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Editorial Note: An analysis of trade cooperation: Central region in China and ASEAN
Standing by Our Colleagues in Gaza — A Plea to the U.S. Medical Community
What are the spatio-temporal differentiation characteristics and driving factors of the coupling coordination degree between green finance and ecological efficiency? Evidence from 84 cities in western China
Facilitating the coordinated and effective progress of green finance (GF) and ecological efficiency (EE) stands as a potent approach to support our nation in attaining sustainable development goals. This paper Utilized panel data encompassing 84 cities in Western China spanning from 2007 to 2021, this paper empirically analyzes the spatio-temporal characteristics and driving factors of the coupling coordination degree between green finance and ecological efficiency (CCD-GFEE) in western cities. The findings indicate that: (1) The level of GF demonstrates a rising trajectory, with significant regional disparities. Besides, the high level area progressively moves from the northwest to the southwest. (2) On the whole, urban EE demonstrates a relatively elevated level, but it still fails to reach DEA effectiveness. Compared to the northwest region, the southwest region has poorer efficiency. (3) The CCD-GFEE in western China showing a slight growth trend. The coupling coordination degree (CCD) in Northwest China is higher than that in Southwest China, and cities with higher CCD are primarily found in Inner Mongolia, Sichuan Province and Shaanxi Province. Within them, the CCD of Chengdu is the highest, Chongqing has achieved the largest stage leap. (4) The global Moran’s I consistently remained positive and exhibited a tendency of initially rising and subsequently falling, indicating that the spatial aggregation effect of CCD-GFEE first increased and then decreased. (5) The CCD-GFEE driving factors are examined using the spatial econometric model, and it has been observed that the impact of population size and government intervention on CCD-GFEE is negative, while the impact of industrial structure, technological progress and economic level on the coupling and coordination of CCD-GFEE is positive. Finally, the paper presents certain policy enlightenments to guide the coordinated development of GF and EE from the aspects of GF system formulation, economic construction and technological progress.
Donor Hearts for Transplantation after Circulatory Death
Evaluation of dental students’ awareness about intraoral scanners
Background There are a few studies evaluating dental students’ knowledge and awareness of intraoral scanners. This study aims to evaluate and compare the knowledge and awareness of levels 3 rd , 4 th, and 5 th -grade dental students regarding intraoral scanners and their use in orthodontics. Methods A survey adapted from similar studies was administered to a total of 278 volunteer undergraduate students [comprising 3 rd (n = 94), 4 th (n = 88), and 5 th- grade (n = 96)] to assess their awareness of intraoral scanners. Descriptive statistics, including frequencies and percentages, were used to analyze the variables within the scope of the study. The Fisher–Freeman–Halton exact test was employed to compare responses across different academic years. A p-value of <0.05 was considered statistically significant. Results Of the participants, 33.81% were 3 rd -grade, 31.65% were 4 th -grade, and 34.53% were 5 th -grade dental students. There was no significant difference in the distribution of participants across academic grades (p > 0.05). Among the students, 96.81% of the 3 rd -grade, 89.77% of the 4 th -grade, and 83.33% of the 5 th -grade students reported that they had never used an intraoral scanner (p < 0,05). A higher proportion of 3 rd -grade students (71.28%) believed that IOSs were used in the treatment of skeletal Class II malocclusions and the fabrication of maxillary expansion appliances, compared to the other grade groups. In contrast, 5 th -grade students more frequently associated IOS usage with indirect bonding procedures (63.54%) (p < 0.05). Conclusion Students in the 4 th and 5 th grades demonstrated a greater level of knowledge compared to 3 rd -grade students. It is recommended that practical training opportunities be expanded and the dental curriculum be revised accordingly to support hands-on experience with intraoral scanners.
Disparities in Kidney Disease and the Race-Neutral eGFR — Research and Action in NYC’s Public Hospital System
Programmable antisense oligomers for phage functional genomics
Abstract Bacteriophages are the most abundant entities on earth and exhibit vast genetic and phenotypic diversity. Exploitation of this largely unexplored molecular space requires identification and functional characterization of genes that act at the phage–host interface. So far, this has been restricted to few model phage–host systems that are amenable to genetic manipulation. Here, to overcome this limitation, we introduce a non-genetic mRNA targeting approach using exogenous delivery of programmable antisense oligomers to silence genes of DNA and RNA phages. A systematic knockdown screen of core and accessory genes of the nucleus-forming jumbo phage ΦKZ, coupled to RNA-sequencing and microscopy analyses, reveals previously unrecognized proteins that are essential for phage propagation and that, upon silencing, elicit distinct phenotypes at the level of the phage and host response. One of these factors is the RNase H-like protein ΦKZ155 (also known as Nlp2), which acts at a major decision point during infection, linking the formation of the protective phage nucleus to phage genome amplification. This non-genetic antisense oligomer-based gene silencing method promises to be a versatile tool for molecular discovery in phage biology, will help to elucidate defence and anti-defence mechanisms in non-model phage–host pairs, and offers potential for optimizing phage therapy and biotechnological procedures.
Centering caregiver voices on caregiving needs of children with neurodevelopmental disorders in low-resource settings
Caregivers of children with neurodevelopmental disorders (NDDs) in low-resource settings face significant challenges in accessing appropriate care, support, and interventions. This study was centred on caregivers’ lived experiences as a channel through which research and intervention planning draws a better understanding of experiences, barriers, and needs for providing care. Using qualitative methods, we applied the interpretive phenomenological approach to navigate caregiving needs required to optimise the caregiving experience. Findings reveal that caregivers navigate multiple hardships, including limited knowledge and care skills on NDDs, access to rehabilitation services, and heightened social stigma exemplified through lack of empathy in families and communities. Despite these challenges, caregivers demonstrate remarkable resilience and develop adaptive strategies to support their children’s development by identifying ways that empower caregiving—increased knowledge, use of rehabilitation services in community spaces, empathy and thriving together through support groups. By centering on caregiver perspectives, this research informs more inclusive and sustainable approaches to supporting families of children with NDDs in resource-constrained environments.
A Randomized Trial of Physical Therapy for Meniscal Tear and Knee Pain
Sentiment polarity in nursing notes predicts perioperative complications and shorter hospital stay in hip arthroplasty: Subgroup-specific associations and mediation by complications
Background Recent advancements in natural language processing (NLP) technology have enabled the extraction of sentiment information from nursing notes. This study aims to investigate the association between sentiment scores and perioperative complications (POC), as well as the length of stay (LOS) in hospital stay, among patients undergoing hip arthroplasty (HA). Methods A total of 382 patients undergoing HA were enrolled for this retrospective study, with a POC rate of 22.17% and a median LOS in hospital of 3.56 days. First, the variance inflation factor (VIF) was calculated to perform multicollinearity diagnostics. Subsequently, a restricted cubic spline (RCS) curve was fitted to evaluate the linear relationship between sentiment scores and the risk of POC. Next, multiple logistic regression models were constructed for association analysis. Furthermore, subgroup analyses were conducted to identify susceptible populations, while mediation analysis was employed to explore the mediating role of sentiment scores. Finally, we performed a series of analyses focusing on the secondary outcome of LOS in hospital. Results After adjusting for covariates (Model 1 adjusted for age and hypertension; Model 2 adjusted for some laboratory indicators), elevated sentiment polarity scores reduced the risk of POC (Model 1: OR=0.227, 95%CI: 0.062–0.840; Model 2: OR=0.219, 95%CI: 0.058–0.8214). However, this association was no longer significant after adjusting for the reason of surgery (OR=0.587, 95%CI: 0.152–2.319). After adjusting for the operation reason, the association between sentiment polarity and POC was observed in three subgroups: left HA patients, those without dyslipidemia, and those not taking aspirin (all P < 0.05). We did not observe the mediating effect of sentiment polarity (all P for IE > 0.05). This study also found that higher polarity scores were significantly associated with shorter hospital LOS (β = −2.119, 95%CI: −3.113, −1.124), with POC serving as a mediator in the relationship between sentiment polarity and hospital LOS in both the overall population and the non-dyslipidemia subgroup ( P for IE < 0.05). Conclusion Our findings indicated that sentiment polarity in nursing notes can serve as a valuable predictor of perioperative outcomes in patients undergoing HA.
The Concierge Cure?
Functional synapses between neurons and small cell lung cancer
Abstract Small cell lung cancer (SCLC) is a highly aggressive type of lung cancer, characterized by rapid proliferation, early metastatic spread, frequent early relapse and a high mortality rate 1–3 . Recent evidence has suggested that innervation has an important role in the development and progression of several types of cancer 4,5 . Cancer-to-neuron synapses have been reported in gliomas 6,7 , but whether peripheral tumours can form such structures is unknown. Here we show that SCLC cells can form functional synapses and receive synaptic transmission. Using in vivo insertional mutagenesis screening in conjunction with cross-species genomic and transcriptomic validation, we identified neuronal, synaptic and glutamatergic signalling gene sets in mouse and human SCLC. Further experiments revealed the ability of SCLC cells to form synaptic structures with neurons in vitro and in vivo. Electrophysiology and optogenetic experiments confirmed that cancer cells can receive NMDA receptor- and GABA A receptor-mediated synaptic inputs. Fitting with a potential oncogenic role of neuron–SCLC interactions, we showed that SCLC cells derive a proliferation advantage when co-cultured with vagal sensory or cortical neurons. Moreover, inhibition of glutamate signalling had therapeutic efficacy in an autochthonous mouse model of SCLC. Therefore, following malignant transformation, SCLC cells seem to hijack synaptic signalling to promote tumour growth, thereby exposing a new route for therapeutic intervention.
Surprise meteorite debris uncovered on Moon’s far side
Myeloid progenitor dysregulation fuels immunosuppressive macrophages in tumours
Author Correction: Crystal structure of heliorhodopsin
Energy deficiency selects crowded live epithelial cells for extrusion
Abstract Epithelial cells work collectively to provide a protective barrier, yet they turn over rapidly through cell division and death. If the numbers of dividing and dying cells do not match, the barrier can vanish, or tumours can form. Mechanical forces through the stretch-activated ion channel Piezo1 link both of the processes; stretch promotes cell division, whereas crowding triggers live cells to extrude and then die 1,2 . However, it was not clear what selects a given crowded cell for extrusion. Here we show that the crowded cells with the least energy and membrane potential are selected for extrusion. Crowding triggers sodium (Na + ) entry through the epithelial Na + channel (ENaC), which depolarizes cells. While those with sufficient energy repolarize, those with limited ATP remain depolarized, which, in turn, triggers water egress through the voltage-gated potassium (K + ) channels K v 1.1 and K v 1.2 and the chloride (Cl − ) channel SWELL1. Transient water loss causes cell shrinkage, amplifying crowding to activate crowding-induced live cell extrusion. Thus, our findings suggest that ENaC acts as a tension sensor that probes for cells with the least energy to extrude and die, possibly damping inadvertent crowding activation of Piezo1 in background cells. We reveal crowding-sensing mechanisms upstream of Piezo1 that highlight water regulation and ion channels as key regulators of epithelial cell turnover.
Cake to the rescue: how these PhD students are cooking up a sense of community
‘Gland-in-a-dish’ secretes stress hormone like the real thing
Structure and mechanism of the mitochondrial calcium transporter NCLX
Abstract As a key mitochondrial Ca 2+ transporter, NCLX regulates intracellular Ca 2+ signalling and vital mitochondrial processes 1–3 . The importance of NCLX in cardiac and nervous-system physiology is reflected by acute heart failure and neurodegenerative disorders caused by its malfunction 4–9 . Despite substantial advances in the field, the transport mechanisms of NCLX remain unclear. Here we report the cryo-electron microscopy structures of NCLX, revealing its architecture, assembly, major conformational states and a previously undescribed mechanism for alternating access. Functional analyses further reveal an unexpected transport function of NCLX as a H + /Ca 2+ exchanger, rather than as a Na + /Ca 2+ exchanger as widely believed 1 . These findings provide critical insights into mitochondrial Ca 2+ homeostasis and signalling, offering clues for developing therapies to treat diseases related to abnormal mitochondrial Ca 2+ .