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Abstract Objective The aim of this study was to investigate the efficacy and safety of the combined treatment regimen of D-TACE, HAIC, and Lenvatinib in patients with massive hepatocellular carcinoma, with the goal of providing a safer and more effective therapeutic strategy for individuals suffering from massive hepatocellular carcinoma. Materials and methods A retrospective analysis was conducted using clinical data from 118 patients with unresectable massive hepatocellular carcinoma who underwent treatment at the Interventional Department of Wuhan Union Hospital between June 2018 and December 2021. Based on the treatment approach, the patients were divided into two groups: the D-TACE + HAIC + Lenvatinib group (N = 54) and the D-TACE + Lenvatinib group (N = 64). The primary study endpoints included the objective response rate (ORR), disease control rate (DCR), overall survival (OS), and progression-free survival (PFS) of the two groups. Additionally, the occurrence of treatment-related adverse events in both groups was considered as a secondary study endpoint. Results Following the treatment, the D-TACE + HAIC + Lenvatinib group exhibited significantly higher ORR and DCR compared to the D-TACE + Lenvatinib group (68.5% vs. 43.8%, 90.7% vs. 73.4%, P 0.05). Conclusion The combined treatment regimen of D-TACE, HAIC, and Lenvatinib demonstrated superior therapeutic efficacy and safety in managing unresectable massive hepatocellular carcinoma. This combination therapy may serve as a viable option for improving the prognosis of patients with unresectable massive hepatocellular carcinoma.

Abstract Thongprayoon et al. found in a study of 12,599 non-dialysis adult hospitalized patients that serum calcium (SC) disturbances affected more than half of the patients and were associated with increased in-hospital mortality. Similar impacts of SC disturbances on in-hospital mortality have been observed in patients with acute myocardial infarction and the general hospitalized population. Atrial fibrillation (AF), the most common arrhythmia in the intensive care unit (ICU), affects around 6% of critically ill patients. However, the significance of the relationship between SC levels and in-hospital mortality in these patients remains unclear. This study aimed to explore the correlation between SC levels and in-hospital mortality in ICU patients diagnosed with AF. Data from the MIMIC-IV database included 11,621 AF patients (average age 75.59 ± 11.74 years; 42.56% male), with an in-hospital mortality rate of 8.90%. A nonlinear relationship between SC levels and in-hospital mortality was observed. Effect sizes on either side of the inflection point were 0.79 (HR: 0.79, 95% CI 0.67–0.94, P = 0.006) and 1.12 (HR: 1.12, 95% CI 1.01–1.25, P = 0.029). Sensitivity analyses confirmed these results. SC levels around 8.56 mg/dL were associated with the lowest risk of in-hospital mortality, with risks increasing as SC levels deviated from this point. SC levels below this inflection point were linked to more pronounced clinical impacts. This finding has significant clinical implications for clinicians. Therefore, in the treatment of ICU patients with AF, clinicians should closely monitor SC levels, with a focus on maintaining them around 8.56 mg/dL.

Abstract Molecular dynamics (MD) is an indispensable atomistic-scale computational tool widely-used in various disciplines. In the past decades, nearly all ab initio MD and machine-learning MD have been based on the general-purpose central/graphics processing units (CPU/GPU), which are well-known to suffer from their intrinsic “memory wall” and “power wall” bottlenecks. Consequently, nowadays MD calculations with ab initio accuracy are extremely time-consuming and power-consuming, imposing serious restrictions on the MD simulation size and duration. To solve this problem, here we propose a special-purpose MD processing unit (MDPU), which could reduce MD time and power consumption by about 103 times (109 times) compared to state-of-the-art machine-learning MD (ab initio MD) based on CPU/GPU, while keeping ab initio accuracy. With significantly-enhanced performance, the proposed MDPU may pave a way for the accurate atomistic-scale analysis of large-size and/or long-duration problems which were impossible/impractical to compute before.

Abstract Purpose Nocardia is emerging as a common and easily neglected cause of both healthcare- and occupation-associated infections worldwide, however, human vaccines for Nocardia prevention are not yet available. In this study, we aimed to evaluate the immunoprotective effect of the NFA47630 protein, a secreted protein abundant in the N. farcinica IFM10152 supernatant. Methods Conservation and characteristics of nfa47630 were analyzed by PCR and bioinformatics. Then recombinant NFA47630 protein was cloned, expressed and purified for further antigenicity analysis. Subsequently, the ability to activate innate immunity was evaluated by examining the phosphorylation status of the MAPK signaling pathway and cytokine levels. Finally, the protective effect was evaluated on rNFA47630-immunized mice. Results nfa47630 was conserved in N. farcinica strains with good antigenicity. The rNFA47630 protein was expressed under the optimal conditions of 0.2 mM IPTG, 28 °C, and it can be recognized by anti-N. farcinica and anti-N. cyriacigeorgica sera, but not anti-N. asteroids, anti-N. brasiliensis, anti-N. nova and anti-Mycobacterium bovis sera. It can upregulate the phosphorylation status of ERK, JNK, P38 and the cytokine levels of TNF-α, IL-10, IL-12, and IFN-γ. In addition, mice immunized with rNFA47630 protein exhibited higher antibody titers, greater bacterial clearance ability, milder organ infection, and higher survival rates than PBS-immunized mice. Conclusions Our data demonstrate that NFA47630 is a potential vaccine candidate for defending against N. farcinica infection.

Abstract Background Volumetric modulated arc therapy (VMAT) planning optimization involves iterative adjustment of numerous parameters, and hence requires repeatedly dose recalculation. In this study, we used the deep learning method to develop a fast and accurate dose calculation method for VMAT. Methods The classical 3D UNet was adopted and trained to learn the physics principle of dose calculation. The inputs included the projected fluence map (FM), computed tomography (CT) images, the radiological depth and the source-to-voxel distance (SVD). The projected FM was generated by projecting the accumulated FM between two consecutive control points (CPs) onto the patient’s anatomy. The accumulated FM was calculated by simulating the movement of the multi-leaf collimator (MLC) from one CP to the next. The dose, calculated by the treatment planning system (TPS), was used as ground truth. 51 head and neck VMAT plans were used, with 43, 1 and 7 cases as training, validation, and testing datasets, respectively. Correspondingly, 7182, 180 and 1260 CP samples were included in the training, validation, and testing datasets. Results This presented method was evaluated by comparing the derived dose distribution to the TPS calculated dose distribution. The dose profiles coincided for both the single CP and the entire plan (summation of all CPs). But the network derived dose was smoother than the TPS calculated dose. Gamma analysis was performed between the network derived dose and the TPS calculated dose. The average gamma pass rate was 96.56%, 98.75%, 98.03% and 99.30% under the criteria of 2% (tolerance) -2 mm (distance to agreement, DTA). 2%-3 mm, 3%-2 mm and 3%-3 mm. No significant difference was observed on the critical indices including the max, mean dose, and the relative volume covered by the 2000 cGy, 4000 cGy and the prescription dose. For one CP, the average computational time of the network and TPS was 0.09s and 0.53s. And for one patient, the average time was 16.51s and 95.60s. Conclusion The dose distribution derived by the network showed good agreement with the TPS calculated dose distribution. The computational time was reduced to approximate one-sixth of its original duration. Therefore the presented deep learning-based dose calculation method has the potential to be used for planning optimization.

Abstract Purpose Bile duct injury is a serious complication after transcatheter arterial chemoembolization (TACE). If it is not detected early and treated actively, it will not only affect the subsequent tumor-related treatment of hepatocellular carcinoma (HCC) patients, but also may lead to serious consequences such as infection, liver failure and even death. To analyze the risk factors of bile duct injury after TACE in patients with HCC and explore the predictive indicators of bile duct injury after TACE, which is helpful for doctors to detect and intervene early and avoid the occurrence of serious complications. Method We retrospectively analyzed the clinical data of 847 patients with primary hepatocellular carcinoma who underwent TACE for the first time in our interventional department. Patients were divided into two groups according to whether bile duct injury occurred after TACE: (1) bile duct injury group, N = 55; (2) no bile duct injury group, N = 792. The basic data, intraoperative conditions and the outcome of bile duct injury were analyzed. The chi-square test was used for comparison of enumeration data. The Mann-Whitney U test was used for comparison of measurement data. Risk factor analysis was performed using binary logistic regression analysis. Results Basic data and intraoperative conditions were compared between the bile duct injury group and the group without bile duct injury: preoperative alkaline phosphatase (ALP) (103.24 ± 32.77U/L vs. 89.17 ± 37.35U/L, P = 0.003); history of hepatobiliary surgery (36.4% vs. 20.8%, P = 0.011); intraoperative lipiodol volume (P = 0.007); combined use of gelatin sponge particles (65.5% vs. 35.0%, P

Purpose: The aim of this article is two-fold. First, it offers a unique account of "San Min," the prototype of the current Chinese educational principle proposed by Yan Fu (1854-1921) that aimed at improving people's physical, intellectual and moral capacities. This system of educational thinking has received only marginal attention in Anglophone research literature. Second, given the influence of Yan Fu's interpretation and promulgation of Herbert Spencer's educational philosophy during that period, it investigates the extent to which "San Min" is derived from Spencer's educational thought (the "Spencerian Triad"). This article focusses on how Yan Fu adapted the ideas of "San Min" from Spencer's account. Design/methodology/approach: This article considers Yan Fu's principle of "San Min" in relation to Spencer's educational triad through a close reading and comparison of key primary texts (including Yan Fu's original writing). It explores the similarities and differences between each account of education's goals and its proposed means of attainment. Findings: Yan Fu's principle of "San Min" is shown to have been adapted from the Spencerian Triad. However, using the theory of Social Organism, Yan Fu re-interpreted Spencer's individual liberty as liberty for the nation. While Spencer's goal was to empower individuals, Yan Fu aimed to serve collective independence, wealth and power. Originality/value: This article addresses oversights concerning "San Min's" Western origins in the Spencerian Triad and its influence on Chinese education under Yan Fu's sway. It is significant because San Min is still at the core of the current Chinese educational policy.

Niobium (Nb) is considered as candidate material for heat pipe in space nuclear reactors due to high melting point, low density, excellent compatibility with alkali liquid metals, irradiation resistance, workability and welding performance, but low strength restricts it's engineering application. In this work, yttrium (Y) was introduced into Nb matrix to achieve solution strengthening from Y atoms and dispersion strengthening from yttrium oxides. The latter one was realized by oxygen carrier route and vacuum electromagnetic levitation melting technique. Finally, one Nb521 (Nb-5.0 wt%W-1.7 wt%Mo-1.0 wt%Zr-0.07 wt%C) and four kinds of Nb521-xY (x = 0.1, 0.2 0.3 and 0.4 wt%) alloys were prepared. TEM characterization indicated that 80 nm Y2O3 particles were formed in Nb521-0.1Y, which exhibited the highest yield strength of 673 MPa, ultimate tensile strength of 740 MPa as well as larger elongation of 12.8%. Moreover, the solution strengthening of Y atoms and Orowan strengthening of yttrium oxides were evaluated quantitatively.

Abstract Objective High‐power ablation has been widely used in atrial fibrillation (AF). However, there were many studies observed the outcomes of the short‐term follow‐up. This study aims to the long‐term results of high‐power ablation guided by ablation index (AI) in patients with AF. Methods Analysis of patients with AF, who first received high‐power (40–50 W) ablation, to pulmonary vein isolation (PVI) in the Second Hospital of Shanxi Medical University from May 2020 to March 2022. All patients were managed perioperatively according to the routine treatment procedures. High‐power ablation was conducted under the guidance of our conventional power AI and baseline data, first‐pass PVI rate, ablation time, operative time, and long‐term surgical success rate were analyzed. Results A total of 83 patients with atrial fibrillation were enrolled in the study, with an average age of 61.62 ± 9.04 years, 47 male patients, and 49 paroxysmal atrial fibrillation. All patients achieved PVI, and the rate of first pass was 82%. The ablation time of the left atrial was 28.54 ± 9.11 min. There were no serious complications related to ablation, and only a small amount of pericardial effusion was found in 4 patients. During the follow‐up period of 26.36 ± 6.11 months, 8 patients were lost to follow‐up and the overall success rate was 84%, including 91% for paroxysmal AF and 71% for persistent AF. Conclusion High‐power ablation long‐term results appear a high freedom atrial arrhythmia, but further expanded samples are needed for controlled studies.

Long-term excessive fertilization and irrigation under greenhouse cultivation systems cause nitrogen leaching, while the residual content varies at different soil depths with cultivation durations. However, it remains unclear whether it changes the composition and assemblage of the soil bacterial community, especially at deeper layers (as deep as 4 m), after long-term intensified cultivation. This study selected soils from three sites in Shouguang (a typical representative intensive planting area), i.e., greenhouse monoculturing for 20 years (G20), greenhouse monoculturing for 10 years (G10), and an adjacent rotation field (F) for physicochemical property determination and high-throughput pyrosequencing. The results showed that, contrary to the vertical characterization of soil bacterial community composition, the 2-m soil was dominated by Methylomirabilota, a nitrate/nitrite-dependent anaerobic methane oxidizer, uncovered for the first time in the soil habitat. This was attributed to the high levels of dissolved organic carbon (DOC, 201.2–255.7 mg kg−1), proving that applying C-rich organic fertilizers, e.g. plant residues, is effective in preventing accumulated nitrate from moving downward and threatening groundwater in greenhouse soils. Besides, greenhouse cultivation increased the inter-layer composition differences of the bacterial community, and compared with the abundant, the rare subcommunity showed higher sensitivity to environmental changes. The total nitrogen most significantly affected the bacterial community composition and assemblage. Therefore, 20 years of consecutive monocropping significantly decreased the microbial co-occurrence network complexity and species dispersal rate, yielding a low-fitted neutral community model (NCM) and more specialized ecological niches, especially for the rare subcommunity. As far as is known, this is the first study that explores the likely changes in the bacterial community composition and quantifies the responses of the rare subcommunity to long-term greenhouse cultivation at this soil depth. Discovery of Methylomirabilota broadens our understanding of micro-biodiversity in deep-soil ecosystem, and hints its application potential in soil remediation.

The human gut microbiota is a vast and complex microbial community. According to statistics, the number of bacteria residing in the human intestinal tract is approximately 10 times that of total human cells, with over 1,000 different species. The interaction between the gut microbiota and various organ tissues plays a crucial role in the pathogenesis of local and systemic diseases, exerting a significant influence on disease progression. The relationship between the gut microbiota and intestinal diseases, along with its connection to the pulmonary immune environment and the development of lung diseases, is commonly referred to as the "gut-lung axis." The incidence of bronchial asthma is rising globally. With ongoing research on gut microbiota, it is widely believed that intestinal microorganisms and their metabolic products directly or indirectly participate in the occurrence and development of asthma. Based on the gut-lung axis, this review examines recent research suggesting that the intestinal microbiota can influence the occurrence and progression of allergic asthma through the modulation of cytokine immune balance and mucosal integrity. Though the precise immune pathways or microbial species influencing asthma through the gut-lung axis are still under exploration, summarizing the immune modulation through the gut-lung axis in allergic asthma may provide insights for the clinical management of the condition.

Prenatal diagnosis is crucial for pregnancies from couples with a carrier of a balanced translocation. We retrospectively reviewed 195 pregnancies from 189 couples with a balanced translocation carrier. Of these, 126 were from natural conception, while 69 were conceived through assisted reproductive technology (ART) with preimplantation genetic diagnosis (PGD). Both single nucleotide polymorphism (SNP) array analysis and conventional karyotyping were conducted on all pregnancies, and karyotype-visible imbalances and pathogenic/likely pathogenic copy number variations (CNVs) were categorized as clinically significant abnormalities. In natural conception group, couples with a female carrier experiencing more than two miscarriages accounted for 30.2 %, significantly higher than the 14.0 % in male carrier couples (p

Objective: Blood-stasis syndrome (BSS), an important syndrome in Type 2 diabetes mellitus(T2DM), is associated with the pathophysiological mechanisms underlying diabetic vascular complications. However, BSS has not been fully characterized as of yet. Due to the strong correlation between BSS and vasculopathy, we hypothesized that the metabolic characteristics of BSS in T2DM (T2DM BSS) are highly specific. By combining untargeted metabolomics and pseudotargeted lipidomics approaches, this study aimed to comprehensively elucidate the metabolic traits of T2DM BSS, thereby providing novel insights into the vascular complications of diabetes and establishing a foundation for precision medicine. Methods: The survey was conducted in Haidian District of Beijing from October 2021 to November 2021, and data collection was completed in January 2022. Liquid chromatography-mass spectrometry (LC-MS) based untargeted metabolomics and liquid chromatography-tandem mass spectrometry (LC-MS/MS) based pseudotargeted lipidomics were performed to detect metabolites and lipids. Multivariate, univariate, and pathway analyses were utilized to investigate metabolic changes. The unique metabolites of BSS were obtained by inter-group comparisons and screening. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic accuracy of metabolites. Results: A total of 1189 participants completed the survey, of which 120 participants were recruited in this study and further divided into a discovery cohort (n = 90) and a validation cohort (n = 30). Among these, 21 participants were selected for psuedotargeted lipidomics analysis. 81 metabolites, mainly involving glycerophospholipids, were identified as unique metabolites of T2DM BSS, while fatty acyls (FAs) were identified as unique lipids. T2DM BSS was associated with significant dysregulation in glycerophospholipid metabolism and choline metabolism within cancer pathways as major metabolic disturbances. Furthermore, analyses of both the discovery and validation cohorts, indicated that LysoPC (20:5(5Z,8Z,11Z,14Z,17Z)/0:0) and LysoPC (15:0) had the greatest impact on distinguishing BSS. Conclusion: Altered levels of glycerophospholipids and FAs have been associated with T2DM BSS. These results provide valuable mechanistic insights linked with the development of BSS in T2DM subjects.

Spectral and texture features play important roles in plantation leaf area index (LAI) estimation, and their combination may enhance LAI inversion accuracy. Furthermore, research on the impact of different machine learning (ML) models on their hyperparameter combinations and splitting ratios remains challenging. In our study, experiments based on spectral and textural features of GF-6 WFV data were conducted on Eucalyptus grandis plantation forests in Huangmian Town, Guangxi, China. ML methods such as multiple stepwise regression (MSR), random forest (RF), back-propagation neural network (BPNN), and support vector regression (SVR) were mainly utilized to perform model hyper-parameter tuning and split-ratio analysis in order to estimate the LAI. The results of the study showed that spectral and gray level co-occurrence matrix (GLCM) texture features were very sensitive to changes in Eucalyptus grandis LAI. The accuracy of combining the two was 10% higher than when they were not combined. Furthermore, it was found that the nonlinear methods (RF, BPNN, and SVR) outperformed the linear method (MSR), with the average Rmax2 of the nonlinear model being 26% higher than that of the linear model, and the RMSE value being 29% lower than that of the linear model. In addition, by analyzing different combinations of features, model hyperparameter fine-tuning, and splitting ratios in the nonlinear model, it was found that the splitting ratios of different combinations of model hyperparameters have a great impact on the accuracy of the model. A total of 12 out of 21 data sets showed high accuracy and stability at a split ratio of 8.5:1.5 (ratio of 0.85), with the best-performing RF model differing from the lowest by 91% for Rmax2 and 39% for Rstd2. Combining spectral and texture features provides highly accurate inversion data. Model hyper-parameter fine-tuning and segmental scale tuning can facilitate the application of inversion data to fully utilize the optimal performance of the ML model.

During the construction and operation of a pumped storage power station in an abandoned mine, the soft rock-coal body structure, comprising the roof and the residual coal pillars, encounters a complex stress environment characterized by cyclic loads. The study of its failure mechanism under cyclic dynamic loading holds significant theoretical and practical importance to stay the safety and stability of the abandoned mine pumped storage power station. In this paper, we take “roof-residual coal pillar” soft rock-coal combinations with different percentages of rock as the research object, and study their mechanical properties, failure mechanism, energy evolution characteristics and acoustic emission distribution characteristics through cyclic dynamic loading experiments. The results of the experiment indicate that: (1) Both weak cyclic dynamic loading and high rock percentage enhance the deformation resistance of soft rock-coal combinations. Under low-disturbance horizontal cyclic loading, its peak strength and modulus of elasticity increase with increasing rock percentage. (2) Under low-disturbance horizontal cyclic loading, an increasing trend is observed in the average total strain energy density, dissipation energy density, and elastic energy density of the combinations as the percentage of rock increases. (3) Under low-disturbance horizontal cyclic loading, as the percentage of rock increases in the soft rock-coal combinations, the degree of failure in the rock body part progressively intensifies, while the destruction of the coal portion progressively decreases. (4) The large number of acoustic emission signals are generated at the instant of destabilization and destruction of the coal-rock combinations, mainly dominated by the signals generated by the destruction of the coal body. Acoustic emission counts and absolute energy at key point N2 decrease as the percentage of rock increases. The b value is primarily distributed in the cyclic dynamic loading stage and the failure stage, both displaying zones of sudden increase and sudden decrease in b value.

Little information is known about the increased aroma compounds and possible mechanism in Tamarix ramosissima Ledeb roasted mutton (TRM). A comprehensive analysis of aroma compounds and lipids were firstly performed by lipidomics and sensomics approach. The results indicated that 9 out of 53 aroma compounds were considered as key odorants, including 5-methyl-2,3-diethylpyrazine. The roasted mutton contained highest levels of phosphatidylcholine (PC, 13.95%), triglyceride (TG, 13.50%), and phosphatidylethanolamine (PE, 12.25%). TG 18:0_18:0_18:1 and nine odorants were the potential biomarkers for discriminating differential samples due to variable importance in projection (VIP) > 1 and p

BackgroundPatients with cancer frequently exhibit alterations in serum lipid profiles associated with chemotherapy. It has been reported that lipid distribution in cancer correlates with tumor progression. However, the prognostic value of serum lipid biomarkers in cancer survivors remains a subject of debate. We aim to explore the relationship between non-high-density lipoprotein to high-density lipoprotein ratio (NHHR) and the prognosis of cancer survivors.MethodsIn this study, we analyzed cancer survivor data from the National Health and Nutrition Examination Survey (NHANES) from 1999–2000 to 2017–2018. The study included prospective cohorts that included total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) levels as well as mortality data. Weighted multivariate cox regression models, competing risk models and restricted cubic spline (RCS) models were applied to investigate the association between NHHR and cancer survival. Subgroup and sensitivity analyses were performed to test the robustness of the results.ResultsThis study involved 4,177 participants, representing about 19.6 million U.S. adults. After adjustment for various factors, the lower NHHR group (≤1.64) had a 31% (HR 1.31; 95% CI [1.11,1.54], p = 0.001) higher risk of death from any cause compared to the higher NHHR group. The link between NHHR and mortality remained stable across most subgroups, with notable interactions for smoking (p = 0.006) and diabetes status (p = 0.046). A J-shaped pattern was observed between NHHR and all-cause mortality, significantly among obesity-related cancer survivors (overall association test p-value = 0.0068, non-linear association test p-value = 0.0016). However, a non-significant negative correlation was observed for cancer-specific mortality (overall association test p-value = 0.48, non-linear association test p-value = 0.66). Considering the competitive risk of heart disease and cancer-specific mortality, there is no difference between the high and low NHHR groups, while the low NHHR group showed an increased risk of non-specific causes of death (p

Abstract The current thyroid ultrasound relies heavily on the experience and skills of the sonographer and the expertise of the radiologist, and the process is physically and cognitively exhausting. In this paper, we report a fully autonomous robotic ultrasound system, which is able to scan thyroid regions without human assistance and identify malignant nod- ules. In this system, human skeleton point recognition, reinforcement learning, and force feedback are used to deal with the difficulties in locating thyroid targets. The orientation of the ultrasound probe is adjusted dynamically via Bayesian optimization. Experimental results on human participants demonstrated that this system can perform high-quality ultrasound scans, close to manual scans obtained by clinicians. Additionally, it has the potential to detect thyroid nodules and provide data on nodule characteristics for American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) calculation.

Abstract Uniaxial compression tests and cyclic loading acoustic emission tests were conducted on 20%, 40%, 60%, 80%, dry and saturated muddy sandstone by using a creep impact loading system to investigate the mechanical properties and acoustic emission characteristics of soft rocks with different water contents under dynamic disturbance. The mechanical properties and acoustic emission characteristics of muddy sandstones at different water contents were analysed. Results of experimental studies show that water is a key factor in the mechanical properties of rocks, softening them, increasing their porosity, reducing their brittleness and increasing their plasticity. Under uniaxial compression, the macroscopic damage characteristics of the muddy sandstone change from mono-bevel shear damage and ‘X’ type conjugate bevel shear damage to a roadway bottom-drum type damage as the water content increases. Dynamic perturbation has a strengthening effect on the mechanical properties of samples with 60% and less water content, and a weakening effect on samples with 80% and more water content, but the weakening effect is not obvious. Macroscopic damage characteristics of dry samples remain unchanged, water samples from shear damage and tensile–shear composite damage gradually transformed into cleavage damage, until saturation transformation monoclinic shear damage. The evolution of acoustic emission energy and event number is mainly divided into four stages: loading stage (I), dynamic loading stage (II), yield failure stage (III), and post-peak stage (IV), the acoustic emission characteristics of the stages were different for different water contents. The characteristic value of acoustic emission key point frequency gradually decreases, and the damage degree of the specimen increases, corresponding to low water content—high main frequency—low damage and high water content—low main frequency—high damage.

Preparing antioxidant coatings to address the inherent oxidation sensitivity of carbon fiber-reinforced carbon aerogel (C/CA) composites is a feasible way to promote their application in oxidizing environments as thermal insulation materials. However, preparing the coatings with excellent oxidation and ablation resistance while avoiding evident damage to the C/CA substrate still remains a challenge. Herein, a SiC@SiO2 nanowire-toughened ZrB2–SiC/SiC bilayer coating with a large thickness of 500 μm was prepared on C/CA using a one-step low-temperature reaction sintering method, which simultaneously formed a sintered outer layer with even-distributed nanowires and a siliconized gradient inner layer. By courtesy of the synergic thermal response of the layers and the crack deflection induced by the nanowires, the resulting coating has moderate residual compressive stress of 0.08–1.22 GPa in the interface, high interfacial bonding strength of 6.02 MPa, and good fracture toughness of 4.36 MPa·m1/2. Benefited from the optimum components and improved structure, the coating shows excellent cyclic ablation resistance with linear ablation rates of 0.1 μm/s at 1650 ℃ for 1500 s (300 s × 5 cycles) and 0.4 μm/s at 1850 ℃ for 900 s (300 s × 3 cycles). The one-step preparation strategy contributes to little damage to the substrate, thus showing the well-preserved mechanical and thermal insulation properties.

Abstract Background Hepatitis B virus (HBV) reactivation (HBVr) is a major concern for hepatocellular carcinoma (HCC) patients undergoing hepatic arterial infusion chemotherapy (HAIC) using mFOLFOX6 regimen. There is insufficient evidence to support the routine use of HAIC combined with immunotherapy in HCC patients with HBVr. The aim of this study was to examine the adverse events (AEs) related to HBVr in HCC patients after HAIC, with or without immunotherapy, and to assess the effectiveness of antiviral prophylaxis for HBVr. Methods Medical records of HCC patients receiving HAIC combined with and without immunotherapy between January 2021 and June 2023 were reviewed. The patients were divided into two groups based on whether they received immunotherapy or not. Results Out of the 106 patients, 32 (30.2%) developed HBVr. Among these, 23 eligible patients with HBVr were included, with 14 patients (61%) receiving immunotherapy and nine patients (39%) not receiving immunotherapy. Prior to HAIC treatment, four patients in each group had detectable HBV DNA with median titre of 3.66 × 102 IU/ml (patients with immunotherapy) and 1.98 × 102 IU/ml (patients without immunotherapy), respectively. Fifteen patients did not show detectable HBV DNA. At HBVr occurrence, the median HBV DNA level was 6.95 × 102 IU/ml for all patients, 4.82 × 102 IU/ml in patients receiving immunotherapy and 1.3 × 103 IU/ml in patients not receiving immunotherapy. Grade 3 hepatitis developed in 12 cases of all patients (12/23, 48%), including five patients with immunotherapy (56%) and seven patients without immunotherapy (78%). At the 3-month follow-up, HBV DNA was detected in 10 patients, with a median HBV DNA level of 2.05 × 102 IU/ml (range, 1.5 × 102– 3.55 × 102 IU/ml) in patients (7/10) with immunotherapy and 4.28 × 102 IU/ml (range, 1.15 × 102– 5.88 × 102 IU/ml) in patients (3/10) without immunotherapy. Intensified antiviral treatment was administered to all patients. No HBVr-related fatal events occurred. Conclusion HBVr can occur after HAIC combined with or without immunotherapy. The degree of liver damage did not differ significantly in patients treated with or without immunotherapy. Intensified antiviral treatment was found to be crucial for HCC patients with HBVr.

Abstract This study aimed to evaluate the etiology and pregnancy outcomes of fetuses underwent invasive prenatal diagnosis for fetal growth restriction (FGR) accompanied by structural malformations. Data from 130 pregnancies referred for prenatal diagnosis for FGR accompanied by structural malformations were obtained between July 2011 and July 2023. Traditional karyotyping was conducted for all the subjects. A total of 37 (28.5%) cases of chromosomal abnormalities were detected by karyotyping, including 30 cases of numerical anomalies and seven cases of unbalanced structural anomalies. Trisomy 18 was the most common abnormalities, accounting for 51.4%, significantly higher than any other chromosomal abnormality. The cohort was predominantly comprised of early-onset FGR (88.5%) compared to late-onset FGR (11.5%). The incidences of chromosomal abnormalities in this two groups were 29.6% (34/115) and 20.0% (3/15), respectively (p > 0.05). The majority (74.6%, 97/130) of the cohort were affected by a single system malformation, with chromosomal abnormalities found in 19.6% (19/97) of cases. In pregnancies of structural malformations involving two and multiple systems, the frequencies were 56.5% (13/23), and 50.0% (5/10), respectively. Single nucleotide polymorphism array (SNP array) was performed in parallel for 65 cases, revealing additional 7.7% cases of copy number variants (CNVs) compared to karyotyping. Polymerase chain reaction (PCR) was used for detection of cytomegalovirus (CMV) DNA in 92 cases. All fetuses with FGR associated with two or more system malformations were either terminated or stillborn, irrespective of chromosomal aberrations. Conversely, 71.8% of pregnancies with a single-system malformation and normal genetic testing results resulted in live births. Furthermore, two (2.2%) cases tested positive for CMV DNA, leading to one termination and one case of serious developmental disorder after birth. Our study suggests that structural malformations associated with FGR are more likely to affect a single organ system. When multiple systems are involved, the incidence of chromosomal abnormalities and termination rates are notably high. We advocate for the use of CMA and CMV DNA examinations in FGR cases undergo invasive prenatal diagnosis, as these tests can provide valuable insights for etiological exploration and pregnancy management guidance.

AbstractZanthoxylum ailanthoides is a deciduous tree, with important medicinal and economic values. The complete chloroplast genome sequence of Z. ailanthoides was assembled and the phylogenetic relationship to other species was inferred in this study. The chloroplast genome is 157,209 bp in length, including two inverted repeats of 26,408 bp, a large single-copy of 86,099 bp and a small single copy of 18,294 bp. Moreover, the chloroplast genome contains 129 genes, including 84 protein-coding genes, 37 tRNA genes, and 8 rRNA genes. The overall GC content of the chloroplast genome is 38.4%. The phylogenetic analysis indicated that Z. ailanthoides was grouped with a clade containing the species of Z. multijugum, Z. calcicola, Z. oxyphyllum, Z. stenophyllum, and the genus was closely related to Phellodendron. This study contributes to a better understanding of the phylogenetic relationships among Zanthoxylum species.

The purpose of this research was to assess the impact of 5 lactic acid bacteria (LAB), Lactiplantibacillus plantarum, Lacticaseibacillus casei, Streptococcus thermophilus, Lacticaseibacillus rhamnosus and Lactobacillus delbrueckii subsp. bulgaricus on the characteristic flavor of the fermented sweet potato juice. Following the fermentation process, significant variations were observed in the concentrations of sugars, organic acids, as well as the overall volatile aroma compounds. LAB can effectively facilitate the production of volatile organic compounds (VOCs), including acids and ketones, thereby enhancing the aroma quality. Inoculation fermentation by LAB decreased the sweet and nutty odor, and increased fresh, floral, and citrus aroma of the sweet potato juice. The sweet potato juice fermented by 5 lactic acid bacteria strains had different flavor features, while the sample of Lp10 showed the highest overall acceptability. Compared to other strains, L. plantarum exerted a more significant influence on the volatile compounds present in fermented sweet potato juice.

Abstract Background Patients with 22q11.2 microduplication syndrome exhibit a high degree of phenotypic heterogeneity and incomplete penetrance, making prenatal diagnosis challenging due to phenotypic variability. This report aims to raise awareness among prenatal diagnostic practitioners regarding the variant's complexity, providing a basis for prenatal genetic counseling. Methods Family and clinical data of 31 fetuses with 22q11.2 microduplications confirmed by chromosomal microarray between June 2017 and June 2023 were considered. Results Primary prenatal ultrasound features of affected fetuses include variable cardiac and cardiovascular anomalies, increased nuchal translucency (≥3 mm), renal abnormalities, and polyhydramnios. More than half of fetuses considered showed no intrauterine manifestations; therefore, prenatal diagnostic indicators were primarily advanced maternal age or high‐risk Down syndrome screening. Most fetuses had microduplications in proximal or central 22q11.2 regions, with only three cases with distal microduplications. Among parents of fetuses considered, 87% (27/31) continued the pregnancy. During follow‐up, 19 cases remained clinically asymptomatic. Conclusion Nonspecific 22q11.2 microduplication features in fetuses and its mild postnatal disease presentation highlight the need to cautiously approach prenatal diagnosis and pregnancy decision‐making. Increased clinical efforts should be made regarding providing parents with specialized genetic counseling, long‐term follow‐up, and fetal risk information.

ObjectivesThis study aimed to explore the synergistic interaction effect between hyperuricemia and hypertension towards chronic kidney disease in patients with type 2 diabetes.MethodsThis research originates from a cross-sectional study performed in Zhejiang Province, Eastern China, between March and November 2018. The correlation between serum uric acid levels and the risk of chronic kidney disease was assessed using a restricted cubic spline model. An unconditional multivariable logistic regression model, along with an interaction table, was utilized to explore the potential interaction effect of hyperuricemia and hypertension towards chronic kidney disease.Results1,756 patients with type 2 diabetes were included in this study, the prevalence of chronic kidney disease (CKD) was 27.62% in this population. A U-shaped non-linear pattern emerged correlating serum uric acid (SUA) levels and CKD risk, indicating that both low and high SUA levels were linked to an increased CKD risk. This risk achieved its lowest point (nadir) at SUA approximately equals to 285μmol/L (p for trend