Serum 25-hydroxyvitamin D concentrations, vitamin D receptor polymorphisms, and risk of infections among individuals with type 2 diabetes: a prospective cohort study.

BACKGROUND: Evidence on the association between serum 25-hydroxyvitamin D [25(OH)D] and infections among patients with type 2 diabetes (T2D), a group susceptible to vitamin D deficiency and infections, is limited. OBJECTIVES: We aimed to examine this association in individuals with T2D, and to evaluate whether genetic variants in vitamin D receptor (VDR) would modify this association. METHODS: This study included 19,851 participants with T2D from UK Biobank. Infections were identified by linkage to hospital inpatient and death registers. Negative binomial regression models were used to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs), with adjustment of potential confounders. RESULTS: In patients with T2D, the incidence rate of infections was 29.3/1000 person-years. Compared to those with 25(OH)D of 50.0-74.9 nmol/L, the multivariable-adjusted IRRs and 95% CIs of total infections, pneumonia, gastrointestinal infections and sepsis were 1.44 (1.31, 1.59), 1.49 (1.27, 1.75), 1.47 (1.22, 1.78), and 1.41 (1.14, 1.73), respectively, in patients with 25(OH)D <25.0 nmol/L. Nonlinear inverse associations between 25(OH)D concentrations and the risks of total infections (P-overall <0.001; P-nonlinear = 0.002) and gastrointestinal infections (P-overall <0.001; P-nonlinear = 0.040) were observed, with a threshold effect at ∼50.0 nmol/L. The vitamin D-infection association was not modified by genetic variants in VDR (all P-interaction >0.050). CONCLUSIONS: In patients with T2D, lower serum 25(OH)D concentration (<50 nmol/L) was associated with higher risks of infections, regardless of genetic variants in VDR. Notably, nonlinear inverse associations between 25(OH)D concentrations and the risks of infections were found, with a threshold effect at ∼50.0 nmol/L. These findings highlighted the importance of maintaining adequate vitamin D in reducing the risk of infections in patients with T2D.

Geographically and Temporally Weighted Regression in Assessing Dengue Fever Spread Factors in YunnanBorder Regions.

Objective: This study employs the Geographically and Temporally Weighted Regression (GTWR) model to assess the impact of meteorological elements and imported cases on dengue fever outbreaks, emphasizing the spatial-temporal variability of these factors in border regions. Methods: We conducted a descriptive analysis of dengue fever's temporal-spatial distribution in Yunnan border areas. Utilizing annual data from 2013 to 2019, with each county in the Yunnan border serving as a spatial unit, we constructed a GTWR model to investigate the determinants of dengue fever and their spatio-temporal heterogeneity in this region. Results: The GTWR model, proving more effective than Ordinary Least Squares (OLS) analysis, identified significant spatial and temporal heterogeneity in factors influencing dengue fever's spread along the Yunnan border. Notably, the GTWR model revealed a substantial variation in the relationship between indigenous dengue fever incidence, meteorological variables, and imported cases across different counties. Conclusion: In the Yunnan border areas, local dengue incidence is affected by temperature, humidity, precipitation, wind speed, and imported cases, with these factors' influence exhibiting notable spatial and temporal variation.

Interaction between CAFs and apoptotic cancer cells promotes OSCC proliferation via STING signaling.

BACKGROUND: Apoptosis can fuel oncogenesis by the education of surrounding stromal cells. However, the function of cancer-associated fibroblasts (CAFs), which interacted with apoptotic cancer cells, in oral squamous cell carcinoma (OSCC) progression is still unknown. OBJECTIVES: This study aimed to explore the prognostic value of apoptosis and the biological effects of CAFs, interacted with apoptotic cancer cells, on OSCC. METHODS: A total of 166 samples from OSCC patients were stained via TUNEL reaction to evaluate the correlation between apoptosis and clinical characteristics. Cell viability and proliferation were assessed through flow cytometry and CCK-8 assays, respectively. Levels of mRNA and protein were examined through qRT-PCR, western blot and immunofluorescence. RESULTS: Higher percentage of apoptotic cancer cells in OSCC positively correlated with more Ki67+ cells and predicted poor clinical outcomes. Conditioned medium from CAFs exposed to apoptotic cancer cells significantly facilitated cell proliferation. Co-culture CAFs with apoptotic cancer cells dampened the phosphorylation of STING/IRF3 signaling, as well as the production of type I interferon, which was required for the inhibition of OSCC cell proliferation. CONCLUSION: These results demonstrate the interplay between apoptotic cancer cells and CAFs promotes OSCC proliferation via STING signaling, identifying a potential therapy targeted CAFs surrounded with apoptotic cancer cells for OSCC.

The mediating effect of job embeddedness on the nursing work environment and transition shock among new nurses: A cross-sectional study.

AIMS: This study aims to investigate the status of transition shock and test the mediating effect of job embeddedness on the nursing work environment and transition shock among new nurses. BACKGROUND: Transition shock, primarily experienced during the first two years of employment, manifests itself as an unsettling or discordant experience among new nurses, which is caused by the gap between theoretical learning and clinical practice. DESIGN: This is a cross-sectional survey study, following the STROBE guidelines. METHODS: A cross-sectional study was conducted among 435 new nurses from November to December 2022 in Hunan Province, China. The participants were recruited to complete a sociodemographic information questionnaire and rank 3 standardized scales of transition shock (Cronbach's alpha = 0.918), job embeddedness (Cronbach's alpha = 0.890) and nursing work environment (Cronbach's alpha = 0.946). Then, the data were analysed by SPSS 26.0 and mediation testing was performed using Hayes' PROCESS macro (Model 4). A p value of < 0.05 was deemed statistically significant. RESULTS: The mean score with standard deviation of the transition shock scale in new nurses was 88.86 (22.50). The place of origin, working months and weekly working hours were the significant sociodemographic factors that affected the transition shock score in new nurses. Transition shock was found to be negatively related to both job embeddedness (r = -0.468, p < 0.001) and nursing work environment (r = -0.416, p < 0.001), while job embeddedness mediated the relationship between transition shock and nursing work environment (R2 = 0.262, F = 30.455, p < 0.001). CONCLUSIONS: New nurses from rural areas and with longer weekly working hours are more prone to transition shock. Those with 6-12 months of employment experience more pronounced transition shock than those with less than 6 months. In addition, the nursing work environment can not only directly influence transition shock for new nurses but also indirectly influence it through job embeddedness. These findings provide a basis for hospitals to develop strategies to effectively address transition shock in new nurses and ultimately solve the nursing shortage issue.

Life changes, self-prevention, knowledge and mental health among inflammatory bowel disease patients during COVID-19 pandemic: a cross-sectional study.

Background: With the COVID-19 pandemic going to be COVID-19 endemic, the negative impact of COVID-19 on the mental health of IBD patients cannot be ignored. This study aimed to investigate the occurrence of anxiety and depression in IBD patients during the COVID-19 pandemic and analyze the factors associated with mental health. Methods: Patients registered at the IBD center were enrolled. Electronic questionnaires about the IBD patient's demographic information, basic knowledge of COVID-19, public self-prevention measures, daily life changes, and anxiety and depression were distributed. Results: Two hundred and fifteen IBD patients finished this study and reported to have anxiety (27%) or depression (34%). During the COVID-19 pandemic, 10.2% of IBD patients reported their diet changes, 58.5% of IBD patients changed their daily physical activities from 3.27 ± 3.252 h to 2.30 ± 2.78 h, 33.7% of IBD patients changed their sleeping duration from 7.99 ± 1.322 h to 8.18 ± 1.447 h. IBD patients' waiting time for admission (OR: 3.688, 95%CI: 1.003-13.554), regularly oral medicine administration (OR: 18.407, 95%CI: 1.975-171.530) and diet changes (OR: 6.167, 95%CI: 2.158-17.626) were positively correlated with anxiety or depression. IBD patients' timely periodic infusion of biological agents (OR: 0.586, 95%CI: 0.413-0.830) was negatively correlated with anxiety or depression. IBD patients' knowledge of COVID-19, public self-prevention, physical activities, and sleep duration changes showed no significant correlation with anxiety and depression, all p values > 0.05. Conclusion: The main factors of IBD patients' mental health were diet changes, waiting time for admission, taking oral medicine regularly, and timely periodic infusions of biological agents. Ensuring the supply of routine treatment and medication for IBD patients and establishing systemic online IBD self-management programs would be the focus of major public health events.

Capsaicin pretreatment attenuates salt-sensitive hypertension by alleviating AMPK/Akt/Nrf2 pathway in hypothalamic paraventricular nucleus.

Background: Long term hypertension seriously promotes target organ damage in the brain and heart, and has increasingly become serious public health problem worldwide. The anti-hypertensive effects of capsaicin has been reported, however, the role and mechanism of capsaicin within the brain on salt-induced hypertension have yet to be elucidated. This study aimed to verify the hypothesis that capsaicin attenuates salt-induced hypertension via the AMPK/Akt/Nrf2 pathway in hypothalamic paraventricular nucleus (PVN). Methods: Dahl salt-sensitive (Dahl S) rats were used as animal model for the present study. Rats were randomly divided into four groups based on their dietary regimen (0.3% normal salt diet and 8% high salt diet) and treatment methods (infusion of vehicle or capsaicin in the PVN). Capsaicin was chronically administered in the PVN throughout the animal experiment phase of the study that lasted 6 weeks. Results: Our results demonstrated that PVN pretreatment with capsaicin can slow down raise of the blood pressure elevation and heart rate (HR) of Dahl S hypertensive rats given high salt diet. Interestingly, the cardiac hypertrophy was significantly improved. Furthermore, PVN pretreatment with capsaicin induced decrease in the expression of mRNA expression of NADPH oxidase-2 (NOX2), inducible nitric oxide synthase (iNOS), NOX4, p-IKKß and proinflammatory cytokines and increase in number of positive cell level for Nrf2 and HO-1 in the PVN of Dahl S hypertensive rats. Additionally, the protein expressions of phosphatidylinositol 3-kinase (p-PI3K) and phosphorylated protein kinase-B (p-AKT) were decreased, phosphorylated adenosine monophosphate-activated protein kinase (p-AMPK) were increased after the PVN pretreatment with capsaicin. Conclusion: Capsaicin pretreatment attenuates salt-sensitive hypertension by alleviating AMPK/Akt/iNOS pathway in the PVN.

Vertical transmission of microbiomes into embryo culture media and its association with assisted reproductive outcomes.

RESEARCH QUESTION: Can microbes vertically transmit from semen and follicular fluid to embryo culture media during assisted reproductive technology (ART) treatment? DESIGN: Spent embryo culture media (SECM), seminal fluid and follicular fluid samples were collected from 61 couples with infertility undergoing ART treatment at the Prince of Wales Hospital, Hong Kong SAR, China. Metagenomic analysis was conducted using 16s rRNA sequencing to identify the source of microbes in SECM, correlation between the semen microbiome and male infertility, and correlation between the follicular fluid microbiome and female infertility. RESULTS: Microbial vertical transmission into SECM was reported in 82.5% of cases, and semen was the main source of contamination in conventional IVF cases. The increased abundances of Staphylococcus spp. and Streptococcus anginosus in semen had negative impacts on total motility and sperm count, respectively (P < 0.001). Significant increases in abundance of the genera Prophyromonas, Neisseria and Facklamia were observed in follicular fluid in women with anovulation, uterine factor infertility and unexplained infertility, respectively (P < 0.01). No significant correlation was found between the bacteria identified in all sample types and ART outcomes, including fertilization rate, embryo development, number of available embryos, and clinical pregnancy rate. CONCLUSION: Embryo culture media can be contaminated during ART treatment, not only by seminal microbes but also by follicular fluid and other sources of microbes. Strong correlations were found between specific microbial taxa in semen and sperm quality, and between the follicular fluid microbiome and the aetiology of female infertility. However, no significant association was found between the microbiomes of SECM, semen and follicular fluid and ART outcomes.

[Research progress on mechanism of traditional Chinese medicine intervention in angiogenesis in prevention and treatment of nontraumatic avascular necrosis of femoral head].

Nontraumatic avascular necrosis of the femoral head(NANFH) is a common and refractory femoral head disease that causes bone death due to interruption of blood supply. Early clinical symptoms are atypical, such as hip pain and limited joint function. In the late stage, severe pain, shortening of the affected limb, claudication, and other serious symptoms are common, which se-riously affects the quality of life of patients. Therefore, it is of great significance to actively improve the clinical symptoms of NANFH to enhance the quality of life of patients. The pathogenesis of NANFH is complex, such as traumatic vascular circulatory disorders, the use of hormones or other drugs, alcoholism, and diabetes mellitus. These factors directly or indirectly lead to femoral head vascular damage, thrombosis, and coagulation system disorders, which reduce the blood supply to the acetabulum and femoral head, thus causing ischaemic death of the femoral head or even femoral head collapse. NANFH is mainly categorized as "bone impotence" and "bone paralysis" in traditional Chinese medicine(TCM). The treatment of NANFH with TCM has the characteristics and advantages of a long history, stable and reliable therapeutic effect, fewer adverse reactions, good patient tolerance, and high acceptance. Previous studies have shown that the promotion of angiogenesis is a key initiative in the prevention and treatment of NANFH, and TCM can promote fe-moral head angiogenesis by interfering with the expression of angiogenesis-related factors, which in turn can help to restore the blood supply of the femoral head and thus improve clinical symptoms of NANFH and prevent and treat NANFH. This article described the roles of blood supply interruption and angiogenesis in NANFH and the accumulated knowledge and experience of TCM in NANFH and summarized the role of angiogenesis-related factors in NANFH and the research progress on TCM intervention, so as to provide an idea for the subsequent research and a new basis for the clinical application of TCM in the treatment of NANFH.

Evaluation of system based psychological first aid training on the mental health proficiency of emergency medical first responders to natural disasters in China: a cluster randomised controlled trial.

OBJECTIVE: To evaluate the effectiveness of a system based psychological first aid (PFA) training programme for emergency medical first responders in China. DESIGN: Parallel-group, assessor-blinded, cluster randomised controlled trial. SETTING: 42 clusters of health workers from various health facilities in China. PARTICIPANTS: 1399 health workers who provide emergency service for survivors of disasters. INTERVENTIONS: One-day system based PFA training programme (PFA) or training as usual (TAU). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the PFA skills, knowledge and attitude (SKA-PFA) score at 2 months postintervention. Secondary outcomes included post-traumatic growth, self-efficacy and professional quality of life. RESULTS: The intervention group (n=690) had significantly higher SKA-PFA scores than the control group (n=709) at 2 months postintervention (adjusted mean difference=4.44; 95% CI 1.17 to 7.52; p=0.007; Cohen's d=0.35). The intervention group also had higher scores on post-traumatic growth (p=0.113, d=0.24), self-efficacy (p=0.032, d=0.20) and professional quality of life (p=0.281, d=0.04). CONCLUSIONS: The system based PFA training programme was more effective than the TAU in enhancing the PFA knowledge and skills of the emergency medical first responders and in increasing their competence to provide emergency service for survivors in China. TRIAL REGISTRATION NUMBER: ChiCTR2200060464.

Pyroptotic macrophages induce disruption of glutamate metabolism in periodontal ligament stem cells contributing to their compromised osteogenic potential.

Macrophage pyroptosis is of key importance to host defence against pathogen infections and may participate in the progression and recovery of periodontitis. However, the role of pyroptotic macrophages in regulating periodontal ligament stem cells (PDLSCs), the main cell source for periodontium renewal, remains unclear. First, we found that macrophage pyroptosis were enriched in gingiva tissues from periodontitis patients compared with those of healthy people through immunofluorescence. Then the effects of pyroptotic macrophages on the PDLSC osteogenic differentiation were investigated in a conditioned medium (CM)-based coculture system in vitro. CM derived from pyroptotic macrophages inhibited the osteogenic differentiation-related gene and protein levels, ALP activity and mineralized nodule formation of PDLSCs. The osteogenic inhibition of CM was alleviated when pyroptosis was inhibited by VX765. Further, untargeted metabolomics showed that glutamate limitation may be the underlying mechanism. However, exogenous glutamate supplementation aggravated the CM-inhibited osteogenic differentiation of PDLSCs. Moreover, CM increased extracellular glutamate and decreased intracellular glutamate levels of PDLSCs, and enhanced the gene and protein expression levels of system xc - (a cystine/glutamate antiporter). After adding cystine to CM-based incubation, the compromised osteogenic potency of PDLSCs was rescued. Our data suggest that macrophage pyroptosis is related to the inflammatory lesions of periodontitis. Either pharmacological inhibition of macrophage pyroptosis or nutritional supplements to PDLSCs, can rescue the compromised osteogenic potency caused by pyroptotic macrophages.

Characteristics of Clinical Isolates of Listeria monocytogenes in Sichuan, China, in 2022 Based on Whole Genome Sequencing Analysis.

Listeria monocytogenes is a foodborne pathogen. In 2022, we collected 15 strains of L. monocytogenes isolated from patients in some foodborne disease sentinel monitoring hospitals in Sichuan Province. Through whole genome sequencing (WGS), we obtained the virulence genes carried by the strains, multi-locus sequence typing (MLST), core genome MLST (cgMLST), clonal complex (CC), and serum groups and constructed a phylogenetic tree and minimum spanning tree with nonhuman strains. An analysis shows that all 15 strains of L. monocytogenes carry virulence genes LIPI-1 and LIPI-2, whereas the carrying rates of LIPI-3 and LIPI-4 virulence genes are relatively low. The MLST typing results showed a total of 10 sequence types (ST), including 10 CCs, with ST7 being the dominant type. The cgMLST clearly distinguishes strains of different lineages and CC types. The serum group is divided into three types: IIa, IIb, and IVb, with IIa being the dominant serum group. An analysis of antibiotic genes showed that all 15 strains carried FosX, lin, mprF, and norB with high carrying rates. The minimum inhibitory concentration results indicated that all were susceptible to eight antibiotics (ampicillin, penicillin, tetracycline, meropenem, erythromycin, vancomycin, ciprofloxacin, and trimethoprim-sulfamethoxazole). The analysis of strains isolated from different sources of Listeria revealed varying degrees of diversity, and the contamination of meat and environment within the province is closely related to clinical cases. L. monocytogenes isolated from clinical cases in Sichuan Province carry multiple virulence and antibiotic genes, with high potential pathogenicity. It is necessary to further strengthen the monitoring and control of food and environment by L. monocytogenes within Sichuan Province.

Driver-response relationships in a large shallow lake since the Anthropocene: Short-term abrupt perturbations versus long-term sustainable.

Lakes, as integral social-ecological systems, are hotspots for exploring climatic and anthropogenic impacts, with crucial pathways revealed by continuous sediment records. However, the response of multi-proxies in large shallow lakes to typical abrupt events and sustained drivers since the Anthropocene remains unclear. Here, we explored the driver-identification relationships between multi-proxy peaks and natural and anthropogenic events as well as the attribution of short-term perturbations and long-term pressures. To this end, sediment core records, socio-ecological data, and documented events from official records were integrated into a large shallow lake (Dongting Lake, China). Significant causal cascades and path effects (goodness-of-fit: 0.488; total effect: -1.10; p < .001) were observed among catchment environmental proxies, lake biogenic proxies, and mixed-source proxies. The peak-event identification rate (PEIR) and event-peak driving rate were proposed, and values of 28.57%-46.43% and 50%-81.25% were obtained, respectively. The incomplete accuracy of depicting event perturbations using sediment proxies was caused by various information filters both inside and outside the lake. PEIRs for compound events were 1.41 (±0.72) and 1.09 (±0.46) times greater than those for anthropogenic-dominated and natural-dominated events, respectively. Furthermore, socio-economic activity, hydrologic dynamics, land-use changes, and agriculture exerted significant and persistent pressures, cumulatively contributing 55.3%-80.9% to alterations in sediment proxies. Relatively synergistic or antagonistic trends in temporal contributions of these forces were observed after 2000, which were primarily attributed to the "Grain for Green" project and the Three Gorges Dam. This study represents one of the few investigations to distinguish the driver-response relationship of multiple proxies in large shallow lakes under typical event perturbations and long-term sustained pressures since the Anthropocene. The findings will help policymakers and managers address ecological perturbations triggered by climate change and human activities over long-term periods.

Analysis of the impact of immunotherapy efficacy and safety in patients with gastric cancer and liver metastasis.

BACKGROUND: Gastric cancer (GC) is the fifth most common type of cancer and has the fourth highest death rate among all cancers. There is a lack of studies examining the impact of liver metastases on the effectiveness of immunotherapy in individuals diagnosed with GC. AIM: To investigate the influence of liver metastases on the effectiveness and safety of immunotherapy in patients with advanced GC. METHODS: This retrospective investigation collected clinical data of patients with advanced stomach cancer who had immunotherapy at our hospital from February 2021 to January 2023. The baseline attributes were compared using either the Chi-square test or the Fisher exact probability method. The chi-square test and Kaplan-Meier survival analysis were employed to assess the therapeutic efficacy and survival duration in GC patients with and without liver metastases. RESULTS: The analysis comprised 48 patients diagnosed with advanced GC, who were categorized into two groups: A liver metastasis cohort (n = 20) and a non-liver metastatic cohort (n = 28). Patients with liver metastasis exhibited a more deteriorated physical condition compared to those without liver metastasis. The objective response rates in the cohort with metastasis and the cohort without metastasis were 15.0% and 35.7% (P > 0.05), respectively. Similarly, the disease control rates in these two cohorts were 65.0% and 82.1% (P > 0.05), respectively. The median progression-free survival was 5.0 months in one group and 11.2 months in the other group, with a hazard ratio of 0.40 and a significance level (P) less than 0.05. The median overall survival was 12.0 months in one group and 19.0 months in the other group, with a significance level (P) greater than 0.05. CONCLUSION: Immunotherapy is less effective in GC patients with liver metastases compared to those without liver metastasis.

[Role of NLRP3 inflammasome in prevention and treatment of cognitive impairment-related diseases and traditional Chinese medicine intervention: a review].

Alzheimer's disease(AD), vascular dementia(VD), and traumatic brain injury(TBI) are more common cognitive impairment diseases characterized by high disability and mortality rates, imposing a heavy burden on individuals and their families. Although AD, VD, and TBI have different specific mechanisms, their pathogenesis is closely related to the nucleotide-binding oligome-rization domain-like receptor protein 3(NLRP3). The NLRP3 inflammasome is involved in neuroinflammatory responses, mediating microglial polarization, regulating the reduction of amyloid ß-protein(Aß) deposition, neurofibrillary tangles(NFTs) formation, autophagy regulation, and maintaining brain homeostasis, and synaptic stability, thereby contributing to the development of AD, VD, and TBI. Previous studies have shown that traditional Chinese medicine(TCM) can alleviate neuroinflammation, promote microglial polarization towards the M2 phenotype, reduce Aß deposition and NFTs formation, regulate autophagy, and maintain brain homeostasis by intervening in NLRP3 inflammasome, hence exerting a role in preventing and treating cognitive impairment-related diseases, reducing psychological and economic pressure on patients, and improving their quality of life. Therefore, this article elucidated the role of NLRP3 inflammasome in AD, VS, and TBI, and provided a detailed summary of the latest research results on TCM intervention in NLRP3 inflammasome for the prevention and treatment of these diseases, aiming to inherit the essence of TCM and provide references and foundations for clinical prevention and treatment of cognitive impairment-related diseases with TCM. Meanwhile, this also offers insights and directions for further research in TCM for the prevention and treatment of cognitive impairment-related diseases.

Repeat Surgery after Percutaneous Endoscopic Lumbar Discectomy for Adolescent Lumbar Disc Herniation: A Multicenter Observational Study.

OBJECTIVE: The reported date in the repeat surgical intervention for adolescent lumbar disc herniation (ALDH) after percutaneous endoscopic lumbar discectomy (PELD) was quite scarce. This study aims to introduce cases of repeat surgeries after PELD for ALDH and assess the incidence, chief causes, repeat surgery methods, and surgical outcomes of repeat surgeries after PELD for ALDH. METHODS: A retrospective multicenter observational study was conducted on patients undergoing repeat surgeries after PELD for ALDH at four tertiary referral hospitals from January 2014 through August 2022. The incidence of repeat surgeries, chief causes, strategies for repeat surgeries, and timing of repeat surgeries were recorded and analyzed. The clinical outcomes were evaluated by the Numeric Rating Scales (NRS) scores and the modified MacNab criteria. Statistical analyses were performed with the Wilcoxon signed-rank test. RESULTS: A total of 23 patients who underwent repeat surgeries after PELD for ALDH were included. The chief causes were re-herniation (homo-lateral re-herniation at the same level, new disc herniation of adjacent level). The repeat surgery methods were revision PELD, micro-endoscopic discectomy (MED), open discectomy and instrumented lumbar inter-body fusion. The NRS scores decreased significantly in follow-up evaluations and these scores demonstrated significant improvement at the last follow-up (p < 0.002). For the modified MacNab criteria, at the last follow-up, 18 patients (78.26%) had an excellent outcome, and the overall success rate was 86.95%. CONCLUSION: This study's data suggest that young patients who underwent repeat surgery improved significantly compared to baseline. The chief cause was re-herniation. Revision PELD was the main surgical procedure, which provides satisfactory clinical results in young patients who underwent repeat surgeries.

Toonanoronoids A-E, five new limonoids from Toona ciliata var. yunnanensis.

Five new B-seco-limonoids, namely toonanoronoids A-E (1-5), in conjunction with three previously reported compounds, were isolated from the EtOAc extract of the twigs and leaves of Toona ciliata var. yunnanensis. Their structures were elucidated through comprehensive spectroscopic and X-ray crystallographic analysis. The cytotoxic activities of new compounds against five human tumor cell lines (HL-60, SMMC-7721, A549, MCF-7, and SW480) were screened, Compounds 4 and 5 exerted inhibition toward two tumor cell lines (HL-60, SW-480) with IC50 values between 1.7 and 5.9 µM.

Cost-Effective Cathode Interlayer Material for Scalable Organic Photovoltaic Cells.

Organic photovoltaic (OPV) cells have demonstrated remarkable success on the laboratory scale. However, the lack of cathode interlayer materials for large-scale production still limits their practical application. Here, we rationally designed and synthesized a cathode interlayer, named NDI-Ph. Benefiting from their well-modulated work function and self-doping effect, NDI-Ph-based binary OPV cells achieve an excellent power conversion efficiency (PCE) of 19.1%. NDI-Ph can be easily synthesized on a 100 g scale with a low cost of 1.96 $ g-1 using low-cost raw materials and a simple postprocessing method. In addition, the insensitivity to the film thickness of NDI-Ph enables it to maintain a high PCE at various coating speeds and solution concentrations, demonstrating excellent adaptability for high-throughput OPV cell manufacturing. As a result, a module with 21.9 cm2 active area achieves a remarkable PCEactive of 15.8%, underscoring the prospects of NDI-Ph in the large-scale production of OPV cells.

Effects of train vibration load on the structure and hydraulic properties of soils.

Investigating the impact of train-induced vibration loads on soil hydraulic properties, this study conducted experiments using a self-designed indoor soil seepage platform that incorporates vibration loads. The experiments were complemented with scanning electron microscopy to analyze the influence of train-induced vibration loads on soil hydraulic conductivity and its evolutionary characteristics under different vibration frequencies. The experimental results indicated that as the vibration frequency increases from no vibration (0 Hz) to 20 Hz, the time required for the soil volumetric moisture content to reach its peak and stabilize decreases rapidly. However, after the vibration frequency exceeds 20 Hz, the rate at which the time required for the volumetric moisture content to reach its peak and stabilize decreases slows down. Furthermore, the soil pore water pressure increases with the increase in vibration frequency. At a vibration frequency of 80 Hz, the peak value of pore water pressure increases by 105% compared to the non-vibration state, suggesting that higher vibration frequencies promote the development and acceleration of soil pore moisture migration. Additionally, as the vibration frequency increases, the soil hydraulic conductivity initially experiences a rapid increase, with a growth rate ranging from 40.1 to 47.4%. However, after the frequency exceeds 20 Hz, this growth rate significantly decreases, settling to only 18.6% to 7.8%. When the soil was subjected to a vibration load, the scanning electron microscopy test revealed alterations in its pore structure. Micropores and small pores transformed into macropores and mesopores. Additionally, the microstructural parameters indicated that vibration load decreased the complexity of soil pores, thereby speeding up the hydraulic conduction process. This, in turn, affected the hydraulic properties of the soil and established a relationship between pore structure complexity and soil hydraulic properties.

Molecular Design of Fully Nonfused Acceptors for Efficient Organic Photovoltaic Cells.

The nonfused thiophene-benzene-thiophene (TBT) unit offers advantages in obtaining low-cost organic photovoltaic (OPV) materials due to its simple structure. However, OPV cells, including TBT-based acceptors, exhibit significantly lower energy conversion efficiencies. Here, we introduce a novel approach involving the design and synthesis of three TBT-based acceptors by substituting different position-branched side chains on the TBT unit. In comparison to TBT-10 and TBT-11, TBT-13, which exclusively incorporates α-position branched side chains with a large steric hindrance, demonstrates a more planar and stable conformation. When blended with the donor PBQx-TF, TBT-13-based blend film achieves favorable π-π stacking and aggregation characteristics, resulting in excellent charge transfer performance in the corresponding device. Due to the simultaneous enhancements in short-circuit current density and fill factor, the TBT-13-based OPV cell obtains an outstanding efficiency of 16.1%, marking the highest value for the cells based on fully nonfused acceptors. Our work provides a practical molecular design strategy for high-performance and low-cost OPV materials.

Coupled effects of human activities and river-Lake interactions evolution alter sources and fate of sedimentary organic carbon in a typical river-Lake system.

Interconnected river-lake systems record sedimentary organic carbon (OCsed) dynamics and watershed environmental changes, providing valuable information for global carbon budgets and watershed management. However, owing to the evolving river-lake interactions under global change, monitoring OCsed is difficult, thereby impeding the understanding of OCsed transport and fate. This study provided new insights into the dynamical mechanisms of OCsed in a typical river-lake system consisting of Dongting Lake and its seven inlet/outlet rivers (the three inlets of the Yangtze River and four tributaries) over the last century using stable isotope tracing and quantified the influences of climate change and human activities on OCsed. Results indicated that exogenous OC dominated the OCsed in the lake (58.2 %-89.0 %) and was lower in the west than in the east due to the differences in the material inputs and depositional conditions within the lake. Temporally, the distribution patterns of OCsed sources mainly responded to human activities in the basin rather than to climate change. Before 2005, the Yangtze River contributed the most OCsed (53.5 %-74.6 %), attributed to the high-intensity land use changes (path coefficient (r∂): 0.48, p-value < 0.01) and agriculture-industry activities (r∂: 0.44, p-value < 0.001) in the Yangtze River basin that increased soil erosion. After 2005, a large amount of Yangtze River OC was intercepted by the Three Gorges Dam, altering the OC exchange in the river-lake system and shifting OCsed dominance to the four tributaries (52.2 %-63.8 %). These findings highlight the active response of OCsed to the river-lake interaction evolution and anthropogenic control, providing critical information for regulating watershed management behavior under global change.