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Abstract Background This study reports the mid-term outcomes of primary total hip arthroplasty (THA) and investigates the effect of bony ankylosis on postoperative hip function in patients with ankylosing spondylitis (AS). Methods We identified 544 primary THAs performed in 319 consecutive patients with AS (median age, 33 years) from 2012 to 2017. Survivorship of the implants, complications, and patient satisfaction were investigated. Functional outcomes were assessed by the measurement of hip flexion–extension range of motion (ROM), the Harris hip score (HHS), and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The hips undergoing THA were divided into a bony ankylosis group and a hip stiffness group based on the severity of hip involvement. The postoperative functional results of the two groups at the most recent follow-up were compared. Results Survivorship was 99.8% with a mean follow-up of 7 years (range, 5–9 years). The main complications included dislocation (5 hips, 0.9%), periprosthetic femoral fracture (15 hips, 2.7%), and infection (primary infection in 2 hips and periprosthetic joint infection in 1 hip, 0.6%). The flexion–extension ROM improved significantly with a median of 0° (0 ~ 120°) pre-operatively to 100° (30 ~ 130°) after THA (P

Abstract Background Surgical management of giant and irregular pituitary neuroendocrine tumors (GIPitNETs) presents a significant challenge in neurosurgery. While endoscopic endonasal surgery (EES) is a widely used approach for PitNETs, GIPitNETs with extensive intracranial extension pose challenges for purely EES. We use simultaneous combined endoscopic endonasal and transcranial surgery (CECS) for the treatment of this type of tumor. Currently, there is limited research comparing CECS to EES for GIPitNETs. This study aims to compare the efficacy and short outcome of CECS and purely EES in the management of GIPitNETs to better understand the advantages and limitations of each surgical approach. Methods The data of GIPitNETs patients who underwent surgery between March 2018 and May 2023 at a single center were retrospectively reviewed. All included cases were divided into CECS and EES groups according to the treatment modality received. The baseline characteristics and tumor imaging features of patients were compared between the groups, as well as surgical results, perioperative complications, and last follow-up outcomes. Results A total of 50 patients met the inclusion criteria, with 27 undergoing CECS and 23 EES. CECS achieved a significantly higher GTR rate compared to EES (66.7% vs. 13.0%, p

Abstract Background This study aimed to report the mid-term functional outcomes of total hip arthroplasty (THA) for the treatment of advanced hip involvement in ankylosing spondylitis (AS) and identify the factors associated with poor hip flexion range of motion (ROM) after THA in patients with AS. Methods We retrospectively investigated the mid-term functional outcomes in 313 AS patients (538 hips) who underwent primary THA from 2012 to 2017, with a mean follow-up of 7 years (range, 4–9 years). Postoperative functional outcomes were assessed by hip flexion ROM, Harris hip score (HHS), and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The hips were divided into poor (≤ 90°) and good hip flexion ROM (> 90°) groups based on the degree of hip flexion ROM recorded at the most recent follow-up. We grouped factors related to postoperative hip flexion ROM into three categories: preoperative (or patient-related), intraoperative (or surgery-related), and postoperative factors. Multivariate logistic regression was performed to identify the independent factors associated with postoperative poor hip flexion ROM. Results The overall flexion-extension ROM improved significantly with a median from 0° (0 ~ 120°) to 100° (30 ~ 130°) after THA (P

Introduction: Transcription of biological nitrogen fixation (nif) genes is activated by the NifA protein which recognizes specific activating sequences upstream of σ54-dependent nif promoters. The large quantities of nitrogenase which can make up 20% of the total proteins in the cell indicates high transcription activating efficiency of NifA and high transcription level of nifHDK nitrogenase genes. Objectives: Development of an efficient gene transcription activating strategy in bacteria based on positive transcription regulatory proteins and their regulating DNA sequences. Methods: We designed a highly efficient gene transcription activating strategy in which the nifA gene was placed directly downstream of its regulating sequences. The NifA protein binds its regulating sequences and stimulates transcription of itself and downstream genes. Overexpressed NifA causes transcription activation by positive reinforcement. Results: When this gene transcription activating strategy was used to overexpress NifA in Pseudomonas stutzeri DSM4166 containing the nif gene cluster, the nitrogenase activity was increased by 368 folds which was 16 times higher than that obtained by nifA driven by the strongest endogenous constitutive promoter. When this strategy was used to activate transcription of exogenous biosynthetic genes for the plant auxin indole-3-acetic acid and the antitumor alkaloid pigment prodigiosin in DSM4166, both of them resulted in better performance than the strongest endogenous constitutive promoter and the highest reported productions in heterologous hosts to date. Finally, we demonstrated the universality of this strategy using the positive transcriptional regulator of the psp operon, PspF, in E. coli and the pathway-specific positive transcription regulator of the polyene antibiotic salinomycin biosynthesis, SlnR, in Streptomyces albus. Conclusion: Many positive transcription regulatory proteins and their regulating DNA sequences have been identified in bacteria. The gene transcription activating strategy developed in this study will have broad applications in molecular biology and biotechnology.

Objective The role of hypoalbuminemia throughout the course of chronic periprosthetic joint infection (PJI) remains poorly understood. This study aimed to determine the prevalence and risk factors of hypoalbuminemia in periprosthetic joint infection (PJI) patients and to explore the association between hypoalbuminemia and treatment outcomes. Methods This retrospective cohort study included 387 PJI cases who underwent two‐stage exchange arthroplasty between January 2007 and August 2020, of which 342 were reimplanted. The mean follow‐up period was 7.9 years. Multivariate logistic regression analyses were performed to identify risk factors for hypoalbuminemia and to assess the effect of hypoalbuminemia at 1st‐ and 2nd‐stage exchange on the treatment outcome. Furthermore, the impact of dynamic changes in hypoalbuminemia was investigated. Results The prevalence of hypoalbuminemia at 1st‐ and 2nd‐stage exchange was 22.2% and 4.7%, respectively. Patients with age ≥ 68 years and those with isolation of Staphylococcus aureus, Streptococcus, or Gram‐negative bacteria exhibited a higher risk of hypoalbuminemia. Hypoalbuminemia at 1st‐stage was significantly related to treatment failure (OR = 3.3), while hypoalbuminemia at 2nd‐stage raised the OR to 10.0. Patients with persistent hypoalbuminemia at both the 1st‐ and 2nd‐stage exchanges had a significantly higher rate of treatment failure than patients with hypoalbuminemia at the 1st‐stage but normal albumin levels at the 2nd‐stage exchange (55.6% vs 20.0%, p = 0.036). Conclusion One in five patients with chronic PJI exhibits hypoalbuminemia. Hypoalbuminemia is more likely to develop in patients of advanced age and those infected by specific highly virulent organisms. Also, our results highlight the close association between hypoalbuminemia and treatment outcomes.

Abstract Background Good wound healing is critical to infection prophylaxis and satisfactory rehabilitation in Total Knee Arthroplasty (TKA). Currently, two techniques, i.e., barbed continuous subcuticular suture without skin adhesive or combined use skin adhesive (n-butyl-2) are being used for superficial wound closure of TKA. While a new skin adhesive (2-octyl) with self-adhesive mesh has been employed as an alternative to conventional surgical skin closure in TKA, its superiority, especially in reducing wound complications and improving wound cosmetic outcomes has not been investigated. This study aimed to compare 2-octyl, n-butyl-2, and no skin adhesive in terms of safety and efficacy in TKA superficial wound closure. Methods We conducted a multicenter, prospective, randomized controlled study in 105 patients undergoing primary TKA between May 2022 and October 2023. Each patient’s knee was randomized to receive 2-octyl, n-butyl-2, or no skin adhesive skin closure with all using barbed continuous sutures in deep tissue. Wounds were followed 1, 3, 5 days, 2, 6 weeks, and 3 months after surgery. Wound discharge, complications, cosmetic outcomes, patient satisfaction, and wound-related costs were compared among these three methods. Results Wound discharge was less in 2-octyl group and n-butyl-2 group than in non-adhesive group at 1 day, with the discharge only being less in 2-octyl group than in the non-adhesive group at day 3 and day 5 days (P 0.05). The 2-octyl group achieved better cosmetic effects than the other two groups in 6 weeks and 3 months (P

Infectious laryngotracheitis (ILT) is a highly contagious disease, usually controlled by vaccination with live attenuated vaccines. However, the latent infection and adverse reactions caused by the live attenuated vaccines against infectious laryngotracheitis virus (ILTV) have limited its use in poultry. Infectious bronchitis virus (IBV) is considered a potential vector for vaccine development, but the issue of poor stability in recombinant IBV expressing foreign genes has not yet been resolved. In this study, we designed a multi-epitope cassette (gD-T/B) containing multiple T and B cell epitopes of ILTV gD protein. The genetic stability of the full-length gD gene and the gD-T/B multi-epitope cassette replacing non-essential genes in IBV was systematically analyzed. We found that, at the same insertion site, the stability of inserting gD-T/B multi-epitope cassette was consistently higher compared to the full-length gD gene. This difference may be related to the presence of more signals affecting virus replication or transcription in larger heterologous genes. In addition, the stability of recombinant IBV varied depending on the genome region being replaced. When the gene 5 was replaced, rH120-Δ5ab-gD-T/B was maintained up to at least passage 20 (P20). Compared with the parental virus H120 strain, rH120-Δ5ab-gD-T/B showed similar growth kinetics. Clinical observations and scoring of clinical signs in the vaccination-challenge experiment showed that rH120-Δ5ab-gD-T/B provided 90% protection against virulent ILTV, effectively alleviating clinical signs caused by infection with a virulent strain of ILTV. Furthermore, rH120-Δ5ab-gD-T/B significantly reduced the replication and shedding of ILTV in the trachea. Overall, this study suggests that rH120-Δ5ab-gD-T/B is a promising candidate vaccine against ILTV.

Background Liver metastasis is highly aggressive and immune tolerant, and lacks effective treatment strategies. This study aimed to develop a neoantigen hydrogel vaccine (NPT-gels) with high clinical feasibility and further investigate its efficacy and antitumor molecular mechanisms in combination with immune checkpoint inhibitors (ICIs) for the treatment of liver metastases.Methods The effects of liver metastasis on survival and intratumor T-cell subpopulation infiltration in patients with advanced tumors were investigated using the Surveillance, Epidemiology, and End Results Program (SEER) database and immunofluorescence staining, respectively. NPT-gels were prepared using hyaluronic acid, screened neoantigen peptides, and dual clinical adjuvants [Poly(I:C) and thymosin α-1]. Then, the efficacy and corresponding antitumor molecular mechanisms of NPT-gels combined with programmed death receptor 1 and cytotoxic T-lymphocyte-associated protein 4 double blockade (PCDB) for the treatment of liver metastases were investigated using various preclinical liver metastasis models.Results Liver metastases are associated with poorer 5-year overall survival, characterized by low infiltration of cytotoxic CD8+ T cells and high infiltration of regulatory T cells (Tregs). NPT-gels overcame the challenges faced by conventional neoantigen peptide vaccines by sustaining a durable, high-intensity immune response with a single injection and significantly improving the infiltration of neoantigen-specific T-cell subpopulations in different mice subcutaneous tumor models. Importantly, NPT-gels further combined with PCDB could enhance neoantigen-specific T-cell infiltration and effectively unlock the immunosuppressive microenvironment of liver metastases, showing superior antitumor efficacy and inducing long-term immune memory in various preclinical liver metastasis models without obvious toxicity. Mechanistically, the combined strategy can inhibit Tregs, induce the production and infiltration of neoantigen-specific CD8+CD69+ T cells to enhance the immune response, and potentially elicit antigen-presenting effects in Naïve B_Ighd+ cells and M1-type macrophages.Conclusions This study demonstrated that NPT-gels combined with PCDB could exert a durable and powerful antitumor immunity by enhancing the recruitment and activation of CD8+CD69+ T cells, which supports the rationale and clinical translation of this combination strategy and provides important evidence for further improving the immunotherapy efficacy of liver metastases in the future.

ObjectivePreoperative prediction of visual recovery after pituitary adenoma resection surgery remains challenging. This study aimed to investigate the value of clinical and radiological features in preoperatively predicting visual outcomes after surgery.MethodsPatients undergoing endoscopic transsphenoidal surgery (ETS) for pituitary adenoma were included in this retrospective and prospective study. Preoperative MRI, visual acuity, visual field, and postoperative visual recovery data were collected. Logistic regression analysis was used to assess the importance of clinical and MRI features, and a prediction model was developed.ResultsThe cohort included 198 patients (150 retrospective, 48 prospective). In the retrospective data, visual recovery was observed in 111 patients (74.0%), while non-recovery was observed in 39 patients (26.0%). In the prospective data, visual recovery was observed in 27 patients (56.25%) and non-recovery in 21 patients (43.75%). Blindness, headache, adenoma area, and adenoma upward growth distance were negatively correlated with visual recovery (p < 0.05), while the pituitary gland area was positively correlated (p = 0.001). Logistic regression selected three clinical features: blindness, headache, and visual impairment course. Two additional imaging features, pituitary gland maximum area, and adenoma maximum area, were incorporated into the prediction model. The area under the curve of the prediction model was 0.944 in the retrospective cohort and 0.857 in the prospective cohort. Accuracy was 88% and 81.25%, respectively.ConclusionThis study successfully developed a clinical practical model combining clinical and radiological features to preoperatively predict visual recovery for patients with pituitary adenoma. The model has the potential to provide personalized counseling for individual patients.

Agricultural modernization urgently requires precise control of pear tree leaf diseases, with accurate identification and segmentation of disease spots becoming crucial aspects for ensuring crop health. Addressing potential issues such as missed segmentation, missegmentation, and low segmentation accuracy in the traditional DeepLabv3+ model for this task, this study proposes an innovative approach based on an improved DeepLabv3+ network model. To enhance computational efficiency, MobileNetV2 is introduced as the backbone network. This reduces the model’s computational load and significantly improves segmentation speed, making it more suitable for real-time applications. Secondly, after the ASPP (Atrous Spatial Pyramid Pooling) convolution, the Squeeze-and-Excitation (SE) attention mechanism is introduced, integrating the features of pear tree leaf diseases to make the network focus more on the critical components of disease spots, thereby enhancing segmentation accuracy. Finally, the loss function is optimized by employing a linear combination of the cross-entropy loss function and Dice loss, encompassing comprehensive overall image loss and accurate loss calculation for the target area. Experimental validation demonstrates a significant improvement in the enhanced DeepLabv3+ across metrics such as MIoU, mPA, mPr, and mRecall, reaching 86.32%, 88.97%, 91.10%, and 88.97%, respectively. The improved model excels in pear tree leaf disease segmentation compared to traditional methods like DeepLabv3+, SegNet, FCN, and PSPNet. This confirms the enhanced model’s outstanding performance and generalization ability in segmenting pear tree leaf lesions, highlighting its potential value in practical applications.

Abstract Although adamantinomatous craniopharyngioma (ACP) is a tumour with low histological malignancy, there are very few therapeutic options other than surgery. ACP has high histological complexity, and the unique features of the immunological microenvironment within ACP remain elusive. Further elucidation of the tumour microenvironment is particularly important to expand our knowledge of potential therapeutic targets. Here, we performed integrative analysis of 58,081 nuclei through single-nucleus RNA sequencing and spatial transcriptomics on ACP specimens to characterize the features and intercellular network within the microenvironment. The ACP environment is highly immunosuppressive with low levels of T-cell infiltration/cytotoxicity. Moreover, tumour-associated macrophages (TAMs), which originate from distinct sources, highly infiltrate the microenvironment. Using spatial transcriptomic data, we observed one kind of non-microglial derived TAM that highly expressed GPNMB close to the terminally differentiated epithelial cell characterized by RHCG, and this colocalization was verified by asmFISH. We also found the positive correlation of infiltration between these two cell types in datasets with larger cohort. According to intercellular communication analysis, we report a regulatory network that could facilitate the keratinization of RHCG+ epithelial cells, eventually causing tumour progression. Our findings provide a comprehensive analysis of the ACP immune microenvironment and reveal a potential therapeutic strategy base on interfering with these two types of cells.

ABSTRACT Objective To investigate the differences in headache and comorbidity symptoms between migraine patients with negative and positive food specific IgG antibodies, and explore the correlation between these symptoms with food specific IgG antibodies. Methods A total of 129 migraine patients were enrolled. Seven questionnaires were used to gather information regarding the symptoms of migraine, gastrointestinal, depression, anxiety, and sleep. Serum specific IgG antibodies against 14 kinds of food were detected using enzyme‐linked immunosorbent assays. Results Patients with migraine diagnosis who had positive food specific IgG antibodies had significantly worse headaches, gastrointestinal and anxiety symptoms, compared to the patients with negative IgG antibodies. Patients with more IgG positive foods and higher total positive IgG concentration generally had worse migraine conditions, anxiety, depression, and gastrointestinal symptoms. Conclusion The effect of food specific IgG antibodies on severity of migraine and its comorbidities were antibody‐quantity and IgG‐concentration dependent. Future studies are warranted to explore the mechanism underlying such relationship.

Abstract Since the first report on single-layer MoS2 based transistor, rapid progress has been achieved in two-dimensional (2D) material-based atomically thin electronics, providing an alternative approach to solve the bottleneck in silicon device miniaturization. In this scenario, reliable contact between the metal electrodes and the subnanometer-thick 2D materials becomes crucial in determining the device performance. Here, utilizing the quasi-van der Waals (vdW) epitaxy of metals on fluorophlogopite mica, we demonstrate an all-stacking method for the fabrication of 2D devices with high-quality vdW contacts by mechanically transferring pre-deposited metal electrodes. This technique is applicable for complex device integration with sizes up to the wafer scale and is also capable of tuning the electric characteristics of the interfacial junctions by transferring selective metals. Our results provide an efficient, scalable, and low-cost technique for 2D electronics, allowing high-density device integration as well as a handy tool for fundamental research in vdW materials.

Abstract The universal flexoelectric effect in solids provides a mechanical pathway for controlling electric polarization in ultrathin ferroelectrics, eliminating potential material breakdown from a giant electric field at the nanoscale. One challenge of this approach is arbitrary implementation, which is strongly hindered by one-way switching capability. Here, utilizing the innate flexibility of van der Waals materials, we demonstrate that ferroelectric polarization and domain structures can be mechanically, reversibly, and arbitrarily switched in two-dimensional CuInP2S6 via the nano-tip imprinting technique. The bidirectional flexoelectric control is attributed to the extended tip-induced deformation in two-dimensional systems with innate flexibility at the atomic scale. By employing an elastic substrate, artificial ferroelectric nanodomains with lateral sizes as small as ~80 nm are noninvasively generated in an area of 1 μm2, equal to a density of 31.4 Gbit/in2. Our results highlight the potential applications of van der Waals ferroelectrics in data storage and flexoelectronics.

Rhododendron simsii plays important roles in maintaining ecological system stability in the north temperate zone. However, its natural growth is greatly affected by soil microorganisms, particularly rhizosphere microbes. In this study, a comparative analysis was conducted of the bacterial community structure in the rhizosphere of R. simsii at the old, adult, juvenile, and seedlings stages. The results showed that Proteobacteria (38.53%‒47.63%), Actinobacteria (23.45%‒34.03%), and Acidobacteria (10.33%‒17.79%) were the dominant phyla in the R. simsii rhizosphere. In particular, 3, 5, 42, and 33 OTUs were unique to the soil samples of ‘old trees’, ‘adult trees’, ‘juvenile trees’, and ‘seedlings’, respectively. Across four sets of R. simsii rhizosphere microbes sampled from seedlings to old trees, the OTUs first increased, then decreased, and finally increased. Overall, alpha diversity (Chao, ACE, and Sobs) revealed similar trends with the highest value i‒n recorded for the rhizosphere sample of ‘adult trees’ and the lowest for the ‘seedlings’ sample. The bacterial genera in the rhizosphere samples from ‘old trees’ and ‘adult trees’ exhibited close clustering. Notably, the R. simsii population of ‘juvenile trees’, demonstrating the highest genetic diversity, were rich in Bradyrhizobium and Streptomycetes. This research serves to benefit the domestication of wild R. simsii and other Rhododendron resources.

Abstract Background The prognostic significance of tumor burden score (TBS) in relation to carcinoembryonic antigen (CEA) has not been investigated among patients undergoing hepatectomy for intrahepatic cholangiocarcinoma (ICC). This study aimed to develop and validate a simplified model, a combination of TBS and CEA (CTC grade), for predicting the long-term outcomes of postoperative ICC patients. Methods Patients who underwent curative − intent resection of ICC between 2011 and 2019 were identified from a large multi − institutional database. The impact of TBS, CEA, and the CTC grade on overall survival (OS) and recurrence − free survival (RFS) was evaluated in both the derivation and validation cohorts. The receiver operating characteristic curve was utilized for assessing the predictive accuracy of the model. Subgroup analyses were performed across 8th TNM stage system stratified by CTC grade to assess the discriminatory capacity within the same TNM stage. Results A total of 812 patients were included in the derivation cohort and 266 patients in the validation cohort. Survival varied based on CEA (low: 36.7% vs. high: 9.0%) and TBS (low: 40.3% vs. high: 17.6%) in relation to 5 − year survival (both p

Abstract Background Bladder cancer (BC) is a very common urinary tract malignancy that has a high incidence and lethality. In this study, we identified BC biomarkers and described a new noninvasive detection method using serum and urine samples for the early detection of BC. Methods Serum and urine samples were retrospectively collected from patients with BC (n = 99) and healthy controls (HC) (n = 50), and the expression levels of 92 inflammation-related proteins were examined via the proximity extension analysis (PEA) technique. Differential protein expression was then evaluated by univariate analysis (p

Cracking in hydraulic buried engineering can cause localized damage or complete structural failure, potentially resulting in catastrophic project outcomes. Traditional methods for detecting cracks in hydraulic concrete buried engineering are often insufficient in terms of reliability and accuracy. With the development and application of particle-based technology, it has been widely used in the field of crack detection. This research investigates the support pier of the Yingxiuwan Hydropower Plant and the lock pier of the Yuzixi Hydropower Plant. Employing principles from quantum physics, quantum particle non-destructive detection technology is introduced to identify crack locations. A three-dimensional simulation model is constructed and verified accurately through integration with CT scanning techniques. The results demonstrate that particle detection technology effectively detects cracks in hydraulic concrete buried engineering, exhibiting minimal susceptibility to external interference. The particle detection data enable 3D visualization of cracks, accurately reflecting the conditions within embedded concrete components. This method provides a reliable and advanced technical solution for precise crack detection in concrete-embedded engineering and offers critical data for exploring crack propagation mechanisms.

Starch films have attracted increasing attention due to their biodegradability, edibility, and potential use as animal feed from post-products. Applications of starch-based films include food packaging, coating, and medicine capsules. However, a major drawback of starch-based films is their brittleness, particularly under dry conditions, caused by starch retrogradation and the instability of plasticizers. To address this challenge, various strategies and methodologies have been developed, including plasticization, chemical modification, and physical reinforcement. This review covers fundamental aspects, such as the microstructures, phase transitions, and compatibility of starch, as well as application-oriented techniques, including processing methods, plasticizer selection, and chemical modifications. Plasticizers play a crucial role in developing starch-based materials, as they mitigate brittleness and improve processability. Given the abundance of hydroxyl groups in starch, the plasticizers used must also contain hydroxyl or polar groups for compatibility. Chemical modification, such as esterification and etherification, effectively prevents starch recrystallization. Reinforcements, particularly with nanocellulose, significantly improved the mechanical properties of starch film. Drawing upon both the literature and our expertise, this review not only summarizes the advancements in this field but also identifies the limitations of current technologies and outlines promising research directions for future development.

Glume-opening of thermosensitive genic male sterile (TGMS) rice (Oryza sativa L.) lines after anthesis is a serious problem that significantly reduces the yield and quality of hybrid seeds. However, the molecular mechanisms regulating the opening and closing of rice glumes remain largely unclear. In this study, we report the isolation and functional characterization of a glum-opening mutant after anthesis, named gom1. gom1 exhibits dysfunctional lodicules that lead to open glumes following anthesis. Map-based cloning and subsequent complementation tests confirmed that GOM1 encodes a receptor-like kinase (RLK). GOM1 was expressed in nearly all floral tissues, with the highest expression in the lodicule. Loss-of-function of GOM1 resulted in a decrease in the expression of genes related to JA biosynthesis, JA signaling, and sugar transport. Compared with LK638S, the JA content in the gom1 mutant was significantly reduced, while the soluble sugar, sucrose, glucose, and fructose contents were significantly increased in lodicules after anthesis. Together, we speculated that GOM1 regulates carbohydrate transport in lodicules during anthesis through JA and JA signaling, maintaining a higher osmolality in lodicules after anthesis, which leads to glum-opening.

Background Musculoskeletal (MSK) disorders, affecting billions of people worldwide, pose significant challenges to the healthcare system and require effective management models. The rapid development of digital healthcare technologies (DHTs) has revolutionized the healthcare industry. DHT-based interventions have shown promising clinical benefits in managing MSK disorders, alleviating pain, and improving functional impairment. There is, however, no bibliometric analysis of the overall trends on this topic. Methods We extracted all relevant publications from the Web of Science Core Collection (WoSCC) database until April 30, 2023. We performed bibliometric analysis and visualization using CiteSpace, VOSviewer, and R software. Annual trends of publications, countries/regions distributions, funding agencies, institutions, co-cited journals, author contributions, references, core journals, and keywords and research hotspots were analyzed. Results A total of 6810 papers were enrolled in this study. Publications have increased drastically from 16 in 1995 to 1198 in 2022, with 4067 articles published in the last five years. In all, 53 countries contributed with publications to this research area. The United States, the United Kingdom, and China were the most productive countries. Harvard University was the most contributing institution. Regarding keywords, research focuses include artificial intelligence, deep learning, machine learning, telemedicine, rehabilitation, and robotics. Conclusion The COVID-19 pandemic has further accelerated the adoption of DHTs, highlighting the need for remote care options. The analysis reveals the positive impact of DHTs on improving physician productivity, enhancing patient care and quality of life, reducing healthcare expenditures, and predicting outcomes. DHTs are a hot topic of research not only in the clinical field but also in the multidisciplinary intersection of rehabilitation, nursing, education, social and economic fields. The analysis identifies four promising hotspots in the integration of DHTs in MSK pain management, biomechanics assessment, MSK diagnosis and prediction, and robotics and tele-rehabilitation in arthroplasty care.

BackgroundThe utility of pre- and post-operative alpha-fetoprotein (AFP) and des-gamma (γ)-carboxy prothrombin (DCP) expression patterns and their dynamic changes as predictors of the outcome of hepatic resection for hepatocellular carcinoma (HCC) has yet to be well elucidated.MethodsFrom a multicenter database, AFP and DCP data during the week prior to surgery and the first post-discharge outpatient visit (within 1-2 months after surgery) were collected from patients with HCC who underwent hepatectomy. AFP-DCP expression patterns were categorized according to the number of positive tumor markers (AFP ≥ 20ng/mL, DCP ≥ 40mAU/mL), including double-negative, single-positive, and double-positive. Changes in the AFP-DCP expression patterns were delineated based on variations in the number of positive tumor markers when comparing pre- and post-operative patterns.ResultsPreoperatively, 53 patients (8.3%), 337 patients (52.8%), and 248 patients (38.9%) exhibited double-negative, single-positive, and double-positive AFP-DCP expression patterns, respectively. Postoperatively, 463 patients (72.6%), 130 patients (20.4%), and 45 patients (7.0%) showed double-negative, single-positive, and double-positive AFP-DCP expression patterns, respectively. Survival analysis showed a progressive decrease in recurrence-free (RFS) and overall survival (OS) as the number of postoperative positive tumor markers increased (both P < 0.001). Multivariate analysis showed that postoperative AFP-DCP expression pattern, but not preoperative AFP-DCP expression pattern, was an independent risk factor for RFS and OS. Further analysis showed that for patients with positive preoperative markers, prognosis gradually improves as positive markers decrease postoperatively. In particular, when all postoperative markers turned negative, the prognosis was consistent with that of preoperative double-negative patients, regardless of the initial number of positive markers.ConclusionsAFP-DCP expression patterns, particularly postoperative patterns, serve as vital sources of information for prognostic evaluation following hepatectomy for HCC. Moreover, changes in AFP-DCP expression patterns from pre- to post-operation enable dynamic prognostic risk stratification postoperatively, aiding the development of individualized follow-up strategies.

Abstract Digital PCR (dPCR) holds immense potential for precisely detecting nucleic acid markers essential for personalized medicine. However, its broader application is hindered by high consumable costs, complex procedures, and restricted multiplexing capabilities. To address these challenges, an all‐in‐one dPCR system is introduced that eliminates the need for microfabricated chips, offering fully automated operations and enhanced multiplexing capabilities. Using this innovative oscillation‐induced droplet generation technique, OsciDrop, this system supports a comprehensive dPCR workflow, including precise liquid handling, pipette‐based droplet printing, in situ thermocycling, multicolor fluorescence imaging, and machine learning‐driven analysis. The system's reliability is demonstrated by quantifying reference materials and evaluating HER2 copy number variation in breast cancer. Its multiplexing capability is showcased with a quadruplex dPCR assay that detects key EGFR mutations, including 19Del, L858R, and T790M in lung cancer. Moreover, the digital stepwise melting analysis (dSMA) technique is introduced, enabling high‐multiplex profiling of seven major EGFR variants spanning 35 subtypes. This innovative dPCR system presents a cost‐effective and versatile alternative, overcoming existing limitations and paving the way for transformative advances in precision diagnostics.

Abstract Background Periprosthetic joint infection (PJI) is a serious complication after total joint arthroplasty (TJA). Although some risk factors of PJI were well studied, the association between trauma and PJI remains unknown in revision patients. Materials and methods Between 2015 and 2018, a total of 71 patients with trauma history before revisions (trauma cohort) were propensity score matched (PSM) at a ratio of 1 to 5 with a control cohort of revision patients without a history of trauma. Then, the cumulative incidence rate of PJI within 3 years after operation between the two groups was compared. The secondary endpoints were aseptic revisions within 3 postoperative years, complications up to 30 postoperative days, and readmission up to 90 days. During a minimal 3-year follow-up, the survival was comparatively analyzed between the trauma cohort and the control cohort. Results The cumulative incidence of PJI was 40.85% in patients with trauma history against 27.04% in the controls (P = 0.02). Correspondingly, the cumulative incidence of aseptic re-revisions was 12.68% in patients with trauma history compared with 5.07% in the control cohort (P = 0.028). Cox regression revealed that trauma history was a risk factor of PJI (HR, 1.533 [95%CI, (1.019,2.306)]; P = 0.04) and aseptic re-revisions (HR, 3.285 [95%CI, (1.790,6.028)]; P

AIM: To explore the factors influencing individuals' willingness to participate in ophthalmic clinical trials. METHODS: A questionnaire survey was conducted from January to April 2021 among patients and their family members at Zhongshan Ophthalmic Center, Sun Yat-sen University, in Guangzhou, China. The survey gathered data on respondents' willingness, demographic and socioeconomic profiles, as well as their reasons and concerns regarding engagement in clinical trials. RESULTS: Of the 1078 residents surveyed (mean age 31.2±13.1y; 65.8% females) in Guangzhou, 749 (69.5%) expressed a willingness to participate in future ophthalmic clinical trials. Specific characteristics associated with greater willingness included a younger age, lower annual income, higher education, prior participation experience, previous ophthalmic treatment, and a better understanding of clinical trials. With the exception of age, these characteristics were significantly linked to a higher willingness. The primary barrier to participation, expressed by 64.8% of those willing and 54.4% of those unwilling, was “Uncertain efficacy”. In terms of motivations, the willing group ranked “Better therapeutic benefits” (35.0%), “Professional monitoring” (34.3%), and “Trust in healthcare professionals” (33.1%) as their top three reasons, whereas the unwilling participants indicated “Full comprehension of the protocol” (46.2%) as the key facilitator. CONCLUSION: This study reveals a substantial willingness to participate in ophthalmic clinical trials and demonstrates the predictive role of demographic and socioeconomic factors. Variations in motivators and concerns between willing and unwilling participants highlight the significance of tailored recruitment strategies. Importantly, the need for and trust in healthcare professionals stand out as powerful motivations, underscoring the importance of enhancing physician-patient relationships, adopting patient-centered communication approaches, and addressing individualized needs to improve accrual rates.

This study designs an energy management strategy for fuel cell hybrid vehicles aimed to alleviating the performance degradation of Proton Exchange Membrane Fuel Cells (PEMFC), fuel consumption, and battery State of Charge (SOC) fluctuations during vehicle operation. The research focuses on the decrease in Electrochemical Surface Area (ECSA) due to Platinum (Pt) catalyst degradation, which is a key factor influencing PEMFC durability. An ECSA model based on the Pt dissolution mechanism is established, and a dynamic condition accelerated stress test (DC-AST) is designed to specifically investigate the impacts of key parameters, such as cycle period, amplitude, and duty cycle on the degradation of ECSA. This reveals the association between ECSA degradation and irregular potential fluctuations. A hierarchical power allocation strategy is then proposed, combining the global search capabilities of optimization algorithms with heuristic strategies in light of these features. The upper level employs Pontryagin’s Minimum Principle (PMP) strategy for global power allocation optimization, while the lower level uses a satisfaction-based heuristic strategy that is tailored to the ECSA degradation characteristics, to dynamically adjust power output. Simulation results demonstrate that, compared to traditional rule-based strategies and classical PMP-based strategies, the proposed energy management strategy more effectively mitigates ECSA degradation of PEMFC under typical vehicle conditions.

Objectives: During the COVID-19 pandemic, there was a decline in vaccine coverage, and the implementation of combined vaccines and co-administration strategies emerged as potential solutions to alleviate this predicament. Our objective is to delve into the concurrent administration of the sabin-strain-based inactivated poliovirus vaccine (sIPV), the diphtheria-tetanus-acellular pertussis vaccine (DTaP), and measles-mumps-rubella vaccine (MMR), with the intention of bridging the evidentiary gap pertaining to vaccine co-administration in Chinese infants, and to ensure a safe and effective vaccination strategy, ultimately leading to an augmentation in immunization coverage. Methods: This study was a follow-up trial of the “Immunogenicity and safety of concomitant administration of the sIPV with the DTaP vaccine in children: a multicenter, randomized, non-inferiority, controlled trial.” Blood samples were collected on day 0 and day 30, and serum antibody levels were detected to measure antibody responses to each of the antigens. Local and systemic adverse events were monitored and compared among groups. This study is the first to fill the knowledge gap in China regarding the safe and effective combined vaccination of sIPV, DTaP, and MMR vaccines. Results: The geometric mean titer of the poliovirus types I, II, and III neutralizing antibodies were 1060.22 (95% CI: 865.73-1298.39), 1537.06 (95% CI: 1324.27-1784.05), and 1539.10 (95% CI: 1296.37-1827.29) in group I on day 30; geometric mean titer of antibodies against DTaP and MMR in the simultaneous vaccination group was non-inferior to those in the DTaP alone and MMR alone group. Reporting rates of local and systemic adverse reactions were similar between groups and no serious adverse events were reported throughout the clinical study period. Conclusion: Co-administration of the sIPV, DTaP, and MMR was safe and did not impact immunogenicity, which would help to mitigate administrative costs and enhance vaccine coverage rates.

Abstract Background Routine clinical staging for hepatocellular carcinoma (HCC) incorporates liver function, general health, and tumor morphology. Further refinement of prognostic assessments and treatment decisions may benefit from the inclusion of tumor biological marker alpha-fetoprotein (AFP) and systemic inflammation indicator C-reactive protein (CRP). Methods Data from a multicenter cohort of 2770 HCC patients undergoing hepatectomy were analyzed. We developed the PACE risk score (Prognostic implications of AFP and CRP Elevation) after initially assessing preoperative AFP and CRP’s prognostic value. Subgroup analyzes were performed in BCLC cohorts A and B using multivariable Cox analysis to evaluate the prognostic stratification ability of the PACE risk score and its complementary utility for BCLC staging. Results Preoperative AFP ≥ 400ng/mL and CRP ≥ 10 mg/L emerged as independent predictors of poorer prognosis in HCC patients who underwent hepatectomy, leading to the creation of the PACE risk score. PACE risk score stratified patients into low, intermediate, and high-risk groups with cumulative 5-year overall (OS) and recurrence-free survival (RFS) rates of 59.6%/44.9%, 43.9%/38.4%, and 20.6%/18.0% respectively (all P

Maize is susceptible to pest disease, and the production of maize would suffer a significant decline without precise early detection. Hyperspectral imaging is well-suited for the precise detection of diseases due to its ability to capture the internal chemical characteristics of vegetation. However, the abundance of redundant information in hyperspectral data poses challenges in extracting significant features. To overcome the above problems, in this study we proposed an attention-based spatial-spectral joint network model for hyperspectral detection of pest-infected maize. The model contains 3D and 2D convolutional layers that extract features from both spatial and spectral domains to improve the identification capability of hyperspectral images. Moreover, the model is embedded with an attention mechanism that improves feature representation by focusing on important spatial and spectral-wise information and enhances the feature extraction ability of the model. Experimental results demonstrate the effectiveness of the proposed model across different field scenarios, achieving overall accuracies (OAs) of 99.24% and 97.4% on close-up hyperspectral images and middle-shot hyperspectral images, respectively. Even under the condition of a lack of training data, the proposed model performs a superior performance relative to other models and achieves OAs of 98.29% and 92.18%. These results proved the validity of the proposed model, and it is accomplished efficiently for pest-infected maize detection. The proposed model is believed to have the potential to be applied to mobile devices such as field robots in order to monitor and detect infected maize automatically.

Cognitive impairment (CI) causes severe impairment of brain function and quality of life of patients, which brings a great burden to society. Cerebral hypoxia is an important factor in the pathogenesis of CI. Hyperbaric oxygen (HBO) therapy may mitigate hypoxia-induced CI, but its efficacy and mechanisms are not fully understood. In this study, a mice model of CI induced by hypoxia environment was established, then behavioral tests, pathological examination, metabolomic and lipidomic analyses, and molecular biology were used to assess the impact of HBO on hypoxia-induced CI. HBO was found to alleviate CI and pathological damage of hypoxia mice. Metabolomic, lipidomic, and molecular biology analyses showed that HBO increased the levels of oleic acid (OA) and membrane-bound O-acyltransferase 2 (MBOAT2), thereby altering the composition of membrane phospholipids (PLs) and reducing hypoxia-induced neuronal ferroptosis (FPT) to interfere with cognitive function in mice. In vitro experiments confirmed that OA and MBOAT2 led to membrane PL remodeling in a mutually dependent manner, affecting cell resistance to hypoxia-FPT. The results emphasized the combined effect value of OA and MBOAT2 in HBO for hypoxia-induced CI, and provided a novel perspective for the treatment of CI by HBO.

Blending gasoline with hydrogenated catalytic biodiesel has the potential to improve combustion problems of gasoline direct-injection compression combustion, and the spray characteristics of the blending fuel can directly affect the combustion effect. In order to understand the spray characteristics of a gasoline–hydrocatalyzed catalytic biodiesel mixture, a numerical spray model of constant volume combustion chamber was established, and the accuracy of the model was verified by experimental data in the literature. Based on this model, the spray penetration, sauter mean diameter, spray velocity field and concentration field of gasoline–hydrocatalyzed catalytic biodiesel at different blending ratios were studied. The results show that under the conditions of 850 K ambient temperature, 5 MPa ambient pressure, and 80 MPa injection pressure, as the proportion of hydrogenated catalytic biodiesel in the blending fuel increases, the spray penetration increases, the sauter mean diameter decreases slightly, and the area of high velocity and high concentration at the spray center increases. The results of this study will contribute to the development of blended fuels for superior combustion performance and reduced pollutant emissions at appropriate blending ratios.

Abstract Objectives The purpose of this study was to develop and validate a radiomics nomogram for predicting thymidylate synthase (TYMS) status in hepatocellular carcinoma (HCC) by using Gd-DTPA contrast enhanced MRI. Methods We retrospectively enrolled 147 consecutive patients with surgically confirmed HCC and randomly allocated to training and validation set (7:3). The TYMS status was immunohistochemical determined and classified into low TYMS (positive cells ≤ 25%) and high TYMS (positive cells > 25%) groups. Radiomics features were extracted from the arterial phases and portal venous phase of Gd-DTPA contrast enhanced MRI. Least absolute shrinkage and selection operator (LASSO) were applied for generating the Rad score. Clinical data and MRI findings were assessed to build a clinical model. Rad score combined with clinical features was used to construct radiomics nomogram. Results A total of 2260 features were extracted and reduced to 7 features as the most important discriminators to build the Rad score. InAFP was identified as the only independent clinical factors for TYMS status. The radiomics nomogram showed good discrimination in training (AUC, 0.759; 95% CI 0.665–0.838) and validation set (AUC, 0.739; 95% CI 0.585–0.860), and showed better discrimination capability (P

BackgroundCervical cancer (CC) poses a global health challenge, with a particularly poor prognosis in cases of recurrence, metastasis, or advanced stages. A single biomarker is inadequate to predict CC prognosis or identify CC patients likely to benefit from immunotherapy, presumably owing to tumor complexity and heterogeneity.MethodsUsing advanced Olink proteomics, we analyzed 92 oncology-related proteins in plasma from CC patients receiving immunotherapy, based upon the comparison of protein expression levels of pre-therapy with those of therapy-Cycle 6 in the partial response (PR) group and progressive disease (PD) group, respectively.Results55 proteins were identified to exhibit differential expression trends across pre-therapy and post-therapy in both PR and PD groups. Enriched GO terms and KEGG pathways were associated with vital oncological and immunological processes. A logistic regression model, using 5 proteins (ITGB5, TGF-α, TLR3, WIF-1, and ERBB3) with highest AUC values, demonstrated good predictive performance for prognosis of CC patients undergoing immunotherapy and showed potential across different cancer types. The effectiveness of these proteins in prognosis prediction was further validated using TCGA-CESC datasets. A negative correlation and previously unidentified roles of WIF-1 in CC immunotherapy was also first determined.ConclusionOur findings reveal multi-biomarker profiles effectively predicting CC prognosis and identifying patients benefitting most from immunotherapy, especially for those with limited treatment options and traditionally poor prognosis, paving the way for personalized immunotherapeutic treatments and improved clinical strategies.

This paper explores linear waves’ instability in nonuniform complex plasmas with dust size distribution and non-adiabatic dust charge fluctuation. For this purpose, the dispersion relation is obtained with the aid of linearizing the hydrodynamic equations governing the properties of linear waves. The contribution of physical parameters such as inhomogeneity, nonadiabatic dust charge fluctuation, and dust size distribution to the features of dust acoustic waves is examined at great length. The numerical results show that the present research results are very important in the phenomenon of space astrophysical and experimental plasmas.

Abstract Background Vacuum sealing drainage (VSD) is widely applied in complex wound repair. We aimed to compare traditional debridement and drainage and VSD in treating Fournier’s gangrene (FG). Methods Data of patients surgically treated for FG were retrospectively analyzed. Results Of the 36 patients (men: 31, women: 5; mean age: 53.5 ± 11.3 [range: 28–74] years) included in the study, no patients died. Between-group differences regarding sex, age, BMI, time from first debridement to wound healing, number of debridements, FGSI, and shock were not statistically significant (P > 0.05). However, lesion diameter, colostomy, VAS score, dressing changes, analgesic use, length of hospital stay, and wound reconstruction method (χ2 = 5.43, P = 0.04) exhibited statistically significant differences. Tension-relieving sutures (6 vs. 21) and flap transfer (4 vs. 2) were applied in Groups I and II, respectively. Conclusion VSD can reduce postoperative dressing changes and analgesic use, and shrunk the wound area, thereby reducing flap transfer in wound reconstruction.

Objective Periprosthetic joint infection (PJI) caused by non‐tubercular mycobacteria (NTM) is uncommon but catastrophic. However, conclusive clinical data on PJI caused by NTM are lacking. In this case series and systematic review, the clinical manifestations, diagnosis, and management of NTM PJI are summarized and analyzed. Methods From 2012 to 2020, we retrospectively analyzed consecutive PJI cases caused by NTM in our institution. A literature review was also conducted from January 2000 to December 2021, utilizing the PubMed, MEDLINE, Cochrane Library, and EMBASE databases to identify all reported NTM‐induced PJI cases. The clinical characteristics, demographics, pathogen identification, treatment protocols, and prognosis of NTM PJI were summarized and analyzed. Results In this retrospective analysis, seven patients infected with NTM following total joint arthroplasty at our institution were included, including six cases of PJI caused by NTM and one case of septic arthritis (SA) caused by NTM. There were six men and one woman, and their average age was 62.3 years. The average interval between TJA and PJI onset was 4 months. The preoperative serological markers, including the mean ESR (51 mm/h), CRP (4.0 mg/dL), fibrinogen (5.7 g/L), and D‐dimer (1.1 g/L), were increased. Six patients underwent staged revision surgery, and one patient with SA received antibiotic‐loaded bone cement beads to treat the infection. After an average of 33 months of observation following surgical intervention, none of the patients showed any symptoms of infection recurrence. From 2000 to 2021, 68 patients with NTM PJI were found in 39 studies in the published literature. Reinfections occurred within 1 year after arthroplasty in more than half (53.2%) of the patients. M. fortuitum and M. abscesses were the most prevalent rapidly growing mycobacteria (RGM) in all PJI patients, whereas Mycobacterium avium intracellulare (MAC) was the most prevalent slowly growing mycobacterium (SGM). The corresponding antibiotics were amikacin and ethambutol. The rate of culture‐negative without specific clinical symptoms was as high as 36.4% (12/33), while 45% (18/40) utilized additional diagnostic techniques such as NGS. A final clinical follow‐up record was available for 59 patients (86.7%; mean follow‐up period, 29 months), and 10.1% of patients failed to respond to treatment. Conclusion Orthopaedic surgeons should consider NTM in patients with negative routine cultures who are at risk for Mycobacterium infection. Treatment options rely on the accurate result of microbiologic identification and drug sensitivity testing, and to achieve this, it may be necessary to send multiple culture specimens, extend the culture time, and change the culture medium. Every effort should be made to identify NTM and its various subtypes through modern diagnostic tools if necessary.

Abstract Aims Periprosthetic joint infection (PJI) is one of the most serious complications after total joint arthroplasty (TJA) but the characterization of the periprosthetic environment microbiome after TJA remains unknown. Here, we performed a prospective study based on metagenomic next-generation sequencing to explore the periprosthetic microbiota in patients with suspected PJI. Methods We recruited 28 patients with culture-positive PJI, 14 patients with culture-negative PJI, and 35 patients without PJI, which was followed by joint aspiration, untargeted metagenomic next-generation sequencing (mNGS), and bioinformatics analysis. Our results showed that the periprosthetic environment microbiome was significantly different between the PJI group and the non-PJI group. Then, we built a “typing system” for the periprosthetic microbiota based on the RandomForest Model. After that, the ‘typing system’ was verified externally. Results We found the periprosthetic microbiota can be classified into four types generally: “Staphylococcus type,” “Pseudomonas type,” “Escherichia type,” and “Cutibacterium type.” Importantly, these four types of microbiotas had different clinical signatures, and the patients with the former two microbiota types showed obvious inflammatory responses compared to the latter ones. Based on the 2014 Musculoskeletal Infection Society (MSIS) criteria, clinical PJI was more likely to be confirmed when the former two types were encountered. In addition, the Staphylococcus spp. with compositional changes were correlated with C-reactive protein levels, the erythrocyte sedimentation rate, and the synovial fluid white blood cell count and granulocyte percentage. Conclusions Our study shed light on the characterization of the periprosthetic environment microbiome in patients after TJA. Based on the RandomForest model, we established a basic “typing system” for the microbiota in the periprosthetic environment. This work can provide a reference for future studies about the characterization of periprosthetic microbiota in periprosthetic joint infection patients.

Abstract Background N6-methyladenosine (m6A) is associated with mammalian mRNA biogenesis, decay, translation and metabolism, and also contributes greatly to gastrointestinal tumor formation and development. Therefore, the specific mechanisms and signaling pathways mediated by methyltransferase-like 3 (METTL3), which catalyzes the formation of m6A chemical labeling in stomach adenocarcinoma (STAD), are still worth exploring. Methods Quantitative real-time PCR (qRT-PCR) was constructed to detect the expression of METTL3 in gastric cancer cell lines and patient tissues. The biological function of METTL3 was investigated in vitro/in vivo by Cell Counting Kit-8, colony formation assay, Transwell assay and nude mouse tumorigenesis assay. Based on the LinkedOmics database, the genes co-expressed with METTL3 in the TCGA STAD cohort were analyzed to clarify the downstream targets of METTL3. Methylated RNA immunoprecipitation-qPCR (MeRIP-qPCR) and RNA stability analysis were employed to explore the mechanism of METTL3 in gastric cancer progression. Results We analyzed TCGA data and found that METTL3 was frequently elevated in STAD, and demonstrated that METTL3 was present at high levels in clinical STAD tissues and cells. High METTL3 expression was more likely to have advanced TNM tumors and distant metastasis. On the other hand, METTL3 silencing effectively impeded the higher oncogenic capacity of AGS and HGC27 cells in vivo and in vitro, as reflected by slowed cell growth and diminished migration and invasion capacities. Continued mining of the TCGA dataset identified the co-expression of angiopoietin-like 3 (ANGPTL3) and METTL3 in STAD. Lower level of ANGPTL3 was related to increased level of METTL3 in STAD samples and shorter survival times in STAD patients. ANGPTL3 enrichment limited the growth and metastasis of STAD cells. Besides, ANGPTL3 mRNA levels could be decreased by METTL3-dominated m6A modifications, a result derived from a combination of MeRIP-qPCR and RNA half-life experiments. Importantly, the inhibitory effect of METTL3 silencing on cancer could be reversed to some extent by ANGPTL3 inhibition. Conclusions Overall, our findings suggested that METTL3 functioned an oncogenic role in STAD by reducing ANGPTL3 expression in an m6A-dependent manner. The discovery of the METTL3-ANGPTL3 axis and its effect on STAD tumor growth will contribute to further studies on the mechanisms of gastric adenocarcinoma development.

Abstract Background Periprosthetic joint infection is a serious complication after total joint arthroplasty. Despite that alpha-defensin was used as diagnostic test in the 2018 ICM (international consensus meeting) criteria, its position in the PJI diagnostic pipeline was controversial. Therefore, we performed a retrospective pilot study to identify whether synovial fluid alpha-defensin test was necessary when corresponding synovial fluid analysis (WBC count, PMN% and LE tests) was performed. Methods Between May 2015 and October 2018, a total of 90 suspected PJI patients who underwent revisions after TJA were included in this study. Based on the 2018 ICM criteria, the interobserver agreements between preoperative diagnostic results and postoperative diagnostic results and the interobserver reliability between preoperative diagnostic results and postoperative diagnostic results with or without synovial fluid alpha-defensin tests were calculated. After that, the ROC analysis, and the direct cost-effectiveness of adding alpha-defensin was performed. Results There were 48,16 and 26 patients in the PJI group, inconclusive group and non-PJI group, respectively. Adding the alpha-defensin tests into 2018 ICM criteria can’t change the preoperative diagnostic results, postoperative diagnostic results, and the concordance between preoperative and postoperative diagnostic results. Moreover, the Risk–benefit Ratio is over 90 per changed decision and the direct cost-effectiveness of alpha-defensin was more than $8370($93*90) per case. Conclusions Alpha-defensin assay exhibit high sensitivity and specificity for PJI detection as a standalone test based on the 2018 ICM criteria. However, the additional order of Alpha-defensin can’t offer additional evidence for PJI diagnosis when corresponding synovial fluid analysis was performed (synovial fluid WBC count, PMN% and LE strip tests). Evidence level Level II, Diagnostic study.

Accurate time synchronisation is critical in modern communication, navigation, and scientific research. In this context, the eLoran receiver, which is an advanced timing device, has attracted increasing scholarly attention. This study aims to comprehensively analyse the performance and potential applications of eLoran systems for timing monitoring and to specifically explore the relevant indices of two eLoran receivers. To this end, we evaluated the performance of these receivers in receiving time signals through both simulated and empirical data and conducted a regularity analysis to uncover their potential value in practical applications. The findings demonstrate that the eLoran receiver excels at timing monitoring and provides highly accurate time information. An analysis of the timing performance of the eLoran system improved its accuracy and integrity.

Background: Rising evidence indicates the development of pyroptosis in the initiation and pathogenesis of spinal cord injury (SCI). However, the associated effects of pyroptosis-related genes (PRGs) in SCI are unclear. Methods: We obtained the gene expression profiles of SCI and normal samples in the GEO. Database: The R package limma screened for differentially expressed (DE) PRGs and performed functional enrichment analysis. Mechanical learning and PPI analysis helped filter essential PRGs to diagnose SCI. Peripheral blood was collected for validation from ten SCI patients and eight healthy individuals. The association of essential PRGs with immune infiltration was evaluated, and pyroptosis subtypes were recognized in SCI patients by unsupervised cluster analysis. Besides, a SCI model was built for in vivo validation of essential PRGs. Result: We identified 25 DE-PRGs between SCI and normal controls. Functional enrichment analysis revealed the principal involvement of DE-PRGs in pyroptosis, inflammasome complex, interleukin-1 beta production, etc. Subsequently, three essential PRGs were identified and validated, showing excellent diagnostic efficacy and significant correlation with immune cell infiltration. Additionally, we developed diagnostic nomograms to predict the occurrence of SCI. Two pyroptosis subtypes exhibited distinct biological functions and immune landscapes among SCI patients. Finally, the expression of these essential PRGswas verified in vivo. Conclusion: The current study described the vital effects of pyroptosis-related genes in SCI, providing a novel direction for effective assessment and management of SCI.

Background: The immune response associated with periprosthetic joint infection (PJI) is an emerging but relatively unexplored topic. The aim of this study was to investigate immune cell infiltration in periprosthetic tissues and identify potential immune-related biomarkers. Methods: The GSE7103 dataset from the GEO database was selected as the data source. Differentially expressed genes (DEGs) and significant modular genes in weighted correlation network analysis (WGCNA) were identified. Functional enrichment analysis and transcription factor prediction were performed on the overlapping genes. Next, immune-related genes from the ImmPort database were matched. The protein-protein interaction (PPI) analysis was performed to identify hub genes. CIBERSORTx was used to evaluate the immune cell infiltration pattern. Spearman correlation analysis was used to evaluate the relationship between hub genes and immune cells. Results: A total of 667 DEGs were identified between PJI and control samples, and 1847 PJI-related module genes were obtained in WGCNA. Enrichment analysis revealed that the common genes were mainly enriched in immune and host defense-related terms. TFEC, SPI1, and TWIST2 were the top three transcription factors. Three hub genes, SDC1, MMP9, and IGF1, were identified in the immune-related PPI network. Higher levels of plasma cells, CD4+ memory resting T cells, follicular helper T cells, resting mast cells, and neutrophils were found in the PJI group, while levels of M0 macrophages were lower. Notably, the expression of all three hub genes correlated with the infiltration levels of seven types of immune cells. Conclusion: The present study revealed immune infiltration signatures in the periprosthetic tissues of PJI patients. SDC1, MMP9, and IGF1 were potential immune-related biomarkers for PJI.

In order to broaden the muffler frequency band in the low-frequency range of the exhaust muffler and to achieve the purpose of broadband noise reduction, in this paper, a model of an annular connecting pipe muffler is proposed using the finite element method (FEM) to simulate the nonreflection boundary condition and to solve the transmission loss (TL). In addition, the experimental value is obtained by the spatial five-point measurement method and compared with the simulated value, and the validity and reliability of the solution model are verified. Compared with a simple expansion muffler, the average TL of the annular connecting pipe muffler is increased by 11.86 dB, and the maximum TL is increased by 18.31 dB, effectively widening the muffler frequency area, and the overall performance is effectively improved. Finally, the influence of structural factors is analyzed, including the width (W) of the annular connecting pipe, the length (L) of the annular connecting pipe, and the length ratio (m) of the front and rear chambers on the TL and on the width of the anechoic frequency band. The results reveal that the width and length of the annular connecting pipe and front-to-back cavity length ratio are the most significant factors to influence the TL, muffler frequency band, and elimination or reduction of the passing frequency, respectively.

Silicon carbide (SiC) nanowhiskers have many application prospects owing to their excellent mechanical properties, thermal conductivity, and good chemical stability. Herein, we examined the effect of enhancing the mechanical properties and impermeability of cement mortar (CM) by improving the microstructural compactness and reducing the porosity after mixing CM using SiC nanowhiskers. Macroscopic and microscopic tests and analyses of CM blended with different amounts of SiC nanowhiskers were performed using an electro-hydraulic flexural and compressive testing machine, cement mortar penetration tester, field-emission scanning electron microscopy, energy-dispersive spectrometry, X-ray diffraction, and three-dimensional X-ray microscopy. Results demonstrated that the incorporation of SiC nanowhiskers can lead to the following: (1) enhance the mechanical properties of CM, especially in the early stage; (2) fulfill the role of crystal nucleation and promote the hydration reaction; (3) fill the pores, play the role of micro-aggregate filling, improve the compactness, and reduce the porosity and relative permeability coefficient; and (4) play a bridging role and connect internal structures. Our results provide a valuable reference for developing nanowhisker-blended CM.

Solar-driven interfacial evaporation has emerged as an efficient and sustainable way to generate freshwater from seawater to address the crisis of drinkable water. Though rational designs of photothermal materials and structures are essential to the interfacial solar evaporation process, the salt accumulation remains a challenge to the long-term operation of seawater desalination. Here, we report a high-yield and low-cost natural sphagnum as solar steam generator with ultra-fast water transportation, unique microstructure to prevent salting out, and high evaporation rates. The carbonized sphagnum based photothermal evaporator exhibits a strong broad-band light absorption (>97.0 %). During the solar steam generation, a high evaporation rate of 3.53 kg m−2 h−1 was achieved under 1.0 sun illumination. More significantly, the 3D sphagnum evaporator shows excellent selective filtration of salt ions and cycling stability in actual sea water even high salinity solution (10 wt.% NaCl) for 7 days. This work provides an environmentally friendly and cost-effective photothermal material for large-scale seawater desalination, and treatment of waste water with high ions concentration.

Background: The Panbio™ COVID-19 IgG Rapid Test Device (“Panbio™”) detects IgG antibodies against the SARS-CoV-2 spike protein from viral infection or vaccination. Objectives: To determine the diagnostic sensitivity and specificity of the Panbio™ professional use test, using fingerstick whole blood and venous plasma. Study design: Fingerstick whole blood and venous plasma from each participant were tested with Panbio™ and compared against the SARS-CoV-2 IgG II assay on the Abbott Architect™ platform (Europe) or the equivalent AdviseDx SARS-CoV-2 IgG II Abbott Alinity i™ platform (US). 447 evaluable participants were enrolled across 6 US and 9 European clinical centers. Results: For unvaccinated participants with PCR-confirmed infection ≥21 days post-symptom onset, the Panbio™ sensitivity with fingerstick whole blood was 92.6 % (95 % CI: 85.9, 96.7), and the specificity was 97.0 % (95 % CI: 93.1, 99.0). For venous plasma, the sensitivity was 90.0 % (95 % CI: 79.5, 96.2) for participants with PCR-confirmed infection and symptom onset 22–180 days ago; the specificity was 96.3 % (92.2, 98.6). For vaccinated participants, the sensitivity was 98.4 % (95 % CI: 91.2, 100.0) for fingerstick whole blood and 96.7 % (95 % CI: 88.7, 99.6) for venous plasma. Conclusion: The Panbio™ test had high sensitivity and specificity for detecting IgG against the SARS-CoV-2 spike protein.

Abstract Background Biological nitrogen fixation converting atmospheric dinitrogen to ammonia is an important way to provide nitrogen for plants. Pseudomonas stutzeri DSM4166 is a diazotrophic Gram-negative bacterium isolated from the rhizosphere of cereal Sorghum nutans. Endogenous constitutive promoters are important for engineering of the nitrogen fixation pathway, however, they have not been systematically characterized in DSM4166. Results Twenty-six candidate promoters were identified from DSM4166 by RNA-seq analysis. These 26 promoters were cloned and characterized using the firefly luciferase gene. The strengths of nineteen promoters varied from 100 to 959% of the strength of the gentamicin resistance gene promoter. The strongest P12445 promoter was used to overexpress the biological nitrogen fixation pathway-specific positive regulator gene nifA. The transcription level of nitrogen fixation genes in DSM4166 were significantly increased and the nitrogenase activity was enhanced by 4.1 folds determined by the acetylene reduction method. The nifA overexpressed strain produced 359.1 µM of extracellular ammonium which was 25.6 times higher than that produced by the wild-type strain. Conclusions The endogenous strong constitutive promoters identified in this study will facilitate development of DSM4166 as a microbial cell factory for nitrogen fixation and production of other useful compounds.