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A 26‐year‐old woman with recurrent syncope was diagnosed with Andersen‐Tawil syndrome (ATS) following abnormal electrocardiographic (ECG) findings. Her history of ventricular arrhythmias and prominent U waves on ECG led to genetic testing, which identified a KCNJ2 mutation. This case underscores the importance of recognizing ATS‐specific ECG patterns, including broad U waves, in diagnosing arrhythmias. Following medication adjustments, her symptoms improved, highlighting the significance of tailored treatment for ATS‐associated arrhythmias.

Considering the risk aversion characteristics of supply chain members, how to effectively design the government subsidy strategy and green supply chain strategy is a realistic and urgent issue. Regarding this, we optimize and compare four three-stage Stackelberg game models between government and a two-echelon green supply chain, namely both manufacturer and retailer risk neutral (BN), manufacturer risk aversion while retailer risk neutral (MA), retailer risk aversion while manufacturer risk neutral (RA) and both manufacturer and retailer risk aversion (BA). The government as the leader decides the subsidy rate of green input cost with the goal of maximizing social welfare; the manufacturer as the first follower makes decisions on product greenness and wholesale price to maximize its own interests; and the retailer as the second follower determines retail prices to maximize its own interests. Employing mathematical reasoning and numerical simulation investigate thoroughly the effects of the government subsidies and the members’ risk aversion. Results indicate that an appropriate government subsidy investment has a positive effect on optimal decisions and related benefits. Risk aversion is in favor of improvement of product greenness and social welfare while reduction of retail price. With the increase of manufacturer risk aversion, green subsidy investment rate and retailer expected revenue increase; on the contrary, the wholesale price and manufacturer expected revenue decrease. With the increase of retailer risk aversion, the wholesale price and manufacturer expected revenue increase, while green subsidy investment rate and retailer expected revenue decrease. In the model of BN, product greenness and social welfare are the lowest, while retail price is the highest. BA is opposite to BN. In the model of RA, green subsidy investment rate and retailer expected revenue the lowest, while wholesale price and manufacturer expected revenue the highest. RA is opposite to MA. The government should formulate appropriate subsidy policies to encourage manufacturers to produce green products and raise consumers’ green awareness. Enterprises should control their own risk aversion and assess the risk aversion of the other party reasonably.

To assess retinal microvascular network impairments in the eyes of mild cognitive impairment (MCI) and Alzheimer's disease (AD) patients with optical coherence tomography angiography (OCTA). A literature search was conducted in the PubMed and EMBASE databases to identify relevant studies detecting retinal microvascular attenuation among AD, MCI patients and cognitively healthy controls (HCs) by OCTA. Data were extracted by Review Manager V.5.4 and Stata V.14.0. Eight investigations were included in this meta-analysis, with 150 AD patients, 195 MCI patients and 226 HCs were eligible for meta-analysis. Evidence based on these studies demonstrated that there was a significantly decreased vessel density (VD) of the Optovue group in superficial capillary plexus (SCP): WMD = -2.26, 95% CI: -3.98 to -0.55, p = 0.01; in deep capillary plexus (DCP): WMD = -3.40, 95% CI: -5.99 to -0.81, p = 0.01, VD of the Zeiss group in SCP:WMD = -0.91, 95% CI: -1.79 to -0.02, p = 0.05 and an enlarged fovea avascular zone (FAZ):WMD = 0.06, 95% CI: 0.01 to 0.11, P = 0.02 in OCTA measurements of MCI patients. Additionally, in OCTA measurements of AD patients, there was a significantly decreased VD in the SCP: WMD = -1.88, 95% CI: -2.7 to -1.07, p<0.00001. In contrast, there was no significant decrease in DCP nor enlargement of FAZ in AD patients. Retinal microvascular alternations could be optimally screened in MCI patients detected by OCTA, which could be a warning sign of relative changes in the MCI before progressing to AD. Retinal microvasculature changes worth further investigation in larger scale clinical trials.

Piper nigrum Linnaeus is often used as a treatment for chills, stomach diseases, and other ailments. Piperine has many biological functions; however, its mechanism for preventing gastric mucosal damage is still unclear. The objective of this study was to investigate the preventive effects of piperine on ethanol-induced gastric mucosal injury by using GES-1 cells and rats. SOD, CAT, GSH-Px and MDA were effectively regulated in GES-1 cells pre-treated with piperine. Piperine significantly increased SOD, CAT and GSH-Px activities, but decreased the ulcer area, MDA, ROS and MPO levels in the gastric tissues of rats. RT-PCR analysis showed that piperine downregulated the mRNA expression levels of keap1, JNK, ERK and p38, and upregulated the mRNA transcription levels of Nrf2 and HO-1. Western blotting results indicated that piperine could activate the protein expression levels of Nrf2 and HO-1 and inhibit the protein expression levels of keap1, p-JNK, p-ERK and p-p38. In conclusion, piperine suppressed ethanol-induced gastric ulcers in vitro and in vivo via oxidation inhibition and improving gastric-protecting activity by regulating the Nrf2/HO-1 and MAPK signalling pathways.

Osteoporosis (OP) is characterized by decreased bone mass and deterioration of bone microstructure, significantly increasing fracture risk. Icariin (ICA), a natural compound, has demonstrated efficacy in improving bone microstructure and bone mineral density (BMD) across multiple OP models, with its targeting efficacy enhanced through innovative drug delivery systems. This review systematically summarizes recent advances in ICA research, focusing on its application dosage forms, therapeutic performance in various animal models, and underlying molecular mechanisms. In order to ensure a comprehensive and reliable report, we conducted a systematic search in the core collection of web of science according to PRISMA guidelines, and finally included 182 publications for in-depth analysis. ICA’s therapeutic efficacy is enhanced through innovative delivery systems, including traditional Chinese medicine formulations and advanced biomaterials. Studies across postmenopausal, glucocorticoid-induced, aging, and diabetic OP models consistently demonstrate ICA’s ability to improve bone microarchitecture and BMD. Mechanistically, ICA exerts dual-regulation effects by promoting osteogenesis while inhibiting osteoclastogenesis, coupled with multi-target actions involving autophagy regulation, anti-inflammatory effects, iron overload mitigation, and oxidative stress reduction. In conclusion, ICA’s comprehensive and multi-mechanistic intervention strategy, augmented by advanced delivery systems, presents a natural, safe, and efficacious candidate for OP treatment. This review synthesizes critical advances from molecular mechanisms to biomedical applications, supporting further clinical translation of ICA-based therapies.

Green technology innovation (GTI) has become a pivotal strategy for governments worldwide to address climate change and environmental degradation. However, the role of government environmental attention (GEA) in driving GTI remains underexplored, particularly at the city level. Utilizing China’s city-level panel data from 2004 to 2020 and textual analysis of 297 government work reports, this study constructs novel indicators for GEA and GTI to empirically examine their relationship. We find that GEA plays a beneficial role in promoting GTI, and the results are robust after considering endogeneity and further robustness test. Heterogeneity analysis reveals that this positive effect is stronger in coastal cities, economically advanced regions, and areas with high industrial agglomeration, highlighting the interplay between policy prioritization and regional development dynamics. The mechanism test shows that GEA has the potential to indirectly support GTI by easing financing constraints and promoting industrial structure upgrading. Our findings underscore the importance of tailoring environmental policies to local contexts, such as designing region-specific green financing mechanisms and industrial transition programs. This study not only contributes to the theoretical discourse on environmental governance and innovation but also provides actionable insights for policymakers to leverage GEA as a catalyst for achieving sustainable low-carbon development.

Background The Body Mass Index (BMI) has long been used as an anthropometric measurement. Waist circumference (WC) and waist-to-height ratio (WHtR) have been proposed as alternatives to BMI. Recently, two new anthropometric indices, the A Body Shape Index (ABSI) and Body Roundness Index (BRI) have been developed as possible improved alternatives to BMI and WC. The main research aim is to assess the capacity of the ABSI and BRI to identify subjects with diabetes mellitus (DM) and the secondary aim is to determine whether ABSI and/or BRI is superior to the traditional body indices (BMI, WC, and WHtR). Methods and Results This cross-sectional study was conducted in the rural areas of northeast China from January 2012 to August 2013, and the final analysis included data obtained form 5253 men and 6092 women. 1182 participants (10.4 %) suffered from DM. Spearman rank test showed that BRI and WHtR showed the highest Spearman correlation coefficient for DM whereas ABSI showed the lowest. The prevalence of DM increased across quartiles for ABSI, BMI, BRI, WC and WHtR. A multivariate logistic regression analysis of the presence of DM for the highest quartile vs. the lowest quartile of each anthropometric measure, showed that the WHtR was the best predictor of DM (OR: 2.40, 95 % CI: 1.42–3.39 in men; OR: 2.67, 95 % CI: 1.60–3.74 in women, both P  < 0.001), and the ABSI was the poorest predictor of DM (OR: 1.51, 95 % CI: 1.05–1.97 in men; OR: 1.55, 95 % CI: 1.07–2.04 in women, both P  < 0.05). ABSI showed the lowest AUCs (AUC: 0.61, 95 % CI: 0.58–0.63 for men; AUC: 0.61, 95 % CI: 0.59–0.63 for women) for DM in both sexes, while BRI (AUC: 0.66, 95 % CI: 0.63–0.68 for men; AUC: 0.67, 95 % CI: 0.65–0.69 for women) had high AUCs for DM that equaled those of WHtR. Conclusions Our results showed neither ABSI nor BRI were superior to BMI, WC, or WHtR for predicting the presence of DM. ABSI showed the weakest predictive ability, while BRI showed potential for use as an alternative obesity measure in assessment of DM.

Piperine, an important natural product, has a good anti-inflammatory effect. However, few researchers have studied its mechanism in these pathways. The objective of this research was to evaluate the molecular mechanism underlying the anti-inflammatory responses of piperine in lipopolysaccharide (LPS)-stimulated RAW264.7 cells. The purification and characterization of piperine from Piper nigrum L. were determined by HPLC, UPLC-Q-TOF-MS and 1H NMR. Then, the anti-inflammatory activity was evaluated by a reagent test kit, ELISA kits, RT-PCR and Western blot experiments. The results suggested that piperine (90.65 ± 0.46% purity) at a concentration of 10–20 mg/L attenuated the production of NO and ROS, downregulated the protein and mRNA expression levels of TNF-α, IL-1β and IL-6, and upregulated the protein and mRNA transcription levels of IL-10. Meanwhile, the Western blot results indicated that piperine could inhibit the phosphorylation levels of the ERK, JNK, p38 and p65 proteins. Our findings suggest that piperine is a potential anti-inflammatory substance, whose molecular mechanism may be to regulate the key factors of the NF-κB and MAPK signalling pathways.

Malaria is still the most widespread parasitic disease and causes the most infections globally. Owing to improvements in sanitary conditions and various intervention measures, including the use of antimalarial drugs, the malaria epidemic in many regions of the world has improved significantly in the past 10 years. However, people living in certain underdeveloped areas are still under threat. Even in some well-controlled areas, the decline in malaria infection rates has stagnated or the rates have rebounded because of the emergence and spread of drug-resistant malaria parasites. Thus, new malaria control methods must be developed. As the spread of the Plasmodium parasite is dependent on the part of its life cycle that occurs in mosquitoes, to eliminate the possibility of malaria infections, transmission-blocking strategies against the mosquito stage should be the first choice. In fact, after the gametocyte enters the mosquito body, it undergoes a series of transformation processes over a short period, thus providing numerous potential blocking targets. Many research groups have carried out studies based on targeting the blocking of transmission during the mosquito phase and have achieved excellent results. Meanwhile, the direct killing of mosquitoes could also significantly reduce the probability of malaria infections. Microorganisms that display complex interactions with Plasmodium , such as Wolbachia and gut flora, have shown observable transmission-blocking potential. These could be used as a biological control strategy and play an important part in blocking the transmission of malaria.

The integration of industrial robot application (IRA) into various sectors has catalyzed significant transformations in the labor market, reshaping the dynamics of individual migration decision (IMD). As industries increasingly adopt automation, the implications for workforce distribution and migration patterns become critical areas of study. Based on the conditional logit model and using CMDS data, this paper explores the relationship between IRA and IMD, as well as the heterogeneity effect and influencing mechanism. The findings indicate that IRA reduces the probability of the floating population choosing the city, and the results are robust after considering endogeneity and further robustness test. The impact of IRA on IMD is heterogeneous. Relatively speaking, the floating population with high education levels, health, younger, unmarried, female, agricultural household registration, state-owned enterprises, and non-routine task work does not over-think the impact of IRA during the migration process. In addition, the floating population also considers geographical location, city size, marketization level, wage level, and environmental quality when making migration decisions. the mechanism test shows that IRA attracts or suppresses the floating population through factors such as wage levels, housing price level, difficulty in finding a job, etc., depending on the result of individual utility maximization. These insights reveal the complex interplay between technological advancements in robotics and labor migration, emphasizing the need for comprehensive policy frameworks to manage these transformations effectively.