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Heart rate turbulence (HRT), a test quantified by turbulence onset (TO) and turbulence slope (TS), has been used to assess cardiac autonomic neuropathy (CAN). CAN is a complication of chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM). Thus, this study aimed to assess the association between HRT parameters and CKD in T2DM patients. This retrospective study included 322 patients with T2DM, grouping them into those with and those without CKD; the data collected from the patients with T2DM were analysed. T2DM was diagnosed according to American Diabetes Association criteria. CKD diagnoses were confirmed according to KDIGO Clinical Practice Guidelines. For HRT parameters, T2DM patients with CKD exhibited a significantly higher turbulence onset (TO) (-0.25 [-1.02, 0.23] vs -0.64 [-1.93 0.10], p = 0.034) and lower turbulence slope (TS) (2.49 [1.27, 4.00] vs 6.20 [2.55, 8.80], p < 0.001) than those without CKD. TO was significantly negatively correlated with estimated glomerular filtration rate (eGFR) (r = -0.184, P = 0.001), whereas TS was significantly positively correlated with eGFR in patients with T2DM (r = 0.203, P < 0.001). Multivariable logistic regression analysis revealed that higher TS, but not for TO, was independently associated with CKD in patients with T2DM(OR=0.885, 95%CI:0.8400.932, P < 0.001). Higher TS, an HRT parameter reflecting heart rate deceleration following ventricular premature beat, was independently associated with CKD in T2DM patients. This study suggests that CKD may change heart rate deceleration following ventricular premature beat in T2DM patients, which may be helpful in improving CAN assessment by HRT in patients with CKD.

The design of new hemostatic materials to mitigate uncontrolled bleeding in emergencies is challenging. Chitosan-based hemostatic hydrogels have frequently been used for hemostasis due to their unique biocompatibility, tunable mechanical properties, injectability, and ease of handling. Moreover, chitosan (CS) absorbs red blood cells and activates platelets to promote hemostasis. Benefiting from these desired properties, the hemostatic application of CS hydrogels is attracting ever-increasing research attention. This paper reviews the recent research progress of CS-based hemostatic hydrogels and their advantageous characteristics compared to traditional hemostatic materials. The effects of the hemostatic mechanism, effects of deacetylation degree, relative molecular mass, and chemical modification on the hemostatic performance of CS hydrogels are summarized. Meanwhile, some typical applications of CS hydrogels are introduced to provide references for the preparation of efficient hemostatic hydrogels. Finally, the future perspectives of CS-based hemostatic hydrogels are presented.

The purpose of this study was to explain the internal mechanism of attention focus affecting performance of countermovement jump based on muscle synergy theory. Participants involved untrained group(N = 10) and high-level group(N = 11). Subjects performed countermovement jump with internal attention focus instruction (IF), external distal attention focus instruction (EDF), and external proximal attention focus instruction (EPF). The electromyography (EMG) signals of the dominant vastus lateralis muscle (VL), semitendinosus muscle (ST), tibial anterior muscle (TA), rectus femoris muscle (RF), and medial gastrocnemius (MG) were recorded. The non-negative matrix factorization was used to extract muscle synergy. 1) Attention focus did not affect countermovement jump performance and the number of muscle synergy in the high-level group (P>0.05). 2) Attention focus instructions affected the untrained group countermovement jump (P<0.05). and EDF and EPF reduced the number of muscle synergy. 3)The Cohen's d of EDF (0.269) was less than EPF (0.377) in untrained group. For the untrained people, the improved motor performance caused by attention focus resembled the adaptive changes that occur with long-term training. The reason why an EDF is superior to EPF is that the former produces more thorough changes in muscle synergy.

The vocal structure of gibbons has long been believed to be under strong genetic control and consistent with phylogeny. Gibbon vocalizations show hierarchical structures and song coordination behaviors, which may have different functions and convey distinct information compared to basic notes. However, previous studies have not compared vocalizations at multiple levels across species. We compared the vocal structures of three Nomascus species in the wild in South China, namely the western black gibbon ( Nomascus concolor ), Cao vit gibbon ( N. nasutus ), and Hainan gibbon ( N. hainanus ) at the levels of note (six features of four types of notes), male sequence (eight features), and song coordination (four features of the overlap pattern between male and female songs). We selected 15 recordings for each species: N. concolor (six groups, 2006 to 2021), N. nasutus (seven groups, 2008 to 2021), and N. hainanus (six groups, 2020 to 2021). We used permuted random forest analysis to test for species differences in vocal structure and the contribution of acoustic features to species differences at each level. We used acoustic features to construct a hierarchical clustering tree, and compared it with phylogenetic relationships. We found significant differences at all levels except the boom note. Acoustic similarity did not match genetic similarity in boom and pre-modulated notes, suggesting that genetic differences are not the only factor leading to species differences in vocal structures. We also found different contributions of acoustic features to differentiation in vocal structure at different levels. Our study suggests that we need to compare gibbon vocalizations at different levels to understand their differentiation and evolution.

Dynamic metal nanoclusters have garnered widespread attention due to their unique properties and potential applications in various fields. Researchers have been dedicated to developing new synthesis methods and strategies to control the morphologies, compositions, and structures of metal nanoclusters. Through optimized synthesis methods, it is possible to prepare clusters with precise sizes and shapes, providing a solid foundation for subsequent research. Accurate determination of their crystal structures is crucial for understanding their behavior and designing custom functional materials. Dynamic metal nanoclusters also demonstrate potential applications in catalysis and optoelectronics. By manipulating the sizes, compositions, and surface structures of the clusters, efficient catalysts and optoelectronic materials can be designed and synthesized for various chemical reactions and energy conversion processes. This review summarizes the research progress in the synthesis methods, crystal structure characterization, and potential applications of dynamic metal nanoclusters. Various nanoclusters composed of different metal elements are introduced, and their potential applications in catalysis, optics, electronics, and energy storage are discussed. Additionally, the important role of dynamic metal nanoclusters in materials science and nanotechnology is explored, along with an overview of the future directions and challenges in this field.

The surface of the iron-based superconductor FeTe 0.55 Se 0.45 has been identified as a potential topological superconductor and is expected to host exotic quasiparticles called the Majorana bound states (MBSs). Wang et al. looked for signatures of MBSs in this material by using scanning tunneling spectroscopy on the vortex cores formed by the application of a magnetic field. In addition to conventional states, they observed the characteristic zero-bias peaks associated with MBSs and were able to distinguish between the two, owing to the favorable ratios of energy scales in the system. Science , this issue p. 333 Scanning tunneling spectroscopy reveals signatures of Majorana bound states on the surface of FeTe 1− x Se x . The search for Majorana bound states (MBSs) has been fueled by the prospect of using their non-Abelian statistics for robust quantum computation. Two-dimensional superconducting topological materials have been predicted to host MBSs as zero-energy modes in vortex cores. By using scanning tunneling spectroscopy on the superconducting Dirac surface state of the iron-based superconductor FeTe 0.55 Se 0.45 , we observed a sharp zero-bias peak inside a vortex core that does not split when moving away from the vortex center. The evolution of the peak under varying magnetic field, temperature, and tunneling barrier is consistent with the tunneling to a nearly pure MBS, separated from nontopological bound states. This observation offers a potential platform for realizing and manipulating MBSs at a relatively high temperature.

Objective To investigate (1) lateral atlantoaxial articulation (LAA) morphology in patients with basilar invagination (BI) with atlantoaxial dislocation (AAD) and healthy individuals and its relationship with the severity of dislocation and (2) the effect of the LAA morphology on reduction degree (RD) after surgery. Methods In this retrospective propensity score matching case-control study, imaging and baseline data of 62 patients with BI and AAD from 2011 to 2022 were collected. Six hundred thirteen  participants without occipitocervical junctional deformity served as controls. Logistic regression and receiver operating characteristic (ROC) curve were used for analysis. Results The age, BMI and sex did not differ significantly between the two groups after propensity score matching. Sagittal slope angle (SSA) and coronal slope angle (CSA) was lower and greater, respectively, in the patient group than in the control group. A negative SSA value usually indicates anteverted LAA. Regression analysis revealed a significant negative correlation between SSA and severity of dislocation. However, no relationship was found between CSA and the severity of dislocation. The multivariate logistic regression analysis revealed that minimum-SSA emerged as an independent predictor of satisfactory reduction (RD ≥ 90%). The ROC curve demonstrated an area under the curve of 0.844, with a cut-off value set at -40.2. Conclusion SSA in patients group was significantly smaller and more asymmetric than that in the control group. Dislocation severity was related to SSA but not to CSA. Minimum-SSA can be used as a predictor of horizontal RD after surgery.

Increasing evidence has demonstrated that hypoxia was an aggressive feature in endometrial cancer (EC), which is significantly associated with the tumor grade, lymph node metastasis, and tumor resistance to chemotherapy. However, the relationship between hypoxia and the immune microenvironment in EC is not very clear. Exosomes are small membrane vesicles secreted from a variety of cell types which mediate cell-to-cell communication through transported biomolecules. Here, we investigated whether exosomes can play an immunomodulatory role in intercellular communication between EC cells and macrophages. EC KEL cells were cultured under hypoxia or normoxic condition to collect exosomes. After identification, the exosomes derived from hypoxic or normoxic KEL cells were cultured with the monocyte cell line THP-1 to study the immunoregulation function of KEL cells. The results showed that the total number of exosomes produced by hypoxic KEL cells was significantly higher than that in normoxic condition. In addition, hypoxia markedly stimulated the increase in miRNA-21 expression in the exosomes. After coculture, we found that exosomal miRNA-21 could be horizontally transferred into THP-1 cells. And then, the notably enhanced mRNA expression levels of IL-10 and CD206 in THP-1 cells were observed, suggestive of M2 polarization. To further study the effect of miRNA-21-containing exosomes, we transfected miRNA-21 mimics or inhibitor into THP-1 cells. The results showed that miRNA-21 mimics promoted IL-10 and CD206 mRNA expression levels, and the miRNA-21 inhibitor significantly prevented the alteration induced by intake of hypoxic KEL cell-derived exosomes. In summary, we found that endometrial cancer KEL cells in hypoxic condition promoted monocyte THP-1 cell transformation to M2-like polarization macrophages through delivering exosomal miRNA-21, which may be a potential mechanism of the formation of the immune microenvironment in EC progression.

The stray-light suppression of a large off-axis three-mirror anastigmatic space camera has been a hot topic, and this study proposes a composite stray-light suppression strategy that effectively suppresses stray light using the combination of a baffle, retaining ring, and internal antistray light measures. Additionally, the light barrier of the third mirror with a three-layered structure was designed to further optimize the composite stray-light suppression system. At the stray-light simulation analysis stage, in view of the limitations of the Torrance–Sparrow scattering analysis model, an analysis model with wide adaptability is proposed, which can be applied to the stray-light simulation analysis of large-size mirrors with rough surfaces. The simulation results indicate that the point source transmittance of the composite stray-light suppression strategy proposed in this paper is of the order of 10−5 before installing the light barrier of the third mirror, and the veiling glare index of the full field of view is less than 5.8%. After installing the light barrier of the third mirror, the point source transmittance reached the order of 10−8, and the veiling glare index of the full field of view was less than 1.31%. Moreover, the influence of the light barrier of the third mirror on the modulation transfer function of the system was less than 2.3%. The modulation transfer function test of the large-width off-axis three-mirror anastigmatic space camera in a simulated vacuum on-orbit environment was completed, and the test results indicated that the negative impact of the light barrier of the third mirror on the modulation transfer function was less than 3.6%. Moreover, an out-of-field imaging test of the space camera was conducted and the results showed that the image was clear, and the SNR reached 80 dB. The simulation and experimental results prove that the solution in this study can effectively solve the problem of stray-light suppression for large off-axis three-mirror anastigmatic space cameras.

Data are scarce regarding the comorbid mental disorders and their management among COVID-19 patients. This study described the clinical characteristics and management of COVID-19 patients treated in psychiatric inpatient settings due to comorbid first-onset mental disorders in Wuhan, China. This electronic medical records-based study included 25 COVID-19 patients with first-onset mental disorders and 55 patients with first-onset mental disorders without COVID-19 (control group). Data collected included ICD-10 diagnoses of mental disorders, psychiatric and respiratory symptoms, treatments, and outcomes. Adjustment disorder ( n  = 11, 44.0%) and acute and transient psychotic disorders, with associated acute stress ( n  = 6, 24.0%) were main clinical diagnoses in the COVID-19 group while serious mental illnesses (i.e., schizophrenia, 24.5%) and alcohol use disorders (10.9%) were overrepresented in the control group. On admission, the most common psychiatric symptom in COVID-19 patients was insomnia symptoms ( n  = 18, 72.0%), followed by aggressive behaviors ( n  = 16, 64.0%), delusion ( n  = 10, 40.0%), and severe anxiety ( n  = 9, 36.0%). In addition to respiratory treatments, 76.0% COVID-19 patients received antipsychotics, 40.0% sedative-hypnotics, and 24.0% mood stabilizers. At the end of inpatient treatment, 4 (16.0%) COVID-19 patients were transferred to other hospitals to continue respiratory treatment after their psychiatric symptoms were controlled while the remaining 21 (84.0%) all recovered. Compared to the control group, COVID-19 group had significantly shorter length of hospital stay (21.2 vs. 37.4 days, P  < 0.001). Adjustment disorder and acute and transient psychotic disorders are the main clinical diagnoses of COVID-19 patients managed in psychiatric inpatient settings. The short-term prognosis of these patients is good after conventional psychotropic treatment.