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PurposeTo identify the most commonly reported drugs associated with QT interval prolongation in the FDA Adverse Event Reporting System (FAERS) and evaluate their risk for QT interval prolongation.MethodsWe employed the preferred term (PT) “electrocardiogram QT prolonged” from the Medical Dictionary for Regulatory Activities (MedDRA) 26.0 to identify adverse drug events (ADEs) of QT interval prolongation in the FAERS database from the period 2004–2022. Reporting odds ratio (ROR) was performed to quantify the signals of ADEs.ResultsWe listed the top 40 drugs that caused QT interval prolongation. Among them, the 3 drugs with the highest number of cases were quetiapine (1,151 cases, ROR = 7.62), olanzapine (754 cases, ROR = 7.92), and citalopram (720 cases, ROR = 13.63). The two most frequently reported first-level Anatomical Therapeutic Chemical (ATC) groups were the drugs for the nervous system (n = 19, 47.50%) and antiinfectives for systemic use (n = 7, 17.50%). Patients with missing gender (n = 3,482, 23.68%) aside, there were more females (7,536, 51.24%) than males (5,158, 35.07%) were involved. 3,720 patients (25.29%) suffered serious clinical outcomes resulting in deaths or life-threatening conditions. Overall, most drugs that caused QT interval prolongation had early failure types according to the assessment of the Weibull's shape parameter (WSP) analysis.ConclusionsOur study offered a list of drugs that frequently caused QT interval prolongation based on the FAERS system, along with a description of some risk profiles for QT interval prolongation brought on by these drugs. When prescribing these drugs in clinical practice, we should closely monitor the occurrence of ADE for QT interval prolongation.

Owing to restrictions on forming dimensions, laser powder bed fusion (LPBF) components will continue to require laser welding in the future. The post-weld thermal cracking of LPBF-Haynes 230 superalloys has become a key issue hindering their assembly in service. In this study, it was found that both the continuous TCP phase and M5Si3 silicides near the crack have a large interface strain with the matrix. Replacing the C and Si atoms with B atoms at the crack reduces the melting point of the carbides and silicides at the grain boundaries (GBs), thereby inducing solidification cracking under the residual tensile stress in the weld waist. The weldability of the alloy is influenced by the grain characteristics of the base metal (BM). Compared to parallel welds, vertical welds are inherited from the BM and exhibit smaller grains. Moreover, by reducing the heat treatment (HT) time and temperature, the grain size and grain misorientation of the BM are reduced and inherited into the weld. The GB area of the weld increases by 37% and the GB energy decreases by 7.3%, increasing the resistance to crack extension. In addition, the decreased HT temperature inhibits the carbide growth at the GBs, thereby reducing the interface strain between the matrix and carbides in the heat-affected zone and correspondingly its cracking sensitivity. This study provides theoretical guidance for improving the laser weldability of LPBF superalloys and will help accelerate the successful application of LPBF superalloy assemblies in engines.

BackgroundLiver hepatocellular carcinoma (LIHC) is a prevalent form of primary liver cancer. Research has demonstrated the contribution of tumor stem cells in facilitating tumor recurrence, metastasis, and treatment resistance. Despite this, there remains a lack of established cancer stem cells (CSCs)-associated genes signatures for effectively predicting the prognosis and guiding the treatment strategies for patients diagnosed with LIHC.MethodsThe single-cell RNA sequencing (scRNA-seq) and bulk RNA transcriptome data were obtained based on public datasets and computerized firstly using CytoTRACE package and One Class Linear Regression (OCLR) algorithm to evaluate stemness level, respectively. Then, we explored the association of stemness indicators (CytoTRACE score and stemness index, mRNAsi) with survival outcomes and clinical characteristics by combining clinical information and survival analyses. Subsequently, weighted co-expression network analysis (WGCNA) and Cox were applied to assess mRNAsi-related genes in bulk LIHC data and construct a prognostic model for LIHC patients. Single-sample gene-set enrichment analysis (ssGSEA), Cell-type Identification By Estimating Relative Subsets Of RNA Transcripts (CIBERSORT) and Tumor Immune Estimation Resource (TIMER) analysis were employed for immune infiltration assessment. Finally, the potential immunotherapeutic response was predicted by the Tumor Immune Dysfunction and Exclusion (TIDE), and the tumor mutation burden (TMB). Additionally, pRRophetic package was applied to evaluate the sensitivity of high and low-risk groups to common chemotherapeutic drugs.ResultsA total of four genes (including STIP1, H2AFZ, BRIX1, and TUBB) associated with stemness score (CytoTRACE score and mRNAsi) were identified and constructed a risk model that could predict prognosis in LIHC patients. It was observed that high stemness cells occurred predominantly in the late stages of LIHC and that poor overall survival in LIHC patients was also associated with high mRNAsi scores. In addition, pathway analysis confirmed the biological uniqueness of the two risk groups. Personalized treatment predictions suggest that patients with a low risk benefited more from immunotherapy, while those with a high risk group may be conducive to chemotherapeutic drugs.ConclusionThe current study developed a novel prognostic risk signature with genes related to CSCs, which provides novel ideas for the diagnosis, prognosis and treatment of LIHC.

Abstract Background Pregnant women with pulmonary hypertension (PH) have higher mortality rates and poor foetal/neonatal outcomes. Tools to assess these risk factors are not well established. Methods Predictive and prognostic nomograms were constructed using data from a “Development” cohort of 420 pregnant patients with PH, recorded between January 2009 and December 2018. Logistic regression analysis established models to predict the probability of adverse maternal and foetal/neonatal events and overall survival by Cox analysis. An independent “Validation” cohort comprised data of 273 consecutive patients assessed from January 2019 until May 2022. Nomogram performance was evaluated internally and implemented with online software to increase the ease of use. Results Type I respiratory failure, New York Heart Association functional class, N-terminal pro-brain natriuretic peptide $$\ge$$ ≥ 1400 ng/L, arrhythmia, and eclampsia with pre-existing hypertension were independent risk factors for maternal mortality or heart failure. Type I respiratory failure, arrhythmia, general anaesthesia for caesarean section, New York Heart Association functional class, and N-terminal pro-brain natriuretic peptide $$\ge$$ ≥ 1400 ng/L were independent predictors of pulmonary hypertension survival during pregnancy. For foetal/neonatal adverse clinical events, type I respiratory failure, arrhythmia, general anaesthesia for caesarean section, parity, platelet count, fibrinogen, and left ventricular systolic diameter were important predictors. Nomogram application for the Development and Validation cohorts showed good discrimination and calibration; decision curve analysis demonstrated their clinical utility. Conclusions The nomogram and its online software can be used to analyse individual mortality, heart failure risk, overall survival prediction, and adverse foetal/neonatal clinical events, which may be useful to facilitate early intervention and better survival rates.

With the continuous development of pipeline industry in China, the third generation of pipeline technology system, represented by China–Russia Eastern Gas Pipeline, has been established, and China's overall technical level of using pipeline for energy transportation has reached the first class in the world. Herein, the development status of technologies in the fields of design and construction, material and equipment, transportation and storage, and security and maintenance of pipeline projects in China was summarized systematically. On this basis, the opportunities and challenges faced by the oil & gas storage and transportation technologies under the drive of the new energy security strategy featuring "Four Revolutions and One Cooperation" were analyzed, and prospect was made for the development directions of upgrading of traditional oil & gas storage and transportation technologies, digital transformation, storage and transportation of new energies, and unconventional pipeline technologies. Facing to the new situations and requirements, the pipeline enterprises should provide powerful support to guarantee the national energy security and improve the construction of modern energy system, while ensuring the safe and efficient transportation of oil and gas.

IntroductionCochlear implantation is currently the most successful intervention for severe-to-profound sensorineural hearing loss, particularly in deaf infants and children. Nonetheless, there remains a significant degree of variability in the outcomes of CI post-implantation. The purpose of this study was to understand the cortical correlates of the variability in speech outcomes with a cochlear implant in pre-lingually deaf children using functional near-infrared spectroscopy (fNIRS), an emerging brain-imaging technique.MethodsIn this experiment, cortical activities when processing visual speech and two levels of auditory speech, including auditory speech in quiet and in noise with signal-to-noise ratios of 10 dB, were examined in 38 CI recipients with pre-lingual deafness and 36 normally hearing children whose age and sex matched CI users. The HOPE corpus (a corpus of Mandarin sentences) was used to generate speech stimuli. The regions of interest (ROIs) for the fNIRS measurements were fronto-temporal-parietal networks involved in language processing, including bilateral superior temporal gyrus, left inferior frontal gyrus, and bilateral inferior parietal lobes.ResultsThe fNIRS results confirmed and extended findings previously reported in the neuroimaging literature. Firstly, cortical responses of superior temporal gyrus to both auditory and visual speech in CI users were directly correlated to auditory speech perception scores, with the strongest positive association between the levels of cross-modal reorganization and CI outcome. Secondly, compared to NH controls, CI users, particularly those with good speech perception, showed larger cortical activation in the left inferior frontal gyrus in response to all speech stimuli used in the experiment.DiscussionIn conclusion, cross-modal activation to visual speech in the auditory cortex of pre-lingually deaf CI children may be at least one of the neural bases of highly variable CI performance due to its beneficial effects for speech understanding, thus supporting the prediction and assessment of CI outcomes in clinic. Additionally, cortical activation of the left inferior frontal gyrus may be a cortical marker for effortful listening.

Abstract Developing organic field-effect transistor (OFET) biosensors for customizable detection of biomarkers for many diseases would provide a low-cost and convenient tool for both biological studies and clinical diagnosis. In this work, design principles of the OFET transducer for biosensors were derived to relate the signal-to-noise ratio (SNR) to the device-performance parameters. Steep subthreshold swing (SS), proper threshold voltage (V th), good-enough bias-stress stability, and mechanical durability are shown to be the key prerequisites for realizing OFET bio-sensors of high transconductance efficiency (g m/I D) for large SNR. Combining a low trap-density channel and a high-k/low-k gate dielectric layer, low-temperature (

Background and aim: Infectious disease (ID) consultation can improve multidrug-resistant organism (MDRO) treatment outcomes. However, the impact of clinical pharmacists’ ID consultation on MDRO therapy, especially early initiation, has not been reported. In this study, we try to explore the impact of the pharmacist early active consultation (PEAC) on MDRO patient management.Methods: We conducted a prospective historical controlled study based on PEAC in MDRO patients. The retrospective control group was patients hospitalized 18 months before the PEAC initiation, and the prospective PEAC group was patients hospitalized 18 months after the PEAC initiation. Primary endpoint was 30-day all-cause mortality. Secondary outcomes were MDRO clinical outcome, duration of antibiotic use, length of stay, antibiotic consumption and antibiotic costs. Further subgroup analysis of secondary outcomes was performed by the condition at admission, MDRO pathogenicity and MDRO clinical outcome.Results: 188 MDRO patients were included. After adjusting for potential predictors, PEAC reduced the 30-day all-cause mortality by 70% (HR 0.30, 95% CI 0.09–0.96, p = 0.042). PEAC group had clinical improvement than control group (89.47% vs. 65.59%, p < 0.001), especially in patients with non-severe clinical conditions at admission (98.41% vs. 70.18%, p < 0.001). However, no significant differences were found between groups in length of stay, antibiotics consumption, and antibiotics costs.Conclusion: Early active pharmacy ID consultation can reduce 30-day all-cause mortality and improve clinical outcomes in MDRO patients.

BackgroundMenopausal women may experience menopausal syndrome and long-term effects caused by low estrogen levels, such as senile dementia and osteoporosis in the elderly. Most menopausal women may have misconceptions about menopause and low use of pharmacological interventions. These misconceptions may damage the quality of life and miss the critical period for preventing senile diseases. Thus, enhancing the awareness of menopausal women regarding psychosocial and physical changes through health education programs was a way to improve positive attitudes toward menopause and make further treatment options.ObjectivesThis study aimed to evaluate the effect of multidisciplinary health education based on lifestyle medicine on menopausal syndrome and lifestyle behaviors of menopausal women.MethodsThe study was conducted in several hospitals in Chongqing, China. The two groups were from different hospitals with similar medical levels in order to reduce information contamination. It was designed as a clinical controlled trial in which the intervention group (n = 100) and control group (n = 87) were matched for age, age at menarche, menopausal symptoms and drug use status at enrollment. Women in the intervention group received multidisciplinary health education based on lifestyle medicine for 2 months while those in the control group received routine outpatient health guidance. Menopausal syndrome, physical activity and dietary status of participants were assessed before and after the intervention. Paired t-tests and Independent-sample t-tests were adopted for comparison within and between groups, respectively, in the normal variables. Wilcoxon signed-rank tests and Mann-Whitney U tests were adopted for comparison within and between group, respectively, in the abnormal variables. Categorical variables were tested using Pearson's χ2. P-value < 0.05 was statistically significant in statistical tests.ResultsPost intervention testing indicated that menopausal syndrome of participants was significantly improved in the intervention group compared to the control group (P < 0.001). Between-group comparison showed a significant improvement of weekly energy expenditure of total physical activity (P = 0.001) and participation in exercise (P < 0.001) in the intervention group compared to the control group after the intervention. The dietary status of participants was significantly improved in the intervention group compared to the control group (P < 0.001). In the intervention group, the menopausal syndrome of participants improved more in the hormone drug group than in the non-hormone group (P = 0.007), as did the control group (P = 0.02). In the hormone drug group, the physical activity (P = 0.003) and dietary status (P = 0.001) mproved more in the intervention group than in the control group.ConclusionsThe multidisciplinary health education based on lifestyle medicine was effective in improving the menopausal syndrome and healthy lifestyle behaviors of menopausal women. Studies with extended observation period and larger sample size are in need to evaluate the long-term scale-up effects of the multidisciplinary health education.

Background & Aims: Immune checkpoint inhibitors (ICIs) have transformed the landscape of cancer treatment, and ICI-related toxicities (i.e., immune-related adverse events (irAEs) have been reported in many clinical studies. However, the toxicity data of real-world have not been fully assessed.Methods: Patients with histologically confirmed solid tumors who had been treated with PD-1 inhibitors were included in the study. Patient data were collected from electronic medical records, including basic characteristics, data of irAEs, management and outcome. Incidences of irAEs were pooled and compared, and the risk of irAEs was also analyzed.Results: A total of 362 solid tumor patients treated with sintilimab (n = 171), camrelizumab (n = 60), toripalimab (n = 72), and pembrolizumab (n = 59) were included. In total, any grade irAEs, grade 1–2 irAEs, and grade ≥3 irAEs accounted for 47.24%, 38.67% and 8.56% of cases, reapectively. Further, 29.24% of patients discontinued immunotherapy due to irAEs, with pneumonitis being the main reason for discontinuation. By comparing the toxicity profiles between different ICIs, we found that reactive capillary haemangiomas were camrelizumab-specific. Additionally, the frequency of irAEs was association with ICIs type, the pooled incidence (standardized rate) of irAEs related to sintilimab, camrelizumab, toripalimab and pembrolizumab were 55.56% (52.81%), 48.33% (55.55%), 33.33% (29.23%) and 38.98% (38.29%), respectively. Sintilimab and camrelizumab had higher incidences of any grade and grade 1–2 than toripalimab (55.56% vs. 33.33%, p = 0.002; 48.54% vs. 25.00%, p = 0.0001) and pembrolizumab (55.56% vs. 38.98%, p = 0.0028; 48.54% vs. 25.42%, p = 0.002), while the grade ≥3 irAEs of pembrolizumab (13.56%) were approximately 1.63- to 1.93-fold higher than other ICIs, and the standardized grade ≥3 of pembrolizumab was significantly higher than that of sintilimab (13.21% vs. 7.12%, p = 0.026), especially for grade ≥3 pneumonitis. Multivariate analysis found that cumulative cycles of ICI (OR = 1.081; 95% CI: 1.023–1.142; p = 0.006), and lung cancer (OR = 1.765; 95% CI: 1.105–2.820; p = 0.017) were independent risk factors for irAEs.Conclusion: The frequency of irAEs is associated with ICI type. The pooled incidence of irAEs related to sintilimab and pneumonitis caused by pembrolizumab were higher. These data indicate the importance of having different monitoring priorities for different PD-1 inhibitors.

Abstract Background Although obstructive sleep apnoea (OSA) is prevalent among patients with aortic dissection, its prognostic impact is not yet determined in patients undergoing major vascular surgery. We aimed to investigate the association of OSA with hypoxaemia and with prolonged intensive care unit (ICU) stay after type A aortic dissection (TAAD) repair. Methods This retrospective study continuously enrolled 83 patients who underwent TAAD repair from January 1 to December 31, 2018. OSA was diagnosed by sleep test and defined as an apnoea hypopnea index (AHI) of ≥ 15/h, while an AHI of > 30/h was defined severe OSA. Hypoxaemia was defined as an oxygenation index (OI) of 72 h. Receiver operating characteristic curve analysis was performed to evaluate the predictive value of postoperative OI for prolonged ICU stay. Multivariate logistic regression was performed to assess the association of OSA with hypoxaemia and prolonged ICU stay. Results A total of 41 (49.4%) patients were diagnosed with OSA using the sleep test. Hypoxaemia occurred postoperatively in 56 patients (67.5%). Postoperatively hypoxaemia developed mostly in patients with OSA (52.4% vs. 83.0%, p = 0.003), and particularly in those with severe OSA (52.4% vs. 90.5%, p = 0.003). The postoperative OI could fairly predict a prolonged ICU stay (area under the receiver-operating characteristic curve, 0.72; 95% confidence intervals [CI] 0.60–0.84; p = 0.002). Severe OSA was associated with both postoperative hypoxaemia (odds ratio [OR] 6.65; 95% CI 1.56–46.26, p = 0.008) and prolonged ICU stay (OR 5.58; 95% CI 1.54–20.24, p = 0.009). Conclusions OSA was common in patients with TAAD. Severe OSA was associated with postoperative hypoxaemia and prolonged ICU stay following TAAD repair.

Traditional optical motion capture (OMC) with retroreflective markers is commonly used to measure joint kinematics but was also reported with unavoidable soft tissue artifacts (STAs) when quantifying the motion of the spine. Additionally, the patterns of the STA on the lumbar spine remain unclear. This study aimed to 1) quantify the in vivo STAs of the human lower back in three-dimensional directions during weight-bearing forward–backward bending and 2) determine the effects of the STAs on the calculated flexion angles between the upper and lower lumbar spines and adjacent vertebrae by comparing the skin marker (SM)- and virtual bone marker (VM)-based measurements. Six healthy volunteers were imaged using a biplanar radiographic system, and thirteen skin markers were mounted on every volunteer’s lower back while performing weight-bearing forward–backward bending. The STAs in the anterior/posterior (AP), medial/lateral (ML), and proximal/distal (PD) directions were investigated. The flexion angles between the upper and lower lumbar segments and adjacent intervertebral segments (L2–L5) throughout the cycle were calculated. For all the participants, STAs continuously increased in the AP direction and exhibited a reciprocal trend in the PD direction. During flexion, the STA at the lower lumbar region (L4–L5: 13.5 ± 6.5 mm) was significantly higher than that at the upper lumbar (L1–L3: 4.0 ± 1.5 mm) in the PD direction (p < 0.01). During extension, the lower lumbar (L4–L5: 2.7 ± 0.7 mm) exhibited significantly less STAs than that exhibited by the upper lumbar region (L1–L3: 6.1 ± 3.3 mm) (p < 0.05). The STA at the spinous process was significantly lower than that on both sides in the AP direction (p < 0.05). The present results on STAs, based on dual fluoroscopic measurements in healthy adult subjects, presented an anatomical direction, marker location, and anatomic segment dependency, which might help describe and quantify STAs for the lumbar spine kinematics and thus help develop location- and direction-specific weighting factors for use in global optimization algorithms aimed at minimizing the effects of STAs on the calculation of lumbar joint kinematics in the future.

The utility of pharmacist consultation for drug-induced liver injury (DILI) management has not been explored. This retrospective cohort study evaluated the impact of a pharmacist active consultation (PAC) service on the management and outcome in patients with DILI. Consecutive patients meeting clinical biochemical criteria for DILI were enrolled at a tertiary teaching hospital between 1 January 2020 and 30 April 2022. The Roussel Uclaf Causality Assessment Method was used to assess causality between drug use and liver injury for each suspected DILI patient. Included patients were grouped according to whether they received PAC, and a proportional hazard model with multivariate risk adjustment, inverse probability of treatment weighting (IPTW), and propensity score matching (PSM) was used to assess DILI recovery. In the PSM cohort, the quality of medical care was compared between PAC and no PAC groups. A total of 224 patients with DILI (108 who received PAC and 116 who did not) were included in the analysis. Of these patients, 11 (10%) were classified as highly probable, 58 (54%) as probable, and 39 (36%) as possible DILI in the PAC group, while six patients (5%) were classified as highly probable, 53 (46%) as probable, and 57 (49%) as possible DILI in the no PAC group (p = 0.089). During patient recovery, PAC was associated with a ∼10% increase in the cumulative 180-day recovery rate. The PAC group had a crude hazard ratio (HR) of 1.73 [95% confidence interval (CI): 1.23–2.43, p = 0.001] for DILI 180-day recovery, which remained stable after multivariate risk adjustment (HR = 1.74, 95% CI: 1.21–2.49, p = 0.003), IPTW (HR = 1.72, 95% CI: 1.19–2.47, p = 0.003), and PSM (HR = 1.49, 95% CI: 1.01–2.23, p = 0.046). In the PSM cohort, PAC was more likely to identify suspect drugs (90% vs. 60%, p < 0.001) and lead to timely withdrawal of the medication (89% vs. 57%, p < 0.001). Thus, PAC is associated with a better quality of medical care for patients with DILI and can improve patient outcomes.

The influence of heat treatment on microstructure evolution and mechanical properties of TiB2/Al 2024 composites fabricated by laser-powder directed energy deposition (DED) were investigated. The results showed that the addition of TiB2 resulted in a significant grains refinement with random orientation. Compared with DED-Al 2024, a lot of network-like θ-Al2Cu phases was generated in the as-deposited TiB2/Al 2024 composite, leading to low plasticity. After 10h solution treatment, the θ phase disappeared, the thermally stable block T-Al20Cu2Mn3 phase was formed and the ultimate tensile strength (UTS) and elongation improved due to solution strengthening. During the aging process, Cu element was precipitated and semi-coherent θ’ phase was generated, improving the effect of Orowan strengthening. The composite material reached the maximum UTS of 453.65 MPa after 10h aging. The yield strength (YS) enhanced with the increase of aging time. After 15h aging, the YS and microhardness reached the maximum of 245.73 MPa and 133.50HV, respectively. This research provides a theoretical basis for the repair and manufacture of Al 2024 alloy and composite parts.

Abstract Background This study investigated the characteristics of corneal higher-order aberrations (HOAs) of the anterior surface, posterior surface, and total cornea in adolescents with mild to moderate myopia. Methods A total of 183 patients with myopia (183 eyes) aged 8 to 18 years were enrolled in this study. The axial length (AL) of the eyes was measured by an IOL-Master, and corneal curvatures (K-values) and HOAs were measured by a Pentacam anterior segment diagnostic analyzer. Results Results of this study showed that the anterior, posterior and total corneal horizontal coma Z3 1 were − 0.1249 ± 0.105 μm, 0.0009 ± 0.001 μm, and − 0.1331 ± 0.116 μm, respectively; the anterior, posterior and total corneal vertical coma Z3 − 1 were − 0.0212 ± 0.164 μm, 0.0003 ± 0.043 μm, and − 0.0216 ± 0.168 μm, respectively; and spherical aberration (SA) Z4 0 values were 0.2244 ± 0.091 μm, 0.1437 ± 0.029 um, and 0.1889 ± 0.090 μm, respectively. Total corneal Z3 1 was statistically correlated with posterior corneal astigmatism (K2b − K1b) (p = 0.038). Total corneal Z3 − 1 was correlated with anterior corneal astigmatism (K2f − K1f) (p = 0.027). Anterior, posterior, and total corneal Z4 0 were correlated with anterior and posterior corneal curvature (K1f, K2f, K1b, K2b) (p = 0.001). Posterior corneal Z4 0b was also significantly correlated with AL. Conclusions In adolescents with mild to moderate myopia, the posterior corneal surface shape may play a compensatory role in the balance of corneal aberrations, and the posterior corneal SA tended to become less negative as the AL increased. The corneal coma may also play a compensatory role in posterior corneal surface astigmatism, which was valuable for the treatment for improving visual quality. This conclusion still needs to be verified.

Abstract Background Most contemporary studies suggested that intersegmental parameters including disc height and local lordosis contribute to the sagittal balance of fused lumbar. Although similar clinical outcomes following MIS- and Open-TLIF were reported essentially at the early postoperative time, the comparison of local balance variables after these two different techniques was lack. The radiological differences maybe not relevant to the postoperative efficacy at an earlier post-operation stage. But during the long-term follow-up, the complications with regards to the sagittal imbalance might occur due to the distinct biomechanical properties of fusion level after MIS- and Open-TLIF. Methods The patients who underwent a single-level MIS- and Open-TLIF were reviewed retrospectively. The anterior disc height (ADH), posterior disc height (PDH), and segmental lordosis (SL) of the fusion segment were measured using recognition technical fluoroscopy. The mean disc height (MDH) was calculated by (ADH + PDH)/2. The relative DH was normalized by the anterior height of the upper vertebrae. The body mass index (BMI), the pain score of low back and leg visual analogue scale (VAS), Oswestry disability index (ODI), estimated blood loss, and hospital stay length was collected. Results A total of 88 patients undergoing a single-level TLIF (MIS and Open) were included. The pre- and post-operative ADH, PDH, MDH, and SL of MIS-TLIF group were 1.57 ± 0.33 cm, 0.79 ± 0.20 cm, 1.18 ± 0.21 cm, 7.36 ± 3.07 and 1.63 ± 0.30 cm, 1.02 ± 0.28 cm, 1.32 ± 0.24 cm, 10.24 ± 4.79 respectively. Whereas, the pre- and post-operative ADH, PDH, MDH, and SL of Open-TLIF group were 1.61 ± 0.40 cm, 0.77 ± 0.21 cm, 1.19 ± 0.24 cm, 9.05 ± 5.48 and 1.81 ± 0.33 cm, 0.98 ± 0.24 cm, 1.39 ± 0.24 cm, 12.34 ± 4,74 respectively. MIS- and Open-TLIF group showed no significant differences in low back VAS, leg VAS, and ODI both in pre-operation and post-operation (P > 0.05). The estimated blood loss and hospital stay length in the MIS-TLIF group were significantly lower than those in the Open-TLIF group (P

Antibacterial drug exposure (ADE) is a well-known potential risk factor for Clostridium difficile infection (CDI), but it remains controversial which certain antibacterial drugs are associated with the highest risk of CDI occurrence. To summarize CDI risk associated with ADE, we reviewed the CDI reports related to ADE in the FDA Adverse Event Reporting System database and conducted disproportionality analysis to detect adverse reaction (ADR) signals of CDI for antibacterial drugs. A total of 8063 CDI reports associated with ADE were identified, which involved 73 antibacterial drugs. Metronidazole was the drug with the greatest number of reports, followed by vancomycin, ciprofloxacin, clindamycin and amoxicillin. In disproportionality analysis, metronidazole had the highest positive ADR signal strength, followed by vancomycin, cefpodoxime, ertapenem and clindamycin. Among the 73 antibacterial drugs, 58 showed at least one positive ADR signal, and ceftriaxone was the drug with the highest total number of positive signals. Our study provided a real-world overview of CDI risk for AED from a pharmacovigilance perspective and showed risk characteristics for different antibacterial drugs by integrating its positive–negative signal distribution. Meanwhile, our study showed that the CDI risk of metronidazole and vancomycin may be underestimated, and it deserves further attention and investigation.

The adjustable bandgap, single crystal structure, and strong chemical inertness of GaN materials make them excellent candidates for water splitting applications. The fabrication of GaN nanostructures can enhance their water splitting performance by increasing their surface area, improving photon absorption, and accelerating photocatalytic reactions. Developing cost-effective methods to fabricate GaN nanostructures is crucial to promote the development of GaN-based materials in water splitting applications. In this review, we introduce the main cost-effective techniques for the fabrication of GaN nanostructures and highlight future development directions.

An unseasonal dust storm hit large parts of Central Asia on 4–5 November 2021, setting records for the column aerosol burden and fine particulate concentration in Tashkent, Uzbekistan. The dust event originated from an agropastoral region in southern Kazakhstan, where the soil erodibility was enhanced by a prolonged agricultural drought resulting from La Niña-related precipitation deficit and persistent high atmospheric evaporative demand. The dust outbreak was triggered by sustained postfrontal northerly winds during an extreme cold air outbreak. The cold air and dust outbreaks were preceded by a chain of processes consisting of recurrent synoptic-scale transient Rossby wave packets over the North Pacific and North Atlantic, upper-level wave breaking and blocking over Greenland, followed by high-latitude blocking over Northern Europe and West Siberia, and the equatorward shift of a tropopause polar vortex and cold pool into southern Kazakhstan. Our study suggests that the historic dust storm in Uzbekistan was a compound weather event driven by cold extreme, high winds, and drought precondition.

Nanorod array and planar green-emission InGaN/GaN multi-quantum well (MQW) LEDs were fabricated by lithography, nano-imprinting, and top–down etching technology. The defect-pinning effect of the nanostructure was found for the first time. The ratio of the bright regions to the global area in the panchromatic CL images of green MQW samples increased from 30% to about 90% after nano-fabrication. The overall luminous performance significantly improved. Throughout temperature-dependent photoluminescence (TDPL) and time-resolved PL (TRPL) measurements, the migration and recombination of carriers in the MQWs of green LEDs were analyzed. It was proved that nanostructures can effectively prevent carriers from being captured by surrounding nonradiative recombination centers. The overall PL integral intensity can be enhanced to above 18 times. A much lower carrier lifetime (decreasing from 91.4 to 40.2 ns) and a higher internal quantum efficiency (IQE) (increasing from 16.9% to 40.7%) were achieved. Some disputes on the defect influence were also discussed and clarified.

Localized surface plasmon (LSP) coupling with many radiators are investigated. The LSP is generated by excitation of laser or electron beam on the random Ag nano particles (NPs) and arrayed ones embedded in the p-GaN of green LEDs. They couple with the excitons or radiative recombination in the quantum well (QW) and electron beam, which enhance or suppress the luminescence of the radiators. The photoluminescence (PL) intensity of periodic Ag NPs can get as much as 4.5 times higher than that of bare LED. In addition to the periodic structure, the morphology of Ag NPs also affects the localized SP (LSP) resonance intensity and light scattering efficiency. In the finite difference time domain (FDTD) simulation, five x-polarized dipoles are approximated to five quantum wells. Considering the interaction between the five dipoles and their feedback effect on LSP, the enhancement effect of SP dipole coupling with Ag NPs is amplified and the energy dissipation is reduced. The enhancement of cathodoluminescence (CL) was also found in green LEDs with Ag NPs. The three-body model composed of two orthogonal dipoles and an Ag NP is used for 3D FDTD simulation. The LSP-QWs coupling effect is separated from the electron beam (e-beam)-LSP-QW system by linear approximation. Under the excitation of electron beam, the introduction of z-dipole greatly reduces the energy dissipation. In the cross-sectional sample, z-polarized dipoles in QWs show more coupling strength to the dipole and quadrupole modes of LSP. The perturbation theory is used to separate the LSP coupling effects to x-dipole and z-dipole. At last, the resonator and the antenna effects are discussed for LSP coupling at different positions to the Ag NP.

Glioma is the most common type of malignant brain tumor. Due to its highly aggressive and metastatic features, glioma is associated with poor prognosis and a lack of effective treatments. Eriodictyol, a natural flavonoid compound, has been reported to possess anti-inflammatory and antioxidant effects. However, the anti-tumor effects of eriodictyol and the underlying mechanisms have rarely been reported. In this study, we found that eriodictyol has anti-tumor activity in lung, colon, breast, pancreas, and liver cancer, and most significantly in glioma cell lines. Eriodictyol dose- and time-dependently suppresses cell proliferation, migration, and invasion in U87MG and CHG-5 glioma cells. In addition, eriodictyol induces apoptosis in U87MG and CHG-5 cells, as evaluated by flow cytometry, immunofluorescence, and Western blot. Furthermore, eriodictyol downregulates the phosphoinositide 3-kinase (PI3K)/Akt/NF-κB signaling pathway in a concentration-dependent manner. Moreover, the effects of eriodictyol on the apoptosis of glioma cells are enhanced by LY294002 (a PI3K inhibitor) and reversed by 740 Y-P (a PI3K agonist). In a mouse xenograft model, eriodictyol not only dramatically suppressed tumor growth but also induced apoptosis in tumor cells. In summary, our data illustrate that eriodictyol effectively inhibits proliferation and metastasis and induces apoptosis of glioma cell lines, which might be a result of the blockade of the PI3K/Akt/NF-κB signaling pathway.

BackgroundSpatial release of masking (SRM) is a measure of an individual's ability to perform speech-noise segregation, which is usually quantified by the extent of improvement of the individual's speech recognition performance when the noise is switched from a spatially co-located position (e.g., speech and noise both presented from the front) to a spatially separated position (e.g., speech presented from the front and noise presented from the right side) with reference to the target speech. SRM is a combined measure of head shadow and binaural unmasking benefits. SRM has only been investigated in young children at group level but not at individual participant level in the international literature due to the lack of reliable speech recognition test materials able to detect subtle statistically significant within-participant changes in speech-recognition-in-noise thresholds.MethodThe performance to signal-to-noise ratio (P-SNR) functions of twenty-four disyllabic words were obtained from 40 native Mandarin-speaking children aged 3.6-6.2 years with reported normal speech, language and hearing. The test items' difficulty levels were homogenized by adjusting the speech intensity level of each item so that the adjusted signal-to-noise ratio for 50% correct score (SNR-50%) point of each item would overlap at the mean SNR-50% point of all test items. In the MAPID-A, the homogenized test items were randomly presented in an adaptive testing procedure at a fixed noise intensity level, but the speech intensity level of the upcoming test item varied in 2-dB SNR steps depending on the recognition result of the previous test item. The SNR reversal point is marked by a change from a decrease to an increase in the SNR or vice versa. Two successive SNR reversal points marked the boundaries of an excursion. The mid-points from 12 excursions (in dB SNR) were averaged to produce the adaptive SNR-50% measure (aSNR-50%).ResultsThe aSNR-50% results were obtained from another 12 children aged 4.8-5.3 years with reported normal speech, language and hearing. The average 99% confidence interval (CI) of all participants' mean aSNR-50% values was ±1.61 dB SNR; therefore, 3.22 dB SNR was the average critical difference required to confirm a significant difference in the scores obtained from the same participant between two test conditions. Statistically significant within-participant SRM was identified in 95% of the participants; in other words, aSNR-50% obtained from the spatially separated condition outperformed aSNR-50% obtained from the spatially co-located condition. The adaptive testing procedure was highly reliable, with an within-participant test-retest reliability of 90.6%. and significantly limited testing time to an average of 4.2 min. This research study has fulfilled its aim on detecting subtle within-participant SRM in very young children starting from 4 years of age with a reliable statistical procedure. MAPID-A offers a reliable and efficient clinical tool to investigate speech-recognition-in-noise and SRM performances in young Mandarin-speaking children.ConclusionsThe narrow CIs, high test-retest reliability, and short testing time has proven that the MAPID-A is a promising sensitive, reliable and time-efficient clinical tool to detect subtle within-participant speech-recognition-in-noise changes in children as young as 4-5 years. The MAPID-A offers a clinical tool to behaviorally track young children's development in speech-recognition-in-noise and SRM, and to potentially review the development of the auditory neural pathway and the cerebral dominance for speech-recognition-in-noise in young children.

Inflammation plays a pivotal role in the development of pulmonary arterial hypertension (PAH). Meanwhile, serum glucocorticoid-regulated kinase-1 (SGK1) has been considered to be an important factor in the regulation of inflammation in some vascular disease. However, the role of SGK1 in hypoxia-induced inflammation and PAH is still unknown. WT and SGK1-/- mice were exposed to chronic hypoxia to induce PAH. The quantitative PCR and immunohistochemistry were used to determine the expression of SGK1. The right ventricular hypertrophy index (RVHI), RV/BW ratio, right ventricle systolic pressure (RVSP), and percentage of muscularised vessels and medical wall thickness were measured to evaluate PAH development. The infiltration of macrophages and localization of SGK1 on cells were examined by histological analysis. The effects of SGK1 on macrophage function and cytokine expression were assessed by comparing WT and SGK1-/- macrophages in vitro. SGK1 has high expression in hypoxia-induced PAH. Deficiency of SGK1 prevented the development of hypoxia-induced PAH and inhibited macrophage infiltration in the lung. In addition, SGK1 knockout inhibited the expression of proinflammatory cytokines in macrophages. SGK1-induced macrophage activation and proinflammatory response contributes to the development of PAH in hypoxia-treated mice. Thus, SGK1 might be considered a promising target for PAH treatment.

To examine the direct and indirect effects of demographical factors on speech perception and vocabulary outcomes of Mandarin-speaking children with cochlear implants (CIs).115 participants implanted before the age of 5 and who had used CI before 1 to 3 years were evaluated using a battery of speech perception and vocabulary tests. Structural equation modeling was used to test the hypotheses proposed.Early implantation significantly contributed to speech perception outcomes while having undergone a hearing aid trial (HAT) before implantation, maternal educational level (MEL), and having undergone universal newborn hearing screening (UNHS) before implantation had indirect effects on speech perception outcomes via their effects on age at implantation. In addition, both age at implantation and MEL had direct and indirect effects on vocabulary skills, while UNHS and HAT had indirect effects on vocabulary outcomes via their effects on age at implantation.A number of factors had indirect and direct effects on speech perception and vocabulary outcomes in Mandarin-speaking children with CIs and these factors were not necessarily identical to those reported among their English-speaking counterparts.

Celangulin V (CV), one of dihydroagarofuran sesquiterpene polyesters isolated from Chinese bittersweet (Celastrus angulatus Maxim), is famous natural botanical insecticide. Decades of research suggests that is displays excellent insecticidal activity against some insects, such as Mythimna separata Walker. Recently, it has been validated that the H subunit of V-ATPase is one of the target proteins of the insecticidal dihydroagarofuran sesquiterpene polyesters. As a continuation of the development of new pesticides from these natural products, a series of β-dihydroagarofuran derivatives have been designed and synthesized. The compound JW-3, an insecticidal derivative of CV with a p-fluorobenzyl group, exhibits higher insecticidal activity than CV. In this study, the potential inhibitory effect aused by the interaction of JW-3 with the H subunit of V-ATPase c was verified by confirmatory experiments at the molecular level. Both spectroscopic techniques and isothermal titration calorimetry measurements showed the binding of JW-3 to the subunit H of V-ATPase was specific and spontaneous. In addition, the possible mechanism of action of the compound was discussed. Docking results indicated compound JW-3 could bind well in ‘the interdomain cleft’ of the V-ATPase subunit H by the hydrogen bonding and make conformation of the ligand–protein complex become more stable. All results are the further validations of the hypothesis, that the target protein of insecticidal dihydroagarofuran sesquiterpene polyesters and their β-dihydroagarofuran derivatives is the subunit H of V-ATPase. The results also provide new ideas for developing pesticides acting on V-ATPase of insects.

To study the transient response characteristics of wind turbine structures–extended foundations under wind loads in mountainous areas, this paper develops a simplified analytical model based on soil–structure interaction theory. It explores the effects of constraint conditions, wind speed, and foundation shear wave speed on the transient response behavior. By analyzing the time–domain and frequency–domain trends of tower top displacement, foundation horizontal displacement, and foundation rotation angle, the relationship between foundation shear wave speed and the safe wind speed of the wind turbine is clarified. The results indicate that different constraint conditions lead to variations in the calculated resonance frequency, maximum tower top displacement, and acceleration response spectrum. Furthermore, based on the analysis of the tower top acceleration response curve, the influence interval of frequency can be categorized into three distinct ranges: stable range, small influence range, and large influence range. Wind speed primarily influences the vibration amplitudes of the three displacement components, while the overall trend of the time-displacement waveform remains unchanged. The foundation shear wave speed primarily affects the displacement of the foundation itself, exerting a smaller influence on the displacements of the wind turbine structure. Notably, the total displacement at the tower top decreases as the shear wave speed increases. Moreover, the safe wind speed of the wind turbine shows a positive correlation with the foundation shear wave speed, indicating a linear relationship between the two variables. [ABSTRACT FROM AUTHOR]

Colon cancer poses a significant threat to global health, and studies have shown a correlation between physical activity (PA) and the incidence of colon cancer. However, existing research has not quantitatively analyzed PA to evaluate its impact on the risk of colon cancer comprehensively. Data related to the study were obtained from the NHANES database for participants aged 20 and above between 2007 and 2018. Calculate the daily total metabolic equivalent (MET) based on the duration of different physical activities for each participant, use multivariate logistic regression analysis to evaluate the association between PA and colon cancer risk, perform subgroup analysis to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) between different subgroups, and use RCS regression analysis to evaluate the non-linear relationship between MET and colon cancer risk. After adjusting for potential confounding factors, multivariate logistic regression analysis showed that compared with the overall data of the participants in this study, the OR of the low PA group (PA ≤ 120MET/day) was 1.224 (95% CI 1.031–1.453, P = 0.023), the OR of the mild PA group (120 < PA ≤ 600MET/day) was 1.026 (95%CI 0.707–1.488, P = 0.894), the OR of the moderate intensity PA group (600 < PA ≤ 1200MET/day) was 0.798 (95% CI 0.506–1.258, P = 0.334), and the OR of the high-intensity PA group (PA > 1200MET/day) was 0.470 (95% CI 0.249–0.885, P = 0.022), these results are consistent in subgroup analysis. The RCS regression analysis results showed a significant nonlinear relationship between MET and the risk of colon cancer(p < 0.001), with an inflection point observed at 1879 MET/day on the correlation curve. Low physical activity increases the risk of colon cancer, while moderate to high-intensity physical activity can reduce the risk of colon cancer. The results of this study emphasize the importance of maintaining appropriate physical activity as a healthy way to prevent colon cancer. [ABSTRACT FROM AUTHOR]

Acrylate emulsion is widely used in various industrial fields and is an important polymer emulsion. However, the high flammability limits its application. Besides, acrylate emulsion generally releases a large amount of smoke during combustion. To improve the fire resistance and smoke suppression properties of acrylate emulsions, methyl methacrylate‐butyl acrylate copolymer P(MMA‐BA)/DOPO‐based polymerizable monomer (HEPO)/zinc molybdate sepiolite (Mo‐Sep) composite emulsion was prepared by emulsion polymerization, and the effect of Mo‐Sep content on the flame‐retardant performance, thermal stability, and smoke suppression performance of the composite emulsion was studied. Through microcalorimeter and smoke density meter tests, it was found that the heat release rate (HRR) of the composite emulsion, added with 30% HEPO/3% Mo‐Sep, was reduced by 63.3%, and the peak heat release rate (PHRR) was reduced by 72.1%. The total heat release (THR) is reduced by 49.0%, while the peak‐specific optical density is reduced by 48.0%. It shows that the composite emulsion has excellent flame‐retardant and smoke suppression properties compared to pure MAA‐BA emulsion. In addition, scanning electron microscope (SEM) images show that the addition of Mo‐Sep increases the density of carbon residue. This composite emulsion may have potential application scenarios in the field of flame‐retardant coatings. [ABSTRACT FROM AUTHOR]

Background: Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder in premenopausal women, often linked to abdominal obesity, insulin resistance, and metabolic issues. With its heterogeneous nature, PCOS treatment should be tailored to individual symptoms and patient preferences. This study examines collaboration networks among countries, institutions, authors, references, and journals related to PCOS treatment. Methods: Web of Science data was analyzed using VOSviewer and CiteSpace for bibliometric visualization. Chinese and Western medicine treatments for PCOS were reviewed, emphasizing symptom-targeted solutions. Results: Data from 4682 records authored by 400 individuals from 515 institutes in 62 countries revealed China as the leading contributor. Notable authors include Monash University and Richard S. Legro. Common research themes include adipocytes, inflammation, insulin sensitivity, oxidative stress, and the gut microbiome. Tailoring treatment to individual needs is essential, focusing on hyperandrogenism, ovulation, and insulin resistance, with lifestyle counseling to address obesity. Conclusion: This bibliometric analysis provides valuable insights into the research status of PCOS treatment. China has made significant contributions, and complementary and alternative therapies, such as traditional Chinese medicine and acupuncture, have also shown beneficial effects recently. The research on inflammation, oxidative stress, and the gut microbiome may provide new targets and strategies for the treatment of PCOS. The recognition of the metabolic problems in PCOS patients facilitates the formulation of more personalized treatment plans to improve the prognosis of patients. [ABSTRACT FROM AUTHOR]

Papillary thyroid carcinoma (PTC) is the most common subtype of thyroid carcinoma. The most effective treatment for PTC is surgical resection, and patients who undergo surgery have good survival outcomes, but some patients have distant metastasis or even multiorgan metastases at the time of initial diagnosis. Distant metastasis is associated with poorer prognosis and a higher mortality rate. Helper T lymphocyte 17 (Th17) cells and regulatory T lymphocytes (Tregs) play different roles in PTC, and the Th17/Treg balance is closely related to the progression of PTC. Th17 cells play anticancer roles, whereas Tregs play cancer-promoting roles. A Th17/Treg imbalance promotes tumor progression and accelerates invasive behaviors such as tumor metastasis. Th17/Treg homeostasis can be regulated by the TGF‐β/IL‐2 and IL‐6 cytokine axes. Immune checkpoint inhibitors contribute to Treg/Th17 cell homeostasis. For PTC, monoclonal antibodies against CTLA-4, PD-1 and PD-L1 inhibit the activation of Tregs, reversing the Th17/Treg cell imbalance and providing a new option for the prevention and treatment of PTC. This article reviews the role of Tregs and Th17 cells in PTC and their potential targets, aiming to provide better treatment options for PTC. [ABSTRACT FROM AUTHOR]