Search

Abstract Background The integration of Virtual Reality (VR) with Case-Based Learning (CBL) has the potential to revolutionise undergraduate medical education, particularly in complex subjects such as the anatomy and rehabilitation of the shoulder joint. This study aimed to explore the effectiveness of this innovative approach in enhancing learning outcomes and knowledge retention. Methods This study employed a parallel-group, assessor-blinded randomised controlled trial (RCT) design. A comprehensive five-week educational programme was developed, combining traditional lecture-based learning with VR-enhanced CBL. The study involved 82 undergraduate students from China Medical University, who were divided into groups receiving different combinations of VR and CBL. Student performance was evaluated through tests and questionnaires. Results In the anatomy-related courses, the integration of VR technology with CBL yielded significantly higher results (87.71 ± 5.60) compared to traditional methods (82.59 ± 6.64), with a statistically significant difference (P 0.05). Conclusion The present study provides preliminary evidence for the benefits of incorporating VR into medical education, particularly in anatomy. While the results are promising, further research is needed to explore the optimal integration of VR and CBL in rehabilitation studies and to assess their long-term impact on student learning and clinical performance. Trial registration The study was registered with Chinese Clinical Trials Registry (Registration Number: ChiCTR2400089295) on 05/09/2024.

Abstract 5-Fluorouracil (5-FU) is used as a standard first-line drug for colorectal cancer malignancy (CRC), but it brings a series of side effects such as severe diarrhea and intestinal damage. Our previous study found that a large number of senescent cells increased while 5-Fu induced intestinal damage, and anti-senescence drugs can alleviate its side effects of inflammatory damage. Oleanolic acid (OA) is a common pentacyclic triterpenoid mainly derived from food fungi and medicinal plants, and studies have shown that it mainly possesses hepatoprotective, enzyme-lowering, anti-inflammatory, and anti-tumor effects. But its role in senescence is still unclear. In the present study, we demonstrated for the first time that OA ameliorated 5-Fu-induced human umbilical vein endothelial cells (HUVECs) and human normal intestinal epithelial cells (NCM460) in a 5-Fu-induced cellular senescence model by decreasing the activity of SA-β-gal-positive cells, and the expression of senescence-associated proteins (p16), senescence-associated genes (p53 and p21), and senescence-associated secretory phenotypes (SASPs: IL-1β, IL-6, IL-8, IFN-γ and TNF-α). Meanwhile, in this study, in a BALB/c mouse model, we demonstrated that 5-FU induced intestinal inflammatory response and injury, which was also found to be closely related to the increase of senescent cells, and that OA treatment was effective in ameliorating these adverse phenomena. Furthermore, our in vivo and in vitro studies showed that OA could alleviate senescence by inhibiting mTOR. In colon cancer cell models, OA also enhanced the ability of 5-FU to kill HCT116 cells and SW480 cells. Overall, this study demonstrates for the first time the potential role of OA in counteracting the side effects of 5-FU chemotherapy, providing a new option for the treatment of colorectal cancer to progressively achieve the goal of high efficacy and low toxicity of chemotherapy.

Abstract Background Conflicting results comparing bivalirudin versus heparin anticoagulation in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), in part due to the confounding effect of glycoprotein IIb/IIIa inhibitors (GPI). The aim of the study was to compare the safety and effectiveness of bivalirudin plus a post-PCI high-dose infusion vs heparin with or without bail-out GPI use. Methods We conducted a pre-specified subgroup analysis from the BRIGHT-4 trial that randomized 6016 STEMI patients who underwent primary PCI to receive either bivalirudin plus a post-PCI high-dose infusion for 2–4 h or heparin monotherapy. GPI use was only reserved as bail-out therapy for procedural thrombotic complications. The primary outcome was a composite of all-cause death or Bleeding Academic Research Consortium (BARC) types 3–5 bleeding at 30 days. Results A total of 5250 (87.4%) patients received treatment without GPI while 758 (12.6%) received bail-out GPI. Bail-out GPI use was associated with an increased risk of the primary outcome compared to non-GPI use (5.28% vs. 3.41%; adjusted hazard ratio (aHR), 1.62; 95% confidence interval (CI), 1.13–2.33; P = 0.009) and all-cause death (5.01% vs. 3.12%; aHR, 1.74; 95% CI, 1.20–2.52; P = 0.004) but not in the risk of BARC types 3–5 bleeding (0.53% vs. 0.48%; aHR, 0.90; 95% CI, 0.31–2.66; P = 0.85). Among patients without GPI use, bivalirudin was associated with lower rates of the primary outcome (2.63% vs. 4.21%; aHR, 0.55; 95% CI, 0.39–0.77; P = 0.0005), all-cause death (2.52% vs. 3.74%; aHR, 0.58; 95% CI, 0.41–0.83; P = 0.003), and BARC types 3–5 bleeding (0.15% vs. 0.81%; aHR, 0.19; 95% CI, 0.06–0.57; P = 0.003) compared with heparin. However, among patients requiring bail-out GPI, there were no significant differences observed in the rates of the primary outcome (5.76% vs. 4.87%; aHR, 0.77; 95% CI, 0.36–1.66; P = 0.50; P interaction = 0.07) or its individual components between bivalirudin and heparin groups. Conclusions Bivalirudin plus a post-PCI high-dose infusion was associated with significantly reduced 30-day composite rate of all-cause death or BARC types 3–5 bleeding compared with heparin monotherapy in STEMI patients undergoing primary PCI without GPI use. However, these benefits might be less pronounced in patients requiring bail-out GPI due to thrombotic complications during primary PCI. Trial registration ClinicalTrials.gov NCT03822975.

Abstract Objective To report a new case of gastroblastoma and conduct an exhaustive review of the clinical, morphological, immunohistochemical, molecular features, diagnosis, treatment, and prognosis, to enhance understanding of this condition. Methods We retrospectively analyzed the case of a 50-year-old woman diagnosed with gastroblastoma and conducted a review and summary of relevant literature. Results To date, 27 cases have been reported, including the present case. The mean patient age at the time of presentation was 35.0 years (range, 5–74 years), and the disease showed no sex predilection. The most common location was the gastric antrum, and the average lesions size was 5.7 cm (range, 1.3–15 cm). Most patients underwent gastrectomy(n = 23), while several underwent ESD(n = 2) or EFTR(n = 1). Fusion genes were identified, including MALAT1–GLI1(n = 8), EWSR1-CTBP1(n = 1), PTCH1:GLI2(n = 1), and ACTB-GLI1(n = 1)Four patients had metastasis and one of them dead of disease. Immunohistochemical (IHC) analysis revealed that pancytokeratin was always positive in epithelioid components, while vimentin and CD10 were always positive in mesenchymal components. CD56 were often positive in both two components. Conclusion A comprehensive evaluation of clinical and pathological features is crucial for accurate diagnosis. Partial gastrectomy and EFTR could be an appropriate treatment. The risk factors that affect the prognosis need more cases to be clearly defined. We present this exhaustive literature review to increase awareness of gastroblastoma, better characterize the disease, and provide a reference point for gastroblastoma research in the future.

Abstract With the booming of Big Data and the Internet of Things, various urban networks have been built based on intercity flow data, and how to combine them to learn a more comprehensive understanding of mega-city regions is becoming more and more indispensable. In this paper, we designed a graph-based multi-view clustering method based on graph learning to explore the mega-city region structures from multi-source data. An example of clustering analysis consists of the people flow network, cargo flow network, and information flow network, covering 88 cities from Beijing, Tianjin, Hebei Province, Shandong Province, Henan Province, Jiangsu Province, Anhui Province, Shanghai, and Zhejiang Province in China is used to illustrate the applicability of the idea in super mega-city region scale studies. Utilizing the proposed clustering method, a unified network representation is calculated, and 5 mega-city regions, Beijing-Tianjin-Hebei Cluster, Henan Cluster, Shandong Cluster, Shanghai-Jiangsu-Anhui Cluster, and Zhejiang Cluster, are detected based on intercity flow networks. City-to-city flows, including Luan-Taizhou, Lianyungang-Chuzhou, and Xuzhou-Bengbu of the people network, Shanghai-Hangzhou, Suzhou-Shanghai, and Shanghai-Ningbo of the cargo network, Shanghai-Hangzhou, Bozhou-Jinhua, and Huaibei-Bozhou of the information network, are suggested to be further enhanced to facilitate the ongoing nationwide constructions of urban agglomerations in China. The multi-view clustering method proved to be a helpful calculation framework for mega-city region analysis, which would also be considered as a substantial foundation for further urban explorations with more advanced graph learning techniques.

Abstract Aims The purpose of this study was to analyze the dynamic trends of ischemic heart disease (IHD) mortality attributable to high low-density lipoprotein cholesterol (LDL-C). Methods Data on IHD mortality attributable to high LDL-C from 1990 to 2021 were extracted from the global disease burden database. Joinpoint software was used to estimate the average annual percentage change (AAPC) in the age-standardized mortality rate (ASMR). An age‒period‒cohort model was used to analyze the impacts of age, period, and cohort on these changes. The Bayesian framework was used to predict IHD mortality attributable to high LDL-C from 2022 to 2040. Results The overall ASMR of IHD attributable to high LDL-C decreased from 50. 479 per 100,000 people in 1990 to 32.286 per 100,000 people in 2021, and ASMR of IHD attributable to high LDL-C was higher in males than in females. The longitudinal age curves of the overall IHD mortality attributable to high LDL-C showed a monotonic upward trend, especially after 65 years of age. The period and cohort effect relative risk (RR) values of overall IHD mortality attributable to high LDL-C showed a downward trend. The overall ASMR of IHD attributable to high LDL-C is predicted to show a downward trend, and male IHD mortality attributable to high LDL-C is expected to be higher than that of females. Conclusion This study revealed a sustained decrease in IHD mortality attributable to high LDL-C over three decades, with a continued decline expected. Despite this, gender disparities persist, with males experiencing higher mortality rates and elderly individuals remaining a vulnerable group.

Abstract Objective To evaluate the clinical outcomes of arthroscopic inside-out ganglionectomy of dominant dorsal wrist ganglion. Methods Patients with dominant wrist ganglion cyst treated in our hospital from January 1, 2014 to June 31, 2023 was enrolled in this retrospective analysis. All patients underwent dye-assist arthroscopic inside-out ganglionectomy. After discharge, the patients were followed for a minimum of 6 months. The primary outcomes were to assess patient wrist function using the Patient-Rated Wrist Evaluation (PRWE) and Mayo Modified Wrist Score (MMWS). The secondary outcomes were visual analog score (VAS), wrist active range of motion (ROM), grip strength, recurrence rate and complication. Results All ganglion were successfully resected after dye staining. Patients were followed for an average of 12.17 months. There were no significant changes between preoperative and postoperative wrist active ROM or grip strength, except for wrist flexion (which showed a slightly greater improvement after surgery, P = 0.049), there were notable improvements in VAS, MMWS, and PRWE postoperatively. Recurrence occurred in 3 patients. No major complications observed during the follow-up period. Conclusion Dye-assist arthroscopic inside-out ganglionectomy is safe and uncomplicated, worth of clinical promotion.

Abstract Tongue squamous cell carcinoma (TSCC) is one of the most common malignant tumors among oral cancers, and its treatment is based on radio-chemotherapy and surgery, which always produces more serious side effects and sequelae. Traditional medicine can compensate for the shortcomings of modern medical treatments and play a better therapeutic role. Currently, active ingredients derived from plants are attracting the attention of researchers and clinical professionals. We examined capsaicin (CAP), an active ingredient isolated from Capsicum annuum (family Solanaceae), and explored the effect of CAP combined with cisplatin (DDP) on epithelial-mesenchymal transition (EMT) and TSCC cells migration. Our results demonstrated that Transforming growth factor-β1(TGF-β1) induced EMT and promoted cell migration in TSCC cells. CAP combined with DDP inhibits non-TGF-β1-induced or TGF-β1-induced EMT and migration. Mechanistically, the inhibition of non-TGF-β1-induced EMT and migration by CAP combined with DDP was mediated by the AMPK/mTOR pathway, whereas TGF-β1-induced EMT and migration were regulated by the Claudin-1/PI3K/AKT/mTOR pathway. A nude lung metastasis mouse model was established for in vivo validation. These results support our hypothesis that the combination of CAP and DDP inhibits TSCC metastasis. These data set the stage for further studies aimed at validating CAP as an effective active ingredient for enhancing chemotherapy efficacy and reducing the dosage and toxicity of chemotherapeutic drugs, ultimately paving the way for translational research and clinical trials for TSCC eradication.

A new bamboo species, Yushania dezhui, from Kunming, Yunnan, China is described and illustrated in this paper. The new species used to be misidentified as Y. polytricha. Based on careful comparison of morphological features and molecular phylogeny evidence, we confirmed its identity as a new member of the genus Yushania. Yushania dezhui resembles Y. maculata, Y. polytricha and Y. weixiensis in several aspects, such as culm height and branch complement structure. However, the glabrous culm leaf sheaths and internodes, the absence of auricles and oral setae on most foliage leaves, except the one-year-old foliage leaves, the pubescence on the adaxial surface of the one-year-old foliage leaves and its limestone habitat preference can readily distinguish this new species from its related taxa. Moreover, we emphasise that individuals from various populations and molecular markers with different inheritance patterns for phylogeny reconstruction should be included in new species discovery, especially in plant groups with complex evolutionary histories.

Nickel foam is widely used as a collector for electrocatalysts because of its excellent electrical conductivity; however, it is prone to react with elements such as oxygen, sulfur, and phosphorus during the growth of electrode materials, which makes it brittle and fragile, thus limiting its large-scale application. In this study, bifunctional electrocatalysts with flexible multilevel Ni-based nanoclusters Ni@(Ni,Fe)Se2/Ni@CC were synthesized on carbon cloth (CC) by hydrothermal and electrodeposition methods; these flexible electrocatalysts are convenient for subsequent industrial applications. At a current density of 10 mA cm−2, the overpotentials of the hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) reached 98 and 224 mV, respectively, exceeding the catalytic effects of most metal-based collectors. The overall water-splitting potential of the catalyst was only 1.56 V at 10 mA cm−2, and the performance was maintained after a 24 h stability test. Ni@(Ni,Fe)Se2/Ni@CC significantly improved the activity in alkaline environments by modulating the center of the d-band, thereby increasing the adsorption capacity of the catalyst for H ions. In this study, we improved the intrinsic activity and charge transfer of transition metal electrocatalysts by modifying the carbon cloth and constructing multilevel Ni-based nanoclusters, which provided some insights into the rational design of flexible bifunctional electrocatalysts.

Abstract The origin of energetic charged particles in universe remains an unresolved issue. Astronomical observations combined with simulations have provided insights into particle acceleration mechanisms, including magnetic reconnection acceleration, shock acceleration, and stochastic acceleration. Recent experiments have also confirmed that electrons can be accelerated through processes such as magnetic reconnection and collisionless shock formation. However, laboratory identifying stochastic acceleration as a feasible mechanism is still a challenge, particularly in the creation of collision-free turbulent plasmas. Here, we present experimental results demonstrating kinetic turbulence with a typical spectrum k −2.9 originating from Weibel instability. Energetic electrons exhibiting a power-law distribution are clearly observed. Simulations further reveal that thermal electrons undergo stochastic acceleration through collisions with multiple magnetic islands-like structures within the turbulent region. This study sheds light on a critical transition period during supernova explosion, where kinetic turbulences originating from Weibel instability emerge prior to collisionless shock formation. Our results suggest that electrons undergo stochastic acceleration during this transition phase.

Abstract Background and purpose PD-1/PD-L1 inhibitors have become a promising therapy. However, the response rate is lower than 30% in patients with cervical cancer (CC), which is related to immunosuppressive components in tumor microenvironment (TME). Tumor-associated macrophages (TAMs), as one of the most important immune cells, are involved in the formation of tumor suppressive microenvironment. Therefore, it will provide a theoretical basis for curative effect improvement about the regulatory mechanism of TAMs on PD-L1 expression. Methods The clinical data and pathological tissues of CC patients were collected, and the expressions of PD-L1, CD68 and CD163 were detected by immunohistochemistry. Bioinformatics was used to analyze the macrophage subtypes involved in PD-L1 regulation. A co-culture model was established to observe the effects of TAMs on the morphology, migration and invasion function of CC cells, and the regulatory mechanism of TAMs on PD-L1. Results PD-L1 expression on tumor cells could predict the poor prognosis of patients. And there was a strong correlation between PD-L1 expression with CD163+TAMs infiltration. Similarly, PD-L1 expression was associated with M1/M2-type TAMs infiltration in bioinformatics analysis. The results of cell co-culture showed that M1/M2-type TAMs could upregulate PD-L1 expression, especially M2-type TAMs may elevate the PD-L1 expression via PI3K/AKT pathway. Meanwhile, M1/M2-type TAMs can affect the morphological changes, and enhance migration and invasion abilities of CC cells. Conclusions PD-L1 expression in tumor cells can be used as a prognostic factor and is closely related to CD163+TAMs infiltration. In addition, M2-type TAMs can upregulate PD-L1 expression in CC cells through PI3K/AKT pathway, enhance the migration and invasion capabilities, and affect the tumor progression.

This paper systematically studies the effect of quenching temperature on the microstructure evolution and the relationship between the microstructure and mechanical properties of air-cooled TRIP steel prepared with C–Si–Mn hot-rolled sheet. The results indicate that when the quenching temperature is lower than (200 °C) or close to (250 °C) the Ms temperature, the martensite transformation mainly occurs during quenching or at early stage of air cooling. When the quenching temperature reaches 300 °C, lathy bainite begins to form. As the quenching temperature increases, the morphology of bainite is transformed from lathy to granular. Bainite transformation during air cooling can promote the C enrichment in austenite, thus improving the thermal stability of the austenite. However, martensite transformation also occurs during subsequent air cooling, and the start temperature of martensite transformation first decreases and then increases with the increase of quenching temperature from 300 °C to 450 °C. The yield and tensile strength of TRIP specimens first decrease and then increase, while the retained austenite content, elongation and product of strength and elongation (PSE) first increase and then decrease. When the quenching temperature is 400 °C, the best elongation and PSE are obtained. The best elongation of 400TRIP specimen is mainly attributed to its highest content and suitable mechanical stability of retained austenite, which is favorable for the expansion of the TRIP effect range. The TRIP specimens prepared with hot-rolled sheet all exhibit ultra-high tensile strength (over 1050 MPa), which is related to the ultrafine ferrite grains, martensite transformation during air cooling and TRIP effect of retained austenite.

Uranium-bearing particle analysis is an important technology in the field of nuclear safeguards. In uranium-related nuclear activities, especially in the processes of uranium enrichment, uranium-bearing aerosols are unavoidable released into the environment. There are significant differences between the uranium particles formed by uranium-bearing aerosols after drying and that from nature in terms of isotopic ratio, elemental composition, and impurity composition. Therefore, we can provide a judgment basis for the monitoring of nuclear facilities and activities by analyzing the characteristic information of micrometer or submicron sized uranium-bearing particle. After nearly 30 years of development, some relatively mature methods for the analysis of uranium-bearing particles have been developed. In this review, the process of particle analysis including sample collection, preliminary screen, particle recovery, identification and localization, and measurement is briefly introduced. The advantages and disadvantages of the commonly used technical in each process are compared. At the same time, according to the different purposes of analysis, uranium-bearing particle analysis is divided into three research directions: uranium isotope analysis, morphology and elemental composition analysis, and age-dating. Recent progress of each direction is discussed. Finally, based on the progress of the research, combined with the Development and Implementation Support Program for Nuclear Verification of the IAEA, the future research direction of uranium-bearing particle analysis technology is prospected.

Abstract Legumin A is a seed storage protein that provides nutrients for seed germination. The purpose of this study was to describe the structure and expression pattern of the EuLEGA gene in Eucommia ulmoides Oliver (E. ulmoides) and to infer its functional role. The 1287 bp coding sequence of the EuLEGA CDS of the EuLEGA gene, encoding a protein containing 428 amino acid residues, was cloned. The structure predicted that the protein belonged to the RmlC (deoxythymidine diphosphates, dTDP)-4-dehydrorhamnose 3,5-epimerase)-like cupin conserved domain family, which contains both RmlC, a key enzyme for the synthesis of rhamnose and legumin A. The overexpression (OE) vector of the EuLEGA gene was constructed and genetically transformed into tobacco and E. ulmoides; the RNA interference (RNAi) vector of the EuLEGA gene was constructed and genetically transformed into E. ulmoides; and the contents of legumin A and rhamnose were detected. The results showed that the EuLEGA gene could significantly increase the content of legumin A in transgenic tobacco leaves and transgenic E. ulmoides regenerative buds, and the OE of this gene in E. ulmoides could promote an increase in rhamnose content. RNAi caused a significant decrease in the legumin A content in the regenerated buds of E. ulmoides. These was a significant increase in legumin A in the transgenic tobacco seeds, and these results indicate that the expression of the EuLEGA gene is closely related to the accumulation of legumin A. Subcellular localization studies revealed that EuLEGA is localized to the cytoplasm with the vacuolar membrane. Analysis of the EuLEGA gene expression data revealed that the expression level of the EuLEGA gene in the samaras was significantly greater than that in the leaves and stems. In addition, the study also demonstrated that GA3 can upregulate the expression levels of the EuLEGA gene, while ABA and MeJA can downregulate its expression levels.

Abstract Background Ulnar impingement syndrome is a prevalent source of ulnar carpal pain; however, there is ongoing debate regarding the specific location of shortening, the method of osteotomy, the extent of shortening, and the resulting biomechanical alterations. Method To investigate the biomechanical changes in the distal radioulnar joint (DRUJ) resulting from different osteotomy methods, a cadaveric specimen was dissected, and the presence of a stable DRUJ structure was confirmed. Subsequently, three-dimensional data of the specimen were obtained using a CT scan, and finite element analysis was conducted after additional processing. Results The DRUJ stress did not change significantly at the metaphyseal osteotomy of 2–3 mm but increased significantly when the osteotomy length reached 5 mm. When the osteotomy was performed at the diaphysis, the DRUJ stress increased with the osteotomy length, and the increase was greater than that of metaphyseal osteotomy. Stress on the DRUJ significantly increases when the position is changed to pronation dorsi-extension. Similarly, the increase in stress in diaphyseal osteotomy was greater than that in metaphyseal osteotomy. When the model was subjected to a longitudinal load of 100 N, neither osteotomy showed a significant change in DRUJ stress at the neutral position. However, the 100 N load significantly increased stress on the DRUJ when the position was changed to pronation dorsi-extension, and the diaphyseal osteotomy significantly increased stress on the DRUJ. Conclusions For patients with distal oblique bundle, metaphyseal osteotomy result in a lower increase in intra-articular pressure in the DRUJ compared to diaphyseal osteotomy. However, it is crucial to note that regardless of the specific type of osteotomy employed, it is advisable to avoid a shortening length exceeding 5 mm.

Abstract Fetal adenocarcinoma of the lung (FLAC) is a rare form of lung adenocarcinoma and was divided into high-grade (H-FLAC) and low-grade (L-FLAC) subtypes. Despite the existence of some small case series studies, a comprehensive multi-omics study of FLAC has yet to be undertaken. In this study, we depicted the multi-omics landscapes of this rare lung cancer type by performing multi-regional sampling on 20 FLAC cases. A comparison of multi-omics profiles revealed significant differences between H-FLAC and L-FLAC in a multi-omic landscape. Two subtypes also showed distinct relationships between multi-layer intratumor heterogeneity (ITH). We discovered that a lower genetic ITH was significantly associated with worse recurrence-free survival and overall survival in FLAC patients, whereas higher methylation ITH in H-FLAC patients suggested a short survival. Our findings highlight the complex interplay between genetic and transcriptional heterogeneity in FLAC and suggest that different types of ITH may have distinct implications for patient prognosis.

Abstract Background The influence of native secondary succession associated with anthropogenic disturbance on the biodiversity of the forests in subtropical China remains uncertain. In particular, the evolutionary response of small understory shrubs, particularly pioneer species inhabiting continuously disturbed habitats, to topographic heterogeneity and climate change is poorly understood. This study aimed to address this knowledge gap by focusing on the Gaultheria crenulata group, a clade of small pioneer shrubs in subtropical China. Results We examined the genetic structure and demographic history of all five species of the G. crenulata group with two maternally inherited chloroplast DNA (cpDNA) fragments and two biparentally inherited low-copy nuclear genes (LCG) over 89 natural populations. We found that the genetic differentiation of this group was influenced by the geomorphological boundary between different regions of China in association with Quaternary climatic events. Despite low overall genetic diversity, we observed an isolation-by-distance (IBD) pattern at a regional scale, rather than isolation-by-environment (IBE), which was attributed to ongoing human disturbance in the region. Conclusion Our findings suggest that the genetic structure of the G. crenulata group reflects the interplay of geological topography, historical climates, and anthropogenic disturbance during the Pliocene–Pleistocene-Holocene periods in subtropical China. The observed IBD pattern, particularly prominent in western China, highlights the role of limited dispersal and gene flow, possibly influenced by physical barriers or decreased connectivity over geographic distance. Furthermore, the east-to-west trend of gene flow, potentially facilitated by the East Asian monsoon system, underscores the complex interplay of biotic and abiotic factors shaping the genetic dynamics of pioneer species in subtropical China’s secondary forests. These findings can be used to assess the impact of environmental changes on the adaptation and persistence of biodiversity in subtropical forest ecosystems.

Abstract Extreme within-lake conditions have the potential to exert detrimental effects on lakes. Here we use satellite observations to investigate how the occurrence of multiple types of extremes, notably algal blooms, lake heatwaves, and low lake levels, have varied in 2724 lakes since the 1980s. Our study, which focuses on bloom-affected lakes, suggests that 75% of studied lakes have experienced a concurrent increase in at least two of the extremes considered (27% defined as having a notable increase), with 25% experiencing an increase in frequency of all three extremes (5% had a notable increase). The greatest increases in the frequency of these extremes were found in regions that have experienced increases in agricultural fertilizer use, lake warming, and a decline in water availability. As extremes in lakes become more common, understanding their impacts must be a primary focus of future studies and they must be carefully considered in future risk assessments.

Abstract Peptide deformylase can catalyse the removal of formyl groups from the N-terminal formyl methionine of the primary polypeptide chain. The peptide deformylase genes of a few herbaceous plants have been studied to some extent, but the peptide deformylase genes of woody plants have not been studied. In this study, we isolated EuPDF1B from Eucommia ulmoides Oliv. The full-length sequence of EuPDF1B is 1176 bp long with a poly-A tail and contains an open reading frame of 831 bp that encodes a protein of 276 amino acids. EuPDF1B was localized to the chloroplast. qRT‒PCR analysis revealed that this gene was expressed in almost all tissues tested but mainly in mature leaves. Moreover, the expression of EuPDF1B was enhanced by ABA, MeJA and GA and inhibited by shading treatment. The expression pattern of EuPDF1B was further confirmed in EuPDF1Bp: GUS transgenic tobacco plants. Among all the transgenic tobacco plants, EuPDF1Bp-3 showed the highest GUS histochemical staining and activity in different tissues. This difference may be related to the presence of enhancer elements in the region from − 891 bp to − 236 bp of the EuPDF1B promoter. In addition, the expression of the chloroplast gene psbA and the net photosynthetic rate, fresh weight and height of tobacco plants overexpressing EuPDF1B were greater than those of the wild-type tobacco plants, suggesting that EuPDF1B may promote the growth of transgenic tobacco plants. This is the first time that PDF and its promoter have been cloned from woody plants, laying a foundation for further analysis of the function of PDF and the regulation of its expression.

Abstract The aims of our study were to examine whether initial or subsequent adiposity status had a greater effect on hypertension. We collected data in 1992 and again in 2007 from the same group of 597 individuals in the middle age. The subjects were classified into four groups: individuals with a normal body mass index (BMI) in 1992 and 2007 were in Group I; those with a normal BMI in 1992, but became overweight or obese in 2007 were in Group II; those who were overweight or obese in 1992, but had a normal BMI in 2007 were in Group III; and those who were overweight or obese in 1992 and 2007 were in Group IV. Their demographic data were recorded. The relationship between adiposity status and hypertension was analyzed using logistic regression model. The cumulative incidence of hypertension was 35.5%, 56.3%, 50.0%, and 65.1% for Group I to IV, respectively. Compared with Group I, after adjusted factors, the hazard ratio (HR) was 1.80 for Group II (P = .001), 1.40 for Group III (P = .150), and 2.31 for Group IV (P

In Ref. [10], we proposed to replace the final dark matter (DM) particle in the semi-annihilation mode DM+DM→antiDM+Higgs boson with its ZN≥3 companion, thus reducing DM number density without DM-nucleon scattering. In this work, we study the indirect detection signals from DM annihilation, the Higgs boson pair with one of them from the companion decay being on- or off- shell, depending on the DM-companion mass splitting. We generate the photon spectrum by using PYTHIA8 and study the properties of the spectrum, to find that the hard part of the spectrum in our model is mainly shaped by the direct Higgs boson and thus does not differ much from that of the conventional semi-annihilation mode. Using the Fermi-LAT data of dwarf spheroidal galaxies, we derive the current limit of the DM annihilation cross section for DM+DM→companion⁎+Higgs boson, and for the relatively light DM, it reaches the typical thermal cross section. However, for the TeV scale DM, we have to rely on the Cherenkov Telescope Array, which is able to rule out the whole parameter space except for the coannihilation region.

Cardiac arrhythmias remain a significant cause of mortality and morbidity, for novel antiarrhythmic therapies. This study states that the first report of sophoridine (SPN), a quinolizidine alkaloid derived from traditional Chinese herbs, shows promise as a potential candidate due to its anti-arrhythmic and antioxidant properties. The study found that cell viability in H9C2 rat cardiomyocytes remained stable even when treated with SPN at a higher dosage of 100 μg/ml. This phenomenon was accompanied by increases in mitochondria-derived reactive oxygen species (ROS) and calcium/calmodulin-dependent protein kinase II (CaMKII) signaling, at 50 and 100 μg/ml. Glucose fluctuations regulate ventricular arrhythmias caused by SPN by activating the ROS/CaMKII pathway. Experimental models using zebrafish provided additional evidence supporting the regulatory effects of SPN on heart rate. In addition, the administration of SPN resulted in substantial deregulation of crucial genes involved in heart development (nppa, nppb, tnnt2a) at the transcriptional level in zebrafish. These findings provide insight into the various pharmacological properties of SPN and this opens up new possibilities for anti-arrhythmic treatment strategies.

BackgroundChina exited strict Zero-COVID policy with a surge in Omicron variant infections in December 2022. Given China’s pandemic policy and population immunity, employing Baidu Index (BDI) to analyze the evolving disease landscape and estimate the nationwide pneumonia hospitalizations in the post Zero COVID period, validated by hospital data, holds informative potential for future outbreaks.MethodsRetrospective observational analyses were conducted at the conclusion of the Zero-COVID policy, integrating internet search data alongside offline records. Methodologies employed were multidimensional, encompassing lagged Spearman correlation analysis, growth rate assessments, independent sample T-tests, Granger causality examinations, and Bayesian structural time series (BSTS) models for comprehensive data scrutiny.ResultsVarious diseases exhibited a notable upsurge in the BDI after the policy change, consistent with the broader trajectory of the COVID-19 pandemic. Robust connections emerged between COVID-19 and diverse health conditions, predominantly impacting the respiratory, circulatory, ophthalmological, and neurological domains. Notably, 34 diseases displayed a relatively high correlation (r > 0.5) with COVID-19. Among these, 12 exhibited a growth rate exceeding 50% post-policy transition, with myocarditis escalating by 1,708% and pneumonia by 1,332%. In these 34 diseases, causal relationships have been confirmed for 23 of them, while 28 garnered validation from hospital-based evidence. Notably, 19 diseases obtained concurrent validation from both Granger causality and hospital-based data. Finally, the BSTS models approximated approximately 4,332,655 inpatients diagnosed with pneumonia nationwide during the 2 months subsequent to the policy relaxation.ConclusionThis investigation elucidated substantial associations between COVID-19 and respiratory, circulatory, ophthalmological, and neurological disorders. The outcomes from comprehensive multi-dimensional cross-over studies notably augmented the robustness of our comprehension of COVID-19’s disease spectrum, advocating for the prospective utility of internet-derived data. Our research highlights the potential of Internet behavior in predicting pandemic-related syndromes, emphasizing its importance for public health strategies, resource allocation, and preparedness for future outbreaks.

IntroductionImproving photosynthetic use efficiency in dryland agroecosystems to sustain high agricultural yields is a key responsibility for ensuring food security.MethodsThis study was conducted in the regions on the semiarid Loess Plateau of China during 2018–2020. Dryland maize of Xianyu 335 comprised four modes: basic yield input (CK, plastic film mulching, 37500 plant.ha-1 of plant density and unfertilized), farmer input (FP, plastic film mulching, 45000 plant.ha-1 of plant density and inorganic nitrogen(N) and phosphate(P) fertilizer were 150kg.ha-1 and 90kg.ha-1), high yield and high-efficiency input (HH, full plastic-film mulching on double furrow, 67500 plant.ha-1 of plant density and N, P and organic manure(M) fertilizer were 230kg.ha-1, 140kg.ha-1 and 1500kg.ha-1), and super high yield input (SH, full plastic-film mulching on double furrow, 9000 plant.ha-1 of plant density and N, P and organic M fertilizer were 300kg.ha-1, 180kg.ha-1 and 7500kg.ha-1). The effects of different cultivation modes on yield, WUE, net photosynthetic rate(Pn), leaf area index(LAI), chlorophyll index(SPAD value) and root index were studied.ResultsThe results showed that the value average of yield and WUE for CK were 7790kg and 17480kg.ha-1 in three years. SH, HH and FP cultivation modes of yield and WUE was significant higher compared with CK cultivation mode (P

Objective In order to facilitate the digital transformation and high-quality development of Shanghai rail transit, it is imperative to construct a digital twin model and create a unified, authoritative, and precise spatial database, providing spatial data service capabilities for application scenarios involving spatial geography such as line network planning, construction, operation and maintenance, and management. Method Combined actual scenes and stock data, a variety of technologies such as 3D laser point cloud, satellite remote sensing and drones are used for 3D reconstruction to generate a spatial digital base model. Urban rail transit thematic spatial data is collected using handheld 3D laser scanners, and the collected point cloud data model is monomerized. Utilizing GIS (geographic information system) technology, the urban rail transit real-world 3D model, planning and control data, and various spatial basic geographic data are integrated into a visualization platform to establish a ′full-space, full-period, and full-factor′ spatial digital base. Taking Shanghai Rail Transit Jiuting Station as example, the layered floor plans and a 3D real-world model of the station are created, and the model files are linked with various attribute information before being integrated inro the urban rail transit line spatial digital base. Result & Conclusion The urban rail transit line spatial digital base, combined with spatial basic geographic data, can provide unified spatial geographic services for the ′planning-design-management-operation′ of the network. Integrating 3D real-world models of stations and information on land acquisition ranges under construction into the spatial digital base could facilitate the daily management of urban rail transit real estate and fixed assets, providing authoritative, accurate and intuitive decision-making basis for the daily operation and management of urban rail transit.

Abstract This study proposes an image-based three-dimensional (3D) vector reconstruction of industrial parts that can generate non-uniform rational B-splines (NURBS) surfaces with high fidelity and flexibility. The contributions of this study include three parts: first, a dataset of two-dimensional images is constructed for typical industrial parts, including hexagonal head bolts, cylindrical gears, shoulder rings, hexagonal nuts, and cylindrical roller bearings; second, a deep learning algorithm is developed for parameter extraction of 3D industrial parts, which can determine the final 3D parameters and pose information of the reconstructed model using two new nets, CAD-ClassNet and CAD-ReconNet; and finally, a 3D vector shape reconstruction of mechanical parts is presented to generate NURBS from the obtained shape parameters. The final reconstructed models show that the proposed approach is highly accurate, efficient, and practical.

Abstract Deterioration development is a recognized worldwide threat to rock carvings, especially in humid regions of southern China. Cultural heritage managers thus require precise identification of different deterioration patterns and conduct comprehensive assessments. However, the quantitative analysis of deterioration patterns is limited due to the severe impact of temperature and humidity on rock carvings. Additionally, the current research on the different deterioration patterns is independent, and the corresponding systematic framework is vague. Based on this, the hyperspectral response is constructed to evaluate the various deterioration patterns using spectral index and intelligent model. Firstly, the remarkable correlation between the feldspar content and the deterioration patterns of rock carvings with the influence of environmental factors is investigated by mineralogical analysis. Secondly, combined with microscopic and mineralogical characteristics, the extracted deterioration characteristics are qualitatively screened. Then, a novel spectral index characterizing the correlation between image grayscale and spectral reflectance is proposed by introducing dynamic correction, and the optimal wavelength combination is applied to identify the distribution of deterioration patterns. Consequently, the quantitative screening of deterioration patterns can be realized. After that, the WOA-XGBoost model exhibits better performance in the classification of deterioration patterns. Finally, the influence of different deterioration patterns on rock carvings is quantified by integrating the deterioration index reflected by chemical composition and the proportion of deterioration pattern distribution identified by the spectral response. In the regional deterioration assessment of Dazu Rock Carvings, biological colonization and surface morphological changes have the highest proportion and degree of deterioration, which is worthy of attention in the protection of rock carvings in this region.

Objective Osteonecrosis of the femoral head (ONFH) is a disease that occurs frequently in young and middle‐aged people. Because of its high disability rate, it affects the ability to work, so the early treatment of this disease is particularly important. This retrospective study aimed to evaluate the clinical efficacy of hip arthroscopy combined with multiple small‐diameter fan‐shaped low‐speed drilling decompression (MSFLD) in treating early‐mid stage ONFH (ARCO II‐IIIA) compared to MSFLD, with at least 10‐year follow‐up. Methods A total of 234 patients who underwent hip arthroscopy and MSFLD for ONFH from 1998 to 2012 were analyzed retrospectively. This study enrolled patients between 18 and 60 years old with ARCO stage II‐III A, diagnosed clinically and through imaging, in accordance with the 2021 guidelines for the treatment of ONFH. Clinical data, including demographics, operation mode, BMI, pre‐ and postoperative Harris score, and femoral head survival rate, were collected. Patients were divided into hip arthroscopy + MSFLD and MSFLD groups based on the operation mode. The t‐test was used to compare the postoperative efficacy, Harris scores, and survival rates of the femoral head between the two groups. Results Among the 234 patients, 160 cases were followed up, including 92 cases in the hip arthroscopy + MSFLD group and 68 cases in MSFLD group, the follow‐up rate was 68.38%, and the follow‐up time was (10–22)14.11 ± 3.06 years. The Harris score (80.65 ± 6.29) in the hip arthroscopy + MSFLD group was significantly higher than that in the MSFLD group (p = 0.00), and the survival rate of femoral head (5‐year survival rate was 84.78%, 10‐year survival rate was 23.91%) was also higher than that in the MSFLD group (5‐year survival rate was 63.24%, 10‐year survival rate was 8.82%). The 5‐year and 10‐year survival rates of patients with ARCO II were 82.11% and 28.42%, which were better than 54% and 33% for ARCO III A. The femur head survival rate of alcoholic ONFH (5‐year survival rate 61.54%, 10‐year survival rate 9.23%) was significantly higher than that of other types of ONFH. Conclusion Clinical follow‐up of at least 10 years suggests that hip arthroscopy combined with MSFLD is an effective treatment for early‐mid stage ONFH, with good clinical effect and high survival rate of femoral head.

Simultaneously manipulating multiple physical fields plays an important role in the increasingly complex integrated systems, aerospace equipment, biochemical productions, etc. For on-chip systems with high integration level, the precise and efficient control of the propagation of electromagnetic waves and heat fluxes simultaneously is particularly important. In this study, we propose a graphical designing method (i.e., thermal-electromagnetic surface transformation) based on thermal-electromagnetic null medium to simultaneously control the propagation of electromagnetic waves and thermal fields according to the pre-designed paths. A thermal-electromagnetic cloak, which can create a cloaking effect on both electromagnetic waves and thermal fields simultaneously, is designed by thermal-electromagnetic surface transformation and verified by both numerical simulations and experimental measurements. The thermal-electromagnetic surface transformation proposed in this study provides a new methodology for simultaneous controlling on electromagnetic and temperature fields, and may have significant applications in improving thermal-electromagnetic compatibility problem, protecting of thermal-electromagnetic sensitive components, and improving efficiency of energy usage for complex on-chip systems.

The rise of mechanical automation in orchards has sparked research interest in developing robots capable of autonomous tree pruning operations. To achieve accurate pruning outcomes, these robots require robust perception systems that can reconstruct three-dimensional tree characteristics and execute appropriate pruning strategies. Three-dimensional modeling plays a crucial role in enabling accurate pruning outcomes. This paper introduces a specialized tree modeling approach using the space colonization algorithm (SCA) tailored for pruning. The proposed method extends SCA to operate in three-dimensional space, generating comprehensive cherry tree models. The resulting models are exported as normalized point cloud data, serving as the input dataset. Multiple criteria decision analysis is utilized to guide pruning decisions, incorporating various factors such as tree species, tree life cycle stages, and pruning strategies during real-world implementation. The pruning task is transformed into a point cloud neural network segmentation task, identifying the trunks and branches to be pruned. This approach reduces the data acquisition time and labor costs during development. Meanwhile, pruning training in a virtual environment is an application of digital twin technology, which makes it possible to combine the meta-universe with the automated pruning of fruit trees. Experimental results demonstrate superior performance compared to other pruning systems. The overall accuracy is 85%, with mean accuracy and mean Intersection over Union (IoU) values of 0.83 and 0.75. Trunks and branches are successfully segmented with class accuracies of 0.89 and 0.81, respectively, and Intersection over Union (IoU) metrics of 0.79 and 0.72. Compared to using the open-source synthetic tree dataset, this dataset yields 80% of the overall accuracy under the same conditions, which is an improvement of 6%.

Abstract China’s Belt and Road Initiative (BRI) aims to strengthen regional economic and policy cooperation and achieve the rapid development among the participating countries. While the impact on the financial development of the economic growth and energy environment of BRI participating countries has garnered close attention among scholars, few studies focus on the impact of financial development on the sustainable development goals (SDGs) of the BRI participating countries. To address this gap, we utilized panel regression models to quantitatively assess the impact of China’s financial development scale, structure, and efficiency on the SDGs of the BRI participating countries, and adopted Geographically and Temporally Weighted Regression (GTWR) model to explore the spatial-temporal effects of China’s financial development scale, structure, and efficiency on the SDGs of the BRI participating countries. Our findings indicate that China’s financial development has significantly promoted the SDGs of the BRI participating countries. This study further reveals that the scale and efficiency of China’s financial development have had a more pronounced impact on the SDGs of Asian countries, low- and middle-income countries, and the Land Silk Road participating countries, compared to those of European countries, high-income countries, and the Maritime Silk Road participating countries, respectively. In contrast, the structure of financial development primarily promotes the SDGs of European and high-income BRI participating countries in the land silk belt. The role of China’s financial development in promoting the SDGs of most BRI participating countries has gradually increased over time. This study provides valuable insights for decision-makers in China to facilitate the sustainable development of BRI participating countries and foster a shared community within the BRI framework.

Abstract Electronic processors are reaching the physical speed ceiling that heralds the era of optical processors. Multifunctional all-optical logic gates (AOLGs) of massively parallel processing are of great importance for large-scale integrated optical processors with speed far in excess of electronics, while are rather challenging due to limited operation bandwidth and multifunctional integration complexity. Here we for the first time experimentally demonstrate a reconfigurable all-in-one broadband AOLG that achieves nine fundamental Boolean logics in a single configuration, enabled by ultrabroadband (400–4000 nm) plasmon-enhanced thermo-optical nonlinearity (TONL) of liquid-metal Galinstan nanodroplet assemblies (GNAs). Due to the unique heterogeneity (broad-range geometry sizes, morphology, assembly profiles), the prepared GNAs exhibit broadband plasmonic opto-thermal effects (hybridization, local heating, energy transfer, etc.), resulting in a huge nonlinear refractive index under the order of 10−4−10−5 within visual-infrared range. Furthermore, a generalized control-signal light route is proposed for the dynamic TONL modulation of reversible spatial-phase shift, based on which nine logic functions are reconfigurable in one single AOLG configuration. Our work will provide a powerful strategy on large-bandwidth all-optical circuits for high-density data processing in the future.

Abstract Accurate identification and localization of multiple abnormalities are crucial steps in the interpretation of chest X-rays (CXRs); however, the lack of a large CXR dataset with bounding boxes severely constrains accurate localization research based on deep learning. We created a large CXR dataset named CXR-AL14, containing 165,988 CXRs and 253,844 bounding boxes. On the basis of this dataset, a deep-learning-based framework was developed to identify and localize 14 common abnormalities and calculate the cardiothoracic ratio (CTR) simultaneously. The mean average precision values obtained by the model for 14 abnormalities reached 0.572-0.631 with an intersection-over-union threshold of 0.5, and the intraclass correlation coefficient of the CTR algorithm exceeded 0.95 on the held-out, multicentre and prospective test datasets. This framework shows an excellent performance, good generalization ability and strong clinical applicability, which is superior to senior radiologists and suitable for routine clinical settings.

Objectives There is no clear consensus so far on which fixation method is most favorable for the tibial tunnel in anterior cruciate ligament reconstruction (ACLR). The purpose of this paper is to investigate the outcome of RigidFix cross pins fixation in the tibial tunnel and to explore the advantages of RigidFix applied both in the femoral and tibial tunnel with hamstring tendon graft in anterior cruciate ligament reconstruction. Methods This retrospective study included 53 patients (male/female, 45/8) who underwent anterior cruciate ligament reconstruction using autologous hamstring tendons between January 2013 and December 2017 at our institute. The participants in group A (n = 36) received anterior cruciate ligament reconstruction with RigidFix cross pins fixation in both femoral and tibial tunnels, while those in group B (n = 17) with RigidFix cross pins fixation in the femoral tunnel and Interference screw fixation in the tibial tunnel. The visual analogue scale (VAS) score, International Knee Documentation Committee subjective knee form 2000 (IKDC2000) score, Lysholm knee scoring scale, Tegner activity score and the side‐to‐side difference were compared at 2 and 5 years postoperatively. The graft diameter, number of strands in graft and the average diameter of each strand were also compared between the two groups. The categorical parameters were analyzed by chi‐square test and the continuous variables conforming to a normal distribution were analyzed by Student's t‐test. Results At 2 years postoperation, the VAS score (1.61 ± 0.55), side‐to‐side difference (1.50 ± 0.58) in group A were significantly lower than that in group B, and the IKDC2000 score (88.81 ± 3.88), Tegner activity score (6.14 ± 0.60) in group A were significantly higher than that in group B. At 5 years postoperation, the VAS score (1.64 ± 0.68), side‐to‐side difference (1.73 ± 0.63) in group A were significantly lower than that in group B, and the IKDC2000 score (89.09 ± 3.85), Tegner activity score (6.58 ± 0.94) in group A were slso significantly higher than that in group B. There was statistical difference in the change of the side‐to‐side difference between the two groups (group A vs. B, 0.22 ± 0.08 vs. 0.34 ± 0.11, p

Probabilistic modeling of the directional wind speed has been an important topic in the fields of wind energy assessment as well as structural wind-resistant design. The mixture model is required for the probabilistic modeling on the directional wind speed as the wind climates often show the mixture nature. For accuracy and robustness concerns in engineering applications, a generalized bivariate mixture (GBM) model of the directional wind speed is developed by using the copula-based bivariate distribution function. In this model, the marginal distributions and connection function for each sub-model can be flexibly defined. In parametrizing the model, the data-driven parametric estimation including a data preprocess and an automatic unsupervised fitting process is presented. The performance of GBM model is verified using two data sets and compared with the offset elliptical normal mixture (OENM) model. The robustness of GBM model is found for its good performance in fitting to the targets with or without smoothing process, and in tackling directional wind speed with the extremely complex probability characteristic.

ABSTRACTLaser powder bed fusion (LPBF) is increasingly prominent in essential fields such as aerospace. However, due to the characteristics of the manufacturing process and the high test cost, the performance of fabricated structures is inherently uncertain, leading to a challenging characterisation of their performance. This paper proposes a non-probabilistic convex modelling framework involving confirming uncertainties, processing data, and establishing a non-probabilistic convex model, to quantitatively describe the uncertainties concerning the physical properties of structures fabricated by LPBF. Firstly, the non-probabilistic convex modelling framework is proposed and an efficient uncertainty quantification method is developed utilising the non-probabilistic convex model. Then, criteria are set up for evaluating the performance of the developed method, and computational efficiency and accuracy are illustrated via benchmark numerical examples. Last but not least, two types of representative structures, solid and lattice structures, are fabricated via the LPBF method. The physical properties are tested through tensile and compression experiments. By confirming the necessity of accounting for uncertainties with limited data, we employing the proposed framework to the real representative specimens fabricated via the LPBF method, demonstrating that the structures fabricated by LPBF have substantial uncertainty and the proposed framework is practical.

Background and purpose: Acute kidney injury (AKI) is a common serious complication in sepsis patients with a high mortality rate. This study aimed to develop and validate a predictive model for sepsis associated acute kidney injury (SA-AKI). Methods: In our study, we retrospectively constructed a development cohort comprising 733 septic patients admitted to eight Grade-A tertiary hospitals in Shanghai from January 2021 to October 2022. Additionally, we established an external validation cohort consisting of 336 septic patients admitted to our hospital from January 2017 to December 2019. Risk predictors were selected by LASSO regression, and a corresponding nomogram was constructed. We evaluated the model’s discrimination, precision and clinical benefit through receiver operating characteristic (ROC) curves, calibration plots, decision curve analysis (DCA) and clinical impact curves (CIC) in both internal and external validation. Results: AKI incidence was 53.2% in the development cohort and 48.2% in the external validation cohort. The model included five independent indicators: chronic kidney disease stages 1 to 3, blood urea nitrogen, procalcitonin, D-dimer and creatine kinase isoenzyme. The AUC of the model in the development and validation cohorts was 0.914 (95% CI, 0.894–0.934) and 0.923 (95% CI, 0.895–0.952), respectively. The calibration plot, DCA, and CIC demonstrated the model’s favorable clinical applicability. Conclusion: We developed and validated a robust nomogram model, which might identify patients at risk of SA-AKI and promising for clinical applications.

Abstract Heavy precipitation, which is changing significantly as Earth's climate warms, can result in flooding that seriously damages societies. However, little is known about how heavy precipitation of varying durations responds to the diverse gradients of urban development in China. Through statistical analyses spanning from 1990 to 2021, we have examined shorter‐duration (≤3 days) and longer‐duration (>3 days) heavy precipitation across a spectrum of urban development, encompassing long‐term built‐up (LTB), recently built‐up (RTB), and rural background catchments within each urban agglomeration catchment (UAC) across China. We find that urbanization primarily influences shorter‐duration heavy precipitation, with a more pronounced effect observed in the LTB catchments. Conversely, the influence of urbanization on longer‐duration heavy precipitation appears to be more weakened in the RTB catchments. The intensification of shorter‐duration heavy precipitation induced by urbanization is more pronounced in humid regions and within larger UACs, while the urban effect on longer‐duration heavy precipitation is weaker in humid regions and within larger UACs. Notably, the attribution analysis results of the geographical detector model confirm our findings. Anthropogenic‐related factors (population density, nighttime light data, impervious surface percent, land surface temperature) significantly influence shorter‐duration heavy precipitation in more UACs than natural factors (distance from the coast, wind and elevation), while natural factors dominate longer‐duration events in larger UACs across China. Our results highlight the necessity of considering the spatial difference between the UAC center and UAC periphery for accurate projections and effective prevention of heavy precipitation and potential flood risks in the future.

Clear aligner therapy is a rapidly developing orthodontic treatment. 3D-printing technology, which enables the creation of complex geometric structures with high precision, has been used in dentistry. This article aims to summarize the various aspects of 3D-printing clear aligners and give an outlook on their future development. The traditional thermoforming technology is introduced and the principle and application of 3D-printed clear aligners and materials are introduced, as well as the application prospects of 3D-printed clear aligners. According to PRISMA statement, the relevant literature of 3D-printing clear aligner was searched in PubMed, Web of Science, Embase and other databases. We searched the related words in the MESH database and then carried out advanced searches. We read systematic review and conference papers to find the articles related to the subject and manually added and excluded articles by reading the title and abstract. The production of clear aligners combines computer-aided 3D analysis, personalized design and digital molding technology. The thickness and edges of the 3D-printed clear aligner can be digitally controlled, which allows appliance more efficiently fitted. Presently, the array of clear resins suitable for 3D-printing include photo polymeric clear methacrylate-based resin (Dental LT) (Form Labs, Somerville, Mass), aliphatic vinyl ester-polyurethane polymer (Tera Harz TC-85) (Graphy, Seoul, South Korea). They all have good biocompatibility. But no such material is currently approved on the market. Developing biocompatible resins and further improving the material’s mechanical properties will be critical for the combination of 3D-printing and clear aligners. However, the literature on 3D-printed clear aligners is limited and lacks clinical application. Further in vivo and in vitro tests, as well as additional exploration in conjunction with corresponding cytological tests, are required for the research on available materials and machinery for 3D-printing clear aligners.

Mycoplasma bovis (M. bovis) is a significant bovine pathogen associated with various diseases, including bovine bronchopneumonia and mastitis resulting in substantial economic losses within the livestock industry. However, the development of effective control measures for M. bovis is hindered by a limited understanding of its virulence factors and pathogenesis. Nucleomodulins are newly identified secreted proteins of bacteria that internalize the host nuclei to regulate host cell gene expression and serve as critical virulence factors. Although recent reports have initiated exploration of mycoplasma nucleomodulins, the efficiency of conventional techniques for identification is very limited. Therefore, this study aimed to establish high-throughput methods to identify novel nucleomodulins of M. bovis. Using a direct biotinylation (DB) approach, a total of 289 proteins were identified including 66 high abundant proteins. In parallel, the use of proximity-based biotinylation (PBB), identified 28 proteins. Finally, seven nucleomodulins were verified to be nuclear by transfecting the bovine macrophage cell line BoMac with the plasmids encoding EGFP-fused proteins and observed with Opera Phenix, including the known nucleomodulin MbovP475 and six novel nucleomodulins. The novel nucleomodulins were four ribosomal proteins (MbovP599, MbovP678, MbovP710, and MbovP712), one transposase (MbovP790), and one conserved hypothetical protein (MbovP513). Among them, one unique nucleomodulin MbovP475 was identified with DB, two unique nucleomodulins (MbovP513 and MbovP710) with PBB, and four nucleomodulins by both. Overall, these findings established a foundation for further research on M. bovis nucleomodulin-host interactions for identification of new virulence factors.

Summary: Simultaneously guiding electromagnetic waves and heat flow at any incidence angle to smoothly bypass some electromagnetic/thermal sensitive elements is a key factor to ensure efficient communication and thermal protection for an on-chip system. In this study, an omnidirectional on-chip electromagnetic-thermal cloak is proposed. Firstly, a holey metallic plate with periodic array of subwavelength apertures is designed by optical surface transformation to realize an omnidirectional electromagnetic cloaking module for on-chip electromagnetic signal. Secondly, a two-layer ring-shaped engineered thermal structure is designed by solving Laplace equation to realize an omnidirectional thermal cloaking module for in-chip heat flow. Finally, these two cloaking modules are combined to achieve cloaking effect for both the electromagnetic waves and thermal fields simultaneously, thus protecting the build-in electromagnetic/thermal sensitive elements without disturbing the external fields. The proposed electromagnetic-thermal cloak may have potential advantage in dealing with omnidirectional electromagnetic compatibility/shielding and multi-directional thermal management/dissipation of an on-chip system.

Abstract The generation of cultured red blood cells (cRBCs) ex vivo represents a potentially unlimited source for RBC transfusion and other cell therapies. Human cRBCs can be generated from the terminal differentiation of proliferating erythroblasts derived from hematopoietic stem/progenitor cells or erythroid precursors in peripheral blood mononuclear cells. Efficient differentiation and maturation into cRBCs highly depend on replenishing human plasma, which exhibits variable potency across donors or batches and complicates the consistent cRBC production required for clinical translation. Hence, the role of human plasma in erythroblast terminal maturation is investigated and uncovered that 1) a newly developed cell culture basal medium mimicking the metabolic profile of human plasma enhances cell growth and increases cRBC yield upon erythroblast terminal differentiation and 2) LDL‐carried cholesterol, as a substitute for human plasma, is sufficient to support erythroid survival and terminal differentiation ex vivo. Consequently, a chemically‐defined optimized medium (COM) is developed, enabling robust generation of cRBCs from erythroblasts of multiple origins, with improved enucleation efficiency and higher reticulocyte yield, without the need for supplementing human plasma or serum. In addition, the results reveal the crucial role of lipid metabolism during human terminal erythropoiesis.

ObjectiveTo examine the effects of an intervention with fructooligosaccharides (FOS), Saccharomyces boulardii, and their combination in a mouse model of colitis and to explore the mechanisms underlying these effects.MethodsThe effects of FOS, S. boulardii, and their combination were evaluated in a DSS-induced mouse model of colitis. To this end, parameters such as body weight, the disease activity index (DAI), and colon length were examined in model mice. Subsequently, ELISA was employed to detect the serum levels of proinflammatory cytokines. Histopathological analysis was performed to estimate the progression of inflammation in the colon. Gas chromatography was used to determine the content of short-chain fatty acids (SCFAs) in the feces of model mice. Finally, 16S rRNA sequencing technology was used to analyze the gut microbiota composition.ResultsFOS was slight effective in treating colitis and colitis-induced intestinal dysbiosis in mice. Meanwhile, S. boulardii could significantly reduced the DAI, inhibited the production of IL-1β, and prevented colon shortening. Nevertheless, S. boulardii treatment alone failed to effectively regulate the gut microbiota. In contrast, the combined administration of FOS/S. boulardii resulted in better anti-inflammatory effects and enabled microbiota regulation. The FOS/S. boulardii combination (109 CFU/ml and 107 CFU/ml) significantly reduced the DAI, inhibited colitis, lowered IL-1β and TNF-α production, and significantly improved the levels of butyric acid and isobutyric acid. However, FOS/S. boulardii 109 CFU/ml exerted stronger anti-inflammatory effects, inhibited IL-6 production and attenuated colon shortening. Meanwhile, FOS/S. boulardii 107 CFU/ml improved microbial regulation and alleviated the colitis-induced decrease in microbial diversity. The combination of FOS and S. boulardii significantly increased the abundance of Parabacteroides and decreased the abundance of Escherichia–Shigella. Additionally, it promoted the production of acetic acid and propionic acid.ConclusionCompared with single administration, the combination can significantly increase the abundance of beneficial bacteria such as lactobacilli and Bifidobacteria and effectively regulate the gut microbiota composition. These results provide a scientific rationale for the prevention and treatment of colitis using a FOS/S. boulardii combination. They also offer a theoretical basis for the development of nutraceutical preparations containing FOS and S. boulardii.

BackgroundTuberculous meningitis (TBM) is the most severe form of tuberculosis (TB) and can be difficult to diagnose and treat. We aimed to describe the clinical presentation, diagnosis, disease spectrum, outcome, and prognostic factors of patients treated for TBM in China.MethodsA multicenter retrospective study was conducted from 2009 to 2019 enrolling all presumptive TBM patients referred to Xijing tertiary Hospital from 27 referral centers in and around Shaanxi province, China. Patients with clinical features suggestive of TBM (abnormal CSF parameters) were included in the study if they had adequate baseline information to be classified as “confirmed,” “probable,” or “possible” TBM according to international consensus TBM criteria and remained in follow-up. Patients with a confirmed alternative diagnosis or severe immune compromise were excluded. Clinical presentation, central nervous system imaging, cerebrospinal fluid (CSF) results, TBM score, and outcome—assessed using the modified Barthel disability index—were recorded and compared.FindingsA total of 341 presumptive TBM patients met selection criteria; 63 confirmed TBM (25 culture positive, 42 Xpert-MTB/RIF positive), 66 probable TBM, 163 possible TBM, and 49 “not TBM.” Death was associated with BMRC grade III (OR = 5.172; 95%CI: 2.298–11.641), TBM score ≥ 15 (OR = 3.843; 95%CI: 1.372–10.761), age > 60 years (OR = 3.566; 95%CI: 1.022–12.442), and CSF neutrophil ratio ≥ 25% (OR = 2.298; 95%CI: 1.027–5.139). Among those with confirmed TBM, nearly one-third (17/63, 27.0%) had a TBM score 60 years) have higher TBM scores or CSF neutrophil ratios, have signs of disseminated/miliary TB, and are at greatest risk of death. In general, more effort needs to be done to improve early diagnosis and treatment outcome in TBM patients.