Effects of Three Kinds of Carbohydrate Pharmaceutical Excipients-Fructose, Lactose and Arabic Gum on Intestinal Absorption of Gastrodin through Glucose Transport Pathway in Rats.

BACKGROUND: Some glucoside drugs can be transported via intestinal glucose transporters (IGTs), and the presence of carbohydrate excipients in pharmaceutical formulations may influence the absorption of them. This study, using gastrodin as probe drug, aimed to explore the effects of fructose, lactose, and arabic gum on intestinal drug absorption mediated by the glucose transport pathway. METHODS: The influence of fructose, lactose, and arabic gum on gastrodin absorption was assessed via pharmacokinetic experiments and single-pass intestinal perfusion. The expression of sodium-dependent glucose transporter 1 (SGLT1) and sodium-independent glucose transporter 2 (GLUT2) was quantified via RT‒qPCR and western blotting. Alterations in rat intestinal permeability were evaluated through H&E staining, RT‒qPCR, and immunohistochemistry. RESULTS: Fructose reduced the area under the curve (AUC) and peak concentration (Cmax) of gastrodin by 42.7% and 63.71%, respectively (P < 0.05), and decreased the effective permeability coefficient (Peff) in the duodenum and jejunum by 58.1% and 49.2%, respectively (P < 0.05). SGLT1 and GLUT2 expression and intestinal permeability remained unchanged. Lactose enhanced the AUC and Cmax of gastrodin by 31.5% and 65.8%, respectively (P < 0.05), and increased the Peff in the duodenum and jejunum by 33.7% and 26.1%, respectively (P < 0.05). SGLT1 and GLUT2 levels did not significantly differ, intestinal permeability increased. Arabic gum had no notable effect on pharmacokinetic parameters, SGLT1 or GLUT2 expression, or intestinal permeability. CONCLUSION: Fructose, lactose, and arabic gum differentially affect intestinal drug absorption through the glucose transport pathway. Fructose competitively inhibited drug absorption, while lactose may enhance absorption by increasing intestinal permeability. Arabic gum had no significant influence.

Latent Profiles and Transitions of Bedtime Procrastination Among Chinese College Students: The Predictive Roles of Anxiety, Depression, Problematic Smartphone Use and Self-Control.

Background: Bedtime procrastination (BP) has become an important factor affecting individual well-being. This study aimed to assess the stability and changes in BP and examine risk and protective factors. Methods: The study recruited 1423 respondents. Latent profile analysis was used to identify subgroups of BP and latent transition analysis to determine transition probabilities for each subgroup. Logistic regression examined associations between identified classes and related factors. Results: Three subgroups of BP were identified. In terms of stability and changes, the moderate bedtime procrastination group showed the highest stability (66%), followed by the severe bedtime procrastination group (62.4%), and the mild bedtime procrastination group had a 52% probability of switching to moderate bedtime procrastination. In terms of influencing factors, more problematic phone use (PSU) (OR: 1.08; 95% CI = 1.05-1.12), more depression (OR: 1.17; 95% CI = 1.06-1.29) and anxiety (OR: 1.16; 95% CI = 1.05-1.28) are all factors that aggravate the transition from mild to moderate sleep procrastination. Similarly, PSU (OR: 1.15; 95% CI = 1.12-1.19), anxiety (OR: 1.10; 95% CI = 1.06-1.14), and depression (OR: 1.10; 95% CI = 1.06-1.14) increased the risk of severe bedtime procrastination. Self-control emerged as a protective factor against BP. Conclusion: This study identified three subgroups of BP at two time points and the rule of transition for each subgroup. Our findings indicate that BP were relatively stable, with some changes over time. The results also highlight the important function that PSU, depression, anxiety, and self-control can play in preventing and intervening in BP.

Evaluating the Causal Effects of Low Density Lipoprotein Cholesterol Levels on Ischemic Stroke: A Mendelian Randomization Study.

Background: Ischemic stroke (IS) is the leading cause of disability and mortality worldwide. Low-density lipoprotein cholesterol (LDL-C) levels hadno potential risk on ischemic stroke. However, higher LDL-C levels were closely related to IS. Based on two antagonistic viewpoints, a Mendelian randomization (MR) study was designed to evaluate the causal effects of LDL-C levels on IS. Methods: Datasets of LDL-C levels and ischemic stroke were acquired from genome-wide association studies (GWAS). Weighted median method was conducted for main analysis, and MR-Egger and inverse-variance weighted (IVW) methods were performed for auxiliary analyses. Heterogeneity and pleiotropic tests were utilized to confirm the reliability of this study. Results: A total of 359 single nucleotide polymorphisms (SNPs) were associated with LDL-C levels (P < 5 × 10-8) and 337 SNPs were available in ischemic stroke with eliminating outliers. LDL-C levels were significantly associated with ischemic stroke (OR = 1.104, 95%CI = 1.019 - 1.195, P = 1.52 × 10-2). MR-Egger and IVW showed directionally similar estimates (MR-Egger: OR = 1.120, 95%CI = 1.040 - 1.207, P = 3.12 × 10-3; IVW: OR = 1.120, 95%CI = 1.064 - 1.178, P = 1.17 × 10-5). Conclusion: LDL-C levels had causal effects on IS, providing insights into the design of future interventions to reduce the burden of ischemic stroke.

Fiber-in-Tube Electrifiable Structure for Virus Filtration Self-Generated Static Electricity by Vibration/Sound.

Fiber has been considered as an ideal material for virus insulation due to the readily available electrostatic adsorption. However, restricted by the electrostatic attenuation and filtration performance decline, their long-lasting applications are unable to satisfy the requirements of medical protective equipment for major medical and health emergencies such as global epidemics, which results in both a waste of resources and environmental pollution. We overcame these issues by constructing a fiber-in-tube structure, achieving the robust reusability of fibrous membranes. Core fibers within the hollow could form generators with tube walls of shell fibers to provide persistent, renewable static electricity via piezoelectricity and triboelectricity. The PM0.3 insulation efficiency achieved 98% even after 72 h of humidity and heat aging, through beating and acoustic waves, which is greatly improved compared with that of traditional nonwoven fabric (∼10% insulation). A mask spun with our fiber also has a low breathing resistance (differential pressure <24.4 Pa/cm2). We offer an approach to enrich multifunctional fiber for developing electrifiable filters, which make the fiber-in-tube filtration membrane able to durably maintain a higher level of protective performance to reduce the replacement and provide a new train of thought for the preparation of other high-performance protective products.

Prevalence and risk factors associated with circadian syndrome in community-dwelling middle-aged to older adults: Based on health ecology model.

OBJECTIVES: To explore the prevalence and risk factors associated with circadian syndrome (CricS) in community-dwelling middle-aged to older adults. METHOD: We performed a cross-sectional analysis of 13,516 participants from the China Health and Retirement Longitudinal Study (CHARLS). We used logistic regression to compute the odds ratios (OR) and 95 % confidence intervals (Cls), using covariates derived through the health ecology model. RESULTS: The overall prevalence of CricS was 31.5 % (25.0 % males and 37.1 % females). With controlling all covariates, social isolation (OR 1.164, 95%CI 1.033-1.310), irritable mood (OR 1.689, 95%CI 1.488-1.917), fear responses (OR 1.546, 95%CI 1.262-1.894), chronic disease (OR 1.577, 95%CI 1.392-1.788), and financial debt (OR 0.806, 95%CI 0.657-0.990) were significantly correlated with increased CricS risk in males, whereas CricS syndrome was significantly associated with age (OR 1.285, 95%CI 1.214-1.361), married (OR 1.258, 95%CI 1.089-1.452), current drinkers (OR 0.835, 95%CI 0.716-0.974), social isolation (OR 1.175, 95%CI 1.065-1.296), irritable mood (OR 1.346, 95%CI 1.210-1.497), fear responses (OR 1.202, 95%CI 1.047-1.378), chronic disease (OR 1.363, 95%CI 1.225-1.517), chronic pain (OR 1.177, 95%CI 1.058-1.309), and universal basic income (OR 0.742, 95%CI 0.611-0.900) in females. CONCLUSION: CricS is common in middle-aged to older adults, and health behavior factors have an important impact on CricS. The potential predictors identified for CricS should be further studied to prevent the occurrence of adverse health events in the presenium stage.

The Anti-Microbial Peptide Citrocin Controls Pseudomonas aeruginosa Biofilms by Breaking Down Extracellular Polysaccharide.

Citrocin is an anti-microbial peptide that holds great potential in animal feed. This study evaluates the anti-microbial and anti-biofilm properties of Citrocin and explores the mechanism of action of Citrocin on the biofilm of P. aeruginosa. The results showed that Citrocin had a significant inhibitory effect on the growth of P. aeruginosa with a minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of 0.3 mg/mL. All five concentrations (1/4MIC, 1/2MIC, MIC, 2MIC, and 4MIC) of Citrocin inhibited P. aeruginosa biofilm formation. Citrocin at the MIC, 2MIC and 4MIC removed 42.7%, 76.0% and 83.2% of mature biofilms, respectively, and suppressed the swarming motility, biofilm metabolic activity and extracellular polysaccharide production of P. aeruginosa. Metabolomics analysis indicated that 0.3 mg/mL of Citrocin up- regulated 26 and down-regulated 83 metabolites, mainly comprising amino acids, fatty acids, organic acids and sugars. Glucose and amino acid metabolic pathways, including starch and sucrose metabolism as well as arginine and proline metabolism, were highly enriched by Citrocin. In summary, our research reveals the anti-biofilm mechanism of Citrocin at the metabolic level, which provides theoretical support for the development of novel anti-biofilm strategies for combatting P. aeruginosa.

Amendments affect the community assembly and co-occurrence network of microorganisms in Cd and Pb tailings of the Eucalyptus camaldulensis rhizosphere.

Mining tailings containing large amounts of Pb and Cd cause severe regional ecosystem pollution. Soil microorganisms play a regulatory role in the restoration of degraded ecosystems. The remediation of heavy metal-contaminated tailings with amendments and economically valuable Eucalyptus camaldulensis is a research hotspot due to its cost-effectiveness and sustainability. However, the succession and co-occurrence patterns of these microbial communities in this context remain unclear. Tailing samples of five kinds of Cd and Pb were collected in E. camaldulensis restoration models. Physicochemical properties, the proportions of different Cd and Pb forms, microbial community structure, and the co-occurrence network of rhizosphere tailings during different restoration process (organic bacterial manure, organic manure, inorganic fertilizer, bacterial agent) were considered. Organic and organic bacterial manures significantly increased pH, cation exchange capacity, and the proportion of residual Pb. Still, there was a significant decrease in the proportion of reducible Pb. The changes in microbial communities were related to physicochemical properties and the types of amendments. Organic and organic bacterium manures decreased the relative abundance of oligotrophic groups and increased the relative abundance of syntrophic groups. Inorganic fertilizers and bacterial agents decreased the relative abundance of saprophytic fungi. B. subtilis would play a better role in the environment improved by organic manure, increasing the relative abundance of beneficial microorganism and reducing the relative abundance of pathogenic microorganism. pH, cation exchange capacity, and the proportion of different forms of Pb were the main factors affecting the bacterial and fungi variation. All four amendments transformed the main critical groups of the microbial network structure from acidophilus and pathogenic microorganisms to beneficial microorganisms. Heavy metal-resistant microorganisms, stress-resistant microorganisms, beneficial microorganisms that promote nutrient cycling, and copiotrophic groups have become critical to building stable rhizosphere microbial communities. The topological properties and stability of the rhizosphere co-occurrence network were also enhanced. Adding organic and organic bacterium manures combined with E. camaldulensis to repair Cd and Pb tailings improved (1) pH and cation exchange capacity, (2) reduced the biological toxicity of Pb, (3) enhanced the stability of microbial networks, and (4) improved ecological network relationships. These positive changes are conducive to the restoration of the ecological functions of tailings.

Constructing a interfacial electric field for efficient reduction of nitrogen to ammonia.

Electrochemical nitrogen reduction (eNRR) is a cost-effective and environmentally sustainable approach for ammonia production. MoS2, as a typical layered transition metal compound, holds significant potential as an electrocatalyst for the eNRR. Nevertheless, it suffers from a limited number of active sites and low electron transfer efficiency. In this study, we constructed a heterostructure by depositing SnO2 (an n-type semiconductor) nanoparticles on MoS2 (a p-type semiconductor). This unique interfacial structure not only generates abundant interfacial contacts but also facilitates the transfer of electrons from SnO2 to MoS2, leading to the formation of an interfacial electric field. Theoretical calculations demonstrate that this electric field increases the number of active electrons, facilitating N2 adsorption and NN bond activation. Moreover, it increases the degree of orbital overlap between N2 and SnO2/MoS2, effectively reducing the energy barrier of the rate-determining step. Benefiting from the interfacial electric field effect, the SnO2/MoS2 catalyst exhibits significant catalytic activity and selectivity towards eNRR, with an ammonia yield of 47.1 µg h-1 mg-1 and a Faraday efficiency of 19.3 %, surpassing those reported for the majority of MoS2- and SnO2-based catalysts.

An optimized non-T cell transfection system based on HEK293FT cells for CD3ζ phosphorylation and ubiquitination.

CD3ζ is part of the T cell receptor (TCR)/CD3 complex that plays a critical role in antigen recognition and subsequent T cell activation. Understanding the mechanisms that regulate CD3ζ can provide new insights into the T cell-mediated immune responses. However, it is challenging to deliver exogenous genes into T cells for functional and mechanistic analyses. To this end, we established a non-T cell transfection system based on HEK293FT cells to screen for candidate regulatory proteins. The transfection was optimized using relatively high confluent cultures and the transfection reagent PolyJet™. Pervanadate (PV) treatment sustained tyrosine phosphorylation of CD3ζ, and facilitated the subsequent activation-dependent ubiquitination by E3 ligase Cbl-b in the HEK293FT system. Lck and Zap70 kinases enhanced the levels of phosphorylated CD3ζ in the presence of PV. We compared the effects of E3 ligases and the corresponding adaptor proteins on activation-dependent ubiquitination of CD3ζ in the PV-stimulated cells, and found that Cbl-b was most effective. Taken together, we have demonstrated that a non-T cell transfection system based on PV-treated HEK293FT cells could effectively mimic CD3ζ phosphorylation and ubiquitination and is a promising model for studying the role of CD3ζ signaling in T cell activation.

The development history, current state, challenges, and future directions of the BASIC-OHCA registry in China: A narrative review.

Out-of-hospital cardiac arrest is a major public health problem worldwide due to its high burden and poor outcomes. Despite progress in treatment, patient outcomes remain unsatisfactory, particularly in low-resource settings. The establishment of a registry is the first step towards gaining a comprehensive understanding of prevailing local conditions and identifying potential opportunities for improving patient survival. Here, we provide a narrative review of the BASeline Investigation of Out-of-hospital Cardiac Arrest (BASIC-OHCA), the first national OHCA registry in China, to introduce its development history, current state, challenges and future directions. We aim to enhance cross-cultural understanding by providing insights from China, while also serving as a reference for the implementation of large-scale registries in low-resource settings.

Extracorporeal Versus Conventional Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest: A Propensity Score Matching Cohort Study.

OBJECTIVE: Comparing the effects of extracorporeal cardiopulmonary resuscitation (ECPR) and conventional cardiopulmonary resuscitation (CCPR) on outcomes in patients with in-hospital cardiac arrest (IHCA) in China. The benefits of ECPR over CCPR in patients with IHCA remain controversial. DESIGN: This article analyzed data from the BASeline Investigation of In-hospital Cardiac Arrest (BASIC-IHCA) study, which consecutively enrolled patients with IHCA from July 1, 2019, to December 31, 2020. Patients who received ECPR were selected as the case group and matched with patients who received CCPR as the control group by propensity score at a ratio of 1:4. A parallel questionnaire survey of participating hospitals was conducted, to collect data on ECPR cases from January 1, 2021 to November 30, 2021. The primary outcome was survival to discharge or 30-day survival. SETTING: We included 39 hospitals across 31 provinces in China. PATIENTS: Patients receiving cardiopulmonary resuscitation and without contraindications to ECPR were selected from the BASIC-IHCA database. Patients older than 75 years, not witnessed, or with cardiopulmonary resuscitation duration less than 10 min were excluded. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 4853 patients met the inclusion criteria before matching, with 34 undergoing ECPR (median age, 56.5 yr; 67.65% male) and 4819 underwent CCPR (median age, 59 yr; 64.52% male). There were 132 patients receiving CCPR and 33 patients receiving ECPR who were eventually matched. The ECPR group had significantly higher survival rates at discharge or 30-day survival (21.21% vs. 7.58%, p = 0.048). The ECPR group had significantly lower mortality rates (hazard ratio 0.57; 95% CI, 0.38-0.91) than the CCPR group at discharge or 30 days. Besides the BASIC-IHCA study, the volume of ECPR implementations and the survival rate of patients with ECPR (29.4% vs. 10.4%. p = 0.004) in participating hospitals significantly improved. CONCLUSIONS: ECPR may be beneficial compared with CCPR for patient survival after IHCA and should be considered for eligible patients with IHCA.

Genome assembly provides insights into the genome evolution of Baccaurea ramiflora Lour.

Baccaurea ramiflora Lour., an evergreen tree of the Baccaurea genus of the Phyllanthaceae family, is primarily distributed in South Asia, Southeast Asia, and southern China, including southern Yunnan Province. It is a wild or semi-cultivated tree species with ornamental, edible, and medicinal value, exhibiting significant development potential. In this study, we present the whole-genome sequencing of B. ramiflora, employing a combination of PacBio SMRT and Illumina HiSeq 2500 sequencing techniques. The assembled genome size was 975.8 Mb, with a contig N50 of 509.33 kb and the longest contig measuring 7.74 Mb. The genome comprises approximately 73.47% highly repetitive sequences, of which 52.1% are long terminal repeat-retrotransposon sequences. A total of 29,172 protein-coding genes were predicted, of which 25,980 (89.06%) have been annotated, Additionally, 3452 non-coding RNAs were identified. Comparative genomic analysis revealed a close relationship between B. ramiflora and the Euphorbiaceae family, with both being sister groups that diverged approximately 59.9 million years ago. During the evolutionary process, B. ramiflora exhibited positive selection in 278 candidate genes. Synonymous substitution rate and collinearity analysis demonstrated that B. ramiflora underwent a single ancient genome-wide triploidization event, without recent genome-wide duplication events. This high-quality B. ramiflora genome provides a valuable resource for basic research and tree improvement programs focusing on the Phyllanthaceae family.

Uric acid levels and heart failure: A mendelian randomization study.

BACKGROUND AND AIMS: Uric acid, the end-product of purine metabolism within the human body, has been the subject of studies exploring its potential association with cardiovascular and cerebrovascular diseases. However, the precise relationship between uric acid levels and heart failure remains elusive. METHODS AND RESULTS: In this particular study, aggregated data from genome-wide association studies on uric acid and heart failure were utilized to perform a two-sample Mendelian randomization (MR) analysis utilizing R software. The aim was to uncover any causal link between these variables. The primary outcome was assessed using inverse variance weighted (IVW) methodology, while sensitivity analyses employed MR-Egger, weighted median (WME), and MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) techniques. IVW results revealed a possible causal relationship between elevated uric acid levels and an increased risk of heart failure (OR: 1.09, 95 % CI: 1.01-1.17, P < 0.05). Encouragingly, the directions provided by MR-Egger and WME aligned with IVW findings, and no anomalies were detected in the remaining sensitivity analyses. CONCLUSION: These outcomes indicate the stability of the results of the study, thereby suggesting that heightened uric acid levels may contribute to an augmented risk of heart failure.

Tristate Photonic Crystal Film with Structural, Fluorescent, and Up-Conversion Luminescent Color for Multilevel Anticounterfeiting.

Counterfeit items are growing worldwide, affecting the global economy and human health. Anticounterfeiting tags based on a physical microstructure or chemical materials have enjoyed long-term commercial success due to their visualization and inexpensive production. However, conventional anticounterfeiting tags can be readily imitated. Herein, we have overcome this limitation by assembling colloidal nanospheres and two luminescent micromaterials into a composited photonic crystal (PhC) and achieved massive scale-up fabrication of multilevel anticounterfeiting PhC films in just several minutes of thermal rolling. The fabricated PhC film exhibits three optical states, including angle-dependent structural color (reflectivity = 66%) under white light, emits green light under 980 nm light, and emits red light under ultraviolet light. Multilevel anticounterfeiting colorful images were obtained by further use of masking templates, which integrate colors from both physically colored microstructures and chemical luminescent materials. Besides, the thermal-rolling process also shows excellent feasibility for assembling microunits with different sizes into high-quality functional PhC films.

Wormwood-infused porous-CaCO3 for synthesizing antibacterial natural rubber latex.

Wormwood leaf is a traditional Chinese herbal medicine with a high medicinal value and long application history and its essential oil is a high-purity plant oil extracted from Wormwood leaf. Pharmacological research reveals that Wormwood leaf and Wormwood essential oil are a broad-spectrum antibacterial and antiviral drug, which can inhibit and kill many bacteria and viruses. We loaded wormwood extract on porous calcium carbonate (Porous-CaCO3) and introduced it and Wormwood essential oil into Natural rubber latex (NRL), thus synthesizing NRL composites with excellent vitro and in vivo antibacterial effect, cell compatibility and mechanical properties. This NRL material can delay the light aging and thermal oxidation of some mechanical properties, which provides a broader avenue for its commercialization.

Associations of legacy perfluoroalkyl and polyfluoroalkyl substances, alternatives, and isomers with gestational diabetes mellitus and glucose homeostasis among women conceiving through assisted reproduction in Shanghai, China.

Prior research has reported that perfluoroalkyl and polyfluoroalkyl substances (PFAS) may be linked to impaired glucose homeostasis in pregnant women. However, few studies have investigated PFAS alternatives and isomers, and even less is known about the association among women conceiving through assisted reproductive technology (ART). The prospective cohort study aimed to explore associations of legacy PFAS, alternatives and isomers with gestational diabetes mellitus (GDM) and glucose homeostasis during pregnancy among 336 women conceiving through ART. Nineteen PFAS, including nine linear legacy PFAS, four short-chain alternatives, four branched isomers, and two emerging PFAS alternatives, were determined in first-trimester maternal serum. Fasting plasma glucose (FPG), 1-h and 2-h glucose concentrations following the oral glucose tolerance test (OGTT), and glycated hemoglobin (HbA1c) were measured during the second trimester. After adjusting for confounding variables, nearly half of individual PFAS (10/19) and PFAS mixtures were correlated with increased GDM risk or elevated 2-h glucose levels. Among PFAS congeners, emerging PFAS alternatives, chlorinated perfluoroalkyl ether sulfonic acids (Cl-PFESAs), showed a notable association with impaired glucose homeostasis. For example, 6:2 Cl-PFESA exhibited a correlation with GDM (OR = 1.31, 95% CI = 1.02, 1.68) and 2-h glucose concentrations (ß = 0.22, 95% CI = 0.08, 0.36), and contributed most to the overall association with 2-h glucose concentrations. Compared to those diagnosed with male factor infertility, the associations were more pronounced in infertile women with reproductive endocrine diseases. We provide evidence that exposure to PFAS, especially emerging PFAS alternatives, may impair glucose homeostasis and increase the risk of GDM among women conceiving through ART.

TREATMENT OF COMATOSE SURVIVORS OF IN-HOSPITAL CARDIAC ARREST WITH EXTENDED ENDOVASCULAR COOLING METHOD FOR 72 H: A PROPENSITY SCORE-MATCHED ANALYSIS.

ABSTRACT: Aims: Targeted temperature management is recommended for at least 24 h in comatose survivors of in-hospital cardiac arrest (IHCA) after the return of spontaneous circulation; however, whether an extension for 72 h leads to better neurological outcomes is uncertain. Methods: We included data from the Qilu Hospital of Shandong University between July 20, 2019, and June 30, 2022. Unconscious patients who had return of spontaneous circulation lasting >20 consecutive min and received endovascular cooling (72 h) or normothermia treatment were compared in terms of survival-to-discharge and favorable neurological survival. Propensity score matching was used to formulate balanced 1:3 matched patients. Results: In total, 2,084 patients were included. Sixteen patients received extended endovascular cooling and 48 matched controls received normothermia therapy. Compared with the normothermia group, patients who received prolonged endovascular cooling had a higher survival-to-discharge rate. However, good neurological outcomes did not differ significantly. Before matching, Cox regression analysis, using mortality as the event, showed that extended endovascular cooling independently affected the survival of IHCA patients. Conclusions: Among comatose patients who had been resuscitated from IHCA, the use of endovascular cooling for 72 h might confer a benefit on survival-to-discharge.

Sex differences in the management of patients with suspected acute coronary syndrome in China.

Few studies have assessed sex differences in the management of suspected acute coronary syndrome (ACS). We aimed to compare the evaluation, treatment, and outcomes between males and females with suspected ACS in the emergency department. Data were obtained from a prospective registry of acute chest pain involving 21 emergency departments in Shandong Province, China. The primary endpoint was 30-day major adverse cardiac events (MACEs). Overlap propensity score weighting was used to address potential confounding. A total of 8046 patients were analysed (42.8% female). Overlap-weighted analysis showed no significant association of female sex with 30-day MACEs (odds ratio, 0.91; 95% CI 0.75 to 1.11; P = 0.363). Secondary analyses found that women were less likely to be identified as high risk at first presentation (odds ratio, 0.86; 95% CI 0.78 to 0.94; P < 0.001). In the emergency department, women were less likely to undergo antiplatelet therapy (odds ratio, 0.87; 95% CI 0.79 to 0.96; P = 0.004) or coronary angiography (odds ratio, 0.78; 95% CI, 0.69 to 0.88; P < 0.001). Women had a longer length of stay in the emergency department and were less likely to be admitted to a ward at disposition. These sex differences existed only in the non-ST-elevation subgroup and were independent of risk stratification. Women with non-ST-elevation chest pain in China received suboptimal treatment in the emergency department. However, their clinical outcomes were not significantly different from those of men. Further studies are needed to determine the causes and impacts of these sex differences.

Leaf Spot of Hedychium coronarium Caused by Colletotrichum gloeosporioides in China.

Hedychium coronarium (white ginger) is widely cultivated for garden decoration and folk medicine. Since 2020, symptomatic leaves showed brown necrosis and yellow borders on H. coronarium in the field (approximately 200 m2) at Southwest University, Rongchang District, Chongqing City. Small brown-yellow spots gradually enlarged and caused withering in severe cases with a mortality rate of around 10%. Disease incidence and severity varied from 55 to 65% and from 30 to 40%, respectively. Infected tissues (5 mm in diameter) were cut from lesion margins, surface sterilized in 70% ethanol for 10 s and 0.1% acidic mercuric chloride for 3 min, followed by rinsing in sterile water three times, and then were cultured onto potato dextrose agar (PDA) at 25 °C. Five isolates were transferred onto fresh PDA and purified by single-spore culturing. The colonies were initially white and turned hoary, and the diameter reached 32.95 to 38.37 mm × 32.42 to 38.61 mm after 3 days of incubation. Pale gray abundant fluffy aerial mycelia were arranged irregularly and densely. Hyphae were septate and branched, 2 to 5 µm in width. Conidiophores were pale brown, septate, branched, cylindrical to ampulliform. Conidia were hyaline, smooth-walled, cylindrical with obtuse ends, and 8.1 to 13.3 µm × 2.4 to 5.8 µm (n = 50) in size. Appressoria were medium brown to dark brown, aseptate, in irregular shape, solitary or in groups, and measured 1.5 to 12.5 µm × 2.1 to 13.3 µm. Morphological characteristics of isolates agreed with the description of Colletotrichum (Liu et al. 2015). Genomic DNA was extracted from fungal colonies incubated on PDA for 7 days following the instructions from the PlantGen DNA Kit (CWBIO, China). The internal transcribed spacer (ITS) region, and fragments of glyceraldehyde-3-phosphate dehydrogenase (GAPDH), actin (ACT), beta-tubulin (TUB2) and large subunit ribosomal DNA (LSU rDNA) genes were amplified by primer pairs ITS1/ ITS4, GDF1/GDR1, ACT512F/ACT783R (Naz et al. 2017), T1/Bt2b (Glass et al. 1995) and LROR/LR7 (Castlebury et al. 2002), respectively. The sequence of representative isolate CG-H (GenBank accession nos. OM010355, OM238213, OM238214, OM045778 and OM010358 for ITS, GAPDH, ACT, TUB2 and LSU rDNA, respectively) exhibited 99 to 100% identity to Colletotrichum gloeosporioides. A multi-locus phylogenetic tree with concatenated sequences of ITS, GAPDH, ACT and TUB regions was constructed using the maximum likelihood method by MEGA7, which revealed that strain CG-H was grouped with C. gloeosporioides. To confirm the pathogenicity, six healthy H. coronarium plants were surface sterilized, and conidial suspension (1 × 106 conidia/mL) was sprayed onto the leaves. Six plants were inoculated with sterile distilled water as controls. All the plants grew in a greenhouse at 25 °C under 12 h/12 h photoperiod. The experiment was repeated four times. Yellow lesions appeared after 7 days of inoculation, irregular-shaped brown spots were formed and slightly sunken within 14 days, and the whole leaf gradually became withered in 50 days. All inoculated plants exhibited leaf spot symptoms while the control plants remained asymptomatic. C. gloeosporioides was re-isolated from lesions of leaves and identified by morphology and sequence analysis, fully confirming Koch's postulates. This is the first report of C. gloeosporioides associated with H. coronarium leaf spot in China and worldwide. Further studies will be conducted on the sensitivity of C. gloeosporioides to various fungicides.

First Report of Leaf Blight of Hedychium coronarium Caused by Alternaria alternata in China.

Hedychium coronarium is an economically significant crop that is widely cultivated for its ornamental, aromatic, and medicinal value (Abbas et al. 2021). From 2020 to 2023, a leaf blight was observed in about 85% of H. coronarium growing in a production field (approximately 500 m2) at Southwest University, Chongqing, China (29° 150'-29° 41' N, 105° 17'-105° 44' E). Symptoms included dark brown necrotic tissue with a clear yellow border. When the disease became severe, affected leaves became dry and abscised. Symptomatic pieces (2 to 5 mm2) between necrotic and healthy tissues were collected from 20 leaf samples, then were immersed in 70% ethanol for 10 s, 0.1% mercury bichloride for 3 min, rinsed in sterile water three times, and placed onto potato dextrose agar (PDA). Four Alternaria isolates were obtained by transferring hyphal tips to new plates. All isolates had identical morphological traits. Cultures on PDA were initially white mycelium on the rim with a light brown center. At around the fourth day, the colony margin changed into light gray and the central part turned sooty black. Conidiophores were branched. Conidia were dark brown, ovoid or ellipsoid in shape, 3.4 to 13.2 µm × 4.1 to 23.5 µm (n = 50) with zero to four transverse and longitudinal septa. For molecular identification, DNA was extracted using the PlantGen DNA Kit CW0553A (Cwbio, Taizhou, China) for PCR amplification of internal transcribed spacer (ITS) region, and 28S large subunit ribosomal RNA (LSU), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), Alternaria major allergen (Alt a 1) and actin (ACT) genes (Choi et al. 2022; Xie et al. 2022; Zhang et al. 2021). BLASTn searches showed that ITS, LSU, GAPDH, Alt a 1 and ACT of four isolates had 100% homology with the corresponding sequences of A. alternata strains MZ578214, KP940477, MK903028, MN655781 and MF564199, respectively. Representative sequences of one strain (AH1) with accession numbers of OK639009, OK639186, OK664976, OK664977 and OK664978 for ITS, LSU, GAPDH, Alt a 1 and ACT regions were deposited in GenBank. The maximum-likelihood tree generated by MEGA 5.10 demonstrated that the pathogenic isolate AH1 obtained from H. coronarium leaf was grouped in the same clade with A. alternata strain CBS121348, which was supported by 100% bootstrap values. To fulfill Koch's postulates, conidia were collected from a 7-day-old culture, suspended in sterile distilled water, and adjusted to 1 × 106 conidia/mL. Leaves on 6-month-old H. coronarium were surface disinfected with 1% sodium hypochlorite solution for 1 min, rinsed twice in water, and then inoculated with AH1 using a sprayer, while leaves treated with sterile water served as negative controls. The experiment was conducted four times, and each repeat contained 10 plants. Pathogenicity tests were performed in the greenhouse at 25°C with a 12 h photoperiod. Partial yellow lesions were observed 3 days of post-inoculation. As the disease progressed, the tawny color gradually spread across the leaf and the tip became dark brown within 7 days. The necrosis expanded and some small leaves were completely affected within 2 weeks. The pathogen was re-isolated from the lesions and re-identified through morphological traits and sequence analysis. A. alternata have been reported to cause leaf diseases in a variety of cereal crops, vegetables, and fruits across China (Sun et al. 2021; Zheng et al. 2015), which cause significant crop loss. To our knowledge, this is the first report of A. alternata causing leaf blight of H. coronarium in the world. More surveys are needed to explore the epidemiology and management strategies for disease caused by A. alternata in Southwest China.