Lenghu on the Tibetan Plateau as an astronomical observing site.

On Earth's surface, there are only a handful of high-quality astronomical sites that meet the requirements for very large next-generation facilities. In the context of scientific opportunities in time-domain astronomy, a good site on the Tibetan Plateau will bridge the longitudinal gap between the known best sites1,2 (all in the Western Hemisphere). The Tibetan Plateau is the highest plateau on Earth, with an average elevation of over 4,000 metres, and thus potentially provides very good opportunities for astronomy and particle astrophysics3-5. Here we report the results of three years of monitoring of testing an area at a local summit on Saishiteng Mountain near Lenghu Town in Qinghai Province. The altitudes of the potential locations are between 4,200 and 4,500 metres. An area of over 100,000 square kilometres surrounding Lenghu Town has a lower altitude of below 3,000 metres, with an extremely arid climate and unusually clear local sky (day and night)6. Of the nights at the site, 70 per cent have clear, photometric conditions, with a median seeing of 0.75 arcseconds. The median night temperature variation is only 2.4 degrees Celsius, indicating very stable local surface air. The precipitable water vapour is lower than 2 millimetres for 55 per cent of the night.

Risk factors for foot ulcer recurrence in patients with comorbid diabetic foot osteomyelitis and diabetic nephropathy: A 3-year follow-up study.

This study aimed to explore the risk factors for foot ulcer recurrence in patients with comorbid diabetic foot osteomyelitis (DFO) and diabetic nephropathy (DN). This is a prospective cohort study. Between May 2018 and May 2021, we selected 120 inpatients with comorbid severe diabetic foot infection (PEDIS Grade 3 or above) and DN for inclusion in our study. All cases were followed up for 36 months. The study outcomes were whether foot ulcer recurred and the time to recurrence. The risk factors of ulcer recurrence were analysed by comparing the data of the three groups. According to the recurrence of foot ulcer, the participants were divided into three groups: Group A (no foot ulcer recurrence, n = 89), Group B (foot ulcer recurrence within 12-36 months, n = 19) and Group C (foot ulcer recurrence within 6-12 months, n = 12). The multivariate Cox regression analysis showed that urine albumin-creatinine ratio (UACR) (HR: 1.008, 95% CI: 1.005-1.011, P < .001) and vibration perception threshold (VPT) (HR: 1.064, 95% CI: 1.032-1.096, P < .001) were identified as independent risk factors. Kaplan-Meier curves showed a significant positive association between UACR or VPT and the risk of foot ulcer recurrence (log rank, all P < .05). Areas under the ROC curves for UACR, VPT and the combination of UACR and VPT were 0.802, 0.799 and 0.842, respectively. The best cut-off values of UACR and VPT were 281.51 mg/g and 25.12 V, respectively. In summary, elevated UACR and VPT were independent risk factors. The best clinical cut-off values of UACR and VPT for prediction of foot ulcer recurrence were 281.51 mg/g and 25.12 V, respectively. Besides, our results suggested that microcirculation disorders rather than macrovascular complications play a major role in the recurrence of foot ulcer in patients with comorbid DFO and DN.

Formation of new stellar populations from gas accreted by massive young star clusters.

Stars in clusters are thought to form in a single burst from a common progenitor cloud of molecular gas. However, massive, old 'globular' clusters--those with ages greater than ten billion years and masses several hundred thousand times that of the Sun--often harbour multiple stellar populations, indicating that more than one star-forming event occurred during their lifetimes. Colliding stellar winds from late-stage, asymptotic-giant-branch stars are often suggested to be triggers of second-generation star formation. For this to occur, the initial cluster masses need to be greater than a few million solar masses. Here we report observations of three massive relatively young star clusters (1-2 billion years old) in the Magellanic Clouds that show clear evidence of burst-like star formation that occurred a few hundred million years after their initial formation era. We show that such clusters could have accreted sufficient gas to form new stars if they had orbited in their host galaxies' gaseous disks throughout the period between their initial formation and the more recent bursts of star formation. This process may eventually give rise to the ubiquitous multiple stellar populations in globular clusters.

The exclusion of a significant range of ages in a massive star cluster.

Stars spend most of their lifetimes on the main sequence in the Hertzsprung-Russell diagram. The extended main-sequence turn-off regions--containing stars leaving the main sequence after having spent all of the hydrogen in their cores--found in massive (more than a few tens of thousands of solar masses), intermediate-age (about one to three billion years old) star clusters are usually interpreted as evidence of internal age spreads of more than 300 million years, although young clusters are thought to quickly lose any remaining star-forming fuel following a period of rapid gas expulsion on timescales of order 10(7) years. Here we report, on the basis of a combination of high-resolution imaging observations and theoretical modelling, that the stars beyond the main sequence in the two-billion-year-old cluster NGC 1651, characterized by a mass of about 1.7 × 10(5) solar masses, can be explained only by a single-age stellar population, even though the cluster has a clearly extended main-sequence turn-off region. The most plausible explanation for the existence of such extended regions invokes a population of rapidly rotating stars, although the secondary effects of the prolonged stellar lifetimes associated with such a stellar population mixture are as yet poorly understood. From preliminary analysis of previously obtained data, we find that similar morphologies are apparent in the Hertzsprung-Russell diagrams of at least five additional intermediate-age star clusters, suggesting that an extended main-sequence turn-off region does not necessarily imply the presence of a significant internal age dispersion.

The impact of propranolol on the growth and development of children with proliferative infantile hemangioma during treatment.

Oral propranolol has not been shown to impact physical development, such as weight and height. The impact of children's intellectual development has received relatively little attention from researchers. The effects of propranolol on the growth and development of children with proliferative infantile hemangiomas during treatment were analyzed retrospectively. The children with infantile hemangioma treated with oral propranolol in the Department of Burn and Plastic Surgery, Fuzhou Children's Hospital of Fujian Province, from February 2017 to May 2022 were analyzed. A uniform therapeutic regimen was applied, including assessment, treatment, and follow-up. The assessment included physical development and intellectual development indices. The physical development indices were height and weight. Neuropsychological assessment uses developmental quotient (DQ) to assess intelligence development. The DQs on months 3, 6, and 9 posttreatment were compared to the pretreatment. Wilcoxon rank sum test of paired samples was used for height and weight. The developmental quotient was determined by paired t test. P < .05 indicated significant difference. A total of 51 patients were enrolled. All children completed the treatment successfully, without severe adverse drug reactions leading to treatment discontinuation. There was no significant difference in height and weight before and after treatment (P > .05). No significant difference was detected in DQ 3 months posttreatment and pretreatment (P = .19), while it decreased at 6 and 9 months posttreatment (P < .05). Oral propranolol does not have an impact on physical development (height and weight). No short-term effect was found on intellectual development, but a decrease was noted over 6 months, which needs to be investigated further.

The Ratio of Serum Uric Acid to Glycosylated Haemoglobin as a Predictor of All-Mortality in Elderly Patients with Diabetic Foot Ulcers: A Longitudinal Cohort Study.

Aim: To clarify the relationship between serum uric acid (UA) and glycosylated hemoglobin (UA/HbA1c) ratio and all-cause mortality in patients with diabetic foot ulcers (DFUs). Methods: A total of 172 inpatients with DFUs (PEDIS grades 2-4) were eligible for inclusion in this study from 2018 to 2023. This was a retrospective, longitudinal cohort study. All subjects were followed up every 6 months for a median of 60 months. According to the cutoff value of the UA/HbA1c ratio of 39.07 obtained from ROC analysis, the participants were divided into two groups: low-level (≤ 39.07, n = 107) and high-level (> 39.07, n = 65) groups. The correlation between UA/HbA1c ratio and all-cause mortality was also evaluated by Cox regression analysis TheKaplan-Meier survival curve analysis and Log rank tests were used to assess the incidence rates of all-cause mortality. The contribution rate of risk factors was estimated by the population-attributable risk percentage (PAR%) analysis. Results: ROC analysis showed that the optimal cutoff values for UA and the UA/HbA1c ratio were 372 µmol/L and 39.07, respectively. Multivariate Cox regression analysis indicated that a high UA/HbA1c ratio (HR =4.63; 95% CI = 2.004-10.7, P < 0.001) was independently associated with a high risk of all-cause mortality in patients with DFUs. Stratified analysis indicated that subjects aged ≥ 60 years had a greater risk of all-cause mortality associated with a high UA/HbA1c ratio (HR = 4.450; 95% CI = 1.711-11.574, P = 0.002). Kaplan-Meier survival analysis showed that all-cause mortality had a significant positive association with a high UA/HbA1c ratio (log-rank, P < 0.001) and a significant negative correlation with the lowered HbA1c level (< 6.5%) after a follow-up of 32 months (log-rank, P < 0.001). The population attributable risk percentage (PAR%) analysis suggested that the contribution rate of the high-level UA/HbA1c ratio to all-cause mortality was 33.7%, which was much greater than the 19.69% of UA. Conclusion: In brief, our study showed that for every 1.0% increase in the UA/HbA1c ratio, the all-cause mortality rate in elderly patients with DFUs aged ≥ 60 years increased by 3.45-fold. For elderly patients with DFUs, a safe and effective strategy to reduce all-cause mortality is to strictly control serum UA levels to < 372 µmol/L and appropriately loosen the control goal of HbA1c to ≥ 6.5%.

Overview of the LAMOST survey in the first decade.

The Large Sky Area Multi-Object Fiber Spectroscopic Telescope (LAMOST), also known as the Guoshoujing Telescope, is a major national scientific facility for astronomical research located in Xinglong, China. Beginning with a pilot survey in 2011, LAMOST has been surveying the night sky for more than 10 years. The LAMOST survey covers various objects in the Universe, from normal stars to peculiar ones, from the Milky Way to other galaxies, and from stellar black holes and their companions to quasars that ignite ancient galaxies. Until the latest data release 8, the LAMOST survey has released spectra for more than 10 million stars, ∼220,000 galaxies, and ∼71,000 quasars. With this largest celestial spectra database ever constructed, LAMOST has helped astronomers to deepen their understanding of the Universe, especially for our Milky Way galaxy and the millions of stars within it. In this article, we briefly review the characteristics, observations, and scientific achievements of LAMOST. In particular, we show how astrophysical knowledge about the Milky Way has been improved by LAMOST data.