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Wind velocity is usually assumed to obey a stationary stochastic process in wind engineering, and this may cause significant bias in describing extremely severe strong wind such as typhoons and thunderstorms. To take into account the non-stationary characteristics of extreme wind, a novel evolutionary power spectral density (EPSD) model is proposed, and the spectral representation method (SRM) is introduced to simulate the whole process of strong winds. Firstly, the wavelet transform (WT) method is adopted to capture the three-dimensional time-varying properties of the low-frequency mean winds, and the associated turbulence features, including turbulent intensity, gust factor, probability density function, and power spectrum, are analyzed in depth. Secondly, the measured horizontal EPSD of strong winds are estimated. Thirdly, the performance of the proposed EPSD model is validated. Finally, the whole process of non-stationary strong winds are simulated and discussed. The results show that the proposed EPSD models are in good agreement with the measured EPSD, and the time-frequency features of the power spectrum of the simulated winds are well reproduced, which provides a powerful tool for large eddy simulation and wind engineering studies under non-stationary extreme wind climate.
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Grime's competitive, stress-tolerant, ruderal (CSR) theory predicts a shift in plant communities from ruderal to stress-tolerant strategies during secondary succession. However, this fundamental tenet lacks empirical validation using long-term continuous successional data. Utilizing a 60-year longitudinal data of old-field succession, we investigated the community-level dynamics of plant strategies over time. Our findings reveal that while plant communities generally transitioned from ruderal to stress-tolerant strategies during succession, initial abandonment conditions crucially shaped early successional strategies, leading to varied strategy trajectories across different fields. Furthermore, we found a notable divergence in the CSR strategies of alien and native species over succession. Initially, alien and native species exhibited similar ruderal strategies, but in later stages, alien species exhibited higher ruderal and lower stress tolerance compared to native species. Overall, our findings underscore the applicability of Grime's predictions regarding temporal shifts in CSR strategies depending on both initial community conditions and species origin.
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Especies Introducidas , Plantas , Fenómenos Fisiológicos de las Plantas , Estrés Fisiológico , Ecosistema , Modelos Biológicos , Desarrollo de la PlantaRESUMEN
Rationally designed defects in a crystal can confer unique properties. This study showcases a novel dual-defects engineering strategy to tailor the electrochemical response of metal-organic framework (MOF) materials used for electrochemical energy storage. Salicylic acid (SA) is identified as an effective modulator to control MOF-74 growth and induce structural defects, and cobalt cation doping is adopted for introducing a second type of defect. The resulting dual-defects engineered bimetallic MOF exhibits a discharging capacity of 218.6 mAh g-1, 4.4 times that of the pristine MOF-74, and significantly improved cycling stability. Moreover, the engineered MOF-74(Ni0.675Co0.325)-8//Zn aqueous battery shows top energy/power density performances for Ni-Zn batteries (266.5 Wh kg-1, 17.22 kW kg-1). Comprehensive investigations reveal that engineered defects modify the local coordination environment and promote the in situ electrochemical reconfiguration during operation to significantly boost the electrochemical activity. This work suggests that rational tailoring of the defects within the MOF crystal is an effective strategy to manipulate the coordination environment of the metal centers and the corresponding electrochemical reconfiguration for electrochemical applications.
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Introduction: We aimed to modify the LR-5 strategy to improve the diagnostic sensitivity for hepatocellular carcinoma (HCC) in high-risk patients while maintaining specificity. Methods: This study retrospectively analyzed 412 patients with 445 liver observations who underwent preoperative gadolinium ethoxybenzyl DTPA (GD-EOB-DTPA)-enhanced MRI followed by surgical procedures or biopsies. All observations were classified according to LI-RADS v2018, and the classifications were adjusted by modifying major features (MF)(substituting threshold growth with a more HCC-specific ancillary features (AF): presence of blood products within the mass, arterial phase hyperenhancement (APHE) was interpreted with hypointensity on precontrast imaging- isointensity in arterial phase (AP) and extending washout to transitional phase (TP)(2 min)). The specificity, sensitivity, and positive predictive value (PPV) were assessed to compare LR-5 (definitely HCC) diagnostic efficacy between LI-RADS version 2018 and modified LI-RADS. Results: Apart from nonenhancing "capsule", the interreader agreement of MFs and HCC-specific AFs between the two readers reached substantial or excellent ranges (κ values ranging from 0.631 to 0.911). According to LI-5 v2018, the specificity, sensitivity and PPV of HCC were 90.74%, 82.35%, and 98.17%, respectively. Based on a more HCC-specific AF, signal intensity in AP and TP (2 min), the sensitivity of the three modified strategies were 86.19%, 93.09%, 96.67% (P < .05)), while maintaining high specificity and PPV rates at 88.89% and 98.25% (P > .05) Conclusion: Further investigation into the efficacy of threshold growth as a MF is warranted. By utilizing GD-EOB-DTPA-enhanced MRI, enhancing the sensitivity of the modified LR-5 category may be achieved without compromising specificity and PPV in diagnosing HCC among high-risk patients.
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Carcinoma Hepatocelular , Medios de Contraste , Gadolinio DTPA , Neoplasias Hepáticas , Imagen por Resonancia Magnética , Humanos , Carcinoma Hepatocelular/diagnóstico por imagen , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/patología , Imagen por Resonancia Magnética/métodos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Adulto , Aumento de la Imagen/métodosRESUMEN
Despite much research in the field of island biogeography, mechanisms regulating insular diversity remain elusive. Here, we aim to explore mechanisms underlying plant species-area relationships in two tropical archipelagoes in the South China Sea. We found positive plant species-area relationships for both coral and continental archipelagoes. However, our results showed that different mechanisms contributed to similar plant species-area relationships between the two archipelagoes. For coral islands, soil nutrients and spatial distance among communities played major roles in shaping plant community structure and species diversity. By contrast, the direct effect of island area, and to a lesser extent, soil nutrients determined plant species richness on continental islands. Intriguingly, increasing soil nutrients availability (N, P, K) had opposite effects on plant diversity between the two archipelagoes. In summary, the habitat quality effect and dispersal limitation are important for regulating plant diversity on coral islands, whereas the passive sampling effect, and to a lesser extent, the habitat quality effect are important for regulating plant diversity on continental islands. More generally, our findings indicate that island plant species-area relationships are outcomes of the interplay of both niche and neutral processes, but the driving mechanisms behind these relationships depends on the type of islands.
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Coal gasification slag (CGS) contains variable amounts of heavy metals, which can negatively impact the environment. The mineral composition, element distribution, occurrence, and leaching characteristics of heavy metals in coal gasification coarse slag (CGCS) and coal gasification fine slag (CGFS) are studied to explain the leaching behavior of heavy metals in CGS. The movable components of heavy metals in CGFS (0.06 %-63.03 %) are significantly higher than those in CGCS (0 %-18.72 %). Leaching Environmental Assessment Framework 1313 data shows that heavy metals Zn, Cr, Cd, As, Pb, Ni, and Cu exhibit high leaching rates at low pH conditions, with Zn leaching concentrations as high as 2.11 mg/L at pH 2. Zn, Cr, and As exhibit obvious amphoteric leaching characteristics, and the leaching concentration of As at high pH (1.34 mg/L) even exceeds that at low pH (1.31 mg/L). Except for Cu, all heavy metals in CGS exceed the class III groundwater standard in some cases. Therefore, evaluation is needed before resource utilization of CGS due to potential leaching of some heavy metals.
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The hydrogenation of CO2 to formic acid is an essential subject since formic acid is a promising hydrogen storage material and a valuable commodity chemical. In this study, we report for the first time the hydrogenation of CO2 to formic acid catalyzed by a Pd2+ catalyst, Pd-V/AC-air. The catalyst exhibited extraordinary catalytic activity toward the hydrogenation of CO2 to formic acid. The TON and TOF are up to 4790 and 2825 h-1, respectively, representing the top level among reported heterogeneous Pd catalysts. By combining a study of first-principles density functional theory with experimental results, the superiority of Pd2+ over Pd0 was confirmed. Furthermore, the presence of V modified the electronic state of Pd2+, thus promoting the reaction. This study reports the effect of metal valence and electronic state on the catalytic performance for the first time and provides a new prospect for the design of an efficient heterogeneous catalyst for the hydrogenation of CO2 to formic acid.
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Lithium (Li) metal is widely recognized as a viable candidate for anode material in future battery technologies due to its exceptional energy density. Nevertheless, the commercial Li foils in common use are too thick (≈100 µm), resulting in a waste of Li resources. Herein, by applying the vacuum evaporation plating technology, the ultra-thin Li foils (VELi) with high purity, strong adhesion, and thickness of less than 10 µm are successfully prepared. The manipulation of evaporation temperature allows for convenient regulation of the thickness of the fabricated Li film. This physical thinning method allows for fast, continuous, and highly accurate mass production. With a current density of 0.5 mA cm-2 for a plating amount of 0.5 mAh cm-2, VELi||VELi cells can stably cycle for 200 h. The maximum utilization of Li is already more than 25%. Furthermore, LiFePO4||VELi full cells present excellent cycling performance at 1 C (1 C = 155 mAh g-1) with a capacity retention rate of 90.56% after 240 cycles. VELi increases the utilization of active Li and significantly reduces the cost of Li usage while ensuring anode cycling and multiplication performance. Vacuum evaporation plating technology provides a feasible strategy for the practical application of ultra-thin Li anodes.
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Oncolytic virus (OV)-based immunotherapy has emerged as a promising strategy for cancer treatment, offering a unique potential to selectively target malignant cells while sparing normal tissues. However, the immunosuppressive nature of tumor microenvironment (TME) poses a substantial hurdle to the development of OVs as effective immunotherapeutic agents, as it restricts the activation and recruitment of immune cells. This review elucidates the potential of OV-based immunotherapy in modulating the immune landscape within the TME to overcome immune resistance and enhance antitumor immune responses. We examine the role of OVs in targeting specific immune cell populations, including dendritic cells, T cells, natural killer cells, and macrophages, and their ability to alter the TME by inhibiting angiogenesis and reducing tumor fibrosis. Additionally, we explore strategies to optimize OV-based drug delivery and improve the efficiency of OV-mediated immunotherapy. In conclusion, this review offers a concise and comprehensive synopsis of the current status and future prospects of OV-based immunotherapy, underscoring its remarkable potential as an effective immunotherapeutic agent for cancer treatment.
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Inmunoterapia , Neoplasias , Viroterapia Oncolítica , Virus Oncolíticos , Microambiente Tumoral , Humanos , Neoplasias/terapia , Neoplasias/inmunología , Microambiente Tumoral/inmunología , Viroterapia Oncolítica/métodos , Virus Oncolíticos/inmunología , Inmunoterapia/métodos , Células Dendríticas/inmunología , AnimalesRESUMEN
In the Anthropocene, non-native freshwater fish introductions and translocations have occurred extensively worldwide. However, their global distribution patterns and the factors influencing their establishment remain poorly understood. We analyze a comprehensive database of 14953 freshwater fish species across 3119 river basins and identify global hotspots for exotic and translocated non-native fishes. We show that both types of non-native fishes are more likely to occur when closely related to native fishes. This finding is consistent across measures of phylogenetic relatedness, biogeographical realms, and highly invaded countries, even after accounting for the influence of native diversity. This contradicts Darwin's naturalization hypothesis, suggesting that the presence of close relatives more often signifies suitable habitats than intensified competition, predicting the establishment of non-native fish species. Our study provides a comprehensive assessment of global non-native freshwater fish patterns and their phylogenetic correlates, laying the groundwork for understanding and predicting future fish invasions in freshwater ecosystems.
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Ecosistema , Agua Dulce , Animales , Filogenia , Ríos , Peces , Especies Introducidas , BiodiversidadRESUMEN
Vinegar is used as fermented condiment and functional food worldwide. Vinegar contains many nutrients and bioactive components, which exhibits health benefits. In this study, the potential effects of Shanxi aged vinegar (SAV) on gut microbiome and metabolome were explored in normal mice. The levels of inflammatory factors were significantly decreased in SAV-treated mice. Immunoglobulin, NK cells and CD20 expression were significantly increased after SAV administration. In addition, SAV intake altered gut microbiota structure by up-regulating Verrucomicrobia, Akkermansia, Hungatella and Alistipes, and down-regulating Firmicutes, Lachnospiraceae_NK4A136_group and Oscillibacter. The differential metabolites were mainly included amino acids, carbohydrates and bile acids. Furthermore, after SAV intake, Verrucomicrobia, and Akkermansia closely impacted the related gut metabolites. These alterations of gut microbiota-related metabolism further modulated some immunoregulatory and inflammatory factors, and confer potential health benefits. Our results imply that vinegar consumption has beneficial effects on regulating gut microbiome and metabolome.
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The structure engineering of metal-organic frameworks (MOFs) forms the cornerstone of their applications. Nonetheless, realizing the simultaneous versatile structure engineering of MOFs remains a significant challenge. Herein, a dynamically mediated synthesis strategy to simultaneously engineer the crystal structure, defect structure, and nanostructure of MOFs is proposed. These include amorphous Zr-ODB nanoparticles, crystalline Zr-ODB-hz (ODB = 4,4'-oxalyldibenzoate, hz = hydrazine) nanosheets, and defective d-Zr-ODB-hz nanosheets. Aberration-corrected scanning transmission electron microscopy combined with low-dose high-angle annular dark-field imaging technique vividly portrays these engineered structures. Concurrently, the introduced hydrazine moieties confer self-reduction properties to the respective MOF structures, allowing the in situ installation of catalytic Pd nanoparticles. Remarkably, in the hydrogenation of vanillin-like biomass derivatives, Pd/Zr-ODB-hz yields partially hydrogenated alcohols as the primary products, whereas Pd/d-Zr-ODB-hz exclusively produces fully hydrogenated alkanes. Density functional theory calculations, coupled with experimental evidence, uncover the catalytic selectivity switch triggered by the change in structure type. The proposed strategy of versatile structure engineering of MOFs introduces an innovative pathway for the development of high-performance MOF-based catalysts for various reactions.
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BACKGROUND: Persistent cough is one of the most frequent complications following lung cancer surgery. To promote optimal recovery, we conducted a study to investigate the trajectories of coughing symptoms and their impact on quality of life (QOL), as well as to identify potential risk factors of persistent cough after pulmonary resection (CAP). METHODS: This prospective observational study assessed patients who underwent pulmonary resection for lung tumor at two medical centers in China. Persistent CAP was evaluated before surgery, at discharge, and 1, 3, and 6 months following surgery using visual analog scale (VAS), cough symptom score (CSS), and Leicester Cough Questionnaire in Mandarin Chinese (LCQ-MC). Univariate and multivariate logistic regression analyses were conducted to explore independent risk factors for persistent CAP. RESULTS: Of the 506 enrolled patients, 130 patients were diagnosed with persistent CAP with an incidence of 25.69%. Compared to the noncough group, patients with persistent CAP reported significantly higher VAS (p < 0.001) and CSS scores (p < 0.001) and experienced worse QOL (p < 0.001) for up to 6 months, particularly at 1 month following surgery. Multivariable regression analysis revealed that a duration of anesthesia exceeding 156 min (odds ratio [OR]: 1.847, 95% confidence interval [CI]: 1.156-2.951, p = 0.010) and gastroesophageal acid reflux (GER) (OR: 3.870, 95% CI: 2.376-6.304, p < 0.001) were independent risk factors of persistent CAP. CONCLUSION: Patients who suffer from persistent CAP face a substantial burden and diminished QOL for an extended period compared to noncough patients. Moreover, prolonged duration of anesthesia and postoperative GER are potential risk factors of persistent CAP.
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Tos Crónica , Calidad de Vida , Humanos , Estudios Prospectivos , Tos/etiología , Tos/epidemiología , Factores de RiesgoRESUMEN
In the cytoplasm, mRNAs are dynamically partitioned into translating and non-translating pools, but the mechanism for this regulation has largely remained elusive. Here, we report that m6A regulates mRNA partitioning between polysome and P-body where a pool of non-translating mRNAs resides. By quantifying the m6A level of polysomal and cytoplasmic mRNAs with m6A-LAIC-seq and m6A-LC-MS/MS in HeLa cells, we observed that polysome-associated mRNAs are hypo-m6A-methylated, whereas those enriched in P-body are hyper-m6A-methylated. Downregulation of the m6A writer METTL14 enhances translation by switching originally hyper-m6A-modified mRNAs from P-body to polysome. Conversely, by proteomic analysis, we identify a specific m6A reader IGF2BP3 enriched in P-body, and via knockdown and molecular tethering assays, we demonstrate that IGF2BP3 is both necessary and sufficient to switch target mRNAs from polysome to P-body. These findings suggest a model for the dynamic regulation of mRNA partitioning between the translating and non-translating pools in an m6A-dependent manner.
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Adenina , Cuerpos de Procesamiento , Biosíntesis de Proteínas , Proteínas de Unión al ARN , Humanos , Cromatografía Liquida , Células HeLa , Polirribosomas/genética , Proteómica , ARN Mensajero/genética , Espectrometría de Masas en Tándem , Adenina/análogos & derivados , Adenina/metabolismo , Proteínas de Unión al ARN/metabolismoRESUMEN
BACKGROUND: Inconsistent pathological responses of tumor and lymph nodes (LNs) were frequently observed in non-small cell lung cancer (NSCLC) receiving neoadjuvant chemoimmunotherapy. However, there is a lack of studies to report the prognostic significance and the relevant clinicopathological factors of tumor-nodal inconsistent responses after neoadjuvant immunotherapy or chemoimmunotherapy. Therefore, this study aimed to depict the inconsistent pathological combined tumor-nodal responses in NSCLC patients after neoadjuvant chemoimmunotherapy as well as the underlying clinical significance. METHODS: A total of 81 node-positive NSCLC patients who underwent neoadjuvant chemoimmunotherapy were eligible for inclusion. Demographic, radiologic, and pathological features of patients were recorded. Patients with pathological complete response of both tumor (ypT(pCR)) and LNs (ypN0) were classified into the combined good responder group and the relevant clinicopathological features were evaluated. The event-free survival (EFS) outcome was analyzed using Kaplan-Meier analysis. RESULTS: The ypN0 and ypT(pCR) rates were 74.1 % and 42.0 %, respectively. A significant correlation was observed between ypT(pCR) and ypN0 (P = 0.003), but inconsistent responses remained. The combined responses of the primary tumor and LNs demonstrated a significant association with the prognosis outcome (P = 0.005). Notably,patients who received at least twice of their infusions of immune checkpoint inhibitors after 15:30 had a worse prognosis (P = 0.015). CONCLUSION: A significant but not absolute correlation was observed between good tumor response and good nodal response in NSCLC patients after neoadjuvant chemoimmunotherapy, but inconsistent responses were also found. The combination of tumor and nodal responses is significantly associated with prognosis and combined good responder can be used as a reliable prognosis predictor.
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Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Humanos , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Terapia Neoadyuvante , Neoplasias Pulmonares/tratamiento farmacológico , Ganglios Linfáticos/patología , Inmunoterapia , Estudios RetrospectivosRESUMEN
Darwin's naturalization conundrum describes two seemingly contradictory hypotheses regarding whether alien species closely or distantly related to native species should be more likely to naturalize in regional floras. Both expectations have accumulated empirical support, and whether such apparent inconsistency can be reconciled at the global scale is unclear. Here, using 219,520 native and 9,531 naturalized alien plant species across 487 globally distributed regions, we found a latitudinal gradient in Darwin's naturalization conundrum. Naturalized alien plant species are more closely related to native species at higher latitudes than they are at lower latitudes, indicating a greater influence of preadaptation in harsher climates. Human landscape modification resulted in even steeper latitudinal clines by selecting aliens distantly related to natives in warmer and drier regions. Our results demonstrate that joint consideration of climatic and anthropogenic conditions is critical to reconciling Darwin's naturalization conundrum.
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Ecosistema , Magnoliopsida , Humanos , Ciudadanía , Especies Introducidas , PlantasRESUMEN
A widely assumed, but largely untested, tenet in ecology is that ecosystem stability tends to increase over succession. We rigorously test this idea using 60-year continuous data of old field succession across 480 plots nested within 10 fields. We found that ecosystem temporal stability increased over succession at the larger field scale (γ stability) but not at the local plot scale (α stability). Increased spatial asynchrony among plots within fields increased γ stability, while temporal increases in species stability and decreases in species asynchrony offset each other, resulting in no increase in α stability at the local scale. Furthermore, we found a notable positive diversity-stability relationship at the larger but not local scale, with the increased γ stability at the larger scale associated with increasing functional diversity later in succession. Our results emphasize the importance of spatial scale in assessing ecosystem stability over time and how it relates to biodiversity.
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Biodiversidad , Ecosistema , EcologíaRESUMEN
The employment of Li metal anodes is a key to realizing ultra-high energy batteries. However, the commercialization of lithium metal batteries (LMBs) remains challenging partially due to the thermodynamic instability and competitive oxidative decomposition of the solvent. Herein, a bi-functional electrolyte for stabilizing the interfaces of both the Li metal anode and LiCoO2 (LCO) cathode is designed by introducing lithium nitrate (LiNO3) through Ethylene Glycol Bis(Propionitrile) Ether (DENE). For the anode, the C8H12N2O2-LiNO3 coordination-solvation contributes to forming a stable Li3N-enhanced solid electrolyte interphase (SEI), which increases the average Li coulombic efficiency (CE) up to 98.5%. More importantly, in situ electrochemical dilatometry further reveals that the highly reversible behavior and a low volume expansion of lithium deposition are related to the stable Li3N-enhanced SEI. The designed electrolyte enables the LiâLCO cell to achieve an average CE of 99.2% and a high capacity retention of 88.2% up to 4.6 V after 100 cycles. This work provides a strategic guidance in developing high-voltage LiâLCO batteries with dual electrolyte additives.
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Polydimethylsiloxane (PDMS)-the simplest and most common silicone compound-exemplifies the central characteristics of its class and has attracted tremendous research attention. The development of PDMS-based materials is a vivid reflection of the modern industry. In recent years, PDMS has stood out as the material of choice for various emerging technologies. The rapid improvement in bulk modification strategies and multifunctional surfaces has enabled a whole new generation of PDMS-based materials and devices, facilitating, and even transforming enormous applications, including flexible electronics, superwetting surfaces, soft actuators, wearable and implantable sensors, biomedicals, and autonomous robotics. This paper reviews the latest advances in the field of PDMS-based functional materials, with a focus on the added functionality and their use as programmable materials for smart devices. Recent breakthroughs regarding instant crosslinking and additive manufacturing are featured, and exciting opportunities for future research are highlighted. This review provides a quick entrance to this rapidly evolving field and will help guide the rational design of next-generation soft materials and devices.
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BACKGROUND: Patients with pulmonary nodules (PNs) often suffer from the psychological burden of their disease and trap in sleep problems. This is insufficiently identified and addressed in clinical practice. The aim of this study was to investigate the psychological distress and sleep quality among PN patients and identify potential risk or protective factors for sleep quality. METHODS: We conducted a cross-sectional study, which included 731 PN patients who visited the thoracic clinic of Guangdong Provincial People's Hospital. Each participant completed a structured questionnaire consisting of demographic characteristics, clinical characteristics, the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI). The reliability of the HADS (Cronbach's α = 0.944) and PSQI (Cronbach's α = 0. 0.757) in this study was satisfactory. RESULTS: A total of 328 patients (44.9%) had PSQI global scores > 5, indicating poor quality of sleep. Age ≥ 50 years (OR 1.88, 95% CI 1.35-2.58; P < 0.001), female (OR 1.56, 95% CI 1.05-2.33; P = 0.028), detection of nodule for 7-12 months (vs for more than 24 months, OR 2.14, 95%CI 1.18-3.89, P = 0.013), anxiety (OR 1.78, 95% CI 1.17-2.71; P = 0.007) and depression (OR 1.84, 95% CI 1.16-2.92; P = 0.010) were independent risk factors for impaired sleep quality. A significant correlation revealed that sleep quality was positively correlated with both anxiety and depression (Spearman r = 0.342, P < 0.001 and Spearman r = 0.314, P < 0.001, respectively). All dimensions of the PSQI scale were significantly decreased in both anxiety group and depression group compared to the psychologically normal group (P < 0.05). CONCLUSIONS: Impaired sleep quality is highly prevalent among patients with PNs and associated with age, gender, time from the date of detection, anxiety and depression. Based on the finding of impaired sleep quality and psychological health, screening for psychological and sleep problems in PN patients will be of great clinical benefit.