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Context: Cassia semen (Cs), a seed of Cassia obtusifolia L. (Leguminosae), is a popular functional beverage. Previous studies reported that Cs displayed antioxidant, antifungal and strong liver protective effects. Objective: This study evaluates the hepatoprotective effects of Cs on non-alcoholic fatty liver disease (NAFLD). Materials and methods: Seventy-two male Wistar rats raised with high-fat diet (HFD) were randomly allotted into model, metformin (0.2 g/kg) and Cs (0.5, 1, and 2 g/kg)-treated groups. Another 12 rats were raised with normal feed as control group; all the rats were orally administrated with drugs and vehicle for 6 weeks. Alanine transferase (ALT), aspartate transaminase (AST), triglycerides (TG), total cholesterol (TC), malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH), tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8 and low density lipoprotein receptor (LDL-R) mRNA levels were measured at the end of the experiment. Results: Twelve weeks of HFD administration significantly increased the levels of AST, ALT, TG, TC, TNF-α, IL-6, IL-8 and MDA, decreased SOD (199.42 vs. 137.70 U/mg protein) and GSH (9.76 vs. 4.55 mg/g protein) contents, compared to control group. Cs administration group significantly decreased the elevated biomarkers with the ED 50  = 1.2 g/kg for NAFLD rats. Cs treatment also prevents the decreased expression of LDL-R mRNA, and improved the histopathological changes compared to model group. Conclusions: The hepatoprotective effect of Cs on NAFLD may possibly be due to its antioxidant effect. Cs may become a potent hepatoprotective agent in clinical therapy in the future.

Background: Remimazolam tosilate is a new ultra-short-acting benzodiazepine sedative medicine. In this study, we evaluated the effect of remimazolam tosilate on the incidence of hypoxemia during sedation in elderly patients undergoing gastrointestinal endoscopy. Methods: Patients in the remimazolam group received an initial dose of 0.1 mg/kg and a bolus dose of 2.5 mg of remimazolam tosilate, whereas patients in the propofol group received an initial dose of 1.5 mg/kg and a bolus dose of 0.5 mg/kg of propofol. Patients received ASA standard monitoring (heart-rate, non-invasive blood pressure, and pulse oxygen saturation) during the entire examination process. The primary outcome was the incidence of moderate hypoxemia (defined as 85%≤ SpO 2 < 90%, >15s) during the gastrointestinal endoscopy. The secondary outcomes included the incidence of mild hypoxemia (defined as SpO 2 90%–94%) and severe hypoxemia (defined as SpO 2 < 85%, >15s), the lowest pulse oxygen saturation, airway maneuvers used to correct hypoxemia, patient’s hemodynamic as well as other adverse events. Results: 107 elderly patients (67.6 ± 5.7 years old) in the remimazolam group and 109 elderly patients (67.5 ± 4.9 years old) in the propofol group were analyzed. The incidence of moderate hypoxemia was 2.8% in the remimazolam group and 17.4% in the propofol group (relative risk [RR] = 0.161; 95% confidence interval [CI], 0.049 to 0.528; p < 0.001). The frequency of mild hypoxemia was less in the remimazolam group, but not statistically significant (9.3% vs. 14.7%; RR = 0.637; 95% CI, 0.303 to 1.339; p = 0.228). There was no significant difference in the incidence of severe hypoxemia between the two groups (4.7% vs. 5.5%; RR = 0.849; 95% CI, 0.267 to 2.698; p = 0.781). The median lowest SpO 2 during the examination was 98% (IQR, 96.0%–99.0%) in patients in the remimazolam group, which was significantly higher than in patients in the propofol group (96%, IQR, 92.0%–99.0%, p < 0.001). Patients in the remimazolam group received more drug supplementation during endoscopy than patients in the propofol group ( p = 0.014). There was a statistically significant difference in the incidence of hypotension between the two groups (2.8% vs. 12.8%; RR = 0.218; 95% CI, 0.065 to 0.738; p = 0.006). No significant differences were found in the incidence of adverse events such as nausea and vomiting, dizziness, and prolonged sedation. Conclusion: This study explored the safety of remimazolam compared with propofol during gastrointestinal endoscopy in elderly patients. Despite the increased supplemental doses during sedation, remimazolam improved risk of moderate hypoxemia (i.e., 85%≤ SpO 2 < 90%) and hypotension in elderly patients.

The gully morphology parameter is an important quantitative index for monitoring gully erosion development. Its extraction method and accuracy evaluation in the “soil-rock dual structure area” are of great significance to the evaluation of gully erosion in this type of area. In this study, unmanned aerial vehicle (UAV) tilt photography data were used to evaluate the accuracy of extracting gully morphology parameters from high-resolution remote sensing stereoscopic images. The images data (0.03 m) were taken as the reference in Zhangmazhuang and Jinzhongyu small river valleys in Yishui County, Shandong Province, China. The accuracy of gully morphology parameters were extracted from simultaneous high-resolution remote sensing stereo images data (0.5 m) was evaluated, and the parameter correction model was constructed. The results showed that (1) the average relative errors of circumference (P), area (A), linear length of bottom (L1), and curve length of bottom (L2) are mainly concentrated within 10%, and the average relative errors of top width (TW) are mainly within 20%. (2) The average relative error of three-dimensional (3D) parameters such as gully volume (V) and gully depth (D) is mainly less than 50%. (3) The larger the size of the gully, the smaller the 3D parameters extracted by visual interpreters, especially the absolute value of the mean relative error (Rmean) of V and D. (4) A relationship model was built between the V and D values obtained by the two methods. When V and D were extracted from high-resolution remote sensing stereo images, the relationship model was used to correct the measured parameter values. These findings showed that high-resolution remote sensing stereo images represents an efficient and convenient data source for monitoring gully erosion in a small watershed in a “soil-rock dual structure area”.

Topography critically affects the occurrence of soil erosion, and computing slope spectrum information entropy (SSIE) allows for the convenient mirroring of the patterns of macroscopic topographic variation. However, whether SSIE can be effectively utilized for the quantitative assessment of soil erosion across various types of water-erosion areas and the specific methodology for its application remain unclear. This study focused on the quantitative relationship between SSIE, the slope length and slope steepness (LS) factor within various types of water-erosion areas across different spatial scales in China using multi-source geographic information data and technical tools such as remote sensing and geographic information systems. The results revealed (1) clear consistency in the spatial patterns of SSIE and the LS factor, which both displayed a distinct three-step distribution pattern from south to north. (2) The power model (Y = A·X^B) demonstrated a superior capacity to explaining the relationship between SSIE and the LS factors compared to the linear or exponential models, as evidenced by a higher coefficient of determination (R2). R2 values of different evaluation units (second-grade water-erosion area, third-grade water-erosion area, 30 km × 30 km grid, and 15 km × 15 km grid) were 0.88, 0.88, 0.81, and 0.79, respectively. (3) Despite a range of variances across various spatial scale evaluation units and different types of water-erosion areas, no significant disparities were evident within the power model. These findings offer a new topographic factor that can be incorporated into models designed for the expedited evaluation of soil erosion rates across water-erosion areas. Information about the proximity of the SSIE to the LS factor is valuable for enhancing the practical utilization of SSIE in the quantitative evaluation of soil erosion.

With the rapid growth of an aging global population and proportion, the prevalence of frailty is constantly increasing. Therefore, finding a frailty assessment tool suitable for clinical application by physicians has become the primary link in the comprehensive management of frailty in elderly patients. This study used the (fr)AGILE scale to investigate the frailty status of elderly patients from internal medicine wards and identified relevant factors that affect the severity of frailty. In this study, 408 elderly inpatients in internal medicine departments of Qilu Hospital of Shandong University from May 2021 to August 2022 were enrolled as research subjects, and a cross-sectional observational study was conducted. Researchers evaluated the frailty based on the (fr)AGILE scale score. The general condition, past medical history, physical examination, laboratory examination, nutrition control score, intervention and treatment measures and other elderly patient information was collected. Logistic regression analysis was used to analyze the relevant factors that affect the severity of frailty and hospitalization costs. According to the (fr)AGILE scale score, the elderly patients were divided into groups to determine whether they were frail and the severity of the frailty. Among them, 164 patients were in the prefrailty stage, which accounted for 40.2%. There were 188 cases of mild frailty that accounted for 46.1%, and 56 cases of moderate to severe frailty that accounted for 13.7%. Decreased grip strength, elevated white blood cell levels, and low sodium and potassium are independent risk factors affecting the severity of frailty. As the severity of frailty increases, the proportion of sodium, potassium, albumin supplementation as well as anti-infection gradually increases. Frailty is a common elderly syndrome with a high incidence among elderly patients in internal medicine departments. The main manifestations of frailty vary with different severity levels. Inflammation, anemia, and poor nutritional status can lead to an increase in the severity of frailty as well as blood hypercoagulability, myocardial damage, and additional supportive interventions. This ultimately leads to prolonged hospitalization and increased hospitalization costs.

To explore IoT-based remote respiratory rehabilitation for chronic respiratory disease patients at home. This was a randomised controlled trial. The study took place in patients' homes (post-discharge) and the Department of Respiratory and Critical Care Medicine of Binzhou People's Hospital, Shandong First Medical University (inpatient period). 123 patients (mean age 68.85 ± 10.72 years, 55% male) with chronic respiratory diseases. Patients were randomly assigned to either a 6-month Internet of Things (IoT)-based remote respiratory rehabilitation programme after hospital discharge (study group, n = 60) or usual care with conventional respiratory rehabilitation (control group, n = 63). The primary outcomes were the 6-min walking test (6MWT) and lung function (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1] and peak expiratory flow [PEF]). The secondary outcomes included the modified Medical Research Council (mMRC) dyspnoea index, diaphragm thickness and rehospitalisation rate. Outcomes were assessed at baseline (during hospitalisation, approximately 4 weeks before the intervention started) and after 6 months. The study group showed significantly greater improvements in 6MWT (mean difference 63.74 m, 95% CI 45.21-82.27), FVC (0.54 L, 95% CI 0.43-0.65), FEV1 (0.68 L, 95% CI 0.54-0.82), PEF (73.16 L/min, 95% CI 46.22-100) and diaphragm thickness (6.79 mm, 95% CI 4.68-8.90) than the control group (all p < 0.001). The between-group difference in 6MWT (63.74 m) exceeded the minimal clinically important difference (30 m) for chronic respiratory diseases. A 6-month IoT-based remote respiratory rehabilitation programme significantly improved exercise capacity, lung function, dyspnoea index and respiratory muscle strength and reduced rehospitalisations when compared with conventional rehabilitation in patients with chronic respiratory diseases.

Electrodermal devices that capture the physiological response of skin are crucial for monitoring vital signals, but they often require convoluted layered designs with either electronic or ionic active materials relying on complicated synthesis procedures, encapsulation, and packaging techniques. Here, we report that the ionic transport in living systems can provide a simple mode of iontronic sensing and bypass the need of artificial ionic materials. A simple skin-electrode mechanosensing structure (SEMS) is constructed, exhibiting high pressure-resolution and spatial-resolution, being capable of feeling touch and detecting weak physiological signals such as fingertip pulse under different skin humidity. Our mechanical analysis reveals the critical role of instability in high-aspect-ratio microstructures on sensing. We further demonstrate pressure mapping with millimeter-spatial-resolution using a fully textile SEMS-based glove. The simplicity and reliability of SEMS hold great promise of diverse healthcare applications, such as pulse detection and recovering the sensory capability in patients with tactile dysfunction. Sensing mechanical signals is an important aspect for a range of applications of E-skins. Here, the authors report on the creation of deforming iontronic sensing structures which can use ionic transport through tissues to create a simple and sensitive E-skin for sensing touch, pulse and motion demonstrating application.

Background With the increase in the aging population worldwide, Alzheimer's disease has become a rapidly increasing public health concern. Monitoring the dementia disease burden will support health development strategies by providing scientific data. Methods Based on data obtained from the 2019 Global Burden of Disease (GBD) database, the numbers and age-standardized rates (ASRs) of incidence, prevalence, death and disability-adjusted life-years (DALYs) of Alzheimer's disease and other dementias from 1990 to 2019 were analyzed. Calculated estimated annual percentage changes (EAPCs) and Joinpoint regression analyses were performed to evaluate trends during this period. We also evaluated the correlations between the epidemiology with the sociodemographic index (SDI), an indicator to evaluate the level of social development in a country or region that considering the education rate, economic situation and total fertility rate. Results From 1990 to 2019, the incidence and prevalence of Alzheimer's disease and other dementias increased by 147.72% and 160.89%, respectively. The ASR of incidence, prevalence, death, and DALYs in both men and female consistently increased over the study period. All the ASRs in female were consistently higher than those in men, but the increases were more pronounced in men. In addition, the ASRs of incidence, prevalence, and DALYs were positively correlated with the SDI. Moreover, the proportion of patients over 70 years old with dementia was also positively correlated with SDI level. Smoking is a major risk factor for the disease burden of dementia in males, while obesity is a major risk factor for females. Conclusions From 1990 to 2019, the Alzheimer’s disease burden increased worldwide. This trend was more serious in high-SDI areas, especially among elderly populations in high-SDI areas, who should receive additional attention. Policy-makers should take steps to reverse this situation. Notably, female were at higher risk for the disease, but the risk in men showed a faster increase. We should give attention to the aging population, attach importance to interventions targeting dementia risk factors, and formulate action plans to address the increasing incidence of dementia.

Bacterial RNA polymerase employs extra-cytoplasmic function (ECF) σ factors to regulate context-specific gene expression programs. Despite being the most abundant and divergent σ factor class, the structural basis of ECF σ factor-mediated transcription initiation remains unknown. Here, we determine a crystal structure of Mycobacterium tuberculosis ( Mtb ) RNAP holoenzyme comprising an RNAP core enzyme and the ECF σ factor σ H (σ H -RNAP) at 2.7 Å, and solve another crystal structure of a transcription initiation complex of Mtb σ H -RNAP (σ H -RPo) comprising promoter DNA and an RNA primer at 2.8 Å. The two structures together reveal the interactions between σ H and RNAP that are essential for σ H -RNAP holoenzyme assembly as well as the interactions between σ H -RNAP and promoter DNA responsible for stringent promoter recognition and for promoter unwinding. Our study establishes that ECF σ factors and primary σ factors employ distinct mechanisms for promoter recognition and for promoter unwinding. Extra-cytoplasmic function (ECF) σ factors allow bacteria to rapidly respond to stress conditions. Here the authors provide insights into the mechanism of bacterial stress-induced transcription by determining the crystal structures of the M. tuberculosis ECF σ factor bound RNA Polymerase (RNAP) holoenzyme and the ECF σ factor-RNAP transcription initiation complex.

This study explores the peer and economic effects of corporate poverty alleviation behavior. Using the data of A-share non-financial listed corporates in Shanghai and Shenzhen of China from 2016 to 2020, the empirical analysis of this study finds that: corporate poverty alleviation behavior has significant peer effects; the guidance of local poverty alleviation policies weakens the peer effects of corporate poverty alleviation behavior; compared to private enterprises, the poverty alleviation behavior of the peer firms has a more significant impact on state-owned enterprises; and corporate poverty alleviation behavior can result in the backflow of economic benefits and achieve the organic unity of economic and social benefits. The purpose of this paper is to explore the peer effects of corporate poverty alleviation behaviors through empirical analysis using available public data. The results of the study not only increase the motivation of corporate to participate in poverty alleviation from a peer effects perspective, but also reveal key factors for sustaining corporate poverty alleviation behaviors.