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Yiqin Xia,1– 3 Hongyu Long,4 Qiang Lai,1– 3 Yiwu Zhou1– 3 1Emergency Department, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 2Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 3Disaster Medical Center, Sichuan University, Chengdu, Sichuan, People’s Republic of China; 4Department of Critical Care Medicine, Chengdu First People’s Hospital, Chengdu, Sichuan, People’s Republic of ChinaCorrespondence: Yiwu Zhou, Emergency Department, West China Hospital of Sichuan University, Chengdu, Sichuan, People’s Republic of China, Email 456zyw@163.comObjective: Acute pancreatitis (AP) progresses to septic shock can be fatal. Early identification of high-risk patients and timely intervention can prevent and interrupt septic shock. By analyzing the clinical characteristics of AP with sepsis, this study uses machine learning (ML) to build a model for early prediction of septic shock within 28 days of admission, which guided emergency physicians in resource allocation and medical decision-making.Methods: This retrospective cohort study collected data from the emergency departments (EDs) of three tertiary care hospitals in China. The dataset was randomly divided into a training dataset (70%) and a testing dataset (30%). Ten ML classifiers were utilized to analyze characteristics of AP with sepsis in the training dataset upon admission. Results were evaluated through cross-validation analysis. The optimal model was then tested on the testing dataset without any parameter modifications. The ML model was evaluated using the receiver operating characteristic curve (ROC) and compared to scoring systems through the DeLong test.Results: A total of 604 AP patients with sepsis were included in this study. The auto-encoder (AE) model based on mean normalization, Pearson correlation coefficient (PCC), and recursive feature elimination (RFE) selection, achieved the highest Area Under the Curve (AUC) on the validation dataset (AUC 0.900, accuracy 0.868), with the AUC of 0.879 and accuracy of 0.790 on the testing dataset. Compared to the Sequential Organ Failure Assessment (AUC 0.741), quick Sequential Organ Failure Assessment (AUC 0.727), Acute Physiology and Chronic Health Evaluation II (AUC 0.778), and Bedside Index of Severity in Acute Pancreatitis (AUC 0.691), the AE model showed superior performance.Conclusion: The AE model outperforms traditional scoring systems in predicting septic shock in AP patients with sepsis within 28 days of admission. This assists emergency physicians in identifying high-risk patients early and making timely medical decisions.Keywords: machine learning, acute pancreatitis, sepsis, septic shock

Background: Primary pulmonary diffuse large B-cell lymphoma (PP-DLBCL) is a rare extranodal non-Hodgkin's lymphoma (EN-NHL). Its prognosis as an aggressive lymphoma is abysmal, and predictive models are still lacking., Methods: We screened patients diagnosed with PP-DLBCL between 2010 and 2019 from the Surveillance, Epidemiology, and End Results (SEER) database. Then, univariate and multivariate COX regression analyses were used to identify independent risk factors affecting patient prognosis. Finally, a novel nomogram was constructed and the model was evaluated by looking at three dimensions., Results: A total of 831 patients were included in this study. Most of the patients were elderly (526 (63.8%)) and female (428 (51.9%)). The included patients were randomized in a 7:3 ratio into a training group (577 (70%)) and a validation group (248 (30%)). We concluded that the independent risk factors of prognosis were age, extrapulmonary metastasis, radiotherapy, chemotherapy, and surgical intervention. The results of receiver operating characteristic curves, calibration curves, and decision curve analysis in the training and validation groups confirmed that the risk prediction nomogram could accurately predict the survival of PP-DLBCL., Conclusion: This study is the first large population-based clinical data study on PP-DLBCL. A novel predictive model about prognosis has been developed to help clinical decision-making.

Background: The effect of transcatheter aortic valve replacement (TAVR) on changes of computed tomography-derived fractional flow reserve (CT-FFR) values was controversial. Thus, we aimed to identify the impact of TAVR on changes of CT-FFR values, plaque characteristics, and the associated clinical impact., Methods: This single-center observational study included 39 consecutive patients with severe aortic valve disease undergone TAVR between August 2019 and April 2023, whom were performed with preoperative and postoperative coronary CT angiography (CCTA). The computation of CT-FFR and plaque characteristics was performed by an independent central core laboratory., Results: Each patient underwent CCTA and CT-FFR assessment without encountering any complications. Notably, both at discharge and six months post-TAVR, there was a significant improvement observed in the New York Heart Association (NYHA) functional classification, left ventricular fractional shortening, and ejection fraction compared to pre-operative levels. The CT-FFR for left anterior descending artery (LAD), left anterior descending artery (LCX), and right coronary artery (RCA) had no obvious change at discharge compared to pre-operation (0.92 ± 0.05 vs. 0.93 ± 0.05, p  = 0.109; 0.96 ± 0.03 vs. 0.95 ± 0.03, p  = 0.523; 0.97 ± 0.04 vs. 0.97 ± 0.03, p  = 0.533; respectively). Furthermore, TAVR did not exert a significant impact on plaque burden during the perioperative period., Our report suggested that TAVR did not significantly affect coronary CT-FFR measurements and plaque characteristics in the perioperative period, and furthermore, the patients' cardiac function showed gradual improvement in the short-term following discharge.

Autographa californica nucleopolyhedrovirus orf89 (vp39) encodes the major capsid protein VP39. Multiple alignments of protein sequences showed that VP39 has 8 conserved cysteine (Cys) residues. Cysteine residues play an important role in proper function of a protein. To determine the importance of these conserved cysteine residues for virus proliferation, a series of recombinant viruses harboring VP39-Cys mutants were constructed. Viral growth curves and transmission electron microscopy showed that mutation of Cys29, Cys132, Cys169, Cys229, or Cys232 of VP39 to alanine did not affect budded virion production; however, the mutation of Cys18, Cys36, or Cys49 to alanine resulted in interruption of capsid assembly. Co-immunoprecipitation assays showed that mutations of these 8 cysteines individually or simultaneously had no effect on self-association of VP39. Immunofluorescence analysis by confocal microscopy revealed that the subcellular localization of VP39 with mutations in Cys18, Cys36 or Cys49 was exclusively distributed in the cytoplasm of a cell regardless of virus infection or not, while the wild-type VP39 or the VP39 carrying mutations in Cys29, Cys132, Cys169, Cys229, or Cys232 was distributed throughout the cytoplasm and the nucleus. Our results demonstrated that Cys18, Cys36, and Cys49 are essential for the proper localization of VP39, which is a prerequisite for successful nucleocapsid assembly of the virus., Competing Interests: Declarations Competing interests The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Nanoplastics (NPs) are widely distributed in the aquatic environment and have become a global concern as a new type of pollutant. Many researchers have studied the physiological effects of NPs on aquatic organisms, but relatively little is known about their effects on intestinal immune function in crustaceans. Therefore, we used NPs concentrations of 0, 5, 10, 20, 40 mg/L for 28 days of stress, evaluated the effects of NPs exposure on intestinal cell apoptosis, histopathological damage, and glutathione (GSH) metabolism of juvenile East Asian river prawns (Macrobrachium nipponense). As NPs concentration increased, the contents of total GSH and oxidized glutathione decreased gradually (P < 0.05), the concentration of GSH first increased and then decreased (P < 0.05), and the activities of lysozyme, acid phosphatase, phenoloxidase, and alkaline phosphatase first increased and then decreased (P < 0.05). Additionally, intestinal tissue structure was damaged, and the apoptosis rate significantly increased (P < 0.05). The expression of intestinal autophagy genes (CTL, ALF, Crustin, ATG8, and BCL-2) increased at first and then decreased, the expression levels of TNF and Wnt4 significantly decreased, and the expression of Beclin significantly increased with increasing NPs concentration. We also found that AP-1 and PTEN were highly expressed in the hepatopancreas and were involved in intestinal immune responses. Our results showed that exposure to NPs may induce apoptosis of intestinal tissue cells, induce autophagy, and inhibit GSH metabolism, thereby reducing intestinal immune function of M. nipponense. These findings provide a reference for healthy aquaculture and ecological risk assessment of prawns., Competing Interests: Declaration of competing interest We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled, “Polystyrene nanoplastics induce apoptosis, histopathological damage, and glutathione metabolism disorder in the intestine of juvenile East Asian river prawns (Macrobrachium nipponense)”., (Copyright © 2024 Elsevier B.V. All rights reserved.)

5-Aminolevulinic acid (5-ALA) is an endogenous non-protein amino acid and has been used as a new type of growth promoter in aquaculture feed. This study explored the effects of 5-ALA on growth and intestinal health in juvenile shrimp, Litopenaeus vannamei. Shrimps were fed diets containing five different 5-ALA levels (0, 15, 30, 45, and 60 g/t) for 90 days. A concentration of 45 g/t 5-ALA significantly improved growth metrics, including the specific growth rate, protein efficiency, and feed conversion (P < 0.05). The optimal concentration of 5-ALA was 38.3 g/t, as indicated by broken-line regression. Dietary supplementation with 5-ALA increased the crude protein content of whole shrimp, but had no significant effect on the moisture, ash, or crude lipid content (P > 0.05). Suitable supplementation of 5-ALA (45 g/t, 60 g/t) improved the activities of the digestive enzymes alpha-amylase, pepsin, trypsin, and lipase, thus promoting digestion and absorption. Shrimp fed with 45 g/t 5-ALA had increased levels of essential amino acids in the muscles and a higher proportion of polyunsaturated fatty acids in the hepatopancreas. Supplementation with 45 or 60 g/t 5-ALA upregulated the expression of genes related to growth and molting, including chitinase, ecdysone receptor, retinoic X receptor, calcium/calmodulin-dependent protein kinase I, heat shock protein 60, and heat shock protein 70. Moreover, dietary supplementation with 5-ALA affected the abundance of intestinal flora, increased the number of beneficial bacteria, and improved intestinal health. These results indicated that 5-ALA may significantly benefit shrimp health and aquaculture productivity, providing a novel theoretical basis for further research into 5-ALA as a dietary supplement., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Antibody-drug conjugates (ADCs) have emerged as a novel class of targeted cancer therapies and been successfully applied in the treatment of breast cancer (BC). Discoidin domain receptor 1 (DDR1) is a single transmembrane receptor tyrosine kinase and has been identified as a possible target for cancer. In this study, we explored the potential of an anti-DDR1 ADC, named T 4 H 11 -DM4, for the treatment of DDR1-positive BC. We demonstrated that high protein expression and RNA expression of DDR1 in BC tissues. In vitro , T 4 H 11 -DM4 was potently cytotoxic to DDR1-expressing BC cells, with IC50 in the nanomolar range. In mice BC xenograft models, T 4 H 11 -DM4 dramatically eliminated BC tumours, without observable toxicity. Taken together, our findings demonstrated that DDR1 can serve as a promising therapeutic target for BC.

Objective: Hemodialysis catheter-related right atrial thrombus (CRAT) is a rare and fatal complication related with catheter. Treatment recommendations are controversial. We reported our institution's recent three cases in managing CRAT and review and analyze the reported cases of CRAT in hemodialysis patients., Methods: A systematic search of the PubMed, Embase and Web of Science databases was conducted to identify the therapy and outcome data in hemodialysis CRAT patients., Results: From 1975 to November 2023, a total of previous 144 cases which reported in the literatures and three new cases in our institution of CRAT in hemodialysis were included and analyzed. Overall mortality was 18.1% (26/144). Most of cases can be detected by echocardiography. Thirty-three patients had no treatment, except for catheter removal, replacement or antibiotics, but eleven of them have died. Thrombolytic therapy was adopted in 14 cases but only nine cases was successful, the remaining cases need to further therapy. Eventually, 71 cases have been treated by anticoagulation and 34 cases received thrombectomy., Conclusions: We recommend that the replacement of the catheter and anticoagulation combined with thrombolysis is a preferred therapy. Thrombectomy should be considered when other methods fail or new complication happened. Thrombolysis alone has a low success rate but may be useful in combination with anticoagulant therapy., Competing Interests: Declarations Ethics approval and consent to participate The case was approved by the Human Ethics Committee of the First Affiliated Hospital of Chongqing Medical University (Number:2023 − 315). Consent for publication The patient provided written informed consent. Clinical trial number Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Electrolyte chemistry regulation is a feasible and effective approach to achieving a stable electrode-electrolyte interface. How to realize such regulation and establish the relationship between the liquid-phase electrolyte environment and solid-phase electrode remains a significant challenge, especially in solid electrolyte interphase (SEI) for metal-ion batteries. In this work, solvent/anion steric hindrance is regarded as an essential factor in exploring the electrolyte chemistry regulation on forming ether-based K + -dominated SEI interface through the cross-combination strategy. Theoretical calculation and experimental evidence have successfully indicated a general principle that the combination of increasing solvent steric hindrance with decreasing anion steric hindrance indeed prompts the construction of an ideal anion-rich sheath solvation structure and guarantees the cycling stability of antimony-based alloy electrode (Sb@3DC, Sb nanoparticles anchored in three-dimensional carbon). These confirm the critical role of electrolyte modulation based on molecular design in the formation of stable solid-liquid interfaces, particularly in electrochemical energy storage systems.

Proton-conducting metal-organic frameworks (MOFs) have attracted tremendous attention for their promising application in proton-exchange membrane fuel cells. Water clusters play an extremely important role in the proton-conduction process and affect the proton conductivity of host materials. To date, the close-packing effect of water clusters within pores on proton conductivity due to the amorphous structure of commercial proton-exchange membranes is unclear. Herein, we prepared two crystalline MOFs containing different water clusters, namely, [Sm 2 (fum) 3 (H 2 O) 4 ]·3H 2 O (Sm-fum-7H 2 O) and [Er 2 (fum) 3 (H 2 O) 4 ]·8H 2 O (Er-fum-12H 2 O) (H 2 fum = fumaric acid), and regulated their proton conductivities by changing the water clusters. As expected, Sm-fum-7H 2 O showed a high proton conductivity of 6.89 × 10 -4 S cm -1 at 333 K and ∼97% RH because of the close packing of the water clusters within the pores triggered by a lanthanide contraction effect, outperforming that of Er-fum-12H 2 O and some previously reported MOFs. Additionally, Sm-fum-7H 2 O and Er-fum-12H 2 O demonstrated high dielectric functions, reaching 2.22 × 10 3 and 1.42 × 10 5 at 10 2.5 Hz, respectively, making Er-fum-12H 2 O a highly dielectric material. More importantly, broadband dielectric spectroscopy measurements indicated that there was a dielectric relaxation process in Er-fum-12H 2 O with an activation energy of 0.59 eV. The present findings provide a better understanding of the crucial role of confined water clusters in proton conductivity and the novel phenomenon of the coexistence of proton conduction and dielectric relaxation in crystalline MOF materials.

The progress in neuroimaging and electrophysiological techniques has shown substantial promise in improving the clinical assessment of disorders of consciousness (DOC). Through the examination of both stimulus-induced and spontaneous brain activity, numerous comprehensive investigations have explored variations in brain activity patterns among patients with DOC, yielding valuable insights for clinical diagnosis and prognostic purposes. Nonetheless, reaching a consensus on precise neuroimaging biomarkers for patients with DOC remains a challenge. Therefore, in this review, we begin by summarizing the empirical evidence related to neuroimaging biomarkers for DOC using various paradigms, including active, passive, and resting-state approaches, by employing task-based fMRI, resting-state fMRI (rs-fMRI), electroencephalography (EEG), and positron emission tomography (PET) techniques. Subsequently, we conducted a review of studies examining the neural correlates of consciousness in patients with DOC, with the findings holding potential value for the clinical application of DOC. Notably, previous research indicates that neuroimaging techniques have the potential to unveil covert awareness that conventional behavioral assessments might overlook. Furthermore, when integrated with various task paradigms or analytical approaches, this combination has the potential to significantly enhance the accuracy of both diagnosis and prognosis in DOC patients. Nonetheless, the stability of these neural biomarkers still needs additional validation, and future directions may entail integrating diagnostic and prognostic methods with big data and deep learning approaches., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Borayflo Haemostatic matrix is a new absorbable hemostatic gelatin matrix which can be used for intraoperative assisted hemostasis. In a prospective, multicenter, non-inferiority, randomized controlled trial, a total of 354 subjects were recruited from the departments of hepatobiliary surgery, obstetrics and gynaecology and orthopaedics of 4 hospitals and randomly allocated to test group (Borayflo Haemostatic matrix) or control group (Surgiflo Haemostatic matrix) in a 1:1 ratio. In the modified intention-to-treat population, 163 (93.14%) of 175 subjects in the test group versus 167 (94.89%) of 176 subjects in the control group successfully achieved hemostasis within 5 min (P > 0.05). Non-inferiority for effective rates of hemostasis at 5 min to Surgiflo Haemostatic matrix was shown in the study (treatment difference: -1.74% [95%CI, -6.70-3.22%] for modified intention-to-treat population). In terms of efficacy and safety, the new hemostatic gelatin matrix (Borayflo Haemostatic matrix) is equivalent to Surgiflo Haemostatic matrix. There was no significant difference in the incidence of AEs or SAEs between the test and control groups(P > 0.05). In addition, Borayflo Haemostatic matrix is a domestically produced haemostatic gelatin product, an advantage that will reduce the cost of surgical haemostasis for Chinese patients., (© 2024. The Author(s).)

An ideal biomimetic periosteum should have excellent biocompatibility to promote osteoclast adhesion and improve osseointegration, which is significant in promoting bone regeneration. In this work, a bionic artificial periosteum printed by the SLA-3D printing was prepared, consisting of a poly (ethylene glycol) diacrylate (PEGDA)/chitosan/tricalcium phosphate (TCP) fibrous layer and a gelatin methacryloyl (GelMA)/ammonium molybdate (Mo) cambium layer. Distinct surface characteristics were achieved on both sides of the biomimetic periosteum. Among them, the fibrous layer has high mechanical properties and low porosity, which is conducive to preventing the pulling of muscle tissues and the invasion of soft tissues. The cambium layer has a porous structure and bioactive factors that can effectively promote osteogenic differentiation of preosteoblasts. Combined with mild photothermal therapy triggered by NIR light, the biomimetic periosteum could promote bone regeneration at both the chemical and physical levels. This 3D-printed bilayer hydrogel can provide a promising strategy for preparing advanced tissue-engineered periosteum with excellent physical and bone regeneration properties., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

This study investigated the effects of different sodium bicarbonate (NaHCO 3 ) concentrations (0 g/L, 1 g/L, and 3 g/L) on Hefang crucian carp (12.0 ± 1.1 g) over a 96-hour period. The experiment is divided into three groups, each with three replicates, and each replicate contains 30 fish. We employed a comprehensive approach integrating histology, physiological and biochemical assays, transcriptomics, as well as artificial intelligence (AI)-assisted analysis. This multifaceted method allowed us to examine changes in gill and liver morphology, osmoregulation, antioxidant capacity, immune response, and physiological metabolism. Results showed that gill and liver tissue damage increased with rising water alkalinity. Serum sodium (Na + ), potassium (K + ), blood ammonia, and gill Na + /K + -ATPase (NKA) levels increased significantly (p < 0.05). Hepatic antioxidant enzymes initially increased, then decreased with prolonged stress. Serum and liver immunoenzyme indices were higher in bicarbonate-treated groups compared to controls. Carbonate treatment altered lipid and glucose metabolism in both serum and liver. Transcriptome analysis, enhanced by large language models (LLMs), revealed differentially expressed genes (DEGs) significantly associated with ion binding, transport, apoptosis, and metabolism. In conclusion, excessive carbonate intake in fish alters serum physiological functions and affects hepatic metabolic functions. Crucian carp primarily regulate hepatic antioxidant systems, utilize carbohydrate breakdown for energy requirements, and employ lipids in osmoregulation. This study provides insights into fish adaptation to saline-alkaline environments and offers support for the development of aquaculture in saline-alkaline waters., Competing Interests: Declaration of competing interest The authors have no relevant financial or non-financial interests to disclose., (Copyright © 2024. Published by Elsevier Inc.)

Selecting the appropriate tractor for small-scale farms is a complex process due to the multitude of technical, environmental, and economic criteria that must be evaluated. This study addresses this challenge by integrating the Analytic Hierarchy Process (AHP) with machine learning (ML) to reduce the number of criteria and simplify the decision-making process. The research aims to determine the most relevant criteria aligned with sustainable development goals for selecting the right tractor, focusing on small farms in the Egyptian Delta. Four tractors, with horsepower ranging from 55 to 95, were evaluated based on inputs from forty-two governmental service providers in the study area. Initially, nine criteria were identified, encompassing key technical, environmental, and economic factors. These criteria were reduced to three-price, power, and maintenance costs by weights 0.142, 0.334, and 0.525, respectively-using Hierarchical Agglomerative Clustering with Euclidean distance. This reduction streamlined the selection process, making it more practical for farmers. Results show that the second tractor (T2), with a priority score of 0.326 and a normalized value of 33.4%, emerged as the optimal choice for small-scale farmers, outperforming the first tractor (T1) (28.7%) and third tractor (T3) (21%). Integrating AHP and ML simplifies tractor selection, ensuring sustainability, cost-efficiency, and operational effectiveness., (© 2024. The Author(s).)

Kudzu (Pueraria lobata) root contains abundant starch, but the physicochemical properties of kudzu starch are not well understood. In this study, we compared the compositions and physicochemical properties of starches isolated from six Pueraria accessions in China. Caige starch exhibited the highest purity (96.99 %) and amylose content (24.76 %), while Yege starch contained higher levels of puerarin (493.37 μg/g) and daidzein (38.68 μg/g). All kudzu starches were rich in resistant starch, with RS2 content ranging from 38.61 % to 46.22 % and RS3 content from 3.59 % to 6.04 %. The granules of kudzu starches varied in morphology, with Yege starch featuring larger polygonal granules. The kudzu starches presented either A-type or A-type-like C-type diffraction patterns. Caige starch had a higher IR2 value (1.28), higher gelatinization temperatures, wider temperature ranges, and greater enthalpy changes. Yege (JX) starch exhibited the highest peak viscosity but the lowest setback viscosity and pasting temperature. Fenge starch showed the highest final viscosity, with Fenge (ZJ) starch demonstrating the highest crystallinity (25.7 %) and IR1 value (0.80). These results indicated that kudzu starches derived from various Pueraria species possess unique structural and physicochemical properties, which provide significant potential for applications in food and other industrial fields., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: To investigate the clinical outcomes of indwelling needle-delivered local urokinase thrombolysis, a cost-saving thrombolytic approach, in the treatment of thrombosed arteriovenous grafts (AVGs)., Methods: The clinical data of 71 patients with a first episode of thrombosed AVG were analyzed. Among them, 49 patients underwent urokinase thrombolysis and percutaneous transluminal angioplasty (PTA), and 22 patients underwent thrombectomy and PTA. The operation success rate, operation time, perioperative and postoperative complications, primary patency, and secondary patency were compared., Results: Clinical success was achieved in all 71 PTAs. After thrombolysis, 29 patients achieved complete lysis, and 20 patients achieved partial lysis. All patients achieved thrombus clearance after PTA. The operating room usage time was 37.48 ± 5.33 min for the complete thrombolysis group and 41.70 ± 6.16 min for the incomplete thrombolysis group, and these values were not significantly different (p = 0.853). The operating room usage time of the thrombectomy group was 124.73 ± 5.08 min, which was significantly longer than that of the other groups (p < 0.001). The log-rank test indicated no significant difference in the 90-, 180-, and 360-day primary patency and corresponding secondary patency (all p > 0.05). The Cox regression showed that no significant difference was noted in the changing rate of primary or secondary patency among the groups (all p > 0.05). No major complications occurred in any of the groups, and the difference in the complication incidence was not significant (p = 0.336)., Conclusions: Indwelling needle-delivered urokinase thrombolysis is an acceptable method for the treatment of thrombosed AVGs. Compared with thrombectomy and PTA, thrombolysis and PTA can significantly shorten the time to use the operating room without reducing primary and secondary patency or increasing complications., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Left brachiocephalic vein (LBCV) stenosis is a common complication in hemodialysis patients and is a heterogenous disorder associated with either prior catheterization or extrinsic compression. This study aimed to characterize patients with LBCV stenosis or occlusion with and without a history of central venous catheterization., Methods: We performed a retrospective study in 84 hemodialysis patients with LBCV stenosis or occlusion with ( n  = 22) or without ( n  = 62) prior catheterization. We compared the clinical features, anatomical factors, restenosis after balloon venoplasty, and patency rates of patients in these two groups., Results: In the cohort of 84 patients with LBCV stenosis or occlusion, 73.8% (62 patients) of them had no history of catheterization. Patients without prior catheterization had more stenotic lesions ( p  < 0.05) but less occlusive lesions ( p  < 0.05) than patients with prior catheterization. The space between the sternum and the aorta was narrower in patients without prior catheterization than that in patients with prior catheterization ( p  < 0.05). Percutaneous venography was performed in 81 patients, and the occurrence of recoil after venoplasty in patients without prior catheterization was significantly higher than that in patients with prior catheterization ( p  < 0.05). The rate of stent implantation was significantly higher in patients without prior catheterization than patients with prior catheterization ( p  < 0.05), whereas there was no significant difference in primary patency between the two groups., Conclusions: LBCV stenosis and occlusion are mainly due to extrinsic compression rather than prior central venous catheterization. Stent implantation is frequently required after venoplasty to treat LBCV obstructive lesions in patients without prior catheterization., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Multiview multi-instance multilabel learning (M3L) is a popular research topic during the past few years in modeling complex real-world objects such as medical images and subtitled video. However, existing M3L methods suffer from relatively low accuracy and training efficiency for large datasets due to several issues: 1) the viewwise intercorrelation (i.e., the correlations of instances and/or bags between different views) are neglected; 2) the diverse correlations (e.g., viewwise intercorrelation, interinstance correlation, and interlabel correlation) are not jointly considered; and 3) high computation burden for training process over bags, instances, and labels across different views. To resolve these issues, a novel framework called fast broad M3L (FBM3L) is proposed with three innovations: 1) utilization of viewwise intercorrelation for better modeling of M3L tasks while existing M3L methods have not considered; 2) based on graph convolutional network (GCN) and broad learning system (BLS), a viewwise subnetwork is newly designed to achieve joint learning among the diverse correlations; and 3) under BLS platform, FBM3L can learn multiple subnetworks jointly across all views with significantly less training time. Experiments show that FBM3L is highly competitive (or even better than) in all evaluation metrics [up to 64% in average precision (AP)] and much faster than most M3L (or MIML) methods (up to 1030 times), especially on large multiview datasets (≥260 K objects).

Exploring precise and effective treatments for liver fibrosis is urgent. The effective therapy for liver fibrosis depends on the specific delivery of antifibrotic drugs to activated hepatic stellate cells (aHSCs). However, this is a challenging task due to pathological barriers, primarily caused by collagen deposition. This study developed vitamin A-functionalized fluorinated peptide/lipid hybrid nanoparticles to co-deliver sorafenib and siRNA against HSP47 (SF-siHSP47@VFPL NPs). This nanoparticle formulation offers significant advantages due to its fluorine‑fluorine and electrostatic interactions, allowing for high SF and siHSP47 loading efficiency and sustained drug release. Importantly, in vitro cell uptake and in vivo biodistribution revealed that VA functionalization significantly improved aHSC-targeted delivery efficiency by engaging retinol-binding protein receptors on HSCs. Furthermore, it dramatically reduced extracellular matrix deposition, as evidenced by diminished levels of liver fibrosis-associated genes (HSP47, TIMP-1, and collagen I), promoting collagen breakdown and preventing collagen production, thus overcoming drug delivery barriers. Thus, SF-siHSP47@VFPL NPs demonstrated optimal antifibrotic effects by triggering apoptosis and ferroptosis in aHSCs. In liver fibrosis mouse models, SF-siHSP47@VFPL NPs remodeled the pathological environment and restored liver functionality through a marked reduction in serum liver transferases, hydroxyproline content, collagen deposition, and α-SMA and CD31 expression in liver tissue, resulting in alleviated liver fibrosis. Consequently, SF-siHSP47@VFPL NPs showed significant potential for HSC-targeted, chemo-gene therapy in the treatment of liver fibrosis., Competing Interests: Declaration of competing interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Availability of liver transplantation (LT) as a treatment for hepatocellular carcinoma (HCC) and other liver malignancies may determine heterogeneity of therapeutic strategies across different centers., Aims: To investigate the practice between hepato-biliary centers without (HB centers) and with a LT program (LT centers), we launched a 38-item web-based national survey, with directors of centers as a target., Methods: The survey, including 4 clinical vignettes, collected data on their approach to HCC and transplant oncology., Results: After duplicates removal, 75 respondents were considered. Respondents from LT centers (n = 22, 29.3 %) were more in favor of LT in the case of HCC outside Milan criteria (90.9 % vs. 67.9 %, p = 0.037), recurrent HCC (95.5 % vs. 50.9 %, p = 0.002) and other malignancies such as cholangiocarcinoma or neuroendocrine tumors. No significant difference was observed concerning the proportion of centers favorable to LT for unresectable colorectal liver metastases (100 % vs. 88.7 %, p = 0.100)., Conclusion: This national survey showed how management of HCC and awareness of transplant oncology may differ between HB and LT centers. Effective networking between HB and LT centers is crucial to provide optimal treatment and access to LT., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2024. Published by Elsevier Ltd.)

Background: The aim of this study was to conduct a systematic review and meta-analysis to comprehensively evaluate the performance and methodological quality of artificial intelligence (AI) in predicting recurrence after single first-line treatment for liver cancer., Methods: A rigorous and systematic evaluation was conducted on the AI studies related to recurrence after single first-line treatment for liver cancer, retrieved from the PubMed, Embase, Web of Science, Cochrane Library, and CNKI databases. The area under the curve (AUC), sensitivity (SENC), and specificity (SPEC) of each study were extracted for meta-analysis., Results: Six percutaneous ablation (PA) studies, 16 surgical resection (SR) studies, and 5 transarterial chemoembolization (TACE) studies were included in the meta-analysis for predicting recurrence after hepatocellular carcinoma (HCC) treatment, respectively. Four SR studies and 2 PA studies were included in the meta-analysis for recurrence after intrahepatic cholangiocarcinoma (ICC) and colorectal cancer liver metastasis (CRLM) treatment. The pooled SENC, SEPC, and AUC of AI in predicting recurrence after primary HCC treatment via PA, SR, and TACE were 0.78, 0.90, and 0.92; 0.81, 0.77, and 0.86; and 0.73, 0.79, and 0.79, respectively. The values for ICC treated with SR and CRLM treated with PA were 0.85, 0.71, 0.86 and 0.69, 0.63,0.74, respectively., Conclusion: This systematic review and meta-analysis demonstrates the comprehensive application value of AI in predicting recurrence after a single first-line treatment of liver cancer, with satisfactory results, indicating the clinical translation potential of AI in predicting recurrence after liver cancer treatment., (© 2024. The Author(s).)

Microbe-driven ammonia nitrogen removal plays a crucial role in the nitrogen cycle and wastewater treatment. However, the rational methods and mechanisms for boosting nitrogen conversion through microbial domestication are still limited. Herein, a combined alkali-photocatalytic stimulation strategy was developed to activate the Halomonas shizuishanensis DWK9 for efficient ammonia nitrogen removal. The strain DWK9 selected from saline-alkaline soil in Northwestern China possessed strong resistance to stress of saline-alkaline environment and free radicals, and was abundant in nitrogen conversion genes, thus is an ideal model for advanced microbial domestication. Bacterial in the combined alkali-photocatalytic stimulation group achieved a high ammonia nitrogen conversion rate of 67.5 %, 10 times outperforming the non-stimulated and single alkali/photocatalytic stimulation control groups. Morphology analysis revealed that the bacteria in the alkali-photocatalytic stimulated group formed a favorable structure for bioelectric transfer. Remarkably, the domesticated bacteria demonstrated improved electrochemical properties, including increased current capacity and lower overpotentials and impedance. Prokaryotic transcription genetic analysis together with qPCR analysis showed upregulation of denitrification-related metabolic pathway genes. A novel FAD dependent and NAD(P)H independent energy mode has been proposed. The universality and effectiveness of the as-developed combined alkali-photocatalytic microbial domestication strategy were further validated through indicator fish survival experiments. This work provides unprecedented degrees of freedom for the exploration of rational microbial engineering for optimized and controllable biogeochemical conversion., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: The intricate anatomical structure of talocalcaneal coalitions (TCCs) presents significant challenges for clinicians in both diagnosis and treatment. This study aimed to investigate the anatomy, imaging characteristics, and biomechanical properties of TCCs, providing essential references for contemporary clinical diagnosis, treatment, scientific research, and education regarding TCCs., Methods: The morphologies of TCCs were examined and classified in intact dry osseous specimens from 131 Asian adults. The imaging characteristics of TCCs were summarized by carefully observing the X-rays and CT scans. Additionally, finite element models of TCCs were established and validated, allowing for the simulation and analysis of stress and strain., Results: The TCCs were primarily located in the region between the posterior end of sustentaculum tali (ST), the medial port of the tarsal canal, and the medial edge of the posterior talar articular surface (PTF). In comparison to specimens with cartilage and ligament connections, the medial tubercle of osseous connections exhibited significant inward and downward protrusion, while the ST was longer and thicker. Statistically significant differences were noted in the widths of the calcaneus and talus, as well as in the thickness and length of the ST (P < 0.05). CT imaging provided an accurate determination of TCCs' locations, while X-rays revealed the presence of the "C sign" and "duck beak sign" in all osseous connection specimens. Finite element model analysis indicated that stress was primarily concentrated at the osseous connection, which also reduced displacement of the subtalar joint., Conclusions: The comprehension of the precise location, anatomical morphological characteristics, imaging features and finite element mechanical properties of TCCs is instrumental in enhancing the diagnosis and treatment of TCCs., Competing Interests: Declaration of competing interest The authors declared no potential competing interests with respect to the research, authorship, and publication of this article., (Copyright © 2024 Asian Surgical Association and Taiwan Society of Coloproctology. Published by Elsevier B.V. All rights reserved.)

Posttransplant HCC recurrence significantly impacts survival, yet its management is challenging due to limited evidence. With recent advancements in HCC treatment, updated data on managing recurrent diseases are needed. In this retrospective study across 6 centers (2000-2022), we employed Cox proportional-hazards regression and log-rank tests to assess survival differences. A prognostic score model was developed to categorize patient survival. The efficacy of tyrosine kinase inhibitors was evaluated through propensity score matching. In our study, 431 of 3349 (14%) patients with HCC who underwent transplantation developed recurrence within a median interval of 18 (IQR: 9-32) months. One hundred forty-seven (34%) underwent curative-intent treatments, 207 (48%) received palliative treatments, and 77 (18%) were given best-supportive care. Patients undergoing curative-intent treatments had better survival from the time of recurrence with a median survival of 45 (95% CI: 36-63) months and 1/3/5-year survival of 90%/56%/43% compared to those receiving noncurative treatments (median: 11 [95% CI: 10-13] mo, 1/3/5-y survival of 46%/10%/7%, log-rank p < 0.001). Patients with recurrence diagnosed in the era 2018-2022 showed improved survival over the previous era (HR 0.64 [95% CI: 0.47-0.86]). Multivariable analysis identified 5 prognostic factors: ineligibility for curative-intent treatment (HR: 3.5 [95% CI: 2.7-4.6]), recurrence within 1 year (HR: 1.7 [95% CI: 1.3-2.1]), poor tumor differentiation (HR: 1.5 [95% CI: 1.1-1.9]), RETREAT score ≥3 (HR: 1.4 [95% CI: 1.1-1.8]), and alpha-fetoprotein at recurrence ≥400 ng/mL (HR: 1.4 [95% CI: 1.1-1.9]). These factors contributed to a prognostic scoring system (0-9) that stratified patients into 3 prognosis groups. Both propensity score-matched analysis and multivariable regression indicated that lenvatinib was not statistically superior to sorafenib in terms of efficacy. Curative-intent treatments should be advocated for patients with posttransplant recurrence whenever possible. Prognostic factors linked to aggressive tumor biology significantly influence survival. Advancements in HCC management have improved survival outcomes over the past 5 years., (Copyright © 2024 American Association for the Study of Liver Diseases.)

The layer-structured oxide cathode for sodium-ion batteries has attracted a widespread attention due to the unique redox properties and the anionic redox activity providing additional capacity. Nevertheless, such excessive oxygen redox reactions will lead to irreversible oxygen release, resulting in a rapid deterioration of the cycling stability. Herein, sulfur ion is successfully introduced to the O3-NaNi 0.3 Mn 0.5 Cu 0.1 Ti 0.05 W 0.05 O 2 material through high-temperature quenching, thereby developing a novel Na 2 S-modified O3/P2-NaNi 0.3 Mn 0.5 Cu 0.1 Ti 0.05 W 0.05 O 2 composite with extended cycling life. The S 2- is analyzed for the ability to enhance the reversibility of oxidation-reduction reactions under high voltage and suppress the loss of lattice oxygen during cycling. The stable S─O covalent bonds are found to inhibit the oxygen generation and release within the structure. Benefiting from these improvements, the Na₂S-modified O3/P2-NaNi 0.3 Mn 0.5 Cu 0.1 Ti 0.05 W 0.05 O 2 exhibited a high reversible capacity of 173.1 mA h g -1 over a wide voltage range of 1.5-4.3 V under test conditions at 0.1 C and 81.5% capacity retention after 120 cycles at 1 C. The Na₂S-modified O3/P2-NaNi 0.3 Mn 0.5 Cu 0.1 Ti 0.05 W 0.05 O 2 demonstrates the excellent rate capability with the reversible capacities of 173.1,137.0,114.7,96.7, and 80.1 mA h g -1 at 0.1, 0.2, 0.5, 1, and 2 C., (© 2024 Wiley‐VCH GmbH.)

Highlights Stratum corneum hydration levels are negatively correlated with HbA1c levels and positively correlated with skin surface pH. Individuals with type 2 diabetes display lower levels of stratum corneum hydration. Because low stratum corneum hydration levels can increase circulating levels of proinflammatory cytokines, which are linked to the pathogenesis of type 2 diabetes, improvement in stratum corneum hydration can be an alternative approach in the management of type 2 diabetes., (© 2024 The Author(s). Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.)

Two Gram-stain-negative bacterial strains, 15-R06ZXC-3 T and R06B22 T , were isolated from the surface sediment of the Arctic Ocean. Phylogenetic analyses based on the 16S rRNA gene and genome sequences indicated that strain 15-R06ZXC-3 T belongs to the genus Thioclava , while strain R06B22 T belongs to the genus Zhongshania . Strain 15-R06ZXC-3 T showed the closest relationship to Thioclava indica DT23-4 T . The digital DNA-DNA hybridization (dDDH) and average nucleotide identity (ANI) values between strain 15-R06ZXC-3 T and all of the type strains of the genus Thioclava ranged from 20.8 to 30.4% and 79.1 to 85.7%, respectively. Strain R06B22 T was most closely related to Zhongshania marina DSW25-10 T . The dDDH and ANI values between strain R06B22 T and all of the type strains of the genus Zhongshania ranged from 18.6 to 20.4% and 77.5 to 79.4%, respectively. These dDDH and ANI values were all below the standard cutoff criteria for the delineation of bacterial species, indicating that the two strains may represent novel species within their respective genera. Furthermore, their phenotypic and chemotaxonomic characteristics also differentiated them from closely related species. Based on the polyphasic analyses, strains 15-R06ZXC-3 T and R06B22 T separately represent novel species of the genera Thioclava and Zhongshania , for which the names Thioclava arctica sp. nov. (type strain 15-R06ZXC-3 T = MCCC 1A07434 T = KCTC 8342 T ) and Zhongshania arctica sp. nov. (type strain R06B22 T = MCCC 1A08273 T = KCTC 8343 T ) are proposed. Additionally, phylogenomic analyses showed that the strain Marortus luteolus ZX-21 T was clustered with the strain Z. marina DSW25-10 T and all other type strains of the genus Zhongshania . Furthermore, the ANI and dDDH values between strains ZX-21 T and DSW25-10 T were 97.6% and 78.8±2.5%, respectively, strongly indicating that they represented a single species. Therefore, it is proposed that M. luteolus Yu et al. 2019 be recognized as a later heterotypic synonym of Z. marina On et al. 2019.

Introduction: Percutaneous thermal segmentectomy is a single-step combination of microwave ablation, performed during arterial occlusion obtained with a balloon micro catheter, followed in the same session by balloon-occluded TACE. The aim of this multicenter retrospective study is to report the mid-term oncological performance of this technique for liver malignancies > 3.0 cm and to identify risk factors for the loss of sustained complete response., Methods: Oncological results were evaluated with CT or MRI according to m-RECIST (HCC) and RECISTv1.1 (metastasis/intra-hepatic cholangiocarcinoma, iCC) at 1-month, 3-6-month and then at regular-6-month intervals. To identify predictive variables associated with not achieving or losing complete response two mixed-effects multivariable logistic regression models were constructed., Results: Sixty-three patients (40/23, male/female) with primary liver malignancies (HCC = 49; iCC = 4) and metastasis (n = 10) were treated. Median diameter of target lesion was 4.5 cm (range 3.0-7.0 cm). The median follow-up time was 9.2 months. At one-month follow-up, 79.4% of patients presented with a complete response and the remaining 20.6% were partial responders. At the 3-6-month follow-up, reached by 59 of the initial 63 patients, 83.3% showed a sustained complete response, while 10.2% had a partial response and 8.5% a local recurrence. At the last follow-up, 69.8% of the lesions showed a complete response. The initial diameter of the target lesion ≥ 5.0 cm was the only independent variable associated with the risk of failure in maintaining a complete response at 6 months (OR = 8.58, 95% CI 1.38-53.43; P = 0.02)., Conclusion: Percutaneous thermal segmentectomy achieves promising oncological results in patients with tumors > 3.0 cm, with tumor dimension ≥ 5.0 cm being the only risk factor associated with the failure of a sustained complete response., (© 2024. The Author(s).)

ConspectusReticular chemistry has provided intriguing opportunities for systematically designing porous materials with different pores by adjusting the building blocks. Among them, framework materials have demonstrated outstanding performance for the design of new functional materials used in a broad range of fields, including energetic materials. Energetic materials are widely used for rockets, satellites, mining, and tunneling. In terms of energetic materials, explosophores and nitrogen-rich heterocycles are fundamental building blocks for high-energy compounds. However, the traditional strategy of synthesizing HEDMs (high energy density materials) at the molecular level has faced the long-term challenge of balancing energy and stability. Inspired by reticular chemistry, nitrogen-rich heterocycles offer diverse nitrogen sites for designing diversified coordination interactions. Ionic bond interactions exist in a wide range of energetic salts. Furthermore, most metastable explosophores, e.g., nitro, nitramino, and amino groups, can form strong hydrogen-bonding networks. Based on these noncovalent interactions (such as coordination, ionic, and/or hydrogen bonds (HBs)) and/or covalent interactions can determine intermolecular packing/linkage of the energetic fuel and oxidizer components, reticular chemistry provides a new platform evolving from single-molecular design to various energetic frameworks (E of the energetic frameworks with superior comprehensive properties. For example, to achieve coordination with metals or introduce sufficient hydrogen bond donor/acceptor structural units, the host structure of energetic framework materials usually contains less oxygen-rich substituents such as nitro, so the host molecules of the framework, F) at the crystal level, which can enhance the integrated stabilities of EFs.Along with growing concerns about the environment and safety issues, considerable effort has been devoted to pursuing environmentally friendly and insensitive energetic materials. The newly emerging EFs are conducive to introducing explosophores into a green chemical pathway. Benefiting from these cross-disciplinary achievements, taming metastable energetic molecules in specific porous frameworks is a green strategy to desensitize energetic materials while concomitantly retaining excellent energetic properties, which has become one of the most forward and promising investigations. In the past decade, EFs have achieved further results in stabilizing and greening energetic materials using HBs, covalent bonds, and alkaline earth metal-involving coordination bonds to avoid heavy metal toxicity and to employ halogen-free oxidizers. Because this field is still expanding rapidly, it is of great value for researchers and possible users of the work to be able to view all the progress.Through this Account, we intend that more readers will become knowledgeable about EFs, including their definition, history, synthesis, properties, and possible applications. The aim of this Account is to present the latest advances in EFs in recent years and to offer a perspective on the future direction of this field.

To date, caval sparing (CS) and total caval replacement (TCR) for recipient hepatectomy in liver transplantation (LT) have been compared only in terms of surgical morbidity. Nonetheless, the CS technique is inherently associated with an increased manipulation of the native liver and later exclusion of the venous outflow, which may increase the risk of intraoperative shedding of tumor cells when LT is performed for HCC. A multicenter, retrospective study was performed to assess the impact of recipient hepatectomy (CS vs. TCR) on the risk of posttransplant HCC recurrence among 16 European transplant centers that used either TCR or CS recipient hepatectomy as an elective protocol technique. Exclusion criteria comprised cases of non-center-protocol recipient hepatectomy technique, living-donor LT, HCC diagnosis suspected on preoperative imaging but not confirmed at the pathological examination of the explanted liver, HCC in close contact with the IVC, and previous liver resection for HCC. In 2420 patients, CS and TCR approaches were used in 1452 (60%) and 968 (40%) cases, respectively. Group adjustment with inverse probability weighting was performed for high-volume center, recipient age, alcohol abuse, viral hepatitis, Child-Pugh class C, Model for End-Stage Liver Disease score, cold ischemia time, clinical HCC stage within Milan criteria, pre-LT downstaging/bridging therapies, pre-LT alphafetoprotein serum levels, number and size of tumor nodules, microvascular invasion, and complete necrosis of all tumor nodules (matched cohort, TCR, n = 938; CS, n = 935). In a multivariate cause-specific hazard model, CS was associated with a higher risk of HCC recurrence (HR: 1.536, p = 0.007). In conclusion, TCR recipient hepatectomy, compared to the CS approach, may be associated with some protective effect against post-LT tumor recurrence., (Copyright © 2024 American Association for the Study of Liver Diseases.)

Memristors are of great theoretical and practical significance for chaotic dynamics research of brain-like neural networks due to their excellent physical properties such as brain synapse-like memorability and nonlinearity, especially crucial for the promotion of AI big models, cloud computing, and intelligent systems in the artificial intelligence field. In this paper, we introduce memristors as self-connecting synapses into a four-dimensional Hopfield neural network, constructing a central cyclic memristive neural network (CCMNN), and achieving its effective control. The model adopts a central loop topology and exhibits a variety of complex dynamic behaviors such as chaos, bifurcation, and homogeneous and heterogeneous coexisting attractors. The complex dynamic behaviors of the CCMNN are investigated in depth numerically by equilibrium point stability analysis as well as phase trajectory maps, bifurcation maps, time-domain maps, and LEs. It is found that with the variation of the internal parameters of the memristor, asymmetric heterogeneous attractor coexistence phenomena appear under different initial conditions, including the multi-stable coexistence behaviors of periodic-periodic, periodic-stable point, periodic-chaotic, and stable point-chaotic. In addition, by adjusting the structural parameters, a wide range of amplitude control can be realized without changing the chaotic state of the system. Finally, based on the CCMNN model, an adaptive synchronization controller is designed to achieve finite-time synchronization control, and its application prospect in simple secure communication is discussed. A microcontroller-based hardware circuit and NIST test are conducted to verify the correctness of the numerical results and theoretical analysis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: The roles of Lenalidomide (Len) and Daratumumab (Dara) in multiple myeloma treatment are well-established, yet their influences on hematopoietic stem cell harvesting and reconstitution remain disputed., Methods: We conducted a systematic database review to identify cohort studies or RCTs evaluating the effect of the use of Len or Dara on hematopoietic stem cell collection and peripheral blood count recovery in multiple myeloma patients. Effects on hematopoietic collection or reconstitution were estimated by comparing standardized mean differences (SMD) and mean differences (MD), or median differences., Results: Eighteen relevant studies were identified, summarizing mobilization results. For Len, data from 13 studies were summarized, including total CD34+ cell yield, collection failure rate, and time to neutrophil and platelet engraftment. Results indicated that Len exposure led to decreased stem cell collection [SMD=-0.23, 95% CI (-0.34, -0.12)]. However, collection failure (<2×106) could be mitigated by plerixafor [OR=2.14, 95% CI (0.96, 4.77)]. For Dara, two RCTs and three cohort studies were included, showing that Dara exposure resulted in a reduction in total stem cells even with optimized plerixafor mobilization [SMD=-0.75, 95% CI (-1.26, -0.23)], and delayed platelet engraftment recovery [MD=1.20, 95% CI (0.73, 1.66)]., Conclusions: Our meta-analysis offers a comprehensive view of Len and Dara's impacts on hematopoietic stem cell collection and reconstitution in multiple myeloma. Len usage could lead to reduced stem cell collection, counteracted by plerixafor mobilization. Dara usage could result in diminished stem cell collection and delayed platelet engraftment., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To investigate changes in proportions of peripheral blood lymphocyte subsets, the correlation between the lymphocyte subsets and cytokine levels in patients with GluR3B antibody-positive epilepsy, analyze the role of GluR3B antibodies and cytokines in the progression of epilepsy. In addition, the immunotherapeutic effect in patients with GluR3B antibody-positive epilepsy will be evaluated., Methods: Patients with epilepsy hospitalized in the Department of Neurology of the affiliated Hospital of Xuzhou Medical University from December 2016 to May 2023 were recruited. GluR3B antibody levels were measured by enzyme-linked immunosorbent assay (ELISA). Lymphocyte subset proportions were determined using flow cytometry, and serum concentrations of 12 cytokines were measured using cytometric beads array. Differences in T lymphocyte subsets and inflammatory factors were analysed between GluR3B antibody positive and negative patients. Structural equation modeling (SEM) was used to analyse the role of GluR3B antibodies and inflammatory factors in drug-resistant epilepsy (DRE). Finally, the therapeutic effect of immunotherapy on epilepsy patients with GluR3B antibodies was assessed., Results: In this study, sixty-four cases of DRE, sixty-six cases of drug-naïve epilepsy (DNE), and forty-one cases of drug-responsive epilepsy were recruited. (1) DRE patients with positive GluR3B antibody were characterized by a significant increase in the proportion of cluster of differentiation (CD)4 + T lymphocytes, a decrease in CD8 + T lymphocytes, and an increase of CD4 + /CD8 + ratio. Similar alterations in T lymphocyte subsets were observed in GluR3B antibody-positive patients with DNE. GluR3B antibody levels correlated positively with CD4 + T lymphocytes (r = 0.23) and negatively with CD8 + T lymphocytes (r=-0.18). (2) In patients with DRE, the serum concentrations of interleukin-1β (IL-1β), IL-8, and interferon-gamma (IFN-γ) were significantly higher in those with positive GluR3B antibody compared to those with negative GluR3B antibody. Serum IL-1β levels were also higher in GluR3B antibody-positive DNE patients compared to antibody-negative DNE patients. In drug-responsive epilepsy patients with GluR3B antibody-positive, both serum IL-1β and IFN-γ levels were higher than those with GluR3B antibody-negative. Moreover, the concentrations of serum GluR3B antibody were positively correlated with the levels of IL-1β, IL-8, and IFN-γ. (3) SEM analysis indicated that GluR3B antibody may be a direct risk factor for DRE (direct effect = 4.479, 95%CI 0.409-8.503), or may be involved in DRE progression through affecting IFN-γ and IL-8 levels (total indirect effect = 5.101, 95%CI 1.756-8.818). (4) Immunotherapy significantly decreased seizure frequency and serum GluR3B antibody levels, and the seizure frequency was positively correlated with the levels of GluR3B antibody levels in patients receiving immunotherapy., Conclusions: This study demonstrates that GluR3B antibody may influence the progression of epilepsy through altering the proportion of CD4 + and CD8 + lymphocyte subsets and increasing proinflammatory cytokines. The seizure suppression of immunotherapy is associated with the decrease of GluR3B antibody levels. Thus, the present study contributes to a better understanding of the immunoregulatory mechanisms of autoimmune-associated epilepsy and provides a potential target for DRE., (© 2024. The Author(s).)

Explant-based models for assessing HCC recurrence after liver transplantation serve as the gold standard, guiding post-liver transplantation screening and immunosuppression adjustment. Incorporating alpha-fetoprotein (AFP) levels into these models, such as the novel R3-AFP score, has notably enhanced risk stratification. However, validation of these models in high-evidence data is mandatory. Therefore, the aim of the present research was to validate the R3-AFP score in a randomized clinical trial. We analyzed the intention-to-treat population from the 2-arm SiLVER trial (NCT00355862), comparing calcineurin-based ([calcineurin inhibitors]-Group A) versus mammalian target of rapamycin inhibitors-based (sirolimus-Group B) immunosuppression for post-liver transplantation HCC recurrence. Competing risk analysis estimated sub-hazard ratios, with testing of discriminant function and calibration. Overall, 508 patients from the intention-to-treat analysis were included (Group A, n = 256; Group B, n = 252). The R3-AFP score distribution was as follows: 42.6% low-risk (n = 216), 35.7% intermediate-risk (n = 181), 19.5% high-risk (n = 99), and 2.2% very-high-risk (n = 11) groups. The R3-AFP score effectively stratified HCC recurrence risk, with increasing risk for each stratum. Calibration of the R3-AFP model significantly outperformed other explant-based models (Milan, Up-to-7, and RETREAT), whereas discrimination power (0.75 [95% CI: 0.69; 0.81]) surpassed these models, except for the RETREAT model ( p = 0.49). Subgroup analysis showed lower discrimination power in the mammalian target of rapamycin group versus the calcineurin inhibitors group ( p = 0.048). In conclusion, the R3-AFP score accurately predicted HCC recurrence using high-quality evidence-based data, exhibiting reduced performance under mammalian target of rapamycin immunosuppression. This highlights the need for further research to evaluate surveillance schedules and adjuvant regimens., (Copyright © 2024 American Association for the Study of Liver Diseases.)

Background: To explore an artificial intelligence (AI) technology employing YOLOv8 for quality control (QC) on elbow joint radiographs., Methods: From January 2022 to August 2023, 2643 consecutive elbow radiographs were collected and randomly assigned to the training, validation, and test sets in a 6:2:2 ratio. We proposed the anteroposterior (AP) and lateral (LAT) models to identify target detection boxes and key points on elbow radiographs using YOLOv8. These identifications were transformed into five quality standards: (1) AP elbow positioning coordinates (X A and Y A ); (2) olecranon fossa positioning distance parameters (S 17 and S 27 ); (3) key points of joint space (Y 3 , Y 4 , Y 5 and Y 6 ); (4) LAT elbow positioning coordinates (X 2 and Y 2 ); and (5) flexion angle. Models were trained and validated using 2,120 radiographs. A test set of 523 radiographs was used for assessing the agreement between AI and physician and to evaluate clinical efficiency of models., Results: The AP and LAT models demonstrated high precision, recall, and mean average precision for identifying boxes and points. AI and physicians showed high intraclass correlation coefficient (ICC) in evaluating: AP coordinates X A (0.987) and Y A (0.991); olecranon fossa parameters S 17 (0.964) and S 27 (0.951); key points Y 3 (0.998), Y 4 (0.997), Y 5 (0.998) and Y 6 (0.959); LAT coordinates X 2 (0.994) and Y 2 (0.986); and flexion angle (0.865). Compared to manual methods, using AI, QC time was reduced by 43% for AP images and 45% for LAT images (p < 0.001)., Conclusion: YOLOv8-based AI technology is feasible for QC of elbow radiography with high performance., Relevance Statement: This study proposed and validated a YOLOv8-based AI model for automated quality control in elbow radiography, obtaining high efficiency in clinical settings., Key Points: QC of elbow joint radiography is important for detecting diseases. Models based on YOLOv8 are proposed and perform well in image QC. Models offer objective and efficient solutions for QC in elbow joint radiographs., (© 2024. The Author(s).)

The increasing incidence and mortality rates of cerebrovascular disease impose a heavy burden on both patients and society. Retinal imaging techniques, such as fundus photography, optical coherence tomography, and optical coherence tomography angiography, can be used for rapid, non-invasive evaluation of cerebral microcirculation and brain function since the retina and the central nervous system share similar embryonic origin characteristics and physiological features. This article aimed to review retinal imaging biomarkers related to cerebrovascular diseases and their applications in cerebrovascular diseases (stroke, cerebral small vessel disease [CSVD], and vascular cognitive impairment [VCI]), thus providing reference for early diagnosis and prevention of cerebrovascular diseases., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zhang, Zhao, Ye, Yan, Shentu, Lai and Qiao.)

Objective: Angioplasty balloon rupture is a rare complication during percutaneous transluminal angioplasty (PTA). Conventional approach to retrieve circumferentially ruptured balloons is open surgery. This study examined the feasibility of a novel approach which can remove ruptured balloon during PTA in vascular access., Methods: This retrospective study analyzed 35 patients of a total 6465 patients that underwent ultrasound-guided PTA with a circumferential balloon rupture from February 2016 and August 2023. The patients underwent surgery (Group I, n  = 13) or the novel method (Group II, n  = 22) for balloon retrieval. Kaplan-Meier curve was used to assess the primary patency rates of the two groups., Result: The total incidence of circumferential balloon rupture was 0.5% in our center. Balloon retrieval was successful in both groups with no complications except one case had an infection in the surgical wound. Kaplan-Meier curve analysis showed that the post-intervention primary patency rates of the two methods were not significantly different ( p  > 0.05). There was a significant difference between pre-operation and post-operation brachial arterial flow ( p  < 0.001)., Conclusion: The feasibility of the novel technique for retrieval of circumferential ruptured balloons during ultrasound-guided PTA is validated. The technique enables less invasive retrieval and continuation of PTA., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: As walking abilities are widely affected among the aging population, investigating the effectiveness of wearable device-based walking programs is essential. The intentions of this meta-analysis were to investigate their effects on gait speed among older adults, as well as to include subgroup analysis to evaluate potential effects on individuals with aging-related conditions such as Parkinson's disease (PD) and stroke., Methods: Systematic retrieval of Pubmed, The Cochrane Library, Embase and Web of Science databases were searched up to February 2024. Outcomes such as gait speed, balance, cadence, and stride length were extracted and analyzed. Study quality was evaluated using the Rob 2 tool and heterogeneity was tested using I 2 statistics through STATA 16., Results: Nine studies with 284 participants were analyzed. The intervention group showed a significant improvement in gait speed (weighted mean difference (WMD) 0.12; 95% CI 0.03 to 0.21). There is a subgroup analysis suggesting differential effects: significant improvements in PD and stroke subgroups, but not in the normal aging group. Balance (WMD: 1.93; 95% CI: 0.20 to 3.66) and stride length (WMD: 8.58; 95% CI: 3.04 to 14.12) were also shown to improve, but the heterogeneity across the studies was moderate (I 2 = 63.91%). No significant changes were observed in the Timed Up and Go test, Gait Variability, and Step Width., Conclusions: Wearable device-based walking programs improve gait speed in older adults, with top notch advantages in the ones tormented by PD or stroke. These findings advocate that such interventions can be a valuable part of individualized treatment strategies in geriatric care, aiming to enhance mobility and usual satisfactory of existence., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Introduction: Programmed death-ligand 1 (PD-L1) plays essential roles in the negative regulation of anti-tumor immunity. However, the regulatory mechanisms of PD-L1 expression need further exploration. MORC family CW-type zinc finger 3 (MORC3) is a transcriptional factor that regulates innate immune responses, but the expression and roles of MORC3 in cancers remain largely unknown. The present study explored the expression of MORC3 in cancers at both transcriptional and translational levels., Methods: The target genes and pathways were analyzed using RNA interference (RNAi), RNA sequencing (RNA-seq), and quantitative real-time polymerase chain reaction (qRT-PCR) technology in head and neck cancer cells. The expression of MORC3 and its target genes were also analyzed in single cancer cells., Results: MORC3 was significantly downregulated in multiple cancers, including head and neck cancer, and low expression of MORC3 was associated with poor overall survival. MORC3 knockdown significantly increased the expression of many immune-related genes, including interferon (IFN)-associated genes [MX dynamin like GTPase 2 (MX2), interferon induced protein with tetratricopeptide repeats 1 (IFIT1), interferon induced protein with tetratricopeptide repeats 2 (IFIT2), interferon regulatory factor 7 (IRF7), interferon regulatory factor 9 (IRF9), interferon induced protein 44 like (IFI44L), interferon induced transmembrane protein 1 (IFITM1), interferon induced transmembrane protein 3 (IFITM3), interferon induced protein 44 (IFI44), and interferon induced with helicase C domain 1 (IFIH1)]. MORC3 knockdown significantly upregulated PD-L1 and signal transducer and activator of transcription 1 (STAT1) expression. Moreover, the LINC00880 immune-related long non-coding RNA (lnc-RNA) was upregulated by MORC3 knockdown. Silencing LINC00880 attenuated PD-L1 expression. MORC3 knockdown also increased the expression of cellular proliferation-related genes and promoted cancer cell proliferation., Conclusion: The present study demonstrated that MORC3 regulates IFN-associated pathways and is a novel repressor of PD-L1 expression and cancer cell proliferation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Fu, Chang, Ye, Zheng, Lai, Ge and Shi.)

Controversy still exists regarding how much the inflow arterial percutaneous transluminal angioplasty (PTA) contributed to maintaining fistula function for hemodialysis. We aimed to analyze patency and risk factors after inflow arterial PTA. Hemodialysis patients with inflow arterial primary stenosis who were admitted to our institution from January 2017 to December 2022 were examined. One group had arterial-venous fistula with inflow artery stenosis alone (AVF + iAS) and another group had AVF with inflow artery stenosis and any vein stenosis (AVF + iAS + VS). The characteristics of patients, stenotic lesions, and PTA procedures were recorded. Kaplan-Meier analysis was used to compare primary patency, assisted primary patency, and secondary patency in the two groups. Cox proportional hazard analysis was used to identify risk factors associated with patency. We examined 213 patients, 53 in the AVF + iAS group (51 radial arterial stenosis and 2 ulnar arterial stenosis) and 160 in the AVF + iAS + VS group (159 radial arterial stenosis and 1 ulnar arterial stenosis). Kaplan-Meier analysis indicated the AVF + iAS group had better primary patency and assisted primary patency (both P < 0.05), but the groups had similar secondary patency. Cox proportional hazard analysis indicated that none of the analyzed clinical and biochemical indexes had clinically meaningful effects on primary patency, assisted primary patency, or secondary patency in either group. The patency and safety after PTA for inflow arterial stenosis were satisfactory, and none of the examined risk factors had a major clinical impact on patency. We recommend PTA as treatment for inflow stenosis of an AVF., (© 2024. The Author(s).)

The 16S rRNA gene of Thermobacterium salinum TK19130 T had the highest sequence similarity to that of Luteirhabdus pelagi A3-108 T (99.7%). Phylogeny of 16S rRNA gene and whole genome sequences indicated that T. salinum TK19130 T and L. pelagi A3-108 T are closely related, and represented an independent clade. Whole genome comparisons showed that T. salinum TK19130 T and L. pelagi A3-108 T shared average amino acid identity of 95.3%, indicating they could be merged into the same genus. The digital DNA-DNA hybridization and average nucleotide identity values between T. salinum TK19130 T and L. pelagi A3-108 T were 52.5 and 93.3%, respectively. These values were below the recommended threshold values of prokaryotic species delineation. Thus, based on the principle of priority, we proposed the transfer of Thermobacterium salinum Chen et al . 2023 to the genus Luteirhabdus Ren et al . 2022 as Luteirhabdus salina comb. nov.

Three Gram-stain-negative, aerobic, non-motile, chemoheterotrophic, short-rod-shaped bacteria, designated CDY1-MB1 T , CDY2-MB3, and BDY3-MB2, were isolated from three marine sediment samples collected in the eastern Pacific Ocean. Phylogenetic analysis based on 16S rRNA gene sequences indicated that these strains were related to the genus Aequorivita and close to the type strain of Aequorivita vitellina F4716 T (with similarities of 98.0-98.1%). Strain CDY1-MB1 T can grow at 15-37 °C (optimum 30 °C) and in media with pH 6-9 (optimum, pH 7), and tolerate up to 10% (w/v) NaCl. The predominant cellular fatty acids of strain CDY1-MB1 T were iso-C 15 : 0 (20.7%) and iso-C 17 : 0 3-OH (12.8%); the sole respiratory quinone was menaquinone 6; the major polar lipids were phosphatidylethanolamine, two unidentified aminolipids and two unidentified polar lipids. The digital DNA-DNA hybridization/average nucleotide identity values between strains CDY1-MB1 T , CDY2-MB3, and BDY3-MB2 and A. vitellina F4716 T were 24.7%/81.6-81.7%, thereby indicating that strain CDY1-MB1 T should represent a novel species of the genus Aequorivita . The genomic DNA G+C contents were 37.6 % in all three strains. Genomic analysis showed the presence of genes related to nitrogen and sulphur cycling, as well as metal reduction. The genetic traits of these strains indicate their possible roles in nutrient cycling and detoxification processes, potentially shaping the deep-sea ecosystem's health and resilience. Based upon the consensus of phenotypic and genotypic analyses, strain CDY1-MB1 T should be classified as a novel species of the genus Aequorivita , for which the name Aequorivita flava sp. nov. is proposed. The type strain is CDY1-MB1 T (=MCCC 1A16935 T =KCTC 102223 T ).

Study Question: Can pregnancy outcomes following fresh elective single embryo transfer (eSET) in gonadotropin-releasing hormone (GnRH) antagonist protocols increase using a gonadotropin (Gn) step-down approach with cessation of GnRH antagonist on the day of hCG administration (hCG day) in patients with normal ovarian response?, Summary Answer: The modified GnRH antagonist protocol using the Gn step-down approach and cessation of GnRH antagonist on the hCG day is effective in improving live birth rates (LBRs) per fresh eSET cycle., What Is Known Already: Currently, there is no consensus on optimal GnRH antagonist regimens. Studies have shown that fresh GnRH antagonist cycles result in poorer pregnancy outcomes than the long GnRH agonist (GnRHa) protocol. Endometrial receptivity is a key factor that contributes to this phenomenon., Study Design, Size, Duration: An open label randomized controlled trial (RCT) was performed between November 2021 and August 2022. There were 546 patients allocated to either the modified GnRH antagonist or the conventional antagonist protocol at a 1:1 ratio., Participants/materials, Setting, Methods: Both IVF and ICSI cycles were included, and the sperm samples used were either fresh or frozen from the partner, or from frozen donor ejaculates. The primary outcome was the LBRs per fresh SET cycle. Secondary outcomes included rates of implantation, clinical and ongoing pregnancy, miscarriage, and ovarian hyperstimulation syndrome (OHSS), as well as clinical outcomes of ovarian stimulation., Main Results and the Role of Chance: Baseline demographic features were not significantly different between the two ovarian stimulation groups. However, in the intention-to-treat (ITT) population, the LBRs in the modified antagonist group were significantly higher than in the conventional group (38.1% [104/273] vs. 27.5% [75/273], relative risk 1.39 [95% CI, 1.09-1.77], P = 0.008). Using a per-protocol (PP) analysis which included all the patients who received an embryo transfer, the LBRs in the modified antagonist group were also significantly higher than in the conventional group (48.6% [103/212] vs. 36.8% [74/201], relative risk 1.32 [95% CI, 1.05-1.66], P = 0.016). The modified antagonist group achieved significantly higher implantation rates, and clinical and ongoing pregnancy rates than the conventional group in both the ITT and PP analyses (P < 0.05). The two groups did not show significant differences between the number of oocytes retrieved or mature oocytes, two-pronuclear zygote (2PN) rates, the number of embryos obtained, blastocyst progression and good-quality embryo rates, early miscarriage rates, or OHSS incidence rates (P > 0.05)., Limitations, Reasons for Caution: A limitation of our study was that the subjects were not blinded to the treatment allocation in the RCT trial. Only women under 40 years of age who had a good prognosis were included in the analysis. Therefore, use of the modified antagonist protocol in older patients with a low ovarian reserve remains to be investigated. In addition, the sample size for Day 5 elective SET was small, so larger trials will be required to strengthen these findings., Wider Implications of the Findings: The modified GnRH antagonist protocol using the Gn step-down approach and cessation of GnRH antagonist on hCG day improved the LBRs per fresh eSET cycle in normal responders., Study Funding/competing Interest(s): This project was funded by grant 2022YFC2702503 from the National Key Research & Development Program of China and grant 2021140 from the Beijing Health Promotion Association. The authors declare no conflicts of interest., Trial Registration Number: The RCT was registered in the Chinese Clinical Trial Registry; Study Number: ChiCTR2100053453., Trial Registration Date: 21 November 2021., Date of First Patient’s Enrollment: 23 November 2021., (© The Author(s) 2024. Published by Oxford University Press on behalf of European Society of Human Reproduction and Embryology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)