin. Postoperative length of stay (7 vs 9 days; P = 0.59) and in-hospital bleeding (1.6% vs 2.0%; P = 1.00) did not differ between DOAC and warfarin groups. Conclusions: At a quaternary referral centre for cardiac surgery, DOACs were used in approximately one-third of patients with an indication for anticoagulation early after cardiac surgery. Résumé: Introduction: Il existe peu de documentation sur la prescription des anticoagulants oraux directs (AOC) peu de temps après la chirurgie cardiaque puisque cette population a été exclue des essais cliniques novateurs à répartition aléatoire. La présente étude vise à déterminer le taux d’utilisation des AOC à l’hôpital par rapport au taux d’utilisation de la warfarine peu de temps après la chirurgie cardiaque, à évaluer les facteurs associés à l’utilisation des AOC, à déterminer l’écart de la durée du séjour et à caractériser les événements hémorragiques. Méthodes: Nous avons réalisé une étude de cohorte rétrospective auprès de patients adultes qui avaient des indications d’anticoagulation et qui recevaient des AOC ou de la warfarine après la chirurgie cardiaque durant l’hospitalisation de référence. Les patients étaient exclus s’ils avaient des contre-indications à l’utilisation des AOC. Le critère d’évaluation principal était la proportion de patients sortis de l’hôpital sous AOC par rapport à celle des patients sortis de l’hôpital sous warfarine. Résultats: Parmi les 210 patients inclus, 30 % ont reçu des AOC et 70 % ont reçu de la warfarine à la sortie de l’hôpital. L’AOC le plus fréquemment utilisé était l’apixaban (74,6 %), et le nombre médian de jours après l’intervention chirurgicale du début du traitement était 5 jours. Les patients qui recevaient les AOC étaient plus âgés (70,8 vs 68,0 ans), avaient moins de cardiopathies valvulaires (38,1 % vs 63,9 %), étaient plus susceptibles de recevoir des AOC avant l’opération (50,8 % vs 31,3 %) et étaient plus susceptibles d’avoir seulement subi un pontage aorto-coronarien (54,0 % vs 24,5 %) que ceux sous warfarine. La durée du séjour postopératoire (7 vs 9 jours ; P = 0,59) et les événements hémorragiques à l’hôpital (1,6 % vs 2,0 % ; P = 1,00) ne différaient pas entre les groupes qui recevaient les AOC et les groupes qui recevaient la warfarine. Conclusions: Dans un centre d’aiguillage de soins quaternaires en chirurgie cardiaque, les AOC ont été utilisés chez environ un tiers des patients qui avaient une indication d’anticoagulation peu de temps après la chirurgie cardiaque.

Glaucoma is a group of diseases characterized by progressive optic nerve damage, ultimately resulting in irreversible visual impairment. Early diagnosis through color fundus photography, including measurement of the vertical cup-to-disk ratio (CDR), can help prevent vision loss. The normal range of CDR values is usually 0.3-0.5, and if it exceeds 0.6, then there may be some problems. However, asymmetrical thinning at the edges of the bottom-superior temporal-nasal region and large gaps in datasets pose challenges for existing automatic segmentation methods. To address these challenges, this paper proposes a joint segmentation method for the optic disc (OD) and optic cup (OC) based on an adversarial network, incorporating new monitoring functions to guide the network optimization process. The effectiveness and stability of this framework were evaluated using two public performance datasets of retinal fundus images, namely Drishti-GS and REFUGE. On the Drishti-GS dataset, our method achieved a score of 0.850/0.964/0.086, while on the REFUGE dataset, it obtained a score of 0.887/0.975/0.061. These results indicate the effectiveness of our approach.

Highlights Low pH value of electrolyte suppresses the charge capabilities of electrolytic Zn–Mn batteries. Unique solid phase alkaline properties of zinc sulfate hydroxide hydrate endow the electrolytic Zn–Mn batteries with greatly enhanced charge capabilities. The highly active Zn2Mn3O8·H2O nanorods array deposited during the charge process improve the discharge efficiency and stability of electrolytic Zn–Mn batteries.

Abstract The disaster caused by landslide is huge. To prevent the spread of the disaster to the maximum extent, it is particularly important to carry out landslide disaster treatment work. The selection of landslide disaster treatment alternative is a large scale group decision-making (LSGDM) problem. Because of the wide application of social media, a large number of experts and the public can participate in decision-making process, which is conducive to improving the efficiency and correctness of decision-making. A IF-TW-LSGDM method based on three-way decision (TWD) and intuitionistic fuzzy set (IFS) is proposed and applied to the selection of landslide treatment alternatives. First of all, considering that experts and the public participate in the evaluation of LSGDM events, respectively, the method of obtaining and handling the public evaluation information is given, and the information fusion approach of the public and experts evaluation information is given. Second, evaluation values represented by fuzzy numbers are converted into intuitionistic fuzzy numbers (IFNs), and the intuitionistic fuzzy evaluation decision matrix described by IFNs is obtained. Then, a new LSGDM method of alternatives classification and ranking based on IFS and TWD is proposed, the calculation steps and algorithm description are given. In this process, we first cluster the experts, then consider the identification and management of non-cooperative behavior of expert groups. This work provides an effective method based on LSGDM for the selection of landslide treatment alternatives. Finally, the sensitivity of parameters is analyzed, and the feasibility and effectiveness of this method are compared and verified.

Abstract Background Foreign bodies (FBs) are a common emergency in medical institutions, that can occur in any area and among people of any age, which are common public health problems. Understanding the epidemiological characteristics of FBs is crucial for their prevention and control. The purpose of this study was to analyze the epidemiological characteristics of FBs worldwide through the data from the Global Burden of Disease Study 2019 (GBD 2019). Methods We obtained data from the GBD 2019, which is an important public database to understand the disease burden of FBs. Joinpoint was used to analyze temporal trends in the incidence and death trends of FBs, which is widely used to study the long-term temporal trend of the burden of diseases. SaTScan was used to detect spatial-temporal clusters of pulmonary aspiration and foreign body in the airway (PAFBA), which is based on a Poisson model, scanning the number of people and diseases in the study area to obtain the spatial-temporal clusters of diseases. Results Globally, the age-standardized incidence rate (ASIR) and the age-standardized death rate (ASDR) of FBs in 2019 were 869.23/100,000 (679.92/100,000-1120.69/100,000) and 1.55/100,000 (1.41/100,000-1.67/100,000), respectively. The ASIR and ASDR showed downtrends with average annual percent changes (AAPCs) of -0.31% and − 1.47% from 1990 to 2019. Of note, the ASIR showed an uptrend during 2010–2019, especially in high, high-middle, and middle SDI regions. Stratified analysis by age group showed that ASIR increased in each age group in recent years. From 1990 to 2019, the ASDR in the over-70 age group showed an uptrend worldwide, especially in high and high-middle SDI regions. In different types of FBs, the ASDR of PAFBA was the highest. The death burden of PAFBA was mainly clustered in 82 countries during 1993–2007, such as Canada, Cuba, and Mexico. Conclusion The most important goal is to improve public awareness and emergency knowledge of FBs through publicity methods, such as the internet or offline activities, and to improve laws and regulations. Additionally, different age groups need different targeted measures, such as strengthening the care of children, caring for elderly individuals, improving necessary monitoring programs and reporting systems, conducting effective hazard assessments, and publicity and education activities.

Sampling density and depth play crucial roles in three-dimensional (3D) soil modeling and prediction, particularly in digital soil mapping (DSM). However, previous studies have yielded inconsistent and even contradictory results regarding impacts of sampling density and depth on the accuracy of 3D DSM. Hence, this study aimed to evaluate the impacts of sampling depth, vertical sampling density and lateral profile density on 3D soil mapping accuracy based on a case study of soil organic carbon (SOC). To achieve this, a comprehensive analysis was conducted based on 511 soil samples collected from 111 profiles in a local hilly area spanning 5.52 km2 in China. A 3D regression geostatistical approach was employed for the analysis. The results revealed that samples taken from different depth intervals exhibited varying degrees of importance in relation to prediction accuracy. Notably, a reduced number of surface soil samples (0–0.3 m) led to significant fluctuations in the accuracy of predictions for the entire soil profile. Furthermore, a lower number of subsurface soil samples (0.3–0.6 m) also diminished the overall prediction accuracy, while the influence of deeper soil samples (0.6–1.2 m) on the overall accuracy was relatively less pronounced. Reducing the number of profiles for calibration led to significantly worse and more variable prediction accuracy, compared to reducing vertical samples. For 3D mapping, this study recommends prioritizing the collection of additional lateral profiles, specifically focusing on surface and subsurface soils, especially for properties that display vertical variation similar to SOC.

Bispecific T-cell-engaging antibodies are a growing class of therapeutics with numerous molecules being tested in clinical trials and, currently, seven of them have received market approval. They are structurally complex and function as adaptors to redirect the cytotoxicity of T cells to kill tumor cells. T-cell-engaging bispecific antibodies can be generally divided into two categories: IgG/IgG-like and non-IgG-like formats. Different formats may have different intrinsic potencies and physiochemical properties, and comprehensive studies are needed to gain a better understanding of how the differences in formats impact on structural and functional characteristics. In this study, we designed and generated bispecific T-cell-engaging antibodies with IgG-like (DVD-Ig) and non-IgG (BiTE) formats. Both target the same pair of antigens (EGFR and CD3) to minimize the possible influence of targets on functional characterization. We performed a side-by-side comparison to assess differences in the physiochemical and biological properties of these two bispecific T-cell-engaging antibodies using a variety of breast and ovarian cancer cell-based functional assays to delineate the structural–functional relationships and anti-tumor activities/potency. We found that the Fc portion of T-cell-engaging bispecific antibodies can significantly impact antigen binding activity, potency, and stability in addition to eliciting different mechanisms of action that contribute the killing of cancer cells.

Neurodegeneration with brain iron accumulation (NBIA) is a clinically and genetically heterogeneous disease characterized by increased iron deposition in the basal ganglia and progressive degeneration of the nervous system in adulthood. However, in early childhood, there were no characteristic features to perform early diagnosis. In our study, a female child exhibited global developmental delay, intellectual disability, and febrile seizure without other distinct clinical phenotypes. Through whole exome sequencing (WES), a de novo nonsense mutation (c.726C > G, p. Tyr242Ter) of WDR45 gene was identified in this child. She was finally diagnosed as β‐propeller protein-associated neurodegeneration (BPAN), one of the recently identified subtypes of NBIA. This mutation could act as a premature stop codon (PSC) which rendered the mutated transcripts to be degraded by nonsense-mediated mRNA decay (NMD), leading to decreased levels of PSC-containing mRNAs. Additionally, through mini-gene splicing assays, this mutation could result in an unprecedented novel transcript with the exon 9 of WDR45 excluded by nonsense-associated splicing alteration (NASA). Transcriptome sequencing (RNA-seq) on total RNAs from PBMCs of the trio revealed three types of alternative splicing events in the patient. Further research implied that downregulation of iron transport genes (TFRC, TFR2, SCARA5) might be the underlying mechanism for the iron accumulation in patients with deficient WDR45. This is the first report about NASA happening in WDR45. It implies that nonsense mutations approximal to splicing sites could affect the disease pathogenesis through more than one molecular mechanism and should be taken into consideration when conducting genetic counseling.

Gypenosides (Gyp) are bioactive components of Gynostemma pentaphyllum that have a variety of pharmacological properties. Extracts of G. pentaphyllum have been found to be effective in the reduction of blood sugar and lipids and prevention of atherosclerosis. Here, the functions of Gyp and the mechanisms underlying their effects on atherosclerosis were investigated. Mice were allocated to three groups, namely, the control (C57BL/6), atherosclerosis model (ApoE−/− mice with high-fat diet), and Gyp-treated groups. Differentially expressed mRNAs, miRNAs, circRNA, and differential metabolites among the groups were analyzed. The results showed that “Fatty acid metabolism”, “Fatty acid elongation”, “Cytokine-cytokine receptor interaction”, and “PI3K-Akt signaling pathway”, amongst others, were involved in treatment process. Differentially expressed genes, including Fabp1, Apoe, FADS1, ADH1, SYNPO2, and Lmod1were also identified. Mmu-miR-30a and mmu-miR-30e showed reduced expression in atherosclerosis models but were increased following Gyp treatment, suggesting involvement in the effects of Gyp. In addition, chr5:150604177-150608440 were found to interact with mmu-miR-30a and mmu-miR-30e to regulate their abundance. In terms of metabolomics, Gyp may regulate biological processes involving PGD2 and PGJ2, potentially alleviating atherosclerosis. In conclusion, Gyp appeared to have complex effects on atherosclerosis, most of which were positive. These results support the use of Gyp in the treatment of atherosclerosis.

Increasing demands for livestock products have stimulated rapid increases in the number of livestock and the scale of farming, thus increasing pressure on resources and the environment. Coordinating the development of livestock production (LP) with residential consumption (RC), resources and the environmental carrying capacity (RECC) is important to ensure sustainable development. In this study, the entropy weight method and the improved-coupling coordination degree (CCD) model were used to identify the spatial–temporal coordination development characteristics of livestock production-residential consumption-resource and environmental carrying capacity (LRRE). Furthermore, the spatial autocorrelation model (SAM) and gray model (GM) were used to analyze the spatial aggregation characteristics and future development trends of the CCDs of the LRRE in China. The findings show that the CCDs of the LRRE values in 31 Chinese provinces increased from 2005 to 2020, but no provinces reached a high coordination level. Specifically, the coordinated development level of LRRE is relatively high in the central, eastern and northeastern regions and relatively low in the western region. The spatial autocorrelation analysis confirmed that the high-high (H-H) aggregation areas were mainly distributed in the northeastern, eastern, and central regions, while low-high (L-H) agglomeration was distributed in the western region. This phenomenon is mainly attributed to the continuous expansion of the scale of livestock production in western China. Regions with relatively developed economies have more funds to invest in environmental protection projects. Using GM method, we find that the CCDs of LRRE in 31 provinces in China will increase from 2021 to 2030, and all provinces will reach the basic coordination level. However, most of the western regions will barely reach the basic coordination level. This result indicates that the low level of LRRE development in western China may be difficult to change in the short term. The level of coordinated LRRE development in the relatively developed eastern region is increasing. The spatial layout of China’s livestock industry should be appropriately adjusted, its expansion rate in the western region should be decreased, and the ecological environment of the areas bordering the western and central regions should be improved. These findings have practical implications for other large livestock production countries. Promoting the coordinated development of LRRE is also an important condition for agricultural transformation in developing countries, especially for improving the environment in key areas of the livestock industry.

Abstract Recent findings have shown that the level of interleukin‐35 (IL‐35) is abnormal in several autoimmune diseases. Nonetheless, whether IL‐35 participates in the pathogenesis of immune thrombocytopenia (ITP) remains unclear. The current study investigates whether IL‐35 modulates megakaryopoiesis. The results show that IL‐35 receptors are progressively expressed on bone marrow megakaryocytes during the in vitro differentiation of CD34+ progenitors. IL‐35 increases the number of megakaryocyte colony‐forming units through the Akt pathway. The level of bone marrow IL‐35 is reduced in ITP patients, and the decreased level of IL‐35 may inhibit megakaryopoiesis. Then, the potential causes of decreased IL‐35 in ITP patients are explored. The primary type of cell that secretes IL‐35, known as IL‐35‐producing regulatory T cells (iTr35), is reduced in ITP patients. Bone marrow mesenchymal stem cells (MSCs) from ITP patients exhibit an impaired capability of inducing iTr35 due to enhanced apoptosis, which may contribute to the reduced level of bone marrow IL‐35 in ITP patients. Iguratimod promotes megakaryocyte development and differentiation by elevating the expression of IL‐35 receptors on megakaryocytes. Iguratimod improves response rates and reduces bleeding symptoms in corticosteroid‐resistant ITP patients.

Objective To investigate the correlations between multigene alterations and clinicopathological features in papillary thyroid carcinoma (PTC) samples. Methods In this retrospective study, 111 cytological specimens of thyroid nodules, including 74 PTC samples and 37 benign samples, were analyzed using a 22-gene mutation assay employing next-generation sequencing. Clinicopathological information was retrospectively collected and analyzed. Results Gene alterations were associated with a higher rate of lymph node metastasis (LNM) and thyroid capsular invasion, a lower rate of coexisting Hashimoto's thyroiditis, the classical PTC subtype, and younger age (

Purpose: Postoperative pain is prevalent and severe complication in elderly surgical patients. Multiple studies propose that a small dose of esketamine administered intraoperatively can alleviate postoperative pain and curtail opioid usage. We aimed to evaluate the impact of esketamine on postoperative acute pain among elderly patients with gastrointestinal tumors. Patients and methods: This is a prospective, parallel-group, randomized controlled trial. Ninety patients aged 60 and above, undergoing resection of gastrointestinal tumors, were randomly assigned to two groups: esketamine group (Group S, a single dose of 0.25 mg/kg and 0.1 mg/kg/h infusion) and control group (Group C, saline). Visual Analogue Scale (VAS) pain scores were the primary outcome. Remifentanil consumption, instances of rescue analgesia, delirium, sleep quality, postoperative recovery quality, serum levels of inflammatory cytokines, and adverse events within 72 h post-surgery were secondary outcomes, respectively. Results: Data of 87 of 99 eligible patients were analyzed. VAS scores at rest in Group S were lower than those in Group C at 6 h [1.2 (0.6, 1.6) vs 1.6 (1.0, 2.0), P = 0.003], 12 h [1.4 (1.0, 2.0) vs 2.0 (1.5, 2.0), P