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Purpose: Portal vein tumor thrombus (PVTT)-related severe symptomatic portal hypertension (SPH) leads to a poor prognosis in patients with advanced hepatocellular carcinoma (HCC). Traditional transjugular intrahepatic portosystemic shunt (TIPS) using covered plus bare stent can effectively relieve SPH, however, the bare segment is susceptible to obstruction due to PVTT invasion. This study aimed to evaluate the safety and efficacy of fully covered stent-TIPS (FCS-TIPS) for treatment of PVTT-related SPH in advanced HCC patients., Patients and Methods: This retrospective study enrolled 25 patients with advanced HCC who underwent FCS-TIPS for PVTT-related severe SPH from June 2018 to January 2024. The evaluated outcomes included overall survival (OS), technical success rate, reduction in portal venous pressure gradient (PPG), stent patency rate, SPH control rate, liver function and complications., Results: The technical success rate was 100% without perioperative deaths or severe procedure-related adverse events. The average PPG decreased by 13.4±4.6 mmHg. The overall symptom control rate of SPH was 96.0%. Variceal bleeding, ascites/hydrothorax, and enteropathy control rates were 100%, 95.0%, and 100%, respectively. Liver function showed mild improvement one month after TIPS. One patient (4.0%) experienced overt hepatic encephalopathy (OHE) and three (12.0%) patients developed shunt dysfunction during the follow-up period. None of the patients experienced shunt-induced extrahepatic metastasis. The median OS was 6.0 months and the cumulative survival rates at 3, 6, 12 months were 80.0%, 52.0% and 21.3%., Conclusion: FCS-TIPS is safe and effective for treating PVTT-related severe SPH and can serve as a bridging therapy for advanced HCC., Competing Interests: The authors report no conflicts of interest in this work., (© 2025 Liu et al.)

Background: Effective management of dual antiplatelet therapy (DAPT) following drug-eluting stent (DES) implantation is crucial for preventing adverse events. Traditional prognostic tools, such as rule-based methods or Cox regression, despite their widespread use and ease, tend to yield moderate predictive accuracy within predetermined timeframes. This study introduces a new contrastive learning-based approach to enhance prediction efficacy over multiple time intervals., Methods: We utilized retrospective, real-world data from the OneFlorida + Clinical Research Consortium. Our study focused on two primary endpoints: ischemic and bleeding events, with prediction windows of 1, 2, 3, 6, and 12 months post-DES implantation. Our approach first utilized an auto-encoder to compress patient features into a more manageable, condensed representation. Following this, we integrated a Transformer architecture with multi-head attention mechanisms to focus on and amplify the most salient features, optimizing the representation for better predictive accuracy. Then, we applied contrastive learning to enable the model to further refine its predictive capabilities by maximizing intra-class similarities and distinguishing inter-class differences. Meanwhile, the model was holistically optimized using multiple loss functions, to ensure the predicted results closely align with the ground-truth values from various perspectives. We benchmarked model performance against three cutting-edge deep learning-based survival models, i.e., DeepSurv, DeepHit, and SurvTrace., Results: The final cohort comprised 19,713 adult patients who underwent DES implantation with more than 1 month of records after coronary stenting. Our approach demonstrated superior predictive performance for both ischemic and bleeding events across prediction windows of 1, 2, 3, 6, and 12 months, with time-dependent concordance (C td ) index values ranging from 0.88 to 0.80 and 0.82 to 0.77, respectively. It consistently outperformed the baseline models, including DeepSurv, DeepHit, and SurvTrace, with statistically significant improvement in the C td -index values for most evaluated scenarios., Conclusion: The robust performance of our contrastive learning-based model underscores its potential to enhance DAPT management significantly. By delivering precise predictive insights at multiple time points, our method meets the current need for adaptive, personalized therapeutic strategies in cardiology, thereby offering substantial value in improving patient outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (© 2025 Li, Sun, abdelhameed, Duan, Rasmy, Hu, He, Dang, Feng, Li, Wang, Lyu, Braun, Pham, Gharacholou, Fairweather, Zhi, Bian and Tao.)

Background: Semi-aquatic mammals represent a transitional phase in the evolutionary spectrum between terrestrial and aquatic mammals. The sense of balance is crucial for mammalian locomotion, and in semi-aquatic mammals, the structural foundation of this sense (the vestibular system) shows distinct morphological adaptations to both aquatic and terrestrial environments compared to their terrestrial counterparts. Despite this, the precise molecular mechanisms driving these adaptations remain elusive. Our study endeavors to unravel the genetic components associated with the sense of balance in semi-aquatic mammals and to examine the evolutionary trajectories of these genes, shed light on the molecular mechanisms underlying the adaptive evolution of balance perception in semi-aquatic mammals., Results: We selected 42 mammal species across 20 orders, 38 families, and 42 genera for analysis. We analyzed a comprehensive set of 116 genes related to the vestibular system's development or function. Our findings indicate that 27 of these genes likely experienced adaptive evolution in semi-aquatic mammals. Particularly, genes such as SLC26A2, SOX10, MYCN, and OTX1 are implicated in collectively orchestrating morphological adaptations in the semicircular canals to suit semi-aquatic environments. Additionally, genes associated with otolith development, including SLC26A2, OC90, and OTOP1, likely regulate otolith sensitivity across various locomotor modes. Moreover, genes linked to vestibular disorders, such as GJB2, GJB6, and USH1C, may provide a molecular foundation for averting vertigo amidst intricate locomotor scenarios in semi-aquatic mammals., Conclusions: Our research offers insights into the molecular mechanisms underlying the evolution of the sense of balance in semi-aquatic mammals, while also providing a new research direction for the adaptive evolution of mammals undergoing a secondary transition to an aquatic lifestyle., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Competing Interests: Disclosures None.

Ischemic stroke is a leading cause of death and disability worldwide, with an increasing trend and tendency for onset at a younger age. China, in particular, bears a high burden of stroke cases. In recent years, the inflammatory response after stroke has become a research hotspot: understanding the role of inflammatory response in tissue damage and repair following ischemic stroke is an important direction for its treatment. This review summarizes several major cells involved in the inflammatory response following ischemic stroke, including microglia, neutrophils, monocytes, lymphocytes, and astrocytes. Additionally, we have also highlighted the recent progress in various treatments for ischemic stroke, particularly in the field of stem cell therapy. Overall, understanding the complex interactions between inflammation and ischemic stroke can provide valuable insights for developing treatment strategies and improving patient outcomes. Stem cell therapy may potentially become an important component of ischemic stroke treatment., (Copyright © 2025 Copyright: © 2025 Neural Regeneration Research.)

Urothelial carcinoma (UC) can arise from either the lower urinary tract or the upper tract; they represent different disease entities and require different clinical treatment strategies. A full understanding of the cellular characteristics in UC may guide the development of novel therapies. Here, we performed single-cell transcriptome analysis from four patients with UC of the bladder (UCB), five patients with UC of the ureter (UCU), and four patients with UC of the renal pelvis (UCRP) to develop a comprehensive cell atlas of UC. We found the rare epithelial cell subtype EP9 with epithelial-to-mesenchymal transition (EMT) and cancer stem cell (CSC) features, and specifically expressed SOX6, which was associated with poor prognosis. We also found that ACKR1+ endothelial cells and inflammatory cancer-associated fibroblasts (iCAFs) were more enriched in UCU, which may promote pathogenesis. While ESM1+ endothelial cells may more actively participate in UCB and UCRP tumorigenesis by promoting angiogenesis. Additionally, CD8 + effector T cells were more enriched in UCU and UCRP patients, while Tregs were mainly enriched in UCB tumors. C1QC+ macrophages and LAMP3+ dendritic cells were more enriched in UCB, which is closely related to the formation of the heterogeneous immunosuppressive microenvironment. Furthermore, we found strong interactions between iCAFs, EP9, and Endo_ESM1, and different degrees of activation of the FGF-FGFR3 axis and immune checkpoint pathway were observed in different UC subtypes. Our study elucidated the cellular heterogeneity and the components of the microenvironment in UC arising from the upper and lower urinary tracts and provided novel therapeutic targets., (© 2024 The Author(s). Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.)

The riverine N 2 O fluxes are assumed to linearly increase with nitrate loading. However, this linear relationship with a uniform EF 5r is poorly constrained, which impedes the N 2 O estimation and mitigation. Our meta-analysis discovered a universal N 2 O emission baseline (EF 5r  = k/[NO 3 - ], k = 0.02) for natural rivers. Anthropogenic impacts caused an overall increase in baselines and the emergence of hotspots, which constitute two typical patterns of anthropogenic sources. The k values of agricultural and urban rivers increased to 0.09 and 0.05, respectively, with 11% and 14% of points becoming N 2 O hotspots. Priority control of organic and NH 4 + pollution could eliminate hotspots and reduce emissions by 51.6% and 63.7%, respectively. Further restoration of baseline emissions on nitrate removal is a long-term challenge considering population growth and declining unit benefits (ΔN-N 2 O/N-NO 3 - ). The discovery of EF lines emphasized the importance of targeting hotspots and managing baseline emissions sustainably to balance social and environmental benefits., (© The Author(s) 2024. Published by Oxford University Press on behalf of China Science Publishing & Media Ltd.)

In recent years, the Piezo1 channel has attracted great attention. Piezo1's research has made remarkable advance in many aspects. However, the overall trends and knowledge structures have not been systematically investigated from a worldwide viewpoint. Therefore, it is important to fill this knowledge gap and utilize a proper tool to show the research status, hotspots, and frontiers in the Piezo1 channel. In order to better investigate the hotspots and frontiers of the Piezo1 channel research, we retrieved relevant literature from Web of Science Core Collection (WoSCC) and applied CiteSpace to perform a bibliometric analysis. Our findings might serve as a reference for future research in this area.

Background: Due to the enormous caregiving burden faced by informal caregivers, providing appropriate skills training has become an important supporting strategy in many countries/regions. Understanding caregivers' training needs is instrumental in designing effective training intervention programs, which are expected to reduce the caregiving burden of informal caregivers and avoid the health deterioration associated with caregiving. This paper aims to explore the potential training needs of informal caregivers in Shanghai, and to identify the factors associated with these perceived training needs., Methods: A total of 196 eligible informal caregivers participated in this survey. A multivariate analysis was conducted to explore the factors associated with informal caregivers' perceived training needs., Results: 86.7% ( N = 170) of the caregivers reported at least one need for targeted training activity, and 62.7% ( N = 123) of them identified two or more training needs. The top three activities requiring training included the following: self-care skills; safety supervision; and functional rehabilitation. The factors associated with various training needs included the health status of the care recipient, complementary caregiving support, caregiving stress, and the personal attributes of the informal caregiver. The technical skills training needs were more related to the care recipients' health status (e.g., dependency level, disease progression) and formal care support resources. Conversely, the intangible skills training needs were more sensitive to caregiver attributes (e.g., gender, age, and education level)., Conclusions: A personalized training strategy and early-stage intervention program are critical to providing effective support to informal caregivers. The potential implications are to raise awareness of the importance of skills training for informal caregivers, and to inform the implementation of effective training strategies for improving the quality of informal care and the well-being of informal caregivers in China.

Introduction: Enhancing migrant workers' settlement intention in cities requires ensuring they have equal public health rights as urban residents. Full access to public health services can strengthen their sense of belonging and improve the well-being of this vulnerable group. Evaluating the welfare impact of public health services from the perspective of city identification offers valuable insights and informs policies aimed at improving the quality of public health service provision., Methods: This study utilizes data from the 2017 China CMDS survey. We employed various analytical methods, including the Probit model, IV-Probit model, Propensity Score Matching, and KHB decomposition, to empirically examine the impact of public health services on the settlement intention of migrant workers. Additionally, we explored the underlying mechanisms and heterogeneity of this impact., Results: Public health services such as health records management and public health education significantly increase the settlement intention of migrant workers. The positive effect of public health services on the settlement intention is more pronounced among migrant workers who have moved across provinces and those who are married. Public health services indirectly enhance the settlement intention by improving urban satisfaction and sense of belonging, with the latter having a more substantial indirect effect., Discussion: The current provision of basic public health services in China for migrant workers still needs improvement. This highlights the necessity of enhancing health record management, increasing health education and training, and tailoring services to better meet the needs of migrant workers. By improving the supply of public health services, we can effectively raise migrant workers' urban satisfaction and sense of belonging, thereby indirectly increasing their willingness to settle in cities. The findings of this study contribute to further optimizing the implementation of public health service policies and provide meaningful guidance for improving the urban integration of migrant workers., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer ZZ declared a shared affiliation with the author to the handling editor at the time of review., (Copyright © 2024 Lyu.)

This study evaluated the antioxidant activity of the methanol extract from aromatic Cynanchum thesioides (Freyn) K. Schum. by fractionating it with different solvents, aiming to provide theoretical evidence for the development of products related to aromatic Cynanchum thesioides (Freyn) K. Schum. The yield of the methanol extract was 13.33%, with the water fraction showing the highest yield, followed by n-hexane, n-butanol, dichloromethane, and ethyl acetate. Among these fractions, the ethyl acetate fraction showed the highest antioxidant activity, as indicated by total polyphenol content and ABTS radical scavenging activity. The DPPH radical scavenging activity, reducing power, and SOD-like activity measurements showed no significant difference between the ethyl acetate and n-butanol fractions, as both showed the highest radical scavenging activity. In the FRAP activity measurement, the n-butanol fraction ranked behind the ethyl acetate and dichloromethane fractions in terms of antioxidant activity. Although the ethyl acetate fraction showed the highest antioxidant activity, its yield was only 1.29%, making it unsuitable for product production considering productivity and economy. However, the n-butanol fraction showed overall high antioxidant activity and was approximately four times more abundant, with a yield of 5.80% compared to the ethyl acetate fraction. Consequently, considering both productivity and economy, the n-butanol fraction is considered suitable for product development and production.

Background: Acupuncture has been increasingly used in obese people, yet no bibliometric analysis of acupuncture studies for obesity exists. This bibliometric study analyzed research trends, cooperation, and knowledge dissemination on acupuncture for obesity over the past 20 years to inform future directions., Objectives: To investigate the characteristics, hotspots, and frontiers of global scientific output in acupuncture research for obesity over the past two decades., Methods: We retrieved publications on acupuncture for obesity published from 2004 to 2023 from the Web of Science Core Collection. Using Citespace, VOSviewer, and Bibliometrix, we analyzed and visualized the publications, countries, institutions, authors, journals, and keywords from various angles., Results: A total of 357 articles were retrieved. The results showed that the number of annual publications on acupuncture for obesity has increased over time. China had the most publications (217 articles, 60.87 %), with Chengdu University of Traditional Chinese Medicine (24 articles, 6.72 %) as the most prolific institution. Ergene Neyhan, Huang Wei, and Zhou Zhongyu were the most productive authors (9 articles), and the article published by Cho SH in 2009 was the most cited article (60 citations). The most published journal was Evidence-based Complementary and Alternative Medicine, while the Journal of American Journal of Chinese Medicine was the most frequently cited. Recently, "electroacupuncture" "insulin resistance" and "systematic review" appeared frequently. The research hotspots and trends of acupuncture for obesity mainly focus on interventions, hotspot diseases, and mechanism exploration. According to keyword analysis, randomized controlled trials of catgut embedding and mechanistic studies of gut flora are the trends for future research., Conclusion: Although China is the leading producer, multinational co-operation still needs to be strengthened. Currently, the main interventions for obesity were acupuncture and electroacupuncture, and the hot diseases were obesity combined with polycystic ovary syndrome and metabolic syndrome. In addition, randomised controlled trials of catgut embedding and mechanistic studies of gut flora may be potential directions for future research in the field of acupuncture for obesity., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: This study aimed to investigate the potential associations between physical activity, sedentary behavior, and the basal metabolic rate (BMR) with post-traumatic stress disorder (PTSD), major depressive disorder (MDD), and emotional instability (EI) using bidirectional Mendelian randomization (MR). Additionally, it sought to identify key molecular mechanisms underlying emotional instability through a comprehensive bioinformatic analysis., Methods: MR analyses utilizing genome-wide association study (GWAS) data were conducted to estimate the effects of physical activity, sedentary behavior, and the BMR on PTSD, MDD, and EI. Sensitivity analyses were performed to assess the robustness of the findings. Concurrently, a bioinformatic analysis was executed on gene expression datasets (GSE53987 and GSE21138) derived from emotionally unstable patients. This analysis encompassed the differential gene expression analysis to identify differentially expressed genes (DEGs), followed by an functional enrichment analysis to uncover key molecular pathways associated with EI., Results: The MR analysis revealed that increased physical activity may have a protective effect against PTSD, albeit with inconsistent effects on MDD and EI. Sedentary behavior and the BMR demonstrated minimal associations with PTSD, MDD, or EI. The bioinformatic analysis identified 114 DEGs associated with EI, with YWHAB, SRRM2, MST1, HDAC10, and HSPA1A highlighted as significant genes. The functional enrichment analysis of these DEGs unveiled key pathways potentially involved in the molecular pathology of emotional instability., Conclusions: Physical activity appears to protect against PTSD, whereas its effects on MDD and EI are less definitive. The bioinformatic findings offer a deeper molecular understanding of EI, pinpointing specific genes and pathways that may serve as potential therapeutic targets. Further research is warranted to elucidate these intricate interactions and the identified molecular mechanisms.

Nonsymmetrical oxygen-bridged binuclear copper centers have been proposed and modeled as intermediates and transition states in several C─H oxidation pathways, leading to the postulation that structural dissymmetry enhances the reactivity of the bridging oxygen. However, experimentally characterizing the structure and reactivity of these transient species is remarkably challenging. Here, we report the high-pressure synthesis of a metastable nonsymmetrical dicopper-μ-oxo compound with exceptional reactivity toward the mono-oxygenation of aliphatic C─H bonds. The nonequivalent coordination environment of copper stabilizes localized mixed valency and greatly enhances the hydrogen atom abstraction activity of the bridging oxygen, enabling room-temperature hydroxylation of methane under pressure. These findings highlight the role of dissymmetry in the reactivity of binuclear copper centers and demonstrate precise control of molecular structures by mechanical means.

Treatment Wetlands (TWs) are widely used for the treatment of domestic wastewater, with an increasing emphasis on provision of multiple co-benefits. However, concerns remain regarding achieving stringent phosphorus (P) discharge limits, system robustness and resilience, and associated guidance on system design and operation. Typically, where P removal is intended with a passive TW, surface flow (SF) systems are the chosen design type. This study analysed long-term monitoring datasets (2-30 years) from 85 full-scale SF TWs (25 m 2 to 487 ha) treating domestic sewage with the influent load ranging from 2.17 to 54,779 m 3 /d, including secondary treatment, tertiary treatment, and combined sewer overflows treatment. The results showed median percentage removals of total P (TP) and orthophosphate (Ortho P) of 28% and 31%, respectively. Additionally, median areal mass removal rates were 5.13 and 2.87 gP/m 2 /yr, respectively. For tertiary SF TWs without targeted upstream P removal, 80% of the 44 systems achieved ≤3 mg/L annual average effluent total P. Tertiary SF TWs with targeted upstream P removal demonstrated high robustness, delivering stable effluent TP < 0.35 mg/L. Seasonality in removal achieved was absent from 85% of sites, with 95% of all systems demonstrating stable annual average effluent TP concentrations for up to a 30-year period. Only two out of 32 systems showed a significant increase in effluent TP concentration after the initial year and remained stable thereafter. The impact of different liner types on water infiltration, cost, and carbon footprint were analysed to quantify the impact of these commonly cited barriers to implementation of SF TW for P removal. The use of PVC enclosed between geotextile gave the lowest additional cost and carbon footprint associated with lining SF TWs. Whilst the P-k-C* model is considered the best practice for sizing SF TWs to achieve design pollutant reductions, it should be used with caution with further studies needed to more comprehensively understand the key design parameters and relationships that determine P removal performance in order to reliably predict effluent quality., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Gabriela Dotro reports financial support was provided by Anglian Water, Dwr Cymru Welsh Water, Northumbrian Water, Severn Trent, South West Water, Southern Water, Thames Water, United Utilities, Wessex Water, Yorkshire Water, the Environment Agency, and Irish Water. Gabriela Dotro reports a relationship with Constructed Wetland Association that includes: board membership. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

JOURNAL/nrgr/04.03/01300535-202410000-00024/figure1/v/2024-02-06T055622Z/r/image-tiff Inflammation is closely related to stroke prognosis, and high inflammation status leads to poor functional outcome in stroke. DNA methylation is involved in the pathogenesis and prognosis of stroke. However, the effect of DNA methylation on stroke at high levels of inflammation is unclear. In this study, we constructed a hyperinflammatory cerebral ischemia mouse model and investigated the effect of hypomethylation and hypermethylation on the functional outcome. We constructed a mouse model of transient middle cerebral artery occlusion and treated the mice with lipopolysaccharide to induce a hyperinflammatory state. To investigate the effect of DNA methylation on stroke, we used small molecule inhibitors to restrain the function of key DNA methylation and demethylation enzymes. 2,3,5-Triphenyltetrazolium chloride staining, neurological function scores, neurobehavioral tests, enzyme-linked immunosorbent assay, quantitative reverse transcription PCR and western blot assay were used to evaluate the effects after stroke in mice. We assessed changes in the global methylation status by measuring DNA 5-mc and DNA 5-hmc levels in peripheral blood after the use of the inhibitor. In the group treated with the DNA methylation inhibitor, brain tissue 2,3,5-triphenyltetrazolium chloride staining showed an increase in infarct volume, which was accompanied by a decrease in neurological scores and worsening of neurobehavioral performance. The levels of inflammatory factors interleukin 6 and interleukin-1 beta in ischemic brain tissue and plasma were elevated, indicating increased inflammation. Related inflammatory pathway exploration showed significant overactivation of nuclear factor kappa B. These results suggested that inhibiting DNA methylation led to poor functional outcome in mice with high inflammation following stroke. Further, the effects were reversed by inhibition of DNA demethylation. Our findings suggest that DNA methylation regulates the inflammatory response in stroke and has an important role in the functional outcome of hyperinflammatory stroke., (Copyright © 2024 Copyright: © 2024 Neural Regeneration Research.)

Background: Despite the emerging application of clinical decision support systems (CDSS) in pregnancy care and the proliferation of artificial intelligence (AI) over the last decade, it remains understudied regarding the role of AI in CDSS specialized for pregnancy care., Objective: To identify and synthesize AI-augmented CDSS in pregnancy care, CDSS functionality, AI methodologies, and clinical implementation, we reported a systematic review based on empirical studies that examined AI-augmented CDSS in pregnancy care., Methods: We retrieved studies that examined AI-augmented CDSS in pregnancy care using database queries involved with titles, abstracts, keywords, and MeSH (Medical Subject Headings) terms. Bibliographic records from their inception to 2022 were retrieved from PubMed/MEDLINE (n=206), Embase (n=101), and ACM Digital Library (n=377), followed by eligibility screening and literature review. The eligibility criteria include empirical studies that (1) developed or tested AI methods, (2) developed or tested CDSS or CDSS components, and (3) focused on pregnancy care. Data of studies used for review and appraisal include title, abstract, keywords, MeSH terms, full text, and supplements. Publications with ancillary information or overlapping outcomes were synthesized as one single study. Reviewers independently reviewed and assessed the quality of selected studies., Results: We identified 30 distinct studies of 684 studies from their inception to 2022. Topics of clinical applications covered AI-augmented CDSS from prenatal, early pregnancy, obstetric care, and postpartum care. Topics of CDSS functions include diagnostic support, clinical prediction, therapeutics recommendation, and knowledge base., Conclusions: Our review acknowledged recent advances in CDSS studies including early diagnosis of prenatal abnormalities, cost-effective surveillance, prenatal ultrasound support, and ontology development. To recommend future directions, we also noted key gaps from existing studies, including (1) decision support in current childbirth deliveries without using observational data from consequential fetal or maternal outcomes in future pregnancies; (2) scarcity of studies in identifying several high-profile biases from CDSS, including social determinants of health highlighted by the American College of Obstetricians and Gynecologists; and (3) chasm between internally validated CDSS models, external validity, and clinical implementation., (©Xinnian Lin, Chen Liang, Jihong Liu, Tianchu Lyu, Nadia Ghumman, Berry Campbell. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 16.09.2024.)

The combination therapy of Tislelizumab plus Lenvatinib has recently emerged as the new standard of care for unresectable hepatocellular carcinoma (HCC). This treatment has demonstrated a significant reduction in tumor burden, raising the possibility of conversion therapy. However, the full safety and efficacy of this combination in real-world settings are not yet fully understood. We recently reported the case of a 36-year-old man with initially unresectable massive HCC, for whom radical surgery (RS) was contraindicated. After receiving Tislelizumab/Lenvatinib plus transarterial chemoembolization (TACE), the patient achieved complete pathological remission and subsequently underwent RS. The patient did not experience postoperative severe complications, and there was no recurrence during the follow-up period. Tislelizumab/Lenvatinib plus TACE therapy may lead to a complete pathological response in advanced HCC. Nevertheless, the safety of prolonged treatment needs to be assessed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Xie, Lyu, Zou and Wang.)

Background: Growing evidence suggests that immunotherapy has a positive effect on non-small cell lung cancer (NSCLC) patients with brain metastases (BMs). However, it remains unclear which type of immunotherapy is more efficient. The aim of this network meta-analysis (NMA) was to compare the efficacy and safety of different immunotherapy types and determine the optimal option., Method: Four databases (PubMed, Cochrane Library databases, Embase, and Web of Science) and ClinicalTrial.gov were searched from inception until January 26, 2023. Randomized controlled trials (RCTs), prospective nonrandomized trials, or observational studies investigating NSCLC patients with BMs treated by immunotherapy were included. The quality of the included studies was evaluated using the Cochrane risk of bias (ROB) tool and the Newcastle-Ottawa Scale (NOS). The efficacy of immunotherapy on NSCLC patients with BMs was evaluated using frequentist random-effects NMA., Result: Eleven studies from 1560 citations, encompassing 1437 participants, were included in this NMA. Statistical analysis showed that pembrolizumab (SMD = 4.35, 95% CI [2.21, 6.60]) and nivolumab+ipilimumab (SMD = 3.81, 95% CI [1.21, 6.40]) could improve overall survival (OS). Pembrolizumab (SMD = 3.32, 95% CI [2.75, 3.90]) demonstrated better effects in improving the overall response rate (ORR). No significant difference in adverse event (AE) was observed between immunotherapy and chemotherapy., Conclusion: Our findings indicated that pembrolizumab was the most promising immunotherapy for NSCLC patients with BMs. Nivolumab+ipilimumab might be an alternative choice to improve OS., Limitation: Inconsistency tests were not performed because of the scarcity of direct comparison. Besides, high heterogeneity was observed in our NMA., (© 2024 The Author(s). The Clinical Respiratory Journal published by John Wiley & Sons Ltd.)

In thermoelectric, phase interface engineering proves effective in reducing the lattice thermal conductivity via interface scattering and amplifying the density-of-states effective mass by energy filtering. However, the indiscriminate introduction of phase interfaces inevitably leads to diminished carrier mobility. Moreover, relying on a singular energy barrier is insufficient for comprehensive filtration of low-energy carriers throughout the entire temperature range. Addressing these challenges, we advocate the establishment of a composite phase interface using atomic layer deposition (ALD) technology. This design aims to effectively decouple the interrelated thermoelectric parameters in ZrNiSn. The engineered coherent dual-interface energy barriers substantially enhance the density-of-states effective mass across the entire temperature spectrum while preser carrier mobility. Simultaneously, the strong interface scattering on phonons is crucial for curtailing lattice thermal conductivity. Consequently, a 40-cycles TiO 2 coating on ZrNi 1.03 Sn 0.99 Sb 0.01 achieves an unprecedented zT value of 1.3 at 873 K. These findings deepen the understanding of coherent composite-phase interface engineering., (© 2024. The Author(s).)

Introduction: Alzheimer's disease (AD) is often misclassified in electronic health records (EHRs) when relying solely on diagnosis codes. This study aimed to develop a more accurate, computable phenotype (CP) for identifying AD patients using structured and unstructured EHR data., Methods: We used EHRs from the University of Florida Health (UFHealth) system and created rule-based CPs iteratively through manual chart reviews. The CPs were then validated using data from the University of Texas Health Science Center at Houston (UTHealth) and the University of Minnesota (UMN)., Results: Our best-performing CP was " patient has at least 2 AD diagnoses and AD-related keywords in AD encounters ," with an F1-score of 0.817 at UF, 0.961 at UTHealth, and 0.623 at UMN, respectively., Discussion: We developed and validated rule-based CPs for AD identification with good performance, which will be crucial for studies that aim to use real-world data like EHRs., Highlights: Developed a computable phenotype (CP) to identify Alzheimer's disease (AD) patients using EHR data.Utilized both structured and unstructured EHR data to enhance CP accuracy.Achieved a high F1-score of 0.817 at UFHealth, and 0.961 and 0.623 at UTHealth and UMN.Validated the CP across different demographics, ensuring robustness and fairness., Competing Interests: Dr. Steven T. DeKosky reports royalties or licenses from UpToDate (point of care electronic medical text), editor for dementia; consulting fees from Boxer Capital, Brainstorm Cell Therapeutics, Lundbeck Pharmaceuticals, Amylyx Pharmaceuticals, Reata Pharmaceuticals, Biogen; payment or honoraria from NYU Grant Rounds, SUNY Downstate; participation on a Data Safety Monitoring Board or Advisory Board for Acumen Pharmaceuticals, Biogen DSMB, Cognition Therapeutics, Prevail Pharmaceuticals, Vaccinex; leadership role as Associate Editor, Neurotherapeutics. Dr. Jingchuan Guo reports grants or contracts from NIH; consulting fees from Pfizer. Huilin Tang reports grants or contracts from AFPE Predoctoral Fellowship, PhRMA Foundation Predoctoral Fellowship. Yonghui Wu reports support for the present manuscript from PCORI ME‐2018C3‐14754, NIA R56AG069880; payment or honoraria from IEEE BHI. Other authors have no conflicts of interest to disclose. Author disclosures are available in the supporting information., (© 2024 The Author(s). Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

Locomotor preferences and habitat types may drive animal evolution. In this study, we speculated that locomotor preference and habitat type may have diverse influences on Bovidae mitochondrial genes. We used selection pressure and statistical analysis to explore the evolution of mitochondrial DNA (mtDNA) protein-coding genes (PCGs) from diverse locomotor preferences and habitat types. Our study demonstrates that locomotor preference (energy demand) drives the evolution of Bovidae in mtDNA PCGs. The habitat types had no significant effect on the rate of evolution in Bovidae mitochondrial genes. Our study provides deep insight into the adaptation of Bovidae., (© 2024. The Author(s).)

Automatically segmenting polyps from colonoscopy videos is crucial for developing computer-assisted diagnostic systems for colorectal cancer. Existing automatic polyp segmentation methods often struggle to fulfill the real-time demands of clinical applications due to their substantial parameter count and computational load, especially those based on Transformer architectures. To tackle these challenges, a novel lightweight long-range context fusion network, named LightCF-Net, is proposed in this paper. This network attempts to model long-range spatial dependencies while maintaining real-time performance, to better distinguish polyps from background noise and thus improve segmentation accuracy. A novel Fusion Attention Encoder (FAEncoder) is designed in the proposed network, which integrates Large Kernel Attention (LKA) and channel attention mechanisms to extract deep representational features of polyps and unearth long-range dependencies. Furthermore, a newly designed Visual Attention Mamba module (VAM) is added to the skip connections, modeling long-range context dependencies in the encoder-extracted features and reducing background noise interference through the attention mechanism. Finally, a Pyramid Split Attention module (PSA) is used in the bottleneck layer to extract richer multi-scale contextual features. The proposed method was thoroughly evaluated on four renowned polyp segmentation datasets: Kvasir-SEG, CVC-ClinicDB, BKAI-IGH, and ETIS. Experimental findings demonstrate that the proposed method delivers higher segmentation accuracy in less time, consistently outperforming the most advanced lightweight polyp segmentation networks.

The two existing clades of Galloanseres, orders Galliformes (landfowl) and Anseriformes (waterfowl), exhibit dramatically different evolutionary trends. Mitochondria serve as primary sites for energy production in organisms, and numerous studies have revealed their role in biological evolution and ecological adaptation. We assembled the complete mitogenome sequences of two species of the genus Aythya within Anseriformes: Aythya baeri and Aythya marila . A phylogenetic tree was constructed for 142 species within Galloanseres, and their divergence times were inferred. The divergence between Galliformes and Anseriformes occurred ~79.62 million years ago (Mya), followed by rapid evolution and diversification after the Middle Miocene (~13.82 Mya). The analysis of selective pressure indicated that the mitochondrial protein-coding genes (PCGs) of Galloanseres species have predominantly undergone purifying selection. The free-ratio model revealed that the evolutionary rates of COX1 and COX3 were lower than those of the other PCGs, whereas ND2 and ND6 had faster evolutionary rates. The CmC model also indicated that most PCGs in Anseriformes exhibited stronger selective constraints. Our study suggests that the distinct evolutionary trends and energy requirements of Galliformes and Anseriformes drive different evolutionary patterns in the mitogenome.

Background/objective: The aim of this study was to evaluate tumor progression and recurrence patterns of radiofrequency ablation (RFA) with or without transarterial chemoembolization (TACE) for treating hepatocellular carcinoma (HCC) that meets Milan criteria., Methods: This retrospective study included consecutive HCC patients meeting Milan criteria who underwent percutaneous RFA with or without TACE as initial treatment at a tertiary academic center between December 2017 and 2022. Technical success rate, local recurrence-free survival (LRFS), progression-free survival (PFS) and recurrence patterns were recorded., Results: A total of 135 HCC patients (109 male [80.7%]) with a mean age of 62 years and 147 target lesions were retrospectively enrolled. The technical success rate was 99.3%. The median LRFS was 60 months, and the cumulative 1-, 3-, and 5-year LRFS were 88.9%, 70.1%, and 30.0%, respectively. Additionally, the median PFS was 23 months, with cumulative 1-, 3-, and 5-year PFS of 74%, 30%, and 0%, respectively. Multivariate analysis confirmed that age > 60, alpha-fetoprotein (AFP) (> 10), and albumin were associated with PFS (2.34, p = 0.004; 1.96, p = 0.021; 0.94, p = 0.007, respectively). Six recurrence patterns were identified: local tumor progression (LTP) alone (n = 15, 25.0%), intrahepatic distant recurrence (IDR) alone (n = 34, 56.7%), extrahepatic recurrence (ER) alone (n = 2, 3.3%), IDR + ER (n = 2, 3.3%), LTP + IDR (n = 5, 8.8%), and LTP + IDR + ER (n = 2, 3.3%). IDR occurred most frequently as a sign of good local treatment., Conclusions: RFA in combination with TACE does not appear to provide an advantage over RFA alone in improving tumor progression in patients with HCC meeting the Milan criteria. However, further prospective studies are needed to confirm these findings and to determine the optimal treatment approach for this patient population., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Xie, Lyu, Guan, Cao, Song, Tong, Zou and Wang.)

With the further development of neural networks, automatic segmentation techniques for melanoma are becoming increasingly mature, especially under the conditions of abundant hardware resources. This allows for the accuracy of segmentation to be improved by increasing the complexity and computational capacity of the model. However, a new problem arises when it comes to actual applications, as there may not be the high-end hardware available, especially in hospitals and among the general public, who may have limited computing resources. In response to this situation, this paper proposes a lightweight deep learning network that can achieve high segmentation accuracy with minimal resource consumption. We introduce a network called DTONet (double-tailed octave network), which was specifically designed for this purpose. Its computational parameter count is only 30,859, which is 1/256th of the mainstream UNet model. Despite its reduced complexity, DTONet demonstrates superior performance in terms of accuracy, with an IOU improvement over other similar models. To validate the generalization capability of this model, we conducted tests on the PH2 dataset, and the results still outperformed existing models. Therefore, the proposed DTONet network exhibits excellent generalization ability and is sufficiently outstanding.

Nano-doped hollow fiber is currently receiving extensive attention due to its multifunctionality and booming development. However, the microfluidic fabrication of nano-doped hollow fiber in a simple, smooth, stable, continuous, well-controlled manner without system blockage remains challenging. In this study, we employ a microfluidic method to fabricate nano-doped hollow fiber, which not only makes the preparation process continuous, controllable, and efficient, but also improves the dispersion uniformity of nanoparticles. Hydrogel hollow fiber doped with carbon nanotubes is fabricated and exhibits superior electrical conductivity (15.8 S m -1 ), strong flexibility (342.9%), and versatility as wearable sensors for monitoring human motions and collecting physiological electrical signals. Furthermore, we incorporate iron tetroxide nanoparticles into fibers to create magnetic-driven micromotors, which provide trajectory-controlled motion and the ability to move through narrow channels due to their small size. In addition, manganese dioxide nanoparticles are embedded into the fiber walls to create self-propelled micromotors. When placed in a hydrogen peroxide environment, the micromotors can reach a top speed of 615 μm s -1 and navigate hard-to-reach areas. Our nano-doped hollow fiber offers a broad range of applications in wearable electronics and self-propelled machines and creates promising opportunities for sensors and actuators.

Background/objective: Treatment of hepatocellular carcinoma (HCC) with ablation alone often results in high rates of recurrence and metastasis, reaching up to 25.9% within two years. Therefore, this study aimed to examine the efficacy and safety of transarterial chemoembolization (TACE)-assisted multi-image guided radiofrequency ablation (RFA) for the treatment of stage Ia HCC according to the China liver cancer staging (CNLC)., Methods: This study enrolled and analyzed a total of 118 patients diagnosed with HCC, each with a single nodular lesion no larger than 5 cm, who received TACE-RFA as first-line therapy between February 1, 2014, and December 31, 2021. The median/mean follow-up period was 29.0 months [95% confidence interval (CI): 21.8-36.2 months] and 31.8 months (95% CI: 27.5-36.0 months), respectively. We assessed the treatment's effectiveness, potential complications, and survival rate., Results: The technical success rate was 100% (118/118) after the initial treatment. Out of the total, 3 out of 118 patients (2.5%) developed local tumor progression (LTP) during the follow-up period. The median time for LTP was 29.0 months (95%CI: 21.9-36.1 months; mean: 31.5 months; range 1-92 months). At 1, 3, 5, and 7 years after treatment, the cumulative LTP rates were 0%, 4.6%, 4.6%, and 4.6%, respectively. The overall survival rates at 1, 3, 5, and 7 years were 100%, 95.2%, 95.2%, and 95.2%, respectively. In total, 28 patients experienced minor Grade B complications, and no major complications or treatment-related mortality occurred., Conclusion: The treatment of CNLC stage Ia HCC using TACE-assisted multi-image-guided RFA was found to be both safe and feasible., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Xie, Lyu, Song, Tong, Wang and Zou.)

The Convention on Biological Diversity seeks to conserve at least 30% of global land and water areas by 2030, which is a challenge but also an opportunity to better preserve biodiversity, including flowering plants (angiosperms). Herein, we compiled a large database on distributions of over 300,000 angiosperm species and the key functional traits of 67,024 species. Using this database, we constructed biodiversity-environment models to predict global patterns of taxonomic, phylogenetic, and functional diversity in terrestrial angiosperms and provide a comprehensive mapping of the three diversity facets. We further evaluated the current protection status of the biodiversity centers of these diversity facets. Our results showed that geographical patterns of the three facets of plant diversity exhibited substantial spatial mismatches and nonoverlapping conservation priorities. Idiosyncratic centers of functional diversity, particularly of herbaceous species, were primarily distributed in temperate regions and under weaker protection compared with other biodiversity centers of taxonomic and phylogenetic facets. Our global assessment of multifaceted biodiversity patterns and centers highlights the insufficiency and unbalanced conservation among the three diversity facets and the two growth forms (woody vs. herbaceous), thus providing directions for guiding the future conservation of global plant diversity., (© 2024. Science China Press.)

Numerous efforts have been made to enhance the performance of anaerobic digestion (AD) for accelerating renewable energy generation, however, it remains unclear whether the intensified measures could enhance the proliferation and transmissions of antibiotic resistance genes (ARGs) in the system. This study assessed the impact of an innovative pig manure AD process, which includes hydrothermal pretreatment (HTP) and a two-stage configuration with separated acidogenic and methanogenic phases, on biomethane (CH 4 ) production and ARGs dynamics. Results showed that HTP significantly increase CH 4 production from 0.65 to 0.75 L/L/d in conventional single-stage AD to 0.82 and 0.91 L/L/d in two-stage AD. This improvement correlated with a rise in the relative abundance of Methanosarcina, a key methanogenesis microorganism. In the two-stage AD, the methanogenic stage offered an ideal environment for methanogens growth, resulting in substantially faster and higher CH 4 production by about 10% compared to single-stage AD. Overall, the combined use of HTP and the two-stage AD configuration enhanced CH 4 production by 40% compared to traditional single-stage AD. The abundance and diversity of ARGs were significantly reduced in the acidogenic reactors after HTP. However, the ARGs levels increased by about two times in the following methanogenesis stage and reached similar or higher levels than in single stage AD. The erm(F), erm(G), ant(6)-Ia, tet(W), mef(A) and erm(B) were the six main ARGs with significant differences in relative abundances in various treatments. The two-stage AD mode could better remove sul2, but it also had a rebound which elevated the risk of ARGs to the environment and human health. Network analysis identified pH and TVFAs as critical factors driving microbial communities and ARG proliferation in the new AD process. With the results, this study offers valuable insights into the trade-offs between AD performance enhancement and ARG-related risks, pinpointing essential areas for future research and practical improvements., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Nanofiltration (NF) membranes, extensively used in advanced wastewater treatment, have broad application prospects for the removal of emerging trace organic micropollutants (MPs). The treatment performance is affected by several factors, such as the properties of NF membranes, characteristics of target MPs, and operating conditions of the NF system concerning MP rejection. However, quantitative studies on different contributors in this context are limited. To fill the knowledge gap, this study aims to assess critical impact factors controlling MP rejection and develop a feasible model for MP removal prediction. The mini-review firstly summarized membrane pore size, membrane zeta potential, and the normalized molecular size (λ = r s /r p ), showeing better individual relationships with MP rejection by NF membranes. The Lindeman-Merenda-Gold model was used to quantitatively assess the relative importance of all summarized impact factors. The results showed that membrane pore size and operating pressure were the high impact factors with the highest relative contribution rates to MP rejection of 32.11% and 25.57%, respectively. Moderate impact factors included membrane zeta potential, solution pH, and molecular radius with relative contribution rates of 10.15%, 8.17%, and 7.83%, respectively. The remaining low impact factors, including MP charge, molecular weight, logKow, pKa and crossflow rate, comprised all the remaining contribution rates of 16.19% through the model calculation. Furthermore, based on the results and data availabilities from references, the machine learning-based random forest regression model was trained with a relatively low root mean squared error and mean absolute error of 12.22% and 6.92%, respectively. The developed model was then successfully applied to predict MPs' rejections by NF membranes. These findings provide valuable insights that can be applied in the future to optimize NF membrane designs, operation, and prediction in terms of removing micropollutants., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background & Aims: Peripartum prophylaxis (PP) with tenofovir disoproxil fumarate (TDF) is the standard of care to prevent mother-to-child transmission of chronic hepatitis B (CHB) infection in mothers who are highly viremic. We investigated the maternal and infant outcomes in a large Chinese cohort of TDF-treated CHB pregnant participants., Methods: In this prospective study, treatment-naive mothers with CHB and highly viremic (HBV DNA ≥200,000 IU/ml) but without cirrhosis were treated with TDF at 24-28 weeks of pregnancy. In accordance with Chinese CHB guidelines, TDF was stopped at delivery or ≥4 weeks postpartum. Serum HBV DNA and alanine aminotransferase were monitored every 6-8 weeks to determine virological relapse (VR). Infants received standard neonatal immunization, and HBV serology was checked at 7-12 months of age., Results: Among 330 participants recruited (median age 30, 82.7% HBeAg+, median HBV DNA 7.82 log IU/ml), TDF was stopped at delivery in 66.4% and at ≥4 weeks in 33.6%. VR was observed in 98.3%, among which 11.6% were retreated with TDF. Timing of TDF cessation did not alter the risk of VR (99.0 vs . 96.9%), clinical relapse (19.5 vs . 14.3%), or retreatment (12.6 vs . 10.1%) (all p  > 0.05). A similar proportion of patients developed alanine aminotransferase flare five times (1.1 vs . 2.1%; p  = 0.464) and 10 times (0.5 vs . 0%; p  = 0.669) above the upper limit of normal (ULN) in the early withdrawal and late withdrawal groups, respectively. No infants developed HBsAg-positivity., Conclusions: PP-TDF and neonatal immunization were highly effective in preventing mother-to-child transmission of HBV in mothers who are highly viremic. Timing of cessation of PP-TDF did not affect the risk of VR or retreatment., Impact and Implications: In pregnant mothers with chronic hepatitis B infection who are started on peripartum tenofovir to prevent mother-to-child-transmission (MTCT), the optimal timing for antiviral withdrawal during the postpartum period remains unknown. This prospective study demonstrates that stopping tenofovir immediately at delivery, compared with longer treatment duration of tenofovir, did not lead to an increased risk of virological relapse, retreatment, or transmission of the virus to the baby. Shortening the duration of peripartum antiviral prophylaxis from 12 weeks to immediately after delivery can be considered. The immediate withdrawal of peripartum tenofovir, combined with standard neonatal immunization schemes, is 100% effective in preventing MTCT among pregnant mothers with CHB who are highly viremic, with a high rate of vaccine response in infants., Competing Interests: MFY received research funding from Assembly Biosciences, Arrowhead Pharmaceuticals, Bristol Myer Squibb, Fujirebio Incorporation, Gilead Sciences, Merck Sharp and Dohme, Springbank Pharmaceuticals, Sysmex Corporation, and Roche, and is an advisory board member of and/or received research funding from AbbVie, Aligos Therarpeutics, Arbutus Biopharma, Bristol Myer Squibb, Dicerna Pharmaceuticals, Finch Therapeutics, GlaxoSmithKline, Gilead Sciences, Janssen, Merck Sharp and Dohme, Clear B Therapeutics, Springbank Pharmaceuticals, and Roche. WKS received speaker’s fees from AstraZeneca; is an advisory board member of and received speaker’s fees from Abbott; received research funding from Alexion Pharmaceuticals, Boehringer Ingelheim, Pfizer, and Ribo Life Science; and is an advisory board member of and received speaker’s fees and researching funding from Gilead Sciences. The other authors have nothing to disclose. Please refer to the accompanying ICMJE disclosure forms for further details., (© 2024 The Authors.)

To determine the priority control sources, an approach was proposed to evaluate the source-specific contribution to health risks from inhaling PM 2.5 -bound heavy metals (PBHMs). A total of 482 daily PM 2.5 samples were collected from urban and suburban areas of Beijing, China, between 2018 and 2019. In addition to the PMF-PSCF model, a Pb isotopic IsoSource model was built for more reliable source apportionment. By using the comprehensive indicator of disability-adjusted life years (DALYs), carcinogenic and noncarcinogenic health risks could be compared on a unified scale. The study found that the annual average concentrations of the total PBHMs were significantly higher in suburban areas than in urban areas, with significantly higher concentrations during the heating season than during the nonheating season. Comprehensive dust accounted for the largest contribution to the concentration of PBHMs, while coal combustion contributed the most to the DALYs associated with PBHMs. These results suggest that prioritizing the control of coal combustion could effectively reduce the disease burden associated with PBHMs, leading to notable public health benefits., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

We reported two cases of full-face 5-aminolevulinic acid-photodynamic therapy (ALA-PDT) for facial multiple actinic keratosis (AK). After the full-face ALA-PDT, we observed that the AK lesions on the faces of the patients were completely cleared and facial rejuvenation was achieved. In our follow-up, one patient was free of recurrence for over 13 months and the other one for over 28 months. The experience of these two cases may indicate that full-face ALA-PDT has an excellent therapeutic effect while potentially preventing the recurrence of AK., Competing Interests: Declaration of Competing Interest The authors have no conflict of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

The increasing global demand for skin disease diagnostics emphasizes the urgent need for advancements in AI-assisted diagnostic technologies for dermatoscopic images. In current practical medical systems, the primary challenge is balancing lightweight models with accurate image analysis to address constraints like limited storage and computational costs. While knowledge distillation methods hold immense potential in healthcare applications, related research on multi-class skin disease tasks is scarce. To bridge this gap, our study introduces an enhanced multi-source knowledge fusion distillation framework, termed DSP-KD, which improves knowledge transfer in a dual-stage progressive distillation approach to maximize mutual information between teacher and student representations. The experimental results highlight the superior performance of our distilled ShuffleNetV2 on both the ISIC2019 dataset and our private skin disorders dataset. Compared to other state-of-the-art distillation methods using diverse knowledge sources, the DSP-KD demonstrates remarkable effectiveness with a smaller computational burden.

Nitrate contamination in aquatic systems is a widespread problem across the world. The isotopic composition (δ 15 N, δ 18 O) of nitrate and their isotope effect ( 15 ε, 18 ε) can facilitate the identification of the source and transformation of nitrate. Although previous researches claimed the isotope fractionations may change the original δ 15 N/δ 18 O values and further bias identification of nitrate sources, isotope effect was often ignored due to its complexity. To fill the gap between the understanding and application, it is crucial to develop a deep understanding of isotopic fractionation based on available evidence. In this regard, this study summarized the available methods to determine isotope effects, thereby systematically comparing the magnitude of isotope effects ( 15 ε and 18 ε) in nitrification, denitrification and anammox. We found that the enzymatic reaction plays the key role in isotope fractionations, which is significantly affected by the difference in the affinity, substrate channel properties and redox potential of active site. Due to the overlapping of microbial processes and accumulation of uncertainties, the significant isotope effects at small scales inevitably decrease in large-scale ecosystems. However, the proportionality of N and O isotope fractionation (δ 18 O/δ 15 N; 18 ε/ 15 ε) associated with nitrate reduction generally follows enzyme-specific proportionalities (i.e., Nar, 0.95; Nap, 0.57; eukNR, 0.98) in aquatic ecosystems, providing enzyme-specific constant factors for the identification of nitrate transformation. With these results, this study finally discussed feasible source portioning methods when considering the isotope effect and aimed to improve the accuracy in nitrate source identification., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Advanced oxidation processes (AOPs) are increasingly applied in water and wastewater treatment, but their energy consumption and chemical use may hinder their further implementation in a changing world. This study investigated the feasibility and mechanisms involved in a chemical-free nanobubble-based AOP for treating organic micropollutants in both synthetic and real water matrices. The removal efficiency of the model micropollutant Rhodamine B (RhB) by oxygen nanobubble AOP (98%) was significantly higher than for air (73%) and nitrogen nanobubbles (69%). The treatment performance was not significantly affected by pH (3-10) and the presence of ions (Ca 2+ , Mg 2+ , HCO 3 - , and Cl - ). Although a higher initial concentration of RhB (10 mg/L) led to a slower treatment process when compared to lower initial concentrations (0.1 and 1 mg/L), the final removal performance reached a similar level (∼98%) between 100 and 500 min. The coexistence of organic matter (humic acid, HA) resulted in a much lower reduction (70%) in the RhB removal rate. Both qualitative and quantitative analysis of reactive oxygen species (ROSs) using fluorescent probe, electron spin resonance, and quenching experiments demonstrated that the contributions of ROSs in RhB degradation followed the order: hydroxyl radical (•OH) > superoxide radical (•O 2 - ) > singlet oxygen ( 1 O 2 ). The cascade degradation reactions for RhB were identified which involve N-de-ethylation, hydroxylation, chromophore cleavage, opening-ring and final mineralisation processes. Moreover, the treatment of real water samples spiked with RhB, including natural lake water and secondary effluent from a sewage works, still showed considerable removals of the dye (75.3%-90.8%), supporting its practical feasibility. Overall, the results benefit future research and application of chemical free nanobubble-based AOP for water and wastewater treatment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: Having sufficient population coverage from the electronic health records (EHRs)-connected health system is essential for building a comprehensive EHR-based diabetes surveillance system. This study aimed to establish an EHR-based type 1 diabetes (T1D) surveillance system for children and adolescents across racial and ethnic groups by identifying the minimum population coverage from EHR-connected health systems to accurately estimate T1D prevalence., Materials and Methods: We conducted a retrospective, cross-sectional analysis involving children and adolescents <20 years old identified from the OneFlorida+ Clinical Research Network (2018-2020). T1D cases were identified using a previously validated computable phenotyping algorithm. The T1D prevalence for each ZIP Code Tabulation Area (ZCTA, 5 digits), defined as the number of T1D cases divided by the total number of residents in the corresponding ZCTA, was calculated. Population coverage for each ZCTA was measured using observed health system penetration rates (HSPR), which was calculated as the ratio of residents in the corresponding ZTCA and captured by OneFlorida+ to the overall population in the same ZCTA reported by the Census. We used a recursive partitioning algorithm to identify the minimum required observed HSPR to estimate T1D prevalence and compare our estimate with the reported T1D prevalence from the SEARCH study., Results: Observed HSPRs of 55%, 55%, and 60% were identified as the minimum thresholds for the non-Hispanic White, non-Hispanic Black, and Hispanic populations. The estimated T1D prevalence for non-Hispanic White and non-Hispanic Black were 2.87 and 2.29 per 1000 youth, which are comparable to the reference study's estimation. The estimated prevalence of T1D for Hispanics (2.76 per 1000 youth) was higher than the reference study's estimation (1.48-1.64 per 1000 youth). The standardized T1D prevalence in the overall Florida population was 2.81 per 1000 youth in 2019., Conclusion: Our study provides a method to estimate T1D prevalence in children and adolescents using EHRs and reports the estimated HSPRs and prevalence of T1D for different race and ethnicity groups to facilitate EHR-based diabetes surveillance., (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Using statistical methods to analyze and summarize the research data of the inclusion criteria, to provide a quantitative average effect size to interpret the influence of mindfulness yoga exercise on patients with different depressive symptoms, explain the therapeutic effect of mindfulness yoga therapy on depression and its possible mechanism of action, and provide new ideas for the clinical treatment of patients with depression., Method: Review Manage 5.4 software was used to comprehensively evaluate the effect of yoga exercise on depression interventions to provide a reference for improving mental health. CNKI, PubMed, Web of science, EBSCO were searched for all case-control research articles on yoga for depression from 2000 to 2022. After screening, data extraction and quality evaluation of randomized controlled trials (RCTs) by inclusion and exclusion criteria, a total of 22 studies with 2,216 patients were included, including 1,101 in the yoga intervention group and 1,115 in the control group., Results: The results showed a large heterogeneity in the literature on the effect of yoga exercise on depression, with a combined total effect size [ SMD  = -1.53, 95% CI (-1.96, -1.10), p  < 0.00001]., Conclusion: Mindfulness yoga exercise is effective in preventing and treating depression and improving mental health, and may be considered as a non-medical, low-cost intervention as an adjunct to pharmacological treatment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Yang, Cao, Lyu and Gao.)

The perennial woody plant Hydrangea arborescens 'Annabelle' is of great research value due to its unique mechanism of flower development that occurs in the current year, resulting in decorative flowers that can be enjoyed for a relatively long period of time. However, the mechanisms underlying the regulation of current-year flower development in H. arborescens 'Annabelle' are still not fully understood. In this study, we conducted an associated analysis to explore the core regulating network in H . arborescens 'Annabelle' by combining phenological observations, physiological assays, and transcriptome comparisons across seven flower developmental stages. Through this analysis, we constructed a gene co-expression network (GCN) based on the highest reciprocal rank (HRR), using 509 differentially expressed genes (DEGs) identified from seven flowering-related pathways, as well as the biosynthesis of eight flowering-related phytohormones and signal transduction in the transcriptomic analysis. According to the analysis of the GCN, we identified 14 key genes with the highest functional connectivity that played critical roles in specific development stages. We confirmed that 135 transcription factors (AP2/ERF, bHLH, CO-like, GRAS, MIKC, SBP, WRKY) were highly co-expressed with the 14 key genes, indicating their close associations with the development of current-year flowers. We further proposed a hypothetical model of a gene regulatory network for the development of the whole flower. This model suggested that the photoperiod, aging, and gibberellin pathways, along with the phytohormones abscisic acid (ABA), gibberellin (GA), brassinosteroid (BR), and jasmonic acid (JA), work synergistically to promote the floral transition. Additionally, auxin, GA, JA, ABA, and salicylic acid (SA) regulated the blooming process by involving the circadian clock. Cytokinin (CTK), ethylene (ETH), and SA were key regulators that affected flower senescence. Additionally, several floral integrators ( HaLFY , HaSOC1-2 , HaAP1 , HaFULL , HaAGL24 , HaFLC , etc.) were dominant contributors to the development of H . arborescens flowers. Overall, this research provides a comprehensive understanding of the dynamic mechanism underlying the entire process of current-year flower development, thereby offering valuable insights for further studies on the flower development of H. arborescens 'Annabelle'.

The growing concerns surrounding water pollution and the degradation of ecosystems worldwide have led to an increased use of nature-based solutions (NbSs). This study assessed the feasibility of using floating treatment wetlands (FTWs) as an NbS to treat propylene glycol-contaminated water and quantitatively investigated different removal pathways. With an environmentally relevant concentration of propylene glycol (1,250 mg/L), FTWs containing Acorus calamus and mixed species demonstrated the highest average glycol mass removal efficacy (99%), followed by Carex acutiformis (98%), Juncus effusus (93%), and the control group without plants (10%) after 1 week. Additional mesocosm-scale experiments with varying FTW configurations, including surface coverage to reduce evaporation and photodegradation processes, and the addition of antibiotics to inhibit microbial activity, were conducted to quantify glycol removal pathways. Mass balance analysis results revealed that microbial biodegradation (33.3-39.7%) and plant uptake (37.9-45.2%) were the primary pathways for glycol removal. Only 15.5-19.5% of the glycol removal via evaporation and photodegradation was accounted in this study, which may be attributed to the mesocosm experimental setup (static water and no wind). Aligned with the broader discussion regarding biodiversity improvements and carbon storage capacity, this study demonstrated that FTWs are an environmentally friendly and effective NbS for addressing glycol-contaminated water.

PM 2.5 is the main component of haze, and PM 2.5 -bound heavy metals (PBHMs) can induce various toxic effects via inhalation. However, comprehensive macroanalyses on large scales are still lacking. In this study, we compiled a substantial dataset consisting of the concentrations of eight PBHMs, including As, Cd, Cr, Cu, Mn, Ni, Pb and Zn, across different cities in China. To improve prediction accuracy, we enhanced the traditional land-use regression (LUR) model by incorporating emission source-related variables and employing the best-fitted machine-learning algorithm, which was applied to predict PBHM concentrations, analyze geographical patterns and assess the health risks associated with metals under different PM 2.5 control targets. Our model exhibited excellent performance in predicting the concentrations of PBHMs, with predicted values closely matching measured values. Noncarcinogenic risks exist in 99.4% of the estimated regions, and the carcinogenic risks in all studied regions of the country are within an acceptable range (1 × 10 -5 -1 × 10 -6 ). In densely populated areas such as Henan, Shandong, and Sichuan, it is imperative to control the concentration of PBHMs to reduce the number of patients with cancer. Controlling PM 2.5 effectively decreases both carcinogenic and noncarcinogenic health risks associated with PBHMs, but still exceed acceptable risk level, suggesting that other important emission sources should be given attention., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Purpose: There is a particular anisometropia occurring in one eye with myopia, while the other eye has very low myopia, emmetropia, or very low hyperopia. It is unclear how the binocular axial length changes when these children wear unilateral OK lenses only in the more myopic eyes. This study investigates the changes in the axial elongation of both eyes., Methods: This is a 1-year retrospective study. In total, 148 children with myopic anisometropia were included. The more myopic eyes were wearing orthokeratology lenses (treated eyes), whereas the contralateral eyes were not indicated for visual correction (untreated eyes). The untreated eyes were classified into three subgroups based on the spherical equivalent refraction (SER): low myopia (≤ -0.50 D, n = 37), emmetropia (+0.49 to -0.49 D, n = 76), and low hyperopia (≥0.50 D, n = 35). Changes in the axial length (AL) were compared between the untreated and treated eyes and among the three subgroups., Results: The axial elongation was 0.14 ± 0.18 mm and 0.39 ± 0.27 mm in all treated and untreated eyes, respectively ( p < 0.001). The interocular AL difference decreased significantly from 1.09 ± 0.45 mm at the baseline to 0.84 ± 0.52 mm at 1 year ( p < 0.001). The baseline median (Q1, Q3) SER of the untreated eyes were -0.75 D (-0.56, -0.88 D), 0.00 D (0.00, -0.25 D), and +0.75 D (+1.00, +0.62 D) in low myopia, emmetropia, and low hyperopia subgroups, respectively. The axial elongation was 0.14 ± 0.18 mm, 0.15 ± 0.17 mm, and 0.13 ± 0.21 mm ( p = 0.92) in the treated eyes and 0.44 ± 0.25 mm, 0.35 ± 0.24 mm, and 0.41 ± 0.33 mm in the untreated eyes ( p = 0.11) after 1 year. Multivariate linear regression analyses only showed significant differences in axial elongation between the emmetropia and low myopia subgroups of untreated eyes ( p = 0.04; p > 0.05 between other subgroups)., Conclusion: Unilateral orthokeratology lenses effectively reduced axial elongation in the more myopic eyes and reduced interocular AL differences in children with myopic anisometropia. The refractive state of the untreated eyes did not affect the axial elongation of the more myopic eye wearing the orthokeratology lens. In the untreated eyes, AL increased faster in the low myopia subgroup than in the emmetropia subgroup., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Qin, Qing, Ji, Lyu, Ma, Shi, Yu, Ma and Fu.)

Particles larger than 10 nm from engine exhaust are gaining global concerns. In light of this, to investigate how EGR affects gasoline vehicle SPN10 (solid particles larger than 10 nm) emissions, seven gasoline vehicles (hybrid or conventional) were studied experimentally. The results revealed that EGR vehicles risk failing the current limit (6 * 10 11 #/km) more than those without EGR if the cut-off size was tightened from 23 nm to 10 nm. More specifically, during the WLTC test, EGR increased the SPN10 emission factors by 2 ∼ 3 times depending on vehicle powertrains (conventional or hybrid). Notably, SPN10 emissions increased significantly when EGR was actively engaged but showed a decrease when the EGR rate remained constant. EGR and the enriched fuel-air mixture are the critical reasons for the increased SPN10., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Pyrolysis of biomass feedstocks can produce valuable biofuel, however, the final products may present excessive corrosion and poor stability due to the lack of hydrogen content. Co-pyrolysis with hydrogen-rich substances such as waste plastics may compensate for these shortcomings. In this study, the co-pyrolysis of a common biomass, i.e. distiller's grains (DG), and waste polypropylene plastic (PP) were investigated towards increasing the quantity and quality of the production of biofuel. Results from the thermogravimetric analyses showed that the reaction interval of individual pyrolysis of DG and PP was 124-471 °C and 260-461 °C, respectively. Conversely, an interaction effect between DG and PP was observed during co-pyrolysis, resulting in a slower rate of weight loss, a longer temperature range for the pyrolysis reaction, and an increase in the temperature difference between the evolution of products. Likewise, the Coats-Redfern model showed that the activation energies of DG, PP and an equal mixture of both were 42.90, 130.27 and 47.74 kJ mol -1 , respectively. It thus follows that co-pyrolysis of DG and PP can effectively reduce the activation energy of the reaction system and promote the degree of pyrolysis. Synergistic effects essentially promoted the free radical reaction of the PP during co-pyrolysis, thereby reducing the activation energy of the process. Moreover, due to this synergistic effect in the co-pyrolysis of DG and PP, the ratio of elements was effectively optimized, especially the content of oxygen-containing species was reduced, and the hydrocarbon content of products was increased. These results will not only advance our understanding of the characteristics of co-pyrolysis of DG and PP, but will also support further research toward improving an efficient co-pyrolysis reactor system and the pyrolysis process itself., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)