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Abstract Background Extended contact with silica particles can lead to Silicosis, a chronic lung condition lacking established treatment protocols or clear mechanisms of development. The urgency for innovative treatments arises from the unavailability of effective treatment methodologies. The origin of silica-induced pulmonary fibrosis includes essential processes such as macrophage activation and the conversion of fibroblasts into myofibroblasts, with oxidative stress playing a pivotal role. Shionone (SHI), a triterpenoid extracted from the Aster tataricus plant, is recognized for its extensive health benefits. This study explores the capability of SHI to alleviate the effects of silica-induced lung fibrosis in mice. Methods This investigation explored the impact of SHI on lung inflammation and fibrosis at different stages (early and late) triggered by silica in mice, focusing specifically on the initial and more developed phases. It comprised an analysis of isolated peritoneal macrophages and fibroblasts extracted from mice to elucidate SHI's therapeutic potential and its underlying mechanism. The methodology employed encompassed quantitative PCR, immunofluorescence, flow cytometry, and western blotting to examine macrophage activity and their transition into myofibroblasts. The activation of the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway by SHI was confirmed via immunofluorescence and western blot studies. SHI's antioxidative properties were evidenced by the measurement of reactive oxygen species (ROS) and mitochondrial ROS within both macrophages and fibroblasts, using 2′, 7′-dichlorodihydrofluorescein diacetate and MitoSOX, respectively. The relevance of SHI was further underscored by applying ML385 and Nrf2 siRNA to gauge its effectiveness. Results Starting SHI treatment early countered the harmful effects of lung inflammation and fibrosis caused by silica, while initiating SHI at a later phase decelerated the advancement of fibrosis. SHI's action was linked to the activation of the Nrf2 signaling pathway, a boost in antioxidant enzyme levels, and a decrease in oxidative stress and inflammation in macrophages affected by silica. Furthermore, SHI prevented the conversion of fibroblasts into myofibroblasts prompted by TGF-β, along with the resultant oxidative stress. The beneficial outcomes of SHI were negated when ML385 and Nrf2 siRNA were applied, highlighting the pivotal role of the Nrf2 pathway in SHI's efficacy. Conclusion SHI plays a significant role in stimulating the Nrf2 pathway, thereby defending against silica-induced oxidative stress and inflammatory reactions in macrophages, and inhibiting the conversion of fibroblasts to myofibroblasts due to TGF-β. This suggests that SHI is a viable option for treating lung inflammation and fibrosis in mice suffering from silicosis.

Abstract In various practical situations, the information about the process distribution is sometimes partially or completely unavailable. In these instances, practitioners prefer to use nonparametric charts as they don’t restrict the assumption of normality or specific distribution. In this current article, a nonparametric double homogeneously weighted moving average control chart based on the Wilcoxon signed-rank statistic is developed for monitoring the location parameter of the process. The run-length profiles of the newly developed chart are obtained by using Monte Carlo simulations. Comparisons are made based on various performance metrics of run-length distribution among proposed and existing nonparametric counterparts charts. The extra quadratic loss is used to evaluate the overall performance of the proposed and existing charts. The newly developed scheme showed comparatively better results than its existing counterparts. For practical implementation of the suggested scheme, the real-world dataset related to the inside diameter of the automobile piston rings is also used.

The impact of climate warming on wetland ecosystems is a current focal point in ecological research. In this study, the Napahai wetland, a typical plateau wetland in northwest Yunnan Province, was selected as the study site to understand the growth and survival strategies of emergent plants in a plateau wetland under climate warming conditions. Open-top chambers (OTCs) were used to simulate warming in three treatments (i.e., control group, 2.0 ± 0.5°C, and 4.0 ± 0.5°C) in order to study the responses of the functional traits of the dominant emergent plant Schoenoplectus tabernaemontani to simulated warming. The results showed that simulated warming significantly reduced the photosynthetic carbon assimilation capacity and biomass accumulation of S. tabernaemontani, as well as its nitrogen content and vascular bundle density, while it significantly increased the vascular bundle size. The growing season accumulated temperature (AT) and the mean temperature of the hottest month (WT) were the main temperature factors influencing the functional traits of S. tabernaemontani. In summary, simulated warming significantly affected the functional traits of S. tabernaemontani, which demonstrated effective adaptation to warming conditions. As the temperature rises and the light and productivity decrease, S. tabernaemontani prioritizes the supply of limited resources to the underground part to ensure the biomass supply of the reproductive structure. This study provides a case for revealing the response patterns and ecological adaptation strategies of plateau wetland plants to climate warming.

Introduction: The Shengxian decoction (SXT), a Chinese herbal medication used to treat heart failure, is composed of Astragali Radix, Anemarrhenae Rhizoma, Bupleuri Radix, Cimicifuage Rhizoma, and Platycodonis Radix. Knowledge of the excretion of the active compounds in this herbal medication is vital for investigating the underlying mechanisms behind its compatibility. However, this remains unclear. Methods: Liquid chromatography coupled with mass spectrometry was performed in both positive and negative modes to assay 18 constituents of SXT from rat urinary, fecal, and biliary samples. Results: The methodology was validated and showed good linearity (r ≥ 0.9), precision, stability, repeatability, and recovery. The relative standard deviations and relative errors for the precision and accuracy did not exceed 15%. The recoveries of all the compounds ranged from 77.37% to 114.82%, and the matrix effect was between 82.53% and 105.71%. The results suggested that, when combined with Platycodonis Radix, the levels of 14 constituents from the four herbs were reduced in the urine, while the levels of six constituents were reduced in the feces. Conclusions: The comparative excretion results indicated that Platycodonis Radix reduced the excretion of compounds in SXT, demonstrating the compatibility mechanism and holistic properties of these compounds, favoring the pharmacological effects of SXT.

Background: Long QT syndrome (LQTS) is characterized by prolonged QT interval in electrocardiogram (ECG), which is highly associated with sudden cardiac death (malignant arrhythmia). The purpose of this study was to explore the clinical and genetic characteristics of LQTS in children. Materials and Methods: Whole-exome sequencing and Sanger sequencing were performed in 18 probands with prolonged QT interval on the surface ECG. The pathogenicity of the detected variants was evaluated. Results: 44.4% (8/18) of patients were diagnosed with LQTS in the QT prolongation cohort, among which five variants in KCNQ1 and three in SCN5A were detected. Syncope was the primary manifestation. The mean QTc for variant-positive patients was 522 ± 36 ms and that for patients with negative results was 481 ± 15 ms. High probability (7/11, 63.6%) of LQTS presented among the patients with high Schwartz score (Schwartz score ≥3.5). Partial variant carrier parents had no symptoms but prolonged QTc on ECG. Besides, a case masquerading as epilepsy was reported. Conclusions: For a rapid and accurate diagnosis of LQTS, genetic testing should be combined with assessment of clinical information and ECG. Moreover, routine ECG examination is proposed in seizure patients to avoid misdiagnosis. Two novel variants in SCN5A were detected and the variant spectrum of which was expanded. Besides, we discuss incomplete penetrance and phenotypic heterogeneity of LQTS and suggest focusing on the variant carriers with no obvious symptoms.

Abstract In this manuscript, our primary objective is to delve into the intricacies of an extended nonlinear Schrödinger equation. To achieve this, we commence by deriving a dynamical system tightly linked to the equation through the Galilean transformation. We then employ principles from planar dynamical systems theory to explore the bifurcation phenomena exhibited within this derived system. To investigate the potential presence of chaotic behaviors, we introduce a perturbed term into the dynamical system and systematically analyze the extended nonlinear Schrödinger equation. This investigation is further enriched by the presentation of comprehensive two- and 3D phase portraits. Moreover, we conduct a meticulous sensitivity analysis of the dynamical system using the Runge–Kutta method. Through this analytical process, we confirm that minor fluctuations in initial conditions have only minimal effects on solution stability. Additionally, we utilize the complete discrimination system of the polynomial method to systematically construct single traveling wave solutions for the governing model.

Background Variants of ubiquitin-specific protease 7 (USP7) gene in humans are associated with a neurodevelopmental disorder—Hao-Fountain syndrome, its core symptoms including developmental delay, intellectual disability, and speech delay. Other variable symptoms can affect multiple systems. In present study, we report two patients with core features from two unrelated consanguineous families originating from the Tianjin Children's Hospital.

Hemophagocytic lymphohistiocytosis (HLH) is a fatal clinical syndrome. The most common cause of secondary HLH is Epstein-Barr virus (EBV) infection. EBV-HLH is a common clinical disease with high mortality, easy relapse, and poor prognosis. Therefore, treating EBV-HLH with T and B lymphocyte involvement is challenging, and selecting an appropriate treatment regimen is critical. Moreover, research on how to evaluate the recurrence index after remission is scarce. In this study, we reported a case of EBV-HLH successfully treated with programmed cell death protein-1 (PD-1) inhibitor in combination with rituximab. The regimen had a good curative effect, and we successfully detected the trend of early recurrence. Our findings indicated that PD-1 inhibitor in combination with rituximab may help to treat EBV-HLH and maintain EBV-infected T and B whole-line lymphocytes.

The oxidation of almonds during the storage and processing would seriously affect their nutrition and quality. The purpose of this study was to establish a sensitive and reliable method for rapid detection of the oxidation of almonds. A rapid and simple phase-transfer of gold nanoparticles (AuNPs) from aqueous solution to toluene was achieved via a strategy of surface ligand exchange. The results of UV-Vis and transmission electron microscopy showed that the morphology of AuNPs after phase-transfer changed no obvious. The AuNPs in toluene could be successfully used as an efficient SERS substrate for detecting the oxidation of almond oil. The characteristic Raman signal of the cis-double bond at 1655 cm−1 of almonds oil gradually decreased during oxidation. Raman signal at 1747 cm−1 of the ester bond was selected as the reference, and the relative intensity of I1655/I1747 showed a good linear relationship with the time of accelerated ageing of almonds (R2=0.98). By virtue of principal component analysis, the developed method was able to quickly and accurately distinguish the almonds with different oxidation levels. This study also provided a new strategy for the preparation and application of SERS substrates for fatty foods.

Background: Lactylation, a newly discovered PTM involving lactic acid, is linked to solid tumor proliferation and metastasis. Lymphoma patients exhibit high lactic acid levels, yet lactylation's role in lymphoma is underexplored. This study aimed to identify lactylation-related genes in lymphoma using tumor databases and assess their predictive value in patient prognosis through cell experiments and clinical specimens. Methods: Using TCGA and GEO datasets, we analyzed the expression levels of lactylation-related genes in diffuse large B-cell lymphoma patients. We also evaluated the prognostic significance of lactylation gene risk scores, exploring their impact on drug sensitivity and tumor immune function. Key lactylation-affecting genes were identified and functionally validated through cell experiments and mouse in vivo experiments. Additionally, the relationship between lactylation and lymphoma prognosis was examined in clinical specimens. Results: We identified 70 genes linked to diffuse large B-cell lymphoma prognosis from the lactylation-related gene set. Using clinical data and a COX regression algorithm, we developed an optimized lactylation Riskscore model. This model significantly correlated with prognosis and showed differences in immune cell infiltration, particularly macrophages. High-risk patients showed resistance to chemotherapy drugs but responded well to immunotherapy. HNRNPH1, a lactylation-related gene, influenced patient prognosis, apoptosis, cell cycle distribution in lymphoma cells, and tumor volume in mice. In lymphoma specimens, lactylation levels correlated with Bcl-2, C-myc, and P53 levels. Conclusions: Lactylation impacts diffuse large B-cell lymphoma prognosis, tumor immune function, and drug resistance. Our lactylation-based Riskscore model aids in patient stratification and treatment selection. HNRNPH1 regulates lactylation, thereby affecting patient prognosis.

Background: Several studies have identified an association between the gut microbiome and post-stroke depression(PSD), and Helicobacter pylori(H. pylori) infection cause significant alterations in the composition of the gastrointestinal microbiome. However, evidence regarding the role of the H. pylori infection in promoting PSD is still lacking. Here, we conducted a retrospective study to explore risk factors associated with PSD.Methods: Patients with cerebral infarction were consecutively enrolled from December 2021 to October 2022. The diagnosis of PSD is based on the DSM-V criteria, and the Hamilton Depression Rating Scale(HAMD) was used to identify patients with PSD. White matter lesions were evaluated using magnetic resonance imaging(MRI) and H. pylori infection was detected by 13C-urea breath test. Further, 16S rRNA gene sequencing was used to evaluate the changes in gut microbiota composition of fecal samples from PSD patients. The concentration of short-chain fatty acids(SCFAs) was determined by gas chromatography–mass spectrometry(GC–MS).Results: Multivariate regression analysis showed that deep white matter lesions(DWMLs) [odds ratio(OR) 3.382, 95% confidence interval(CI) 1.756–6.512; P = 0.001] and H. pylori infection(OR 2.186, 95% CI 1.149–4.159; P = 0.017) were the independent risk factors for PSD. Patients with H. pylori infection had more severe depressive symptoms than patients without infection. Intestinal microbiota was significantly different between H. pylori-positive PSD[H. pylori(+)] patients and H. pylori-negative PSD[H. pylori (−)] patients. Fecal SCFAs concentrations were significantly reduced in the H. pylori(+) group compared to the negative ones.Conclusion: DWMLs and H. pylori infection may play important roles in the development of PSD. H. pylori infection is likely to be involved in the pathogenesis of PSD by altering the intestinal flora.

Understanding the relationship between tree growth and environmental conditions is essential to elucidating the impact of global climate change on forest ecosystems. We used the dendrochronology method to examine the growth sensitivity of a typical conifer to climate change in mountain forests of Central Hengduan Mountain. The study involved the establishment of tree ring width chronologies of Pinus yunnanensis in both Haba Snow Mountain (HB) and Yulong Snow Mountain (YL) in northwestern Yunnan, enabling the detection of the relationship between its radial growth and climates, i.e., monthly total precipitation, monthly temperatures (average minimum, mean and maximum) and monthly Palmer Drought Severity Index (PDSI). Response function and redundancy analysis (RDA) were used to identify correlations between climate variables and radial growth, and moving interval analysis was applied to determine the stability of climate-growth relationship. The findings demonstrated that the growth of P. yunnanensis had similar response patterns to climate change at two sites, exhibiting growth synchronization and common signals. Specifically, the radial growth of P. yunnanensis was negatively correlated with May temperature, while temperature in current October significantly promoted radial growth. Precipitation in June was the common climate variable with inverse effects between two sites, with positive impacts on YL and negative impacts on HB. The results of moving interval analysis were consistent with response function and RDA, presenting significant correlations in many years for those climatic variables significantly affecting tree growth. Stability analysis also revealed that the climate-growth relationship could fluctuate over a small range of time scales, induced by an abrupt change in climate. A forecast of strengthen in growth of P. yunnanensis forests was expected, since increases in precipitation and temperature of most months would benefit tree growth, and negative impacts of May temperature would be offset by the increase of precipitation in the corresponding month. These results could provide a basis for developing sustainable strategies of forest management under the climate change.

Aims: To synthesize the influencing factors of the stigma of nursing students towards people with mental illness (PMI). Background: The stigma of nursing students towards PMI may affect their career choices and negatively impact people seeking health services. While many studies have examined the educational aspects of mental health, they often overlook the multiple dimensions of possible factors influencing nursing students' perceptions. Design: A mixed‐method systematic review using the Framework Integrating Normative Influences on Stigma (FINIS). Methods: We will search six databases, including PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL and PsycINFO. The reference list of the included literature will be thoroughly examined to identify if any additional studies meet the criteria. Two authors will independently screen all titles, abstracts, full text and extract data. The Mixed-method Appraisal Tool will be used to assess quality. The extracted data will be disposed to different levels, including micro (demographic characteristics, disease characteristics), meso (social networks, treatment systems) and macro (media images, national context) to comply with the FINIS. Expected results: This systematic review aims to comprehensively analyze the influencing factors of the stigma of nursing students towards PMI, providing a reference basis for anti-stigma intervention measures.Prospero registration number: CRD42022374419.

Lakeside plants of plateau wetland show strong functional responses to climate warming, one of the main phenomena of global change. Anatomical traits are closely related to the ecological function in plants. In order to explore the influences of climate warming on stem anatomical structures of wetland plants, the effects of simulated temperature increase on the stem anatomical structure of Zizania latifolia, an emergent plant in the lakeside zone of the Napahai wetland in the northwest of Yunnan Province, were studied by using an open-top chamber. The results were as follows: (1) In the temperature-increasing range of 4℃, the aboveground stem of Z. latifolia responded to warming mainly by increasing the thickness of the epidermal structure to increase the epidermal water loss. The response strategy of the underground stem was the same as that of the aboveground stem when the temperature was increased by 2℃, while the response to the temperature increase was mainly through reducing the sizes of the vascular structure to reduce the risk of cavitation when the temperature were increased by 4℃. (2) Annual maximum temperature(MAX) and nighttime accumulated temperature(NAT) were the key factors affecting the stem anatomical structure of Z. latifolia, but both of which only have significant effects on the sieve tube size of the underground stem (R2=0.838, P

Climate change is an environmental issue of common concern to the international community. The response of plants to climate change reflects the growth and survival strategies of plants in response to climate change. Leaf economic traits are directly related to the resource acquisition, utilization and storage of plant, and are significantly affected by temperature conditions and CO2 concentration. A capped growth chamber with an artificial environment control system was used to study the response of the leaf economic traits of the widely spread wetland plants Scirpus validus and Typha orientalis to the simulated warming (current ambient temperature +2℃) and doubled CO2 concentration (increased to 850 μmol·mol-1). The results were as follows: (1) The net photosynthetic rate, contents of N and P Scirpus validus were significantly reduced, but the intercellular CO2 concentration and leaf mass per area increased significantly under increased temperature treatment. Both the intercellular CO2 concentration and net photosynthetic rate of S. validus were significantly reduced, but the leaf mass per area was significantly increased under the treatment of doubled CO2 concentration. (2) Similar to S. validus, the leaf mass per area of Typha orientalis also increased significantly, while the contents of N and P were significantly reduced under warming treatment; in addition, the photosynthetic parameters, contents of N and P of T. orientalis were significantly reduced, while the leaf mass per area increased significantly under the treatment of doubled CO2 concentration. (3) The leaf mass per area, contents of N and P, net photosynthetic rate, stomatal conductance, and intercellular CO2 concentration of Scirpus validus were significantly correlated with the first two axes of the principal component analysis; while all the studied leaf economic traits of Typha orientalis were related to two environment variables, indicating that these traits played an important role in the response of plants to changes in temperature and CO2 concentration. (4) In addition to C content, other economic trait parameters of Scirpus validus and Typha orientalis including net photosynthetic rate, stomatal conductance, transpiration rate, intercellular CO2 concentration, contents of N and P and leaf mass per area were all played important roles in response to increasing temperature and doubled CO2 concentration. Overall, these results reflect the response strategies of Scirpus validus and Typha orientalis on functional traits to increasing temperature and doubled CO2 concentration. The photosynthetic capacity and nutrient contents of the two species are significantly inhibited under the two treatments, but their resistance to stress increased, indicating that the increase in temperature and CO2 concentration are not conducive to the growth of the two species.

A novel axially chiral all-hydrocarbon cyclo[7] (1,3-(4,6-dimethyl)benzene (CDMB-7) was designed and synthesized using atroposelective[2 + 5] cyclization through Suzuki–Miyaura coupling. CDMB-7 adopts an irregular bowl-like shape with C2 symmetry and exhibits two diastereoisomers in its crystallographic structure. The conformational isomers of CDMB-7 racemates remain stable at high temperatures (393 K). High-performance liquid chromatography (HPLC) confirmed that a single chiral isomer will spontaneously undergo racemization within 30 min at room temperature. This finding opens up possibilities for achieving adaptive chirality in all-hydrocarbon cyclo[7] m-benzene macrocycles.

Postpartum women present a high risk of disordered eating behaviors, but the heterogeneity between groups was not identified. This cross-sectional study aimed to identify eating styles profiles in postpartum women and explore the correlates based on demographic characteristics and psychosocial factors. Questionnaires were administered to 507 Chinese postpartum women. Latent profile analysis (LPA) was conducted to identify eating styles profiles. Multinomial logistic regression was used to investigate the correlates of these profiles among postpartum women. The LPA identified three eating styles profiles: postpartum women with low emotional, external, and restrained eating (Profile 1, 6.9%); postpartum women with medium emotional, external, and restrained eating (Profile 2, 66.1%); and postpartum women with high emotional, external, and restrained eating (Profile 3, 27.0%). Compared to Profile 1, higher postpartum depression (PPD) and body mass index (BMI) were more likely to be associated with Profile 2 and Profile 3, whereas higher postpartum weight retention (PPWR) was more likely to be associated with Profile 1. Compared to Profile 2, higher PPD and BMI were more likely associated with Profile 3. Disordered eating behaviors in postpartum women with three eating styles were associated with BMI, PPD, and PPWR. This study can guide healthcare professionals in developing targeted interventions to improve maternal and child health globally.

Low-cadmium (Cd) accumulating wheat cultivars (LAWC-Cds) can effectively reduce the total Cd content in wheat grains (Grain-Cd). Thirteen LAWC-Cds were planted in three fields to study the enrichment, transport, and accumulation patterns of Cd in LAWC-Cds. Compared with the soil properties before planting, the soil pH and the total Cd content in the soil decreased, while the Cd content in the diethylenetriaminepentaacetic acid extract, soil conductivity, and soil organic matter increased at wheat maturity. The Cd enrichment capacity of the different organs of wheat decreased in the following order: root > leaf > rachis > stem > glume > grain. The dynamics of Cd accumulation in roots affected Grain-Cd, and these factors were negatively correlated. The Cd content and Cd accumulation in all organs of LAWC-Cds showed strong negative correlations with the lengths of the first and second internodes and highly significant positive correlations with both grains per spike and awn length. Structural equation modeling showed that the Cd content of wheat organs had the most direct effect (0.639) in determining Grain-Cd, and soil properties had the largest effect (0.744) in influencing Grain-Cd. This study is important for screening wheat cultivars with stable low Cd-accumulation characteristics.

The purpose of this research was to investigate the impact of dietary supplementation of Caragana korshinskii tannin (CKT) on rumen fermentation, methane emission, methanogen community and metabolome in rumen of sheep. A total of 15 crossbred sheep of the Dumont breed with similar body conditions, were divided into three groups (n = 5), which were fed with CKT addition at 0, 2 and 4%/kg DM. The study spanned a total of 74 days, with a 14-day period dedicated to adaptation and a subsequent 60-day period for conducting treatments. The results indicated that the levels of ammonia nitrogen (NH3-N) and acetate were reduced (p

Objective. During in vitro fertilization-embryo transfer (IVF-ET) treatment, the reproductive endocrine regulatory mechanisms hold pivotal importance. Specifically, the serum estradiol (E2) level during ovulation emerges as a critical factor influencing pregnancy outcomes. This retrospective study aimed to comprehensively compare two common clinical regimens based on the grouping of serum E2 levels and the number of oocytes retrieved on the trigger day. Our objective was to evaluate the pregnancy outcomes in IVF-ET patients across different ovarian response groups, exploring the efficacy of the dual-trigger and single-trigger regimens to provide valuable insights for optimizing clinical strategies in the context of IVF-ET. Methods. A retrospective analysis was conducted on the clinical data of 2778 infertile patients who underwent ART (IVF/ICSI). Subsequently, a detailed statistical analysis was performed on 1032 patients following an antagonist regimen. Participants were categorized into single-trigger and dual-trigger groups based on real-world trigger protocols, considering different ovarian responses. Comprehensive statistical assessments were conducted on baseline characteristics, ovulation induction, and pregnancy outcomes. Results. Baseline characteristics and cycle parameters among the three patient groups (high ovarian response, normal response, and poor response) exhibited no significant differences between the dual-trigger and single-trigger regimen groups. Despite the dual-trigger regimen utilizing a significantly lower HCG dose, no notable discrepancies were observed in laboratory results and pregnancy outcomes (embryo transfer rate, pregnancy rate, and live birth rate) for normal and high responders. Remarkably, E2 levels were higher in the dual-trigger group compared to the single-trigger group. In high and normal responders, the dual-trigger regimen demonstrated increased oocyte counts and oocyte acquisition rates, coupled with decreased transfer cancellation rates attributed to ovarian hyperstimulation syndrome (OHSS). Intriguingly, patients with a poor ovarian response experienced no graft cancellations due to OHSS prevention in either group. Conclusion. For patients with high and normal ovarian responses, the utilization of a dual-trigger regimen on the trigger day effectively mitigates the risk of OHSS. Our large sample study supports the substitutability of the dual-trigger regimen over the single-trigger regimen without compromising pregnancy outcomes. However, this conclusion is not applicable to patients with poor ovarian responses. The results of this study highlight the necessity of adopting a customized and individualized treatment approach that should be based on the patient’s ovarian response. Additionally, recognizing the pivotal role of the endocrine environment in influencing pregnancy outcomes and the occurrence of OHSS, further exploration of the effects of different triggering regimens on endocrine parameters is warranted. Such investigations will contribute to enhancing the reproductive outcomes of IVF-ET technology.

This manuscript addresses the rational solutions of a (3+1)-dimensional Boiti–Leon–Manna–Pempinelli (BLMP) equation, emphasizing key aspects in response to specific questions. The study begins by elucidating the problem’s significance, highlighting the pursuit of rational solutions for the mentioned equation. The methodology involves obtaining the Hirota bilinear (HB) form through a transformative process. Furthermore, the analysis extends to the dimensionally reduced BLMP equation, specifically exploring lump and rogue wave-like (Rwl) solutions, along with the interaction between kink and lump solutions. The HB forms play a crucial role in this examination. Importantly, the solutions presented in this study are characterized as non-singular and localized. Visualizations of these solutions are instrumental in understanding the equation’s behavior, particularly how the solutions evolve under varying physical conditions. The outcomes are visually conveyed through 3D and surface graphs, offering a comprehensive representation for specific parameter values. In conclusion, this work contributes novel insights beyond previous efforts in the literature, showcasing the importance and advancements in the study of the (3+1)-dimensional BLMP equation.

BackgroundMiddle-aged and older adults frequently experience hearing loss and a decline in cognitive function. Although an association between hearing difficulty and cognitive function has been demonstrated, its temporal sequence remains unclear. Therefore, we investigated whether there are bidirectional relationships between hearing difficulty and cognitive function and explored the mediating role of depressive symptoms in this relationship.MethodWe used the cross-lagged panel model and the random-intercept cross-lagged panel model to look for any possible two-way link between self-reported hearing difficulty and cognitive function. To investigate depressive symptoms’ role in this association, a mediation analysis was conducted. The sample was made up of 4,363 adults aged 45 and above from the China Health and Retirement Longitudinal Study (CHARLS; 2011–2018; 44.83% were women; mean age was 56.16 years). One question was used to determine whether someone had a hearing impairment. The tests of cognitive function included episodic memory and intelligence. The Center for Epidemiologic Studies Depression Scale, which consists of 10 items, was used to measure depressive symptoms.ResultsA bidirectional association between hearing and cognition was observed, with cognition predominating (Wald χ2 (1) = 7.241, p

Purpose This qualitative study aimed to gather insights into the experiences of older adults after losing their only child and explore meaningful life needs as a basis for social interventions. Methods We conducted individual face-to-face interviews with 29 participants from 10 communities in Changsha, Hunan Province, China. Interviews were transcribed verbatim and then analysed using the inductive category development of conventional content analysis. Results The experience of losing an only child was devastating and linked with a helpless life in old age. The analysis generated the following three themes encompassing their lived experiences and needs: afraid of getting sick, lying on the edge of misery and surrounded by loneliness. Conclusions Losing an only child triggered older adults’ feelings of being misunderstood, disconnected and hopeless. They had an increased likelihood of lacking more on love and belonging, esteem and self-actualization needs than their physiologic and safety needs. Findings from our study will raise awareness on this vulnerable group and help design intervention programmes targeting the specific needs of this neglected segment of the population.

Context In China, HUANGQI is widely used for the treatment of Alzheimer’s disease (AD). However, a comprehensive understanding of its mechanism of anti-AD effects is lacking.Objective To explore the active ingredients of HUANGQI and its potential targets and mechanisms of action in AD.Materials and methods The active ingredients and targets of HUANGQI were screened from databases (TCSMP, ETCM, and BATMan), and AD-related genes were obtained from DrugBank and GeneCards. The same target genes were screened, and a drug-target disease network was constructed. The PPI network was constructed and GO and KEGG pathway enrichment analyses of the targets. The Cell Counting Kit-8 (CCK-8) assay was used to determine suitable HUANGQI treatment concentrations for HT-22 cells between 0-480 μg/mL. CCK-8, FITC-phalloidin and propidium iodide (PI) assays were used to examine the protective effect of (0, 60, 120, 240 μg/mL) of HUANGQI on 20 μM Aβ1-42-induced HT-22 cell cytotoxicity.Results Twelve active ingredients of HUANGQI were selected, with 679 common targets associated with AD. GO and KEGG analysis revealed that the therapeutic mechanisms of HUANGQI involve TNF, AGE, the NF-κB pathway, and nuclear receptor activity-related processes. The CCK-8 assay indicated that HUANGQI was not cytotoxic to HT-22 cells at concentrations less than 240 μg/mL and was able to attenuate Aβ1-42-induced cellular damage (EC50 = 83.46 μg/mL). FITC-phalloidin and PI assays suggested that HUANGQI could alleviate 20 μM Aβ1-42-induced neuronal cell cytotoxicity in a dose-dependent manner.Conclusion HUANGQI has a protective effect on Aβ1-42-induced nerve cell injury; further mechanism research was needed.

Idiopathic pulmonary fibrosis is a fatal interstitial lung disease for which effective drug therapies are lacking. Senegenin, an effective active compound from the traditional Chinese herb Polygala tenuifolia Willd, has been shown to have a wide range of pharmacological effects. In this study, we investigated the therapeutic effects of senegenin on pulmonary fibrosis and their associated mechanisms of action. We found that senegenin inhibited the senescence of epithelial cells and thus exerted anti-pulmonary-fibrosis effects by inhibiting oxidative stress. In addition, we found that senegenin promoted the expression of Sirt1 and Pgc-1α and that the antioxidative and antisenescent effects of senegenin were suppressed by specific silencing of the Sirt1 and Pgc–1α genes, respectively. Moreover, the senegenin-induced effects of antioxidation, antisenescence of epithelial cells, and antifibrosis were inhibited by treatment with Sirt1 inhibitors in vivo. Thus, the Sirt1/Pgc-1α pathway exerts its antifibrotic effect on lung fibrosis by mediating the antioxidative and antisenescent effects of senegenin.

A novel metal-free synthesis of 3-substituted isocoumarins through a sequential O-acylation/Wittig reaction has been established. The readily accessible (2-carboxybenzyl)-triphenylphosphonium bromide and diverse chlorides produced various 1H-isochromen-1-one in the presence of triethylamine, employing sequential O-acylation and an intramolecular Wittig reaction of acid anhydride. Reactions using these facile conditions have exhibited high functional group tolerance and excellent yields (up to 90%). Moreover, the fluorescence properties of isocoumarin derivatives were evaluated at the theoretical and experimental levels to determine their potential application in fluorescent materials. These derivatives have good photoluminescence in THF with a large Stokes shift and an absolute fluorescence quantum yield of up to 14%.

Dye/salt separation has gained increasing attention in recent years, prompting the quest to find cost-effective and environmentally friendly raw materials for synthesizing high performance nanofiltration (NF) membrane for effective dye/salt separation. Herein, a high-performance loose-structured NF membrane was fabricated via a simple vacuum filtration method using a green nanomaterial, 2,2,6,6-tetramethylpiperidine-1-oxide radical (TEMPO)-oxidized cellulose nanofiber (TOCNF), by sequentially filtrating larger-sized and finer-sized TOCNFs on a microporous substrate, followed by crosslinking with trimesoyl chloride. The resulting TCM membrane possessed a separating layer composed entirely of pure TOCNF, eliminating the need for other polymer or nanomaterial additives. TCM membranes exhibit high performance and effective dye/salt selectivity. Scanning Electron Microscope (SEM) analysis shows that the TCM membrane with the Fine-TOCNF layer has a tight layered structure. Further characterizations via Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) confirmed the presence of functional groups and chemical bonds of the crosslinked membrane. Notably, the optimized TCM-5 membrane exhibits a rejection rate of over 99% for various dyes (Congo red and orange yellow) and 14.2% for NaCl, showcasing a potential candidate for efficient dye wastewater treatment.

Multi-angular remote sensing observation contains crucial information on forest structure parameters. Here, our goal is to examine the ability of multi-angular indices, which are constructed by the typical-angular reflectances in red and NIR bands from MODIS observations, for the retrieval of forest biomass based on the field-measured above-ground biomass (AGB) data. Specifically, we employed the updated version of the MCD43A1 BRDF parameter product as an input for BRDF models to reconstruct the MODIS typical-angular reflectances. Furthermore, we evaluated the effects of different configurations of BRDF models and solar zenith angles (SZA) on forest AGB estimation using our developed multi-angular indices. The semivariogram analysis strategy combined with Landsat ground-surface reflectance data was employed to determine the MODIS pixel heterogeneity; the survey data from field sites of homogeneous pixels was used in our analysis and validation. The results show that our developed multi-angular indices based on a hot-revised BRDF model, under a SZA of 45°, when combined with forest cover information, can account for up to 72% of the variation forest AGB, with an RMSE = 45 Mg/ha. We also found that different kernels for the BRDF models influenced the weight parameters of the biomass inversion equation but did not significantly affect the estimated AGB. In conclusion, our method can enable the better usage of MODIS multi-angular observations for forest AGB estimation.

An unparalleled copper(I)-catalyzed synthesis of 1,3,4-oxadiazoles from tertiary amines in one step has been described. The one-pot reactions involving (N-isocyanimine)triphenylphosphorane, tertiary amines, and carboxylic acids resulted in the formation of 1,3,4-oxadiazoles in moderate to good yields through a consecutive oxidative Ugi/aza-Wittig reaction, enabling the direct functionalization of sp3 C-H bonds adjacent to the nitrogen atom. This method offered several notable advantages, including ligands-free, exceptional productivity and a high functional group tolerance. The preliminary biological evaluation demonstrated that compound 4f inhibited hepatoma cells efficiently, suggesting potentially broad applications of the approach for synthesis and medicinal chemistry.

IntroductionCongenital diarrhea is a rare inherited intestinal disease characterized by persistent and severe diarrhea and malabsorption in the first few weeks after birth, which can be life-threatening. Some congenital diarrheal diseases are associated with mutations in the diacylglycerol acyltransferase 1 (DGAT1) gene.Case descriptionsThis study delineated 2 cases of diarrhea and growth retardation, subsequently confirmed as congenital diarrhea via genetic testing, revealing that the etiology involved compound heterozygous mutations in the DGAT1 gene.Diagnostic assessmentsHigh-MCT milk powder did not obtain an ideal outcome, whereas low-fat diets improved the symptoms of diarrhea and increased the body weigths.DisscussionThe two cases facilitated our understanding of the clinical features of, and treatments for, patients harboring a DGAT1 mutation and enriched the existing DGAT1 mutation database.

Retinal vein occlusion(RVO)is the second most common cause of visual loss classified under retinal vascular disorders after diabetic retinopathy, and its complication, macular edema(ME), is the leading cause of vision loss. Currently, the first-line treatment for RVO-ME is the intravitreal injection of anti-vascular endothelial growth factor drugs, which can improve retinal morphology and patients' vision. Optical coherence tomography(OCT)can clearly image retinal structures, and some specific imaging features found by OCT have become biomarkers for evaluating the prognosis of RVO patients. The recent findings of biomarkers are reviewed, such as central retinal thickness, choroidal thickness, disorganization of retinal inner layers, hyperreflective foci, integrity of external limiting membrane and ellipsoid zone, central macular volume, prominent middle limiting membrane, paracentral acute middle maculopathy, highly reflective line, to provide references for selecting the best treatment for RVO.

High temperature inhibits the growth and development of maize (Zea mays L.) and wheat (Triticum aestivum L.) seedlings. The current study attempts to elucidate the underlying mechanisms of exogenous trehalose for the improvement of maize and wheat responses to heat stress. Results show that, in maize seedlings, exogenously-supplied trehalose was able to effectively elevate the capacity of photosynthetic carbon assimilation and improve the carbohydrate content via up-regulating the transcript levels of key enzymes including phosphoenol pyruvate carboxylase (PEPC), NADP-malate dehydrogenase (NADP-MDH), NADP-malic enzyme (NADP-ME), pyruvate phosphate dikinase (PPDK) and Ribulose-1,5-bisphosphate carboxylase/oxygenase small subunit. Besides, it was also able to improve C4 pathway enzyme activities, including PEPC, NADP-MDH, NADP-ME and Ribulose-1,5-bisphosphate carboxylase (RUBPCase). In wheat seedlings, exogenously-supplied trehalose promoted photosynthetic carbon assimilation by elevating the activity of RUBPCase. These results show that exogenous trehalose improved photosynthetic carbon assimilation capacities in maize and wheat seedlings under heat stress through different mechanisms.

The fouling of separation membranes has consistently been a primary factor contributing to the decline in membrane performance. Enhancing the surface hydrophilicity of the membrane proves to be an effective strategy in mitigating membrane fouling in water treatment processes. Zwitterionic polymers (containing an equimolar number of homogeneously distributed anionic and cationic groups on the polymer chains) have been used extensively as one of the best antifouling materials for surface modification. The conventional application of zwitterionic compounds as surface modifiers is intricate and inefficient, adding complexity and length to the membrane preparation process, particularly on an industrial scale. To overcome these limitations, zwitterionic polymer, directly used as a main material, is an effective method. In this work, a novel zwitterionic polymer (TB)—zwitterionic Tröger’s base (ZTB)—was synthesized by quaternizing Tröger’s base (TB) with 1,3-propane sultone. The obtained ZTB is blended with TB to fabricate microfiltration (MF) membranes via the vapor-induced phase separation (VIPS) process, offering a strategic solution for separating emulsified oily wastewater. Atomic force microscopy (AFM), scanning electron microscopy (SEM), water contact angle, and zeta potential measurements were employed to characterize the surface of ZTB/TB blended membranes, assessing surface morphology, charge, and hydrophilic/hydrophobic properties. The impact of varying ZTB levels on membrane surface morphology, hydrophilicity, water flux, and rejection were investigated. The results showed that an increase in ZTB content improved hydrophilicity and surface roughness, consequently enhancing water permeability. Due to the attraction of water vapor, the enrichment of zwitterionic segments was enriched, and a stable hydration layer was formed on the membrane surface. The hydration layer formed by zwitterions endowed the membrane with good antifouling properties. The proposed mechanism elucidates the membrane’s proficiency in demulsification and the reduction in irreversible fouling through the synergistic regulation of surface charge and hydrophilicity, facilitated by electrostatic repulsion and the formation of a hydration layer. The ZTB/TB blended membranes demonstrated superior efficiency in oil–water separation, achieving a maximum flux of 1897.63 LMH bar−1 and an oil rejection rate as high as 99% in the oil–water emulsion separation process. This study reveals the migration behavior of the zwitterionic polymer in the membrane during the VIPS process. It enhances our comprehension of the antifouling mechanism of zwitterionic membranes and provides guidance for designing novel materials for antifouling membranes.

Purpose Evidence from previous studies on the association between cholecystectomy and risk of gastric cancer are still inconsistent. We aimed at conducting a meta-analysis of epidemiological studies to evaluate this association.Methods Researchers searched three databases (PubMed, Embase and Web of Science) through January 2021 for eligible studies. Relative risks (RRs) and 95% CIs in each included studies were pooled by random-effects models. Patients and the public were not involved in our study.Results Eight studies were identified. Four studies reported significantly positive association between history of cholecystectomy and risk of gastric cancer, and the remaining studies reported null association. The pooled RR of these eight studies showed that a history of cholecystectomy was associated with a 11% higher risk of gastric cancer (pooled RR=1.11, 95% CI: 1.03 to 1.20). Moderate heterogeneity across the studies was detected (p=0.117, I2=37.8%). The pooled RRs were 1.12 (95% CI: 1.01 to 1.24) for five cohort studies and 0.95 (95% CI: 0.66 to 1.38) for three case–control studies. Compared with the risk in Europe and the USA, the pooled RR was higher for two studies conducted in Asia. Six studies were assessed as high-quality studies with the pooled RR of 1.12 (95% CI: 1.02 to 1.23). The pooled results were robust by sensitivity analyses, and no indication of publication bias was detected.Conclusion This meta-analysis suggests that a history of cholecystectomy may be associated with an increased risk of gastric cancer.

The Delta variant of SARS-CoV-2 dominated the COVID-19 pandemic due to its high viral replication capacity and immune evasion, causing massive outbreaks of cases, hospitalizations, and deaths. Currently, variant identification is performed mainly by sequencing. However, the high requirements for equipment and operators as well as its high cost have limited its application in underdeveloped regions. To achieve an economical and rapid method of variant identification suitable for undeveloped areas, we applied an amplification-refractory mutation system (ARMS) based on PCR for the detection of novel coronavirus variants. The results showed that this method could be finished in 90 min and detect as few as 500 copies/mL and not react with SARS-Coronavirus, influenza A H1N1(2009), and other cross-pathogens or be influenced by fresh human blood, α- interferon, and other interfering substances. In a set of double-blind trials, tests of 262 samples obtained from patients confirmed with Delta variant infection revealed that our method was able to accurately identify the Delta variant with high sensitivity and specificity. In conclusion, the ARMS-PCR method applied in Delta variant identification is rapid, sensitive, specific, economical, and suitable for undeveloped areas. In our future study, ARMS-PCR will be further applied in the identification of other variants, such as Omicron.

The stigma of nursing students towards people with mental illness (PMI) creates significant barriers to diagnosis, treatment, and recovery for those with PMI. It can also have a significant impact on the future career choices of nursing students in the field of psychiatry. Current research has found various influencing factors, including personal characteristics and educational influences. However, a comprehensive analysis that encompasses all aspects is lacking. The aim of the study was to conduct a convergent mixed‐method systematic review to synthesize the influencing factors of the stigma of nursing students towards PMI according to Framework Integrating Normative Influences on Stigma (FINIS) at micro, meso, and macro levels. PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL and PsycINFO were searched from 1990 to 31 December 2023. The reference lists of the included literature were further checked to identify potentially relevant articles. Two authors independently screened all titles, abstracts, and full-text articles and extracted data. Study quality was assessed by two authors using the Mixed Method Appraisal Tool (MMAT). A total of 4865 articles were initially retrieved, and 73 of these articles were included. The results suggested that the stigma towards PMI by nursing students was influenced by micro, meso and macro levels. At each FINIS level, the most frequent influencing factors are personal characteristics, the treatment system and media images. Numerous interconnected factors exert an influence on the stigma towards PMI among nursing students. Our research can be used to identify barriers and facilitators to nursing students’ stigma towards PMI and to provide supporting information for interventions designed to reduce this stigma.

Abstract Background Alagille syndrome (ALGS) is a multisystem disorder with variable clinical penetrance. The genes responsible for this disease are JAGGED1 (JAG1) and NOTCH2. Clinical data of this disease are limited in China. The purpose of this study was to enrich the present data of Chinese children with Alagille syndrome by summarizing the clinical characteristics and genetic variations of these cases. Case summary From January 2011 to February 2022, 10 children were diagnosed with ALGS. The organs involved in ALGS were as follows: liver (10, 100%); heart (7, 70%); characteristic facial features (7, 70%); skeleton (4, 40%); brain (1,10%) and kidney (3, 30%). Four patients (40%) were small for gestational age. The main clinical manifestations were cholestasis, heart disease, and facial features. The median total bilirubin, direct bilirubin, and total bile acid levels were 138.75 μmol/L (normal, 3.4–20.5 μmol/L), 107.25 μmol/L (normal, 0–8.6 μmol/L), and 110.65 μmol/L (normal, 0.5–10.0 μmol/L), respectively. The median value of gamma-glutamyltranspeptidase was 223 U/L (normal, 9–64 U/L). Six (60%) children had hypercholesteremia. Eight different JAG1 gene variations and one NOTCH2 gene pathogenic variant in the 10 Chinese ALGS patients were identified. Conclusion Cholestasis was the most common initial presenting symptom in Chinese ALGS pediatric patients. Pathogenic variants in JAG1 and NOTCH2 are the primary mutations in Chinese children with ALGS, but we had our own unique variant spectrum. ALGS should be considered for cholestasis in infants and young children, especially those with multiorgan abnormalities.

Abstract The diagnostic procedure of pleural effusion (PEs) is challenging due to low detection rates and numerous aetiologies. Hence, any attempt to enhance diagnosis is worthwhile. We present a clinical pathway to guide combined application of interventional pulmonology (IP) for tracing causes of undiagnosed PEs. Subjects with undiagnosed PEs were identified in the Hospital Information System of Dalian Municipal Central Hospital from January 1, 2012, to December 31, 2018. Eligible subjects were divided into a group of combined tests and a group of medical thoracoscopy (MT). Optimal and subsequent diagnostic tests were performed depending on the guidance of the clinical pathway by matching profitable chest lesions with the respective adaptation. As the guidance of clinical pathway, common bronchoscopy would be preferentially selected if pulmonary lesions involved or within the central bronchus, EBUS-TBNA was favoured when pulmonary lesions were adjacent to the central bronchus or with the enlarged mediastinal/hilar lymph nodes, guided bronchoscopy would be preferred if pulmonary nodules/masses were larger than 20 mm with discernible bronchus signs, CT-assisted transthoracic core biopsy was preferred if pulmonary nodules were less than 20 mm, image guided cutting needle biopsy was the recommendation if the pleural thickness was larger than 10 mm and pulmonary lesions were miliary. MT was preferred only when undiagnosed PEs was the initial symptom and pulmonary lesions were miliary or absent. A total of 83.57% cases of undiagnosed PEs were eligible for the clinical pathway, and 659 and 216 subjects were included in the combined tests and MT groups, respectively, depending on the optimal recommendation of the clinical pathway. The total diagnostic yields in the combined tests and MT groups were 95.99% and 91.20%, respectively, and the difference in total diagnostic yield was statistically significant (χ2 = 7.510, p = 0.006). Overall, clinical pathway guidance of the combined application of IP is useful for tracing the causes of undiagnosed PEs. The diagnostic yield of undiagnosed PEs is significantly increased compared with that of MT alone.

While the application of manure to improve soil quality has attracted attention, the effect of pig manure application rates on soil acidity remains poorly understood. In this study, we analyzed the changes and correlations between soil acidity, pH buffer capacity (pHBC), soil chemical properties, and crop yields after 8 years of pig manure application at different rates (i.e., 0, 7.5, 15, 30, and 45 Mg ha−1) in a red upland soil (Ultisol). With an increase in the application rates, the crop yields were 0.77–8.85 times higher; the pH was enhanced by 0.4–0.8 units; and the soil organic matter (SOM), pHBC, iron activation (Feo), exchangeable calcium (ExCa), and exchangeable magnesium (ExMg) contents increased by up to 74.1%, 92.7%, 36.7%, 62.2%, and 48.7%, respectively, whereas that of total exchangeable acid (ExAcid) decreased by 17.2–52.9%. The crop yields were positively related to the soil pH but negatively correlated with ExAcid. Redundancy analysis revealed ExAcid and pHBC were more sensitive than pH was to the other chemical indicators. ExAcid was negatively correlated with SOM and ExCa; pHBC was positively correlated with ExMg, TN, SOM, and Feo. In conclusion, the crop yield could be improved by adjusting the soil acidity characteristics, and the application of pig manure reduced the soil acidity, with an optimal application rate of 15 Mg·ha−1.

Improved understanding of the responses of stem radial growth to climates is necessary for modeling and predicting the response of forest ecosystems to future climate change. We used dendrochronological methods to study climate effects on the radial growth of a subalpine deciduous conifer, Larix potaninii. Tree-ring residual chronologies were developed for five sites at the upper distributional limits in the Central Hengduan Mountains, Southwestern China. Redundancy analysis and response function were used to compare inter-annual variability in growth sensitivity among the chronologies and to identity key climatic factors controlling tree radial growth. The results showed that both precipitation and temperature influenced tree growth, and response patterns were consistent for five chronologies. During the current year’s early growing season (Tmean in May and Tmax in June), temperature positively affected the radial growth of L. potaninii, while September Tmin and October precipitation in the previous year and May and June precipitation in the current year all had negative impacts on its radial growth. L. potaninii growth appeared to be mainly limited by photothermal conditions in May and June. In the context of increasing CO2 concentrations accompanied with warmer temperatures, future climate change would likely stimulate the radial growth of L. potaninii in Central Hengduan Mountain.

IntroductionThis systematic review and meta-analysis evaluates the overall effects of lifestyle interventions upon hepatic fat content and metabolism-related indicators among adults with metabolic associated fatty liver disease.MethodsIt was registered under PROSPERO (CRD42021251527). We searched PubMed, EMBASE, MEDLINE, Cochrane, CINAHL, Scopus, CNKI, Wan-fang, VIP, and CBM from the inception of each database to May 2021 for RCT studies of lifestyle interventions on hepatic fat content and metabolism-related indicators. We used Review Manager 5.3 for meta-analysis and used text and detailed tabular summaries when heterogeneity existed.ResultsThirty-four RCT studies with 2652 participants were included. All participants were obesity, 8% of whom also had diabetes, and none was lean or normal weight. Through subgroup analysis, we found low carbohydrate diet, aerobic training and resistance training significantly improved the level of HFC, TG, HDL, HbA1c, and HOMA-IR. Moreover, low carbohydrate diet is more effective in improving HFC than low fat diet and resistance training is better than aerobic training in reduction in HFC and TG (SMD, -0.25, 95% CI, -0.45 to -0.06; SMD, 0.24, 95% CI, 0.03 to 0.44, respectively).DiscussionOverall, this is the first review that systematically synthesizes studies focused on the effects of various lifestyle on adults with MAFLD. The data generated in this systematic review were more applicable to obesity MAFLD rather than lean or normal weight MAFLD.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier (CRD42021251527).

In vivo, the complex process of drugs metabolism alters the change in drug composition and determines the final pharmacological properties of oral drugs. Ginsenosides are primary constituents of ginseng, whose pharmacological activities are greatly affected by liver metabolism. However, the predictive power of existing in vitro models is poor due to their inability to mimic the complexity of drug metabolism in vivo. The advance of organs-on-chip-based microfluidics system could provide a new in vitro drug screening platform by recapitulating the metabolic process and pharmacological activity of natural product. In this study, an improved microfluidic device was employed to establish an in vitro co-culture model by culturing multiple cell types in compartmentalized microchambers. Different cell lines were seeded on the device to examine the metabolites of ginsenosides from the hepatocytes in top layer and its resulting efficacy on the tumors in bottom layer. Metabolism dependent drug efficacy of Capecitabine in this system demonstrated the model is validated and controllable. High concentrations of CK, Rh2 (S), and Rg3 (S) ginsenosides showed significant inhibitory effects on two types of tumor cells. In addition, apoptosis detection showed that Rg3 (S) through liver metabolism promoted early apoptosis of tumor cells and displayed better anticancer activity than prodrug. The detected ginsenoside metabolites indicated that some protopanaxadiol saponins were converted into other anticancer aglycones in varying degrees due to orderly de-sugar and oxidation. Ginsenosides exhibited different efficacy on target cells by impacting their viabilities, indicating hepatic metabolism plays an important role in determining ginsenosides efficacy. In conclusion, this microfluidic co-culture system is simple, scalable, and possibly widely applicable in evaluating anticancer activity and metabolism of drug during the early developmental phases of natural product.

IntroductionDeath anxiety has increased following the COVID-19 pandemic. Although terror management theory has suggested social support, presence of meaning and self-esteem functioned as death anxiety buffers, few existing works have explored the mechanism of how social support, presence of meaning, and self-esteem buffer death anxiety. To identify these mechanisms is the aim of this study.MethodsOur cross-sectional study was conducted with 1167 people in China from 19 May 2020 to 1 June 2020 during the COVID-19 outbreak. The average age of participants was 26 years. Data were by questionnaire, including demographic information, the Templer's Death anxiety scale, the multidimensional scale of perceived social support, the presence of meaning scale, and the Rosenberg self-esteem scale.ResultsResults using structural equation modeling showed presence of meaning and self-esteem fully mediated the relationship between social support and death anxiety, respectively and sequentially. The proposed model showed good fit of indices: χ2 = 243.384, df = 58, p < 0.001; CFI = 0.968, TLI = 0.954, RMSEA = 0.052, SRMR = 0.044.DiscussionThis study demonstrates significant mediator roles of presence of meaning and self-esteem in the relationship of social support and death anxiety. Multi-component interventions are needed to manage death anxiety by targeting increasing social support, presence of meaning and self-esteem and increasing presence of meaning and self-esteem when social support is diminished in the pandemic.

Collagen XII is a fibril-associated collagen with interrupted triple helices (FACIT). This non-fibrillar collagen is a homotrimer composed of three α1(XII) chains assembled into a collagenous molecule with a C terminal collagenous domain and a large N terminal non-collagenous domain. During tendon development and growth, collagen XII is broadly expressed throughout the extracellular matrix and enriched pericellularly around tenocytes. Tendons in a global Col12a1-/- knockout model demonstrated disrupted fibril and fiber structure and disordered tenocyte organization, highlighting the critical regulatory roles of collagen XII in determining tendon structure and function. However, muscle and bone also are affected in the collagen XII knockout model. Therefore, secondary effects on tendon due to involvement of bone and muscle may occur in the global knockout. The global knockout does not allow the definition of intrinsic mechanisms involving collagen XII in tendon versus extrinsic roles involving muscle and bone. To address this limitation, we created and characterized a conditional Col12a1-null mouse model to permit the spatial and temporal manipulation of Col12a1 expression. Collagen XII knockout was targeted to tendons by breeding conditional Col12a1flox/flox mice with Scleraxis-Cre (Scx-Cre) mice to yield a tendon-specific Col12a1-null mouse line, Col12a1Δten/Δten. Both mRNA and protein expression in Col12a1Δten/Δten mice decreased to near baseline levels in flexor digitorum longus tendons (FDL). Collagen XII immuno-localization revealed an absence of reactivity in the tendon proper, but there was reactivity in the cells of the surrounding peritenon. This supports a targeted knockout in tenocytes while peritenon cells from a non-tendon lineage were not targeted and retained collagen XII expression. The tendon-targeted, Col12a1Δten/Δten mice had significantly reduced forelimb grip strength, altered gait and a significant decrease in biomechanical properties. While the observed decrease in tendon modulus suggests that differences in tendon material properties in the absence of Col12a1 expression underlie the functional deficiencies. Together, these findings suggest an intrinsic role for collagen XII critical for development of a functional tendon.

A new species of Goodyera (Orchidaceae) from Tibet, China, G. medogensis, is described and illustrated here. Molecular phylogenetic results based on one nuclear (ITS) and two plastid markers (matK and trnL-F) support the recognition of G. medogensis as a new species in Goodyera subsection Reticulum. Morphologically, the novelty is most similar to G. biflora, G. vittata and especially to G. hemsleyana, but differs by the thick grid lines of the reticulations with a diffused margin on the adaxial surface of the leaf blades, the inflorescence with more flowers, the obliquely obovate-rhombic petals, the yellow or yellowish labellum without a lamella on the blade, and the shorter trichomes on the floral bracts, sepals and ovary. Finally, a key to the species of Goodyera subsect. Reticulum in China is also provided.

Abstract Residual shallow neuromuscular block (NMB) is potentially harmful and contributes to critical respiratory events. Evidence for the optimal dose of sugammadex required to reverse vecuronium‐induced shallow NMB is scarce. The aims of the present study were to find suitable doses of sugammadex and neostigmine to reverse a residual vecuronium‐induced NMB from a time of flight (TOF) ratio of 0.3–0.9 and evaluate their safety and efficacy. In total, 121 patients aged 18–65 years were randomly assigned to 11 groups to receive placebo, sugammadex (doses of 0.125, 0.25, 0.5, 1.0, or 2.0 mg/kg), or neostigmine (doses of 10, 25, 40, 55, or 70 μg/kg). The reversal time of sugammadex and neostigmine to antagonize a vecuronium‐induced shallow residual NMB (i.e., TOF ratio of 0.3) and related adverse reactions were recorded. Several statistical models were tested to find an appropriate statistical model to explore the suitable doses of sugammadex and neostigmine required to reverse a residual vecuronium‐induced NMB. Based on a monoexponential model with the response variable on a logarithmic scale, sugammadex 0.56 mg/kg may be sufficient to reverse vecuronium‐induced shallow residual NMB at a TOF ratio of 0.3 under anesthesia maintained with propofol. Neostigmine may not provide prompt and satisfactory antagonism as sugammadex, even in shallow NMB.

Abstract Background Against the background of a changing climate, the responses of functional traits of plateau wetland plants to increasing temperatures and CO2 concentrations need to be understood. Hydraulic traits are the key for plants to maintain their ecological functions and affect their growth and survival. However, few studies have comprehensively considered the response strategies of wetland plants' hydraulic traits to environmental changes in the context of water and matter transport, loss, and retention. According to the latest IPCC prediction results, we performed experiments under increased temperature (2 °C) and CO2 levels (850 μmol/mol) in an artificial Sealed-top Chamber (STC) to investigate the responses of the hydraulic characteristics of Schoenoplectus tabernaemontani, the dominant species in plateau wetlands in China. Results Compared with the CK group, net photosynthetic rate, transpiration rate, stomatal length, cuticle thickness, vascular bundle length, vascular bundle width, and vascular bundle area of S. tabernaemontani in the ET group were significantly reduced, whereas stomatal density and vein density increased significantly. Compared with the CK group, the hydraulic traits of S. tabernaemontani in the EC group were reduced considerably in stomatal length and cuticle thickness but increased dramatically in stomatal density, and there were no significant differences between other parameter values and the control group. Net photosynthetic rate was significantly positively correlated with stomatal length, cuticle thickness, and vascular bundle length, and stomatal conductance was significantly positively correlated with cuticle thickness. The transpiration rate was significantly positively correlated with cuticle thickness, epidermal cell area, vascular bundle length, vascular bundle width, and vascular bundle area. Regarding the hydraulic traits, there was a significant negative correlation between stomatal density and stomatal length, or cuticle thickness, and a significant positive correlation between the latter two. The epidermal cell area was significantly positively correlated with epidermal thickness, vascular bundle length, vascular bundle width, and vascular bundle area. Conclusions Increased temperature and CO2 levels are not conducive to the photosynthetic activity of S. tabernaemontani. Photosynthetic rate, stomatal density and size, vein density, epidermal structure size, and vascular bundle size play an essential role in the adaptation of this species to changes in temperature and CO2 concentration. In the process of adaptation, hydraulic traits are not isolated from each other, and there is a functional association among traits. This study provide a scientific basis for the management and protection of plateau wetlands.