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ObjectivesOur objective was to compare the effectiveness of TXA in improving recurrence in patients with chronic subdural hematoma (CSDH).MethodsEligible randomized controlled trials (RCTs), prospective trials and retrospective cohort studies were searched in PubMed, Cochrane Library, Embase, and CNKI from database inception to December 2023. After the available studies following inclusion and exclusion criteria were screened, the main outcome measures were strictly extracted. Reman v5.4. was used to assess the overall recurrence rate. A random-effects model was used to assess pooled ORs, with the Mantel–Haenszel estimation method applied. Cochran Q (Chi-square) test and I2 statistics were used to assess inter-study heterogeneity. Funnel plots were used to evaluate publication bias.ResultsFrom the 141 articles found during initial citation screening, 9 literatures were ultimately included in our study. Our NMA results illustrated that patients with newly diagnosed Chronic subdural hematoma revealed a significantly improved recurrence rate when patients were treated with Tranexamic acid (OR: 0.33; 95% CI 0.26–0.41; p

Loess mudflow is a unique geological hazard in the Loess Plateau, presenting a significant risk to the lives and properties of the region’s inhabitants. Defining and categorizing loess mudflow scientifically, as well as comprehending their disaster-prone environment and patterns of development, are crucial for implementing effective disaster prevention and mitigation strategies. Based on extensive field investigations and statistical analyses, this study defines and categorizes the loess mudflow into five types: liquefaction flow, freeze-thaw creep, subsurface erosion failure, collapse-mudflow, and erosion-enlargement. Statistical analysis reveals that the drainage area of loess mudflow is mostly concentrated between 0.15 and 30 km2, the bed slope typically ranges from 10‰–200‰, material storage in channels is mostly above 5 × 104 m3/km2, and the rainfall intensity triggering mudflow formation is generally greater than 10 mm/h; furthermore, a correlation analysis between the parameters of loess mudflow and the influencing factors reveals a significant linear growth relationship between mudflow volume and drainage area, and also reveals a significant power function relationship with the increase in channel bed slope. However, there is no significant correlation between mudflow volume and solid material storage, and mudflow density shows no significant correlation with drainage area, channel bed slope, or solid material storage. Finally, an empirical formula for estimating mudflow volume is proposed through regression analysis. The research findings aim to provide a theoretical basis for the study and risk assessment of loess mudflow disasters.

BackgroundThe learning curve for percutaneous endoscopic transforaminal discectomy (PETD) is steep, especially for the puncturing and localization procedures. The implementation of 3D printing technology may solve this problem.MethodsA novel individualized 3D-printing template (3D-PT) was designed and utilized in PETD. A prospective randomized controlled trial was performed. A total of 28 patients with lumbar disc herniation treated with PETD were analyzed. Of these, 14 patients were treated with the assistance of 3D printing technology (3D-PT group) in conjunction with fluoroscopy, while the remaining 14 patients were treated exclusively under the guidance of C-arm fluoroscopy (control group).ResultsThe number of puncture attempts in the 3D-PT group was significantly less than in the control group (1.36 ± 0.63 vs. 6.07 ± 3.08, p = 0.000). The 3D-PT group exhibited a significant reduction in both intraoperative puncture fluoroscopies (2.71 ± 1.27 vs. 12.14 ± 6.15, p = 0.000) and the overall number of fluoroscopies (2.71 ± 1.27 vs. 17.43 ± 6.27, p = 0.000). In the 3D-PT group, there was a significant reduction in both the puncture time (5.77 ± 1.82 vs. 13.99 ± 4.36, p = 0.000) and the total operation time (60.39 ± 9.78 vs. 76.25 ± 17.78, p = 0.007). Complications were not observed in either group.ConclusionThe application of the novel individualized 3D-PT for PETD is effective and safe. The technique has substantial potential and is worth widely promoting.

Satellite video object tracking has become an emerging technology for dynamically observing the earth, providing the possibility for tracking moving objects in a short time. Deep learning methods such as CNN-based trackers and transformer-based trackers have been widely applied for single object tracking in natural videos. The target in natural videos is captured by ground sensors, whereas satellite sensors come from high altitudes of hundreds of kilometers or more, the trackers designed for natural videos may suffer the influence of complex background, especially small targets with weak features in view of remote sensing platforms. Furtherly, the confusion of visually similar objects with the target and the deformation of target in satellite videos can also lead to incorrect positioning. To address these problems, we proposed a target-aware bilateral CNN-Transformer network (TabCtNet). In TabCtNet, the bilateral CNN-Transformer architecture with the aggregation and interaction of local spatial information and global temporal context is designed to tackle the challenge of small target with weak features in complex and clutter background in satellite videos. To effectively reduce the impact of similar objects, the target-aware block-erasing strategy (TAS) is constructed to generate weakened heatmaps from the template target mask in a data-driven manner. Moreover, a pixel-wise refinement module with corner-based box estimation (PE) is designed to extract more fine-grained spatial information for more accurate box estimation and reduce the effect of target deformation. Experimental results show that TabCtNet quantitatively and qualitatively outperforms advanced single object tracking methods on two different satellite video datasets with four categories of targets from different scenarios. Furthermore, to investigate the generalizability of the TabCtNet framework, satellite videos sourced from different countries captured by various satellite platforms were used for evaluation, and the results reveal its robust performance across various scenarios.

Abstract Major cereal crops have benefitted from Green Revolution traits such as shorter and more compact plants that permit high-density planting, but soybean has remained relatively overlooked. To balance ideal soybean yield with plant height under dense planting, shortening of internodes without reducing the number of nodes and pods is desired. Here, we characterized a short-internode soybean mutant, reduced internode 1 (rin1). Partial loss of SUPPRESSOR OF PHYA 105 3a (SPA3a) underlies rin1. RIN1 physically interacts with two homologs of ELONGATED HYPOCOTYL 5 (HY5), STF1 and STF2, to promote their degradation. RIN1 regulates gibberellin metabolism to control internode development through a STF1/STF2–GA2ox7 regulatory module. In field trials, rin1 significantly enhances grain yield under high-density planting conditions comparing to its wild type of elite cultivar. rin1 mutants therefore could serve as valuable resources for improving grain yield under high-density cultivation and in soybean–maize intercropping systems.

Abstract Objective Lumbosacral vertebral osteoblastic metastasis is treated with percutaneous vertebroplasty (PVP) combined with 125I seed implantation and PVP alone. Compared to PVP alone, we evaluated the effects of combination therapy with PVP and 125I seed implantation on pain, physical condition, and survival and evaluated the clinical value of PVP combined with 125I particle implantation. Methods We retrospectively analyzed 62 patients with lumbosacral vertebral osseous metastases treated at our hospital between 2016 and 2019. All the patients met the inclusion criteria for 125I implantation, and they were randomly divided into a combined treatment group and a pure PVP surgery group. The visual analog pain scale (VAS), Karnofsky Performance Status (KPS), and survival time were recorded at different time points, including preoperative, postoperative 1 day, 1 month, 3 months, 6 months, 12 months, and 36 months in each group. The variation in clinical indicators and differences between the groups were analyzed using SPSS version 20.0. Correlations between different variables were analyzed using the nonparametric Spearman’s rank test. The Kaplan–Meier method was used to estimate the relationship between survival time and KPS score, VAS score, or primary tumor progression, and survival differences were analyzed using the log-rank test. Multivariate analyses were performed using a stepwise Cox proportional hazards model to identify independent prognostic factors. Results Compared to the PVP treatment group, the pain level in the combined treatment group was significantly reduced (P = 0.000), and the patient’s physical condition in the combination treatment group significantly improved. Kaplan–Meier analysis showed that the survival rate of the PVP group was significantly lower than that of the combination group (P = 0.038). We also found that the median survival of patients in both groups significantly increased with an increase in the KPS score (14 months vs. 33 months) (P = 0.020). Patients with more than three transfer sections had significantly lower survival rates than those with one or two segments of the section (P = 0.001). Further, Cox regression analysis showed that age (P = 0.002), the spinal segment for spinal metastasis (P = 0.000), and primary tumor growth rate (P = 0.005) were independent factors that affected the long-term survival of patients with lumbosacral vertebral osseous metastases. Conclusions PVP combined 125I seeds implantation surgery demonstrated superior effectiveness compared to PVP surgery alone in treating lumbosacral vertebral osseous metastases, which had feasibility in the clinical operation. Preoperative KPS score, spine transfer section, and primary tumor growth rate were closely related to the survival of patients with lumbosacral vertebral osteoblastic metastasis. Age, spinal segment for spinal metastasis, and primary tumor growth can serve as prognostic indicators and guide clinical treatment.

Abstract Hepatocellular carcinoma (HCC) is a prevalent malignancy and there is a lack of effective biomarkers for HCC diagnosis. Living organisms are complex, and different omics molecules interact with each other to implement various biological functions. Genomics and metabolomics, which are the top and bottom of systems biology, play an important role in HCC clinical management. Fatty acid metabolism is associated with malignancy, prognosis, and immune phenotype in cancer, which is a potential hallmark in malignant tumors. In this study, the genes and metabolites related to fatty acid metabolism were thoroughly investigated by a dynamic network construction algorithm named EWS-DDA for the early diagnosis and prognosis of HCC. Three gene ratios and eight metabolite ratios were identified by EWS-DDA as potential biomarkers for HCC clinical management. Further analysis using biological analysis, statistical analysis and document validation in the discovery and validation sets suggested that the selected potential biomarkers had great clinical prognostic value and helped to achieve effective early diagnosis of HCC. Experimental results suggested that in-depth evaluation of fatty acid metabolism from different omics viewpoints can facilitate the further understanding of pathological alterations associated with HCC characteristics, improving the performance of early diagnosis and clinical prognosis.

Escherichia coli is an important component of the normal bacterial community in humans and animals. However, in recent years, the pathogenicity of some virulent strains to the outside of the intestine has been confirmed in clinical medicine. The purpose of this study was to analyze the effect of cyaA gene knockout on the biological characteristics and pathogenicity of extraintestinal pathogenic E. coli. In this study, ExPEC strain (XJ10) was isolated from the lung tissue of sheep with respiratory tract infection, and the mutation strain and complementary strain of cyaA gene were constructed. Real-time PCR analysis showed that expression levels of most genes related to carbon source utilization and adhesion invasion were down-regulated in the cyaA mutant compared to the wild type; Quantification of the number of colonies showed that cyaA mutation results in the number of adhesion and invasive to TC-1 cells colonies decreased compared with wild type; Finally, as the cyaA gene mutated, the value of the LD50 increased as compared to wild type, based on the LD50 calculation. Taken together, mutations in the cyaA gene reduce growth rates, resulting in down-regulation of the transcription levels of genes associated with carbon source utilization and adhesion invasion, and a marked reduction in virulence.

Through the active control of shield thrust system oil pressures, a synchronous shield tunnelling technology combining advancement and segment fabrication was proposed. The key to this technology was to completely exploit the additional stroke of the hydraulic jacks generated by the axial insertion of a key block to assemble the segments. Taking the tunnelling project of the Shanghai Airport Railway Link Line as a demonstration project, this paper uses a large model test platform for this synchronous technology. A single-ring construction process along a straight line was simulated, in which the theoretical external loads were implemented on the shield machine. The feasibility and reliability of this synchronous technology were evaluated considering the accuracy of total thrust force control, maintenance of tunnelling speed and shield postures and segment compression. The effectiveness of the redistribution principle for the missing thrust force due to the withdrawal of cylinders located in the segment fabrication region was discussed. Furthermore, some other interesting phenomena were observed in the practical application in addition to the model test. This technology primarily realizes synchronous assembly by improving the control of the propulsion system of conventional shield machines without any transformation of the shield machine’s primary structure, segment patterns or excavation method. The proposed method has good adaptability and a low construction cost, which will be beneficial for future long-distance tunnelling projects.

Abstract With the rapid urbanization process in China, there has been a significant development of urban underground spaces. The pipe-jacking method has gained popularity in various projects due to its advantages such as short construction period, adaptability to different soil conditions, and minimal excavation disturbance. This study focuses on a tunnel project involving double-hole rectangular pipe-jacking under an expressway. Utilizing FLAC software, a three-dimensional numerical model was created to analyze the impact of double-hole pipe-jacking construction on surface settlement and deformation of the expressway. The simulation results were validated by comparing them with field monitoring data. The study also investigated the impact of different construction parameters, such as excavation sequence and the angle of underpassing the expressway, on surface settlement. Additionally, the surface settlement curve at the slope bottom of the expressway exhibits asymmetric distribution and an offset center in the settlement trough. It is recommended to carry out the construction of double-hole pipe-jacking in the sequence of "big first and then small". Furthermore, when the included angle between the expressway and the jacking axis is 90°, the impact on surface settlement is minimized. This research provides valuable insights for the construction of double-hole pipe-jacking underpass structures in tunnel engineering.

Purposes Methane dehydroaromatization (MDA) is a frontier topic in the field of natural gas chemical industry. Methods Mo/commercial-HZSM-5, Mo/nano-HZSM-5, and Mo/hollow capsule HZSM-5 were synthesized by using a conventional wet impregnation strategy. The samples were characterized by ICP, XRD, BET, SEM, TEM, NH3-TPD, and XPS, and tested in MDA reaction. The properties of carbonaceous species were measured by TG and TPO techniques. The carbon cycle path was investigated through periodic 12CH4/13CH4 isotope switch pulse experiment over Mo/hollow capsule HZSM-5 catalyst during MDA reaction. Findings The active carbonaceous species located inside the pores could take part in the formation of benzene. Among these three Mo-based catalysts, the Mo/hollow capsule HZSM-5 showed higher CH4 conversion and aromatic yield, as well as superior catalytic lifespan. Compared to Mo/nano-HZSM-5 in zeolite particle size and acidity, Mo/hollow capsule HZSM-5 with lower deactivation rate is attributed enhanced gas molecules diffusion in its hollow capsule structure.

Abstract Primary aldosteronism (PA) with unilateral adrenal disease can be cured or improved by adrenalectomy. Adrenal venous sampling (AVS) is recommended to identify patients for surgical management. However, surgeries based on computed tomography (CT) images are only advocated for PA patients aged 55 years old were likely to have worse biochemical outcomes; however, these were still not significantly different (21.4% vs. 8.6%, p = 0.220). Of the 114 AVS‐based patients who achieved complete biochemical success, 37 (32.4%) with bilateral normal or bilateral abnormal CT images changed treatment options according to AVS results, 1 (0.9%) avoided adrenalectomy on the wrong side. Our results indicated that surgery based on CT images might be feasible for highly selected PA patients with visible unilateral adenomas and less limited by age, while for those with normal adrenal or bilateral adrenal lesions, treatment strategy must be decided by AVS.

In order to predict the damage of submarine pipeline on saturated clay seabed by falling objects, a dynamic finite element model of interaction between saturated clay seabed and submarine pipeline under the impact of falling objects was established. The influence of six parameters, namely, energy of falling objects, diameter of the pipeline, wall thickness, grade of the steel material, internal pressure, and undrained shear strength of seabed soil on the damage of the submarine pipeline was analyzed by combining with the range of changes of the actual working conditions of the submarine pipeline. Taking the six parameters as input parameters, the damage of pipeline as output parameters, and the numerical simulation results as training samples, a BP neural network model for submarine pipeline damage prediction was constructed through learning and training. The results show that the larger the impact energy of the falling object is, the larger the pipeline damage is, and the pipeline damage growth rate tends to slow down with the increase in the impact energy of the falling object. The increase in pipeline diameter, wall thickness, internal pressure, and the pipeline yield strength leads to a decrease in the pipeline damage. The saturated soil undrained shear strength increases, while pipe damage increases. The established BP neural network prediction model for submarine pipe damage needs only six parameters, namely, falling object impact energy, pipe diameter, wall thickness, steel grade, internal pressure and undrained shear strength of seabed soil. It is simple and convenient, and can better predict the damage of submarine pipeline impacted by falling objects in saturated clay seabed. The numerical examples cover the working conditions of common saturated clay seabed submarine pipelines, so the model has good applicability, which provides new ideas for the prediction of submarine pipeline damage.

Abstract Background The triglyceride-glucose (TyG) index, which is a reliable substitute indicator for insulin resistance, has been considered an independent risk factor for long-term outcomes in patients with cardiovascular disease. However, it remains unknown whether the TyG index is associated with poor prognosis in acute coronary syndrome (ACS) patients with prior coronary artery bypass grafting (CABG) undergoing percutaneous coronary intervention (PCI). Methods A total of 1158 ACS patients with prior CABG undergoing PCI were retrospectively studied. The TyG index was calculated by ln[fasting triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2]. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), a composite of all-cause death, nonfatal myocardial infarction, nonfatal stroke, and unplanned repeat revascularization. Results During a median of 42-month follow-up, 350 patients (30.2%) experienced at least one endpoint event. Based on the optimal cut-off value of the TyG index, patients were divided into the high TyG index group and the low TyG index group. Patients in the high TyG index group had higher risks of MACCE (35.3% vs. 25.3%, p

Abstract. Background:. Existing evidence suggests that fruit consumption is a significant influencing factor for chronic obstructive pulmonary disease (COPD), but this is unclear in the Chinese population. We examined the association of fresh fruit consumption with the risk of COPD-related hospitalization and death in a nationwide, population-based prospective cohort from China. Methods:. Between 2004 and 2008, the China Kadoorie Biobank recruited >0.5 million adults aged 30 to 79 years from ten diverse regions across China. After excluding individuals diagnosed with major chronic diseases and prevalent COPD, the prospective analysis included 421,428 participants. Cox regression was used to calculate the hazard ratios (HRs) for the association between fresh fruit consumption and risk of COPD-related hospitalization and death, with adjustment for established and potential confounders. Results:. During a mean follow-up of 10.9 years, 11,292 COPD hospitalization events and deaths were documented, with an overall incidence rate of 2.47/1000 person-years. Participants who consumed fresh fruit daily had a 22% lower risk of COPD-related hospitalization and death compared with non-consumers (HR = 0.78, 95% confidence interval [CI]: 0.71–0.87). The inverse association between fresh fruit consumption and COPD-related hospitalization and death was stronger among non-current smokers and participants with normal body mass index (BMI) (18.5 kg/m2 ≤ BMI < 24.0 kg/m2); the corresponding HRs for daily fresh fruit consumption were 0.78 (95% CI: 0.68–0.89) and 0.69 (95% CI: 0.59–0.79) compared with their counterparts, respectively. Conclusions:. High-frequency fruit consumption was associated with a lower risk of COPD in Chinese adults. Increasing fruit consumption, together with cigarette cessation and weight control, should be considered in the prevention and management of COPD.

Abstract Background Epidemiological studies demonstrated that multiple amino acids (AAs) were associated with cardiovascular diseases (CVDs), but whether these associations were causal remains unclear. This study aims to investigate the causal relationships between circulating levels of 20 AAs and 10 CVDs in European and East Asian populations by Mendelian randomization (MR). Methods This MR study utilized single-nucleotide polymorphisms that were significantly associated with AAs as instrumental variables. Summary-level data for AAs and CVDs were obtained from public genome-wide association studies. The causal effects were primarily estimated by inverse variance weighting with multiplicative random effect method. Sensitivity analyses, including weighted median, weighted mode, and MR Egger regression, were used to test the robustness of our results. Results In the European population, alanine and serine were inversely associated with angina pectoris (AP) and chronic heart failure, respectively. With each unit increase of leucine, the risk of ischemic stroke increased by 10%. Moreover, tyrosine was positively associated with AP and deep vein thrombosis. In the East Asian population, each unit increase in glycine was associated with 4.1% and 9.0% decreased risks of coronary artery disease (CAD) and myocardial infarction (MI), respectively. A unit increase in serine was associated with 13.1%, 12.6% and 15.5% decreased risks of AP, CAD and MI, respectively. Sensitivity analyses supported the robustness of our results. Conclusions This MR study demonstrated significant causal effects of circulating levels of AAs on CVDs, indicating the potential use of AAs as biomarkers or as therapeutic targets for CVD in clinical scenarios. Graphical Abstract

Abstract Wound healing is one of the major global health concerns in diabetic patients. Overactivation of proinflammatory M1 macrophages could lead to delayed wound healing in diabetes. 4-octyl itaconate (4OI), a derivative of the metabolite itaconate, has aroused growing interest recently on account of its excellent anti-inflammatory properties. Cell membrane coating is widely regarded as a novel biomimetic strategy to deliver drugs and inherit properties derived from source cells for biomedical applications. Herein, we fused induced pluripotent stem cell-derived endothelial cell (iEC) membrane together with M1 type macrophage membrane to construct a hybrid membrane (iEC-M) camouflaged 4OI nanovesicles (4OI@iEC-M). Furthermore, bioinspired nanovesicles 4OI@iEC-M are incorporated into the injectable, multifunctional gelatin methacryloyl hydrogels for diabetic wound repair and regeneration. In our study, bioinspired nanovesicles could achieve dual-targeted deliver of 4OI into both M1 macrophages and endothelial cells, thereby promoting macrophage polarization and protecting endothelial cells. With the synergistically anti-inflammatory and immunoregulative effects, the bioinspired nanovesicles-loaded hydrogels could facilitate neovascularization and exhibit superior diabetic wound repair and regeneration. Taken together, this study might provide a novel strategy to facilitate diabetic wound healing, thereby reducing limb amputation and mortality of diabetes.

Background: Invisibility of subgingival scaling is the most important negative factor affecting the performance of periodontal treatment. A multisensory teaching strategy is used in the preclinical training of undergraduates in order to increase the haptic-auditory-visual feedback, aiming to overcome the invisibility and achieve minimal postoperative complications, improving patients’ treatment experience. Methods: One hundred undergraduate dental students in grade 5 were divided into a multisensory teaching strategy group (MTS: n = 50) and a conventional training pattern group (CTP: n = 50). All participants attended a lecture on using an ultrasonic subgingival scaler (USS) and Gracey curettes (GRA), followed by a 3-week training programme. Students in the MTS group were trained in a haptic/auditory-visual feedback manner, whereas students in the CTP group were trained conventionally. After the training phase, paired students in the 2 different groups performed subgingival scaling in paired patients with equivalent teeth of periodontitis using USS and GRA. Objective and subjective postoperative evaluations were recorded. Probing depth (PD) and gingival index (GI) were evaluated before and 4 weeks after scaling by the same periodontal specialist. Results: MTS significantly reduced treatment time and ameliorated postoperative complications (gingival injury, haemorrhage and root surface roughness; P < .05). Postoperative sensitivity was reduced in the MTS group from day 1 to day 7 (D1–D5: P < .001; D6: P = .002; D7: P = .003), whereas postoperative pain was reduced on day 1 (P = .006), compared with that in the CTP group. The PD reduction was not significant between the groups (MTS: 3.17 ± 0.95 mm vs CTP: 3.07 ± 0.97 mm, P > .05), whereas the GI change showed a significant difference between the groups (MTS: 1.71 ± 0.41 vs CTP: 1.67 ± 0.41, P < .05). Conclusions: Multisensory teaching strategies in the preclinical periodontal training of undergraduates can reduce postoperative complications (gingival injury, postoperative haemorrhage, and root surface roughness) and provide a better treatment experience (decreased treatment time and postoperative pain and sensitivity) for patients.

Microneedles (MNs), characterized by their micron-sized sharp tips, can painlessly penetrate the skin and have shown significant potential in disease treatment and biosensing. With the development of artificial intelligence (AI), the design and application of MNs have experienced substantial innovation aided by machine learning (ML). This review begins with a brief introduction to the concept of ML and its current stage of development. Subsequently, the design principles and fabrication methods of MNs are explored, demonstrating the critical role of ML in optimizing their design and preparation. Integration between ML and the applications of MNs in therapy and sensing were further discussed. Finally, we outline the challenges and prospects of machine learning-assisted MN technology, aiming to advance its practical application and development in the field of smart diagnosis and treatment.

Understanding population genetic structure and its possible causal factors is critical for utilizing genetic resources and genetic breeding of economically important plants. Although Torreya grandis is an important conifer producing nuts in China, little is known about its population structure, let alone the causal factors that shaped its genetic variation pattern and population structure. In this work, we intended to characterize the genetic variation pattern and population structure of the nut-yielding conifer T. grandis throughout its whole geographical distribution and further explore the potentially causal factors for the population structure using multiple approaches. A moderate level of genetic diversity and a novel population structure were revealed in T. grandis based on eleven robust EST-SSR loci and three chloroplast fragments. Alien genetic composition derived from the closely related species T. nucifera endemic to Japan was detected in the Kuaiji Mountain area, where the seed quality of T. grandis is considered the best in China. Demography history and niche modeling were inferred and performed, and the contribution of geographic isolation to its population structure was compared with that of environmental isolation. Significant demographic changes occurred, including a dramatic population contraction during the Quaternary, and population divergence was significantly correlated with geographic distance. These results suggested that early breeding activities and demographic changes significantly contributed to the population structure of T. grandis. In turn, the population structure was potentially associated with the excellent variants and adaptation of cultivars of T. grandis. The findings provide important information for utilizing genetic resources and genetic breeding of T. grandis in the future.

This study aimed to identify whether gyrate atrophy of the choroid and retina (GACR) heterozygous individuals have possible clinical manifestations and to explore the potential pathogenic mechanism. In this retrospective study, we surveyed a two-generation pedigree of an individual diagnosed with GACR. Two family members underwent ophthalmological, hematologic, and genetic tests. An arginine-restricted diet with vitamin B6 supplementation was implemented; clinical assessments were repeated every 3 months during follow-up. The relative OAT mRNA expression was determined using a real-time quantitative polymerase chain reaction. The 19-year-old compound heterozygous daughter (OAT: c.1186C>T; c.748C>T) had bilateral pathologic myopia, posterior staphyloma, chorioretinal atrophy, macular abnormalities, and elevated hematologic ornithine. The 54-year-old heterozygous mother (OAT: c.1186C>T) presented with bilateral pathologic myopia, asymmetric posterior staphyloma, retina and choroidal capillary layer atrophy, retinal pigment epithelium abnormalities, and mildly elevated hematologic ornithine. Compared to normal individuals, the daughter and mother had 29% and 46% relative OAT mRNA expression, respectively (p < 0.001). We believe that this is the first report of a carrier of one OAT variant allele exhibiting a mild phenotype, suggesting that family members should be aware of the possibility of clinical involvement in carriers with some autosomal recessive conditions. Additional data suggest that nonsense-mediated, decay-initiated mRNA degradation may cause GACR.

Longitudinal corrugated tubes (LCTs) exhibit stable platform force under axial compression but have low specific energy absorption. Conversely, circumferential corrugated tubes (CCTs) offer higher specific energy absorption but with unstable platform force. To overcome these limitations, this paper introduces a novel bi-directional corrugated tube (BCT) that amalgamates the strengths of both the CCT and LCT while mitigating their weaknesses. The BCT is formed by rolling a bi-directional corrugated structure into a circular tubular form. Numerical simulations of the BCT closely align with experimental results. The study further examines the influence of discrete parameters on the BCT’s performance through simulations and identifies the tube’s optimal design using the integral entropy TOPSIS method. A full factorial experimental approach is then employed to investigate the impact of radial amplitude, axial amplitude, and neutral surface diameter on the crushing behavior of the BCT, comparing it with the CCT and LCT. The results reveal that increasing Ai enhances the axial resistance of the structure, while increasing Aj reduces the buckling effect, resulting in a higher specific energy absorption and lower ultimate load capacity for the BCT compared to the CCT and LCT. A simultaneous multi-objective optimization of the CCT, LCT, and BCT confirms that the BCT offers superior specific energy absorption and ultimate load capacity. The optimal configuration parameters for the BCT have been determined, providing significant insights for practical applications in crashworthiness engineering.

High-energy-density Li-CO2 batteries are promising candidates for large-capacity energy storage systems. However, the development of Li-CO2 batteries has been hindered by low cycle life and high overpotential. In this study, we propose a CO2-based thermoplastic polyurethane (CO2-based TPU) with CO2 adsorption properties and excellent self-healing performance to replace traditional polyvinylidene fluoride (PVDF) as the cathode binder. The CO2-based TPU enhances the interfacial concentration of CO2 at the cathode/electrolyte interfaces, effectively increasing the discharge voltage and lowering the charge voltage of Li-CO2 batteries. Moreover, the CO2 fixed by urethane groups (-NH-COO-) in the CO2-based TPU are difficult to shuttle to and corrode the Li anode, minimizing CO2 side reactions with lithium metal and improving the cycling performance of Li-CO2 batteries. In this work, Li-CO2 batteries with CO2-based TPU as the multifunctional binders exhibit stable cycling performance for 52 cycles at a current density of 0.2 A g−1, with a distinctly lower polarization voltage than PVDF bound Li-CO2 batteries.

Background: Cardiac autonomic neuropathy (CAN) is a severe complication of type 1 diabetes mellitus (T1DM). This meta-analysis aimed to synthesize relevant literature on the prevalence of CAN and its risk factors in individuals with T1DM. Methods: We screened relevant literature from databases based on predefined search criteria until June 28, 2022. Data extraction and quality assessment were conducted independently by two reviewers. A meta-analysis was conducted to determine the prevalence of CAN and its risk factors in individuals with T1DM using a random-effects model. A subgroup analysis was conducted to assess variations in CAN prevalence based on diabetes duration, diagnostic criteria, study quality, study design, and geographic region of the participants. Results: A total of 21 studies provided information on the prevalence of CAN, while 18 studies explored the potential risk factors for CAN. The overall estimated prevalence of CAN in individuals with T1DM was 25.8% (95% confidence interval (95% CI): 0.208–0.307), with no significant differences observed among the five regions. Additionally, smoking, lipid abnormalities, hypertension, duration of diabetes, increased body mass index, elevated glycated haemoglobin concentrations, and presence of chronic complications of diabetes, such as diabetic retinopathy, diabetic neuropathy, and diabetic nephropathy, were associated with a higher prevalence of CAN in individuals with diabetes. Conclusions: CAN is prevalent in individuals with T1DM worldwide. Efforts should be made to improve early screening and intervention for CAN, as well as to implement strategies aimed at improving or controlling early risk factors associated with CAN.

When faced with salinity stress, plants typically exhibit a slowdown in their growth patterns. Boron (B) is an essential micronutrient for plants that are known to play a critical role in controlling cell wall properties. In this study, we used the model plant Arabidopsis thaliana Col-0 and relevant mutants to explore how the difference in B availability may modulate plant responses to salt stress. There was a visible root growth suppression of Col-0 with the increased salt levels in the absence of B while this growth reduction was remarkably alleviated by B supply. Pharmacological experiments revealed that orthovanadate (a known blocker of H+-ATPase) inhibited root growth at no B condition, but had no effect in the presence of 30 μM B. Salinity stress resulted in a massive K+ loss from mature zones of A. thaliana roots; this efflux was attenuated in the presence of B. Supplemental B also increased the magnitude of net H+ pumping by plant roots. Boron availability was also essential for root halotropism. Interestingly, the aha2Δ57 mutant with active H+-ATPase protein exhibited the same halotropism response as Col-0 while the aha2-4 mutant had a stronger halotropism response (larger bending angle) compared with that of Col-0. Overall, the ameliorative effect of B on the A. thaliana growth under salt stress is based on the H+-ATPase stimulation and a subsequent K+ retention, involving auxin- and ROS-pathways.

Serious games play a key role in the medical field, particularly in enhancing cognitive abilities in the elderly. However, the sensory organs of the elderly decline over time, and the intervention effect of traditional serious games for older adults. The objective of this study is to identify the evolution and current problems of serious game technology for the elderly by using bibliometric analysis. We selected 319 relevant documents from 2013 to 2024 from the Web of Science (WOS) database. This study uses Publish or Perish (Windows GUl Edition) and VOSviewer (1.6.20) for performance analysis and scientific charting. We deeply analyze the early trends, emerging technologies, and publication trends, including citations and journals, subject areas, and regional and institutional. Here, we identified serious games for older adults rely heavily on visual presentation, often utilizing screens for screening, rehabilitation, and therapeutic interventions. This may cause further visual impairment in older adults who are experiencing visual decline. In addition, we proposed the combination of rich tactile feedback and external devices as one of the effective solutions to the current problems for future research.

Abstract China's severe particle pollution could affect the regional climate and weather conditions that consequently threaten local to global food security. Yet, the underlying mechanisms and quantitative assessment of aerosols on crop yields remain unknown. Here, by integrating a meteorology–chemistry model and a crop model, we show the impacts of atmospheric aerosols on China's meteorology and soybean yields. We find that the potential yields of soybean would decrease in most parts of China due to direct aerosol radiation effects, while showing diverse responses in parts of the Northeast and North China Plain. Moreover, because of the high sensitivity of soybean growth to water, potential yield fluctuations are closely related to aerosol‐induced precipitation changes in most soybean‐growing regions of China. In particular, aerosols play the most important role during soybean's pod‐filling stage, in which the influence of both precipitation perturbations and negative solar radiative forcing is about 5–10 times that of air temperature on crop yield. Our study thereby identifies aerosol mitigation can bring a notable increase in crop yields, highlighting the potential for important co‐benefits in food security across polluting developing countries.

Wood essential oil and wood products with special fragrances are high value-added forest products. Despite the availability of essential oil and volatile organic compounds (VOCs) from Phoebe zhennan wood, their variation and dependence on tree age have not been examined. After essential oil extraction and wood processing, the yields and compositions of essential oils and VOCs in wood from P. zhennan trees of different ages (10a, 30a, and 80a) were determined. The yield of essential oil from 30a wood was significantly greater than that from 10a and 80a wood. Liquid chromatography–mass spectrometry (LC−MS) and gas chromatography−mass spectrometry (GC−MS) revealed 672 and 41 volatile compounds, respectively, in the essential oil and wood, the majority of which exhibited large fluctuations in relative content and composition depending on tree age. Sesquiterpenoids, fatty acids and conjugates may greatly contribute to the main components of essential oil from wood. Almost all major sesquiterpenoid compounds, such as caryophyllene α-oxide, eudesmo, and cubebene, were identified in the essential oils from the 30a and 80a wood, and their relative contents were much greater than those in the 10a wood. The main components of the wood fragrance were sesquiterpenoids. The types and relative contents of sesquiterpenoids from wood increased with tree age. These results suggest that choosing wood from trees of a suitable age will significantly improve the efficiency of wood utilization.

Osteoarthritis (OA) is the most common degenerative disease of the joint with irreversible cartilage damage as the main pathological feature. With the development of regenerative medicine, mesenchymal stem cells (MSCs) have been found to have strong therapeutic potential. However, intraarticular MSCs injection therapy is limited by economic costs and ethics. Exosomes derived from MSC (MSC-Exos), as the important intercellular communication mode of MSCs, contain nucleic acid, proteins, lipids, microRNAs, and other biologically active substances. With excellent editability and specificity, MSC-Exos function as a targeted delivery system for OA treatment, modulating immunity, inhibiting apoptosis, and promoting regeneration. This article reviews the mechanism of action of MSC-Exos in the treatment of osteoarthritis, the current research status of the preparation of MSC-Exos and its application of drug delivery in OA therapy.

IntroductionPolycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting reproductive-aged women. Some retrospective studies with small sample sizes have reported that bariatric metabolic surgery is effective in remission of irregular menstruation in patients with PCOS and obesity. However, the correlation between preoperative body mass index (BMI), postoperative weight loss, and remission of irregular menstruation in patients with obesity and PCOS after sleeve gastrectomy (SG) is lack of consensus.MethodsWe enrolled 229 participants with obesity and PCOS who underwent SG. All patients were followed up for one year after surgery. Remission of irregular menstruation was defined as a spontaneous consecutive six-month menstrual cycle in one year. Subgroup analysis was conducted using tertiles of preoperative BMI and postoperative total weight loss (TWL)% to determine their correlation with the remission of irregular menstruation after SG.Results79.03% (181/229) patients achieved remission of irregular menstruation one year after SG with a TWL% of 33.25 ± 0.46%. No significant difference was detected in the remission rate among the subgroups with different BMI (P=0.908). TWL% was correlated with the remission of irregular menstruation (OR 1.78, 95% CI 1.18-2.69, P

Continuous cropping obstacles seriously constrained the sustainable development of the ginseng industry. The allelopathic autotoxicity of ginsenosides is the key “trigger” of continuous cropping obstacles in ginseng. During harvest, the ginseng plants could be broken and remain in the soil. The decomposition of ginseng residue in soil is one of the important release ways of ginsenosides. Therefore, the allelopathic mechanism of ginsenosides through the decomposed release pathway needs an in-depth study. To investigate this allelopathic regulation mechanism, the integrated analysis of transcriptomics and metabolomics was applied. The prototype ginsenosides in ginseng were detected converse to rare ginsenosides during decomposition. The rare ginsenosides caused more serious damage to ginseng hairy root cells and inhibited the growth of ginseng hairy roots more significantly. By high-throughput RNA sequencing gene transcriptomics study, the significantly differential expressed genes (DEGs) were obtained under prototype and rare ginsenoside interventions. These DEGs were mainly enriched in the biosynthesis of secondary metabolites and metabolic pathways, phytohormone signal transduction, and protein processing in endoplasmic reticulum pathways. Based on the functional enrichment of DEGs, the targeted metabolomics analysis based on UPLC-MS/MS determination was applied to screen endogenous differential metabolized phytohormones (DMPs). The influence of prototype and rare ginsenosides on the accumulation of endogenous phytohormones was studied. These were mainly involved in the biosynthesis of diterpenoid, zeatin, and secondary metabolites, phytohormone signal transduction, and metabolic pathways. After integrating the transcriptomics and metabolomics analysis, ginsenosides could regulate the genes in phytohormone signaling pathways to influence the accumulation of JA, ABA, and SA. The conclusion was that the prototype ginsenosides were converted into rare ginsenosides by ginseng decomposition and released into the soil, which aggravated its allelopathic autotoxicity. The allelopathic mechanism was to intervene in the response regulation of genes related to the metabolic accumulation of endogenous phytohormones in ginseng. This result provides a reference for the in-depth study of continuous cropping obstacles of ginseng.

Cellular immunotherapy is a crucial aspect of current tumor immunotherapy, though it presents several challenges such as immune cell dysfunction, limited recognition of neoantigens, and inadequate lymphocyte infiltration into the tumor microenvironment. This study proposes a novel approach utilizing a combination of dendritic cell (DC)-based cellular immunotherapy and a photothermal nanoadjuvant black phosphorus (BP) nanoparticles to overcome these challenges. A new platform called PLGA@BP-R848, which consists of modifying poly-(lactic-co-glycolic acid) (PLGA) onto BP nanosheets loading the immune adjuvant R848. The PLGA@BP-R848 nanoparticles demonstrated exceptional drug delivery and release capabilities, as well as a photothermal effect, biocompatibility, and the ability to activate the mitochondrial apoptotic pathway Blc-2-Bax-Cytochrome c-caspase-3 and inhibit the PI3K-AKT-mTOR signaling pathway. In a hepatocellular carcinoma mouse model, the binding of PLGA@BP-R848 nanoparticles and dendritic cells primed with GPC3 peptides, successfully induced a systemic anti-tumor immune response. PLGA@BP-R848 nanoparticles bolster immune cell infiltration into tumors and induce cancer cell apoptosis. The synergistic therapy involving dendritic cells and photothermal nanoadjuvant effectively suppressed tumor growth, and facilitated the formation of tertiary lymphatic structures (TLS) in tumors. This study presents a novel approach in using photothermal nanoadjuvants to advance antitumor effect of cellular immunotherapy, such as DCs therapy.

The prevalence of diabetes mellitus has exhibited a notable surge in recent years, thereby augmenting the susceptibility to fractures and impeding the process of fracture healing. The primary objective of this investigation is to employ synchrotron radiation phase-contrast imaging computed tomography (SR-PCI-CT) to examine the morphological and structural attributes of different types of callus in a murine model of diabetic partial fractures. Additionally, a deep learning image segmentation model was utilized to facilitate both qualitative and quantitative analysis of callus during various time intervals. A total of forty male Kunming mice, aged five weeks, were randomly allocated into two groups, each consisting of twenty mice, namely, simple fracture group (SF) and diabetic fracture group (DF). Mice in DF group were intraperitoneally injected 60 mg/kg 1 % streptozotocin(STZ) solution for 5 consecutive days, and the standard for modeling was that the fasting blood glucose level was ≥11.1 mmol /l one week after the last injection of STZ. The right tibias of all mice were observed to have oblique fractures that did not traverse the entire bone. At three, seven, ten and fourteen days after the fracture occurred, the fractured tibias were extracted for SR-PCI-CT imaging and histological analysis. Furthermore, a deep learning image segmentation model was devised to automatically detect, categorize and quantitatively examine different types of callus. Image J software was utilized to measure the grayscale values of different types of callus and perform quantitative analysis. The findings demonstrated that: 1) SR-PCI-CT imaging effectively depicted the morphological attributes of different types of callus of fracture healing. The grayscale values of different types of callus were significantly different(P

Triptolide (TP) is the major bioactive component of traditional Chinese medicine Tripterygium wilfordii Hook. F., a traditional Chinese medicinal plant categorized within the Tripterygium genus of the Celastraceae family. It is recognized for its therapeutic potential in addressing a multitude of diseases. Nonetheless, TP is known to exhibit multi-organ toxicity, notably hepatotoxicity, which poses a significant concern for the well-being of patients undergoing treatment. The precise mechanisms responsible for TP-induced hepatotoxicity remain unresolved. In our previous investigation, it was determined that TP induces heightened hepatic responsiveness to exogenous lipopolysaccharide (LPS). Additionally, natural killer (NK) cells were identified as a crucial effector responsible for mediating hepatocellular damage in this context. However, associated activating receptors and the underlying mechanisms governing NK cell represented innate lymphoid cell (ILC) activation remained subjects of inquiry and were not yet investigated. Herein, activating receptor Killer cell lectin like receptor K1 (NKG2D) of group 1 ILCs was specifically upregulated in TP- and LPS-induced acute liver failure (ALF), and in vivo blockade of NKG2D significantly reduced group 1 ILC mediated cytotoxicity and mitigated TP- and LPS-induced ALF. NKG2D ligand UL16-binding protein-like transcript 1 (MULT-1) was found upregulated in liver resident macrophages (LRMs) after TP administration, and LRMs did exhibit NK cell activating effect. Furthermore, M1 polarization of LRMs cells was observed, along with an elevation in intracellular tumor necrosis factor (TNF)-α levels. In vivo neutralization of TNF-α significantly alleviated TP- and LPS-induced ALF. In conclusion, the collaborative role of group 1 ILCs and LRMs in mediating hepatotoxicity was confirmed in TP- and LPS-induced ALF. TP-induced MULT-1 expression in LRMs was the crucial mechanism in the activation of group 1 ILCs via MULT-1-NKG2D signal upon LPS stimulation, emphasizing the importance of infection control after TP administration.

Background: The association between dietary habits and metabolic syndrome (MetS) has not been well documented, due to the complexity and individualization of dietary culture in the Chinese population. Objective: To construct a composite score from various bad dietary habits and to evaluate their comprehensive association with the prevalence of MetS and its components among Chinese men and women across various age groups. Setting: Serial cross-sectional studies. Methods: Twenty-three dietary habits were assessed through face-to-face interviews with 98,838 males and 83,099 females in health check-up programs from 2015 to 2021, among which eighteen bad dietary habits were observed to be associated independently with total MetS. The total score of bad dietary habits was composed of four categories via variable clustering analysis, including irregular dietary habits, unhealthy dietary flavors, unbalanced dietary structure, and high-fat diet. The 2016 Chinese guideline for the management of dyslipidemia in adults was used to define MetS. Results: Men had a higher score of bad dietary habits than women (9.63 ± 3.11 vs. 8.37 ± 3.23), which decreased significantly with increasing age in both males and females (Pinteraction

Abstract Sulfate aerosol greatly contributes to wintertime haze pollution in emission‐intensive regions like the North China Plain (NCP) in China. Fast sulfate increase and accumulation are usually recorded during winter haze; however, the multiphase oxidation of sulfur dioxide (SO2) and the physical processes affecting near‐surface sulfate are not fully understood. By combining in situ observations and numerical simulations, we found that high sulfur oxidation ratios (>0.6) under heavily polluted conditions are associated with low clouds and fog over NCP, induced by the moist southerly airflow. Thick low clouds and high SO2 levels in NCP provide a reaction environment for sulfate production. The sulfate production rate in cloud water can reach 0.5–1.3 μg m−3 h−1. The results demonstrate that the vertical mixing of sulfate generated within the cloud water to the surface plays a significant role in rapid sulfate production, highlighting the importance of understanding cloud‐water processes in haze pollution.

In clinical practice and research, the classification and diagnosis of neurological diseases such as Parkinson’s Disease (PD) and Multiple System Atrophy (MSA) have long posed a significant challenge. Currently, deep learning, as a cutting-edge technology, has demonstrated immense potential in computer-aided diagnosis of PD and MSA. However, existing methods rely heavily on manually selecting key feature slices and segmenting regions of interest. This not only increases subjectivity and complexity in the classification process but also limits the model’s comprehensive analysis of global data features. To address this issue, this paper proposes a novel 3D context-aware modeling framework, named 3D-CAM. It considers 3D contextual information based on an attention mechanism. The framework, utilizing a 2D slicing-based strategy, innovatively integrates a Contextual Information Module and a Location Filtering Module. The Contextual Information Module can be applied to feature maps at any layer, effectively combining features from adjacent slices and utilizing an attention mechanism to focus on crucial features. The Location Filtering Module, on the other hand, is employed in the post-processing phase to filter significant slice segments of classification features. By employing this method in the fully automated classification of PD and MSA, an accuracy of 85.71%, a recall rate of 86.36%, and a precision of 90.48% were achieved. These results not only demonstrates potential for clinical applications, but also provides a novel perspective for medical image diagnosis, thereby offering robust support for accurate diagnosis of neurological diseases.

Abstract Effectively eliminating apoptotic cells is precisely controlled by a variety of signaling molecules and a phagocytic effect known as efferocytosis. Abnormalities in efferocytosis may bring about the development of chronic conditions, including angiocardiopathy, chronic inflammatory diseases and autoimmune diseases. During wound healing, failure of efferocytosis leads to the collection of apoptosis, the release of necrotic material and chronic wounds that are difficult to heal. In addition to the traditional phagocytes‐macrophages, other important cell species including dendritic cells, neutrophils, vascular endothelial cells, fibroblasts and keratinocytes contribute to wounding healing. This review summarizes how efferocytosis‐mediated immunomodulation plays a repair‐promoting role in wound healing, providing new insights for patients suffering from various cutaneous wounds.

BackgroundAtherosclerosis and cardiovascular diseases are significantly affected by low-grade chronic inflammation. As a new inflammatory marker, the systemic inflammation response index (SIRI) has been demonstrated to be associated with several cardiovascular disease prognoses. This study aimed to investigate the prognostic impact of SIRI in individuals having ischemic heart failure (IHF) following percutaneous coronary intervention (PCI).MethodsThis observational, retrospective cohort study was conducted at a single site. Finally, the research involved 1,963 individuals with IHF who underwent PCI, with a 36-month follow-up duration. Based on the SIRI quartiles, all patients were classified into four groups. Major adverse cardiovascular events (MACEs) were the primary outcomes. Every element of the main endpoint appeared in the secondary endpoints: all-cause mortality, non-fatal myocardial infarction (MI), and any revascularization. Kaplan–Meier survival analysis was conducted to assess the incidence of endpoints across the four groups. Multivariate Cox proportional hazards analysis confirmed the independent impact of SIRI on both the primary and secondary endpoints. The restricted cubic spline (RCS) was used to assess the nonlinear association between the SIRI and endpoints. Subgroup analysis was performed to confirm the implications of SIRI on MACE in the different subgroups.ResultsThe main outcome was much more common in patients with a higher SIRI. The Kaplan–Meier curve was another tool that was used to confirm the favorable connection between SIRI and MACE. SIRI was individually connected to a higher chance of the main outcome according to multivariate analyses, whether or not SIRI was a constant [SIRI, per one−unit increase, hazard ratio (HR) 1.04, 95% confidence interval (95% CI) 1.01–1.07, p = 0.003] or categorical variable [quartile of SIRI, the HR (95% CI) values for quartile 4 were 1.88 (1.47–2.42), p

Abstract Objective To investigate the effects of different polishing methods on the surface microstructure and roughness of teeth following initial periodontal treatment. Methods Teeth were divided into three groups (silica onegloss, polishing disc, and polishing strip) in vitro. Tooth surface microstructure was characterized via scanning electron microscopy. Roughness was measured by profilometry and laser scanning confocal microscopy (LSCM). According to the in vitro results, one group was chosen for further clinical trials. Effects of the chosen polishing method on patient plaque control and satisfaction were assessed via plaque staining and visual analog scale (VAS). Results Electron microscopy results revealed that the polishing disc group had smoother roots and crowns than did the other two groups. Roughness analysis revealed that the crown roughness with the polishing disc and silica onegloss was lower, and the root roughness with the polishing disc was the lowest (p

BackgroundCowden syndrome (CS) is a rare genetic disorder associated with PTEN gene mutations. It is characterized by macrocephaly, specific mucocutaneous features, and a predisposition to benign and malignant tumors. Cases of CS primarily presenting with oral clinical manifestations are relatively uncommon.Methods/ResultsWe report the case of a 41-year-old male proband who presented with bilateral commissural and lingual externally projecting symmetric lesions for over two years. The proband also exhibited other features, including macrocephaly, communication difficulties, and obesity. Similar oral clinical manifestations were observed in family members. Whole exome sequencing analysis revealed PTEN gene mutations associated with CS in both the proband and his younger brother. This case serves as a reminder to be aware of the diverse presentations of CS in oral clinical practice and highlights the importance of genetic testing for guiding diagnosis and treatment.ConclusionThere are few reported cases of CS primarily presenting with oral lesions. This finding contributes to further understanding of certain aspects of the pathogenesis of CS and enhances awareness of CS cases primarily exhibiting oral clinical manifestations.

To achieve the objective of high-quality development, an in-depth examination of the coupling coordination relationship between industrial green water and science and technology (S&T) innovation is essential. This study takes Chinese 30 provincial regions as specific examples and constructs the improved three-stage SBM-DEA model and entropy weight TOPSIS model to assess industrial green water efficiency and the level of S&T innovation during 2009–2021. Based on this, the coupling coordination model is applied to investigate the coupling coordination degree of industrial green water efficiency and S&T innovation, as well as the characteristics of the spatio-temporal distributions. Finally, we utilize a spatial autocorrelation model to reveal the spatial clustering characteristics of the coordination degree of the two. The findings indicate that: (1) The results of the evaluation of industrial green water efficiency and the level of S&T innovation show that the development of each province is not balanced, and the performance of the eastern coastal region is more prominent. (2) China's overall coupling coordination degree is rising steadily and moving from primary coordination into the good coordination stage. Most provinces are in the primary coordination and good coordination stages. Qinghai remains in the low coordination stage throughout the study period. Jiangsu, Zhejiang, Shandong, and Guangdong enter the high coordination stage. (3) The spatial distribution of the coupling coordination level of the two systems shows a pattern of high in the east and low in the west, with a positive spillover effect on the spatial adjacency. The high-high coupling coordination degree area exhibits a tendency to shift towards the central region. This paper provides a scientific basis for analyzing the coupling coordination degree and spatio-temporal differences between industrial green water efficiency and S&T innovation.

ObjectiveTo investigate the causal relationship between educational attainment (EA) and gout, as well as the potential mediating effects of individual physical status (IPS) such as body mass index (BMI) and systolic blood pressure (SBP) and lifestyle habits (LH) including alcohol intake frequency (drinking), current tobacco smoking (smoking), and time spent watching television (TV).MethodsUtilizing two-sample Mendelian randomization (MR), we analyzed the causal effects of EA on gout risk, and of IPS (BMI and SBP) and LH (smoking, drinking, and TV time) on gout risk. Multivariable MR (MVMR) was employed to explore and quantify the mediating effects of IPS and LH on the causal relationship between EA and gout risk.ResultsAn elevation of educational attainment by one standard deviation (4.2 years) exhibited a protective effect against gout (odds ratio 0.724, 95% confidence interval 0.552–0.950; p = 0.020). We did not observe a causal relationship between smoking and gout, but BMI, SBP, drinking, and TV time were found to be causal risk factors for gout. Moreover, BMI, SBP, drinking, and TV time acted as mediating factors in the causal relationship between EA and gout risk, explaining 27.17, 14.83, 51.33, and 1.10% of the causal effects, respectively.ConclusionOur study indicates that having a genetically predicted higher level of EA may provide protection against gout. We found that this relationship is influenced by IPS factors such as BMI and SBP, as well as LH including drinking and TV time.

ObjectiveAnalyzing the association between sociodemographic status and the type 2 diabetes mellitus (T2DM)-related risks in China to reduce the disease burden of T2DM.MethodsWe downloaded data from the Global Burden of Disease Study 2019 to estimate the disease burden of T2DM in China. Secondary analyses were performed by year, age, gender, summary exposure value (SEV), and sociodemographic index (SDI).ResultsIn China, it is estimated that 3.74 (3.44–4.10) million incidence, 90.0 (82.3–98.5) million prevalence, 168.4 (143.2–194.0) thousand deaths, and 9.6 (7.6–11.9) million DALYs occurred in 2019, showing an increase of 96.8, 156.7, 162.8, and 145.4% compared to 1990. An inverse U-shaped curve was observed for the correlations between T2DM-related burden and SDI. A heavier burden was found in males. The top four risk factors were high body mass index (HBMI), dietary risks, air pollution and tobacco. HBMI, as the key risk, accounted for half of the disease burden of T2DM in China. Lower degree of SEV and higher level of attributable T2DM-related burden could be found in main risks, meaning their critical role of them in the development and progression of T2DM. An inverse U-shaped curve could be found in the association between age-standardized incidence, mortality, DALYs rate, and SDI.ConclusionThe disease burden of T2DM has rapidly increased in China. Gender disparities, different age distributions and inconsistent socioeconomic levels all played an important role in it. The key risk was HBMI. With the improvement of socioeconomic level, the main risk factors for T2DM have changed from environmental factors to lifestyle factors. Targeted control and preventative strategies to address adjustable risk factors could put an end to this soaring burden.

BackgroundNo sex-specific guidelines for surgical anti-obesity strategies have been proposed, partially due to the controversy regarding sex-related differences in weight loss after bariatric metabolic surgery.ObjectivesTo explore sex dimorphism in the effect and predictors of weight loss after sleeve gastrectomy (SG), thereby providing clinical evidence for the sex-specific surgical treatment strategy.MethodsIn a prospective cohort design, participants scheduled for SG at an affiliated hospital between November 2020 and January 2022 were assessed for eligibility and allocated to the Male or Female group with a 1-year follow-up after surgery. The primary outcome was the sex difference in the weight-loss effect after SG indicated by both percentage of total weight loss (TWL%) and excess weight loss (EWL%). The secondary outcome was the analysis of sex-specific preoperative predictors of weight loss after SG based on univariate and multivariate analyses. Independent predictors were obtained to construct a nomogram model. The discrimination, calibration, and clinical utility of the nomogram were based on receiver operating characteristic curve, concordance index, calibration curve, and decision curve analysis, respectively.ResultsNinety-five male and 226 female patients were initially included. After propensity score matching by baseline body mass index (BMI), 85 male and 143 female patients achieved comparable TWL% and EWL% for 1 year after SG. For male patients, baseline BMI, area under the curve for insulin during oral glucose tolerance test, and progesterone were independent predictors of weight loss after SG. Baseline BMI, age, thyroid stimulating hormone, and Self-Rating Anxiety Scale score were independent predictors for female patients.ConclusionNo obvious sex difference is detected in the weight-loss effect after SG. Sex dimorphism exists in the predictors of weight loss after SG. Further research with long-term and a multicenter design is needed to confirm the predictive model.

ObjectiveThis study comprehensively evaluated the causal relationship between different types of statins use and knee/hip osteoarthritis (OA) using a two-sample and multivariate Mendelian randomization (MR) method.MethodsMR analysis was conducted using publicly available summary statistics data from genome-wide association studies (GWAS) to assess the causal associations between total statins use (including specific types) and knee/hip OA. The primary analysis utilized the inverse variance-weighted (IVW) method, with sensitivity analysis conducted to assess robustness. Multivariable MR (MVMR) analysis adjusted for low-density lipoprotein cholesterol (LDL-C), intermediate-density lipoprotein cholesterol (IDL-C), high-density lipoprotein cholesterol (HDL-C), and body mass index (BMI).ResultsThe MR analysis revealed a significant inverse association between genetically predicted total statins use and the risk of knee OA (OR = 0.950, 95%CI: 0.920-0.982, p = 0.002) as well as hip OA (OR = 0.932, 95%CI: 0.899-0.966, p ConclusionThis study provides compelling evidence of the close relationship between statin use and a reduced risk of knee/hip OA, particularly with atorvastatin and simvastatin. LDL-C and IDL-C may mediate these effects. These findings have important implications for the clinical prevention and treatment of knee/hip OA.

BackgroundThe long non-coding RNA cancer susceptibility candidate (CASC) has abnormal expression in lung cancer tissues and may correlate with lung cancer prognosis. This study aimed to comprehensively evaluate the association between CASC expression and the cancer prognosis.MethodsPubMed, Embase, Web of Science, Google Scholar, Cochrane Library, and China National Knowledge Infrastructure databases were searched until April 1, 2023, to obtain the relevant literature. Studies that met the predefined eligibility criteria were included, and their quality was independently assessed by 2 investigators according to the Newcastle-Ottawa Scale (NOS) score. Detailed information was obtained, such as first author, year of publication, and number of patients. Hazard ratio (HR) with a 95% confidence interval (CI) was extracted and grouped to assess the relationship between CASC expression and cancer prognosis. The dichotomous data was merged and shown as the odds ratio (OR) with a 95% CI was extracted to assess the relationship between CASC expression and clinicopathological parameters.ResultsA total of 12 studies with 746 patients with lung cancer were included in the meta-analysis. The expression levels of lncRNA CASC2 and CASC7 were decreased, while those of CASC9, 11, 15, and 19 were induced in lung cancer tissues compared with paracancerous tissues. In the population with low CASC expression (CASC2 and CASC7), high CASC expression indicated a good lung cancer prognosis (HR = 0.469; 95% CI, 0.271-0.668). Conversely, in the population with high CASC expression (CASC9, 11, 15, and 19), high CASC expression predicted a poor lung cancer outcome (HR = 1.910; 95% CI, 1.628-2.192). High CASC expression also predicted worse disease-free survival (DFS) (HR = 2.803; 95% CI, 1.804-6.319). Combined OR with 95% CI revealed an insignificant positive association between high CASC expression and advanced TNM stage (OR = 1.061; 95% CI, 0.775-1.454), LNM (OR = 0.962; 95% CI, 0.724-1.277), tumor size (OR = 0.942; 95% CI, 0.667-1.330), and histological grade (OR = 1.022; 95% CI, 0.689-1.517).ConclusionThe CASC expression levels negatively correlate with lung cancer prognosis. Therefore, CASC expression may serve as a prognostic marker and a potential therapeutic target for lung cancer.