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Abstract Purpose To compare clinical outcomes of transjugular intrahepatic portosystemic shunt (TIPS) created with the single covered-uncovered stent (Viatorr TIPS Endoprosthesis) versus covered stent (Fluency) versus a combination of covered and uncovered stent. Materials and methods From May 2016 and July 2019, a total of 180 liver cirrhosis patients with recurrent variceal bleeding underwent TIPS creation with single covered-uncovered stent (n = 63) or covered stent (n = 41) or a covered and uncovered stent combination (n = 76). Shunt dysfunction, rebleeding, overt hepatic encephalopathy and mortality was estimated using the Kaplan–Meier method and compared with the log-rank test. Results The difference of baseline characteristics among these three groups were not significant. The included patients had a median age of 51 years (IQR 43–61), and 101 (56.1%) were men. The 1-year and 2-year shunt dysfunction rates were 1.6% and 3.2% in the single covered-uncovered stent group, 7.3% and 7.3% in the covered stent group and 5.3% and 6.6% in the combination group, respectively. There was no significant difference among groups [Hazard Ratio (HR) (95%CI): 1 vs 2.29 (0.38 − 13.72) vs 2.10 (0.41 − 10.83); P = 0.913]. No significant differences in the incidence of all-cause rebleeding were observed between the groups at 1 year (Viatorr vs Fluency vs combination: 11.1% vs 17.1% vs 10.5%) as well as 2 years (15.9% vs 17.1% vs 11.8%), with the HR (95%CI) being 1 vs 1.27 (0.5—3.21) vs 0.74 (0.30–1.82); P = 0.475). The 1-year and 2-year incidence of overt hepatic encephalopathy were 30.2% and 30.2% in the single covered-uncovered stent group, 22.0% and 22.0% in the covered stent group and 25.0% and 25.0% in the combination group, respectively. However, there was no significant difference among these three groups (P = 0.402). In addition, there was no significant difference in the 1-year and 2-year mortality (6.3% and 7.9% vs. 4.9% and 9.8% vs. 6.6% and 9.2%, P = 0.606). Conclusion No significant difference was observed among different stent groups. Fluency covered stent and the generic bare stent/Fluency covered stent was not an unreasonable alternative to the Viatorr stent for TIPS creation.

Abstract Aortic valve replacement (AVR) leads to reverse cardiac remodeling in patients with aortic stenosis (AS). The aim of this secondary pooled analysis was to assess the degree and determinants of changes in myocardial perfusion post AVR, and its link with exercise capacity, in patients with severe AS. A total of 68 patients underwent same-day echocardiography and cardiac magnetic resonance imaging with adenosine stress pre and 6–12 months post-AVR. Of these, 50 had matched perfusion data available (age 67 ± 8 years, 86% male, aortic valve peak velocity 4.38 ± 0.63 m/s, aortic valve area index 0.45 ± 0.13cm2/m2). A subgroup of 34 patients underwent a symptom-limited cardiopulmonary exercise test (CPET) to assess maximal exercise capacity (peak VO2). Baseline and post-AVR parameters were compared and linear regression was used to determine associations between baseline variables and change in myocardial perfusion and exercise capacity. Following AVR, stress myocardial blood flow (MBF) increased from 1.56 ± 0.52 mL/min/g to 1.80 ± 0.62 mL/min/g (p

Abstract Deep neural networks can improve the quality of fluorescence microscopy images. Previous methods, based on Convolutional Neural Networks (CNNs), require time-consuming training of individual models for each experiment, impairing their applicability and generalization. In this study, we propose a novel imaging-transformer based model, Convolutional Neural Network Transformer (CNNT), that outperforms CNN based networks for image denoising. We train a general CNNT based backbone model from pairwise high-low Signal-to-Noise Ratio (SNR) image volumes, gathered from a single type of fluorescence microscope, an instant Structured Illumination Microscope. Fast adaptation to new microscopes is achieved by fine-tuning the backbone on only 5–10 image volume pairs per new experiment. Results show that the CNNT backbone and fine-tuning scheme significantly reduces training time and improves image quality, outperforming models trained using only CNNs such as 3D-RCAN and Noise2Fast. We show three examples of efficacy of this approach in wide-field, two-photon, and confocal fluorescence microscopy.

Abstract Aims Surveys and research on the applications of the hepatic venous pressure gradient (HVPG) are important for understanding the current status and future development of this technology in China. This article aimed to investigate the status of hepatic venous pressure gradient measurement in China in 2022. Methods We investigated the overall status of HVPG technology in China—including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications, and current challenges by using online questionnaire. By counting the number and percentages of cases of these results, we hope to clarify the current status of HVPG measurements in China. Results According to the survey, 85 hospitals in China used HVPG technology in 2022 distributed across 29 provinces. A total of 4989 HVPG measurements were performed in all of the surveyed hospitals in 2022, of which 2813 cases (56.4%) were measured alone. The average cost of HVPG measurement was 5646.8 ± 2327.9 CNY. Of the clinical teams who performed the measurements (sometimes multiple per hospital), 94.3% (82/87) used the balloon method, and the majority of the teams (72.4%, 63/87) used embolectomy catheters. Conclusions This survey clarified the clinical application status of HVPG in China and confirmed that some medical institutions in China have established a foundation for this technology. It is still necessary to continue promoting and popularizing this technology in the future.

Abstract Background Pulmonary transit time (PTT) can be measured automatically from arterial input function (AIF) images of dual sequence first-pass perfusion imaging. PTT has been validated against invasive cardiac catheterisation correlating with both cardiac output and left ventricular filling pressure (both important prognostic markers in heart failure). We hypothesized that prolonged PTT is associated with clinical outcomes in patients with heart failure. Methods We recruited outpatients with a recent diagnosis of non-ischaemic heart failure with left ventricular ejection fraction (LVEF)

Abstract Background Adverse drug events (ADEs) represent challenges affecting Africa’s healthcare systems owing to the increased healthcare expenditure and negative health outcomes of ADEs. Objectives We aimed to systematically review published studies on ADEs and synthesize the existing evidence of ADE prevalence in Africa. Methods Studies reporting on ADE occurrence in African settings and published from Jan 1, 2000 to Oct 1, 2023 were identified by searching PubMed, EBSCO, Science Direct, and Web of Science. Studies that either articulately investigated ADEs caused by clinical condition (such as HIV patients) or ADEs caused by exposure to specific drug(s) (such as antibiotics) were considered specific and the remaining were general. Grouped ADE prevalence rates were described using median and interquartile range (IQR). PROSPERO registration (CRD42022374095). Results We included 78 observational studies from 15 African countries that investigated the prevalence of ADEs leading to hospital admissions (17 studies), developed during hospitalizations (30 studies), and captured in the outpatient departments (38 studies) or communities (4 studies). Twelve studies included multiple settings. The median prevalence of ADE during hospitalization was 7.8% (IQR: 4.2–21.4%) and 74.2% (IQR: 54.1–90.7%) in general and specific patients, respectively. The ADE-related fatality rate was 0.1% and 1.3% in general and specific patients. The overall median prevalence of ADEs leading to hospital admissions was 6.0% (IQR: 1.5–9.0%); in general, patients and the median prevalence of ADEs in the outpatient and community settings were 22.9% (IQR: 14.6–56.1%) and 32.6% (IQR: 26.0–41.3%), respectively, with a median of 43.5% (IQR: 16.3–59.0%) and 12.4% (IQR: 7.1–28.1%) of ADEs being preventable in general and specific patients, respectively. Conclusions The prevalence of ADEs was significant in both hospital and community settings in Africa. A high ADE prevalence was observed in specific patients, emphasizing important areas for improvement, particularly in at-risk patient groups (e.g., pediatrics, HIV, and TB patients) in various settings. Due to limited studies conducted in the community setting, future research in this setting is encouraged.

The consumption value seems to be insufficient to explain consumers' domestic electric vehicle purchase behaviour, especially in a highly competitive global environment. This study aims to investigate how consumer ethnocentrism and perceived interactivity influence consumption value and pro-environmental value, subsequently affecting attitude and intention. A total of 353 valid questionnaires were collected through convenience sampling in Xuzhou, China, and the partial least square (PLS) path modelling approach was performed to test the hypotheses. The results show that consumer ethnocentrism and perceived interactivity positively influence function value, emotional value, and social value; perceived interactivity also positively influences altruistic value, biospheric value, and collectivistic value. Function value, social value, and collectivistic value positively influence attitude; however, emotional value, altruistic value and biospheric value did not find a correlation with attitude. Furthermore, attitude positively influences intention to adopt domestic electric vehicles. Finally, the theoretical and practical implications, as well as limitations were discussed accordingly.

Abstract Schizophrenia, a multifaceted mental disorder characterized by disturbances in thought, perception, and emotion, has been extensively investigated through resting-state fMRI, uncovering changes in spontaneous brain activity among those affected. However, a bibliometric examination regarding publication trends in resting-state fMRI studies related to schizophrenia is lacking. This study obtained relevant publications from the Web of Science Core Collection spanning the period from 1998 to 2022. Data extracted from these publications included information on countries/regions, institutions, authors, journals, and keywords. The collected data underwent analysis and visualization using VOSviewer software. The primary analyses included examination of international and institutional collaborations, authorship patterns, co-citation analyses of authors and journals, as well as exploration of keyword co-occurrence and temporal trend networks. A total of 859 publications were retrieved, indicating an overall growth trend from 1998 to 2022. China and the United States emerged as the leading contributors in both publication outputs and citations, with Central South University and the University of New Mexico being identified as the most productive institutions. Vince D. Calhoun had the highest number of publications and citation counts, while Karl J. Friston was recognized as the most influential author based on co-citations. Key journals such as Neuroimage, Schizophrenia Research, Schizophrenia Bulletin, and Biological Psychiatry played pivotal roles in advancing this field. Recent popular keywords included support vector machine, antipsychotic medication, transcranial magnetic stimulation, and related terms. This study systematically synthesizes the historical development, current status, and future trends in resting-state fMRI research in schizophrenia, offering valuable insights for future research directions.

ABSTRACTSevere fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease with an increasing annual incidence rate. In this case report, we presented two patients infected with the SFTS virus, suggesting a potential direct transmission route from camels to humans through blood contact. Both patients developed symptoms after engaging in the slaughtering of one sick camel, while their family members living in the same environment or co-diners remained unaffected. Subsequent detection revealed a high viral load of SFTS virus, reaching 1010 viral RNA copies/ml, in the sample obtained from the sick camel. Metagenomic sequencing did not identify any other pathogens. The SFTS virus was successfully isolated from both patient and camel samples. The complete nucleotide sequences obtained from the infected patients demonstrated a remarkable 100% similarity to those found in the camel, and genetic evolution analysis classified the virus as genotype A. Additionally, partial sequences of the SFTS virus were identified in ticks captured from the camel rearing environment, however, these sequences showed only 95.9% similarity to those found in camel and humans. Furthermore, immunoglobulin M and immunoglobulin G antibodies were detected in serum samples collected from the patient. Our findings provide evidence that camel may serve as a competent reservoir for transmitting the SFTS virus to humans. Further in vitro investigations into SFTS virus infections in large animals are warranted to understand their role in viral maintenance and transmission.

Major depressive disorder (MDD) is a debilitating mental health condition that poses significant risks and burdens. Resting-state functional magnetic resonance imaging (fMRI) has emerged as a promising tool in investigating the neural mechanisms underlying MDD. However, a comprehensive bibliometric analysis of resting-state fMRI in MDD is currently lacking. Here, we aimed to thoroughly explore the trends and frontiers of resting-state fMRI in MDD research. The relevant publications were retrieved from the Web of Science database for the period between 1998 and 2022, and the CiteSpace software was employed to identify the influence of authors, institutions, countries/regions, and the latest research trends. A total of 1501 publications met the search criteria, revealing a gradual increase in the number of annual publications over the years. China contributed the largest publication output, accounting for the highest percentage among all countries. Particularly, the University of Electronic Science and Technology of China, Capital Medical University, and Harvard Medical School were identified as key institutions that have made substantial contributions to this growth. Neuroimage, Biological Psychiatry, Journal of Affective Disorders, and Proceedings of the National Academy of Sciences of the United States of America are among the influential journals in the field of resting-state fMRI research in MDD. Burst keywords analysis suggest the emerging research frontiers in this field are characterized by prominent keywords such as dynamic functional connectivity, cognitive control network, transcranial brain stimulation, and childhood trauma. Overall, our study provides a systematic overview into the historical development, current status, and future trends of resting-state fMRI in MDD, thus offering a useful guide for researchers to plan their future research.

Objectives The efficacy of transjugular intrahepatic portosystemic shunt (TIPS) plus extrahepatic collateral embolisation (TIPS+E) in reducing rebleeding and hepatic encephalopathy (HE) post-TIPS was recently reported in a meta-analysis, but further validation is essential. This study aims to confirm the effectiveness of TIPS+E using real-world data.Methods The multicentre retrospective cohort included 2077 patients with cirrhosis who underwent TIPS±E (TIPS: 631, TIPS+E: 1446) between January 2010 and December 2022. Regression and propensity score matching (PSM) were used to adjust for baseline characteristic differences. After PSM, clinical outcomes, including rebleeding, HE, survival and further decompensation (FDC), were analysed. Baseline data from all patients contributed to the construction of prognostic models.Results After PSM, 1136 matched patients (TIPS+E: TIPS=568:568) were included. TIPS+E demonstrated a significant reduction in rebleeding (HR 0.77; 95% CI 0.59 to 0.99; p=0.04), HE (HR 0.82; 95% CI 0.68 to 0.99; p=0.04) and FDC (HR 0.85; 95% CI 0.73 to 0.99; p=0.04), comparing to TIPS. Significantly, TIPS+E also reduced rebleeding, HE and FDC in subgroup of using 8 mm diameter stents and embolising of gastric varices+spontaneous portosystemic shunts (GV+SPSS). However, there were no differences in overall or subgroup survival analysis. Additionally, the random forest models showed higher accuracy and AUROC comparing to other models. Controlling post-TIPS portal pressure gradient (pPPG) within 7 mm Hg

Black ginseng as the functional food, has been used to improve obesity and insulin resistance. However, the underlying mechanism remains unclear. We found that Black ginseng extract (BGS) significantly ameliorated diet-induced obesity and insulin resistance in mice. The components eluted by 70% and 95% ethanol from BGS by using polystyrene resin (BGS/70) had superior anti-obesity effects when compared with other fractions. It significantly decreased the abundance of bile salt hydrolase (BSH)-producing genera and increased serum taurine-bound bile acids in obese mice. BGS/70 administration-related metabolic improvements in obese mice was lost in TGR5 gut-specific knockout mice and antibiotic mixture (ABX)-cleared enterobacteria mice. Fecal microbiota transplantation (FMT) experiments demonstrated that the anti-obesity effects of BGS/70 were mediated by gut flora. Taken together, our results suggest that BGS can treat obesity via gut microbiota and the activation of TGR5. Thus, BGS may be a promising therapy for obesity.

Abstract Hyperuricemia (HUA) is a metabolic disease caused by excessive uric acid in patients. Flavonoids have attracted extensive attention due to their safety, effectiveness, and little side effects in the treatment of HUA and inhibition of xanthine oxidase (XO) activity. In this paper, the studies on the treatment of HUA and the inhibition of XO activity by flavonoids (including flavones, flavonols, flavanones, flavanols, isoflavonoids, anthocyanins, and chalcones) were comprehensively reviewed from the aspects of structure–activity relationship and animal experiments. Results showed that hydrogen bonds and hydrophobic interactions were the two most important forces involved in the interaction between flavonoids and XO. Flavonoids could combine with the hydrophobic cavity of XO to cause changes in XO structure and influence the action of enzyme and substrate, thereby decreasing the catalytic activity of XO. Moreover, flavonoids undergo a series of metabolic reactions in the organism, which plays a role in alleviating HUA by affecting the expression of related genes and proteins (e.g., glucose transporter 9, urate transporter 1, and organic anion transporter 1) in the kidneys, liver, and intestinal tract of the organism and changing the internal environment in organs. In addition, this paper provides new perspectives on the shortcomings of the current research, to promote the in‐depth development and application of flavonoids.

Abstract Neuroimaging studies have revealed that patients with schizophrenia exhibit disrupted resting-state functional connectivity. However, the inconsistent findings across these studies have hindered our comprehensive understanding of the functional connectivity changes associated with schizophrenia, and the molecular mechanisms associated with these alterations remain largely unclear. A quantitative meta-analysis was first conducted on 21 datasets, involving 1057 patients and 1186 healthy controls, to examine disrupted resting-state functional connectivity in schizophrenia, as measured by whole-brain voxel-wise functional network centrality (FNC). Subsequently, partial least squares regression analysis was employed to investigate the relationship between FNC changes and gene expression profiles obtained from the Allen Human Brain Atlas database. Finally, gene enrichment analysis was performed to unveil the biological significance of the altered FNC-related genes. Compared with healthy controls, patients with schizophrenia show consistently increased FNC in the right inferior parietal cortex extending to the supramarginal gyrus, angular gyrus, bilateral medial prefrontal cortex, and right dorsolateral prefrontal cortex, while decreased FNC in the bilateral insula, bilateral postcentral gyrus, and right inferior temporal gyrus. Meta-regression analysis revealed that increased FNC in the right inferior parietal cortex was positively correlated with clinical score. In addition, these observed functional connectivity changes were found to be spatially associated with the brain-wide expression of specific genes, which were enriched in diverse biological pathways and cell types. These findings highlight the aberrant functional connectivity observed in schizophrenia and its potential molecular underpinnings, providing valuable insights into the neuropathology of dysconnectivity associated with this disorder.

Abstract Background Myocardial bridges are congenital coronary artery anomalies. There are still many controversies surrounding surgical treatment strategies for myocardial bridges combined with other heart disorders. The purpose of this study was to evaluate the surgical treatment strategies and outcomes in patients with these conditions. Methods Between March 2004 and October 2021, our institution witnessed 77 patients diagnosed with myocardial bridging who underwent surgical intervention. According to the myocardial bridge and combined heart disorder, four groups were identified: 1. isolated LAD supra-arterial myotomy group, 2. LAD CABG and(or not) myotomy group, 3. LAD supra-arterial myotomy and grafting of other branches group, and 4. LAD supra-arterial myotomy and other cardiac surgery group. The perioperative outcomes, symptoms, life quality, mortality, and major adverse cardiac events (MACEs) were analyzed. Results There were no deaths during hospitalization and no rethoractomy for postoperative bleeding or major adverse cardiac events (MACEs). The follow-up period ranged from 2 months to 199.2 months (55.61 ± 10.21) months, the 10-year cumulative survival rates for the four groups of patients were 95.0%, 100%, 100% and 74.1%, and the 10-year freedom rates from the MACEs were 83.9%, 92.0%, 87.5% and 76.2%, respectively. Conclusions Supra-arterial myotomy is preferred in patients with isolated myocardial bridge, and acceptable results can be achieved by choosing supra-arterial myotomy in combination with CABG or other cardiac surgery simultaneously for patients with myocardial bridges and other heart disorders.

Pt-based hybrid materials are demonstrated to be the most effective catalysts for alkaline hydrogen evolution reactions (HER) due to the synergy effect of heterogeneous interfaces. However, the heterogeneous interfaces are often constructed at the sacrifice of the electrochemical active surface area to cause relatively lower HER activity than expected. Herein, a permeable Ni(OH)2 layer and strained Pt atoms heterogeneous interface with enhanced electrocatalytic activity and minimal loss of active surface sites have been created by using an in-situ electrochemical self-reconstruction strategy. The permeable Ni(OH)2 layer promotes H2O dissociation without blocking proton contact with the active Pt sites. This unique design creates a favorable local acid-like environment that results in an ultra-high mass activity of 17.8 A mgPt−1 at an overpotential of 70 mV, which is 20.5 times superior to that of the commercial Pt/C catalyst and higher than those of the previously reported Pt-based catalysts. Meanwhile, the HER overpotential displays as low as 15 mV at 10 mA cm−2, showing superior HER efficiency and representing one of the optimal Pt-based HER catalysts in alkaline solution. In-situ Raman spectroscopy and DFT calculations prove that the interfacial synergistic interaction between permeable Ni(OH)2 layer and strained Pt atoms can significantly promote the H2O dissociation and the H2 formation. This electrochemical self-reconstruction method provides an effective and facile strategy for optimizing the electronic structure, electrocatalytic activity, and mass activity of active Pt atoms to develop efficient Pt-based heterostructure electrocatalysts.

Paederia foetida L. leaf (PFL) is recognized for its uric acid-lowering. However, the key compounds and their mechanisms of countering hyperuricemia remain unclear. In this study, bioaffinity ultrafiltration in combination with UPLC-ESI-QTrap-MS/MS was used to screen and identify potential xanthine oxidase (XO) inhibitors in the purified PFL extract, and the possible mechanisms of their interaction were investigated by molecular docking. The experimental results showed that the purified PFL extract exhibited excellent antioxidant and anti-XO effect. Further the results of enzyme inhibition experiments in vitro showed that luteolin-7-O-glucoside (IC50 = 61.41 μg/mL), astragalin (IC50 = 114.89 μg/mL), quercitrin (IC50 = 124.50 μg/mL), dihydromyricetin (IC50 = 296.32 μg/mL), cyanidin-3-O-rutinoside (IC50 = 373.82 μg/mL), kaempferol-3-O-rutinoside (IC50 = 450.10 μg/mL) and (-)-epigallocatechin (IC50 = 610.48 μg/mL) in purified PFL extract were the major contributors to the XO inhibitory activity, and confirmed this finding. Molecular docking revealed these inhibitors interact with critical XO residues through hydrogen bonding, hydrophobic, and electrostatic interactions, highlighting flavonoids in purified PFL extract as potent XO inhibitors. This work provides insight into flavonoids in the purified PFL extract as potent XO inhibitors.

It has been revealed that abnormal voxel-mirrored homotopic connectivity (VMHC) is present in patients with schizophrenia, yet there are inconsistencies in the relevant findings. Moreover, little is known about their association with brain gene expression profiles. In this study, transcription-neuroimaging association analyses using gene expression data from Allen Human Brain Atlas and case-control VMHC differences from both the discovery (meta-analysis, including 9 studies with a total of 386 patients and 357 controls) and replication (separate group-level comparisons within two datasets, including a total of 258 patients and 287 controls) phases were performed to identify genes associated with VMHC alterations. Enrichment analyses were conducted to characterize the biological functions and specific expression of identified genes, and Neurosynth decoding analysis was performed to examine the correlation between cognitive-related processes and VMHC alterations in schizophrenia. In the discovery and replication phases, patients with schizophrenia exhibited consistent VMHC changes compared to controls, which were correlated with a series of cognitive-related processes; meta-regression analysis revealed that illness duration was negatively correlated with VMHC abnormalities in the cerebellum and postcentral/precentral gyrus. The abnormal VMHC patterns were stably correlated with 1287 genes enriched for fundamental biological processes like regulation of cell communication, nervous system development, and cell communication. In addition, these genes were overexpressed in astrocytes and immune cells, enriched in extensive cortical regions and wide developmental time windows. The present findings may contribute to a more comprehensive understanding of the molecular mechanisms underlying VMHC alterations in patients with schizophrenia.

Maritime training can improve safety by equipping seafarers with the knowledge and skills to manage risk. However, designing a quality training program can be challenging and stress can negatively impact performance and safety. To address this, the present study aims to investigate the relationship between stress and training outcomes, with the goal of developing more effective stress-based training systems. Two stressful scenarios were designed with varying safety factors involved during navigation tasks. The study examines the impact of stress levels on training outcomes and performance based on safety factors and the correlation between self-assessed stress levels and objective stress levels obtained from biosignal data. The study was conducted in a simulated bridge environment in Tromsø, Norway, and analyzed using statistical tests and machine learning models. The findings of this study indicate that training scenarios can be classified by stress levels, which were found to be associated with reduced visibility, equipment failures, and severe weather conditions. Additionally, the study revealed that stress levels can negatively impact performance in maritime navigation and sailing route reliability. These findings provide insights into how to improve the quality and effectiveness of maritime training programs and ultimately enhance safety at sea.

Abstract Aim This study aims to develop and validate a clinical nutrition risk screening tool to predict nutrition risk in home for the patients with gastric cancer after surgery at home so that high‐risk patients can be targeted for preventive nutrition care. Design The development of self‐screening tool for nutrition risk in patients with gastric cancer after gastrectomy (SNRSGC) through literature review, expert panel ratings and cognitive interview; the validation of SNRSGC is evaluated through prospective research on participants. Methods This research is divided into four parts: Step 1, Identification of a potential referred nutritional risk screening; Step 2, Item generation and scoring are selected through literature review methods to screen sensitive indicators which can reflect the nutritional characteristics of patients after gastric cancer surgery, establish the frame and update according to the latest guidelines; Step 3, Item reduction is determined by the rating of SNRSGC items by an expert panel and cognitive interview; Step 4, During the validation stage, we conducted research design based on the Consensus‐based Standards for the selection of health Measurement Instruments checklist to evaluate the validity, reliability, interpretability and acceptability of SNRSGC. Results SNRSGC is the first screening tool specifically to predict nutrition risk for stay‐at‐home postoperative patients with gastric cancer, which can help patients at home detect nutritional risks at home in time and guide patients to seek medical treatment as soon as possible to improve their nutritional status.

Abstract The oriental armyworm, Mythimna separata, is an extremely destructive polyphagous pest with a broad host range that seriously threatens the safety of agricultural production. Here, a high-quality chromosome-level genome was assembled using Illumina, PacBio HiFi long sequencing, and Hi-C scaffolding technologies. The genome size was 706.30 Mb with a contig N50 of 22.08 Mb, and 99.2% of the assembled sequences were anchored to 31 chromosomes. In addition, 20,375 protein-coding genes and 258.68 Mb transposable elements were identified. The chromosome-level genome assembly of M. separata provides a significant genetic resource for future studies of this insect and contributes to the development of management strategies.

Abstract Left ventricular fibrosis can be identified by late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) in some veteran athletes. We aimed to investigate prevalence of ventricular fibrosis in veteran athletes and associations with cardiac arrhythmia. 50 asymptomatic male endurance athletes were recruited. They underwent CMR imaging including volumetric analysis, bright blood (BB) and dark blood (DB) LGE, motion corrected (MOCO) quantitative stress and rest perfusion and T1/T2/extracellular volume mapping. Athletes underwent 12-lead electrocardiogram (ECG) and 24-h ECG. Myocardial fibrosis was identified in 24/50 (48%) athletes. All fibrosis was mid-myocardial in the basal-lateral left ventricular wall. Blood pressure was reduced in athletes without fibrosis compared to controls, but not athletes with fibrosis. Fibrotic areas had longer T2 time (44 ± 4 vs. 40 ± 2 ms, p

Abstract To compare outcomes after oblique lateral interbody fusion (OLIF) versus minimally invasive transforaminal lumbar interbody fusion (MISTLIF) with bilateral decompression via unilateral approach for treating mild to moderate symptomatic degenerative lumbar spinal stenosis (DLSS). We retrospectively compared patients who underwent single-level (L4/5) OLIF with an age-, sex-, and segment-matched MISTLIF with bilateral decompression via unilateral approach cohort. Perioperative data were collected for the operative time, intraoperative blood loss, drainage in the first postoperative day, postoperative hospital stay, cost, intraoperative fluoroscopy, and complications. Lumbar radiographs were measured for changes in posterior intervertebral space height (PISH), intervertebral space foramen height (IFH), intervertebral foramen area (IFA), and area of the spinal canal (ASC). Clinical and psychological outcomes included the visual analog scale (VAS), Oswestry Disability Index (ODI), and hospital anxiety and depression scale (HADS). 35 OLIF patients were compared with 35 MISTLIF patients in L4/5 DLSS. The OLIF group had shorter bedtime, postoperative hospital stays, less intraoperative and postoperative blood loss (all P

Given the swift expansion of fresh e-commerce, the front warehouse mode can respond quickly and ensure the quality of fresh products. However, the complexity of the supply chain structure under front warehouse mode poses a challenge in reducing logistics costs and improving distribution efficiency while meeting consumers’ immediate delivery demands. Therefore, this paper studies the vehicle routing problem of two-echelon fresh e-commerce under front warehouse mode. Considering trans-shipment time constraints between the two echelons and the characteristics of terminal distribution, this paper initially models the vehicle routing problem for front warehouses as a two-echelon multi-trip capacitated vehicle routing problem with time windows. A mixed-integer linear programming model is subsequently established. To solve the model, a hybrid genetic algorithm integrated with neighborhood search is developed. Matrix coding is employed to merge vehicle selection and route assignment decisions. Simultaneously, neighborhood search is applied to enhance the search capability of algorithms, thereby improving the quality of solutions. Furthermore, the effectiveness and efficiency of the model and algorithm are verified through experiments of varying scales. Finally, comparative strategies and sensitivity analysis highlight the advantages of multi-trip strategies and provide insights into the optimal vehicle capacity limit.

The effect of the active element yttrium and its content on the oxidation behavior of GH4169 Ni-based superalloy at extreme temperature was studied by isothermal oxidation experiments. The results show that the oxide scale of GH4169 alloy presents a multi-layer structure, in which the continuous and dense Cr2O3 oxide layer is located in the subouter layer (II layer) and the continuous Nb-rich layer is in the subinner layer (III layer). These layers can inhibit the diffusion of oxygen and alloying elements, preventing the further oxidation of the alloy. The appropriate addition of yttrium can promote the selective oxidation of Cr element, reduce the thickness of the oxide scale and the oxidation rate of the alloy, inhibit the formation of voids at the interface of the oxide scale/alloy matrix, improve the resistance of the alloy to spalling as well as the adhesion of the oxide scale, and improve the high-temperature oxidation resistance of the alloy. Of those tested, the alloy containing 0.04 wt.%Y has the lowest oxidation weight gain, the slowest oxidation rate, and less oxide scale spalling. Based on this, the effect of yttrium on the high-temperature oxidation behavior of GH4169 Ni-based superalloy and its mechanism were revealed.

Abstract Aim This study aimed to evaluate the effect of abdominal massage (AM) on feeding intolerance (FI) in patients receiving enteral nutrition (EN). Design A systematic review and meta‐analysis. Methods We searched seven electronic databases to September 2021. STATA and RevMan were used to analyse the data. Results Eleven studies were included. The results revealed that AM could significantly reduce gastric residual volume and abdominal circumference difference, and reduce the incidence of gastric retention, vomiting, abdominal distention (all p

Background: Quantitative cardiovascular magnetic resonance (CMR) first pass perfusion maps are conventionally acquired with 3 short-axis (SAX) views (basal, mid, and apical) in every heartbeat (3SAX/1RR). Thus, a significant part of the left ventricle (LV) myocardium, including the apex, is not covered. The aims of this study were 1) to investigate if perfusion maps acquired with 3 short-axis views sampled every other RR-interval (2RR) yield comparable quantitative measures of myocardial perfusion (MP) as 1RR and 2) to assess if acquiring 3 additional perfusion views (i.e., total of 6) every other RR-interval (2RR) increases diagnostic confidence. Methods: In 287 patients with suspected ischemic heart disease stress and rest MP were performed on clinical indication on a 1.5T MR scanner. Eighty-three patients were examined by acquiring 3 short-axis perfusion maps with 1RR sampling (3SAX/1RR); for which also 2RR maps were reconstructed. Additionally, in 103 patients 3 short-axis and 3 long-axis (LAX; 2-, 3, and 4-chamber view) perfusion maps were acquired using 2RR sampling (3SAX + 3LAX/2RR) and in 101 patients 6 short-axis perfusion maps using 2RR sampling (6SAX/2RR) were acquired. The diagnostic confidence for ruling in or out stress-induced ischemia was scored according to a Likert scale (certain ischemia [2 points], probably ischemia [1 point], uncertain [0 points], probably no ischemia [1 point], certain no ischemia [2 points]). Results: There was a strong correlation (R = 0.99) between 3SAX/1RR and 3SAX/2RR for global MP (mL/min/g). The diagnostic confidence score increased significantly when the number of perfusion views was increased from 3 to 6 (1.24 ± 0.68 vs 1.54 ± 0.64, p

IntroductionPlatelet indices (PIs) are hematological parameters that indicate the number, morphology, and activation of platelets. Although some clinical trials suggest an association between PIs and the risk of stroke, the lack of robust evidence is attributed to confounding effects and reverse causation.ObjectiveThis study aimed to evaluate the association between PIs and stroke risk through Mendelian randomization (MR) while exploring the mediating effect of blood pressure in this association.MethodsWe identified genetic variants associated with PIs, including platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), and platelet crit (PCT), in the UK Biobank (n = 350,474). Relevant genome-wide association studies were utilized to gather summary statistics pertaining to the traits of interest. We primarily used the inverse-variance weighted analysis to obtain estimates for individual causal power.ResultWe observed a positive correlation between genetically predicted increases in PCT levels with the stroke onset [PCT: OR (95%CI) = 1.113(1.047, 1.183), p

Objective To characterise cardiac remodelling, exercise capacity and fibroinflammatory biomarkers in patients with aortic stenosis (AS) with and without diabetes, and assess the impact of diabetes on outcomes.Methods Patients with moderate or severe AS with and without diabetes underwent echocardiography, stress cardiovascular magnetic resonance (CMR), cardiopulmonary exercise testing and plasma biomarker analysis. Primary endpoint for survival analysis was a composite of cardiovascular mortality, myocardial infarction, hospitalisation with heart failure, syncope or arrhythmia. Secondary endpoint was all-cause death.Results Diabetes (n=56) and non-diabetes groups (n=198) were well matched for age, sex, ethnicity, blood pressure and severity of AS. The diabetes group had higher body mass index, lower estimated glomerular filtration rate and higher rates of hypertension, hyperlipidaemia and symptoms of AS. Biventricular volumes and systolic function were similar, but the diabetes group had higher extracellular volume fraction (25.9%±3.1% vs 24.8%±2.4%, p=0.020), lower myocardial perfusion reserve (2.02±0.75 vs 2.34±0.68, p=0.046) and lower percentage predicted peak oxygen consumption (68%±21% vs 77%±17%, p=0.002) compared with the non-diabetes group. Higher levels of renin (log10renin: 3.27±0.59 vs 2.82±0.69 pg/mL, p

Abstract Background The treatment of coronary artery disease combined with severe atherosclerotic stenosis proximal to a left anterior descending artery myocardial bridge (LAD-MB) is still controversial. This study aimed to analyze the outcomes of surgical intervention in patients with severe atherosclerotic stenosis proximal to a LAD-MB. Methods We retrospectively reviewed all patients with coronary artery disease combined with severe atherosclerotic stenosis proximal to the LAD-MB. The enrolled criteria were systolic compression of LAD more than or equal to 50% and atherosclerotic stenosis proximal to the LAD-MB more than or equal to 70%. All patients suffered from anginal symptoms refractory to medical therapy. All patients received supra-arterial myotomy and coronary artery bypass grafting (CABG) procedures. Clinical characteristics, intraoperative findings, and postoperative outcomes were evaluated. Results Between 2004 and 2021, sixteen patients underwent supra-arterial myotomy and CABG procedure. The compression and length of LAD-MB were 63 ± 17.9% and 25.9 ± 16.3 mm, respectively. Of the 16 patients, one patient had a LAD-MB and proximal coronary stenosis, and 15 patients had LAD-MBs and multivessel lesions. All patients survived and recovered uneventfully without in-hospital mortality or severe complications. The median transfusion amount of red blood cells in the operation was 2 units, and no patients required unplanned reoperation for bleeding. The average length of intensive care unit stay was 2.74 days. Fifteen patients were followed up for 6–146.1 months (mean 45.3 ± 42.9 months). One patient had a recurrence of angina pectoris one year after surgery, and 14 patients had no symptoms of myocardial ischemia during the follow-up period. Significant improvement in symptoms and quality of life using the Seattle Angina Questionnaire assessment was observed in all five categories after surgery (p

Abstract A low‐profile planar end‐fire broadband antenna with wide beamwidth is presented. The proposed antenna consists of a grounded coplanar waveguide (GCPW), an antipodal dipole, and a pair of directors. A transition from the GCPW to the substrate integrated waveguide (SIW) with tapered coupling slots is designed to achieve a wide impedance bandwidth. Wide beamwidths of the proposed antenna are realised through the antipodal dipole with bilaterally symmetrical sector arms. A pair of directors are symmetrically located on both sides of the sector arms to further widen the beamwidth. An antenna prototype operating at Ka band with a size of 2.18 λ0 × 0.77 λ0 × 0.06 λ0 (λ0 is the wavelength of the centre frequency) is fabricated based on the conventional printed circuit board process. The measurement results show that the reflection coefficient is lower than −12.5 dB in the frequency range of 32.2–37.0 GHz. At 35.5 GHz, the peak gain is 3.8 dBi, and the half‐power beamwidths (HPBWs) in E‐plane and H‐plane are 116° and 215°, respectively.

Abstract Aim The transjugular intrahepatic portosystemic shunt (TIPS) procedure has been performed in China for 30 years, but our understanding of the status and difficulties associated with the use of TIPS for portal hypertension is incomplete. This study aims to investigate the current situation of the use of TIPS for portal hypertension, which should aid the development of TIPS in China. Methods This study involved a questionnaire survey, initiated by the China Portal Hypertension Alliance (CHESS) to investigate the use of TIPS for portal hypertension in China. Questionnaires were released on the Internet between August 16, 2022 and September 16, 2022. Detailed information was collected from 545 hospitals contracted by the CHESS in China, which performed TIPS surgery in 2021. Results The 545 hospitals covers the majority of hospitals in China that conduct TIPS intervention. In the survey, a total of 13,527 TIPS interventions were carried out with 94.1% (498/545) of them had a system of routine follow‐up after TIPS. The majority (42.6% [232/545]) believed that the main indication of TIPS was the control of acute bleeding. Overall, 48.1% (262/545) carried out early or pre‐emptive TIPS, 53.0% (289/545) carried out TIPS for cavernous transformation of the portal vein, and 81.0% (441/545) chose routine embolization of collateral circulation during operation. Most used coils (97.0% [475/490]) and biological glue (72.0% [353/490]) as embolic materials, and 78.5% (428/545) routinely performed intraoperative portal pressure gradient measurements. When selecting TIPS stents, 57.1% (311/545) chose viator‐specific stents, and 57.2% (312/545) chose conventional anticoagulation after TIPS. Conventional anticoagulation after TIPS is over a time interval of 3–6 months (55.4% [173/312]). The limitation of TIPS surgery is mainly its cost (72.3% [394/545]) and insufficient understanding of the procedure by doctors in other related departments (77.4% [422/545]). Most of the hospital teams accept the use of domestic instruments in TIPS surgery (92.7% [505/545]). Conclusions This survey shows that TIPS is an essential part of the treatment of portal hypertension in China. TIPS is widely used in Chinese patients with portal hypertension, and this survey presents a more comprehensive picture of the options and difficulties encountered in the implementation of TIPS. In the future, it is necessary to promote TIPS technology and further standardize surgical indications, routine operations, and instrument application.

Abstract Background Apolygus lucorum is a worldwide omnivorous pest damaging a range of crops and causing great economic losses. Symbiotic bacteria living in insects play a key role in the nutrition, physiology, and behavior of hosts. Here, we present an experiment using Illumina HiSeq sequencing targeting the V3–V4 regions of bacteria’s 16S rRNA throughout the entire life cycle of A. lucorum. Results The first and second instar nymphs have the largest alpha diversity compared with other life stages of the insect. Bacterial phyla Proteobacteria (72.29%), Firmicutes (15.24%), Actinobacteria (7.76%) exhibit the largest relative abundance in all developmental stages. Erwinia (23.97%) and Lactococcus (10.62%) are the two genera with the highest relative abundance. The relative abundance of Erwinia in the nymph stage is significantly greater than the adult stage, and the relative abundance of Lactococcus in 6-day-old and 9-day-old adult females is higher compared with adult males. Conclusions These results reveal that microbial community composition and relative abundance shift dynamically at different life stages, implying that different bacterial phyla and genera may have specific roles in specific life stages such as metabolism, nutrition absorption, detoxification, and reproduction. This study reveals for the first time the community composition and ecological dynamics of symbiotic bacteria throughout the life stages of A. lucorum, and thus may provide insight to new strategies for pest control.

Abstract Hypertrophic obstructive cardiomyopathy (HOCM) can bring a high risk of sudden cardiac death in young people. It is particularly urgent to understand the development and mechanism of HOCM to prevent unsafe incidents. Here, the comparison between pediatric and adult patients with HOCM has been performed to uncover the signaling mechanism regulating pathological process through histopathological analysis and immunohistochemical analysis. We found SMAD proteins played an important role during myocardial fibrosis for HOCM patients. In patients with HOCM, Masson and HE staining showed that myocardial cells were diffusely hypertrophied with obvious disorganized myocardial fiber alignment, and myocardial tissue was more damaged and collagen fibers increased significantly, which come early in childhood. Increased expressions of SMAD2 and SMAD3 contributed to myocardial fibrosis in patients with HOCM, which happened early in childhood and continued through adulthood. In addition, decreased expression of SMAD7 was closely related to collagen deposition, which negatively expedited fibrotic responses in patients with HOCM. Our study indicated that the abnormal regulation of SMAD signaling pathway can lead to severe myocardial fibrosis in childhood and its fibrogenic effects persist into adulthood, which is a crucial factor in causing sudden cardiac death and heart failure in HOCM patients.

Abstract Severe Covid-19 may cause a cascade of cardiovascular complications beyond viral pneumonia. The severe inflammation may affect the microcirculation which can be assessed by cardiovascular magnetic resonance (CMR) imaging using quantitative perfusion mapping and calculation of myocardial perfusion reserve (MPR). Furthermore, native T1 and T2 mapping have previously been shown to identify changes in myocardial perfusion by the change in native T1 and T2 during adenosine stress. However, the relationship between native T1, native T2, ΔT1 and ΔT2 with myocardial perfusion and MPR during long-term follow-up in severe Covid-19 is currently unknown. Therefore, patients with severe Covid-19 (n = 37, median age 57 years, 24% females) underwent 1.5 T CMR median 292 days following discharge. Quantitative myocardial perfusion (ml/min/g), and native T1 and T2 maps were acquired during adenosine stress, and rest, respectively. Both native T1 (R2 = 0.35, p 0.05 for both). Native T1 and native T2 correlate with myocardial perfusion during adenosine stress, reflecting the coronary circulation in patients during long-term follow-up of severe Covid-19. Neither ΔT1 nor ΔT2 can be used to assess MPR in patients with severe Covid-19.

Summary: Correlation between blood-oxygen-level-dependent (BOLD) and cerebral blood flow (CBF) has been used as an index of neurovascular coupling. Hippocampal BOLD-CBF correlation is associated with neurocognition, and the reduced correlation is associated with neuropsychiatric disorders. We conducted the first genome-wide association study of the hippocampal BOLD-CBF correlation in 4,832 Chinese Han subjects. The hippocampal BOLD-CBF correlation had an estimated heritability of 16.2–23.9% and showed reliable genome-wide significant association with a locus at 3q28, in which many variants have been linked to neuroimaging and cerebrospinal fluid markers of Alzheimer’s disease. Gene-based association analyses showed four significant genes (GMNC, CRTC2, DENND4B, and GATAD2B) and revealed enrichment for mast cell calcium mobilization, microglial cell proliferation, and ubiquitin-related proteolysis pathways that regulate different cellular components of the neurovascular unit. This is the first unbiased identification of the association of hippocampal BOLD-CBF correlation, providing fresh insights into the genetic architecture of hippocampal neurovascular coupling.