Octopuses,due to their flexible arms,marvelous adaptability,and powerful suckers,are able to effortlessly grasp and disengage various objects in the marine surrounding without causing devastation.However,manipulating ...Octopuses,due to their flexible arms,marvelous adaptability,and powerful suckers,are able to effortlessly grasp and disengage various objects in the marine surrounding without causing devastation.However,manipulating delicate objects such as soft and fragile foods underwater require gentle contact and stable adhesion,which poses a serious challenge to now available soft grippers.Inspired by the sucker infundibulum structure and flexible tentacles of octopus,herein we developed a hydraulically actuated hydrogel soft gripper with adaptive maneuverability by coupling multiple hydrogen bond-mediated supramolecular hydrogels and vat polymerization three-dimensional printing,in which hydrogel bionic sucker is composed of a tunable curvature membrane,a negative pressure cavity,and a pneumatic chamber.The design of the sucker structure with the alterable curvature membrane is conducive to realize the reliable and gentle switchable adhesion of the hydrogel soft gripper.As a proof-of-concept,the adaptive hydrogel soft gripper is capable of implement diversified underwater tasks,including gingerly grasping fragile foods like egg yolks and tofu,as well as underwater robots and vehicles that station-keeping and crawling based on switchable adhesion.This study therefore provides a transformative strategy for the design of novel soft grippers that will render promising utilities for underwater exploration soft robotics.展开更多
Wireless sensor networks (WSNs) operate in complex and harshenvironments;thus, node faults are inevitable. Therefore, fault diagnosis ofthe WSNs node is essential. Affected by the harsh working environment ofWSNs and ...Wireless sensor networks (WSNs) operate in complex and harshenvironments;thus, node faults are inevitable. Therefore, fault diagnosis ofthe WSNs node is essential. Affected by the harsh working environment ofWSNs and wireless data transmission, the data collected by WSNs containnoisy data, leading to unreliable data among the data features extracted duringfault diagnosis. To reduce the influence of unreliable data features on faultdiagnosis accuracy, this paper proposes a belief rule base (BRB) with a selfadaptivequality factor (BRB-SAQF) fault diagnosis model. First, the datafeatures required for WSN node fault diagnosis are extracted. Second, thequality factors of input attributes are introduced and calculated. Third, themodel inference process with an attribute quality factor is designed. Fourth,the projection covariance matrix adaptation evolution strategy (P-CMA-ES)algorithm is used to optimize the model’s initial parameters. Finally, the effectivenessof the proposed model is verified by comparing the commonly usedfault diagnosis methods for WSN nodes with the BRB method consideringstatic attribute reliability (BRB-Sr). The experimental results show that BRBSAQFcan reduce the influence of unreliable data features. The self-adaptivequality factor calculation method is more reasonable and accurate than thestatic attribute reliability method.展开更多
Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in s...Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in spinal cord injury.Previous studies have shown that microglia can promote neuronal survival by phagocytosing dead cells and debris and by releasing neuroprotective and anti-inflammatory factors.However,excessive activation of microglia can lead to persistent inflammation and contribute to the formation of glial scars,which hinder axonal regeneration.Despite this,the precise role and mechanisms of microglia during the acute phase of spinal cord injury remain controversial and poorly understood.To elucidate the role of microglia in spinal cord injury,we employed the colony-stimulating factor 1 receptor inhibitor PLX5622 to deplete microglia.We observed that sustained depletion of microglia resulted in an expansion of the lesion area,downregulation of brain-derived neurotrophic factor,and impaired functional recovery after spinal cord injury.Next,we generated a transgenic mouse line with conditional overexpression of brain-derived neurotrophic factor specifically in microglia.We found that brain-derived neurotrophic factor overexpression in microglia increased angiogenesis and blood flow following spinal cord injury and facilitated the recovery of hindlimb motor function.Additionally,brain-derived neurotrophic factor overexpression in microglia reduced inflammation and neuronal apoptosis during the acute phase of spinal cord injury.Furthermore,through using specific transgenic mouse lines,TMEM119,and the colony-stimulating factor 1 receptor inhibitor PLX73086,we demonstrated that the neuroprotective effects were predominantly due to brain-derived neurotrophic factor overexpression in microglia rather than macrophages.In conclusion,our findings suggest the critical role of microglia in the formation of protective glial scars.Depleting microglia is detrimental to recovery of spinal cord injury,whereas targeting brain-derived neurotrophic factor overexpression in microglia represents a promising and novel therapeutic strategy to enhance motor function recovery in patients with spinal cord injury.展开更多
Solid lubricating coatings play a crucial role in preventing friction and wear failure of the hot-end sliding components in aviation engines.In this study,VAlN/Ag multi-layer coatings with excellent interfacial matchi...Solid lubricating coatings play a crucial role in preventing friction and wear failure of the hot-end sliding components in aviation engines.In this study,VAlN/Ag multi-layer coatings with excellent interfacial matching were fabricated using a hybrid magnetron sputtering technique.The type and energy of discharge plasmas were analyzed to comprehend their effects on depositing coatings.The coatings exhibit self-adaptive lubrication properties during the designed consecutive friction with stepwise heating from 25℃to 650℃.The microstructure evolution during early friction facilitates sufficient tribo-chemical reaction at 650℃,leading to the formation of a distinctive"ball-on-rail"structure that significantly reduces friction coefficient.Based on the first-principles calculations,it was found that the bond energy of Ag-O is lower than that of V-O in both AgVO_(3)and Ag_(3)VO_(4),which promotes slipping along the(110)crystal plane and contributes to exceptional tribological properties.The fatigue wear failure mechanism of hard coatings under the thermal-force coupling effects has been elucidated,alongside an exploration of consecutive tribology mechanism at atomic scales over a wide temperature range.展开更多
Gecko-inspired van der Waals force-based adhesion technology demonstrates significant potential for robotic operations.While superior adhesion is achieved under parallel contact during testing,engineering operations o...Gecko-inspired van der Waals force-based adhesion technology demonstrates significant potential for robotic operations.While superior adhesion is achieved under parallel contact during testing,engineering operations often involve non-parallel contact,weakening adhesion,and compromising task stability and efficiency.Stable attachment under such non-parallel contacts remains challenging.Inspired by the soft muscle and rigid bone in the gecko’s sole,this study proposes a self-adaptive core-shell dry adhesive by embedding a thin,rigid piece into a soft,thick elastomer comprising a top adhesion tip with a mushroom-like geometry for interfacial adhesion based on the van der Waals force and a bottom core-shell configuration for interface stress regulation.Unlike traditional core-shell structures with a fixed“dead core,”the proposed“live core”rotates within the soft shell,mimicking skeletal joints.This enables stress equalization at the interface and facilitates adaptive contact to macroscopic interfacial angle errors.This innovative core-shell configuration demonstrates an adhesion strength 100 times higher than conventional homogeneous structures under non-parallel contact and offers anti-overturning ability by mitigating torsional effects.The proposed strategy can advance the development of gecko-inspired adhesion-based devices and systems.展开更多
This systematic review synthesizes empirical research on external risk factors for adolescent smartphone addiction.Scopus and Web of Science were searched for English peer-reviewed empirical articles from 2008 onward;...This systematic review synthesizes empirical research on external risk factors for adolescent smartphone addiction.Scopus and Web of Science were searched for English peer-reviewed empirical articles from 2008 onward;28 met inclusion criteria(excluding non-adolescents,generic internet addiction,non-empirical work,or non-English).Thematic synthesis organized findings into three external risk domains—family,school,and peers—considering cultural/contextual mechanisms.Family dynamics(parental phubbing,harsh parenting,dysfunction),school stressors,and adverse peer relationships were identified as accumulating,direct and indirect contributors to smartphone addiction.These operate within a techno-ecological framework,where digital technologies amplify vulnerabilities and create new pathways for maladaptive use.Evidence favors an ecological,multi-level perspective.Future research should use longitudinal designs,standardize measures across cultures,and examine understudied regions—especially Africa—to guide culturally sensitive interventions.展开更多
BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and dep...BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and depression(PSD)do not receive sufficient attention.AIM To systematically evaluate risk factors and early identification markers for PSD for more precise screening and intervention strategies in clinical practice.METHODS This retrospective study analyzed clinical data from 112 patients with ischemic stroke admitted between January 2022 and December 2024.Based on assessments using the Hamilton Rating Scale for Anxiety(HAMA)and Hamilton Rating Scale for Depression(HAMD)at 2 weeks(±3 days)post-stroke,patients were classified into the PSD group(HAMA≥7 and/or HAMD≥7)and the non-PSD group(HAMA<7 and HAMD<7).Observation indicators included psychological assessment,demographic and clinical characteristics,stroke-related clinical indicators,neuroimaging assessments,and laboratory biomarkers.Multivariate logistic regression analysis was used to identify independent risk factors for PSD,and receiver operating characteristic curve analysis was used to evaluate the diagnostic value of potential biomarkers.RESULTS Of the 112 patients,46(41.1%)were diagnosed with PSD.Multivariate analysis identified five independent risk factors:Female gender[Odds ratio(OR)=2.32,95%confidence interval(CI):1.56-3.45],history of mental disorders prior to stroke(OR=3.17,95%CI:1.89-5.32),infarct location in the frontal lobe or limbic system(OR=2.86,95%CI:1.73-4.71),stroke severity with National Institutes of Health Stroke Scale≥8 at admission(OR=2.54,95%CI:1.62-3.99),and low social support(Social Support Rating Scale<35,OR=2.18,95%CI:1.42-3.36).Subgroup analysis showed that depression patients more commonly had left hemisphere lesions(68.4%vs 45.2%),while anxiety patients more frequently presented with right hemisphere lesions(59.5%vs 39.5%).The PSD group exhibited larger infarct volumes(8.7 cm^(3) vs 5.3 cm^(3)),more severe white matter hyperintensities,and more pronounced frontal lobe atrophy.Analysis of inflammatory markers showed significantly elevated levels of interleukin-6(7.8 pg/mL vs 4.5 pg/mL)and tumor necrosis factor-alpha(15.6 pg/mL vs 9.8 pg/mL)in the PSD group,while hypothalamicpituitary-adrenal axis function assessment revealed higher cortisol levels(386.5±92.3 nmol/L vs 328.7±75.6 nmol/L)and flattened diurnal rhythm in the PSD group.CONCLUSION PSD is a complex neuropsychiatric consequence of stroke involving disruption of the frontal-limbic circuitry,neuroinflammatory responses,and dysfunction of the hypothalamic-pituitary-adrenal axis.展开更多
Strokes include both ischemic stroke,which is mediated by a blockade or reduction in the blood supply to the brain,and hemorrhagic stroke,which comprises intracerebral hemorrhage and subarachnoid hemorrhage and is cha...Strokes include both ischemic stroke,which is mediated by a blockade or reduction in the blood supply to the brain,and hemorrhagic stroke,which comprises intracerebral hemorrhage and subarachnoid hemorrhage and is characterized by bleeding within the brain.Stroke is a lifethreatening cerebrovascular condition characterized by intricate pathophysiological mechanisms,including oxidative stress,inflammation,mitochondrial dysfunction,and neuronal injury.Critical transcription factors,such as nuclear factor erythroid 2-related factor 2 and nuclear factor kappa B,play central roles in the progression of stroke.Nuclear factor erythroid 2-related factor 2 is sensitive to changes in the cellular redox status and is crucial in protecting cells against oxidative damage,inflammatory responses,and cytotoxic agents.It plays a significant role in post-stroke neuroprotection and repair by influencing mitochondrial function,endoplasmic reticulum stress,and lysosomal activity and regulating metabolic pathways and cytokine expression.Conversely,nuclear factor-kappa B is closely associated with mitochondrial dysfunction,the generation of reactive oxygen species,oxidative stress exacerbation,and inflammation.Nuclear factor-kappa B contributes to neuronal injury,apoptosis,and immune responses following stroke by modulating cell adhesion molecules and inflammatory mediators.The interplay between these pathways,potentially involving crosstalk among various organelles,significantly influences stroke pathophysiology.Advancements in single-cell sequencing and spatial transcriptomics have greatly improved our understanding of stroke pathogenesis and offer new opportunities for the development of targeted,individualized,cell typespecific treatments.In this review,we discuss the mechanisms underlying the involvement of nuclear factor erythroid 2-related factor 2 and nuclear factor-kappa B in both ischemic and hemorrhagic stroke,with an emphasis on their roles in oxidative stress,inflammation,and neuroprotection.展开更多
BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making ...BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making it a signifi cant public health concern.This study is to determine the prevalence and factors associated with acute pain among emergency trauma patients.METHODS:A multicenter cross-sectional study was conducted.Data were collected via interviewer-administered questionnaires and patient chart review.The data were analyzed via the statistical package for social science version 25.Bivariable and multivariable logistic regression analyses were used.Variables with a P-value<0.05 were considered statistically signifi cant.RESULTS:A total of 397 patients were included in the study,for a response rate of 96.8%.The prevalence of pain during admission was 91.9%(95%confi dence intervals[95%CIs]:88.8%-94.4%).Blunt trauma(adjusted odds ratio[aOR]=2.82;95%CI:1.23-6.45),analgesia before admission to the emergency department(aOR=2.71;95%CI:1.16-6.36),documentation of pain severity in the chart(aOR=2.71;95%CI:1.16-6.36),analgesia provided within two hours after admission(aOR=7.60;95%CI:2.79-20.68),use of non-pharmacological pain management methods(aOR=3.09;95%CI:1.35-7.08)and availability of analgesia(aOR=3.95;95%CI:1.36-11.43)were associated with acute pain experience.CONCLUSION:The prevalence of acute pain among emergency trauma patients was high in the study area.Analgesia should be administered prior to admission,and non-pharmacological pain management should be implemented.Moreover,training on pain assessment and management should be provided for healthcare providers in the emergency department.展开更多
Nerve trauma commonly results in chronic neuropathic pain. This is by triggering the release of proinflammatory mediators from local and invading cells that induce inflammation and nociceptive neuron hyperexcitability...Nerve trauma commonly results in chronic neuropathic pain. This is by triggering the release of proinflammatory mediators from local and invading cells that induce inflammation and nociceptive neuron hyperexcitability. Even without apparent inflammation, injury sites are associated with increased inflammatory markers. This review focuses on how it might be possible to reduce neuropathic pain by reducing inflammation. Physiologically, pain is resolved by a combination of the out-migration of pro-inflammatory cells from the injury site, the down-regulation of the genes underlying the inflammation, up-regulating genes for anti-inflammatory mediators, and reducing nociceptive neuron hyperexcitability. While various techniques reduce chronic neuropathic pain, the best are effective on < 50% of patients, no technique reliably or permanently eliminates neuropathic pain. This is because most techniques are predominantly aimed at reducing pain, not inflammation. In addition, while single factors reduce pain, increasing evidence indicates significant and longer-lasting pain relief requires multiple factors acting simultaneously. Therefore, it is not surprising that extensive data indicate that the application of platelet-rich plasma provides more significant and longer-lasting pain suppression than other techniques, although its analgesia is neither complete nor permanent. However, several case reports indicate that platelet-rich plasma can induce permanent neuropathic pain elimination when the platelet concentration is significantly increased and is applied to longer nerve lengths. This review examines the primary triggers of the development and maintenance of neuropathic pain and techniques that reduce chronic neuropathic pain. The application of plateletrich plasma holds great promise for providing complete and permanent chronic neuropathic pain elimination.展开更多
BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite imp...BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite improved renal function.It is potentially associated with an increased risk of cardiovascular events,renal osteodystrophy,pathologic fractures,graft loss,and mortality.AIM To evaluate the incidence,risk factors,and outcomes of PT-tHPT amongst kidney transplant recipients.METHODS A total of 887 transplant recipients who underwent transplantation between 2000 and 2020 were evaluated.Univariable and multivariable logistic regression was performed to determine the predictors of tertiary hyperparathyroidism.Graft and recipient outcomes were assessed using multivariable Cox regression.A separate multivariable Cox regression was performed to determine the effect of treatment strategies on outcomes.RESULTS PT-tHPT,defined as elevated PTH(>65 ng/L)and persistent hypercalcemia(>2.60 mmol/L),was diagnosed in 14%of recipients.Risk factors for PT-tHPT included older age[odds ratio(OR)=1.36,P<0.001],Asian ethnicity(OR=0.33,P=0.006),total ischemia time(OR=1.03,P=0.048 per hour),pre-transplant serum calcium(OR=1.38,P<0.001)per decile increase,pre-transplant PTH level(OR=1.31,P<0.001)per decile increase,longer dialysis duration(OR=1.12,P=0.002)per year,history of acute rejection(OR=2.37,P=0.012),and slope of estimated glomerular filtration rate change(OR=0.91,P=0.001).There were a 3.4-fold higher risk of death-censored graft loss and a 1.9-fold greater risk of recipient death with PT-tHPT.The three treatment strategies of conservative management,calcimimetic and parathyroidectomy did not significantly change the graft or patient outcome.CONCLUSION Pretransplant elevated calcium and PTH levels,older age and dialysis duration are associated with PT-tHPT.While PT-tHPT significantly affects graft and recipient survival,the treatment strategies did not affect survival.展开更多
Background:The trajectory of intrinsic capacity(IC)among the older population is characterized by its diversity and is predictive of adverse health outcomes such as disability,nursing home admission,decline in quality...Background:The trajectory of intrinsic capacity(IC)among the older population is characterized by its diversity and is predictive of adverse health outcomes such as disability,nursing home admission,decline in quality of life,and mortality.Gaining an understanding of the trajectory of IC and the factors that influence it is of paramount importance for fostering healthy aging.This research is focused on exploring the trajectory of IC among older adults in China and examining the factors that influence it.Methods:This observational longitudinal cohort study leveraged data from the China Health and Retirement Longitudinal Study(CHARLS),which was conducted in the years 2011,2013,and 2015.For the purpose of this analysis,a total of 2,233 participants who were aged 60 and over were included.A Growth Mixture Model(GMM)was utilized to define trajectory categories for IC.Influential factors were ascertained based on the health ecology model,and binary logistic regression analysis was utilized to investigate the factors linked with the different trajectory categories.Results:Two distinct trajectory classes of IC were identified:Class 1,the normal-stable group,encompassed 90.4%of the elderly population,while Class 2,the declining group,made up 9.6%.Advanced age and a history of stroke were found to be significantly associated with Class 2.High scores in activities of daily living(ADL),employment status,receiving primary or junior high school education,and residence in the East or Central regions of China were significantly linked with Class 1.Conclusion:The trajectory of IC among older Chinese adults is marked by its heterogeneity.Advanced age and a history of stroke are significant risk factors for a declining IC trajectory,while higher ADL scores,being employed,receiving primary or junior high school education,and residing in the East or Central regions of China are protective factors associated with a stable IC trajectory.Healthcare institutions must closely monitor IC levels and understand these trajectory patterns to implement personalized and targeted interventions promptly to maintain IC at a healthy level and advocate for healthy aging.展开更多
Landslides pose a formidable natural hazard across the Qinghai-Tibet Plateau(QTP),endangering both ecosystems and human life.Identifying the driving factors behind landslides and accurately assessing susceptibility ar...Landslides pose a formidable natural hazard across the Qinghai-Tibet Plateau(QTP),endangering both ecosystems and human life.Identifying the driving factors behind landslides and accurately assessing susceptibility are key to mitigating disaster risk.This study integrated multi-source historical landslide data with 15 predictive factors and used several machine learning models—Random Forest(RF),Gradient Boosting Regression Trees(GBRT),Extreme Gradient Boosting(XGBoost),and Categorical Boosting(CatBoost)—to generate susceptibility maps.The Shapley additive explanation(SHAP)method was applied to quantify factor importance and explore their nonlinear effects.The results showed that:(1)CatBoost was the best-performing model(CA=0.938,AUC=0.980)in assessing landslide susceptibility,with altitude emerging as the most significant factor,followed by distance to roads and earthquake sites,precipitation,and slope;(2)the SHAP method revealed critical nonlinear thresholds,demonstrating that historical landslides were concentrated at mid-altitudes(1400-4000 m)and decreased markedly above 4000 m,with a parallel reduction in probability beyond 700 m from roads;and(3)landslide-prone areas,comprising 13%of the QTP,were concentrated in the southeastern and northeastern parts of the plateau.By integrating machine learning and SHAP analysis,this study revealed landslide hazard-prone areas and their driving factors,providing insights to support disaster management strategies and sustainable regional planning.展开更多
Objectives This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models(DLNMs).Methods We utilized data from the China Health and ...Objectives This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models(DLNMs).Methods We utilized data from the China Health and Retirement Longitudinal Study(CHARLS).After feature selection via Elastic Net Regularization,we applied DLNMs to evaluate the lagged effects of risk factors.Disability was defined as the presence of any difficulties in basic activities of daily living(BADL).The cumulative relative risk(CRR)was calculated by summing the lag-specific risk estimates,representing the cumulative disability risk over the specified lag period.Effect modifications and sensitivity analyses were also performed.Results This study included a total of 2,318 participants.Early-phase lag factors,such as the difficulty in stooping(CRR=3.58;95%CI:2.31-5.55;P<0.001)and walking(CRR=2.77;95%CI:1.39-5.55;P<0.001),exerted the strongest effects immediately upon occurrence.Mid-phase lag factors,such as arthritis(CRR=1.51;95%CI:1.10-2.06;P=0.001),showed a resurgence in disability risk within 2-3 years.Late-phase lag factors,including depressive symptoms(CRR=2.38;95%CI:1.30-4.35;P<0.001)and elevated systolic blood pressure(CRR=1.64;95%CI:1.06-2.79;P=0.02),exhibited significant long-term cumulative risks.Conversely,grip strength(CRR=0.80;95%CI:0.54-0.95;P=0.02)and social participation(CRR=0.89;95%CI:0.73-0.99;P=0.04)were significant protective factors.Conclusions The findings underscore the importance of tailored interventions that account for various lag characteristics of different factors to effectively mitigate disability risk.Future studies should explore the underlying biological and sociological mechanisms of these lagged effects,identify intervention strategies that target risk factors with different lagged patterns,and evaluate their effectiveness.展开更多
Objective:Based on the theory of“Taiyang governs tendons”,to explore the effect of acupuncture at points of the Bladder Meridian of Foot-Taiyang on the expression of serum inflammatory factors in rabbit models of ce...Objective:Based on the theory of“Taiyang governs tendons”,to explore the effect of acupuncture at points of the Bladder Meridian of Foot-Taiyang on the expression of serum inflammatory factors in rabbit models of cervical spondylosis.Methods:Thirty New Zealand white rabbits were randomly divided into a blank group,a model group,and a treatment group,with 10 rabbits in each group.The models of cervical spondylosis in the model group and treatment group were established by long-term head-down flexion combined with cold-damp stimulation.After modeling,the treatment group received acupuncture at three points(Kunlun,Weizhong,and Feishu)on the Bladder Meridian of Foot-Taiyang,once a day for 20 minutes each time,for 14 consecutive days;the model group and blank group received no therapeutic intervention.After the intervention,cardiac blood was collected from all rabbits to detect the expression levels of serum inflammatory factors IL-6,TNF-α,and IL-1β.Meanwhile,cervical muscle tissue was collected,stained with HE,and the morphological changes of the posterior cervical muscle tissue in each group were observed under an optical microscope.Results:After modeling,the levels of inflammatory factors in the serum of rabbits in the model group and treatment group were significantly increased compared with those before modeling,with a statistically significant difference(p<0.01).After intervention,the serum inflammatory factors in the treatment group decreased significantly compared with those in the model group,and the difference was statistically significant(p<0.01).Conclusion:Acupuncture at points of the Bladder Meridian of Foot-Taiyang in rabbit models of cervical spondylosis can reduce the serum levels of inflammatory factors TNF-α,IL-1β,and IL-6.展开更多
This paper provides a systematic review of the histochemical localization,content characteristics,and influencing factors of saponins in Pseudostellaria heterophylla based on an extensive literature survey.It provides...This paper provides a systematic review of the histochemical localization,content characteristics,and influencing factors of saponins in Pseudostellaria heterophylla based on an extensive literature survey.It provides an in-depth analysis and summary of the effects of biological factors,environmental conditions,agronomic practices,processing methods,and continuous cropping obstacles on the synthesis of P.heterophylla saponins,as well as their underlying mechanisms.Based on identified gaps in the current literature,future research directions and prospects are proposed.The findings of this review offer valuable insights for advancing the understanding of the saponin biosynthesis mechanisms in P.heterophylla and for enhancing its quality.展开更多
Epimedium is commonly used to treat bone injury and kidney disease,with prenylated flavonol glycosides(PFGs)as its active ingredients.It has attracted much attention due to prominent healthcare and therapeutic effects...Epimedium is commonly used to treat bone injury and kidney disease,with prenylated flavonol glycosides(PFGs)as its active ingredients.It has attracted much attention due to prominent healthcare and therapeutic effects,but faces problems of adulteration with closely related species and confusion about geographical origins.In this study,multiple technical approaches were employed to identify its genetic characteristics and metabolic differences.Based on DNA barcoding,20 batches of samples were analyzed.The genetic distances of matK,ITS and psbA-trnH within species were all smaller than those between species,and psbA-trnH along with ITS+psbA-trnH proved most effective in distinguishing botanical sources.With Inter-simple sequence repeat(ISSR)technology,12 highly polymorphic and reproducible primers were selected from 21,and 189 alleles were detected.Epimedium sagittatum showed distinct genetic diversity.Samples with similar genetic distance and geographical location also tended to cluster together.Eight index components were analyzed,and their contents showed significant differences.The total content ranged from 0.50%to 7.09%,and icariin and epimedin C were identified as potential biomarkers.Integrative analysis revealed that the differences in index components were jointly driven by genetic diversity and ecological factors.Additionally,“mean temperature of driest quarter”,“precipitation seasonality”,and“temperature annual range”were identified as key environmental factors.This study provides a reliable experimental basis for the authenticity and quality evaluation of Epimedium.展开更多
Understanding the spatial distributions and corresponding variation mechanisms of key soil nutrients in fragile karst ecosystems can assist in promoting sustainable development.However,due to the implementation of eco...Understanding the spatial distributions and corresponding variation mechanisms of key soil nutrients in fragile karst ecosystems can assist in promoting sustainable development.However,due to the implementation of ecological restoration initiatives such as land-use conversions,novel changes in the spatial characteristics of soil nutrients remain unknown.To address this gap,we explored nutrient variations and the drivers of the variation in the 0–15 cm topsoil layer using a regional-scale sampling method in a typical karst area in northwest Guangxi Zhuang Autonomous Region,Southwest China.Descriptive statistics,geostatistics,and spatial analysis were used to assess the soil nutrient variability.The results indicated that soil organic carbon(SOC),total nitrogen(TN),total phosphorus(TP),and total potassium(TK)concentrations showed moderate variations,with coefficients of variance being 0.60,0.60,0.71,and 0.72,respectively.Moreover,they demonstrated positive spatial autocorrelations,with global Moran's indices being 0.68,0.77,0.64,and 0.68,respectively.However,local Moran's index values were low,indicating large spatial variations in soil nutrients.The best-fitting semi-variogram models for SOC,TN,TP,and TK concentrations were spherical,Gaussian,exponential,and exponential,respectively.According to the classification criteria of the Second National Soil Census in China,SOC and TN concentrations were relatively sufficient,with the proportions of rich and very rich levels being up to 90.9 and 96.0%,respectively.TP concentration was in the mediumdeficient level,with the areas of medium and deficient levels accounting for 33.7 and 30.1%of the total,respectively.TK concentration was deficient,with the cumulative area of extremely deficient,very deficient,and deficient levels accounting for 87.6%of the total area.Consequently,the terrestrial ecosystems in the study area were more vulnerable to soil P and K than soil N deficiencies.Furthermore,variance partitioning analysis of the influencing factors showed that,except for the interactions,the single effect of other soil properties accounted more for soil nutrient variations than spatial and environmental variables.These results will aid in the future management of terrestrial ecosystems.展开更多
BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different ...BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.展开更多
To achieve low-carbon regulation of electric vehicle(EV)charging loads under the“dual carbon”goals,this paper proposes a coordinated scheduling strategy that integrates dynamic carbon factor prediction and multiobje...To achieve low-carbon regulation of electric vehicle(EV)charging loads under the“dual carbon”goals,this paper proposes a coordinated scheduling strategy that integrates dynamic carbon factor prediction and multiobjective optimization.First,a dual-convolution enhanced improved Crossformer prediction model is constructed,which employs parallel 1×1 global and 3×3 local convolutionmodules(Integrated Convolution Block,ICB)formultiscale feature extraction,combinedwith anAdaptive Spectral Block(ASB)to enhance time-series fluctuationmodeling.Based on high-precision predictions,a carbon-electricity cost joint optimization model is further designed to balance economic,environmental,and grid-friendly objectives.The model’s superiority was validated through a case study using real-world data from a renewable-heavy grid.Simulation results show that the proposed multi-objective strategy demonstrated a superior balance compared to baseline and benchmark models,achieving a 15.8%reduction in carbon emissions and a 5.2%reduction in economic costs,while still providing a substantial 22.2%reduction in the peak-valley difference.Its balanced performance significantly outperformed both a single-objective strategy and a state-of-the-art Model Predictive Control(MPC)benchmark,highlighting the advantage of a global optimization approach.This study provides theoretical and technical pathways for dynamic carbon factor-driven EV charging optimization.展开更多
基金the financial support from the Strategic Priority Research Program of the Chinese Academy of Sciences (XDB0470303)the National Key Research and Development Program of China (2022YFB4600101)+5 种基金the National Natural Science Foundation of China (52175201)the Research Program of Science and Technology Department of Gansu Province (24JRRA059, 24JRRA044, and 24YFFA014)the Science Fund of Shandong Laboratory of Advanced Materials and Green Manufacturing at Yantai (AMGM2024F12)the Major Program (ZYFZFX-2) of the Lanzhou Institute of Chemical Physics, CASthe Special Research Assistant Project of the Chinese Academy of Sciencesthe Oasis Scholar of Shihezi University
文摘Octopuses,due to their flexible arms,marvelous adaptability,and powerful suckers,are able to effortlessly grasp and disengage various objects in the marine surrounding without causing devastation.However,manipulating delicate objects such as soft and fragile foods underwater require gentle contact and stable adhesion,which poses a serious challenge to now available soft grippers.Inspired by the sucker infundibulum structure and flexible tentacles of octopus,herein we developed a hydraulically actuated hydrogel soft gripper with adaptive maneuverability by coupling multiple hydrogen bond-mediated supramolecular hydrogels and vat polymerization three-dimensional printing,in which hydrogel bionic sucker is composed of a tunable curvature membrane,a negative pressure cavity,and a pneumatic chamber.The design of the sucker structure with the alterable curvature membrane is conducive to realize the reliable and gentle switchable adhesion of the hydrogel soft gripper.As a proof-of-concept,the adaptive hydrogel soft gripper is capable of implement diversified underwater tasks,including gingerly grasping fragile foods like egg yolks and tofu,as well as underwater robots and vehicles that station-keeping and crawling based on switchable adhesion.This study therefore provides a transformative strategy for the design of novel soft grippers that will render promising utilities for underwater exploration soft robotics.
基金supported by the Postdoctoral Science Foundation of China under Grant No.2020M683736partly by the Teaching reform project of higher education in Heilongjiang Province under Grant No.SJGY20210456+2 种基金partly by the Natural Science Foundation of Heilongjiang Province of China under Grant No.LH2021F038partly by the Haiyan foundation of Harbin Medical University Cancer Hospital under Grant No.JJMS2021-28partly by the graduate academic innovation project of Harbin Normal University under Grant Nos.HSDSSCX2022-17,HSDSSCX2022-18 and HSDSSCX2022-19.
文摘Wireless sensor networks (WSNs) operate in complex and harshenvironments;thus, node faults are inevitable. Therefore, fault diagnosis ofthe WSNs node is essential. Affected by the harsh working environment ofWSNs and wireless data transmission, the data collected by WSNs containnoisy data, leading to unreliable data among the data features extracted duringfault diagnosis. To reduce the influence of unreliable data features on faultdiagnosis accuracy, this paper proposes a belief rule base (BRB) with a selfadaptivequality factor (BRB-SAQF) fault diagnosis model. First, the datafeatures required for WSN node fault diagnosis are extracted. Second, thequality factors of input attributes are introduced and calculated. Third, themodel inference process with an attribute quality factor is designed. Fourth,the projection covariance matrix adaptation evolution strategy (P-CMA-ES)algorithm is used to optimize the model’s initial parameters. Finally, the effectivenessof the proposed model is verified by comparing the commonly usedfault diagnosis methods for WSN nodes with the BRB method consideringstatic attribute reliability (BRB-Sr). The experimental results show that BRBSAQFcan reduce the influence of unreliable data features. The self-adaptivequality factor calculation method is more reasonable and accurate than thestatic attribute reliability method.
基金supported by the National Natural Science Foundation of China,Nos.82072165 and 82272256(both to XM)the Key Project of Xiangyang Central Hospital,No.2023YZ03(to RM)。
文摘Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in spinal cord injury.Previous studies have shown that microglia can promote neuronal survival by phagocytosing dead cells and debris and by releasing neuroprotective and anti-inflammatory factors.However,excessive activation of microglia can lead to persistent inflammation and contribute to the formation of glial scars,which hinder axonal regeneration.Despite this,the precise role and mechanisms of microglia during the acute phase of spinal cord injury remain controversial and poorly understood.To elucidate the role of microglia in spinal cord injury,we employed the colony-stimulating factor 1 receptor inhibitor PLX5622 to deplete microglia.We observed that sustained depletion of microglia resulted in an expansion of the lesion area,downregulation of brain-derived neurotrophic factor,and impaired functional recovery after spinal cord injury.Next,we generated a transgenic mouse line with conditional overexpression of brain-derived neurotrophic factor specifically in microglia.We found that brain-derived neurotrophic factor overexpression in microglia increased angiogenesis and blood flow following spinal cord injury and facilitated the recovery of hindlimb motor function.Additionally,brain-derived neurotrophic factor overexpression in microglia reduced inflammation and neuronal apoptosis during the acute phase of spinal cord injury.Furthermore,through using specific transgenic mouse lines,TMEM119,and the colony-stimulating factor 1 receptor inhibitor PLX73086,we demonstrated that the neuroprotective effects were predominantly due to brain-derived neurotrophic factor overexpression in microglia rather than macrophages.In conclusion,our findings suggest the critical role of microglia in the formation of protective glial scars.Depleting microglia is detrimental to recovery of spinal cord injury,whereas targeting brain-derived neurotrophic factor overexpression in microglia represents a promising and novel therapeutic strategy to enhance motor function recovery in patients with spinal cord injury.
基金supported by the National Natural Science Foundation of China(No.52025014)Natural Science Foundation of Zhejiang Province(No.LQ23E010002)+1 种基金Natural Science Foundation of Ningbo(No.2023QL049)Major Special Project of Ningbo(No.2023Z022).
文摘Solid lubricating coatings play a crucial role in preventing friction and wear failure of the hot-end sliding components in aviation engines.In this study,VAlN/Ag multi-layer coatings with excellent interfacial matching were fabricated using a hybrid magnetron sputtering technique.The type and energy of discharge plasmas were analyzed to comprehend their effects on depositing coatings.The coatings exhibit self-adaptive lubrication properties during the designed consecutive friction with stepwise heating from 25℃to 650℃.The microstructure evolution during early friction facilitates sufficient tribo-chemical reaction at 650℃,leading to the formation of a distinctive"ball-on-rail"structure that significantly reduces friction coefficient.Based on the first-principles calculations,it was found that the bond energy of Ag-O is lower than that of V-O in both AgVO_(3)and Ag_(3)VO_(4),which promotes slipping along the(110)crystal plane and contributes to exceptional tribological properties.The fatigue wear failure mechanism of hard coatings under the thermal-force coupling effects has been elucidated,alongside an exploration of consecutive tribology mechanism at atomic scales over a wide temperature range.
基金supported by the National Natural Science Foundation(52025055,52175546,and 52405624)the Shaanxi University Youth Innovation Team.
文摘Gecko-inspired van der Waals force-based adhesion technology demonstrates significant potential for robotic operations.While superior adhesion is achieved under parallel contact during testing,engineering operations often involve non-parallel contact,weakening adhesion,and compromising task stability and efficiency.Stable attachment under such non-parallel contacts remains challenging.Inspired by the soft muscle and rigid bone in the gecko’s sole,this study proposes a self-adaptive core-shell dry adhesive by embedding a thin,rigid piece into a soft,thick elastomer comprising a top adhesion tip with a mushroom-like geometry for interfacial adhesion based on the van der Waals force and a bottom core-shell configuration for interface stress regulation.Unlike traditional core-shell structures with a fixed“dead core,”the proposed“live core”rotates within the soft shell,mimicking skeletal joints.This enables stress equalization at the interface and facilitates adaptive contact to macroscopic interfacial angle errors.This innovative core-shell configuration demonstrates an adhesion strength 100 times higher than conventional homogeneous structures under non-parallel contact and offers anti-overturning ability by mitigating torsional effects.The proposed strategy can advance the development of gecko-inspired adhesion-based devices and systems.
基金supported by the 2025 Fujian Provincial Social Science Foundation Project(FJ2025C074).
文摘This systematic review synthesizes empirical research on external risk factors for adolescent smartphone addiction.Scopus and Web of Science were searched for English peer-reviewed empirical articles from 2008 onward;28 met inclusion criteria(excluding non-adolescents,generic internet addiction,non-empirical work,or non-English).Thematic synthesis organized findings into three external risk domains—family,school,and peers—considering cultural/contextual mechanisms.Family dynamics(parental phubbing,harsh parenting,dysfunction),school stressors,and adverse peer relationships were identified as accumulating,direct and indirect contributors to smartphone addiction.These operate within a techno-ecological framework,where digital technologies amplify vulnerabilities and create new pathways for maladaptive use.Evidence favors an ecological,multi-level perspective.Future research should use longitudinal designs,standardize measures across cultures,and examine understudied regions—especially Africa—to guide culturally sensitive interventions.
文摘BACKGROUND Ischemic stroke is one of the leading global causes of disability and death.Despite advances in modern medical technology that improve acute treatment and rehabilitation measures,post-stroke anxiety and depression(PSD)do not receive sufficient attention.AIM To systematically evaluate risk factors and early identification markers for PSD for more precise screening and intervention strategies in clinical practice.METHODS This retrospective study analyzed clinical data from 112 patients with ischemic stroke admitted between January 2022 and December 2024.Based on assessments using the Hamilton Rating Scale for Anxiety(HAMA)and Hamilton Rating Scale for Depression(HAMD)at 2 weeks(±3 days)post-stroke,patients were classified into the PSD group(HAMA≥7 and/or HAMD≥7)and the non-PSD group(HAMA<7 and HAMD<7).Observation indicators included psychological assessment,demographic and clinical characteristics,stroke-related clinical indicators,neuroimaging assessments,and laboratory biomarkers.Multivariate logistic regression analysis was used to identify independent risk factors for PSD,and receiver operating characteristic curve analysis was used to evaluate the diagnostic value of potential biomarkers.RESULTS Of the 112 patients,46(41.1%)were diagnosed with PSD.Multivariate analysis identified five independent risk factors:Female gender[Odds ratio(OR)=2.32,95%confidence interval(CI):1.56-3.45],history of mental disorders prior to stroke(OR=3.17,95%CI:1.89-5.32),infarct location in the frontal lobe or limbic system(OR=2.86,95%CI:1.73-4.71),stroke severity with National Institutes of Health Stroke Scale≥8 at admission(OR=2.54,95%CI:1.62-3.99),and low social support(Social Support Rating Scale<35,OR=2.18,95%CI:1.42-3.36).Subgroup analysis showed that depression patients more commonly had left hemisphere lesions(68.4%vs 45.2%),while anxiety patients more frequently presented with right hemisphere lesions(59.5%vs 39.5%).The PSD group exhibited larger infarct volumes(8.7 cm^(3) vs 5.3 cm^(3)),more severe white matter hyperintensities,and more pronounced frontal lobe atrophy.Analysis of inflammatory markers showed significantly elevated levels of interleukin-6(7.8 pg/mL vs 4.5 pg/mL)and tumor necrosis factor-alpha(15.6 pg/mL vs 9.8 pg/mL)in the PSD group,while hypothalamicpituitary-adrenal axis function assessment revealed higher cortisol levels(386.5±92.3 nmol/L vs 328.7±75.6 nmol/L)and flattened diurnal rhythm in the PSD group.CONCLUSION PSD is a complex neuropsychiatric consequence of stroke involving disruption of the frontal-limbic circuitry,neuroinflammatory responses,and dysfunction of the hypothalamic-pituitary-adrenal axis.
基金supported by grants from the Zhejiang Provincial TCM Science and Technology Plan Project,No.2023ZL156(to YH)Ningbo Top Medical and Health Research Program,No.2022020304(to XG)+1 种基金the Natural Science Foundation of Ningbo,No.2023J019(to YH)Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province,No.2022E10026(to YH)。
文摘Strokes include both ischemic stroke,which is mediated by a blockade or reduction in the blood supply to the brain,and hemorrhagic stroke,which comprises intracerebral hemorrhage and subarachnoid hemorrhage and is characterized by bleeding within the brain.Stroke is a lifethreatening cerebrovascular condition characterized by intricate pathophysiological mechanisms,including oxidative stress,inflammation,mitochondrial dysfunction,and neuronal injury.Critical transcription factors,such as nuclear factor erythroid 2-related factor 2 and nuclear factor kappa B,play central roles in the progression of stroke.Nuclear factor erythroid 2-related factor 2 is sensitive to changes in the cellular redox status and is crucial in protecting cells against oxidative damage,inflammatory responses,and cytotoxic agents.It plays a significant role in post-stroke neuroprotection and repair by influencing mitochondrial function,endoplasmic reticulum stress,and lysosomal activity and regulating metabolic pathways and cytokine expression.Conversely,nuclear factor-kappa B is closely associated with mitochondrial dysfunction,the generation of reactive oxygen species,oxidative stress exacerbation,and inflammation.Nuclear factor-kappa B contributes to neuronal injury,apoptosis,and immune responses following stroke by modulating cell adhesion molecules and inflammatory mediators.The interplay between these pathways,potentially involving crosstalk among various organelles,significantly influences stroke pathophysiology.Advancements in single-cell sequencing and spatial transcriptomics have greatly improved our understanding of stroke pathogenesis and offer new opportunities for the development of targeted,individualized,cell typespecific treatments.In this review,we discuss the mechanisms underlying the involvement of nuclear factor erythroid 2-related factor 2 and nuclear factor-kappa B in both ischemic and hemorrhagic stroke,with an emphasis on their roles in oxidative stress,inflammation,and neuroprotection.
文摘BACKGROUND:Acute pain is a sudden experience secondary to injuries and varies in perception among individuals.In trauma patients,it can negatively aff ect respiratory function,immune response,and wound healing,making it a signifi cant public health concern.This study is to determine the prevalence and factors associated with acute pain among emergency trauma patients.METHODS:A multicenter cross-sectional study was conducted.Data were collected via interviewer-administered questionnaires and patient chart review.The data were analyzed via the statistical package for social science version 25.Bivariable and multivariable logistic regression analyses were used.Variables with a P-value<0.05 were considered statistically signifi cant.RESULTS:A total of 397 patients were included in the study,for a response rate of 96.8%.The prevalence of pain during admission was 91.9%(95%confi dence intervals[95%CIs]:88.8%-94.4%).Blunt trauma(adjusted odds ratio[aOR]=2.82;95%CI:1.23-6.45),analgesia before admission to the emergency department(aOR=2.71;95%CI:1.16-6.36),documentation of pain severity in the chart(aOR=2.71;95%CI:1.16-6.36),analgesia provided within two hours after admission(aOR=7.60;95%CI:2.79-20.68),use of non-pharmacological pain management methods(aOR=3.09;95%CI:1.35-7.08)and availability of analgesia(aOR=3.95;95%CI:1.36-11.43)were associated with acute pain experience.CONCLUSION:The prevalence of acute pain among emergency trauma patients was high in the study area.Analgesia should be administered prior to admission,and non-pharmacological pain management should be implemented.Moreover,training on pain assessment and management should be provided for healthcare providers in the emergency department.
文摘Nerve trauma commonly results in chronic neuropathic pain. This is by triggering the release of proinflammatory mediators from local and invading cells that induce inflammation and nociceptive neuron hyperexcitability. Even without apparent inflammation, injury sites are associated with increased inflammatory markers. This review focuses on how it might be possible to reduce neuropathic pain by reducing inflammation. Physiologically, pain is resolved by a combination of the out-migration of pro-inflammatory cells from the injury site, the down-regulation of the genes underlying the inflammation, up-regulating genes for anti-inflammatory mediators, and reducing nociceptive neuron hyperexcitability. While various techniques reduce chronic neuropathic pain, the best are effective on < 50% of patients, no technique reliably or permanently eliminates neuropathic pain. This is because most techniques are predominantly aimed at reducing pain, not inflammation. In addition, while single factors reduce pain, increasing evidence indicates significant and longer-lasting pain relief requires multiple factors acting simultaneously. Therefore, it is not surprising that extensive data indicate that the application of platelet-rich plasma provides more significant and longer-lasting pain suppression than other techniques, although its analgesia is neither complete nor permanent. However, several case reports indicate that platelet-rich plasma can induce permanent neuropathic pain elimination when the platelet concentration is significantly increased and is applied to longer nerve lengths. This review examines the primary triggers of the development and maintenance of neuropathic pain and techniques that reduce chronic neuropathic pain. The application of plateletrich plasma holds great promise for providing complete and permanent chronic neuropathic pain elimination.
文摘BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite improved renal function.It is potentially associated with an increased risk of cardiovascular events,renal osteodystrophy,pathologic fractures,graft loss,and mortality.AIM To evaluate the incidence,risk factors,and outcomes of PT-tHPT amongst kidney transplant recipients.METHODS A total of 887 transplant recipients who underwent transplantation between 2000 and 2020 were evaluated.Univariable and multivariable logistic regression was performed to determine the predictors of tertiary hyperparathyroidism.Graft and recipient outcomes were assessed using multivariable Cox regression.A separate multivariable Cox regression was performed to determine the effect of treatment strategies on outcomes.RESULTS PT-tHPT,defined as elevated PTH(>65 ng/L)and persistent hypercalcemia(>2.60 mmol/L),was diagnosed in 14%of recipients.Risk factors for PT-tHPT included older age[odds ratio(OR)=1.36,P<0.001],Asian ethnicity(OR=0.33,P=0.006),total ischemia time(OR=1.03,P=0.048 per hour),pre-transplant serum calcium(OR=1.38,P<0.001)per decile increase,pre-transplant PTH level(OR=1.31,P<0.001)per decile increase,longer dialysis duration(OR=1.12,P=0.002)per year,history of acute rejection(OR=2.37,P=0.012),and slope of estimated glomerular filtration rate change(OR=0.91,P=0.001).There were a 3.4-fold higher risk of death-censored graft loss and a 1.9-fold greater risk of recipient death with PT-tHPT.The three treatment strategies of conservative management,calcimimetic and parathyroidectomy did not significantly change the graft or patient outcome.CONCLUSION Pretransplant elevated calcium and PTH levels,older age and dialysis duration are associated with PT-tHPT.While PT-tHPT significantly affects graft and recipient survival,the treatment strategies did not affect survival.
基金China Health and Retirement Longitudinal Study(CHARLS)the 2022-2023 Nursing Research Project of Chinese Medical Association Publishing House(Grant No.CMAPH-NRD2022024)。
文摘Background:The trajectory of intrinsic capacity(IC)among the older population is characterized by its diversity and is predictive of adverse health outcomes such as disability,nursing home admission,decline in quality of life,and mortality.Gaining an understanding of the trajectory of IC and the factors that influence it is of paramount importance for fostering healthy aging.This research is focused on exploring the trajectory of IC among older adults in China and examining the factors that influence it.Methods:This observational longitudinal cohort study leveraged data from the China Health and Retirement Longitudinal Study(CHARLS),which was conducted in the years 2011,2013,and 2015.For the purpose of this analysis,a total of 2,233 participants who were aged 60 and over were included.A Growth Mixture Model(GMM)was utilized to define trajectory categories for IC.Influential factors were ascertained based on the health ecology model,and binary logistic regression analysis was utilized to investigate the factors linked with the different trajectory categories.Results:Two distinct trajectory classes of IC were identified:Class 1,the normal-stable group,encompassed 90.4%of the elderly population,while Class 2,the declining group,made up 9.6%.Advanced age and a history of stroke were found to be significantly associated with Class 2.High scores in activities of daily living(ADL),employment status,receiving primary or junior high school education,and residence in the East or Central regions of China were significantly linked with Class 1.Conclusion:The trajectory of IC among older Chinese adults is marked by its heterogeneity.Advanced age and a history of stroke are significant risk factors for a declining IC trajectory,while higher ADL scores,being employed,receiving primary or junior high school education,and residing in the East or Central regions of China are protective factors associated with a stable IC trajectory.Healthcare institutions must closely monitor IC levels and understand these trajectory patterns to implement personalized and targeted interventions promptly to maintain IC at a healthy level and advocate for healthy aging.
基金The National Key Research and Development Program of China,No.2023YFC3206601。
文摘Landslides pose a formidable natural hazard across the Qinghai-Tibet Plateau(QTP),endangering both ecosystems and human life.Identifying the driving factors behind landslides and accurately assessing susceptibility are key to mitigating disaster risk.This study integrated multi-source historical landslide data with 15 predictive factors and used several machine learning models—Random Forest(RF),Gradient Boosting Regression Trees(GBRT),Extreme Gradient Boosting(XGBoost),and Categorical Boosting(CatBoost)—to generate susceptibility maps.The Shapley additive explanation(SHAP)method was applied to quantify factor importance and explore their nonlinear effects.The results showed that:(1)CatBoost was the best-performing model(CA=0.938,AUC=0.980)in assessing landslide susceptibility,with altitude emerging as the most significant factor,followed by distance to roads and earthquake sites,precipitation,and slope;(2)the SHAP method revealed critical nonlinear thresholds,demonstrating that historical landslides were concentrated at mid-altitudes(1400-4000 m)and decreased markedly above 4000 m,with a parallel reduction in probability beyond 700 m from roads;and(3)landslide-prone areas,comprising 13%of the QTP,were concentrated in the southeastern and northeastern parts of the plateau.By integrating machine learning and SHAP analysis,this study revealed landslide hazard-prone areas and their driving factors,providing insights to support disaster management strategies and sustainable regional planning.
基金supported by ScientificResearch Fund of National Health Commission of the People’s Republic of China-Major Science and Technology Program for Medicine and Health in Zhejiang Province(WKJ-ZJ-2406).
文摘Objectives This study aimed to explore the lagged and cumulative effects of risk factors on disability in older adults using distributed lag non-linear models(DLNMs).Methods We utilized data from the China Health and Retirement Longitudinal Study(CHARLS).After feature selection via Elastic Net Regularization,we applied DLNMs to evaluate the lagged effects of risk factors.Disability was defined as the presence of any difficulties in basic activities of daily living(BADL).The cumulative relative risk(CRR)was calculated by summing the lag-specific risk estimates,representing the cumulative disability risk over the specified lag period.Effect modifications and sensitivity analyses were also performed.Results This study included a total of 2,318 participants.Early-phase lag factors,such as the difficulty in stooping(CRR=3.58;95%CI:2.31-5.55;P<0.001)and walking(CRR=2.77;95%CI:1.39-5.55;P<0.001),exerted the strongest effects immediately upon occurrence.Mid-phase lag factors,such as arthritis(CRR=1.51;95%CI:1.10-2.06;P=0.001),showed a resurgence in disability risk within 2-3 years.Late-phase lag factors,including depressive symptoms(CRR=2.38;95%CI:1.30-4.35;P<0.001)and elevated systolic blood pressure(CRR=1.64;95%CI:1.06-2.79;P=0.02),exhibited significant long-term cumulative risks.Conversely,grip strength(CRR=0.80;95%CI:0.54-0.95;P=0.02)and social participation(CRR=0.89;95%CI:0.73-0.99;P=0.04)were significant protective factors.Conclusions The findings underscore the importance of tailored interventions that account for various lag characteristics of different factors to effectively mitigate disability risk.Future studies should explore the underlying biological and sociological mechanisms of these lagged effects,identify intervention strategies that target risk factors with different lagged patterns,and evaluate their effectiveness.
基金Yunnan Provincial High-Level Traditional Chinese Medicine Talent Training ProjectYunnan Provincial Department of Science and Technology Traditional Chinese Medicine Basic Research Joint Special Project(Project No.:202101AZ070001-138)。
文摘Objective:Based on the theory of“Taiyang governs tendons”,to explore the effect of acupuncture at points of the Bladder Meridian of Foot-Taiyang on the expression of serum inflammatory factors in rabbit models of cervical spondylosis.Methods:Thirty New Zealand white rabbits were randomly divided into a blank group,a model group,and a treatment group,with 10 rabbits in each group.The models of cervical spondylosis in the model group and treatment group were established by long-term head-down flexion combined with cold-damp stimulation.After modeling,the treatment group received acupuncture at three points(Kunlun,Weizhong,and Feishu)on the Bladder Meridian of Foot-Taiyang,once a day for 20 minutes each time,for 14 consecutive days;the model group and blank group received no therapeutic intervention.After the intervention,cardiac blood was collected from all rabbits to detect the expression levels of serum inflammatory factors IL-6,TNF-α,and IL-1β.Meanwhile,cervical muscle tissue was collected,stained with HE,and the morphological changes of the posterior cervical muscle tissue in each group were observed under an optical microscope.Results:After modeling,the levels of inflammatory factors in the serum of rabbits in the model group and treatment group were significantly increased compared with those before modeling,with a statistically significant difference(p<0.01).After intervention,the serum inflammatory factors in the treatment group decreased significantly compared with those in the model group,and the difference was statistically significant(p<0.01).Conclusion:Acupuncture at points of the Bladder Meridian of Foot-Taiyang in rabbit models of cervical spondylosis can reduce the serum levels of inflammatory factors TNF-α,IL-1β,and IL-6.
基金Supported by Open Fund Project of the Engineering Technology Research Center of Characteristic Medicinal Plants of Fujian(PP202003).
文摘This paper provides a systematic review of the histochemical localization,content characteristics,and influencing factors of saponins in Pseudostellaria heterophylla based on an extensive literature survey.It provides an in-depth analysis and summary of the effects of biological factors,environmental conditions,agronomic practices,processing methods,and continuous cropping obstacles on the synthesis of P.heterophylla saponins,as well as their underlying mechanisms.Based on identified gaps in the current literature,future research directions and prospects are proposed.The findings of this review offer valuable insights for advancing the understanding of the saponin biosynthesis mechanisms in P.heterophylla and for enhancing its quality.
基金supported by Beijing Nova Program(20240484546)the Fundamental Research Funds for the Central Public Welfare Research Institutes(No.ZZ13-YQ-049,ZXKT22001)Shaanxi Province Key R&D Program Projects(2024SF-ZDCYL-03-10).
文摘Epimedium is commonly used to treat bone injury and kidney disease,with prenylated flavonol glycosides(PFGs)as its active ingredients.It has attracted much attention due to prominent healthcare and therapeutic effects,but faces problems of adulteration with closely related species and confusion about geographical origins.In this study,multiple technical approaches were employed to identify its genetic characteristics and metabolic differences.Based on DNA barcoding,20 batches of samples were analyzed.The genetic distances of matK,ITS and psbA-trnH within species were all smaller than those between species,and psbA-trnH along with ITS+psbA-trnH proved most effective in distinguishing botanical sources.With Inter-simple sequence repeat(ISSR)technology,12 highly polymorphic and reproducible primers were selected from 21,and 189 alleles were detected.Epimedium sagittatum showed distinct genetic diversity.Samples with similar genetic distance and geographical location also tended to cluster together.Eight index components were analyzed,and their contents showed significant differences.The total content ranged from 0.50%to 7.09%,and icariin and epimedin C were identified as potential biomarkers.Integrative analysis revealed that the differences in index components were jointly driven by genetic diversity and ecological factors.Additionally,“mean temperature of driest quarter”,“precipitation seasonality”,and“temperature annual range”were identified as key environmental factors.This study provides a reliable experimental basis for the authenticity and quality evaluation of Epimedium.
基金supported by the National Natural Science Foundation of China(U2344201 and 42101316)the Natural Science Foundation of Hunan Province,China(2022JJ40866)the Outstanding Youth Project of Education Bureau of Hunan Province,China(20B613)。
文摘Understanding the spatial distributions and corresponding variation mechanisms of key soil nutrients in fragile karst ecosystems can assist in promoting sustainable development.However,due to the implementation of ecological restoration initiatives such as land-use conversions,novel changes in the spatial characteristics of soil nutrients remain unknown.To address this gap,we explored nutrient variations and the drivers of the variation in the 0–15 cm topsoil layer using a regional-scale sampling method in a typical karst area in northwest Guangxi Zhuang Autonomous Region,Southwest China.Descriptive statistics,geostatistics,and spatial analysis were used to assess the soil nutrient variability.The results indicated that soil organic carbon(SOC),total nitrogen(TN),total phosphorus(TP),and total potassium(TK)concentrations showed moderate variations,with coefficients of variance being 0.60,0.60,0.71,and 0.72,respectively.Moreover,they demonstrated positive spatial autocorrelations,with global Moran's indices being 0.68,0.77,0.64,and 0.68,respectively.However,local Moran's index values were low,indicating large spatial variations in soil nutrients.The best-fitting semi-variogram models for SOC,TN,TP,and TK concentrations were spherical,Gaussian,exponential,and exponential,respectively.According to the classification criteria of the Second National Soil Census in China,SOC and TN concentrations were relatively sufficient,with the proportions of rich and very rich levels being up to 90.9 and 96.0%,respectively.TP concentration was in the mediumdeficient level,with the areas of medium and deficient levels accounting for 33.7 and 30.1%of the total,respectively.TK concentration was deficient,with the cumulative area of extremely deficient,very deficient,and deficient levels accounting for 87.6%of the total area.Consequently,the terrestrial ecosystems in the study area were more vulnerable to soil P and K than soil N deficiencies.Furthermore,variance partitioning analysis of the influencing factors showed that,except for the interactions,the single effect of other soil properties accounted more for soil nutrient variations than spatial and environmental variables.These results will aid in the future management of terrestrial ecosystems.
基金Supported by the National Natural Science Foundation of China,No.82402789Beijing Jishuitan Hospital Youcai Plan,No.KYYC202402+1 种基金Beijing Jishuitan Research Funding,No.HL202402and Beijing Natural Science Foundation,No.L232062,No.L222063.
文摘BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.
基金Supported by State Grid Corporation of China Science and Technology Project:Research on Key Technologies for Intelligent Carbon Metrology in Vehicle-to-Grid Interaction(Project Number:B3018524000Q).
文摘To achieve low-carbon regulation of electric vehicle(EV)charging loads under the“dual carbon”goals,this paper proposes a coordinated scheduling strategy that integrates dynamic carbon factor prediction and multiobjective optimization.First,a dual-convolution enhanced improved Crossformer prediction model is constructed,which employs parallel 1×1 global and 3×3 local convolutionmodules(Integrated Convolution Block,ICB)formultiscale feature extraction,combinedwith anAdaptive Spectral Block(ASB)to enhance time-series fluctuationmodeling.Based on high-precision predictions,a carbon-electricity cost joint optimization model is further designed to balance economic,environmental,and grid-friendly objectives.The model’s superiority was validated through a case study using real-world data from a renewable-heavy grid.Simulation results show that the proposed multi-objective strategy demonstrated a superior balance compared to baseline and benchmark models,achieving a 15.8%reduction in carbon emissions and a 5.2%reduction in economic costs,while still providing a substantial 22.2%reduction in the peak-valley difference.Its balanced performance significantly outperformed both a single-objective strategy and a state-of-the-art Model Predictive Control(MPC)benchmark,highlighting the advantage of a global optimization approach.This study provides theoretical and technical pathways for dynamic carbon factor-driven EV charging optimization.
