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Abstract Background Pay-for-performance (P4P) schemes are commonly used to incentivize primary healthcare (PHC) providers to improve the quality of care they deliver. However, the effectiveness of P4P schemes can vary depending on their design. In this study, we aimed to investigate the preferences of PHC providers for participating in P4P programs in a city in Shandong province, China. Method We conducted a discrete choice experiment (DCE) with 882 PHC providers, using six attributes: type of incentive, whom to incentivize, frequency of incentive, size of incentive, the domain of performance measurement, and release of performance results. Mixed logit models and latent class models were used for the statistical analyses. Results Our results showed that PHC providers had a strong negative preference for fines compared to bonuses (− 1.91; 95%CI − 2.13 to − 1.69) and for annual incentive payments compared to monthly (− 1.37; 95%CI − 1.59 to − 1.14). Providers also showed negative preferences for incentive size of 60% of monthly income, group incentives, and non-release of performance results. On the other hand, an incentive size of 20% of monthly income and including quality of care in performance measures were preferred. We identified four distinct classes of providers with different preferences for P4P schemes. Class 2 and Class 3 valued most of the attributes differently, while Class 1 and Class 4 had a relatively small influence from most attributes. Conclusion P4P schemes that offer bonuses rather than fines, monthly rather than annual payments, incentive size of 20% of monthly income, paid to individuals, including quality of care in performance measures, and release of performance results are likely to be more effective in improving PHC performance. Our findings also highlight the importance of considering preference heterogeneity when designing P4P schemes.

Organoids, miniature and simplified in vitro model systems that mimic the structure and function of organs, have attracted considerable interest due to their promising applications in disease modeling, drug screening, personalized medicine, and tissue engineering. Despite the substantial success in cultivating physiologically relevant organoids, challenges remain concerning the complexities of their assembly and the difficulties associated with data analysis. The advent of AI-Enabled Organoids, which interfaces with artificial intelligence (AI), holds the potential to revolutionize the field by offering novel insights and methodologies that can expedite the development and clinical application of organoids. This review succinctly delineates the fundamental concepts and mechanisms underlying AI-Enabled Organoids, summarizing the prospective applications on rapid screening of construction strategies, cost-effective extraction of multiscale image features, streamlined analysis of multi-omics data, and precise preclinical evaluation and application. We also explore the challenges and limitations of interfacing organoids with AI, and discuss the future direction of the field. Taken together, the AI-Enabled Organoids hold significant promise for advancing our understanding of organ development and disease progression, ultimately laying the groundwork for clinical application.

The impact of degradation on plastics is a critical factor influencing their properties and behavior, particularly evident in polyethylene (PE) and polypropylene (PP) and their blends. However, the effect of photoaging and thermal degradation, specifically within recycled polyethylene (rPE) and recycled polypropylene (rPP), on the thermo-mechanical and thermostability aspects of these blends remains unexplored. To address this gap, a range of materials, including virgin polyethylene (vPE), recycled polyethylene (rPE), virgin polypropylene (vPP), recycled polypropylene (rPP), and their blends with different ratios, were comprehensively investigated. Through a systematic assessment encompassing variables such as melting flow index (MFI), functional groups, mechanical traits, crystallization behavior, microscopic morphology, and thermostability, it was found that thermo-oxidative degradation generated hydroxyl and carboxyl functional groups in rPE and rPP. Optimal mechanical properties were achieved with a 6:4 mass ratio of rPE to rPP, as validated by FTIR spectroscopy and microscopic morphology. By establishing the chemical model, the changes in the system with an rPE–rPP ratio of 6:4 and 8:2 were monitored by the molecular simulation method. When the rPE–rPP ratio was 6:4, the system’s energy was lower, and the number of hydrogen bonds was higher, which also confirmed the above experimental results. Differential scanning calorimetry revealed an increased crystallization temperature in rPE, a reduced crystallization peak area in rPP, and a diminished crystallization capacity in rPE/rPP blends, with rPP exerting a pronounced influence. This study plays a pivotal role in enhancing recycling efficiency and reducing production costs for waste plastics, especially rPE and rPP—the primary components of plastic waste. By uncovering insights into the degradation effects and material behaviors, our research offers practical pathways for more sustainable waste management. This approach facilitates the optimal utilization of the respective performance characteristics of rPE and rPP, enabling the development of highly cost-effective rPE/rPP blend materials and promoting the efficient reuse of waste materials.

Articular cartilage injury is a frequent worldwide disease, while effective treatment is urgently needed. Due to lack of blood vessels and nerves, the ability of cartilage to self-repair is limited. Despite the availability of various clinical treatments, unfavorable prognoses and complications remain prevalent. However, the advent of tissue engineering and regenerative medicine has generated considerable interests in using biomaterials for articular cartilage repair. Nevertheless, there remains a notable scarcity of comprehensive reviews that provide an in-depth exploration of the various strategies and applications. Herein, we present an overview of the primary biomaterials and bioactive substances from the tissue engineering perspective to repair articular cartilage. The strategies include regeneration, substitution, and immunization. We comprehensively delineate the influence of mechanically supportive scaffolds on cellular behavior, shedding light on emerging scaffold technologies, including stimuli-responsive smart scaffolds, 3D-printed scaffolds, and cartilage bionic scaffolds. Biologically active substances, including bioactive factors, stem cells, extracellular vesicles (EVs), and cartilage organoids, are elucidated for their roles in regulating the activity of chondrocytes. Furthermore, the composite bioactive scaffolds produced industrially to put into clinical use, are also explicitly presented. This review offers innovative solutions for treating articular cartilage ailments and emphasizes the potential of biomaterials for articular cartilage repair in clinical translation.

Abstract The use of non-smart materials in structural components and kinematic pairs allows for flexible assembly in practical applications and is promising for aerospace applications. However, this approach can result in a complex structure and excessive kinematic pairs, which limits its potential applications due to the difficulty in controlling and actuating the mechanism. While smart materials have been integrated into certain mechanisms, such integration is generally considered a unique design for specific cases and lacks universality. Therefore, organically combining universal mechanism design with smart materials and 4D printing technology, innovating mechanism types, and systematically exploring the interplay between structural design and morphing control remains an open research area. In this work, a novel form-controlled planar folding mechanism is proposed, which seamlessly integrates the control and actuation system with the structural components and kinematic pairs based on the combination of universal mechanism design with smart materials and 4D printing technology, while achieving self-controlled dimensional ratio adjustment under a predetermined thermal excitation. The design characteristics of the mechanism are analyzed, and the required structural design parameters for the preprogrammed design are derived using a kinematic model. Using smart materials and 4D printing technology, folding programs based on material properties and control programs based on manufacturing parameters are encoded into the form-controlled rod to achieve the preprogrammed design of the mechanism. Finally, two sets of prototype mechanisms are printed to validate the feasibility of the design, the effectiveness of the morphing control programs, and the accuracy of the theoretical analysis. This mechanism not only promotes innovation in mechanism design methods but also shows exceptional promise in satellite calibration devices and spacecraft walking systems.

Abstract The regeneration of weight-bearing bone defects and critical-sized cartilage defects remains a significant challenge. A wide range of nano-biomaterials are available for the treatment of bone/cartilage defects. However, their poor compatibility and biodegradability pose challenges to the practical applications of these nano-based biomaterials. Natural biomaterials inspired by the cell units (e.g., nucleic acids and proteins), have gained increasing attention in recent decades due to their versatile functionality, compatibility, biodegradability, and great potential for modification, combination, and hybridization. In the field of bone/cartilage regeneration, natural nano-based biomaterials have presented an unparalleled role in providing optimal cues and microenvironments for cell growth and differentiation. In this review, we systematically summarize the versatile building blocks inspired by the cell unit used as natural nano-based biomaterials in bone/cartilage regeneration, including nucleic acids, proteins, carbohydrates, lipids, and membranes. In addition, the opportunities and challenges of natural nano-based biomaterials for the future use of bone/cartilage regeneration are discussed.

Abstract Despite enormous advances in the generation of organoids, robust and stable protocols of organoids are still a major challenge to researchers. Research for assessing structures of organoids and the evaluations of their functions on in vitro or in vivo is often limited by precision strategies. A growing interest in assessing organoids has arisen, aimed at standardizing the process of obtaining organoids to accurately resemble human‐derived tissue. The complex microenvironment of organoids, intricate cellular crosstalk, organ‐specific architectures and further complicate functions urgently quest for high‐through schemes. By utilizing multi‐omics analysis and single‐cell analysis, cell‐cell interaction mechanisms can be deciphered, and their structures can be investigated in a detailed view by histological analysis. In this review, we will conclude the novel approaches to study the molecular mechanism and cell heterogeneity of organoids and discuss the histological and morphological similarity of organoids in comparison to the human body. Future perspectives on functional analysis will be developed and the organoids will become mature models.

Abstract Background Plant organelle genomes are a valuable resource for evolutionary biology research, yet their genome architectures, evolutionary patterns and environmental adaptations are poorly understood in many lineages. Rhodiola species is a type of flora mainly distributed in highland habitats, with high medicinal value. Here, we assembled the organelle genomes of three Rhodiola species (R. wallichiana, R. crenulata and R. sacra) collected from the Qinghai-Tibet plateau (QTP), and compared their genome structure, gene content, structural rearrangements, sequence transfer and sequence evolution rates. Results The results demonstrated the contrasting evolutionary pattern between plastomes and mitogenomes in three Rhodiola species, with the former possessing more conserved genome structure but faster evolutionary rates of sequence, while the latter exhibiting structural diversity but slower rates of sequence evolution. Some lineage-specific features were observed in Rhodiola mitogenomes, including chromosome fission, gene loss and structural rearrangement. Repeat element analysis shows that the repeats occurring between the two chromosomes may mediate the formation of multichromosomal structure in the mitogenomes of Rhodiola, and this multichromosomal structure may have recently formed. The identification of homologous sequences between plastomes and mitogenomes reveals several unidirectional protein-coding gene transfer events from chloroplasts to mitochondria. Moreover, we found that their organelle genomes contained multiple fragments of nuclear transposable elements (TEs) and exhibited different preferences for TEs insertion type. Genome-wide scans of positive selection identified one gene matR from the mitogenome. Since the matR is crucial for plant growth and development, as well as for respiration and stress responses, our findings suggest that matR may participate in the adaptive response of Rhodiola species to environmental stress of QTP. Conclusion The study analyzed the organelle genomes of three Rhodiola species and demonstrated the contrasting evolutionary pattern between plastomes and mitogenomes. Signals of positive selection were detected in the matR gene of Rhodiola mitogenomes, suggesting the potential role of this gene in Rhodiola adaptation to QTP. Together, the study is expected to enrich the genomic resources and provide valuable insights into the structural dynamics and sequence divergences of Rhodiola species.

Phytomining is a sustainable approach that uses hyperaccumulators for critical element extraction from various substrates, such as contaminated soils, mine tailings, and aqueous solutions. In this study, grass seeds were fed with a solution containing Y, La, Ce, and Dy, resulting in around 510 mg/kg (dry basis) of total rare earth elements (TREEs) accumulated in grass leaves. Electron probe microanalyzer (EPMA) analysis showed that rare earth elements (REEs) in the grass leaves (GL) predominantly complexed with phosphorous (P). Around 95% of Y, 93% of La, 92% of Ce, and 93% of Dy were extracted from the GL using 0.5 mol/L H2SO4 at a solid concentration of 5 wt.%. Subsequently, microwave-assisted hydrothermal carbonization (MHTC) was used to convert the leaching residue into hydrochar to achieve a comprehensive utilization of GL biomass. The effect of temperature on the structural properties and chemical composition of the resulting hydrochar was evaluated. Scanning electron microscopy (SEM) analysis revealed that the original structure of GL was destroyed at 180 °C during MHTC, producing numerous microspheres and pores. As the reaction temperature increased, there was a concurrent increase in carbon content, a higher heating value (HHV), and energy densification, coupled with a decrease in the hydrogen and oxygen contents of hydrochar. The evolution of H/C and O/C ratios indicated that dehydration and decarboxylation occurred during MHTC. The results showed that the waste biomass of the GL after REE extraction can be effectively converted into energy-rich solid fuel and low-cost adsorbents via MHTC.

In recent two decades, ultrasound has been broadly applied to the hydrometallurgical leaching process to recover valuable metals within raw materials, aiming to solve the shortcomings of the conventional leaching process, including relatively low leaching recovery, long leaching duration, high reagent usage, high energy consumption and so on. The present work focuses on a comprehensive overview of the ultrasound-enhanced leaching of various metals, such as common nonferrous and ferrous metals, rare metals, rare earth elements, and precious metals, from raw metal ores and secondary resources. Moreover, the enhanced leaching mechanisms by ultrasound are discussed in detail and summarized based on the improvement of leaching kinetics, enhancement of the mass transfer and diffusion of lixiviants, and promotion of the oxidative conversion of metals from insoluble to soluble states. Lastly, the challenges and outlooks of future research on the leaching recovery for valuable metals with the assistance of ultrasound irradiation are proposed.

BackgroundCoronary artery calcification (CAC) is associated with high rates of restenosis and adverse clinical events after percutaneous coronary intervention (PCI) with drug-eluting stents (DES).ObjectivesThe aim of this study was to evaluate the long-term clinical outcomes of drug-coated balloon (DCB)-only treatment for de novo lesions with and without CAC.MethodsPatients with de novo coronary disease treated with the DCB-only strategy were retrospectively enrolled from three centers and categorized into a CAC group and a non-CAC group. The primary endpoint was the target lesion failure (TLF) rate during the 3-year follow-up. Secondary endpoints included the occurrence of major adverse cardiac events (MACEs), target lesion revascularization (TLR), cardiac death, myocardial infarction (MI) and any revascularization. Propensity score matching (PSM) was conducted to assemble a cohort of patients with similar baseline characteristics.ResultsA total of 1,263 patients with 1,392 lesions were included, and 243 patients were included in each group after PSM. Compared with the non-CAC group, the incidence rates of TLF (9.52% vs. 4.94%, odds ratio [OR]: 2.080; 95% confidence interval [CI]: 1.083–3.998, P = 0.034) and TLR (7.41% vs. 2.88%, OR: 2.642; 95% CI: 1.206–5.787, P = 0.020) in the CAC group were higher. The incidence rates of MACE (12.35% vs. 7.82%, OR: 1.665; 95% CI: 0.951–2.916, P = 0.079), cardiac death (2.06% vs. 2.06%, OR: 0.995; 95% CI: 0.288–3.436, P = 0.993), MI (1.23% vs. 0.82%, OR: 2.505; 95% CI: 0.261–8.689, P = 0.652) and any revascularization (12.76% vs. 9.67%, OR: 1.256; 95% CI: 0.747–2.111, P = 0.738) were similar between groups.ConclusionsCAC increased the incidence of TLF and TLR without a substantial increase in the risk of MACE, cardiac death, MI, or any revascularization in patients treated with DCB-only angioplasty during the 3-year follow-up.

Abstract Accurate identification of microRNA (miRNA) targets at base-pair resolution has been an open problem for over a decade. The recent discovery of miRNA isoforms (isomiRs) adds more complexity to this problem. Despite the existence of many methods, none considers isomiRs, and their performance is still suboptimal. We hypothesize that by taking the isomiR–mRNA interactions into account and applying a deep learning model to study miRNA–mRNA interaction features, we may improve the accuracy of miRNA target predictions. We developed a deep learning tool called DMISO to capture the intricate features of miRNA/isomiR–mRNA interactions. Based on tenfold cross-validation, DMISO showed high precision (95%) and recall (90%). Evaluated on three independent datasets, DMISO had superior performance to five tools, including three popular conventional tools and two recently developed deep learning-based tools. By applying two popular feature interpretation strategies, we demonstrated the importance of the miRNA regions other than their seeds and the potential contribution of the RNA-binding motifs within miRNAs/isomiRs and mRNAs to the miRNA/isomiR–mRNA interactions.

BackgroundData on drug-coated balloons (DCB) for de novo coronary chronic total occlusion (CTO) are limited. We aimed to investigate the long-term outcomes of substitution of drug-eluting stents (DES) by DCB.MethodsWe compared the outcomes of less DES strategy (DCB alone or combined with DES) and DES-only strategy in treating de novo coronary CTO in this prospective, observational, multicenter study. The primary endpoints were major adverse cardiovascular events (MACE), target vessel revascularization, myocardial infarction, and death during 3-year follow-up. The secondary endpoints were late lumen loss (LLL) and restenosis until 1-year after operation.ResultsOf the 591 eligible patients consecutively enrolled between January 2015 and December 2019, 281 (290 lesions) were treated with DCB (DCB-only or combined with DES) and 310 (319 lesions) with DES only. In the DCB group, 147 (50.7%) lesions were treated using DCB-only, and the bailout stenting rate was relatively low (3.1%). The average stent length per lesion in the DCB group was significantly shorter compared with the DES-only group (21.5 ± 25.5 mm vs. 54.5 ± 26.0 mm, p 0.999). The Kaplan–Meier estimates of MACE at 3-year (11.8% vs. 12.0%, log-rank p = 0.688) was similar between the groups.ConclusionPercutaneous coronary intervention with DCB is a potential “stent-less” therapy for de novo CTO lesions with satisfactory long-term clinical results compared to the DES-only approach.

In order to study the effect of soil salt content on the corrosion of buried metal by the stray current in urban rail transit, a small experimental platform for the buried metal corrosion is built. The corrosion rate and mass loss of buried carbon steel specimens in soil samples with or without DC stray current are measured and calculated when different content of NaCl is added into the soil samples, respectively. The experimental results show that the corrosion rate and mass loss of the buried metal increase with the increase of soil salt content. DC stray current will aggravate the corrosion of the buried metal. The corrosion degree of buried metal will be seriously aggravated under the coupling action of DC stray current and salt. When there is no DC stray curren, the corrosion degree of buried metal is relatively small, and the influence of soil salt content on the buried metal corrosion is also relatively small. Finally, a multiphysics simulation model corresponding to the experiment is established to verify the experimental results. The simulation results are basically consistent with the experimental results, which proves the accuracy of the experimental results. The research results can provide a theoretical basis for the corrosion protection design of subway stray current.

Abstract Background Tendon is a major component of musculoskeletal system connecting the muscles to the bone. Tendon injuries are very common orthopedics problems leading to impeded motion. Up to now, there still lacks effective treatments for tendon diseases. Methods Tendon stem/progenitor cells (TSPCs) were isolated from the patellar tendons of SD rats. The expression levels of genes were evaluated by quantitative RT-PCR. Immunohistochemistry staining was performed to confirm the presence of tendon markers in tendon tissues. Bioinformatics analysis of data acquired by RNA-seq was used to find out the differentially expressed genes. Rat patellar tendon injury model was used to evaluate the effect of U0126 on tendon injury healing. Biomechanical testing was applied to evaluate the mechanical properties of newly formed tendon tissues. Results In this study, we have shown that ERK inhibitor U0126 rather PD98059 could effectively increase the expression of tendon-related genes and promote the tenogenesis of TSPCs in vitro. To explore the underlying mechanisms, RNA sequencing was performed to identify the molecular difference between U0126-treated and control TSPCs. The result showed that GDF6 was significantly increased by U0126, which is an important factor of the TGFβ superfamily regulating tendon development and tenogenesis. In addition, NBM (nonwoven-based gelatin/polycaprolactone membrane) which mimics the native microenvironment of the tendon tissue was used as an acellular scaffold to carry U0126. The results demonstrated that when NBM was used in combination with U0126, tendon healing was significantly promoted with better histological staining outcomes and mechanical properties. Conclusion Taken together, we have found U0126 promoted tenogenesis in TSPCs through activating GDF6, and NBM loaded with U0126 significantly promoted tendon defect healing, which provides a new treatment for tendon injury.

Shape memory polymers (SMP) are the smart materials that have received the most attention and are the most commonly employed. SMP can be 4D printed to create prefabricated components with transform shapes, properties, or functions under different external excitations. Although smart equipment assembled from these prefabricated components is extensively used in various fields, a systematic overview summary of their design ideas still needs to be provided. This paper briefly analyzes current trends in the design ideas and application of SMP-based prefabricated components. By summarizing two different design ideas: structural combination and material modification, it demonstrates the application of smart equipment assembled from SMP-based prefabricated components in medical, industrial, and aerospace fields. Furthermore, current challenges with both design ideas are discussed.

Osteoporotic fractures, also known as fragility fractures, are prevalent in the elderly and bring tremendous social burdens. Poor bone quality, weak repair capacity, instability, and high failure rate of internal fixation are main characteristics of osteoporotic fractures. Osteoporotic bone defects are common and need to be repaired by appropriate materials. Proximal humerus, distal radius, tibia plateau, calcaneus, and spine are common osteoporotic fractures with bone defect. Here, the consensus from the Osteoporosis Group of Chinese Orthopaedic Association concentrates on the epidemiology, characters, and management strategies of common osteoporotic fractures with bone defect to standardize clinical practice in bone repair of osteoporotic fractures.

Because the failure potential of a landslide is difficult to assess, a motorway landslide that has obviously deformed was used as a case study in this research. Several multi-integrated geotechniques, including field investigation, drilling, electrical resistivity tomography (ERT), stability analysis, and numerical simulations, were used to achieve this goal. Field investigation with drilling was used to roughly determine the failure potential mass boundary and the material composition ERT technique was further used to distinguish the structure and composition of underground materials; the results agreed well with the field investigation, as well as the drilling data in the lithology judgement. The above investigations also showed the failure potential mass is in a slow sliding state and the slip surface roughly follows the contact zone between the upper soil and bedrock. Next, stability analysis based on the limit equilibrium method (LEM) was used to judge the current stability status of the slope, and its factor of safety (FOS) was 1.2 under the natural condition, 1.05 under the earthquake condition, and 1.15 under the rainfall condition. Based on the assessed potential slip surface and digital elevation data, a three-dimensional smoothed particle hydrodynamics (SPH) model was used to simulate the failure potential process. The dynamic information of the run-out behavior, including velocity, movement distance, and frictional energy, can be obtained, which is useful for hazard prediction.

In this study, a ternary blend modifier (TBM) was prepared with RPE, RPP, and various dosages of PP-g-MAH (i.e., 0%, 1%, 3%, 5%, 7%, and 9% by weight of RPE and RPP) by a twin-screw extruder. The performance of TBM (4% by weight of asphalt) modified asphalt was studied, with the increase of PP-g-MAH content, the penetration decreases gradually, but softening point and viscosity increases and ductility exists minimum value at 7% content, with the increasing of PP-g-MAH percentage, the dynamic rheological properties show that |G*| increases, while the δ and |G*|cosδ decrease, and the fatigue performance (|G*|sinδ) of TBM modified asphalt is worse than virgin asphalt. Dynamic stability test shows that TBM shows the prominent high-temperature properties of a modified (asphalt mixture. BBR test indicates that the m-value of asphalt modified with TBM does not fulfill the requirements (m-value>0.3) except at 5% and 7%, but the S meets the standard requirements (S < 300 MPa), and increases from 0% to 7%, then decreases slightly. In order to illuminate possible reasons, a chemical reaction (ester compounds generated) and physical twines of concerned polymer molecules were put forward, and the results were confirmed by infrared analysis.

Exploring the transformation of spatial mechanisms from their unfolded to controlled folding states to meet the requirements of various application scenarios has long been a hot topic in mechanical structure research. Although conventional spatial mechanisms can be designed to meet almost any application scenario, the design’s complex and excessive combinations of structural components, kinematic pairs, and drive units are unavoidable. It introduces many problems, such as poor reliability, drive complexity, and control difficulties. Based on 4D printing technology, the design of self-folding spatial mechanisms that use pre-stressed response properties under predetermined thermal excitation to achieve different shrinkage ratios integrates the control and drive system and the structural components and kinematic pairs. It brings novel features of self-folding while effectively avoiding many problems associated with conventional mechanical design. Further, the pre-stressed response model introduces the self-folding spatial mechanisms’ excitation, morphing, and driving investigation. Self-folding spatial mechanisms with different shrinkage ratios were prepared via fused deposition modeling, which verified the theoretical analysis and pre-stress response model and the design’s correctness and feasibility by experiments. The existing 4D printing technology lacks a paradigmatic design method in the application field. Contrarily, this work organically combined the conventional mechanical structure design with materials and fabrication via fused deposition modeling. A systematic study of self-folding spatial mechanisms from structural design to morphing control was carried out. This design is expected to introduce a novel paradigm of 4D printing technology in conventional mechanical design and has considerable application prospects in spherical radar calibration mechanisms.

Follicular regulatory T cells (Tfr) have critical functions in inflammatory and autoimmune disorders. The main purpose of the current work was to assess Tfr cell frequency in patients with dilated cardiomyopathy (DCM). Flow cytometry showed that, compared with normal controls, DCM cases showed markedly reduced Tfr cell rates and Tfr/Tfh ratios, but significantly increased follicular helper T cell (Tfh) rates. Correlation analysis showed that the Tfr rate in DCM patients was positively correlated with left ventricular ejection fraction (LVEF), and negatively correlated with N-terminal brain natriuretic peptide (NT-proBNP) levels. Lower Foxp3 and higher Bcl-6, ICOS, and PD-1 mRNA expression levels were found in patients with DCM. In addition, plasma interleukin (IL)-6, tumor necrosis factor (TNF)-α, and IL-21 levels were significantly increased in DCM cases. Moreover, IgG and IgG3 levels were also elevated in individuals with DCM. Correlation analysis showed that the Tfr rate in DCM patients was negatively correlated with IgG and IgG3, while the Tfh rate was positively correlated with IgG and IgG3. Changes in circulating Tfr levels may have a critical immunomodulatory function in DCM and may become a new therapeutic target for DCM.

Background. The revascularization of small vessels using drug-eluting stents remains challenging. The use of the drug-coated balloon is an attractive therapeutic strategy in de novo lesions in small coronary vessels, particularly in the diabetic group. This study aimed to assess the outcomes of DCB-only angioplasty in small vessel disease. Methods. A total of 1198 patients with small vessel disease treated with DCB-only strategy were followed. Patients were divided into the diabetic and nondiabetic groups. Clinical and angiographical follow-up were organized at 12 months. The primary endpoints were target lesion failure and secondary major adverse cardiac events. Results. There was a significantly higher rate of target lesion failure among diabetic patients compared to nondiabetic [17 (3.9%) vs. 11 (1.4%), P=0.006], taken separately, the rate of target lesion revascularization significantly differed between groups with a higher rate observed in the diabetic group [9 (2%) vs. 4 (0.5%), P=0.014]. Diabetes mellitus remained an independent predictor for TLF (HR: 2.712, CI: 1.254–5.864, P=0.011) and target lesion revascularization (HR: 3.698, CI: 1.112–12.298, P=0.033) after adjustment. However, no significant differences were observed between groups regarding the target vessel myocardial infarction (0.6% vs. 0.1%, P=0.110) and MACE [19 (4.4%) vs. 21 (2.7%), P=0.120]. Conclusion. Drug-coated balloon-only treatment achieved lower incidence rates of TLF and MACE. Diabetes is an independent predictor for target lesion failure and target lesion revascularization at one year following DCB treatment in small coronary vessels. We observed no significant differences between groups regarding MACE in one year.

Background. Relative to nondiabetic patients, percutaneous coronary intervention (PCI) in patients with diabetes mellitus (DM) is associated with inferior clinical outcomes. We aimed to evaluate the outcomes of drug-coated balloon (DCB) in diabetic versus nondiabetic patients. Methods and Results. In this observational, prospective, multicenter study, we compared the outcomes of patients with and without DM after undergoing PCI with DCBs. Target lesion failure (TLF) was analyzed as primary endpoint. Secondary endpoints were the rates of target lesion revascularization (TLR), major adverse cardiovascular events (MACE), cardiac death, myocardial infarction (MI), and any revascularization. Propensity score matching was used to assemble a cohort of patients with similar baseline characteristics. Among 2,306 eligible patients, 578 with DM and 578 without DM had similar propensity scores and were included in the analyses. During follow-up (366±46 days), compared with DM patients, patients without DM were associated with a lower yearly incidence of TLF (2.77% vs. 5.36%; OR, 1.991; 95% CI, 1.077 to 3.681; P=0.025) and TLR (1.90% vs. 4.15%; OR, 2.233; 95% CI, 1.083 to 4.602; P=0.026). No significant differences were observed with regards to rates of MACE (OR: 1.580, 95% CI: 0.912-2.735; P=0.100), cardiac death (OR: 1.608, 95% CI: 0.523-4.946; P=0.403), MI (OR: 4.042, 95% CI: 0.855-19.117; P=0.057), and any revascularization (OR: 1.534, 95% CI: 0.983-2.393; P=0.058). Conclusions. Diabetic patients experience higher TLF and TLR rates following DCB angioplasty without substantial increase in the risk of MACE, cardiac death, MI, or revascularization.

Gamma-delta (γδ) T cells are a subset of T cells that promote the inflammatory responses of lymphoid and myeloid lineages, and are especially vital to the initial inflammatory and immune responses. Given the capability to connect crux inflammations of adaptive and innate immunity, γδ T cells are responsive to multiple molecular cues and can acquire the capacity to induce various cytokines, such as GM-CSF, IL-4, IL-17, IL-21, IL-22, and IFN-γ. Nevertheless, the exact mechanisms responsible for γδ T cell proinflammatory functions remain poorly understood, particularly in the context of the central nervous system (CNS) diseases. CNS disease, usually leading to irreversible cognitive and physical disability, is becoming a worldwide public health problem. Here, we offer a review of the neuro-inflammatory and immune functions of γδ T cells, intending to understand their roles in CNS diseases, which may be crucial for the development of novel clinical applications.

In this paper, the effect of sodium alginate (SA) on the flotation separation of molybdenite (MoS2) from chalcopyrite using kerosene as collector was systematically investigated. The results of single-mineral micro-flotation tests indicated that SA exhibited strong depression on chalcopyrite flotation while it imposed no impact on the floatability of molybdenite. However, in the chalcopyrite–molybdenite mixed-mineral flotation system, the presence of chalcopyrite significantly increased the depressing effect of SA on molybdenite flotation, leading to a considerable reduction in the flotation selectivity. The negative impact of chalcopyrite on the performance of SA in molybdenite flotation was eliminated by adding a certain dosage of kerosene prior to SA. A concentrate containing 53.43% of molybdenum (Mo) was obtained at 76.90% of recovery using 19 mg/L kerosene and 40 mg/L SA at pH 5.4. Zeta potential measurements indicated that the adsorption of SA on chalcopyrite surfaces was stronger than that on molybdenite surfaces, which agreed with the single-mineral flotation test results. The adsorption of SA on chalcopyrite was further confirmed to be chemisorption by Fourier-transform infrared spectroscopy (FTIR) spectra analyses. When Cu2+ appeared in solution, the flotation of molybdenite was strongly depressed by SA. Mechanism analyses indicated that more active sites were generated on molybdenite surfaces after the addition of Cu2+, thus promoting the adsorption of SA.

Little evidence exists to confirm whether the sensory-related neural activity that occurs when observing others in pain is highly responsive to empathy for pain. From a perspective of intervention, the present study employed placebo manipulation with a transferable paradigm to explore whether the sensory regional activation that occurs when viewing pictures of others in pain could be modulated by the placebo effect. We first performed a screening behavioral experiment for selecting placebo responders and then entered them into a functional magnetic resonance (fMRI) experiment in which they were exposed to the same conditions as before. Participants were informed that it was equally possible to be assigned to the treatment group (placebo manipulation) or the no-treatment group (control); they all, in fact, received treatment and placebo effect would be detected by comparing placebo conditions and no-placebo control condition. Each participant experienced a phase of reinforcing placebo belief with pain in self and a phase of testing transferable placebo effect on empathy for pain. As a result, we found significant activation in sensory areas, including the posterior insula (PI) and the postcentral gyrus, and in the middle cingulate cortex while participants observed pictures of others in pain. More importantly, for the first time, we observed relieved activation in the PI modulated by the placebo effect only associated with pain pictures but not with no-pain pictures. This suggests that sensory activity in the PI might be involved in the processing for empathic pain. This new approach sheds light on research and applications in clinical settings.

Aiming at the problem of unmanned reconfiguration and docking of ground vehicles under complex working conditions, we designed a piece of docking equipment composed of an active mechanism based on a six-degree-of-freedom platform and a locking mechanism with multi-sensors. Through the proposed control method based on laser and image sensor information fusion calculation, the six-dimensional posture information of the mechanism during the docking process is captured in real time so as to achieve high-precision docking. Finally, the effectiveness of the method and the feasibility of the 6-DOF platform are verified by the established model. The results show that the mechanism can meet the requirements of smooth docking of ground unmanned vehicles.

Railway yard is the basic composition unit of railways, therefore, the efficiency and quality of railway yard design have a crucial effect on the construction and operation of railways. Plane design is the basis and core of railway yard design, consequently, it is significant to research plane design of railway yard. In this study, through analysis and summary of the research status as well as integrated application of computer technology and railway yard plane design methods, we researched and developed railway yard plane design system based on AutoCAD platform. According to the characteristics of railway yard plane design, we constructed the information model based on which we established specialized database, with the information data organized and managed efficiently; moreover, we put forward methods of constructing geometric models of the plane equipment, meanwhile, we did a focused research on associated design of yard equipment and preliminarily realized linkage design of planar yards.

Objective: To detect the changes of gray matter volume (GMV) and their correlation with severity of symptom in patients with post-traumatic stress disorder (PTSD) who were defined with updated DSM-5 diagnostic criteria.Method: 71 participants were assigned into PTSD group (n = 35) or trauma-exposed control (TEC) group (n = 36) with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Voxel-based morphometry analysis was used to detect alterations in GMV in the PTSD group.Results: We found that the PTSD group had larger GMV in the left middle temporal gyrus (MTG) and in the right dorsal medial prefrontal cortex (dmPFC), and smaller GMV in the region of the right temporal pole (TP) than the TEC group. We also found that PTSD Checklist for DSM-5 (PCL-5) scores correlated positively with the left MTG and right dmPFC GMV, and negatively with left TP GMV. These correlations were consistent with the findings of the between-group comparisons.Conclusions: GMV alterations in the MTG, dmPFC, and TP are detected in the group comparisons and correlated with symptom severity when classifying PTSD individuals according to DSM-5 diagnostic criteria within an earthquake-exposed population.

In this investigation, the fine-grained bauxite ore flotation was conducted in a plate-packed flotation column. This paper evaluated the effects of packing-plates on recovering fine bauxite particles and revealed the fundamental mechanisms. Bubble coalescence and break-up behaviors in the packed and unpacked flotation columns were characterized by combining Computational Fluid Dynamics (CFD) and Population Balance Model (PBM) techniques. Flotation experiments showed that packing-plates in the collection zone of a column can improve bauxite flotation performance and increase the smaller bauxite particles recovery. Using packing-plates, the recovery of Al2O3 increased by 2.11%, and the grade of Al2O3 increased by 1.85%. The fraction of −20 μm mineral particles in concentrate increased from 47.31% to 54.79%. CFD simulation results indicated that the packing-plates optimized the bubble distribution characteristics and increased the proportion of microbubbles in the flotation column, which contributed to improving the capture probability of fine bauxite particles.

An innovative self-designed medium was packed in a bench-scale flotation column to study its influence on the flotation recovery of bauxite. Computational fluid dynamics (CFD) simulation was conducted to reveal the impact of the packing medium on the turbulent characteristics of collection zone in the column. Simulation results show that multilayer packing of the medium divides the collection zone into small units having different turbulent intensities, which is more suitable for flotation separation. The packing medium decreases the turbulence kinetic energy (from 1.08 × 10−2 m2/s2 to 2.1 × 10−3 m2/s2), turbulence eddy dissipation (from 3.71 × 10−2 m2/s3 to 9.8 × 10−3 m2/s3) and axial fluid velocity of fluid in the column. With three layers of packing, the recovery of Al2O3 increased by 2.11% and the aluminum to silicon content ratio of the concentrate improved from 5.16 to 9.72.

Many studies have been published in recent years focusing on the recovery of rare earth elements (REEs) from coal-related materials, including coal, coal refuse, coal mine drainage, and coal combustion byproducts particularly fly ash. The scientific basis and technology development have been supported by coal geologists and extractive metallurgists, and through these efforts, the concept has progressed from feasibility assessment to pilot-scale production over the last five years. Physical beneficiation, acid leaching, ion-exchange leaching, bio-leaching, thermal treatment, alkali treatment, solvent extraction, and other recovery technologies have been evaluated with varying degrees of success depending on the feedstock properties. In general, physical beneficiation can be a suitable low-cost option for preliminary upgrading; however, most studies showed exceedingly low recovery values unless ultrafine grinding was first performed. This finding is largely attributed to the combination of small RE-bearing mineral particle size and complex REE mineralogy in coal-based resources. Alternatively, direct chemical extraction by acid was able to produce moderate recovery values, and the inclusion of leaching additives, alkaline pretreatment, and/or thermal pretreatment considerably improved the process performance. The studies reviewed in this article revealed two major pilot plants where these processes have been successfully deployed along with suitable solution purification technologies to continuously produce high-grade mixed rare earth products (as high as +95%) from coal-based resources. This article presents a systematic review of the recovery methods, testing outcomes, and separation mechanisms that are involved in REE extraction from coal-related materials. The most recent findings regarding the modes of occurrence of REEs in coal-related materials are also included.

Certain Central Appalachian coals, most notably the Fire Clay coal with a REY-enriched volcanic ash fall tonstein, are known to be enriched in rare earth elements. The Fire Clay tonstein has a greater contribution to the total coal + parting REY than would be inferred from its thickness, accounting for about 20%–35% of the REY in the coal + parting sequence. Underground mining, in particular, might include roof and floor rock and the within-seam partings in the mined product. Beneficiation, necessary to meet utility specifications, will remove some of the REY from the delivered product. In at least one previously published example, even though the tonstein was not present in the Fire Clay coal, the coal was enriched in REY. In this case, as well as mines that ship run-of-mine products to the utility, the shipped REY content should be virtually the same as for the mined coal. At the power plant, however, the delivered coal will be pulverized, generally accompanied by the elimination of some of the harder rock, before it is fired into the boiler. Overall, there are a wide range of variables between the geologic sample at the mine and the power plant, any or all of which could impact the concentration of REY or other critical materials in the coal combustion products.

The IL-33/ST2 signaling pathway plays an important role in coronary artery disease (CHD); however, few studies have explored how variants in IL-33/ST2 genes influence CHD risk. Here, we examined the association between genetic variants in IL-33, ST2, and IL-1RAcP of the IL-33/ST2 axis and the risk of CHD. We conducted a case-controlled study with 1146 CHD cases and 1146 age- and sex-frequency-matched controls. Twenty-eight single nucleotide polymorphisms (SNPs) in IL-33, ST2, and IL-1RAcP were genotyped by Sequenom MassArray and TaqMan assay. Logistic regression was used to analyze these associations. The SNP rs4624606 in IL-1RAcP was nominally associated with CHD risk. The AA genotype was associated with a 1.85-fold increased risk of CHD (95% confidence interval (CI) = 1.01–3.36; p = 0.045) compared to the TT genotype. Further analysis showed that AA carriers also had a higher risk of CHD than TT + TA carriers (odds ratio (OR) = 1.85; 95% CI = 1.85–3.35; p = 0.043). However, no significant association was observed between variants in IL-33/ST2 genes and CHD risk. Further studies are needed to replicate our results in other ethnic groups with larger sample size.

The influence of conditioning on the flotation of pyrrhotite in the presence of chlorite was investigated through flotation tests, sedimentation tests, and X-ray photoelectron spectroscopy (XPS) analysis. The flotation results show that chlorite slimes dramatically impair the flotation of pyrrhotite. Sedimentation and flotation tests reveal that conditioning can effectively remove chlorite slimes from pyrrhotite surfaces, resulting in an enhanced flotation recovery of pyrrhotite. When mixed minerals were conditioned under the natural atmosphere, a faster conditioning speed and longer conditioning time decreased the flotation recovery of pyrrhotite. However, when mixed minerals were conditioned under a nitrogen atmosphere, a more intensive conditioning process provided better flotation results. XPS analyses illustrate that a faster conditioning speed and longer conditioning time under the natural atmosphere accelerates the oxidation of pyrrhotite, leading to a decrease in the flotation recovery of pyrrhotite.

Although the regulatory role of cognitive reappraisal in negative emotional responses is widely recognized, this reappraisal's effect on acute saliva secretory immunoglobulin A (SIgA), as well as the relationships among affective, immunological, and event-related potential (ERP) changes, remains unclear. In this study, we selected only people with low positive coping scores (PCSs) as measured by the Trait Coping Style Questionnaire to avoid confounding by intrinsic coping styles. First, we found that the acute stress of viewing unpleasant pictures consistently decreased SIgA concentration and secretion rate, increased perceptions of unpleasantness and amplitude of late positive potentials (LPPs) between 200-300 ms and 400-1000 ms. After participants used cognitive reappraisal, their SIgA concentration and secretion rate significantly increased and their unpleasantness and LPP amplitudes significantly decreased compared with a control condition. Second, we found a significantly positive correlation between the increases in SIgA and the decreases in unpleasantness and a significantly negative correlation between the increases in SIgA and the increases in LPP across the two groups. This study is the first to demonstrate that cognitive reappraisal reverses the decrease of SIgA. In addition, it revealed strong correlations among affective, SIgA and electrophysiological changes with convergent multilevel evidence.

The vast majority of decision-making research is performed under the assumption of the value maximizing principle. This principle implies that when making decisions, individuals try to optimize outcomes on the basis of cold mathematical equations. However, decisions are emotion-laden rather than cool and analytic when they tap into life-threatening considerations. Using functional magnetic resonance imaging (fMRI), this study investigated the neural mechanisms underlying vital loss decisions. Participants were asked to make a forced choice between two losses across three conditions: both losses are trivial (trivial-trivial), both losses are vital (vital-vital), or one loss is trivial and the other is vital (vital-trivial). Our results revealed that the amygdala was more active and correlated positively with self-reported negative emotion associated with choice during vital-vital loss decisions, when compared to trivial-trivial loss decisions. The rostral anterior cingulate cortex was also more active and correlated positively with self-reported difficulty of choice during vital-vital loss decisions. Compared to the activity observed during trivial-trivial loss decisions, the orbitofrontal cortex and ventral striatum were more active and correlated positively with self-reported positive emotion of choice during vital-trivial loss decisions. Our findings suggest that vital loss decisions involve emotions and cannot be adequately captured by cold computation of minimizing losses. This research will shed light on how people make vital loss decisions.

The conventional variable-diameter wheel's complex control system and structure seriously affect its mobility and dependability in unstructured terrain. Based on 4-dimensional (4D) printing technology, this work proposes a self-folding composite variable-diameter wheel consisting of a self-folding structure and an outer hub that can self-adjust the wheel diameter under thermal stimulation, avoiding the drawbacks of conventional structures. The structure integrates the control system and variable-diameter mechanical structure using 4D printing. The design and construction of the self-folding structures are introduced, and the mathematical model and design parameters for self-folding motion are obtained using kinematic analysis. Based on the above research and material properties analysis, a programmable morphing structural design and morphing influence investigation based on manufacturing parameters are carried out for the self-folding rod that controls the contraction of this structure. The digital model and prototype have been developed to verify the feasibility of the design and the correctness of the theoretical analysis and to realize the self-adjusting wheel diameter under thermal stimulation. [ABSTRACT FROM AUTHOR]