Observation of nonlinear fractal higher order topological insulator.

Higher-order topological insulators (HOTIs) are unique materials hosting topologically protected states, whose dimensionality is at least by 2 lower than that of the bulk. Topological states in such insulators may be strongly confined in their corners which leads to considerable enhancement of nonlinear processes involving such states. However, all nonlinear HOTIs demonstrated so far were built on periodic bulk lattice materials. Here, we demonstrate the first nonlinear photonic HOTI with the fractal origin. Despite their fractional effective dimensionality, the HOTIs constructed here on two different types of the Sierpinski gasket waveguide arrays, may support topological corner states for unexpectedly wide range of coupling strengths, even in parameter regions where conventional HOTIs become trivial. We demonstrate thresholdless spatial solitons bifurcating from corner states in nonlinear fractal HOTIs and show that their localization can be efficiently controlled by the input beam power. We observe sharp differences in nonlinear light localization on outer and multiple inner corners and edges representative for these fractal materials. Our findings not only represent a new paradigm for nonlinear topological insulators, but also open new avenues for potential applications of fractal materials to control the light flow.

A preliminary study of renal function for renal artery stenosis using multiparametric magnetic resonance imaging.

OBJECTIVE: To comprehensively evaluate the renal structure and function of patients with renal artery stenosis (RAS) using multiparametric magnetic resonance imaging (MRI), and analyze the correlation between magnetic resonance (MR) parameters and renal function. MATERIALS AND METHODS: Renal multiparametric MRI was conducted on 62 patients with RAS utilizing a Philips Ingenia CX 3.0 T MRI system. The scanning protocols encompassed arterial spin labeling, phase contrast MRI, diffusion weighted imaging, T1 mapping, and blood oxygen level-dependent MRI. All patients underwent radionuclide renal dynamic imaging to calculate the glomerular filtration rate (GFR) for assessing renal function. RESULTS: Most MR parameters were correlated with GFR: renal parenchymal volume (R = 0.603), whole kidney renal blood flow (RBF) (R = 0.192), renal cortical RBF (R = 0.294), renal artery mean velocity (R = 0.593), stroke volume (R = 0.599), mean flux (R = 0.629), renal cortical apparent diffusion coefficient (ADC) (R = 0.466), medullary ADC (R = 0.332), cortical T1 value (R = - 0.206), corticomedullary T1 difference (R = 0.204), cortical T2* value (R = 0.448), and medullary T2* value (R = 0.272). The best prediction model for GFR using multiparametric MRI was obtained, including renal PV, whole kidney RBF, cortical RBF, mean velocity, mean flux, and CMD T1. CONCLUSION: Multiparametric MRI is a novel noninvasive examination method that can effectively and comprehensively assess the renal structure and function of RAS.

Analysis of anterior segment in primary angle closure suspect with deep learning models.

OBJECTIVE: To analyze primary angle closure suspect (PACS) patients' anatomical characteristics of anterior chamber configuration, and to establish artificial intelligence (AI)-aided diagnostic system for PACS screening. METHODS: A total of 1668 scans of 839 patients were included in this cross-sectional study. The subjects were divided into two groups: PACS group and normal group. With anterior segment optical coherence tomography scans, the anatomical diversity between two groups was compared, and anterior segment structure features of PACS were extracted. Then, AI-aided diagnostic system was constructed, which based different algorithms such as classification and regression tree (CART), random forest (RF), logistic regression (LR), VGG-16 and Alexnet. Then the diagnostic efficiencies of different algorithms were evaluated, and compared with junior physicians and experienced ophthalmologists. RESULTS: RF [sensitivity (Se) = 0.84; specificity (Sp) = 0.92; positive predict value (PPV) = 0.82; negative predict value (NPV) = 0.95; area under the curve (AUC) = 0.90] and CART (Se = 0.76, Sp = 0.93, PPV = 0.85, NPV = 0.92, AUC = 0.90) showed better performance than LR (Se = 0.68, Sp = 0.91, PPV = 0.79, NPV = 0.90, AUC = 0.86). In convolutional neural networks (CNN), Alexnet (Se = 0.83, Sp = 0.95, PPV = 0.92, NPV = 0.87, AUC = 0.85) was better than VGG-16 (Se = 0.84, Sp = 0.90, PPV = 0.85, NPV = 0.90, AUC = 0.79). The performance of 2 CNN algorithms was better than 5 junior physicians, and the mean value of diagnostic indicators of 2 CNN algorithm was similar to experienced ophthalmologists. CONCLUSION: PACS patients have distinct anatomical characteristics compared with health controls. AI models for PACS screening are reliable and powerful, equivalent to experienced ophthalmologists.

The prognosis and metabolite changes of NSCLC patients receiving first-line immunotherapy combined chemotherapy in different M1c categories according to 9th edition of TNM classification.

BACKGROUND: The 9th edition of the TNM Classification for lung cancer delineates M1c into two subcategories: M1c1 (Multiple extrathoracic lesions within a single organ system) and M1c2 (Multiple extrathoracic lesions involving multiple organ systems). Existing research indicates that patients with lung cancer in stage M1c1 exhibit superior overall survival compared to those in stage M1c2. The primary frontline therapy for patients with advanced non-small cell lung cancer (NSCLC), lacking driver gene mutations, involves the use of immune checkpoint inhibitors (ICIs) combined with chemotherapy. Nevertheless, a dearth of evidence exists regarding potential survival disparities between NSCLC patients with M1c1 and M1c2 undergoing first-line immune-chemotherapy, and reliable biomarkers for predicting treatment outcomes are elusive. Serum metabolic profiles may elucidate distinct prognostic mechanisms, necessitating the identification of divergent metabolites in M1c1 and M1c2 undergoing combination therapy. This study seeks to scrutinize survival discrepancies between various metastatic patterns (M1c1 and M1c2) and pinpoint metabolites associated with treatment outcomes in NSCLC patients undergoing first-line ICIs combined with chemotherapy. METHOD: In this study, 33 NSCLC patients lacking driver gene mutations diagnosed with M1c1, and 22 similarly diagnosed with M1c2 according to the 9th edition of TNM Classification, were enrolled. These patients received first-line PD-1 inhibitor plus chemotherapy. The relationship between metastatic patterns and progression-free survival (PFS) in patients undergoing combination therapy was analyzed using univariate and multivariate Cox regression models. Serum samples were obtained from all patients before treatment initiation for untargeted metabolomics analysis, aiming to identify differential metabolites. RESULTS: In the univariate analysis of PFS, NSCLC patients in M1c1 receiving first-line PD-1 inhibitor plus chemotherapy exhibited an extended PFS (HR = 0.49, 95% CI, 0.27-0.88, p = 0.017). In multivariate PFS analyses, these M1c1 patients receiving first-line PD-1 inhibitor plus chemotherapy also demonstrated prolonged PFS (HR = 0.45, 95% CI, 0.22-0.92, p = 0.028). The serum metabolic profiles of M1c1 and M1c2 undergoing first-line PD-1 inhibitors plus chemotherapy displayed notable distinctions. In comparison to M1c1 patients, M1c2 patients exhibited alterations in various pathways pretreatment, including platelet activation, linoleic acid metabolism, and the VEGF signaling pathway. Diminished levels of lipid-associated metabolites (diacylglycerol, sphingomyelin) were correlated with adverse outcomes. CONCLUSION: NSCLC patients in M1c1, devoid of driver gene mutations, receiving first-line PD-1 inhibitors combined with chemotherapy, experienced superior outcomes compared to M1c2 patients. Moreover, metabolomic profiles strongly correlated with the prognosis of these patients, and M1c2 patients with unfavorable outcomes manifested distinct changes in metabolic pathways before treatment. These changes predominantly involved alterations in lipid metabolism, such as decreased diacylglycerol and sphingomyelin, which may impact tumor migration and invasion.

Endomembrane trafficking driven by microtubule growth regulates stomatal movement in Arabidopsis.

Microtubule-based vesicle trafficking usually relies upon kinesin and dynein motors and few reports describe microtubule polymerisation driving directional vesicle trafficking. Here we show that Arabidopsis END BINDING1b (EB1b), a microtubule plus-end binding protein, directly interacts with SYP121, a SNARE protein that mediates the trafficking of the K+ channel KAT1 and its distribution to the plasma membrane (PM) in Arabidopsis guard cells. Knockout of AtEB1b and its homologous proteins results in a modest but significant change in the distribution of KAT1 and SYP121 in guard cells and consequently delays light-induced stomatal opening. Live-cell imaging reveals that a portion of SYP121-associated endomembrane compartments co-localise with AtEB1b at the growing ends of microtubules, trafficking along with the growth of microtubules for targeting to the PM. Our study reveals a mechanism of vesicle trafficking driven by microtubule growth, which is involved in the redistribution of PM proteins to modulate guard cell movement.

Bisphosphonate- and disumab-related gingival disorders: case analysis from the U.S. Food and Drug Administration Adverse Event Reporting System.

Prior research has indicated that bisphosphonates (BPs) can improve periodontal disease because of their anti-osteoporosis properties. In vitro studies have shown that BPs induce cytotoxicity, inhibit wound healing, and thus affect periodontal disease. Denosumab and BPs have alternative indications. BP and denosumab are not known to correlate with gingival disorders. We assessed such a relationship by applying Bayesian and nonproportional analyses to data in the US FDA Adverse Event Reporting System (FAERS) database. The study analyzed BPs and denosumab-reported incidents with preferred terms found in the narrow Standardized MedDRA Queries for gingival disorders. A total of 5863 reported cases of gingival disorders were associated with five BPs (alendronate, pamidronate, ibandronate, risedronate, and zoledronate) and denosumab. More than 15% of patients with gingival disorders related to BPs and denosumab other than denosumab were hospitalized over short- or long-term periods. Our findings indicated BPs and denosumab had significant reporting odds ratios (ROR), proportional reporting ratios (PRR), and information components (IC) with respect to gingival disorders. Pamidronate had the highest association (ROR = 64.58, PRR = 57.99, IC = 5.71), while the weakest association was found with denosumab (ROR = 3.61, PRR = 3.60, IC = 1.77). Significant associations were found between the six drugs and gingival pain, gingival recession, gingivitis, periodontal disease, and periodontitis. In conclusion, our comprehensive overview of the correlations, clinical characteristics, and prognoses of BPs and denosumab-related gingival disorders suggests that these issues deserve continued surveillance and appropriate management.

Efficient gene editing of a model fern species through gametophyte-based transformation.

The clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated nuclease (Cas) system allows precise and easy editing of genes in many plant species. However, this system has not yet been applied to any fern species through gametophytes due to the complex characteristics of fern genomes, genetics, and physiology. Here, we established a protocol for gametophyte-based screening of single-guide RNAs (sgRNAs) with high efficiency for CRISPR/Cas9-mediated gene knockout in a model fern species, Ceratopteris richardii. We utilized the C. richardii ACTIN promoter to drive sgRNA expression and the enhanced CaMV 35S promoter to drive the expression of Streptococcus pyogenes Cas9 in this CRISPR-mediated editing system, which was employed to successfully edit a few genes, such as Nucleotidase/phosphatase 1 (CrSAL1) and Phytoene Desaturase (CrPDS), which resulted in an albino phenotype in C. richardii. Knockout of CrSAL1 resulted in significantly (P<0.05) reduced stomatal conductance (gs), leaf transpiration rate (E), guard cell length, and abscisic acid (ABA)-induced reactive oxygen species (ROS) accumulation in guard cells. Moreover, CrSAL1 overexpressing plants showed significantly increased net photosynthetic rate (A), gs, and E as well as most of the stomatal traits and ABA-induced ROS production in guard cells compared to the wild-type (WT) plants. Taken together, our optimized CRISPR/Cas9 system provides a useful tool for functional genomics in a model fern species, allowing the exploration of fern gene functions for evolutionary biology, herbal medicine discovery, and agricultural applications.

Metabolomics combined with physiology reveal how white clover (Trifolium repens L.) respond to 6PPD stress.

As a ubiquitous tire antioxidant, N-(1,3-Dimethyl-butyl)-N'-phenyl-p-phenylene- diamine (6PPD) exists widely in various environmental media and has been detected at high levels in the environment. However, the effects of 6PPD on plants are still poorly understood. In this study, a hydroponic experiment was carried out to investigate the response of white clover (Trifolium repens L.) stressed by 6PPD on physiology and metabolomics. The results indicated that the length of stem and root, as well as biomass were significantly reduced after 500 µg L-1 6PPD treatment. Photosynthetic performances including photosynthetic rate (Pn), stomatal conductance (Gs), intercellular CO2 concentration (Ci), transpiration rate (Tr) and chlorophyll content of leaves decreased in all treatments except 500 µg L-1 of 6PPD. The malondialdehyde (MDA) content in the shoot of white clover increased by 66.33 % when exposed to 500 µg L-1 of 6PPD compared to control group (CK). Hydrogen peroxide and superoxide anion presented a U-shape trend and began to increase at 500 µg L-1. Besides, peroxidase and catalase significantly decreased compared to CK after exposure to 500 µg L-1. Metabolic analysis of clover showed that 6PPD treatment induced changes in 10 metabolic pathways of white clover. Metabolites were significantly down-regulated after exposure to 500 µg L-1 in shoot, while significantly down-regulated in all treatment groups except 500 µg L-1 in root. These findings may provide a novel perspective for phytotoxicity assessment and phytoremediation of 6PPD.

High Transition Temperature Driven by Type-II Dirac Fermions in Topological Superconductor B7Be2B7 Nanosheet.

Topological superconductors (TSCs) offer a promising avenue for delving into exotic states of matter and fundamental physics. We propose a strategy for realizing high transition temperatures (high-Tc) in TSCs by leveraging nontrivial topology alongside a high carrier density near the Fermi level in metal-doped borophenes. We identified 39 candidates with exceptional thermodynamic stability from thousands of Be-intercalated borophenes (Be1-xBx) via extensive structural searches. Seven candidates exhibit high carrier densities, with B7Be2B7 emerging as a particularly promising candidate. This nanosheet displays both type-I and type-II Dirac fermions, indicative of Z2 topological metals, thereby positioning it as an ideal platform for high-Tc TSCs. The high-density π electrons of B7Be2B7 originating from type-II Dirac fermions, coupled with the out-of-plane vibrations of B and Be atoms, significantly enhance the electron-phonon coupling (λ = 1.42), resulting in a substantially high-Tc of 31.5 K. These findings underscore the potential of metal-doped borophenes as a cutting-edge material platform for achieving high-Tc TSCs.

Serum inflammatory markers in children with Mycoplasma pneumoniae pneumonia and their predictive value for mycoplasma severity.

BACKGROUND: Mycoplasma pneumoniae pneumonia (MPP) significantly impacts pediatric health, necessitating markers for early severe disease identification. AIM: To investigate the correlation between serum inflammatory marker and the severity of MPP in children. METHODS: A prospective study was carried out from January 2023 to November 2023. A total of 160 children with MPP who underwent treatment were selected: 80 had severe MPP and 80 had mild MPP. Clinical and laboratory data were collected at the time of hospital admission and during hospitalization. Receiver operating characteristic curves were utilized to assess the diagnostic and prognostic for severe MPP. RESULTS: Fever duration and length of hospitalization in pediatric patients with severe MPP exceeded those with mild MPP. The incidence of pleural effusion, lung consolidation, and bronchopneumonia on imaging was markedly elevated in the severe MPP cohort compared to the mild MPP cohort. In contrast to the mild cohort, there was a notable increase in C-reactive protein (CRP), procalcitonin (PCT), erythrocyte sedimentation rate, lactic dehydrogenase, D-dimer, and inflammatory cytokines [interleukin (IL)-6, IL-8, IL-10 and tumor necrosis factor (TNF)-α] in the severe MPP group were significantly higher. CONCLUSION: Serum inflammatory markers (CRP, PCT, IL-6, D-dimer, IL-10 and TNF-α) were considered as predictors in children with severe MPP.

A deep learning system for myopia onset prediction and intervention effectiveness evaluation in children.

The increasing prevalence of myopia worldwide presents a significant public health challenge. A key strategy to combat myopia is with early detection and prediction in children as such examination allows for effective intervention using readily accessible imaging technique. To this end, we introduced DeepMyopia, an artificial intelligence (AI)-enabled decision support system to detect and predict myopia onset and facilitate targeted interventions for children at risk using routine retinal fundus images. Based on deep learning architecture, DeepMyopia had been trained and internally validated on a large cohort of retinal fundus images (n = 1,638,315) and then externally tested on datasets from seven sites in China (n = 22,060). Our results demonstrated robustness of DeepMyopia, with AUCs of 0.908, 0.813, and 0.810 for 1-, 2-, and 3-year myopia onset prediction with the internal test set, and AUCs of 0.796, 0.808, and 0.767 with the external test set. DeepMyopia also effectively stratified children into low- and high-risk groups (p < 0.001) in both test sets. In an emulated randomized controlled trial (eRCT) on the Shanghai outdoor cohort (n = 3303) where DeepMyopia showed effectiveness in myopia prevention compared to NonCyc-based model, with an adjusted relative reduction (ARR) of -17.8%, 95% CI: -29.4%, -6.4%. DeepMyopia-assisted interventions attained quality-adjusted life years (QALYs) of 0.75 (95% CI: 0.53, 1.04) per person and avoided blindness years of 13.54 (95% CI: 9.57, 18.83) per 1 million persons compared to natural lifestyle with no active intervention. Our findings demonstrated DeepMyopia as a reliable and efficient AI-based decision support system for intervention guidance for children.

Vonoprazan-amoxicillin dual therapy for Helicobacter pylori eradication in Chinese population: A prospective, multicenter, randomized, two-stage study.

BACKGROUND: The efficacy of Vonoprazan-amoxicillin dual therapy (VAT) in the treatment of Helicobacter pylori (H. pylori) is controversial. AIM: To evaluate the efficacy of VAT in the Chinese population. METHODS: This prospective, multicenter, randomized, open-label, and two-stage study was conducted at 23 centers in Fujian, China (May 2021-April 2022). H. pylori-infected patients were randomized to bismuth quadruple therapy (BQT), BQT-Vonoprazan (BQT-V), seven-day VAT (VAT-7), ten-day VAT (VAT-10), and fourteen-day VAT (VAT-14) groups. The primary endpoint was the H. pylori eradication rate. The secondary endpoint was the frequency of adverse events. This study was registered with the Chinese Clinical Trial Registry, ChiCTR2100045778. RESULTS: In the first stage, VAT-7 and BQT-V groups were selected for early termination because less than 23 among 28 cases were eradicated. In the second stage, the eradication rates for BQT, VAT-10, and VA-14 were 80.2% [95% confidence interval (95%CI): 71.4%-86.8%], 93.2% (86.6%-96.7%), 92.2% (85.3%-96.0%) in the intention-to-treat (ITT) analysis, and 80.9% (95%CI: 71.7%-87.5%), 94.0% (87.5%-97.2%), and 93.9% (87.4%-97.2%) in the per-protocol analysis. The ITT analysis showed a higher eradication rate in the VAT-10 and VAT-14 groups than in the BQT group (P = 0.022 and P = 0.046, respectively). The incidence of adverse events in the VAT-10 and VAT-14 groups was lower than in the BQT group (25.27% and 13.73% vs 37.62%, respectively; P < 0.001). CONCLUSION: VAT with a duration of 10 or 14 days achieves a higher eradication rate than the BQT, with a more tolerable safety profile in H. pylori-infected patients in Fujian.

P T-symmetric photonic lattices with type-II Dirac cones.

The type-II Dirac cone is a special feature of the band structure, whose Fermi level is represented by a pair of crossing lines. It has been demonstrated that such a structure is useful for investigating topological edge solitons and, more specifically, for mimicking the Klein tunneling. However, it is still not clear what the interplay between type-II Dirac cones and the non-Hermiticity mechanism will result in. Here, this question is addressed; in particular, we report the P T-symmetric photonic lattices with type-II Dirac cones for the first time to our knowledge. We identify a slope-exceptional ring and name it the type-II exceptional ring. We display the restoration of the P T symmetry of the lattice by reducing the separation between the sites in the unit cell. Curiously, the amplitude of the beam during propagation in the non-Hermitian lattice with P T symmetry only decays because of diffraction, whereas in the P T symmetry-broken lattice it will be amplified, even though the beam still diffracts. This work establishes the link between the non-Hermiticity mechanism and the violation of Lorentz invariance in these physical systems.

A multicenter, open-label, parallel-group, randomized controlled trial of Tongluo-Qutong rubber plaster for the treatment of cervical spondylotic radiculopathy.

BACKGROUND: In China, Tongluo-Qutong rubber plaster (TQRP) is commonly used for cervical spondylotic radiculopathy, but lacks high-quality trials. OBJECTIVE: This study aimed to conduct a multicenter, open-label, parallel-group, randomized controlled trial in China to investigate the practical efficacy and safety of TQRP in the treatment of CSR. METHODS: A total of 240 patients diagnosed with CSR were recruited for the investigation from multiple hospitals in Gansu province, China. The patients were randomly assigned to either an experimental or a control group. The experimental group received treatment with TQRP, whereas the control group was administered a diclofenac sodium patch (DSP) for a maximum duration of 21 days. The visual analogue scale (VAS) score for pain, the proportion of patients experiencing 50% or more pain relief, the neck disability index (NDI), changes as per the Eaton trial, and recurrence during the follow-up period were evaluated for both groups. The safety and adverse events associated with the concurrent drug therapy were also evaluated. RESULTS: At each time point, the mean VAS and NDI scores of both groups demonstrated a downward trend. The experimental group exhibited a greater decline in VAS score at each time point compared to the control group (P< 0.01). In the Eaton trial, both the percentage of patients experiencing pain relief of 50% or more and the number of abnormal results exhibited improvement. However, the outcomes in the 21 ± 3d experimental group were significantly superior to those in the control group (P< 0.01). During the follow-up period, the recurrence events in the experimental group were reduced compared to the control group. The difference between the two groups was statistically significant (P< 0.05). The incidence of adverse reactions was 1.74% for TQRP and 3.54% for DSP. CONCLUSION: TQRP is effective and safe in the treatment of CSR.

Chromosome-specific painting reveals the Y genome origin and chromosome rearrangements of the St genome in Triticeae.

Karyotypes provide key cytogenetic information on phylogenetic relationships and evolutionary origins in related plant species. The St genome of Pseudoroegneria contributes to eight alloploid genera, representing over half of the species that are highly valuable for wheat (Triticum aestivum) breeding and for understanding Triticeae species evolution. However, St chromosome characterization is challenging due to limited cytogenetic markers and DNA information. We developed a complete set of St genome-specific chromosome painting probes for identification of the individual chromosomes 1St to 7St based on the genome sequences of Pse. libanotica and wheat. We revealed the conservation of St chromosomes in St-containing species by chromosome painting, including Pseudoroegneria, Roegneria, Elymus, and Campeiostachys. Notably, the Y genome showed hybridization signals, albeit weaker than those of the St genome. The awnless species harboring the Y genome exhibited more intense hybridization signals compare to the awned species in Roegneria and Campeiostachys, yet weaker than the hybridization signals of the St genome in autotetraploid Pse. strigosa. Although awnless species were morphologically more similar to each other, phenotypic divergence progressively increased from awnless to awned species. Our results indicate that the Y genome originated from the St genome and shed light on the possible origin of the Roegneria and Campeiostachys species, enhancing our understanding of St-genome-containing species evolution.

Unusual quadruple bonds featuring collective interaction-type σ bonds between first octal-row atoms in the alkaline-earth compounds AeOLi2 (Ae = Be-Ba).

Quantum chemical calculations are reported for the complexes of alkaline earth metals AeOLi2 (Ae = Be-Ba) at the BP86-D3(BJ)/def2-QZVPP and CCSD(T)/def2-QZVPPQZVPP levels. The nature of the Ae-OLi2 bond has been analyzed with a variety of methods. The AeOLi2 molecules exhibit an unprecedented σ donor bond Ae→OLi2 where the (n)s2 lone-pair electrons of the Ae atom are donated to vacant O-Li2 antibonding orbitals having the largest coefficient at lithium. This is a covalent bond where the accumulation of the associated electronic charge is located at two positions above and below the Ae-OLi2 axis. The bifurcated component of orbital interactions is structurally related to the recently proposed collective bonding model, but exhibits a completely different type of bonding. The most stable isomer of AeOLi2 has a C 2v geometry and a singlet (1A1) electronic ground state. The bond dissociation energy (BDE) of the Ae-OLi2 bonds exhibits a zig-zag trend from BeOLi2 to BaOLi2, with BeOLi2 having the largest BDE (D e = 73.0 kcal mol-1) and MgOLi2 possessing the lowest BDE (D e = 42.3 kcal mol-1) at the CCSD(T) level. The calculation of the atomic partial charges by the Hirshfeld and Voronoi methods suggests that Be and Mg carry small negative charges in the lighter molecules whereas the heavier atoms Ca-Ba have small positive charges. In contrast, the NBO and QTAIM methods give positive charges for all Ae atoms that are larger for Ca-Ba than that calculated by the Hirshfeld and Voronoi approaches. The molecules AeOLi2 have large dipole moments where the negative end is at the Ae atom with the polarity Ae→OLi2. The largest dipole moments are predicted for the lighter species BeOLi2 and MgOLi2 and the smallest value is calculated for BaOLi2. The calculation of the vibrational spectra shows a significant red-shift toward lower wave numbers for the Ae-OLi2 stretching mode in comparison to diatomic AeO. Besides the Ae→OLi2 σ-donor bonds there are also three dative bonds due to Ae←OLi2 backdonation which consist of one σ bond and two π bonds. The appearance of strong Ae→OLi2 σ donation leads to quadruple bonds AeOLi2 in all systems AeOLi2, even for the lightest species with Ae = Be, Mg. The valence orbitals of Ca, Sr, and Ba, which are involved in the dative interactions, are the (n)s and (n-1)d AOs whereas Be and Mg use their (n)s and (n)p AOs. The EDA-NOCV results are supported by the AdNDP calculations which give four 2c-2e bonding orbitals. Three bonding orbitals have occupation numbers ∼2. One σ orbital has smaller occupation numbers between 1.32 and 1.73 due to the delocalization to the lithium atoms. The analysis of the electronic structure with the ELF method suggests multicenter bonds with mainly trisynaptic and tetrasynaptic basins, which also support the results of the EDA-NOCV calculations.

Anti-inflammatory Properties of Tongfeng Li'an Granules in an Acute Gouty Arthritis Rat Model.

OBJECTIVES: To examine the anti-inflammatory properties and underlying mechanisms of Tongfeng Li'an Granules (TFLA), a traditional medicine, in acute gouty arthritis using a rat model. MATERIALS AND METHODS: We identified 55 major compounds in TFLA via ultrahigh-performance liquid chromatography connected to quadrupole time-of-flight mass spectrometry (UPLC-TQF-MS/MS). Databases were employed for the prediction of potential targets, followed by PPI network construction as well as GO and KEGG analyses. After network-pharmacology-based analysis, a rat gouty arthritis model was used to validate the anti-inflammatory mechanism of TFLA. RESULTS: UPLC-TQF-MS/MS and network pharmacology analyses revealed 55 active ingredients and 160 targets of TFLA associated with gouty arthritis, forming an ingredient-target-disease network. The PPI network identified 20 core targets, including TLR2, TLR4, IL6, NFκB, etc. Functional enrichment analyses highlighted the Toll-like receptor signaling pathway as significantly enriched by multiple targets, validated in in vivo experiments. Animal experiments demonstrated that TFLA improved pathological changes in gouty joint synovium, with decreased ankle joint circumference, serum IL6, IL10, and TNFα levels, as well as reduced protein and mRNA expression of NLRP3, TLR2, and TLR4 in ankle joint synovial tissue observed in the middle- and high-dose TFLA and positive control groups compared to the model group (p < 0.05). CONCLUSION: This research elucidated the pharmacological mechanisms of TFLA against gouty arthritis, implicating various ingredients, targets, and signaling pathways. Animal experiments confirmed TFLA's efficacy in alleviating inflammation in acute gouty arthritis by modulating Toll-like receptor signaling and NLRP3 expression.

Effects of Fu's subcutaneous needling on clinical efficacy and psychological cognitive characteristics in patients with chronic non-specific low back pain: A randomized controlled trial.

BACKGROUND AND PURPOSE: Low back pain (LBP) is a major global public health problem. Evidence shows that LBP is also related to cognitive, psychological, and lifestyle factors. Fu's subcutaneous needling (FSN) has been used for the treatment of musculoskeletal problems for many years. This prospective randomized controlled trial aimed to evaluate the clinical efficacy and fear avoidance beliefs of FSN in the treatment of patients with chronic non-specific LBP. MATERIAL AND METHODS: Ninety participants with chronic non-specific LBP were randomly divided into the FSN and the traditional acupuncture (TA) groups (n = 45) and received either FSN or TA treatment for three consecutive days from December 2021 to March 2023. The primary outcome was pain intensity measured by the visual analogue scale (VAS). Secondary outcomes were trunk extensor endurance (TEE), lumbar range of motion (ROM), and the Fear Avoidance Beliefs Questionnaire (FABQ). Outcome measurements were made before the first treatment and after each treatment. Follow-up assessments of VAS and FABQ scores were conducted one month after treatment. RESULTS: The FSN group had significantly lower VAS and FABQ scores at each time point after intervention compared to the TA group (P < 0.01). The scores of TEE and lumbar ROM were higher in the FSN group than those in the TA group (P < 0.01). Repeated measures analysis of variance (ANOVA) showed significant time effects, group effects, and interaction effects for VAS, TEE, lumbar ROM, and FABQ in both groups (P < 0.01). One month after treatment, the FSN group had significantly lower VAS and FABQ scores compared to the TA group (P < 0.05). CONCLUSION: This study suggested that FSN was superior to TA in terms of clinical efficacy and fear-avoidance beliefs in the treatment of chronic non-specific LBP. FSN could be used as an effective clinical treatment.

Zero-Intrarenal Pressure Percutaneous Nephrolithotomy for One-Stage Treatment of Non-Acute Infectious Calculous Pyonephrosis: A Strategy to Avert Sepsis.

Purpose: To evaluate the efficacy and safety of a novel zero-intrarenal pressure (IRP) percutaneous nephrolithotomy (PCNL) technique for one-stage treatment of non-acute infectious calculous pyonephrosis. Patients and Methods: This retrospective study analyzed 12 patients (4 males, 8 females; mean age 56.4 years) who underwent zero-IRP PCNL. The technique utilized a double-sheath vacuum suction system, with the outer sheath allowing for gravity irrigation and the inner sheath facilitating continuous suction. Keeping the height of gravity perfusion at the level of the kidney inherently prevented high IRP and achieved zero-IRP PCNL, even when stone fragments obstructed the suction channel. Results: The procedure demonstrated a high initial stone-free rate of 75%, improving to 91.7% after 1 month. The average operative time was 50.7 minutes. The mean hemoglobin drop was 6.1 g/L, managed without transfusions. Complications were minimal, with low-grade fever in two patients. No significant intraoperative or postoperative complications, such as sepsis, were noted. Conclusions: The zero-IRP PCNL technique, characterized by its double-sheath vacuum suction system and zero-pressure gravity perfusion, shows promise in safely and effectively managing non-acute infectious calculous pyonephrosis. Preliminary results are encouraging, but further research with larger sample sizes is essential for broader clinical validation.

The Impact of Stigma on Self-Management Behavior Among People with HIV in China: The Role of Social Support and Self-Esteem.

Understanding the psychosocial factors influencing self-management behaviors among people with HIV (PWH) is crucial for effective medical interventions and improving their quality of life. However, there has been limited research exploring the psychosocial mechanisms influencing self-management behaviors among PWH in China. Our study examined the relationship between stigma, social support, self-esteem, and self-management behaviors among PWH, as well as whether social support and self-esteem mediate these relationships. Cross-sectional data were collected from 282 PWH in Sichuan Province, China. Data were collected using four validated self-report measures (HIV Stigma Scale, HIV/AIDS Patient Self-Management Scale, Social Support Rating Scale, and Self-Esteem Scale). Structural equation modeling was used to examine the different pathways influencing self-management behaviors. All the impacts on self-management behavior outcomes were found to be significant. The final mediation model indicated that social support and self-esteem significantly mediated the relationship between stigma and self-management behaviors. These findings underscore the importance of addressing stigma and enhancing social support and self-esteem in interventions aimed at promoting self-management behaviors among PWH.