Search

Abstract Background Iron deficiency anemia (IDA) is a common health problem worldwide. The objective of this study was to noninvasively and quantitatively evaluate early changes in left ventricular systolic function in patients with IDA using the left ventricular press–strain loop (LV-PSL). Methods Sixty-two patients with IDA were selected and divided into two groups based on hemoglobin (Hb) concentration: Group B with Hb > 9 g/dL and group C with 6 g/dL

Objective To investigate the genotypes of human papillomavirus (HPV) infection in male patients with condyloma acuminatum (CA) and to develop a model for predicting recurrence risk. Methods Wart samples were collected from 724 CA patients at Jiaozhou Branch of Shanghai East Hospital, Tongji University from January 2021 to June 2023. Human papillomavirus DNA was extracted and genomic DNA was genotyped. Multivariate logistic regression analysis was used to analyze the risk factors for recurrence within 6 months after being cured with physiotherapy, and a prediction model for recurrence risk was developed. Receiver operating characteristic (ROC) curves was used to verify the prediction value of the prediction model. Results Among 724 CA patients, the main genotypes were HPV 6, 11, 16, and 42. Multivariate logistic regression analysis showed that a disease course of ≥ 6 months, high-risk HPV infection, multiple HPV infections, and the number of warts ≥ 5 were independent risk factors for recurrence (P13.00, the sensitivity and specificity were 71.39% and 83.01%, respectively, and the area under the curve (AUC) was 0.863. Conclusions The main genotypes of HPV infection are HPV 6, 11, 16, and 42 in male CA patients. The prediction model for recurrence risk factors has high predictive value for predicting recurrence of CA.

Abstract Alternative polyadenylation (APA) is a crucial mechanism for regulating gene expression during pre-mRNA 3′ processing. Pre-mRNA 3′ end processing factors is the main factor involved in this process. However, pre-mRNA 3′ end processing factors in different cancer expression profiles and the relationship between pre-mRNA 3′ end processing factors and tumor microenvironment and the prognosis of the same patient is still unclear. In this study, we conducted a comprehensive exploration of the core pre-mRNA 3′ end processing factors across various cancer types by utilizing common cancer database, and revealing a robust correlation between the expression of these core factors and tumor characteristics. Leveraging advanced bioinformatics databases, we evaluated the expression levels and prognostic relevance of pre-mRNA 3′ end processing factors across pan-cancer tissues. Our extensive pan-cancer analysis revealed unique expression patterns of pre-mRNA 3′ end processing factors in both tumor and adjacent non-tumorous tissues. Notably, we found a significant correlation between the expression levels of pre-mRNA 3′ end processing factors and patient prognosis. Furthermore, we identified strong associations between pre-mRNA 3′ end processing factors expression and various factors, such as stromal, immune, RNA stemness, and DNA stemness scores across pan-cancer tissues. Our data also highlighted a link between the expression of pre-mRNA 3′ end processing factors and sensitivity to specific drugs, including pyrazoloacndine, amonaflide, and chelerythrinede, among others. We found four key pre-mRNA 3′ end processing factors that play a crucial role in mRNA preprocessing. Our study illuminates the potential promotion and inhibition role of pre-mRNA 3′ end processing regulators in the progression of cancer, CPSF2, CPSF3, CSTF2, SYMPK offering valuable insights for future research investigations on these regulators as diagnostic markers and therapeutic targets across pan-cancer.

Abstract To understand the ecology of species and promote biotechnology through beneficial strain selection for improving starch yield in maize wet-milling steeping, bacterial diversity and community structure during the counter-current steeping process in a commercial steeping system were characterized and investigated. The microbial diversity in the steeping liquor, which consisted of 16 phyla, 131 families, and 290 genera, was more abundant compared to those present on the surface of unsteeped maize. As the counter-current steeping progressed, exposing newer maize to the older steepwater, Lactobacillus dominated, replacing Rahnella, Pseudomonas, Pantoea, and Serratia. The thermophilic and acidophilic microbial consortia were enriched through adaptive evolution engineering and employed to improve starch yield. Several steeping strategies were evaluated, including water alone, SO2 alone, mono-culture of B. coagulans, microbial consortia, and a combination of consortium and SO2. Combining the microbial consortium with SO2 significantly increased the starch yield to, about 66.4 ± 0.5%, a 22% and 46% increase over SO2 alone and the consortium alone, respectively. Scanning electron microscope (SEM) of steeped maize structure indicated that the combination of consortium and SO2 disrupted the protein matrix and widened gaps between starch granules in maize endosperm. This released proteins into the steepwater and left starch granules in the aleurone layer. The steeping strategy of using thermophilic and acidophilic microbial consortium as additives shows potential application as an environmentally friendly alternative to conventional maize steeping procedures.

Abstract Background The coronavirus disease (COVID-19) pandemic has accentuated the need for effective clinical skills training in infectious diseases. This study aimed to explore the influencing factors of infectious disease clinical skills training based on scenario simulation teaching for medical staff in China. Methods This hospital-based, cross-sectional study was conducted at the Third People’s Hospital of Shenzhen between March and December 2022. Scenario simulation teaching was applied, and factors such as gender, educational level, professional background, and previous experience were examined to determine their impact on qualification outcomes. Results The study included participants primarily between the ages of 20–40 years, with a higher proportion of women holding university degrees. Nurses and physicians were more likely to qualify, indicating the significance of professional backgrounds. Women showed a higher likelihood of qualifying than men and higher educational attainment correlated with better qualification rates. Prior experience with protective clothing in isolation wards was a significant determinant of successful qualification. Multivariate analysis underscored the influence of sex, education, and previous experience on training effectiveness. Conclusion Scenario simulation is an effective strategy for training clinical skills in treating infectious diseases. This study highlights the importance of considering sex, education, professional background, and prior experience when designing training programs to enhance the efficacy and relevance of infectious disease training.

Abstract The overall health condition of patients significantly affects the diagnosis, treatment, and prognosis of endodontic diseases. A systemic consideration of the patient’s overall health along with oral conditions holds the utmost importance in determining the necessity and feasibility of endodontic therapy, as well as selecting appropriate therapeutic approaches. This expert consensus is a collaborative effort by specialists from endodontics and clinical physicians across the nation based on the current clinical evidence, aiming to provide general guidance on clinical procedures, improve patient safety and enhance clinical outcomes of endodontic therapy in patients with compromised overall health.

Abstract Focusing on the anthropogenic aerosols effects on the East Asian Summer Monsoon (EASM) progression, we found that aerosols delay the northward progression of EASM by one pentad in the south of the middle-lower reaches of the Yangtze River (PD1: pentads 25-35) and the North-Northeast China (PD3: pentads 38-42). However, aerosols have minimal impact on the seasonal march of EASM over the Yangtze-Huai River basin (PD2: pentads 36-37). In PD1 and PD3, aerosols reduce sea-land temperature differences. Also, a southward shift in the westerly jet causing lower-level north winds, which weakens the EASM in PD3. The delayed EASM progress shows its weakness in PD1 and PD3. While in PD2, EASM intensity weakens without affecting its northward progression. Aerosols, though affecting the position and intensity of Western Pacific Subtropical High, minimally influence its northward movement speed, hence no effect on the seasonal march of EASM in PD2.

The complete intestinal structure is important to ensure the rapid and h ealthy growth of fish. However, the feed composition, aquaculture water environment, intestinal microbial population, and other factors may affect the intestinal health of fish. Intestinal health problems caused by feed ingredients are mainly due to the antinutrient factors contained in raw materials. Antinutritional factors contained in high-level soybean meal can cause oxidative damage to the intestine, thus, inducing soybean meal-induced enteritis (SBMIE), which leads to a decreased appetite and the slow growth of fish. Alleviating the damage of soybean meal to the fish intestinal tract and improving intestinal health through nutrition are essential methods for ensuring the sustainable development of the feed industry, which has significant ecological and economic significance.As a functional amino acid, arginine is a precursor to the synthesis of bioactive substances, such as urea, glutamic acid, creatine, proline, polyamine, and nitric oxide. Arginine modulates metabolic regulation, including growth, immunity, intestinal barrier, and endocrine regulation. It plays a vital role in the immune regulation, maintenance, and protection of the intestinal mucosal structure and function. It has been reported that arginine is beneficial for repairing intestinal mucosal injury in poultry and aquatic animals. In this study, the carnivorous marine economic fish Sebastes schlegelii (54.97±0.12) g were used to investigate the repair effect and mechanism of arginine on SBMIE. This study aimed to provide a scientific basis for the application of arginine for maintaining the intestinal health of fish and provide a reference for the application of plant protein to the compound feed of the carnivorous economic fish S. schlegelii.The purpose of this study was to investigate the repairing effects of arginine on the growth performance, arginine metabolism, intestinal structure, antioxidant performance, relative expression levels of intestinal tight junction protein genes (occludin, clnd15, and zo-1), and inflammatory factor-related genes (il-1β, il-8, il-15, and tlr8) and anti-inflammatory factor-related gene (il-12b) of S. schlegelii with SBMIE. S. schlegelii were fed high-level soybean meal (40%) for 28 days to induce SBMIE. SBMIE-S. schlegelii weighing (54.97±0.12) g were used as the study animals. Four isonitrogen and isoenergetic experimental feeds were formulated. The basic formula was supplemented with 30% soybean meal, arginine 0 supplementation as the control group (D0), and 1%, 2%, and 3% arginine supplementation as the treatment groups, named D1, D2, and D3, respectively. Each diet group had three replicates, and each replicate consisted of 40 fish. The fish were randomly placed in 12 homemade cages (60 cm × 60 cm × 90 cm). The experiment lasted for 6 weeks. The experimental fish were fed twice a day (08:00 and 17:00), with the initial feeding amount being 1% of the body weight, and the feeding amount being adjusted according to the feeding situation. During the experiment, the bottom of the cages was cleaned, and the water was changed every day to maintain the water temperature at 18~22 ℃, the dissolved oxygen at > 6 mg/L, the pH at 7.6~8.2, the ammonia nitrogen content at < 0.05 mg/L, and the nitrite nitrogen content at < 0.05 mg/L. The light cycle was the natural cycle. The results showed that the weight gain rate of the fish in the D2 and D3 groups was significantly higher than that in D0 group (P < 0.05). The hepatosomatic and viscerosomatic indexes of the fish in the arginine treatment groups were significantly lower than those in the D0 group, and the condition factor was significantly higher than that in the D0 group (P < 0.05). There was no significant effect on the survival rate (P > 0.05). Diamine oxidase (DAO) activity, NO content, and iNOS activity values in the serum of the treatment groups were significantly lower than those in the D0 group (P < 0.05). The serum T-NOS activity in the D2 and D3 groups was significantly lower than that in the D0 group (P < 0.05). The duplicature height in the treatment groups was significantly higher than that in the D0 group, while no significant difference was found in the duplicature number and muscle thickness (P > 0.05). In group D0, the intestinal mucosa lamina propria widened, and the number of goblet cells increased, while in groups supplemented with arginine, the intestinal mucosa was intact, and the problems mentioned above improved significantly. Intestinal total antioxidant capacity (T-AOC) in arginine supplementation groups was significantly increased, and the highest value was found in group D2 (P < 0.05). The malondialdehyde content in groups D2 and D3 was decreased significantly compared to that in the D0 group (P < 0.05). The relative expression of occludin mRNA in each treatment group was significantly upregulated compared to that in the D0 group (P < 0.05). The relative expression level of clnd15 mRNA in the D2 group was significantly higher than that in the D0 and D1 groups (P < 0.05). The relative expression level of zo-1 mRNA in group D1 was significantly higher than that in the other groups (P < 0.05). The relative expression levels of IL-1β, IL-15, and TLR8 mRNA were downregulated in all treatment groups, while the relative expression of IL-12b mRNA was upregulated (P < 0.05). No significant differences were found in IL-8 mRNA relative expression (P > 0.05). In conclusion, under the conditions of this experiment, the growth and antioxidant performances of S. schlegelii with SBMIE were significantly increased, arginine metabolism and the intestinal structure were improved significantly, and the relative expression of intestinal tight junction protein and anti-inflammatory factor-related genes was upregulated, while that of inflammatory factor-related genes was downregulated, with arginine supplementation in a high-level soybean meal diet. Arginine (2% best) was effective in repairing SBMIE of S. schlegelii. The results of this study provide a theoretical basis for the mechanism of repairing SBMIE with arginine.

Abstract This study investigates the longitudinal dynamic changes in immune cells in COVID-19 patients over an extended period after recovery, as well as the interplay between immune cells and antibodies. Leveraging single-cell mass spectrometry, we selected six COVID-19 patients and four healthy controls, dissecting the evolving landscape within six months post-viral RNA clearance, alongside the levels of anti-spike protein antibodies. The T cell immunophenotype ascertained via single-cell mass spectrometry underwent validation through flow cytometry in 37 samples. Our findings illuminate that CD8 + T cells, gamma-delta (gd) T cells, and NK cells witnessed an increase, in contrast to the reduction observed in monocytes, B cells, and double-negative T (DNT) cells over time. The proportion of monocytes remained significantly elevated in COVID-19 patients compared to controls even after six-month. Subpopulation-wise, an upsurge manifested within various T effector memory subsets, CD45RA + T effector memory, gdT, and NK cells, whereas declines marked the populations of DNT, naive and memory B cells, and classical as well as non-classical monocytes. Noteworthy associations surfaced between DNT, gdT, CD4 + T, NK cells, and the anti-S antibody titer. This study reveals the changes in peripheral blood mononuclear cells of COVID-19 patients within 6 months after viral RNA clearance and sheds light on the interactions between immune cells and antibodies. The findings from this research contribute to a better understanding of immune transformations during the recovery from COVID-19 and offer guidance for protective measures against reinfection in the context of viral variants.

Abstract LHPP has been shown to be a new tumor suppressor, and has a tendency to be under-expressed in a variety of cancers. Oncolytic virotheray is a promising therapeutics for lung cancer in recent decade years. Here we successfully constructed a new recombinant oncolytic adenovirus GD55-LHPP and investigated the effect of GD55-LHPP on the growth of lung cancer cells in vitro and in vivo. The results showed that LHPP had lower expression in either lung cancer cells or clinical lung cancer tissues compared with normal cells or tissues, and GD55-LHPP effectively mediated LHPP expression in lung cancer cells. GD55-LHPP could effectively inhibit the proliferation of lung cancer cell lines and rarely affected normal cell growth. Mechanically, the oncolytic adenovirus GD55-LHPP was able to induce stronger apoptosis of lung cancer cells compared with GD55 through the activation of caspase signal pathway. Notably, GD55-LHPP also activated autophagy-related signal pathway. Further, GD55-LHPP efficiently inhibited tumor growth in lung cancer xenograft in mice and prolonged animal survival rate compared with the control GD55 or PBS. In conclusion, the novel construct GD55-LHPP provides a valuable strategy for lung cancer-targeted therapy and develop the role of tumor suppress gene LHPP in lung cancer gene therapy.

Parameter identification involves the estimation of undisclosed parameters within a system based on observed data and mathematical models. In this investigation, we employ DAISY to meticulously examine the structural identifiability of parameters of a within-host SARS-CoV-2 epidemic model, taking into account an array of observable datasets. Furthermore, Monte Carlo simulations are performed to offer a comprehensive practical analysis of model parameters. Lastly, sensitivity analysis is employed to ascertain that decreasing the replication rate of the SARS-CoV-2 virus and curbing the infectious period are the most efficacious measures in alleviating the dissemination of COVID-19 amongst hosts.

In this paper, the active parts of sea cucumber (Apostichopus japonicus) with high antihypertensive activity were screened and the preparation process of active peptides was optimized. Different parts (body wall, intestine, and ovum) of A. japonicus were hydrolyzed by enzymolysis, and the ACE inhibition rate was used as an indicator to screen the optimal protease. The optimal active site for inhibition was selected by comparative screening of the half maximal inhibitory concentration (IC50) determination of ACE inhibitory rate of each lysate. Single factor and response surface tests were used to determine the optimum enzymatic hydrolysis conditions of the active peptides. The relative molecular weight of the protease hydrolysates was determined to determine its distribution range. The ACE inhibition activity of different components was analyzed after separation by ultrafiltration membrane. Search results, alkaline protease was selected as the optimal hydrolytic enzyme, and the IC50 values of ACE inhibition of each protease lysate from body wall, intestine and ovum were 1.11, 4.02, 0.65 mg/mL, respectively, so that A. japonicus ovum had a better ACE inhibition effect and were the optimal active site for inhibition. Its optimal preparation process parameters for enzymatic hydrolysis were as follows: 5 h enzymatic hydrolysis time, 3.5 U/mg enzyme added, 65.26 °C enzymatic hydrolysis temperature, 3.51% substrate concentration, pH9.02 enzymatic hydrolysis, and ACE inhibition rate of A. japonicusr ovum was 80.65%±0.52% under these conditions, which was close to the predicted value. The molecular weight of proteolytic products was concentrated under 3000 Da, accounting for 98.37% of the total content, of which 1000~3000 Da accounted for 9.50%, and less than 1000 Da accounted for 88.87%. The ACE inhibitory activity of oligopeptide components (IC50=0.30 mg/mL) isolated by ultrafiltration membrane was significantly higher than that of hydrolysates and trapped liquid components after process optimization. The results of this study would provide a theoretical basis for high-quality utilization of the by-products of A. japonicus, which could be used as high-quality resources for the isolation and purification of antihypertensive peptides.

Human milk oligosaccharides (HMOs) are key components of breast milk, playing a vital role in fostering the healthy development of infants and young children. Among the main HMOs components, 2′-fucosyllactose (2′-FL) and 3-fucosyllactose (3-FL) exhibit considerable benefits in terms of inhibiting pathogenic infections, regulating gut microbiota, and enhancing immunity. In recent years, the synthesis of 2′-FL and 3-FL has emerged as a prominent area of research in the field. Despite the potential advantages of chemical or enzymatic synthesis of 2′-FL and 3-FL, these methods are hindered by their inherent limitations, including intricate reaction procedures, high costs, and poor yield, which are not conducive to meeting the demand of the market. Therefore, more efficient microbial methods have been developed and applied in the commercial production of 2′-FL and 3-FL. This article systematically outlines the methods for preparing both 2′-FL and 3-FL, thoroughly expounds upon the engineering strategies for microbial synthesis of 2′-FL and 3-FL, and provides a compelling framework for further microbial production exploration of 2′-FL and 3-FL.

Abstract Background Osteocytes are critical mechanosensory cells in bone, and mechanically stimulated osteocytes produce exosomes that can induce osteogenesis. MicroRNAs (miRNAs) are important constituents of exosomes, and some miRNAs in osteocytes regulate osteogenic differentiation; previous studies have indicated that some differentially expressed miRNAs in mechanically strained osteocytes likely influence osteoblastic differentiation. Therefore, screening and selection of miRNAs that regulate osteogenic differentiation in exosomes of mechanically stimulated osteocytes are important. Results A mechanical tensile strain of 2500 με at 0.5 Hz 1 h per day for 3 days, elevated prostaglandin E2 (PGE2) and insulin-like growth factor-1 (IGF-1) levels and nitric oxide synthase (NOS) activity of MLO-Y4 osteocytes, and promoted osteogenic differentiation of MC3T3-E1 osteoblasts. Fourteen miRNAs differentially expressed only in MLO-Y4 osteocytes which were stimulated with mechanical tensile strain, were screened, and the miRNAs related to osteogenesis were identified. Four differentially expressed miRNAs (miR-1930-3p, miR-3110-5p, miR-3090-3p, and miR-3058-3p) were found only in mechanically strained osteocytes, and the four miRNAs, eight targeted mRNAs which were differentially expressed only in mechanically strained osteoblasts, were also identified. In addition, the mechanically strained osteocyte-derived exosomes promoted the osteoblastic differentiation of MC3T3-E1 cells in vitro, the exosomes were internalized by osteoblasts, and the up-regulated miR-3110-5p and miR-3058-3p in mechanically strained osteocytes, were both increased in the exosomes, which was verified via reverse transcription quantitative polymerase chain reaction (RT-qPCR). Conclusions In osteocytes, a mechanical tensile strain of 2500 με at 0.5 Hz induced the fourteen differentially expressed miRNAs which probably were in exosomes of osteocytes and involved in osteogenesis. The mechanically strained osteocyte-derived exosomes which contained increased miR-3110-5p and miR-3058-3p (two of the 14 miRNAs), promoted osteoblastic differentiation.

We report a case of the meyerson phenomenon around cavernous hemangioma. A 23-year-old male presented with a dark purplish red nodule on the back for over 20 years, and pruritic annular erythema and papules with clear boundaries around the nodule for 1 day. Dermatological examination revealed a dark purplish red nodule about 0.7 cm in diameter on the back, encircled by a 1 cm diameter erythema with papules. Dermoscopic examination showed that several small purplish red cavities with clear boundaries and irregularly distributed dotted blood vessels on the skin lesion under the red background. The histopathology showed that the lesion was covered with squamous epithelium. Large irregular lumens, and sinusoids of different sizes contained red blood cells and fibrin in the superficial and deep dermis. The sinusoids were lined with a single layer of endothelial cells. The patient was diagnosed with the meyerson phenomenon around cavernous hemangioma. After surgical resection, the eczema-like dermatitis subsided. But hemangioma reoccurred without discomfort after more than 1 month. The patient is in follow-up.

Global biodiversity loss is one of the most serious environmental crises of the 20th and 21st centuries. Fish diversity, an important component of biodiversity, is also in decline. The conservation of fish diversity is therefore essential for ecosystem management and the sustainable use of resources. Most current aquatic biodiversity surveys rely on conventional methods. The emergence and application of environmental DNA (eDNA) technology has triggered unprecedented innovations in aquatic organism investigation and monitoring. eDNA metabarcoding refers to the selection of appropriate universal primers for different target taxa and the identification of multiple target species in environmental samples via PCR amplification combined with high-throughput sequencing. The Zhoushan Archipelago, located in the northeastern waters of Zhejiang Province, consists of 2 085 islands with a total area of 22 216 square kilometers. Located at the confluence of the Yangtze River, the Qiantang River, the Yongjiang River, and the Taiwan Warm Current, the Zhoushan Archipelago forms a unique and complex hydrological environment, which provides a rich source of nutrients and a suitable habitat for fish. In recent years, the large-scale exploitation of marine resources and marine pollution have led to a serious loss of fish diversity near the Zhoushan Archipelago. To restore fish diversity, conservation efforts have been implemented by the government and researchers, including stricter fishing bans and ecological fish stock enhancement and release. However, the lack of reliable tools to understand the species and assess biodiversity is the most critical issue in conservation efforts. Trawl sampling and morphological identification are the primary fish diversity assessment methods. However, these conventional methods are often inefficient, time-consuming, selective, and destructive. The extensive rocky reefs in the Zhoushan Archipelago make it difficult to use conventional fishery resource survey methods efficiently. Therefore, simple and accurate methods for species diversity monitoring are needed. In this study, Xixuan Island, an offshore island in Zhoushan, was taken as a reference. Four different sampling stations were designed, and a total of 12 water samples were collected in February, May, and November 2019. The species composition and diversity characteristics of offshore fish communities around Xixuan Island were described, and the spatial and temporal differences in fish diversity were evaluated. A total of 33 fish species belonging to 12 orders, 26 families, and 32 genera were detected. Among them, Perciformes has the most abundant species, with 19 species, accounting for approximately 57.6% of all species detected. The diversity and evenness indices of the different sampling seasons were significantly different (P < 0.05), indicating that season may be one of the factors affecting the diversity of offshore fish around Xixuan Island. The results of the combined temporal and spatial analysis showed that more fish species were detected during the breeding season at sampling sites far from the main island side of Zhoushan. By comparing the results with the conventional fishery resources survey, we found a large variation in the dominant species in different seasons, which may be related to the limited sampling site numbers. Temperature and longitude may be important factors affecting the fish diversity around Xixuan Island. The result of enriching the dominant species in each season by heat trees differed significantly from those of traditional surveys, indicating that eDNA cannot completely substitute the conventional survey methods; however, it can be applied as an auxiliary method to monitor fishery resources, improve detection efficiency, and reduce interference to ecosystems. This study not only provides novel methods for the fishery resources survey in offshore Zhoushan but also provides technical support for the subsequent investigation and evaluation of fish diversity and its protection and management.

Abstract Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy (RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system’s anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

Abstract Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment. However, irrigant selection or irrigation procedures are far from clear. The vapor lock effect in the apical region has yet to be solved, impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes. Additionally, ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified. Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes. Indeed, clinicians have been aware of these concerns for years. Based on the current evidence of studies, this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions. The evolution of different kinetic irrigation methods, their effects, limitations, the paradigm shift, current indications, and effective operational procedures regarding intracanal medication are also discussed. This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication, thus facilitating a better understanding of infection control, standardizing clinical practice, and ultimately improving the success of endodontic therapy.

BackgroundThe efficiency of systemic immune-inflammation index (SII) in predicting prognosis of osteosarcoma (OSA) patients has been extensively analyzed, but no consistent findings are obtained. Therefore, this meta-analysis focused on identifying the precise prognostic value of SII for OSA.MethodsWe comprehensively searched electronic databases of PubMed, Embase, Web of Science, Cochrane Library, and China National Knowledge Infrastructure (CNKI) from inception to 24 February, 2024. Meanwhile, the efficiency of SII in predicting prognosis of OSA was evaluated by calculating pooled hazard ratios (HRs) as well as 95% confidence intervals (CIs). Additionally, the correlation of SII with the OSA clinicopathological characteristics was analyzed based on pooled odds ratios (ORs) and 95%CIs.ResultsSix studies with 1015 cases were enrolled into this work. According to the combined data, the higher SII was markedly related to poor overall survival (OS) (HR=2.01, 95%CI=1.30-3.09, p=0.002) and Enneking stage III (OR=2.21, 95%CI=1.11-4.39, p=0.024) of patients with OSA. Nonetheless, SII was not significantly related to gender, age, pathological fracture, tumor size, tumor location, tumor differentiation, and metastasis in patients with OSA.ConclusionsIn summary, the higher SII is markedly related to poor OS and advanced Enneking stage in OSA patients.Systematic review registrationhttps://inplasy.com/inplasy-2024-7-0107/, identifier INPLASY202470107.

Abstract Novel active DNA transposons, such as Spy transposons from the PHIS superfamily, are identified through bioinformatics in this study. The native transposases cgSpy and cvSpy displayed transposition activities of approximately 85% and 35% compared to the hyperactive piggyBac transposase (hyPB). The cgSpy transposon showed unique characteristics, including a lack of overproduction inhibition and reduced efficiency for insertion sizes between 3.1 to 8.5 kb. Integration preferences of cgSpy are found in genes and regulatory regions, making it suitable for genetic manipulation. Evaluation in T‐cell engineering demonstrated that cgSpy‐mediated chimeric antigen receptor (CAR) modification is comparable to the PB system, indicating its potential utility in cell therapy. This study unveils the promising application of the active native transposase, Spy, from Colletes gigas, as a valuable tool for genetic engineering, particularly in T‐cell manipulation.

Introduction: The epididymis is important for sperm transport, maturation, and storage.Methods: The head and tail of the epididymis of 5-week-old and 10-week-old C57 BL/6J male mice were used for single-cell sequencing.Results: 10 cell types including main, basal, and narrow/clear cells are identified. Next, we performed cell subgroup analysis, functional enrichment analysis, and differentiation potential prediction on principal cells, clear cells, and basal cells. Our study indicates that the principal cells are significantly involved in sperm maturation, as well as in antiviral and anti-tumor immune responses. Clear cells are likely to play a crucial role in safeguarding sperm and maintaining epididymal pH levels. Basal cells are implicated in the regulation of inflammatory and stress responses. The composition and functions of the various cell types within the epididymis undergo significant changes before and after sexual maturity. Furthermore, pseudo-temporal analysis elucidates the protective and supportive roles of epididymal cells in sperm maturation during sexual maturation.Discussion: This study offers a theoretical framework and forecasts for the investigation of epididymal sperm maturation and epididymal immunity.

Invasion and migration are the primary factors for mortality in lung adenocarcinoma (LUAD) patients. The precise role of RNA-binding motif protein15 (RBM15)-mediated m6A modification in LUAD is not yet fully clarified. This research aims to elucidate the mechanism of RBM15 in the invasion and migration of LUAD.Western blot and dot blot assay results showed that RBM15 and methylation levels of m6A were highly expressed in LUAD tissues. Overexpression of RBM15 by lentivirus transfection increased m6A levels and promoted the invasion, migration, and proliferation of A549 and H1734 cells. Knockdown of RBM15 by lentivirus transfection had opposite effects on m6A levels, invasion, migration, and proliferation of A549 and H1734 cells. The results of nude mouse proliferation models confirmed that RBM15 knockdown inhibited in vivo tumor proliferation . Sequencing and immunoprecipitation identified RASSF8 as an interacting protein of RBM15 involved in cell invasion and migration. RBM15-mediated m6A modification inhibited RASSF8 protein levels and increased LUAD cell invasion and migration. The rescue assays demonstrated that the regulation of RBM15 on LUAD cell invasion and migration was partially rescued by RASSF8.In conclusion, RBM15-mediated m6A modification inhibits the RASSF8 protein levels and increases cell invasion and migration. Thus, targeting the RBM15-m6A-RASSF8 axis may be a promising strategy for repressing LUAD cell invasion and migration.

Abstract Mitogen‐activated protein kinase‐activated protein kinase 2 (MK2) emerges as a pivotal target in developing anti‐cancer therapies. The limitations of ATP‐competitive inhibitors, due to insufficient potency and selectivity, underscore the urgent need for a covalent irreversible MK2 inhibitor. Our initial analyses of The Cancer Genome Atlas database revealed MK2's overexpression across various cancer types, especially those characterized by inflammation, linking it to poor prognosis and highlighting its significance. Investigating MK2's kinase domain led to the identification of a unique cysteine residue, enabling the creation of targeted covalent inhibitors. Compound 11 was developed, demonstrating robust MK2 inhibition (IC50 = 2.3 nM) and high selectivity. It binds irreversibly to MK2, achieving prolonged signal suppression and reducing pathological inflammatory cytokines in macrophages. Furthermore, compound 11 or MK2 knockdown can inhibit the tumor‐promoting macrophage M2 phenotype in vitro and in vivo. In macrophage‐rich tumor model, compound 11 notably slowed growth in a dose‐dependent manner. These findings support MK2 as a promising anticancer target, especially relevant in cancers fueled by inflammation or dominated by macrophages, and provide compound 11 serving as an invaluable chemical tool for exploring MK2's functions.

ObjectiveThis study aimed to assess the clinical effectiveness and safety of electroacupuncture (EA) for the treatment of postpartum depression (PPD).MethodsWe systematically retrieved relevant randomized controlled trials (RCTs) from electronic databases, including PubMed, Cochrane Library, China National Knowledge Infrastructure, EMBASE, China Science and Technology Journal Database, Chinese Biological Medical Database, and the Wanfang database from their inception to November 2023. The outcomes measured were the Hamilton Depression Rating Scale (HAMD) scores, Edinburgh Postnatal Depression Scale (EPDS) scores, adverse events (AEs), and the total response rate. The study aimed to estimate heterogeneity, publication bias, mean difference (MD), and risk ratios (RR) with 95% confidence intervals (CIs).ResultsThis study included 12 RCTs with a total of 1364 participants (571 in the treatment group and 793 in the control group) for analysis. The results of the meta-analysis indicated that EA did not significantly reduce HAMD (MD = 1.49, 95% CI = [−0.30, 3.27], P = 0.1, I2 = 0%) and EPDS (MD = 1.12, 95% CI = [−1.62, 3.85], P = 0.42, I2 = 32%) scores compared to sham EA among patients with PPD, resulting in low heterogeneity. In terms of the total response rate, the EA group exhibited superior results compared to the placebo group (RR = 1.77, 95% CI = [1.15, 2.74], P = 0.01, I2 = 0%) and the sham EA group (RR = 1.2, 95% CI = [1.02, 4.4], P = 0.02, I2 = 0%), with statistical significance and low heterogeneity. The incidence of AEs was lower, also with low heterogeneity (RR = 0.9, 95% CI = [0.57, 1.43], P = 0.66, I2 = 12%).ConclusionThe current evidence indicates that the effectiveness and safety of EA in the treatment of PPD warrant affirmation. However, EA does not demonstrate superiority over sham EA in reducing HAMD and EPDS scores in patients with PPD. Due to the limited quantity and quality of curent research, the above conclusion should be further validated through high-quality studies to confirm the efectiveness of EA in PPD management.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=318917, identifier CRD42023318917.

Ferroptosis is a form of non-apoptotic regulated cell death (RCD) that depends on iron and is characterized by the accumulation of lipid peroxides to lethal levels. Ferroptosis involves multiple pathways including redox balance, iron regulation, mitochondrial function, and amino acid, lipid, and glycometabolism. Furthermore, various disease-related signaling pathways also play a role in regulating the process of iron oxidation. In recent years, with the emergence of the concept of ferroptosis and the in-depth study of its mechanisms, ferroptosis is closely associated with various biological conditions related to kidney diseases, including kidney organ development, aging, immunity, and cancer. This article reviews the development of the concept of ferroptosis, the mechanisms of ferroptosis (including GSH-GPX4, FSP1-CoQ1, DHODH-CoQ10, GCH1-BH4, and MBOAT1/2 pathways), and the latest research progress on its involvement in kidney diseases. It summarizes research on ferroptosis in kidney diseases within the frameworks of metabolism, reactive oxygen biology, and iron biology. The article introduces key regulatory factors and mechanisms of ferroptosis in kidney diseases, as well as important concepts and major open questions in ferroptosis and related natural compounds. It is hoped that in future research, further breakthroughs can be made in understanding the regulation mechanism of ferroptosis and utilizing ferroptosis to promote treatments for kidney diseases, such as acute kidney injury(AKI), chronic kidney disease (CKD), diabetic nephropathy(DN), and renal cell carcinoma. This paves the way for a new approach to research, prevent, and treat clinical kidney diseases.

Distinct brain regions are differentially affected during the various stages of Alzheimer's disease (AD). While the hippocampus and cortex are known to play significant roles, the involvement of the cerebellum has received less attention. Understanding the changes in diverse brain regions is essential to unravel the neuropathological mechanism in early-stage AD. Our research aimed to explore and compare amyloid-β (Aβ) pathology and gene expression profiles across the hippocampus, cortex, and cerebellum in the early stages of the Amyloid Precursor Protein/Presenilin-1 (APP/PS1) mouse model. By 7 months of age, significant Aβ plaque accumulation was observed in the hippocampus and cortex of APP/PS1 mice, while no such deposits were found in the cerebellum. Gene expression analysis revealed predominant effects on immune response pathways in the hippocampus and cortex. Even in the absence of Aβ deposition, notable gene expression changes were observed in the cerebellum of APP/PS1 mice. Intriguingly, Neuronal PAS Domain protein 4 (Npas4) expression was consistently down-regulated across all brain regions, independent of Aβ plaque presence. Our findings reveal distinct transcriptomic alterations and Aβ pathology in select cerebral regions during the initial phase of AD. Notably, the diminished expression of the Npas4 across three brain regions implies that Npas4 could play a pivotal role in the early pathogenesis of AD.

ObjectivesThe application of artificial intelligence (AI) in healthcare is an important public health issue. However, few studies have investigated the perceptions and attitudes of healthcare professionals toward its applications in nursing. This study aimed to explore the knowledge, attitudes, and concerns of healthcare professionals, AI-related professionals, and others in China toward AI in nursing.MethodsWe conducted an online cross-sectional study on nursing students, nurses, other healthcare professionals, AI-related professionals, and others in China between March and April 2024. They were invited to complete a questionnaire containing 21 questions with four sections. The survey followed the principle of voluntary participation and was conducted anonymously. The participants could withdraw from the survey at any time during the study.ResultsThis study obtained 1,243 valid questionnaires. The participants came from 25 provinces and municipalities in seven regions of China. Regarding knowledge of AI in nursing, 57% of the participants knew only a little about AI, 4.7% did not know anything about AI, 64.7% knew only a little about AI in nursing, and 13.4% did not know anything about AI in nursing. For attitudes toward AI in nursing, participants were positive about AI in nursing, with more than 50% agreeing and strongly agreeing with each question on attitudes toward AI in nursing. Differences in the numbers of participants with various categories of professionals regarding knowledge and attitudes toward AI in nursing were statistically significant (p

Background: Diabetic nephropathy represents a significant microvascular complication of diabetes, characterized by extracellular matrix accumulation, loss of cell-cell junctions, microalbuminuria, and diminished creatinine clearance. Despite its prevalence, therapeutic options dedicated to this condition are currently lacking. Natural products like bioflavonoids have garnered attention for their potential therapeutic benefits. The present study aimed to evaluate the efficacy of a bioflavonoid combination, including ginger extract, soy extract, and hesperetin, in a diabetic rat model. Methods: Diabetes was initiated in the rat pups via intraperitoneal injection of streptozotocin on the fifth postnatal day. After six weeks, rats exhibiting blood sugar levels exceeding 160 mg/dL were allocated into diabetic control and treatment groups, with eight animals each. A subset of rats received citrate buffer as a control. The treatment group received the bioflavonoid combination orally for twenty-four weeks. Various parameters, including glycemic levels, urinary parameters, antioxidant status, mRNA expression via Western blot, gel zymography, and immunohistochemistry, were assessed at the study's conclusion. Results: The bioflavonoid combination demonstrated significant reductions in hyperglycemia and various urinary parameters compared to controls. Notably, it modulated MMP-9/TIMP-1 expression, upregulated GLUT-4, and downregulated TGF-β. Additionally, the combination enhanced total antioxidant capacity, indicating potential antioxidative benefits. Conclusions: This study highlights the therapeutic potential of a bioflavonoid combination (ginger extract, soy extract, and hesperetin) in improving renal function in diabetic nephropathy. By modulating key factors such as MMP-9/TIMP-1, TGF-β, and GLUT-4, this combination presents a promising avenue for further exploration in managing diabetic nephropathy. These findings underscore the importance of natural products as potential therapeutic agents in addressing diabetic complications.

Abstract Highly crystalline organic semiconductors are ideal materials for photocatalytic hydrogen evolution in water splitting. However, the instability and complex synthesis processes of most reported organic molecule‐based photocatalysts restrict their applications. In this study, we introduce benzo [1,2‐b:4,5‐bʹ] bis [1] benzothiophene‐3,9‐dicarboxylic acid, 5,5,11,11‐tetraoxide (FSOCA), a highly crystalline, stable molecular crystal that is easy to synthesize and serves as an efficient photocatalyst for the hydrogen evolution reaction. FSOCA exhibits high efficiency in sacrificial hydrogen evolution reaction (760 µmol h−1, 76 mmol g−1 h−1 at 330 mW cm−2; 570 µmol h−1, 57 mmol g−1 h−1 at 250 mW cm−2), and FSOCA remains stable during photocatalysis for up to 400 h. Experiments and theoretical studies confirmed the presence of hydrogen bonds between the sulfone group and the sacrificial agent (ascorbic acid). This interaction significantly improved the oxidation reaction kinetics and boosted the photocatalytic performance. This study presents a scalable and convenient approach to synthesize highly crystalline, active, and stable organic photocatalysts with potential applications in large‐scale photocatalysis.

BackgroundVaccines serve as a crucial public health tool, although vaccine hesitancy continues to pose a significant threat to full vaccine uptake and, consequently, community health. Understanding and tracking vaccine hesitancy is essential for effective public health interventions; however, traditional survey methods present various limitations. ObjectiveThis study aimed to create a real-time, natural language processing (NLP)–based tool to assess vaccine sentiment and hesitancy across 3 prominent social media platforms. MethodsWe mined and curated discussions in English from Twitter (subsequently rebranded as X), Reddit, and YouTube social media platforms posted between January 1, 2011, and October 31, 2021, concerning human papillomavirus; measles, mumps, and rubella; and unspecified vaccines. We tested multiple NLP algorithms to classify vaccine sentiment into positive, neutral, or negative and to classify vaccine hesitancy using the World Health Organization’s (WHO) 3Cs (confidence, complacency, and convenience) hesitancy model, conceptualizing an online dashboard to illustrate and contextualize trends. ResultsWe compiled over 86 million discussions. Our top-performing NLP models displayed accuracies ranging from 0.51 to 0.78 for sentiment classification and from 0.69 to 0.91 for hesitancy classification. Explorative analysis on our platform highlighted variations in online activity about vaccine sentiment and hesitancy, suggesting unique patterns for different vaccines. ConclusionsOur innovative system performs real-time analysis of sentiment and hesitancy on 3 vaccine topics across major social networks, providing crucial trend insights to assist campaigns aimed at enhancing vaccine uptake and public health.

BackgroundLimited is known on the profiles of apple allergy in China.ObjectiveTo explore the clinical significance of apple allergen components in northern China.MethodsThis study recruited 40 participants and categorized into apple tolerance (n = 19) and allergy (n = 21) group. The latter was categorized into oral allergy symptoms (OAS, n = 14) and generalized symptoms (GS, n = 7). All participants underwent ImmunoCAP screening to assess sIgE levels of birch, apple, and their components.ResultsThe sensitization rates were 90% for Bet v 1, 85% for Mal d 1, 35% for Bet v 2, and 20% for Mal d 3. The overall positive rate for apple allergens was 97.5%, with half demonstrating mono-sensitization to Mal d 1. Birch, Bet v 1 and Mal d 1 sIgE levels had consistent areas under the curve (AUC 0.747, p = 0.037; AUC 0.799, p = 0.012; AUC 0.902, p

GNSS signals are vulnerable to spoofing and interference, which poses a threat to the security of critical national infrastructure. GNSS data sets with spoofing and jamming are lacking, which hinders the research of GNSS anti-spoofing and anti-interference techniques. This data article presents a dataset recorded by a low-cost sensor deployed on the balcony at the 5th floor of the Science Hall of Yunnan University (25°3’26’’ N, 102°41’55’’ E). The sensor suite includes a GNSS antenna, a u-blox GNSS receiver and an embedded computer. In the experiment, interferences including spoofing and jamming were irregularly emitted using a SDR HackRF One and a commercial jammer, respectively. The dataset collected by the receiver consists of two parts: (1) raw data; (2) processed data. The types of the raw data include hardware information, satellite information and receiver parameters of GPS, Campass, Galileo, GLONASS and QZSS systems. The processed data are extracted from the raw data, including the signals, Doppler shift, pseudorange observations, carrier phase, position (latitude, longitude, and altitude), satellite azimuth and elevation angles, etc. The provided datasets are interesting for the GNSS security, anti-jamming and anti-spoofing mechanisms based scientific communities.

Abstract Real-world data on effectiveness and safety of a single non-vitamin K antagonist oral anticoagulant in the Chinese population with atrial fibrillation (AF) are limited. This study reports characteristics of patients treated with edoxaban and factors associated with dosing patterns from routine care in China. ETNA-AF-China (NCT04747496) is a multicentre, prospective, observational study enrolling edoxaban-treated patients from four economic regions with a targeted 2-year follow-up. Of the 4930 patients with AF (mean age: 70.2 ± 9.5 years; male, 57.1%), the mean creatinine clearance (CrCl), CHA2DS2-VASc, and HAS-BLED scores were 71.2 mL/min, 2.9, and 1.6. Overall, 6.4% of patients were perceived as frail by investigators. Available label dose reduction criteria (N = 4232) revealed that 3278 (77.5%) patients received recommended doses and 954 (22.5%) non-recommended doses. Northeast (53.0%) and West (43.1%) regions had the highest prescriptions of 60 mg and 30 mg recommended doses, respectively. Non-recommended 30 mg doses were more frequently prescribed in patients with antiplatelet use and history of heart failure than recommended 60 mg. Multivariate analysis identified advanced age as the strongest associated factor with non-recommended doses. Frailty had the strongest association with 30 mg except for age, and history of TIA was the most relevant factor associated with 60 mg. In conclusion, patients in the ETNA-AF-China study were predominantly aged 65 years and older, had mild-to-moderate renal impairment and good label adherence. Advanced age was associated with non-recommended doses, with frailty most common for non-recommended 30 mg and a history of TIA for the non-recommended 60 mg dose.

Abstract Background With the development of Hematopoietic Stem Cell Transplantation (HSCT) technology, increasing numbers of elderly patients were undergoing allogeneic HSCT and elderly patients with hematologic malignancies could benefit most from it. Preformed donor-specific human leukocyte antigen (HLA) antibodies (DSA) were associated with graft failure in HLA-mismatched allogeneic HSCT and the absence of DSA was the main criterion of selecting the donor. Except for sensitization events such as transfusion, pregnancy or previous transplantation, ageing affects the humoral immune response both quantitatively and qualitatively. To evaluate the prevalence and distribution of anti-HLA and antibodies of MHC class I chain related antigens A (MICA) specificities in different age groups before initial HSCT would provide HLA and MICA specific antibody profiles under the impact of ageing, which could provide meaningful information in the process of selecting suitable HLA-mismatched donors by avoiding preformed DSA. Results There were no significant differences in the distribution of anti-HLA class I, class II and anti-MICA antibodies among the three age groups in this study except that a significant lower negative ratio of anti-HLA class I, class II antibodies and higher positive rate of MICA antibodies with maximum mean fluorescent intensity (MFI) > 5000 in the elderly than in young age group. The distribution of antibody specificities against HLA -A, -B, -C, -DR, -DQ, -DP and MICA antigens in the three age groups were generally consistent. The anti-HLA class I antibody specificities with higher frequencies were A80,A68;B76,B45;Cw17, which were unlikely to become DSA in Chinese. Anti-HLA class II antibody specificities were more likely to become potential DSA than class I.DR7, DR9, DQ7, DQ8 and DQ9 were most likely to become potential DSA. Conclusions The prevalence of anti-HLA and anti-MICA antibodies increased slightly as age increased. While ageing had a small impact on the distribution of antibody specificity frequencies against HLA-A, -B, -C, -DR,-DQ, -DP and MICA antigens in recipients awaiting initial HSCT from East China. The risk of developing preformed DSA was basically consistent in the three age groups and the elderly group might be more favorable in HLA-mismatched HSCT due to higher positive rate of anti-MICA antibody.

Abstract Tongue squamous cell carcinoma (TSCC) is an aggressive oral cancer with a high incidence of metastasis and poor prognosis. We aim to identify and verify potential biomarkers for TSCC using bioinformatics analysis. To begin with, we examined clinical and RNA expression information of individuals with TSCC from the Gene Expression Omnibus (GEO) database. Differential expression analysis and functional analysis were conducted. Multiple machine-learning strategies were next employed to screen and determine the hub gene, and receiver operating characteristic (ROC) analysis was used to assess diagnostic value. Semaphorin3C (SEMA3C) was identified as a critical biomarker, presenting high diagnostic accuracy for TSCC. In the validation cohorts, SEMA3C exhibited high expression levels in TSCC. The high expression of SEMA3C was a poor prognostic factor in TSCC by the Kaplan–Meier curve. Based on the Gene Ontology (GO) analysis, SEMA3C was mapped in terms related to cell adhesion, positive regulation of JAK-STAT, positive regulation of stem cell maintenance, and positive regulation of NF-κB activity. Single-cell RNA sequencing (ScRNA-seq) analysis showed cells expressing SEMA3C were predominantly tumor cells. Then, we further verified that SEMA3C had high expression in TSCC clinical samples. In addition, the knockdown of SEMA3C suppressed the proliferation, migration, and invasion of TSCC cells in vitro. This study is the first to report the involvement of SEMA3C in TSCC, suggesting that upregulated SEMA3C could be a novel and critical potential biomarker for future predictive diagnostics, prevention, prognostic assessment, and personalized medical services in TSCC.

Abstract Background Whether early dietary fiber intake in septic patients is associated with a better clinical prognosis remains unclear, especially the time and the amount. Therefore, we assessed the association between early dietary fiber intake and clinical outcomes in septic patients by examining an extensive database. Methods We conducted a retrospective cohort study using data from the MIMIC IV 2.1 database, focusing on consecutive septic patients requiring mechanical ventilation in medical or mixed medical-surgical ICUs. We collected patient demographics and nutritional data. Dietary fiber amounts were calculated according to enteral nutrition instructions from manufacturers within the first 72 h after admission. After adjusting for covariates, we employed restricted cubic spline (RCS) regression to investigate the relationship between fiber intake (FI) and 28-day mortality. Patients were categorized into three groups based on their fiber index (FI) within 72 h of admission: low fiber index (LFI) group when FI was

Abstract Loess-paleosol sequences have been used in Asia to study climate and environmental changes during the Quaternary. The scarcity of age control datasets and proxy indices analysis data for Asian loess has limited our understanding of loess depositional processes and the reconstruction of paleoclimatic changes from loess-paleosol records. In this study, we present a dataset that includes 1785 quartz optically stimulated luminescence ages and 1038 K-feldspar post-infrared infrared stimulated luminescence ages from 128 loess-paleosol sequences located in different regions of Asia. We generate 38 high-resolution age-depth models of loess records based on the provided datasets. We provide data on 12,365 grain size records, 14,964 magnetic susceptibility records, 2204 CaCO3 content records, and 3326 color reflection records. This dataset contains the most detailed and accurate chronologies and proxy index data for loess records in Asia yet published. It provides fundamental data for understanding the spatial-temporal variations in loess depositional processes and climatic changes across the continent during the mid-late Quaternary.

Abstract Background Corpus callosum glioblastoma (ccGBM) is a specific type of GBM and has worse outcomes than other non-ccGBMs. We sought to identify whether en-bloc resection of ccGBMs based on T2-FLAIR imaging contributes to clinical outcomes and can achieve a satisfactory balance between maximal resection and preservation of neurological function. Methods A total of 106 adult ccGBM patients (including astrocytoma, WHO grade 4, IDH mutation, and glioblastoma) were obtained from the Department of Neurosurgery in Nanfang Hospital between January 2008 and December 2018. The clinical data, including gender, age, symptoms, location of tumor, involvement of eloquent areas, extent of resection (EOR), pre- and postoperative Karnofsky Performance Status (KPS) scales, and National Institute of Health stroke scale (NIHSS) scores were collected. Propensity score matching (PSM) analysis was applied to control the confounders for analyzing the relationship between the en-bloc technique and EOR, and the change in the postoperative KPS scales and NIHSS scores. Results Applying the en-bloc technique did not negatively affect the postoperative KPS scales compared to no-en-bloc resection (P = 0.851 for PSM analysis) but had a positive effect on preserving or improving the postoperative NIHSS scores (P = 0.004 for PSM analysis). A positive correlation between EOR and the en-bloc technique was identified (r = 0.483, P

Background: This study aimed to construct an enteral nutrition evaluation system for critically ill patients using the Delphi method to direct the formulation of enteral nutrition support strategies and reduce interruption to enteral feeding. Methods: We used domestic and foreign databases to obtain and analyze the literature and form “The Whole-Proceeding Enteral Nutrition Evaluation System for Critically Ill Patients.” The Delphi method was used to conduct two rounds of expert opinion consultation, combined with the suggestions from the research group to finalize the nutrition evaluation content of the system. Results: After two rounds of expert consultation, a nutrition evaluation system was formed around three dimensions: before the start, during, and after the end of nutritional support. The effective recovery rates of the two rounds of expert consultation were 90.0% (18/20) and 100.0% (18/18), respectively. Authority coefficients were 0.865 and 0.908, while Kendall coordination coefficients were 0.108 (P < 0.05) and 0.115 (P < 0.001), respectively. Finally, the full enteral nutrition evaluation system for critically ill patients was constructed based on the Delphi method, including three primary items and seven secondary and 28 tertiary indicators. Conclusion: The established “Whole-Proceeding Enteral Nutrition Evaluation System for Critically Ill Patients” has high consistency from expert opinions and reliability, which can provide a practical evaluation tool for the process of enteral nutrition for severe patients.

Abstract There lacks real‐world study with a large sample size assessing olmesartan medoxomil‐amlodipine besylate (OM‐AML) tablet. Therefore, this study aimed to evaluate the efficacy and safety of OM‐AML tablet in patients with essential hypertension. Totally, 1341 patients from 36 medical centers with essential hypertension who took OM‐AML (20/5 mg) tablet were analyzed in the current prospective, single‐arm, multi‐center, real‐world study (SVK study). Seated systolic blood pressure (SeSBP) and seated diastolic blood pressure (SeDBP) at baseline, week (W)4 and W8 were measured. The mean (±SE) change of SeSBP/SeDBP was ‐10.8 ± 0.4/‐6.6 ± 0.3 mmHg at W4 and ‐12.7 ± 0.5/‐7.6 ± 0.3 mmHg at W8, respectively. At W4, 78.8% and 29.0% patients achieved BP target by China and American Heart Association (AHA) criteria; at W8, 84.7% and 36.5% patients reached blood pressure (BP) target by China and AHA criteria, accordingly. Meanwhile, 80.2% and 86.4% patients achieved BP response at W4 and W8, respectively. Home‐measured SeSBP and SeDBP decreased from W1 to W8 (both p

Abstract Background Placenta accreta spectrum (PAS) carries an increased risk of maternal-fetal mortality and morbidity, and magnetic resonance imaging (MRI) features for PAS have been used for preoperative identification. This study aims to investigate the role of placental volume evaluated by MRI in identifying PAS in pregnant women with complete placenta previa. Methods Totally 163 cases of complete placenta previa pregnant women with a history of cesarean section underwent MRI for suspected PAS were included. We categorized the patients into two groups according to the presence or absence of PAS, and the maternal-fetal perinatal outcomes and placental volume analyzed by 3D Slice software were compared. Results There were significantly more gravidity, parity, and number of previous cesarean delivery in the PAS group (P

Abstract Seminoma is the most common malignant solid tumor in 14 to 44 year-old men. However, its molecular features and tumor microenvironment (TME) is largely unexplored. Here, we perform a series of studies via genomics profiling (single cell multi-omics and spatial transcriptomics) and functional examination using seminoma samples and a seminoma cell line. We identify key gene expression programs share between seminoma and primordial germ cells, and further characterize the functions of TFAP2C in promoting tumor invasion and migration. We also identify 15 immune cell subtypes in TME, and find that subtypes with exhaustion features were located closer to the tumor region through combined spatial transcriptome analysis. Furthermore, we identify key pathways and genes that may facilitate seminoma disseminating beyond the seminiferous tubules. These findings advance our knowledge of seminoma tumorigenesis and produce a multi-omics atlas of in situ human seminoma microenvironment, which could help discover potential therapy targets for seminoma.

Abstract The fintech (financial technology) employment market presents significant barriers to entry, including rigorous selection criteria based on factors such as profitability, risk, security, and confidentiality, which limit students’ opportunities to enter the industry. The negative impact of the COVID-19 pandemic has further exacerbated the challenges faced by the fintech employment market in China. Consequently, it is crucial to assist fintech students in enhancing their professional abilities to navigate the job market successfully. Virtual reality is gaining increasing importance in educational fields due to its immersive virtual simulation capabilities. In this study, a hybrid fintech course was designed based on the principles of outcome-based education theory and the flipped classroom model. The project objective was to provide students with virtual training and project-based assessments that facilitate a seamless transition from theoretical knowledge to practical application in the industry. To evaluate the effectiveness of hybrid education, a comparative user experiment was conducted involving 60 participants (students) from Guangdong University of Finance. The study used median data, average data, and the entropy weight method for analysis. The results indicated that hybrid education has a positive impact on individual-level critical thinking, communication, and teamwork skills. We believe that our study can provide critical data references for global online/hybrid education researchers and contribute to the education field.

Abstract Digital guided therapy (DGT) has been advocated as a contemporary computer-aided technique for treating endodontic diseases in recent decades. The concept of DGT for endodontic diseases is categorized into static guided endodontics (SGE), necessitating a meticulously designed template, and dynamic guided endodontics (DGE), which utilizes an optical triangulation tracking system. Based on cone-beam computed tomography (CBCT) images superimposed with or without oral scan (OS) data, a virtual template is crafted through software and subsequently translated into a 3-dimensional (3D) printing for SGE, while the system guides the drilling path with a real-time navigation in DGE. DGT was reported to resolve a series of challenging endodontic cases, including teeth with pulp obliteration, teeth with anatomical abnormalities, teeth requiring retreatment, posterior teeth needing endodontic microsurgery, and tooth autotransplantation. Case reports and basic researches all demonstrate that DGT stand as a precise, time-saving, and minimally invasive approach in contrast to conventional freehand method. This expert consensus mainly introduces the case selection, general workflow, evaluation, and impact factor of DGT, which could provide an alternative working strategy in endodontic treatment.

In this paper, a pipeline leakage detection algorithm based on information fusion of pressure and flow is proposed, and its core work is the construction of BPA based on discount factors. The wavelet packet decomposition is carried out for the original signals, and the processed signals are used to train different SVM classifiers to achieve the first identification results. For the samples whose initial classification results are not completely consistent, BPA is calculated according to the confusion matrixes of the initial SVM classifiers. In this paper, static discount factors and dynamic discount factors are constructed using different methods, and dynamic discount factors are modified when decisions fail. Then comprehensive discount factors are constructed based on the combination of different static discount factors and dynamic discount factors. The Shafer discount rule is used to modify BPA. Finally, D-S evidence theory is used to fuse the BPA results of all classifiers under different discount combinations. Experiments show that this algorithm can effectively use the correlation of evidences to reasonably fuse the decision results of multiple sensors, overcome the problem that the accuracy of a single sensor is not high enough for leakage identification, and improve the identification accuracy of pipeline leakage.

AbstractObjective To assess the trends in non-melanoma skin cancer (NMSC) incidence in Hong Kong from 1990 to 2019 and the associations of age, calendar period, and birth cohort, to make projections to 2030, and to examine the drivers of NMSC incidence.Methods We assessed the age, calendar period, and birth cohort effects of NMSC incidence in Hong Kong between 1990 and 2019 using an age-period-cohort model. Using Bayesian age-period-cohort analysis with integrated nested Laplace approximations, we projected the incidence of NMSC in Hong Kong to 2030.Results From 1990 to 2019, the age-standardized incidence rate of NMSC increased from 6.7 per 100,000 population to 8.6 per 100,000 population in men and from 5.4 per 100,000 to 5.9 per 100,000 population in women, among the 19,568 patients in the study (9812 male patients [50.14%]). The annual net drift was 2.00% (95% confidence interval [CI]: 1.50–2.50%) for men and 1.53% (95% CI: 0.95–2.11%) for women. Local drifts increased for both sexes above the 35–39-year age group. The period and cohort risk of developing NMSC tended to rise but slowed gradually in the most recent period and post-1975 birth cohort. From 2019 to 2030, it is projected that the number of newly diagnosed NMSC cases in Hong Kong will increase from 564 to 829 in men and from 517 to 863 in women. Population aging, population growth, and epidemiologic changes contributed to the increase in incident NMSCs, with population aging being the most significant contributor.Conclusion The slowing of the period and cohort effects suggests that the rising incidence of NMSC is partly attributable to increased awareness and diagnosis. The increasing prevalence of NMSC among the elderly and an aging population will significantly impact the clinical workload associated with NMSC for the foreseeable future.

The application of low-condensation diesel in cold regions with extremely low ambient temperatures (−14 to −29 °C) has enabled the operation of diesel vehicles. Still, it may contribute to heavy haze pollution in cold regions during winter. Here we examine pollutant emissions from low-condensation diesel in China. We measure the emissions of elemental carbon (EC), organic carbon (OC), and elements, including heavy metals such as arsenic (As). Our results show that low-condensation diesel increased EC and OC emissions by 2.5 and 2.6 times compared to normal diesel fuel, respectively. Indicators of vehicular sources, including EC, As, lead (Pb), cadmium (Cd), chromium (Cr), nickel (Ni), and manganese (Mn), increased by approximately 20.2–162.5% when using low-condensation diesel. Seasonal variation of vehicular source indicators, observed at road site ambient environments revealed the enhancement of PM2.5 pollution by the application of low-condensation diesel in winter. These findings suggest that −35# diesel, a low-cetane index diesel, may enhance air pollution in winter, according to a dynamometer test conducted in laboratory. It raises questions about whether higher emissions are released if −35# diesel is applied to running vehicles in real-world cold ambient environments.

Gastric precancerous lesion (GPL) is a crucial stage in the development of gastric cancer, characterized by incomplete intestinal epithelial chemotaxis and heterogeneous hyperplasia with high malignant potential. Early intervention in GPL is vital for preventing gastric cancer. Additionally, there are shared risk factors and pathogenesis between tumors and coronary heart disease (CHD), with an increasing number of tumor patients GPL complicated with CHD due to improved survival rates. Reperfusion therapy in CHD can result in myocardial ischemia-reperfusion injury (MIRI). Traditional Chinese medicine (TCM) has demonstrated unique advantages in treating GPL and MIRI by promoting blood circulation and removing blood stasis. Panax ginseng total saponin (PNS), a component of TCM known for its blood circulation benefits, has shown positive effects in inhibiting tumor growth and improving myocardial ischemia. This study utilized a GPL-MIRI mouse model to investigate the effects of PNS in treatment. Results indicated that PNS significantly improved typical GPL lesions in mice, such as incomplete intestinal epithelialization and heteroplasia, and also reduced myocardial infarction. At the molecular level, PNS exhibited a bidirectional regulatory role in the GPL-MIRI model. It enhanced the autophagic process in gastric mucosal cells by inhibiting the PI3K/Akt/mTOR signaling pathway, while suppressed excessive autophagy in cardiomyocytes. These findings offer new insights and treatment strategies for managing GPL and MIRI using the TCM compound PNS.

Intestinal disease is a group of complex digestive system diseases imposing a significant burden globally. Identifying the risk factors and potential complications of intestinal disease is important for its prevention and treatment. However, traditional observational clinical studies are limited by confounding factors and reverse causation, making causal inference challenging. Mendelian randomisation (MR) method has been developed to effectively mitigate these constraints and assess the causal relationships. This review briefly introduces the MR method, summarises MR research on intestinal disease and delineates the prospective avenues for future research. Conventional risk factors, such as lifestyle behaviours (eg, physical activity, smoking and alcohol consumption), nutrients (eg, selenium), obesity markers (eg, body mass index and waist-to-hip ratio) and inflammatory biomarkers, have been validated in MR studies. Multiomics MR studies are becoming novel hotspots, which provide a theoretical foundation for the exploration of pathogenesis and the investigation of new drug targets. However, most of the recent studies are based on European individuals, and thus it is necessary to replicate the results in other ancestries. Moreover, triangulation integrating MR and other epidemiology methods is suggested as a validated paradigm for causal inference in future MR studies.