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Abstract Background and purpose Radiomics offers little explainability. This study aims to develop a radiomics model (Rad-Score) using diffusion-weighted imaging (DWI) to predict high-risk patients for nodal metastasis or recurrence in endometrial cancer (EC) and corroborate with choline metabolism. Materials and methods From August 2015 to July 2018, 356 EC patients were enrolled. Rad-Score was developed using LASSO regression in a training cohort (n = 287) and validated in an independent test cohort (n = 69). MR spectroscopy (MRS) was also used in 230 patients. Nuclear MRS measured choline metabolites in 70 tissue samples. The performance was compared against European Society for Medical Oncology (ESMO) risk groups. A P

Abstract Background This study aimed to explore the effects of the titanium dioxide (TiO2) concentration and particle size in hydrogen peroxide (HP) on tooth bleaching effectiveness and enamel surface properties. Methods TiO2 at different concentrations and particle sizes was incorporated into 40% HP gel to form an HP/TiO2 gel. The specimens were randomly divided into 8 groups: C1P20: HP + 1% TiO2 (20 nm); C3P20: HP + 3% TiO2 (20 nm); C5P20: HP + 5% TiO2 (20 nm); C1P100: HP + 1% TiO2 (100 nm); C3P100: HP + 3% TiO2 (100 nm); C5P100: HP + 5% TiO2 (100 nm); C0: HP with LED; and C0-woL: HP without LED. Bleaching was conducted over 2 sessions, each lasting 40 min with a 7-day interval. The color differences (ΔE00), whiteness index for dentistry (WID), surface microhardness, roughness, microstructure, and composition were assessed. Results The concentration and particle size of TiO2 significantly affected ΔE00 and ΔWID values, with the C1P100 group showing the greatest ΔE00 values and C1P100, C3P100, and C5P100 groups showing the greatest ΔWID values (p 0.05). Conclusions Incorporating 1% TiO2 with a particle size of 100 nm into HP constitutes an effective bleaching strategy to achieve desirable outcomes.

Paralytic shellfish toxins (PSTs) are a class of acute neurotoxins with nearly 60 congeners. Shellfish that filter feed on toxin-producing algae exhibit PST accumulation in tissues, and the consumption of toxic shellfish poses a major threat to human health. China has the largest aquaculture industry in the world, with shellfish production of approximately 15.89 million tons in 2022 and many shellfish consumers. The PST poisoning incidents in China exhibit the characteristics of a wide distribution area, recurring regional risk, diverse toxin sources, and seasonal differences. PST consumption causes acute symptoms of poisoning and even death in many people, with a high lethality rate. This is a serious threat to the health of consumers and detrimental to the social stability of the region. In northern China, Hebei Province has rich fisheries resources, with a mariculture output of approximately 580, 000 tons in 2022. In recent years, PSTs have been detected several times in bivalve shellfish inshore in Hebei Province, especially along the coast of Qinhuangdao. A serious shellfish poisoning episode was reported in Qinhuangdao in 2016, with PST concentrations exceeding the safety limit of 800 μgSTX equivalents/kg (μg STXeq/kg) by a factor of 65. The main algal species responsible for the poisoning was Alexandrium catenella. However, the current investigations of PST pollution in Hebei Province mainly focus on the shellfish species Mytilus galloprovincialis and Argopecten irradians in the sea area of Shanhaiguan, Qinhuangdao, and investigations on other coastal cities of Hebei Province and a wide range of different shellfish species are lacking. Moreover, few risk assessment studies have been conducted.A continuous PST survey was conducted in 2022 on six species of shellfish, namely M. galloprovincialis, Scapharca subcrenata, A. irradians, Scapharca broughtonii, Ruditapes philippinarum, and Crassostrea gigas, collected by netting in Tangshan and Qinhuangdao, and the residual status of PSTs was assessed for acute exposure using liquid chromatography-tandem mass spectrometry. The results showed that PSTs were detected in shellfish samples collected from March to June, with a detection rate of 100%. However, no values exceeded the European Union limit. Among the shellfish samples collected from March to June, those assessed in April had the highest average concentration, followed by those in May, March, and June, which had the lowest average concentration. The main components detected in shellfish samples from March to June were gonyautoxins (GTX) 1–4; the highest concentrations were detected in April. Highly toxic saxitoxin (STX) and decarbamoylneosaxitoxin (dcNEO) were detected from April to June and not in March. Decarbamoylgonyautoxin (dcGTX) 2 was not detected in March or April; however, it was detected in May and June. The sea area near Qinhuangdao was more polluted than that near Tangshan. Among the collected shellfish samples, significant differences were observed in the average concentration of PSTs in shellfish samples of different species, and the concentration ranged from highest to lowest in species as follows: M. galloprovincialis > S. subcrenata > A. irradians > S. broughtonii > R. philippinarum > C. gigas. Large differences were observed between the six shellfish species regarding the accumulation of 11 PST components, among which GTX1–4 and carbamatetoxin (C) 1 and 2 were the most commonly detected components. The highest concentrations of GTX1 and 4 were observed in M. galloprovincialis, the highest concentrations of GTX2 and 3 were observed in S. subcrenata, and the highest concentrations of C1 and 2 were observed in A. irradians. A low detection rate was recorded for highly toxic STX and neosaxitoxin (NEO in samples, except in M. galloprovincialis and S. subcrenata, in which all 11 PSTs were detected. In the other four shellfish species, only certain of the components were detected. Statistical analysis of the highest levels of PSTs in nearshore shellfish in Hebei Province in recent years showed a decreasing trend. Acute exposure assessments using the maximum value of PSTs showed that none of the six shellfish species exceeded the acute reference dose values recommended by the Food and Agriculture Organization of the United Nations/World Health Organization and European Food Safety Authority, suggesting that toxin levels were safe and acceptable. M. galloprovincialis had the highest dietary exposure risk, as a few residues were present, and symptoms of PST poisoning, such as dizziness and nausea, may occur after ingesting large quantities of M. galloprovincialis. Increased attention should be paid to shellfish with high dietary exposure assessment values, such as M. galloprovincialis and S. subcrenata.In this study, we investigated PSTs in shellfish from Hebei coastal waters and observed that PSTs were detected in shellfish samples from March to June, with the highest average concentration in April, followed by May and March, with the lowest average concentration in June. In addition, the main components detected in shellfish samples were GTX1–4. The analysis of different shellfish species showed that M. galloprovincialis had the highest average PST concentration, followed by S. subcrenata, A. irradians, S. broughtonii, R. philippinarum, and C. gigas; GTX1–4 and C1 and 2 were detected in all six shellfish species. Dietary exposure assessment for consumers in Hebei Province showed that the toxin levels were safe and acceptable. However, follow-up surveys and studies are necessary due to the paucity of surveys for different cities and species on the coast of Hebei.

Abstract Background Microbial infection and colonization are frequently associated with disease progression and poor clinical outcomes in bronchiectasis. Identification of pathogen spectrum is crucial for precision treatment at exacerbation of bronchiectasis. Methods We conducted a prospective cohort study in patients with bronchiectasis exacerbation onset and stable state. Bronchoalveolar lavage fluid (BALF) was collected for conventional microbiological tests (CMTs) and metagenomic Next-Generation Sequencing (mNGS). Bronchiectasis patients were monitored for documenting the time to the next exacerbation during longitudinal follow-up. Results We recruited 168 eligible participants in the exacerbation cohorts, and 38 bronchiectasis patients at stable state at longitudinal follow-up. 141 bronchiectasis patients at exacerbation onset had definite or probable pathogens via combining CMTs with mNGS reports. We identified that Pseudomonas aeruginosa, non-tuberculous mycobacteria, Haemophilus influenzae, Nocardia spp, and Staphylococcus aureus were the top 5 pathogens with a higher detection rate in our cohorts via combination of CMTs and mNGS analysis. We also observed strong correlations of Pseudomonas aeruginosa, Haemophilus influenzae, non-tuberculous mycobacteria with disease severity, including the disease duration, Bronchiectasis Severity Index, and lung function. Moreover, the adjusted pathogenic index of potential pathogenic microorganism negatively correlated (r = -0.7280, p

Abstract Background Waterlogging stress (WS) negatively impacts crop growth and productivity, making it important to understand crop resistance processes and discover useful WS resistance genes. In this study, rye cultivars and wild rye species were subjected to 12-day WS treatment, and the cultivar Secale cereale L. Imperil showed higher tolerance. Whole transcriptome sequencing was performed on this cultivar to identify differentially expressed (DE) messenger RNAs (DE-mRNAs) and long non-coding RNAs (DE-lncRNAs) involved in WS response. Results Among the 6 species, Secale cereale L. Imperil showed higher tolerance than wild rye species against WS. The cultivar effectively mitigated oxidative stress, and regulated hydrogen peroxide and superoxide anion. A total of 728 DE-mRNAs and 60 DE-lncRNAs were discovered. Among these, 318 DE-mRNAs and 32 DE-lncRNAs were upregulated, and 410 DE-mRNAs and 28 DE-lncRNAs were downregulated. GO enrichment analysis discovered metabolic processes, cellular processes, and single-organism processes as enriched biological processes (BP). For cellular components (CC), the enriched terms were membrane, membrane part, cell, and cell part. Enriched molecular functions (MF) terms were catalytic activity, binding, and transporter activity. LncRNA and mRNA regulatory processes were mainly related to MAPK signaling pathway-plant, plant hormone signal transduction, phenylpropanoid biosynthesis, anthocyanin biosynthesis, glutathione metabolism, ubiquitin-mediated proteolysis, ABC transporter, Cytochrome b6/f complex, secondary metabolite biosynthesis, and carotenoid biosynthesis pathways. The signalling of ethylene-related pathways was not mainly dependent on AP2/ERF and WRKY transcription factors (TF), but on other factors. Photosynthetic activity was active, and carotenoid levels increased in rye under WS. Sphingolipids, the cytochrome b6/f complex, and glutamate are involved in rye WS response. Sucrose transportation was not significantly inhibited, and sucrose breakdown occurs in rye under WS. Conclusions This study investigated the expression levels and regulatory functions of mRNAs and lncRNAs in 12-day waterlogged rye seedlings. The findings shed light on the genes that play a significant role in rye ability to withstand WS. The findings from this study will serve as a foundation for further investigations into the mRNA and lncRNA WS responses in rye.

Abstract Objectives To develop an interactive, non-invasive artificial intelligence (AI) system for malignancy risk prediction in cystic renal lesions (CRLs). Methods In this retrospective, multicenter diagnostic study, we evaluated 715 patients. An interactive geodesic-based 3D segmentation model was created for CRLs segmentation. A CRLs classification model was developed using spatial encoder temporal decoder (SETD) architecture. The classification model combines a 3D-ResNet50 network for extracting spatial features and a gated recurrent unit (GRU) network for decoding temporal features from multi-phase CT images. We assessed the segmentation model using sensitivity (SEN), specificity (SPE), intersection over union (IOU), and dice similarity (Dice) metrics. The classification model’s performance was evaluated using the area under the receiver operator characteristic curve (AUC), accuracy score (ACC), and decision curve analysis (DCA). Results From 2012 to 2023, we included 477 CRLs (median age, 57 [IQR: 48–65]; 173 men) in the training cohort, 226 CRLs (median age, 60 [IQR: 52–69]; 77 men) in the validation cohort, and 239 CRLs (median age, 59 [IQR: 53–69]; 95 men) in the testing cohort (external validation cohort 1, cohort 2, and cohort 3). The segmentation model and SETD classifier exhibited excellent performance in both validation (AUC = 0.973, ACC = 0.916, Dice = 0.847, IOU = 0.743, SEN = 0.840, SPE = 1.000) and testing datasets (AUC = 0.998, ACC = 0.988, Dice = 0.861, IOU = 0.762, SEN = 0.876, SPE = 1.000). Conclusion The AI system demonstrated excellent benign-malignant discriminatory ability across both validation and testing datasets and illustrated improved clinical decision-making utility. Critical relevance statement In this era when incidental CRLs are prevalent, this interactive, non-invasive AI system will facilitate accurate diagnosis of CRLs, reducing excessive follow-up and overtreatment. Key Points The rising prevalence of CRLs necessitates better malignancy prediction strategies. The AI system demonstrated excellent diagnostic performance in identifying malignant CRL. The AI system illustrated improved clinical decision-making utility. Graphical Abstract

Abstract Background High levels of neutrophil extracellular trap (NET) formation or NETosis and autoantibodies are related to poor prognosis and disease severity of COVID-19 patients. Human angiotensin-converting enzyme 2 (ACE2) cross-reactive anti-severe acute respiratory syndrome coronavirus 2 spike protein receptor-binding domain (SARS-CoV-2 RBD) antibodies (CR Abs) have been reported as one of the sources of anti-ACE2 autoantibodies. However, the pathological implications of CR Abs in NET formation remain unknown. Methods In this study, we first assessed the presence of CR Abs in the sera of COVID-19 patients with different severity by serological analysis. Sera and purified IgG from CR Abs positive COVID-19 patients as well as a mouse monoclonal Ab (mAb 127) that can recognize both ACE2 and the RBD were tested for their influence on NETosis and the possible mechanisms involved were studied. Results An association between CR Abs levels and the severity of COVID-19 in 120 patients was found. The CR Abs-positive sera and IgG from severe COVID-19 patients and mAb 127 significantly activated human leukocytes and triggered NETosis, in the presence of RBD. This NETosis, triggered by the coexistence of CR Abs and RBD, activated thrombus-related cells but was abolished when the interaction between CR Abs and ACE2 or Fc receptors was disrupted. We also revealed that CR Abs-induced NETosis was suppressed in the presence of recombinant ACE2 or the Src family kinase inhibitor, dasatinib. Furthermore, we found that COVID-19 vaccination not only reduced COVID-19 severity but also prevented the production of CR Abs after SARS-CoV-2 infection. Conclusions Our findings provide possible pathogenic effects of CR Abs in exacerbating COVID-19 by enhancing NETosis, highlighting ACE2 and dasatinib as potential treatments, and supporting the benefit of vaccination in reducing disease severity and CR Abs production in COVID-19 patients.

Optical paths in telescopes frequently incorporate silver mirrors for high sensitivity. Unfortunately, silver mirrors without protective coatings are susceptible to sulfurization and oxidation, compromising their quality. Even with protective layers, insufficient adhesion between the coating and the silver film can lead to peeling, exposing the silver to external environments and affecting its quality. This study aimed to identify dielectric materials with superior adhesion to silver, rendering them ideal choices for silver coating applications. By electron gun evaporation, different dielectric layers were deposited on the top and bottom of the silver film under a substrate temperature below 150 °C. These coatings were composed of materials with desired refractive indices, including aluminum oxide (Al2O3), aluminum-doped silicon, magnesium fluoride (MgF2), and other dielectrics. Following the deposition, a tape adhesion test was conducted to evaluate the bond strength of the samples. X-ray photoelectron spectroscopy (XPS) analysis was carried out to investigate the interaction between silver and its neighboring layers. The results revealed that Al2O3 and MgF2 exhibited exceptional adhesion to silver. Moreover, these multilayer coatings can effectively enhance the reflectance of silver in the visible (VIS) wavelength ranges.

This study employs the super-efficiency directional distance function (SDDF) to assess the productivity of each administrative region in China over the period 2013–2017. The focus is on exploring variations in gross domestic production and efficiency related to waste gas and wastewater discharge across regions. The inputs include labor, capitalization, energy usage, and total water consumption, with domestic gross production as the output, and total wastewater and exhaust gas discharges as unintended outputs. The findings highlight Beijing, Tianjin, Hainan, Qinghai, Guangdong, Shanghai, Jiangsu, and Shandong as the most efficient regions, while Zhejiang, Ningxia, Hunan, and others exhibit lower performance. Notably, Guangxi ranks lowest (0.631). Unlike traditional direct distance function models, the SDDF model provides a more accurate estimation of the production efficiency of all 30 administrative regions, and addresses the limitation of generating the same efficiency values of 1 simultaneously for multiple regions. The study emphasizes the need for inefficient regions to reduce water consumption and emissions and enhance productivity, offering valuable insights for policymakers in formulating environmental and production policies. HIGHLIGHTS Water-used and production efficiency of China are evaluated.; Analyzing data for the period 2013–2017, changes in gross domestic production are tracked.; Efficiency varies notably in China among regions.; The study urges resource reduction in less efficient regions.;

The paper introduces two decoding techniques based on grouping for symbol flipping non-binary LDPC codes. Firstly, a new technique of adaptive grouping of variable nodes in each iteration using bit reliability and majority voting of each received symbol is presented. Grouping of variable nodes and the subsequent decoding are based on individual symbol reliability and majority voting. To form groups adaptively, the cumulative density of variable nodes is used where a high priority group is considered to contain the most unreliable variable nodes and is decoded while the second priority group contains variable nodes having a second level of reliability and so on. Secondly, a fixed grouping technique is applied to symbol flipping decoding of non-binary LDPC codes. In the fixed grouping decoding, each group contains an equal number of variable nodes, and selected symbols in each group are flipped according to pre-defined flipping criteria. Numerical results and analysis show that the proposed group-based hard decision symbol flipping decoding algorithms have the advantage of reduced computational complexity and show better performance. Therefore, the proposed algorithms can be considered for applications like data storage and mobile communication.

The adoption of electric vehicles (EVs) promises a reduction of carbon emissions and a crucial step towards a cleaner environment. While more EVs are expected to replace internal combustion engine vehicles to operate on the road worldwide, their adoption is inhibited by factors such as high power demand. Unregulated or poorly regulated charging of EVs can cause grid instability, especially in grids that were not initially designed to handle the charging of EVs. This calls for leveraging the available grid resources to control the charging of EVs in a manner that ensures optimal grid operation. This work proposes a distribution network-level dynamic pricing strategy for charging EVs to optimally utilize the distribution network and balance the load between residential and commercial/industrial distribution networks. Different EV charging probabilities that cause the EV load to differ from the optimal state with a mean average percentage error (MAPE) as high as 30% are explored. Simulation results show that with the dynamic pricing strategy as an incentive to the EVs users, EVs charging load will contribute to the optimal grid resources utilization.

Content caching has emerged as an effective approach to combat the increasing strains on our current network infrastructure. This method is further improved when combining caching with source coding. However, additional complexity is incurred by creating this hybrid method, as the source coding component comes with associated feasibility constraints and decoding costs. This paper presents an approach to balance this complexity with the coding gains by selecting the best-performing subset of files to compress, while the others are left uncoded. This problem is shown to be NP-hard in general and difficult to solve in an iteration-free manner. To this end, two novel approaches are outlined: an iterative-based solution, which uses the features of the entropy function to derive the most suitable files to compress jointly, and a meta-heuristic version, which is based on the Genetic Algorithm. When compared to an exhaustive search, the proposed solutions are found to be sub-optimal but falling above the 90th percentile of all possible solutions on average. Significantly, the iterative method produces results within one percentile of the meta-heuristic approach yet it finds a solution 2.31 times faster. The iterative approach has an additional benefit, in that it is able to predict the relative gains when adding more files to a compression group. It is thus able to terminate prematurely if the estimated gains are less than a chosen threshold.

IntroductionThere exists a noticeable gap between consumers' willingness to purchase green food and their actual purchase behavior. However, the awareness of green development is a crucial factor influencing this purchase behavior and acts as an internal driving force promoting green consumption. Consumers' green development awareness is shaped by various psychological motivations, including environmental concern, health consciousness, knowledge, norms, and price considerations. The existing literature often focuses on specific regions or groups, lacking comprehensive cross-regional and multivariate evaluations, and frequently overlooks the potential impact of moderating variables such as economic development level, product type, and behavior type.MethodsTo clarify the overall effect of each motivational factor on green food purchase behavior, this study conducted a meta-analysis. We selected eight causal variables and three moderating variables that significantly influence consumers' green food purchase behavior. The analysis included 132 independent effect values from 45 research papers.ResultsThe meta-analysis revealed that: Consumers' green food purchase behavior is significantly positively correlated with eight motivational factors: environmental awareness, health awareness, green attitude, green knowledge, subjective norms, price awareness, perceived behavior control, and perceived usefulness. Economic development level, product type, and behavior type significantly affect consumers' green food purchase behavior. The impact of motivational factors on actual purchase behavior is weaker than on purchase intention, suggesting that interventions should focus on converting purchase intentions into actual purchase behavior. The findings indicate that environmental responsibility, government policies, and marketing strategies can influence consumers' psychological motives, guiding them toward more responsible consumption choices.DiscussionEnhancing consumers' environmental and health awareness is essential, and policy support and marketing strategies can effectively promote green food consumption. These insights underscore the importance of targeted interventions to bridge the gap between green purchase intention and behavior.

ABSTRACT Kidney transplant recipients (KTRs) have been identified as a population at increased risk for severe SARS-CoV-2 infection outcomes. This study focused on understanding the immune response of KTRs post-vaccination, specifically examining both serological and cellular responses to the SARS-CoV-2 vaccine. Thirteen individuals, including seven KTRs and six healthy donors, were evaluated for antibody levels and T cell responses post-vaccination. The study revealed that KTRs had significantly lower serological responses, including reduced anti-receptor binding domain (RBD) binding antibodies and neutralizing antibodies against the Wuhan, Delta, and Omicron BA.2 strains. Additionally, KTRs demonstrated weaker CD8 T cell cytotoxic responses and lower Th1 cytokine secretion, particularly IFN-γ, after stimulation with variant spike peptide pools. These findings highlight the compromised immunity in KTRs post-vaccination and underscore the need for tailored strategies to bolster immune responses in this vulnerable group. Further investigations are warranted into the mechanisms underlying reduced vaccine efficacy in KTRs and potential therapeutic interventions.IMPORTANCESome studies have revealed that KTRs had lower serological response against SARS-CoV-2 than healthy people. Nevertheless, limited studies investigate the cellular response against SARS-CoV-2 in KTRs receiving SARS-CoV-2 vaccines. Here, we found that KTRs have lower serological and cellular responses. Moreover, we found that KTRs had a significantly lower IFN-γ secretion than healthy individuals when their PBMCs were stimulated with SARS-CoV-2 spike peptide pools. Thus, our findings suggested that additional strategies are needed to enhance KTR immunity triggered by the vaccine.

Objective Patients with systemic lupus erythematosus (SLE) have increased risk of premature atherosclerosis but the exact mechanisms remains unclear. Flow-mediated dilatation (FMD) is an established non-invasive assessment of vascular endothelial function. Lipoprotein subfractions may be better predictors of FMD than conventional cholesterol measurements. We tested the hypothesis that lipoprotein subfractions are independently associated with FMD.Methods Forty-one consecutive adult patients with SLE without known cardiovascular risk factors or disease were recruited in this cross-sectional study. Endothelial function and early atherosclerosis were assessed by brachial FMD and common carotid artery (CCA) intima-media thickness (IMT). High-density lipoprotein (HDL)/low-density lipoprotein (LDL) subfractions were measured. Machine learning models were also constructed to predict FMD and CCA IMT.Results Median FMD was 4.48% (IQR 5.00%) while median IMT was 0.54 mm (IQR 0.12 mm). Univariate analysis showed lower LDL1 (r=−0.313, p

Abstract Aim This study aimed to undertake a bibliometric analysis to provide comprehensive information in demonstrating the current status and outline the overall trends in the area of readiness for hospital discharge (RHD). Design A bibliometric and visual analysis of RHD literature was undertaken. Methods Articles were retrieved from the Web of Science network from 2002 to 2021. VOSviewer was used to identify the co‐authorship network of countries/institutions, co‐authorship and co‐citation analysis of authors, and co‐citation analysis of references and citation analysis of documents. CiteSpace was used to identify the keyword co‐occurrence network and perform cluster analysis, detecting the keywords with citation bursts and speculated frontiers in this research field. Results A total of 512 articles were included in the final analysis. Key findings are: (1) There has been a continuous but somewhat fluctuating rise in the number of publications. (2) 56.05% of publications come from the USA with Marquette University making the highest contribution. (3) Most publications (17, 3.32%) in RHD research were from the Journal of Clinical Nursing, and Anaesthesia and Analgesia had the highest number of citations (584 citations). (4) Weiss ME (25, 4.88%) was the most productive author whose articles have been the most highly cited (646 citations). (5) Cited references from Weiss ME (2007) also made the largest contribution to co‐citations, and the most cited reference was from Jack BW (2009) (1022 citations). (6) The 20 most frequent keywords and keywords with the strongest citation bursts were retrieved. There were seven research hotspots, and three emerging research frontiers were explored. Conclusions The bibliometric analysis of material published in the last 20 years indicates that there have been statistically significant gains in comprehensive information on RHD, including the knowledge mapping of the countries, institutions, authors, references and keywords. The hotspots and frontiers, which have been explored can give guidance to researchers as to new angles and directions to take. Implications for Nursing Management The effects of the implementation of ERAS on RHD‐related risk for adverse post‐discharge outcomes in surgical patients will be of increasing concern for healthcare professionals. It is important for patients and their relatives to be confident that on discharge they are sufficiently ready for hospital discharge to enable them to safely and smoothly make the transition to home. Improving the level of RHD in discharged patients can help nurse managers and researchers measure the effectiveness of discharge planning services.

Abstract Background Sarcopenia is defined as the disease of muscle loss and dysfunction. The prevalence of sarcopenia is strongly age-dependent. It could bring about disability, hospitalization, and mortality. The purpose of this study was to identify plasma metabolites associated with possible sarcopenia and muscle function to improve disease monitoring and understand the mechanism of muscle strength and function decline. Methods The participants were a group of healthy older adult who live in retirement homes in Asia (Taiwan) and can manage their daily lives without assistance. The participants were enrolled and divided into four groups: control (Con, n = 57); low physical function (LPF, n = 104); sarcopenia (S, n = 63); and severe sarcopenia (SS, n = 65) according to Asian countries that used Asian Working Group for Sarcopenia (AWGS) criteria. The plasma metabolites were used and the results were calculated as the difference between the control and other groups. Results Clinical parameters, age, gender, body mass index (BMI), hand grip strength (HGS), gait speed (GS), blood urea nitrogen (BUN), hemoglobin, and hematocrit were significantly different between the control and LPF groups. Metabolite patterns of LPF, S, and SS were explored in our study. Plasma kynurenine (KYN) and acylcarnitines (C0, C4, C6, and C18:1-OH) were identified with higher concentrations in older Taiwanese adults with possible sarcopenia and S compared to the Con group. After multivariable adjustment, the data indicate that age, BMI, and butyrylcarnitine (C4) are more important factors to identify individuals with low physical function and sarcopenia. Conclusion This metabolomic study raises the importance of acylcarnitines on muscle mass and function. It suggests that age, BMI, BUN, KYN, and C4/Cr can be important evaluation markers for LPF (AUC: 0.766), S (AUC: 0.787), and SS (AUC: 0.919).

Background: Given the fundamental physiological differences between the sexes, this study aimed to investigate the effect of metabolic syndrome on ventilatory defects stratified by sex. Methods: We conducted a nationwide, pooled, cross-sectional study. Data from 45,788 participants (men, n = 15,859; women, n = 29,929) aged 30 years or more were obtained from the Taiwan Biobank. Age–sex-adjusted and multivariate logistic regression models were used to estimate the risk of developing impaired pulmonary function (restrictive or obstructive ventilatory defects) in individuals with or without metabolic syndromes. Separate models were also used to estimate the effect of metabolic syndrome scores and the effect of individual metabolic abnormalities on the risk of restrictive ventilatory defects. Results: The overall prevalence of metabolic syndrome was estimated to be 15.9% in Taiwan, much higher in men than in women (18.6% versus 14.4%). A significant association was observed between metabolic syndromes and the risk of restrictive ventilatory defects. The risk of developing a restrictive ventilator defect was 35% higher in participants with metabolic syndromes (odds ratio, 1.35; 95% confidence interval, 1.26–1.45) than in those without metabolic syndromes. Elevated blood pressure and a triglycerides abnormality were important predictors of restrictive ventilator defects. Sex-stratified subgroup analyses of the individual metabolic abnormalities indicated that men with abdominal obesity and women with dysglycemia were more likely to develop restrictive ventilatory defects. Conclusions: Our study’s evidence suggested that metabolic syndromes were important predictors of impaired pulmonary function and an increased risk of developing restrictive ventilatory defects, and its risk increased with increasing numbers of metabolic abnormalities.

Huntington’s disease (HD) is characterized by progressive involuntary chorea movements and cognitive decline. Recent research indicates that metabolic disturbance may play a role in its pathogenesis. Bile acids, produced during cholesterol metabolism in the liver, have been linked to neurodegenerative conditions. This study investigated variations in plasma bile acid profiles among individuals with HD. Plasma levels of 16 primary and secondary bile acids and their conjugates were analyzed in 20 healthy controls and 33 HD patients, including 24 with symptoms (symHD) and 9 carriers in the presymptomatic stage (preHD). HD patients exhibited significantly higher levels of glycochenodeoxycholic acid (GCDCA) and glycoursodeoxycholic acid (GUDCA) compared to healthy controls. Conversely, isolithocholic acid levels were notably lower in the HD group. Neurotoxic bile acids (glycocholic acid (GCA) + glycodeoxycholic acid (GDCA) + GCDCA) were elevated in symHD patients, while levels of neuroprotective bile acids (ursodeoxycholic acid (UDCA) + GUDCA + tauroursodeoxycholic acid (TUDCA)) were higher in preHD carriers, indicating a compensatory response to early neuronal damage. These results underscore the importance of changes in plasma bile acid profiles in HD and their potential involvement in disease mechanisms. The identified bile acids (GCDCA, GUDCA, and isolithocholic acid) could potentially serve as markers to distinguish between HD stages and healthy individuals. Nonetheless, further research is warranted to fully understand the clinical implications of these findings and their potential as diagnostic or therapeutic tools for HD.

Osteoarthritis (OA) is a chronic degenerative disease leading to articular cartilage destruction. Menopausal and postmenopausal women are susceptible to both OA and osteoporosis. S-equol, a soy isoflavone-derived molecule, is known to reduce osteoporosis in estrogen-deficient mice, but its role in OA remains unknown. This study aimed to explore the effect of S-equol on different degrees of menopausal OA in female Sprague–Dawley (SD) rats induced by estrogen deficiency caused by bilateral ovariectomy (OVX) combined with intra-articular injection of mono-iodoacetate (MIA). Knee joint histopathological change; serum biomarkers of bone turnover, including N-terminal propeptide of type I procollagen (PINP), C-terminal telopeptide of type I collagen (CTX-I) and N-terminal telopeptide of type I collagen (NTX-I); the cartilage degradation biomarkers hyaluronic acid (HA) and N-terminal propeptide of type II procollagen (PIINP); and the matrix-degrading enzymes matrix metalloproteinases (MMP)-1, MMP-3 and MMP-13, as well as the oxidative stress-inducing molecules nitric oxide (NO) and hydrogen peroxide (H2O2), were assessed for evaluation of OA progression after S-equol supplementation for 8 weeks. The results showed that OVX without or with MIA injection induced various severity levels of menopausal OA by increasing pathological damage, oxidative stress, and cartilage matrix degradation to various degrees. Moreover, S-equol supplementation could significantly reduce these increased biomarkers in different severity levels of OA. This indicates that S-equol can lessen menopausal OA progression by reducing oxidative stress and the matrix-degrading enzymes involved in cartilage degradation.

ObjectiveTo explore the modulations of electroacupuncture in subjective tinnitus (ST) by comparing the difference of functional connectivity (FC) in ST patients and healthy volunteers between the insular (INS) and the whole brain region.MethodsA total of 34 ST patients were selected into electroacupuncture group (EG) and 34 age- and sex-matched normal subjects were recruited into control group (CG). The EG received acupuncture at SI19 (Tinggong), GB11 (Touqiaoyin), TE17 (Yifeng), GV20 (Baihui), GV15 (Yamen), GV14 (Dazhui), SJ13 (Zhongzhu), among which the points of SI19 and GB11 were connected to the electroacupuncture instrument with the density wave of 2/50 Hz, and 3 treatments per week for 10 sessions in total. The severity of tinnitus was evaluated by Tinnitus Handicap Inventory (THI), the hearing status was recorded using pure tone audiometry, and resting-state functional magnetic resonance imaging (rs-fMRI) was performed on the brain before and after treatment, the CG received no intervention yet only rs-fMRI data were collected.ResultsWith the electroacupuncture treatment, the total THI score, average air conduction threshold of patients of EG were significantly lower than before (p

Introduction: Dental erosion and abrasion pose significant clinical challenges, often leading to exposed dentinal tubules and dentine demineralization. The aim of this study was to analyse the efficacy of quercetin-encapsulated hollow mesoporous silica nanocomposites (Q@HMSNs) on the prevention of dentine erosion and abrasion.Method: Q@HMSNs were synthesized, characterized, and evaluated for their biocompatibility. A total of 130 dentine specimens (2 mm × 2 mm × 2 mm) were prepared and randomly distributed into 5 treatment groups (n = 26): DW (deionized water, negative control), NaF (12.3 mg/mL sodium fluoride, positive control), Q (300 μg/mL quercetin), HMSN (5.0 mg/mL HMSNs), and Q@HMSN (5.0 mg/mL Q@HMSNs). All groups were submitted to in vitro erosive (4 cycles/d) and abrasive (2 cycles/d) challenges for 7 days. The specimens in the DW, NaF, and Q groups were immersed in the respective solutions for 2 min, while treatment was performed for 30 s in the HMSN and Q@HMSN groups. Subsequently, the specimens were subjected to additional daily erosion/abrasion cycles for another 7 days. The effects of the materials on dentinal tubule occlusion and demineralized organic matrix (DOM) preservation were examined by scanning electron microscopy (SEM). The penetration depth of rhodamine B fluorescein into the etched dentine was assessed using confocal laser scanning microscopy (CLSM). The erosive dentine loss (EDL) and release of type I collagen telopeptide (ICTP) were measured. The data were analysed by one-way analysis of variance (ANOVA) with post hoc Tukey’s test (α = 0.05).Results: Q@HMSNs were successfully synthesized and showed minimal toxicity to human dental pulp stem cells (HDPSCs) and gingival fibroblasts (HGFs). Q@HMSNs effectively occluded the dentinal tubules, resulting in a thicker DOM in the Q@HMSN group. The CLSM images showed more superficial penetration in the HMSN and Q@HMSN groups than in the quercetin, NaF, and DW groups. The Q@HMSN group exhibited a significantly lower EDL and reduced ICTP levels compared to the other groups (p < 0.05).Conclusion: Q@HMSNs hold promise for inhibiting dentine erosion and abrasion by promoting tubule occlusion and DOM preservation.

The Brown planthopper (Nilaparvata lugens Stål; BPH) is known to cause significant damage to rice crops in Asia, and the use of host-resistant varieties is an effective and environmentally friendly approach for controlling BPH. However, genes limited resistance genes that are used in insect-resistant rice breeding programs, and landrace rice varieties are materials resources that carry rich and versatile genes for BPH resistance. Two landrace indica rice accessions, CL45 and CL48, are highly resistant to BPH and show obvious antibiosis against BPH. A novel resistance locus linked to markers 12M16.983 and 12M19.042 was identified, mapped to chromosome 12 in CL45, and designated Bph46. It was finely mapped to an interval of 480 kb and Gene 3 may be the resistance gene. Another resistance locus linked to markers RM26567 and 11MA104 was identified and mapped to chromosome 11 in CL48 and designated qBph11.3 according to the nominating rule. It was finely mapped to an interval of 145 kb, and LOC_Os11g29090 and LOC_Os11g29110 may be the resistance genes. Moreover, two markers, 12M16.983 and 11MA104, were developed for CL45 and CL48, respectively, using marker-assisted selection (MAS) and were confirmed by backcrossing individuals and phenotypic detection. Interestingly, we found that the black glume color is closely linked to the BPH resistance gene in CL48 and can effectively assist in the identification of positive individuals for breeding. Finally, several near-isogenic lines with a 9311 or KW genetic background, as well as pyramid lines with two resistance parents, were developed using MAS and exhibited significantly high resistance against BPHs.

Summary: While fecal microbiota transplantation (FMT) shows promise in treating human diseases, oral capsule FMT is more accepted and accessible to patients. However, microbe selection in the upper gastrointestinal tract (UGIT) through oral administration remains unclear. Here, we demonstrate that short-term oral fecal gavage (OFG) alleviates acetaminophen-induced acute liver injury (AILI) in mice, regardless of the divergent effects of commensal gut microbes. Pasteurized fecal gavage yields similar therapeutic effects. OFG enriches gut Lachnospiraceae and butyrate compared to donor feces. Butyrate mitigates AILI-induced ferroptosis via AMPK-ULK1-p62 signaling to simultaneously induce mitophagy and Nrf2 antioxidant responses. Combined N-acetylcysteine and butyrate administration significantly improves AILI mouse survival rates. These observations indicate the significance of the UGIT in modulating the implanted fecal microbes through oral administration and its potential biological and clinical impacts. Our findings also highlight a possible strategy for applying microbial metabolites to treat acute liver injury.

Background: Maternal transplacental antibody is an important origins of passive immunity against neonatal enterovirus infection. Echovirus 11 (E11) and coxsackievirus B3 (CVB3) are important types causing neonatal infections. There were few investigations of enterovirus D68 (EVD68) infection in neonates. We aimed to investigate the serostatus of cord blood for these three enteroviruses and evaluate the factors associated with seropositivity. Methods: We enrolled 222 parturient (gestational age 34–42 weeks) women aged 20–46 years old between January and October 2021. All participants underwent questionnaire investigation and we collected the cord blood to measure the neutralization antibodies against E11, CVB3 and EVD68. Results: The cord blood seropositive rates were 18% (41/222), 60% (134/232) and 95% (211/222) for E11, CVB3 and EVD68, respectively (p

Sucrose phosphate synthase (SPS) is a rate-limiting enzyme that works in conjunction with sucrose-6-phosphate phosphatase (SPP) for sucrose synthesis, and it plays an essential role in energy provisioning during growth and development in plants as well as improving fruit quality. However, studies on the systematic analysis and evolutionary pattern of the SPS gene family in apple are still lacking. In the present study, a total of seven MdSPS and four MdSPP genes were identified from the Malus domestica genome GDDH13 v1.1. The gene structures and their promoter cis-elements, protein conserved motifs, subcellular localizations, physiological functions and biochemical properties were analyzed. A chromosomal location and gene-duplication analysis demonstrated that whole-genome duplication (WGD) and segmental duplication played vital roles in MdSPS gene family expansion. The Ka/Ks ratio of pairwise MdSPS genes indicated that the members of this family have undergone strong purifying selection during domestication. Furthermore, three SPS gene subfamilies were classified based on phylogenetic relationships, and old gene duplications and significantly divergent evolutionary rates were observed among the SPS gene subfamilies. In addition, a major gene related to sucrose accumulation (MdSPSA2.3) was identified according to the highly consistent trends in the changes of its expression in four apple varieties (‘Golden Delicious’, ‘Fuji’, ‘Qinguan’ and ‘Honeycrisp’) and the correlation between gene expression and soluble sugar content during fruit development. Furthermore, the virus-induced silencing of MdSPSA2.3 confirmed its function in sucrose accumulation in apple fruit. The present study lays a theoretical foundation for better clarifying the biological functions of the MdSPS genes during apple fruit development.

The magnetic properties of a 0.10 mm ultra-thin, grain-oriented (UTGO) silicon steel and an Fe-based amorphous (FBA) alloy under sinusoidal excitation were experimentally researched, and the magnetic field strength and iron loss of the two materials under different frequencies and magnetic densities were obtained. Based on the measured data, the magnetization and loss characteristics of the two materials were analyzed and compared. Furthermore, two Epstein square ring models of the same dimensions and different materials were designed, and the reliability of the models was verified. Then, the electromagnetic characteristics of the two Epstein square ring models at higher and lower frequencies were calculated using the finite element method, and the iron losses were obtained and compared. The results show that the FBA alloy has good application characteristics at low frequencies and low power, and the 0.10 mm UTGO silicon steel has good application characteristics at high frequencies and high power. This research provides important data, promoting the application of these two materials in new energy equipment.

Abstract Background Circulating thyroid-stimulating hormone (TSH) levels within the normal reference range can affect the cardiovascular system. The present study investigated the prognostic value of normal TSH levels in patients presenting with acute myocardial infarction (AMI) following percutaneous coronary intervention (PCI). Methods Between January 2013 and July 2019, 1240 patients with AMI and normal thyroid function were enrolled and classified according to TSH tertile. The trial endpoint was all-cause mortality. The integrated discrimination index (IDI) and the net reclassification index (NRI) were used to assess the combined predictive values of the TSH levels and the Global Registry of Acute Coronary Events (GRACE) scores. Results After a median 44.25-month follow-up, 195 individuals died. Even after covariate adjustment by multivariate Cox regression (HR: 1.56; 95% CI 1.08–2.25; P = 0.017), the patients in the third TSH tertile were at the highest risk of all-cause mortality. A subgroup analysis revealed significant interactions between the TSH levels and the GRACE scores (high risk vs. low/medium risk) (P = 0.019). The addition of the TSH levels to the GRACE scores substantially improved the prediction of all-cause mortality, especially for high-risk patients (NRI = 0.239; IDI = 0.044; C-statistic value range 0.649–0.691; all significant). Conclusions The third TSH tertile is associated with a higher incidence of all-cause mortality than the first TSH tertile in high-risk patients presenting with AMI after PCI.

Abstract Background During biological aging, significant metabolic dysregulation in the central nervous system may lead to cognitive decline and neurodegeneration. However, the metabolomics of the aging process in cerebrospinal fluid (CSF) has not been thoroughly explored. Methods In this cohort study of CSF metabolomics using liquid chromatography-mass spectrometry (LC–MS), fasting CSF samples collected from 92 cognitively unimpaired adults aged 20–87 years without obesity or diabetes were analyzed. Results We identified 37 metabolites in these CSF samples with significant positive correlations with aging, including cysteine, pantothenic acid, 5-hydroxyindoleacetic acid (5-HIAA), aspartic acid, and glutamate; and two metabolites with negative correlations, asparagine and glycerophosphocholine. The combined alterations of asparagine, cysteine, glycerophosphocholine, pantothenic acid, sucrose, and 5-HIAA showed a superior correlation with aging (AUC = 0.982). These age-correlated changes in CSF metabolites might reflect blood–brain barrier breakdown, neuroinflammation, and mitochondrial dysfunction in the aging brain. We also found sex differences in CSF metabolites with higher levels of taurine and 5-HIAA in women using propensity-matched comparison. Conclusions Our LC–MS metabolomics of the aging process in a Taiwanese population revealed several significantly altered CSF metabolites during aging and between the sexes. These metabolic alterations in CSF might provide clues for healthy brain aging and deserve further exploration.

The high sensitivity to color browning during room-temperature storage was a significant factor in limiting the development of fresh spinach noodles (FSN). The practice of humidity-controlled heat treatment (HCHT) at varying temperatures, relative humidity, and time was carried out to limit enzyme activity and improve the quality of FSN. Results showed that HCHT could maximize the color preservation of fresh spinach noodle quality while effectively inactivating polyphenol oxidase and the yeasts, and mold count in FSN during storage was almost undetectable after mild conditions (80 °C). The hardness and chewiness of HCHT noodles were significantly increased, but the free sulfhydryl content was reduced. At 80 °C, 90 %, 5 min, protein structural aggregation was found in the microstructure of HCHT fresh spinach noodles. HCHT also caused partial gelatinization, as evidenced by the decrease in starch gelatinization enthalpy from 5.49 to 4.77 J/g, although the gelatinization degree of FSN was comparatively low.

The adoption of the Fifth Generation (5G) and beyond 5G networks is driving the demand for learning approaches that enable users to co-exist harmoniously in a multi-user distributed environment. Although resource-constrained, the Cognitive Radio (CR) has been identified as a key enabler of distributed 5G and beyond networks due to its cognitive abilities and ability to access idle spectrum opportunistically. Reinforcement learning is well suited to meet the demand for learning in 5G and beyond 5G networks because it does not require the learning agent to have prior information about the environment in which it operates. Intuitively, CRs should be enabled to implement reinforcement learning to efficiently gain opportunistic access to spectrum and co-exist with each other. However, the application of reinforcement learning is straightforward in a single-agent environment and complex and resource intensive in a multi-agent and multi-objective learning environment. In this paper, (1) we present a brief history and overview of reinforcement learning and its limitations; (2) we provide a review of recent multi-agent learning methods proposed and multi-agent learning algorithms applied in Cognitive Radio (CR) networks; and (3) we further present a novel framework for multi-CR reinforcement learning and conclude with a synopsis of future research directions and recommendations.

It has always been difficult to achieve accurate information of the channel for underwater acoustic communications because of the severe underwater propagation conditions, including frequency-selective property, high relative mobility, long propagation latency, and intensive ambient noise, etc. To this end, a deep unfolding neural network based approach is proposed, in which multiple layers of the network mimic the iterations of the classical iterative sparse approximation algorithm to extract the inherent sparse features of the channel by exploiting deep learning, and a scheme based on the Sparsity-Aware DNN (SA-DNN) for UAC estimation is proposed to improve the estimation accuracy. Moreover, we propose a Denoising Sparsity-Aware DNN (DeSA-DNN) based enhanced method that integrates a denoising CNN module in the sparsity-aware deep network, so that the degradation brought by intensive ambient noise could be eliminated and the estimation accuracy can be further improved. Simulation results demonstrate that the performance of the proposed schemes is superior to the state-of-the-art compressed sensing based and iterative sparse recovery schems in the aspects of channel recovery precision, pilot overhead, and robustness, particularly under unideal circumstances of intensive ambient noise or inadequate measurement pilots.

The Gilbert-Varshamov (GV) lower bound is used to provide indications and prescriptions for the outer code coding parameters for a memory synchronisation model that focuses solely on the internal resynchronisation process. The binary and $q$ -ary GV bounds are utilised in this analysis to indicate parameters to remove the remaining substitution errors and provide a complete framework. Procedures and examples are provided to determine optimal outer code parameters for given inner-entropies and residual substitution errors produced during resynchronisation. In particular, using the non-binary GV bounds allows us to match the best alphabet size for given parameters. For the cases explored, a 16-ary GV bound provides the best results, with an ( $n$ , $k$ , $d$ ) code of (120, 57, 37) being a possible outer code when the inner entropy is 0.1. Using GV bounds for outer code parameter considerations frees the system from using stringent codes and instead allows any outer code to be utilised to meet the required error correction needs.

Osteoarthritis (OA) causes joint pain and disability due to the abnormal production of inflammatory cytokines and reactive oxygen species (ROS) in chondrocytes, leading to cell death and cartilage matrix destruction. Selenium (Se) intake can protect cells against oxidative damage. It is still unknown whether Se supplementation is beneficial for OA. This study investigated the effects of Se on sodium iodoacetate (MIA)-imitated OA progress in human chondrocyte cell line (SW1353 cells) and rats. The results showed that 0.3 μM of Se treatment could protect SW1353 cells from MIA-induced damage by the Nrf2 pathway by promoting the gene expression of glutathione-synthesis-related enzymes such as the glutamate–cysteine ligase catalytic subunit, the glutamate–cysteine ligase modifier subunit, and glutathione synthetase. In addition, glutathione, superoxide dismutase, glutathione peroxidase, and glutathione reductase expressions are also elevated to eliminate excessive ROS production. Moreover, Se could downregulate NF-κB, leading to a decrease in cytokines, matrix proteases, and glycosaminoglycans. In the rats, MIA-induced cartilage loss was lessened after 2 weeks of Se supplementation by oral gavage; meanwhile, glutathione synthesis was increased, and the expressions of pro-inflammatory cytokines were decreased. These results suggest that Se intake is beneficial for OA due to its effects of decreasing cartilage loss by enhancing antioxidant capacity and reducing inflammation.

The coming of the hyper-aged society in Taiwan prompts us to investigate the relationship between the metabolic status of sarcopenic patients and their most adverse outcome–death. We studied the association between any plasma metabolites and the risk for mortality among older Taiwanese sarcopenic patients. We applied a targeted metabolomic approach to study the plasma metabolites of adults aged ≥65 years, and identified the metabolic signature predictive of the mortality of sarcopenic patients who died within a 5.5-year follow-up period. Thirty-five sarcopenic patients who died within the follow-up period (Dead cohort) had shown a specific plasma metabolic signature, as compared with 54 patients who were alive (Alive cohort). Only 10 of 116 non-sarcopenic individuals died during the same period. After multivariable adjustment, we found that sex, hypertension, tetradecanoyl-carnitine (C14-carnitine), and docosahexaenoic acid (DHA)-containing phosphatidylcholine diacyl (PCaa) C38:6 and C40:6 were important risk factors for the mortality of sarcopenic patients. Low PCaa C38:6 levels and high C14-carnitine levels correlated with an increased mortality risk; this was even the same for those patients with hypertension (HTN). Our findings suggest that plasma PCaa C38:6 and acylcarnitine C14-carnitine, when combined, can be a better early biomarker for evaluating the mortality risk of sarcopenia patients.

Gynecologic tract melanoma is a malignant tumor with poor prognosis. Because of the low survival rate and the lack of a standard treatment protocol related to this condition, the investigation of the mechanisms underlying melanoma progression is crucial to achieve advancements in the relevant gynecological surgery and treatment. Mitochondrial transfer between adjacent cells in the tumor microenvironment regulates tumor progression. This study investigated the effects of endothelial mitochondria on the growth of melanoma cells and the activation of specific signal transduction pathways following mitochondrial transplantation. Mitochondria were isolated from endothelial cells (ECs) and transplanted into B16F10 melanoma cells, resulting in the upregulation of proteins associated with tumor growth. Furthermore, enhanced antioxidation and mitochondrial homeostasis mediated by the Sirt1-PGC-1α-Nrf2-HO-1 pathway were observed, along with the inhibition of apoptotic protein caspase-3. Finally, the transplantation of endothelial mitochondria into B16F10 cells promoted tumor growth and increased M2-type macrophages through Nrf2/HO-1-mediated pathways in a xenograft animal model. In summary, the introduction of exogenous mitochondria from ECs into melanoma cells promoted tumor growth, indicating the role of mitochondrial transfer by stromal cells in modulating a tumor’s phenotype. These results provide valuable insights into the role of mitochondrial transfer and provide potential targets for gynecological melanoma treatment.

Coronary artery dissection caused by trauma is a rare occurrence that can be life-threatening. Accordingly, its rapid identification and treatment are essential to improve patient outcomes. Here, we present a case of a patient who suffered multiple rib and femur fractures after falling from a height of eighteen meters and subsequently experienced persistent chest pain. After the initial diagnostic workup, the medical team diagnosed the patient's chest pain as rib fractures and failed to consider the potential of a cardiac injury as the underlying cause. No emphasis was placed on monitoring changes in myocardial enzymes and ECG, which could have indicated coronary artery dissection. The dissection was confirmed and treated with a stent only after the subsequent coronary angiography (CAG) and optical coherence tomography (OCT) examinations, gradually relieving the patient's chest pain. In this case report, we discuss the management of fractures complicated by traumatic coronary artery dissection and highlight the benefits of OCT in diagnosing and treating this condition. The case also emphasizes the importance of considering coronary artery injury in patients with chest pain due to trauma.

Major depressive disorder (MDD) is a chronic relapsing psychiatric disorder. Conventional antidepressants usually require several weeks of continuous administration to exert clinically significant therapeutic effects, while about two-thirds of the patients are prone to relapse of symptoms or are completely ineffective in antidepressant treatment. The recent success of the N-methyl-D-aspartic acid (NMDA) receptor antagonist ketamine as a rapid-acting antidepressant has propelled extensive research on the action mechanism of antidepressants, especially in relation to its role in synaptic targets. Studies have revealed that the mechanism of antidepressant action of ketamine is not limited to antagonism of postsynaptic NMDA receptors or GABA interneurons. Ketamine produces powerful and rapid antidepressant effects by affecting α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptors, adenosine A1 receptors, and the L-type calcium channels, among others in the synapse. More interestingly, the 5-HT2A receptor agonist psilocybin has demonstrated potential for rapid antidepressant effects in depressed mouse models and clinical studies. This article focuses on a review of new pharmacological target studies of emerging rapid-acting antidepressant drugs such as ketamine and hallucinogens (e.g., psilocybin) and briefly discusses the possible strategies for new targets of antidepressants, with a view to shed light on the direction of future antidepressant research.

Rhododendron simsii Planch, a folk medicine recorded in the ‘Dictionary of Chinese Materia Medica’, has been used by many ethnic regions of China to treat various inflammatory and immune-related diseases such as skin disorders and rheumatoid arthritis. However, its protective effect against autoimmune hepatitis and the underlying mechanisms remain unclear. The present study aimed to aimed to investigate the protective effects on autoimmune hepatitis through an integrated approach established by combining chemical composition identification, network pharmacology and in vivo experimental validation. Animal experiments showed that R. simsii Planch extract ameliorated ConA-induced liver injury, as evidenced by a reduction in ALT and AST levels and varying degrees of improvement in liver histopathology, with the R-EE (R. simsii Planch EtOAc extract) treated group showing the most obvious therapeutic effect. Then, chemical investigations into R-EE yielded 15 flavonoid and phenolic acid derivatives namely quercetin 3-O-α-L-rhamnoside (1), tamarixetin 3-rhamnoside (2), isoquercitrin (3), hyperoside (4), myricetin-3-O-α-L-rhamnopyranoside (5), afzelin (6), quercetin-3-O-α-L-arabinofuranoside (7), quercetin-3-O-α-D-arabinopyranoside (8), (+)-catechin (9), kaempferol (10), dihydromyricetin (11), quercetin (12), vanillic acid (13), gallic acid (14) and farrerol (15). Further network pharmacological analysis indicated that the potential mechanism against ConA-induced liver injury is probably related to the regulation of the NF-κB signaling pathway. Experiments confirmed that R-EE could reduce liver damage and downregulate CD4+ and inflammatory cytokine levels and the expressions of NLPR3, COX-2 and p-IκBα, and exhibited considerable hepatoprotective effects in ConA-induced AIH mice, which may be related to its flavonoids, and the underlying mechanism may involve the regulation of the NF-κB signaling pathway. The present results indicated that R. simsii Planch extract has more therapeutic potential in the treatment of autoimmune hepatitis, and provide the experimental basis for traditional application of R simsii Planch in the treatment of inflammatory diseases, and is a potential treatment agent for AIH that deserves further study.

BackgroundMalnutrition is a rising global health issue associated with unfavorable outcomes of a variety of disorders. Currently, the prevalence and prognostic significance of malnutrition to patients with acute coronary syndrome (ACS) and chronic kidney disease (CKD) remained largely unclear.MethodsA total of 705 patients diagnosed with ACS and CKD in the First Affiliated Hospital of Wenzhou Medical University between 2013 and 2021 were included in this retrospective cohort study. Malnutrition was assessed by the Controlling Nutritional Status (CONUT), the Geriatric Nutritional Risk Index (GNRI), and the Prognostic Nutritional Index (PNI), respectively. The relationships between malnutrition and all-cause mortality and major cardiovascular events (MACEs) were analyzed.ResultsDuring a median follow-up of 31 months, 153 (21.7%) patients died, and 165 (23.4%) had MACEs. The prevalence of malnutrition was 29.8, 80.6, and 89.8% for the PNI, CONUT, and GNRI, respectively. All the malnutrition indexes were correlated with each other (r = 0.77 between GNRI and PNI, r = −0.72 between GNRI and CONUT, and r = −0.88 between PNI and CONUT, all p

The rural industry is the foundation for promoting farmers' income and rural development, and adhering to the green development of the rural industry is the internal requirement for comprehensively promoting Rural Revitalization Strategy (RRS) in China. Firstly, the article explains the three aspects of China's rural eco-industries' development logic: the rural eco-industries have the historical inevitability of action under the Ecological Civilization (EC), academic rationality of development under the theory of urban-rural integration development, and strategic action under ecological poverty alleviation. Secondly, it establishes the six components of the Chinese rural eco-eco-industries' scientific connotation: one guiding concept, three theoretical foundations, three development carriers, two practical paths, a 3*3 development model, and two fundamental goals. Thirdly, Suggestions to encourage the development of rural eco-industry in the three dimensions of ''space, organization, and subject'' from primary mode to advanced mode.

The bay ecosystem plays an important role in maintaining energy flow, material circulation, community stability and ecosystem balance. In the present study, the comprehensive evaluation model for marine ecosystem of Laizhou Bay was established by using index system method, in which, five indicators were selected including water environment, sedimentary environment, marine community, primary productivity and ecological disaster indexes. The relative importance and weight of the evaluation indexes were determined combined using analytic hierarchy process and experts consultation method. By analyzing the survey data obtained, this assessment system was applied to assess and compare the health level of Laizhou Bay in recent ten years. Results showed that the condition of Laizhou Bay was always being sub-health, the main indicators that had given adverse impact on the health level of Laizhou Bay included inorganic nitrogen, phosphate, petroleum hydrocarbon, plankton species and benthic biomass. The results of evaluation model were more sensitive to Laizhou Bay, which could identify the adverse effects of extreme events such as oil spills and typhoons, therefore, the use of interval index and environmental admissible value could avoid disadvantage concealment, information omissions and the overestimation of limit value-based assessment method effectively.

Abstract Background Laparoscopic liver resections (LLR) have been shown a treatment approach comparable to open liver resections (OLR) in hepatocellular carcinoma (HCC). However, the influence of procedural type on body composition has not been investigated. The aim of the current study was to compare the degree of skeletal muscle loss between LLR and OLR for HCC. Methods By using propensity score matching (PSM) analysis, 64 pairs of patients were enrolled. The change of psoas muscle index (PMI) after the operation was compared between the matched patients in the LLR and OLR. Risk factors for significant muscle loss (defined as change in PMI > mean change minus one standard deviation) were further investigated by multivariate analysis. Results Among patients enrolled, there was no significant difference in baseline characteristics between the two groups. The PMI was significantly decreased in the OLR group (P = 0.003). There were also more patients in the OLR group who developed significant muscle loss after the operations (P = 0.008). Multivariate analysis revealed OLR (P = 0.023), type 2 diabetes mellitus, indocyanine green retention rate at 15 min (ICG-15) > 10%, and cancer stage ≧ 3 were independent risk factors for significant muscle loss. In addition, significant muscle loss was associated with early HCC recurrence (P = 0.006). Metabolomic analysis demonstrated that the urea cycle may be decreased in patients with significant muscle loss. Conclusion LLR for HCC was associated with less significant muscle loss than OLR. Since significant muscle loss was a predictive factor for early tumor recurrence and associated with impaired liver metabolism, LLR may subsequently result in a more favorable outcome.