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Abstract Evidence for the treatment of patients with mild-to-moderate chronic obstructive pulmonary disease (COPD) is limited. The efficacy of N-acetylcysteine (an antioxidant and mucolytic agent) for patients with mild-to-moderate COPD is uncertain. In this multicentre, randomised, double-blind, placebo-controlled trial, we randomly assigned 968 patients with mild-to-moderate COPD to treatment with N-acetylcysteine (600 mg, twice daily) or matched placebo for two years. Eligible participants were 40-80 years of age and had mild-to-moderate COPD (forced expiratory volume in 1 second [FEV1] to forced vital capacity ratio

Abstract Background Acute respiratory distress syndrome (ARDS) is a life-threatening condition frequently encountered in critically ill patients, including those with advanced non-small cell lung cancer (NSCLC). Almonertinib, a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), has shown promise as a first-line treatment for NSCLC with classical EGFR mutations. However, its efficacy in NSCLC patients suffering from ARDS has not been well-documented. Case Presentation We report the case of a 63-year-old Chinese Han female with severe NSCLC complicated by ARDS. Upon hospital admission, the patient exhibited progressive dyspnea and required intubation to maintain oxygenation. Pathological analysis of bronchoalveolar lavage fluid sediment confirmed lung adenocarcinoma, and genetic testing of blood identified an EGFR E19 mutation. The patient was treated with almonertinib, resulting in significant clinical improvement and successful extubation after nine days. Radiographic imaging showed substantial reduction in pulmonary lesions, highlighting the efficacy of almonertinib. Conclusion This case represents the first documented successful treatment of ARDS induced by EGFR E19 mutated NSCLC using almonertinib. The favorable clinical response observed in this critically ill patient suggests that almonertinib may be a viable therapeutic option for managing severe complications in NSCLC. Further research is necessary to corroborate these findings and optimize dosage and toxicity management strategies for broader clinical application.

Pharmacologic treatment of orthopedic diseases is a common challenge for clinical orthopedic surgeons, and as an important step in the stepwise treatment of orthopedic diseases, it is often difficult to achieve satisfactory results with existing pharmacologic treatments. Therefore, it is increasingly important to find new ways to effectively improve the treatment pattern of orthopedic diseases as well as to enhance the therapeutic efficacy. It has been found that metal-organic frameworks (MOFs) possess the advantages of high specific surface area, high porosity, chemical stability, tunability of structure and biocompatibility. Therefore, MOFs are expected to improve the conventional traditional treatment modality for bone diseases. This manuscript reviewed the applications of MOFs in the treatment of common clinical bone diseases and look forward to its future development.

Abstract Background This study examined the association between chest muscles and chronic obstructive pulmonary disease (COPD) and the relationship between chest muscle areas and acute exacerbations of COPD (AECOPD). Methods There were 168 subjects in the non-COPD group and 101 patients in the COPD group. The respiratory and accessory respiratory muscle areas were obtained using 3D Slicer software to analysis the imaging of computed tomography (CT). Univariate and multivariate Poisson regressions were used to analyze the number of AECOPD cases during the preceding year. The cutoff value was obtained using a receiver operating characteristic (ROC) curve. Results We scanned 6342 subjects records, 269 of which were included in this study. We then measured the following muscle areas (non-COPD group vs. COPD group): pectoralis major (19.06 ± 5.36 cm2 vs. 13.25 ± 3.71 cm2, P

Coalbed methane represents an important kind of natural gas resource in many countries. However, the low-concentration property of coalbed methane limits its applications. To gain insight into the combustion kinetics of coalbed methane and facilitate its combustion utilization, this work reports an experimental and kinetic simulation study on the autoignition properties of methane at ultra-lean and lean conditions. A shock-tube (ST) facility is used for ignition delay time (IDT) measurements with equivalence ratios at 0.5, 0.1, and 0.05 with pressure at 2 and 10 bar under the temperature ranging from 1320 to 1850 K. The measured IDTs can be correlated into a general Arrhenius expression, and the equivalence ratio effect on IDTs is then analyzed. Seven detailed chemical kinetic mechanisms are employed to predict the IDTs and statistical error indicators are used to evaluate their performance. Detailed kinetic analysis via sensitivity and reaction path analysis is performed to uncover the kinetic differences among the seven mechanisms. It is shown that some of the reaction paths only exist in the NUIGMech1.3 mechanism, while the other detailed mechanisms do not consider them. Reaction path analysis indicates that the reactions related to O2, OH and O species become more important compared to the reactions involving CH3 and H radicals as the equivalence ratio decreases from lean to ultra-lean conditions. Detailed chemical kinetics analysis is also conducted to demonstrate the uncertainty of key reactions. The present work should be valuable to gain insight into the methane ignition characteristics and to facilitate kinetic mechanism optimization of methane combustion.

Microplastics (MPs), emerging as significant pollutants, have been consistently detected in aquatic environments, with the Yangtze River experiencing a particularly severe level of microplastic pollution, exceeding all other watersheds in China. Polypropylene (PP), the plastic most abundantly found in the middle and lower reaches of the Yangtze River Basin, has less comprehensive research results into its toxic effects. Consequently, the present investigation employed zebrafish as a model organism to delve into the toxicological impacts of polypropylene microplastics (PP-MPs) with a diameter of 5 μm across varying concentrations (300 mg/L and 600 mg/L). Using histopathological, microbiota profiling, and transcriptomic approaches, we systematically evaluated the impact of PP-MPs exposure on the intestine and liver of zebrafish. Histopathological analysis revealed that exposure to PP-MPs resulted in thinner intestinal walls, damaged intestinal mucosa, and hepatic cellular damage. Intestinal microbiota profiling demonstrated that, the richness, uniformity, diversity, and homogeneity of gut microbes significantly increased after the PP-MPs exposure at high concentration. These alterations were accompanied by shifts in the relative abundance of microbiota associated with intestinal pathologies, suggesting a profound impact on the intestinal microbial community structure. Concurrently, hepatic transcriptome analysis and RT-qPCR indicated that the downregulation of pathways and genes associated with cell proliferation regulation and DNA damage repair mechanisms contributed to hepatic cellular damage, ultimately exerting adverse effects on the liver. Correlation analysis between the intestinal microbiota and liver transcriptome profiles further highlighted significant associations between intestinal microbiota and the downregulated hepatic pathways. Collectively, these results provide novel insights into the subacute toxicological mechanisms of PP-MPs in aquatic organisms and highlight the need for further research on the ecological and health risks associated with PP-MPs pollution.

Abstract Background Ferroptosis in alveolar and bronchial epithelial cells is one of the main mechanisms underlying the development of chronic obstructive pulmonary disease (COPD). Sodium pyruvate (NaPyr) is a natural antioxidant in the body, exhibiting anti-inflammatory and antioxidant activities. NaPyr has been used in a Phase II clinical trial as a novel therapy for COPD; however, the mechanism underlying NaPyr-mediated therapeutic benefits in COPD is not well understood. Objective We aimed to assess the protective effects of NaPyr and elucidate its potential mechanism in cigarette smoke extract (CSE)-induced ferroptosis.To minic the inflammatory response and ferroptosis triggered by cigarette smoke in COPD in an invitro cell based system, we expose a human bronchial epithelial cells to CSE. Methods To minic the inflammatory response and ferroptosis triggered by cigarette smoke in COPD in an invitro cell based system, the A549 (human lung carcinoma epithelial cells) and BEAS-2B (bronchial epithelial cells) cell lines were cultured, followed by treatment with CSE. To measure cellular viability and iron levels, we determined the levels of malondialdehyde (MDA), glutathione (GSH), reactive oxygen species (ROS), mitochondrial superoxide (MitoSOX), membrane potential (MMP), and inflammatory factors (tumor necrosis factor [TNF] and interleukin [IL]-8), and examined CSE-induced pulmonary inflammation and ferroptosis. To clarify the molecular mechanisms of NaPyr in COPD therapy, we performed western blotting and real-time PCR (qPCR) to determine the expression of glutathione peroxidase 4 (GPX4), nuclear factor E2-related factor 2 (Nrf2), and cyclooxygenase 2 (COX2). Results We found that NaPyr effectively mitigated CSE-induced apoptosis and improved apoptosis induced by erastin, a ferroptosis inducer. NaPyr significantly decreased iron and MDA levels and increased GSH levels in CSE-induced cells. Furthermore, NaPyr suppressed ferroptosis characteristics, such as decreased levels of ROS, MitoSOX, and MMP. NaPyr significantly increases the expression levels of GPX4 and Nrf2, indicating that activation of the GPX4/Nrf2 axis could inhibit ferroptosis in alveolar and bronchial epithelial cells. More importantly, NaPyr inhibited the secretion of downstream inflammatory factors, including TNF and IL-8, by decreasing COX2 expression levels to suppress CSE-induced inflammation. Conclusion Accordingly, NaPyr could mitigate CSE-induced ferroptosis in alveolar and bronchial epithelial cells by activating the GPX4/Nrf2 axis and decreasing COX2 expression levels. In addition, NaPyr reduced the secretion of inflammatory factors (TNF and IL-8), affording a novel therapeutic candidate for COPD. Graphical Abstract

Nano‐impact (NIE) (also referred to as collision) single‐entity electrochemistry is an emerging technique that enables electrochemical investigation of individual entities, ranging from metal nanoparticles to single cells and biomolecules. To obtain meaningful information from NIE experiments, analysis and feature extraction on large datasets are necessary. Herein, a method is developed for the automated analysis of NIE data based on unsupervised machine learning and template matching approaches. Template matching not only facilitates downstream processing of the NIE data but also provides a more accurate analysis of the NIE signal characteristics and variations that are difficult to discern with conventional data analysis techniques, such as the height threshold method. The developed algorithm enables fast automated processing of large experimental datasets recorded with different systems, requiring minimal human intervention and thereby eliminating human bias in data analysis. As a result, it improves the standardization of data processing and NIE signal interpretation across various experiments and applications.

Background: Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are considered as the first-line treatment for advanced EGFR mutation-positive non-small cell lung cancer (NSCLC). We aimed to analyze the efficacy of EGFR-TKIs treatment in patients with advanced NSCLC of different smoking habits. Methods: We conducted a search for meta-analyses and systematic reviews on the PubMed, MEDLINE, Embase, and the Cochrane Library to address this knowledge gap. Patients were divided into 2 groups: (1) experimental group: treated with EGFR-TKIs or EGFR-TKIs combined with chemotherapy, immunotherapy, antiangiogenesis, radiotherapy and (2) control group: treated with chemotherapy. Progressive-free survival (PFS) and total survival (OS) were adopted for evaluating the efficacy of EGFR-TKIs between experimental group and control group. Results: Eleven studies including 6760 patients were included in the meta-analysis. The results showed that smoking (including previous and current smoking) significantly reduces the PFS and OS in comparison to non-smoking group in the treatment of NSCLC with EGFR-TKIs. In addition, EGFR-TKIs combined with anti-vascular endothelial growth factor therapy can reduce the risk of disease progression in smokers. Conclusions: Our study indicated that smoking significantly reduced the PFS and OS in comparison to non-smoking group in the treatment of NSCLC with EGFR-TKIs.

Abstract Background Sex-related differences in cancer epidemiology, tumor biology, immune system activity, and pharmacogenomics have been suggested to be important considerations for precision cancer control. Here we elucidated systematically sex biases in genetic variants, gene expression profiles, and immunological landscapes of lung adenocarcinoma patients (LUADs) with different ancestry and smoking status. Methods Somatic mutation and mRNA expression data of Asian and Non-Asian LUADs were obtained from public databases. Sex-biased genetic mutations, gene expression, biological pathways, and immune infiltration were identified in the context of smoking status and race. Results Among nonsmokers, male-biased mutations were prevalent in Asian LUADs, while few sex-biased mutations were detected in Non-Asian LUADs. EGFR was the only mutation whose frequency was significantly higher in females than males in both Asian and Non-Asian nonsmokers. More genes exhibited sex-biased expression in Non-Asian LUADs compared to Asian LUADs. Moreover, genes distinctly expressed in females were mainly related to immune-related pathways, whereas those in males were more involved in activation of DNA repair, E2F_targets, and MYC_targets pathways. We also detected sex-specific immune infiltration in the context of genetic variation. In EGFR-mutant LUADs, males had a significantly increased infiltration of CD8 + T cells, whereas resting CD4 + memory T cells were more abundant in females. Additionally, in KRAS-mutant LUADs, CD8 + and CD4 + T cells were more abundant in females than males. In addition, we detected all female patients with high SCGB3A2 expression were exclusively sensitive to immunotherapy, while this phenomenon was not observed in male patients. Conclusions Our findings provided evidence that sex-related molecular and cellular components are involved in shaping tumor distinct genetic and immune features, which might have important impact on personalized targeted and immune therapy.

Based on a multi-source error model, this paper discusses the principle of error element identification and uses the mirror bias method to compensate the geometric errors of a process system. Firstly, a nine-line measurement method to determine the geometric error of the linear feed axes of machine tools is introduced, and the geometric error identification model based on the “nine-line method” is established. Then, using a ballbar mounted in the axial, tangential, and radial directions of the machine, the geometric error elements of the rotation axis are identified by three simple measurements in each direction. Subsequently, for the more common flat vise clamping workpiece in actual production, the workpiece position error is identified by using the traditional process of dimensional chain, and the workpiece attitude error is identified by fitting the angle between the positioning plane and the horizontal plane by the least squares method. Finally, based on the tool position points and tool axis vectors obtained from the multi-source error model, the error compensation value is solved using inverse machine tool kinematics to offset the machining error by mirroring the error value of the same size, and based on the “S-shaped specimen” to compensate the processing experiments, after compensation, the processing error is reduced by 30~45%, verifying the effectiveness of the compensation method.

Abstract Introduction The activation of STING (stimulator of interferon genes) pathway enhances antitumor immunity in small‐cell lung cancer (SCLC), while the DNA damage induced by non‐cGAMP‐based agonists is a potent inducer of STING activity. Here, we investigate the intrinsic expression of STING in cancer cells and evaluate the value of the combination of ATR and TOP1 inhibitors in enhancing antitumor immunity. Methods STING expression was assessed at mRNA and protein levels in SCLC and normal lung tissues. Transcriptomic subsets of SCLC were identified based on STING‐related genes. Distinct mutation and immunogenomic profiles of these subsets were determined. The direct antitumor efficacy and the potential of enhancing antitumor immunity of the strategy using the ATR‐TOP1‐inhibitor combination were tested in SCLC cell lines. Results The intrinsic expression of STING was significantly reduced in SCLC compared to normal lung tissues (p

Abstract Background Small cell lung cancer (SCLC) is an aggressive disease with poor survival. Although molecular and clinical characteristics have been established for SCLC in western patients, limited investigation has been performed for Chinese SCLC patients. Objective In this study, we investigated the genomic features of Chinese SCLC patients. Methods A total of 75 SCLC patients were enrolled. Genomic alterations in 618 selected genes were analyzed by targeted next-generation sequencing. Results Here, we showed that TP53 (77.30%) and RB1 (30.70%) were the most prevalent genes alterations, followed by KMT2D, ALK, LRP1B, EGFR, NOTCH3, AR, CREBBP, ROS1, and BRCA2. And the most common genetic alterations were enriched in the cell cycle signaling pathway (84.00%) of Chinese SCLC patients. DNA damage repair (DDR) pathway analysis showed that the most frequently enriched DDR pathways were fanconi anaemia (FA, 29.41%) and homology recombination (HR, 21.57%). Notably, 9.33% SCLC patients in our cohort had pathogenic or likely pathogenic germline gene variants. Compared with the U Cologne cohort, a higher prevalence in EGFR, AR, BRCA2, TSC1, ATXN3, MET, MSH2, ERBB3 and FOXA1 were found in our cohort; while compared to the data from the Johns Hopkins cohort, a higher mutated frequency in TP53, KMT2D, ALK, and EGFR were found in our cohort. Moreover, a significant association was found between high tumor mutation burden (TMB) and mutations involved in TP53, CREBBP, EPHA3, KMT2D, ALK and RB1. Approximately 33.33% of patients with SCLC harbored at least one actionable alteration annotated by OncoKB, of which one patient had alterations of level 1; seventeen patients had level 3; fifteen patients possessed level 4. Conclusion Our data might provide an insightful meaning in targeted therapy for Chinese SCLC patients.

Lung adenocarcinoma (LUAD) accounts for almost 40% of lung cancers, leading to significant associated morbidity and mortality rates. However, the mechanism of LUAD tumorigenesis remains far from clear. Here, we scanned down‐regulated genes involved in LUAD sourced from The Cancer Genome Atlas and Gene Expression Omnibus data and focused on G protein‐coupled receptor 133 (GPR133). We offer compelling evidence that GPR133 was expressed at low levels in the setting of LUAD, and higher expression was positively related to a better prognosis among patients with LUAD. Functionally, GPR133 inhibited cell proliferation and tumor growth in vitro and in vivo. Regarding the mechanism, flow cytometry assays and western blot assays showed that GPR133 enhanced p21 and decreased cyclin B1 expression, thus triggering LUAD cells at G2/M‐phase arrest. Consistent with this, we evaluated the expression levels of cell‐cycle biomarkers and found that bioinformatics analysis combined with N6‐methyladenosine (methylation at the N6 position in adenosine) RNA immunoprecipitation‐qPCR assay indicated that GPR133 expression was down‐regulated by this modification. Moreover, we observed that methyltransferase‐like 3 was impaired in LUAD, and that it is able to significantly increase levels of GPR133 by enhancing its RNA stability. In conclusion, we found that GPR133 expression was down‐regulated in LUAD via N6‐methyladenosine modification. Increasing GPR133 levels could suppress LUAD cell proliferation and tumor growth.

Since COVID-19 might have a lasting impact on global public health, it is crucial to analyze its effect on drug-resistant bacterial infections in the respiratory system for the prevention and control of hospital infections. This work aimed to investigate the impact of the COVID-19 outbreak on the clinical distribution and antibiotic resistance of bacterial infection among hospitalized patients in the respiratory unit in order to establish strategies to control antibiotic-resistant infections. Electronic clinical data registry records from 2018 to 2022 were retrospectively analyzed. A total of 36,829 clinical specimens, including sputum, bronchoalveolar lavage fluid, blood, and urine, were collected from 16,073 patients admitted to the Guangzhou First People’s Hospital from January 2018 to December 2022. Among them, 2209 samples were culture-positive. The bacterial isolation rates of different types of samples showed a similar trend from 2019 to 2022, with an increase in 2020 and 2022 and a decrease in 2021. Different bacterial species were separated from different types of samples. The most reported pathogens were identified in sputum samples. Gram-positive isolates were prevalent in urine samples, while Gram-negative bacilli were the predominant pathogenic bacteria isolated from respiratory tract and blood samples. Pseudomonas aeruginosa (P. aeruginosa), Acinetobacter baumannii (A. baumannii) complex, and Klebsiella pneumoniae (K. pneumoniae) were the most abundant Gram-negative bacteria in sputum samples, of which A. baumannii complex had the highest resistance to all tested antibiotics except colistin. Notably, there has been a substantial prevalence of carbapenem-resistant P. aeruginosa, A. baumannii, and K. pneumoniae in the past five years. This alarming situation calls for greater attention and precaution with prescribed antibiotics to limit the generation and spread of new multidrug-resistant bacteria and improve therapeutic management.

Psittacosis and Guillain-Barré syndrome are both rare clinical diseases with low incidence, and their combination has rarely been reported. Here, we report a case of Chlamydia psittaci pneumonia combined with Guillain-Barré syndrome. The patient initially presented with high fever, difficulty breathing, and fatigue. Chest computerised tomography indicated large consolidation opacities in both lungs. Metagenomic next-generation sequencing clearly identified the pathogen as C. psittaci. The patient’s fever subsided after targeted antibiotic treatment, but difficulty breathing and fatigue worsened, and the patient developed symmetric limb numbness and weakness. Lumbar puncture, electrophysiological examination, and clinical characteristics were suggestive of Guillain-Barré syndrome, and the symptoms improved after treatment with human immunoglobulin. The results of this study suggest that metagenomic next-generation sequencing is useful for the rapid diagnosis of pulmonary infectious agents. Psittacosis is closely associated with the development of Guillain-Barré syndrome; however, more cases are needed to support this conclusion, and early targeted antibiotic treatment, immunotherapy, and basic supportive treatment are essential for improving outcomes.

DNA methylation is a class of epigenetic modification manner, which is responsible for the inactivation of various tumor suppressors. Recently, long non-coding RNAs (lncRNAs) were revealed to be implicated in a variety of malignancies, including non-small cell lung cancer (NSCLC). However, the contributions of lncRNAs to DNA-methylation-induced oncogenic effects in NSCLC remain largely unknown. In this study, we identified a DNA-methylation-repressed lncRNA DIO3 opposite strand upstream RNA (DIO3OS) in NSCLC. DIO3OS is downregulated in NSCLC, and its low expression is related to poor prognosis. Ectopic expression of DIO3OS repressed NSCLC cell growth and motility and promoted NSCLC cell apoptosis in vitro. DIO3OS also repressed NSCLC tumorigenesis and metastasis in vivo. DIO3OS knockdown exhibited opposite biological effects. DIO3OS competitively bound heterogeneous nuclear ribonucleoprotein K (hnRNPK), repressed the binding of hnRNPK to MYC DNA and MYC mRNA, reduced the promoting roles of hnRNPK on MYC transcription and translation, led to the repression of MYC transcription and translation, and therefore remarkably decreased the expression of MYC and CDC25A, a downstream target of MYC. Additionally, depletion of hnRNPK blocked the tumor-suppressive roles of DIO3OS in NSCLC. In conclusion, these findings identified DIO3OS as an important protective factor against NSCLC via modulating hnRNPK-MYC-CDC25A axis.

Talaromyces marneffei (T. marneffei) is one of the most important opportunistic human pathogens endemic in Southeast Asia. Talaromycosis, which was once regarded as an opportunistic infectious disease in patients with acquired immunodeficiency syndrome, is being increasingly reported in HIV-negative populations. Since T. marneffei infection can be localized or disseminated, patients may present with a variety of symptoms. However, mediastinal infection attributed to T. marneffei is extremely rare. We report the case of a 32-year-old female who manifested a large mediastinal mass and was eventually diagnosed as acute T. marneffei mediastinitis. The patient was HIV-negative and had no direct contact with intermediate hosts. We successfully managed to treat the patient with inhaled amphotericin B deoxycholate and observed lesion absorption in subsequent CT examinations. To our knowledge, this is the first published case of T. marneffei mediastinitis and first use of inhaled antifungal monotherapy on patients with T. marneffei infection.

Microplastic pollution and changes to soil hydraulic characteristics affect the physical properties and functions of soil; however, knowledge remains limited on how microplastics influence soil hydraulic properties. Nonetheless, it is important to understand these relationships to maintain soil health and ensure sustainable land use, especially in the current “plastic age.” This case study explored how different particle sizes (20, 200, and 500 μm) and concentrations (up to 6%) of polypropylene microplastics affect the hydraulic properties of three soil textures (loam, clay, and sand). The results show that addition of microplastic reduced the saturated hydraulic conductivity (Ks) of the three soils by 69.79%, 77.11%, and 95.79%, respectively. These observed adverse effects of microplastics on the infiltration properties of the three studied soils were influenced by particle size, with larger particles having the weakest effect. Furthermore, microplastic addition reduced the water retention capacity of the clay to a greater extent than that of the loam and sand. In the case of clay, the slope of the water characteristic curve (SWRC) increased significantly, whereas the saturated water content (θs) and residual water content (θr) curves decreased significantly. Importantly, the interaction between microplastics and soil alters the soil pore-size distribution and reduces pore availability. Overall, this case study demonstrates the impact of microplastic on the hydraulic properties of different soil textures, which can inform management strategies to minimize the adverse effects of microplastic accumulation on yields where plastics are used in agricultural production.

Abstract Background Life-threatening hemoptysis presents an immediate diagnostic and therapeutic challenge, especially during the perinatal period. Case presentation A 28-year-old perinatal woman with no significant past medical or surgical history presented with repeating hemoptysis and respiratory failure. Computed tomography revealed a 2.1 × 3.2 cm2 inhomogeneous tumorous lesion in the right superior mediastinum and a right main bronchus obstruction along with atelectasis of the right lung. Bronchoscopy showed a tumorous protrusion blocking the right main bronchus with active hemorrhage, and malignancy was suspected. Bronchial artery embolization (BAE) was performed to control the bleeding. The arteriogram revealed tortuosity, dilation and hypertrophy of the right bronchial arteries and aneurysms of the internal thoracic artery (ITA). The bleeding completely stopped after BAE. Bronchoscopy was performed again to remove residual blood clots. The patient recovered soon after the procedure and was discharged. Conclusions Life-threatening hemoptysis concomitant with ITA aneurysms, which may have a misleading clinical diagnosis and treatment options, has not been reported previously in perinatal women. BAE could be used as a first-line treatment irrespective of the underlying causes.

Bismuth telluride (Bi2Te3) has attracted much attention in the field of thermoelectrics since it is one kind of commercial room-temperature thermoelectric material. Herein three kinds of Bi2Te3 thermoelectric fibers with internal tensile stress are fabricated utilizing an optical fiber template method. The effects of internal stress on the microstructure and the electrical transportation of Bi2Te3 thermoelectric fibers are investigated. The Bi2Te3 cores in the fibers are highly crystalline and possess a tensile nanosheet structure with preferential orientation as evidenced by X-ray diffraction and Raman studies. Tensile stress can enhance electrical properties of the fibers. And a paper cup generator covered with 20 pieces of optimized fibers provides a μW-level output power. It is inferred that tensile stress tuning can be an effective tool for the material optimization of thermoelectric performance.

Abstract Background Patients with cardiovascular comorbidities are at high risk of poor outcome from COVID-19. However, how the burden (number) of vascular risk factors influences the risk of severe COVID-19 disease remains unresolved. Our aim was to investigate the association of severe COVID-19 illness with vascular risk factor burden. Methods We included 164 (61.8 ± 13.6 years) patients with COVID-19 in this retrospective study. We compared the difference in clinical characteristics, laboratory findings and chest computed tomography (CT) findings between patients with severe and non-severe COVID-19 illness. We evaluated the association between the number of vascular risk factors and the development of severe COVID-19 disease, using a Cox regression model. Results Sixteen (9.8%) patients had no vascular risk factors; 38 (23.2%) had 1; 58 (35.4%) had 2; 34 (20.7%) had 3; and 18 (10.9%) had ≥4 risk factors. Twenty-nine patients (17.7%) experienced severe COVID-19 disease with a median (14 [7–27] days) duration between onset to developing severe COVID-19 disease, an event rate of 4.47 per 1000-patient days (95%CI 3.10–6.43). Kaplan-Meier curves showed a gradual increase in the risk of severe COVID-19 illness (log-rank P

To address the issues of privacy budget and quality of service in trajectory differential privacy protection,a trajectory differential privacy mechanism integrating prediction disturbance was proposed.Firstly,Markov chain and exponential perturbation method were used to predict the location which satisfies the differential privacy and temporal and spatial security,and service similarity map was introduced to detect the availability of the location.If the prediction was successful,the prediction location was directly used to replace the location of differential disturbance,to reduce the privacy cost of continuous query and improve the quality of service.Based on this,the trajectory privacy budget allocation mechanism based on w sliding window was designed to ensure that any continuous w queries in the trajectory meet the ε-differential privacy and solve the trajectory privacy problem of continuous queries.In addition,a privacy customization strategy was designed based on the sensitivity map.By customizing the privacy sensitivity of semantic location,the privacy budget could be customized to improve its utilization.Finally,the validity of the scheme was verified by real data set experiment.The results illustrate that it offers the better privacy and quality of service.

Background The microbial decomposition of soil organic carbon (SOC) is a major source of carbon loss, especially in ecologically fragile regions (e.g., the Tibetan Plateau), which are also affected by global warming and anthropogenic activities (e.g., fertilization). The inherent differences between bacteria and fungi indicate that they are likely to play distinct roles in the above processes. However, there still have been no reports on that, which is restricting our knowledge about the mechanisms underlying SOC decomposition. Methods A long-term nitrogen (N) and phosphorus (P) addition field experiment was conducted to assess their effects on soil microbial, fungal, and bacterial respiration (RM, RF, and RB, respectively) and temperature sensitivity (Q10; at 15 °C, 25 °C, and 35 °C) using cycloheximide and streptomycin to inhibit the growth of fungi and bacteria. Results We found that N suppressed RM and RF at all temperatures, but RB was only suppressed at 15 °C, regardless of the addition of P. The addition of N significantly decreased the ratio of RF/RM at 35 °C, and the combined NP treatment increased the Q10 of RB but not that of RF. Results of the redundancy analysis showed that variations in soil respiration were linked with NO3−-N formation, while the variations in Q10 were linked with SOC complexity. Long-term N addition suppressed RM by the formation of NO3−-N, and this was mediated by fungi rather than bacteria. The contribution of fungi toward SOC decomposition was weakened by N addition and increasing temperatures. Combined NP addition increased the Q10 of RB due to increased SOC complexity. The present study emphasizes the importance of fungi and the soil environment in SOC decomposition. It also highlights that the role of bacteria and SOC quality will be important in the future due to global warming and increasing N deposition.

As an important alternative to alleviate the shortage of wild fishery resources, mariculture is facing increasing challenges on the wastewater treatment, mainly due to the salinity brought from seawater and low nutrient concentration. In this study, Spirulina platensis (S. platensis) was adopted as the target algae stain for synthetic mariculture wastewater treatment, which exhibited excellent adaptability to high-saline wastewater during a 40 days’ adaptive culture. Then, the microalgae stain was inoculated into photo-bioreactors with different uplift airflow velocity (UAV) to achieve microalgal aggregation. After 10 days of pre-cultivation and a 30-day granulation process, the maximum nutrient removal rates by S. platensis were 86.5% of TN (to 3.4 mg/L), 98.1% of TP (to 0.1 mg/L) and 95.8% of DOC (to 5.5 mg/L), with 3.5 g/L of biomass content in synthetic wastewater. Analysis of phosphorus and EPS content showed that higher protein content in tightly bound EPS and enhanced P accumulation was accompanied with the microalgal aggregation processes, and P was mainly distributed in the residual rather than the EPS part of microalgal aggregates, indicating that the development of aggregates from suspension S. platensis would benefit not only biomass separation, but also phosphorus recovery, being a potential treatment for simultaneously removing nutrients and recovering mariculture wastewater.

Background: Malignant fibrous histiocytoma (MFH) is a common type of soft tissue sarcoma and a serious threat to human health. MFH often relapses locally after the curettage is related to the residual cancer stem cells (CSCs). Currently, the dysregulation of microRNA (miRNA) has been found to be closely related to the recurrence of CSCs. However, whether dysregulations of miRNAs exist in MFH, CSCs remained unknown.Methods: In this study, miRNAs in MFH CSCs and MFH common cells were examined by gene probe. Then, target genes and their functions involved in the signal pathway were predicted by the relevant database. Finally, the miRNAs’ target regulatory network was constructed. Furthermore, the miRNAs and target genes were identified by quantitative polymerase chain reaction, whereas miRNA analogs and antagonists were transfected in tumor cells to investigate cell proliferation ability further.Results: Results showed that a total of 47 miRNAs were found, including 16 that were upregulated and 31 that were downregulated. The screened differential miRNA showed a different expression in the cell resistant strains compared with the control group. Quantitative polymerase chain reaction analysis confirmed that the relative abundance of seven miRNAs and four target genes varied significantly. The encouraging issue is that we found Hsa-miR-206 significantly inhibited MFH proliferative activity.Conclusion: Hsa-miR-206 played a key role in regulating MFH CSC properties that might be a representative marker and target for the diagnosis and treatment of MFH in the future.

Water management is a key issue in the design and operation of proton exchange membrane fuel cells (PEMFCs). For an efficient and stable operation, the accumulation of liquid water inside the flow channels has to be prevented. Existing measurement methods for localizing water are limited in terms of the integration and application of measurements in operating PEMFC stacks. In this study, we present a measurement method for the localization of liquid water based on ultrasonic guided waves. Using a sparse sensing array of four piezoelectric wafer active sensors (PWAS), the measurement requires only minor changes in the PEMFC cell design. The measurement method is demonstrated with ex situ measurements for water drop localization on a single bipolar plate. The wave propagation of the guided waves and their interaction with water drops on different positions of the bipolar plate are investigated. The complex geometry of the bipolar plate leads to complex guided wave responses. Thus, physical modeling of the wave propagation and tomographic methods are not suitable for the localization of the water drops. Using machine learning methods, it is demonstrated that the position of a water drop can be obtained from the guided wave responses despite the complex geometry of the bipolar plate. Our results show standard deviations of 4.2 mm and 3.3 mm in the x and y coordinates, respectively. The measurement method shows high potential for in situ measurements in PEMFC stacks as well as for other applications that require deposit localization on geometrically complex waveguides.

Carbapenem-resistant Klebsiella pneumoniae (CRKP) are usually multidrug resistant (MDR) and cause serious therapeutic problems. Colistin is a critical last-resort therapeutic option for MDR bacterial infections. However, increasing colistin use has led to the emergence of extensively drug-resistant (XDR) strains, raising a significant challenge for healthcare. In order to gain insight into the antibiotic resistance mechanisms of CRKP and identify potential drug targets, we compared the molecular characteristics and the proteomes among drug-sensitive (DS), MDR, and XDR K. pneumoniae strains. All drug-resistant isolates belonged to ST11, harboring blaKPC and hypervirulent genes. None of the plasmid-encoded mcr genes were detected in the colistin-resistant XDR strains. Through a tandem mass tag (TMT)-labeled proteomic technique, a total of 3531 proteins were identified in the current study. Compared to the DS strains, there were 247 differentially expressed proteins (DEPs) in the MDR strains and 346 DEPs in the XDR strains, respectively. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis revealed that a majority of the DEPs were involved in various metabolic pathways, which were beneficial to the evolution of drug resistance in K. pneumoniae. In addition, a total of 67 DEPs were identified between the MDR and XDR strains. KEGG enrichment and protein–protein interaction network analysis showed their participation in cationic antimicrobial peptide resistance and two-component systems. In conclusion, our results highlight the emergence of colistin-resistant and hypervirulent CRKP, which is a noticeable superbug. The DEPs identified in our study are of great significance for the exploration of effective control strategies against infections of CRKP.

This paper proposes a novel 1D-3D approach for the stability characteristics of the hydropower generation system (HGS) in transition processes. First, a 1D-3D coupling model was established for the HGS in the load-reduction process. Second, a sensitivity analysis of the HGS’s parameters to the rotation speed and discharge was conducted. Third, the pressure pulsation characteristics of the HGS with three typical guide vane openings were analyzed during the load-reduction process. The results show that with the closure of the guide vane, the discharge gradually decreases and it is sensitive to the change in hydraulic parameters. The rotation speed fluctuates at the early stage of the transition process and is easily affected by mechanical parameters. In addition, the pressure pulsation inside the Francis turbine is more intense under small openings than large openings, and the primary frequency of pressure pulsation under three opening degrees is the blade frequency. The 1D-3D coupling model successfully integrates the advantages of traditional methods and provides a reference for predicting system stability and exploring the stability mechanism.

Vehicles sent location information to third parties to obtain location-based services in the Internet of vehicles,which may lead to vehicle trajectory privacy leakage.To address the privacy problem,trajectory privacy protection mechanism of obfuscating paths based on vehicles cooperation was proposed.Firstly,after the vehicle trajectory entropy reaches the custom trajectory protection threshold,the overhead of paths confusion saves by reducing the number of vehicle paths confusion.Then,paths confusion algorithm was designed to increase chances of vehicle paths confusion at intersections,which can improve the degree of vehicle trajectory protection.Finally,the simulation experiment verified the validity and efficiency of the method from the trajectory entropy and trajectory tracking success rate.

Protein-based nanocarriers with inherent biocompatibility have been widely served as building blocks to construct versatile therapeutic nanoplatforms. Herein, bovine serum albumin-iridium oxide nanoparticles (denoted BSA-IrO2 NPs) are successfully synthesized via one-step biomineralization approach. The BSA-IrO2 NPs exhibits uniform size (40 nm), superb biocompatibility and high drug loading capacity for doxorubicin (27.4 wt%). Under near-infrared (NIR) laser irradiation, the as-prepared BSA-IrO2 NPs exhibited high photothermal conversion ability (54.3%) and good photostability. The in vitro drug release experiments displayed pH and NIR laser -triggered DOX release profiles, which could enhance the therapeutic anticancer effect. By utilizing this DOX loaded nanoplatform, effective synergistic chemo-photothermal therapy against human osteosarcoma can be realized, which has been systematically verified both in vitro and in vivo. Notably, in vivo pharmacokinetics studies showed that BSA-IrO2@DOX had prolonged blood circulation time due to the BSA component can improve the stealthiness of the nanoparticles during the blood circulation. Meanwhile, in vitro and in vivo toxicity studies demonstrated that the BSA-IrO2 NPs can act as biocompatible agents for drug delivery and cancer therapy. Therefore, this work presents a biomineralized iridium-based NPs with remarkable features and be used as a very potential therapeutic nanoplatform for cancer treatment.

Artificial grasslands have been regarded as an effective method to improve grass production and quality, especially on the Qinghai–Tibet Plateau. Soil ecosystem multifunctionality (EMF) plays an important role in sustainable regional development. However, few studies have investigated the impacts of artificial grasslands on soil EMF. Here, we constructed single-species artificial grasslands in a natural temperate steppe and investigated soil microbial communities, abiotic factors (soil moisture and pH), and functions related to biogeochemical cycles to explore (1) how the transformation from temperate steppe to artificial grasslands affected soil EMF and (2) the roles of species and phylogenetic microbial diversities, microbial community composition, and abiotic factors in driving differences in soil EMF. Our results showed that artificial grasslands decreased soil EMF regardless of planting species; that the bacterial and fungal community composition contributed more to soil EMF prediction than species and phylogenetic diversities; and that microbial phylogenetic diversities were negatively associated with soil EMF. Soil pH played an important role in the effects of artificial grasslands on soil EMF—artificial grasslands increased soil pH, which was negatively associated with soil EMF. Overall, the benefits of establishing artificial grasslands, for example, higher grass production and quality, might be at the expense of soil EMF. Further studies should explore mixed-species artificial grasslands.

The penetration of multiple integrated renewable energies to the power grid are relevant for decision making in energy policy, environment and business. Such an electricity penetration is affected by the intermittent and volatile characteristics of integrated energies, mostly significantly related to the safe and stable electricity production and supply in real world. Here, this paper focuses on the low frequency oscillation analysis of the hydropower generation response to the wind and solar variability. To enable this analysis, a hybrid model of hydropower system integrating with the wind and solar power system is presented. The Nyquist and root-locus stability methods are used to investigate the sensitivity performance of the hydropower governor to the fluctuation of the integrated renewable energies. Additionally, to quantify the risk of the hybrid system, the low frequency oscillation response of hydropower system to wind/solar/hydropower quota and transmission line distance ratio is extensively investigated in this study. The results show that under the case of the wind, solar and hydropower ratio is 40:1:150, the optimal values for maximally reducing hydropower low frequency oscillation are finally determined as kp = 0.8, ki = 0.25 and kd = 0.5. Regarding a certain wind/solar/hydropower quota, it is a promising strategy to increase the solar-load transmission line in order to achieve the safe and stable operation of the hybrid system and a relatively excellent dynamic regulation capacity of the hydropower governor. The model, methods and results implemented in this study are exploited to markedly improve new knowledge applications, policy management, low carbon emissions and investment competitiveness of future energy systems.

The fabrication and characterization of Si1-xGex core fiber have attracted much attention because of its great application potential in new optoelectronic devices. In this work, by assembling two semi-cylindrical monocrystalline Si and Ge rods into a silica tube, we present a fabrication method to draw Si1-xGex core silica clad fiber with graphite furnace. Raman spectra analysis reveals that in all regions of the core formed the Si1-xGex alloy. The optical microscopic photograph shows that in the core of a diameter of 36 μm distributed the bright and dark regions, where it was further proved by Raman spectroscopy that the bright regions are Ge-rich areas and the dark regions are rich in silicon. By recording the Raman spectra of consecutive regions, it was found that with the increase of Ge content (x

INTRODUCTION:Multidrug-resistant Acinetobacter baumannii (A. baumannii) has become one of the greatest threats worldwide to the therapeutic management of infections. Our previous research confirmed an in vitro synergistic effect of amlodipine and imipenem against A. baumannii, and this study is designed to understand its mechanism. METHODS:Sixty-four non-duplicate A. baumannii isolates were collected and tested for antimicrobial susceptibility by the disk diffusion method. PCR amplification and sequencing were used to identify the presence of the adeB, adeE, adeH, adeJ, abeM and abeS efflux pump genes. The minimal inhibitory concentrations of imipenem, imipenem+amlodipine and imipenem+carbonyl cyanide m-chlorophenyl-hydrazone against these isolates were also determined by the broth microdilution method before and after siRNA silencing of the expression of the adeABC efflux pump. RESULTS:In this study, the combination of amlodipine with imipenem showed synergistic antimicrobial activity against sixty-four A. baumannii isolates when compared with the activity of imipenem alone (p