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Abstract Background Sphingosine-1-phosphate receptor 1 (S1PR1) is considered to be closely related to a variety of malignant tumors, but the role and mechanism of S1PR1 in lung adenocarcinoma are not fully understood. In this study, we aim to explore the role and downstream signaling pathways of S1PR1 in the malignant biological functions of lung adenocarcinoma (LUAD). Methods Bioinformatics analysis, RT-qPCR, western blot and immunohistochemistry (IHC) were was used to investigate the expression of S1PR1 in LUAD. The prognosis of S1PR1 was also analyzed. CCK-8 assay, colony formation assay, scratch assay, transwell migration and invasion assay, cell adhesion assay were performed to examine the effect of S1PR1 on LUAD. RNA sequencing was employed to analyze the DEGs in LUAD cells overexpressing S1PR1. Enrichment pathway analysis using KEGG, GO, and GSEA was conducted to predict potential signaling pathways and downstream targets. chromatin immunoprecipitation (ChIP) and dual luciferase reporter assay were performed to verify the direct regulation between FOXA1 and the target genes. Then FOXA1 overexpression were performed to functional rescue experiments. miRNA-30c-5p was identified as a microRNA regulating FOXA1 by dual luciferase reporter assay. The downstream signaling pathways of S1PR1 was detected to clarify the specific pathways to regulates miR-30c-5p. Results S1PR1 is significantly decreased in LUAD and is positively correlated with the prognosis. Overexpression of S1PR1 inhibits the proliferation, migration, invasion and adhesion function of LUAD cells by suppressing the expression of COL5A1, MMP1, and SERPINE1. FOXA1 is a key transcription factor regulating the expression of MMP1, COL5A1 and SERPINE1. S1PR1 inhibits the expression of FOXA1 through p-STAT1/miR-30c-5p, thereby suppressing the malignant function of LUAD cells. Conclusions The expression of S1PR1 is downregulated in LUAD, which is positively correlated with prognosis. S1PR1 regulates the malignant function of LUAD cells by inhibiting the expression of COL5A1, MMP1 and SERPINE1 through the p-STAT1/miR-30c-5p/FOXA1 signaling pathway.

Abstract Focusing solely on enhancing the resilience of power systems at a systemic level would lead to a significant underestimation of the actual impact of extreme disasters. Equally vital is the assurance of livelihood security amidst such extreme conditions, which is crucial for the development of a truly resilient power system. Hence, this paper attempts to incorporate quantifiable metrics assessing public safety impacts into resilience enhancement works, thereby guiding the precise allocation of funds. Considering that the residents' intuitive feelings are the most direct reflection of the severity of the disaster, this paper employs the modified prospect theory to formulate functions representing residents' psychological risk perception and risk‐taking willingness to tolerate risks during disruptions in power, gas, and water supplies. Meanwhile, in order to accurately calculate the energy loss duration for each residential customer, a resilience enhancement method for post‐disaster collaborative dispatch of electricity‐gas‐water systems is proposed. With the objective of minimizing the public safety and economic impact of disasters, the optimal multi‐source collaborative emergency restoration strategy is developed. The significant necessity and efficiency of the proposed strategy are verified with exhaustive case studies. Numerical results evince the resilience enhancement by considering the livelihood security in the post‐disaster restoration stage.

Intelligent electromagnetic interference (EMI) shielding materials with adaptively adjustable structure and performance under external stimuli hold great potential in developing new generation of intelligent EMI shielding materials. In this review, the latest and most impressive works of advanced materials for stimulus-responsive EMI shielding are highly focused on. Based on stimulating sources, the smart EMI materials are discussed in five categories: mechanical-, temperature-, electrical-, humidity-responsive and others. The key information, including structural design principle, EMI behavior, and structure-function relationship, is extracted and well organized with profundity and easy-to-understand approach. What’s more, the merit and demerit are revealed by comparison. Finally, a profound comment on the stimulus-responsive EMI materials as well as challenges are proposed, and the future directions are forecasted. Schematic illustration for stimulus-responsive EMI shielding, including mechanical-responsive (top left) (Reproduced with permission. Copyright 2021, Elsevier), temperature-responsive (top right) (Reproduced with permission. Copyright 2021, Elsevier; Reproduced with permission. Copyright 2022, The Authors, Elsevier), electrical-responsive (bottom right) (Reproduced with permission, Copyright 2015 Springer Nature), humidity-responsive (bottom) (Reproduced with permission. Copyright 2018, Elsevier), and others (bottom left) (Reproduced with permission. Copyright 2022, American Chemical Society; Reproduced with permission. Copyright 2020, Wiley-VCH).

Abstract Current research on the dynamics and vibrations of geared rotor systems primarily focuses on deterministic models. However, uncertainties inevitably exist in the gear system, which cause uncertainties in system parameters and subsequently influence the accurate evaluation of system dynamic behavior. In this study, a dynamic model of a geared rotor system with mixed parameters and model uncertainties is proposed. Initially, the dynamic model of the geared rotor-bearing system with deterministic parameters is established using a finite element method. Subsequently, a nonparametric method is introduced to model the hybrid uncertainties in the dynamic model. Deviation coefficients and dispersion parameters are used to reflect the levels of parameter and model uncertainty. For example, the study evaluates the effects of uncertain bearing and mesh stiffness on the vibration responses of a geared rotor system. The results demonstrate that the influence of uncertainty varies among different model types. Model uncertainties have a more significant than parametric uncertainties, whereas hybrid uncertainties increase the nonlinearities and complexities of the system’s dynamic responses. These findings provide valuable insights into understanding the dynamic behavior of geared system with hybrid uncertainties.

Research vessels are typically equipped with multiple receivers for positioning and attitude measurement; however, there is no data interaction or model fusion to implement the Precise Point Positioning (PPP) for these receivers. Therefore, a Constrained PPP (CPPP) is established by using the baseline length and tropospheric constraints of two receivers to improve the vessel’s remote marine positioning performance. Based on two integrated Real-Time Kinematic (RTK) receivers, marine experiments are conducted at a distance of 300–600 km from land. Compared to the ground environment, the Root Mean Square error (RMS) of the multipath and the STandard Deviation (STD) of the carrier-to-noise ratio in the marine environment are increased by 2.87 and 2.6 times, respectively. The length constraints reduce the RMS of positioning in the East, North, and Up (ENU) directions by about 0.053 (67%), 0.020 (34%), and 0.054 m (34%), respectively, and also rapidly recover positioning after interruptions, achieving positioning with errors in the ENU-directions of 10, 15, and 20 cm, respectively, within 3 minutes. When the baseline length and tropospheric constraints are combined, with or without the addition of the Zenith Wet Delay bias (dZWD), the average STD can be reduced by about 0.060 m (43%) and the accuracy of the up-positioning can be significantly improved. The correlation of dZWD to the up-positioning deviation of du=−2.161*dZWD is obtained by simulation. Since the acquisition of dZWD depends on the PPP accuracy, it is recommended that dZWD be set to compensate for unmodeled receiver errors when the STD of the up-positioning is superior to 0.06 m.

Abstract Implant-related infections pose significant challenges to orthopedic surgeries due to the high risk of severe complications. The widespread use of bioactive prostheses in joint replacements, featuring roughened surfaces and tight integration with the bone marrow cavity, has facilitated bacterial proliferation and complicated treatment. Developing antibacterial coatings for orthopedic implants has been a key research focus in recent years to address this critical issue. Researchers have designed coatings using various materials and antibacterial strategies. In this study, we fabricated 3D-printed porous titanium rods, incorporated vancomycin-loaded mPEG750-b-PCL2500 gel, and coated them with a PCL layer. We then evaluated the antibacterial efficacy through both in vitro and in vivo experiments. Our coating passively inhibits bacterial biofilm formation and actively controls antibiotic release in response to bacterial growth, providing a practical solution for proactive and sustained infection control. This study utilized 3D printing technology to produce porous titanium rod implants simulating bioactive joint prostheses. The porous structure of the titanium rods was used to load a thermoresponsive gel, mPEG750-b-PCL2500 (PEG: polyethylene glycol; PCL: polycaprolactone), serving as a novel drug delivery system carrying vancomycin for controlled antibiotic release. The assembly was then covered with a PCL membrane that inhibits bacterial biofilm formation early in infection and degrades when exposed to lipase solutions, mimicking enzymatic activity during bacterial infections. This setup provides infection-responsive protection and promotes drug release. We investigated the coating’s controlled release, antibacterial capability, and biocompatibility through in vitro experiments. We established a Staphylococcus aureus infection model in rabbits, implanting titanium rods in the femoral medullary cavity. We evaluated the efficacy and safety of the composite coating in preventing implant-related infections using imaging, hematology, and pathology. In vitro experiments demonstrated that the PCL membrane stably protects encapsulated vancomycin during PBS immersion. The PCL membrane rapidly degraded at a lipase concentration of 0.2 mg/mL. The mPEG750-b-PCL2500 gel ensured stable and sustained vancomycin release, inhibiting bacterial growth. We investigated the antibacterial effect of the 3D-printed titanium material, coated with PCL and loaded with mPEG750-b-PCL2500 hydrogel, using a rabbit Staphylococcus aureus infection model. Imaging, hematology, and histopathology confirmed that our composite antibacterial coating exhibited excellent antibacterial effects and infection prevention, with good safety in trials. Our results indicate that the composite antibacterial coating effectively protects vancomycin in the hydrogel from premature release in the absence of bacterial infection. The outer PCL membrane inhibits bacterial growth and prevents biofilm formation. Upon contact with bacterial lipase, the PCL membrane rapidly degrades, releasing vancomycin for antibacterial action. The mPEG750-b-PCL2500 gel provides stable and sustained vancomycin release, prolonging its antibacterial effects. Our composite antibacterial coating demonstrates promising potential for clinical application.

Abstract It is crucial to precisely calculate temperature utilizing thermal models, which require the determination of thermal parameters that optimally align model outcomes with experimental data. In many instances, the refinement of these models is undertaken within space instruments. This paper introduces an optimization methodology for thermal network models, with the objective of enhancing the accuracy of temperature predictions for aerial cameras. The investigation of internal convective heat transfer coefficients for both cylindrical and planar structures provides an estimation of convective thermal parameters. Based on the identification of thermally sensitive parameters and the reliability evaluation of transient temperature data through the Monte-Carlo simulation, the genetic algorithm is employed to search for global optimal parameter values that minimize the root mean square error (RMSE) between calculated and measured node temperatures. As a result, the optimized model shows significantly improved accuracy in temperature prediction, attaining an RMSE of 1.07 ℃ and reducing the maximum relative error between predicted and experimental results from 33.8 to 3.1%. Furthermore, the flight simulation and thermal control experiments validate the robustness of the optimized model, demonstrating that discrepancies between the observed and predicted temperatures are within 2 °C after re-correcting the external convection heat transfer coefficient value.

Abstract Diabetic retinopathy (DR) is the most prevalent cause of preventable vision loss worldwide, imposing a significant economic and medical burden on society today, of which early identification is the cornerstones of the management. The diagnosis and severity grading of DR rely on scales based on clinical visualized features, but lack detailed quantitative parameters. Retinal non-perfusion area (NPA) is a pathogenic characteristic of DR that symbolizes retinal hypoxia conditions, and was found to be intimately associated with disease progression, prognosis, and management. However, the practical value of NPA is constrained since it appears on fundus fluorescein angiography (FFA) as distributed, irregularly shaped, darker plaques that are challenging to measure manually. In this study, we propose a deep learning-based method, NPA-Net, for accurate and automatic segmentation of NPAs from FFA images acquired in clinical practice. NPA-Net uses the U-net structure as the basic backbone, which has an encoder-decoder model structure. To enhance the recognition performance of the model for NPA, we adaptively incorporate multi-scale features and contextual information in feature learning and design three modules: Adaptive Encoder Feature Fusion (AEFF) module, Multilayer Deep Supervised Loss, and Atrous Spatial Pyramid Pooling (ASPP) module, which enhance the recognition ability of the model for NPAs of different sizes from different perspectives. We conducted extensive experiments on a clinical dataset with 163 eyes with NPAs manually annotated by ophthalmologists, and NPA-Net achieved better segmentation performance compared to other existing methods with an area under the receiver operating characteristic curve (AUC) of 0.9752, accuracy of 0.9431, sensitivity of 0.8794, specificity of 0.9459, IOU of 0.3876 and Dice of 0.5686. This new automatic segmentation model is useful for identifying NPA in clinical practice, generating quantitative parameters that can be useful for further research as well as guiding DR detection, grading severity, treatment planning, and prognosis.

The fine modeling of the lunar gravity field is a fundamental task for establishing lunar altitude references, conducting research on lunar interior structure, and other scientific endeavors. The lunar gravity field model constructed solely based on spacecraft orbit data has limited spatial resolution, making it challenging to meet the demands of fine gravity field research. The acquisition of high-resolution terrain models presents new opportunities for the study of precise lunar gravity fields. This paper reviews the current status and advancements in fine lunar gravity field modeling, including research efforts and evaluation methods for global lunar gravity field models, principles and technologies for fine gravity field modeling, as well as related research outcomes. On this basis, this paper systematically summarizes the key theoretical issues and technical challenges in the theory of lunar gravity field modeling based on high-resolution terrain models. These include data updating, error correction in high-frequency gravity field modeling, calculation efficiency, and the series divergence problem in spherical harmonic analysis. In addition, future research directions are discussed. This work will provide references for gravity field research on the Moon and other terrestrial planets.

Purpose: To explore the clinical characteristics of pediatric pelvic fracturs caused by traffic accidents and to analyze the accompanying injuries and complications. Methods: A total of 222 cases involved traffic accidents was enrolled in this case-control study. The data of children with pelvic fractures caused by traffic accidents who were admitted to our hospital from January 2006 to December 2021 were analyzed retrospectively. Sex, age, Tile classification, abbreviated injury scale score, injury severity score, mortality, and accompanying injuries were studied. The ANOVA was used for measurement data, and the non-parametric rank sum test was used for non-normally distributed data. The Fisher's exact probability method was used for the count data. Results: Of all enrolled cases, 140 are boys and 82 are girls, including 144 cases aged < 6 years, 65 aged between 6 and 12 years, and 13 aged > 12 years. Depending on the injury mechanism, there are 15 cases involving pedestrians vs. motorcycles (PVM), 91 cases involving pedestrians vs. passenger cars (PVC), 78 cases involving pedestrians vs. commercial vehicles (PVV), and 38 cases involving motor vehicles vs. motor vehicles (MVM). Associated injuries are reported in 198 cases (89.2%), primarily involving the abdomen injury in 144 cases (64.9%), and lower limb injury in 99 cases (44.6%). PVV injury involves longer hospital stay (p = 0.004). Intensive care unit admission rate is significantly higher in the MVM group than in other groups (p = 0.004). Head injury (p = 0.001) and face injury (p = 0.037) are more common in the MVM group, whereas abdominal injury (p = 0.048) and lower limb injury (p = 0.037) are more common in the PVV group. In the MVM group, the brain injury (p = 0.004) and femoral neck injury (p = 0.044) are more common. In the PVM group, the mediastinum (p = 0.004), ear (p = 0.009), lumbar vertebrae (p = 0.008), and spinal cord (p = 0.011) are the most vulnerable regions, while in the PVV group, the perineum (p 12 years have higher pelvic abbreviated injury scale scores (p = 0.019). There are significant differences in the classification of pelvic fractures among children < 6, 6 – 12, and > 12 years of age, with Tile C being more likely to occur in children > 12 years of age (p = 0.033). Children aged > 12 years are more likely to sustain injuries to the spleen (p = 0.022), kidneys (p = 0.019), pancreas (p

The Gravity Recovery and Climate Experiment (GRACE) and GRACE Follow-On (GRACE-FO) missions have enabled consistent production of monthly gravity field solutions by international institutes, contributing to the International Centre for Global Earth Models. Each institute employs distinct processing strategies, yielding varied estimates of terrestrial water storage (TWS). In this study, we employ statistical collocation techniques (Total assessment ratio, TAR) to assess and compare the performance of GRACE TWS data products (2003.03 ~ 2014.03) and GRACE-FO TWS data (2018.06 ~ 2022.11). For GRACE TWS, the TAR values are as follows: COST-G (0.15), ITSG (0.83), APM-SYSU (0.85), CSR (0.91), JPL (0.93), GFZ (0.94), Tongji (0.96), HUST (1.08), SUST (1.18), CNES (1.37), and AIUB (1.41). Similarly, for GRACE-FO TWS, the TAR values are COST-G (0.15), JPL (0.81), ITSG (0.96), CSR (0.97), GFZ (1.06), and CNES (1.41). Furthermore, our comparison across basin sizes and climatic regions reveals that COST-G exhibits lower uncertainty and larger signal-to-noise ratios in TWS, making it particularly noteworthy for its utility. Conversely, other single solutions that depict long-term trends and annual amplitudes demonstrate comparable values across various basin sizes, climatic regions, and specific areas.

Abstract Purpose This study investigated the clinical and functional outcomes of children with distal both-bone forearm fractures treated by fixation of the radius only compared to fixation of both the radius and ulna. Methods A total of 71 patients from two centres with distal both-bone forearm fractures (30 in the ulna-yes group, 41 in the ulna-no group) who underwent closed reduction and percutaneous pinning treatment were retrospectively analysed. Operation duration, number of fluoroscopic exposures, loss of reduction rate and angulation based on radiographic assessment were compared between the two groups. Evaluation of wrist function including Gartland-Werley Score and Mayo Wrist Score were compared at the last follow-up. Results Ulna angulation upon bone healing on the posteroanterior and the lateral plane of ulna-no group (6.11 ± 1.56°; 6.51 ± 1.69°) was significantly greater than that of ulna-yes group (4.49 ± 1.30°; 5.05 ± 2.18°) (p 0.05). At last follow-up, no significant difference was found between the Gartland-Werley Scores of the ulna-yes group (1.83 ± 3.25, range: 0–16) and ulna-no group (1.85 ± 2.72, range: 0-11.5) (p > 0.05). No significant difference was found between the Mayo Wrist Scores of the ulna-yes group (92.60 ± 6.20) and ulna-no group (92.15 ± 7.58) (p > 0.05). Conclusions For distal both-bone forearm fractures in children, fixation of only the radius appears to be a viable method with equivalent clinical outcomes compared to fixation of both the radius and ulna.

The hands and face are the most important parts for expressing sign language morphemes in sign language videos. However, we find that existing Continuous Sign Language Recognition (CSLR) methods lack the mining of hand and face information in visual backbones or use expensive and time-consuming external extractors to explore this information. In addition, the signs have different lengths, whereas previous CSLR methods typically use a fixed-length window to segment the video to capture sequential features and then perform global temporal modeling, which disturbs the perception of complete signs. In this study, we propose a Multi-Scale Context-Aware network (MSCA-Net) to solve the aforementioned problems. Our MSCA-Net contains two main modules: (1) Multi-Scale Motion Attention (MSMA), which uses the differences among frames to perceive information of the hands and face in multiple spatial scales, replacing the heavy feature extractors; and (2) Multi-Scale Temporal Modeling (MSTM), which explores crucial temporal information in the sign language video from different temporal scales. We conduct extensive experiments using three widely used sign language datasets, i.e., RWTH-PHOENIX-Weather-2014, RWTH-PHOENIX-Weather-2014T, and CSL-Daily. The proposed MSCA-Net achieve state-of-the-art performance, demonstrating the effectiveness of our approach.

Abstract. Background:. Long non-coding RNAs (lncRNAs) plays an important role in the progression of gastric cancer (GC). Their involvement ranges from genetic regulation to cancer progression. However, the mechanistic roles of RP11-789C1.1 in GC are not fully understood. Methods:. We identified the expression of lncRNA RP11-789C1.1 in GC tissues and cell lines by real-time fluorescent quantitative polymerase chain reaction. A series of functional experiments revealed the effect of RP11-789C1.1 on the proliferation of GC cells. In vivo experiments verified the effect of RP11-789C1.1 on the biological behavior of a GC cell line. RNA pull-down unveiled RP11-789C1.1 interacting proteins. Western blot analysis indicated the downstream pathway changes of RP11-789C1.1, and an oxaliplatin dosing experiment disclosed the influence of RP11-789C1.1 on the drug sensitivity of oxaliplatin. Results:. Our results demonstrated that RP11-789C1.1 inhibited the proliferation of GC cells and promoted the apoptosis of GC cells. Mechanistically, RP11-789C1.1 inhibited checkpoint kinase 1 (CHK1) phosphorylation by binding ataxia-telangiectasia mutated and Rad3 related (ATR), a serine/threonine-specific protein kinase, promoted GC apoptosis, and mediated oxaliplatin sensitivity. Conclusion:. In general, we discovered a tumor suppressor molecule RP11-789C1.1 and confirmed its mechanism of action, providing a theoretical basis for targeted GC therapy.

The recyclable paper based on photochromic materials not only reduces the pollution in the paper manufacture process, but also reduces the pollution caused by the use of ink, which receives wide attention. In this paper, a series of phosphomolybdic acid–phosphotungstic acid/ZnO/polyvinylpyrrolidone (PMoA-PWA/ZnO/PVP) hybrid films, which had different ratio of PMoA/PWA, was prepared by the ultrasonic composite method. The results indicated that the hybrid film prepared when the ratio of PMoA to PWA was 3 had the best photochromic performance. In this system, ZnO was the photosensitizer, while PMoA/PWA was the chromophore. The photochromic mechanism of the PMoA-PWA/ZnO/PVP hybrid film was based on the photogenerated electron transfer mechanism. ZnO generated photoelectron under the excitation of visible light, then PMoA and PWA obtained the photoelectron and produced photoreduction reaction to generate heteropolyblue. The visible light photochromic paper was prepared by loaded PMoA-PWA/ZnO/PVP hybrid film (A3) on A4 paper. Application tests showed that the prepared paper had extremely stable, excellent and reversible visible light photochromic properties, whether it was printing patterns or words, and could replace ordinary paper to realize the reuse of paper.

Abstract Background The timing of surgical intervention for Hirschsprung’s disease (HSCR) has been a topic of continued discussion. The objective of this study was to evaluate the significance of age at surgery in the management of HSCR by conducting a comparative analysis of the correlation between surgical age and midterm outcomes. Methods We conducted a retrospective analysis of children with HSCR who underwent one-stage laparoscopic assisted pull-through surgery with modified Swenson technology at our hospital between 2015 and 2019. The study population was stratified into two groups based on surgical age: patients who underwent surgery within a period of less than 3 months and those who underwent surgery between 3 and 12 months. The basic conditions, complications at 3–7 years after surgery, anal function (Rintala scale) and quality of life (PedsQLTM4.0) were compared between the groups. Results A total of 235 children (196 males and 39 females) were included in the study. No statistically significant differences in postoperative bowel function (P = 0.968) or quality of life (P = 0.32) were found between the two groups. However, there was a significant reduction in the incidence of Hirschsprung-associated enterocolitis (HAEC) among individuals under the age of three months prior to undergoing surgical intervention (69.1%) compared to the incidence observed postsurgery (30.9%). This difference was statistically significant (P

Abstract Background Cardiac arrest after coronary artery bypass grafting (CABG) is a serious complication with low survival rate. The prognosis of patients with cardiac arrest in the general ward is worse than that in the intensive care unit (ICU) because of the delayed and poor rescue conditions. Methods This retrospective study included patients who experienced cardiac arrest after CABG surgery between January 2010 and December 2019 at the Fuwai Hospital. Differences in cardiac arrest between the ICU and the general ward were compared. The patients were divided into shockable and non-shockable rhythm groups, and the differences between the two groups were compared. Finally, we proposed a management protocol for cardiac arrest in the general ward. Results We retrospectively analyzed 41,450 patients who underwent CABG only, of whom 231 (0.56%) experienced cardiac arrest post-surgery in the ICU (185/231) or in the general ward (46/231). The rescue success rate and 30-day survival rate of the patients with cardiac arrest in the general ward were 76.1% (35/46) and 58.7% (27/46), respectively. The incidence of the different arrhythmia types of cardiac arrest in the general ward compared with that in the ICU was different (P = 0.010). The 30-day survival rate of the non-shockable rhythm group was 31.8% (7/22), which was worse than that of the shockable rhythm group (83.3% [20/24]; P = 0.001). Kaplan–Meier survival analysis showed that the prognosis of the non-shockable group was poor (P

Abstract Background With Primary Health Care (PHC) being a cornerstone of accessible, affordable, and effective healthcare worldwide, its efficiency, especially in developing countries like China, is crucial for achieving Universal Health Coverage (UHC). This study evaluates the efficiency of PHC systems in a southwest China municipality post-healthcare reform, identifying factors influencing efficiency and proposing strategies for improvement. Methods Utilising a 10-year provincial panel dataset, this study employs an enhanced Data Envelopment Analysis (DEA) model integrating Slack-Based Measure (SBM) and Directional Distance Function (DDF) with the Global Malmquist-Luenberger (GML) index for efficiency evaluation. Tobit regression analysis identifies efficiency determinants within the context of China’s healthcare reforms, focusing on horizontal integration, fiscal spending, urbanisation rates, and workforce optimisation. Results The study reveals a slight decline in PHC system efficiency across the municipality from 2009 to 2018. However, the highest-performing county achieved a 2.36% increase in Total Factor Productivity (TFP), demonstrating the potential of horizontal integration reforms and strategic fiscal investments in enhancing PHC efficiency. However, an increase in nurse density per 1,000 population negatively correlated with efficiency, indicating the need for a balanced approach to workforce expansion. Conclusions Horizontal integration reforms, along with targeted fiscal inputs and urbanisation, are key to improving PHC efficiency in underdeveloped regions. The study underscores the importance of optimising workforce allocation and skillsets over mere expansion, providing valuable insights for policymakers aiming to strengthen PHC systems toward achieving UHC in China and similar contexts.

Abstract Background Increasing evidence suggested that immune abnormalities involved in the pathophysiology of schizophrenia. However, the relationship between immunity and clinical features has not been clarified. The aim of this study was to measure the plasma levels of tumor necrosis factor alpha (TNF-α) and soluble TNF-α receptor 1 (sTNF-α R1) and to investigate their association with agitation in first episode patients with schizophrenia (FEPS). Methods The plasma TNF-α and sTNF-α R1 levels were measured using sandwich enzyme-linked immunosorbent assay (ELISA) in the FEPS with (n = 36) and without agitation (n = 49) symptoms, and healthy controls (HCs, n = 54). The psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS), and the agitation symptoms were evaluated by the PANSS excitatory component (PANSS-EC). Results The plasma TNF-α levels in patients with and without agitation symptoms were significantly higher than those in HCs. The patients with agitation had significantly higher plasma TNF-α levels compared to the patients without agitation. There were no significant differences in the sTNF-α R1 levels among the three groups. Furthermore, the plasma TNF-α levels were positively correlated with the PANSS total score, Positive and General psychopathological subscores, and PANSS-EC score in the FEPS, but the relationships were not found for the plasma sTNF-α R1 levels. Conclusions These results suggested that TNF-α might play an important role in the onset and development of agitation symptoms of schizophrenia.

The significant demand of coal mine intelligence has put forward some higher requirements for the intelligent perception of underground mobile robots in coal mines, and the Visual Simultaneous Localization and Mapping (VSLAM) is a key technology for the intelligent perception of coal mine robots. However, due to unstructured environmental features, weak textures, uneven illumination, and small space in underground coal mines, the existing methods that rely on heuristic thresholds for keyframe selection cannot meet the localization and mapping requirements of visual SLAM in underground coal mines. Therefore, a visual SLAM keyframe selection method with multiple constraints in underground coal mines was proposed, which achieves a real-time and robust pose estimation of mobile robot in coal mines and provides data for digital twin in coal mines. Firstly, the proposed method was constrained according to geometric structure, adaptive thresholding was used instead of static heuristic thresholding for keyframe selection to achieve the effectiveness and robustness of keyframe selection. Secondly, the distribution of effective feature points was homogenized by the balance of gravity principle to further ensure the stability of keyframe selection and the denseness and accuracy of created map points. Finally, the steering place was further constrained by using the heading angle threshold to reduce the impact of viewpoint abrupt change on the visual SLAM accuracy. In order to verify the effectiveness of the proposed method, an experimental analysis was conducted in indoor scenes and underground coal mines respectively using an independently designed mobile robot data acquisition platform. Then, the qualitative and quantitative evaluations were made from Absolute Trajectory Error (ATE) and Root Mean Square Error (RMSE). The results show that compared with the heuristic keyframe selection method, the proposed method improves the trajectories RMSE by 29% and 44% in the indoor scenes and the fully enclosed promenade environment, respectively. The proposed method also has a higher robustness, localization accuracy and globally consistent map building effect in underground coal mines.

Foam cells play a pivotal role in the progression of atherosclerosis progression by triggering inflammation within arterial walls. They release inflammatory molecules that attract additional immune cells, leading to further macrophage recruitment and plaque development. In this study, we develop an osteopontin (OPN) antibody-conjugated niobium carbide (Nb2C-aOPN) MXenzyme designed to selectively target and mildly ablate foam cells while reducing inflammation in the plaque microenvironment. This approach utilizes photonic hyperthermia to decrease plaque size by enhancing cholesterol regulation through both passive cholesterol outflow and positive cholesterol efflux. Nb2C-aOPN MXenzyme exhibits multiple enzyme-mimicking properties, including catalase, superoxide dismutase, peroxidase and glutathione peroxidase, and acts as a scavenger for reactive oxygen and nitrogen species. The inhibition of reactive oxygen and nitrogen species synergizes with photothermal ablation to promote positive cholesterol efflux, leading to reduced macrophage recruitment and a shift in macrophage phenotype from M1 to M2. This integrative strategy on cholesterol regulation and anti-inflammation highlights the potential of multifunctional 2D MXenzyme-based nanomedicine in advancing atherosclerotic regression.

A visible-light photochromic hybrid film was synthesized based on combining phosphomolybdic acid (PMoA) with the polythiophene (PTh) matrix. The microstructure and photochromic properties of the materials were analyzed through atomic force microscopy (AFM), Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS) and ultraviolet-visible spectra (UV-vis). According to FTIR spectra, the geometries of PMoA and PTh were well preserved in hybrid film and there exists a strong interaction at the interface of PMoA and PTh. The XPS spectra revealed the change in the chemical microenvironment and the reduction of Mo6+ atoms in the photoreduction reaction. Under visible light irradiation, the composite film changed from transparent to blue and deepened gradually, generating heteropoly blue. The hybrid film also shows reversibility in the presence of oxygen. The results indicated that the photochromic reaction was inconsistent with photoinduced electron transfer mechanism.

Abstract Objectives Acute upper respiratory tract infections (AURTIs) are prevalent in the general population. However, studies on the association of short-term exposure to air pollution with the risk of hospital visits for AURTIs in adults are limited. This study aimed to explore the short-term exposure to air pollutants among Chinese adults living in Ningbo. Methods Quasi-Poisson time serious regressions with distributed lag non-linear models (DLNM) were applied to explore the association between ambient air pollution and AURTIs cases. Patients ≥ 18 years who visit three hospitals, being representative for urban, urban–rural junction and rural were included in this retrospective study. Results In total, 104,441 cases with AURTIs were enrolled in hospital during 2015–2019. The main results showed that particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5), nitrogen dioxide (NO2) and nitrogen dioxide (SO2), were positively associated to hospital visits for AURTIs, except for nitrogen dioxide (O3), which was not statistically significant. The largest single-lag effect for PM2.5 at lag 8 days (RR = 1.02, 95%CI: 1.08–1.40), for NO2 at lag 13 days (RR = 1.03, 95%CI: 1.00–1.06) and for SO2 at lag 5 days (RR = 1.27, 95%CI: 1.08–1.48), respectively. In the stratified analysis, females, and young adults (18–60 years) were more vulnerable to PM2.5 and SO2 and the effect was greater in rural areas and urban–rural junction. Conclusions Exposure to ambient air pollution was significantly associated with hospital visits for AURTIs. This study provides epidemiological evidence for policymakers to control better air quality and establish an enhanced system of air pollution alerts.

Abstract As the global data strategy deepens and data elements accelerate integrating and flowing more rapidly, the demand for data security and privacy protection has become increasingly prominent. Confidential computing emerges as a crucial security technology to solve security and privacy problem, and it is also a hot subject of in contemporary security technologies. Leveraging collaborative security in both hardware and software, it builds a trusted execution environment to ensure confidentiality and integrity protection for data in use. This paper provides a comprehensive overview of the development process of confidential computing, summarizing its current research status and issues, which focuses on the security requirements for data security and privacy protection. Furthermore, it deeply analyses the common technical features of confidential computing, and proposes a trusted confidential computing architecture based on collaborative hardware and software trust. Then, it elaborates on the research status and issues of confidential computing from four aspects: hardware security, architecture and key technologies, applications, and standards and evaluation. Finally, this paper provides a synthesis and outlook for the future development of confidential computing. In summary, confidential computing is currently in a rapidly developing stage and will play an important role in cyber security in the future.

The nucleocapsid protein (NP) plays a crucial role in SARS-CoV-2 replication and is the most abundant structural protein with a long half-life. Despite its vital role in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) assembly and host inflammatory response, it remains an unexplored target for drug development. In this study, we identified a small-molecule compound (ciclopirox) that promotes NP degradation using an FDA-approved library and a drug-screening cell model. Ciclopirox significantly inhibited SARS-CoV-2 replication both in vitro and in vivo by inducing NP degradation. Ciclopirox induced abnormal NP aggregation through indirect interaction, leading to the formation of condensates with higher viscosity and lower mobility. These condensates were subsequently degraded via the autophagy-lysosomal pathway, ultimately resulting in a shortened NP half-life and reduced NP expression. Our results suggest that NP is a potential drug target, and that ciclopirox holds substantial promise for further development to combat SARS-CoV-2 replication.

Abstract Aims Due to its low incidence, poor prognosis, and high mortality in the acute phase, the long‐term prognosis of the left ventricular aneurysm (LVA) complicated by ventricular septal rupture (VSR) has received little attention. This study focus on the long‐term prognosis of patients with LVA complicated by relatively stable VSR. Methods and results Over a decade of retrospection, 68 patients with both LVA and VSR were compared with 136 patients with LVA alone after propensity score matching. Patients with both LVA and VSR were further divided into two groups depending on whether pre‐operative intra‐aortic balloon pump (IABP) was used (23 pre‐operative IABP vs. 45 non‐pre‐operative IABP). The primary endpoint was defined as major adverse cardiovascular and cerebrovascular events, a composite endpoint including mortality, myocardial infarction, revascularization, stroke, and heart failure. Patients with both LVA and VSR were generally in a worse condition upon admission compared with those with LVA alone [percentage of patients in New York Heart Association IV: 42.6% (29/68) vs. 11.0% (15/136), P

Protocatechuic acid (PCA), a naturally occurring polyphenol abundant in fruits, vegetables, and various plants, exhibits diverse biological activities. However, the mechanism of action of PCA in osteoporosis (OP) is unclear. This study aims to elucidate the anti-OP mechanisms of PCA through an integrated approach involving network pharmacology, virtual screening, and experimental validation. In this study, we found that PCA improved zebrafish skeletal development and promoted MC3T3-E1 cell proliferation, increasing ALP activity. In addition, PCA decreased the level of ROS and MDA, increased the level of SOD, GSH and NO, and mitigated the degree of oxidative stress. Concurrently, network pharmacological analysis indicated that PCA upregulated core target levels, activated the HIF-1 signaling pathway, ameliorated oxidative stress, and exerted an anti-OP effect by promoting bone formation. In conclusion, PCA may provide a new strategy in the prevention and treatment of OP.

Abstract As a structural protein of SARS‐CoV‐2, the envelope (E) protein not only plays a key role in the formation of viral particles, but also forms ion channels and has pathogenic functions, including triggering cell death and inflammatory responses. The stability of E proteins is controlled by the host ubiquitin‐proteasome system. By screening human deubiquitinases, it is found that ubiquitin‐specific protease 33 (USP33) can enhance the stability of E proteins depending on its deubiquitinase activity, thereby promoting viral replication. In the absence of USP33, E proteins are rapidly degraded, leading to a reduced viral load and inflammation. Using lipid nanoparticle (LNP) encapsulation of siUSP33 by adjusting the lipid components (ionizable cationic lipids), siUSP33 is successfully delivered to mouse lung tissues, rapidly reducing USP33 expression in the lungs and maintaining knockdown for at least 14 days, effectively suppressing viral replication and virulence. This method of delivery allows efficient targeting of the lungs and a response to acute infections without long‐term USP33 deficiency. This research, based on the deubiquitination mechanism of USP33 on the E protein, demonstrates that LNP‐mediated siRNA delivery targeting USP33 plays a role in antiviral and anti‐inflammatory responses, offering a novel strategy for the prevention and treatment of SARS‐CoV‐2.

Purpose To study epidemiology, complications, risk factors, clinical course and treatment patterns of diabetes, the Nanjing Diabetes Cohort (NDC) was established using anonymised electronic health records from 650 hospitals and primary care since 2020. This cohort provides valuable data for researchers and policy-makers focused on diabetes management and public health strategies.Participants Diabetes was defined as having inpatient or outpatient encounters with a diagnosis of diabetes International Classification of Diseases-9/10 codes, any use of insulin or oral hypoglycaemic drugs, or one encounter with haemoglobin A1C >4.8 mmol/mol or 6.5%. Patients with diabetes have been continuously enrolled on hospitals and primary care in Nanjing since 2020. Demographic, medications and comorbidities data were extracted from clinical notes, diagnostic codes, labs, prescriptions and vital signs among different types of diabetes.Findings to date The NDC consisted of 1 033 904 patients from 1 January 2020 to 31 December 2022, the majority were male (50.62%) and from the Gulou district (30.79%). The clinical characteristics and medication usage of patients with type 1 diabetes, type 2 diabetes, gestational diabetes and other diabetes were assessed. The prevalences of hypertension, ischemic heart disease, and cerebrovascular disease were 49.72%, 17.85% and 24.90%, respectively.Future plans NDC will annually enrol eligible patients and include socioeconomic data in future updates. The data of NDC are maintained by the Department of Medical Informatics at Nanjing Medical University.

IntroductionCancer patients have a heightened susceptibility to anxiety and depressive disorders, which significantly impact the effectiveness of cancer treatments and long-term quality of life. This study aimed to compare the efficacy of different antidepressants in cancer and non-cancer patients.MethodsA total of 610 patients diagnosed with depressive episodes and/or anxiety disorders were retrospectively included and divided into a cancer group and a non-cancer control group. Antidepressants used included escitalopram, duloxetine, sertraline, venlafaxine, and vortioxetine, combined with trazodone or not. The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder Questionnaire-7 (GAD-7) scores were used to evaluate the efficacy after 4 weeks and 8 weeks of systematic antidepressants treatment.ResultsCompared to the non-cancer group, the cancer group had higher proportions of females, older individuals, and patients with poor sleep quality, while reporting fewer somatic symptoms at baseline (all p < 0.05). PHQ-9 and GAD-7 scores in cancer patients treated with antidepressants were significantly lower than baseline at week 4 and week 8 (all p < 0.05). The sertraline group demonstrated significantly less improvement in GAD-7 scores at week 4 and in both GAD-7 and PHQ-9 scores at week 8 compared to the escitalopram group, while duloxetine, venlafaxine, and vortioxetine showed comparable efficacy to escitalopram. Antidepressants combined with trazodone showed significant improvement in PHQ-9 scores at week 4 compared to those without trazodone. The gynecological cancer group showed significantly more improvement in GAD-7 and PHQ-9 scores at week 4 and 8 compared to breast cancer patients.ConclusionAntidepressant treatment in cancer patients with anxiety and depression is as effective as in non-cancer patients. The efficacy of escitalopram is comparable to duloxetine, venlafaxine, and vortioxetine, all of which outperformed sertraline in cancer patients.

Abstract Microbial fuel cells (MFCs) benefit from the introduction of iron in the anode, as its multiple valence states and high electron‐catalytic activity led to improved power densities in MFCs. However, the effect of long‐term Fe3+ release into the electrolyte on the power density of MFCs is often overlooked. Herein, an anode consisting of a three‐dimensional iron foam uniformly coated by reduced graphene oxide (rGO/IF) with a suitable loading density (8 g/m2) and a large specific surface area (0.05 m2/g) for high‐density bacterial loading was prepared. The hybrid cells based on the rGO/IF anode exhibit a maximum power density of 5330 ± 76 mW/m2 contributed by MFCs and galvanic cells. The rGO/IF anode enables continuous Fe3+ release for high electron‐catalytic activity in the electrolyte during the discharging of the galvanic cells. As a result, the hybrid cells showed a power density of 2107 ± 64 mW/m2 after four cycles, facilitated through reversible conversion between Fe3+ and Fe2+ in the electrolyte to accelerate electron transfer efficiency. The results indicate that the rGO/IF anode can be used for designing and fabricating high‐power MFCs by optimizing the rate of release of Fe3+ in the electrolyte.

BackgroundGravity-driven depositional processes play a pivotal role in shaping the geomorphology of subaqueous deltas worldwide, particularly by eroding the seafloor, leading to the formation of rugged submarine channels (SCs) and triggering various subaqueous geohazards. A comprehensive understanding of SCs is crucial for elucidating these depositional mechanisms and mitigating the risks associated with submarine geohazards. Although SCs in the Huanghe delta front have been previously identified, often described as seafloor gullies or subsurface “disturbed strata,” most studies have primarily concentrated on their engineering geological properties. However, there has been limited research on the scale, morphology, and development of these SCs, especially those that are buried within the stratigraphy.MethodsThis study integrates high-resolution sub-bottom data, sediment core analyses, and historical bathymetric data to investigate the morphology, distribution, and formation mechanisms of SCs in the Huanghe subaqueous delta.ResultsThe SCs, both buried and exposed, are widespread along the middle and upper delta front, predominantly located at or near the landward flank of sediment gravity flow (SGF) -related accumulations. The buried SCs are characterized by cut-and-fill structures with transparent to semi-transparent fills, indicating rapid infilling processes as SGF energy dissipates. These buried channels were preserved within different sets of delta front deposits formed during 1855–1964 CE, 1964–1976 CE, and 1976–2007 CE, with the latter two periods separated by a significant lobe-switching event in 1976 CE. This event, combined with prevailing southeastward sediment transport and erosional regimes, appears to have controlled the preservation of SCs along the delta front: SCs in the Diaokou Lobe's delta front (pre-1976) suffered significant erosion, leaving only one set of channel (erosional remnants) preserved, while the SCs in the Qingshuigou Lobe's delta front (post-1976) are characterized by well-preserved, multi-phase channels at different horizons. The cross-section morphology of the SCs reveal three primary types: symmetrical, asymmetrical, and composite, corresponding respectively to (1) idealized SGF incision, (2) uneven incision intensity on either side of the SCs, and (3) the merging of two or more symmetrical/asymmetrical SCs.ConclusionsWe describe in detail the morphology, distribution and development of SCs in the modern Huanghe subaqueous delta. These findings provide insights into the formation and distribution of SCs in other shallow marine settings, particularly in delta front areas, and potentially offer information for disaster prevention and engineering development in such regions.

Abstract Collaboration between cancer treatment and inflammation management has emerged as an integral facet of comprehensive cancer care. Nevertheless, the development of interventions concurrently targeting both inflammation and cancer has encountered significant challenges stemming from various external factors. Herein, a bioactive agent synthesized by genetically engineering melanin‐producing Bacillus thuringiensis (B. thuringiensis) bacteria, simultaneously achieves eco‐friendly photothermal agent and efficient reactive oxygen/nitrogen species (RONS) scavenger benefits, perfectly tackling present toughies from inflammation to cancer therapies. The biologically derived melanin exhibits exceptional photothermal‐conversion performance, facilitating potent photonic hyperthermia that effectively eradicates tumor cells and tissues, thereby impeding tumor growth. Additionally, the RONS‐scavenging properties of melanin produced by B. thuringiensis bacteria contribute to inflammation reduction, augmenting the efficacy of photothermal tumor repression. This study presents a representative paradigm of genetic engineering in B. thuringiensis bacteria to produce functional agents tailored for diverse biomedical applications, encompassing inflammation and cancer therapy.

In this study, a ddPCR method for the detection of scale drop disease virus (SDDV) in yellowfin seabream (Acanthopagrus latus) was established based on Real-time fluorescence quantitative PCR detection methods and principles. The reaction conditions were optimized, and the sensitivity, specificity, accuracy, and reproducibility were assessed. The results showed that threshold line position was determined to be 1900 by the ddPCR method; the optimum annealing temperature for SDDV detection by the ddPCR method was 60°C; the limit of detection was 1.4–1.7 copies/μL; the results of specific detection of other common viruses, except for SDDV specific amplification, were all negative; and the relative standard deviation (RSD) for the reproducibility validation was 0.77%. The samples of yellowfin seabream (Acanthopagrus latus) liver, spleen, kidney, heart, intestine, brain, blood, muscle, skin and ascites with three replicates, respectively, were tested using the ddPCR method, and the results were consistent with clinical findings. The ddPCR method established in this study has the advantages of high sensitivity, high specificity, good reproducibility and simple steps for the quantitative detection of SDDV, which could be used for the nucleic acid detection of clinical SDDV samples, and provided a new quantitative method for the diagnosis of yellowfin seabream SDDV in the early stage of pathogenesis.

Ureteral metastasis of prostate cancer is extremely rare, with less than 50 cases at present. Kidney cancer with prostate cancer is also rare, and ureteral metastasis with prostate cancer is difficult to diagnose. Especially if there are no symptoms of hematuria, the ureteral mass should be clearly understood. Although there is no error in the diagnosis and treatment process in this case, there are still many points worth considering, such as whether unilateral nephroperectomy should be performed if there is no kidney cancerHere, we report a case of renal cancer complicated with prostate cancer and ureteral metastasis.

An analog PID controller-based galvanometer scanner is widely used by fractional laser medical equipment (FLME) to scan lasers across tissue surfaces, achieving the desired therapeutic effect. This type of driver, primarily composed of passive components and operational amplifiers, can only accept commands from the central controller of the FLME, with a simple hardware circuit-based fault diagnosis; thus, the safety of the FLME is compromised. To address these issues, the failure mechanisms of galvanometers and their impact on the safety of FLME are thoroughly analyzed first. Then, an adaptive limit protection method, a coil open circuit fault diagnosis, a communication timeout protection based on two handshakes, and a galvanometer control timeout protection are proposed, respectively, based on a digital driver platform, to supplement the deficiencies in the original fault diagnosis and protection system. This ensures the safety of the FLME. Finally, the effectiveness of the proposed strategies is validated through experiments.

Abstract This article conducts a comprehensive study on the activation characteristics of faults in the mine and analyzes the distribution patterns of the original rock stress field. Through quantitative research and analysis, we determine the partitioning characteristics of tectonic stress in the mine field under the dual effects of fault activation and original rock stress. The study also reveals the significant impact of different fault activation characteristics and different tectonic stress partitions on the stability of roadway surrounding rock. Using the Mohr–Coulomb strength criterion as a foundation, we investigate the mechanisms of fault activation and establish a mathematical model for fuzzy comprehensive evaluation. This model enables us to determine the strength level of fault activation in coal seam 9 of the Limin coal mine and construct a geological structure model. It has realized the transformation of fault activation degree from qualitative evaluation to quantitative evaluation. The stress state analysis software is used to draw the division of tectonic stress dangerous areas under the synergistic effect of fault activation and original rock stress. We then analyze the impact on the stability of roadway surrounding rock in these different hazardous areas. Utilizing the fuzzy comprehensive evaluation method, we take into account the impact of faults on the distribution characteristics of stress fields and the stability of roadway surrounding rock. This approach enables us to more accurately and comprehensively determine the hazardous areas of tectonic stress in the mine field under the dual effects of faults and original rock stress.

Abstract To study the characteristics of nasal airflow in the presence of nasal cycle by computational fluid dynamics. CT scan data of a healthy Chinese individual was used to construct a three-dimensional model of the nasal cavity to be used as simulation domain. A sinusoidal airflow velocity is set at the nasal cavity entrance to reproduce the breathing pattern of a healthy human. There was a significant difference in the cross-sectional area between the two sides of the nasal cavity. Particularly, the decongested side is characterized by a larger cross-section area, and consequently, by a larger volume with respect to the congested side. The airflow velocity, pressure, and nasal resistance were higher on the congested narrow side. The temperature regulation ability on the congested narrow side was stronger than that on the decongested wider side. During the nasal cycle, there are differences in the nasal cavity function between the congested and decongested sides. Therefore, when evaluating the impact of various factors on nasal cavity function, the nasal cycle should be considered.

Abstract Background Several methods have been used for the treatment of pediatric distal femoral fractures, such as elastic stable intramedullary nail (ESIN), external fixator (EF) and plate osteosynthesis, but there has been no consensus about the optimal method. The purpose of this study was to compare the clinical outcome between EF and ESIN techniques used in metaphyseal-diaphyseal junction (MDJ) fractures of the pediatric distal femur. Methods We retrospectively analyzed operatively treated MDJ fractures of pediatric distal femur between January 2015 and January 2022. Patient charts were reviewed for demographics, injury and data of radiography. All of the patients were divided into EF and ESIN groups according to the operation techniques. Malalignment was defined as more than 5 degrees of angular deformity in either plane. Clinical outcomes were measured by Flynn scoring system. Results Thirty-eight patients were included in this study, among which, 23 were treated with EF, and 15 with ESIN. The mean follow-up time was 18 months (12-24 months). At the final follow-up, all of the fractures were healed. Although there were no statistical differences between the two groups in demographic data, length of stay, estimated blood loss (EBL), rate of open reduction, time to fracture healing and Flynn score, the EF was superior to ESIN in operative time, fluoroscopic exposure and time to partial weight-bearing. The EF group had a significantly higher rate of skin irritation, while the ESIN had a significantly higher rate of malalignment. Conclusion EF and ESIN are both effective methods in the treatment of MDJ fractures of the pediatric distal femur. ESIN is associated with lower rates of skin irritation. However, EF technique has the advantages of shorter operative time, reduced fluoroscopic exposure, and shorter time to partial weight-bearing, as well as lower incidence of malalignment. Level of evidence Level III.

Highlights A composite thermal interface material with three-dimensional hybrid carbon network-reinforced polydimethylsiloxane was proposed. The cooperative regulation of thermal conductivity and mechanical properties was achieved by controlling the assembly process of micro-nano scale unit carbon materials. The orthotropic continuous carbon structure endowed the composites with in-plane and out-of-plane thermal conductivities of up to 113.61 and 24.37 W m−1 K−1, respectively. The excellent compressibility and adhesion properties cooperatively improved the effective thermal conductivity by more than an order of magnitude.

Choline acetyltransferase (ChAT)-positive neurons in neural stem cell (NSC) niches can evoke adult neurogenesis (AN) and restore impaired brain function after injury, such as acute ischemic stroke (AIS). However, the relevant mechanism by which ChAT+ neurons develop in NSC niches is poorly understood. Our RNA-seq analysis revealed that dimethylarginine dimethylaminohydrolase 1 (DDAH1), a hydrolase for asymmetric NG,NG-dimethylarginine (ADMA), regulated genes responsible for the synthesis and transportation of acetylcholine (ACh) (Chat, Slc5a7 and Slc18a3) after stroke insult. The dual-luciferase reporter assay further suggested that DDAH1 controlled the activity of ChAT, possibly through hypoxia-inducible factor 1α (HIF-1α). KC7F2, an inhibitor of HIF-1α, abolished DDAH1-induced ChAT expression and suppressed neurogenesis. As expected, DDAH1 was clinically elevated in the blood of AIS patients and was positively correlated with AIS severity. By comparing the results among Ddah1 general knockout (KO) mice, transgenic (TG) mice and wild-type (WT) mice, we discovered that DDAH1 upregulated the proliferation and neural differentiation of NSCs in the subgranular zone (SGZ) under ischemic insult. As a result, DDAH1 may promote cognitive and motor function recovery against stroke impairment, while these neuroprotective effects are dramatically suppressed by NSC conditional knockout of Ddah1 in mice.

Abstract Introduction Recent studies have suggested a potential association between methotrexate use and an increased risk of dementia. However, the causal relationship between methotrexate and dementia remains unclear. This study aims to investigate the potential causal effect of methotrexate use on the risk of dementia using a two-sample Mendelian randomization (TSMR) approach. Methods We conducted a TSMR study using summary statistics from genome-wide association studies (GWAS) of methotrexate use and dementia. We obtained genetic instruments for methotrexate use from a large-scale GWAS meta-analysis and genetic instruments for dementia from a separate GWAS meta-analysis. We performed several statistical analyses, including inverse-variance weighted (IVW), weighted median (WM1), weighted mode (WM2), and MR-Egger regression methods, to estimate the causal effect of methotrexate on dementia risk. Results Our TSMR analysis showed a significant positive association between genetic predisposition to methotrexate use and dementia risk. The IVW method estimated a causal odds ratio (OR) of 0.476 [95% confidence interval (CI) 0.362–0.626] per unit increase in the log odds ratio of methotrexate use. WM1, WM2, and MR-Egger methods provided consistent results. Conclusion The findings of this mendelian randomization (MR) study suggest a potential causal effect of methotrexate use on the risk of dementia. However, further research is needed to validate these findings and explore the underlying mechanisms. Since methotrexate is widely prescribed for various autoimmune diseases, a better understanding of its potential impact on dementia risk is crucial for optimizing treatment strategies and addressing potential adverse effects.

Background: Gastrointestinal perforation in extremely low birth weight infants, characterized by its rapid onset, multiple complications, and critical condition, poses a significant risk of infant mortality. The aim of this study was to investigate the clinical characteristics of pneumoperitoneum in extremely low birth weight infants (ELBWI) and explore the risk factors associated with gastrointestinal perforation in very low birth weight preterm infants. Additionally, we shared our surgical experiences in managing gastrointestinal perforation among extremely low birth weight infants. Methods: The Department of Neonatology at Chengdu Women and Children's Central Hospital conducted a retrospective study on gastrointestinal perforation in extremely low birth weight infants (birth weight

Abstract Facile and efficient photocatalysts using sunlight, as well as fast and sensitive surface-enhanced Raman spectroscopy (SERS) substrates, are urgently needed for practical degradation of tetracycline (TC). To meet these requirements, a new paradigm for PI/TiO2/Ag organic‒inorganic ternary flexible microfibers based on semiconducting titanium dioxide (TiO2), the noble metal silver (Ag) and the conjugated polymer polyimide (PI) was developed by engineering a simple method. Under sunlight, the photocatalytic characteristics of the PI/TiO2/Ag flexible microfibers containing varying amounts of Ag quantum dots (QDs) were evaluated with photocatalytic degradation of TC in aqueous solution. The results demonstrated that the amount of Ag affected the photocatalytic activity. Among the tested samples, PI/TiO2/Ag-0.07 (93.1%) exhibited a higher photocatalytic degradation rate than PI/TiO2 (25.7%), PI/TiO2/Ag-0.05 (77.7%), and PI/TiO2/Ag-0.09 (63.3%). This observation and evaluation conducted in the present work strongly indicated a charge transfer mechanism. Moreover, the PI/TiO2/Ag-0.07 flexible microfibers exhibited highly sensitive SERS detection, as demonstrated by the observation of the Raman peaks for TC even at an extremely low concentration of 10–10 moles per liter. The excellent photocatalytic performance and SERS detection capability of the PI/TiO2/Ag flexible microfibers arose from the Schottky barrier formed between Ag and TiO2 and also from the outstanding plasmonic resonance and visible light absorptivity of Ag, along with immobilization by the PI. The successful synthesis of PI/TiO2/Ag flexible microfibers holds significant promise for sensitive detection and efficient photocatalytic degradation of antibiotics.

Abstract Background Prenatal diagnosis of Berry syndrome, a rare combination of cardiac anomalies including aortopulmonary window (APW), aortic origin of the right pulmonary artery (RPA), interrupted aortic arch (IAA), hypoplastic aortic arch, or coarctation of the aorta (COA), poses a significant challenge. Due to the rarity of the disease, and the limited case reports available to features the complex malformation of Berry syndrome postpartum, this article introduces an innovative approach to visually showcase this unusual disease. The proposed method provides a comprehensive display of the structural deformities, offering valuable insights for clinical practitioners seeking to comprehend this condition. Case presentation In this report, we present a case where fetal echocardiography aided in diagnosing Berry syndrome, which was later confirmed through postpartum cardiovascular casting. Our experience highlights the importance of using the three-vessel view to diagnose APW and aortic origin of the right pulmonary artery. Additionally, obtaining true cross-sectional and sagittal views by continuously scanning from the three-vessel-trachea view to the long-axis view of the aortic arch is necessary to image IAA or coarctation of the aortic arch. Conclusions Early and accurate prenatal diagnosis of Berry syndrome is feasible and our cardiovascular cast can perfectly display the microvascular morphology of the fetal heart, which may have great application prospects for postpartum diagnosis and teaching of complex cardiac abnormalities.

Abstract Background Circular RNAs (circRNAs) have been proved to play crucial roles in the development of various cancers. However, the molecular mechanism of circGLIS3 involved in gastric cancer (GC) tumorigenesis has not been elucidated. Methods The higher expression level of circGLIS3 was identified in GC through RNA sequencing and subsequent tissue verification using Quantitative real-time PCR (qRT-PCR). A series of functional experiments in vitro and in vivo were performed to evaluated the effects of circGLIS3 on tumor growth and metastasis in GC. The interaction and regulation of circGLIS3/miR-1343-3p/PGK1 axis was confirmed by RNA pulldown, western blot, and rescue experiments. RIP and western blot were performed to demonstrate the role of circGLIS3 in regulating phosphorylation of VIMENTIN. We then used qRT-PCR and co culture system to trace circGLIS3 transmission via exosomal communication and identify the effect of exosomal circGLIS3 on gastric cancer and macrophages. Finally, RIP experiments were used to determine that EIF4A3 regulates circGLIS3 expression. Results CircGLIS3(hsa_circ_0002874) was significantly upregulated in GC tissues and high circGLIS3 expression was associated with advanced TNM stage and lymph node metastasis in GC patients. We discovered that overexpression of circGLIS3 promoted GC cell proliferation, migration, invasion in vitro and in vivo, while suppression of circGLIS3 exhibited the opposite effect. Mechanistically, circGLIS3 could sponge miR-1343-3p and up-regulate the expression of PGK1 to promote GC tumorigenesis. We also found that circGLIS3 reduced the phosphorylation of VIMENTIN at ser 83 site by binding with VIMENTIN. Moreover, it was proven that exosomal circGLIS3 could promote gastric cancer metastasis and the M2 type polarization of macrophages. In the final step, the mechanism of EIF4A3 regulating the generation of circGLIS3 was determined. Conclusion Our findings demonstrate that circGLIS3 promotes GC progression through sponging miR-1343-3p and regulating VIMENTIN phosphorylation. CircGLIS3 is a potential therapeutic target for GC patients.

Influenced by various geophysical factors, gravity and bathymetry exhibit significant correlations only at certain intermediate wavelengths. In this study, a deep neural network (DNN) combined with multi-source gravity data was used to recovery the intermediate wavelength (15–160 km) depth in the Sea of Japan (37–42°N, 130–138°E), to analyze the contributions of different gravity data to the bathymetric model. Subsequently, the gravity anomaly (GA), vertical gravity gradient (VGG), and vertical deflection were used as training data with a suitable DNN framework and designed training strategy. Evaluation results show that: the precision of the final DNN training models at test points surpasses that of the topo_25.1 model by 13 to 14 m; the TC1 model, with GA, VGG, and vertical deflection, is optimal, and the accuracy is 7.2 m higher than that of the (gravity geology method) GGM model on check cruises. The three types of gravity data can complement and constrain each other. In addition, predicting depths at intermediate wavelengths with significant coherence, as opposed to directly predicting absolute depths, results in higher accuracy by 20–30 m at test points, and an improvement of approximately 10 m in check accuracy.

Summary: Buildings worldwide, which represent the final piece to be addressed in the transition to carbon neutrality, require a multisectoral, comprehensive strategy for decarbonization. We provide an overview of the current global status and features of carbon emissions associated with buildings, then outline pathways and steps to achieving carbon neutrality by mid-century. By synergizing technical innovation, encompassing advanced building technologies and renewable energy solutions, with robust financial support mechanisms, we can expedite the widespread adoption of building electrification and energy system decarbonization. This integrated approach stands as the most practical and effective strategy for decarbonizing building operations. Vital measures for reducing embodied carbon include constraining the building stock growth, decarbonizing materials, and extending building lifetimes. We emphasize the importance of raising awareness of building carbon emissions among governments, residents, and other stakeholders. Understanding the challenges and the urgent need for action is crucial to achieving carbon neutrality in the building sector.