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Respiratory failure caused by acute respiratory distress syndrome and severe pneumonia is common diseases in intensive care medicine. In recent years, with the continuous updating of treatment methods, prone position ventilation has been found to have a good therapeutic effect on such diseases, and has been widely used in clinical practice. However, prone position ventilation significantly increases the workload of medical staff and the risk of accidental extubation and pressure injuries to patients, seriously affecting the safety of diagnosis and treatment. At present, various devices such as mattresses have been used for prone position ventilation, but there are few devices specifically designed to protect and fix the head and face. Therefore, the medical staff of Affiliated Hospital of Zunyi Medical University designed and developed a head support frame for prone position ventilation, and obtained a National Utility Model Patent of China (patent number: ZL 2018 2 0056891.6). The head support frame for prone position ventilation includes a movable chassis and rollers for easy movement and fixation. The retractable column 1 is vertically fixed on the movable chassis, and its height can be freely adjusted according to the position of the patient. A transverse bridge is fixed at the top of the retractable column 1, the two ends of the bridge are designed a bulge, and the rotating ring is fixed above the transverse bridge, so that the rotating ring can rotate along the bridge at a certain angle. The rotating ring is designed with an inner ring and an inlet and outlet which can pass through the tube is designed on the rotating ring. The inflatable air bag is designed above the rotating ring to improve the comfort of patients and reduce the pressure injury of facial skin. A sliding rod is vertically designed on the upper part of the retractable column 1, and there is a retractable column 2 at the distal end of the slide rod, and the retractable column 2 is connected with the rotating ring, so that the rotating ring adjusts the angle along the cross bridge with the contraction of the collapsible column 2. A retractable column 3 is arranged in the middle of the slide rod, and a catheter clamp is arranged at its far end to facilitate the fixation of the artificial airway and the mechanical ventilation tube. The support frame is practical and convenient, which can protect the patient's head safely in the prone position, and greatly reduce the workload of medical staff.

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Water use efficiency (WUE) represents the trade-off between carbon assimilation and water loss in plants. It remains unclear how leaf stomatal and photosynthetic traits regulate the spatial variation of leaf WUE in different natural forest ecosystems. We investigated 43 broad-leaf tree species spanning from cold-temperate to tropical forests in China. We quantified leaf WUE using leaf δ13C and measured stomatal traits, photosynthetic traits as well as maximum stomatal conductance ( G w max $$ {G}_{{\mathrm{w}}_{\mathrm{max}}} $$ ) and maximum carboxylation capacity ( V c max $$ {V}_{{\mathrm{c}}_{\mathrm{max}}} $$ ). We found that leaves in cold-temperate forests displayed 'fast' carbon economics, characterized by higher leaf nitrogen, Chl, specific leaf area, and V c max $$ {V}_{{\mathrm{c}}_{\mathrm{max}}} $$ , as an adaptation to the shorter growing season. However, these leaves exhibited 'slow' hydraulic traits, with larger but fewer stomata and similar G w max $$ {G}_{{\mathrm{w}}_{\mathrm{max}}} $$ , resulting in higher leaf WUE. By contrast, leaves in tropical forests had smaller and denser stomata, enabling swift response to heterogeneous light conditions. However, this stomatal configuration increased potential water loss, and coupled with their low photosynthetic capacity, led to lower WUE. Our findings contribute to understanding how plant photosynthetic and stomatal traits regulate carbon-water trade-offs across climatic gradients, advancing our ability to predict the impacts of climate changes on forest carbon and water cycles.

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Ammonia (NH3) is the most abundant alkaline gas in the atmosphere, mainly emitted by agricultural activities. NH3 readily reacts with other atmospheric acidic pollutants, such as the oxidation products of sulfur dioxide (SO2) and nitrogen oxides (NOₓ), to create fine particulate matter, which has far-reaching effects on human health and ecosystems. Here, we investigated long-term atmospheric NH3 trends in South Asia (SA) using satellite observations from the Infrared Atmospheric Sounding Interferometer (IASI). We analyzed 15 years (2008-2022) of IASI-NH3 retrievals against climate, biophysical, and chemical variables using an ensemble of multivariate statistical methods to identify the major factors driving the observed patterns in the region. Trend analysis of IASI-NH3 data reveals a significant rise in atmospheric NH3 over 51 % of SA plains, but a downward trend over 31 % of the region. Spatial correlation analysis reveals that biophysical factors, representing cropland expansion and agriculture intensification, have the highest positive correlation over 56 % of SA plains experiencing positive NH3 trends. However, our results reveal that the chemical conversion of NH3 to ammonium compounds, driven by the positive trends in NOₓ and SO2 pollution, is driving the apparently declining trend of NH3 in the other regions. Our results provide important insights into the NH3 trends detected by satellite data and can better inform the policy design aimed at reducing NH3 emissions and improving air quality for developing regions of the world.

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Foot-and-mouth disease virus (FMDV), a member of picornavirus, can enter into host cell via macropinocytosis. Although it is known that receptor tyrosine kinases (RTKs) play a crucial role in FMDV macropinocytic entry, the specific RTK responsible for regulating this process and the intricacies of RTK-mediated downstream signaling remain to be elucidated. Here, we conducted a screening of RTK inhibitors to assess their efficacy against FMDV. Our findings revealed that two compounds specifically targeting fibroblast growth factor receptor 1 (FGFR1) and FMS-like tyrosine kinase 3 (FLT3) significantly disrupted FMDV entry. Furthermore, additional evaluation through gene knockdown and overexpression confirmed the promotion effect of FGFR1 and FLT3 on FMDV entry. Interestingly, we discovered that the increasement of FMDV entry facilitated by FGFR1 and FLT3 can be ascribed to increased macropinocytic uptake. Additionally, in-depth mechanistic study demonstrated that FGFR1 interacts with FMDV VP3 and undergoes phosphorylation during FMDV entry. Furthermore, the FGFR1 inhibitor inhibited FMDV-induced activation of p21-activated kinase 1 (PAK1) on Thr212 and Thr423 sites. Consistent with these findings, the ectopic expression of FGFR1 resulted in a concomitant increase in phosphorylation level of PAK1 on Thr212 and Thr423 sites. Taken together, our findings represent the initial exploration of FGFR1's involvement in FMDV macropinocytic entry, providing novel insights with potential implications for the development of antiviral strategies.

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Environmental magnetism plays an important role in monitoring heavy metal pollution, but most studies are confined to indicating only the levels of heavy metals using magnetic parameters. This study established new magnetic proxies for accurately depicting the sources and bioavailability of heavy metals in contaminated soils. We observed different relationships between χ and SIRM in the soils contaminated by non-ferrous metal smelting compared to those polluted by coal combustion and steel smelting. Furthermore, we found that the soft magnetic components (IRMsoft) in the soils were mainly controlled by the non-ferrous metal smelting activities, while the hard magnetic components (HIRM) might be affected by the iron erosion. These new magnetic proxies enriched the source composition spectrum and improved the accuracy of the source apportionment analyses (principal component analysis and positive matrix factorization), yielding a result that was comparable to that by Pb isotope fingerprinting. We also found strong relationships between magnetic parameters (especially IRMsoft) and bioavailable fractions of heavy metals, indicating that magnetic measurement may be a powerful tool for monitoring the bioavailability of heavy metals. This study expands the application fields of magnetism in environmental science research.

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The source diversity and health risk of trace elements (TEs) in soil make it necessary to reveal the relationship between pollution, source, and risk. However, neglect of spatial heterogeneity restricts the reliability of existing identification methods. In this study, spatial heterogeneity is proposed as a necessary and feasible factor for accurately dissecting the pollution-source-risk link of soil TEs. A comprehensive framework is developed by integrating positive matrix factorization, Geodetector, and risk evaluation tools, and successfully applied in a mining-intensive city in northern China. Overall, the TEs are derived from natural background (28.5 %), atmospheric deposition (25.6 %), coal mining (21.8 %), and metal industry (24.1 %). The formation mechanism of heterogeneity for high-variance TEs (Se, Hg, Cd) is first systematically deciphered by revealing the heterogeneous source-sink relationship. Specifically, Se is dominated (76.5 %) by heterogeneous coal mining (q=0.187), Hg is determined (92.6 %) by the heterogeneity of metal mining (q=0.183) and smelting (q=0.363), and Cd is caused (50.9 %) by heterogeneous atmospheric deposition (q>0.254) co-influenced by the terrains and soil properties. Highly heterogeneous sources are also noteworthy for their potential to pose extreme risks (THI=1.122) in local areas. This study highlights the necessity of integrating spatial heterogeneity in pollution and risk assessment of soil TEs.

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Luminescent CuI complexes are an important class of coordination compounds due to their relative abundance, low cost and ability to display excellent luminescence. The title Cu2I2P2S2-type binuclear complex, di-µ-iodido-bis[(thiourea-κS)(triphenylphosphine-κP)copper(I)], [Cu2I2(CH4N2S)2(C18H15P)2], conventionally abbreviated as Cu2I2TPP2TU2, where TPP and TU represent triphenylphosphine and thiourea, respectively, is described. In this complex, each CuI atom adopts a CuI2PS four-coordination mode and pairs of atoms are connected to each other by two µ2-I ligands to form a centrosymmetric binuclear cluster. It was also found that the paper-based film of this complex exhibited obvious luminescence light-up sensing for pyridine and 4-methylpyridine.

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Seawater batteries are attracting continuous attention because seawater as an electrolyte is inexhaustible, eco-friendly, and free of charge. However, the rechargeable seawater batteries developed nowadays show poor reversibility and short cycle life, due to the very limited electrode materials and complicated yet inappropriate working mechanism. Here, we propose a rechargeable seawater battery that works through a rocking-chair mechanism encountered in commercial lithium ion batteries, enabled by intercalation-type inorganic electrode materials of open-framework-type cathode and Na-ion conducting membrane-type anode. The rechargeable seawater battery achieves a high specific energy of 80.0 Wh/kg at 1,226.9 W/kg and a high specific power of 7,495.0 W/kg at 23.7 Wh/kg. Additionally, it exhibits excellent cycling stability, retaining 66.3% of its capacity over 1,000 cycles. This work represents a promising avenue for developing sustainable aqueous batteries with low costs.

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BACKGROUND: Anemia is a common long-term metabolic sequela caused by anatomical changes after major gastrointestinal surgery, such as bariatric surgery and gastrectomy. Pancreaticoduodenectomy (PD) involves resection of the duodenum and enteral bypass, which may contribute to malabsorption and nutrient deficiency. Hence, PD may cause anemia. METHODS: This study included 322 patients who presented with PD during the 5-year follow-up from 2006 to 2017. The Kaplan-Meier method and the Cox regression model were used to investigate the association between risk factors and anemia. RESULTS: Approximately 44.4% of patients developed post-PD anemia during the 5-year post-PD follow-up. Further, 30 (9.3%) patients were treated with oral iron supplementation for anemia with associated symptoms. In the Cox multivariate model, a higher Charlson Comorbidity Index (CCI) score and pancreatic ductal adenocarcinoma were significantly associated with the development of post-PD anemia. CONCLUSION: Post-PD anemia is a common sequela among long-term survivors. A higher CCI and pancreatic ductal adenocarcinoma diagnosis were considered as independent risk factors for post-PD anemia. Therefore, regular monitoring of hematological profiles and appropriate management of post-PD anemia are required during follow-up.

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Biodegradable polymer microspheres in bone tissue engineering have become appealing as their non-invasive advantages in irregular damage bone repair. However, current microspheres used in BTE still lack sufficient osteogenic capacity to induce effective bone regeneration. In this study, we developed osteogenic composite microspheres concurrently loaded with magnesium oxide (MgO) and zinc oxide (ZnO), both of which are osteogenic active substances, using a facile and scalable emulsification method. The osteogenic composite microspheres exhibited a sequential yet complementary release profile characterized by a rapid release of Mg2+ and a gradual release of Zn2+ in a physiological environment, thereby maintaining the concentration of bioactive ions at a sustained high level. As a result, the combination of Mg2+ and Zn2+ in the composite microspheres led to a synergistic enhancement in biomimetic mineralization and the upregulation in the expression of osteogenic-related genes and proteins at the cellular level. Through a critical-sized calvarial rate defect model, the osteogenic composite microspheres were demonstrated to have strong osteogenic ability to promote new bone formation via ultrasonic imaging, histological and immunohistochemical evaluations. In sum, these osteogenic composite microspheres as microcarriers of Mg2+ and Zn2+ have great potential in the delivery of therapeutic ions for treating bone defects.

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BACKGROUND: Distal tibial fractures represent common lower limb injuries, frequently accompanied by significant soft tissue damage. The optimal surgical approach for managing these fractures remains a topic of considerable debate. The aim of this study was to perform a comparative analysis of the outcomes associated with retrograde intramedullary tibial nails (RTN) and minimally invasive plate osteosynthesis (MIPO) in the context of treating extra-articular distal tibial fractures. METHODS: A retrospective review was conducted on a cohort of 48 patients who sustained extra-articular distal tibial fractures between December 2019 and December 2021. Patients underwent either RTN or MIPO procedures. Various parameters, including operative duration, intraoperative fluoroscopy exposure, time to union, duration until full weight-bearing, American Orthopedic Foot and Ankle Society (AOFAS) scores, and complications, were recorded and compared between the two treatment groups. RESULTS: No statistically significant differences were observed in operative duration, time to union, angulation of the distal tibial coronal plane, or AOFAS scores between the RTN and MIPO groups. However, the RTN group had a higher average number of intraoperative fluoroscopy images (8.2 ± 2.3) compared to the MIPO group (4.1 ± 2.0). The RTN group demonstrated shorter average hospital stays (7.1 ± 1.4 days) and a quicker return to full weight-bearing (9.9 ± 1.3 weeks), which were significantly superior to the MIPO group (9.0 ± 2.0 days and 11.5 ± 1.5 weeks, respectively). In terms of complications, the RTN group had one case of superficial infection, whereas the MIPO group exhibited two cases of delayed union and nonunion, two occurrences of deep infection, and an additional three cases of superficial infection. CONCLUSIONS: Both RTN and MIPO are effective treatment options for extra-articular distal tibial fractures. However, RTN may offer superior outcomes in terms of decreased inpatient needs, faster return to full weight-bearing capacity, and a lower rate of complications.

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Ferroptosis is a novel, iron-dependent cell death characterized by the excessive accumulation of ferroptosis lipid peroxides ultimately leading to oxidative damage to the cell membrane. Iron, lipid, amino acid metabolism, and other signaling pathways all control ferroptosis. Numerous bodily tissues experience hypoxia under normal and pathological circumstances. Tissue cells can adjust to these changes by activating the hypoxia-inducible factor (HIF) signaling pathway and other mechanisms in response to the hypoxic environment. In recent years, there has been increasing evidence that hypoxia and ferroptosis are closely linked, and that hypoxia can regulate ferroptosis in specific cells and conditions through different pathways. In this paper, we review the possible positive and negative regulatory mechanisms of ferroptosis by hypoxia-inducible factors, as well as ferroptosis-associated ischemic diseases, with the intention of delivering novel therapeutic avenues for the defense and management of hypoxic illnesses linked to ferroptosis.

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Forest restoration is a vital nature-based solution for mitigating climate change and land degradation. To ensure restoration effectiveness, the costs and benefits of alternative restoration strategies (i.e., active restoration vs. natural regeneration) need to be evaluated. Existing studies generally focus on maximum restoration potential, neglecting the recovery potential achievable through natural regeneration processes, leading to incomplete understanding of the true benefits and doubts about the necessity of active restoration. In this study, we introduce a multi-stage framework incorporating both restoration and regeneration potential into prioritized planning for ecosystem restoration. We used the vegetated landscape of Hong Kong (covering 728 km2) as our study system due to its comprehensive fine-resolution data and unique history of vegetation recovery, making it an ideal candidate to demonstrate the importance of this concept and inspire further research. We analyzed vegetation recovery status (i.e., recovering, degrading, and stable) over the past decade based on the canopy height data derived from multi-temporal airborne LiDAR. We assessed natural regeneration potential and maximum restoration potential separately, producing spatially-explicit predictions. Our results show that 44.9% of Hong Kong's vegetated area has showed evidence of recovery, but remaining gains through natural regeneration are limited, constituting around 4% of what could be attained through active restoration. We further estimated restoration priority by maximizing the restoration gain. When prioritizing 5% of degraded areas, the increment in canopy height could be up to 10.9%. Collectively, our findings highlight the importance of integrating both restoration and regeneration potential into restoration planning. The proposed framework can aid policymakers and land managers in optimizing forest restoration options and promoting the protection and recovery of fragile ecosystems.

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The macrophage to myofibroblasts transition (MMT) has been reported as a newly key target in renal fibrosis. Lycium barbarum L. is a traditional Chinese medicine for improving renal function, in which its polysaccharides (LBPs) are the mainly active components. However, whether the role of LBPs in treating renal fibrosis is related to MMT process remain unclear. The purpose of this study was to explore the relationship between the regulating effect on MMT process and the anti-fibrotic effect of LBPs. Initially, small molecular weight LBPs fractions (LBP-S) were firstly isolated via Sephadex G-100 column. Then, the potent inhibitory effect of LBP-S on MMT process was revealed on bone marrow-derived macrophages (BMDM) model induced by TGF-ß. Subsequently, the chemical structure of LBP-S was elucidated through monosaccharide, methylation and NMR spectrum analysis. In vivo biodistribution characteristics studies demonstrated that LBP-S exhibited effectively accumulation in kidney via intraperitoneal administration. Finally, LBP-S showed a satisfactory anti-renal fibrotic effect on unilateral ureteral obstruction operation (UUO) mice, which was significantly reduced following macrophage depletion. Overall, our findings indicated that LPB-S could alleviate renal fibrosis through regulating MMT process and providing new candidate agents for chronic kidney disease (CKD) related fibrosis treatment.

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Background: Colorectal cancer (CRC) presents a significant global health burden, with high rates of incidence and mortality, and an urgent need to improve prognosis. STM2457, a novel small molecule inhibitor specific for N6-methyladenosine (m6A) catalytic enzyme Methyltransferase-like 3 (METTL3) has implicated significant treatment potentials in a few of types of cancer. However, its impact and underlying mechanism are still unclear in CRC cells. Methods: We used CCK-8 and colony formation assay to observe cell growth, flow cytometry and TUNEL approaches to detect cell apoptosis under the treatment of STM2457 on CRC cells in vitro or in vivo. RNA-sequencing, qRT-PCR and western blotting were performed to explore downstream effectors of STM2457. Messenger RNA stability was evaluated by qRT-PCR after treatment with actinomycin D. The methylated RNA immunoprecipitation (MeRIP) qPCR, dual-luciferase reporter analyses and m6A dot blotting were carried out to measure the m6A modification. Associated gene expression pattern and clinical relevance in CRC clinical tissue samples were analyzed using online database. Results: STM2457 exhibited a strong influence on cell growth suppression and apoptosis of CRC cells in vitro and subcutaneous xenograft growth in vivo. Asparagine synthetase (ASNS) was markedly downregulated upon STM2457 treatment or METTL3 knockdown and exogenous overexpression of ASNS could rescue the biological defects induced by STM2457. Mechanistically, the downregulation of ASNS by STM2457 may be due to the decrease of m6A modification level in ASNS mRNA mediated by METTL3. Conclusions: Our findings suggest that STM2457 may serve as a potential therapeutic agent and ASNS may be a new promising therapeutic target for CRC.

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Meteorological factors and anthropogenic activities significantly affect atmospheric ammonia （NH3） concentration and its dry deposition. Former studies have examined the spatial and temporal variability in atmospheric NH3 concentrations at monthly scales. However, the characteristics of atmospheric concentrations at finer time scales such as hourly and daily scales and the influencing factors remain unclear. In this study, atmospheric NH3 concentration and related meteorological factors were continuously monitored online for one year in a double cropping rice region in subtropical China, and atmospheric NH3 concentration and its meteorological influencing factors as well as dry deposition were analyzed at different time scales （hourly, daily, and monthly）. The main results were as follows： The annual average daily concentration of NH3 in the rice area varied from 0.01 to 58.0 µg·m-3 （in N, same below）, and the annual average concentration was 5.3 µg·m-3. On the hourly scale, the 24-hour dynamics of atmospheric NH3 concentration showed a unimodal pattern, and the time of the NH3 peak appearance in different seasons was different； the time of the peak that appeared in winter lagged behind that in the other seasons. From the perspective of daily scale, NH3 concentration was mainly affected by fertilization in the paddy fields, peaking at 1-3 days after fertilization and then gradually decreasing. On the monthly scale, NH3 concentration peaked at 12.8 µg·m-3 in July and was the lowest in October at 1.6 µg·m-3. On the hourly scale, NH3 concentration varied seasonally due to the influences of meteorological factors, mainly as follows： NH3 concentration showed significant positive correlations with air temperature and solar radiation in all four seasons and with wind speed in spring and summer, whereas it showed significant negative correlations with relative humidity except in winter. On the daily scale, NH3 concentration showed a significant positive correlation with air temperature, rainfall, and solar radiation, whereas it showed a significant negative correlation with relative humidity. On the monthly scale, no significant correlation existed between each meteorological factor and NH3 concentration. The annual dry deposition flux （in N） calculated from the hourly average NH3 concentration was 8.5 kg·ï¼ˆhm2·a）-1, which was 11.6% higher than the annual flux calculated from the daily average and 12.4% higher than the annual flux calculated from the monthly average. In summary, there were significant daily and seasonal variations in atmospheric NH3 concentration in the paddy rice region in subtropical China, and conducting hourly-scale observations of NH3 concentration can help to reveal the multi-time scale variations in NH3 concentration and to quantify NH3 dry deposition more accurately.

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BACKGROUND: Inguinal hernia repair (IHR) is a common surgical procedure worldwide. Although IHR can be performed by the minimally invasive method, which accelerates recovery, postoperative urinary retention (POUR) remains a common complication that significantly impacts patients. Thus, it is essential to identify the risk factors associated with POUR to diminish its negative impact. METHODS: We conducted a single-center retrospective review of elective IHR from 2018 to 2021. POUR was defined as the postoperative use of straight catheter or placement of an indwelling catheter to relieve the symptoms. Adjusted multivariate regression analysis was performed to address the associations of clinicodemographic, surgical, and intraoperative factors with POUR. RESULTS: A total of 946 subjects were included in the analysis after excluding cases of emergent surgery, recurrent hernia, or concomitant operations. The median age was 68.4 years, and 92.0% of the patients were male. Twenty-three (2.4%) patients developed POUR. In univariate analysis, POUR in comparison with non-POUR was significantly associated with increased age (72.2 versus 68.3 years, P = 0.012), a greater volume of intraoperative fluid administered (500 versus 400 ml, P = 0.040), and the diagnosis with benign prostate hypertrophy (34.8% versus 16.9%, P = 0.025). In the multivariate model, both increased age (odds ratio [OR] 1.04, 95% CI 1.01-1.08; P = 0.049) and a greater volume of intraoperative fluid administered (OR 1.12 per 100-mL increase, 95% CI 1.01-1.27; P = 0.047) were significantly associated with the occurrence of POUR. CONCLUSIONS: We found that increased age and a greater volume of intraoperative fluid administered were significantly associated with the occurrence of POUR. Limiting the administration of intraoperative fluid may prevent POUR. From the perspective of practical implications, specific guidelines or clinical pathways should be implemented for fluid management and patient assessment.

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Objective: Difficulties in emotion regulation (DERs) can contribute to disordered eating behavior in children and adolescents with type 1 diabetes (T1D), although it is unknown how DERs may affect eating behavior in these children and adolescents. This study examined the relationship between disordered eating behaviors and emotion regulation in children and adolescents with T1D. Methods: For this cross-sectional study, 128 patients (aged 8-16 years) were recruited to complete the Diabetes Eating Problem Survey-Revised (DEPS-R) and Difficulties in Emotion Regulation Scale (DERs). Results: The mean age of the 128 patients (99 females) who completed the DEPS-R was 11.63 ± 2.27 years. The participants' mean DEPS-R score was 17.78 ± 8.56 points. Of the total sample, 61 participants' scores surpassed the established threshold, resulting in a DEPS-R positivity rate of 47.66%. The participants' mean total DERS score was 72.3 ± 21.15 points, and it was found that children and adolescents with T1D who had a positive DEPS-R screening result had significant differences in emotional regulation and that eating behavior disorders were positively correlated with emotional regulation and all dimensions scores. Conclusions: The prevalence of disordered eating behavior is high among children and adolescents with T1D. DERs are related to disordered eating behavior in children and adolescents with T1D. The novel finding that DERs may be a predictor of eating problems lends preliminary support for the inclusion of DERs in future risk models and as a potential target for intervention.

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BACKGROUND: Urinary tract infections (UTIs) have been one of the most common bacterial infections in clinical practice worldwide. Artificial intelligence (AI) and machine learning (ML) based algorithms have been increasingly applied in UTI case identification and prediction. However, the overall performance of AI/ML algorithms in identifying and predicting UTI has not been evaluated. The purpose of this paper is to quantitatively evaluate the application value of AI/ML in identifying and predicting UTI cases. METHODS: MEDLINE, EMBASE, Web of Science, and PubMed databases were systematically searched for articles published up to December 31, 2023. Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2) and Prediction Model Risk of Bias Assessment Tool (PROBAST) were used to assess the risk of bias. Study characteristics and detailed algorithm information were extracted. Pooled sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were synthesized using a bivariate mix-effects model. Meta-regression and subgroup analysis were conducted to test the source of heterogeneity. RESULTS: In total, 11 studies with 14 AI/ML models were included in the final meta-analysis. The overall pooled AUC was 0.89 (95%CI 0.86-0.92). Additionally, the pooled Sen, Spe, PLR, NLR, and DOR were 0.78 (95%CI 0.71-0.84), 0.89 (95%CI 0.83-0.93), 6.99 (95%CI 4.38-11.14), 0.25 (95%CI 0.18-0.34) and 28.07 (95%CI 14.27-55.20), respectively. The results of meta-regression suggested that reference standard definitions might be the source of heterogeneity. CONCLUSION: AI/ML algorithms appear to be promising to help clinicians detect and identify patients at high risk of UTIs. However, further studies are demanded to evaluate the application value of AI/ML more thoroughly.

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