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Background Air pollution may induce or reinforce nasal inflammation regardless of allergy status. There is limited direct clinical evidence informing the treatment of airborne pollution-related rhinitis. Objective To assess the effectiveness of intranasal budesonide in adults with self-reported rhinitis symptoms triggered/worsened by airborne pollution. Methods Adults in northern China with self-reported rhinitis symptoms triggered or worsened by airborne pollution were randomized to budesonide 256 µg/day or placebo for 10 days in pollution season (October 2019 to February 2020). The primary endpoint was the mean change from baseline in 24-h reflective total nasal symptom score (rTNSS) averaged over 10 days. The secondary endpoints were subject-assessed Global Impression of Change (SGIC), mean change from baseline in individual nasal symptom severity, and mean change from baseline in individual non-nasal symptoms of cough and postnasal drip severity. One-sided P  < 0.0125 was considered statistically significant. Results After an interruption by COVID-19, an interim analysis showed that the study could be ended for efficacy with n = 206 participants (103/group) since the primary efficacy endpoint demonstrated significant results. The final efficacy results showed that the 10-day-averaged rTNSS change in the budesonide group was greater than with placebo (− 2.20 vs − 1.72, P  = 0.0107). Budesonide also significantly improved 10-day-averaged itching/sneezing change (− 0.75 vs − 0.51, P  = 0.0009). Results for SGIC and all other individual symptoms did not show significant differences between the two groups. Conclusions Intranasal budesonide 256 µg once daily improved the total nasal symptoms and itching/sneezing over 10 days in adults with rhinitis triggered/worsened by airborne pollution.

This paper presents a comprehensive analysis of the impact of adaptive cruise control on energy consumption in real-world driving conditions based on a natural experiment: a large-scale observational dataset of driving data from a diverse fleet of vehicles and drivers. The analysis is conducted at two different fidelity levels: (1) a macroscopic trip-level benefit estimate that compares trips with and without cruise control in a counterfactual way using statistical methods, and (2) a situation-based comparison achieved through the segmentation of trips into distinct driving situations such as acceleration, braking, cruising, and other maneuvers. The results of this research show that the effect of cruise control on energy consumption varies across different driving situations and levels of analysis. In a macroscopic trip-level analysis, cruise control engagement is associated with a slight increase in fuel consumption across the fleet. As revealed later by the situation-based analysis, this result can be attributed to the negative impact of cruise control on energy consumption in cruising mode, which is the most common driving situation. However, the situation-based comparison demonstrates that cruise control can provide fuel consumption benefits in situations involving acceleration and braking, particularly when a preceding vehicle is present. The study also emphasizes the importance of controlling for various factors that can influence both fuel consumption and the likelihood of cruise control engagement to properly evaluate its effects. Efficient automated driving technology to improve upon human driving behaviour offer a promising pathway to energy and fuel savings. Here, authors analyse real-world data to determine how adaptive cruise control affects fuel consumption and identify specific driving situations where it can be optimized.

Oral squamous cell carcinoma (OSCC), a common type of oral cancer, has traditionally relied on surgery or radiotherapy as the main treatment. However, these treatments often put patients at risk of deformity and speech dysfunction due to the special anatomical location of the tongue. Local 5-aminolevulinic acid photodynamic therapy (ALA-PDT) is an effective and non-invasive in situ treatment method that can treat tumors while preserving normal tissue morphology and structure. Nevertheless, the curative effect of ALA-PDT is constrained by the permeability of the photosensitizer and the penetration depth of the therapeutic laser source. This study reports three cases of early-stage well-differentiated OSCC that were managed with a nonsurgical approach. In an attempt to enhance the therapeutic effectiveness of ALA-PDT, we employed Waterlase technology to perform abrasion on the lesioned area, with the dual goals of eliminating local hyperplasia and white lesions and facilitating deeper penetration of the laser light source. Immediately following this, these patients underwent local puncture-like injections of 20% ALA. By means of this procedure, the interference caused by the epithelium on the penetration of ALA could be directly avoided. Upon completion of a 2 h incubation period, PDT was initiated at a dose of 119.4 J/cm². Before and after treatment, we evaluated the treatment effect by artificial intelligence (AI)-assisted deoxyribo nucleic acid (DNA) aneuploidy cytology by image cytometry (DNA-ICM). After 6 months of follow-up observation, these patients showed no signs of tumor recurrence. This preliminary case series suggests that Waterlase ablation-assisted submucosal ALA-PDT may provide a potential treatment alternative for early-stage OSCC. Notably, it particularly shines in the aspects of maintaining the patient’s normal physiological functions and elevating the quality of life. All patients provided linguistically appropriate written informed consent after receiving detailed information about ALA-PDT’s therapeutic mechanisms, recurrence risks, and alternative therapies.

This review critically examines the latest advancements in clay mineral-based photocatalysts for water purification. Clay minerals, owing to their natural abundance, low cost, and unique physicochemical properties, have emerged as promising candidates for enhancing photocatalytic efficiency. This article delves into various activation methods for clay minerals, including acid, alkali, calcination, and mechanochemical activation, highlighting their roles in enhancing surface area, creating active sites, and improving photocatalytic performance. Moreover, the review explores various modification strategies for photocatalysts, such as doping with metal and non-metal ions, deposition of metals, and the design of heterojunctions, to further boost photocatalytic activity. In particular, the utilization of kaolinite, montmorillonite, attapulgite, and sepiolite as clay mineral supports for photocatalysts is discussed in detail, showcasing their potential in wastewater treatment. The review underscores the significant strides made in the development of clay mineral-based photocatalysts, highlighting their effectiveness in degrading organic contaminants under light exposure. Nevertheless, there are persisting challenges such as the optimization of loading quantities, improvement in compatibility between clay minerals and photocatalysts, and reduction in preparation costs for large-scale applications. In summary, this review offers valuable insights into the current status of clay mineral-based photocatalysts for water purification, thereby stimulating future research in this promising field.

Moderate intraoperative hypothermia promotes myocardial injury, surgical site infections, and blood loss. Whether aggressive warming to a truly normothermic temperature near 37°C improves outcomes remains unknown. We aimed to test the hypothesis that aggressive intraoperative warming reduces major perioperative complications. In this multicentre, parallel group, superiority trial, patients at 12 sites in China and at the Cleveland Clinic in the USA were randomly assigned (1:1) to receive either aggressive warming to a target core temperature of 37°C (aggressively warmed group) or routine thermal management to a target of 35·5°C (routine thermal management group) during non-cardiac surgery. Randomisation was stratified by site, with computer-generated, randomly sized blocks. Eligible patients (aged ≥45 years) had at least one cardiovascular risk factor, were scheduled for inpatient non-cardiac surgery expected to last 2–6 h with general anaesthesia, and were expected to have at least half of the anterior skin surface available for warming. Patients requiring dialysis and those with a body-mass index exceeding 30 kg/m2 were excluded. The primary outcome was a composite of myocardial injury (troponin elevation, apparently of ischaemic origin), non-fatal cardiac arrest, and all-cause mortality within 30 days of surgery, as assessed in the modified intention-to-treat population. This study is registered with ClinicalTrials.gov, NCT03111875. Between March 27, 2017, and March 16, 2021, 5056 participants were enrolled, of whom 5013 were included in the intention-to-treat population (2507 in the aggressively warmed group and 2506 in the routine thermal management group). Patients assigned to aggressive warming had a mean final intraoperative core temperature of 37·1°C (SD 0·3) whereas the routine thermal management group averaged 35·6°C (SD 0·3). At least one of the primary outcome components (myocardial injury after non-cardiac surgery, cardiac arrest, or mortality) occurred in 246 (9·9%) of 2497 patients in the aggressively warmed group and in 239 (9·6%) of 2490 patients in the routine thermal management group. The common effect relative risk of aggressive versus routine thermal management was an estimated 1·04 (95% CI 0·87–1·24, p=0·69). There were 39 adverse events in patients assigned to aggressive warming (17 of which were serious) and 54 in those assigned to routine thermal management (30 of which were serious). One serious adverse event, in an aggressively warmed patient, was deemed to be possibly related to thermal management. The incidence of a 30-day composite of major cardiovascular outcomes did not differ significantly in patients randomised to 35·5°C and to 37°C. At least over a 1·5°C range from very mild hypothermia to full normothermia, there was no evidence that any substantive outcome varied. Keeping core temperature at least 35·5°C in surgical patients appears sufficient. 3M and the Health and Medical Research Fund, Food and Health Bureau, Hong Kong. For the Chinese translation of the abstract see Supplementary Materials section.

A study was conducted on the fatigue assessment method for composite ship structures under complex marine environments, and a fatigue assessment method based on the principle of stiffness degradation was proposed. Fatigue tests were performed on the composite material of the target ship to obtain the stiffness degradation parameters under tension–compression loading. Four fatigue hotspot areas in the midsection of the hull were selected, and mesh refinement was applied to these locations to accurately capture the variations in stress gradients. The structural stress response transfer function was calculated, and the short-term and long-term distribution data of wave loads were obtained. Finally, the fatigue life of the target ship hotspots was predicted by combining spectral fatigue analysis with the stiffness degradation theory. The results indicate that the connection between the bulkhead stiffener and the inner bottom plate has the shortest fatigue life, and its dimensions were optimized.

Influenza, an acute respiratory infectious disease caused by the influenza virus, remains a significant challenge for prevention and treatment due to rapid viral mutation and high pathogenicity. Traditional Chinese Medicine (TCM), including Shuangyu Granule (SYKL), has demonstrated efficacy in managing influenza. This study aimed to systematically identify the chemical components of SYKL in vitro and its absorbed constituents in vivo, and to preliminarily explore its potential mechanism in regulating influenza-related immune inflammation. UPLC-Orbitrap-MS/MS and GC-MS were used to characterize SYKL's chemical profile, identifying 148 in vitro components and 21 prototype absorbed blood components. Network target analysis, integrated with single-cell RNA sequencing (scRNA-seq) data from influenza patients, predicted that the absorbed components may target multiple immune-inflammatory regulatory genes across various immune cell types. Molecular docking suggested favorable predicted binding potential between these components and target proteins. Experimental validation using poly(I:C)-induced inflammatory models in both RAW264.7 macrophages and mouse bone marrow-derived macrophages (BMDMs) showed that the absorbed components-loganic acid, 8-epiloganic acid, calycosin, atractylodin, eucalyptol, secoxyloganin, and paeoniflorin-significantly reduced mRNA expression of immune-inflammatory genes (DUSP6, MAPKAPK2, NOD2) and inhibited secretion of TNF-α, IL-6, IL-8, and NO. These findings suggest that SYKL may alleviate influenza-associated inflammation through multi-component, multi-cell, and multi-target pathways, highlighting its potential in modulating excessive immune responses in influenza.

Purpose Pelvic fractures in polytrauma patients represent complex injuries associated with substantial mortality rates. This study examined clinical characteristics, multidisciplinary collaborative management approaches, and mortality risk factors in these patients to establish clinical references for optimizing comprehensive treatment strategies. Methods We retrospectively analyzed clinical data from 32 polytrauma patients with pelvic fractures managed under an integrated multidisciplinary treatment protocol in our trauma center’s Emergency Intensive Care Unit (EICU). This protocol incorporated expedited prehospital transport, trauma team activation before patient arrival, “resuscitation in the operating room” strategy, and collaborative intervention from emergency surgery, trauma surgery, interventional radiology, and EICU teams. We collected patient demographics, injury characteristics, therapeutic interventions, and outcome data. Univariate and correlation analyses were employed to identify mortality risk factors. Results The study cohort ( n  = 32) had a mean age of 51.2 ± 18.3 years, with female predominance (62.5%). Motor vehicle accidents constituted the primary injury mechanism (75.0%). Thoracic injuries were the most prevalent concomitant injuries (87.5%). Under the multidisciplinary collaborative approach, 37.5% of patients underwent early external pelvic fixation, and 6.3% received transcatheter arterial embolization (TAE). Surgical interventions significantly reduced pain scores ( p  < 0.001). The overall mortality rate was 9.4% (3/32). Correlation analysis demonstrated a negative association between mortality and Glasgow Coma Scale (GCS) scores (-0.710) and a positive correlation with Injury Severity Score (ISS) (0.547). Conclusion Polytrauma with pelvic fractures carries substantial mortality risk. Initial GCS scores and ISS were identified as independent mortality risk factors. Optimization of integrated multidisciplinary treatment protocols with early identification of mortality risk factors and timely interventions appears essential for reducing mortality in this complex patient population.

Soil water content (SWC) plays a vital role in agricultural management, geotechnical engineering, hydrological modeling, and climate research. Image-based SWC recognition methods show great potential compared to traditional methods. However, their accuracy and efficiency limitations hinder wide application due to their status as a nascent approach. To address this, we design the LG-SWC-R3 model based on an attention mechanism to leverage its powerful learning capabilities. To enhance efficiency, we propose a simple yet effective encoder–decoder architecture (PVP-Transformer-ED) designed on the principle of eliminating redundant spatial information from images. This architecture involves masking a high proportion of soil images and predicting the original image from the unmasked area to aid the PVP-Transformer-ED in understanding the spatial information correlation of the soil image. Subsequently, we fine-tune the SWC recognition model on the pre-trained encoder of the PVP-Transformer-ED. Extensive experimental results demonstrate the excellent performance of our designed model (R2 = 0.950, RMSE = 1.351%, MAPE = 0.081, MAE = 1.369%), surpassing traditional models. Although this method involves processing only a small fraction of original image pixels (approximately 25%), which may impact model performance, it significantly reduces training time while maintaining model error within an acceptable range. Our study provides valuable references and insights for the popularization and application of image-based SWC recognition methods.

Background: Inflammatory bowel disease (IBD) is a chronic condition characterized by recurrent episodes and an unclear etiology. Given the limitations of current therapeutic options, which include suboptimal efficacy and significant side effects, there is a pressing need to explore novel treatments. Probiotics derived from diverse species have been identified as a promising approach for managing IBD, owing to their anti-inflammatory properties and their ability to regulate gut flora, among other beneficial effects. Methods: In this study, three strains of lactic acid bacteria (LAB) were isolated from the feces of the scavenger spotted hyena (Crocuta crocuta), a scavenging mammal. Based on their capability to survive within and adhere to the gastrointestinal tract, along with their profile of antibiotic resistance, a high-quality strain of Lactobacillus acidophilus (LA) was selected and demonstrated to be safe for mice. Subsequently, the therapeutic efficacy of LA was evaluated using a dextran sulfate sodium (DSS)-induced model of ulcerative colitis in mice. Results: The results indicated that LA restored the disease activity index and improved histopathological lesions in the model group. It also reduced inflammation and oxidative stress and significantly restored the expression of mucins and intestinal tight junction (TJ) proteins (ZO-1, Occludin). Furthermore, LA corrected the DSS-induced disruption of the intestinal flora, leading to a significant decrease in the prevalence of potentially harmful bacterial genera, such as Bacteroides, and an increase in beneficial bacterial genera, including Lactobacillus. In conclusion, Lactobacillus acidophilus LA1, isolated from spotted hyena feces, has potential as a functional supplement for alleviating symptoms of IBD and regulating intestinal flora.