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Abstract Background Osimertinib is regarded as a promising third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for advanced non-squamous non-small cell lung cancer (NSCLC) patients who developed T790M. However the adverse effects, primarily fatigue, remain an overwhelming deficiency of Osimertinib, hindering it from achieving adequate clinical efficacy for such NSCLC. Ganoderma lucidum has been used for thousands of years in China to combat fatigue, while Ganoderma Lucidum spores powder (GLSP) is the main active ingredient. The aim of this study is to investigate whether GLSP is sufficiently effective and safe in improving fatigue and synergizing with Osimertinib in non-squamous NSCLC patients with EGFR mutant. Method/design A total of 140 participants will be randomly assigned to receive either de-walled GSLP or placebo for a duration of 56 days. The primary outcome measure is the fatigue score associated with EGFR-TKI adverse reactions at week 8, evaluated by the Chinese version of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire for Cancer Patients (QLQ-C30). Secondary outcomes include evaluation of treatment effectiveness, assessment of quality of life (QoL), and exploration of immune indicators and gut microbiota relationships. Following enrollment, visits are scheduled biweekly until week 12. Trial registration China Clinical Trial Registry ChiCTR2300072786. Registrated on June 25, 2023.

IntroductionChronic kidney disease (CKD) is worldwide healthcare burden with growing incidence and death rate. Emerging evidence demonstrated the compositional and functional differences of gut microbiota in patients with CKD. As such, gut microbial features can be developed as diagnostic biomarkers and potential therapeutic target for CKD.MethodsTo eliminate the outcome bias arising from factors such as geographical distribution, sequencing platform, and data analysis techniques, we conducted a comprehensive analysis of the microbial differences between patients with CKD and healthy individuals based on multiple samples worldwide. A total of 980 samples from six references across three nations were incorporated from the PubMed, Web of Science, and GMrepo databases. The obtained 16S rRNA microbiome data were subjected to DADA2 processing, QIIME2 and PICRUSt2 analyses.ResultsThe gut microbiota of patients with CKD differs significantly from that of healthy controls (HC), with a substantial decrease in the microbial diversity among the CKD group. Moreover, a significantly reduced abundance of bacteria Faecalibacterium prausnitzii (F. prausnitzii) was detected in the CKD group through linear discriminant analysis effect size (LEfSe) analysis, which may be associated with the alleviating effects against CKD. Notably, we identified CKD-depleted F. prausnitzii demonstrated a significant negative correlation with three pathways based on predictive functional analysis, suggesting its potential role in regulating systemic acidbase disturbance and pro-oxidant metabolism.DiscussionOur findings demonstrated notable alterations of gut microbiota in CKD patients. Specific gut-beneficial microbiota, especially F. prausnitzii, may be developed as a preventive and therapeutic tool for CKD clinical management.

Abstract Critical Zone Science (CZS) explores the deep evolution of landscapes from the base of the groundwater or the saprolite‐rock interface to the top of vegetation, the zone that supports all terrestrial life. Here we propose a framework for CZS to evolve further as a discipline, building on 1st generation CZOs in natural systems and 2nd generation CZOs in human‐modified systems, to incorporate human behaviour for more holistic understanding in a 3rd generation of CZOs. This concept was tested in the China‐UK CZO programme (2016–2020) that established four CZOs across China on different lithologies. Beyond conventional CZO insights into soil resources, biogeochemical cycling and hydrology across scales, surveys of farmers and local government officials led to insights into human‐environment interactions and key pressures affecting the socio‐economic livelihoods of local farmers. These learnings combined with the CZS data identified knowledge exchange (KE) opportunities to unravel diverse factors within the Land‐Water‐Food Nexus, that could directly improve local livelihoods and environmental conditions, such as reduction in fertilizer use, contributing toward Sustainable Development Goals (SDGs) and environmental policies. Through two‐way local KE, the local cultural context and socio‐economic considerations were more readily apparent alongside the environmental rationale for policy and local action to improve the sustainability of farming practices. Seeking solutions to understand and remediate CZ degradation caused by human‐decision making requires the co‐design of CZS that foregrounds human behavior and the opinions of those living in human modified CZOs. We show how a new transdisciplinary CZO approach for sustainable Earth futures can improve alignment of research with the practical needs of communities in stressed environments and their governments, supporting social‐ecological and planetary health research agendas and improving capacity to achieve SDGs.

Advances in in vivo iron-based coordination assembly have enabled the simultaneous detection and treatment of iron-overload disorders. Specific interactions between local FeIII and organic ligands (e.g., indocyanine green and lecithin) facilitate magnetic resonance imaging with enhanced sensitivity and photoacoustic imaging with high contrast, thus overcoming the longstanding limitations of traditional iron quantification approaches. Moreover, enhanced iron depletion can also be achieved in murine genetic models of iron-overload disorders. These advances provide great promise in interdisciplinary leveraging of biology, medicine and materials science to design nanomedicines for addressing unmet clinical needs.

Some problems still exist in health management and application such as insufficient data, limited technology, and lack of professional evaluation methods by physicians with medical theory. In this study, an intelligent method is based on an analysis of physiological big data collected by wearable smartwatches. Firstly, physiological data such as pulse, heart rate, and blood oxygen were collected continuously from individuals by wearing smartwatches, and the data was digitally transmitted. Secondly, the transmitted data was sent to a health management platform by Narrow Band Internet of Things. Analyzing the data, physicians evaluated individual situations via an intelligent math model. Finally, the results were fed back to individuals through a smartphone APP to finish a medical diagnosis, disease prediction, or warning. The intelligent health management method and technology created via years of studies have been verified and will provide a new and effective strategy for health management.

Abstract Objective This healthcare improvement initiative was designed to increase inpatient osteoporosis treatment after hip fracture. Methods A new protocol was developed by Geriatric Medicine and Endocrinology departments at a tertiary care hospital in Sydney. Its aim was to standardize assessment and treatment of osteoporosis in patients admitted with hip fracture. Eligible inpatients would receive intravenous zoledronic acid during their admission. A 6‐month sample of hip fracture patients admitted after the protocol's implementation was compared to a group admitted before. Data collected included demographics, biochemistry, treatment rates, adverse effects, and admission survival. Results There was a considerable increase in osteoporosis treatment after introducing the protocol. Before the protocol's introduction, none of 36 eligible patients received treatment. After the intervention 79% (23 out of 29) of eligible patients were treated. All treated patients had renal function and serum calcium levels checked post‐infusion with no adverse outcomes. Eight patients developed flu‐like symptoms within 24 h of the infusion. There were no instances of arrhythmias, ocular inflammation, or death. The cost per patient treated was AUD $87. Conclusion Adopting a standardized protocol for osteoporosis treatment in patients admitted for hip fracture was effective in improving treatment rates whilst being relatively safe and inexpensive.

IntroductionDue to their bioactive compounds and beneficial health effects, functional foods and plant-based natural medicines are widely consumed. Due to its bioactivities, vinegar is one of them that helps humans. Sugarcane original vinegar (SOV) is a special vinegar made from sugarcane as a raw material through biological fermentation processes.MethodsThe objective of this study was to assess the effects of sugarcane original vinegar on growth performance, immune response, acute oral toxicity, bacterial reverse mutation, mammalian erythrocyte micronucleus, mouse spermatogonial chromosome aberration, mammalian bone marrow cell chromosome aberration changes, and serum characteristics in mice. Distortion parameters were used to assess its safety, and at the same time, the functionality of SOV was monitored during experimentation.ResultsThe results show that the SOV has no damage or inhibitory effect on the bone marrow red blood cells of mice and no mutagenic or distortion-inducing effects on the bone marrow cell chromosomes or spermatogonia chromosomes, so it is safe to eat. SOV can improve blood lipids and reduce blood lipid content.DiscussionThe study results provide data basis for the intensive processing of sugarcane and the development of high-value SOV products. Sugarcane original vinegar has a beneficial impact on performance, immune response, and chromosomal aberration. The production application influences the vinegar's quality and, consequently, its health benefits.

3D printed concrete (3DPC) is an essential technology for achieving efficient, precise, and sustainable construction. Nevertheless, due to limitations in materials and processes, 3DPC is prone to insufficient green strength and weakness in the interlayer area, which can result in print collapse and diminish its interlayer adhesion strength. Therefore, understanding green strength and interlayer adhesion strength of 3DPC is crucial for ensuring its structural safety. Superabsorbent polymer (SAP) serves as a novel type of concrete admixture, demonstrating the potential to promote green strength development and augment interlayer adhesion properties by facilitating the hydration process through water absorption and release. This study presents the first investigation into the effects of two commercially available SAPs on green strength and interlayer adhesion of 3D printed concrete. The role of SAP in improving interlayer adhesion performance in 3DPC is further elucidated through X-ray diffraction (XRD), Scanning electron microscopy (SEM). The results indicate that, compared to the control group, in the absence of added compensated water to SA1, the compressive strength at 15 min and splitting tensile strength of the printed specimen at 28 d increased by 282 % and 24.9 %, respectively, whereas SA2 demonstrates a relatively weaker enhancement effect. This study demonstrates that SAP promotes structural accumulation during the 3DPC printing stage, thereby presenting itself as a favorable material choice for applications involving 3DPC.