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［Objective］ The OD (obstacle deflector) serves as a primary passive safety device on high-speed trains, effectively clearing obstacles between the wheels and the tracks. However, conventional OD designs do not meet the energy absorption requirements under the newly-added intermediate position overloading conditions specified in the EN 15227:2020 standard. Therefore, it is necessary to optimize the energy absorption design of high-speed train OD. ［Method］ The existing OD design is optimized, and a new design incorporating a built-in aluminum honeycomb covered energy absorber is proposed. A 3D model of the high-speed train OD with the built-in energy absorber is created, and the LS-DYNA software is used for computational analysis of the OD compression process, obtaining a simulated buffer force-displacement curve of the pilot. A quasi-static compression test is conducted on the OD using a 500-ton press machine, and the experimental buffer force-displacement curve of the OD is obtained. The simulated and experimental curves are compared to verify the reliability of the simulation results. ［Result & Conclusion］ Both the simulation and experimental results meet the requirements of EN 15227:2020, and the simulated curve shows high consistency with the experimental curve, confirming the feasibility of applying the established 3D OD model and simulation calculations results for guiding design proposals. During both the simulated and experimental compression processes, the optimized OD demonstrates stable compression performance, with a stable and controllable buffer force-displacement curve.

Implementing forest protection measures, such as afforestation, can be an effective approach toward slowing down the increase of CO$_{2}$ concentration and attaining carbon neutrality. The estimation of forest parameters is of great significance in understanding regional and global climate change patterns, and the Forest Leaf Area Index (LAI) is a crucial parameter. Current LAI products are mostly generated by moderate-resolution remote sensing data which does not meet the precision requirements for mountain forest ecosystems. To overcome this issue, there is an urgent need for higher resolution LAI data. This article proposes a data fusion method to map LAI in Wolong Nature Reserve that utilizes Sentinel-2 reflectance data, solar sensor geometry parameters, and vegetation indices extracted from the Google Earth Engine platform, along with canopy height data derived from canopy height estimation models in previous studies, combined with GLASS LAI V6 to estimate LAI using the random forest algorithm. The resulting LAI distribution map was plotted at a resolution of 20 m. The study demonstrated that incorporating canopy heights into the estimation model led to an $R^{2}$ model accuracy of greater than 0.83. The 20-m resolution LAI map increased spatial details compared to the moderate-resolution LAI map, making it more suitable for mountain forest ecosystems that exhibit significant spatial heterogeneity.

Abstract The lining cavities in tunnels have strong concealment and pose significant risks, seriously affecting tunnel operational safety. Therefore, it is necessary to develop efficient and high-precision detection techniques for tunnel lining cavities. In this study, concrete slabs with different parameter cavities were selected as the research object, and experiments on remote detection using Laser Doppler Vibrometry were conducted. During the experiments, the vibration parameters of the concrete surface were measured for cavities of varying sizes and depths, filled with different materials, and under different detection distance conditions. The vibration differences between the defective and healthy parts were analyzed using the spatial spectral entropy algorithm. The results showed that for cavities with side lengths of 200mm, depths of 50mm, and filled with hollow wooden boxes, the maximum velocity amplitudes of the surface concrete were 10.68, 3.55, and 4.01 times higher than those of the healthy parts, respectively. Moreover, at the same frequency, larger cavity areas and shallower depths resulted in greater surface vibration amplitudes. The vibration amplitudes of the surface with hollow wooden box filling were higher than those with foam polystyrene board filling. With increasing detection distance, the overall surface vibration velocity of the cavities was higher at a distance of 3 m from the laser probe compared to 5 m, indicating the ability to quantitatively describe the apparent vibration characteristics of concrete cavities under different parameters. This study demonstrates the significant effectiveness of laser Doppler vibrometry in remote detection of lining cavities in tunnels.

Abstract Propagation of intercellular calcium waves through tissues has been found to coordinate different multicellular responses. Nevertheless, our understanding of how calcium waves operate remains limited. In this study, we explore the real-time dynamics of intercellular calcium waves in Drosophila adipose tissues. We identify Adipokinetic Hormone (AKH), the fly functional homolog of glucagon, as the key factor driving Ca2+ activities in adipose tissue. We find that AKH, which is released into the hemolymph from the AKH-producing neurosecretory cells, stimulates calcium waves in the larval fat by a previously unrecognized gap-junction-independent mechanism to promote lipolysis. In the adult fat body, however, gap-junction-dependent intercellular calcium waves are triggered by a presumably uniformly diffused AKH. Additionally, we discover that amino acids activate the AKH-producing neurosecretory cells, leading to increased intracellular Ca2+ and AKH secretion. Altogether, we show that dietary amino acids regulate the AKH release from the AKH-producing neurosecretory cells in the brain, which subsequently stimulates gap-junction-independent intercellular calcium waves in adipose tissue, enhancing lipid metabolism.

Abstract Molecules in immune cells plays a vital role in the pathogenesis of ischemic stroke (IS). The aim of this study is to profile the landscape of molecules on the basis of immune cells in IS peripheral blood and construct an immunoregulatory competing endogenous RNA (ceRNA) network. We collected and combined multiple public transcriptome datasets from the peripheral blood of IS patients and healthy controls. CIBERSORT deconvolution revealed that the proportions of CD8 and CD4 naive T cells, monocytes, and neutrophils changed significantly in the IS group. Intersecting the immune cell-related genes identified by weighted gene co-expression network analysis (WGCNA) and differential expression analysis, 38 overlapping candidate biomarkers were selected. Three machine learning algorithms, including least absolute shrinkage and selection operator (LASSO), support vector machine-recursive feature elimination (SVM-RFE), and random forest were applied, and 11 distinct immune cell-related genes were identified. We obtained the mRNA-miRNA and miRNA-lncRNA interactions from StarBase v3.0, and constructed a ceRNA network based on the differentially expressed mRNAs, miRNAs, and lncRNAs. The aberrant expression of HECW2-centered ceRNAs in the peripheral blood of in-house patients was validated using quantitative PCR. We also revealed that the expression of HECW2 was positively correlated with lncRNAs LINC02593 through miRNAs miR-130a-3p, miR-130b-3p and miR-148b-3p in cells. These results show that there are distinct immune features between IS patients and healthy controls. The ceRNA network may help elucidate the mechanism of immune cell-related genes in IS and may serve as a therapeutic target.

Phytopathogens can continuously cause serious losses worldwide to crop, fruit, and vegetable yields. The excessive use of conventional fungicides in pathogen management has raised severe environmental and health side effects and induced fungicide-resistant pathogen strains. RNA-based spray-induced gene silencing (SIGS) has emerged as an ecologically sustainable pathogen control approach. Here, we introduce the SIGS mechanism in plant pathogens, summarize the application of SIGS in controlling plant pathogens, and highlight the major considerations of SIGS. In addition, we propose the future perspectives of SIGS in crop protection and disease management.

Abstract Background Acute myocardial infarction (AMI) is the most serious manifestation of coronary artery disease. At present, existing treatments cannot change the risk factors for the occurrence of the disease, so patients are prone to fear of progression or recurrence, and studies have shown that excessive fear will cause patients to over-examine, mental abnormalities, suicide and other behaviors, increase unnecessary medical care costs and the social medical burden. Thus to investigate the current situation of progression fear in patients with Acute Myocardial Infarction (AMI) admitted to hospital in stable stage and analyze its influencing factors. Methods This is a cross-sectional study. In this study, 160 AMI patients admitted to the Department of Cardiology of a 3 A hospital in Changchun from November 2022 to April 2023 were selected as the research sample by a convenient sampling method. Patients completed the general information questionnaire, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF), the Brief Illness Perception Questionnaire (BIPQ), the Medical Coping Modes Questionnaire (MCSQ), the Social Support Rating Scale (SSRS), and the Positive Psychological Questionnaire (PPQ) at the time of stable condition. Using SPSS 25.0 software for data analysis, statistical methods mainly include descriptive statistics, analysis of variance, Pearson correlation analysis and multiple linear regression analysis. Results A total of 160 subjects were included, among which the score of simplified fear of progression scale was (33.43 ± 7.09), and the incidence of disorder of fear of progression was 50.60%. The influencing factors included gender (Beta = 0.118, P

Abstract Objective Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is widely recognized for its advantages, including reduced postoperative pain and the absence of visible scarring. However, the anatomical specificity required for vNOTES may increase the risk of injury to nearby organs, such as the rectum and bladder. This study aims to evaluate the safety and potential benefits of vNOTES compared to transumbilical laparoendoscopic single-site surgery (LESS) for Hysterectomy. Methods The Longitudinal Vaginal Natural Orifice Transluminal Endoscopic Surgery Study (LovNOTESS), conducted in Chengdu, China, included 192 patients who underwent hysterectomy between May and October 2023. This study prospectively collected and compared perioperative and follow-up data between the two groups. Results The vNOTES group demonstrated shorter surgery times, postoperative flatus time, and hospital stays, but it also had a higher conversion rate. Specifically, the vNOTES approach reduced surgery duration by approximately 29.8 min (95% CI: -41.31, -18.34, P

Abstract Conducting arable land suitability evaluation (ALSE) is essential for identifying agricultural development opportunities and ensuring sustainable production and food security. Traditional ALSE methods, relying on suitability proportion functions, often encounter constraints due to land use structures. Therefore, it is necessary to develop new function methods to avoid the constraints imposed by land use structures, thus making ALSE more convenient. This study aims to propose a novel set of rules for constructing proportion functions, aiming to enhance the applicability of suitability functions in arable land suitability evaluation. The study findings reveal that: (1) In the Anning River Basin, the highly Suitable, Moderately Suitable, and Marginally Suitable current arable land (CAL) respectively account for 45.3%, 29.8%, and 18.9% of the arable land (AL). The proportion of areas deemed Temporarily Unsuitable and Permanently Unsuitable is only 6%. The distribution of suitability levels for the potential arable land (PAL) is relatively uniform, with a proportion of suitable areas reaching 66.1%, indicating substantial development potential. (2) The agricultural production conditions in the arid and warm river valley area of the Anning River Basin are exceptional. Highly Suitable CAL and Highly Suitable PAL cover 93.14% and 82.97% of this region, respectively, making it a focal point for regional agricultural development. (3) The spatial distribution patterns of ALSE results based on the original function and the improved function are essentially consistent. However, there are significant differences among the suitability levels. The correlation analysis results indicate that the evaluation results based on the improved function are closer to reality. This study enhanced the accuracy of ALSE results based on the suitability function. It provided a new approach for evaluating the suitability of AL and offers a beneficial reference for regional arable land resource utilization and sustainable agricultural development.

Objective When implanting the Zero‐P device, the screws of Zero‐P form a bone wedge with a 40 ± 5° cranial and caudal angle (CCA). However, no study has been performed in the optimal CCA of the Zero‐P implant. To investigate whether the cranial/caudal angles (CCA) of the screws affect the clinical and radiological outcomes in patients undergoing ACDF with the Zero‐P implant. Methods From January 2016 to December 2023, we retrospectively analyzed 186 patients who underwent 1‐level ACDF with the Zero‐P device. The patients were divided into four groups: group A (cranial angle ≤40°, caudal angle ≤40°); group B (cranial angle ≤40°, caudal angle >40°); group C (cranial angle >40°, caudal angle ≤40°); and group D (cranial angle >40°, caudal angle >40°). The clinical outcomes, including Japanese Orthopaedic Association (JOA), neck disability index (NDI), and visual analogue scale (VAS) scores, the radiological parameters, including cervical lordosis (CL), cervical lordosis of operated segments (OPCL), intervertebral space height (ISH) and fusion rate (FR), and the complications, were evaluated and compared. Parametric tests, non‐parametric tests, and chi‐square tests were conducted to analyze the data. Results The OPCL of group A was significantly less than that of the other groups at the final follow‐up (p 0.05). Conclusion A larger CCA of the screws (cranial angle >40°, caudal angle >40°) was better for maintaining OPCL and reducing the incidence of ASD. A smaller CCA of the screws (cranial angle ≤40°, caudal angle ≤40°) was better for maintaining ISH and reducing the rate of subsidence.

An integrated oxic-anoxic-anaerobic-oxic(OAAO)-ceramic membrane MBR process with a treatment capacity of 20 000 m3/d was built to solve the problem of long-term full-load and even overload operation of a municipal wastewater treatment plant in Dinghu, Guangdong Province, China. With microbial environment precisely control, high-efficiency treatment with micro-oxygenated organisms was realized. The project operated stably after completion, with COD and NH4+-N in effluent reaching the Ⅳ class water standard in the Environmental Quality Standard for Surface Water(GB 3838-2002), while TN and TP could also meet the Class A standard in the Pollutant Discharge Standard for Urban Wastewater Treatment Plants(GB 18918-2002) stably. This project involved a total investment of 40.61 million yuan, covered an area of 4 713.4 m2, and the unit treatment cost was 0.42 yuan/t. Compared with the AAO-denitrification filter process with the same treatment capacity in this wastewater treatment plant, integrated OAAO-ceramic membrane MBR process saved 43.8% of the total investment, reduced 66% of area and 19.23% of unit treatment cost, also decreased the waste sludge production to 1.5 t/d.

Abstract Background With the rapid aging of the global population, identifying lifestyle patterns that effectively delay aging and reduce mortality risk is of paramount importance. This study utilizes the UK Biobank to analyze the associations of the Dietary Inflammatory Index, physical activity, and sleep on biological aging and all-cause mortality. Methods A prospective cohort study was conducted using data from over half a million UK Biobank participants. Two datasets were created by subjective and objective measurements of physical activity: the Subjective Physical Activity (SPA) and Objective Physical Activity (OPA) datasets. Lifestyle patterns, including diet habits, exercise levels, and sleep quality, were assessed within these datasets. Biological aging was quantified using validated methods, including Homeostatic Dysregulation, Klemera-Doubal Method Biological Age, Phenotypic Age, and Telomere Length. All-cause mortality data were obtained from the National Health Service. Statistical analyses included weighted linear regression and Cox proportional hazard models, adjusted for a range of covariates. Results The findings indicate that, in most cases, maintaining an anti-inflammatory diet, engaging in at least moderate physical activity, and ensuring healthy sleep conditions are associated with delayed physiological aging (Cohen’s d ranging from 0.274 to 0.633) and significantly reduced risk of all-cause mortality (HR-SPA: 0.690, 95% CI: 0.538, 0.884; HR-OPA: 0.493, 95% CI: 0.293, 0.828). These effects are particularly pronounced in individuals under 60 years of age and in women. However, it was observed that the level of physical activity recommended by the World Health Organization (600 MET-minutes/week) does not achieve the optimal effect in delaying biological aging. The best effect in decelerating biological aging was seen in the high-level physical activity group (≥ 3000 MET-minutes/week). The study also highlights the potential of biological age acceleration and telomere length as biomarkers for predicting the risk of mortality. Conclusions Choosing healthy lifestyle patterns, especially an anti-inflammatory diet, at least moderate physical activity, and healthy sleep patterns, is crucial for delaying aging and reducing mortality risk. These findings support the development of targeted interventions to improve public health outcomes. Future research should focus on objective assessments of lifestyle to further validate these associations.

An unexpected troglobitic staphylinid is described from a dolomite cave in western China as Domene lizeyui Wang & He, sp. nov. (Coleoptera, Staphylinidae, Paederinae). The habitus of both sexes and important diagnostic features are illustrated. Brief notes on the habitat, biology and taxonomic status of the new species are provided. This is the first discovery of a troglobitic representative of Paederinae from China, the first record of a troglobitic Domene species, and only the third cavernicolous species of Paederinae from eastern Asia.

Abstract Background Ophiocordyceps sinensis (O. sinensis) is the dominant bacterium in the asexual stage of Chinese cordyceps, and its growth usually suffers from water stress. Thus, simulating its ecological growth environment is crucial for artificial cultivation. This study aimed to reveal the mechanism underlying the water stress tolerance of Ophiocordyceps sinensis (O. sinensis) by combining metabolomic and transcriptome analyses to identify crucial pathways related to differentially expressed genes (DEGs) and metabolites (DEMs) involved in the response to water stress. Results Gene coexpression analysis revealed that many genes related to ‘betalain biosynthesis’, ‘tyrosine metabolism’, ‘linoleic acid metabolism’, ‘fructose and mannose metabolism’, and ‘starch and sucrose metabolism’ were highly upregulated after 20d-water stress. Metabolomic analysis revealed that many metabolites regulated by these genes in these metabolic pathways were markedly decreased. On the one hand, we surmised that carbohydrate metabolism and the β-oxidation pathway worked cooperatively to generate enough acyl-CoA and then entered the TCA cycle to provide energy when exposed to water stress. On the other hand, the betalain biosynthesis and tyrosine metabolism pathway might play crucial roles in response to water stress in O. sinensis by enhancing cell osmotic potential and producing osmoregulatory substances (betaine) and antioxidant pigments (eumelanin). Conclusions Overall, our findings provide important information for further exploration of the mechanism underlying the water stress tolerance of O. sinensis for the industrialization of artificial cultivation of Chinese cordyceps.

Abstract Background Based on their place of employment, workers with agricultural hukou (WAH) are categorized into local workers with agricultural hukou (LWAH) and migrant workers with agricultural hukou (MWAH). Research shows that although LWAH often find themselves at a disadvantage in terms of labour income and access to public services, the significant growth of this group in recent years has drawn attention to their choice of workplace and the factors influencing it. Guided by the theories of self-determination and social comparison, this study aims to explore the impact of the differences between LWAH and MWAH in psychological needs and social comparisons on life satisfaction, as well as the underlying mechanisms. Methods This study utilizes data from the China Family Panel Studies (CFPS) from 2014 to 2020, employing a two-way fixed effects model to investigate the differences in life satisfaction between 1,976 LWAH and MWAH. Additionally, propensity score matching (PSM) is used to conduct regression analysis on the matched sample, providing a more accurate comparison of life satisfaction between LWAH and MWAH under similar individual characteristics. Finally, the study further examines the mediating effects of perceived social status and job satisfaction and analyses the differences in life satisfaction between LWAH and MWAH across dimensions such as generation, region, and work conditions. Results The baseline regression results indicate that LWAH have significantly higher life satisfaction compared to MWAH, and this finding is robust to various tests. Mediation analysis reveals that perceived social status plays a mediating role in the difference in life satisfaction between LWAH and MWAH, while job satisfaction does not have a significant mediating effect. Heterogeneity analysis further shows that intergenerational, regional, and work condition differences have varying impacts on the life satisfaction of two groups. Conclusions This study provides important insights into understanding the workplace choices and quality of life of Chinese workers with agricultural hukou. Finally, to effectively promote situ urbanization processes, local governments need to prioritize enhancing workers with agricultural hukou (WAH)’s autonomy, sense of competence, and social status, thereby improving their perceived social status in society and attracting more labourers to return to their hometowns for work and entrepreneurship.

The integration of TiCN particles into superalloy composites for laser powder bed fusion (LPBF) and the construction of Triply Periodic Minimal Surface (TPMS) lattice structures have been understudied. This research systematically examines the microstructure and mechanical properties of LPBF-processed 10 vol% micron sized TiCN particle reinforced Inconel 718 (IN718) composites. The compressive behavior of the resultant TPMS lattice structures, derived from the TiCN-IN718 composite, was scrutinized through a combination of experimental testing and Finite Element (FE) simulation. The micro-sized TiCN reinforcement is demonstrated to notably augment the hardness, tensile strength, and wear resistance of the LPBFed TiCN-IN718 composite. Furthermore, the application of homogenization-solution-aging (HSA) heat treatment is shown to provide additional enhancements to the composite's mechanical behavior. Both the TiCN reinforcement and the HSA heat treatment are identified as pivotal factors influencing the compressive response of the TPMS lattice structures. Experimental findings indicate that the HSA-treated D-structure attains the highest compressive strength, reaching 122 MPa, outperforming both the G- and P-structures. During quasi-static compression testing, the D- and G-structures undergo a layer-by-layer collapse, while the P-structure exhibits tilt shear band behavior. The congruence between FE simulation results and experimental data substantiates the simulation's reliability and its capacity to accurately evaluate the mechanical behavior of TPMS lattice structures.

Abstract Background This study aimed to assess the effects of enteral nutrition with different protein concentrations on muscle mass in severe pneumonia patients, providing insights for enteral nutrition practice in intensive care units (ICUs). Methods A total of 120 severe pneumonia patients admitted to Dazhou Central Hospital’s ICU between June 1, 2022, and February 1, 2023, meeting inclusion criteria, were randomly assigned to either a high-protein group (n = 60, 1.8 g/kg/d) or a standard-protein group (n = 60, 1.2 g/kg/d). Changes in relevant indicators were monitored on days 1, 5, and 10 of ICU admission, including quadriceps and diaphragm thickness, nutritional status (prealbumin and albumin), and adverse events such as diarrhea and constipation. Results Autoregressive of order 1 model (AR(1)) analysis revealed a decrease in both quadriceps and diaphragm thickness over time in both groups. A significant group × time interaction was observed in quadriceps thickness. By day 10, compared to baseline, quadriceps thickness decreased in the high-protein (-0.315 cm [95% CI, -0.340 to -0.289]) and standard-protein (-0.429 cm [95% CI, -0.455 to -0.404]) groups. The high-protein group exhibited a lower quadriceps atrophy rate (13.97 ± 2.43%) compared to the standard-protein group (18.96 ± 2.61%), showing a significant difference (P

Abstract This study aims to objectively assess the effect of three surgical approaches for posterior uterine fibroid resection: transumbilical laparoendoscopic single-site surgery (LESS), vaginal natural orifice transluminal endoscopic surgery (vNOTES) in prone position (vNOTES-P), and vNOTES in the lithotomy position (vNOTES-L). A retrospective analysis was conducted on data pertaining to all patients who underwent vNOTES and LESS for single posterior fibroids at our institution from January 2023 to July 2023. Patients were categorized into three groups based on the surgical approach: vNOTES-P group (n = 30), vNOTES-L group (n = 17), and LESS group (n = 32). Comparative analysis was performed on the demographic characteristics and perioperative outcomes among the three groups of patients. All 79 patients underwent surgery without the need for conversion to laparotomy. There were no statistically significant differences among the LESS group, vNOTES-P group, and vNOTES-L group in terms of operative time, intraoperative blood loss, and perioperative complication rates. In the vNOTES-L group, two patients required conversion to LESS during surgery. Patients had faster return of bowel function (less time to flatus) in the vNOTES group compared to the LESS group (P

BackgroundAt present, the relationship among inflammatory markers [monocytes/HDL-c (MHR), neutrophils/HDL-c (NHR) and lymphocytes/HDL-c (LHR)] and long-term prognosis of coronary heart disease (CHD) is still unclear. Therefore, this study explores the relationship between inflammatory indicators and the risk of long-term major adverse cardiovascular events (MACE) in elderly patients with CHD.MethodsA retrospective analysis was conducted on 208 elderly patients who underwent coronary angiography at Wuhan Fourth Hospital from August 2022 to August 2023. They were divided into the CHD group (N = 116) and control group (N = 92). Patients in the CHD group were followed up for 1 year and divided into the MACE group (N = 36) and the non-MACE group (N = 80) according to whether MACE occurred.ResultsIn elderly patients, logistic regression analysis shows that MHR is an independent risk factor for CHD (OR = 3.050, 95% CI 1.318–1.772). ROC curve analysis found that MHR (AUC = 0.865, 95% CI 0.811–0.919, p

This study introduces an innovative system for combined cycle power plants that significantly enhances efficiency and sustainability through advanced heat recovery techniques. By integrating various cycles and units, including the Brayton, Rankine, and Kalina cycles, along with a thermoelectric generator, proton exchange membrane electrolysis hydrogen production unit, and RO desalination unit, the proposed system optimizes performance across multiple dimensions. Multi-objective optimization, employing a genetic algorithm, ensures optimal system performance in terms of energy, exergy, economics, and environmental impact. The novelty of this research lies in its comprehensive approach to combining power generation with water desalination and hydrogen production, thereby addressing multiple energy and environmental challenges simultaneously. The thermodynamic analysis confirms the system's capability to deliver 1.45 MW of electrical power and produce 3.24 kg/h of hydrogen, with a unit cost of production (UCOP) of 10.24 cents/kWh. Key findings highlight the significant impact of gas turbine inlet temperature on system cost and efficiency, and the trade-offs involved in optimizing pressure ratios for peak performance. The optimized system demonstrates an exergy efficiency of 37. 6 % at a cost rate of 57. 2 $/h. The integrated approach not only increases power generation capacity but also enables the production of hydrogen fuel and fresh water, showcasing technological advancements with significant practical applications. The potential prospects of this research include its application in various industrial sectors, contributing to sustainable energy solutions and environmental conservation.

This study comprehensively analyzes the physical and chemical properties of soil across different layers under Salix paraplesia shrubs, comparing these properties inside and outside the shrub canopies. It also examines species diversity and community stability in these areas, discussing the impact of soil from resource islands at different formation stages on vegetation restoration. Focusing on Salix paraplesia shrubs over varying restoration periods (45 years, 25 years, and 13 years), with unrepaired mobile sandy land serving as the control, the results are as follows: (1) As vegetation restoration progresses, the content of soil organic matter (SOM) and alkali-hydrolyzable nitrogen (AN) significantly increase. After 45 years of restoration, SOM and AN contents are 250.08 % and 442.43 % higher than in the control. SOM, AN, and total phosphorus (TP) contents are greater under the shrubs than outside the canopies, indicating pronounced fertilizer accumulation. (2) The number of plant species increases during the restoration process, with 18 more species present after 45 years compared to the control. Community diversity is highest after 13 years of restoration, with greater overall diversity outside the canopies than under the shrubs. These differences decrease as restoration progresses. (3) The stability of Salix paraplesia shrub communities is higher outside the canopies compared to under the shrubs. As restoration proceeds, stability differences between these areas diminish. The Euclidean distances for community stability outside and under the canopies are 13.97 and 14.68, respectively, after 45 years, indicating relative stability. (4) In the early stages of restoration, soil carbon (C) and nitrogen (N) significantly impact species diversity, while in the later stages, phosphorus (P) content becomes more limiting. Resource islands enhance plant community stability and vegetation restoration, playing a crucial role in ecological protection and vegetation restoration in the alpine sandy land of the Yellow River's upper reaches.

Background Chinese resident physicians confront challenges such as staff shortages and heavy workloads, leading to a heightened prevalence of mental distress. This study aims to investigate the symptom network of stress, burnout, anxiety, depression (SBAD) and adverse personal outcomes in this cohort.Methods From October 2020 to April 2022, 994 physicians were recruited across China through snowball sampling. Stress, burnout, anxiety and depression were assessed using the 10-item Perceived Stress Scale, a two-item burnout questionnaire, Generalized Anxiety Disorder Scale-7 and the Patient Health Questionnaire-9, respectively. Data on adverse personal outcomes (low quality of life [QOL] and suicidal ideation) were collected. We constructed and visualized two networks, calculating expected influence (EI) and bridge EI indices to identify central and bridge symptoms.Results In the SBAD network, perceived helplessness was the most central and critical bridge symptom connecting stress and mental distress, with emotional exhaustion identified as the secondary bridge symptom. Perceived helplessness, perceived self-efficacy and emotional exhaustion exhibited the highest negative correlations with QOL. Worthless (PHQ6) and motor (PHQ8) symptoms were strongly correlated with suicidal ideation. The estimated SBAD network showed excellent stability and accuracy.Conclusions Our study emphasizes that perceived helplessness may be a high-priority target for preventing and intervening in mental distress and improving QOL among residents. Burnout transcends workplace problems and is widely connected to depression, anxiety and QOL. Implementing early detection and intervention measures at three levels—the individual physician, health system and professional colleges, and external regulators—is crucial for preventing and alleviating stress and mental distress among residents.

ABSTRACTThe insights into interactions between host genetics and gut microbiome (GM) in colorectal tumor susceptibility (CTS) remains lacking. We used Collaborative Cross mouse population model to identify genetic and microbial determinants of Azoxymethane-induced CTS. We identified 4417 CTS-associated single nucleotide polymorphisms (SNPs) containing 334 genes that were transcriptionally altered in human colorectal cancers (CRCs) and consistently clustered independent human CRC cohorts into two subgroups with different prognosis. We discovered a set of genera in early-life associated with CTS and defined a 16-genus signature that accurately predicted CTS, the majority of which were correlated with human CRCs. We identified 547 SNPs associated with abundances of these genera. Mediation analysis revealed GM as mediators partially exerting the effect of SNP UNC3869242 within Duox2 on CTS. Intestine cell-specific depletion of Duox2 altered GM composition and contribution of Duox2 depletion to CTS was significantly influenced by GM. Our findings provide potential novel targets for personalized CRC prevention and treatment.

Background: While allergen-specific immunotherapy (AIT) is acknowledged as an effective treatment, its efficacy varies, and consensus on predictive indicators for AIT responders remains elusive. Objective: This study aimed to identify alternative parameters for predicting AIT responders based on clinical data collected in daily practice. Method: We conducted a retrospective analysis of patients with house-dust-mite-driven asthma and/or rhinitis who completed 3 years of subcutaneous AIT (3y-AIT). We assessed the efficacy of AIT using the estimated daily symptom and medication score (edSMS) during different treatment periods, including up-dosing, maintenance I, II, and III phases. These scores were derived from detailed records of symptoms and medication use for AIT injections. A responder was defined as an individual with a reduction in edSMS of at least 30% from up-dosing to maintenance III phase (ΔedSMSU-M3). Results: A cohort of 133 patients was analyzed, revealing a significant overall improvement in the disease condition after 3y-AIT. Responders demonstrated lower rates of polysensitization, daily tobacco smoke exposure, and milder pretreatment disease severity compared to non-responders (p = 0.003, p = 0.001, and p = 0.019, respectively). We observed 8 clinical response patterns among included subjects, but only a small group of patients (16/133, 12.03%) demonstrated consistent improvement throughout the 3y-AIT. Serum total immunoglobulin E (tIgE), specific immunoglobulin E (sIgE), sIgE/tIgE ratios, and edSMS during the up-dosing phase failed to differentiate the clinical response patterns or correlate with 3y-AIT efficacy. Notably, the reduction in edSMS from up-dosing phase to maintenance I phase (ΔedSMSU-M1) significantly associated with the 3y-AIT outcome (r = 0.443, p

Background The early diagnosis of Alzheimer's disease (AD) and mild cognitive impairment (MCI) remains a significant challenge in neurology, with conventional methods often limited by subjectivity and variability in interpretation. Integrating deep learning with artificial intelligence (AI) in magnetic resonance imaging (MRI) analysis emerges as a transformative approach, offering the potential for unbiased, highly accurate diagnostic insights.

Abstract Background Decision fatigue is a new concept in the field of psychology and refers to a state of fatigue alongside impaired cognitive processing and emotional regulation ability. Previous studies have confirmed that nurses are prone to decision fatigue, and nurses who experience decision fatigue may implement nursing measures that are inconsistent with clinical evidence, thus affecting patients’ benefits. COVID-19, as a large-scale global public health emergency, increased the workload and burden of nurses and aggravated decision fatigue. However, the factors leading to decision fatigue among nurses have not yet been identified. Methods This study is guided by interpretative phenomenology. During the epidemic period of COVID-19: From November 2022 to February 2023, a one-to-one, semi-structured in-depth interview was conducted among nurses with decision fatigue experience who were participating in front-line work in Jilin Province using homogenous sampling. The interview recordings and related data were transcribed into text within 24 h, and data analysis was assisted by NVivo 12.0 software. Results After a total of 14 front-line nurses were analyzed in this study, The thematic level reaches saturation, the findings present a persuasive and coherent narrative, and the study is terminated, and finally extracted and formed three core themes: “Cognition, influence and attitude of decision fatigue”, “Approaching factors of decision fatigue” and “Avoidant factors of decision fatigue”. Conclusion This study confirmed that decision fatigue was widespread in the work of front-line nurses, affecting the physical and psychological health of nurses, the quality of nursing work, the degree of benefit of patients and the clinical outcome. However, nursing staff do not know enough about decision fatigue, so the popularization and research of decision fatigue should be strengthened. Improve the attention of medical institutions, nursing managers and nursing staff.Some suggestions are put forward for the intervention of decision fatigue through personnel, task, tool and technology, organization and environment.

Abstract Polyploidization presents an unusual challenge for species with sex chromosomes, as it can lead to complex combinations of sex chromosomes that disrupt reproductive development. This is particularly true for allopolyploidization between species with different sex chromosome systems. Here, we assemble haplotype-resolved chromosome-level genomes of a female allotetraploid weeping willow (Salix babylonica) and a male diploid S. dunnii. We show that weeping willow arose from crosses between a female ancestor from the Salix-clade, which has XY sex chromosomes on chromosome 7, and a male ancestor from the Vetrix-clade, which has ancestral XY sex chromosomes on chromosome 15. We find that weeping willow has one pair of sex chromosomes, ZW on chromosome 15, that derived from the ancestral XY sex chromosomes in the male ancestor of the Vetrix-clade. Moreover, the ancestral 7X chromosomes from the female ancestor of the Salix-clade have reverted to autosomal inheritance. Duplicated intact ARR17-like genes on the four homologous chromosomes 19 likely have contributed to the maintenance of dioecy during polyploidization and sex chromosome turnover. Taken together, our results suggest the rapid evolution and reversion of sex chromosomes following allopolyploidization in weeping willow.

Abstract Background Transvaginal Natural Orifice Transluminal Endoscopy (vNOTES) is regarded as a challenging surgical technique to learn but is promising in reducing perioperative pain and significantly improves the cosmetic outcomes. Previous studies on the learning curve analysis of vNOTES mainly focuses on the hysterectomy approach, while the vNOTES ovarian cystectomy’s learning curve was merely reported though more frequently performed than vNOTES hysterectomy. Therefore, this study seeks to analyze the learning curve of three surgeons with varying levels of experience in performing endoscopic surgery and vaginal surgeries for the treatment of ovarian cysts using vNOTES. Methods A total of 127 patients with ovarian cysts of a variety of pathological types were treated by ovarian vNOTES performed by three surgeons of different levels of endoscopic and transvaginal surgical experience. Each surgeon’s learning curve was plotted using the Cumulative Sum method and divided into three or four phases of technique learning at the turning point of the learning curve. The sociodemographic and clinical features of patients in each phase were then compared and factors potentially associated with operation time were also screened. Results The learning curve was presented in four phases. The operation time (OT) was significantly shorter in phases II (53.66 ± 16.55 min) and IV (54.39 ± 23.45 min) as compared with phases I (68.74 ± 15.85) and III (75.93 ± 30.55) (p

Abstract Background In China, economic, urbanization, and policy differences between the eastern and western regions lead to uneven healthcare resources. This disparity is more pronounced in the west due to fewer healthcare personnel per thousand individuals and imbalanced doctor-to-nurse ratios, which exacerbates healthcare challenges. This study examines the spatial distribution of human resources in maternal and child healthcare from 2016 to 2021, highlighting regional disparities and offering insights for future policy development. Methods The data were sourced from the “China Health and Family Planning Statistical Yearbook” (2017) and the “China Health and Health Statistics Yearbook” (2018–2022). This study utilized GeoDa 1.8.6 software to conduct both global and local spatial autocorrelation analyses, using China’s administrative map as the base dataset. Results From 2016 to 2021, there was an upward trend in the number of health personnel and various types of health technical personnel in Chinese maternal and child healthcare institutions. The spatial distribution of these personnel from 2016 to 2021 revealed clusters characterized as high-high, low-low, high-low and low-high. Specifically, high-high clusters were identified in Guangxi, Hunan, Jiangxi, and Guangdong provinces; low-low in Xinjiang Uygur Autonomous Region and Inner Mongolia Autonomous Region; high-low in Sichuan province; and low-high in Fujian and Anhui provinces. Conclusions From 2016 to 2021, there was evident spatial clustering of health personnel and various health technical personnel in Chinese maternal and child healthcare institutions, indicating regional imbalances.

Effective conservation actions for endangered species rely on a good understanding of the evolutionary forces driving population decline. Detailed genetic analyses, including assessment of demographic history, population structure and diversity, are essential for gaining insights into the species’ adaptive potential and developing strategies of genetic rescue. Salix baileyi is an endemic vulnerable species in China with extremely small population sizes and a limited distribution. The samples of S. baileyi used for whole-genome resequencing cover its whole distribution. The results reveal four distinct genetic lineages within S. baileyi (DBSW, DBSE, TMS, and LXS), with divergence likely driven by paleoclimatic events and geographic barriers. All populations contracted during the Marine Isotope Stage 5 (MIS 5) up to the Last Glacial Maximum (LGM), with most recovering after the LGM, except for LXS lineage that continued to decline. Our results show that climate events, isolation barriers, inbreeding, and population bottlenecks have impacted the genetic status and evolutionary potential of these lineages of S. baileyi. Lineage-specific conservation measures should be applied based on the unique population dynamics of each lineage. This study provides valuable results for studies of vulnerable dioecious plants.

Pseudomonas plecoglossicida is a pathogenic bacterium affecting aquatic animals, responsible for causing a highly fatal disease known as “Visceral White Spot Disease” in various economically important fish species, leading to significant economic losses. The two-component PhoP/PhoQ system plays a crucial role in bacterial responses to environmental stimuli and regulates the expression of virulence-related genes; however, its role in P. plecoglossicida has not been thoroughly studied. In this study, we constructed a phoQ gene deletion strain (ΔphoQ) and a complemented strain (C-ΔphoQ) of P. plecoglossicida to explore the biological characteristics mediated by the phoQ gene and its impact on the host. Results indicated that, compared to the wild-type strain (NZBD9), the ΔphoQ strain exhibited significant impairments in growth and swimming motility. The absence of the phoQ gene also affected the bacterium’s response to acidic conditions, low Mg²⁺ levels, and polymyxin B. Furthermore, RNA-seq analysis revealed that 486 genes were downregulated and 216 genes were upregulated in the ΔphoQ strain compared to NZBD9. Among these, genes related to flagellar assembly, two-component systems, type III secretion systems, and bacterial chemotaxis were downregulated, while genes involved in ABC transport, magnesium ion transport, type VI secretion systems, and membrane permeability were upregulated. In artificial infection experiments, the ΔphoQ strain showed significantly reduced virulence when infecting hybrid grouper (Epinephelus fuscoguttatus♀ × E. lanceolatus♂), with an LD50 value of 3.931 × 104 cfu/mL. These results suggest that the PhoP/PhoQ system may play a key role in regulating the environmental adaptability and pathogenicity of P. plecoglossicida.

Abstract Background and Aims This network meta‐analysis aimed to compare the perioperative efficacy of various minimally invasive hysterectomy procedures for treating benign gynecological diseases and to assess whether vaginal natural orifice transluminal endoscopic hysterectomy (VNOTEH), a recently emerging procedure, is inferior to traditional laparoscopy. Methods We searched PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), Wanfang Data, and China VIP Database from inception to August 2022 and updated in June 2023. We included randomized controlled trials (RCTs) comparing different minimally invasive hysterectomy techniques in patients with benign gynecological conditions. The intervention measures included nine minimally invasive hysterectomies. The two researchers used the Cochrane risk‐of‐bias assessment tool for study appraisal. All statistical analyses and drawings were performed using STATA 17.0 and R 4.4.1. A network meta‐analysis (NMA) was conducted to compare the effectiveness of minimally invasive hysterectomy and rank its relative impact probabilistically. Results A total of 78 RCTs involving 7640 patients and nine minimally invasive hysterectomy methods with 16 intervention combinations were included in this study. Among these, 2, 63, and 13 studies were deemed to have a low, medium, and high risk of bias, respectively. Based on the Surface Under the Cumulative Ranking (SUCRA) probability ranking results of NMA, laparoendoscopic single‐site surgery‐laparoscopic‐assisted vaginal hysterectomy (LESS‐LAVH) demonstrated superior outcomes in terms of complications, infections, and 24‐h postoperative pain scores. LAVH exhibited better performance in injuries and hospital stays, total laparoscopic hysterectomy showed the least blood loss, and vaginal hysterectomy had the shortest operation time. Conclusion LESS‐LAVH and LAVH are recommended options, if feasible. Meanwhile, VNOTEH can achieve comparable results to traditional laparoscopy but requires careful attention to the risk of injury and infection. Future research should aim to broaden the search scope by including high‐quality, large‐scale, multicenter RCTs.

Introduction Atrial fibrillation (AF) is the prevalent cardiac arrhythmia and can significantly impair the quality of life (QoL). Although catheter ablation (CA) is an established treatment for AF,post-procedural complications or perceived inadequate control of AF may diminish the QoL for some patients, potentially even to levels lower than pre-procedure. Preliminary findings from our previous pilot trial indicate that acupuncture may positively influence QoL in AF patients post-CA. This study aims to increase the sample size to evaluate the efficacy of acupuncture as an adjunctive treatment to conventional medical therapy in improving QoL of patients with AF after CA.Methods and design This multicentre randomised clinical trial will be conducted in China. A total of 146 eligible patients will be randomly assigned in a 1:1 ratio to either the acupuncture group or the sham acupuncture group. All patients will receive standard postablation care and undergo 18 sessions of acupuncture/sham acupuncture within 12 weeks following CA, followed by a 9-month follow-up period. The primary outcome is the change in the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) summary score from baseline to months 6 after CA. Secondary outcomes include the changes in the AFEQT subscale scores at months 6, the AFEQT summary and subscale score at months 3 and 12, AF burden, AF recurrence, heart rate variability, number of cardioversions, repeat CA procedures, European Heart Rhythm Association score, number of arrhythmia-related hospitalisations, average heart rate, use of Six-Dimensional Health State Short Form to assess health status, costs incurred by disease treatment, Credibility/Expectancy Questionnaire and blinded assessments. Adverse events will also be meticulously recorded throughout the trial.Ethics and dissemination Ethics approval has been granted by the Ethics Committee of Beijing University of Traditional Chinese Medicine (approval no: 2020BZYLL0802) and seven other subcentres. The findings of the study results will be disseminated through presentations at scientific conferences or publications in peer-reviewed journals.Trial registration number ChiCTR2100049323.

IntroductionMyopia has emerged as a leading global reason for poor vision in children and adolescents. this study aims to investigate the influence of lifestyles on myopia in schoolchildren in Chongqing, China.MethodsThis cross-sectional study was conducted on primary and junior high school graduates in Chongqing City, China. Students who came to the assigned hospital for the physical examination of their upgrade school enrollment were recruited. In addition to regular examination and eyeusing questionnaire, visual acuity and non-cycloplegic autorefraction were measured.ResultsOf all 1806 eligible students, 1,623 students (89.87%) were included in the analysis. The prevalence of myopia in elementary and junior middle school graduates was 73.1 and 81.8%, respectively. According to the multivariate logistic regression analysis, 1 h more homework (OR = 1.272, p = 0.032), attending out-school courses (OR = 1.973, p = 0.006), frequently checking of eyes (OR = 1.337, p = 0.015) and using eye-protecting lamp (OR = 2.528, p

BackgroundDepression is a significant risk factor affecting the mental health of older adults. In the context of accelerated population aging and the policy of “delayed retirement,” self-employment has become an important alternative for older adults. Thus, studying the difference in depression levels between self-employed older adults and retirees, along with the mechanisms behind these differences, has emerged as a crucial theoretical and practical issue.MethodsThis research, based on panel data from the China Health and Retirement Longitudinal Study for the years 2011, 2013, 2015, and 2018, employed fixed-effect, instrumental variable, mediation models to analyze the difference in depression levels between self-employed older adults and retirees, as well as the mediating mechanisms involved.ResultsThe findings indicate that self-employed older adults have lower levels of depression than retirees. The results of the mediating mechanism analysis suggest that self-employment can indirectly lower the depression levels of older adults by frequent social participation and greater life satisfaction. However, heterogeneity analysis revealed significant urban–rural differences and different types of self-employment in the impact of self-employment on the depression levels of older adults.ConclusionsThe results of this study are of great significance for enhancing the mental health of older adults and provide empirical support for China and other developing countries in formulating more effective aging policies and building a more beneficial aging society.

Abstract Intelligent antibacterial agent with controllable activities adaptive to the wound microenvironment is appealing to reduce drug resistance and enhance antibacterial efficiency. In this study, celery is chosen as the carbon source to construct celery‐based carbon dots (CECDs) with double activities, i.e., reactive oxygen species (ROS)‐production and ROS‐clearance activities. The ROS‐production capability of CECDs is dependent on the oxidase (OXD)‐mimicking activity, which is only photo‐activated and thus artificially controlled by light to avoid the production of excess ROS. Meanwhile, the optimal OXD‐mimicking activity occurrs at the pH of 5, close to microenvironmental pH at the bacterial infection site, which will enhance the antibacterial efficacy. On the other hand, CECDs exhibit the antioxidant activity at the neutral or weak alkaline pH, which will assist the healing of the wound. Thus, the conversion of ROS‐production and ROS‐clearance ability of CECDs can be dynamically and intelligently switched automatically with microenvironmental pH at different stages of treatment (from acid to neutral/weak basic). The proposed CECDs exert adorable selective antibacterial activity against Gram‐positive bacteria and satisfactory therapeutic effect on bacteria infected mice. This study paves a new avenue to design the intelligent antibacterial nanoagent sensitive to the infected microenvironmental condition, reducing drug resistance and assisting precise medicine.

Classic Hodgkin lymphoma rarely undergoes pathological transformation, and the transformation type is usually common non-Hodgkin lymphoma. This study describes a 71-year-old male diagnosed with stage III classic Hodgkin lymphoma positive for Epstein‒Barr virus. The disease was partially relieved soon after chemotherapy but quickly progressed with transformation into composite lymphoma with a mixture of T and B cells. Then he developed symptoms in his nervous system and was diagnosed with Guillain‒Barré syndrome. EBV remained positive throughout the course of the disease. Classic Hodgkin lymphoma may transform into composite lymphoma, and the composite lymphoma may be complicated with Guillain‒Barré syndrome after chemotherapy. We hypothesized that EBV infection may play a role in the progression of the disease.

Our prior research has effectively developed tissue-engineered vascularized oral mucosa equivalents (VOME); however, challenges such as low repeatability and stability, as well as the inability to accurately replicate the complexity of real blood vessels, were encountered. Therefore, this study aimed to screen the VOME and native oral mucosa vascular homeostasis phenotypes by tandem mass tag-tagged proteomics associated with laser capture microdissection and human angiogenesis antibody array technology. Then, lentiviruses were constructed and stably transfected with vascular endothelial-like cells (VELCs) to detect angiogenic capacity. HE, EdU Apollo tracer staining, immunofluorescence staining, scanning electron microscopy, biomechanical testing, and a small animal ultrasound imaging system were used to analyze the characteristics of vascularization homeostasis and monitor functional regeneration of the vascularized homeostatic phenotypic oral mucosal equivalents (VHPOME). The results showed that PGAM1, COL5A1, ANG, and RNH1 are potential specific angiogenesis phenotypes. High expression of PGAM1, COL5A1, and ANG and/or low expression of RNH1 can promote the angiogenesis of VOME. ANG/shRNH1 has the most significant tube-like structure-formation ability. The expression of PGAM1, COL5A1, and ANG in the VHPOME group was higher than that of the control group, and the expression of RNH1 was lower than that of the control group. COL5A1/ANG can significantly improve the mechanical properties. The blood flow signal was most significant in the ANG/shRNH1 group. PGAM1, COL5A1, ANG, shRNH1, PGAM1/ANG, COL5A1/ANG, PGAM1/shRNH1, PGAM1/shRNH1, COL5A1/shRNH1, and ANG/shRNH1 may be the targets for establishing vascularization homeostasis and functional regeneration of oral mucosal equivalent genes (groups), and ANG/shRNH1 has the most significant effect.

This research investigates the ecological impacts of heavy metals in downstream river sediments with a focus on carbon emission efficiency in agriculture under the environmental regulation context. In this study, thirty sediment samples have been taken from the downstream region of the Shichuanhe River located in Xi'an, Shaanxi province, China, to analyze the availability of heavy metals. The results show that there are high ecological impacts in relation to the heavy metals and that impacts the carbon emission efficiency in agriculture directly. The analysis has also found the importance of significant environmental regulations in the management of such risks. This research has offered a unique angle on the relationship between heavy metal pollution and agricultural carbon release and has given important information on the improvement of environmental control measures. The implications highlight the need for the implementation of measures to enhance the policies that will help to prevent the ecological threats that are connected with heavy metals in the agricultural areas and, thus, improve the management of the environment.

PurposeMedication overuse headache (MOH) is a chronic headache caused by regular overuse of medications. OnabotulinumtoxinA (BoNTA) is used for preventive treatment of MOH. However, its efficacy and safety remain controversial.MethodsSeven online databases (Cochrane Library, Embase, Medline, PubMed, China National Knowledge Infrastructure, Wanfang data, and Chinese BioMedical Literature Database) were searched for relevant articles published between January 2002 and March 2024. We included randomized controlled trials (RCTs) and cohort studies on the treatment of MOH using BoNTA versus a placebo or other active treatments.ResultsWe retrieved 487 articles in the database search. Of these, four eligible RCTs were identified after detailed screening. A total of 1,259 patients with MOH (622 patients treated with BoNTA, 607 with placebo, and 30 with topiramate) were included in the four RCTs. We found that BoNTA significantly reduced headache frequency compared with placebo (mean difference, 1.89; 95% confidence interval (CI), 1.11–2.67; I2 = 0%; p

[Objective] Achieving non-destructive testing of sub-healthy watercore apples. [Methods] First, the logarithmic function method and the power function method proposed by this study were used to correct the sample spectra. Subsequently, the corrected data were converted into different images of gramian angular difference field (GADF), gramian angular summation field (GASF), markov transition field (MTF), recurrence plot (RP), symmetric dot pattern (SDP). Then, the ResNet50 network model with the convolutional block attention module (CBAM) was used to mine the deep image features related to the degree of watercore, which were downscaled by the t-distributed stochastic neighbor embedding (t-SNE) method and analyzed by clustering to determine the most suitable image transformation method. Finally, the most suitable image features were inputted into the improved particle swarm algorithm (IPSO) optimized support vector machine (SVM), extreme learning machine (ELM), k-nearest neighbour (KNN) and random forest (RF) classifier for the three-class classification of watercore apple. [Results] The results showed that the power function method was better than the logarithmic function method in eliminating the effect of diameter on the transmission spectrum. The silhouette coefficient (SC), the calinski harabasz score (CHS), and the davies-bouldin index (DBI) were 0.93, 0.88 and 0.24 after visualization of the image features in the GADF, better than the rest of the image transformation methods. ResNet50-IPSO-ELM achieved the highest classification accuracy of 96.8%. The overall discrimination accuracy of the three watercore classes apples in the test set reached 96.3%, and the stable precision (SP), stable recall (SR), and stable F1-score (SF) were 87.2%, 95.8%, and 92.3%, respectively. [Conclusion] The model maintains a high classification accuracy for the majority class of apples without watercore and healthy apples with watercore and a high discriminatory ability for the minority class of sub-healthy apples with watercore.

Background Endovascular treatment (EVT) has been demonstrated to be effective for patients with tandem occlusion. The efficacy and safety of intravenous thrombolysis before EVT in patients with tandem occlusion remain debatable. Methods and Results We conducted a systematic review and meta‐analysis with PubMed, EMBASE, and the Cochrane Library from inception to September 2023. The primary outcome was functional independence, defined as a modified Rankin Scale score of 0 to 2 at 90 days. The secondary outcomes included the successful recanalization rate, symptomatic intracerebral hemorrhage, and mortality at 90 days. In total, 9 studies with 1838 enrolled participants were identified. Our results showed that, compared with treatment with EVT alone, intravenous thrombolysis before EVT was associated with a greater proportion of functional independence at 90 days (odds ratio [OR], 1.39 [95% CI, 1.14–1.69]; P=0.001), a greater rate of successful recanalization (OR, 1.45 [95% CI, 1.11–1.89]; P=0.007) and decreased mortality (OR, 0.68 [95% CI, 0.50–0.93]; P=0.02). Furthermore, there was no significant difference in symptomatic intracerebral hemorrhage between the intravenous thrombolysis plus EVT group and the EVT alone group (OR, 1.16 [95% CI, 0.79–1.70]; P=0.45). Conclusions In patients with acute ischemic stroke and tandem occlusion, intravenous thrombolysis before EVT was associated with a greater rate of favorable functional outcomes and successful recanalization and a lower mortality rate without an increased risk of symptomatic intracerebral hemorrhage compared with patients receiving EVT alone.

Abstract In this report, we described a new technique of gasless V-NOTES for hysterectomy and salpingectomy on a robotic platform with flexible devices in a porcine model. As a result, the gynecological procedures were successfully completed. The total operative time was 110 min, while the docking time was 10 min. The estimated blood loss was estimated to be 10 mL with no intraoperative complications. It revealed that gasless V-NOTES for hysterectomy and salpingectomy on a robotic platform with flexible devices appeared to be feasible and safe in the porcine model and has the potential for clinical use in human beings.

Abstract Background Emerging evidence has indicated the associations between subacromial impingement syndrome (SIS) of shoulder and lifestyle factors. However, whether unhealthy lifestyle factors causally increase SIS risk is not determined. This study aims to evaluate whether lifestyle factors are the risk factors of SIS. Methods A two-sample Mendelian randomization (MR) study was designed to evaluate the effect of 11 lifestyle factors on SIS risk. Causality was determined using the inverse-variance weighted method to calculate the odds ratio (OR) and establish a 95% confidence interval (CI). Weighted median method, MR-Egger method and MR-PRESSO method were conducted as sensitivity analysis. Results Four lifestyle factors were identified causally associated with an increased risk of SIS using the IVW method: insomnia (OR: 1.66 95% CI 1.38, 2.00; P = 8.86 × 10− 8), short sleep duration (OR: 1.53 95% CI 1.14, 2.05: P = 0.0043), mobile phone usage (OR: 4.65, 95% CI 1.59, 13.64; P = 0.0051), and heavy manual or physical work (OR: 4.24, 95% CI 2.17, 8.26; P = 2.20 × 10− 5). Another causal but weak association was found between smoking initiation on SIS (OR: 1.17, 95% CI 1.01, 1.35; P = 3.50 × 10− 2). Alcohol, coffee consumption, physical activity, sedentary behavior, sleep duration and computer usage were not found to be causally associated with an increased risk of SIS. Sensitivity analyses indicated that the MR estimates were robust and no heterogeneity and pleiotropy were identified in these MR analyses. Conclusion Sleep habits and shoulder usage were identified as causal factors for SIS. This evidence supports the development of strategies aimed at improving sleep behaviors and optimizing shoulder usage patterns as effective measures to prevent SIS.

【Objective】 The Yangtze-to-Huaihe hydraulic project was initiated in 2016 to move water from the Yangtze River to the Huai River to alleviate water shortage in the latter. In this paper, we analyze water saving levels in the beneficiary areas located in Henan province. 【Method】 We selected 11 water-related indexes covering agriculture, industry, living and ecological environment in the comprehensive analysis to establish an index system to evaluate water-saving levels in the beneficiary areas. A TOPSIS model was then derived, based on the combined weight of AHP-CRITIC method to evaluate water-saving levels in 2020. 【Result】 Among the nine counties we studied in the analysis, one county (Yongcheng) reached grade I, five counties (Liangyuan, Luyi, Suiyang, Zhecheng and Xiayi) reached grade II, and three counties (Dancheng, Huaiyang, Taikang) reached grade III water saving levels. Overall, water-saving levels in the beneficiary areas were higher. Water consumption per 10000-yuan GDP, water-saving irrigation rate, domestic water consumption per capita in urban areas, leakage losses from the water supply network in urban areas, and reclaimed water utilization were the factors that influenced the water-saving levels in the beneficiary areas. The evaluated results were consistent with the ground-truth data observed in the studied areas. 【Conclusion】 The TOPSIS method based on the AHP-CRITIC combination weighting is reliable for evaluating water-saving levels at regional scale. Our results provide guidelines for optimal allocation of the diverted water to the beneficiary areas in Henan province.

Developing an effective vegetation classification method for mountain–plain transition zones is critical for understanding ecological patterns, evaluating ecosystem services, and guiding conservation efforts. Existing methods perform well in mountainous and plain areas but lack verification in mountain–plain transition zones. This study utilized terrain data and Sentinel-1 and Sentinel-2 imagery to extract topographic, spectral, texture, and SAR features as well as the vegetation index. By combining feature sets and applying feature elimination algorithms, the classification performance of one-dimensional convolutional neural networks (1D-CNNs), Random Forest (RF), and Multilayer Perceptron (MLP) was evaluated to determine the optimal feature combinations and methods. The results show the following: (1) multi-feature combinations, especially spectral and topographic features, significantly improved classification accuracy; (2) Recursive Feature Elimination based on Random Forest (RF-RFE) outperformed ReliefF in feature selection, identifying more representative features; (3) all three algorithms performed well, with consistent spatial results. The MLP algorithm achieved the best overall accuracy (OA: 81.65%, Kappa: 77.75%), demonstrating robustness and lower dependence on feature quantity. This study presents an efficient and robust vegetation classification workflow, verifies its applicability in mountain–plain transition zones, and provides valuable insights for small-region vegetation classification under similar topographic conditions globally.

The ‘Cuimi’ kumquat is a unique citrus cultivar known for its thin, crisp pulp and sweet, aromatic flavor. In addition to its use in fresh consumption and processing, this variety exhibits certain medicinal properties. This study aims to investigate the genetic diversity of the Huanglongbing (HLB) bacterium across different tissues of the ‘Cuimi’ kumquat, offering a theoretical basis for understanding the HLB epidemic in Dechang County, Sichuan. The research focuses on the absolute quantification of the HLB bacterium in seven specific tissues of the ‘Cuimi’ kumquat, including new leaves, upper phloem of branches, fruit peduncle, pith, fruit axis, old leaves, and lower phloem of branches. Additionally, the types and contents of prophages were identified in these tissues. In the same diseased branch group, Candidatus Liberibacter asiaticus (CLas) exhibited an uneven distribution, with the highest concentration detected in the pith, significantly surpassing levels found in the stem and leaf tissues (new leaves, upper phloem of branches, old leaves, lower phloem of branches). Infected fruit peduncles and pith slices showed noticeable shrinkage and collapse in the phloem. Prophage analysis indicated that multiple types of prophages could be simultaneously detected within the same infected ‘Cuimi’ kumquat branch. New shoot tissues contained both Type 2 and Type 4 prophages, with a relatively higher abundance of Type 4 and a lower abundance of Type 2. The relative abundance of Type 1 prophage in the fruit tissues was generally higher than in other tissues. CLas primarily accumulates in the fruit tissues of the ‘Cuimi’ kumquat, and the situation in Dechang County suggests that individual trees may be infected with multiple prophage strains simultaneously.

Summary: Background: Deeper insights into ERBB2-driven cancers are essential to develop new treatment approaches for ERBB2+ breast cancers (BCs). We employed the Collaborative Cross (CC) mouse model to unearth genetic factors underpinning Erbb2-driven mammary tumour development and metastasis. Methods: 732 F1 hybrid female mice between FVB/N MMTV-Erbb2 and 30 CC strains were monitored for mammary tumour phenotypes. GWAS pinpointed SNPs that influence various tumour phenotypes. Multivariate analyses and models were used to construct the polygenic score and to develop a mouse tumour susceptibility gene signature (mTSGS), where the corresponding human ortholog was identified and designated as hTSGS. The importance and clinical value of hTSGS in human BC was evaluated using public datasets, encompassing TCGA, METABRIC, GSE96058, and I-SPY2 cohorts. The predictive power of mTSGS for response to chemotherapy was validated in vivo using genetically diverse MMTV-Erbb2 mice. Findings: Distinct variances in tumour onset, multiplicity, and metastatic patterns were observed in F1-hybrid female mice between FVB/N MMTV-Erbb2 and 30 CC strains. Besides lung metastasis, liver and kidney metastases emerged in specific CC strains. GWAS identified specific SNPs significantly associated with tumour onset, multiplicity, lung metastasis, and liver metastasis. Multivariate analyses flagged SNPs in 20 genes (Stx6, Ramp1, Traf3ip1, Nckap5, Pfkfb2, Trmt1l, Rprd1b, Rer1, Sepsecs, Rhobtb1, Tsen15, Abcc3, Arid5b, Tnr, Dock2, Tti1, Fam81a, Oxr1, Plxna2, and Tbc1d31) independently tied to various tumour characteristics, designated as a mTSGS. hTSGS scores (hTSGSS) based on their transcriptional level showed prognostic values, superseding clinical factors and PAM50 subtype across multiple human BC cohorts, and predicted pathological complete response independent of and superior to MammaPrint score in I-SPY2 study. The power of mTSGS score for predicting chemotherapy response was further validated in an in vivo mouse MMTV-Erbb2 model, showing that, like findings in human patients, mouse tumours with low mTSGS scores were most likely to respond to treatment. Interpretation: Our investigation has unveiled many new genes predisposing individuals to ERBB2-driven cancer. Translational findings indicate that hTSGS holds promise as a biomarker for refining treatment strategies for patients with BC. Funding: The U.S. Department of Defense (DoD) Breast Cancer Research Program (BCRP) (BC190820), United States; MCIN/AEI/10.13039/501100011039 (PID2020-118527RB-I00, PDC2021-121735-I00), the “European Union Next Generation EU/PRTR,” the Regional Government of Castile and León (CSI144P20), European Union.

Hydrogenation and fluorination is a significant method to tune the electronic properties of two-dimensional (2D) materials. This paper theoretically predicted and analyzed the effects and regulatory mechanisms of surface functionalization on the electronic properties of 2D semiconductor tetrahex Boron/Aluminium Nitride (th-BN/th-AlN). The density-functional theory (DFT) calculations were employed to study various trends of band structure, effective mass, and work function. The results show that the electronic properties of 2D th-BN/th-AlN are susceptible to the surface adsorption atom species and coverage. Interconversions between semiconductor and metal properties or indirect and direct band structures in 2D th-XN (X = B, Al) can be realized by hydrogen and fluorine surface adsorption. The band gap expands and the work function decreases after H atom is adsorbed on the surface, while the band gap first increases and then decreases and the work function expands after F is adsorbed on the surface. After functionalization, the effective mass of the hole will be reduced to even lighter than that of an electron in certain directions. The change mechanisms of electronic properties in th-BN/AlN is surface adsorbed atoms will cause sp2-hybridized atoms to turn into sp3-hybridized atoms, which leads to the polarized double bonds between adjacent atoms becoming a single σ bond. The chemical bond changing will result in the band near the Fermi level gradually disappearing.

Summary: Liver sinusoidal endothelial cells (LSECs) have a unique morphological structure known as “fenestra” that plays a crucial role in liver substance exchange and homeostasis maintenance. In this study, we demonstrate that ADAMTS18 protease is primarily secreted by fetal liver endothelial cells. ADAMTS18 deficiency leads to enlarged fenestrae and increased porosity of LSECs, microthrombus formation in liver vessels, and an imbalance of liver oxidative stress. These defects worsen carbon tetrachloride (CCl4)-induced liver fibrosis and diethylnitrosamine (DEN)/high-fat-induced hepatocellular carcinoma (HCC) in adult Adamts18-deficient mice. Mechanically, ADAMTS18 functions as a modifier of fibronectin (FN) to regulate the morphological acquisition of LSECs via the vascular endothelial growth factor A (VEGFA) signaling pathways. Collectively, a mechanism is proposed for LSEC morphogenesis and liver homeostasis maintenance via ADAMTS18-FN-VEGFA niches.