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An open type of microchannel with diamond pin fins (OM-DPFs) is introduced for the cooling of high-performance electronic chips. For a Reynolds number (Re) of 247~1173, a three-dimensional model is established to explore the hydrothermal properties of the OM-DPF and compare it to traditional heat sinks with closed rectangular microchannels (RMs), heat sinks with open microchannels (OMs), and the results in the existing research. Firstly, the synergy between tip clearance and pin fins on the hydrothermal properties is discussed. Secondly, the entropy production principle is adopted to analyze the irreversible losses for different heat sinks. Lastly, the total efficiencies of different heat sinks are assessed. The RMs present the worst heat transfer with the lowest friction loss. For the OMs, the temperature and pressure drop are decreased slightly compared to those of the RMs, and the irreversible loss is reduced by 4% at Re = 1173 because of the small tip clearance. But the total efficiency is lower than that of the RMs because the pressure drop advantage is offset by the weak heat transfer. For the OM-DPF, the combined structure has a noticeable impact on the multiple physical fields and hydrothermal characteristics, which present the best thermal performance at the cost of the highest friction loss. The irreversible loss of heat transfer in the OM-DPF is reduced obviously, but the friction irreversible loss significantly increases at high Re values. At Re = 429, the total entropy production of the OM-DPF is reduced by 47.57% compared with the RM. Compared to the OM and the single-pin fin structure in the literature, the total efficiency of the OM-DPF is increased by 14.56% and 40.32% at Re = 614. For a pump power of 0.1 W, the total thermal resistance (Rth) of the OM-DPF is dropped by 23.77% and 21.19% compared to the RM and OM. For a similar Rth, the pump power of the combined structure is 63.64% and 42.86% lower than that of the RM and OM. Thus, the novel combined heat sink can achieve efficient heat removal while controlling the energy consumption of liquid cooling systems, which has bright application prospects.

Macrophage filopodia, which are dynamic nanotube-like protrusions, have mainly been studied in the context of pathogen clearance. The mechanisms by which they facilitate intercellular communication and mediate tissue inflammation remain poorly understood. Here, we show that macrophage filopodia produce a unique membrane structure called “filopodial tip vesicle” (FTV) that originate from the tip of macrophages filopodia. Filopodia tip-derived particles contain numerous internal-vesicles and function as cargo storage depots via nanotubular transport. Functional studies indicate that the shedding of FTV from filopodia tip allows the delivery of many molecular signalling molecules to fibroblasts. We observed that FTV derived from M1 macrophages and high glucose (HG)-stimulated macrophages (HG/M1-ftv) exhibit an enrichment of the chemokine IL11, which is critical for fibroblast transdifferentiation. HG/M1-ftv induce renal interstitial fibrosis in diabetic mice, while FTV inhibition or targeting FTV IL11- alleviates renal interstitial fibrosis, suggesting that the HG/M1-ftv IL11 pathway may be a novel mechanism underlying renal fibrosis in diabetic nephropathy. Collectively, FTV release could represent a novel function by which filopodia contribute to cell biological processes, and FTV is potentially associated with macrophage filopodia-related fibrotic diseases. 8XMabVtTRQ4kBojsCRSFmY Video Abstract

Douyin (TikTok) has gradually emerged as an important channel through which the public obtains health information. This study aimed to evaluate the content, quality, and reliability of syphilis-related short videos on Douyin. We conducted two rounds of data collection on Douyin, extracting video duration, engagement metrics, uploader identity, and video content for syphilis-related videos. Video quality and reliability were assessed using the Global Quality Score (GQS) and the modified DISCERN (mDISCERN) tool. Correlation analyses were performed between video metrics and quality scores. A total of 81 and 95 videos were included in the first and second rounds, respectively. Clinical manifestations were the most frequently discussed topic, whereas key information on diagnosis and prognosis was insufficiently covered. In the first round, the median GQS was 2.00 (IQR: 2.00-3.00), and the median mDISCERN score was 3.00 (IQR: 3.00-3.00). In the second round, the median GQS was 2.00 (IQR: 2.00-2.00), and the median mDISCERN score was 2.00 (IQR: 2.00-2.00). In both analyses, videos uploaded by healthcare professionals had higher GQS and mDISCERN scores than those uploaded by individual users (  < 0.05). No significant correlations were found between video engagement metrics and either GQS or mDISCERN scores in either round (  > 0.05). The overall quality and reliability of syphilis-related videos on Douyin are suboptimal, and current content may not adequately meet public health information needs. Strengthening the involvement of healthcare professionals and improving content structure are essential to enhance the health education value of short video platforms.

Background Gonorrhea is a common sexually transmitted disease that remains highly prevalent worldwide. Social media platforms such as TikTok have become important sources of public health information, yet the quality and reliability of video content on these platforms remain unclear. This study aimed to evaluate the content, quality, and reliability of gonorrhea-related short videos on TikTok. Methods A cross-sectional analysis was conducted on 71 gonorrhea-related short videos on TikTok. Video characteristics, uploader types, and content themes were extracted. The Global Quality Score (GQS) and modified DISCERN (mDISCERN) tool were used to assess video quality and reliability. Correlation analysis was performed between video metrics and quality scores. Results The videos were generally short in duration (median: 49.00 s) but exhibited high user engagement. Common topics included clinical manifestations (64.79%), transmission routes (47.89%), and diagnosis (45.07%), while prevention, treatment and prognosis were less frequently discussed. The main uploaders were dermatologists, urologists, and individual users. Videos uploaded by healthcare professionals had significantly higher GQS scores than those from individual users, with a similar but statistically insignificant trend in mDISCERN scores. Positive correlations were found among engagement metrics (likes, favorites, comments, and shares), but no correlation was observed between engagement and video quality. Conclusions Gonorrhea-related TikTok videos are highly interactive but generally lack in quality, reliability, and content coverage. Increasing professional involvement and improving platform-level content regulation are essential to enhance the educational value of health information delivered via TikTok platforms.

Cardiac valve calcification (CVC) is common in dialysis patients and associated with increased cardiovascular risk. However, early screening has been limited by cost concerns. This study aimed to develop and validate a machine learning model to enhance early detection of CVC. Data were collected at four centers between 2020 and 2023, including 852 dialysis patients in the development dataset and 661 in the external validation dataset. Predictive factors were selected using LASSO regression combined with univariate and multivariate analyses. Machine learning models including CatBoost, XGBoost, decision tree, support vector machine, random forest, and logistic regression were used to develop the CVC risk model. Model performance was evaluated in both validation sets. Risk thresholds were defined using the Youden index and validated in the external dataset. In the development dataset, 32.9% of patients were diagnosed with CVC. Age, dialysis duration, alkaline phosphatase, apolipoprotein A1, and intact parathyroid hormone were selected to construct the CVC risk prediction model. CatBoost exhibited the best performance in the training dataset. The logistic regression model demonstrated the best predictive performance in both internal and external validation sets, with AUROCs of 0.806 (95% CI 0.750-0.863) and 0.757 (95% CI 0.720-0.793), respectively. Calibration curves and decision curves confirmed its predictive accuracy and clinical applicability. The logistic regression model was selected as the optimal model and achieved excellent risk stratification in CVC risk prediction. The predictive model effectively identifies CVC risk in dialysis patients and offers a robust tool for early detection and improved management.

In view of the oilfield well thin oil layer, small gap, and side drilling cementing after perforating and subsequent stimulation caused by the cement ring embrittlement (i.e., secondary channeling), the preparation of nano-SiO2/carbon fiber-reinforced body and its influence on the performance of oil well cement were studied to improve the cement stone and enhance its adaptability to oil well pressure in this study. Carbon fibers were treated by liquid phase oxidation and a coupling agent, and the “grafting to” was used to bond nano-SiO2 and carbon fibers. It was found that the mechanical properties of the enhanced cement stone are far better than those of the blank cement stone. The compressive strength and tensile strength of the enhanced oil well cement stone were increased by 25% and 26%, respectively, compared with those of the blank oil well cement sample; the modulus of elasticity was reduced by 29%. Finally, the enhancement mechanism of SiO2/carbon fiber reinforcement on cement stone was explored by infrared, scanning electron microscopy, and XRD patterns. The deflection effect, pull-out effect, and bridging effect of crack were obtained.

To investigate the performance of transcritical CO2 quasi-secondary compression cycle with ejector (TCIEJ) for heat pump water heaters, the thermodynamic model of TCIEJ is established based on the pinch point, and TCEX, TCEJ, and TCI are selected as comparisons. The effects of changing high pressure and ambient temperature on the heating COP and compressor exhaust temperature are analyzed, and the influence of cooling water inlet and outlet temperature and vapor injection pressure on TCIEJ is further analyzed. The results show that there are optimal high pressures that make the heating COP of the four heat pump cycles reach the maximum value, of which TCIEJ has the best performance. At an ambient temperature of −15 °C, the maximum heating COP of TCIEJ increased by about 20.5%, 14.9%, and 7.9% compared with TCEX, TCEJ, and TCI. With the increase in ambient temperature, the optimal high pressure continues to increase, and the corresponding maximum heating COP gradually increases. Selecting the geometric mean of high pressure and evaporation pressure as the optimal vapor injection pressure for TCIEJ, the error is small compared to the actual optimal vapor injection pressure. With the increase in ambient temperature and cooling water outlet temperature, the optimal high pressure of TCIEJ continues to increase, and the correlation formula of optimal high pressure is fitted according to the simulation results.

Utidelone, a genetically engineered epothilone analogue, has shown promise as a potential treatment for breast cancer in phase 1 and 2 trials. The aim of this phase 3 trial was to compare the efficacy and safety of utidelone plus capecitabine versus capecitabine alone in patients with metastatic breast cancer. We did a multicentre, open-label, superiority, phase 3, randomised controlled trial in 26 hospitals in China. Eligible participants were female patients with metastatic breast cancer refractory to anthracycline and taxane chemotherapy regimens. We randomly assigned participants (2:1) using computer based randomisation and block sizes of 6 to a 21-day cycle of either utidelone (30 mg/m2 intravenously once per day on days 1–5) plus capecitabine (1000 mg/m2 orally twice per day on days 1–14), or capecitabine alone (1250 mg/m2 orally twice per day on days 1–14), until disease progression or unacceptable toxicity occurred. Patients, physicians, and assessors were not masked to treatment allocation; however, an independent radiology review committee used to additionally assess response was masked to allocation. The primary endpoint was centrally assessed (by an independent radiology review committee) progression-free survival, and analysed using the Kaplan-Meier product-limit method in the intention-to-treat population. Safety was assessed in all participants who received at least one dose of study drug. Follow-up is ongoing. This study is registered at ClinicalTrials.gov, number NCT02253459. Between Aug 8, 2014, and Dec 14, 2015, we enrolled and randomly assigned 270 patients to treatment with utidelone plus capecitabine, and 135 to capecitabine alone. Median follow-up for progression-free survival was 6·77 months (IQR 3·81–10·32) for the utidelone plus capecitabine group and 4·55 months (2·55–9·39) for the capecitabine alone group. Median progression-free survival by central review in the utidelone plus capecitabine group was 8·44 months (95% CI 7·95–9·92) compared with 4·27 months (3·22–5·68) in the capecitabine alone group; hazard ratio 0·46, 95% CI 0·36–0·59; p<0·0001. Peripheral neuropathy was the most common grade 3 adverse event in the utidelone plus capecitabine group (58 [22%] of 267 patients vs 1 [<1%] of 130 patients in the capecitabine alone group). Palmar-plantar erythrodysaesthesia was the most prominent grade 3 adverse event in the capacitabine alone group (in 10 [8%] of 130 patients) and was the next most frequent grade 3 event in the utidelone plus capecitabine group (in 18 [7%] of 267 patients). 16 serious adverse events were reported in the combination therapy group (diarrhoea was the most common, in three [1%] patients) and 14 serious adverse events were reported in the monotherapy group (the most common were diarrhoea, increased blood bilirubin, and anaemia, in two [2%] patients for each event). 155 patients died (99 in the combination therapy arm, 56 in the monotherapy arm). All deaths were related to disease progression except for one in each group (attributed to pericardial effusion in the combination therapy group and dyspnoea in the monotherapy group) that were considered possibly or probably treatment-related. Despite disease progression with previous chemotherapies, utidelone plus capecitabine was more efficacious compared with capecitabine alone for the outcome of progression-free survival, with mild toxicity except for peripheral sensory neuropathy, which was manageable. The findings from this study support the use of utidelone plus capecitabine as an effective option for patients with metastatic breast cancer. Beijing Biostar Technologies, Beijing, China.

In order to improve the efficiency of the system and promote its application in other industries, the performance of a thermoelectric subcooled CO2 transcritical heat pump system was studied. A simulation model of the system was established using steady-state lumped parameter technology, and the experimental data were compared with the simulation results. The effects of cooling and chilled water flow rate and temperature, subcooling degree, compressor discharge pressure on the coefficient of performance (COP), and heating coefficient of performance (COPh) were analyzed. The results showed that COP/COPh increased with the increase in cooling and chilled water flow rate and chilled water temperature and decreased with the increase in cooling water temperature. The experimental COPh and COP of the system with a thermoelectric subcooler increased by 4.19% and 4.62%, respectively, compared to the system without it. The simulated data was in good agreement with the experimental data, and the error was within 10%, thus verifying the correctness of the model. When the subcooling degree increased to 11 °C, the system simulation results showed that COP/COPh increased by about 40% and 13.3%, respectively. The optimal high pressure was about 8.0 MPa, which corresponded to the maximum COP and COPh of the system of 3.25 and 4.25, respectively. The research results can provide a theoretical basis for future system optimization.

Community-based peer support service is widely and effectively deployed for persons suffering severe mental illness (SMI) in countries with well-developed outpatient mental health systems. The objective of this study is to evaluate the effectiveness of a 1-year peer service project among persons with SMI implemented in China. A total of 101 consumers (service recipients) and 66 family caregivers were recruited at baseline from communities located in Beijing and Chengdu. Severity of psychiatric symptoms, personal and social functioning, self-esteem, life satisfaction, and medication adherence were evaluated among consumers. Self-esteem, life satisfaction, anxiety, and depressive symptoms were assessed among family caregivers. Participants were reevaluated at 1 year with the same measures. Changes in outcomes from baseline to 1-year follow-up were examined using paired sample tests or Stuart-Maxwell tests. Consumers' psychiatric symptoms were decreased at 1 year (  < 0.001). Their personal and social functioning (  = 0.003) and life satisfaction (  < 0.001) were increased. There were no improvements in self-esteem (  = 0.108) and medication adherence (  ≥ 0.827) among consumers. For caregivers, no increases were presented in outcomes at the 1-year assessment (  ≥ 0.164). The findings suggest that peer support services could be sustainably implemented across China, with positive impacts on the psychiatric symptoms, social functioning, and life satisfaction of participants suffering SMI.