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Background & aimsPatients with fatty liver disease may experience stigma from the disease or comorbidities. In this cross-sectional study, we aimed to understand stigma among patients with nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) and healthcare providers.MethodsMembers of the Global NASH Council created two surveys about experiences/attitudes toward NAFLD and related diagnostic terms: a 68-item patient and a 41-item provider survey.ResultsSurveys were completed by 1,976 patients with NAFLD across 23 countries (51% Middle East/North Africa [MENA], 19% Europe, 17% USA, 8% Southeast Asia, 5% South Asia) and 825 healthcare providers (67% gastroenterologists/hepatologists) across 25 countries (39% MENA, 28% Southeast Asia, 22% USA, 6% South Asia, 3% Europe). Of all patients, 48% ever disclosed having NAFLD/NASH to family/friends; the most commonly used term was "fatty liver" (88% at least sometimes); "metabolic disease" or "MAFLD" were rarely used (never by >84%). Regarding various perceptions of diagnostic terms by patients, there were no substantial differences between "NAFLD", "fatty liver disease (FLD)", "NASH", or "MAFLD". The most popular response was being neither comfortable nor uncomfortable with either term (56%-71%), with slightly greater discomfort with "FLD" among the US and South Asian patients (47-52% uncomfortable). Although 26% of patients reported stigma related to overweight/obesity, only 8% reported a history of stigmatization or discrimination due to NAFLD. Among providers, 38% believed that the term "fatty" was stigmatizing, while 34% believed that "nonalcoholic" was stigmatizing, more commonly in MENA (43%); 42% providers (gastroenterologists/hepatologists 45% vs. 37% other specialties, p = 0.03) believed that the name change to metabolic dysfunction-associated steatotic liver disease (or MASLD) might reduce stigma. Regarding the new nomenclature, the percentage of providers reporting "steatotic liver disease" as stigmatizing was low (14%).ConclusionsThe perception of NAFLD stigma varies among patients, providers, geographic locations and sub-specialties.Impact and implicationsOver the past decades, efforts have been made to change the nomenclature of nonalcoholic fatty liver disease (NAFLD) to better align with its underlying pathogenetic pathways and remove any potential stigma associated with the name. Given the paucity of data related to stigma in NAFLD, we undertook this global comprehensive survey to assess stigma in NAFLD among patients and providers from around the world. We found there is a disconnect between physicians and patients related to stigma and related nomenclature. With this knowledge, educational programs can be developed to better target stigma in NAFLD among all stakeholders and to provide a better opportunity for the new nomenclature to address the issues of stigma.

Abstract Diabetic foot ulcer (DFU) is a leading cause of high-level amputation in DM patients, with a low wound healing rate and a high incidence of infection. Vascular endothelial growth factor (VEGF) plays an important role in diabetes mellitus (DM) related complications. This study aims to explore the VEGF expression and its predictive value for prognosis in DFU, in order to provide basis for the prevention of DFU related adverse events. We analyzed 502 patients, with 328 in healing group and 174 in non-healing/recurrent group. The general clinical data and laboratory indicators of patients were compared through Spearman correlation analysis, ROC analysis and logistic regression analysis. Finally, the independent risk factors for adverse prognosis in DFU patients were confirmed. Spearman analysis reveals a positive correlation between the DFU healing rate and ABI, VEGF in wound tissue, and positive rate of VEGF expression, and a negative correlation with DM duration, FPG, HbA1c, TC, Scr, BUN, and serum VEGF. Further logistic regression analysis finds that the DM duration, FPG, HbA1c, ABI, serum VEGF, VEGF in wound tissue, and positive rate of VEGF expression are the independent risk factors for adverse prognosis in DFU (p

Abstract Nanoplasmas induced by intense laser fields have attracted enormous attention due to their accompanied spectacular physical phenomena which are vigorously expected by the community of science and industry. For instance, the energetic electrons and ions produced in laser-driven nanoplasmas are significant for the development of compact beam sources. Nevertheless, effective confinement on the propagating charged particles, which was realized through magnetic field modulation and target structure design in big facilities, are largely absent in the microscopic regime. Here we introduce a reliable scheme to provide control on the emission direction of protons generated from surface ionization in gold nanoparticles driven by intense femtosecond laser fields. The ionization level of the nanosystem provides us a knob to manipulate the characteristics of the collective proton emission. The most probable emission direction can be precisely steered by tuning the excitation strength of the laser pulses. This work opens new avenue for controlling the ion emission in nanoplasmas and can vigorously promote the fields such as development of on-chip beam sources at micro-/nano-scales.

Abstract Understanding how student peers influence learning outcomes is crucial for effective education management in complex social systems. The complexities of peer selection and evolving peer relationships, however, pose challenges for identifying peer effects using static observational data. Here we use both null-model and regression approaches to examine peer effects using longitudinal data from 5,272 undergraduates, where roommate assignments are plausibly random upon enrollment and roommate relationships persist until graduation. Specifically, we construct a roommate null model by randomly shuffling students among dorm rooms and introduce an assimilation metric to quantify similarities in roommate academic performance. We find significantly larger assimilation in actual data than in the roommate null model, suggesting roommate peer effects, whereby roommates have more similar performance than expected by chance alone. Moreover, assimilation exhibits an overall increasing trend over time, suggesting that peer effects become stronger the longer roommates live together. Our regression analysis further reveals the moderating role of peer heterogeneity. In particular, when roommates perform similarly, the positive relationship between a student’s future performance and their roommates’ average prior performance is more pronounced, and their ordinal rank in the dorm room has an independent effect. Our findings contribute to understanding the role of college roommates in influencing student academic performance.

Abstract Background There is limited understanding regarding prospective associations of insomnia symptoms and trajectories with functional disability. We aimed to investigate the associations of insomnia symptoms and trajectories with functional disability. Method A total of 13 197 participants were eligible from the Health and Retirement Study. Insomnia symptoms included non-restorative sleep, difficulty initiating sleep, early morning awakening, and difficulty maintaining sleep. We also identified four distinct trajectories of insomnia symptoms: low, decreasing, increasing, and high insomnia symptoms. Functional status was assessed through activities of daily living (ADL) and instrumental activities of daily living (IADL). Results Participants experiencing one (HR, 1.21; 95% CI, 1.13–1.29), two (HR, 1.43; 95% CI, 1.29–1.57), or three to four (HR, 1.41; 95% CI, 1.25–1.60) insomnia symptoms had a higher risk of ADL disability than asymptomatic respondents. Similarly, participants with one or more insomnia symptoms had a higher risk of IADL disability. Furthermore, using the trajectory with low insomnia symptoms as the reference, decreasing insomnia symptoms (HR, 1.22; 95% CI, 1.12–1.34), increasing insomnia symptoms (HR, 1.21; 95% CI, 1.05–1.41), and high insomnia symptoms (HR, 1.36; 95% CI, 1.18–1.56) were all associated with an increased risk of ADL disability. Conclusion Both a single measurement and dynamic trajectory of insomnia symptoms are associated with the onset of ADL disability. Increased awareness and management of insomnia symptoms may contribute to the prevention of functional disability occurrence.

30Cr3 is a novel ultra-high strength steel (UHSS) with excellent strength and plastic toughness, which has been mainly used in aerospace shells and stressed parts. Currently, there is still a lack of systematic research and comprehensive evaluation on the laser cleaning of this particular material. In this study, a nanosecond pulsed laser was employed for the cleaning process. First, the energy distribution model was derived, the influence of the spatial and temporal distribution of laser energy on the cleaning quality was discussed, and the cleaning experiment was conducted. The results showed that a laser energy density of 15 J/cm2, combined with the beam overlap rate 52% in the x-direction and 61% in the y-direction, can effectively remove the oxide layer and thoroughly expose the natural metal matrix. Then, under the optimum parameters, the oxygen content decreased from 22.3% to 3.4%, the Fe content increased from 54.5 to 83.4%, the Fe3+ peak disappeared in the X-ray photoelectron spectroscopy (XPS), a remelted layer of only 1 μm was observed. Last, the roughness was slightly reduced from 3.573 μm to 2.985 μm, the hardness was restored to the original hardness level of the substrate (∼260 HV), and the electron back scatter diffraction (EBSD) showed that the structure hardly changed after cleaning, the grain size was comparable to that of the matrix. These findings indicated that laser cleaning can effectively remove the oxide layer of 30Cr3 UHSS without damaging the properties of the base material, which has promising application in the cleaning of UHSS.

Abstract Millirobots must have low cost, efficient locomotion, and the ability to track target trajectories precisely if they are to be widely deployed. With current materials and fabrication methods, achieving all of these features in one millirobot remains difficult. We develop a series of graphene-based helical millirobots by introducing asymmetric light pattern distortion to a laser-induced polymer-to-graphene conversion process; this distortion resulted in the spontaneous twisting and peeling off of graphene sheets from the polymer substrate. The lightweight nature of graphene in combine with the laser-induced porous microstructure provides a millirobot scaffold with a low density and high surface hydrophobicity. Magnetically driven nickel-coated graphene-based helical millirobots with rapid locomotion, excellent trajectory tracking, and precise drug delivery ability were fabricated from the scaffold. Importantly, such high-performance millirobots are fabricated at a speed of 77 scaffolds per second, demonstrating their potential in high-throughput and large-scale production. By using drug delivery for gastric cancer treatment as an example, we demonstrate the advantages of the graphene-based helical millirobots in terms of their long-distance locomotion and drug transport in a physiological environment. This study demonstrates the potential of the graphene-based helical millirobots to meet performance, versatility, scalability, and cost-effectiveness requirements simultaneously.

ABSTRACT: Klebsiella pneumoniae can cause severe clinical mastitis in dairy cows, with K. pneumoniae type K57 (K57-KP) being the most common capsular serotype. To identify virulence factors and antimicrobial-resistance (AMR) genes of K57-KP with varying virulence, Galleria mellonella (greater wax moth) larvae were infected as a screening model to characterize virulence of 90 K57-KP strains, with 10 and 11 strains defined as virulent or attenuated, respectively, based on larval survival rates. Next, virulence of these 21 isolates was subsequently confirmed in adhesion and lactate dehydrogenase release assays, using bovine mammary epithelial cells cultured in vitro. Finally, genes associated with virulence and AMR were characterize with whole-genome sequencing. These 21 K57-KP strains were designated into 16 sequence types based on multi-locus sequence typing and allocated in phylogenetic analysis based on single nucleotide polymorphisms. We found great genetic diversity among isolates. In addition, adhesion-associated genes (e.g., fimA, sfaA, and focA) aminoglycoside-resistance genes (aph(6)-Id, strAB) were associated with virulence. This study provided new knowledge regarding virulence of K57-KP associated with bovine mastitis, which may inform development of novel diagnostic tools and prevention strategies for bovine mastitis.

Abstract Background Urinary tract infection (UTI) is a common cause of sepsis. Elderly patients with urosepsis in intensive care unit (ICU) have more severe conditions and higher mortality rates owing to factors such as advanced age, immunosenescence, and persistent host inflammatory responses. However, comprehensive studies on nomograms to predict the in-hospital mortality risk in elderly patients with urosepsis are lacking. This study aimed to construct a nomogram predictive model to accurately assess the prognosis of elderly patients with urosepsis and provide therapeutic recommendations. Methods Data of elderly patients with urosepsis were extracted from the Medical Information Mart for Intensive Care (MIMIC) IV 2.2 database. Patients were randomly divided into training and validation cohorts. A predictive nomogram model was constructed from the training set using logistic regression analysis, followed by internal validation and sensitivity analysis. Results This study included 1,251 patients. LASSO regression analysis revealed that the Glasgow Coma Scale (GCS) score, red cell distribution width (RDW), white blood count (WBC), and invasive ventilation were independent risk factors identified from a total of 43 variables studied. We then created and verified a nomogram. The area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA) of the nomogram were superior to those of the traditional SAPS-II, APACHE-II, and SOFA scoring systems. The Hosmer-Lemeshow test results and calibration curves suggested good nomogram calibration. The IDI and NRI values showed that our nomogram scoring tool performed better than the other scoring systems. The DCA curves showed good clinical applicability of the nomogram. Conclusions The nomogram constructed in this study is a convenient tool for accurately predicting in-hospital mortality in elderly patients with urosepsis in ICU. Improving the treatment strategies for factors related to the model could improve the in-hospital survival rates of these patients.

Abstract Objective Branchio-oto-renal syndrome (BOR, OMIM#113,650) is a rare autosomal dominant disorder that presents with a variety of symptoms, including hearing loss (sensorineural, conductive, or mixed), structural abnormalities affecting the outer, middle, and inner ear, branchial fistulas or cysts, as well as renal abnormalities.This study aims to identify the pathogenic variants by performing genetic testing on a family with Branchio-oto-renal /Branchio-otic (BO, OMIM#602,588) syndrome using whole-exome sequencing, and to explore possible pathogenic mechanisms. Methods The family spans 4 generations and consists of 9 individuals, including 4 affected by the BOR/BO syndrome. Phenotypic information, including ear malformation and branchial cleft, was collected from family members. Audiological, temporal bone imaging, and renal ultrasound examinations were also performed. Whole-exome sequencing was conducted to identify candidate pathogenic variants and explore the underlying molecular etiology of BOR/BO syndrome by minigene experiments. Results Intra-familial variability was observed in the clinical phenotypes of BOR/BO syndrome in this family. The severity and nature of hearing loss varied in family members, with mixed or sensorineural hearing loss. The proband, in particular, had profound sensorineural hearing loss on the left and moderate conductive hearing loss on the right. Additionally, the proband exhibited developmental delay, and her mother experienced renal failure during pregnancy and terminated the pregnancy prematurely. Genetic testing revealed a novel heterozygous variant NM_000503.6: c.639 + 3 A > C in the EYA1 gene in affected family members. In vitro minigene experiments demonstrated its effect on splicing. According to the American College of Medical Genetics (ACMG) guidelines, this variant was classified as likely pathogenic. Conclusion This study highlights the phenotypic heterogeneity within the same family, reports the occurrence of renal failure and adverse pregnancy outcomes in a female patient at reproductive age with BOR syndrome, and enriches the mutational spectrum of pathogenic variants in the EYA1 gene.

Abstract Patients suffering from osteoporotic fractures often require effective fixation and subsequent bone repair. However, the currently available materials are functionally limited and often fail to improve outcomes in this patient population. In this study, we developed orthopedic adhesives doped with romosozumab-loaded mesoporous bioactive glass nanoparticles to aid in osteoporotic fracture fixation and restore dysregulated bone homeostasis. These adhesives were designed to promote osteoblast formation while simultaneously inhibiting osteoclastic bone-resorbing activity, thus working synergistically to promote the healing of osteoporotic fractures. Orthopedic adhesives exhibit injectability, reversible adhesiveness, and malleability, enhancing their adaptability to complex clinical scenarios. Furthermore, the release of romosozumab from mesoporous bioactive glass nanoparticles accelerated osteogenesis and inhibited osteoclastogenesis, delaying the bone resorption process. This dual action contributes to the regulation of bone regeneration and remodeling. Notably, our orthopedic adhesive could restore the disrupted bone homeostasis associated with osteoporotic fractures.

Abstract Diode effects are of great interest for both fundamental physics and modern technologies. Electrical diode effects (nonreciprocal transport) have been observed in Weyl systems. Optical diode effects arising from the Weyl fermions have been theoretically considered but not probed experimentally. Here, we report the observation of a nonlinear optical diode effect (NODE) in the magnetic Weyl semimetal CeAlSi, where the magnetization introduces a pronounced directionality in the nonlinear optical second-harmonic generation (SHG). We demonstrate a six-fold change of the measured SHG intensity between opposite propagation directions over a bandwidth exceeding 250 meV. Supported by density-functional theory, we establish the linearly dispersive bands emerging from Weyl nodes as the origin of this broadband effect. We further demonstrate current-induced magnetization switching and thus electrical control of the NODE. Our results advance ongoing research to identify novel nonlinear optical/transport phenomena in magnetic topological materials and further opens new pathways for the unidirectional manipulation of light.

Finding out the specific location of the fault structure is of great significance for the engineering site selection and stability evaluation. Electrical resistivity tomography and acoustic logging are geophysical methods widely used in detecting fracture structures. Although electrical resistivity tomography is sensitive to low resistance bodies and has a large detection range, it is difficult to accurately delineate the boundary position of geological bodies because of its limited resolution. Acoustic logging can identify strata accurately, but its lateral detection range is limited. This study combined the advantages of the two methods in fault structure detection to improve the precision of geological body delineation. Firstly, the correlation between the resistivity of rock before and after fracture and the change of acoustic wave velocity was proved by physical property experiments. Then the case analysis of the resistivity and acoustic wave velocity characteristics of the fault structure and their combined application in the detection process was conducted. Finally, the depth correction of the inversion result of the electrical resistivity tomography was carried out using the acoustic logging data; and the three-dimensional distribution position of the fault structure in the underground space was obtained. Theresults show that the resistivity and acoustic wave velocity of the rock after fracture are lower than those before fracture. The fracture zone of the fault structure exists in the inversion section of the electrical resistivity tomography with a low resistivity anomaly region. On the wave velocity curve, the wave velocity value in the fracture zone decreases significantly. The combined detection mode of the two methods could provide a guidance for the delineation of the specific location of the fracture structure. The drilling results also verified that the inversion results of the electrical resistivity tomography corrected by acoustic logging data are more consistent with the actual geological conditions than those without correction.

Abstract The SnRK (sucrose non-fermentation-related protein kinase) plays an important role in regulating various signals in plants. However, as an important bamboo shoot and wood species, the response mechanism of PheSnRK in Phyllostachys edulis to hormones, low energy and stress remains unclear. In this paper, we focused on the structure, expression, and response of SnRK to hormones and sugars. In this study, we identified 75 PheSnRK genes from the Moso bamboo genome, which can be divided into three groups according to the evolutionary relationship. Cis-element analysis has shown that the PheSnRK gene can respond to various hormones, light, and stress. The PheSnRK2.9 proteins were localized in the nucleus and cytoplasm. Transgenic experiments showed that overexpression of PheSnRK2.9 inhibited root development, the plants were salt-tolerant and exhibited slowed starch consumption in Arabidopsis in the dark. The results of yeast one-hybrid and dual luciferase assay showed that PheIAAs and PheNACs can regulate PheSnRK2.9 gene expression by binding to the promoter of PheSnRK2.9. This study provided a comprehensive understanding of PheSnRK genes of Moso bamboo, which provides valuable information for further research on energy regulation mechanism and stress response during the growth and development of Moso bamboo.

Abstract Background Knowledge regarding the health impacts of daily eating frequency (DEF) and nighttime fasting duration (NFD) on mortality is very limited. Objective This study aimed to examine whether DEF and NFD are associated with CVD and all-cause mortality. Methods This was a prospective cohort study of a nationally representative sample from the United States, including 30,464 adults who participated in the National Health and Nutrition Examination Survey 2003–2014. Using 24-h dietary recall, DEF was assessed by the number of eating episodes, and NFD was calculated by the first and last eating time across a day. Death information was obtained from the National Death Index up to 2019. Weighted Cox proportional hazards regression models were used to assess survival relationships of DEF and NFD with mortality. Results During 307,686 person-years of follow-up, 4560 deaths occurred, including 1824 CVD cases. After adjustment for confounders, compared to DEF at 4–6 times, participants whose DEF was less than 3 times had greater CVD [hazard-ratio (HR) = 1.33, 95% confidence-interval (CI): 1.06–1.67] and all-cause (HR = 1.16, 95% CI: 1.01–1.33) mortality risks. Furthermore, compared to NFD of 10 to 11 h, participants whose NFD was shorter than 10 h had HRs of 1.30 (95% CI: 1.08–1.55) for CVD mortality and 1.23 (95% CI: 1.08–1.39) for all-cause mortality. NFD longer than 14 h was also related to CVD mortality (HR = 1.37, 95% CI: 1.12–1.67) and all-cause mortality (HR = 1.36, 95% CI: 1.19–1.54). Similar results for the association of NFD and DEF with heart-specific and stroke-specific mortality were observed. Conclusion This study found that DEF less than 3 times and NFD shorter than 10 h or longer than 14 h were independently associated with greater cardiovascular and all-cause mortality.

IntroductionHepatitis E (HE), caused by the Hepatitis E virus (HEV), is a significant cause of acute viral hepatitis globally and a major public health concern, particularly in specific high-prevalence areas in China, which have diverse transmission routes and regional differences. Identifying the primary risk factors for HE transmission is essential to develop targeted interventions for vulnerable populations.MethodsThis study employed a 1:1 matched case–control methodology, using a standardized questionnaire complemented by medical records for data validation.ResultsAmong the 442 HE cases and 428 healthy controls, the case group had a higher prevalence of fatigue (46.21%) and loss of appetite (43.84%) compared to the control group. Furthermore, liver function indicators were significantly higher in the case group, with an average alanine aminotransferase (ALT) level of 621.94 U/L and aspartate aminotransferase (AST) level of 411.53 U/L. Severe HE patients were predominantly male, with significantly increased ALT and AST levels reaching 1443.81 U/L and 862.31 U/L respectively, along with a higher incidence of fatigue (90%) and loss of appetite (75%). Multifactorial analysis indicated that frequent dining out (OR = 2.553, 95%CI:1.686–3.868), poor hygiene conditions (OR = 3.889, 95%CI:1.399–10.807), and comorbid chronic illnesses (OR = 2.275, 95%CI:1.616–3.202) were risk factors for HE infection; conversely, good hygiene practices were protective factors against HE infection (OR = 0.698, 95%CI:0.521–0.934).ConclusionIn conclusion, HE infection in Zhejiang Province is closely associated with dietary habits and environmental hygiene, and individuals with chronic diseases or co-infections are at increased risk. This highlights the need for targeted health education to reduce the incidence of HE among these populations.

Background & Aims: Patients with nonalcoholic fatty liver disease (NAFLD)/metabolic dysfunction-associated steatotic liver disease (MASLD) face a multifaceted disease burden which includes impaired health-related quality of life (HRQL) and potential stigmatization. We aimed to assess the burden of liver disease in patients with NAFLD and the relationship between experience of stigma and HRQL. Methods: Members of the Global NASH Council created a survey about disease burden in NAFLD. Participants completed a 35-item questionnaire to assess liver disease burden (LDB) (seven domains), the 36-item CLDQ-NASH (six domains) survey to assess HRQL and reported their experience with stigmatization and discrimination. Results: A total of 2,117 patients with NAFLD from 24 countries completed the LDB survey (48% Middle East and North Africa, 18% Europe, 16% USA, 18% Asia) and 778 competed CLDQ-NASH. Of the study group, 9% reported stigma due to NAFLD and 26% due to obesity. Participants who reported stigmatization due to NAFLD had substantially lower CLDQ-NASH scores (all p

N-acetyltransferase 10 (NAT10) is acknowledged as a tumor promoter in various cancers due to its role as a regulator of acetylation modification. Tumor-associated macrophages (TAMs) play a pivotal role in the tumor microenvironment (TME). However, the intercellular communication between esophageal squamous cell carcinoma (ESCC) cells and TAMs involving NAT10 remains poorly understood. This study aimed to elucidate the regulatory mechanism of NAT10 in modulating macrophage lipid metabolism and polarization. Experimental evidence was derived from in vitro and in vivo analyses. We explored the association between upregulated NAT10 in ESCC tissues, macrophage polarization, and the therapeutic efficacy of PD-1. Furthermore, we investigated the impact of methyltransferase 3 (METTL3)-induced m6A modification on the increased expression of NAT10 in ESCC cells. Additionally, we examined the role of exosomal NAT10 in stabilizing the expression of fatty acid synthase (FASN) and promoting macrophage M2 polarization through mediating the ac4C modification of FASN. Results indicated that NAT10, packaged by exosomes derived from ESCC cells, promotes macrophage M2 polarization by facilitating lipid metabolism. In vivo animal studies demonstrated that targeting NAT10 could enhance the therapeutic effect of PD-1 on ESCC by mediating macrophage reprogramming. Our findings offer novel insights into improving ESCC treatment through NAT10 targeting.

Abstract Earthquakes that rupture several faults occur frequently within the shallow lithosphere but are rarely observed for intermediate‐depth events (70–300 km). On 29 November 2007, the Mw7.4 Martinique earthquake struck the Lesser Antilles Island Arc near the deep end of the Wadati‐Benioff‐Zone. The sparse regional seismic network of 2007 previously hampered a detailed examination of this unusually complex event. Here, we combine seismic data from different studies with regional moment tensor inversion results and 3D full‐waveform modeling. We show that the earthquake is a doublet consisting of dip‐slip and strike‐slip motion along two oblique structures, both activated under extensional stress along the strike of the slab. Comparison with tectonic reconstructions suggests that the earthquake ruptured along a re‐activated ridge‐transform segment of the subducted Proto‐Caribbean spreading ridge. The unprecedented resolution of the source process highlights the influence of pre‐existing structures on localizing slab deformation also at intermediate‐depth.

Multiagent Reinforcement Learning (MARL) has been well adopted due to its exceptional ability to solve multiagent decision-making problems. To further enhance learning efficiency, knowledge transfer algorithms have been developed, among which experience-sharing-based and action-advising-based transfer strategies share the mainstream. However, it is notable that, although there exist many successful applications of both strategies, they are not flawless. For the long-developed action-advising-based methods (namely KT-AA, short for knowledge transfer based on action advising), their data efficiency and scalability are not satisfactory. As for the newly proposed experience-sharing-based knowledge transfer methods (KT-ES), although the shortcomings of KT-AA have been partially overcome, they are incompetent to correct specific bad decisions in the later learning stage. To leverage the superiority of both KT-AA and KT-ES, this study proposes KT-Hybrid, a hybrid knowledge transfer approach. In the early learning phase, KT-ES methods are employed, expecting better data efficiency from KT-ES to enhance the policy to a basic level as soon as possible. Later, we focus on correcting specific errors made by the basic policy, trying to use KT-AA methods to further improve the performance. Simulations demonstrate that the proposed KT-Hybrid outperforms well-received action-advising- and experience-sharing-based methods.

Suppressing random noise and improving the signal-to-noise ratio of seismic data holds immense significance for subsequent high-precision processing. As one of the most widely used denoising methods, self-learning-based algorithms typically partition the large zone into several smaller zones for individual training and processing, thereby achieving lower training costs. However, as the volume of seismic data that needs to be processed continues to increase, the cost advantage of this method becomes less apparent. This is because a larger data volume necessitates more independent training, ultimately increasing the overall training cost. Therefore, we propose a denoising method based on self-supervised learning to overcome the aforementioned problem. This method can directly acquire higher-quality training data from large zones by leveraging similarity differences, decreasing the need to divide the large zone into smaller parts for individual processing. As a result, it can effectively reduce the times for individual processing, leading to a decrease in the overall training cost. Compared to traditional denoising methods and self-supervised learning methods, the experimental results on both synthetic and field data demonstrate that the proposed denoising method exhibits superior performance in random noise attenuation and reduction in training costs.

Abstract Background Aslanger’s pattern in electrocardiogram (ECG) indicates that patients may have acute inferior myocardial infarction(AMI) with concomitant critical stenoses on other coronary arteries, which needs to be evaluated the timing of revascularization as risk equivalents of ST elevation myocardial infarction(STEMI). Case Presentation The patient was a 62-year-old male with chief complaint of intermittent exertional subxiphoid pain for 20 days from 30th June. One day after the last episode (19th July), the 18-lead electrocardiogram showed ST segment elevation of 0.05-0.1mV in lead III, ST segment depression in leads I, avL, and V2-V6, T wave inversion with positive terminal vector in lead V4-V5, and positive T wave in lead V6, which indicated Aslanger’s pattern. With increased Troponin I (0.162ng/mL, 0-0.02), The patient was diagnosed as acute non-ST-segment elevation myocardial infarction (NSTEMI) and admitted to coronary ward on 20th July. The coronary angiography showed 95% stenosis in the distal left main coronary artery (LM) to the ostium of the left anterior descending artery (LAD), 90% stenosis in the proximal segment of the LAD, and 80% stenosis in the middle segment of the LAD, and TIMI blood flow was graded score 2. Three drug-eluting stents were implanted at the lesions. The patient’s ECG returned close to normal one month after revascularization. Conclusion We presented an acute coronary syndrome case whose ECG showed with Aslanger’s pattern (i.e., isolated ST-segment elevation in lead III, associated ST-segment depression in lead V4-V6 with positive T wave/terminal vector, and greater ST-segment elevation in lead V1 than in lead V2), and was confirmed severe stenosis of the LM and the proximal segment of the LAD via coronary angiography. In clinical practice, especially in the emergency, patients with ECG presenting Aslanger’s pattern should be urgently evaluated with prompt treatment, and the timing of emergency coronary angiography and revascularization should be evaluated to avoid adverse outcomes caused by delayed treatment.

Abstract Background Hereditary hearing loss is a highly heterogeneous disorder. This study aimed to identify the genetic cause of a Chinese family with autosomal recessive non-syndromic sensorineural hearing loss (ARNSHL). Methods Clinical information and peripheral blood samples were collected from the proband and its parents. Two-step high-throughput next-generation sequencing on the Ion Torrent platform was applied to detect variants as follows. First, long-range PCR was performed to amplify all the regions of the GJB2, GJB3, SLC26A4, and MT-RNR1 genes, followed by next-generation sequencing. If no candidate pathogenetic variants were found, the targeted exon sequencing with AmpliSeq technology was employed to examine another 64 deafness-associated genes. Sanger sequencing was used to identify variants and the lineage co-segregation. The splicing of the MYO15A gene was assessed by in silico bioinformatics prediction and minigene assays. Results Two candidate MYO15A gene (OMIM, #602,666) heterozygous splicing variants, NG_011634.2 (NM_016239.3): c.6177 + 1G > T and c.9690 + 1G > A, were identified in the proband, and these two variants were both annotated as pathogenic according to the American College of Medical Genetics and Genomics (ACMG) guidelines. Further bioinformatic analysis predicted that the c.6177 + 1G > T variant might cause exon skipping and that the c.9690 + 1G > A variant might activate a cryptic splicing donor site in the downstream intronic region. An in vitro minigene assay confirmed the above predictions. Conclusions We identified a compound heterozygous splicing variant in the MYO15A gene in a Han Chinese family with ARNSHL. Our results broaden the spectrum of MYO15A variants, potentially benefiting the early diagnosis, prevention, and treatment of the disease.

Wideband spectrum sensing with a high-speed analog-digital converter (ADC) presents a challenge for practical systems. The Nyquist folding receiver (NYFR) is a promising scheme for achieving cost-effective real-time spectrum sensing, which is subject to the complexity of processing the modulated outputs. In this case, a multipath NYFR architecture with a step-sampling rate for the different paths is proposed. The different numbers of digital channels for each path are designed based on the Chinese remainder theorem (CRT). Then, the detectable frequency range is divided into multiple frequency grids, and the Nyquist zone (NZ) of the input can be obtained by sensing these grids. Thus, high-precision parameter estimation is performed by utilizing the NYFR characteristics. Compared with the existing methods, the scheme proposed in this paper overcomes the challenge of NZ estimation, information damage, many computations, low accuracy, and high false alarm probability. Comparative simulation experiments verify the effectiveness of the proposed architecture in this paper.

Abstract Objective By reviewing the literature analyzing vancomycin powder for preventive surgery, the effect of this method on reducing the infection rate after TJA was systematically evaluated to provide a basis for future clinical work. Methods Using PubMed, Medline, Elsevier, and CNKI, with the following mesh words: “vancomycin”, “local / intraoperative / topical / intrawound”, “TJA”, “TKA”, “THA”, “total joint arthroplasty”, “total knee arthroplasty”, “total hip arthroplasty”, “infection”, and “SSI”, to search for case-control research papers on the impact of prophylactic application of vancomycin powder on the incidence of postoperative infection, we compared the overall infection rate in the literature by using RevMan 5.3 meta-analysis software and analyzed the impact of vancomycin on the infection rate of different parts and types of TJA according to different subgroups. Results A total of 22 qualified studies were selected; twenty-five studies compared the effect of prophylactic use of vancomycin powder on infection rates after TJA. There were 23,363 cases in total, including 9545 cases in the vancomycin group and 13,818 cases in the control group. The results of the meta-analysis showed that the possibility of postoperative infection after prophylactic use of vancomycin powder was significantly lower than that without vancomycin risk ratio: 0.38 [0.23,0.59], P

Abstract To realize the resourceful use of soilbags filled with graphite tailings, their load-bearing and deformation characteristics must be fully understood. In this study, the following results were obtained by performing geometric testing of water-filled sealing bags and uniaxial compression tests of soilbags filled with graphite tailings. The volume of the soilbag expressed in rectangular form was approximately 0.773 times the actual volume. The types of compression damage to soilbags can be defined as surface damage and overall damage. The surface damage load increases with decreasing filling density and decreases with decreasing soilbag size. Moreover, the higher the tensile capacity of the soilbag material and the lower the friction between the soilbags, the greater the surface damage load. The overall damage load increased with an increase in the tensile strength of the soilbag material and decreased with an increase in the degree of filling; the overall damage load was greater for large-sized soilbags at high degrees of filling. Thus, the existing theoretical calculation method cannot accurately calculate the damage load of soilbags filled with graphite tailings, and the test results deviate from the theoretical calculation results, with the latter showing an increasing damage load with a decreasing filling degree.

Abstract Background Emerging metabolomics-based studies suggested links between amino acid metabolism and metabolic dysfunction-associated fatty liver disease (MAFLD) risk; however, whether there exists an aetiological role of amino acid metabolism in MAFLD development remains unknown. The aim of the present study was to assess the causal relationship between circulating levels of amino acids and MAFLD risk. Methods We conducted a two-sample Mendelian randomization (MR) analysis using summary-level data from genome-wide association studies (GWAS) to evaluate the causal relationship between genetically predicted circulating levels of amino acids and the risk of MAFLD. In the discovery MR analysis, we used data from the largest MAFLD GWAS (8434 cases and 770,180 controls), while in the replication MR analysis, we used data from a GWAS on MAFLD (1483 cases and 17,781 controls) where MAFLD cases were diagnosed using liver biopsy. We used Wald ratios or inverse variance-weighted (IVW) methods in the MR main analysis and weighted median and MR-Egger regression analyses in sensitivity analyses. Furthermore, we performed a conservative MR analysis by restricting genetic instruments to those directly involved in amino acid metabolism pathways. Results We found that genetically predicted higher alanine (OR = 1.43, 95% CI 1.13–1.81) and lower glutamine (OR = 0.83, 95% CI 0.73–0.96) levels were associated with a higher risk of developing MAFLD based on the results from the MR main and conservative analysis. The results from MR sensitivity analyses and complementary analysis using liver proton density fat fraction as a continuous outcome proxying for MAFLD supported the main findings. Conclusions Novel causal metabolites related to MAFLD development were uncovered through MR analysis, suggesting future potential for evaluating these metabolites as targets for MAFLD prevention or treatment.

Abstract The laminar combustion characteristics of CH4/air premixed flames with CO2 addition are systemically studied. Experimental measurements and numerical simulations of the laminar burning velocity (LBV) are performed in CH4/CO2/Air flames with various CO2 doping ratio under equivalence ratios of 1.0–1.4. GRI 3.0 mech and Aramco mech are employed for predicting LBV, adiabatic flame temperature (AFT), important intermediate radicals (CH3, H, OH, O) and NO x emissions (NO, NO2, N2O), as well as the sensitivity analysis is also conducted. The detail analysis of experiment and simulation reveals that as the CO2 addition increases from 0% to 40%, the LBVs and AFTs decrease monotonously. Under the same CO2 doping ratio, the LBVs and AFTs increase first and then decrease with the increase of equivalence ratio, and the maximum of LBV is reached at equivalence ratio of 1.05. The mole fraction tendency of important intermediates and NO x with equivalence ratio and CO2 doping ratio are similar to the LBVs and AFTs. Reaction H + O2 ⇔ O + OH is found to be responsible for the promotion of the generation of important intermediates and NO x under the equivalence ratios and CO2 addition through sensitivity analysis. The sensitivity coefficients of elementary reactions that the increasing of CO2 doping ratio promotes or inhibits formation of intermediate radicals and NO x decreases. Graphical abstract

The cutting thickness of the flame cutting nozzle mainly depends on the characteristics of the cutting oxygen jet, and in the process of designing and manufacturing a flame cutting nozzle with an ultralarge thickness, it is impossible to carry out multiple experiments to optimize the design due to the difficulty in testing, safety, manufacturing cost, environmental pollution, and other problems. In this paper, the Laval-type cutting oxygen orifice channel was first designed by theoretical calculation, the pressure, velocity, Mach number, and density distribution characteristics of the cutting oxygen jet were investigated by numerical simulation, and the reliability and adaptability of the numerical simulation results were verified by experiments. Then, the numerical simulation comparison and estimation method of jet characteristics with the general-purpose G301-7# nozzle was used to study the cutting oxygen orifice channel of the ultralarge thickness flame cutting nozzle. The results show that under the condition of a 19 mm throat diameter and 10 atm inlet pressure, it was estimated that the length of cutting oxygen flow from the design nozzle can reach 1800 mm and the cutting thickness can reach 2500 mm based on the density value; the length of cutting oxygen flow can reach 2000 mm and the cutting thickness can reach 3800 mm based on the velocity value; the length of cutting oxygen flow can reach 1600 mm according to the value of the oxygen quality fraction; and the cutting thickness can reach 2800 mm based on the oxygen mass fraction content. Finally, trial production of the nozzle design, verification of the cutting test, the nozzle with a cutting thickness of 2500 mm at an oxygen pressure of 7 atm, and the cutting quality were all good.

Introduction and Objectives: Fatty liver disease is a multisystem disease. Metabolic dysfunction-associated fatty liver disease (MAFLD) is a more accurate indicator of chronic kidney disease (CKD) than nonalcoholic fatty liver disease (NAFLD). However, the relationship between recently defined metabolic dysfunction-associated steatotic liver disease (MASLD) and CKD is currently unclear. The objective of this cross-sectional study was to investigate the prevalence of CKD and albuminuria among individuals diagnosed with either MAFLD or MASLD. Patients and Methods: This study involved 5,492 participants who provided biochemical marker and liver ultrasound data from the U.S. National Health and Nutrition Examination Survey (2017–2020). Multiple logistic regression analyses were conducted to assess the independent associations of nonoverlapping MAFLD and MASLD with the presence of CKD or albuminuria (urinary albumin-to-creatinine ratio ≥ 3 mg/mmol). Results: MAFLD and MASLD were identified in 47% and 44.5% of the participants, respectively. Individuals with MAFLD-only had a greater prevalence of CKD (24.7% vs. 8.3 %, P < 0.006) and albuminuria (18.6% vs. 5%, P < 0.01) than did those with MASLD-only. Importantly, after adjusting for factors such as sex, age, ethnicity, and alcohol use, it was demonstrated that individuals in the MAFLD-only group had a 4.73-fold greater likelihood of having prevalent CKD than those in the MASLD-only group (P < 0.03). Conclusions: The MAFLD criteria better identify patients with CKD than do the MASLD criteria. Therefore, it is suggested that the MASLD criteria be reconsidered, as currently, the justification for changing from MAFLD to MASLD criteria may not be appropriate.