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The need for cross-comparison and validation of all-weather Land Surface Temperature (LST) products has arisen due to the release of multiple such products aimed at providing comprehensive all-weather monitoring capabilities. In this study, we focus on validating two well-established all-weather LST products (i.e. MLST-AS and TRIMS LST) against in-situ measurements obtained from four high-quality LST validation sites: Evora, Gobabeb, KIT-Forest, and Lake Constance. For the land sites, MLST-AS exhibits better accuracy, with RMSEs ranging from 1.6 K to 2.1 K, than TRIMS LST, the RMSEs of which range from 1.9 K to 3.1 K. Because MLST-AS pixels classified as “inland water” are masked out, the validation over Lake Constance is limited to TRIMS LST: it yields a RMSE of 1.6 K. Furthermore, the validation results show that MLST-AS and TRIMS LST exhibit better accuracy under clear-sky conditions than unclear-sky conditions across all sites. Since the accuracy of the all-weather LST products is considerably affected by the input clear-sky LST products, we further compare the all-weather LST with the corresponding input clear-sky LST to conduct an error source analysis. Considering the clear-sky pixels on MLST-AS directly using the estimates from MLST, the error source analysis is limited to examining TRIMS LST and its input (i.e. MODIS LST). The findings indicate that TRIMS LST is highly correlated with MODIS LST. The investigation and validation of the two selected all-weather LST products objectively evaluate their accuracy and stability, which provides important information for applications of these all-weather LST products.

Abstract Hypoxic preconditioning (HPC) has been shown to improve organ tolerance to subsequent severe hypoxia or ischemia. However, its impact on intestinal ischemic injury has not been well studied. In this study, we evaluated the effects of HPC on intestinal ischemia in rats. Intestinal rehabilitation, levels of fatty acid oxidation (FAO) by-products, intestinal stem cells (ISCs), levels of hypoxia-inducible factor 1 subunit α (HIF-1α) and its downstream genes such as peroxisome proliferator-activated receptor α (PPARα), and carnitine palmitoyltransferase 1a (CPT1A) were assessed at distinct time intervals following intestinal ischemia with or without the interference of HIF-1α. Our data showed that HPC facilitates the restoration of the intestinal structure and enhances the FAO, by boosting intestinal stem cells. Additionally, HIF-1α, PPARα, and CPT1A mRNA and their protein levels were generally up-regulated in the small intestine of HPC rats as compared to the control group. Our vitro experiment also shows low-oxygen induces highly levels of HIF-1α and its downstream genes, with a concurrent increase in FAO products in IEC-6 cells. Furthermore, the above phenomenon could be reversed by silencing HIF-1α. In conclusion, we hypothesize that HPC can stimulate the activation of intestinal stem cells via HIF-1α/PPARα pathway-mediated FAO, thereby accelerating the healing process post ischemic intestinal injury.

Abstract Background Mental health problems are critical and common in medical staff working in Intensive Care Units (ICU) even at the late stage of COVID-19, particularly for nurses. There is little research to explore the inner relationships between common syndromes, such as depression and burnout. Network analysis (NA) was a novel approach to quantified the correlations between mental variables from the perspective of mathematics. This study was to investigate the interactions between burnout and depression symptoms through NA among ICU nurses. Method A cross-sectional study with a total of 616 Chinese nurses in ICU were carried out by convenience sampling from December 19, 2022 to January19, 2023 via online survey. Burnout symptoms were measured by Maslach Burnout Inventory-General Survey (MBI-GS) (Chinese version), and depressive symptoms were assessed by the 9-item Patient Health Questionnaire (PHQ-9). NA was applied to build interactions between burnout and depression symptoms. We identified central and bridge symptoms by R package qgraph in the network model. R package bootnet was used to examined the stability of network structure. Results The prevalence of burnout and depressive symptoms were 48.2% and 64.1%, respectively. Within depression-burnout network, PHQ4(Fatigue)-MBI2(Used up) and PHQ4(Fatigue)-MBI5(Breakdown) showed stronger associations. MBI2(Used up) had the strongest expected influence central symptoms, followed by MBI4(Stressed) and MBI7 (Less enthusiastic). For bridge symptoms. PHQ4(Fatigue), MBI5(Breakdown) and MBI2(Used up) weighed highest. Both correlation stability coefficients of central and bridge symptoms in the network structure were 0.68, showing a high excellent level of stability. Conclusion The symptom of PHQ4(Fatigue) was the bridge to connect the emotion exhaustion and depression. Targeting this symptom will be effective to detect mental disorders and relieve mental syndromes of ICU nurses at the late stage of COVID-19 pandemic.

Intelligent detection and recognition of ship targets is the basis of naval battlefield situational assessment and threat estimation. Its core task is to determine whether there is a ship target in the image and to detect, identify, and locate the ship target, which also has broad application prospects in fisheries management, maritime rescue, maritime traffic management, and marine environment monitoring. To this end, a multi-scale ship target detection improved algorithm for remote sensing images is proposed based on the YOLOv5 model, called CPE-YOLO. Firstly, a multi-scale attention fusion module based on coordinate position is proposed to solve the problem of missing spatial perception ability for ship detection in optical remote sensing images, to process the multi-scale coordinate information of feature maps, and to effectively establish long-range channel dependency among multi-scale channel attention. Secondly, a more refined feature pyramid network is constructed to effectively mitigate the impact of target scale variation due to remote sensing images on model performance, and to provide richer feature information for feature fusion layer regression localization. Ultimately, the decoupled head is integrated into the YOLO Head to disentangle the classifier and regressor, facilitating accelerated network convergence and concurrent enhancement of network detection accuracy. Finally, thorough tests on the HRSC2016, ASDC and SIGE datasets are presented to support our methodology. The results show that the performance of our proposed methods is better than other existing methods, with an mAP of 94.0%, 76.5%, and 98.7% on the HRSC2016, ASDC, and SIGE datasets. Moreover, comparative assessments against alternative deep learning methodologies affirm the sustained superiority of the enhanced method across overall performance metrics.

AIM: To investigate the effects of Sonic hedgehog (Shh) gene-modified bone marrow mesenchymal stem cells (MSCs) on graft-induced retinal gliosis and retinal ganglion cells (RGCs) survival in diabetic mice. METHODS: Bone marrow-derived MSCs were genetically modified with the Shh gene to generate a stably transfected cell line of Shh-modified MSCs (MSC-Shh). Intravitreal injections of MSC-Shh and green fluorescent protein-modified MSCs (MSC-Gfp; control) were administered in diabetic mice. After 4wk, the effects of MSC-Shh on retinal gliosis were evaluated using fundus photography, and markers of gliosis were examined by immunofluorescence and Western blotting. The neurotrophic factors expression and RGCs survival in the host retina were evaluated using Western blotting and immunofluorescence. The mechanisms underlying the effects of MSC-Shh was investigated. RESULTS: A significant reduction of proliferative vitreoretinopathy (PVR) was observed after intravitreal injection of MSC-Shh compared to MSC-Gfp. Significant downregulation of glial fibrillary acidic protein (GFAP) was demonstrated in the host retina after MSC-Shh administration compared to MSC-Gfp. The extracellular signal-regulated kinase 1/2 (ERK1/2), protein kinase B (AKT) and phosphatidylin-ositol-3-kinase (PI3K) pathways were significantly downregulated after MSC-Shh administration compared to MSC-Gfp. Brain-derived neurotrophic factor (BDNF) and ciliary neurotrophic factor (CNTF) levels were significantly increased in the host retina, and RGCs loss was significantly prevented after MSC-Shh administration. CONCLUSION: MSC-Shh administration reduces graft-induced reactive gliosis following intravitreal injection in diabetic mice. The ERK1/2, AKT and PI3K pathways are involved in this process. MSC-Shh also increases the levels of neurotrophic factors in the host retina and promoted RGCs survival in diabetic mice.

Soil life revolves around microorganisms that are crucial for soil ecosystems and health. In megacities, the combined exposure of multiple pollutants exerts a significant impact on the structures and functions of soil microorganisms; however, there is a lack of empirical studies on this topic. Hence, we conducted a study including urban parks in Beijing, China. The results indicate that bacteria were abundant in the soils of Beijing parks, showing the same dominant groups but different rare groups. The dominant groups included Actinobacteria and Proteobacteria. Candidate phyla radiation bacteria, a large evolutionary radiation of bacterial lineages whose members remain mostly uncultivated, were the main specialists. Under the combined exposure of multiple pollutants, the structures of soil microbial communities in different parks were similar. Community change due to pollutants (31%) was greater than that due to natural factors (2.4%). Among multipollutants, organophosphate esters, led by dibutyl phosphate, had the highest influence on microbial abundance and distribution. An increase in dibutyl phosphate concentration decreased the abundance of Firmicutes, while the abundance of Synergistota was increased. The interactions among pollutants affecting the bacteria were different. Bis(2-chloroethyl) phosphate, nickel and benzo[g,h,i]perylene influenced microorganisms by working with organophosphate esters. High-molecular-weight polycyclic aromatic hydrocarbons, such as benzo[a]pyrene and benzo[g,h,i]perylene, mainly acted on the functional genes and thus affected multiple biogeochemical cycles. Benzo[a]anthracene, bis(2-chloroethyl) phosphate, and arsenic were the primary pollutants affecting metabolic pathways. Our research helps to better understand the impacts of urban environmental pollution on soil microorganisms.

Abstract Lithium–sulfur (Li–S) batteries promise high‐energy‐density potential to exceed the commercialized lithium‐ion batteries but suffer from limited cycling lifespan due to the side reactions between lithium polysulfides (LiPSs) and Li metal anodes. Herein, a three‐way electrolyte with ternary solvents is proposed to enable high‐energy‐density and long‐cycling Li–S pouch cells. Concretely, ternary solvents composed of 1,2‐dimethoxyethane, di‐isopropyl sulfide, and 1,3,5‐trioxane are employed to guarantee smooth cathode kinetics, inhibit the parasitic reactions, and construct a robust solid electrolyte interphase, respectively. The cycling lifespan of Li–S coin cells with 50 µm Li anodes and 4.0 mg cm−2 sulfur cathodes is prolonged from 88 to 222 cycles using the three‐way electrolyte. Nano‐heterogeneous solvation structure of LiPSs and organic‐rich solid electrolyte interphase are identified to improve the cycling stability of Li metal anodes. Consequently, a 3.0 Ah‐level Li–S pouch cell with the three‐way electrolyte realizes a high energy density of 405 Wh kg−1 and undergoes 27 cycles. This work affords a three‐way electrolyte recipe for suppressing the side reactions of LiPSs and inspires rational electrolyte design for practical high‐energy‐density and long‐cycling Li–S batteries.

This study investigated the impact of transcutaneous electrical acupoint stimulation (TEAS) at Neiguan acupoint (PC6) on the physiological and behavioral responses of participants exposed in virtual height. 40 participants were included in the study and were randomly assigned to either a control group or an intervention group. Participants had an immersive experience with a VR interactive platform that provided somatosensory interaction in height stimulation scenes. Psychological scores, behavioral and cognitive performance, and physiological responses were recorded and analyzed. The results indicated that the intervention group had significantly lower fear scores compared to the control group. Analysis of heart rate variability revealed that the intervention group exhibited improved heart rate variability, indicating enhanced cardiovascular function and emotion regulation. The behavioral and cognitive results demonstrated that the intervention group exhibited higher left eye openness, faster reaction times, and greater movement distance, suggesting enhanced attentional focus, cognitive processing, and reduced avoidance behaviors. These findings suggest that TEAS at PC6 can effectively reduce fear and improve the regulation of physiological and behavioral responses to negative emotional stimuli.

Alfalfa (Medicago sativa L.) is a feed crop due to its rich nutrition and high productivity. The utilization of titanium oxide nanoparticles (TiO2 NPs) brings benefits to agricultural production but also has potential hazards. To investigate the duality and related mechanism of TiO2 NPs on alfalfa, its different doses including 0, 50, 100, 200, 500, and 1000 mg L− 1 (CK, Ti-50, Ti-100, Ti-200, Ti-500, and Ti-1000) were sprayed on leaves. The results showed that greater doses of TiO2 NPs (500 and 1000 mg L−1) negatively affected the physiological parameters, including morphology, biomass, leaf ultrastructure, stomata, photosynthesis, pigments, and antioxidant ability. However, 100 mg L−1 TiO2 NPs revealed an optimal positive effect; compared with the CK, it dramatically increased plant height, fresh weight, and dry weight by 22%, 21%, and 41%, respectively. Additionally, TiO2 NPs at low doses significantly protected leaf tissue, promoted stomatal opening, and enhanced the antioxidant system; while higher doses had phytotoxicity. Hence, TiO2 NPs are dose-dependent on alfalfa. The transcriptomic analysis identified 4625 and 2121 differentially expressed genes (DEGs) in the comparison of CK vs. Ti-100 and CK vs. Ti-500, respectively. They were mainly enriched in photosynthesis, chlorophyll metabolism, and energy metabolism. Notably, TiO2 NPs-induced phytotoxicity on photosynthetic parameters happened concurrently with the alterations of the genes involved in the porphyrin and chlorophyll metabolism and carbon fixation in photosynthetic organisms in the KEGG analysis. Similarly, it affected the efficiency of alfalfa energy transformation processes, including pyruvate metabolism and chlorophyll synthesis. Several key related genes in these pathways were validated. Therefore, TiO2 NPs have positive and toxic effects by regulating morphology, leaf ultrastructure, stomata, photosynthesis, redox homeostasis, and genes related to key pathways. It is significant to understand the duality of TiO2 NPs and cultivate varieties resistant to nanomaterial pollution.

Abstract. Background:. We have recently developed a new Coronary Artery Tree description and Lesion EvaluaTion (CatLet) angiographic scoring system. Our preliminary studies have demonstrated its superiority over the the Synergy between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery (SYNTAX) score with respect to outcome predictions for acute myocardial infarction (AMI) patients. The current study hypothesized that the residual CatLet (rCatLet) score predicts clinical outcomes for AMI patients and that a combination with the three clinical variables (CVs)—age, creatinine, and ejection fraction, will enhance its predicting values. Methods:. The rCatLet score was calculated retrospectively in 308 consecutively enrolled patients with AMI. Primary endpoint, major adverse cardiac or cerebrovascular events (MACCE) including all-cause mortality, non-fatal AMI, transient ischemic attack/stroke, and ischemia-driven repeat revascularization, was stratified according to rCatLet score tertiles: rCatLet_low ≤3, rCatLet_mid 4-11, and rCatLet_top ≥12, respectively. Cross-validation confirmed a reasonably good agreement between the observed and predicted risks. Results:. Of 308 patients analyzed, the rates of MACCE, all-cause death, and cardiac death were 20.8%, 18.2%, and 15.3%, respectively. Kaplan-Meier curves for all endpoints showed increasing outcome events with the increasing tertiles of the rCatLet score, with P values

Abstract DC microgrid clusters are a collection of interconnected microgrids that allow for flexible power flow, leading to economic benefits and improved resilience from distributed generation. However, managing power flow among interconnected microgrids with different components such as photovoltaic, wind turbine, and battery energy storage systems, as well as various dynamic operation scenarios, presents a significant challenge for proportional‐integral (PI)‐based controllers. To address this challenge, this paper proposes a distributed predictive control design in the hierarchical control paradigm that aims to achieve economically optimal power flow (EOPF) for DC microgrid clusters. The predictive controller considers multiple objectives optimisation, including generation cost models, converter losses, and transmission losses over both local lines and tie‐lines, and design and implementation of the two‐layer tertiary control for the EOPF of DCMGCs are presented. Hardware‐in‐the loop (HIL) experimental results demonstrate the effectiveness of the controller design.

Abstract Despite being a clean and renewable energy source, photovoltaic (PV) power generation faces severe challenges in operation due to its strong intermittency and volatility compared to the traditional fossil fuel power generation. Accurate predictions are therefore crucial for PV’s grid connections and the system security. The existing methods often rely heavily on weather forecasts, the accuracy of which is hard to be guaranteed. This paper proposes a novel GBDT-BiLSTM day-ahead PV forecasting model, which leverages the Teacher Forcing mechanism to combine the strong time-series processing capabilities of BiLSTM with an enhanced GBDT model. Given the uncertainty and volatility inherent in solar energy and weather conditions, the gradient boosting method is employed to update the weak learner, while a decision tree is incorporated to update the strong learner. Additionally, to explore the correlation between photovoltaic power output and historical time-series data, the adaptive gradient descent-based Adam algorithm is utilized to train the bidirectional LSTM model, enhancing the accuracy and stability of mid- to long-term time-series predictions. A prediction experiment, conducting with the real data from a PV power station in Sichuan Province, China, was compared with other methods to verify the model’s effectiveness and robustness.

Objective: This study aimed to explore the impact of late night shift work on the functional outcomes of patients with acute ischemic stroke (AIS) treated with endovascular thrombectomy (EVT). Methods: Consecutive AIS patients who underwent EVT between June 2019 and June 2021 were enrolled and divided into non-night shift work and night shift work groups based on their occupational histories. The primary outcome was the modified Rankin Scale score defined 3-month functional outcome. The secondary outcomes were 3-month mortality, symptomatic intracerebral hemorrhage (sICH), ICH and early recanalization. Results: A total of 285 patients were enrolled, 35 patients (12.3%) were night shift workers, who were younger (P

Backgrounds: The validity of heart rate variability (HRV) has been substantiated in mental workload assessments. However, cognitive tasks often coincide with physical exertion in practical mental work, but their synergic effects on HRV remains insufficiently established. The study aims were to investigate the combined effects of cognitive and physical load on autonomic nerve functions.Methods: Thirty-five healthy male subjects (aged 23.5 ± 3.3 years) were eligible and enrolled in the study. The subjects engaged in n-back cognitive tasks (1-back, 2-back, and 3-back) under three distinct physical conditions, involving isotonic contraction of the left upper limb with loads of 0 kg, 3 kg, and 5 kg. Electrocardiogram signals and cognitive task performance were recorded throughout the tasks, and post-task assessment of subjective experiences were conducted using the NASA-TLX scale.Results: The execution of n-back tasks resulted in enhanced perceptions of task-load feelings and increased reaction times among subjects, accompanied by a decline in the accuracy rate (p < 0.05). These effects were synchronously intensified by the imposition of physical load. Comparative analysis with a no-physical-load scenario revealed significant alterations in the HRV of the subjects during the cognitive task under moderate and high physical conditions. The main features were a decreased power of the high frequency component (p < 0.05) and an increased low frequency component (p < 0.05), signifying an elevation in sympathetic activity. This physiological response manifested similarly at both moderate and high physical levels. In addition, a discernible linear correlation was observed between HRV and task-load feelings, as well as task performance under the influence of physical load (p < 0.05).Conclusion: HRV can serve as a viable indicator for assessing mental workload in the context of physical activities, making it suitable for real-world mental work scenarios.

Previous neuroimaging studies have revealed abnormal brain networks in patients with major depressive disorder (MDD) in emotional processing. While any cognitive task consists of a series of stages, little is yet known about the topology of functional brain networks in MDD for these stages during emotional face recognition. To address this problem, electroencephalography (EEG)-based functional brain networks of MDD patients at different stages of facial information processing were investigated in this study. First, EEG signals were collected from 16 patients with MDD and 18 age-, gender-, and education-matched normal subjects when performing an emotional face recognition task. Second, the global field power (GFP) method was employed to divide group-averaged event-related potentials into different stages. Third, using the phase transfer entropy (PTE) approach, the brain networks of MDD patients and normal individuals were constructed for each stage in negative and positive face processing, respectively. Finally, we compared the topological properties of brain networks of each stage between the two groups using graph theory approaches. The results showed that the analyzed three stages of emotional face processing corresponded to specific neurophysiological phases, namely, visual perception, face recognition, and emotional decision-making. It was also demonstrated that depressed patients showed abnormally decreased characteristic path length at the visual perception stage of negative face recognition and normalized characteristic path length in the stage of emotional decision-making during positive face processing compared to healthy subjects. Furthermore, while both the MDD and normal groups’ brain networks were found to exhibit small-world network characteristics, the brain network of patients with depression tended to be randomized. Moreover, for patients with MDD, the centro-parietal region may lose its status as a hub in the process of facial expression identification. Together, our findings suggested that altered emotional function in MDD patients might be associated with disruptions in the topological organization of functional brain networks during emotional face recognition, which further deepened our understanding of the emotion processing dysfunction underlying MDD.

Independent predictors of mortality and transfusion therapy in polytrauma patients from the Chinese population remain unknown. Here, we aimed to identify these predictors by retrospectively collecting and analyzing vital signs and laboratory results for 408 critically ill patients suffering from polytrauma who were treated in Affiliated Kunshan Hospital of Jiangsu University, Jiangsu Province, China from January 2020 to December 2021. We identified risk factors for mortality and transfusion therapy using logistic regression analysis. As a results, we enrolled a total of 408 polytrauma patients, with a male-to-female ratio of 2:1, a mean age of 49.02 ± 16.84 years, a mortality rate of 15.9 %, and a blood transfusion rate of 45.8 %. The multivariate logistic regression showed that decreased Glasgow Coma Scale (GCS) score (Odds ratio (OR) = 0.72, 95 % confidence interval (95%CI): 0.63–0.83, P

Ischemia-reperfusion injury (IRI) represents a prevalent pathological phenomenon. Traditional treatment approaches primarily aim at restoring blood supply to ischemic organs, disregarding the consequent damage caused by IRI. Belonging to the class of protopanaxadiol ginsenosides that are found in Panax ginseng, ginsenoside Rd (GSRd) demonstrates notable safety alongside a diverse range of biological functions. Its active components exhibit diverse pharmacological effects, encompassing anti-inflammatory, anti-tumor, neuroprotective, cardiovascular-protective, and immune-regulatory properties, making it a promising candidate for addressing multiple medical conditions. GSRd shields against I/R injury by employing crucial cellular mechanisms, including the attenuation of oxidative stress, reduction of inflammation, promotion of cell survival signaling pathways, and inhibition of apoptotic pathways. Additionally, GSRd regulates mitochondrial function, maintains calcium homeostasis, and modulates the expression of genes involved in I/R injury. This review seeks to consolidate the pharmacological mechanism of action of GSRd within the context of IRI. Our objective is to contribute to the advancement of GSRd-related pharmaceuticals and provide novel insights for clinicians involved in developing IRI treatment strategies.

Abstract Lithium manganese oxides are considered as promising cathodes for lithium‐ion batteries due to their low cost and available resources. Layered LiMnO2 with orthorhombic or monoclinic structure has attracted tremendous interest thanks to its ultrahigh theoretical capacity (285 mAh g−1) that almost doubles that of commercialized spinel LiMn2O4 (148 mAh g−1). However, LiMnO2 undergoes phase transition to spinel upon cycling cause by the Jahn‐Teller effect of the high‐spin Mn3+. In addition, soluble Mn2+ generates from the disproportionation of Mn3+ and oxygen release during electrochemical processes may cause poor cycle performance. To address the critical issues, tremendous efforts have been made. This paper provides a general review of layered LiMnO2 materials including their crystal structures, synthesis methods, structural/elemental modifications, and electrochemical performance. In brief, first the crystal structures of LiMnO2 and synthetic methods have been summarized. Subsequently, modification strategies for improving electrochemical performance are comprehensively reviewed, including element doping to suppress its phase transition, surface coating to resist manganese dissolution into the electrolyte and impede surface reactions, designing LiMnO2 composites to improve electronic conductivity and Li+ diffusion, and finding compatible electrolytes to enhance safety. At last, future efforts on the research frontier and practical application of LiMnO2 have been discussed.

Summary: Exercise training can stimulate the formation of fatty-acid-oxidizing slow-twitch skeletal muscle fibers, which are inversely correlated with obesity, but the molecular mechanism underlying this transformation requires further elucidation. Here, we report that the downregulation of the mitochondrial disulfide relay carrier CHCHD4 by exercise training decreases the import of TP53-regulated inhibitor of apoptosis 1 (TRIAP1) into mitochondria, which can reduce cardiolipin levels and promote VDAC oligomerization in skeletal muscle. VDAC oligomerization, known to facilitate mtDNA release, can activate cGAS-STING/NFKB innate immune signaling and downregulate MyoD in skeletal muscle, thereby promoting the formation of oxidative slow-twitch fibers. In mice, CHCHD4 haploinsufficiency is sufficient to activate this pathway, leading to increased oxidative muscle fibers and decreased fat accumulation with aging. The identification of a specific mediator regulating muscle fiber transformation provides an opportunity to understand further the molecular underpinnings of complex metabolic conditions such as obesity and could have therapeutic implications.

AbstractObjectives The aim of this study is to determine whether new European Kidney Function Consortium (EKFC) equation is more applicable than Asian-modified CKD-EPI equation in clinical practice, having a higher accuracy in estimating GFR in our external CKD population.Methods We calculated estimated GFREKFC and GFRCKD-EPI independently using the EKFC and Asian-modified CKD-EPI formulas, respectively. The clinical diagnostic performance of the two equations was assessed and compared by median bias, precision, accuracy (P30) and so on, using 99mTc-DTPA dual plasma sample clearance method as a reference method for GFR measurement (mGFR). The equation that met the following targets was superior: (1) median bias within ± 3 mL/min/1.73 m2; (2) P30 > 75%; and (3) better precision and 95% limits of agreement in Bland–Altman analysis.Results Totally, 160 CKD patients were recruited in our external cohort. GFREKFC was highly related to mGFR, with a regression equation of GFREKFC=mGFR × 0.87 + 5.27. Compared with the Asian-modified CKD-EPI equation, EKFC equation demonstrated a wider median bias (–1.64 vs. 0.84 mL/min/1.73 m2, p

Objective To explore the research status, hot spots and trends of platelet rich plasma (PRP). Methods With "platelet rich plasma (PRP)" and its Chinese equivalent as the subject words, the PRP related articles during January 1, 2013 to December 31, 2022 from PubMed and CNKI database were retrieved. The bibliometric analysis was performed by Bicomb 2.0 software to extract the annual number of literature publications, authors, journals and high-frequency theme words/sub theme words. The gCLUTO software was used to evaluate and visualize the results, and strategic diagram was drawn according to the results of biclustering. Results A total of 9 066 PRP related articles were retrieved (7 027 from PubMed, 2 039 from CNKI), and the number of publications showed an increasing trend year by year. Papers have been published in 1 527 journals in PubMed, among which the journal with the highest number of publications was Arthroscopy: Journal of Arthroscopic & Related Surgery (175 articles), followed by American Journal of Sports Medicine (171 articles ) and Journal of Cosmetic Dermatology (121 articles) . PRP-related studies were published in 541 journals in CNKI, with the top 3 journals as Chinese Tissue Engineering Research (113 articles), Chinese Aesthetic Medicine (64 articles) and Chinese Journal of Blood Transfasion (45 articles) . In Pubmed, Anitua Eduardo (84 articles), Filardo Giuseppe (53 articles) and Cole Brian J (44 articles) were the top three productive authors on PRP; Cheng Biao from the General Hospital of Southern Theater Command of Chinese PLA was the most productive Chinese author (25 articles) . Shan Guiqiu from the General Hospital of the Southern Theater Command of the Chinese People's Liberation Army published the most articles(29 articles) in CNKI. American journals published the most articles (2 745 articles ), accounting for 39.06% of the total articles, followed by British and Swiss journals, with 1 499 articles and 550 articles, respectively. A total of 42 high-frequency subject words/sub-subject words were selected from PubMed, and were classified into 6 roups, while 30 high-frequency subject words were selected from CNKI and grouped into 5 categories. The strategic coordinates show that the treatment of rotator cuff and tendon injury with PRP in PubMed, the study of PRP and tissue engineering materials in CNKI are the core themes of current PRP research. Conclusion The strategic coordinate map and bibliometrics can reveal the current research status of PRP and predict future research hotspots, but current research cores of PubMed and CNKI are not consistent, and further research is still needed.

This study used Tweedie-GAM to evaluate the distribution characteristics of Japanese scad (Decapterus maruadsi) in spring, summer, and autumn (from 2015 to 2020) and its relationship with marine environmental factors. The fishery resources data from the southern Zhejiang coastal waters were combined with the hydrological environment survey data collected simultaneously. The results showed significant differences in the Japanese scad spatial distribution in different seasons. Japanese scad is mainly concentrated in the nearshore waters in spring and concentrated primarily on the south and north regions of the Zhejiang southern waters in summer, showing a "high on both sides, low in the middle" pattern. The distribution pattern in autumn is opposite to that in spring, wherein the Japanese scad mainly concentrated in open waters. There are some differences in the key influencing factors of Japanese scad in different seasons. In spring, with a range of 19.5~25.0 ℃, the resource density firstly showed an increasing trend and then decreased with the rise in water temperature, peaking at 22.7 ℃. During summer, the water temperature reached 28.0~30.3 ℃, and the resource density showed the maximum value when the salinity was 32.3. In autumn, the resource density showed a decreasing trend and later increased with the increment in the water salinity, with a minimum value of 29.8. The relationship between resource density and water depth remained stable, showing a multi-wavy nonlinear relationship, with an overall increasing trend and later stable pattern. This study revealed the relationship between the Japanese scad's temporal and spatial distribution characteristics and environmental factors. It provides a research reference for the conservation, management, and sustainable utilization of Japanese scad in the coastal waters of southern Zhejiang.

While a gambler may occasionally win, continuous gambling inevitably results in a net loss to the casino. This study experimentally demonstrates the profitability of a particularly deceptive casino game: a two-armed antique Mills Futurity slot machine. The main findings clearly show that both non-random and random two-arm strategies, predetermined by the player and repeated without interruption, are always profitable for the casino, despite two coins being refunded for every two consecutive losses by the gambler. We theoretically explore the cyclical nature of slot machine strategies and speculate on the impact of the frequency of switching strategies on casino returns. Our results not only assist casino owners in developing and improving casino designs, but also guide gamblers to participate more cautiously in gambling.

In a renewable-energy-penetrated power system (RPPS), inverter-based resources (IBRs) pose serious challenges to power system stability due to their completely different dynamic characteristics compared with conventional generators; thus, it is necessary to study the dynamic interactions between IBRs and power systems. Although many research efforts have been dedicated to this topic from both power electronics and power system researchers, some research from the power electronics field treats the external power system as a voltage source with an impedance, therefore ignoring the dynamic characteristics of a power system, while most of the research from the power system field applies simulation-based methods, for which it is difficult to directly interpret the interaction mechanism of IBRs and external system dynamics. Thus, none of these studies can explore the accurate dynamic interaction mechanism between IBRs and power systems, leading to performance degradation of IBR-integrated power systems. Our study takes into account the dynamic characteristics of both IBRs and the external power system, resulting in the development of a new open-loop transfer function for RPPSs. Based on this formulation, it is observed that under certain operating conditions, the dynamic interactions between the inverter and the power system help enhance IBR-penetrated power system stability compared with the case for which the external power system is controlled as a voltage source. The study also reveals how the inverter (phase-locked loop, control parameters, etc.), external power system (network strength) and penetration ratio in an IBR-penetrated power system affect the dynamic interactions between IBRs and the external power system using the proposed quantified interaction indices.

Most of the existing coal mine water inrush risk assessment methods are global assessment methods, which have the following problems: they ignore the difference in importance of the evaluation indicators at different locations in the study area and assign the same weight value; the area of the danger zone in the evaluation results is thus too large. The evaluation results improve the prediction accuracy by reducing the safe zone area. To address the aforementioned issues, this study employs a local analysis method based on a moving circular window, taking into account the spatial heterogeneity of criterion indicators in the decision-making process. By traversing each position of the raster with a circular moving window, the method performs local standardization and calculates local weights of indicators within the local window range. Based on the obtained maps of locally standardized evaluation criteria and local weights, a local water inrush risk assessment model is established using Geographic Information Systems (ArcGIS), considering the differences in the importance of evaluation indicators within the study area. Taking the Liangshuijing mining area as an example, both global and local evaluation models were employed to assess its water inrush risk. The evaluation results obtained from these two models were compared and validated against geological survey data and historical water inrush points. The comparative analysis between the two methods reveals that the local evaluation model demonstrates higher accuracy. It offers a more precise delineation of the distribution of water inrush risk zones, which better corresponds to the actual conditions within the mine. The localized water inrush risk assessment method proposed in this paper breaks away from the traditional approach of uniformly weighting evaluation indicators across the entire area, offering a novel method for assessing water inrush risk.

Abstract Background Non-suicidal self-injury (NSSI) is a risk factor for suicide. This study aimed to investigate the prevalence of NSSI and professional psychological help-seeking status and influencing factors among left-behind children (LBC) in China. Methods We implemented a population-based cross-sectional study in participants aged 10–18 years. Sociodemographic characteristics, NSSI, help-seeking status and coping style were measured by self-reported questionnaires. A total of 16,866 valid questionnaires were collected, including 6096 LBC. Binary logistic regression models were used to analyze the factors influencing NSSI and professional psychological help-seeking. Results The incidence of NSSI among LBC was 4.6%, significantly higher than that of non-left-behind children (NLBC). This incidence was higher among girls. Moreover, 53.9% of LBC with NSSI did not receive any treatment and only 22.0% sought professional psychological help. LBC often adopt emotion-oriented coping styles, specifically, those with NSSI. LBC with NSSI who seek professional help tend to adopt problem-oriented coping styles. Logistic regression analysis revealed that girls, learning stage, single-parent, remarried families, patience, and emotional venting were risk factors for NSSI in LBC, while problem-solving and social support seeking were protective factors. Moreover, problem-solving was also a predictor for seeking professional psychological help, patience will prevent it. Limitations This was an online survey. Conclusions The prevalence of NSSI in LBC is high. Gender, grade, family structure, and coping style affect the occurrence of NSSI among LBC. Only a few LBC with NSSI seek professional psychological help, while the coping style will affect the help-seeking behavior.

Lagerstroemia L. (Lythraceae) is a widely distributed genus of trees and shrubs native to tropical and subtropical environments from Southeast Asia to Australia, with numerous species highly valued as ornamentals. Although the plastomes of many species in this genus have been sequenced, the rates of functional gene evolution and their effect on phylogenetic analyses have not been thoroughly examined. We compared three plastome sequence matrices to elucidate how differences in these datasets affected phylogenetic analyses. Robust phylogenetic relationships for Lagerstroemia species were reconstructed based on different plastome sequence partitions and multiple phylogenetic methods. Identification of single-nucleotide variants within different genes also provides basic data on the patterns of functional gene evolution in Lagerstroemia and may provide insights into how those mutations affect protein structure and potentially drive divergence via cytonuclear incompatibility. These results as well as analyses of non-synonymous and synonymous mutations, indicate that heterotachic modes of evolution are present in functional plastome genes and should be accounted for in the analyses of molecular evolution. In addition, divergence events within the Lagerstroemia were dated for the first time. Several of the divergence estimates corresponded to well-known Earth history events, such as the reduction in global temperatures at the Eocene/Oligocene boundary. Our analyses conducted in Lagerstroemia here dissects the various patterns in the divergence of Lagerstroemia and may provide a useful guide to help plant breeders, as well as the necessity of using plastomic data and as possible as to combine evidence from morphological characteristics to investigate the complicated interspecies relationship and the evolutionary dynamics of species.

Deep learning-based intelligent vehicle perception has been developing prominently in recent years to provide a reliable source for motion planning and decision making in autonomous driving. A large number of powerful deep learning-based methods can achieve excellent performance in solving various perception problems of autonomous driving. However, these deep learning methods still have several limitations, for example, the assumption that lab-training (source domain) and real-testing (target domain) data follow the same feature distribution may not be practical in the real world. There is often a dramatic domain gap between them in many real-world cases. As a solution to this challenge, deep transfer learning can handle situations excellently by transferring the knowledge from one domain to another. Deep transfer learning aims to improve task performance in a new domain by leveraging the knowledge of similar tasks learned in another domain before. Nevertheless, there are currently no survey papers on the topic of deep transfer learning for intelligent vehicle perception. To the best of our knowledge, this paper represents the first comprehensive survey on the topic of the deep transfer learning for intelligent vehicle perception. This paper discusses the domain gaps related to the differences of sensor, data, and model for the intelligent vehicle perception. The recent applications, challenges, future researches in intelligent vehicle perception are also explored.

Objective In the aging world, the depression of older adults has aroused great concern. It brings detrimental side effects to old adults and the sustainability of society. The information and communication technologies have reshaped how people live among which the Internet has gained much popularity in the senior community. This study aims to explore the association between Internet use and depression in older adults. Methods This study applied a representative national dataset (China Longitudinal Aging Social Survey, CLASS 2018) to examine by conducting regression analysis. Inspired by the social capital theory, we further examined the mediating role of general social networks (as a general concept) and specific networks (family and friend networks) in reducing depression. All calculations and analyses were conducted by STATA. Results (a) Internet use significantly reduces depressive symptoms among Chinese older adults; (b) internet use enhances social network support for Chinese older adults; and (c) social networks in general and family networks and friend networks in specific all play a mediating role between internet use and depression symptoms. Conclusion This work proved that internet use could reduce depression levels in older adults in China, and social networks, including family networks and friend networks, have a mediation role in the relationship between internet use and depression in older adults in China. Combined with the Chinese social context, we explained that the existence of an empty-nest elderly community in Chinese society and the emphasis on kinship in Chinese tradition may be the reasons. Based on the main findings, tailor-made suggestions for addressing depression issues among older adults were discussed.

Cryopyrin-associated periodic syndrome (CAPS) comprises a group of disorders characterized by recurrent bouts of systemic inflammation related to overactivation of inflammasome. So far, neither large cases of the correlation between genotype and phenotype nor treatment strategies have been clearly stated in China. Here, we studied the clinical and genetic characteristics and their correlation from 30 CAPS patients in China. We identified the pathogenesis for novel mutations by activating NLRP3 inflammasome for peripheral cells with ATP plus LPS, compared characteristics with other case series, and analyzed treatment outcomes of these patients. The patients harbored 19 substitutions in NLRP3, and 8 of them were novel mutations. Among these novel mutations, percentages of severe musculoskeletal, ophthalmologic, and neurological symptoms were higher compared with other case serials. The correlation of phenotypes and their variants seemed different in our cases, such as T350M, S333G/I/R, and F311V (somatic mosaicism). Ten patients received Canakinumab treatment, which proved effective at alleviating musculoskeletal, neurological, auditory, visual manifestations, fever, and rash for 10–20 months follow-up. Patients treated with prednisolone or prednisolone plus thalidomide or methotrexate, tocilizumab, TNF inhibiting agents, and sirolimus achieved only partial remission. Importantly, we firstly identified somatic mosaicism mutation of F311V, which was severe. Our study extended the spectrum of genotype and phenotype and characteristics of their correlations and provided detailed responses to different treatment strategies. These data provide guidance for future diagnosis and management for CAPS.

Objective Alarmingly, the individuals’ reach and coverage to get vaccinated in developing regions during the pandemic is a massive challenge for concerned authorities. This study aimed to demonstrate how cyberchondria play a significant role in a classical health belief model. Cyberchondria may influence cognitive factors (e.g. self-efficacy), which may contribute to an increase in attitude–behavior gap. Especially in the context of a health-centric scenario, it may discourage individuals to take protective measures. Method By using the cross-sectional research design, the authors conducted a quantitative survey in Pakistan and collected 563 responses from 303 male respondents (rural = 91; urban = 212) with (Urban M:35.5, standard deviation (SD):13.4) and rural M:37.5, SD:8.4). Result The findings indicate that decision self-efficacy among males is stronger than that in females. It dominates other determinants, which can dampen the individuals’ intentions to get vaccinated. For instance, the effect of conspiracies and perceived seriousness was noted nonsignificant and weak. In females, perceived seriousness was stronger determinant than in males. In addition, the negative effect of decision self-efficacy was noted in the case of females, and conspiracy and cyberchondria had a negative role. Conclusion This study highlights valuable implications for future research in infodemic, health communication and health literacy, and practical implications for regulatory bodies and public administration.

Acute poisoning is a significant public health concern. This retrospective study investigates trends in acute poisoning cases and explores the clinical and sociodemographic profiles associated with this condition. Medical data from 859 hospitalized patients diagnosed with acute poisoning between January 2017 and December 2022 were comprehensively analyzed. The descriptive statistical analysis revealed that 360 patients had underlying diseases, with depression being the most prevalent among them. Furthermore, urban areas accounted for 87.2% of the acute poisoning cases, indicating a higher incidence compared to rural areas. The substances implicated in acute poisoning incidents varied, with drugs of abuse being the most common (53.2%), followed by pesticides (22.2%), carbon monoxide (11.8%), and alcohol (5.4%). Suicide attempt/suicide emerged as the leading cause of acute poisoning incidents, accounting for 75.9% of cases, while poisoning accidents predominantly occurred within the home setting. Through chi-square tests, it was determined that risk factors for suicide attempt/suicide included female gender and underlying medical conditions. Temporal analysis showed that the total number of acute poisoning cases increased from 2017 to 2019 and decreased from 2019 to 2022. Notably, suicide-related cases exhibited an upward trend, with suicide attempt/suicide accounting for over 80% of all acute poisoning cases after 2020. This study contributes valuable insights into the trends, profiles, and risk factors associated with acute poisoning cases.

Near-surface air temperature lapse rate (NSATLR) is one of the key criteria for judging atmospheric stability. It is an important model parameter in glacier, hydrology, ecology, climate, and meteorology in high mountains such as the Tibetan Plateau (TP). However, due to the complex interaction between the atmosphere and land surface, retrieving NSATLR from remotely sensed data is challenging. In this article, we develop a novel model based on the MODIS data to estimate the daily 5-km NSATLR over the TP. The input parameters of the model include digital elevation model and the near-surface air temperature estimated from the MODIS data. By combining moving window and specified criteria, the pixel-based NASTLR with a 5-km spatial resolution over the TP is estimated. In addition, we also estimate the NSATLR based on the meteorological data over the TP (NSATLRin situ) to evaluate the accuracy of NSATLR estimation model. Results demonstrate that the NSATLR estimate agrees well with NSATLRin situ in the eastern TP, with an overall root-mean-square error of 1.51 °C/km and a mean bias error of −0.78 °C/km. Larger deviation exists in the southern TP. Thanks to the evident advantages of simplicity, the availability of input parameters and the independence from the meteorological data, the developed model can be applied to larger areas.

The purpose of this retrospective study was to evaluate the clinicopathological features of papillary thyroid microcarcinoma (PTMC) and the lymph node metastasis of PTMC. We retrospectively reviewed a total of 1433 patients with PTMC. The analysis data including demographics, tumor size, multifocality, bilateral, invasion capsule and Hashimoto’s thyroiditis were collected from XinJiang, China. Univariate and multivariate analyses were performed to identify the clinicopathologic predictors of central lymph node metastasis: male gender [odds ratio (OR) = 2.358, p < 0.001], age ≤ 45 years (OR = 2.302, p 6.5 mm (OR = 2.388, p < 0.001), adjacent or invasion capsule (OR = 1.750, p = 0.002), Hashimoto’s thyroiditis (OR = 0.501, p < 0.001). The optimal critical value of the number of dissected lymph nodes was found to be 8.5 using ROC analysis, with a sensitivity and specificity of 41.8% and 75.5%, respectively. This study suggests that evaluation of nodal metastasis is required to guide the surgical treatment of PTMC patients.

Abstract Background Depression is a psychiatric disorder with global public health concerns. Although a number of risk factors have been identified for depression, there is no clear relationship between biochemistry and depression. In this study, we assessed whether depressive disorders are significantly associated with biochemical indicators. Methods Our study included 17,561 adults (age ≥ 18 years) participating in the 2009-2018 National Health and Nutrition Examination Survey (NHANES). The relationship between depression and biochemical and obesity indicators was analyzed by logistic regression. Results As compared to the control group, men with depression showed significantly higher levels of gamma-glutamyl transferase, glucose, and triglycerides, and lower levels of albumin and total bilirubin. The depressed group had higher levels of alkaline phosphatase, bicarbonate, and sodium than the control group. Conclusion Several biochemical and anthropometric indices were associated with depression in this study. It would be interesting to further analyze their cause-effect relationship. Limitations This study is a cross-sectional study. The population is less restricted and does not exclude people with diabetes, pregnancy, etc., so it is less significant for a specific population. Dietary information was not included, as diet plays an important role in many indicators.

Abstract Horticulture productivity has been increasingly restricted by heat stress from growing global warming, making it far below the optimum production capacity. As a popular ornamental cultivar of tree peony, Paeonia suffruticosa ‘Yu Hong’ has also been suffering from heat stress not suitable for its optimal growth. To better understand the response mechanisms against heat stress of tree peony, investigations of phenotypic changes, physiological responses, and quantitative proteomics were conducted. Phenotypic and physiological changes indicated that 24 h of exposure to heat stress (40 °C) was the critical duration of heat stress in tree peony. The proteomic analyses revealed a total of 100 heat-responsive proteins (HRPs). According to bioinformatic analysis of HRPs, the heat tolerance of tree peony might be related to signal transduction, synthesis/degradation, heat kinetic proteins, antioxidants, photosynthesis, energy conversion, and metabolism. Our research will provide some new insights into the molecular mechanism under the response against the heat stress of tree peony, which will benefit the future breeding of heat-resistant ornamental plants.

Yunnan, the region hardest hit by HIV/AIDS in China, is also an area with the most abundant HIV-1 genetic diversity. A large number of novel HIV-1 circulating recombinant forms (CRFs) and unique recombinants were identified among injection drug users in Yunnan; however, few were found among sexual contacts. Here, we obtained 15 near full-length genome sequences (NFLGs) from HIV-1 seropositive heterosexual contacts in Yunnan who received antiretroviral therapy during the period from 2014 to 2016. Phylogenetic analysis showed that six NFLGs belonged to CRF01_AE (n = 3) and CRF106_cpx (n = 3), and the other nine sequences were novel inter-subtype recombinants. Of the recombinants, two novel CRFs (CRF111_01 C (n = 4) and CRF116_0108 (n = 4)) and one CRF106_cpx variant (n = 1) were identified. CRF111_01 C had a CRF01_AE backbone with seven subtype C fragments inserted into the gag, pol, vif, env, nef and 3ʹLTR regions. CRF116_0108 had a CRF08_BC backbone with a CRF01_AE fragment inserted into the pol, tat, rev, vif, vpr, vpu and env regions. Phylogeographic analyses estimated that CRF111_01 C and CRF116_0108 originated approximately 1995.7–1998.6 and 1991.7–1993.7, respectively. These identifications of two novel HIV-1 CRFs highlighted the importance of continuous surveillance in heterosexual contacts and other high-risk groups in this region and the surrounding regions.

Anthropogenic or environmental changes can impact not only the composition and diversity of fish communities but also their species interactions. However, our current understanding of changes in species interactions remains limited. In this study, we utilized the bottom trawling survey data from 2017 to 2020 to investigate the temporal shift of fish communities in the south inshore of Zhejiang through co-occurrence networks, species composition, and diversity analysis. Our findings indicated significant changes in the fish community in recent years, including a decrease in the number of dominant fish families, a shift in dominant species from medium-sized commercial fish to low-value small fish, a decline in relative biomass of fish resources, a loss of diversity and species co-occurrences, an increase in community modularity, and a decrease in community clustering. The changes in co-occurrence networks revealed the local decline or loss of keystone species critical to the functioning of the ecosystem and the fragmentation of the fish community in the south inshore of Zhejiang. We also found that despite the dominant species being the major component of the community, not all of them held central positions in the co-occurrence networks. Additionally, the high fishing intensity and stochastic environmental changes may have consistently negatively affected offshore fish communities. As a result, the resilience or function of the fish community under external disturbance threats was likely decreasing over time. It is imperative that ongoing monitoring and assessment are needed to expose the ecological impacts of a range of pervasive anthropogenic threats. Further measures should be taken to mitigate the negative impact of fishing or other disturbances on the coastal ecosystems are necessary.

Aims: Gut-microbiome derived short-chain fatty acids exert anti-inflammatory effects and delay progression of kidney disease in diabetic nephropathy. The aim of this study was to examine the impact in vivo and in vitro of short-chain fatty acid treatment on cellular pathways involved in the development of experimental diabetic nephropathy.Methods: To determine the effect of short-chain fatty acids in diabetic nephropathy, we compared wildtype, GPR43−/− and GPR109A−/− mice diabetic mice treated with acetate or butyrate and assessed variables of kidney damage. We also examined the impact of short-chain fatty acid treatment on gene expression in renal tubular cells and podocytes under high glucose conditions.Results: Short-chain fatty acid treatment with acetate or butyrate protected wild-type mice against development of diabetic nephropathy, exhibiting less glomerular hypertrophy, hypercellularity and interstitial fibrosis compared to diabetic controls. Acetate and butyrate treatment did not provide the same degree of protection in diabetic GPR43−/− and GPR109A−/− diabetic mice respectively. Consistent with our in vivo results, expression of pro-inflammatory genes in tubular epithelial cells exposed to high glucose were attenuated by acetate and butyrate treatment. Acetate did not reduce inflammatory or fibrotic responses in glucose stimulated GPR43−/− TECs. Butyrate mediated inhibition of pro-fibrotic gene expression in TECs through GPR109A, and in podocytes via GPR43.Conclusion: SCFAs protect against progression of diabetic nephropathy and diminish podocyte and tubular epithelial injury and interstitial fibrosis via direct, GPR-pathway dependent effects on intrinsic kidney cells. GPR43 and GPR109A are critical to short-chain fatty acid mediated reno-protection and have potential to be harnessed as a therapeutic target in diabetic nephropathy.

Background: Standardized training of resident physicians (STRP) includes clinical practice, professional required courses, and public required courses, among others. Of them, clinical practice is the most important as it allows residents to implement what they have learned in theoretical education to practice. Clinical practice includes different teaching methods, such as traditional lectures, bedside teaching, and workshops, and each method has its advantages and disadvantages in different situations of interest. Emergency medicine (EM) focuses on the diagnosis and treatment of urgent medical conditions and entails several emergency procedures. In this study, we aimed to compare the effects of workshop-based STRP and traditional STRP on emergency physicians. Methods: Overall, 125 residents who received STRP in EM between January and December 2021 were selected and randomly divided into two groups: the control group (n = 60; received traditional teaching) and the intervention group (n = 65; received workshop-based training). The theoretical performance, operative performance, and satisfaction of both groups were compared and analyzed. Results: Regarding theoretical assessment, the scores of airway management, cardiopulmonary resuscitation, and trauma management in the intervention group were 4.81 (t = 5.82, p

Asiatic acid (AA) is the most crucial component of Asiaticoside in many edible and medicinal plants. It has diverse biological activities such as anti-inflammatory, antioxidant, anti-infective, and anti-tumor. Additionally, AA has been intensively studied in the last decades. It has shown great potential in the treatment of various neurological diseases such as spinal cord injury (SCI), cerebral ischemia, epilepsy, traumatic brain injury (TBI), neural tumors, Alzheimer's disease (AD), and Parkinson's disease (PD). Moreover, AA provides pertinent data for neuroprotective signaling pathways, and its substantial neuroprotective ability makes it a novel candidate for developing drugs that target the central nervous system.

BackgroundChimeric antigen receptor - T (CAR-T) cell therapy has shown remarkable efficacy in patients with relapsed/refractory multiple myeloma (R/R MM). However, a subset of patients still experienced progression or relapse, and the predictors of prognosis are little known. We analyzed the inflammatory markers before CAR-T cell infusion, to clarify their correlation with survival and toxicity.MethodsThis study involved 109 R/R MM patients who received CAR-T therapy between June 2017 and July 2021. Inflammatory markers, including ferritin, c-reactive protein (CRP), and interleukin-6 (IL-6) before CAR-T cell infusion were detected and then categorized by quartiles. Adverse events and clinical outcomes were compared between patients with upper quartile of inflammatory markers and patients with lower three quartiles of inflammatory markers. An inflammatory prognostic index (InPI) based on these three inflammatory markers was developed in this study. Patients were divided into 3 groups according to the InPI score, progression-free survival (PFS) and overall survival (OS) were compared among the groups. In addition, we explored the correlation between cytokine release syndrome (CRS) and pre-infusion inflammatory markers.ResultsWe found that the pre-infusion high ferritin (hazard ratio [HR], 3.382; 95% confidence interval [CI], 1.667 to 6.863; P = .0007), high CRP (HR, 2.043; 95% CI, 1.019 to 4.097; P = .044), and high IL-6 (HR, 3.298; 95% CI, 1.598 to 6.808; P = .0013) were significantly associated with inferior OS. The formula of the InPI score was based on the HR value of these 3 variables. Three risk groups were formed: (good, 0 to 0.5 point; intermediate, 1 to 1.5 points; poor, 2 to 2.5 points). Median OS for patients with good, intermediate, and poor InPI was not reached, 24 months, and 4 months, respectively, and median PFS was 19.1 months, 12.3 months, and 2.9 months, respectively. In the cox proportional hazards model, poor InPI remained an independent prognostic factor for PFS and OS. Pre-infusion ferritin was negatively associated with CAR T-cell expansion normalized to baseline tumor burden. Spearman correlation analysis showed that pre-infusion ferritin and IL-6 levels positively correlated with the grade of CRS (P = .0369 and P = .0117, respectively). The incidence of severe CRS was higher in patients with high IL-6 compared with patients with low IL-6 (26% vs. 9%, P = .0405). Pre-infusion ferritin, CRP and IL-6 were positively correlated with each peak values within the first month after infusion.ConclusionsOur results suggest that patients with elevated inflammation markers before CAR-T cell infusion are more likely to have poor prognosis.

In this study, 7075 Al alloy was prepared by solution treatment + natural aging. The anisotropic behavior of 7075 Al alloy in extrusion direction (ED), 45° direction (45°) and radial direction (RD) was studied by quasi-static tensile test and strain controlled low cycle fatigue (LCF) test. The specimens of ED, 45° and RD were 0°, 45° and 90° to the extrusion direction of the bar, respectively. The mechanical properties of the specimens in three directions showed strong anisotropy. The yield strength (YS) and ultimate tensile strength (UTS) of ED specimens were better than 45° and RD specimens, but 45° specimens had better plasticity. With the extension of aging time, the YS and UTS increase significantly. In the quasi-static tensile process, the specimens would have dynamic strain aging (DSA), and obvious serrated flow behavior could be observed on the curve. For the fatigue performance of specimens in three directions, when the strain amplitude was low, the fatigue life of ED and 45° specimens was high. When the strain amplitude was high, the fatigue life of RD specimens was high. The experimental results showed that after cyclic loading, the second phase size of solution treatment + cyclic loading specimens was larger than T6 (480 °C × 3 h + 130 °C × 24 h). Therefore, the fatigue fracture mode was multi-source fracture at low strain amplitude.

AimThe purpose of this study was to evaluate the effectiveness of the graded transport mode in the intrahospital transport (IHT) of critically ill patients.MethodsThis is a retrospective study, including 800 patients and categorized them into control and observation groups. The control group included 420 critically ill patients who were transported via conventional methods from our emergency resuscitation unit from June 2017 to December 2017. The observation group included 380 critically ill patients who were transported through a graded transport mode from January 2018 to June 2018. We performed intergroup comparisons of the incidence rates and causes of adverse events (AEs), transport time, length of stay, and mortality rate.ResultsThe observation group had significantly lower transport time and AE incidence rates than the control group. However, no significant differences were observed in terms of the length of stay and mortality rate between the two groups.ConclusionThe most notable merits of the graded transport mode in the IHT of critical care patients include the fact that it significantly reduces the incidence of AEs during IHT, shortens the transport time, and improves transport efficiency, thereby ensuring the safety of critically ill patients.

AimsThe Ca+/NFAT (Nuclear factor of activated T cells) signaling pathway activation is implicated in the pathogenesis of Kawasaki disease (KD); however, we lack detailed information regarding the regulatory network involved in the human coronary endothelial cell dysfunction and cardiovascular lesion development. Herein, we aimed to use mouse and endothelial cell models of KD vasculitis in vivo and in vitro to characterize the regulatory network of NFAT pathway in KD.Methods and ResultsAmong the NFAT gene family, NFAT2 showed the strongest transcriptional activity in peripheral blood mononuclear cells (PBMCs) from patients with KD. Then, NFAT2 overexpression and knockdown experiments in Human coronary artery endothelial cells (HCAECs) indicated that NFAT2 overexpression disrupted endothelial cell homeostasis by regulation of adherens junctions, whereas its knockdown protected HCAECs from such dysfunction. Combined analysis using RNA-sequencing and transcription factor (TF) binding site analysis in the NFAT2 promoter region predicted regulation by Forkhead box O4 (FOXO4). Western blotting, chromatin immunoprecipitation, and luciferase assays validated that FOXO4 binds to the promoter and transcriptionally represses NFAT2. Moreover, Foxo4 knockout increased the extent of inflamed vascular tissues in a mouse model of KD vasculitis. Functional experiments showed that inhibition NFAT2 relieved Foxo4 knockout exaggerated vasculitis in vivo.ConclusionsOur findings revealed the FOXO4/NFAT2 axis as a vital pathway in the progression of KD that is associated with endothelial cell homeostasis and cardiovascular inflammation development.

Introduction: To explore the mechanism of action of appling Radix Ginseng and Semen Ziziphi Spinosae Drug pair (R-S) in the treatment of insomnia by investigating the effect of R-S on GLU/GABA-GLN metabolic cycle and intestinal microflora of rats with insomnia.Methods: Rats were intraperitoneally injected with 4-chloro-DL-phenylalanine (PCPA) to make sleep deprivation (SD) models. The rats were divided into 6 groups, with 8 rats in each group. The general status of the rats was observed and the pentobarbital sodium sleep synergy experiment was performed. The contents of GABA, GLU, GLN, GAD65, and GS in hippocampus of rats were determined by ELISA. The expressions of GABAARα1mRNA, mGluR5mRNA, NR1mRNA and GluR1mRNA in rats’ hippocampal tissue were determined by Realtime PCR. 16SrRNA gene sequencing was used to analyze the intestinal microflora of insomnia rats.Results: In PCPA-induced insomnia rats, the state of insomnia was relieved, the sleep rate was improved, the duration of sleep latency was shortened and the sleep duration was prolonged in each dose group of R-S (p < 0.05, p < 0.01) compared with the model group. The contents of GABA, GLN, GAD65 and GS were increased (p < 0.05, p < 0.01) while GLU content was decreased (p < 0.01) in both medium and high dose groups, especially in the high dose group. The expression of GABAARα1mRNA was increased (p < 0.01), and the expressions of mGluR5mRNA, NR1mRNA and GluR1mRNA were decreased (p < 0.01) in hippocampal tissue of rats in R-S groups, especially in the high dose group. At the same time, the various dose groups of R-S could improve the species diversity, microflora abundance of insomnia rats and regulate the KEGG metabolic pathway related to sleep.Discussion: R-S can improve the sleep of PCPA-induced insomnia rats by regulating GLU/GABA-GLN metabolic cycle and intestinal microflora, which provides experimental basis for appling R-S in the treatment of insomnia.

ObjectiveSerum inflammatory biomarkers play crucial roles in the development of acute ischemic stroke (AIS). In this study, we explored the association between inflammatory biomarkers including platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and monocyte-to-lymphocyte ratio (MLR), and clinical outcomes in AIS patients who achieved successful recanalization.MethodsPatients with AIS who underwent endovascular thrombectomy (EVT) and achieved a modified thrombolysis in the cerebral infarction scale of 2b or 3 were screened from a prospective cohort at our institution between January 2013 and June 2021. Data on blood parameters and other baseline characteristics were collected. The functional outcome was an unfavorable outcome defined by a modified Rankin Scale of 3–6 at the 3-month follow up. Other clinical outcomes included symptomatic intracranial hemorrhage (sICH) and 3-month mortality. Multivariable logistic regression analysis was performed to evaluate the effects of PLR, NLR, and MLR on clinical outcomes.ResultsA total of 796 patients were enrolled, of which 89 (11.2%) developed sICH, 465 (58.4%) had unfavorable outcomes at 3 months, and 168 (12.1%) died at the 3-month follow up. After adjusting for confounding variables, a higher NLR (OR, 1.076; 95% confidence interval [CI], 1.037–1.117; p < 0.001) and PLR (OR, 1.001; 95%CI, 1.000–1.003; p = 0.045) were significantly associated with unfavorable outcomes, the area under the receiver operating characteristic curve of NLR and PLR was 0.622 and 0.564, respectively. However, NLR, PLR, and MLR were not independently associated with sICH and 3-month mortality (all adjusted p > 0.05).ConclusionOverall, our results indicate that higher PLR and NLR were independently associated with unfavorable functional outcomes in AIS patients with successful recanalization after EVT; however, the underlying mechanisms are yet to be elucidated.