Search

PurposeThis study aims to optimize neoadjuvant radiotherapy target area for locally advanced rectal cancer (LARC) patients undergoing total neoadjuvant therapy (TNT) by examining local recurrence patterns.Methods and materialsWe retrospectively analyzed the clinical data of rectal cancer patients who undergone local recurrence after surgery. Recurrence sites were categorized and compared with initial diagnosis imaging, focusing on visible and suspicious lesions.ResultsOf the 126 patients who met our criteria, 186 lesions were analyzed. Within these, 75.40% of cases (95/126) and 83.33% of lesions (155/186) were located within the pelvic cavity. Conversely, 3.97% of cases (5/126) and 3.33% of lesions (6/186) occurred outside the pelvic cavity. Additionally, 20.63% of cases (26/126) and 13.44% of lesions (25/186) were found in both regions. Recurrences were predominantly observed in mesenteric regions (MR) (40.86%, 76/186) and presacral regions (PR) (32.26%, 60/186). In addition, 86.51% of patients (109/126) had recurrent lesions in HRA and the suspected lesions areas. Further analysis showed that initial CEA levels and adjuvant therapy types were identified as independent predictors for recurrence in MR/PR and initially suspected lesions. 86.51% of patients had recurrent lesions in HRA and the suspected lesions areasConclusionThe MR, PR, and areas of initial suspicious lesions are high-risk zones for post-surgical recurrence of LARC. Exploratory study of involved-field irradiation (IFI) can be carried out in the context of TNT in LARC.

ObjectivesPrevious studies have reported that immunoinflammatory responses have associations with mastitis. Here, we aimed to further figure out whether circulating inflammatory cytokines and immune cells causally impact mastitis liability.MethodsThe two-sample Mendelian randomization made use of genetic variances of 91 inflammatory cytokines from a large publicly available genome-wide association study (GWAS) containing 14,824 participants, 731 immunophenotypes data from 3,757 individuals as exposures separately, and mastitis from a GWAS summary (1880 cases and 211699 controls of European ancestry) as outcome. The primary analysis applied the inverse-variance weighted (IVW) method to estimate causal influences, with MR-Egger, weighted median, weighted mode and simple mode as supplementary approaches. Heterogeneity and pleiotropy were evaluated by the Cochrane Q test, MR-Egger intercept test, and MR-PRESSO global test.ResultsThe results indicated that CX3CL1 may be suggestively relevant to the risk of mastitis (odds ratio, OR = 1.434, 95% CI = 1.142~1.800, p = 0.002). Moreover, three immunophenotypes were identified as having a potential causal link to mastitis (p < 0.05). Significantly, CD28- CD8dim %CD8dim (OR = 1.058, 95% CI = 1.024 ~ 1.093, p = 0.0006) and CD45 on CD33br HLA DR+ (OR = 1.097, 95% CI = 1.039 ~ 1.157, p = 0.0008) were found to induce mastitis possibly. Conversely, CD39+ secreting Treg AC (OR = 0.929, 95% CI = 0.884~ 0.978, p = 0.005) pertained to protective factors of mastitis. Cochran’s Q test and MR-Egger intercept test indicated no significant heterogeneity (p > 0.05) or pleiotropy (p > 0.05), supporting the robustness and reliability of our findings.ConclusionOur study adds to current knowledge on the causal roles of inflammatory cytokines and immune cells on mastitis by genetic means, thus guiding future clinical research.

BackgroundInflammation is associated with the pathophysiology of schizophrenia. The blood markers for systemic inflammation include neutrophil-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), lymphocyte-monocyte ratio (LMR), system inflammation response index (SIRI), and platelet-lymphocyte ratio (PLR). However, these inflammation markers and their relationships with clinical phenotypes among Han Chinese patients with first-episode adolescent-onset schizophrenia (AOS) is unclear. This investigation aimed to elucidate the impact of inflammation on Han Chinese AOS patients as well as the association of blood-based inflammation markers with clinical symptoms.MethodsAltogether, 203 Han Chinese individuals participated in this study, 102 first-episode AOS patients and 101 healthy controls. The assessment of inflammatory indices was based on complete blood cell count. Furthermore, schizophrenia-related clinical symptoms were evaluated using the five-factor model of the Positive and Negative Syndrome Scale (PANSS).ResultsIn Han Chinese first-episode AOS patients, levels of SIRI, PLR, SII, and NLR were significantly increased (p < 0.001), while LMR decreased (p < 0.001) compared to healthy controls. Furthermore, multivariate logistic regression showed that LMR, NLR, SII, and SIRI (all p < 0.05) were independently associated with AOS. Moreover, Receiver operating characteristics assessment indicated that NLR, SIRI, LMR, and SII could effectively distinguish AOS patients from healthy controls. Their areas under the curves were 0.734, 0.701, 0.715, and 0.730 (all p < 0.001). In addition, Correlation analysis revealed that LMR was negatively correlated with the PANSS total, negative, and cognitive factor scores (all p < 0.05); NLR was positively correlated with the cognitive factor score (p < 0.01); SII was negatively correlated with the positive factor score and positively with the negative and cognitive factor scores (all p < 0.05); SIRI was positively correlated with the PANSS total and cognitive factor scores (all p < 0.01).ConclusionsThis research established the involvement of peripheral blood inflammatory markers (LMR, NLR, SII, and SIRI) with the clinical manifestations and pathophysiology of schizophrenia, and these can serve as screening tools or potential indices of the inflammatory state and AOS symptoms severity.

Choroid plexus papilloma (CPP) is a rare benign intracranial tumor origin that predominantly manifests in the lateral ventricle in children, accounting for 0.3%–0.6% of all primary intracranial tumors. It is extremely rare to have the CPP in the trigone of the lateral ventricle through the contralateral posterior interhemispheric transfalcine transprecuneus approach (PITTA). Herein, we report this rare case. A 7-year-old girl presented with headache. Magnetic resonance imaging of the brain showed periatrial lesions, and histopathological examination confirmed CPP (WHO grade I). The contralateral PITTA is a safe, effective, reasonable, and appropriate for some lesions in the trigone of the lateral ventricle. It provides a wider surgical angle (especially for the lateral extension) and reduces the risk of disturbance of the optic radiation compared with the conventional approaches. The use of multiple modern neurosurgical techniques, including interventional embolization, intraoperative navigation, microscope, and electrophysiological monitoring, make the procedure much easier and more accurate, and the neuroendoscope adds to the visualization of the microscope and can reduce surgical complications.

BackgroundSeveral studies have explored the effectiveness of PD-1/PD-L1 inhibitors combined with neoadjuvant chemoradiotherapy (nCRT) in the treatment of locally advanced rectal cancer(LARC), particularly in microsatellite stable(MSS) or mismatch repair proficient(pMMR) LARC patients. We undertook a single-arm systematic review to comprehensively evaluate the advantages and potential risks associated with the use of PD-1/PD-L1 inhibitors in conjunction with nCRT for patients diagnosed with locally advanced rectal cancer.MethodsThe PubMed, Embase, Cochrane Library, ClinicalTrials.gov, ASCO and ESMO were searched for related studies. The main outcomes were pathologic complete response (pCR), major pathological response (MPR), anal preservation, and adverse effects (AEs).ResultsFourteen articles including 533 locally advanced rectal cancer (LARC) patients were analyzed. The pooled pCR, MPR, and anal preservation rates were 36%, 66% and 86%. Grade ≥3 adverse events occurred in 20%. Subgroup analysis showed that; dMMR/MSI-H had a pooled pCR (100%) and MPR (100%), pMMR/MSS had a pooled pCR (38%) and MPR (60%); the short-course radiotherapy and long-course radiotherapy had pooled pCR rates of 51% and 30%, respectively. The rates of pCR for the concurrent and sequential immuno-chemoradiotherapy subgroups at 30% and 40%, mirroring pCR rates for the PD-L1 and PD-1 inhibitor subgroups were 32% and 40%, respectively.ConclusionIn cases of locally advanced rectal cancer, PD-1/PD-L1 inhibitors combined with neoadjuvant chemoradiotherapy have shown promising response rates and acceptable toxicity profiles. PD-1/PD-L1 inhibitors combined with neoadjuvant chemoradiotherapy hence has a positive outcome even in MSS LARC patients.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/#myprospero, identifier CRD42023465380.

This study examined the influence of preferential flow on pore water flows and marine nitrogen transport reaction in variable saturation and variable density coastal aquifers. The 2-D unconfined aquifer model established was based on the software COMSOL by coupling the dynamic and chemical processes together. The results showed that preferential flow affects groundwater flow and salinity distribution, leading to a more complicated mixing process. The preferential flow resulted in an increase in mixing zone area and the upper saline plume area of 10.33 and 2.62 m2, respectively, a decrease in saltwater wedge area of 7.22 m2, and an increase in nitrate (NO3-) removal efficiency from 7.9% to 8.97%. The NO3- removal efficiency increases progressively with the depth (h) and quantity (n) of preferential flows; however, it decreases after a certain quantity. Further quantitative analysis revealed an increase in the intensity of nitrification and dissolved oxygen inflow flux with preferential flow depth and quantity increase. This phenomenon usually occurs on coasts where biological caves are abundant. The results also offer significant implications for designing engineering measures to mitigate saltwater intrusion and are significant to prevent groundwater quality deterioration in coastal zones.

Fluvial islands are vital from both morphological and ecological perspectives and consequently have been hotspots of morphodynamic research in large rivers around the world. This study selected 14 representative fluvial islands in the lower reaches of the Yangtze River and explored their spatial-temporal evolution, including their shape and area dynamics during 1945–2016, by interpreting remote sensing images and analyzing the hydrological data. Results indicated that the total area of the 14 fluvial islands showed a growing trend at an average rate of 0.30 km2 yr−1 during the 72 years. The island Fenghuangzhou experienced the largest change in area, while Xiaohuangzhou (XHZ) had the smallest change in area. Sediment discharge and flooding were assumed to be the primary natural factors controlling the island dynamics. Furthermore, dam construction and bank reinforcement also played a critical role in preventing shoreline collapse, improving channel conditions, and promoting the stability of fluvial islands. From 1976 to 2016, the maximum erosion occurred on the left XHZ, while the maximum accretion was found on the Qingjiezhou island. Almost the entire river section experienced an accretion process on the right bank, which was assumed to be caused by the construction of erosion control structures. Besides, the dynamics of the fluvial islands along the lower Yangtze River appears to follow the erosion processes of the river bank. Our findings can provide an important reference for sustainable utilization and management of fluvial islands.

BackgroundVitamin D is a key factor in bone metabolism, yet vitamin D insufficiency and deficiency are prevalent among postmenopausal women, with potential repercussions on bone mineral density (BMD), bone turnover markers (BTMs), and parathyroid hormone (PTH). Nonetheless, the findings from existing studies exhibit inconsistency, and a notable gap exists in the availability of large-scale investigations.MethodsIn this real-world study, 8,532 postmenopausal women over 50 years old with a diagnosis of osteopenia (50.9%) and osteoporosis (49.1%) at the first visit were enrolled in this study. Serum 25(OH)D level, PTH, osteocalcin (OC) and Beta-CrossLaps of type 1 collagen containing cross-linked C-telopeptide (β-CTX), were measured. BMD at all sites, including the lumbar spine, femoral neck, and total hip were obtained by dual-energy X-ray absorptiometry (DXA). The associations of serum 25(OH)D level with BMDs and BTMs were investigated using spearman correlation analysis and analysis of general linear model adjusted by age and body mass index.ResultsThe serum 25(OH)D level was 22.17 ± 9.75 ng/mL among all patients included in this study. For the osteopenia group, the serum 25(OH)D level was 22.40 ± 9.41 ng/mL, while for the osteoporosis group, it measured 21.93 ± 10.08 ng/mL. In the osteopenia group, the prevalence of vitamin D deficiency, insufficiency and sufficiency was 45.8, 34.6, and 19.6%, respectively, which was close to that of the osteoporosis group (47.4, 34.3, and 18.3%) (p = 0.202). Spearman correlation analysis unveiled negative associations between serum 25(OH)D concentrations and both BTMs and PTH within both the osteopenia and osteoporosis group. In the osteoporosis group, there were positive correlations between 25(OH)D levels and femoral neck BMD (r = 0.040, p = 0.010) and total hip BMD (r = 0.053, p = 0.001). Furthermore, we found that for the osteopenia group, greater vitamin D levels were associated with greater femoral neck BMD (p = 0.020) and total hip BMD (p = 0.008) and lower β-CTX (p

Acetate is a low-cost feedstock for the production of different bio-chemicals. Electrochemical reduction of CO2 into acetate and subsequent acetate fermentation is a promising method for transforming CO2 into value-added chemicals. However, the significant inhibitory effect of acetate on microbial growth remains a barrier for acetate-based biorefinery. In this study, the deletion of genes involved in L-leucine degradation was found to be beneficial for the growth of Pseudomonas stutzeri A1501 in acetate. P. stutzeri (Δpst_3217), in which the hydroxymethylglutaryl-CoA lyase catalyzing β-hydroxy-β-methylglutaryl-CoA into acetyl-CoA and acetoacetate was deleted, grew faster than other mutants and exhibited increased tolerance to acetate. Then, the genes phbCAB from Ralstonia eutropha H16 for poly-3-hydroxybutyrate (PHB) biosynthesis were overexpressed in P. stutzeri (∆pst_3217) and the recombinant strain P. stutzeri (∆pst_3217-phbCAB) can accumulate 0.11 g L−1 PHB from commercial acetate. Importantly, P. stutzeri (∆pst_3217-phbCAB) can also use CO2-derived acetate to produce PHB and the accumulated PHB accounted for 5.42% (w/w) of dried cell weight of P. stutzeri (∆pst_3217-phbCAB).

Persistent hypoglossal artery (PHA) is a rare carotid-vertebrobasilar anastomosis in adults. Here, we report a case of mechanical thrombectomy for acute basilar artery occlusion via the PHA. A 44-year-old man was admitted to our stroke unit with an unstable gait and aphasia for 2 h. The baseline National Institutes of Health Stroke Scale (NIHSS) score was 4, but the clinical symptoms continued to worsen. Computed tomography angiography showed the absence of the basilar artery and an abnormal anastomosis between the anterior and posterior circulation. Clinical symptoms continued to worsen, and endovascular treatment was scheduled. PHA was demonstrated and basilar artery occlusion was confirmed using digital subtraction angiography. Mechanical thrombectomy with a stent retriever and aspiration was performed via the PHA, and modified thrombolysis in cerebral infarction level 3 was achieved. The patient underwent intravenous antiplatelet therapy after the operation, and follow-up neuroimaging revealed multiple small infarcts in the cerebellum and medulla oblongata. The patient was discharged after 10 days for further rehabilitation, with an NIHSS score of 25. At 10 months follow-up, the NIHSS score decreased to 18. Recognition of this rare variation is particularly important for interventional strategy determination and rapid recanalization of basilar artery occlusion.

Paravalvular leak (PVL) is a shortcoming that can erode the clinical benefits of transcatheter valve replacement (TAVR) and therefore a readily applicable method (aortography) to quantitate PVL objectively and accurately in the interventional suite is appealing to all operators. The ratio between the areas of the time-density curves in the aorta and left ventricular outflow tract (LVOT-AR) defines the regurgitation fraction (RF). This technique has been validated in a mock circulation; a single injection in diastole was further tested in porcine and ovine models. In the clinical setting, LVOT-AR was compared with trans-thoracic and trans-oesophageal echocardiography and cardiac magnetic resonance imaging. LVOT-AR > 17% discriminates mild from moderate aortic regurgitation on echocardiography and confers a poor prognosis in multiple registries, and justifies balloon post-dilatation. The LVOT-AR differentiates the individual performances of many old and novel devices and is being used in ongoing randomized trials and registries.

BackgroundRectal squamous cell carcinoma (RSCC) is a rare malignancy of the rectal tumor. Due to its extremely low incidence, there is still a lack of high-level treatment evidence and clinical consensus on this disease.Case reportIn this article, we report a treatment process of RSCC with high PD-L1 expression. Firstly, this patient received 2 cycles of Pembrolizumab immunotherapy, but the efficacy was less sanguine. Subsequently, 4 cycles of mFOLFOX6 chemotherapy were synchronously performed on the basis of the initial regimen. Although partial remission was achieved in the lymph nodes thereafter, the changes in the primary lesions were still not significant. After that, the patient received radiotherapy, and followed by 6 cycles of PC (Albumin-binding Paclitaxel and Nedaplatin) regimen chemotherapy combined with Pembrolizumab. Eventually, the patient achieved no evidence of disease (NED) status, and no signs of recurrence or metastasis were found after 12 months of follow-up.ConclusionThis is the first report of a RSCC patient with high PD-L1 expression achieving a complete response. Looking back over the whole treatment process of this patient, we found that the participation of radiotherapy was the inflection point of prominent efficacy, which may provide a new idea for the selection of comprehensive treatment strategies for patients with RSCC.

The non-invasive and rapid assessment of the developmental potential of embryos is of great clinical importance in assisted reproductive technology (ART). In this retrospective study, we analyzed the metabolomics of 107 samples provided by volunteers and utilized Raman spectroscopy to detect the substance composition in the discarded culture medium of 53 embryos resulting in successful pregnancies and 54 embryos that did not result in pregnancy after implantation. The culture medium from D3 cleavage-stage embryos was collected after transplantation and a total of 535 (107 × 5) original Raman spectra were obtained. By combining several machine learning methods, we predicted the developmental potential of embryos, and the principal component analysis–convolutional neural network (PCA-CNN) model achieved an accuracy rate of 71.5%. Furthermore, the chemometric algorithm was used to analyze seven amino acid metabolites in the culture medium, and the data showed significant differences in tyrosine, tryptophan, and serine between the pregnancy and non-pregnancy groups. The results suggest that Raman spectroscopy, as a non-invasive and rapid molecular fingerprint detection technology, shows potential for clinical application in assisted reproduction.

Stress fractures are rare, occurring in 1.5/100,000 high school athletes. High impact, repetitive loading participation in woman's sports, and being a white athlete have been identified as risk factors for stress fractures. Mostly treated conservatively, they are more common in the tibia (33%). Stress fractures requiring surgery, which are extremely rare, have been reported in the scaphoid, fifth metatarsal, and neck of femur. Herein, a 16-year-old adolescent patient with obesity presented with atypical knee pain after prolonged exercise. Advanced imaging revealed a stress fracture of the left tibia with a Salter–Harris type V fracture and varus deformity of the knee. We initially managed the fatigue fracture conservatively, followed by surgical correction of the varus deformity in the knee joint. The patient made a satisfactory recovery with equal limb length and no evidence of claudication. This is the first case of a proximal tibial metaphyseal stress fracture requiring surgery. The clinical manifestations of proximal tibial metaphyseal stress fractures and potential treatment strategies and the use of magnetic resonance for tibial stress fractures have been discussed. Understanding the location of unusual stress fractures can improve early diagnostic efficiency and reduce complication rates, healthcare costs, and recovery time.

BackgroundThe endoplasmic reticulum-membrane protein complex (EMC) as a molecular chaperone is required for the proper synthesis, folding and traffic of several transmembrane proteins. Variants in the subunit 1 of EMC (EMC1) have been implicated in neurodevelopmental disorders.MethodsWhole exome sequencing (WES) with Sanger sequencing validation was performed for a Chinese family, including the proband (a 4-year-old girl who displayed global developmental delay, severe hypotonia and visual impairment), her affected younger sister and her non-consanguineous parents. RT-PCR assay and Sanger sequencing were used to detect abnormal RNA splicing.ResultsNovel compound heterozygous variants in EMC1, including the maternally inherited chr1: 19566812_1956800delinsATTCTACTT[hg19];NM_015047.3:c.765_777delins ATTCTACTT;p.(Leu256fsTer10) and the paternally inherited chr1:19549890G> A[hg19];NM_015047.3:c.2376G>A;p.(Val792=) are identified in the proband and her affected sister. RT-PCR assay followed by Sanger sequencing reveals that the c.2376G>A variant leads to aberrant splicing, with retention of intron 19 (561bp) in the mature mRNA, which is presumed to introduce a premature translational termination codon (p.(Val792fsTer31)).ConclusionNovel compound heterozygous variants in EMC1 have been identified in individuals with global developmental delay. Non-silent synonymous mutations should be kept in mind in genetic analysis.

Planting spacing plays a key role in the root system architecture of the cotton group under local irrigation. This study used the Cellular Automata (CA) theory to establish a root visualization model for the cotton group at two different planting spacing (30 and 15 cm) within a leaching-pond. At a planting spacing of 30 cm, the lateral roots grew almost horizontally toward the irrigation point, and a logarithmic relationship was observed between root length density and soil water suction. However, at a planting spacing of 15 cm, the lateral roots exhibited overlapping growth and mainly competed for resources, and a power function relationship was observed between root length density and soil water suction. The main parameters of the visualization model for each treatment were essentially consistent with the experimental observations, with respective simulation errors were 6.03 and 15.04%. The findings suggest that the correlation between root length density and soil water suction in the cotton plants is a crucial driving force for the model, leading to a more accurate replication of the root structure development pathway. In conclusion, the root system exhibits a certain degree of self-similarity, which extends into the soil.

PurposeTo investigate the clinical factors affecting pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC).MethodsClinical data of 124 LARC patients treated with nCRT and surgery in the fourth Hospital of Hebei Medical University from 2014 to 2019 were retrospectively analyzed. In this study, univariate analysis and logistic dichotomous multivariate regression analysis were used to study the clinical factors affecting pCR, and the receiver operator characteristic curve (ROC) analysis was used to further verify the accuracy of partial indexes in predicting pCR.ResultsOf the 124 enrolled patients, 19 patients (15.32%) achieved pCR. Univariate analysis showed that the number of cycles of consolidation chemotherapy, serum carcino-embryonic antigen (CEA) level before treatment, MRI longitudinal length of tumor, and extramural vascular invasion (EMVI) were statistically correlated with pCR. ROC analysis of the longitudinal length of tumor measured by MRI showed that the area under the curve (AUC) value, sensitivity and specificity were 0.735, 89.47% and 48.57% respectively, and the optimal cut-off value was 5.5cm. The ROC analysis showed that the AUC value, sensitivity and specificity of pCR prediction using CEA were 0.741, 63.16% and 90.48%, respectively, and the optimal cut-off value was 3.1ng/ml. Multivariate results showed that the number of cycles of consolidation chemotherapy, serum CEA level before treatment, and EMVI were independent predictors of pCR.ConclusionThe number of cycles of consolidation chemotherapy, serum CEA level before treatment, and EMVI may be important determinants of LARC patients to reach pCR after nCRT.

Introduction: Melatonin (5-methoxy-N-acetyl-tryptamine) is a circadian hormone synthesized and secreted by the pineal gland. In addition to regulating circadian rhythms of many physiological functions, melatonin is involved in regulating autonomic nervous function and blood pressure. Hypothalamus paraventricular nucleus (PVN), receiving melatonin projections from the superchiasmatic nucleus, is a critical brain region to regulate neuroendocrine and cardiovascular function. Here, we determined the synaptic mechanisms involved in the effect of melatonin on the sympathetic outflow and blood pressure.Methods and Results: Microinjection of melatonin into the PVN produced a depressor effect and decreased renal sympathetic nerve activity (RSNA). While microinjection of luzindole, a non-selective melatonin receptor antagonist, into the PVN did not change melatonin-induced sympathoinhibition, GABAA receptor antagonist bicuculline eliminated melatonin-induced sympathoinhibition. Furthermore, melatonin decreased firing rate of retrogradely labeled PVN neurons which project to the rostral ventrolateral medulla (RVLM), an effect was not altered by luzindole but eliminated by bicuculline. Melatonin significantly increased the amplitude of spontaneous and evoked GABAergic inhibitory synaptic currents, as well as GABA-induced currents.Conclusion: These data suggest that melatonin in the PVN suppresses sympathetic vasomotor tone through enhancing GABAA receptor activity. This study provides novel information for understanding the cellular mechanisms involved in the effect of melatonin on regulating blood pressure and sympathetic output.

This paper investigates the effects of the cutoff wall on the fate of nitrate (NO3-), the NO3- removal rate, and the salinity distribution in a coastal aquifer under tidal action. A numerical study was performed based on a coupled model with variable-saturation and variable-density flow and a convection-diffusion-reaction equation for solute transport in a coastal unconfined aquifer. The results showed that the cutoff wall led to a larger upper salinity plume (USP) and that the saltwater wedge (SW) further retreated seaward. The recirculation pathways of saltwater and groundwater were largely modified by the wall. The cutoff wall within the tidal range could increase the NO3- mass of denitrification and the NO3- removal efficiency and decrease the length of the SW and the freshwater flux. This modification of the saltwater and groundwater recirculation pathways was enhanced with increasing wall depth. A deeper cutoff wall led to a further retreated SW, lower freshwater flux, and greater improvements in the NO3- mass of denitrification and the NO3- removal efficiency. In addition, the cutoff wall significantly decreased the terrestrial dissolved organic carbon (TDOC) discharge into the sea. Dissolved organic carbon source (SDOC) promoted a higher NO3- removal efficiency. This study provides us with a better understanding of coastal physical-biogeochemical processes and dynamic mechanisms, as well as a guide for designing engineering measures to mitigate NO3- contamination and thus enhance groundwater quality management.

Oil-immersion transformer plays an important role in the operation of power system, and its reliable operation is the basis of the safe and economic operation of power system. Transformer internal failure will not only cause the transformer to stop, but also damage, affecting the proper operation of the power system. The transformer is often in a high-temperature and high-pressure environment during its operation, so it is difficult to effectively and accurately protect the transformer from failure in the harsh working environment. Because the existing methods can not detect and protect the faults of transformer equipment sensitively and accurately, based on this, this paper carried out the research on the detection and protection of oil immersed transformer. By analyzing the calculation results, the relationship between the temperature rise of the transformer structure and the ambient temperature is discussed. It is found that the higher the ambient temperature of the transformer, the greater the harm to the equipment. High temperature area is mainly concentrated at the pull plate of transformer. This provides a reference for making the starting strategies of transformers in different environments, and helps to avoid mechanical structure damage and insulation aging damage caused by temperature.

In order to explain the difference in adsorption characteristics of CH4 and CO2 on continental shale from the perspective of thermodynamics, the isothermal adsorption experiments of CH4 and CO2 adsorbed by shale in Yanchang Formation in Ordos Basin were carried out, and the excess adsorption capacity was corrected to absolute adsorption capacity. Then the Clausius-Clapeyron equation was used to analyze the isosteric heat of adsorption of CH4 and CO2 on shale. The results show that, for calculating the absolute adsorption capacity, Ozawa empirical formula or Van der Waals approximation method should be used to calculate the adsorption phase density. The absolute adsorption capacity should be selected as the basic data for calculating the isosteric heat of adsorption. The reason is that the excess isosteric heat of adsorption has a negative value in the low adsorption capacity stage, which is contradictory to the fact that the adsorption process is exothermic, and is significantly higher than the absolute isosteric heat of adsorption. There is a good linear positive correlation between the isosteric heat of adsorption and the adsorption amount of CH4 and CO2 adsorbed by continental shale, and the isosteric heat of adsorption of CH4 is greater than that of CO2. The absolute initial isosteric heat of adsorption of CH4 and CO2 adsorbed by shale is 52.04 kJ/mol and 27.71 kJ/mol, indicating that the adsorption force of CH4 on Yanchang Formation shale is stronger than that of CO2.

BackgroundTubridge flow diverter is a widely used device aimed at reconstructing parent arteries and occluding complex aneurysms in China. The experience of Tubridge in treating small and medium aneurysms is still limited. In this study, we aimed to evaluate the safety and efficacy of the Tubridge flow diverter for the treatment of the two types of aneurysms.MethodsWe reviewed the clinical records of aneurysms treated with a Tubridge flow diverter between 2018 and 2021 in a national cerebrovascular disease center. Cases were divided into small and medium aneurysms according to aneurysm size. The therapeutic process, occlusion rate, and clinical outcome were compared.ResultsIn total, 57 patients and 77 aneurysms were identified. The patients were divided into two groups: small aneurysms (39 patients, 54 aneurysms) and medium aneurysms (18 patients, 23 aneurysms). There were 19 patients with tandem aneurysms (a total of 39 aneurysms) in the two groups, among which 15 patients (30 aneurysms) were in the small aneurysm group and four patients (nine aneurysms) were in the medium aneurysm group. The results show that the mean maximal diameter/neck in the small and medium aneurysms was 3.68/3.25 and 7.61/6.24 mm, respectively. In total, 57 Tubridge flow diverters were successfully implanted without unfolding failure, and there were six patients with new mild cerebral infarction in the small aneurysm group. The complete occlusion rate on the last angiographic follow-up was achieved in 88.46% of the small aneurysms group and 81.82% of the medium aneurysms group. The complete occlusion rate of patients with tandem aneurysms in the last angiographic follow-up was 86.67% (13/15) of the small aneurysms group and 50% (2/4) of the medium aneurysm group. Intracranial hemorrhage was nonencountered in the two groups.ConclusionOur preliminary experience suggests that the Tubridge flow diverter might be a safe and effective treatment for small and medium aneurysms along the internal carotid artery. Long stents may increase the risk of cerebral infarction. Adequate evidence is required to clarify the definite indications and complications in a multicenter randomized controlled trial with a long-term follow-up.

In this paper, taking the shale of Chang 7-Chang 9 oil formation in Yanchang Formation in the southeastern Ordos Basin as an example, through the study of shale heterogeneity characteristics, starting from the preprocessing of supervision data set, a logging interpretation method of total organic carbon content (TOC) on the lithofacies-based Categorical regression model (LBCRM) is proposed. It is show that: 1) Based on core observation, and Differences of sedimentation and structure, five lithofacies developed in the Yanchang Formation: shale shale facies, siltstone/ultrafine sandstone facies, tuff facies, argillaceous shale facies with silty lamina and argillaceous shale facies with tuff lamina. 2) The strong heterogeneity of shale makes it difficult to accurately explain the TOC distribution of shale intervals in the application of model-based interpretation methods. The LBCRM interpretation method based on the understanding of shale heterogeneity can effectively reduce the influence of formation factors other than TOC on the prediction accuracy by studying the characteristics of shale heterogeneity and constructing a TOC interpretation model for each lithofacies category. At the same time, the degree of unbalanced distribution of data is reduced, so that the data mining algorithm achieves better prediction effect. 3) The interpretability of lithofacies logging ensures the wellsite application based on the classification and regression model of lithofacies. Compared with the traditional homogeneous regression model, the prediction performance has been greatly improved, TOC segment prediction is more accurate. 4) The LBCRM method based on shale heterogeneity can better understand the reasons for the deviation of the traditional model-based interpretation method. After being combined with the latter, it can make logging data provide more useful information.

The Chukchi Sea has experienced significant changes under global warming in the Common Era, including the shift of primary productivity. However, modern observations are too short to fully investigate the effects of environmental changes in this area. Here, we analyzed lipid biomarkers (e.g. long-chain n-alkanes, n-alkanols, n-alkanoic acids, diols, and sterols) from a sediment core (R07) collected from the Chukchi Sea shelf to determine phytoplankton primary productivity variations and factors influencing these changes over the past 70 years. Similar trends of the abundance of terrestrial ecosystem-derived compounds (e.g. long-chain n-alkanes, n-alkanols, n-alkanoic acids, and C32 1,15-diol) indicate that terrigenous input increased from ca. 1946 towards ca. 1983 and then decreased thereafter. In comparison, biomarkers with marine origin indicate that the ratio of diatoms to dinoflagellates increased after ca. 1983 towards the core-top (ca. 2011). Concurrent changes in terrigenous input and phytoplankton community indicated a shift in water mass structure at ca. 1983 (i.e. the Alaska Coastal Water decreased and the Bering Sea Water increased), which may be attributed to the phase shift of the Arctic Oscillation and/or unsynchronized flow changes in different water masses. Owing to the different water mass properties, the change of water mass structure caused intense water mixing and the resulting high turbidity in the study area, which led to light limitation for phytoplankton growth. These conditions probably account for the reduced phytoplankton primary productivity from ca. 1983 to ca. 2000 in the general trend of increasing. The results indicate that, in addition to global warming and sea ice retreat, other factors, such as change in regional water mass structure (i.e. different water masses), may also have a significant influence on the primary productivity and the phytoplankton community in the Chukchi Sea shelf.

Mycobacterium tuberculosis possesses a dynamic cell envelope, which consists of a peptidoglycan layer, a mycolic acid layer, and an arabinogalactan polysaccharide. This envelope possesses a highly complex and unique structure representing a barrier that protects and assists the growth of M. tuberculosis and allows its adaptation to the host. It regulates the immune response of the host cells, causing their damage. Therefore, the cell envelope of M. tuberculosis is an attractive target for vaccine and drug development. The emergence of multidrug-resistant as well as extensively drug resistant tuberculosis and co-infection with HIV prevented an effective control of this disease. Thus, the discovery and development of new drugs is a major keystone for TB treatment and control. This review mainly summarizes the development of drug enzymes involved in the biosynthesis of the cell wall in M. tuberculosis, and other potential drug targets in this pathway, to provide more effective strategies for the development of new drugs.

BackgroundThe aim of this study was to evaluate the clinical usefulness of radiomics signature-derived 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography–computed tomography (PET-CT) for the early prediction of neoadjuvant chemotherapy (NAC) outcomes in patients with (BC).MethodsA total of 124 patients with BC who underwent pretreatment PET-CT scanning and received NAC between December 2016 and August 2019 were studied. The dataset was randomly assigned in a 7:3 ratio to either the training or validation cohort. Primary tumor segmentation was performed, and radiomics signatures were extracted from each PET-derived volume of interest (VOI) and CT-derived VOI. Radiomics signatures associated with pathological treatment response were selected from within a training cohort (n = 85), which were then applied to generate different classifiers to predict the probability of pathological complete response (pCR). Different models were then independently tested in the validation cohort (n = 39) regarding their accuracy, sensitivity, specificity, and area under the curve (AUC).ResultsThirty-five patients (28.2%) had pCR to NAC. Twelve features consisting of five PET-derived signatures, four CT-derived signatures, and three clinicopathological variables were candidates for the model’s development. The random forest (RF), k-nearest neighbors (KNN), and decision tree (DT) classifiers were established, which could be utilized to predict pCR to NAC with AUC ranging from 0.819 to 0.849 in the validation cohort.ConclusionsThe PET/CT-based radiomics analysis might provide efficient predictors of pCR in patients with BC, which could potentially be applied in clinical practice for individualized treatment strategy formulation.

BackgroundPivotal trials of percutaneous left atrial appendage closure (LAAC) used dedicated post-procedure antithrombotic protocols. However, there is no consensus on the selection of new oral anticoagulants (NOAC) and warfarin monotherapy after LAAC. This study aims to compare NOAC with warfarin monotherapy for efficacy and safety in patients undergoing LAAC.MethodsA database search was conducted using PubMed, EMBASE, Cochrane Library, and Clinicaltrials.gov for trials that compared NOAC with warfarin monotherapy after LAAC. The effective outcomes included any major adverse events (all-cause death, stroke, major bleeding) and their individual components. Safety outcomes included all-cause death, major bleeding, total bleeding, DRT, and PDL >5 mm.ResultsWe included 10 non-randomized clinical trials with 10,337 patients, of whom 4,960 patients received NOAC, while 5,377 patients received warfarin. There were no statistically significant differences in any major adverse events (LogOR: −0.11, 95% CI: −0.27, 0.04, P = 0.16), stroke (LogOR: 0.00, 95% CI: −0.42, 0.42, P = 1.00), all-cause death (LogOR: −0.23, 95% CI: −0.48, 0.02, P = 0.07), major bleeding (LogOR: −0.22, 95% CI: −0.45, 0.01, P = 0.06). NOAC was associated with a significant reduction in total bleeding (LogOR: −1.01, 95% CI: −1.47, −0.55, P < 0.0001) compared to warfarin. No statistically significant differences were found in DRT (LogOR: −0.19, 95% CI: −0.15, 0.52, P = 0.27) and PDL >5 mm (LogOR: 0.19, 95% CI: −0.33, 0.72, P = 0.47). Meta-regression and subgroup analysis showed that total bleeding (LogOR: −1.56, 95% CI: −2.15, −0.97, P < 0.001) was significantly lower in the NOAC group in the subgroup of

Globally, Prostate cancer (PCa) is the second most common cancer in the male population worldwide, but clinically significant prostate cancer (CSPCa) is more aggressive and causes to more deaths. The authors aimed to construct the risk category based on Prostate Imaging Reporting and Data System score version 2.1 (PI-RADS v2.1) in combination with Prostate-Specific Antigen Density (PSAD) to improve CSPCa detection and avoid unnecessary biopsy. Univariate and multivariate logistic regression and receiver-operating characteristic (ROC) curves were performed to compare the efficacy of the different predictors. The results revealed that PI-RADS v2.1 score and PSAD were independent predictors for CSPCa. Moreover, the combined factor shows a significantly higher predictive value than each single variable for the diagnosis of CSPCa. According to the risk stratification model constructed based on PI-RADS v2.1 score and PSAD, patients with PI-RADS v2.1 score of ≤2, or PI-RADS V2.1 score of 3 and PSA density of

The organic-rich shales of the Chang 7 Member in the Yan’an Formation of the Yan’an area, Ordos Basin is a hot spot for lacustrine shale gas exploration. In this paper, taking the Chang 7 Member shale in the Yan’an area as an example, the main controlling factors of lacustrine shale gas accumulation and the prediction of “sweet spots” are systematically carried out. The results show that the Yanchang Formation shale has the complete gas generating conditions. Shale gas accumulation requires three necessary accumulation elements, namely gas source, reservoir and good preservation conditions. The dynamic hydrocarbon generation process of the Chang 7 shale reservoirs is established according to the thermal simulation experiments of hydrocarbon generation, and the mechanism of catalytic degradation and gas generation in the Chang 7 Member under the background of low thermal evolution degree is revealed. The enriched authigenic pyrite can catalyze the hydrocarbon generation of organic matter with low activation energy, thereby increasing the hydrocarbon generation rates in the low-mature-mature stage. Different types of pores at different scales (2–100 nm) form a multi-scale complex pore network. Free gas and dissolved gas are enriched in laminar micro-scale pores, and adsorbed gas is enriched in nano-scale pores of thick shales, and silty laminates can improve the physical properties of the reservoir. This is because the laminar structure has better hydrocarbon generation conditions and is favorable for the migration of oil and gas molecules. The thickness of the lacustrine shale in the Chang 7 Member is between 40 and 120 m, which has exceeded the effective hydrocarbon expulsion thickness limit (8–12 m). At the end of the Early Cretaceous, the excess pressure of the Chang 7 shale was above 3 MPa. At present, horizontal wells with a daily gas production of more than 50,000 cubic meters are distributed in areas with high excess pressures during the maximum burial depth.

Objective: Several studies have shown the significance of neuroinflammation in the pathological progress of cerebral palsy (CP). However, the etiology of CP remains poorly understood. Spastic CP is the most common form of CP, comprising 80% of all cases. Therefore, identifying the specific factors may serve to understand the etiology of spastic CP. Our research aimed to find some relevant factors through protein profiling, screening, and validation to help understand the pathogenesis of cerebral palsy.Materials and methods: In the current study, related clinical parameters were assessed in 18 children with spastic CP along with 20 healthy individuals of the same age. Blood samples of the spastic CP children and controls were analyzed with proteomics profiling to detect differentially expressed proteins. On the other hand, after hypoxic-ischemic encephalopathy (HIE) was induced in the postnatal day 7 rat pups, behavioral tests were performed followed by detection of the differentially expressed markers and inflammatory cytokines in the peripheral blood and cerebral cortex of the CP model rats by Elisa and Western blot. Independent sample t-tests, one-way analysis of variance, and the Pearson correlation were used for statistical analysis.Results: Through proteomic analysis, differentially expressed proteins were identified. Among them, tissue-nonspecific alkaline phosphatase (TNAP), the gene expression product of alkaline phosphatase (ALPL), was downregulated in spastic CP. In addition, significantly lower TNAP levels were found in the children with CP and model rats. In contrast, compared with the sham rats, the model rats demonstrated a significant increase in osteopontin and proinflammatory biomarkers in both the plasma and cerebral cortex on the ischemic side whereas serum 25 hydroxyvitamin D and IL-10 were significantly decreased. Moreover, serum TNAP level was positively correlated with serum CRP and IL-10 in model rats.Conclusion: These results suggest that TNAP is the potential molecule playing a specific and critical role in the neuroinflammation in spastic CP, which may provide a promising target for the diagnosis and treatment of spastic CP.

ObjectiveCholangiocarcinoma (CHOL) is a deadly cancer worldwide with limited available therapies. The aim of this study was to investigate key exosomal miRNAs and their functions in CHOL development.MethodsSerum exosomes were isolated from patients with CHOL and healthy controls, followed by miRNA sequencing for identifying differentially expressed miRNAs (DEMs) and their functions. Then, the expression of key DEMs was experimentally validated in exosomes from clinical CHOL patients and CHOL cells. The effects of overexpression of key DEMs on CHOL cell migration and proliferation were investigated. A key exosomal DEM miR-3124-5p was identified. The effects of overexpression or knockdown of exosomal miR-3124-5p on the proliferation, migration, and angiogenesis of human umbilical vein endothelial cells (HUVECs) were investigated. Moreover, the function of exosomal miR-3124-5p on tumor growth in vivo was explored.ResultsA total of 632 exosomal DEMs were identified between CHOL and control samples. Target genes of DEMs were significantly enriched in pathways, such as the p53 signaling pathway. miR-3124-5p was upregulated in serum exosomes from CHOL patients and exosomes from CHOL cells, and overexpression of miR-3124-5p promoted RBE cell migration and viability. Moreover, overexpression of exosomal miR-3124-5p promoted the proliferation, migration, and angiogenesis of HUVECs, while knockdown of miR-3124-5p had the opposite effect. miR-3124-5p could target growth differentiation factor 11 (GDF11) and downregulate GDF11 expression. Furthermore, exosomal miR-3124-5p promoted tumor growth in vivo.ConclusionsOur findings revealed that exosome-encapsulated miR-3124-5p promoted the malignant progression of CHOL by targeting GDF11. Exosomal miR-3124-5p and GDF11 could be promising biomarkers or therapeutic targets for CHOL.

ObjectiveThis study aimed to investigate the association of altered cortical thickness and functional connectivity (FC) with depression in Parkinson’s disease (PD).Materials and methodsA total of 26 non-depressed PD patients (PD-ND), 30 PD patients with minor depression (PD-MnD), 32 PD patients with major depression (PD-MDD), and 30 healthy controls (HC) were enrolled. Differences in cortical thickness among the four groups were assessed, and the results were used to analyze FC differences in regions of cortical atrophy. Binary logistic regression and receiver operating characteristic (ROC) curve analyses were also performed to identify clinical features and neuroimaging biomarkers that might help in the prediction of PD-MDD.ResultsPatients with PD-MDD showed decreased cortical thickness compared to patients with PD-ND in the left superior temporal and right rostral middle frontal gyri (RMFG), as well as weak FC between the left superior temporal gyrus and right cerebellum posterior lobe and between right RMFG and right inferior frontal gyrus and insula. The combination of cortical thickness, FC, and basic clinical features showed strong potential for predicting PD-MDD based on the area under the ROC curve (0.927, 95% CI 0.854–0.999, p < 0.001).ConclusionPatients with PD-MDD show extensive cortical atrophy and FC alterations, suggesting that cortical thickness and FC may be neuroimaging-based diagnostic biomarkers for PD-MDD.

Sustainable and environment-friendly microbial fermentation processes have been developed to produce numerous chemicals. However, the high energy input required for sterilization and substantial fresh water consumption restrict the economic feasibility of traditional fermentation processes. To address these problems, Vibrio natriegens, a promising microbial chassis with low nutritional requirements, high salt tolerance and rapid growth rate can be selected as the host for chemical production. In this study, V. natriegens was metabolic engineered to produce 2,3-butanediol (2,3-BD), an important platform chemical, through non-sterilized fermentation with seawater-based minimal medium after expressing a 2,3-BD synthesis cluster and deleting two byproduct encoding genes. Under optimized fermentative conditions, 41.27 g/L 2,3-BD was produced with a productivity of 3.44 g/L/h and a yield of 0.39 g/g glucose by recombinant strain V. natriegensΔfrdAΔldhA-pETRABC. This study confirmed the feasibility of non-sterilized fermentation using seawater to replace freshwater and other valuable chemicals may also be produced through metabolic engineering of the emerging synthetic biology chassis V. natriegens.

ObjectivesThe aim of this research is to discuss the research status, hotspots, frontiers and development trends in the field of adult-onset Still’s disease (AOSD) based on bibliometrics and visual analysis by CiteSpace software.MethodsThe relevant research articles on AOSD from 1921 to 2021 were retrieved from the Scopus database. CiteSpace software was used to form a visual knowledge map and conduct analysis for the countries/regions, journals, authors, keywords, clusters, research hotspots and frontiers of the included articles.ResultsThere were 2,373 articles included, and the number of articles published during 1921-2021 is increasing. The country with the highest number of articles published was Japan (355, 14.96%), followed by the United States (329, 13.86%) and France (215, 9.06%). The author with the highest number of publications is Ansell, Barbara M. (30, 1.26%), and the author with the highest co-citation frequency is Yamaguchi, Masaya (703). Clinical Rheumatology is the journal with the highest publication frequency. The top five cluster groups were “joint”, “differential diagnosis”, “prednisolone”, “methotrexate” and “macrophage activation syndrome”. The diagnosis, treatment and pathogenesis of AOSD form the main research fields, and prognosis and complications are the research hotspots and trends.ConclusionsThe global research field in AOSD has expanded in the past 100 years. The complications and new pathogenesis of AOSD are hotspots in this field and need further study in the future.

BackgroundThe healing response of the Firehawk stent in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear.AimWe compared the vascular healing of a biodegradable polymer sirolimus-eluting stent (Firehawk) vs. a durable polymer everolimus-eluting stent (Xience) at 6 months after percutaneous coronary intervention (PCI) in patients with STEMI.MethodsIn this prospective, multicenter, randomized, non-inferiority study, patients within 12 h of STEMI onset were randomized in a ratio of 1:1 to receive Firehawk or Xience stents. Optical coherence tomography (OCT) follow-up was performed 6 months after the index procedure and assessed frame by frame. The primary endpoint was the neointimal thickness (NIT) at 6 months evaluated by OCT. The safety endpoint was target lesion failure (TLF) at 12 months.ResultsThe Firehawk stent was non-inferior to the Xience stent in terms of the neointimal thickness (73.03 ± 33.30 μm vs. 78.96 ± 33.29 μm; absolute difference: −5.94 [one-sided 95% lower confidence bound: −23.09]; Pnon−inferiority < 0.001). No significant difference was observed between the Firehawk and Xience groups regarding the percentage of uncovered struts (0.55 [0.08, 1.32]% vs. 0.40 [0.21, 1.19]%, P = 0.804), the percentage of malapposed struts (0.17 [0.00, 1.52]% vs. 0.17 [0.00, 0.69]%, P = 0.662), and the healing score (1.56 [0.23, 5.74] vs. 2.12 [0.91, 3.81], P = 0.647). At 12 months, one patient in the Firehawk group experienced a clinically indicated target lesion revascularization. No other TLF events occurred in both groups. Independent risk factors of the NIT included body mass index, hyperlipidemia, B2/C lesions, thrombus G3–G5, thrombus aspiration, and postdilation pressure.ConclusionIn patients with STEMI, Firehawk was non-inferior to Xience in vascular healing at 6 months. Both stents exhibited nearly complete strut coverage, moderate neointimal formation, and minimal strut malapposition.Clinical Trial NumberNCT04150016.

4-1BB is a T cell costimulatory receptor and a member of the tumor necrosis factor receptor superfamily. Here, we show that Galectin-3 (Gal-3) decreases the cellular response to its ligand (4-1BBL). Gal-3 binds to both soluble 4-1BB (s4-1BB) and membrane-bound 4-1BB (mem4-1BB), without blocking co-binding of 4-1BBL. In plasma, we detected complexes composed of 4-1BB and Gal-3 larger than 100 nm in size; these complexes were reduced in synovial fluid from rheumatoid arthritis. Both activated 4-1BB+ T cells and 4-1BB-transfected HEK293 cells depleted these complexes from plasma, followed by increased expression of 4-1BB and Gal-3 on the cell surface. The increase was accompanied by a 4-fold decrease in TNFα production by the 4-1BBhighGal-3+ T cells, after exposure to 4-1BB/Gal-3 complexes. In RA patients, complexes containing 4-1BB/Gal-3 were dramatically reduced in both plasma and SF compared with healthy plasma. These results support that Gal-3 binds to 4-1BB without blocking the co-binding of 4-1BBL. Instead, Gal-3 leads to formation of large soluble 4-1BB/Gal-3 complexes that attach to mem4-1BB on the cell surfaces, resulting in suppression of 4-1BBL’s bioactivity.

Emotion regulation in childhood and adolescence is related to their social development. Better emotion regulation is associated with great individual academic performance and mental health. However, compared with the research on emotion regulation strategies, children’s automatic emotion regulation has been less investigated. Using event-related potential (ERP) technology, this study adopts the cued-emotion Go/Nogo paradigm to investigate the processing characteristics of automatic emotion regulation in children aged 8–12 years. The current study selected 34 younger group [16 boys, 18 girls, mean (M) ± SD = 8.91 ± 0.75], and 31 older group [18 boys, 13 girls, M ± SD = 11.26 ± 0.45]. The results showed that, for Nogo trials, the amplitude of N2 and P3 evoked by emotional faces were significantly larger than those evoked by neutral faces, reflecting the cognitive conflict experienced and the process of children’s automatic response inhibition to emotional stimuli, respectively. However, no significant difference in N2 and P3 amplitude were found in Go trials, which may indicate that children aged 8–12 showed similar top-down control and similar motivated attention in this experiment, respectively. Further analysis found that the negative affect of temperament was significantly positively correlated with Nogo-P3 induced by neutral pictures (r = 0.37, p < 0.001), and preadolescents’ social anxiety was significantly positively correlated with Nogo-P3 followed by neutral pictures (r = 0.31, p < 0.01). These findings can provide inspiration and empirical support for the promotion and intervention of emotion regulation in children and adolescents.

BackgroundHypertrophic cardiomyopathy (HCM) is a widely distributed, but clinically heterogeneous genetic heart disease, affects approximately 20 million people worldwide. Nowadays, HCM is treatable with the advancement of medical interventions. However, due to occult clinical presentations and a lack of easy, inexpensive, and widely popularized screening approaches in the general population, 80–90% HCM patients are not clinically identifiable, which brings certain safety hazards could have been prevented. The majority HCM patients showed abnormal and diverse electrocardiogram (ECG) presentations, it is unclear which ECG parameters are the most efficient for HCM screening.ObjectiveWe aimed to develop a pragmatic prediction model based on the most common ECG features to screen for HCM.MethodsBetween April 1st and September 30th, 2020, 423 consecutive subjects from the International Cooperation Center for Hypertrophic Cardiomyopathy of Xijing Hospital [172 HCM patients, 251 participants without left ventricular hypertrophy (non-HCM)] were prospectively included in the training cohort. Between January 4th and February 30th, 2021, 163 participants from the same center were included in the temporal internal validation cohort (62 HCM patients, 101 non-HCM participants). External validation was performed using retrospectively collected ECG data from Xijing Hospital (3,232 HCM ECG samples from January 1st, 2000, to March 31st, 2020; 95,184 non-HCM ECG samples from January 1st to December 31st, 2020). The C-statistic was used to measure the discriminative ability of the model.ResultsAmong 30 ECG features examined, all except abnormal Q wave significantly differed between the HCM patients and non-HCM comparators. After several independent feature selection approaches and model evaluation, we included only two ECG features, T wave inversion (TWI) and the amplitude of S wave in lead V1 (SV1), in the HCM prediction model. The model showed a clearly useful discriminative performance (C-statistic > 0.75) in the training [C-statistic 0.857 (0.818–0.896)], and temporal validation cohorts [C-statistic 0.871 (0.812–0.930)]. In the external validation cohort, the C-statistic of the model was 0.833 [0.825–0.841]. A browser-based calculator was generated accordingly.ConclusionThe pragmatic model established using only TWI and SV1 may be helpful for predicting the probability of HCM and shows promise for use in population-based HCM screening.

Camellia oleifera is a woody oil tree species unique to China that has been cultivated and used in China for more than 2,300 years. Most biological research on C. oleifera in recent years has focused on the development of new varieties and breeding. Novel genomic information has been generated for C. oleifera, including a high-quality reference genome at the chromosome level. Camellia seeds are used to process high-quality edible oil; they are also often used in medicine, health foods, and daily chemical products and have shown promise for the treatment and prevention of diseases. C. oleifera by-products, such as camellia seed cake, saponin, and fruit shell are widely used in the daily chemical, dyeing, papermaking, chemical fibre, textile, and pesticide industries. C. oleifera shell can also be used to prepare activated carbon electrodes, which have high electrochemical performance when used as the negative electrode of lithium-ion batteries. C. oleifera is an economically valuable plant with diverse uses, and accelerating the utilization of its by-products will greatly enhance its industrial value.

Aldosterone is a major mineralocorticoid steroid hormone secreted by glomerulosa cells in the adrenal cortex. It regulates a variety of physiological responses including those to oxidative stress, inflammation, fluid disruption, and abnormal blood pressure through its actions on various tissues including the kidney, heart, and the central nervous system. Aldosterone synthesis is primarily regulated by angiotensin II, K+ concentration, and adrenocorticotrophic hormone. Elevated serum aldosterone levels increase blood pressure largely by increasing Na+ re-absorption in the kidney through regulating transcription and activity of the epithelial sodium channel (ENaC). This review focuses on the signaling pathways involved in aldosterone synthesis and its effects on Na+ reabsorption through ENaC.

Trimethylamine N-oxide (TMAO), which was detected at nanomolar concentrations in surface seawaters, is an important carbon, nitrogen and/or energy source for marine bacteria. It can be metabolized by marine bacteria into volatile methylated amines, the second largest source of nitrogen after N2 gas in the oceans. The SAR11 bacteria are the most abundant oligotrophic plankton in the oceans, which represents approximately 30% of the bacterial cells in marine surface waters. Genomic analysis suggested that most SAR11 bacteria possess an ATP-binding cassette transporter TmoXWV that may be responsible for importing TMAO. However, it was still unclear whether SAR11 bacteria can utilize TMAO as the sole nitrogen source and how they import TMAO. Here, our results showed that Pelagibacter strain HTCC1062, a SAR11 bacterium, can grow with TMAO as the sole nitrogen source. TmoXWV from strain HTCC1062 (TmoXWV1062) was verified to be a functional TMAO importer. Furthermore, TmoX1062, the periplasmic substrate binding protein of TmoXWV1062, was shown to have high binding affinities toward TMAO at 4°C (Kd = 920 nM), 10°C (Kd = 500 nM) and 25°C (Kd = 520 nM). The high TMAO binding affinity and strong temperature adaptability of TmoX1062 reveal a possible oligotrophic niche adaptation strategy of strain HTCC1062, which may help it gain a competitive advantage over other bacteria. Structure comparison and mutational analysis indicated that the TMAO binding mechanism of TmoX1062 may have differences from the previously reported mechanism of TmoX of Ruegeria pomeroyi DSS-3. This study provides new insight into TMAO utilization by the widespread SAR11 bacteria.

ObjectivesTo compare the quantitative angiographic aortic regurgitation (AR) of six self-expanding valves after transcatheter aortic valve replacement (TAVR).BackgroundQuantitative videodensitometric aortography (LVOT-AR) is an accurate and reproducible tool for assessment of AR following TAVR.MethodsThis is a retrospective central core-lab analysis of 1,257 consecutive cine aortograms performed post-TAVR. The study included 107 final aortograms of consecutive patients who underwent TAVR with first-generation VitaFlow in four Chinese centers and 1,150 aortograms with five other transcatheter aortic valves (Evolut Pro, Evolut R, CoreValve, Venus A-Valve, and Acurate Neo). LVOT-AR analyses of these five valves were retrieved from a previously published pooled database.ResultsAmong 172 aortograms of patients treated with VitaFlow, 107 final aortograms (62.2%) were analyzable by LVOT-AR. In this first in man eight cases necessitated a procedural valve in valve due to inappropriate TAVR positioning and severe aortic paravalvular regurgitation. In the VitaFlow group, the mean LVOT-AR of the intermediate aortograms was 7.3 ± 7.8% and the incidence of LVOT-AR >17% was 8.6%. The mean LVOT-AR of the final aortogram was 6.1 ± 6.4% in the VitaFlow group, followed by Evolut Pro (7.3 ± 6.5%), Evolut R (7.9 ± 7.4%), Venus A-valve (8.9 ± 10.0%), Acurate Neo (9.6 ± 9.2%), and lastly CoreValve (13.7 ± 10.7%) (analysis of variance p < 0.001). Post hoc 2-by-2 testing showed that CoreValve had significantly higher LVOT-AR compared with each of the other five THVs. No statistical difference in LVOT-AR was observed between VitaFlow, Evolut Pro, Evolut R, Acurate Neo, and Venus A-valves. The VitaFlow system had the lowest proportion of patients with LVOT-AR >17% (4.7%) (AR after the final aortograms), followed by Evolut Pro (5.3%), Evolut R (8.8%), Acurate Neo (11.3%), Venus A-valve (14.2%), and CoreValve (30.1%) (chi-square p < 0.001).ConclusionCompared to other commercially available self-expanding valves, VitaFlow seems to have a low degree of AR and a low proportion of patients with ≥moderate/severe AR as assessed by quantitative videodensitometric angiography. Once the learning phase is completed, comparisons of AR between different transcatheter heart valves should be attempted in a prospective randomized trial.

Monteggia fracture refers to breakage of the upper third of the ulna combined with dislocation of the radial head. It often occurs in children and adolescents and represents a combined injury. Fracture of the distal forearm is among the most common trauma suffered by children. However, distal forearm fractures have rarely been reported as having an association with Monteggia fractures. We report on a 9-year-old boy diagnosed with a type III Monteggia fracture combined with a distal forearm fracture. He underwent surgery and received rehabilitation training 1 month later. He was followed-up for 1 year. The affected limb functioned well with no sign of radial head dislocation.

This study investigated university students’ perceptions of facilitation strategies, learning motivation, and satisfaction, and the relationships between them in a cloud-based virtual classroom in mainland China. The results of an online questionnaire survey from a sample of 7,210 university students showed that students perceived high levels of facilitation strategies, learning motivation, and satisfaction. Students’ demographic characteristics, such as discipline, university type, gender, and grade, did not significantly affect their perceptions of facilitation strategies and learning outcomes. Instructor-student interaction and instructor innovation were positively related to student learning motivation and satisfaction whereas the relationships between student interaction and learning motivation and satisfaction were weak and had no practical meaning. The findings of this study have implications for creating more effective synchronous online learning environments and achieving desirable learning outcomes.

Objective: To determine using a systematic assessment and meta-analysis if GFA injection is an appropriate substitute of propafenone for arrhythmic.Design: Conduct a systematic review and meta-analysis of randomized controlled trials.Data Source: PubMed, Web of Science, Cochrane Library, Embase, Wan-Fang Database, VIP, CNKI, and Sino Med from their inception to 7 March 2021.Eligibility Criteria for Selecting Studies: Inclusion of randomized controlled trials, which draws a comparison between GFA and propafenone. Evaluation of study integrity and conducted an extraction of independent data.Main Outcome Measure: Efficacy for supraventricular tachycardia, it is considered effective if it is reversed within 40 min (without considering recurrence); for premature ventricular beats, if they are reduced by more than 50% within 6 h.Results: Included in this current study are 1,294 research subjects pooled from 14 clinical studies. From the pooled assessment, GFA is demonstrated to be the equivalent of propafenone regarding the potency of effectiveness for tachycardia (RR = 1.11, 95% CI: 0.96, 1.28, P = 0.15). The subset analysis indicated that GFA has a better effect on premature ventricular beats (RR = 1.35, 95% CI: 1.07, 1.70, P = 0.01) and a similar effect on supraventricular tachycardia (RR = 1.07, 95% CI: 0.98, 1.12, P = 0.21). GFA effectiveness is lesser than propafenone in the case of mean converting time (WMD = −1.18, 95% CI: −2.30, −0.07, P = 0.04), systolic blood pressure (WMD = −3.53, 95% CI: −6.97, −0.09, P = 0.04), and QRS complex (WMD = −3.82, 95% CI: −6.96, −0.69, P = 0.02). Both GFA and propafenone have identical effects for diastolic blood pressure, heart rate, P-R interval, and QTc interval.Conclusion: A meta-analysis of RCTs was performed across 14 clinical trials, whereby 1,294 patients are used as research subjects. From the results, it is revealed that the effect exhibited by GFA injection is similar to the propafenone injection when treating premature ventricular beats or supraventricular tachycardia. Nevertheless, in certain academic disciplines, it was found that GFA is safer and beneficial compared to propafenone. Based on facts from relevant studies, GFA is deemed applicable during clinical practice.Systematic Review Registration:https://www.inplasy.com/inplasy-2021-3-0077/, identifier: INPLASY202130077.

Traumatic myositis ossificans (MO) is an unusual complication after muscle injury and is predominantly seen in young adults and adolescents. Pediatric MO cases are even rarer. We report an 8-year-old girl who was diagnosed with a lateral humeral condyle fracture. She was treated surgically, and her elbow joint was fixed with plaster. Rehabilitation exercise was administered 1 month after the operation. Due to the wrong exercise method, a palpable bony mass appeared around the elbow 1 month later. The clinical radiological diagnosis showed MO, and conservative treatment was administered. After 3 years of follow-up, the affected limb functioned well, with no sign of recurrence. Here, we report this long-term follow-up case of MO resulting from excessive rehabilitation exercise.

This study investigated the relationships between university EFL teachers' perceived teaching support, teacher innovation, and teaching satisfaction in online teaching environments, especially the mediating role of teaching efficacy. The results of an online questionnaire survey with 473 university EFL teachers revealed that although online peer support did not directly make any difference to teacher innovation and teaching satisfaction, greater perceived support in the form of teaching resources and teaching autonomy improved university EFL teachers' online teaching satisfaction. Online teaching efficacy significantly mediated the relationships between teaching support and teacher innovation and satisfaction. The results offer significant implications for improving the effectiveness of EFL teaching and promoting university EFL teachers' innovation and satisfaction in online teaching environments.

Pseudomonas putida KT2440 is a promising chassis of industrial biotechnology due to its metabolic versatility. Butane-2,3-diol (2,3-BDO) is a precursor of numerous value-added chemicals. It is also a microbial metabolite which widely exists in various habiting environments of P. putida KT2440. It was reported that P. putida KT2440 is able to use 2,3-BDO as a sole carbon source for growth. There are three stereoisomeric forms of 2,3-BDO: (2R,3R)-2,3-BDO, meso-2,3-BDO and (2S,3S)-2,3-BDO. However, whether P. putida KT2440 can utilize three stereoisomeric forms of 2,3-BDO has not been elucidated. Here, we revealed the genomic and enzymic basis of P. putida KT2440 for dehydrogenation of different stereoisomers of 2,3-BDO into acetoin, which will be channeled to central mechanism via acetoin dehydrogenase enzyme system. (2R,3R)-2,3-BDO dehydrogenase (PP0552) was detailedly characterized and identified to participate in (2R,3R)-2,3-BDO and meso-2,3-BDO dehydrogenation. Two quinoprotein alcohol dehydrogenases, PedE (PP2674) and PedH (PP2679), were confirmed to be responsible for (2S,3S)-2,3-BDO dehydrogenation. The function redundancy and inverse regulation of PedH and PedE by lanthanide availability provides a mechanism for the adaption of P. putida KT2440 to variable environmental conditions. Elucidation of the mechanism of 2,3-BDO catabolism in P. putida KT2440 would provide new insights for bioproduction of 2,3-BDO-derived chemicals based on this robust chassis.