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This study aimed to investigate whether driving pressure-guided ventilation can reduce postoperative pulmonary complications in patients who have undergone heart transplantation. Patients who underwent orthotopic heart transplantation were divided into two groups according to the perioperative ventilation strategy: (1) conventional lung-protective ventilation (group C) and (2) driving pressure-guided ventilation (group D). The primary outcome was the occurrence of postoperative pulmonary complications within 30 days of surgery. Univariate and multivariate logistic regression analyses were performed to evaluate the independent risk factors associated with postoperative pulmonary complications (PPCs). Compared with group C, patients in group D exhibited lower driving pressure. Oxygenation improved significantly in the early period after surgery in patients in group D. Group C exhibited a higher number of patients with postoperative pulmonary complications, especially respiratory infections and atelectasis. Patients in group D experienced a shorter duration of postoperative mechanical ventilation and a shorter stay in the intensive care unit. The conventional ventilation strategy, the high driving pressure level and the low PaO2 value at the end of the surgery were the independent risk factors for PPCs in heart transplantation. Compared with conventional lung-protective ventilation, driving pressure-guided ventilation was associated with improved pulmonary oxygenation and lower incidences of pulmonary complications among patients after heart transplantation. [ABSTRACT FROM AUTHOR]

Abstract The southeastern region of Tibet, which serves as the primary concentration area for marine-type glaciers, has fostered a multitude of glacial lakes that are highly sensitive to global climate change. Glacial lakes play a crucial role in regulating the freshwater ecosystems of the region, but they also pose a significant threat to local infrastructure and populations due to flooding caused by glacial lake outbursts. Currently, a limited amount of research has focused on the monitoring and analysis of glacial lakes in southeastern Tibet. Using Google Earth Engine (GEE) data in conjunction with meteorological data, this study examined the variation characteristics of glacial lakes in southeastern Tibet from 1993 to 2023. The region is subjected to segmentation and extraction of glacial lake boundaries via the FCN model. According to research findings, by 2023, southeastern Tibet is projected to contain 3,877 glacial lakes, encompassing an area of approximately 395.74 ± 22.72 km2. The distribution of glacial lakes in this region follows a pattern characterized by a relatively high concentration in the southern region and a relatively low concentration in the northern region. The glacial lakes with areas less than 0.1 km2 accounted for 94.24%, whereas those exceeding 3.0 km2 experienced the least amount of change. The analysis of regional elevation using the natural segmentation method reveals that glacial lakes are predominantly distributed within the altitude range of 4442 ~ 4909 m. The fluctuations in the annual mean precipitation and average annual temperature in the study area have decreased since 2008, while the growth trajectories of both the area and number of glacial lakes have gradually stabilized. However, given the backdrop of a slight increase in precipitation and a gradual increase in temperature, the proliferation of glacial lakes is projected to accelerate predominantly in Nyingchi City’s eastern and western regions.

Abstract The topological attributes of structural covariance networks (SCNs) based on fractal dimension (FD) and changes in brain network connectivity were investigated using graph theory and network-based statistics (NBS) in patients with noise-induced hearing loss (NIHL). High-resolution 3D T1 images of 40 patients with NIHL and 38 healthy controls (HCs) were analyzed. FD-based Pearson correlation coefficients were calculated and converted to Fisher’s Z to construct the SCNs. Topological attributes and network hubs were calculated using the graph theory. Topological measures between groups were compared using nonparametric permutation tests. Abnormal connection networks were identified using NBS analysis. The NIHL group showed a significantly increased normalized clustering coefficient, normalized characteristic path length, and decreased nodal efficiency of the right medial orbitofrontal gyrus. Additionally, the network hubs based on betweenness centrality and degree centrality were both the right transverse temporal gyrus and left parahippocampal gyrus in the NIHL group. The NBS analysis revealed two subnetworks with abnormal connections. The subnetwork with enhanced connections was mainly distributed in the default mode, frontoparietal, dorsal attention, and somatomotor networks, whereas the subnetwork with reduced connections was mainly distributed in the limbic, visual, default mode, and auditory networks. These findings demonstrate the abnormal topological structure of FD-based SCNs in patients with NIHL, which may contribute to understand the complex mechanisms of brain damage at the network level, providing a new theoretical basis for neuropathological mechanisms.

Abstract Mobile technology has significantly accelerated the rapid development of healthcare services. Despite the convenience brought by the proliferation of mobile health (mHealth) apps, the challenge of promoting their continued use among patients has garnered attention from many scholars and administrators. Based on the Expectation Confirmation Model (ECM), this study explores the impact of quality elements on the continuance intention of mHealth apps in Southwest China’s ethnic minority regions. Researchers conducted a structured questionnaire survey on 337 users of mHealth apps in these regions to measure their self-reported responses to seven constructs: information quality, system quality, service quality, perceived usefulness, confirmation, satisfaction, and continuance intention. The study uses the structural equation model-artificial neural network (SEM-ANN) approach to interpret the compensatory and non-linear relationships between predictors and continuance intention. The findings reveal that user satisfaction and perceived usefulness significantly predict the continuance intention to use mHealth apps. All other relationships were confirmed except for the non-significant relationships between service quality and confirmation, service quality and perceived usefulness, and system quality and perceived usefulness. Furthermore, based on the normalized importance obtained from the multilayer perceptron, the most critical predictors identified were satisfaction (100%), followed by information quality (70.2%), perceived usefulness (43.2%), system quality (25.1%), and confirmation (17.6%). Finally, this study presents theoretical and practical implications for the continuance intention towards mHealth apps in Southwest China’s ethnic minority regions.

Abstract 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) has been widely utilized for tumor diagnosis. Hyperglycemia affects the 18F-FDG uptake and reduces tumor-to-tissue contrasts, however, ideal hypoglycemic drugs are lacking. This study compared the role of insulin with the novel widely used hypoglycemic drug, sodium-glucose cotransporter 2 (SGLT2) inhibitor, on 18F-FDG PET imaging in diabetic conditions. The streptozotocin (STZ)-induced diabetic C57BL/6N mice were inoculated with B16 (mouse melanoma) cells to establish the xenograft tumor model. After the mice had been administrated with dapagliflozin (30 mg/kg, IG) or insulin (0.75 U/kg, IP) for one hour, 9.25 MBq/10 g 18F-FDG was injected. Biodistributions were detected by gamma counting and microPET imaging. The results showed dapagliflozin did not significantly affect the 18F-FDG uptake in tumors but reduced uptake in reference tissues, resulting in a significant increase in the tumor-to-skeletal muscle ratio. Conversely, insulin increased 18F-FDG uptake in tumors without significant reduction in uptake in reference tissues; Although there was an observable improvement in tumor imaging, it did not reach significantly statistical differences. This study suggests that insulin and SGLT2 inhibitor yield comparable effects on the quality of 18F-FDG PET imaging in diabetic patients. Nevertheless, SGLT2 inhibitors would be more suitable when skeletal muscle is used as reference tissue.

(b, c) Representative images of whole-body (b) or lung metastasis (c) bioluminescence 4 weeks following subcutaneous (b) or tail vein injection (c) of 1 × 105 PBS- or RAD001-treated SSEA-4+ Well5 cells (as in (a)) into NOD/SCID mice. (f) Secondary tumorigenic xenograft formation of tumor tissue or cells after post-PBS or -RAD001 treatment, as in (a, b) (upper panel). (d) Two representative tissue samples retrieved from the PBS-treated and RAD001-treated groups, respectively. [Extracted from the article]