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The Bedside Index for Severity in Acute Pancreatitis (BISAP) score has been developed to identify patients at high risk for mortality or severe disease early during the course of acute pancreatitis. We aimed to undertake a meta-analysis to quantify the accuracy of BISAP score for predicting mortality and severe acute pancreatitis (SAP). We searched the databases of Pubmed, Embase, and the Cochrane Library to identify studies using the BISAP score to predict mortality or SAP. The pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratio (DOR) were calculated from each study and were compared with the traditional scoring systems. Twelve cohorts from 10 studies were included. The overall sensitivity of a BISAP score of ≥3 for mortality was 56% (95% CI, 53%-60%), with a specificity of 91% (95% CI, 90%-91%). The positive and negative likelihood ratios were 5.65 (95% CI, 4.23-7.55) and 0.48 (95% CI, 0.41-0.56), respectively. Regarding the outcome of SAP, the pooled sensitivity was 51% (43%-60%), and the specificity was 91% (89%-92%). The pooled positive and negative likelihood ratios were 7.23 (4.21-12.42) and 0.56 (0.44-0.71), respectively. Compared with BISAP score, the Ranson criteria and APACHEⅡscore showed higher sensitivity and lower specificity for both outcomes. The BISAP score was a reliable tool to identify AP patients at high risk for unfavorable outcomes. Compared with the Ranson criteria and APACHEⅡscore, BISAP score outperformed in specificity, but having a suboptimal sensitivity for mortality as well as SAP.

Dysglycemia is associated with poorer prognosis in patients with acute myocardial infarction (AMI). Whether admission glycemic variability (GV) has important value in prognosis of AMI patients is still unknown. The aim of the study is to investigate the prognostic value of admission GV, glucose, and glycosylated hemoglobin (HbA(1c)) in AMI patients. We measured blood glucose, HbA(1c), and GV on admission in 222 consecutive patients with diagnosed AMI. GV, indicated as the mean amplitude of glycemic excursions (MAGE), was determined by a continuous glucose monitoring system. MAGE was categorized as ≥3.9 or <3.9 mmol/L, admission glucose as ≥8.61 or <8.61 mmol/L, and HbA(1c) as ≥6.5 or <6.5%. Participants were followed up prospectively for 12 months. The relationship of admission MAGE, glucose, and HbA(1c) to the major adverse cardiac event (MACE) of AMI patients was analyzed. In 222 enrolled patients with AMI, the rate of MACE by MAGE category (<3.9 or ≥3.9 mmol/L) was 8.4 and 24.1%, respectively (P = 0.001), by admission glucose category (<8.61 or ≥8.61 mmol/L) was 10.1 and 21.6%, respectively (P = 0.020), and by HbA(1c) category (<6.5 vs. ≥6.5%) was 10.7 versus 18.7%, respectively (P = 0.091). In multivariate analysis, high MAGE level was significantly associated with incidence of MACE (hazard ratio 2.419 [95% CI 1.273-9.100]; P = 0.017) even after adjusting for Global Registry of Acute Coronary Events risk score, but admission glucose and HbA(1c) was not. Elevated admission GV appears more important than admission glucose and prior long-term abnormal glycometabolic status in predicting 1-year MACE in patients with AMI.

Background There is limited data on the characteristics of conventional risk factors (RFs) in young Chinese men hospitalized with a first acute myocardial infarction (AMI). Hypothesis We analyzed the trends in and prevalence of cardiovascular RFs and subtypes of MI during the first AMI in young Chinese men. Methods A total of 2739 men aged 18–44 years hospitalized for a first AMI were identified from 2007 to 2017. The overall prevalence of RFs and their respective temporal trends and subtypes of AMI were evaluated. Results The most prevalent conditions were smoking, followed by hypertension and then obesity. Patients aged <35 years had a much higher prevalence of hypercholesterolemia and obesity. Compared with a similar reference population in the United States, young Chinese men had a higher prevalence of smoking and dyslipidemia, but a lower prevalence of obesity, hypertension, and diabetes. The prevalence of hypertension increased from 2007 through 2017 (p trend <.001), whereas smoking decreased gradually. AMI frequently presented as ST‐segment elevation MI (STEMI) (77.5%). Cluster of conventional RFs (3 RFs, odds ratio [OR]: 1.69, 95% confidence interval [CI]: 1.11–2.57; ≥4 RFs, OR: 2.50, 95% CI: 1.55–4.03] and multivessel disease (OR = 1.32, 95% CI: 1.08–1.60) increased the risk of non‐STEMI (NSTEMI). Conclusions Conventional RFs were highly prevalent in young Chinese men who were hospitalized for first AMI events, and the temporal trends varied different between China and US populations. Multivessel disease and cluster of conventional RFs are closely related to NSTEMI. Optimized preventive strategies among young adults are warranted.

To address the limitations of traditional cadmium telluride (CdTe) photovoltaic (PV) windows in comprehensively considering overall building energy consumption, indoor lighting comfort, and outdoor visibility, this study proposes a three-domain division CdTe PV window design, which divides the window into three areas, each undertaking different functions. This study utilized the Energy Plus 9.3.0 software and Radiance 1.6.0 software for numerical simulation to explore the impact of different design parameters (such as coverage rate and arrangement mode of PV) of the three-domain division PV windows on building energy consumption and the proportion of indoor effective natural lighting (UDI300lx–2000lx) in single-story office buildings in Yan’an. Additionally, this study employed the entropy weight–TOPSIS method to conduct a comprehensive evaluation of 84 schemes. The results indicate that both the coverage rate and the arrangement mode of PV significantly influence building energy-saving and indoor lighting environment. The energy-saving rate initially increases and then decreases with higher PV coverage, while UDI300lx–2000lx generally exhibits an upward trend and slightly decreases later. The V3-V1 or H3-V1 arrangement mode demonstrates superior energy-saving performance, whereas the H3-V1 or V3-H1 arrangement mode provides better indoor lighting comfort. The evaluation weights for energy-saving rate and effective daylighting are 0.38 and 0.62, respectively. Based on the comprehensive evaluation, the optimal configuration is determined to be V1-90%-V2-10%-H3-90%, achieving an energy-saving rate of 11.1% and a UDI300lx–2000lx value of 56.95%.

In the context of China’s vigorous promotion of “better housing” construction, transforming affordable housing into “better housing” has become an important practical task. Since the 1960s, when the public housing system was standardized, South Korea has established a diversified and high-quality public housing supply system. Therefore, this study takes public rental housing in Seoul as examples, summarizes the development experience of public housing in South Korea, with the aim of providing new inspirations for the development direction, concepts, and spatial optimization of affordable housing in China. The research examines the Korean public housing policies, housing history, and cultural background from a theoretical perspective, analyzes the formation background and supply types of public housing, as well as the evolution mechanism of the unit plan, and takes typical public rental housing completed in the 2010s as examples to analyze and explore the spatial composition and structural characteristics of the affordable housing unit plans. Finally, based on China’s national conditions, this study highlights the policy implications of South Korea’s public housing experience for the development of affordable housing in China and proposes a “policy-space-culture” tripartite guidance framework to support the realization of the goal of constructing “better housing” within the affordable housing sector. Specifically, (1) at the policy level, it is recommended to establish a multi-tiered supply mechanism and implement an early warning system for emerging affordable housing demands; (2) at the spatial design level, standardization and modularization of housing design are advocated; and (3) at the cultural level, it is suggested to enhance cultural adaptability by aligning housing design with local residential culture and residents’ living habits.

Myocardial fibrosis is closely related to high morbidity and mortality. In Inner Mongolia, Gentianella amarella subsp. acuta (Michx.) J.M.Gillett ( G. acuta ) is a kind of tea used to prevent cardiovascular diseases. Bellidifolin (BEL) is an active xanthone molecule from G. acuta that protects against myocardial damage. However, the effects and mechanisms of BEL on myocardial fibrosis have not been reported. In vivo , BEL dampened isoprenaline (ISO)-induced cardiac structure disturbance and collagen deposition. In vitro, BEL inhibited transforming growth factor (TGF)-β1-induced cardiac fibroblast (CF) proliferation. In vivo and in vitro , BEL decreased the expression of α-smooth muscle actin (α-SMA), collagen Ⅰ and Ⅲ, and inhibited TGF-β1/Smads signaling. Additionally, BEL impeded p38 activation and NR4A1 (an endogenous inhibitor for pro-fibrogenic activities of TGF-β1) phosphorylation and inactivation in vitro . In CFs, inhibition of p38 by SB203580 inhibited the phosphorylation of NR4A1 and did not limit Smad3 phosphorylation, and blocking TGF-β signaling by LY2157299 and SB203580 could decrease the expression of α-SMA, collagen I and III. Overall, both cell and animal studies provide a potential role for BEL against myocardial fibrosis by inhibiting the proliferation and phenotypic transformation of CFs. These inhibitory effects might be related to regulating TGF-β1/Smads pathway and p38 signaling and preventing NR4A1 cytoplasmic localization.

Severe flower and fruit abscission leading to low yields makes improving fruit set and increasing production critical challenges in Macadamia cultivation. Irrigation and artificial pollination during the flowering period significantly influence the fruiting and yield of macadamia. However, the synergistic effect of these two factors on macadamia production and yield remains unclear. This study investigated the effects of irrigation and artificial pollination on fruit set and yield using 11-year-old ‘A16’ Macadamia trees. Four treatments were applied: drought (DC), drought with artificial pollination (DC + AP), irrigation (I), and irrigation with artificial pollination (I + AP). Each treatment included three biological replicates, with a total of 12 trees. We assessed fruit set and yield, analyzing underlying mechanisms by evaluating changes in pollen viability, leaf morphology, inflorescence characteristics, and leaf/inflorescence physiology. Results revealed that DC + AP, I, and I + AP treatments exhibited significantly higher pollen viability and raceme length compared to DC. The I + AP treatment also resulted in the longest summer shoot internode length. Racemes were more sensitive to drought stress than leaves. Soluble protein and soluble sugar content in racemes were significantly higher in I + AP than in I and DC + AP, and lowest in DC. The DC treatment showed significantly higher superoxide dismutase (SOD), peroxidase (POD), catalase (CAT), and malondialdehyde (MDA) contents compared to I and I + AP. Leaf physiological traits exhibited inconsistent changes across treatments. Both artificial pollination and irrigation significantly increased fruit set. Treatment efficacy ranked as follows: I + AP (102.00% increase) > DC + AP (56.00% increase) > I (14.00% increase) > DC. Consequently, the I + AP treatment achieved significantly higher yield, fruit numbers, and fruit diameters than the other treatments. In terms of yield, treatment efficacy ranked as follows: I + AP (77.72% increase) > DC + AP (41.14 increase) > I (27.54% increase) > DC. These findings provide a scientific basis for enhancing yield in high-yield Macadamia cultivation systems.

Gentianella acuta (G. acuta) is one of the most commonly used herbs in Chinese Mongolian medicine for the treatment of heart disease. Previously, it was found that G. acuta ameliorated cardiac function and inhibited isoproterenol (ISO)-induced myocardial fibrosis in rats. In this study, the underlying anti-fibrotic mechanism of G. acuta was further elucidated. Histopathological changes in the heart were observed by hematoxylineosin, Masson trichrome and wheat germ agglutinin staining. Relevant molecular events were investigated using immunohistochemistry and western blotting. The results revealed that G. acuta caused improvements in myocardial injury and fibrosis. G. acuta also inhibited collagens I and III and α-smooth muscle actin production in heart tissue. G. acuta downregulated the expression of transforming growth factor β1 (TGF-β1) and notably inhibited the levels of phosphorylation of TGF-β receptors I and II. Furthermore, G. acuta caused downregulation of the intracellular mothers against decapentaplegic homolog (Smads)2 and 4 expression and inhibited Smads2 and 3 phosphorylation. The results further demonstrated that the mechanism underlying anti-myocardial fibrosis effects of G. acuta was based upon the suppression of the TGF-β1/Smads signaling pathway. Therefore, G. acuta may be a potential therapeutic agent for ameliorating myocardial fibrosis.

Background: Farmers harvest two batches fruits of Lemons ( Citrus limon L. Burm. f.) i.e., spring flowering fruit and autumn flowering fruit in dry-hot valley in Yunnan, China. Regular lemons harvested in autumn have smooth skin. However, lemons harvested in spring have rough skin, which makes them less attractive to customers. Furthermore, the rough skin causes a reduction in commodity value and economical losses to farmers. This is a preliminary study that investigates the key transcriptomic and metabolomic differences in peels of lemon fruits (variety Yuning no. 1) harvested 30, 60, 90, 120, and 150 days after flowering from the same trees in different seasons. Results: We identified 5,792, 4,001, 3,148, and 5,287 differentially expressed genes (DEGs) between smooth peel (C) and rough peel (D) 60, 90, 120, and 150 days after flowering, respectively. A total of 1,193 metabolites differentially accumulated (DAM) between D and C. The DEGs and DAMs were enriched in the mitogen-activated protein kinase (MAPK) and plant hormone signaling, terpenoid biosynthesis, flavonoid, and phenylalanine biosynthesis, and ribosome pathways. Predominantly, in the early stages, phytohormonal regulation and signaling were the main driving force for changes in peel surface. Changes in the expression of genes associated with asymmetric cell division were also an important observation. The biosynthesis of terpenoids was possibly reduced in rough peels, while the exclusive expression of cell wall synthesis-related genes could be a possible reason for the thick peel of the rough-skinned lemons. Additionally, cell division, cell number, hypocotyl growth, accumulation of fatty acids, lignans and coumarins- related gene expression, and metabolite accumulation changes were major observations. Conclusion: The rough peels fruit (autumn flowering fruit) and smooth peels fruit (spring flowering fruit) matured on the same trees are possibly due to the differential regulation of asymmetric cell division, cell number regulation, and randomization of hypocotyl growth related genes and the accumulation of terpenoids, flavonoids, fatty acids, lignans, and coumarins. The preliminary results of this study are important for increasing the understanding of peel roughness in lemon and other citrus species.

Myocardial fibrosis is the main morphological change of ventricular remodelling caused by cardiovascular diseases, mainly manifested due to the excessive production of collagen proteins. SRY-related high mobility group-box gene 9 (SOX9) is a new target regulating myocardial fibrosis. Bellidifolin (BEL), the active component of G. acuta, can prevent heart damage. However, it is unclear whether BEL can regulate SOX9 to alleviate myocardial fibrosis. The mice were subjected to isoproterenol (ISO) to establish myocardial fibrosis, and human myocardial fibroblasts (HCFs) were activated by TGF-β1 in the present study. The pathological changes of cardiac tissue were observed by HE staining. Masson staining was applied to reveal the collagen deposition in the heart. The measurement for expression of fibrosis-related proteins, SOX9, and TGF-β1 signalling molecules adopted Western blot and immunohistochemistry. The effects of BEL on HCFs, activity were detected by CCK-8. The result showed that BEL did not affect cell viability. And, the data indicated that BEL inhibited the elevations in α-SMA, Collagen I, and Collagen III by decreasing SOX9 expression. Additionally, SOX9 suppression by siRNA downregulated the TGF-β1 expression and prevented Smad3 phosphorylation, as supported by reducing the expression of α-SMA, Collagen I, and Collagen III. In vivo study verified that BEL ameliorated myocardial fibrosis by inhibiting SOX9. Therefore, BEL inhibited SOX9 to block TGF-β1 signalling activation to ameliorate myocardial fibrosis.