Analysis of clinical features and prognostic factors in Takayasu arteritis involving pulmonary hypertension: A retrospective study.

BACKGROUND: Multiple takayasu arteritis (TA) is a chronic nonspecific large to medium vasculitis disease that mainly accumulates the aorta and its branches. Pulmonary vascular disease is often seen as stenosis and occlusion, and patients may show no moderate to severe pulmonary hypertension (PH). This study aims to summarize the clinical characteristics and analysis of prognostic factors in patients with PH caused by TA. METHODS: Patients diagnosed with aortitis involving the pulmonary artery by pulmonary arteriography or pulmonary artery and total aortic computed tomography arteriography (CTA). All patients underwent detailed clinical assessment, laboratory data collection, and analysis of imaging data. Patients were followed up and factors affecting the prognosis of the pulmonary arteries were analyzed. RESULTS: Most of the patients' complaints were chest tightness, shortness of breath, decreased activity tolerance, hemoptysis and chest pain. 56.90% of the patients were in at the time of admission. Echocardiographic estimation of pulmonary artery systolic pressure was 90.39 ±â€…22.87 mm Hg. In terms of laboratory tests, 39.66%% of the patients had elevated C-reactive protein and erythrocyte sedimentation rate, and amino-terminal natriuretic peptide precursor on admission. In terms of imaging, all patients had pulmonary artery involvement, which was combined with aortic involvement in 31.03%. Nuclide lung perfusion/ventilation imaging of the patients revealed multiple perfusion defects/absences in the segmental and subsegmental distribution of the lungs. Univariate Cox regression model analysis suggested that patients' WHO functional class at admission, age ≧ 51 years at the time of consultation, and amino-terminal natriuretic peptide precursor ≧ 3500 pg/mL were factors affecting the prognosis. Further multifactorial Cox regression model analysis suggested amino-terminal natriuretic peptide precursor ≧ 3500 pg/mL was an independent predictor of poor prognosis with a hazard ratio (HR) value of 5.248. CONCLUSION: Electrocardiogram and echocardiogram may suggest an increased right heart load; some patients have elevated serum inflammatory indexes. Characteristic imaging manifestations include widening of the main pulmonary artery, multiple pulmonary segmental and subsegmental stenoses.

Clinicopathological characteristics and prognostic factors in invasive micropapillary carcinoma of the breast.

Introduction: Invasive micropapillary carcinoma (IMPC) treatment only relies on the standard treatment of nonspecific invasive breast cancer (NSIBC), and it remains controversial whether the survival of patients improves. Therefore, this study aimed to analyze the clinicopathological features of IMPC and to investigate the factors affecting its prognosis. Material and methods: This retrospective cohort study included 104 IMPC patients who met the study's inclusion criteria out of a total of 4,532 patients with invasive breast cancer between January 2015 and December 2019. A contemporaneous cohort of 230 patients with non-specific invasive breast cancer (NSIBC) who underwent surgery was identified and matched using propensity scores. Results: The survival rate for patients with IMPC ranged from 1.12% to 7.03%. Statistically significant differences were observed in the proportion of endocrine treatment, lymphatic invasion, estrogen receptor (ER)-positive rate, molecular subtypes, molecular typing, and 5-year loco-regional recurrence-free survival (LRRFS) between the two cohorts (p < 0.05). The univariate analysis showed that T stage, N stage, lymphatic invasion, vascular invasion, ER-positive rate, and progesterone receptor (PR)-negative rate were all prognosis risk factors (p < 0.05) for IMPC. Furthermore, the multivariate analysis indicated that lymphatic invasion and N stage were independent prognostic factors (p < 0.05). Conclusions: The incidence of micropapillary IMPC, among other pathological subtypes, is steadily increasing. ER-positive and PR-positive rates, as well as luminal subtypes, are frequent, with a concurrent increase in the 5-year locoregional recurrence rate. It would be interesting to compare the effect following these therapeutic modifications in larger cohorts in future studies.

Mitochondrial carrier homolog 2 increases malignant phenotype of human gastric epithelial cells and promotes proliferation, invasion, and migration of gastric cancer cells.

BACKGROUND: The precise role of mitochondrial carrier homolog 2 (MTCH2) in promoting malignancy in gastric mucosal cells and its involvement in gastric cancer cell metastasis have not been fully elucidated. AIM: To determine the role of MTCH2 in gastric cancer. METHODS: We collected 65 samples of poorly differentiated gastric cancer tissue and adjacent tissues, constructed MTCH2-overexpressing and MTCH2-knockdown cell models, and evaluated the proliferation, migration, and invasion of human gastric epithelial cells (GES-1) and human gastric cancer cells (AGS) cells. The mitochondrial membrane potential (MMP), mitochondrial permeability transformation pore (mPTP) and ATP fluorescence probe were used to detect mitochondrial function. Mitochondrial function and ATP synthase protein levels were detected via Western blotting. RESULTS: The expression of MTCH2 and ATP2A2 in gastric cancer tissues was significantly greater than that in adjacent tissues. Overexpression of MTCH2 promoted colony formation, invasion, migration, MMP expression and ATP production in GES-1 and AGS cells while upregulating ATP2A2 expression and inhibiting cell apoptosis; knockdown of MTCH2 had the opposite effect, promoting overactivation of the mPTP and promoting apoptosis. CONCLUSION: MTCH2 can increase the malignant phenotype of GES-1 cells and promote the proliferation, invasion, and migration of gastric cancer cells by regulating mitochondrial function, providing a basis for targeted therapy for gastric cancer cells.

Serine/Threonine Kinase (STK) 33 promotes the proliferation and metastasis of human esophageal squamous cell carcinoma via inflammation-related pathway.

The serine/threonine kinase (STK) 33 plays a key role in cancer cell proliferation and metastasis. Abnormal STK33 expression is closely related to malignancy of numerous cancers. This study suggests the important role of STK33 in the pathogenesis and metastatic progression of esophageal squamous cell carcinoma (ESCC). STK33 expression in human ESCC tissues was detected by immunohistochemical technique. Further, we analyzed the relationship between STK33 and clinical and pathological factors as well as the prognosis of patients. ECa109 cell line was cultured and transfected with STK33-RNAi lentiviral vector to perform Hochest33342 & PI and metastasis experiments. The TCGA database was used to analyze the STK33 expression level in ESCC. All statistical analyses were performed in SPSS 23.0 software. Differences with P < 0.05 were considered statistically significant. In human ESCC specimens, STK33 was overexpressed and associated with poor prognosis. Silencing STK33 expression suppressed ESCC proliferation, migration, invasion, and tumor growth. STK33 also mediated angiogenesis, TGFß, and inflammatory response in ESCC. Mechanistic investigations revealed that STK33 regulates ESCC through multiple complex pathways. Dysregulated STK33 signaling promotes ESCC growth and progression. Thus, our findings identified STK33 as a candidate treatment target that improves ESCC therapy.

Association of molecular subtypes and treatment with survival in invasive micropapillary breast cancer: an analysis of the Surveillance, Epidemiology, and End Results database.

BACKGROUND: This study aims to examine the features, treatments, and survival of invasive micropapillary carcinoma (IMPC) according to different molecular subtypes. METHODS: In this cohort study, data between 2010 and 2018 were retrospectively reviewed from the Surveillance, Epidemiology, and End Results database. Molecular subtypes were categorized into four varieties: hormone receptor (HR)+/HER2- (Luminal A), HR+/HER2+ (Luminal B), HR-/HER2- [triple-negative (TN)], and HR-/HER2+ (HER2 enriched). RESULTS: In this study, 1,180 IMPC patients were included, with 99 patients (8.39%) of the 1,180 patients having an overall mortality, and 53 patients (53.54%) of the 99 patients having a breast cancer-specific mortality. The follow-up duration was 40.00 (18.50, 61.00) months. TN molecular subtype was associated with worse OS and BCSS in IMPC patients. Treatment of chemotherapy, radiation, and combination therapy were associated with better survival in HR+/HER2+ molecular subtype and HR+/HER2- molecular subtype. However, in HR-/HER2- molecular subtype, treatment of chemotherapy was associated with a poor BCSS, and treatment of radiation was not associated with OS and BCSS. Surgery treatment was not associated with survival in HR+/HER2+ molecular subtype and HR+/HER2- molecular subtype. However, surgery treatment of mastectomy was associated with better OS in HR-/HER2- molecular subtype (P < 0.05). CONCLUSION: The prognosis of IMPC was significantly influenced by different molecular subtypes. Chemotherapy and radiotherapy are beneficial in HR+/HER2+ and HR+/HER2- patients. However, they should be used with caution in HR-/HER2- (TN) patients.

DEHP and DBP, common phthalates, induce glucose metabolism disorders in rats via oxidative damage of PI3K/Akt/GLUT4 signaling.

Phthalic acid esters (PAEs) are environmental endocrine disruptors thought to interfere with glucose metabolism in humans. Most of the related research has focused on population epidemiological studies, with the underlying mechanisms remaining unresolved. Using an in vivo animal model, we examined the effects of oral administration of two commonly used PAEs [di(2-ethylhexyl) phthalate (DEHP) and dibutyl phthalate (DBP)] on glucose homeostasis and insulin secretion. DEHP (750 mg/kg, 1/40 LD50), DBP (500 mg/kg, 1/40 LD50), and DEHP (750 mg/kg) + DBP (500 mg/kg) exert an influence on glucose metabolism and elicit a reduction in insulin sensitivity in rats. Furthermore, these substances induce detrimental effects on the structure and functionality of pancreatic ß-cells. DEHP and/or DBP triggered an increase in plasma malondialdehyde (MDA) and reduction in superoxide dismutase (SOD) activity; a reduction in the phosphorylation of phosphatidyl inositol 3 kinase (PI3K) and phospho-protein kinase B (p-Akt473) proteins; an increase in the relative expression of Bax, Caspase-8, cleaved-Caspase-9, and cleaved-Caspase-3; and a reduction in the relative expression of Bcl-2-related Bax in pancreatic tissue and of gastrocnemius glucose transporter 4 (GLUT4) in the gastrocnemius muscle. Based on these findings, these PAEs can disrupt glucose metabolism, possibly via oxidative damage of the PI3K/Akt/GLUT4 pathway; this damage induces pancreatic ß-cell apoptosis, affects pancreatic ß-cell function, and affects glucose metabolism and insulin resistance in rats. To the best of our knowledge, this study was the first to show that the combined effect of the two PAEs affects glucose metabolism and insulin resistance in rats that is significantly higher than the effects of each PAE. Thus, safety standards and studies do not consider this effect as a significant oversight when blending PAEs. We assert that this must be addressed and corrected for establishing more impactful and safer standards.

Fronto-parietal theta high-definition transcranial alternating current stimulation may modulate working memory under postural control conditions in young healthy adults.

Objects: This study aimed to investigate the immediate effects of fronto-parietal θ HD-tACS on a dual task of working memory-postural control. Methods: In this within-subject cross-over pilot study, we assessed the effects of 20 min of 6 Hz-tACS targeting both the left dorsolateral prefrontal cortex (lDLPFC) and posterior parietal cortex (PPC) in 20 healthy adults (age: 21.6 ± 1.3 years). During each session, single- and dual-task behavioral tests (working memory single-task, static tandem standing, and a dual-task of working memory-postural control) and closed-eye resting-state EEG were assessed before and immediately after stimulation. Results: Within the tACS group, we found a 5.3% significant decrease in working memory response time under the dual-task following tACS (t = -3.157, p = 0.005, Cohen's d = 0.742); phase synchronization analysis revealed a significant increase in the phase locking value (PLV) of θ band between F3 and P3 after tACS (p = 0.010, Cohen's d = 0.637). Correlation analyses revealed a significant correlation between increased rs-EEG θ power in the F3 and P3 channels and faster reaction time (r = -0.515, p = 0.02; r = -0.483, p = 0.031, respectively) in the dual-task working memory task after tACS. However, no differences were observed on either upright postural control performance or rs-EEG results (p-values <0.05). Conclusion: Fronto-parietal θ HD-tACS has the potential of being a neuromodulatory tool for improving working memory performance in dual-task situations, but its effect on the modulation of concurrently performed postural control tasks requires further investigation.

Functional Near-Infrared Spectroscopy-Based Evidence of the Cerebral Oxygenation and Network Characteristics of Upper Limb Fatigue.

OBJECTIVE: The objective of this research is to better understand the effects of upper limb fatigue on the cerebral cortex. The aim of this study was to investigate the characteristics of cerebral oxygenation and cortical functional connectivity in healthy adults after upper limb fatigue using functional near-infrared spectroscopy (fNIRS). METHODS: Nineteen healthy adults participated in this study. The participants began exercising on an arm crank ergometer with no load, which was then increased by 0.2 kg per minute, maintaining a speed of at least 90 revolutions per minute during the exercise. Functional near-infrared spectroscopy covering the prefrontal cortex and motor area was used to monitor brain activity during rest and exercise. Heart rate and RPE were monitored during exercise to evaluate the degree of fatigue. Paired-sample t-tests were used to examine differences in the concentration of oxygenated hemoglobin (HbO2) and functional connectivity before and after fatigue. RESULTS: All participants completed the exercise test that induced fatigue. We observed a significant decrease in HbO2 levels in the prefrontal and motor areas after exercise. In addition, brain network features showed a significant decrease in functional connectivity between the left and right motor cortices, between the motor and prefrontal cortices, and between both prefrontal cortices after fatigue. CONCLUSION: This study demonstrates that, in healthy adults, exercise-induced fatigue in the upper limbs significantly affects brain function. In particular, it leads to reduced functional connectivity between the motor cortex and the prefrontal cortex.

Mesoporous Poly(3,4-ethylenedioxythiophene):Poly(styrenesulfonate) as Efficient Iodine Host for High-Performance Zinc-Iodine Batteries.

Here, by introducing polystyrenesulfonate (PSS) as a multifunctional bridging molecule to synchronously coordinate the interaction between the precursor and the structure-directing agent, we developed a mesoporous conductive polymer of poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) featuring adjustable size in the range of 105-1836 nm, open nanochannels, large specific surface area (105.5 m2 g-1), and high electrical conductivity (172.9 S cm-1). Moreover, a large-area ultrathin PEDOT:PSS thin film with well-defined mesopores can also be obtained by controllable growth on various functional interfaces. As an example, we demonstrated that the iodine-loaded mesoporous PEDOT:PSS nanospheres can serve as a promising cathode for aqueous zinc-iodine batteries with high specific capacity (241 mAh g-1), excellent rate performance, and superlong 20,000 cycle life. In-depth theoretical calculations and systematic experimental results together reveal that the exposed sulfur- and oxygen-containing functional groups hold strong interactions with iodine species, resulting in effectively anchoring iodine species and inhibiting the shuttling of polyiodide intermediates, thus ensuring the long-term stability of the batteries. This work introduces a member to the family of mesoporous materials as well as porous polymers with versatile applications.

Tuning electron delocalization of hydrogen-bonded organic framework cathode for high-performance zinc-organic batteries.

Stable cathodes with multiple redox-active centres affording a high energy density, fast redox kinetics and a long life are continuous pursuits for aqueous zinc-organic batteries. Here, we achieve a high-performance zinc-organic battery by tuning the electron delocalization within a designed fully conjugated two-dimensional hydrogen-bonded organic framework as a cathode material. Notably, the intermolecular hydrogen bonds endow this framework with a transverse two-dimensional extended stacking network and structural stability, whereas the multiple C = O and C = N electroactive centres cooperatively trigger multielectron redox chemistry with super delocalization, thereby sharply boosting the redox potential, intrinsic electronic conductivity and redox kinetics. Further mechanistic investigations reveal that the fully conjugated molecular configuration enables reversible Zn2+/H+ synergistic storage accompanied by 10-electron transfer. Benefitting from the above synergistic effects, the elaborately tailored organic cathode delivers a reversible capacity of 498.6 mAh g-1 at 0.2 A g-1, good cyclability and a high energy density (355 Wh kg-1).

Case reports of collision and composite carcinomas of the thyroid: an insight into their origin and clinical significance.

BACKGROUND: Collision and composite carcinomas of the thyroid are extremely rare, and their clinical and biological characteristics are poorly understood. CASE PRESENTATION: The first case was a 41-year-old female patient with a right thyroid nodule. Pathological diagnosis was papillary thyroid carcinoma (PTC) and medullary thyroid carcinoma composite carcinoma. Surgical treatment was right thyroid lobectomy + left partial thyroidectomy + right central neck lymph node dissection. The second case was a 60-year-old female with bilateral thyroid nodules. Total thyroidectomy was performed, and the pathological diagnosis was thyroid collision carcinoma involving follicular thyroid carcinoma on the left side and PTC on the right side. The clinical, histological and gene changes of collision and composite carcinomas of the thyroid are poorly described. With different biological invasion characteristics, the ideal treatment and the prognosis is currently unknown and individualized treatment is necessary. CONCLUSIONS: It is recommended that in composite carcinoma, each cancer is evaluated and treated according to the most severe tumor. Collision carcinoma should be treated as two separate synchronous primary tumors. For both collision and composite carcinomas of the thyroid, the follow-up after treatment should be extensive.

Lymphocytes regulate expression of the SARS-CoV-2 cell entry factor ACE2 in the pancreas of T2DM patients.

AIMS: COVID-19 patients with type 2 diabetes mellitus (T2DM) show both poorer clinical outcomes and have an increased risk of death. SARS-CoV-2 virus infection requires simultaneous expression of the SARS-CoV-2 cell entry factors angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine type 2 (TMPRSS2) in the same cell. The aim of the study was to explore the underlying mechanisms of a COVID-19 infection in patients with T2DM. METHODS: The distribution and expression of AEC2 and TMPRSS2 in different pancreatic cell types in clinical samples of T2DM patients and diabetic mouse models were analysed by single-cell sequencing, bioinformatics analysis and basic experiments. RESULTS: The results showed that ACE2 and TMPRSS2 are expressed in the ducts of the human pancreas. These findings suggest that SARS-CoV-2 can infect ductal cells in vivo through ACE2 and TMPRSS2. T2DM can promote the co-expression of ACE2 and TMPRSS2 in exocrine ducts, including in the human pancreas. We hypothesize that ACE2 expression levels are associated with increased numbers of lymphocytes in vivo. CONCLUSIONS: Increased blood glucose levels are associated with increased ACE2 expression and an increased number of lymphocytes. At the same time, lymphocytes can promote ACE2 expression.

Polyoxometalate-Bridged Synthesis of Superstructured Mesoporous Polymers and Their Derivatives for Sodium-Iodine Batteries.

Despite the impressive progress in mesoporous materials over past decades, for those precursors having no well-matched interactions with soft templates, there are still obstacles to be guided for mesoporous structure via soft-template strategies. Here, a polyoxometalate-assisted co-assembly route is proposed for controllable construction of superstructured mesoporous materials by introducing polyoxometalates as bifunctional bridge units, which weakens the self-nucleation tendency of the precursor through coordination interactions and simultaneously connects the template through the induced dipole-dipole interaction. By this strategy, a series of meso-structured polymers, featuring highly open radial mesopores and dendritic pore walls composed of continuous interwoven nanosheets can be facilely obtained. Further carbonization gave rise to nitrogen-doped hierarchical mesoporous carbon decorated uniformly with ultrafine γ-Mo2 N nanoparticles. Density functional theory proves that nitrogen-doped carbon and γ-Mo2 N can strongly adsorb polyiodide ions, which effectively alleviate polyiodide dissolving in organic electrolytes. Thereby, as the cathode materials for sodium-iodine batteries, the I2 -loaded carbonaceous composite shows a high specific capacity (235 mA h g-1 at 0.5 A g-1 ), excellent rate performance, and cycle stability. This work will open a new venue for controllable synthesis of new hierarchical mesoporous functional materials, and thus promote their applications toward diverse fields.

Light-independent anaerobic microbial oxidation of manganese driven by an electrosyntrophic coculture.

Anaerobic microbial manganese oxidation (AMMO) has been considered an ancient biological metabolism for Mn element cycling on Archaean Earth before the presence of oxygen. A light-dependent AMMO was recently observed under strictly anoxic conditions, providing a new proxy for the interpretation of the evolution of oxygenic photosynthesis. However, the feasibility of biotic Mn(II) oxidation in dark geological habitats that must have been abundant remains unknown. Therefore, we discovered that it would be possible to achieve AMMO in a light-independent electrosyntrophic coculture between Rhodopseudomonas palustris and Geobacter metallireducens. Transmission electron microscopy analysis revealed insoluble particle formation in the coculture with Mn(II) addition. X-ray diffraction and X-ray photoelectron spectroscopy analysis verified that these particles were a mixture of MnO2 and Mn3O4. The absence of Mn oxides in either of the monocultures indicated that the Mn(II)-oxidizing activity was induced via electrosyntrophic interactions. Radical quenching and isotopic experiments demonstrated that hydroxyl radicals (•OH) produced from H2O dissociation by R. palustris in the coculture contributed to Mn(II) oxidation. All these findings suggest a new, symbiosis-dependent and light-independent AMMO route, with potential importance to the evolution of oxygenic photosynthesis and the biogeochemical cycling of manganese on Archaean and modern Earth.

Amentoflavone induces apoptosis and suppresses proliferation of thyroid carcinoma SW579 cells by inhibiting the activation of JAK2-STAT3 pathway / 中国肿瘤生物治疗杂志

@#[摘 要] 目的：探讨阿曼托双黄酮（AF）对甲状腺癌SW579细胞中JAK2-STAT3通路活化及其细胞增殖和凋亡的影响。方法：用0、50、100、150、200 μmol/L的AF处理SW579细胞24、48、72 h，采用CCK-8和Celigo计数、FCM、WB及qPCR法检测AF对SW579细胞的增殖、凋亡、JAK2-STAT3通路活化及其下游调控基因c-Myc、Bcl2、survivin的mRNA及蛋白表达水平的影响。结果：AF处理后，SW579细胞增殖能力显著下降（P<0.05）且呈浓度依赖性，细胞凋亡呈浓度依赖性增多（P<0.05），细胞中JAK2-STAT3通路的活化受到显著抑制（P<0.05），其下游基因c-Myc、Bcl2、survivin的mRNA及蛋白表达均明显下降（均P<0.05）。结论：AF可通过抑制SW579细胞中JAK2-STAT3通路活化及其下游基因的表达而抑制SW579细胞的增殖并促进其凋亡，有望成为治疗甲状腺癌的有效药物。

Corrigendum: Experimental Periodontitis Deteriorated Atherosclerosis Associated With Trimethylamine N-Oxide Metabolism in Mice.

[This corrects the article DOI: 10.3389/fcimb.2021.820535.].

Structure and core taxa of bacterial communities involved in extracellular electron transfer in paddy soils across China.

Microbial communities with extracellular electron transfer (EET) activity are capable of driving geochemical changes and cycles, but a comprehensive understanding of the key microbiota responsible for EET in complex soil matrices is still lacking. Herein, the EET activities, in terms of maximum current density (jmax) and accumulated charge output (Cout), of 41 paddy soils across China were evaluated from the exoelectrogenic properties with a conventional bioelectrochemical system (BES). The jmax with a range of 8.85 × 10-4 to 0.41 A/m2 and Cout with a range of 0.27 to 172.21C were obtained from these soil-based BESs. The bacterial community analyses revealed that the most abundant phylum, order, and genus were Firmicutes, Clostridiales, and Clostridum-sensus-stricto 10, respectively. Bacterial network analysis displayed the positive correlations between the majority of electroactive bacteria-containing genera and multiple other genera, indicating their underlying cooperation for the EET. Partial least squares regression (PLSR) model showed remarkable performance in describing the EET activity with 75 most abundant genera as input variables, identified that 32 genera were very important for governing the EET activities. Multiple linear regression (MLR) analyses further prioritized that the genera norank-c-Berkelbacteria and Fonticella were the key contributors, while the genus Paenibacillus was the key competitor against bacterial exoelectrogenesis in paddy soils. Moreover, the spearman analysis showed that the abundance of these keystone taxa was mainly influenced by the carbon content and pH. This approach provides a promising avenue to monitor the microbial activities in paddy soils as well as the links between microbial community composition and ecological function.

Understanding different cultural ecosystem services: An exploration of rural landscape preferences based on geographic and social media data.

Rural landscapes offer a variety of cultural ecosystem services (CESs). However, the relationship between rural landscape characteristics and different CESs is still poorly understood. Therefore, this study explored the rural areas of Huzhou city, China, as a case study to assess the main rural landscape characteristics of different CESs based on public preferences. First, 148 scenic spots were classified into four CESs (physical, experiential, intellectual and inspirational), and the public preferences for each scenic spot were determined by combining tourists' scores obtained from social media and government assessment scores. Then, the landscape characteristic indicators were constructed from the natural, infrastructural and sensory perspectives by combining geographic and social media data. Finally, the random forest model was used to evaluate the public preferences for rural landscape characteristics overall and for different CESs. The word frequency analysis showed that, in addition to the nature landscape, infrastructure and service had a strong influence on public preferences. The relationship with rural landscape characteristics varied across different CESs. For physical CESs, the convenience of infrastructure played a greater role than natural landscape characteristics. Experiential CESs, on the other hand, were affected by natural landscape characteristics themselves. Intellectual CESs had higher requirements for both infrastructure and nature. Inspirational CESs included sensory evaluation indicators, in addition to their focus on natural landscape characteristics and infrastructure, indicating that this category of CESs was more concerned with inner experience. The use of social media data has enriched the dimensions of sensory elements and provided new ideas and information supplements for comprehensively understanding different CESs, thus better supporting the management, planning and protection of rural landscapes.

Assessing economic sustainability and ecological efficiency with genuine progress indicator: a case study of the Yangtze River Delta from 2000 to 2018.

To achieve urban sustainability, it is critical to enhance the environment, economy, and society simultaneously. This study adopted the revised genuine progress indicator (GPI) and ecological footprint (EF) to evaluate the ecological efficiency and economic sustainability of the Yangtze River Delta from 2000 to 2018. Spatial analysis was utilized to identify spatial autocorrelation. A total of 27 cities were then partitioned through k-means cluster analysis. The results showed that GPI and ecological efficiency improved rapidly, but economic sustainability showed a downward trend. GPI and GDP had a high degree of spatial correlation, especially in Suzhou-Wuxi-Changzhou Metropolitan Area. However, no spatial correlation existed between GPI and EF. The city with high GEE can reach 3000 $/gha, indicating the city consumed 1 global hectare to create $3000 of genuine economic growth. Shanghai, Hangzhou, and Taizhou were cities with the highest level of economic sustainability and ecological efficiency. The spatiotemporal characteristics of economic sustainability and ecological efficiency revealed in this study will provide theoretical guidance for alleviating ecological pressure and promoting economic sustainable development.

Dedicator of cytokinesis 8 deficiency and hyperimmunoglobulin E syndrome: A case report.

RATIONALE: Hyperimmunoglobulin E syndrome (HIES) is a rare and complex immunoregulatory multisystem disorder characterized by recurrent eczema, skin and sinopulmonary infections, elevated serum immunoglobulin E levels, and eosinophilia. Onset is most likely in childhood, although infrequent adult cases have been reported. Early diagnosis is important. The use of the National Institutes of Health scoring system and the HIES signal transducer and activation of transcription 3 score can standardize the diagnosis of HIES. PATIENT CONCERNS: A 19-year-old woman presented with complaints of dry cough, pyrexia, dyspnea, and recurrent pneumonia. She had a history of milk allergy, recurrent eczema, suppurative otitis media, chalazia, and aphthous ulcers. Her parents had a consanguineous marriage. DIAGNOSIS: HIES; severe pneumonia. INTERVENTIONS: Voriconazole (200 mg iv 2 times/d) and flucytosine (1 g orally 4 times/d) for 3 weeks were administered, followed by oral administration of fluconazole for 3 weeks. OUTCOMES: The patient experienced near-complete remission of her respiratory symptoms. The patient was followed-up for one and a half years. During the follow-up, the patient presented again with cough and dyspnea and was again admitted to hospital. After being hospitalized for 3 weeks of antibiotic treatment, the patient experienced near-complete relief of her respiratory symptoms. LESSONS: Regardless of patient age, it is important to consider the possibility of HIES when a patient has recurrent eczema, skin and sinopulmonary infections, elevated serum immunoglobulin E levels, and eosinophilia. Early diagnosis and intervention are essential to improve prognosis.