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This study aimed to explore extracellular microRNA derived from Echinococcus multilocularis (EM) in the plasma of patients with alveolar echinococcosis (AE) and assess its potential as a diagnostic biomarker. EM-derived miRNAs were identified in plasma samples from 20 AE patients through miRNA sequencing. Three novel miRNA molecules (emu-miR-novel 1, 2 and 3) were predicted through bioinformatic analysis to elucidate their chromosomal locations, secondary structures and precursor forms. Subsequently, plasma samples from 30 AE patients and 30 controls were utilized to establish an assay via stem-loop reverse transcription PCR, optimizing primers, reaction systems, and conditions to assess cross-reactivity and sensitivity. Clinical validation revealed that emu-miR-novel 1 had the highest diagnostic accuracy, with an area under the curve (AUC) of 0.8994, a P value of less than 0.0001, a sensitivity of 83.3%, and a specificity of 86.7%. Statistically significant differences were observed between the groups for emu-miR-novel 1 (P < 0.05), whereas emu-miR-novel 2 and 3 showed AUC values of 0.7922 and 0.6883, with P values of 0.0001 and 0.012, respectively, indicating no significant difference between groups (P > 0.05). Furthermore, the assay showed no cross-reactivity with samples from 18 common viruses, 4 parasitic infections, and miRNAs from AE sequenced from 8 species, confirming its high specificity. Emu-miR-novel 1 exhibited a sensitivity of 1 femtomolar. Emu-miR-novel 1 holds promise as a key diagnostic tool for AE, offering a novel perspective and approach for disease diagnosis.
We investigate when a group of the form $G\times \mathbb {Z}^m\ (m\geq 1)$ has the finitely generated fixed subgroup property of automorphisms ($\mathrm {FGFP_a}$), by using the BNS-invariant, and provide some partial answers and nontrivial examples.
Clay minerals are effective adsorbents for the remediation of pesticides in wastewater due to their large superficial areas and excellent cation-exchange capabilities. However, this adsorption effect can be reduced by the accumulation of adsorbents on clay minerals, amongst other problems. Therefore, in this study, montmorillonite (Mnt) modified by layered double hydroxide (LDH) with different loading amounts was successfully prepared using an in situ method. The results from X-ray diffraction, Fourier-transform infrared spectrometry, Brunauer–Emmet–Teller (BET) and scanning electron microscopy analyses revealed that LDH structures were successfully combined with the Mnt layer and formed a porous structure. However, excess LDH still caused the aggregation and accumulation of layers. The adsorption performance of LDH@Mnt for atrazine (ATZ) and paraquat (PQ) was investigated, and the removal efficiency of the LDH@Mnt composite was higher than those of Mnt and LDH alone. The kinetic study revealed that the adsorption process fitted the pseudo-second-order model and internal diffusion model, and 3-LDH@Mnt had the greatest absorbability efficiency for both ATZ and PQ, indicating the adsorption process was controlled by the number of active sites of the adsorbent. The generalized Langmuir model accurately characterized the adsorption process of ATZ and PQ elimination in the adsorption isotherm investigation, indicating that the adsorption energies of the active sites on the adsorbents were different. 3-LDH@Mnt had better absorbability performance for ATZ/PQ, and the sorption capacities were 7.03 and 91.9 mg g–1, respectively. According to site energy distribution theory, the amount of sorption sites of the composite adsorbent was large and the average adsorption energy was high, both of which being beneficial for the adsorption of ATZ and PQ. The effects of pH, coexisting anions and reuse experiments were also tested, indicating that the LDH@Mnt composite possessed high adsorption stability. This excellent removal performance represents a promising strategy for the remediation and elimination of pesticide contaminations from the environment.
Energy loss of protons with 90 and 100 keV energies penetrating through a hydrogen plasma target has been measured, where the electron density of the plasma is about 1016 cm−3 and the electron temperature is about 1-2 eV. It is found that the energy loss of protons in the plasma is obviously larger than that in cold gas and the experimental results based on the Bethe model calculations can be demonstrated by the variation of effective charge of protons in the hydrogen plasma. The effective charge remains 1 for 100 keV protons, while the value for 90 keV protons decreases to be about 0.92. Moreover, two empirical formulae are employed to extract the effective charge.
This study assesses the difference in professional attitudes among medical students, both before and after coronavirus disease 2019 (COVID-19), and identifies the determinants closely associated with it, while providing precise and scientific evidence for implementing precision education on such professional attitudes.
Methods:
A pre-post-like study was conducted among medical students in 31 provinces in mainland China, from March 23, to April 19, 2021.
Results:
The proportion of medical students whose professional attitudes were disturbed after the COVID-19 pandemic, was significantly lower than before the COVID-19 pandemic (χ2 = 15.6216; P < 0.0001). Compared with the “undisturbed -undisturbed” group, the “undisturbed-disturbed” group showed that there was a 1.664-fold risk of professional attitudes disturbed as grade increased, 3.269-fold risk when others suggested they choose a medical career rather than their own desire, and 7.557-fold risk for students with COVID-19 in their family, relatives, or friends; while the “disturbed-undisturbed” group showed that students with internship experience for professional attitudes strengthened was 2.933-fold than those without internship experience.
Conclusions:
The professional attitudes of medical students have been strengthened during the COVID-19 pandemic. The results provide evidence of the importance of education on professional attitudes among medical students during public health emergencies.
HIV-1 molecular surveillance provides a new approach to explore transmission risks and targeted interventions. From January to June 2021, 663 newly reported HIV-1 cases were recruited in Zhaotong City, Yunnan Province, China. The distribution characteristics of HIV-1 subtypes and HIV-1 molecular network were analysed. Of 542 successfully subtyped samples, 12 HIV-1 strains were identified. The main strains were CRF08_BC (47.0%, 255/542), CRF01_AE (17.0%, 92/542), CRF07_BC (17.0%, 92/542), URFs (8.7%, 47/542), and CRF85_BC (6.5%, 35/542). CRF08_BC was commonly detected among Zhaotong natives, illiterates, and non-farmers and was mostly detected in Zhaoyang County. CRF01_AE was frequently detected among married and homosexual individuals and mostly detected in Weixin and Zhenxiong counties. Among the 516 pol sequences, 187 (36.2%) were clustered. Zhaotong natives, individuals aged ≥60 years, and illiterate individuals were more likely to be found in the network. Assortativity analysis showed that individuals were more likely to be genetically associated when stratified by age, education level, occupation, and reporting area. The genetic diversity of HIV-1 reflects the complexity of local HIV epidemics. Molecular network analyses revealed the subpopulations to focus on and the characteristics of the risk networks. The results will help optimise local prevention and control strategies.
According to the positive time-discounting assumption of intertemporal decision-making, people prefer to undergo negative events in the future rather than in the present. However, negative discounting has been identified in the intertemporal choice and loss domains, which refers to people’s preference to experience negative events earlier rather than later. Studies have validated and supported the "anticipated dread" as an explanation for negative discounting. This study again explored the effect of anticipated dread on intertemporal choice using content analysis; that is, having participants identify anticipated dread among reasons for negative discounting. This study also validated the effect of anticipated dread on negative discounting by manipulating anticipated dread. This study adds empirical and direct evidence for the role of anticipated dread in negative discounting.
Intertemporal choices involve tradeoffs between outcomes that occur at different times. Most of the research has used pure gains tasks and the discount rates yielding from those tasks to explain and predict real-world behaviors and consequences. However, real decisions are often more complex and involve mixed outcomes (e.g., sooner-gain and later-loss or sooner-loss and later-gain). No study has used mixed gain-loss intertemporal tradeoff tasks to explain and predict real-world behaviors and consequences, and studies involving such tasks are also scarce. Considering that tasks involving a combination of gains and losses may yield different discount rates and that existing pure gains tasks do not explain or predict real-world outcomes well, this study conducted two experiments to compare the discount rates of mixed gain-loss intertemporal tradeoffs with those of pure gains or pure losses (Experiment 1) and to examine whether these tasks predicted different real-world behaviors and consequences (Experiment 2). Experiment 1 suggests that the discount rate ordering of the four tasks was, from highest to lowest, pure gains, sooner-loss and later-gain, pure losses, and sooner-gain and later-loss. Experiment 2 indicates that the evidence supporting the claim that the discount rates of the four tasks were related to different real-world behaviors and consequences was insufficient.
Insulin-like growth factor 1 receptor (IGF1R) is a cell surface receptor, belonging to the tyrosine kinase receptor superfamily. IGF1R plays a role not only in normal cell development but also in malignant transformation, which has become a candidate therapeutic target for the treatment of human cancer. This study aimed to explore insertions and deletions (indels) in IGF1R gene and investigate their association with growth traits in four Chinese cattle breeds (Xianan cattle, Jinnan cattle, Qinchuan cattle and Nanyang cattle). The current paper identified a 28-bp indel by polymerase chain reaction within IGF1R gene. The analysis showed that there was a significant correlation between the locus and the hucklebone width of Nanyang cattle in four periods, in which it was highly correlated at 6, 12 and 18 months. At the age of 6 months, it was also significantly correlated with body height, body weight and body length. Association analysis showed that the locus in Jinnan cattle was extremely significantly correlated with body slanting length and body weight, and significantly correlated with chest circumference. There was no significant correlation between this locus and growth traits of Xianan cattle and Qinchuan cattle. The detected indel in the IGF1R gene was significantly associated with growth traits in Jinnan and Nanyang cattle, and could be used as a molecular marker for growth trait selection.
The complex sea ice conditions in Arctic waters has different impacts on the legs of the Arctic passage, and ships of specific ice classes face different navigation risks. Therefore, the quantitative analysis of the navigation risks faced in different legs has important practical significance. Based on the POLARIS introduced by IMO, the sea ice condition data from 2011 to 2020 was used to quantify the navigation risk of the Arctic Northeast passage. The risk index outcome (RIO) of the Arctic Northeast Passage were calculated. The navigable windows of the route for ice class 1A ships sailing independently under different sea ice conditions in the last decade were determined, with a navigable period of 91 days under normal sea ice conditions, approximately 175 days under light sea ice conditions and only week 40 close to navigation under severe sea ice conditions. The three critical waters affecting the safety of ships were identified. Combined with the navigable windows and critical waters, recommendations on ship's navigation and manipulation and recommendations for stakeholders were given. The method and results provided reference and support for the assessment of the navigation risk of ships in the Northeast Passage and safety navigation and operations of ships, and satisfied the needs of relevant countries and enterprises to rationally arrange shipment dates and sailing plans based on different ice classes of ships.
Sarcopenic obesity is regarded as a risk factor for the progression and development of non-alcoholic fatty liver disease (NAFLD). Since male sex is a risk factor for NAFLD and skeletal muscle mass markedly varies between the sexes, we examined whether sex influences the association between appendicular skeletal muscle mass to visceral fat area ratio (SVR), that is, an index of skeletal muscle mass combined with abdominal obesity, and the histological severity of NAFLD. The SVR was measured by bioelectrical impedance in a cohort of 613 (M/F = 443/170) Chinese middle-aged individuals with biopsy-proven NAFLD. Multivariable logistic regression and subgroup analyses were used to test the association between SVR and the severity of NAFLD (i.e. non-alcoholic steatohepatitis (NASH) or NASH with the presence of any stage of liver fibrosis). NASH was identified by a NAFLD activity score ≥5, with a minimum score of 1 for each of its categories. The presence of fibrosis was classified as having a histological stage ≥1. The SVR was inversely associated with NASH in men (adjusted OR 0·62; 95 % CI 0·42, 0·92, P = 0·017 for NASH, adjusted OR 0·65; 95 % CI 0·43, 0·99, P = 0·043 for NASH with the presence of fibrosis), but not in women (1·47 (95 % CI 0·76, 2·83), P = 0·25 for NASH, and 1·45 (95 % CI 0·74, 2·83), P = 0·28 for NASH with the presence of fibrosis). There was a significant interaction for sex and SVR (Pinteraction = 0·017 for NASH and Pinteraction = 0·033 for NASH with the presence of fibrosis). Our findings show that lower skeletal muscle mass combined with abdominal obesity is strongly associated with the presence of NASH only in men.
The research was to introduce the experience of doubly committed subarterial ventricular septal defect (DCVSD) repaired through tricuspid approach.
Methods:
From January, 2015 to September, 2019, 86 consecutive DCVSD paediatrics underwent repair via right subaxillary vertical incision (RAVI) through tricuspid approach. Perioperative and follow-up data were collected.
Results:
The age and weight at operation were 28.1 ± 18.5 (range: 7–101) months and 12.2 ± 4.2 (6–26.5) kg. There were two patients combined with discrete subaortic membrane, two patients with patent ductus arteriosus, one patient with atrial septal defect, and two patients with abnormal muscle bundle in right ventricular outflow tract. The mean size of ventricular septal defect was 7.0 ± 2.4 (3–13) mm. The defect was repaired with a piece of Dacron patch in 68 patients or directly with 1–2 pledgetted polypropylene sutures in 18 patients. The cardiopulmonary bypass time and aortic cross-clamp time were 46.2 ± 13.3 (23–101) minutes and 29.2 ± 11.5 (12–84) minutes. After 3.1 ± 2.4 (0–14) hours’ ventilator assist and 23.2 ± 32.1 (0–264) hours’ ICU stay, all patients were discharged safely. At the latest follow-up (27.9 ± 14.6 months), echocardiography showed trivial residual shunt in two patients. There was no malignant arrhythmia occurred and there was no chest deformity or asymmetrical development of the breast was found.
Conclusions:
DCVSD repaired via right subaxillary vertical incision through tricuspid approach was safe and feasible, providing a feasible alternative to median sternotomy, and it can be performed with favourable cosmetic results.
Owing to limited data, we conducted a meta-analysis to re-evaluate the relationship between obesity and coronavirus-2019 (COVID-19). Literature published between 1 January 2020 and 22 August 2020 was comprehensively analysed, and RevMan3.5 was used for data analysis. A total of 50 studies, including data on 18 260 378 patients, were available. Obesity was associated with a higher risk of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2) infection (odds ratio (OR): 1.39, 95% confidence interval (CI) 1.25–1.54; P < 0.00001) and increased severity of COVID-19 (hospitalisation rate: OR: 2.45, 95% CI 1.78–3.39; P < 0.00001; severe cases: OR: 3.74, 95% CI 1.18–11.87; P: 0.02; need for intensive care unit admission: OR: 1.30, 95% CI 1.21–1.40; P < 0.00001; need for invasive mechanical ventilation: OR: 1.59, 95% CI 1.35–1.88; P < 0.00001 and mortality: OR: 1.65, 95% CI 1.21–2.25; P: 0.001). However, we found a non-linear association between BMI and the severity of COVID-19. In conclusion, we found that obesity could increase the risk of SARS-CoV2 infection and aggregate the severity of COVID-19. Further studies are needed to explore the possible mechanisms behind this association.
The FNDC5 gene encodes the fibronectin type III domain-containing protein 5 that is a membrane protein mainly expressed in skeletal muscle, and the FNDC5 rs3480 polymorphism may be associated with liver disease severity in non-alcoholic fatty liver disease (NAFLD). We investigated the influence of the FNDC5 rs3480 polymorphism on the relationship between sarcopenia and the histological severity of NAFLD. A total of 370 adult individuals with biopsy-proven NAFLD were studied. The association between the key exposure sarcopenia and the outcome liver histological severity was investigated by binary logistic regression. Stratified analyses were undertaken to examine the impact of FNDC5 rs3480 polymorphism on the association between sarcopenia and the severity of NAFLD histology. Patients with sarcopenia had more severe histological grades of steatosis and a higher prevalence of significant fibrosis and definite non-alcoholic steatohepatitis than those without sarcopenia. There was a significant association between sarcopenia and significant fibrosis (adjusted OR 2·79, 95 % CI 1·31, 5·95, P = 0·008), independent of established risk factors and potential confounders. Among patients with sarcopenia, significant fibrosis occurred more frequently in the rs3480 AA genotype carriers than in those carrying the FNDC5 rs3480 G genotype (43·8 v. 17·2 %, P = 0·031). In the association between sarcopenia and liver fibrosis, there was a significant interaction between the FNDC5 genotype and sarcopenia status (P value for interaction = 0·006). Sarcopenia is independently associated with significant liver fibrosis, and the FNDC5 rs3480 G variant influences the association between sarcopenia and liver fibrosis in patients with biopsy-proven NAFLD.
Early life stress has been associated with emotional dysregulations and altered architecture of limbic-prefrontal brain systems engaged in emotional processing. Serotonin regulates both, developmental and experience-dependent neuroplasticity in these circuits. Central serotonergic biosynthesis rates are regulated by Tryptophan hydroxylase 2 (TPH2) and transgenic animal models suggest that TPH2-gene associated differences in serotonergic signaling mediate the impact of aversive early life experiences on a phenotype characterized by anxious avoidance.
Methods
The present study employed an imaging genetics approach that capitalized on individual differences in a TPH2 polymorphism (703G/T; rs4570625) to determine whether differences in serotonergic signaling modulate the effects of early life stress on brain structure and function and punishment sensitivity in humans (n = 252).
Results
Higher maltreatment exposure before the age of 16 was associated with increased gray matter volumes in a circuitry spanning thalamic-limbic-prefrontal regions and decreased intrinsic communication in limbic-prefrontal circuits selectively in TT carriers. In an independent replication sample, associations between higher early life stress and increased frontal volumes in TT carriers were confirmed. On the phenotype level, the genotype moderated the association between higher early life stress exposure and higher punishment sensitivity. In TT carriers, the association between higher early life stress exposure and punishment sensitivity was critically mediated by increased thalamic-limbic-prefrontal volumes.
Conclusions
The present findings suggest that early life stress shapes the neural organization of the limbic-prefrontal circuits in interaction with individual variations in the TPH2 gene to promote a phenotype characterized by facilitated threat avoidance, thus promoting early adaptation to an adverse environment.
Increased intake of vegetables and fruits has been associated with reduced risk of tuberculosis infection. Vegetables and fruits exert immunoregulatory effects; however, it is not clear whether vegetables and fruits have an adjuvant treatment effect on tuberculosis. Between 2009 and 2013, a hospital-based cohort study was conducted in Linyi, Shandong Province, China. Treatment outcome was ascertained by sputum smear and chest computerised tomography, and dietary intake was assessed by a semi-quantitative FFQ. The dietary questionnaire was conducted at the end of month 2 of treatment initiation. Participants recalled their dietary intake of the previous 2 months. A total of 2309 patients were enrolled in this study. After 6 months of treatment, 2099 patients were successfully treated and 210 were uncured. In multivariate models, higher intake of total vegetables and fruits (OR 0·70; 95 % CI 0·49, 0·99), total vegetables (OR 0·68; 95 % CI 0·48, 0·97), dark-coloured vegetables (OR 0·61; 95 % CI 0·43, 0·86) and light-coloured vegetables (OR 0·67; 95 % CI 0·48, 0·95) were associated with reduced failure rate of tuberculosis treatment. No association was found between total fruit intake and reduced failure rate of tuberculosis treatment (OR 0·98; 95 % CI 0·70, 1·37). High intake of total vegetables and fruits, especially vegetables, is associated with lower risk of failure of tuberculosis treatment in pulmonary tuberculosis patients. The results provide important information for dietary guidelines during tuberculosis treatment.
A 6-week growth trial was conducted to evaluate the influences of dietary valine (Val) levels on growth, protein utilisation, immunity, antioxidant status and gut micromorphology of juvenile hybrid groupers. Seven isoenergetic, isoproteic and isolipidic diets were formulated to contain graded Val levels (1·21, 1·32, 1·45, 1·58, 1·69, 1·82 and 1·94 %, DM basis). Each experimental diet was hand-fed to triplicate groups of twelve hybrid grouper juveniles. Results showed that weight gain percentage (WG%), protein productive value, protein efficiency ratio, and feed efficiency were increased as dietary Val level increased, reaching a peak value at 1·58 % dietary Val. The quadratic regression analysis of WG% against dietary Val levels indicated that the optimum dietary Val requirement for hybrid groupers was estimated to be 1·56 %. Gut micromorphology and expression of growth hormone in pituitary, insulin-like growth factor 1, target of rapamycin and S6 kinase 1 in liver were significantly affected by dietary Val levels. In serum, fish fed 1·58 % dietary Val had higher superoxide dismutase, catalase, lysozyme activities and IgM concentrations than fish fed other dietary Val levels. Fish fed 1·58 % dietary Val had higher expression of NF-E2-related factor 2 in head kidney than fish fed other dietary Val levels. Generally, the optimum dietary Val requirement for maximal growth of hybrid groupers was estimated to be 1·56 % of DM, corresponding to 3·16 % of dietary protein, and dietary Val levels affected growth, protein utilisation, immunity and antioxidant status in hybrid groupers.
Isolated congenital tricuspid regurgitation other than Ebstein’s anomaly was rare especially for children. The objective of this study was to investigate the clinical characteristics and to assess the results of tricuspid valvuloplasty for children with isolated tricuspid regurgitation.
Methods:
From January 2010 to June 2019, 10 consecutive patients with isolated tricuspid regurgitation who were unresponsive to drug therapy underwent tricuspid valvuloplasty in our hospital. Patients’ clinical data were analysed retrospectively.
Results:
Mean age at operation was 48.5 ± 31.0 (range: 9–106) months and mean weight at operation was 16.1 ± 6.9 (range: 8.6–33.0) kg. All patients presented severe isolated tricuspid regurgitation. According to pathological lesions, the main causes accounted for chordae tendinea rupture (3/10), leaflet cleft (2/10), mal-connected chordal tendinea to leaflets (2/10), elongated chordae (1/10) and chordae absent (1/10), and severe anterior leaflet dysplasia (1/10). Individualised tricuspid valvuloplasty was adapted to all of them successfully. Post-operative echocardiography showed no tricuspid regurgitation in two patients and mild regurgitation in eight patients. The cardiothoracic ratios on their chest roentgenograms decreased from 0.59 ± 0.05 to 0.54 ± 0.05. At the latest follow-up (50.4 ± 47.2 months), echocardiography showed that mild to moderate tricuspid regurgitation in seven patients, moderate tricuspid regurgitation in three patients, and no patient with severe tricuspid regurgitation. All patients were in NYHA functional class I.
Conclusions:
For patients with isolated tricuspid regurgitation who were not well responsive to drug therapy, individualised tricuspid valve repair can achieve an excellent result.
The gut microbiota is directly influenced by dietary components, and it plays critical roles in chronic diseases. Excessive consumption of trans-fatty acids (TFA) is associated with obesity induced by alterations in gut microbiota, but the links between obesity and gut microbiota remain unclear. Therefore, studies examining the impact of TFA on intestinal microflora are essential. In our study, we performed 16S ribosomal RNA gene sequencing on faecal samples from Sprague–Dawley rats fed a basal diet (control (CON) group), high-fat (HF) diet (diet-induced obesity (DIO) group) or TFA diets (1 % TFA group and 8 % TFA group) for 8 weeks to investigate the effects of TFA/HF diets on obesity and gut microbiota composition. We found that the TFA/HF diets significantly induced obesity and changes in blood and brain physiological parameters of the rats. The relative abundance of the phyla Firmicutes and Bacteroidetes was inversely altered in the three test groups compared with the CON group. Proteobacteria increased slightly in the DIO, 1 % TFA and 8 % TFA groups. The genus Bacteroides increased in the DIO and 1 % TFA groups, but Muribaculaceae decreased in all experimental groups compared with the CON group. Moreover, significant differences were observed among clusters of orthologous group functional categories of the four dietary groups. Our observations suggested that the TFA/HF diets induced obesity and dysfunction of gut microbiota. Gut dysbiosis might mediate the obesity effects of TFA/HF diets.
Clay often has severe detrimental impacts on cement-based materials. Therefore, it is necessary to investigate the mechanism causing the deterioration to improve the service life of cement-based materials. Based on accurate dimensional analysis, a mechanism that influences clay is proposed: the intercalation of the side chains of superplasticizer molecules in the interlayer space of the clay. To lessen this harmful effect, a new clay-resistant admixture (CRA) possessing cationic groups of small molecular size was synthesized through a novel dimensional design. The length and width of the side chains of this superplasticizer molecule were 9.50–17.50 and 0.25–0.40 nm, respectively, with a radius of ~3.74 nm in solvent, which is larger than the interlayer spacing of montmorillonite (i.e. 1.09–2.14 nm). The longitudinal and latitudinal lengths of the CRA molecule were 0.468 and 9.456 nm, respectively, ensuring intercalation in the interlayer of montmorillonite. The increase in interlayer spacing of the clay was 0.364 nm following addition of polycarboxylate superplasticizer (PCE) plus CRA and 0.632 nm following addition of PCE, which suggests that the CRA plays the role of a ‘sacrificial agent’ that is preferentially intercalated into the interlayer space of clay to further prevent the side chains of the superplasticizer molecules from entering the interlayer. The aim of this study was to propose a suitable means of synthesizing a new CRA to address the impact of clay through dimensional design and mechanism analysis, which contributes to the theoretical study and technological improvement of cement-based materials.