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Abstract Although previous studies have shown that preoperative pulmonary rehabilitation training may improve postoperative prognosis in patients with lung cancer, the literature included in the existing meta-analysis is highly heterogeneous and lacks effective subgroup analysis. Therefore, an updated meta-analysis is needed to integrate the latest published randomized controlled clinical trials (RCT). This updated analysis was performed to identify the clinical effects of preoperative pulmonary rehabilitation on physical rehabilitation (lung function, activity endurance, and dyspnea), psychological rehabilitation, quality of life, length of hospital stay, and postoperative pulmonary complications in patients with lung cancer. The PubMed, Embase, Cochrane Library, and Web of Science database were searched since inception up to March 2024. A random-effects model was used to pool data, and sensitivity and subgroup analyses were performed to explore the stability of outcomes and potential sources of heterogeneity. All analyses were conducted via Review Manager 5.4.1 and STATA 15.0. The final analysis included 11 RCTs with 1250 patients. The results of meta-analysis suggest that preoperative pulmonary rehabilitation can significantly improve the quality of life of patients with lung cancer after surgery (SMD: 0.16; 95% CI: 0.01, 0.32; P = 0.04) and significantly reduce the risk of postoperative pulmonary complications (PPCs) (RR: 0.39; 95% CI: 0.25, 0.60; P

Abstract Introduction Cognitive dysfunction is believed to be among the core features of Bipolar Depression(BD-D). However, its evaluation and available treatments are limited. Here, we conducted a longitudinal follow-up clinical trial using the THINC-it tool to evaluate temporal sensitivity to change over time in cognitive function among patients with bipolar depression from a Chinese cohort. It is helpful to verify whether the scale can continuously and reliably measure cognitive function in different time points and reduce the measurement error caused by time factors. Hope our findings could provide insights into the significance of the THINC-it tool as an iterative clinical cognitive evaluation tool. Methods A total of 120 patients with bipolar depression(40 males and 80 females, respectively) alongside 100 healthy controls(23 males and 77 females, respectively) were recruited in the study. All participants were interviewed for 8 weeks, using the 17-item Hamilton Depression Rating Scale (HAMD-17) and the Young Mania Rating Scale(YMRS). The primary dependent measure was the previously validated THINC-it tool, followed by psychometric analysis. Results Repeated measures of the THINC-it tool at baseline, one-week, and eight-week periods were conducted after controlling for age, gender, and education effects. Results from the general linear model revealed no significant time differences in variances(P > 0.05). Similarly, adjusting for confounding factors (age, gender, education, and HAMD-17 scores), results from the longitudinal analysis showed that there were no significant differences in cognitive impairment over time(P > 0.05). However, we found significant differences between BD-D and Healthy Control(HC) groups with regards to Spotter, Codebreaker, Trails, Perceived Deficits Questionnaire for Depression-5-items(PDQ-5-D), and THINC-it Total composite(P

Abstract This study investigated the influence of different temperatures (35℃ High temperature and average indoor ambient temperature of 25℃) and lactic acid bacterial additives (Lactiplantibacillus plantarym, Lentilactobacillus buchneri, or a combination of Lactiplantibacillus plantarym and Lentilactobacillus buchneri) on the chemical composition, fermentation quality, and microbial community of alfalfa silage feed. After a 60-day ensiling period, a significant interaction between temperature and additives was observed, affecting the dry matter (DM), crude protein (CP), acid detergent fiber (ADF), and neutral detergent fiber (NDF) of the silage feed (p < 0.05). Temperature had a highly significant impact on the pH value of the silage feed (p 0.05), while the inoculation of additives had a significant effect on lactic acid, acetic acid, and butyric acid (p > 0.05). As for the dynamic changes of microbial community after silage, the addition of three kinds of bacteria increased the abundance of lactobacillus. Among all treatment groups, the treatment group using complex bacteria had the best fermentation effect, indicating that the effect of complex lactic acid bacteria was better than that of single bacteria in high temperature fermentation. In summary, this study explained the effects of different temperatures and lactic acid bacterial additives on alfalfa fermentation quality and microbial community, and improved our understanding of the mechanism of alfalfa related silage at high temperatures.

The traditional evaporator of water source heat pump system is easy to freeze when the water source temperature is too low in winter. A novel ice source heat pump system is proposed, which can use low temperature surface water to supply heat to buildings. One of the key problems for safe transportation is velocity range of ice slurry in ice outlet pipeline. In order to study the critical flow velocity of ice slurry in the pipe, an Euler model of horizontal straight pipe and 90° elbow pipe were established by Fluent software. The influence of five factors on the critical flow velocity of two kinds of pipes, including initial ice packing fraction, ice particle size, pipe diameter, length of straight pipe and radius curvature of elbow was studied. It found that the initial ice content should be controlled from 10% to 15%. The inlet flow rate was 20% higher than the critical flow rate under the most unfavorable condition. Ice particle size was less than 0.2 mm. The total length of ice discharge pipeline was less than 50 m. Curvature radius of the bend should be met the minimum requirements of the specification of the pipe used.

Penaeus vannamei is an important shrimp species that is farmed globally, owing to its fast growth and good environmental adaptability. However, vibriosis outbreaks, such as acute hepatopancreatic necrosis disease and translucent post-larva disease, have become a considerable constraint on the development of the shrimp aquaculture industry globally in recent years. Due to the negative consequences associated with the use of antibiotics to control bacterial diseases, alternative technologies, such as improving shrimp immunity, the nutrition level of shrimp diets, and the ecological environment of shrimp ponds by using probiotics, have been developed. Owing to the limitations related to the sourcing and cost of fish meal, a large amount of vegetable protein is often used as a fish meal substitute in shrimp artificial feed, which is not only difficult for the shrimp to digest and absorb but can also lead to nutritional antagonism. In order to improve the health status of aquaculture animals by providing high-quality feed, the development and optimization of fermented feed have received extensive attention. Probiotics in fermented feed can produce exogenous cellulase, protease, amylase, and other digestive enzymes in the digestive tract of farmed animals, which can improve the feed utilization rate, promote growth performance, and enhance the immunity of shrimp.In this study, in order to explore the application effects of shrimp feed fermented by different probiotic bacteria, probiotic strains, including Bacillus subtilis, Saccharomyces cerevisiae, and Lactobacillus acidophilus, were used individually and in combination for the fermentation of commercial feed and fed to shrimp (P. vannamei) for 28 days. The survival, body length growth, specific growth, and feed conversion rates of the shrimp were analyzed, and the density of Vibrio in vitro and in vivo, as well as relevant immune indicators in the serum, were analyzed. Furthermore, ammonia nitrogen and nitrite nitrogen concentrations in the water column were compared between the groups.The results demonstrated that the survival rates of shrimp in the fermented feed groups of B. subtilis, L. acidophilus, and complex bacteria were 8.54%, 8.54%, and 9.76%, respectively, which were significantly higher than that of the control group (P < 0.05). The body length growth rates in the B. subtilis and L. acidophilus groups were significantly higher than that of the control group (P < 0.05), while the feed conversion rate in the L. acidophilus group was significantly decreased compared with that of the control group (P < 0.05). There was no significant difference in the specific growth rate of shrimp between the experimental groups and the control group (P > 0.05). Fermented feed can affect the composition of bacteria in the hepatopancreas of shrimp. The density of Vibrio in the hepatopancreas of shrimp in each experimental group was significantly lower than that in the control group on days 14 and 21 of the experiment (P < 0.05). The feeding of different fermented feed in the short term (within 14 days) had no significant effect on reducing the total density of Vibrio in the water. However, feeding B. subtilis and L. acidophilus fermented feed significantly reduced the Vibrio density in the water body on day 21 (P < 0.05). In addition, the serum total protein concentration in each experimental group was significantly higher than that in the control group (P < 0.05). The activities of serum peroxidase, superoxide dismutase, and phenoloxidase in the L. acidophilus fermented feed group increased significantly compared with those of the other experimental and control groups (P < 0.05). The activities of serum peroxidase and phenoloxidase in the serum of shrimp fed S. cerevisiae fermented feed were significantly higher than those of the control group (P < 0.05). Complex bacteria-fermented feed could significantly increase the activities of serum lysozyme, peroxidase, and phenoloxidase (P < 0.05). However, the activity of the detected immune-related enzymes in the B. subtilis group did not increase significantly compared with that of the control group (P > 0.05), except for the activity of total serum protein, which was higher than that of the control group. The results also revealed that the concentration of ammonia nitrogen and nitrite nitrogen in the water group of each experimental group at the end of the experiment was significantly lower compared to that of the control group. S. cerevisiae and L. acidophilus groups had the best effect in reducing the concentration of ammonia nitrogen and nitrite nitrogen in the water, respectively.In summary, shrimp feed fermented by B. subtilis, S. cerevisiae, and L. acidophilus singly or in combination could improve the survival rate, growth performance, and immunity of shrimp to a degree, and reduce the concentration of ammonia nitrogen and nitrite nitrogen in aquaculture water. Moreover, L. acidophilus shows great potential as a candidate probiotic for shrimp feed fermentation. The results of this study provide a theoretical basis for the development of shrimp fermentation feed, which can improve the feed utilization and survival rates of shrimp in aquaculture.

Abstract Melanoma is one of the most prevalent skin cancers, with high metastatic rates and poor prognosis. Understanding its molecular pathogenesis is crucial for improving its diagnosis and treatment. Integrated analysis of multi-omics data from 207 treatment-naïve melanomas (primary-cutaneous-melanomas (CM, n = 28), primary-acral-melanomas (AM, n = 81), primary-mucosal-melanomas (MM, n = 28), metastatic-melanomas (n = 27), and nevi (n = 43)) provides insights into melanoma biology. Multivariate analysis reveals that PRKDC amplification is a prognostic molecule for melanomas. Further proteogenomic analysis combined with functional experiments reveals that the cis-effect of PRKDC amplification may lead to tumor proliferation through the activation of DNA repair and folate metabolism pathways. Proteome-based stratification of primary melanomas defines three prognosis-related subtypes, namely, the ECM subtype, angiogenesis subtype (with a high metastasis rate), and cell proliferation subtype, which provides an essential framework for the utilization of specific targeted therapies for particular melanoma subtypes. The immune classification identifies three immune subtypes. Further analysis combined with an independent anti-PD-1 treatment cohort reveals that upregulation of the MAPK7-NFKB signaling pathway may facilitate T-cell recruitment and increase the sensitivity of patients to immunotherapy. In contrast, PRKDC may reduce the sensitivity of melanoma patients to immunotherapy by promoting DNA repair in melanoma cells. These results emphasize the clinical value of multi-omics data and have the potential to improve the understanding of melanoma treatment.

Abstract Background Nurses' nursing competence and nutritional care literacy directly affect patients' health and safety. Self-directed learning ability was pervasive throughout the entire work process of nursing work and was the basis for improving both. However, there are few studies has explored the mechanism from the perspective of nutritional care literacy. The purpose of this study was to analyze the relationship between self-directed learning ability and nursing competence, and to explore the mediating role of nutritional care literacy between self-directed learning and nursing competence among clinical nurses in China. Methods A cross-sectional survey was conducted among 805 clinical nurses recruited from seven general hospitals in Hunan Province, China, between January 25 and March 6, 2022. The self-directed learning ability, nutritional care literacy and nursing competence of nurses were evaluated through investigation. A total of 799 questionnaires were received, resulting in an response rate of 99.25%.We performed an intermediary modeling to examine the mediating roles of nutritional care literacy on the relationship between self-directed learning ability and nursing competence in clinical nurses. Results Self-directed learning ability was positively correlated with nutritional care literacy (r=0.792, P

IntroductionFusarium oxysporum f. sp. Lycopersici (Fol) is one of the most devastating plant pathogenic fungi, the causal agent of root rot for Atractylides macrocephala Koidz (AMK). An accurate rapid and convenient diagnosis for FoL detection is essential for determining management practices and preventing future losses for AMK.MethodsHere, we developed a novel method for Fol detection by integrating loop-mediated isothermal amplification (LAMP) assay and CRISPR/Cas12b detection in one-pot, and the whole reaction can simultaneously amplify and detect the target gene of Fol in one-step.ResultsThe total time of the present method is limited to 45 min and isothermally performed at 60°C. The limit of detection of this assay is 88.9 copies per reaction. The specificity of the LAMP-CRISPR/Cas12b method was 100% without any cross-reaction of other pathogens. A total of 24 nucleic acid samples were used to evaluate the performance of the LAMP-CRISPR/Cas12b method, including 12 with-Fol and 12 without-Fol. Compared with the gold standard results from real-time PCR, the present method provides a sensitivity of 100% (12/12), specificity of 100% (12/12), and consistency of 100% (24/24).DiscussionTogether, our preliminary results illustrated that the LAMP-CRISPR/Cas12b method is a rapid simple, and reliable tool for Fol diagnosis and could be applied in point-of-need phytopathogen detection.

The C6orf120 gene is a novel gene whose function has not been fully defined. Previous studies have associated it with various liver pathologies, but its specific role in hepatocellular carcinoma (LIHC) remains unclear. This study aimed to investigate the diagnostic and prognostic value of C6orf120 in LIHC, as well as its potential biological functions. In this preliminary research, we utilized data from various databases and bioinformatics tools, including TCGA, GEO, TIMER2, HPA, GEPIA, Linkeomics, Metascape, CIBERSORT, TargetScan, DIANA-microT, RNAinter, and ENCORI, to analyze the expression patterns and mechanisms of C6orf120 in LIHC. Our bioinformatics analysis revealed that C6orf120 is upregulated in LIHC and may serve as a diagnostic and prognostic biomarker. The aberrant expression of C6orf120 in LIHC was further supported by clinical samples and cell lines. In vitro experiments demonstrated that the knockdown of C6orf120 in HepG2 cells significantly reduced migration capacity without affecting proliferation. Additionally, the downregulation of C6orf120 in LIHC cells appeared to inhibit endothelial cell migration and angiogenesis, which are critical in tumorigenesis and development. In conclusion, our findings suggest that C6orf120 could serve as a novel diagnostic and prognostic biomarker for LIHC and is expected to be a prognostic marker and a potential therapeutic target in the clinical management of LIHC.

Abstract Background Social alienation refers to the state of feeling isolated, helpless, and unsatisfied due to maintaining distance from others or avoiding social interaction and activities. This phenomenon is caused by a lack of social skills, social anxiety, physical health problems, and other reasons. Older maintenance hemodialysis patients are exposed to a higher risk of social alienation. However, previous studies have been performed using the total score of the scale, which does not allow the identification of the characteristics of various patient groups with different levels of social alienation. In contrast, latent profile analysis can classify individuals into different categories based on continuous observational indicators, which improves accuracy and provides a more objective assessment by accounting for the uncertainty of variables. Given the concealed nature of social alienation and the differences in characteristics and treatment measures between different profiles, developing a predictive model for social alienation in older maintenance hemodialysis patients holds significance. Objective To explore the latent profile analysis of social alienation in older maintenance hemodialysis patients and to develop and validate a predictive model for social alienation in this population. Methods A total of 350 older maintenance hemodialysis patients were selected as the study subjects using convenience sampling. A cross-sectional survey was conducted using a general information questionnaire, the Generalized Alienation Scale, and the Self-Perceived Burden Scale. Based on the results of the Generalized Alienation Scale, a latent profile analysis was performed, followed by univariate analysis and multinomial logistic regression to develop a predictive model. The effectiveness of the predictive model was evaluated in terms of its authenticity, reliability, and predictive ability. Results Three hundred nineteen valid questionnaires were collected. The social alienation of older maintenance hemodialysis patients based on latent profile analysis were divided into three profiles, which were named the low/medium/high-symptom groups, comprising 21%, 38.9%, and 40.1% of participants, respectively. Based on male, monthly social activity hours, Age-Adjusted Charlson Comorbidity Index, dialysis age, and Self-Perceived Burden Scale, a predictive model of social alienation for older maintenance hemodialysis patients was developed, and the Hosmer–Lemeshow tests showed no statistical significance (P > 0.05). The model has high predictive efficiency in authenticity, reliability and predictability. Conclusion Older maintenance hemodialysis patients exhibited moderate to high levels of social alienation. The latent profile analysis based method was used to divide patients into low/medium/high-symptom profiles, and the predictive model demonstrates excellent authenticity, reliability, and predictability.

Abstract Background Balanced propofol sedation is extensively used in endoscopic retrograde cholangiopancreatography (ERCP), but sedation-related adverse events (SRAEs) are common. In various clinical settings, the combination of dexmedetomidine with opioids and benzodiazepines has provided effective sedation with increased safety. The aim of this investigation was to compare the efficacy and safety of dexmedetomidine and propofol for sedation during ERCP. Methods Forty-one patients were randomly divided into two groups: the dexmedetomidine (DEX) group and the propofol (PRO) group. Patients in the DEX group received an additional bolus of 0.6 μg kg−1 dexmedetomidine followed by a dexmedetomidine infusion at 1.2 μg kg−1 h−1, whereas the PRO group received 1–2 mg kg−1 of propofol bolus followed by a propofol infusion at 2–3 mg kg−1 h−1. During ERCP, the primary outcome was the incidence of hypoxemia (SpO2 10 s). Other intraoperative adverse events were also recorded as secondary outcomes, including respiratory depression (respiratory rate of

Background: While numerous studies have examined the influence of perineural dexamethasone on nerve block duration, its potential impact on postoperative nerve injury has not been adequately addressed. Objective: This study aims to elucidate the effect of perineural dexamethasone on nerve injury and nerve function recovery after surgery. Design: A prospective randomized double-blinded trial. Setting: The First Affiliated Hospital of Chengdu Medical College, Chengdu, China. The study was conducted between 14 June and 30 December 2022. Participants: Patients aged 18 – 80 years, ASA I - II, scheduled for elective orthopedic or burn and plastic surgery. Interventions: Patients were randomized to receive either perineural dexamethasone (D group) or no dexamethasone (ND group). Main outcome measures: Primary outcomes were the incidence and recovery of nerve injury. Secondary outcomes included postoperative pain scores, analgesic consumption, and adverse events. Results: Initial postoperative nerve injury rates were similar between groups (D: 30.4 %, ND: 33.3 %, P > 0.05). At 12 weeks post-discharge, significantly more patients in the ND group recovered from nerve deficits (78.8 % vs 60.3 %; OR = 2.45, 95 % CI = 1.05 – 5.72, P

Food security and diet diversity is essential to sustainable food system all over the world. As the income of rural residents achieves great increase, the structure of food consumption and food diversification face significant change. Rural residents' food consumption and nutrients intake worth more attention. Chinese government has been striving to achieve sustainable development in rural areas. We conducted this study to explore area-level practices aiming at achieving food and nutrition security in rural China. In order to search for the change principle and main influencing factors of residents' food consumption, three rural areas in Henan Province were selected. According to the data obtained from the Henan Province Bureau of Statistics, changes in food consumption from 2012 to 2021 in three rural areas were analyzed in this study. This study led to the following remarkable results: (1) The per capita consumption of poultry, meat, sugar, and eggs of the three rural residents has increased much more than that of other food items. (2) In the three rural areas, the proportions of grains, vegetables, liquor, and edible oils have decreased overall. The proportions of other categories, such as poultry, meat, and fruits, have increased. (3) The rural residents’ per capita nutrition intake has increased remarkably. The results provide some empirical foundation for local government who need suggest that rural residents should control their intake of high-energy food, such as poultry, meat, and sugar. This study has significant policy implication for achieving sustainable goals in rural areas of China.

Objective Explainable machine learning (XAI) was introduced in this study to improve the interpretability, explainability and transparency of the modelling results. The survex package in R was used to interpret and compare two survival models – the Cox proportional hazards regression (coxph) model and the random survival forest (rfsrc) model – and to estimate overall survival (OS) and its determinants in heart failure (HF) patients using these models. Methods We selected 1159 HF patients hospitalised at the First Affiliated Hospital of Kunming Medical University. First, the performance of the two models was investigated using the C-index, the integrated C/D AUC, and the integrated Brier score. Second, a global explanation of the whole cohort was carried out using the time-dependent variable importance and the partial dependence survival profile. Finally, the SurvSHAP(t) and SurvLIME plots and the ceteris paribus survival profile were used to obtain a local explanation for each patient. Results By comparing the C-index, the C/D AUC, and the Brier score, this study showed that the model performance of rfsrc was better than coxph. The global explanation of the whole cohort suggests that the C-reactive protein, lg BNP (brain natriuretic peptide), estimated glomerular filtration rate, albumin, age and blood chloride were significant unfavourable predictors of OS in HF patients in both the cxoph and the rfsrc models. By including individual patients in the model, we can provide a local explanation for each patient, which guides the clinician in individualising the patient's treatment. Conclusion By comparison, we conclude that the model performance of rfsrc is better than that of coxph. These two predictive models, which address not only the whole population but also selected patients, can help clinicians personalise the treatment of each HF patient according to his or her specific situation.

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

IntroductionFusarium oxysporum is a significant soil-borne fungal pathogen that affects over 100 plant species, including crucial crops like tomatoes, bananas, cotton, cucumbers, and watermelons, leading to wilting, yellowing, growth inhibition, and ultimately plant death. The root rot disease of A. macrocephala, caused by F. oxysporum, is one of the most serious diseases in continuous cropping, which seriously affects its sustainable development.MethodsIn this study, we explored the interaction between A. macrocephala and F. oxysporum through integrated small RNA (sRNA) and degradome sequencing to uncover the microRNA (miRNA)–mediated defense mechanisms.ResultsWe identified colonization of F. oxysporum in A. macrocephala roots on day 6. Nine sRNA samples were sequenced to examine the dynamic changes in miRNA expression in A. macrocephala infected by F. oxysporum at 0, 6, and 12 days after inoculation. Furthermore, we using degradome sequencing and quantitative real-time PCR (qRT-PCR), validated four miRNA/target regulatory units involved in A. macrocephala–F. oxysporum interactions.DiscussionThis study provides new insights into the molecular mechanisms underlying A. macrocephala's early defense against F. oxysporum infection, suggesting directions for enhancing resistance against this pathogen.

Abstract Carbon fibers (CFs) have attracted attention in the automotive, aviation, and aerospace industries. However, the coloration of CFs is challenging due to their brittleness, inertness, complexity, and time/energy-intensive processes. Herein, inspired by the naturally grown protrusive nanostructures on the green central surface of peacock back feathers, we report an in-situ self-growing strategy for developing carbon spheres (CSs) on the CFs surface to achieve color tuning. This is achieved via the dynamic growth of CSs using glucose as the feeding material. Combined with the coloration process, the interaction between CSs and CFs promotes stable interfacial forces in integrated molding. This strategy allows the coloring system to continuously vary its color in a designated manner, thereby, endowing it with satisfactory mechanical robustness, acid durability, and light fastness. We anticipate this developed approach can be potentially competitive in the color construction of CFs with multi-colors due to its low-cost manufacturing.

ObjectiveTo investigate the effect of walnut oligopeptides (WOPs) on digestive function-related gastric secretion and blood/serum indicators in rats and on small intestinal propulsion in mice.MethodsTotally 130 male Sprague-Dawley (SD) rats and 70 male ICR mice were included in the study. The SD rats were first randomly divided into two subgroups (70 in subgroup Ⅰ and 60 in subgroup Ⅱ). The 70 SD rats of subgroup I and the 70 ICR mice were then randomly assigned into three control groups (normal, model, and whey protein control), three WOPs treatment groups (at dosages of 220, 440 and 880 mg/kg·bw), and a WOPs plus bovine collagen oligopeptides (BCOPs), with 10 rats or mice in each group respectively. The group-specific treatment was conclucted by intragastric administration of once a day for 30 days for the rats and 7 days for the mice; the grouping and treatments in 60 SD rats of subgroup II were the same as those of subgroup I, except for the absence of model control group. By the end of the treatments, the rats of subgroup I underwent pyloric ligation and collection of gastric fluid for detecting gastric acid and gastric tissue pepsin and serum gastrointestinal-associated regulatory hormones were also measured; while, the rats of subgroup II had choledochal cannula for bile collection. After 7-day′s treatment, the mice had another gavage of loperamide hydrochloride for examination of small intestinal propulsive function. ResultsCompared with those in the model control group, the free acid, total acid and total acid excretion of gastric juice were significantly higher and the pepsin activity was significantly lower in the WOPs dose groups (all P < 0.05). The content of growth inhibitory hormone in high WOPs dose (880 mg/kg·bw) group was significantly lower than that in the model control group; the rats with medium (440 mg/kg·bw) and high (880 mg/kg·bw) WOPs treatment and combined treatment of WOPs and BCOPs had significantly higher motilin, substance P, and gastrin than those in the rats of model control group. The small intestinal propulsion rates of the mice in WOPs dose groups were significantly higher than that of model control mice (P < 0.05 for all). ConclusionWOPs can exert pro-digestive effect by regulating the secretions of gastric acid, pepsin, gastrointestinal hormone in rats and by promoting gastrointestinal peristalsis in mice.

Objectives: Accumulating evidence has confirmed the efficacy and safety of COVID-19 vaccines against SARS-CoV-2 infection. However, the effect of COVID-19 vaccination on immuno-virological parameters in people with HIV (PWH) is uncertain. Methods: A total of 372 PWH treated at Beijing Ditan Hospital were included. Unvaccinated PWH were matched 1:3 with vaccinated PWH using a propensity score matching algorithm. Differences in immuno-virological markers between the matched groups were analyzed. The Wilcoxon signed rank test was used to test for changes in CD4 and CD8 counts and HIV viral load over two months around vaccination. In addition, we investigated the long-term changes in HIV-related markers in different vaccination dose groups and in the entire vaccinated population. Results: Vaccinated PWH had a higher CD4/CD8 ratio (0.64 (0.49, 0.78) vs. 0.80 (0.56, 1.03), p = 0.037) than unvaccinated PWH within a two-month window after the third dose. There were 337 PWH who received COVID-19 vaccination, and 73.9% (n = 249) received three doses of vaccine. We observed a transient increase in CD4 count and CD4/CD8 ratio within a two-month window after vaccination, especially after the second dose (CD4 count: 583.5 (428.5, 706.8) vs. 618.0 (452.0, 744.0), p = 0.018; CD4/CD8 ratio: 0.70 (0.50, 0.91) vs. 0.71 (0.53, 0.96), p < 0.001)) and the third dose (CD4 count: 575.5 (435.5, 717.0) vs. 577.5 (440.8, 754.8), p = 0.001; CD4/CD8 ratio: 0.70 (0.52, 0.93) vs. 0.79 (0.53, 1.00), p < 0.001)). Recent CD4 counts and CD4/CD8 ratios were lower than after COVID-19 but remained higher than before COVID-19 in vaccinated PWH. In addition, COVID-19 vaccination had no negative effect on HIV viral load. Conclusions: A transient increase in CD4 count and CD4/CD8 ratio was observed after COVID-19 vaccination. However, the enhanced cellular immune response induced by vaccination may diminish over time and return to normal levels. There is no adverse effect of vaccination on HIV viral load.

Background: The serum C-reactive protein-to-albumin ratio (CAR) has been identified as an adverse prognostic indicator in a variety of diseases. Nevertheless, there have been not been any studies reporting a relationship between CAR and the prognosis of chronic heart failure (CHF). This study was designed to evaluate the association between CAR and all-cause mortality in CHF patients with different ejection fractions. Methods: A total of 1221 heart failure (HF) patients were enrolled at the First Affiliated Hospital of Kunming Medical University due to acute exacerbation of chronic HF from January 2017 to October 2021. The main outcome was all-cause mortality. After collecting baseline characteristics and laboratory results from all patients, we classified all participants into four groups based on CAR quartile (G1–G4). Kaplan-Meier survival curves and multivariate Cox proportional hazard models were employed to investigate the association between CAR and all-cause mortality in the patients. Furthermore, receiver operating characteristic (ROC) curves were constructed for CARs, and the area under the curve (AUC) was calculated. Results: After excluding ineligible patients, we ultimately included 1196 patients with CHF. The mean age was 66.38 ± 12.521 years, and 62% were male. According to the Kaplan‒Meier analysis, with different ejection fractions, the risk of all-cause mortality was always highest for G4 (CAR >63.27) and lowest for G1 (CAR ≤7.67). Cox multivariate regression analyses indicated that the CAR was an independent predictor of all-cause mortality in all HF patients and in patients with different HF subtypes. According to the ROC curves, the AUC for the CAR was 0.732 (p < 0.001), with a sensitivity of 66.2% and the specificity of 72.7%. CAR had a greater predictive value for all-cause mortality than did C-reactive protein (CRP). Conclusions: An elevated serum CAR was independently associated with an increased risk of all-cause death, regardless of heart failure subtype.

Background and Objectives: The relationship between circulating retinol-binding protein 4 (RBP4) levels and hepatitis C virus (HCV) infection remains unclear. This study aims to systematically assess RBP4 expression in patients with HCV and its correlation with disease severity. Materials and Methods: We searched the Embase, PubMed, and Cochrane databases for relevant studies up to 1 January 2024. This study was registered on PROSPERO (CRD42023489051). Results: Our analysis included eight studies with 2612 participants (1152 controls and 1282 patients with HCV). Overall, RBP4 levels did not significantly differ between patients with HCV and controls (SMD: −0.36; 95% CI: −0.94, 0.23; p = 0.23). However, in a subgroup of Asian subjects, patients with HCV showed significantly lower RBP4 levels (SMD: −0.40; 95% CI: −0.49, −0.31; p = 0.10). Additionally, a negative correlation between RBP4 levels and disease severity was observed across all studied populations. Conclusions: RBP4 levels may vary due to HCV genotype, ethnicity, and environmental factors. In the context of HCV infection, RBP4 levels appear to reflect the severity of disease progression. Our findings indicate that RBP4 could serve as a biomarker for HCV disease progression. Further research is needed to elucidate the complex mechanisms of RBP4 in HCV infection.

Abstract Background This study was undertaken to explore the predictive value of the advanced lung cancer inflammation index (ALI) combined with the geriatric nutritional risk index (GNRI) for all-cause mortality in patients with heart failure (HF). Methods and results We enrolled 1123 patients with HF admitted to our cardiology department from January 2017 to October 2021. Patients were divided into four groups, according to the median ALI and GNRI. From the analysis of the relationship between the ALI and GNRI, we concluded that there was a mild positive linear correlation (r = 0.348, p

Abstract The immunonutritional status has important effects on outcomes for cancer patients. Albumin-to-globulin ratio (AGR) and the prognostic nutrition index (PNI) are often used to assess the immunonutritional status of cancer patients. However, the clinical significance of these factors in colorectal cancer (CRC) remains unclear. We aimed to evaluate the clinical significance of the AGR and PNI in CRC. We reviewed the clinical data of 511 patients with CRC in two hospitals. Data from one institution was used as the training cohort. The optimal cutoff values for AGR and PNI in the training cohort were 1.4 and 48.65, respectively. Patients in both the low AGR and low PNI groups had poor overall survival (OS) and progression-free survival (PFS), while those in the low AGR-low PNI group had the lowest OS and PFS. Multivariate analysis revealed that preoperative AGR, preoperative PNI, gross type, and TNM stage were independent prognostic factors influencing OS in patients with CRC. Preoperative AGR, preoperative PNI, and TNM stage were independently associated with PFS in patients with CRC. According to the results of multivariate analysis in the training cohort, we developed the nomograms for OS and PFS and performed internal and external validation, which showed good prediction ability of the nomograms. In conclusion, preoperative AGR and PNI can be used as effective indicators to predict survival for patients with CRC. AGR and PNI may help develop effective adjuvant-therapy schedules.

Abstract Bassoon (BSN) is a component of a hetero-dimeric presynaptic cytomatrix protein that orchestrates neurotransmitter release with Piccolo (PCLO) from glutamatergic neurons throughout the brain. Heterozygous missense variants in BSN have previously been associated with neurodegenerative disorders in humans. We performed an exome-wide association analysis of ultra-rare variants in about 140,000 unrelated individuals from the UK Biobank to search for new genes associated with obesity. We found that rare heterozygous predicted loss of function (pLoF) variants in BSN are associated with higher BMI with p-value of 3.6e-12 in the UK biobank cohort. Additionally, we identified two individuals (one of whom has a de novo variant) with a heterozygous pLoF variant in a cohort of early onset or extreme obesity and report the clinical histories of these individuals with non-syndromic obesity with no history of neurobehavioral or cognitive disability. The BMI association was replicated in the All of Us whole genome sequencing data. Heterozygous pLoF BSN variants constitute a new etiology for obesity.

Broodiness in egg-laying hens (EHs) leads to ovarian atrophy, resulting in reduced egg-laying performance. However, the ovarian regulatory mechanisms in broody hens (BCs) remain elusive. Therefore, ovaries were removed from 300-day-old BCs and EHs for RNA sequencing. Ovarian morphology and histological characteristics of the BC and EH groups were compared and analyzed. The EH group had significantly more hierarchical follicles (HFs) and small yellow follicles (SYFs) than that of the BC group. Although several secondary follicles (SFs) and primary follicles were observed in the ovaries of the EH group, only a few SFs were observed in the ovaries of the BC group. Subsequently, RNA-sequencing analysis was conducted to determine the ovarian expression profiles of the two groups. Transcriptome sequencing identified 259 differentially expressed genes (DEGs) between the BC and EH groups. Of the 259 DEGs, 136 were upregulated and 123 were downregulated. The DEGs were mapped to 22 gene ontology terms and 4 Kyoto Encyclopedia of Genes and Genomes pathways for ovarian tissue. The analysis showed that matrix metalloproteinases 11/13 (MMP11/MMP13) were enriched in the extracellular matrix. The extracellular matrix mediated by MMP13 is affected by follicle-stimulating hormone, prolactin, and estrogen, which are critical signaling pathways that may affect ovarian follicle development to regulate the large yellow follicle reserve process and the ovulation cycle of broody Chahua chickens. These findings indicate that understanding differences in gene expression between the ovarian tissues of BCs and EHs could serve as a valuable reference point for enhancing egg-laying performance in Chahua chickens.

BackgroundImproving the young college students’ national identity is crucial for ensuring social stability and fostering development during public health critical events such as COVID-19. Young college students’ recognition of national COVID-19 crisis governance capabilities can influence their national identity, and online participation in public health criticalevents may serve as a crucial role in shaping this intricate relationship. To investigate this possibility, the present study established an intermediary model to examine the impact of online participation in public health critical events on young college students’ recognition of national COVID-19 crisis governance capabilities and improvement of national identity.MethodsThis cross-sectional survey study employed a convenience sampling method to investigate a total of 3041 young college students in China. The correlations between study variables were analyzed using Spearman’s rank correlation. The mediation model was established using PROCESS Model 4 with 5000 bootstrap samples in SPSS. The bias-corrected bootstrap method provided statistical efficacy and identification interval estimation.ResultsYoung college students’ recognition of national COVID-19 crisis governance capabilities (r=0.729, P

RNA interference (RNAi) shows great potential in plant defense against pathogens through RNA-mediated sequence-specific gene silencing. Among RNAi-based plant protection strategies, spray-induced gene silencing (SIGS) is considered a more promising approach because it utilizes the transfer of exogenous RNA between plants and microbes to silence target pathogen genes. The application of nanovesicles significantly enhances RNA stability and delivery efficiency, thereby improving the effectiveness of SIGS and further enhancing plant resistance to diseases and pathogens. This review explores the role of RNAi in plant protection, focusing on the cross-kingdom transport of small RNAs (sRNAs) via extracellular vesicles. It also explores the potential of nanotechnology to further optimize RNA-based plant protection, offering innovative tools and methods in modern plant biotechnology.

As the most abundant group of mammals, rodents possess a very rich ecotype, which makes them ideal for studying the relationship between diet and host gut microecology. Zokors are specialized herbivorous rodents adapted to living underground. Unlike more generalized herbivorous rodents, they feed on the underground parts of grassland plants. There are two species of the genus Myospalax in the Eurasian steppes in China: one is Myospalax psilurus, which inhabits meadow grasslands and forest edge areas, and the other is M. aspalax, which inhabits typical grassland areas. How are the dietary choices of the two species adapted to long-term subterranean life, and what is the relationship of this diet with gut microbes? Are there unique indicator genera for their gut microbial communities? Relevant factors, such as the ability of both species to degrade cellulose, are not yet clear. In this study, we analyzed the gut bacterial communities and diet compositions of two species of zokors using 16S amplicon technology combined with macro-barcoding technology. We found that the diversity of gut microbial bacterial communities in M. psilurus was significantly higher than that in M. aspalax, and that the two species of zokors possessed different gut bacterial indicator genera. Differences in the feeding habits of the two species of zokors stem from food composition rather than diversity. Based on the results of Mantel analyses, the gut bacterial community of M. aspalax showed a significant positive correlation with the creeping-rooted type food, and there was a complementary relationship between the axis root-type-food- and the rhizome-type-food-dominated (containing bulb types and tuberous root types) food groups. Functional prediction based on KEGG found that M. psilurus possessed a stronger degradation ability in the same cellulose degradation pathway. Neutral modeling results show that the gut flora of the M. psilurus has a wider ecological niche compared to that of the M. aspalax. This provides a new perspective for understanding how rodents living underground in grassland areas respond to changes in food conditions.

Extracellular vesicles (EVs) are vesicle-like structures composed of lipid bilayers, which can be divided into apoptotic bodies, microbubbles and exosomes. They are nanoparticles used for the exchange of information between cells. EVs contains many substances, including protein. With the development of proteomics, we know more about the types and functions of protein in vesicles. The potential functions of proteins in the envelope are mainly discussed, including cell wall construction, fungal virulence transmission, signal transmission and redox reactions, which provides a new perspective for studying the interaction mechanism between fungi and other organisms. The fungal protein markers of EVs are also summarized, which provided an exploration tool for studying the mechanism of vesicles. In addition, the possible role of immune protein in the EVs in the treatment of human diseases is also discussed, which provides new ideas for vaccine development.

ObjectiveHuman identical sequences of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) promoted the coronavirus disease 2019 (COVID-19) progression by upregulating hyaluronic acid (HA) via NamiRNA-enhancer network, based on previous experimental research. This study aimed to investigate the predictive value of HA for the severity of SARS-CoV-2 infection in the post-COVID-19 era.MethodsA total of 217 consecutive patients with COVID-19 were enrolled at Beijing Ditan Hospital between July 2023 and October 2023. HA levels were analyzed using biochemical detector. Logistic regression analysis was used to screen independent factors for severe COVID-19. The predictive performance of HA for severe infection was assessed by ROC curve. Furthermore, the relationship between HA levels and COVID-19 severity was investigated using multivariate logistic regression models after adjustment for potential confounders.ResultsAccording to the cut-off value of HA, COVID-19 patients were divided into HA < 90 ng/mL group (80 cases) and HA ≥ 90 ng/mL group (137 cases). High HA levels were positively associated with the severe SARS-CoV-2 infection, including elevated inflammatory indicators, severe lung involvement, prolonged clinical course, and higher incidence of respiratory failure and death (P < 0.05). Logistic regression analysis suggested that HA was an independent predictor of severe COVID-19 (OR = 4.540, 95% CI = 2.105-9.790, P < 0.001). ROC curve analysis showed that the AUC of HA for severe infection was 0.724. HA levels were significantly higher in COVID-19 cases compared to the healthy population (123.9 (82.6, 174.1) vs. 50.5 (37.8, 66.8), P < 0.001), but similar to those with non-SARS-CoV-2 lung infection (121.6 (78.5, 175.6) vs. 106.0 (66.5, 149.7), P = 0.244). We also found that the first COVID-19 infections had higher HA levels (118.8 (79.5, 174.3) vs. 85.0 (61.1, 128.8), P < 0.001) and a higher proportion of severe infection (37.1% vs. 21.3%, P = 0.043) than re-infections. However, HA expression failed to fully return to normal levels with infection recovery (204.7 (152.9, 242.2) vs. 97.0 (69.3, 137.3), P < 0.001).ConclusionHA was associated with severe SARS-CoV-2 infection and could be used as a novel serum biomarker to predict the risk of COVID-19 progression in the post-COVID-19 era.

Abstract Environmental stressors and disturbances can cause changes in an ecosystem's community structure, which can be reflected in its functional diversity. As grazing intensity increases, this causes changes in the environment that inevitably lead to changes in the community structure, which can especially affect rodents due to their sensitivity to the environment. The effects of grazing prohibition and overgrazing on the functional diversity of desert rodent communities in Alxa were studied in April, July, and October of 2018–2020. The trap‐day method was used to study rodent communities in disturbed habitats. Five functional traits were selected and quantified: nutrition, life history, physiology, morphology, and activity rhythm. The results showed that: (1) The species composition of rodent communities in the Alxa Desert in spring and autumn was significantly correlated with the functional traits of the hibernation, reproductive cycle, and feeding habits. The species composition in the summer was only significantly correlated with the functional traits of reproductive cycle and diet. (2) The effects of overgrazing on the functional diversity of rodents in desert areas have significant temporal and spatial characteristics. (3) In spring and summer, overgrazing made the Functional Richness index of the rodent community lower than that of areas where grazing is prohibited, but the Functional Evenness index was higher than that of grazing‐prohibition areas. In autumn, overgrazing increased the Functional Richness index of the rodent community and decreased the Functional Evenness index. The Functional Divergence index was higher in overgrazing areas than in grazing‐prohibited ones. These results suggest that, in spring and summer, overgrazing reduced the ecological space utilization ability of rodent communities; however, the impact on the degree of utilization of community resources is more comprehensive. In autumn, overgrazing increases the ability of rodent communities to use ecological space but reduces resource efficiency. Overgrazing makes the niche differentiation of rodent communities higher, the degree of overlap lower, and the competition between species weaker. Therefore, overgrazing will affect the functional diversity of the community through the utilization of ecological space, resource utilization, interspecific competition, and niche.

Abstract Metallic lithium (Li) is considered the “Holy Grail” anode material for the next‐generation of Li batteries with high energy density owing to the extraordinary theoretical specific capacity and the lowest negative electrochemical potential. However, owing to inhomogeneous Li‐ion flux, Li anodes undergo uncontrollable Li deposition, leading to limited power output and practical applications. Carbon materials and their composites with controllable structures and properties have received extensive attention to guide the homogeneous growth of Li to achieve high‐performance Li anodes. In this review, the correlation between the behavior of Li anode and the properties of carbon materials is proposed. Subsequently, we review emerging strategies for rationally designing high‐performance Li anodes with carbon materials, including interface engineering (stabilizing solid electrolyte interphase layer and other functionalized interfacial layer) and architecture design of host carbon (constructing three‐dimension structure, preparing hollow structure, introducing lithiophilic sites, optimizing geometric effects, and compositing with Li). Based on the insights, some prospects on critical challenges and possible future research directions in this field are concluded. It is anticipated that further innovative works on the fundamental chemistry and theoretical research of Li anodes are needed.

Embryonic development is a critical period for phenotype formation. Environmental variation during embryonic development can induce changes in postnatal phenotypes of animals. The thyroxine secretion and aerobic metabolic activity of small birds are important phenotypes closely related to their winter survival. In the context of climate change, it is necessary to determine whether temperature variation during incubation in birds leads to developmental plasticity of these cold responsive phenotypes. We incubated Japanese Quail (Coturnix japonica) eggs at 36.8 °C, 37.8 °C, and 38.8 °C, and raised the chicks to 35-day old at 22 °C with same raising conditions, then all the quails were exposed to gradually temperature dropping environment (from 15 °C to 0 °C). After cold treatment, serum T3 level, resting metabolic rate, skeletal muscle and liver metabolomes of the birds were measured. The serum T3 levels were significantly lower in the 38.8 °C group and significantly higher in the 36.8 °C group compared to the 37.8 °C group. The metabolic rate in the 38.8 °C group was significantly lower compared to the 37.8 °C group. Compared with the 37.8 °C group, metabolites involved in the tricarboxylic acid cycle in the liver were significantly lower in the 38.8 °C group, and metabolites related to lipid oxidation metabolism and fatty acid biosynthesis were significantly lower in the skeletal muscles in the 38.8 °C group but significantly higher in the 36.8 °C group. These results indicate that incubation temperature variation can lead to developmental plasticity in cold responsive physiological phenotypes. Higher incubation temperature may impair the capacity of birds coping with cold challenge.

Abstract Background Patients diagnosed withmajor depressive disorder (MDD) usually experience impaired cognitive functioning, which might negatively impact their clinical and functional outcomes. This study aimed to investigate the association of specific clinical factors with cognitive dysfunction in a group of MDD patients. Methods A total of 75 subjects diagnosed with recurrent MDD were evaluated during the acute stage. Their cognitive functions were assessed using the THINC-integrated tool (THINC-it) for attention/alertness, processing speed, executive function, and working memory. Clinical psychiatric evaluations, such as the Hamilton Anxiety Scale (HAM-A), the Young Mania Rating Scale (YMRS), the Hamilton Depression Scale (HAM-D), and the Pittsburgh Sleep Quality Index(PSQI), were used to assess patients’ levels of anxiety, depression and sleeping problems. The investigated clinical variables were age, years of education, age at onset, number of depressive episodes, disease duration, presence of depressive and anxiety symptoms, sleep problems, and number of hospitalizations. Results The results revealed that significant differences were observed between the two groups in the THINC-it total scores, Spotter, Codebreaker, Trails, and PDQ-5-D scores (P

[Objective] The factors affecting landscape ecological risk in karst watersheds were determined in order to formulate ecological risk prevention and control measures and landscape management planning in mountain watersheds. [Methods] This study was conducted in the Guizhou section of the Hongshui River basin (a typical karst basin). The study utilized the perspective of “productive-living-ecological” space, and used GIS spatial analysis, landscape ecological risk index, and other methods to explore the temporal and spatial change mechanism of landscape ecological risk in the study area. The relationship between the temporal and spatial distributions of landscape ecological risk and topography was analyzed by means of the distribution index method. [Results] ① Since 2000, land use transformation based on the productive-living-ecological space in the Hongshui River basin was characterized by a reduction in the production and ecological space and a rapid increase in the living space. The contribution rates of regional landscape ecological risk changes caused by the transfer of different land use types were different. ② During the period from 2000 to 2020, the overall landscape ecological risk showed a moderate trend, and the landscape ecological risk in the southern part of the Hongshui River basin was generally better than in the northern part. ③ From the distribution of landscape ecological risk on the terrain gradient, the degree of landscape ecological risk was inversely proportional to the terrain gradient. In addition, the landscape ecological risk in the non-karst area and pure karst area was lower than that in the subkarst area. [Conclusion] Although the landscape ecological risk in the Hongshui River basin has improved, some landscape ecological problems are still prominent, and it will be necessary to strengthen the management and protection of the ecological environment.

Abstract Background Systemic mastocytosis (SM), a rare myeloid neoplasm, is defined as a clonal and neoplastic proliferation of mast cells in at least one extracutaneous organ(s). The pathologic diagnosis and treatment of SM are challenging. Case presentation We presented a 44-year-old male patient who had endured abdomen discomfort for 4 years and diarrhea for 5 months. Colonoscopy and PET/CT found a protuberant lesion in the cecum with adjacent lymphadenopathy. Histopathology of the cecum biopsy showed diffuse infiltration of medium-sized round/oval cells in lamina propria with immunohistochemical expressions of CD45, CD117, CD25, CD68, CD123, CD56, CD4, and CD35, mimicking blastic plasmacytoid dendritic cell neoplasm. Sanger sequencing revealed missense mutation (D816V) in the exon 17 of KIT gene. Serum tryptase level was 38.56 ng/ml. No abnormality was found in skin examination and bone marrow biopsy. No primitive cells were observed in bone marrow smear and peripheral blood smear. The diagnosis of aggressive SM with intestinal tract involvement was established. The patient received avapritinib treatment at an initial dosage of 200 mg once daily and exhibited dramatic clinical improvement but memory impairment within 1 month. No recurrence was observed in 1-year follow-up at the adjusted avapritinib dose (75 mg once daily). Conclusions SM is very rare and should be considered in patients with long-term diarrhea symptoms and hematopoietic/lymphoid-appearing tumors. KIT D816V mutation contributes to the differentiation of CD123, CD4, and CD56 immunoreactive SM from blastic plasmacytoid dendritic cell neoplasm. The rare side-effect of memory impairment in this case helps to accumulate the experience of avapritinib in treating KIT D816V-mutant SM.

Abstract Background The prevalence of COVID-19 highlights the shortage of human medical resources, and improving medical students' professional identity is crucial to improving this situation. The sources of confidence in overcoming COVID-19 and medical students' attention to COVID-19 were significant factors affecting their professional identity. However, no study has investigated the mediating role of medical students' attention to COVID-19 in their relationship. This study investigates the relationship between these three factors in three medical university students in Hunan Province. Methods A cross-sectional survey study that used convenience sampling method was conducted on 2775 medical students from three universities in the Hunan Province of China from March 15 to April 19, 2020. An intermediary model was established to evaluate the role of medical students' attention to COVID-19 in the sources of confidence in overcoming COVID-19 and the improvement of medical students' professional identity. Results The sources of confidence in overcoming COVID-19, medical students' attention to national crisis events, and the improvement of medical students' professional identity was positively associated with each other (β = 0.328 ~ 0.464, P

Abstract Objectives To evaluate the discriminatory capability of spectral CT-based radiomics to distinguish benign from malignant solitary pulmonary solid nodules (SPSNs). Materials and methods A retrospective study was performed including 242 patients with SPSNs who underwent contrast-enhanced dual-layer Spectral Detector CT (SDCT) examination within one month before surgery in our hospital, which were randomly divided into training and testing datasets with a ratio of 7:3. Regions of interest (ROIs) based on 40-65 keV images of arterial phase (AP), venous phases (VP), and 120kVp of SDCT were delineated, and radiomics features were extracted. Then the optimal radiomics-based score in identifying SPSNs was calculated and selected for building radiomics-based model. The conventional model was developed based on significant clinical characteristics and spectral quantitative parameters, subsequently, the integrated model combining radiomics-based model and conventional model was established. The performance of three models was evaluated with discrimination, calibration, and clinical application. Results The 65 keV radiomics-based scores of AP and VP had the optimal performance in distinguishing benign from malignant SPSNs (AUC65keV-AP = 0.92, AUC65keV-VP = 0.88). The diagnostic efficiency of radiomics-based model (AUC = 0.96) based on 65 keV images of AP and VP outperformed conventional model (AUC = 0.86) in the identification of SPSNs, and that of integrated model (AUC = 0.97) was slightly further improved. Evaluation of three models showed the potential for generalizability. Conclusions Among the 40-65 keV radiomics-based scores based on SDCT, 65 keV radiomics-based score had the optimal performance in distinguishing benign from malignant SPSNs. The integrated model combining radiomics-based model based on 65 keV images of AP and VP with Zeff-AP was significantly superior to conventional model in the discrimination of SPSNs.

Abstract Smart windows refer to those which can dynamically modulate the transmitted light by changing their colors. Dual‐band electrochromic materials (ECMs) refer to materials that can change their colors and regulate light transmission in both visible (VIS) and infrared (IR) regions under different voltages. The dual‐band ECMs‐based building windows can thus regulate the indoor temperature to reduce the energy consumption for heating and air‐conditioning systems. Therefore, the wide application of ECMs in building windows will contribute a lot to establishing an energy‐saving society. During the past decades, enormous efforts have been made to improve the performance of dual‐band ECMs. This review presents a summary of the recent progress of dual‐band ECMs, focusing on their modulation mechanism, material design, and performance optimization. Finally, the challenges and outlook of dual‐band ECMs are also discussed.

Composites of amorphous ZrP and N-doped carbon were prepared in a one-step pyrolysis process instead of general post-loading technique. Owing to their mesoporous structure (6–10 nm) and Zr content (up to 41 wt%), the amphoteric materials have potential use in the cycloaddition of CO2 to epoxides, which is an acid‒base tandem process including the ring opening of epoxides and the addition of CO2. Substantial work has been done on how starting materials impact the structure and performance of composite materials. The coordination between metal and melamine has been confirmed, and it can be implanted in the melamine-polymer initiation of formation of porous metal-carbon materials. The composite catalysts exhibit amphoteric properties, present broad-spectrum adsorption, and finally produce carbonates via cycloaddition of CO2 to epoxides. It is remarkable that the multiple characteristics of porous solids are stabilized, and no significant loss of catalytic performance is observed after four cycles.

BackgroundA growing number of studies have suggested that adolescents’ prosocial behavior can protect against depression and anxiety. It is known that anxiety and depression are often comorbid. However, it remains unclear if when depression is present, prosocial behavior remains protective against anxiety, and if when anxiety is present, prosocial behavior remains protective against depression. The purpose of this study was to determine the association of anxiety and depressive with prosocial behavior.MethodsA large representative sample of middle-school students was recruited for a cross-sectional study and completed standardized instruments (the Children’s Depression Inventory (CDI), Screen for Child Anxiety Related Emotional Disorders–Child version (SCARED-C), and Strengths and Difficulties Questionnaire (SDQ)). We used structural equation modeling (SEM) to examine the protective effect of prosocial behavior against anxiety when depression was present.ResultsA survey of 3,510 students was conducted, and the final analysis included 3,169 students, comprising 1,616 boys (51.0%) and 1,553 girls (49.0%), with a mean age of 13.09 years (SD = 1.31, range 11–16).The prevalence rates of anxiety and depression in early adolescents were 31.6 and 16.7%, respectively. More than two-thirds of depressed adolescents had comorbid anxiety, while more than one-third of anxious adolescents had comorbid depression. Regression models showed that compared with depressed adolescents, adolescents without depressive symptoms exhibited a significant negative correlation between prosocial behaviors and anxiety and depression (β = −0.01, p > 0.01, β = −0.06, p > 0.01; β = −0.11, p < 0.01, and β = −0.17, p < 0.01). There was no difference in the relationship between prosocial behavior and depression between anxious and non-anxious adolescents (p > 0.05).ConclusionAnxiety and depression are common in adolescence and are often comorbid disorders. However, the comorbidity is not symmetrical. Specifically, the protective effect of prosocial behavior against anxiety is weaker in depressed adolescents. Findings are discussed in light of related research and theory, and insights for intervention programs and future research are presented.

ObjectiveThis study sought to examine the impacts of a high dietary fiber cereal meal in comparison to conventional dietary management for diabetes on body weight, distribution of adipose tissue, and cardiovascular risk among individuals diagnosed with type 2 diabetes (T2DM).MethodsA cohort of 120 patients diagnosed with T2DM was enlisted as the study population and divided into two groups using a ratio of 2:1—namely, the W group (n=80) and the U group (n=40). The U group (control) received usual diet, while the W group (intervention) incorporated a high dietary fiber cereal meal in place of their regular staple food in addition to adhering to conventional diabetes dietary recommendations. The high dietary fiber cereal meal was based on whole grains, traditional Chinese medicinal foods, and prebiotics. A subsequent follow-up period of 3 months ensued, during which diverse parameters such as body mass index (BMI),waist-hip ratio (WHR), glycated hemoglobin (HbA1c),fasting blood glucose(FBG),C-peptide levels, blood pressure, blood lipids, high-sensitivity C-reactive protein (hsCRP),10-year cardiovascular disease (CVD) risk, and Lifetime CVD risk were assessed before and after the intervention.ResultsAmong the participants, a total of 107 successfully completed the intervention and follow-up, including 72 individuals from the W group and 35 from the U group. Following the intervention, both cohorts exhibited decrease in BMI, WHR, HbA1c, FBG, blood pressure, and blood lipid levels in contrast to their initial measurements. Remarkably, the improvements in BMI, WHR, HbA1c, FBG, total cholesterol (TC), triglycerides(TG), low-density lipoprotein cholesterol (LDL-C), the ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C), and the ratio of 2-hour C-peptide (2hCP) to fasting C-peptide (FCP) were more marked within the W group, exhibiting statistically significant disparities (P

Renal injury is a fatal complication in critically ill patients with sepsis. As an ultrashort-acting synthetic opioid derivative, remifentanil has been reported to mitigate renal injury and sepsis. Nevertheless, whether remifentanil also suppresses sepsis-triggered renal injury is uncertain. The aim of this study was to investigate the effect of remifentanil on endoplasmic reticulum stress (ERS) and inflammatory response in an in vitro lipopolysaccharide (LPS)-stimulated renal tubular epithelial cell (HK-2) model and its mechanism. The viability of HK-2 cells with the absence or presence of LPS treatment was surveyed by cell counting kit-8 assay. Under the condition of LPS treatment, apoptosis was appraised by TUNEL assay and western blot. Levels of inflammatory factors were estimated though corresponding kits. Western blot tested the expression of toll-like receptor 4 (TLR4)/nuclear factor-kappaB (NF-κB) signaling-associated proteins. Also, the expression of ERS-related proteins was detected by western blot. Further, ERS inducer tunicamycin (TM) was added and the aforementioned experiments were conducted again. The results underlined the protective effects of remifentanil on LPS-evoked viability injury, inflammation, activation of TLR4/NF-κB signaling and ERS in HK-2 cells. Moreover, the impacts of remifentanil on the biological events of LPS-insulted HK-2 cells were all reversed by TM administration. To conclude, remifentanil might have a remarkable ameliorative effect on sepsis-induced renal injury, which implied the potential of remifentanil-based drug therapy in sepsis-induced renal injury.

Abstract Background Pancreatic cancer (PC) is a highly lethal malignancy regarding digestive system, which is the fourth leading factor of cancer-related mortalities in the globe. Prognosis is poor due to diagnosis at advanced disease stage, low rates of surgical resection, and resistance to traditional radiotherapy and chemotherapy. In order to develop novel therapeutic strategies, further elucidation of the molecular mechanisms underlying PC chemoresistance is required. Ribosomal RNA biogenesis has been implicated in tumorigenesis. Small nucleolar RNAs (snoRNAs) is responsible for post-transcriptional modifications of ribosomal RNAs during biogenesis, which have been identified as potential markers of various cancers. Here, we investigate the U3 snoRNA-associated protein RRP9/U3-55 K along with its role in the development of PC and gemcitabine resistance. Methods qRT-PCR, western blot and immunohistochemical staining assays were employed to detect RRP9 expression in human PC tissue samples and cell lines. RRP9-overexpression and siRNA-RRP9 plasmids were constructed to test the effects of RRP9 overexpression and knockdown on cell viability investigated by MTT assay, colony formation, and apoptosis measured by FACS and western blot assays. Immunoprecipitation and immunofluorescence staining were utilized to demonstrate a relationship between RRP9 and IGF2BP1. A subcutaneous xenograft tumor model was elucidated in BALB/c nude mice to examine the RRP9 role in PC in vivo. Results Significantly elevated RRP9 expression was observed in PC tissues than normal tissues, which was negatively correlated with patient prognosis. We found that RRP9 promoted gemcitabine resistance in PC in vivo and in vitro. Mechanistically, RRP9 activated AKT signaling pathway through interacting with DNA binding region of IGF2BP1 in PC cells, thereby promoting PC progression, and inducing gemcitabine resistance through a reduction in DNA damage and inhibition of apoptosis. Treatment with a combination of the AKT inhibitor MK-2206 and gemcitabine significantly inhibited tumor proliferation induced by overexpression of RRP9 in vitro and in vivo. Conclusions Our data reveal that RRP9 has a critical function to induce gemcitabine chemoresistance in PC through the IGF2BP1/AKT signaling pathway activation, which might be a candidate to sensitize PC cells to gemcitabine. Graphical Abstract Video abstract

Abstract Background Although clozapine is an effective option for treatment-resistant schizophrenia (TRS), there are still 1/3 to 1/2 of TRS patients who do not respond to clozapine. The main purpose of this randomized, double-blind, placebo-controlled trial was to explore the amisulpride augmentation efficacy on the psychopathological symptoms and cognitive function of clozapine-resistant treatment-refractory schizophrenia (CTRS) patients. Methods A total of 80 patients were recruited and randomly assigned to receive initial clozapine plus amisulpride (amisulpride group) or clozapine plus placebo (placebo group). Positive and Negative Syndrome Scale (PANSS), Scale for the Assessment of Negative Symptoms (SANS), Clinical Global Impression (CGI) scale scores, Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Treatment Emergent Symptom Scale (TESS), laboratory measurements, and electrocardiograms (ECG) were performed at baseline, at week 6, and week 12. Results Compared with the placebo group, amisulpride group had a lower PANSS total score, positive subscore, and general psychopathology subscore at week 6 and week 12 (P Bonferroni

Abstract Falling is a significant cause of injuries and even death in the elderly. The timely detection of the fall action helps to rescue people who may have physical health problems due to the fall, so fall detection is necessary. The traditional fall detection methods are mostly based on wearable devices, which need to be worn all the time, and the cost of the device is high. In recent years, the fall detection method based on computer vision has become a research hot spot. This paper proposes a framework for falling motion detection based on deep learning. To quickly and accurately classify human movements, a method using bone key points as the feature descriptors of human movements is proposed. The OpenPose algorithm is used to extract the human skeleton point information as the primary human body feature, and then use the deep learning method to classify further and recognise our action features. In this paper, four types of daily actions, such as falling and walking, are classified and recognised. The results show that the algorithm achieves an accuracy of 99.4% on our dataset. Simultaneously, 86.1% accuracy is reached in the public dataset fall detection dataset.

Abstract Objective To examine the effects and mechanisms of transcutaneous electrical acupoint stimulation (TEAS) on pregnancy outcomes in women undergoing in vitro fertilization (IVF)-embryo transfer (ET). Design, setting, and participants This efficacy study was a multicenter, randomized, controlled clinical trial (RCT) in women receiving IVF-ET. The mechanistic study was a single-center RCT. Interventions The participants received TEAS vs. no TEAS treatment. Main outcome measures In the efficacy study, the primary outcomes were the rates of clinical pregnancy, embryo implantation, and live birth. In the mechanistic study, sex hormones and endometrial protein expression were examined. Results Ultimately, 739 participants were enrolled (367 and 372 in the TEAS and control groups, respectively). The clinical pregnancy rate was higher in the TEAS group than in the controls (55.1% vs. 46.7%, P = 0.03). There were no significant differences in embryo implantation, biochemical pregnancy, and live birth rates between the two groups (all P > 0.05) in the study population. In women > 35 years, the clinical pregnancy rates, embryo implantation rates and live birth rates in the TEAS and control groups were 48.9% vs. 23.7% (P = 0.004),30.8 vs. 13.9% (P = 0.001) and 34.0% vs. 19.7% (P = 0.06) respectively. In the mechanistic study with 120 participants, on the theoretical embryo implantation day, better developed endometrial pinopodes, elevated endometrial integrin α1β1/αVβ3, leukemia inhibitory factor, and elevated serum progesterone levels were found in the TEAS group compared with controls. Conclusion TEAS significantly improved the clinical pregnancy rate in women undergoing IVF-ET, especially in women of older age. It might be due to improved endometrial receptivity. Trial registration ChiCTR-TRC-13003950.

Abstract Background While interventions have been developed and tested to help youth who have become disconnected from work and school, there is a paucity of research on young people’s intervention preferences. This study aims to understand young people’s preferred intervention outcomes and approaches for youth who are out of work and school. Methods Thirty youth participated in virtual focus groups. Transcripts were analyzed using thematic analysis. Results Youth want interventions and approaches that support them in (1) vocational readiness, (2) securing a job, and (3) mental health and well-being, while providing them with (4) high-contact, individualized, and integrated support. Conclusions Young people want interventions to be individualized and integrated, providing a high level of support for their educational and employment pursuits as well as their mental health and well-being. Incorporating youth's perspectives when designing interventions can increase intervention relevance and potentially service uptake, helping youth continue to pursue their educational and vocational goals.

Age-related muscle atrophy (sarcopenia), characterized by reduced skeletal muscle mass and muscle strength, is becoming increasingly prevalent worldwide, which is especially true for older people, and can seriously damage health and quality of life in older adults. This study aims to investigate the beneficial effects of 5′-cytimidine monophosphate (CMP) on H2O2-induced muscular atrophy in C2C12 myotubes. C2C12 myotubes were treated with H2O2 in the presence and absence of CMP and the changes in the anti-oxidation, mitochondrial functions, and expression of sarcopenia-related proteins were observed. Immunofluorescence analysis showed that CMP significantly increased the diameter of myotubes. We found that CMP could increase the activity of antioxidant enzymes and improve mitochondrial dysfunction, as well as reduce inflammatory cytokine levels associated with sarcopenia. RNA-seq analysis showed that CMP could relieve insulin resistance and promote protein digestion and absorption. Western blot analysis further confirmed that CMP could promote the activation of the IRS-1/Akt/S6K signaling pathway and decrease the expression of MuRF1 and Atrogin-1, which are important markers of muscle atrophy. The above results suggest that CMP protects myotubes from H2O2-induced atrophy and that its potential mechanism is associated with activating the IRS-1/Akt/S6K pathway to promote protein synthesis by improving mitochondrial dysfunction and insulin resistance. These results indicate that CMP can improve aging-related sarcopenia.

Background: The aim of this study was to compare the diagnostic performance of native antigen ELISAs and ADAMU-AE/CE commercial ICT test kits in subjects either exposed to Echinococcus infection or with clinically diagnosed alveolar (AE) or cystic (CE) echinococcosis. Methods: A total of 370 subjects with a previous clinical confirmation of CE or AE from northwestern China were recruited. Serum samples were also obtained from 3923 children/teenagers during a community survey. All sera were tested using native antigen ELISAs. The ADAMU-AE/CE test kits were subsequently used for the serology of the 370 clinically confirmed individuals and of 251 children/teenagers that were ELISA antibody-positive for both Echinococcus species but ultrasound-negative during baseline survey. An analysis of the association between the serological tests and ultrasound classification was carried out amongst 89 AE and 164 CE cases. A Kappa consistency analysis was undertaken to compare the diagnostic performance of the native antigen ELISAs and the ADAMU kits and the ultrasound imaging results. The χ² test was also used for a comparison of the different seropositivity rates between the groups. Findings: There was poor consistency (Kappa = 0.26 and 0.28 for AE and CE respectively) between the native antigen ELISAs and the ADAMU kits for the diagnosis of AE and CE among the cases and the surveyed children/teenagers, but a relatively good consistency (Kappa = 0.63) between the ADAMU-AE kit and ultrasound observations for the AE cases. Additionally, of the 251 teenagers co-positive for both AE and CE antibodies by the native antigen ELISAs, only one was found positive by the ADAMU-AE kit, verified as a new AE case on subsequent ultrasound follow-up. The remainder (N = 250) were negative by serology using the ADAMU-AE/CE kits and by ultrasound examination. The two native antigen ELISAs did not discriminate well between cases of clinically diagnosed AE and CE. In contrast, ADAMU-AE and ADAMU-CE commercial ICT test kits readily differentiated cases of AE from CE with specificities of 99% for AE and 100% for CE. Conclusions: The ADAMU-AE/CE kits proved reliable, accurate, and amenable diagnostic tools in the clinical setting for confirmation of suspected AE/CE cases. The native antigen ELISAs tests can provide useful information on the level of human exposure to Echinococcus infection.