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Epoxy resins, as important thermosetting polymers, exhibit excellent adhesion to various substrates. In view of this, reticulate coating of triglycidyl isocyanate with triethylenetetramine was introduced onto the surface of poly(styrene-divinylbenzene) utilizing amine curing reaction to obtain poly(styrene-divinylbenzene)@triglycidyl isocyanate-triethylenetetramine composite microspheres. The amino groups and epoxy groups of triglycidyl isocyanate-triethylenetetramine endowed poly(styrene-divinylbenzene) with good reactivity, which could be quaternized under mild conditions to obtain an anion exchange chromatographic stationary phase. The quaternized poly(styrene-divinylbenzene)@triglycidyl isocyanate-triethylenetetramine was characterized by scanning electron microscope, Fourier-transform infrared spectroscopy, N2 adsorption-desorption experiment, et al. The chromatographic performance of the customized column was evaluated by separating seven conventional anions, organic weak acids, and carbohydrates. Poly(styrene-divinylbenzene)@triglycidyl isocyanate-triethylenetetramine possesses the uniform size of poly(styrene-divinylbenzene) microspheres and good reactivity of triglycidyl isocyanate-triethylenetetramine, which offers a flexible strategy for the preparation of anion exchange stationary phase. The column exhibits excellent chemical and mechanical stability and chromatographic performance. Finally, the column was successfully applied for the determination of nitrite in pickles.

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OBJECTIVE: Clinical practice guidelines (CPGs) for Integrated Traditional Chinese and Western Medicine (TCM and WM) are important medical documents used to assist medical decision-making and are of great significance for standardizing clinical pathways. However, due to the constraints of text format, it is difficult for Integrated TCM and WM CPGs to play a real role in medical practice. In addition, how to standardize the structure and semantic relationships between Integrated TCM and WM CPG knowledge, and realize the construction of computable, sharable and reliable CPGs, remains an urgent issue to be addressed. Therefore, we are proposing an ontology of CPGs for Integrated TCM and WM. METHODS: We first initialized domain concepts and relationships to ensure the accuracy of the ontology knowledge structure. We then screened CPGs that meet the standards for Integrated TCM and WM, analyzed and classified the contents, and extracted the common structures. Based on the seven-step ontology construction method combined with inference-complement, referring to the representation methods and hierarchical relationships of terms and concepts in MeSH, ICD-10, SNOMED-CT, and other ontologies and terminology sets, we formed the concept structure and semantic relationship tables for the ontology. We also achieved the matching and mapping between the ontology and reference ontologies and term sets. Next, we defined the aspects and constraints of properties, selected multiple Integrated TCM and WM CPGs as instances to populate, and used ontology reasoning tools and formulated defined inference rules to reason and extend the ontology. Finally, we evaluated the performance of the ontology. RESULTS: The content of the Integrated TCM and WM CPGs is divided into nine parts: basic information, background, development method, clinical question, recommendation, evidence, conclusion, result, and reason for recommendations. The Integrated TCM and WM CPG ontology has 152 classes and defines 90 object properties and 114 data properties, with a maximum classification depth of 4 layers. The terms of disease, drug and examination item names in the ontology have been standardized. CONCLUSIONS: This study proposes an Integrated TCM and WM CPG ontology. The ontology adopts a modular design, which has both sharing and scaling ability, and can express rich guideline knowledge. It provides important support for the semantic processing and computational application of guideline documents.

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The development of alternative conductive polymers for the well-known poly (3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) is of great significance for improving the stability in long-term using and high-temperature environments. Herein, an innovative PEDOT:S-ANF aqueous dispersion is successfully prepared by using sulfamic acid (SA) to modified aramid nanofibers (S-ANF) as an alternative dispersant for PSS and the subsequent in situ polymerization of PEDOT. Thanks to the excellent film forming ability and surface negative groups of S-ANF, the PEDOT:S-ANF films show comparable tensile strength and elongation to unmodified PEDOT:ANF. Meanwhile, PEDOT:S-ANF has a high conductivity of 27.87 S cm-1, which is more than 20 times higher than that of PEDOT:PSS. The film exhibits excellent electromagnetic interference (EMI) shielding and thermoelectric performance, with a shielding effectiveness (SE) of 31.14 dB and a power factor (PF) of 0.43 µW m-1K-2. As a substitute for PSS, S-ANF exhibits significant structural and physicochemical properties, resulting in excellent chemical and thermal stability. Even under harsh conditions such as immersing to 0.1 M HCl, 0.1 M NaOH, and 3.5% NaCl solution, or high temperature conditions, the PEDOT:S-ANF films still maintain exceptional EMI shielding performance. Therefore, this multifunctional conductive polymer exhibits enormous potential and even proves its reliability in extreme situations.

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Recently we have shown that protein disulfide isomerase (PDI or PDIA1) is involved in mediating chemically-induced, glutathione (GSH) depletion-associated ferroptotic cell death through NOS activation (dimerization) and NO accumulation. The present study aims to determine the role of PDI in mediating chemically-induced hepatocyte injury in vitro and in vivo and whether PDI inhibitors can effectively protect against chemically-induced hepatocyte injury. We show that during the development of erastin-induced ferroptotic cell death, accumulation of cellular NO, ROS and lipid-ROS follows a sequential order, i.e., cellular NO accumulation first, followed by accumulation of cellular ROS, and lastly cellular lipid-ROS. Cellular NO, ROS and lipid-ROS each play a crucial role in mediating erastin-induced ferroptosis in cultured hepatocytes. In addition, it is shown that PDI is an important upstream mediator of erastin-induced ferroptosis through PDI-mediated conversion of NOS monomer to its dimer, which then leads to accumulation of cellular NO, ROS and lipid-ROS, and ultimately ferroptotic cell death. Genetic manipulation of PDI expression or pharmacological inhibition of PDI function each can effectively abrogate erastin-induced ferroptosis. Lastly, evidence is presented to show that PDI is also involved in mediating acetaminophen-induced liver injury in vivo using both wild-type C57BL/6J mice and hepatocyte-specific PDI conditional knockout (PDIfl/fl Alb-cre) mice. Together, our work demonstrates that PDI is an important upstream mediator of chemically-induced, GSH depletion-associated hepatocyte ferroptosis, and inhibition of PDI can effectively prevent this injury.

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Atherosclerosis is the pathological cause of atherosclerotic cardiovascular disease (ASCVD), which rapidly progresses during the cellular senescence. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) reduce major cardiovascular events in patients with ASCVD and have potential antisenescence effects. Here, we investigate the effects of the SGLT2 inhibitor dapagliflozin on cellular senescence in atherosclerotic mice. Compared with ApoE-/- control mice treated with normal saline, those in the ApoE-/- dapagliflozin group, receiving intragastric dapagliflozin (0.1 mg kg-1 d-1) for 14 weeks, exhibited the reduction in the total aortic plaque area (48.8%±6.6% vs. 74.6%±8.0%, P<0.05), the decrease in the lipid core area ((0.019±0.0037) mm2vs. (0.032±0.0062) mm2, P<0.05) and in the percentage of senescent cells within the plaques (16.4%±3.7% vs. 30.7%±2.0%, P<0.01), while the increase in the thickness of the fibrous cap ((21.6±2.1) µm vs. (14.6±1.5) µm, P<0.01). Transcriptome sequencing of the aortic arch in the mice revealed the involvement of the PPARα and the fatty acid metabolic signaling pathways in dapagliflozin's mechanism of ameliorating cellular aging and plaque progression. In vitro, dapagliflozin inhibited the expression of PPARα and its downstream signal FABP4, by which the accumulation of senescent cells in human aortic smooth muscle cells (HASMCs) was reduced under high-fat conditions. This effect was accompanied by a reduction in the intracellular lipid content and alleviation of oxidative stress. However, these beneficial effects of dapagliflozin could be reversed by the PPARα overexpression. Bioinformatics analysis and molecular docking simulations revealed that dapagliflozin might exert its effects by directly interacting with the RXRA protein, thereby influencing the expression of the PPARα signaling pathway. In conclusion, the cellular senescence of aortic smooth muscle cells is potentially altered by dapagliflozin through the suppression of the RXRA-PPARα-FABP4 signaling pathway, resulting in a deceleration of atherosclerotic progression.

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Despite the advances in devising green methodologies for selective hydrogenation of nitrobenzene toward p-aminophenol, it is still difficult to realize p-aminophenol as the exclusive product in heterogeneous metal catalysis, as the excessive hydrogenation of nitrobenzene usually results in the aniline byproduct. Herein we report that a metal cluster containing 36 gold atoms capped by 24 thiolate ligands provides a unique pathway for nitrobenzene hydrogenation to achieve a p-aminophenol selectivity of ∼100%. The gold cluster can efficiently suppress the over-hydrogenation of amino groups via hydroxyl rearrangement with the aid of water and sequentially the proton transfer promoted by acid toward p-aminophenol. More notably, remarkable catalytic performances can be extended to clusters with similar structures such as Au28(SR)20 and Au44(SR)28, where only an atomic layer change of 2.1 Šthickness in the Au36(SR)24 cluster can tailor the proton affinity for the amino group of the key intermediate phenylhydroxylamine, thereby altering the activity while the p-aminophenol selectivity remained.

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OBJECTIVES: We aimed to explore the lived experiences and needs of women after a recent stillbirth event. DESIGN: Qualitative phenomenological study. SETTING: The current study was conducted in a tertiary obstetric hospital in East China between 25 January 2024 and 29 March 2024. PARTICIPANTS: 14 women having experienced a stillbirth within the last 6 months. RESULTS: Researchers agreed on four key themes including individual variations in emotional reaction and recovery, physical recovery and concerns about future pregnancies, the critical role of social support systems and variations in perceptions of stillbirth as the death of a fetus versus a human being, along with related mourning rituals. These themes collectively highlight the multifaceted nature of the stillbirth experience, underscoring the complex interplay between personal, cultural and medical factors that shape women's emotional and physical responses. CONCLUSIONS: Post-stillbirth experiences among Chinese women are deeply individualised and influenced by a complex interplay of personal emotions, cultural contexts and medical interactions. It is imperative for healthcare systems to implement tailored care strategies beyond standard protocols to proactively address their varied emotional landscapes and physical concerns with an enhanced awareness of cultural sensitivities. Specialised training for healthcare providers should be devised to recognise and respond to the unique grief processes. Comprehensive support systems should be established to significantly enhance the recovery journey by providing essential resources and community connections.

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By highly efficient ligand-exchange strategy, atomically precise Au8Pd1(PPh3)82+ (PPh3 = triphenylphosphine) cluster can be transformed into a Au8Pd1(DPPF)42+ (DPPF = 1,1'-bis(diphenylphosphino)ferrocene) cluster that can maintain the atomic-packing structure but overcome the lability of Au8Pd1(PPh3)82+. Catalytic evaluation for the CO2 hydrogenation coupled with o-phenylenediamine demonstrates that the Au8Pd1(DPPF)42+ catalyst can remarkably enhance both activity and stability compared to the Au8Pd1(PPh3)82+ catalyst. More notably, the direct construction of a two-dimensional metal-organic framework (2D MOF) can be elaborately accomplished in the formylation process of o-phenylenediamine, CO2 and H2 with zinc nitrate enabled by the Au8Pd1(DPPF)42+ catalyst. The 2D MOF further enables the capture and transformation of CO2 to combine in the organic synthesis with epoxides under mild conditions.This work provides opportunities for creating highly active cluster sites for the chemical recycling of CO2.

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BACKGROUND: High temperature stress (HTS) has become a serious threat to rice grain quality and few studies have examined the effects of HTS across multiple stages on rice grain quality. In the present study, we conducted 2 years of HTS treatments under three temperature regimes (32/22 °C, 40/30 °C and 44/34 °C) and HTS durations of 2 days and 4 days at three critical stages: booting, flowering, and a combination of booting and flowering. We employed the heat degree days (HDD) metric, which accounts for both the level and duration of HTS, to quantify the relationships between grain quality traits and HTS. RESULTS: The results revealed the diverse effects of HTS on rice grain quality at different stages, durations and temperature levels. HTS significantly (P < 0.05) reduced grain quality, with the highest sensitivities (reduction per 1 °C day-1 increase in HDD) observed at the flowering stage, followed by the combined and booting stages treatments under mild HTS treatment (40/30 °C). However, under extreme HTS treatments (44/34 °C) for 4 days, rice grains subjected to combined HTS treatment experienced complete mortality. CONCLUSION: Pre-exposed to HTS at the booting stage within a certain intensity can alleviate the adverse effects of post-flowering HTS on grain quality. This provides valuable insights for assessing the potential impact of multiple HTS events on the grain quality under future climate warming. © 2024 Society of Chemical Industry.

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Glutathione S-transferase-Pi 1 (GSTP1) is an isozyme that plays a key role in detoxification and antioxidative damage. It also confers resistance to tumor therapy. However, the specific role of GSTP1 in radiotherapy resistance in pancreatic cancer (PC) is not known. In this study, we investigated how GSTP1 imparts radioresistance in PC. The findings of previous studies and this study revealed that ionizing radiation (IR) induces ferroptosis in pancreatic cancer cells, primarily by upregulating the expression of ACSL4. Our results showed that after IR, GSTP1 prolonged the survival of pancreatic cancer cells by inhibiting ferroptosis but did not affect apoptosis. The expression of GSTP1 reduced cellular ferroptosis by decreasing the levels of ACSL4 and increasing the GSH content. These changes increase the resistance of pancreatic cancer cells and xenograft tumors to IR. Our findings indicate that ferroptosis participates in irradiation-induced cell death and that GSTP1 prevents IR-induced death of pancreatic cancer cells by inhibiting ferroptosis.

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ETHNOPHARMACOLOGICAL RELEVANCE: Caryopteris trichosphaera W. W. Sm., a traditional ethnic medicine, was recorded in the Compendium of Materia Medica for treating wound infection by pathogenic infection. However, its antibacterial potential and bioactive compositions against drug-resistant bacteria need to be validated. AIM OF THE STUDY: To investigate the chemical constituents of C. trichosphaera and explore its anti-MRSA component in vitro and in vivo, together with the antibacterial mechanism. MATERIALS AND METHODS: Bioactive constituents investigation was carried out by phytochemical method and antibacterial screening. The antibacterial mechanism was predicted by network pharmacology, which was further validated by time-kill analysis, membrane function tests, multigenerational resistance induction assay and biofilm test, and metabolomics analysis in vitro. In addition, MRSA-induced epidermal infection in mice was selected to evaluate its pharmacological effect in vivo. RESULTS: Six antibacterial diterpenoids against MRSA and VRE with MIC values 4-32 µg/mL from C. trichosphaera were reported for the first time, in which the major compound cativic acid (1) disrupted MRSA cell membranes by modulating permeability, depolarization, and fluidity while increasing reactive oxygen species (ROS) and malondialdehyde (MDA) levels. It also displayed remarkable anti-biofilm activity without inducing bacterial resistance or cytotoxicity. Moreover, cativic acid affected MRSA biosynthesis of cofactors, amino acid biosynthesis, nucleotide metabolism by metabolomics analysis. Furthermore, cativic acid accelerated wound healing in MRSA-infected mouse skin wounds, even better than vancomycin. CONCLUSIONS: The results supported the traditional use of C. trichosphaera, and presented unreported anti-MRSA agent, cativic acid, as a plant-derived bactericide in vitro and in vivo for the first time.

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This study investigates the prevalence and risk factors associated with venous thrombotic events in patients receiving (ECMO) support. Systematic review and meta-analysis of case-control and cohort studies. PubMed, Cochrane Library, Embase, CINAHL, Web of Science, Scopus, and ProQuest databases from inception through November 25, 2023.Case-control and cohort studies focusing on the prevalence and risk factors for venous thrombotic events in patients supported by ECMO. Identification of risk factors and calculation of incidence rates. Nineteen studies encompassing 10,767 participants were identified and included in the analysis. The pooled prevalence of venous thrombotic events among patients receiving ECMO support was 48% [95% confidence interval (CI) 0.37-0.60, I2 = 97.18%]. Factors associated with increased incidence rates included longer duration of ECMO support (odds ratio [OR] 1.08, 95% CI 1.07-1.09, I2 = 49%), abnormal anti-coagulation monitoring indicators (OR 1.02, 95% CI 1.00-1.04, I2 = 84%), and type of ECMO cannulation (OR 1.77, 95% CI 1.14-3.34, I2 = 64%). The pooled prevalence of venous thrombotic events in patients with ECMO support is high. Increased risk is associated with extended duration of ECMO support, abnormal anti-coagulation monitoring, and specific types of ECMO cannulation.

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The timely and accurate acquisition of crop-growth information is a prerequisite for implementing intelligent crop-growth management, and portable multispectral imaging devices offer reliable tools for monitoring field-scale crop growth. To meet the demand for obtaining crop spectra information over a wide band range and to achieve the real-time interpretation of multiple growth characteristics, we developed a novel portable snapshot multispectral imaging crop-growth sensor (PSMICGS) based on the spectral sensing of crop growth. A wide-band co-optical path imaging system utilizing mosaic filter spectroscopy combined with dichroic mirror beam separation is designed to acquire crop spectra information over a wide band range and enhance the device's portability and integration. Additionally, a sensor information and crop growth monitoring model, coupled with a processor system based on an embedded control module, is developed to enable the real-time interpretation of the aboveground biomass (AGB) and leaf area index (LAI) of rice and wheat. Field experiments showed that the prediction models for rice AGB and LAI, constructed using the PSMICGS, had determination coefficients (R²) of 0.7 and root mean square error (RMSE) values of 1.611 t/ha and 1.051, respectively. For wheat, the AGB and LAI prediction models had R² values of 0.72 and 0.76, respectively, and RMSE values of 1.711 t/ha and 0.773, respectively. In summary, this research provides a foundational tool for monitoring field-scale crop growth, which is important for promoting high-quality and high-yield crops.

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The inorganic matrices such as metal concentrates, steel, cement, glass, clay, coal, graphite, rocks and sediments, ores etc. play a pivotal role in infrastructure development, transportation, and energy. The presence of non-metallic elements particularly halogens influence their quality, processing cost, and environment dynamics. The analysis of non-metals in such matrices is critically challenging due to their hardness, rigidity, and non-digestibility. This comprehensive review provides a critical comparison of various sample preparation methods in conjunction with pros and cons of advanced techniques for the detection of non-metals in complex matrices, particularly focusing on ion chromatography. Moreover, the review also addresses the challenges related to the enrichment and automation of non-metals analysis. In addition, the previous literature on non-metals determination in diverse range of inorganic matrices has been tabulated for the first time. These insights are intended to guide researchers, quality control analysts, environmental scientists, and policymakers in enhancing pollution monitoring and control strategies.

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Emerging pollutants such as antibiotics have aroused great concern in recent years. However, the knowledge of low concentration-induced hormesis was not well understood. This study evaluated and quantified hormetic effects of ofloxacin on Chlorella pyrenoidosa. LogNormal model predicted the maximal non-effect concentration was 0.13 mg/L and 2.96 mg/L at 3 and 21 d, respectively. The sensitive alterations in chlorophyll fluorescence suggested PSII was the main target. Transcriptomics revealed ofloxacin inhibited genes related to photosynthetic system while the cyclic electron around PSI decreased the pH value in stroma side and stimulated photoprotection via up-regulating psbS. The stimulation in citrate cycle pathway met the urgent requirements of energy for DNA replication and repair. In addition, the negative feedback of G3P in glycolysis pathway inhibited Calvin cycle. The degradation products illustrated the occurrence of multiple detoxification mechanisms such as demethylation and ring-opening. The mobilization of cytochrome P450 generated the constant detoxication of ofloxacin while glutathione was consumptively involved in biological binding. This study provided new insights into the molecular mechanisms of antibiotic-induced hormesis in microalgae.

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Temporomandibular joint osteoarthritis (TMJOA) is a commonly encountered degenerative joint disease in oral and maxillofacial surgery. Recent studies have shown that the excessive unbalanced activation of Wnt/ß-catenin signaling is connected with the pathogenesis of TMJOA and due to the inability to inhibit the over-activated Wnt pathway, while Wnt16-deficient mice has a more severe Knee OA. However, the efficacy of direct intra-TMJ injection of Wnt16 for the relief of TMJOA is still not directly confirmed. Moreover, small-molecule drugs such as Wnt16 usually exhibit short-lived efficacy and poor treatment adherence. Therefore, in order to obtain a stable release of Wnt16 both in the short and long term, this study fabricates a double-layer slow-release Wnt16 carrier based on mesoporous silica nanospheres (MSNs) encased within hyaluronic acid (HA) hydrogels. The biofunctional hydrogel HA/Wnt16@MSN is analyzed both in vitro and in vivo to evaluate the treatment of TMJOA. As a result, it shows superior pro-cartilage matrix restoration and inhibition of osteoclastogenesis ability, and effectively inhibits the over-activation of the Wnt/ß-catenin pathway. Taken together, biofunctional hydrogel HA/Wnt16@MSN is a promising candidate for the treatment of TMJOA.

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In piglets, oxidative stress can exacerbate gut injury caused by pathogens. C-Jun amino-terminal kinase (JNK) is associated with oxidative stress-induced damage to intestinal epithelial barrier. However, it is unclear whether oxidative stress can increase gut injury by Clostridium perfringens type A (CpA) and whether JNK mediates this process. We aimed to investigate if and how the JNK can regulate the effect of oxidative stress on gut injury induced by CpA infection. In this study, the oxidative stress in IPEC-J2 cells was modeled, and the changes in the susceptibility of IPEC-J2 cells to CpA were examined after treatment of oxidative stressed IPEC-J2 cells with JNK inhibitor (SP600125) and JNK siRNA. Pre-injection with the SP600125 solution was also carried out in oxidative stressed mice, followed by CpA infection. Results indicated that compared to that in the Control group, IPEC-J2 cells under oxidative stress showed reduced transmembrane resistance, degraded tight junction (TJ) proteins, increased membrane permeability, and enhanced CpA infection, all of which were reversed by inhibiting or interfering with JNK expression. Similarly, compared to that in the Control group, mice under oxidative stress showed degradation of jejunal TJ proteins, increased intestinal permeability and barrier damage by CpA, while mice pre-injected with the SP600125 solution showed alleviation of these alterations. These results suggested that oxidative stress enhanced the infection of IPEC-J2 cells and the gut injury caused by CpA, which was mediated by JNK. This study provides important insights regarding the mechanism by which oxidative stress enhanced intestinal damage by CpA.

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Accurate estimation of pandemic likelihood in every US state of interest and at any time. Coronavirus disease 2019 (COVID-19) is an infectious illness with a high potential for global dissemination and low rates of fatality and morbidity, placing some strains on national public health systems. This research intends to benchmark a novel technique, that enables hazard assessment, based on available clinical data, and dynamically observed patient numbers while taking into account pertinent territorial and temporal mapping. Multicentre, population-based, and biostatistical strategies have been utilized to process raw/unfiltered medical survey data. The expansion of extreme value statistics from the univariate to the bivariate situation meets with numerous challenges. First, the univariate extreme value types theorem cannot be directly extended to the bivariate (2D) case,-not to mention challenges with system dimensionality higher than 2D. Assessing outbreak risks of future outbreaks in any nation/region of interest. Existing bio-statistical approaches do not always have the benefits of effectively handling large regional dimensionality and cross-correlation between various regional observations. These methods deal with temporal observations of multi-regional phenomena. Apply contemporary, novel statistical/reliability techniques directly to raw/unfiltered clinical data. The current study outlines a novel bio-system hazard assessment technique that is particularly suited for multi-regional environmental, bio, and public health systems, observed over a representative period. With the use of the Gaidai multivariate hazard assessment approach, epidemic outbreak spatiotemporal risks may be properly assessed. Based on raw/unfiltered clinical survey data, the Gaidai multivariate hazard assessment approach may be applied to a variety of public health applications. The study's primary finding was an assessment of the risks of epidemic outbreaks, along with a matching confidence range. Future global COVID-19/severe acute respiratory syndrome coronavirus 2 (SARS-COV2) epidemic risks have been examined in the current study; however, COVID-19/SARS-COV2 infection transmission mechanisms have not been discussed.

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Rheumatoid arthritis (RA) is a chronic autoimmune disease with a complex etiology. Neutrophil extracellular traps (NETs are NETwork protein structures activated by neutrophils to induce the cleavage and release of DNA-protein complexes). Current studies have shown the critical involvement of NETs in the progression of autoimmune diseases, Neutrophils mostly gather in the inflammatory sites of patients and participate in the pathogenesis of autoimmune diseases in various ways. NETs, as the activated state of neutrophils, have attracted much attention in immune diseases. Many molecules released in NETs are targeted autoantigens in autoimmune diseases, such as histones, citrulline peptides, and myeloperoxidase. All of these suggest that NETs have a direct causal relationship between the production of autoantigens and autoimmune diseases. For RA in particular, as a disorder of the innate and adaptive immune response, the pathogenesis of RA is inseparable from the generation of RA. In this article, we investigate the emerging role of NETs in the pathogenesis of RA and suggest that NETs may be an important target for the treatment of inflammatory autoimmune diseases.

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Objectives: The purpose of this paper is to explore the relationship between blood levels of cadmium, lead, and mercury and anxiety in American adults. Methods: Blood metals and self-reported anxiety days were extracted from laboratory data and questionnaire data, respectively, using NHANES data from 2007-2012. Weighted logistic regression was used to assess the relationship between cadmium, lead and mercury with anxiety. Restricted cubic spline was used to visualize the non-linear relationship between metal concentrations and anxiety. Weighted quantile sum (WQS) regression was used to investigate the effect of combined exposure to the three metals on anxiety. Results: The prevalence of anxiety in adults was 26.0%. After adjusting for potential confounding variables, cadmium levels in the highest quartile (Q4) were associated with a higher risk of anxiety compared to the lowest quartile (Q1) (OR = 1.279, 95% CI: 1.113-1.471, p < 0.01). Restricted cubic spline analysis indicated a positive association between blood cadmium levels and anxiety. Furthermore, co-exposure to multiple heavy metals was positively associated with anxiety risk (WQS positive: OR = 1.068, 95% CI: 1.016-1.160, p < 0.05), with cadmium contributing the most to the overall mixture effect. Compared to the Light RPA, the Vigorous/Moderate RPA group had a relatively low risk of anxiety after cadmium exposure. Conclusion: High levels of blood cadmium are positively associated with the development of anxiety disorders, which needs to be further verified in future studies.

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