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Background: Pediatric cancer ranks among the leading causes of mortality in children globally. While serving as primary caregivers, certain parents may experience anxiety, depression, and other related challenges. However, not all parents succumb to such psychological distress. Resilience emerges as a potential protective factor. Assessing parental resilience holds paramount importance for healthcare professionals in identifying issues and offering tailored interventions. Yet, mainland China lacks adequate tools for this assessment. Hence, this study endeavors to translate the Resilience Scale for Parents of Children with Cancer (RSP-CC) into Chinese and scrutinize its psychometric properties. Methods: From April 2023 to January 2024, a methodological study was conducted in Chengdu, Chongqing, and Jinzhou, China, recruiting 377 eligible parents via convenience sampling for a multicenter cross-sectional survey. The translation process of the RSP-CC adhered rigorously to the Brislin model, involving forward and back-translation, followed by necessary modifications. Item analysis was assessed using the critical ratio and the item-total correlation coefficient. Validity evaluation encompassed content and internal validity assessments. Scale reliability was determined through Cronbach's α coefficient, retest reliability, and split-half reliability coefficients. Results: The Chinese version of the RSP-CC comprises 4 dimensions and 24 items, explaining a cumulative variance contribution of 63.58%. In this investigation, the content validity index attained a score of 0.97. Exploratory factor analysis (EFA) yielded four factors consistent with the original scale, while confirmatory factor analysis (CFA) indicated satisfactory fit indices. Both Cronbach's α coefficient and retest reliability stood at 0.95, with a split-half reliability coefficient of 0.82. Conclusion: After rigorous translation and verification, the RSP-CC was adapted in China, demonstrating favorable psychometric characteristics. It stands as an effective instrument for parents of children diagnosed with cancer in China. Additionally, this scale could serve as a crucial tool for clinical staff in formulating specific interventions.
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This study presents a bidirectional flow tidal bioreactor designed to enhance H2-driven CO2 biomethanation. The bioreactor alternated biofilms between immersion in nutrient solution and exposure to H2/CO2, creating alternating dry and wet states. This tidal operation minimized liquid film thickness during dry periods and ensured uniform nutrient distribution during wet periods. Bidirectional H2/CO2 supply was used to reduce biofilm thickness heterogeneity across the reactor height. CO2 biomethanation remained stable with an empty bed residence time of 9.7 min, achieving a methane (CH4) formation rate of 26.8 Nm3 CH4/(m3·d). The product gas contained 95.0 ± 2.5 % CH4, with a H2/CO2 conversion efficiency of 90.8 %. Tidal operation mitigated the buildup of dissolved and suspended organics, such as organic acids and detached biofilms. Dominant bacteria in biofilms included fermentative species like Petrimonas and H2-utilizing homoacetogens like Sporomusa. Enriched hydrogenotrophic methanogens, particularly Methanobacterium, were observed. Overall, this study highlights the bioreactor's effectiveness in improving CO2 biomethanation.
Subject(s)
Biofilms , Bioreactors , Carbon Dioxide , Hydrogen , Methane , Carbon Dioxide/metabolism , Methane/metabolism , Hydrogen/metabolism , Bacteria/metabolismABSTRACT
There are several prospective applications for omnidirectional ultraviolet (UV) detectors and underwater detection detectors in optical systems and optical fields. In this work, ZnO nanorods arrays were grown on carbon fibers (CFs). An appropriate amount of Ag nanoparticles (NPs) was deposited on the surface of ZnO nanorods by photochemical deposition. This improved the performance of photoelectrochemical (PEC) based UV detectors. Under 365 nm and 10 mW cm-2UV irradiation, the photocurrent density of the 30s-Ag/ZnO@CFs based PEC UV detector can reach 1.28 mA cm-2, which is about 7 times that of the ZnO@CFs based PEC UV detector, and the rising time is shortened from 0.17 to 0.10 s. The reason is that increased absorption of ultraviolet light induced by the localized surface plasmon resonance. In addition, the detector exhibits a good flexibility and remains flexible after hundreds of bends and twists. Moreover, the detector is responsive in the range of rotation angle from 0° to 360°. It provides an insight to improve the photoelectric performance and underwater omnidirectional detection ability of the PEC UV detector.
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Diabetic kidney disease (DKD) is a common complication of diabetes mellitus that contributes to the risk of end-stage kidney disease (ESKD). Wide glycemic var-iations, such as hypoglycemia and hyperglycemia, are broadly found in diabetic patients with DKD and especially ESKD, as a result of impaired renal metabolism. It is essential to monitor glycemia for effective management of DKD. Hemoglobin A1c (HbA1c) has long been considered as the gold standard for monitoring glycemia for > 3 months. However, assessment of HbA1c has some bias as it is susceptible to factors such as anemia and liver or kidney dysfunction. Continuous glucose monitoring (CGM) has provided new insights on glycemic assessment and management. CGM directly measures glucose level in interstitial fluid, reports real-time or retrospective glucose concentration, and provides multiple glycemic metrics. It avoids the pitfalls of HbA1c in some contexts, and may serve as a precise alternative to estimation of mean glucose and glycemic variability. Emerging studies have demonstrated the merits of CGM for precise monitoring, which allows fine-tuning of glycemic management in diabetic patients. Therefore, CGM technology has the potential for better glycemic monitoring in DKD patients. More research is needed to explore its application and management in different stages of DKD, including hemodialysis, peritoneal dialysis and kidney transplantation.
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OBJECTIVES: To evaluate the assessment scores of a novel digital training program versus traditional training in dental preclinical crown preparation. METHODS: Crown preparations in two consecutive preclinical training sessions were retrospectively collected and assigned to three groups: traditional group (TG), scanning group (SG), and digital evaluation group (DG). Students in the TG (n = 20) were taught by conventional visual grading, while students in the SG (n = 25) received three-dimensional feedback from digitally scanned preparations. All the SG students continued with supplementary digital evaluation and preparations were allocated into the DG (n = 25). Comparison of total scores between groups was investigated using independent samples t-test and paired samples t-test. MannâWhitney U-test and Wilcoxon signed-rank test were used to statistically analyze the differences in subdividing categories. The level of significance was p < 0.05. Questionnaires on the digital evaluation procedure were answered by students in DG. RESULTS: The results showed a significant improvement (p < 0.01) in the total scores of DG than those of TG and SG, while there were no statistically significant differences between TG and SG. Scores of surface finish and undercut improved significantly in DG compared to TG and SG. The reduction scores of DG were significantly higher than those of SG. Students' feedback indicated a positive perspective on the implementation of the novel digital evaluation technology. CONCLUSIONS: These findings suggest that digital evaluation technology is useful for preclinical crown preparation training. Attention should also be paid to studying the optimal integration of digital dentistry into traditional dental curricula and its effects on students' learning curves.
Subject(s)
Crowns , Education, Dental , Tooth Preparation, Prosthodontic , Education, Dental/methods , Humans , Tooth Preparation, Prosthodontic/methods , Retrospective Studies , Educational Measurement/methodsABSTRACT
Cholangiocarcinoma (CCA) is a malignancy with an extremely poor prognosis, and much remains unknown about its pathogenesis and treatment modalities. Circular RNA (circRNA) has been proven to play regulatory roles in various tumorigenesis, yet its potential function and mechanism in cholangiocarcinoma require further investigation. This study is the first to identify the aberrant expression and functional role of a novel circRNA, circ_0007534, derived from the DDX42 gene, in cholangiocarcinoma. Compared to the normal control group, the expression of circ_0007534 was significantly elevated in the tissues and cells with CCA and that high expression correlated with lymph node invasion and poor prognosis. Functional experiments indicated that downregulating circ_0007534 markedly inhibited the proliferation, migration, invasion, stemness, and anti-anoikis ability of CCA cells, as well as the tumor growth and liver and lung metastasis in nude mice. Mechanistic studies revealed that DDX42, as the parent gene of circ_0007534, can mutually regulate each other's expression. Predominantly located in the cytoplasm, circ_0007534 can form a complex with the RNA-binding protein DDX3X, which enhances the stability of DDX42 mRNA, thereby upregulating the expression of DDX42. This creates a positive feedback loop among the three, collectively promoting the progression of cholangiocarcinoma. In conclusion, this study sheds light on the pivotal role and molecular mechanism of circ_0007534 in the development of CCA, offering potential new targets for early diagnosis and treatment.
Subject(s)
Bile Duct Neoplasms , Cholangiocarcinoma , MicroRNAs , Animals , Mice , MicroRNAs/genetics , MicroRNAs/metabolism , RNA, Circular/genetics , RNA, Circular/metabolism , Anoikis , Mice, Nude , Feedback , Cell Line, Tumor , Cholangiocarcinoma/genetics , Cholangiocarcinoma/metabolism , Bile Ducts, Intrahepatic/metabolism , Bile Duct Neoplasms/genetics , Bile Duct Neoplasms/metabolism , Cell Proliferation/genetics , Gene Expression Regulation, Neoplastic , Cell Movement/geneticsABSTRACT
Objectives: Cyberchondria is increasingly recognized as the dark side of digital health, given the pervasive use of the internet as a main source of health information in people's daily lives. While previous studies have identified many factors contributing to cyberchondria, there is a dearth of research on the impact of health-related advertisements. Therefore, this study adopts the stressor-strain-outcome (SSO) model to investigate how health-related advertising interference is directly and indirectly related to cyberchondria. Methods: To empirically validate the proposed research model, we conducted an online survey with 437 internet users with medical information seeking experience in China. Structural equation modeling (SEM) was employed to analyze the survey data. Results: Our findings revealed a positive, direct association between health-related advertising interference and cyberchondria. Meanwhile, advertising interference was positively related to both information overload and information irrelevance, with the former further predicting cyberchondria. Moreover, doctor-patient communication weakened the positive effect of information overload on cyberchondria. Conclusions: The study not only theoretically contributes to the literature by theorizing the relationship between health-related advertising interference and cyberchondria but also practically underlines the pivotal role of effective doctor-patient communication in reducing the development of cyberchondria.
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Background: Tinnitus is strongly associated with an increased risk of cognitive disabilities. The findings of this research will provide valuable support for future investigations aimed at determining the correlation between tinnitus and the risk of cognitive impairments. Objectives: We investigated the potential correlation between tinnitus and the risk of various cognitive impairments, such as dementia, compromised learning attention, anxiety, depression, and insomnia. The study examined this relationship collectively and by categorizing the data based on different age groups. Methods: We compiled data from case-control studies and cohort studies obtained from reputable databases such as PubMed, Cochrane Library, and Embase. To minimize potential bias, two reviewers independently assessed the selected articles. After extracting the data, we calculated the pooled odds ratios (ORs) using a random-effects model. Results: Seventeen relevant studies, comprising an adult population, were included in this analysis. Pooled estimated outcomes revealed a strong association between tinnitus and an elevated risk of dementia-compromised learning, auditory attention, anxiety, depression, and poor sleep quality (P<0.05). Furthermore, the pooled analysis stratified by age demonstrated that patients aged above 60 years, in comparison to those aged 18 to 60 years, exhibited more significant outcomes in relation to the progression of cognitive impairments. Conclusion: Tinnitus has the potential to increase the risk of cognitive impairments. Moreover, geriatric patients aged above 60 shows a higher susceptibility to developing cognitive disabilities compared to their younger counterparts.
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This study thoroughly investigated the role of the long non-coding RNA LOXL1-AS1 in the pathogenesis of cholangiocarcinoma (CCA). Through bioinformatics analysis and tissue samples validation, the study found that LOXL1-AS1 was significantly elevated in CCA, with its high expression closely tied to clinical pathological features and prognosis. In vitro and in vivo experiments revealed that LOXL1-AS1 was crucial in regulating CCA cell apoptosis, proliferation, migration, and invasion. Further investigations using FISH, subcellular localization experiments, RNA pull down, and RIP uncovered that LOXL1-AS1 primarily resided in the cytoplasm and influenced CCA progression by modulating the JAK2/STAT3 signaling pathway. Notably, LOXL1-AS1 might regulate the activity of JAK2 through modulating its ubiquitination and degradation. YY1 had also been found to act as an upstream transcription factor of LOXL1-AS1 to impact CCA cell malignancy. These findings shed light on the pivotal role of LOXL1-AS1 in CCA and offered potential directions for novel therapeutic strategies, providing a fresh perspective on tumor pathogenesis.
Subject(s)
Bile Duct Neoplasms , Cholangiocarcinoma , MicroRNAs , RNA, Long Noncoding , STAT3 Transcription Factor , Humans , Bile Duct Neoplasms/genetics , Bile Duct Neoplasms/metabolism , Bile Ducts, Intrahepatic/metabolism , Cell Line, Tumor , Cell Movement/genetics , Cell Proliferation/genetics , Cholangiocarcinoma/genetics , Cholangiocarcinoma/metabolism , Gene Expression Regulation, Neoplastic , Janus Kinase 2/genetics , Janus Kinase 2/metabolism , MicroRNAs/genetics , RNA, Long Noncoding/genetics , RNA, Long Noncoding/metabolism , Signal TransductionABSTRACT
Long-term high blood glucose levels brings extremely detrimental effect on diabetic patients, such as blindness, renal failure, and cardiovascular diseases. Therefore, there is an urgent need to develop highly flexible and sensitive sensors for precisely non-invasive and continuous monitoring glucose levels. Herein, we present a highly flexible and sensitive wearable sensor for non-enzymatic electrochemical glucose analysis with vertically aligned mushroom-like gold nanowires (v-AuNWs) chemically grown on stainless steel wire sieve (SSWS) as integrated electrode. Owing to the unique nanostructures and excellent catalysis of the v-AuNWs, the as-fabricated glucose sensors exhibit superior flexibility and excellent electro-catalytic capability. In detail, these sensors display rapid response towards glucose within 5 s, and the sensor constructed with v-AuNWs for growth time of 15 min shows the highest sensitivity of 180.1 µA mM-1 cm-2 within a wide linear range of 6.5 × 10-4 mM-12.0 mM and the lowest detection limit of 0.65 µM (S/N = 3). It is noteworthy that due to the good ductility of the v-AuNWs and their strong contact with the SSWS substrate, these glucose sensors exhibit no obvious response variation after repeated bending for 100 times at bending angle of 180°. Additionally, the glucose sensors display superior anti-interfering capability as well as desirable repeatability. More importantly, these glucose sensors can be attached on human skin to determine sweat glucose reliably and analyze glucose concentration in human serum in vitro.
Subject(s)
Biosensing Techniques , Nanowires , Wearable Electronic Devices , Humans , Nanowires/chemistry , Gold/chemistry , Stainless Steel , Glucose/analysisABSTRACT
OBJECTIVES: Evidence of the optimal antiplatelet therapy for elderly patients who had a stroke is limited, especially those elder than 80 years. This study aimed to explore the efficacy and safety of dual antiplatelet therapy (DAPT) in old-old patients compared with younger patients in the ticagrelor or Clopidogrel with aspirin in High-risk patients with Acute Non-disabling Cerebrovascular Events-II (CHANCE-2) trial. METHODS: CHANCE-2 was a randomised, double-blind, placebo-controlled trial in China involving patients with high-risk transient ischaemic attack or minor stroke with CYP2C19 loss-of-function alleles. In our substudy, all enrolled patients were stratified by age: old-old (≥80 years), young-old (65-80 years) and younger (<65 years). The primary outcomes were stroke recurrence and moderate to severe bleeding within 90 days, respectively. RESULTS: Of all the 6412 patients, 406 (6.3%) were old-old, 2755 (43.0%) were young-old and 3251 (50.7%) were younger. Old-old patients were associated with higher composite vascular events (HR 1.41, 95% CI 1.00 to 1.98, p=0.048), disabling stroke (OR 2.43, 95% CI 1.52 to 3.88, p=0.0002), severe or moderate bleeding (HR 8.40, 95% CI 1.95 to 36.21, p=0.004) and mortality (HR 7.56, 95% CI 2.23 to 25.70, p=0.001) within 90 days. Ticagrelor-aspirin group was associated with lower risks of stroke recurrence within 90 days in younger patients (HR 0.68, 95% CI 0.51 to 0.91, p=0.008), which was no differences in old-old patients. CONCLUSION: Elderly patients aged over 80 in CHANCE-2 trial had higher risks of composite vascular events, disabling stroke, severe or moderate bleeding and mortality within 90 days. Genotype-guided DAPT might not be as effective in old-old patients as in younger ones. TRIAL REGISTRATION NUMBER: NCT04078737.
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BACKGROUND: Given the swift advancements in artificial intelligence (AI), the utilisation of AI-based clinical decision support systems (AI-CDSSs) has become increasingly prevalent in the medical domain, particularly in the management of cerebrovascular disease. AIMS: To describe the design, rationale and methods of a cluster-randomised multifaceted intervention trial aimed at investigating the effect of cerebrovascular disease AI-CDSS on the clinical outcomes of patients who had a stroke and on stroke care quality. DESIGN: The GOLDEN BRIDGE II trial is a multicentre, open-label, cluster-randomised multifaceted intervention study. A total of 80 hospitals in China were randomly assigned to the AI-CDSS intervention group or the control group. For eligible participants with acute ischaemic stroke in the AI-CDSS intervention group, cerebrovascular disease AI-CDSS will provide AI-assisted imaging analysis, auxiliary stroke aetiology and pathogenesis analysis, and guideline-based treatment recommendations. In the control group, patients will receive the usual care. The primary outcome is the occurrence of new vascular events (composite of ischaemic stroke, haemorrhagic stroke, myocardial infarction or vascular death) at 3 months after stroke onset. The sample size was estimated to be 21 689 with a 26% relative reduction in the incidence of new composite vascular events at 3 months by using multiple quality-improving interventions provided by AI-CDSS. All analyses will be performed according to the intention-to-treat principle and accounted for clustering using generalised estimating equations. CONCLUSIONS: Once the effectiveness is verified, the cerebrovascular disease AI-CDSS could improve stroke care and outcomes in China. TRIAL REGISTRATION NUMBER: NCT04524624.
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Promoting angiogenesis is an effective therapeutic strategy to repair damaged hearts after myocardial infarction (MI). Copper ions and mild heat (41-42 °C) have been shown to promote angiogenesis, but their efficacy in MI is unknown. Here, a multicomponent hydrogel (EDR@PHCuS HG) is developed by encapsulating edaravone (EDR, a free radical scavenger) loaded porous hollow copper sulfide nanoparticles (PHCuS NPs) in a hyaluronic acid hydrogel (HG). Exposed to 808 nm near-infrared (NIR) light irradiation, the EDR@PHCuS HG exhibits controlled copper-ion release and mild photothermal effect to synergistically promote angiogenesis. In addition, released EDR inhibits cardiomyocyte apoptosis to further repair hearts. In the mouse model of MI, treatment with the EDR@PHCuS HG under an 808 nm laser significantly recovers the cardiac function and inhibits ventricular remodeling. This platform elucidates the cardioprotective effects of copper ions and mild heat and will provide a highly efficient treatment for MI.
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Background This study aimed to investigate the efficacy and safety of ticagrelor-aspirin versus clopidogrel-aspirin in Chinese patients by the presence and clinical presentation of intracranial artery stenosis (ICAS) using randomized trial data from the CHANCE-2 (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events-II) trial. Methods and Results A total of 6412 patients with minor stroke or transient ischemic attack who carried CYP2C19 loss-of-function alleles were randomized to either the ticagrelor-aspirin or clopidogrel-aspirin group. Patients without imaging of the intracranial artery were excluded from the nonprespecified subgroup analysis of CHANCE-2. All patients included were classified into the following groups: without ICAS, symptomatic ICAS, or asymptomatic ICAS. The primary efficacy outcome was new strokes within 90 days. There were 5893 patients (median age, 64.8 years; 33.9% women) included, and 172 (4.9%), 171 (10.5%), and 57 (7.7%) cases of new strokes occurred within 90 days in the without ICAS, with symptomatic ICAS, and with asymptomatic ICAS groups, respectively. Ticagrelor-aspirin was associated with reduced risk of new stroke in patients without ICAS (62 [3.5%] versus 110 [6.3%]; hazard ratio [HR], 0.57 [95% CI, 0.41-0.78]) but not in those with symptomatic ICAS (HR, 0.77 [95% CI, 0.56-1.05]) or in those with asymptomatic ICAS (HR, 0.77 [95% CI, 0.43-1.38]) compared with clopidogrel-aspirin (P for interaction=0.14). There were no significant differences in the proportion of severe or moderate bleeding events among different ICAS groups. Conclusions Patients without ICAS received a significantly greater benefit from ticagrelor-aspirin than clopidogrel-aspirin after minor ischemic stroke or transient ischemic attack, and there was no statistically significant difference between treatments in patients with symptomatic ICAS or asymptomatic ICAS. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT04078737.
Subject(s)
Ischemic Attack, Transient , Stroke , Humans , Female , Middle Aged , Male , Ischemic Attack, Transient/drug therapy , Clopidogrel/therapeutic use , Ticagrelor/therapeutic use , Platelet Aggregation Inhibitors/therapeutic use , Constriction, Pathologic , Treatment Outcome , Stroke/drug therapy , Aspirin/therapeutic use , Arteries , Drug Therapy, CombinationABSTRACT
Despite the distortion of speech signals caused by unavoidable noise in daily life, our ability to comprehend speech in noisy environments is relatively stable. However, the neural mechanisms underlying reliable speech-in-noise comprehension remain to be elucidated. The present study investigated the neural tracking of acoustic and semantic speech information during noisy naturalistic speech comprehension. Participants listened to narrative audio recordings mixed with spectrally matched stationary noise at three signal-to-ratio (SNR) levels (no noise, 3 dB, -3 dB), and 60-channel electroencephalography (EEG) signals were recorded. A temporal response function (TRF) method was employed to derive event-related-like responses to the continuous speech stream at both the acoustic and the semantic levels. Whereas the amplitude envelope of the naturalistic speech was taken as the acoustic feature, word entropy and word surprisal were extracted via the natural language processing method as two semantic features. Theta-band frontocentral TRF responses to the acoustic feature were observed at around 400 ms following speech fluctuation onset over all three SNR levels, and the response latencies were more delayed with increasing noise. Delta-band frontal TRF responses to the semantic feature of word entropy were observed at around 200 to 600 ms leading to speech fluctuation onset over all three SNR levels. The response latencies became more leading with increasing noise and decreasing speech comprehension and intelligibility. While the following responses to speech acoustics were consistent with previous studies, our study revealed the robustness of leading responses to speech semantics, which suggests a possible predictive mechanism at the semantic level for maintaining reliable speech comprehension in noisy environments.
Subject(s)
Comprehension , Speech Perception , Humans , Comprehension/physiology , Semantics , Speech/physiology , Speech Perception/physiology , Electroencephalography , Acoustics , Acoustic StimulationABSTRACT
Porous ionic liquids (PILs) offer a distinctive combination of liquid-like fluidity and solid porosity, making them well-suited for various applications including separation, catalysis, and energy storage. Nevertheless, the design limitations and complex synthesis processes have hindered the development of PILs. Here, the one-step coupling neutralization reaction (OCNR) method has been first proposed for the controllable synthesis of functionalized protic porous ionic liquids (PPILs). Specifically, three types of PPILs have been synthesized based on tuning the position of the corona amino functional groups. The results indicate the crucial role of protic ion pairs in the formation of pure liquid PPILs with low viscosity. The extraction efficiency has obviously increased after introducing the porous materials from 38.5% to 51.9%. The results showed PPILs play good extraction-adsorption coupled desulfurization (EADS) performance. The density functional theory (DFT) results show that both the protic ion pairs and the porous structure have significant roles in EADS, with the former offering CH···π interactions, while the latter provides hydrogen bonding (CH···O) interactions. Ultimately, the strategy simplifies the synthesis process, providing a new idea for the directional design of low-viscosity PILs with specific functions.
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Structural variations (SVs) are a major contributor to genetic diversity and phenotypic variations, but their prevalence and functions in domestic animals are largely unexplored. Here we generated high-quality genome assemblies for 15 individuals from genetically diverse sheep breeds using Pacific Biosciences (PacBio) high-fidelity sequencing, discovering 130.3 Mb nonreference sequences, from which 588 genes were annotated. A total of 149,158 biallelic insertions/deletions, 6531 divergent alleles, and 14,707 multiallelic variations with precise breakpoints were discovered. The SV spectrum is characterized by an excess of derived insertions compared to deletions (94,422 vs. 33,571), suggesting recent active LINE expansions in sheep. Nearly half of the SVs display low to moderate linkage disequilibrium with surrounding single-nucleotide polymorphisms (SNPs) and most SVs cannot be tagged by SNP probes from the widely used ovine 50K SNP chip. We identified 865 population-stratified SVs including 122 SVs possibly derived in the domestication process among 690 individuals from sheep breeds worldwide. A novel 168-bp insertion in the 5' untranslated region (5' UTR) of HOXB13 is found at high frequency in long-tailed sheep. Further genome-wide association study and gene expression analyses suggest that this mutation is causative for the long-tail trait. In summary, we have developed a panel of high-quality de novo assemblies and present a catalog of structural variations in sheep. Our data capture abundant candidate functional variations that were previously unexplored and provide a fundamental resource for understanding trait biology in sheep.
Subject(s)
Genome-Wide Association Study , Tail , Animals , Sheep/genetics , 5' Untranslated Regions , Alleles , PhenotypeABSTRACT
Importance: Reperfusion therapy is the most effective treatment for acute ischemic stroke but remains underused in China. Objective: To evaluate the effect of a problem-oriented, culturally adapted, targeted quality improvement intervention on reperfusion therapy for patients with acute ischemic stroke in China. Design, Setting, and Participants: In this stepped-wedge cluster randomized clinical trial, patients from 16 secondary and 33 tertiary hospitals in China with acute ischemic stroke within 6 hours of symptom onset were consecutively recruited between July 1, 2018, and June 30, 2020. Interventions: Hospitals were randomly assigned to 1 of 3 sequences to receive the targeted quality improvement intervention (n = 5689), in which workflow reconstruction was promoted to reduce in-hospital reperfusion treatment delays, or usual care (n = 6443), in which conventional stroke care was left to the discretion of the stroke team. Main Outcomes and Measures: The primary outcome was the reperfusion therapy rate, a composite outcome of intravenous recombinant tissue plasminogen activator (IV rtPA) or endovascular thrombectomy (EVT) for eligible patients who arrived within 3.5 or 4.5 hours of symptom onset. Secondary outcomes were the IV rtPA administration rate among eligible patients who arrived within 3.5 hours of symptom onset, the EVT rate among eligible participants who arrived within 4.5 hours of symptom onset, the proportion of patients with door-to-needle time within 60 minutes, the proportion of patients with door-to-puncture time within 90 minutes, in-hospital mortality, and 3-month disability as measured by a modified Rankin Scale score greater than 2. Results: All 12â¯132 eligible patients (mean [SD] age, 66 [12.1] years; 7759 male [64.0%]) completed the trial. The reperfusion rate was 53.5% (3046 of 5689) for the eligible patients in the intervention period and 43.9% (2830 of 6443) in the control period. No significant improvement in primary outcomes was found for the intervention after adjusting for cluster, period, and imbalanced baseline covariates (adjusted risk difference [ARD], 5.5%; 95% CI, -8.0% to 19.0%; adjusted odds ratio [AOR], 1.26; 95% CI, 0.72-2.21) or for the secondary outcomes. However, significant improvements were found in secondary hospitals for reperfusion therapy (1081 of 1870 patients [57.8%] vs 945 of 2022 patients [42.9%]; ARD, 19.0%; 95% CI, 6.4%-31.6%; AOR, 2.24; 95% CI, 1.29-3.88), IV rtPA administration (1062 of 1826 patients [58.2%] vs 916 of 2170 patients [42.2%]; ARD, 20.3%; 95% CI, 7.4%-33.1%; AOR, 2.37; 95% CI, 1.34-4.19), and EVT (51 of 231 patients [22.1%] vs 37 of 259 patients [14.3%]; ARD, 13.6%; 95% CI, 1.0%-26.3%; AOR, 3.03; 95% CI, 1.11-8.25) in subgroup analyses. Conclusions and Relevance: In this stepped-wedge cluster randomized clinical trial of patients with acute ischemic stroke in China, the use of a targeted quality improvement intervention compared with usual care did not improve the reperfusion therapy rate. However, the intervention may be effective in secondary hospitals. Trial Registration: ClinicalTrials.gov Identifier: NCT03578107.
Subject(s)
Ischemic Stroke , Stroke , Humans , Male , Aged , Ischemic Stroke/therapy , Tissue Plasminogen Activator/therapeutic use , Quality Improvement , ReperfusionABSTRACT
Electrocatalytic CO2 reduction reaction (eCO2RR) into value-added chemicals is highly desirable to mitigate the global warming effect and energy crisis. Metal aerogels, as featured by a self-supporting structure, large specific surface area, outstanding conductivity, and a hierarchical porous structure, are ideal electrocatalysts in eCO2RR. Herein, we report a simple and general strategy for constructing a series of Au-based alloy aerogels which contain Au with another metal including Ga, Ni, Mo, Zn, and Cr, respectively. For the first time, the electrocatalytic activities of AuGa aerogels, AuNi aerogels, and AuMo aerogels for CO2RR were studied in detail. The resultant Au81Ga19 aerogel achieves a 95.2% Faradaic efficiency (FE) at -1.16 V versus reversible hydrogen (vs RHE) in H-cells. Impressively, a total 99.4% FE for C1 products (CO + HCOOH) with a current density of 100 mA cm-2 at -0.6 V vs RHE and a large current density of 228 mA cm-2 can be achieved at -0.9 V with a 72.3% FE for the C1 product in a flow cell. Electrochemical characterization and theoretical calculations further revealed that the outstanding performance of the Au-based aerogels was derived from the large specific surface area, abundant grain boundaries, low interfacial charge transfer resistance, and synergetic effect. Overall, this study provides a promising alternative to engineer alloy aerogel electrocatalysts for highly efficient CO2 electroreduction.
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The development of aqueous zinc-ion batteries (AZIBs) still faces a huge challenge due to poor cycling stability and slow kinetics of the cathode material. In this work, we report an advanced cathode of Ti4+/Zr4+ as dual-supporting sites in Na3V2(PO4)3 with an expanded crystal structure, exceptional conductivity, and superior structural stability for AZIBs, which exhibits fast Zn2+ diffusion and excellent performance. The results of AZIBs afford remarkably high cycling stability (91.2% retention rate over 4000 cycles) and exceptional energy density (191.3 W h kg-1), outperforming most Na+ superionic conductor (NASICON)-type cathodes. Furthermore, different in/ex situ characterization techniques and theoretical studies reveal the reversible storage mechanism of Zn2+ in an optimal Na2.9V1.9Ti0.05Zr0.05(PO4)3 (NVTZP) cathode and demonstrate that Na+ defects together with Ti4+/Zr4+ sites can intrinsically contribute to the high electrical conductivity and low Na+/Zn2+ diffusion energy barrier of NVTZP. Moreover, the flexible soft-packaged batteries further demonstrate a superior capacity retention rate of 83.2% after 2000 cycles from the perspective of practicality.