Improved green and red GRAB sensors for monitoring spatiotemporal serotonin release in vivo.

The serotonergic system plays important roles in both physiological and pathological processes, and is a therapeutic target for many psychiatric disorders. Although several genetically encoded GFP-based serotonin (5-HT) sensors were recently developed, their sensitivities and spectral profiles are relatively limited. To overcome these limitations, we optimized green fluorescent G-protein-coupled receptor (GPCR)-activation-based 5-HT (GRAB5-HT) sensors and developed a red fluorescent GRAB5-HT sensor. These sensors exhibit excellent cell surface trafficking and high specificity, sensitivity and spatiotemporal resolution, making them suitable for monitoring 5-HT dynamics in vivo. Besides recording subcortical 5-HT release in freely moving mice, we observed both uniform and gradient 5-HT release in the mouse dorsal cortex with mesoscopic imaging. Finally, we performed dual-color imaging and observed seizure-induced waves of 5-HT release throughout the cortex following calcium and endocannabinoid waves. In summary, these 5-HT sensors can offer valuable insights regarding the serotonergic system in both health and disease.

Pathophysiological Relevance and Therapeutic Outlook of GPR43 in Atherosclerosis.

Atherosclerosis (AS) is an inflammatory arterial disorder that occurs due to the deposition of the excessive lipoprotein under the artery intima, mainly including low-density lipoprotein (LDL) and other apolipoprotein B-containing lipoproteins. G protein-coupled receptors (GPCRs) play a crucial role in transmitting signals in physiological and pathophysiological conditions. GPCRs recognize inflammatory mediators, thereby serving as important players during chronic inflammatory processes. It has been demonstrated that free fatty acids can function as ligands for various GPCRs, such as free fatty acid receptor (FFAR)1/GPR40, FFAR2/GPR43, FFAR3/GPR41, FFAR4/GPR120, and the lipid metabolite binding glucose-dependent insulinotropic receptor (GPR119). This review discusses GPR43 and its ligands in the pathogenesis of AS, especially focusing on its distinct role in regulating chronic vascular inflammation, inhibiting oxidative stress, ameliorating endothelial dysfunction and improving dyslipidemia. It is hoped that this review may provide guidance for further studies aimed at GPR43 as a promising target for drug development in the prevention and therapy of AS.

The synergy between the PscC subunits for electron transfer to the P840 special pair in Chlorobaculum tepidum.

The primary photochemical reaction of photosynthesis in green sulfur bacteria occurs in the homodimer PscA core proteins by a special chlorophyll pair. The light induced excited state of the special pair producing P840+ is rapidly reduced by electron transfer from one of the two PscC subunits. Molecular dynamics (MD) simulations are combined with bioinformatic tools herein to provide structural and dynamic insight into the complex between the two PscA core proteins and the two PscC subunits. The microscopic dynamic model involves extensive sampling at atomic resolution and at a cumulative time-scale of 22µs and reveals well defined protein-protein interactions. The membrane complex is composed of the two PscA and the two PscC subunits and macroscopic connections are revealed within a putative electron transfer pathway from the PscC subunit to the special pair P840 located within the PscA subunits. Our results provide a structural basis for understanding the electron transport to the homodimer RC of the green sulfur bacteria. The MD based approach can provide the basis to further probe the PscA-PscC complex dynamics and observe electron transfer therein at the quantum level. Furthermore, the transmembrane helices of the different PscC subunits exert distinct dynamics in the complex.

Heterogeneous sapphire-supported low-loss photonic platform.

Sapphire is a promising wideband substrate material for visible photonics. It is a common growth substrate for III-nitride light-emitting diodes and laser structures. Doped sapphires are important gain media foundational to the development of titanium-sapphire and ruby lasers. For lasers operating at visible and near-infrared wavelengths, a photonic platform that minimizes loss while maximizing gain material overlap is crucial. Here, we introduce a novel low-loss waveguiding strategy that establishes high-performance integrated photonics on sapphire substrates. This platform achieves a high intrinsic quality factor of 5.6 million near 780 nm and features direct compatibility with a range of solid-state laser gain media.

Identification of differentially expressed ER stress-related genes and their association with pulmonary arterial hypertension.

BACKGROUND: Pulmonary arterial hypertension (PAH) is a complex and progressive illness that has a multifaceted origin, significant fatality rates, and profound effects on health. The pathogenesis of PAH is poorly defined due to the insufficient understanding of the combined impact of endoplasmic reticulum (ER) stress and immune infiltration, both of which play vital roles in PAH development. This study aims to identify potential ER stress-related biomarkers in PAH and investigate their involvement in immune infiltration. METHODS: The GEO database was used to download gene expression profiles. Genes associated with ER stress were obtained from the MSigDB database. Weighted gene co-expression network analysis (WGCNA), GO, KEGG, and protein-protein interaction (PPI) were utilized to conduct screening of hub genes and explore potential molecular mechanisms. Furthermore, the investigation also delved into the presence of immune cells in PAH tissues and the correlation between hub genes and the immune system. Finally, we validated the diagnostic value and expression levels of the hub genes in PAH using subject-workup characterization curves and real-time quantitative PCR. RESULTS: In the PAH and control groups, a total of 31 genes related to ER stress were found to be differentially expressed. The enrichment analysis revealed that these genes were primarily enriched in reacting to stress in the endoplasmic reticulum, dealing with unfolded proteins, transporting proteins, and processing proteins within the endoplasmic reticulum. EIF2S1, NPLOC4, SEC61B, SYVN1, and DERL1 were identified as the top 5 hub genes in the PPI network. Immune infiltration analysis revealed that these hub genes were closely related to immune cells. The receiver operating characteristic (ROC) curves revealed that the hub genes exhibited excellent diagnostic efficacy for PAH. The levels of SEC61B, NPLOC4, and EIF2S1 expression were in agreement with the findings of bioinformatics analysis in the PAH group. CONCLUSIONS: Potential biomarkers that could be utilized are SEC61B, NPLOC4, and EIF2S1, as identified in this study. The infiltration of immune cells was crucial to the development and advancement of PAH. This study provided new potential therapeutic targets for PAH.

Clinicopathological and molecular characteristics of colorectal adenosquamous carcinoma in an Asian population.

BACKGROUND: Adenosquamous carcinoma is a rare sub-type of colorectal cancer with a poor prognosis. Little is known about its clinicopathological and molecular characteristics in Asian populations. This study aimed to investigate these features in a cohort of patients with adenosquamous carcinoma in the colorectum. METHODS: Tumor cases pathologically diagnosed with colorectal adenosquamous carcinoma were retrieved from the Sixth Affiliated Hospital, Sun Yat-sen University tissue archive between December 2012 and June 2020. Clinicopathological features, molecular characteristics, and oncology outcomes were analyzed. RESULTS: Among 18,139 cases of colorectal cancer, 11 were diagnosed with adenosquamous carcinoma, providing an incidence rate of 0.061%. The median overall survival (OS) was 14 months, and the expected 3-year OS rate was 29.6%. As of October 14, 2022, four cases had local recurrence and five had distant metastasis. KRAS gene mutations were found in four of seven patients (57.1%), and three out of eleven (27.3%) patients had mismatch repair-deficient (dMMR) tumors. CONCLUSIONS: Adenosquamous carcinoma is associated with a poor prognosis. Compared to other sub-types of colorectal cancer, a higher proportion of patients with dMMR and KRAS mutations were observed. These findings suggested that more patients with adenosquamous carcinoma could benefit from targeted therapies, such as immunotherapy.

Combined sedation in pediatric magnetic resonance imaging: determination of median effective dose of intranasal dexmedetomidine combined with oral midazolam.

BACKGROUND: The exact median effective dose (ED50) of intranasal dexmedetomidine combined with oral midazolam sedation for magnetic resonance imaging (MRI) examination in children remains unknow and the aim of this study was to determine the ED50 of their combination. METHODS: This is a prospective dose-finding study. A total of 53 children aged from 2 months to 6 years scheduled for MRI examination from February 2023 to April 2023 were randomly divided into group D (to determine the ED50 of intranasal dexmedetomidine) and group M (to determine the ED50 of oral midazolam). The dosage of dexmedetomidine and midazolam was adjusted according to the modified Dixon's up-and-down method, and the ED50 was calculated with a probit regression approach. RESULTS: The ED50 of intranasal dexmedetomidine when combined with 0.5 mg∙kg- 1 oral midazolam was 0.39 µg∙kg- 1 [95% confidence interval (CI) 0.30 to 0.46 µg∙kg- 1] while the ED50 of oral midazolam was 0.17 mg∙kg- 1 (95% CI 0.01 to 0.29 mg∙kg- 1) when combined with 1 µg∙kg- 1 intranasal dexmedetomidine. The sedation onset time of children with successful sedation in group D was longer than in group M (30.0[25.0, 38.0]vs 19.5[15.0, 35.0] min, P < 0.05). No other adverse effects were observed in the day and 24 h after medication except one dysphoria. CONCLUSION: This drug combination sedation regimen appears suitable for children scheduled for MRI examinations, offering a more precise approach to guide the clinical use of sedative drugs in children. TRIAL REGISTRATION: Chinese Clinical Trial Registry, identifier: ChiCTR2300068611(24/02/2023).

Analysis of the incidence and risk factors of blood transfusion in total knee revision: a retrospective nationwide inpatient sample database study.

OBJECTIVE: This study sought to determine the incidence and risk factors of blood transfusion among patients undergoing total knee revision (TKR) using a nationwide database. METHODS: A retrospective data analysis was conducted based on the Nationwide Inpatient Sample (NIS), enrolling patients who underwent TKR from 2010 to 2019 with complete information. The patients were divided into two groups based on whether they received blood transfusion or not. The demographic characteristics (race, sex, and age), length of stay (LOS), total charge of hospitalization, hospital characteristics (admission type, insurance type, bed size, teaching status, location, and region of hospital), hospital mortality, comorbidities, and perioperative complications were analyzed. Finally, we conducted univariate and multivariate logistic regression to identify factors that were associated with TKR patients to require blood transfusion. RESULTS: The NIS database included 115,072 patients who underwent TKR. Among them, 14,899 patients received blood transfusion, and the incidence of blood transfusion was 13.0%. There was a dramatic decrease in the incidence over the years from 2010 to 2019, dropping from 20.4 to 6.5%. TKR patients requiring transfusions had experienced longer LOS, incurred higher total medical expenses, utilized Medicare more frequently, and had increased in-hospital mortality rates (all P < 0.001). Independent predictors for blood transfusion included advanced age, female gender, iron-deficiency anemia, rheumatoid disease, chronic blood loss anemia, congestive heart failure, coagulopathy, uncomplicated diabetes, lymphoma, fluid and electrolyte disorders, metastatic carcinoma, other neurological diseases, paralysis, peripheral vascular disorders, pulmonary circulation disorders, renal failure, valvular disease, and weight loss. In addition, risk factors for transfusion in TKR surgery included sepsis, acute myocardial infarction, deep vein thrombosis, pulmonary embolism, gastrointestinal bleeding, heart failure, renal insufficiency, pneumonia, wound infection, lower limb nerve injury, hemorrhage/seroma/hematoma, wound rupture/non healing, urinary tract infection, acute renal failure, and postoperative delirium. CONCLUSIONS: Our findings highlight the importance of recognizing the risk factors of blood transfusion in TKR to reduce the occurrence of adverse events.

Incidence and related risk factors for postoperative delirium following revision total knee arthroplasty: a retrospective nationwide inpatient sample database study.

BACKGROUND: Postoperative delirium (POD) is a common surgical complication. However, the incidence and risk factors associated with postoperative delirium after revision total knee arthroplasty (rTKA) have not been comprehensively explored through extensive national databases. METHODS: Utilizing the National Inpatient Sample (NIS), the largest comprehensive U.S. hospital healthcare database, we undertook a retrospective investigation involving 127,400 patients who underwent rTKA between 2010 and 2019. We assessed various aspects, including patient demographics, hospital characteristics, pre-existing medical conditions, and perioperative complications. RESULTS: The overall incidence of postoperative delirium (POD) in patients undergoing rTKA between 2010 and 2019 was 0.97%. The highest incidence rate of 1.31% was recorded in 2013. Notably, this patient cohort demonstrated advanced age, increased burden of co-morbidities, prolonged hospital stays, increased hospitalization costs, and elevated in-hospital mortality rates (P < 0.001). Moreover, non-elective admissions, non-private insurance payments, and a preference for teaching hospitals were commonly observed among these patients. During their hospitalization, individuals who developed delirium subsequent to rTKA were more prone to experiencing certain perioperative complications. These complications encompassed medical issues like acute myocardial infarction, continuous invasive mechanical ventilation, postoperative shock, sepsis, stroke and other medical problems. Additionally, surgical complications including hemorrhage / seroma / hematoma, irrigation and debridement, prosthetic joint infection, periprosthetic fracture, and wound dehiscence / nonunion were noted. Several risk factors were found to be linked with the development of POD. These included advanced age (≥ 75 years), alcohol abuse, coagulation disorders, congestive heart failure, depression, fluid and electrolyte imbalances, and more. Conversely, female sex, having private insurance, and undergoing elective hospitalization emerged as protective factors against POD. CONCLUSION: Our findings suggest that the general prevalence of POD in rTKA is relatively low according to NIS. There was a significant connection between the POD of rTKA and advanced age, prolonged length of stay (LOS), more in-patients' costs, higher in-hospital mortality rate, increased comorbidities, postoperative medical complications and postoperative surgical complications. This study helps to understand the risk factors associated with POD to improve poor outcomes.

GCNT3 Promotes Hepatocellular Carcinoma Progression and EMT by Activating the PI3K/AKT Pathway.

Primary liver cancer, specifically hepatocellular carcinoma (HCC), is a major global health concern. GCNT3 has been identified as an oncogene in various human malignancies. This investigation aimed to discover the GCNT3 function in HCC. The present study employed integrated bioinformatics analyses to assess the expression pattern, prognostic implications, and putative function of GCNT3 in HCC. Transwell flow cytometry, CCK-8, and wound healing assays were performed to examine HCC cell growth, cell cycle, apoptosis, invasion, and migration. In addition, the epithelial-mesenchymal transition (EMT) markers and PI3K/AKT mechanism markers were examined via western blot analysis to elucidate the underlying mechanisms. In HCC, GCNT3 was significantly overexpressed, which was connected with enhanced tumor aggressiveness and an unfavorable prognosis of individuals. In vitro experiments demonstrated that elevated levels of GCNT3 promoted cell growth, migration, cell cycle development, and invasion, in addition to EMT, while suppressing apoptosis. Conversely, knockdown of GCNT3 exerted the opposite effects. GCNT3 overexpression increased PI3K/AKT phosphorylation in HCC cells, and LY294002 counteracted the impacts of upregulated GCNT3 on cell cycle, migration, invasion, proliferation, and EMT in HCC. The investigation showed that GCNT3 may enhance HCC progression and EMT by stimulating PI3K/AKT mechanism.

Effects of Chemical Modification on the Structure and Biological Activities of Polysaccharides Extracted from Inonotus Obliquus by Microwave.

A novel polysaccharide, Inonotus obliquus polysaccharide (IOP), was extracted using a microwave extraction method and subsequently subjected to modifications through sulfation, carboxymethylation, phosphorylation, and acetylation. Its physical and chemical properties were analyzed using various chemical techniques, including high-pressure liquid chromatography, ultraviolet light, Fourier-transform infrared spectroscopy, X-ray diffraction, Congo red test, and scanning electron microscopy. The antioxidant capacity was assessed using DPPH, ABTS, and hydroxyl radical assays, as well as by measuring the reducing power. Additionally, hypoglycemic activity was evaluated through α-glucosidase and α-amylase assays. The results indicated that the chemical modifications effectively altered the physical and chemical properties, as well as the biological activities of IOP. Compared to the unmodified IOP, the derivatives exhibited reduced sugar content, uronic acid content, and molecular weight, while demonstrating varying levels of antioxidant and hypoglycemic capabilities. Notably, the carboxymethylated IOP (IOP-C) displayed lower molecular weight, higher ABTS free radical scavenging rate, greater reducing ability, and increased α-amylase inhibition rate. Therefore, IOP-C shows promise as a potential edible antioxidant and hypoglycemic agent.

Spatial-temporal variation and correlation analysis of ecosystem service values and ecological risks in winter city Shenyang, China.

Ecosystems in winter cities are complex and fragile, experiencing significant changes due to climate variations and human construction activities. Previous studies on the assessment of overall ecosystem service value (ESV) and ecological risk index (ERI) in winter cities are scarce. In this study, we constructed ESV and ERI measurement models using land use data in 2000, 2010, and 2020 using the improved value per unit area factor method and the landscape pattern index method, respectively, to reveal their spatial and temporal change characteristics. Geographic detectors were used to explore the driving roles of natural and artificial factors on the changes of ESV and ERI. The combination in ESV and ERI can then provide a more quantitative and accurate basis for policy decisions, identify priority areas for urban ecological restoration, and reduce the risk to ecosystems. The results of the study show that the total ESV of Shenyang city decreased from 273.97 × 108 CNY to 270.38 × 108 CNY during 2000-2020. Although the decrease is not large, the ESV changes structurally with the advancement of urbanization. During the 20 years, the construction land with the lowest ecological service function continues to expand, increasing by 354 km2, the grassland decreased by 215.9 km2, and the arable land decreased by 196.6 km2. The ecological service function of the water area is the strongest, with an increase of 51.3 km2 in the water area, ensuring that there is no significant decline in ESV. The size of the ERI is Very high, High, and Medium value zones remained relatively stable, while the size of the Very Low-value zone decreased by 12.78% and the size of the Low-value zone increased by 13.21%. The interaction factors that contributed most to the changes in ESV and ERI were annual evapotranspiration (EVP)/ Normalized Difference Vegetation Index (NDVI) and Annual sunshine hours (SSD)/ Digital Elevation Model (DEM) , respectively. There was a spatial correlation between ESV and ERI. The areas with the highest ESV supply capacity and at the same time facing severe ecological risks to the landscape pattern are distributed in the northeastern hilly lands. This area should be prioritized to develop planning and control measures to prevent further erosion of forest lands and grasslands and reduce ecological risks. These results provide a theoretical basis for ensuring ecological security and sustainable development in winter cities.

Biomimic Design of Solar Steam Generation Devices Enabled by the Tannin-Iron Complex.

Solar-powered steam generation equipment has experienced considerable advancement in recent years as it offers a cleaner and greener method for freshwater production. However, the devices always suffer from a complicated process, high cost, and salt accumulation, which hinder their further application. Here, inspired by the water lily, a highly efficient and antisalt accumulation interfacial solar-driven steam generation device was designed by using the tannic acid-Fe3+ complex as photothermal material. The designed evaporator could be quickly unfolded within 24 s after being irradiated with light and then produce fresh water. It folded within 10 s and then sank into water for removing the accumulated salt after removing the irradiation sources. In addition, the tannic acid-Fe3+ complex on the evaporator surface and the angle of the evaporator allowed light to be reflected several times within the evaporator, effectively increasing the solar energy conversion efficient (2.22 kg/(m2·h)), and apparently, the overall evaporation efficiency of 139.18% was achieved under 1 sun illumination. Moreover, it exhibited an extraordinary antisalt accumulation capacity (by working continuously for 7 days in 10 wt % saline water and 80% reduction in salt accumulation) as well as a low price ($ 1.11/m2). This design would provide a strategy to prepare an antisalt accumulation solar steam devices.

Photo-aging of brominated epoxy microplastics in water under simulated solar irradiation.

Microplastics have become an increasingly concerning pollutant in aquatic environments, and photodegradation is their main degradation pathway in water. Gaining insight into the transformation process of microplastics will enhance our understanding of their behavior and destiny in natural environments. This paper studied the aging process of BER microplastics in aquatic environments under simulated sunlight and investigated the changes in the physical and chemical properties of microplastics and the changes in the leachate. During the photodegradation process, BER-MPs underwent extensive oxidation and reduction in particle size, and the originally smooth surface developed numerous voids, accompanied by yellowing. Introduction of O atoms in the molecular chains increased their hydrophilicity, resulting in the polymer chains breaking away from the plastic particles and dissolving in water. Also, once BER was excited by light, environmentally persistent free radicals are produced on its surface. Moreover, the breaking of C-Br bonds occurred during the photodegradation process of BER-MPs, which suggested that tetrabromobisphenol A would be transformed during the photoaging process of BER even if it was covalently bound to BER.

Comparative study on the efficacy of Conbercept and Aflibercept in the treatment of neovascular age-related macular degeneration.

This study compares the effectiveness of Conbercept and Aflibercept in treating neovascular age-related macular degeneration (nAMD). Conducted at the First Affiliated Hospital of Chongqing Medical University's Ophthalmology Department (May 2020-May 2023), this prospective study enrolled 159 nAMD patients. Participants were randomly divided into two groups: one receiving 0.5 mg Conbercept and the other 2 mg Aflibercept intravitreal injections. Over 12 months, the study, employing a Treat-and-Extend (T&E) regimen, assessed Best-Corrected Visual Acuity (BCVA), Central Retinal Thickness (CRT) changes and injection frequency. Of the 159 patients, 137 (149 eyes) completed the study. No significant age difference was found between the groups (P = 0.331). After 12 months, BCVA improved similarly in both groups (Conbercept: 52.8 ± 18.9, Aflibercept: 52.0 ± 19.7 letters; P = 0.820). CRT reduction was also comparable (Conbercept: 246.3 ± 82.8 µm, Aflibercept: 275.9 ± 114.3 µm; P = 0.079). Injection frequencies averaged 6.9 ± 0.7 (Conbercept) and 6.7 ± 0.7 (Aflibercept; P = 0.255). Subtype analysis revealed Type 1 MNV had higher baseline BCVA and lower CRT, with more frequent injections compared to other types. Both Conbercept and Aflibercept are clinically similar in efficacy for nAMD, with the T&E regimen proving therapeutically effective and potentially reducing patient costs. Anti-VEGF treatment efficacy varies across nAMD subtypes, indicating a potential benefit in tailored treatments for specific subtypes.Clinical trial registration number NCT05539235 (Protocol Registration and Results System).

Multi-Label Action Anticipation for Real-World Videos With Scene Understanding.

With human action anticipation becoming an essential tool for many practical applications, there has been an increasing trend in developing more accurate anticipation models in recent years. Most of the existing methods target standard action anticipation datasets, in which they could produce promising results by learning action-level contextual patterns. However, the over-simplified scenarios of standard datasets often do not hold in reality, which hinders them from being applied to real-world applications. To address this, we propose a scene-graph-based novel model SEAD that learns the action anticipation at the high semantic level rather than focusing on the action level. The proposed model is composed of two main modules, 1) the scene prediction module, which predicts future scene graphs using a grammar dictionary, and 2) the action anticipation module, which is responsible for predicting future actions with an LSTM network by taking as input the observed and predicted scene graphs. We evaluate our model on two real-world video datasets (Charades and Home Action Genome) as well as a standard action anticipation dataset (CAD-120) to verify its efficacy. The experimental results show that SEAD is able to outperform existing methods by large margins on the two real-world datasets and can also yield stable predictions on the standard dataset at the same time. In particular, our proposed model surpasses the state-of-the-art methods with mean average precision improvements consistently higher than 65% on the Charades dataset and an average improvement of 40.6% on the Home Action Genome dataset.

Acute macular neuroretinopathy and COVID-19 or SARS-CoV-2 infection: case report and literature review.

Purpose: To describe a case of acute macular neuroretinopathy (AMN) associated with COVID-19 infection and a related literature review. Methods: A case from the First Affiliated Hospital of Chongqing Medical University was reported that could be linked to COVID-19 or SARS-CoV-2 infection. We performed a comprehensive search on PubMed, retrieving articles containing information on AMN after COVID-19 or SARS-CoV-2 infection. The key words used were 'COVID-19', 'SARS-CoV-2', 'ophthalmic manifestations', 'acute macular neuroretinopathy', and 'paracentral scotomas'. The relevant data were extracted, charted, consolidated, and evaluated. Moreover, manual exploration of the reference lists of pertinent articles was carried out. Results: We describe the case of a 30-year-old young woman who developed bilateral AMN one day after being infected with COVID-19 or SARS-CoV-2. She had severe visual impairment (20/2000 OD and 20/32 OS), and her vision recovered after taking oral corticosteroids. After reviewing the literature, we summarized 16 relevant reports and found that symptoms of AMN tend to arise 1 day to 1 month after COVID-19 or SARS-CoV-2 infection. Contraceptive pills and other risk factors should be avoided to reduce the risk of adverse outcomes. Oral prednisone may be an effective treatment for those experiencing important vision loss. Conclusion: Symptoms of AMN can arise 1 day to 1 month after COVID-19 or SARS-CoV-2 infection. Ophthalmologists should remain vigilant about this disease, notably because patient characteristics may deviate from the norm.

Incidence and risk factors of blood transfusion after total knee arthroplasty: A retrospective nationwide inpatient sample database study.

Introduction: Common postoperative complications of total knee arthroplasty (TKA) include blood transfusion. Although risk factors and incidence of blood transfusion have been studied through national databases, the relative impact of each risk factor needs to be synthesized over a longer time period into a new model need to be revised. Material and methods: Patient data were extracted from the National Inpatient Sample (NIS), which is the largest hospital care database in the US, and analyse patient data retrospectively from 2010 through 2019. The final data included the patients undergoing TKA. The final analysis assessed the demographics of patients, type of insurance, type of hospital, length of stay (LOS), preoperative comorbidities, total charge, inpatient mortality, medical-surgical postoperative complications. Results: After extracting data from the NIS database, a total of 1,250,533 patients with TKA were included in the analysis, and the rate of transfusion was 6.60 %. TKA patients who receive blood transfusion had longer LOS (from 2-3 days to 3-4 days), more preoperative comorbidities, higher inpatient mortality rate, and increased total charge (P < 0.001). Moreover, postoperative complications associated with inpatients included sepsis, acute myocardial infarction and shock. Elective admission and private insurance were also regarded as protective factors. Conclusion: Blood transfusion could bring postoperative complications to patients, which were also linked to health costs and risks. It was also a common preoperative comorbidities for older patients who underwent TKA. Through better blood management strategies, we could reduce patient transfusion rates and improve clinical outcomes.Level of Evidence: Diagnostic Level Ⅲ.

TkJAZs-TkMYC2-TkSRPP/REF Regulates the Biosynthesis of Natural Rubber in Taraxacum kok-saghyz.

Taraxacum kok-saghyz (TKS) is a natural rubber (NR)-producing plant and a model plant for studying the biosynthesis of NR. Analyzing and studying the biosynthetic mechanism of NR is an important way to cultivate high-yield rubber TKS varieties. JAZ proteins, which belong to the Jasmonate ZIM domain family, function as negative regulators in the jasmonic acid (JA) signal transduction pathway. MYC2 is typically regarded as a regulatory factor for the target genes of JAZ proteins; JAZ proteins indirectly influence the gene expression regulated by MYC2 by modulating its activity. Theoretically, JAZ is expected to participate in growth, development, and responses to environmental cues related to rubber and biomass accumulation in TKS, all of which rely on the interaction between JAZ and MYC2. In this study, we identified 11 TkJAZs through homology searching of the TKS genomes and bioinformatics analyses. Subcellular localization, Y2H, and BiFC analysis demonstrate that TkJAZs and TkMYC2 are localized in the nucleus, with all TkJAZs and TkMYC2 showing nuclear colocalization interactions. Overexpression of TkMYC2 in TKS inhibited leaf development, promoted root growth, and simultaneously increased NR production. RNA-seq and qRT-PCR analysis revealed that the TkSRPP/REF genes exhibit varying degrees of upregulation compared to the wild type, upregulating the TkREF1 gene by 3.7-fold, suggesting that TkMYC2 regulates the synthesis of NR by modulating the TkSRPP/REF genes.

Investigation on Creep Deformation and Age Strengthening Behavior of 304 Stainless Steel under High Stress Levels.

The creep deformation behavior and age strengthening behavior of 304 stainless steel under high stress levels were systematically studied by uniaxial creep test, tensile test, XRD diffraction test and transmission electron microscopy. The results show that the total creep strain and the initial creep strain rate increase with the increase in stress level, and the creep strain in the whole aging process is mainly produced in the initial creep stage. The calculated stress exponent shows that the main mechanism of creep deformation of 304 stainless steel at 453 K is dislocation slip. The strength and plasticity of 304 stainless steel after creep aging are improved simultaneously. Microstructural observations indicate an increase in dislocation density and martensite content, as well as austenite and twins, leading to an improvement in strength and plasticity, respectively. In addition, considering the influence of dislocation density on creep behavior, the relative dislocation density increase is introduced into the hyperbolic sine creep model, and a simple mechanism-based creep aging constitutive model is established. The creep strain predicted by the model is in good agreement with the experimental data of 304 stainless steel. The findings can provide theoretical support for the application of creep age forming in 304 stainless steel parts.