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Gallbladder cancer (GBC) is an extremely lethal malignancy with aggressive behaviors, including liver or distant metastasis; however, the underlying mechanisms driving the metastasis of GBC remain poorly understood. In this study, it is found that DNA methyltransferase DNMT3A is highly expressed in GBC tumor tissues compared to matched adjacent normal tissues. Clinicopathological analysis shows that DNMT3A is positively correlated with liver metastasis and poor overall survival outcomes in patients with GBC. Functional analysis confirms that DNMT3A promotes the metastasis of GBC cells in a manner dependent on its DNA methyltransferase activity. Mechanistically, DNMT3A interacts with and is recruited by YAP/TAZ to recognize and access the CpG island within the CDH1 promoter and generates hypermethylation of the CDH1 promoter, which leads to transcriptional silencing of CDH1 and accelerated epithelial‐to‐mesenchymal transition. Using tissue microarrays, the association between the expression of DNMT3A, YAP/TAZ, and CDH1 is confirmed, which affects the metastatic ability of GBC. These results reveal a novel mechanism through which DNMT3A recruitment by YAP/TAZ guides DNA methylation to drive GBC metastasis and provide insights into the treatment of GBC metastasis by targeting the functional connection between DNMT3A and YAP/TAZ. [ABSTRACT FROM AUTHOR]

Objective: Children with self‐limited epilepsy characterized by centrotemporal spikes (SeLECTS) exhibit cognitive deficits in memory during the active phase, but there is currently a lack of studies and techniques to assess their memory development after well‐controlled seizures. In this study, we employed eye‐tracking techniques to investigate visual memory and its association with clinical factors and global intellectual ability, aiming to identify potential risk factors by examining encoding and recognition processes. Methods: A total of 26 recruited patients diagnosed with SeLECTS who had been seizure‐free for at least 2 years, along with 24 control subjects, underwent Wechsler cognitive assessment and an eye‐movement‐based memory task while video‐electroencephalographic (EEG) data were recorded. Fixation and pupil data related to eye movements were utilized to detect distinct memory processes and subsequently to compare the cognitive performance of patients exhibiting different regression patterns on EEG. Results: The findings revealed persistent impairments in visual memory among children with SeLECTS after being well controlled, primarily observed in the recognition stage rather than the encoding phase. Furthermore, the age at onset, frequency of seizures, and interictal epileptiform discharges exhibited significant correlations with eye movement data. Significance: Children with SeLECTS exhibit persistent recognition memory impairment after being well controlled for the disease. Controlling the frequency of seizures and reducing prolonged epileptiform activity may improve memory cognitive development. The application of the eye‐tracking technique may provide novel insights into exploring memory cognition as well as underlying mechanisms associated with pediatric epilepsy. [ABSTRACT FROM AUTHOR]

Diabetic foot ulcers (DFUs) are chronic, difficult‐to‐heal wounds with a very high incidence of amputation. For patients with DFUs, prevention of amputation is crucial. However, the risk factors associated with DFU amputation and the extent to which different risk factors increase the risk of amputation are still uncertain. This study intends to provide a clinical basis for early intervention in DFU by retrospectively analysing the risk factors for DFU amputation. A retrospective analysis of 200 patients with DFUs admitted between October 2019 and October 2023 was conducted. Sixty‐eight of the 200 underwent amputations. The overall amputation rate was 34%. Multiple logistic regression model showed that neutrophil/lymphocyte ratio (OR = 1.943; 95% CI:1.826–2.139), white blood cell (OR = 1.143; 95% CI:1.034–1.267), C‐reactive protein (OR = 1.307; 95% CI:1.113–2.194) and Wagner grading (OR = 2.783; 95% CI: 1.751–4.302) were independent risk factors for amputation, while haemoglobin (OR = 0.742; 95% CI:0.638–0.965) and high density lipoprotein were independent protective factors for amputation (OR = 0.168; 95% CI:0.037–0.716), and further Receiver Operating Characteristic Curve curves showed that they showed high accuracy and were good predictors of amputation of DFUs. [ABSTRACT FROM AUTHOR]

Background and purpose: Several previous studies have shown that skin sebum analysis can be used to diagnose Parkinson's disease (PD). The aim of this study was to develop a portable artificial intelligence olfactory‐like (AIO) system based on gas chromatographic analysis of the volatile organic compounds (VOCs) in patient sebum and explore its application value in the diagnosis of PD. Methods: The skin VOCs from 121 PD patients and 129 healthy controls were analyzed using the AIO system and three classic machine learning models were established, including the gradient boosting decision tree (GBDT), random forest and extreme gradient boosting, to assist the diagnosis of PD and predict its severity. Results: A 20‐s time series of AIO system data were collected from each participant. The VOC peaks at a large number of time points roughly concentrated around 5–12 s were significantly higher in PD subjects. The gradient boosting decision tree model showed the best ability to differentiate PD from healthy controls, yielding a sensitivity of 83.33% and a specificity of 84.00%. However, the system failed to predict PD progression scored by Hoehn−Yahr stage. Conclusions: This study provides a fast, low‐cost and non‐invasive method to distinguish PD patients from healthy controls. Furthermore, our study also indicates abnormal sebaceous gland secretion in PD patients, providing new evidence for exploring the pathogenesis of PD. [ABSTRACT FROM AUTHOR]

Purpose: We aim to understand the knowledge of and attitudes toward pregnancy issues among women with epilepsy (WWE) and their caregivers and analyze the answers from the questionnaire to expose topics that require educational activities; thus, WWE experiences pregnancy better. Methods: WWE at their childbearing age and/or their caregivers who entered the Fourth Affiliated Hospital of Zhejiang University for treatment of their condition were invited to fill out a questionnaire between March 1 and November 31, 2022. Results: A combined total of 205 WWE and 142 caregivers completed the questionnaires. Among the surveyed WWE, a majority (63.74%) reported experiencing at least one miscarriage or induced abortion. However, a significant proportion (84.62%) of these WWE were still able to successfully give birth to at least one child. Furthermore, the offspring of these WWE showed no significant differences compared to the offspring of women without epilepsy, as reported by 93.51% of the participants. The participants' knowledge regarding the impact of epilepsy on pregnancy was found to be comparable, with average scores of 7.74 and 7.84, respectively. The participants exhibited a limited comprehension of antiseizure medications (ASMs)‐related knowledge, specifically pertaining to ASMs adjustment during pregnancy (17.56% vs. 16.90%) and offspring outcomes (30.24% vs. 26.06%). Statistical analysis revealed significant correlations between the overall score and education level (p <.001), as well as epilepsy duration (p =.008). Regarding the source of knowledge, participants acknowledged primarily relying on neurologists, who remained their preferred choice for consultation. Conclusion: In our study, the understanding of pregnancy‐related knowledge did not differ from WWE and their caregivers, both are far from satisfactory in certain areas. It is urgent for WWE and their caregivers to improve their pregnancy‐related knowledge of epilepsy. As their primary access is from knowledgeable health care professionals like neurologists, well‐trained neurologists in epilepsy management during pregnancy are in need. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to distinguish between cholesterol and neoplastic gallbladder polyps using dynamic contrast‐enhanced CT. Methods: The dataset retrospectively comprised 222 cases, including 106 cases of cholesterol polyps and 116 cases of neoplastic polyps (59 adenoma and 57 adenocarcinoma). The perception and Hounsfield units of the polyps and gallbladder bile were assessed by contrast‐enhanced CT, and the polyp‐to‐bile ratio (PBR) was calculated. Receiver operating characteristic (ROC) curves and area under the curve analyses were used to assess the diagnostic value of the diameter and PBR for neoplastic polyps. Results: The diameter of cholesterol polyps was significantly smaller than that of neoplastic polyps. The proportion of perceived cholesterol polyps in the plain and arterial phases of CT were significantly lower than those of neoplastic polyps (p <.001). On the contrary, the CT values of gallbladder bile of cholesterol polyps were always significantly higher than those of neoplastic polyps (p <.001). The median PBR values of cholesterol polyps were significantly lower than those of neoplastic polyps (p ≤.001). ROC analysis showed that diameter and a plain phase PRB had better diagnostic value for neoplastic polyps. Polyp diameter ≥ 11.95 mm and the plain phase PBR ≥1.48 were the optimal cut‐off values for diagnosis of neoplastic polyps. Combining a diameter ≥ 12 mm and a PBR in the plain phase ≥1.48 further improved neoplastic polyp diagnostic specificity and positive likelihood ratio (10.453). Conclusions: Polyp‐to‐bile ratio in contrast‐enhanced CT scanning is a new and convenient index for identifying cholesterol and neoplastic gallbladder polyps. [ABSTRACT FROM AUTHOR]

Aim: To examine ways in which human‐centred design was integrated into a nursing school's research processes involving individuals with multiple chronic conditions. Design: Cross‐sectional survey study. Methods: Three surveys were sent out, with surveys 1 and 2 involving faculty who had worked closely with design strategists and survey 3 as a school‐wide survey eliciting experience with human‐centred design, respectively. Results: Survey respondents (n = 7 for surveys 1 and 2 and n = 36 for survey 3) had no or minimal experience with human‐centred design. Faculty respondents indicated it helped engaging various stakeholders, particularly in intervention development. Key lessons learned included: (1) the importance of designer involvement from study conception, (2) distinguishing a design strategist's skillset from strictly visual design, (3) challenges during the ethical review processes, and (4) sustainability of resources. The dynamic approach of human‐centred design has benefited our efforts to advance the science of caring for individuals with multiple chronic conditions. [ABSTRACT FROM AUTHOR]

A recent technology breakthrough in spatial molecular profiling (SMP) has enabled the comprehensive molecular characterizations of single cells while preserving spatial information. It provides new opportunities to delineate how cells from different origins form tissues with distinctive structures and functions. One immediate question in SMP data analysis is to identify genes whose expressions exhibit spatially correlated patterns, called spatially variable (SV) genes. Most current methods to identify SV genes are built upon the geostatistical model with Gaussian process to capture the spatial patterns. However, the Gaussian process models rely on ad hoc kernels that could limit the models' ability to identify complex spatial patterns. In order to overcome this challenge and capture more types of spatial patterns, we introduce a Bayesian approach to identify SV genes via a modified Ising model. The key idea is to use the energy interaction parameter of the Ising model to characterize spatial expression patterns. We use auxiliary variable Markov chain Monte Carlo algorithms to sample from the posterior distribution with an intractable normalizing constant in the model. Simulation studies using both simulated and synthetic data showed that the energy-based modeling approach led to higher accuracy in detecting SV genes than those kernel-based methods. When applied to two real spatial transcriptomics (ST) datasets, the proposed method discovered novel spatial patterns that shed light on the biological mechanisms. In summary, the proposed method presents a new perspective for analyzing ST data. [ABSTRACT FROM AUTHOR]

Background: Despite profound financial challenges during the COVID‐19 pandemic, there is a gap in estimating their effects on mental health and well‐being among older adults. Methods: The National Health and Aging Trends Study is an ongoing nationally representative cohort study of US older adults. Outcomes included mental health related to COVID‐19 (scores averaged across eight items ranging from one to four), sleep quality during COVID‐19, loneliness during COVID‐19, having time to yourself during COVID‐19, and hopefulness during COVID‐19. Exposures included income decline during COVID‐19 and financial difficulty due to COVID‐19. Propensity score weighting produced covariate balance for demographic, socioeconomic, household, health, and well‐being characteristics that preceded the pandemic to estimate the average treatment effect. Sampling weights accounted for study design and non‐response. Results: In weighted and adjusted analyses (n = 3257), both income decline during COVID‐19 and financial difficulty due to COVID‐19 were associated with poorer mental health related to COVID‐19 (b = −0.159, p < 0.001 and b = −0.381, p < 0.001, respectively), poorer quality sleep (OR = 0.63, 95% CI: 0.46, 0.86 and OR = 0.42, 95% CI: 0.30, 0.58, respectively), more loneliness (OR = 1.53, 95% CI: 1.16, 2.02 and OR = 2.72, 95% CI: 1.96, 3.77, respectively), and less time to yourself (OR = 0.54, 95% CI: 0.40, 0.72 and OR = 0.37, 95% CI: 0.27, 0.51, respectively) during COVID‐19. Conclusions: Pandemic‐related financial challenges are associated with worse mental health and well‐being regardless of pre‐pandemic characteristics, suggesting that they are distinct social determinants of health for older adults. Timely intervention is needed to support older adults experiencing pandemic‐related financial challenges. [ABSTRACT FROM AUTHOR]

Microfluidic paper‐based analytical devices (μPADs) are commonly used in point‐of‐care testing (POCT) due to their advantages of low cost and easy operation. However, the fabrication and potential environmental pollution of μPADs are the universal and pendent concerns. In this respect, a simple and novel method is developed for preparing photo‐adjustable μPADs using the photocatalytic properties of TiO2. A superhydrophobic TiO2‐paper substrate with unique photoactivity is fabricated. The flow channels on the superhydrophobic TiO2‐paper substrate can be quickly generated and on‐demand edited by a simple UV irradiation process, to fabricate various 2D and 3D μPADs for specific applications. After usage, the residual organics and biological specimens on μPADs can be easily bleached via TiO2‐assited degradation under UV or sunlight, avoiding the risk of potential environment pollution and disease transmission. The successful application of such novel substrate in the fabrication of smart and safe μPADs for sweat analysis and motion monitoring is shown. [ABSTRACT FROM AUTHOR]

Background: Programs to reduce disability are crucial to the quality of life for older adults with disabilities. Reducing disability is also important to avert unnecessary and costly hospitalizations, relocation, or nursing home placements. Few programs reduce disability and few have been replicated and scaled beyond initial research settings. CAPABLE is one such program initially tested in a randomized control trial and has now been tested and replicated in multiple settings. CAPABLE, a 10‐session, home‐based interprofessional program, provides an occupational therapist, nurse, and handyworker to address older adults' self‐identified functional goals by enhancing individual capacity and home environmental supports. We examine evidence for the CAPABLE program from clinical trials embedded in different health systems on outcomes that matter most to older adults with disability. Methods: Six trials with peer‐reviewed publications or reports were identified and included in this review. Participants' outcomes included basic and instrumental activities of daily living (ADLs, IADLs), fall efficacy, depression, pain, and cost savings. Results: A total of 1144 low‐income, community‐dwelling older adults with disabilities and 4236 matched comparators were included in the six trials. Participants were on average ≥74–79 years old, cognitively intact, and with self‐reported difficulty with ≥1 ADLs. All six studies demonstrated improvements in ADLs and IADLs, with small to strong effect sizes (0.41–1.47). Outcomes for other factors were mixed. Studies implementing the full‐tested dose of CAPABLE showed more improvement in ADLS and cost savings than studies implementing a decreased dose. Conclusions: The CAPABLE program resulted in substantial improvements in ADLs and IADLs in all six trials with other outcomes varying across studies. A dose lower than the original protocol tested resulted in less benefit. The four studies examining cost showed that CAPABLE saved more than it costs to implement. See related editorial by Thomas M. Gill. [ABSTRACT FROM AUTHOR]

In this study, we observed the fate of the inverted limbus after closed reduction for the treatment of developmental dysplasia of the hip (DDH) and its impact on acetabular development. Clinical data were reviewed for 26 DDH patients with an inverted or overriding limbus after closed reduction for hip dysplasia. Patients were divided into a residual inversion group (19 cases, 22 hips) and a spontaneous resolution group (7 cases, 7 hips) according to the limbus status at the last follow‐up. Differences in the osseous acetabular index (AI) and cartilaginous AI (CAI), the magnitude of limbus inversion, center‐edge angle (CEA), height‐to‐width index (HWI) of the femoral head epiphysis, and avascular necrosis (AVN) at last follow‐up were compared. There were no statistically significant differences in the preoperative AI and CAI between groups. The magnitude of limbus inversion after reduction and the AI at the final follow‐up in the residual inversion group were both larger than those in the spontaneous resolution group. The CAI, CEA, and HWI were not significantly different between groups. The magnitude of limbus inversion in the residual inversion group did not significantly decrease over time. AVN occurred in five hips in the residual inversion group. No cases of AVN occurred in the spontaneous resolution group. After closed reduction, the inverted limbus was not absorbed in the majority of cases; instead, it evolved into a thin layer of fibrous tissue embedded between the femoral head and acetabulum. This may delay the endochondral ossification of the acetabulum. [ABSTRACT FROM AUTHOR]

Aims: This study was initiated to evaluate different responses of sugarcane (Saccharum officinarum L.) genotypes to sparingly soluble phosphorus (P) treatments and to identify useful plant traits contributing to P efficiency for the selection of efficient and responsive genotypes. Methods: Plant growth, root morphological parameters, photosynthetic parameters, and P efficiency were evaluated under soluble P [KH2PO4 (K‐P)] and sparingly soluble P [Ca3(PO4)2 (Ca‐P), AlPO4 (Al‐P), FePO4 · 4 H2O (Fe‐P), and sodium phytate C6H6O24P6Na12 (Org‐P)] treatments using sand cultures. Results: Sugarcane growth was inhibited under sparingly soluble P or low P treatments, by an average of 22.9% or 71.3% reduction in shoot and root biomass, respectively. Al‐P and Org‐P had higher bioavailability than Fe‐P and Ca‐P for the tested sugarcane genotypes, which showed lower rate decreases for biomass, root morphological and photosynthetic parameters under Al‐P and Org‐P treatment than those under Fe‐P and Ca‐P. In addition, the P content in shoot decreased by an average of 29.2% and 39.2% under Al‐P and Org‐P treatment, respectively, while 55.7% and 62.9% reduction was detected under Fe‐P and Ca‐P treatment, respectively, compared with K‐P treatment. BC2‐32 (hybrid progeny of sugarcane and E. arundinaceus) exhibiting greater P absorption efficiency than other two genotypes under P‐starvation treatments; and the root length, root surface areas, root volume, P accumulation, net photosynthetic rate, and shoot and root dry matter of BC2‐32 were greater than those of other genotypes under sparingly soluble P forms. Significantly correlations were found between root morphological parameters, photosynthetic parameters and P efficiency under sparingly soluble P and low‐P treatment, indicating that stronger root system and less sensitivity of photosynthesis may contribute greatly to activate and take up more P from sparingly soluble P sources. Conclusions: Therefore, BC2‐32 would be the ideal material for breeding good varieties and exhibited better growth behavior to P‐deficient soils, and root morphological parameters and photosynthetic rate would be the useful plant traits in combination to screen these sugarcane varieties. [ABSTRACT FROM AUTHOR]

In this paper, tobermorite was hydrothermally synthesized from the dicalcium silicate (C2S) in sodium silicate solution, and the crystallization and phase transition process were investigated in detail using XRD, Raman spectra, and SEM. The tobermorite is difficult to synthesize when the temperature is lower than 160°C because it gets converted into xonotlite (without Na2O) or pectolite (with Na2O) when the temperature is higher than 180°C. The crystallization process of tobermorite shows "S" trend with the increase in time, which can be divided into three stages: the nucleation stage, rapid crystal growth stage, and perfect crystal forming stage. During the crystallization, 90% of the crystallization of tobermorite is completed in the stage of rapid crystal growth. Raman spectra and SEM analysis show that with the increase in hydrothermal time, the C2S of monomer (Q0) is first converted into the calcium silicate hydrate of sheet (Q2 and Q3), and then continues to convert into tobermorite of chain (Q2). [ABSTRACT FROM AUTHOR]

In this paper, we consider the problem of modeling a matrix of count data, where multiple features are observed as counts over a number of samples. Due to the nature of the data generating mechanism, such data are often characterized by a high number of zeros and overdispersion. In order to take into account the skewness and heterogeneity of the data, some type of normalization and regularization is necessary for conducting inference on the occurrences of features across samples. We propose a zero-inflated Poisson mixture modeling framework that incorporates a model-based normalization through prior distributions with mean constraints, as well as a feature selection mechanism, which allows us to identify a parsimonious set of discriminatory features, and simultaneously cluster the samples into homogenous groups. We show how our approach improves on the accuracy of the clustering with respect to more standard approaches for the analysis of count data, by means of a simulation study and an application to a bag-of-words benchmark data set, where the features are represented by the frequencies of occurrence of each word. [ABSTRACT FROM AUTHOR]

A novel drug delivery system, multiple solid particles (MLPs), combining the advantages of water-in-oilin- water (W/O/W) multiple emulsions and solid lipid nanoparticles (SLN) was proposed. The MLPs were produced by simply adding the solid lipid in liquid lipid of W/O/W multiple emulsions and removing the outer aqueous phase of W/O/W multiple emulsions. MLPs could form typical W/O/W multiple emulsion microstructure by self-emulsifying after dispersing in water. MLPs were used to encapsulate both coenzyme Q10 and tea polyphenols (CT-MLPs), and encapsulation efficiency measurement revealed that both coenzyme Q10 and tea polyphenols had high encapsulation efficiency (98.14% and 99.36%, respectively). The effect of the factors on viscosity, stability, and solubility of CTMLPs were investigated, and the results showed that increasing the concentration of solid lipid glycerin monostearate or hydrophilic emulsifier polyglyceryl-10 laurate, or decreasing the concentration of the inner aqueous phase could increase the viscosity of CT-MLPs. Consequently, the stability of CT-MLPs was improved by increasing the viscosity of the oil phase. Moreover, addition of glycerin monostearate also increased the water solubility of CT-MLPs. During a 60-day stability study, CT-MLPs showed terrific stability and high retention ratio (above 83.82%) at various conditions. [ABSTRACT FROM AUTHOR]

Highlights from the article: Polydopamine: UV-Triggered Polydopamine Secondary Modification: Fast Deposition and Removal of Metal Nanoparticles (Adv. Funct. Keywords: patterning; polydopamine; secondary modification; surface metallization; UV trigger This UV-triggered, and at the same time wavelength-dependent method, enables the formation of complex metal patterns on polydopamine surfaces with an option to erase the patterns and recycle substrates.

Since the first report in 2007, polydopamine (PDA) coating has shown great potential as a general and versatile method to create functional nanocoatings on arbitrary substrates. Slow kinetics and poor controllability of the coating and secondary modification processes, however, have limited the further development of this attractive method. In this work, it is demonstrated that UV irradiation at 365 nm significantly accelerates the process of secondary modification of a PDA‐coated surface. The kinetics of both thiol and amine modifications of PDA are increased 12‐fold via UV irradiation, while the kinetics of metal ion reduction at the PDA interface is increased more than 550 times. Moreover, it is demonstrated that irradiating a PDA/metal nanoparticle composite surface with UV light at 254 nm leads to dissolution of the deposited metal nanoparticles (MNPs). Finally, grayscale metallic patterns, dynamic deposition, and removal of MNPs on PDA surface are realized with the proposed method. [ABSTRACT FROM AUTHOR]

The cover image is based on the Reflection on Opportunities for High Penetration of Renewable Energy in China, by Xi Lu, Jiahui Chen, and Qiwei Li, Jiaxuan Zhang. https://doi.org/10.1002/wene.344. Cover image © Haoran Zhang/Beijing Xinrui Vision Technology Co., Ltd. [ABSTRACT FROM AUTHOR]

Increasing penetration of renewable energy (RE) is expected to be an essential component for China to achieve goals in mitigating global climate change and domestic air pollution. Although China has experienced rapid growth of RE over the past two decades, problems restricting further development of RE occur, among which high curtailment rate of wind and solar power raises great attention. This paper reflects on the challenges and opportunities of high penetration of RE from both technical and market perspectives in China based on literature review. In particular, it emphasizes technical options to address the inherent variability of RE from three layers, namely using interconnected geographically dispersed sources to reduce random variance, increasing storage capacity to deal with minute‐to‐day imbalance, and applying backup capacity for seasonally mismatch. From the market perspective, the paper analyzes the needs of shifting from central planning to market‐based dispatch, introducing markets for ancillary services, and having a larger and more precise market. Meanwhile, our paper further points out that opportunities for high RE integration may rely on deep electrification of transportation and building sectors, which are also the foci for future air pollution control in China. It is feasible for China to achieve a high if not 100% RE system, but first these technical and market challenges have to be addressed in the process of adjusting its energy structure. This article is categorized under:Energy Systems Analysis > Climate and EnvironmentEnergy and Climate > Climate and Environment Opportunities for China's High Penetration of Renewable Energy [ABSTRACT FROM AUTHOR]