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Abstract Photoluminescence is one of the most intriguing properties of metal nanoclusters derived from their molecular-like electronic structure, however, achieving high photoluminescence quantum yield (PLQY) of metal core-dictated fluorescence remains a formidable challenge. Here, we report efficient suppression of the total structural vibrations and rotations, and management of the pathways and rates of the electron transfer dynamics to boost a near-unity absolute PLQY, by decorating progressive addition of cations. Specifically, with the sequential addition of Zn2+, Ag+, and Tb3+ into the 3-mercaptopropionic acids capped Au nanoclusters (NCs), the low-frequency vibration of the metal core progressively decreases from 144.0, 55.2 to 40.0 cm−1, and the coupling strength of electrons-high-frequency vibration related to surface motifs gradually diminishes from 40.2, 30.5 to 14.4 meV. Moreover, introducing cation additives significantly reduces electron transfer time from 40, 27 to 12 ps in the pathway from staple motifs to the metal core. This benefits from the shrinkage of the total structure that speeds up the shell-core electron transition, and in particular, the Tb3+ provides a hopping platform for the excited electrons as their intrinsic ladder-like energy level structure. As a result, it allows a remarkable enhancement in PLQY, from 51.2%, 83.4%, up to 99.5%.

This study investigated the effect of electron beam generated X-ray (EBGX) irradiation at different doses (0, 0.3, 0.6, 0.9 and 1.2 kGy) on the storage quality of harvested Agaricus bisporus at (15 ± 1) ℃. The results indicated that EBGX-treated mushroom had significant superiority in delaying mass loss, maintaining apparent color and textural properties, and promoting phenol accumulation compared with the non-treatment group. Different from the other irradiation doses, the 0.9 kGy treatment effectively delayed the rate of superoxide anion radical production, reduced the accumulation of reactive oxygen species (ROS), enhanced the activities of superoxide dismutase (SOD) and catalase (CAT), and inhibited microbial growth. It is suggested that EBGX treatment can obviously delay the quality deterioration of A. bisporus during storage. This study provides a theoretical basis for the application of EBGX treatment in the preservation of A. bisporus.

AIM: To evaluate the efficacy, timing of retreatment and safety of dexamethasone (DEX) implant on macular edema (ME) secondary to diabetic retinopathy (DME) and retinal vein occlusion (RVO-ME) patients who were refractory to anti-vascular endothelial growth factor (VEGF) treatment. METHODS: This retrospective study included 37 eyes received at least one DEX implant treatment for DME or RVO-ME between January 1, 2019, and January 1, 2023. These refractory DME and RVO-ME cases received at least 5 anti-VEGF injections and failure to gain more than 5 letters or a significant reduction in central retinal thickness (CRT). The best corrected visual acuity (BCVA) and CRT were measured at baseline, and at 1, 3, 4 and 6mo post-DEX implant injection. Adverse events such as elevated intraocular pressure (IOP) and cataract were recorded. RESULTS: For RVO cases (n=22), there was a significant increase in BCVA from 0.27±0.19 to 0.35±0.20 at 6mo post-DEX injection (P

Abstract Background Primary malignant neoplasms of the spermatic cord are extremely rare, with most reported cases being sarcomas or metastatic carcinomas. However, primary adenocarcinoma of the spermatic cord has not been previously reported. Case presentation A 34-year-old male with a solid mass in the right spermatic cord, was eventually diagnosed with primary adenocarcinoma. Histological examination revealed a moderately-to-poorly differentiated adenocarcinoma exhibiting glandular, cribriform, or nested growth patterns, characterized by medium to large-sized cells and focal extracellular mucus. Immunohistochemical analysis demonstrated positive staining for CK (AE1/AE3), CK8/18, CK19, MOC31 (EP-CAM), and Ber-EP4, while negative staining was observed for CK7, D2-40, WT-1, MC, PAX-8, NKX3.1, PSA, CEA, TTF-1, and NapsinA. Furthermore, a complete loss of INI-1 expression and consistent BRG1 expression were noted in all tumor cells. Next-generation sequencing revealed SMARCB1 deletion, low tumor mutation burden (TMB-L), and microsatellite stability (MSS). Conclusion We reported the first case of primary adenocarcinoma of the spermatic cord with SMARCB1 (INI-1) deficiency. This case contributes to the expanding understanding of rare neoplasms and underscores the importance of further research into therapeutic strategies targeting SMARCB1-deficient tumors.

Abstract Objective Knee osteoarthritis is the most common osteoarthritis and imposes a significant burden on patients’ lives. Several treatment methods can promote cartilage repair to varying extents, but there are limited studies on the combined application of different treatments. The purpose of this study is to evaluate the clinical efficacy of microfracture combined with fibrinogen and platelet-rich plasma (PRP) under arthroscopic in treating knee osteoarthritis, so as to provide a basis for clinical treatment decisions. Method A total of 113 patients with knee osteoarthritis who received orthopedic treatment from January 2021 to June 2022 were selected. They were divided into two groups according to whether they received fibrinogen and PRP treatment in addition to microfracture treatment. The two groups were analyzed to compare the differences in knee joint function and quality of life at different points. Results The study compared changes in knee joint function scores and quality of life between the two groups after treatment and found that the quality of life of patients in the combined treatment group was significantly better than that of patients who received microfracture only (at 12-month follow-up, EuroQol-VAS scores were 64.32 ± 5.63 for the microfracture group (MFx) and 75.65 ± 8.57 for the fibrinogen combined with platelet-rich plasma-assisted microfracture group (FPRPA MFx); P = 0.015; at 24-month follow-up, EuroQol-VAS scores were 66.47 ± 5.18 for the MFx group and 79.40 ± 7.43 for the FPRPA MFx group, P = 0.022). There was also a strong correlation between patients’ quality of life and knee joint function score index (IKDC score correlation coefficient r=-0.375, Lysholm score correlation coefficient r = 0.497, MOCART score correlation coefficient r = 0.579, VAS score correlation coefficient r = 0.242, T2 value correlation coefficient r=-0.293, P

ABSTRACT Objectives The study aims to understand the return to work (RTW) needs of young and middle‐aged people who have experienced a stroke and to contribute to the development of supportive RTW services. Design A qualitative study employing the phenomenological method. Participants Eleven young and middle‐aged people who have experienced a stroke participated in the study. Methods Semi‐structured in‐depth interviews were conducted and analysed using Colaizzi's 7‐step method to identify and categorize the RTW needs of participants. Results The analysis delineated four overarching thematic categories of RTW needs among the participants: self‐management needs, emphasizing the regulation of symptoms, health maintenance and recovery planning; social support needs, highlighting the significance of workplace accommodations, professional medical guidance, and emotional encouragement from companions and family; the need for information related to returning to work, which includes accessing resources on rehabilitation opportunities, labour rights and professional consultation services; and personal development needs, focusing on fostering self‐worth, identifying growth opportunities and acquiring new skills to adapt to changing professional demands. Conclusion The diverse and comprehensive needs of young and middle‐aged people who have experienced a stroke underscore the importance of multifaceted support from healthcare professionals. This support should encompass medical, psychological, informational and skill‐development aspects and should involve enhanced communication and collaboration with relevant stakeholders to facilitate a successful RTW. Patient or Public Contribution This study was designed without direct involvement from patients or the public in the development of the research question, the design of the study, or the conduct of the research. This decision was informed by the specific focus on qualitative experiences and perceptions of stroke survivors regarding their RTW journey, which relied heavily on personal narratives and subjective accounts collected through individual interviews. However, the insights gained from these narratives have been crucial in shaping the research outcomes, emphasizing the patient‐centred approach to understanding RTW barriers and facilitators. Reporting Method This study followed the SRQR checklist for qualitative studies as its reporting method.

Abstract Persistent biofilm infections pose a critical health threat with their relentless presence and amplified antibiotic resistance. Traditional antibacterial photodynamic therapy can inhibit bacteria extracellularly but struggles to control biofilm formation and virulence. Thus, there is an urgent need to develop photosensitizers, such as ultra‐small gold nanoclusters (AuNCs), that can penetrate biofilms and internalize into bacteria. However, AuNCs still face the challenge of insufficient reactive oxygen species (ROS) production and limited near‐infrared light absorption. This study develops a model of indocyanine green (ICG)‐sensitized AuNCs with atomic‐precision size effect. This approach achieved near‐infrared light absorption while inhibiting radiation transitions, thereby regulating the generation of ROS. Notably, different‐sized AuNCs (Au10NCs, Au15NCs, Au25NCs) yielded varied ROS types, resulting from different energy level distributions and electron transfer rates. ICG‐Au15NCs achieved a treatment efficacy of 99.94% against Staphylococcus aureus infections in vitro and significantly accelerated wound healing in vivo. Moreover, this study highlights the unique role of ICG‐AuNCs in suppressing quorum sensing, virulence, and ABC transporters compared to their larger counterparts. This strategy demonstrates that atomic‐precision size effect of AuNCs paves the way for innovative approaches in antibacterial photodynamic therapy for infection control.

Abstract Background There is still a lack of knowledge about the relationship between metabolic syndrome (MetS) and Parkinson’s disease (PD). This study aimed to determine whether MetS increases PD risk. Methods To identify relevant clinical studies, databases such as PubMed, Embase, and the Cochrane Library were searched in depth from the inception of databases until March 31, 2024. The study evaluated the correlation between MetS and the likelihood of developing PD through the computation of aggregated relative risks (RR) and their respective 95% confidence intervals (CIs) utilizing selnRR and lnRR. Results Seven studies were included in our systematic review. The meta-analysis revealed that patients with MetS have a 0.3-fold increased risk of developing PD (p = 0.001). Furthermore, the analysis revealed a positive correlation between central obesity and the incidence of PD, with an RR of 1.19 (95% CI, 1.16–1.22; p = 0.001), as well as a greater risk of PD in patients with elevated blood pressure, with an RR of 1.13 (95% CI, 1.07–1.19; p = 0.001); elevated serum triglyceride levels, with an RR of 1.09 (95% CI, 1.02–1.15; p = 0.001); lower serum HDL cholesterol levels, with an RR of 1.21 (95% CI, 1.15–1.28; p = 0.001); and elevated plasma fasting glucose levels, with an RR of 1.18 (95% CI, 1.11–1.26; p = 0.001). Conclusion MetS can contribute to the incidence of Parkinson’s disease, with individual components of MetS demonstrating comparable effects.

Abstract Background Osteo-sarcopenia (OS) has become a global public health problem and a frontier research problem, as a combination of sarcopenia (SP) and osteoporosis (OP) diseases. The clinical performances include muscle weakness, systemic bone pain, standing difficulty, even falls and fractures, etc., which seriously affect the patient’s life and work. The pathological mechanism of the OS may be the abnormal metabolism which disrupts the equilibrium stability of the musculoskeletal system. Therefore, this study combined vitamin D (Vit. D) and whole-body vibration training (WBVT) to intervene in subjects of OS, aiming to evaluate the effectiveness and safety of the diagnosis and treatment protocol and to explore the efficacy mechanism. Methods We propose a multicenter, parallel-group clinical trial to evaluate the efficacy and safety of Vit. D combined with WBVT intervention in OS. Subjects who met the inclusion or exclusion criteria and signed the informed consent form would be randomly assigned to the WBVT group, Vit. D group, or WBVT+ Vit. D group. All subjects will be treated for 1 month and followed up after 3 and 6 months. The primary outcomes are lumbar bone mineral density (BMD) and appendicular skeletal muscle mass (ASM) measured by dual-energy X-ray absorptiometry (DXA) and handgrip strength measured by grip strength meter. Secondary outcomes include serum markers of myostatin (MSTN), irisin and bone turnover markers (BTM), SARC-CalF questionnaire, 1-min test question of osteoporosis risk, patient health status (evaluated by the SF-36 health survey), physical performance measurement that includes 5-time chair stand test, 6-m walk, and the short physical performance battery (SPPB). Discussion If Vit. D combined with WBVT can well relieve OS symptoms without adverse effects, this protocol may be a new treatment strategy for OS. After therapeutic intervention, if the serum marker MSTN/irisin is significant, both have the potential to become sensitive indicators for screening OS effective drugs and treatments, which also indicates that WBVT combined with Vit. D plays a role in improving OS by regulating MSTN/irisin. Trial registration Chinese Clinical Trial Registry ChiCTR2400082269 . Registered on March 26, 2024.

Abstract Background The presence of lateral lymph node metastases (LNM) in paediatric patients with papillary thyroid cancer (PTC) is an independent risk factor for recurrence. We aimed to identify risk factors and establish a prediction model for lateral LNM before surgery in children and adolescents with PTC. Methods We developed a prediction model based on data obtained from 63 minors with PTC between January 2014 and June 2023. We collected and analysed clinical factors, ultrasound (US) features of the primary tumour, and pathology records of the patients. Multivariate logistic regression analysis was used to determine independent predictors and build a prediction model. We evaluated the predictive performance of risk factors and the prediction model using the area under the receiver operating characteristic (ROC) curve. We assessed the clinical usefulness of the predicting model using decision curve analysis. Results Among the minors with PTC, 21 had lateral LNM (33.3%). Logistic regression revealed that independent risk factors for lateral LNM were multifocality, tumour size, sex, and age. The area under the ROC curve for multifocality, tumour size, sex, and age was 0.62 (p = 0.049), 0.61 (p = 0.023), 0.66 (p = 0.003), and 0.58 (p = 0.013), respectively. Compared to a single risk factor, the combined predictors had a significantly higher area under the ROC curve (0.842), with a sensitivity and specificity of 71.4% and 81.0%, respectively (cutoff value = 0.524). Decision curve analysis showed that the prediction model was clinically useful, with threshold probabilities between 2% and 99%. Conclusions The independent risk factors for lateral LNM in paediatric PTC patients were multifocality and tumour size on US imaging, as well as sex and age. Our model outperformed US imaging and clinical features alone in predicting the status of lateral LNM.

Abstract Background The aim of this study was to assess the risk factors for anastomotic stricture in esophageal cancer patients undergoing esophagectomy. Esophageal anastomotic stricture is the most common long-term complication for esophagectomy. The risk factors for esophageal anastomotic stricture still remain controversial. Methods MEDLINE, Cochrane Library, and EMBASE were searched to identify observational studies reporting the risk factors for esophageal anastomotic stricture after esophagectomy. A meta-analysis was conducted to investigate the impact of various risk factors on esophageal anastomotic stricture. The GRADE [Grading of Recommendations Assessment, Development and Evaluation] approach was used for quality assessment of evidence on outcome levels. Results This review included 14 studies evaluating 5987 patients.The meta-analysis found that anastomotic leakage (odds ratio [OR]: 2.75; 95% confidence interval[CI]:2.16–3.49), cardiovascular disease [OR:1.62; 95% CI: 1.22–2.16],diabete [OR: 1.62; 95% CI: 1.20–2.19] may be risk factors for esophageal anastomotic stricture.There were no association between neoadjuvant therapy [OR: 0.78; 95% CI:0.62–0.97], wide gastric conduit [OR:0.98; 95% CI: 0.37–2.56],mechanical anastomosis [OR: 0.84; 95% CI:0.47–1.48],colonic interposition[OR:0.20; 95% CI: 0.12–0.35],and transhiatal approach[OR:1.16; 95% CI:0.81–1.64],with the risk of esophageal anastomotic stricture. Conclusions This meta-analysis provides some evidence that anastomotic leakage,cardiovascular disease and diabete may be associated with higher rates of esophageal anastomotic stricture.Knowledge about those risk factors may influence treatment and procedure-related decisions,and possibly reduce the anastomotic stricture rate.

Objective To construct prediction models for moderate/severe bronchopulmonary dysplasia （BPD） in extremely preterm infants at different days after birth. Methods The preterm infants with BPD at a gestational age of < 28 weeks at the Third Affiliated Hospital of Guangzhou Medical University from September 2017 to December 2019 were retrospectively selected. They were divided into the mild-BPD group and moderate/severe-BPD group. The significant variables screened by using single-factor analysis were subject to risk assessment analysis by multivariate Logistic regression analysis. Early prediction models were established， and the predictive performance was validated and evaluated. Results Ninety extremely preterm infants were included in this study， including 58 cases （64.4%） in the mild-BPD group and 32 cases （35.6%） in the moderate/severe-BPD group. Multiple Logistic regression analysis showed birth weight， maternal pre-pregnancy body mass index （BMI） ≥ 25 kg/m2， 1-minute Apgar score≤7 after birth and pneumonia were the influencing factors for moderate/severe BPD at 7 days after birth. Preeclampsia， maternal pre-pregnancy BMI≥25 kg/m2， pneumonia and hsPDA were the risk factors for moderate/severe BPD at 14 days postnatal age. Preeclampsia， maternal pre-pregnancy BMI≥25 kg/m2， days of invasive mechanical ventilation and hsPDA were the risk factors for moderate/severe BPD at 28 days after birth. The area under the receiver operating characteristic （ROC） curve of the prediction models for 7， 14 and 28 days after birth were 0.864 （95% CI 0.776-0.952）， 0.860 （95% CI 0.774-0.946） and 0.863 （95% CI 0.783-0.944）， respectively. A nomogram was constructed based on high risk factors， the calibrated curve was close to the reference line， and the predicted value was close to the actual value， indicating good calibration of the model. Conclusions The risk factors for moderate/severe BPD in preterm infants vary slightly on 7， 14 and 28 days after birth， mainly the birth weight， maternal pre-pregnancy BMI ≥ 25 kg/m2， 1-minute Apgar score≤7， pneumonia， preeclampsia， hsPDA and days of invasive mechanical ventilation. The predictive models based on different factors at different time points have good predictive value， which can provide guidance for clinical practice.

The Mental Health Gap Action Program Intervention Guide (mhGAP-IG) is an international evidence-based intervention to enhance the scalability of non-specialized workforce to address mental, neurological, and substance use disorders, including child mental and behavioral disorders (CMBDs). Implementation in China remains limited. This study sought to adapt the CMBDs-related components of the mhGAP-IG to the local context and assess the educational impacts of the adapted CMBDs-mhGAP-IG in non-specialized settings in Guangdong Province, China. Contextual adaptation was conducted through a four-step process guided by the Consolidated Framework for Implementation Research (CFIR) and the Ecological Validity Model (EVM). Qualitative data were collected via key informant interviews with six mental health experts and two focus group discussions involving seven kindergarten teachers or doctors and six general practitioners (GPs) from primary care centers. A qualitative analysis utilizing deductive and inductive thematic coding was applied. The educational impacts of a two-day training based on the adapted CMBDs-mhGAP-IG were assessed using a pre-post design among 89 participants, including kindergarten teachers or doctors and GPs. Changes in knowledge and stigma toward CMBDs were analyzed using paired t-tests. Qualitative findings identified barriers and facilitators to implementation across four CFIR domains: intervention characteristics, outer setting, inner setting, and characteristic of individuals. Barriers were concentrated in intervention characteristics (e.g., complexity, time and labor costs) and outer setting (e.g., stigma, high treatment cost). Contextual adaptation based on EVM addressed many of these barriers. Quantitative results indicated that the adapted CMBDs-mhGAP-IG training was associated with increased knowledge and reduced stigma toward CMBDs, demonstrating its educational effectiveness. This study identified barriers and facilitators to mhGAP implementation and documented a contextual adaptation process, offering insights into integrating contextual adaptation methods with implementation science. Trainings based on the adapted mhGAP-IG for non-specialists improved knowledge and stigma toward CMBDs, laying the foundation for future effectiveness evaluations.

Summary: There is an urgent need to understand the molecular landscape beyond the conventional cellular landscape, maximizing the translational use and generalized interpretation of state-of-the-art single-cell genomic techniques in biological studies. We introduced a multimodal explainable artificial intelligence (xAI) model Vec3D to identify a joint definition of cellular states and their distribution in a quantified graphic organization as structured molecular landscape (SML). First, Vec3D substantially improves the accuracy and efficiency of multimodal data analysis. Further, an SML was learned on CITE-seq data of human peripheral blood mononuclear cells (PBMCs), simultaneously revealing the predictive multi-label cell state and corresponding joint cell state markers with complementary effects from genes and proteins. Third, Vec3D demonstrated that the spatial-temporal SML efficiently characterizes molecular dynamics of cell lineages during human lung development. Collectively, Vec3D will be a broadly applicable computational method in the principle of “AI-for-biology”, providing a unified framework for understanding cellular homeostasis and imbalance through SML dynamics.

Abstract Mammalian voltage‐gated calcium channels (CaV) play critical roles in cardiac excitability, synaptic transmission, and gene transcription. Dysfunctions in CaV are implicated in a variety of cardiac and neurodevelopmental disorders. Current pharmacological approaches to enhance CaV activity are limited by off‐target effects, drug metabolism issues, cytotoxicity, and imprecise modulation. Additionally, genetically‐encoded channel activators and optogenetic tools are restricted by gene delivery challenges and biosafety concerns. Here a novel terahertz (THz) wave‐based method to upregulate CaV1.2, a key subtype of CaV, and boost CaV1‐mediated Ca2+ signaling in neurons without introducing exogenous DNA is presented. Using molecular dynamics simulations, it is shown that 42.5 THz (7.05 µm, 1418 cm−1) waves enhance Ca2+ conductance in CaV1.2 by resonating with the stretching mode of the ‐COO− group in the selectivity filter. Electrophysiological recordings and Ca2+ imaging confirm that these waves rapidly, reversibly, and non‐thermally increase calcium influx of CaV1.2 in HEK293 cells and induce acute Ca2+ signals in neurons. Furthermore, this irradiation upregulates critical CaV1 signals, including CREB phosphorylation and c‐Fos expression, in vitro and in vivo, without raising significant biosafety risks. This DNA‐free, non‐invasive approach offers a promising approach for modulating CaV gating and Ca2+ signaling and treating diseases characterized by deficits in CaV functions.

A 51-year-old female patient with diabetes mellitus and hypertension, exhibiting poor control of blood sugar and blood pressure, was unexpectedly found to have multiple large adrenal nodules, excessive cortisol secretion, and adrenocorticotropic hormone inhibition. Cortisol levels remained unresponsive to both low-dose and high-dose dexamethasone tests, leading to a diagnosis of primary bilateral macronodular adrenal hyperplasia. Concurrently, elevated blood calcium and parathyroid hormone levels, along with 99mTc-methoxyisobutyl isonitrile (99mTc-MIBI) imaging revealing increased 99mTc-MIBI uptake in the right inferior parathyroid gland, suggest the consideration of primary hyperparathyroidism. This case is presented in light of the uncommon clinical coexistence of primary bilateral macronodular adrenal hyperplasia and primary hyperparathyroidism.

Innovative superabsorbent hydrogels were synthesized from watermelon rind (WR), an abundant agricultural waste. The process involved free radical polymerization of acrylic acid (AA) and acrylamide (AAm) with WR particles activated by ammonium persulfate (APS), resulting in (AA-co-AAm)/WR hydrogels with high equilibrium swelling capacities of 749 ± 32 g/g. Notably, after eight cycles, the WR hydrogel maintained 94.88 % of its initial swelling capacity, significantly outperforming the (AA-co-AAm) hydrogel without WR (13.80 % retention). This durability, combined with excellent water retention across various soil textures and high adsorption capacity for methylene blue (MB), underscores the WR hydrogel as a superior soil moisture conservation agent. This study marks a significant advance in recycling organic waste and enhancing water management in agricultural soils, demonstrating the potential for sustainable hydrogel development.