Search

Abstract Background Lifestyle and cardiovascular mortality and all-cause mortality have been exhaustively explored by traditional methods, but the advantages of machine learning (ML) over traditional methods may lead to different or more precise conclusions. The aim of this study was to evaluate the effectiveness of machine learning-based lifestyle factors in predicting cardiovascular and all-cause mortality and compare the results obtained by traditional methods. Method A prospective cohort study was conducted using a nationally representative sample of adults aged 40 years or older, drawn from the US National Health and Nutrition Examination Survey from 2007 to 2010. The participants underwent a comprehensive in-person interview and medical laboratory examinations, and subsequently, their records were linked with the National Death Index for further analysis. Extreme gradient enhancement, random forest, support vector machine and other machine learning methods are used to build the prediction model. Result Within a cohort comprising 7921 participants, spanning an average follow-up duration of 9.75 years, a total of 1911 deaths, including 585 cardiovascular-related deaths, were recorded. The model predicted mortality with an area under the receiver operating characteristic curve (AUC) of 0.862 and 0.836. Stratifying participants into distinct risk groups based on ML scores proved effective. All lifestyle behaviors were associated with a reduced risk of all-cause and cardiovascular mortality. As age increases, the effects of dietary scores and sedentary time on mortality risk become more pronounced, while the influence of physical activity tends to diminish. Conclusion We develop a ML model based on lifestyle behaviors to predict all-cause and cardiovascular mortality. The developed model offers valuable insights for the assessment of individual lifestyle-related risks. It applies to individuals, healthcare professionals, and policymakers to make informed decisions.

Abstract Background Intrauterine adhesion (IUA) is a common cause of clinically refractory infertility, and there exists significant heterogeneity in the treatment outcomes among IUA patients with the similar severity after transcervical resection of adhesion(TCRA). The underlying mechanism of different treatment outcomes occur remains elusive, and the precise contribution of various cell subtypes in this process remains uncertain. Results Here, we performed single-cell transcriptome sequencing on 10 human endometrial samples to establish a single-cell atlas differences between patients who responded to estrogen therapy and those who did not. The results showed increased infiltration of immune cells such as monocyte macrophages, T cells, and natural killer (NK) cells in patients who did not respond to estrogen therapy. Our findings indicate that distinct fibroblast subsets are implicated in the modulation of the Wnt, Hippo, and Hedgehog signaling pathways, as evidenced by functional enrichment analyses. This may have implications for the therapeutic efficacy in patients with IUA. Furthermore, we delineated the markers and transcriptional status of different macrophage subsets and identified two cell clusters, CXCL10high and CCL4L2high macrophage subsets, which are intimately associated with inflammation and fibrosis. The state of fibrosis and inflammatory response in human endometrial tissues with disparate treatment outcomes is revealed, and providing evidence to clarify the underlying determinants of sensitivity to estrogen therapy. Conclusions We described the transcriptional status of different cell subtypes in the two groups of patients, providing new ideas for exploring the molecular mechanism of the difference in the effectiveness of estrogen therapy in patients, and providing theoretical basis for providing precise and individualized treatment plans for IUA patients.

This study elucidated the optimization conditions, GC-MS analysis conditions, total antioxidant activity, and components closely related to antioxidant activity for supercritical extraction of active ingredients in Huoluo Xiaoling Dan (HLXLD). The yield, octyl acetate content, and total antioxidant activity of HLXLD under different conditions were obtained through orthogonal experiments, and the optimal supercritical extraction conditions were determined to be 45°C, 25 MPa, and 4 h. The supercritical extract was subjected to GC-MS analysis and matched with the WILEY and NIST databases, resulting in the qualitative identification of 37 chemical components with a matching degree above 60. The similarity evaluation system of traditional Chinese medicine fingerprint was used to evaluate all orthogonal experimental samples, with a similarity ranging from 0.522 to 0.989. Thirteen common characteristic peaks were selected, and the quantification of these peaks was performed using peak area normalization method. The combination of the content of common characteristic peaks in different samples and their total antioxidant activity was analyzed using multivariate statistical methods such as principal component analysis and multiple regression equation. It was found that five components, F3, F2, F5, F7 and F12, among the common characteristic peaks were closely related to antioxidant activity.

Abstract Background This study utilizes a Knowledge, Attitude, and Practice (KAP) questionnaire to investigate the awareness of medical professionals in the Ningxia region regarding research integrity and their attitudes towards academic misconduct. A comprehensive analysis of the factors contributing to academic misconduct is performed, with the aim of providing insights for the formulation of policies to enhance research integrity. Methods This study is a cross-sectional study. It performed between May 2023 and October 2023, and the questionnaires were distributed and collected through Wenjuanxing and WeChat platforms. The research employs a self-designed KAP survey questionnaire distributed online for clinical doctors and nurses in hospital, faculty members in medical higher education institutions, and undergraduates enrolled in medical schools in the Ningxia region. Results A total of 1013 valid questionnaires were collected, with a majority of participants (76.2%) having received training in research integrity. The survey results indicate that a significant majority of participants (75.04%) cannot tolerate academic misconduct. More than 70% of respondents believe that the main reasons for academic misconduct are a lack of understanding of academic ethical norms, a deficiency in personal integrity awareness, individual inadequacy in research capabilities, and excessive pressure. When it comes to measures for academic misconduct reduction, over 70% of individuals believe that strengthening research integrity training, improving the assessment methods for research outcomes, and enhancing personal research capabilities can decrease instances of academic misconduct. Most respondents demonstrated a basic understanding of research integrity and maintained a resistant attitude towards academic misconduct. However, there exists an insufficient awareness of certain forms of academic misconduct. The study recommends implementing multifaceted measures to enhance the ethical awareness and attitudes of researchers. Conclusion In this study, a KAP questionnaire was administered to clinicians, nurses, medical faculty and students to find out their understanding of research integrity and their attitudes towards academic misconduct. Most of the respondents had a negative attitude towards academic misconduct, but their understanding of research integrity could be improved. Furthermore, university teachers’ understanding of research integrity and their attitudes towards academic misconduct were better than other groups, and university students had lower scores in this area, so it is recommended to take various measures to improve their understanding of research integrity.

Abstract With increasing life spans, breast cancer (BC) survivors may face the possibility of developing second primary cancer (SPC), which can considerably shorten survival. Lung cancer (LC) is a common SPC among BC survivors. This study explored the association between these two cancers through Mendelian randomization (MR) analysis. A bidirectional two-sample MR analysis was conducted with BC genome-wide association study (GWAS) data from the Breast Cancer Association Consortium (BCAC) included 228,951 individuals and the GWAS summary statistics from the Transdisciplinary Research in Cancer of the Lung (TRICL) of LC included 112,781 individuals. The IVW method and MR-RAPS method showed a causal effect of overall BC on lung adenocarcinoma (LUAD) (IVW: OR = 1.060, 95% CI = 1.008–1.116, P = 0.024; MR-RAPS: OR = 1.059, 95% CI = 1.005–1.116, P = 0.033), which indicated that patients with BC had an increased risk of LUAD. However, there is no strong evidence for a causal effect of LUAD on BC. Our study revealed a causal effect of BC on second primary LUAD, suggesting that we should intensify screening for second primary LC in BC survivors. Early intervention and treatment for patients with second primary LC are needed to reduce mortality in BC survivors.

Abstract Background Incorporating backfill cohorts in phase I oncology trials is a recently developed strategy for dose optimization. However, the efficacy assessment window is long in general, causing a lag in identifying ineffective doses and more patients being backfilled to those doses. There is necessity to investigate how to use patient-reported outcomes (PRO) to determine doses for backfill cohorts. Methods We propose a unified Bayesian design framework, called ‘Backfill-QoL’, to utilize patient-reported quality of life (QoL) data into phase I oncology trials with backfill cohorts, including methods for trial monitoring, algorithm for dose-finding, and criteria for dose selection. Simulation studies and sensitivity analyses are conducted to evaluate the proposed Backfill-QoL design. Results The simulation studies demonstrate that the Backfill-QoL design is more efficient than traditional dose-expansion strategy, and fewer patients would be allocated to doses with unacceptable QoL profiles. A user-friendly Windows desktop application is developed and freely available for implementing the proposed design. Conclusions The Backfill-QoL design enables continuous monitoring of safety, efficacy and QoL outcomes, and the recommended phase II dose (RP2D) can be identified in a more patient-centered perspective.

Abstract Systems with broken continuous symmetry in ideal lattices cannot be rectified through rearrangement or deformation. Topological metamaterials featuring nontrivial, artificially induced phase transitions have emerged as pivotal constituents for engineering these topological defects, which, until now, have mostly been experimentally realized in linear or planar configurations. Buckminster Fuller lent his name to the C60 ball-shaped carbon allotrope, which is not only the roundest molecule in existence but also embodies 3D topological defects. Here, we construct a C540 metamaterial composed of interspersed pentagons in a hexagonal network of hollow tubes and cavities. By 3D printing this giant closed-cage topology, the nontrivial state-confinements can be fully controlled and visualized, which, in contrast, in synthesized or naturally found fullerenes, is highly challenging. Thanks to our macroscopic metamaterials approach, we are able to map in real-space topological pentagon states probed by sound waves. Our results show how a seemingly unrelated approach can unveil deep physical understanding in carbon allotropes and potentially in a plethora of other complex systems in the near future.

Abstract Objective To evaluate implementation of a patient decision aid for symptomatic uterine fibroid management to improve shared decision-making at five clinical settings across the United States. Methods We used a type 3 hybrid effectiveness-implementation stepped-wedge design and the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) planning and evaluation framework. We conducted clinician training, monthly reach tracking with feedback to site clinical leads, patient and clinician surveys, and visit audio-recordings. Implementation strategies included assessment of organizational readiness for shared decision-making, synchronous clinician training, audit and feedback of decision aid reach, and access to multiple decision aid formats. Outcomes and analyses included patient-level reach, clinician-level adoption, and associations of patient-reported decision aid exposure (as treated) and setting-level implementation (intention-to-treat) with patient-reported (collaboRATE measure) and observed (OPTION-5 measure) shared decision-making. We also designed and assessed setting-level plans for sustainability and other factors impacting sustained decision aid use. Results The decision aid was adopted by 72 of the 74 eligible gynecologists (97%) and reached 2553 patients across five settings. CollaboRATE scores improved among patients who reported receiving the decision aid (as-treated analysis, 69% vs. 59%; OR 1.6, 95% CI 1.16–2.27). CollaboRATE scores remained consistent before and after setting-level decision aid implementation (intention-to-treat analysis, 64% vs. 63%; OR 0.86, 95% CI 0.61–1.22). Participants would prefer to receive a decision aid at multiple time points (91.9% before the visit, 90.7% during the visit, 86.5% after the visit). Shared decision-making experiences did not improve when comparing pre vs. post-implementation collaboRATE scores across included settings (intention-to-treat, 64% vs. 63%; OR 0.86, 95% CI 0.61–1.22). Conclusion When patients with symptomatic uterine fibroids are given decision aids, they report higher shared decision-making scores. However, the differences we observed between the as-treated and intention-to-treat results suggest that unaddressed implementation challenges continue to limit the extent to which patients receive decision aids and likely hinder their overall impact. Future efforts to implement decision aids should explore enhancing their integration into clinical workflows and standard operating procedures, supported by organizational incentives that prioritize shared decision-making. Trial registration ClinicalTrials.gov NCT03985449; registered 6 June 2019.

Background The global prevalence of low back pain is gradually increasing, and it is the main cause of disability, sick leave, and unemployment, posing a heavy burden on individuals and society. Assessing the degree of disability in patients with chronic low back pain is crucial for evaluating the efficacy of clinical interventions and clinical epidemiology. The Roland-Morris Disability Questionnaire (RMDQ) is currently the main tool for evaluating disability in patients with low back pain, but the applicability of its measurement performance in the Chinese population remains unclear. Objective To evaluate the applicability of RMDQ in the Chinese population with low back pain and provide evidence for clinical practice and research application. Methods CNKI, Wanfang Data Knowledge Service Platform, SinoMed, PubMed, Embase and Web of Science were searched from inception to 2023-10-01, to establish a literature base for the performance of the low back pain scale, and then select research on the measurement performance of RMDQ from it. The measurement performance of the RMDQ scale was evaluated according to the COSMIN system evaluation guidelines, and the evidence evaluation level was used to grade the evidence. Results A total of six RMDQ documents were included, with insufficient methodological quality for RMDQ content validity and adequate measurement performance. The quality of internal consistency methodology was very good with uncertainty and measurement performance was adequate; the methodological quality of retesting was uncertain, and the measurement performance was sufficient; the methodological quality of measurement error was uncertain, and the measurement performance was sufficient; the methodological quality of criterion validity was uncertain, and the measurement performance was insufficient; hypothesis testing methodological quality was very good with uncertain, and the measurement performance was sufficient and uncertain; the quality of reactivity methodology was very good, with sufficient and insufficient, while the measurement performance was sufficient with insufficient. According to the GRADE evidence quality rating results, there is low quality evidence to prove uncertainty in content validity, and moderate quality evidence to prove sufficient retesting reliability and internal consistency; there is sufficient evidence of low quality to prove the measurement error and reactivity. There is very low quality evidence of insufficient calibration validity when using the Oswestry Dysfunction Index (ODI) and the Visual Analog Scale (VAS) as calibrators; hypothesis testing had moderate quality evidence of uncertainty. Conclusion The methodological quality of the RMDQ scale is not high, with acceptable measurement performanceand low quality of evidence, and needs to be used cautiously in clinical practice or trials of low back pain in China. Although there is sufficient evidence of moderate quality to prove the reliability and internal consistency of retesting, the research content and methods are not standardized. In future research, attention should be paid to standardization to more accurately assess its applicability in the Chinese population.

Abiotic and biotic stressors adversely affect plant survival, biomass generation, and crop yields. As the global availability of arable land declines and the impacts of global warming intensify, such stressors may have increasingly pronounced effects on agricultural productivity. Currently, researchers face the overarching challenge of comprehensively enhancing plant resilience to abiotic and biotic stressors. The secondary cell wall plays a crucial role in bolstering the stress resistance of plants. To increase plant resistance to stress through genetic manipulation of the secondary cell wall, we cloned a cell wall protein designated glycine-rich protein-like (GhGRPL) from cotton fibers, and found that it is specifically expressed during the period of secondary cell wall biosynthesis. Notably, this protein differs from its Arabidopsis homolog, AtGRP, since its glycine-rich domain is deficient in glycine residues. GhGRPL is involved in secondary cell wall deposition. Upregulation of GhGRPL enhances lignin accumulation and, consequently, the thickness of the secondary cell walls, thereby increasing the plant's resistance to abiotic stressors, such as drought and salinity, and biotic threats, including Verticillium dahliae infection. Conversely, interference with GhGRPL expression in cotton reduces lignin accumulation and compromises that resistance. Taken together, our findings elucidate the role of GhGRPL in regulating secondary cell wall development through its influence on lignin deposition, which, in turn, reinforces cell wall robustness and impermeability. These findings highlight the promising near-future prospect of adopting GhGRPL as a viable, effective approach for enhancing plant resilience to abiotic and biotic stress factors.

Abstract Backgrounds Acute transplant rejection is a major component of poor prognoses for organ transplantation. Owing to the multiple complex mechanisms involved, new treatments are still under exploration. Endometrial regenerative cells (ERCs) have been widely used in various refractory immune-related diseases, but the role of ERC-derived exosomes (ERC-Exos) in alleviating transplant rejection has not been extensively studied. Signaling lymphocyte activation molecule family 6 (SLAMF6) plays an important role in regulating immune responses. In this study, we explored the main mechanism by which ERC-Exos loaded with siSLAMF6 can alleviate allogeneic transplant rejection. Methods C57BL/6 mouse recipients of BALB/c mouse kidney transplants were randomly divided into four groups and treated with exosomes. The graft pathology was evaluated by H&E staining. Splenic and transplanted heart immune cell populations were analyzed by flow cytometry. Recipient serum cytokine profiles were determined by enzyme-linked immunosorbent assay (ELISA). The proliferation and differentiation capacity of CD4+ T cell populations were evaluated in vitro. The α-2,6-sialylation levels in the CD4+ T cells were determined by SNA blotting. Results In vivo, mice treated with ERC-siSLAMF6 Exo achieved significantly prolonged allograft survival. The serum cytokine profiles of the recipients were significantly altered in the ERC-siSLAMF6 Exo-treated recipients. In vitro, we found that ERC-siSLAMF6-Exo considerably downregulated α-2,6-sialyltransferase (ST6GAL1) expression in CD4+ T cells, and significantly reduced α-2,6-sialylation levels. Through desialylation, ERC-siSLAMF6 Exo therapy significantly decreased CD4+ T cell proliferation and inhibited CD4+ T cell differentiation into Th1 and Th17 cells while promoting regulatory T cell (Treg) differentiation. Conclusions Our study indicated that ERC-Exos loaded with siSLAMF6 reduce the amount of sialic acid connected to α-2,6 at the end of the N-glycan chain on the CD4+ T cell surface, increase the number of therapeutic exosomes endocytosed into CD4+ T cells, and inhibit the activation of T cell receptor signaling pathways, which prolongs allograft survival. This study confirms the feasibility of using ERC-Exos as natural carriers combined with gene therapy, which could be used as a potential therapeutic strategy to alleviate allograft rejection.

Abstract Polyorchidism is an uncommon congenital condition often discovered incidentally, which may significantly impact male fertility. We present a case of a 34-year-old man with unilateral polyorchidism and associated severe asthenozoospermia and teratozoospermia. Despite normal hormonal levels and no detected genetic anomalies, the patient’s sperm showed mitochondrial damage, and his fertility remained compromised after conservative management and assisted reproductive attempts. This case underscores the intricate relationship between polyorchidism and male infertility, highlighting the need for personalized management strategies and further research into its etiology and impact.

Abstract Due to varying energy demands and supply levels in different regions, the distribution of power load exhibits an imbalanced state. It contributes to increased power loss and poses a threat to the security constraints of the electrical grid. Simultaneously, the global energy transition has led to a continuous increase in the proportion of renewable energy integrated into the grid. Electric vehicles (EVs), serving as representative of renewable energy, further magnify this load imbalance with their charging requirements, which poses a significant challenge to the stable operation of the grid. Therefore, to ensure the smooth operation of the grid under the context of renewable energy integration, the authors investigate the coordinated strategies of EV charging scheduling and route planning. The authors first model the coupling of the transportation network with the smart grid as a cyber‐physical system. Subsequently, the authors simulate and analyse the daily charging load curve of the network, capturing the travel characteristics of EVs. Based on this, the authors research the EV charging scheduling in both individual and collective travel scenarios during peak and off‐peak hours. For the off‐peak travel period of EVs, a charging schedule strategy based on travel plans is proposed, which reduces the time cost of EV owners' travel. Furthermore, for the collective travel of a large number of EVs within the system, a multi‐EV charging scheduling strategy based on charging station load balancing is presented. This strategy effectively balances the load levels of various charging stations while reducing the overall system travel time. Ultimately, through experimental results, the authors demonstrate that by deploying appropriate charging scheduling strategies, EVs cease to be a burden on the grid and can be transformed into tools for balancing the loads across different regions.

Abstract Diabetic cardiomyopathy (DCM) is a cardiovascular complication of diabetes mellitus with a poor prognosis and is the leading cause of death in diabetic patients. Sleep deficiency is not only recognized as an important risk factor for the development of type 2 DM, but is also associated with increased morbidity and mortality of cardiovascular disease. The underlying role and mechanisms of sleep restriction (SR) in DCM are far from clear. The KK/Upj-Ay mouse model of T2 DM was used as a study subject, and the small animal ultrasound imaging system was used to detect the function of the heart; immunopathological staining was used to clarify the histo-structural pathological alterations of the heart; and TUNEL staining, qPCR, transmission electron microscopy (TEM), and ELISA kits were used to detect apoptosis, oxidative stress, inflammation, and mitochondrial damage, and related molecular alterations. SR led to a significant increase in mortality, cardiac hypertrophy, necrosis, glycogen deposition and fibrosis further deteriorated in DM KK mice. SR increased cardiomyocyte death in KK mice through the Bax/Bcl2 pathway. In addition to this, SR not only exacerbated the inflammatory response, but also aggravated mitochondrial damage and promoted oxidative stress in KK mice through the PRDM16-PGC-1α pathway. Overall, SR exacerbates structural alterations and dysfunction through inflammation, oxidative stress, and apoptosis in DM KK mice, increasing the risk of death. Clinicians and diabetic patients are prompted to pay attention to sleep habits to avoid accelerating the transition of DCM to heart failure and inducing death due to poor sleep habits.

Abstract Objective This study aims to analyze the clinical features, Radiological findings and diagnostic characteristics (tissue biopsy, flow cytometry and cerebrospinal fluid cytology) of primary central nervous system lymphoma (PCNSL). To improve the diagnosis of the disease. Methods A total of 19 patients with primary central nervous system lymphoma admitted to the Second Hospital of Hebei Medical University from 2014 to 2023 were selected. The clinical data of the patients were retrospectively analyzed. Combined with the relevant literature, the clinical characteristics of PCNSL patients were analyzed to assist the diagnosis. Result Most of the patients were middle-aged and elderly patients (65 years old), and the main clinical manifestations showed no obvious specificity, including headache, dizziness and limb weakness. Radiological findings showed that common site of currence were located in the brain parenchyma. The PCNSL subtype of 19 patients was all diffuse large B cell subtype by cytology, flow cytometry or histopathology. Six cases were diagnosed by biopsy pathology and 11 cases were diagnosed by flow cytometry of cerebrospinal fluid. In all patients diagnosed with PCNSL by clinical cytology (CSF cytology and flow cytometry), abnormal cells were found on CSF examination. Conclusion The pathological type of primary central nervous system lymphoma was diffuse large B-cell subtype, with diverse clinical manifestations and multiple. Both tissue directed biopsy and flow cytometry could effectively assist clinical diagnosis. Early and timely diagnosis and intervention are of great significance for delaying the disease process and reducing the economic burden of patients and families.

Background: Streptococcus agalactiae is a recognized pathogen that primarily affects infants and pregnant women. However, its increasingly important role in causing invasive infections among non-pregnant adults has become a significant health concern due to the severity and variety of its clinical impacts. Methods: Nonduplicate S. agalactiae clinical strains associated with clinical infections (n = 139) were isolated from non-pregnant adults in Shandong, China. Antibiotic susceptibility testing, whole-genome sequencing and genomic analyses were conducted to characterize the genome and identify resistance features of these strains. Results: The strains exhibited universal susceptibility to penicillin, ampicillin, cefotaxime, meropenem, linezolid and vancomycin. Notably, high resistance rates were observed for erythromycin (91.4%), clindamycin (89.2%), levofloxacin (84.2%), tetracycline (54.0%) and, to a lesser extent, chloramphenicol (12.9%). Serotyping revealed seven serotypes and one non-typeable strain. Serotypes Ia, Ib, III and V predominated, representing 95.7% of the strains. Nineteen sequence types were categorized into seven clonal complexes, with CC10 being the most prevalent at 48.9%. The resistance genes mreA (100%), ermB (70.5%) and tetM (46.0%) were commonly detected. All the isolates carried at least one pilus backbone determinant and one alpha-like protein gene, with the PI-1+PI-2a and the bca gene being the most frequent at 84.2% and 54.7%, respectively. Conclusions: While S. agalactiae strains in non-pregnant adults retain sensitivity to β-lactam antibiotics, the elevated resistance to erythromycin, clindamycin, levofloxacin and tetracycline is concerning. Given the growing elderly population worldwide, the burden of S. agalactiae infections is significant. Continuous surveillance of serotype distribution and antibiotic resistance patterns is imperative for targeted prevention and therapeutic strategies.

Abstract Objective To evaluate the prediction value of Dual-energy CT (DECT)-based quantitative parameters and radiomics model in preoperatively predicting muscle invasion in bladder cancer (BCa). Materials and methods A retrospective study was performed on 126 patients with BCa who underwent DECT urography (DECTU) in our hospital. Patients were randomly divided into training and test cohorts with a ratio of 7:3. Quantitative parameters derived from DECTU were identified through univariate and multivariate logistic regression analysis to construct a DECT model. Radiomics features were extracted from the 40, 70, 100 keV and iodine-based material-decomposition (IMD) images in the venous phase to construct radiomics models from individual and combined images using a support vector machine classifier, and the optimal performing model was chosen as the final radiomics model. Subsequently, a fusion model combining the DECT parameters and the radiomics model was established. The diagnostic performances of all three models were evaluated through receiver operating characteristic (ROC) curves and the clinical usefulness was estimated using decision curve analysis (DCA). Results The normalized iodine concentration (NIC) in DECT was an independent factor in diagnosing muscle invasion of BCa. The optimal multi-image radiomics model had predictive performance with an area-under-the-curve (AUC) of 0.867 in the test cohort, better than the AUC = 0.704 with NIC. The fusion model showed an increased level of performance, although the difference in AUC (0.893) was not statistically significant. Additionally, it demonstrated superior performance in DCA. For lesions smaller than 3 cm, the fusion model showed a high predictive capability, achieving an AUC value of 0.911. There was a slight improvement in model performance, although the difference was not statistically significant. This improvement was observed when comparing the AUC values of the DECT and radiomics models, which were 0.726 and 0.884, respectively. Conclusion The proposed fusion model combing NIC and the optimal multi-image radiomics model in DECT showed good diagnostic capability in predicting muscle invasiveness of BCa.

Abstract There are no studies exploring the correlation between sleep duration and abdominal aortic calcification (AAC). This study aims to investigate this relationship and its significance. Additionally, given the higher prevalence of sleep disorders and AAC in patients with chronic kidney disease (CKD), we conducted further studies in this population. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2013–2014. Sleep duration was assessed by a sleep questionnaire and categorized into 2–5, 6–8, and ≥ 9 h. The AAC-24 score is determined using the Kauppila scoring system and used for AAC assessment. Multivariable linear and logistic regression analysis were used to explore the relationship between sleep duration and AAC. Among the 2,996 participants, 14.29% reported nightly short sleep (2–5 h), 77.64% reported intermediate sleep (6–8 h), and 8.08% reported long sleep (≥ 9 h). After adjusting for potential confounding factors, among male participants with CKD, long sleep (≥ 9 h) significantly increased AAC-24 scores compared with intermediate sleep (6–8 h) (β: 2.12; 95% CI: 0.75, 3.50), and the risk of severe AAC (SAAC) was increased by 1.55 times (OR: 2.55; 95% CI: 1.02, 6.36). And among female CKD and non-CKD participants, sleep duration was not associated with AAC. Long sleep duration increases the risk of AAC among male adults with CKD. Prospective studies are needed to confirm this finding.

BackgroundData sharing plays a crucial role in health informatics, contributing to improving health information systems, enhancing operational efficiency, informing policy and decision-making, and advancing public health surveillance including disease tracking. Sharing individual participant data in public, environmental, and occupational health trials can help improve public trust and support by enhancing transparent reporting and reproducibility of research findings. The International Committee of Medical Journal Editors (ICMJE) requires all papers to include a data-sharing statement. However, it is unclear whether journals in the field of public, environmental, and occupational health adhere to this requirement. ObjectiveThis study aims to investigate whether public, environmental, and occupational health journals requested data-sharing statements from clinical trials submitted for publication. MethodsIn this bibliometric survey of “Public, Environmental, and Occupational Health” journals, defined by the Journal Citation Reports (as of June 2023), we included 202 journals with clinical trial reports published between 2019 and 2022. The primary outcome was a journal request for a data-sharing statement, as identified in the paper submission instructions. Multivariable logistic regression analysis was conducted to evaluate the relationship between journal characteristics and journal requests for data-sharing statements, with results presented as odds ratios (ORs) and corresponding 95% CIs. We also investigated whether the journals included a data-sharing statement in their published trial reports. ResultsAmong the 202 public, environmental, and occupational health journals included, there were 68 (33.7%) journals that did not request data-sharing statements. Factors significantly associated with journal requests for data-sharing statements included open access status (OR 0.43, 95% CI 0.19-0.97), high journal impact factor (OR 2.31, 95% CI 1.15-4.78), endorsement of Consolidated Standards of Reporting Trials (OR 2.43, 95% CI 1.25-4.79), and publication in the United Kingdom (OR 7.18, 95% CI 2.61-23.4). Among the 134 journals requesting data-sharing statements, 26.9% (36/134) did not have statements in their published trial reports. ConclusionsOver one-third of the public, environmental, and occupational health journals did not request data-sharing statements in clinical trial reports. Among those journals that requested data-sharing statements in their submission guidance pages, more than one quarter published trial reports with no data-sharing statements. These results revealed an inadequate practice of requesting data-sharing statements by public, environmental, and occupational health journals, requiring more effort at the journal level to implement ICJME recommendations on data-sharing statements.

Rapeseed (Brassica napus L.) is an important overwintering oilseed crop and suffers from severe cold stress during the seedling stage, due to the increasingly delayed sowing in the Yangtze river basin. However, the genetic basis underlying cold tolerance in rapeseed seedlings is not well understood. In this study, we observed the cold tolerance of 217 rapeseed accessions in the field and found a significant negative correlation between cold tolerance grades and malondialdehyde (MDA) content. A genome-wide association study (GWAS) of cold tolerance grades identified four significant loci in the genomic region of one MYB transcription factor BnaA8.MYB60. Furthermore, field accessions with BnaA8.MYB60 Hap1 exhibited significantly higher cold tolerance and lower expression of BnaA8.MYB60 compared to the majority of accessions with BnaA8.MYB60 Hap2. These results suggested that variation in the genomic sequences of BnaA8.MYB60 caused the divergence of gene expression levels and functions on cold tolerance in rapeseed seedlings. This study could provide the theoretical guidance for the breeding of cold-tolerant rapeseed varieties.

The genetic basis of complex traits involves the function of many genes with small effects as well as complex gene-gene and gene-environment interactions. As one of the major players in complex diseases, the role of gene-environment interactions has been increasingly recognized. Motivated by epidemiology studies to evaluate the joint effect of environmental mixtures, we developed a functional varying-index coefficient model (FVICM) to assess the combined effect of environmental mixtures and their interactions with genes, under a longitudinal design with quantitative traits. Built upon the previous work, we extend the FVICM model to accommodate binary longitudinal traits through the development of a generalized functional varying-index coefficient model (gFVICM). This model examines how the genetic effects on a disease trait are nonlinearly influenced by a combination of environmental factors. We derive an estimation procedure for the varying-index coefficient functions using quadratic inference functions combined with penalized splines. A hypothesis testing procedure is proposed to evaluate the significance of the nonparametric index functions. Extensive Monte Carlo simulations are conducted to evaluate the performance of the method under finite samples. The utility of the method is further demonstrated through a case study with a pain sensitivity dataset. SNPs were found to have their effects on blood pressure nonlinearly influenced by a combination of environmental factors.

Sertoli cells (SCs), as the somatic cells in the testis of male mammals, play a crucial role in the close association with germ cells. The blood-testicular barrier (BTB), established by their tight junctions, provides immune protection to germ cells, leading to their characterization as "sentinel" cells. Moreover, the physiological process of testicular development and spermatogenesis in male animals is intricately tied to the secretory activities of SCs. These cells secrete a diverse array of proteins and cytokines that interact with various targets, working in concert with mechanisms in the spermatogenesis pathway and contributing to each stage, from spermatogonial cell division to the maturation of spermatozoa. Hence, the secretory products of SCs are pivotal in fostering germ cell development and directing the appropriate maturation of sperm. This study is dedicated to investigating the varied secretions of SCs, outlining their critical functions throughout distinct phases of spermatogenesis, thus elucidating the substantial influence of SC secretion on male fertility. Furthermore, it offers valuable perspectives on reproductive disorders stemming from irregular spermatogenesis in clinical contexts.

Abstracts: An on-site, sensitive, and cost-effective method for determining aflatoxin B1 (AFB1) in rice samples is proposed, combining magnetic solid phase extraction (MSPE) and time-resolved fluorescence immunochromatography (TRFICA) techniques. Cost-effective rice husks were carbonized and combined with nanomaterials to make magnetic nanocomposites that acted as effective adsorbents in MSPE. Under optimal conditions, the entire process was completed in 15 min with a visual detection limit of 0.16 μg/kg. Recoveries ranged from 85.2 % to 109.4 %, with intra- and inter-day precisions below 11.5 %. The proposed MSPE-TRFICA method offers a viable alternative for the rapid and highly sensitive quantitative detection of AFB1 for quality assurance.

BackgroundProbiotics, which are beneficial to the host, have been shown to benefit the health of cats. Lactic acid bacteria (LAB) are commonly used probiotics, but most strains used for cats are not derived from cats, leading to reduced efficacy and poor adaptation to cats. The objective was to identify LAB with promising probiotic potential specific to cats.MethodLABs were isolated from fecal samples of 20 healthy cats. Gram staining and the survival rate in the simulated gastrointestinal tract were used for preliminary screening. Candidate strains were identified by 16S rDNA sequencing, and further evaluated for adhesion ability, growth characteristics, antibacterial activity, antioxidant capacity, and safety.Results24 Gram-positive isolates were identified, with 10 (F1-F10) showing robust viability in the simulated gastroenteric fluid. These 10 strains exhibited excellent adhesion to Caco-2 cells and strong auto-agglutination properties. They also possessed the capacity to antagonize and aggregate pathogens (Staphylococcus aureus ATCC 25923, Salmonella Braenderup H9812, Escherichia coli ATCC 25922, and Pseudomonas aeruginosa PAO1), Moreover, all strains demonstrated tolerance to H2O2 concentrations ranging from 0.5–2 mmol/L and the ability to scavenge 1, 1-diphenyl-2-picrylhydrazyl (DPPH) free radicals, indicating a certain level of antioxidant activity. Safety tests showed no hemolytic activity, and all but F6 were highly sensitive to antibiotics, with over 62.5% sensitivity to 16 antibiotics. Remarkably, F4 (Lactobacillus reuteri) and F10 (Lactobacillus brevis) exhibited exceptional viability in the simulated gastrointestinal tract, coupled with robust growth potential, enhanced adhesion efficiency, significant antibacterial and antioxidant properties.ConclusionOur findings revealed that F4 (Lactobacillus reuteri) and F10 (Lactobacillus brevis) hold promising potential as probiotics. This research lays a solid scientific foundation for the selection and application of probiotics tailored specifically for cats.

As a critical grain-producing region in the middle and lower reaches of the Yangtze River Plain in China, the quality of arable land use (QALU) in the plain lake areas is essential for maintaining regional food security. This study develops an interactive analytical framework from the dual perspectives of riverine ecological constraints and socioeconomic structural fluctuations, termed the “environmental pressure-utilization intensity-output efficiency” framework. Employing the ESTDA model and the obstacle degree model, the study assesses the QALU in the Dongting Lake region from 2000 to 2020, quantifying spatiotemporal transitions and identifying key obstacle factors. The aim is to provide a theoretical foundation and scientific support for a deeper understanding of QALU dynamics. The findings reveal that (1) QALU demonstrates a spatial distribution characterized by lower levels in peripheral areas and higher levels in central areas. With declining environmental pressures, the primary factors influencing QALU in the plain lake areas shift towards utilization intensity and output efficiency. (2) QALU shows a trend toward spatiotemporal coordination, with transitions exhibiting both spatial lock-in and dynamic characteristics strongly associated with the spatial features of the plain lake areas. (3) The primary obstacle factors gradually shift from natural resource endowments to socioeconomic structures, highlighting the urgent need for policy interventions to improve QALU. The study concludes that enhancing QALU in the plain lake areas requires an integrated approach that harmonizes natural and socioeconomic structures with tailored strategies to achieve sustainable arable land use.

Commercial pilots endure multiple stressors in their daily and occupational lives which are detrimental to psychological well-being and cognitive functioning. The Quick coherence technique (QCT) is an effective intervention tool to improve stress resilience and psychophysiological balance based on a five-minute paced breathing exercise with heart rate variability (HRV) biofeedback. The current research reports on the application of QCT training within an international airline to improve commercial pilots’ psychological health and support cognitive functions. Forty-four commercial pilots volunteered in a one-month training programme to practise self-regulated QCT in day-to-day life and flight operations. Pilots’ stress index, HRV time-domain and frequency-domain parameters were collected to examine the influence of QCT practice on the stress resilience process. The results demonstrated that the QCT improved psychophysiological indicators associated with stress resilience and cognitive functions, in both day-to-day life and flight operation settings. HRV fluctuations, as measured through changes in RMSSD and LF/HF, revealed that the resilience processes were primarily controlled by the sympathetic nervous system activities that are important in promoting pilots’ energy mobilization and cognitive functions, thus QCT has huge potential in facilitating flight performance and aviation safety. These findings provide scientific evidence for implementing QCT as an effective mental support programme and controlled rest strategy to improve pilots’ psychological health, stress management, and operational performance.

Diterpenoids are terpenoids containing four isoprene units with a total of 20 carbon atoms. They are derived from geranyl pyrophosphate, including acyclic diterpenes, monocyclic diterpenes, dicyclic diterpenes, tricyclic diterpenes, and tetracyclic diterpenes. These compounds are widely found in plants, insects, fungi and marine organisms, and are important bioactive substances in plant extracts. Diterpenoids have a variety of biological activities due to their structural diversity. Particularly, their outstanding antioxidant and antibacterial activities make them widely applied in meat preservation. In this article, the chemical and structural characteristics, biological activities and sources of diterpenoids are reviewed, and recent advances in the application of diterpenoids in the preservative of meat are summarized, aiming to provide a reference for the theoretical research and commercial application of diterpenoids in meat products.

Abstract Infection of piglets with Glaesserella parasuis (G. parasuis) induces host immunosuppression. However, the mechanism underlying the immunosuppression of piglets remains unclear. Activation of the PD-1/PD-L1 axis has been shown to trigger host immunosuppression. Baicalin possesses anti-inflammatory and immunomodulatory functions. However, whether baicalin inhibits PD-1/PD-L1 activation and thus alleviates host immunosuppression has not been investigated. In this study, the effect of baicalin on the attenuation of piglet immunosuppression induced by G. parasuis was evaluated. Seventy piglets were randomly divided into the control group, infection group, levamisole group, BMS-1 group, 25 mg/kg baicalin group, 50 mg/kg baicalin group and 100 mg/kg baicalin group. Following pretreatment with levamisole, BMS-1 or baicalin, the piglets were challenged with 1 × 108 CFU of G. parasuis. Our results showed that baicalin, levamisole and BMS-1 modified routine blood indicators and biochemical parameters; downregulated IL-1β, IL-10, IL-18, TNF-α and IFN-γ mRNA expression; and upregulated IL-2 and IL-8 mRNA expression in blood. Baicalin, levamisole and BMS-1 increased the proportions of CD3+ T cells, CD3+CD4+ T cells, CD3+CD8+ T cells and CD3–CD21+ B cells in the splenocyte population, increased the proportions of CD3+ T cells, CD3+CD4+ T cells and CD3+CD8+ T cells in the blood, and inhibited PD-1/PD-L1 and TIM-3 activation. Baicalin, levamisole and BMS-1 reduced p-PI3K, p-Akt, and p-mTOR expression, the p-MEK1/2/MEK1/2 and p-ERK1/2/ERK1/2 ratios and increased RAS expression. Baicalin, levamisole and BMS-1 provided substantial protection against G. parasuis challenge and relieved tissue histopathological damage. Our findings might provide new strategies for controlling G. parasuis infection and other immunosuppressive diseases.

Abstract Percutaneous coronary intervention (PCI) addresses myocardial ischaemia, but a significant subset of patients encounter major adverse cardiovascular events (MACE) post‐treatment. This meta‐analysis investigated the relationship between the post‐PCI triglyceride‐glucose (TyG) index and MACE. Comprehensive searches of the Embase, PubMed, Cochrane Library, and Web of Science databases were conducted up to 3 March 2023, using relevant keywords. The effect size was determined based on I2 statistic using random‐effects models. Cluster‐robust standard errors crafted the dose–response curve, and the GRADE Evaluation Scale was employed to rate the quality of evidence. The group with the highest TyG index had significantly higher post‐PCI MACE rates than the lowest index group, with hazard ratios (HRs) of 2.04 (95% CI 1.65–2.52; I2 = 77%). Each unit increase in TyG index corresponded to HRs of 1.82 for MACE (95% CI 1.34–2.46; I2 = 92%), 2.57 for non‐fatal MI (95% CI 1.49–4.41; I2 = 63%), and 2.06 for revascularization (95% CI 1.23–3.50; I2 = 90%). A linear relationship between TyG index and MACE risk was established (R2 = 0.6114). For all‐cause mortality, the HR was 1.93 (95% CI 1.35–2.75; I2 = 50%), indicating a higher mortality risk with elevated TyG index. The GRADE assessment yielded high certainty for non‐fatal MI but low certainty for all‐cause mortality, revascularization, and MACE. The TyG index may predict risks of post‐PCI MACE, all‐cause mortality, non‐fatal MI, and revascularization, with varied levels of certainty. A potential linear association between the TyG index and MACE post‐PCI was identified. Future research should validate these findings.

Abstract Novelty and appropriateness are two fundamental components of creativity. However, the way in which novelty and appropriateness are separated at behavioral and neural levels remains poorly understood. In the present study, we aim to distinguish behavioral and neural bases of novelty and appropriateness of creative idea generation. In alignment with two established theories of creative thinking, which respectively, emphasize semantic association and executive control, behavioral results indicate that novelty relies more on associative abilities, while appropriateness relies more on executive functions. Next, employing a connectome predictive modeling (CPM) approach in resting-state fMRI data, we define two functional network-based models—dominated by interactions within the default network and by interactions within the limbic network—that respectively, predict novelty and appropriateness (i.e., cross-brain prediction). Furthermore, the generalizability and specificity of the two functional connectivity patterns are verified in additional resting-state fMRI and task fMRI. Finally, the two functional connectivity patterns, respectively mediate the relationship between semantic association/executive control and novelty/appropriateness. These findings provide global and predictive distinctions between novelty and appropriateness in creative idea generation.

Taihe Black-Bone Silky Fowl (SF) is a famous local breed in China, known for its high nutritional and medicinal value. However, its low egg-laying rate significantly limits its economic benefits. This study aims to explore the ovarian development status, as well as the changes in the transcriptome and chromatin accessibility landscape at different egg-laying stages of SF, in order to reveal the epigenetic regulatory mechanisms underlying ovarian development in laying hens. The results showed that during peak egg-laying, serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and progesterone (P4) in the SF were higher than in the other laying periods. Meanwhile, the serum and ovarian matrix total antioxidant capacity (T-AOC) level decreased with increasing age, whereas the ovarian matrix malondialdehyde (MDA) level showed the opposite trend. Compared to the late laying period, several genes related to ovarian development and reproductive hormone secretion, including TDRD5, CCNO, CYP17A1, BMP15, and STAR, were upregulated during the peak egg-laying period. Additionally, we identified key transcription factors (TF) associated with different egg-laying periods. Specific TF, such as Fli1, Etv2, and AT2G15740, linked to the peak egg-laying period, play significant roles in cell and tissue development. The specific transcription factor Nr5a2, associated with the late laying period, has been shown to inhibit E2 production. Furthermore, genes related to poultry reproductive performance, such as STAR and WNT4, were found to be regulated by specific distal enhancers in open chromatin regions (OCR). In conclusion, this study elucidated the dynamic changes in the transcriptome and chromatin accessibility landscape during ovarian development in SF at different egg-laying stages and highlighted key TF, including Fli1, Etv2, and Nr5a2, as well as essential genes like STAR and WNT4 that regulate ovarian development. These findings provide valuable insights into the regulatory mechanisms influencing egg-laying performance in SF and offer new strategies for improving ovarian follicle development and egg production performance in poultry.

ObjectiveThe value of robotic pancreaticoduodenectomy (RPD) compared with laparoscopic pancreaticoduodenectomy (LPD) for pancreatic and periampullary tumors is controversial. This study aims to assess the available literature and compare the short outcomes of RPD and LPD.MethodsThe PubMed, Cochrane Library, Embase, and Web of Science databases were searched to identify available research published up to 24 July, 2024. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated.ResultsSeventeen studies with a total of 9417 patients (RPD group: 3334 patients; LPD group: 6083 patients) were included in this meta-analysis. The RPD group had lower overall morbidity (RR, 0.79), conversion (RR, 0.29) and blood transfusion rates (RR, 0.61), shorter length of stay (MD, -0.72 days), and higher number of harvested lymph nodes (MD, 0.62) than the LPD group. There were no significant differences in 90-day mortality (RR, 0.89), major complications (RR, 0.87), operative time (MD, -3.74 mins), blood loss (MD, -24.14 mL), reoperation (RR, 0.94), bile leak (RR, 0.62), postoperative pancreatic hemorrhage (RR, 0.96), postoperative pancreatic fistula (RR, 0.74), delayed gastric emptying (RR, 1.24), and R0 resection (RR, 1.00) between the groups.ConclusionsCompared with LPD, RPD for pancreatic and periampullary tumors could be safe and effective, and it has superior surgical outcomes. Further randomized controlled trials to verify the potential advantages of RPD over LPD are necessary.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=581133, identifier CRD42024581133.

Drug-related problems (DRPs) are prevalent in critically ill patients and may significantly increase mortality risks. The participation of critical care pharmacists (CCPs) in the medical team has demonstrated a benefit to healthcare quality. Research indicates that CCP medication order evaluations can reduce DRPs, while their participation in rounds can reduce adverse drug events and shorten hospital stays. Pharmacist medication reconciliation often proves more effective than physicians, and CCPs play a crucial role in antimicrobial management and reducing treatment costs. Despite these benefits, there is a noticeable lack of practical guidance for implementing CCP roles effectively. Their workflow heavily influences the efficiency of CCPs. Integrating results from the literature with our practical experience, we have detailed workflows and critical entry points that CCPs can refer to. Pharmacists should be proactive rather than passive consultants. Pre-round medication order evaluations are crucial for determining the depth of a pharmacist’s involvement in patient care. These evaluations should cover the following aspects: medication indication, dosage, treatment duration, detection of DRPs, implementation of therapeutic drug monitoring, dosing of sedatives and analgesics, and pharmaceutical cost containment. Beyond identifying medication issues, a primary task during rounds is gathering additional information and building trust with the medical team. Post-round responsibilities for CCPs include patient and caregiver education on medication, medication reconciliation for transitioning patients, and follow-up care for post-ICU patients. Establishing a rationalized and standardized workflow is essential to minimize daily work omissions and maximize the pharmacist’s value. A multidisciplinary pharmacist-led team can significantly promote the rational use of antibiotics. Participation in post-ICU outpatient follow-ups can reduce drug-induced injuries after discharge. This review provides a detailed overview of the tasks performed by CCPs before, during, and after medical rounds, serving as a valuable reference for establishing an efficient workflow for CCPs.

Abstract Robust and reliable piezo‐ionic materials that are both crack resistant and self‐healable like biological skin hold great promise for applications inflexible electronics and intelligent systems with prolonged service lives. However, such a combination of high toughness, superior crack resistance, autonomous self‐healing and effective control of ion dynamics is rarely seen in artificial iontronic skin because these features are seemingly incompatible in materials design. Here, we resolve this perennial mismatch through a molecularly engineered strategy of implanting carboxyl‐functionalized groups into the dynamic hard domain structure of synthesized poly(urethane‐urea). This design provides an ultra‐high fracture energy of 211.27 kJ m−2 that is over 123.54 times that of tough human skin, while maintaining skin‐like stretchability, elasticity, and autonomous self‐healing with a 96.40% healing efficiency. Moreover, the carboxyl anion group allows the dynamic confinement of ionic fluids though electrostatic interaction, thereby ensuring a remarkable pressure sensitivity of 7.03 kPa−1 for the tactile sensors. As such, we successfully demonstrated the enormous potential ability of this skin‐like piezo‐ionic sensor for biomedical monitoring and robotic item identification, which indicates promising future uses in flexible electronics and human–machine interactions.

The disorderly expansion of human production-living construction activities into aquatic ecological sensitive areas has triggered severe production-living-ecological space (PLES) conflicts. However, research on the risk-triggering mechanisms of PLES conflicts in lake network regions and multidimensional scenario simulation techniques is relatively lacking. To address these issues, this study constructs an integrated model chain by coupling the Markov-GMOP-PLUS model to achieve a quantified diagnosis and simulated regulation of spatial conflict strength index (SCSI) under sustainable development goals. Applying it to the Dongting Lake region reveals that: (1) The overall PLES exhibited a distribution pattern where “ecological space encompasses production space, with living space interspersed within”. The category conversion mainly reflected the encroachment of agricultural production space on the plain water ecological space, with a conversion area of up to 899.48 km2. (2) The distinctive “high in the north, low in the south” PLES conflict pattern was closely aligned with the land use structure and water system distribution, with conflict hotspots persistently clustering in the core lake network regions amid rapid urbanization. Among these, the growth rate of severe conflicts in the last ten years was 3.86 times that of the previous ten years. (3) The sustainable development scenario showcased the most effective conflict mitigation by curtailing production-living space expansion and ecological space encroachment. This scenario reversed the growth trend in conflict high-value zones and the reduction trend in low-value zones, with change rates of −3.30 % and 7.05 %, respectively, compared to 2020. This study provides a scientific basis for formulating sustainable land-use policies in lake network regions.

Water resources are important supporting elements in the ecological environment and socio-economic system of sustainable development. The purpose of this study is to evaluate the comprehensive resilience level of the water resources–ecology–socioeconomic system against external disturbances in the Anhui and Shandong sections of the Huaihe River Basin. The comprehensive index system is constructed with the characteristic dimensions of resistance, resilience, and adaptability. Use the game theory combination weighting-VIKOR method to quantify the resilience level, and use the kernel density analysis and Markov chain to explore the spatial and temporal evolution characteristics and transition probability. The results show that (1) the resilience index of the composite system in the Huaihe River Basin shows an increasing trend, and the resilience level of the Anhui section is generally higher than that of the Shandong section. (2) The resilience level gradually evolved into the spatial distribution characteristics of high in the west and low in the east, high in the south and low in the north during the study period. (3) The resilience grade has strong robustness, and the probability of transferring to the higher grade is greater than that of transferring to the lower grade. HIGHLIGHTS Enriches the research on the resilience of river basin composite systems.; Exploring the evolution law of watershed ecological resilience from the spatial dimension.;

Abstract Hedgehog (Hh) signaling relies on the primary cilium, a cell surface organelle that serves as a signaling hub for the cell. Using proximity labeling and quantitative proteomics, we identify Numb as a ciliary protein that positively regulates Hh signaling. Numb localizes to the ciliary pocket and acts as an endocytic adaptor to incorporate Ptch1 into clathrin-coated vesicles, thereby promoting Ptch1 exit from the cilium, a key step in Hh signaling activation. Numb loss impedes Sonic hedgehog (Shh)-induced Ptch1 exit from the cilium, resulting in reduced Hh signaling. Numb loss in spinal neural progenitors reduces Shh-induced differentiation into cell fates reliant on high Hh activity. Genetic ablation of Numb in the developing cerebellum impairs the proliferation of granule cell precursors, a Hh-dependent process, resulting in reduced cerebellar size. This study highlights Numb as a regulator of ciliary Ptch1 levels during Hh signal activation and demonstrates the key role of ciliary pocket-mediated endocytosis in cell signaling.

Abstract Background/Purpose Little is known about long-term clinical outcomes or urate-lowering (ULT) therapy use following pegloticase discontinuation. We examined ULT use, serum urate (SU), inflammatory biomarkers, and renal function following pegloticase discontinuation. Methods We conducted a retrospective analysis of gout patients who discontinued pegloticase using the Rheumatology Informatics System for Effectiveness (RISE) registry from 1/2016 to 6/2022. We defined discontinuation as a gap ≥ 12 weeks after last infusion. We examined outcomes beginning two weeks after last dose and identified ULT therapy following pegloticase discontinuation. We evaluated changes in lab values (SU, eGFR, CRP and ESR), comparing on- treatment (≤ 15 days of the second pegloticase dose) to post-treatment. Results Of the 375 gout patients discontinuing pegloticase, median (IQR) laboratory changes following discontinuation were: SU: +2.4 mg/dL (0.0,6.3); eGFR: -1.9 mL/min (− 8.7,3.7); CRP: -0.8 mg/L (-12.8,0.0); and ESR: -4.0 mm/hr (-13.0,0.0). Therapy post-discontinuation included oral ULTs (86.0%), restarting pegloticase (4.5%), and no documentation of ULT (9.5%), excluding patients with multiple same-day prescriptions (n = 17). Oral ULTs following pegloticase were: 62.7% allopurinol, 34.1% febuxostat. The median (IQR) time to starting/restarting ULT was 92.0 days (55.0,173.0). Following ULT prescribing (≥ 30 days), only 51.0% of patients had SU

Abstract Background Mycoplasma pneumoniae infections have increased in China recently, causing some evidence of familial clustering. The purpose of this study was to compare the clinical features of parents and children in cases of familial clustering of Mycoplasma pneumoniae infection. Methods A retrospective analysis was performed on the cases of familial clustering of Mycoplasma pneumoniae infection, and the clinical characteristics of parents and children were compared. Results We identified 63 families, of these, 57 (65.5%) adults and 65 (94.2%) children required hospitalization. Fifty-seven adults (mean age 35.1 ± 4.6 years, 80.7% female) and 55 children (mean age 6.3 ± 3.9 years, 54.5% female) were included in the analysis. The incidence of mycoplasma infection in adults had increased gradually over the past year, while the rate in children had spiked sharply since June 2023. The clinical symptoms were similar in the two groups, mainly fever and cough. The peak temperature of children was higher than that of adults (39.1 ± 0.7℃ vs 38.6 ± 0.7℃, p = 0.004). Elevated lactate dehydrogenase was more common in children than in adults (77.8% vs 11.3%, p

Abstract Ancient Chinese architecture drawing is a unique form of ancient Chinese art. Porcine blood hydrogels are distinctive ingredients used to prepare the composite material of the substrate layer for architecture drawing. This investigation was focused on the mechanism for porcine blood hydrogel formation. Based on the traditional Chinese recipe for the preparation of porcine blood-lime mortar, samples with different ratios of porcine blood and lime water were prepared, and the molecular-scale interactions between the lime water and proteins in the porcine blood were examined with FTIR spectroscopy, Raman spectroscopy, XRD, XPS, fluorescence spectroscopy, contact angle and rheology studies. The mechanical properties and morphological features of the samples were detected with a rheometer, universal material testing machine and SEM. The results indicated that an appropriate amount of lime water was required for gelation of the porcine blood. With the appropriate alkalinity, sufficient carboxyl groups on the fibrin chains were deprotonated, and coordination with Ca2+ ions formed enough cross-links for support networks within the structure of the porcine blood hydrogel. Complexation of deprotonated carboxyl groups on the fibrin chains with Ca2+ ions led to the formation of a hydrophobic surface due alterations of the fibrin conformation and increased the adhesive properties of the hydrogel. With the hydrogel used as an ingredient in the preparation of a substrate layer composite, it is suggested that the hydrophobic surface of the hydrogel facilitated mixing with hydrophobic tung oil during preparation of the composite material, and strong adhesion of the hydrogel increased the mechanical strength and crack resistance of the substrate layer.

Abstract Predicting carbon prices is crucial for the growth of China's carbon trading industry. This paper proposes a residual correction model that considers multiple influencing factors. First, the best historical data and main external factors input by the model are determined by using the partial autocorrelation function and Spearman correlation analysis, and the carbon price forecasting index system is constructed. Second, the whale optimization algorithm (WOA) is utilized to determine the optimal parameters of the extreme gradient boosting (XGBoost), and the WOA‐XGBoost model is built to perform preliminary carbon price forecasts and obtain the residual series. Finally, the carbon price residual series undergoes decomposition into multiple components utilizing the complete ensemble empirical mode decomposition for subsequent forecasting and the aggregation of outcomes. Experiments are conducted to predict two carbon trading markets in Hubei and Guangzhou, and a feature importance analysis is performed. The results indicate that the proposed hybrid model consistently outperforms the comparative models in terms of prediction accuracy. Furthermore, it is revealed that historical carbon prices and European Union carbon prices are the key factors influencing the prediction of carbon market prices.

Dissolved organic matter (DOM) is widely present in soil environments and plays a crucial role in controlling the morphology, environmental behavior, and hazards of arsenic (As) in soil. In the Fe-rich red soil of tea plantations, the decomposition of tea tree litter complicates DOM properties, leading to more uncertain interactions between DOM, Fe, and As. This study focused on three tea plantations in Huangshan City to investigate the contents of DOM, Fe, and As in surface red soils (Ferralsols) and establish their correlations. Three-dimensional fluorescence spectroscopy and PARAFAC analysis methods were used to analyze the DOM components and fluorescence signatures. Additionally, the process and mechanism of the binding of DOM-Fe with As were explored through laboratory experiments on the morphological transformation of As by DOM-Fe. The results showed that the pH values of the soils in the three tea plantations ranged from 3.9 to 5.2, and the entire sample was strongly acidic. The DOM exhibited strong intrinsic properties and low humification, containing three types of humic acid components and one intermediate protein component. The DOC content in the Fe-rich red soil did not have a direct correlation with Fe and As, but the interaction of DOM fractions with Fe significantly influenced the As content. Specifically, the interaction of protein-like fractions with Fe had a more pronounced effect on the As content. The maximum sorption rate of As by DOM was 15.45%, and this rate increased by 49 to 75% with the participation of Fe. In the configuration of the metal electron bridge, Fe acts as a cation, forming a connecting channel between the negatively charged DOM and As, thus enhancing the DOM’s binding capacity to As. DOM-Fe compounds bind As through surface pores and functional groups. These findings provide deeper insights into the influence of DOM on As behavior in Fe-rich soil environments and offer theoretical support for controlling As pollution in red soil.

The dual-energy spectral CT (DEsCT) employs material decomposition (MD) technology, opening up novel avenues for the opportunistic assessment of bone status. Radiomics, a powerful tool for elucidating the structural and textural characteristics of bone, aids in the detection of mineral loss. Therefore, this study aims to compare the efficacy of bone status assessment using both bone density measurements and radiomics models derived from MD images and to further explore the clinical value of radiomics models. Methods: Retrospective data were collected from 307 patients who underwent both quantitative computed tomography (QCT) and full-abdomen DEsCT scans at our institution. Based on QCT measurements, patients were divided into three categories: normal bone mineral density (BMD), osteopenia, and osteoporosis. Using the abdominal DEsCT data, six types of MD images were reconstructed, including HAP (Water), HAP (Fat), Ca (Water), Ca (Fat), Fat (Ca), and Fat (HAP). Patients were randomly divided into a training cohort (n = 214) and a validation cohort (n = 93) at a ratio of 7:3. Focusing on the L1 to L3 vertebrae, density values from the six MD images were measured. Six density value models and six radiomics models were constructed using a random forest (RF) classifier. The performance of these models in assessing bone status was evaluated using the receiver operating characteristic (ROC) curves, and the DeLong test was employed to compare performance differences between the models. Results: The macro-area under the curve (AUC) values for the density value models based on HAP (Water), HAP (Fat), Ca (Water), and Ca (Fat) MD images were 0.870, 0.870, 0.847, and 0.765, respectively, which outperformed those of Fat (Ca) (AUC = 0.623) and Fat (HAP) (AUC = 0.618) density value models. In the comparison of radiomics models, the trends of model performance were consistent with the density value models across the six MD images. However, the models based on HAP (Water), Ca (Water), HAP (Fat), Ca (Fat), Fat (Ca), and Fat (HAP) images exhibited superior performance than those of the density value models with the corresponding MD images, with values of 0.946, 0.941, 0.934, 0.926, 0.831, and 0.824, respectively. Conclusions: Bone status assessment can be accurately conducted using density values from HAP (Water), HAP (Fat), Ca (Water), and Ca (Fat) MD images. However, radiomics models derived from MD images surpass traditional density measurement methods in evaluating bone status, highlighting their superior diagnostic potential.