Landscape genomics reveals adaptive genetic differentiation driven by multiple environmental variables in naked barley on the Qinghai-Tibetan Plateau

Understanding the local adaptation of crops has long been a concern of evolutionary biologists and molecular ecologists. Identifying the adaptive genetic variability in the genome is crucial not only to provide insights into the genetic mechanism of local adaptation but also to explore the adaptation potential of crops. This study aimed to identify the climatic drivers of naked barley landraces and putative adaptive loci driving local adaptation on the Qinghai-Tibetan Plateau (QTP). To this end, a total of 157 diverse naked barley accessions were genotyped using the genotyping-by-sequencing approach, which yielded 3123 high-quality SNPs for population structure analysis and partial redundancy analysis, and 37,636 SNPs for outlier analysis. The population structure analysis indicated that naked barley landraces could be divided into four groups. We found that the genomic diversity of naked barley landraces could be partly traced back to the geographical and environmental diversity of the landscape. In total, 136 signatures associated with temperature, precipitation, and ultraviolet radiation were identified, of which 13 had pleiotropic effects. We mapped 447 genes, including a known gene HvSs1. Some genes involved in cold stress and regulation of flowering time were detected near eight signatures. Taken together, these results highlight the existence of putative adaptive loci in naked barley on QTP and thus improve our current understanding of the genetic basis of local adaptation.

Healthy Human Fecal Microbiota Transplantation into Mice Attenuates MPTP-Induced Neurotoxicity via AMPK/SOD2 Pathway

Increasing evidence has shown that gut dysbacteriosis may play a crucial role in neuroinflammation in Parkinson's disease (PD). However, the specific mechanisms that link gut microbiota to PD remain unexplored. Given the critical roles of blood-brain barrier (BBB) dysfunction and mitochondrial dysfunction in the development of PD, we aimed to evaluate the interactions among the gut microbiota, BBB, and mitochondrial resistance to oxidation and inflammation in PD. We investigated the effects of fecal microbiota transplantation (FMT) on the physiopathology of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated mice. The aim was to explore the role of fecal microbiota from PD patients and healthy human controls in neuroinflammation, BBB components, and mitochondrial antioxidative capacity via the AMPK/SOD2 pathway. Compared to control mice, MPTP-treated mice exhibited elevated levels of Desulfovibrio, whereas mice given FMT from PD patients exhibited enriched levels of Akkermansia and mice given FMT from healthy humans showed no significant alterations in gut microbiota. Strikingly, FMT from PD patients to MPTP-treated mice significantly aggravated motor impairments, dopaminergic neurodegeneration, nigrostriatal glial activation and colonic inflammation, and inhibited the AMPK/SOD2 signaling pathway. However, FMT from healthy human controls greatly improved the aforementioned MPTP-caused effects. Surprisingly, the MPTP-treated mice displayed a significant loss in nigrostriatal pericytes, which was restored by FMT from healthy human controls. Our findings demonstrate that FMT from healthy human controls can correct gut dysbacteriosis and ameliorate neurodegeneration in the MPTP-induced PD mouse model by suppressing microgliosis and astrogliosis, ameliorating mitochondrial impairments via the AMPK/SOD2 pathway, and restoring the loss of nigrostriatal pericytes and BBB integrity. These findings raise the possibility that the alteration in the human gut microbiota may be a risk factor for PD and provide evidence for potential application of FMT in PD preclinical treatment.

Research on rheological behavior of fresh concrete single-cylinder pumping based on SPH-DEM

In contrast to traditional approaches to simulating fresh concrete, the model applied here allows issues such as liquid phase and the motion of sub-scale particles to be considered. The rheological behavior of fresh concrete materials was investigated, and the slump test and pumping process of fresh concrete were simulated by combining the smooth particle hydrodynamics coupled with discrete element method. Based on Bi-viscosity model and Bingham model, linear and nonlinear fitting of rheometer data and the derivation equations were educing. Bi-viscosity model and the Bingham model were compared in slump test. The results show that the Bi-viscosity model is more accurate in simulation, and the error percentage is less than 10%. The Bi-viscosity model was used to simulate and predict the results of slump experiment, and the influence of rheological parameters on the slump velocity and shape was obtained. The simulation analysis model of concrete single-cylinder pumping is established, and the experimental and simulation analysis models are compared. The results show that the SPH-DEM pumping pressure prediction is very close to the experimental results.

Prognostic value of the fibrinogen albumin ratio index (FARI) in nasopharyngeal carcinoma patients undergoing radiotherapy

There is mounting evidence that malnutrition and systemic inflammation status are involved in the prognosis of various cancers. In this study, we aimed to evaluate the prognostic value of the pretreatment fibrinogen-albumin ratio index (FARI) in nasopharyngeal carcinoma (NPC) patients receiving definite radiotherapy. NPC patients who received definite radiotherapy between January 2013 and December 2019 were included. A receiver operating characteristic (ROC) curve was used to determine the optimal cutoff value. The clinicopathological characteristics of the patients were compared via the Chi-square test. Survival curves were analyzed by the Kaplan‒Meier method. The prognostic factors were evaluated by univariate and multivariate analyses via Cox hazards regression analysis. A total of 225 patients were enrolled, and the median follow-up time was 48.5 months. High FARI was correlated with worse ECOG score (p = 0.003), higher EBV-DNA titer (p = 0.047), and more advanced clinical stage (p < 0.001). In the multivariable analysis, FARI independently predicted OS (HR 2.399, 95% CI 1.294-4.450, P < 0.001), PFS (HR 2.085, 95% CI 1.200-3.625, P = 0.009), and DMFS (HR 2.527, 95% CI 1.288-4.958, P < 0.001). The current findings suggest that a high pretreatment FARI is an independent predictor of OS, PFS and DMFS in NPC patients undergoing definite radiotherapy.

Pressure-controlled ventilation-volume guaranteed mode improves bronchial mucus transport velocity in patients during laparoscopic surgery for gynecological oncology: a randomized controlled study

BACKGROUND

Mechanical ventilation during general anesthesia may impair airway mucosal function. This study aimed to investigate the effect of pressure-controlled ventilation-volume guaranteed (PCV-VG) on bronchial mucus transport velocity (BTV) in patients during laparoscopic surgery for gynecological oncology compared with volume controlled ventilation (VCV).

METHODS

66 patients undergoing elective a laparoscopic surgery for gynecological oncology. The patients were randomized into two group receiving either PCV-VG or VCV. a drop of methylene blue was placed on the surface of the airway mucosa under the bronchoscopeand, then the distance the dye movement was measured after 2, 4, and 6 min. Outcomes were assessed at T0 (5 min after endotracheal intubation and before initiation of pneumoperitoneum), T1 and T2 (1 and 2 h after stabilization of pneumoperitoneum respectively). BTV at T0, T1 and T2 was the primary outcome. Secondary outcomes included heart rate (HR), mean arterial pressure (MAP), body temperature, end-tidal CO2 pressure (PETCO2), tidal volume(VT), peak inspiratory pressure (PIP), mean inspiratory pressure (Pmean), respiratory rate (RR), and dynamic compliance (CDyn) at T0, T1, and T2.

RESULTS

64 patients were included in the analysis. The median [interquartile range] BTV was significantly lower in VCV group at T1 and T2 that at T0 (P < 0.05). Furthermore, BTV was slightly reduced in PCV-VG compared with VCV. BTV in PCV-VG was significantly decreased at T2 compared with BTV at T0 (P < 0.05) and slightly decreased at T1 compared with T0(P > 0.05). Compared with the PCV-VG group, BTV in VCV group significantly decreased at T2 (P < 0.05). No participants experienced respiratory complications.

CONCLUSIONS

PCV-VG is more suitable for patients undergoing laparoscopic surgery for gynecological oncology than VCV since it can protect mucociliary clearance function.

TRIAL REGISTRATION

This trial is registered on https://www.chictr.org.cn/ in Chinese Clinical Trial Registry (ChiCTR.2200064564: Date of registration 11/10/2022).

Antibody-Mediated Nanodrug of Proteasome Inhibitor Carfilzomib Boosts the Treatment of Multiple Myeloma

Multiple myeloma (MM) is the second most common hematological malignancy. For relapsed and refractory MM, a proteasome inhibitor, carfilzomib (CFZ), has become one of the few clinical options. CFZ suffers, nevertheless, metabolic instability and poor bioavailability and may induce severe cardiovascular and renal adverse events. Here, we report that daratumumab (Dar)-decorated polypeptide micelles (Dar-PMs) mediate the targeted delivery of CFZ to CD38-positive MM, effectively boosting its anti-MM efficacy. CFZ-loaded Dar-PMs (Dar-PMs-CFZ) exhibited an average diameter of ca. 80 nm and Dar density-dependent cell endocytosis and anti-MM activity, in which over 6-fold greater inhibitory effect to LP-1 and MM.1S MM cells than nontargeted PMs-CFZ control was achieved at a Dar density of 3.2 (Dar3.2-PMs-CFZ). Interestingly, Dar3.2-PMs-CFZ markedly enhanced the growth inhibition of orthotopic LP-1 MM in mice and significantly extended the median survival time compared with PMs-CFZ and free CFZ (95 days vs 60 and 54 days, respectively). In line with its high MM targetability and anti-MM efficacy, Dar3.2-PMs-CFZ revealed little toxic effects and effectively prevented osteolytic lesions. The antibody-targeted nanodelivery of a proteasome inhibitor appears to be an appealing strategy to treat multiple myeloma.

Causal effect of gut-microbiota-derived metabolite trimethylamine N-oxide on Parkinson's disease: A Mendelian randomization study

BACKGROUND AND PURPOSE

It has been suggested that trimethylamine N-oxide (TMAO) is related to Parkinson's disease (PD) in observational studies. However, the direction of this association is inconsistent. An exploratory Mendelian randomization study was conducted to investigate whether TMAO and its precursors have a causal relationship with PD.

METHODS

Summary statistics were obtained for single nucleotide polymorphisms related to circulating levels of TMAO, betaine, carnitine and choline, and the corresponding data for the risk, age at onset and progression of PD from genome-wide association studies. Inverse-variance weighting was used as the primary method for effect estimation. The false discovery rate was applied to the correction of multiple testing. A p value of association <0.05 but above the false discovery rate corrected threshold was deemed suggestive evidence of a possible association. A range of robust Mendelian randomization methods were used for sensitivity analysis.

RESULTS

Suggestive evidence was observed of an inverse causal effect of TMAO on motor fluctuations (odds ratio [OR] 0.851, 95% confidence interval [CI] 0.731, 0.990, p = 0.037) and carnitine on insomnia (OR 0.817, 95% CI 0.700, 0.954, p = 0.010) and a positive causal effect of betaine on Hoehn-Yahr stage (OR 1.397, 95% CI 1.112, 1.756, p = 0.004), Unified Parkinson's Disease Rating Scale (UPDRS) III score (β = 0.138, 95% CI 0.051, 0.225, p = 0.002), motor fluctuations (OR 1.236, 95% CI 1.011, 1.511, p = 0.039), and choline on UPDRS IV (β = 0.106, 95% CI 0.026, 0.185, p = 0.009) and modified Schwab and England Activities of Daily Living Scale score (β = 0.806, 95% CI 0.127, 1.484, p = 0.020).

CONCLUSIONS

Our findings provide suggestive evidence that TMAO and its precursors have a causal effect on the progression of PD. Further investigation of the underlying mechanisms is required.

Data-Driven Practical Cooperative Output Regulation Under Actuator Faults and DoS Attacks

This article addresses the resilient practical cooperative output regulation problem (RPCORP) for multiagent systems subjected to both denial-of-service (DoS) attacks and actuator faults. Fundamentally different from the existing solutions to RPCORPs, the system parameters considered in this article are unknown to each agent, and a novel data-driven control approach is introduced to handle such an issue. The solution starts with developing resilient distributed observers for each follower in the presence of DoS attacks. Then, a resilient communication mechanism and a time-varying sampling period are introduced to, respectively, ensure the neighbor state is available as soon as attacks disappear and to avoid targeted attacks launched by intelligent attackers. Furthermore, a model-based fault-tolerant and resilient controller is designed based on the Lyapunov approach and the output regulation theory. In order to remove the reliance on system parameters, we leverage a new data-driven algorithm to learn controller parameters via the collected data. Rigorous analysis shows that the closed-loop system can resiliently achieve practical cooperative output regulation. Finally, a simulation example is given to illustrate the effectiveness of the achieved results.

A Gene Set-Integrated Approach for Predicting Disease-Associated Genes

It is important to identify disease-associated genes for studying the pathogenic mechanism of complex diseases. Recently, models for disease gene prediction are dominantly based on molecular expression data and networks, including gene expression, protein expression, co-expression networks, protein-protein interaction networks, etc. One limitation of these methods is that they do not consider the knowledge of annotated gene sets representing known pathways or functionally-related sets of genes. In this study, we propose a new approach to predict disease-associated genes by integrating annotated gene sets data from the Molecular Signature Database (MSigDB). It first represents and integrates the different types of annotated gene sets in the MSigDB database in the form of the signal matrix. It then uses the signal matrix as the gene feature to train the disease gene prediction model. We compare our method with existing methods in predicting genes for five complex diseases. The results show that our method is superior to other methods. Further, we perform a case study on autism spectrum disorder (ASD). We find that ASD predictions are associated with ASD based on the statistical analysis of biological networks and independent ASD studies. The source code, prediction results and datasets are publicly available on https://github.com/genemine/GSI.git.

Synthesis Strategies, Optical Mechanisms, and Applications of Dual-Emissive Carbon Dots

Tuning the optical properties of carbon dots (CDs) and figuring out the mechanisms underneath the emissive phenomena have been one of the most cutting-edge topics in the development of carbon-based nanomaterials. Dual-emissive CDs possess the intrinsic dual-emission character upon single-wavelength excitation, which significantly benefits their multi-purpose applications. Explosive exploitations of dual-emissive CDs have been reported during the past five years. Nevertheless, there is a lack of a systematic summary of the rising star nanomaterial. In this review, we summarize the synthesis strategies and optical mechanisms of the dual-emissive CDs. The applications in the areas of biosensing, bioimaging, as well as photoelectronic devices are also outlined. The last section presents the main challenges and perspectives in further promoting the development of dual-emissive CDs. By covering the most vital publications, we anticipate that the review is of referential significance for researchers in the synthesis, characterization, and application of dual-emissive CDs.

Leveraging Generative AI and Large Language Models: A Comprehensive Roadmap for Healthcare Integration

Generative artificial intelligence (AI) and large language models (LLMs), exemplified by ChatGPT, are promising for revolutionizing data and information management in healthcare and medicine. However, there is scant literature guiding their integration for non-AI professionals. This study conducts a scoping literature review to address the critical need for guidance on integrating generative AI and LLMs into healthcare and medical practices. It elucidates the distinct mechanisms underpinning these technologies, such as Reinforcement Learning from Human Feedback (RLFH), including few-shot learning and chain-of-thought reasoning, which differentiates them from traditional, rule-based AI systems. It requires an inclusive, collaborative co-design process that engages all pertinent stakeholders, including clinicians and consumers, to achieve these benefits. Although global research is examining both opportunities and challenges, including ethical and legal dimensions, LLMs offer promising advancements in healthcare by enhancing data management, information retrieval, and decision-making processes. Continued innovation in data acquisition, model fine-tuning, prompt strategy development, evaluation, and system implementation is imperative for realizing the full potential of these technologies. Organizations should proactively engage with these technologies to improve healthcare quality, safety, and efficiency, adhering to ethical and legal guidelines for responsible application.

Sn-doped PdCu alloy nanosheet assemblies as an efficient electrocatalyst for formic acid oxidation

A ternary alloy catalyst has been confirmed to be an effective catalyst for anode catalysis in direct formic acid fuel cells, which can improve the electrocatalytic performance of the fuel cell by introducing commonly used metal elements to change the Pd electronic structure and can reduce the use of precious metals and the cost of catalyst production. In this study, PdCuSn Ns/C with a special 3D structure was synthesized by a simple two-step wet chemical method. The PdCuSn Ns/C catalyst prepared exhibits excellent catalytic activity and stability for the formic acid oxidation reaction (FAOR). The mass activity of 2420.1 mA mg-1Pd is 3.94 times that of the Pd/C catalyst. The improvement in the electrocatalytic performance stems from the introduction of Cu and Sn atoms and the unique 3D nanosheet structure, which changes the electronic structure of Pd to increase the reactive active site and accelerates the reaction mass transfer rate, and also reduces the content of precious metals, while improving the electrocatalytic performance. Therefore, the PdCuSn Ns/C catalyst has a promising future in the field of electrocatalysis.

Study on Porosity of Thermal-Sprayed Commercially Pure Aluminum Coating

Porosity is closely related to the corrosion and wear properties of a coating processed by thermal-spraying technology, and the quantitative characterization of porosity is a crucial part of the research on coating structures. The current image analysis method often uses the mechanical polishing method recommended by ISO to measure a coating porosity. This method has been proved to be an effective method for the characterization of oxide coatings. However, due to the significant differences in the physical and chemical properties between aluminum and oxides, this method may not be suitable for aluminum coatings, and a more appropriate approach needs to be explored. In this paper, the effects of three polishing technologies (mechanical polishing, argon-ion-beam polishing, and electrolytic polishing) on the porosity measurement of pure aluminum coatings were compared and studied. The research results showed that the commonly used mechanical polishing method and more advanced argon-ion-beam polishing method could not completely reveal the pore structure because SiC particles would be embedded in the pure aluminum coatings during mechanical polishing, filling large pores. Although electrolytic polishing technology had advantages in revealing the macroporous structure, it would introduce a microporous structure and oxides, which would affect the measurement of the coating porosity. The composite polishing technology (electrolytic polishing + argon-ion-beam polishing) could perfectly reveal the pore structure in the pure-aluminum coating, and the porosity of arc-sprayed aluminum coating was 9.9%, which was close to the macroscopic true value measured using the weighing method of 10.2%.

Pan-cancer analysis of NFE2L2 mutations identifies a subset of lung cancers with distinct genomic and improved immunotherapy outcomes

BACKGROUND

Mutations in the KEAP1-NFE2L2 signaling pathway were linked to increased tumorigenesis and aggressiveness. Interestingly, not all hotspot mutations on NFE2L2 were damaging; some even were activating. However, there was conflicting evidence about the association between NFE2L2 mutation and Nrf2-activating mutation and responsiveness to immune checkpoint inhibitors (ICIs) in non-small cell lung cancer (NSCLC) and other multiple cancers.

METHODS

The study with the largest sample size (n = 49,533) explored the landscape of NFE2L2 mutations and their impact response/resistance to ICIs using public cohorts. In addition, the in-house WXPH cohort was used to validate the efficacy of immunotherapy in the NFE2L2 mutated patients with NSCLC.

RESULTS

In two pan-cancer cohorts, Nrf2-activating mutation was associated with higher TMB value compared to wild-type. We identified a significant association between Nrf2-activating mutation and shorter overall survival in pan-cancer patients and NSCLC patients but not in those undergoing ICIs treatment. Similar findings were obtained in cancer patients carrying the NFE2L2 mutation. Furthermore, in NSCLC and other cancer cohorts, patients with NFE2L2 mutation demonstrated more objective responses to ICIs than patients with wild type. Our in-house WXPH cohort further confirmed the efficacy of immunotherapy in the NFE2L2 mutated patients with NSCLC. Lastly, decreased inflammatory signaling pathways and immune-depleted immunological microenvironments were enriched in Nrf2-activating mutation patients with NSCLC.

CONCLUSIONS

Our study found that patients with Nrf2-activating mutation had improved immunotherapy outcomes than patients with wild type in NSCLC and other tumor cohorts, implying that Nrf2-activating mutation defined a distinct subset of pan-cancers and might have implications as a biomarker for guiding ICI treatment, especially NSCLC.

Association between uric acid and risk of venous thromboembolism in East Asian populations: a cohort and Mendelian randomization study

Background

Serum uric acid (SUA) levels have been associated with an increased risk and recurrence of venous thromboembolism (VTE) in European populations, but the potential causal relationship remains unclear. Large-scale studies on the association between SUA and VTE in East Asian populations are lacking, despite the high prevalence of hyperuricemia in this region. To address this, we conducted a cohort analysis and a two-sample Mendelian randomization (MR) study in East Asian populations.

Methods

We collected data on VTE patients from the China Pulmonary Thromboembolism Registry Study (CURES) and compared them to controls obtained from the China Health and Retirement Longitudinal Survey (CHARLS). Propensity score matching (PSM) and cubic-spline models were applied to assess the effect of SUA on VTE risk while adjusting for multiple covariates. We also performed two-sample MR analyses to infer potential causality based on summary statistics from Genome-wide Association Studies (GWAS) of SUA and VTE in the East Asian population.

Findings

We found that the SUA levels were higher in VTE patients (317.95 mmol/L) compared to the general population (295.75 mmol/L), and SUA ≥ 325 mmol/L was associated with an increased risk of VTE recurrence (P-value = 0.0001). The univariable MR suggested a causal relationship between elevated SUA and higher VTE risk (Pinverse variance weighted < 0.05), and multivariable MR showed that elevated SUA levels continued to promote the development of VTE after adjusting for multiple covariates (Pmultivariable residual < 0.05). Sensitivity analyses produced similar results for these estimations.

Interpretation

Our study provides evidence supporting a robust positive association between SUA and VTE in the East Asian population, and MR analyses suggest that this association is likely to be causal. Our findings underscore the importance of monitoring SUA levels in VTE prevention and call for urgent action to address the growing burden of hyperuricemia in the Asia-Pacific region.

Funding

This research was funded by Beijing Nova Program (No. Z211100002121057), National Natural Science Foundation of China (No. 82100065 and No. 62350004), CAMS Innovation Fund for Medical Sciences (No. 2021-I2M-1-061 and No. 2021-1-I2M-001), Elite Medical Professionals project of China-Japan Friendship Hospital (No. ZRJY2021-QM12), National Key Research and Development Project (No. 2021YFF1201200 and No. 2022YFC3341004).

One-Pot Synthesis of Ultra-Small Pt Nanoparticles-Loaded Nitrogen-Doped Mesoporous Carbon Nanotube for Efficient Catalytic Reaction

In this study, Pt nanoparticles-loaded nitrogen-doped mesoporous carbon nanotube (Pt/NMCT) was successfully synthesized through a polydopamine-mediated "one-pot" co-deposition strategy. The Pt source was introduced during the co-deposition of polydopamine and silica on the surface of SiO2 nanowire (SiO2 NW), and Pt atoms were fixed in the skeleton by the chelation of polydopamine. Thus, in the subsequent calcination process in nitrogen atmosphere, the growth and agglomeration of Pt nanoparticles were effectively restricted, achieving the in situ loading of uniformly dispersed, ultra-small (~2 nm) Pt nanoparticles. The method is mild, convenient, and does not require additional surfactants, reducing agents, or stabilizers. At the same time, the use of the dual silica templates (SiO2 NW and the co-deposited silica nanoclusters) brought about a hierarchical pore structure with a high specific surface area (620 m2 g-1) and a large pore volume (1.46 cm3 g-1). The loading process of Pt was studied by analyzing the electron microscope and X-ray photoelectron spectroscopy of the intermediate products. The catalytic performance of Pt/NMCT was investigated in the reduction of 4-nitrophenol. The Pt/NMCT with a hierarchical pore structure had an apparent reaction rate constant of 0.184 min-1, significantly higher than that of the sample, without the removal of the silica templates to generate the hierarchical porosity (0.017 min-1). This work provides an outstanding contribution to the design of supported noble metal catalysts and also highlights the importance of the hierarchical pore structure for catalytic activity.

Hypoxic mesenchymal stem cell-derived exosomes promote the survival of skin flaps after ischaemia-reperfusion injury via mTOR/ULK1/FUNDC1 pathways

Flap necrosis, the most prevalent postoperative complication of reconstructive surgery, is significantly associated with ischaemia-reperfusion injury. Recent research indicates that exosomes derived from bone marrow mesenchymal stem cells (BMSCs) hold potential therapeutic applications in several diseases. Traditionally, BMSCs are cultured under normoxic conditions, a setting that diverges from their physiological hypoxic environment in vivo. Consequently, we propose a method involving the hypoxic preconditioning of BMSCs, aimed at exploring the function and the specific mechanisms of their exosomes in ischaemia-reperfusion skin flaps. This study constructed a 3 × 6 cm2 caudal superficial epigastric skin flap model and subjected it to ischaemic conditions for 6 h. Our findings reveal that exosomes from hypoxia-pretreated BMSCs significantly promoted flap survival, decrease MCP-1, IL-1β, and IL-6 levels in ischaemia-reperfusion injured flap, and reduce oxidative stress injury and apoptosis. Moreover, results indicated that Hypo-Exo provides protection to vascular endothelial cells from ischaemia-reperfusion injury both in vivo and in vitro. Through high-throughput sequencing and bioinformatics analysis, we further compared the differential miRNA expression profiles between Hypo-Exo and normoxic exosomes. Results display the enrichment of several pathways, including autophagy and mTOR. We have also elucidated a mechanism wherein Hypo-Exo promotes the survival of ischaemia-reperfusion injured flaps. This mechanism involves carrying large amounts of miR-421-3p, which target and regulate mTOR, thereby upregulating the expression of phosphorylated ULK1 and FUNDC1, and subsequently further activating autophagy. In summary, hypoxic preconditioning constitutes an effective and promising method for optimizing the therapeutic effects of BMSC-derived exosomes in the treatment of flap ischaemia-reperfusion injury.

Exploring the Effect of Pain Sensitive Questionnaire on Guiding Intravenous Analgesia After Cesarean Section: A Randomised Double Blind Controlled Trial

Objective

This study investigates the effect of the Pain Sensitivity Questionnaire (PSQ) in guiding patient controlled intravenous analgesia (PCIA) on postoperative analgesia in women undergoing cesarean section.

Methods

A total of 160 women who were to undergo a cesarean section under combined spinal and epidural anaesthesia were included in this study. Women with a preoperative PSQ <4 were randomly divided into a low pain-sensitive control group (LC group), and a low pain-sensitive observation group (LO group), and women with preoperative PSQ >6 were randomly divided into a high pain-sensitive control group (HC group) and a high pain-sensitive observation group (HO group). After the surgery, patients received the pump butorphanol concentration was 3.5 µg·kg-1·h-1 in the LC and HC groups, 3.0 µg·kg-1·h-1 in the LO group and 4.0 µg·kg-1·h-1 in the HO group.To compare the analgesic effects of postoperative PCIA and postoperative recovery in women.

Results

Wound pain and uterine contraction pain VAS scores at rest and activity were significantly lower in the LC group than in the LO group at 4 and 8 h postoperatively (P<0.05). Similarly, wound pain and uterine contraction pain VAS scores at rest and activity were significantly lower in the HO group than in the HC group at 8, 12, and 24 h postoperatively (P<0.05). The Ramsay scores were significantly higher in the LC than in the LO groups at 4, 8, 12, 24, and 48 h postoperatively (P<0.05), but there was no statistically significant difference between the Ramsay scores in the HC group and the HO group. There was no statistical difference in any of the post-operative recoveries (P>0.05).

Conclusion

Compared to the weight-based postoperative PCIA, the PSQ-based postoperative PCIA has better analgesic effects and can improve maternal satisfaction with postoperative analgesia.

[Application of the Chinese Expert Consensus on Diabetes Classification in clinical practice]

Objective: To evaluate the diagnostic for classification of newly diagnosed diabetes patients and assess the application of the screening tests recommended by the 2022 Chinese Expert Consensus on Diabetes Classification. Methods: Retrospective case series study. The data from the electronic medical record system of patients with new-onset diabetes mellitus (within 1 year of disease onset) who attending the Diabetes Specialist Outpatient Clinic at the Second Xiangya Hospital of Central South University from January 1, 2018 to December 31, 2021 were collected for the analysis. Based on the consensus, patients were categorized according their age of onset, body mass index (BMI), and suspicion of type 1 diabetes mellitus (T1DM). The chi-square statistic was used to compare key classifier indicators, including C-peptide, islet autoantibodies, and genetic markers, in the subgroups. The diagnosis in suspected T1DM patients was also evaluated. The screening strategy recommended in the consensus was further assessed using a logistic regression model and the area under the receiver-operating curve (AUC). Results: A total of 3 384 patients with new-onset diabetes were included. The average age of disease onset was (46.3±13.9) years, and 61.0% (2 065/3 384) of the patients were male. The proportions of patients who completed C-peptide and glutamic acid decarboxylase antibody (GADA) tests were 36.6% (1 238/3 384) and 37.5% (1 269/3 384), respectively. There were no significant differences in C-peptide test results among the subgroups (all P>0.05). In contrast, the GADA detection rate was higher in patients with young age of onset (<30 years old), in those who were non-obese (BMI<24 kg/m2), and in those clinically suspected of T1DM (all P<0.05). According to the diagnostic pathway proposed by the consensus, only 57.4% (1 941/3 384) of patients could be subtyped. For a definitive diagnosis, the remaining patients needed completion of C-peptide, islet autoantibody, genetic testing, or follow-up. Furthermore, among patients with clinical features of suspected T1DM, the antibody positivity rate was higher than in non-suspected T1DM patients [24.5% (154/628) vs. 7.1% (46/646), P<0.001]. When the clinical features of suspected T1DM defined in the consensus were taken as independent variables and antibody positivity was considered the outcome variable in the logistic regression model, young onset, non-obese onset, and ketosis onset could enter the model. Based on AUC analysis, the accuracy of the diagnostic model was 0.77 (95%CI 0.73-0.81), suggesting that the clinical features of suspected T1DM in the consensus have good clinical diagnostic value for this patient subgroup. Conclusions: There was a significant discrepancy between the clinical practice of diabetes classification and the process recommended by the consensus, which was specifically reflected in the low proportions of both subtyping indicator testing and definitively subtyped diabetes patients. Attention should be pay to the classification diagnosis process proposed in the consensus and the clinical detection rate of key diabetes subtyping indicators such as C-peptide and islet autoantibodies for diabetes classification should be improved. Noteworthy, the screening strategy for T1DM proposed by the consensus showed good clinical application value.

Effects of grape seed procyanidins on antioxidant function, barrier function, microbial community, and metabolites of cecum in geese

The gut is the first line of defense for body health and is essential to the overall health of geese. Grape seed procyanidins (GSPs) are proverbial for their antioxidant, anti-inflammatory, and microflora-regulating capabilities. This study aimed to inquire into the influences of dietary GSPs on the intestinal antioxidant function, barrier function, microflora, and metabolites of geese based on 16S rRNA sequencing and metabolomics. In total, 240 twenty-one-day-old Sichuan white geese were randomly divided into 4 groups, each of which was supplied with 1 of 4 diets: basal diet or a basal diet supplemented with 50, 100, or 150 mg/kg GSPs. Diets supplemented with GSPs at different concentrations significantly increased the total antioxidant capacity and superoxide dismutase activity in cecal mucosa (P < 0.001). Dietary supplementation with 50 or 100 mg/kg GSPs significantly increased catalase activity (P < 0.001). The serum diamine oxidase, D-lactic acid, and endotoxin concentrations were decreased by GSP supplementation in the goose diet. Dietary GSP supplementation increased microbial richness and diversity, enhanced the relative abundance of Firmicutes, and decreased that of Bacteroidetes in the cecum. Diets supplemented with 50 or 100 mg/kg GSPs enriched Eubacterium coprostanoligenes and Faecalibacterium. Dietary GSPs substantially raised the acetic and propionic acid concentrations in the cecum. The butyric acid concentration increased when the GSP dosage was 50 or 100 mg/kg. Additionally, dietary GSPs increased the levels of metabolites that belong to lipids and lipid-like molecules or organic acids and derivatives. Dietary GSP supplementation at 100 or 150 mg/kg reduced the levels of spermine (a source of cytotoxic metabolites) and N-acetylputrescine, which promotes in-vivo inflammation. In conclusion, dietary supplementation with GSPs was beneficial to gut health in geese. Dietary GSPs improved antioxidant activity; protected intestinal barrier integrity; increased the abundance and diversity of cecal microflora; promoted the proliferation of some beneficial bacteria; increased the production of acetic, propionic, and butyric acids in the cecum; and downregulated metabolites associated with cytotoxicity and inflammation. These results offer a strategy for promoting intestinal health in farmed geese.

Model-Free Adaptive Resilient Control for Nonlinear CPSs With Aperiodic Jamming Attacks

The problem of the model-free adaptive resilient control (MFARC) for nonlinear cyber-physical systems (CPSs) suffered from aperiodic jamming attacks is investigated in this article. First, the MFARC framework subject to aperiodic jamming attacks is established, and an intermediate variable method is introduced to avoid using the unavailable time-varying parameter and further eliminate an extra assumption on the sign limit of it. Then, a MFARC scheme is devised to track the desired output, where the problem of the tracking control can be transformed into solving a feasibility problem, and the controller parameters can be obtained with the aid of the linear matrix inequality technique. What is more, a novel attack compensation mechanism is developed in the MFARC scheme to mitigate the impact of aperiodic jamming attacks. In the last, an example is provided to verify the effectiveness of the devised MFARC scheme.