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Abstract The spin dynamics and electronic orders of the kagome system at different filling levels stand as an intriguing subject in condensed matter physics. By first-principles calculations and random phase approximation analyses, we investigate the spin fluctuations and superconducting instabilities in kagome phase of CsCr3Sb5 under high pressure. At the filling level slightly below the kagome flat bands, our calculations reveal strong antiferromagnetic spin fluctuations in CsCr3Sb5, together with a leading s ±-wave and a competing (d x y , $${d}_{{x}^{2}-{y}^{2}}$$ d x 2 − y 2 )-wave superconducting order. Unlike the general intuition that the flat bands are closely related to the ferromagnetic correlations, here we propose a sublattice-momentum-coupling-driven mechanism for the antiferromagnetic fluctuations enhanced from the unoccupied flat bands. The mechanism is generally applicable to kagome systems where the Fermi level intersects near the flat bands, offering a new perspective for future studies of geometrically frustrated systems.

Abstract Background Chemical-induced acute lung injury is characterized by impaired epithelial regenerative capacity, leading to acute pulmonary edema. Numerous studies have investigated the therapeutic potential of endogenous stem cells with particular emphasis on alveolar type 2 epithelial (AEC2) cells owing to their involvement in lung cell renewal. Sox9, a transcription factor known for its role in maintaining stem cell properties and guiding cell differentiation, marks a subset of AEC2 cells believed to contribute to epithelial repair. However, the role of Sox9+AEC2 cells in the distal lung alveolar cells and the potential roles in chemically induced acute lung injury have never been explored. Methods In this study, we generated Sox9 flox/flox ;Sftpc Cre−ERT2 mice and examined the effects of Sox9+AEC2 cells on the pathophysiology of epithelial damage during chemical-induced acute lung injury. Subsequently, Sox9-Cre ERT2 Ai9 mice were used for lineage tracing to elucidate the repair mechanisms. Results Our findings revealed that Sox9+AEC2 cells endowed with stem cell properties induced cell proliferation during lung injury, predominantly in the damaged alveolar region. This process is accompanied by the regulation of inflammatory responses and orderly differentiation, thereby promoting epithelial regeneration. Conclusion These results provide compelling in vivo genetic evidence supporting the characterization of Sox9+AEC2 cells as bona fide lung epithelial stem cells, demonstrating their multipotency and self-renewal capabilities during lung repair and regeneration. The identification of Sox9+AEC2 cells as crucial contributors to the promotion of epithelial repair underscores their potential as therapeutic targets in chemical-induced acute lung injury.

Abstract Background Persistent inflammation in the airways is a hallmark of asthma, and researchers have extensively explored various inflammatory indicators that contribute to the condition. Despite this, there is limited research on the relationship between the systemic immune-inflammation index (SII), a novel marker of inflammation, and overall mortality rates as well as mortality rates due to specific causes in individuals with asthma. Methods We analyzed data from the National Health and Nutrition Examination Survey (NHANES) covering a 20-year period, from 1999 to 2018. To examine the association between SII and mortality rates in asthma patients, we used a combination of statistical methods, including weighted Kaplan-Meier analysis and multivariate-adjusted Cox analysis. Additionally, we applied restricted cubic spline (RCS) analysis to investigate the potential non-linear relationship between these variables. To further validate our findings, we performed subgroup and sensitivity analyses to ensure the reliability of the results. Results This study analyzed data from 5,384 individuals with asthma, finding a link between increased SII levels and a higher risk of death from all-cause, cardiovascular disease and respiratory disease, but no association with cancer mortality. There were J-shaped non-linear relationships between SII and all-cause, cardiovascular and respiratory diseases mortality in asthma patients. The inflection points were 326, 350 and 355, respectively. Below these inflection points, each 100-unit increase in SII was associated with a decrease in mortality by 8%, 11% and 10%, while above these thresholds, mortality rates increased by 4%, 4%, and 3%, respectively. Subgroup analyses showed that SII was a significant predictor of all-cause mortality across various subgroups, and sensitivity analyses confirmed these findings, with the highest SII group consistently showing higher mortality rates for all-cause, cardiovascular, and respiratory disease mortality in the fully adjusted model. Conclusions Our study initially demonstrated a strong link between elevated SII levels and a higher risk of death from all-cause, cardiovascular disease, and respiratory disease in individuals with asthma. Furthermore, our analysis showed that the relationship between SII and mortality rates in asthma patients followed a non-linear, J-shaped pattern for all-cause, cardiovascular, and respiratory disease mortality. Clinical trial number Clinical trial number not applicable.

Abstract Background As bronchiectasis progresses, increasing degrees of airflow limitation can occur. Objectives This study aimed to investigate whether concomitant airflow limitation was associated with poor prognosis in patients with bronchiectasis and to identify the characteristics of patients with airflow limitation in bronchiectasis. Design A prospective longitudinal study was conducted to determine the characteristics and prognosis of bronchiectasis patients with airflow limitation. Methods We conducted a prospective longitudinal study. Patients who failed to complete the follow-up were withdrawn from the trial. High-resolution computed tomography (HRCT) was used for diagnosing bronchiectasis, whereas postbronchodilator forced expiratory volume in one second of the predicted value (post-FEV1%) was employed for grading airflow limitation. The main variables included questionnaires, anthropometric measurements, pulmonary function tests, laboratory tests, and CT findings. The primary outcome was frequent exacerbations. Differences among the groups were evaluated via two-tailed Student’s t test or ANOVA for continuous variables if the data were normally distributed. In the case of a nonnormal distribution, the Mann–Whitney U test and Kruskal–Wallis test were used. The chi-square test or Fisher’s exact test was used for categorical variables. Binary logistic regression analyses were used to identify factors and calculate the odds ratio (OR) for frequent exacerbations. Results A total of 189 subjects with bronchiectasis were enrolled in the study, including 97 patients with airflow limitation and 92 patients without airway obstruction. Patients with airflow limitation had greater numbers of exacerbations (1.46 ± 0.83 vs. 1.76 ± 1.10 times, P = 0.013) at 12 months after enrolment and greater numbers of hospitalizations (1.10 ± 0.30 vs. 1.36 ± 0.67 times, P = 0.0016) at 24 months after enrolment. In addition, acute exacerbations lasted longer (8.69 ± 3.78 vs. 13.11 ± 14.03 days, P = 0.0171), and the total number of hospitalizations was greater (1.34 ± 0.77 vs. 1.80 ± 1.67 times, P = 0.0421) for patients with a mean follow-up duration of 32 months (Table 3). Bronchiectasis patients with airflow limitation exhibit more severe manifestations of bronchiectasis both clinically and functionally. Furthermore, the cohort of bronchiectasis patients with airflow limitation had a significantly greater infection rate than did the BE group (P = 0.0244), with a notable disparity observed in the incidence of P. aeruginosa infection (P

Abstract Background Due to the ability of circRNA to bind with corresponding RBPs and play a critical role in gene regulation and disease prevention, numerous identification algorithms have been developed. Nevertheless, most of the current mainstream methods primarily capture one-dimensional sequence features through various descriptors, while neglecting the effective extraction of secondary structure features. Moreover, as the number of introduced descriptors increases, the issues of sparsity and ineffective representation also rise, causing a significant burden on computational models and leaving room for improvement in predictive performance. Results Based on this, we focused on capturing the features of secondary structure in sequences and developed a new architecture called CRBPSA, which is based on a sequence-structure attention mechanism. Firstly, a base-pairing matrix is generated by calculating the matching probability between each base, with a Gaussian function introduced as a weight to construct the secondary structure. Then, a Structure_Transformer is employed to extract base-pairing information and spatial positional dependencies, enabling the identification of binding sites through deeper feature extraction. Experimental results using the same set of hyperparameters on 37 circRNA datasets, totaling 671,952 samples, show that the CRBPSA algorithm achieves an average AUC of 99.93%, surpassing all existing prediction methods. Conclusions CRBPSA is a lightweight and efficient prediction tool for circRNA-RBP, which can capture structural features of sequences with minimal computational resources and accurately predict protein-binding sites. This tool facilitates a deeper understanding of the biological processes and mechanisms underlying circRNA and protein interactions.

Since the dissemination of information is more rapid and the scale of users on online platforms is enormous, the public opinion risk is more visible and harder to tackle for universities and authorities. Improving the accuracy of predictions regarding online public opinion crises, especially those related to campuses, is crucial for maintaining social stability. This research proposes a public opinion crisis prediction model that applies the Grey Wolf Optimizer (GWO) algorithm combined with long short-term memory (LSTM) and implements it to analyze a trending topic on Sina Weibo to validate its prediction accuracy. A full-chain analytical framework for online public opinion prediction is established in this study, which enables the model to illustrate the level of risk related to public opinion and its variation trend by introducing the public opinion risk index. The prediction accuracy of the model is validated through several evaluation criteria, and a comparison between real and predicted results, and the simulation of the intervention on this incident indicates that the proposed model is competent for both trend prediction and assisting in intervention. The study also demonstrates the importance of immediate response and intervention to public opinion crises.

ObjectiveThe aim of this research was to explore the possible connection between combined Oxidative Balance Score (OBS) and the prevalence of chronic inflammatory airway diseases (CIAD), including asthma, chronic obstructive pulmonary disease (COPD), and chronic bronchitis, along with the mortality rate among individuals with CIAD.MethodsData were gathered from the National Health and Nutrition Examination Survey (NHANES) 2013–2018 cycles. The Oxidative Balance Score (OBS) was calculated using 16 different nutrients and 4 different lifestyles, which was then categorized into four groups. The CIAD included individuals with self-reported asthma, chronic bronchitis, or COPD. Mortality data up to December 31, 2019, was obtained from the National Death Index. In cross-sectional studies, the association between OBS and the prevalence of total and specific CIAD was examined using multiple logistic regressions. Dose–response relationships were analyzed through restricted cubic spline regression (RCS). In prospective cohort studies, cumulative survival rates were determined using the Kaplan–Meier method and compared with log-rank tests. Multiple COX regressions were conducted to evaluate the relationship between OBS and all-cause as well as respiratory diseases mortality among participants with CIAD.ResultsA total of 12,458 adults were enrolled in this study. The demographic characteristics of the study population revealed a mean age of 52.25 ± 15.8 years, 47.73% being male, and the majority identified as Non-Hispanic White (66.87%). We found that 20.26% of the participants were suffered from CIAD, followed by asthma (15.41%), chronic bronchitis (6.10%) and COPD (3.80%), respectively. The median OBS levels were 20.98 with a standard deviation of 0.17. After adjusting for all confounders, we found that the highest quartile of OBS was significantly associated with lower prevalence of total CIAD (OR = 0.71, 95% CI 0.64–0.81), asthma (OR = 0.62, 95% CI 0.52–0.73), chronic bronchitis (OR = 0.64, 95% CI 0.44–0.92), and COPD (OR = 0.48, 95% CI 0.31–0.77) compared to the lowest quartile. Additionally, a linear and inverse relationship was found between OBS and the incidence of various respiratory disorders. Kaplan–Meier survival analysis showed that individuals in the highest quartile of OBS had the lowest risk of both all-cause mortality (log-rank test p = 0.017) and respiratory diseases mortality (log-rank test p

The advancement of drug delivery systems (DDSs) in recent decades has demonstrated significant potential in enhancing the efficacy of pharmacological agents. Despite the approval of certain DDSs for clinical use, challenges such as rapid clearance from circulation, toxic accumulation in the body, and ineffective targeted delivery persist as obstacles to successful clinical application. Blood cell-based DDSs have emerged as a popular strategy for drug administration, offering enhanced biocompatibility, stability, and prolonged circulation. These DDSs are well-suited for systemic drug delivery and have played a crucial role in formulating optimal drug combinations for treating a variety of diseases in both preclinical studies and clinical trials. This review focuses on recent advancements and applications of DDSs utilizing blood cells and their membrane-derived microvesicles. It addresses the current therapeutic applications of blood cell-based DDSs at the organ and tissue levels, highlighting their successful deployment at the cellular level. Furthermore, it explores the mechanisms of cellular uptake of drug delivery vectors at the subcellular level. Additionally, the review discusses the opportunities and challenges associated with these DDSs.

Abstract Objective The objective of this study was to investigate the potential association between the inflammatory burden index (IBI) and the prevalence of chronic inflammatory airway diseases (CIAD), as well as mortality rates among individuals diagnosed with CIAD. Methods Participants were sourced from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2010. The IBI was calculated using the formula: IBI = C-reactive protein * neutrophils / lymphocytes. CIAD comprised self-reported asthma, chronic bronchitis, and chronic obstructive pulmonary disease (COPD). Mortality outcomes, including all-cause and respiratory disease mortality, were determined through linked data from the National Death Index (NDI) up to December 2019. Results A total of 27,495 adults were included. IBI was divided into quartiles, with the lowest quartile as the reference group. After adjusting for confounding variables, a positive correlation was observed between higher IBI and increased prevalence of total CIAD (OR = 1.383 [1.215–1.575]), asthma (OR = 1.267 [1.096–1.465]), chronic bronchitis (OR = 1.568 [1.263–1.946]), and COPD (OR = 1.907 [1.311–2.774]). Over a median follow-up of 12.33 [9.92-16.00] years, there were 1221 deaths from all causes and 220 deaths from respiratory disease among 4499 patients with CIAD. Following multivariate adjustments, the fourth quartile was significantly associated with increased risk of all-cause mortality (HR = 2.227 [1.714–2.893]) and respiratory disease mortality (HR = 2.748 [1.383–5.459]) compared to the first quartile of IBI in CIAD participants. Moreover, variable importance analysis using a random survival forest model demonstrated the significance of IBI in predicting mortality from both all-cause and respiratory diseases. Conclusion IBI exhibited an association with the prevalence of CIAD, with higher IBI levels correlating with elevated all-cause and respiratory disease mortality among individuals with CIAD.

BackgroundIn recent years, COVID-19 and tuberculosis have emerged as major infectious diseases, significantly contributing to global mortality as respiratory illnesses. There is increasing evidence of a reciprocal influence between these diseases, exacerbating their incidence, severity, and mortality rates.MethodsThis study involved retrieving COVID-19 and tuberculosis data from the GEO database and identifying common differentially expressed genes. Machine learning techniques, specifically random forest analysis, were applied to pinpoint key genes for diagnosing COVID-19. The Cibersort algorithm was employed to estimate immune cell infiltration in individuals with COVID-19. Additionally, single-cell sequencing was used to study the distribution of VNN1 within immune cells, and molecular docking provided insights into potential drugs targeting these critical prognosis genes.ResultsGMNN, SCD, and FUT7 were identified as robust diagnostic markers for COVID-19 across training and validation datasets. Importantly, VNN1 was associated with the progression of severe COVID-19, showing a strong correlation with clinical indicators and immune cell infiltration. Single-cell sequencing demonstrated a predominant distribution of VNN1 in neutrophils, and molecular docking highlighted potential pharmacological targets for VNN1.ConclusionsThis study enhances our understanding of the shared pathogenic mechanisms underlying tuberculosis and COVID-19, providing essential insights that could improve the diagnosis and treatment of severe COVID-19 cases.

BackgroundCadmium is a heavy metal that accumulates in the body due to environmental and occupational exposure. The neurotoxicity of cadmium received increasingly attention in recent years. Sleeping is regulated and coordinated by nervous system, however, little is known about the relationship between cadmium and sleep. This study aimed to examine the relationship between blood cadmium concentrations and sleep-related disorders in US adults.MethodsThis cross-sectional study used data on blood cadmium and sleep from the 2005–2008 and 2015–2020 National Health and Nutrition Examination Survey (NHANES). Weighted multiple regression, generalized weighted modeling, and weighted restricted cubic splines (RCS) were utilized to investigate the association between blood cadmium and sleep outcomes (sleep duration, trouble sleeping, symptoms of obstructive sleep apnea (OSA) and daytime sleepiness). Furthermore, subgroup analyses were conducted to investigate any differences in the associations between age, gender, ethnicity, education level, marital status, smoking status, alcohol consumption, diabetes mellitus (DM), cardiovascular disease (CVD) and hypertension groups.ResultsIn 19,152 participants, the median blood cadmium concentration was 0.48 (IQR: 0.28, 0.82)μg/L. Compared with the lowest reference quartile, participants in the higher quartile had a significantly higher risk of insufficient sleeping (0.05).ConclusionInsufficient sleep, symptoms of OSA, trouble sleeping and daytime sleepiness were found to have a positive association with the blood cadmium concentration in US adults. However, further prospective studies are necessary to establish whether there is a causal relationship between these factors.

Background: Prolonged sitting and reduced physical activity lead to low energy expenditures. However, little is known about the joint impact of daily sitting time and physical activity on body fat distribution. We investigated the independent and joint associations of daily sitting time and physical activity with body fat among adults. Methods: This was a cross-sectional analysis of U.S. nationally representative data from the National Health and Nutrition Examination Survey 2011–2018 among adults aged 20 years or older. Daily sitting time and leisure-time physical activity (LTPA) were self-reported using the Global Physical Activity Questionnaire. Body fat (total and trunk fat percentage) was determined via dual X-ray absorptiometry. Results: Among 10,808 adults, about 54.6% spent 6 h/day or more sitting; more than one-half reported no LTPA (inactive) or less than 150 min/week LTPA (insufficiently active) with only 43.3% reported 150 min/week or more LTPA (active) in the past week. After fully adjusting for sociodemographic data, lifestyle behaviors, and chronic conditions, prolonged sitting time and low levels of LTPA were associated with higher total and trunk fat percentages in both sexes. When stratifying by LTPA, the association between daily sitting time and body fat appeared to be stronger in those who were inactive/insufficiently active. In the joint analyses, inactive/insufficiently active adults who reported sitting more than 8 h/day had the highest total (female: 3.99% (95% confidence interval (95%CI): 3.09%–4.88%); male: 3.79% (95%CI: 2.75%–4.82%)) and trunk body fat percentages (female: 4.21% (95%CI: 3.09%–5.32%); male: 4.07% (95%CI: 2.95%–5.19%)) when compared with those who were active and sitting less than 4 h/day. Conclusion: Prolonged daily sitting time was associated with increased body fat among U.S. adults. The higher body fat associated with 6 h/day sitting may not be offset by achieving recommended levels of physical activity.

Inertial microfluidics, as an efficient method for the manipulation of micro-/nanoparticles, has garnered significant attention due to its advantages of high throughput, structural simplicity, no need for external fields, and sheathless operation. Common structures include straight channels, contraction–expansion array (CEA) channels, spiral channels, and serpentine channels. In this study, we developed a CEA channel embedded with hook-shaped microstructures to modify the characteristics of vortices. Through experimental studies, we investigated the particles’ migration mechanisms within the proposed structure. The findings indicated that, in comparison to conventional rectangular microstructures, the particles within the hook-shaped microstructured CEA channels experienced a more pronounced influence from inertial lift forces. Moreover, the magnitude of the second flow within the novel configuration was directly proportional to the channel width, the length of the expansion segment, and the embedding depth of the microstructure. The innovative structure was subsequently employed for particle trapping, focusing, and separation. The experimental outcomes revealed focusing efficiency of up to 99.1% and sorting efficiency of up to 97%. This research holds the potential to enhance the foundational theory of Dean flows and broaden the application spectrum of inertial contraction–expansion microfluidic chips.

Abstract Background Smoke exposure is a prevalent and well-documented risk factor for various diseases across different organ systems. Serum neurofilament light chain (sNfL) has emerged as a promising biomarker for a multitude of nervous system disorders. However, there is a notable paucity of research exploring the associations between smoke exposure and sNfL levels. Methods We conducted a comprehensive analysis of the National Health and Nutrition Examination Survey (NHANES) cross-sectional data spanning the years 2013 to 2014. Serum cotinine levels were classified into the following three groups: < 0.05, 0.05–2.99, and ≥ 3 ng/ml. Multiple linear regression models were employed to assess the relationships between serum cotinine levels and sNfL levels. Additionally, we utilized restricted cubic spline analyses to elucidate the potential nonlinear relationship between serum cotinine and sNfL levels. Results A total of 2053 participants were included in our present research. Among these individuals, the mean age was 47.04 ± 15.32 years, and males accounted for 48.2% of the total study population. After adjusting the full model, serum cotinine was positively correlated with sNfl in the second group (β = 0.08, 95%CI 0.01–0.15) and in the highest concentration of serum cotinine (β = 0.10, 95%CI 0.01–0.19) compared to the group with the lowest serum cotinine concentrations. Current smokers, in comparison to non-smokers, exhibited a trend toward elevated sNfL levels (β = 0.07, 95%CI 0.01–0.13). Furthermore, subgroup analyses revealed interactions between serum cotinine levels and different age groups (P for interaction = 0.001) and gender stratification (P for interaction = 0.015) on sNfL levels. Conclusion The study suggested that serum cotinine was significantly and positively associated with sNfl levels in adult participants. Furthermore, current smokers tend to exhibit elevated sNfL levels. This research sheds light on the potential implications of smoke exposure on neurological function impairment and underscores the importance of further exploration in this area.

Automatic seizure detection plays a crucial role in epilepsy diagnosis and treatment. Traditional machine learning based automatic seizure detection requires additional feature engineering and finding the optimal hand-crafted features is a challenging issue. Therefore, a novel end-to-end deep learning model that combines attention mechanism, temporal convolutional network(TCN), and bidirectional gated recurrent unit (BiGRU) is proposed for seizure detection in this work. Our model only requires filtering of the raw electroencephalogram(EEG) signals to remove artifacts, without the need for time-consuming feature extraction. Post-processing procedures including moving-average filtering, thresholding, and the collar technique are then applied to enhance the model’s performance. Experiments were conducted on the CHB-MIT dataset and the SH-SDU dataset. In patient-specific experiments, our model achieved average accuracies of 98.77% on the CHB-MIT dataset and 93.61% on the SH-SDU dataset. In cross-patient experiments, average accuracies of 93.78% and 91.37% were obtained, respectively. The total time required for the model to process 1-hour EEG signals is only 5.33s. These outstanding results indicate that our model achieves high accuracy and real-time performance in seizure detection tasks and could provide reference for clinical seizure diagnosis.

Abstract Acute pulmonary embolism (APE) is a potentially fatal disease. Early risk stratification is essential to determining appropriate treatment. We aimed to investigate the predictive value of the Naples Prognostic Score (NPS) for 30-day all-cause mortality in patients with APE. In this retrospective analysis, 325 hospitalized patients with APE were divided into Groups 0 (n = 131), 1 (n = 153), and 2 (n = 41) according to the NPS. The primary outcome event was all-cause mortality during 30 days of follow-up from the day of admission. The correlation between NPS, clinical features, and outcomes in each group was evaluated. The patients were divided into two groups, survivor (n = 294) and nonsurvivor (n = 31), according to their prognosis. The results of the comparison between the three NPS groups revealed that patients with older age, faster heart rate, lower systolic blood pressure, low albumin and total cholesterol levels, high neutrophil to lymphocyte ratio (NLR), low lymphocyte-to-monocyte ratio (LMR), right heart dilatation, heart failure, malignancy, and lower extremity venous thrombosis had significantly higher 30-day all-cause mortality (P

Abstract Owing to its unique geometry, the kagome lattice hosts various many-body quantum states including frustrated magnetism, superconductivity, and charge-density waves (CDWs). In this work, using inelastic X-ray scattering, we discover a dynamic short-range $$\sqrt{3}\times \sqrt{3}\times 2$$ 3 × 3 × 2 CDW that is dominant in the kagome metal ScV6Sn6 above T CDW ≈ 91 K, competing with the $$\sqrt{3}\times \sqrt{3}\times 3$$ 3 × 3 × 3 CDW that orders below T CDW. The competing CDW instabilities lead to an unusual CDW formation process, with the most pronounced phonon softening and the static CDW occurring at different wavevectors. First-principles calculations indicate that the $$\sqrt{3}\times \sqrt{3}\times 2$$ 3 × 3 × 2 CDW is energetically favored, while a wavevector-dependent electron-phonon coupling (EPC) promotes the $$\sqrt{3}\times \sqrt{3}\times 3$$ 3 × 3 × 3 CDW as the ground state, and leads to enhanced electron scattering above T CDW. These findings underscore EPC-driven correlated many-body physics in ScV6Sn6 and motivate studies of emergent quantum phases in the strong EPC regime.

Abstract Background Accurate prediction of acute exacerbation helps select patients with chronic obstructive pulmonary disease (COPD) for individualized therapy. The potential of lymphocyte subsets to function as clinical predictive factors for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) remains uncertain. Methods In this single-center prospective cohort study with a 2-year follow-up, 137 patients aged 51 to 79 with AECOPD were enrolled. We examined the prognostic indicators of AECOPD by analyzing lymphocyte subsets and baseline symptom score. Furthermore, a predictive model was constructed to anticipate the occurrence of respiratory failure in patients experiencing AECOPD. Results The COPD Assessment Test (CAT) score combined with home oxygen therapy and CD4+CD8+ T cells% to predict respiratory failure in AECOPD patients were the best (the area under the curves [AUC] = 0.77, 95% CI: 0.70–0.86, P

As escalating environmental pressures threaten the world’s beaches, understanding the driving factors influencing their geomorphological changes is of critical global importance. This study focuses on the morphological changes of Sigeng beach adjacent to Changhua River Mouth in Hainan Island, China through decadal monitoring of shoreline and profile topography and tries to illuminate the natural and anthropogenic factors that drove geomorphological changes. The results showed that Sigeng beach undergone significant changes between 2008 and 2024, with notable accretion at the northernmost and southernmost and general erosion at other sections. The shoreline change rates ranged between -18.4 m/yr and 13.0 m/yr, with the average rate of -1.9 m/yr, indicating overall erosion. The net longshore sediment transport (LST) rates along Sigeng beach was estimated through the combination of the cross-shore (profile) and longshore (shoreline) changes. The overall direction of net LST along the beach were southward, except for the northern section where the direction was northward due to the diffraction of NE waves by the long sand spit at the northernmost. The net LST rates at each profile varied from 0.8×104 m3/yr to 3.5×104 m3/yr. The main factors controlling Sigeng beach evolution, including seasonal wave action and reduction in fluvial sediment load, followed by sand spit and coastal structures, typhoon events, aeolian transport, and sea level rise, were discussed. Subsequently, adaptive protection measures, including beach nourishment, accompanied with groin system or multiple detached breakwaters were proposed to combat with beach erosion. The analysis presented in this study is helpful to understand the morphodynamics and to predict the future change of beaches.

Abstract Background and Aims The relationship between oral contraceptive pill (OCP) and suicidal ideation remains unclear. This study aims to estimate the prevalence of suicidal ideation among US women and evaluate their associates overall and according to OCP use status. Methods Data from the National Health and Nutrition Examination Survey (NHANES) 2005−2012 were used to calculate the prevalence and associates of suicidal ideation in women using OCP. Suicidal ideation was assessed using the Patient Health Questionnaire‐9. Overall and OCP‐specific weighted prevalence of suicidal ideation were estimated. Multivariable logistic regressions were used to investigate overall and OCP‐specific associates. Results The prevalence of suicidal ideation was 3.6% with no evident disparity between OCP groups, suggesting that OCP use is not associated with increased prevalence of suicidal ideation. Smoking was inversely associated with suicidal ideation in the former users of OCP. In the overall population, the prevalence of suicidal ideation was greater in those who were: Black or Hispanic, smoking, taking antidepressants, those with lower educational attainment, and women with low and middle income. Conclusion Our findings suggest that OCP use was not associated with increased prevalence of suicidal ideation. Unique associates were identified among different OCP groups.

In this work, a four-port directional filter (DF) with a broad passband and low reflection is proposed at the W-band, which comprises three unit filters at 92, 95, and 97 GHz, cascaded in series. Each unit consists of two microstrip lines in the top circuit layer for signal input and output, two pairs of apertures in the middle ground layer for directional coupling, and one square loop in the bottom layer as a selective resonator. By sweeping the working frequencies of the three units and optimizing the phase delays between them, the proposed filter achieves a 3-dB bandwidth as broad as 16%, an insertion loss of 2.5 dB at 95 GHz, and an out-of-band rejection of −28 and −23 dB at 80 and 110 GHz, respectively. The corresponding reflection attenuation is larger than 9.6 dB from 60 to 105 GHz. To verify our design, a prototype is fabricated and characterized, and its experimental data are consistent with the simulation. This work significantly expands the bandwidth of DFs and may find many applications in frequency division multiplexing and high-gain wireless systems.

Springback error is a major obstacle in L-bending sheets via cold working. Although thermal processing can effectively reduce the springback phenomenon, it is challenging to heat the sheet globally due to the influence of working conditions. Therefore, this study applied local induction heating to reduce the springback of 45 steel sheets and investigated the effects of bending parameters on springback behavior. Initially, a thermodynamic coupling model and a static model were created utilizing the VOCE hardening model and the von Mises yield criterion in the ANSYS workbench 2022 R2 software. The springback behavior and stress distribution of the sheets were then investigated under different temperatures (room temperature and 800 °C) and bending angles (15°, 30°, 45°, 60°, 75°, and 90°). Simultaneously, the experiments were performed to investigate springback behavior and guarantee the accuracy of the model. The results indicate that the springback reached a minimum value at the 45° bending angle at room temperature while increasing with the increasing bending angle under 800 °C local heating. The springback under local heating can be decreased by 75.2% and the error of the bending angle can improve by 2–7° compared with samples processed in room temperature.

Pulmonary fibrosis is a fatal lung disease affecting approximately 5 million people worldwide, with a 5-year survival rate of less than 50%. Currently, the only available treatments are palliative care and lung transplantation, as there is no curative drug for this condition. The disease involves the excessive synthesis of the extracellular matrix (ECM) due to alveolar epithelial cell damage, leading to scarring and stiffening of the lung tissue and ultimately causing respiratory failure. Although multiple factors contribute to the disease, the exact causes remain unclear. The mechanical properties of lung tissue, including elasticity, viscoelasticity, and surface tension, are not only affected by fibrosis but also contribute to its progression. This paper reviews the alteration in these mechanical properties as pulmonary fibrosis progresses and how cells in the lung, including alveolar epithelial cells, fibroblasts, and macrophages, respond to these changes, contributing to disease exacerbation. Furthermore, it highlights the importance of developing advanced in vitro models, based on hydrogels and 3D bioprinting, which can accurately replicate the mechanical and structural properties of fibrotic lungs and are conducive to studying the effects of mechanical stimuli on cellular responses. This review aims to summarize the current understanding of the interaction between the progression of pulmonary fibrosis and the alterations in mechanical properties, which could aid in the development of novel therapeutic strategies for the disease.

DesignUltra-processed foods (UPFs) have become a pressing global health concern, prompting investigations into their potential association with low muscle mass in adults.MethodsThis cross-sectional study analyzed data from 10,255 adults aged 20−59 years who participated in the National Health and Nutritional Examination Survey (NHANES) during cycles spanning from 2011 to 2018. The primary outcome, low muscle mass, was assessed using the Foundation for the National Institutes of Health (FNIH) definition, employing restricted cubic splines and weighted multivariate regression for analysis. Sensitivity analysis incorporated three other prevalent definitions to explore optimal cut points for muscle quality in the context of sarcopenia.ResultsThe weighted prevalence of low muscle mass was 7.65%. Comparing the percentage of UPFs calories intake between individuals with normal and low muscle mass, the values were found to be similar (55.70 vs. 54.62%). Significantly linear associations were observed between UPFs consumption and low muscle mass (P for non-linear = 0.7915, P for total = 0.0117). Upon full adjustment for potential confounding factors, participants with the highest UPFs intake exhibited a 60% increased risk of low muscle mass (OR = 1.60, 95% CI: 1.13 to 2.26, P for trend = 0.003) and a decrease in ALM/BMI (β = −0.0176, 95% CI: −0.0274 to −0.0077, P for trend = 0.003). Sensitivity analysis confirmed the consistency of these associations, except for the International Working Group on Sarcopenia (IWGS) definition, where the observed association between the highest quartiles of UPFs (%Kcal) and low muscle mass did not attain statistical significance (OR = 1.35, 95% CI: 0.97 to 1.87, P for trend = 0.082).ConclusionOur study underscores a significant linear association between higher UPFs consumption and an elevated risk of low muscle mass in adults. These findings emphasize the potential adverse impact of UPFs on muscle health and emphasize the need to address UPFs consumption as a modifiable risk factor in the context of sarcopenia.

At the dawn of of Artificial General Intelligence (AGI), the emergence of large language models such as ChatGPT show promise in revolutionizing healthcare by improving patient care, expanding medical access, and optimizing clinical processes. However, their integration into healthcare systems requires careful consideration of potential risks, such as inaccurate medical advice, patient privacy violations, the creation of falsified documents or images, overreliance on AGI in medical education, and the perpetuation of biases. It is crucial to implement proper oversight and regulation to address these risks, ensuring the safe and effective incorporation of AGI technologies into healthcare systems. By acknowledging and mitigating these challenges, AGI can be harnessed to enhance patient care, medical knowledge, and healthcare processes, ultimately benefiting society as a whole.

Chronic Pseudomonas aeruginosa (PA) infection significantly contributes to morbidity and mortality in bronchiectasis patients. Initiating antibiotics early may lead to the eradication of PA. Here we outline the design of a trial (ERASE; NCT06093191) assessing the efficacy and safety of inhaled tobramycin, alone or with oral ciprofloxacin, in bronchiectasis patients with a new isolation of PA. This multicentre, 2×2 factorial randomised, double-blind, placebo-controlled, parallel-group trial includes a 2-week screening period, a 12-week treatment phase (with a combination of ciprofloxacin or a placebo at initial 2 weeks) and a 24-week follow-up. 364 adults with bronchiectasis and a new PA isolation will be randomly assigned to one of four groups: placebo (inhaled saline and ciprofloxacin placebo twice daily), ciprofloxacin alone (750 mg ciprofloxacin and inhaled saline twice daily), inhaled tobramycin alone (inhaled 300 mg tobramycin and ciprofloxacin placebo twice daily) or a combination of both drugs (inhaled 300 mg tobramycin and 750 mg ciprofloxacin twice daily). The primary objective of this study is to assess the proportion of patients successfully eradicating PA in each group by the end of the study. Efficacy will be evaluated based on the eradication rate of PA at other time points (12, 24 and 36 weeks), the occurrence of exacerbations and hospitalisations, time to first pulmonary exacerbations, patient-reported outcomes, symptom measures, pulmonary function tests and the cost of hospitalisations. To date no randomised trial has evaluated the benefit of different PA eradication strategies in bronchiectasis patients. The ERASE trial will therefore generate crucial data to inform future clinical guidelines.

Abstract Background Circular RNAs (circRNAs) play a significant role in some diseases by acting as transcription templates. Therefore, analyzing the interaction mechanism between circRNA and RNA-binding proteins (RBPs) has far-reaching implications for the prevention and treatment of diseases. Existing models for circRNA-RBP identification usually adopt convolution neural network (CNN), recurrent neural network (RNN), or their variants as feature extractors. Most of them have drawbacks such as poor parallelism, insufficient stability, and inability to capture long-term dependencies. Methods In this paper, we propose a new method completely using the self-attention mechanism to capture deep semantic features of RNA sequences. On this basis, we construct a CircSSNN model for the cirRNA-RBP identification. The proposed model constructs a feature scheme by fusing circRNA sequence representations with statistical distributions, static local contexts, and dynamic global contexts. With a stable and efficient network architecture, the distance between any two positions in a sequence is reduced to a constant, so CircSSNN can quickly capture the long-term dependencies and extract the deep semantic features. Results Experiments on 37 circRNA datasets show that the proposed model has overall advantages in stability, parallelism, and prediction performance. Keeping the network structure and hyperparameters unchanged, we directly apply the CircSSNN to linRNA datasets. The favorable results show that CircSSNN can be transformed simply and efficiently without task-oriented tuning. Conclusions In conclusion, CircSSNN can serve as an appealing circRNA-RBP identification tool with good identification performance, excellent scalability, and wide application scope without the need for task-oriented fine-tuning of parameters, which is expected to reduce the professional threshold required for hyperparameter tuning in bioinformatics analysis.

Obtaining high-quality Pt coatings remains a challenging task. Here, explosive welding was attempted to prepare Pt coatings on a steel plate, and the complex interfacial phenomena of the achieved Pt/Fe joints as well as the governing mechanisms were carefully investigated by multi-scale microstructure analyses and smoothed particles hydrodynamics simulations. The results demonstrated that the self-development explosive welding was a suitable method for preparing Pt coatings, featuring a desirable undulating metallurgical interface. Two types of transition regions, namely the isolated zones and continuous layers, were formed at the wave interface, and their formation mechanisms were revealed. Besides, special attention was given to the frequent formed elliptic void in the isolated transition regions, and its formation mechanism was found to be combined actions of excessive shear instability and rapid cooling process. The multi-area EBSD analyses revealed diverse grain structures near the interface, such as formation of columnar grains in isolated transition region and small equiaxed grains in continuous melting layer. These grain characteristics provide strong supports for the interface formation mechanisms developed in this paper. Thus, this work enables to provide a new perspective for Pt coating preparation and improve the understanding of explosive welding process behavior.

Objective: This study was to evaluate the prognostic value of the Naples prognostic score (NPS) in adult patients with asthma. Methods: Data on 44 601 participants from the 1999–2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. The NPS was calculated based on serum albumin, total cholesterol, neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR), and participants were divided into 3 groups. Self-administered questionnaires were used to collect information on asthma, and mortality was identified using the National Death Index through December 31, 2019. Multiple logistic regressions were used to analyze the relationship between NPS and its components and the prevalence of asthma. Kaplan-Meier survival analysis, Cox proportional regressions, and the random survival forest (RSF) were used to assess the significance of NPS and its components in predicting all-cause and cause-specific (cardiovascular, cancer, and respiratory diseases) mortality in asthma patients. Results: The mean age of the participants was 47.59 ± 0.18 years, and 48.47% were male. The prevalence of asthma was 13.11%. The participants were categorized into 3 groups: 8306 (18.6%) participants were in group 0 (NPS 0), 30 842 (69.2%) were in group 1 (NPS 1 or 2), and 5453 (11.2%) were in group 2 (NPS 3 or 4). Compared to the reference group, participants in group 2 had a higher prevalence of asthma (odds ratio [OR] = 1.40 [1.24–1.56]). Participants with asthma in group 2 had a significantly increased risk of all-cause mortality (hazard ratio [HR] = 2.42 [1.67–3.50]), cardiovascular mortality (HR = 2.68 [1.50–4.79]), cancer mortality (HR = 2.10 [1.00–4.45]), and respiratory disease mortality (HR = 3.00 [1.18–7.65]) compared to those with asthma in group 0. The RSF showed that NPS had the highest value in predicting all-cause mortality in adults with asthma, compared to its components. Conclusions: The results of this study indicate that the NPS is a powerful prognostic indicator for outcomes in asthma patients.

Abstract In this paper, a three‐dimensional simulation model of the engine cylinder is established using commercial simulation software AVL‐Fire, and the accuracy of the model is verified with experimental results. The effects of diesel/biodiesel/n‐butanol blends on diesel engine performance, and combustion and emissions characteristics were investigated by performing simulation operations on the model. The combustion process in the cylinder was simulated for 0%, 5%, 10%, 15%, and 20% of n‐butanol in the fuel mixture. The results showed that at 75% load, the brake thermal efficiency of D95N5, D90N10, D85N15, and D80N20 engines increased by 0.84%, 1.68%, 2.48%, and 3.19%, respectively, and soot emissions decreased by 2.76%, 5.52%, 8.25%, and 10.96%, respectively, compared with D100. However, the brake power of the engine was reduced, the brake ratio fuel consumption increased, and NOx emission increased. In addition, at all loads, soot and CO emissions decrease as the percentage of n‐butanol in the fuel mixture increases.

Abstract The combination of magnetic symmetries and electronic band topology provides a promising route for realizing topologically nontrivial quasiparticles, and the manipulation of magnetic structures may enable the switching between topological phases, with the potential for achieving functional physical properties. Here, we report measurements of the electrical resistivity of EuCd2As2 under pressure, which show an intriguing insulating dome at pressures between p c1 ~ 1.0 GPa and p c2 ~ 2.0 GPa, situated between two regimes with metallic transport. The insulating state can be fully suppressed by a small magnetic field, leading to a colossal negative magnetoresistance on the order of 105%, accessible via a modest field of ~ 0.2 T. First-principles calculations reveal that the dramatic evolution of the resistivity under pressure can be attributed to consecutive transitions of EuCd2As2 from a magnetic topological insulator to a trivial insulator, and then to a Weyl semimetal, with the latter resulting from a pressure-induced change in the magnetic ground state. Similarly, the colossal magnetoresistance results from a field-induced polarization of the magnetic moments, transforming EuCd2As2 from a trivial insulator to a Weyl semimetal. These findings underscore weak exchange couplings and weak magnetic anisotropy as ingredients for discovering tunable magnetic topological materials with desirable functionalities.

We perform systematic first-principles calculations on the electronic structure of n -type magnetic semiconductor Ba(Zn $_{1-x}$ Co _x ) _2 As _2 with the facilitation of HSE06 hybrid functional. Supercells are used to consider the doping of Co atoms, and the first-principles band structures are unfolded for clarity. Based on the calculation results, magnetic states are preferred by individual Co atoms doped in Ba(Zn $_{1-x}$ Co _x ) _2 As _2 at diluted limit, and carriers are originated mainly from situations where only one Co atom exists in the nearest neighbor Zn sites out of certain doped Co atoms. The origination of carriers can be explained by the density of states and the unfolded band structure, where it is found that the scattering effects from single Co atom is small but quite large when more Co atoms are located at adjacent Zn sites. The large scattering effects of two adjacent Co atoms will alter the band structures near the Fermi-level. Carriers in Ba(Zn $_{1-x}$ Co _x ) _2 As _2 mainly originate from the As-4p orbitals, with partial contributions from the Co-3d orbitals. Our work provides new insights into the origin of the n -type carriers in magnetic semiconductors and will inspire the development of new magnetic semiconducting systems.

Abstract Background Considering the considerable prevalence of allergic disease in the general population, an urgent need exists for inactivated SARS-CoV-2 vaccines that can be safely administered to those subjects. Methods This retrospective cohort study including 1926 participants who received inactivated SARS-CoV-2 vaccines, compared their local and systemic reactions in 7 days after each dose of inactivated SARS-CoV-2 vaccine, and anti–SARS-CoV-2 IgG after vaccination in all participants. Results Pain at the injection site within seven days after the first injection was the most commonly reported local reaction, occurring in 31.0% of the patients with allergic disease and 18.9% in the control group, respectively (P

Abstract The electronic property and magnetic susceptibility of Ce3Pd3Bi4 were systemically investigated from 18 to 290 K for varying values of cell volume using dynamic mean-field theory coupled with density functional theory. By extrapolating to zero temperature, the ground state of Ce3Pd3Bi4 at ambient pressure is found to be a correlated semimetal due to insufficient hybridization. Upon applying pressure, the hybridization strength increases and a crossover to the Kondo insulator is observed at finite temperatures. The characteristic temperature signaling the formation of Kondo singlet, as well as the characteristic temperature associated with f-electron delocalization–localization change, simultaneously vanishes around a critical volume of 0.992 V 0, suggesting that such metal–insulator transition is possibly associated with a quantum critical point. Finally, Wilson’s loop calculations indicate that the Kondo insulating side is topologically trivial, thus a topological transition also occurs across the quantum critical point.

This study aimed to identify clinical characteristics of cancer patients with incidental pulmonary embolism (IPE) and assess the variables associated with 30-day mortality in cancer patients with PE including symptomatic pulmonary embolism (SPE) and IPE. 6-Month mortality rate in cancer patients with SPE and IPE were also compared. We retrospectively analyzed electronic medical records of cancer patients with newly diagnosed PE between January 2016 and June 2021. We compared clinical and radiological characteristics in cancer patients with IPE and SPE and identified variables associated with the overall 30-day mortality on multivariate analysis. All patients were followed up for 6 months and survival analysis was performed by use of Kaplan–Meier. Five hundred and nine eligible cancer patients with pulmonary embolism were identified during the study period. IPE is associated with lower BMI, colorectal and pancreas cancers, stage III/IV of cancer, recent antiangiogenic therapy, central venous catheter (CVC) and chronic cardiac or respiratory disease compared to SPE. The factors associated with 30-day mortality included poor performance status, lung/pleura or upper gastrointestinal cancers, stage III/IV of cancer, previous VTE, oxygen saturation < 95%, lactic acid > 2 mmol/l and bilateral PE. The overall survival in patients with IPE at 6-month follow-up was similar to those diagnosed with SPE. The present study has allowed the identification of factors associated with 30-day mortality in cancer patients with IPE and SPE. We also found similar mortality rate in cancer patients with IPE compared with patients with SPE at 6-month follow-up.

We introduce an efficient training framework for constructing machine learning-based emulators and demonstrate its capability by training an artificial neural network to predict the time evolution of quantum wave packets propagating through a potential landscape. This approach is based on the idea of knowledge distillation and uses elements of curriculum learning. It works by constructing a set of simple, but rich-in-physics training examples (a curriculum). These examples are used by the emulator to learn the general rules describing the time evolution of a quantum system (knowledge distillation). We show that this emulator is capable of learning the rules of quantum dynamics from a curriculum of simple training examples (wave packet interacting with a single rectangular potential barrier), and subsequently generalizes this knowledge to solve more challenging cases (propagation through an arbitrarily complex potential landscape). Furthermore, we demonstrate, that using this framework we can not only make high-fidelity predictions, but we can also learn new facts about the underlying physical system, detect symmetries, and measure relative importance of the contributing physical processes.

Objective To investigate the risk factors of pulmonary embolism in patients with lung cancer and develop and validate a novel nomogram scoring system-based prediction model. Method We retrospectively analyzed the clinical data and laboratory characteristics of 900 patients with lung cancer who were treated, including patients with lung cancer without pulmonary embolism (LC) and patients with lung cancer with pulmonary embolism (LC + PE). The patients were randomly divided into derivation and internal validation groups in a 7:3 ratio. Using logistic regression analysis, a diagnostic model of the nomogram scoring system was developed by incorporating selected variables in the derivation group and validated in the internal and external validation groups (n = 108). Result Seven variables (adenocarcinoma, stage III-IV LC, indwelling central venous catheter, chemotherapy, and the levels of serum albumin, hemoglobin, and D-dimer) were identified as valuable parameters for developing the novel nomogram diagnostic model for differentiating patients with LC and LC + PE. The scoring system demonstrated good diagnostic performance in the derivation (area under the curve [AUC]; 95% confidence interval [CI], 0.918; 0.893, 0.943; sensitivity, 88.5%; specificity, 80.5%), internal validation (AUC; 95% CI, 0.921; 0.884, 0.958; sensitivity, 90.5%; specificity, 80.4%), and external validation (AUC; 95% CI, 0.929; 0.875, 0.983; sensitivity; 85.0%; specificity; 87.5%) groups. Conclusion In this study, we constructed and validated a nomogram scoring system based on 7 clinical parameters. The scoring system exhibits good accuracy and discrimination between patients with LC and LC + PE and can effectively predict the risk of PE in patients with LC.

Coastal erosion vulnerability assessment is widely used to assess the loss degree of coastal zone caused by erosion, and plays an important role in coastal natural resources protection, planning, management and decision-making. Based on the natural and social characteristics of the east coast of Qiongdong and the coastal erosion vulnerability index (CVI) method, this study selected 8 assessment indicators, such as shoreline change rate (U1). The Delphi method and the entropy weight method were used to calculate the comprehensive index weight, combined with CVI method and geographic information system (GIS) technology, to quantitatively evaluate the temporal and spatial distribution characteristics of typical coastal erosion vulnerability such as coral reefs in the east of Hainan Island. The study area was divided into 5 grades: very low (31%), low (10%), moderate (28%), high (24%) and high vulnerability (7%), and the overall performance was moderate erosion vulnerability. The research showed that the interannual downward rate erosion of beach (U3) and the rate of change of the isobath (U2) of the beach were the main controlling factors affecting the vulnerability of coastal erosion in the study area, and the coastal dynamic factor had a greater impact than the other two factors. As a natural barrier, the coral reefs in the study area had good wave absorption and energy reduction, and the coral reef coasts showed low coastal erosion vulnerability, due to the complex hydrodynamic characteristics, estuary coasts is the most vulnerable areas. The verification results of the ROC-AUC method showed that the accuracy of erosion vulnerability was 68.9%, which provided an important reference for the ecological restoration of tropical coral reef biological coasts and the development and management of the Hainan Qiongdong coastal zone.

Background: Sleep affects health. Sleep habits differ between population subgroups and may also differ between weekdays and weekends; however, these patterns are rarely described at the population level. Purpose: To investigate age and racial/ethnic differences in sleep duration and timing between weekdays (workdays) and weekends (non-workdays). Methods: A cross-sectional analysis of the US nationally representative data from the National Health and Nutrition Examination Survey among adolescents (16-19 years) and adults (≥20 years). Results: Data on 10069 individuals were analyzed (51% female), including 959 adolescents and 9110 adults. The hours per night of sleep were shorter during weekdays (7.6, 95%CI: 7.6 to 7.7) than on weekends (8.3, 95% CI: 8.3 to 8.2). Females slept shorter hours than males on weekdays (7.7 [95%CI, 7.7 to 7.8] vs. 7.5 [95%CI, 7.4 to 7.5]) and on weekends (8.5, [95%CI, 8.4 to 8.5] vs. 8.2 [95% CI, 8.1 to 8.2]). Non-Hispanic blacks (7.4, 95% CI: 7.4 to 7.5) reported the shortest weekdays sleep. With respect to sleep timing, comparing to weekdays, males reported 30-min delayed weekends bedtime (23:30 [IQR, 22:30-00:30] vs. 23:00 [IQR, 22:00-00:00]), whereas both sexes reported 1.5-hour delayed weekends wake-up time (male: 07:30 [IQR, 06:30-09:00] vs. 06:00 [IQR, 05:30-07:30]; female: 08:00 [IQR, 06:30-09:00] vs. 06:30 [IQR, 05:30-07:30]). The delayed weekend bedtime and wake-up times were observed in all racial/ethnic groups. Conclusions: In the US population, sleep habits differed between weekdays and weekends. Shorter sleep hours and delayed sleep timing were noted and more apparent among racial/ethnic minorities of both sexes.

Abstract To manage acute, long‐term, and late effects of cancer, current guidelines recommend moderate‐to‐vigorous intensity aerobic and resistance exercise. Unfortunately, not all cancer survivors are able or willing to perform higher intensity exercise during difficult cancer treatments or because of other existing health conditions. Tai Chi is an equipment‐free, multicomponent mind–body exercise performed at light‐to‐moderate intensity that may provide a more feasible alternative to traditional exercise programs for some cancer survivors. This systematic review evaluated the therapeutic efficacy of Tai Chi across the cancer care continuum. We searched MEDLINE/PubMed, Embase, SCOPUS, and CINAHL databases for interventional studies from inception to 18 September 2020. Controlled trials of the effects of Tai Chi training on patient‐reported and objectively measured outcomes in cancer survivors were included. Study quality was determined by the RoB 2 tool, and effect estimates were evaluated using the Best Evidence Synthesis approach. Twenty‐six reports from 14 trials (one non‐randomized controlled trial) conducted during (n = 5) and after treatment (after surgery: n = 2; after other treatments: n = 7) were included. Low‐level evidence emerged to support the benefits of 40–60 min of thrice‐weekly supervised Tai Chi for 8–12 weeks to improve fatigue and sleep quality in cancer survivors. These findings need to be confirmed in larger trials and tested for scaling‐up potential. Insufficient evidence was available to evaluate the effects of Tai Chi on other cancer‐related outcomes. Future research should examine whether Tai Chi training can improve a broader range of cancer outcomes including during the pre‐treatment and end of life phases.

DesignThere is a strong correlation between dietary intake and allergic diseases. Ultra-processed foods (UPFs) are gradually becoming dominant worldwide and causing health problems for children and adults. We hope to determine whether links exist between UPFs and allergic symptoms.MethodsWe investigated data from 2,736 children (16–19 years) and 4,256 adults (≥20 years) from the National Health and Nutritional Examination Survey (NHANES) 2005–2006. The associations between the mean UPFs contribution to total energy intake and all allergic symptoms (IgE, current asthma, allergy, rash, sneeze, wheeze, eczema, and hay fever) were estimated by weighted multivariate logistic regression.ResultsLogistic regression analysis showed UFPs were negatively associated with IgE levels in children. Those with higher quartiles had a reduced risk from 16% (OR, 0.84, 95%CI, 0.55 to 1.28) to 34% (OR, 0.66, 95%CI, 0.49 to 0.89), p for trend = 0.006. UPFs were also positively related to current asthma in children with an increased risk of 11% (OR, 1.11, 95%CI, 0.79 to 1.56) to 76% (OR, 1.76, 95%CI, 1.10 to 2.82), p for trend = 0.0393. UPFs were also associated with eczema in girls. But there was no association observed between UPFs and allergic symptoms in adults.ConclusionOur results suggested that UPFs assessed by the NOVA system were associated with IgE, current asthma in children, and eczema in girls. These results further support the need to test the association of modern dietary patterns with allergic symptoms.

Objective To explore the diagnostic value of liquid-based cytology (LBC) of bronchoalveolar lavage fluid (BALF) combined with bronchial brushing (BB). Methods One hundred patients with pulmonary masses or nodules found by chest computed tomography (CT) or X-ray before bronchoscopy or other diagnostic biopsy examinations were selected consecutively for this retrospective study. BALF and BB were performed for all patients. After conventional smear via BB, we mixed the BALF and BB samples in a prepared thin-layer bottle. Results The sensitivity of LBC of BALF combined with BB was noticeably higher than that of BB alone in the total sample group (65.15% vs. 32.84%, respectively). Similarly, in both the bronchoscopically visible group and invisible group, a higher sensitivity for LBC of BALF with BB vs BB alone (68.89% vs. 39.13%, respectively; 57.14% vs. 19.05%, respectively) was observed. Additionally, the negative predictive value of LBC of BALF with BB was higher than that with BB alone (58.56% vs. 42.31%; 61.29% vs. 44.73%; 53.47% vs. 37.83%; total sample vs visible vs invisible groups, respectively). Conclusion Regardless of whether lesions or nodules are bronchoscopically visible or invisible, LBC of BALF combined with BB may increase the diagnostic value over BB alone in lung cancer diagnosis.

Abstract Background This study was performed to investigate clinical features of patients with severe SARS-CoV-2 pneumonia and identify risk factors for converting to severe cases in those who had mild to moderate diseases at the start of the pandemic in China. Methods In this retrospective, multicenter cohort study, patients with mild to moderate SARS-CoV-2 pneumonia were included. Demographic data, symptoms, laboratory values, and clinical outcomes were collected. Data were compared between non-severe and severe patients. Results 58 patients were included in the final analysis. Compared with non-severe cases, severe patients with SARS-CoV-2 pneumonia had a longer: time to clinical recovery (12·9 ± 4·4 vs 8·3 ± 4·7; P = 0·0011), duration of viral shedding (15·7 ± 6·7 vs 11·8 ± 5·0; P = 0·0183), and hospital stay (20·7 ± 1·2 vs 14·4 ± 4·3; P = 0·0211). Multivariate logistic regression indicated that lymphocyte count was significantly associated with the rate of converting to severe cases (odds ratio 1·28, 95%CI 1·06–1·54, per 0·1 × 109/L reduced; P = 0·007), while using of low-to-moderate doses of systematic corticosteroids was associated with reduced likelihood of converting to a severe case (odds ratio 0·14, 95%CI 0·02–0·80; P = 0·0275). Conclusions The low peripheral blood lymphocyte count was an independent risk factor for SARS-CoV-2 pneumonia patients converting to severe cases. However, this study was carried out right after the start of the pandemic with small sample size. Further prospective studies are warranted to confirm these findings. Trial registration Chinese Clinical Trial Registry, ChiCTR2000029839 . Registered 15 February 2020 - Retrospectively registered.

The mechanism of the delocalization transition of 4f electrons in closely-packed Ce metal has been debated. Here, the authors present photoemission evidence for bandwidth-controlled Mott delocalization in a previously unreported structural phase of thin epitaxial Ce films obtained by thermal annealing.

Phosgene (COCl2) gas is a chemical intermediate of high-volume production with numerous industrial applications worldwide. Due to its high toxicity, accidental exposure to phosgene leads to various chemical injuries, primarily resulting in chemical-induced lung injury due to inhalation. Initially, the illness is mild and presents as coughing, chest tightness, and wheezing; however, within a few hours, symptoms progress to chronic respiratory depression, refractory pulmonary edema, dyspnea, and hypoxemia, which may contribute to acute respiratory distress syndrome or even death in severe cases. Despite rapid advances in medicine, effective treatments for phosgene-inhaled poisoning are lacking. Elucidating the pathophysiology and pathogenesis of acute inhalation toxicity caused by phosgene is necessary for the development of appropriate therapeutics. In this review, we discuss extant literature on relevant mechanisms and therapeutic strategies to highlight novel ideas for the treatment of phosgene-induced acute lung injury.

Owing to the specific topological states in nodal-line semimetals, novel topological superconductivity is expected to emerge in these systems. In this Letter, we demonstrate that La_{3}Pt_{3}Bi_{4} is a topologically nontrivial nodal-ring semimetal protected by the gliding-mirror symmetry using first-principles calculations. Meanwhile, we discover bulk superconductivity with a transition temperature of ∼1.1 K and an upper critical field of ∼0.41 T by means of resistivity, susceptibility, and specific heat measurements. These findings demonstrate that La_{3}Pt_{3}Bi_{4} provides a material platform for studying novel superconductivity in the nodal-ring system.

Introduction The study aimed to establish and internally validate a nomogram to predict successful smoking cessation in a Chinese outpatient population. Methods A total of 278 participants were included, and data were collected from March 2016 to December 2018. Predictors for successful smoking cessation were evaluated by 3-month sustained abstinence rates. Least absolute shrinkage and selection operator (LASSO) regression was used to select variables for the model to predict successful smoking cessation, and multivariable logistic regression analysis was performed to establish a novel predictive model. The discriminatory ability, calibration, and clinical usefulness of the nomogram were determined by the concordance index (C-index), calibration plot, and decision curve analysis, respectively. Internal validation with bootstrapping was performed. Results The nomogram included living with a smoker or experiencing workplace smoking, number of outpatient department visits, reason for quitting tobacco, and varenicline use. The nomogram demonstrated valuable predictive performance, with a C-index of 0.816 and good calibration. A high C-index of 0.804 was reached with interval validation. Decision curve analysis revealed that the nomogram for predicting successful smoking cessation was clinically significant when intervention was conducted at a successful cessation of smoking possibility threshold of 19%. Conclusions This novel nomogram for successful smoking cessation can be conveniently used to predict successful cessation of smoking in outpatients.

Perturbation of the microbiome has numerous associations with the phenotypes and progression in chronic airways disease. However, the differences in the nasal microbiome in asthma and allergic rhinitis (AR) have not been defined. We examined whether the nasal microbiome would vary among different comorbidities in asthma and AR and that those differences may be associated with the severity of asthma. Nasal lavage fluid was collected from 110 participants, including 20 healthy controls, 30 subjects with AR, 30 subjects with asthma and 30 subjects with combined asthma + AR. The Asthma Control Questionnaire (ACQ-7) was used to evaluate asthma control status. Using 16S rRNA bacterial gene sequencing, we analyzed nasal microbiome in patients with asthma, AR, combined asthma + AR, and healthy controls. Bacterial diversity was analyzed in corresponding with α diversity indices (Chao and Shannon index). Compared with healthy controls, the Chao index tended to be lower in subjects with AR (P = 0.001), asthma (P = 0.001), and combined asthma + AR (P = 0.001) when compared with healthy controls. Furthermore, the Shannon index was significantly lower in subjects with asthma (P = 0.013) and comorbid asthma with AR (P = 0.004) than the control subjects. Disparity in the structure and composition of nasal bacteria were also observed among the four groups. Furthermore, patients with combined asthma + AR and isolated asthma were divided into two groups according to the level of disease control: partially or well-controlled and uncontrolled asthma. The mean relative abundance observed in the groups mentioned the genera of Pseudoflavonifractor were dominated in patients with well and partially controlled disease, in both isolated asthma and combined asthma + AR. In subjects with uncontrolled asthma and combined asthma + AR, a lower evenness and richness (Shannon index, P = 0.040) was observed in nasal microbiome composition. Importantly, lower evenness and richness in the nasal microbiome may be associated with poor disease control in combined asthma + AR. This study showed the upper airway microbiome is associated with airway inflammation disorders and the level of asthma control.

BackgroundThe comprehensive impacts of diverse breathing air volumes and preexisting immunity on the host susceptibility to and transmission of COVID-19 at various pandemic stages have not been investigated.MethodsWe classified the US weekly COVID-19 data into 0–4, 5–11, 12–17, 18–64, and 65+ age groups and applied the odds ratio (OR) of incidence between one age group and the 18–64 age group to delineate the transmissibility change.ResultsThe changes of incidence ORs between May, 2020 and November, 2021 were 0.22–0.66 (0–4 years), 0.20–1.34 (5–11 years), 0.39–1.04 (12–17 years), and 0.82–0.73 (65+ years). The changes could be explained by age-specific preexisting immunity including previous infection and vaccination, as well as volumes of breathing air. At the early pandemic, the ratio that 0–4-year children exhaled one-fifth of air and discharge a similar ratio of viruses was closely associated with incidence OR between two age groups. While, after a rollout of pandemic and vaccination, the much less increased preexisting immunity in children resulted in rapidly increased OR of incidence. The ARIMA model predicted the largest increase of relative transmissibility in 6 coming months in 5–11-year children.ConclusionsThe volume of breathing air may be a notable factor contributing to the infectivity of COVID-19 among different age groups of patients. This factor and the varied preexisting greatly shape the transmission of COVID-19 at different periods of pandemic among different age groups of people.

Under the dual effects of global climate change and intensive human development activities, vulnerability to coastal erosion in bay areas is becoming increasingly serious. This study focuses on 15 counties and districts along the coast of the Pearl River Estuary (PRE) Great Bay Area and selects 12 evaluation indices from five perspectives for analysis, including coastal characteristics, hydrodynamic forces, economics, population and coastal reconstruction. The analytic hierarchy process (AHP) method, Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) method, independent weight method, Jenks natural breaks method (Jenks), exposure-sensitivity-adaptation (ESA) model and obstacle degree method are used in conjunction with the above indices to construct a coastal erosion vulnerability evaluation system for the PRE. The results show that coastal erosion vulnerability in the PRE is low in the eastern hilly area and high in the central and western delta areas. Coastal characteristics, coastal lowlands and protection capability are the main controlling elements of erosion. The PRE experienced an era of rapid economic development from 1980 to 2010, and coastal erosion vulnerability gradually increased, with a cost of ecological environment destruction. Then, an era of coastal zone ecological restoration supported by policy protection occurred from 2010 to 2020. Compared with three major bay areas with similar developed economies worldwide, the PRE is characterized by comparatively late but rapid economic development. Notably, the development and utilization efficiency of coastal zones is very high, the duration of damage to the ecological environment is short, and the effects of ecological repair and restoration are obvious. The results of this study provide a reference for economic development and ecological restoration in the bay areas of China and provide scientific guidance for coastal zone development, management and planning.