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Abstract Objectives To explore the impact of hepatic steatosis measured by MRI-proton density fat fraction (MRI-PDFF) on liver stiffness measurement (LSM) value and its diagnostic performance for staging liver fibrosis in patients with chronic hepatitis B (CHB). Methods A total of 914 patients with CHB who underwent liver biopsy and MRI-PDFF were retrospectively reviewed. The influence of MRI-PDFF on LSM value was assessed using univariate and multivariate linear analyses. To assess the influence of liver steatosis on the diagnostic performance of LSM, a series of ROC analyses were performed and compared by stratifying patients into non-steatosis (PDFF

The derivation of water quality criteria (WQC) for antibiotics is influenced by the inclusion of various organisms' toxicity data, including microbial data, though no definitive conclusions have been reached. This study focuses on sulfonamide antibiotics, common in the Yangtze River Delta (YRD), to assess the influences of different organisms' toxicity data on determining WQCs and subsequent evaluation of ecological risks. A total of 263 toxicity data points from eight sulfonamides, including sulfamethoxazole (SMX) and sulfamethazine (SM2), were selected to derive WQCs using Species Sensitivity Distribution (SSD) methods. Three WQC types were calculated: based on native species (WQC-n), a combination of native and non-native species (WQC-nn), and a combination of species and microorganisms (WQC-nnm). While WQC-nn showed minimal differences from WQC-n, the inclusion of microbial data resulted in more conservative short-term WQCs (SWQC-nnm), calculated as 256.90 μg/L for SMX and 196.09 μg/L for SM2, approximately half of SWQC-nn values (435.20 μg/L for SMX and 491.11 μg/L for SM2). Monitoring data from the past 15 years in the YRD revealed a 133 % increase in ecological risks when using LWQC-nnm compared to LWQC-n and LWQC-nn, particularly under the worst-case pollution scenarios. However, there was a slight temporal decline in overall ecological risks. The study concludes that incorporating microbial toxicity data results in more protective WQCs and underscores the need for further research to develop WQCs that safeguard sensitive organisms and better reflect real-world exposure scenarios, e.g., the mixture exposure.

BackgroundsMany pregnant women suffer from more than one pregnancy complication. However, whether those women experienced a higher risk of adverse birth outcomes is unclear. This study aims to assess the association between the comorbidity of gestational diabetes mellitus (GDM) and hypertension disorders of pregnancy (HDP) and adverse birth outcomes.MethodsThe data was from the Zhoushan Maternal and Child Health Hospital electronic medical recorder system (EMRS) between 2015 and 2022. Multivariate linear regression model was used to analyze the association of GDM, HDP, and comorbidity with birth weight and gestational age, respectively. Multiple logistic regression model was used to analyze the association of GDM, HDP, and comorbidity with adverse birth outcomes.Results13645 pregnant women were included. GDM+HDP was significantly associated with a higher risk of composite adverse neonatal outcomes (OR=1.82, 95%CI: 1.02-3.04), including preterm birth, placenta previa, and/or neonatal jaundice, a higher risk of small for gestational age (SGA) (OR=2.2, 95% CI: 1.24 3.92) and large for gestational age (LGA) (OR=2.33, 95% CI: 1.64 3.31) compared with the normal group. Further analysis showed that HDP diagnosed in the 21-27th week comorbid with GDM had the lowest gestational age at delivery (β= -1.57, P=0.0002) and birth weight (β= -189.57, P=0.0138). Moreover, combined hyperglycemia (CH) comorbid with HDP had the strongest association with reduced gestational age (β= -0.83, P=0.0021).ConclusionPregnant women suffering from both GDM and HDP had a higher risk of adverse neonatal outcomes; hence, the prevent and treatment of GDM and HDP, especially their comorbidity, are very important for pregnant women.

ObjectiveConflicting associations have been noted between thyroid function and gestational diabetes mellitus (GDM), with indications that pre-pregnancy BMI might influence these relationships. This study aims to examine the effect of thyroid hormone indices and their mediation role on the risk of GDM.MethodsPregnant women in our study were recruited from the Zhoushan Pregnant Women Cohort, Zhejiang Province, China. Participants who had their first prenatal follow-up and measured thyroid biomarkers in the first trimester, and oral glucose tolerance test (OGTT) records in the second trimester were eligible for inclusion in this study. The data were extracted from the Electronic Medical Record System database, at Zhoushan Maternal and Child Care Hospital. Maternal information about sociodemographic and health-related characteristics was extracted from the dataset. A unique personal identification number was provided to link both datasets. Multivariate logistic regression models were applied to investigate the correlations between thyroid hormone indices with GDM. The interaction effects of first-trimester thyroid hormone indices with pre-pregnancy BMI on GDM risk using a generalized linear regression model. Furthermore, the mediation analysis was used to explore the potential mediating effects of thyroid hormone indices on the relationship between pre-pregnancy BMI and GDM.ResultsOverall, 5895 pregnant women were included in this study. The first-trimester FT4, thyroid feedback quantile-based index (TFQI), thyrotropin index (TSHI) and thyrotroph thyroxine resistance index (TT4RI) levels were negatively associated with fasting blood glucose (FBG) and postprandial blood glucose (PBG2H) in the second trimester (all P

Electrolysis from biomass is a promising process for hydrogen generation from biomass and biowaste that is still unexplored. The paper used lignocellulosic biomass components and food waste (banana and cucumber peels) as feedstocks to explore hydrogen generation through an H-type proton exchange membrane electrolytic cell. Polyoxometalates (PMo12) were employed as a catalyst and charge carrier during the pre-treatment stage in the biomass degradation process. Electrochemical characterisations were conducted in a potential range of 0–1.20 V to analyse the electrochemical reaction behaviour at the anode. To assess the impact of temperature on the hydrogen yield rates, the electrolysis was conducted at both room temperature (19 °C) and a higher temperature (80 °C). Results show that the maximum hydrogen produced in the first hour was 7.8 mL per gram of biomass. With an electrical potential of 1.20 V and a temperature of 80 °C, the hydrogen yield rate of glucose was three times higher than that of the individual biomass components, i.e., cellulose, lignin, hemicellulose, and starch. The volume of hydrogen yielded from banana peel and cucumber was 49.2 mL and 39.6 mL, respectively. The overall conversion efficiency was calculated as the weight percentage ratio of the hydrogen contained in cucumber and banana peels and the hydrogen collected was 10 % and 17 %, respectively, suggesting the need to identify solutions to extract the hydrogen content from biomass material further.

ObjectiveFew comparisons have been implemented between different prenatal care utilization indices and their effects on adverse outcomes. This study investigated the appropriateness of Chinese antenatal care (ANC) regulations and compared Chinese and American adequacy of prenatal care utilization (APNCU) scores.MethodsFrom 2010 to 2022, the medical records of 60,114 pregnant women were collected from the electronic medical record system (EMRS) in Zhoushan, China. ANC utilization was measured using the APNCU score and five times antenatal care (ANC5). Birth weight outcomes, including small for gestational age (SGA) and large for gestational age (LGA), low birth weight (LBW), macrosomia, birth weight, and preterm birth (PTB), were utilized as outcomes. Multinomial, linear, and logistic regression were used to analyze the association of ANC5 and APNCU with outcomes, respectively. Crossover analysis was implemented to compare the interaction between ANC5 and APNCU on the outcomes.ResultsWomen who received inadequate prenatal care had increased odds for PTB (ANC5: odds ratio (OR) = 1.12, 95% confidence interval (95%CI) = 1.03–1.21; APNCU: OR = 1.18, 95%CI: 1.07–1.29), delivering SGA infants (ANC5: OR = 1.13, 95%CI = 1.07–1.21; APNCU: OR = 1.11, 95%CI = 1.03–1.20). Crossover analysis revealed that inadequate prenatal care in APNCU only was significantly associated with an increased risk of PTB (OR = 1.48, 95%CI: 1.26–1.73).ConclusionWomen with inadequate prenatal care in ANC5 or APNCU were more likely to suffer from adverse birth outcomes, including PTB, birth weight loss, SGA, and LBW. It indicated that adequate prenatal care is necessary for pregnant women. However, there were interactions between ANC5 and APNCU on PTB, with inadequate prenatal care use by APNCU showing the highest risk of PTB. This indicates that APNCU would be a better tool for evaluating prenatal care use.

Abstract In the multi‐variety and large‐scale order production mode, enterprises must balance delivery deadlines and maintain customer satisfaction while also considering the health status of machines. Therefore, the authors propose a method for jointly optimising production scheduling and machine maintenance. Before machine processing, an order value grading and sorting model and a machine health‐status group partitioning model are constructed to classify orders into different production value levels and machines into different health‐status groups, respectively. During machine processing, based on the Weibull distribution theory, a ‘health evaluation function value’ constraint machine preventive maintenance (PM) model and PM strategy are proposed to account for the changing health status of machines; these are integrated with the order allocation machine strategy as decision‐making elements in the production schedule. Finally, two case studies are used to verify the effectiveness of this proposed model and method. The results show that compared to general scheduling schemes, the proposed method can reduce total delay and improve customer satisfaction. Additionally, the PM plan proposed in this method can improve production efficiency and line stability compared to periodic maintenance.

The quest to decarbonize the lime and cement industry is challenging because of the amount and the nature of the CO2 emissions. The process emissions from calcination are unavoidable unless carbon capture is deployed. Nevertheless, the majority of the available carbon capture technologies are expensive and energy inefficient. The indirectly heated carbonate looping (IHCaL) process is a promising technology to capture CO2 from the lime and cement production, featuring low penalties in terms of economics and energy utilization. Previous works have highlighted the potential of the IHCaL, but the optimization of the process has not been discussed in enough detail and techno-economic implications are not yet fully understood. Within this work, ten scenarios using IHCaL technology to capture CO2 from a lime plant were simulated. Hereby, different process configurations, heat recovery strategies and fueling options were computed. The calculations for the capture facilities were performed with Aspen Plus® software and EBSILON®Professional was used to simulate the steam cycles. A techno-economic assessment was included as well, aided by the ECLIPSE software.The results demonstrate that the selection of the fuel for the combustor not only affects the CO2 balance and energy performance but is also an important cost driver —there were considerable economic advantages for the computed cases with middle-caloric solid recovered fuel (SRF). The analysis shows how the heat recovery strategy can be optimized to achieve tailored outcomes, such as reduced fuel requirement or increased power production. The specific primary energy consumption (from −0.3 to +2.5 MJLHV/tCO2,av) and cost for CO2 avoided (from −11 to +25 €/tCO2,av) using SRF are considerably low, compared with other technologies for the same application. The sensitivity study revealed that the main parameters that impact the economics are the discount rate and the project life. The capture plants are more sensitive to parameter changes than the reference plant, and the plants using SRF are more sensitive than the lignite-fueled plants. The conclusions from this work open a new pathway of experimental research to validate key assumptions and enable the industrial deployment of IHCaL technology before 2030.

Abstract Purpose To report a case of primary vitreoretinal lymphoma masquerading as infectious retinitis that was diagnosed via a retinal biopsy. Observations A 72-year-old female patient was referred to our ophthalmology clinic for evaluation of retinitis and vasculitis in the right eye (OD). On examination, best-corrected visual acuities (BCVAs) were hand motions OD and 20/20 in the left eye (OS). Fundus examination revealed optic disc edema and diffuse retinal whitening superior to the superotemporal arcade OD. Given the high suspicion of infectious retinitis, the patient was treated with intravitreal foscarnet, systemic acyclovir, and oral prednisone and underwent a comprehensive uveitis workup, which was unremarkable for viral and autoimmune entities. Given the patient’s history of diffuse large B cell lymphoma with cutaneous involvement, vitreoretinal lymphoma was suspected, prompting pars plana vitrectomy with a retinal biopsy. Biopsy and immunohistochemistry results were consistent with B-cell lymphoma, and the patient was treated with high-dose methotrexate and rituximab. At 5-month follow-up, BCVAs were hand motions OD and 20/30 OS, and fundus examination demonstrated disc edema with resolution of retinal whitening OD. She responded well to the treatment with regression of vitreoretinal lymphoma on examination and is being monitored closely for lymphoma recurrence. Conclusions and importance Although uncommon, patients with vitreoretinal lymphoma may masquerade as infectious retinitis, and vitreoretinal lymphoma should be suspected when refractory to antiviral therapy and in the setting of a negative workup for viral etiologies. Vitrectomy with retinal biopsy may be considered to aid the diagnosis of vitreoretinal lymphoma although careful consideration of the risks and benefits is warranted.

Abstract HPLC analysis determined six small-molecule organic acids, maltol, 5-hydroxymethylfurfural (5-HMF), 17 ginsenosides, four oligosaccharides, and 20 amino acids in black ginseng samples with different processing times. Based on the content determination results, the differential ingredients in the processing of black ginseng were screened by multivariate statistical analysis. Network pharmacological methods obtained the core targets and pathways of the above ingredients against prostate cancer. Finally, the entropy weight method was used to assign values to the above ingredients, targets, and pathways, and the vector space network pharmacology method was established to study the anti-prostate cancer mechanism of black ginseng in the process of "nine steaming and nine sun-drying". Based on principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA), fructose, glucose, dencichin, glutamate, ginsenoside 20 (S)-Rg3, 20 (R)-Rg3, 20 (S)-Rh2, Rg1, Re, and Rc were the main differential ingredients in various steaming and sun-drying cycle periods of black ginseng. The results of vector space network pharmacology showed that the main reason for the change in the anti-prostate cancer pathway of black ginseng with the number of steaming and sun-drying was the different regulatory ability of black ginseng on the PI3K-Akt signaling pathway and chemical carcinogenesis-receptor activation pathway. It gave researchers a fresh perspective for exploring the anti-prostate cancer active components of black ginseng and the change in the mechanism of the effect of traditional Chinese medicine in processing.

Abstract Background Ilizarov method has become one of primary methods for treating bone defects. Currently, there is growing trend in the application of modified Ilizarov methods (e.g., applying unilateral external fixators or with flap tissue) and its combined methods (e.g., Ilizarov method with antibiotic spacer or internal fixation) to manage bone defects. However, there is a lack of studies with systematical evaluation of the clinical effects of these evolving methods. This study aimed to conduct a systematic review and meta-analysis for overall evaluating the clinical effects on long bone defects of lower extremity in Ilizarov methods and its combined methods. Methods Studies were identified in three electronic databases (Pubmed, Embase and Cochrane Library) from the earliest indexing year through November 01, 2022, and relevant data were extracted subsequently. The total number of participants, number of participants with bone unions, bone result or functional result, and related complications including pin infection, pin loosening, pain, refracture, limb discrepancy, malalignment, joint stiffness, recurrent infection, and amputation were extracted in this study. Then, union rate (defined as the proportion of patients who achieved bone unions) and specific complication incidence rate (defined as the proportion of patients who experienced specific complication) were pooled estimated respectively. Relative risk (RR) was used for comparing the clinical effects among various Ilizarov technique. Results Sixty-eight case series studies, 29 comparative studies, and 3 randomized clinical trials were finally included. The union rate of Ilizarov methods was 99.29% (95% CI: 98.67% ~ 99.86%) in tibial defects and 98.81% (95% CI: 98.81% ~ 100.00%) in femoral defects. The union rate of Ilizarov method with antibiotic spacer and intramedullary nail in tibial defects was 99.58% (95% CI: 98.05% ~ 100.00%) and 95.02% (95% CI: 87.28% ~ 100.00%), respectively. Compared to the Ilizarov methods, the union rate of the Ilizarov method with antibiotic spacer in tibial defects increased slightly (RR = 1.02, 95% CI: 1.01 ~ 1.04). Meanwhile, compared to Ilizarov methods, we found lower excellent rate in bone result in Ilizarov method with antibiotic spacer, with the moderate to high heterogeneity. Compared to the Ilizarov method, lower rate of pin infection, higher rate of recurrent infection and amputation were observed in Ilizarov method with intramedullary nail, however, the findings about the comparison of pin infection and recurrent infection between the two groups were presented with high degree of statistical heterogeneity. Conclusion Our study confirmed the reliable treatment of Ilizarov methods and its combined technique on long bone defects, and founded there were significant differences on some complications rate between Ilizarov methods and its combined technique. However, the findings need to be confirmed by further studies.

Abstract Background High-fat diet (HFD) is closely associated with the increased prevalence of inflammatory bowel disease (IBD). Excessive gut microbial metabolite deoxycholic acid (DCA) caused by HFD plays significant roles in eliciting intestinal inflammation, however, the mechanism underlining the induction of inflammatory response by DCA has not been fully elucidated. The purpose of this study was to investigate the role of DCA in the triggering of inflammation via affecting CD4+ T cell differentiation. Results Murine CD4+T cells were cultured under Th1, Th2 or Th17-polarizing conditions treated with or without different dosage of DCA, and flowcytometry was conducted to detect the effect of DCA on CD4+ T cell differentiation. Alteration of gene expression in CD4+ T cells upon DCA treatment was determined by RNA-sequencing and qRT-PCR. Bioinformatic analysis, cholesterol metabolic profiling, ChIP assay and immuno-fluorescent staining were further applied to explore the DCA-regulated pathway that involved in CD4+T cell differentiation. The results showed that DCA could dose-dependently promote the differentiation of CD4+ T cell into Th17 linage with pathogenic signature. Mechanistically, DCA stimulated the expression of cholesterol biosynthetic enzymes CYP51 and led to the increased generation of endogenous RORγt agonists, including zymosterol and desmosterol, therefore facilitating Th17 differentiation. Up-regulation of CYP51 by DCA was largely mediated via targeting transcription factor SREBP2 and at least partially through bile acid receptor TGR5. In addition, DCA-supplemented diet significantly increased intestinal Th17 cell infiltration and exacerbated TNBS-induced colitis. Administration of cholestyramine to eliminate fecal bile acid obviously alleviated colonic inflammation accompanied by decreased Th17 cells in HFD-fed mice. Conclusions Our data establish a link between DCA-induced cholesterol biosynthesis in immune cells and gut inflammation. Modulation of bile acid level or targeting cholesterol metabolic pathway may be potential therapeutic measurements for HFD-related colitis.

Reliability of joints in solar arrays significantly influences the service life of satellites. Interface between solar cell and interconnector experiences serious temperature cycling during space service which would further lead to failure. To further improve the interface joining thermal reliability, elucidation of the interface formation and corresponding microstructure evolution during thermal fatigue is necessary. In this study, parallel gap resistance welded (PGRW) multi-layered joint between GaAs solar cell and Ag foil are subjected to different temperature cycling tests (−160–120 °C, −165–160 °C) with various cycles. Obtained results confirm the joining mechanism of the joint as solid-solution interdiffusion between Ag foil and Au surface of solar cell electrode. Also, conducted temperature cycling essentially lead to thermal fatigue process at Ag/Au interface, therefore more serious interface strength degradation is generated by larger temperature cycling range. Joint failure is initiated by thermal fatigue induced dislocation and residual strain concentrations around dissimilar interface. And the large mismatch in coefficients of thermal expansion (CTE) of the multilayer structure amplifies the thermal fatigue effect.

BackgroundAssociations of liver function with the risk of gestational diabetes mellitus (GDM) remain unclear. This study aimed to examine the relationship and the potential causality between maternal liver biomarkers and the risk of subsequent GDM, as well as to evaluate the interaction between liver biomarkers and lipids on GDM risk.MethodsIn an ongoing Zhoushan Pregnant Women Cohort, pregnant women who finished the first prenatal follow-up record, underwent liver function tests in early pregnancy, and completed the GDM screening were included in this study. Logistic regression models were used to investigate the association, and the inverse-variance weighted method supplemented with other methods of two-sample Mendelian randomization (MR) analysis was applied to deduce the causality.ResultsAmong 9,148 pregnant women, 1,668 (18.2%) developed GDM. In general, the highest quartile of liver function index (LFI), including ALT, AST, GGT, ALP, and hepatic steatosis index, was significantly associated with an increased risk of GDM (OR ranging from 1.29 to 3.15), especially an elevated risk of abnormal postprandial blood glucose level. Moreover, the causal link between ALT and GDM was confirmed by the MR analysis (OR=1.28, 95%CI:1.05-1.54). A significant interaction between AST/ALT and TG on GDM risk was observed (Pinteraction = 0.026).ConclusionElevated levels of LFI in early pregnancy were remarkably associated with an increased risk of GDM in our prospective cohort. Besides, a positive causal link between ALT and GDM was suggested.

The Homeodomain-Leucine Zipper (HD-ZIP) transcription factors play a pivotal role in governing various aspects of plant growth, development, and responses to abiotic stress. Despite the well-established importance of HD-ZIPs in many plants, their functions in Acoraceae, the basal lineage of monocots, remain largely unexplored. Using recently published whole-genome data, we identified 137 putative HD-ZIPs in two Acoraceae species, Acorus gramineus and Acorus calamus. These HD-ZIP genes were further classified into four subfamilies (I, II, III, IV) based on phylogenetic and conserved motif analyses, showcasing notable variations in exon-intron patterns among different subfamilies. Two microRNAs, miR165/166, were found to specifically target HD-ZIP III genes with highly conserved binding sites. Most cis-acting elements identified in the promoter regions of Acoraceae HD-ZIPs are involved in modulating light and phytohormone responsiveness. Furthermore, our study revealed an independent duplication event in Ac. calamus and a one-to-multiple correspondence between HD-ZIP genes of Ac. calamus and Ac. gramineus. Expression profiles obtained from qRT-PCR demonstrated that HD-ZIP I genes are strongly induced by salinity stress, while HD-ZIP II members have contrasting stress responses in two species. HD-ZIP III and IV genes show greater sensitivity in stress-bearing roots. Taken together, these findings contribute valuable insights into the roles of HD-ZIP genes in stress adaptation and plant resilience in basal monocots, illuminating their multifaceted roles in plant growth, development, and response to abiotic stress.

The TIFY family is a plant-specific gene family that is involved in regulating a variety of plant processes, including developmental and defense responses. The Cymbidium species have certain ornamental and ecological value. However, the characteristics and functions of TIFY genes in Cymbidium remain poorly understood. This study conducted a genome analysis of the TIFY gene family in Cymbidium goeringii, C. ensifolium, and C. sinense and investigated their physicochemical properties, phylogenetic relationships, gene structures, and expression patterns under heat stress in C. goeringii. C. goeringii (26), C. ensifolium (19), and C. sinense (21). A total of 66 TIFY genes were identified, and they were classified into four subfamilies (JAZ, ZML, PPD, and TIFY) based on their systematic evolutionary relationships. Sequence analysis showed that TIFYs contained a conserved TIFY domain and that genes within the same subfamily had structural similarity. Analysis of cis-regulatory elements revealed that these genes contain numerous light-responsive elements and stress-responsive elements. We subjected C. goeringii (16 h light/8 h dark) to 24 h of 38 °C high-temperature stress in a climate chamber. Additionally, results from RT-qPCR experiments showed that under heat stress, the expression levels of eight genes in C. goeringii show significant differences. Among them, the JAZ subfamily exhibited the strongest response to heat stress, initially showing upregulation followed by a downregulation trend. In conclusion, this study investigated the role of TIFY genes in three Cymbidium species, providing insights into C. goeringii under heat stress.

ZF-HD transcription factors, which are unique to land plants, are involved in the regulation of abiotic stress response and related signaling pathways, and play a crucial role in plant growth and development. Dendrobium is one of the largest genera of orchids, with a high ornamental and ecological value. However, the specific functions of the ZF-HDs in Dendrobium remain unknown. In this study, we identified a total of 53 ZF-HDs from D. chrysotoxum (17), D. catenatum (23), and D. huoshanense (13), and analyzed their physicochemical properties, phylogenetic relationships, chromosomal locations, protein structures, conserved motifs, and expression patterns. The phylogenetic relationships revealed that 53 ZF-HDs were classified into six subfamilies (ZHDI–V and MIF), and all ZF-HD proteins contained motif 1 and motif 4 conserved domains, while a minority of these proteins had exons. The analysis of cis-elements in the promoters of ZF-HDs from three Dendrobium species showed that growth- and development-related elements were the most prevalent, followed by hormone response and abiotic stress response elements. Through collinearity analysis, 14 DchZF-HDs were found to be collinear with DhuZF-HDs, and 12 DchZF-HDs were found to be collinear with DcaZF-HDs. Furthermore, RT-qPCR analysis revealed that DchZF-HDs play a regulatory role in the development of lateral organs during the flowering process. The results indicated that DchZHD2 plays a role in the unpigmented bud stage, while DchMIF8 and DchZHD16 play significant roles during the pigmented bud and initial bloom stages. Hence, this study provides a crucial basis for further exploring ZF-HDs functions in regulating the floral organs of orchids.

Percutaneous needle insertion is a minimally invasive surgery with broad medical application prospects, such as biopsy and brachytherapy. However, the currently adopted rigid needles have limitations, as they cannot bypass obstacles or correct puncture deviations and can only travel along a straight path. Bevel-tip flexible needles are increasingly being adopted to address these issues, owing to their needle body's ease of deformation and bending. Successful puncture of flexible needles relies on accurate models and path planning, ensuring the needle reaches the target while avoiding vital tissues. This review investigates puncture models and path-planning algorithms by reviewing recent literature, focusing on the path-planning part. According to the literature, puncture models can be divided into three types: mechanical, finite element method (FEM), and kinematic models, while path-planning algorithms are categorized and discussed following the division used for mobile robots, which differs from the conventional approach for flexible needles—an innovation in this review. This review systematically summarizes the following categories: graph theory search, sampling-based, intelligent search, local obstacle avoidance, and other algorithms, including their implementation, advantages, and disadvantages, to further explore the potential to overcome obstacles in path planning for minimally invasive puncture needles. Finally, this study proposes future development trends in path-planning algorithms, providing possible directions for subsequent research for bevel-tipped flexible needles. This research aims to provide a resource for researchers to quickly learn about common path-planning algorithms, their backgrounds, and puncture models.

Childhood blindness is an issue of global health impact, affecting approximately 2 million children worldwide. Vision 2020 and the United Nations Sustainable Development Goals previously identified childhood blindness as a key issue in the twentieth century, and while public health measures are underway, the precise etiologies and management require ongoing investigation and care, particularly within resource-limited settings such as sub-Saharan Africa. We systematically reviewed the literature on childhood blindness in West Africa to identify the anatomic classification and etiologies, particularly those causes of childhood blindness with systemic health implications. Treatable causes included cataract, refractive error, and corneal disease. Systemic etiologies identified included measles, rubella, vitamin A deficiency, and Ebola virus disease. While prior public health measures including vitamin A supplementation and vaccination programs have been deployed in most countries with reported data, multiple studies reported preventable or reversible etiologies of blindness and vision impairment. Ongoing research is necessary to standardize reporting for anatomies and/or etiologies of childhood blindness to determine the necessity of further development and implementation of public health measures that would ameliorate childhood blindness and vision impairment.

As technology continues to evolve, the possibility for a wide range of dangers to people, organizations, and countries escalate globally. The United States federal government classifies types of threats with the capability of inflicting mass casualties and societal disruption as Chemical, Biological, Radiological, Nuclear, and Energetics/Explosives (CBRNE). Such incidents encompass accidental and intentional events ranging from weapons of mass destruction and bioterrorism to fires or spills involving hazardous or radiologic material. All of these have the capacity to inflict death or severe physical, neurological, and/or sensorial disabilities if injuries are not diagnosed and treated in a timely manner. Ophthalmic injury can provide important insight into understanding and treating patients impacted by CBRNE agents; however, improper ophthalmic management can result in suboptimal patient outcomes. This review specifically addresses the biological agents the Center for Disease Control and Prevention (CDC) deems to have the greatest capacity for bioterrorism. CBRNE biological agents, encompassing pathogens and organic toxins, are further subdivided into categories A, B, and C according to their national security threat level. In our compendium of these biological agents, we address their respective CDC category, systemic and ophthalmic manifestations, route of transmission and personal protective equipment considerations as well as pertinent vaccination and treatment guidelines.

ObjectiveThis study aimed to compare the stability and mechanical properties of the double chevron-cut (DCC) and biplanar (BP) distal femoral osteotomy (DFO) techniques, along with analyzing their respective contact surface areas.MethodsBiomechanical testing was performed using sawbone and 3D modeling techniques to assess axial and torsional stability, torsional stiffness, and maximum torque of both osteotomy configurations. Additionally, 3D models of the sawbone femur were created to calculate and compare the contact surface area of the DCC, BP, and conventional single-plane DFO techniques.ResultsAxial stiffness and maximum strength did not significantly differ between the two osteotomy techniques. However, in terms of torsional properties, the DCC technique exhibited superior torsional stiffness compared to the BP group (27 ± 7.7 Nm/° vs. 4.5 ± 1.5 Nm/°, p = 0.008). Although the difference in maximum torque did not reach statistical significance (63 ± 10.6 vs. 56 ± 12.1, p = 0.87), it is noteworthy that the DCC group sawbone model exhibited fracture in the shaft region instead of at the osteotomy site. Therefore, the actual maximum torque of the DCC construct may not be accurately reflected by the numerical values obtained in this study. The contact surface area analysis revealed that the BP configuration had the largest contact surface area, 111% larger than that of the single-plane configuration. but 60% of it relied on the less reliable axial cut. Conversely, the DCC osteotomy offered a 31% larger contact surface area than the single-plane configuration, with both surfaces being weight-bearing.ConclusionThe DCC osteotomy exhibited superior mechanical stability, showing improved rotational stiffness and maximum torque when compared to the BP osteotomy. Although the BP osteotomy resulted in a larger contact surface area than the DCC osteotomy, both were larger than the conventional single-plane configuration. In clinical practice, both the DCC and BP techniques should be evaluated based on patient-specific characteristics and surgical goals.

Purpose: To describe the novel application of a urological instrument, the nitinol stone basket, in the removal of a retained intraocular foreign body (IOFB). Observations: This is a retrospective case series describing two eyes of two patients presenting with metallic IOFBs after hammering metal-on-metal. Both patients underwent 23-gauge pars plana vitrectomy (PPV) and successful IOFB extraction using the NCircle® Nitinol Tipless Stone Extractor. There were no intraoperative or post-surgical complications. Both patients demonstrated improvement in vision, with most recent postoperative visual acuities of 20/40 and 20/60. Conclusions and importance: The nitinol stone basket may be considered for removal of IOFBs, particularly larger IOFBs that are difficult to grasp with forceps. Our cases add to the literature showing favorable visual outcomes and few complications in the post-operative period using this technique.

Microbial fuel cells (MFCs) are a promising technology to generate electricity from wastewater and reduce the organic content. Whilst there has been a significant enhancement in MFC efficiency arising from the introduction of novel materials and cell designs, challenges remain with respect to the performance, cost, and sustainability of anode materials. This paper reports the development of single chamber MFCs with a focus on novel, cost-effective, and recycled carbon-based anode materials, including Recycled Water Filter Block/Powder (RWFB/RWFP), Recycled Chopped Carbon Fibre (RCCF), Carbon Felt (CF) and Graphite Flexible powder (GFG). Anodes prepared from GFG were shown to provide high power density (342.8 mW/m2), followed by RCCF, CF, RWFP, RWFB and CF (77.6, 71.8, 59.0 and 57.9 mW/m2, respectively). Chemical Oxygen Demand (COD) reduction was measured initially and at day 30, with GFG anodes observed to remove 83% of the initial load, compared to RCCF, RWFB, RWFP and CF anodes, where COD reductions of 69%, 61%, 65% and 73% were observed, respectively. Electrochemical analysis and biofilm imaging confirmed recycled materials were colonised by microorganisms and performed to high standards. GFG offers significant promise as an anode material, with excellent performance supported by a reduction in capital cost of up to 90% in comparison to CF. The use of recycled carbon material as MFC anodes shows promise, but requires additional work to improve the stability and durability of systems to permit scale-up.

ABSTRACT Sexual reproduction is the primary driving force behind eukaryotic environmental adaptation and evolution. In the human fungal pathogen Cryptococcus neoformans, sexual reproduction plays a critical role in the emergence of highly virulent strains and drug-resistant variants. The sexual life cycle of C. neoformans commences with the yeast-hyphae transition in response to mating stimulation, followed by hyphal extension and further differentiation into basidium, where meiosis takes place to produce basidiospore. Although extensive studies have been conducted on the determining factors and genetic pathways involved in the sexual cycle, the precise contribution of epigenetic modifications in this process remains elusive. Here, through a systematic genetic screening assay, we find that Gcn5 is the specific histone acetyltransferase involved in yeast-hyphae morphogenesis in C. neoformans. Furthermore, we demonstrate that Gcn5 is indispensable for completing the entire sexual cycle of C. neoformans, including yeast-hyphae transition, hyphal development, basidium differentiation, meiosis, and subsequent sporulation. Additionally, chromatin immunoprecipitation assay demonstrates that Gcn5-mediated H3K14ac modification is closely associated with the activated transcription of master transcriptional regulator gene ZNF2 and its downstream targets under mating-inducing condition. Moreover, disruption of two additional subunits encoding gene within the SAGA complex, ADA3 and SPT20, resulted in a similar phenotype to that observed with GCN5 deletion, indicating that Gcn5 functions in the context of an intact SAGA/ADA complex in regulating the sexual life cycle. Taken together, these results elucidated a key epigenetic modification, Gcn5-mediated histone acetylation, in orchestrating yeast-hyphae morphogenesis and sexual reproduction in the human fungal pathogen C. neoformans. IMPORTANCE Eukaryotic gene transcription is typically regulated by a series of histone modifications, which play a crucial role in adapting to complex environmental stresses. In the ubiquitous human fungal pathogen Cryptococcus neoformans, sexual life cycle is a continuous intracellular differentiation process that strictly occurs in response to mating stimulation. Despite the comprehensive identification of the regulatory factors and genetic pathways involved in its sexual cycle, understanding of the epigenetic modifications involved in this process remains quite limited. In this research, we found that histone acetyltransferase Gcn5-mediated histone H3 acetylation plays a crucial role in completing the cryptococcal sexual cycle, including yeast-hyphae morphogenesis and the subsequent sexual reproduction. Furthermore, we demonstrated that Gcn5 participates in this process primarily through regulating the key morphogenesis regulator Znf2 and its targets. This study thus provided a comprehensive understanding of how histone acetylation modification impacts sexual life cycle in a high-risk human pathogenic fungus.

AbstractD-alpha-tocopheryl polyethylene glycol 1000 succinate (TPGS) is a commonly used nonionic surfactant used as a pharmaceutical carrier in different drug delivery systems. TPGS can reverse P-glycoprotein (P-gp)-mediated multidrug resistance (MDR) and also has anticancer activities. It suggests that when designing antitumor drug preparation, it’s necessary to take into account the antitumor activity of TPGS. Our in vivo studies showed that TPGS exerted the strongest cytotoxicity in MCF-7-ADR cells when compared with seven other tumor cell lines. The further study revealed TPGS caused apoptosis and blocked MCF-7 cell growth in G2/M phase. Mechanistic insights suggested that TPGS increased intracellular calcium ion concentrations, leading to apoptosis via the mitochondrial pathway. Furthermore, two in vivo experiments were performed. One was TPGS, and DOX solution was administered by tail vein injection on MCF-7-ADR tumor bearing nude mice. The other was temperature sensitive TPGS gel (TPGS-TG) was administered by intratumoral injection on MCF-7-ADR tumor bearing nude mice combined with paclitaxel albumin nanoparticles (Abraxane®) administered by tail vein injection. The findings confirmed that TPGS could play its role in anti-tumor to reduce the toxicity of chemotherapeutic drugs and improve the efficiency of drug-resistant tumors, thereby enhancing the development of safe oncology therapeutics.

Abstract Background Charlson Comorbidity Index (CCI) is positively associated with all-cause readmission in patients with heart failure (HF) in western countries. However, there is a scarcity of strong scientific evidence supporting the correlation in China. This study aimed at testing this hypothesis in Chinese. Methods We conducted a secondary analysis of 1,946 patients with HF in Zigong Fourth People’s Hospital in China between December 2016 to June 2019. Logistic regression models were used to study the hypotheses, with adjustments for the four regression models. We also explore the linear trend and possible nonlinear relationship between CCI and readmission within six months. We further conducted subgroup analysis and tests for interaction to examine the possible interaction between CCI and the endpoint. Additionally, CCI alone and several combinations of variables based on CCI were used to predict the endpoint. Under the curve (AUC), sensitivity and specificity were reported to evaluate the performance of the predicted model. Results In the adjusted II model, CCI was an independent prognostic factor for readmission within six months in patients with HF (OR = 1.14, 95% CI: 1.03–1.26, P = 0.011). Trend tests revealed that there was a significant linear trend for the association. A nonlinear association was identified between them and the inflection point of CCI was 1. Subgroup analyses and tests for interaction indicated that cystatin played an interactive role in the association. ROC analysis indicated neither CCI alone nor combinations of variables based on CCI were adequate for prediction. Conclusion CCI was independently positively correlated with readmission within six months in patients with HF in Chinese population. However, CCI has limited value on predicting readmission within six months in patients with HF.

Annona is a genus of family Annonaceae within the magnoliids and plays a crucial role in revealing the evolution of magnolias. Annona species provide important fruit resources. Here, we report a chromosome-level genome assembly of A. montana, an edible and ornamental fruit species. Integration with other genomes provides clear evidence that the magnoliids were sisters to eudicots, and the ASTRAL trees showed discordance in the phylogenetic position of magnoliids, which might be caused by incomplete lineage sorting (ILS). Whole genome duplication (WGD) analysis showed that the common ancestor of A. montana and Liriodendron chinense experienced a WGD event, and this WGD event occurred after the splitting of Magnoliales and Laurales. We identified the gene family expansions and contractions in Annonaceae. Based on the identification of MADS-box gene families, we inferred the pathway integrators of morphological regulation, the occurrence of florescence and the development of fruit in A. montana. In addition, we identified key sugar transporter genes and the key enzyme genes related to sugar accumulation in A. montana fruit. The gene function analysis indicated that starch and cell wall degradation might be the main reasons for the softening of A. montana fruit. Furthermore, aromatic alcohols were suggested be the main volatile aromatic compounds in A. montana fruit. Our results provide the genetic basis of fruit development, softening, aroma, and sugar accumulation in A. montana and the evolution and diversification of Annonaceae.

With a great diversity of species, Orchidaceae stands out as an essential component of plant biodiversity, making it a primary resource for studying angiosperms evolution and genomics. This study focuses on 13 published orchid genomes to identify and analyze the CYP75 gene family belonging to the cytochrome P450 superfamily, which is closely related to flavonoid biosynthetic enzymes and pigment regulation. We found 72 CYP75s in the 13 orchid genomes and further classified them into two classes: CYP75A and CYP75B subfamily, the former synthesizes blue anthocyanins, while the latter is involved in the production of red anthocyanins. Furthermore, the amount of CYP75Bs (53/72) greatly exceeds the amount of CYP75As (19/72) in orchids. Our findings suggest that CYP75B genes have a more important evolutionary role, as red plants are more common in nature than blue plants. We also discovered unique conserved motifs in each subfamily that serve as specific recognition features (motif 19 belong to CYP75A; motif 17 belong to CYP75B). Two diverse-colored varieties of C. goeringii were selected for qRT-PCR experiments. The expression of CgCYP75B1 was significantly higher in the purple-red variant compared to the yellow-green variant, while CgCYP75A1 showed no significant difference. Based on transcriptomic expression analysis, CYP75Bs are more highly expressed than CYP75As in floral organs, especially in colorful petals and lips. These results provide valuable information for future studies on CYP75s in orchids and other angiosperms.

The ARF gene family is a representative transcription factor that plays a crucial role in the regulation of various growth and development processes in plants. Although the ARF gene family has been identified in five Orchidaceae species, limited research has been conducted on the ARF gene within Dendrobium. To explore ARF family genes in different Dendrobium species, we selected chromosome-level genomic data from D. nobile, D. chrysotoxum, and D. huoshanense for genome-wide identification, and to analyze expression patterns in the D. nobile flower. In this study, 13, 18, and 23 ARF genes were identified in the genomes of D. chrysotoxum, D. huoshanense, and D. nobile, respectively. These genes were then subsequently classified into four classes (Classes I, II, III, and IV) based on our phylogenetic analysis. Additional protein sequence analysis found that 30 ARF proteins with three classically conserved structural domains (BDB, MR, and RD) were present in the three Dendrobium species. Our gene structure comparative analysis also found the same evolutionary branch with similar intron-exon structural features. Specifically, Class I and Class III display longer introns that potentially constitute a distinctive characteristic of Dendrobium. Gene expression patterns analysis showed the potential involvement of DnoARF 5, 7, 10, 11, 12, 13, 16, 17, and 23 in initial differentiation and flower bud formation. Likewise, transcriptomic analysis and RT-qPCR expression profiles indicated flower-specific expression patterns for four ARF genes (DnoARF5, DnoARF6, DnoARF16, and DnoARF22), which suggest an important impact on flower development and regulation. Ultimately, this study provides comprehensive data to elucidate the potential functions of ARF genes in three Dendrobium species and suggests new insights for further exploration concerning the function and regulatory mechanisms in Dendrobium during flower development.

Background:. Immediate expander/implant-based breast reconstruction after mastectomy has become more sought after by patients. Although many patients choose this technique due to good aesthetic outcomes, lack of donor site morbidity, and shorter procedure times, it is not without complications. The most reported complications include seroma, infection, hematoma, mastectomy flap necrosis, wound dehiscence, and implant exposure, with an overall complication rate as high as 45%. Closed incision negative pressure therapy (ciNPT) has shown value in wound healing and reducing complications; however, the current literature is inconclusive. We aimed to examine if ciNPT improves outcomes for patients receiving this implant-based reconstruction. Methods:. This is a retrospective single-institution study evaluating the ciNPT device, 3M Prevena Restor BellaForm, on breast reconstruction patients. The study was performed between July 1, 2019 and October 30, 2020, with 125 patients (232 breasts). Seventy-seven patients (142 breasts) did not receive the ciNPT dressing, and 48 patients (90 breasts) received the ciNPT dressing. Primary outcomes were categorized by major or minor complications. Age, BMI, and final drain removal were summarized using medians and quartiles, and were compared with nonparametric Mann-Whitney test. Categorical variables were compared using chi-square or Fisher exact test. Results:. There was a statistically significant reduction in major complications in the ciNPT group versus the standard dressing group (P = 0.0247). Drain removal time was higher in the ciNPT group. Conclusion:. Our study shows that ciNPT may help reduce major complication rates in implant-based breast reconstruction patients.

The genus Lycoris Herb. belongs to the Amaryllidaceae family, which consists of about 20 species and is distributed in warm temperate to subtropical zones of East Asia, from southwestern China to Japan and southern Korea, with a few zones extending to northern Indochina and Nepal. The species is easy to hybridize with each other, and more than half of the currently recognized taxa are certainly of hybrid origin (Hsu et al. 1994; Ji and Meerow 2000; Tsi and Meerow 2000). In recent years, with the in-depth development of field investigation and taxonomic research, many new species have been published successively. Up to now, more than 30 species have been named legally, of which more than 20 are endemic to China (Li et al. 2022; Lu et al. 2020; Meng et al. 2018; Quan et al. 2013; Zhang et al. 2021). Lycoris has its specific traits and benefits. When they bloom from summer to fall, when others are not active, the stems are leafless, with an inflorescence at the top containing four to eight flowers. These flowers are characterized by their pastel, plentiful colors, and multiple flower shapes (Hsu et al. 1994). Because of the special flower shape and biological habit, they have common names such as spider lily, surprise lily, hurricane lily, and magic lily. Moreover, the bulbs of Lycoris have been used in traditional Chinese medicine, as some Amaryllidaceae alkaloids isolated from the bulbs of Lycoris have been reported to exhibit immunostimulatory, antitumor, antiviral, and antimalarial activity (Wang et al. 2013). With an increasing demand for Lycoris as a commercial horticultural product, the breeding of different varieties with new petal forms and/or colors has become a valued necessity for Lycoris (Yang et al. 2021). This new cultivar is a natural hybrid population between Lycoris radiata and Lycoris aurea, which has a unique red-pink color, taller stem, and bigger flower, making it more beautiful and suitable for landscaping and cut flowers.

Abstract Background Primary vitreoretinal lymphoma (PVRL) is an aggressive lymphoma that may present with protean features and represents a diagnostic challenge. Given that patients with PVRL are at high risk of CNS involvement with a high mortality and morbidity rate, prompt diagnosis is crucial to initiate treatment early in the disease course. A multimodality imaging approach including fundus photography, fundus autofluorescence (FAF), optical coherence tomography (OCT), fluorescein and indocyanine angiography, and electroretinography (ERG) can provide information to establish a diagnosis and provide objective measures for management. We review key findings seen via these imaging modalities in patients with PVRL. Observations Fundus photography can highlight commonly seen patterns of PVRL including vitritis, subretinal disease, retinal pigment epithelial (RPE) abnormalities, optic nerve edema, retinal detachment, and less typical retinitis-like lesions. FAF can identify characteristic patterns of hyper- and hypoautofluorescent signal abnormalities in the macula. Spectral-domain OCT will demonstrate vitreous cells, RPE nodularity, and hyperreflectivity of the outer retina. The presence of a hyper-reflective band in the subretinal space and infiltrates between the RPE and Bruch’s membrane can assist in distinguishing PVRL from choroidal lymphoma. Vertical hyperreflective columns (VHRLs) are another pertinent finding that may represent microinfiltrates of the tumor. OCT has proven to be a particularly useful modality in assessing the progress of treatment in PVRL. Fluorescein angiography can show RPE changes, which include granularity, late staining at the RPE level, and blockage. Indocyanine green angiography (ICGA) primarily shows hypocyanescence, which corresponds to PVRL lesions on fundus photography and may occur secondary to loss of RPE and choriocapillaris. Conclusion While PVRL remains a challenging disease to diagnose and follow, the use of a multimodality imaging approach may assist in establishing a diagnosis. Because of the anatomic spaces PVRL may affect, fundus photography, OCT, FAF, angiography, and ERG can identify key characteristics of the disease, differentiate PVRL from other diseases, and provide baseline information for targeted systemic and local therapies. Further assessment of anatomic and functional targets will aid our clinical application of multimodal imaging in the management of PVRL.

Robotic fiber positioner (RFP) arrays are commonly adopted in multiobject spectroscopic instruments. The positioning accuracy is a common but vital issue for RFP as inaccurate fiber placement may heavily affect the observation performance. The calibration of RFP can effectively improve the positioning accuracy. Least-square is a widely used calibration method. However, it has disadvantages, such as sensitivity to the initial values and calculation complexity. To improve the positioning accuracy and reduce the iteration moves, we propose a new calibration method based on the differential evolution algorithm and verify it by calibrating the RFP of the Large Sky Area Multi-Object Fiber Spectroscopy Telescope. We first build the kinematic models of the RFP based on the Denavit–Hartenberg matrix and geometry relationship. Then, we analyze the error components and present the proposed calibration algorithms. The experiments are done with the digital universal tool microscope 19JC and the errors are calculated using the distance between the positions of achieved and target. Results show that the proposed algorithm can achieve higher accuracy than the least-square method and the average positioning accuracy is improved by 78.94% after calibration. Combined with the “pulse reduction” strategy and close-loop compensation, after two moves, the positioners can place the fiber ends within 40 μ m of the intended location. The proposed calibration method is also suitable for other similar theta-phi positioners.

Abstract Background Opening wedge high tibial osteotomy (OWHTO) is an effective surgical treatment for knee osteoarthritis. This study aimed to explore the feasibility and accuracy of a novel 3D-printed patient-specific instrument (PSI) based on “H-point” for medial OWHTO in a prospective cadaver study. Methods Twenty-six fresh-frozen lower limbs were collected and randomly divided into two groups: PSI group treated with 3D virtual preoperative planning and a novel 3D-printed PSI; control group with the standard technique. 3D models were reversely reconstructed for preoperative surgical planning, guide plate design, and simulated osteotomy. Anatomic features of “H-point,” surgical time, fluoroscopic dose, correction accuracy including tibiofemoral angle (FTA) and posterior tibial slope (TS) angle were measured. Results First, H-point was always described as a bony bulge in the posteromedial to the proximal tibia and had a relatively constant relationship with the osteotomy site. Second, the absolute correction error of mFTA and TS were significantly smaller in the PSI group. The effective rate of TS in the PSI group was more concentrated with absolute correction error within 1° and within 2° for 53.3% and 93.3%, compared to 9.1% and 45.5% in the control group. The total operation time, positioning osteotomy time, distraction correction time and fluoroscopy dose in the PSI group were significantly less than those in the control group. Conclusions The novel 3D-printed PSI based on H-point is feasibility and accuracy with advantages in terms of TS, surgery time and radiation dose for OWHTO.

Quantum‐dot light‐emitting diodes (QLEDs) have been considered the next‐generation display. However, the toxicity of Cd or Pb in these quantum dots (QDs) and the low performance of blue QLEDs remain critical issues, which greatly limit their sustainable development. Herein, first blue‐emitting quantum‐dot light‐emitting diode based on orthorhombic BN QDs with high photoluminescence quantum yield (PLQY) of 31.3% and electroluminescence at 437 nm is reported. With optimal solvothermal parameters, high photoluminescence quantum yield (PLQY) of 31.3% can be realized in the as‐synthesized BN QDs. The turn‐on voltage, maximum luminance, and maximum current density of these novel QLEDs are 9 V, 6.55 Cd m−2, and 34.42 mA cm−2, respectively. This work demonstrates that BN QDs have great potential for blue QLEDs with advantages of being nontoxic, Earth abundant, and having low‐cost manufacturing.

Methamphetamine use has become a rampant public health issue that not only causes devastating consequences to the user but also poses a burden to surrounding communities. A spectrum of ophthalmic sequelae is associated with methamphetamine use and includes episcleritis, scleritis, corneal ulceration, panophthalmitis, endophthalmitis, retinal vasculitis, and retinopathy. In many instances, prompt recognition of the condition and associated infectious process and early initiation of antimicrobial therapy are crucial steps to preventing vision loss. In this review, we summarize the reported ocular complications that may result from methamphetamine use in addition to several postulated mechanisms regarding the ocular toxicity of methamphetamine. The increasing prevalence of methamphetamine use as a public health threat highlights the need for continued investigation of this ophthalmologic issue.

Early diagnosis of infectious uveitis can lead to prompt initiation of treatment to minimize vision-threatening sequelae. As various infectious etiologies of uveitis share similar clinical features, advancements in polymerase chain reaction (PCR) and metagenomic next-generation sequencing (MDS) have shown significant promise in improving diagnostic capabilities. Various techniques of PCR, including real-time, multiplex, comprehensive, and broad-range, have increased the armamentarium for infectious uveitis diagnosis. Additionally, metagenomic deep sequencing technology has provided a methodology to identify causative pathogens as well as novel etiologies of uveitis. This review discusses the diagnostic tools available for infectious uveitis and highlights the advantages and disadvantages of the techniques.

Abstract Background Albumin (ALB) levels are negatively associated with mortality in patients with sepsis. However, among sepsis patients with acute kidney injury (AKI) undergoing continuous renal replacement therapy (CRRT), there has been no similar study on the correlation between ALB levels and mortality alone. This study tested the hypothesis that ALB levels are negatively associated with mortality among such patients. Methods We conducted a secondary analysis of 794 septic patients who were diagnosed with AKI and underwent CRRT in South Korea. For the Kaplan–Meier survival analysis, Cox proportional hazards models were used to study the hypotheses, with adjustments for the pertinent covariables. We also explore the possible nonlinear relationship and conducted sensitivity analyses including subgroup analyses and tests for interactions to investigate the association further. Additionally, ALB was used to construct model and we then compared the performance of ALB with that of APACHE II and SOFA in predicting mortality. Results The ALB level was an independent prognostic factor for death at 28 and 90 days after CRRT initiation (HR = 0.75, 95% CI: 0.62–0.90, P = 0.0024 for death at 28 days and HR = 0.73, 95% CI: 0.63–0.86, P

BackgroundResidual varus after Oxford unicompartmental knee arthroplasty (UKA) happens frequently. This study aims to evaluate the pre-operative contributing factors of residual varus.MethodsA total of 1,002 knees (880 patients, 201 patients were male, and 679 were female) underwent Oxford UKA in the Orthopedic Surgery Department of the Beijing Jishuitan Hospital from March 2018 to April 2021. The mean age of the patient was 64.7 ± 7.7 years. To assess residual varus, the full-length lower extremity is placed upright for EOS imaging, with the knee fully extended. The angle of post-operative residual varus was measured as described by Noyes et al. Of the knees studied, they were either categorized into an under-corrected group (post-operative Noyes angle >5°) or a corrected group (post-operative Noyes angle ≤5°). Age, gender, body mass index (BMI), range of motion (ROM), Clinical American Knee Society Score (Clinical AKSS), and Function American Knee Society Score (Function AKSS) were compared. The following additional parameters were measured: pre-operative Noyes angle, lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), the posterior slope of the proximal tibia angle (PPTA), joint line converge angle (JLCA), and fixed flexion deformity (FFD).ResultsThere was no statistically significant difference between the two groups in regards to gender (p = 0.428), surgical leg (p = 0.937), age (p = 0.851), BMI (p = 0.064), pre-operative Clinical AKSS (p = 0.206) and Function AKSS (p = 0.100). However, pre-operative ROM statistically differed between the two groups (p

BackgroundBreast cancer is one of the major malignancies threatening women’s health worldwide. The incidence of breast cancer at high altitudes increased over the years. But few studies focused on the characteristics of clinicopathology and molecular subtypes among breast cancer at high altitudes, which are still unknown. Tibet, with an average altitude over 4000 meters, is a representative city at high altitudes, lying in the Qinghai-Tibetan Plateau in southwestern China. This study aimed to identify the clinicopathological characteristics and features of molecular subtypes among Tibetan women with breast cancer, and provide evidence for cancer prevention and personalized therapeutics in high-altitude regions.MethodsBetween May 2013 and March 2022, 104 Tibetan women from high-altitude regions (Tibetan-group) and 34 Han Chinese women from low-altitude regions (Han-group), consecutively diagnosed with breast cancer in the Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region, were included in the study. We retrospectively reviewed the clinical character, altitudes of residence, tumor size, lymph nodes metastasis, distant metastasis, pathological type, immunohistochemical index, and molecular subtype.ResultsIn the study, we calculated the patient delay, equal to the period from symptoms onset to hospital visits. The patient delay of Tibetan-group was 7.47 ± 11.53 months, which was significantly longer than that of Han-group, 7.22 ± 22.96 months (p

Based on the online patient-physician communication data, this study used natural language processing and machine learning algorithm to construct a medical intelligent guidance and recommendation model. First, based on 16,935 patient main complaint data of nine diseases, this study used the word2vec, long-term and short-term memory neural networks, and other machine learning algorithms to construct intelligent department guidance and recommendation model. Besides, taking ophthalmology as an example, it also used the word2vec, TF-IDF, and cosine similarity algorithm to construct an intelligent physician recommendation model. Furthermore, to recommend physicians with better service quality, this study introduced the information amount of physicians' feedback to the recommendation evaluation indicator as the text and voice service quality. The results show that the department guidance model constructed by long-term and short-term memory neural networks has the best effect. The precision is 82.84%, and the F1-score is 82.61% in the test set. The prediction effect of the LSTM model is better than TextCNN, random forest, K-nearest neighbor, and support vector machine algorithms. In the intelligent physician recommendation model, under certain parameter settings, the recommendation effect of the hybrid recommendation model based on similar patients and similar physicians has certain advantages over the model of similar patients and similar physicians.

ObjectivesOverweight and obesity are harmful to human health. However, the latest trends of Chinese childhood overweight and obesity prevalence are not available. The aim of this study was to examine the trends from 2000 to 2019 among students in China.MethodsWe analyzed data of 66,072 students in the Chinese National Survey on Students' Constitution and Health from 2000 to 2019. Overweight and obesity were defined based on the standard formulated by the International Obesity Task Force (IOTF standard), the World Health Organization (WHO standard), and the Working Group on Obesity in China (WGOC standard), respectively. The χ2-test was used to test the trends of overweight and obesity prevalence and logistic regression was conducted to evaluate the prevalence odds ratios of boys vs. girls and urban vs. rural areas.ResultsThe prevalence of obesity/overweight and obesity combined was 6.03/23.58% (IOTF standard), 10.56/25.88% (WGOC standard) and 10.75/29.69% (WHO standard) in 2019. From 2000 to 2019, according to the WGOC standard, the prevalence increased from 2.51 to 10.56% for obesity and increased from 9.81 to 25.88% for overweight and obesity combined (P for trend < 0.001). Obesity/overweight and obesity were greater problems in boys than girls and urban than rural areas, but urban-rural differences decreased over time.ConclusionOverweight and obesity prevalence increased significantly in children and adolescents in China from 2000 to 2019. The prevalence of overweight and obesity in rural areas may contribute to a large percentage of children with overweight and obesity.

The drive towards net-zero carbon emissions has prompted many industries to alter the way they operate. The agriculture industry is responsible for a large proportion of the UK’s greenhouse gas emissions. Thus, the feasibility of implementing an anaerobic digestion (AD) system supplying biogas to a trigeneration system with energy storage for the provision of heating, cooling and power has been investigated in the context of a medium-scale arable farm. Two configurations – one supplied with wheat straw only, and the other supplied with wheat straw, barley straw and manure – were identified to meet the energy demands of the farm. Technical feasibility was investigated via simulations run in ECLIPSE, with the two configurations returning overall system efficiencies of 66.8% and 67.1%, respectively. Economic analyses indicated simple payback periods of 9.4 and 11 years, which fall within the expected 20-year lifetime of the project. Furthermore, the potential reduction in CO2 emissions for each scenario was determined to be 42,764 kg and 43,956 kg per year.

The way of our living and working has changed intensely throughout the past half-century. The era we live in is interlinked with rapid technological changes, paving the way for digitalization. The students are considered digital natives and are expected to have e-learning abilities to improve their academic effectiveness. However, digital readiness is an important factor that can play a valuable role in boosting students’ e-learning abilities and satisfaction. The previous studies of students’ e-learning abilities revealed the lack of students’ digital readiness for academic achievements. Therefore, the present study aims to examine the role of digital readiness in the e-learning satisfaction of students. Based on the theory of motivation, the present study attempts to check the association of digital readiness with e-learning satisfaction. The current study also determines the relationship of digital readiness with entrepreneur psychological capital. Further, this study examines the correlation of entrepreneur psychological capital with e-learning satisfaction. The present study also assumes the mediating role entrepreneur of psychological capital and moderating role of mindfulness. For empirical analyses, this study gathered data from 376 music learning students of entrepreneur training institutes in China through a structured questionnaire method using a convenient sampling technique. This study applied partial least square structural equation modeling for empirical analyses using Smart PLS software. The present study confirmed that digital readiness positively correlates with e-learning satisfaction and psychological capital. The findings also acknowledged that psychological capital positively enhances e-learning satisfaction. The results also confirmed that psychological capital mediates the association between digital readiness and e-learning satisfaction. However, the outcomes revealed that mindfulness does not moderate the association between digital readiness and e-learning satisfaction. On the other hand, the findings acknowledged that mindfulness moderates the relationship between psychological capital and e-learning satisfaction. In addition, this study’s findings also serve the literature by providing important theoretical and practical implications. This study points out that digital readiness is an important antecedent to increasing students’ learning satisfaction and performance. The findings also suggest that students’ mindfulness could play a bridging role in enhancing their performance.

Abstract Evidence indicates that glucose variation (GV) plays an important role in mortality of critically ill patients. We aimed to investigate the relationship between the coefficient of variation of 24-h venous blood glucose (24-hVBGCV) and mortality among patients with acute respiratory failure. The records of 1625 patients in the Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC II) database were extracted. The 24-hVBGCV was calculated as the ratio of the standard deviation (SD) to the mean venous blood glucose level, expressed as a percentage. The outcomes included ICU mortality and in-hospital mortality. Participants were divided into three subgroups based on tertiles of 24-hVBGCV. Multivariable logistic regression models were used to evaluate the relationship between 24-hVBGCV and mortality. Sensitivity analyses were also performed in groups of patients with and without diabetes mellitus. Taking the lowest tertile as a reference, after adjustment for all the covariates, the highest tertile was significantly associated with ICU mortality [odds ratio (OR), 1.353; 95% confidence interval (CI), 1.018–1.797] and in-hospital mortality (OR, 1.319; 95% CI, 1.003–1.735), especially in the population without diabetes. The 24-hVBGCV may be associated with ICU and in-hospital mortality in patients with acute respiratory failure in the ICU, especially in those without diabetes.

Purpose: To describe the devastating ophthalmic sequelae of methamphetamine use disorder in two patients who developed vision loss from ocular complications, including keratitis and endophthalmitis. Observations: Case 1 is a 26-year-old male with hepatitis C, poorly controlled type 1 diabetes, and chronic methamphetamine use who presented with a corneal ulcer in the left eye. Corneal culture grew Staphylococcus aureus and Streptococcus viridans, prompting antibiotic therapy. Follow-up exam showed peripheral corneal ulceration OD and diffusely vascularized and scarred cornea OS, although nonadherence was reported. Vision eventually worsened to hand motions OD and light perception OS.Case 2 is a 44-year-old woman with hepatitis C, acute myeloid leukemia, dry eye syndrome secondary to chronic graft-versus-host disease (GVHD), and chronic methamphetamine use who presented with a diffuse corneal infiltrate and hypopyon. She underwent emergent corneal transplantation, vitrectomy, and broad-spectrum intravitreal and intravenous antibiotics. Vitreous cultures were positive for Streptococcus pyogenes. However, progressive disease eventually required enucleation despite initial globe salvaging measures. Conclusions and importance: These two patient cases highlight the risk of vision loss or blindness due to the detrimental effects of chronic methamphetamine use on the eye, including the potential for keratitis and endophthalmitis. Given the increasing prevalence of methamphetamine use disorder in the United States, further understanding of these toxicities and preventive strategies are needed.

Abstract The process of microbiologically influenced corrosion (MIC) in soils has received widespread attention. Herein, long-term outdoor soil burial experiments were conducted to elucidate the community composition and functional interaction of soil microorganisms associated with metal corrosion. The results indicated that iron-oxidizing (e.g., Gallionella), nitrifying (e.g., Nitrospira), and denitrifying (e.g., Hydrogenophaga) microorganisms were significantly enriched in response to metal corrosion and were positively correlated with the metal mass loss. Corrosion process may promote the preferential growth of the abundant microbes. The functional annotation revealed that the metabolic processes of nitrogen cycling and electron transfer pathways were strengthened, and also that the corrosion of metals in soil was closely associated with the biogeochemical cycling of iron and nitrogen elements and extracellular electron transfer. Niche disturbance of microbial communities induced by the buried metals facilitated the synergetic effect of the major MIC participants. The co-occurrence network analysis suggested possible niche correlations among corrosion related bioindicators.

Abstract Background Distal tibial tuberosity high tibial osteotomy (DTT-HTO) can prevent distalization of the tibial tuberosity and thus patellar infera. However, no studies on the clinical and radiological effects of DTT-HTO on the patellofemoral joint have been conducted. The purpose of the study was to evaluate the effect of DTT-HTO on patella height and patellofemoral joint congruity based on the severity of patellofemoral joint OA. Methods Twenty-nine patients (33 knees) who underwent DTT-HTO and second-look arthroscopy when implant was removed between January 2018 and May 2020 were eligible for the study. Among them, 6 were males, and 23 were females, with ages from 51 to 78 years old. The Caton-Deschamps index (CDI), congruence angle (CA), and lateral patellar tilt (LPT) were measured to evaluate the effect of surgery on patellar height and patellofemoral joint congruity. The weight-bearing line ratio (WBLR) was measured to assess lower limb alignment. The cartilage lesion in the patellofemoral joint was assessed arthroscopically during surgery and implant removal by the International Cartilage Repair Society (ICRS) grading system at 18–24 months after surgery. The Hospital for Special Surgery (HSS) scale was used to evaluate knee joint function. Results Twenty-nine patients were followed up for 18–28 months. The preoperative CDI, CA, and LPT changed from 0.92 ± 0.16 to 0.89 ± 0.14, from 5.52 ± 2.19 to 5.44 ± 2.27, and from 6.95 ± 2.88 to 6.54 ± 2.42, respectively, and the differences were not statistically significant (p > 0.05). The preoperative WBLR significantly increased from 16.72 ± 6.77 to 58.77 ± 7.69% (p < 0.001). The cartilage lesions in the patella and femoral trochlea did not progress significantly from the first- to the second-look arthroscopy, according to the ICRS grades (p > 0.05). The HSS score significantly improved from 50.64 ± 19.18 preoperatively to 67.33 ± 14.72, 81.63 ± 11.92, and 82.73 ± 8.05 at the 3-month, 12-month, and last follow-up after surgery (p < 0.001). Conclusion DTT-HTO can effectively prevent patellar infera, and its effects on postoperative patellofemoral joint congruity and patellofemoral joint OA progression are inconspicuous. It can be recommended as a treatment of varus knee combined with patellar infera or patellofemoral joint OA.

Bone morphogenetic proteins (BMPs), have been shown to enhance the osteogenic differentiation of mesenchymal cells (MCs) and to promote bone formation. BMP6 is known to play an important role in the process of MCs towards osteogenic differentiation by virtue of their osteoinductive and cell type specific proliferative activity. However, the molecular mechanism relate to BMP6 osteoinductive activity is still unclear and continues to warrant further investigation. Msx2 is a member of the homeobox gene family of transcription factors and promotes calcification. Hence, we wondered if it might also play a role in BMP6-induced osteogenesis. In this study, two mouse mesenchymal cell lines were treated with BMP6, adenovirus-Msx2 (Ad-Msx2) or adenovirus-siMsx2 (Ad-siMsx2). Based on the results of mRNA and protein expression, it was indicated that BMP6 could enhance the expression of Msx2 and activate the phosphorylation of Smad 1/5/8, p38 and ERK1/2. Being transfected by Ad-Msx2, the BMP6-induced activation of phosphorylation was significantly promoted. On the contrary, two cell lines transfected by Ad-siMsx2 presented an inhibited expression of three phosphorylated proteins even after being induced by BMP6. The evaluation of ALP, OPN, OC and calcium deposits revealed the osteogenic results those were corresponding to the results of mRNA and protein. Taken together, these findings can be a novel viewpoint for the understanding of the mechanisms of BMP6-induced osteogenesis and provide therapeutic targets of bone defect.