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ObjectiveDue to mixed-frequency multi-source disturbances, unmanned surface vehicles (USVs) encounter challenges in accurately capturing state information and ensuring path-tracking precision. To address this issue, a composite anti-disturbance control method based on an extended state observer combined with Kalman filter (KFESO) is proposed for distributed cooperative path following of multiple USVs.MethodsFirstly, an extended state observer combined with Kalman filter is constructed to estimate the state variables and lumped disturbances of USVs. Secondly, a distributed state observer is designed to obtain the speed information of the virtual leader. Based on the consistency theory and the line-of-sight guidance law, a kinematic cooperative controller is designed by combining the output of the KFESO and the estimated reference speed. Furthermore, a kinetic anti-disturbance controller is designed using the backstepping method and the dynamic surface control technique. The Lyapunov stability theory is employed to prove that all error signals in the control system are uniformly ultimately bounded. ResultsSimulation experiments show that the proposed method can accurately obtain the states of USVs. Under mixed-frequency multi-source disturbances, compared with the standard ESO-based control method, it has higher tracking precision and stronger anti-disturbance ability. Regarding path tracking trajectories, the proposed method achieves reduced lateral deviations and more stable trajectories. For position errors, the convergence times are comparable, but the proposed method effectively eliminates oscillations. In terms of path parameter coordination error, the proposed method can stabilize the formation, whereas the comparison method suffers from high-frequency oscillations. In terms of state estimation accuracy, the proposed method significantly improves the estimation accuracy of various state variables, enables the distributed state observer to effectively estimate the speed of the virtual leader, and achieves smaller errors in speed and control force (moment), effectively mitigating the frequent actuator response to noise.ConclusionThis method can resolve the trade-off between estimation speed and accuracy in ESO, and improve the precision of multi-USV cooperative path following.

Abstract Augmented reality (AR) displays are emerging as the next generation of interactive platform, providing deeper human-digital interactions and immersive experiences beyond traditional flat-panel displays. Diffractive waveguide is a promising optical combiner technology for AR owing to its potential for the slimmest geometry and lightest weight. However, severe chromatic aberration of diffractive coupler has constrained widespread adoption of diffractive waveguide. Wavelength-dependent light deflection, caused by dispersion in both in-coupling and out-coupling processes, results in limited full-color field of view (FOV) and nonuniform optical responses in color and angular domains. Here we introduce an innovative full-color AR system that overcomes this long-standing challenge of chromatic aberration using a combination of inverse-designed metasurface couplers and a high refractive index waveguide. The optimized metasurface couplers demonstrate true achromatic behavior across the maximum FOV supported by the waveguide (exceeding 45°). Our AR prototype based on the designed metasurface waveguide, exhibits superior color accuracy and uniformity. This unique achromatic metasurface waveguide technology is expected to advance the development of visually compelling experience in compact AR display systems.

Abstract This study aims to investigate the expression of seven cancer testis antigens (MAGE-A1, MAGE-A4, MAGE-A10, MAGE-A11, PRAME, NY-ESO-1 and KK-LC-1) in pan squamous cell carcinoma and their prognostic value, thus assessing the potential of these CTAs as immunotherapeutic targets. The protein expression of these CTAs was evaluated by immunohistochemistry in 60 lung squamous cell carcinoma (LUSC), 62 esophageal squamous cell carcinoma (ESCA) and 62 head and neck squamous cell carcinoma (HNSC). The relationship between CTAs expression and progression-free survival (PFS) was assessed. PD-L1 expression and tumor-infiltrating lymphocytes were also collected and correlated with CTAs expression. The prognostic impact of CTAs gene expression was evaluated using the Kaplan–Meier Plotter website. CTAs expression was 0–48% in ESCA, 3%-77% in LUSC, and 3%-71% in HNSC. Analysis of PFS showed that MAGE-A1 expression in HNSC (**p

Abstract Colloidal quantum dots (CQDs) are attractive gain media due to their wavelength-tunability and low optical gain threshold. Consequently, CQD lasers, especially the surface-emitting ones, are promising candidates for display, sensing and communication. However, it remains challenging to achieve a low-threshold surface-emitting CQD laser array with high stability and integration density. For this purpose, it is necessary to combine the improvement of CQD material and laser cavity. Here, we have developed high-quality CQD material with core/interlayer/graded shell structure to achieve a low gain threshold and high stability. Subsequently, surface-emitting lasers based on CQD-integrated circular Bragg resonator (CBR) have been achieved, wherein the near-unity mode confinement factor (Γ of 89%) and high Purcell factor of 22.7 attributed to the strong field confinement of CBR enable a low lasing threshold of 17 μJ cm− 2, which is 70% lower than that (56 μJ cm− 2) of CQD vertical-cavity surface-emitting laser. Benefiting from the high quality of CQD material and laser cavity, the CQD CBR laser is capable of continuous stable operation for 1000 hours (corresponding to 3.63 × 108 pulses) at room temperature. This performance is the best among solution-processed lasers composed of nanocrystals. Moreover, the miniaturized mode volume in CBR allows the integration of CQD lasers with an unprecedentedly high density above 2100 pixels per inch. Overall, the proposed low-threshold, stable and compactly integrated CQD CBR laser array would advance the development of CQD laser for practical applications.

Introduction: Widespread mask use is an important intervention for control of the coronavirus disease 2019 pandemic. However, data on the factors affecting mask use are lacking. In this observational study, we evaluated the proportion of and factors influencing face mask use and related hygiene practices. Methods: We observed randomly selected members from the public in 367 venues across Singapore, and recorded the proportion of individuals with full compliance with mask use and mask hygiene (hand hygiene before and after touching the mask or face). Logistic regression analyses were used to determine variables associated with mask and hand hygiene compliance. Results: We made 3,821 observations — 2,149 (56.2%) females, 3,569 (93.4%) adults (≥21 years), 212 (5.5%) children (6–20 years) and 40 (1.0%) children (2–5 years). The overall full compliance rate (correct mask use), poor compliance rate (incorrect mask use) and absent mask use were 84.5%, 12.9% and 2.6%, respectively. The factors — male gender, fabric mask usage and crowded indoor venues — were associated with lower mask compliance. Face or mask touching behaviour was observed in 10.7% and 13.7% of individuals observed, respectively. Only one individual performed hand hygiene before and after touching the mask. Conclusion: The rate of mask compliance was high, probably due to legislation mandating mask usage. However, specific factors and crowded indoor venues associated with lower mask compliance were identified. We also noted an issue with the absence of hand hygiene before and after face or mask touching. These issues may benefit from targeted public health messaging.

ObjectiveMulti-fidelity surrogate (MFS) modeling technology can reduce simulation costs in the design process of engineering products. In order to relax the hierarchical relationship between low-fidelity (LF) analysis models and broaden the engineering application of MFS, this paper proposes an MFS modelling method based on variance-weighted sum (VWS-MFS) for the fusion of multiple non-hierarchical LF data. MethodThe proposed method builds LF surrogate models using Kriging technology. By quantifying the uncertainty of the LF surrogate models with variance, the non-hierarchical LF data is weighted to construct a trend function. In addition, the improved hierarchical Kriging (IHK) model is introduced to fuse the high-fidelity (HF) and LF data, enabling the correction coefficient of the trend function to change throughout the design space. The proposed method is then tested on nine typical examples and applied to the performance prediction of a vibration isolator. ResultsAccording to the experimental results, the proposed method shows higher prediction accuracy than similar methods by more than 85%, and its vibration isolator performance prediction is significantly improved by more than 60% compared with the static prediction method. ConclusionThe proposed method integrates the HF analysis model and multiple non-hierarchical LF analysis models. While the hierarchical relationship between LF analysis models is relaxed, the information of LF data is mined to the maximum extent.

Abstract. Liver disease involves a complex interplay of pathological processes, including inflammation, hepatocyte necrosis, and fibrosis. End-stage liver disease (ESLD), such as liver failure and decompensated cirrhosis, has a high mortality rate, and liver transplantation is the only effective treatment. However, to overcome problems such as the shortage of donor livers and complications related to immunosuppression, there is an urgent need for new treatment strategies that need to be developed for patients with ESLD. For instance, hepatocytes derived from donor livers or stem cells can be engrafted and multiplied in the liver, substituting the host hepatocytes and rebuilding the liver parenchyma. Stem cell therapy, especially mesenchymal stem cell therapy, has been widely proved to restore liver function and alleviate liver injury in patients with severe liver disease, which has contributed to the clinical application of cell therapy. In this review, we discussed the types of cells used to treat ESLD and their therapeutic mechanisms. We also summarized the progress of clinical trials around the world and provided a perspective on cell therapy.

Abstract The golden camellia, a highly valued ornamental plant, belongs to the Chrysantha section, the sole group in the Camellia genus that produces yellow flowers. The cultivation and broader application of this unique species have been significantly hindered by the scarcity of golden camellia and the limited knowledge of the molecular mechanisms governing yellow flower development. To investigate the dynamics of metabolite accumulation and gene expression during the yellow flower formation of C. perpetua, a continuously flowering golden camellia, a comprehensive metabolomic and transcriptomic analysis was performed across five distinct developmental stages. This analysis identified 1,160 metabolites, with flavonoids constituting the largest proportion at 21.6%. Comparative transcriptomic profiling indicated that differentially expressed genes (DEGs) associated with photosynthesis were predominantly active during the early stages of flower development, while DEGs involved in the flavonoid biosynthesis pathway showed a marked increase as the flowers matured. The integrated metabolomic and transcriptomic data highlighted the pivotal regulatory role of the flavonoid biosynthesis pathway in the formation of yellow flowers in C. perpetua, identifying 50 key genes and 17 crucial metabolites and mapping their interaction networks. Furthermore, weighted gene co-expression network analysis pinpointed several hub genes, such as flavonol synthase, which are likely critical to flavonoid production due to their elevated expression levels, particularly in the early bud and yellowing phases. This study provides valuable insights into the molecular pathways that underlie yellow flower development in golden camellia species.

Abstract Due to global climate anomalies, the intensity and spatial extent of weather and climate extremes have increased notably. Therefore, extreme events must be studied to ensure agricultural production. In this study, the growing season accumulated temperature above 10 °C (GSAT10) was used as the climate regionalization index for maize in the Songliao Plain region, and the study area was divided into three climate zones. The standardized precipitation requirement index (SPRI) and standardized temperature index (STI) were introduced to analyze the spatial and temporal patterns of drought, waterlogging, and heat during the maize growing season from May to September using meteorological station data from the Songliao Plain between 1991 and 2020. The compound event magnitude indices were constructed by modeling the marginal distribution to detect the patterns of compound drought and heat events (CDHEs) and compound waterlogging and heat events (CWHEs), and to assess their potential impacts on maize production. The results show that: (1) The major meteorological disasters in the Songliao Plain region were drought and heat. The areas with prolonged high temperatures were similar to the areas with higher severity of temperature extremes, and were mainly concentrated in the central and southern parts of the study area (Zone 3). (2) The CWHEs mainly occurred in the northern part of the study area (Zones 1 and 2), and the CDHEs predominantly occurred in the central and southern parts of the study area. (3) For most sites on the Songliao Plain, the duration, severity, and intensity of compound extreme events were positively correlated with relative meteorological yield (Y w). Maize yield reduction was significantly affected by the CDHEs.

Abstract Early Diagnosis of oral cancer is very important and can save you from some oral malignancies. However, while this approach aids in the rapid healing of patients and the preservation of their lives, there are several causes for poor and wrong diagnosis of oral cancer. In recent years, the use of computer-aided design diagnosis tools as an auxiliary tool alongside clinicians has greatly benefited in more accurate identification of this malignancy. The current study proposes a new approach for identifying oral cancer patients based on image processing and deep learning. The current study employs a recently integrated model of an improved tunicate swarm algorithm to produce an efficient tool for improving a convolutional neural network and delivering an accurate cancer diagnostic system. The approach is then implemented on the oral cancer pictures dataset. The approach is then validated by comparing it to other published papers using various measurement markers. The proposed model achieved an accuracy of 98.70% and a recall of 93.71% in detecting oral cancerous lesions from photographic images. The model also achieved an F1-score of 90.08% and a precision of 96.42%. The final results demonstrate that the offered approach can produce more exact results and can be used in conjunction with clinicians to help in diagnosing oral cancer.

Abstract Background Renal fibrosis is a key process in the progression from acute kidney injury (AKI) to chronic kidney disease (CKD), while the intricate mechanisms of renal fibrosis remain obscure. While the signal-transducing adaptor protein 2 (STAP2) was well-studied for its notable function in inflammation and immune-related disorders, its specific implication in renal fibrosis remains unclear. This study assessed the mechanism by which STAP2 could promote the progression of renal fibrosis. Methods The expression level of STAP2 in fibrotic human samples, murine fibrosis models, and cellular fibrosis models was measured, respectively. Subsequently, immunoprecipitation (IP), mass spectrometry, and RNA sequencing (RNA-seq) were employed to identify HSP27 as an interacting protein and the PI3K-AKT signaling pathway. STAP2 was thereafter knocked down or overexpressed in both in vivo and in vitro models to assess the expression levels of pathway-related and fibrosis-related proteins. Finally, the important role of STAP2 in the fibrosis process in animal models induced by ischemia-reperfusion injury (IRI) and cisplatin was validated. Results Functionally, in vivo assays demonstrated that the genetic knockout of STAP2 could remarkably mitigate epithelial-mesenchymal transition (EMT), diminish inflammatory cell infiltration, and reduce collagen deposition in mice with renal fibrosis. Conversely, in vitro assays employing STAP2-overexpressing cell models exacerbated the expression levels of fibrosis markers. The outcomes uncovered a potential mechanism by which STAP2 could modulate renal fibrosis through its impact on the expression level of phosphorylated HSP27, as well as modulating the PI3K/AKT signaling pathway. Conclusions This comprehensive investigation delineated the noticeable function of STAP2 in the advancement of renal fibrosis, and the outcomes might contribute to the development of targeted therapies concentrated on STAP2 to mitigate renal fibrosis.

Transcranial magnetic stimulation (TMS) is a promising intervention for treatment-resistant psychiatric disorders. However, conventional TMS typically utilises a one-size-fits-all approach when determining stimulation targets. Recent retrospective brain circuit-based analyses using lesion network mapping have suggested that a left dorsal lateral prefrontal cortex target has a higher efficacy for alleviating depression symptoms, a dorsomedial prefrontal cortex target is more effective for anxiety symptoms, and a rostromedial prefrontal cortex target is effective for schizophrenia-associated psychiatric symptoms. Nonetheless, symptom-specific brain circuit targeting has not been tested prospectively. We conducted a narrative review of selected literature to investigate individualised targeting for TMS and discuss potential future directions to elucidate the efficacy of this approach.

Background One of the goals of nursing education is to facilitate the transition of nursing students to nursing positions on graduation, and career locus of control can assess nursing students’ expectations and beliefs about their future careers, while ‘critical thinking skill’ is listed by the International Organization for Medical Education as one of the most essential core competencies for medical graduates.Objective To investigate the distribution of career locus of control among nursing students before and after the COVID-19 epidemic, to explore the association between career locus of control and critical thinking and to analyse the pathways of influence of critical thinking on career locus of control among nursing students.Design and method In this study, a total of 456 current undergraduate nursing students were selected online from Chengdu University in China in December 2022 and March 2024, respectively. A career locus of control scale and a critical thinking disposition inventory-Chinese version were used.Patient or public involvement This study was approved by the Department of Social Science and the School of Medicine of Chengdu University. The researchers explained the purpose of the study to the subjects, so as to obtain their voluntary participation, ensure anonymity and confidentiality, and require each subject to read the informed consent form carefully and have the right to refuse to participate. Two surveys were conducted separately in December 2022 (during the COVID-19 pandemic) and March 2024 (during the normal control period of the epidemic) among 227 and 229 undergraduate nursing students, yielding a full response rate of 100%.Result There was a correlation between career locus of control and critical thinking, among which career internal control was positively correlated with the score of critical thinking, and low professional efficacy and career opportunities were negatively correlated with the score of critical thinking. Analyticity and inquisitiveness could be used to predict the scores of career internal control, and open-mindedness could be used to predict the scores of critical thinking (β=−0.103). Confidence in reasoning (β=−0.055) could be used to predict the scores of career opportunity. Analyticity and truth-seeking could be used to predict the scores of career external control. The COVID-19 epidemic reduced the career opportunity score by 0.596 points.Conclusion Nurse educators should recognise the importance of critical thinking training for nursing students, which enables them to adjust their career locus of control by improving critical thinking and may influence professional expectations, improve self-image within the nursing profession and increase retention of nurses.

The Qilian Mountains and Huangshui River Basin (HRB) represent significant ecological functional areas and carbon reservoirs within China. The estimation and prediction of vegetation net primary productivity (NPP) in this area is beneficial for the management of China’s terrestrial ecosystems. Nevertheless, the existing estimation methods for vegetation NPP at the local scale are characterised by considerable uncertainty and error, and have not accounted for the influence of multi-factor interactions. Accordingly, this study initially sought to quantify the vegetation NPP data within the HRB from 2000 to 2019 through the implementation of an improved Carnegie-Ames-Stanford Approach (CASA) model. Subsequently, it endeavoured to elucidate the spatiotemporal evolution patterns and influencing factors of vegetation NPP within the HRB over the years. Subsequently, the ConvGRU spatiotemporal prediction model was employed to investigate the prospective trajectory of vegetation NPP in the HRB. The findings revealed a notable upward trajectory in the annual variation of vegetation NPP in the HRB between 2000 and 2019. The majority of regions have demonstrated a notable increase in vegetation NPP, although a few areas have exhibited a decline. Furthermore, the correlation between vegetation NPP and PRE, TEMP, SR, and NDVI exhibits regional disparities. Furthermore, the spatial variation characteristics of vegetation NPP in the HRB in the future also demonstrate an overall increasing trend. Additionally, the vegetation NPP in the HRB exhibits significant spatial distribution characteristics, with evident trends of hot spot contraction or cold spot expansion. This study provides pivotal methods and theoretical support for the assessment of carbon sequestration status in the HRB of the Qilian Mountains and analogous regions.

Abstract In this work, AlGaN‐based deep ultraviolet Fabry–Perot (FP) laser diodes (DUV LDs) are designed by using Technology Computer Aided Design (TCAD) simulations, and the physical models for DUV LDs are also developed. It is found that the optical absorption in the p‐region significantly increases the optical loss and reduces the laser power. Hence, properly increasing the Al composition for the p‐waveguide (p‐WG) and the p‐type cladding layer (CL) helps shift the optical field to the n‐region, which is effective in decreasing the free‐carrier absorption in the p‐region. However, if not properly optimized, this will decrease the optical confinement factor, which will decrease the stimulated recombination rate between electrons and holes. Then, the electron leakage becomes significant. The studies show that the p‐electron blocking layer (p‐EBL) will not strongly affect the optical field profiles. Hence, the Al composition in the p‐EBL has more freedom for electrical optimization. Therefore, a compromised design is required so that both the optical and the electrical properties can be improved.

Melamine is one of the most frequently detected adulterants in dairy products. The current study proposes a surface-enhanced Raman spectroscopy (SERS)-based analytical tool for fast and reliable screening of melamine in bovine milk. A hand-held Raman spectrometer was used in conjunction with a substrate composed of silver nanoparticles (AgNPs) that was 2D printed onto glass fiber (GF) filter paper. Under optimized conditions, a sensitive and fingerprint-like signal at 674 cm−1 was obtained. The AgNPs/GF substrate exhibited high sensitivity to melamine in milk down to 1.9498×10−5 mg/mL, which is well below the USA and EU safety limits (2.5×10−3 mg/mL). Remarkably, the proposed technology was also highly reproducible, showing spot-to-spot and block-to-block variations below 3.3% and 4.9% at 674 cm−1 in Raman intensity, respectively. The characteristic peak intensity and concentration of melamine showed an acceptable linear relationship (R2=0.9909) within the range of 0.0001-1 mg/mL. Overall, the method established in this study can provide an efficient and effective method for the quantitative target screening and detection of melamine in dairy products.

Repetitive transcranial magnetic stimulation (rTMS) is a novel and noninvasive neuromodulation therapy used for treatment-resistant major depressive disorder (MDD)1 and obsessive-compulsive disorder (OCD).2 OCD and depression are disabling psychiatric disorders, which have a detrimental impact on individuals, their families and society.3,4 The lifetime prevalence of depression is high at 5.8% and OCD affects 1 in 28 Singaporeans.5 Depression contributes substantially to the global burden of disease and disability.6 However, despite effective pharmacological and psychological interventions, approximately 40% to 50% of patients have not responded satisfactorily to standard treatment.7

[Objective] This study aims to investigate the carbon storage, carbon sink function, and response mechanism to climate in Pinus sylvestris var. mongolica plantations with different initial planting densities on the southern edge of Horqin Sandy Land. The goal is to facilitate the assessment of the carbon sequestration function and adaptive management of forest ecosystems. [Methods] Estimating carbon storage and carbon sequestration rate of Pinus sylvestris plantations using stand height and cross-sectional area, and analyzing their responses to temperature, precipitation, and evaporation in conjunction with meteorological factors. The GM (1,1) grey prediction model was used to predict forest carbon storage in 2030. [Results] The carbon storage and sequestration rate of Pinus sylvestris plantations with different initial planting densities exhibited similar annual fluctuations, with an overall increase in carbon storage each year. The curve of the sequestration rate showed a “U” shape. Both thinly and excessive initial planting densities can reduce the carbon carbon sequestration capacity of Pinus sylvestris plantations. Before reaching 32 years old, the highest carbon sequestration intensity was observed in stands with initial planting densities of 1 500~2 000 tree/hm2, and for stands aged 35~46 years, the optimal density was 1 000~1 200 tree/hm2. The carbon storage increased logarithmically with increasing stand density.The response pattern of the planted Pinus sylvestris forests’carbon sequestration rate differed among stands with different initial planting densities regarding temperature but not precipitation. For high and extremely high-density Pinus sylvestris plantations, the average temperature in August of the previous year and in March, May, June and July of the current year were the main climatic factors limiting carbon sink. For low and medium-density plantations, the average temperature in August of the previous year and in March and October of the current year were the main climatic factors that constrain carbon sink. The correlation analysis between evapotranspiration and carbon sequestration rate in different planting density stands showed that carbon sink of low-density Pinus sylvestris plantations was more sensitive to evapotranspiration. Based on the GM (1,1) grey model, it was found that excessively high or low initial planting density would reduce the carbon sequestration potential of future Pinus sylvestris plantations. The optimal planting density for carbon sequestration rate was 1 772 tree/hm2. [Conclusion] The initial planting density of Pinus sylvestris has a significant impact on carbon storage and carbon sequestration, as well as their response to climate change in sandy areas. Adjusting the initial planting density may be one of the key adaptive management measures for Pinus sylvestris plantations under climate change.

To summarize and report nursing experience of the application of interactive online health education in impression making for biological functional denture restoration in a patient with dentition defects. Nursing staff applied interactive online health education in advance, and provided individual guidance on oral-motor movement in the impression making. As a result, the patient demonstrated excellent cooperation with oral movements during the procedure, leading to optimal impression-taking outcomes and improved clinical efficiency. (本文总结网络互动式健康教育应用于1例牙列缺失患者生物功能性义齿修复印模制取中的护理经验。护理人员通过应用网络互动式健康教育提前进行了沟通和教导, 指导患者掌握印模制取时的口腔功能性配合动作, 有效提高患者配合度和印模制取精度。)

The rare and endangered wild plant, Horsfieldia hainanensis, has been listed as a second-level key protected plant in China. Currently, its habitat is severely damaged, and the population has dramatically declined, necessitating urgent intervention for protection. In this study, the aim was to explore the correlations and differences from the perspectives of photosynthetic characteristics and leaf structure, providing scientific references for in-situ conservation and ex-situ cultivation. The results revealed the following: (1) The maximum net photosynthetic rate (Pmax) and light saturation point (LSP) of mature trees were significantly higher than those of seedlings, while the light compensation point (LCP), CO2 compensation point (CCP), and CO2 saturation point (CSP) were significantly lower in seedlings. (2) The average daily net photosynthetic rate of mature trees was significantly higher than that of seedlings. When both mature trees and seedlings exhibited a “midday depression” phenomenon, accompanied by an increase in intercellular CO2 concentration (Ci), it indicated that the “midday depression” was caused by non-stomatal limiting factors. (4) Both mature trees and seedlings showed peak values of water use efficiency (WUE) under low light conditions. Mature trees had smaller upper and lower epidermis thickness but larger leaf thickness, and their leaf structure, characterized by well-developed palisade and spongy tissues, conformed to the cellular structure adaptations for low light. Therefore, both were more adapted to low light conditions. (5) The stomatal density (SD) and individual stomatal area (SA) of seedlings were significantly higher than those of mature trees. (6) The total chlorophyll content of mature trees was significantly higher than that of seedlings, while the chlorophyll a/chlorophyll b ratio was significantly lower in mature trees and remained below three in both cases. In summary, the photosynthetic capacity and light adaptability of mature trees are stronger than those of seedlings, but both mature trees and seedlings exhibit shade-tolerant characteristics. For in-situ conservation, it is possible to promote the growth and development of seedlings by appropriately employing artificial “windowing” or shading methods based on the actual growth environment of the seedlings. In the case of ex-situ cultivation, seedlings should be provided with appropriate shading initially, while ensuring sufficient moisture and CO2 concentration. As the plants grow, the shading intensity can be gradually reduced. Once the plants reach maturity, they have a broader range of light adaptability and can be transplanted to environments with less shading.

ABSTRACTThe personalized neoantigen nanovaccine (PNVAC) platform for patients with gastric cancer we established previously exhibited promising anti-tumor immunoreaction. However, limited by the ability of traditional neoantigen prediction tools, a portion of epitopes failed to induce specific immune response. In order to filter out more neoantigens to optimize our PNVAC platform, we develop a novel neoantigen prediction model, NUCC. This prediction tool trained through a deep learning approach exhibits better neoantigen prediction performance than other prediction tools, not only in two independent epitope datasets, but also in a totally new epitope dataset we construct from scratch, including 25 patients with advance gastric cancer and 150 candidate mutant peptides, 13 of which prove to be neoantigen by immunogenicity test in vitro. Our work lay the foundation for the improvement of our PNVAC platform for gastric cancer in the future.

This study investigated the effects of incorporating different levels of Euglena gracilis microalgae powder (MP) on the dough properties, rheology, and quality attributes of Chinese steamed bread (CSB) for the first time. Moderate levels of MP (2%) reinforced the gluten network and improved protein structure, while higher levels (4–8%) adversely affected the gluten network and rheological properties. The addition of MP decreased the specific volume, pore number, and pore density of CSB, but increased pore size, hardness, and chewiness. It also imparted a yellow color to the CSB and slowed down moisture loss during storage. Notably, MP effectively increased the protein and lipid content of CSB, enhancing its nutritional value. The results suggest that optimizing the MP level is crucial to achieve nutritional enhancement while maintaining desirable texture and sensory attributes. An addition of 2% MP can strike a balance between nutrition and the overall quality of the final product.

In order to mitigate spring frost damage to wheat in the Huanghuaihai region, this paper developed a combined frost index (CFI) based on daily meteorological observations collected from 46 stations between 2000 and 2020, along with wheat yield data. Grounded in the Soil-Plant-Atmosphere Continuum (SPAC) theory, which encompasses meteorological, soil, and crop factors, the study employed a combination assignment method based on ideal points to allocate indicators. Subsequently, this study delves into the spatial and temporal distribution characteristics of frost events in the Huanghuaihai region and carefully assesses the risk of frost damage in the region. The findings indicate that: (1) CFI was a significant predictor of relative meteorological yield in wheat across various growth stages, with a highly significant negative correlation observed, thus verifying the index’s validity. (2) The results of our analysis indicated significant inter-annual variations in the wheat frost index (Tz), with particularly abrupt changes observed during the early and late spring frost events of 1997 and 2009. (3) The spatial distribution of wheat frost damage during the two growth stages exhibited distinct regional disparities, with a consistent northward increase in severity, predominantly concentrated in the northern part of the Huanghuaihai region.

Abstract Optical detection of magnetic field is appealing for integrated photonics; however, the light-matter interaction is usually weak at low field. Here we observe that the photoluminescence (PL) decreases by > 40% at 10 mT in rubrene microcrystals (RMCs) prepared by a capillary-bridge assembly method. The giant magneto-PL (MPL) relies on the singlet-triplet conversion involving triplet-triplet pairs, through the processes of singlet fission (SF) and triplet fusion (TF) during radiative decay. Importantly, the size of RMCs is critical for maximizing MPL as it influences on the photophysical processes of spin state conversion. The SF/TF process is quantified by measuring the prompt/delayed PL with time-resolved spectroscopies, which shows that the geminate SF/TF associated with triplet-triplet pairs are responsible for the giant MPL. Furthermore, the RMC-based magnetometer is constructed on an optical chip, which takes advantages of remarkable low-field sensitivity over a broad range of frequencies, representing a prototype of emerging opto-spintronic molecular devices.

Abstract Molecular ferroelectrics are attracting great interest due to their light weight, mechanical flexibility, low cost, ease of processing and environmental friendliness. These advantages make molecular ferroelectrics viable alternatives or supplements to inorganic ceramics and polymer ferroelectrics. It is expected that molecular ferroelectrics with good performance can be fabricated, which in turns calls for effective chemical design strategies in crystal engineering. To achieve so, we propose a hydrogen bond modification method by introducing the hydroxyl group, and successfully boost the phase transition temperature (T c) by at least 336 K. As a result, the molecular ferroelectric 1-hydroxy-3-adamantanammonium tetrafluoroborate [(HaaOH)BF4] can maintain ferroelectricity until 528 K, a T c value much larger than that of BTO (390 K). Meanwhile, micro-domain patterns, in stable state for 2 years, can be directly written on the film of (HaaOH)BF4. In this respect, hydrogen bond modification is a feasible and effective strategy for designing molecular ferroelectrics with high T c and stable ferroelectric domains. Such an organic molecule with varied modification sites and the precise crystal engineering can provide an efficient route to enrich high-T c ferroelectrics with various physical properties.

Abstract Compared with conventional soils, such as sand and clay, little knowledge on the coefficient of lateral earth pressure at-rest (K 0) has been established for loess in the current literature. This paper presents an experimental investigation on K 0 of compacted loess and the associated impacts on undrained shear behaviour. By adopting a K 0 consolidation module in the triaxial system, the K 0 stress state for loess samples was achieved through a unique feedback control. During the K 0 consolidation, the deviatoric stress (q) increases progressively with the premise that the volumetric strain (ε v) of the sample equals to the axial strain (ε a). The results show that the K 0 value of compacted loess is in a range of 0.28 to 0.53, which is dependent on the packing density and the clay content. A distinguishable decrease of K 0 was found in the course of K 0 consolidation for the loosely compacted loess sample, whereas a similar trend was not observed in the dense sample. In the undrained shear stage, all loess specimens revealed contractive response in the stress path (q-p’) diagram, which can be quantified by a modified collapsibility index (I c). The index is consistently higher for the K 0 consolidated loess samples than for the isotropic ones. The experimental results indicate a strong impact of the initial stress state on the shear behaviour of compacted loess.

Low cost stainless steels (SS) with high performance, especially with good mechanical properties and oxidation resistance at high temperature, are continuous pursuit for manufacture industry. To achieve good combination of mechanical properties, oxidation resistance and cost, nanoprecipitate strengthened alumina forming austenitic (NSAFA) SS have been developed by removing expensive elements such as Nb and Ta, lowering Ni concentration in Fe–26Ni–15Cr-1.5Mo-(2.8–3.5)Al-(1–2.35)Ti (wt.%) alloys. Microstructure investigation demonstrates that NSAFA SS are strengthened by L12 structured (Ni, Fe)3(Al, Ti) γ′ nanoprecipitates with area fraction around 25%–40%. Oxidation experiments (750 °C/480 h) in air demonstrates that all the NSAFA steels have alumina forming ability. In addition, it is found that Al and Ti are all necessary for γ′ nanoprecipitates, but additional Al and Ti facilitate formation of the Ni2AlTi phase. To ensure high volume fraction of γ′ nanoprecipitates and reduce Ni2AlTi phase, 2.8–3.0 wt% Al and 1.8–2.35 wt% Ti are preferred. Benefit from the high volume fraction of γ′ nanoprecipitates, yield strength of NSAFA steels is much higher than that of Fe-base superalloy (e.g., A286) and can compare to some Ni-base superalloys (e.g., Hayners 282 & Inconel 740H).

Abstract Objective Weight regain after weight loss is a challenge in obesity management. The metabolic changes and underlying mechanisms in obese people with weight fluctuation remain to be elucidated. In the present study, we aimed to profile the features and clinical significance of liver transcriptome in obese mice with weight regain after weight loss. Methods The male C57BL/6J mice were fed with standard chow diet or high-fat diet (HFD). After 9 weeks, the HFD-induced obese mice were randomly divided into weight gain (WG), weight loss (WL) and weight regain (WR) group. After 10 weeks of dietary intervention, body weight, fasting blood glucose (FBG), intraperitoneal glucose tolerance, triglycerides (TG), total cholesterol (T-CHO) and low-density lipoprotein cholesterol (LDL-C) were measured. Morphological structure and lipid droplet accumulation in the liver were observed by H&E staining and oil red O staining, respectively. The liver transcriptome was detected by RNA sequencing. Protein expressions of liver cytochrome P450 3a11 (Cyp3a11) and E4 promoter-binding protein 4 (E4bp4) were determined by Western blot. Results After 10 weeks of dietary intervention, the body weight, FBG, glucose area under the curve, T-CHO and LDL-C in WL group were significantly lower than those in WG group (P

A rapid increase in natural gas consumption has resulted in a shortage of conventional natural gas resources, while an increasing concentration of CH4 in the atmosphere has intensified the greenhouse effect. The exploration and utilization of coalbed methane (CBM) resources not only has the potential to fill the gap in natural gas supply and promote the development of green energy, but could also reduce CH4 emissions into the atmosphere and alleviate global warming. However, the efficient separation of CH4 and N2 has become a significant challenge in the utilization of CBM, which has attracted significant attention from researchers in recent years. The development of efficient CH4/N2 separation technologies is crucial for enhancing the exploitation and utilization of low-concentration CBM and is of great significance for sustainable development. In this paper, we provide an overview of the current methods for CH4/N2 separation, summarizing their respective advantages and limitations. Subsequently, we focus on reviewing research advancements in adsorbents for CH4/N2 separation, including zeolites, metal–organic frameworks (MOFs), and porous carbon materials. We also analyze the relationship between the pore structure and surface properties of these adsorbents and their adsorption separation performances, and summarize the challenges and difficulties that different types of adsorbents face in their future development. In addition, we also highlight that matching the properties of adsorbents and adsorbates, controlling pore structures, and tuning surface properties on an atomic scale will significantly increase the potential of adsorbents for CH4 capture and separation from CBM.

Intermediate temperature brittleness in alloys characterized as brittle fracture along grain boundaries (GBs) with less than 5% elongation to fracture (EF) at 600 °C–900 °C diminishes work hardening, leads to sudden failure under load, and thus threatens the reliability during the service of alloys. Here, in a precipitation-strengthened CoNiCr alloy, through two grain boundary engineering (GBE) methods, fiber-like γ ′ or topologically close-packed phase is introduced at GBs, which effectively optimizes the grain structure and prevents GB cracking under tensile stresses. GBEs not only alter the deformation mode from dislocation pairs to stacking faults and/or deformation twins, but also transform the failure mode from GB cracking to GB void formation, because the crack propagation along GBs is constrained by GB bridging phases. Consequently, our GBE approach enhances tensile EF from ∼1% to ∼10% and concurrently increases the yield strength from ∼650 to ∼770–850 MPa at 800 °C. A cavity growth model is then developed to illustrate the role of these bridging phases in GBs for ductility improvement. The fundamental philosophy utilized in the present work might be also applicable to other metallic materials.

Background We compared the relative benefits, harms and cost-effectiveness of hyperthermic intraoperative peritoneal chemotherapy + cytoreductive surgery ± systemic chemotherapy versus cytoreductive surgery ± systemic chemotherapy or systemic chemotherapy alone in people with peritoneal metastases from colorectal, gastric or ovarian cancers by a systematic review, meta-analysis and model-based cost–utility analysis. Methods We searched MEDLINE, EMBASE, Cochrane Library and the Science Citation Index, ClinicalTrials.gov and WHO ICTRP trial registers until 14 April 2022. We included only randomised controlled trials addressing the research objectives. We used the Cochrane risk of bias tool version 2 to assess the risk of bias in randomised controlled trials. We used the random-effects model for data synthesis when applicable. For the cost-effectiveness analysis, we performed a model-based cost–utility analysis using methods recommended by The National Institute for Health and Care Excellence. Results The systematic review included a total of eight randomised controlled trials (seven randomised controlled trials, 955 participants included in the quantitative analysis). All comparisons other than those for stage III or greater epithelial ovarian cancer contained only one trial, indicating the paucity of randomised controlled trials that provided data. For colorectal cancer, hyperthermic intraoperative peritoneal chemotherapy + cytoreductive surgery + systemic chemotherapy probably results in little to no difference in all-cause mortality (60.6% vs. 60.6%; hazard ratio 1.00, 95% confidence interval 0.63 to 1.58) and may increase the serious adverse event proportions compared to cytoreductive surgery ± systemic chemotherapy (25.6% vs. 15.2%; risk ratio 1.69, 95% confidence interval 1.03 to 2.77). Hyperthermic intraoperative peritoneal chemotherapy + cytoreductive surgery + systemic chemotherapy probably decreases all-cause mortality compared to fluorouracil-based systemic chemotherapy alone (40.8% vs. 60.8%; hazard ratio 0.55, 95% confidence interval 0.32 to 0.95). For gastric cancer, there is high uncertainty about the effects of hyperthermic intraoperative peritoneal chemotherapy + cytoreductive surgery + systemic chemotherapy versus cytoreductive surgery + systemic chemotherapy or systemic chemotherapy alone on all-cause mortality. For stage III or greater epithelial ovarian cancer undergoing interval cytoreductive surgery, hyperthermic intraoperative peritoneal chemotherapy + cytoreductive surgery + systemic chemotherapy probably decreases all-cause mortality compared to cytoreductive surgery + systemic chemotherapy (46.3% vs. 57.4%; hazard ratio 0.73, 95% confidence interval 0.57 to 0.93). Hyperthermic intraoperative peritoneal chemotherapy + cytoreductive surgery + systemic chemotherapy may not be cost-effective versus cytoreductive surgery + systemic chemotherapy for colorectal cancer but may be cost-effective for the remaining comparisons. Limitations We were unable to obtain individual participant data as planned. The limited number of randomised controlled trials for each comparison and the paucity of data on health-related quality of life mean that the recommendations may change as new evidence (from trials with a low risk of bias) emerges. Conclusions In people with peritoneal metastases from colorectal cancer with limited peritoneal metastases and who are likely to withstand major surgery, hyperthermic intraoperative peritoneal chemotherapy + cytoreductive surgery + systemic chemotherapy should not be used in routine clinical practice (strong recommendation). There is considerable uncertainty as to whether hyperthermic intraoperative peritoneal chemotherapy + cytoreductive surgery + systemic chemotherapy or cytoreductive surgery + systemic chemotherapy should be offered to patients with gastric cancer and peritoneal metastases (no recommendation). Hyperthermic intraoperative peritoneal chemotherapy + cytoreductive surgery + systemic chemotherapy should be offered routinely to women with stage III or greater epithelial ovarian cancer and metastases confined to the abdomen requiring and likely to withstand interval cytoreductive surgery after chemotherapy (strong recommendation). Future work More randomised controlled trials are necessary. Study registration This study is registered as PROSPERO CRD42019130504. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 17/135/02) and is published in full in Health Technology Assessment; Vol. 28, No. 51. See the NIHR Funding and Awards website for further award information. Plain language summary What was the question? Cancers of the bowel, ovary or stomach can spread to the lining of the abdomen (‘peritoneal metastases’). Chemotherapy (the use of drugs that aim to kill cancer cells) given by injection or tablets (‘systemic chemotherapy’) is one of the main treatment options. There is uncertainty about whether adding cytoreductive surgery (cytoreductive surgery; an operation to remove the cancer) and ‘hyperthermic intraoperative peritoneal chemotherapy’ (warm chemotherapy delivered into the lining of the abdomen during cytoreductive surgery) are beneficial. What did we do? We reviewed all the information from medical literature published until 14 April 2022, to answer the above uncertainty. What did we find? We found the following from eight trials, including about 1000 participants. In people with peritoneal metastases from bowel cancer, hyperthermic intraoperative peritoneal chemotherapy + cytoreductive surgery + systemic chemotherapy probably does not provide any benefits and increases harm compared to cytoreductive surgery + systemic chemotherapy, while cytoreductive surgery + systemic chemotherapy appears to increase survival compared to systemic chemotherapy alone. There is uncertainty about the best treatment for people with peritoneal metastases from stomach cancer. In women with peritoneal metastases from ovarian cancer who require systemic chemotherapy before cytoreductive surgery to shrink the cancer to allow surgery (‘advanced ovarian cancer’), hyperthermic intraoperative peritoneal chemotherapy + cytoreductive surgery + systemic chemotherapy probably increases survival compared to cytoreductive surgery + systemic chemotherapy. What does this mean? In people who can withstand a major operation and in whom cancer can be removed, cytoreductive surgery + systemic chemotherapy should be offered to people with peritoneal metastases from bowel cancer, while hyperthermic intraoperative peritoneal chemotherapy + cytoreductive surgery + systemic chemotherapy should be offered to women with peritoneal metastases from ‘advanced ovarian cancer’. Uncertainty in treatment continues for gastric cancer. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 17/135/02) and is published in full in Health Technology Assessment; Vol. 28, No. 51. See the NIHR Funding and Awards website for further award information. Scientific summary Background There is uncertainty about whether hyperthermic intraoperative peritoneal chemotherapy (HIPEC) with cytoreductive surgery (CRS) improves survival and/or quality of life (QoL) compared to CRS or no treatment in addition to systemic chemotherapy in people with peritoneal metastases who can withstand major surgery. Objectives Primary objectives To compare the relative benefits and harms of HIPEC + CRS ± systemic chemotherapy versus CRS ± systemic chemotherapy or systemic chemotherapy alone in people with peritoneal metastases from colorectal, gastric or stage III or greater epithelial ovarian cancers eligible to undergo HIPEC + CRS by a systematic review and meta-analysis. Secondary objectives To compare the cost-effectiveness of HIPEC + CRS ± systemic chemotherapy versus CRS ± systemic chemotherapy or systemic chemotherapy alone from the NHS and personal social services (PSS) perspective using a model-based cost–utility analysis. Methods We performed a systematic review of literature by searching MEDLINE, EMBASE, Cochrane Library, Science Citation Index, Conference Proceedings Citation Index, as well as trial registers until 14 April 2022. We followed the standard guidance for performing a high-quality systematic review and meta-analysis. We included only randomised controlled trials (RCTs) and assessed the risk of bias using Risk of Bias version 2.0 (ROB 2.0). We were unable to perform an individual participant data (IPD) meta-analysis as planned because of unforeseen circumstances related to coronavirus disease 2019 (COVID-19). This led to trialists who were also clinical researchers being unable to engage for transfer of IPD. We did not foresee that study authors (surgeons) would be sufficiently engaged with providing IPD soon because of the backlog with surgeries and the fatigue induced by COVID-19. Therefore, we performed a meta-analysis based on aggregate data. We calculated the hazard ratio (HR), risk ratio (RR), rate ratio or mean difference (MD) with 95% confidence intervals (CIs) as appropriate. When applicable, we performed meta-analysis using the random-effects model using Review Manager 5.4. We used GRADE guidance to assess the certainty of evidence and determine the strength of recommendations. For the cost-effectiveness analysis, we performed a model-based cost–utility analysis using methods recommended by The National Institute for Health and Care Excellence (NICE). We estimated the costs and quality-adjusted life-years (QALYs) per patient using lifetime horizon. We calculated the incremental net monetary benefit (incremental NMB) for each comparison based on deterministic analysis and probabilistic sensitivity analysis (PSA). We also performed univariate sensitivity analysis and value of information analysis. Results The systematic review included a total of eight RCTs. A total of 955 participants in seven RCTs were included in the quantitative analysis. All comparisons other than those of ovarian cancer contained only one trial. For colorectal cancer, HIPEC + CRS + systemic chemotherapy probably results in little to no difference in all-cause mortality (60.6% in HIPEC + CRS + systemic chemotherapy vs. 60.6% in CRS + systemic chemotherapy; median follow-up 64 months; HR 1.00, 95% CI 0.63 to 1.58; one trial; 265 participants; moderate-certainty evidence) and may increase the number of people who developed serious adverse events compared to CRS +/– systemic chemotherapy (25.6% in HIPEC + CRS + systemic chemotherapy vs. 15.2% in CRS + systemic chemotherapy; RR 1.69, 95% CI 1.03 to 2.77; one trial; 265 participants; low-certainty evidence). HIPEC + CRS + systemic chemotherapy probably decreases all-cause mortality compared to fluorouracil-based systemic chemotherapy alone (40.8% in HIPEC + CRS + systemic chemotherapy vs. 60.8% in systemic chemotherapy alone; median follow-up 22 months; HR 0.55, 95% CI 0.32 to 0.95; one trial; 105 participants; moderate-certainty evidence). For gastric cancer, there is high uncertainty about the effect of HIPEC + CRS + systemic chemotherapy versus CRS + systemic chemotherapy on all-cause mortality (effect estimates not presented because of very low-certainty evidence). HIPEC + CRS + systemic chemotherapy probably decreases all-cause mortality compared to systemic chemotherapy (40.8% in HIPEC + CRS + systemic chemotherapy vs. 100% in systemic chemotherapy alone; minimum follow-up 24 months; HR 0.40, 95% CI 0.30 to 0.52; one trial; 17 participants; moderate-certainty evidence). For stage III or greater epithelial ovarian cancer requiring interval CRS, HIPEC + CRS + systemic chemotherapy probably decreases all-cause mortality compared to CRS + systemic chemotherapy (46.3% in HIPEC + CRS + systemic chemotherapy vs. 57.4% in CRS + systemic chemotherapy; median follow-up 32–70 months; HR 0.73, 95% CI 0.57 to 0.93; three trials; 500 participants; moderate-certainty evidence). It may result in little to no difference in health-related quality of life (HRQoL) (MD 4.85, 95% CI −7.74 to 17.44; one trial; 71 participants; moderate-certainty evidence) or number of people who developed serious adverse events compared to CRS + systemic chemotherapy (26.7% in HIPEC + CRS + systemic chemotherapy vs. 25.2% in CRS + systemic chemotherapy; RR 1.06, 95% CI 0.73 to 1.54; two trials; 316 participants; moderate-certainty evidence), although it probably increases the number of serious adverse events per participant compared to CRS + systemic chemotherapy (41.4 events per 100 participants in HIPEC + CRS + systemic chemotherapy vs. 32.6 events per 100 participants in CRS + systemic chemotherapy; rate ratio 1.27, 95% CI 1.09 to 1.49; one trial; 184 participants; moderate-certainty evidence). The cost-effectiveness analysis included the five comparisons described above: HIPEC + CRS + systemic chemotherapy versus CRS + systemic chemotherapy for each of the colorectal, gastric and ovarian cancers and HIPEC + CRS + systemic chemotherapy versus systemic chemotherapy alone for each of the colorectal and gastric cancers. In people with colorectal peritoneal metastases, the incremental NMBs at willingness to pay (WTP) of £20,000 and £30,000 were −£6162.83 and −£6164.19, respectively, indicating that HIPEC + CRS + systemic chemotherapy was not cost-effective compared to CRS + systemic chemotherapy in NHS. The likelihood of HIPEC + CRS + systemic chemotherapy being cost-effective compared to CRS + systemic chemotherapy was 46.5% and 47.6% at WTP of £20,000 and £30,000, respectively. In the same group of people, the incremental NMBs at WTP of £20,000 and £30,000 were £107,909.46 and £167,621.58, respectively, indicating that HIPEC + CRS + systemic chemotherapy may be cost-effective compared to systemic chemotherapy alone in NHS. The likelihood of HIPEC + CRS + systemic chemotherapy being cost-effective compared to systemic chemotherapy alone was 89.3% and 90.3% at WTP of £20,000 and £30,000, respectively. In people with gastric peritoneal metastases, the incremental NMBs at WTP of £20,000 and £30,000 were £14,174.73 and £22,955.89, respectively, for HIPEC + CRS + systemic chemotherapy versus CRS + systemic chemotherapy and £81,796.38 and £127,768.23, respectively, for HIPEC + CRS + systemic chemotherapy versus systemic chemotherapy, indicating that HIPEC + CRS + systemic chemotherapy may be cost-effective compared to CRS + systemic chemotherapy or systemic chemotherapy alone in NHS. The likelihood of HIPEC + CRS + systemic chemotherapy being cost-effective ranged between 60% and 70% for the different comparisons and different thresholds. In women with grade III or greater epithelial ovarian cancer requiring interval CRS, the incremental NMBs at WTP of £20,000 and £30,000 were £46,761.81 and £71,938.23, respectively, indicating that HIPEC + CRS + systemic chemotherapy was cost-effective compared to CRS +systemic chemotherapy in NHS. The likelihood of HIPEC + CRS + systemic chemotherapy being cost-effective compared to CRS + systemic chemotherapy was 71.9% and 72.4% at WTP of £20,000 and £30,000, respectively. The value of information analysis indicated that the expected value of perfect information (EVPI) ranged between £3 and £53 million for the different cancer types (when estimation was possible) for WTP of £20,000 and £30,000. Discussion and conclusions Limitations of the review We were unable to obtain IPD as planned. IPD would have allowed us to refine our effect estimates for subgroups of people with peritoneal metastases from colorectal, gastric or stage III or greater epithelial ovarian cancer. It is difficult to estimate whether our conclusions would have changed if we had IPD; however, our systematic review and meta-analysis support similar conclusions as the trial authors, suggesting that the impact of IPD may not be major enough to warrant an IPD once the health services have recovered from the impact of COVID-19. We estimated the HR for survival for gastric cancer trials from Kaplan–Meier curves. This might have introduced bias. However, because of the small number of participants and the estimations that we have performed to calculate the effect estimates, we have concluded that there is uncertainty in the benefit of HIPEC + CRS + systemic chemotherapy in gastric cancers. Because of the paucity of trials under each comparison, evidence from new RCTs of low risk of bias may change our recommendations. There are concerns regarding the clinical recommendations for people with colorectal peritoneal metastases based on the PRODIGE-7 trial. We have discussed in detail the different concerns raised and why these concerns should not be used as a justification for not basing clinical practice on PRODIGE-7 trial (in the full article). In summary, we based our clinical practice recommendations for colorectal peritoneal metastases on PRODIGE-7 trial because the trial was a low risk of bias trial for the comparison of HIPEC + CRS + systemic chemotherapy versus CRS + systemic chemotherapy. An appropriate analysis was used to analyse trial data, and there was no other trial of low of bias comparing HIPEC + CRS + systemic chemotherapy versus CRS + systemic chemotherapy. While the CRS + systemic chemotherapy was not directly compared with systemic chemotherapy alone, we recommended CRS + systemic chemotherapy in people with colorectal peritoneal metastases because of the lack of any ‘systemic chemotherapy alone’ treatments that provide equivalent median survival as that observed in the control arm (CRS + systemic chemotherapy) in the PRODIGE-7 trial. Because of the difficulties in estimating the Peritoneal Cancer Index (PCI) during surgery, we have not recommended HIPEC + CRS + systemic chemotherapy even for the subset of patients with PCI 11–15, but this exploratory subgroup analysis can guide future research. We have not based our recommendations on non-randomised studies, as we did not find any non-randomised study in which similar participants with colorectal peritoneal metastases underwent HIPEC + CRS + systemic chemotherapy versus CRS + systemic chemotherapy or systemic chemotherapy alone. CRS + systemic chemotherapy provides equivalent median survival of 41 months as HIPEC + CRS + systemic chemotherapy. When there is an existing, less invasive treatment that provides equivalent survival, it can hardly be considered life-threatening to warrant recommendations based on low-or very low-certainty evidence. Recommendations for clinical practice In people with peritoneal metastases from colorectal cancer, based on the results of PRODIGE-7 trial, HIPEC + CRS + systemic chemotherapy probably results in little to no difference in all-cause mortality or progression-free survival and results in increased complications compared to CRS + systemic chemotherapy. Therefore, HIPEC based on oxaliplatin regimen used in PRODIGE-7 trial + CRS + systemic chemotherapy should not be used in routine clinical practice (strong recommendation). Because of the lack of reliability of preoperative or perioperative PCI, the lack of pre-PRODIGE-7 trial standard classification of PCI into PCI 15 and pre-defined subgroup analysis based on the PCI classification, HIPEC based on oxaliplatin regimen used in PRODIGE-7 trial + CRS + systemic chemotherapy cannot be recommended for any subgroups. Because of the median survival observed in the CRS + systemic chemotherapy arm of PRODIGE-7 trial (41 months) and the poor survival observed in people with disseminated colorectal peritoneal metastases (

BackgroundProlonged postoperative hospital stay following gastric cancer (GC) surgery is an important risk factor affecting patients’ mood and increasing complications. We aimed to develop a nomogram to predict risk factors associated with prolonged postoperative length of stay (PLOS) in patients undergoing gastric cancer resection.MethodsData were collected from 404 patients. The least absolute shrinkage and selection operator (LASSO) was used for variable screening, and a nomogram was designed. The nomogram performance was evaluated by the area under the receiver operating characteristic curve (AUC). The consistency between the predicted and actual values was evaluated via a calibration map, and the clinical application value was evaluated via decision curve analysis (DCA) and clinical impact curve analysis (CICA).ResultsA total of 404 patients were included in this study. Among these patients, 287 were assigned to the training cohort, and 117 were assigned to the validation cohort. According to the PLOS quartile distance, 103 patients were defined as having prolonged PLOS. LASSO regression and logistic multivariate analysis revealed that 4 clinical characteristics, the neutrophil–lymphocyte ratio (NLR) on postoperative day one, the NLR on postoperative day three, the preoperative prognostic nutrition index and the first time anal exhaust was performed, were associated with the PLOS and were included in the construction of the nomogram. The AUC of the nomogram prediction model was 0.990 for the training set and 0.983 for the validation set. The calibration curve indicated good correlation between the predicted results and the actual results. The Hosmer-Lemeshow test revealed that the P values for the training and validation sets were 0.444 and 0.607, respectively, indicating that the model had good goodness of fit. The decision curve analysis and clinical impact curve of this model showed good clinical practicability for both cohorts.ConclusionWe explored the risk factors for prolonged PLOS in GC patients via the enhanced recovery after surgery (ERAS) program and developed a predictive model. The designed nomogram is expected to be an accurate and personalized tool for predicting the risk and prognosis of PLOS in GC patients via ERAS measures.

BackgroundCongenital absence of the gallbladder (CAGB) is an exceedingly rare embryological anomaly of the biliary system, with a complex etiology involving the failure of gallbladder formation during embryogenesis. Clinical manifestations are diverse; most patients are asymptomatic, while some present with symptoms such as biliary colic. The complexity of its clinical presentation and radiological features renders diagnosis challenging.Case presentationFetal ultrasound at 22 weeks of gestation revealed an absent gallbladder. At 9 years and 11 months of age, the child exhibited significant weight gain and abnormalities. Abdominal ultrasound and magnetic resonance images demonstrated fatty liver and gallbladder agenesis. Liver function tests indicated mild abnormalities, with aspartate aminotransferase at 67 IU/L and alanine aminotransferase at 44 IU/L. Following 6 months of hepatoprotective and lipid-lowering therapy, a satisfactory treatment response was achieved, with normalization of liver function and improvement in fatty liver.ConclusionsCAGB may be associated with other congenital abnormalities, although isolated cases are uncommon. Clinically, it may manifest as nonspecific biliary, gastrointestinal, or urinary symptoms, mimicking various digestive disorders and leading to misdiagnosis. Genetic sequencing and in-depth embryological research may elucidate the etiology and enhance diagnostic accuracy.

Abstract Background Mesenchymal stem cells (MSCs) are attracting attention as a promising cell-based therapy for the treatment of liver fibrosis or cirrhosis. However, the strategies and potential mechanisms of MSCs therapy need further investigation. The CXCL12/CXCR4/CXCR7 chemokine axis is well known to regulate cell migration and is involved in the regulation of liver fibrosis. This study aims to treat MSCs with a CXCR7-specific agonist to evaluate its therapeutic effects on hepatic fibrosis and potential mechanisms. Methods TC14012, a potent agonist of CXCR7, has been used to pretreat human umbilical cord-derived MSCs (UC-MSCs) and assess its effect on proliferation, apoptosis, migration, immunoregulation, and gene regulatory network. Then, CCl4-induced liver fibrosis mice models were used to evaluate the therapeutic effect and mechanism of TC14012-treated UC-MSCs for treating hepatic fibrosis. Results TC14012 increased CXCR7 expression in UC-MSCs. Notably, co-culture of liver sinusoidal endothelial cells (LSEC) with TC14012-pretreated UC-MSCs increased CXCR7 expression in LSEC. Additionally, TC14012 promoted cell migration and mediated the immunoregulation of UC-MSCs. Compared to UC-MSCs without TC14012 pretreatment, UC-MSCs treated with TC14012 ameliorated live fibrosis by restoring CXCR7 expression, reducing collagen fibril accumulation, inhibiting hepatic stellate cells activation, and attenuating the inflammatory response. Conclusion This study suggests that TC14012 pretreatment can enhance the therapeutic effects of UC-MSCs on liver fibrosis, mainly by promoting the migration and immunoregulation of MSCs.

Abstract Organic heterostructures (OHTs) with the desired geometry organization on micro/nanoscale have undergone rapid progress in nanoscience and nanotechnology. However, it is a significant challenge to elucidate the epitaxial-growth process for various OHTs composed of organic units with a lattice mismatching ratio of > 3%, which is unimaginable for inorganic heterostructures. Herein, we have demonstrated a vivid visualization of the morphology evolution of epitaxial-growth based on a doped interfacial-layer, which facilitates the comprehensive understanding of the hierarchical self-assembly of core-shell OHT with precise spatial configuration. Significantly, the barcoded OHT with periodic shells obviously illustrate the shell epitaxial-growth from tips to center parts along the seeded rods for forming the core-shell OHT. Furthermore, the diameter, length, and number of periodic shells were modulated by finely tuning the stoichiometric ratio, crystalline time, and temperature, respectively. This epitaxial-growth process could be generalized to organic systems with facile chemical/structural compatibility for forming the desired OHTs.

Developing new approaches to fulfill the enantioseparation of nanocluster racemates and construct cluster-based nanomaterials with optical activity remains highly desired in cluster science, because it is an essential prerequisite for fundamental research and extensive applications of these nanomaterials. We herein propose a strategy termed “active-site exposing and partly re-protecting” to trigger the symmetry breaking of highly symmetrical nanoclusters and to render cluster crystals optically active. The vertex PPh3 of the symmetrical Ag29(SSR)12(PPh3)4 (SSR = 1, 3-benzenedithiol) nanocluster was firstly dissociated in the presence of counterions with large steric hindrance, and then the exposed Ag active sites of the obtained Ag29(SSR)12 nanocluster were partly re-protected by Ag+, yielding an Ag29(SSR)12-Ag2 nanocluster with a symmetry-breaking construction. Ag29(SSR)12-Ag2 followed a chiral crystallization mode, and its crystal displayed strong optical activity, derived from CD and CPL characterizations. Overall, this work presents a new approach (i.e., active-site exposing and partly re-protecting) for the symmetry breaking of highly symmetrical nanoclusters, the enantioseparation of nanocluster racemates, and the achievement of highly optical activity.

Objective To investigate the status quo of health education implemented by nurses in stomatology clinics in Guangdong Province, analyze the factors affecting the implementation of oral health education, so as to provide reference for the implementation of health education for patients in stomatology clinics in the future. Methods A self-designed questionnaire on the implementation of health education was used to investigate 382 oral outpatient nurses in Guangdong Province from May to July 2022 by convenience sampling method. Results Totally 344 valid questionnaires were obtained, the effective recovery rate was 90. 05%. Among the 344 nurses surveyed, 87. 79%(302/344)of them conducted health education assessment before health education, 56. 10%(193/344) of nurses made oral health education plan, and 63. 95%(220/344)of nurses conducted oral health education effect evaluation. Among the 344 nurses surveyed, 85. 47%(294/344)of the nurses in the dental clinic chose armchair preaching in the course of practice, 97. 97%(337/344)of the nurses said that "oral immediate preaching" was the main teaching medium. Information provided to patients mainly focuses on disease prevention, treatment, oral health care knowledge, etc. Among the 344 nurses surveyed, 86. 92%(299/344)nurses believed that the lack of manpower and full-time health education personnel were the main factors affecting the implementation of oral health education. Conclusion At present, there has been a lack of choice of health education methods and media. The theory of health education and oral professional knowledge need to be strengthened, the procedure and system of oral health education need to be standardized, and there is an urgent need to establish the full-time oral health education post. (目的 调查广东省口腔门诊护士实施健康教育的现状, 分析影响口腔健康教育实施的因素, 为未来口腔门诊患者健康教育的实施提供参考依据。方法 采用便利抽样的方法, 自行设计口腔门诊护士健康教育实施情况的调查问卷, 于2022年5—7月对广东省382名口腔门诊护士进行调查。结果 本次调查获得有效问卷344份, 有效回收率为90. 05%。在调查的344名护理人员中, 87. 79%(302/344)的护理人员在进行健康宣教前会进行健康教育评估, 56. 10%(193/344)的护士制定过口腔健康宣教计划, 63. 95%(220/344)的护士进行过口腔健康教育效果评价。85. 47%(294/344)的口腔门诊护士在实践过程中选择椅旁宣教, 97. 97%(337/344)的护士表示“口头即时宣教”为主要宣教媒介。为患者提供的信息主要集中在疾病的预防、治疗、口腔卫生保健知识等。86. 92%(299/344)的护理人员认为人力不足, 缺乏专职健康教育人员是影响护理人员实施口腔健康宣教的主要因素。结论 目前口腔门诊护理人员健康宣教方式和媒介选择单一, 健康教育理论、口腔专业知识亟待加强培训, 口腔健康教育的程序及体系有待规范, 口腔专职健康宣教岗位设置迫在眉睫。)

The Yellow River basin (YRB) is a major ecological functional area in China, and its ecological safety development and change have extremely significant impacts on the natural environment and human society. However, existing studies on the YRB lack spatiotemporal characteristics analysis and prediction of ecological safety with vegetation as the core. Therefore, this study proposes to construct an ecological safety index (ESI) of the YRB based on the comprehensive multidimensional ecological safety evaluation system “vigor-pressure-state-response,” using the normalized difference vegetation index, vegetation carbon sink indicator parameters, temperature, precipitation, the digital elevation model, population density, and the per capita gross domestic product from 2000 to 2020. The spatiotemporal characteristics of the ESI were then analyzed for the YRB, and a long-term and short-term memory network model was constructed to predict the ESI trend of the YRB over the next 10 years. According to the results, from 2000 to 2020, the ESI of the YRB showed a fluctuating upward trend, and the annual average of the ESI changed abruptly in 2015 due to drastic changes in hazardous areas. The ESI in most areas of the YRB showed a significant upward trend, the stability of ESI changes was weak in some areas, and the overall spatial distribution showed significant positive spatial agglomeration characteristics. Further, the response of ESI to landscape complexity in different reaches of the YRB varied. Most of the middle reaches were positively correlated with landscape complexity, while most of the upper and lower reaches were not significantly or negatively correlated. Notably, over the next 10 years, YRB's ESI growth will slow down, with areas with degradation increasing, areas with significant growth decreasing, and areas currently showing stability improvement.

The yellow river basin (YRB) plays a crucial role in maintaining national ecological security, and controlling desertification is a critical factor in strengthening the foundation for the high-quality development of the basin. However, there are fewer studies on the spatiotemporal patterns of desertification change in different regions of the YRB, and the mechanisms affecting desertification change are not yet clear. The objective of this article was to construct a desertification difference index (DDI) to characterize the degree of desertification in the YRB based on surface Albedo and normalized difference vegetation index. We analyzed the spatiotemporal patterns of desertification in different regions of the YRB. We used geographical detector and correlation analyses to screen out the main drivers affecting desertification change. We found that the DDI increased significantly at a rate of 0.5 × 10−3/a from 2001 to 2021, indicating a slowing down trend of desertification in the YRB. The spatial concentration of desertification was a high degree of agglomeration and significant spatial autocorrelation. Precipitation (PRE) and surface radiation were the primary factors influencing desertification in the YRB. The most important factor influencing desertification in the upstream of the YRB and midstream of the YRB areas was PRE. However, human footprint has exacerbated desertification in the downstream of the YRB. This article aims to reveal the driving mechanisms behind desertification in the YRB. The objective is to provide a reference for combating desertification and improving the ecological environment in the region.

Biochar-based additives can enhance the ability to produce methane during anaerobic digestion (AD), and biogas residues (BRs) are solid waste that can cause environmental pollution. Therefore, in this work, BRs were used as raw material to prepare biochar, and Fe3+ was used to modify biochar for use in the AD process, generating pig manure water (PMW). The results showed that biogas residue biochar (BRB) showed good pore size and had a “honeycomb structure” on its surface. The commercially available iron–carbon composite material (Fe-C) showed the greatest cumulative methane production (CMP), the greatest removal rates of chemical oxygen demand (COD), and the greatest degradation rate of volatile fatty acids (VFAs), with the order of Fe-C > Fe3+-modified biogas residue biochar (FBRB) > BRB > control group. Fe3+ and Fe0 showed similar effects, where both could enhance the methanogenesis performance of anaerobic digestion by promoting direct interspecific electron transfer, and Fe0 was slightly more effective than Fe3+. Bacteroidotas and Firmicutes were the predominant phyla, and Clostridium_sensu_stricto_1 was the predominant genus. The addition of biochar and Fe3+ promoted the transformation of microorganisms from the conventional metabolic mode into an efficient metabolic mode. Extracellular electron transfer played a crucial role in this.

Abstract Background Vitamin D plays a crucial role in oral health, and its deficiency is associated to significant changes in oral health diseases. We aimed to explore the relationship between levels of 25-hydroxyvitamin D (25(OH) D) and dental caries in children. Methods Four electronic databases were searched by two investigators including PubMed, Embase, Web of Science, and Cochrane Library. Dental caries results were presented as either prevalence or based on the index of primary and permanent teeth/surfaces with decaying, missing, and filled areas, while vitamin D levels were determined through laboratory testing. Two researchers independently selected studies, collected information, assessed risk of bias, and evaluated the study quality. Any disagreements were resolved through discussion. Results A total of 13 studies were included, comprising 5 cross-sectional studies, 5 cohort studies, 3 case–control studies, all of which had high methodological quality. Our meta-analysis showed that children with vitamin D deficiency had a 22% higher risk of dental caries than those with normal vitamin D levels, with a relative risk (RR) of 1.22 and a 95% confidence interval (CI) of 1.18 to 1. 25. Further subgroup analysis according to the three types of studies showed that the risk of dental caries in children with vitamin D deficiency was higher than that in normal vitamin D level group (cohort studies: 62%; cross-sectional studies, 19%; and case–control studies, 5%). Additionally, according to age, subgroup analysis also showed that the risk of dental caries in children with vitamin D deficiency was higher than that in normal vitamin D level group (permanent teeth studies, 28%; deciduous teeth studies, 68%; and mixed dentition studies 8%). Conclusions Levels of 25 (OH) D have been found negatively associated with dental caries in children, indicating that low vitamin D levels may be considered a potential risk factor to this dental disease.

Sepsis is a complex and heterogeneous syndrome that remains a serious challenge to healthcare worldwide. Patients afflicted by severe sepsis or septic shock are customarily placed under intensive care unit (ICU) supervision, where a multitude of apparatus is poised to produce high-granularity data. This reservoir of high-quality data forms the cornerstone for the integration of AI into clinical practice. However, existing reviews currently lack the inclusion of the latest advancements. This review examines the evolving integration of artificial intelligence (AI) in sepsis management. Applications of artificial intelligence include early detection, subtyping analysis, precise treatment and prognosis assessment. AI-driven early warning systems provide enhanced recognition and intervention capabilities, while profiling analyzes elucidate distinct sepsis manifestations for targeted therapy. Precision medicine harnesses the potential of artificial intelligence for pathogen identification, antibiotic selection, and fluid optimization. In conclusion, the seamless amalgamation of artificial intelligence into the domain of sepsis management heralds a transformative shift, ushering in novel prospects to elevate diagnostic precision, therapeutic efficacy, and prognostic acumen. As AI technologies develop, their impact on shaping the future of sepsis care warrants ongoing research and thoughtful implementation.

Abstract High‐performance organic phototransistors (OPTs) have attracted considerable attention owing to their high photoresponse and low‐cost solution‐processing manufacturing. To meet the increasing demand for integrated optoelectronic circuits, organic single‐crystalline micro‐/nanowire arrays for OPTs construction are prominently anticipated. However, the manufacturing and patterning of organic single‐crystalline arrays have hit a bottleneck due to the uncontrollable dewetting dynamics. In this work, a capillary‐bridge lithography strategy is proposed to guide ordered nucleation and unidirectional dewetting of microfluid, thus enabling the large‐scale preparation of highly aligned organic single‐crystalline microwire arrays. Taking advantage of efficient carrier transport, a competitive average field‐effect hole mobility (μ) of 6.64 cm2 V−1 s−1 is obtained, and the high‐throughput one‐dimensional (1D) arrays based OPTs also exhibit excellent optoelectrical performance with photosensitivity (P) of 1.36 × 106, responsivity (R) of 3.18 × 104 A W−1, and specific detectivity (D*) of 9.22 × 1014 Jones. This work provides a guide for the designing and patterning of high‐throughput OPTs toward multifunctional integrated optoelectronics.

Digital Signal Processing (DSP) finds a wide range of applications in various fields, including telecommunications, audio and video processing, biomedical engineering, radar systems, and image processing. Previous DSP designs faced limitations in available processing power and computational resources. Insufficient processing power could result in slower execution times, an inability to handle complex algorithms, or limited capacity to process high-speed or large-scale signals. As the demand for minimal power consumption in DSP circuits continues to grow, reversible logic and quantum-dot cellular automata (QCA) have emerged as promising technologies due to their inherent ability to reduce energy loss. Within this landscape, the arithmetic and logic unit (ALU) plays a vital role in complex circuitry, serving as a key component in digital signal processing applications. However, challenges persist, including high quantum cost and the need to limit the number of cells in the ALU design. To address these challenges, our research aims to develop an efficient ALU by integrating reversible logic and QCA technology. Our focus will be on generating essential components, such as Feynman gates, Fredkin gates, and full adder circuits, which serve as foundational building blocks for reversible logic and QCA designs. These components will be combined to construct a comprehensive ALU capable of performing 20 different operations. Our implementation efforts will be centered around QCADesigner, with a specific emphasis on digital signal processing systems that prioritize energy efficiency and optimal utilization of occupied areas.

With the emergence of spot electricity trading, market-oriented trading has been intensively carried out, forming a multi-cycle trading system. In this process, a large amount of fine-grained electricity trading data circulates on the trading platform. Trading data is an important basis for decision-making in the electricity spot market, which directly affects the trading profits of market entities, proper disclosure of this information is very important for market enterprises. Information disclosure must ensure the validity and security. However, it is hard to judge the security demand for trading data, and there is no suitable evaluation system for determining the security requirement of data, which will limit the electricity market’s further development. In this paper, we first design an indicator system for security requirements classification, which manages data risks from three aspects: data classification, data risk, and entity demand. This system will guide us in determining data security requirements and further help identify differentiated data security protection schemes. Then, based on this system, we propose the classification method of data security requirements through a hierarchical fuzzy Petri net. The lower network realizes a reasonable assessment of data risk with reference to the index system, and the upper network finally determines the level of security requirements through the fuzzy rule base. Last, two types of data are selected to judge their security requirements. The results show that our method can provide a reference for privacy protection in electricity market data.

Abstract Whether ex situ populations constructed in the limited nursery resources of botanical gardens can preserve enough genetic diversity of endangered plants in the wild remains uncertain. Here, a case study was conducted with Camellia tunghinensis, which is one of the species with the lowest natural distribution area in the sect. Chrysantha (golden camellia) of the family Theaceae. We investigated the genetic diversity and population structure of 229 samples from wild and ex situ populations using genotyping by sequencing (GBS). Core germplasm was constructed from these samples. The results showed that wild C. tunghinensis exhibited high genetic diversity, with observed heterozygosity of 0.257–0.293 and expected heterozygosity of 0.247–0.262. Compared with wild populations, the genetic diversity of ex situ populations established by transplanting wild seedlings was close to or even higher. However, the genetic diversity of those established by seed or cuttings of a few superior trees was lower. The Admixture analysis revealed that the structure of the ex situ populations derived from seeds and cuttings was relatively simple compared with the ex situ populations derived from transplanted wild seedlings and wild populations. These results suggested that direct transplanting of wild seedlings was more conducive to preserving the genetic diversity of endangered plants in the wild. In addition, wild populations demonstrated a small differentiation (mean FST = 0.044) among themselves, possibly due to long‐term and frequent gene flow between the wild populations. In contrast, moderate differentiation (mean FST > 0.05) was detected among ex situ populations and between ex situ and wild populations. This may be the combined result of the absence of gene flow pathways and strong selection pressure in various ex situ environments. Finally, 77 core germplasms were extracted from 229, likely representing the genetic diversity of C. tunghinensis. This study provides future strategies for the ex situ conservation and management of the golden camellia species and other rare and endangered plants.