Search

Abstract Cervical cancer (CC) is a significant global health issue and remains one of the leading causes of cancer-related mortality in women. Radiotherapy is a crucial treatment modality for CC; however, tumor heterogeneity and resistance to radiotherapy often result in suboptimal outcomes for some patients, including recurrence and metastasis. Periostin (POSTN), a matricellular protein within the tumor microenvironment, has been implicated in the promotion of tumor progression and treatment resistance, particularly through mechanisms such as epithelial-mesenchymal transition (EMT). Despite this, the role of POSTN in radiotherapy resistance in CC patients remains underexplored. Therefore, in this study, we investigated the prognostic significance of POSTN expression in CC patients undergoing radical radiotherapy and explored potential mechanisms underlying radiotherapy resistance. We analyzed data from 92 CC patients in The Cancer Genome Atlas (TCGA) and 153 patients from our institution, assessing POSTN expression levels through mRNA analysis and immunohistochemistry (IHC). Our findings revealed that high POSTN expression was significantly associated with advanced tumor stages, poorer radiotherapy outcomes, and worse overall survival (OS). Additionally, multivariate Cox regression analysis identified POSTN as an independent prognostic factor for CC patients undergoing radical radiotherapy. A prognostic nomogram integrating POSTN expression and clinicopathological features demonstrated superior predictive accuracy for OS. Drug sensitivity analysis suggested that high POSTN expression may be linked to resistance to multiple chemotherapeutic agents. Furthermore, weighted correlation network analysis (WGCNA) and gene set enrichment analysis (GSEA) identified EMT as a top enriched pathway in patients with high POSTN expression, suggesting it may play a critical role in radiotherapy resistance. Subsequently, in vitro experiments confirmed that POSTN knockdown significantly inhibited HeLa cell proliferation, invasion, and enhanced radiosensitivity, while promoting apoptosis. These findings indicate that high POSTN expression is a risk factor for poor prognosis in CC patients undergoing radical radiotherapy, and targeting POSTN may improve radiotherapy efficacy by reducing tumor proliferation and resistance.

Abstract Breast cancer (BC) is a significant cause of cancer-related deaths among women worldwide. Hypoxia, a common feature of solid tumor, is associated with drug resistance and a poor prognosis in BC. In this study, we present a strategy to overcome hypoxia-induced chemotherapy tolerance in BC. Specifically, we synthesized a hollow gold (Au)-platinum (Pt) bimetallic nanoshell for the first time, which acted as a drug delivery system (DDS) for doxorubicin (DOX). The photothermal effect, induced by the surface plasmon resonance (SPR) from the Au-Pt shell under near infrared-II (NIR-II) laser irradiation, not only directly causes tumor cell death through photothermal therapy (PTT), but also significantly enhances the catalase-like activity between Pt nanoparticles and endogenous H2O2. This, subsequently, results in a heightened yield of O2, which further facilitates the release of DOX. This process alleviates tumor hypoxia and down-regulating hypoxia-inducible factor-1α (HIF-1α), multidrug resistance gene 1 (MDR1), and P-glycoprotein (P-gp), which can reverse drug resistance and achieve more effective DOX chemotherapy effects. Significantly, the increased availability of oxygen further re-polarizes immunosuppressive M2 macrophages into antitumor M1 macrophages. This study presents a novel strategy to tackle tumor proliferation and enhance tumor response to chemotherapy, offering hope for reversing in drug resistance in cancerous lesions. Graphical Abstract

Abstract Direct resin restoration has been widely used to restore the tooth defect for its convenience and minimal invasion. However, the accuracy of the final contour of class II restoration is often unpredictable and quite technique-sensitive due to the limitation of traditional matrix band system. In this study, the authors developed a novel matrix band system using shape memory polymer (SMP), which possessed two reversible shapes including digitized permanent shape to reproduce anatomical proximal contour and programmable temporary shape for clinical practice and reservation. The permanent shape could be designed and customized in software or retrieved from imaging database collected from large general population. Only warm saline or water was needed to trigger the shape transformation without any auxiliary tools. The results of in vitro class II restoration showed the shape memory matrix bands brought the best proximal profile and contact point, compared to traditional metal matrix and sectional matrix. The novel shape memory matrix system represents the comfortable, precise, and minimally invasive trend of dentistry and has a broad industrialization prospect as a dental instrument.

Abstract Correct classification of type 1 (T1D) and type 2 diabetes (T2D) is challenging due to overlapping clinical features and the increasingly early onset of T2D, particularly in South Asians. Polygenic risk scores (PRSs) for T1D and T2D have been shown to work relatively well in South Asians, despite being derived from largely European-ancestry samples. Here we used PRSs to investigate the rate of potential misclassification of diabetes amongst British Bangladeshis and Pakistanis. Using linked health records from the Genes & Health cohort (n = 38,344) we defined two reference groups meeting stringent diagnostic criteria: 31 T1D cases, 1842 T2D cases, and after excluding these, two further groups: 839 insulin-treated diabetic individuals with ambiguous features and 5174 non-diabetic controls. Combining these with 307 confirmed T1D cases and 307 controls from India, we calculated ancestry-corrected PRSs for T1D and T2D, with which we estimated the proportion of T1D cases within the ambiguous group at ~ 6%, dropping to ~ 4.5% within the subset who had T2D codes in their health records (and are thus most likely to have been misclassified). We saw no significant association between the T1D or T2D PRS and BMI at diagnosis, time to insulin, or the presence of T1D or T2D diagnostic codes amongst the T2D or ambiguous cases, suggesting that these clinical features are not particularly helpful for aiding diagnosis in ambiguous cases. Our results emphasise that robust identification of T1D cases and appropriate clinical care may require routine measurement of diabetes autoantibodies and C-peptide.

Abstract Background Complications following kidney transplantation elevate the risks of readmission and mortality. The aim of this study was to assess the association between the age-adjusted Charlson Comorbidity Index (ACCI) and postoperative complications among kidney transplant (KT) recipients. Methods Between January 2015 and March 2021, a study involving 886 kidney transplant recipients at the Third Affiliated Hospital of Sun Yat-sen University was conducted. Postoperative complications were defined by the Clavien-Dindo Classification of Surgical Complications. Target Maximum Likelihood Estimation (TMLE) was employed to assess the association between ACCI and postoperative complications. The odds ratio (OR) was computed to determine the relationship between ACCI and postoperative complications. Subsequent interaction and stratified analyses were performed to assess the robustness of the findings. Results Out of 859 KT participants ultimately included in the study, 30.7% were documented to have encountered postoperative complications. Participants with an ACCI value exceeding 3 exhibited a notably increased risk of postoperative complications following multivariable adjustment [aOR = 1.64, 95% CI [1.21,2.21], p = 0.001]. Congestive heart failure (OR = 16.18, 95% CI [1.98–132.17], p

Abstract In the context of advancing medical procedures, postoperative infections in cancer patients, particularly those involving multidrug-resistant organisms, have become a significant clinical concern. This study aims to comprehensively and systematically evaluate the effectiveness of infection prevention and control for multidrug-resistant organisms (MDROs) in postoperative cancer patients using Failure Mode and Effects Analysis (FMEA). This study was conducted in a tertiary A-level cancer specialty hospital in China, employing Failure Mode and Effects Analysis (FMEA) to assess the risks of hospital infections. Intervention measures were implemented for high-risk and medium-high-risk factors. Through the hospital’s infection information system, data on patients who underwent surgical treatment from 2017 to 2022 were extracted. Data from 2017 to 2019 served as the control group, and data from 2020 to 2022 as the intervention group, to compare the changes in hospital infection incidence and MDRO infection incidence before and after the intervention. Categorical data were described in terms of frequency and percentage. The chi-square test was utilized for statistical inference to assess the differences in infection rates before and after the intervention. Prior to the intervention (2017–2019), the incidence rate of hospital infections was 1.66%, which decreased to 1.22% after the intervention (2020–2022), showing a statistically significant difference (χ2 = 48.83, P

Abstract Background Limited data on the impact of the coronavirus disease 2019 (COVID-19) during pregnancy on newborn outcomes are available. This study aimed to characterize and compare the clinical outcomes of newborns from women with and without the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during late pregnancy. Method This was a retrospective cohort study of women who were either infected or not infected with the SARS-CoV-2 virus during late pregnancy. The neonatal complications associated with COVID-19-positive pregnant women were investigated and analyzed. Results Among 2063 pregnant women over 28 weeks of gestation, 1.2%, 3.3%, and 18.7% of patients with multiple pregnancies, abnormal fetal positions, and lack of maternal or neonatal follow-up data, respectively, were excluded. Patients who were COVID-19-negative (60.6%) and -positive (16.2%) remained for further analysis. SARS-CoV-2 infection was significantly associated with higher SARS-CoV-2 infection rates in newborns (0% vs. 1.49%, P

Background Study: As flipped learning is a flexible pedagogical methodology to tailor students' needs and maximize the learning effects, this study integrated peer learning with MosoTeach-supported flipped mode in an undergraduate blended EFL course. MosoTeach is a popular online learning platform in China with a variety of learning resources. Objectives: The study aimed to test the impact of MosoTeach flipped learning (MTFL) mode on undergraduate EFL students' perceived motivation, participation, feedback, and test performance. Methods: A quasi-experimental design was carried out in Z university during the spring semester of 2020, with the experimental group (n = 34) adopting the MTFL model and a control group (n = 33) the non-flipped mode. Results and Conclusions: The independent t-test results showed that the experimental MTFL group outperformed the control group in post-test scores, and a positive correlation was found in the relationship between the experimental MTFL group's post-test scores and MosoTeach learning experience points (LEPs). Moreover, the course perception questionnaire survey indicated a higher level of students' perceived motivation, participation, and feedback in the experimental MTFL group, which corresponded to the results of the content analysis of students' responses to open-ended questions and reflective reports. But students in both groups experienced challenges such as isolation, procrastination and technological anxiety.

Objective To estimate the prevalence of organophosphate (OP) poisoning in Nepal. Methods PubMed, Web of Science Core Collection (WoSCC), Cochrane Library, Ovid, and Springer databases were searched. The search strategies were used in different databases until December 13, 2024. The Joanna Briggs Institute (JBI) critical appraisal checklist was used to assess the quality of the included studies. The R project was used to estimate the pooled prevalence rate and 95% confidence interval ( CI) based on the results of the heterogeneity test. Results Eleven studies, involving 4809 participants. Heterogeneity indicated a P value of Conclusion The overall prevalence of OP poisoning was 36.7% in Nepal. The hospital-based studies indicated a higher pooled prevalence than community-based studies and other cities-based studies reported a higher prevalence than Kathmandu-based studies. Future research is warranted to provide more accurate and comprehensive evidence regarding the prevalence of OP poisoning in Nepal.

ABSTRACT Background The present study aimed to evaluate the predictive abilities of hematoma volume, perihematomal edema (PHE) volume, and total lesion (hematoma + PHE) volume for poor outcome in patients with intracerebral hemorrhage (ICH). Methods Patients admitted to our department between January 2015 and March 2023 were retrospectively enrolled according to the inclusion criteria and exclusion criteria. Demographic characteristics, clinical information, laboratory examinations, and imaging data were collected. Results We included 510 patients with initial computerized tomography (CT) scan (342 [67.1%] male, median age = 62 years); 142 patients had CT scans at admission and 72 h post ICH, and 350 patients had CT scans at admission and 5–9 days after onset. Multivariate logistic regression analysis revealed that absolute hematoma, absolute PHE, and absolute total lesion at admission; absolute hematoma and absolute total lesion at 72 h after onset; absolute hematoma, absolute PHE, and absolute total lesion at 5–9 days post ICH were independently related to poor outcome (p < 0.05). Furthermore, receiver operating characteristic curves demonstrated that the total volume of hematoma and PHE at 5–9 days post ICH was a better indicator to predict poor outcome, compared to other risk factors in patients with ICH (area under curve = 0.778, 95%CI: 0.729–0.826). Conclusion The total volume of hematoma and PHE at 5–9 days after onset had the highest ability in predicting poor outcome in patients with ICH.

BackgroundThe ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) is a novel marker related to atherosclerosis, but its role in diabetic kidney disease (DKD) remains unclear. This study investigated the relationship between NHHR and DKD risk in patients with type 2 diabetes mellitus (T2DM) and evaluated its potential as a marker for early DKD screening.MethodsData from adults with T2DM participating in the National Health and Nutrition Examination Surveys (NHANES) from 1999 to 2018 were analyzed. Demographic information, laboratory tests, and other relevant information were collected. To evaluate the correlation between NHHR levels and DKD risk, weighted multivariable logistic regression and weighted restricted cubic spline (RCS) analyses were employed. Furthermore, threshold effect analysis was employed to further explore the relationship at different NHHR levels, and subgroup analyses validated the results.ResultsThe study enrolled a total of 3,243 participants, comprising 1,258 individuals with DKD (38.79%) and 1,985 individuals without DKD (61.21%). The multivariable logistic regression analysis showed that T2DM patients with higher NHHR levels exhibited a 45% reduction in the risk of developing DKD in comparison to those with lower NHHR levels (Q2 vs. Q1: OR 0.55, 95% CI 0.40–0.76). The weighted RCS analysis revealed a nonlinear correlation between NHHR and the risk of DKD in patients with T2DM (P for nonlinear = 0.003), with the RCS plot exhibiting an L-shaped association. A negative association was observed between NHHR levels and the risk of DKD when NHHR was ≤2.82 (OR 0.63, 95% CI 0.49–0.83). A statistically significant correlation between NHHR and DKD risk was not observed when NHHR was >2.82. The subgroup analyses indicated that age may have an interaction effect on this association at higher NHHR levels (p for interaction

ObjectiveOvarian cancer is one of the most lethal gynecological malignancies. This study aimed to evaluate the prognostic significance of complete blood count (CBC) and lipid profile in patients with optimally debulked epithelial ovarian cancer (EOC) and develop a nomogram model to predict recurrence-free survival (RFS).MethodsThis retrospective study analyzed patients diagnosed with EOC between January 2018 and June 2022.ResultsA total of 307 patients were randomly divided into training and validation sets in a ratio of 7:3. Grade, International Federation of Gynecology and Obstetrics (FIGO) stage, platelet-to-lymphocyte ratio, red blood cell distribution width-coefficient of variation, triglycerides, and human epididymal protein 4 were identified as independent prognostic factors. The novel nomogram displayed a good predictive performance, with a concordance index (C-index) of 0.787 in the training group and 0.807 in the validation group. The areas under the curve for 1-, 3-, and 5-year RFS were 0.770, 0.881, and 0.904, respectively, in the training group, and 0.667, 0.906, and 0.886, respectively, in the validation group. The calibration curves exhibited good concordance between the predicted survival probabilities and actual observations. Time-dependent C-index curves, integrated discrimination improvement, net reclassification index, and decision curve analysis showed that the nomogram outperformed FIGO staging.ConclusionThis study established and validated a nomogram combining CBC and lipid profiles to predict RFS in patients with optimally debulked EOC, which is expected to aid gynecologists in individualized prognosis assessment and clinical management.

Rectal cancer is a leading cause of morbidity and mortality among patients with malignant tumors in China. In light of the advances made in therapeutic approaches such as neoadjuvant therapy and total mesorectal excision, precise preoperative assessment has become crucial for developing a personalized treatment plan. As an emerging technology, radiomics has gained widespread application in the diagnosis, assessment of treatment response, and analysis of prognosis for rectal cancer by extracting high-throughput quantitative features from medical images. Radiomics thus demonstrates considerable potential for optimizing clinical decision-making. In this paper, we reviewed recent research focusing on advances in the use of radiomics for managing rectal cancer. The review covers TNM staging of tumors, assessment of neoadjuvant therapy outcomes, and survival prediction. We also discuss the challenges and prospects for future developments in translational medicine, particularly the need for data standardization, consistent feature extraction methodologies, and rigorous model validation.

IntroductionUlcerative colitis (UC) is a chronic inflammatory disease. Patients with UC typically exhibit disruption of the Treg/Th17 immune axis, but its exact mechanism is still unclear.MethodsThis study first analyzed RNA- seq data from public databases of humans and mice, and in vitro cytology experiments were conducted to induce or inhibit the expression of SIRT1. In vivo, UC mice were treated with moxibustion and SIRT1 inhibitor EX-527 to confirm the changes in the transcription factors identified through analysis of the datasets.ResultsThe results show that Treg/Th17 axis disruption is an important feature of UC. Differential gene expression and immune infiltration analysis showed that upstream transcription factors, including Forkhead box P3 (FOXP3), were significantly disrupted. In vitro cytology experiments, the results indicate that SIRT1 is activated in LPS induced inflammation, subsequently perturbing the Treg/Th17 immune balance axis. Finally, in vivo studies, the results have shown that administering EX-527 to inhibit SIRT1 leads to an increasing in FOXP3 expression and a decreasing in RORγt expression in UC colon tissue. In addition, the results indicate that traditional Chinese moxibustion can down regulate the expression of SIRT1, directly affecting the balance of Th17/Treg axis, and the combined use of EX-527 further improves the therapeutic effect of moxibustion.ConclusionOur research shows that inhibition SIRT1 can regulate Treg and Th17 immune balance axis. This finding indicates a new important potential target for the treatment of UC.

Abstract Nutrition support is an important care component for patients on hemodialysis. Also, patient self-management is important to maintaining proper nutritional intake during hemodialysis. This cross-sectional study investigated the knowledge, attitude, and practice (KAP) towards nutrition support and management among hemodialysis patients treated at the West China Hospital of Sichuan University between January and March 2023. Among 445 (95.91%) valid questionnaires, 58.43% were filled out by male patients. The knowledge, attitude, and practice scores were 11.44 ± 1.80 (possible range: 0–13), 30.29 ± 3.22 (possible range: 8–40), and 31.27 ± 5.67 (possible range: 8–40), respectively. Age > 60 years (OR = 0.487, 95%CI: 0.260–0.913, P = 0.025) and junior college or undergraduate or above (OR = 2.606, 95%CI: 1.621–4.189, P

Abstract Introduction This study analyzed and discussed the characteristics of peripheral blood lymphocytes (PBLs) in patients with endometrial carcinoma (EC) to explore the PBLs’ clinical application value. Methods This single-center case‒control study analyzed the clinical data of patients with EC and uterine fibroids who underwent surgery at the First Affiliated Hospital of Chongqing Medical University between October 2018 and October 2023 retrospectively. The Center for Clinical Molecular Medical Detection of our hospital performed PBLs detection using flow cytometry, and recorded the detection results in the electronic medical records system. Between-group and subgroup comparisons of PBLs in patients with EC were analyzed using t-test or Mann–Whitney U test. The effect of surgery on PBLs in patients with EC was assessed using a paired t-test or the Wilcoxon signed rank test. Results The immune function of patients with EC was significantly lower than that of healthy people (P < 0.05) and those with benign uterine diseases (P < 0.05) and was related to body mass index (BMI), hypertension, diabetes, and blood lipids (P < 0.05). In patients with EC, the PBLs counts decreased significantly after surgery (P < 0.05) and more kinds of lymphocytes were affected in the laparoscopic surgery group than in the open surgery group. Conclusions With the decrease of PBLs counts, the immune status of patients with EC is impaired. Metabolic syndrome (Mets), including obesity, hypertension, diabetes, and high blood lipids, also affects the immune function of patients with EC. And for EC patients, the effect of laparoscopic surgery is greater than that of open surgery. PBLs has the potential to be one of indicator during the diagnosis and treatment of EC. Trial registration This study was retrospectively registered by the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University (approval number K2023-578).

Abstract Broadening gene therapy applications requires manufacturable vectors that efficiently transduce target cells in humans and preclinical models. Conventional selections of adeno-associated virus (AAV) capsid libraries are inefficient at searching the vast sequence space for the small fraction of vectors possessing multiple traits essential for clinical translation. Here, we present Fit4Function, a generalizable machine learning (ML) approach for systematically engineering multi-trait AAV capsids. By leveraging a capsid library that uniformly samples the manufacturable sequence space, reproducible screening data are generated to train accurate sequence-to-function models. Combining six models, we designed a multi-trait (liver-targeted, manufacturable) capsid library and validated 88% of library variants on all six predetermined criteria. Furthermore, the models, trained only on mouse in vivo and human in vitro Fit4Function data, accurately predicted AAV capsid variant biodistribution in macaque. Top candidates exhibited production yields comparable to AAV9, efficient murine liver transduction, up to 1000-fold greater human hepatocyte transduction, and increased enrichment relative to AAV9 in a screen for liver transduction in macaques. The Fit4Function strategy ultimately makes it possible to predict cross-species traits of peptide-modified AAV capsids and is a critical step toward assembling an ML atlas that predicts AAV capsid performance across dozens of traits.

ObjectiveTo construct an early warning model of maintenance hemodialysis （MHD） capacity overload based upon basic dialysis data, ultrasound and routine blood biochemistry and examine its clinical effectiveness. Methods From January 2023 to December 2023, 603 patients on MHD were retrospectively reviewed. They were assigned into two sets of modeling （n = 402） and validation （n = 201） according to a ratio of 2:1. The relevant clinical were collected. And the influencing factors of MHD capacity overload in modeling set were analyzed by univariate and LASSO-Logistic regression. The risk prediction nomogram model was constructed. And consistency index, calibration curve, receiver operating characteristic （ROC） curve and decision curve were utilized for verifying the prediction model internally and externally. Results Serum albumin, Kt/V, RRF and left ventricular ejection fraction （LVEF） in overload group were lower than those in normal group. NT-proBNP, ultrasonic lung B-line and right atrial diameter were higher than those in normal group （P＜0.05）. LASSO results indicated that serum albumin, Kt/V, RRF, LVEF, NT-proBNP, ultrasonic lung B-line and right atrial internal diameter were Top 7 characteristic variables of volume overload in MHD. Logistic regression results revealed that Kt/V, serum albumin, RRF and LVEF were the protective factors for MHD volume overload. And NT-proBNP, ultrasonic lung B-line and right atrial diameter were the risk factors for MHD volume overload （P＜0.05）. The risk prediction nomogram model of capacity overload was constructed according to the influencing factors of Logistic regression. Consistency index in modeling and validation sets was 0.860 and 0.814, respectively. Calibration curve showed that the incidence of MHD capacity overload predicted by the model in modeling and validation sets was basically consistent with the actual incidence. ROC curve indicated that the area under the curve as predicted by the model in modeling and validation sets was 0.917（95%CI: 0.886-0.948） and 0.916（95%CI: 0.869-0.962）. Decision curve revealed that when the high-risk threshold of modeling set was 0-0.7 and the high risk threshold of validation set 0-0.7. The model had an excellent clinical net benefit. Conclusion In MHD patients, the occurrence of volume overload is affected by serum albumin, Kt/V, RRF, LVEF, NT-proBNP, ultrasonic lung B-line and right atrial diameter. The early warning model built according to the factors related to volume overload has excellent predictive capability and clinical benefit.

AIM: To investigate the biomechanical properties and practical application of absorbable materials in orbital fracture repair. METHODS: The three-dimensional (3D) model of orbital blowout fractures was reconstructed using Mimics21.0 software. The repair guide plate model for inferior orbital wall fracture was designed using 3-matic13.0 and Geomagic wrap 21.0 software. The finite element model of orbital blowout fracture and absorbable repair plate was established using 3-matic13.0 and ANSYS Workbench 21.0 software. The mechanical response of absorbable plates, with thicknesses of 0.6 and 1.2 mm, was modeled after their placement in the orbit. Two patients with inferior orbital wall fractures volunteered to receive single-layer and double-layer absorbable plates combined with 3D printing technology to facilitate surgical treatment of orbital wall fractures. RESULTS: The finite element models of orbital blowout fracture and absorbable plate were successfully established. Finite element analysis (FEA) showed that when the Young's modulus of the absorbable plate decreases to 3.15 MPa, the repair material with a thickness of 0.6 mm was influenced by the gravitational forces of the orbital contents, resulting in a maximum total deformation of approximately 3.3 mm. Conversely, when the absorbable plate was 1.2 mm thick, the overall maximum total deformation was around 0.4 mm. The half-year follow-up results of the clinical cases confirmed that the absorbable plate with a thickness of 1.2 mm had smaller maximum total deformation and better clinical efficacy. CONCLUSION: The biomechanical analysis observations in this study are largely consistent with the clinical situation. The use of double-layer absorbable plates in conjunction with 3D printing technology is recommended to support surgical treatment of infraorbital wall blowout fractures.

Speaking and communicating in English language can be a traumatic experience for many Chinese EFL university learners in class and in public. In many situations, they prefer to remain silent and passive listeners. This study aims to detect linguistic, psychological, socio-cultural hindrances and lends a sympathetic ear to Chinese university EFL learners enrolled in a public sector university in Wuhan and sheds light on their perspective that cause apprehension in communicating English as a FL/SL. Horwitz's FLA, Krashen's input hypothesis, affective filter hypothesis, Tanveer's learners' perspective, Vygotsky's and Feuerstein's social constructivism have been used as theoretical frameworks. The present study employed a qualitative method for collecting data and directed content analysis was conducted with deductive and inductive approach. Focus group discussion and semi-structured interviews were conducted with eight Chinese EFL university students within an academic and social context. The respondents were from social sciences discipline and had enrolled in fall semester for attending one course of English oral communication skills in the department of FL. The results of the directed content analysis indicated that respondents experienced communication apprehension and anxiety due to their own self-related psychological, cognitive, linguistic, academic, social and cultural aspects. They felt anxiety due to personality traits, low language proficiency, perceived academic issues, scholastic competence, poor pronunciation, and above all lack of lexical knowledge in TL.

Birth cohort studies involve repeated surveys of large numbers of individuals from birth and throughout their lives. They collect information useful for a wide range of life course research domains, and biological samples which can be used to derive data from an increasing collection of omic technologies. This rich source of longitudinal data, when combined with genomic data, offers the scientific community valuable insights ranging from population genetics to applications across the social sciences. Here we present quality-controlled whole exome sequencing data from three UK birth cohorts: the Avon Longitudinal Study of Parents and Children (8,436 children and 3,215 parents), the Millenium Cohort Study (7,667 children and 6,925 parents) and Born in Bradford (8,784 children and 2,875 parents). The overall objective of this coordinated effort is to make the resulting high-quality data widely accessible to the global research community in a timely manner. We describe how the datasets were generated and subjected to quality control at the sample, variant and genotype level. We then present some preliminary analyses to illustrate the quality of the datasets and probe potential sources of bias. We introduce measures of ultra-rare variant burden to the variables available for researchers working on these cohorts, and show that the exome-wide burden of deleterious protein-truncating variants, S het burden, is associated with educational attainment and cognitive test scores. The whole exome sequence data from these birth cohorts (CRAM & VCF files) are available through the European Genome-Phenome Archive, and here we provide guidance for their use.

Understanding the patterns and drivers of plant functional diversity is crucial for assessing the functioning and resilience of terrestrial ecosystems to global climate change. Despite the well-documented variability in plant species richness with elevation, the elevational patterns and underlying mechanisms of functional diversity remain poorly understood. This study employed drone equipped with multispectral and light detection and ranging (LiDAR) sensors to investigate the elevational gradients (3208 m to 3984 m) of physiological and morphological functional diversity of canopy tree species in six 1-hectare plots in Baima Snow Mountain, Yunnan, China. Results demonstrated that drone-based multispectral and LiDAR data enabled high-resolution mapping of physiological and morphological functional diversity in forest canopies over large areas. Importantly, functional diversity declined with increasing elevation, with a more pronounced pattern observed for physiological traits compared to morphological traits. Variance partitioning analysis revealed that functional richness was primarily driven by climatic and edaphic factors, particularly temperature, while plant factors played a subordinate role, interacting with climate and soil. Our findings highlight the potential of drone for rapid, large-scale monitoring and mapping of canopy species functional diversity in forests. Moreover, the influences of climate and soil factors on functional diversity suggest that future global warming may enhance functional diversity in alpine forest ecosystems, with implications for ecosystem functioning and services.

Abstract Oesophagomediastinal fistula is uncommon. Oesophageal fistulas, may manifest as recurrent pneumonias. While pulmonary infections can lead to pulmonary artery pseudoaneurysms (PAPs), particularly in fungal infections. PAPs pose a rupture risk, potentially causing life‐threatening hemoptysis. We report a unique case of a 45‐year‐old male who presented with sudden cough, dyspnea, and hemoptysis. Bronchoscopy triggered massive hemoptysis, necessitating emergency embolization. Persistent hemoptysis prompted further imaging, revealing an aneurysmal dilation located next to the spine and infectious lesions, suggesting an oesophagomediastinal fistula. After initiating therapy with Amphotericin B Cholesterol Sulfate Complex and fistula closure, the patient's hemoptysis resolved, with imaging resolution of the PAP. Long‐term Voriconazole therapy ensured continued improvement. This case highlights the rarity and severity of such fistulas may be associated with fungal infections and PAPs, emphasizing the importance of prompt recognition, aggressive treatment for favourable outcomes.

Abstract Synthetic biology applications require finely tuned gene expression, often mediated by synthetic transcription factors (sTFs) compatible with the human genome and transcriptional regulation mechanisms. While various DNA-binding and activation domains have been developed for different applications, advanced artificially controllable sTFs with improved regulatory capabilities are required for increasingly sophisticated applications. Here, in mammalian cells and mice, we validate the transactivator function and homo-/heterodimerization activity of the plant-derived phytochrome chaperone proteins, FHY1 and FHL. Our results demonstrate that FHY1/FHL form a photosensing transcriptional regulation complex (PTRC) through interaction with the phytochrome, ΔPhyA, that can toggle between active and inactive states through exposure to red or far-red light, respectively. Exploiting this capability, we develop a light-switchable platform that allows for orthogonal, modular, and tunable control of gene transcription, and incorporate it into a PTRC-controlled CRISPRa system (PTRCdcas) to modulate endogenous gene expression. We then integrate the PTRC with small molecule- or blue light-inducible regulatory modules to construct a variety of highly tunable systems that allow rapid and reversible control of transcriptional regulation in vitro and in vivo. Validation and deployment of these plant-derived phytochrome chaperone proteins in a PTRC platform have produced a versatile, powerful tool for advanced research and biomedical engineering applications.

Abstract Aim This study was conducted in Urumqi, Xinjiang, to assess the prevalence of sarcopenia and to determine the relationship between physical activity, nutritional status, and sarcopenia among community-dwelling patients with type 2 diabetes mellitus. Methods Four hundred eight cases of older people patients with type 2 diabetes mellitus in the community in Urumqi, Xinjiang, from May to August 2022 were selected for a cross-sectional on-site survey, and general information questionnaires, clinical information surveys, physical function measurements, and criteria developed by the Asian sarcopenia working group in 2019 were selected for diagnosis of sarcopenia, and unifactorial and multifactorial binary Logistic regression were applied to analyze the influencing factors of T2DM combined with sarcopenia in patients with sarcopenia. Results Among the 408 patients, 84 (20.6%) had sarcopenia, with a prevalence of 12.6%, 32.1%, and 51.9% in those aged 60–70, 71– 80, and 81 or older respectively. The prevalence increased significantly with age. Adjusting for variables, the study found that FFM of the Left Leg (OR: 0.710, 95% CI: 0.612–0.804, P = 0.024), FFM of the Right Arm (OR: 0.710, 95% CI: 0.612–0.804, P

Abstract Objectives Prolonged mechanical ventilation (PMV) is a common complication following cardiac surgery linked to unfavorable patient prognosis and increased mortality. This study aimed to search for the factors associated with the occurrence of PMV after valve surgery and to develop a risk prediction model. Methods The patient cohort was divided into two groups based on the presence or absence of PMV post-surgery. Comprehensive preoperative and intraoperative clinical data were collected. Univariate and multivariate logistic regression analyses were employed to identify risk factors contributing to the incidence of PMV. Based on the logistic regression results, a clinical nomogram was developed. Results The study included 550 patients who underwent valve surgery, among whom 62 (11.27%) developed PMV. Multivariate logistic regression analysis revealed that age (odds ratio [OR] = 1.082, 95% confidence interval [CI] = 1.042–1.125; P

Abstract Background Diffusion kurtosis imaging (DKI) and neurite orientation dispersion and density imaging (NODDI) provide more comprehensive and informative perspective on microstructural alterations of cerebral white matter (WM) than single-shell diffusion tensor imaging (DTI), especially in the detection of crossing fiber. However, studies on systemic lupus erythematosus patients without neuropsychiatric symptoms (non-NPSLE patients) using multi-shell diffusion imaging remain scarce. Methods Totally 49 non-NPSLE patients and 41 age-, sex-, and education-matched healthy controls underwent multi-shell diffusion magnetic resonance imaging. Totally 10 diffusion metrics based on DKI (fractional anisotropy, mean diffusivity, axial diffusivity, radial diffusivity, mean kurtosis, axial kurtosis and radial kurtosis) and NODDI (neurite density index, orientation dispersion index and volume fraction of the isotropic diffusion compartment) were evaluated. Tract-based spatial statistics (TBSS) and atlas-based region-of-interest (ROI) analyses were performed to determine group differences in brain WM microstructure. The associations of multi-shell diffusion metrics with clinical indicators were determined for further investigation. Results TBSS analysis revealed reduced FA, AD and RK and increased ODI in the WM of non-NPSLE patients (P

Owing to lifestyle changes since COVID-19, new needs for various usages and spatial experiences of open spaces have become apparent. Suburban parks and green spaces are thought to be suitable uses. This study used structural equation modeling to examine the direct and indirect effects of diverse usages and experiences on the desirability of three proposed park plans for a major park in City A, near Tokyo, based on questionnaire survey data. The findings highlight the importance of “Nature, Passive, and Healing” usage, including nature experiences and small-group activities. “Nature, Passive, and Healing” is negatively affected by “Gathering and Active” but positively by “Multifunctional and Borderless”. A potential for significant improvement in park desirability was also found by linking “Nature, Passive, and Healing” to “Multifunctional and Borderless”. For those aged 60 and older, the indirect effect of “Multifunctional and Borderless” via “Nature, Passive, and Healing” was large and significant, whereas its direct effect was not. “Multifunctional and Borderless” park usage was also been proven to have the greatest impact on female users, whereas, for males, “Nature, Passive, and Healing” had the largest impact. These results emphasize the importance of designs that balance diverse usages and ensure appropriate distancing to meet new needs.

Summary: Background: Premature ovarian failure (POF) is a prevalent and severe condition that impairs female health but there is currently no effective treatment available to restore ovarian function. Human amniotic epithelial cells (hAECs) exhibit ovarian protection in pre-clinical models. Thus, we conducted a single-arm, phase 1 clinical trial to assess the safety and efficacy of allogenic hAECs in treating POF. Methods: A total of 35 patients received 6 × 107 hAECs via ovarian artery and completed a five-month follow-up from December 30, 2020 to January 31, 2022. The follow-up assessments were conducted at various intervals after hAECs treatment, including one month (Visit-1, V-1), three months (Visit-2, V-2), and five months (Visit-3, V-3) post-treatment. The primary endpoints were incidence of adverse events (AEs), and clinically significant laboratory abnormalities. Secondary endpoints included evaluation of transvaginal ultrasound results, sex hormone levels, Menopausal Quality of Life (MENQOL) questionnaire, as well as reproductive indicators. This trial was registered at www.clinicaltrials.gov as NCT02912104. Findings: No serious AEs were observed throughout the five-month follow-up period. The most common AE was hematoma (7/35, 20.00%), and other AEs include pelvic pain (4/35, 11.43%), fever (2/35, 5.71%), anaphylaxis (2/35, 5.71%), and hepatotoxicity (1/35, 2.86%). After hAECs transplantation (hAECT), significant improvements were observed in the levels of endometrial thickness, left ovarian volume, sex hormones (follicle-stimulating hormone (FSH) and estradiol (E2)), and MENQOL scores in all patients during the five-month follow-up period. Among them, 13 participants (37.14%) experienced spontaneous menstrual bleeding, and 20.00% (7/35) reported more than one regular menstrual bleeding post-hAECT. In this response group, significant improvements were observed in endometrial thickness, left ovarian volume, levels of FSH, E2, anti-Müllerian hormone (AMH), and MENQOL scores one month after hAECT in comparison to pre-hAECT. Interpretation: hAECT via ovarian artery is safe, well-tolerated and temporarily ameliorates endometrial thickness, ovarian size, hormone levels, and menopausal symptoms in POF patients. Further randomized controlled trial of hAECs with longer follow-up period and a larger sample size is warranted. Funding: National Natural Science Foundation of China (No. 82271664), the Interdisciplinary Program of Shanghai Jiao Tong University (YG2022ZD028), the Shanghai Municipal Health Committee (202240345), Shanghai Key Laboratory of Embryo Original Diseases (No. Shelab2022ZD01), Shanghai Municipal Education Commission (No. 20152236), and National Key Research and Development Program of China (No. 2018YFC1004802), Shanghai Clinical Research Center for Cell Therapy, China (No. 23J41900100).

Objectives This study aimed to assess the factors influencing pregnant women’s participation in perinatal education and their demand for educational courses.Design A cross-sectional study.Setting Tertiary hospital in Suzhou, China, July–September 2022.Participants Pregnant women from a general grade A tertiary hospital in Suzhou were recruited via online survey invitations during the specified period.Measures A self-designed scale was used to evaluate pregnant women’s demand for perinatal education. Multiple response sets were employed for the assessment of multiple-choice items and analyses included frequency and cross-tabulation. Logistic regression analysis was conducted to assess the factors influencing pregnant women’s participation in perinatal education.Outcome The primary outcome measured was the demand for perinatal education among pregnant women.Results A majority (53.8%) of pregnant women expressed a preference for a mixed teaching mode combining online and offline formats. Logistic regression analysis showed that education level significantly influenced pregnant women’s participation in online learning. Specifically, women with higher education levels were more likely to participate actively in online courses. Additionally, compared with those with first-born children, pregnant women with second-born children participated less actively in online learning. Pregnant women in their second and third trimesters showed greater engagement in online learning compared with those in their first trimester.Conclusions These findings indicate that Chinese pregnant women’s preferences for perinatal education are influenced by their educational background, pregnancy history and the mode of teaching employed. The variability in educational needs underscores the importance of regularly updating course content based on participant feedback.

We report the case of a 54-year-old healthy Han Chinese male presenting with fever, pallor, erythematous subcutaneous nodules on the limbs, and significant anemia as indicated by routine blood tests, with no response to antimicrobial therapy. Initial skin biopsy was inconclusive. The erythematous subcutaneous nodules on the limbs rapidly progressed to widespread subcutaneous nodules across the body, with worsening anemia. Bone marrow biopsy revealed multifocal fibroblastic proliferation with focal fibrosis, classified as MF-2, and positive for the JAK2V617F mutation alongside SRSF2 positivity. Whole-body PET-CT scans did not reveal any lymph nodes or suspect lesions with high SUV uptake. A subsequent skin biopsy identified the condition as nodular panniculitis (NP), leading to a final diagnosis of primary myelofibrosis(PMF)with NP. The patient initially received treatment with oral ruxolitinib and prednisone acetate, resulting in normalization of body temperature, resolution of erythematous nodules, and normalization of blood parameters.

Sugarcane aphid, Melanaphis sacchari Zehntner, is an important piercing-sucking pest on sorghum, sugarcane, and other graminaceous crops, not only damaging host plants by direct feeding, but also transmitting plant viruses that is detrimental to crop production. To evaluate the performance of two native parasitoid species, Aphelinus varipes (Förster) and Lysiphlebia japonica (Ashmead), on M. sacchari, the age stage, two-sex life table analysis was conducted to evaluate the demographic parameters of the two species. The results showed that the two parasitoids parasitized M. sacchari and completed their whole life history. The number of eggs laid by A. varipes (F: 209.49 offspring/female) and the number of oviposition days (Od: 14.18 d) were significantly higher than those of L. japonica (F: 87.47 offspring/female, Od: 3.36 d). Moreover, the intrinsic rate of increase (r), finite rate of increase (λ), and net reproductive rate (R0) of A. varipes (r: 0.3746 d-1, λ: 1.4160 d-1, R0: 113.125 offspring/individual) were significantly higher for A. varipes than those of L. japonica (r: 0.3386 d-1, λ: 1.4030 d-1, R0: 48.092 offspring/individual). In addition, the net killing rate (C0) of A. varipes was 119.57 (eggs/female), which was significantly higher than that of L. japonica (53.34 eggs/female). These findings suggested that A. varipes had higher performance with promising potential as biological control agent for sugarcane aphid.

ObjectiveThis research aims to investigate the levels of lymphocytes, immunoglobulins, and cytokines in children with infantile spasms (IS) before and after adrenocorticotropic hormone (ACTH) therapy and to explore the application of these markers in evaluating the therapeutic effects of ACTH on infantile spasms.MethodsFrom May to November 2022, 35 children initially diagnosed with IS and treated at our hospital were regarded as the observation group, and 35 healthy children who underwent physical examination at our hospital during the same period were regarded as the control group. Children in the observation group received intramuscular injections of ACTH for 2 weeks. Fasting venous blood was collected from the control group and the observation group before and after ACTH therapy. Serum levels of immunoglobulins IgG, IgA, and IgM in serum were detected by immunoturbidimetry. T-cell subsets (CD3+, CD3+CD4+, and CD3+CD8+) and B-cell subsets [CD3−CD19+ and CD3−CD16+CD56+ natural killer (NK) cells] were detected by flow cytometry, and the ratio of CD3+CD4+/CD3+CD8+ was calculated. Serum levels of interleukin-1β (IL-1β), interleukin-2R (IL-2R), and interleukin-6 (IL-6) cytokines were detected by the enzyme-linked immunosorbent assay, and changes in serum cytokine and immunoglobulin levels in the two groups were compared before therapy, whereas in observation group one, these comparisons were made both before and after ACTH therapy.ResultsCompared to the control group, the observation group showed significantly increased serum levels of immunoglobulins IgG and IgM before therapy, while the level of IgA was significantly decreased (p 0.05); the levels of cytokines IL-1 β, IL-2R, and IL-6 were significantly increased (p 0.05). The percentages of CD3+ T cells and CD3+CD4+ T cells were significantly increased, while the percentages of CD3−CD16+CD56+ NK cells and CD3−CD19+ B cells were significantly decreased (p 0.05). Furthermore, the levels of cytokines IL-1 β, IL-2R, and IL-6 were significantly reduced (p