Enhanced performance of quantum dot light-emitting diodes enabled by zirconium doped SnO2 as electron transport layers.

Next-generation display and lighting based on quantum dot light-emitting diodes (QLEDs) require a balanced electron injection of electron transport layers (ETLs). However, classical ZnO nanoparticles (NPs) as ETLs face inherent defects such as excessive electron injection and positive aging effects, urgently requiring the development of new types of ETL materials. Here, we show that high stability SnO2 NPs as ETL can significantly improve the QLED performance to 100567 cd·m-2 luminance, 14.3% maximum external quantum efficiency, and 13.1 cd·A-1 maximum current efficiency using traditional device structures after optimizing the film thickness and annealing the temperature. Furthermore, experimental tests reveal that by doping Zr4+ ions, the size of SnO2 NPs will reduce, dispersion will improve, and energy level will shift up. As expected, when using Zr-SnO2 NPs as the ETL, the maximum external quantum efficiency can reach 16.6%, which is close to the state-of-the-art QLEDs based on ZnO ETL. This work opens the door for developing novel, to the best of our knowledge, type ETLs for QLEDs.

Differential impacts of nonsteroidal anti-inflammatory drugs on lifespan and healthspan in aged Caenorhabditis elegans.

Aging and age-related diseases are intricately associated with oxidative stress and inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) have shown their promise in mitigating age-related conditions and potentially extending lifespan in various model organisms. However, the efficacy of NSAIDs in older individuals may be influenced by age-related changes in drug metabolism and tolerance, which could result in age-dependent toxicities. This study aimed to evaluate the potential risks of toxicities associated with commonly used NSAIDs (aspirin, ibuprofen, acetaminophen, and indomethacin) on lifespan, healthspan, and oxidative stress levels in both young and old Caenorhabditis elegans. The results revealed that aspirin and ibuprofen were able to extend lifespan in both young and old worms by suppressing ROS generation and enhancing the expression of antioxidant SOD genes. In contrast, acetaminophen and indomeacin accelerated aging process in old worms, leading to oxidative stress damage and reduced resistance to heat stress through the pmk-1/skn-1 pathway. Notably, the harmful effects of acetaminophen and indomeacin were mitigated when pmk-1 was knocked out in the pmk-1(km25) strain. These results underscore the potential lack of benefit from acetaminophen and indomeacin in elderly individuals due to their increased susceptibility to toxicity. Further research is essential to elucidate the underlying mechanisms driving these age-dependent responses and to evaluate the potential risks associated with NSAID use in the elderly population.

One-Pot Synthesis of N-Doped NiO for Enhanced Photocatalytic CO2 Reduction with Efficient Charge Transfer.

The green and clean sunlight-driven catalytic conversion of CO2 into high-value-added chemicals can simultaneously solve the greenhouse effect and energy problems. The controllable preparation of semiconductor catalyst materials and the study of refined structures are of great significance for the in-depth understanding of solar-energy-conversion technology. In this study, we prepared nitrogen-doped NiO semiconductors using a one-pot molten-salt method. The research shows that the molten-salt system made NiO change from p-type to n-type. In addition, nitrogen doping enhanced the adsorption of CO2 on NiO and increased the separation of photogenerated carriers on the NiO. It synergistically optimized the CO2-reduction system and achieved highly active and selective CO2 photoreduction. The CO yield on the optimal nitrogen-doped photocatalyst was 235 µmol·g-1·h-1 (selectivity 98%), which was 16.8 times that of the p-type NiO and 2.4 times that of the n-type NiO. This can be attributed to the fact that the nitrogen doping enhanced the oxygen vacancies of the NiOs and their ability to adsorb and activate CO2 molecules. Photoelectrochemical characterization also confirmed that the nitrogen-doped NiO had excellent electron -transfer and separation properties. This study provides a reference for improving NiO-based semiconductors for photocatalytic CO2 reduction.

Regional heterogeneity and driving factors of road runoff pollution from urban areas in China.

Due to the multiple influences of natural and anthropogenic factors, stormwater runoff from urban roads generally presents heterogeneous pollution among cities. The identification of regional heterogeneity and related driving factors of road runoff pollution is of significance for the optimal management of road runoff pollution according to the local circumstances. In this study, the regional heterogeneity of urban road runoff pollution from fourteen representative cities in China is analyzed for four typical pollutants including total suspended solids (TSS), chemical oxygen demand (COD), total nitrogen (TN) and total phosphorus (TP). The results show wide variations in TSS, COD, TN and TP pollution among cities, with the average event mean concentrations ranging from 77.0 to 1347.9, 31.4 to 488.1, 0.81 to 8.46, 0.139 to 1.930 mg/L, respectively. One-way ANOVA analyses demonstrate significant differences in road runoff pollution among cities. The TSS pollution is significantly heavier for northern and northwestern inland cities than that for eastern and southern cities. Pearson correlation analysis and Stepwise linear regression analysis are performed to identify and rank the influence of climate, population, economy, industry structure, traffic and environmental quality. Direct relationships of road runoff pollution are detected with PM2.5, PM10, secondary industry, tertiary industry, annual rainfall, and urban green coverage, among which PM10 and urban green coverage are the most important and common factors exerting positive and negative influences on road runoff pollution, respectively. Based on the findings of this work, improvement of atmospheric particulate pollution and increase in urban greenness are recommended measures to manage the road runoff pollution. Furthermore, the traffic-related emissions accompanying the upgrading of industry structure should be effectively controlled to attenuate the TSS and COD pollution in road runoff.

Prevalence and risk factors of dementia in elder adults in Xiamen, China: A cross-sectional study.

BACKGROUND: The prevalence of dementia can vary by region and there is a cluster of more than 10 modifiable risk factors for dementia. Therefore, this study aimed to determine the prevalence of dementia in Xiamen, China, and identify independent risk factors associated with dementia. METHODS: This cluster sampling-based cross-sectional study enrolled elder adults from Xiamen City and conducted face-to-face interviews between April and August 2019. Data on the demographic characteristics and prevalence of dementia were collected. Multivariable logistic regression was used to analyse the factors associated with dementia. RESULTS: A total of 6430 subjects were enrolled. The prevalence of dementia was 7.62% (490/6430). A total of 490 patients were in the dementia group and 196 healthy matched subjects were selected for the control group with similar profiles for age, gender, and occupation as the dementia patients. Dementia patients were at increased risk for cerebrovascular disease, traumatic brain injury, and hypertension (all P < 0.05). Multivariable logistic regression analysis showed hypertension (odds ratio (OR) = 2.4, 95% confidence interval (CI): 1.62-3.63, P < 0.001) and traumatic brain injury (OR = 2.19, 95% CI: 1.16-4.53, P = 0.023) were independent risk factors for dementia. CONCLUSIONS: The prevalence of dementia was high among elder adults residing in Xiamen, China. Dementia patients were more likely to have hypertension and traumatic brain injury than the matched control group.

Integrating indices based on different chemical extractions and bioaccumulation in Bellamya aeruginosa to assess metal pollution and ecological risk in sediment.

Various indices based on metal chemical data are used to evaluate pollution and ecological risk, but the consistency of the assessment results is usually unsatisfactory, and it is unclear if the ecological risk from sediment metals is accurately represented in in situ zoobenthos. Herein, the pollution and ecological risk associated with As, Cd, Cr, Cu, Ni, Pb and Zn in the sediments of two adjacent lakes (Datun (DT) and Changqiao (CQ)) were comprehensively evaluated by integrating metal concentrations, chemical forms and bioaccumulation in Bellamya aeruginosa (B. aeruginosa). The metal concentrations and chemical compositions varied widely in the sediments. Over 50% of the Cd, Pb and Zn in the sediments was present in bioavailable forms, followed by 28% of Cu and less than 25% of As, Cr and Ni. According to the enrichment factor (EF) and concentration enrichment ratio (CER) assessments, Cr and Ni were natural in origin, while the other metals were at minor to extremely high pollution levels, with average EFs of 1.5-77.6 and CERs of 1.1-113.4. The pollution levels for Cd, Cu and Pb from the EF and CER assessments were similar, while those for As and Zn were higher according to CER than EF (p = 0.05), likely due to the baseline underestimation associated with the potential diagenetic remobilization of bioavailable metals. The ecological risk index (Er), sediment quality guidelines (SQGs) and risk assessment code (RAC) showed a high eco-risk for Cd, while no similar risk was found for the other metals. By integrating risk indices with the chemical forms and pollution levels of metals, we deduced high eco-risks for As and Pb and moderate eco-risks for Cu and Zn in DT Lake and moderate eco-risks for As, Pb and Zn in CQ Lake. The other metals in the sediments of the two lakes presented low eco-risks. No significant positive correlations (p = 0.05) between metal accumulation in B. aeruginosa and the indices of pollution and eco-risk were observed except for the case of As, implying that measuring the metal concentrations in B. aeruginosa would not accurately characterize the metal pollution and ecological risk of sediments.

Cd0.5Zn0.5S/CoWO4 Nanohybrids with a Twinning Homojunction and an Interfacial S-Scheme Heterojunction for Efficient Visible-Light-Induced Photocatalytic CO2 Reduction.

The construction of a phase junction photocatalyst can significantly enhance the photocatalytic performance with high selectivity for CO2 reduction. In this study, an S-scheme junction Cd0.5Zn0.5S/CoWO4 semiconductor with the coupling of a twin crystal Cd0.5Zn0.5S homojunction and CoWO4 was designed through a hydrothermal method, which could convert CO2 to CO with high efficiency under visible-light illumination. Cd0.5Zn0.5S-10%CoWO4 exhibited the optimal performance and its CO yield and selectivity were up to 318.68 µmol·g-1 and 95.90%, respectively, which were 4.54 and 1.62 times higher than that of twin crystal Cd0.5Zn0.5S. Moreover, the Cd0.5Zn0.5S homojunction with a zinc-blende and wurtzite phase and the S-scheme phase junction of Cd0.5Zn0.5S/CoWO4 enhanced the property of CO2 adsorption and accelerated the detachment of photogenerated carriers. The combination of photogenerated holes in Cd0.5Zn0.5S and the electrons of CoWO4 can retain the reduction sites to improve photocatalytic performance. This study provides a neoteric concept and reference for the construction of the S-scheme phase junction.

Thermodynamic prediction and experimental investigation of short-term dynamic membrane formation in dynamic membrane bioreactors: Effects of sludge properties.

In dynamic membrane bioreactors (DMBRs), a dynamic membrane (DM) forms on a support material to act as the separation membrane for solids and liquids. In this study, batch filtration tests were carried out in a DMBR using nylon mesh (25 µm) as support material to filtrate sludge suspensions of variable properties from three different sources to evaluate the effects on the short-term DM formation process (within 240 min). Furthermore, the extended Derjaguin-Landau-Verwey-Overbeek (XDLVO) theory was applied to analyze the sludge adhesion and cohesion behaviors on the mesh surface to predict quantitative parameters of the short-term DM formation process (including initial formation and maturation stage). The filtration results showed that the order of the initial DM formation time (permeate turbidity <1 NTU as an indicator) was as follows: sludge with poor settleability and dewaterability < normal sludge < sludge with poor flocculability. Moreover, normal sludge (regarding settleability, dewaterability, flocculability, and extracellular polymeric substance) showed a more acceptable DM formation performance (short DM formation time, low permeate turbidity, and high permeate flux) than sludge with poor settleability, dewaterability and flocculability. The influence of sludge properties on the initial DM formation time corroborates the prediction of sludge adhesion behaviors by XDLVO theory. Additionally, the XDLVO calculation results showed that acid-based interaction, energy barrier, and secondary energy minimum were important determinants of the sludge adhesion and cohesion behaviors. Therefore, short-term DM formation process may be enhanced to achieve stable long-term DMBR operation through positive modification of the sludge properties.

Dynamic membrane bioreactor performance enhancement by powdered activated carbon addition: Evaluation of sludge morphological, aggregative and microbial properties.

The effects of powdered activated carbon (PAC) addition on sludge morphological, aggregative and microbial properties in a dynamic membrane bioreactor (DMBR) were investigated to explore the enhancement mechanism of pollutants removal and filtration performance. Sludge properties were analyzed through various analytical measurements. The results showed that the improved sludge aggregation ability and the evolution of microbial communities affected sludge morphology in PAC-DMBR, as evidenced by the formation of large, regularly shaped and strengthened sludge flocs. The modifications of sludge characteristics promoted the formation process and filtration flux of the dynamic membrane (DM) layer. Additionally, PAC addition did not exert very significant influence on the propagation of eukaryotes (protists and metazoans) and microbial metabolic activity. High-throughput pyrosequencing results indicated that adding PAC improved the bacterial diversity in activated sludge, as PAC addition brought about additional microenvironment in the form of biological PAC (BPAC), which promoted the enrichment of Acinetobacter (13.9%), Comamonas (2.9%), Flavobacterium (0.31%) and Pseudomonas (0.62%), all contributing to sludge flocs formation and several (such as Acinetobacter) capable of biodegrading relatively complex organics. Therefore, PAC addition could favorably modify sludge properties from various aspects and thus enhance the DMBR performance.

Bmi-1 plays a critical role in the protection from acute tubular necrosis by mobilizing renal stem/progenitor cells.

The regeneration of injured tubular cell occurs primarily from intrinsic renal stem/progenitor cells (RSCs) labeled with CD24 and CD133 after acute tubular necrosis (ATN). Bmi-1 plays a crucial role in regulating self-renewal, differentiation and aging of multiple adult stem cells and progenitor cells. Bmi-1 was rapidly elevated in the induction of adult kidney regeneration by renal injury. To determine whether Bmi-1 maintained mobilization of RSCs in the protection from ATN, glycerol-rhabdomyolysis-induced ATN were performed in wild type (WT) and Bmi-1-deficient (Bmi-1-/-) mice. Their ATN phenotypes were analyzed; CD24 and CD133 double positive (CD24+CD133+) cells were measured; and the levels of serum urea nitrogen (SUN) and serum creatinine (SCr) were detected. We found that CD24+CD133+ RSCs were mobilized in WT ATN mice with the increased expression of Bmi-1; Bmi-1 deficiency led to increased tubular cast formation and necrosis, elevated levels of SUN and SCr, decreased tubular proliferation, and immobilized ratio of RSCs in ATN. These findings indicated that Bmi-1 played a critical role in the protection from ATN by maintaining mobilization of RSCs and would be a novel therapeutic target for preventing the progression of ATN.

A model to predict the onset of non-alcoholic fatty liver disease within 2 years in elderly adults.

BACKGROUND AND AIM: Non-alcoholic fatty liver disease (NAFLD) is a common cause of chronic hepatitis, which leads to cirrhosis and hepatocellular carcinoma. However, it is difficult to identify subjects at high risk for NAFLD onset. This study aims to construct a model to predict the onset of NAFLD within 2 years in elderly adults. METHODS: This study included and followed 3378 initial NAFLD-free subjects aged 60 years or over for 2 years, which were randomly divided into a training set and a validation set. NAFLD was diagnosed on ultrasound. Clinical and laboratory data were recorded at baseline. A model was constructed in the training set to predict the onset of NAFLD and validated in the validation set. RESULTS: Body mass index, hemoglobin, fasting blood glucose, and triglycerides were identified as predictors for the onset of NAFLD. A risk score (R) was calculated by them. It classified the subjects into low-risk group (R ≤ -2.88), moderate-risk group (-2.88 < R ≤ -1.26), and high-risk group (R > -1.26). In the training set, 4.68% of the participants in the low-risk group, 11.59% of the participants in the moderate-risk group, and 31.02% of the participants in the high-risk group developed NAFLD. In the validation set, 5.84% of the participants in the low-risk group, 10.57% of the participants in the moderate-risk group, and 29.44% of the participants in the high-risk group developed NAFLD. CONCLUSIONS: This study developed a model to predict the onset of NAFLD in elderly adults, which might provide indications for intervention to these subjects.

Source identification of bacterial and viral pathogens and their survival/fading in the process of wastewater treatment, reclamation, and environmental reuse.

Pathogenic safety is drawing wide concern in water reclamation and reuse. In order to elucidate survive/fade of pathogens during the processes of wastewater treatment and reclamation, general indicators (fecal coliform and Escherichia coli), pathogenic bacteria (Salmonella and Shigella) and viruses (enterovirus, rotavirus and norovirus) were investigated in an A(2)O-MBR system. Attention was paid to their strengths from different sources, at various stages of the treatment, and in the product water. According to findings, black water was the main source for pathogens-at least 1-2-log higher in concentration than those from other sources. The preliminary treatment of wastewater by fine screens could bring about 0.2-0.4-log removal for almost all pathogens. The biological treatment units achieved almost identical removal (1.3-1.7-log) for bacteria and viruses. However, subsequent treatment in the membrane bioreactor showed varied removal for fecal coliform (4.7-log), E. coli (2.6-log) and the other pathogens (0.7-1.0-log), indicating that a high reduction of indicator bacteria may not imply equivalent removal of bacterial and viral pathogens. Chlorination was proved to be effective for eliminating all pathogens. In the artificial lake where the product water was stored, fecal coliform was not detected during the study period, but E. coli and pathogens were frequently detected, indicating that these bacterial and viral pathogens may be originating from non-fecal sources. On sunny summer days, the lake water could be bacteria-free due to sunlight radiation, but viruses were still detectable. Therefore, secondary disinfection may have to be adopted when the reclaimed water stored in such an open reservoir is supplied for strict reuse purposes.

Case-control study of GRIA1 and GRIA3 gene variants in migraine.

BACKGROUND: As the most abundant excitatory neurotransmitter in the central nervous system, glutamate has been accepted to play a major role in the pathophysiology of migraine. The previous studies have reported the glutamate receptor ionotropic GRIA1 and GRIA3 genes variants associated with migraine. The project aims to investigate the polymorphisms in both genes for their association with migraine in the Chinese Han population. METHODS: A Han-Chinese case-control population, including 331 unrelated female migraine patients and 330 matched controls, was studied. Variants in genes (GRIA1 and GRIA3) were genotyped by Multiplex SNaPshot assay. RESULTS: In the group of patients, the frequency of allele C was 84.1 % (557 C alleles) and allele T was 15.9 % (105 T alleles) for the GRIA1 (rs2195450) in migraineurs, this was significantly as compared with the controls (P = .001, OR = 1.786, 95 % CI: 1.28-2.49). And an association was also seen in the migraine with aura (MA) subtype (P = .012, OR = 2.092, 95 % CI: 1.17-3.76) and migraine without aura (MO) subtype (P = .002, OR = 1.737, 95 % CI: 1.23-2.45). However, no evidence was found that GRIA1 (rs548294) or GRIA3 (rs3761555) is associated with migraine. CONCLUSION: Our data of this study confirmed the association of GRIA1 (rs2195450) to female migraine (MA, MO) susceptibility in the Chinese Han population. The result provides evidence that the glutamatergic system is implicated in the pathophysiology of migraine.

High efficiency, linearly polarized, directly diode-pumped Er:YAG laser at 1617 nm.

An efficient, directly diode-pumped Er:YAG laser at 1617 nm was demonstrated. A folding mirror with high reflectivity for the s-polarized light at the laser wavelength was used to achieve a linearly polarized laser. A maximum continuous-wave output power of 7.73 W was yielded under incident pump power of 50.57 W, and the optical conversion efficiency with respect to incident pump power was ∼15.28%, which was the highest optical conversion efficiency with directly diode-pumped Er:YAG lasers up to now; in Q-switched operation, the maximum pulse energy of 7.82 mJ was generated with pulse duration of about 80 ns at a pulse repetition frequency of 500 Hz.

The Prevalence and Risk Factors of Sexual Dysfunction in the Elderly in Southern China.

Objective: This study aims to evaluate the epidemiological features of sexual dysfunction in people aged more than 65 years in parts of China, and to investigate the independent significant risk factors. Methods: According to the population distribution of five communities in Xiamen and Chongqing, we have randomly enrolled 2403 people more than 65 years-of-age. We collected data information through a questionnaire survey. Then demonstrated the current condition of sexual dysfunction in the samples by statistical analysis, and multivariable logistic regression was used to disclose the risk factors of sexual dysfunction in the older adults. Results: According to this study, about 10.48% of the elderly had sexual dysfunctions of different degrees and duration. The proportion of men was about twice that of women (14.5% of males and 7.3% of females). During the course of the disease, 3.19% (43/1344) of women and 3.31% (35/1059) of men had more than 15 years duration of sexual dysfunction. In severity, 5.7% (77/1344) of women and 7.0% (74/1059) of men had very severe sexual dysfunction. There were statistically significant differences in BMI, smoking, drinking history, hypertension, depression incidence or median (p<0.05). Alcohol consumption history [OR = 1.711, 95% CI: 1.124-2.604, p = 0.012] and depression [OR = 2.107, 95% CI: 1.109-4.356, p =0.044] were independent risk factors for sexual dysfunction. Conclusion: The prevalence of sexual dysfunction was low among elderly in the southern part of China. But the course of the disease is long and the degree of the disease is very severe. Elderly with a history of drinking and depression are more prone to sexual dysfunction.

Deliberate self-harm among pediatric psychiatric inpatients in China: A single-center retrospective study.

BACKGROUND: For children and adolescents, deliberate self-harm (DSH) is becoming a mental health problem of concern. Despite several studies on the prevalence and factors of DSH in the world, there is little information on DSH among children and adolescents in China. This study explores the prevalence, types, associated risk factors and tendency of DSH in pediatric psychiatric inpatients in China. AIM: To understand the situation of DSH among hospitalized children and adolescents and its related factors. METHODS: In this study, we retrospectively studied 1414 hospitalized children and adolescents with mental illness at Xiamen Mental Health Center from 2014 to 2019, extracted the demographic and clinical data of all patients, and analyzed clinical risk factors of DSH. RESULTS: A total of 239 (16.90%) patients engaged in at least one type of DSH in our study. Cutting (n = 115, 48.12%) was the most common type of DSH. Females (n = 171, 71.55%) were more likely to engage in DSH than males (n = 68, 28.45%). DSH was positively associated with depressive disorders [OR = 3.845 (2.196-6.732); P < 0.01], female [OR = 2.536 (1.815-3.542); P < 0.01], parental marital status [OR = 5.387 (2.254-12.875); P < 0.01] and negative family history of psychiatric illness [OR = 7.767 (2.952-20.433); P < 0.01], but not with occupation, substance use and history of physical abuse. CONCLUSION: Our findings suggest that for patients with depression, females, an abnormal marriage of parents, and no history of mental illness, attention should be paid to the occurrence of DSH.

A Mechanistic Analysis of Metformin's Biphasic Effects on Lifespan and Healthspan in C. elegans: Elixir in Youth, Poison in Elder.

Aging, a complex biological process influenced by genetic, environmental, and pharmacological factors, presents a significant challenge in understanding its underlying mechanisms. In this study, we explored the divergent impacts of metformin treatment on the lifespan and healthspan of young and old C. elegans, demonstrating a intriguing "elixir in youth, poison in elder" phenomenon. By scrutinizing the gene expression changes in response to metformin in young (day 1 of adulthood) and old (days 8) groups, we identified nhr-57 and C46G7.1 as potential modulators of age-specific responses. Notably, nhr-57 and C46G7.1 exhibit contrasting regulation patterns, being up-regulated in young worms but down-regulated in old counterparts following metformin treatment. Functional studies employing knockdown approaches targeting nhr-57, a gene under the control of hif-1 with a documented protective function against pore-forming toxins in C. elegans, and C46G7.1, unveiled their critical roles in modulating lifespan and healthspan, as well as in mediating the biphasic effects of metformin. Furthermore, deletion of hif-1 retarded the influence of metformin, implicating the involvement of hif-1/nhr-57 in age-specific drug responses. These findings underscored the necessity of deciphering the mechanisms governing age-related susceptibility to pharmacological agents to tailor interventions for promoting successful aging.

Cancer screening in hospitalized ischemic stroke patients: a multicenter study focused on multiparametric analysis to improve management of occult cancers.

Background/aims: The reciprocal promotion of cancer and stroke occurs due to changes in shared risk factors, such as metabolic pathways and molecular targets, creating a "vicious cycle." Cancer plays a direct or indirect role in the pathogenesis of ischemic stroke (IS), along with the reactive medical approach used in the treatment and clinical management of IS patients, resulting in clinical challenges associated with occult cancer in these patients. The lack of reliable and simple tools hinders the effectiveness of the predictive, preventive, and personalized medicine (PPPM/3PM) approach. Therefore, we conducted a multicenter study that focused on multiparametric analysis to facilitate early diagnosis of occult cancer and personalized treatment for stroke associated with cancer. Methods: Admission routine clinical examination indicators of IS patients were retrospectively collated from the electronic medical records. The training dataset comprised 136 IS patients with concurrent cancer, matched at a 1:1 ratio with a control group. The risk of occult cancer in IS patients was assessed through logistic regression and five alternative machine-learning models. Subsequently, select the model with the highest predictive efficacy to create a nomogram, which is a quantitative tool for predicting diagnosis in clinical practice. Internal validation employed a ten-fold cross-validation, while external validation involved 239 IS patients from six centers. Validation encompassed receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis (DCA), and comparison with models from prior research. Results: The ultimate prediction model was based on logistic regression and incorporated the following variables: regions of ischemic lesions, multiple vascular territories, hypertension, D-dimer, fibrinogen (FIB), and hemoglobin (Hb). The area under the ROC curve (AUC) for the nomogram was 0.871 in the training dataset and 0.834 in the external test dataset. Both calibration curves and DCA underscored the nomogram's strong performance. Conclusions: The nomogram enables early occult cancer diagnosis in hospitalized IS patients and helps to accurately identify the cause of IS, while the promotion of IS stratification makes personalized treatment feasible. The online nomogram based on routine clinical examination indicators of IS patients offered a cost-effective platform for secondary care in the framework of PPPM. Supplementary Information: The online version contains supplementary material available at 10.1007/s13167-024-00354-8.

Patent foramen ovale-associated stroke repeatedly misdiagnosed as cerebral small vessel disease: A case report.

BACKGROUND: Transthoracic echocardiography (TTE) is the most commonly used screening method for cardiac structural abnormalities. However, it may lead to a missed diagnosis of partial patent foramen ovale (PFO)-associated stroke. CASE PRESENTATION: A 60-year-old male was admitted to the hospital for recurrent left limb weakness with or without slurred speech for 14 months. No stroke-related cardiac structural abnormality was detected during repeated TTE, and the patient was diagnosed with cerebral small vessel disease. Finally, right-to-left shunt was detected by contrast-enhanced transcranial Doppler. Subsequently, the patient was diagnosed with PFO-associated stroke by transesophageal echocardiography and contrast transesophageal echocardiography. CONCLUSIONS: TTE has a low detection rate of PFO, such that it is easily missed. Contrast-enhanced transcranial Doppler is easy to operate and should be promoted as a supplementary measure to stroke etiological investigation and primary PFO screening.

Potential to Reduce Chemical Fertilizer Application in Tea Plantations at Various Spatial Scales.

Tea is the main commercial crop grown in China, and excessive application of chemical fertilizers in tea plantations is common. However, the potential to reduce chemical fertilizer use in tea plantations is unclear. In this study, Zhejiang Province was selected as the research object to systematically analyze the potential for tea plantation chemical-fertilizer reduction at different spatial scales. The geographic information system-based analytic hierarchy process method and Soil and Water Assessment Tool model were used to determine the chemical fertilizer reduction potential at the province scale and watershed scale, respectively. At the field scale, two consecutive years of field experiments were conducted on a tea plantation. Province-level analysis showed that 51.7% of the area had an average total fertilization intensity greater than 350 kg/hm2 and a high reduction potential. Watershed analysis revealed that chemical fertilizer reduction had better potential in reducing total nitrogen and total phosphorus inputs to runoff in the short term, whereas 50% organic fertilizer substitution was the best strategy to achieve long-term effects. The field experiments further proved that organic fertilizer substitution balanced tea growth and environmental protection. This study provides a useful method to investigate strategies to reduce chemical fertilizer use in tea-growing areas.