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Abstract Background Clear cell renal cell carcinoma (ccRCC) is closely associated with steroid hormones and their receptors affected by lipid metabolism. Recently, there has been growing interest in the carcinogenic role of NR3C1, the sole gene responsible for encoding glucocorticoid receptor. However, the specific role of NR3C1 in ccRCC remains unclear. The present study was thus developed to explore the underlying mechanism of NR3C1’s carcinogenic effects in ccRCC. Methods Expression of NR3C1 was verified by various tumor databases and assessed using RT-qPCR and western blot. Stable transfected cell lines of ccRCC with NR3C1 knockdown were constructed, and a range of in vitro and in vivo experiments were performed to examine the effects of NR3C1 on ccRCC proliferation and migration. Transcriptomics and lipidomics sequencing were then conducted on ACHN cells, which were divided into control and sh-NR3C1 group. Finally, the sequencing results were validated using transmission electron microscopy, mitochondrial membrane potential assay, immunofluorescence co-localization, cell immunofluorescent staining, and Western blot. The rescue experiments were designed to investigate the relationship between endoplasmic reticulum stress (ER stress) and mitophagy in ccRCC cells after NR3C1 knockdown, as well as the regulation of their intrinsic signaling pathways. Results The expression of NR3C1 in ccRCC cells and tissues was significantly elevated. The sh-NR3C1 group, which had lower levels of NR3C1, exhibited a lower proliferation and migration capacity of ccRCC than that of the control group (P

This study assesses the morphological effectiveness of benign prostatic hyperplasia (BPH) surgery using multislice spiral computed tomography three-dimensional imaging (CT3D) with urethral contrast. Twenty-five male patients with BPH and bladder outlet obstruction (BOO) who underwent bipolar transurethral resection of the prostate were selected. Preoperative and postoperative CT3D indicators of retrograde and voiding cystourethrography, including bladder neck diameter, length of the posterior urethra, and degree of prostate protrusion into the bladder and upper and lower diameter of the prostate were used to assess bladder neck and posterior urethra morphology and BOO severity. In addition, preoperative and postoperative International Prostate Symptom Scores and maximum urine flow rates were compared. Postoperative CT3D was used to evaluate changes following obstruction relief postsurgery. Preoperative CT3D indicated significant BOO, whereas postoperative imaging showed improved patency but with irregular posterior urethral lumens and varying degrees of residual glandular tissue. Comparative analysis of preoperative and postoperative bladder outlet metrics revealed significant changes ( p < 0.05). Urethral contrast CT3D effectively visualizes the prostate, bladder neck, and prostatic urethra. It quantifies changes in the urethral lumen postsurgery, correlating the extent of posterior urethral lumen spaciousness with urinary flow rates.

BackgroundOsteoking has been extensively used for the treatment of knee osteoarthritis (KOA). However, it is lack of high-quality evidence on the clinical efficacy of Osteoking against KOA and the comparison with that of nonsteroidal anti-inflammatory drugs (NSAIDs).AimsTo evaluate the efficacy and safety of Osteoking in treating KOA.MethodsIn the current study, a total of 501 subjects were recruited from 20 medical centers, and were divided into the Osteoking treatment group (n = 428) and the NSAIDs treatment group (n = 73). The Propensity Score Matching method was used to balance baseline data of different groups. Then, the therapeutic effects of Osteoking and NSAIDs against KOA were evaluated using VAS score, WOMAC score, EQ-5D-3L and EQ-VAS, while the safety of the two treatment were both assessed based on dry mouth, dizziness, diarrhea, etc.ResultsAfter 8 weeks of treatment, the Osteoking group was compared with the NSAIDs group, the VAS score [2.00 (1.00, 3.00) vs. 3.00 (2.00, 4.00)], WOMAC pain score [10.00 (8.00, 13.00) vs. 11.00 (8.00, 16.00) ], WOMAC physical function score [32.00 (23.00, 39.00) vs. 39.07 ± 16.45], WOMAC total score [44.00 (31.00, 55.00) vs. 53.31 ± 22.47) ], EQ-5D-3L score [0.91 (0.73, 0.91) vs. 0.73 (0.63, 0.83) ] and EQ-VAS score [80.00 (79.00, 90.00) vs. 80.00 (70.00, 84.00) ] were improved by the treatment of Osteoking for 8 weeks more effectively than that by the treatment of NSAIDs. After 8 weeks of treatment with Osteoking, the VAS scores of KOA patients with the treatment of Osteoking for 8 weeks were reduced from 6.00 (5.00, 7.00) to 2.00 (1.00, 3.00) (p < 0.05), which was better than those with the treatment of NSAIDs starting from 2 weeks during this clinical observation. Importantly, further subgroup analysis revealed that the treatment of Osteoking was more suitable for alleviating various clinical symptoms of KOA patients over 65 years old, with female, KL II-III grade and VAS 4-7 scores, while the clinical efficacy of NSAIDs was better in KOA patients under 65 years old and with VAS 8–10 scores. Of note, there were no differences in adverse events and adverse reactions between the treatment groups of the two drugs.ConclusionOsteoking may exert a satisfying efficacy in relieving joint pain and improving life quality of KOA patients without any adverse reactions, especially for patients with KL II-III grades and VAS 4–7 scores.Clinical Trial Registration:https://www.chictr.org.cn/showproj.html?proj=55387, Identifier ChiCTR2000034475

Abstract Introduction Fatigue is a common symptom that negatively affects the outcomes and functions of rheumatoid arthritis (RA) patients. This study aimed to assess the fatigue by two scales and validate their consistency, also to comprehensively evaluate fatigue‐related risk factors in RA patients. Methods In this case–control study, the fatigue of 160 RA patients and 60 healthy controls was evaluated by the Bristol Rheumatoid Arthritis Fatigue Multi‐Dimensional Questionnaire (BRAF‐MDQ) and the Chinese version of the Brief Fatigue Inventory (BFI‐C). The 28‐joint disease activity score using erythrocyte sedimentation rate of RA patients was assessed. Results The BRAF‐MDQ and BFI‐C scores were elevated in RA patients versus healthy controls (all p

Abstract Objective To investigate the prognostic factors of patients with anti‐melanoma differentiation‐associated gene 5 (MDA5) positive clinically amyopathic dermatomyositis (CADM) and interstitial lung disease (ILD). Methods A retrospective analysis was conducted on clinical data of 125 patients with anti‐MDA5 + CADM‐ILD collected from 10 branches in eastern China between December 2014 and December 2022. Prognostic factors were analyzed using χ2 test, Log‐rank test, COX and logistic regression analysis. Results In this cohort, 125 anti‐MDA5 + CADM‐ILD patients exhibited a rapidly progressive interstitial lung disease (RPILD) incidence of 37.6%, and an overall mortality rate of 24.8%. One patient was lost to follow‐up. After diagnosis of RPILD, a mortality rate of 53.2% occurred in patients died within 3 months, and that of 5.6% appeared in those who survived for more than 3 months. Multiple factor analysis revealed that C‐reactive protein (CRP) ≥ 10 mg/L (p = 0.01) and recombinant human tripartite motif containing 21 (Ro52) (+) (p = 0.003) were associated with a higher risk of RPILD in anti‐MDA5 + CADM‐ILD patients; CRP ≥ 10 mg/L (p = 0.018) and the presence of RPILD (p = 0.003) were identified as the factors influencing survival time in these patients, while arthritis was the protective factor (p = 0.016). Conclusion Patients with anti‐MDA5 + CADM‐ILD will have a higher mortality rate, and the initial 3 months after diagnosis of RPILD is considered the risk window for the dismal prognosis. Patients with CRP ≥ 10 mg/L, Ro52 (+) and RPILD may be related to a shorter survival time, while patients complicated with arthritis may present with relatively mild conditions.

Soft tissue injuries (STIs) are the most common cause of extremity pain and motion dysfunction. Persistent inflammatory activation of immune cells characterized by senescence‐associated secretory phenotype (SASP) and mitochondrial stress are considered the primary causes of STIs, a pathological process also termed inflammaging. Meanwhile, scavenging excessive “cellular waste” in the inflammaging microenvironment and further activating tissue repair processes remain elusive. Herein, an anti‐inflammaging photothermal hydrogel microneedle patch for treating STIs is developed. Taurine‐loaded Prussian blue nanoparticles (Taurine@PB) are encapsulated in a methacrylate‐based hyaluronic acid hydrogel (HAMA) and further fabricated into taurine@PB@HAMA@microneedles (TPH@MN) patches. The acidic microenvironment of chronic inflammation and mild photothermal effects promote taurine release and anti‐inflammaging immunomodulation, inhibiting mitochondrial stress via the SIRT3‐NF‐κB axis to promote glycolytic metabolic microenvironment of neutrophils reprogramming toward oxidative phosphorylation metabolism. Furthermore, TPH@MN activates macrophage efferocytosis and initiates the process of tissue repair. In mouse models of chronic diabetic wounds and tibialis anterior (TA) muscle injury, TPH@MN inhibits SASP expression and promotes STIs healing through thermosensitized anti‐inflammaging immunomodulation. In summary, TPH@MN circumvents the side effects of systemic administration, providing new translatable options in the treatment modalities for patients suffering from STIs worldwide.

Introduction Cardiopulmonary complications and cognitive impairment following craniotomy have a significantly impact on the general health of individuals with brain tumours. Observational research indicates that engaging in walking is linked to better prognosis in patient after surgery. This trial aims to explore whether walking exercise prior to craniotomy in brain tumour patients can reduce the incidence of cardiopulmonary complications and preserve patients’ cognitive function.Methods and analysis In this randomised controlled trial, 160 participants with supratentorial brain tumours aged 18–65 years, with a preoperative waiting time of more than 3–4 weeks and without conditions that would interfere with the trial such as cognitive impairment, will be randomly assigned in a ratio of 1:1 to either receive traditional treatment or additional combined with a period of 3–4 weeks of walking exercise of 10 000–15 000 steps per day. Wearable pedometer devices will be used to record step counts. The researchers will evaluate participants at enrolment, baseline, 14 days preoperatively, 3 days prior to surgery and 1 week after surgery or discharge (select which occurs first). The primary outcomes include the incidence of postoperative cardiopulmonary complications and changes in cognitive function (gauged by the Montreal Cognitive Assessment test). Secondary outcomes include the average length of hospital stay, postoperative pain, participant contentment, healthcare-associated costs and incidence of other postoperative surgery-related complications. We anticipate that short-term preoperative walking exercises will reduce the incidence of surgery-related complications in the short term after craniotomy, protect patients’ cognitive function, aid patients’ postoperative recovery and reduce the financial cost of treatment.Ethics and dissemination The study protocol has been approved by Ethics Committee of Xiangya Hospital of Central South University (approval number: 202305117). The findings of the research will be shared via publications that have been reviewed by experts in the field and through presentations at conferences.Trial registration number NCT05930288.

Point cloud segmentation is one of the most important tasks in LiDAR remote sensing with widespread scientific, industrial, and commercial applications. The research thereof has resulted in many breakthroughs in 3D object and scene understanding. Existing methods typically utilize hierarchical architectures for feature representation. However, the commonly used sampling and grouping methods in hierarchical networks are not only time-consuming but also limited to point-wise 3D coordinates, ignoring the local semantic homogeneity of point clusters. To address these issues, we propose a novel 3D point cloud representation network, called Dynamic Clustering Transformer Network (DCTNet). It has an encoder–decoder architecture, allowing for both local and global feature learning. Specifically, the encoder consists of a series of dynamic clustering-based Local Feature Aggregating (LFA) blocks and Transformer-based Global Feature Learning (GFL) blocks. In the LFA block, we propose novel semantic feature-based dynamic sampling and clustering methods, which enable the model to be aware of local semantic homogeneity for local feature aggregation. Furthermore, instead of traditional interpolation approaches, we propose a new semantic feature-guided upsampling method in the decoder for dense prediction. To our knowledge, DCTNet is the first work to introduce semantic information-based dynamic clustering into 3D Transformers. Extensive experiments on an object-based dataset (ShapeNet), and an airborne multispectral LiDAR dataset demonstrate the State-of-the-Art (SOTA) segmentation performance of DCTNet in terms of both accuracy and efficiency. Our code will be made publicly available.

BackgroundIn Chinese medicine, the mental focus and emotional stability of acupuncturists are key to optimal clinical outcomes. Many renowned acupuncturists utilize Traditional Chinese Qigong practices to enhance their concentration and emotional regulation abilities. Nevertheless, the existing literature lacks comprehensive evidence addressing this matter.MethodsThis study will enroll 99 acupuncturists and randomly allocate them to one of three groups: Baduanjin, aerobic exercise, or a waiting-list control. The Baduanjin group will undertake 24 weeks of training, with three one-hour sessions weekly. The aerobic group will engage in brisk walking for the same duration and frequency. The control group will not receive any specific training. Assessments of emotion regulation, attention, cognitive functions, finger sensation, and athletic ability will be conducted at baseline (−1 week), mid-intervention (12 weeks), and post-intervention (24 weeks). Additionally, 20 participants from each group will undergo fMRI scans before and after the intervention to explore brain functional and structural changes relating to emotion, attention, cognition, motor skills, and sensory perception.DiscussionThis study aims to contribute valuable insights into the effectiveness of Qigong practice, specifically Baduanjin, in enhancing emotional regulation, attention, and cognitive functions in acupuncturists and to investigate the neuroimaging mechanisms behind these effects.Ethics and disseminationApproved by the Sichuan Regional Ethics Review Committee on Traditional Chinese Medicine (No. 2023KL − 118) and adhering to the Declaration of Helsinki. Results will be shared through policy briefs, workshops, peer-reviewed journals, and conferences.Clinical trial registrationwww.chictr.org.cn, ChiCTR2300076447.

Background Post-translational modification by Small Ubiquitin-like MOdifier (SUMO) is an important mechanism to regulate protein activity, protein stability, and localization of substrates. Zbtb21 is a zinc finger and BTB (Broad-complex, Tram-track and Bric à brac) domain-containing transcription factor. Bioinformatic prediction suggests several putative SUMOylated sites in Zbtb21 protein. Methods Two evolutionarily conserved lysine residues in Zbtb21 protein were mutated alone or in combination to disrupt the binding with SUMO molecules. Western blot and co-immunoprecipitation analyses were performed to detect the SUMOylation state of wild type and mutant Zbtb21 proteins, respectively. Luciferase reporter assays were conducted to evaluate their transcription activities. Meanwhile, immunofluorescence staining was carried out to show their sub-nuclear localizations. Finally, co-immunoprecipitation was performed to detect the interaction between Zbtb21 and its partners. Results Phylogenetically conserved lysines 419 and 845 of zebrafish Zbtb21 protein can be conjugated with SUMO molecules. SUMOylation does not affect the subcellular localization and protein stability of Zbtb21, as well as the interaction with Zbtb14 or Zbtb21. Nevertheless, luciferase reporter assays revealed that Zbtb21 is a dual-function transcription factor which exerts activation or repression effect on different promoters, and SUMOylation can modulate the transcriptional activity of Zbtb21 in regulating downstream target genes. Hence, Zbtb21 is identified as a novel substrate of SUMOylation, which would be important for its function. Conclusions Zebrafish Zbtb21 protein can be SUMOylated on lysines 419 and 845, which is evolutionary conserved. SUMOylation affects the dual role of Zbtb21 on transcription.

Wolfberry (Lycium, of the family Solanaceae) has special nutritional benefits due to its valuable metabolites. Here, 16 wolfberry-specific metabolites were identified by comparing the metabolome of wolfberry with those of six species, including maize, rice, wheat, soybean, tomato and grape. The copy numbers of the riboflavin and phenyllactate degradation genes riboflavin kinase (RFK) and phenyllactate UDP-glycosyltransferase (UGT1) were lower in wolfberry than in other species, while the copy number of the phenyllactate synthesis gene hydroxyphenyl-pyruvate reductase (HPPR) was higher in wolfberry, suggesting that the copy number variation of these genes among species may be the main reason for the specific accumulation of riboflavin and phenyllactate in wolfberry. Moreover, the metabolome-based neighbor-joining tree revealed distinct clustering of monocots and dicots, suggesting that metabolites could reflect the evolutionary relationship among those species. Taken together, we identified 16 specific metabolites in wolfberry and provided new insight into the accumulation mechanism of species-specific metabolites at the genomic level.

This study aimed to investigate altered static and dynamic functional network connectivity (FNC) and its correlation with clinical symptoms in patients with knee osteoarthritis (KOA). One hundred and fifty-nine patients with KOA and 73 age- and gender-matched healthy subjects (HS) underwent resting-state functional magnetic resonance imaging (rs-fMRI) and clinical evaluations. Group independent component analysis (GICA) was applied, and seven resting-state networks were identified. Patients with KOA had decreased static FNC within the default mode network (DM), visual network (VS), and cerebellar network (CB) and increased static FNC between the subcortical network (SC) and VS (p < 0.05, FDR corrected). Four reoccurring FNC states were identified using k-means clustering analysis. Although abnormalities in dynamic FNCs of KOA patients have been found using the common window size (22 TR, 44 s), but the results of the clustering analysis were inconsistent when using different window sizes, suggesting dynamic FNCs might be an unstable method to compare brain function between KOA patients and HS. These recent findings illustrate that patients with KOA have a wide range of abnormalities in the static and dynamic FNCs, which provided a reference for the identification of potential central nervous therapeutic targets for KOA treatment and might shed light on the other musculoskeletal pain neuroimaging studies.

Dynamic unloading is instantaneous, and the transient unloading effect has important influence on deep rock blasting excavation. In order to study the deformation law and failure mechanism of surrounding rock under dynamic excavation with unloading condition. And tunderstand further dynamic characteristics and the dynamic effects of transient unloading in rock mass excavation. There used a self-developed simulation test device for simulating the process of dynamic excavation in confining pressure loading. The experimental model was made similar material, and used the test device to impact it. It focus on monitoring the unloading effect in real time with the help of strain gauge, high-speed camera and fiber grating sensor. These devices that monitored effective strain-time curves, crack propagation image and the tensile state or compressive state of rock mass after excavation. The test results show that surrounding rock stress of model have experienced five stages that were called initial stress stage, dynamic loading stage, dynamic unloading stage, initial stress unloading stage and creep stage respectively. After model was impacted, each monitoring point occured different strain variation, and some occured compressive strrain, others occured tensile strain. The whole model in compressived state. The model showed creep phenonmen after excavation. Through observing crack propagation image, crack propagation process shown clearly. Firstly, radial cracks were rapidly generated during dynamic excavation. Then, with the free face increase constantly, the stored energy of surrounding rock of model was rapidly released toward the free face, resulting in annular crack occured. Annular crack belongs to tensile faiure, which was generated in vertical radial crack direction and propagated along the adjacent radial crack. Finally, annular crack was parallelled with the free face. The simulation test device system monitored the unloading effect of rock-like marterial well in whole time. Unloading strain value varied with distance, the rock mass model can be divided into near unloading area, middle unloading area and far unloading area after excavation.

Boron(B)element is often utilized to enhance mechanical properties of stainless steel due to its excellent performance. In this study, selective laser melting (SLM) was used to print 316L/B stainless steel with varying boron weight content. The effects of boron content on microstructure, nanoindentation, and mechanical properties of the printed 316L stainless steel were discussed. Fine cell dendrites and columnar crystals were found in the SLM printed stainless steel due to the rapid solidification in SLM. It was found that boron has a higher growth limiting factor in the iron system and the boron solute can provide a high component supercooling. By adding boron element to stainless steel during printing, the honeycomb and grain size after solidification are significantly reduced due to interactions between the boron element and the 316L. Tensile testing results show that the ultimate tensile strength of the SLM fabricated parts with 0.5 wt% and 1 wt% boron element addition can be increased significantly to 1071 MPa and 1174 MPa, respectively.

Abstract Background Peritonitis is the most important complication of peritoneal dialysis (PD) and coagulase-negative staphylococci (CNS) are a frequent cause of dialysis-related infections. The association between SCCmec typing with psm-mec positivity in staphylococci and PD-related infections has not been identified. We aim to investigate the molecular epidemiology of CNS isolated from PD-peritonitis in a single Chinese center, focusing on the genetic determinants conferring methicillin resistance. Methods We collected 10 genetically unrelated CNS isolates from 10 patients with CNS PD-related peritonitis. The patients were divided into two groups based on the results of MIC to oxacillin: the methicillin-resistant CNS (MRCNS) and methicillin-sensitive CNS (MSCNS) groups. The biofilm formation group (BFG) and the non-biofilm formation group (NBFG) were used as the control groups. Phenotypic and molecular methods were used to analyze SCCmec types I, II and III, associated genes and biofilm formation and the existence of psm-mec. The demographic data and clinical indicators were collected. Results Ten CNS PD-related peritonitis patients were enrolled for this study. There were 6 MRCNS and 4 MRCNS isolates. SCCmec types were fully determined in 10 isolates. Seven staphylococci (70%) carried SCCmec, of which 4 isolates carried single SCCmec type I (40%) and 3 isolates had multiple SCCmec elements (I + III). Of the 6 MRCNS isolates, 3 carried SCCmec type I (50%) and 2 isolates carried SCCmec type I + III (33.3%). A high diversity of ccr types, mec complexes and ccr-mec complex combinations was identified among the 10 CNS isolates. The psm-mec gene was detected in 2/10 (20%) CNS isolates. There was no mutation in the psm-mec gene. Conclusions The majority of isolates were hospital-associated isolates. Furthermore, 2 psm-mec positive isolates were MRCNS in the NBFG. The PD patients frequent exposure to hospital would be the main risk factor. The presence of the psm-mec signal in the spectra of the MRCNS tested here demonstrates the presence of certain SCCmec cassettes that convey methicillin resistance.

Abstract Pancreatic cancer lacks effective therapy. Here, we reported two metastatic pancreatic cancer patients administrated with Claudin 18.2 (CLDN 18.2) CART therapy after the failure of standard therapy (NCT04581473 and NCT03874897). In case 1, with CLDN 18.2 expression of 2+, 70%, 250 × 106 cells were infused after lymphodepletion. Grade 1 cytokine release syndrome (CRS) occurred on d1 which was later controlled by tocilizumab. Partial response (PR) was achieved according to RECIST v1.1, with great shrinkage of lung metastasis. An increasing CD8+ T cell and Treg cells and declining CD4+ T cell and B cell were observed. In case 2, IHC result of ClDN18.2 showed 3+, 60%. 250 × 106 CLDN18.2 CART cells were subsequently administered. Patient experienced grade 2 CRS, which was controlled with tocilizumab. Target lesions of lung metastasis further achieved complete response. Similar increasing CD8+ T cell and Treg cell was detected from peripheral blood. Elevating IL-8 and declining TGF-β1 were also observed. The tumor is still under well control until the last follow-up on July 18, 2023.

As a future-oriented new network architecture, the core idea of computing and network convergence is to manage cloud-edge-end computing network resources in a centralized or distributed way by centering on the deep integration of computing force and network resources, so as to provide computing service for users’ needs.Although the CNC has made some progress in standard setting and industrial promotion, the overall development still faces many challenges, and there are still many scientific and engineering problems to be broken through.Research on CNC and its brain was carried out, the latest progress in related fields in the industry was analyzed, and the idea of building intelligent CNC brain was put forward, hoping to throw a brick at the table, jointly promote the implementation of AI in CNC, and truly realize intelligent CNC.

Abstract Approximately 20% of aged captive giant pandas (Ailuropoda melanoleuca) have cataracts that impair their quality of life. To identify potential biomarkers of cataract formation, we carried out a quantitative proteomics analysis of 10 giant pandas to find proteins differing in abundance between healthy and cataract-bearing animals. We identified almost 150 proteins exceeding our threshold for differential abundance, most of which were associated with GO categories related to extracellular localization. The most significant differential abundance was associated with components of the proteasome and other proteins with a role in proteolysis or its regulation, most of which were depleted in pandas with cataracts. Other modulated proteins included components of the extracellular matrix or cytoskeleton, as well as associated signaling proteins and regulators, but we did not find any differentially expressed transcription factors. These results indicate that the formation of cataracts involves a complex post-transcriptional network of signaling inside and outside lens cells to drive stress responses as a means to address the accumulation of protein aggregates triggered by oxidative damage. The modulated proteins also indicate that it should be possible to predict the onset of cataracts in captive pandas by taking blood samples and testing them for the presence or absence of specific protein markers.

Abstract Purpose This review was made to identify the risk factors for knee osteoarthritis (KOA) in middle-older aged (≥ 40 years), and to provide the newest evidence for the prevention of KOA. Method Cohort study and case–control study of the risk factors of KOA was included from Pubmed, Web of Science, Ovid Technologies, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang Database, SinoMed from their inceptions to July 2023. Two authors independently screened the literature and extracted data. Assessment of quality was implemented according to Agency for Healthcare Research and Quality (AHRQ) and Newcastle–Ottawa Quality Assessment Scale. Meta-analysis was performed using RevMan 5.3 software. Results 3597 papers were identified from the seven databases and 29 papers containing 60,354 participants were included in this review. Meta-analysis was performed for 14 risk factors, and 7 of these were statistical significance (P

Abstract Background Hepatocellular adenomas (HCAs) are rare benign tumors of the liver that occur predominantly in women taking oral contraceptives. In children, HCAs comprise

TiAlSiN coatings are deposited on zircaloy-4 by multi-arc ion plating at 50 A, 60 A and 70 A, respectively. The macro-morphology, micro-morphology, chemical composition and phases of the prepared coatings are observed and analyzed, and the high temperature oxidation behavior and adhesion strength of coatings are tested. The results demonstrate that the quantity of large particles on TiAlSiN coating increases gradually as the arc current increases, the coating becomes denser and denser with the porosity decreases gradually, and the content of Al elements in the coating increases gradually with the increase of multi-arc current. The phases of TiAlSiN coatings deposited at different multi-arc currents before oxidation mainly includes Ti3AlN, AlN, Ti2N. Meanwhile, the high temperature oxidation behavior of the coating is also improved gradually and the adhesion strength increases first and then decreases. When the arc current is 60 A, the adhesion strength is up to 23 N which is relatively large. The coatings deposited at 70 A shows the best high temperature oxidation resistance behavior, mainly due to the generation of a large amount of Al2O3 oxide in the coating after oxidation.

In this paper, Al/Cu laminated tubes were fabricated by strong staggered spinning at room temperature. The interface behavior and mechanical properties of the laminates with different thinning rates were studied. The results show that the laminated tubes have good deformation coordination, no obvious interface defects and good bonding. With the increase of thinning rate, the metals in the diffused layer decrease during the spinning process and transition to the new diffused layer interface, and the interface bonding strength is improved, the microstructure on both sides of the interface becomes finer and more uniform. The Cu side is dominated by fibrous texture and equiaaxial grains formed by recrystallization, forming strong shear Brass-R {111} texture. The Al side grains are mainly equiaxed, forming deformed Goss {110} texture. Due to the strong plastic strain exerted by the diffusion layer metal on the surrounding material and the occurrence of dynamic recrystallization (DRX), the average grain size on the Cu and Al sides near the interface decreased to 1.18 μm and 1.33 μm at a 70% thinning rate, respectively. With the increase of thinning rate, the yield strength (YS) and ultimate tensile strength (UTS) of laminated tube increase first and then decrease. Compared with the BM, YS (131.0 MPa) and UTS (180.9 MPa) of the sample with 50% thinning rate increase 50.4% and 64.0%. The increase in strength is attributed to work hardening and grain refinement. The fracture mechanism is brittle fracture on Cu side and ductile fracture on Al side.

With the development of large-diameter shield tunnels, how to realize effective security and stability control of shield tunnel lining has become a significant research topic. This paper investigates the deformation and failure mechanism of lining large diameter shield tunnels in depth and discusses the deformation characteristics and influencing factors of the lining of the shield tunnel with various diameters through the software of finite element analysis ABACUS. A set of models with varying diameters is built under identical stress conditions in order to maintain control over the variable. The utilization of the elastic–plastic model is observed in the application of bolts and rebar. The utilization of the Concrete Damage Plasticity model has been taken into account for the concrete lining. For the sake of comparison, the crown displacement of the shield tunnel, strain in tension and compressive zones, bolt stress and strain, deformation and intemal force distribution around the shield tunnel, and cracks in the tension zone, are carefully studied. An in-depth analysis is conducted to elucidate the variations in damage evolution mechanisms across linings of different sizes, within the framework of plastic hinge theory. The results indicate that the convergence deformation of large-diameter tunnel lining increases significantly during loading compared with that of small-diameter tunnel. Moreover, the probability of brittle failure is higher in big-diameter shield tunnels compared to small-diameter tunnels, indicating that these larger tunnel structures are more prone to suffering geometric instability.

To guarantee the safety of tunnel construction and the continued use of nearby structures, it is crucial to accurately forecast the size and extent of the plastic region that may occur due to tunnel excavation, as well as examine the impact on resilience. In this paper, the influence mechanism of tunnel construction on adjacent pile foundation and resilience assessment is investigated. Firstly, the stratum deformation and stress induced by tunnel construction are derived based on the thin-walled theory considering the influence of tunnel structure stiffness. Moreover, the resilience assessment based on the characteristics of the stratum plastic region is proposed to describe the degree of disturbance caused by tunnel construction to the adjacent pile foundation. Then, a comparison with a numerical simulation is conducted to verify the correctness of the prediction method of the stratum plastic region proposed in this paper. Finally, parameter sensitivity analysis is carried out, which indicates that pile parameters, soil parameters, and different tunnel outline conditions have a great influence on the prediction results. In order to reasonably control the impact of tunnel construction on the surrounding environment, safety control techniques, including advance grouting reinforcement and grouting uplift, need to be carefully designed.

In response to global energy, environment, and climate concerns, distributed photovoltaic (PV) power generation has seen rapid growth. However, the intermittent and uncertain nature of PVs can cause voltage fluctuations in distribution systems, threatening their stability. To address this challenge, this paper proposes an active distribution network voltage optimization method, of which the main contribution is the development of a comprehensive voltage optimization strategy that integrates day-ahead prediction and real-time adjustment, significantly enhancing the stability and efficiency of distribution networks with high PV penetration. In the day-ahead prediction stage, the forecast scenarios of load and PV output guide network reconfiguration for improved voltage distribution. In the real-time operation stage, flexible regulation of PV and energy storage systems is used to adjust power outputs, further optimizing voltage quality. Simulations on the IEEE 33-bus system show that the method effectively improves voltage distribution, enhances renewable energy consumption, and ensures the safe, economic operation of the distribution system.

Face recognition is a widely used computer vision, which plays an increasingly important role in user authentication systems, security systems, and consumer electronics. The models for most current applications are based on high-definition digital cameras. In this paper, we focus on digital images derived from historical motion picture films. Historical motion picture films often have poorer resolution than modern digital imagery, making face detection a more challenging task. To approach this problem, we first propose a trunk–branch concatenated multi-task cascaded convolutional neural network (TB-MTCNN), which efficiently extracts facial features from blurry historical films by combining the trunk with branch networks and employing various sizes of kernels to enrich the multi-scale receptive field. Next, we build a deep neural network-integrated object-tracking algorithm to compensate for failed recognition over one or more video frames. The framework combines simple online and real-time tracking with deep data association (Deep SORT), and TB-MTCNN with the residual neural network (ResNet) model. Finally, a state-of-the-art image restoration method is employed to reduce the effect of noise and blurriness. The experimental results show that our proposed joint face recognition and tracking network can significantly reduce missed recognition in historical motion picture film frames.

The crystal structure has a great influence on the dielectric and piezoelectric performance of poly(vinylidene fluoride) (PVDF). In this work, we prepared PVDF films with two typical crystalline phases (α and β). In situ Kelvin probe force microscopy (KPFM) and Piezoelectric force microscopy (PFM) were employed to investigate the responses of different PVDF crystalline phases to charge mobility, polarization, and piezoelectric properties. We used a homemade Kelvin probe force microscope (KPFM) to inject charges into the two crystalline phases to investigate the differences in the response of different crystalline phases of PVDF to electrical excitation on a microscopic scale. It was found that the α-phase has a lower charge injection barrier and is more susceptible to charge injection and that the α-phase is accompanied by a faster charge dissipation rate, which makes it easier to accumulate charge at the interface between the α-phase and β-phase PVDF. Moreover, the PFM polarization manipulation showed no change in the amplitude and phase diagram of the α-phase under ±10 V bias. In contrast, the β-phase showed a clear polarization reversal phenomenon and a significant increase in piezoelectric amplitude, which is consistent with its polar intrinsic properties. This study provides valuable insights into the multiphase contributions and a reference for designing advanced PVDF dielectrics.

The gas-gathering pipeline network is a critical infrastructure for collecting and conveying natural gas from the extraction site to the processing facility. This paper introduces a design optimization model for a star–tree gas-gathering pipeline network within a discrete space, aimed at determining the optimal configuration of this infrastructure. The objective is to reduce the investment required to build the network. Key decision variables include the locations of stations, the plant location, the connections between wells and stations, and the interconnections between stations. Several equality and inequality constraints are formulated, primarily addressing the affiliation between wells and stations, the transmission radius, and the capacity of the stations. The design of a star–tree pipeline network represents a complex, non-deterministic polynomial (NP) hard combinatorial optimization problem. To tackle this challenge, a hierarchical optimization framework coupled with an improved genetic algorithm (IGA) is proposed. The efficacy of the genetic algorithm is validated through testing and comparison with other traditional algorithms. Subsequently, the optimization model and solution methodology are applied to the layout design of a pipeline network. The findings reveal that the optimized network configuration reduces investment costs by 16% compared to the original design. Furthermore, when comparing the optimal layout under a star–star topology, it is observed that the investment needed for the star–star topology is 4% higher than that needed for the star–tree topology.

Body size is an important growth indicator in ducks and is a primary selection criterion for physical improvement. An excessively rapid growth rate in meat ducks can result in excessive body size, which may hinder subsequent processing and slaughter operations. However, only a few molecular markers related to body size have been studied in meat ducks. In this study, we performed a genome-wide association study (GWAS) to identify candidate genes and QTLs affecting body length (BL), keel bone length (KBL), neck length (NL), and breast width (BrW) in Pekin ducks (Anas platyrhynchos domestica). Our results indicate the significant SNP for NL is located within a pseudogene, whereas the significant SNP for BrW is located in an intergenic region. More importantly, our analysis identified a haplotype that was significantly associated with both BL and KBL. This haplotype, containing 48 single-nucleotide polymorphisms (SNPs), is localized within the XKR4 gene. The identification of this haplotype suggests that XKR4 may be a key candidate gene influencing BL and KBL in Pekin ducks. These findings have important implications for the breeding and genetic improvement of Pekin ducks, and provide valuable insights into the genetic architecture of body size traits in this species.

The cerebral ganglion and muscle are important regulatory tissues in Eriocheir sinensis. Therefore, it is of great significance to explore their synergistic roles in this organism’s anti-stress response. In this study, proteomics, metabolomics, and combination analyses of the cerebral ganglion and muscle of E. sinensis under alkalinity stress were performed. The cerebral ganglion and muscle played a significant synergistic regulatory role in alkalinity adaptation. The key regulatory pathways involved were amino acid metabolism, energy metabolism, signal transduction, and the organismal system. They also played a modulatory role in the TCA cycle, nerve signal transduction, immune response, homeostasis maintenance, and ion channel function. In conclusion, the present study provides a theoretical reference for further research on the mechanisms regulating the growth and development of E. sinensis in saline–alkaline environments. In addition, it provides theoretical guidelines for promoting the vigorous development of the E. sinensis breeding industry in saline–alkaline environments in the future.

(1) The development and utilization of the vast saline–alkali land worldwide is an important way to solve the worsening food crisis. Eriocheir sinensis, due to its strong osmotic regulation capability and its characteristics of being suitable for culturing in alkaline water, has become a potential aquaculture species in saline–alkali water. The brain and heart are the key tissues for signal transduction and energy supply under environmental stress. (2) This study is the first to explore the synergistic regulatory molecular mechanism by integrated analysis on cerebral ganglion proteomics and heart metabolomics of Eriocheir sinensis under alkalinity stress. (3) The results indicate that the cerebral ganglion and heart of E. sinensis were closely related in response to acute alkalinity stress. The differential regulatory pathways mainly involved regulation of energy metabolism, amino acid metabolism, and homeostasis maintenance. Importantly, alkalinity stress induced the regulation of antioxidants and further adjusted longevity and rhythm in the cerebral ganglion and heart, reflecting that the cerebral ganglion and heart may be the key tissues for the survival of Eriocheir sinensis under an alkalinity environment. (4) This study provides a theoretical reference for research on the regulation mechanism of E. sinensis under alkalinity condition and contributes to the development of aquaculture in saline–alkali water.

There are numerous risk factors across various dimensions that lead to unsafe behaviors among construction workers, and the interactions between these factors are complex and intertwined. Therefore, it is crucial to comprehensively explore the mechanisms of these risk factors across all dimensions to reduce the accident rate. This paper combines cascading failure and entropy flow models to construct a cascading trigger model for identifying key nodes and paths in a risk network. First, this paper identifies the risk factors in the individual, organizational, managerial, and environmental dimensions, dividing them into deep and surface factors. Based on this, a risk network is constructed, and cascading failure is introduced to simulate the dynamic evolution of risks. Then, the entropy flow model is introduced to quantify the risk flow in risk propagation. Finally, to address the uncertainty of risk occurrence, Visual Studio Code is used for coding, and a simulation platform is built using JavaScript. After conducting simulation experiments, the results are statistically analyzed. The results show that the key nodes of deep factors are mainly concentrated in the individual dimension (herd mentality, negative emotions, physical fatigue, fluke mindset), organizational dimension (poor cohesion, poor internal communication), and managerial dimension (abusive leadership style and insufficient/low-quality safety education and training); the surface factors are mainly the poor safety climate in the organizational dimension. The findings provide theoretical support for reducing the accident rate caused by unsafe worker behaviors, aiming to reduce accident risk losses by cutting off risk propagation paths.

The emergences of silicon-based photonic crystal (PhC) waveguides and two-dimensional (2D) PhC line-defect optical cavities have revolutionized the field of integrated photonics. In this paper, we design and fabricate a high-quality (high-Q) 2D silicon-based PhC optical cavity with integrated waveguides. We employ the 2D finite-difference time-domain (FDTD) method to simulate the cavity, considering two different thicknesses: 0.5 μm and 0.25 μm. By optimizing the line-defect and air-slot widths for the integrated PhC waveguides, we are able to achieve remarkable Q-factors for the PhC optical cavity. With a silicon thickness of 0.5 μm, the high-Q achieves an impressively high value of 8.01 × 106, while at a silicon thickness of 0.25 μm, it achieves 1.91 × 107. This research highlights the importance of design optimization and fabrication techniques in achieving high-Q optical devices using PhC and silicon-based structures.

Non-invasive load monitoring (NILM) deduces changes in energy consumption patterns and operational statuses of electrical equipment from power signals in the feed line. With the emergence of fine-grained power load distribution, the importance of utilizing this technology for implementing demand-side energy management in smart grid development has become increasingly prominent. To address the issue of low load identification accuracy stemming from complex and diverse load types, this paper introduces a NILM method based on uniform manifold approximation and projection (UMAP) reduction and enhanced density-based spatial clustering of applications with noise (DBSCAN). Firstly, this paper combines the characteristics of user load under transient and steady-state conditions and selects data with significant differences to construct a load-characteristic database. Additionally, UMAP is employed to reduce the dimensionality of high-dimensional load features and rebuild a load feature database. Subsequently, DBSCAN is utilized to categorize typical user loads, followed by a correlation analysis with the load-characteristic database to determine the types or classes of loads that involve switching actions. Finally, this paper simulates and analyzes the proposed method using the electricity consumption data of industrial users from the CER–Electricity–Data dataset. It identifies the electricity load data commonly utilized by users in a specific area of Zhejiang Province in China. The experimental results indicate that the accuracy of the proposed non-invasive load identification method reaches 95%. Compared to the wavelet transform, decision tree, and backpropagation network methods, the improvement is approximately 5%.

Reinforced concrete structures play a pivotal role in island and reef engineering projects. Given the resource constraints typical of island regions, substituting traditional manufactured sand aggregate with reef limestone not only reduces reliance on river sand but also addresses the issue of disposing of waste reef limestone slag generated during excavation. However, the performance characteristics of reef limestone concrete, particularly its bond strength with reinforcing steel, warrant further investigation. This is particularly true for the bond–slip behavior of the reinforcement. This study aims to elucidate the effects of various parameters on the bond performance between steel and reef limestone concrete through central pullout tests. These parameters include the type and diameter of the reinforcement, bond length, and loading rate. The investigation encompasses the analysis of load–slip curves, bond failure modes, and variations in bond stress. Additionally, using the Abaqus software, a numerical simulation was conducted to analyze the mesoscopic stress characteristics, thereby revealing the mechanisms of bond formation and failure modes between steel reinforcement and reef limestone concrete. The results indicate that the bond–slip curve for reef limestone concrete reinforced with ribbed rebars and Glass Fiber-Reinforced Polymer (GFRP) rebars can be broadly categorized into four phases: minor slip, slip, decline, and residual, with the residual phase exhibiting a wave-like pattern. The predominant failure modes in reef limestone concrete are either pulling out or splitting. The bond stress in reef limestone concrete decreases with an increase in rebar diameter and bond length; conversely, it increases with the loading rate, although the ultimate slip decreases. The mesoscopic failure characteristics of reinforced reef limestone concrete, as simulated in Abaqus, are consistent with the experimental outcomes.

It is crucial to assess the nodal modulation for tides in high-latitude coast areas within the context of global warming. In this paper, five stations (Maloy, Rorvik, Andenes, Vardo, and Honningsvag) along the Norwegian coast are selected to analyze the nodal modulation using the S_TIDE toolbox, which is developed from the enhanced harmonic analysis method. Three criterions are proposed to determine the optimal number of independent points (IPs), a parameter in S_TIDE toolbox, and the decision steps are elaborated in detail. The optimal number of IPs is evaluated by comparing the primary and the hindcasts tidal amplitudes. The amplitudes of 18.61-year cycle and 4.42-year cycle show noticeable temporal and spatial variations, which can be attributed to the changes of sea levels, local topography, and the active and robust mesoscale activity in the Norwegian Sea. Moreover, the temporal and spatial variations in nodal modulation are quantitatively demonstrated at the Rorvik and Vardo stations, highlighting the importance of nodal modulation in assessing tides over interdecadal periods.

Abstract This year marks the 20th anniversary of the discovery of LaAlO3/SrTiO3 (LAO/STO) oxide heterointerfaces. Since their discovery, transition metal oxide (TMO) interfaces have emerged as a fascinating and fast‐growing area of research, offering a variety of unique and exotic physical properties which has provided a strong impetus for the rapid advances and actualization of oxide electronics. This review revisits the fundamental mechanisms accounting for the two‐dimensional (2D) conducting interfaces, and how new models proposed to better account for the unique interfacial effects. Recent breakthroughs in the theoretical and experimental domains of oxide interfaces are also discussed including the detection and investigation of 2D quasiparticle. Moving beyond the well‐known LAO/STO interface, this review delves into other systems where unconventional interfacial superconductivity, interfacial magnetism, and spin polarization are dealt with in greater detail. In terms of device applications, this review proceeds with a treatment on the recent developments in domains including field effect transistors and freestanding heterostructure membranes. By emphasizing the opportunities and challenges of integrating oxide interfaces with existing technologies, the review will end off with an outlook projecting the progress and the trajectory of this research domain in the years to come.

BackgroundMetabolic dysfunction-associated fatty liver disease (MAFLD) is presently the most prevalent chronic liver disorder globally that is closely linked to obesity, dyslipidemia metabolic syndrome, and type 2 diabetes mellitus (T2DM). Its pathogenesis is strongly associated with inflammation, and diet is a major factor in reducing inflammation. However, current research has focused primarily on exploring the relationship between diet and NAFLD, with less research on its link to MAFLD.MethodsIn this research, using dietary inflammatory index (DII) as a measure to assess dietary quality, we analyzed the relationship between diet and MAFLD. Data from the National Health and Nutrition Examination Survey (NHANES) 2017–2018, including 3,633 adults with complete DII and MAFLD, were used to develop cross-sectional analyses. Logistic regression analysis was adapted for investigating the relationship between DII and MAFLD development. Additionally, subgroup analysis and threshold effect analysis were carried out.ResultsA positive link between DII and MAFLD was found in the fully adjusted model (OR = 1.05; 95%CI, 1.00–1.11, p

Nanopolystyrene (NP) and phoxim (PHO) are common environmental pollutants in aquatic systems. We evaluated the toxic effects of exposure to ambient concentrations of NP and/or PHO in the intestines of the Chinese mitten crab (Eriocheir sinensis). Our study showed that histopathological changes were observed in the intestines. Specifically, NP and/or PHO exposure increased intraepithelial lymphocytes. Furthermore, NP and/or PHO exposure induced oxidative stress, as evidenced by a significant decrease in superoxide dismutase activity (SOD), peroxidase activity (POD), and total antioxidant capacity (T-AOC). Pro-inflammatory gene expression and transcriptome analysis demonstrated that NP and/or PHO exposure induced the intestinal inflammatory response. Transcriptome results showed that NP and/or PHO exposure upregulated the NF-κB signaling pathway, which is considered a key pathway in the inflammatory response. Additionally, the expression of pro-inflammatory genes significantly increased after a single exposure to NP or PHO, but it exhibited a significant decrease after the co-exposure. The downregulation of these genes in the co-exposure group likely suggested that the co-exposure mitigated intestinal inflammation response in E. sinensis. Collectively, our findings mainly showed that NP and/or PHO exposure at ambient concentrations induces oxidative stress and inflammatory response in the intestines of E. sinensis.

BackgroundThe fermented wax gourd, often referred to as “smelly wax gourd,” is a traditional food that undergoes natural fermentation. It’s a staple in eastern China and is recognized as Ningbo’s “city-fermented food.” Characterized by its distinct putrid flavor and soft texture, its safety, nutritional aspects, and sensory attributes have not been extensively studied.MethodsIn this research, the microbial community and flavor components of fermented wax gourd during its traditional fermentation were analyzed. The safety and impact on the gut microbiota were also assessed by administering it to healthy and pseudo-germ-free mice.ResultsThe findings revealed that organic acids primarily contribute to the gourd’s flavor during fermentation. The aroma reminiscent of fruits is due to 2-methyl-butyric acid, while butyric, pentanoic, caproic, and octanoic acids are responsible for their characteristic smelly taste. In the fermentation of traditional foods, the abundance of substances and open fermentation contribute to the diversity of microorganisms in the system, and the reproduction and metabolism of microorganisms drive the fermentation of foods. From the results of this study, the flavor peaks on the 10th day of fermentation. Predominant microbes include Lactobacillus fermentum, Streptococcus equinus, Fusobacterium perfoetens, Weissella confusa, and Lactobacillus plantarum. Notably, Lactobacillus was the most abundant probiotic in the early fermentation stages. The “smelly” taste of smelly wax gourd was mainly derived from butyric acid, valeric acid, caproic acid, caprylic acid, p-methylphenol and other compounds, and the abundance of Caldicoprobacter algeriensis, Mariniphaga anaerophila, Streptococcus equi and Lactobacillus were significantly correlated with 4 of the above 5 acids. These four bacteria may contribute more to the “smelly” taste of smelly wax gourd. In the study, compared with the control group (CONT), the abundance of Helicobacter ganmani, H. Chanicola, Lactobacillus animalis, Lactobacillus gadi and Lactobacillus reuteri decreased in mice groups treated with anti-biological pretreatment followed by gavage of smelly wax gourd (A.SWG) and the smelly wax gourd (SWG) groups. Conversely, Muribaculum intestinale, Prevotellamassilia timonensis, Alistipes putredinis, Kineothrix alysoides and Clostridium indolis’ abundance of increases. Mice that underwent fecal microbiota transplantation (FMT) exhibited a higher abundance of probiotics like Bifidobacterium animalis, Bifidobacterium pseudolongum, Lactobacillus johnsonii, and others compared to the fecal culture microbiota transplantation (CMT) group. However, the CMT group had a higher presence of fermented and Royce lactobacilli.ImplicationConsuming fermented wax gourd can enhance the presence of beneficial probiotics and reduce pathogenic Helicobacter sp. in the mouse gut. Both Lactobacillus sp. and Bifidobacterium sp. showed increased abundance post fecal microbiota and fecal culture microbiota transplantation.

ObjectiveThis study aimed to analyze the current state of research on preoperative anxiety in children through CiteSpace, VOSviewer, and the identification of hot spots and frontiers.MethodRelevant data were retrieved from the Web of Science Core Collection using the search terms children and preoperative anxiety. Data were analyzed using VOSviewer (version 1.6.18), CiteSpace (5.7. R5) software, and Scimago Graphica.ResultsA total of 622 articles were published between 2007 and 2022, with an increasing trend over time. Kain, Zeev N. (13; 2.09%) and Dalhousie University (15; 2.41%) were the most influential authors and most prolific institutions, respectively. The United States (121; 19.45%) was the country with the most publications. Pediatric anesthesia (55; 8.84%) had the most publications. High-frequency keywords were categorized into three themes, including nonpharmacologic interventions for preoperative anxiety in children, preoperative medications, and risk factors for anxiety; of these, “predictor” (38; 2016) and “sedative premedication” (20; 2016) were the most studied keywords over the past 6 years. “Distraction” (67; 2019) and “dexmedetomidine” (65; 2019) have been the main areas of interest in recent years.ConclusionResearch on preoperative anxiety in children has been the focus of increasing attention over the past fifteen years, with the majority of publications from high-income countries. This review provides a useful perspective for understanding research trends, hot topics, and research gaps in this expanding field.

ABSTRACT Purpose To present a case series of Cushing's syndrome (CS) during pregnancy caused by adrenocortical adenomas, highlighting clinical features, hormonal assessments and outcomes. Methods We describe five pregnant women with CS, detailing clinical presentations and laboratory findings. Results Common clinical features included a full moon face, buffalo back and severe hypertension. Elevated blood cortisol levels with circadian rhythm disruption and suppressed adrenocorticotrophic hormone (ACTH) levels were observed. Imaging revealed unilateral adrenal tumours. Two cases underwent laparoscopic adrenalectomies during the second trimester, while three had postpartum surgery. All required hormone replacement therapy, with postoperative pathological confirmation of adrenocortical adenomas. Conclusion Diagnosis of CS during pregnancy is challenging due to overlapping features with normal pregnancy: elevated blood cortisol levels and abnormal diurnal rhythm of blood cortisol, suppressed aid diagnosis. Treatment should be individualised due to a lack of explicit optimum therapeutic approaches. Laparoscopic adrenalectomy may be an optimal choice, along with multidisciplinary management including hormone replacement therapy.

Global cerebral ischemia/reperfusion (GCI/R) injury poses a risk for cognitive decline, with neuroinflammation considered pivotal in this process. This study aimed to unravel the molecular mechanisms underlying GCI/R injury and propose a potential therapeutic strategy for associated cognitive deficits. Utilizing bioinformatics analysis of a public microarray profile (GSE30655 and GSE80681) in cerebral ischemic mice, it was observed that neuroinflammation emerged as a significant gene ontology item, with an increase in the expression of thioredoxin-interacting protein (TXNIP) and NLRP3 genes. Experimental models involving bilateral occlusion of the common carotid arteries in mice revealed that GCI/R induced cognitive impairment, along with a time-dependent increase in TXNIP and NLRP3 levels. Notably, TXNIP knockdown alleviated cognitive dysfunction in mice. Furthermore, the introduction of adeno-associated virus injection with TXNIP knockdown reduced the number of activated microglia, apoptosis neurons, and levels of oxidative stress and inflammatory cytokines in the hippocampus. Collectively, these findings underscore the significance of TXNIP/NLRP3 in the hippocampus in exacerbating cognitive decline due to GCI/R injury, suggesting that TXNIP knockdown holds promise as a therapeutic strategy.

Significance: Angiokeratoma corporis diffusum (ACD) is one type of angiokeratomas which are characterized on histology by superficial dilated capillaries with epidermal proliferation. ACD seriously influences patients’ appearance and quality of life. Many therapies have been used to solved this problem. However, all the treatments have not been proved very effective. Hemoporfin-mediated photodynamic therapy (Hemoporfin-PDT) was considered recently as a promising treatment for PWS according to the principle of targeted photodynamic destruction of the vascular wall of the lesion. Approach: approach: A 27-year-old male patient diagnosed with angiokeratoma corporis diffusum (ACD) by skin tissue biopsy has undergone pulsed dye laser for times, but the result was unsatisfying. After evaluating and obtaining the patient's agreement, we utilized Hemoporfin-PDT with 530 nm LED green light to treat ACD. When followed up in the 1 year after 2 treatments, the patient was pleased with the efficacy that most red papules on his face disappeared. Results: The patient achieved great improvement after two treatments. Conclusions: Hemoporfin-PDT could be used to treat ACD.

Summary: Background: Although the antibody–drug conjugates (ADCs) have significantly improved the survival outcomes of patients with human epidermal receptor 2 (HER2)-expressing gastric or gastroesophageal junction (G/GEJ) cancer, the efficacy of ADC used as a single agent is limited. Therefore, it is necessary to investigate effective and safe combination regimens. Preclinical data indicated a synergetic antitumour effect of RC48 and programmed cell death protein 1 (PD-1) inhibitors. We aimed to evaluate the safety and efficacy of RC48 plus toripalimab in patients with HER2-expressing G/GEJ cancer and other solid tumours. Methods: This was a open-label, multicentre, phase 1 trial performed at three hospitals in China. Eligible patients had advanced G/GEJ cancer or other solid tumours with HER2 IHC≥1 or ISH positivity and were refractory to at least one line of treatment, or standard treatment was intolerable or unavailable for these patients. This study followed a “3 + 3” design with predefined RC48 dosages of 2.0 mg/kg and 2.5 mg/kg plus toripalimab 3 mg/kg, once every 2 weeks (q2w). The primary objectives were to evaluate the safety and determine the recommended phase II dose (RP2D), and the secondary objectives included assessing the pharmacokinetics (PK) and preliminary efficacy. This study was registered with ClinicalTrials.gov, NCT04280341. Findings: Between July 13, 2020 and August 30, 2022, 56 patients, including 30 patients with G/GEJ cancer and 26 patients with other solid tumours, were enrolled and received RC48 plus toripalimab (n = 7 for RC48 2.0 mg/kg, toripalimab 3 mg/kg, q2w; n = 49 for RC48 2.5 mg/kg, toripalimab 3 mg/kg, q2w). No dose-limiting toxic effects occurred. The RP2D was declared as RC48 2.5 mg/kg plus toripalimab 3 mg/kg, q2w. The most common grade 3 adverse events were a decreased neutrophil count (n = 13), and a decreased white blood cell count (n = 7). The efficacy assessment was completed for 52 patients. Among patients with G/GEJ cancer (n = 30), the confirmed objective response rate (ORR) was 43% (12/28, 95% CI 25, 63), median progression-free survival (PFS) was 6.2 months (95% CI 4.0, 6.9), median overall survival (OS) was 16.8 months (95% CI 7.2, NE). The ORR of patients with G/GEJ cancer receiving RP2D (n = 24) reached 50% (11/22, 95% CI 28, 72), with median PFS of 5.1 months (95% CI 1.4, 7.3) and median OS of 14.0 months (95% CI 6.3, NE). Among patients with G/GEJ cancer who received RP2D, a clinical benefit was observed in both HER2-positive and low HER2 expressing populations, with an ORR of 56% (5/9, 95% CI 21, 86) vs. 46% (6/13, 95% CI 19, 75), median PFS of 7.8 months (95% CI 0.9, NE) vs. 5.1 months (95% CI 1.2, 6.9), median OS of NE months (95% CI 4.3, NE) vs. 14.0 months (95% CI 5.1, NE), respectively. Antitumour activity was also observed for other solid tumours, including breast cancer (5/13) and endometrial carcinoma (1/1). Interpretation: Our findings suggested that RC48 plus toripalimab had a manageable safety profile and showed encouraging efficacy in pretreated patients with HER2-positive and low HER2-expressing G/GEJ cancer. The findings of our phase 1 clinical trial support further investigation of HER2-targeted ADC plus immunotherapy in HER2-expressing G/GEJ cancer and pancancer treatment in the future. Funding: Beijing Municipal Medical Research Institutes, Beijing Medical Research Institute (Z200015).

Microwave hotspots or thermal runaway is a long-standing challenge that severely limits the uniformity of microwave heating. In particular, the evolvement process and suppression methods of focused hotspots in high permittivity dimers are still not clear. In this work, thermal imaging was used to in situ track the microwave hotspots of grape dimers with different gaps and shapes in a multi-mode microwave oven. Two thermal characteristics of microwave resonance-induced focused hotspots, gap sensitivity and shape selectivity, were found. Finite element simulation verified the experimental results and calculated the influence of different conditions on the heating uniformity and the enhanced electric field. The results indicated that gap can gradually weaken the enhanced electric field between grapes and rapidly improve the heating uniformity by approximately 30 times. For dimers of different shapes in contact, the sharper the contact area, the more pronounced the focused hotspots. Moreover, the heating uniformity raises with increasing shape factor n, and when n = ∞, it is improved by about 35 times compared with n = 1. In addition, the enhanced electric field, which exhibits complexity due to microwave scattering interaction between grapes, was analyzed. These findings provide two strategies for improving the heating homogeneity of dimers or particle systems.

High catalytic performances of metal-semiconductor heterostructures have gained significant attention in recent years. However, developing fast and low-cost synthesis of multiphase heterojunction catalysts has long been a challenge. Herein, three phases of Cu-CeO2-SrTiO3-δ heterojunction catalyst are successfully synthesized by combining with sol-gel and rapid plasma exsolution method. Using dielectric barrier discharge plasma (DBD), Cu nanoparticles are exsolved and uniformly distributed on the surface of CeO2-SrTiO3-δ. This unique multiphase heterojunction catalyst exhibits superior performance in photothermal reverse water gas shift (RWGS) reactions. The yield of CO from this catalyst is impressive at 11.32 mmol g−1 h−1, 9 times greater than pure SrTiO3, and the selectivity for CO is high (99.95%). The enhanced activity is primarily attributed to the synergistic effect resulting from the incorporation of three phases of Cu nanoparticles, CeO2, and SrTiO3-δ, as well as their interfaces. The increase in oxygen vacancy sites in CeO2 enhances the adsorption of CO2, whereas the doping and exsolution of Cu help to broaden the light absorption range. A significant role is played by the localized surface plasmon resonance (LSPR) effect of Cu nanoparticles in promoting the catalytic performance of RWGS. This study demonstrates a simple and efficient method for fabricating multiphase heterojunction catalysts, providing new strategies for photothermal CO2 reduction.

BackgroundThis study aimed to understand the knowledge, attitude, and practice (KAP) of drug use among residents in western China and its influencing factors for accurately designing the knowledge, contents, and methods of popular science activities for safe drug use among residents to provide a reference for conducting rational drug use educational activities and improving residents’ level of safe drug use.MethodsA cross-sectional questionnaire survey was conducted to investigate the KAP of medication among western China residents and its influencing factors from March to April 2023. Each question option was assigned a score according to logic, and the risk factors for resident medication safety KAP were explored through univariate and logistic regression analyses.ResultsA total of 7,557 valid questionnaires were collected, with an effective recovery rate of 96.7%. The average scores of KAP were 72.77 ± 22.91, 32.89 ± 10.64, and 71.27 ± 19.09, respectively. In the evaluation criteria of the questionnaire, the score of medication knowledge reached “good,” and the score of attitude and practice was “average.” Multiple linear regression analysis indicated that male sex and low education level were significant factors affecting the lack of drug knowledge among residents. Old age and low education level were the factors of poor attitude toward medication. The low condition of medical security was a factor in residents’ irregular drug use behavior.ConclusionThe overall level of rational drug use among residents in western China is good, but there are still some inconsistencies. Rational drug use education should be conducted according to the risk points of residents in drug safety KAP to further improve the level of rational drug use of residents.