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Abstract Background Central obesity was considered as a risk factor for falls among the older population. Waist circumference (WC), lipid accumulation product (LAP), visceral adiposity index (VAI), and the Chinese visceral adiposity index (CVAI) are considered as surrogate markers for abdominal fat deposition in increasing studies. Nevertheless, the longitudinal relationship between these indices and falls among the older population remains indistinct. This study aimed to explore the association between abdominal obesity indices and falls among older community-dwellers. Methods Our study included 3501 individuals aged ≥ 65 years from the Guangzhou Falls and Health Status Tracking Cohort at baseline in 2021 and then prospectively followed up in 2022. The outcome of interest was the occurrence of falls. The Kaplan-Meier curves and multivariable Cox regression analysis were used to explore the associations between abdominal obesity indices and falls. Moreover, the restricted cubic spline analysis (RCS) was conducted to test the non-linear relationships between abdominal obesity indices and hazards of falls incident. Results After a median follow-up period of 551 days, a total of 1022 participants experienced falls. The cumulative incidence rate of falls was observed to be higher among individuals with central obesity and those falling within the fourth quartile (Q4) of LAP, VAI, and CVAI. Participants with central obesity and those in Q4 of LAP, VAI, and CVAI were associated with higher risk of falls, with hazard ratios (HRs) of 1.422 (HR 95%CI: 1.255–1.611), 1.346 (1.176–1.541), 1.270 (1.108–1.457), 1.322 (1.154–1.514), respectively. Each 1-SD increment in WC, LAP, VAI, and CVAI was a significant increased risk of falls among participants. Subgroup analysis further revealed these results were basically stable and appeared to be significantly stronger among those females, aged 65–69 years, and with body mass index (BMI) ≥ 28 kg/m2. Additionally, RCS curves showed an overall upward trend in the risk of falls as the abdominal indices increased. Conclusions Abdominal obesity indices, as WC, LAP, VAI, and CVAI were significantly associated with falls among older community-dwellers. Reduction of abdominal obesity indices might be suggested as the strategy of falls prevention.

As a “cold tumor”, triple-negative breast cancer (TNBC) exhibits limited responsiveness to current immunotherapy. How to enhance the immunogenicity and reverse the immunosuppressive microenvironment of TNBC remain a formidable challenge. Herein, an “in situ nanovaccine” Au/CuNDs-R848 was designed for imaging-guided photothermal therapy (PTT)/chemodynamic therapy (CDT) synergistic therapy to trigger dual immunoregulatory effects on TNBC. On the one hand, Au/CuNDs-R848 served as a promising photothermal agent and nanozyme, achieving PTT and photothermal-enhanced CDT against the primary tumor of TNBC. Meanwhile, the released antigens and damage-associated molecular patterns (DAMPs) promoted the maturation of dendritic cells (DCs) and facilitated the infiltration of T lymphocytes. Thus, Au/CuNDs-R848 played a role as an “in situ nanovaccine” to enhance the immunogenicity of TNBC by inducing immunogenic cell death (ICD). On the other hand, the nanovaccine suppressed the myeloid‐derived suppressor cells (MDSCs), thereby reversing the immunosuppressive microenvironment. Through the dual immunoregulation, “cold tumor” was transformed into a “hot tumor”, not only implementing a “turning foes to friends” therapeutic strategy but also enhancing immunotherapy against metastatic TNBC. Furthermore, Au/CuNDs-R848 acted as an excellent nanoprobe, enabling high-resolution near-infrared fluorescence and computed tomography imaging for precise visualization of TNBC. This feature offers potential applications in clinical cancer detection and surgical guidance. Collectively, this work provides an effective strategy for enhancing immune response and offers novel insights into the potential clinical applications for tumor immunotherapy.

Abstract Background Several studies have demonstrated that older adults with type 2 diabetes mellitus (T2DM) have a higher risk of falls compared to those without T2DM, which may lead to disability and a lower quality of life. While, limited prospective studies have quantified the associations in southern China. We conducted a longitudinal cohort study to quantify the associations between T2DM and falls and investigate the risk factors of falls among community-dwelling elderly people in Guangzhou, China. Methods The population-based study included 8800 residents aged 65 and over in 11 counties of Guangzhou at baseline in 2020 and then prospectively followed up through 2022. Of 6169 participants had complete follow-up and were included in the present study. A fall event was identified by self-reported. The Cox regression was applied to quantify the associations between T2DM and falls, and hazard ratios (HRs) were calculated to the factors associated with falls among participants. Results The median follow-up time for participants was 2.42 years. During the follow-up period, the incidence of falls among all participants was 21.96%. After adjusting for covariates in Cox regression models, T2DM remained a significant risk factor for falls, with HR of 1.781 (95% CI: 1.600-1.983) in the unadjusted covariates model and 1.757 (1.577–1.957) in the adjusted covariates model. Female (1.286, 1.136–1.457), older age (≥ 80: 1.448, 1.214–1.729), single marital status (1.239, 1.039–1.477), lower education level (primary school and below: 1.619, 1.004–1.361), hypertension (1.149, 1.026–1.286) and stroke (1.619, 1.176–2.228) were associated with a higher risk of falls, whereas everyday physical exercise (0.793, 0.686–0.918) was associated with a lower risk of falls. Conclusion Falls are common, with risks between T2DM and falls quantified and several factors investigated in the longitudinal cohort study among community-dwelling elderly people in Guangzhou, China. Targeted action on the risk factors may reduce the burden of falls in elderly people with T2DM in the future.

Abstract The dynamic behavior of a physical system often originates from its spectral properties. In open systems, where the effective non-Hermitian description enables a wealth of spectral structures in the complex plane, the concomitant dynamics are significantly enriched, whereas the identification and comprehension of the underlying connections are challenging. Here we experimentally demonstrate the correspondence between the transient self-acceleration of local excitations and the non-Hermitian spectral topology using lossy photonic quantum walks. Focusing first on one-dimensional quantum walks, we show that the measured short-time acceleration of the wave function is proportional to the area enclosed by the eigenspectrum. We then reveal a similar correspondence in two-dimension quantum walks, where the self-acceleration is proportional to the volume enclosed by the eigenspectrum in the complex parameter space. In both dimensions, the transient self-acceleration crosses over to a long-time behavior dominated by a constant flow at the drift velocity. Our results unveil the universal correspondence between spectral topology and transient dynamics, and offer a sensitive probe for phenomena in non-Hermitian systems that originate from spectral geometry.

Colorectal cancer (CRC) ranks as the second leading cause of cancer-related deaths globally, trailing only behind lung cancer, and stands as the third most prevalent malignant tumor, following lung and breast cancers. The primary cause of mortality in colorectal cancer (CRC) stems from distant metastasis. Among the various routes of metastasis in CRC, lymph node metastasis predominates, serving as a pivotal factor in both prognostication and treatment decisions for patients. This intricate cascade of events involves multifaceted molecular mechanisms, highlighting the complexity underlying lymph node metastasis in CRC. The cytokines or proteins involved in lymph node metastasis may represent the most promising lymph node metastasis markers for clinical use. In this review, we aim to consolidate the current understanding of the mechanisms and pathophysiology underlying lymph node metastasis in colorectal cancer (CRC), drawing upon insights from the most recent literatures. We also provide an overview of the latest advancements in comprehending the molecular underpinnings of lymph node metastasis in CRC, along with the potential of innovative targeted therapies. These advancements hold promise for enhancing the prognosis of CRC patients by addressing the challenges posed by lymph node metastasis.

Active phytochemicals with unique electron structures can adsorb on metal surfaces and effectively mitigate metal corrosion. Recently, plant extracts have garnered significant attention as green and renewable corrosion inhibitors. In this study, the abundant agricultural byproducts, namely Zea mays bracts, were used as the extract raw materials, and Zea mays bracts extract (ZMBE) was served as an eco-friendly corrosion inhibitor for mild steel (MS) in 1 M HCl pickling solution. The organic substances in ZMBE were analyzed via ultra-high performance liquid chromatography- quadrupole time-of-flight mass spectrometry (UPLC-QTFMS). The interaction between the active functional groups and MS was investigated using Fourier transform infrared (FT-IR) and ultraviolet–visible (UV–visible) spectroscopy and X-ray photoelectron spectroscopy (XPS). The corrosion inhibition behavior was scrutinized through potentiodynamic polarization (PDP) curves and electrochemical impedance spectroscopy (EIS). The results show that functional groups such as aromatic rings, double bonds, and hydroxyls successfully adsorb on the MS surface to form the protective films. ZMBE exhibits a mixed-type corrosion inhibition with a “geometric coverage” effect. The corrosion inhibition efficiency (η) increases with ZMBE concentration and solution temperature, the optimum η with 5.0 g·L−1 ZMBE at 318 K is 96.2 %. The adsorption of active ingredients follows the Langmuir and El-Awady isotherms. Density functional theory (DFT) and molecular dynamics (MD) simulations prove the synergistic effect of complex components in ZMBE and the corrosion inhibition mechanism. ZMBE is a promising acid pickling corrosion inhibitor with broad application prospects.

Background: Multimorbidity, individuals suffering from two or more chronic diseases, has become a major health challenge worldwide, especially in populous and prosperous cities, where studies of this phenomenon in China are limited. We examined the prevalence, trends, patterns, and associated factors of multimorbidity from 2009 to 2018 among community-dwelling adults in Guangzhou, China. Methods: We conducted serial cross-sectional surveys for chronic diseases in Guangzhou, China, in 2009, 2013, and 2018. General and stratified prevalence were standardized using demographic data. Multivariable logistic regression and hierarchical cluster analysis were applied to identify associated factors and to assess the correlations and patterns of multimorbidity, respectively. Results: This study included 23,284 adults aged 18 and over in 2009, 18,551 in 2013, and 15,727 in 2018. The standardized prevalence of multimorbidity increased substantially, with 12.69% (95% CI: 10.45–15.33) in 2009, 25.44% (95% CI: 23.47–27.52) in 2013, and 35.13% (95% CI:32.64−37.70) in 2018 (P for trend

CDT1, a gene that shows excessive expression in various malignancies, functions as a pivotal regulator of replication licensing. In this study, we observed a positive correlation in expression between CDT1 and E2F2 among patients with lung adenocarcinoma (LUAD). Our findings substantiated that E2F2 directly interacted with the promoter region of CDT1, as confirmed by ChIP-qPCR assays, and depletion of E2F2 resulted in a downregulation of CDT1 expression in LUAD cell lines by gene interference technology. Furthermore, we identified an upregulation of CDT1 mRNA level in Chinese LUAD samples. Notably, in the loss-of-function assays, depletion of CDT1 in LUAD cell lines inhibited cell proliferation, migration, and invasion. Concurrently, it promoted cell apoptosis and induced G0/G1 phase arrest using MTT, flow cytometry, and Transwell assays, reinforcing its role as an oncogene.Furthermore, enhanced tumor ablation was determined in a CDT1-downregulated LUAD tumor-bearing nude mouse model. Collectively, our results strongly suggest that E2F2 positively regulates CDT1 expression and actively participates in the progression of lung adenocarcinoma, thereby providing valuable insights into identifying novel therapeutic targets for LUAD treatment.

ObjectivesThis study investigated the prevalence of suicidal ideation (SI) among Chinese medical students and its associated risk factors.MethodsA total of 6643 medical students (2383 males/4260 females) were recruited from a medical college in Hebei Province, China. Demographic data were collected via a self-administered questionnaire. The Childhood Trauma Questionnaire Short Form (CTQ-SF) was used to evaluate childhood maltreatment (CM), and the Adolescent Self-Rating Life Events Checklist (ASLEC) was used to evaluate the stressful life events. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation (BSSI). Univariate and multivariate logistic regression models were used to analyze the factors affecting SI.ResultsThe prevalence of SI in medical students was 11.5% (763/6643). Multivariate logistic regression analysis revealed that SI was significantly associated with younger age, a female sex, being lovelorn, being introverted, experiencing CM during childhood, and experiencing stressful life events within the past 12 months. Of the five subtypes of CM, emotional abuse may have the strongest effect on SI (OR=2.76, 95% CI: 1.72–4.42). The joint effects of CM and stressful life events were significantly associated with an increased risk of SI (OR=5.39, 95% CI: 4.15–6.98).ConclusionThe prevalence of SI among medical students is high, and medical students who have experienced CM and stressful life events have a higher tendency towards SI. Screening for both CM and stressful life events may be an effective way of identifying individuals at high risk of SI.

Background: Accumulating evidence has shown that circular RNAs (circRNAs) are involved in gastric cancer (GC) tumorigenesis. However, specific functional circRNAs in GC remain to be discovered, and their underlying mechanisms remain to be elucidated. Methods: CircRNAs that were differentially expressed between GC tissues and controls were analyzed using a circRNA microarray dataset. The expression of circVDAC3 in GC was determined using quantitative real-time PCR (qRT-PCR), and the structural features of circVDAC3 were validated. Cell function assays and animal experiments were conducted to explore the effects of circVDAC3 on GC. Finally, bioinformatics analysis, fluorescent in situ hybridization, and dual luciferase assays were used to analyze the downstream mechanisms of circVDAC3. Results: Our results showed that circVDAC3 was downregulated in GC and inhibited the proliferation and metastasis of GC cells. Mechanistically, circVDAC3 acts as a competing endogenous RNA (ceRNA) of miR-592 and deregulates the repression of EIF4E3 by miR-592. EIF4E3 is downregulated in GC and overexpression of miR-592 or knockdown of EIF4E3 in circVDAC3-overexpressing cells weakens the anticancer effect of circVDAC3. Conclusion: Our study provides evidence that circVDAC3 affects the growth and metastasis of GC cells via the circVDAC3/miR-592/EIF4E3 axis. Our findings offer valuable insights into the mechanisms underlying GC tumorigenesis and suggest novel therapeutic strategies.

Abstract The accurate preoperative diagnosis and tracking of lung adenocarcinoma is hindered by non-targeting and diffusion of dyes used for marking tumors. Hence, there is an urgent need to develop a practical nanoprobe for tracing lung adenocarcinoma precisely even treating them noninvasively. Herein, Gold nanoclusters (AuNCs) conjugate with thyroid transcription factor-1 (TTF-1) antibody, then multifunctional nanoprobe Au-TTF-1 is designed and synthesized, which underscores the paramount importance of advancing the machine learning diagnosis and bioimaging-guided treatment of lung adenocarcinoma. Bright fluorescence (FL) and strong CT signal of Au-TTF-1 set the stage for tracking. Furthermore, the high specificity of TTF-1 antibody facilitates selective targeting of lung adenocarcinoma cells as compared to common lung epithelial cells, so machine learning software Lung adenocarcinoma auxiliary detection system was designed, which combined with Au-TTF-1 to assist the intelligent recognition of lung adenocarcinoma jointly. Besides, Au-TTF-1 not only contributes to intuitive and targeted visualization, but also guides the following noninvasive photothermal treatment. The boundaries of tumor are light up by Au-TTF-1 for navigation, it penetrates into tumor and implements noninvasive photothermal treatment, resulting in ablating tumors in vivo locally. Above all, Au-TTF-1 serves as a key platform for target bio-imaging navigation, machine learning diagnosis and synergistic PTT as a single nanoprobe, which demonstrates attractive performance on lung adenocarcinoma. Graphical Abstract

Background and aims: Non-tunneling and submucosal tunneling endoscopic resection (STER) techniques are the most frequent treatments for cardial submucosal tumor (SMT). Here, we analyzed common machine learning (ML) algorithms and compared them with traditional regression models in surgical decision-making for cardial SMTs. Methods: Using key baseline predictive factors, ML algorithms and logistic regression (LR) were conducted in 246 patients. For the ML algorithms, gradient boosting machines (GBM), artificial neural networks (ANN), random forests (RF), and support vector machines (SVM), were included. For small sample-sized data, a technique for k-fold cross-validation was exploited to avoid over-fitting. Meanwhile, we tuned the parameters through several replications. Then, we quantified the discrimination (area under the curve, AUC) and predictive ability (Brier score, F1 score, specificity, sensitivity, and accuracy) of models. We divided patients (n ​= ​246) into STER-treated (n ​= ​97) and non-tunneling endoscopic resection (NTER)-treated (n ​= ​149) groups. Results: LR outperformed among all groups (Brier score ​= ​0.1398, F1 score ​= ​0.7391, AUC ​= ​0.8729, and predictive accuracy ​= ​80.65 ​%). In comparison to ML algorithms, an outperformance of the traditional regression approach was also found in a low-dimensional setting for surgical decision prediction of cardial SMTs. Conclusions: The traditional regression approach outperformed ML algorithms for the prediction of the best surgical method in patients with SMTs.

This study presents the synthesis, structural characterization, and evaluation of the photocatalytic performance of two novel one-dimensional (1D) lead(II) bromide hybrids, [Co(2,2′-bpy)3][Pb2Br6CH3OH] (1) and [Fe(2,2′-bpy)3][Pb2Br6] (2), synthesized via solvothermal reactions. These compounds incorporate transition metal complex cations as structural directors, contributing to the unique photophysical and photocatalytic properties of the resulting materials. Single-crystal X-ray diffraction analysis reveals that both compounds crystallize in monoclinic space groups with distinct 1D lead bromide chain configurations influenced by the nature of the complex cations. Optical property assessments show band gaps of 3.04 eV and 2.02 eV for compounds 1 and 2, respectively, indicating their potential for visible light absorption. Photocurrent measurements indicate a significantly higher electron–hole separation efficiency in compound 2, correlated with its narrower band gap. Additionally, photocatalytic evaluations demonstrate that while both compounds degrade organic dyes effectively, compound 2 also exhibits notable hydrogen evolution activity under visible light, a property not observed in 1. These findings highlight the role of metal complex cations in tuning the electronic and structural properties of lead(II) bromide hybrids, enhancing their applicability in photocatalytic and optoelectronic devices.

BackgroundObservational studies have indicated a potential association between education and cardiovascular diseases (CVDs). However, uncertainties regarding the causal relationship persist. Therefore, this study aimed to investigate whether higher levels of education causally reduce the risks of CVDs.MethodsEmploying a two-sample Mendelian randomization (MR) design, our study examined the relationship between education and ten different CVDs. Utilizing data from the IEU Open GWAS database, relevant single nucleotide polymorphisms (SNPs) were identified through stringent screening criteria. Causality was assessed using the inverse-variance weighted (IVW), ME-Egger regression, and weighted median methods. Sensitivity analyses, including heterogeneity and pleiotropy tests, were conducted to ensure the robustness of our findings.ResultsOur study identified a genetic predisposition associated with an additional 3.6 years of education, which significantly reduced the risk of various CVDs. Specifically, this genetic factor was found to lower the risk of type 2 diabetes by 46.5%, coronary heart disease by 37.5%, ischemic stroke by 35.4%, cardiac-related mortality by 28.6%, heart failure by 28.2%, transient ischemic attack by 24%, atrial fibrillation by 15.2%, peripheral artery disease by 0.3%, and hypertension by 0.3%. However, no significant evidence revealed a causal relationship between education and pulmonary embolism.ConclusionOur study provides robust evidence supporting the role of higher educational attainment in reducing the incidence of various cardiovascular diseases, including type 2 diabetes, coronary heart disease, ischemic stroke, cardiac-related mortality, heart failure, transient ischemic attack, atrial fibrillation, peripheral artery disease, and hypertension. However, the impact of education on pulmonary embolism remains inconclusive.

Abstract Matter transport is a fundamental process in nature. Understanding and manipulating flow in a synthetic media often have rich implications for modern device design. Here we experimentally demonstrate directional transport of photons in a two-dimensional quantum walk, where the light propagation is highly tunable through dissipation and synthetic magnetic flux. The directional flow hereof underlies the emergence of the non-Hermitian skin effect, with its orientation continuously adjustable through the photon-loss parameters. By contrast, the synthetic magnetic flux originates from an engineered geometric phase, which, by inducing localized cyclotron orbits, suppresses the bulk flow through magnetic confinement. We further demonstrate how the directional flow and synthetic flux impact the dynamics of the Floquet topological edge modes along an engineered boundary. Our results exemplify an intriguing strategy for engineering directed light transport, highlighting the interplay of non-Hermiticity and gauge fields in synthetic systems of higher dimensions.

After over three years of COVID-19, it has become clear that infectious diseases are difficult to eradicate, and humans remain vulnerable under their influence in a long period. The presence of presymptomatic and asymptomatic patients is a significant obstacle to preventing and eliminating infectious diseases. However, the long-term transmission of infectious diseases involving asymptomatic patients still remains unclear. To address this issue, this paper develops a novel Markov process for infectious diseases with asymptomatic patients by means of a continuous-time level-dependent quasi-birth-and-death (QBD) process. The model accurately captures the transmission of infectious diseases by specifying several key parameters (or factors). To analyze the role of asymptomatic and symptomatic patients in the infectious disease transmission process, a simple sufficient condition for the stability of the Markov process of infectious diseases is derived using the mean drift technique. Then, the stationary probability vector of the QBD process is obtained by using RG-factorizations. A method of using the stationary probability vector is provided to obtain important performance measures of the model. Finally, some numerical experiments are presented to demonstrate the model's feasibility through analyzing COVID-19 as an example. The impact of key parameters on the system performance evaluation and the infectious disease transmission process are analyzed. The methodology and results of this paper can provide theoretical and technical support for the scientific control of the long-term transmission of infectious diseases, and we believe that they can serve as a foundation for developing more general models of infectious disease transmission.