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ABSTRACT Objective The rehabilitation methods after total knee arthroplasty (TKA) can affect the recovery of complications and joint function, and the selection and comparison of rehabilitation methods after TKA still need further research. Methods A comprehensive search of five databases and two clinical trial registration platforms was conducted from inception through March 31, 2024, and conducted to identify eligible randomized controlled trials (RCTs). We extracted the required data according to the Cochrane Handbook for Systematic Reviews of Interventions. Finally, 32 trials involving 2292 patients were included, the mean age of the enrolled patients was ~69.10 years, the sex ratio of males was (31.6%), and the longest follow‐up time was 2 years. And we have summarized nine rehabilitation intervention measures: conventional physical therapy (CPT), cryotherapy, thermal therapy (TT), acupuncture, hydrotherapy, neuromuscular training (NT), electrotherapy, continuous passive motion (CPM), continuous active motion (CAM). And use the range of motion (ROM), visual analog scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) as the outcome measure to evaluate the effectiveness of various interventions. A Bayesian network meta‐analysis (NMA) was carried out for calculating standardized mean difference (SMD) and the surface under cumulative ranking curve (SUCRA) of improvement of knee joint function after TKA by different rehabilitation methods. Result After treatment, the ROM results showed that cryotherapy, electrotherapy, and NT had better therapeutic effects. Among them, cryotherapy (WMD = 10.3, 95% CI 1.63–18.2) had a significant therapeutic effect. In terms of VAS, NT and TT showed good therapeutic effects. Among them, NT had a more significant therapeutic effect, while CAM had less effect. After treatment, in terms of WOMAC, TT, hydrotherapy, cryotherapy, and NT had better therapeutic effects. TT had the best therapeutic effect, while Hydrotherapy and Cryotherapy also had certain advantages. Conclusion NT, TT, cryotherapy, hydrotherapy, and electrotherapy rehabilitation therapies have good therapeutic effects for TKA patients compared with other interventions. Among them, NT may be the best postoperative rehabilitation therapy.

As one of the main motor indicators of Parkinson’s disease (PD), postural instability and gait disorder (PIGD) might manifest in various but subtle symptoms at early stage resulting in relatively high misdiagnosis rate. Quantitative gait assessment under dual task or complex motor task (i.e., turning) may contribute to better understanding of PIGD and provide a better diagnostic indicator of early-stage PD. However, few studies have explored gait deviation evaluation algorithms under a complex dual task that reflect disease specificity. In this work, we proposed a novel inertial-based gait normalcy index (GNI) based on inertial-based quantitative gait assessment model to characterize the overall gait performance during both straight walking and turning with or without serial-3 subtraction task. The factor of group and task on the GNI variable was investigated and the feasibility of GNI to improve early-stage PD diagnostic performance was validated. The experimental results showed that the task paradigm is a significant factor on GNI performance where the dual-task GNI at turn had the best discriminating ability between early PD and HC (AUC =0.992) and was significantly correlated with UPDRS III (r =0.81), MMSE(r =0.57) and Mini-BEST(r =0.65). We also observed that the turning-based GNI has larger effect size compared to clinical scales, demonstrating that GNI during turning can reflect the changes of functional mobility in rehabilitation for the early PD. Our work offers an innovative and potential gait biomarker for early-stage PD diagnostics and provides a new perspective into gait performance of complex dual task and its application in early PD.

Part II of this paper presents a reduced-order stability region (ROSR) based method to estimate the full-order stability region (FOSR) of a large-scale power system. First, we introduce the definitions of FOSR and ROSR, followed by a comprehensive theory that reveals the relationships between them. Since the full-order system can be rewritten as a standard two timescale model and the reduced-order system is regarded as the slow subsystem of it, the proposed theory is derived based on the idea of singular perturbation. With rigorous mathematical proof, the properties of FOSR and ROSR are revealed. Moreover, a modified Energy Augmented Dynamic (EAD) algorithm and a constrained equidistant projection (CEP) approach are employed to estimate the ROSR and FOSR, respectively. The modified EAD algorithm and CEP form a so-called reduced-order stability region mapping (ROSRM) method. Finally, the proposed ROSRM method is applied to the IEEE 10-machine-39-bus power system, and simulation studies confirm its superiority to the traditional energy function method in terms of computational speed and reliability of results.

This paper presents an estimation of transient stability regions for large-scale power systems. In Part I, a Koopman operator based model reduction (KOMR) method is proposed to derive a low-order dynamical model with reasonable accuracy for transient stability analysis of large-scale power systems. Unlike traditional reduction methods based on linearized models, the proposed method does not require linearization, but captures dominant modes of the original nonlinear dynamics by employing a Koopman operator defined in an infinite-dimensional observable space. Combined with the Galerkin projection, the obtained dominant Koopman eigenvalues and modes produce a reduced-order nonlinear model. To approximate the Koopman operator with sufficient accuracy, we introduce a Polynomial-based Multi-trajectory Kernel Dynamic Mode Decomposition (PMK-DMD) algorithm, which outperforms traditional DMD in various scenarios. In the end, the proposed method is applied to the IEEE 10-machine-39-bus power system and IEEE 16-machine-68-bus power system, which demonstrates that our method is significantly superior to the modal analysis method in both qualitative and quantitative aspects.

Abstract Background Previous studies have shown that epicardial edipose tissue(EAT) appears to be associated with myocardial inflammation and fibrosis, but this is not clear in patients with new-onset atrial arrhythmias after STEMI. The present study focused on using CMR to assess the association of epicardial fat with myocardial inflammation and fibrosis and its predictive value in patients with new-onset atrial arrhythmias after STEMI. Methods This was a single-centre, retrospective study. We consecutively selected patients who completed CMR during their hospitalisation for PCI after STEMI from May 2019-January 2023, and then underwent regular follow-up, grouped by the presence or absence of new atrial arrhythmias, and enrolled patients were divided into atrial arrhythmia and non-atrial arrhythmia groups. Results In the atrial arrhythmia group, age, heart rate, Peak hs-TnT, PeakNT-proBNP, EATV, LAES, LAED, T1 native, T1*, ECV, and T2 were higher than those in the non-atrial arrhythmia group, and LVEF was lower than those in the non-atrial arrhythmia group. EATV showed a positive and significant correlation with T1native, T1*, ECV, and T2. (T1 native: r = 0.476,p

Abstract This survey aimed to investigate the availability of drugs for stable chronic obstructive pulmonary disease (COPD) treatment in Chinese hospitals and to determine whether drug availability significantly varied among hospitals with different characteristics. A well-constructed questionnaire was designed according to the Chinese Guidelines for the Diagnosis and Management of COPD (revised version 2021). Both inhaled drugs (monotherapy, double therapy and triple therapy) and oral drugs (expectorants, theophylline, antibiotics, and bacterial lysates) were included in this survey. Doctors from different hospitals completed the survey via WeChat. The availability of each category and kind of drug was analyzed based on final valid responses. Subgroup analyses were also conducted to reveal drug availability in hospitals with different characteristics. A total of 1018 hospitals with different characteristics were enrolled in this survey, with 53.73% of which establishing independent respiratory departments. Insufficient supply of COPD-related drugs was observed, with only short-acting β2 agonists (80.6%), expectorants (88.2%) and antibiotics (84.3%) reaching 80%. Results of subgroup analyses suggested that primary hospitals were associated with poorer availability of all kinds of drugs than secondary and tertiary hospitals (all p

Abstract E-point septal separation (EPSS) and tricuspid annular plane systolic excursion (TAPSE) are M-mode measures of left and right ventricular systolic function, with limited pediatric point-of-care ultrasound (POCUS) research. We conducted a cross-sectional study in a pediatric emergency department, enrolling 12–17-year-olds without cardiopulmonary complaints. Exclusion criteria included abnormal vital signs, fever, altered mental status, or psychiatric illness. POCUS faculty performed the measurements, while blinded to pediatric echocardiography reference values. Data was analyzed using unpaired t-tests and Pearson’s correlation. Correlations with age, height, weight, body mass index, and heart rate were examined. Twenty subjects were enrolled. The mean EPSS was 2.5 mm (SD 1.9 mm), and the mean TAPSE was 2.6 cm (SD 0.4 cm), aligning with pediatric echocardiography reference values. No significant correlations were found between EPSS or TAPSE and anthropometric data.

Abstract Short-term traffic forecasting is an important part of intelligent transportation systems. Accurately predicting short-term traffic trends can avoid traffic congestion and plan travel routes, which is of great significance to urban management and traffic scheduling. The difficulty of short-term urban traffic forecasting is that the traffic flow is random and will be dynamically changed by the traffic conditions of nearby nodes. In order to solve this problem, this paper proposes a model based on Dynamic Diffusion Spatial-Temporal Graph Convolutional Network. It first combines the dynamic generation matrix and the static distance matrix to grasp real-time traffic conditions, and then introduces the diffusion random walk strategy to capture the correlation of spatial nodes. Finally, the convolutional LSTM module is used to mine the spatiotemporal dependence of traffic data to improve the accuracy of traffic prediction. Compared to several baseline models, the experimental results show that the model is 7% better than other models on several metrics and demonstrates the necessity of the module through ablation experiments.

Abstract Background The Objective Structured Clinical Examination (OSCE) is a systematic and structured assessment tool that evaluates candidates’ professional medical skills in a simulated environment through a series of time-limited stations. The aim of this meta-analysis was to determine the optimal station number and duration time per station of OSCE to achieve good reliability. Methods A comprehensive search was conducted across PubMed and Embase from inception until August 2024, without language restrictions. Studies were included if they provided data on the station number and duration time of OSCE, along with Cronbach’s alpha. A random-effects model was used to pool the data. Results A total of 23 studies encompassing 26 Cronbach’s alpha were finally included. Cronbach’s alpha values ranged from 0.43 to 0.93, and 11 studies demonstrated good internal consistency (Cronbach’s alpha ≥ 0.8). The analysis indicated that a design of 5–10 stations, with each station lasting less than 10 min, yielded the best internal consistency (Cronbach’s alpha = 0.88, 95% CI: 0.86, 1.00). Conclusions This meta-analysis suggests that the station number of OSCE falling in between 5 and 10, with each station time lasting no more than 10 min are likely to yield good reliability and strong internal consistency.

Abstract Aim Assessing the effect of various forms of exercise training on patients with sarcopenic obesity. Methods Two independent reviewers systematically searched English and Chinese databases (PubMed, Embase, Cochrane Library, Web of Science, CNKI) for randomized controlled trials on various exercise training effects in sarcopenic obesity patients until October 2023. Reference materials and grey literature were also included. Selected studies underwent screening, data extraction, and quality assessment. Meta-analysis was conducted using Review Manager 5.4 software. Results A total of 8 studies were included in the final analysis. The Meta-analysis results indicated that resistance training (RT) significantly improved grip strength (MD = 3.85, 95%CI: 1.50 to 6.20, P

Background: Extracorporeal membrane oxygenation (ECMO) has been proven to be a support method and technology for patients with cardiopulmonary failure. However, the transport of patients under ECMO support is challenging given the high-risk technical maneuvers and patient-care concerns involved. Herein, we examined the safety of ECMO during the transport of critically ill patients and its impact on mortality rates, to provide more secure and effective transport strategies in clinical practice. Method: To assess the safety of ECMO patient transport, this study conducted a retrospective analysis on critically ill adults who required ECMO support and transport at the intensive care unit (ICU) center between 2017 and 2023. The study utilized standard ECMO transport protocols and conducted a comprehensive statistical analysis of the collected clinical data and transport processes. The 28-day survival rate for ECMO patients was determined using Kaplan–Meier analysis, while logistic regression identified prognostic factors. Result: Out of 303 patients supported with ECMO, 111 (36.6%) were transported. 69.4% of the transport group were male, mean age was (42.0±17.0) years, mean body mass index was (24.4±4.6) kg/m2, and veno-arterial-ECMO accounted for 52.5%. The median transportation distance was 190 (interquartile range [IQR]: 70–260) km, and the longest distance was 8100 km. The median transit time was 180 (IQR: 100–260) min, and the maximum duration was 1720 min. No severe adverse events including death or mechanical failure occurred during transportation. The 28-day survival rate was 64.7% (n=196) and ICU survival rate was 56.1% (n=170) for the entire cohort; whereas, the 28-day survival rate was 72.1% (n=80) and ICU survival rate was 66.7% (n=74) in the transport group. A non-significant difference in 28-day survival was observed between the two groups after propensity score matching (P=0.56). Additionally, we found that acute physiology and chronic health evaluation II score (odds ratio [OR]=1.06, P 5 mmol/L, OR=2.80, P=0.01), and renal replacement therapy initiation (OR=3.03, P

Abstract In order to control urban dust pollution and to improve the utilization of agricultural and forestry straw solid waste, this paper prepared an environmentally friendly dust suppressant with plant straw using nine different types of waste straw as raw materials with environmentally friendly additives. By the single factor experiment, the composition of each component reagent and the effect of mass concentration on its properties under single factor were determined. Multi-factor interaction tests were designed by response surface method. Three independent variables including wheat straw based superabsorbent polymers (SAP), hydroxyethyl cellulose (HEC10S) and octyl glucopyranoside (APG0810) were selected. Viscosity (Y1), anti-evaporation rate (Y2) and surface tension (Y3) were determined as response values. Meanwhile, the functional relationship between the fitting factors and the response values is established by regression analysis. The results showed that the predicted values are in good agreement with the experimental values. The plant straw-based dust suppressant with 1.93% SAP, 0.10% HEC10S and 0.80% APG0810 exhibited good bonding performance, wettability and anti-evaporation rate.

Abstract This study aimed to explore the synergistic effect of lipid accumulation product (LAP) and visceral adiposity index (VAI) on diabetes risk, and to evaluate the potential associations of these novel metabolic markers with diabetes. The current cross-sectional survey utilised data from the 2015–2018 National Health and Nutrition Examination Survey (NHANES). The relationship between LAP and VAI levels and diabetes was examined using multiple logistic regression analysis. Moreover, threshold effects analysis and smoothed curve fitting were used as analytical techniques. The diabetes group exhibited significantly higher LAP (90.1 ± 84.1) and VAI (2.8 ± 2.8) levels compared to the non-diabetes group (p

Abstract Pipelines are the primary mode of oil and gas transport in cold regions. Differential frost heaving of frozen and non-frozen soil masses can damage such pipelines, posing economic and environmental risks. The present study investigates the mechanical behaviors of buried pipelines under differential frost heaving forces. A discrete forecasting model of these mechanical behaviors based on frost heaving springs is proposed. The relationship between the frost heaving amount and force at any moment is established using the Takashi empirical equation and the corresponding development of frost depth. On this basis, the properties of nonlinear frost heaving springs are disclosed. A model of pipeline mechanical state is derived to understand the deformation and stress at any moment, allowing the dynamic prediction of mechanical behaviors. The model is applied to two case studies involving the Caen and Alaska buried pipelines. The modeling results agree well with measurements taken at these pipelines, and the discrete descriptions of their mechanical modes are effective. A sensitivity analysis of the modeling results for pipelines of different size was conducted, providing a theoretical foundation for the optimal design of buried pipelines in cold regions.

Abstract Harvesting the energy from the interaction between hygroscopic materials and atmospheric water can generate green and clean energy. However, the ion diffusion process of moisture-induced dissociation leads to the disappearance of the ion concentration gradient gradually, and there is still a lack of moisture-based power generation devices with truly continuous operation, especially the duration of the current output still needs to be extended. Here, we propose a design for reconstructing the ion concentration gradient by coupling photocatalytic hydrogen evolution reaction with hydrovoltaic effect, to report a moisture-enabled electric generator (MEG) with continuous current output. We show that the introduction of the photocatalytic layer not only absorbs light energy to greatly increase the power generation of the MEG (500% power density enhancement), but more importantly, the photocatalytic hydrogen evolution process consumes the pre-stacked ions to restore the ion concentration gradient, allowing the MEG to continuously output current for more than 600 hours, which is 1 to 2 orders of magnitude higher than the great majority of existed MEGs in terms of the current output duration.

Abstract The objective of the present study was to examine the impact of different plyometric training (PT) surfaces on the adaptive changes of jumping ability, sprinting speed, change of direction ability and strength performance in volleyball players. Forty male players participated in the study and were divided into four equal groups performing PT in aquatic (APT), sand (SPT), and land (LPT) surfaces, or an active control group (CON). All training groups indicated small to large significant (p = 0.001) improvements in countermovement vertical jump (CMVJ), standing long jump (SLJ), spike jump, block jump, 10-m sprint, T-test, and maximal strength after the 6 weeks of progressive volume-based overload PT and in comparison to CON group (p

Abstract Background Formerly known as non-alcoholic fatty liver disease (NAFLD), metabolic dysfunction-associated steatotic liver disease (MASLD) has now become the most widespread chronic liver disease worldwide. The primary goal of this study is to assess the ability of different indexes (including VAI, TyG, HOMA-IR, BMI, LAP, WHtR, TyG-BMI, TyG-WC, and TyG-WHtR) to predict MASLD in individuals diagnosed with type 2 diabetes mellitus (T2DM), particularly within the Chinese population. Methods This cross-sectional study involved 1,742 patients with T2DM, recruited from the Metabolic Management Centers (MMC) at Suzhou Municipal Hospital. Abdominal ultrasonography was employed for MASLD diagnosis in patients with T2DM. The predictive accuracy of various screening indexes for MASLD in the Chinese T2DM population was evaluated using logistic regression and receiver operating characteristic (ROC) curve analyses. Results Among the 1,742 participants, 996 were diagnosed with MASLD. After adjusting for potential confounding factors, positive associations with the risk of MASLD were found for all the nine indexes. The lipid accumulation product (LAP) exhibited the greatest predictive value for detecting MASLD, with an area under the curve (AUC) of 0.786(95%CI 0.764,0.807), followed by BMI(AUC = 0.785), VAI(AUC = 0.744), TyG(AUC = 0.720), WHtR(AUC = 0.710) and HOMA-IR(AUC = 0.676). The composite Indexes (TyG-BMI, TyG-WC, TyG-WHtR) also showed considerable predictive ability with AUCs of 0.765, 0.752 and 0.748, respectively. Conclusion Our results indicated that all nine indexes have favorable correlations with the risk of MASLD, and most of them have a good performance in predicting MASLD. According to our study, LAP was a reliable index for predicting MASLD among Chinese T2DM patients. The exploration of non-invasive screenings will provide significant support for the early detection and diagnosis of MASLD.

Abstract Background Benign and malignant breast tumors differ in their microvasculature morphology and distribution. Histologic biomarkers of malignant breast tumors are also correlated with the microvasculature. There is a lack of imaging technology for evaluating the microvasculature. Ultrasound localization microscopy (ULM) can provide detailed microvascular architecture at super-resolution. The objective of this trial is to explore the role of ULM in distinguishing benign from malignant breast tumors and to explore the correlations between ULM qualitative and quantitative parameters and histologic biomarkers in malignant breast tumors. Methods/design This prospective and multicenter study will include 83 patients with breast tumors that will undergo ULM. 55 patients will be assigned to the malignant group, and 28 patients will be assigned to the benign group. The primary outcome is the differences in the qualitative parameters (microvasculature morphology, distribution, and flow direction) between benign and malignant breast tumors on ULM. Secondary outcomes include (1) differences in the quantitative parameters (microvasculature density, tortuosity, diameter, and flow velocity) between benign and malignant breast tumors based on ULM; (2) diagnostic performance of the qualitative parameters in distinguishing benign and malignant breast tumors; (3) diagnostic performance of the quantitative parameters in distinguishing benign and malignant breast tumors; (4) relationships between the qualitative parameters and histologic biomarkers in malignant breast tumors; (5) relationships between the quantitative parameters and histologic biomarkers in malignant breast tumors; and (6) the evaluation of inter-reader and intra-reader reproducibility. Discussion Detecting vascularity in breast tumors is of great significance to differentiate benign from malignant tumors and to predict histologic biomarkers. These histologic biomarkers, such as ER, PR, HER2 and Ki67, are closely related to prognosis evaluation. This trial will provide maximum information about the microvasculature of breast tumors and thereby will help with the formulation of subsequent differential diagnosis and the prediction of histologic biomarkers. Trial registration number/date Chinese Clinical Trial Registry ChiCTR2100048361/6th/July/2021. This study is a part of that clinical trial.

We developed a unique lean duplex stainless steel with a highly unstable austenite phase, exhibiting positive strain rate dependence in tensile properties. Specifically, increased strain rates enhanced the strength-ductility synergy. Adiabatic heating was actively utilized to stabilize austenite, extending the TRIP effect over a wide strain range and maintaining high strain hardening rates until a large strain particularly at high strain rates. Additionally, brittle cracking in ferrite and martensite was significantly reduced with increasing strain rate, resulting in a brittle-to-ductile transition. This discovery offers novel insights into alloy design strategies for metastable steels, improving production efficiency in forming processes.

Abstract Background Despite the significant prevalence of chronic obstructive pulmonary disease (COPD) in Southwest China, cognitive function among middle-aged and elderly individuals in this area surpasses the national average. This study aims to reveal the overall pulmonary ventilation function status of this population, and investigate whether pulmonary ventilation dysfunction is a risk factor for mild cognitive impairment (MCI) in this region, as suggested by previous researches. Methods Data were obtained from the 2019–2021 baseline survey of a natural population cohort study conducted in Southwest China. Pulmonary function was tested by experienced and well-trained medical personnel using a spirometer. The Mini-Mental State Examination was used to evaluate cognitive function. Subsequently, multiple logistic regression analysis was employed to examine the associations between pulmonary function and cognitive levels. Results A total of 2,337 middle-aged and elderly adults were included in this study, with 10.18% (238 individuals) classified as having mild cognitive impairment. According to the Chinese experts’ consensus on the standardization of adult lung function diagnosis, approximately 41.16% (962/2,337) of middle-aged and elderly individuals in Southwest China suffer from pulmonary ventilation dysfunction, predominantly mild (37.53%, 877/2,337), with the primary type being obstructive ventilation dysfunction (38.60%, 902/2,337; COPD: 14.21%, 332 participants). And 81.56% participants (1,906/2,337) were found to have small airway dysfunction. Multiple logistic regression analyses showed that individuals with poor pulmonary ventilation function (PPF) were associated with an increased risk of MCI (OR [95% CI]: 1.38 [1.04, 1.83], P = 0.026). Moreover, the more severe the pulmonary ventilation dysfunction, the higher the risk of cognitive impairment (P for trend = 0.009). Similar association were found between PPF and MCI when we use ATS/ERS technical standards. No significant association was observed between small airway dysfunction and cognitive impairment (OR [95% CI]: 1.05 [0.72, 1.56], P = 0.819). Conclusions The pulmonary function status of middle-aged and elderly individuals in Southwest China requires attention, particularly regarding obstructive pulmonary ventilation dysfunction. We recommend integrating pulmonary health assessments into routine care for these populations to raise awareness of lung health, improve lung function, and ultimately enhance cognitive function.

Abstract Inspired by the natural symbiotic relationships between diverse microbial members, researchers recently focused on modifying microbial chassis to create artificial coculture systems using synthetic biology tools. An increasing number of scientists are now exploring these systems as innovative biosynthetic platforms for biomass conversion. While significant advancements have been achieved, challenges remain in maintaining the stability and productivity of these systems. Sustaining an optimal population ratio over a long time period and balancing anabolism and catabolism during cultivation have proven difficult. Key issues, such as competitive or antagonistic relationships between microbial members, as well as metabolic imbalances and maladaptation, are critical factors affecting the stability and productivity of artificial coculture systems. In this article, we critically review current strategies and methods for improving the stability and productivity of these systems, with a focus on recent progress in biomass conversion. We also provide insights into future research directions, laying the groundwork for further development of artificial coculture biosynthetic platforms. Graphical Abstract

Abstract Background 24-hour movement behavior, including Physical activity (PA), Sedentary behavior (SB), and sleep, is independently associated with health after stroke. Few studies have explored 24-hour movement behavior patterns in stroke survivors and their transitions, as well as the health implications of the transitions. This study aimed to explore the different subgroups and stability of 24-hour movement behavior patterns in people after stroke and the relationship of profile transitions with physical function and health-related quality of life (HRQoL). Methods In this study, 131 people with first-ever stroke were investigated at one week (T1), one month (T2), three months (T3), and six months (T4) after discharge. The participants were asked to wear a wristband smartwatch for 7 consecutive days during each pe riod to collect 24-hour exercise data. After each period, their physical function and HRQoL were assessed. Latent profile analysis (LPA) identified typologies of 24-hour movement behaviors, and latent transition analysis (LTA) examined the stability and change in these profiles over time. The relationship of transition types with physical function and HRQoL was analyzed using a generalized linear regression model. Results 108 participants were categorized into 3 latent profiles of 24-hour movement behavior: “Active, Non-sedentary, and Short sleep,” “Active and Sedentary,” and “Inactive and Sedentary.” The LTA results indicated that the proportion of participants with the “Active, Non-sedentary, and Short Sleep” profile and “Active and Sedentary” profile staying in the original latent profile was high. However, participants in the “Inactive and Sedentary” profile showed a high probability of transitioning to “Active and Sedentary” profile (T1→T2: 65.2%; T2→T3: 76.3%; T3→T4: 51.7%;T1→T4: 54.2%). Transition types are associated with physical function and HRQoL. Conclusions The results demonstrated substantial transitions in 24-hour movement behaviors within 6 months of rehabilitation after discharge, associated with later physical function and HRQoL. Furthermore, the participants’ sedentary behavior was highly stable within 24-hour movement behaviors, necessitating prompt diagnosis and intervention.

Abstract Background Glioblastoma multiforme (GBM) represents the most prevalent form of primary malignant tumor within the central nervous system. The emergence of resistance to radiotherapy and chemotherapy represents a significant impediment to advancements in glioma treatment. Methods We established temozolomide (TMZ)-resistant GBM cell lines by chronically exposing U87MG cell lines to TMZ, and dimethyl sulfoxide (DMSO) was used as placebo control. In vivo and in vitro experiments verified the resistance of resistant cells to chemotherapy and radiotherapy. LAT4 was identified by transcriptomics to be associated with GBM treatment resistance and relapse. The relationship between LAT4 and mTOR pathway activity was also analyzed. Finally, the effect of BCH (LAT inhibitor) combined with radiotherapy on GBM prognosis was verified in vivo. Results We have first confirmed that TMZ not only induces resistance to chemotherapy in GBM cells but also enhances their resistance to radiotherapy, which is a significant finding in the process of building TMZ-resistant U87MG GBM cell lines. We then performed comprehensive transcriptomic analysis and identified amino acid metabolism as a potential key factor in radiotherapy resistance. Specifically, we confirmed that the upregulation of LAT4 following chemotherapy enhances leucine metabolism within tumors in vitro and in vivo, thereby modulating the mechanistic target of mTOR pathway and leading to radiotherapy resistance. Of note, the application of inhibitors targeting leucine metabolism was shown to restore the sensitivity of these cells to radiotherapy, highlighting a potential therapeutic strategy for overcoming resistance in GBM. Conclusions Our study links tumor sensitivity to chemotherapy and radiotherapy and highlights the critical role of LAT4 in activating the mTOR pathway and GBM radiotherapy resistance. It suggests ways to improve radiotherapy sensitivity to GBM.

Abstract There is a phenomenon that better teachers cannot teach out better students in knowledge distillation due to the capacity mismatch. Especially in pixel-level object segmentation, there are some challenging pixels that are difficult for the student model to learn. Even if the student model learns from the teacher model for each pixel, the student’s performance still struggles to show significant improvement. Mimicking the learning process of human beings from easy to difficult, a dynamic dropout self-distillation method for object segmentation is proposed, which solves this problem by discarding the knowledge that the student struggles to learn. Firstly, the pixels where there is a significant difference between the teacher and student models are found according to the predicted probabilities. And these pixels are defined as difficult-to-learn pixel for the student model. Secondly, a dynamic dropout strategy is proposed to match the capability variation of the student model, which is used to discard the pixels with hard knowledge for the student model. Finally, to validate the effectiveness of the proposed method, a simple student model for object segmentation and a virtual teacher model with perfect segmentation accuracy are constructed. Experiment results on four public datasets demonstrate that, when there is a large performance gap between the teacher and student models, the proposed self-distillation method is more effective in improving the performance of the student model compared to other methods.

Abstract Background Retroperitoneal abscesses caused by donor-derived Carbapenem-Resistant Klebsiella Pneumoniae (CRKP) infections are rare and often challenging to diagnose early due to a lack of specific symptoms. Case presentation In case one, a 64-year-old male presented with unexplained fever and emaciation three months after undergoing a kidney transplant for end-stage renal disease. Metagenomic Next-Generation Sequencing identified CRKP in peripheral blood samples, and CT scans confirmed a retroperitoneal abscess. Considering the infectious status of the donor and other recipients, donor-derived infection (DDI) was suspected. Surgical incision and drainage were performed along with anti-infection treatment and immunosuppressive agents were adjusted. There was no recurrence of infection after a six-month follow-up. In case two, a 45-year-old male was readmitted due to light red pus discharge from the drainage tube fistula on day 32 after undergoing a kidney transplant for end-stage renal disease. A CT scan confirmed a retroperitoneal abscess between the kidney allograft and the spinal column. Based on the culture results of the purulent sample and perfusion fluid from the donor kidney, DDI was suspected, leading to prompt surgical incision and drainage, along with anti-infection treatment. After a five-month follow-up period, no infection recurrence was observed. Conclusions This study reported two cases of retroperitoneal abscesses caused by DDI following kidney transplantation, highlighting the importance of considering donor-derived CRKP infections in transplant recipients presenting with unexplained symptoms. Timely interventions are crucial for effective management and prevention of recurrence.

Abstract The research on hypernetworks robustness focuses on improving their ability to resist various risks such as attacks and disasters. In the face of deliberate attacks, there is a huge risk of failure in Barabási-Albert (BA) hypernetworks. However, the methods to improve the risk resistant capacity of BA hypernetwork are lack. In this paper, two optimization mechanisms are proposed based on structural characteristics and connectivity. They are the self-optimization mechanism of random recombination for hyperedges(RRH) and the self-optimization mechanism of low degree preference recombination for hyperedges(LDPRH). The best improvement performance (BIP) is used as the evaluation metric, and a comparative analysis is conducted to assess the effectiveness of these mechanisms in enhancing the robustness of BA hypernetworks through simulation experiments. The research results indicate that both mechanisms effectively improve the hypernetwork’s risk resistance, but the optimization effects differ. When the number of recombined hyperedges is 0.2*M (where M is the total number of hyperedges in the hypernetwork), the BIP of the random recombination mechanism stabilize at 25%, while the BIP of the low preference recombination mechanism ultimately reaches about 65%. To further validate the effectiveness of these optimization mechanisms, they were applied to Newman-Watts (NW) hypernetworks and Barabási-Albert (BA) ordinary networks, the latter based on binary relationships. The results showed that these optimization mechanisms also improved the risk resistance of NW hypernetworks and BA ordinary networks, especially in the BA ordinary network, where the BIP could reach up to 73%. Additionally, a significant correlation is observed between BIP, the number of hyperedge reshuffling operations, and the uniformity of the hypernetwork. Moreover, these optimization mechanisms are further validated in the context of China’s high-speed railway hypernetwork, highlighting their practical application potential.

Abstract Influenza virus infections are a serious danger to people’s health worldwide as they are responsible for seasonal flu outbreaks. There is an urgent need to improve the effectiveness and durability longevity of the immune response to influenza vaccines. We synthesized the CpG HP021 and examined the impact of it on the immune response to an influenza vaccine. In BALB/c mice, hemagglutination inhibition (HI) titers to the vaccine were increased four- to eightfold against H1N1, H3N2, BV, and BY viruses by 3 μg IIV4 + 40 μg CpG HP021 compared with those of the non-adjuvanted IIV4 group, and the CpG HP021 group had a broader HI activity. Additionally, the immune response was directed towards Type 1 T helper (Th1) cells due to the CpG HP021 adjuvant. The CpG HP021-adjuvanted IIV4 induced a higher number of T cells secreting interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α), and increased the percentage of effector memory T cells in mice. In SD rats, the immune responses induced by IIV4 with CpG HP021 were similar to those in BALB/c mice. The development of CpG HP021 may expand the options for adjuvants in vaccines against infectious diseases.

Abstract Background Rice, as one of the most important staple crops, its genetic improvement plays a crucial role in agricultural production and food security. Although extensive research has utilized single nucleotide polymorphisms (SNPs) data to explore the genetic basis of important agronomic traits in rice improvement, reports on the role of other types of variations, such as insertions and deletions (INDELs), are still limited. Results In this study, we extracted INDELs from resequencing data of 148 rice improved varieties. We identified 938,585 INDELs and found that as the length of the variation increases, the number of variations decreases, with 89.0% of INDELs being 2–10 bp. The highest number of INDELs was found on chromosome 1, while the least was on chromosome 10. INDELs were unevenly distributed across the genome, generating a total of 33 hotspot regions. 47.0% of INDELs were located within 2 kb upstream and downstream of genes. Using phenotypic data from five agronomic traits (heading date, flag leaf length, flag leaf width, panicle number, and plant height) along with INDEL data to perform genome-wide association study (GWAS), we identified 6,331 significant loci involving 157 cloned genes. Haplotype analysis of candidate genes revealed INDELs affecting important functional genes, such as OsMED25 and OsRRMh related to heading date, and MOC2 related to plant height. Conclusions Our work analyzed the variation patterns of INDELs in rice improvement and identified INDELs associated with agronomic traits. These results will provide valuable genetic and material resources for the genetic improvement of rice.

The deformation of a target plate in underwater explosion is manifested as a complex nonlinear coupling interaction between the structure and the fluid under the impact of shock waves. In this paper, a deep learning neural network is designed and optimized to predict the dynamic deformation displacement data of the target plate under different conditions of target plate thickness, shock factor, explosive dosage, and explosion distance. The coefficient of determination and accuracy of prediction on the test set reach 0.99 and 0.95, respectively. Compared with 25 simulation conditions, the explosion deformation response analysis graph formed by 9 261 working conditions based on the prediction model can cover a more detailed range of characteristic parameters and the trend of maximum deformation variation, providing important reference for underwater weapon design and underwater protection applications.

Perinatal depression is a psychological disorder that occurs during pregnancy and within one year of delivery, which can seriously affect the physical and mental health of pregnant and postpartum women, as well as the cognitive and behavioral abilities of offspring, with potential multigenerational effects. Therefore, it is important to identify its potential modifiable risk factors. Phthalic acid esters (PAEs), as common environmental endocrine disruptors, can affect maternal estrogen through multiple mechanisms and are important potential modifiable risk factors for developing maternal perinatal depression. At present, studies on the correlation between PAEs and perinatal depression are still very limited, and the mechanisms by which PAEs affect perinatal depression have not been clarified. Based on existing epidemiological and toxicological studies at home and abroad, the article briefly introduced the characteristics of multiple pathways, high doses, and long-term exposure to maternal PAEs, focused on reviewing the current status of epidemiological studies, pointed out the possible associations between some specific PAEs exposure and elevated risk of perinatal depression. It also summarized the potential roles of hormone-neurotransmitter pathway, inflammation mediation, gene regulation, and other possible mechanisms in the association between exposure to PAEs and perinatal depression. The article concluded with a look at how future research on the association between exposure to PAEs and perinatal depression can be scientifically validated, with a view to providing more high-quality evidence for the scientific prevention of the onset and progression of maternal depressive symptoms.

Background: S100A8 is a member of the S100 protein family and plays a pivotal role in regulating inflammation and tumor progression. This study aimed to comprehensively assess the expression patterns and functional roles of S100A8 in glioma progression. Methods: Glioma tissues were collected from 98 patients who underwent surgical treatment at Fudan University Shanghai Cancer Center. S100A8 expression in glioma tissues was analyzed using immunohistochemistry (IHC) to establish its correlation with clinicopathological features in patients. The expression and prognostic effect of S100A8 in glioma were analyzed using TCGA and CGGA public databases. Then, we investigated the role of S100A8 in glioma through a series of in vivo and in vitro experiments including Transwell, wound healing, CCK8, and intracranial tumor models. Subsequently, bioinformatics analysis, single-cell sequencing and coimmunoprecipitation (Co-IP) were used to explore the underlying mechanism. Results: S100A8 was upregulated in gliomas compared to paracancerous tissues, and this phenotype was significantly correlated with poor prognosis. Subgroup analysis showed that S100A8 expression was higher in the high-grade glioma (HGG) group than that in the low-grade glioma (LGG) group. S100A8 overexpression in glioma cell lines promoted cell proliferation, migration and invasion, while silencing S100A8 reversed these effects. In vivo experiments showed that S100A8 knockdown can significantly reduce the tumor burden of glioma cells. Notably, S100A8 was observed to stimulate microglial M2 polarization by interacting with TLR4, which subsequently induced NF-κB signaling and IL-10 secretion within the tumor microenvironment. Conclusions: S100A8 promotes tumor progression by inducing phenotypic polarization of microglia through the TLR4/IL-10 signaling pathway in glioma. It might represent a therapeutic target for further basic research or clinical management of glioma.

In object segmentation, the existence of hard-classified-pixels limits the segmentation performance. Focusing on these hard pixels through assigning different weights to pixel loss can guide the learning of segmentation model effectively. Existing loss weight assignment methods perceive pixels hardness by current predicted information, pay less attention to past predicted information. While current studies show that samples with less improvement in predicted probability compared to the past are difficult to learn. To define hard pixels more accurately, a hardness-aware loss for object segmentation is proposed. Firstly, the metric of pixel hardness degree is defined, and a mapping function is proposed to quantitatively evaluate the hardness degree which is defined on the difference between current and past predicted probabilities. Then a new compound metric, hardness value, is defined based on hardness degree and the uncertainty. Based on the compound metric, a new loss function is proposed. Experiment results on four datasets using convolutional neural network and Transformer as the backbone models demonstrate that the proposed method effectively improves the accuracy of object segmentation. Especially, in the segmentation model based on ResNet-50, the proposed method improves mean Intersection over Union (mIoU) by almost 4.3 % compared to cross entropy on DUT-O dataset.

The advantages of multi-element carbides with combination of outstanding physical properties such as high hardness, high melting points, good resistance to corrosion, oxidation are attracting considerable interests due to their potential applications at extreme conditions. Herein, a new type of hexagonal ternary transition metal carbosilicides TM0.5Si0.5C (TM = Cr, Mo, W) possessing high-temperature stability and improved mechanical properties like hardness, toughness and strengths relative to the well-known SiC are firstly reported and systematically studied using first-principles calculations. Employing a hybrid approach that integrates ab initio molecular dynamics (AIMD) simulations with lattice dynamics, we determined the renormalized phonon spectra at high temperatures, confirming their dynamic and thermodynamic stabilities up to 2500 K. Utilizing a refined approach within density-functional AIMD simulations, we also investigate the ideal strengths at different temperatures, revealing these compounds exhibit large tensile strengths up to 35 GPa even at 2000 K. Electronic analysis indicates that the orbital hybridizations of TM-d and C-p as well as Si-p and C-p play the key role in determining the exceptional mechanical properties. Correlating the current results with our prior findings, we formulate a general principle guiding the design of a new class of hard multi-element ceramic compounds with superior mechanical properties and high-temperature stability.

Abstract Background Microvascular obstruction (MVO) develops in approximately 50% of patients with ST-segment elevation myocardial infarction (STEMI) after undergoing percutaneous coronary intervention (PCI). MVO is strongly linked to inflammation, myocardial fibrosis, and adverse clinical outcomes. Soluble suppression of tumorigenicity 2 (sST2) serves as a biomarker for inflammation and myocardial fibrosis. Yet, the correlation between sST2 and MVO in STEMI patients has not been fully elucidated. This study attempts to evaluate the association between sST2 levels and MVO in STEMI patients following pPCI. Methods In this retrospective study, 315 STEMI patients who underwent pPCI at the Affiliated Hospital of Xuzhou Medical University between June 2018 and August 2023 were included. Cardiac magnetic resonance imaging (CMR) was used to assess the characteristics of myocardial infarction and microvascular obstruction (MVO), while sST2 levels were measured upon admission. Results The median time for completion of CMR after hospitalization was 5 (4, 6) days. Multivariate regression analysis showed that sST2 (OR 1.01, 95% CI 1.01–1.02, p

Abstract The efficacy of loncastuximab tesirine (lonca) following chimeric antigen receptor T-cell therapy (CAR-T) progression/failure is unknown. Hence, we sought to examine real-world use and outcomes of lonca following CAR-T in patients with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) in the USA. In this retrospective study, we included adults (age ≥ 18 years) with R/R DLBCL who received lonca monotherapy as third- (3 L) or fourth line (4 L) treatment after progressing on second line (2 L) or 3 L CAR-T, respectively. Post-CAR-T lonca outcomes included response rates (overall response rate [ORR] and complete response [CR] rate), duration of response (DOR), progression-free survival (PFS), and overall survival (OS). A total of 118 patients were included in the analysis with 95 receiving lonca following 2 L CAR-T (median age:66 years; 61% male) and 23 following 3 L CAR-T (median age:57 years; 43% male). Patients with 2 L CAR-T/3 L lonca had an ORR of 73% (CR rate of 34%). With a median follow-up of 8.5 months following lonca initiation, median DOR, PFS, and OS were not reached. The DOR, PFS, and OS at 12 months were 68%, 77%, and 84%, respectively. Patients with 3 L CAR-T/4 L lonca had an ORR of 78% (CR rate of 17%). With a median follow-up of 13 months following lonca initiation, the median DOR and PFS were 7.6 and 12.0 months, while median OS was not reached. OS at 12 months was 95%. In this study, we found that lonca monotherapy was an effective treatment option in R/R DLBCL in 3 L and 4 L settings including those who were resistant to or progressed after CAR-T.

Abstract Background The issue of whether abortion increases the risk of future mental health problems for women remains a debated topic, and there is a lack of evidence from large-scale studies conducted in China. This study aimed to investigate the potential associations between abortions, particularly repeated abortions, and the mental health status of postmenopausal women in Southwest China. Methods The data were obtained from the baseline survey of a multi-center natural population cohort study in cooperated with medical consortia in Southwest China. A standard structured questionnaire was used to assess abortion status among women of childbearing age. The 7-item Generalized Anxiety Disorder Scale (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9) were used to evaluate psychological well-being. Subsequently, multiple logistic regression analysis was employed to examine the associations between the quantity and reasons for abortions and the mental health status of postmenopausal women. Results A total of 9991 postmenopausal women were enrolled (mean age: 60.51 years), of whom 11.09% (1108 individuals) reported mental health problems (5.54% for depression and 8.27% for anxiety). Multiple logistic regression analysis revealed that, compared with women without any history of abortion, postmenopausal women who reported three or more abortions during their childbearing years were likely to have worse mental health conditions (OR [95% CI]: 1.37 [1.13, 1.67]). Additionally, women who reported a history of abortions for socio-economic reasons were also correlated with an increased risk of mental health issues after menopause (OR [95% CI]: 1.34 [1.08, 1.66]). Conclusions Women who reported a history of three or more abortions were at an increased risk of experiencing mental health issues after menopause. Reproductive-age women should enhance their contraceptive awareness to prevent unintended pregnancies and subsequent abortions. Healthcare institutions are recommended to strengthen psychological counseling for women who have undergone abortions.

Abstract Due to the aim of developing sustainable energy systems, promoting the large‐scale accommodation of distributed renewable energy sources (DRESs) and flexible loads in DC distribution networks (DCDNs) is significant. The uncertainty of DRESs and the insufficient use of flexible loads pose a considerable challenge to the economical and safe operation of DCDNs. To address the challenge, this paper puts forward a two‐stage optimal scheduling model for the DCDNs considering flexible load response. The proposed model realises joint economic optimisation and reactive power optimisation, which is solved by the hybrid NSGAII‐MOPSO algorithm and the CPLEX. The performance of the proposed model in the modified Institute of Electrical and Electronics Engineers 33‐node system with the DCDNs is validated under different scenarios. The hybrid NSGAII‐MOPSO performs better in obtaining the Pareto front than the NSGA‐II and MOPSO individually. Compared to the traditional scheduling model, the proposed model can realise the power coordination of the flexible loads and energy storage systems to reduce the negative impact of uncertainty of DRESs while decreasing operating costs and carbon emissions by 3.94% and 36.4%. In addition, the proposed model can alleviate the network losses and ensure the node voltage for the DCDNs. Hence, the efficiency of the proposed model has been confirmed.

Abstract Urban road networks function as surface passage for floodwater transport during extreme storm events to reduce potential risks in the city. However, precise estimation of these flow rates presents a significant challenge. This difficulty primarily stems from the intricate three-dimensional flow fields at road intersections, which the traditional one-dimensional models, such as Storm Water Management Model (SWMM), fail to precisely capture. The two-dimensional and three-dimensional hydraulic models are overly complex and computationally intensive and thus not particularly efficient. This study addresses these issues by integrating a semiempirical flow diversion formula into the SWMM source code. The semiempirical formula, derived from hydraulic experiments and computational fluid dynamics simulations, captures the flow dynamics at T-shaped intersections. The modified SWMM’s performance was evaluated against experimental data, and the original SWMM, the two-dimensional MIKE21, and the three-dimensional FLUENT models. The results indicate that the modified SWMM matches the precision of the two-dimensional MIKE21, while significantly reducing computational time. Compared to MIKE21, this study achieved a Nash-Sutcliffe efficiency of 0.9729 and a root mean square error of 0.042, with computational time reduced by 99%. The modified SWMM is suitable for real-sized urban road networks. It provides a high-precision tool for urban road drainage system computation that is crucial for effective stormwater management.

Abstract Background The brown planthopper (BPH) is an economically significant pest of rice. Bph3 is a key BPH resistance gene. However, the proteomic response of rice to BPH infestation, both in the presence and absence of Bph3, remains largely unexplored. Results In this study, we employed tandem mass tag labeling in conjunction with liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis to identify differentially expressed proteins (DEPs) in rice samples. We detected 265 and 125 DEPs via comparison of samples infected with BPH for 2 and 4 days with untreated samples of the BPH-sensitive line R582. For the Bph3 introgression line R373, we identified 29 and 94 DEPs in the same comparisons. Bioinformatic analysis revealed that Bph3 significantly influences the abundance of proteins associated with metabolic pathways, secondary metabolite biosynthesis, microbial metabolism in diverse environments, and phenylpropanoid biosynthesis. Moreover, Bph3 regulates the activity of proteins involved in the calcium signaling pathway, mitogen-activated protein kinase (MAPK) signaling pathway, and plant hormone signal transduction. Conclusions Our results indicate that Bph3 enhances the resistance of rice to BPH mainly by inhibiting the down-regulation of proteins associated with metabolic pathways; calcium signaling, the MAPK signaling pathway, and plant hormone signal transduction might also be involved in BPH resistance induced by Bph3.

Abstract Cytokinin Response Factors (CRFs) play a crucial role in plant growth and development, hormone signaling, and responses to biotic and abiotic stresses. However, there have been no reports on CRF genes in rice until now. We analyzed the CRF families in four rice subspecies: cultivated rice Oryza sativa Japonica Group, Oryza sativa Indica Group, and Oryza sativa (circum-Aus1 var. N22), as well as wild rice Oryza rufipogon. We identified 7, 6, 6, and 7 CRF in their genomes, respectively, distributed across different chromosomes. The protein motifs and gene structures of CRF in these four types of rice show high conservation. Cis-regulatory element analysis revealed that the promoter regions of the CRF contain numerous hormone and stress-related elements. The number of CRF in these four types of rice is not influenced by gene duplication. The expression pattern showed that OsCRF exhibit significant tissue-specific expression. The qRT-PCR results showed that OsCRF strongly responded to low-temperature stress and can be induced by melatonin and cytokinin to increase expression levels. In addition, the nuclear localisation of OsCRF4/5 was confirmed to be as predicted. The results above will provide a foundation for further and deeper investigation of CRFs.

Abstract This paper employs two-way fixed effects models, mediation models and spatial panel models to examine the impact of digital economy development on carbon emission intensity in 72 countries from 2013 to 2020 using TIMG index as the proxy variable of digital economic development. The results of this paper show that (1) there is an inverted U-shaped relationship between the development of the digital economy and the carbon emissions in various countries. The development of digital economy first has a positive effect on carbon emissions, and then, its impact turns negative after it reaches a designated inflection point. (2) The results of the mechanism analysis show that the development of the digital economy can reduce carbon emissions by promoting industrial upgrading, while it could have an inverted U-shaped nonlinear effect on carbon emissions through energy efficiency. (3) The development of a country’s digital economy may have a significantly inverted U-shaped spatial spillover effect on neighboring countries. This paper provides reference for countries to formulate carbon emission reduction policies and promote the coordinated development of digital economy and environmental protection.

By regulating the proportion of large and small boron nitride particles, BN-ZrO2-SiC composites with particle gradation are designed. Through the strategy of particle grading, small particles could be filled into the “card-house structure” formed by h-BN with large particle size, promoting the densification process. At the same time, this also shortens the mass transfer distance between particles, which is conducive to the mass transfer during the hot-pressing sintering. On the basis of achieving the second phase strengthening effect, the performance of hexagonal boron nitride composite has been further improved. The results demonstrate that by a volumetric proportionality of 6:4 between the constituent large particle (7 μm) and small (1 μm) particle. Thus, the BN-ZrO2-SiC composite with high density has been successfully fabricated at a sintering temperature of 1700 °C under 25 MPa. The optimization mechanical properties of BN-ZrO2-SiC composites are achieved when the volumetric ratio of large particle (7 μm) to small (1 μm) particle is 6:4. The optimal flexural strength, fracture toughness, Vickers’ hardness and elastic modulus is 187 ± 4 MPa, 2.2 ± 0.3 MPa m1/2, 0.74 ± 0.06 GPa, and 57 ± 1.1 GPa, respectively. Comparing to the h10 and H10 sample, the thermal conductivity of samples with particle size gradation has been improved, especially the H8h2 and H4h6 samples. The thermal conductivity is significantly enhanced from 14.79 W/(m·K) to 16.83 W/(m·K).

Background: Evidence has demonstrated that visceral fat area (VFA) and subcutaneous fat area (SFA) have different influences on cardiovascular disease (CVD) risk in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the relationship between the visceral fat area (VFA), the subcutaneous fat area (SFA) ratio (V/S), and carotid atherosclerosis (CAS) in patients with T2DM. Methods: From January 2018 to May 2023, 1838 patients with T2DM admitted to the National Metabolic Management Centre in our hospital were assigned to two groups based on comorbid CAS. Dual bioelectrical impedance analysis was used to measure the VAF and SFA, and the V/S was calculated. Patient characteristics and serum biochemical indices were compared between groups. Factors influencing comorbid CAS were determined, and correlations between V/S and other clinical indices were analyzed. Results: The group with comorbid CAS included 858 individuals and 980 without comorbid CAS. Those with comorbid CAS were older and had a longer disease duration, more significant systolic blood pressure, and greater V/S. The proportions of patients with comorbid hypertension increased significantly with the V/S ratio. The V/S ratio positively correlated with triglyceride (TG), low-density lipoprotein cholesterol levels, and waist circumference. According to binary logistic regression analysis, V/S was an independent risk factor for CAS. Conclusion: Elevated V/S is an independent risk factor for CAS in patients with T2DM.

Cotton is an important natural fiber crop worldwide which plays a vital role in our daily life. High yield is a constant goal of cotton breeding, and lint percentage (LP) is one of the important components of cotton fiber yield. A stable QTL controlling LP, qLPA01.1, was identified on chromosome A01 from Gossypium hirsutum introgressed lines with G. tomentosum chromosome segments in a previous study. To fine-map qLPA01.1, an F2 population with 986 individuals was established by crossing G. hirsutum cultivar CCRI35 with the chromosome segment substitution line HT_390. A high-resolution genetic map including 47 loci and spanning 56.98 cM was constructed in the QTL region, and qLPA01.1 was ultimately mapped into an interval corresponding to an ~80 kb genome region of chromosome A01 in the reference genome, which contained six annotated genes. Transcriptome data and sequence analysis revealed that S-acyltransferase protein 24 (GoPAT24) might be the target gene of qLPA01.1. This result provides the basis for cotton fiber yield improvement via marker-assisted selection (MAS) and further studies on the mechanism of cotton fiber development.

Abstract Background The global rise in developmental delays underscores the critical need for a thorough understanding and timely interventions during early childhood. Addressing this issue, the Chinese Baby Connectome Project (CBCP)’s behavior branch is dedicated to examining language acquisition, social-emotional development, and environmental factors affecting Chinese children. The research framework is built around three primary objectives: developing a 0–6 Child Development Assessment Toolkit, implementing an Intelligent Coding System, and investigating environmental influence. Methods Utilizing an accelerated longitudinal design, the CBCP aims to enlist a minimum of 1000 typically developing Chinese children aged 0–6. The data collected in this branch constitutes parental questionnaires, behavioral assessments, and observational experiments to capture their developmental milestones and environmental influences holistically. The parental questionnaires will gauge children’s developmental levels in language and social-emotional domains, alongside parental mental well-being, life events, parenting stress, parenting styles, and family relationships. Behavioral assessments will involve neurofunctional developmental evaluations using tools such as the Griffiths Development Scales and Wechsler Preschool and Primary Scale of Intelligence. Additionally, the assessments will encompass measuring children’s executive functions (e.g., Head-Toe-Knee-Shoulder), social cognitive abilities (e.g., theory of mind), and language development (e.g., Early Chinese Vocabulary Test). A series of behavior observation. experiments will be conducted targeting children of different age groups, focusing primarily on aspects such as behavioral inhibition, compliance, self-control, and social-emotional regulation. To achieve the objectives, established international questionnaires will be adapted to suit local contexts and devise customized metrics for evaluating children’s language and social-emotional development; deep learning algorithms will be developed in the observational experiments to enable automated behavioral analysis; and statistical models will be built to factor in various environmental variables to comprehensively outline developmental trajectories and relationships. Discussion This study’s integration of diverse assessments and AI technology will offer a detailed analysis of early childhood development in China, particularly in the realms of language acquisition and social-emotional skills. The development of a comprehensive assessment toolkit and coding system will enhance our ability to understand and support the development of Chinese children, contributing significantly to the field of early childhood development research. Trial registration This study was registered with clinicaltrials.gov NCT05040542 on September 10, 2021.

Background Periprosthetic bone loss is a well‐known phenomenon following total hip arthroplasty (THA). However, the choice of drugs for prevention remains controversial. Therefore, the aim of this study was to determine the best drug to treat periprosthetic bone loss by comparing changes in bone mineral density (BMD) at different times after THA. Methods A comprehensive search of five databases and two clinical trial registration platforms was undertaken from their inception through to August 31, 2023 to identify eligible randomized controlled trials. A Bayesian network meta‐analysis (NMA) was carried out for calculating the standardized mean difference (SMD) and the surface under cumulative ranking curve (SUCRA) of the BMD in calcar (Gruen zone 7) at 6 months, 12 months, and 24 months and over. Results Twenty‐nine trials involving 1427 patients and 10 different interventions were included. The results demonstrated that at 6 months, denosumab had the highest ranking (SUCRA = 0.90), followed by alendronate (SUCRA = 0.76), and zoledronate (SUCRA = 0.73). At 12 months, clodronate ranked highest (SUCRA = 0.96), followed by denosumab (SUCRA = 0.84) and teriparatide (SUCRA = 0.82). For interventions with a duration of 24 months and over, denosumab had the highest SUCRA value (SUCRA = 0.96), followed by raloxifene (SUCRA = 0.90) and zoledronate (SUCRA = 0.75). Conclusion Investigating the existing body of evidence revealed that denosumab demonstrates potential as an intervention of superior efficacy at the three specifically examined time points. However, it remains crucial to conduct further research to confirm these findings and determine the most effective treatment strategy.

Abstract The sugar and organic acid content significantly impacts the flavor quality of star fruit, and it undergoes dynamic changes during development. However, the metabolic network and molecular mechanisms governing the formation of sugar and organic acid in star fruit remain unclear. In this study, 23 of 743 components were detected by metabonomic analysis. The highest metabolites contents were organic acids and derivatives. The highest sugar content in the fruit was fructose and glucose, followed by sucrose, which proved that A. carambola is a hexose accumulation type fruit. Genome identification preliminarily screened 141 genes related to glucose metabolism and 67 genes related to acid metabolism. A total of 7,881 unigenes were found in transcriptome data, 6,124 differentially expressed genes were screened, with more up-regulated than down-regulated genes. Transcriptome and metabolome association analysis screened seven core candidate genes related to glucose metabolism and 17 core genes highly related to organic acid pathway, and eight differentially expressed sugar and acid genes were selected for qRT-PCR verification. In addition, 29 bHLHs and eight bZIPs transcription factors were predicted in the glucose metabolism pathway, and 23 MYBs, nine C2H2s transcription factors and one GRAS transcription factor was predicted in the acid metabolism pathway, and transcription factors have both positive and negative regulatory effects on sugar and acid structure genes. This study increased our understanding of A. carambola fruit flavor and provided basic information for further exploring the ornamental and edible values of star fruit.

Abstract Patients with chronic kidney disease (CKD) often have impaired immune function, making them more prone to infections that can lead to sepsis. The coexistence of these conditions can result in decreased hemoglobin levels and is associated with a higher mortality rate. To investigate whether the transfusion of red blood cells (RBCs) improves the prognosis of septic patients with concomitant CKD and to explore the indications for red blood cell transfusion. This retrospective cohort study utilizes data from the MIMIC-IV (v2.0) database. The study enrolled 6,604 patients with sepsis and concomitant CKD admitted to the Intensive Care Unit (ICU). Propensity score matching (PSM) was applied to adjust for confounding factors. Multivariate Cox regression analysis revealed an association between RBC transfusion and a decreased risk of 28-day mortality (HR: 0.61, 95% CI: 0.54–0.70, P

Abstract Background Cardiac lipoma, a seldom-encountered benign tumor positioned beneath the endocardium, has the potential to impair electrophysiological functions. Diagnosis is principally based on imaging modalities. The uniqueness of this case lies in the tumor’s extension both internally and externally within the right atrium, rendering it of special interest. From a clinical standpoint, surgical removal is commonly advocated, wherein early intervention is pivotal in improving patients’ long-term prognoses. Case presentation A 35-year-old male was admitted to the hospital for treatment subsequent to the identification of a cardiac mass two days prior. Initial diagnostic assessments, encompassing CT scans and echocardiography, identified a space-occupying lesion within the heart. The patient underwent surgical excision of the cardiac tumor, utilizing mild hypothermic extracorporeal circulation via femoral vessel access. Intraoperative findings revealed adipose-like tissue of a “dumbbell-shaped” configuration situated both within and external to the right atrium, measuring approximately 8 cm*9 cm internally and 7 cm*6 cm externally, with the extracardiac mass being marginally larger. Postoperative pathological analysis confirmed a cardiac lipoma diagnosis. A follow-up echocardiogram conducted three months post-surgery exhibited no notable abnormalities. The patient is under continuous observation to monitor for any recurrence or potential long-term complications. Conclusion In this case report, we detail with precision a rare cardiac pathology manifested by an expansive infiltrative lipoma that pervades the endocardial and epicardial layers of the right atrium. After thorough preoperative diagnostic workup and evaluation, we contend that surgical intervention represents the optimal therapeutic approach for managing such conditions, with the goal of preemptively reducing the likelihood of cardiac compression or intracardiac obstruction.