Minhang District Central Hospital

With the rapid development of big data, interactions in the network environment are increasing and the environment is becoming more complex. Cross-domain authentication plays a key role in secure data sharing. However, the cross-domain authentication scheme under the traditional centralized structure has problems such as over-reliance on trusted third parties, privacy leakage and low certificate efficiency. As an emerging technology, the decentralized feature of blockchain can avoid the drawbacks of traditional centralized trust mechanisms and effectively solve the cross-domain authentication problem. In this paper, we propose a cross-domain authentication and key agreement protocol based on blockchain technology. The root CA based on blockchain is used to establish a trusted consortium blockchain to ensure the authenticity and legitimacy of the root certificate. Then the identity authentication is realized through on-chain information and off-chain signature verification and uses biometrics identification to ensure the correctness of node identity. The protocol achieves identity authentication based on biometrics and signature and key agreement while ensuring security.

"Stroke 1-2-0" is a Chinese numeric mnemonic linking face drooping, arm weakness, and speech difficulty to calling emergency services (1-2-0). We propose an enhanced repeated version-"Stroke 1-2-0, Stroke 1-2-0"-that adds visual impairment and imbalance to better detect posterior-circulation strokes, while repetition may boost recall and stresses zero delay in seeking help.

BackgroundThe global rise in Type 2 Diabetes (T2D) is a particularly evident in China, where dietary patterns have shifted towards a Western diet, potentially exacerbating the issue. This necessitates effective prevention strategies, and objective dietary pattern analysis can inform such strategies.ObjectiveTo preliminarily reveal the health benefits of the EAT-Lancet Diet in preventing T2D among adults in Shanghai, China.MethodsInformation gathered from the Shanghai Suburban Adult Cohort and Biobank (SSACB) were utilized, encompassing 29 507 participants with complete dietary and health assessments. Adherence to the EAT-Lancet diet was quantified by employing a semi-quantitative Food Frequency Questionnaire (FFQ) that included 29 food categories based on participants’ responses recalling food frequency and average consumption amount over a 12-month period. The EAT-Lancet Index (ELDI) was obtained based on the intake level and reference range of 14 food components defined in the EAT-Lancet Diet (0–3 points per component; 0–42 points in total). Incident T2D cases were identified through medical records until February 28, 2023. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed by Cox proportional hazards models. Restricted cubic splines (RCS) were implemented to analyze the dose–response correlation.ResultsOver a median follow-up duration of 5.6 years (maximum 6.9 years), 977 new cases of T2D were recorded. A downward trend in the incidence rate was observed across different categories of the ELDI, ranging from 6.7 to 4.6 per 1000 person-years. Participants with top adherence to the EAT-Lancet diet (≥ 33) had a significantly lower risk of T2D compared to those with the lowest adherence (≤ 26), with a hazard ratio (HR) of 0.70 (95% CI: 0.52, 0.95). The incidence risk of T2D was reduced by 2% for each one-unit increment in the ELDI across adjusted models (HR: 0.98, 95% CI: 0.96, 0.99; p-value < 0.05). A nonlinear correlation between the ELDI and T2D was observed, indicating that higher adherence to the EAT-Lancet diet, particularly with an index above 32, was associated with a decreased likelihood of T2D.ConclusionThis study provides compelling evidence that greater adherence to the EAT-Lancet diet is associated with a reduced likelihood of T2D events among Shanghai residents. This highlights the critical importance of sustainable dietary patterns in preventing diabetes within the demographic context of China.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12889-025-24961-w.

Abstract Enhancing stiffness of thin-walled workpieces is essential to suppress chatter during milling, and applying pre-bending on workpieces is an effective method to achieve this. A semi-analytical dynamic model based on the variational method is developed to uncover how pre-bending curvature and direction modulate dynamic stiffness and milling stability. A fixture-based pre-bending technique is then applied to maintain the workpiece in its bent configuration during milling. Numerical analysis confirms the stiffness enhancement is generally applicable across various geometries, with the first natural frequency increased in all simulated cases and the increase exceeding 110% in high aspect ratio cases. Stability simulations indicate that pre-bending expands the stable spindle-speed range, easing parameter selection under uncertainty. Experimental results show a transition from an unstable to a stable milling state at a spindle speed of 8000 rpm. The results validate the established dynamic model and demonstrate that applying pre-bending technique, with theoretically guided selection of curvature and direction, significantly improves milling stability.

Acetaminophen, or N-acetyl-para-aminophenol (APAP), causes severe liver damage and acute liver failure when overdosed. Oligodeoxynucleotides containing CpG motifs (CpG ODN) can regulate the function of macrophages, which play an important role in drug-induced liver injury. It is unclear whether CpG ODN-treated macrophages play an immune regulation role in APAP-induced liver injury. In the present study, we aim to explore the role of CpG ODN-activated macrophages in APAP-induced liver injury and the underlying mechanism in protecting against the cytotoxicity of APAP. In vivo, C57BL/6 mice were treated with APAP (300mg/Kg) or/and CpG ODN (ODN 1826, 1.65mg/Kg) by intraperitoneal injection, then survival rate, histopathological evaluation, and inflammatory factors were observed to ascertain the protective effect of CpG ODN. Then, CpG ODN-treated macrophages were reinfused into the animal model to determine the effector cells. In vitro, RNA sequencing and untargeted metabolomics detection were performed to illustrate the underlying mechanism. Last, Acod1 siRNA interference was used to clarify the role of IRG1 in resistance to APAP cytotoxicity by ROS and apoptosis indicator detections. We found that CpG ODN showed a protective effect against APAP cytotoxicity by stimulating macrophages rather than hepatic parenchymal cells. In particular, reinfusion of CpG ODN-treated macrophages to mice can alleviate APAP-induced liver injury. Transcriptome and metabolome analysis revealed that the expression of aconitate decarboxylase 1 (Acod1; also known as immune responsive gene 1, IRG1) and the metabolite itaconate generated by IRG1 catalysis increased after CpG ODN stimulation. In addition, we found that the mechanism of this protective effect is ascribed to the increased expression of Acod1 and the antioxidative function of itaconate by the activation of the TLR9/NF-κB signaling pathway. CpG ODN alleviated liver injury induced by APAP through the activation of the TLR9/NF-κB signaling pathway in macrophages, upregulating the expression of IRG1 protein, promoting the production of endogenous metabolite itaconate, and inhibiting macrophage apoptosis which was regulated by upregulating the expression of Nrf2 to inhibit ROS production. This study sheds new light on CpG ODN as a therapeutic strategy in resistance to APAP-induced liver injury.

PurposeTo evaluate the correlation between intraoperative vault measured by optical coherence tomography (OCT) and postoperative vault, and to assess dynamic changes in vault following EVO implantable collamer lens (ICL) implantation.SettingEye and ENT Hospital of Fudan University.DesignProspective observational study.MethodsThis prospective study enrolled 14 patients (5 males, 9 females) who underwent EVO ICL implantation at the Eye and ENT Hospital of Fudan University between July and August 2024, involving a total of 27 eyes. The mean age of the patients was 25.5 ± 4.4 years (range: 19 to35 years), and the average manifest refraction spherical equivalent was − 7.84 ± 2.25 D (range: −11.63 to − 2.00 D). Intraoperative OCT was used to measure real-time vault height without the application of viscoelastic agents. Central vault was measured using CASIA-2 immediately after ICL implantation and reassessed at 1 day, 1 week, and 1 month postoperatively. At each follow-up, visual acuity, subjective and objective refraction, and anterior segment parameters were recorded.ResultsThe mean intraoperative vault was 937.30 ± 402.27 μm. Postoperative vault measurements demonstrated a progressive decline: 912.00 ± 269.96 μm at 2 hours, 777.43 ± 252.19 μm at 1 day, 722.22 ± 226.37 μm at 1 week, and 675.98 ± 224.34 μm at 1 month. A strong correlation was observed between intraoperative and postoperative vault values, with an r² of 0.827 at 2 hours. Bland–Altman analysis indicated a systematic bias of 39.63 μm, with 92.6% of eyes falling within the 95% limits of agreement. The anterior chamber depth to both the crystalline lens and ICL remained stable throughout the postoperative period.ConclusionThe vault measured by intraoperative OCT during EVO ICL implantation closely corresponded with postoperative measurements obtained via CASIA-2, and vault decreased in the early postoperative period.