关键词： Lake energy balance modeling   Lake temperature   South America   Tropical Andes   Climate change   High elevation warming  

摘要： The response of Andean high-alpine lakes (>4000 m above sea level) to atmospheric warming is poorly understood, in part due to a lack of long-term limnological and meteorological observations. Here, we use in situ observations, reanalysis data, satellite-derived data, and climate modeling output data paired with a one-dimensional lake energy balance model to investigate the response of lake thermal properties to observed and projected 21st century warming in the tropical high Andes of Peru. The lake model configuration is based on Lake Sibinacocha (13.86 degrees S, 71.02 degrees W, 4860 m a.s.l.), the largest high-alpine lake in the Andes and one of the few such lakes with temperature observations sufficient for model calibration. Relationships between recent air and lake temperature changes were investigated using the model forced with 21st-century ERA5-Land climate reanalysis data, CERES satellite-based observations, and future relationships were investigated using two CMIP6 future climate scenarios with CESM2 (SSP2-4.5 and SSP5-8.5). Results show that Sibinacocha whole-lake average temperature stayed relatively consistent between 2000 and 2023 due to high interannual variability. Lake Sibinacocha temperatures also display interannual variability that aligns with air temperature variations, suggesting that broad climatic teleconnections that affect Andean air temperatures also influence lake temperature and stratification. Under the SSP2-4.5 and SSP5-8.5 scenarios, the model indicates an acceleration of Lake Sibinacocha's whole-lake warming rate. By 2091-2100, Lake Sibinacocha is projected to increase 2.5 degrees C to 5.9 degrees C. Lake Sibinacocha is projected to warm unevenly, with greater warming in the top 20 m and austral spring, contributing to increased weak stratification in spring. Lake Sibinacocha is anticipated to respond more slowly to warming simply due to its large size. Therefore, our results should be considered a conservative end-member for other

关键词： Spatial-temporal   Mamba   Transformer   Time-series  

摘要： Accurate traffic flow prediction is essential for optimizing traffic management, enhancing road safety, and reducing environmental impacts. However, traditional models face challenges with long sequence data with multi-sensors, demanding substantial memory and computational resources, resulting in slow inference times due to the lack of a unified summary state. This paper introduces ST-MambaSync, a novel unified traffic prediction model that uniquely integrates Mamba and Transformer technologies with balanced computational cost and higher accuracy. Our contributions include: (1) We present the first theoretical investigation demonstrating that Mamba functions as a specialized form of attention mechanism with ResNet structure, enhancing its ability to capture local features critical for traffic pattern recognition;(2) We provide the first theoretical proof of the complementary nature between Mamba and Transformer technologies, showing how their respective strengths in local and global feature extraction work synergistically to improve overall performance;and (3) we validate these benefits through extensive experiments with reducing MAE by 0.70%, RMSE by 0.62%, and MAPE by 0.31%. Also, a 64.86% reduction in inference time and a 19.44% reduction in training time compared to the formal state-of-the-art (SOTA) model, establishing new benchmarks for accuracy and processing speed. This breakthrough sets new standards in traffic flow prediction and has significant implications for urban planning and real-time traffic management.

关键词： STEMI   Obstructive sleep apnea   Mortality   Prevalence   Complications   United States   National inpatient sample  

摘要： Introduction Obstructive Sleep Apnea (OSA) is a prevalent condition affecting millions worldwide and is associated with an increased risk of cardiovascular complications, including ST-Elevation Myocardial Infarction (STEMI). The relationship between OSA and STEMI is complex, with OSA potentially exacerbating the severity of coronary artery disease and influencing outcomes following acute coronary events. Methods We retrospectively analyzed data from the National Inpatient Sample database from 2016 to 2021. Hospitalized patients aged 18 and older diagnosed with STEMI were included. Key outcomes, such as in-hospital mortality, cardiac interventions and inpatient complications, were compared between those with and without OSA. Propensity score matching was utilized to account for potential confounders and risk of complications was compared. Results Among 1,203,915 STEMI hospitalizations, 75,035 (6.2%) had OSA. After PSM, OSA was associated with lower in-hospital mortality (aOR: 0.82, 95% CI: 0.76-0.89, p < 0.001) but higher risks of atrial fibrillation (aOR: 1.28, 95% CI: 1.21-1.36, p < 0.001), venous thromboembolism (aOR: 1.23, 95% CI: 1.06-1.44, p = 0.009), acute kidney injury (aOR: 1.10, 95% CI: 1.04-1.16, p = 0.001), and second-degree atrioventricular block (aOR: 1.69, 95% CI: 1.33-2.15, p < 0.001). OSA patients were more likely to require non-invasive ventilation (aOR: 2.78, 95% CI: 2.48-3.11, p < 0.001) but less likely to need invasive ventilation (aOR: 0.91, 95% CI: 0.84-0.96, p < 0.001) or vasopressors (aOR: 0.77, 95% CI: 0.68-0.87, p = 0.001). Female STEMI patients with OSA had higher mortality than males (aOR: 1.17, 95% CI: 1.14-1.20, p < 0.001) and underwent fewer invasive interventions. Conclusion OSA in STEMI patients was associated with lower in-hospital mortality but a higher burden of complications, emphasizing the need for proactive risk stratification. The increased reliance on non-invasive ventilation highlights distinct management patterns. Addition

关键词： NLRP3 inhibitor   St. John's wort   Antidepressant effects  

摘要： Depression is a chronic mental disorder characterized by persistent low mood and loss of interest, often associated with dysregulation of neuroinflammatory pathways. Inhibition of NOD-like receptor protein 3 (NLRP3), a key mediator of neuroinflammation, is a promising strategy for alleviating depressive symptoms by modulating inflammatory responses in the brain. Seven polycyclic polyprenylated acylphloroglucinols (PPAPs), including six new hyperioxides A-F (1-6) and furohyperforin (7) were isolated from St. John's wort and characterized via spectroscopic analyses. Compounds 2 and 7 exhibited neuroprotective effects at 10 mu M in corticosterone (CORT)injured SH-SY5Y cells. Furthermore, furohyperforin (7) was demonstrated potent antidepressant activity at 1.25 mg/kg in the forced swimming test (FST) of mice, which was equivalent to fluoxetine (10 mg/kg) and neurostan (78 mg/kg). Additionally, compound 7 was shown to reduce serum CORT levels in mice. Further studies highlighted its effects and potential mechanism through the NLRP3 inflammasome pathway and NLRP3 might be a protein target for the antidepressant effects of 7. Notably, this study provided the first evidence of furohyperforin (7)'s antidepressant properties in mice, highlighting its potential as a bioactive compound for antidepression.

关键词： Job satisfaction   Long-term care   Cross-sectional data   Austria  

摘要： Background: With increasing care needs and a decline in nursing staff, measures must be f ound to make long-term care (LTC) attractive for nursing staff and at the same time encourage them to care sector. For this reason, the question is answered: "How do organizational measures, nursing staff, contribute to improving job satisfaction?". Method: In a non-proportional quota sample along the federal state distribution, the implementation of measures was surveyed in a cross-sectional survey in LTC facilities. The effect of the me satisfaction was analyzed using multiple linear regression. remain in the identified by asures on job Results: The bundles of measu revealed that the bundles of measures, like making LTC more attractive (B = 0.244;p < 0.05), integrating interns (B = 0.222, p < 0.05), d relationships (B = 0.078), expl tive effect but can be mitigated by duty scheduling (B = -0.017, p < 0.05). Women report higher levels of job satisfaction than men. The type of organization, age and vocational training have no influence on job satisfaction. Discussion: Duty scheduling and working hours are important factors. Loss in job satisfaction can be cushioned by focusing on these measures. Conclusions: The bundles of measures "Making LTC more attractive", "Duty scheduling and working hours", "Integrating interns", and "Strengthening relationships" are positively associated with job satisfaction. Accordingly, care faciliti rates. res show a high internal consistency of 0.771 to 0.863. Regression analyses uty scheduling and working hours (B = 0.324, p < 0.05), and strengthening ain more than 60% of the variance in job satisfaction. Overtime has a negaes that implement these bundles of measures have higher job satisfaction

关键词： Biomarkers   Hypertensive Nephropathy   Immunoassay   Lupus nephritis  

摘要： The absence of a biologic marker for hypertensive nephrosclerosis (HN) remains a challenge. This study aimed at exploring the relationship between sST2 and early HN and examining their interaction in glomerular mesangial cells. The serum sST2 levels of healthy controls (HC;n=9), patients with HN (n=15), and patients with lupus nephritis (LN;n=27) were measured using ELISA. The association between the serum sST2 levels and clinicopathologic characteristics, including kidney function and mesangial proliferation, were assessed. The expression of ST2 and fibrotic markers in glomerular mesangial cells in hypertensive conditions was evaluated using a 5/6 nephrectomy rat model. To mimic intraglomerular hypertension, human primary glomerular mesangial cells (hPGMCs) were subjected to a 3-mmHg pressure using a newly developed mechanical pressurizing device. The cells were then treated with anti-ST2 antibody (0.5 and 1 mu g/mL) to examine inflammation, apoptosis, and necrosis. The serum sST2 levels were significantly higher in the HN and LN groups than in the HC group. Increased expression of ST2 and fibrotic markers in glomerular mesangial cells was observed in the hypertension- induced animal model. In the in vitro study, pressure-stimulated hPGMCs exhibited increased population of early and late apoptosis, which were markedly reduced after treatment with anti-ST2 antibody (1.0 mu g/mL). ST2 indicates the early pathologic changes of hypertensive kidney damage and may serve as a mesangial cell-specific marker for HN in terms of determining kidney function and pathologic findings. Thus, ST2 blockade could be a novel therapeutic approach for HN.

关键词： Enterobacter cloacae   IMP   Carbapenemase   Cefiderocol   Colistin resistance  

摘要： Objective: To describe the molecular characterisation of an Enterobacter cloacae strain resistant to cefiderocol and co-harbouring blaIMP-19 and mcr-4.3 resistance genes Methods: The strain was isolated from the rectal swab of a 77-year-old woman during screening for the detection of patients colonised by carbapenemase-producing Enterobacterales (CPE) in Bologna (Italy). The strain was identified at species level by MALDI-TOF mass spectrometry and the presence of active-onimipenem (IMP) carbapenemase was confirmed both by a phenotypic immunochromatographic method, and by a rapid commercial nucleic acid amplification test. The strain underwent antimicrobial susceptibility testing and its genome was fully characterised to assess (i) the multilocus sequence type, (ii) the presence of antimicrobial resistance (AMR) genes, and (iii) the presence of virulence genes coupled with mobile genetic elements. Results: Multilocus sequence typing identified the strain as ST837. A plasmid of 60 691 bp, very similar to the MW574937 plasmid of Escherichia coli , was identified and carried the following AMR genes: aac(6' )-II , blaBEL-1 , blaIMP-19 , msr(E), mph(E) , and sul1. This plasmid harboured several tra genes ( traB, traC, traD, traG, traI, traJ, traKtraL , and traM ) of the transfer operon of the E. coli conjugative F plasmid. Other AMR genes were located in the chromosome ( blaCMH-3 and fosA ) or in other plasmids ( blaSHV-12 and mcr-4.3 ). The strain showed resistance to many beta-lactams in vitro, including cefiderocol, whereas, despite the presence of the mcr-4.3 gene, it was susceptible to colistin. Conclusions: Further studies are needed to better evaluate the origin of this strain and monitor the presence of Gram-negative bacilli with a similar molecular structure in our area. (c) 2025 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy. This is an open access article under the CC BY-NC-ND license ( http://creative

摘要： UCF-18

关键词： medical education   remote learning   virtual microscopy