Clinical efficacy analysis of tip­flexible suctioning ureteral access sheath combined with disposable flexible ureteroscope to treat 2-4 cm renal stones.

PURPOSE: This study aims to evaluate the clinical efficacy of using a tip­flexible suctioning ureteral access sheath (TFS-UAS) in combination with a traditional ureteral access sheath (T-UAS) and a disposable flexible ureteroscope (DFU) for treating large renal stones (2-4 cm in diameter). METHODS: We retrospectively collected clinical data from 238 patients who underwent retrograde intrarenal surgery (RIRS) at Ganzhou People's Hospital between January 2019 and October 2023. The study included 238 patients who met the inclusion criteria, with 125 in the observation group using TFS-UAS and 113 in the control group using T-UAS. We compared differences in the stone-free rate (SFR), complication rates, surgery duration, and average hospital stay between the two groups. RESULTS: All 238 surgeries were successfully completed. The stone-free rates for the observation group at the first and thirtieth day post-surgery were 87.20% and 95.20%, respectively, whereas for the control group, the rates were 73.45% and 85.84%, showing statistically significant differences (P < 0.05). The overall complication rates were 1.6% for the observation group and 14.16% for the control group, also statistically significant (P < 0.001). The surgical times for stone removal were (101.17 ± 25.64) minutes for the observation group and (86.23 ± 20.35) minutes for the control group, with significant differences (P < 0.05). CONCLUSION: Compared to T-UAS, combining TFS-UAS with DFU for treating renal stones of 2-4 cm diameter, although more time-consuming, resulted in higher SFRs and improved safety.

Sulfonyl Molecules Induced Oriented Lithium Deposition for Long-Term Lithium Metal Batteries.

Dendrites growth and unstable interfacial Li+ transport hinder the practical application of lithium metal batteries (LMBs). Herein, we report an active layer of 2,4,6-trihydroxy benzene sulfonyl fluorine on copper substrate that induces oriented Li+ deposition and generates highly crystalline solid-electrolyte interphase (SEI) to achieve high-performance LMBs. The lithiophilic -SO2 - groups of highly crystalline SEI accept the rapidly transported Li+ ions and form a dense inner layer of LiF and Li3 N, which regulate Li+ plating morphology along the (110) crystal surface toward dendrite-free Li anode. Thus, Li||Cu cells with lithiophilic SEI achieve an average deposition efficiency of 99.8 % after 700 cycles, and Li||Li cells operate well for 1100 h. Besides, Li||LiNi0.8 Co0.1 Mn0.1 O2 cells with modified SEI exhibit a capacity retention that is 14 times than that of conventional SEI. Even at -60 °C, Li||Cu cells reach stable deposition efficiency of 83.2 % after 100 cycles.

Clinical efficacy analysis of partial cystectomy and radical cystectomy in the treatment of muscle-invasive sarcomatoid carcinoma of the urinary bladder.

Objective: This study compares the clinical efficacy of partial cystectomy (PC) versus radical cystectomy (RC) in the treatment of muscle-invasive bladder urothelial carcinoma (SCUB) through a retrospective analysis. Methods: We retrospectively analyzed the clinical data of 20 patients diagnosed with muscle-invasive SCUB from July 2015 to August 2023 at Ganzhou People's Hospital. All patients underwent surgical treatment followed by chemotherapy, with 9 receiving PC and 11 undergoing RC. We compared the average survival time of deceased patients for both treatments and conducted survival and multivariate analyses using the Kaplan-Meier method and Cox proportional hazards model, respectively. Results: All 20 patients were postoperatively diagnosed with muscle-invasive SCUB and were followed up for 4 to 60 months. The average survival time for patients undergoing PC was 11.5 months, with survival rates at 1 year, 2 years, and 5 years of 55.56%, 22.22%, and 11.11%, respectively. In contrast, patients receiving RC had an extended average survival time of 22.5 months, and their 1-year, 2-year, and 5-year survival rates increased to 63.64%, 36.36%, and 18.18%, respectively. Survival analysis revealed statistically significant differences in prognosis between PC and RC for the treatment of muscle-invasive SCUB (P<0.05). Conclusion: SCUB is a rare malignant tumor with unique biological characteristics often associated with poor prognosis. Upon diagnosis, RC should be considered as an early treatment approach when the patient's overall condition permits.

Phylogenetic evidence reveals early Kra-Dai divergence and dispersal in the late Holocene.

Studying language evolution brings a crucial perspective to bear on questions of human prehistory. As the most linguistically diverse region on earth, East and Southeast Asia have witnessed extensive sociocultural and ethnic contacts among different language communities. Especially, the Kra-Dai language family exhibits tremendous socio-cultural importance in these regions. Due to limited historical accounts, however, there are several controversies on their linguistic relatedness, ambiguities regarding the divergence time, and uncertainties on the dispersal patterns. To address these issues, here we apply Bayesian phylogenetic methods to analyze the largest lexical dataset containing 646 cognate sets compiled for 100 Kra-Dai languages. Our dated phylogenetic tree showed their initial divergence occurring approximately 4000 years BP. Phylogeographic results supported the early Kra-Dai language dispersal from the Guangxi-Guangdong area of South China towards Mainland Southeast Asia. Coupled with genetic, archaeological, paleoecologic, and paleoclimatic data, we demonstrated that the Kra-Dai language diversification could have coincided with their demic diffusion and agricultural spread shaped by the global climate change in the late Holocene. The interdisciplinary alignments shed light on reconstructing the prehistory of Kra-Dai languages and provide an indispensable piece of the puzzle for further studying prehistoric human activities in East and Southeast Asia.

High-frequency chest wall oscillation multiple times daily can better reduce the loss of pulmonary surfactant and improve lung compliance in mechanically ventilated patients.

BACKGROUND: High-frequency chest wall oscillation (HFCWO) has been widely recognized for its airway secretion clearance effectiveness in critically ill ICU patients. OBJECTIVES: The purpose of this randomized controlled trial is to validate and compare the effects of different frequencies of HFCWO on oxygenation, lung compliance, and pulmonary surfactant proteins (SPs) in critically ill patients admitted to the intensive care unit (ICU). METHODS: Sixty patients with severe craniocerebral injury treated with a tracheostomy and mechanical ventilation were randomized into three groups (20 patients in each group): a single group (treated with 30 minutes of HFCWO once daily) and a double group (treated with 30 minutes of HFCWO twice daily), and a blank group (treated without HFCWO). Primary outcome measures included results on several specific proteins (SP-A, SP-B, SP-C, and SP-D) in serum and alveolar lavage fluid. Secondary outcome measures were lung static compliance test and oxygenation. RESULTS: Patients in both the single and double groups exhibited significant oxygenation and static compliance improvement. Similar results were observed in changes in SPs concentrations in the alveolar lavage fluid. However, a significant reduction of SPs levels was observed in the serum. In the group comparison analysis for the same variables between the single and double group, twice daily HFCWO treatments showed a significantly better result. CONCLUSION: Compared with HFCWO once daily, HFCWO twice daily is advantageous in patients with tracheostomy and prolonged ventilation, which demonstrated significantly greater effectiveness in improving oxygenation and lung static compliance linked to the increase of and SPs contents in the airways as well as a reduction of SPs shift from airways to the blood.

Microbial coexistence in the rhizosphere and the promotion of plant stress resistance: A review.

Plants can recruit soil microorganisms into the rhizosphere when experiencing various environmental stresses, including biotic (e.g., insect pests) and abiotic (e.g., heavy metal pollution, droughts, floods, and salinity) stresses. However, species coexistence in plant resistance has not received sufficient attention. Current research on microbial coexistence is only at the community scale, and there is a limited understanding of the interaction patterns between species, especially microbe‒microbe interactions. The relevant interaction patterns are limited to a few model strains. The coexisting microbial communities form a stable system involving complex nutritional competition, metabolic exchange, and even interdependent interactions. This pattern of coexistence can ultimately enhance plant stress tolerance. Hence, a systematic understanding of the coexistence pattern of rhizosphere microorganisms under stress is essential for the precise development and utilization of synthetic microbial communities and the achievement of efficient ecological control. Here, we integrated current analytical methods and introduced several new experimental methods to elucidate rhizosphere microbial coexistence patterns. Some advancements (e.g., network analysis, coculture experiments, and synthetic communities) that can be applied to plant stress resistance are also updated. This review aims to summarize the key role and potential application prospects of microbial coexistence in the resistance of plants to environmental stresses. Our suggestions, enhancing plant resistance with coexisting microbes, would allow us to gain further knowledge on plant-microbial and microbial-microbial functions, and facilitate translation to more effective measures.

Development characteristics of the rock fracture field in strata overlying a mined coal seam group.

The fracture development of the overlying strata after coal mining is an important guarantee of efficient gas drainage. In order to explore the fracture evolution characteristics close to a mined coal seam group, the F15.16-24130 working face in the Pingdingshan No. 10 coal mine was taken as the research background. The FLAC3D numerical simulation software was used to study the migration and failure characteristics of the overlying strata during mining of a coal seam group, and the fracture evolution process of the stope was investigated. The results show that as the advancing distance increased, the fracture density and fracture height increased continuously due to deformation and failure of the overlying rock. The displacement of the overlying rock initially increased and then decreased, and the displacement of the floor rock initially decreased and then increased. When working face F15.16 of the coal seam advanced to 75 m, a saddle-shaped plastic zone gradually formed in the upper part of the goaf and the floor of the goaf was formed. The pressure relief depth was proportional to the advancement distance. As the advancement distance of the working face increased, the pressure relief depth gradually extended to the F17 coal seam, which was conducive to the development and penetration of the fractures in the coal floor and rock mass and was convenient for pressure relief gas drainage from the F17 coal seam.

A Hemagglutinin Stem Vaccine Designed Rationally by AlphaFold2 Confers Broad Protection against Influenza B Infection.

Two lineages of influenza B viruses (IBV) co-circulating in human beings have been posing a significant public health burden worldwide. A substantial number of broadly neutralizing antibodies (bnAbs) have been identified targeting conserved epitopes on hemagglutinin (HA) stem domain, posing great interest for universal influenza vaccine development. Various strategies to design immunogens that selectively present these conserved epitopes are being explored. However, it has been a challenge to retain native conformation of the HA stem region, especially for soluble expression in prokaryotic systems. Here, using a structure prediction tool AlphaFold2, we rationally designed a stable stem antigen "B60-Stem-8071", an HA stem vaccine derived from B/Brisbane/60/2006 grafted with a CR8071 epitope as a linker. The B60-Stem-8071 exhibited better solubility and more stable expression in the E. coli system compared to the naïve HA stem antigen. Immunization with B60-Stem-8071 in mice generated cross-reactive antibodies and protected mice broadly against lethal challenge with Yamagata and Victoria lineages of influenza B virus. Notably, soluble expression of B60-stem-8071 in the E. coli system showed the potential to produce the influenza B vaccine in a low-cost way. This study represents a proof of concept for the rational design of HA stem antigen based on structure prediction and analysis.

Future Developments in Geographical Agent-Based Models: Challenges and Opportunities.

Despite reaching a point of acceptance as a research tool across the geographical and social sciences, there remain significant methodological challenges for agent-based models. These include recognizing and simulating emergent phenomena, agent representation, construction of behavioral rules, and calibration and validation. While advances in individual-level data and computing power have opened up new research avenues, they have also brought with them a new set of challenges. This article reviews some of the challenges that the field has faced, the opportunities available to advance the state-of-the-art, and the outlook for the field over the next decade. We argue that although agent-based models continue to have enormous promise as a means of developing dynamic spatial simulations, the field needs to fully embrace the potential offered by approaches from machine learning to allow us to fully broaden and deepen our understanding of geographical systems.

Food and nutrition security under global trade: a relation-driven agent-based global trade model.

This paper addresses the highly relevant and timely issues of global trade and food security by developing an empirically grounded, relation-driven agent-based global trade model. Contrary to most price-driven trade models in the literature, the relation-driven agent-based global trade model focuses on the role of relational factors such as trust, familiarity, trade history and conflicts in countries' trade behaviour. Moreover, the global trade model is linked to a comprehensive nutrition formula to investigate the impact of trade on food and nutrition security, including macro and micronutrients. Preliminary results show that global trade improves the food and nutrition security of countries in Africa, Asia and Latin America. Trade also promotes a healthier and more balanced diet, as countries have access to an increased variety of food. The effect of trade in enhancing nutrition security, with an adequate supply of macro and micronutrients, is universal across nutrients and countries. As researchers call for a holistic and multifactorial approach to food security and climate change (Hammond and Dubé 2012 Proc. Natl Acad. Sci. USA 109, 12 356-12 363. (doi:10.1073/pnas.0913003109)), the paper is one of the first to develop an integrated framework that consists of socio-economic, geopolitical, nutrition, environmental and agri-food systems to tackle these global challenges. Given the ongoing events of Brexit, the US-China trade war and the global COVID-19 pandemic, the paper will provide valuable insights on the role of trade in improving the food and nutrition security across countries.

[Remediation of Heavy-Metal-Contaminated Soil by EGTA Washing Enhanced with Reduction Solubilization].

This study used a reducing agent to regulate the activity of heavy metals in soil, with the aim of enhancing the washing efficiency of heavy metals in soil by ethylene glycol bis (2-aminoethyl ether) tetraacetic acid (EGTA). The effects of EGTA dosage, reductant type, liquid-solid ratio, and leaching time on washing efficiency were studied. The heavy metal concentrations in the washing solution and the chemical specification under different washing conditions were analyzed. Scanning electron microscopy/energy-dispersive X-ray spectroscopy and Fourier-transform infrared spectroscopy were used to characterize the soil samples under different treatments. The results showed that the washing efficiencies of Cu, Zn, Pb, and Cd were 85.0%, 60.7%, 88.6%, and 66.4%, respectively, when the liquid-solid ratio was 7.5:1, the leaching time was 2 h, and the dosage of EGTA and sodium thiosulfate (Na2S2O3) was 5 g·L-1. Compared with single EGTA treatment, the leaching concentration of the four heavy metals all decreased, with the Pb decreasing most significantly. The soil particles became smaller, the aggregate structure was destroyed, the O and Al content decreased, the Si content increased, and therefore the adsorption capacity of soil mineral components was supposed to decrease. The soil organic matter content decreased significantly, and the -OH vibration was significantly weakened, indicating that the organic functional groups with stronger coordination ability were reduced, and the adsorption of organic components in the soil was reduced. The decrease in content of strongly adsorbed components in soil is an important mechanism for Na2S2O3 to enhance heavy metal elution by EGTA.

Not one Brexit: How local context and social processes influence policy analysis.

This paper develops an empirical agent-based model to assess the impacts of Brexit on Scottish cattle farms. We first identify several trends and processes among Scottish cattle farms that were ongoing before Brexit: the lack of succession, the rise of leisure farming, the trend to diversify and industrialise, and, finally, the phenomenon of the "disappearing middle", characterised by the decline of medium-sized farms and the polarization of farm sizes. We then study the potential impact of Brexit amid the local context and those ongoing social processes. We find that the impact of Brexit is indeed subject to pre-Brexit conditions. For example, whether industrialization is present locally can significantly alter the impact of Brexit. The impact of Brexit also varies by location: we find a clear divide between constituencies in the north (highland and islands), the middle (the central belt) and the south. Finally, we argue that policy analysis of Brexit should consider the heterogeneous social context and the complex social processes under which Brexit occurs. Rather than fitting the world into simple system models and ignoring the evidence when it does not fit, we need to develop policy analysis frameworks that can incorporate real world complexities, so that we can assess the impacts of major events and policy changes in a more meaningful way.