Existing research in metasurface design was based on trial-and-error high-intensity iterations and requires deep acoustic expertise from the researcher, which severely hampered the development of the metasurface field. Using deep learning enabled the fast and accurate design of hypersurfaces. Based on this, in this paper, an integrated learning approach was first utilized to construct a model of the forward mapping relationship between the hypersurface physical structure parameters and the acoustic field, which was intended to be used for data enhancement. Then a dual-feature fusion model (DFCNN) based on a convolutional neural network was proposed, in which the first feature was the high-dimensional nonlinear features extracted using a data-driven approach, and the second feature was the physical feature information of the acoustic field mined using the model. A convolutional neural network was used for feature fusion. A genetic algorithm was used for network parameter optimization. Finally, generalization ability verification was performed to prove the validity of the network model. The results showed that 90% of the integrated learning models had an error of less than 3 dB between the real and predicted sound field data, and 93% of the DFCNN models could achieve an error of less than 5 dB in the local sound field intensity. Full article

Ulcerative colitis (UC), as a chronic inflammatory disease, presents a global public health threat. However, the mechanism of Poria cocos (PC) in treating UC remains unclear. Here, LC-MS/MS was carried out to identify the components of PC. The protective effect of PC against UC was evaluated by disease activity index (DAI), colon length and histological analysis in dextran sulfate sodium (DSS)-induced UC mice. ELISA, qPCR, and Western blot tests were conducted to assess the inflammatory state. Western blotting and immunohistochemistry techniques were employed to evaluate the expression of tight junction proteins. The sequencing of 16S rRNA was utilized for the analysis of gut microbiota regulation. The results showed that a total of fifty-two nutrients and active components were identified in PC. After treatment, PC significantly alleviated UC-associated symptoms including body weight loss, shortened colon, an increase in DAI score, histopathologic lesions. PC also reduced the levels of inflammatory cytokines TNF-α, IL-6, and IL-1β, as evidenced by the suppressed NF-κB pathway, restored the tight junction proteins ZO-1 and Claudin-1 in the colon, and promoted the diversity and abundance of beneficial gut microbiota. Collectively, these findings suggest that PC ameliorates colitis symptoms through the reduction in NF-κB signaling activation to mitigate inflammatory damage, thus repairing the intestinal barrier, and regulating the gut microbiota. Full article

Acute graft-versus-host disease (aGVHD) remains a barrier to successful allogeneic hematopoietic stem cell transplantation (HSCT) outcomes. Contemporary comprehensive analyses of real-world clinical outcomes among patients who develop aGVHD post-HSCT are needed to better understand the unmet needs of this patient population. This multicenter, retrospective chart review describes treatment patterns and clinical outcomes among patients (≥18 years old) from Finland, Sweden, and France who developed grades II–IV aGVHD after their first HSCT (January 2016–June 2017). From 13 participating centers, 151 patients were included. The median (Q1, Q3) age at HSCT was 56 (45, 62) years old. One line of aGVHD treatment was received by 47.7%, and the most common first-line treatment was methylprednisolone (alone or in a combination regimen, 74.2%; monotherapy, 25.8%). Among patients treated with methylprednisolone, 79.5% achieved a complete or partial response. The median (Q1, Q3) number of treatment lines was 2.0 (1.0, 3.0). The median (Q1, Q3) time to obtain an aGVHD diagnosis from transplant was 29.5 (21.0, 44.0) days, and 14.5 (7.0, 34.0) days to achieve the best response for 110 evaluable patients. At 6 and 12 months, 53.6% and 49.0%, respectively, achieved a complete response. Chronic GVHD occurred in 37.7% of patients, and aGVHD reoccurred in 26.5%. Following aGVHD diagnosis, mortality rates were 30.0% at 6 months and 37.3% at 12 months. Findings from this study demonstrate a continuing unmet need for new therapies that control aGVHD and improve mortality. Full article

Modern chemotherapies offer a broad approach to cancer treatment but eliminate both cancer and non-cancer cells indiscriminately and, thus, are associated with a host of side effects. Advances in precision oncology have brought about new targeted therapeutics, albeit mostly limited to a subset of patients with an actionable mutation. They too come with side effects and, ultimately, ‘self-resistance’ to the treatment. There is recent interest in the modulation of ion channels, transmembrane proteins that regulate the flow of electrically charged molecules in and out of cells, as an approach to aid treatment of cancer. Phytochemicals have been shown to act on ion channels with high specificity regardless of the tumor’s genetic profile. This paper explores the use of phytochemicals in cancer symptom management and treatment. Full article

Deformation of ultra-deep pit walls and surrounding geotechnical bodies due to engineering disturbances typically shows intricate spatiotemporal patterns. In this study, deformations at critical steps of the construction process were first numerically simulated by Midas GTS NX, and this was followed by lab-scale geophysical model tests of the entire process of the pit construction. Data on deformation obtained from numerical simulations and lab-scale geophysical model tests were compared with those obtained from a dynamic monitoring scheme in the field to analyze the characteristics of the deformation and evolution of the pit wall. This was used to derive a generally applicable theoretical expression to predict variations in the horizontal displacements. Full article

Background/Objectives: Older patients are subject to a high number of Emergency Department (ED) visits and hospitalizations. Innovative strategies to manage geriatric urgencies in the community are thus needed. Methods: In this prospective observational study, we examined the case mix of a hospital-based domiciliary urgent care service tailored to older patients, called Multidisciplinary Mobile Unit (MMU), from January to September 2023. The service, activated by general practitioners or territorial specialists during workdays, provided domiciliary geriatric assessment, point-of-care diagnostics, including multi-site ultrasound and lab tests, and therapeutical measures, including intravenous treatment and insertion of invasive devices, with the goal of reaching on-site stabilization and avoiding ED referral. We collected data regarding multimorbidity, polypharmacy, and frailty according to the Clinical Frailty Scale (CFS), reasons for MMU activation, and diagnostic and therapeutical services provided. The assessed outcomes were immediate hospitalization after a visit, 30-day admission, and 30-day mortality. Results: Participants (n = 205, 102 M) were mostly aged (median age 83 years old), with multimorbidity and frailty (CFS median 6). The most frequent reasons for MMU activation were dyspnea (49%), cough (34%), and musculoskeletal pain (17%), while the commonest diagnostic test provided was thoracic ultrasound (81%). Only five patients (2.4%) were hospitalized immediately after MMU visit. The 30-day rate of hospitalization was 10.2%, with age, cancer, and abdominal pain as independent predictors on a stepwise binary logistic regression model. 30-day mortality was 4.9%. Conclusions: The MMU model is a feasible strategy to manage geriatric urgencies, especially involving the cardiorespiratory system, is associated with good outcomes and may prevent ED visits. Full article

Remote passive sonar detection with low-frequency band spectral lines has attracted much attention, while complex low-frequency non-Gaussian impulsive noisy environments would strongly affect the detection performance. This is a challenging problem in weak signal detection, especially for the high false alarm rate caused by heavy-tailed impulsive noise. In this paper, a novel matched stochastic resonance (MSR)-based weak signal detection model is established, and two MSR-based detectors named MSR-PED and MSR-PSNR are proposed based on a theoretical analysis of the MSR output response. Comprehensive detection performance analyses in both Gasussian and non-Gaussian impulsive noise conditions are presented, which revealed the superior performance of our proposed detector under non-Gasussian impulsive noise. Numerical analysis and application verification have revealed the superior detection performance with the proposed MSR-PSNR detector compared with energy-based detection methods, which can break through the high false alarm rate problem caused by heavy-tailed impulsive noise. For a typical non-Gasussian impulsive noise assumption with $\alpha =1.5$, the proposed MSR-PED and MSR-PSNR can achieve approximately 16 dB and 22 dB improvements, respectively, in the detection performance compared to the classical PED method. For stronger, non-Gaussian impulsive noise conditions corresponding to $\alpha =1$, the improvement in detection performance can be more significant. Our proposed MSR-PSNR methods can overcome the challenging problem of a high false alarm rate caused by heavy-tailed impulsive noise. This work can lay a solid foundation for breaking through the challenges of underwater passive sonar detection under non-Gaussian impulsive background noise, and can provide important guidance for future research work. Full article

Utilizing data from the 2016 Vietnam Household Living Standard Survey, we undertake an empirical investigation into the influence of energy poverty on the health expenditure of Vietnamese households. Employing a double-hurdle model, our empirical findings reveal a negative relationship between energy poverty and health expenditure. Specifically, our results indicate that for each incremental unit increase in energy poverty, there is a substantial reduction of 42.5 percentage points in the overall health expenditure of the households. Furthermore, as energy poverty deepens, we observe declines of 24.6 percentage points and 45.5 percentage points in the expenses incurred for inpatient/outpatient care and self-treatment, respectively. To validate the robustness of our results, we conduct several sensitivity analyses, including propensity score matching, double/debiased machine learning. Across all these methods, our findings consistently underscore the significant and persistent adverse impact of energy poverty on the examined outcome variables. Additionally, to examine the underlying pathways, we conduct a structural equation modeling analysis and find that the relationship between energy poverty and health expenses is mediated by household hospitalization and expenditures on essential items, such as food and daily necessities. Full article

Vitamin B₁₂ (cobalamin) is an essential nutrient for humans and animals. Metabolically active forms of B₁₂-methylcobalamin and 5-deoxyadenosylcobalamin are cofactors for the enzymes methionine synthase and mitochondrial methylmalonyl-CoA mutase. Malfunction of these enzymes due to a scarcity of vitamin B₁₂ leads to disturbance of one-carbon metabolism and impaired mitochondrial function. A significant fraction of the population (up to 20%) is deficient in vitamin B₁₂, with a higher rate of deficiency among elderly people. B₁₂ deficiency is associated with numerous hallmarks of aging at the cellular and organismal levels. Cellular senescence is characterized by high levels of DNA damage by metabolic abnormalities, increased mitochondrial dysfunction, and disturbance of epigenetic regulation. B₁₂ deficiency could be responsible for or play a crucial part in these disorders. In this review, we focus on a comprehensive analysis of molecular mechanisms through which vitamin B₁₂ influences aging. We review new data about how deficiency in vitamin B₁₂ may accelerate cellular aging. Despite indications that vitamin B₁₂ has an important role in health and healthy aging, knowledge of the influence of vitamin B₁₂ on aging is still limited and requires further research. Full article

Chemotherapy exhibits numerous side effects in anti-tumour therapy. The clinical experiments indicated that deuterium-depleted water (DDW) monotherapy or in combination with chemotherapy was beneficial in inhibiting cancer development. To further understand the potential mechanism of DDW in cancer therapy, we performed a systematic review. The data from experiments published over the past 15 years were included. PubMed, Cochrane and Web of Science (January 2008 to November 2023) were systemically searched. Fifteen studies qualified for review, including fourteen in vivo and in vitro trials and one interventional trial. The results showed that DDW alone or in combination with chemotherapy effectively inhibited cancer progression in most experiments. The combination treatment enhances the therapeutic effect on cancer compared with chemotherapeutic monotherapy. The inhibitory role of DDW in tumours is through regulating the reactive oxygen species (ROS)-related genes in Kelch-like ECH-associated protein 1 (Keap 1) and Nuclear erythroid 2-related factor 2 (Nrf2) signalling pathways, further controlling ROS production. An abnormal amount of ROS can inhibit the tumour progression. More extensive randomized controlled trials should be conducted to evaluate the accurate effect of DDW in Keap1-Nrf2 signalling pathways. Full article

Enisamium is an orally available therapeutic that inhibits influenza A virus and SARS-CoV-2 replication. We evaluated the clinical efficacy of enisamium treatment combined with standard care in adult, hospitalized patients with moderate COVID-19 requiring external oxygen. Hospitalized patients with laboratory-confirmed SARS-CoV-2 infection were randomly assigned to receive either enisamium (500 mg per dose, four times a day) or a placebo. The primary outcome was an improvement of at least two points on an eight-point severity rating (SR) scale within 29 days of randomization. We initially set out to study the effect of enisamium on patients with a baseline SR of 4 or 5. However, because the study was started early in the COVID-19 pandemic, and COVID-19 had been insufficiently studied at the start of our study, an interim analysis was performed alongside a conditional power analysis in order to ensure patient safety and assess whether the treatment was likely to be beneficial for one or both groups. Following this analysis, a beneficial effect was observed for patients with an SR of 4 only, i.e., patients with moderate COVID-19 requiring supplementary oxygen. The study was continued for these COVID-19 patients. Overall, a total of 592 patients were enrolled and randomized between May 2020 and March 2021. Patients with a baseline SR of 4 were divided into two groups: 142 (49.8%) were assigned to the enisamium group and 143 (50.2%) to the placebo group. An analysis of the population showed that if patients were treated within 4 days of the onset of COVID-19 symptoms (n = 33), the median time to improvement was 8 days for the enisamium group and 13 days for the placebo group (p = 0.005). For patients treated within 10 days of the onset of COVID-19 symptoms (n = 154), the median time to improvement was 10 days for the enisamium group and 12 days for the placebo group (p = 0.002). Our findings suggest that enisamium is safe to use with COVID-19 patients, and that the observed clinical benefit of enisamium is worth reporting and studying in detail. Full article

This paper introduces an innovative Particle Swarm Optimization (PSO) Algorithm incorporating Sobol and Halton random number samplings. It evaluates the enhanced PSO’s performance against conventional PSO employing Monte Carlo random number samplings. The comparison involves assessing the algorithms across nine benchmark problems and the renowned Travelling Salesman Problem (TSP). The results reveal consistent enhancements achieved by the enhanced PSO utilizing Sobol/Halton samplings across the benchmark problems. Particularly noteworthy are the Sobol-based PSO improvements in iterations and the computational times for the benchmark problems. These findings underscore the efficacy of employing Sobol and Halton random number generation methods to enhance algorithm efficiency. Full article

Abiotic stressors, including drought, salt, cold, and heat, profoundly impact plant growth and development, forcing elaborate cellular responses for adaptation and resilience. Among the crucial orchestrators of these responses is the CBL-CIPK pathway, comprising calcineurin B-like proteins (CBLs) and CBL-interacting protein kinases (CIPKs). While CIPKs act as serine/threonine protein kinases, transmitting calcium signals, CBLs function as calcium sensors, influencing the plant’s response to abiotic stress. This review explores the intricate interactions between the CBL-CIPK pathway and plant hormones such as ABA, auxin, ethylene, and jasmonic acid (JA). It highlights their role in fine-tuning stress responses for optimal survival and acclimatization. Building on previous studies that demonstrated the enhanced stress tolerance achieved by upregulating CBL and CIPK genes, we explore the regulatory mechanisms involving post-translational modifications and protein–protein interactions. Despite significant contributions from prior research, gaps persist in understanding the nuanced interplay between the CBL-CIPK system and plant hormone signaling under diverse abiotic stress conditions. In contrast to broader perspectives, our review focuses on the interaction of the pathway with crucial plant hormones and its implications for genetic engineering interventions to enhance crop stress resilience. This specialized perspective aims to contribute novel insights to advance our understanding of the potential of the CBL-CIPK pathway to mitigate crops’ abiotic stress. Full article

MYB transcription factors (TFs) have been shown to be important regulators of plant growth and development, and the R2R3−MYB family plays an important role in the regulation of plant primary and secondary metabolism, growth, and development. In this study, the PmMYB45 gene sequence was successfully cloned from Pinus massoniana, with an open reading frame of 1476 bp, encoding 491 amino acids. The results of subcellular localization and transcriptional self-activation showed that the gene was localized in the nucleus and was self-activating. qPCR showed that the highest expression of PmMYB45 was found in stems. PmMYB45 can promote lignin synthesis when overexpressed in tobacco. These results suggest that PmMYB45 promotes lignin synthesis by regulating the lignin biosynthesis pathway. These findings improve our understanding of the mechanism of lignin biosynthesis in P. massoniana and provide a basis for molecular breeding functions. It also provides insights into the role of the MYB transcription factor family in lignin accumulation. Full article

According to parental reports, about 10% of children are believed to be allergic to at least one antibiotic, leading to the prescription of second line medications. This incurs higher costs, results in less effective treatments, and contributes to global concern of antibiotic resistance. De-labeling programs could mitigate these problems. The primary objectives of this study were to assess the proportion of children that tolerate the suspected antibiotic well through allergy testing and, secondly, to examine which information in their medical history correlates with a positive test result. Children with a history of antibiotic allergy were categorized into high- and low-risk groups for immediate allergic reaction. The latter underwent oral provocation testing (OPT), while the high-risk group underwent the test only after negative skin tests (STs). In total, 76.8% of children tolerated the tested antibiotic well. Among children with positive OPT, two (8.0%) had to receive adrenaline for symptom resolution. Children who had exhibited suspected symptoms within one hour after antibiotic administration, and those with a history of asthma or food allergy, had an increased risk of positive allergic testing (p < 0.05). In conclusion, the adoption of a standardized protocol for an antibiotic allergy de-labeling program is essential for every allergy department. Full article

Graphene has achieved mass production via various preparative routes and demonstrated its uniqueness in many application fields for its intrinsically high electron mobility and thermal conductivity. However, graphene faces limitations in assembling macroscopic structures because of its hydrophobic property. Therefore, balancing high crystal quality and good aqueous dispersibility is of great importance in practical applications. Herein, we propose a tape-wrapping strategy to electrochemically fabricate water-dispersible graphene (w-Gr) with both excellent dispersibility (~4.5 mg/mL, stable over 2 months), and well-preserved crystalline structure. A large production rate (4.5 mg/min, six times faster than previous electrochemical methods), high yield (65.4% ≤5 atomic layers) and good processability are demonstrated. A mechanism investigation indicates that the rational design of anode configuration to ensure proper oxidation, deep exfoliation and unobstructed mass transfer is responsible for the high efficiency of this strategy. This simple yet efficient electrochemical method is expected to promote the scalable preparation and applications of graphene. Full article

In the vast field of organic functional materials, viologens are widely recognized as an extremely versatile family of substances, due in part to the possibility of extending conjugation between the terminal pyridinium rings, for instance through the insertion of additional aromatic moieties. In this work, a new, extended viologen with a thiophene core and two acetylene bonds is presented. It was synthesized through a straightforward route, using well-established Sonogashira coupling reactions, and its optical properties were investigated by UV–visible absorption and fluorescence spectroscopy, revealing a very interesting material for diverse fluorescence-related applications. Full article

(1) Background: To better understand the dynamic characteristics of a ball bearing with an elastic ring squeeze film damper (ERSFD) under sudden unbalance, a novel dynamic model was established by fully considering the coupling between the ERSFD, bearing outer ring (the journal), rotor, and disc (loading bearing); (2) Methods: An improved secant method was developed to determine the initial eccentricity values of the bearing’s outer ring and the disc. The dynamic response of the outer ring under different speed ratios, damping ratios, and mass ratios was solved using the variable-step Runge–Kutta method; (3) Results: In comparison, a low-speed ratio, high damping ratio, and low mass ratio were more conducive to suppressing the bearing vibration. When the imbalance was suddenly introduced, the displacement amplitude of the eccentricity, transmissibility, amplitude–frequency response, and the radius of the outer ring center locus increased; (4) Conclusions: This work provides a reference for further studying the nonlinear vibration of rolling bearings coupled with an ERSFD. Full article

The COVID-19 pandemic disrupted families and displaced individuals. For migrant workers, these disruptions and displacements exacerbated the state-imposed constraints on family formation. But how did high-skilled and high-wage immigrants, presumably immune from these challenges, provide care to and receive care from families during the pandemic? Based on 33 in-depth interviews with high-skilled Asian Indian immigrants in the USA during the pandemic, we note disruptions in their care to and from families. These disruptions reveal a persistent pattern of dispersion in immigrant families which leads to what we call “dispersed care.” By “dispersed care” we identify the effects of various state-imposed immigration laws and policies, which force immigrants to divide and allocate care among multiple fragments of their families in home and host countries. Dispersed care affects immigrant workers’ professional output, forcing them to make difficult choices between their career and care commitments. To unsettle the assumed homogeneity of high-skilled “Asian Indians,” we choose participants at diverse intersections of their migration pathways—naturalized US citizens, permanent US residents, and temporary visa holders or nonimmigrants. While naturalized US citizens and permanent residents have better resources to maintain transnational family ties than nonimmigrants, all of them face the intersectional challenges of dispersed care. Full article

Broilers are particularly sensitive to heat stress, which can impair growth, and lower conversion efficiency and survival rates. Under a climate change scenario, maintaining optimal thermal conditions within broiler houses becomes more complex and energy-intensive. Climate change can worsen air quality issues inside broiler houses by increasing the concentration of harmful gases, and proper mechanical ventilation systems are essential for diluting and removing these gases. The present study aimed to develop and validate a model for the ideal broiler housing strategy by applying the Paraconsistent Annotated Evidential Logic Eτ. A database from four broiler houses in a commercial farm, rearing 157,700 birds from the 1st to the 42nd day of growth, was used in the research. All environmental data were recorded weekly inside the houses, and on day 42, flock mortality, overall feed-to-gain ratio, and body weight were calculated and registered. The Cohen’s Kappa statistics for each environmental parameter classification compared to the paraconsistent classification. Results indicated that temperature shows good agreement, relative humidity shows slight agreement, air velocity presents a good agreement, CO₂ concentration has a slight agreement, and NH₃ concentration is classified by slight agreement. The environmental and productivity variables as a function of the broiler age using the extreme True paraconsistent state indicate the model validation. The paraconsistent analysis presented the ideal scenario for broilers’ growth, maintaining the environmental variables level within a particular threshold and providing greater profit to broiler farmers. Full article

Full-depth reclamation with Portland cement (FDR-PC) represents an innovative cold recycling technology for pavements, holding significant promise due to its capacity to reuse deteriorated pavement base layers. This paper investigates the key factors influencing the strength properties of FDR-PC. The results indicate that, compared to the static compaction method, the vibratory compaction method yields cold-recycled mixtures with higher maximum dry density and unconfined compressive strength (UCS). Increasing the cement content and base-to-surface ratio, extending the curing time, and raising the curing temperature all contribute to enhancing UCS. Furthermore, increasing the base-to-surface ratio and cement content enhances both indirect tensile strength and flexural strength. An approximate linear correlation exists between indirect tensile strength and UCS, as well as between flexural strength and UCS. The strength characteristics of FDR-PC were comprehensively characterized in this study, providing effective verification of its applicability. Full article

Microplastics as micropollutants are widely spread in aquatic areas that can have a toxic effect on aquatic life. To reduce the potential risk they pose, it is essential to detect the microplastics and the source of the contamination of the environment. Here, we designed and developed a droplet-based microfluidic impedance flow cytometer for in situ detection of microplastics in water. Impedance spectroscopy enables the direct measurement of the electrical features of microplastics as they move in water, allowing for sizing and identification of concentration. To show the feasibility of the developed method, pure and functionalized polystyrene beads ranging from 500 nm to 6 μm in four size groups and different concentrations were used. Focusing on three different frequencies (4.4 MHz, 11 MHz, and 22.5 MHz), the changes in the signal phase at frequencies of 4.4 MHz and 11 MHz are a strong indicator of microplastic presence. In addition, the functionalized microplastics showed different magnitudes of the measured signal phase than the pure ones. A k-nearest neighbors classification model demonstrated our developed system’s impressive 97.4% sensitivity in accurately identifying microplastics based on concentration. The equivalent circuit model revealed that the double-layer capacity of water droplets is significantly impacted by the presence of the microplastics. Our findings show the potential of droplet-based microfluidic impedance flow cytometry as a practical method for detecting microplastics in water. Full article