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Abstract Based on the research progress and traditional usage with whole herbal of the TCM "Tianma", chemical studies herein on the flower branch of Gastrodia elata were carried out in-depth and got 13 compounds including the gastrodinols (1–4), the flavonoid morins (5–8, 11–12), together with the specialist mulberrofurans (9, 13) and gastrodiamide (10) for the first time from the species. The antibacterial and cholinesterase inhibitory activities were then evaluated and the results showed that compounds 5, 11, 12, 13 have good activity against anti-methicillin-resistant Staphylococcus aureus, and compounds 9, 13 had good acetylcholinesterase inhibitory activity. All these results provide new chemical composition for better understanding the traditional application of "Tianma" and for exploring new pharmacological ingredients. Graphical Abstract

Abstracts: The Internet of Things (IoT) has been growing quickly since the 5 G era arrived, which has boosted the quantity of data stream and computational demands. Ultra-dense Edge Computing (UDEC) is a result of the growing popularity of Mobile Edge Computing (MEC) and Ultra-dense Network (UDN), two vital technologies with bright futures. Task offloading is viewed in the UDEC network as a successful strategy to offer mobile users low-latency and flexible computing capabilities. However, the edge cloud's constrained computing capacity and mobile users' dynamically shifting computing requirements present difficulties for the reasonable scheduling of computing requests to the edge cloud. The Power Allocation (PA) problem for mobile users to address this issue. This problem attempts to use quasiconvex technique to minimize energy consumption. Next, the Joint Request Offloading and Resource Scheduling (JRORS) problem is treated as a mixed-integer nonlinear programming problem to minimize request delay and improve welfare. The request offloading problem and the computational resource scheduling challenge are two subproblems of the JRORS problem that can be further broken down, the JRORS issue is therefore viewed as a dual decision-making problem. A Ratio of Power Consumption to Welfare (RCW) problem through mathematical modeling. An improved snake optimizer (SO) is therefore proposed, which was added with oscillation factor to optimize the location of the weight parameter in the location update and the variation of food production. It can enhance the global search capability and local search ability. By conducting simulation experiments, divide the mobile users into nine groups for testing, select energy consumption, welfare, and RCW as the objective functions, respectively, and compare them with other swarm optimization algorithms, such as Differential Evolution (DE), Particle Swarm Optimization (PSO), Ant-Lion Optimizer (ALO), Butterfly Optimization Algorithm (BOA), and Gray Wolf Optimizer (GWO). The improved algorithm achieved minimal energy consumption and optimal welfare in nearly every test case, contributing to the enhanced effectiveness and cost-efficiency of edge systems, thereby achieving the optimization of task offloading and scheduling.

Objective To investigate the application effect of narrative medicine in the ideological and political education of Traditional Chinese Medicine nursing courses. Methods Totally120 nursing students from two classes in a certain university of Traditional Chinese Medicine were divided into the two groups by cluster grouping method. The course assessment score, narrative nursing knowledge-attitude-behavior questionnaire and Jefferson Scales of Empathy (JSE) were used to evaluate the teaching effect. Results The final exam scores for the study group and control groups were (87. 65±8. 42) points and (79. 34±4. 23) points, respectively, and with a significant difference (P＜0. 01). The narrative nursing knowledge-attitude-behavior scores for the study group and control groups were (98. 54±4. 73) points and (80. 23±4. 51) points, respectively, with a significant difference (P＜0. 01). The JSE scores for the study group and control groups after training were (118. 27±8. 13) points and (105. 47±6. 24) points, respectively, with a significant difference (P＜0. 01). Conclusion It is effective to improve the teaching effect and empathy level of nursing students by integrating narrative medicine into the ideological and political education of Traditional Chinese Medicine nursing courses (目的 探讨叙事医学融入《中医护理学》课程思政教学中的应用效果。方法 2021年9月—12月, 选取两个班级120名护理专业学生为对象, 其中一个班级(n=60)设为对照组, 按照《中医护理学》教学大纲内容进行教学; 另一个班级(n=60)设为研究组, 将叙事医学融入《中医护理学》课程思政教学。对比两组课程总成绩、叙事护理知识-态度-行为问卷、Jefferson同理心测量量表(JSE)评分。结果 研究组学生课程总成绩为(87. 65±4. 23)分, 差异有统计学意义(P＜0. 01); 研究组学生叙事护理知信行得分为(98. 54±4. 73)分, 高于对照组的(80. 23±4. 51)分, 差异有统计学意义(P＜0. 01)。研究组学生JSE量表得分为(118. 27±6. 24)分、差异有统计学意义(P＜0. 01)。结论 将叙事医学融入中医护理学课程思政教学, 有助于提高教学效果, 提升护生共情水平。)

Transfer of learning is a fundamental goal of education but is challenging to achieve, especially where far transfer to remote contexts is at stake. How can we improve learners' flexible application of knowledge to distant domains? In a counterintuitive phenomenon termed the "derring effect," deliberately committing and correcting errors in low-stakes contexts enhances learning more than avoiding errors. Whereas this benefit has been demonstrated with tests in domains similar to those in the initial learning task, the present set of three experiments (N = 120) investigated whether deliberate erring boosts far transfer of conceptual knowledge to dissimilar domains. Undergraduates studied scientific expository texts either by generating conceptually correct responses or by deliberately generating conceptually erroneous responses then correcting them. Deliberate erring improved not only retention (Experiment 1), but also far transfer on inferential test questions that required applying the learned concepts to remote knowledge domains (e.g., from biology/vaccines to geography/forest management techniques; Experiment 2). This advantage held even over a control that further involved spotting and correcting the same errors that one's peers had deliberately made (Experiment 3). Yet, learners failed to predict or recognize the benefits of deliberate erring even after the test. Altogether, these results suggest that the derring effect is specific to generating incorrect, but not correct, elaborations. Neither does mere exposure to others' errors nor juxtaposing these errors with the correct responses suffice. Rather, guiding learners to personally commit and correct deliberate errors is vital for enhancing generalization and far transfer of learning to distant knowledge domains.

BackgroundFungal infections are associated with high morbidity and mortality in the intensive care unit (ICU), but their diagnosis is difficult. In this study, machine learning was applied to design and define the predictive model of ICU-acquired fungi (ICU-AF) in the early stage of fungal infections using Random Forest.ObjectivesThis study aimed to provide evidence for the early warning and management of fungal infections.MethodsWe analyzed the data of patients with culture-positive fungi during their admission to seven ICUs of the First Affiliated Hospital of Chongqing Medical University from January 1, 2015, to December 31, 2019. Patients whose first culture was positive for fungi longer than 48 h after ICU admission were included in the ICU-AF cohort. A predictive model of ICU-AF was obtained using the Least Absolute Shrinkage and Selection Operator and machine learning, and the relationship between the features within the model and the disease severity and mortality of patients was analyzed. Finally, the relationships between the ICU-AF model, antifungal therapy and empirical antifungal therapy were analyzed.ResultsA total of 1,434 cases were included finally. We used lasso dimensionality reduction for all features and selected six features with importance ≥0.05 in the optimal model, namely, times of arterial catheter, enteral nutrition, corticosteroids, broadspectrum antibiotics, urinary catheter, and invasive mechanical ventilation. The area under the curve of the model for predicting ICU-AF was 0.981 in the test set, with a sensitivity of 0.960 and specificity of 0.990. The times of arterial catheter (p = 0.011, OR = 1.057, 95% CI = 1.053–1.104) and invasive mechanical ventilation (p = 0.007, OR = 1.056, 95%CI = 1.015–1.098) were independent risk factors for antifungal therapy in ICU-AF. The times of arterial catheter (p = 0.004, OR = 1.098, 95%CI = 0.855–0.970) were an independent risk factor for empirical antifungal therapy.ConclusionThe most important risk factors for ICU-AF are the six time-related features of clinical parameters (arterial catheter, enteral nutrition, corticosteroids, broadspectrum antibiotics, urinary catheter, and invasive mechanical ventilation), which provide early warning for the occurrence of fungal infection. Furthermore, this model can help ICU physicians to assess whether empiric antifungal therapy should be administered to ICU patients who are susceptible to fungal infections.

Background: Active vitamin D analog eldecalcitol is clinically applied in treatment of postmenopausal osteoporosis. This study aims to determine the role of eldecalcitol in the protection of osteocytes from senescence and the associated ferroptosis. Methods: The MLO-Y4 osteocytes were exposed to D-gal inducing senescence. The ovariectomized (OVX) mice treated with D-gal using as an aging inducer were intraperitoneally injected with eldecalcitol. The multiplexed confocal imaging, fluorescence in situ hybridization and transmission electron microscopy were applied in assessing osteocytic properties. Immunochemical staining and immunoblotting were carried out to detect abundance and expression of molecules. Results: The ablation of vitamin D receptor led to a reduction in amounts of osteocytes, a loss of dendrites, an increase in mRNA expression of SASP factors and in protein expression of senescent factors, as well as changes in mRNA expression of ferroptosis-related genes (PTGS2 & RGS4). Eldecalcitol reversed senescent phenotypes of MLO-Y4 cells shown by improving cell morphology and density, decreasing β-gal-positive cell accumulation, and down-regulating protein expression (P16, P21 & P53). Eldecalcitol reduced intracellular ROS and MDA productions, elevated JC-1 aggregates, and up-regulated expression of Nrf2 and GPX4. Eldecalcitol exhibited osteopreserve effects in D-gal-induced aging OVX mice. The confocal imaging displayed its improvement on osteocytic network organization. Eldecalcitol decreased the numbers of senescent osteocytes at tibial diaphysis by SADS assay and attenuated mRNA expression of SASP factors as well as down-regulated protein expression of senescence-related factors and restored levels of ferroptotic biomarkers in osteocytes-enriched bone fraction. It reduced 4-HNE staining area, stimulated Nrf2-positive staining, and promoted nuclear translocation of Nrf2 in osteocytes of mice as well as inhibited and promoted protein expression of 4-HNE and Nrf2, respectively, in osteocytes-enriched bone fraction. Conclusions: The present study revealed the ameliorative effects of eldecalcitol on senescence and the associated ferroptosis of osteocytes, contributing to its preservation against osteoporosis of D-gal-induced senescent ovariectomized mice.

Human pluripotent stem cell-derived cardiovascular progenitor cells (hCVPCs) and cardiomyocytes (hCMs) possess therapeutic potential for infarcted hearts; however, their efficacy needs to be enhanced. Here we tested the hypotheses that the combination of decellularized porcine small intestinal submucosal extracellular matrix (SIS-ECM) with hCVPCs, hCMs, or dual of them (Mix, 1:1) could provide better therapeutic effects than the SIS alone, and dual hCVPCs with hCMs would exert synergic effects in cardiac repair. The data showed that the SIS patch well supported the growth of hCVPCs and hCMs. Epicardially implanted SIS-hCVPC, SIS-hCM, or SIS-Mix patches at 7-day post-myocardial infarction significantly ameliorated functional worsening, ventricular dilation and scar formation at 28- and 90-day post-implantation in C57/B6 mice, whereas the SIS only mildly improved function at 90-day post-implantation. Moreover, the SIS and SIS-cell patches improved vascularization and suppressed MI-induced cardiomyocyte hypertrophy and expression of Col1 and Col3, but only the SIS-hCM and the SIS-Mix patches increased the ratio of collagen III/I fibers in the infarcted hearts. Further, the SIS-cell patches stimulated cardiomyocyte proliferation via paracrine action. Notably, the SIS-Mix had better improvements in cardiac function and structure, engraftments, and cardiomyocyte proliferation. Proteomic analysis showed distinct biological functions of exclusive proteins secreted from hCVPCs and hCMs, and more exclusive proteins secreted from co-cultivated hCVPCs and hCMs than mono-cells involving in various functional processes essential for infarct repair. These findings are the first to demonstrate the efficacy and mechanisms of mono- and dual-hCVPC- and hCM-seeding SIS-ECM for repair of infarcted hearts based on the side-by-side comparison.

Gestational diabetes mellitus (GDM) is a common pregnancy disorder associated with an increased risk of pre-eclampsia and macrosomia. Recent research has shown that the buildup of excess lipids within the placental trophoblast impairs mitochondrial function. However, the exact lipids that impact the placental trophoblast and the underlying mechanism remain unclear. GDM cases and healthy controls were recruited at Kaohsiung Medical University Hospital. The placenta and cord blood were taken during birth. Confocal and electron microscopy were utilized to examine the morphology of the placenta and mitochondria. We determined the lipid composition using liquid chromatography-mass spectrometry in data-independent analysis mode (LC/MSE). In vitro studies were carried out on choriocarcinoma cells (JEG3) to investigate the mechanism of trophoblast mitochondrial dysfunction. Results showed that the GDM placenta was distinguished by increased syncytial knots, chorangiosis, lectin-like oxidized low-density lipoprotein (LDL) receptor-1 (LOX-1) overexpression, and mitochondrial dysfunction. Lysophosphatidylcholine (LPC) 16:0 was significantly elevated in the cord blood LDL of GDM patients. In vitro, we demonstrated that LPC dose-dependently disrupts mitochondrial function by increasing reactive oxygen species (ROS) levels and HIF-1α signaling. In conclusion, highly elevated LPC in cord blood plays a pivotal role in GDM, contributing to trophoblast impairment and pregnancy complications.

Dengue infection is caused by the dengue virus (DENV) and is transmitted to humans by infected female Aedes aegypti and Aedes albopictus mosquitoes. There are nearly 100 million new dengue cases yearly in more than 120 countries, with a five-fold increase in incidence over the past four decades. While many patients experience a mild illness, a subset suffer from severe disease, which can be fatal. Dysregulated immune responses are central to the pathogenesis of dengue, and haematologic manifestations are a prominent feature of severe disease. While thrombocytopaenia and coagulopathy are major causes of bleeding in severe dengue, leucocyte abnormalities are emerging as important markers of prognosis. In this review, we provide our perspective on the clinical aspects and pathophysiology of haematologic manifestations in dengue. We also discuss the key gaps in our current practice and areas to be addressed by future research.