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Hupo Bian,1 Shaoqi Zhu,2 Yonghua Zhang,3 Qiang Fei,4 Xiuhua Peng,1 Zanhui Jin,1 Tianxiang Zhou,5 Hongxing Zhao1,6 1Department of Radiology, The First Affiliated Hospital of Huzhou Normal University, Huzhou, Zhejiang, People’s Republic of China; 2Department of Endocrinology, The First Affiliated Hospital of Huzhou Normal University, Huzhou, Zhejiang, People’s Republic of China; 3Department of Radiology, The Wuxing District People’s Hospital, Huzhou, Zhejiang, People’s Republic of China; 4Department of Radiology, The Linghu People’s Hospital, Huzhou, Zhejiang, People’s Republic of China; 5Department of Urinary Surgery, The First Affiliated Hospital of Huzhou Normal University, Huzhou, Zhejiang, People’s Republic of China; 6Huzhou Key Laboratory of Precise Diagnosis and Treatment of Urinary Tumors, Huzhou, Zhejiang, 313000, People’s Republic of ChinaCorrespondence: Hongxing Zhao, Department of Radiology, The First Affiliated Hospital of Huzhou Normal University, No. 158, Plaza Back Road, Wuxing District, Huzhou City, Zhejiang Province, People’s Republic of China, Email zhx2113408@126.comObjective: A bibliometric analysis was conducted using VOSviewer and CiteSpace to examine studies published between 2009 and 2023 on the utilization of artificial intelligence (AI) in chronic obstructive pulmonary disease (COPD).Methods: On March 24, 2024, a computer search was conducted on the Web of Science (WOS) core collection dataset published between January 1, 2009, and December 30, 2023, to identify literature related to the application of artificial intelligence in chronic obstructive pulmonary disease (COPD). VOSviewer was utilized for visual analysis of countries, institutions, authors, co-cited authors, and keywords. CiteSpace was employed to analyze the intermediary centrality of institutions, references, keyword outbreaks, and co-cited literature. Relevant descriptive analysis tables were created using Excel2021 software.Results: This study included a total of 646 papers from WOS. The number of papers remained small and stable from 2009 to 2017 but started increasing significantly annually since 2018. The United States had the highest number of publications among countries/regions while Silverman Edwin K and Harvard Medical School were the most prolific authors and institutions respectively. Lynch DA, Kirby M. and Vestbo J. were among the top three most cited authors overall. Scientific Reports had the largest number of publications while Radiology ranked as one of the top ten influential journals. The Genetic Epidemiology of COPD (COPDGene) Study Design was frequently cited. Through keyword clustering analysis, all keywords were categorized into four groups: epidemiological study of COPD; AI-assisted imaging diagnosis; AI-assisted diagnosis; and AI-assisted treatment and prognosis prediction in the COPD research field. Currently, hot research topics include explainable artificial intelligence framework, chest CT imaging, and lung radiomics.Conclusion: At present, AI is predominantly employed in genetic biology, early diagnosis, risk staging, efficacy evaluation, and prediction modeling of COPD. This study’s results offer novel insights and directions for future research endeavors related to COPD.Keywords: chronic obstructive pulmonary disease, artificial intelligence, visual analysis, bibliometric analysis

Jisheng Lin,1,* Sijia Guo,1,* Weiyang Zuo,1,* Hao Wu,2 Yongjin Li,3 Xiuquan Yang,4 Yong Yang,1 Qi Fei1,* 1Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Fangzhuang Community Health Service Center, Beijing, People’s Republic of China; 3Tuanjiehu Community Health Service Center, Beijing, People’s Republic of China; 4Wangzuo Community Health Service Center, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qi Fei, Tel +86 10 6313 8353, Fax +86 10 8391 1029, Email spinefei@126.comPurpose: This cross-sectional study estimated three clinical tools including the Osteoporosis Self-Assessment Tool for Asians (OSTA), Body Mass Index (BMI), and Beijing Friendship Hospital Osteoporosis Self-assessment Tool for Elderly Male (BFH-OSTM) for identifying primary osteoporosis and found optimal cut-off values in an elderly Han Beijing male population.Materials and Methods: We conducted a cross-sectional study, enrolling 400 community-dwelling elderly Han Beijing males aged ≥ 50 from 8 medical institutions. Osteoporosis was diagnosed as a T-score of − 2.5 standard deviations or lower than that of the average young adult in different diagnostic criteria [lumbar spine (L1-L4), femoral neck, total hip, WHO]. BFH-OSTM, OSTA, and BMI were assessed for predicting OP by receiver operating characteristic (ROC) curves. Sensitivity, specificity, and areas under the ROC curves (AUC) were determined. Ideal thresholds for the omission of screening BMD were proposed.Results: The prevalence of osteoporosis ranged from 9.25% to 19.0% according to different diagnostic criteria. The present study indicated the highest discriminating ability was BFH-OSTM in different criteria. The AUCs of OSTA and BMI were 0.748 and 0.770 in WHO criteria, which suggested limiting predictive value for identifying OP in elderly Beijing males. The AUC of BFH-OSTM to predict OP based on WHO criteria was 0.827, yielding a sensitivity of 65.8% and specificity of 82.7%, respectively. With a cost of missing 6.5% of osteoporosis patients, BFH-OSTM could reduce 73.5% of participants in screening BMD tests.Conclusion: BFH-OSTM may be a simple and effective tool for identifying OP in the elderly male population in Beijing to omit BMD screening reasonably.Keywords: male, osteoporosis, osteoporosis self-assessment tool for Asians, OSTA, Beijing friendship hospital osteoporosis self-assessment tool for elderly male, BFH-OSTM, body mass index, BMI

Shitong Feng,* Zihan Fan,* Yong Yang, Qi Fei, Xiang Li Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiang Li; Yong YangDepartment of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, People’s Republic of ChinaTel +86-10-63138353; +86-13641225060Fax +86-10-83911029Email lixiang@ccmu.edu.cn; spineyang@126.comPurpose: The aim of this study was to present a novel case of unilateral proximal cervical spondylotic amyotrophy (CSA) with contralateral spinal cord compression, which is subject to misdiagnosis and missed diagnosis.Background: CSA is the rare form of cervical spondylosis, which is characterized by severe muscle atrophy in the upper extremities. It can be classified in the proximal subtype and the distal subtype. The etiology, pathophysiology and treatment of CSA are still controversial.Methods: A rare case of atypical proximal CSA, who presented with left shoulder and arm weakness, but cervical magnetic resonance imaging (MRI) showed large right paracentral disc herniation in the C4-5 level. Twelve weeks after undergoing anterior cervical discectomy and fusion technique in C4-5 level, the patient’s symptoms obviously recovered.Conclusion: The opposite sides between disc herniation and clinical symptoms of upper extremity may be attributed to C5 ventral rootlet becoming stretched caused by spinal cord rotation or shift to the opposite side.Keywords: cervical spondylotic amyotrophy, muscle atrophy, anterior decompression

Qi Fei,* Xiaoyu Li,* Jisheng Lin,* Lingjia Yu,* Yong Yang* Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qi Fei Tel +86 10 6313 8353Fax +86 10 8391 1029Email spinefei@126.comPurpose: To investigate different expression profiles of long non-coding RNAs (lncRNAs) and mRNAs between male osteoporosis and normal control by high throughput RNA sequencing.Methods: We obtained the different expression profiles of long non-coding RNAs (lncRNAs) and mRNAs between male osteoporosis and normal control by high throughput RNA sequencing. Compared to normal control, we identified the differentially expressed genes (DEGs), differentially expressed lncRNAs (DElncRNAs) and the nearby targeted DEGs of DElncRNAs in male osteoporosis. Functional annotation was used to further study the functions of DEGs in male osteoporosis. The DElncRNAs–DEGs interaction network was constructed. One DElncRNA-nearby targeted DEG interaction pair of LINC02009-CCR2 was validated in vitro.Results: Totally, 3296 DEGs, 204 DElncRNAs and 168 DElncRNAs-nearby targeted DEGs pairs were obtained. The most significantly up-regulated and down-regulated DElncRNAs in male osteoporosis were Loc105372801 and KCNQ1OT1, respectively. Osteoclast differentiation and chemokine signaling pathway were significantly enriched pathways in male osteoporosis. Based on the DElncRNAs–DEGs interaction network in male osteoporosis, we obtained several interaction pairs including SNHG5-SYNCRIP-HBA1-HBB, HCG27-HLA-C, LINC02009-CCR2, and LOC101926887-IFIT1-IFIT2/IFIT3/IFIT5. The expression of LINC02009 and CCR2 was down-regulated in keeping with the RNA sequencing data.Conclusion: Identified DElncRNAs–DEGs interaction pairs may be involved in the development of male osteoporosis, which make a contribution to underlying the mechanism of male osteoporosis. Among which, the validated DElncRNAs-nearby targeted DEGs interaction pair of LINC02009-CCR2 may be important regulators in the development of male osteoporosis.Keywords: male osteoporosis, RNA sequencing, differentially expressed lncRNAs, differentially expressed genes, osteoclast differentiation, in vitro validation

Zihan Fan, Xiaoyu Li, Xiaodong Zhang, Yong Yang, Qi Fei, Ai Guo Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Qi Fei; Ai GuoDepartment of Orthopedics, Beijing Friendship Hospital, Capital Medical University, No. 95, Yong’an Road, Xicheng District, Beijing 100050, People’s Republic of ChinaTel +86 10 6313 8353Fax +86 10 8391 1029Email spinefei@126.com; guoaiortho@126.comPurpose: To validate the efficacies of three screening tools including the Osteoporosis Self-Assessment Tool for Asians (OSTA), Fracture Risk Assessment Tool (FRAX) without bone mineral density (BMD), and body mass index (BMI) for predicting postmenopausal osteoporosis (OP) and to define the ideal thresholds for avoidance of dual-energy X-ray absorptiometry (DXA) scanning in a Han Chinese population in Beijing.Patients and Methods: A total of 2055 community-dwelling Han Beijing postmenopausal females aged ≥ 45 years were enrolled in this study. All participants completed a questionnaire, and BMD was measured by DXA. OP was defined by a T-score at least − 2.5 SD less than that of average young adults in different diagnostic criteria [lumbar spine, femoral neck, total hip, worst hip, WHO]. The abilities of the OSTA, FRAX, and BMI to predict OP were analyzed by receiver operating characteristic (ROC) curves. Sensitivity, specificity, and area under the ROC curves (AUC) were calculated. Ideal thresholds for identifying OP were proposed.Results: The prevalence of OP ranged from 8.1% to 28.4% according to different diagnostic criteria. The AUC range for the OSTA (0.758– 0.849) was similar to the FRAX (0.728– 0.855), which revealed that both tools predicted OP reliably. The AUC range for BMI was 0.643– 0.682, suggesting limited predictive value. According to WHO criteria, the AUC values for the FRAX for hip fracture risk (FRAX-HF) and for the OSTA were 0.796 and 0.798, with corresponding sensitivities of 74.79% and 69.64% and specificities of 70.45% and 75.07%, respectively. At defined thresholds, the FRAX-HF and OSTA allowed avoidance of DXA in 42.4– 37.6% of participants, at a cost of missing only 7.2– 8.6% of individuals with OP.Conclusion: The OSTA and FRAX-HF may be reliable and effective tools for identifying postmenopausal OP in the Han Beijing population without BMD.Keywords: postmenopausal osteoporosis, OSTA, FRAX, BMI

Lingjia Yu,1 Qi Fei,1 Jisheng Lin,1 Yong Yang,1 Yisheng Xu2 1Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, People’s Republic of China; 2Orthopedics Department, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong 510120, People’s Republic of ChinaCorrespondence: Yong YangDepartment of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, People’s Republic of ChinaEmail spineyang@126.comYisheng XuOrthopedics Department, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong 510120, People’s Republic of ChinaEmail xuyishengdr@gzucm.edu.cnPurpose: Bone tissue infections are a difficult problem in orthopedic surgery. Topical application of vancomycin and tobramycin powder has been proved to significantly reduce infection rates. However, the osteogenic effect of the topical application of these two antibiotics is unclear. In this study, the osteogenic effect of local delivery antibiotics on bone regeneration was investigated in vitro.Methods: Bone marrow stromal cells (BMSCs) were incubated in the presence of vancomycin (14.28μg/mL), tobramycin (28.57μg/mL), or vancomycin combined with tobramycin (vancomycin 14.28μg/mL and tobramycin 28.57μg/mL). Cell viability, proliferation, and migration were analyzed. The alizarin red staining as well as the alkaline phosphatase staining was investigated. Then, the quantitative real-time (qRT)-PCR of osteogenic mRNA expression levels were also evaluated.Results: The results showed that vancomycin combined with tobramycin has no adverse effect on the viability and proliferation of BMSCs. The topical application of vancomycin alone may interfere with the bone regenerative processes. However, the tobramycin can promote the osteogenic differentiation of BMSCs and also rescue the osteogenic potential of BMSCs inhibited by vancomycin both in vitro.Conclusion: From this in vitro study, local application of vancomycin combined with tobramycin does not affect the osteogenic potential of BMSCs.Keywords: vancomycin, tobramycin, osteogenesis, bone regeneration

XiaoDong Zhang,1,* JiSheng Lin,1,* Yong Yang,1 Hao Wu,2 Yongjin Li,3 Xiuquan Yang,4 Qi Fei1,* 1Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, 2Fangzhuang Community Health Service Center, 3Tuanjiehu Community Health Service Center, 4Wangzuo Community Health Service Center, Beijing, People’s Republic of China *These authors contributed equally to this work Purpose: In this cross-sectional study, three clinical tools, the Osteoporosis Self-Assessment Tool for Asians (OSTA), Fracture Risk Assessment Tool (FRAX) without bone mineral density (BMD), and body mass index (BMI), for predicting primary osteoporosis (OP) were compared and ideal thresholds for omission of screening BMD were proposed in a community-dwelling elderly Han Beijing male population. Patients and methods: A total of 1,349 community-dwelling elderly Han Beijing males aged ≥50 years were enrolled in this study. All subjects completed a questionnaire and measured BMD by dual-energy X-ray absorptiometry (DXA). Osteoporosis was defined as a T-score of -2.5 SD or lower than that of the average young adult in different diagnostic criteria (lumbar spine [L1–L4], femoral neck, total hip, worst hip, and World Health Organization [WHO]). FRAX without BMD, OSTA, and BMI were assessed for predicting OP by receiver operating characteristic (ROC) curves. Sensitivity, specificity, and areas under the ROC curves (AUCs) were determined. Ideal thresholds for omission of screening BMD were proposed. Results: The prevalence of OP ranged from 1.8% to 12.8% according to different diagnostic criteria. This study showed that the BMI has highest discriminating ability. The AUC of FRAX without BMD ranged from 0.536 to 0.630, which suggested limiting predictive value for identifying OP in elderly Beijing male. The AUCs of BMI (0.801–0.880) were slightly better than OSTA (0.722–0.874) in predicting OP at all sites. The AUC of BMI to identify OP in worst hip was 0.824, yielding a sensitivity of 84.8% and a specificity of 64.4%. 40% of participants on BMD measurements saved only 0.1%–2.7% missed OP. Compared to OSTA and FRAX without BMD, the BMI got the best predictive value for OP. Conclusion: BMI may be a simple and effective tool for identifying OP in the elderly male population in Beijing to omit BMD screening reasonably. Keywords: male, osteoporosis, Osteoporosis Self-Assessment Tool for Asians, OSTA, Fracture Risk Assessment Tool, FRAX, body mass index, BMI

JiSheng Lin,1 Yong Yang,1 XiaoDong Zhang,1 Zhao Ma,1 Hao Wu,2 Yongjin Li,3 Xiuquan Yang,4 Qi Fei,1 Ai Guo1 1Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Xicheng District, Beijing, People’s Republic of China; 2Fangzhuang Community Health Service Center, Fengtai District, Beijing, People’s Republic of China; 3Tuanjiehu Community Health Service Center, Chaoyang District, Beijing, People’s Republic of China; 4Wangzuo Community Health Service Center, Fengtai District, Beijing, People’s Republic of China Purpose: To develop and validate a new clinical screening tool to identify primary osteoporosis by dual-energy X-ray absorptiometry (DXA) in two elderly Han Chinese male populations.Methods: A cross-sectional study was conducted, enrolling 1,870 community-dwelling and 574 hospital-checkup elderly Han Chinese males aged ≥50 years. All subjects completed a structured questionnaire and had their bone mineral density (BMD) measured using DXA. Using logistic regression analysis in the 1,870 community-dwelling males, we assessed the ability of numerous potential clinical risk factors to identify male with osteoporosis. Multiple variable regression analysis and item reduction yielded a final tool named the Beijing Friendship Hospital Osteoporosis Self-assessment Tool for Elderly Male (BFH-OSTM). Receiver operating characteristic (ROC) curve was generated to compare the validation of the BFH-OSTM and Osteoporosis Self-assessment Tool for Asians (OSTA) for identifying elderly male at increased the risk of primary osteoporosis in the 574 hospital-checkup males.Results: In screening the 1,870 community-dwelling subjects with DXA, 14.2% (266/1,870) had osteoporosis, and a further 51.8% (969/1,870) had osteopenia. Of the items screened in the questionnaire, weight, height and previous history of fragility fracture were predictive of osteoporosis. A final tool (BFH-OSTM) was based on body weight and fragility fracture history only. The BFH-OSTM index (cutoff =70) had a sensitivity of 85% and specificity of 53% for identifying osteoporosis according to the WHO criteria, with an area under the ROC curve of 0.763. The predictive value of BFH-OSTM was validated in the 574 hospital-checkup population, which performed better than OSTA.Conclusion: The BFH-OSTM may perform well for identifying elderly male at increased risk for osteoporosis and applying it would result in more prudent use of BMD measurement by DXA, especially for Han Chinese male. Keywords: osteoporosis, bone mineral density, male, risk factors, screening

Nan Su, Qi Fei, Bingqiang Wang, Dong Li, Jinjun Li, Hai Meng, Yong Yang, Ai Guo Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Xicheng District, Beijing, People’s Republic of China Objectives: The purpose of the present study was to explore and analyze the long-term outcomes and factors that affect the prognosis of expansive open-door laminoplasty with lateral mass screw fusion in treatment of cervical spondylotic myelopathy (CSM). Methods: We retrospectively reviewed 49 patients with multilevel CSM who had undergone expansive open-door laminoplasty with lateral mass screws fixation and fusion in our hospital between February 2008 and February 2012. The average follow-up period was 4.6 years. The clinical data of patients, including age, sex, operation records, pre- and postoperation Japanese Orthopedic Association (JOA) scores, cervical spine canal stenosis, and cervical curvature, were collected. Increased signal intensity (ISI) on T2-weighted magnetic resonance imaging and ossification of the posterior longitudinal ligament were also observed. Paired t-test was used to analyze the treatment effectiveness and recovery of neuronal function. The prognostic factors were analyzed with multivariable linear regression model. Results: Forty-nine patients with CSM with a mean age of 59.44 years were enrolled in this study. The average of preoperative JOA score was 9.14±2.25, and postoperative JOA score was 15.31±1.73. There was significant difference between the pre- and postoperative JOA scores. The clinical improvement rate was 80.27%. On follow-up, five patients had complaints of neck and shoulder pain, but no evidence of C5 nerve palsy was found. Developmental cervical spine canal stenosis was present in all patients before surgery. Before surgery, ISI was observed in eight patients, while ossification of the posterior longitudinal ligament was found in 12 patients. The average of preoperative cervical curvature was 21.27°±8.37° and postoperative cervical curvature was 20.09°±1.29°, and there was no significant difference between the pre- and postoperative cervical curvatures. Multivariable linear regression analysis results showed that the postoperation JOA scores were significantly affected by age, preoperative JOA scores, and preoperative ISI. Except one case of epidural hematoma, there were no complications associated with the surgery. Conclusion: Treatment of CSM with posterior open-door laminoplasty with lateral mass screw fusion is effective with few complications. In addition, the normal cervical lordosis was well maintained. Age, preoperative JOA scores, and preoperative ISI were the independent factors that significantly affect disease prognosis and surgical outcomes. Keywords: cervical spondylotic myelopathy, laminoplasty, lateral mass screw, prognostic factors, ossification of the posterior longitudinal ligament, JOA scores

Zhao Ma, Yong Yang,* JiSheng Lin, XiaoDong Zhang, Qian Meng, BingQiang Wang, Qi Fei* Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China *These authors contributed equally to this work Purpose: To develop a simple new clinical screening tool to identify primary osteoporosis by dual-energy X-ray absorptiometry (DXA) in postmenopausal women and to compare its validity with the Osteoporosis Self-Assessment Tool for Asians (OSTA) in a Han Chinese population.Methods: A cross-sectional study was conducted, enrolling 1,721 community-dwelling postmenopausal Han Chinese women. All the subjects completed a structured questionnaire and had their bone mineral density measured using DXA. Using logistic regression analysis, we assessed the ability of numerous potential risk factors examined in the questionnaire to identify women with osteoporosis. Based on this analysis, we build a new predictive model, the Beijing Friendship Hospital Osteoporosis Self-Assessment Tool (BFH-OST). Receiver operating characteristic curves were generated to compare the validity of the new model and OSTA in identifying postmenopausal women at increased risk of primary osteoporosis as defined according to the World Health Organization criteria.Results: At screening, it was found that of the 1,721 subjects with DXA, 22.66% had osteoporosis and a further 47.36% had osteopenia. Of the items screened in the questionnaire, it was found that age, weight, height, body mass index, personal history of fracture after the age of 45 years, history of fragility fracture in either parent, current smoking, and consumption of three of more alcoholic drinks per day were all predictive of osteoporosis. However, age at menarche and menopause, years since menopause, and number of pregnancies and live births were irrelevant in this study. The logistic regression analysis and item reduction yielded a final tool (BFH-OST) based on age, body weight, height, and history of fracture after the age of 45 years. The BFH-OST index (cutoff =9.1), which performed better than OSTA, had a sensitivity of 73.6% and a specificity of 72.7% for identifying osteoporosis, with an area under the receiver operating characteristic curve of 0.797.Conclusion: BFH-OST may be a powerful and cost-effective new clinical risk assessment tool for prescreening postmenopausal women at increased risk for osteoporosis by DXA, especially for Han Chinese women. Keywords: women, osteoporosis, osteoporosis screening tool, validation

JiSheng Lin,* Yong Yang,* Qi Fei, XiaoDong Zhang, Zhao Ma, Qi Wang, JinJun Li, Dong Li, Qian Meng, BingQiang Wang Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China *These authors contributed equally to this work Objective: This cross-sectional study compared three tools for predicting painful new osteoporotic vertebral fractures (PNOVFs) in older Chinese men: bone mineral density (BMD), the Osteoporosis Self-Assessment Tool for Asians (OSTA), and the World Health Organization fracture risk assessment tool (FRAX) (without BMD). Methods: Men aged ≥50 years were apportioned to a group for men with fractures who had undergone percutaneous vertebroplasty (n=111), or a control group of healthy men (n=385). Fractures were verified on X-ray and magnetic resonance imaging. BMD T-scores were determined by dual energy X-ray absorptiometry. Diagnosis of osteoporosis was determined by a BMD T-score of ≤2.5 standard deviations below the average for a young adult at peak bone density at the femoral neck, total hip, or L1–L4. Demographic and clinical risk factor data were self-reported through a questionnaire. BMD, OSTA, and FRAX scores were assessed for identifying PNOVFs via receiver-operating characteristic (ROC) curves. Optimal cutoff points, sensitivity, specificity, and areas under the ROC curves (AUCs) were determined. Results: Between the men with fractures and the control group, there were significant differences in BMD T-scores (at femoral neck, total hip, and L1–L4), and OSTA and FRAX scores. In those with fractures, only 53.15% satisfied the criteria for osteoporosis. Compared to BMD or OSTA, the FRAX score had the best predictive value for PNOVFs: the AUC of the FRAX score (cutoff =2.9%) was 0.738, and the sensitivity and specificity were 82% and 62%, respectively. Conclusion: FRAX may be a valuable tool for identifying PNOVFs in older Chinese men. Keywords: osteoporosis, male, vertebral fracture, FRAX, OSTA, bone mineral density

Qi Fei,* Jinjun Li,* Nan Su, Bingqiang Wang, Dong Li, Hai Meng, Qi Wang, Jisheng Lin, Zhao Ma, Yong Yang, Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China *These authors contributed equally to this work Background: Whether anterior cervical discectomy with fusion (ACDF) or anterior cervical corpectomy with fusion (ACCF) is superior in the treatment of cervical spondylotic myelopathy remains controversial. Therefore, we conducted a meta-analysis to quantitatively compare the efficacy and safety of ACDF and ACCF in the treatment of cervical spondylotic myelopathy.Methods: PubMed, Embase, Web of Science, SinoMed (Chinese BioMedical Literature Service System, People’s Republic of China), and CNKI (China National Knowledge Infrastructure, People’s Republic of China) were systematically searched to identify all available studies comparing efficacy and safety between patients receiving ACDF and ACCF. The weighted mean difference (WMD) was pooled to compare the Japanese Orthopaedic Association scores, visual analog scale scores, hospital stay, operation time, and blood loss. The risk ratio was pooled to compare the incidence of complications and fusion rate. Pooled estimates were calculated by using a fixed-effects model or a random-effects model according to the heterogeneity among studies.Results: Eighteen studies (17 observational studies and one randomized controlled trial) were included in this meta-analysis. Our results suggest that hospital stay (WMD =-1.33, 95% confidence interval [CI]: -2.29, -0.27; P=0.014), operation time (WMD =-26.9, 95% CI: -46.13, -7.67; P=0.006), blood loss (WMD =-119.36, 95% CI: -166.94, -71.77; P=0.000), and incidence of complications (risk ratio =0.51, 95% CI: 0.33, 0.80; P=0.003) in the ACDF group were significantly less than that in the ACCF group. However, other clinical outcomes, including post-Japanese Orthopaedic Association score (WMD =-0.27, 95% CI: -0.57, 0.03; P=0.075), visual analog scale score (WMD =0.03, 95% CI: -1.44, 1.50; P=0.970), and fusion rate (risk ratio =1.04, 95% CI: 0.99, 1.09; P=0.158), between the two groups were not significantly different.Conclusion: Evidence from the meta-analysis of 18 studies demonstrated that surgical options of cervical spondylotic myelopathy using ACDF or ACCF seemed to have similar clinical outcomes. However, ACDF was found to be superior to ACCF in terms of hospital stay, operation time, blood loss, and incidence of complications. Keywords: anterior cervical discectomy with fusion, anterior cervical corpectomy with fusion, cervical spondylotic myelopathy, meta-analysis

Hai Meng, Qi Fei, Bingqiang Wang, Yong Yang, Dong Li, Jinjun Li, Nan Su Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China Background: Epidural injections of anesthetic with or without steroids are widely used for treating lumbar spinal stenosis, a common cause of chronic low back pain, but there is a lack of rigorous data comparing the effectiveness of epidural injections of anesthetic with and without steroids. This meta-analysis presents a current, comprehensive picture of how epidural injections of anesthetic with steroids compare with those using local anesthetic alone.Methods: PubMed, Embase, Web of Science, and Cochrane Library databases were searched from their inception through February 5, 2015. Weight mean difference, risk ratio, and 95% confidence intervals were calculated. A random effects model or fixed effects model was used to pool the estimates, according to the heterogeneity between the included studies.Results: We included 13 randomized controlled trials, involving 1,465 patients. Significant pain relief (≥50%) was demonstrated in 53.7% of patients administered with epidural injections of anesthetic with steroids (group 1) and in 56.4% of those administered with local anesthetic alone (group 2). Patients showed a reduction in numeric rating scale pain score of 3.7 and 3.6 in the two groups, respectively. Significant functional improvement was achieved in 65.2% of patients in group 1 and 63.1% of patients in group 2, with Oswestry Disability Index reductions of 13.8 and 14.5 points, respectively. The overall number of injections per year was 3.2±1.3 and 3.4±1.2 with average total relief per year of 29.3±19.7 and 33.8±19.3 weeks, respectively. The opioid intakes decreased from baseline by 12.4 and 7.8 mg, respectively. Among the outcomes listed, only total relief time differed significantly between the two groups.Conclusion: Both epidural injections with steroids or with local anesthetic alone provide significant pain relief and functional improvement in managing chronic low back pain secondary to lumbar spinal stenosis, and the inclusion of steroids confers no advantage compared to local anesthetic alone. Keywords: chronic low back pain, spinal stenosis, epidural injections, steroids, local anesthetics

Abstract Mangiferin, a C-glucosyl xanthone, is a biologically active glycoside naturally synthesized in mango. Glycosyltransferase can catalyze the biosynthesis of mangiferin. In this study, we identified 221 members of the UGT glycosyltransferase family in mango. The 221 MiUGT genes were grouped into 13 subfamilies through phylogenetic tree analysis with Arabidopsis, Chinese bayberry, and mango. All UGT family members in mango were unevenly distributed on 17 chromosomes and found that tandem duplication dominated the expansion of UGT family members in mango. Purification selection primarily influenced the evolution of the mango UGT family members. In addition, cis-element analysis of the mango UGT gene family revealed the presence of MYB binding sites, which are involved in flavonoid biosynthesis; which further supports the role of UGT family members in the synthesis of flavonoids. To verify these results, we analyzed the expression of UGT family members in mango leaves, stems, and different developmental stages of fruit peel. The RNA-seq and qRT-PCR results showed significant differences in the expression patterns of MiUGT genes in various tissues and developmental stages of mango. We identified MiUGT gene-specific expression at different stages of fruit development. These results lay a theoretical foundation for research on the relationship between members of the mango UGT family and the synthesis of flavonoids, mangiferin.

Abstract This paper presents a symmetric all-dielectric two-dimensional grating with high transmittance and high figure of merit based on cylindrical nanoarrays as a liquid sensing structure with small volume and high sensitivity. The device is optimized using the finite element method to calculate the transmissivity under TE/TM polarization. When the incident angle is 4 degrees, the transmissivity of the grating is nearly 1 with a full width at half maximum of 0.016 nm and a sensitivity of 256.2 nm/RIU. The high figure of merit is 16214.936, and the corresponding quality factor can reach 56572.438. The sensor characteristics of the incident angle on the device are analyzed, and the normalized electric field distribution indicates that the change of the incident angle has a significant modulation ability for the resonance energy distribution. The proposed sensor is independent of polarization state, easy to control and integrate, and has broad application prospects in fields such as liquid solution detection, ocean surveys, and position sensing.

Abstract Background Age-related reproductive aging is a natural and irreversible physiological process, and delaying childbearing is increasingly common all over the world. Transplantation of mesenchymal stem cells (MSCs) is considered a new and effective therapy to restore ovarian function, but the relevant mechanisms remain unclear. Recently, it has been found that there is a local Renin–angiotensin system (RAS) in human ovary and it plays a key role. Methods After collecting follicular fluid from women who received oocyte retrieval for pure male factor infertility, the level of RAS components in it were detected, and the correlation analysis by linear regression. Then, the in vivo experiments on female C57BL/6 mice were designed to measure ovarian function, and the transcription and translation levels of RAS pathway were detected by molecular biology methods. Moreover, the role of RAS in regulating inflammation and oxidative stress in the co-culture system were explored in in vitro experiments on KGN cells. Results First, a total of 139 samples of analyzable follicular fluid were obtained. The local RAS of ovary, which is independent of systemic RAS (P > 0.05), is affected by age (Pearson r 0.05). Conclusions Together, our findings indicate that a novel possible mechanism to explain how stem cells restore age-related ovarian functional decline.

To study the compressive mechanical properties and failure mechanism of satin woven composites with void defects， the longitudinal compression experiments on C/C-SiC satin woven composites with void defects were conducted. The microscopic strength prediction model of satin woven composites with void defects was established by introducing random pores through the explosive fragment algorithm based on the discrete element method. Based on this model， the progressive failure process of the mesoscopic model under meridional compression load was simulated， revealing the influence of pores on the damage process. The progressive damage process and failure mechanism prediction model are verified by experimental data. The results show that the main failure modes of the material under warp compression load are shear failure and delamination failure， manifesting in three forms： interlaminar local matrix cracking and associated， delamination between the matrix and the warp， complete or partial fracture along the warp and weft debonding and matrix separation， weft cracking. At the same time， the numerical simulation results are basically the same as the experimental values， which verifies the validity of the model of C/C-SiC satin woven composites with void defects， and provides an effective method for the study of mechanical properties of two-dimensional woven composites.

OBJECTIVE: Lumbar spinal stenosis is the most common spinal degenerative disease in patients over 60 years, and the unilateral biportal endoscopic (UBE) spine surgery treatment of lumbar spinal stenosis (LSS) has achieved preliminary clinical results. This systematic review and meta-analysis aimed to reveal the clinical efficacy of UBE for LSS and provide evidence for clinical practice. MATERIALS AND METHODS: PubMed, Embase, Web of Science, and Cochrane databases were searched for literature. The papers selected were those published from inception till October 2021. The selected pieces of literature were graded for evidence using the Oxford Centre for Evidence-Based Medicine: Levels of Evidence (March 2009). Outcomes measures were operation time, blood loss, complication rate, admission period, Visual Analogue Scale (VAS)-back, VAS-leg, and Oswestry Disability Index (ODI) score, and radiological outcomes. The mean comparisons were based on VAS and ODI scores. RESULTS: A total of 823 patients with a single LSS segment were included from the selected nine studies. There were nine studies comparing UBE clinical outcomes and micro-endoscopic unilateral laminotomy for bilateral decompression (M-ULBD). The meta-analysis revealed that the UBE group had better VAS-leg and -back scores in the first week postoperatively [total: mean difference (MD) = -0.96, 95% confidence interval (CI): -1.19, -0.74, p < 0.00001; total: MD = -1.69, 95% CI: -1.93, -1.45, p < 0.00001], 1st month postoperatively (total: MD = -0.35, 95% CI: -0.61, -0.08, p = 0.01; total: MD = -0.40, 95% CI: -0.68, -0.12, p = 0.005), 6th month postoperatively (total: MD = -0.22, 95% CI: -0.35, -0.08, p = 0.002; total: MD = -0.24, 95% CI: -0.40, -0.07, p = 0.005), and UBE group also performed better in ODI score at 1st month postoperatively (total: MD = -3.36, 95% CI: -4.26, -2.46, p < 0.00001). There was no significant difference in VAS-leg and -back scores between both groups at the 3rd and 12th month postoperatively, and ODI scores did not significantly differ between both groups at 3, 6, and 12 months postoperatively (all p > 0.05). CONCLUSIONS: UBE has achieved good preliminary clinical results and may be a minimally invasive alternative surgery for patients with single segmental LSS. [ABSTRACT FROM AUTHOR]

Abstract Objective The ultrasonographic characteristics of lymph node metastasis in breast cancer patients were retrospectively analyzed, and a predictive nomogram model was constructed to provide an imaging basis for better clinical evaluation. Methods B-mode ultrasound was used to retrospectively analyze the imaging characteristics of regional lymph nodes and tumors. Pathological examination confirmed the presence of lymph node metastasis in breast cancer patients. Univariable and multivariable logistic regression analyses were performed to analyze the risk factors for lymph node metastasis. LASSO regression analysis was performed to screen noninvasive indicators, and a nomogram prediction model was constructed for breast cancer patients with lymph node metastasis. Results A total of 187 breast cancer patients were enrolled, including 74 patients with lymph node metastasis in the positive group and 113 patients without lymph node metastasis in the negative group. Multivariate analysis revealed that pathological type (OR = 4.58, 95% CI: 1.44–14.6, p = 0.01), tumor diameter (OR = 1.37, 95% CI: 1.07–1.74, p = 0.012), spiculated margins (OR = 7.92, 95% CI: 3.03–20.67, p

Abstract Complex coumarins (CCs) represent characteristic metabolites found in Apiaceae plants, possessing significant medical value. Their essential functional role is likely as protectants against pathogens and regulators responding to environmental stimuli. Utilizing genomes and transcriptomes from 34 Apiaceae plants, including our recently sequenced Peucedanum praeruptorum, we conduct comprehensive phylogenetic analyses to reconstruct the detailed evolutionary process of the CC biosynthetic pathway in Apiaceae. Our results show that three key enzymes – p-coumaroyl CoA 2’-hydroxylase (C2’H), C-prenyltransferase (C-PT), and cyclase – originated successively at different evolutionary nodes within Apiaceae through various means of gene duplications: ectopic and tandem duplications. Neofunctionalization endows these enzymes with novel functions necessary for CC biosynthesis, thus completing the pathway. Candidate genes are cloned for heterologous expression and subjected to in vitro enzymatic assays to test our hypothesis regarding the origins of the key enzymes, and the results precisely validate our evolutionary inferences. Among the three enzymes, C-PTs are likely the primary determinant of the structural diversity of CCs (linear/angular), due to divergent activities evolved to target different positions (C-6 or C-8) of umbelliferone. A key amino acid variation (Ala161/Thr161) is identified and proven to play a crucial role in the alteration of enzymatic activity, possibly resulting in distinct binding forms between enzymes and substrates, thereby leading to different products. In conclusion, this study provides a detailed trajectory for the establishment and evolution of the CC biosynthetic pathway in Apiaceae. It explains why only a portion, not all, of Apiaceae plants can produce CCs and reveals the mechanisms of CC structural diversity among different Apiaceae plants.

High Mach flight has put forward more stringent requirements for the material and structure design of new generation of high-speed vehicles. This paper reviews the application of ceramic matrix composites（CMCs） in the structural design of aircraft from the aspects of selection，application，and evaluation，and then the future development direction is put forward to provide reference for aircraft ceramic matrix composite structure design. The selection criteria and corresponding preparation methods of CMCs in different application scenarios are comprehensively reviewed，the typical applications of CMCs in aircraft structures are systematically introduced，and the evaluation criteria and ground test methods of the materials under near-service conditions are analyzed. To order to meet the future demands of aircraft，it is necessary to integrate computer-aided optimization technology and innovative preparation methods to enhance the temperature resistance and fatigue performance of CMCs. Developing highly reliable，long-life joining techniques and integrated design solutions will fully leverage the advantages of these materials. Additionally，in-situ characterization techniques under multi-physical field coupling need to be developed to obtain the performance evolution behaviour of CMCs in actual use，providing a reliable basis for the lightweight structural design of aircraft.

Abstract Background Spinal tuberculosis (STB) is a local manifestation of systemic infection caused by Mycobacterium tuberculosis, accounting for a significant proportion of joint tuberculosis cases. This study aimed to explore the diagnostic value of MRI combined with mannose-binding lectin (MBL) for STB. Methods 124 patients suspected of having STB were collected and divided into STB and non-STB groups according to their pathological diagnosis. Serum MBL levels were measured using ELISA and a Pearson analysis was constructed to determine the correlation between MBL and STB. ROC was plotted to analyze their diagnostic value for STB. All the subjects included in the study underwent an MRI. Results The sensitivity of MRI for the diagnosis of STB was 84.38% and specificity was 86.67%. The serum MBL levels of the patients in the STB group were significantly lower than the levels in the non-STB group. ROC analysis results indicated that serum MBL’s area under the curve (AUC) for diagnosis of STB was 0.836, with a sensitivity of 82.3% and a specificity was 77.4%. The sensitivity of MRI combined with MBL diagnosis was 96.61%, and the specificity was 92.31%, indicating that combining the two diagnostic methods was more effective than using either one alone. Conclusions Both MRI and MBL had certain diagnostic values for STB, but their combined use resulted in a diagnostic accuracy than either one alone.

Abstract Accurately controlling the product selectivity in syngas conversion, especially increasing the olefin selectivity while minimizing C1 byproducts, remains a significant challenge. Epsilon Fe2C is deemed a promising candidate catalyst due to its inherently low CO2 selectivity, but its use is hindered by its poor high-temperature stability. Herein, we report the successful synthesis of highly stable ε-Fe2C through a N-induced strategy utilizing pyrolysis of Prussian blue analogs (PBAs). This catalyst, with precisely controlled Mn promoter, not only achieved an olefin selectivity of up to 70.2% but also minimized the selectivity of C1 byproducts to 19.0%, including 11.9% CO2 and 7.1% CH4. The superior performance of our ε-Fe2C-xMn catalysts, particularly in minimizing CO2 formation, is largely attributed to the interface of dispersed MnO cluster and ε-Fe2C, which crucially limits CO to CO2 conversion. Here, we enhance the carbon efficiency and economic viability of the olefin production process while maintaining high catalytic activity.

BackgroundThe thrombocytopenia influences prognoses of critically ill patients. There are few studies exploring the prognostic value of thrombocytopenia among ICH patients. We perform this study to explore the correlation between thrombocytopenia at different timepoints of hospitalizations and mortality of ICH.MethodsICH patients recorded in the Medical Information Mart for Intensive Care-III were selected for this observational study. The thrombocytopenia, defined as platelet

BackgroundA standard treatment recommendation for third-line and subsequent treatments for advanced HER2-positive breast cancer is still missing, especially for low HER2 expression. Nevertheless, there is evidence that these patients might benefits from antibody-drug conjugates (ADCs) treatment. Therefore, this study aimed to evaluate the clinical efficacy, safety, and factors affecting efficacy of Disitamab Vedotin (RC48) for treating HER2-positive and HER2-low metastatic breast cancer (MBC) in the real-world setting.MethodsA retrospective study at five clinical sites was conducted in China, enrolling MBC patients treated with RC48 from July 01, 2021 and May 31, 2023. Patient demographics, treatment patterns, and adverse events (AEs) were recorded and analyzed.ResultsA total of 154 patients were included: 104 (67.53%) patients with HER2-positive and 50 (32.47%) patients with HER2-low MBC. The median progression-free survival (mPFS) was 5.06 months. The objective response rate (ORR) and disease control rate (DCR) were 36.36% and 68.83%, respectively. HER2-positive patients exhibited a mPFS of 5.93 and an ORR of 41.35%. In contrast, patients with low-HER2 had a mPFS of 4.28 months and an ORR of 26.00%. The most common AEs included neutropenia (54.55%), increased AST (53.25%), leukopenia (51.95%), and fatigue (43.51%), mostly graded mild to moderate (grade 1-2).ConclusionsThis extensive study in China demonstrated that RC48 has excellent therapeutic potential for both HER2-positive and HER2-low MBC with a favorable safety profile. The study also suggests that combination therapy significantly boosts efficacy beyond monotherapy, indicating a promising avenue for future ADC development.

BackgroundNocardiosis poses a diagnostic challenge due to its rarity in clinical practice, non-specific clinical symptoms and imaging features, and the limitations of traditional detection methods. Nocardia aobensis (N. aobensis) is rarely detected in clinical samples. Metagenomic next-generation sequencing (mNGS) offers significant advantages over traditional methods for rapid and accurate diagnosis of infectious diseases, especially for rare pathogens.Case presentationA 52-year-old woman with a history of immune thrombocytopenia for over 2 years was hospitalized for recurrent fever and cough lasting for 10 days. Her initial diagnosis on admission was community-acquired pneumonia, based on chest computed tomography findings of lung inflammation lesion. Empirical treatment with moxifloxacin and trimethoprim-sulfamethoxazole (TMP-SMZ) was initiated. However, her condition failed to improve significantly even after 1 week of treatment. Bronchoalveolar lavage fluid (BALF) subjected to mNGS revealed the presence of N. aobensis, resulting in a diagnosis of pulmonary nocardiosis caused by N. aobensis. This diagnosis was also supported by Sanger sequencing of the BALF. After adjusting the antibiotic regimen to include TMP-SMZ in combination with imipenem, the patient’s condition significantly improved. She was finally discharged with instructions to continue oral treatment with TMP-SMZ and linezolid for 6 months. The patient’s first follow-up 1 month after discharge showed good treatment outcomes but with obvious side effects of the drugs. Consequently, the antibiotic regimen was changed to doxycycline, and the patient continued to improve.ConclusionWe report the first detailed case of pulmonary nocardiosis caused by N. aobensis diagnosed by mNGS. mNGS could be an effective method that facilitates early diagnosis and timely decision-making for the treatment of nocardiosis, especially in cases that involve rare pathogens.

As more multi-ancestry GWAS summary data become available, we have developed a comprehensive trans-ancestry pathway analysis framework that effectively utilizes this diverse genetic information. Within this framework, we evaluated various strategies for integrating genetic data at different levels-SNP, gene, and pathway-from multiple ancestry groups. Through extensive simulation studies, we have identified robust strategies that demonstrate superior performance across diverse scenarios. Applying these methods, we analyzed 6,970 pathways for their association with schizophrenia, incorporating data from African, East Asian, and European populations. Our analysis identified over 200 pathways significantly associated with schizophrenia, even after excluding genes near genome-wide significant loci. This approach substantially enhances detection efficiency compared to traditional single-ancestry pathway analysis and the conventional approach that amalgamates single-ancestry pathway analysis results across different ancestry groups. Our framework provides a flexible and effective tool for leveraging the expanding pool of multi-ancestry GWAS summary data, thereby improving our ability to identify biologically relevant pathways that contribute to disease susceptibility.

Artemisinin and its derivatives are widely recognized as first-line treatments for malaria worldwide. Recent studies have demonstrated that artemisinin-based antimalarial drugs, such as artesunate, dihydroartemisinin, and artemether, not only possess excellent antimalarial properties but also exhibit antitumor, antifungal, and immunomodulatory effects. Researchers globally have synthesized artemisinin derivatives like SM735, SM905, and SM934, which offer advantages such as low toxicity, high bioavailability, and potential immunosuppressive properties. These compounds induce immunosuppression by inhibiting the activation of pathogenic T cells, suppressing B cell activation and antibody production, and enhancing the differentiation of regulatory T cells. This review summarized the mechanisms by which artemisinin and its analogs modulate excessive inflammation and immune responses in rheumatic and skeletal diseases, autoimmune inflammatory diseases, and autoimmune disorders, through pathways including TNF, Toll-like receptors, IL-6, RANKL, MAPK, PI3K/AKT/mTOR, JAK/STAT, and NRF2/GPX4. Notably, in the context of the NF-κB pathway, artemisinin not only inhibits NF-κB expression by disrupting upstream cascades and/or directly binding to NF-κB but also downregulates multiple downstream genes controlled by NF-κB, including inflammatory chemokines and their receptors. These downstream targets regulate various immune cell functions, apoptosis, proliferation, signal transduction, and antioxidant responses, ultimately intervening in systemic autoimmune diseases and autoimmune responses in organs such as the kidneys, nervous system, skin, liver, and biliary system by modulating immune dysregulation and inflammatory responses. Ongoing multicenter randomized clinical trials are investigating the effects of these compounds on rheumatic, inflammatory, and autoimmune diseases, with the aim of translating promising preclinical data into clinical applications.

ABSTRACT Introduction As a common malignancy, lung cancer has a relatively poor prognosis and a low survival rate. In recent years, ferroptosis, as an emerging filed, has great promise in the potential treatment of cancer. Brucea javanica oil (BJO) is often used to treat various cancers. Oleic acid (OA) is the main ingredient of BJO. In this study, we investigated the role and molecular mechanism of OA in lung cancer treatment by promoting ferroptosis. Methods In this study, A549 cells and H1299 cells were used for in vitro experiments, and a CCK‐8 test, scratch test, and MTT experiment were carried out. We examined reactive oxygen species (ROS), the JC‐1 probe, glutathione (GSH) expression, lipid peroxidation, SDC4 mRNA levels, and ACSL4, SLC7A11, GPX4, and SDC4 protein levels. Results The results showed that OA could inhibit the proliferation and migration of A549 cells and H1299 cells, SDC4 was a potential therapeutic target of OA against lung cancer, and OA treatment significantly inhibited the expression of SDC4 in A549 cells and H1299 cells. OA induces ferroptosis in A549 cells and H1299 cells, decreases GSH levels, increases lipid peroxidation levels, and decreases SDC4 mRNA expression; in addition, OA upregulates ACSL4 expression and decreases SLC7A11, GPX4, and SDC4 expression. Conclusion This study confirmed that OA could inhibit SDC4 expression and promote the occurrence of ferroptosis in A549 cells and H1299 cells through the GPX4/ACSL4 pathway, providing an effective basis for the use of drugs targeting ferroptosis in lung cancer treatment.

Background: Teacher well-being, encompassing emotional, psychological, and social dimensions, significantly influences teaching effectiveness. Understanding the factors that enhance teacher well-being and effectiveness is crucial, particularly amidst global teacher shortages and high turnover rates. Method: The present study gathered data from 252 university-level foreign language teachers from eight provinces in China. Participants completed measures assessing well-being (using the PERMA model), teaching effectiveness, and life satisfaction scales through online surveys. Data were analyzed using JASP and SPSS for regression and mediation analyses. Results: The findings revealed that Positive emotions and relationships significantly predicted life satisfaction, while accomplishment significantly predicted teaching effectiveness. Both teaching effectiveness and overall well-being were significant predictors of life satisfaction. However, teaching effectiveness did not significantly mediate the relationship between overall well-being and life satisfaction, indicating that these factors independently contribute to life satisfaction. Conclusion: Our findings share the inclusion of PERMA principles in enhancing teaching effectiveness and life satisfaction among foreign language teachers. Constructive future directions are suggested for professional development for improving teacher well-being and effectiveness.

Abstract Background The latitudinal diversity gradient (LDG), characterized by an increase in species richness from the poles to the equator, is one of the most pervasive biological patterns. However, inverse LDGs, in which species richness peaks in extratropical regions, are also found in some lineages and their causes remain unclear. Here, we test the roles of evolutionary time, diversification rates, and niche conservatism in explaining the inverse LDG of Potentilla (ca. 500 species). We compiled the global distributions of ~ 90% of Potentilla species, and reconstructed a robust phylogenetic framework based on whole-plastome sequences. Next, we analyzed the divergence time, ancestral area, diversification rate, and ancestral niche to investigate the macroevolutionary history of Potentilla. Results The genus originated in the Qinghai-Tibet Plateau during the late Eocene and gradually spread to other regions of the Northern Hemisphere posterior to the late Miocene. Rapid cooling after the late Pliocene promoted the radiating diversification of Potentilla. The polyploidization, as well as some cold-adaptive morphological innovations, enhanced the adaptation of Potentilla species to the cold environment. Ancestral niche reconstruction suggests that Potentilla likely originated in a relatively cool environment. The species richness peaks at approximately 45 °N, a region characterized by high diversification rates, and the environmental conditions are similar to the ancestral climate niche. Evolutionary time was not significantly correlated with species richness in the latitudinal gradient. Conclusions Our results suggest that the elevated diversification rates in middle latitude regions and the conservatism in thermal niches jointly determined the inverse LDG in Potentilla. This study highlights the importance of integrating evolutionary and ecological approaches to explain the diversity pattern of biological groups on a global scale.

Abstract The development of genotypes that can tolerate high levels of salt is crucial for the efficient use of salt-affected land and for enhancing crop productivity worldwide. Therefore, incorporating salinity tolerance is a critical trait that crops must possess. Salt resistance is a complex character, controlled by multiple genes both physiologically and genetically. To examine the genetic foundation of salt tolerance, we assessed 16 F1 hybrids and their eight parental lines under normal and salt stress (15 dS/m) conditions. Under salt stress conditions significant reduction was observed for plant height (PH), bolls/plant (NBP), boll weight (BW), seed cotton yield (SCY), lint% (LP), fiber length (FL), fiber strength (FS), potassium to sodium ratio (K+/Na+), potassium contents (K+), total soluble proteins (TSP), carotenoids (Car) and chlorophyll contents. Furthermore, the mean values for hydrogen peroxide (H2O2), sodium contents (Na+), catalase (CAT), superoxide dismutase (SOD), peroxidase (POD), and fiber fineness (FF) were increased under salt stress. Moderate to high heritability and genetic advancement was observed for NBP, BW, LP, SCY, K+/Na+, SOD, CAT, POD, Car, TSP, FL, and FS. Mean performance and multivariate analysis of 24 cotton genotypes based on various agro-physiological and biochemical parameters suggested that the genotypes FBS-Falcon, Barani-333, JSQ-White Hold, Ghauri, along with crosses FBS-FALCON × JSQ-White Hold, FBG-222 × FBG-333, FBG-222 × Barani-222, and Barani-333 × FBG-333 achieved the maximum values for K+/Na+, K+, TSP, POD, Chlb, CAT, Car, LP, FS, FL, PH, NBP, BW, and SCY under salt stress and declared as salt resistant genotypes. The above-mentioned genotypes also showed relatively higher expression levels of Ghi-ERF-2D.6 and Ghi-ERF-7A.6 at 15 dS/m and proved the role of these ERF genes in salt tolerance in cotton. These findings suggest that these genotypes have the potential for the development of salt-tolerant cotton varieties with desirable fiber quality traits.

The ultra-fine grain Ti–6Al–4V alloy sheet was successfully achieved by friction stir processing (FSP). The low-temperature superplastic deformation mechanism of Ti–6Al–4V alloy under the strain rate of 3 × 10−4 s−1 at 600 °C was studied by scanning electron microscope, electron backscatter diffraction and superplastic tensile test. It is found that the grain size of Ti–6Al–4V alloy by FSP is refined from 7.48 μm to 0.82 μm, and there is no preferential crystallographic orientation of the uniform grain. After FSP, the β phase of the base material (BM) in the grain boundary is refined and homogenized. During the superplastic tensile processing, with the increase of strain, the grain is refined continuously, and the α→β phase transition is induced by the dislocations pile-up at the β grain boundary, and the content of β phase increases. The grain near the fracture was refined to 0.35 μm, and the stress concentration led to the formation of cavities near the β phase, which eventually caused the fracture. The dynamic recrystallization in superplastic tensile processing is mainly geometric dynamic recrystallization and discontinuous dynamic recrystallization. The elongation of superplastic tensile (1033%) is 19.7 times higher than that of BM (50%). The order of superplastic deformation mechanism in the low-temperature superplastic deformation of the ultra-fine grain Ti–6Al–4V alloy sheet is as follows: intragranular dislocation slip and diffusion, grain boundary sliding, and phase boundary sliding. Phase boundary sliding is the main deformation mechanism for low-temperature superplastic deformation.

Abstract Textile wastewater is among the most polluted types of industrial waste. Wastewater treatment in the textile industry is notoriously difficult because of the use of complex chemicals and dyes in the textile production steps, and conventional methods are not enough to treat these. Textile wastewater, known for its high pollution levels, poses challenges for treatment due to complex chemicals and dyes. A comparative study was conducted on simple ozonation and catalytic ozonation (CO) using alum to degrade methylene blue (MB). The authors analyzed various factors like time, pH, catalyst loading and ozone dosages during the study. Results showed that catalytic activity in ozonation depends on pH and ozone flow. The maximum MB elimination was achieved at pH 6.6 and 200 V ozone flow. Scanning electron microscopy (SEM) was used to characterize the surface morphology of the catalyst, Fourier transform infrared spectroscopy (FTIR) was used to identify the important functional groups, and energy dispersive X-ray spectroscopy (EDS) was used to characterize the catalyst's elemental composition. Compared to simple ozonation, CO showed higher removal in the initial phase. Real textile wastewater analysis confirmed the effectiveness of alum catalysts in achieving significant removal of MB (87%) through this novel cost-efficient process. Graphical Abstract

Abstract Solanaceous plants produce tropane alkaloids (TAs) via esterification of 3α- and 3β-tropanol. Although littorine synthase is revealed to be responsible for 3α-tropanol esterification that leads to hyoscyamine biosynthesis, the genes associated with 3β-tropanol esterification are unknown. Here, we report that a BAHD acyltransferase from Atropa belladonna, 3β-tigloyloxytropane synthase (TS), catalyzes 3β-tropanol and tigloyl-CoA to form 3β-tigloyloxytropane, the key intermediate in calystegine biosynthesis and a potential drug for treating neurodegenerative disease. Unlike other cytosolic-localized BAHD acyltransferases, TS is localized to mitochondria. The catalytic mechanism of TS is revealed through molecular docking and site-directed mutagenesis. Subsequently, 3β-tigloyloxytropane is synthesized in tobacco. A bacterial CoA ligase (PcICS) is found to synthesize tigloyl-CoA, an acyl donor for 3β-tigloyloxytropane biosynthesis. By expressing TS mutant and PcICS, engineered Escherichia coli synthesizes 3β-tigloyloxytropane from tiglic acid and 3β-tropanol. This study helps to characterize the enzymology and chemodiversity of TAs and provides an approach for producing 3β-tigloyloxytropane.

Abstract Background The treatment of lung adenocarcinoma is difficult due to the limited therapeutic options. Cancer-associated fibroblasts play an important role in the development of cancers. This study aimed to identify a promising molecular target associated with cancer-associated fibroblasts for the treatment of lung adenocarcinoma. Methods The Cancer Genome Atlas lung adenocarcinoma dataset was used to screen hub genes associated with cancer-associated fibroblasts via the EPIC algorithm and Weighted Gene Co-expression Network Analysis. Multiple databases were used together with our data to verify the differential expression and survival of COL11A1. Functional enrichment analysis and the single-cell TISCH database were used to elucidate the mechanisms underlying COL11A1 expression. The correlation between COL11A1 and immune checkpoint genes in human cancers was also evaluated. Results Using the EPIC algorithm and Weighted Gene Co-expression Network Analysis, 13 hub genes associated with cancer-associated fibroblasts in lung adenocarcinoma were screened. Using the GEPIA database, Kaplan-Meier Plotter database, GSE72094, GSE75037, GSE32863, and our immunohistochemistry experiment data, we confirmed that COL11A1 overexpresses in lung adenocarcinoma and that high expression of COL11A1 is associated with a poor prognosis. COL11A1 has a genetic alteration frequency of 22% in patients with lung adenocarcinoma. COL11A1 is involved in the extracellular matrix activities of lung adenocarcinoma. Using the TISCH database, we found that COL11A1 is mainly expressed by cancer-associated fibroblasts in the tumor microenvironment rather than by lung adenocarcinoma cells. Finally, we found that COL11A1 is positively correlated with HAVCR2(TIM3), CD274 (PD-L1), CTLA4, and LAG3 in lung adenocarcinoma. Conclusion COL11A1 may be expressed and secreted by cancer-associated fibroblasts, and a high expression of COL11A1 may result in T cell exhaustion in the tumor microenvironment of lung adenocarcinoma. COL11A1 may serve as an attractive biomarker to provide new insights into cancer therapeutics.

Objective To understand the impact of chronic disease comorbidity on healthcare institution-seeking behavior of elderly people in China, and to provide a theoretical basis for optimizing healthcare order and enhancing the management capacity of primary care for chronic diseases. MethodsThe data on 4 508 elderly people aged ≥ 60 years in 25 provincial-level administrative divisions across China were collected from the China Family Panel Studies (CFPS) conducted in 2020. The Stata 17.0 statistical software was used to analyze the impact of chronic disease comorbidity on healthcare facility-seeking behavior of elderly people in China using the probit regression model and the propensity score matching (PSM) method. ResultsOf the 4 508 elderly people surveyed, 748 (16.59%) reported having chronic disease comorbidity (suffering from two or more chronic diseases); 2 536 (56.26%) and 1 972 (43.74%) reported seeking medical treatment at primary and non-primary healthcare institutions during past six months. After adjusting for predisposing factors (gender, age, education level, marital status), enabling factors (household registration type, monthly retirement pension, satisfaction with medical treatment, participation in medical insurance, emotional relationship with children, financial support from children, caregiving provided by children), and need factors (self-rated health status, changes in health conditions, physical discomfort in the past two weeks, the ability to take care of oneself), the results of probit regression analysis showed that the elderly people with comorbid chronic diseases were more inclined to seek medical treatment at non-primary healthcare institutions (β = – 0.130, 95% confidence interval: – 0.237 – – 0.022). The estimated values of average treatment effect on the treated (ATT) of chronic disease comorbidity on the healthcare institution selection of the elderly people were – 0.052, – 0.048, and – 0.047, respectively, based on matched propensity scores of predisposing, enabling, and need factors with K-nearest neighbor, kernel, and radius matching (all P < 0.05), indicating that chronic disease comorbidity can reduce the probability of elderly people seeking medical treatment at primary healthcare institutions. The heterogeneity test results showed that the impact of chronic disease comorbidity on females (ATT = – 0.078 – – 0.063, all P < 0.05) and the elderly people with a junior high school education or below (ATT = – 0.058 – – 0.052, all P < 0.05) was more significant, but there was no statistically significant difference in the impact on males and elderly people with a high school education or above (all P > 0.05). ConclusionChronic disease comorbidity may affect the selection of medical institutions for elderly people in China to some extent, and its influence differs by gender and education level of the elderly.

Abstract In the era of 5G, billions of terminal devices achieve global interconnection and intercommunication, which leads to the generation of massive data. However, the existing cloud‐based data‐sharing mechanism faces challenges such as sensitive information leakage and data islands, which makes it difficult to achieve secure sharing across domains. In this paper, the authors propose a fine‐grained data‐sharing scheme based on blockchain and ciphertext policy attribute‐based encryption, and design a verifiable outsourced computation method to reduce the computational pressure of end users. Second, the authors comprehensively consider the user's identity privacy and transaction privacy, and propose a multi‐level privacy protection method based on ring signature and garbled bloom filter, which enhance the user's data privacy and availability, and prevent the traceability of requests. Finally, the authors design a set of interconnected smart contracts, and verify that their scheme can achieve secure and efficient data sharing through security analysis and performance testing.

Abstract Background Quitting support from smokers’ partners can predict quit attempts and smoking abstinence but research on factors that predict such support has been limited. To add more evidence for partner support and the improved interventions for smoking cessation, we analyzed some new potential predictors of quitting support from smokers’ spouses. Method This cross-sectional study was conducted in in 2022 and 2023, selecting the students’ families in which fathers smoked and mothers didn’t smoke from grade 1–5 of 13 primary schools in Qingdao, China. Parents who met the criteria completed the online questionnaires and 1018 families were included in the analysis. We measured personal information related to smokers and their spouses such as age, education and nicotine dependence, and variables related to family and marital relationship such as family functioning, perceived responsiveness and power in decision-making of quitting smoking. Quitting support from smokers’ spouses was measured by Partner Interaction Questionnaire and generalized linear model was used to explore the potential predictors of partner support. Results In this study, the mean age of smokers was 39.97(SD = 5.57) and the mean age of smokers’ spouses was 38.24(SD = 4.59). The regression analysis showed that for smokers and their spouses, the older age groups showed the lower ratio of positive/negative support(P

AbstractFor over 50 years, the Xianyang city on the Chinese loess plateau, has been deeply affected by land subsidence and its associated ground fissures. In this study, 67 Sentinel-1A images from 2015 to 2022 were analysed to obtain the spatio-temporal evolution of land subsidence. Subsidence centers identified in Yunyang town and Luqiao town exhibit annual subsidence rates of −31 mm/a and −26.7 mm/a, respectively, culminating in total subsidence of −258 mm in Yunyang town and −139 mm in Luqiao town. Moreover, time series analysis revealed that both towns exhibit pronounced seasonal subsidence patterns. It is believed that human cultivation and groundwater overuse, combined with the effects of active faults, have led to uneven land subsidence. Then, the gradient of land subsidence and its potential relation to ground fissure hazards were evaluated. The results highlight a strong spatial correlation between high subsidence gradient areas and dense ground fissure distribution. Therefore, we proposed for the first time to introduce the land subsidence gradient factors for the susceptibility mapping of ground fissures using the artificial neural network algorithm. The susceptibility zonation results show that integrating the gradient factor can improve the rationality of the susceptibility evaluation. The above understanding provides valuable support for disaster prevention and mitigation in urban areas affected by land subsidence and ground fissures in loess regions.

Smog has emerged as a pressing environmental issue in Lahore, Pakistan, exacerbating health problems and threatening agricultural productivity. This is comprehensively examined, the mechanisms contributing to smog formation in Lahore, highlighting the interplay of industrial emissions, vehicular pollution, crop residue burning, and atmospheric conditions. The review further explores the multifaceted impacts of smog on agriculture, highlighting decreased crop yields, soil degradation, and adverse effects on agricultural workers' health and productivity. Moreover, the health ramifications of prolonged exposure to smog are delineated, encompassing respiratory illnesses, cardiovascular diseases, and exacerbation of pre-existing conditions, particularly affecting vulnerable populations. The study consolidates current research findings and identifies knowledge gaps, emphasizing the need for interdisciplinary approaches to tackle the smog crisis effectively. Strategies for mitigating smog pollution are discussed, encompassing policy interventions, technological innovations, and public awareness campaigns. By providing a comprehensive overview of the complexities surrounding smog formation, agricultural repercussions, and public health implications, these findings underscore the urgency of adopting sustainable practices and implementing stringent regulations to combat smog pollution in Pakistan.

BackgroundExercise is recognized for its broad health benefits, influencing various physiological processes, including the behavior of adipose tissue macrophages (ATMs). While existing studies mainly associate ATM activity with obesity and metabolic syndrome, our study explores the impact of aerobic exercise on ATM microRNA expression profiling in a non-obese context, highlighting its general health-promoting mechanisms.MethodsSixty male C57BL/6 mice were randomly assigned to either a sedentary (S) or an exercise (E) group. The S group remained inactive, while the E group underwent a one-week treadmill adaptation, followed by an 8-week aerobic treadmill exercise protocol (60 min/day, 5 days/week, at 65%-75% VO2max). Post-training, glucose tolerance and the serum lipid levels were measured in mice subjected to both exercise and non-exercise conditions. ATMs harvested from visceral adipose tissues were analyzed and sorted using flow cytometer. To further investigate the effects of exercise in ATMs at the molecular level, miRNA microarray analysis was performed, followed by bioinformatic analysis.ResultsThe 8-week regimen of moderate-intensity aerobic exercise ameliorated glucolipid metabolism and fostered a dynamic shift toward an M2 macrophage phenotype in the adipose tissue, independent of obesity. A total of 62 differentially expressed miRNAs were identified in ATMs of mice post-exercise. Notably, six miRNAs (miR-212-5p, miR-511-5p, miR-7b-5p, miR-142-3p, miR-1894-3p, and miR-31-5p) as well as their target gene were consistently altered and associated with macrophage polarization and metabolic regulation.ConclusionOur findings broaden the understanding of how exercise regulates ATM functions through significant changes in microRNA profiles, emphasizing its potential to enhance health and prevent chronic conditions. This study supports the application of aerobic exercise for its preventive effects on chronic diseases and underscores the importance of microRNA profiling in understanding the immune-modulatory impacts of exercise.