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BackgroundCholesterol crystals (CCs) in lesions are the hallmark of advanced atherosclerotic plaque. Previous studies have demonstrated that CCs could activate NLRP3 inflammasome, which played an important role in atherosclerotic lesion progression. However, the relationship between CCs, NLRP3 inflammasome pathway, and plaque vulnerability in patients with ACS is still not elucidated.MethodsTwo hundred sixty-nine consecutive acute coronary syndrome (ACS) patients with 269 culprit lesions were included in this study. CCs and other plaque characteristics within the culprit lesion segment were evaluated by optical coherence tomography (OCT) before percutaneous coronary intervention (PCI). The NLRP3 mRNA expression in peripheral blood mononuclear cells (PBMCs) and the serum levels of interleukin (IL)-1β, IL-18, and other biological indices were measured.ResultsCholesterol crystals were observed in 105 (39%) patients with 105 culprit lesions. There were no significant differences in baseline clinical characteristics between the patients with CCs (CCs group, n = 105) and the patients without CCs (non-CCs group, n = 164) within the culprit lesion segment except for lipoprotein(a) [Lp(a)]. The CCs group had a higher level of NLRP3 mRNA expression in PBMCs and higher levels of serum cytokine IL-1β and IL-18. OCT showed that the CCs group had longer lesion length, more severe diameter stenosis, and less minimum luminal area (MLA) than the non-CCs group (all p < 0.05). The frequency of thin-cap fibroatheroma (TCFA), thrombus, accumulation of macrophages, plaque rupture, micro-channel, calcification, spotty calcification, and layered plaque was higher in the CCs group than in the non-CCs groups (all p < 0.05). Multivariate logistic analysis revealed that the level of NLRP3 expression (OR = 10.204), IL-1β levels (OR = 3.523), IL-18 levels (OR = 1.006), TCFA (OR = 3.593), layered plaque (OR = 5.287), MLA (OR = 1.475), macrophage accumulation (OR = 2.881), and micro-channel (OR = 3.185) were independently associated with CCs.ConclusionAcute coronary syndrome patients with CCs in culprit lesions had a higher expression of NLRP3, IL-1β, and IL-18, and had more vulnerable plaque characteristics than patients without CCs. CCs might have interacted with NLRP3 inflammasome activation in patients with ACS, which could contribute to plaque vulnerability in culprit lesions.

Summary: Understanding lung immunity requires an unbiased profiling of tissue-resident T cells at their precise anatomical locations within the lung, but such information has not been characterized in the immunized mouse model. In this pilot study, using 10x Genomics Chromium and Visium platform, we performed an integrative analysis of spatial transcriptome with single-cell RNA-seq and single-cell ATAC-seq on lung cells from mice after immunization using a well-established Klebsiella pneumoniae infection model. We built an optimized deconvolution pipeline to accurately decipher specific cell-type compositions by anatomic location. We discovered that combining scATAC-seq and scRNA-seq data may provide more robust cell-type identification, especially for lineage-specific T helper cells. Combining all three modalities, we observed a dynamic change in the location of T helper cells as well as their corresponding chemokines. In summary, our proof-of-principle study demonstrated the power and potential of single-cell multi-omics analysis to uncover spatial- and cell-type-dependent mechanisms of lung immunity.

The proportion of non-cancer death in patients with esophagus cancer (EC) still increasing, especially cardiovascular disease (CVD) related death. The aim of this study was assess non-cancer causes of death and identified independent risk factors of CVD related death in EC patients. Patients diagnosed with EC were extracted from the Surveillance, Epidemiology, and End Result database (SEER) database for analysis. Standardized mortality rates (SMRs) for non-EC deaths were calculated, the risk of death were assessed and compared with US general population. Multivariate competitive risk analysis were performed to select independent risk factors for death from CVD in EC patients. A total of 43739 EC patients were enrolled and 35139 died during follow-up, of which 4248 died from non-cancer cause of death. The risk of non-cancer death in EC patients was 2.27-fold higher than in the general population (SMR=2.27; 95% CI, 2.20-2.34). CVD were the most important cause of non-cancer death in EC patients, accounting for 43.4% of non-cancer of deaths. Compare with the general population, EC patients have higher risk of death from disease of heart (SMR, 2.24; 95% CI, 2.13-2.35), pneumonia and influenza (SMR, 2.92; 95% CI, 2.50-3.39), septicemia (SMR, 5.01; 95% CI, 4.30-5.79), along with other causes. Patients with advanced age and patients who received radiotherapy has higher risk of death caused by CVD, patients with female sex, poor differentiated and undifferentiated, regional and distant stage, married, diagnosed between 2010-2016 has lower risk of CVD related death, compared with patients without any treatment measures, patients received chemotherapy alone has lower risk of death from CVD. Non-cancer cause of death has become an important cause of death in EC patients. Improving public awareness of the major risk factors for non-cancer death is beneficial to the prevention and treatment of malignant tumors.

Anodal transcranial direct current stimulation (tDCS) over the left dorsal lateral prefrontal cortex (lDLPFC) can improve distraction suppression ability, possibly by distantly regulating the connection properties of several large-scale brain networks and local brain state changes. However, little is known about the local state alteration that tDCS can induce in distant but task-related regions and the relationship between performance enhancement and local state alteration in potentially related regions, resulting in inefficient and uncertain tDCS regulation. We aimed to examine the alteration of brain local state before and after tDCS and its relationship with performance enhancement. With the within-subject design, the participants received anodal (1.5 mA) and sham tDCS at F3 (lDLPFC) for 20 min. The visual search task and resting-state functional magnetic resonance imaging (rsfMRI) were performed before and after stimulation. Anodal tDCS significantly enhanced distraction suppression. The amplitude of low-frequency fluctuation (ALFF) in the left parietal region significantly decreased, the decrement significantly positively correlated with performance enhancement after anodal tDCS. As well, the regional homogeneity (ReHo) in the left precuneus significantly increased, and the increasement significantly positively correlated with performance enhancement. Anodal tDCS over the lDLPFC can distantly modulate the local state of the brain and improve the distraction suppression ability. These two aspects are closely related and provide a direct and efficient approach to enhancing performance.

Wuyi tea (Camellia. sinensis, Synonym: Thea Bohea L.) is recognized as the most prestigious oolong tea in China. For germplasm identification and protection, the complete chloroplast genomes of five classical Wuyi tea varieties were determined by next-generation sequencing. These chloroplast genomes showed highly conserved structures and are 157,024–157,126 bp in length, consisting of a pair of reverse repeats (IR) regions of 25,944–26,095 bp, one large single-copy (LSC) region of 86,594–86,859 bp, and one small single copy (SSC) region of 18,276–18,291 bp. A total of 137 genes were observed and overall GC contents were all about 37.3%. Phylogenetic analysis revealed Wuyi tea varieties did not cluster together, suggesting that these Wuyi tea varieties might have diverged early in their evolutionary history and the complete chloroplast genome could be used as a super-barcode to identify these varieties. This study will be valuable for future studies of evolution and intraspecific identification in Wuyi tea.

A robust controller for the waypoint tracking of a quadrotor unmanned aerial vehicle (UAV) is proposed in this paper, in which position control and attitude control are effectively decoupled. Model predictive control (MPC) is employed in the position controller. The constraints of motors are imposed on the state and input variables of the optimization equation. This design effectively mitigates the nonlinearity of the attitude loop and enhances the planning efficiency of the position controller. The attitude controller is designed using a nonlinear and robust control law based on SO(3) space, which enables continuous control on the SO(3) manifold. By extending the differential flatness of the quadrotor-UAV to the angular acceleration level, the mapping of the control reference from the position controller to the attitude controller is achieved. Simulations are carried out to demonstrate the capability of the proposed controller. In the simulations, multiple aggressive flight trajectories and severe external disturbances are designed. The results show that the controller is robust, with superior accuracy in tracking aggressive trajectories.

Treatment of organic wastewater is still a difficult problem to solve. In this paper, Cu-doped SnSe powder was synthesized by a convenient and efficient hydrothermal method. Meanwhile, the degradation effect of different doping concentrations of SnSe on methylene blue was investigated. It was found that at low doping concentrations, the degradation effect on methylene blue was not obvious because Cu was dissolved in the lattice of the SnSe matrix at low concentrations. As the doping concentration increased, SnSe changed from a layered structure to a nanocluster structure with reduced particle size, and a mixed phase of SnSe and Cu2SnSe4 appeared. In fact, the degradation effect on methylene blue was significantly enhanced, and we found that the catalytic degradation effect on methylene blue was best at a doping concentration of 10 wt.%.

In recent decades, low-dimensional nanodevices have shown great potential to extend Moore’s Law. The n-type semiconductors already have several candidate materials for semiconductors with high carrier transport and device performance, but the development of their p-type counterparts remains a challenge. As a p-type narrow bandgap semiconductor, tellurium nanostructure has outstanding electrical properties, controllable bandgap, and good environmental stability. With the addition of methods for synthesizing various emerging tellurium nanostructures with controllable size, shape, and structure, tellurium nanomaterials show great application prospects in next-generation electronics and optoelectronic devices. For tellurium-based nanomaterials, scanning electron microscopy and transmission electron microscopy are the main characterization methods for their morphology. In this paper, the controllable synthesis methods of different tellurium nanostructures are reviewed, and the latest progress in the application of tellurium nanostructures is summarized. The applications of tellurium nanostructures in electronics and optoelectronics, including field-effect transistors, photodetectors, and sensors, are highlighted. Finally, the future challenges, opportunities, and development directions of tellurium nanomaterials are prospected.

The wear and corrosion resistance of Ni-based niobium carbide (NbC) coatings were investigated via scanning electron microscopy, energy dispersive spectrometry, particle size analysis, X-ray diffraction, electrochemical polarization, electrochemicl impedance spectroscopy, digital microhardness testing and wear testing. The results showed that the substrate was mainly composed of a γ-Cr (Fe) solid solution, and the composite coating was composed of FeNi, NbC, and Ni. In addition, the hardness of the coating increased gradually with increasing NbC content. The optimal corrosion resistance and wear resistance of the coating were realized at an NbC content of 20%.

Due to its balanced nutrition,quinoa has been gaining popularity in research and among consumers.Germination,as a common processing method for cereals,can improve the product flavor and sensory quality,reduce harmful substances and promote the enrichment of functional ingredients such as polyphenols and flavonoids.Therefore,quinoa has been used to the development of food for diarrhea and diabetes patients.With the aim of providing a scientific evidence for the development of new generations of quinoa products with targeted functions,this paper focuses on illustrating the changes of quinoa’s main nutrients in germination process and understanding quinoa’s functions.

Quinoa (Chenopodium quinoa Willd.) has gaining wider attention for its well-balanced nutrition in recent years.As the main ingredient of quinoa grain,starch accounts for more than 50% of the dry weight,which plays an important role in defining the functions and properties of quinoa-contained products.Quinoa starch has smaller granules (1～3 μm) and lower amylose content,compared with other grains.Its amylopectin contains a larger amount of short chains and super-long chains.In terms of nutrition,quinoa starch contains a higher proportion of slow-digesting starch (SDS),indicating its possibility of being applied to produce processed food with low glycemic index.Furthermore,quinoa starch has many applications within and outside of the food industry.To provide theory to support the application of quinoa in different industries,this paper reviewed quinoa’s composition,starch structure and related properties.

Exosomes derived from cancer cells have emerged as important mediators of malignant phenotypes of tumors, being involved in the transmission of biological signals between cells. Herein, we intended to clarify the role of exosome-mediated transfer of oncogenic microRNA-27a (miR-27a) in angiogenesis of renal clear cell carcinoma (RCCC). Through bioinformatics analysis, we identified the differentially expressed genes of RCCC and predicted miRNAs targeting SFRP1. We manipulated the expression of miR-27a and/or SFRP1 in RCCC cells to explore their roles in angiogenesis through Cell Counting Kit-8 (CCK-8), Transwell, and Matrigel tubule formation assays. miR-27a loaded in exosomes was overexpressed and downregulated in vitro and in vivo to verify its effect on angiogenesis. SFRP1 was poorly expressed and miR-27a was highly expressed in RCCC tissues, showing a negative correlation. Dual-luciferase assay verified that miR-27a targeted and downregulated SFRP1 expression. Notably, miR-27a enhanced angiogenesis by downregulating SFRP1 expression. miR-27a-loaded exosomes can be delivered from RCCC cells to human umbilical vein endothelial cells (HUVECs). In vitro and in vivo experiments substantiated that miR-27a-loaded exosomes from RCCC cells repressed SFRP1, augmenting the viability, migration, and angiogenesis of RCCC cells. Together, RCCC-derived miR-27a-loaded exosomes inhibit SFRP1 expression and accelerate tumor angiogenesis in RCCC.

Abstract Bromodomain-containing protein 4 (BRD4) has emerged as a promising treatment target for bone-related disorders. (+)-JQ1, a thienotriazolodiazepine compound, has been shown to inhibit pro-osteoclastic activity in a BRD4-dependent approach and impede bone loss caused by ovariectomy (OVX) in vivo. However, clinical trials of (+)-JQ1 are limited because of its poor druggability. In this study, we synthesized a new (+)-JQ1 derivative differing in structure and chirality. One such derivative, (+)-ND, exhibited higher solubility and excellent inhibitory activity against BRD4 compared with its analogue (+)-JQ1. Interestingly, (-)-JQ1 and (-)-ND exhibited low anti-proliferative activity and had no significant inhibitory effect on RANKL-induced osteoclastogenesis as compared with (+)-JQ1 and (+)-ND, suggesting the importance of chirality in the biological activity of compounds. Among these compounds, (+)-ND displayed the most prominent inhibitory effect on RANKL-induced osteoclastogenesis. Moreover, (+)-ND could inhibit osteoclast-specific gene expression, F‐actin ring generation, and bone resorption in vitro and prevent bone loss in OVX mice. Collectively, these findings indicated that (+)-ND represses RANKL‐stimulated osteoclastogenesis and averts OVX-triggered osteoporosis by suppressing MAPK and NF-κB signalling cascades, suggesting that it may be a prospective candidate for osteoporosis treatment.

BackgroundHow to deal with large thrombus burdens of culprit’s blood vessel remains a great challenge in the treatment of acute myocardial infarction.Case presentationA 32-year-old Chinese man was diagnosed with ST-segment elevation myocardial infarction (STEMI). Coronary angiography revealed that the distal end of a tortuous left circumflex was completely occluded by a large amount of thrombus. Cutted balloon-directed intracoronary artery retrograde thrombolysis (ICART) with urokinase led to the restoration of coronary blood flow. Because there was no obvious plaque rupture or artery stenosis in the coronary artery, it was only dilated, and no stent was implanted.ConclusionCutted balloon-directed ICART can be performed effectively and safely in some STEMI patients with tortuous coronary vessels and large thrombus. (REST or named ICART ClinicalTrials.gov number, ChiCTR1900023849).

ObjectivesTo analyze the characteristics of oral microbiota in plateau and plain youth and the possible function of the microbiome.Materials and methodsA total of 120 healthy young males (80 on the plateau, 40 on the plain) completed this cross-sectional study. Oral microflora samples were collected from all participants. The bacterial 16S rDNA was amplified using PCR and sequenced using Illumina MiSeq high-throughput sequencing. The data were analyzed to determine the microbial distribution and community structure of the oral microflora from the two groups. Metastats was used to test differences in relative species abundance between the groups. The correlation between the abundance of specific bacteria and blood indicators was also analyzed.ResultsAs demonstrated by alpha and beta diversity, the plateau group had lower microbial richness and a less even distribution of oral microbiota than the plain group. All predominant phyla and genera were qualitatively similar between the two groups, but their relative abundances differed. The relative abundance of bacteria in the phylum Firmicutes was significantly higher in the plateau group than in the plain group. At the genus level, Streptococcus spp. and Gemella spp. were also more abundant in the plateau group. The functional prediction indicated vigorous microbial metabolism in the oral bacterial community. We also found that the relative abundance of Streptococcus spp., the dominant genus, was positively correlated with triglyceride levels in the plateau group.ConclusionsWith increasing altitude, the diversity of oral microbiota and the relative proportion of predominant bacteria were altered. The distribution and related function of Streptococcus spp. were prominent in plateau samples. This comprehensive study of the relationship between oral microecology and elevation provides a point of reference for studying the human body’s adaptability or inadaptability to high altitude.

Background and Aims: To investigate the association between obstructive sleep apnea (OSA) severity and baseline serum cystatin C (Cys-C) concentration and to explore the association between baseline serum Cys-C and long-term cardiovascular outcomes and mortality in older patients with OSA.Methods: Between January 2015 and October 2017, a total of 1107 consecutive eligible older patients (≥60 years) with OSA were included in this multicenter, prospective cohort study, and baseline demographics, clinical characteristics, sleep parameters, and follow-up outcomes were collected. Participants were divided into different groups based on baseline serum Cys-C levels. The primary end point was major adverse cardiovascular events (MACE) and the secondary end point was all-cause mortality. The correlation between OSA severity and baseline serum Cys-C was evaluated by Spearman correlation analysis. Multivariate Cox regression was used to analyze the association between Cys-C and the incidence of MACE and mortality.Results: Participants included 672 men and 435 women, with a median age of 66 (range, 60–96) years. At baseline, apnea–hypopnea index (AHI) (r = 0.128, p < 0.05), oxygen desaturation index (ODI) (r = 0.116, p < 0.05), and the lowest pulse oxygen saturation (LSpO2) (r = −0.097, p < 0.05) were correlated with serum Cys-C concentration. During the median follow-up period of 42 months, 97 patients (8.8%) experienced MACE and 40 patients (3.6%) experienced death. The association between serum Cys-C levels and the risk of MACE and all-cause mortality was slow rising shaped. The multivariable Cox regression analysis showed patients with a serum Cys-C concentration of ≥1.14 mg/L had higher risks of MACE (HR = 5.30, 95% CI: 2.28–12.30, p < 0.05) and all-cause mortality (HR = 9.66, 95% CI: 2.09–44.72, p < 0.05) compared with patients with serum Cys-C of ≤0.81 mg/L in older patients with OSA. The receiver-operating characteristic curve showed baseline serum Cys-C levels exhibited moderately capable of identifying patients with a long-term risk of clinical adverse events (MACE and mortality).Conclusion: OSA severity was positively correlated with serum Cys-C concentration. High levels of Cys-C were independently associated with increased risks of MACE and all-cause mortality in older patients with OSA, suggesting that lowering Cys-C levels should be considered as a therapeutic target, and monitoring serum Cys-C may be beneficial to the favorable prognosis of older patients with OSA.

ObjectiveTo propose a new definition of partial remission (PR) for patients with type 1 diabetes (T1D) of all-ages using insulin dose and glycated albumin (GA), and find the optimal cut-off values for stimulated C-peptide to diagnose PR in different age-groups.Research Design and MethodsPatients with newly diagnosed T1D (n=301) were included. GA/insulin dose was used to diagnose PR, and insulin dose-adjusted glycated albumin (IDAGA) was proposed to facilitate clinical application. The optimal diagnostic levels of IDAGA and stimulated C-peptide were determined in different age-groups (≤ 12y, 12-18y and ≥ 18y). Furthermore, the diagnostic consistency between different PR definitions was studied.ResultsGA≤ 23%/insulin dose ≤ 0.5u/kg/day was used to define PR, and IDAGA (GA (%) + 40 * insulin dose(u/kg/day)) ≤ 40 was feasible in all age-groups. Whereas, the optimal diagnostic level showed difference for stimulated C-peptide (265.5, 449.3 and 241.1 pmol/L for the ≤ 12y, 12-18y and ≥ 18y age-group, respectively). About 40% of patients met the PR definition by stimulated C-peptide but not GA/insulin dose or IDAGA, who showed dyslipidemia and higher insulin resistance.ConclusionsA new definition of the PR phase is proposed using GA/insulin dose, and the calculated IDAGA≤ 40 applies to all age-groups. The stimulated C-peptide to diagnose PR is the highest in the 12-18y age-group, which reflects the effect of puberty on metabolism. For patients with insulin resistance, it is not recommended to use stimulated C-peptide alone to diagnose PR.

AimsThere is limited evidence that evaluates the glycemic control of type 1 diabetes mellitus (T1DM) during the Chinese New Year public holiday in China. The Chinese New Year public holiday represents various challenges to glycemic control, especially in T1DM patients, in China. We aimed to assess the effect of the Chinese New Year public holiday on several glucose metrics using flash glucose monitoring (FGM) in patients with T1DM.MethodsComplete FGM data for 1 week before, 1 week during and 1 week after the Chinese New Year public holiday were available for 71 T1DM patients treated with multiple daily insulin injection (MDI) therapy (n = 51) or continuous subcutaneous insulin infusion (CSII) treatment (n = 20). The mean age of the study participants was 13 (9, 30) years. Of note, 59.2% of the patients (n = 42) were adults, and 40.8% of the patients (n = 29) were minors. The interval between each two adjacent periods was one week. The indicators of mean glucose, glucose variability and time in different glycemic ranges were analyzed.ResultsThe Chinese New Year public holiday was associated with an increase in mean blood glucose (8.2 ± 1.9 vs. 8.9± 2.8; P < 0.001) and time above range (TAR) (26.1% ± 18.1% vs. 31.7% ± 23.9%; P < 0.001) but a decrease in time in range (TIR) (65.7% ± 16.8% vs. 59.9% ± 21.1%; P < 0.001) and coefficient of variation (CV) (38.2% ± 8.2% vs. 36.7% ± 7.7%; P =0.037). There was no statistically significant difference in time below range (TBR). The glycemic control deteriorated during the Chinese New Year public holiday in our study population regardless of age. Interestingly, in the CSII group, none of the metrics of glucose control significantly changed during the Chinese New Year public holiday.ConclusionsThese results suggested that less self-management may worsen glycemic control in the short term, indicating a need for more refined management algorithms during the Chinese New Year public holiday for T1DM patients.

ObjectiveThis study aimed to develop effective artificial intelligence (AI) diagnostic models based on CT images of pulmonary nodules only, on descriptional and quantitative clinical or image features, or on a combination of both to differentiate benign and malignant ground-glass nodules (GGNs) to assist in the determination of surgical intervention.MethodsOur study included a total of 867 nodules (benign nodules: 112; malignant nodules: 755) with postoperative pathological diagnoses from two centers. For the diagnostic models to discriminate between benign and malignant GGNs, we adopted three different artificial intelligence (AI) approaches: a) an image-based deep learning approach to build a deep neural network (DNN); b) a clinical feature-based machine learning approach based on the clinical and image features of nodules; c) a fusion diagnostic model integrating the original images and the clinical and image features. The performance of the models was evaluated on an internal test dataset (the “Changzheng Dataset”) and an independent test dataset collected from an external institute (the “Longyan Dataset”). In addition, the performance of automatic diagnostic models was compared with that of manual evaluations by two radiologists on the ‘Longyan dataset’.ResultsThe image-based deep learning model achieved an appealing diagnostic performance, yielding AUC values of 0.75 (95% confidence interval [CI]: 0.62, 0.89) and 0.76 (95% CI: 0.61, 0.90), respectively, on both the Changzheng and Longyan datasets. The clinical feature-based machine learning model performed well on the Changzheng dataset (AUC, 0.80 [95% CI: 0.64, 0.96]), whereas it performed poorly on the Longyan dataset (AUC, 0.62 [95% CI: 0.42, 0.83]). The fusion diagnostic model achieved the best performance on both the Changzheng dataset (AUC, 0.82 [95% CI: 0.71-0.93]) and the Longyan dataset (AUC, 0.83 [95% CI: 0.70-0.96]), and it achieved a better specificity (0.69) than the radiologists (0.33-0.44) on the Longyan dataset.ConclusionThe deep learning models, including both the image-based deep learning model and the fusion model, have the ability to assist radiologists in differentiating between benign and malignant nodules for the precise management of patients with GGNs.

Abstract Background This study aimed to investigate the associations of sarcopenia and its defining components with cognitive function in community-dwelling oldest old (over 80 years old) in China. Methods Sarcopenia was diagnosed by the 2019 Asian Working Group for Sarcopenia (AWGS) criteria. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA). Logistic and linear regression models were used to explore the associations of sarcopenia and its defining components with risk of mild cognitive impairment (MCI), and performance on multiple cognitive domains among 428 adults aged 80 years and older. Results The overall prevalence of sarcopenia was 35.5%, with 40.34% for men and 32.14% for women. The prevalence of MCI was higher among sarcopenic oldest old than non-sarcopenic oldest old (28.95% vs. 17.39%, p = 0.005). Multivariate logistic regression analyses showed that sarcopenia [odds ratio (OR) = 1.86, 95% confidence interval (CI): 1.04–3.33], low handgrip strength (HS) [OR = 2.33, 95% CI: 1.40–3.87] and slow gait speed (GS) [OR = 2.31, 95% CI: 1.13–4.72] were significantly and independently associated with risk of MCI. Multivariate linear regression analyses showed that low HS was associated with worse performance in global cognitive function, visuospatial and executive function, naming and delayed recall. Conclusions Sarcopenia, low HS and low GS was significantly associated with MCI in community-dwelling oldest old. The associations between sarcopenia and its defining components with different cognitive subdomains could be further explored in the future.

Abstract Background The Pittsburgh Fatigability Scale (PFS) was developed to capture fatigue and demand in a single tool, filling a gap that no validated questionnaire existed to measure perceived fatigability. Since fatigability is a more sensitive measure of a person’s susceptibility to fatigue, we validated the simplified-Chinese version of the PFS among Chinese community-dwelling older adults. Methods This cross-sectional study was conducted in an urban community in Beijing between November 2018 and July 2019. The PFS was translated into simplified-Chinese by the translation, retro-translation method. Internal consistency of the Physical subscale of the PFS was evaluated by Cronbach’s alpha. Convergent validity and discriminant validity were evaluated against physical performance measures (i.e., Short Physical Performance Battery & Timed Up and Go Test) and daily living performance (i.e., Barthel Index & Instrumental activity of daily living). Results Our study included 457 participants, including 182 men (39.8%) and 275 women (60.2%). The age range of the included participants was 61–96 years (mean = 84.8 years, SD = 5.8 years). The simplified-Chinese version of PFS Physical scores showed strong internal consistency (Cronbach’s alpha = 0.81). Higher PFS Physical scores were associated with worse physical performance, and daily living performance (|correlation coefficient| range: 0.36–0.56, p

Abstract We report on a non-sharp-corner quarter wave plate (NCQW) within the single layer of only 8 nm thickness structured by the Ag hollow elliptical ring array, where the strong localized surface plasmons (LSP) resonances are excited. By manipulating the parameters of the hollow elliptical ring, the transmitted amplitude and phase of the two orthogonal components are well controlled. The phase difference of π/2 and amplitude ratio of 1 is realized simultaneously at the wavelength of 834 nm with the transmission of 0.46. The proposed NCQW also works well in an ultrawide wavelength band of 110 nm, which suggests an efficient way of exciting LSP resonances and designing wave plates, and provides a great potential for advanced nanophotonic devices and integrated photonic systems.

Objective To summarize the clinical phenotypes and genetic mutations of DNAJB6 related myopathies. Methods We retrospectively reviewed the clinical information, laboratory tests, muscle MRIs, electromyography results, muscle pathology examinations and genetic mutations of 2 patients of DNAJB6 related myopathies from one family and reviewed related published literatures of DNAJB6 related myopathies. Results The proband presented with muscle weakness of both proximal and distal limbs, with lower limbs more serious than upper limbs, and proximal more serious than distal. The father of proband presented with abnormal gait, and he could only climb stairs with assistance. Serum creatine kinase (CK) levels of both patients were normal. Muscle MRIs of both patients showed different degrees of fatty infiltration. Muscle biopsies of both patients showed similar changes with dystrophic features, and some muscle fibers with rimmed vacuoles inside, as well as increased internal nuclei and a few regenerating fibers. Genetic tests proved both patients carried the same DNAJB6 gene variant, c.161A ＞ C (p.Glu54Ala), which was the first report in mainland China. The proband was diagnosed as limb ⁃ girdle muscular dystrophy D1 (LGMD⁃D1) type, and the father of proband was diagnosed as distal myopathy. This family was considered as autosomal dominant DNAJB6 related myopathy. Referring to literature, heterogeneities exist in DNAJB6 related myopathies, and different clinical phenotypes could be presented in one single family. Conclusions The phenotypes of DNAJB6 related myopathies include limb ⁃ girdle muscular dystrophy and distal myopathy. Muscle pathology shows similar changes of rimmed vacuoles and dystrophic features. This reported family further expands the spectrum of phenotypes of DNAJB6 related myopathies. doi：10.3969/j.issn.1672⁃6731.2021.03.013

Highly sensitive staphylococcal enterotoxin B (SEB) assay is of great importance for the prevention of toxic diseases caused by SEB. In this study, we present a gold nanoparticle (AuNP)-linked immunosorbent assay (ALISA) for detecting SEB in a sandwich format using a pair of SEB specific monoclonal antibodies (mAbs) performed in microplates. First, the detection mAb was labeled with AuNPs of different particle sizes (15, 40 and 60 nm). Then the sandwich immunosorbent assay for SEB detection was performed routinely in a microplate except for using AuNPs-labeled detection mAb. Next, the AuNPs adsorbed on the microplate were dissolved with aqua regia and the content of gold atoms was determined by graphite furnace atomic absorption spectrometry (GFAAS). Finally, a standard curve was drawn of the gold atomic content against the corresponding SEB concentration. The detection time of ALISA was about 2.5 h. AuNPs at 60 nm showed the highest sensitivity with an actual measured limit of detection (LOD) of 0.125 pg/mL and a dynamic range of 0.125–32 pg/mL. AuNPs at 40 nm had an actual measured LOD of 0.5 pg/mL and a dynamic range of 0.5 to 128 pg/mL. AuNPs at 15 nm had an actual measured LOD of 5 pg/mL, with a dynamic range of 5–1280 pg/mL. With detection mAb labeled with AuNPs at 60 nm, ALISA’s intra- and interassay coefficient variations (CV) at three concentrations (2, 8, and 20 pg/mL) were all lower than 12% and the average recovery level was ranged from 92.7% to 95.0%, indicating a high precision and accuracy of the ALISA method. Moreover, the ALISA method could be successfully applied to the detection of various food, environmental, and biological samples. Therefore, the successful establishment of the ALISA method for SEB detection might provide a powerful tool for food hygiene supervision, environmental management, and anti-terrorism procedures and this method might achieve detection and high-throughput analysis automatically in the near future, even though GFAAS testing remains costly at present.

The continuous emergence of Essentially Derived Varieties (EDVs) in the process of tea tree breeding will endanger and affect the innovation ability and development potential of tea tree breeding. In this study, genotyping by sequencing (GBS) technology was used to screen high-quality genomic SNPs for the first time to investigate the derived relationships of 349 tea trees from 12 provinces in China. A total of 973 SNPs uniformly covering 15 tea tree chromosomes with high discrimination capacity were screened as the core SNP set. A genetic similarity analysis showed that 136 pairs of tea trees had a genetic similarity coefficient (GS) > 90%, among which 60 varieties/strains were identified as EDVs, including 22 registered varieties (19 were indisputably EDVs). Furthermore, 21 SNPs with 100% identification of 349 tea trees were selected as rapid identification markers, of which 14 SNP markers could be used for 100% identification of non-EDV. These results provide the basis for the analysis of the genetic background of tea trees in molecular-assisted breeding.

Abstract Background The overlap of burnout and depression is a phenomenon that can effectively reflect the psychological state of a group. However, whether burnout is a type of depression is still debated in current research. The high incidence of burnout and depressive symptoms among medical students indicates that it is urgent to provide appropriate health services for them. However, the proportion of burnout and depression in the overlapping symptoms experienced by medical students, and the characteristics of the relative influencing factors, remain unclear. Therefore, we addressed these issues for neurology graduate students in China. Methods Using data from a cross-sectional survey of Chinese neurology graduate students, a diagnostic model was established according to their burnout and/or depression symptoms. Burnout was assessed by using the Maslach Burnout Inventory. Depression symptoms were assessed with a two-item depression screening tool for primary care evaluation of mental disorders. Univariate analyses with chi-squared tests were conducted to assess associations between variables. Multinomial logistic regression models were used to analyze the effects of multiple factors on dependent variables. The factors included demographic information and three medical-study related problems. Results In total, 32.2% of surveyed students evidenced overlapping burnout and depression symptoms. Students with depressive symptoms tended to be included in the burnout students’ category. In the regression model, being unmarried, having children, and career choice regret were related to students who had only burnout, while the students with overlapping symptoms were affected by more factors such as family income, the consideration of dropping out once. Conclusions The symptoms and related factors of burnout and depression among Chinese neurology postgraduates have obvious overlap and show a significant trend. The occurrence of depressive symptoms among medical students is closely related to whether they are burned out. Students with only burnout were common, but students with only depressive symptoms were uncommon. Finally, burnout may be a pre-depression state.

Abstract Background This study aimed to determine the left ventricular (LV) systolic function in patients on maintenance hemodialysis (MHD) using the myocardial work (MW) technique and investigate the clinical value of the MW technique for the quantitative analysis of left ventricular (LV) systolic function in MHD patients with left ventricular hypertrophy (LVH). Methods A total of 68 MHD patients and 35 controls were registered in this study. The MHD patients were divided into the non-left ventricular hypertrophy (NLVH) group (n = 35) and the LVH group (n = 33) according to the LV mass index (LVMI). MW was used to generate the LV global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), and global wasted work (GWW), global work efficiency (GWE). GLS and the MW parameters (GWI, GCW, GWW, GWE) were compared between groups and the correlations between these parameters and the LV ejection fraction (LVEF) in the LVH group were examined. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of MW parameters and GLS for the assessment of LV systolic dysfunction in MHD with LVH patients. Results The LVH group had significantly lower GWE, GWI, GCW, and GLS but higher GWW than the control and NLVH groups. Compared with the control group, the NLVH group had significantly lower GWE and GLS and higher GWW, but no significant differences in GWI, GCW were observed between these two groups. The LVEF was negatively correlated with GWW in MHD patients, but positively correlated with GWI, GWE, and GCW in the LVH group. Receiver operating characteristic curve (ROC) analysis revealed that GWE, GWW, GWI, and GCW had appreciable area under the curve (AUC), sensitivity, and specificity for evaluating LV function in LVH patients on MHD. Conclusions The MW parameters can quantitatively represent the LV myocardial work in MHD patients. Thus, the technique provides a new method for the quantitative evaluation of LV systolic function in MHD with LVH patients.

Abstract Adolescent depression is a common and serious mental disorder with unique characteristics that are distinct from adult depression. The adult non-human primate stress-induced model of depressive-like behavior is an excellent model for the study of mechanisms; however, an adolescent nonhuman primate model is still lacking. Ten male adolescent cynomolgus monkeys were divided into a chronic unpredictable mild stress (CUMS, n = 5) group and a control (CON, n = 5) group by age and weight-matched pairs. The CUMS group was exposed to multiple unpredictable mild stressors for five cycles over 55 days. At baseline, there were no differences between CUMS and CON groups. At endpoint, the CUMS group demonstrated significantly higher depressive-like behavior (huddle posture), and significantly lower locomotion compared with the CON group. Furthermore, depressive-like behavior increased from baseline to endpoint in the CUMS group, but not changed in the CON group. In the attempt for apple test, the CUMS group made significantly fewer attempts for the apple than the CON group. In the human intruder test, the CUMS group showed significantly higher anxiety-like behaviors in the stare phase than the CON group. Hair cortisol level was significantly higher in the CUMS group than the CON group at endpoint, and was also elevated from baseline to endpoint. Metabolic profiling of plasma at endpoint identified alterations in metabolite pathways which overlapped with those of adolescent depression patients. CUMS can induce depressive-like and anxiety-like behaviors, hypercortisolemia, and metabolic perturbations in adolescent cynomolgus monkeys. This is a promising model to study the mechanisms underlying adolescent depression.

Abstract Background Anxiety disorder is the most prevalent mental disorder among children and adolescents, causing significant psychosocial problems and physical health conditions. Cognitive behavioral therapy (CBT) is an effective treatment for anxiety disorder in children and adolescents. And parent-only CBT is an alternative treatment for childhood anxiety disorder, which includes psychologists and parents rather than children in the treatment. As a new type of CBT, parent-only CBT has some advantages. However, it remains unclear whether parent-only CBT interventions are effective for treating children and adolescents with anxiety disorder. Methods In this study, we evaluated the efficacy (the mean change scores of the anxiety rating scale from baseline to post-treatment, standardized mean difference SMD) and acceptability (the proportion of patients in the treatment group who withdrew from treatment early for any reason, risk ratios RRs) of parent-only cognitive behavioral therapy (CBT) for children and adolescents with anxiety disorder. We searched electronic databases, including PubMed, Cochrane Library, Embase, Web of Science, ProQuest, and PsycINFO from inception to June 2019. We included randomized controlled trials (RCTs) comparing parent-only CBT either with waitlist (WL), or CBT with parents in children and adolescents with anxiety disorder. Results Finally, six RCTs with 407 participants were included in the meta-analyses. In terms of efficacy, pooled analyses indicated that parent-only CBT was significantly more effective than WL for reducing anxiety symptoms with SMD of − 0.72 (95% CI − 1.41 to − 0.03, p = 0.04), and more remission rate with RR of 4.33 (37.96% vs. 6.85, 95% CI 1.82 to 10.27, p = 0.0009) at post-treatment. And our analyses showed no evidence that parent-only CBT had significantly greater efficacy than CBT with parents with SMD of 0.21 (95% CI − 0.09 to 0.50, p = 0.17). Acceptability in the parent-only CBT group was not significantly different to the WL group with RR of 0.92 (95% CI 0.52 to 1.62, p = 0.77), and was significantly worse than in the CBT with parents group with RR of 1.93 (95% CI 1.05 to 3.57, p = 0.03). Conclusions Current evidence indicates that parent-only CBT can be an alternative and acceptable intervention for treating children and adolescents with anxiety disorder.

Cerebral autoregulation (CA) refers to the ability to maintain cerebral blood flow (CBF) relatively constant under the condition of systemic arterial blood pressure (ABP) fluctuation. Up to now, the research on the function of CA has a history of nearly 100 years. From animal models to noninvasive real ⁃ time human hemodynamic monitoring, progress of detecting techniques, especially the wide application of transcranial Doppler ultrasonography (TCD) and the introduction of mathematical methods have brought revolutionary changes to the study of CA. This study aims to summarize the development history of mechanism of CA and detecting techniques, and to provide reference for the related clinical study.

Abstract It is challenging to increase the sensitivity of a hydrogen sensor operating at room temperature due to weak sorption and tiny mass of hydrogen. In this work, an ultrasonic sensor is presented for detecting hydrogen, which is composed of a 128° YX-LiNbO3 substrate and a reduced graphene oxide (RGO) sensitive layer with a platinum catalyzer. By optimizing the depositing parameters of RGO and platinum, a considerably high sensitivity is achieved at room temperature. A frequency shift of 308.9 kHz is obtained in 100 ppm hydrogen mixed with argon, and a frequency shift of 24.4 kHz is obtained in 1000 ppm hydrogen mixed in synthetic air. It is demonstrated that in addition to strong sorption of the sensitive layer, the coaction of mass load and conductivity variation is key to high sensitivity of the sensor. By establishing the original conductivity of the sensitive layer within the “conductivity window” for enhancing electrical response, we improve the sensitivity of the ultrasonic sensor, which is available for detecting hydrogen with an extremely low concentration of 5 ppm.

Polycarbosilanes have been considered as potential materials used in electronic packaging and circuit boards owing to their excellent low-dielectric performance. In this work, we prepared new hyperbranched carbosilane oligomers (HCBOs) which were functionalized by benzocyclobutene (BCB) groups. HCBOs can be thermally cured to produce transparent (HCBRs) with low dielectric constant and high thermostability.

Objective: To reduce the toxicity and side effects of arsenic trioxide (ATO) and provide a new approach for the treatment of primary liver cancer, a folic acid-modified calcium arsenite liposomal “target-controlled” drug delivery system (FA-LP-CaAs) was fabricated using the reverse microemulsion method. Methods: A Malvern particle size analyzer and a transmission electron microscope were employed to determine the particle size, distribution, zeta potential and morphology of FA-LP-CaAs. Further, inductively coupled plasma emission spectrometry was employed to determine the drug loading capacity, entrapment efficiency, and in vitro release behavior of FA-LP-CaAs. To determine its toxicity in human hepatoma cells (HepG2) and human normal hepatocytes (LO2) and its effect on HepG2 cell cycle and apoptosis, the MTT method was used. Laser confocal and flow cytometry were also employed to determine the uptake of FA-LP-CaAs by cells. After establishing a mouse liver cancer model, the in vivo distribution of the drug included in the formulation was investigated using in vivo fluorescence. To evaluate the liver cancer targeting and anti-tumor effects of FA-LP-CaAs in vivo, the distribution of ATO in tissues and changes in tumor volume and body weight after liposomal administration were investigated using hematoxylin-eosin (HE)-stained tumor sections. Results: The particle size, zeta potential and PDI of FA-LP-CaAs were (122.67 ± 2.18) nm, (12.81 ± 0.75) mV and 0.22 ± 0.01, respectively, while its drug loading capacity was 18.49% ± 1.14%. In vitro experimental results revealed that FA-LP-CaAs had a strong killing effect on HepG2 cells. Further, the cell uptake capacity of this formulation was found to improve. Based on in vivo assessments, FA-LP-CaAs could significantly increase the distribution of ATO in tumor sites and inhibit tumor growth. Conclusions: Herein, an FA-LP-CaAs formulation was successfully fabricated. This liposomal drug delivery system had a round appearance, uniform particle size, good polydispersity coeffi-cient, evident “core-shell” structure, high drug loading capacity and pH response, tumor targeted drug delivery and sustained drug release. These findings support further research and the application of ATO as an anti-liver cancer prodrug and provide a new method for the treatment of liver cancer.

Heavy metal resistant bacteria play an important role in the metal biogeochemical cycle in soil, but the benefits of microbial oxidation for plants and soil have not been well-documented. The purpose of this study was to explore the contribution of two Bacillus spp. to alleviate the antimony (Sb) toxicity in plants, and, then, to propose a bioremediation method for Sb contaminated soil, which is characterized by environmental protection, high efficiency, and low cost. This study explored the effects of Bacillus cereus HM5 and Bacillus thuringiensis HM7 inoculation on Broussonetia papyrifera and soil were evaluated under controlled Sb stressed conditions (0 and 100 mmol/L, antimony slag) through a pot experiment. The results show that the total root length, root volume, tips, forks, crossings, and root activities of B. papyrifera with inoculation are higher than those of the control group, and the strains promote the plant absorption of Sb from the soil environment. Especially in the antimony slag treatment group, B. cereus HM5 had the most significant effect on root promotion and promoting the absorption of Sb by B. papyrifera. Compared with the control group, the total root length, root volume, tips, forks, crossings, and root activities increased by 64.54, 70.06, 70.04, 78.15, 97.73, and 12.95%, respectively. The absorption of Sb by root, stem, and leaf increased by 265.12, 250.00, and 211.54%, compared with the control group, respectively. Besides, both B. cereus HM5 and B. thuringiensis HM7 reduce the content of malondialdehyde, proline, and soluble sugars in plant leaves, keeping the antioxidant enzyme activity of B. papyrifera at a low level, and alleviating lipid peroxidation. Principal component analysis (PCA) shows that both B. cereus HM5 and B. thuringiensis HM7 are beneficial to the maintenance of plant root functions and the improvement of the soil environment, thereby alleviating the toxicity of Sb. Therefore, B. cereus HM5 and B. thuringiensis HM7 in phytoremediation with B. papyrifera is a promising inoculant used for bacteria-assisted phytoremediation on Sb contaminated sites.

ObjectivesTo analyze the serum lipid profiles and investigate the relationship between the lipoprotein cholesterol levels and all-cause mortality in Chinese inpatient centenarians.DesignRetrospective study.MethodsCentenarians aged 100 years and older were admitted from January 2010 to January 2021 in our hospital. All centenarians completed a follow up visit till April 2021 of all-cause mortality and serum lipid profiles, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) levels. Cox proportional hazard models were used to assess the association between lipid profiles and all-cause mortality.Results(1) These 121 centenarians on average were 100.85 ± 1.37 years old (100~107 years), including 114 males and 7 females. (2) The rate of treatment with lipid-lowering drugs was 69.4%, and the lipid-lowering drugs were mainly statins (63.6%). (3) The results of serum lipid profiles were as follows: TC 3.90 ± 0.69 mmol/L, TG 1.36 ± 0.55 mmol/L, HDL-C 1.14 ± 0.24 mmol/L, and LDL-C 2.05 ± 0.46 mmol/L. (4) The median follow-up time was 589 days (95% CI: 475, 703), and the all-cause mortality rate was 66.1%. (5) Multivariable analysis showed that higher TC level (HR = 1.968, 95% CI = 1.191–3.253, P = 0.008), lower LDL-C level (HR = 0.379, 95% CI = 0.212–0.677, P = 0.001) was independent factors contributed to all-cause mortality. Sensitivity analysis showed that the above results were stable. The therapy and complication morbidity did not present significant publication bias.ConclusionsThe serum lipid profiles of Chinese inpatient centenarians were lower than those of the previous studies. Low LDL-C level was associated with an increased risk of all-cause mortality, which may indicate that more intensive lowering of LDL-C had a potential adverse effect on all-cause mortality for centenarians.

At present, we have entered an aging society. Many diseases suffered by the elderly, such as malignant tumors, cardiovascular diseases, fractures, surgical emergencies and so on, need surgical intervention. With the improvement of Geriatrics, surgical minimally invasive technology and anesthesia level, more and more elderly patients can safely undergo surgery. Elderly surgical patients are often complicated with a variety of chronic diseases, and the risk of postoperative myocardial injury/infarction (PMI) is high. PMI is considered to be the increase of cardiac troponin caused by perioperative ischemia, which mostly occurs during operation or within 30 days after operation, which can increase the risk of short-term and long-term death. Therefore, it is suggested to screen troponin in elderly patients during perioperative period, timely identify patients with postoperative myocardial injury and give appropriate treatment, so as to improve the prognosis. The pathophysiological mechanism of PMI is mainly due to the increase of myocardial oxygen consumption and / the decrease of myocardial oxygen supply. Preoperative and postoperative risk factors of myocardial injury can be induced by mismatch of preoperative and postoperative oxygen supply. The treatment strategy should first control the risk factors and use the drugs recommended in the guidelines for treatment. Application of cardiovascular drugs, such as antiplatelet β- Receptor blockers, statins and angiotensin converting enzyme inhibitors can effectively improve postoperative myocardial ischemia. However, the risk of perioperative bleeding should be fully considered before using antiplatelet and anticoagulant drugs. This review is intended to describe the epidemiology, diagnosis, pathophysiology, risk factors, prognosis and treatment of postoperative myocardial infarction /injury.

BackgroundAbnormal intracellular glucose/fatty acid metabolism of T cells has tremendous effects on their immuno-modulatory function, which is related to the pathogenesis of autoimmune diseases. However, the association between the status of intracellular metabolism of T cells and type 1 diabetes is unclear. This study aimed to investigate the uptake of glucose and fatty acids in T cells and its relationship with disease progression in type 1 diabetes.MethodsA total of 86 individuals with type 1 diabetes were recruited to detect the uptake of glucose and fatty acids in T cells. 2-NBDG uptake and expression of glucose transporter 1 (GLUT1); or BODIPY uptake and expression of carnitine palmitoyltransferase 1A(CPT1A) were used to assess the status of glucose or fatty acid uptake in T cells. Patients with type 1 diabetes were followed up every 3-6 months for 36 months, the progression of beta-cell function was assessed using generalized estimating equations, and survival analysis was performed to determine the status of beta-cell function preservation (defined as 2-hour postprandial C-peptide >200 pmol/L).ResultsPatients with type 1 diabetes demonstrated enhanced intracellular glucose uptake of T cells as indicated by higher 2NBDG uptake and GLUT1 expression, while no significant differences in fatty acid uptake were observed. The increased T cells glucose uptake is associated with lower C-peptide and higher hemoglobin A1c levels. Notably, patients with low T cell glucose uptake at onset maintained high levels of C-peptide within 36 months of the disease course [fasting C-petite and 2-hour postprandial C-peptide are 60.6 (95%CI: 21.1-99.8) pmol/L and 146.3 (95%CI: 14.1-278.5) pmol/L higher respectively], And they also have a higher proportion of beta-cell function preservation during this follow-up period (P

Background: The availability and use of frozen–thawed embryos after controlled ovarian hyperstimulation for assisted reproduction have increased with improvements in vitrification techniques and the rise of gonadotropin-releasing hormone (GnRH) antagonist protocols. Although evidence has shown that frozen–thawed embryo transfers (FETs) result in higher live birth rates than fresh embryo transfers, it is uncertain whether this association exists in cycles employing the GnRH antagonist protocol.Objective: To test the hypothesis that FETs are more likely to result in a live birth than fresh embryo transfers in a GnRH antagonist protocol cycle and to investigate whether frozen blastocyst transfer increases live birth rates compared to fresh blastocyst transfer.Design: A retrospective historical cohort study was conducted using data collected from the Department of Reproductive Medicine of Liuzhou Maternity and Child Healthcare Hospital for 1,437 patients who underwent the GnRH antagonist protocol between 1 January 2015, and 31 December 2020. The primary outcome was the live birth rate, which was compared between fresh embryo transfer and FET, and the secondary outcomes were clinical pregnancy rate and miscarriage rate, which were compared between the two groups. Analyses were adjusted to account for the age of the patient, number of embryo transfers, day of embryo transfer, and type of infertility.Results: Fresh embryo transfers accounted for 1,026 (71.4%) of the 1,437 patients who underwent the GnRH antagonist protocol in our analysis, while FETs accounted for 411 (28.6%). Patients with fresh and frozen–thawed embryos had comparable median body mass index (body mass index; 22.3 [IQR, 24.6–20.0] vs. 22.0 [IQR, 24.5–19.9]). There was a significant difference in the median age of the fresh embryo transfer group (34.0 [IQR, 39.0–30.0]) and the Frozen–thawed embryo transfer group (32.0 [IQR, 37.0–29.0]). Blastocysts were transferred in 14.6% of the fresh embryo transfer cycles and 45.5% of the FET cycles, whereas they account for 10.4% and 13.0% of all patients, respectively. The mean number of embryos transferred was 2 (IQR, 2.0–1.0) for the fresh embryo transfer group and 1 (IQR, 2.0–1.0) for the FET group, with a significant difference in the mean number of embryos transferred. The live birth rate after fresh embryo transfer vs. FET was 28.7% vs. 34.5% (absolute difference, 5.9%; adjusted relative risk [aRR], 1.15 [95% CI, 0.88–1.51]). The clinical pregnancy rates were 39.9% vs. 46.0%, respectively (absolute difference, 6.1%; aRR, 1.10 [95% CI, 0.85–1.43]). The miscarriage rates were 22.5% vs. 23.8%, respectively (absolute difference, 1.3%; aRR, 1.13 [95% CI, 0.75–1.70]).Conclusion: In this retrospective study of women who underwent assisted reproduction using GnRH antagonists, FETs resulted in a higher live birth rates and clinical pregnancy rates than fresh embryo transfers, which parts of these differences were attributable to embryo stage. However, the interpretation of the findings is limited by the possibility of selection and confounding biases.

Shape-controlled alloy nanoparticle catalysts have been shown to exhibit improved performance in the oxygen reduction reaction (ORR) in liquid half-cells. However, translating the success to catalyst layers in fuel cells faces challenges due to the more demanding operation conditions in membrane electrode assembly (MEA). Balancing durability and activity is crucial. Here, we developed a strategy that limits the atomic diffusion within surface layers, fostering the phase transition and shape retention during thermal treatment. This enables selective transformation of platinum-iron nanowire surfaces into intermetallic structures via atomic ordering at a low temperature. The catalysts exhibit enhanced MEA stability with 50% less Fe loss while maintaining high catalytic activity comparable to that in half-cells. Density functional calculations suggest that the ordered intermetallic surface stabilizes morphology against rapid corrosion and improves the ORR activity. The surface engineering through atomic ordering presents potential for practical application in fuel cells with shape-controlled Pt-based alloy catalysts.