Unusual Geometric and Electronic Structures at Domain Boundaries in a Heterochiral Charge Density Wave Superlattice.

Domain boundaries (DBs) in charge density wave (CDW) systems not only are important for understanding the mechanism of how CDW interplays with other quantum phases but also have potential for future CDW-based nanodevices. However, current research on DBs in CDW materials has been mainly limited to those between homochiral CDW domains, whereas DBs between heterochiral CDW domains, especially in the atomic layers, remain largely unexplored. Here, we have studied the geometric and electronic states of heterochiral DBs in single-layer and bilayer 1T-NbSe2 using scanning tunneling microscopy/spectroscopy. We observe the existence of diverse CDW configurations in a single heterochiral CDW DB with atomic resolution and reveal the corresponding electronic states. In addition, interlayer stacking further enriches the electronic properties of the DB. Our results offer deep insights into the relationship between the detailed CDW nanostructures and electronic behaviors, which has significant implications for DB engineering in strongly correlated CDW systems and related nanodevices.

Draft genome sequence data of Pythium cedri Chen 4, the causal pathogen of deodar cedar root rot.

Pythium species are distributed globally, with certain members playing significant roles as plant and animal pathogens. Pythium cedri Chen 4 has been identified as a pathogenic isolate responsible for causing root rot on Cedrus deodara. Here, a comprehensive genome-wide sequence of P. cedri strain Chen 4 utilizing the Illumina NovaSeq sequencing platform and a Pacific Biosciences Sequel sequencing platform is presented. The genome of P. cedri strain Chen 4 was assembled into 150 contigs containing a combined size of 41.25 Mb, N50 value of 1,717,859 bp and N90 value of 431,829 bp. Genome annotation revealed 14,077 protein-encoding genes and 364 of the 1016 predicted proteins were putative effectors. The present work enriches the genetic resources of P. cedri for studying its evolution and can contribute to a better understanding of P. cedri-host interaction.

Elasticity of the HIV-1 core facilitates nuclear entry and infection.

HIV-1 infection requires passage of the viral core through the nuclear pore of the cell, a process that depends on functions of the viral capsid. Recent studies have shown that HIV-1 cores enter the nucleus prior to capsid disassembly. Interactions of the viral capsid with the nuclear pore complex are necessary but not sufficient for nuclear entry, and the mechanism by which the viral core traverses the comparably sized nuclear pore is unknown. Here we show that the HIV-1 core is highly elastic and that this property is linked to nuclear entry and infectivity. Using atomic force microscopy-based approaches, we found that purified wild type cores rapidly returned to their normal conical morphology following a severe compression. Results from independently performed molecular dynamic simulations of the mature HIV-1 capsid also revealed its elastic property. Analysis of four HIV-1 capsid mutants that exhibit impaired nuclear entry revealed that the mutant viral cores are brittle. Adaptation of two of the mutant viruses in cell culture resulted in additional substitutions that restored elasticity and rescued infectivity and nuclear entry. We also show that capsid-targeting compound PF74 and the antiviral drug Lenacapavir reduce core elasticity and block HIV-1 nuclear entry at concentrations that preserve interactions between the viral core and the nuclear envelope. Our results indicate that elasticity is a fundamental property of the HIV-1 core that enables nuclear entry, thereby facilitating infection. These results provide new insights into the role of the capsid in HIV-1 nuclear entry and the antiviral mechanisms of HIV-1 capsid inhibitors.

[Trend analysis and regulatory strategies for traditional Chinese medicine formula granules].

With the advent of the "post-pilot era" of traditional Chinese medicine formula granules, there are still a series of policy, technical, and industrial issues that need to be addressed in their production, regulation, and application practices. This article systematically reviews the development history and relevant policy evolution of traditional Chinese medicine formula granules, and summarizes the current industrial status in terms of quality standards, medical insurance payments, and market landscape. Based on a comparative analysis and positioning discussion between traditional Chinese medicine formula granules and traditional herbal decoctions, it is believed that the following practical issues still exist in this field:(1)A reasonable competitive evolution mechanism has not yet been formed, making it difficult to "improve quality and efficiency" of products;(2)The number of national standards is limited, and local standards operate independently;(3)Production processes are relatively constrained;(4)There is a contradiction between fixed equivalents and fluctuations in raw materials;(5)Market positioning needs to be clarified, and medication scenarios are limited. Furthermore, based on the perspective of shaping a healthy ecosystem for the traditional Chinese medicine industry and promoting rational clinical use of traditional Chinese medicine, the following suggestions are put forward:(1)Guide the formation of a product-based competitive landscape for traditional Chinese medicine formula granules;(2)Promote the establishment of a comprehensive regulatory system for the entire production process of traditional Chinese medicine formula granules;(3)Conduct systematic research on the relationship between the equivalents and intake of formula granules;(4)Break through existing application scenarios and reasonably expand the application forms of formula granules.

Analysis of Fatty Acid Compositions and Acid Values of Krill Oil Supplementary Products from the Korean Market.

In order to provide the qualitative data for the 20 commercially available krill oil supplementary products ,the levels of omega-3 polyunsaturated fatty acids (PUFA) such as docosahexaenoic acid ( DHA) and eicosapentaenoic acid (EPA),fatty acid compositions, and chemical indices, including acid values , of the supplements , were determined . The acid values ranged from 7.4 to 43 .7 mg of potassium hydroxide (KOH)/ g of oil. The relative percentages of EPA andDHA in the oils ranged from 14.2 to 34.8 % (w/w).Although all 20 krill oil supplements used 100% krill oil as raw material,the fatty acid composition of 4 samples differed from typical krill oil in terms ofthe content of myristic acid (C14:0), palmitic acid (C16:0), palmitoleic acid (C16:1), linoleic acid (C18:2, n-6), and eicosenoic acid (C20:1, n-9). Accordingly, the Ministry of Food and Drug Safety recently standardized linoleic acid (3% orless) and myristic acid (5-13%) as part ofthe fatty acid components of krill oil. This study provides a reference for analyzing the chemical and nutritional properties and evaluating the adulteration of krill oil supplements in theKorean market.

Minimally invasive technique facilitates early extubation after cardiac surgery: a single-center retrospective study.

BACKGROUND: Postoperative time to extubation plays a role in prognosis after heart valve surgery; however, its exact impact has not been clarified. This study compared the postoperative outcomes of minimally invasive surgery and conventional sternotomy, focusing on early extubation and factors influencing prolonged mechanical ventilation. METHODS: Data from 744 patients who underwent heart valve surgery at the Zhejiang Provincial People's Hospital between August 2019 and June 2022 were retrospectively analyzed. The outcomes in patients who underwent conventional median sternotomy (MS) and minimally invasive (MI) video-assisted thoracoscopic surgery were compared using inverse probability of treatment weighting (IPTW) and Kaplan-Meier curves. Clinical data, including surgical data, postoperative cardiac function, postoperative complications, and intensive care monitoring data, were analyzed. RESULTS: After propensity score matching and IPTW, 196 cases of conventional MS were compared with 196 cases of MI video-assisted thoracoscopic surgery. Compared to patients in the conventional MS group, those in the MI video-assisted thoracoscopic surgery group in the matched cohort had a higher early postoperative extubation rate (P < 0.01), reduced incidence of postoperative pleural effusion (P < 0.05), significantly shorter length of stay in the intensive care unit (P < 0.01), shorter overall length of hospital stay (P < 0.01), and lower total cost of hospitalization (P < 0.01). CONCLUSIONS: Successful early tracheal extubation is important for the intensive care management of patients after heart valve surgery. The advantages of MI video-assisted thoracoscopic surgery over conventional MS include significant reductions in the duration of use of mechanical ventilation support, reduced length of intensive care unit stay, reduced total length of hospitalization, and a favorable patient recovery rate.

Multi-Layered Mechanisms of Immunological Tolerance at the Maternal-Fetal Interface.

Pregnancy represents an immunological paradox where the maternal immune system must tolerate the semi-allogeneic fetus expressing paternally-derived Ags. Accumulating evidence over decades has revealed that successful pregnancy requires the active development of robust immune tolerance mechanisms. This review outlines the multi-layered processes that establish fetomaternal tolerance, including the physical barrier of the placenta, restricted chemokine-mediated leukocyte trafficking, lack of sufficient alloantigen presentation, the presence of immunosuppressive regulatory T cells and tolerogenic decidual natural killer cells, expression of immune checkpoint molecules, specific glycosylation patterns conferring immune evasion, and unique metabolic/hormonal modulations. Interestingly, many of the strategies that enable fetal tolerance parallel those employed by cancer cells to promote angiogenesis, invasion, and immune escape. As such, further elucidating the mechanistic underpinnings of fetal-maternal tolerance may reciprocally provide insights into developing novel cancer immunotherapies as well as understanding the pathogenesis of gestational complications linked to dysregulated tolerance processes.

Leisure-time activities and disability among Chinese community-dwelling oldest old: evidence from the Chinese Longitudinal Healthy Longevity Study.

With the acceleration of population aging, disability in older adults is a growing public health problem; however, little is known about the role of specific leisure-time activities in affecting disability. This study prospectively examined the association of leisure-time activities with disability among the Chinese oldest old. A total of 14 039 adults aged 80 years or older (median age of 89.8 years) were enrolled from the Chinese Longitudinal Healthy Longevity Survey from 1998 to 2014. Disability was defined as the presence of concurrent impairment in activities of daily living and physical performance. Cox proportional hazards models were used to estimate the associations between leisure-time activities and disability. During a mean of 4.2 years (2.7 years) of follow-up, 4487 participants developed disability. Compared with participants who never engaged in leisure-time activities, participants who engaged in almost daily activities, including gardening, keeping domestic animals or pets, playing cards or mahjong, reading books or newspapers, and watching TV or listening to the radio had a lower risk of disability, with HRs of 0.78 (0.69-0.88), 0.64 (0.58-0.70), 0.74 (0.63-0.86), 0.74 (0.65-0.84), and 0.84 (0.77-0.90), respectively. Moreover, the risk of disability gradually decreased with participation in an increasing number of those leisure-time activities (P for trend <0.001). Frequent engagement in leisure-time activities was associated with a lower risk of disability among the Chinese oldest old. This study highlights the importance of incorporating a broad range of leisure-time activities into the daily lives of older adults.

Fabrication of thermo-responsive microcapsule pesticide delivery system from maleic anhydride-functionalized cellulose nanocrystals-stabilized pickering emulsion template.

The overuse of pesticides has shown their malpractices. Novel and sustainable formulations have consequently attracted abundant attention but still appear to have drawbacks. Here, we use a maleic anhydride-functionalized cellulose nanocrystals-stabilized Pickering emulsions template to prepare thermo-responsive microcapsules for a pesticide delivery system via radical polymerization with N-isopropyl acrylamide. The microcapsules (MACNCs-g-NIPAM) are characterized by the microscope, SEM, FTIR, XRD, TG-DTG, and DSC techniques. Imidacloprid (IMI) is loaded on MACNCs-g-NIPAM to form smart release systems (IMI@MACNCs-g-NIPAM) with high encapsulation efficiency (~88.49%) and loading capability (~55.02%). The IMI@MACNCs-g-NIPAM present a significant thermo-responsiveness by comparing the release ratios at 35°C and 25°C (76.22% vs 50.78%). It also exhibits advantages in spreadability, retention and flush resistance on the leaf surface compared with the commercial IMI water-dispersible granules (CG). IMI@MACNCs-g-NIPAM also manifest a significant advantage over CG (11.12 mg/L vs 38.90 mg/L for LC50) regarding activity tests of targeted organisms. In addition, IMI@MACNCs-g-NIPAM has shown excellent biocompatibility and low toxicity. All the benefits mentioned above prove the excellent potential of IMI@MACNCs-g-NIPAM as a smart pesticide formulation.

Biosensor Based on ZIF-67-HRP and MWCNTs Nanocomposite Modified Glass Carbon Electrode for the Detection of Luteolin in Vegetables.

Luteolin has various pharmacological properties, including anti-inflammatory, antioxidant, and antitumor characteristics. Due to its potential value in drugs and functional foods, it is important to develop an efficient method for detecting luteolin. In this work, the poor selectivity of existing luteolin nonenzymatic sensors was solved by translating the enzyme-catalyzed reaction from bulk solution to the surface of a horseradish peroxidase (HRP) modified electrode through an electrocatalytic oxidation process. Here, we modified the surface of a glassy carbon electrode (GCE) with metal-organic frameworks (MOFs; ZIF-67 here, abbreviated as ZIF), functional nanomaterials, and HRP and finally covered it with Nafion (NF). In this case, luteolin acts as a hydrogen donor, and the electrode acts as a hydrogen acceptor; the oxidation reaction occurs on the electrode surface. The use of ZIF-67 ensured the conformational stability of HRP to ensure the selectivity and anti-interference property, and SDS-dispersed multiwalled carbon nanotubes (MWCNTs) enhanced the electrode conductivity. The use of NF avoids shedding of the electrode material during the testing process. A UV-vis spectrophotometer was used to study the selectivity of luteolin by HRP and the compatibility between HRP and ZIF. The materials were characterized and analyzed by scanning electron microscopy and transmission electron microscopy. Due to the synergistic effect of these nanomaterials, the linear range of NF/ZIF-HRP/MWCNTs-SDS/GCE was 1.0 × 10-2 to 6.0 µM, with detection limits of 25.3 nM (S/N = 3). The biosensor showed long-term stability and reproducibility, with a relative standard deviation of 4.2% for the peak current (n = 5). Finally, the biosensor was successfully used to detect luteolin in carrots, celery, and cauliflower.

Geometric evaluation and quantifying dosimetric impact of diverse deformable image registration algorithms on abdomen images with biomechanically modeled deformations.

PURPOSE: Deformable image registration (DIR) has been increasingly used in radiation therapy (RT). The accuracy of DIR algorithms and how it impacts on the RT plan dosimetrically were examined in our study for abdominal sites using biomechanically modeled deformations. METHODS: Five pancreatic cancer patients were enrolled in this study. Following the guidelines of AAPM TG-132, a patient-specific quality assurance (QA) workflow was developed to evaluate DIR for the abdomen using the TG-132 recommended virtual simulation software ImSimQA (Shrewsbury, UK). First, the planning CT was deformed to simulate respiratory motion using the embedded biomechanical model in ImSimQA. Additionally, 5 mm translational motion was added to the stomach, duodenum, and small bowel. The original planning CT and the deformed CT were then imported into Eclipse and MIM to perform DIR. The output displacement vector fields (DVFs) were compared with the ground truth from ImSimQA. Furthermore, the original treatment plan was recalculated on the ground-truth deformed CT and the deformed CT (with Eclipse and MIM DVF). The dose errors were calculated on a voxel-to-voxel basis. RESULTS: Data analysis comparing DVF from Eclipse versus MIM show the average mean DVF magnitude errors of 2.8 ± 1.0  versus 1.1 ± 0.7 mm for stomach and duodenum, 5.2 ± 4.0  versus 2.5 ± 1.0 mm for small bowel, and 4.8 ± 4.1  versus 2.7 ± 1.1 mm for the gross tumor volume (GTV), respectively, across all patients. The mean dose error on stomach+duodenum and small bowel were 2.3 ± 0.6% for Eclipse, and 1.0 ± 0.3% for MIM. As the DIR magnitude error increases, the dose error range increase, for both Eclipse and MIM. CONCLUSION: In our study, an initial assessment was conducted to evaluate the accuracy of DIR and its dosimetric impact on radiotherapy. A patient-specific DIR QA workflow was developed for pancreatic cancer patients. This workflow exhibits promising potential for future implementation as a clinical workflow.

IDH2 regulates macrophage polarization and tumorigenesis by modulating mitochondrial metabolism in macrophages.

BACKGROUND: Targeting the tumor microenvironment represents an emerging therapeutic strategy for cancer. Macrophages are an essential part of the tumor microenvironment. Macrophage polarization is modulated by mitochondrial metabolism, including oxidative phosphorylation (OXPHOS), the tricarboxylic acid (TCA) cycle, and reactive oxygen species content. Isocitrate dehydrogenase 2 (IDH2), an enzyme involved in the TCA cycle, reportedly promotes cancer progression. However, the mechanisms through which IDH2 influences macrophage polarization and modulates tumor growth remain unknown. METHODS: In this study, IDH2-deficient knockout (KO) mice and primary cultured bone marrow-derived macrophages (BMDMs) were used. Both in vivo subcutaneous tumor experiments and in vitro co-culture experiments were performed, and samples were collected for analysis. Western blotting, RNA quantitative analysis, immunohistochemistry, and flow cytometry were employed to confirm changes in mitochondrial function and the resulting polarization of macrophages exposed to the tumor microenvironment. To analyze the effect on tumor cells, subcutaneous tumor size was measured, and growth and metastasis markers were identified. RESULTS: IDH2-deficient macrophages co-cultured with cancer cells were found to possess increased mitochondrial dysfunction and fission than wild-type BMDM. Additionally, the levels of M2-associated markers decreased, whereas M1-associated factor levels increased in IDH2-deficient macrophages. IDH2-deficient macrophages were predominantly M1. Tumor sizes in the IDH2-deficient mouse group were significantly smaller than in the wild-type mouse group. IDH2 deficiency in macrophages was associated with inhibited tumor growth and epithelial-mesenchymal transition. CONCLUSIONS: Our findings suggest that IDH2 deficiency inhibits M2 macrophage polarization and suppresses tumorigenesis. This study underlines the potential contribution of IDH2 expression in macrophages and tumor microenvironment remodeling, which could be useful in clinical cancer research.

Wernicke encephalopathy in a patient with medullary infarctions: a case report.

Wernicke encephalopathy (WE) is an acute life-threatening neurological condition caused by thiamine (vitamin B1) deficiency. Patients with WE often present with a triad of symptoms consisting of ophthalmoplegia, gait ataxia, and mental confusion. If WE is not treated in a timely manner, it can lead to serious complications such as confusion, coma, or death. Although alcohol abuse is the most commonly reported cause of WE, nonalcoholic causes-although rare-do exist. Herein, we present the case of a nonalcoholic woman with medullary infarctions who presented with intractable vomiting. Her clinical state subsequently progressed to include ophthalmoplegia and gait ataxia. A diagnosis of WE was suspected based on her clinical presentation; this was confirmed by brain magnetic resonance imaging (MRI) and the finding of decreased serum thiamine levels. Brain magnetic resonance imaging demonstrated the complete resolution of abnormal hyperintensities during a follow-up visit, 6 months after treatment.

The HIV-1 capsid serves as a nanoscale reaction vessel for reverse transcription.

The viral capsid performs critical functions during HIV-1 infection and is a validated target for antiviral therapy. Previous studies have established that the proper structure and stability of the capsid are required for efficient HIV-1 reverse transcription in target cells. Moreover, it has recently been demonstrated that permeabilized virions and purified HIV-1 cores undergo efficient reverse transcription in vitro when the capsid is stabilized by addition of the host cell metabolite inositol hexakisphosphate (IP6). However, the molecular mechanism by which the capsid promotes reverse transcription is undefined. Here we show that wild type HIV-1 virions can undergo efficient reverse transcription in vitro in the absence of a membrane-permeabilizing agent. This activity, originally termed "natural endogenous reverse transcription" (NERT), depends on expression of the viral envelope glycoprotein during virus assembly and its incorporation into virions. Truncation of the gp41 cytoplasmic tail markedly reduced NERT activity, suggesting that gp41 licenses the entry of nucleotides into virions. By contrast to reverse transcription in permeabilized virions, NERT required neither the addition of IP6 nor a mature capsid, indicating that an intact viral membrane can substitute for the function of the viral capsid during reverse transcription in vitro. Collectively, these results demonstrate that the viral capsid functions as a nanoscale container for reverse transcription during HIV-1 infection.

Bullying Involvement and Subtypes of Disabilities: Who is Likely to be Affected by What?

The current study uses latent class analysis (LCA) and binary logistic regression analysis to explore profiles of bullying and how they might be associated with the types of disabilities. LCA was used to determine a categorization of involvement in bullying among youth with various types of disabilities. Binary logistic regression analysis was conducted to explore how profiles of bullying involvement might be associated with types of disabilities. The study uses the 2016 National Survey of Children's Health, a large-scale survey completed on children's health, ages 0-17, in the United States. A total of 139,923 households were screened for eligibility. The study participants consisted of 50,212 caregivers of a child who completed the survey. Findings revealed that among caregivers of children without disabilities, 79.5% reported that their child was uninvolved, and 20.5% reported that their child was a victim of bullying. Children in the developmental disabilities, speech and/or language disorders, and learning disabilities groups, showed significant odds of being in the bullying victim group compared to those without any disabilities. The study did not find that children in any disability groups were likely to be in the perpetrator group.

Visualizing localized nematic states in twisted double bilayer graphene.

Direct visualization of the states originating from electron-electron interactions is of great importance for engineering the surface and interfacial properties of graphene-based quantum materials. For instance, the rotational symmetry breaking or nematic phase inferred from spectroscopic imaging has confirmed the existence of correlated states in a wide range of moiré materials. Here, we study the atomic-scale spatial distributions and symmetry of wave functions in gate-tunable twisted double bilayer graphene by employing scanning tunneling microscopy/spectroscopy and continuum model calculations. A series of spectroscopic imaging analyses are used to identify dominant symmetry breaking of the emergent states. Interestingly, in non-integer hole fillings, a completely new localized electronic state with rotational symmetry breaking is observed on the left side of the valence flat band. The degree of anisotropy is found to increase from the conduction flat band through the valence flat band to the new state. Our results provide an essential microscopic insight into the flat band and its adjacent state for a full understanding of their electric field response in twisted graphene systems.

Development of message passing-based graph convolutional networks for classifying cancer pathology reports.

BACKGROUND: Applying graph convolutional networks (GCN) to the classification of free-form natural language texts leveraged by graph-of-words features (TextGCN) was studied and confirmed to be an effective means of describing complex natural language texts. However, the text classification models based on the TextGCN possess weaknesses in terms of memory consumption and model dissemination and distribution. In this paper, we present a fast message passing network (FastMPN), implementing a GCN with message passing architecture that provides versatility and flexibility by allowing trainable node embedding and edge weights, helping the GCN model find the better solution. We applied the FastMPN model to the task of clinical information extraction from cancer pathology reports, extracting the following six properties: main site, subsite, laterality, histology, behavior, and grade. RESULTS: We evaluated the clinical task performance of the FastMPN models in terms of micro- and macro-averaged F1 scores. A comparison was performed with the multi-task convolutional neural network (MT-CNN) model. Results show that the FastMPN model is equivalent to or better than the MT-CNN. CONCLUSIONS: Our implementation revealed that our FastMPN model, which is based on the PyTorch platform, can train a large corpus (667,290 training samples) with 202,373 unique words in less than 3 minutes per epoch using one NVIDIA V100 hardware accelerator. Our experiments demonstrated that using this implementation, the clinical task performance scores of information extraction related to tumors from cancer pathology reports were highly competitive.

Electrochemical biosensor based on functional nanomaterials and horseradish peroxidase for the determination of luteolin in peanut shell, honeysuckle and perilla.

Constructing a biosensor to detect luteolin content accurately is essential, especially considering its specific health benefits at certain concentrations. In this work, the reaction of HRP catalyzed luteolin could be successfully applied in electrocatalytic processes, the oxidation process of electron loss and dehydrogenation occurring on the electrode replaced the hydrogen receptor role of H2O2 in the HRP biocatalytic process. This oxidation reaction had an apparent current response, thus achieving accurate measurement of luteolin. On this biosensor, CTAB was used to disperse MWCNTs, and BSA was used to improve the hydrophobicity of MWCNTs, which was conducive to the subsequent AuNPs fixation of HRP. Three detection methods (LSV, DPV and SWV) for the detection of luteolin were compared and showed that SWV method had a wider linear range (1 × 10-8-2 × 10-5 M) and lower detection limit (8 × 10-10 M). The determination of luteolin in Traditional Chinese Medicine (TCM) by high performance liquid chromatography (HPLC) and biosensor was almost identical. Therefore, this biosensor could successfully replace HPLC in detecting luteolin in TCM.

Vonoprazan and amoxicillin dual therapy for 14 days as the first-line treatment of Helicobacter pylori infection: A non-inferiority, randomized clinical trial.

BACKGROUND: We previously optimized the duration and dose of vonoprazan and amoxicillin dual therapy in China. The efficacy of vonoprazan with b.i.d. amoxicillin in comparison with vonoprazan-containing quadruple therapy as the first-line treatment of Helicobacter pylori infection has not been adequately evaluated. METHODS: In a non-inferiority, randomized clinical trial, H. pylori infected and treatment-naïve patients were randomly assigned to receive 14 days of either vonoprazan dual (vonoprazan 20 mg and amoxicillin 1 g twice daily) or quadruple therapy (vonoprazan 20 mg + amoxicillin 1 g + furazolidone 100 mg + bismuth potassium citrate 600 mg twice daily). H. pylori status was confirmed using 13C-urea breath tests or fecal antigen test. The primary outcome was the H. pylori eradication rate following vonoprazan dual and quadruple therapy at 4-12 weeks. We also compared drug compliance to either regimen and documented their side effect. RESULTS: A total of 190 subjects were randomized. The eradication rate of vonoprazan dual and quadruple therapy were 87.4% and 92.6% (p = 0.23) by intention-to-treat analysis, respectively, and 96.5% and 97.7% (p = 0.63) by per-protocol analysis, respectively. The efficacy of vonoprazan dual therapy was non-inferior to vonoprazan-containing quadruple therapy in per-protocol analysis (p < 0.001; difference: -1.2%; 90% confidence interval: -5.4% to 3.0%). CONCLUSION: Vonoprazan with b.i.d. amoxicillin for 14 days provided similar satisfactory efficacy with vonoprazan-containing quadruple therapy as a first-line H. pylori treatment in China.

Directly visualizing nematic superconductivity driven by the pair density wave in NbSe2.

Pair density wave (PDW) is a distinct superconducting state characterized by a periodic modulation of its order parameter in real space. Its intricate interplay with the charge density wave (CDW) state is a continuing topic of interest in condensed matter physics. While PDW states have been discovered in cuprates and other unconventional superconductors, the understanding of diverse PDWs and their interactions with different types of CDWs remains limited. Here, utilizing scanning tunneling microscopy, we unveil the subtle correlations between PDW ground states and two distinct CDW phases - namely, anion-centered-CDW (AC-CDW) and hollow-centered-CDW (HC-CDW) - in 2H-NbSe2. In both CDW regions, we observe coexisting PDWs with a commensurate structure that aligns with the underlying CDW phase. The superconducting gap size, Δ(r), related to the pairing order parameter is in phase with the charge density in both CDW regions. Meanwhile, the coherence peak height, H(r), qualitatively reflecting the electron-pair density, exhibits a phase difference of approximately 2π/3 relative to the CDW. The three-fold rotational symmetry is preserved in the HC-CDW region but is spontaneously broken in the AC-CDW region due to the PDW state, leading to the emergence of nematic superconductivity.