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Abstract This study aims to construct and validate noninvasive diagnosis models for evaluating significant liver fibrosis in patients with chronic hepatitis B (CHB). A cohort of 259 CHB patients were selected as research subjects. Through random grouping, 182 cases were included in the training set and 77 cases in the validation set. The nomogram was developed based on univariate analysis and multivariate regression analysis. Various machine learning models were employed to construct prediction models for significant liver fibrosis. The area under the ROC curve (AUC), sensitivity, specificity, NPV, PPV, and F1 score were used to evaluate the diagnostic performance. The new nomogram had excellent diagnostic efficiency (AUC 0.806, 95% CI: 0.740–0.872). Compared with other traditional noninvasive diagnostic models, the nomogram demonstrated higher AUC values and better prediction performance. Among six machine learning models, the random forest (RF) model achieved the highest AUC (AUC 0.819, 95% CI: 0.720–0.906). Finally, the importance of all variables in the RF model was ordered to illustrate the contribution of different variables, providing the clinical factors associated with the risk of significant liver fibrosis. This new nomogram may more reliably than other traditional models and the RF model demonstrated superior accuracy among six machine learning models.

Abstract Background Different left atrial appendage closure (LAAC) devices have been introduced into the clinical setting. A new dual-seal mechanism LACbes® occluder with isogenous barbs for LAAC has been designed to facilitate easier delivery and improve safety. The purpose of this study is to compare the clinical outcomes of the WATCHMAN with those of the LACbes® device for LAAC. Methods Consecutive patients with atrial fibrillation (AF) who had undergone LAAC performed using a WATCHMAN or LACbes® device from June 2016 to February 2022 were included. The primary efficacy endpoint included ischemic stroke, cardiovascular/unexplained death and device-related thrombus, while the primary safety endpoint included major peri-procedural complications and major bleeding events during clinical follow-ups. 1:1 propensity score matching (PSM) was performed. Results After PSM, 184 patients were included in each group. The mean CHA2DS2-VASc score was 3.1 ± 1.5 (LACbes®) vs. 3.1 ± 1.4 (WATCHMAN), and the HAS-BLED score was 2.7 ± 1.1 vs. 2.7 ± 1.0. At a mean follow-up of 2.5 ± 1.5 vs. 2.4 ± 0.9 years, the defined three endpoints were comparable between the two groups. The occurrence of all-cause stroke was lower in 5/452 (1.8%) with LACbes® vs. 16/433 (3.7%) with WATCHMAN occluders (HR, 0.40, 95% confidence interval (CI), 0.18–0.89, P = 0.023), and the incidence of any bleeding was higher in the WATCHMAN group (41/433, 9.5% vs. 8/452, 1.8%; HR, 0.19, 95% CI, 0.11–0.33). Conclusion The LACbes® occluder exhibited comparable safety and efficacy of stroke prevention for AF when compared with the WATCHMAN device.

Hemophilic articular cartilage damage presents a significant challenge for surgeons, characterized by recurrent intraarticular bleeding, a severe inflammatory microenvironment, and limited self-repair capability of cartilage tissue. Currently, there is a lack of tissue engineering-based integrated therapies that address both early hemostasis, anti-inflammation, and long-lasting chondrogenesis for hemophilic articular cartilage defects. Herein, we developed an adhesive hydrogel using oxidized chondroitin sulfate and gelatin, loaded with exosomes derived from bone marrow stem cells (BMSCs) (Hydrogel-Exos). This hydrogel demonstrated favorable injectability, self-healing, biocompatibility, biodegradability, swelling, frictional and mechanical properties, providing a comprehensive approach to treating hemophilic articular cartilage defects. The adhesive hydrogel, featuring dynamic Schiff base bonds and hydrogen bonds, exhibited excellent wet tissue adhesiveness and hemostatic properties. In a pig model, the hydrogel could be smoothly injected into the knee joint cartilage defect site and gelled in situ under fluid-irrigated arthroscopic conditions. Our in vitro and in vivo experiments confirmed that the sustained release of exosomes yielded anti-inflammatory effects by modulating macrophage M2 polarization through the NF-κB pathway. This immunoregulatory effect, coupled with the extracellular matrix components provided by the adhesive hydrogel, enhanced chondrogenesis, promoted the cartilage repair and joint function restoration after hemophilic articular cartilage defects. In conclusion, our results highlight the significant application potential of Hydrogel-Exos for early hemostasis, immunoregulation, and long-term chondrogenesis in hemophilic patients with cartilage injuries. This innovative approach is well-suited for application during arthroscopic procedures, offering a promising solution for addressing the complex challenges associated with hemophilic articular cartilage damage.

Abstract Potentially blinding corneal diseases alter the morphology of the human cornea. At the early stages of disease development, these changes occur at the cellular level. The ability to visualize and quantify such changes can lead to early diagnostics of corneal pathologies, which is pivotal for the long-term preservation of vision. Here we present a Powell Lens-based Line-Field Optical Coherence Tomography system that combines high spatial resolution (2.4 μm × 2.2 μm × 1.7 μm (x × y × z)) in biological tissue, sufficient to resolve individual cells, high sensitivity (90.5 dB), sufficient to image the semi-transparent human cornea, and fast image acquisition rate (~ 2,400 fps), sufficient to suppress most involuntary eye motion artifacts and allow for contactless, in-vivo imaging of the cellular structure of the human cornea. Volumetric images acquired in-vivo from corneas of healthy subjects show epithelial, endothelial and keratocytes cells, as well as sub-basal and stromal nerves. The system’s high axial resolution also allows for volumetric morphometry of the corneal endothelium, Descemet’s membrane and the pre-Descemet’s (Dua) layer.

With the proposal of “Dual-carbon” target, the electricity market and carbon market has been gradually improved. Establishing a deep coupling of electricity-carbon market to promote the in-depth development of two markets has become a new research focus. Based on the cooperative game theory, a bidding strategy for the virtual power plant (VPP) which considers Chinese certified emission reduction mechanism and demand response is proposed. Firstly, the framework of VPP participating in the electricity-carbon joint market is constructed. Secondly, an upper and lower iterative bidding strategy model is established. The upper model uses the whale optimization algorithm to obtain the optimal bidding strategy, and the lower model is optimized to obtain the optimal power consumption. Thirdly, the elastic influence weight is introduced into the price-based demand response, and then an improved Shapley value method about profit distribution considering prediction accuracy and environmental benefits is proposed. Finally, the examples and simulation results verify that the proposed model can increase the total profit, reduce the carbon emission and the peak-valley difference rate of load. Meanwhile, it’s demonstrated that the profit distribution method improves the enthusiasm of the cooperative operation of the internal units in VPP.

The global epidemic of type 2 diabetes mellitus (T2DM) imposes a substantial burden on public health and healthcare expenditures, thereby driving the pursuit of cost-effective preventive and therapeutic strategies. Emerging evidence suggests a potential association between dysbiosis of gut microbiota and its metabolites with T2DM, indicating that targeted interventions aimed at modulating gut microbiota may represent a promising therapeutic approach for the management of T2DM. In this review, we concentrated on the multifaceted interactions between the gut microbiota and the intestinal barrier in the context of T2DM. We systematically summarized that the imbalance of beneficial gut microbiota and its metabolites may constitute a viable therapeutic approach for the management of T2DM. Meanwhile, the mechanisms by which gut microbiota interventions, such as probiotics, prebiotics, postbiotics, and synbiotics, synergistically improve insulin resistance in T2DM are summarized. These mechanisms include the restoration of gut microbiota structure, upregulation of intestinal epithelial cell proliferation and differentiation, enhancement of tight junction protein expression, promotion of mucin secretion by goblet cells, and the immunosuppressive functions of regulatory T cells (Treg) and M2 macrophages. Collectively, these actions contribute to the amelioration of the body's metabolic inflammatory status. Our objective is to furnish evidence that supports the clinical application of probiotics, prebiotics, and postbiotics in the management of T2DM.

Abstract Hematoma expansion (HE) is a high risky symptom with high rate of occurrence for patients who have undergone spontaneous intracerebral hemorrhage (ICH) after a major accident or illness. Correct prediction of the occurrence of HE in advance is critical to help the doctors to determine the next step medical treatment. Most existing studies focus only on the occurrence of HE within 6 h after the occurrence of ICH, while in reality a considerable number of patients have HE after the first 6 h but within 24 h. In this study, based on the medical doctors recommendation, we focus on prediction of the occurrence of HE within 24 h, as well as the occurrence of HE every 6 h within 24 h. Based on the demographics and computer tomography (CT) image extraction information, we used the XGBoost method to predict the occurrence of HE within 24 h. In this study, to solve the issue of highly imbalanced data set, which is a frequent case in medical data analysis, we used the SMOTE algorithm for data augmentation. To evaluate our method, we used a data set consisting of 582 patients records, and compared the results of proposed method as well as few machine learning methods. Our experiments show that XGBoost achieved the best prediction performance on the balanced dataset processed by the SMOTE algorithm with an accuracy of 0.82 and F1-score of 0.82. Moreover, our proposed method predicts the occurrence of HE within 6, 12, 18 and 24 h at the accuracy of 0.89, 0.82, 0.87 and 0.94, indicating that the HE occurrence within 24 h can be predicted accurately by the proposed method.

BackgroundClassic trigeminal neuralgia (CTN) seriously affects patients’ quality of life. Percutaneous balloon compression (PBC) is a surgical program for treating trigeminal neuralgia. But some patients are ineffective or relapse after treatment. The aim is to use machine learning to construct clinical imaging models to predict relapse after treatment (PBC).MethodsThe clinical data and intraoperative balloon imaging data of CTN from January 2017 to August 2023 were retrospectively analyzed. The relationship between least absolute shrinkage and selection operator and random forest prediction of PBC postoperative recurrence, ROC curve and decision -decision curve analysis is used to evaluate the impact of imaging histology on TN recurrence.ResultsImaging features, like original_shape_Maximum2D, DiameterRow, Original_Shape_Elongation, etc. predict the prognosis of TN on PBC. The areas under roc curve were 0.812 and 0.874, respectively. The area under the ROC curve of the final model is 0.872. DCA and calibration curves show that nomogram has a promising future in clinical application.ConclusionThe combination of machine learning and clinical imaging and clinical information has the good potential of predicting PBC in CTN treatment. The efficacy of CTN is suitable for clinical applications of CTN patients after PBC.

Smart construction technology offers fresh avenues for advancing the field of civil engineering. It seamlessly integrates across the entire life cycle of civil engineering projects, encompassing planning, design, construction, and maintenance, thereby fundamentally reshaping the landscape of civil engineering development. Nonetheless, it is essential to recognize that, presently, smart construction’s developmental stage remains relatively nascent. Its progression is subject to a myriad of adoption barriers, and the complex dynamics of their interactions remain insufficiently understood. Therefore, this study aims to (1) explore the barriers to the adoption of smart construction; (2) analyze the impact level of each barrier; and the interaction mechanism between the barriers (3) propose effective strategies to promote the development of smart construction. This study commences by identifying 16 major impediments to the adoption of smart construction through a comprehensive synthesis of existing literature and expert interviews. Subsequently, Euclidean similarity analysis is employed to harmonize varying expert assessments. Following this, the Decision-Making Trial and Evaluation Laboratory model is utilized to ascertain the degree of influence associated with each barrier. Further, the Interpretive Structural Model is employed to establish a hierarchical framework that illuminates the interdependencies among these barriers. Additionally, the Matrice d’Impacts Croisés Multiplication Appliqués à un Classement method is invoked to elucidate the roles and statuses of each barrier. Finally, strategies are proposed based on the results of the analysis. This study offers practical strategies for overcoming barriers and driving the adoption of smart construction, filling a critical gap in understanding by identifying key barriers and providing actionable insights, thus significantly advancing the field and empowering stakeholders for successful implementation and dissemination.

Building information modeling (BIM) and blockchain applications have introduced significant benefits to the architecture, engineering, construction, and operation (AECO) industry in recent years. Although publications on BIM and blockchain integration have been increasing, no systematic examination of the present status and managerial implications of integrated BIM and blockchain has been conducted. To bridge this gap, this paper conducts a state-of-the-art review of the development of integrated BIM and blockchain in a built environment. A combination of qualitative and quantitative methods was adopted to synthesize and analyze the research evidence. The results revealed five key managerial implica­tions of BIM integration with blockchain at the project level: design and collaboration, financial management, construction management, information management, and integration management (with other cutting-edge technologies). Challenges and opportunities are outlined and articulated from both technological and managerial perspectives, such as stakeholder management, impact assessment, real-time project management, information redundancy, and incompatibility.

BackgroundXiaojin Pill (XJP) is a traditional Chinese medicine prescribed for treating benign prostatic hyperplasia (BPH). It has been proven to have multiple effects, such as regulating sex hormone levels, exhibiting anti-tumor, anti-inflammatory, analgesic, and anti-platelet aggregation properties, and improving immunity. However, the material basis of XJP's therapeutic effect on BPH and its metabolic process in vivo remains to be clarified. At the same time, many microorganisms that exist in the urogenital tract, including those related to BPH, can also affect the health of the host.MethodsUsing ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), the chemical components of XJP were identified. A BPH model was created through bilateral testicular ablation and injections of testosterone propionate. A comprehensive evaluation of XJP efficacy was conducted using pathological ELISA, TUNEL, and immunohistochemical techniques. In addition, UPLC-MS metabolomics and 16S rRNA sequencing revealed the serum metabolic profile and intestinal microbiota composition. We performed a Spearman correlation coefficient analysis to highlight the interactions between “intestinal microbiota-serum factors” and “intestinal microbiota-metabolites.”ResultsXJP contains 91 compounds that alleviate pathologies of BPH in rats, decreasing prostate weight, index, and serum levels of Dihydrotestosterone (DHT), Prostate-Specific Antigen (PSA), epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), and vascular endothelial growth factor (VEGF) levels. It inhibits prostatic epithelial cell apoptosis and downregulates Bax, TGF-β1, and IGF-1 proteins in the caspase-3 pathway. Metabolomics studies have revealed 10 upregulated and 10 downregulated metabolites in treated rats, with 5-methylcytosine, uracil, and cytosine enriched in pyrimidine metabolism. L-arginine plays a pivotal role in metabolic pathways encompassing pyrimidine metabolism, arginine biosynthesis, and the mammalian target of rapamycin (mTOR) signaling pathway. 16S rRNA sequencing revealed that XJP optimized the diversity and balance of intestinal flora in BPH rats by decreasing the Bacteroidetes/Firmicutes (B/F) ratio, enhancing the beneficial bacteria, such as Eggerthellaceae, Anaerovoracaceae, and Romboutsia, and suppressing the dysfunctional bacteria, such as Atopobiaceae, Prevotellaceae_NK3B31_group, Dorea, and Frisingicoccus. According to the Spearman correlation coefficient analysis, Lactobacillus was found to be most associated with serum factors, whereas Romboutsia showed the highest correlation with metabolites. This finding suggests that XJP modulates pyrimidine metabolism disorders in BPH rats, a regulation that aligns closely with Romboutsia, Prevotellaceae_NK3B31_group, Lactobacillus, Chujaibacter, and Enterorhabdus, thereby providing valuable biological insights.ConclusionIn summary, these findings indicate that XJP possesses a synergistic anti-BHP effect through its multi-component, multi-target, multi-gut microbiota, and multi-metabolic pathway properties. The effect involves the regulation of sex hormone levels, growth factors, and the anti-epithelial cell apoptosis process. The modulation of specific gut microbiota by the host and the involvement of multiple metabolic pathways are likely one of the significant mechanisms of XJP in treating BPH. Notably, pyrimidine metabolism and the intestinal microbial ecosystem are closely intertwined in this process.

Abstract Organic-inorganic molecular assembly has led to numerous nano/mesostructured materials with fantastic properties, but it is dependent on and limited to the direct interaction between host organic structure-directing molecules and guest inorganic species. Here, we report a “solvent-pair surfactants” enabled assembly (SPEA) method to achieve a general synthesis of mesostructured materials requiring no direct host-guest interaction. Taking the synthesis of mesoporous metal oxides as an example, the dimethylformamide/water solvent pairs behave as surfactants and induce the formation of mesostructured polyoxometalates/copolymers nanocomposites, which can be converted into metal oxides. This SPEA method enables the synthesis of functional ordered mesoporous metal oxides with different pore sizes, structures, compositions and tailored pore-wall microenvironments that are difficult to access via conventional direct organic-inorganic assembly. Typically, nitrogen-doped mesoporous ε-WO3 with high specific surface area, uniform mesopores and stable framework is obtained and exhibits great application potentials such as gas sensing.

In the context of digital construction, responsibility management in smart city building information modeling (BIM) projects spans the entire building lifecycle. The involvement of numerous BIM designers in project management and frequent data exchanges pose significant challenges for the traceability, immutability, and responsibility attribution of BIM models. To address these issues, this study proposes a blockchain-based responsibility management and collaboration framework for BIM projects using non-fungible tokens (NFTs), aiming to enhance the management of responsibilities and accountability in BIM projects. This research adopts a design science methodology, strictly adhering to scientific research procedures to ensure rigor. First, NFTs based on blockchain technology were developed to generate corresponding digital signatures for BIM model files. This approach ensures that each BIM model file has a unique digital identity, enhancing transparency and traceability in responsibility management. Next, the interplanetary file system (IPFS) was used to generate digital fingerprints, with the content identifier generated by IPFS uploaded to the blockchain to ensure the immutability of BIM model files. This method guarantees the integrity and security of BIM model files throughout their lifecycle. Finally, the proposed methods were validated through a blockchain network. The experimental results indicate that the proposed framework is theoretically highly feasible and demonstrates good applicability and efficiency in practical production. The constructed blockchain network meets the actual needs of responsibility management in smart city BIM projects, enhancing the transparency and reliability of project management.

Abstract Diabetic vascular complications (DVCs), including macro- and micro- angiopathy, account for a high percentage of mortality in patients with diabetes mellitus (DM). Endothelial dysfunction is the initial and role step for the pathogenesis of DVCs. Hyperglycemia and lipid metabolism disorders contribute to endothelial dysfunction via direct injury of metabolism products, crosstalk between immunity and inflammation, as well as related interaction network. Although physiological and phenotypic differences support their specified changes in different targeted organs, there are still several common mechanisms underlying DVCs. Also, inhibitors of these common mechanisms may decrease the incidence of DVCs effectively. Thus, this review may provide new insights into the possible measures for the secondary prevention of DM. And we discussed the current limitations of those present preventive measures in DVCs research. Video Abstract

Background: Trigeminal neuralgia (TN) secondary to a dural arteriovenous fistula (DAVF) is quite rare, and the goal of treatment is to resolve both the fistula and the pain. Case presentation: We herein report a case of TN secondary to a DAVF in a 64-year-old woman with a 1-year history of right-sided TN. Brain magnetic resonance imaging and digital subtraction angiography showed a right tentorial DAVF. Interventional embolization was performed, but the pain was not relieved after the operation. Six months later, we performed microvascular decompression of the trigeminal nerve. During the operation, we electrocoagulated the tortuous and dilated malformed vein, which was compressing the trigeminal nerve, to reduce its diameter and mitigate the compression on the cisternal segment of the trigeminal nerve. That patient's pain was relieved postoperatively. In addition, we reviewed the literature of TN caused by DAVF and found a total of 30 cases, 22 of which were treated by interventional embolization. Of these 22 cases, the interventional embolization healed the fistula with pain relief in 14 cases and healed the fistula without pain relief in 8 cases. We found that the venous drainage methods of the 8 cases were all classified into the posterior mesencephalic group. Conclusions: We believe that this drainage pattern contributes to the more common occurrence of unrelieved pain. For such patients, microvascular decompression can be performed with intraoperative coagulation to narrow the dilated veins until the cisternal segment of the trigeminal nerve is no longer compressed. Satisfactory curative effects can be obtained using this technique.

Abstract Background Tranexamic acid (TXA) has been widely used in orthopedic surgery, but its efficacy in adolescent scoliosis (AS) surgery remains unclear in the literature. The purpose of this systematic review and meta-analysis is to evaluate the safety and efficacy of TXA compared to placebo treatment during or after AS surgery, by gathering data from randomized both controlled trials (RCTs) and non-RCTs. Methods English and Chinese electronic databases including PubMed, Web of Science, Embase, Cochrane, CNKI, and Wan Fang database were searched to identify the relevant literature up until August 2022. The primary outcomes were intraoperative blood loss and total blood loss. The secondary outcomes included the need for transfusion, postoperative hemoglobin (Hb) level, and change in Hb level. Stata 17 was used for data analysis and the risk of bias was assessed. We followed the PRISMA checklist to ensure the quality of this article. Results Twelve studies (795 participants) were included in the meta-analysis for intraoperative blood loss during surgery. The results suggest that TXA can reduce the intraoperative blood loss of the patients (MD = -306.40ml, 95%CI = -404.04ml to -208.77ml, p

In recent years, with the continuous expansion of artificial intelligence (AI) application forms and fields, users’ acceptance of AI applications has attracted increasing attention from scholars and business practitioners. Although extant studies have extensively explored user acceptance of different AI applications, there is still a lack of understanding of the roles played by different AI applications in human–AI interaction, which may limit the understanding of inconsistent findings about user acceptance of AI. This study addresses this issue by conducting a systematic literature review on AI acceptance research in leading journals of Information Systems and Marketing disciplines from 2020 to 2023. Based on a review of 80 papers, this study made contributions by (i) providing an overview of methodologies and theoretical frameworks utilized in AI acceptance research; (ii) summarizing the key factors, potential mechanisms, and theorization of users’ acceptance response to AI service providers and AI task substitutes, respectively; and (iii) proposing opinions on the limitations of extant research and providing guidance for future research.

Diabetes is a widespread chronic disease that occurs mainly in the elderly population. Due to the difference in pathophysiology between elderly and young patients, the current clinical practice to treat elderly patients with anti-diabetes medications still faces some challenges and dilemmas, such as the urgent need for early diagnosis and prevention, and an imbalance between restricted dietary intake and the risk of undernutrition. Traditional Chinese medicine (TCM) offers various treatment regimens that are actively utilized in the field of diabetes management. Through multiple targets and multiple pathways, TCM formulas, medicinal herbs, and active natural products enhance the efficacy of diabetes prevention and diabetes control measures, simplify complex medication management, and improve common symptoms and common diabetic complications in elderly people. Historically, natural products have played a key role in material composition analysis of TCM and mechanism interpretation to enable drug discovery. However, there have been few conclusions on this topic. This review summarizes the development of TCM for the prevention and management of diabetes in elderly people, existing evidence-based clinical practices, and prospects for future development.

Diabetes mellitus has become a major public health issue globally, putting an enormous burden on global health systems and people. Among all diseased groups, a considerable part of patients are elderly, while their clinical features, pathogenic processes, and medication regimens are different from patients of other ages. Despite the availability of multiple therapies and techniques, there are still numerous elderly diabetes patients suffering from poor blood glucose control, severe complications, and drug adverse effects, which negatively affect the quality of life in their golden years. Traditional Chinese Medicine (TCM) has been widely used in the treatment of diabetes for several decades, and its relevant clinical practice has confirmed that it has a satisfactory effect on alleviating clinical symptoms and mitigating the progression of complications. Chinese herbal medicine and its active components were used widely with obvious clinical advantages by multiple targets and signaling pathways. However, due to the particular features of elderly diabetes, few studies were conducted to explore Traditional Chinese Medicine intervention on elderly diabetic patients. This study reviews the research on clinical features, pathogenic processes, treatment principles, and TCM treatments, hoping to provide fresh perspectives on the prevention and management strategies for elderly diabetes.

Abstract Few rare‐earth (RE) atoms incorporated in lattice greatly tunned the optical, electrical, magnetic, and catalytic performance of doped crystal through the peculiar atomic electron structure of RE. The dimensionality scale‐down of RE oxides can further promote their unique traits and broaden their applications. The UV photodetection performance of (111) oriented CeO2 thin film is limited by the existence of grain boundaries, defects, and strains. Consequently, single‐crystal 2D CeO2 is promising for photodetection as it lacks of grain boundaries and defects. However, the synthesis of large‐sized high‐quality 2D CeO2 with lateral dimensions over 100 µm is challenging. In this work, a 3.9 nm thick CeO2 single crystal with 120 µm lateral size is synthesized over a sapphire substrate through a salt‐assisted chemical vapor deposition method, in which an intermediate insulating CeAlO3 layer is formed between the substrate and 2D CeO2 to enhance the crystal lattice matching and therefore facilitates the large area growth. The photodetector based on 2D CeO2 exhibits a photo response from 395 to 532 nm, possibly ascribed to a micro‐strain narrowed bandgap induced at the heterointerface. The photoresponsivity reaches 43.6 A W−1 while the detectivity reaches 7.58 × 1011 Jones under the 395 nm laser irradiation. Besides, the sub‐ms switching kinetics is achieved without gating bias, which is significantly improved over other reported RE oxides‐based photodetectors. This work demonstrates the possibility of the synthesis of large‐size high‐quality 2D RE oxides and their strong potential in high‐performance optoelectronic devices.

ABSTRACT Global warming is increasing human exposure to pathogens and has already had an impact on human health. Vibrio parahaemolyticus, a major pathogen causing foodborne illness, accumulates in numerous aquatic organisms and can be affected by environmental stressors such as increased replication errors or DNA damage resulting in point mutations. This could lead to an elevation in the mutation rate, which influences the expansion of Vibrio spp. habitats and the spread of associated diseases. In this study, a total of 241 strains were isolated from aquatic products imported or exported through China Customs between 2005 and 2010. The whole genomes of those strains were sequenced, revealing a highly significant level of genetic diversity. Our analysis identified 27 new sequence types (STs) ranging from ST2950 to ST2976. The global temperature trend since 1950 affects the thermolabile hemolysin gene (tlh) found in all Vibrio parahaemolyticus leading to mutant sites exhibiting similar trends as temperatures rise; seven high-frequency mutation hotspots (A180G, T552G, G657T, T858C, C1062T, A1137G, and T1179C) were identified along with two clinically specific sites (T259C and A951T) that may indicate adaptation over time due to climate change, leading to increased virulence potential for this bacterial species. These results provide insight into the genetics of Vibrio parahaemolyticus and provide a reference for subsequent research, identification, and monitoring efforts related to its spread. IMPORTANCE In this study, Vibrio parahaemolyticus strains were collected from a large number of aquatic products globally and found that temperature has an impact on the virulence of these bacteria. As global temperatures rise, mutations in a gene marker called thermolabile hemolysin (tlh) also increase. This suggests that environmental isolates adapt to the warming environment and become more pathogenic. The findings can help in developing tools to analyze and monitor these bacteria as well as assess any link between climate change and vibrio-associated diseases, which could be used for forecasting outbreaks associated with them.

Abstract Purpose Phyllodes tumors (PTs) are rare neoplasms with a certain risk of recurrence and/or metastasis. In clinical practice, there is a lack of high‐quality clinical studies and unified guidelines to guide the treatment. Materials and Methods All malignant and recurrence/metastasis PTs were retrospectively collected, which were diagnosed from 2008 to 2022. Results A total of 82 patients were enrolled, including 69 malignant and 13 borderline tumors. 96.3% (79/82) received surgical treatment. During a median follow‐up of 55.5 months, 20 patients (20/82, 24.4%) had distant metastasis (DM), while 32 (32/82, 39.0%) had local recurrence (LR). Univariate analysis showed the survival of PTs was associated with surgical methods (p

Abstract We have studied the fragmentation of the brominated cyclic hydrocarbons bromocyclo-propane, bromocyclo-butane, and bromocyclo-pentane upon Br(3d) and C(1s) inner-shell ionization using coincidence ion momentum imaging. We observe a substantial yield of CH3 + fragments, whose formation requires intramolecular hydrogen (or proton) migration, that increases with molecular size, which contrasts with prior observations of hydrogen migration in linear hydrocarbon molecules. Furthermore, by inspecting the fragment ion momentum correlations of three-body fragmentation channels, we conclude that CH x + fragments (with x = 0, …, 3) with an increasing number of hydrogens are more likely to be produced via sequential fragmentation pathways. Overall trends in the molecular-size-dependence of the experimentally observed kinetic energy releases and fragment kinetic energies are explained with the help of classical Coulomb explosion simulations.

Abstract Epigenetic mechanisms involved in gene expression play an essential role in various cellular processes, including lipid metabolism. Lysine acetyltransferase 8 (KAT8), a histone acetyltransferase, has been reported to mediate de novo lipogenesis by acetylating fatty acid synthase. However, the effect of KAT8 on lipolysis is unclear. Here, we report a novel mechanism of KAT8 on lipolysis involving in its acetylation by general control non-repressed protein 5 (GCN5) and its deacetylation by Sirtuin 6 (SIRT6). KAT8 acetylation at K168/175 residues attenuates the binding activity of KAT8 and inhibits the recruitment of RNA pol II to the promoter region of the lipolysis-related genes adipose triglyceride lipase (ATGL) and hormone-sensitive lipase (HSL), subsequently down-regulating lipolysis to affect the invasive and migratory potential of colorectal cancer cells. Our findings uncover a novel mechanism that KAT8 acetylation-controlled lipolysis affects invasive and migratory potential in colorectal cancer cells.

Purpose: Dexmedetomidine exerts a sedative effect by promoting the sleep pathway endogenously and producing a state similar to N2 sleep. This study aimed to study the efficacy and safety of dexmedetomidine nasal spray in the treatment of postoperative sleep disturbance.Methods: This study enrolled 120 participants [men and women; age, 18–40 years; American Society of Anesthesiologists grade, I or II] who underwent maxillofacial surgery under general anesthesia through nasotracheal intubation. The participants were randomly divided into three groups: blank control group (BC group), 1.0 μg/kg dexmedetomidine group (1.0 Dex group), and 1.5 μg/kg dexmedetomidine group (1.5 Dex group), with 40 patients allocated to each group. At 21:30 on the night after the operation, the intervention groups were administered their corresponding doses of dexmedetomidine nasal spray. The Pittsburgh Sleep Quality Index (PSQI) scale was used to evaluate the baseline sleep status of participants 1 month preoperatively and on the night after the operation. Polysomnography (PSG) was used to record the sleep status on the night after the operation. We recorded the rescue times of sedative and analgesic drugs on the first night after surgery, adverse reactions, total hospital stay duration, and total costs.Results: Compared with patients in the BC group, those in 1.0 Dex and 1.5 Dex groups had longer N2 sleep duration, were awake for a shorter time after dose administration, woke up less often, and had significantly improved sleep efficiency (p < 0.05). Compared with the BC group, the PSQI scores of 1.0 Dex and 1.5 Dex groups were significantly lower on the night after operation, and the proportion of PSQI > 5 was significantly lower (p < 0.05). Compared with patients in the BC group and the 1.0 Dex group, those in the 1.5 Dex group had significantly prolonged N3 sleep, reduced frequency of requiring sufentanil rescue, lower incidence of sore throat after surgery, and shorter average length of hospital stay (all, p < 0.05).Conclusion: The sleep quality of participants on the night after having undergone maxillofacial surgery was safely and effectively improved by 1.0–1.5 μg/kg dexmedetomidine atomized nasal sprays. Notably, only the latter could prolong N3 sleep. Level of Evidence II: Evidence was obtained from at least one properly designed randomized controlled trial.

Building information modeling (BIM) has been attracting increasing attention in the architecture, engineering, and construction (AEC) industry in recent years. The wide spread of BIM marks the transition from 2D and paper-based archiving to 3D and digital archiving of project information. However, the commonly used centralized managing approaches for BIM data have high risks of data loss and data tampering. With cryptographic algorithms and distributed databases, blockchain has the potential to address the limitations of data loss and trust in conventional BIM management methods. Therefore, this paper proposes a blockchain-based framework for digital archiving of BIM data. In this paper, the axiomatic design approach is utilized to design the archiving framework in order to systematically map the design parameters with the functional requirements and minimize the information contents. The proposed framework contains five modules, including the BIM module, building plan approval (BPA) module, building data simplification (BDS) module, distributed data storage (DDS) module, and digital document verification (DDV) module. Hyperledger Fabric is utilized to develop the blockchain system based on the proposed framework. In the end, a simple BIM model with 240 components and around 11,000 lines of content in the Industry Foundation Classes (IFC) file is taken as an illustrative example to validate the proposed blockchain approach. By storing the BIM model on to the developed blockchain, it is found that each transaction of a blockchain can store over 5000 lines of IFC contents with 0.09 s of uploading latency. The results show that the proposed blockchain-based approach can effectively and securely archive BIM data.

Soil moisture content is an important measure of soil health, and high-precision soil moisture trend analysis is essential for understanding regional ecological quality in the context of climate change, flood monitoring, and water cycle processes. However, in the arid regions of Central Asia, where data are severely lacking, obtaining high-spatial-resolution, continuous soil moisture data is difficult due to the scarcity of stations. Moreover, because soil moisture is easily affected by evaporation time, surface morphology, and anthropogenic factors, mature theoretical models or empirical or semiempirical models to measure soil moisture are also lacking. To investigate the distribution and trend of soil moisture in the Ebinur Lake water, in this study, microwave remote sensing and visible remote sensing data were selected as inputs, and the Global Land Data Assimilation System (GLDAS-2.2) data products were downscaled using the GTWR model, which increased the spatial scale from 27,830 m × 27,830 m to 30 m × 30 m. The phenomena involved in the soil moisture change cycle, spatial distribution, temporal variation, and internal randomness distance were analyzed in the study area through wavelet analysis, Theil–Sen trend analysis, the Mann–Kendall (MK) test, and a variogram. This study obtained high-resolution continuous soil moisture data in the arid and data-scarce region in Central Asia, thus broadening the field of multisource remote sensing analysis and providing a theoretical basis for the construction of precision agriculture in northwest China.

The automatic identification of bird’s nest in the inspection image of transmission line is of great significance to the safe operation of transmission line. In this paper, a bird’s nest recognition method which combines visual saliency and depth learning is proposed. This method not only has the advantage of rich feature information of visible light image, but also has the advantage of significant bird’s nest target. The experimental results show that this method can accurately identify the images with different background, tower shape, shooting angle and shooting distance, and has good robustness and generalization, and the precision index values of Precision, Recall and IoU are 0.9622, 0.9465 and 0.9543 respectively. Compared with Faster R-CNN model, YOLO model and RetinaNet model, each index is greatly improved. This method is instructive to the operation and maintenance of transmission lines.

Abstract Mesenchymal stromal cells (MSCs) have been considered a promising alternative for treatment of acute respiratory distress syndrome (ARDS). However, there is significant heterogeneity in their therapeutic efficacy, largely owing to the incomplete understanding of the mechanisms underlying the therapeutic activities of MSCs. Here, we hypothesize that the cholinergic anti-inflammatory pathway (CAP), which is recognized as a neuroimmunological pathway, may be involved in the therapeutic mechanisms by which MSCs mitigate ARDS. Using lipopolysaccharide (LPS) and bacterial lung inflammation models, we found that inflammatory cell infiltration and Evans blue leakage were reduced and that the expression levels of choline acetyltransferase (ChAT) and vesicular acetylcholine transporter (VAChT) in lung tissue were significantly increased 6 hours after MSC infusion. When the vagus nerve was blocked or α7 nicotinic acetylcholine (ACh) receptor (α7nAChR)-knockout mice were used, the therapeutic effects of MSCs were significantly reduced, suggesting that the CAP may play an important role in the effects of MSCs in ARDS treatment. Our results further showed that MSC-derived prostaglandin E2 (PGE2) likely promoted ACh synthesis and release. Additionally, based on the efficacy of nAChR and α7nAChR agonists, we found that lobeline, the nicotinic cholinergic receptor excitation stimulant, may attenuate pulmonary inflammation and alleviate respiratory symptoms of ARDS patients in a clinical study (ChiCTR2100047403). In summary, we reveal a previously unrecognized MSC-mediated mechanism of CAP activation as the means by which MSCs alleviate ARDS-like syndrome, providing insight into the clinical translation of MSCs or CAP-related strategies for the treatment of patients with ARDS.

Artificial Intelligence has been widely applied in intelligent transportation systems. In this work, Swin-APT, a deep learning-based approach for semantic segmentation and object detection in intelligent transportation systems is presented. Swin-APT includes a lightweight network and a multiscale adapter network designed for image semantic segmentation and object detection tasks. An inter-frame consistency module is proposed to extract more accurate road information from images. Experimental results on four datasets: BDD100K, CamVid, SYNTHIA, and CeyMo, demonstrate that Swin-APT outperforms the baseline by 13.1%. Furthermore, experiments on the road marking detection benchmark show an improvement of 1.85% of mAcc.

In this study, a composite film was developed for the electrochemical sensing of tryptophan (Trp). Porous reduced graphene oxide (PrGO) was utilized as the electron transfer layer, and a C-undecylcalix[4]resorcinarene Langmuir–Blodgett (CUCR-LB) film served as the molecular recognition layer. Atomic force microscopy (AFM), transmission electron microscopy (TEM), Raman spectroscopy, scanning electron microscopy (SEM), and electrochemical experiments were employed to analyze the characteristics of the CUCR-LB/PrGO composite film. The electrochemical behavior of Trp on the CUCR-LB/PrGO composite film was investigated, revealing a Trp linear response range of 1.0 × 10−7 to 3.0 × 10−5 mol L−1 and a detection limit of 3.0 × 10−8 mol L−1. Furthermore, the developed electroanalytical method successfully determined Trp content in an amino acid injection sample. This study not only introduces a rapid and reliable electrochemical method for the determination of Trp but also presents a new strategy for constructing high-performance electrochemical sensing platforms.

Abstract Background Open online forums like Reddit provide an opportunity to quantitatively examine COVID-19 vaccine perceptions early in the vaccine timeline. We examine COVID-19 misinformation on Reddit following vaccine scientific announcements, in the initial phases of the vaccine timeline. Methods We collected all posts on Reddit (reddit.com) from January 1 2020 - December 14 2020 (n=266,840) that contained both COVID-19 and vaccine-related keywords. We used topic modeling to understand changes in word prevalence within topics after the release of vaccine trial data. Social network analysis was also conducted to determine the relationship between Reddit communities (subreddits) that shared COVID-19 vaccine posts, and the movement of posts between subreddits. Results There was an association between a Pfizer press release reporting 90% efficacy and increased discussion on vaccine misinformation. We observed an association between Johnson and Johnson temporarily halting its vaccine trials and reduced misinformation. We found that information skeptical of vaccination was first posted in a subreddit (r/Coronavirus) which favored accurate information and then reposted in subreddits associated with antivaccine beliefs and conspiracy theories (e.g. conspiracy, NoNewNormal). Conclusions Our findings can inform the development of interventions where individuals determine the accuracy of vaccine information, and communications campaigns to improve COVID-19 vaccine perceptions, early in the vaccine timeline. Such efforts can increase individual- and population-level awareness of accurate and scientifically sound information regarding vaccines and thereby improve attitudes about vaccines, especially in the early phases of vaccine roll-out. Further research is needed to understand how social media can contribute to COVID-19 vaccination services.

Recent studies have demonstrated that the combination of Cyclin-Dependent Kinase 4/6 Inhibitor (CDK4/6i) and endocrine therapy (ET) is more effective than ET alone and significantly improves progression-free survival (PFS) and overall survival (OS) in patients with hormone receptor-positive (HR+)/human epidermal growth factor receptor-2 negative (HER2-) breast cancer (BC). Palbociclib is the first CDK4/6i approved for use, and its clinical advantages have been shown. However, 30% of patients will continue to develop secondary drug resistance. Therefore, exploring the parameters that can predict the efficacy of Palbociclib and developing a clinical prediction model is essential for evaluating the prognosis of patients.

Background and aimsReal-world data regarding hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) patients receiving tenofovir alafenamide (TAF) as an antiviral drug are limited. Hence, we evaluated the efficacy and kidney safety of TAF among this population.MethodsA total of 272 HBV-related ACLF patients hospitalized at Xiangya Hospital of Central South University were enrolled in this retrospective research. All patients received antiviral therapy with TAF (n = 100) or ETV (n = 172) and comprehensive medical treatments.ResultsThrough 1:1 propensity score matching, 100 patients were finally included in each group. At week 48, the survival rates without transplantation of the TAF group and ETV group were 76.00 and 58.00%, separately (P = 0.007). After 4 weeks of treatment, the TAF treatment group exhibited a significantly decline in HBV DNA viral load (P = 0.029). The mean estimated glomerular filtration rate was apparently improved in the TAF group compared with the ETV group (TAF 5.98 ± 14.46 vs. ETV 1.18 ± 18.07 ml/min/1.73 m2) (P < 0.05). There were 6 patients in TAF group and 21 patients in ETV group with chronic kidney disease (CKD) stage progression ≥ 1. By contrast, the ETV treatment group has a greater risk of renal function progression in CKD 1 stage patients (P < 0.05).ConclusionThis real-world clinical study showed that TAF is more effective than ETV in reducing viral load and improving survival rate in HBV-ACLF patients and the risk of renal function decline is lower.Clinical trial registrationhttps://ClinicalTrials.gov, identifier NCT05453448.

Objectives: Approximately 240 million individuals are infected with chronic hepatitis B virus (HBV) worldwide. HBV infection can develop into liver fibrosis. The mechanism of HBV-related liver fibrosis has not been fully understood, and there are few effective treatment options. The goal of this study was to use transcriptomics in conjunction with experimental validation to identify new targets to treat HBV-related liver fibrosis.Methods: To identify differentially expressed genes (DEGs), five liver tissues were collected from both healthy individuals and patients with chronic hepatitis B. NovoMagic and Java GSEA were used to screen DEGs and key genes, respectively. Immunocell infiltration analysis of RNA-seq data was, and the results were confirmed by Western blotting (WB), real-time quantitative polymerase chain reaction (RT-qPCR), and immunohistochemistry.Results: We evaluated 1,105 genes with differential expression, and 462 and 643 genes showed down- and upregulation, respectively. The essential genes, such as tumor necrosis factor (TNF) receptor-associated factor-2 (TRAF2), were screened out of DEGs. TRAF2 expression was abnormally high in hepatic fibrosis in patients with hepatitis B compared with healthy controls. The degree of hepatic fibrosis and serum levels of glutamate transaminase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBIL) were positively linked with TRAF2 expression. TRAF2 may be crucial in controlling T lymphocyte-mediated liver fibrosis.Conclusion: Our findings imply that TRAF2 is essential for HBV-induced liver fibrosis progression, and it may potentially be a promising target for the treatment of hepatic fibrosis in hepatitis B.

Based on the data of 253 A-share listed new energy enterprises from 2010–2021, this paper studies the correlations among equity incentives, the three contract elements of equity incentives and the financial performance of new energy enterprises by using fixed-effect regression analysis, and on this basis, Granger causality analysis is applied to determine the causal relationship, and finally, the degree of influence of equity incentives contract elements is further studied by Grey Relational Analysis. It is found that equity incentives positively affect the financial performance of new energy enterprises as a whole. In terms of the choice of equity incentive contract elements, the influence is more significant when the granting method is stock options, when the exercise duration is longer, and when the exercise conditions are stricter. As to the degree of influence, the influence of equity incentive method and exercise conditions on the financial performance of new energy enterprises is greater, but the influence of exercise duration is the lowest. Therefore, it is suggested that new energy enterprises can choose more stock options for equity incentives, create stricter exercise conditions and set the duration of the equity incentive scheme between 5 and 10 years with their own characteristics.

To accurately predict the remaining useful life (RUL) of cutting tool, a novel RUL prediction method is proposed. Firstly, the complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN) is used to decompose original cutting tool vibration signals to get six intrinsic mode function (IMF) components from each sample. Secondly, high-frequency IMF components and low-frequency IMF components are obtained from IMF components and they are respectively fused into high-frequency data and low-frequency data using the improved fine-to-coarse reconstruction (IFTC), and high-frequency data and low-frequency data are reconstructed using phase space reconstruction (PSR). Thirdly, multiple prediction branches are adopted to construct an ensemble RUL prediction model for cutting tool, the high-frequency data and low-frequency data are input into bi-directional long short-term memory (BiLSTM) and convolutional neural network (CNN) to train a RUL prediction model respectively in each prediction branch. Finally, a series of experiments are conducted to verify the effectiveness of the proposed RUL prediction method, and the results show that the proposed method obtains a high score of RUL prediction for cutting tool.

The utilization of urban underground space in a smart city requires an accurate understanding of the underground structure. As an effective technique, Rayleigh wave exploration can accurately obtain information on the subsurface. In particular, Rayleigh wave dispersion curves can be used to determine the near-surface shear-wave velocity structure. This is a typical multiparameter, high-dimensional nonlinear inverse problem because the velocities and thickness of each layer must be inverted simultaneously. Nonlinear methods such as simulated annealing (SA) are commonly used to solve this inverse problem. However, SA controls the iterative process though temperature rather than the error, and the search direction is random; hence, SA always falls into a local optimum when the temperature setting is inaccurate. Specifically, for the inversion of Rayleigh wave dispersion curves, the inversion accuracy will decrease with an increasing number of layers due to the greater number of inversion parameters and large dimension. To solve the above problems, we convert the multiparameter, high-dimensional inverse problem into multiple low-dimensional optimizations to improve the algorithm accuracy by incorporating the principle of block coordinate descent (BCD) into SA. Then, we convert the temperature control conditions in the original SA method into error control conditions. At the same time, we introduce the differential evolution (DE) method to ensure that the iterative error steadily decreases by correcting the iterative error direction in each iteration. Finally, the inversion stability is improved, and the proposed inversion method, the block coordinate descent differential evolution simulated annealing (BCDESA) algorithm, is implemented. The performance of BCDESA is validated by using both synthetic data and field data from western China. The results show that the BCDESA algorithm has stronger global optimization capabilities than SA, and the inversion results have higher stability and accuracy. In addition, synthetic data analysis also shows that BCDESA can avoid the problems of the conventional SA method, which assumes the S-wave velocity structure in advance. The robustness and adaptability of the algorithm are improved, and more accurate shear-wave velocity and thickness information can be extracted from Rayleigh wave dispersion curves.

Ni3Al superlattice alloys with the L12 structure have garnered much attention due to their attractive high-temperature mechanical properties; however, their grain-boundary brittleness and low ductility in the ambient temperature range have greatly restricted their widespread application. In this study, we developed an L12 structure multicomponent Ni46.5Co24Fe8Al12.5Ti9 (at. %) superlattice alloy that notably suppressed the room-temperature intergranular brittleness and exhibited a large tensile elongation of 17.1% ± 5.2% together with a high ultimate tensile strength of 1,080.2 ± 57.4 MPa. Multiple microstructural examinations reveal an L12 equiaxed-grain microstructure, with the presence of a minor B2 phase. Moreover, the co-segregation of Fe and Co atoms, and the associated reduction or elimination of the L12 chemical order at the grain-boundary regions were characterized, which were proved to be the root cause of the suppression of intergranular brittleness and the high tensile ductility. Further theoretical calculations show that alloying of Fe and Co to binary Ni3Al reduced the ordering energy, which promoted intergranular segregation and associated disordering. This observation demonstrated that the elimination or reduction of interfacial chemical order is an effective ductilizing method for superlattice alloys.

Abstract Background The aim of this study was to investigate the applicable safety and biomechanical stability of iliosacral triangular osteosynthesis (ITO) through 3D modeling and finite element (FE) analysis. Methods Pelvic CT imaging data from 100 cases were imported into Mimics software for the construction of 3D pelvic models. The S2-alar-iliac (S2AI) screws and S2 sacroiliac screws were placed in the S2 segment with optimal distribution and their compatibility rate on the S2 safe channel was observed and analyzed. In the FE model, the posterior pelvic ring was fixed with two transsacral screws (TTS), triangular osteosynthesis (TO) and ITO, respectively. Four different loading methods were implemented in sequence to simulate the force in standing, flexion, right bending, and left twisting, respectively. The relative displacement and change in relative displacement of the three fixing methods were recorded and analyzed. Results The theoretical compatibility rate of S2AI screw and S2 sacroiliac screw in S2 segment was 94%, of which 100% were in males and 88% in females. In the FE model, in terms of overall relative displacement, TTS group showed the smallest relative displacement, the ITO group showed the second smallest, and the TO group the largest relative displacement. The change in relative displacement of the TTS group displayed the smaller fluctuations in motion. The change in relative displacement of the TO group under right bending and left twisting displayed larger fluctuations, while the ITO group under flexion displayed larger fluctuations. Conclusions The simultaneous placement of S2AI screw and S2 sacroiliac screw in the S2 segment is theoretically safe. Although the biomechanical stability of ITO is slightly lower than TTS, it is better than TO, and can be used as a new method for the treatment of posterior pelvic ring injuries.

With global prevalence, metabolic diseases, represented by obesity and type 2 diabetes mellitus (T2DM), have a huge burden on human health and medical expenses. It is estimated that obese population has doubled in recent 40 years, and population with diabetes will increase 1.5 times in next 25 years, which has inspired the pursuit of economical and effective prevention and treatment methods. Natural polyphenols are emerging as a class of natural bioactive compounds with potential beneficial effects on the alleviation of obesity and T2DM. In this review, we investigated the network interaction mechanism of “gut microbial disturbance, metabolic disorder, and immune imbalance” in both obesity and T2DM and systemically summarized their multiple targets in the treatment of obesity and T2DM, including enrichment of the beneficial gut microbiota (genera Bifidobacterium, Akkermansia, and Lactobacillus) and upregulation of the levels of gut microbiota-derived metabolites [short-chain fatty acids (SCFAs)] and bile acids (BAs). Moreover, we explored their effect on host glucolipid metabolism, the AMPK pathway, and immune modulation via the inhibition of pro-inflammatory immune cells (M1-like Mϕs, Th1, and Th17 cells); proliferation, recruitment, differentiation, and function; and related cytokines (TNF-α, IL-1β, IL-6, IL-17, and MCP-1). We hope to provide evidence to promote the clinical application of natural polyphenols in the management of obesity and T2DM.

The riparian zone is an important ecological corridor connecting the upstream and downstream rivers. Its highly complex biological and physical environments significantly affect the biogeographical pattern of species and various ecosystem functions. However, in alpine riparian ecosystems, the distribution patterns and drivers of arbuscular mycorrhizal (AM) fungi, a group of functionally important root-associated microorganisms, remain poorly understood. In this study, we investigated the AM fungal diversity and community composition in near-bank (wetland) and far-bank (alpine meadows) soils along the Niaqu River in the Nam Co watershed, and assessed the relative importance of abiotic and biotic filtering in shaping these distributions. Overall, 184 OTUs were identified in the riparian ecosystem, predominantly belonging to the genus Glomus, especially in the downstream soils, and Claroideoglomus in near-bank soils. AM fungal colonization, spore density, and α diversity showed an overall increasing trend along the river, while the extraradical hyphae declined dramatically from the middle of the river. AM fungal communities significantly varied between the wetland and alpine meadows in the riparian zone, mainly driven by the geographic distance, soil water content, soil pH, and plant communities. Specifically, soil pH was the principal predictor of AM fungal community in near-bank wetland soils, while soil water content had a most substantial direct effect in alpine meadows. These findings indicate that abiotic factors are the most important divers in shaping AM fungal communities at the watershed scale, which could be helpful in alpine riparian biodiversity conservation and management.

Breast cancer is a kind of malignant tumor that seriously endangers women's life and health. Once diagnosed, most patients will receive a combination of treatments to achieve a cure. However, breast cancer is a heterogeneous disease. Even with the same clinical stage and pathological features, its response to treatment and postoperative recurrence risk may still be completely different. With the advent of genomic assay, some patients with early-stage breast cancer who originally needed treatment can still achieve long-term disease-free survival without adjuvant chemotherapy, so as to achieve personalized and accurate treatment mode to a certain extent. In this paper, we reviewed the 5 most widely used and studied genomic panel technologies in breast cancer, namely Oncotype DX , MammaPrint , RecurIndex , PAM50, and EndoPredict , according to accessibility and availability. Based on the results of the completed or ongoing clinical studies, we summarized the origin, applicable population, and clinical efficacy of each detection method, and discussed the potential development prospect of detection technology in the future.

Abstract Background Hemophilic pseudotumor (HPT)-related fracture is a rare but severe complication in patients with HPTs. These fractures often occur in femurs. There is no consensus on the standard surgical protocol for HPT-related femoral fracture. The present retrospective study evaluated the outcomes of these patients treated with surgical interventions. Methods Ten patients with HPT-related femoral fractures who were treated with 14 surgical procedures due to 11 fractures in our hospital from January 2014 to April 2020 were evaluated retrospectively. Demographic data, fracture location, complications after surgery, and follow-up outcomes were recorded and analyzed. The mean follow-up period was 39.7 months. Results The mean age at surgery was 31 years. Closed reduction external fixation (CREF) was originally performed in 2 patients, open reduction internal fixation (ORIF) was performed in 4 patients, screw fixation alone was performed in 1 patient, brace immobilization was performed in 1 patient, and amputation was performed in 3 patients. Bone union was observed in 5 patients, and an adequate callus was visible in 2 patients. Both patients with CREF had pin infections. Nonunion combined with external fixation (EF) failure occurred in 1 patient, and the plate was broken after ORIF. Three patients underwent autogenous or allogeneic cortical strut grafting. Three patients had HPT recurrence. Conclusions It is necessary to perform surgery in patients with HPT-related femoral fractures. Surgical treatments must consider fracture stabilization and HPT resection. Internal fixation is preferable, and EF should only be used for temporary fixation. If the HPT erodes more than one third of the bone diameter, strut grafts are necessary for mechanical stability. Amputation is an appropriate curative method in certain situations.

Background: Coronavirus disease 2019 (COVID-19) was declared a global pandemic in March 2020 by the World Health Organization (WHO). As of July 2, 2022, COVID-19 has caused more than 545 million infections and 6.3 million deaths worldwide, posing a significant threat to human health. Currently, there is still a lack of effective prevention and control strategies for the variation and transmission of SARS-CoV-2. Traditional Chinese medicine (TCM), which has a unique theoretical system, has treated various conditions for thousands of years. Importantly, recent studies have revealed that TCM contributed significantly to COVID-19. SanHanHuaShi (SHHS) granules, a Chinese herbal medicine, which has been included in Protocol for the Diagnosis and Treatment of Novel Coronavirus Disease 2019 (6th to 9th editions) issued by the National Health Commission of China and used to prevent and treat COVID-19 disease. A previous retrospective cohort study showed that SHHS could significantly reduce the severity of mild and moderate COVID-19. However, there is an absence of high-quality randomized controlled clinical studies to confirm the clinical effectiveness of SHHS. Therefore, a clinical study protocol and a statistical analysis plan were designed to investigate the efficacy and safety of SHHS for the prevention and treatment of COVID-19. This study will increase the integrity and data transparency of the clinical research process, which is of great significance for improving the practical application of SHHS granules in the future.Methods and analysis: The study was designed as a 7-day, randomized, parallel controlled, open-label, noninferiority clinical trial of positive drugs. A total of 240 patients with mild and moderate COVID-19 will be enrolled and randomly assigned to receive SanHanHuaShi granules or LianHuaQingWen granules treatment in a 1:1 ratio. Disease classification, vital signs, SARS-CoV-2 nucleic acid testing, symptoms, medications, adverse events, and safety evaluations will be recorded at each visit. The primary outcome will be the clinical symptom recovery rate. Secondary outcomes will include the recovery time of clinical symptoms, negative conversion time of SARS-CoV-2 nucleic acid test negative conversion rate, hospitalization time, antipyretic time, rate of conversion to severe patients, and time and rate of single symptom recovery. Adverse incidents and safety assessments will be documented. All data will be analyzed using a predetermined statistical analysis plan, including our method for imputation of missing data, primary and secondary outcome analyses, and safety outcomes.Discussion: The results of this study will provide robust evidence to confirm the effectiveness and safety of SHHS in the treatment of COVID-19.Clinical Trial Registration:http://www.chictr.org.cn. Trial number: ChiCTR2200058080. Registered on 29 March 2022.

BackgroundDeveloping brain is highly plastic and can be easily affected. Growing pediatric usage of anesthetics during painless procedures has raised concerns about the effect of low-dose anesthetics on neurodevelopment. It is urgent to ascertain the neuronal effect of low-dose Propofol, a widely used anesthetic in pediatrics, on developing brains.MethodsThe behavioral tests after neonatal exposure to low-dose/high-dose Propofol in mice were conducted to clarify the cognitive effect. The nascent cells undergoing proliferation and differentiation stage in the hippocampus and cultured neural stem cells (NSCs) were further identified. In addition, single-nuclei RNA sequencing (snRNA-seq), NSCs bulk RNA-seq, and metabolism trials were performed for pathway investigation. Furthermore, small interfering RNA and stereotactic adenovirus injection were, respectively, used in NSCs and hippocampal to confirm the underlying mechanism.ResultsBehavioral tests in mice showed enhanced spatial cognitive ability after being exposed to low-dose Propofol. Activated neurogenesis was observed both in hippocampal and cultured NSCs. Moreover, transcriptome analysis of snRNA-seq, bulk RNA-seq, and metabolism trials revealed a significantly enhanced oxidative phosphorylation (OXPHOS) level in NSCs. Furthermore, PGC-1α, a master regulator in mitochondria metabolism, was found upregulated after Propofol exposure both in vivo and in vitro. Importantly, downregulation of PGC-1α remarkably prevented the effects of low-dose Propofol in activating OXPHOS and neurogenesis.ConclusionsTaken together, this study demonstrates a novel alteration of mitochondrial function in hippocampal neurogenesis after low-dose Propofol exposure, suggesting the safety, even potentially beneficial effect, of low-dose Propofol in pediatric use.

Underwater signal processing based on passive acoustic technology has carried out a lot of research on the behavioral sound of underwater creatures and the protection of marine resources, which proves the feasibility of passive acoustic technology for long-term and non-destructive monitoring of underwater biological sound production. However, at present, most relevant research focuses on fish but little research on shrimp. At the same time, as the main economic breeding industry, Penaeus vannamei has a backward industrial structure, in which the level of intelligence needs to be improved. In this paper, the acoustic signals generated by different physiological behaviors of P. vannamei are collected based on passive acoustic technology. Their different behaviors are finally classified and identified through feature extraction and analysis. Meanwhile, the characteristic non-parametric ANOVA is carried out to explore the relationship between the acoustic signals and the behavior state of P. vannamei to achieve the purpose of real-time monitoring of the behavior state of P. vannamei. The experimental results show that linear prediction cepstrum coefficient (LPCC) and Mel-frequency cepstrum coefficient (MFCC) characteristic coefficients are effective in the classification and recognition of different behavioral acoustic signals with interspecific acoustic signals of P. vannamei. Meanwhile, the SVM classifier based on OvR classification strategy can model the acoustic signal characteristics of different underwater biological behaviors more efficiently and has classification accuracy as high as 93%.

Abstract Background Recently, the infra-acetabular screw has been proposed for use in treatment of acetabular fractures as a part of a periacetabular fixation frame. Biomechanical studies have shown that an additional infra-acetabular screw placement can enhance the fixation strength of acetabular fracture internal fixation. Currently, the reported exit point of the infra-acetabular screw has been located at the ischial tuberosity (Screw I). However, our significant experience in placement of the infra-acetabular screw has suggested that when the exit point is located between the ischial tuberosity and the ischial spine (Screw II), the placement of a 3.5 mm infra-acetabular screw may be easier for some patients. We conducted this study in order to determine the anatomical differences between the two different IACs. Methods The raw datasets were reconstructed into 3D models using the software MIMICS. Then, the models, in the STL format model, were imported into the software Geomagic Studio to delete the inner triangular patches. Additionally, the STL format image processed by Geomagic Studio was imported again into MIMICS. Finally, we used an axial perspective based on 3D models in order to study the anatomical parameters of the two infra-acetabular screw corridors with different exit points. Hence, we placed the largest diameter virtual screw in the two different screw corridors. The data obtained from this study presents the maximum diameter, length, direction, and distances between the entry point and center of IPE. Results In 65.31% males and 40.54% females, we found a screw I corridor with a diameter of at least 5 mm, while a screw II corridor was present in 77.55% in males and 62.16% in females. Compared to screw I, the length of screw II is reduced, the angle with the coronal plane is significantly reduced, and the angle with the transverse plane is significantly increased. Conclusions For East Asians, changing the exit point of the infra-acetabular screw can increase the scope of infra-acetabular screw use, especially for females.

T2DM, as a typical metabolic inflammatory disease, is under the joint regulation of environmental factors and genetics, combining with a variety of epigenetic changes. Apart from epigenetic changes of islet β cells and glycometabolic tissues or organs, the inflammation-related epigenetics is also the core pathomechanism leading to β-cell dysfunction and insulin resistance. In this review, we focus on the epigenetic modification of immune cells’ proliferation, recruitment, differentiation and function, providing an overview of the key genes which regulated by DNA methylation, histone modifications, and non-coding RNA in the respect of T2DM. Meanwhile, we further summarize the present situation of T2DM epigenetic research and elucidate its prospect in T2DM clinical diagnosis and treatment.