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Background: Endoscopic pancreatic stenting is an effective way to relieve the stricture of the pancreatic duct. However, proximal stent migration presents a threat to the patient and a challenge to the doctor. The limited space in the pancreatic duct often prevents the operation of suitable devices for stent removal. Case presentation: A 34-year-old man with painful chronic pancreatitis received endoscopic retrograde cholangiopancreatography (ERCP) and insertion of a pancreatic plastic stent, with 8.5 Fr in diameter and 12 cm in length. A year later, radiography revealed that the proximal end of the stent rested in the pancreatic tail while the distal end rested in the branch duct. Both balloon and rat-tooth forceps were used but failed to retrieve the stent. A week later, a second ERCP was performed. After dilation with a 10-mm balloon, a small amount of bleeding was noticed and a crack appeared in the wall of the branch duct. Consequently, the distal end of the stent was released. Then, rat-tooth forceps was used to grasp the distal end, and the stent was pulled out successfully. Conclusions: For a proximally migrated pancreatic stent stuck at both ends, a strategy of maximum dilation can be used cautiously to retrieve the stent.

The study aimed to investigate the learning motivation of freshmen from a university in Northwest China, which can supply a reference for improving their learning quality and objectives. Data were collected from 800 freshmen of different majors with a learning motivation questionnaire. Differences in learning motivation between different majors, genders, regions, and students are studied. The results show that gender, seeking knowledge orientation, and material pursuit have significant effects on students’ learning motivation. The gender had a significant impact on personal achievement and the only child or not had an obvious effect on material pursuit, while other factors had no obvious difference in gender, regional, and only child or not, while other factors on the gender, regional, and whether the one-child had no obvious difference. According to the results of the research, measures to improve learning motivation are proposed. Our research results provide a reference for improving learning attitude and the quality of universities.

The incidence of malignant tumors diagnosed during pregnancy is increasing, often ascribed to the recently recognized trend that many women are postponing childbirth. Although early diagnosis is optimal for both mothers and fetuses, the diagnosis of malignant tumors during pregnancy is often delayed until an advanced stage, because generalized symptoms of pregnancy and malignancy may overlap, such as shortness of breath, chest or abdominal discomfort. The study patient was 21 years old, and 31 weeks-pregnant when she was diagnosed with primary tracheal adenoid cystic carcinoma (ACC). The patient initially presented with dyspnea and decreased blood oxygen saturation and underwent a cesarean section on the first night of hospitalization, resulting from fetal distress. This case report intended to investigate potential barriers to the timely diagnosis of tracheal ACC and consider optimal management strategies when it is diagnosed during pregnancy.

Yellowhorn (Xanthoceras sorbifolium) is an oil-bearing tree species growing naturally in poor soil. The kernel of yellowhorn contains valuable fatty acids like nervonic acid. However, the genetic basis underlying the biosynthesis of valued fatty acids and adaptation to harsh environments is mainly unexplored in yellowhorn. Here, we presented a haplotype-resolved chromosome-scale genome assembly of yellowhorn with the size of 490.44 Mb containing scaffold N50 of 34.27 Mb. Comparative genomics, in combination with transcriptome profiling analyses, showed that expansion of gene families like long-chain acyl-CoA synthetase and ankyrins contribute to yellowhorn fatty acid biosynthesis and defense against abiotic stresses, respectively. By integrating genomic and transcriptomic data of yellowhorn, we found that the transcription of 3-ketoacyl-CoA synthase gene XS04G00959 was consistent with the accumulation of nervonic and erucic acid biosynthesis, suggesting its critical regulatory roles in their biosynthesis. Collectively, these results enhance our understanding of the genetic basis underlying the biosynthesis of valuable fatty acids and adaptation to harsh environments in yellowhorn and provide foundations for its genetic improvement.

The COVID-19 pandemic has brought enormous challenges to both employees and organizations all over the world. Previous studies have found high turnover rates among prison officers since the outbreak of COVID-19. This cross-sectional study aimed to investigate the mediating role of job burnout between job demands and turnover intention, as well as the moderating role of the perceived efficacy in overcoming COVID-19 in Chinese prison officers. In total, 1316 prison officers were recruited to complete an online questionnaire between May 2022 and June 2022 (during the COVID-19 pandemic). The bootstrapping approach was used to assess the moderated mediation model in this study. The results showed that prison officers’ job demands were positively associated with their turnover intention. Job burnout mediated the relationship between job demands and turnover intention. Perceived efficacy in overcoming COVID-19 moderated the effect of job burnout on turnover intention. Based on these results, suggestions were provided to reduce the high turnover rate of prison officers in public health events like the COVID-19 pandemic.

Dredging materials from reef flats have become an important source of sand and aggregates for meeting the infrastructure needs of coral-lined shores in subtropical and tropical regions, especially for low-lying atoll islands. Dredging at the reef flats can generate artificial excavation pits, which not only have profound influences on coral ecological stability but also deeply affect the hydrodynamic characteristics of coral reefs. To deepen the understanding of the influence of excavation on the wave hydrodynamics of fringing reefs, the wave propagation, wave transformation, wave setup, and wave runup processes of regular waves on fringing reefs with artificial pits have been systematically analyzed using a non-hydrostatic numerical wave solver (NHWAVE). The effects of some significant factors have been carefully investigated. According to the study findings, the existence of artificial pits can result in a slight decrease in the wave height around the artificial pit. The time-mean maximum of wave runup height at the backreef slope can be reduced to some extent when the artificial pit is present. When placed close to the reef edge, the artificial pit can have noticeable effects on the hydrodynamic characteristics of fringing reefs, particularly the wave setup along the reef flat. It is hoped that the study findings can provide further reference for evaluation of the influences of artificial pits on the wave hydrodynamics of fringing reefs.

Abstract Background Walnut anthracnose induced by Colletotrichum gloeosporioides is a disastrous disease affecting walnut production. The resistance of walnut fruit to C. gloeosporioides is a highly complicated and genetically programmed process. However, the underlying mechanisms have not yet been elucidated. Results To understand the molecular mechanism underlying the defense of walnut to C. gloeosporioides, we used RNA sequencing and label-free quantitation technologies to generate transcriptomic and proteomic profiles of tissues at various lifestyle transitions of C. gloeosporioides, including 0 hpi, pathological tissues at 24 hpi, 48 hpi, and 72 hpi, and distal uninoculated tissues at 120 hpi, in anthracnose-resistant F26 fruit bracts and anthracnose-susceptible F423 fruit bracts, which were defined through scanning electron microscopy. A total of 21,798 differentially expressed genes (DEGs) and 1929 differentially expressed proteins (DEPs) were identified in F26 vs. F423 at five time points, and the numbers of DEGs and DEPs were significantly higher in the early infection stage. Using pairwise comparisons and weighted gene co-expression network analysis of the transcriptome, we identified two modules significantly related to disease resistance and nine hub genes in the transcription expression gene networks. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis of the DEGs and DEPs revealed that many genes were mainly related to immune response, plant hormone signal transduction, and secondary metabolites, and many DEPs were involved in carbon metabolism and photosynthesis. Correlation analysis between the transcriptome data and proteome data also showed that the consistency of the differential expression of the mRNA and corresponding proteins was relatively higher in the early stage of infection. Conclusions Collectively, these results help elucidate the molecular response of walnut fruit to C. gloeosporioides and provide a basis for the genetic improvement of walnut disease resistance.

While the role of PbTiO3 in PbTiO3/SrTiO3 superlattices has been widely studied, little attention is paid to possible polar topologies in SrTiO3. Here, the authors create atomic-scale vortex–antivortex pairs in the superlattices, expanding the understanding of topological structures.

To investigate the roles of both coupling noises and distributed delays with strong kernels, a novel delayed stochastic two-species facultative mutualism model is established, in where the strong kernels indicate that the maximum influence on the growth rate response at some time is due to population densities at the previous time, and the saturation effect is also incorporated because the facultative capacity of each species is finite and their interspecific mutualism should be upper bounded in real life. We first transfer the two-species stochastic model with strong kernels into an equivalent six-dimensional model through a linear chain technique. Later, sufficient conditions for the extinction exponentially, persistence in the mean, permanent in time average and stationary distribution are respectively obtained. Finally, numerical simulations are supplied to support our theoretical results. Our analytical results show that the coupling noise intensities play an important role in the long-time behaviors while the strong kernels are independent of the above asymptotic properties.

ObjectiveThis study aims to identify all actors that hold some responsibility for ensuring food safety based on the complete food supply chain in the context of China's current circumstances.MethodsThe study was conducted among citizens in Wuxi, Jiangsu, China. All citizens fully understood the purpose of the study and voluntarily agreed to participate. From December 10 to 14, 2020, a total of 398 valid samples were collected by the researchers using a structured questionnaire. Survey data were assessed using best–worst scaling and a mixed logit model from the perspective of citizen responsibility.ResultsIn descending order, responsibility for ensuring food safety goes from food producers and traders (including producers, distributors, and retailers) to the government, social organizations, news media, and finally to citizens. Food producers and traders are the actors who should take the greatest responsibility, whereas citizens bear the least responsibility.ConclusionThe responsibility of citizens in food safety co-governance should be recognized but it should not be arbitrarily extended.

BackgroundThe current American Joint Committee on Cancer (AJCC) system only considered the importance of the size and laterality of lymph nodes while not the positive lymph node number (PLNN) for hypopharyngeal squamous cell carcinoma (HPSCC).MethodsA total of 973 patients with HPSCC from the Surveillance, Epidemiology, and End Results database (2004–2015) were identified. Univariate and multivariate Cox regression analyses were used to evaluate the prognostic effects. We applied six Cox regression models to compare the survival prognostic values of PLNN and AJCC systems.ResultsPositive lymph node number showed a significant association with overall survival (OS) and cancer-specific survival (CSS) (P < 0.001) in univariate and multivariable analyses. The increased PLNN of HPSCC gave rise to poor OS and CSS. The survival model incorporating a composite of PLNN and TNM classification (C-index for OS:0.682, C-index for CSS:0.702) performed better than other models.ConclusionsA positive lymph node number could serve as a survival predictor for patients with HPSCC and a complement to enhance the prognostic assessment effects of TNM cancer staging systems.

ObjectiveFood safety risk management is an important cross-boundary issue from both theoretical and practical standpoints. Because food safety has the social attributes of public goods, public-public collaboration can be considered a particularly important mode of cross-boundary governance. The study aims to provide a theoretical basis for the Chinese government to promote public-public collaboration for food safety risk management by identifying key factors.MethodsBased on a review of literature across diverse fields, such as political science, sociology, and new public governance, this study discusses the essence, modes, and dilemma of public-public collaboration for food safety risk management using practical explorations in various countries as the main thread and taking into account the actual situation in China. Moreover, this study quantitatively analyzes the relationships between the dimensions and factors affecting public-public collaboration and identifies key dimensions and factors using the Decision-making Trial and Evaluation Laboratory-based Analytic Network Process (DANP).ResultsAmong the 20 factors in the calculation results of DANP, Lawmaking has the highest value of (fi+ei) (7.022) and ranks sixth in terms of influence weight. The (fi+ei)value of Professionalism (6.993) ranks second and its influence weight ranks fourth. The (fi+ei) value of Administrative enforcement (6.722) ranks fifth, and its influence weight ranks seventh. The (fi+ei) value of Improvement of the social environment (6.699) ranks sixth, and its influence weight ranks fifth. The (fi+ei) value of Legal authorization (6.614) ranks seventh, and its influence weight ranks tenth. Data analysis indicated that these are the five key factors affecting the governance capacity in public-public collaboration for food safety risk management.ConclusionThe legal basis is the most important dimension affecting public-public collaboration. Legislation-based governance, administrative law enforcement–based governance, and social environment improvement–based governance in the behavior and capabilities dimension, professionalism in the basic characteristics dimension, and laws and regulations in the legal basis dimension are the five key factors.

By establishing a linear regression relationship between the projection coefficient of the empirical orthogonal function (EOF) of the sound speed profile (SSP) and remote sensing parameters of the sea surface, the single empirical orthogonal function regression (sEOF-r) method was used to reconstruct the underwater SSP from satellite remote sensing data. However, because the ocean is a complex dynamical system, the parameters of the surface and the subsurface did not conform to the linear regression model in strict sense. This paper proposes a self-organizing map (SOM)-based nonlinear inversion method that used satellite observations to obtain anomalies in data on the sea surface temperature and height, and combined them with the EOF coefficient from an Argo buoy to train and generate a map. The SSP was then reconstructed by obtaining the best matching neuron. The results of SSP reconstruction in the northern part of the South China Sea showed that the relationship between the parameters of the sea surface and the subsurface could be adequately expressed by the nonlinear neuronal topology. The SOM algorithm generated a smaller inversion error than linear inversion and had better robustness. It improved the average accuracy of reconstruction by 0.88 m/s and reduced the mean-squared reconstruction error to less than 1.19 m/s. It thus offered significant promise for acoustic applications.

Abstract Background Walnut anthracnose caused by Colletotrichum gloeosporioides (Penz.) Penz. and Sacc. is an important walnut production problem in China. Although the long non-coding RNAs (lncRNAs) are important for plant disease resistance, the molecular mechanisms underlying resistance to C. gloeosporioides in walnut remain poorly understood. Results The anthracnose-resistant F26 fruits from the B26 clone and the anthracnose-susceptible F423 fruits from the 4–23 clone of walnut were used as the test materials. Specifically, we performed a comparative transcriptome analysis of F26 and F423 fruit bracts to identify differentially expressed LncRNAs (DELs) at five time-points (tissues at 0 hpi, pathological tissues at 24 hpi, 48 hpi, 72 hpi, and distal uninoculated tissues at 120 hpi). Compared with F423, a total of 14,525 DELs were identified, including 10,645 upregulated lncRNAs and 3846 downregulated lncRNAs in F26. The number of upregulated lncRNAs in F26 compared to in F423 was significantly higher at the early stages of C. gloeosporioides infection. A total of 5 modules related to disease resistance were screened by WGCNA and the target genes of lncRNAs were obtained. Bioinformatic analysis showed that the target genes of upregulated lncRNAs were enriched in immune-related processes during the infection of C. gloeosporioides, such as activation of innate immune response, defense response to bacterium, incompatible interaction and immune system process, and enriched in plant hormone signal transduction, phenylpropanoid biosynthesis and other pathways. And 124 known target genes for 96 hub lncRNAs were predicted, including 10 known resistance genes. The expression of 5 lncRNAs and 5 target genes was confirmed by qPCR, which was consistent with the RNA-seq data. Conclusions The results of this study provide the basis for future functional characterizations of lncRNAs regarding the C. gloeosporioides resistance of walnut fruit bracts.

Friction stir lap welding (FSLW) was employed to weld dissimilar joints of zirconium and stainless steel for the first time. The microstructure, evolution mechanism of intermetallic compounds (IMCs) and mechanical properties of joint were investigated. Discontinuous dynamic recrystallization (DDRX) and continuous dynamic recrystallization (CDRX) occurred in zirconium, while DDRX occurred in stainless steel during FSLW. The formation sequence of IMCs at the interface was FeZr3, FeZr2, Fe2Zr, and Fe23Zr6. The crack nucleated at the hook zone on the advancing side (HookAS), and IMCs in the Zr/SS mixed zone accelerated crack propagation. The fracture surface exhibited ductile-brittle mixed fracture characteristic.

Objective To investigate the effect of inhibiting DLK1 expression on the radiosensitivity of esophageal cancer cells. Methods The difference in radiosensitivity between KYSE-R and KYSE cells was verified by colony formation assay. RT-PCR and Western blot were used to detect DLK1 expression. The best DLK1 interference sequence was used to transfect KYSE-R cells. After 4Gy radiation treatment, clone formation experiment was used to detect the radiosensitivity of KYSE-R cells, and flow cytometry was used to detect apoptosis and cell cycle. Results KYSE-R cells showed stronger radioresistance than KYSE cells. The expression of DLK1 in KYSE-R cells was significantly higher than that in KYSE cells, and the interference effect of siDLK1-3 was the best(all P < 0.05). Compared with the control group, the cell viability was significantly lower after 4Gy irradiation, while the apoptosis rate and cell proportion in G2/M phase were significantly higher in DLK1 interference group(all P < 0.05). Conclusion The inhibition of DLK1 expression could provide a new target for radiosensitization research of esophageal cancer by reducing cell survival, promoting apoptosis, increasing the cell proportion in G2/M phase and enhancing radiosensitivity.

A bulk pure Al sample was prepared through cold spray-friction stir processing composite additive manufacturing (CFAM). The microstructure is uniform, and consists of fine and equiaxed recrystallized grains with an average grain size of 4.4 μm. Continuous and discontinuous dynamic recrystallizations are primary recrystallization mechanisms. The ultimate tensile strength and elongation are 87 MPa and 60.3%, respectively, with the fracture mode being ductile. The order of contribution of strengthening mechanisms for the CFAM sample, from highest to lowest, is fine grain strengthening, dislocation strengthening, and grain orientation strengthening.

Background and Aims: EUS-guided gallbladder drainage has been increasingly applied for acute cholecystitis in high-risk surgical patients. In cases of EUS-guided gallbladder drainage with lumen-apposing metal stents (LAMSs), endoscopic retrieval of gallstones becomes feasible. However, retrieval of giant gallstones is still difficult because of the limited space in the saddle section of the LAMS. In this study, we aimed to evaluate the efficacy and safety of endoscopic laser lithotripsy and lithotomy through LAMSs for the removal of giant gallstones. Methods: Five consecutive patients with recurrent cholecystitis due to giant gallstones were enrolled. We proceeded with EUS-guided LAMS implantation. Endoscopic laser lithotripsy and lithotomy then was performed through the LAMSs, and the stents were removed after all stones were extracted. The patients were followed up at scheduled times. Results: EUS-guided LAMS implantation was successfully performed, and target gallstones were completely removed in all 5 patients. There was no severe bleeding, perforation, or stent migration during the operation. No recurrence of gallstones was found at late follow-up. Conclusions: Endoscopic laser lithotripsy and lithotomy through LAMSs could be a safe and effective approach for removal of giant gallstones.

Friction stir processing (FSP) is a new severe plastic deformation technique where microstructure refinement, homogenization, and densification occur simultaneously. In this study, the microstructure and superplastic deformation behavior of AZ80 magnesium alloy prepared by FSP were investigated. FSP led to remarkable grain refinement and modification of texture for AZ80 magnesium alloy. A maximum elongation of 606% was obtained at 3 × 10−4 s−1 and 350 ℃. When superplastic deformation was conducted at 3 × 10-3 s−1 and 300 ℃, or at 1 × 10-4 s−1 and 400 ℃, the superplasticity was relatively lower, thus exhibiting a lower strain rate sensitivity. The coarsening of both grains and β-Mg17Al12 precipitates deteriorated superplastic elongation. Applied deformation promoted the premature dissolution of β precipitates at 400 ℃ during superplastic deformation. Moreover, superplastic deformation weakened and spread the basal texture. Although the activation of prismatic and pyramidal slips is beneficial for superplastic deformation, grain boundary sliding is the main superplastic deformation mechanism.

Background: Cornus wilsoniana Wanger is a widely distributed woody oil plant in south China; oil extracted from its fruits has been the main source of edible oil for local residents for hundreds of years. Previous studies have demonstrated that Cornus wilsoniana oil (CWO) has hypolipidemic activity in rats. However, the hepatoprotective effects of CWO and their underlying mechanisms are not clear. Objective: The purpose of this study was to explore the protective effects and mechanisms of the CWO against carbon tetrachloride (CCl4)-induced hepatic fibrosis in mice. Methods: Hepatic fibrosis mouse model was induced by intraperitoneal injection with 1 mL/kg CCl4 (mixed 1:4 in olive oil) twice a week for 6 weeks. In the meantime, the mice were orally administrated with CWO (0.5, 2 mL/kg) once daily for 6 weeks. Serological changes as well as oxidative stress, inflammatory, and histological alteration in the liver were determined. Results: The results showed that CWO significantly attenuated CCl4-induced serological changes in mice, as assessed by serum markers, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), procollagen III, collagen type IV, hyaluronic acid, and laminin. At the same time, CWO significantly improved CCl4-induced liver histological changes, as detected by hematoxylin and eosin (H&E), Sirius red, and Masson’s trichrome staining. In addition, treatment with CWO reduced oxidative stress and inflammation in the liver. Furthermore, CWO also reduced the expression of extracellular matrix (ECM) in liver induced by CCl4, and TGF-β1/Smad3 signaling may be involved in the process. Conclusions: CWO ameliorates CCl4-induced hepatic fibrosis by attenuating hepatic oxidative stress, reducing hepatic inflammation and inhibiting TGF-β1/Smad3 signaling pathway in liver. CWO may be a potentially beneficial edible oil for the adjuvant treatment of hepatic fibrosis.

Recently, a lot of renewable energy sources have been integrated into the distribution network. In consideration of economy and construction feasibility, some renewable energy sources are required to be installed in specific areas. In this paper, a bi-layer distribution network planning optimization model that considers the geographical restrictions of the installation locations of the substation, pumped storage plant, photovoltaic (PV) and wind power, as well as the impact of operation on planning, is proposed. In the planning optimization layer, the optimal distribution network topology with minimal total cost is obtained. The locations of the renewable energy sources and the substation are determined by the particle swarm optimization (PSO), and then all the components are interconnected using the dynamic minimum spanning tree (DMST) method. In the operation optimization layer, the economic operation strategy of the hybrid energy system with uncertainty is obtained by the scenario-based stochastic optimal power flow (OPF). The forecast error of the uncertain variable is represented by the probability distribution function, and the roulette wheel mechanism (RWM) is used to generate the stochastic scenarios. A modified 103-bus system is used to test the effectiveness of the proposed method, and the simulation results show that the proposed method can effectively reduce the total cost of the distribution network.

Soil salinization is a major environmental problem that seriously threatens the sustainable development of regional ecosystems and local economies. Fraxinus velutina Torr. is an excellent salt-tolerant tree species, which is widely planted in the saline-alkaline soils in China. A growing body of evidence shows that microRNAs (miRNAs) play important roles in the defense response of plants to salt stress; however, how miRNAs in F. velutina exert anti-salt stress remains unclear. We previously identified two contrasting F. velutina cuttings clones, salt-tolerant (R7) and salt-sensitive (S4) and found that R7 exhibits higher salt tolerance than S4. To identify salt-responsive miRNAs and their target genes, the leaves and roots of R7 and S4 exposed to salt stress were subjected to miRNA and degradome sequencing analysis. The results showed that compared with S4, R7 showed 89 and 138 differentially expressed miRNAs in leaves and roots, respectively. Specifically, in R7 leaves, miR164d, miR171b/c, miR396a, and miR160g targeting NAC1, SCL22, GRF1, and ARF18, respectively, were involved in salt tolerance. In R7 roots, miR396a, miR156a/b, miR8175, miR319a/d, and miR393a targeting TGA2.3, SBP14, GR-RBP, TCP2/4, and TIR1, respectively, participated in salt stress responses. Taken together, the findings presented here revealed the key regulatory network of miRNAs in R7 responding to salt stress, thereby providing new insights into improving salt tolerance of F. velutina through miRNA manipulation.

Fraxinus velutina Torr with high salt tolerance has been widely grown in saline lands in the Yellow River Delta, China. However, the salt-tolerant mechanisms of F. velutina remain largely elusive. Here, we identified two contrasting cutting clones of F. velutina, R7 (salt-tolerant), and S4 (salt-sensitive) by measuring chlorophyll fluorescence characteristics (Fv/Fm ratio) in the excised leaves and physiological indexes in roots or leaves under salt treatment. To further explore the salt resistance mechanisms, we compared the transcriptomes of R7 and S4 from leaf and root tissues exposed to salt stress. The results showed that when the excised leaves of S4 and R7 were, respectively, exposed to 250 mM NaCl for 48 h, Fv/Fm ratio decreased significantly in S4 compared with R7, confirming that R7 is more tolerant to salt stress. Comparative transcriptome analysis showed that salt stress induced the significant upregulation of stress-responsive genes in R7, making important contributions to the high salt tolerance. Specifically, in the R7 leaves, salt stress markedly upregulated key genes involved in plant hormone signaling and mitogen-activated protein kinase signaling pathways; in the R7 roots, salt stress induced the upregulation of main genes involved in proline biosynthesis and starch and sucrose metabolism. In addition, 12 genes encoding antioxidant enzyme peroxidase were all significantly upregulated in both leaves and roots. Collectively, our findings revealed the crucial defense pathways underlying high salt tolerance of R7 through significant upregulation of some key genes involving metabolism and hub signaling pathways, thus providing novel insights into salt-tolerant F. velutina breeding.

BackgroundThe predictive role of retinol-binding protein 4 (RBP4) in the adverse prognosis of patients with stable coronary artery disease (CAD) has not been well-defined. We thus conducted this cohort study to investigate the association between circulating RBP4 level and major adverse cardiovascular events (MACEs) in Chinese patients with stable CAD.MethodsPatients with stable CAD and serum RBP4 concentration measurement at admission between July 2012 and January 2015 were included. The primary outcome in this study was incident MACEs, which included acute coronary syndrome, heart failure, stroke, peripheral vascular disease, and cardiovascular death. Cox proportional hazards regression was adopted to investigate the association between RBP4 and the incidence of MACEs.ResultsA total of 840 patients with stable CAD were analyzed. The mean age of patients was 61.2 ± 15.9 years, and 56.1% of them were men. After a median follow-up of 2.3 years, 129 MACEs were observed. Compared to participants exposed to the first quartile of serum RBP4 level, those in the second, the third, and the fourth quartiles had associated hazard ratios (HRs) of 2.38 [95% confidence interval (CI): 1.33–4.26], 2.35 (95% CI: 1.31–4.21), and 2.27 (95% CI: 1.28–4.04) after adjusted for confounders, respectively. Every 5 μg/ml increment in serum RBP4 concentration was associated with an adjusted HR of 1.13 (95% CI: 1.05–1.22) for the occurrence of MACEs. Subgroup analyses suggested no significant modifying effects of baseline characteristics for the association between RBP4 and MACEs in patients with stable CAD.ConclusionOur finding suggested that the higher circulating RBP4 level was significantly associated with an increased risk of MACEs in patients with stable CAD.

BackgroundTricuspid regurgitation after left-sided valve surgery was associated with terrible outcomes and high perioperative mortality for surgical treatment. In current years, minimally invasive isolated tricuspid valve repair is increasingly performed in our institution to address tricuspid regurgitation.MethodsThirty-seven consecutive patients with previous left-sided valve surgery underwent minimally invasive isolated tricuspid valve repair in our institution between November 2017 and December 2020. Twenty-nine patients(78.4%) were women and the mean age of patients was 58.4 ± 8.5 years. Follow-up was 100% complete with a mean follow-up time of 17.2 ± 9.5 months.ResultsBoth the in-hospital and 30-day mortalities were 2.7%. The overall NYHA class had improved significantly during the follow-up (p < 0.001). The grade of TR had decreased before discharge (p < 0.001) and during the follow-up (p < 0.001) compared with the preoperative level although severe TR was recurrent in one patient.ConclusionsMinimally invasive isolated tricuspid valve repair has acceptable early and midterm outcomes, may be the preferred surgical option to address tricuspid regurgitation after previous left-sided valve surgery when it is feasible.

In recent years, Kubernetes (K8s) has become a dominant resource management and scheduling system in the cloud. In practical scenarios, short-running cloud workloads are usually scheduled through different scheduling algorithms provided by Kubernetes. For example, artificial intelligence (AI) workloads are scheduled through different Volcano scheduling algorithms, such as GANG_MRP, GANG_LRP, and GANG_BRA. One key challenge is that the selection of scheduling algorithms has considerable impacts on job performance results. However, it takes a prohibitively long time to select the optimal algorithm because applying one algorithm in one single job may take a few minutes to complete. This poses the urgent requirement of a simulator that can quickly evaluate the performance impacts of different algorithms, while also considering scheduling-related factors, such as cluster resources, job structures and scheduler configurations. In this paper, we design and implement a Kubernetes simulator called K8sSim, which incorporates typical Kubernetes and Volcano scheduling algorithms for both generic and AI workloads, and provides an accurate simulation of their scheduling process in real clusters. We use real cluster traces from Alibaba to evaluate the effectiveness of K8sSim, and the evaluation results show that (i) compared to the real cluster, K8sSim can accurately evaluate the performance of different scheduling algorithms with similar CloseRate (a novel metric we define to intuitively show the simulation accuracy), and (ii) it can also quickly obtain the scheduling results of different scheduling algorithms by accelerating the scheduling time by an average of 38.56×.

After the first national-scale outbreak of Hand, foot, and mouth disease (HFMD) in China, a national surveillance network was established. Here we described the epidemiology and pathogenic profile of HFMD and the impact of EV-A71 vaccination on pathogen spectrum of enteroviruses in the southeastern Chinese city of Nanchang during 2010–2019. A total of 7,951 HFMD cases from sentinel hospitals were included, of which 4,800 EV-positive cases (60.4%) were identified by real-time RT-PCR. During 2010–2012, enterovirus 71 (EV-A71) was the main causative agent of HFMD, causing 63.1% of cases, followed by 19.3% cases associated with coxsackievirus A16 (CV-A16). Since 2013, the proportion of other enteroviruses has increased dramatically, with the sub genotype D3 strain of Coxsackievirus A6 (CV-A6) replacing the dominance of EV-A71. These genetically diverse native strains of CV-A6 have co-transmitted and co-evolved in Nanchang. Unlike EV-A71 and CV-A16, most CV-A6 infections were concentrated in autumn and winter. The incidence of EV-A71 infection negatively correlated with EV-A71 vaccination (r = −0.990, p = 0.01). And severe cases sharply declined as the promotion of EV-A71 vaccines. After 2-year implementation of EV-A71 vaccination, EV-A71 is no longer detected from the reported HFMD cases in Nanchang. In conclusion, EV-A71 vaccination changed the pattern of HFMD epidemic, and CV-A6 replaced the dominance of EV-A71 over time.

In this paper, we describe the advances in the design, actuation, modeling, and control field of continuum robots. After decades of pioneering research, many innovative structural design and actuation methods have arisen. Untethered magnetic robots are a good example; its external actuation characteristic allows for miniaturization, and they have gotten a lot of interest from academics. Furthermore, continuum robots with proprioceptive abilities are also studied. In modeling, modeling approaches based on continuum mechanics and geometric shaping hypothesis have made significant progress after years of research. Geometric exact continuum mechanics yields apparent computing efficiency via discrete modeling when combined with numerical analytic methods such that many effective model-based control methods have been realized. In the control, closed-loop and hybrid control methods offer great accuracy and resilience of motion control when combined with sensor feedback information. On the other hand, the advancement of machine learning has made modeling and control of continuum robots easier. The data-driven modeling technique simplifies modeling and improves anti-interference and generalization abilities. This paper discusses the current development and challenges of continuum robots in the above fields and provides prospects for the future.

Sound speed profile (SSP) inversion is usually performed by linear statistical regression, such as the single empirical orthogonal function regression (sEOF-r) model. However, due to the complex dynamic activities of the ocean, the relationship between parameters is not strictly linear, often resulting in an unsatisfactory inversion result. In this study, an algorithm based on the random forest (RF) integrated learning model, for SSP inversion, was proposed. Using the sea surface temperature anomaly (SSTA) and sea surface height anomaly (SSHA) data, the sound speed profile of the upper 1000 m layer in the South China Sea was reconstructed, and its accuracy was evaluated through the root mean square error (RMSE). The accuracy of the evaluation demonstrated that the RF model proposed here could reconstruct the SSP in the upper 1000 m layer better than the sEOF-r can. Compared with the latter, the average reconstruction accuracy of the RF model was improved by 0.56 m/s. The linear regression of the sEOF-r model fell short of expectations in the regression between surface and subsurface parameters. By removing the constraints of linear inversion, the nonlinear regression of the RF model showed a smaller RMSE and better robustness in the reconstruction process and was superior to the sEOF-r model at all depths. As a result, it provided an effective integrated learning model for SSP reconstruction.

Qufeng Zhitong capsule (QZC), a Chinese patent medicine officially approved in China for the treatment of rheumatoid arthritis (RA) and other diseases, possesses the primary effects of dispelling wind, relieving pain, and promoting blood circulation, whose clinical applications have been confined owing to the incomplete elucidation of its chemical compositions and the underlying molecular mechanism for the treatment of RA. In this study, 61 compounds including 16 phenylpropanoids, 15 organic acids, 13 alkaloids, seven flavonoids, six iridoids, one saccharide, two aldehydes, and one saponin in QZC were simultaneously identified and traced to their herbal origins by ultra-high performance liquid chromatography tandem Q-Exactive Orbitrap high-resolution mass spectrometry (UHPLC/Q-Orbitrap-MS), where 31 of them were unambiguously identified by reference compounds, and the other 30 were tentatively characterized. Besides, all these compounds were proven to have potential pharmacological activity in the treatment of RA based on network pharmacology analysis. In conclusion, this study first investigated the chemical composition and potential pharmacological effects of the main chemical compounds in QZC, which will contribute to the revelation of bioactive compounds in QZC and provide evidence for clinical application.

In the Galaxy, close binaries with compact objects are important low-frequency gravitational wave (GW) sources. As potential low-frequency GW sources, neutron star/white dwarf (WD) ultracompact X-ray binaries (UCXBs) have been investigated extensively. Using the Modules for Experiments in Stellar Astrophysics code, we systematically explored the evolution of black hole (BH)-main-sequence star (MS) binaries to determine whether their descendants can be detected by space-borne GW detectors. Our simulations showed that BH-MS binaries with an initial orbital period less than the bifurcation period can evolve into BH UCXBs that can be detected by LISA. Such an evolutionary channel would form compact mass-transferring BH-WD systems rather than detached BH-WD systems. The calculated X-ray luminosities of BH UCXBs that can be detected by LISA at a distance d = 1 kpc are ∼10 ^33 –10 ^35 erg s ^−1 (∼10 ^34 –10 ^35 erg s ^−1 for d = 10 kpc); hence, it is possible to detect their electromagnetic counterparts. It is worth emphasizing that only some BH-MS systems with an initial orbital period very close to the bifurcation period can evolve toward low-frequency GW sources whose chirp masses can be measured. The maximum GW frequency of BH UCXBs forming via the BH-MS pathway is about 3 mHz, which is smaller than the minimum GW frequency (6.4 mHz) of mass-transferring BH-WDs originating from a dynamic process. Furthermore, we obtain an initial parameter space (donor-star masses and orbital periods) of progenitors of BH UCXB-GW sources, which can be applied to future population synthesis simulations. By a rough estimation, we predict that LISA would only be able to detect a few BH UCXB-GW sources formed by the BH-MS channel.

The low-lying reef islands distributed in the tropical and subtropical coastal regions are highly vulnerable to the devastating damages of surges and waves during the severe weather events. Over the past two decades, extreme waves have caused tremendous loss and damages to the tropical and subtropical coastal regions. Previous research has focused on the wave hydrodynamics of tsunami waves, as well as regular and irregular waves on the fringing reefs. The complex wave hydrodynamics of extreme waves on the fringing reefs are rarely studied. By applying the nonhydrostatic numerical flow solver (NHWAVE), transformation and breaking process of the crest- and trough-focused wave groups on the fringing reef are analyzed in this study. Influences of the major factors, i.e., water depth, significant wave height, peak wave period, forereef slope and backreef slope, and ridge width, are discussed in detail. The results show that there are complex interactions between the fringing reef and the focused wave group. Breaking waves of high intensity can form at the reef crest. Meanwhile, due to the wave breakings at the reef crest and bottom friction of the reef flat, the local wave height can be effectively reduced. Within the complex wave hydrodynamics of focused waves on the fringing reef, most of the wave energy can be dissipated. In addition, hydrodynamic difference between the crest- and trough-focused waves on the fringing reef is very limited. The research results of this study will further help researchers to better understand the wave hydrodynamics of extreme waves over the fringing reefs.