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Abstract. Background:. In vitro fertilization (IVF) has emerged as a transformative solution for infertility. However, achieving favorable live-birth outcomes remains challenging. Current clinical IVF practices in IVF involve the collection of heterogeneous embryo data through diverse methods, including static images and temporal videos. However, traditional embryo selection methods, primarily reliant on visual inspection of morphology, exhibit variability and are contingent on the experience of practitioners. Therefore, an automated system that can evaluate heterogeneous embryo data to predict the final outcomes of live births is highly desirable. Methods:. We employed artificial intelligence (AI) for embryo morphological grading, blastocyst embryo selection, aneuploidy prediction, and final live-birth outcome prediction. We developed and validated the AI models using multitask learning for embryo morphological assessment, including pronucleus type on day 1 and the number of blastomeres, asymmetry, and fragmentation of blastomeres on day 3, using 19,201 embryo photographs from 8271 patients. A neural network was trained on embryo and clinical metadata to identify good-quality embryos for implantation on day 3 or day 5, and predict live-birth outcomes. Additionally, a 3D convolutional neural network was trained on 418 time-lapse videos of preimplantation genetic testing (PGT)-based ploidy outcomes for the prediction of aneuploidy and consequent live-birth outcomes. Results:. These two approaches enabled us to automatically assess the implantation potential. By combining embryo and maternal metrics in an ensemble AI model, we evaluated live-birth outcomes in a prospective cohort that achieved higher accuracy than experienced embryologists (46.1% vs. 30.7% on day 3, 55.0% vs. 40.7% on day 5). Our results demonstrate the potential for AI-based selection of embryos based on characteristics beyond the observational abilities of human clinicians (area under the curve: 0.769, 95% confidence interval: 0.709–0.820). These findings could potentially provide a noninvasive, high-throughput, and low-cost screening tool to facilitate embryo selection and achieve better outcomes. Conclusions:. Our study underscores the AI model’s ability to provide interpretable evidence for clinicians in assisted reproduction, highlighting its potential as a noninvasive, efficient, and cost-effective tool for improved embryo selection and enhanced IVF outcomes. The convergence of cutting-edge technology and reproductive medicine has opened new avenues for addressing infertility challenges and optimizing IVF success rates.

Abstract Background Aripiprazole is the most frequently recommended antipsychotic for the treatment of tics in children and adolescents with Tourette’s disorder (TD). However, to date, a randomized controlled trial for aripiprazole oral solution has not been conducted despite being widely preferred by children. Therefore, we examined whether aripiprazole oral solution is effective for treating tics. Methods All patients received a flexible dose of aripiprazole oral solution (1 mg/mL, range: 2–20 mg) with a starting dose of 2 mg. The target dose for patients weighing

Parkinson’s Disease (PD) and Drug-induced parkinsonism (DIP) are the most common subtypes of parkinsonism, yet no studies have reported that the subcortical volume alterations in DIP patients. This study aimed to identify specific alterations of subcortical structures volume in DIP patients, and investigate association between the subcortical structure modifications and clinical symptoms. We recruited 27 PD patients, 25 DIP patients and 30 healthy controls (HCs). The clinical symptom-related parameters (Unified Parkinson’s Disease Rating Scale, UPDRS) were evaluated. Structural imaging was performed on a 3.0 T scanner, and volumes of subcortical structures were obtained using FreeSurfer software. Analysis of covariance (ANCOVA) and partial correlation analysis were performed. DIP group had significantly smaller volume of the thalamus, pallidum, hippocampus and amygdala compared to HCs. ROC curve analysis demonstrated that the highest area under curve (AUC) value was in the right pallidum (AUC = 0.831) for evaluating the diagnostic efficacy in DIP from HCs. Moreover, the volumes of the putamen, hippocampus and amygdala were negatively correlated with UPDRSII in the DIP patients. The volume of the amygdala was negatively correlated with UPDRSIII. The present study provides novel information regarding neuroanatomical alteration of subcortical nuclei in DIP patients, suggesting that these methods might provide the basis for early diagnosis and differential diagnosis of DIP.

Abstract Background Acute kidney injury (AKI) in patients with acute myocardial infarction (AMI) often indicates a poor prognosis. Objective This study aimed to investigate the association between the TyG index and the risk of AKI in patients with AMI. Methods Data were taken from the Medical Information Mart for Intensive Care (MIMIC) database. A 1:3 propensity score (PS) was set to match patients in the AKI and non-AKI groups. Multivariate logistic regression analysis, restricted cubic spline (RCS) regression and subgroup analysis were performed to assess the association between TyG index and AKI. Results Totally, 1831 AMI patients were included, of which 302 (15.6%) had AKI. The TyG level was higher in AKI patients than in non-AKI patients (9.30 ± 0.71 mg/mL vs. 9.03 ± 0.73 mg/mL, P

Abstract Background Congenital heart disease (CHD) is a prevalent congenital cardiac malformation, which lacks effective early biological diagnosis and intervention. MicroRNAs, as epigenetic regulators of cardiac development, provide potential biomarkers for the diagnosis and treatment of CHD. However, the mechanisms underlying miRNAs-mediated regulation of cardiac development and CHD malformation remain to be further elucidated. This study aimed to explore the function of microRNA-20b-5p (miR-20b-5p) in cardiac development and CHD pathogenesis. Methods and results miRNA expression profiling identified that miR-20b-5p was significantly downregulated during a 12-day cardiac differentiation of human embryonic stem cells (hESCs), whereas it was markedly upregulated in plasma samples of atrial septal defect (ASD) patients. Our results further revealed that miR-20b-5p suppressed hESCs-derived cardiac differentiation by targeting tet methylcytosine dioxygenase 2 (TET2) and 5-hydroxymethylcytosine, leading to a reduction in key cardiac transcription factors including GATA4, NKX2.5, TBX5, MYH6 and cTnT. Additionally, knockdown of TET2 significantly inhibited cardiac differentiation, which could be partially restored by miR-20b-5p inhibition. Conclusions Collectively, this study provides compelling evidence that miR-20b-5p functions as an inhibitory regulator in hESCs-derived cardiac differentiation by targeting TET2, highlighting its potential as a biomarker for ASD.

Objective: This study aimed to develop and validate several artificial intelligence (AI) models to identify acute myocardial infarction (AMI) patients at an increased risk of acute kidney injury (AKI) during hospitalization. Methods: Included were patients diagnosed with AMI from the Medical Information Mart for Intensive Care (MIMIC) III and IV databases. Two cohorts of AMI patients from Changzhou Second People's Hospital and Xuzhou Center Hospital were used for external validation of the models. Patients' demographics, vital signs, clinical characteristics, laboratory results, and therapeutic measures were extracted. Totally, 12 AI models were developed. The area under the receiver operating characteristic curve (AUC) were calculated and compared. Results: AKI occurred during hospitalization in 1098 (28.3 %) of the 3882 final enrolled patients, split into training (3105) and test (777) sets randomly. Among them, Random Forest (RF), C5.0 and Bagged CART models outperformed the other models in both the training and test sets. The AUCs for the test set were 0.754, 0.734 and 0.730, respectively. The incidence of AKI was 9.8 % and 9.5 % in 2202 patients in the Changzhou cohort and 807 patients in the Xuzhou cohort with AMI, respectively. The AUCs for patients in the Changzhou cohort were RF, 0.761; C5.0, 0.733; and bagged CART, 0.725, respectively, and Xuzhou cohort were RF, 0.799; C5.0, 0.808; and bagged CART, 0.784, respectively. Conclusion: Several machines learning-based prediction models for AKI after AMI were developed and validated. The RF, C5.0 and Bagged CART model performed robustly in identifying high-risk patients earlier. Clinical trial approval statement: This Trial was registered in the Chinese clinical trials registry: ChiCTR1800014583. Registered January 22, 2018 (http://www.chictr.org.cn/searchproj.aspx).

Objective: Ferroptosis has been recognized as being closely associated with cognitive impairment. Research has established that Alzheimer's disease (AD)-associated proteins, such as amyloid precursor protein (APP) and phosphorylated tau, are involved in brain iron metabolism. These proteins are found in high concentrations within senile plaques and neurofibrillary tangles. Repetitive transcranial magnetic stimulation (rTMS) offers a non-pharmacological approach to AD treatment. This study aims to explore the potential therapeutic effects of rTMS on cognitive impairment through the modulation of the ferroptosis pathway, thereby laying both a theoretical and experimental groundwork for the application of rTMS in treating Alzheimer's disease. Methods: The study utilized senescence-accelerated mouse prone 8 (SAMP8) mice to model brain aging-related cognitive impairment, with senescence-accelerated-mouse resistant 1 (SAMR1) mice acting as controls. The SAMP8 mice were subjected to high-frequency rTMS at 25 Hz for durations of 14 and 28 days. Cognitive function was evaluated using behavioral tests. Resting-state functional magnetic resonance imaging (rs-fMRI) assessed alterations in cerebral activity by measuring the fractional amplitude of low-frequency fluctuations (fALFF) of the blood oxygen level-dependent signal. Neuronal recovery post-rTMS in the SAMP8 model was examined via HE and Nissl staining. Immunohistochemistry was employed to detect the expression of APP and Phospho-Tau (Thr231). Oxidative stress markers were quantified using biochemical assay kits. ELISA methods were utilized to measure hippocampal levels of Fe2+ and Aβ1–42. Finally, the expression of proteins related to the ferroptosis pathway was determined through western blot analysis. Results: The findings indicate that 25 Hz rTMS enhances cognitive function and augments cerebral activity in SAMP8 model mice. Treatment with rTMS in these mice resulted in diminished oxidative stress and safeguarded neurons against damage. Additionally, iron accumulation was mitigated, and the expression of ferroptosis pathway proteins Gpx4, system Xc-, and Nrf2 was elevated. Conclusions: The Tau/APP-Fe-GPX4/system Xc-/Nrf2 pathway is implicated in the remedial effects of rTMS on cognitive dysfunction, offering a theoretical and experimental basis for employing rTMS in AD treatment.

Abstract Background The purpose of this study was to develop a Nomogram model to identify the risk of all-cause mortality during hospitalization in patients with heart failure (HF). Methods HF patients who had been registered in the Medical Information Mart for Intensive Care (MIMIC) III and IV databases were included. The primary outcome was the occurrence of all-cause mortality during hospitalization. Two Logistic Regression models (LR1 and LR2) were developed to predict in-hospital death for HF patients from the MIMIC-IV database. The MIMIC-III database were used for model validation. The area under the receiver operating characteristic curve (AUC) was used to compare the discrimination of each model. Calibration curve was used to assess the fit of each developed models. Decision curve analysis (DCA) was used to estimate the net benefit of the predictive model. Results A total of 16,908 HF patients were finally enrolled through screening, of whom 2,283 (13.5%) presented with in-hospital death. Totally, 48 variables were included and analyzed in the univariate and multifactorial regression analysis. The AUCs for the LR1 and LR2 models in the test cohort were 0.751 (95% CI: 0.735∼0.767) and 0.766 (95% CI: 0.751–0.781), respectively. Both LR models performed well in the calibration curve and DCA process. Nomogram and online risk assessment system were used as visualization of predictive models. Conclusion A new risk prediction tool and an online risk assessment system were developed to predict mortality in HF patients, which performed well and might be used to guide clinical practice.

BackgroundCongenital insensitivity to pain with anhidrosis (CIPA, OMIM #256800), also known as hereditary sensory and autonomic neuropathy type Ⅳ (HSAN-IV), is a rare autosomal recessive disorder characterized by recurrent episodic fevers, anhidrosis, insensitivity to noxious stimuli, self-mutilating behavior and intellectual disability. CIPA can be caused by the variants in NTRK1 gene, which encodes a high-affinity tyrosine kinase receptor for nerve growth factor. To ascertain the hereditary cause of a patient with CIPA accompanied by the additional symptoms of mild growth retardation, prone to fracture, underdeveloped nails of fingers and toes, irregular tooth alignment, enamel hypoplasia, postoperative wound healing difficulty, hand and limb deformity, and dislocation of hip joint, whole exome sequencing was used and revealed a compound heterozygous variant in NTRK1.MethodsDNA was extracted from peripheral blood samples of pediatric patients and their parents, and subjected to comprehensive analysis using whole-exome sequencing (WES), followed by verification of variant sites in the NTRK1 gene through Sanger sequencing. To elucidate the functional impact of the newly discovered variants, an in vitro experimental system was established. Splicing analysis was conducted using PCR and Sanger sequencing, while expression levels were assessed through qPCR and Western blot techniques.ResultsOne hotspot variant c.851-33T>A(ClinVar ID: 21308) and a novel variant c.850 + 5G>A(ClinVar ID:3069176) was inherited from her father and mother, respectively, identified in the affected individuals. The c.850 + 5G>A variant in NTRK1 resulted in two forms of aberrant mRNA splicing: 13bp deletion (c.838_850del13, p. Val280Ser fs180) and 25bp deletion (826_850del25, p. Val276Ser fs180) in exon 7, both leading to a translational termination at a premature stop codon and forming a C-terminal truncated protein. The expression of two abnormal splicing isoforms was decreased both in the level of mRNA and protein.ConclusionIn conclusion, this study elucidated the genetic cause of a patient with CIPA and identified a novel variant c.850 + 5G>A in NTRK1, which broadened the and enriched the NTRK1 mutation spectrum.

ObjectivesTo develop a predictive model for patent ductus arteriosus (PDA) in preterm infants at seven days postpartum. The model employs ultrasound measurements of the ductus arteriosus (DA) intimal thickness (IT) obtained within 24 h after birth.MethodsOne hundred and five preterm infants with gestational ages ranging from 27.0 to 36.7 weeks admitted within 24 h following birth were prospectively enrolled. Echocardiographic assessments were performed to measure DA IT within 24 h after birth, and DA status was evaluated through echocardiography on the seventh day postpartum. Potential predictors were considered, including traditional clinical risk factors, M-mode ultrasound parameters, lumen diameter of the DA (LD), and DA flow metrics. A final prediction model was formulated through bidirectional stepwise regression analysis and subsequently subjected to internal validation. The model's discriminative ability, calibration, and clinical applicability were also assessed.ResultsThe final predictive model included birth weight, application of mechanical ventilation, left ventricular end-diastolic diameter (LVEDd), LD, and the logarithm of IT (logIT). The receiver operating characteristic (ROC) curve for the model, predicated on logIT, exhibited excellent discriminative power with an area under the curve (AUC) of 0.985 (95% CI: 0.966–1.000), sensitivity of 1.000, and specificity of 0.909. Moreover, the model demonstrated robust calibration and goodness-of-fit (χ2 value = 0.560, p > 0.05), as well as strong reproducibility (accuracy: 0.935, Kappa: 0.773), as evidenced by 10-fold cross-validation. A decision curve analysis confirmed the model's broad clinical utility.ConclusionsOur study successfully establishes a predictive model for PDA in preterm infants at seven days postpartum, leveraging the measurement of DA IT. This model enables identifying, within the first 24 h of life, infants who are likely to benefit from timely DA closure, thereby informing treatment decisions.

Objective: Extracellular vesicles (EVs) have garnered considerable attention among researchers as candidates for natural drug delivery systems. This study aimed to investigate whether extracellular vesicle mediated targeting delivery of growth differentiation factor-15 (GDF15) improves myocardial repair by reprogramming macrophages post myocardial injury. Methods: EVs were isolated from macrophages transfected with GDF15 (EXO-GDF15) and control macrophages (EXO-NC). In vitro and vivo experiments, we compared their reprogram ability of macrophages and regeneration activity. Furthermore, proteomic analysis were employed to determine the specific mechanism by which GDF15 repairs the myocardium. Results: Compared with EXO-NC, EXO-GDF15 significantly regulated macrophage phenotypic shift, inhibited cardiomyocyte apoptosis, and enhanced endothelial cell angiogenesis. Moreover, EXO-GDF15 also significantly regulated macrophage heterogeneity and inflammatory cytokines, reduced fibrotic area, and enhanced cardiac function in infarcted rats. Proteomic analysis revealed a decrease in fatty acid-binding protein 4 (FABP4) protein expression following treatment with EXO-GDF15. Mechanistically, the reprogramming of macrophages by EXO-GDF15 is accomplished through the activation of Smad2/3 phosphorylation, which subsequently inhibits the production of FABP4. Conclusions: Extracellular vesicle mediated targeting delivery of growth differentiation factor-15 improves myocardial repair by reprogramming macrophages post myocardial injury via down-regulating the expression of FABP4. EXO-GDF15 may serve as a promising approach of immunotherapy.

To explore the association between the optimal coagulant for tofu and the components of soybeans,30 different kinds of soybeans were selected, and tested for their optimal coagulant MgCl2 content. The optimal amount of coagulant was taken as the dependent variable, and the soybean Composition were taken as independent variables for the correlation analysis. The results showed that there was a positive correlation between the optimal coagulant content and the content of histidine, 7S β-conglycinin, B1aB1bB2B3B4 of 11 s glycincin, and α'-subunit of 7S β-conglycinin, negative correlation with lysine. The regression formula is y = -1.186 + 3.457*B1aB1bB2B3B4 + 2.304*7S + 0.351*histidine − 0.084*lysine + 4.696*α', and the model is validated to be within 10 % of the error value and has a high degree of confidence. This study provides theoretical support for realizing the green production of traditional soybean products.

Abstract Background To investigate the prevalence and risk factors of refractive astigmatism (RA) and corneal astigmatism (CA) in preschool children and school-aged children in Shanghai, China. Methods In this school-based, cross-sectional study, 4–15 years old children across three learning stages of kindergarten, primary school, and junior high school underwent noncycloplegic autorefraction and completed comprehensive questionnaires involving time spent on daily homework and outdoor activities. Data from the right eyes were analysed. Results Overall, 7084 children (mean ± standard deviation (SD) of age: 8.08 ± 3.11 years) were included, and the prevalence rates of RA/CA ( ≤ − 1.0 D) in children were 15.8%/64% in kindergartens, 16.5%/65% in primary schools, and 32.8%/76.9% in junior high schools. The magnitude and prevalence of RA and CA all increased with age or with learning stage (all P

Abstract Anemia is the most common manifestation in myelodysplastic syndrome (MDS) patients, but the cause of ineffective hematopoiesis is not fully understood. Enucleation is an important event in the maturation process of erythroblasts. According to a series of morphological phenotypes of the pathological development of MDS erythroblasts, we speculate that there may be enucleation disorders. To verify this hypothesis, we cultured MDS bone marrow CD34+ cells in vitro and induced erythroblast development. The results showed that erythroblast enucleation in MDS was significantly lower than that in the normal group, and the rate of enucleation was positively correlated with hemoglobin concentration. Risk stratification of MDS was performed to further analyze the differences in enucleation among the normal group, low-middle risk group and high-risk group. The results showed that the enucleation rate of the high risk group was higher than that of the low-middle risk group but still lower than that of the normal group. Moreover, the expression of pERK and pAKT in MDS erythroblasts in the high risk group was higher than that in the normal group, while the expression of pERK and pAKT in the low-middle risk group was lower than that in the normal group. Furthermore, the enucleation of MDS was positively correlated with the phosphorylation degree of ERK and AKT. In conclusion, this study reveals that the enucleation of erythroblasts is one of the possible causes of anemia in MDS. Video Abstract

In order to improve the overall positive design ability of ship power engineering, the digital design method of ship power systems engineering is studied. The model-based systems engineering (MBSE) method theory was integrated with the system engineering method, using the independently developed V-Dats software platform and the graphical SysML language, modeling is carried out from four dimensions: requirements, behavior, structure and parameters of the auxiliary system of the generator set. The process analysis of system requirements-function-logic-physics was completed. The system requirement architecture, functional architecture and physical architecture model were obtained, then closed-loop verification and validation were carried out at the system level. By summarizing the top-level framework of the overall design process of ship power systems, an overall forward design method based on MBSE was proposed. The research results can effectively support the overall demonstration and design of ship power engineering.

Background Acute-on-chronic kidney disease (ACKD) increases the risk of progression of chronic kidney disease (CKD). This study aimed to evaluate the ability of a novel criteria of reference change value of the serum creatinine optimized criteria for acute kidney injury in CKD (cROCK) to detect ACKD patients. Methods This was a retrospective observational study with a 3-year follow-up. All included patients with CKD stage 3 were evaluated using cROCK, Kidney Disease Improving Global Outcomes (KDIGO), and their combined criteria. The renal composite endpoints, major adverse cardiovascular events (MACEs), and all-cause mortality were recorded as clinical outcomes. Results A total of 812 patients was enrolled. The cROCK criteria detected more ACKD events than did the KDIGO (68.0% vs. 59.5%, p < 0.001). Compared to KDIGO (−) & cROCK (−) group, ACKD patients diagnosed by cROCK had significantly higher hazard ratio [HR] for renal composite endpoints (HR, 3.591; p < 0.001), MACEs (HR, 1.748; p < 0.001), and all-cause mortality (HR, 2.985; p < 0.001). The patients in KDIGO (+) & cROCK (+) group had the lowest survival probability when considering renal composite endpoints, MACEs, and all-cause mortality (all p < 0.001). Furthermore, cROCK resulted in the largest area under the receiver operating characteristic curve (AUC) for predicting renal composite endpoints, and the combined criteria led to the largest AUC for predicting MACEs and all-cause mortality. Conclusion Compared to the KDIGO, the cROCK detected more ACKD events. Combining both cROCK and KDIGO criteria might improve the predictive ability for long-term outcomes in ACKD patients.

Excessive CO2 emissions and increased total costs of liner shipping are the two main problems affecting the environmental and economic benefits of liner companies under the European Union Emission Trading System (EU ETS). To address the upcoming EU ETS, we propose a carbon and cost accounting model for liner shipping that accurately calculates CO2 emissions and total cost of liner shipping. We conduct a case study that a containership operates on the liner route from the Far East to Northwest Europe. The results show that the sailing stage plays a pivotal role in CO2 emissions from liner shipping, accounting for 94.70% of CO2 emissions. Among four types of fuel, CO2 emissions from liner shipping using MGO is the largest, while CO2 emissions from liner shipping using methanol is the smallest. Methanol, as an alternative fuel, proves to be a better choice than LNG for CO2 control of liner shipping. The relationship between sailing speed and CO2 emissions follows a U-shaped curve for the selected containership. Notably, speed reduction is effective in carbon control of liner shipping only when the sailing speed exceeds 8.29 knots. Under the EU ETS, sailing speed is a key variable affecting the total cost of liner shipping. Speed reduction may not always be cost-effective. When keeping the total cost of liner shipping unchanged, sailing speed should be reduced as the EU allowance (EUA) price rises within a certain range. For the selected containership using MGO and HFO, the most economical sailing speed is 8.29 knots, corresponding to the increase in EUA price of 304.95% and 261.21%, respectively. If EUA price continues to rise, speed reduction will become ineffective in controlling the total cost of liner shipping. This model can enhance the environmental and economic benefits of liner companies, meet compliance requirements of the EU ETS, and provide a new perspective for carbon and cost control of liner shipping.

Triclosan (TCS) is a broad-spectrum antibacterial chemical widely presents in people’s daily lives. Epidemiological studies have revealed that TCS exposure may affect female puberty development. However, the developmental toxicity after low-dose TCS continuous exposure remains to be confirmed. In our study, 8-week-old ICR female mice were continuously exposed to TCS (30, 300, 3000 μg/kg/day) or vehicle (corn oil) from 2 weeks before mating to postnatal day 21 (PND 21) of F1 female mice, while F1 female mice were treated with TCS intragastric administration from PND 22 until PND 56. Vaginal opening (VO) observation, hypothalamic-pituitary-ovarian (HPO) axis related hormones and genes detection, and ovarian transcriptome analysis were carried out to investigate the effects of TCS exposure on puberty onset. Meanwhile, human granulosa-like tumor cell lines (KGN cells) were exposed to TCS to further explore the biological mechanism of the ovary in vitro. The results showed that long-term exposure to low-dose TCS led to approximately a 3-day earlier puberty onset in F1 female mice. Moreover, TCS up-regulated the secretion of estradiol (E2) and the expression of ovarian steroidogenesis genes. Notably, ovarian transcriptomes analysis as well as bidirectional validation in KGN cells suggested that L-type calcium channels and Pik3cd were involved in TCS-induced up-regulation of ovarian-related hormones and genes. In conclusion, our study demonstrated that TCS interfered with L-type calcium channels and activated Pik3cd to up-regulate the expression of ovarian steroidogenesis and related genes, thereby inducing the earlier puberty onset in F1 female mice.

Abstract Aims Exosomes are known as nanovesicles that are naturally secreted, playing an essential role in stem-mediated cardioprotection. This study mainly focused on investigating if exosomes derived from miR-214 overexpressing mesenchymal stem cells (MSCs) show more valid cardioprotective ability in a rat model of acute myocardial infarction (AMI) and its potential mechanisms. Methods Exosomes were isolated from control MSCs (Ctrl-Exo) and miR-214 overexpressing MSCs (miR-214OE-Exo) and then they were delivered to cardiomyocytes and endothelial cells in vitro under hypoxia and serum deprivation (H/SD) condition or in vivo in an acutely infarcted Sprague-Dawley rat heart. Regulated genes and signal pathways by miR-214OE-Exo treatment were explored using western blot analysis and luciferase assay. Results in vitro , miR-214OE-Exo enhanced migration, tube-like formation in endothelial cells. In addition, miR-214OE-Exo ameliorated the survival of cardiomyocytes under H/SD. In the rat AMI model, compared to Ctrl-Exo, miR-214OE-Exo reduced myocardial apoptosis, and therefore reduced infarct size and improved cardiac function. Besides, miR-214OE-Exo accelerated angiogenesis in peri-infarct region. Mechanistically, we identified that exosomal miR-214-3p promoted cardiac repair via targeting PTEN and activating p-AKT signal pathway. Conclusion Exosomes derived from miR-214 overexpressing MSCs have greatly strengthened the therapeutic efficacy for treatment of AMI by promoting cardiomyocyte survival and endothelial cell function. Graphical abstract

Small incision lenticule extraction (SMILE) has become one of the mainstream refractive surgeries in recent years, with satisfactory efficacy, safety, and predictability. SMILE-derived refractive lenticule, the byproduct of the surgery, holds great potential in clinical practice given its easy access and good biocompatibility. Numerous studies have been published to describe its applications in refractive correction, corneal ectasia diseases, and corneal defects. The feasibility and safety were validated in both animal models and clinical studies. Moreover, the preservation method is also crucial for its further promotion and application. Novel techniques are also evaluated and applied in lenticule preservation. We covered the recent advances in the preservation of corneal stromal lenticules and their clinical reuse in this review.

With the intensification of global climate problems, electric heating has recently attracted much attention as a clean and low-carbon heating method. Carbon nanotubes (CNTs) are an ideal medium for electric heating applications due to their excellent mechanical, electrical, and thermal properties. The preparation of electrothermal films based on an aqueous CNT dispersion as a raw material is environmentally friendly. However, in the traditional one-step filtration method, the residual excess dispersant and the small aspect ratio of the CNTs in the preparation process limit the performance of electrothermal CNT films. In this paper, we report a two-step filtration method that removes the free dispersant and small CNTs in the first filtration step and obtains denser CNT films by controlling the pores of the filter membrane in the second filtration step. The results suggest that, compared to the CNT1 film obtained from one-step filtration, the CNT1-0.22 film, obtained from two-step filtration using 1 and 0.22 μm membranes, has a smoother and flatter surface, and the surface resistance is 80.0 Ω sq−1, which is 29.4% lower. The convective radiation conversion efficiency of the CNT1-0.22 film is 3.36 mW/°C, which is 36.1% lower. We anticipate that such CNT films could be widely applied in building thermal insulation and underfloor heating.

In order to design Cu-Sn alloys with excellent overall performance, the structural stability, mechanical properties, and electronic structure of X-doped Cu-Sn alloys were systematically calculated using first-principles calculations. The calculation results of the cohesive energy indicate that the Cu-Sn-X structures formed by X atoms (X = Ag, Ca, Cd, Mg, Ni, Zr) doping into Cu-Sn can stably exist. The Cu-Sn-Ni structure is the most stable, with a cohesive energy value of −3.84 eV. Doping of X atoms leads to a decrease in the bulk modulus, Possion’s ratio and B/G ratio. However, doping Ag and Ni atoms can improve the shear modulus, Young’s modulus, and strain energy of the dislocation. The doping of Ni has the highest enhancement on shear modulus, Young’s modulus, and strain energy of the dislocation, with respective values as follows: 63.085 GPa, 163.593 GPa, and 1.689 W/J·m−1. The analysis of electronic structure results shows that the covalent bond between Cu and X is the reason for the performance differences in Cu-Sn-X structures.

The Ozone Monitoring Suite-Nadir (OMS-N) instrument is the first hyperspectral remote sensor in the ultraviolet band of China’s Fengyun series satellites. It can be used to detect several kinds of atmospheric constituents. This paper describes the prelaunch spectral calibration of the OMS-N onboard FengYun 3F. Several critical spectral parameters including the spectral resolution, spectral dispersion, and the instrument spectral response function were determined through laser-based measurements. A secondary peak of the instrument spectral response function from the short wavelength side of the ultraviolet band was found, and the possible influence on data applications was analyzed using a reference solar model and radiative transfer model. The results indicate that the spectral resolution and spectral accuracy of OMS-N meet the mission requirements. However, the asymmetries in the instrument spectral response function in the ultraviolet band were found near nadir rows, which are expressed as the “asymmetric central peak” and “secondary peak”. The analysis results show that if the influences of the instrument spectral response function “asymmetric central peak” and “secondary peak” in the ultraviolet band are ignored, they will bring an error as large as 5% at the center of the absorption line.

Sea surface temperature (SST) is a key parameter in ocean hydrology. Currently, existing SST prediction methods fail to fully utilize the potential spatial correlation between variables. To address this challenge, we propose a spatiotenporal UNet (ST-UNet) model based on the UNet model. In particular, in the encoding phase of ST-UNet, we use parallel convolution with different kernel sizes to efficiently extract spatial features, and use ConvLSTM to capture temporal features based on the utilization of spatial features. Atrous Spatial Pyramid Pooling (ASPP) module is placed at the bottleneck of the network to further incorporate the multi-scale features, allowing the spatial features to be fully utilized. The final prediction is then generated in the decoding stage using parallel convolution with different kernel sizes similar to the encoding stage. We conducted a series of experiments on the Bohai Sea and Yellow Sea SST data set, as well as the South China Sea SST data set, using SST data from the past 35 days to predict SST data for 1, 3, and 7 days in the future. The model was trained using data spanning from 2010 to 2021, with data from 2022 being utilized to assess the model’s predictive performance. The experimental results show that the model proposed in this research paper achieves excellent results at different prediction scales in both sea areas, and the model consistently outperforms other methods. Specifically, in the Bohai Sea and Yellow Sea sea areas, when the prediction scales are 1, 3, and 7 days, the MAE of ST-UNet outperforms the best results of the other three compared models by 17%, 12%, and 2%, and the MSE by 16%, 18%, and 9%, respectively. In the South China Sea, when the prediction ranges are 1, 3, and 7 days, the MAE of ST-UNet is 27%, 18%, and 3% higher than the best of the other three compared models, and the MSE is 46%, 39%, and 16% higher, respectively. Our results highlight the effectiveness of the ST-UNet model in capturing spatial correlations and accurately predicting SST. The proposed model is expected to improve marine hydrographic studies.

Abstract Objective This study aims to investigate the association of lysine methyltransferase 2 C (MLL3) and transforming growth factor β (TGF-β) signaling-related gene polymorphisms with the susceptibility of Stanford type B aortic dissection (AD) and its clinical prognostic outcomes. The methods involved investigating the MLL3 (rs10244604, rs6963460, rs1137721), TGFβ1 (rs1800469), TGFβ2 (rs900), TGFR1 (rs1626340) and TGFR2 (rs4522809) gene polymorphisms. Logistic regression was performed to investigate the association between 7 single nucleotide gene polymorphisms (SNPs) and Stanford type B aortic dissection. The GMDR software was used to analyze gene-gene and gene-environment interactions. The odds ratio (OR) with a 95% confidence interval (CI) was employed to evaluate the association of genes and Stanford type B AD risk. Results Genotypes and allele distributions in the case and control groups showed significant differences (P

The correlation between ubiquitin-editing enzyme A20 and E3 ubiquitin ligase ring finger protein (RNF) 168 has been reported to be critical for repair of DNA damage. This study aimed to evaluate the potential role of this regulatory interaction in the pathogenesis of lupus nephritis (LN). The expression of RNF168 and A20 was measured in the podocytes derived from MRL/lpr murine lupus as well as patients with LN. Cell-based studies using renal podocytes bearing silenced RNF168, over-expressed A20, autophagy-related gene (Atg) 5 (a ubiquitin-like modifier), or silenced Atg5 were used to assess the effect of RNF168, A20, and Atg5 on DNA damage repair and nuclear factor kappa-B (NF-κB) activation in LN. It was found that podocyte autophagy was over-activated in LN and the abnormal podocyte autophagy led to down-regulation of A20, up-regulation of RNF168, and activation of the NF-κB. RNF168 silencing or A20 restoration inhibited activation of NF-κB pathway and promoted repair of DNA damage, where the level of autophagy was not changed. Activated A20 in podocytes weakened the promoting action of cell autophagy on RNF168. The current results suggest that RNF168 dysfunction may be involved in the pathogenesis of LN via down-regulation of A20 expression. Autophagy and RNF168 may be therapeutic targets for the prevention and treatment of LN.

Abstract We retrospectively enrolled 325 gastric cancer (GC) patients to investigate the associations of programmed death ligand‐1 (PD‐L1) expression with clinicopathological characteristics by different scoring methods and different cutoff values. PD‐L1 expression was evaluated by the tumor proportion score (TPS) and the combined positive score (CPS). The positive rate of PD‐L1 TPS ≥1%, CPS ≥1, CPS ≥5 and CPS ≥10 in our study were 12.0%, 87.4%, 69.8% and 42.2%, respectively. Multivariate analysis showed that PD‐L1 CPS ≥5 was related to high expression of Ki67 (OR = 2.658, 95% CI: 1.401–5.045, p = .003) and pTNM staging (p = .033). PD‐L1 CPS ≥10 was correlated with larger tumor size (OR = 2.322, 95% CI: 1.052–5.127, p = .037) and lymph node metastasis (OR = 2.495, 95% CI: 1.293–4.814, p = .006). It is expected that these results can provide a reference for screening GC patients with high PD‐L1 expression level.

Purpose: This study aimed to investigate the features of progressive keratoconus by means of machine learning.Methods: In total, 163 eyes from 127 patients with at least 3 examination records were enrolled in this study. Pentacam HR was used to measure corneal topography. Steepest meridian keratometry (K1), flattest meridian keratometry (K2), steepest anterior keratometry (Kmax), central corneal thickness (CCT), thinnest corneal thickness (TCT), anterior radius of cornea (ARC), posterior elevation (PE), index of surface variation (ISV), and index of height deviation (IHD) were input for analysis. Support vector machine (SVM) and logistic regression analysis were applied to construct prediction models.Results: Age, PE, and IHD showed statistically significant differences as the follow-up period extended. K2, PE, and ARC were selected for model construction. Logistic regression analysis presented a mean area under the curve (AUC) score of 0.780, while SVM presented a mean AUC of 0.659. The prediction sensitivity of SVM was 52.9%, and specificity was 79.0%.Conclusion: It is feasible to use machine learning to predict the progression and prognosis of keratoconus. Posterior elevation exhibits a sensitive prediction effect.

In 2024, the EU intends to include the global shipping industry in the European Union Emission Trading Scheme (EU ETS). Shipping companies will have to pay for the carbon emissions of ships over 5,000 GT on routes between EU and non-EU ports. This paper selects typical shipping companies in the world. Based on the principle of fairness, historical method, baseline method and mixed method are adopted to explore their carbon emission quota allocation. The ZSG-DEA efficiency model is used to evaluate the distribution results and verify the optimal efficiency. The research results show that the mixed method has a high efficiency of allocation. The method predicts that the carbon quota of typical shipping companies in the world will reach the Pareto optimal allocation in 2024 and Maersk has the highest carbon emission quota among the eight typical shipping companies, reaching 32,431,800 tons, followed by MSC and EMC, reaching 8,542,400 tons and 6,809,500 tons, respectively. Based on the results, we can obtain a reasonable allocation of carbon allowances in the EU carbon market according to the proportion of business of shipping companies involved in EU routes. The research is still applicable to the allocation of carbon emmissions in future years. Therefore, this paper provides suggestions for the orderly allocation of carbon quota and carbon trading in the global shipping market.

The operational carbon intensity indicator (CII) proposed by the International Maritime Organization (IMO) has been officially implemented on January 1, 2023. As an important way of ship operation, applicable time charter ships are subject to the CII regulation. How to properly deal with the CII regulation is a challenge for the shipowner and charterer of time charter ships. Speed reduction is an effective measure to reduce carbon emissions and carbon intensity of ships. This study establishes a speed model including CII penalty for time charter ships. Results show that speed reductions of a time charter ship of 10 %, 20 % and 30 % reduce carbon emissions by 27.1 %, 48.8 % and 65.7 % and carbon intensity by 19 %, 36 % and 51 %, respectively. Speed reduction leads to reductions of carbon emissions, carbon intensity and CII penalty, with greater reductions for larger ships. Under the optimal charterer profit, the speed of a time charter ship increases with the rise of freight rate and reduces with the decrease of freight rate. When the fluctuation range of freight rate is the same, the larger the ship type is, the smaller the speed adjustment range is. For the same ship type, when its freight rate decreases, it is suggested that the charterer reduces speed; otherwise, it is suggested that the charterer increases speed. For different ship types, if the shipping market is booming, the charterer should charter more large ships; otherwise, the charterer can choose more small ships.

Abstract Background To compare the characteristics of corneal thickness measurements among the RTVue, Casia-2, and Pentacam in patients with mild-to-moderate keratoconus. Methods We recruited 46 eyes of 46 patients diagnosed with mild-to-moderate keratoconus at our hospital between January and March 2022. The central corneal thickness (CCT) and thinnest corneal thickness (TCT) were measured using two optical coherence tomography (OCT) instruments (RTVue and Casia-2) and the more conventional Pentacam. Differences and correlations between the CCTs and TCTs, based on the device and influencing factors, were explored. Results The CCTs were highly consistent among the groups (p = 0.434) and correlated with one another (p 0.05). Multivariate analysis identified that the TCT measurement difference between the RTVue and Pentacam was related to the difference between the CCT and TCT (b = 0.490, 95% confidence interval [CI]: 0.033 to 0.948, p = 0.036), whereas the difference between the Casia-2 and Pentacam was related to the anterior radius for curvature (A) grade (b = 3.9, 95% CI: 1.753 to 6.074, p = 0.001), corneal pachymetry at the thinnest (C) grade (b = − 7.875, 95% CI: − 11.404 to − 4.346, p

Abstract Background An increasing prevalence of mental disorders (MDs) has been reported among children and adolescents. However, only few studies have conducted ocular examinations, including those on refractive status, in these groups of patients. Thus, the purpose of this study was to evaluate the refractive status and ocular findings in children and adolescents with MDs compared with matched controls with similar socioeconomic backgrounds. Methods A total of 178 participants with MDs and 200 controls were recruited between April 2021 and May 2022. All the children and adolescents underwent cycloplegic or noncycloplegic autorefraction and retinoscopy, slit-lamp biomicroscopy, and dilated fundus examinations. Ocular alignment was assessed using Hirschberg, Krimsky, or prism cover tests. The prevalence of refractive errors and ocular findings was the main outcome. Results Twenty-seven percent of patients with MDs and 8% of controls had ocular findings, the most common of which were conjunctivitis, keratitis, and trichiasis. For refractive status, 70% (124/178) of patients with MDs had myopia ≤-1.00 DS, and 2% (4/178) had hyperopia ≥+2.00 DS. In the control group, 70% (140/200) of patients had myopia ≤-1.00 DS, and 1% (2/200) had hyperopia ≥+2.00 DS. No differences were observed between the MD and control groups. However, the patients in the MD group (14.25±2.69 years) were significantly more susceptible to strabismus (P

Blood flow is an important physiological parameter of the human body. Real-time measurement of blood flow in the brain, skeletal muscle, and breast tissue is of great significance for disease diagnosis, treatment, surgery, and intensive care. Near-Infrared Diffuse Correlation Spectroscopy (DCS) is a new-type tissue blood flow measurement technology. When using DCS technology for blood flow measurement, the light source-detector (S-D) at each distance contains different degrees of mixed signals of superficial and deep tissues, among which the superficial signals show greater impact on the extraction of blood flow in deep tissues. This paper combines the Nth order linear algorithm (NL algorithm) with the independent component analysis algorithm (Independent Component Analysis, ICA) to separate and process the short-range and long-range optical signals obtained by DCS technology. The computer simulation shows that the algorithm proposed in this paper can better separate the blood flow signals of the superficial and deep tissues, and demonstrates important potential for the application of DCS technology in clinical blood flow measurement in the future.

ObjectivesThis study seeks to explore the dynamic response characteristics of a marine steam power system under the condition of rapid and large power disturbance. MethodsA complete set of onshore experimental devices for a steam power system is established, and the dynamic response characteristics are studied by applying power disturbance by simulated load. ResultsThe experimental results show that under the condition of a single period disturbance, the fluctuation range of the drum pressure is within ± 1.5% and that of the propeller speed is within ± 2.5%; under the condition of continuous periodic disturbance, the fluctuation range of the drum pressure is within ± 2.5% and that of the propeller speed is within ± 3.5%; during the experiment, the steam power system generally runs in a stable manner. ConclusionThe results of this study can provide technical support for the actual operation and use of steam power systems.

ABSTRACT Importance Optical coherence tomography (OCT) is a high‐resolution intravascular imaging tool and has shown promise for providing real‐time quantitative and qualitative descriptions of pulmonary vascular structures in vivo in adult pulmonary hypertension (PH), while not popular in pediatric patients with congenital heart diseases (CHD). Objective The aim of this review is to summarize all the available evidence on the use of OCT for imaging pulmonary vascular remodeling in pediatric patients. Methods We conducted the systematic literature resources (Cochran Library database, Medline via PubMed, EMBASE, and Web of Knowledge) from January 2010 to December 2021 and the search terms were “PH”, “child”, “children”, “pediatric”, “OCT”, “CHD”, “pulmonary vessels”, “pulmonary artery wall”. Studies in which OCT was used to image the pulmonary vessels in pediatric patients with CHD were considered for inclusion. Results Five studies met the inclusion criteria. These five papers discussed the study of OCT in the pulmonary vasculature of different types of CHD, including common simple CHD, complex cyanotic CHD, and Williams‐Beuren syndrome. In biventricular anatomy, pulmonary vascular remodeling was primarily reflected by pulmonary intima thickening from two‐dimensional OCT. In single‐ventricle anatomy, due to the state of hypoxia, the morphology of pulmonary vessels was indirectly reflected by the number and shape of nourishing vessels from three‐dimensional OCT. Interpretation OCT may be an adequate imaging procedure for the demonstration of pulmonary vascular structures and provide additional information in pediatric patients.

Abstract Background This study evaluated the effects of less invasive surfactant administration (LISA) and intubation-surfactant-extubation (InSurE) on bronchopulmonary dysplasia (BPD) in preterm infants with respiratory distress syndrome (RDS). Methods Neonates with respiratory distress syndrome requiring surfactant, with gestational age 0.05, respectively). The incidences of necrotizing enterocolitis requiring surgery, retinopathy of prematurity ≥ stage 3, patent ductus arteriosus requiring medical therapy or surgery, and length of hospitalization did not differ significantly between the two groups (P > 0.05, respectively). Conclusions For surfactant administration among preterm infants with respiratory distress syndrome, LISA did not decrease bronchopulmonary dysplasia and severity of BPD at 36 weeks postmenstrual age. The benefits of LISA would require further evaluations.

Abstract Bronchoscopic TransParenchymal Nodule Access (BTPNA) technology is mainly used for sampling or ablative treatment of lung parenchymal lesions that cannot be reached by bronchoscopy and its appendages, generally for palliative treatment of some lung tumors. We used BTPNA to treat a 32‐year‐old young woman with pulmonary tuberculosis and successfully perforated her occluded left main bronchus. Her left atelectasis was recovered, and a silicone stent was inserted to preserve the shape of the left main bronchus.

Background Diabetic kidney disease (DKD) is a common and serious complication in patients with diabetic mellitus (DM), the risk of cardiovascular events and all-cause mortality also increases in DKD patients. This study aimed to detect the influencing factors of DKD in type 2 DM (T2DM) patients, and construct DKD prediction models and nomogram for clinical decision-making.Methods A total of 14,628 patients with T2DM were included. These patients were divided into pre-DKD and non-DKD groups, depending on the occurrence of DKD during a 3-year follow-up from first clinic attendance. The influencing indicators of DKD were analyzed, the prediction models were established by multivariable logistic regression, and a nomogram was drawn for DKD risk assessment.Results Two prediction models for DKD were built by multivariate logistic regression analysis. Model 1 was created based on 17 variables using the forward selection method, Model 2 was established by 19 variables using the backward elimination method. The Somers’ D values of both models were 0.789. Four independent predictors were selected to build the nomogram, including age, UACR, eGFR, and neutrophil percentages. The C-index of the nomogram reached 0.864, suggesting a good predictive accuracy for DKD development.Conclusions Our prediction models had strong predictive powers, and our nomogram provided visual aids to DKD risk calculation, which was simple and fast. These algorithms can provide early DKD risk prediction, which might help to improve the medical care for early detection and intervention in T2DM patients, and then consequently improve the prognosis of DM patients.

Background: Animal reproduction performance is crucial in husbandry. Immunocastrated animals serve as an ideal animal model for studying testicular function. During androgen suppression, the testis undergoes dramatic developmental and structural changes, including the inhibition of hormone secretion and spermatogenesis. Methods: To characterize this process, we investigated the effects of castration using a recombinant B2L and KISS1 DNA vaccine, and then identified functional genes in the testes of Yiling goats using RNA-seq and WGS. The experimental animals were divided into three groups: the PVAX-asd group (control), PBK-asd-immunized group, and surgically castrated group. Results: The results demonstrated that the administration of the recombinant PBK-asd vaccine in goats elicited a significant antibody response, and reduced serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH), resulting in smaller scrotal circumferences and decreased sexual desire compared to the control group. In addition, RNA transcriptome sequencing (RNA-seq) analysis of the testes revealed that the biological processes after immunocastration mainly focused on the regulation of cell matrix adhesion, histone acetylation, negative regulation of developmental processes, apoptosis, and activation of the complement system and the thrombin cascade reaction system. Then, we integrated the whole-genome sequencing and testis transcriptome, and identified several candidate genes (FGF9, FST, KIT, TH, TCP1, PLEKHA1, TMEM119, ESR1, TIPARP, LEP) that influence steroidogenesis secretion and spermatogenesis. Conclusions: Multiple pathways and polygenic co-expression participate in the response to castration vaccines, altering hormone secretion and spermatogenesis. Taken together, our atlas of the immunocastration goat testis provides multiple insights into the developmental changes and key factors accompanying androgen suppression, and thus may contribute to understanding the genetic mechanism of testis function. Joint analysis of whole genome sequencing and RNA-seq enables reliable screening of candidate genes, benefiting future genome-assisted breeding of goats.

Objective: The effect of oxygen therapy on the prognosis of chronic obstructive pulmonary disease (COPD) with nocturnal hypoxemia (NOD) has been controversial. Therefore, this study systematically evaluated the relevant literature and included it into randomized controlled studies for meta-analysis to evaluate the efficacy and prognosis.Methods: We searched PubMed, EMBASE, web of science, Cochrane, China HowNet and Wanfang database for the literature on the prognosis of COPD patients with simple NOD from the establishment of the database to 30 June 2022. The outcome indicators were death and aggravation of the disease. The efficacy evaluation measures were pulmonary function and arterial blood gas results. The publication bias and heterogeneity of the included studies were evaluated.Results: A total of 621 patients from 5 studies were included in this meta-analysis, and there was no publication bias in the included studies. The total mortality of long-term oxygen therapy (LTOT) in COPD patients with simple NOD in oxygen therapy group (RR = 1.04; 95% CI: 0.81–1.33, p = 0.77), mortality (RR = 0.87; 95% CI: 0.58–1.31, p = 0.50), risk of progression to LTOT events (RR = 1.07; 95% CI: 0.76–1.51, p = 0.71). PaO2 in patients with COPD and simple NOD in oxygen therapy group was higher than that in non-oxygen therapy group (mean difference (MD) = 13.47; 95% CI: 3.49–23.46, p = 0.008), the decrease of PaCO2 level was not statistically significant (MD = −10.05; 95% CI: −26.36-6.27, p = 0.23).Conclusion: Oxygen therapy can improve the prognosis of blood oxygen partial pressure in COPD patients with simple NOD, but oxygen therapy has no significant effect on the survival rate, controlling the progression of the disease to LTOT and reducing the partial pressure of carbon dioxide.

Purpose: To compare bilateral differences in corneal biomechanics between keratoconus and normal eyes.Methods: In this case-control study, 346 eyes of 173 patients (aged 22.1 ± 6.1 years) with keratoconus (KC group) and 378 eyes of 189 patients (aged 26.7 ± 5.6 years) with ametropia (control group) were enrolled. Corneal tomography and biomechanical properties were examined using Pentacam HR and Corvis ST, respectively. The corneal biomechanical parameters were compared between eyes with forme fruste keratoconus (FFKC) and normal eyes. Bilateral differences in corneal biomechanical parameters were compared between the KC and control groups. Receiver operating characteristic (ROC) analysis was used to assess discriminative efficacies.Results: The areas under the ROC curves (AUROCs) of stiffness parameter at the first applanation (SP-A1) and Tomographic and Biomechanical Index (TBI) for identifying FFKC were 0.641 and 0.694, respectively. The bilateral differential values of major corneal biomechanical parameters were significantly increased in the KC group (all p < 0.05), except for the Corvis Biomechanical Index (CBI). The AUROCs of the bilateral differential values of the deformation amplitude ratio at 2 mm (ΔDAR2), Integrated Radius (ΔIR), SP-A1 (ΔSP-A1), and the maximum inverse concave radius (ΔMax ICR) for discriminating keratoconus were 0.889, 0.884, 0.826, and 0.805, respectively. The Logistic Regression Model-1 (comprising of ΔDAR2, ΔIR, and age) and the Logistic Regression Model-2 (comprising of ΔIR, ΔARTh, ΔBAD-D, and age) had AUROCs of 0.922 and 0.998, respectively, for discriminating keratoconus.Conclusion: The bilateral asymmetry of corneal biomechanics was significantly increased in keratoconus compared with normal eyes, which may be helpful for the early detection of keratoconus.

Abstract Background and aims The effect of dapagliflozin (DAPA) on the prognosis of patients with acute myocardial infarction (AMI) is unclear. The present study was conducted to evaluate the association between DAPA administration and adverse events in patients with AMI undergoing percutaneous coronary intervention (PCI). Methods This single-center retrospective analysis study included a total of 786 patients with AMI from January 2019 to August 2021 who were or were not administered DAPA at discharge. The primary endpoint was the composite of major adverse cardiovascular events (MACE), including overall deaths, heart failure, nonfatal MI, nonfatal stroke, and unplanned repeat revascularization (URR). Differences in the triglyceride glucose (TyG) index and the atherogenic index of plasma (AIP) both during hospitalization and 12 months after discharge (if achievable) were also compared. Results During a median follow-up of 23 months, 130 patients had MACE (118 in the DAPA-free group and 12 in the DAPA group). Kaplan–Meier survival analyses revealed that the cumulative incidence of MACE (log-rank test, p = 0.009), heart failure (p = 0.003), nonfatal MI (p = 0.005), and URR (p = 0.031) was higher in the DAPA-free group. In addition, the multivariate Cox analysis showed that DAPA was significantly associated with the reduced risk of MACE (hazard ratio = 0.170, 95% confidence interval = 0.078–0.373, p

Miniaturized infrared spectrometers are required for imaging and remote sensing applications, but they are usually characterized by a cm-scale footprint. Here, the authors report the realization of near-infrared spectrometers based on Au-atom-intercalated ReS2/WSe2 heterostructures with an active footprint < 10 μm and electrically tunable photoresponse.

Abstract Background Many studies that collect maternal and neonatal outcomes rely on patient self-report phone calls. It is unclear how reliable or accurate these phone call reports are. Objective To evaluate the reliability of telephone calls in information collection in IVF. Study design The women were interviewed seven days after delivery by a nurse via telephone. The maternal and neonatal outcomes were recorded based on a self-report from one of the spouses. Meanwhile, the standardized electronic hospitalized discharge records were extracted from the hospital medical database. For each case, maternal and neonatal information obtained from telephone interviews and extracted from medical files were compared. Results Agreement was classified as “almost perfect, K = 0.81–1.00” for preterm birth, cesarean delivery, low birth weight baby, and macrosomia. The strength of agreement was classified as “moderate, K = 0.41–0.60” for some antepartum complications: gestational diabetes (K = 0.569); pregnancy-induced hypertension (K = 0.588); intrahepatic cholestasis of pregnancy (K = 0.597) and oligohydramnios (K = 0.432). The strength of agreement between telephone interviews and hospitalized discharge records can be classified as “slight (K = 0–0.20)” for some complications: thyroid diseases (K = 0.137), anemia (K = 0.047), postpartum hemorrhage (K = 0.016), and Fetal distress (K = 0.106). Conclusion Some variables (preterm birth, cesarean delivery, birth weight) information collected by telephone follow-up were reliable. However, other complications (thyroid diseases, anemia, postpartum hemorrhage, and fetal distress) collected via self-report was non-reliable. Compared with complications during labor, antepartum complications have higher agreement between different follow-up methods. IVF records and hospitalized discharge records should be matched and collected simultaneously when discussing maternal and neonatal outcomes of IVF.

Objective To genetically analyze the Del sample from a blood donor in Jiangyin and make clear the molecular basis of the serological phenotype. Methods The EDTA anticoagulant blood were collected: buffy coat were used for nucleic acid extract and cDNA analysis; red blood cells for serological test. Tube method and microcolumn gel were used for serological test. Genotyping kit were used for exon analysis. Gene mutation was analyzed using the sequence analyzer. Results Serological analysis demonstrated the sample′s RhD phenotype was Del. The phenotype of RhCE was CCEe. Real-time fluorescence quota PCR result demonstrated the existence of all exones. Weak D15 and RHD*DEL1 [RHD(1227G>A)], which had a high frequency of occurrence in China, were excluded according to real-time fluorescence quota PCR result. Sequence analyzing result verified RHD(28C>T) SNP mutation in cDNA. The genotype of this sample was RHD*01 W. 61[RHD(28C>T)]. Conclusion A weak D61 was found among blood donors in our city, Jiangyin.

Objective: Post-treatment contrast-induced acute kidney injury (CI-AKI) is associated with poor outcomes in patients with acute myocardial infarction (AMI). A lower free triiodothyronine (FT3) level predicts a poor prognosis of AMI patients. This study evaluated the effect of plasma FT3 level in predicting CI-AKI and short-term survival among AMI patients. Methods: Coronary arteriography or percutaneous coronary intervention was performed in patients with AMI. A 1:3 propensity score (PS) was used to match patients in the CI-AKI group and the non-CI-AKI group. Results: Of 1480 patients enrolled in the study, 224 (15.1%) patients developed CI-AKI. The FT3 level was lower in CI-AKI patients than in non-CI-AKI patients (3.72 ± 0.88 pmol/L vs 4.01 ± 0.80 pmol/L, P < 0.001). Compared with those at the lowest quartile of FT3, the patients at quartiles 2–4 had a higher risk of CI-AKI respectively (P for trend = 0.005). The risk of CI-AKI increased by 17.7% as FT3 level decreased by one unit after PS-matching analysis (odds ratio: 0.823; 95% CI: 0.685–0.988, P = 0.036). After a median of 31 days of follow-up (interquartile range: 30–35 days), 78 patients died, including 72 cardiogenic deaths and 6 non-cardiogenic deaths, with more deaths in the CI-AKI group than in the non-CI-AKI group (53 vs 25, P < 0.001). Kaplan–Meier survival analysis showed that patients at a lower FT3 quartile achieved a worse survival before and after matching. Conclusion: Lower FT3 may increase the risk of CI-AKI and 1-month mortality in AMI patients.

Abstract Background The composition and diversity of root microbial community are affected by plant genotypes and soil environment, which in turn affect plant growth and development. Grafting rootstock types of the apple tree can affect phenotypes in cultivation practice, but it is not clear whether grafting rootstock types can affect the composition and diversity of root microbial community and the resistance of apple tree to apple Valsa canker. Methods To explore root microbial differences and the correlation, 16S rRNA and ITS genes were sequenced using Novaseq technology. Results The results showed that the influence of grafting rootstock types on the composition of the root fungal community was greater than that of bacteria. And the bacterial community richness was higher in the healthy (OTUs: 1693) and dwarfing rootstock (OTUs: 1526) than in the disease (OTUs: 1181) and standard rootstock (OTUs: 1412), while the fungal community richness was the opposite. Moreover, the bacterial abundance of root zone, rhizosphere, and root endophytic microorganisms with the same grafting rootstock type exhibited a decreasing trend. Results of Nested PCR assay on soil and root tissue of Valsa mali showed that the content of V. mali in dwarfing rootstocks are lower than standard rootstocks. These results suggest that apple trees grafting with dwarfing rootstocks are more resistant to V. mali than standard rootstocks. Conclusions Under different grafting types, the effect on the composition of fungal community in apple tree root was greater than that of bacteria. The bacterial community in dwarfing rootstocks is more abundant and diverse, including more beneficial microorganisms. Therefore, dwarfing rootstock is more conducive to the resistance to apple Valsa canker from biological control.

Background: Extracellular vesicles (EVs) derived from mesenchymal stem cells (MSCs), due to their inner functional substances, have shown great value in treating acute myocardial infarction (AMI). However, their clinical application is limited by a low yield. In the present study, we cultured EVs using a hollow fiber bioreactor-based three-dimensional (3D) system, and assessed their therapeutic effectiveness on AMI. Methods: The MSCs separated from fresh human umbilical cord were planted into the flasks of two systems: two-dimensional (2D) culture and hollow-fiber-bioreactor based 3D culture. EVs were extracted from the culture supernatants. Characteristics and yields of EVs from two culture systems, namely 2D-EVs and 3D-EVs, were compared. A rat model of AMI was built up to assess their therapeutic efficacy on AMI. Results: The yield of 3D-EVs was higher, with biofunctions similar to those of 2D-EVs. 3D-EVs repressed the apoptosis of cardiomyocytes, facilitated angiogenesis, and regulated the transition of macrophage subpopulations after myocardial infarction, and eventually improved cardiac function in the AMI rats. Conclusions: The hollow fiber 3D culture system can increase the yield of MSCs-derived EVs to render a strong cardioprotective effect in AMI rats.

ObjectivesAssess the validity of the Chinese version of the Dominic Interactive (DI), a 91-item, video-based diagnostic screening instrument for children that assesses four internalized disorders (phobias, separation anxiety disorder, generalized anxiety disorder, and major depressive disorder) and three externalized disorders (attention-deficit/hyperactivity disorder, conduct disorder, oppositional defiant disorder).Methods(1) Compare DI-generated “probable” or “possible” diagnoses to diagnoses based on the Development and Well-Being Assessment (DAWBA) instrument in 113 psychiatric outpatients and 20 community controls. (2) Administer DI to 1,479 children from elementary schools in Tianjin.ResultsIn the validation sample, DI with DAWBA concordance was much greater for internalized disorders (mean Kappa = 0.56) than for externalized disorders (mean kappa = 0.11). The positive predictive value of DI diagnoses ranged from 0.96 (generalized anxiety disorder) to 25% (oppositional defiant disorder) and negative from 0.81 to 0.96. Using “probable” cuts provides better results. In the survey, prevalence of probable DI disorders ranged from 1.0% (conduct disorder) to 13.1% (phobias). Internal consistency of all DI items was excellent (Cronbach alpha = 0.93) and that of the seven subscales ranged from 0.64 (phobias) to 0.87 (major depressive disorder). In multilevel SEM analyses, SRMR (Standardized root mean square residual) or each of the seven diagnoses was below 0.08 and each coefficient of determination was below 0.60.ConclusionThe Chinese DI is a convenient method of screening common mental disorders in Chinese children mainly for internalized disorders, which are the most prevalent diagnoses in that population. However its high negative predictive values for externalized could be used for screening.