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Abstract The aim of this study was to explore gestational weight gain (GWG) trajectories and their associations with adverse pregnancy outcomes. A retrospective cohort study including 11,064 women with gestational diabetes mellitus (GDM) was conducted between 2015 and 2019 in China. The latent class trajectory model was used to identify GWG trajectories, and logistic regression was performed to examine odds ratio (OR) of pregnancy outcomes. Three trajectories of GWG were identified in these 11,604 women with GDM. Trajectory 1: 64.02% of women had sustained moderate GWG throughout pregnancy; Trajectory 2: 17.75% of women showed a high initial GWG but followed by a low GWG from the third trimester until delivery; Trajectory 3: 18.23% had low initial GWG but followed by drastic GWG from the second trimester until delivery. Compared with pregnant women with Trajectory 1, women with Trajectory 2 had a higher risk of large for gestational age (adjusted odds ratio [AOR]: 1.29, 95% confidence interval [CI]: 1.12–1.48) but at a lower risk of having hypertensive disorders of pregnancy (AOR: 0.76, 95% CI: 0.57–0.96). Women in Trajectory 3 were more likely to develop small for gestational age (AOR: 2.12, 95% CI: 1.62–2.78), low birthweight (AOR: 1.49, 95% CI: 1.07–2.08), preterm birth (AOR: 1.28, 95% CI: 1.05–1.63), caesarean section (AOR: 1.26, 95% CI: 1.112–1.42) and hypertensive disorders of pregnancy (AOR: 2.24, 95% CI: 1.82–2.76). The association of GWG trajectory with adverse pregnancy outcomes differs across prepregnancy body mass index and GWG categories. Women with a slow initial GWG but followed by drastic GWG had higher risks of adverse pregnancy outcomes. Early clinical recognition of poor GWG trajectory will contribute to early intervention in high‐risk groups to minimise adverse outcomes.

Introduction Digital therapeutics have been approved as a treatment aid for various medical conditions and are increasingly prevalent. Despite numerous studies on the potential of digital therapeutic interventions in preventing gestational diabetes mellitus (GDM), there is a critical need for more high-quality, large-scale studies to validate their effectiveness. This need arises from the inconsistencies in results and variations in the quality of previous research.Methods and analysis We propose a non-randomised controlled trial involving 800 high-risk pregnant women in 6 maternity and child health hospitals in Fujian, China. This study aims to investigate the role and effectiveness of digital therapeutics-based lifestyle intervention in managing the health of pregnant women at high risk for GDM. The study will compare the differences in GDM prevalence, pregnancy weight management and other pregnancy-related health outcomes between pregnant women who received digital therapeutics-based lifestyle intervention and those in the control group. The intervention includes dietary guidance, a personalised physical activity programme and lifestyle improvement strategies delivered through a smartphone app. Primary outcomes include the incidence of GDM at 24–28 weeks gestation and gestational weight gain (GWG). Secondary outcomes comprise improvements in individual lifestyle and risk factors, nutritional issues, implementation outcomes and other pregnancy-related outcomes.Ethics and dissemination section The trial was approved by the Ethics Committee of Fujian Maternity and Child Health Hospital (approval number: 2023KY046), Jianyang Maternity and Child Health Hospital (approval number: A202401), Fuqing Maternity and Child Health Hospital (approval number: FY2024003), Changting Maternity and Child Health Hospital (approval number: 202401), Datian Maternity and Child Health Hospital (approval number: dtfy202401) and Quanzhou Maternity and Child Health Hospital (approval number: 2024(50)). We will disseminate our findings by publishing articles in leading peer-reviewed journals.Trial registration number ChiCTR2300071496.

Abstract So-called Z-scheme systems permit overall water splitting using narrow-bandgap photocatalysts. To boost the performance of such systems, it is necessary to enhance the intrinsic activities of the hydrogen evolution photocatalyst and oxygen evolution photocatalyst, promote electron transfer from the oxygen evolution photocatalyst to the hydrogen evolution photocatalyst, and suppress back reactions. The present work develop a high-performance oxysulfide photocatalyst, Sm2Ti2O5S2, as an hydrogen evolution photocatalyst for use in a Z-scheme overall water splitting system in combination with BiVO4 as the oxygen evolution photocatalyst and reduced graphene oxide as the solid-state electron mediator. After surface modifications of the photocatalysts to promote charge separation and redox reactions, this system is able to split water into hydrogen and oxygen for more than 100 hours with a solar-to-hydrogen energy conversion efficiency of 0.22%. In contrast to many existing photocatalytic systems, the water splitting activity of the present system is only minimally reduced by increasing the background pressure to 90 kPa. These results suggest characteristics suitable for applications under practical operating conditions.

Introduction: Hyperglycaemia induces the production of a large quantity of reactive oxygen species (ROS) and activates the transforming growth factor β1(TGF-β1)/Smad signalling pathway, which is the main initiating factor in the formation of diabetic nephropathy. Indoxyl sulfate (IS) is a protein-binding gut-derived uraemic toxin that localizes to podocytes, induces oxidative stress and inflames podocytes. The involvement of podocyte damage in diabetic nephropathy through the TGF-β1/) signalling pathway is still unclear. Methods: In this study, we cultured differentiated rat podocytes in vitro and measured the expression levels of nephrin, synaptopodin, CD2AP, SRGAP2a and α-SMA by quantitative real-time PCR (qRT‒PCR) and western blotting after siRNA-mediated TGF-β1 silencing, TGF-β1 overexpression and the presence of the ROS inhibitor acetylcysteine. We detected the expression levels of nephrin, synaptopodin, CD2AP, SRGAP2a, SRGAP2a in the Smad2/3, phosphorylated-Smad2/3 (p-Smad2/3), Smad7, NADPH oxidase 4 (NOX4), and ROS levels under high glucose (HG) and IS conditions. Results: The results indicated that nephrin, synaptopodin, CD2AP and SRGAP2a expressions were significantly upregulated and α-SMA expression was significantly downregulated in the presence of HG under siRNA-mediated TGF-β1 silencing or after the addition of acetylcysteine. However, in the presence of HG, the expressions of nephrin, synaptopodin, CD2AP and SRGAP2a were significantly downregulated, and the expression of α-SMA was significantly upregulated with the overexpression of TGF-β1. IS supplementation under HG conditions further significantly reduced the expressions of nephrin, synaptopodin, CD2AP and SRGAP2a; altered the expressions of Smad2/3, p-Smad2/3, Smad7 and NOX4; and increased ROS production in podocytes. Conclusions: This study suggests that IS may modulate the expression of nephrin, synaptopodin, CD2AP and SRGAP2a by regulating the ROS and TGF-β1/Smad signalling pathways, providing new theoretical support for the treatment of diabetic nephropathy.

To explore the association and the underlying process between meaning in life and psychological health, a stratified random sampling was conducted on undergraduate students from five universities in Fujian Province from March to April 2022, with the Meaning in Life Questionnaire, the Self-Esteem Scale, the Interpersonal Trust Scale, and the Kessler10 Scale. The results indicated that 34.5% of Chinese undergraduates were in poor or worse mental health. There were significant positive correlations among meaning in life, self-esteem, and interpersonal trust; meaning in life, self-esteem, and interpersonal trust were all significantly and positively correlated with mental health. Self-esteem and interpersonal trust played a chain mediating role between meaning in life and mental health. Schools and families should conduct appropriate activities to help them enhance meaning in life so as to improve the level of mental health.

With the rapid development of artificial intelligence and big data technology, intelligent education systems have become a key research focus in the field of modern educational technology. This study aims to enhance the intelligence level of educational systems by accurately detecting student behavior in the classroom using deep learning techniques. We propose a method for detecting student classroom behavior based on an improved RT DETR (Real-Time Detection Transformer) object detection algorithm. By combining actual classroom observation data with AI-generated data, we create a comprehensive and diverse student behavior dataset (FSCB-dataset). This dataset not only more realistically simulates the classroom environment but also effectively addresses the scarcity of datasets and reduces the cost of dataset construction. The study introduces MobileNetV3 as a lightweight backbone network, reducing the model parameters to one-tenth of the original while maintaining nearly the same accuracy. Additionally, by incorporating learnable position encoding and dynamic upsampling techniques, the model significantly improves its ability to recognize small objects and complex scenes. Test results on the FSCB-dataset show that the improved model achieves significant improvements in real-time performance and computational efficiency. The lightweight network is also easy to deploy on mobile devices, demonstrating its practicality in resource-constrained environments.

Abstract Background To investigate the relationship between body mass index (BMI) changes and large for gestational age (LGA) in women with gestational diabetes mellitus (GDM). Methods A retrospective cohort study including 10,486 women with GDM was conducted. A dose‒response analysis of BMI changes and the occurrence of LGA was performed. Binary logistic regressions were performed to assess crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Receiver operating characteristic (ROC) curves and areas under the curve (AUCs) were used to assess the ability of BMI changes to predict LGA. Results The probability of LGA increased with increasing BMI. The risk of LGA increased across the BMI change quartiles. The BMI change remained positively associated with the risk of LGAafter stratification analysis. The AUC was 0.570 (95% CI: 0.557 ~ 0.584)in the entire study population, and the best optimal predictive cut-off value was 4.922, with a sensitivity of 0.622 and a specificity of 0.486. The best optimal predictive cut-off value decreased from the underweight group to the overweight and obese group. Conclusions BMI changes are related to the risk of LGA and may be a useful predictor of the incidence of LGA in singleton pregnant women with GDM.

BackgroundTo investigate the pathogenic characteristics and risk factors of pediatric severe community-acquired pneumonia (CAP).MethodsWe retrospectively analyzed the clinical data of hospitalized children with severe CAP from April 2014 to June 2019 in China. Data of age, sex and pathogenic results were collected: bacterial and fungal cultures, respiratory viruses from sputum or bronchoalveolar lavage fluid (BALF), serum Mycoplasma pneumoniae (MP)-IgM and Chlamydia Pneumoniae-IgM, and BALF or blood (1-3)-β-D-glucan/galactomannan test.ResultsA total of 679 children with severe CAP were included in the analysis. The number of cases infected with MP was higher in males than in females. There were significant differences between the ≤1-year and >1-year groups in terms of pathogen. The top three bacteria cultured were Haemophilus influenzae (57/679, 8.4%), Streptococcus pneumoniae (50/679, 7.4%), and Pseudomonas aeruginosa (25/679, 3.7%). The top three viruses detected were adenovirus (AdV, 124/679, 18.3%), respiratory syncytial virus (24/679, 3.5%), and parainfluenza virus (21/679, 3.1%). AdV and MP were the leading pathogens, detected in 18.3% and 32.6% cases, respectively. MP infection increased the risk of AdV infection (OR 3.77, p

Abstract. The pandemic of coronavirus disease 2019 is “not over,” in fact, the “dynamic clearing” policy for SARS-CoV-2 control and prevention in China has been firmly enforced. This study aimed to analyze the clinical symptoms and dynamic viral RNA changes in 2021 at Guangzhou Eighth People’s Hospital. This study showed that 31.4% of the patients (695/2212) tested negative for viral RNA from admission to the final release from quarantine. Of all negative cases, 86.5% (601/695) remained in the hospital for no more than 5 days and were asymptomatic or mild. Among the remaining 402 patients who stayed for no more than 5 days, 76.4% (307/402) were viral RNA retest positive during the isolation stage. However, 96.4% of the peak viral RNA (296/307) was over Ct = 33 cycles during the isolation stage.

This study's objective is to evaluate the correlation relationship between Podocalyxin (PCX), an urinary marker of podocytes, urinary albumin-creatinine ratio (ACR) and the predictive value of PCX in the routine screen of early diabetic kidney disease (DKD) among older people. We also aimed to explore its prediction value despite of other metabolic factor and how PCX alters in the predictive power for early stage of diabetic nephropathy. In retrospective, 320 cases of older patients diagnosed with type 2 diabetes mellitus who met both inclusion and exclusion criteria were collected and divided with levels of urinary albumin, that is, normal albuminuria group, microalbuminuria group and healthy group. The correlation coefficient between PCX and ACR, and the odds ratio of PCX were gauged in the study. Area under the receiver operating characteristic (ROC) curve was also calculated. There were 188 patients in the normal group with urine ACR

Schematic diagrams of SD-PQLED based on light interaction layer and light-emitting layer and proof-of-concept diagram of the light interactive display by a four-pixel SD-PQLEDs.

To investigate the effect of pesticide use on surface water, the concentration and distribution characteristics of 57 pesticides and 3 degradation products were analyzed in the farmland soil and surface water in the Xingkai Lake area, including water from paddy fields, drainages and the Xingkai Lake, in Heilongjiang Province, China. Forty-three pesticides and three degradation products were detected in farmland soil. In dry field (corn and soybean field) soil, the main detected pesticides were atrazine and acetochlor with mean concentrations of 26.09 ng·g−1 and 49.08 ng·g−1, respectively. In paddy field soil, oxadiazon, mefenacet and chlorpyrifos were the main detected pesticides with mean concentrations of 14.32 ng·g−1, 78.60 ng·g−1 and 20.03 ng·g−1, respectively. In the surrounding water, including water from paddy fields, drainages and Xingkai Lake, the total concentrations of contaminants detected in the water samples ranged from 71.19 ng·L−1 to 10,145.76 ng·L−1. Of the three sampling periods, the mean concentration of contaminants in the water exhibited its peak during the vegetative period. In the analysis of the drainage water, the primary pesticides detected were atrazine, acetochlor and buprofezin with mean concentrations of 354.83 ng·L−1, 109.09 ng·L−1 and 254.56 ng·L−1, respectively. Atrazine, simetryn, buprofezin and isoprothiolane were the main pesticides detected in Xingkai Lake water, with the mean concentrations of 222.35 ng·L−1, 112.76 ng·L−1, 301.87 ng·L−1 and 138.02 ng·L−1, respectively. The concentrations of contaminants could be correlated with drainage, Da Xingkai Lake and Xiao Xingkai Lake water (ρ > 0.8) suggested that the source of these contaminants in drainage and Xingkai Lake water could be the same. The maximum potentially affected fraction (PAF) values of atrazine, chlorpyrifos and prometryn were higher than 5% in Xingkai Lake water, resulting in high ecological risks.

Abstract ZnSe/ZnS core/shell quantum dots (QDs) are environmental‐friendly blue light‐emitting material, which can easily achieve deep blue emission upon external excitation. However, its deep valence band (VB) and numerous defect states remain handicap to realize sufficient performance of quantum dot light‐emitting diodes (QLEDs). In this work, high‐performance cadmium‐free ZnSe/ZnS QLEDs by constructing a double organic hole‐transport layer (HTL) to obtain carrier balance are presented. The double HTLs, which consist of poly(9,9‐dioctylfluorene‐co‐N‐(4‐butylphenyl)diphenylamine) (TFB) and 2,7‐dioctyl[1]benzothieno[3,2‐b][1]benzothiophene (C8‐BTBT), can suppress the accumulation of electrons between the HTL and the emissive layer (EML), leading to more hole and electron recombination luminescence in QD layer. In addition, the C8‐BTBT layer is conducive to improve the uniformity of QDs film. Thus, the resulting device achieves an external quantum efficiency of 7.23% with TFB/C8‐BTBT double HTLs, which is almost 150% higher than that of traditional devices based on a single hole‐transport layer (4.84%). The authors anticipate that these results can provide a guidance for the optimization of cadmium‐free blue QLEDs.

Abstract Background Diabetic nephropathy (DN) is the major cause of kidney failure, and glomerular podocytes play critical roles in the pathogenesis of DN by maintaining the glomerular structure and filtration barrier. Klotho and Slit-Robo GTP activating protein 2a (SRGAP2a) have been indicated to play protective roles in reducing kidney injury, but whether there is an internal relationship between these two factors is unclear. Methods In this study, we cultured differentiated rat podocytes in vitro and measured the SRGAP2a expressions by immunofluorescence staining, quantitative real-time PCR (qRT-PCR) and western blotting, after siRNA-mediated transforming growth factor β1 (TGF-β1) silencing, TGF-β1 overexpression and in the presence of a reactive oxygen species (ROS) inhibitor. And we detected the expressions of SRGAP2a, small mother against decapentaplegic (Smad)2/3, phosphorylated-Smad2/3 (p-Smad2/3), Smad7, and NAD(P)H oxidase 4 (NOX4), ROS levels and podocyte cytoskeletal remodelling under high glucose (HG) and exogenous klotho conditions. In addition, we performed haematoxylin–eosin (HE) staining and immunohistochemistry with diabetic rat models to confirm the in vitro results. Results The results indicated that SRGAP2a expression was significantly upregulated under siRNA-mediated TGF-β1 silencing conditions or after adding a ROS inhibitor, but significantly downregulated with TGF-β1 overexpression, in the presence of HG. The supplementation of exogenous klotho under HG conditions significantly increased the SRGAP2a expression, remodelled the actin cytoskeleton and altered the expressions of Smad2/3, p-Smad2/3, Smad7 and NOX4 and reduced the ROS generation in podocytes. Moreover, klotho administration protected kidney injury in DN rats. Conclusions This study indicated that klotho may modulate the expression of SRGAP2a by regulating the ROS and TGF-β1 signalling pathways and provided theoretical support for klotho protein as a novel therapeutic strategy for treating DN patients.

Therapeutic oligonucleotides (TOs) represent one of the most promising drug candidates in the targeted cancer treatment due to their high specificity and capability of modulating cellular pathways that are not readily druggable. However, efficiently delivering of TOs to cancer cellular targets is still the biggest challenge in promoting their clinical translations. Emerging as a significant drug delivery vector, nanoparticles (NPs) can not only protect TOs from nuclease degradation and enhance their tumor accumulation, but also can improve the cell uptake efficiency of TOs as well as the following endosomal escape to increase the therapeutic index. Furthermore, targeted and on-demand drug release of TOs can also be approached to minimize the risk of toxicity towards normal tissues using stimuli-responsive NPs. In the past decades, remarkable progresses have been made on the TOs delivery based on various NPs with specific purposes. In this review, we will first give a brief introduction on the basis of TOs as well as the action mechanisms of several typical TOs, and then describe the obstacles that prevent the clinical translation of TOs, followed by a comprehensive overview of the recent progresses on TOs delivery based on several various types of nanocarriers containing lipid-based nanoparticles, polymeric nanoparticles, gold nanoparticles, porous nanoparticles, DNA/RNA nanoassembly, extracellular vesicles, and imaging-guided drug delivery nanoparticles.

Deciphering charge dynamics is imperative to realize efficient oxysulfide photocatalysts. Herein, with experiments and modelling, the authors report the dominant mechanisms behind decay, estimate material parameters, and formulate design principles.

In aquatic systems, sediment is both a sink for persistent organic pollutants (POPs) and a potential source of POPs release. Consequently, it is important to understand the pollution characteristics and sources of polychlorinated naphthalenes (PCNs) as POPs of Stockholm Convention in sediment for control of the ecological risk. Atmospheric deposition is a potential source of PCNs in sediment. However, there is no clear report on the contribution of atmospheric deposition to PCNs in sediments. In this study, the Chaobai River in China was selected because it is an important drinking water source that is not affected by wastewater discharge. Surface sediments from the river were analyzed for 75 PCN congeners by using high resolution gas chromatography combined with high resolution mass spectrometry. The total PCNs concentration ranged from 54 to 2266 (mean: 402) pg/g. The toxic equivalent quantity of 19 PCNs in surface sediments was 9.69 × 10−2, and CN73, CN66/CN67, and CN63 had the largest contributions to this value. Dichlorinated and trichlorinated naphthalenes were the dominant homologs. The PCN data from the sediment samples in this study were combined with data for PCNs in ambient air from a literature, which has a good match with this study in both temporal and spatial scales. The contribution of atmospheric deposition to PCNs in the surface sediment was evaluated by comparing congener characteristics and correlation analysis. Our study indicated atmospheric transportation and deposition are important pathways for transport of PCNs into surface sediments.

The old economic and social growth model, characterized by centralized fossil energy consumption, is progressively shifting, and the third industrial revolution, represented by new energy and Internet technology, is gaining traction. Energy Internet, as a core technology of the third industrial revolution, aims to combine renewable energy and Internet technology to promote the large-scale use and sharing of distributed renewable energy as well as the integration of multiple complex network systems, such as electricity, transportation, and natural gas. This novel technology enables power networks to save energy. However, multienergy synchronization optimization poses a significant problem. As a solution, this study proposed an optimized approach based on the concept of layered control–collaborate optimization. The proposed method allows the distributed device to plan the heat, cold, gas, and electricity in the regional system in the most efficient way possible. Moreover, the proposed optimization model is simulated using a real-number genetic algorithm. It improved the optimal scheduling between different regions and the independence of distributed equipment with minimal cost. Furthermore, the inverse system and energy and cost saving rate of the proposed method are better than those of existing methods, which prove its effectiveness.

Objective: This study investigated the acute effects of PNF stretching on hamstring flexibility and muscle stiffness of lower limbs between genders.Methods: 15 male and 15 female university students without any injury histories on lower limbs in the past 3 months were included in this study were selected. All subjects were measured by MyotonPRO before and after stretching to determine the muscle stiffness of the biceps femoris muscle (BF), semitendinosus muscle (ST) of the hamstring and the medial gastrocnemius muscles (MG), lateral gastrocnemius muscles (LG), and the soleus (SOL) of the triceps surae muscles. Additionally, their flexibility was measured using the sit-and-reach test (the SR test) and passive hip range of motion (ROM). Differences based on time (pre-stretching vs. post-stretching) and sex (females vs. males) were assessed using 2 × 2 repeated measures AVONA.Results: There was a significant decrease in the stiffness of the hamstring and triceps surae muscles after stretching (BF, MG, LG, and SOL: p < 0.001; ST: p = 0.003). The muscle stiffness of the hamstring and triceps surae muscles is larger in males than in females at all time points (p < 0.001). There was a significant increase in hip flexion angle and the SR test in males and females after PNF stretching (p < 0.001); However, there was no difference in the change in the muscle stiffness and the flexibility between genders (p > 0.05).Conclusion: PNF stretching helped improve hamstring flexibility and decrease muscle stiffness. Stretching the hamstrings can also contribute to a decrease in the stiffness of the triceps surae muscles. The muscle stiffness of males before and after stretching is always greater than that of females. However, there was no difference in the change of improvement in stretching between genders.

Objectives: We aimed to compare the efficiency of the CapitalBioMycobacterium real-time polymerase chain reaction (PCR) detection test with the standard Xpert MTB/RIF assay for the diagnosis of tuberculous meningitis (TBM). Methods: We analyzed cerebrospinal fluid (CSF) from 163 patients with suspected TBM that were collected between January 1, 2018, and December 31, 2019. For both tests, we determined the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC). Next, we compared the diagnostic accuracy of the two techniques using clinical diagnosis as a reference standard. Results: The sensitivity, specificity, PPV, NPV, and AUC, of the CapitalBio Mycobacterium detection test were 48.5%, 100%, 100%, 29.6%, and 0.74, respectively, when used for the diagnosis of TBM. In comparison, the Xpert MTB/RIF assay returned values of 47.0%, 100%, 100%, 29.0%, and 0.74, respectively. Our analysis showed that the diagnostic accuracies of the CapitalBio Mycobacterium detection test and the Xpert MTB/RIF assay were very similar; the accuracy of both tests for detecting mycobacteria was significantly higher than that associated with acid­fast staining. Conclusions: The CapitalBio Mycobacterium real-time PCR detection test has moderate sensitivity and very high specificity for TBM; results are very similar to those generated by the Xpert MTB/RIF assay. We recommend that the CapitalBio PCR test should be used as an initial screening method for TB.

Constructing a large section bifurcated small clear distance tunnel poses significant challenges due to its large section and small clear distance, complex and overlapping construction steps, unsynchronized excavation and support processes, and disturbance of surrounding rock caused by blasting. Timely and effective construction monitoring is crucial to ensure construction safety and quality. However, traditional monitoring methods are unable to fully satisfy requirements and realize real-time monitoring. Therefore, this study proposes an automatic monitoring and control method for a large section bifurcated small clear distance tunnel to leverage the positive role of information construction. Using the Xiamen Haicang Evacuate Channel project as a case study, this paper introduces the tunnel monitoring and layout scheme of monitoring points. The monitoring data were analyzed from different perspectives, including cumulative deformation, deformation rate, cumulative deformation control value, and deformation rate control value. The follow-up excavation and support measures were optimized based on the measurement results. Additionally, an automatic monitoring and control method of the middle rock pillar combined with the criterion of stability of the middle rock pillar was proposed, constructing a working idea and framework for timely feedback and three-dimensional and dynamic monitoring. Site monitoring predicted the danger before construction and provided feedback on construction information to improve the specific construction method of subsequent excavation and support. The proposed automatic monitoring and control method can solve the problem of accidental errors in traditional monitoring methods and enable real-time automatic monitoring. The research results provide valuable experience for constructing a bifurcated small clear distance tunnel.

Activation of narrow-bandgap photocatalysts holds key to applicable solar-to-hydrogen energy conversion. Here, the authors demonstrate effective sequential cocatalyst decoration for such narrow-bandgap photocatalysts to realise highly-efficient hydrogen evolution and Z-scheme water splitting.

Peritoneal dialysis (PD) is an important part of replacement therapy for kidney failure. However, long-term PD treatment can cause peritoneal fibrosis. Autophagy may be involved in the pathological mechanism of peritoneal fibrosis (PF). Although autophagy is currently known to be involved in course of PF, its specific effects still lack in-depth research. In this experiment, a high-glucose (HG)-induced peritoneal fibrosis rat model was successfully established via intraperitoneal injection of HG peritoneal dialysate, and the phosphatidylinositol 3-kinase (PI3K) inhibitor LY294002 and the mechanistic target of rapamycin (mTOR) inhibitor rapamycin were used to treat peritoneal fibrosis rats. In addition, in vitro studies of high glucose-induced peritoneal fibrosis were performed using rat peritoneal mesothelial cells (PMCs). In vivo and in vitro experiments showed that LY294002 and rapamycin effectively inhibited the process of PF induced by high glucose. In addition, LY294002 and rapamycin were found to alleviate fibrosis by eliminating intracellular reactive oxygen species (ROS) levels, promoting the expression of the epithelial mesenchymal transdifferentiation proteins zonula occludens-1 (ZO-1) and E-cadherin, and inhibiting the expression of p-PI3K, PI3K, p-mTOR, mTOR, the fibroblast-specific proteins ferroptosis suppressor protein 1 (FSP1), and alpha-smooth muscle actin (α-SMA). Moreover, LY294002 and rapamycin promoted expression of autophagy-related proteins LC3-II/I, p62, and beclin-1. The current data indicated that inhibition of PI3K/AKT/mTOR signalling pathway activated autophagy and suppressed PF in the process of PD. Therefore, intervention in this signalling pathway may become a research goal for the prevention and treatment of PF, which has important clinical significance.

Abstract Background To establish age-standardized charts of weight gain for term twin pregnancies in Southeast China. Methods We designed a retrospective study on data from women pregnant with twins, a gestational age beyond 36 weeks and an average weight ≥ 2500 g. We established hierarchical linear regression models to express gestational weight gain patterns. Results We analyzed data from 884 women pregnant with twins (151 underweight, 597 normal weight, and 136 overweight). Our final models fit the crude weight measurement data well. The means of weight gain generally decreased as the pre-pregnancy BMI increased. For each BMI category, the mean weight gains increased with the gestational age and the standard deviation increased slightly. The mean weight gains were 18.82 ± 6.73, 18.53 ± 6.74, and 16.97 ± 6.95 kg at 37 weeks in underweight, normal weight, and overweight women, respectively. Conclusion The weight gain chart can be used to estimate maternal weight gain to be gestational age–standardized z scores by pre-pregnancy BMI and may serve as an innovative tool for perinatal care providers to guide the weight gain of women pregnant with twins.

Aortic dissection (AD) is a cardiovascular disease characterized by high mortality and poor prognosis. Although FBN1 is associated with syndromic AD, its association with non-syndromic AD remains unclear. In this study, DNA samples from 90 Chinese individuals with non-syndromic AD (60 Stanford A, 30 Stanford B types) were analyzed to determine the relationship between diverse genotypes of the FBN1 gene and non-syndromic AD. Eleven pathogenic/likely pathogenic variants (1 novel) were identified in 12.2% of patients with non-syndromic AD. Patients with positive variants suffered from AD at a younger age than those in the negative variant group. Among the six positive missense mutations associated with cysteine residue hosts, four (66.7%) were Stanford A AD, whereas two (33.3%) were Stanford B AD. Three (100%) positive splicing/truncation variant hosts were Stanford A AD. The splicing/truncation variants and missense variants involving cysteine residues in the FBN1 gene increased the risk of Stanford A AD. Ten common SNPs that increased susceptibility to AD were identified. In particular, five SNPs were detected significantly in Stanford A AD, whereas another four SNPs were significantly detected in Stanford B AD. These significant variants can function as biomarkers for the identification of patients at risk for AD. Our findings have the potential to broaden the database of positive mutations and common SNPs of FBN1 in non-syndromic AD among the Chinese population.

In tunnel design and construction, proper and accurate classification of rock surrounding tunnels is needed to ensure tunnel construction safety, guarantee construction quality, and reduce project costs. With rapid urbanization, numerous small clear-distance tunnels have been constructed in dense urban road networks. Compared with ordinarily separated tunnels, the construction scale and difficulty of small clear-distance tunnels are greater, and the requirements for the classification of rock surrounding tunnels are accordingly higher. A small clear-distance tunnel in an urban super large and complex underground interchange hub of the Xiamen Haicang Evacuation Channel was selected as the background, and the classification method of the middle rock pillar in a small clear-distance tunnel is presented based on the general classification standard of surrounding rocks. Based on the geometric, physical, and mechanical factors of the middle rock pillar, six indices affecting the stability and quality of the middle rock pillar were selected, and the classification index system of the middle rock pillar was established from the two dimensions of the basic and auxiliary indices. The basic and auxiliary indices were scored using the scoring method, and the different grades of the middle rock pillar were divided according to different scores. The middle rock pillar classification standard was applied to the quality assessment of the middle rock pillar, which provided a basis for the on-site assessment of the quality of the middle rock pillar and proved the accuracy and superiority of the improved classification standard. The newly established classification standard can provide a reference for selecting the correct construction method and supporting structure type for small clear-distance tunnels.

Although previous research has found the impact of fears of compassion on eating disorders, the mechanism underlying the relationship between fears of compassion and emotional eating remains to be examined. This study aimed to examine the mediating role of emotion regulation difficulties in the relationships between fears of compassion and emotional eating in college students, as well as the gender difference in the mediation model. The Fears of Compassion Scale, Difficulties in Emotion Regulation Scale, and Dutch Eating Behavior Questionnaire were completed by 673 college students in Fujian Province, China. Structural Equation Modeling was primarily employed to analyze the data. The results showed that both fear of compassion for self and fear of compassion from others were positively associated with emotion regulation difficulties, which in turn were related to emotional eating for female college students. Emotion regulation difficulties played a significant mediating effect in the relationship between fears of compassion and emotional eating. Comparatively, for male college students, only fear of compassion for self was positively associated with emotion regulation difficulties, but emotion regulation difficulties were not related to emotion eating. Moreover, the mediating effect of emotion regulation difficulties was not significant in the relationship between fears of compassion and emotion eating for male college students. The findings suggest that it is important to improve individuals’ fears of compassion to reduce emotional eating, particularly for female college students.

Close excavation section spacing, the mutual influence and interpenetration of various processes, and the multiple disturbances of the middle rock pillar in a small clear-distance tunnel pose great difficulty to construction. This study adopted the small clear-distance tunnel of Xiamen Haicang Evacuate Channel as the research object. The tunnel belonged to a small clear-distance tunnel in an urban super large and complex underground interchange hub where complex adjacent small clear-distance tunnels were adopted. ABAQUS was used to analyze the influence of different excavation schemes, lithological grades, and footage lengths for tunnel stability. The deformation and stress characteristics of the tunnel’s surrounding rock and lining structure in different excavation schemes (full section method, bench method, center diaphragm (CD) method, and double wall heading method), lithological grades (III, IV and V), and footage lengths (3 m, 4 m and 5 m) were introduced. The results showed that the double wall heading method could effectively control the horizontal displacement of the hance, and the overall stress state of the lining in the CD and double wall heading methods were reasonable. The vertical displacement of the surface and vault was positively correlated with the elastic modulus of the rock mass. When no temporary support was present in the grade V rock mass, the area from the hance to the arch foot was prone to large deformation. Reducing the footage was beneficial to controlling the deformation of the vault and hance. This study can provide a reference for the on-site construction of small clear-distance tunnels.

Large section tunnels have huge excavation spans, complex excavation procedures, mutual influence among various procedures, multiple disturbances of the surrounding rock, and discontinuous connection among linings under different procedures, which bring great difficulties to their construction. The Caijianwei Mountain No. 2 tunnel of the Xiamen Haicang Evacuate-channel project in China belongs to a super large section tunnel. The tunnel’s maximum excavation section span reaches 30.52 m, and the excavation area reaches 421.73 m2. Its excavation sequence, the timing of the second primary lining support, temporary support disassembly, and secondary lining support of the double-side heading method were analyzed using numerical methods. The excavation sequence of the double side-heading method from the right pilot tunnel to the left pilot tunnel and then to the middle pilot tunnel can avoid a large horizontal displacement at the arch waist and control the deformation of the lining. The excavation sequence from the middle pilot tunnel to the two side pilot tunnels was conducive to the bearing performance of the concrete at the arch crown. The excavation sequence from the two side pilot tunnels to the middle pilot tunnel can better protect the concrete safety at the arch waist. The timing of the second primary lining support, temporary support removal, and secondary lining support have different effects on the deformation and stress of the surrounding rock and support structures. In the construction process, the timing of the second primary lining support, temporary support disassembly, and secondary lining support should be determined according to the actual deformation and stress of the site section. The research results can provide a reference for the construction design of the double-side heading method for large section tunnels.

Objective To investigate the safety and efficacy of regional citrate anticoagulation (RCA) on elderly patients at high risk of bleeding after continuous renal replacement therapy (CRRT). Methods A total of 31 patients at high risk of bleeding who received CRRT in the intensive care unit were collected. The patients were divided into RCA group (n = 17) and no anticoagulation group (NA, n = 14) according to whether RCA was used or not. The levels of creatinine (Cr), blood urea nitrogen (BUN), prothrombin time (PT), activated partial thromboplastin time (APTT), total calcium (tCa), ionized calcium ion (iCa 2+ ), sodium ion (Na + ), bicarbonate ion (HCO 3 − ), tCa/iCa 2+ ratio, and pH were observed after treatment. The filter use time, number of filters used, filter obstruction events, clinical outcomes, and safety evaluation indexes were compared post-treatment. Results After treatment, serum Cr and BUN levels, APTT and PT levels in the RCA group were significantly lower than the NA group. The tCa, iCa 2+ , HCO 3 − , tCa/iCa 2+ , and pH were within the normal range after RCA treatment while Na + levels saw a significant increase. In the RCA group, the filter using time was significantly longer, with significantly reduced numbers of filter use within 72 h and filter disorder events. Additionally, patients in the RCA group showed significant recovery of renal function and a significant reduction in bleeding events and in-hospital mortality. Conclusion RCA treatment significantly improves clinical outcome of patients at high risk of bleeding after CRRT, safely and effectively prolongs the filter life and avoids coagulation incidences.

A heterologous pathway for sucrose transport and metabolism was introduced into Clostridium beijerinckii to improve sucrose use for n-butanol production. The combined expression of StSUT1, encoding a sucrose transporter from potato (Solanum tuberosum), and SUC2, encoding a sucrose invertase from Saccharomyces cerevisiae, remarkably enhanced n-butanol production. With sucrose, sugarcane molasses and sugarcane juice as substrates, the C. beijerinckii strain harbouring StSUT1 and SUC2 increased acetone–butanol–ethanol production by 38.7%, 22.3% and 52.8%, respectively, compared with the wild-type strain. This is the first report to demonstrate enhanced sucrose fermentation due to the heterologous expression of a sucrose transporter and invertase in Clostridium. The metabolic engineering strategy used in this study can be widely applied in other microorganisms to enhance the production of high-value compounds from sucrose-based biomass.

BackgroundNontuberculous mycobacteria (NTM) infection is similar to Mycobacterium tuberculosis (MTB) infection. Early clinical identification and differentiation of NTM and MTB infections continues to be a major challenge. Nucleic acid amplification tests (NAATs) have the ability to efficiently and rapidly detect pathogens and are widely used in mycobacterial infections. The objective of this study is to estimate the diagnostic accuracy of NAATs for NTM.MethodsWe will search candidate studies that assessing the accuracy of NAATs for diagnosis of NTM through PubMed, Embase and the Cochrane Library until May 2021. Studies with full text that meet the inclusion criteria will be included. Following a revised tool for Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2), two researchers will independently evaluate the study quality. The STATA software (version 15.0) will be used to carry out meta-analyses. When heterogeneity is observed, subgroup analyses and meta-regression analyses will be used to explore sources of heterogeneity. Sensitivity analyses will be used to check the robustness of analyses.ConclusionWe hope that this study will provide meaningful evidence for the early and rapid diagnosis of NAATs for NTM, which will help to guide the treatment of NTM and improve the prognosis of patients.

Despite the popularity of video in ELT, video use in primary English classrooms remains under-scrutinized. Grounded in a social semiotic conceptualization of video as multimodal ensemble, this study explored 115 Chinese primary English teachers' use of videos and the influencing factors in the post-pandemic era. Data were collected through a narrative frame, semi-structured interviews, and classroom observations. The findings revealed a predominant use of video for motivational and linguistic purposes, with occasional use of video as multimodal ensemble for critical and creative viewing purposes. Factors that shaped video use were also identified, including limited understanding of viewing multimodal texts as part of language competence, absence of institutional policies and support, and constrained access to quality videos. These findings call for attention to the importance of multimodal awareness for primary English teachers to develop pedagogic competences to use videos for an expanded range of literacy purposes in contemporary ELT landscape.

A convenient and effective sucrose transport assay for Clostridium strains is needed. Traditional methods, such as 14C-sucrose isotope labelling, use radioactive materials and are not convenient for many laboratories. Here, a sucrose transporter from potato was introduced into Clostridium, and a fluorescence assay based on esculin was used for the analysis of sucrose transport in Clostridium strains. This showed that the heterologously expressed potato sucrose transporter is functional in Clostridium. Recombinant engineering of high-level sucrose transport would aid sucrose fermentation in Clostridium strains. The assay described herein provides an important technological platform for studying sucrose transporter function following heterologous expression in Clostridium.

Under an external magnetic field, when circularly polarized light was transmitted through binary ferrofluids based on strongly magnetic γ-Fe2O3 and weakly magnetic ZnFe2O4 nanoparticles, the birefringence Δn and dichroism Δk arising from the chains of γ-Fe2O3 particles system were modulated and decreased by the unchained ZnFe2O4 particles. In our experiments, we used two types of ZnFe2O4 nanoparticles: one consisted of ZnFe2O4(1) particles with higher moments, and the other consisted of ZnFe2O4(2) particles with lower moments. Comparing the birefringence and dichroism of the γ-Fe2O3–ZnFe2O4(1) and γ-Fe2O3–ZnFe2O4(2) binary ferrofluids, it was found that the modulating action of the ZnFe2O4(2) particle system with lower moments was larger than that of the ZnFe2O4(1) particle system with higher moments. Using a model for a bi-dispersed system based on chained and unchained particles, the behavior of the modulating action was explained by an additional effective relative magnetic permeability, which depends on the background of the unchained ZnFe2O4 particles for the chained γ-Fe2O3 particles and a field-induced demixing phase transition. These results showed that for binary ferrofluids based on both strong and weak magnetic nanoparticles, the power of the modulation of the magneto-optical effects depends on the difference in magnetization between the particles.