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Abstract Aims To describe the home care experience, challenges and coping strategies of caregivers with children on automatic peritoneal dialysis (PD) in mainland China during the early stage of the COVID‐19 outbreak. Design A qualitative descriptive approach was adopted. Semi‐structured telephone interviews were conducted among 14 families with children on automatic peritoneal dialysis from February 2nd to 10th, 2020. The care routine, stress and coping strategies of caregivers of children on peritoneal dialysis were collected. The data were analysed using thematic analysis. Methods Four key themes were defined: (1) concerns about PD treatment intertwined with worries about COVID‐19; (2) retaining a sense of normality in the middle of the challenges; (3) staying safe; and (4) staying positive and carrying on. Results Families with children on automatic PD addressed the stress from COVID‐19 and its containment measures by closely adhering to COVID‐19 preventative measures, actively adjusting mentality and maintaining a sense of normality during the outbreak. This implies that healthcare staff need to be more aware of the complex medical needs of families with children on automatic PD, advocate for them and facilitate their navigation through the repurposed healthcare system.

Abstract Background Multiple doses of dexamethasone and tranexamic acid can inhibit postoperative inflammation and reduce fibrinolysis and perioperative blood loss in total knee arthroplasty. In this single-center, double-blind, randomized clinical trial, the aim was to investigate whether applying a tourniquet to patients on dexamethasone and tranexamic acid could further reduce perioperative blood loss. Materials and methods Patients who underwent cemented total knee arthroplasty at our hospital were randomized to receive a tourniquet (n = 71) or not (n = 70) during the procedure. All patients received multiple doses of dexamethasone and tranexamic acid perioperatively. The primary outcome was perioperative blood loss, while secondary outcomes were surgery duration, postoperative laboratory indices of inflammation and fibrinolysis, range of knee motion, VAS pain score, knee circumference, knee swelling rate, homologous transfusion, albumin use, and complications. Results Using a tourniquet was associated with significantly lower intraoperative blood loss (P

Silicosis is a pulmonary disease caused by the inhalation of silica. There is a lack of early and effective prevention, diagnosis, and treatment methods, and addressing silicotic fibrosis is crucial. Quercetin, a flavonoid with anti-carcinogenic, anti-inflammatory, and antiviral properties, is known to have a suppressive effect on fibrosis. The present study aimed to determine the therapeutic effect of quercetin on silicotic mice and macrophage polarity. We found that quercetin suppressed silicosis in mice. It was observed that SiO2 activated macrophage polarity and the macrophage-to-myofibroblast transition (MMT) by transforming the growth factor-β (TGF-β)-Smad2/3 signaling pathway in silicotic mice and MH-S cells. Quercetin also attenuated the MMT and the TGF-β-Smad2/3 signaling pathway in vivo and in vitro. The present study demonstrated that quercetin is a potential therapeutic agent for silicosis, which acts by regulating macrophage polarity and the MMT through the TGF-β-Smad2/3 signaling pathway.

Chemodynamic therapy (CDT), a noninvasive strategy, has emerged as a promising alternative to conventional chemotherapy for treating tumors. However, its therapeutic effect is limited by the amount of H2O2, pH value, the hypoxic environment of tumors, and it has suboptimal tumor-targeting ability. In this study, tumor cell membrane-camouflaged mesoporous Fe3O4 nanoparticles loaded with perfluoropentane (PFP) and glucose oxidase (GOx) are used as a tumor microenvironment-adaptive nanoplatform (M-mFeP@O2-G), which synergistically enhances the antitumor effect of CDT. Mesoporous Fe3O4 nanoparticles are selected as inducers for photothermal and Fenton reactions and as nanocarriers. GOx depletes glucose within tumor cells for starving the cells, while producing H2O2 for subsequent ·OH generation. Moreover, PFP, which can carry O2, relieves hypoxia in tumor cells and provides O2 for the cascade reaction. Finally, the nanoparticles are camouflaged with osteosarcoma cell membranes, endowing the nanoparticles with homologous targeting and immune escape abilities. Both in vivo and in vitro evaluations reveal high synergistic therapeutic efficacy of M-mFeP@O2-G, with a desirable tumor-inhibition rate (90.50%), which indicates the great potential of this platform for clinical treating cancer.

Rosacea is a chronic inflammatory skin disease whose late manifestations have not yet been clearly reported in animal models. The objective of this study is to describe the skin lesions and major histopathological changes in a rosacea-like phenotype in mice induced by prolonged LL-37 administration and furthermore, to assess the potential of long-term LL-37 administration in inducing irreversible rosacea-like skin lesion models. Balb/c mice were continuously injected intradermally with LL-37 every 12 h to induce a rosacea-like phenotype. After LL-37 injections were administered for 20 consecutive days, the area of rosacea-like lesions gradually expanded in the first 13 days, then entered a stable phase. Haematoxylin and eosin (H&E) and Van Gieson’s staining showed a high degree of inflammatory cell aggregation, thickening of the epidermis and dermis, and collagen deposition in large quantities. The results of immunofluorescence staining and Western blotting showed that the expression of α-SMA, TNF-α, vimentin, and COL1 in the skin of mice was significantly upregulated. Short-term LL-37 administration induced rosacea-like lesions that only featured the aggregation of inflammatory factors and thickening of the epidermis, whereas no collagen hyperplasia was observed, and a full recovery was noticed. However, rosacea-like skin lesions induced by long-term LL-37 administration did not completely recover. Our study compares rosacea-like lesions induced by short-term versus long-term LL-37 administration, and the results suggest that irreversible rosacea-like lesions can be induced by long-term LL-37 administration.

Abstract Background Patients with rheumatoid arthritis (RA) undergoing bilateral total hip arthroplasty (THA) and total knee arthroplasty (TKA) are an uncommon population, and their outcomes are also difficult to predict. The purpose of this study was to evaluate whether both bilateral cementless THA and cemented posterior-stabilized TKA (PS-TKA) can provide reliable outcomes for RA patients. Methods We retrospectively reviewed 30 RA patients (60 hips and 60 knees) who underwent both elective bilateral cementless THA and cemented PS-TKA, with a minimum follow-up of 2 years. Clinical, patient-reported, and radiographic data were retrospectively analyzed. Results The mean follow-up was 84 months (range, 24–156). By the last follow-up, the post-operative range of motion, Harris Hip Score, Knee Society Score (KSS) clinical, KSS functional, Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC) hip, and WOMAC knee scores were significantly improved compared to the preoperative values. All patients achieved the ability to walk. In addition, overall satisfaction scores on a 100-point scale were 92.5 after THA and 89.6 after TKA. Only one patient underwent revision surgery due to knee joint instability, and all replaced hips and knees were radiographically stable by the assessment of the radiolucent line. The proportion of implants that did not suffer loosening or require revision surgery was 99.2% during the 84-month follow-up, based on Kaplan-Meier analysis. Conclusions Our study suggests that bilateral cementless THA and cemented PS-TKA provides reliable mid-long-term clinical, patient-reported, and radiographic outcomes in RA patients, with high survivorship and patient satisfaction.

Abstract Background Blau syndrome is a rare autoinflammatory disease caused by autosomal dominant mutations in the CARD15/NOD2 gene. Vascular involvement is a rare phenotype in Blau syndrome patients. In this study, we aimed to describe a 20-year- old Chinese girl with Blau syndrome complicated by renal arteritis. In addition, we summarized a literature review of published cases of vascular involvement in patients with Blau syndrome. Case presentation We describe a 20-year-old girl who was initially misdiagnosed with juvenile idiopathic arthritis (JIA) almost 15 years prior. In October 2019, she developed renal arteritis at the age of 17 years and was eventually diagnosed with Blau syndrome. A de-novo M513T mutation was found in her gene testing. A review of the literature on patients with Blau syndrome and vasculitis showed that a total of 18 cases were reported in the past 40 years. The vast majority of them were predominantly involved medium and large vessel arteritis. Of the 18 patients included in our literature review, 14 patients had aorto-arteritis, and 4 of them had renal artery involvement. Two patients presented with renal artery stenosis, 1with a sinus of Valsalva aneurysm, and 1 with retinal vasculitis. Conclusion A detailed medical history inquiry and a careful physical examination are helpful for the early identification of Blau syndrome, especially for infant onset refractory JIA. Medium-and large-vessel arteritis is a rare clinical manifestation in Blau syndrome patients. Careful examination of the peripheral pulse and measurement of blood pressure at every regular visit may be helpful in the early identification of Blau syndrome-arteritis. Early diagnosis and appropriate treatment may prevent or delay the occurrence of severe symptoms in patients to improve the patient’s quality of life.

Abstract Background Tomato yellow leaf curl virus (TYLCV) is a major monopartite virus in the family Geminiviridae and has caused severe yield losses in tomato and tobacco planting areas worldwide. Wall-associated kinases (WAKs) and WAK-like kinases (WAKLs) are a subfamily of the receptor-like kinase family implicated in cell wall signaling and transmitting extracellular signals to the cytoplasm, thereby regulating plant growth and development and resistance to abiotic and biotic stresses. Recently, many studies on WAK/WAKL family genes have been performed in various plants under different stresses; however, identification and functional survey of the WAK/WAKL gene family of Nicotiana benthamiana have not yet been performed, even though its genome has been sequenced for several years. Therefore, in this study, we aimed to identify the WAK/WAKL gene family in N. benthamiana and explore their possible functions in response to TYLCV infection. Results Thirty-eight putative WAK/WAKL genes were identified and named according to their locations in N. benthamiana. Phylogenetic analysis showed that NbWAK/WAKLs are clustered into five groups. The protein motifs and gene structure compositions of NbWAK/WAKLs appear to be highly conserved among the phylogenetic groups. Numerous cis-acting elements involved in phytohormone and/or stress responses were detected in the promoter regions of NbWAK/WAKLs. Moreover, gene expression analysis revealed that most of the NbWAK/WAKLs are expressed in at least one of the examined tissues, suggesting their possible roles in regulating the growth and development of plants. Virus-induced gene silencing and quantitative PCR analyses demonstrated that NbWAK/WAKLs are implicated in regulating the response of N. benthamiana to TYLCV, ten of which were dramatically upregulated in locally or systemically infected leaves of N. benthamiana following TYLCV infection. Conclusions Our study lays an essential base for the further exploration of the potential functions of NbWAK/WAKLs in plant growth and development and response to viral infections in N. benthamiana.

Rapid and facile detection of specific nucleic acid modifications could have numerous applications. Here the authors present Specific Terminal Mediated Polymerase Chain Reaction (STEM-PCR) as a generic and accessible approach, and demonstrate proof-of-principle cancer biomarker detection.

The fabrication of Al/steel bimetal with a good metallurgical interface is always a great challenge, particularly for the improvement of bonding strength due to the inevitably extensive formation of brittle Al–Fe intermetallic compounds (IMCs) at the interface. Therefore, in this work, the electroplated Cr coating with thickness of 5 μm was firstly used as the interlayer of Al/steel bimetal to suppress Al–Fe IMCs and further improve the interfacial bonding strength. Al/steel bimetal was prepared by compound casting combined with a hot-dip aluminizing process. The results showed that the interface of Al/steel bimetal with Cr interlayer contained an unmolten Cr coating and a reaction layer, in which the latter consisted mainly of Al13Cr4Si4, Al5Cr, Al-rich solid solution and CrSi2 phases. Besides, the morphology of these new Al–Cr–Si and Al–Cr phases was granular rather than the tongue-shaped of Al–Fe phase and the polygonal blocky of Al–Fe–Si phase. Both the microstructure characterization and kinetics calculation results revealed that the application of Cr interlayer could avoid the contact between Fe atoms from steel side and Al atoms from Al alloy side, thereby suppressing the formation of brittle Al–Fe phases at the interface. Moreover, the reaction layer showed a lower nano-hardness than that of without Cr interlayer. With assistance of Cr interlayer, Al/steel bimetal with maximum shear strength of 115.5 MPa was obtained and the interface failed through the Al alloy side. The morphology characteristic and lower nano-hardness of these new phases, the composite structure consisting of Al–Cr–Si and Al–Cr layer together with the Al-rich solid solution layer greatly contributed to the enhancement of the interfacial strength for the Al/steel bimetal.

The seriousness of the greenhouse effect has forced more and more national and international institutions to actively develop carbon dioxide separation technologies, capture and storage technologies to control CO2 emissions. Among the many CO2 separation technologies, adsorption separation is a common method used in mixed gas separation technology at present. Pressure swing adsorption (PSA) has less regeneration time and less energy consumption, so is used more widely than temperature swing adsorption (TSA) and vacuum swing adsorption (VSA), which are the other two types of adsorption separation technologies. However, the adsorption capacity and adsorption selectivity of the existing adsorbents are poor, resulting in high energy consumption. This study is based on the results of industrial process simulation of flue gas from power plants [Sai et al. 2022], when the economic benefits of CO2 / N2 mixed gas PSA separation process are optimal, the adsorption capacity of MOF material is within a certain range. More than 4000 computation-ready, experimental metal-organic frameworks (CoRE MOFs) were calculated using Grand Canonical Monte Carlo (GCMC) high-throughput simulation, the PSA process of 1bar and a temperature of 298K, obtained 142 MOFs with potential performance.

Objectives Implementing ethics is crucial to prevent harm and promote widespread benefits in social experiments based on medical artificial intelligence (MAI). However, insufficient information is available concerning this within the paediatric healthcare sector. We aimed to conduct a comparative survey among paediatricians, nurses and health information technicians regarding ethics implementation knowledge of and attitude towards MAI social experiments at children’s hospitals in Shanghai.Design and setting A cross-sectional electronic questionnaire was administered from 1 July 2022 to 31 July 2022, at tertiary children’s hospitals in Shanghai.Participants All the eligible individuals were recruited. The inclusion criteria were as follows: (1) should be a paediatrician, nurse and health information technician, (2) should have been engaged in or currently participating in social experiments based on MAI, and (3) voluntary participation in the survey.Primary outcome Ethics implementation knowledge of and attitude to MAI social experiments among paediatricians, nurses and health information technicians.Results There were 137 paediatricians, 135 nurses and 60 health information technicians who responded to the questionnaire at tertiary children’s hospitals. 2.4–9.6% of participants were familiar with ethics implementation knowledge of MAI social experiments. 31.9–86.1% of participants held an ‘agree’ ethics implementation attitude. Health information technicians accounted for the highest proportion of the participants who were familiar with the knowledge of implementing ethics, and paediatricians or nurses accounted for the highest proportion among those who held ‘agree’ attitudes.Conclusions There is a significant knowledge gap and variations in attitudes among paediatricians, nurses and health information technicians, which underscore the urgent need for individualised education and training programmes to enhance MAI ethics implementation in paediatric healthcare.

A rapid rise in the popularity of e-scooters has brought forth an increasing number of e-scooter-related conflicts, crashes, and injuries to pedestrians in many cities. There is a pressing need to understand the factors influencing the severity of injury to pedestrians involved in e-scooter collisions. This paper investigates the dynamics of e-scooter-pedestrian collisions and presents a new method for relating the probability of severe head injury to collision speed in e-scooter-pedestrian collisions. A total of 160 computer simulations representing different collision scenarios have been analyzed. Our results have shown that e-scooter speed is the main determinant of the severity of pedestrian head injury. E-scooter speed ranging from 10 to 15 km/h is found to be critical for pedestrian safety as the probability of severe head injury rises rapidly within this speed range. Moreover, an e-scooter-pedestrian collision is more likely to cause severe head injury to the pedestrian than a bicycle-pedestrian collision within the same speed range. It has also been found that the weight of the e-scooter and the direction of impact do not have a strong influence on the collision metrics, especially on the probability of severe head injury. The study has also investigated the post-collision fall mechanism for different pedestrian profiles and the influence of different impact angles. Finally, some recommendations have been proposed, including a speed limit of not more than 11 km/h for e-scooterist on shared paths where the likelihood of pedestrian and e-scooter conflicts is higher. The recommendations could help authorities develop legislation for safe micro-mobility.

Resumo Fundamento Apesar das evidências crescentes de que pacientes com insuficiência cardíaca (IC) são suscetíveis à sarcopenia, o motivo da associação não é bem compreendido. Objetivo O objetivo deste estudo é explorar ainda mais o mecanismo molecular de ocorrência desta complicação. Métodos Conjuntos de dados de expressão gênica para HF (GSE57345) e Sarcopenia (GSE1428) foram obtidos do banco de dados Gene Expression Omnibus (GEO). Genes diferencialmente expressos (DEGs) foram identificados usando pacotes ‘edgeR’ e “limma” de R, e suas funções foram analisadas usando Gene Ontology (GO) e a Enciclopédia de Genes e Genomas de Kyoto (KEGG). Redes de interação proteína-proteína (PPI) foram construídas e visualizadas usando Search Tool for the Retrieval of Interacting Genes (STRING) e Cytoscape. Os genes hub foram selecionados usando o plugin cytoHubba e validados com GSE76701 para IC e GSE136344 para Sarcopenia. As vias relacionadas e os mecanismos moleculares dos genes hub foram realizados pela análise de enriquecimento de genes (GSEA). As análises estatísticas foram realizadas no software R. P < 0,05 foi considerado estatisticamente significativo. Resultados Foram encontrados 114 DEGs comuns. As vias relacionadas ao fator de crescimento, secreção de insulina e cGMP-PKG estavam enriquecidas tanto na IC quanto na sarcopenia. Descobriu-se que CYP27A1, KCNJ8, PIK3R5, TIMP2, CXCL12, KIT e VCAM1 são genes hub significativos após validação com GSEA enfatizando a importância dos genes hub na regulação da resposta inflamatória. Conclusão Nosso estudo revela que a IC e a Sarcopenia compartilham vias e mecanismos patogênicos comuns. Estes achados podem sugerir novas direções para pesquisas futuras sobre a patogênese subjacente.

BackgroundMedical artificial intelligence (AI) has significantly contributed to decision support for disease screening, diagnosis, and management. With the growing number of medical AI developments and applications, incorporating ethics is considered essential to avoiding harm and ensuring broad benefits in the lifecycle of medical AI. One of the premises for effectively implementing ethics in Medical AI research necessitates researchers' comprehensive knowledge, enthusiastic attitude, and practical experience. However, there is currently a lack of an available instrument to measure these aspects. ObjectiveThe aim of this study was to develop a comprehensive scale for measuring the knowledge, attitude, and practice of ethics implementation among medical AI researchers, and to evaluate its measurement properties. MethodsThe construct of the Knowledge-Attitude-Practice in Ethics Implementation (KAP-EI) scale was based on the Knowledge-Attitude-Practice (KAP) model, and the evaluation of its measurement properties was in compliance with the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) reporting guidelines for studies on measurement instruments. The study was conducted in 2 phases. The first phase involved scale development through a systematic literature review, qualitative interviews, and item analysis based on a cross-sectional survey. The second phase involved evaluation of structural validity and reliability through another cross-sectional study. ResultsThe KAP-EI scale had 3 dimensions including knowledge (10 items), attitude (6 items), and practice (7 items). The Cronbach α for the whole scale reached .934. Confirmatory factor analysis showed that the goodness-of-fit indices of the scale were satisfactory (χ2/df ratio:=2.338, comparative fit index=0.949, Tucker Lewis index=0.941, root-mean-square error of approximation=0.064, and standardized root-mean-square residual=0.052). ConclusionsThe results show that the scale has good reliability and structural validity; hence, it could be considered an effective instrument. This is the first instrument developed for this purpose.

Congenital anomalies of the kidney and urinary tract (CAKUT) is a general term for a class of diseases that are mostly caused by intrauterine genetic development limitation. Without timely intervention, certain children with CAKUT may experience progressive decompensation and a rapid decline in renal function, which will ultimately result in end-stage renal disease. At present, a comprehensive understanding of the pathogenic signaling events of CAKUT is lacking. The role of long noncoding RNAs (lncRNAs) in renal development and disease have recently received much interest. In previous research, we discovered that mice overexpressing the lncRNA 4933425B07Rik (Rik) showed a range of CAKUT phenotypes, primarily renal hypoplasia. The current study investigated the molecular basis of renal hypoplasia caused by Rik overexpression. We first used Rapid Amplification of cDNA ends (RACE) to obtain the full-length sequence of Rik in Rik+/+;Hoxb7 mice. Mouse proximal renal tubule epithelial cells (MPTCs) line with Rik overexpression was constructed using lentiviral methods, and mouse metanephric mesenchyme cell line (MK3) with Rik knockout was then constructed by the CRISPR‒Cas9 method. We performed RNA-seq on the Rik-overexpressing cell line to explore possible differentially expressed molecules and pathways. mRNA expression was confirmed by qRT‒PCR. Reduced levels of Wnt10b, Fzd8, and β-catenin were observed when Rik was expressed robustly. On the other hand, these genes were more highly expressed when Rik was knocked out. These results imply that overabundance of Rik might inhibit the Wnt/β-catenin signaling pathway, which may result in renal hypoplasia. In general, such research might help shed light on CAKUT causes and processes and offer guidance for creating new prophylactic and therapeutic strategies.

BackgroundOlaparib has been proven for the treatment of metastatic castration-resistant prostate cancer (mCRPC). This meta-analysis aims to comprehensively evaluate the efficacy and safety of the combination of olaparib and abiraterone in patients with mCRPC.MethodsThe literature in PubMed, Embase, and Cochrane Library up until April 27, 2023, was systematically searched. In the studies included in this meta-analysis, olaparib combined with abiraterone was compared with abiraterone combined with placebo.ResultsTwo randomized controlled trials involving a total of 938 patients were included. Analysis indicated that olaparib combined with abiraterone significantly prolonged radiographic progression-free survival (rPFS: relative risk [RR] 0.66, 95% confidence interval [CI] 0.55–0.79), time to secondary progression or death (PFS2: hazard ratio [HR] 0.72, 95% CI 0.56–0.93), time to first subsequent therapy or death (TFST: HR 0.75, 95% CI 0.63–0.89), time to second subsequent therapy or death (TSST: HR 0.73, 95% CI 0.58–0.93), and confirmed prostate-specific antigen (PSA) response (RR 1.14, 95% CI 1.05–1.24). However, no statistically significant differences were found in the overall survival (OS: HR 0.87 95% CI 0.70–1.09), objective response rate (ORR: RR 0.97, 95% CI 0.70–1.33), and incidence of total adverse events (RR 1.07, 95% CI 0.94–1.22). A notable detail that the combination of olaparib and abiraterone was associated with an increased incidence of high-grade anemia (RR 7.47, 95% CI 1.36–40.88).ConclusionOlaparib combined with abiraterone is effective for patients with mCRPC. However, combination therapy has treatment-related adverse events compared with monotherapy, and this could be improved in future treatment management.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023432287.

The role and mechanisms of integrated stress response inhibitor (ISRIB) on silicosis are still not well defined. In the present study, the effects of ISRIB on cellular senescence and pulmonary fibrosis in silicosis were evaluated by RNA sequencing, micro-computed tomography, pulmonary function assessment, histological examination, and Western blot analysis. The results showed that ISRIB significantly reduced the degree of pulmonary fibrosis in mice with silicosis and reduced the expression of type I collagen, fibronectin, α-smooth muscle actin, and transforming growth factor-β1. Both in vivo and in vitro results showed that ISRIB reversed the expression of senescence-related factors β-galactosidase, phosphor-ataxia telangiectasia mutated, phosphor-ataxia telangiectasia and Rad3-related protein, p-p53, p21, p16, and plasminogen activator inhibitor type 1. The aforementioned results were consistent with the sequencing results. These findings implied that ISRIB might reduce the degree of pulmonary fibrosis in mice with silicosis by inhibiting the cellular senescence of alveolar epithelial cell type II.

Kinesin family member 3 A (KIF3A) decrease have been reported in silicotic patients and rats. However, the detailed mechanisms of KIF3A in silicosis remain unknown. In this study, we demonstrated that KIF3A effectively blocked the expression of β-catenin and downstream myocardin-related transcription factor (MRTF)-A/serum response factor (SRF) signaling, thus inhibiting silica-induced epithelial−myofibroblast transition (EMyT). Moreover, KIF3A was identified as a downstream mediator of an antifibrotic tetrapeptide N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP). Knockdown of KIF3A expression reactivated β-catenin/myocardin-related transcription factor (MRTF)-A/serum response factor (SRF) signaling that was attenuated by Ac-SDKP in vitro. Collectively, our findings suggest that Ac-SDKP plays its anti-fibrosis role via KIF3A-mediated β-catenin suppression, at least in part, in both in vivo model of silicosis and in vitro model of EMyT.

Nontyphoidal Salmonella (NTS) infection can lead to gastroenteritis, enteric fever, and bacteremia. However, bone and joint infections due to NTS are rarely encountered, accounting for only 0.8% of all Salmonella infections and 0.45% of all types of osteomyelitis. We herein report an extremely rare case of acute multifocal osteomyelitis (bilateral femurs and left tibia) with septic arthritis of the bilateral hips caused by Salmonella Dublin in an immunocompetent adult. We performed thorough debridement of the bilateral hips and surgical decompression of the involved bones. At 1 year of follow-up, the patient’s inflammatory biomarkers were within normal limits, and clinical and radiologic examinations showed no signs of infection. We emphasize that invasive NTS can lead to multifocal bone and joint infections in immunocompetent adults. The manifestations of Salmonella osteomyelitis may be insidious; thus, we recommend performing a simultaneous magnetic resonance imaging examination of the bone adjacent to the infected joint to avoid missed or delayed diagnosis. Thorough surgical debridement combined with a long course of sensitive antibiotic therapy is essential to eradicate the infection.

Abstract Recently, increasing studies are indicating a close association between dysregulated enhancers and neurodegenerative diseases, such as Alzheimer’s disease (AD). However, their contributions were poorly defined for lacking direct links to disease genes. To bridge this gap, we presented the Hi-C datasets of 4 AD patients, 4 dementia-free aged and 3 young subjects, including 30 billion reads. As applications, we utilized them to link the AD risk SNPs and dysregulated epigenetic marks to the target genes. Combining with epigenetic data, we observed more detailed interactions among regulatory regions and found that many known AD risk genes were under long-distance promoter-enhancer interactions. For future AD and aging studies, our datasets provide a reference landscape to better interpret findings of association and epigenetic studies for AD and aging process.

Abstract Objectives To characterize the clinical features and outcomes of childhood-onset primary Sjögren’s syndrome (pSS). Methods Patients less than 18 years old who were diagnosed with pSS by paediatric rheumatologists were included, and all patients were applied the 2002 American-European Consensus Group (ACEG) criteria, the 2016 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for pSS, or the 1999 proposed juvenile pSS criteria. The electronic medical records of patients with pSS from 2013 to 2020 were collected and analysed. Results Thirty-nine patients were included. Of them, 27 (69.2%), 38 (97.4%) and 35 (89.7%) patients fulfilled the AECG criteria, ACR/EULAR criteria and proposed juvenile pSS criteria, respectively. The female:male ratio was 3.9:1. The median ages at first signs or symptoms and at diagnosis were 9.2 (4.7, 14.5) years and 10.9 (6.3, 15.0) years, respectively. The main clinical manifestations were rash or purpura (20, 51.3%), followed by fever (12, 30.8%), glandular enlargement/recurrent parotitis (10, 25.6%), and dry mouth and/or dry eyes (9, 23.1%). Twenty-eight (56.4%) patients had systemic damage, the most common of which was haematological involvement (14, 35.9%), followed by hepatic (13, 33.3%) and renal involvement (8, 20.5%). Thirty-eight (97.4%) patients underwent labial minor salivary gland biopsy, and all exhibited focal lymphocytic sialadenitis. All patients had a global ESSDAI score ≥ 1 at diagnosis, and the median total score at diagnosis was 8 (2, 31). Thirty-six (92.3%) patients were followed up for a median time of 23.6 (7.9, 79.5) months, and three patients developed systemic lupus erythematosus (SLE) at follow-up times of 13.3, 38.8 and 63.8 months. Conclusions The presentation of childhood-onset pSS is atypical, and extraglandular manifestations and systemic involvement are more common than in adult-onset pSS. Labial salivary gland biopsy is vital for patients with probable pSS. Some patients may develop SLE over time.

Abstract Background Dementia and psychotropic medications are discussed as risk factors for severe/lethal outcome of the coronavirus disease 2019 (COVID-19). We aimed to explore the associations between the presence of dementia and medication use with mortality in the hospitalized and discharged patients who suffered from COVID-19. Methods We conducted an open-cohort observational study based on electronic patient records from nine geriatric care clinics in the larger Stockholm area, Sweden, between February 28, 2020, and November 22, 2021. In total, we identified 5122 hospitalized patients diagnosed with COVID-19, out of which 762 (14.9%) patients had concurrent dementia and 4360 (85.1%) were dementia-free. Patients’ age, sex, baseline oxygen saturation, comorbidities, and medication prescription (cardiovascular and psychotropic medication) were registered at admission. The hazard ratios (HRs) with 95% confidence intervals (CIs) of in-hospital, 30-day, 90-day, 365-day post-discharge, and overall mortality during the follow-up were obtained. Then, the associations of dementia and medication use with mortality were determined using proportional hazards regression with time since entry as a time scale. Results After adjustment, dementia was independently associated with 68% higher in-hospital mortality among COVID-19 patients compared to patients who were dementia-free at admission [HRs (95% CI) 1.68 (1.37–2.06)]. The increase was consistent post-discharge, and the overall mortality of dementia patients was increased by 59% [1.59 (1.40–1.81)]. In addition, the prescription of antipsychotic medication at hospital admission was associated with a 70% higher total mortality risk [1.70 (1.47–1.97)]. Conclusions The clinical co-occurence of dementia and COVID-19 increases the short- and long-term risk of death, and the antipsychotics seem to further the risk increase. Our results may help identify high-risk patients in need of more specialized care when infected with COVID-19.

As a “plug-and-play” nuclear system, the technology of fission battery enables nuclear reactor systems to function as batteries. Undoubtedly, advanced intelligent technologies have to be adopted to realize the excellent attributes of fission batteries, i.e., economic, standardized, installed, unattended, and reliable, and its commercial applications. This article proposed the edge-cloud collaboration technology for fission batteries to satisfy its intelligent requirements. A detailed framework for a fission battery management system has been developed. To develop such a management system, four types of concrete transmission information for the edge-cloud collaboration (i.e. resource and data, AI technologies, application and services, safety and strategies) are identified. The edge and cloud designs are also discussed in detail, including their hardware and software. A functional framework of edge-cloud collaboration network platform for fission battery management system is developed preliminarily. The framework is based on a three-layer structure, i.e., perception layer, technical layer and application layer. Although no detailed algorithm or verification is introduced (since the edge-cloud collaboration framework has been widely used in some industry fields but not in nuclear engineering), as primarily work for the future detailed study of fission battery, it is necessary and extremely important.

Abstract Background The role of transvaginal sonography (TVS) in screening endometrial cancer and hyperplasia is significant in postmenopausal women. The objective of this study is to determine the endometrium thickness (ET) cut-off to distinguish premalignancy and malignancy in asymptomatic postmenopausal women. Methods We retrospectively evaluated data of 968 eligible patients among 2537 asymptomatic postmenopausal women with ET ≥ 5 mm examined by TVS who were subjected to hysteroscopy and endometrial biopsy between January 1, 2017, and June 30, 2020 in an urban tertiary specialized hospital in China. The patients were divided into two groups according to the pathology outcomes: benign, and atypical hyperplasia (AH) and endometrial carcinoma (EC). The risk factors and the optimal cut-off of ET for detecting AH and EC were determined by logistic regression analysis and receiver operating characteristic curve. Results 2537 patients were offered hysteroscopy during a 42-month period. Finally, 968 patients were included for further analysis. Of these, 8 (0.8%) women were diagnosed with EC and 5 (0.5%) women with AH. The mean ET of AH and EC group was substantially higher than that in benign group (10.4 mm vs. 7.7 mm, P

Abstract Background In children, focal segmental glomerulosclerosis (FSGS) is the main cause of steroid resistant nephrotic syndrome (SRNS). To identify specific candidates and the mechanism of steroid resistance, we examined the formalin-fixed paraffin embedded (FFPE) renal tissue protein profiles via liquid chromatography tandem mass spectrometry (LC-MS/MS). Methods Renal biopsies from seven steroid-sensitive (SS) and eleven steroid-resistant (SR) children FSGS patients were obtained. We examined the formalin-fixed paraffin embedded (FFPE) renal tissue protein profiles via liquid chromatography tandem mass spectrometry (LC-MS/MS). Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment and Gene Ontology (GO) analysis, as well as the construction of protein-protein interaction (PPI) network were performed. Two proteins were further valiadated by immunohistochemistry staining in FSGS patients and mice models. Results In total, we quantified more than 4000 proteins, of which 325 were found to be differentially expressed proteins (DEPs) between the SS and SR group (foldchange ≥2, P

Two-phase flow may almost exist in every branch of the energy industry. For the corresponding engineering design, it is very essential and crucial to monitor flow patterns and their transitions accurately. With the high-speed development and success of deep learning based on convolutional neural network (CNN), the study of flow pattern identification recently almost focused on this methodology. Additionally, the photographing technique has attractive implementation features as well, since it is normally considerably less expensive than other techniques. The development of such a two-phase flow pattern online monitoring system is the objective of this work, which seldom studied before. The ongoing preliminary engineering design (including hardware and software) of the system are introduced. The flow pattern identification method based on CNNs and transfer learning was discussed in detail. Several potential CNN candidates such as ALexNet, VggNet16 and ResNets were introduced and compared with each other based on a flow pattern dataset. According to the results, ResNet50 is the most promising CNN network for the system owing to its high precision, fast classification and strong robustness. This work can be a reference for the online monitoring system design in the energy system.

Objectives To retrospectively investigate the clinical characteristics, prognosis, treatment, and therapy outcome of Chinese patients with primary testicular lymphoma (PTL).Methods we collected data of 49 PTL patients from four hospitals over 13 years. The median age was 63 years old. We described the clinical characteristics of the patients including the laterality, serum lactate dehydrogenase (LDH), pathology classification, stage, International prognostic index (IPI) scores and more.Results Complete remission (CR) was achieved in 34 patients and partial remission (PR) in 3 patients; Progressive disease (PD) was detected in 11 patients, and 10 patients died. The average progression-free survival (PFS) of all patients was 43.92 months, and the average overall survival (OS) was 47.55 months. The Ann Arbor stage, IPI score, and LDH were associated with OS, while Ann Arbor stage, IPI score, LDH, and histotype were significantly associated with PFS. Chemotherapy and radiotherapy following orchiectomy was associated with a significantly longer PFS.Conclusion Most patients can achieve CR after induced therapy or orchiectomy. However, there are many associated prognostic factors.

In recent years, perfluoroalkyl substances (PFASs), a family of fluorinated organic com pounds, have garnered much attention due to their reproductive and developmental toxicity in humans. Polycystic ovary syndrome (PCOS) is a prevalent endocrine disease that affects women of reproductive age and is a significant contributor to female infertility. A previous study suggested that PFASs play a possible role in PCOS. We conducted a clinical study investigating the relationship between PCOS and PFAS in follicular fluid. A total of 73 infertile patients with PCOS and 218 controls were recruited from the International Peace Maternity and Child Health Hospital, affiliated with the Shanghai Jiao Tong University School of Medicine. The concentrations of 12 PFASs in follicular fluid samples and sex hormones in serum were measured. Correlation analysis and multiple linear regression revealed a positive relationship between perfluorooctanoic acid (PFOA) and testosterone (T) concentrations. The adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for each PFAS were estimated using multivariable logistic regression and quantile-based g-computation (QGC). The PFOA concentrations in follicular fluid were correlated with increased odds of PCOS (second vs. first quartile: OR = 3.65, 95% CI: 1.47–9.05, p = 0.005; third vs. first quartile: OR = 2.91, 95% CI: 1.17–7.26, p = 0.022; fourth vs. first quartile: OR = 3.13, 95% CI: 1.21–8.09, p = 0.019; P for trend = 0.032). This association was confirmed with QGC. Mediation analysis suggested that the mediation effect of T in association with PFOA and PCOS was not statistically significant. Our study suggests that PFOA may be a risk factor for PCOS.

Deinococcus radiodurans is an extremophilic microorganism that possesses a unique DNA damage repair system, conferring a strong resistance to radiation, desiccation, oxidative stress, and chemical damage. Recently, we discovered that D. radiodurans possesses an N4-methylation (m4C) methyltransferase called M.DraR1, which recognizes the 5′-CCGCGG-3′ sequence and methylates the second cytosine. Here, we revealed its cognate restriction endonuclease R.DraR1 and recognized that it is the only endonuclease specially for non-4C-methylated 5′-CCGCGG-3′ sequence so far. We designated the particular m4C R.DraR1-M.DraR1 as the DraI R-M system. Bioinformatics searches displayed the rarity of the DraI R-M homologous system. Meanwhile, recombination and transformation efficiency experiments demonstrated the important role of the DraI R-M system in response to oxidative stress. In addition, in vitro activity experiments showed that R.DraR1 could exceptionally cleave DNA substrates with a m5C-methlated 5′-CCGCGG-3′ sequence instead of its routine activity, suggesting that this particular R-M component possesses a broader substrate choice. Furthermore, an imbalance of the DraI R-M system led to cell death through regulating genes involved in the maintenance of cell survival such as genome stability, transporter, and energy production. Thus, our research revealed a novel m4C R-M system that plays key roles in maintaining cell viability and defending foreign DNA in D. radiodurans.

In this study, we synthesized a coumarin–hemicyanine-based deep red fluorescent dye that exhibits an intramolecular charge transfer (ICT). The probe had a large Stokes shift of 287 nm and a large molar absorption coefficient (ε = 7.5 × 105 L·mol−1·cm−1) and is best described as a deep red luminescent fluorescent probe with λem = 667 nm. The color of probe W changed significantly when it encountered cyanide ions (CN−). The absorption peak (585 nm) decreased gradually, and the absorption peak (428 nm) increased gradually, so that cyanide (CN−) could be identified by the naked eye. Moreover, an obvious fluorescence change was evident before and after the reaction under irradiation using 365 nm UV light. The maximum emission peak (667 nm) decreased gradually, whilst the emission peak (495 nm) increased gradually, which allowed for the proportional fluorescence detection of cyanide (CN−). Using fluorescence spectrometry, the fluorescent probe W could linearly detect CN− over the concentration range of 1–9 μM (R2 = 9913, RSD = 0.534) with a detection limit of 0.24 μM. Using UV-Vis spectrophotometry, the linear detection range for CN− was found to be 1–27 μM (R2 = 0.99583, RSD = 0.675) with a detection limit of 0.13 μM. The sensing mechanism was confirmed by 1H NMR spectroscopic titrations, 13C NMR spectroscopy, X-ray crystallographic analysis and HRMS. The recognition and detection of CN− by probe W was characterized by a rapid response, high selectivity, and high sensitivity. Therefore, this probe provides a convenient, effective and economical method for synthesizing and detecting cyanide efficiently and sensitively.

Due to the silent operation of the receiver station in a multistatic radar system, it is difficult for the jammer to generate the cooperative active deception target for the multistatic radar system. Making use of the spatial diversity property, a data level fusion method is proposed to counter the active deception jamming in this paper. According to the spatial correlation difference in physical target and active false target motion states, the deception velocity of the physical target, which is obtained by the radial velocity of each receiver, obeys the Gaussian distribution with zero mean, and the one of the active false target obeys the Gaussian distribution with the mean being its true deception velocity. Based on this fact, the active false target and physical target are discriminated by the deception velocity testing. The proposed deception velocity-based (DVB) method can keep a constant misjudgment probability for physical targets and discriminate active false targets effectively, especially in large deception velocity cases. The simulation verifies the feasibility and validity of the proposed discrimination method. Moreover, the proposed method can be combined with the location information association method to enhance the ability to discriminate the range–velocity joint deception of false targets.

In recent years, superhydrophobic surfaces have attracted significant attention due to their promising applications, especially in ice prevention, reduction in air resistance, and self-cleaning. This study utilizes femtosecond laser processing technology to prepare different surface microstructures on polytetrafluoroethylene (PTFE) surfaces. Through experiments, it investigates the relationship between the solid–liquid contact ratio and surface hydrophobicity. The shape of water droplets on different microstructure surfaces is simulated using ANSYS, and the relationship between surface microstructures and hydrophobicity is explored in the theoretical model. A superhydrophobic surface with a contact angle of up to 166° was obtained by machining grooves with different spacings in polytetrafluoroethylene sheets with femtosecond laser technology. Due to the micro- and nanostructures on the surface, the oleophobicity of the processed oleophilic PTFE surface is enhanced.

Introduction: Comprehensive data on the risk of hospital-acquired (HA) acute kidney injury (AKI) among adult users of opioid analgesics are lacking. This study aimed to systematically compare the risk of HA-AKI among the users of various opioid analgesics. Methods: This multicenter, retrospective real-world study analyzed 255265 adult hospitalized patients who received at least one prescription of opioid analgesic during the first 30 days of hospitalization. Primary outcome was the time from the first opioid analgesic prescription to HA-AKI occurrence. 12 subtypes of opioid analgesics were analyzed, including 9 for treating moderate-to-severe pain and 3 for mild-to-moderate pain. We examined the association between the exposure to each subtype of opioid analgesic and the risk of HA-AKI using Cox proportional hazards models, using the most commonly used opioid analgesic as the reference group. Results: As compared to dezocine, the most commonly used opioid analgesic treating moderate-to-severe pain, exposure to morphine, but not the other 7 types of opioid analgesics, was associated with a significantly increased risk of HA-AKI (adjusted hazard ratio 1.56, 95% confidence interval [CI] 1.40–1.78). The association was consistent in stratified analyses and in a propensity-matched cohort. There were no significant differences in the risk of HA-AKI among the opioid analgesics users with mild-to-moderate pain after adjusting for confounders. Conclusion: The use of morphine was associated with an increased risk of HA-AKI in adult patients with moderate-to-severe pain. Opioid analgesics other than morphine should be chosen preferentially in adult patients with high risk of HA-AKI when treating moderate-to-severe pain.

During the tunnel construction process using the drilling and blasting method, the induced blasting vibration always poses a great threat to the stability and safety of the adjacent tunnel supporting structure. To improve the efficiency and safety of tunnel blasting construction, the vibration propagation and peak particle velocity (PPV) distribution of the lining of an excavated tunnel were investigated during the blasting of an adjacent tunnel located in Guangxi province. The evolution process and distribution characteristics of the PPV of the lining of adjacent tunnels were monitored and analyzed. The results show that the maximum blasting vibration velocity of the lining of the adjacent tunnel can be shown as: PPVx > PPVz > PPVy; hence, the PPVx plays a significant role in the vibration of the adjacent tunnel. According to the tensile stress failure criterion, the PPV threshold was determined to be 12.7 cm/s in this study. To control the damage of surrounding rock induced by the blasting vibration, compound wedge-shaped cutting technology, stress wave dislocation superposition technology, and pre-splitting blasting technology were employed to reduce the impact of blasting vibration on the excavated tunnel.

ObjectiveThis study aimed to provide a realistic observation of survival by major site for 48,866 cancer patients treated at a tertiary cancer hospital in a rural area of China.MethodsPatients with cancer registered between 2007 and 2017 in the Nantong rural area were followed up. The starting date for survival calculation was the date of the first diagnosis of cancer at the Nantong Tumor Hospital, and the closing date was December 31, 2020. Observed survival (OS) was analyzed according to ICD-10 site, sex, age, region, and hospitalization period using the life table method and compared using the Wilcoxon (Gehan) statistic.ResultsThe overall 5-year OS rate was 40.48% for all 48,866 patients, 30.19% for males, and 51.90% for females. The top five cancer sites, accounting for 60.51% of the total cases, were the esophagus, lung, stomach, liver, and cervix, with 5-year OS rates of 33.72%, 18.64%, 32.10%, 19.04%, and 71.51%, respectively. The highest 5-year OS was observed in the thyroid (87.52%) and the lowest was in the pancreas (6.37%). Survival was significantly higher in younger patients than in older patients, with 5-year OSs of 69.26% and 19.84% in those aged 20-29 and 90-99 years, respectively. Five-year OSs improved significantly from 39.35% in 2007-2011 to 41.26% in 2012-2017.ConclusionOverall survival improved over the years, although the improvement at some sites was not significant. The observed survival varies from region to region, reflecting differences in the patterns of major sites, disparities in proportions of hospitalization, and demographic characteristics.

BackgroundPodocyte injury, which involves the podocyte epithelial-mesenchymal transition (EMT) process, is a crucial factor contributing to the progression of diabetic nephropathy (DN) and proteinuria. Our study aimed to examine the protective properties of Angiopoietin-like protein 3 (Angptl3) knockout on podocyte damage and macrophage polarization in DN mice and podocytes treated with HG. Furthermore, we also sought to investigate the underlying molecular mechanism responsible for these effects.MethodsDN was induced in B6;129S5 mice through intraperitoneal injection of 40 mg/kg of streptozotocin (STZ). Subsequently, the changes in renal function, podocyte apoptosis, inflammatory factors (tumor necrosis factor-α [TNF-α], interleukin-6 [IL-6], and interleukin-1β [IL-1β]), IL-10, TGF-β1, IL-1Ra, IL-10Ra, and nephrin were evaluated. Moreover, we investigated the mechanism underlying the role of Angptl3 in macrophages polarization, podocyte injury, podocyte EMT.ResultsOur findings revealed that Angptl3 knockout significantly attenuated STZ or HG-induced renal dysfunction and podocyte EMT. In both in vivo and in vitro studies, Angptl3 knockout led to (1) promote the transformation of M1 type macrophages into M2 type macrophages; (2) amelioration of the reduced expression of nephrin, synaptopodin, and podocin; (3) inhibition of NLRP3 inflammasome activation and release of IL-1β; and (4) regulation of α-SMA expression via the macrophage polarization. (5) After HG treatment, there was an increase in pro-inflammatory factors and foot cell damage. These changes were reversed upon Angptle knockdown.ConclusionOur study suggests that the knockout of Angptl3 alleviates podocyte EMT and podocyte injury by regulating macrophage polarization.

ObjectivesThe study aimed to describe the characteristics of gastrointestinal (GI) involvement in a cohort of hospitalized children with IgA vasculitis (IgAV) in China.MethodWe reviewed the records of hospitalized IgAV patients from January 2014 to December 2020 at one tertiary medical center. The patients were divided into the severe GI group and the non-severe GI group according to the presence of massive GI bleeding and complications. The clinical manifestations, laboratory factors, and treatment were analyzed between the two groups.ResultsA total of 1,179 patients were hospitalized due to IgAV. GI involvement was noted in 50% (589) of the patients, of whom 288 (48.9%) had severe GI involvement. GI complications were observed in 34 patients with IgAV with GI involvement. Rare onset age (

Aimed at the preparation of bimetallic composites by using a liquid–liquid compound casting method with a sound interface, this study focused on the interface evolution with an increase in the pouring time interval. The results revealed that the melt mixing occurred when the pouring interval was 3 s. The transition zone appeared at the interface when the pouring interval was 10 s, and a good metallurgical bond was obtained. When the pouring interval was 20 s, a discontinuous oxide layer appeared at the interface. The oxide layer gap formed a channel for the transport of the SiC particles.

Abstract The widespread promotion of the sulfur‐based cathode is continuously threatened by the dissolution or slow kinetic reactions of polysulfides, resulting in a deterioration of capacity and volume expansion. Herein, a hierarchical imine‐based covalent organic framework (COFs) with AA stacking structure is constructed as a sulfur host matrix. The one‐dimensional channels in COF are decorated with polarized methoxy groups which can confine and immobilize sulfur species through weak interactions, alleviating the shuttle effect during the battery tests. The composite electrode (COF@S) is fabricated through the melt‐diffusion method in one‐pot synthesis and exhibits a slow fading rate (0.20% each cycle) in a 0.5 C stability test. A promising mechanism for constructing the cathode composite is demonstrated in lithium‐sulfur chemistry in this work.

Obesity has become one of the major public health problems in both the developing and developed countries. Recent studies have suggested that the purinergic signalling is involved in obesity-associated end-organ damage through purine P1 and P2 receptors. In the search for new components for the treatments of obesity, we and other researchers have found much evidence that natural plant extracts may be promising novel therapeutic approaches by modulating purinergic signalling. In this review, we summarize a critical role of purinergic signalling in modulating obesity-associated end-organ damage, such as overhigh appetite, myocardial ischemia, inflammation, atherosclerosis, non-alcoholic fatty liver disease (NAFLD), hepatic steatosis and renal inflammation. Moreover, we focus on the potential roles of several natural plant extracts, including quercetin, resveratrol/trans-resveratrol, caffeine, evodiamine and puerarin, in alleviating obesity-associated end-organ damage via purinergic signalling. We hope that the current knowledge of the potential roles of natural plant extracts in regulating purinergic signalling would provide new ideas for the treatment of obesity and obesity-associated end-organ damage.

According to crystal engineering, the pharmaceutical intermediate m-nitrobenzoic acid (MNBA), which contains a carboxylic acid group, was selected as a coformer (CCF) for drug cocrystallization with famotidine (FMT), and a new stable FMT salt cocrystal was synthesized. The salt cocrystals were characterized by scanning electron microscopy, differential scanning calorimetry, thermogravimetric analysis, infrared spectroscopy, powder X-ray diffraction and X-ray single crystal diffraction. A single crystal structure of FMT–MNBA (1:1) was successfully obtained, and then the solubility and permeability of the newly synthesized salt cocrystal were studied. The results showed that, compared with free FMT, the FMT from the FMT–MNBA cocrystal showed improved permeability. This study provides a synthetic method to improve the permeability of BCS III drugs, which will contribute to the development of low-permeability drugs.

An ecological safety pattern is the basic guarantee for pollution control, ecological environmental protection, economic construction, and sustainable social development, and is an important means of integrated and coordinated development, protection, and governance. This study proposes a research method to identify ecological source sites based on the evaluation of the importance of ecosystem services and ecological sensitivity, and to identify ecological corridors using the minimum cumulative resistance model. The empirical analysis was carried out in Yangxin County, Hubei Province, as an example. The results show that the study area has 16 key corridors and 29 potential corridors, a total of 45 ecological corridors, with a total length of 452 km. In addition, these ecological corridors present a network-like intertwined distribution, connecting various ecological source sites and ensuring the connectivity between ecological source sites, while the well-developed water source sites in the study area provide excellent ecosystem service functions such as water containment for the area.

In many shoulder joint diseases, there is often a combination of long head biceps tendon（LHBT）pathology. Biceps pathology is one of the main causes of shoulder pain, and it is effectively managed with tenodesis. Biceps tenodesis can be performed in a variety of ways with different fixation and at different locations. This article introduces an all-arthroscopic suprapectoral biceps tenodesis technique with a 2-suture anchor. Double 360° Lasso Loop is used to fix the biceps tendon, and only one puncture of the biceps tendon was required, which caused little damage to the tendon and was not easy for the suture to slip and fail.

IntroductionChlamydia trachomatis is the etiological agent of the commonest sexually transmitted bacterial infection. This study aimed to examine the prevalence of genital chlamydia and associated risk factors in Chinese female outpatients with genital tract infections.MethodsA prospective, multicenter epidemiological study of genital chlamydia prevalence in 3008 patients with genital tract infections in 13 hospitals in 12 provinces of China was performed between May 2017 and November 2018. Vaginal secretion specimens were collected for the clinical diagnosis of vaginitis, whereas cervical secretion specimens were tested for Chlamydia trachomatis and Neisseria gonorrhoeae. All patients participated in a one-on-one cross-sectional questionnaire interview. ResultsTotally 2,908 participants were included. The prevalence rates of chlamydia and gonococcal infections in women with genital tract infections were 6.33% (184/2908) and 0.01% (20/2908), respectively. Multivariate analysis showed high risk factors for chlamydia were premarital sex behavior, first sexual intercourse before the age of 20 and bacterial vaginosis.DiscussionGiven that most chlamydia cases are asymptomatic and no vaccine is currently available, chlamydia prevention strategies should include behavioral interventions as well as early screening programs to identify and treat individuals with genital tract infections, especially those with the above identified risk factors.

BackgroundOsteoprotegerin (OPG) is a secretory glycoprotein and participates in the progression of atherosclerotic lesions. We aim to explore the relationship between OPG and the prognosis of coronary artery disease (CAD).MethodsPlasma OPG concentrations were measured in 3,766 patients with stable CAD enrolled in the PEACE trial. The PEACE trial (NCT00000558) group followed up the patients and examined their future clinical outcomes.ResultsIn summary, 208 (5.5%) primary outcomes occurred, 295 patients (7.8%) died from all-cause death, 128 (3.4%) died from cardiovascular causes, and 94 (2.5%) experienced heart failure during a median follow-up of 1,892 days. In addition, we found that higher plasma levels of OPG were associated with a higher incidence of all-cause death, cardiovascular death, and heart failure, even after adjusting clinical cofounders.ConclusionIt was demonstrated that elevated plasma OPG levels were associated with an increased incidence of all-cause death, cardiovascular death, and heart failure in patients with stable CAD.Systematic Review Registrationhttps://clinicaltrials.gov/ct2/show/NCT00000558?term=NCT00000558&draw=2&rank=1, identifier: NCT00000558.

ObjectiveIn the present systematic review and meta-analysis, we aimed to evaluate and update the effects of aquatic exercise on physical fitness and quality of life (QoL) in postmenopausal women.MethodsThe databases Cochrane Library, PubMed, Web of Science, and MEDLINE were searched for randomized controlled trials (RCTs) on the topic from inception to July 2022. The GetData software was used to extract data from the published images. RevMan5.4 software was used for statistical analysis. Data are expressed as standardized mean difference (SMD) with 95% confidence intervals (CI). I2 index was employed for heterogeneity. Egger's test was used to assess publication bias. We evaluated the methodological quality of included studies using the Physiotherapy Evidence Database scale.ResultsWe included 594 participants in 16 RCTs (19 comparison groups). The results indicated that aquatic exercise can significantly improve lower limb strength (LLS), upper limb strength (ULS), agility, flexibility, and overall QoL. No significant effects were found on aerobic capacity. Subgroup-analysis results indicated that aquatic exercise only significantly improved LLS, ULS, agility, and flexibility in postmenopausal women < 65 years of age. However, aquatic exercise improves the overall QoL both in postmenopausal women < 65 years and ≥ 65 years. Aquatic resistance exercise significantly improves LLS, ULS, agility and flexibility. In addition, aquatic aerobic exercise can effectively increase LLS, and combined aquatic aerobic and resistance exercise can enhance the overall QoL.ConclusionsAquatic exercise can effectively improve physical fitness and overall QoL in postmenopausal women, but has limited effects on aerobic capacity; thus, it is highly recommended in postmenopausal women.

Mixed-matrix membranes (MMMs) leverage the processability of polymers and selectivity of Metal-Organic Frameworks (MOFs). However, they still suffer from poor interfacial compatibility and limited scalability in preparation. In certain polymers, MOFs can bridge the pores within the polymer membrane, enhancing the CO2 adsorption and solubility properties, thus selectively boosting the CO2 permeability. In this study, high-performance MMMs were prepared using scalable CALF-20 in combination with PIM-1. MMMs with a 5% doping level achieved CO2 permeability up to 8003 barrer with 25% improvement in CO2/N2 selectivity. This enhancement was attributed to well-designed MMMs, where MOFs matched the abundant non-interconnecting pores in the PIM-1 membrane. This study represents a significant advancement towards scaling up the preparation of high-performance MOF-based MMMs for carbon capture applications.