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Abstract Early insulin therapy is capable to achieve glycemic control and restore β-cell function in newly diagnosed type 2 diabetes (T2D), but its effect on cardiovascular outcomes in these patients remains unclear. In this nationwide real-world study, we analyzed electronic health record data from 19 medical centers across China between 1 January 2000, and 26 May 2022. We included 5424 eligible patients (mean age 56 years, 2176 women/3248 men) who were diagnosed T2D within six months and did not have prior cardiovascular disease. Multivariable Cox regression models were used to estimate the associations of early insulin therapy (defined as the first-line therapy for at least two weeks in newly diagnosed T2D patients) with the incidence of major cardiovascular events including coronary heart disease (CHD), stroke, and hospitalization for heart failure (HF). During 17,158 persons years of observation, we documented 834 incident CHD cases, 719 stroke cases, and 230 hospitalized cases for HF. Newly diagnosed T2D patients who received early insulin therapy, compared with those who did not receive such treatment, had 31% lower risk of incident stroke, and 28% lower risk of hospitalization for HF. No significant difference in the risk of CHD was observed. We found similar results when repeating the aforesaid analysis in a propensity-score matched population of 4578 patients and with inverse probability of treatment weighting models. These findings suggest that early insulin therapy in newly diagnosed T2D may have cardiovascular benefits by reducing the risk of incident stroke and hospitalization for HF.

Abstract Aims The current management of patients with atrial fibrillation (AF) and concomitant heart failure (HF) remains a significant challenge. Catheter ablation (CA) has been shown to improve left ventricular ejection fraction (LVEF) in these patients, but which patients can benefit from CA is still poorly understood. The aim of our study was to determine the predictors of improved ejection fraction in patients with persistent atrial fibrillation (PeAF) complicated with HF undergoing CA. Methods and results A total of 435 patients with persistent AF underwent an initial CA between January 2019 and March 2023 in our hospital. We investigated consecutive patients with left ventricular systolic dysfunction (LVEF

Abstract The performance of the heavy-duty escalator truss greatly affects the stability and service life of the whole escalator system, and the manufacturing cost of truss structure accounts for more than 1/5. Thus, how to design the truss structure reasonably is a pivotal issue drawing the attention of numerous engineers and researchers. In this work, the experimental research of heavy-duty escalators under full load conditions were performed in terms of the end restraints, the docking port clearances, and the deflection. Based on the experimental results, the three-dimensional simulation model of truss structure was created, and the influences of various factors such as the internal chamfer of truss member, the lower deviation of truss member, the dead weight of escalator, and the pretension force of each bolt at the docking port were analyzed and quantified. Finally, the finite element model which can almost completely characterize the actual structure was obtained with slight difference. The conclusions drawn in this work provide the basis for the efficient design, correct simulation, low cost production and rapid installation of the heavy-duty escalator truss.

Objective To examine the association of cerebral palsy with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), providing evidence for interdisciplinary medical service for children with cerebral palsy.Design A large-scale nationwide population-based study.Setting The National Health Interview Survey (NHIS).Patients 177 899 children aged 3–17 years among NHIS participants from 1997 to 2003 and 2008 to 2018.Results Among the 177 899 children included in this analysis, 602 (0.33%) had cerebral palsy, 1997 (1.16%) had ASD, and 13 697 (7.91%) had ADHD. Compared with children without cerebral palsy, children with cerebral palsy had a higher prevalence of ASD (6.09% vs 1.15%; p

The honeycomb magnetic carbons (xFe@HCNs) were prepared by sacrificial template method novelty using polyacrylamide resin (PAAS) as template and ammonium pyrrolidine dithioate/Fe3+ complex (APDC-Fe) as carbon skeleton and metal source. Tetracycline (TC) and copper (Cu2+) as target pollutants were used to investigate the adsorption properties of xFe@HCNs in single or binary TC and Cu2+ systems. The adsorption capacity sequence for TC among the adsorbents was (mmol·g−1): 2Fe@HCNs (0.088) > 8Fe@HCNs (0.061) > HCNs (0.054) > RC (0.036), and for Cu2+ was (mmol·g−1): 2Fe@HCNs (1.120) > 8Fe@HCNs (1.026) > RC (0.792) > HCNs (0.681). 2Fe@HCNs demonstrated notable affinity for adsorbing both TC and Cu2+. Additionally, the influence of hydrochemical factors (i.e., cation species, anion species, and pH) on the adsorption properties of 2Fe@HCNs. Combined with advanced oxidation technology, the regeneration methods of magnetic adsorbent were explored using oxidizing agents (e.g., H2O2 and peroxymonosulfate) as eluents which could increase the adsorption sites of magnetic carbon adsorbents during the regenerating process, which was the novelty of the study. Furthermore, the regeneration mechanisms of H2O2 as eluent were investigated. This study discussed the application and regeneration methods of magnetic adsorbents in water treatment, offering new insights into environmental remediation using magnetic materials.

Abstract Purpose The study retrospectively analyzed the accuracy and predictive ability of preoperative integrated whole-body 18F-FDG PET/CT for the assessment of high-risk factors in patients with endometrial carcinoma (EC). Materials and methods A total of 205 patients with endometrial cancer who underwent preoperative PET/CT at Shanghai General Hospital from January 2018 to December 2021 were retrospectively evaluated and last follow-up was June 2023. Our study evaluated the ability and optimal cutoff values of three metabolic and volumetric parameters—standardized uptake value (SUV), metabolic tumor volume (MTV) and total lesion glycolysis (TLG)—to predict deep myometrial invasion (DMI), endocervical stroma invasion (ESI) and lymph node metastases (LNM) in endometrial cancer. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PET/CT were used to assess the diagnostic performance for the prediction. Results Our study demonstrated a significant relationship between SUVmax (11.29, 17.38, 9.47), SUVmean (5.20, 6.12, 4.49), MTV (38.15, 36.28, 33.79 ml), and TLG (199.30, 225.10, 156.40 g) on PET/CT and histologically confirmed DMI, ESI and LNM in endometrial carcinoma (EC), with sensitivity, specificity, accuracy, PPV, and NPV of 100%/100%/100%, 96.53%/98.89%/87.14%, 97.56%/99.02%/91.22%, 92.42%/92.85%/78.31%, and 100%/100%/100%, respectively. Our study showed a risk model based on optimal cutoff values for MTV and TLG of 19.6 ml/126.3 g, 20.54 ml/84.80 g and 24 ml/49.83 g to preoperatively predict DMI, ESI, and LNM, respectively, in endometrial carcinoma. The 4-year OS (HR) for Stage IA, IB, II, III and IV according to 2009 FIGO was 98.00% (0.22), 95.20% (0.04), 83.90% (0.18), 90.50% (0.09) and 60% (0.51). Accordingly, estimated 4-year DFS (HR) for the stage IA-III was 98% (0.02), 95.20% (0.05), 76.90% (0.27) and 76.30% (0.35), all the patients in stage IV occurred recurrence and progression. Conclusion The present study showed patients with MTV > = 19.6 ml of MI and PET- positive LN with MTV cutoff > = 24 ml tended to predict poor OS and PFS in endometrial carcinoma. The cutoff of MTV and TLG in PET/CT assessment could be an independent prognostic factors to predict aggressive forms of EC. Graphic Abstract

Abstract Background Few previous studies have introduced general techniques to overcome the “chopstick effect” in laparoendoscopic single-site surgery (LESS). We aim to investigate and highlight the key ergonomic methodologies for gynaecologic LESS based on the surgeon’s hands-on performance. Methods The first author surgeon A reviewed and analyzed the LESS procedures performed by herself and how she taught surgeon B from January 2021 to April 2022. The procedures were classified based on technical difficulty and learning periods, and the hands-on technical skills of LESS module were evaluated. Results Surgeon A conducted 580 LESS procedures, which were divided into the novice (n = 48) and intermediate (n = 33) periods, and the remaining cases were included in the routine period. We formed a special ergonomic LESS operating methodology: Maintain good LESS laparoscopic spatial sensation, keep hand-eye coordination, well cooperation between the main surgeon and the assistant; Experienced multiport laparoscopy surgery (MPS) skills, improve basic LESS technique: grasp, lift, transfer, place, blunt separating, coagulation and cutting. Coordination location, orientation, movements, and flexion or extension of shoulders, arms, elbow, wrist and finger joints; Maintain strength, tension and ambidexterity postures with joint and muscular efforts to control instruments. Surgeon B learned the above experiences by performing 39 LESS procedures under the guidance of surgeon A. Conclusion This educational research sheds light on the common challenges faced in LESS and presents the importance of ergonomic hands-on performance skills in improving surgical outcomes, which could serve as a guide for future training and education in LESS.

Abstract Few studies have investigated the potential combined effects of multiple PCB congeners on diabetes. To address this gap, we used data from 1244 adults in the National Health and Nutrition Examination Survey (NHANES) 2003–2004. We used (1) classification trees to identify serum PCB congeners and their thresholds associated with diabetes; and (2) logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of diabetes with combined PCB congeners. Of the 40 PCB congeners examined, PCB 126 has the strongest association with diabetes. The adjusted OR of diabetes comparing PCB 126 > 0.025 to ≤ 0.025 ng/g was 2.14 (95% CI 1.30–3.53). In the subpopulation with PCB 126 > 0.025 ng/g, a lower PCB 101 concentration was associated with an increased risk of diabetes (comparing PCB 101 0.025 & PCB 101 0.65 to ≤ 0.65 ng/g, OR 2.79, 95% CI 1.06–7.35). This nationally representative study provided new insights into the combined associations of PCBs with diabetes.

Abstract Background Parkinson’s disease (PD) is often clinically associated with posture instability and more easily falling. The Berg balance scale is a clinical indicator commonly used to subjectively evaluate a patient’s balance ability. Meanwhile, computerized force platforms have been used in research on postural control. The various parameters obtained from posturography are interpreted to assess balance ability. The present study aims to explore the correlations between posturographic variables and the BBS, and furthermore to efficiently evaluate postural instability and fall risk of early and moderate PD patients. Methods A total of 46 PD patients were involved in the experiment. Patients were asked to perform BBS tests and force platform tests under eye open (EO) and eye closed (EC) conditions. The recorded COP signal was analyzed with the time domain statistical method, the frequency domain method of Power Spectral Density (PSD), and structural methods of Stabilogram Diffusion Analysis (SDA), Sway Density Plot (SDP) to retrieve different posturographic variables. The correlation between posturographic variables under EO and EC conditions with BBS was compared statistically. The significantly correlated posturographic parameters were then applied to analyze posturographic differences between different groups: faller vs. non-faller (patients with/without a history of falls in the past 12 months). Results Among the different posturographic parameters, the prediction ellipse area, the slope of the regression line at a high-frequency band of PSD in the medial-lateral (ML) direction, the crossover point of the regression lines of SDA in the anterior-posterior (AP) direction, and the distance between successive peaks of SDP had significant correlations with BBS. These selected BBS-related parameters also showed significant differences between faller and non-faller. The selected posturographic parameters can be used as effective indicators to evaluate the balance ability of Parkinson’s disease patients.

Nano-calcium carbonate (NC) is a novel ultrafine solid powder material that possesses quantum size effects, small size effects, surface effects, and macroscopic quantum effects that ordinary calcium carbonate lacks. As a nanomaterial with superior properties, graphene oxide (GO) has been studied extensively in the field of construction. In microscopic characterization, the reaction between NC and tricalcium aluminate (C3A) formed a new hydration product, hydrated calcium aluminum carbonate (C3A·CaCO3·11H2O), which enhanced the arrangement of hydration products and optimized the distribution of pore size in the mortar. Regarding the mechanical properties, the addition of GO and NC significantly enhanced the early-age mechanical performance of the mortar. In terms of durability, the incorporation of GO and NC significantly improved the water permeability, chloride ion permeability, and resistance to sulfate attack of the cement mortar. In this study, it was found that adding 1 wt% NC and 0.02 wt% GO not only improves the mechanical and durability properties but also promotes the hydration reaction according to the microstructure analysis. With the help of NC, compared with other studies, the amount of GO is reduced, while the cost is reduced, and the application of GO in the field of cement-based materials is promoted.

BackgroundThe fermented wax gourd, often referred to as “smelly wax gourd,” is a traditional food that undergoes natural fermentation. It’s a staple in eastern China and is recognized as Ningbo’s “city-fermented food.” Characterized by its distinct putrid flavor and soft texture, its safety, nutritional aspects, and sensory attributes have not been extensively studied.MethodsIn this research, the microbial community and flavor components of fermented wax gourd during its traditional fermentation were analyzed. The safety and impact on the gut microbiota were also assessed by administering it to healthy and pseudo-germ-free mice.ResultsThe findings revealed that organic acids primarily contribute to the gourd’s flavor during fermentation. The aroma reminiscent of fruits is due to 2-methyl-butyric acid, while butyric, pentanoic, caproic, and octanoic acids are responsible for their characteristic smelly taste. In the fermentation of traditional foods, the abundance of substances and open fermentation contribute to the diversity of microorganisms in the system, and the reproduction and metabolism of microorganisms drive the fermentation of foods. From the results of this study, the flavor peaks on the 10th day of fermentation. Predominant microbes include Lactobacillus fermentum, Streptococcus equinus, Fusobacterium perfoetens, Weissella confusa, and Lactobacillus plantarum. Notably, Lactobacillus was the most abundant probiotic in the early fermentation stages. The “smelly” taste of smelly wax gourd was mainly derived from butyric acid, valeric acid, caproic acid, caprylic acid, p-methylphenol and other compounds, and the abundance of Caldicoprobacter algeriensis, Mariniphaga anaerophila, Streptococcus equi and Lactobacillus were significantly correlated with 4 of the above 5 acids. These four bacteria may contribute more to the “smelly” taste of smelly wax gourd. In the study, compared with the control group (CONT), the abundance of Helicobacter ganmani, H. Chanicola, Lactobacillus animalis, Lactobacillus gadi and Lactobacillus reuteri decreased in mice groups treated with anti-biological pretreatment followed by gavage of smelly wax gourd (A.SWG) and the smelly wax gourd (SWG) groups. Conversely, Muribaculum intestinale, Prevotellamassilia timonensis, Alistipes putredinis, Kineothrix alysoides and Clostridium indolis’ abundance of increases. Mice that underwent fecal microbiota transplantation (FMT) exhibited a higher abundance of probiotics like Bifidobacterium animalis, Bifidobacterium pseudolongum, Lactobacillus johnsonii, and others compared to the fecal culture microbiota transplantation (CMT) group. However, the CMT group had a higher presence of fermented and Royce lactobacilli.ImplicationConsuming fermented wax gourd can enhance the presence of beneficial probiotics and reduce pathogenic Helicobacter sp. in the mouse gut. Both Lactobacillus sp. and Bifidobacterium sp. showed increased abundance post fecal microbiota and fecal culture microbiota transplantation.

Objective: The high mortality rate of epithelial ovarian cancer (EOC) is often attributed to the frequent development of chemoresistance. DNA methylation is a predictive biomarker for chemoresistance. Methods: This study utilized DNA methylation profiles and relevant information from GEO and TCGA to identify different methylated CpG sites (DMCs) between chemoresistant and chemosensitive patients. Subsequently, we constructed chemoresistance risk models with DMCs. The genes corresponding to candidate DMCs in chemoresistance risk models were further analyzed to identify different methylated gene symbols (DMGs) associated with chemoresistance. The DMGs that showed a strong correlation with the corresponding DMCs were analyzed through immunohistochemistry. Results: Compared to chemosensitive EOC patients, chemoresistant patients showed 423 hypermethylated CpGs and 1445 hypomethylated CpGs. The chemoresistance risk models based on DMCs have shown the improved predictive ability for chemoresistance in EOC (AUC = 65.0–76.2%). The methylations of cg25510164, cg13154880, cg15362155 and cg08665359 were strongly associated with decreased risk of chemoresistance. Conversely, the methylation of cg08872590 and cg14739437 significantly increased the risk. We identified 13 DMGs, from 47 DMCs corresponding genes, between chemosensitive and chemoresistant samples. Among the DMGs, the expression levels of DDR2 and OPCML exhibited strong correlations with the corresponding DMCs. DDR2 and OPCML both showed enhanced expression in chemoresistant ovarian microarray tissue. Conclusions: Hypomethylated CpGs may play a significant role in DNA methylation associated with chemoresistance in EOC. The epigenetic modification of DDR2 could have important implications for the development of chemoresistance. Our study provides valuable insights for future research on DNA methylation in the chemoresistance of EOC.

Abstract Background Diets rich in plant-based foods are associated with lower risks of non-alcoholic fatty liver disease (NAFLD), while the prospective evidence is limited. We aimed to examine longitudinal associations of plant-based diets and genetic susceptibility with NAFLD risk. Methods This longitudinal cohort study included 159,222 participants (58.0 ± 8.0 years old, 55.7% female) free of NAFLD in the UK Biobank. We calculated the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI). New-onset NAFLD was the primary outcome. The weighted polygenic risk score was calculated based on risk variants associated with NAFLD. Hazard ratios (HR) and 95% confidential intervals (CI) were estimated by Cox proportional hazards model. Magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) measured liver fat content in a subsample of 20,692 participants (57.5 ± 7.4 years old, 52.6% female) was the secondary outcome. The associations between plant-based diet indices and MRI-PDFF were evaluated using generalized linear models. Results During a median follow-up of 9.5 years, 1541 new-onset NAFLD cases were documented. Compared to the lowest quintile, multivariable-adjusted hazard ratios (HRs) of NAFLD in the highest quintile were 0.78 (95% confidential intervals [CI], 0.66–0.93, p-trend =0.02), 0.74 (95% CI, 0.62–0.87, p-trend

The long-standing fermented meat products were deeply popular with consumers due to the distinctive flavor and long storage life. From the point of protein degradation in the process of fermentation of meat products and based on the recent researches of fermented meat products, this paper discusses the factors affecting the muscle protein degradation including the function of microbial proteases and endogenous enzymes, and the protein hydrolysis activity of core microorganism. The structure changes of muscle protein during fermentation are analyzed, including secondary and tertiary structure and functional properties of protein. This paper furthermore summarizes how the muscle protein degradation during fermentation improving the texture properties and flavor of the fermented meat products, and deterioration of products due to excessive protein degradation. Finally, the perspectives of the future researches are listed in order to provide some meaningful ideas for the intensive study of the fermentation control of meat products.

Abstract Background Arterial stiffness has been shown to be an independent risk factor for adverse events and all-cause mortality in patients. Although PWV is the gold standard for pulse wave velocity, its application in clinical practice is limited by the high cost and complexity. ePwv is a new, simple, non-invasive indicator of arterial stiffness. The aim of this study was to assess the relationship between ePwv and all-cause mortality in patients with coronary artery disease. Methods This is a cohort study, selected from NHANES 2005 to 2008, 402 patients with coronary artery disease were included. The ePWV was divided into two groups and KM survival curves were used to calculate cumulative mortality in patients with coronary artery disease. Restricted cubic spline were used to represent the relationship between ePWV and all-cause mortality in patients with coronary artery disease. Cox regression was used to diagnose the relationship between ePwv and all-cause mortality. Results The mean age of the study subjects was 68.5 ± 11.8 years, of which 282 (70.1%) were men and 120 (29.9%) were women. During 180 months of follow-up, 160 all-cause mortality occurred. KM survival curves indicated that all-cause mortality increased with increasing ePWV. The relationship between ePWV and all-cause mortality in patients with coronary artery disease was verified by cox models. Patients in higher ePWV tertile tended to have higher all-cause mortality. After complete multivariate adjustment, an increase in ePWV was positively associated with all-cause mortality (HR = 1.180, 95% confidence interval (CI): 1.056–1.320). The multivariate-adjusted HR and 95% CI for the highest ePWV tertile was 1.582 (95% CI: 0.968–2.587) compared to the lowest tertile. In addition, the association between ePWV and mortality was visualized employing restricted spline curves, in which we found curves indicating a possible threshold for the effect of ePWV on all-cause mortality, with HR less than 1 when ePWV was less than 11.15 m/s; thereafter, there was a tendency for HR to increase with enhanced ePWV. Subgroup analysis showed that the correlation between ePWV and mortality persisted in population subgroups. Conclusion Our findings suggest that higher ePWV is associated with increased all-cause mortality in patients with coronary artery disease, particularly when ePWV exceeds 11.15 m/s.

Barley (Hordeum vulgare L.), a diverse cereal crop, exhibits remarkable versatility in its applications, ranging from food and fodder to industrial uses. The content of cellulose in barley is significantly influenced by the COBRA genes, which encode the plant glycosylphosphatidylinositol (GPI)-anchored protein (GAP) that plays a pivotal role in the deposition of cellulose within the cell wall. The COBL (COBRA-Like) gene family has been discovered across numerous species, yet the specific members of this family in barley remain undetermined. In this study, we discovered 13 COBL genes within the barley genome using bioinformatics methods, subcellular localization, and protein structure analysis, finding that most of the barley COBL proteins have a signal peptide structure and are localized on the plasma membrane. Simultaneously, we constructed a phylogenetic tree and undertook a comprehensive analysis of the evolutionary relationships. Other characteristics of HvCOBL family members, including intraspecific collinearity, gene structure, conserved motifs, and cis-acting elements, were thoroughly characterized in detail. The assessment of HvCOBL gene expression in barley under various hormone treatments was conducted through qRT-PCR analysis, revealing jasmonic acid (JA) as the predominant hormonal regulator of HvCOBL gene expression. In summary, this study comprehensively identified and analyzed the barley COBL gene family, aiming to provide basic information for exploring the members of the HvCOBL gene family and to propose directions for further research.

The cognitive reflection test (CRT) is an experiment task commonly used in Western countries to test intuitive and analytical thinking styles. However, the validity of this task for Chinese participants has not been explored. Therefore, this study recruited Chinese college students to finish CRT tasks with various experimental designs. To gauge the accuracy of the CRT tasks, 438 Chinese college students first completed online questionnaires. Participants were then invited to participate in an offline laboratory with the same experimental settings. Finally, time pressure was used to strictly control intuition and analytical thinking to explore the performance of Chinese college students on CRT tasks. The results show that of the three experiments, Chinese college students had the highest accuracy in the offline test, and the CRT’s intuitive conflict problem still applies to Chinese students under the time-limited condition. This study demonstrates the validity of the CRT in China and proves that time pressure is an effective method for identifying individuals with strong logic ability.

Abstract Poly(ADP-ribose) polymerase inhibitors (PARPis) induce DNA lesions that preferentially kill homologous recombination (HR)-deficient breast cancers induced by BRCA mutations, which exhibit a low incidence in breast cancer, thereby limiting the benefits of PARPis. Additionally, breast cancer cells, particularly triple-negative breast cancer (TNBC) cells, exhibit HR and PARPi resistance. Therefore, targets must be identified for inducing HR deficiency and sensitizing cancer cells to PARPis. Here, we reveal that CXorf56 protein increased HR repair in TNBC cells by interacting with the Ku70 DNA-binding domain, reducing Ku70 recruitment and promoting RPA32, BRCA2, and RAD51 recruitment to sites of DNA damage. Knockdown of CXorf56 protein suppressed HR in TNBC cells, specifically during the S and G2 phases, and increased cell sensitivity to olaparib in vitro and in vivo. Clinically, CXorf56 protein was upregulated in TNBC tissues and associated with aggressive clinicopathological characteristics and poor survival. All these findings indicate that treatment designed to inhibit CXorf56 protein in TNBC combined with PARPis may overcome drug resistance and expand the application of PARPis to patients with non-BRCA mutantion.

ABSTRACTVibrio cholerae adapts to the host environment by altering gene expression. Because of the complexity of the gut microbiome, current in vivo V. cholerae transcriptome studies have focused on microbiota-undeveloped conditions, neglecting the interaction between the host’s commensal gut microbiota and V. cholerae. In this study, we analyzed the transcriptome of fully colonized adult mice in vivo using V. cholerae coated-magnetic chitin beads (vcMCB). This provides a simple yet powerful method for obtaining high-quality RNA from V. cholerae during colonization in mice. The transcriptome of V. cholerae recovered from adult mice infected with vcMCB shows differential expression of several genes when compared to V. cholerae recovered from the infant mouse and infant rabbit model. Some of these genes were also observed to be differentially expressed in previous studies of V. cholerae recovered from human infection when compared to V. cholerae grown in vitro. In particular, we confirmed that V. cholerae resists the inhibitory effects of low pH and formic acid from gut microbiota, such as Anaerostipes caccae and Dorea formicigenerans, by downregulating vc1080. We propose that the vc1080 product may protect V. cholerae from formic acid stress through a novel acid tolerance response mechanism. Transcriptomic data obtained using the vcMCB system provide new perspectives on the interaction between V. cholerae and the gut microbiota, and this approach can also be applied to studies of other pathogenic bacteria.

Objective To examine the efficacy and safety of telitacicept in the treatment of patients with SLE in everyday clinical practice.Methods Seventy-two patients with active SLE who received telitacicept for more than 24 weeks at multiple centres in China between 2019 and 2022 were retrospectively identified. Twenty-one of these patients received 52 continuous weeks of treatment with telitacicept. Treatment outcomes were analysed separately according to whether patients had renal or haematological abnormalities. Trajectory analysis was performed to identify patients with a limited response. Factors contributing to a limited response were explored by multivariable logistic regression analysis.Results After treatment with telitacicept for 4, 12, 24 and 52 weeks, 22.22%, 54.17%, 72.22% and 80.95% of patients, respectively, achieved an SLE Responder Index 4; 8.33%, 26.39%, 34.72% and 47.62% achieved a Lupus Low Disease Activity State; and 0%, 4.17%, 8.33% and 23.81% achieved remission. Significant decreases in serum IgA, IgG and IgM levels were observed at 4 weeks and showed a downward trend at 12, 24 and 52 weeks. The median 24-hour urinary protein declined from 1323.5 mg to 224.0 mg in patients with lupus nephritis after treatment with telitacicept for 52 weeks. Furthermore, a large proportion of patients (10 of 13) with haematological abnormalities recovered after 52 weeks of treatment with telitacicept. No severe adverse events were reported during the observation period. Age appeared to have a negative impact on treatment efficacy.Conclusions Telitacicept demonstrated favourable efficacy and safety in patients with active SLE and improved the renal and haematological manifestations of the disease.

PurposeTo investigate the impact of N6-methyladenosine- (m6A) and neutrophil extracellular traps- (NETs) related lncRNAs (MNlncRNAs) on the prognosis of hepatocellular carcinoma (HCC).MethodsWe collected m6A and NETs-related genes from published studies. We identified the MNlncRNAs by correlation analysis. Cox regression and the least absolute selection operator (LASSO) method were used to select predictive MNlncRNAs. The expressions of predictive MNlncRNAs were detected by cell and tissue experiments. Survival, medication sensitivity, and immunological microenvironment evaluations were used to assess the model’s prognostic utility. Finally, we performed cellular experiments to further validate the model’s prognostic reliability.ResultsWe obtained a total of 209 MNlncRNAs. 7 MNlncRNAs comprised the prognostic model, which successfully stratifies HCC patients, with the area under the curve (AUC) ranging from 0.7 to 0.8. In vitro tests confirmed that higher risk patients had worse prognosis. Risk score, immunological microenvironment, and immune checkpoint gene expression were all significantly correlated with each other in HCC. In the group at high risk, immunotherapy could be more successful. Cellular assays confirmed that HCC cells with high risk scores have a higher proliferation and invasive capacity.ConclusionThe MNlncRNAs-related prognostic model aided in determining HCC prognosis, revealing novel therapeutic options, notably immunotherapy.

The strata with large impedance differences are presented as strong amplitude seismic events on the seismic profile, which obscure useful information of nearby reservoirs and need interpretive target processing to remove the strong shielding. Therefore, this study proposes a multi-channel matching pursuit algorithm based on adaptive weight to remove strong shielding. Moreover, to address the problem of poor matching accuracy and spatial continuity of normal multi-channel matching pursuit at area where strong tectonic changes occur, a multi-channel matching pursuit de-strong shielding method based on adaptive weights is proposed. First, we used the layer structure information to flatten the strong reflection layer locally to weaken the influence of stratigraphic structure changes on the extraction of the strong reflection layer. Subsequently, we introduced a correlation coefficient between adjacent seismic traces and the central trace as the weight of multi trace averaging, which improved the stability and lateral continuity of the matching results. The result analysis of model processing tests and practical seismic data application shows that the proposed method can effectively strip the strong reflections and highlight the effective reservoir information; the well seismic match degree is significantly improved with higher matching accuracy, better spatial continuity, and better striping effect than those of the conventional matching pursuit algorithm.

Automatic Generation Control (AGC) is a key control system to maintain the power system’s balance between load and supply by maintaining its frequency in a specific range. It collects the tie-line power flow and frequency measurements of each control area to calculate the Area Control Error (ACE) and then adjusts power generation based on the calculated ACE. However, malicious frequency or tie-line power flow measurements can be injected and then AGC is misled to make false power generation adjustments which will harm power system operations. Such attacks can be carefully designed to pass the power system’s existing bad data detection schemes. In this work, we propose Long Short Term Memory (LSTM) neural network-based methods and a Fourier Transform-based method to detect and localize such data forgery attacks in AGC. These methods only utilize historical data, which are already available in existing AGC systems, making them easy to deploy in the real world. They learn normal data patterns from historical data and detect abnormal patterns caused by attacks. To make it easier for users to use the solution, we also propose methods to automatically find the proper detection threshold based on user needs. These methods are tested both on real and simulated datasets and show high detection and localization accuracy.

We study the trajectory of basketball based on nonlinear differential equations. At the same time, we design the optimal plan for shooting. We discuss the effect of the distance between the center of the ball and the center of the basket when shooting, the height of the center of the ball, and the change in the speed of the ball on the ball hit rate. The article comprehensively solves its motion trajectory. At the same time, we use the meaning of derivatives to find the maximum value of variables such as required height and speed. Research to find the best shooting spot and shooting angle.

Pipeline hydrogen transport is one of the main technical paths to achieve large-scale storage and transportation of hydrogen energy, and standards are important technical support for pipeline hydrogen transport applications. China’s hydrogen pipeline construction started late, and a relatively complete hydrogen pipeline standard system has been established in the world, but China’s hydrogen pipeline standard system has not been established, the lack of key technical standards and other problems. This paper investigates the current situation of hydrogen transport pipeline standards and the applicability to China. A standard system is preliminarily constructed for hydrogen transport pipelines, including 6 sub-systems and 23 technical standard fields. Some suggestions are put forward for the development of China’s hydrogen pipeline standardization.

Alzheimer's disease (AD) is considered as one of the leading causes of death among people over the age of 70 that is characterized by memory degradation and language impairment. Due to language dysfunction observed in individuals with AD patients, the speech-based methods offer non-invasive, convenient, and cost-effective solutions for the automatic detection of AD. This paper systematically reviews the technologies to detect the onset of AD from spontaneous speech, including data collection, feature extraction and classification. First the paper formulates the task of automatic detection of AD and describes the process of data collection. Then, feature extractors from speech data and transcripts are reviewed, which mainly contains acoustic features from speech and linguistic features from text. Especially, general handcrafted features and deep embedding features are organized from different modalities. Additionally, this paper summarizes optimization strategies for AD detection systems. Finally, the paper addresses challenges related to data size, model explainability, reliability and multimodality fusion, and discusses potential research directions based on these challenges.

BackgroundIdentifying individuals at high risk of atherosclerotic cardiovascular disease (ASCVD) and implementing targeted prevention strategies might be the key to reducing the heavy disease burden in China. This study aimed to evaluate the prevalence, awareness, treatment, and risk factor control among individuals with high 10-year ASCVD risk in Guangzhou, China.MethodsThis study included 15,165 adults (aged 18 years and older) from 138 urban and rural communities in the 2018 survey of China Chronic Disease and Risk Factors Surveillance in Guangzhou. 10-year ASCVD risk was estimated using the risk assessment models recommended in the Chinese Guideline for the Prevention of Cardiovascular Disease 2017. The prevalence, awareness, treatment, and risk factor control of high ASCVD risk (defined as 10-year risk ≥10%) were examined.ResultsAmong the study population, the weighted proportion of men was 51.9%, and the mean age was 41.27 ± 0.52 years. The overall standardized prevalence of high 10-year ASCVD risk was 13.8% (95% CI, 12.4%–15.3%). The awareness rates for hypertension, diabetes, and hyperlipidemia were 48.0% (95% CI, 42.8%–53.4%), 48.3% (95% CI, 43.0%–53.7%), and 17.9% (95% CI, 14.4%–22.1%) among those with corresponding risk factors. The proportions of drug use in prevention were relatively low in primary prevention, with the rates of using BP-lowering, glucose-lowering, lipid-lowering, and aspirin being 37.7% (95% CI, 32.8%–42.8%), 41.4% (95% CI, 35.8%–47.3%), 6.7% (95% CI, 4.5%–10.0%), and 1.0% (95% CI, 0.6%–1.8%), respectively. As for risk factor control, only 29.3% (95% CI, 25.7%–33.2%), 16.8% (95% CI, 15.0%–18.6%), and 36.0% (95% CI, 31.1%–41.2%) of individuals with high ASCVD risk had ideal levels of blood pressure, LDL-C, and body weight.ConclusionThe estimated prevalence of 10-year high ASCVD risk was high in Guangzhou, while the rates of treatment and risk factor control in primary prevention were still far from optimal, especially for lipid management. These findings suggested that substantial improvement in ASCVD prevention is needed in this population.

Abstract Background Adding salt at the table is a prevalent eating habit, but its long-term relationship with cardiovascular disease (CVD) and all-cause mortality remains unclear. We evaluated the associations of adding salt at the table with the risk of incident CVD and all-cause mortality. Methods Among 413,109 middle- and old-aged adults without cancer or CVD, all participants reported the frequency of adding salt at the table at baseline. The associations between adding salt at the table and incident CVD (the composite endpoint of coronary heart disease, stroke, heart failure, and CVD deaths) and all-cause mortality were investigated using Cox proportional hazards models. Results Of the study population, the mean age was 55.8 years and 45.5% were men; 44.4% reported adding salt at the table; 4.8% reported always adding salt at the table. During a median follow-up of 12 years, there were 37,091 incident CVD cases and 21,293 all-cause deaths. After adjustment for demographic, lifestyle, and cardiometabolic risk factors, the multivariable-adjusted hazard ratios (HRs) for participants who always added salt at the table versus never/rarely added salt at the table were 1.21 (95% confidence interval [CI]: 1.16-1.26) for CVD, 1.19 (95%CI: 1.05–1.35) for CVD mortality, and 1.22 (95%CI: 1.16–1.29) for all-cause mortality, respectively. Conclusions In this prospective cohort study, a higher frequency of adding salt at the table was associated with a greater risk of incident CVD and mortality. Our findings support the benefits of restricting the habit of adding salt at the table in promoting cardiovascular health.

Abstract Background Angiopoietin-like 4 (ANGPTL4) is highly expressed in a variety of neoplasms and promotes cancer progression. Nevertheless, the mechanism of ANGPTL4 in ovarian cancer (OC) metastasis remains unclear. This study aimeds to explore whether ANGPTL4 regulates OC progression and elucidate the underlying mechanism. Methods ANGPTL4 expression in clinical patient tumor samples was determined by immunohistochemistry (IHC) and high-throughput sequencing. ANGPTL4 knockdown (KD) and the addition of exogeneous cANGPTL4 protein were used to investigate its function. An in vivo xenograft tumor experiment was performed by intraperitoneal injection of SKOV3 cells transfected with short hairpin RNAs (shRNAs) targeting ANGPTL4 in nude mice. Western blotting and qRT-PCR were used to detect the levels of ANGPTL4, CDH5, p-AKT, AKT, ETV5, MMP2 and MMP9 in SKOV3 and HO8910 cells transfected with sh-ANGPTL4 or shRNAs targeting ETV5. Results Increased levels of ANGPTL4 were associated with poor prognosis and metastasis in OC and induced the angiogenesis and metastasis of OC cells both in vivo and in vitro. This tumorigenic effect was dependent on CDH5, and the expression levels of ANGPTL4 and CDH5 in human OC werepositively correlated. In addition, CDH5 activated p-AKT, and upregulated the expression of MMP2 and MMP9. We also found that the expression of ETV5 was upregulated by ANGPTL4, which could bind the promoter region of CDH5, leading to increased CDH5 expression. Conclusion Our data indicated that an increase in the ANGPTL4 level results in increased ETV5 expression in OC, leading to metastasis via activation of the CDH5/AKT/MMP9 signaling pathway.

Wastewater and pollutants emitted from cotton fabric production have generated several impacts on the ecosystem and human health. The Environmental Profit and Loss (EP&L) methodology was proposed to assess the environmental performance of a business by converting various environmental impacts into social marginal cost (SMC). This study applied the EP&L method to calculate the SMC of 1,000 kg of knit cotton T-shirts from the knit-yarn production to the end-of-life stage. The results show that the highest SMC was that of greenhouse gas emissions, followed by water pollution and water use which were $40.2, $28.3, and $0.04, respectively. In terms of production processes, the SMC of batch dyeing was the highest, and compaction was the stage with the least SMC. Through analysis of results, the SMC of cotton T-shirt was found to be closely related to the production activities of enterprises and the use of consumers. Findings of this study are of practical importance and can be used as a reference for green production of cotton products.

Lead halide perovskites have recently emerged as a promising platform for the study of polariton superfluidity at room temperature. Here the authors report a complete set of quantum fluid phase transitions in both 1D and 2D homogeneous single crystals of CsPbBr3.

Although the common genetic variants contributing to blood lipid levels have been studied, the contribution of rare variants is less understood. Here, the authors perform a rare coding and noncoding variant association study of blood lipid levels using whole genome sequencing data.

Accurate load forecasting is critical to guarantee the security, steadiness and economic operation of the power system. Therefore, in order to improve the load forecasting accuracy, improved coyote optimization (ICOA) was proposed in this paper to optimizing the Extreme learning machine for load forecasting, which is a novel load forecasting model. The ICOA algorithm effectively improves the accuracy and speed of convergence by introducing the sobol sequence and improving the pack culture trend, which is approved beneath a set of benchmark capacities from the Organized of Electrical and Hardware Engineers (IEEE) Congress on Developmental Computation (CEC) 2017. The result comparisons have moreover shown the exceptional execution of ICOA, since it could rank to begin with within the optimization of 16 benchmark. In addition, the ELM was optimized using to address the problem that the randomly formed weights and thresholds of the ELM lead to an unstable model, as well as experiment with different models using real electricity load data. The results show that the ICOA-ELM model possesses excellent accuracy and stability in short-term load forecasting. Its R2 and RMSE are 0.9970 and 0.3840 MW respectively, which are much better than ELM and LSTM. Thus, the proposed ICOA-ELM is a viable strategy for short-term load forecasting.

Abstract Background Altered expressions of genes in immune cells and synovial tissues are involved in the pathology of rheumatoid arthritis (RA). Long noncoding RNAs act as competing endogenous RNAs and can cause immune disorders. The goal of this study was to reveal the association between noncoding RNA linc00324 and RA, and a plausible action mechanism was proposed. Methods RT‐qPCR was used to evaluate the expression of linc00324 in peripheral blood mononuclear cells isolated from 50 RA patients and 50 healthy controls, and the correlations between linc00324 level and the clinical indicators were analyzed. Flow cytometry was used to characterize CD4+ T cells. The effects of linc00324 on cytokine production and cell proliferation of CD4+ T cells were evaluated by ELISA assay and Western blot. The interaction between linc00324 and miR‐10a‐5p was investigated by RNA immunoprecipitation and dual‐luciferase assays. Results The linc00324 expression was significantly enhanced in RA patients, and linc00324 expression was positively correlated with rheumatoid factor and CD4+ T cells. Overexpression of linc00324 promoted CD4+ T cells proliferation, and enhanced chemokine MIP‐1α secretion and NF‐κB phosphorylation level, whereas knockout of linc00324 blocked CD4+ T cell proliferation and NF‐κB phosphorylation. Overexpression of miR‐10a‐5p led to the decrease of CD4+ T cells proliferation and NF‐κB phosphorylation, and reversed the effects of linc00324 on cell proliferation and NF‐κB activity. Conclusion Linc00324 was upregulated in RA and may exaggerate inflammation by targeting miR‐10a‐5p through NF‐κB signaling pathway.

VPS4 series proteins play a crucial role in the endosomal sorting complexes required for the transport (ESCRT) pathway, which is responsible for sorting and trafficking cellular proteins and is involved in various cellular processes, including cytokinesis, membrane repair, and viral budding. VPS4 proteins are ATPases that mediate the final steps of membrane fission and protein sorting as part of the ESCRT machinery. They disassemble ESCRT-III filaments, which are vital for forming multivesicular bodies (MVBs) and the release of intraluminal vesicles (ILVs), ultimately leading to the sorting and degradation of various cellular proteins, including those involved in cancer development and progression. Recent studies have shown a potential relationship between VPS4 series proteins and cancer. Evidence suggests that these proteins may have crucial roles in cancer development and progression. Several experiments have explored the association between VPS4 and different types of cancer, including gastrointestinal and reproductive system tumors, providing insight into the underlying mechanisms. Understanding the structure and function of VPS4 series proteins is critical in assessing their potential role in cancer. The evidence supporting the involvement of VPS4 series proteins in cancer provides a promising avenue for future research and therapeutic development. However, further researches are necessary to fully understand the mechanisms underlying the relationship between VPS4 series proteins and cancer and to develop effective strategies for targeting these proteins in cancer therapy. This article aims to review the structures and functions of VPS4 series proteins and the previous experiments to analyze the relationship between VPS4 series proteins and cancer.

Background: Procyanidins have antioxidative properties that may protect against age-related brain oxidative stress. Previous studies indicated that procyanidin-rich foods could improve cognitive function and prevent neurodegenerative diseases. This study hypothesized that grape seed procyanidins extract (GSPE) would have a favorable effect on cognitive function in elderly people with mild cognitive impairment (MCI). Methods: A community-based, randomized, double-blind, placebo-controlled trial was conducted. Participants aged 60 years or older with MCI were randomly assigned into the GSPE group (n = 35, 320 mg/d) or placebo group (n = 36), and received capsules for 6 months. Cognitive function was assessed using the Montreal Cognitive Assessment Scale (MoCA). The change in MoCA scores between groups were tested by the time ✕ treatment interaction in mixed-design ANOVA. Results: After 6 months of intervention, the MoCA score was higher than the baseline both in the intervention group and placebo control group, while the there was no significant difference for mean change in MoCA score from baseline between the intervention group and the placebo group (2.35 ± 3.20 vs. 1.28 ± 2.93, P = 0.192). Conclusions: Present study showed that 6-month supplementation with GSPE did not significantly improve cognitive function in subjects with MCI. Further investigations regarding the longer-term intervention effect of procyanidins extract on mild or moderate cognitive disorders are needed.

Background Studies on the associations between maternal complications during pregnancy and childhood asthma are exclusively conducted in Western countries. The findings are mixed and may not be translated to other populations. We aimed to investigate the associations among the Chinese population and to determine whether the associations were mediated through pre-term birth, caesarean delivery, low birthweight and not breastfeeding in the first 6 months. Methods We conducted a retrospective cohort study of 166 772 children in Guangzhou, China. Information on maternal gestational hypertension, gestational diabetes and gestational anaemia during pregnancy was extracted from medical records. Ever-diagnosis of asthma in children aged 6–12 years was obtained by questionnaire. Logistic regression models and mediation analyses were used to estimate the adjusted odds ratios (aORs) and 95% confidence intervals for childhood asthma. Results Gestational hypertension, gestational diabetes and gestational anaemia during pregnancy were associated with an increased risk of ever-diagnosed childhood asthma: aOR 1.48 (95% CI 1.37–1.60), 1.71 (95% CI 1.65–1.78) and 1.34 (95% CI 1.26–1.45), respectively. A stronger association was observed for two or three gestational complications (aOR 2.02 (95% CI 1.93–2.16)) than one gestational complication (aOR 1.64 (95% CI 1.52–1.77)). The aOR for the three gestational complications was 1.35 (95% CI 1.26–1.45), 1.63 (95% CI 1.58–1.70) and 1.32 (95% CI 1.24–1.43), respectively, after controlling for the mediators, including pre-term birth, caesarean delivery, low birthweight and not breastfeeding in the first 6 months. Conclusions Gestational hypertension, gestational diabetes and gestational anaemia were associated with childhood asthma, and the associations were partially explained by the mediation effects.

Acid mine drainage (AMD) is a special kind of acidic wastewater produced in the process of mining and utilization. In this study, AMD was treated using the adsorption method. Domestic waste was prepared by pyrolysis, and the resulting waste pyrolysis ash adsorbent was studied experimentally by a static adsorption test to treat metal ions in AMD. The results showed that the maximum adsorption amounts of Zn2+, Cu2+, Mn2+, Fe2+, Pb2+, and Cd2+ reached 0.425, 0.593, 0.498, 18.519, 0.055, and 0.039 mg/g, respectively, when the amount of pyrolysis ash was added at 30 g/L, the initial pH of the water was 4.1 and the reaction time was 150 min. It was found that the waste pyrolysis ash could be reused at least three times by using Na2S as the regeneration agent. The SEM and BET characterization results prove that its large specific surface areas and well-developed pore structures have the potential to promote the adsorption of metal ions. The pseudo-second-order kinetic equation and Freundlich adsorption isotherms fit the adsorption process well, and the experiments reveal that the metal ions in AMD are well treated by waste pyrolysis ash through adsorption, flocculation and chemical precipitation. Waste pyrolysis ash has great potential for the treatment of acid mine drainage, providing a new approach to solid waste disposal and new ideas for water treatment as a low-cost alternative material. HIGHLIGHTS Acid mine drainage treated with domestic waste pyrolysis ash.; Utilized residue from domestic waste pyrolysis treatment.; Over 90% metals removal from acid mine drainage.;

Abstract Background Undifferentiated carcinoma with osteoclast-like giant cells (OGCs) of pancreas (UCOGCP) is a rare subtype of pancreatic ductal adenocarcinoma (PDAC), which had poorly described histopathological and clinical features. Methods In this study, single-cell RNA sequencing (scRNA-seq) was used to profile the distinct tumor microenvironment of UCOGCP using samples obtained from one UCOGCP patient and three PDAC patients. Bioinformatic analysis was carried out and immunohistochemical (IHC) staining was used to support the findings of bioinformatic analysis. After quality control of the raw data, a total of 18,376 cells were obtained from these four samples for subsequent analysis. These cells were divided into ten main cell types following the Seurat analysis pipeline. Among them, the UCOGCP sample displayed distinct distribution patterns from the rest samples in the epithelial cell, myeloid cell, fibroblast, and endothelial cell clusters. Further analysis supported that the OGCs were generated from stem-cell-like mesenchymal epithelial cells (SMECs). Results Functional analysis showed that the OGCs cluster was enriched in antigen presentation, immune response, and stem cell differentiation. Gene markers such as LOX, SPERINE1, CD44, and TGFBI were highly expressed in this SMECs cluster which signified poor prognosis. Interestingly, in myeloid cell, fibroblasts, and endothelial cell clusters, UCOGCP contained higher percentage of these cells and unique subclusters, compared with the rest of PDAC samples. Conclusions Analysis of cell communication depicted that CD74 plays important roles in the formation of the microenvironment of UCOGCP. Our findings illustrated the genesis and function of OGCs, and the tumor microenvironment (TME) of UCOGCP, providing insights for prognosis and treatment strategy for this rare type of pancreatic cancer.

Alzheimer's disease (AD) is a neurodegenerative disorder that causes memory degradation and cognitive function impairment in elderly people. The irreversible and devastating cognitive decline brings large burdens on patients and society. So far, there is no effective treatment that can cure AD, but the process of early-stage AD can slow down. Early and accurate detection is critical for treatment. In recent years, deep-learning-based approaches have achieved great success in Alzheimer's disease diagnosis. The main objective of this paper is to review some popular conventional machine learning methods used for the classification and prediction of AD using Magnetic Resonance Imaging (MRI). The methods reviewed in this paper include support vector machine (SVM), random forest (RF), convolutional neural network (CNN), autoencoder, deep learning, and transformer. This paper also reviews pervasively used feature extractors and different types of input forms of convolutional neural network. At last, this review discusses challenges such as class imbalance and data leakage. It also discusses the trade-offs and suggestions about pre-processing techniques, deep learning, conventional machine learning methods, new techniques, and input type selection.

BackgroundPatients with Parkinson's disease (PD) and those with multiple system atrophy (MSA) show similar symptoms but have different clinical treatments. It will be helpful to discriminate between these two kinds of patients at an early or middle stage. The purpose of this study is to highlight the differences in posturographic characterization between patients with PD and those with MSA during quiet standing and perturbed standing.MethodsA total of clinically diagnosed 42 patients with PD and 32 patients with MSA participated in the experiment. Patients were asked to first stand on a static balance force platform and then on a dynamic balance (medial-lateral rocker) force platform to measure the center of pressure (COP) trajectory during an eyes-open (EO) state. The posturographic parameters were obtained under the two standing conditions for statistical analysis.ResultsFour posturographic variables were calculated and analyzed, namely, the standard deviation of COP position (SD), sway path of COP position (SP), an elliptical area covering the 95% COP position trajectory (EA), sway path of COP position (SP), and integral area of the power spectral density at 0–0.5 Hz frequency band (PSD). Except for variable EA, the other three variables are all in the medial-lateral (ML) direction. In the static balance experiment, there were no significant differences between the four variables between patients with PD and those with MSA. However, in the dynamic balance experiment, the obtained four variables all presented significant differences between patients with PD and those with MSA.ConclusionThe dynamic posturographic variables with significant differences between patients with PD and those with MSA imply that patients with MSA have worse postural control ability in the medial-lateral (ML) direction compared to patients with PD. The obtained dynamic indices may help supplemental clinical evaluation to discriminate between patients with MSA and those with PD.

Abstract Background We aimed to report pregnancy outcomes of women with type 1 diabetes (T1D) in China, on which data were sparse. Methods This is a nationwide retrospective study conducted in 11 general medical centers in 8 cities across China. We investigated the clinical data of all women who attended these centers with a singleton pregnancy and whose pregnancy ended between 1 January 2004 and 31 December 2014. Pregnancies of women with pregestational T1D were ascertained and compared with those of women without T1D. Results From over 300 000 pregnancies over the 11‐year study period, we identified 265 singleton pregnancies of women with T1D. One maternal death was documented among 265 (0.37%) women with T1D and 83 among 318 486 (0.03%) women without T1D. Women with T1D suffered from higher rates of pregnancy loss (13.21% vs 2.92%, crude risk ratio [cRR] 5.08 [95% CI, 3.56‐7.26]) and preeclampsia (17.74% vs 4.20%, cRR 4.94 [95% CI, 3.60‐6.77]) compared with those without T1D. Infants of these women with T1D had elevated rates of neonatal death (5.65% vs 0.16%, cRR 37.36 [95% CI, 21.21‐65.82]) and congenital malformation(s) (8.26% vs 3.53%, cRR 2.46 [95% CI, 1.54‐3.93]) compared with those of women without T1D. No significant improvement in pregnancy outcomes in women with T1D was observed over the period 2004 to 2014. Conclusions Pregnancy outcomes were persistently poor in women with T1D during 2004 to 2014 in China. Pregnancy care needs to be improved to reduce adverse pregnancy outcomes among Chinese women with T1D.

Airplane detection in synthetic aperture radar (SAR) images has drawn much attention owing to the success of deep learning methods. However, the development of fine-grained airplane detection in SAR images is still in a dilemma due to the small interclass variance and the large intraclass variance in complex scenes with strong interference from the background. In addition, the class imbalance problem in multiclass fine-grained airplane recognition also significantly limits the direct application of general deep-learning-based airplane detectors. This article proposes two effective methods to tackle the above two problems, respectively. First, we propose a sparse attention-guided fine-grained pyramid module to simultaneously sample discriminative local features scattered in multiscale layers and adaptively aggregate them with fine-grained attention to better classify subordinate-level airplanes with multiple scales. Second, a simple class-balanced copy-paste data augmentation strategy, which randomly copies an airplane of one category and pastes it onto an image according to the classwise probability, is proposed for class balance. Finally, extensive experiments on one public dataset and three representative deep-learning-based detection benchmarks are conducted to show the effectiveness and generalization of the two proposed methods. The combination of these two methods based on the cascade R-CNN benchmark also won the fifth place in fine-grained airplane detection in SAR images in the 2021 GaoFen Challenge.

BackgroundPediatric obesity has become a global public health problem. China has the largest population of obese children in the world. It is important to develop effective interventions to control child obesity. This systematic review summarizes proof from randomized controlled trials to assess the efficacy of lifestyle intervention to reduce BMI and metabolic risk factors for overweight/obese Chinese children.MethodsWe searched studies from five databases (PubMed, MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, and CNKI). Research that meets the following requirements was included: randomized controlled trials, participants are overweight/obese Chinese children aged

Abstract Background Vertebral augmentation (VA) techniques are used to treat acute osteoporotic vertebral compression fractures (OVCFs). However, the incidence of recurrent vertebral fractures after VA is controversial. Various factors have been discussed in the literature, but no convincing study on the quality of paraspinal muscles has been reported. The purposes of this study were to evaluate the changes in paraspinal muscles and discuss the relationship between paraspinal muscle degeneration and vertebral refractures after percutaneous kyphoplasty (PKP). Methods This retrospective study was conducted in patients who underwent PKP for an initial OVCF between July 2017 and August 2018. Patients were followed up and categorized in the refractured or non-refractured group. A final magnetic resonance imaging (MRI) scan and a preoperative MRI scan were used to determine the measurements. The paraspinal muscles at the mid-height level of the initial fractured vertebral body were measured using regions of interest (ROIs), including the cross-sectional area (CSA) and signal intensity (SI). The changes in the observed data were compared between the groups using rank-sum tests. Results Overall, 92 patients were enrolled in the study; 33 of them sustained vertebral refractures during the follow-up and the other 59 patients did not. There were no significant differences in terms of sex, age, preoperative bone mineral density, and body mass index between the groups (all, P > 0.05). The refractured group had a significantly higher decrease in the ROI-CSA and CSA/SI, and a higher increase in ROI-SI, compared with the preoperative data (all, P < 0.05). Conclusions The quality of paraspinal muscles significantly decreased in patients with new OVCFs after PKP. This brings a new perspective to the study of postoperative recurrent fractures; patients and physicians need to pay more attention to the efficacy of bed rest and bracing.

Background Current cholesterol guidelines have recommended very low low‐density lipoprotein cholesterol (LDL‐C) treatment targets for people at high risk of cardiovascular disease (CVD). However, recent observational studies indicated that very low LDL‐C levels may be associated with increased mortality and other adverse outcomes. The association between LDL‐C levels and long‐term risk of overall and cardiovascular mortality among the U.S. general population remains to be determined. Methods and Results This prospective cohort study included a nationally representative sample of 14 035 adults aged 18 years or older, who participated in the National Health and Nutrition Examination Survey III 1988–1994. LDL‐C levels were divided into 6 categories:

BackgroundAdherence to a healthy lifestyle (no smoking, consuming a healthy diet, engaging in physical activity, and maintaining a healthy weight) is recommended in current guidelines for hypertension prevention. However, evidence regarding the association between sleep behaviors, independently and jointly with traditional lifestyle factors, and the risk of hypertension is limited.MethodsThis prospective study included 165,493 participants who are free of hypertension at baseline from the UK Biobank. Sleep behaviors, including chronotype, sleep duration, insomnia, snoring, and daytime sleepiness were used to construct a healthy sleep score. We also derived a healthy lifestyle score based on smoking status, diet quality, physical activity, and body mass index (BMI). Cox proportional hazards regression models and competing risk analyses were used to estimate the associations of the healthy sleep score and healthy lifestyle score with the risk of hypertension. The population attributable risk percent (PAR%) was estimated for increased cases of hypertension due to poor adherence to a healthy sleep pattern or a healthy lifestyle.ResultsA total of 10,941 incident hypertension cases were documented during a median of 11.8 years of follow-up. The multivariable-adjusted hazard ratio (HR) for hypertension was 0.58 [95% confidence interval (CI): 0.52, 0.65] for participants with a sleep score of 5 compared with 0–1, and 0.48 (95% CI: 0.43, 0.54) for participants with a lifestyle score of 4 compared with those who scored 0. For joint association, those with a poor sleep pattern and a poor lifestyle had the highest risk of hypertension [HR: 2.41 (95% CI: 2.12, 2.74)]. PAR% was 14.7% (95% CI: 12.3%, 17.1%), 20.1% (95% CI: 17.6%, 22.6%), and 31.7% (95% CI: 27.6%, 35.6%) for poor adherence to a healthy sleep pattern, a healthy lifestyle, and the combination of a healthy sleep pattern and a healthy lifestyle.ConclusionBoth a healthy sleep pattern and a healthy lifestyle were associated with a lower risk of hypertension, and the benefits of adhering to a healthy sleep pattern complement the well-established lifestyle for the optimal primary prevention of hypertension. These findings support the current perspective that a healthy sleep pattern is an important part of a healthful and productive lifestyle for hypertension prevention.

Abstract Background Prevalence of neonatal microcephaly in populations without Zika-epidemics is sparse. The study aimed to report baseline prevalence of congenital microcephaly and its relationship with prenatal factors in an area at risk of Zika outbreak. Methods This study included singletons born after 24 gestational weeks in 2017–2018 at four hospitals in Guangzhou, China. Microcephaly was defined as a head circumference at birth >3SD below the mean for sex and gestational age. Prevalence of microcephaly was estimated by binomial exact method. Multivariable logistic regression was used to examine the associations of microcephaly with prenatal factors. The population attributable fraction (PAF) for associated risk factors was calculated. Results Of 46,610 live births included, 154 (3.3, 95% CI 2.8–3.9 per 1000 live births) microcephalies were identified. Maternal hepatitis B virus carriers (HBV, OR 1.80, 95% CI 1.05–3.10) and primipara (OR 2.68, 95% CI 1.89–3.81) had higher risk of having a microcephalic baby. Higher prevalence of microcephaly was observed in women who had premature labor (OR 1.98, 95% CI 1.17–3.34) and had a baby with fetal growth restriction (OR 16.38, 95% CI 11.81–22.71). Four identified factors (HBV, primiparity, preterm labor, and fetal growth restriction) contributed to 66.4% of the risk of microcephaly. Conclusions The prevalence of microcephaly in Guangzhou was higher than expected. This study identified four prenatal risk factors that, together, contributed to two-thirds of the increased risk of microcephaly. This is the first reported association between maternal HBV carrier status and microcephaly.

Abstract This study investigated the association between pre-pregnancy body mass index (BMI) and adverse pregnancy outcomes among women participated in the National Free Preconception Health Examination Project in Guangdong Province, China, and explored these associations according to maternal age. Pre-pregnancy BMI was classified into underweight (BMI