Base editing enables efficient nucleotide conversions without inducing DNA double-strand breaks(DSBs)or requiring exogenous donor DNA templates.However,its broader editing window often causes bystander editing,increas...Base editing enables efficient nucleotide conversions without inducing DNA double-strand breaks(DSBs)or requiring exogenous donor DNA templates.However,its broader editing window often causes bystander editing,increasing the risk of unintended mutations.In this study,we find that linker length significantly influences the editing window,and base editors with a 7-amino-acid linker reduce bystander editing by an average of 54.4%across 13 endogenous genomic sites in both rice and human cell lines.We further develop an optimized strategy by modulating the linker length between various deaminases and Cas9 nickases,which effectively reduces bystander editing across multiple applications,including functional studies,precise crop breeding,and correction of pathogenic variants.Our work reveals that shortening the linker enhances the specificity of base editing,addressing a key safety concern for its agricultural and therapeutic applications.展开更多
The diversion effect caused by the linked structure in a metro tunnel with cross-passage complicates the impact of longitudinal fire source location on the smoke backflow layering behavior that has not been clarified,...The diversion effect caused by the linked structure in a metro tunnel with cross-passage complicates the impact of longitudinal fire source location on the smoke backflow layering behavior that has not been clarified,despite the fact that the scenario exists in practice.A series of laboratory-scale experiments were conducted in this study to investigate the smoke back-layering length in a model tunnel with cross-passage.The heat release rate,the velocity of longitudinal air flow,and the location of the fire source were all varied.It was found that the behavior of smoke backflow for the fire source located at the upstream of bifurcation point resembles a single-hole tunnel fire.As the fire source’s position shifts downstream from the bifurcation point,the length of smoke back-layering progressively increases.A competitive interaction exists between airflow diversion and smoke diversion during smoke backflow,significantly affecting the smoke back-layering length in the main tunnel.The dimensionless smoke back-layering length model was formulated in a tunnel featuring a cross-passage,taking into account the positions of longitudinal fire sources.The dimensionless smoke back-layering length exhibits a positive correlation with the 17/18 power of total heat release rate Q and a negative correlation with the 5/2 power of longitudinal ventilation velocity V.展开更多
Locked segments are high-strength structural elements in fault zones that release significantseismic energy during earthquakes.In fracture mechanics,they act as high-stress concentration patches(asperities)where ruptu...Locked segments are high-strength structural elements in fault zones that release significantseismic energy during earthquakes.In fracture mechanics,they act as high-stress concentration patches(asperities)where rupture initiates.The progressive failure of locked segments along faults plays a crucial role in the energy partition of earthquakes.The impact of locked segments on the near-fielddeformation and nucleation of faults,however,remains poorly understood.In this study,rock-like materials with pre-manufactured strike-slip faults containing various locked segments lengths under uniaxial stress.The mechanical properties,local deformation fields,and slip displacement rates during the uniaxial loading of the models were quantified.Results indicate that the uniaxial compressive strength and elastic modulus of the system peak once the ratio of locked segment to fault length is approximately 0.6.Meanwhile,the resistance of the models to deformation increased,and the failure mode transformed from shear failure to tensile failure.Under loading,compression and dilatation quadrants were formed on both sides of the fault.Large-scale fractures dominate the dilatation quadrants,and the degree of deformation disturbance in this region was significantly higher than that in the compression quadrants.With increasing locked segment length,the amplitude of deformation perturbations decreased after the peak strength.Shorter locked segments were more susceptible to deformation and failure.In the fracture evolution process,a relationship between the stress deflectionangle and the displacement rate was found,which is empirically described by an exponential function.These findings clarify geological structures failure mechanisms and support seismic hazard assessment for strike-slip earthquake regions.展开更多
Introduction:A28L,a virion membrane protein involved in mpox virus(MPXV)attachment and fusion,is a major target of neutralizing antibodies and a hotspot for genetic variation.This study investigated variations in its ...Introduction:A28L,a virion membrane protein involved in mpox virus(MPXV)attachment and fusion,is a major target of neutralizing antibodies and a hotspot for genetic variation.This study investigated variations in its low-complexity region(LCR7)among MPXV strains circulating in Shenzhen,China.Methods:A total of 6,834 publicly available MPXV clade IIb genomes from the Global Initiative on Sharing All Influenza Data(GISAID)were analyzed,and whole-genome sequencing was performed on 260 clinical isolates collected in Shenzhen during 2023–2025.LCR7 polymorphisms in OPG153/A28L and associated amino acid substitutions were characterized.Results:Global genomic analysis identified a conserved four-residue deletion(D382–D385)in LCR7 that was prevalent in lineage A viruses.In contrast,the dominant B.1 lineage and its derivatives,including all Shenzhen isolates,exhibited heterogeneous truncations,most commonly a single D385 deletion.Among locally circulating E.4 viruses,complex deletion patterns(e.g.,D383–D385 and D384–D385)and a characteristic amino acid substitution,OPG153_E293Q,were identified,the latter representing a lineage-defining mutation.Conclusion:MPXV evolution in Shenzhen was characterized by LCR7 structural plasticity and the accumulation of lineage-specific amino acid substitutions,supporting the genomic accordion model of viral adaptation.Continued surveillance of these genomic features is essential for monitoring local transmission and informing public health interventions.展开更多
BACKGROUND Coronary artery bypass grafting(CABG)reduces morbidity and mortality in coronary artery disease,but postoperative complications may prolong the length of hospital stay(LoS).Previous studies have reported as...BACKGROUND Coronary artery bypass grafting(CABG)reduces morbidity and mortality in coronary artery disease,but postoperative complications may prolong the length of hospital stay(LoS).Previous studies have reported associations between physical activity level(PAL),handgrip strength(HGS),postoperative complications,and LoS.However,evidence directly examining the relationship between preoperative PAL or HGS and LoS remains limited,particularly in small exploratory cohorts.AIM To explore the potential association between preoperative PAL and HGS and postoperative LoS in patients undergoing CABG.METHODS This retrospective exploratory study analyzed medical records of CABG patients treated at Dr.Hasan Sadikin General Hospital,Bandung,Indonesia,between October 2023 and March 2024.Preoperative PAL was assessed using the Global Physical Activity Questionnaire,and HGS was measured in both hands.Patients with complete PAL,HGS,and LoS data were included(n=27).Associations were analyzed using Spearman correlation for HGS and the Mann-Whitney U test for PAL,considering the limited sample size.RESULTS No statistically significant associations were observed between LoS and right-hand HGS(P=0.537),left-hand HGS(P=0.536),or total HGS(P=0.436).PAL was also not significantly associated with LoS(P=0.174),although patients with moderate PAL had a numerically shorter LoS.CONCLUSION In this study,no clear association was found between preoperative HGS or PAL and postoperative LoS following CABG.These findings should be interpreted as hypothesis-generating.Larger prospective studies are warranted.展开更多
Polyurethane elastomers exhibit high dielectric constants owing to their polar groups,and can be used as energy storage capacitors.Energy storage depends not only on the dielectric constant but also on the dielectric ...Polyurethane elastomers exhibit high dielectric constants owing to their polar groups,and can be used as energy storage capacitors.Energy storage depends not only on the dielectric constant but also on the dielectric loss.However,the relationship between chain structure and dielectric properties is not yet clear.Ketal-containing crosslinked polyurethane elastomers were prepared using cyclic ketal diol as a chain extender.The effect of the soft segment length on the dielectric properties and energy storage was investigated.The cause of the change in the dipolar polarization with the soft segment length was analyzed.As the soft segment length increased,the hard-soft hydrogen bonding decreased,whereas the hard-hard hydrogen bonding increased.Under the action of an electric field,the polar bonds in the ketal-containing polyurethane elastomer overcome the hydrogen bonding between hard-soft segments to produce polarization;meanwhile,they also experience crankshaft motions to generate polarization.The former has a relatively high relaxation activation energy of approximately 10-20 k J·mol-1,resulting in a large dielectric loss.The latter has a relatively low relaxation activation energy,approximately 0.7-1.7 kJ·mol-1,leading to low dielectric loss.As a result,the dielectric constant showed a decreasing trend,and the dielectric loss gradually decreased.This study provides a theoretical foundation for improving the dielectric properties of polyurethane elastomers.展开更多
Men frequently present to their health practitioners with concerns that they are not“normal”in the domains of sexual anatomy and function.This narrative review aims to synthesize the existing evidence on the general...Men frequently present to their health practitioners with concerns that they are not“normal”in the domains of sexual anatomy and function.This narrative review aims to synthesize the existing evidence on the general male population’s perception of normative sexual anatomy(penile length)and function(erectile and ejaculatory function).A structured literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines,limited to English language studies that involved adult participants from non-medical backgrounds.Of the 1098 studies identified,only seven met the predefined inclusion and exclusion criteria,indicating an insufficiency in research directly addressing men’s perceptions of normative sexual anatomy and function.The studies included in this review found that there was an inaccurate understanding of what empirically constitutes“normal”.Men considered above-average penis lengths to be common and perceived themselves as“small”despite being within the normal range.They tended to overestimate typical intercourse durations and were inaccurate in self-diagnosing ejaculatory dysfunction and erectile dysfunction.The inability to differentiate normal and abnormal sexual function reflects a poor understanding of what constitutes normal.These findings may inform future research and provide guidance for educating clinicians and the public to improve sexual health.展开更多
Static cracking demolition agent(SCDA)is an environmentally friendly and cost-effective material with broad potential for building demolition and rock fracturing engineering.Under expansive loading induced by SCDA,the...Static cracking demolition agent(SCDA)is an environmentally friendly and cost-effective material with broad potential for building demolition and rock fracturing engineering.Under expansive loading induced by SCDA,the directional fracture mechanisms of symmetrically slotted boreholes remain inadequately understood.Acoustic emission(AE)monitoring,digital image correlation(DIC),and numerical simulations were combined to systematically investigate the regulating mechanism of slot length on fracture behavior.The results indicate that as the slot length increases,the fracture modes transition from competitive propagation of multiple cracks to rapid through-going propagation of the main cracks along the slot direction.The competitive propagation of multiple cracks disperses the expansive energy among the propagating cracks,whereas rapid through-going propagation along the slot concentrates energy release in the slot direction.A critical slot length is identified at which energy release is most intense,causing the cumulative AE energy to first increase and then decrease with increasing slot length.The expansive pressure required for through-going of the main crack decreases progressively as the slot length increases.Once the main crack causes pressure release,the propagation of secondary cracks is suppressed due to insufficient driving force.These findings provide a theoretical basis for achieving controllable SCDA-induced directional fracturing.展开更多
Subarachnoid hemorrhage is a subtype of stroke that causes severe neurological damage and is associated with poor long-term prognosis.Cognitive impairment is a major manifestation of long-term neurological dysfunction...Subarachnoid hemorrhage is a subtype of stroke that causes severe neurological damage and is associated with poor long-term prognosis.Cognitive impairment is a major manifestation of long-term neurological dysfunction in patients with subarachnoid hemorrhage.However,there is notable absence of biological markers to predict long-term prognosis in this patient population.Given the aging-like neurocognitive phenomena associated with subarachnoid hemorrhage,this study postulates that telomere length,a recognized biomarker for aging,could be used as a prognostic indicator for subarachnoid hemorrhage.A left internal carotid artery intravascular puncture mouse model was used to simulate subarachnoid hemorrhage.Comprehensive neurological test scores were obtained through neurobehavioral assessments conducted at one-month intervals.Concurrently,the relative telomere length was analyzed by quantitative polymerase chain reaction,which was performed using DNA extracted from ear notch and brain tissue after each assessment.Furthermore,proteomic analysis was employed to investigate differential protein expression in hippocampal tissue.Subarachnoid hemorrhage mice exhibited persistent neurocognitive impairment over a prolonged period of time.There was a significant positive correlation between telomere length and neurological test scores,confirming the usefulness of telomere length as a prognostic indicator in subarachnoid hemorrhage.Hippocampal tissue from subarachnoid hemorrhage mice showed reduced expression of acetyl-coenzyme A synthetase-2 and abnormalities in the expression of proteins related to ribosomes,energy metabolism,and cellular signal transduction.This study confirmed telomere shortening in the brain and metabolic disturbances in the hippocampi of subarachnoid hemorrhage mice.Thus,telomere length is a predictive marker for long-term impairment of cognitive function in mice following experimental subarachnoid hemorrhage.展开更多
AIM:To observe the clinical features and the surgical outcomes of the high myopic(HM)patients with epiretinal membranes(ERM).METHODS:This was a retrospective study enrolled HM patients diagnosed with ERM who underwent...AIM:To observe the clinical features and the surgical outcomes of the high myopic(HM)patients with epiretinal membranes(ERM).METHODS:This was a retrospective study enrolled HM patients diagnosed with ERM who underwent vitrectomy between May 2012 and November 2021.Three groups were divided according to axial length(AXL):26–<28 mm(n=43),28–<30 mm(n=22),and≥30 mm(n=11).Baseline characteristics and postoperative visual and anatomical outcomes were analyzed.RESULTS:Totally 76 consecutive eyes of 73 HM patients(27 males),with a mean age of 60.5±9.2y(range:38–84y)were enrolled.The initial best-corrected visual acuity(BCVA)of the three groups was not significantly different(P=0.498).Longer AXL was associated with a higher incidence of both inner and outer macular retinoschisis(MRS),ellipsoid zone(EZ)disruption,and foveal retinal detachment(all P<0.05).Only the eyes in the 26–<28 mm group showed a significant improvement in postoperative BCVA.BCVA was improved in 77.6%of the eyes.Among the eyes with BCVA not improved,58.8%belonged to the group 26–<28 mm.The postoperative macular hole was seen in 1(1.32%)eye.Multivariate linear regression analysis indicated that initial BCVA(P<0.001)and epiretinal proliferation(P=0.010)influenced the final BCVA.CONCLUSION:AXL is not significantly associated with visual recovery.Early operative intervention might have better visual and anatomical outcomes in HM-ERM patients.展开更多
The onset,cessation,and length of the rainy season are crucial for global water resources,agricultural practices,and food security.However,the response of precipitation seasonality to global warming remains uncertain....The onset,cessation,and length of the rainy season are crucial for global water resources,agricultural practices,and food security.However,the response of precipitation seasonality to global warming remains uncertain.In this study,we analyze how global warming levels(GWLs)of 1.5℃ and 2℃ could affect the timing of rainfall onset(RODs),rainfall cessation(RCDs),and the overall duration of the rainy season(LRS)over global land monsoon(GLM)regions using simulations from CMIP6 under the SSP2-4.5 and SSP5-8.5 scenarios.With high model consensus,our results reveal that RODs are projected to occur later over Southern Africa,North Africa,and South America,but earlier over South Asia and Australia,in a warmer climate.The projected early RODs in Australia are more pronounced at the 2℃ GWL under SSP5-8.5.On the other hand,early RCDs are projected over South America and East Asia,while late RCDs are projected over North Africa,with high inter-model agreement.These changes are associated with a future decrease in LRS in most GLM regions.Additionally,we found that continuous warming over 1.5℃ will further reduce the length of the rainy season,especially over the South America,North Africa,and Southern Africa monsoon regions.The findings underscore the urgent need to mitigate global warming.展开更多
Titanium dioxide(TiO2),a versatile inorganic semiconductive material with a wide band gap and various crystal structures,has attracted a great deal of research interest and is used in a wide variety of fields.To bu...Titanium dioxide(TiO2),a versatile inorganic semiconductive material with a wide band gap and various crystal structures,has attracted a great deal of research interest and is used in a wide variety of fields.To build the gas sensor arrays that are the building blocks of artificial olfaction,gas-sensitive materials with particular properties are especially desirable to introduce diverse interactions between gases and materials,transducing them into differentiated resistive changes for pattern recognition.Therefore,it is important for researchers to develop new synthesis methods in pursuit of TiO2 nanowires(NWs)with small diameters,high length-to-diameter ratios,and arbitrary doping.In this study,a general and versatile method was developed for synthesizing quasi-single-crystalline doped TiO2(QSDTO)NWs with ultra-high length-to-diameter ratios(ca.200-730),small diameters(ca.55-210 nm),and,critically,arbitrary elemental doping.The morphology,crystal phase,band gap,and elemental composition of QSDTO NWs were systematically investigated.The tunability of their physical and chemical properties through transition metal doping,which is a valuable essential feature for the gas-sensitive materials used in sensor array applications,was clearly demonstrated.These results underscore the potential of this approach not only for the controlled synthesis of TiO2NWs but also for their implementation in advanced gas sensing technologies.展开更多
Limb lengthening stands as a transformative surgical procedure,offering newfound hope for individuals suffering from limb deformities or discrepancies.Several studies underscore the efficacy of both external and inter...Limb lengthening stands as a transformative surgical procedure,offering newfound hope for individuals suffering from limb deformities or discrepancies.Several studies underscore the efficacy of both external and internal fixators in correcting limb length discrepancy(LLD).The choice between these modalities depends on multiple patient-specific factors,with each method presenting distinct advantages and limitations.While the success of limb lengthening in managing LLD is well established,both short-term and long-term physical as well as psychological implications necessitate a critical evaluation of indications.The appropriateness of pursuing limb lengthening should be guided by meticulously considering the prospective physical benefits and psychological ramifications.To address this need,we present a novel treatment algorithm designed to guide clinical decision-making in the management of LLD.This algorithm integrates current evidence,complication patterns,and patient-centered considerations to provide a structured approach to selecting appropriate interventions.A multidisciplinary,patient-focused strategy remains essential for optimizing outcomes and improving the overall quality of life for individuals undergoing limb lengthening.展开更多
Understanding the particle behavior at the solid-liquid interface and regulating the interfacial thermal resistance is the key to solving the chip heat dissipation problem at extreme heat flux.To this end,non-equilibr...Understanding the particle behavior at the solid-liquid interface and regulating the interfacial thermal resistance is the key to solving the chip heat dissipation problem at extreme heat flux.To this end,non-equilibrium molecular dynamics simulations were used in this study to investigate the effects of water-solid interactions,surface charges,and static structure factors on the thermal resistance length.The number density and temperature profiles show that both water-solid interaction and surface charge determine the density and temperature distribution of the liquid in the system,and there is a competitive relationship between them.The temperature gradient,jump and thermal resistance length were calculated.We found that the thermal resistance length decreases with the increase of the interaction and surface charge mainly because of the drastic change in temperature jump.In particular,enhancing the water-solid interaction can reduce the thermal resistance length from 263.5A to 114.6A by a maximum of 56.5%,while increasing the surface charge can reduce the thermal resistance length from 263.5A to 46.7A by a maximum of 82.3%in the scope of this study.Moreover,it is found that the static structure factor is related to the solid-liquid interaction and the surface charge.For atomic-scale solid-liquid interfaces,the heat transfer performance can be optimized by increasing the peak value of the static structure factor to reduce the thermal resistance length.The findings in this study provide guidance for future studies to evaluate the possible solutions to improve the heat transfer performance of the solid-liquid interface,such as reducing the interfacial thermal resistance,and promoting its application in chip heat dissipation.展开更多
Physical fitness is well‐known to be associated with health outcomes.This pilot study examined the impact of different measures of fitness on length of stay following colectomy.A case‐control study was designed to e...Physical fitness is well‐known to be associated with health outcomes.This pilot study examined the impact of different measures of fitness on length of stay following colectomy.A case‐control study was designed to evaluate the effect of skeletal muscle mass,body fat,and frailty measures on post‐operative length of stay(LOS).A simple random sample of 50 patients in each arm was selected based on prolonged LOS.Binary logistic regression analysis was performed to determine associations between each covariate and LOS.After exclusions,40 cases and 36 controls were included in the analysis.Frailty,as determined by weight loss and the Modified Frailty Index was not associated with prolonged LOS(p=0.060 and p=0.469).Cross‐sectional muscle area(OR:0.994,95%CI:0.989-0.999,p=0.029)and skeletal muscle index(OR:0.981,95%CI:0.965-0.996,p=0.015)were associated with decreased LOS.Measures of body fat,as well as muscle‐to‐body fat ratios were not associated with LOS.These results suggest that body fat may be less influential than skeletal muscle when predicting post‐operative outcomes.This pilot study warrants further investigation with a larger number of patients to identify cut‐off values with which to provide targeted prehabilitation.展开更多
BACKGROUND Malnutrition is a common comorbidity in elderly patients with severe aortic valve stenosis undergoing transcatheter aortic valve replacement(TAVR).The geriatric nutritional risk index(GNRI),a validated and ...BACKGROUND Malnutrition is a common comorbidity in elderly patients with severe aortic valve stenosis undergoing transcatheter aortic valve replacement(TAVR).The geriatric nutritional risk index(GNRI),a validated and easy-to-use tool,has been previously associated with short/mid-term outcomes in such patients.This study aimed to confirm this association in the long-term in the contemporary TAVR era using new-generation devices and to evaluate its impact on length of hospitalization.METHODS A total of 1090 consecutive patients aged≥65 years undergoing TAVR between October 2015 and December 2021 at a single tertiary center were included.Patients were stratified into two groups based on baseline GNRI:the GNRI>98(low-risk)group and the GNRI≤98(moderate-to-high risk)group.The primary endpoint was all-cause mortality.Secondary endpoints included total length of hospitalization and length of intensive care unit stay.Kaplan-Meier curves and Cox regression models were used to assess survival differences and potential independent predictors.RESULTS Patients with GNRI≤98 had significantly higher cumulative mortality rates at all evaluated time points compared to patients with GNRI>98(30-day:6.9%vs.2.7%,1-year:39.1%vs.11.4%,5-year:67.3%vs.53.2%,all P<0.05).A multivariable Cox regression analysis showed that GNRI was an independent predictor of long-term mortality(up to five years)after adjusting for clinical,echocardiographic and laboratory parameters(HR=0.94,95%CI:0.92-0.96,P<0.001),with an increasing effect over time.The impact of GNRI on clinical outcomes was observed in patients in all three EuroSCORE II categories(low risk,intermediate risk,and high risk).Total hospitalization and intensive care unit stays were longer in patients with GNRI≤98[8(6-13)days vs.7(5-9)days,P<0.001 and 3(2-5)days vs.2(2-4)days,P<0.001,respectively].CONCLUSIONS In this large European cohort,GNRI was confirmed to be an independent predictor for long-term mortality up to five years in the contemporary era of TAVR use with new-generation devices.Hospital stay was longer in patients with lower GNRI.This easyto-use index could play a valuable role in the preprocedural assessment of patients undergoing TAVR and studies to explore the use of nutritional preprocedural optimization of patients with low GNRI values are warranted.展开更多
Discrete Fracture Network(DFN)modeling is widely employed to simulate fractured rock masses for various geotechnical applications.However,challenges in statistically characterizing three-dimensional fractures arise du...Discrete Fracture Network(DFN)modeling is widely employed to simulate fractured rock masses for various geotechnical applications.However,challenges in statistically characterizing three-dimensional fractures arise due to orientation,size,truncation,and censoring biases when inferring parameters from two-dimensional rock surface observation.This study introduces a fully automated method that leverages Monte Carlo Tree Search(MCTS),a reinforcement learning-based algorithm,to optimize DFN parameters,including fracture density and length.By defininga reward function that compares the simulated rock masses with observed data,the proposed method iteratively minimizes biases and enhances accuracy.Examined on natural outcrop data of a granitic rock body,this method demonstrates significantimprovements in parameter inference,achieving robust convergence and high fidelityto observed fracture characteristics.The approach offers a practical and efficientsolution for DFN modeling in rock engineering and geological applications.展开更多
AIM:To compare the effect of orthokeratology(OK)and defocus incorporated multiple segment(DIMS)lenses on axial length(AL)elongation in bilateral myopic anisometropic children.METHODS:This retrospective study enrolled ...AIM:To compare the effect of orthokeratology(OK)and defocus incorporated multiple segment(DIMS)lenses on axial length(AL)elongation in bilateral myopic anisometropic children.METHODS:This retrospective study enrolled bilateral myopic anisometropic children categorized into two groups:OK lenses and DIMS lenses.The eyes with more myopia(MM)were divided into MM eyes and the fellow eyes with less myopia(LM)into LM eyes.According to the myopia degree in MM eyes,the subjects were further assigned to-0.50 to-3.00 D subgroup and-3.25 to-6.00 D subgroup.The t-test was used to analyze the changes in AL elongation between groups and AL differences in both eyes,and the relationship between AL changes and baseline data was evaluated by Pearson linear correlation analysis.RESULTS:Totally 202 children(8-14y)were divided into OK group with mean age 10.97±1.91y(46 males and 50 females)and DIMS group with mean age 11.05±2.06y(58 males and 48 females).After 1y,the changes of AL in OK-MM eyes(0.14±0.18 mm)were significantly slower than that in OK-LM eyes(0.20±0.19 mm)and DIMS-MM eyes(0.19±0.18;P<0.001,P=0.037).The OK-LM eyes and DIMS-LM eyes,DIMS-MM eyes and DIMS-LM eyes showed no statistically significant difference in AL changes(P=0.337,0.381).In the-0.50 to-3.00 D subgroups,DIMSLM eyes had better effect of AL control than OK-LM eyes,the changes of AL in OK-MM eyes and DIMS-MM eyes were no statistically significant.In the-3.25 to-6.00 D subgroups,the results were similar in total group.The change of AL in four subgroups was negatively correlated with age(P<0.05).CONCLUSION:OK lens can reduce binocular anisometropia;DIMS lens has similar effect on the control of binocular myopia in children with myopic anisometropia.The OK lenses are more effective than DIMS lenses with higher degrees of myopia,while DIMS lens retard AL elongation more effectively than OK lens when the spherical equivalent refraction of MM eyes is lower than-3.00 D.展开更多
●AIM:To investigate the effects of cataract surgery on the axial length/corneal radius(AL/CR)ratio and choroidal thickness(CT)in school-age children and to analyze the underlying mechanisms.●METHODS:This prospective...●AIM:To investigate the effects of cataract surgery on the axial length/corneal radius(AL/CR)ratio and choroidal thickness(CT)in school-age children and to analyze the underlying mechanisms.●METHODS:This prospective cohort study enrolled school-age children who underwent phacoemulsification with intraocular lens(IOL)implantation between September 2024 and February 2025.The right eyes of bilateral cases and the affected eyes of unilateral cases were classified as Group A.Within this group,eyes implanted with trifocal IOLs were designated as Subgroup A1,whereas those receiving monofocal IOLs were designated as Subgroup A2.The contralateral healthy eyes of the unilateral cases formed Group B.Axial length(AL)and corneal curvature were measured using the IOL Master 700.CT was assessed using swept-source optical coherence tomography.●RESULTS:A total of 50 eyes from 32 patients(Subgroup A1,n=21,8.38±2.36y;Subgroup A2,n=11,7.55±2.16y;Group B,n=18,8.22±2.44y)were included in the study.Preoperatively,AL was markedly shorter in Group A compared to Group B(P0.05).Conversely,Group B showed a considerable increase in the AL/CR ratio and a pronounced reduction in CT,both statistically significant(all P<0.05).No notable differences were observed between Subgroups A1 and A2 in any of the measured parameters.Correlation analysis revealed meaningful negative correlations between AL,AL/CR ratio,and central subfield choroidal thickness(CSCT)in Group A at 1mo postoperatively and at the final follow-up(P<0.05).Still,no correlation was found among the changes in these parameters over the follow-up period.●CONCLUSION:In the early postoperative period,operated eyes of school-aged children show a stable AL/CR ratio and CT.Although a stable structural negative correlation between these two parameters is observed in operated eyes,the longitudinal coordinated relationship is disrupted,which may be related to the loss of accommodative function.Longer-term follow-up is needed to corroborate these findings.展开更多
The anchoring capacity of the anchor cable is closely related to the bonding length and radial pressure conditions.Through field pull-out tests,theoretical analysis,numerical simulation,and industrial tests,this study...The anchoring capacity of the anchor cable is closely related to the bonding length and radial pressure conditions.Through field pull-out tests,theoretical analysis,numerical simulation,and industrial tests,this study clarifies the relationship between radial pressure and bonding length for the ultimate pullout force and reveals the microscopic failure process of the resin-rock interface in the anchoring system.The results show that the ultimate load increases with the increase of bonding length in three different stages:rapid,slow,and uniform growth.The new mechanical model developed considering radial pressure describes the inverse relationship between radial pressure and the plastic zone on the bonding section,and quantifies the reinforcing effect of confining pressure on the anchoring force.During the pull-out process of the anchor cable,the generation of failure cracks is in the order of orifice,bottom,and middle of the hole.Radial pressure can effectively enhance the ultimate pull-out force,alleviate the oscillation increase of pull-out force,and inhibit resin cracking,but will produce an external crushing zone.It also reveals the synergistic effect between bonding length and radial pressure,and successfully carries out industrial tests of anchor cable support,which ensures the stability of the stope roof and provides an important reference for the design of anchor cable support in deep high-stress mines.展开更多
基金supported by the STI 2030-Major Projects(2023ZD04074)the National Natural Science Foundation of China(32422050 and 32401250)+4 种基金the National Key R&D Program of China(2024YFC3408200 and 2024YFF1000800)the Young Elite Scientists Sponsorship Program of the China Association for Science and Technology,Guangdong Provincial“Pearl River Talent Program”Innovation and Entrepreneurship Team Project(2023ZT10N019)the Key R&D Program of Guangxi Province(GKN AB24153006)Science and Technology Projects in Guangzhou(2025A04J7124 and 2025A04J3669)a specific university discipline construction project(2023B10564004).
摘要Base editing enables efficient nucleotide conversions without inducing DNA double-strand breaks(DSBs)or requiring exogenous donor DNA templates.However,its broader editing window often causes bystander editing,increasing the risk of unintended mutations.In this study,we find that linker length significantly influences the editing window,and base editors with a 7-amino-acid linker reduce bystander editing by an average of 54.4%across 13 endogenous genomic sites in both rice and human cell lines.We further develop an optimized strategy by modulating the linker length between various deaminases and Cas9 nickases,which effectively reduces bystander editing across multiple applications,including functional studies,precise crop breeding,and correction of pathogenic variants.Our work reveals that shortening the linker enhances the specificity of base editing,addressing a key safety concern for its agricultural and therapeutic applications.
基金funded by the National Natural Science Foundation of China(NSFC)under Grant No.52278415the National Key Research and Development Program of China under Grant No.2022YFC3801104+2 种基金Hebei Provincial Department of Education Project under Grant No.QN2025304the Innovation Fund Project of Hebei University of Engineering under Grant No.SJ2401002066the Sichuan Science and Technology Program under Grant No.2023YFS0407。
摘要The diversion effect caused by the linked structure in a metro tunnel with cross-passage complicates the impact of longitudinal fire source location on the smoke backflow layering behavior that has not been clarified,despite the fact that the scenario exists in practice.A series of laboratory-scale experiments were conducted in this study to investigate the smoke back-layering length in a model tunnel with cross-passage.The heat release rate,the velocity of longitudinal air flow,and the location of the fire source were all varied.It was found that the behavior of smoke backflow for the fire source located at the upstream of bifurcation point resembles a single-hole tunnel fire.As the fire source’s position shifts downstream from the bifurcation point,the length of smoke back-layering progressively increases.A competitive interaction exists between airflow diversion and smoke diversion during smoke backflow,significantly affecting the smoke back-layering length in the main tunnel.The dimensionless smoke back-layering length model was formulated in a tunnel featuring a cross-passage,taking into account the positions of longitudinal fire sources.The dimensionless smoke back-layering length exhibits a positive correlation with the 17/18 power of total heat release rate Q and a negative correlation with the 5/2 power of longitudinal ventilation velocity V.
基金supported by the National Natural Science Foundation of China(Grant No.42372322)Science and Technology Innovation Program for Postgraduate students in IDP subsidized by Fundamental Research Funds for the Central Universities(Grant No.ZY20240314)the research project of Spark Plan for Earthquake Science and Technology(Grant No.XH24060A).
摘要Locked segments are high-strength structural elements in fault zones that release significantseismic energy during earthquakes.In fracture mechanics,they act as high-stress concentration patches(asperities)where rupture initiates.The progressive failure of locked segments along faults plays a crucial role in the energy partition of earthquakes.The impact of locked segments on the near-fielddeformation and nucleation of faults,however,remains poorly understood.In this study,rock-like materials with pre-manufactured strike-slip faults containing various locked segments lengths under uniaxial stress.The mechanical properties,local deformation fields,and slip displacement rates during the uniaxial loading of the models were quantified.Results indicate that the uniaxial compressive strength and elastic modulus of the system peak once the ratio of locked segment to fault length is approximately 0.6.Meanwhile,the resistance of the models to deformation increased,and the failure mode transformed from shear failure to tensile failure.Under loading,compression and dilatation quadrants were formed on both sides of the fault.Large-scale fractures dominate the dilatation quadrants,and the degree of deformation disturbance in this region was significantly higher than that in the compression quadrants.With increasing locked segment length,the amplitude of deformation perturbations decreased after the peak strength.Shorter locked segments were more susceptible to deformation and failure.In the fracture evolution process,a relationship between the stress deflectionangle and the displacement rate was found,which is empirically described by an exponential function.These findings clarify geological structures failure mechanisms and support seismic hazard assessment for strike-slip earthquake regions.
基金Supported by the Shenzhen Medical Research Fund(B24010010,E24010011)Sanming Project of Medicine in Shenzhen(SZSM202211023)the Shenzhen Science and Technology Program(SYSPG20241211173921049).
摘要Introduction:A28L,a virion membrane protein involved in mpox virus(MPXV)attachment and fusion,is a major target of neutralizing antibodies and a hotspot for genetic variation.This study investigated variations in its low-complexity region(LCR7)among MPXV strains circulating in Shenzhen,China.Methods:A total of 6,834 publicly available MPXV clade IIb genomes from the Global Initiative on Sharing All Influenza Data(GISAID)were analyzed,and whole-genome sequencing was performed on 260 clinical isolates collected in Shenzhen during 2023–2025.LCR7 polymorphisms in OPG153/A28L and associated amino acid substitutions were characterized.Results:Global genomic analysis identified a conserved four-residue deletion(D382–D385)in LCR7 that was prevalent in lineage A viruses.In contrast,the dominant B.1 lineage and its derivatives,including all Shenzhen isolates,exhibited heterogeneous truncations,most commonly a single D385 deletion.Among locally circulating E.4 viruses,complex deletion patterns(e.g.,D383–D385 and D384–D385)and a characteristic amino acid substitution,OPG153_E293Q,were identified,the latter representing a lineage-defining mutation.Conclusion:MPXV evolution in Shenzhen was characterized by LCR7 structural plasticity and the accumulation of lineage-specific amino acid substitutions,supporting the genomic accordion model of viral adaptation.Continued surveillance of these genomic features is essential for monitoring local transmission and informing public health interventions.
摘要BACKGROUND Coronary artery bypass grafting(CABG)reduces morbidity and mortality in coronary artery disease,but postoperative complications may prolong the length of hospital stay(LoS).Previous studies have reported associations between physical activity level(PAL),handgrip strength(HGS),postoperative complications,and LoS.However,evidence directly examining the relationship between preoperative PAL or HGS and LoS remains limited,particularly in small exploratory cohorts.AIM To explore the potential association between preoperative PAL and HGS and postoperative LoS in patients undergoing CABG.METHODS This retrospective exploratory study analyzed medical records of CABG patients treated at Dr.Hasan Sadikin General Hospital,Bandung,Indonesia,between October 2023 and March 2024.Preoperative PAL was assessed using the Global Physical Activity Questionnaire,and HGS was measured in both hands.Patients with complete PAL,HGS,and LoS data were included(n=27).Associations were analyzed using Spearman correlation for HGS and the Mann-Whitney U test for PAL,considering the limited sample size.RESULTS No statistically significant associations were observed between LoS and right-hand HGS(P=0.537),left-hand HGS(P=0.536),or total HGS(P=0.436).PAL was also not significantly associated with LoS(P=0.174),although patients with moderate PAL had a numerically shorter LoS.CONCLUSION In this study,no clear association was found between preoperative HGS or PAL and postoperative LoS following CABG.These findings should be interpreted as hypothesis-generating.Larger prospective studies are warranted.
基金financially supported by the Hubei Key Laboratory of Pollutant Analysis&Reuse Technology(No.PA230102)。
摘要Polyurethane elastomers exhibit high dielectric constants owing to their polar groups,and can be used as energy storage capacitors.Energy storage depends not only on the dielectric constant but also on the dielectric loss.However,the relationship between chain structure and dielectric properties is not yet clear.Ketal-containing crosslinked polyurethane elastomers were prepared using cyclic ketal diol as a chain extender.The effect of the soft segment length on the dielectric properties and energy storage was investigated.The cause of the change in the dipolar polarization with the soft segment length was analyzed.As the soft segment length increased,the hard-soft hydrogen bonding decreased,whereas the hard-hard hydrogen bonding increased.Under the action of an electric field,the polar bonds in the ketal-containing polyurethane elastomer overcome the hydrogen bonding between hard-soft segments to produce polarization;meanwhile,they also experience crankshaft motions to generate polarization.The former has a relatively high relaxation activation energy of approximately 10-20 k J·mol-1,resulting in a large dielectric loss.The latter has a relatively low relaxation activation energy,approximately 0.7-1.7 kJ·mol-1,leading to low dielectric loss.As a result,the dielectric constant showed a decreasing trend,and the dielectric loss gradually decreased.This study provides a theoretical foundation for improving the dielectric properties of polyurethane elastomers.
摘要Men frequently present to their health practitioners with concerns that they are not“normal”in the domains of sexual anatomy and function.This narrative review aims to synthesize the existing evidence on the general male population’s perception of normative sexual anatomy(penile length)and function(erectile and ejaculatory function).A structured literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines,limited to English language studies that involved adult participants from non-medical backgrounds.Of the 1098 studies identified,only seven met the predefined inclusion and exclusion criteria,indicating an insufficiency in research directly addressing men’s perceptions of normative sexual anatomy and function.The studies included in this review found that there was an inaccurate understanding of what empirically constitutes“normal”.Men considered above-average penis lengths to be common and perceived themselves as“small”despite being within the normal range.They tended to overestimate typical intercourse durations and were inaccurate in self-diagnosing ejaculatory dysfunction and erectile dysfunction.The inability to differentiate normal and abnormal sexual function reflects a poor understanding of what constitutes normal.These findings may inform future research and provide guidance for educating clinicians and the public to improve sexual health.
基金funded by the National Natural Science Foundation of China(Nos.52478440,52578463,52004036,and 52208330)Project of Natural Science Foundation of Hunan Province(No.2024JJ5005)+1 种基金Key Scientific Research Project of Hunan Provincial Department of Education(Nos.23A0271 and 23C0131)Postgraduate Scientific Research Innovation Project of Hunan Province of China(No.CX20240768)。
摘要Static cracking demolition agent(SCDA)is an environmentally friendly and cost-effective material with broad potential for building demolition and rock fracturing engineering.Under expansive loading induced by SCDA,the directional fracture mechanisms of symmetrically slotted boreholes remain inadequately understood.Acoustic emission(AE)monitoring,digital image correlation(DIC),and numerical simulations were combined to systematically investigate the regulating mechanism of slot length on fracture behavior.The results indicate that as the slot length increases,the fracture modes transition from competitive propagation of multiple cracks to rapid through-going propagation of the main cracks along the slot direction.The competitive propagation of multiple cracks disperses the expansive energy among the propagating cracks,whereas rapid through-going propagation along the slot concentrates energy release in the slot direction.A critical slot length is identified at which energy release is most intense,causing the cumulative AE energy to first increase and then decrease with increasing slot length.The expansive pressure required for through-going of the main crack decreases progressively as the slot length increases.Once the main crack causes pressure release,the propagation of secondary cracks is suppressed due to insufficient driving force.These findings provide a theoretical basis for achieving controllable SCDA-induced directional fracturing.
基金National Natural Science Foundation of China,No.81901336(to JM).
摘要Subarachnoid hemorrhage is a subtype of stroke that causes severe neurological damage and is associated with poor long-term prognosis.Cognitive impairment is a major manifestation of long-term neurological dysfunction in patients with subarachnoid hemorrhage.However,there is notable absence of biological markers to predict long-term prognosis in this patient population.Given the aging-like neurocognitive phenomena associated with subarachnoid hemorrhage,this study postulates that telomere length,a recognized biomarker for aging,could be used as a prognostic indicator for subarachnoid hemorrhage.A left internal carotid artery intravascular puncture mouse model was used to simulate subarachnoid hemorrhage.Comprehensive neurological test scores were obtained through neurobehavioral assessments conducted at one-month intervals.Concurrently,the relative telomere length was analyzed by quantitative polymerase chain reaction,which was performed using DNA extracted from ear notch and brain tissue after each assessment.Furthermore,proteomic analysis was employed to investigate differential protein expression in hippocampal tissue.Subarachnoid hemorrhage mice exhibited persistent neurocognitive impairment over a prolonged period of time.There was a significant positive correlation between telomere length and neurological test scores,confirming the usefulness of telomere length as a prognostic indicator in subarachnoid hemorrhage.Hippocampal tissue from subarachnoid hemorrhage mice showed reduced expression of acetyl-coenzyme A synthetase-2 and abnormalities in the expression of proteins related to ribosomes,energy metabolism,and cellular signal transduction.This study confirmed telomere shortening in the brain and metabolic disturbances in the hippocampi of subarachnoid hemorrhage mice.Thus,telomere length is a predictive marker for long-term impairment of cognitive function in mice following experimental subarachnoid hemorrhage.
基金Supported by National Natural Science Foundation of China(No.82401269).
摘要AIM:To observe the clinical features and the surgical outcomes of the high myopic(HM)patients with epiretinal membranes(ERM).METHODS:This was a retrospective study enrolled HM patients diagnosed with ERM who underwent vitrectomy between May 2012 and November 2021.Three groups were divided according to axial length(AXL):26–<28 mm(n=43),28–<30 mm(n=22),and≥30 mm(n=11).Baseline characteristics and postoperative visual and anatomical outcomes were analyzed.RESULTS:Totally 76 consecutive eyes of 73 HM patients(27 males),with a mean age of 60.5±9.2y(range:38–84y)were enrolled.The initial best-corrected visual acuity(BCVA)of the three groups was not significantly different(P=0.498).Longer AXL was associated with a higher incidence of both inner and outer macular retinoschisis(MRS),ellipsoid zone(EZ)disruption,and foveal retinal detachment(all P<0.05).Only the eyes in the 26–<28 mm group showed a significant improvement in postoperative BCVA.BCVA was improved in 77.6%of the eyes.Among the eyes with BCVA not improved,58.8%belonged to the group 26–<28 mm.The postoperative macular hole was seen in 1(1.32%)eye.Multivariate linear regression analysis indicated that initial BCVA(P<0.001)and epiretinal proliferation(P=0.010)influenced the final BCVA.CONCLUSION:AXL is not significantly associated with visual recovery.Early operative intervention might have better visual and anatomical outcomes in HM-ERM patients.
基金supported by the Australian Research Council(Grant No.CE230100012)。
摘要The onset,cessation,and length of the rainy season are crucial for global water resources,agricultural practices,and food security.However,the response of precipitation seasonality to global warming remains uncertain.In this study,we analyze how global warming levels(GWLs)of 1.5℃ and 2℃ could affect the timing of rainfall onset(RODs),rainfall cessation(RCDs),and the overall duration of the rainy season(LRS)over global land monsoon(GLM)regions using simulations from CMIP6 under the SSP2-4.5 and SSP5-8.5 scenarios.With high model consensus,our results reveal that RODs are projected to occur later over Southern Africa,North Africa,and South America,but earlier over South Asia and Australia,in a warmer climate.The projected early RODs in Australia are more pronounced at the 2℃ GWL under SSP5-8.5.On the other hand,early RCDs are projected over South America and East Asia,while late RCDs are projected over North Africa,with high inter-model agreement.These changes are associated with a future decrease in LRS in most GLM regions.Additionally,we found that continuous warming over 1.5℃ will further reduce the length of the rainy season,especially over the South America,North Africa,and Southern Africa monsoon regions.The findings underscore the urgent need to mitigate global warming.
基金the Israel Science Foundation(ISF)(Grant No.1944/23)the institutional scholarships for Ph.D.students that she received from Ben-Gurion University of the Negev+1 种基金the Ariane de Rothschild Women's Doctoral Program grant scholarship to outstanding female Ph.D.studentsfinancially supported by the Fundamental Research Funds for the Central Universities(Grant No.QTZX25116)。
摘要Titanium dioxide(TiO2),a versatile inorganic semiconductive material with a wide band gap and various crystal structures,has attracted a great deal of research interest and is used in a wide variety of fields.To build the gas sensor arrays that are the building blocks of artificial olfaction,gas-sensitive materials with particular properties are especially desirable to introduce diverse interactions between gases and materials,transducing them into differentiated resistive changes for pattern recognition.Therefore,it is important for researchers to develop new synthesis methods in pursuit of TiO2 nanowires(NWs)with small diameters,high length-to-diameter ratios,and arbitrary doping.In this study,a general and versatile method was developed for synthesizing quasi-single-crystalline doped TiO2(QSDTO)NWs with ultra-high length-to-diameter ratios(ca.200-730),small diameters(ca.55-210 nm),and,critically,arbitrary elemental doping.The morphology,crystal phase,band gap,and elemental composition of QSDTO NWs were systematically investigated.The tunability of their physical and chemical properties through transition metal doping,which is a valuable essential feature for the gas-sensitive materials used in sensor array applications,was clearly demonstrated.These results underscore the potential of this approach not only for the controlled synthesis of TiO2NWs but also for their implementation in advanced gas sensing technologies.
摘要Limb lengthening stands as a transformative surgical procedure,offering newfound hope for individuals suffering from limb deformities or discrepancies.Several studies underscore the efficacy of both external and internal fixators in correcting limb length discrepancy(LLD).The choice between these modalities depends on multiple patient-specific factors,with each method presenting distinct advantages and limitations.While the success of limb lengthening in managing LLD is well established,both short-term and long-term physical as well as psychological implications necessitate a critical evaluation of indications.The appropriateness of pursuing limb lengthening should be guided by meticulously considering the prospective physical benefits and psychological ramifications.To address this need,we present a novel treatment algorithm designed to guide clinical decision-making in the management of LLD.This algorithm integrates current evidence,complication patterns,and patient-centered considerations to provide a structured approach to selecting appropriate interventions.A multidisciplinary,patient-focused strategy remains essential for optimizing outcomes and improving the overall quality of life for individuals undergoing limb lengthening.
摘要Understanding the particle behavior at the solid-liquid interface and regulating the interfacial thermal resistance is the key to solving the chip heat dissipation problem at extreme heat flux.To this end,non-equilibrium molecular dynamics simulations were used in this study to investigate the effects of water-solid interactions,surface charges,and static structure factors on the thermal resistance length.The number density and temperature profiles show that both water-solid interaction and surface charge determine the density and temperature distribution of the liquid in the system,and there is a competitive relationship between them.The temperature gradient,jump and thermal resistance length were calculated.We found that the thermal resistance length decreases with the increase of the interaction and surface charge mainly because of the drastic change in temperature jump.In particular,enhancing the water-solid interaction can reduce the thermal resistance length from 263.5A to 114.6A by a maximum of 56.5%,while increasing the surface charge can reduce the thermal resistance length from 263.5A to 46.7A by a maximum of 82.3%in the scope of this study.Moreover,it is found that the static structure factor is related to the solid-liquid interaction and the surface charge.For atomic-scale solid-liquid interfaces,the heat transfer performance can be optimized by increasing the peak value of the static structure factor to reduce the thermal resistance length.The findings in this study provide guidance for future studies to evaluate the possible solutions to improve the heat transfer performance of the solid-liquid interface,such as reducing the interfacial thermal resistance,and promoting its application in chip heat dissipation.
摘要Physical fitness is well‐known to be associated with health outcomes.This pilot study examined the impact of different measures of fitness on length of stay following colectomy.A case‐control study was designed to evaluate the effect of skeletal muscle mass,body fat,and frailty measures on post‐operative length of stay(LOS).A simple random sample of 50 patients in each arm was selected based on prolonged LOS.Binary logistic regression analysis was performed to determine associations between each covariate and LOS.After exclusions,40 cases and 36 controls were included in the analysis.Frailty,as determined by weight loss and the Modified Frailty Index was not associated with prolonged LOS(p=0.060 and p=0.469).Cross‐sectional muscle area(OR:0.994,95%CI:0.989-0.999,p=0.029)and skeletal muscle index(OR:0.981,95%CI:0.965-0.996,p=0.015)were associated with decreased LOS.Measures of body fat,as well as muscle‐to‐body fat ratios were not associated with LOS.These results suggest that body fat may be less influential than skeletal muscle when predicting post‐operative outcomes.This pilot study warrants further investigation with a larger number of patients to identify cut‐off values with which to provide targeted prehabilitation.
摘要BACKGROUND Malnutrition is a common comorbidity in elderly patients with severe aortic valve stenosis undergoing transcatheter aortic valve replacement(TAVR).The geriatric nutritional risk index(GNRI),a validated and easy-to-use tool,has been previously associated with short/mid-term outcomes in such patients.This study aimed to confirm this association in the long-term in the contemporary TAVR era using new-generation devices and to evaluate its impact on length of hospitalization.METHODS A total of 1090 consecutive patients aged≥65 years undergoing TAVR between October 2015 and December 2021 at a single tertiary center were included.Patients were stratified into two groups based on baseline GNRI:the GNRI>98(low-risk)group and the GNRI≤98(moderate-to-high risk)group.The primary endpoint was all-cause mortality.Secondary endpoints included total length of hospitalization and length of intensive care unit stay.Kaplan-Meier curves and Cox regression models were used to assess survival differences and potential independent predictors.RESULTS Patients with GNRI≤98 had significantly higher cumulative mortality rates at all evaluated time points compared to patients with GNRI>98(30-day:6.9%vs.2.7%,1-year:39.1%vs.11.4%,5-year:67.3%vs.53.2%,all P<0.05).A multivariable Cox regression analysis showed that GNRI was an independent predictor of long-term mortality(up to five years)after adjusting for clinical,echocardiographic and laboratory parameters(HR=0.94,95%CI:0.92-0.96,P<0.001),with an increasing effect over time.The impact of GNRI on clinical outcomes was observed in patients in all three EuroSCORE II categories(low risk,intermediate risk,and high risk).Total hospitalization and intensive care unit stays were longer in patients with GNRI≤98[8(6-13)days vs.7(5-9)days,P<0.001 and 3(2-5)days vs.2(2-4)days,P<0.001,respectively].CONCLUSIONS In this large European cohort,GNRI was confirmed to be an independent predictor for long-term mortality up to five years in the contemporary era of TAVR use with new-generation devices.Hospital stay was longer in patients with lower GNRI.This easyto-use index could play a valuable role in the preprocedural assessment of patients undergoing TAVR and studies to explore the use of nutritional preprocedural optimization of patients with low GNRI values are warranted.
基金funding support from the Japan Science and Technology Agency Support for Pioneering Research Initiated by the Next Generation(Grant No.JPMJSP2110).
摘要Discrete Fracture Network(DFN)modeling is widely employed to simulate fractured rock masses for various geotechnical applications.However,challenges in statistically characterizing three-dimensional fractures arise due to orientation,size,truncation,and censoring biases when inferring parameters from two-dimensional rock surface observation.This study introduces a fully automated method that leverages Monte Carlo Tree Search(MCTS),a reinforcement learning-based algorithm,to optimize DFN parameters,including fracture density and length.By defininga reward function that compares the simulated rock masses with observed data,the proposed method iteratively minimizes biases and enhances accuracy.Examined on natural outcrop data of a granitic rock body,this method demonstrates significantimprovements in parameter inference,achieving robust convergence and high fidelityto observed fracture characteristics.The approach offers a practical and efficientsolution for DFN modeling in rock engineering and geological applications.
基金Supported by the Aier Eye Hospital Fund Project(No.AGF2503D08).
摘要AIM:To compare the effect of orthokeratology(OK)and defocus incorporated multiple segment(DIMS)lenses on axial length(AL)elongation in bilateral myopic anisometropic children.METHODS:This retrospective study enrolled bilateral myopic anisometropic children categorized into two groups:OK lenses and DIMS lenses.The eyes with more myopia(MM)were divided into MM eyes and the fellow eyes with less myopia(LM)into LM eyes.According to the myopia degree in MM eyes,the subjects were further assigned to-0.50 to-3.00 D subgroup and-3.25 to-6.00 D subgroup.The t-test was used to analyze the changes in AL elongation between groups and AL differences in both eyes,and the relationship between AL changes and baseline data was evaluated by Pearson linear correlation analysis.RESULTS:Totally 202 children(8-14y)were divided into OK group with mean age 10.97±1.91y(46 males and 50 females)and DIMS group with mean age 11.05±2.06y(58 males and 48 females).After 1y,the changes of AL in OK-MM eyes(0.14±0.18 mm)were significantly slower than that in OK-LM eyes(0.20±0.19 mm)and DIMS-MM eyes(0.19±0.18;P<0.001,P=0.037).The OK-LM eyes and DIMS-LM eyes,DIMS-MM eyes and DIMS-LM eyes showed no statistically significant difference in AL changes(P=0.337,0.381).In the-0.50 to-3.00 D subgroups,DIMSLM eyes had better effect of AL control than OK-LM eyes,the changes of AL in OK-MM eyes and DIMS-MM eyes were no statistically significant.In the-3.25 to-6.00 D subgroups,the results were similar in total group.The change of AL in four subgroups was negatively correlated with age(P<0.05).CONCLUSION:OK lens can reduce binocular anisometropia;DIMS lens has similar effect on the control of binocular myopia in children with myopic anisometropia.The OK lenses are more effective than DIMS lenses with higher degrees of myopia,while DIMS lens retard AL elongation more effectively than OK lens when the spherical equivalent refraction of MM eyes is lower than-3.00 D.
基金Supported by the National Natural Science Foundation of China(No.82371093).
摘要●AIM:To investigate the effects of cataract surgery on the axial length/corneal radius(AL/CR)ratio and choroidal thickness(CT)in school-age children and to analyze the underlying mechanisms.●METHODS:This prospective cohort study enrolled school-age children who underwent phacoemulsification with intraocular lens(IOL)implantation between September 2024 and February 2025.The right eyes of bilateral cases and the affected eyes of unilateral cases were classified as Group A.Within this group,eyes implanted with trifocal IOLs were designated as Subgroup A1,whereas those receiving monofocal IOLs were designated as Subgroup A2.The contralateral healthy eyes of the unilateral cases formed Group B.Axial length(AL)and corneal curvature were measured using the IOL Master 700.CT was assessed using swept-source optical coherence tomography.●RESULTS:A total of 50 eyes from 32 patients(Subgroup A1,n=21,8.38±2.36y;Subgroup A2,n=11,7.55±2.16y;Group B,n=18,8.22±2.44y)were included in the study.Preoperatively,AL was markedly shorter in Group A compared to Group B(P0.05).Conversely,Group B showed a considerable increase in the AL/CR ratio and a pronounced reduction in CT,both statistically significant(all P<0.05).No notable differences were observed between Subgroups A1 and A2 in any of the measured parameters.Correlation analysis revealed meaningful negative correlations between AL,AL/CR ratio,and central subfield choroidal thickness(CSCT)in Group A at 1mo postoperatively and at the final follow-up(P<0.05).Still,no correlation was found among the changes in these parameters over the follow-up period.●CONCLUSION:In the early postoperative period,operated eyes of school-aged children show a stable AL/CR ratio and CT.Although a stable structural negative correlation between these two parameters is observed in operated eyes,the longitudinal coordinated relationship is disrupted,which may be related to the loss of accommodative function.Longer-term follow-up is needed to corroborate these findings.
基金Financial supports for this work,provided by the National Natural Science Foundation Project of China(No.52374152)the Guangxi Science and Technology Plan Project of China(No.2022AB31023)the National Basic Research Development Program of China(No.2022YFC2904602)are gratefully acknowledged。
摘要The anchoring capacity of the anchor cable is closely related to the bonding length and radial pressure conditions.Through field pull-out tests,theoretical analysis,numerical simulation,and industrial tests,this study clarifies the relationship between radial pressure and bonding length for the ultimate pullout force and reveals the microscopic failure process of the resin-rock interface in the anchoring system.The results show that the ultimate load increases with the increase of bonding length in three different stages:rapid,slow,and uniform growth.The new mechanical model developed considering radial pressure describes the inverse relationship between radial pressure and the plastic zone on the bonding section,and quantifies the reinforcing effect of confining pressure on the anchoring force.During the pull-out process of the anchor cable,the generation of failure cracks is in the order of orifice,bottom,and middle of the hole.Radial pressure can effectively enhance the ultimate pull-out force,alleviate the oscillation increase of pull-out force,and inhibit resin cracking,but will produce an external crushing zone.It also reveals the synergistic effect between bonding length and radial pressure,and successfully carries out industrial tests of anchor cable support,which ensures the stability of the stope roof and provides an important reference for the design of anchor cable support in deep high-stress mines.