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Cognitive impairment (CI) is a common complication in patients with type 2 diabetes mellitus (T2DM), but its relationship with long-term glycemic control remains unclear. This study aimed to investigate the associations between mean hemoglobin A1c (HbA1c) levels, HbA1c control status, HbA1c fluctuations, and CI in Chinese adults aged 45 years and older with T2DM using data from the China Health and Retirement Longitudinal Study (CHARLS). A total of 797 participants with HbA1c measurements from 2011 to 2015 and cognitive function assessments in 2018 were included. Logistic regression models and restricted cubic spline (RCS) analysis were applied, adjusting for potential confounders. Higher mean HbA1c levels (≥ 9%) were significantly associated with an increased risk of CI, particularly in global cognition and episodic memory (OR 4.03 (1.45–11.20) for global cognition; OR 2.92 (1.02–8.38) for episodic memory). RCS analysis revealed a U-shaped relationship between mean HbA1c and CI, indicating that both excessively low and high HbA1c levels elevate CI risk. Uncontrolled HbA1c levels (≥ 8%) were also linked to higher CI risk compared to stable HbA1c levels. Maintaining HbA1c levels below 8% may significantly reduce CI risk in T2DM patients, highlighting the importance of personalized glycemic management.

Hyperspectral images (HSIs) contain rich spatial–spectral information but are highly susceptible to various types of noise during the imaging process, which significantly degrades image quality and undermines the reliability of subsequent applications. To address this issue, we propose a novel end-to-end denoising framework, termed Quasi-Recursive Spectral Attention Network (QRSAN), which aims to design a feature extraction module that leverages the intrinsic characteristics of hyperspectral noise while preserving high-quality spatial and spectral information. Specifically, QRSAN introduces a Quasi-Recursive Attention Unit (QRAU) to jointly model inherent spatial–spectral dependencies, where 2D convolutions are employed for spatial feature extraction and frequency pooling is utilized for spectral representation. In addition, we develop a multi-head spectral attention mechanism to effectively capture inter-band correlations and suppress spectrally dependent noise. To further preserve fine-grained spatial structures and spectral fidelity, we design an adaptive cross-layer skip connection strategy that integrates channel-wise concatenation and transition blocks, enabling efficient feature propagation and fusion within an asymmetric encoder–decoder architecture. Extensive experiments on both synthetic and real HSI datasets demonstrate that QRSAN consistently outperforms existing methods in terms of visual quality and objective evaluation metrics, achieving superior denoising performance and generalization ability while maintaining high spatial–spectral fidelity.

To address the need for a simple model to predict ≥ F2 fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD) patients, a study utilized data from 791 biopsy-proven MASLD patients from the NASH Clinical Research Network and Jinan University First Affiliated Hospital. The data were divided into training and internal testing sets through randomized stratified sampling. A multivariable logistic regression model using key categorical variables was developed to identify ≥ F2 fibrosis. External validation was performed using data from the FLINT trial and multiple centers in China. The DA-GAG score, incorporating diabetes, age, GGT, aspartate aminotransferase/ platelet ratio, and globulin/ total protein ratio, demonstrated superior performance in distinguishing ≥ F2 fibrosis with an area under the receiver operating characteristic curve of 0.79 in training and over 0.80 in testing datasets. The DA-GAG score efficiently identifies MASLD patients with ≥ F2 fibrosis, significantly reducing the medical burden.

Background Previous studies have found that bone mesenchymal stem cells (BMSCs) were capable of self-replication, multi-differentiation, and regeneration. The aim of this study was to carry out a systematic review and meta-analysis of the efficacy of BMSC therapy for ovariectomized rats. Methods The PubMed, Embase, Web of Science, China National Knowledge Infrastructure, VIP, and Chinese Sinomed databases were searched systematically from their initiation date to October 5, 2018. Two researchers independently screened the literatures, which used the bone mineral density (BMD), total bone volume by total tissue volume (BV/TV) (%), and trabecular thickness/spacing (Tb/Sp) as the outcome measures. Results Five eligible studies were selected. In the BMSC treatment groups, the BMD values and normalized BV/TV values remarkably increased. In addition, in the BMSCs plus other treatment groups, the BMD and Tb/Sp values significantly increased. Conclusion This study showed that BMSCs could accelerate callus maturity, ossification and restore mechanical properties of bones in osteoporotic fractures.

Purposes To study the relationship between nursing humanistic care and quality of life in patients with nasopharyngeal carcinoma (NPC). Methods A total of 382 NPC patients of Sun Yat-sen University Cancer Center were included from October 1, 2018, to July 30, 2019. The Nursing Humanistic Care Experience Scale-Noninfectious Chronic Disease Patients version (NHCES-NCDP) and quality of life questionnaire of the European Organisation for the Research and Treatment of Cancer (EORTC) QLQ-C30 (V3.0)、QLQ—H&N35 (V1.0) were used to assess the relationship between the score of nursing humanistic care and quality of life. Paired sample T-test, Pearson correlation test and linear regression were used to analyse the data on the relationship between nursing humanistic care and the quality of NPC patients. Results The score of humanistic care post-treatment in NPC patients was higher than that of pre-treatment (101.4 ± 16.6 vs. 99.3 ± 16.8); The scales of cognitive functioning, social functioning, financial difficulties, nausea and vomiting among quality of life were significantly associated with the scores of Nursing Humanistic Care before treatment. Emotional functioning, Cognitive functioning, Social functioning, Fatigue, Nausea and vomiting, Insomnia, Appetite loss, Financial difficulties, and pain among quality of life were significantly associated with Nursing Humanistic Care after treatment. Still, there was no correlation among other items. Conclusion The quality of life score was reduced after chemo-radiotherapy in NPC patients, and it was significantly associated with humanistic nursing care. The quality of life of NPC patients may be improved by elevating the nursing humanistic care level. Clinical trial number Not applicable.

Background The risk of hepatitis B virus (HBV) reactivation after biologic and targeted synthetic disease‐modifying antirheumatic drugs (b/tsDMARDs) therapy in patients with rheumatoid arthritis (RA) combined with HBsAg–/HBcAb+ is still inconsistent. Methods We conducted a systematic review of existing databases from 1977 to August 22, 2021. Studies of RA patients combined with HBsAg−/HBcAb +, treated with b/tsDMARDs and the reported number of HBV reactivation were included. Results We included 26 studies of 2252 HBsAg−/HBcAb+ RA patients treated with b/tsDMARDs. The pooled HBV reactivation rate was 2.0% (95% confidence interval [CI]: 0.01−0.04; I2 = 66%, p < .01). In the subgroup analysis, the HBV reactivation rate of rituximab (RTX), abatacept, and inhibitors of Janus kinase (JAK), interleukin‐6 (IL‐6), and tumor necrosis factor‐α (TNF‐α) were 9.0% (95% CI: 0.04−0.15; I2 = 61%, p = .03), 6.0% (95% CI: 0.01−0.13; I2 = 40%, p = .19), 1.0% (95% CI: 0.00−0.03; I2 = 41%, p = .19), 0.0% (95% CI: 0.00−0.02; I2 = 0%, p = .43), 0.0% (95% CI: 0.00−0.01; I2 = 0%, p = .87), respectively. While HBsAb‐ patients have a significant risk of reactivation (odds ratio [OR] = 4.56, 95% CI = 2.45−8.48; I2 = 7%, p = .37), low HBsAb+ group also display a significant risk of reactivation (OR = 5.45, 95% CI: 1.35−21.94; I2 = 0%, p = .46). Conclusions This meta‐analysis demonstrates the highest potential risk of HBV reactivation in HBsAg−/HBcAb+ RA patients receiving RTX treatment, especially HBsAb− patients. Our study furthers the understanding of the prophylactic use of anti‐HBV drugs in such patients. However, it is relative safety to use the inhibitors of IL‐6, TNF‐α, and JAK in these patients. Abatacept is second to rituximab (RTX) at high risk of HBV reactivation in RA patients combined with HBsAg−/HBcAb + . Prophylactic use of anti‐HBV drugs should also be considered in HBsAg−/HBcAb+ RA patients treated with abatacept if they have multiple risk factors.

Late embryogenesis abundant (LEA) proteins comprise a diverse superfamily involved in plant development and stress responses. This study presents a first genome-wide analysis of LEA genes in papaya (Carica papaya L., Caricaceae), an economically important tree fruit crop widely cultivated in the tropics and subtropics. A total of 28 members were identified from the papaya genome, which belong to eight families with defined Pfam domains, i.e., LEA_1 (3), LEA_2 (4), LEA_3 (5), LEA_4 (5), LEA_5 (2), LEA_6 (2), DHN (4), and SMP (3). The family numbers are comparable to those present in Ricinus communis (Euphorbiaceae, 28) and Moringa oleifera (Moringaceae, 29), but relatively less than that found in Moringa oleifera (Cleomaceae, 39) and Arabidopsis thaliana (Brassicaceae, 51), implying lineage-specific evolution in Brassicales. Indeed, best-reciprocal-hit-based sequence comparison and synteny analysis revealed the presence of 29 orthogroups, and significant gene expansion in Tarenaya and Arabidopsis was mainly contributed by whole-genome duplications that occurred sometime after their split with the papaya. Though a role of transposed duplication was also observed, tandem duplication was shown to be a key contributor in gene expansion of most species examined. Further comparative analyses of exon-intron structures and protein motifs supported fast evolution of this special superfamily, especially in Arabidopsis. Transcriptional profiling revealed diverse expression patterns of CpLEA genes over various tissues and different stages of developmental fruit. Moreover, the transcript level of most genes appeared to be significantly regulated by drought, cold, and salt stresses, corresponding to the presence of cis-acting elements associated with stress response in their promoter regions. These findings not only improve our knowledge on lineage-specific family evolution in Brassicales, but also provide valuable information for further functional analysis of LEA genes in papaya.

Objective Immune tolerance and evasion play a critical role in virus‐driven malignancies. However, the phenotype and clinical significance of programmed cell death 1 (PD‐1) and its ligands, PD‐L1 and PD‐L2, in aggressive acquired immunodeficiency syndrome (AIDS)‐related non‐Hodgkin lymphoma (AR‐NHL) remain poorly understood, particularly in the Epstein–Barr virus (EBV)‐positive subset. Methods We used in situ hybridization with EBV‐encoded RNA (EBER) to assess the EBV status. We performed immunohistochemistry and flow cytometry analysis to evaluate components of the PD‐1/PD‐L1/L2 pathway in a multi‐institutional cohort of 58 patients with AR‐NHL and compared EBV‐positive and EBV‐negative cases. Results The prevalence of EBV+ in AR‐NHL was 56.9% and was associated with a marked increase in the expression of PD‐1/PD‐L1/PD‐L2 in malignant cells. Patients with AR‐NHLs who tested positive for both EBER and PD‐1 exhibited lower survival rates compared to those negative for these markers (47.4% vs. 93.8%, p = 0.004). Similarly, patients positive for both EBER and PD‐L1 also demonstrated poorer survival (56.5% vs. 93.8%, p = 0.043). Importantly, PD‐1 tissue‐expression demonstrated independent prognostic significance for overall survival in multivariate analysis and was correlated to elevated levels of LDH (r = 0.313, p = 0.031), increased PD‐1+ Tregs (p = 0.006), and robust expression of EBER (r = 0.541, p < 0.001) and PD‐L1 (r = 0.354, p = 0.014) expression. Conclusions These data emphasize the importance of PD‐1‐mediated immune evasion in the complex landscape of immune oncology in AR‐NHL co‐infected with EBV, and contribute to the diagnostic classification and possible definition of immunotherapeutic strategies for this unique subgroup.

A worldwide outbreak of coronavirus disease (COVID-19), since 2019, has brought a disaster to people all over the world. Many researchers carried out clinical epidemiological studies on patients with COVID-19 previously, but risk factors for patients with different levels of severity are still unclear. 562 patients with laboratory-confirmed COVID-19 from 12 hospitals in China were included in this retrospective study. Related clinical information, therapies, and imaging data were extracted from electronic medical records and compared between patients with severe and non-severe status. We explored the risk factors associated with different severity of COVID-19 patients by logistic regression methods. Based on the guideline we cited, 509 patients were classified as non-severe and 53 were severe. The age range of whom was 5-87 years, with a median age of 47 (IQR 35.0-57.0). And the elderly patients (older than 60 years old) in non-severe group were more likely to suffer from fever and asthma, accompanied by higher level of D-dimer, red blood cell distribution width and low-density lipoprotein. Furthermore, we found that the liver and kidney function of male patients was worse than that of female patients in both severe and non-severe groups with different age levels, while the severe females had faster ESR and lower inflammatory markers. Of major laboratory markers in non-severe cases, baseline albumin and the lymphocyte percentage were higher, while the white blood cell and the neutrophil count were lower. In addition, severe patients were more likely to be accompanied by an increase in cystatin C, mean hemoglobin level and a decrease in oxygen saturation. Besides that, advanced age and indicators such as count of white blood cell, glucose were proved to be the most common risk factors preventing COVID-19 patients from aggravating. The potential risk factors found in our study have shown great significance to prevent COVID-19 patients from aggravating and turning to critical cases during treatment. Meanwhile, focusing on gender and age factors in groups with different severity of COVID-19, and paying more attention to specific clinical symptoms and characteristics, could improve efficacy of personalized intervention to treat COVID-19 effectively.

Instrumental analysis is an important part of analytical chemistry, which plays a crucial role in cultivating the experimental operation ability of students in disciplines such as environment, geology, and medicine. Inductively coupled plasma mass spectrometry (ICP-MS) is currently an irreplaceable basic equipment in inorganic element analysis, and incorporating it into experimental teaching content is a requirement of the times. However, there is still a lack of application in this area. This article focuses on the graduate course “Modern Detection Technology”. The experimental course adopts a mixed teaching mode of pre class theoretical guidance and in class emphasis on practical operation. It combines theoretical and practical teaching organically, and takes the current hot topic of radioactive pollution as the problem orientation. The teaching mainly focuses on analyzing experimental design, instrument operation and use, sample measurement and result analysis, etc. The teaching mode and content of ICP-MS continuously explored to improve the quality of experimental teaching and enable students to comprehensively enhance their basic skill knowledge, scientific research literacy, and innovation awareness.