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BackgroundBiomarkers can be used to assess the severity of spinal muscular atrophy (5q SMA; SMA). Despite their potential, the relationship between biomarkers and clinical outcomes in SMA remains underexplored. This study aimed to assess the association among biomarkers, phenotypes, and motor milestones in Chinese patients diagnosed with SMA.MethodsWe collected retrospective clinical and follow-up data of disease-modifying therapy (DMT)-naïve patients with SMA at our center from 2019 to 2021. Four biomarkers were included: survival motor neuron 2 (SMN2) copies, neuronal apoptosis inhibitory protein (NAIP) copies, full-length SMN2 (fl-SMN2), and F-actin bundling protein plastin 3 (PLS3) transcript levels. Data were analyzed and stratified according to SMA subtype.ResultsOf the 123 patients, 30 were diagnosed with Type 1 (24.3%), 56 with Type 2 (45.5%), and 37 with Type 3 (30.1%). The mortality rate for Type 1 was 50%, with median survival times of 2 and 8 months for types 1a and 1b, respectively. All four biomarkers were correlated with disease severity. Notably, fl-SMN2 transcript levels increased with SMN2 copies and were higher in Type 2b than those in Type 2a (p = 0.028). Motor milestone deterioration was correlated with SMN2 copies, NAIP copies, and fl-SMN2 levels, while PLS3 levels were correlated with standing and walking function.DiscussionOur findings suggest that SMN2 copies contribute to survival and that fl-SMN2 may serve as a valuable biomarker for phenotypic variability in SMA Type 2 subtypes. These insights can guide future research and clinical management of SMA.

ObjectiveThe aim of this study is to assess the effectiveness of foot skin protection technology in elderly patients with diabetic peripheral neuropathy.MethodsThe foot skin protection technology was developed based on a comprehensive literature review and preliminary research conducted by our research team. Subsequently, 88 elderly patients with diabetic peripheral neuropathy and experiencing foot skin problems were recruited from two community health service centers in Shanghai. Using a random number table, the participants were randomly assigned to either the control group or the experimental group. Patients in the experimental group received foot skin protection technology interventions, while those in the control group received standard community nursing guidance for a duration of 3 months. The incidence, severity, and discomfort associated with foot skin problems were evaluated before and after the intervention period in both groups.ResultsThe incidence, severity, and discomfort of foot skin problems notably reduced in the experimental group (all P< 0.05).ConclusionThe foot skin protection technology demonstrates significant potential in enhancing foot skin condition.

Sugar was transported from photosynthetic source cells to sink cells, sugar efflux transporter protein (sugars will eventually be exported to transporters, SWEETs) play an important role in the process. Although SWEET family members had been identified in many plants, transcriptome or genomics analysis of Actinidia polygama SWEET genes remains uncharacterized. In this study, 14 SWEET genes of Actinidia polygama were identified by protein Blast. The structural characteristics of SWEET genes showed that the number of amino acids encoded by the gene family was between 233 and 304, the relative molecular weight was between 25,918.83 and 33,192.12, the isoelectric point was within the range of 6.96 to 9.71, 14 ApSWEET from Actinidia polygama and the known grape and Arabidopsis SWEETs were divided into four clades (I, II, III, and IV) according to the phylogenetic relationships. The gene structure analysis showed that most of ApSWEET genes have six exons and five introns except ApSWEET5 and ApSWEET14. All ApSWEET proteins also contained P-loop, MtN3-slv, and transmembrane domain. Expression patterns of 14 ApSWEET in different organs and at different fruit developmental stages were analyzed. ApSWEET1 and ApSWEET5 exhibited tissue-specific expression, whereas other genes were more ubiquitously expressed. ApSWEET1, ApSWEET10, and ApSWEET11 exhibited higher expression in fruit. The results of this study provide insights into the characteristics of the SWEET genes in Actinidia polygama and may serve as a basis for further functional studies of such genes.

Abstract Iron is an extraordinary promoter to impose nickel/cobalt (hydr)oxides as the most active oxygen evolution reaction catalysts, whereas the synergistic effect is actively debated. Here, we unveil that active oxygen species mediate a strong electrochemical interaction between iron oxides (FeOxHy) and the supporting metal oxyhydroxides. Our survey on the electrochemical behavior of nine supporting metal oxyhydroxides (M(O)OH) uncovers that FeOxHy synergistically promotes substrates that can produce active oxygen species exclusively. Tafel slopes correlate with the presence and kind of oxygen species. Moreover, the oxygen evolution reaction onset potentials of FeOxHy@M(O)OH coincide with the emerging potentials of active oxygen species, whereas large potential gaps are present for intact M(O)OH. Chemical probe experiments suggest that active oxygen species could act as proton acceptors and/or mediators for proton transfer and/or diffusion in cooperative catalysis. This discovery offers a new insight to understand the synergistic catalysis of Fe-based oxygen evolution reaction electrocatalysts.

Long-term intensive tillage has led to soil environment degradation, reduced fertility, difficulty in increasing maize yield, and low nitrogen (N) use efficiency in the Mollisol region of northeast China. In order to raise maize yield and improve the soil hydrothermal environment, we conducted field experiments to investigate the effects of different tillage practices and straw returning on the soil hydrothermal environment, maize yield, N fertilizer recovery and loss, aiming to increase both the maize yield and N fertilizer recovery rate. Four treatments were established: flat no-tillage with full straw mulching (NM), ridge no-tillage with full straw mulching (RM), rotary tillage with full straw incorporation (RR), and conventional tillage without straw (CK) as the control treatment. The two-year results indicate that both tillage practices and straw returning increased maize yield and the 15N fertilizer recovery rate, accompanied by improvements in the soil water content (SWC) and regulation of soil temperature changes, as compared to the CK treatment. Specifically, the total 15N fertilizer recovery rate of RM was significantly increased by 15.23% and 23.46%, while the 15N fertilizer losses were notably reduced by 14.99% and 25.12%, respectively, compared to the NM and RR treatments. Additionally, the maize yield of RM was significantly increased by 3.10% in 2021 and 1.97% in 2022 compared to RR (P < 0.05), and it increased by 2.06% in 2021 and 0.91% in 2022 compared to NM (P > 0.05). The mean SWC of the 0–100-cm soil layer in RM significantly increased by 7.99% and 5.74% in 2021 and by 8.09%, and 5.50% in 2022 compared to NM and RR treatments during the maize growth seasons. At 60–80 days after sowing (DAS), when the air temperature was higher, the mean soil temperature of RM was significantly lower than that of the NM and RR treatments, by 0.46 ℃ and 0.54 ℃ in 2021 and by 0.31 ℃ and 0.70 ℃ in 2022. However, as the air temperature decreased at 100–140 DAS, the mean soil temperature in RM was significantly increased by 0.69 ℃ and 0.81 ℃ in 2021 and by 0.73 ℃ and 0.94 ℃ in 2022 compared to the NM and RR treatments. Our study indicates that RM treatment is the most suitable tillage practice and straw returning method in the Mollisol region of northeast China.

Accurate genetic diagnosis is necessary for guiding the treatment of spinal muscular atrophy (SMA). An updated consensus for the diagnosis and management of SMA was published in 2018. However, clinicians should remain alert to some pitfalls of genetic testing that can occur when following a routine diagnosis. In this study, we report the diagnosis of three unrelated individuals who were initially misdiagnosed as carrying a homozygous deletion of SMN1 exon 7. MLPA (P060 and P021) and qPCR were used to detect the copy number of SMN. SMN1 variants were identified by SMN1 clone and next-generation sequencing (NGS). Transcription of SMN1 variants was detected using qRT-PCR and ex vivo splicing analysis. Among the three individuals, one was identified as a patient with SMA carrying a heterozygous deletion and a pathogenic variant (c.835-17_835-14delCTTT) of SMN1, one was a healthy carrier only carrying a heterozygous deletion of SMN1 exon 7, and the third was a patient with nemaline myopathy 2 carrying a heterozygous deletion of SMN1 exon 7. The misdiagnosis of these individuals was attributed to the presence of the c.835-17_835-14delCTTT or c.835-17C > G variants in SMN1 intron 6, which affect the amplification of SMN1 exon 7 during MLPA-P060 and qPCR testing. However, MLPA-P021 and NGS analyses were unaffected by these variants. These results support that additional detection methods should be employed in cases where the SMN1 copy number is ambiguous to minimize the misdiagnosis of SMA.

The explosion dynamics process is complex and difficult to carry out accurate analytical analysis. Numerical simulation with controllable boundary conditions and initial conditions can continuously and repeatedly display the explosion development process over time. In this paper, we take a single-layer reinforced concrete slab contact explosion as an example and use Lagrange method, Arbitrary Lagrangian–Eulerian (ALE) method, and smoothed particle hydrodynamics (SPH) method in LS-DYNA software to simulate the explosion of explosives. The results show that Lagrange method can display a clear material interface, but the explosives elements in the simulation of explosion process could cause serious distortion easily leading to the termination of the calculation; the explosives and air in the ALE method are Eulerian materials, there is no element distortion, but the number of the explosives and air elements that need to be established is relatively large; SPH algorithm can simulate the large deformations caused by explosion, making it more realistic in simulating the splashing of explosive materials. In the comparison of three algorithms, the ALE algorithm matches the experimental results the best.

Objectives: To investigate the challenges of patients with spinal muscular atrophy (SMA) during the Omicron variant COVID-19 pandemic. Design: A cross-sectional survey was conducted in China from January 02, 2023, to January 12, 2023, using a questionnaire that covered three aspects: (1) Demographic information; (2) SMA-related information; and (3) COVID-19-related information. We recruited patients with SMA from 33 provinces. The prevalence, course, and clinical manifestations of COVID-19 were calculated. The relationships between independent and outcome variables were investigated. Results: In total, 677 patients (male: 349; female: 328) were included in this study (average age = 11.40 years); 534 (78.88%) suffered from COVID-19. The most common symptoms were fever (95.51%), cough (57.87%), and sputum (49.44%). Of the infected patients, 91.57% recovered with at-home care, and 8.43% were hospitalized; 1.31% were admitted to the intensive care unit (ICU). A positive correlation was observed between the SMA severity and hospitalization rate. The ICU stay rate in patients with SMA type I was significantly higher than that in other SMA types. Conclusion: This is the first large sample survey to timely reveal the living situation of patients with SMA during the COVID-19 pandemic's Omicron variant. Patients with SMA type I should be paid more attention in terms of hospitalization and ICU stay.

Abstract Accumulating evidence indicates that patients treated with rosuvastatin have an increased risk of developing new‐onset diabetes. However, the underlying mechanism remains unclear. In this study, we administered rosuvastatin (10 mg/kg body weight) to male C57BL/6J mice for 12 weeks and found that oral rosuvastatin dramatically reduced intraperitoneal glucose tolerance. Rosuvastatin‐treated mice showed considerably higher serum levels of branched‐chain amino acids (BCAAs) than control mice. They also showed dramatically altered expression of BCAA catabolism‐related enzymes in white adipose tissue and skeletal muscle, including downregulated mRNA expression of BCAT2 and protein phosphatase 2Cm (PP2Cm) and upregulated mRNA expression of branched‐chain ketoacid dehydrogenase kinase (BCKDK). The levels of BCKD in the skeletal muscle were reduced in rosuvastatin‐treated mice, which was associated with lower PP2Cm protein levels and increased BCKDK levels. We also investigated the effects of rosuvastatin and insulin administration on glucose metabolism and BCAA catabolism in C2C12 myoblasts. We observed that incubation with insulin enhanced glucose uptake and facilitated BCAA catabolism in C2C12 cells, which was accompanied by elevated Akt and glycogen synthase kinase 3 β (GSK3β) phosphorylation. These effects of insulin were prevented by co‐incubation of the cells with 25 μM rosuvastatin. Moreover, the effects of insulin and rosuvastatin administration on glucose uptake and Akt and GSK3β signaling in C2C12 cells were abolished when PP2Cm was knocked down. Although the relevance of these data, obtained with high doses of rosuvastatin in mice, to therapeutic doses in humans remains to be elucidated, this study highlights a potential mechanism for the diabetogenic effects of rosuvastatin, and suggests that BCAA catabolism could be a pharmacological target for preventing the adverse effects of rosuvastatin.

Background: Conventional regimens for refractory idiopathic membranous nephropathy (IMN) still have limitations. Rituximab (RTX) has a good effect in the treatment of refractory IMN. However, whether RTX single or combined with immunosuppressive therapy is more effective and whether adverse events will increase are still inconclusive. Aims: To investigate the efficacy and safety of RTX combined with low-dose tacrolimus (TAC) versus RTX alone in the treatment of refractory IMN. Study Design: A retrospective cohort study. Methods: We retrospectively studied 91 cases of refractory IMN diagnosed between January 2018 and June 2021, all of which immunosuppressive regimens had failed. Thirty-four patients received RTX combined with TAC (RTX + TAC group), and 57 patients were treated with RTX alone (RTX group). The RTX + TAC group was given RTX 1 g once every 2 weeks, two times, and TAC 0.03 mg/kg/day orally. In the RTX group, RTX was given at the same dosage as the RTX + TAC group. Clinical data were collected at 12 months of follow-up to compare the complete and partial remission rates and the incidence of adverse reactions between the two groups. Results: The overall effectiveness rate of RTX + TAC in the treatment of refractory IMN was 87.14%, of which the partial and complete remission rates were 50.01% and 37.13%, respectively, and the median time to complete remission was 9 (interquartile range [IQR] 6.0, 12.0) months. The overall effectiveness rate of RTX was 65.87%, of which the partial and complete remission rates were 39.48% and 26.39%, respectively, and the median time to complete remission was 10.5 (IQR 6.0, 12.0) months. Adverse events occurred in 6 (17.65%) patients in the RTX + TAC group and in 11 (19.30%) in the RTX group (P = 0.473). Proteinuria and high titer of PLA2R are risk factors for non-remission. Conclusion: The complete and partial remission rates of RTX combined with low-dose TAC in the treatment of refractory IMN are higher than those of RTX alone, and no significant increase in adverse events was noted.

Taste sensors with an allostery approach have been studied to detect non-charged bitter substances, such as xanthine derivatives, used in foods (e.g., caffeine) or pharmaceuticals (e.g., etofylline). In this study, the authors modified a taste sensor with 3-bromo-2,6-dihydroxybenzoic acid and used it in conjunction with sensory tests to assess the bitterness of non-charged pharmaceuticals with xanthine scaffolds (i.e., acefylline and doxofylline), as well as allopurinol, an analogue of hypoxanthine. The results show that the sensor was able to differentiate between different levels of sample bitterness. For instance, when assessing a 30 mM sample solution, the sensor response to acefylline was 34.24 mV, which corresponded to the highest level of bitterness (τ = 3.50), while the response to allopurinol was lowest at 2.72 mV, corresponding to relatively weaker bitterness (τ = 0.50). Additionally, this study extended the application of the sensor to detect pentoxifylline, an active pharmaceutical ingredient in pediatric medicines. These results underscore the taste sensor’s value as an additional tool for early-stage assessment and prediction of bitterness in non-charged pharmaceuticals.

Objective To evaluate the application value of dual-energy computed tomography (DECT) in the differential diagnosis of acute intracranial hemorrhage and calcification. Methods This retrospective study involved patients who underwent non-contrast-enhanced cranial DECT in Anhui Wannan Rehabilitation Hospital from January 2015 to November 2022. The processed mixed images obtained after DECT were used as the conventional CT images. Each hyperdense lesion was analyzed based on virtual non-calcium and calcium overlay and classified as calcification or hemorrhage. The sensitivity, specificity, and accuracy of conventional CT and DECT were calculated by the chi-square test according to the unified reference standard. Results Sixty-six hyperdense intracranial lesions of 60 patients were analyzed; of these lesions, 41 (62.12%) were calcifications and 25 (37.88%) were hemorrhages. The sensitivity, specificity, and accuracy of DECT in identifying hemorrhage were 96.00%, 100%, and 98.48%, respectively, while those of conventional CT were 72.00%, 97.56%, and 87.88%, respectively. Of the 66 lesions, 4 (6.06%) could not be qualitatively identified and 3 (4.55%) were misdiagnosed by conventional CT but correctly identified by DECT. Conclusions DECT can accurately distinguish acute intracranial hemorrhage from calcification, especially in cases that are difficult to diagnose by conventional CT.

IntroductionWith the declining birth rate and increasingly aging population in Japan, an increased care burden may be placed on the family and the younger generation will address challenging circumstances when they can care for their parents. This study aimed to develop a scale for examining the perspectives of Japanese university students on parental care and determines its reliability and validity.MethodsA web-based survey on a total of 408 Japanese students was adopted. This study performed exploratory and confirmatory factor analyses to obtain the underlying factors of the scale. Reliability was verified using Cronbach’s α coefficient and Spearman–Brown’s split-half reliability α coefficient. Validity was verified through sample, criterion-related, and convergent and discriminant validity.ResultsIn total, the study identified a three-factor 11 item-scale. Cronbach’s α for the scale was 0.901, and the Cronbach’s α and split-half reliability α coefficients of each factor were greater than 0.7. Three factors explained 64.6% of the total variance. The model indicators were χ2/df = 2.241, comparative fit index (CFI) = 0.951, incremental fit index (IFI) = 0.951, TLI = 0.942, root mean square error of approximation (RMSEA) = 0.078 (p

Abstract Background This study explored the impact of MTM service on MMD patients with hypertension. Methods A total of 120 MMD inpatients from September to November 2019 were received and randomly divided into intervention group and control group. General services for noninfectious chronic diseases were given to the control group, while a standard MTM service was given to the intervention group. Patients’ blood pressure, EQ-5D utility value, readmission rate, drug-related problems, and average daily medication therapy cost were compared between the two groups and within the groups. This was done at the initial admission phase and in the first, third, sixth, and twelfth months after discharge. Results The intervention group had significantly lower blood pressure and average daily medication therapy cost 12 months after discharge compared to the control group (systolic blood pressure: P = 0.023, diastolic blood pressure: P 0.05). Conclusions MTM implementation in MMD patients can improve health outcomes and reduce healthcare-related costs among MMD patients. Trial registration Chinese Clinical Trial Register ChiCTR2200065111, date of registration: October 28, 2022.

“Three-whole nurturing”, i.e., all-member, all-process, all-round nurturing, is an important principle to strengthen the ideological and political work of colleges and universities under the new situation, and is also the premise for colleges and universities to answer the fundamental question of “what kind of people to train, how to train people, and for whom to train people”. In the training of postgraduates, the relationship between “guidance” and “learning” runs through the whole process of postgraduate training. In recent years, the relationship between supervisors and postgraduates has caused many problems, and in order to better solve the relationship between postgraduates’ supervision and learning, the postgraduate supervision and learning community has emerged. The article describes the basic connotation of the graduate student guidance community, and puts forward the relevant path to build the graduate student guidance community.

IntroductionDue to declining birthrates and aging populations, parental care is going to place a greater burden on younger generations in the future, especially in East Asia where it is more common for children to provide care regardless of whether there is a national long-term care insurance program. Therefore, it has become important to understand the younger generation's views on parental care.MethodsAn explorative, metathematic qualitative study design was used. Data collection relied on semi-structured interviews, of which 19 Chinese and 19 Japanese university students were conducted from December 2021 to July 2022 using a snowball sampling method. Metatheme analysis was then used to identify broad cross-cultural metathemes and inter-relationships on parental care.ResultsThree parental care metathemes were identified for the perspectives of parental care: distrust of leaving parental care to others, responsibility to care for their parents, and importance of parent-child interactions about parental care.ConclusionTo improve social support for care, both countries must improve long-term care service delivery and healthcare systems and ensure that there is a trusting relationship between healthcare professionals and the public. Governments should also ensure that adult children receive assistance to balance their work, life, and parental care responsibilities. The findings provide several practical suggestions for improving healthcare systems in China and Japan through the younger generations' views.

Background and aimsThe role of circular RNAs (circRNAs) in the pathophysiology of cardiovascular disease is gradually being elucidated; however, their roles in atrial fibrillation (AF)-related fibrosis are largely unknown. This study aimed to characterize the different circRNA profiles in the rapid-pacing atria of dogs and explore the mechanisms involved in atrial fibrosis.MethodsA rapid right atrial-pacing model was established using electrical stimulation from a pacemaker. After 14 days, atrial tissue was collected for circRNA sequencing analysis. In vitro fibrosis was established by stimulating canine atrial fibroblasts with angiotensin II (Ang II). The fibroblasts were transfected with siRNA and overexpressing plasmids to explore the effects of cfa-circ002203 on fibroblast proliferation, migration, differentiation, and the expression of fibrosis-related proteins.ResultsIn total, 146 differentially expressed circRNAs were screened, of which 106 were upregulated and 40 were downregulated. qRT-PCR analysis showed that cfa-circ002203 was upregulated in both in vivo and in vitro fibroblast fibrosis models. The upregulation of cfa-circ002203 enhanced proliferation and migration while weakening the apoptosis of fibroblasts. Western blotting showed that cfa-circ002203 overexpression increased the protein expression levels of fibrosis-related indicators (Col I, Col III, MMP2, MMP9, and α-SMA) and decreased the protein expression levels of pro-apoptotic factors (Bax and Caspase 3) in Ang II-induced fibroblast fibrosis.ConclusionCfa-circ002203 might serve as an active promoter of the proliferation, migration, and fibrosis of atrial fibroblasts and is involved in AF-induced fibroblast fibrosis.