Effectiveness of Initial Corticosteroid Treatment in Kawasaki Disease Children Suspected to be IVIG Resistant.

This retrospective study assessed the efficacy of initial treatment with intravenous immunoglobulin (IVIG), aspirin, and corticosteroids in Kawasaki disease (KD) patients at risk for IVIG resistance. Data from pediatric patients with KD between January 2010 and December 2019 were divided into the IVIG-sensitive and IVIG-resistant groups based on treatment response. Risk factors for IVIG resistance were identified through univariate analysis. Outcomes included comparison of fever resolution time, hospital stay, and coronary artery lesion (CALs) incidence at multiple intervals post-treatment. An observational group (January 2020 to December 2022) was given additional methylprednisolone if they exhibited three or more IVIG resistance risk factors. The IVIG-resistant group had a higher proportion of males and significantly elevated inflammatory markers (CRP, ESR, PCT) and TBIL, NT-proBNP compared to the IVIG-sensitive group (all p < 0.05), while showing lower levels of albumin, ARR (AST/ALT ratio), and serum sodium (all p < 0.05). Both the IVIG-sensitive and observational groups had significantly shorter fever resolution times and hospital stays than the IVIG-resistant group (all p < 0.05). CALs incidence was consistently higher in the IVIG-resistant group across all follow-up periods (all p < 0.05), with significant differences observed between the observational group and IVIG-resistant group at 1-month, 3-month, and 6-month post-treatment (all p < 0.05). Notably, prior to treatment, the observational group had a higher CALs incidence compared to the IVIG-sensitive group (all p < 0.05). In children with KD who exhibit ≥ 3 risk factors for IVIG non-response, initial treatment with IVIG, aspirin, and glucocorticoids can effectively reduce fever duration, hospitalization duration, and incidence of CALs and is considered safe.

Comprehensively prognostic and immunological analyses of GLP-1 signaling-related genes in pan-cancer and validation in colorectal cancer.

Background: Glucagon-like peptide-1 (GLP-1) has crucial impact on glycemic control and weight loss physiologically. GLP-1 receptor agonists have been approved for treatment of diabetes and obesity. Emerging evidence suggests that GLP-1 receptor agonists exert anticancer effect in tumorigenesis and development. However, the role and mechanism of GLP-1 signaling-related genes in pan-cancer still need further study. Methods: We comprehensively investigated the aberrant expression and genetic alterations of GLP-1 signaling-related genes in 33 cancer types. Next, GLP-1 signaling score of each patient in The Cancer Genome Atlas were established by the single-sample gene set enrichment analysis. In addition, we explored the association of GLP-1 signaling score with prognostic significance and immune characteristics. Furthermore, qRT-PCR and immunohistochemistry staining were applied to verify the expression profiling of GLP-1 signaling-related genes in colorectal cancer (CRC) tissues. Wound-healing assays and migration assays were carried out to validate the role of GLP-1 receptor agonist in CRC cell lines. Results: The expression profiling of GLP-1 signaling-related genes is commonly altered in pan-cancer. The score was decreased in cancer tissues compared with normal tissues and the lower expression score was associated with worse survival in most of cancer types. Notably, GLP-1 signaling score was strongly correlated with immune cell infiltration, including T cells, neutrophils, dendritic cells and macrophages. In addition, GLP-1 signaling score exhibited close association with tumor mutation burden, microsatellite instability and immunotherapy response in patients with cancer. Moreover, we found that the expression of GLP-1 signaling-related genes ITPR1 and ADCY5 were significantly reduced in CRC tissues, and GLP-1 receptor agonist semaglutide impaired the migration capacity of CRC cells, indicating its protective role. Conclusion: This study provided a preliminary understanding of the GLP-1 signaling-related genes in pan-cancer, showing the prognosis significance and potential immunotherapeutic values in most cancer types, and verified the potential anticancer effect of GLP-1 receptor agonist in CRC.

Chinese nursing students' academic self-concept and deep learning in online courses: Does psychological capital play a moderating role?

The advent of online education has become indispensable for nursing students seeking to acquire knowledge. However, the efficacy of online education often falls short of initial expectations. Deep learning (DL) can assist learners tackle complex problems and make innovative decisions. Despite its potential, there has been limited exploration into the underlying mechanisms of DL among nursing students, both domestically and globally. This study examined the potential moderating effect of psychological capital (PC) on the association between academic self-concept (AS-c) and DL among nursing students from China enrolled in online courses. Conducted from October 2022 to January 2023, the survey involved 635 nursing students from four public universities in eastern China, utilizing convenience sampling. Data was collected using the AS-c scale, psychological capital scale, and DL scale in online courses. Correlation analyses, univariate analyses, multiple linear regression analyses, and the PROCESS macro were employed for a comprehensive examination. The results revealed a strong positive relationship between nursing students' DL and both their AS-c (r = 0.766, P < 0.01) and PC (r = 0.714, P < 0.01), respectively. Additionally, the effect of AS-c on DL was stronger among individuals with high PC (ß = 0.34, SE = 0.03, P < 0.001) compared to those with low (ß = 0.29, SE = 0.02, P < 0.001) or medium (ß = 0.24, SE = 0.02, P < 0.001) levels of PC, indicating that PC exerts moderating effects and promotes DL among nursing students enrolled in online courses. Based on these findings, several implications are suggested for the theory and practice of facilitating DL.

Exploration of port environmental efficiency measurement and influential factors in the Yangtze River Delta Pilot Free Trade Zone.

This study focuses on the environmental efficiency of ports in China's Yangtze River Delta Pilot Free Trade Zone (YRD PFTZ), a critical factor in advancing the high-quality development of ports and facilitating Chinese-style modernization. Current research on port efficiency primarily focuses on the geographical level, with relatively few studies examining the economic regional framework. We selected the YRD PFTZ port for our study to address this gap. Covering 2013 to 2021, we employed the Super-SBM with undesirable outputs and utilized the GML index method. We conducted a spatiotemporal analysis to assess dynamic and static aspects and used the Tobit model to thoroughly investigate the factors influencing the GML Index of these ports. The study showed that: (1) the overall environmental efficiency of these ports was relatively high with a fluctuating trend of initial increase, followed by a decrease, and then an upturn. (2) From a dynamic perspective, the average Green Total Factor Productivity (GTFP) Index is 1.549, denoting an exceptional level primarily driven by technological efficiency. The technical efficiency change index is the main factor improving GTFP in Shanghai, Jiangsu, and Anhui provinces. (3) The port cargo volume and total import and export volume significantly impact the environmental efficiency.

Photo-to-Thermal Conversion Harnessing Low-Energy Photons Renders Efficient Solar CO2 Reduction.

Efficient photocatalytic solar CO2 reduction presents a challenge because visible-to-near-infrared (NIR) low-energy photons account for over 50% of solar energy. Consequently, they are unable to instigate the high-energy reaction necessary for dissociating C═O bonds in CO2. In this study, we present a novel methodology leveraging the often-underutilized photo-to-thermal (PTT) conversion. Our unique two-dimensional (2D) carbon layer-embedded Mo2C (Mo2C-Cx) MXene catalyst in black color showcases superior near-infrared (NIR) light absorption. This enables the efficient utilization of low-energy photons via the PTT conversion mechanism, thereby dramatically enhancing the rate of CO2 photoreduction. Under concentrated sunlight, the optimal Mo2C-C0.5 catalyst achieves CO2 reduction reaction rates of 12000-15000 µmol·g-1·h-1 to CO and 1000-3200 µmol·g-1·h-1 to CH4. Notably, the catalyst delivers solar-to-carbon fuel (STF) conversion efficiencies between 0.0108% to 0.0143% and the STFavg = 0.0123%, the highest recorded values under natural sunlight conditions. This innovative approach accentuates the exploitation of low-frequency, low-energy photons for the enhancement of photocatalytic CO2 reduction.

Harnessing the power of natural alkaloids: the emergent role in epilepsy therapy.

The quest for effective epilepsy treatments has spotlighted natural alkaloids due to their broad neuropharmacological effects. This review provides a comprehensive analysis of the antiseizure properties of various natural compounds, with an emphasis on their mechanisms of action and potential therapeutic benefits. Our findings reveal that bioactive substances such as indole, quinoline, terpenoid, and pyridine alkaloids confer medicinal benefits by modulating synaptic interactions, restoring neuronal balance, and mitigating neuroinflammation-key factors in managing epileptic seizures. Notably, these compounds enhance GABAergic neurotransmission, diminish excitatory glutamatergic activities, particularly at NMDA receptors, and suppress proinflammatory pathways. A significant focus is placed on the strategic use of nanoparticle delivery systems to improve the solubility, stability, and bioavailability of these alkaloids, which helps overcome the challenges associated with crossing the blood-brain barrier (BBB). The review concludes with a prospective outlook on integrating these bioactive substances into epilepsy treatment regimes, advocating for extensive research to confirm their efficacy and safety. Advancing the bioavailability of alkaloids and rigorously assessing their toxicological profiles are essential to fully leverage the therapeutic potential of these compounds in clinical settings.

The role of polyphenols in modulating mitophagy: Implications for therapeutic interventions.

This review rigorously assesses the burgeoning research into the role of polyphenols in modulating mitophagy, an essential cellular mechanism for the targeted removal of impaired mitochondria. These natural compounds, known for their low toxicity, are underscored for their potential in therapeutic strategies against a diverse array of diseases, such as neurodegenerative, cardiovascular, and musculoskeletal disorders. The analysis penetrates deeply into the molecular mechanisms whereby polyphenols promote mitophagy, particularly by influencing crucial signaling pathways and transcriptional regulators, including the phosphatase and tensin homolog (PTEN) induced putative kinase 1 (PINK1)/parkin and forkhead box O3 (FOXO3a) pathways. Noteworthy discoveries include the neuroprotective properties of resveratrol and curcumin, which affect both autophagic pathways and mitochondrial dynamics, and the pioneering integration of polyphenols with other natural substances to amplify therapeutic effectiveness. Furthermore, the review confronts the issue of polyphenol bioavailability and emphasizes the imperative for clinical trials to corroborate their therapeutic viability. By delivering an exhaustive synthesis of contemporary insights and recent advancements in polyphenol and mitophagy research, this review endeavors to catalyze additional research and foster the creation of innovative therapeutic modalities that exploit the distinctive attributes of polyphenols to manage and prevent disease.

Solar overall water-splitting by a spin-hybrid all-organic semiconductor.

Direct solar-to-hydrogen conversion from pure water using all-organic heterogeneous catalysts remains elusive. The challenges are twofold: (i) full-band low-frequent photons in the solar spectrum cannot be harnessed into a unified S1 excited state for water-splitting based on the common Kasha-allowed S0 → S1 excitation; (ii) the H+ → H2 evolution suffers the high overpotential on pristine organic surfaces. Here, we report an organic molecular crystal nanobelt through the self-assembly of spin-one open-shell perylene diimide diradical anions (:PDI2-) and their tautomeric spin-zero closed-shell quinoid isomers (PDI2-). The self-assembled :PDI2-/PDI2- crystal nanobelt alters the spin-dependent excitation evolution, leading to spin-allowed S0S1 → 1(TT) → T1 + T1 singlet fission under visible-light (420 nm~700 nm) and a spin-forbidden S0 → T1 transition under near-infrared (700 nm~1100 nm) within spin-hybrid chromophores. With a triplet-triplet annihilation upconversion, a newly formed S1 excited state on the diradical-quinoid hybrid induces the H+ reduction through a favorable hydrophilic diradical-mediated electron transfer, which enables simultaneous H2 and O2 production from pure water with an average apparent quantum yield over 1.5% under the visible to near-infrared solar spectrum.

A Comprehensive Review of Image Line Segment Detection and Description: Taxonomies, Comparisons, and Challenges.

An image line segment is a fundamental low-level visual feature that delineates straight, slender, and uninterrupted portionsof objects and scenarios within images. Detection and description of line segments lay the basis for numerous vision tasks. Althoughmany studies have aimed to detect and describe line segments, a comprehensive review is lacking, obstructing their progress. This studyfills the gap by comprehensively reviewing related studies on detecting and describing two-dimensional image line segments to provideresearchers with an overall picture and deep understanding. Based on their mechanisms, two taxonomies for line segment detectionand description are presented to introduce, analyze, and summarize these studies, facilitating researchers to learn about them quicklyand extensively. The key issues, core ideas, advantages and disadvantages of existing methods, and their potential applications for eachcategory are analyzed and summarized, including previously unknown findings. The challenges in existing methods and correspondinginsights for potentially solving them are also provided to inspire researchers. In addition, some state-of-the-art line segment detectionand description algorithms are evaluated without bias, and the evaluation code will be publicly available. The theoretical analysis, coupledwith the experimental results, can guide researchers in selecting the best method for their intended vision applications. Finally, this studyprovides insights for potentially interesting future research directions to attract more attention from researchers to this field.

Time-dependent Changes in Shrimp Armor and Escape Kinematics under Ocean Acidification and Warming.

Pandalid shrimp use morphological and behavioral defenses against their numerous fish and invertebrate predators. Their rapid tail-flip escape and rigid exoskeleton armor may be sensitive to changes in ocean temperature and carbon chemistry in ways that alter their efficacy and impact mortality. Here we tested the hypothesis that ocean warming and acidification conditions affect the antipredator defenses of Pandalus gurneyi. To test this hypothesis, we exposed shrimp to a combination of pH (8.0, 7.7, 7.5) and temperature (13°C, 17°C) treatments and assessed their tail-flip escape and exoskeleton armor after short-term (2 weeks) and medium-term (3 months) exposure. Results revealed complex effects on escape kinematics, with changes in different variables explained by either pH, temperature, and/or their interaction; decreased pH, for instance, primarily explains reduced acceleration while cold temperature explains increased flexion duration. Carapace mineral content (Ca and Mg) was unaffected, but warmer temperatures primarily drove enhanced mechanical properties (increased hardness and stiffness). No effects were observed in the stiffness and strength of the rostrum. Furthermore, most of the observed effects were temporary, as they occurred after short-term exposure (2 weeks), but disappeared after longer exposure (3 months). This demonstrates that P. gurneyi defenses are affected by short-term exposure to temperature and pH variations; however, they can acclimate to these conditions over time. Nonetheless, changes in the tail-flip escape kinematics may be disadvantageous when trying to flee predators and the enhanced exoskeleton armor could make them more resistant to predation during short periods of environmental change.