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Abstract Introduction Sepsis is a life-threatening condition that poses a globally high mortality rate. Identifying risk factors is crucial. Insulin resistance and the TYG index, associated with metabolic disorders, may play a role. This study explores their correlation with mortality in non-diabetic septic patients. Methods This retrospective cohort study used data from the MIMIC-IV (version 2.1) database, which includes over 50,000 ICU admissions from 2008 to 2019 at Beth Israel Deaconess Medical Center in Boston. We included adult patients with sepsis who were admitted to the intensive care unit in the study. The primary outcome was to evaluate the ability of TYG to predict death at 28-day of hospital admission in patients with sepsis. Results The study included 2213 patients with sepsis, among whom 549 (24.8%) died within 28 days of hospital admission. We observed a non-linear association between TYG and the risk of mortality. Compared to the reference group (lower TYG subgroup), the 28-day mortality increased in the higher TYG subgroup, with a fully adjusted hazard ratio of 2.68 (95% CI: 2.14 to 3.36). The area under the curve (AUC) for TYG was 67.7%, higher than for triglycerides alone (AUC = 64.1%), blood glucose (AUC = 62.4%), and GCS (AUC = 63.6%), and comparable to SOFA (AUC = 69.3%). The final subgroup analysis showed no significant interaction between TYG and each subgroup except for the COPD subgroup (interaction P-values: 0.076–0.548). Conclusion In our study, TYG can be used as an independent predictor for all-cause mortality due to sepsis within 28 days of hospitalization.

Abstract For the polarization multiplexing requirements in all-optical networks, this work presents a compact all-fiber polarization beam splitter (PBS) based on dual-core photonic crystal fiber (PCF) and an elliptical gold layer. Numerical analysis using the finite element method (FEM) demonstrates that the mode modulation effect of the central gold layer effectively reduces the dimensions of the proposed PBS. By determining reasonable structural parameters of the proposed PCF, the coupling length ratio (CLR) between X- and Y-polarized super-modes can approach 2, achieving a minimal device length of 0.122 mm. The PBS exhibits a maximum extinction ratio (ER) of − 65 dB at 1.55 μm, with an operating bandwidth spanning 100 nm (1.5–1.6 μm) and a stable insertion loss (IL) of ~ 1.5 dB at 1.55 μm. Furthermore, the manufacture feasibility and performance verification scheme are also investigated. It is widely anticipated that the designed PBS will play a crucial role in the ongoing development process of miniaturization and integration of photonic devices.

In an era marked by rapid digitalization and the convergence of media platforms, gender equality, particularly within journalism, has gained prominence. However, gender discrimination remains a challenge for female journalists. This research collected 387 valid responses from Spanish media professionals through digital and other channels. Data analysis, including statistical methods like frequency analysis and chi-square tests, aims to uncover factors affecting the careers of Spanish female journalists. The goal is to provide empirically supported recommendations for gender equality in the dynamic Spanish media landscape.

Abstract The amount of actively cultivated land in China is increasingly threatened by rapid urbanization and rural population aging. Quantifying the extent and changes of active cropland and cropping intensity is crucial to global food security. However, national-scale datasets for smallholder agriculture are limited in spatiotemporal continuity, resolution, and precision. In this paper, we present updated annual Cropland Use Intensity maps in China (China-CUI10m) with descriptions of the extent of fallow/abandoned, actively cropped fields and cropping intensity at a 10-m resolution in recent six years (2018–2023). The dataset is produced by robust algorithms with no requirements for regional adjustments or intensive training samples, which take full advantage of the Sentinel-1 (S1) SAR and Sentinel-2 (S2) MSI time series. The China-CUI10m maps have achieved high accuracy when compared to ground truth data (Overall accuracy = 90.88%) and statistical data (R2 > 0.94). This paper provides the recent trends in cropland abandonment and agricultural intensification in China, which contributes to facilitating geographic-targeted cropland use control policies towards sustainable intensification of smallholder agricultural systems in developing countries.

Abstract Background Peritoneal dialysis (PD) and conventional in‐center hemodialysis (HD) are treatment options for patients with end‐stage kidney disease (ESKD). However, their impact on all‐cause mortality is unclear. Methods We conducted a multicenter, open‐label, randomized, non‐inferiority trial to determine the effect of dialysis modality on mortality in patients with ESKD. Eligible patients were recruited from 30 sites across China and assigned to receive either PD or HD in a ratio of 1:1. The primary outcome was all‐cause mortality. Non‐inferiority was defined as the upper bound of the one‐sided 95% confidence interval (CI) for the hazard ratio (HR) being ≤1.25. Results A total of 414 patients with incident ESKD were randomly assigned to PD (n = 213) or HD (n = 201). During a median follow‐up of 1.7 years, 37 patients in the PD group and 31 in the HD group died, giving respective event rates per patient‐year of 0.061 and 0.071. The HR for mortality on PD in comparison with HD was 0.76 (95% CI 0.47–1.24) after adjustment for age, sex, and diabetes status, achieving the limit for non‐inferiority. There were more adverse events (p = 0.003), serious adverse events (p = 0.009), and adverse events leading to hospitalization (p = 0.003) in the PD group than in the HD group; however, there was no significant between‐group difference in adverse events leading to death or discontinuation of treatment. Conclusions PD was non‐inferior to conventional in‐center HD in terms of survival in patients with ESKD. Our findings underscore the need for shared decision‐making between physicians and patients regarding the selection of dialysis modality. Trial registration Registered at ClinicalTrials.gov (NCT01413074).

Steel containers used for geological disposal of high-level radioactive waste will be gradually thinned or even perforated due to corrosion, which will lead to radiolysis of nuclides when they contact with infiltrated groundwater and produce H2O2. This work focused on investigating the influence of H2O2 concentration (0%, 0.001%, 0.01%, 0.1% and 1% by volume) on the corrosion behavior of NiCu low alloy steel as the candidate material for containers was comparatively studied by combining corrosion weight loss test, corrosion product analysis, morphology characterization, thermodynamic analysis and electrochemical measurements. As [H2O2] = 0.001%, H2O2 inhibited the formation of γ-FeOOH and enhanced the compactness of rust layer, which effectively blocked the migration of aggressive ions and slowed down the cathodic reduction reaction of rust, thus improving the corrosion resistance of NiCu steel. With the increase of [H2O2] (0.01%→1%), the cathodic process of NiCu steel corrosion was promoted by the increase of dissolved oxygen involved in cathodic depolarization. Meanwhile, the relative content of Fe3O4 in the rust increased, while Fe6(OH)12SO4 and Fe6(OH)12CO3 decreased obviously, which led to the loose and porous rust layer, thus accelerating the corrosion of NiCu steel.

Abstract Cardiovascular function and adipose metabolism were markedly influenced under high altitudes. However, the interplay between adipokines and heart under hypoxia remains to be elucidated. We aim to explore alterations of adipokines and underlying mechanisms in regulating cardiac function under high altitudes. We investigated the cardiopulmonary function and five adipokines in Antarctic expeditioners at Kunlun Station (4,087 m) for 20 days and established rats exposed to hypobaric hypoxia (5,000 m), simulating Kunlun Station. Antarctic expeditioners exhibited elevated heart rate, blood pressure, systemic vascular resistance, and decreased cardiac pumping function. Plasma creatine phosphokinase-MB (CK-MB) and platelet-endothelial cell adhesion molecule-1 (sPecam-1) increased, and leptin, resistin, and lipocalin-2 decreased. Plasma leptin significantly correlated with altered cardiac function indicators. Additionally, hypoxic rats manifested impaired left ventricular systolic and diastolic function, elevated plasma CK-MB and sPecam-1, and decreased plasma leptin. Chronic hypoxia for 14 days led to increased myocyte hypertrophy, fibrosis, apoptosis, and mitochondrial dysfunction, coupled with reduced protein levels of leptin signaling pathways in myocardial tissues. Cardiac transcriptome analysis revealed leptin was associated with downregulated genes involved in rhythm, Na+/K+ transport, and cell skeleton. In conclusion, chronic hypoxia significantly reduced leptin signaling pathways in cardiac tissues along with significant pathological changes, thus highlighting the pivotal role of leptin in regulation of cardiac function under high altitudes.

Water hammer protection is one of the key factors for the safe operation of the long-distance water delivery systems, which has lots of useful results. However, the protection experiences for bidirectional water delivery systems using the same pipeline are lacking. In this study, the protection method with one-way surge tanks in the bidirectional water delivery system is investigated. The theoretical formula for one-way surge tank setting is derived based on the theory of water hammer propagation, and the pump head and bidirectional water hammer protection constraints. Subsequently, the pump trip transient processes in an actual system are simulated. Finally, different kinds of one-way surge tank protection schemes are compared. The results show that the pressure along the pipeline after the pump trip can meet the standard when using the one-way surge tank protection scheme calculated by the theoretical formula. The proposed method can provide the effective protection strategy for the bidirectional water delivery systems. HIGHLIGHTS Negative pressure protection for the bidirectional water delivery systems in the same pipeline is studied.; The theoretical formula for one-way surge tank setting in bidirectional water delivery system is presented.; The proposed one-way surge tank setting strategy can provide effective water hammer protection for the system.;

Abstract Apple moldy core is a fungus-infested disease that is extremely insidious, usually occurring inside the fruit, making it very difficult to distinguish from the exterior with the naked eye. Using VIS/NIR transmission spectroscopy, this study successfully detected moldy core apples. By combining four wavelength selection algorithms (CARS, CARS-SPA, MC-UVE, and MC-UVE-SPA) with four classifiers (SVM, ELM, KNN, and LDA-KNN), discrimination models were established for two-class and three-class classifications. MC-UVE-SPA-LDA-KNN achieved an AUC of 0.99 and an accuracy of 98.82% for two-class classification, while MC-UVE-SPA achieved an AUC of 0.99 and an accuracy of 97.64% for three-class classification. This confirms MC-UVE-SPA as an effective tool for selecting wavelengths specific to moldy core apples, facilitating precise identification and differentiation of apple states. This study advances dynamic online detection of early-stage moldy core conditions in apples, reducing post-harvest disease occurrence and preserving fruit quality effectively. Graphical Abstract

Abstract Background Numerous previous reports have demonstrated the efficacy of Lactic acid bacteria (LAB) in promoting growth and preventing disease in animals. In this study, Enterococcus faecium ZJUIDS-R1 and Ligilactobaciiius animalis ZJUIDS-R2 were isolated from the feces of healthy rabbits, and both strains showed good probiotic properties in vitro. Two strains (108CFU/ml/kg/day) were fed to weaned rabbits for 21 days, after which specific bacterial infection was induced to investigate the effects of the strains on bacterial diarrhea in the rabbits. Results Our data showed that Enterococcus faecium ZJUIDS-R1 and Ligilactobaciiius animalis ZJUIDS-R2 interventions reduced the incidence of diarrhea and systemic inflammatory response, alleviated intestinal damage and increased antibody levels in animals. In addition, Enterococcus faecium ZJUIDS-R1 restored the flora abundance of Ruminococcaceae1. Ligilactobaciiius animalis ZJUIDS-R2 up-regulated the flora abundance of Adlercreutzia and Candidatus Saccharimonas. Both down-regulated the flora abundance of Shuttleworthia and Barnesiella to restore intestinal flora balance, thereby increasing intestinal short-chain fatty acid content. Conclusions These findings suggest that Enterococcus faecium ZJUIDS-R1 and Ligilactobaciiius animalis ZJUIDS-R2 were able to improve intestinal immunity, produce organic acids and regulate the balance of intestinal flora to enhance disease resistance and alleviate diarrhea-related diseases in weanling rabbits.

Abstract Previous studies have shown a bidirectional communication between human gut microbiota and the brain, known as the microbiota–gut–brain axis (MGBA). The MGBA influences the host's nervous system development, emotional regulation, and cognitive function through neurotransmitters, immune modulation, and metabolic pathways. Factors like diet, lifestyle, genetics, and environment shape the gut microbiota composition together. Most research have explored how gut microbiota regulates host physiology and its potential in preventing and treating neurological disorders. However, the individual heterogeneity of gut microbiota, strains playing a dominant role in neurological diseases, and the interactions of these microbial metabolites with the central/peripheral nervous systems still need exploration. This review summarizes the potential role of gut microbiota in driving neurodevelopmental disorders (autism spectrum disorder and attention deficit/hyperactivity disorder), neurodegenerative diseases (Alzheimer's and Parkinson's disease), and mood disorders (anxiety and depression) in recent years and discusses the current clinical and preclinical gut microbe‐based interventions, including dietary intervention, probiotics, prebiotics, and fecal microbiota transplantation. It also puts forward the current insufficient research on gut microbiota in neurological disorders and provides a framework for further research on neurological disorders.

Introduction: Previous studies have shown that rituximab (RTX) and cyclic oral corticosteroid-cyclophosphamide (CTX) regimens have similar effects on Primary Membranous Nephropathy. However, no studies have compared RTX with an intravenous CTX regimen, which is more commonly used in China and requires fewer cumulative CTX doses. Methods: We prospectively assigned 141 PMN patients with baseline proteinuria ≥ 4 g/24 h, serum albumin < 30 g/L, and eGFR ≥ 30 mL/min × 1.73 m2 despite at least 3 months of treatment with ACEI and/or ARB to the RTX group (375 mg/m2 per injection per week × 4 injections) or to the CTX group (prednisone 0.8 mg/kg/d and intravenous CTX 500 mg/m2 per month until the total dose reached 6–8 g). The primary endpoint was defined as a combination of partial remission or complete remission at 12 months. Results: By the end of 12 months, 43 of 70 patients (61.43%) in the RTX group and 54 of 71 patients (76.06%) in the CTX group reached the primary endpoint(P=0.06). Significantly fewer patients in the RTX group achieved complete remission than the CTX group (14.29% vs. 33.80%, P=0.01). The adverse events rate was similar between the RTX group and the CTX group (28.57% vs. 40.85%, P=0.13). In subgroup analysis, we found that fewer patients from the RTX group achieved the primary endpoint than the CTX group (48.65% vs. 74.29%, P=0.03) among patients with massive proteinuria (urine protein ≥ 8 g/24 h). During the observational phase, 61 patients in the RTX group and 58 in the CTX group completed 24 months of follow-up, exhibiting similar remission rates (RTX vs. CTX: 75.41% vs. 68.97%, P=0.54). Conclusions: Our results show that the intravenous CTX regimen has similar safety and efficacy with higher rates of early complete remission than RTX in the treatment of PMN patients.

ABSTRACT Hypermucoviscosity (HMV) is a phenotype that is commonly associated with hypervirulence in Klebsiella pneumoniae. The factors that contribute to the emergence of HMV subpopulations remain unclear. In this study, eight K. pneumoniae strains were recovered from an inpatient who had been hospitalized for 20 days. Three of the isolates exhibited a non-HMV phenotype, which was concomitant with higher biofilm formation than the other five HMV isolates. All eight isolates were highly susceptible to serum killing, albeit HMV strains were remarkably more infective than non-HMV counterparts in a mouse model of infection. Whole genome sequencing (WGS) showed that the eight isolates belonged to the K57-ST412 lineage. Average nucleotide identity (FastANIb) analysis indicated that eight isolates share 99.96% to 99.99% similarity and were confirmed to be the same clone. Through comparative genomics analysis, 12 non-synonymous mutations were found among these isolates, eight of which in the non-HMV variants, including rmpA (c.285delG) and wbaP (c.1305T > A), which are assumed to be associated with the non-HMV phenotype. Mutations in manB (c.1318G > A), dmsB (c.577C > T) and tkt (c.1928C > A) occurred in HMV isolates only. RNA-Seq revealed transcripts of genes involved in energy metabolism, carbohydrate metabolism and membrane transport, including cysP, cydA, narK, tktA, pduQ, aceB, metN, and lsrA, to be significantly dysregulated in the non-HMV strains, suggesting a contribution to HMV phenotype development. This study suggests that co-occurrence of HMV and non-HMV phenotypes in the same clonal population may be mediated by mutational mechanisms as well as by certain genes involved in membrane transport and central metabolism.IMPORTANCEK. pneumoniae with a hypermucoviscosity (HMV) phenotype is a community-acquired pathogen that is associated with increased invasiveness and pathogenicity, and underlying diseases are the most common comorbid risk factors inducing metastatic complications. HMV was earlier attributed to the overproduction of capsular polysaccharide, and more data point to the possibility of several causes contributing to this bacterial phenotype. Here, we describe a unique event in which the same clonal population showed both HMV and non-HMV characteristics. Studies have demonstrated that this process is influenced by mutational processes and genes related to transport and central metabolism. These findings provide fresh insight into the mechanisms behind co-occurrence of HMV and non-HMV phenotypes in monoclonal populations as well as potentially being critical in developing strategies to control the further spread of HMV K. pneumoniae.

Summary: Pyrrolidine (PyD) has an important impact on the environment and human health. However, there is currently no method for trace detection of PyD. Here, we successfully designed diaminomethylene-4H-pyran (1) as the first specific fluorescent probe for PyD. Only by adding PyD to probe 1, there is blue fluorescence at 455 nm, and the color of the solution changes from colorless to yellow. The detection limit is 1.12 × 10−6 M, and the response time is less than 5 min. Meanwhile, probe 1 can also sense the gaseous PyD and detect PyD in actual water samples. Moreover, due to the low biological toxicity, probe 1 can detect the exogenous PyD in zebrafish. The preliminary mechanism shows that probe 1 and PyD undergo a combination-type chemical reaction to generate a new substance 1-PyD. Therefore, the 100% atom utilization reaction enables probe 1 to exhibit specific adsorption and removal of PyD.

ABSTRACT The rapid and effective identification of pathogens in patients with pulmonary infections has posed a persistent challenge in medicine, with conventional microbiological tests (CMTs) proving time-consuming and less sensitive, hindering early diagnosis of respiratory infections. While there has been some research on the clinical performance of targeted sequencing technologies, limited focus has been directed toward bronchoalveolar lavage fluid (BALF). This study primarily evaluates the pathogen detection capabilities of nanopore-targeted sequencing (NTS) in BALF, providing a comprehensive analysis. The retrospective study, spanning from January 2022 to November 2023, includes 223 patients exclusively sourced from a single center. We conducted a detailed comparative analysis among NTS, targeted next-generation sequencing (tNGS), and CMTs. Initially, we compared the detection capabilities of NTS and tNGS and found no significant differences in their sensitivity and specificity. Specifically, we observed that the sensitivity of NTS was significantly higher than that of CMTs (74.83% vs 33.11%, P < 0.001). Furthermore, NTS exhibited a higher positivity rate in common pulmonary infections (62.88% vs. 23.48%) and in clinically suspected tuberculosis patients compared to CMTs (87.18% vs. 48.72%). Additionally, NTS showed less susceptibility to antibiotic interference, indicating a more sensitive detection capability, especially in detecting fastidious organisms. It complements GeneXpert in tuberculosis diagnosis and offers excellent advantages in identifying pathogens challenging for CMTs, such as non-tuberculous mycobacteria and viruses. Moreover, NTS significantly shortens the reporting time and is only a quarter of the cost of metagenomic next-generation sequencing. Clearly, NTS can facilitate faster and more cost-effective early diagnosis of respiratory infections.IMPORTANCEThis study holds paramount significance in advancing the field of respiratory infection diagnostics. By assessing the pathogen detection capabilities in bronchoalveolar lavage fluid (BALF) of patients with pulmonary infections, we illuminate the promising potential of nanopore-targeted sequencing (NTS). The findings underscore NTS as a comparable yet distinct alternative to traditional methods like comprehensive conventional microbiological tests (CMTs). Notably, NTS demonstrates a pivotal edge, expanding the spectrum of identified pathogens, particularly excelling in the detection of challenging entities like non-tuberculous mycobacteria and viruses. The study also highlights the complementary role of NTS alongside GeneXpert in the identification of tuberculosis, providing a comprehensive overview of the diagnostic landscape for respiratory infections. This insight carries significant implications for clinicians seeking rapid, cost-effective, and accurate diagnostic tools in the realm of pulmonary infections.

Abstract Background New “noncardiac” problems in children with congenital heart disease (CHD), such as developmental delay or long-term neurodevelopmental impairments, have attracted considerable attention in recent years. It is hypothesized that exercise might attenuate CHD-associated neurodevelopmental impairments; however, this has not been thoroughly investigated. The objective of this prospective, single-blinded, randomized controlled experiment was to evaluate the impact of customized home-based exercise for children with CHD. Methods Children aged 0–5 years with echocardiography-confirmed simple CHD subtypes who were scheduled to undergo cardiac catheterization were screened for enrolment. Among 420 screened CHD children, 192 were enrolled and randomly assigned at a 1:1 ratio to receive a 6-month intervention (30 min daily customized home-based exercise program with supervision for no less than 5 days per week, combined with home-based exercise education) or control treatment (home-based education). The primary outcome was motor development (gross motor quotient (GMQ), fine motor quotient (FMQ), and total motor quotient (TMQ)). The secondary outcomes were cardiac function and structure, bone quality, physical development, parental anxiety, caregiver burden, and quality of life. Children and their families were assessed before and 1, 3, and 6 months after catheterization; 183 (95.3%) children were included in the primary analysis. Results After 6-month treatment, the intervention group significantly increased their motor quotient, which was consistently higher than that of the control group (GMQ p 0.017). For parents, higher quality of life level (total score p = 0.016) was observed in the intervention group; while effects of exercise on the anxiety (rude score p = 0.159, standard score p = 0.159) or the Zarit caregiver burden scale score (p = 0.404) were non-significant. No adverse events occurred during the study period. Conclusions Customized home-based exercise improved motor development in children with CHD. While the long-term effects of parent training in home-based exercise are unknown, the study results suggest positive outcomes. Trial registration A home-based exercise program in congenital heart disease children with cardiac catheterization: a randomized controlled trial. ( http://www.chictr.org.cn/ , ChiCTR-IOR-16007762, January 14, 2016).

Abstract Gasdermin D (GSDMD) functions as a pivotal executor of pyroptosis, eliciting cytokine secretion following cleavage by inflammatory caspases. However, the role of posttranslational modifications (PTMs) in GSDMD-mediated pyroptosis remains largely unexplored. In this study, we demonstrate that GSDMD can undergo acetylation at the Lysine 248 residue, and this acetylation enhances pyroptosis. We identify histone deacetylase 4 (HDAC4) as the specific deacetylase responsible for mediating GSDMD deacetylation, leading to the inhibition of pyroptosis both in vitro and in vivo. Deacetylation of GSDMD impairs its ubiquitination, resulting in the inhibition of pyroptosis. Intriguingly, phosphorylation of HDAC4 emerges as a critical regulatory mechanism promoting its ability to deacetylate GSDMD and suppress GSDMD-mediated pyroptosis. Additionally, we implicate Protein phosphatase 1 (PP1) catalytic subunits (PP1α and PP1γ) in the dephosphorylation of HDAC4, thereby nullifying its deacetylase activity on GSDMD. This study reveals a complex regulatory network involving HDAC4, PP1, and GSDMD. These findings provide valuable insights into the interplay among acetylation, ubiquitination, and phosphorylation in the regulation of pyroptosis, offering potential targets for further investigation in the field of inflammatory cell death.

Carotenoids are a class of fat-soluble compounds widely associated with human health, because of their antioxidant, vision-protective and other effects. Deep eutectic solvents (DESs) are a new generation of green solvents. DESs are convenient to produce and have higher biocompatibility, biodegradability, solvent efficiency, thermal stability, and lower volatility compared to traditional organic solvents. Although DES has exhibited effective extraction on natural substances in food, its application on the extraction of carotenoids have not yet been widely studied. In this paper, the characteristics and classification of DES are described, the application of DES on extraction of carotenoids is reviewed, the existing problems for the separation of carotenoids from DES are proposed, and the application perspective of DES in the extraction and separation of carotenoids is outlined, aiming to provide a reference for the development and application of new green solvents for carotenoid extraction.

Abstract Aqueous zinc-ion batteries (AZIBs) are promising for future large-scale energy storage systems, however, suffer from inferior cycling life due to the dendrites growth and side reaction on Zn metal anode. Herein, a fast ion conductor Na5YSi4O12 (NYSO) was synthesized and fabricated as a protection layer of the Zn metal anode. By adjusting the thickness, an optimized NYSO coating of 20.3 µm was obtained and the corresponding symmetry cell demonstrates an extended life span of 1896 h at the current density of 0.5 mA cm−2. In addition, a favorable rate performance of the NYSO@Zn anode at a high current density of 10 mA cm−2 was achieved. Benefiting from the NYSO coating, uniform diffusion and deposition of Zn2+ on the Zn anode could be realized, leading to the elimination of Zn dendrites and side reactions. Therefore, the aqueous NYSO@Zn|CNT@MnO2 full cell shows superior capacity and cycling stability to that of the bare Zn full cell.

Highlights An efficient moist-electric generator with ultra-fast electric response to moisture is achieved by triggering Grotthuss protons hopping in the moisture-electric–moisture-sensitive heterostructure. The moist-electric generator produces a quick response (0.435 s), an unprecedented ultra-fast response rate of 972.4 mV s−1 to alternating moisture stimulation and stable output for 8 h. An obstructive sleep apnea hypoventilation syndrome diagnostic system based on a moist-electric generator was developed to monitor hypopnea and apnea in real time and successfully diagnose them with early warning.

Abstract Introduction Sarcopenic obesity (SO) is characterised by decreased muscle mass, diminished muscle strength and/or reduced physical performance and a high percentage of body fat (PBF). Conventional-load resistance exercise (CRE) may be difficult for older people with SO owing to their declining physical functions. Low-load resistance exercise (LRE) combined with blood flow restriction (BFR; LRE-BFR) is a viable alternative to CRE for improving muscle mass and strength and potential exercise mode for managing SO. This study has two objectives: (1) to comprehensively evaluate the efficacy of CRE and LRE-BFR in improving body composition, muscle strength, physical performance, haematological parameters, cardiovascular disease (CVD) risk factors and quality of life and (2) to compare the efficacy of CRE and LRE-BFR and explore their potential mechanisms. Methods and analysis This work is a 12-week assessor-blinded randomised clinical trial that will be conducted thrice a week. Sarcopenia will be defined using the Asian Working Group for Sarcopenia 2019, and obesity will be determined using the criteria developed by the World Health Organization. Community-dwelling older people aged ≥ 65 years will be screened as the participants using inclusion and exclusion criteria. A total of 33 participants will be randomised into a CRE group (n = 11), an LRE-BFR group (n = 11) and a control group that will be given only health education (n = 11). The primary outcomes will be knee extensor strength and PBF, and the secondary outcomes will be body composition, anthropometric measurements, muscle strength of upper limbs, physical performance, haematological parameters, CVD risk factors and quality of life. The outcomes will be measured at the baseline (week 0), end of the intervention (week 12) and follow up (week 24). All the collected data will be analysed following the intention-to-treat principle. Ethics and dissemination The Ethics Research Committee has approved this study (approval No. CMEC-2022-KT-51). Changes or developments in this study will be reported at www.chictr.org.cn . Trial registration ChiCTR2300067296 (3 January 2023).

The novel gelling polysaccharides (NPGP) were extracted and characterized from Nicandra physalodes (Linn.) Gaertn. seeds, while properties and potential application of NPGP gels with tea polyphenols were further explored. NPGP was composed of GalA, Glc, Rha, Gal, Xyl, Ara, and Man at a molar ratio of 71.87:17.13:3.10:2.55:2.19:1.64:1.52, with molecular weight of 6.32 × 104 Da and low methoxylation degree of 45.21%. The gelling properties of NPGP gel induced by tea polyphenols showed that tea polyphenols significantly improved the structural and rheological properties of NPGP gel, due to the formation of dense network by hydrogen bonds and the increase of crystalline degree of NPGP. NPGP gels with tea polyphenols could significantly ameliorated the texture, water-holding capacity, aggregation, leading force, and moisture distribution of surimi during freeze-thaw cycles. All results suggest that NPGP gels with tea polyphenols has fine properties and show potential to be applied as natural additives in food industry.

The COVID-19 pandemic has significantly impacted the tourism sector, particularly tour guides (TGs), affecting their professional identity (TGPI) and intentions to return to work. As China strives to revive its tourism industry, it is crucial to understand the current state of TGPI, its evolution, influencing factors, and its impact on TGs' return intentions. This study employed a quantitative approach, using comparative analysis and binary logistic regression, to investigate these issues among frontline TGs in China, pre- and post-pandemic. Cross-sectional surveys were conducted with 422 participants in 2019 and 398 in 2022, yielding 370 and 342 valid responses, respectively. The questionnaire utilized a five-point Likert scale. Findings reveal that (1) The overall TGPI level in 2022 post-pandemic is medium (3.93), showing a significant decrease from the pre-pandemic level in 2019 (4.15). (2) Influencing factors of TGPI are predominantly material, reflected in social insurance and income changes pre- and post-pandemic. (3) This study presents a novel definition and scale of TGPI, encompassing tour guides' professional value identity (TGPVI), emotion identity (TGPEI), relationship identity (TGPRI), and behavior tendency (TGPBT). (4) The two dimensions of the TGPI, TGPVI and TGPRI, income and education level, significantly influence TGs' return intentions. The study provides valuable academic and practical insights into TGPI and offers significant implications for enhancing TGs' return intentions and policymaking for post-pandemic tourism industry development.

Background: Immunotherapy has changed the treatment landscape for lung cancer. This study aims to construct a tumor mutation-related model that combines long non-coding RNA (lncRNA) expression levels and tumor mutation levels in tumor genomes to detect the possibilities of the lncRNA signature as an indicator for predicting the prognosis and response to immunotherapy in lung adenocarcinoma (LUAD). Methods: We downloaded the tumor mutation profiles and RNA-seq expression database of LUAD from The Cancer Genome Atlas (TCGA). Differentially expressed lncRNAs were extracted based on the cumulative number of mutations. Cox regression analyses were used to identify the prognostic lncRNA signature, and the prognostic value of the five selected lncRNAs was validated by using survival analysis and the receiver operating characteristic (ROC) curve. We used qPCR to validate the expression of five selected lncRNAs between human lung epithelial and human lung adenocarcinoma cell lines. The ImmuCellAI, immunophenoscore (IPS) scores and Tumor Immune Dysfunction and Exclusion (TIDE) analyses were used to predict the response to immunotherapy for this mutation related lncRNA signature. Results: A total of 162 lncRNAs were detected among the differentially expressed lncRNAs between the Tumor mutational burden (TMB)-high group and the TMB-low group. Then, five lncRNAs (PLAC4, LINC01116, LINC02163, MIR223HG, FAM83A-AS1) were identified as tumor mutation-related candidates for constructing the prognostic prediction model. Kaplan‒Meier curves showed that the overall survival of the low-risk group was significantly better than that of the high-risk group, and the results of the GSE50081 set were consistent. The expression levels of PD1, PD-L1 and CTLA4 in the low-risk group were higher than those in the high-risk group. The IPS scores and TIDE scores of patients in the low-risk group were significantly higher than those in the high-risk group. Conclusion: Our findings demonstrated that the five lncRNAs (PLAC4, LINC01116, LINC02163, MIR223HG, FAM83A-AS1) were identified as candidates for constructing the tumor mutation-related model which may serve as an indicator of tumor mutation levels and have important implications for predicting the response to immunotherapy in LUAD.

Background: Whether chemiluminescence immunoassay (CLIA) and liquid chromatography-tandem mass spectrometry (LC-MS/MS) for plasma aldosterone concentration (PAC) measurement can be used interchangeably in primary aldosteronism (PA) screening is still controversial. The purpose of this study was to compare CLIA to LC-MS/MS for PAC measurement in PA screening. Methods: All participants underwent aldosterone-to-renin ratio (ARR) testing. PA was diagnosed by captopril challenge test or saline infusion test. PAC in screening test was measured with CLIA and LC-MS/MS. Plasma direct renin concentration in screening and confirmatory test was measured with CLIA. The concordance between CLIA and LC-MS/MS for PAC measurement in PA screening was analyzed. Results: Twenty-one healthy volunteers, 61 patients with essential hypertension (EH) and 43 PA patients were enrolled. Median PAC by CLIA was 84.7 % higher than that by LC-MS/MS in screening test (P

Abstract Background Previous studies have demonstrated an association between diabetes mellitus (DM) and latent tuberculosis infection (LTBI). This study was conducted to update the current understanding of the association between DM and LTBI. By conducting a systematic review and meta-analysis using adjusted odds ratios (aOR) or risk ratios (aRR), we aimed to further explore the association between DM and LTBI and provide essential reference for future research. Methods We conducted comprehensive searches in Embase, Cochrane Library, and PubMed without imposing any start date or language restrictions, up to July 19, 2022. Our study selection encompassed observational research that compared from LTBI positive rates in both DM and non-DM groups and reported aRR or aOR results. The quality of the included studies was assessed utilizing the Newcastle–Ottawa Scale. Pooled effect estimates were calculated using random-effects models, along with their associated 95% confidence intervals (CI). Results We included 22 studies involving 68,256 subjects. Three cohort studies were eligible, with a pooled aRR of 1.26 (95% CI: 0.71–2.23). Nineteen cross-sectional studies were eligible, with a pooled aOR of 1.21 (95% CI: 1.14–1.29). The crude RR (cRR) pooled estimate for three cohort studies was 1.62 (95% CI: 1.03–2.57). Among the cross-sectional studies we included, sixteen studies provided crude ORs, and the crude OR (cOR) pooled estimate was 1.64 (95% CI: 1.36–1.97). In the diagnosis of diabetes, the pooled aOR of the HbA1c group was higher than that of self-reported group (pooled aOR: 1.56, 95% CI: 1.24–1.96 vs. 1.17, 95% CI: 1.06–1.28). Conclusion Our systematic review and meta-analysis suggest a positive association between DM and LTBI. Individuals with DM may have a higher risk of LTBI compared to those without DM. These findings provide important insights for future research and public health interventions in managing LTBI in diabetic populations.

Abstract Background Early detection of hepatocellular carcinoma (HCC) is important in order to improve patient prognosis and survival rate. Methylation sequencing combined with neural networks to identify cell-free DNA (cfDNA) carrying aberrant methylation offers an appealing and non-invasive approach for HCC detection. However, some limitations exist in traditional methylation detection technologies and models, which may impede their performance in the read-level detection of HCC. Methods We developed a low DNA damage and high-fidelity methylation detection method called No End-repair Enzymatic Methyl-seq (NEEM-seq). We further developed a read-level neural detection model called DeepTrace that can better identify HCC-derived sequencing reads through a pre-trained and fine-tuned neural network. After pre-training on 11 million reads from NEEM-seq, DeepTrace was fine-tuned using 1.2 million HCC-derived reads from tumor tissue DNA after noise reduction, and 2.7 million non-tumor reads from non-tumor cfDNA. We validated the model using data from 130 individuals with cfDNA whole-genome NEEM-seq at around 1.6X depth. Results NEEM-seq overcomes the drawbacks of traditional enzymatic methylation sequencing methods by avoiding the introduction of unmethylation errors in cfDNA. DeepTrace outperformed other models in identifying HCC-derived reads and detecting HCC individuals. Based on the whole-genome NEEM-seq data of cfDNA, our model showed high accuracy of 96.2%, sensitivity of 93.6%, and specificity of 98.5% in the validation cohort consisting of 62 HCC patients, 48 liver disease patients, and 20 healthy individuals. In the early stage of HCC (BCLC 0/A and TNM I), the sensitivity of DeepTrace was 89.6 and 89.5% respectively, outperforming Alpha Fetoprotein (AFP) which showed much lower sensitivity in both BCLC 0/A (50.5%) and TNM I (44.7%). Conclusions By combining high-fidelity methylation data from NEEM-seq with the DeepTrace model, our method has great potential for HCC early detection with high sensitivity and specificity, making it potentially suitable for clinical applications. DeepTrace: https://github.com/Bamrock/DeepTrace

The protection of negative pressures generated by the hydraulic transient process in the water supply system is crucial to safe and stable operation. In this study, a mathematical model of a pipeline hydraulic transient system with multi-undulating terrain was established based on the method of characteristics (MOC). The generation and development of water hammer negative pressures were analyzed, and double one-way surge tank protection schemes were proposed. It proved that the first surge tank should be located at the initial negative pressure point, and the second surge tank should be located at the second-highest point rather than the highest point. Additionally, compared with the theoretical minimum height, there was an optimization margin for the total surge tank height, which was reduced by 21% in this study. Meanwhile, the applicability of protection schemes and the influence of the one-way surge tank number on the total height were analyzed. The total height reduced with the increase of one-way surge tank number and tended to a minimum value. By comprehensively considering the engineering investment and negative pressure protection effect, the optimal surge tank number could be determined. This research represents an advance in negative pressure protection in multi-undulating terrain and provides support for further engineering studies. HIGHLIGHTS Double one-way surge tank schemes can fully protect negative pressures in water supply systems with multi-undulating terrain. The optimal locations are revealed.; Compared with the theoretical minimum surge tank height, the total surge tank height can be further reduced.; The total height reduces with the increase of surge tank number and tends to a minimum value.;

Abstract Background The vast majority of patients with ROS1 positive non‐small cell lung cancer (NSCLC) derive clinical benefit from currently approved ROS1 therapies, including crizotinib and entrectinib. However, a small proportion of patients treated with ROS1 inhibitors fail to derive any clinical benefit and demonstrate rapid disease progression. The biological mechanisms underpinning intrinsic resistance remain poorly understood for oncogene‐driven cancers. Methods We generated a patient‐derived cell line, CUTO33, from a ROS1 therapy naive patient with CD74‐ROS1+ NSCLC, who ultimately did not respond to a ROS1 inhibitor. We evaluated a panel of ROS1+ patient‐derived NSCLC cell lines and used cell‐based assays to determine the mechanism of intrinsic resistance to ROS1 therapy. Results The CUTO33 cell line expressed the CD74‐ROS1 gene fusion at the RNA and protein level. The ROS1 fusion protein was phosphorylated at baseline consistent with the known intrinsic activity of this oncogene. ROS1 phosphorylation could be inhibited using a wide array of ROS1 inhibitors, however these inhibitors did not block cell proliferation, confirming intrinsic resistance in this model and consistent with the patient's lack of response to a ROS1 inhibitor. CUTO33 expressed high levels of AXL, which has been associated with drug resistance. Combination of an AXL inhibitor or AXL knockdown with a ROS1 inhibitor partially reversed resistance. Conclusions In summary, we demonstrate that AXL overexpression is a mechanism of intrinsic resistance to ROS1 inhibitors.

This paper proposes a solution for the challenges faced in predicting the output of distributed solar power stations due to difficulties in obtaining and utilizing data. The proposed method is a multi-scale regional photovoltaic power generation forecasting approach that uses sequence coding reconstruction. Firstly, the reference sites were selected to enhance the data in time domain and frequency domain for the limited site dataset. Then, the forecasting model of sequence coding reconstruction is constructed based on convLSTM, and the attention mechanism is added in the decoding process, so that it can make full use of the spatio-temporal correlation characteristics of regional photovoltaic power and realize the rolling forecasting of regional photovoltaic power. The result shows that the proposed method can maintain a good multi-scale regional photovoltaic power forecasting effect under the condition of limited data amount and low data collection cost, the accuracy of the proposed model is increased compared with the naive forecasting method.

Live streaming e-commerce has emerged as a novel online marketing model. Drawing upon influencer marketing theory, this study examines the mechanisms through which influencers (live streamers) promote consumers’ purchase intention in the context of live streaming e-commerce. A sample of 449 valid questionnaires was utilized to test the proposed theoretical framework. The empirical research findings reveal that customer experience significantly and positively impacts both influencer trust and influencer attachment. Furthermore, trust and attachment established with live streamers are identified as two effective mechanisms influencing consumer decision-making. Notably, influencer attachment exhibits a stronger influence on consumer purchase intention compared to influencer trust. By comparing the effects of Taobao and Douyin live streamers on stimulating consumption and purchase intention, the study demonstrates that live streamers play a crucial mediating role between customer experience and consumer purchase intention. Specifically, the results indicate that consumer purchase intention influenced by top Taobao streamers is stronger than that of Douyin streamers, whereas influencer attachment for Taobao streamers is relatively weaker than that for Douyin streamers. These findings provide theoretical and managerial implications for platforms and live streamers seeking to stimulate robust purchase intentions among consumers by fostering attachment relationships. The establishment of an emotional connection between the live streamer and the audience proves particularly valuable in increasing purchase intention. This research contributes to the understanding of the underlying mechanisms driving consumer behavior in the context of live streaming e-commerce. It emphasizes the significance of customer experience, influencer trust, and influencer attachment as key drivers of consumer purchase intention. The findings offer valuable insights for platforms and live streamers to optimize their strategies and enrich user data labels in order to enhance consumer engagement and stimulate purchase intentions. Ultimately, this research contributes to the advancement of the live streaming e-commerce field, strengthens the application of data elements in live streaming e-commerce marketing, and guides effective decision-making by industry practitioners.

Fozi Mountain National Geopark is located in Zhenghe County in the northern region of Fujian Province, where the volcanic rocks of the Zhaixia Formation of the Shimaoshan Group are exposed. Zircon U-Pb dating and geochemical analysis were carried out to constrain its age and tectonic environment. The results show that three zircon U-Pb dating samples have attained ages of 99.2 ± 1.0 Ma, 99.6 ± 0.8 Ma, and 99.7 ± 2.0 Ma. Volcanic rocks in the core scenic area of Fozi Mountain were formed during the Late Cretaceous period. Elemental analysis showed that these volcanic rocks were dominated by the shoshonite series. They include gray dacite porphyry, grayish-white breccia tuff, volcanic agglomerate, and gray tuffaceous sandstone. These rocks were characterized by high silicon, high alkali content, and rich potassium levels. Lu-Hf isotope analysis of zircons revealed that their εHf(t) values varied from −8.7 to −6.8. The corresponding TDM2 values were primarily distributed in the range of 1.71 Ga to 1.59 Ga. These findings indicated that the magma primarily originated from the partial melting of the Mesoproterozoic crystalline basement, accompanied by a small number of mantle-derived materials. Tectonic environment analysis indicated that these rocks were formed in the post-orogenic intraplate extensional environment, which was associated with the back-arc extension or lithospheric thinning caused by the subduction of the paleo-Pacific plate beneath the Eurasian plate. The formation of these volcanic rocks was attributed to post-orogenic magmatism.

This paper presents a 14-bit hybrid column-parallel compact analog-to-digital converter (ADC) for the application of digital infrared focal plane arrays (IRFPAs) with compromised power and speed performance. The proposed hybrid ADC works in two phases: in the first phase, a 7-bit successive approximation register (SAR) ADC performs coarse quantization; in the second phase, a 7-bit single-slope (SS) ADC performs fine quantization to complete the residue voltage conversion. In this work, the number of unit capacitors is reduced to 1/128th of that of a conventional 14-bit SAR ADC, which is beneficial for the application of small pixel-pitch IRFPAs. In this work, a tradeoff segmented thermometer-coded digital-to-analog converter (DAC) is adopted in the first 7-bit coarse quantization process: the lower 3-bit is binary coded, and the upper 4-bit is thermometer coded. A thermometer-coded DAC can improve the linearity of ADC. Capacitor array matching can be incredibly relaxed compared with a binary-weight 14-bit SAR ADC, resulting in a noncalibration feature. Moreover, by sharing DAC and comparator analog circuits between the SAR ADC and the SS ADC, the power consumption and layout area are consequently reduced. The proposed hybrid ADC was fabricated using a 180 nm CMOS process. The measurement results show that the proposed ADC has a differential nonlinearity of −0.61/+0.84 LSB and a sampling rate of 120 kS/s. The developed ADC achieves a temporal noise of 1.7 LSBrms at a temperature of 77 K. In addition, the SNDR is 72.9 dB, and the ENOB is 11.82 bit, respectively. Total power consumption is 71 μW from supply voltages of 3.3 V (analog) and 1.8 V (digital).

A highly sensitivity balloon-like fiber interferometer based on ethanol coating is presented in this paper. The Mach–Zehnder interferometer is formed by bending a single-mode fiber to a balloon-like structure and nested in the Teflon tube. Then, an ethanol solution was filled into the tube of the balloon-like fiber interferometer by the capillary effect. Due to the high sensitivity of the refractive index (RI) of ethanol solutions to temperature, when the external temperature varies, the optical path difference changes. The change in temperature can be detected by the shift in the interference spectrum. Limited by the size of the balloon-like structure, three kinds of these structures with different sensitive lengths were prepared to select the best parameters. The sensitive lengths were 10, 15 and 20 mm, respectively, and the RI detection performance of each structure in 10~26% NaCl solutions was investigated experimentally. The results show that when the sensitive length is 20 mm, the RI sensitivity of the sensor is the highest, which is 212.88 nm/RIU. Ultimately, the sensitive length filled with ethanol is 20 mm. The experimental results show that the temperature sensitivity of the structure is 1.145 nm/°C in the range of 28.1 °C~35 °C, which is 10.3 times higher than that of an unfilled balloon-like structure (0.111 nm/°C). The system has the advantages of low cost and easy fabrication, which can potentially be used in high-precision temperature monitoring processes.

Introduction Enthesitis-related arthritis (ERA) is a category of juvenile idiopathic arthritis (JIA). The complications of JIA include pain, muscle weakness, limited movement and worsening quality of life. Yoga is an effective exercise therapy for rheumatoid arthritis and may have similar benefits for JIA. Considering the limitation of yoga for strengthening muscles, combined yoga and resistance training (CYRT) may compensate for the shortcomings and provide more benefits for JIA patients. Despite this, there is currently a lack of studies investigating the effectiveness of CYRT for JIA patients. Due to the inaccessibility of traditional exercise therapy, home-based exercise is needed. The study aims to assess the effectiveness of home-based CYRT on JIA.Methods and analysis This is a 12-week randomised single-blind controlled trial study. 60 patients with ERA will be randomised into two groups: the home-based exercise group (HBE) and the health education (HE) group. The HBE group (n=30) will perform the CYRT programme 3 times a week at home for 12 weeks and receive HE. The HE group (n=30) will only receive HE. The outcomes include primary outcome (pain levels) and secondary outcomes (lower limb muscle strength, motion range of joint, aerobic fitness, function ability, fatigue levels, mental health, quality of life and blood biomarkers). The assessments will be conducted at baseline, postintervention (12 weeks) and follow-up (24 weeks). Data will be analysed by intention to treat.Ethics and dissemination This study has been approved by the Ethics Committee of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine in December 2023 (approval no. XHEC-C-2023-059-3). This study will require informed consent from all subjects and guardians of children under 18 years of age. The findings will be published in a peer-reviewed journal and international conferences.Trial registration number ChiCTR2300073446.

The effect of scanning strategy on the microstructure and properties of GH3536 Ni-based superalloy prepared by Laser Powder Bed Fusion was investigated, for the purpose of building high quality hydrocyclone part. The results show that the strength of Z67° (a zone with 67° hatch angle strategy) specimen is the highest among the four scanning strategies (0°, 67°, 90°and Z67°), with yield strength and tensile strength of 681 ​MPa and 837 ​MPa, respectively. Selective orientation of crystals occurs during the forming process because the longitudinal section of the specimen exhibits a high texture strength in (001). As the stretching proceeds, the plastic deformation mechanism of the specimen gradually changes from slip to twin-dominated, a substantial amount of twinning is observed in the region where the deformation of the specimen reaches 80%. The additive manufacturing simulation suite: Ansys Additive is used to simulate the stress and deformation of the part during the process, and the displacement results are consistent with the experimental phenomena. According to the simulation results, the structure design is optimized and the surface quality of the part is improved. The results show that the support of the part is more reasonable when the overhang angle is 45°.

ObjectiveWinter-over expeditioners in Antarctica are challenged by various environmental and psycho-social stress factors, which may induce psychophysiological changes. The autonomic nervous system (ANS) plays a crucial role in the adaptation process under stress. However, the relationship between ANS activity and the mood states of expeditioners remains largely unexplored. This study aims to uncover the pattern of ANS adjustment under extreme Antarctic environments and provide new insights into the correlations between ANS activity and mood state changes, which may provide scientific data for medical interventions.MethodsFourteen expeditioners at Zhongshan Station participated in this study. The study was conducted during four representative periods: pre-Antarctica, Antarctica-1 (pre-winter), Antarctica-2 (winter), and Antarctica-3 (summer). The heart rate variability (HRV) of the expeditioners was continuously measured for 24 hours to evaluate ANS activity. Plasma levels of catecholamines were tested by ELISA. Mood states were assessed by the Profile of Mood States (POMS) scale.ResultsHRV analysis showed a disturbance of ANS during winter and summer periods. For frequency domain parameters, very low frequency (VLF), low frequency (LF), high frequency (HF), and total power (TP) significantly increased during the second half of the mission. Especially, LF/HF ratio decreased during summer, indicating the predominance of vagal tone. Results of the time domain analysis showed increased heart rate variability during the austral winter and summer. Plasma epinephrine (E) significantly increased during residence in Antarctica. Compared with pre-Antarctica, the vigor, depression, and anger scores of the expeditioners decreased significantly during the austral summer. Notably, the depression score showed a moderate positive correlation with LF/HF, while weak negative correlations with other HRV indicators, including TP, VLF, and LF. Anger score showed a moderate positive correlation with LF/HF and weak negative correlations with the average normal-to-normal (NN) interval, and the root mean square of differences between adjacent RR intervals (RMSSD). Plasma E level weakly correlated with the average NN interval.ConclusionProlonged residence in Antarctica increased the ANS activities and shifted the cardiac autonomic modulation towards vagal predominance. The alteration of HRV correlated with mood states and plasma epinephrine levels.

BackgroundPrenatal depressive symptoms (PDS) is a serious public health problem. This study aimed to develop an integrated panel and nomogram to assess at-risk populations by examining the association of PDS with the serum metabolome, multivitamin supplement intake, and clinical blood indicators.MethodsThis study comprised 221 pregnant women, categorized into PDS and non-PDS groups based on the Edinburgh postnatal depression scale. The participants were divided into training and test sets according to their enrollment time. We conducted logistic regression analysis to identify risk factors, and employed liquid chromatography/high resolution mass spectrometry-based serum metabolome analysis to identify metabolic biomarkers. Multiple factor analysis was used to combine risk factors, clinical blood indicators and key metabolites, and then a nomogram was developed to estimate the probability of PDS.ResultsWe identified 36 important differential serum metabolites as PDS biomarkers, mainly involved in amino acid metabolism and lipid metabolism. Multivitamin intake works as a protective factor for PDS. The nomogram model, including multivitamin intake, HDL-C and three key metabolites (histidine, estrone and valylasparagine), exhibited an AUC of 0.855 in the training set and 0.774 in the test set, and the calibration curves showed good agreement, indicating that the model had good stability.ConclusionOur approach integrates multiple models to identify metabolic biomarkers for PDS, ensuring their robustness. Furthermore, the inclusion of dietary factors and clinical blood indicators allows for a comprehensive characterization of each participant. The analysis culminated in an intuitive nomogram based on multimodal data, displaying potential performance in initial PDS risk assessment.

Influenza A viruses (IAVs) continue to pose a huge threat to public health, and their prevention and treatment remain major international issues. Neuraminidase (NA) is the second most abundant surface glycoprotein on influenza viruses, and antibodies to NA have been shown to be effective against influenza infection. In this study, we generated a monoclonal antibody (mAb), named FNA1, directed toward N1 NAs. FNA1 reacted with H1N1 and H5N1 NA, but failed to react with the NA proteins of H3N2 and H7N9. In vitro, FNA1 displayed potent antiviral activity that mediated both NA inhibition (NI) and blocking of pseudovirus release. Moreover, residues 219, 254, 358, and 388 in the NA protein were critical for FNA1 binding to H1N1 NA. However, further validation is necessary to confirm whether FNA1 mAb is indeed a good inhibitor against NA for application against H1N1 and H5N1 viruses.

Zeolitic imidazolate framework-8 (ZIF-8) is a versatile candidate for next-generation electronics owing to its adjustable lattice and physicochemical properties. However, the utilization of ZIF-8 for the fabrication of solid-state electronics and circuit components, such as field-effect transistors (FETs), has not been realized thus far, primarily due to ongoing debates surrounding its electrical properties. In this work, we fabricated n-type FETs using ZIF-8@ZnO nanorod arrays. A significant hysteresis behavior was observed. It was demonstrated that this hysteresis cannot be assigned to the well-established ferroelectric effect but rather to the polarization of ZIF-8, wherein the electric field of the gate aligns the dipole of 2-methylimidazole through molecular orientation rotation. It was clarified that the process of annealing in air can result in the chemisorption of oxygen on methylimidazole, leading to a limitation in the rotation of methylimidazole. This restriction ultimately causes the depolarization of ZIF-8, resulting in the erasure of hysteresis. This study unfolds the tunable hysteresis behavior of ZIF-8 and its sensibility to oxygen, thereby highlighting the potential applications of ZIF-8 in FETs, nonvolatile memories, and gas sensors.

Background: Different RAS/BRAF allele mutations imply distinct biological properties in various solid tumors. Recently, several studies have focused on the predictive and prognostic roles of various RAS/BRAF allele mutations in colorectal cancer (CRC) but the results remain controversial. Methods: Between March 2017 and September 2022, the patients diagnosed as stages I–IV CRC with detailed medical records including next-generation sequencing (NGS) data and clinicopathological follow-up information available at our center were enrolled. Survival data were estimated using the Kaplan–Meier method, and the difference was tested in a log-rank test. Multivariate tests were carried out using Cox models. Results: A total of 1029 CRC patients were included, and the incidence of RAS/BRAF mutation was 58.4%. The hypermutated cohort was defined as patients with microsatellite instability-H or POLE/D mutation. In the non-hypermutational cohort, only KRAS G13D mutation was associated with a higher incidence and inferior disease-free survival in patients with stage I-III CRC. In the cohort of patients with non-hypermutated metastatic colorectal cancer (mCRC), we assessed the risk of various RAS/BRAF allele mutations and subsequently reclassified patients into four groups based on first-line median progression-free survival: wild type (group 1), low-risk RAS /BRAF mutation (group 2, RAS/BRAF mutations other than KRAS G13D/G12V/G12C or BRAF V600E), high-risk RAS mutation (group 3, KRAS G13D/G12V/G12C), and BRAF V600E mutation (group 4). mCRC patients with high-risk RAS mutation could significantly benefit from intensive triplet chemotherapy (hazard ratio, 2.54; 95% confidence interval, 1.36–5.12; p = 0.0091). Conclusion: In the non-hypermutated CRC cohort, the prognostic risk of various RAS/BRAF allele mutations varied between local and metastatic CRC. KRAS G13D mutation tended to be the only prognostic marker for stages I–III CRC; however, KRAS G13D/G12V/G12C mutations collectively defined a high-risk subgroup of mCRC patients with poor prognosis, who would benefit from intensive triplet chemotherapy.

In this study, we observed pediatric complete spinal cord injury (CSCI) patients receiving MI training and divided them into different groups according to the effect of motor imagery (MI) training on neuropathic pain (NP). Then, we retrospectively analysed the differences in brain structure of these groups before the MI training, identifying brain regions that may predict the effect of MI on NP. Thirty pediatric CSCI patients were included, including 12 patients who experienced NP during MI and 18 patients who did not experience NP during MI according to the MI training follow‐up. The 3D high-resolution T1-weighted images of all subjects were obtained using a 3.0 T MRI system before MI training. A two-sample t-test was performed to evaluate the differences in gray matter volume (GMV) between patients who experienced NP and those who did not experience NP during MI. Receiver operating characteristic (ROC) analysis was performed to compute the sensitivity and specificity of the imaging biomarkers for the effect of MI on NP in pediatric CSCI patients. MI evoked NP in some of the pediatric CSCI patients. Compared with patients who did not experience NP, patients who experienced NP during MI showed larger GMV in the right primary sensorimotor cortex (PSMC) and insula. When using the GMV of the right PSMC and insula in combination as a predictor, the area under the curve (AUC) reached 0.824. Our study demonstrated that MI could evoke NP in some pediatric CSCI patients, but not in others. The individual differences in brain reorganization of the right PSMC and insula may contribute to the different effects of MI on NP. Moreover, the GMV of the right PSMC and insula in combination may be an effective indicator for screening pediatric CSCI patients before MI training therapy.

Modern-day optical systems are evolving towards miniaturization and integration, leading to higher performance demands for polarizing beam splitters (PBSs). A simple-structure and high-performance PBS based on dual-core photonic crystal fiber (DC-PCF) with As2S3 layer is proposed. The finite element method (FEM) and classical coupled-mode theory (CMT) are utilized to investigate the performance of this PBS. Simulation results demonstrate that the proposed PBS can achieve a minimum length of 2.65 mm, a minimum extinction ratio of −64 dB, an operating bandwidth of 420 nm, and a minimum insertion loss of 0.03 dB when the optimal parameters include cladding hole diameter of 1.0 μm, central hole diameter of 2.0 μm, lattice spacing of 2.0 μm, and As2S3 ring layer thickness of 50 nm. Moreover, it also possesses a high birefringence of 3.58 × 10−3 and a negative dispersion of −30 ps/km/nm at 1.55 μm. It is believed that the proposed PBS holds great potential to become a critical device in optical multiplexing technologies.

Crohn's disease (CD) affecting the jejunum and ileum is uncommon and its diagnosis can be challenging. This case report describes a 35 year old male patient who had been experiencing intermittent periumbilical pain, diarrhoea and fever for five years. Despite undergoing gastroscopy, colonoscopy and capsule endoscopy; no significant abnormalities were found. This case was seen at the Shenzhen Hospital of Traditional Chinese Medicine; Shenzhen, China. However, the patient underwent a double-balloon enteroscopy (DBE), which revealed multiple ulcers in the jejunum and ileum, leading to a confirmed diagnosis of CD. The patient was successfully treated with infliximab to relieve symptoms. DBE can be particularly valuable in diagnosing CD in young patients with symptoms when conventional endoscopic techniques have been unsuccessful. This case highlights the importance of considering small bowel disease in patients with CD symptoms and the potential benefits of DBE in diagnosing such cases.

BackgroundBilirubin has been widely reported to be a protective factor against diabetic kidney disease (DKD) in Asian populations. However, few large-sample analyses have been conducted in American populations. This study aimed to investigate the association between serum total bilirubin (STB) level and DKD in a US diabetic cohort.MethodsThis cross-sectional study enrolled participants from the National Health and Nutrition Examination Survey (NHANES) 2003–2018. Univariate and multivariate logistic regression analyses were performed to assess the association between STB level and DKD. Three models were conducted to control the potential confounding factors. Subgroup analysis was carried out for further validation.ResultsAmong the 5,355 participants, the median age [interquartile range (IQR)] was 62 [52–71] years; 2,836 (52.96%) were male, and 1,576 (29.43%) were diagnosed with DKD. In the entire cohort, no significant association between STB level and DKD was observed in any logistic regression models (p > 0.05). Subgroup analysis revealed that, in U.S. diabetic males, STB levels > 11.98 µmol/L were associated with a nearly 30% lower risk of DKD than STB levels ≤ 8.55 µmol/L. Additionally, a moderate STB level (8.56–11.98 μmol/L) was found associated with a nearly 25% lower risk of DKD in U.S. diabetic patients over 65 years old.ConclusionThe association of STB level with DKD may depict differences across diverse populations, among which the impact of race, sex, and age requires thorough consideration and relevant inferences should be interpreted cautiously.

Abstract Mononuclear phagocytes (MPs) are vital components of host immune defenses against cancer. However, tumor‐infiltrating MPs often present tolerogenic and pro‐tumorigenic phenotypes via metabolic switching triggered by excessive lipid accumulation in solid tumors. Inspired by viral infection‐mediated MP modulation, here enveloped immunometabolic nanoparticles (immeNPs) are designed to co‐deliver a viral RNA analog and a fatty acid oxidation regulator for synergistic reshaping of intratumoral MPs. These immeNPs are camouflaged with cancer cell membranes for tumor homing and opsonized with anti‐CD163 antibodies for specific MP recognition and uptake. It is found that internalized immeNPs coordinate lipid metabolic reprogramming with innate immune stimulation, inducing M2‐to‐M1 macrophage repolarization and tolerogenic‐to‐immunogenic dendritic cell differentiation for cytotoxic T cell infiltration. The authors further demonstrate that the use of immeNPs confers susceptibility to anti‐PD‐1 therapy in immune checkpoint blockade‐resistant breast and ovarian tumors, and thereby provide a promising strategy to expand the potential of conventional immunotherapy.