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Abstract Autonomous driving technology has led to an increasing preference for rearward seating postures. However, current restraint systems exhibit significant shortcomings in protecting reclined occupants. In this paper, based on the existing restraint system components, various restraint strategies were configured to enhance the protection for reclined occupants. Firstly, this research developed a model of the driver-side restraint system and validated its accuracy; secondly, it analyzed the kinematic response and damage of the occupants with the protection of the conventional restraint system; and then, based on the characteristics of the occupant’s kinematic response, it put forward three kinds of restraint strategies. The results indicated that incorporating larger airbags and additional knee bolsters could significantly enhance the protective effectiveness of the restraint system. This strategy achieved reduction of 18.9% in HIC15ms, 2.6% in maximum stress on the cervical spine, 17% in maximum chest compression, 4% in maximum rib strain, and 21% in axial force on the legs. The research findings offer valuable insights for the future design of protection systems for reclined occupants.

Abstract Metabolic disorder significantly contributes to diabetic vascular complications, including diabetic retinopathy, the leading cause of blindness in the working-age population. However, the molecular mechanisms by which disturbed metabolic homeostasis causes vascular dysfunction in diabetic retinopathy remain unclear. O-GlcNAcylation modification acts as a nutrient sensor particularly sensitive to ambient glucose. Here, we observe pronounced O-GlcNAc elevation in retina endothelial cells of diabetic retinopathy patients and mouse models. Endothelial-specific depletion or pharmacological inhibition of O-GlcNAc transferase effectively mitigates vascular dysfunction. Mechanistically, we find that Yes-associated protein (YAP) and Transcriptional co-activator with PDZ-binding motif (TAZ), key effectors of the Hippo pathway, are O-GlcNAcylated in diabetic retinopathy. We identify threonine 383 as an O-GlcNAc site on YAP, which inhibits its phosphorylation at serine 397, leading to its stabilization and activation, thereby promoting vascular dysfunction by inducing a pro-angiogenic and glucose metabolic transcriptional program. This work emphasizes the critical role of the O-GlcNAc-Hippo axis in the pathogenesis of diabetic retinopathy and suggests its potential as a therapeutic target.

Observational fear learning delineates the process by which individuals learn about potential threats through observing others’ reactions. Prior research indicates that individuals with high trait anxiety (HTA) manifest pronounced fear responses in direct fear learning scenarios. However, the specific influence of trait anxiety on observational fear learning remains insufficiently explored. This study aimed to fill this gap by examining 64 university students, divided equally between those with HTA and low trait anxiety (LTA), selected from an initial pool of 483 participants. Participants were subjected to observational fear learning tasks, and their behavioral responses, physiological reactions, and brain activations were recorded. Results demonstrated that HTA participants exhibited differentiated skin conductance responses to threat and safety stimuli during the observational fear acquisition phase, notwithstanding prior assurances against shock delivery. Furthermore, during the direct test phase, HTA participants reported significantly elevated fear and shock expectancy ratings for both types of stimuli, in contrast to their LTA counterparts. Neuroimaging data, derived via functional near-infrared spectroscopy (fNIRS) revealed heightened medial prefrontal cortex activation in HTA participants when directly facing threats. This study systematically explores the influence of high trait anxiety on observational fear learning, uncovering that HTA individuals exhibit excessive fear responses. These findings highlight the critical role of trait anxiety as a significant risk factor in the development of anxiety disorders.

Background: This study investigated the association between photoreceptor structural restoration and visual function outcomes in patients undergoing surgery for closed macular holes (MHs). Using adaptive optics scanning laser ophthalmoscopy (AOSLO) and microperimetry, we aimed to provide a more detailed understanding of photoreceptor recovery and visual improvement in closed MHs. Methods: We conducted a retrospective observational study of 31 eyes of 28 patients who underwent vitrectomy with internal limiting membrane (ILM) peeling to treat idiopathic MHs. Visual and structural outcomes were monitored 3 months to 2 years postoperatively: best-corrected visual acuity (BCVA), MH diameter and duration, optical coherence tomography (OCT) images, 4° retinal mean sensitivity (RMS), fixation rates, 68.2 % BCEA (binary contour ellipse area) of microperimetry, and cone density as measured by AOSLO. Based on the OCT findings, the patients were categorized into two groups: type 1 (closed MH with no neurosensory defect at the fovea) and type 2 (closed MH with a foveal neurosensory defect). Results: The analysis revealed that type 1 closures resulted in significantly better photoreceptor recovery, with cone cells migrating toward the fovea and forming dense islets, consistent with the integrity of the inner segment/outer segment layer on OCT. These patients also had better postoperative BCVA and higher RMS rather than fixation improvement, aligning with the improved cone density. In contrast, type 2 closures exhibited sparse cone distribution and a prevalence of large, high-density cells, possibly indicating glial cell proliferation and exposed retinal pigment epithelium (RPE). MH size, rather than duration or preoperative BCVA, was a key determinant of type 1 closure outcomes. Conclusion: AOSLO is a valuable tool for evaluating microstructural healing in MHs and reveals that type 1 closure, characterized by cone migration, leads to greater neuroretinal repair and improved BCVA and retinal sensitivity. Meanwhile, type 2 closures, marked by less photoreceptor recovery and higher glial proliferation, correspond to poorer visual function outcomes. This study highlights the role of photoreceptor density and migration in achieving optimal visual function post-surgery for MH closure.

Environment modeling serves as the foundation for path planning in unmanned systems. Single-scale maps have many nodes and impose large memory requirements; tree-based multi-scale grid maps used for representing large-scale urban scenes have limited aggregation ability in the presence of dimensional anisotropy. This study proposes a novel multi-scale map-construction method based on a scale-elastic discrete grid structure. The method provides more flexible node aggregation in grid-based representations, reducing the number of grid and border-grid nodes while maintaining the same modeling accuracy. Furthermore, a novel multi-scale A* path-planning algorithm that modifies the neighborhood-expansion phase of A* is proposed to reduce the number of algorithm search nodes in framed multi-scale maps while ensuring optimal path planning. The experimental results demonstrate that the proposed map-construction method requires 71.5% fewer grids and 10.8% fewer border grids than framed-octree grid maps in three-dimensional scenarios with the same modeling accuracy. Consequently, memory requirements are smaller, making this method more efficient on devices with limited performance. The multi-scale A* algorithm also improves path-planning efficiency by reducing the number of search nodes. The proposed method is suitable for path planning in large-scale and complex urban scenes.

Abstract This study aimed to elucidate the effects of long day and night shifts on immune cells in a population of nurses. This cross-sectional study in December 2019 was based on a group of nurses. 1568 physically healthy caregivers were included, including 1540 women and 28 men. 1093 nurses had long-term shift work (working in a rotating system for > 1 year). The receiver operating characteristic curve, Ensemble Learning, and Logistic regression analyses were used to evaluate factors related to long-term shift work. The night shift group nurses had significantly higher MPV, PLCR, and WBC and significantly lower BASO%, ELR, MCHC, PLR, RDW-CV, and RDW-SD (P

Abstract Backgrounds Insulin resistance (IR) plays a vital role in the pathogenesis of the metabolic dysfunction-associated steatotic liver disease (MASLD). However, it remains unclear whether triglyceride–glucose (TyG) related parameters, which serve as useful biomarkers to assess IR, have prognostic effects on mortality outcomes of MASLD. Methods Participants in the National Health and Nutrition Examination Survey (NHANES) database from 1999 to 2018 years were included. TyG and its related parameters [TyG-waist circumference (TyG-WC) and TyG-waist to height ratio (TyG-WHtR)] were calculated. Kaplan–Meier curves, Cox regression analysis, and restricted cubic splines (RCS) were conducted to evaluate the association between TyG-related indices with the all-cause and cardiovascular mortality of adults with MASLD. The concordance index (C-index) was used to evaluate the prediction accuracy of TyG-related indices. Results A total of 8208 adults (4209 men and 3999 women, median age 49.00 years) with MASLD were included in this study. Multivariate-adjusted Cox regression analysis revealed that high quartile levels of TyG-related indices were significantly associated with the all-cause mortality of participants with MASLD [TyGadjusted hazard ratio (aHR) = 1.25, 95% confidence interval (CI) 1.05–1.50, P = 0.014; TyG-WCaHR for all-cause mortality = 1.28, 95% CI 1.07–1.52, P = 0.006; TyG-WHtRaHR for all-cause mortality = 1.50, 95% CI 1.25–1.80, P

Efficient solar energy utilization is a crucial determinant of crop yield formation. Moreover, various planting methods have dissimilar impacts on crop solar energy utilization and its measurement methods. This study examined the differences in solar energy utilization between monoculture and intercropping by considering density configuration, plant type arrangement, timing schedule, and spatial layout. We further evaluated the traditional methodologies versus remote sensing technology for solar energy measurements and described the differences in calculation methods for monoculture and intercropping, drawing from the photosynthesis model. Additionally, we discussed the potential advantages and limitations of employing remote sensing technology for the monitoring and prediction of solar energy utilization in field crops.

The flowering of plants is a complex biological process that signifies the transition from vegetative growth to reproductive growth. Choosing the optimal timing for flowering is crucial for plant reproduction and yield. The timing of flowering in plants is influenced not only by their developmental status but also by external abiotic stress factors. This paper summarizes the effects of abiotic stress factors such as light, temperature, moisture, and nitrogen on flowering time, reviews the genes involved in the regulation of flowering time by environmental factors, and outlines the corresponding genetic regulatory pathways. By analyzing these abiotic stress factors and related genes, this study reveals the multilayered regulatory network through which plants alter their flowering time, aiming to provide insights into the molecular mechanisms underlying the adaptability of flowering time.

Nonalcoholic fatty liver disease is a complex disease involving abnormal liver metabolism. Its strong association with metabolic dysfunction has led to a change in nomenclature to metabolism dysfunction-associated fatty liver disease (MAFLD). MAFLD pathogenesis involves abnormal accumulation of hepatic lipids that lead to the production of excess free fatty acids (FFAs), which in turn cause an imbalance in hepatic mitochondrial function. Lactucin, a natural compound extracted from Cichorium glandulosum Boiss. et Huet, regulates liver metabolism and protects the liver. However, the potential mechanisms underlying the lactucin-mediated effects in MAFLD require further investigation. In the present study, HepG2 cells were treated with FFAs to establish an in vitro model of MAFLD. Parameters related to lipid accumulation and mitochondrial function, including triglycerides (TG), oil red O-stained lipid droplets, reactive oxygen species (ROS), mitochondrial membrane potential (JC-1), adenine triphosphate (ATP), and complex III were analysed. Morphology of the mitochondria were evaluated by transmission electron microscopy. Furthermore, key proteins in the sirtuin 1 (SIRT1)/peroxisome proliferator-activated receptor gamma coactivator-1α (PGC-1α) signalling axis and mitochondrial quality control were analysed. The SIRT1 inhibitor EX-527 was used to verify the key role of the SIRT1 signalling pathway. Western blotting showed that lactucin upregulated the expression of SIRT-1, PGC-1α, Nrf1, Tfam, Mfn2, and Opa1, and promoted mitochondrial biosynthesis and kinetics. The results suggest that lactucin restores mitochondrial dynamic homeostasis by upregulating the SIRT1/PGC-1α signalling axis, thereby reducing FFA-induced lipid accumulation in HepG2 cells.

BackgroundCardiometabolic multimorbidity (CMM) and aging are increasing public health concerns. This prospective study used UK Biobank cohort to investigate the relationship between biological aging and the trajectory of CMM to dementia and mortality.MethodsCMM is the coexistence of at least two cardiometabolic diseases (CMD), including stroke, ischemic heart disease, and diabetes. Biological age was calculated using the KDM-BA and PhenoAge algorithms. Accelerated aging indicated biological age advances more rapidly than chronological age.ResultsThe study included 415,147 individuals with an average age of 56.5 years. During the average 11-year follow-up period, CMD-free individuals with accelerated aging had a significantly greater risk of CMD (KDM-BA, HR 1.456; PhenoAge, HR 1.404), CMM (KDM-BA, HR 1.952; PhenoAge, HR 1.738), dementia (KDM-BA, HR 1.243; PhenoAge, HR 1.212), and mortality (KDM-BA, HR 1.821; PhenoAge, HR 2.047) in fully-adjusted Cox regression models (p

The electricity consumption and electricity cost of industrial and commercial enterprises (ICEs) are high, and the disorderly charging and discharging of electric vehicles (EVs) brings a great risk to the safe and stable operation of the power grid. Therefore, this paper proposes a V2G demand response pricing strategy for ICE based on cooperative game. Firstly, a V2G demand response mode of ICE is proposed, in which the costs and benefits of both ICE and the corresponding EV employees (EVEs) are analysed, laying the foundation for determining the optimal V2G demand response price. Then, an optimal pricing strategy of V2G demand response for ICE based on cooperative game is put forward, considering the benefits of both ICE and EVE. Finally, an enterprise located in a high-tech zone in Zhejiang province is taken as a case study. The results show that the proposed cooperative game-based pricing strategy of V2G demand response for ICE can increase the benefit of EVE, and reduce the electricity consumption cost of ICE, thus realizing the win–win situation for both ICE and EVE.

Seepage is a critical problem in earthfill dams which threatens the dam's stability and safety owing to extreme shifts in climate change with the rise in water intake in dams. To cope with this challenge dam monitoring is essential for structural stability and rehabilitation enhancement in earth dams with the integration of a deep learning approach. This research presents a novel approach for evaluating the dam seepage by using a Recurrent Neural Network and its associated co-variant to predict seepage at multiple location in earth fill Tarbela dam. Short-term peak seasonal hydraulic and hydro climatological monitoring data was used from Pakistan's Earth and Rockfill Tarbela dam over the period from 2014 to 2020. The results demonstrate that, compared to other models, the proposed model efficiently predicts the extent of seepage in the dam. This study highlights the importance of considering historical correlations in seepage data analysis, providing significant insights to stakeholders regarding the most effective utilization of data resources for monitoring purposes, and provide the idea of digitization of the earth fill dam monitoring system in Pakistan with integrated DL algorithms.

Background: The neural differentiation of dental pulp stem cells (DPSCs) exhibits great potential in the treatment of dental pulp repair and neurodegenerative diseases. However, the precise molecular mechanisms underlying this process remain unclear. This study was designed to reveal the roles and regulatory mechanisms of the armadillo repeat-containing X-linked 3 (ARMCX3) in neural differentiation and inflammatory microenvironment in human DPSCs (hDPSCs). Methods: We treated hDPSCs with porphyromonas gingivalis lipopolysaccharide (Pg-LPS) to simulate the inflammatory microenvironment. Then the lentiviral vectors were introduced to construct stable cell lines with ARMCX3 knockdown or overexpression. The expression of neural-specific markers, ARMCX3 and inflammation factors were estimated by immunofluorescence (IF), quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immunosorbent assay (ELISA) assays. Additionally, we used IF assays and specific kits to investigate the regulatory role of ARMCX3 on reactive oxygen species (ROS) signaling. Moreover, a ROS inhibitor was utilized to verify whether ROS inhibition reversed the effects of ARMCX3 in Pg-LPS-treated hDPSCs. Results: This work illustrated that Pg-LPS treatment significantly enhanced ARMCX3 expression and inflammatory response, and inhibited neural differentiation in hDPSCs. ARMCX3 knockdown effectively accelerated neural differentiation and controlled inflammatory cytokines at a lower level in hDPSCs in the presence of Pg-LPS. Additionally, knockdown of ARMCX3 notably reduced ROS production and ROS inhibition effectively eliminated the roles of ARMCX3 overexpression in hDPSCs. Besides, all results were proved to be statistically significant. Conclusion: This investigation proved that ARMCX3 affected neural differentiation and inflammation microenvironment in hDPSCs at least partly by mediating ROS signal. These findings provided a new perspective on the mechanism of neural differentiation of hDPSCs and help to better explore the therapeutic schedule of pulpitis and neurodegenerative diseases.

Aggressive adolescents tend to exhibit abnormal fear acquisition and extinction, and reactive aggressive adolescents are often more anxious. However, the relationship between fear generalization and reactive aggression (RA) remains unknown. According to Reactive-Proactive Aggression Questionnaire (RPQ) scores, 61 adolescents were divided into two groups, namely, a high RA group (N = 30) and a low aggression (LA) group (N = 31). All participants underwent three consecutive phases of the Pavlovian conditioning paradigm (i.e., habituation, acquisition, and generalization), and neural activation of the medial prefrontal cortex (mPFC) was assessed by functional near-infrared spectroscopy (fNIRS). The stimuli were ten circles with varying sizes, including two conditioned stimuli (CSs) and eight generalization stimuli (GSs). A scream at 85 dB served as the auditory unconditioned stimulus (US). The US expectancy ratings of both CSs and GSs were higher in the RA group than in the LA group. The fNIRS results showed that CSs and GSs evoked lower mPFC activation in the RA group compared to the LA group during fear generalization. These findings suggest that abnormalities in fear acquisition and generalization are prototypical dysregulations in adolescents with RA. They provide neurocognitive evidence for dysregulated fear learning in the mechanisms underlying adolescents with RA, highlighting the need to develop emotional regulation interventions for these individuals.

Chemical Exchange Saturation Transfer (CEST) is a technique that uses specific off-resonance saturation pulses to pre-saturate targeted substances. This process influences the signal intensity of free water, thereby indirectly providing information about the pre-saturated substance. Among the clinical applications of CEST, Amide Proton Transfer (APT) is currently the most well-established. APT can be utilized for the preoperative grading of gliomas. Tumors with higher APTw signals generally indicate a higher likelihood of malignancy. In predicting preoperative molecular typing, APTw values are typically lower in tumors with favorable molecular phenotypes, such as isocitrate dehydrogenase (IDH) mutations, compared to IDH wild-type tumors. For differential diagnosis, the average APTw values of meningiomas are significantly lower than those of high-grade gliomas. Various APTw measurement indices assist in distinguishing central nervous system lesions with similar imaging features, such as progressive multifocal leukoencephalopathy, central nervous system lymphoma, solitary brain metastases, and glioblastoma. Regarding prognosis, APT effectively differentiates between tumor recurrence and treatment effects, and also possesses predictive capabilities for overall survival (OS) and progression-free survival (PFS).

To start with an infinitely repeated game of supply chains of public goods, a stout reciprocity mechanism is introduced into income games to build a matric dynamic equation. The conventional evolutionary game method is employed to propose a model called the evolutionary game for the cooperative strategy of both the manufacturer and the seller groups in the supply chain of public goods. Also, white Gaussian noise (WGN) is added to reflect random interference in the evolution process. Then, a stochastic dynamic system is established, and Ito’s differential equation is used to analyze both sides’ strategy evolution in a game, interpret changes in system stability when random disturbance is added, and finally test the influence of different situations on the system stability by running a numerical simulation. The research shows that the stronger the reciprocity coefficient is, and the system is subjected to random interference, the greater the strategy choice change in players’ decision-making procedures when the repeated game of public goods is conducted.

With the rapid growth of photovoltaic integration, the volatility and uncertainty of intermittent photovoltaic injection will dramatically reduce system operation reliability from the generation side. The system operator may face certain financial risks brought by unexpected power failure under low operation reliability. Therefore, maintaining sufficient power reserve to meet system operation reliability and reduce risk, especially in an isolated system, is essential. However, the traditional reserve preparation strategy fails to consider the uncertainties of the power generation under the high penetration levels of emerging renewable energy resources. A novel reserve preparation strategy for an isolated system is developed in this paper using a two-stage model. In the first stage, the optimal hourly scheduling of an isolated system is determined. In the second stage, a minute level conditional value-at-risk (CVaR) based model is established where the uncertainty of the reserve requirement is introduced with the chance constraint. The proposed discretized step transformation (DST) and subtraction type convolution (STC) methods are utilized to convert the model into mixed-integer linear programming, and finally solved by applying the CPLEX solver. The IEEE 39-bus system is used as the test case to validate the feasibility and effectiveness of the proposed two-stage model.

Automatic emergency steering (AES) is an advanced assisted driving system. AES systems help avoid collisions by controlling the lateral movement of a vehicle. However, in some scenarios—such as those involving a laterally approaching vehicle that cannot be detected by AES sensors owing to the vehicle’s obstruction by an obstacle—AES systems do not have sufficient time to act, and side impact may still occur. Limited research has been conducted on driver impairment analysis under the influence of AES. This study investigated driver kinematic responses and injuries after side impact following the AES. First, the study was based on accident cases in the National Automobile Accident In-Depth Investigation System database; a precrash scenario involving AES was established using the PreScan software. Second, a finite element model subjected to side impact was established in HyperMesh; a validated driver restraint system was added to the model. The effects of the impact angle, impact location, and ride posture on driver responses and injuries were investigated. It appears that as the impact angle increases, the forces on the abdomen tend to decrease. When the impact angle is 60°, the abdominal combined force APF is 2638N, which exceeds the threshold value. We have got the weighted injury criterion (WIC) for five angles: 60°, 75°, 90°, 105°, and 120°. Their values are 0.485, 0.393, 0.408, 0.200, and 0.158. The impact location had WIC values of 0.230, 0.407, and 0.228 for pillars A, B, and C, respectively; the WIC values for normal and left-toward positions were 0.492 and 0.407 respectively. Finally, the effects of an active seat belt pre-tensioning system on driver responses and injuries under various lateral accelerations were also investigated. These results contribute to a reference for investigating scenarios of AES or integrated technology of vehicle active and passive safety.

The ubiquitous spatiotemporal information extracted from Internet texts limits its application in spatiotemporal association and analysis due to its unstructured nature and uncertainty. This study uses ST-Voxel modeling to solve the problem of structured modeling and the association of ubiquitous spatiotemporal information in natural language texts. It provides a new solution for associating ubiquitous spatiotemporal information on the Internet and discovering public opinion. The main contributions of this paper include: (1) It proposes a convolved method for ST-Voxel, which solves the voxel modeling problem of unstructured and uncertain spatiotemporal objects and spatiotemporal relation in natural language texts. Experiments show that this method can effectively model 5 types of spatiotemporal objects and 16 types of uncertain spatiotemporal relation founded in texts; (2) It realizes the unknown event discovery based on voxelized spatiotemporal information association. Experiments show that this method can effectively solve the aggregation of ubiquitous spatiotemporal information in multi-natural language texts, which is conducive to discovering spatiotemporal events. The selection of convolution parameters in voxel modeling is also discussed. A parameter selection method for balancing the discovery capability and discovery accuracy of spatiotemporal events is given.

Abstract The safety of vehicle occupants in oblique collision scenarios continues to pose challenges, even with the implementation of Automatic Emergency Braking (AEB) systems. While AEB reduces collision risks, studies indicate it may heighten injury risks for out-of-position (OOP) occupants. To counteract this issue, the integration of active seat belts in vehicles equipped with AEB systems is recommended. Firstly, this study established an oblique angle collision scenario post-AEB activation using data from the Chinese National Automobile Accident In-depth Investigation System (NAIS) database, analyzed through Prescan software. The dynamic response of the vehicle was examined. Following this, finite element (FE) models were validated to assess the effects of collision overlap rate, AEB braking strategy, and active seat belt pre-tensioning on occupant injuries and kinematics. Under specific collision conditions, the impact of the timing and amount of seat belt pre-tensioning, as well as airbag deployment timing on occupant injuries, was also explored. Findings revealed that a 75% collision overlap rate significantly increases driver injury risk. Active seat belts effectively mitigate injuries caused by OOP statuses during AEB interventions, with the lowest Weighted Injury Criterion (WIC) observed at a pre-tensioning time of 200 ms for active seat belts. The study further suggests that optimal results in reducing occupant injuries are achieved when active pre-tensioning seat belts are complemented by appropriately timed airbag deployment.

The early detection accuracy of early gastric cancer (EGC) determines the choice of the optimal treatment strategy and the related medical expenses. We aimed to develop a simple, affordable, and time-saving diagnostic model using six machine learning (ML) algorithms for the diagnosis of EGC. It is based on the endoscopy-based Kyoto classification score obtained after the completion of endoscopy and other clinical features obtained after medical consultation. We retrospectively evaluated 1999 patients who underwent gastrointestinal endoscopy at the China Beijing Hospital. Of these, 203 subjects were diagnosed with EGC. The data were randomly divided into training and test sets (ratio 4:1). We constructed six ML models, and the developed models were evaluated on the testing set. This procedure was repeated five times. The Kolmogorov–Arnold Networks (KANs) model achieved the best performance (mean AUC value: 0.76; mean balanced accuracy: 70.96%; mean precision: 58.91%; mean recall: 70.96%; mean false positive rate: 26.11%; mean false negative rate: 31.96%; and mean F1 score value: 58.46). The endoscopy-based Kyoto classification score was the most important feature with the highest feature importance score. The results suggest that the KAN model, the optimal ML model in this study, has the potential to identify EGC patients, which may result in a reduction in both the time cost and medical expenses in clinical practice.

Abstract With the development of organic germanium and nanotechnology, germanium serves multiple biological functions, and its potential value in biochemistry and medicine has increasingly captured the attention of researchers. In recent years, germanium has gradually gained significance as a material in the field of biomedicine and shows promising application prospects. However, there has been a limited amount of research conducted on the biological effects and mechanisms of germanium, and a systematic evaluation is still lacking. Therefore, the aim of this review is to systematically examine the application of germanium in the field of biomedicine and contribute new insights for future research on the functions and mechanisms of germanium in disease treatment. By conducting a comprehensive search on MEDLINE, EMBASE, and Web of Science databases, we systematically reviewed the relevant literature on the relationship between germanium and biomedicine. In this review, we will describe the biological activities of germanium in inflammation, immunity, and antioxidation. Furthermore, we will discuss its role in the treatment of neuroscience and oncology-related conditions. This comprehensive exploration of germanium provides a valuable foundation for the future application of this element in disease intervention, diagnosis, and prevention.

Abstract Background Metabolic dysfunction-associated fatty liver disease (MAFLD) is a newly defined condition encompassing hepatic steatosis and metabolic dysfunction. However, the relationship between MAFLD and multi-system diseases remains unclear, and the time-dependent sequence of these diseases requires further clarification. Methods After propensity score matching, 163,303 MAFLD subjects and 163,303 matched subjects were included in the community-based UK Biobank study. The International Classification of Diseases, Tenth Revision (ICD-10), was used to reclassify medical conditions into 490 and 16 specific causes of death. We conducted a disease trajectory analysis to map the key pathways linking MAFLD to various health conditions, providing an overview of their interconnections. Results Participants aged 59 (51–64) years, predominantly males (62.5%), were included in the study. During the 12.9-year follow-up period, MAFLD participants were found to have a higher risk of 113 medical conditions and eight causes of death, determined through phenome-wide association analysis using Cox regression models. Temporal disease trajectories of MAFLD were established using disease pairing, revealing intermediary diseases such as asthma, diabetes, hypertension, hypothyroid conditions, tobacco abuse, diverticulosis, chronic ischemic heart disease, obesity, benign tumors, and inflammatory arthritis. These trajectories primarily resulted in acute myocardial infarction, disorders of fluid, electrolyte, and acid–base balance, infectious gastroenteritis and colitis, and functional intestinal disorders. Regarding death trajectories of MAFLD, malignant neoplasms, cardiovascular diseases, and respiratory system deaths were the main causes, and organ failure, infective disease, and internal environment disorder were the primary end-stage conditions. Disease trajectory analysis based on the level of genetic susceptibility to MAFLD yielded consistent results. Conclusions Individuals with MAFLD have a risk of a number of different medical conditions and causes of death. Notably, these diseases and potential causes of death constitute many pathways that may be promising targets for preventing general health decline in patients with MAFLD.

Abstract Aim This study investigated the scientific research ability of Chinese specialist nurses (SNs) in the Guangxi Zhuang Autonomous Region and its influencing factors. Design A cross‐sectional design. Methods A total of 652 SNs in the Guangxi Zhuang Autonomous Region were investigated from March to October 2021. The nursing scientific research ability level was measured using the Nursing Research Competence of Nurses Self‐evaluation Scale. Descriptive statistics, univariate analysis and ordinal logistic regression analysis were used to evaluate factors affecting the scientific research ability of SNs. Results The median score of scientific research ability of SNs was 31 (interquartile range: 19–41). Approximately 74.8% of clinical speciality nurses had low scientific research ability. Educational background, working hospital level, being the first author of a published paper and successful application for scientific research projects were identified as factors influencing scientific research ability score.

The prevailing customized electricity pricing methods in China primarily utilize a single power price, which is an extra service cost charged per kWh. This paper suggests a customed power pricing optimization method that takes into account not only electricity quantity (kWh), but also capacity (kVA), and considers the gaming ability of both users and the electricity retail company. Firstly, the method for determining level of the quality of power is introduced in this paper, which is based on various quality of power indices Next, an optimization model for the customized electricity pricing is suggested, which takes into account the gaming ability of both users and the new power sales company (NPSC). Lastly, this paper conducts a case study of four representative users situated in an industrial park in Chengdu, Sichuan province to demonstrate the practical application of the proposed approach. The findings indicate that the suggested approach can allocate customized electricity charges between capacity and electricity consumed by users in a rational manner, thus enhancing the efficiency of production equipment for users.

The pervasive use of smartphones, while enhancing accessibility to information and communication, has raised concerns about its potential negative effects on physical and mental health, including the impairment of decision-making abilities. This study investigates the influence of smartphone addiction on decision-making in college students. A sample of 80 individuals aged 17 to 26 was selected and divided into two groups based on their Smartphone Addiction Scale-Short Version (SAS-SV) scores. Participants underwent the Iowa Gambling Task (IGT) to evaluate their decision-making in risky and uncertain conditions, while fNIRS recorded their prefrontal cortex activity. The study found that individuals prone to smartphone addiction tend to make riskier choices in risky situations. However, when faced with decisions based on ambiguity, the smartphone addiction group showed increased brain activity in the dlPFC (specifically in channels 4, 9, and 11) compared to when making risky decisions. Despite this increased brain activation, there was no observable difference in behavior between the addiction-prone and control groups in ambiguous scenarios. Notably, the left dlPFC (e.g., channel 4) exhibited significantly higher activation in the addiction group compared to the control group. Findings suggest that smartphone addiction can detrimentally influence decision-making, behaviorally and neurologically, particularly in uncertain contexts. This study supports the classification of smartphone addiction as a genuine addiction and underscores its significance in psychiatric research. In essence, our research underscores the adverse effects of excessive smartphone use on decision-making processes, reinforcing the necessity to treat smartphone addiction as a pressing public health issue.

IntroductionOsteoporosis, a disease of reduced bone mass and microstructural deterioration leading to fragility fractures, is becoming more prevalent as aging progresses, significantly increasing the socioeconomic burden. In past studies, there has been a growing awareness of the harmful effects of heavy metals on bone, with cadmium being a significant exposure factor. The purpose of this study was to look into the association between adult bone mineral density(BMD) and blood cadmium levels.MethodsBased on information from the 2013–2014, 2017–2018 NHANES, weighted multiple regression, generalized weighted modeling, and smoothed curve fitting were utilized to investigate the association between blood cadmium and femur BMD. Furthermore, subgroup analyses were conducted to investigate any differences in the associations between age, sex, race, chronic kidney disease, and diabetes.ResultsIn 2,146 participants, blood cadmium levels and total femur [-0.02 (-0.03, -0.01), 0.0027], femoral neck [-0.01 (-0.02, -0.00), 0.0240], femoral trochanter [-0.01 (-0.02, -0.00), 0.0042], and intertrochanteric femoral trochanter [-0.02 (-0.03, -0.00), 0.0101] BMD were negatively correlated. Subgroup analyses showed that this association was more pronounced in women, non-Hispanic white people and other Hispanics, and those with chronic kidney disease and diabetes. Our results pointed to a negative relationship between femoral BMD and blood cadmium. This negative association varied by age, sex, race, diabetes, and chronic kidney disease. In particular, bone mineral density was more significantly negatively affected by blood cadmium levels in groups with diabetes and chronic kidney disease.ConclusionOur findings demonstrated a significant negative association between blood cadmium levels and bone mineral density in a population of U.S. adults.

Morphine is a widely used opioid for treatment of pain. The attendant problems including morphine tolerance and morphine dependence pose a major public health challenge. In recent years, there has been increasing interest in the gastrointestinal microbiota in many physiological and pathophysiological processes. The connectivity network between the gut microbiota and the brain is involved in multiple biological systems, and bidirectional communication between them is critical in gastrointestinal tract homeostasis, the central nervous system, and the microbial system. Many research have previously shown that morphine has a variety of effects on the gastrointestinal tract, but none have determined the function of intestinal microbiota in morphine tolerance. This study reviewed the mechanisms of morphine tolerance from the perspective of dysregulation of microbiota-gut-brain axis homeostasis, by summarizing the possible mechanisms originating from the gut that may affect morphine tolerance and the improvement of morphine tolerance through the gut microbiota.

Abstract Dermatological toxicities are well-recognized immune-related adverse events (irAEs) secondary to immune checkpoint inhibitor (ICI) use. Corticosteroids are considered the first-line therapy for grade 3 or grade 4 skin irAEs, but long-term usage of corticosteroids may abolish the effect of ICIs. Multiple antitumor therapies might be an influencing factor in an increased incidence of skin irAEs. The safety and prognostic value in resuming ICIs after irAEs has been inconsistently reported, especially the severe skin irAE. We report a case of a 75-year-old man with non-small cell lung cancer (NSCLC) and prostate cancer with a Stevens-Johnson syndrome (SJS)-like eruption. The severe rash might have been induced by resuming pembrolizumab was successfully treated with a combination of corticosteroids, gamma globulin, and immunosuppressants. Early detection of dermatologic toxicity is crucial, especially for patients receiving multiple antitumor treatments. We should treat ICI resumption seriously after skin irAE.

Crops often face light intensity fluctuations in natural settings. Intercropping is widely used to improve crop yield and resource utilization worldwide, but crops suffer from high-frequency and high-intensity light fluctuations due to mutual crop influence. Soybean is an important legume crop and is often intercropped with other crops, but little is known about soybean’s response to light fluctuation environments. Herein, three fluctuation frequencies (1, 10, and 20 min/cycle) were used to analyze soybean photosynthesis responses by measuring leaf growth, chlorophyll content, gas exchange, and electron transfer. Our data revealed that faster fluctuation frequencies led to the stronger suppression of soybean morphology and photosynthesis, with significant reductions of 31.31% and 21.58%, respectively. Damage to photosystems II (PSII) and I (PSI) also intensified, with significant decreases of 18.52% and 18.38% in their effective quantum yields Y(II) and Y(I). Additionally, increased fluctuation frequency exacerbated the consumption of the plastoquinone pool and linear electron flow but enhanced the cyclic electron flow across the thylakoid membrane and, thus, increased heat dissipation in PSII. Our findings indicate that an increased fluctuation frequency inflicted more severe damage on the soybean photosynthesis system. However, PSI-enhanced CEF improved NPQ and coordinated photoprotection to some extent.

ObjectiveThe objective of this study was to investigate the effectiveness of a machine learning algorithm in diagnosing OSA in children based on clinical features that can be obtained in nonnocturnal and nonmedical environments.Patients and methodsThis study was conducted at Beijing Children's Hospital from April 2018 to October 2019. The participants in this study were 2464 children aged 3–18 suspected of having OSA who underwent clinical data collection and polysomnography(PSG). Participants’ data were randomly divided into a training set and a testing set at a ratio of 8:2. The elastic net algorithm was used for feature selection to simplify the model. Stratified 10-fold cross-validation was repeated five times to ensure the robustness of the results.ResultsFeature selection using Elastic Net resulted in 47 features for AHI ≥5 and 31 features for AHI ≥10 being retained. The machine learning model using these selected features achieved an average AUC of 0.73 for AHI ≥5 and 0.78 for AHI ≥10 when tested externally, outperforming models based on PSG questionnaire features. Linear Discriminant Analysis using the selected features identified OSA with a sensitivity of 44% and specificity of 90%, providing a feasible clinical alternative to PSG for stratifying OSA severity.ConclusionsThis study shows that a machine learning model based on children's clinical features effectively identifies OSA in children. Establishing a machine learning screening model based on the clinical features of the target population may be a feasible clinical alternative to nocturnal OSA sleep diagnosis.

BackgroundA link between food-induced inflammation and common chronic diseases has been identified in studies. However, there was uncertainty about the influence of dietary inflammatory potential on the risk of chronic kidney disease (CKD) among middle-aged and older groups. Our research aimed to examine the connection between dietary inflammatory index (DII) to CKD in people aged 40 years and older.MethodsThis study comprised ten cycles of the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Linear associations of DII with CKD, low-eGFR, and albuminuria were examined using multiple logistic regression, whereas non-linear associations were assessed by smoothed curve fitting. Besides, we conducted subgroup analyses and interaction tests.ResultsOf the 23,175 middle-aged and older individuals, a total of 5,847 suffered from CKD, making up 25.23% of all participants. After adjustment for all covariates, we found that increased DII scores were positive with an increased hazard of CKD (OR = 1.08, 95% CI: 1.05, 1.10, p < 0.0001), and the same was shown between DII and low-eGFR (OR = 1.16, 95% CI: 1.13, 1.19, p < 0.0001). After further converting DII into categorical variables, the above relationship still existed. These relations were consistent in different ages, genders, BMI, whether smoking, whether suffering from hypertension, and whether suffering from diabetes, with no significant stratification differences (all P for interaction >0.05). Surprisingly, we did not find a statistically significant correlation of DII to albuminuria after complete adjustment for covariates (OR = 1.02, 95% CI: 1.00, 1.05, p = 0.0742). Even when DII was considered as a categorical variable, this relation was still not statistically significant. Furthermore, we found an association in the shape of a U between DII and low-eGFR in the fully adjusted model, with a turning point at a DII of 1.6.ConclusionOur findings indicated that middle-aged and older persons with greater levels of DII had a significantly higher risk of CKD.

This work presents the automated assessment method of civic education using fusion psychology. The basis for it is the development of abilities in psychological and civic education. Five first-level evaluation indicators and seventeen second-level indicators have been filtered out. The computerized assessment model of Civic and Political Education of Integrated Psychology is constructed with timeliness by preprocessing the quantified index data with dynamic clustering and fusion using the fuzzy C-mean clustering algorithm, which is based on the evaluation indexes and training sample set. The research program on the relationship between mental health education and civics instruction is designed with the incorporation of mental health into the civics course as the starting point. Statistical analysis tools are used to analyze civics education examples that incorporate mental health education from the perspective of educational psychology. The model in this paper may successfully enhance the precision of the evaluation of the standard design of Civic and Political Education, which includes mental health education, as evidenced by its smaller RMSE and MAE of the evaluation results when compared with BP and RBF, which are 0.3151 and 0.1834, respectively. Cultural confidence appears to have a partly mediation effect between curricular citizenship and mental health since curricular civics positively impacts cultural confidence (p

Abstract Objectives Regulatory T (Treg) cells regulate immunity in autoimmune diseases and cancers. However, immunotherapies that target tumor‐infiltrating Treg cells often induce unwanted immune responses and tissue inflammation. Our research focussed on exploring the expression pattern of CD177 in tumor‐infiltrating Treg cells with the aim of identifying a potential target that can enhance immunotherapy effectiveness. Methods Single‐cell RNA sequencing (scRNA‐seq) data and survival data were obtained from public databases. Twenty‐one colorectal cancer patient samples, including fresh tumor tissues, peritumoral tissues and peripheral blood mononuclear cells (PBMCs), were analysed using flow cytometry. The transendothelial activity of CD177+ Treg cells was substantiated using in vitro experiments. Results ScRNA‐seq and flow cytometry results indicated that CD177 was exclusively expressed in intratumoral Treg cells. CD177+ Treg cells exhibited greater activation status and expressed elevated Treg cell canonical markers and immune checkpoint molecules than CD177− Treg cells. We further discovered that both intratumoral CD177+ Treg cells and CD177‐overexpressing induced Treg (iTreg) cells had lower levels of PD‐1 than their CD177− counterparts. Moreover, CD177 overexpression significantly enhanced the transendothelial migration of Treg cells in vitro. Conclusions These results demonstrated that Treg cells with higher CD177 levels exhibited an enhanced activation status and transendothelial migration capacity. Our findings suggest that CD177 may serve as an immunotherapeutic target and that overexpression of CD177 may improve the efficacy of chimeric antigen receptor T (CAR‐T) cell therapy.

BackgroundAlthough healthy sleep patterns have been linked to a lower risk of cardiovascular disease in earlier research, it is unclear how beneficial they are for venous thromboembolism (VTE).AimThis research aimed to examine the correlation between sleep patterns, genetic susceptibility, and VTE.MethodsIn the UK Biobank cohort, healthy sleep behaviors were defined as early chronotype, 7-8 hours of sleep each day, no snoring, infrequent insomnia, and infrequent daytime sleepiness. Each of the five criteria was given 1 point, creating a healthy sleep score ranging from 0 to 5. Cox proportional hazards regression models were utilized to examine the associations between genetic susceptibility, healthy sleep score and VTE.ResultsThe UK Biobank study included 384,758 participants aged 56.6 ± 8.0 years. After a median of 11.9 years of follow-up, 8,885 (2.3%) participants were diagnosed with VTE. A healthy sleep score inversely affected VTE risk. For participants with a score of 5, the hazard ratio of VTE was 0.813 (95% confidence interval: 0.758-0.873, PConclusionsOur secondary analysis of a large-scale prospectively gathered registry revealed that individuals with a healthy sleep pattern are significantly correlated with lower risk of developing VTE, irrespective of genetic susceptibility.

Abstract In this study, we explored whether satisfaction with government management, perception of risk, and gratitude influenced public anxiety during the COVID-19 pandemic in China. Using a cross-sectional, anonymous and confidential online survey, a nationwide sample of Chinese adults (N = 876) was targeted between March 25–March 30, 2020, a period in which newly confirmed cases significantly declined in China. The anxiety level was decreased as compared to that assessed during the peak period. Multiple parallel mediation modeling demonstrated that risk perception and gratitude partially mediated the relationship between satisfaction with government management and public anxiety. Increasing satisfaction and gratitude, as well as reducing risk perception contribute to the public’s mental health. The results may shed light on the positive factors for psychological well-being during the COVID-19 pandemic and may aid potential strategies for the policy maker, the public, and the clinic to regulate negative emotions or future emerging infectious diseases.

Due to the unevenness of ground surface, mismatch between trig interval and sampling speed, or other electromagnetic interferences, traces missing is a quite typical occurrence during the on-ground ground penetrating radar (GPR) testing. Effective reconstruction of GPR missing traces has been regarded a crucial link to improve both the signal-to-noise ratio of raw data and the resolution of GPR imaging. In this article, we propose a novel deep-learning framework based on the residual feature distillation block U-Net (RFDB-U-Net) to mitigate the transmission loss problem of the conventional U-Net. To be specific, by employing the information distillation network based on the multiple feature extraction connections, RFDB is capable of utilizing the adequate residual information of each layer for feature learning. Moreover, a skip connection is additional patched on the residual units to properly compensate the missing features in the convolution process. In particular, the merging of lightweight U-Net ensures the lightness of RFDB. The outperformance of the proposed framework is verified in detail through the reconstruction accuracy and evaluation metrics in the test of synthetic data, laboratorial data, and in-site field data.

IntroductionAccording to reports, obesity has a significant impact on bone health. And the weight-adjusted-waist index (WWI), superior to BMI and waist circumference (WC), is a new obesity indicator arising in recent years. This research investigated the relationship between WWI and total bone mineral density (BMD) for adults aged 20 to 59.MethodsUsing data from the 2011–2018 NHANES, we looked into the independent link between WWI and total BMD as well as its nonlinearity using weighted multiple linear regression and smooth curve fitting. Two-stage linear regression models were employed to calculate the threshold effects. There were additional subgroup analyses and testing for interactions.ResultsMultiple linear regression studies on a total of 10,372 individuals showed a significant inverse link between WWI and total BMD in adults between 20 and 59 [β = -0.04, 95% CI: (-0.04, -0.03), P0.05). In addition, we found a nonlinear relationship between WWI and total BMD in diabetic and CKD patients, for which the saturation point was 11.38 cm/√kg in the CKD patient group and 10.29 cm/√kg in the diabetic patient group.ConclusionOur analysis demonstrated a significant inverse association between WWI and total BMD in adults aged 20-59.

Summary: Neovascular age-related macular degeneration AMD (nAMD) is characterized by choroidal neovascularization (CNV) and could lead to irreversible blindness. However, anti-vascular endothelial growth factor (VEGF) therapy has limited efficacy. Therefore, we generated a chimpanzee adenoviral vector (AdC68-PFC) containing three genes, pigment endothelial-derived factor (PEDF), soluble fms-like tyrosine kinase-1 (sFlt-1), and soluble forms of CD59 (sCD59), to treat nAMD. The results showed that AdC68-PFC mediated a strong onset of PEDF, sFlt-1, and sCD59 expression both in vivo and in vitro. AdC68-PFC showed preventive and therapeutic effects following intravitreal (IVT) injection in the laser-induced CNV model and very low-density lipoprotein receptor-deficient (Vldlr−/−) mouse model. In vitro assessment indicated that AdC68-PFC had a strong inhibitory effect on endothelial cells. Importantly, the safety test showed no evidence of in vivo toxicity of adenovirus in murine eyes. Our findings suggest that AdC68-PFC may be a long-acting and safe gene therapy vector for future nAMD treatments.

The estrogen receptor (ER) is a classical receptor protein that plays a crucial role in mediating multiple signaling pathways in various target organs. It has been shown that ER-targeting therapies inhibit breast cancer cell proliferation, enhance neuronal protection, and promote osteoclast formation. Several drugs have been designed to specifically target ER in ER-positive (ER+) breast cancer, including selective estrogen receptor modulators (SERM) such as Tamoxifen. However, the emergence of drug resistance in ER+ breast cancer and the potential side effects on the endometrium which has high ER expression has posed significant challenges in clinical practice. Recently, novel ER-targeted drugs, namely, selective estrogen receptor degrader (SERD) and selective estrogen receptor covalent antagonist (SERCA) have shown promise in addressing these concerns. This paper provides a comprehensive review of the structural functions of ER and highlights recent advancements in SERD and SERCA-related small molecule drugs, especially focusing on their structural optimization strategies and future optimization directions. Additionally, the therapeutic potential and challenges of novel SERDs and SERCAs in breast cancer and other ER-related diseases have been discussed.

Chlorphenamine maleate is a prohibited additive found in herbal teas and health foods. Excessive intake of this substance can result in adverse health effects. In this study, two novel haptens, PEM and bepotastine (PB1), mimicking chlorphenamine maleate structure were designed and synthesized based on molecular simulation for developing two corresponding polyclonal antibodies (PEM-Ab and PB1-Ab), respectively. Afterward, an indirect competitive enzyme-linked immunosorbent assay (ic-ELISA) was developed to quickly and accurately detect chlorphenamine maleate in herbal teas using PB1-Ab, which has a high sensitivity and specificity. For chlorphenamine maleate, the half-maximal inhibitory concentration (IC50) and limit of detection (LOD) of PB1-Ab under ideal circumstances were found to be 1.18 µg/L and 0.07 µg/L, respectively. Besides, an environmentally friendly sample pre-treatment strategy was employed that allowed easy and effective elimination of complex matrices. The ic-ELISA method observed the average recovery rate from 87.7% to 94.0% with the variance coefficient (CV) ranging from 2.2% to 9.4%. Additionally, the identification of 25 commercially available herbal teas using liquid chromatography-tandem mass spectrometry (LC-MS/MS) further confirmed the validity of our detection. The results of the two methods are consistent. Overall, the proposed ic-ELISA could be an ultrasensitive and reliable method for chlorphenamine maleate adulterated in foods or exposure to the environment.

Objective To reveal the association between different types of panniculitis and tuberculosis infection. Methods The clinical data of 33 patients with panniculitis were collected from January 2019 to December 2021 and analyzed association of epidemiology, clinical features, and pathological features with tuberculosis infection, efficacy of anti-tuberculosis treatment, and adverse reactions in some patients, and follow-up after the treatment. Results ①Among the 33 patients with panniculitis, 24 cases were erythema nodosum and 9 cases were Bazin's disease. The male to female ratio was 1∶4.5. The average age was 46 years, and the average disease duration was 10 months. ②The lesions with pain, erythema, nodules and swelling were observed in 90.91% of the patients, including a case of Bazin's disease with ulcer (3.03%). Fever, cough and night sweats were found in 18.18% of patients. Two cases with Bazin's disease had papulonecrotic tuberculid, and two patients with erythema nodosum had systemic multi-joint pain. ③Twenty-two of 33 (66.67%) patients with panniculitis were associated with tuberculosis infection. There were 9 cases of Bazin's disease and 13 cases of erythema nodosum with mycobacterium tuberculosis latent infection (LTBI). The positive rate of tuberculosis infection was significantly higher in patients with erythema induratum than in patients with erythema nodosum (P=0.020).④The pathological manifestations included septal panniculitis (11 cases), lobular panniculitis (3 cases) and mixed panniculitis (19 cases). Epithelial-cell granulomas, multinucleated giant cells, and caseous necrosis were seen in 22 patients associated with tuberculosis infection. Perivascular and fat septal lymphocytic infiltration in the dermis were observed in 11 patients unrelated to tuberculosis infection, with no epithelioid granuloma or multinucleated giant cells. All 33 patients showed negative for acid-fast staining, PAS staining and direct immunofluorescence. ⑤Among the 22 cases related to tuberculosis infection, 15 cases received anti-tuberculosis treatment, resulting in a cure rate of 68.18%, while the cure rate was 14.29% in 7 cases who declined anti-tuberculosis. Eleven patients unrelated tuberculosis infection were cured following the treatments with immunomodulatory combination therapy. No serious adverse drug reactions were observed. Conclusions The positive rate of tuberculosis infection in patients with Bazin's disease was significantly higher than that in patients with erythema nodosum. In patients with tuberculosis infection-related panniculitis, the cure rate of anti-tuberculosis therapy was significantly higher than that of immunomodulatory combination therapy. For erythema nodosum with no evidence of tuberculosis infection, immunoregulatory therapy may be effective. The etiology of erythema nodosum may be related to tuberculosis infection.

Abstract Background General practitioners are the main providers of primary care services. To better strengthen the important role of general practitioners in primary healthcare services, China is promoting the general practitioners’ office system. There is a lack of well-accepted methods to measure the performance of general practitioner offices in China. We thus aim to develop a systematic and operable performance measurement system for evaluating the general practitioner’s office. Methods We establish an index pool of the performance measurement system of general practitioners’ offices by a cross-sectional study and the literature research method and adopt the focus group method to establish the preliminary system. The Delphi method is then used to conduct three rounds of consultation to modify indices, which aims to form the final indicator system. We determine the weight of each index by the analytic hierarchy process method, which together with the final indicator system constitutes the final performance measurement system. Finally, we select three offices from three different cities in Sichuan Province, China, as case offices to conduct the case study, aiming to assess its credibility. Results Our results show that the first office scored 958.5 points, the second scored 768.1 points, and the third scored 947.7 points, which corresponds to the reality of these three offices, meaning that the performance measurement system is effective and manoeuvrable. Conclusions Our study provides support for standardizing the functions of China’s general practitioner’s office, improving the health service quality of generalists, and providing a theoretical basis for the standardization of the general practitioner’s office.

The “do not eat me” signaling pathway is extremely active in tumor cells, providing a means for these cells to elude macrophage phagocytosis and escape immune surveillance. Representative markers of this pathway, such as CD47 and CD24, are highly expressed in numerous tumors. The interaction of SIRPα with CD47 reduces the accumulation of non-myosin ⅡA on the cell membrane. The combination of CD24 and Siglec10 ultimately leads to the recruitment of SHP-1 or SHP-2 to reduce signal transduction. Both of them weaken the ability of macrophages to engulf tumor cells. Blocking the mutual recognition between CD47-SIRPα or CD24-Siglec10 using large molecular proteins or small molecular drugs represents a promising avenue for tumor immunotherapy. Doing so can inhibit signal transduction and enhance macrophage clearance rates of cancer cells. In this paper, we summarize the characteristics of the drugs that affect the “do not eat me” signaling pathway via classical large molecular proteins and small molecule drugs, which target the CD47-SIRPα and CD24-Siglec10 signaling pathways, which target the CD47-SIRPα and CD24-Siglec10 signaling pathways. We expect it will offer insight into the development of new drugs centered on blocking the “do not eat me” signaling pathway.

Vortex beams carrying orbital angular momentum (OAM) provide a new degree of freedom for light waves in addition to the traditional degrees of freedom, such as intensity, phase, frequency, time, and polarization. Due to the theoretically unlimited orthogonal states, the physical dimension of OAM is capable of addressing the problem of low information capacity. With the advancement of the OAM optical communication technology, OAM router devices (OAM-RDs) have played a key role in significantly improving the flexibility and practicability of communication systems. In this review, major breakthroughs in the OAM-RDs are summarized, and the latest technological standing is examined. Additionally, a detailed account of the recent works published on techniques related to the OAM-RDs has been categorized into five areas: channel multicasting, channel switching, channel filtering, channel hopping, and channel adding/extracting. Meanwhile, the principles, research methods, advantages, and disadvantages are discussed and summarized in depth while analyzing the future development trends and prospects of the OAM-RDs.

Malicious attacks can cause significant damage to the structure and functionality of complex networks. Previous research has pointed out that the ability of networks to withstand malicious attacks becomes weaker when networks are coupled. However, traditional research on improving the robustness of networks has focused on individual low-order or higher-order networks, lacking studies on coupled networks with higher-order and low-order networks. This paper proposes a method for optimizing the robustness of coupled networks with higher-order and low-order based on a simulated annealing algorithm to address this issue. Without altering the network’s degree distribution, the method rewires the edges, taking the robustness of low-order and higher-order networks as joint optimization objectives. Making minimal changes to the network, the method effectively enhances the robustness of coupled networks. Experiments were conducted on Erdős–Rényi random networks (ER), scale-free networks (BA), and small-world networks (SW). Finally, validation was performed on various real networks. The results indicate that this method can effectively enhance the robustness of coupled networks with higher-order and low-order.

IntroductionAtrial fibrillation (AF) is a challenging cardiovascular disease worldwide. Wearable electrocardiograph devices (WEDs) have great potential to improve the detection rate of AF in primary care. However, the factors that influence general practitioners’ (GPs) perception and acceptance of WEDs are not well understood. To identify factors that influence the intention of GPs to utilize WEDs in a clinical setting to screen patients for AF.MethodThe research hypotheses and questionnaire items were designed and developed based on the unified theory of acceptance and technology (UTAUT) framework. We used stratified sampling and obtained the data through an online survey. Structural equation modeling was used to analyze the collected data.Results: A total of 1,004 valid questionnaires from GPs across Sichuan province in China were collected. Three factors increased GPs’ intention to utilize WEDs to screen patients for AF, including performance expectancy (β = 0.121, p = 0.004), social influence (β = 0.356, p

The purpose of this study is to investigate the effects of different extraction methods (hot water-assisted extraction (HWE), microwave-assisted extraction (MAE), ultrasonic-assisted extraction (UAE), and ultrasonic-microwave- assisted extraction (UAME)) on the yield, chemical structures and antioxidant activity of Dictyophora indusiata polysaccharides (DPs). The research results showed that UMAE treatment had greater degree of damage to the cell wall of DPs and better comprehensive antioxidant capacity. Different extraction methods had no obvious effect on the types of glycosidic bonds and sugar rings, similar chemical composition and monosaccharide composition, with different absolute molecular weight (Mw) and molecular conformation. In particular, DPs for UMAE method had the highest polysaccharides yield, which was related to the conformational stretching and degradation avoidance of DPs in the higher molecular weight components under the simultaneous action of microwave and ultrasonic. These findings suggest that the UMAE technology has good potential for modification and application of DPs in the functional food industry.