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Introduction and aims: Altering the position and orientation of the root canal access cavity passway, or modifying the reduction of dentin volume, can influence the strength of dentition. This study aimed to compare the effects of different access cavities on the biomechanical performances of maxillary central incisors with a finite element analysis. Methods: Based on the micro-computed tomography (CT) scan of a maxillary central incisor, the finite element models of the intact tooth and teeth with 4 access cavity designs: conservative incisal access cavity, incisal access cavity, conservative access cavity, and traditional access cavity were generated. Simulated occlusal forces were applied at the incisal edge of the incisor in the finite element analysis procedure. Results: The maximum von Mises stress and maximum principal stress in the cervical area are highest in the traditional access cavity group, followed by the conservative access cavity group, incisal access cavity group, and conservative incisal access cavity group. Conclusion: The conservative access cavities minimise the extent of dentin removal from the cervical region, protecting the mechanical behaviour of the incisor. Moving the access cavity entry point to the incisal edge also improves the fracture resistance of the incisor. Clinical Relevance: This study's findings would help clinicians select the most appropriate endodontics access cavity method when performing the root canal on maxillary central incisors.

Abstract Background Functional disability significantly burdens healthcare services, negatively affecting older adults’ social interaction and quality of life. This study aims to identify the association between functional disability and mental health, and examine the moderating effects of social participation and physical exercise on the association. Methods The data were drawn from 2018 wave of Chinese Longitudinal Healthy Longevity Survey, and ordinary least squares regression model was exploited to explore the association between functional disability and mental health. Results Activity of daily living (ADL) disability negatively predicted mini-mental state examination (MMSE) score. Furthermore, social participation and physical exercise moderated the association between ADL disability and MMSE score. Conclusion The results highlight the importance of social participation and physical exercise for the older adults with ADL disability.

Abstract Background Follicular thyroid carcinoma (FTC) is the second most common cancer of the thyroid gland and has a greater propensity for haematogenous metastasis. However, the preoperative differentiation of FTC from follicular thyroid adenoma (FTA) is not well established. Certain ultrasound characteristics are associated with an increased risk of thyroid malignancy, but mainly for papillary thyroid cancers and not for FTC. Objectives This retrospective study aimed to evaluate the ultrasound characteristics of FTC and the value of ultrasound characteristics in differentiating FTC from FTA. Methods A total of 96 patients with pathologically confirmed FTC or FTA who underwent preoperative thyroid ultrasound were included in this study. The ultrasound and pathological characteristics were evaluated. Results Our data revealed that the incidences of lesions with tubercle-in-nodule, spiculated/microlobulated margins, mixed vascularization, egg-shell calcification, central stellate scarring, extension toward the capsule and chronic lymphocytic thyroiditis were significantly higher in the FTC group (all p

BackgroundDepression is a significant burden on individuals and society, which requires our attention and action. As the aging wave collides with digitalization, further research is needed to understand how internet use relates to depression in older adults. This study aimed to investigate whether volunteer activity participation and friend networks played a chain mediating role in this relationship from the perspective of the socioemotional selectivity theory.MethodThis study’s data was derived from the 2018 China Longitudinal Aging Social Survey (CLASS), comprising 5,558 samples. The study employed the OLS model for benchmark regression and multiple robust check methods, including altering variable settings and utilizing the instrumental variable model. In addition, the generalized structural equation model (GSEM) was used to analyze the mechanism.ResultUsing the internet was significantly associated with reduced depression in older adults (coefficient = −0.9321, p

Background: Zhiqiao Gancao decoction (ZQGCD) was created by Professor Gong Zhengfeng, a renowned Chinese medicine expert. Clinical studies have shown its efficacy in alleviating pain and enhancing lumbar function in intervertebral disc degeneration (IDD) patients. However, the precise mechanism of ZQGCD in treating IDD remains unclear. Methods: The active components of ZQGCD were identified using Liquid chromatography-tandem mass spectrometry (LC-MS/MS). A rat model of intervertebral disc degeneration was established, and rats in each group received ZQGCD for three weeks. Assessment parameters included hyperalgesia status, observation of intervertebral disc tissue degeneration and macrophage infiltration, and analysis of JAK2/STAT3 pathway protein expression in the intervertebral disc. Primary macrophage M1 polarization was induced using LPS, with cells treated using the JAK2 inhibitor (AZD1480) and ZQGCD to evaluate macrophage polarization, cellular supernatant inflammatory factors, and JAK2/STAT3 pathway expression. Macrophage supernatant served as a conditioned medium to observe its effects on the proliferation of nucleus pulposus cells (NPCs) and the expression of collagen II and MMP3 proteins. Results: A total of 81 active components were identified in ZQGCD. Following ZQGCD treatment, infiltrating macrophages in intervertebral disc tissues of model rats decreased, the content of M1 macrophages decreased, while the content of M2 macrophages increased, the expression of proinflammatory factors and pain-inducing factors in serum decreased, and the expression of substance P in intervertebral disc tissue decreased. Consequently, the intervertebral disc degeneration and hyperalgesia of rats were improved. In vitro studies revealed that LPS induced M1 macrophage polarization. By inhibiting the JAK2/STAT3 pathway, both JAK2 inhibitors and ZQGCD effectively suppressed M1 polarization, resulting in decreased levels of IL-1β, IL-6, TNF-α, and various other inflammatory factors. Consequently, this inhibition led to a delay in the degeneration of NPCs. Conclusion: There is macrophage infiltration in the intervertebral disc tissue of IDD rats, and JAK2/STAT3 pathway is activated, macrophages are polarized to M1 type, resulting in inflammatory microenvironment, leading to intervertebral disc degeneration and hyperalgesia. ZQGCD exhibited a delaying effect on IDD and improved hyperalgesia by inhibiting the JAK2/STAT3/macrophage M1 polarization pathway.

Abstract Background Periprosthetic infection is a serious complication after arthroplasty and is characterized by a long duration, recurrence, and a low cure rate. Although fungal infections are infrequent, they are often catastrophic, with an insidious onset, a long duration, atypical clinical symptoms, and imaging features in the early stage. They are easily misdiagnosed, or the diagnosis is missed, resulting in wrong treatment approaches. Case presentation This paper reports a case involving a 62-year-old female patient of Korean ethnicity with a periprosthetic infection after knee arthroplasty who underwent joint debridement. A preoperative metagenomic next-generation sequencing of joint aspirate revealed Staphylococcus epidermidis. However, postsurgical tissue cultures confirmed the fungal infection. The patient received oral voriconazole and intra-articular injection of voriconazole for antifungal treatment. Since bacterial infection could not be ruled out, we also prescribed levofloxacin. No infection recurrence was observed after more than 22 months of follow-up. In the treatment of this patient, successful short-term follow-up was achieved, but long-term efficacy still cannot be determined. Conclusions In addition to the case study, we provide an analysis of the diagnosis and treatment of fungal infection after arthroplasty, especially the efficacy of debridement, antibiotics, and implant retention for a short-term outcome.

Aiming at the problems of the complex in situ stress measurement process, difficult measurement and long-term monitoring, it is particularly important to design a three-dimensional borehole full stress monitoring method based on the principle of rock mass rheological stress recovery, which lays a foundation for underground construction, such as roadway engineering and tunnel engineering. Through theoretical calculation and mechanical analysis, the magnitude, direction and inclination of the stress at any point in the borehole of the geological body are analyzed. Based on this, a three-dimensional borehole full stress monitor is constructed. At the same time, the rheological stress change process of rock mass around the borehole is analyzed by numerical simulation, the rationality of the three-dimensional borehole full stress monitor is determined, and a new method of borehole surrounding rock stress monitoring is proposed. The results show that: (1) the stress monitoring of the surrounding rock can be realized by the stress recovery principle of a rock mass rheological borehole, and it can be monitored for a long time; (2) the three-dimensional borehole total stress monitor can reflect the size and direction of the six principal stresses of the surrounding rock stress through eight measuring points; (3) the design structure and mechanical properties of the three-dimensional borehole full stress monitor are reasonable, and the linearity and sensitivity of the hydraulic membrane material are reasonable, which can meet the standards of long-term monitoring.

Background: Inflammation and immune factors are the core of intervertebral disc degeneration (IDD), but the immune environment and epigenetic regulation process of IDD remain unclear. This study aims to identify immune-related diagnostic candidate genes for IDD, and search for potential pathogenesis and therapeutic targets for IDD. Methods: Gene expression datasets were obtained from the Gene Expression Omnibus (GEO). Differential expression immune genes (Imm-DEGs) were identified through weighted gene correlation network analysis (WGCNA) and linear models for microarray data analysis (Limma). LASSO algorithm was used to identify feature genes related to IDD, which were compared with core node genes in PPI network to obtain hub genes. Based on the coefficients of hub genes, a risk model was constructed, and the diagnostic value of hub genes was further evaluated through receiver operating characteristic (ROC) analysis. Xcell, an immunocyte analysis tool, was used to estimate the infiltration of immune cells. Finally, nucleus pulposus cells were co-cultured with macrophages to create an M1 macrophage immune inflammatory environment, and the changes of hub genes were verified. Results: Combined with the results of WGCNA and Limma gene differential analysis, a total of 30 Imm-DEGs were identified. Imm-DEGs enriched in multiple pathways related to immunity and inflammation. LASSO algorithm identified 10 feature genes from Imm-DEGs that significantly affected IDD, and after comparison with core node genes in the PPI network of Imm-DEGs, 6 hub genes (NR1H3, SORT1, PTGDS, AGT, IRF1, TGFB2) were determined. Results of ROC curves and external dataset validation showed that the risk model constructed with the 6 hub genes had high diagnostic value for IDD. Immunocyte infiltration analysis showed the presence of various dysregulated immune cells in the degenerative nucleus pulposus tissue. In vitro experimental results showed that the gene expression of NR1H3, SORT1, PTGDS, IRF1, and TGFB2 in nucleus pulposus cells in the immune inflammatory environment was up-regulated, but the change of AGT was not significant. Conclusions: The hub genes NR1H3, SORT1, PTGDS, IRF1, and TGFB2 can be used as immunorelated biomarkers for IDD, and may be potential targets for immune regulation therapy for IDD.

Huanglongbing (HLB), also known as citrus greening disease, represents a severe and imminent threat to the global citrus industry. With no complete cure currently available, effective control strategies are crucial. This article presents a transmission model of HLB, both with and without nutrient injection, to explore methods for controlling disease spread. By calculating the basic reproduction number (R0) and analyzing threshold dynamics, we demonstrate that the system remains globally stable when R0<1, but persists when R0>1. Sensitivity analyses reveal factors that significantly impact HLB spread on both global and local scales. We also propose a comprehensive optimal control model using the pontryagin minimum principle and validate its feasibility through numerical simulations. Results show that while removing infected trees and spraying insecticides can significantly reduce disease spread, a combination of measures, including the production of disease-free budwood and nursery trees, nutrient solution injection, removal of infected trees, and insecticide application, provides superior control and meets the desired control targets. These findings offer valuable insights for policymakers in understanding and managing HLB outbreaks.

Abstract Background Previous studies have not investigated the association between medical insurance and instrumental activity of daily living (IADL) disability. To fulfill this research gap, this study aims to explore the association between Urban and Rural Resident Basic Medical Insurance (URRBMI) and IADL disability among middle-aged and older adults in China. Methods The data of this study were sourced from the 2018 wave of China Health and Retirement Longitudinal Study (CHARLS). Logit regression models were used to analyze the association between URRBMI and odds of suffering from IADL disability. Furthermore, we used IV-Probit regression model to address the potential endogeneity problem. Moreover, propensity score matching and generalized random forest model were employed to conduct robustness checks. Results The logit regression results reveal that URRBMI participation was significantly related to reduced odds of suffering from IADL disability by 39.86% after adjusting for the control variables (p

Citrus huanglongbing (HLB) is one of the most devastating diseases affecting citrus almost worldwide due to the lack of a cure. To better understand the impact of insecticide resistance and grafting infection on the spread of HLB disease, a vector-borne compartmental model is formulated to describe the transmission dynamics of HLB between citrus and Asian citrus psyllid (ACP). The basic reproduction number R0 is computed by using the next generation matrix approach, which is a threshold value of the uniform persistence and disappearance of HLB disease. By applying the sensitivity analysis of R0, we obtain some parameters with the most significant influence on the transmission dynamics of HLB. Moreover, we also obtain that grafting infection has the least influence on the transmission dynamics of HLB. Additionally, a time-dependent control model of HLB to minimize the cost of implementing control efforts and infected trees and ACPs is formulated. By using Pontryagin's Minimum Principle, we obtain the optimal integrated strategy and prove the uniqueness of optimal control solution. The simulation results illustrate that the strategy involving two time-dependent optimal controls is the most effective to suppress the spread of the disease. However, insecticide spraying is more effective measure compared with infected tree removing.

Extracting relation quintuple and feature words from unstructured text is a prelude to the construction of the scientific knowledge base. At present, the prior works use explicit clues between entities to study this task but ignore the use and the association of the feature words. In this work, we propose a new method to generate self-adaptive feature words from the original text for every single sample. These words can add additional correlation information to the knowledge graph. We allow the model to generate a new word representation and apply it to the original sentence to judge the relation type and locate the head and tail of the relation quintuple. Compared with the previous works, the feature words increase the flexibility of relying on information and improve the explanatory ability. Extensive experiments on scientific field datasets illustrate that the self-adaptive feature words method (SAFW) is good at ferreting out the unique feature words and obtaining the core part for the quintuple. It achieves good performance on four public datasets and obtains a markable performance improvement compared with other baselines.

Background: Closed reduction is the preferred treatment for distal radius fractures. However, it requires a multiple experienced medical staff and manually maintaining stable traction is difficult. Additionally, doctors cannot assess the reduction status of a fracture in real-time through radiographic images, which may lead to improper reduction. Furthermore, post-fracture complications such as joint adhesion, stiffness, and impaired mobility pose a challenge for the doctors. So it is necessary to optimize the treatment process of the distal radius fracture through technological means.Methods: A robot-assisted closed reduction and rehabilitation system, which could assist doctors throughout the entire process of reduction, fixation, and rehabilitation of distal radius fractures, was developed. A mechanical system, composed of two grippers and a cooperative robotic arm, was used to grasp and tract the affected limb. A doctor controlled the robot through a joystick console and Windows application program. A biplane radiographic device was integrated into the system, which is not only convenient for doctors to view radiographic images of the fracture at any time but also for them to select the rotation axis of the wrist on the images before reduction and rehabilitation. Important information including the anteroposterior and lateral radiographic data and force and position parameters during the reduction and rehabilitation process were displayed on a graphic user interface.Results: Experimental results showed that the proposed robotic system can meet the technical requirements for the reduction and rehabilitation of distal radius fractures, all the rotation angles could be achieved, a maximum force of more than 50 N could be achieved in all traction directions, and the error in selecting the wrist joint rotation axis line using radiographic images was less than 5 mm.Conclusion: The developed robot-assisted system was shown to be suitable for closed reduction and rehabilitation of distal radius fractures, contributing a potential improvement in the quality of the procedures.

Air pollution is closely related to people's health and economic and social development.However, monitoring sites are sparsely distributed and cannot provide fine-grained air pollutant concentrations.In addition, the existing air pollutant concentration inference methods lack the ability to process relevant data in real time, so they have a hysteresis.To solve the above problems, a metaverse air pollutant concentration inference model based on digital twin technology was proposed.The model maped the real data into the metaverse space, and built a data warehouse to achieve real-time accurate inference of air pollutant concentrations through the construction of an air pollutant feature library.The experimental results show that the model can improve the accuracy and validity of air pollutant concentration inference.

Background: Chemonucleolysis is a minimally invasive treatment of lumbar disc herniation (LDH). However, the low specificity of the enzyme and the existence of serious adverse events limit the application of chemonucleolysis. Clinical studies in recent years have shown that Chondroitin sulfate ABC endolyase (condoliase) is a potential therapeutic enzyme for LDH. Aim. A meta-analysis was conducted to determine the efficacy and safety of condoliase in LDH treatment.Methods: We searched Web of Science, Embase, PubMed, and Cochrane Library databases. Two reviewers independently screened articles, extracted data, and assessed the risk of bias. The outcomes were the total effective rate, Oswestry Disability Index (ODI) score change, the proportion of lumbar surgery after condoliase treatment, herniated mass volume change, Pfirrmann grade change, and adverse events. Review Manager 5.3 and Stata 12.0 were used for meta-, sensitivity, and bias analysis.Results: Ten studies were included. A single-arm meta-analysis showed that the total effective rate was 78% [95% confidence interval (CI) 75%–81%], the proportion of surgery was 9% (95% CI 7%–12%), the proportion of Pfirrmann grade change was 43% (95%CI 38%–47%), and the adverse events were 4% (95% CI 2%–6%) after condoliase treatment. The two-arm meta-analysis showed that the ODI score change [standardized mean difference (SMD) −2.46, 95% CI −3.30 to −1.63] and the herniated mass volume change (SMD −16.97, 95% CI −23.92 to −10.03) of the condoliase treatment group were greater than those of the placebo control group, and there was no difference in adverse events between the two groups (OR 1.52, 95% CI 0.60–3.85). The results of sensitivity and publication bias analyses showed that the results were robust.Conclusion: Condoliase intradiscal injection has excellent eutherapeutic and safety for LDH, thus, has considerable potential as a treatment option besides conservative treatment and surgical intervention for LDH.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022375492, PROSPERO (CRD42022375492).

PurposeThe aim of this study was to develop and validate a dynamic nomogram by combining conventional ultrasound (US) and contrast-enhanced US (CEUS) to preoperatively evaluate the probability of central lymph node metastases (CLNMs) for patients with papillary thyroid carcinoma (PTC).MethodsA total of 216 patients with PTC confirmed pathologically were included in this retrospective and prospective study, and they were divided into the training and validation cohorts, respectively. Each cohort was divided into the CLNM (+) and CLNM (−) groups. The least absolute shrinkage and selection operator (LASSO) regression method was applied to select the most useful predictive features for CLNM in the training cohort, and these features were incorporated into a multivariate logistic regression analysis to develop the nomogram. The nomogram’s discrimination, calibration, and clinical usefulness were assessed in the training and validation cohorts.ResultsIn the training and validation cohorts, the dynamic nomogram (https://clnmpredictionmodel.shinyapps.io/PTCCLNM/) had an area under the receiver operator characteristic curve (AUC) of 0.844 (95% CI, 0.755–0.905) and 0.827 (95% CI, 0.747–0.906), respectively. The Hosmer–Lemeshow test and calibration curve showed that the nomogram had good calibration (p = 0.385, p = 0.285). Decision curve analysis (DCA) showed that the nomogram has more predictive value of CLNM than US or CEUS features alone in a wide range of high-risk threshold. A Nomo-score of 0.428 as the cutoff value had a good performance to stratify high-risk and low-risk groups.ConclusionA dynamic nomogram combining US and CEUS features can be applied to risk stratification of CLNM in patients with PTC in clinical practice.

Since the current remote sensing pre-trained models trained on optical images are not as effective when applied to SAR image tasks, it is crucial to create sensor-specific SAR models with generalized feature representations and to demonstrate with evidence the limitations of optical pre-trained models in downstream SAR tasks. The following aspects are the focus of this study: pre-training, fine-tuning, and explaining. First, we collect the current large-scale open-source SAR scene image classification datasets to pre-train a series of deep neural networks, including convolutional neural networks (CNNs) and vision transformers (ViT). A novel dynamic range adaptive enhancement method and a mini-batch class-balanced loss are proposed to tackle the challenges in SAR scene image classification. Second, the pre-trained models are transferred to various SAR downstream tasks compared with optical ones. Lastly, we propose a novel knowledge point interpretation method to reveal the benefits of the SAR pre-trained model with comprehensive and quantifiable explanations. This study is reproducible using open-source code and datasets, demonstrates generalization through extensive experiments on a variety of tasks, and is interpretable through qualitative and quantitative analyses. The codes and models are open source.

ObjectivesThis retrospective study aimed to evaluate the safety and feasibility of ultrasound-guided microwave ablation in the treatment of abdominal wall endometriosis (AWE).BackgroundAWE is a rare form of endometriosis that often results in cyclic abdominal pain. The current treatment algorithm for AWE is not well established. Microwave ablation technology is a promising new thermal ablation technique for treating AWE.MethodsThis was a retrospective study of nine women with pathologically proven endometriosis of the abdominal wall. All patients were treated with ultrasound-guided microwave ablation. Grey-scale and color Doppler flow ultrasonography, contrast-enhanced ultrasonography, and MRI were used to observe the lesions before and after treatment. The complications, pain relief, AWE lesion volume, and volume reduction rate were recorded 12 months after treatment to evaluate the treatment efficacy. Complications were classified according to the Common Terminology Criteria for Adverse Events and the Society of Interventional Radiology classification system.ResultsContrast-enhanced ultrasound showed that all lesions underwent successful treatment with microwave ablation. The average initial nodule volume was 7.11 ± 5.75 cm3, which decreased significantly to 1.85 ± 1.02 cm3 at the 12-month follow-up with a mean volume reduction rate of 68.77 ± 12.50%. Periodic abdominal incision pain disappeared at 1 month after treatment in all nine patients. The adverse events and complications were Common Terminology Criteria for Adverse Events grade 1 or Society of Interventional Radiology classification grade A.ConclusionsUltrasound-guided microwave ablation is a safe and effective technique for the treatment of AWE, and further study is warranted.

PurposeTo develop and validate a radiomics nomogram based on ultrasound (US) to predict central cervical lymph node (LN) metastasis in patients with papillary thyroid carcinoma (PTC).MethodsPTC patients with pathologically confirmed presence or absence of central cervical LN metastasis in our hospital between March 2021 and November 2021 were enrolled as the training cohort. Radiomics features were extracted from the preoperative US images, and a radiomics signature was constructed. Univariate and multivariate logistic regression analyses were used to screen out the independent risk factors, and a radiomics nomogram was established. The performance of the model was verified in the independent test cohort of PTC patients who underwent thyroidectomy and cervical LN dissection in our hospital from December 2021 to March 2022.ResultsIn the independent test cohort, the radiomics model based on long-axis cross-section and short-axis cross-section images outperformed the radiomics models based on either one of these sections (the area under the curve (AUC), 0.69 vs. 0.62 and 0.66). The radiomics signature consisted of 4 selected features. The US radiomics nomogram included the radiomics signature, age, gender, BRAF V600E mutation status, and extrathyroidal extension (ETE) status. In the independent test cohort, the AUC of the receiver operating curve(ROC) of this nomogram was 0.76, outperformingthe clinical model and the radiomics model (0.63 and 0.69, respectively), and also much better than preoperative US examination (AUC, 0.60). Decision curve analysis indicated that the radiomics nomogram was clinically useful.ConclusionsThis study presents an efficient and useful US radiomics nomogram that can provide comprehensive information to assist clinicians in the individualized preoperative prediction of central cervical LN metastasis in PTC patients.

Ageratum conyzoides (A. conyzoides) is commonly found or intentionally planted in citrus orchards due to its ability to provide habitat and breeding grounds for the natural enemies of citrus pests. This study aims to expand from a switching Huanglongbing model by incorporating the effects of A. conyzoides, vector preferences for settling, and pesticide application intervals on disease transmission. Additionally, we establish the basic reproduction number R0 and its calculation for a general switching compartmental epidemic model. Theoretical findings demonstrate that the basic reproduction number serves as a threshold parameter to characterize the dynamics of the models: if R0<1, the disease will disappear, whereas if R0>1, it will spread. Numerical results indicate that the recruitment rate of A. conyzoides not only affects the spread speed of Huanglongbing but also leads to paradoxical effects. Specifically, in cases of high infection rates, a low recruitment rate of A. conyzoides can result in a decrease, rather than an increase, in the basic reproduction number. Conversely, a high recruitment rate can accelerate the spread of Huanglongbing. Furthermore, we show how different vector bias and pesticide spraying periods affect the basic reproduction number.

BackgroundAortic stenosis (AS) is a severe disease that causes heart failure and sudden death. Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are both recommended for patients with intermediate surgical risk, but the cost-effectiveness of TAVR compared to SAVR in China has not been investigated.MethodsA combined decision tree and Markov model were conducted to compare the cost-effectiveness of TAVR versus SAVR with a 5-year simulation. The primary outcome was the incremental cost-effectiveness ratio (ICER), a ratio of incremental costs to incremental quality-adjusted life-year (QALY). One-way sensitive analysis and probabilistic sensitivity analysis (PSA) were conducted to test the robustness of the model.ResultsAfter a simulation of 5 years, the costs of TAVR and SAVR were 54,573 and 35,002 USD, respectively, and the corresponding effectiveness was 2.826 versus 2.712 QALY, respectively. The ICER for the TAVR versus SAVR comparison was 170,056 USD/QALY, which was three times higher than the per capita gross domestic product (GDP) in China. One-way sensitive analysis showed that the cost of the TAVR device impacted the ICER. The TAVR could be cost-effective only in the case where its cost is lowered to 29,766 USD.ConclusionTAVR is currently not cost-effective in China, but it could be cost-effective with a reduction of costs to 29,766 USD, which is approximately 65% of the current price.

[Objectives] To explore the clinical effect of Erxian decoction on relieving low back pain after percutaneous vertebroplasty (PVP) of vertebral compression fracture caused by postmenopausal osteoporosis (PMOP). [Methods] Ninety patients who were treated in Suzhou TCM Hospital from September 2021 to January 2023 were randomly divided into three groups: traditional Chinese medicine group (n =30), western medicine group (n = 30) and blank group (n = 30). The patients in all the three groups were treated with basic anti-osteoporosis drugs. The patients in the traditional Chinese medicine group were treated with Erxian decoction after PVP, and those in the western medicine group were treated with celecoxib to relieve pain after operation. The visual analogue (VAS) score, Oswestry dysfunction index (OD1) score, TCM syndrome score and serum indexes such as interleukin-6 (IL-6) and estrogen E2 were recorded before treatment and 2 weeks, 1 month and 3 months after treatment. [Results] (i) In terms of pain relief, the VAS score of the western medicine group was lower than that of the traditional Chinese medicine group after 2 weeks of treatment, but there was no significant difference in VAS score between the two groups after 1 month and 3 months, and the pain improvement of the two groups was better than that of the blank group, (ii) After 3 months of treatment, the OD1 score in the traditional Chinese medicine group was lower than that in the western medicine group, and the improvement of TCM syndrome in the traditional Chinese medicine group was better than that in the other two groups 1 and 3 months after treatment (P <0.05). (iii) The level of IL-6 in the western medicine group was lower than that in the other groups after 2 weeks, and there was no significant difference between the two groups after 3 months of treatment. After 3 months of treatment, the level of E2 in the traditional Chinese medicine group was higher than that before treatment and higher than that in the western medicine group and the blank group, but there was no significant difference between the two groups (P > 0. 05). [Conclusions] Both Erxian decoction and non-steroidal anti -inflammatory drugs can relieve residual low back pain after PVP, and their long-term effects are similar, but Erxian decoction has more advantages in alleviating pain, muscle and joint pain and sensory abnormalities in postmenopausal women. Moreover, it is safe and reliable, and is worthy of clinical application. [ABSTRACT FROM AUTHOR]

The discovery of deserialization vulnerabilities has garnered significant attention from cybersecurity researchers, with an increasing number of vulnerabilities being uncovered, posing severe threats to enterprise network security. The Java language's polymorphism and reflection capabilities render its deserialization vulnerability exploitation chains more varied and intricate, amplifying the challenges in defense and detection efforts. Consequently, developing strategies to counter Java deserialization vulnerability attacks has become a critical aspect of network security. Following an examination of numerous publicly known Java deserialization vulnerabilities, a runtime detection-based defense technology solution for Java deserialization vulnerabilities was proposed. Deserialization vulnerabilities were categorized into four types based on the data formats involved: Java native deserialization vulnerability, JSON deserialization vulnerability, XML deserialization vulnerability, and YAML deserialization vulnerability. For each type, the entry function within the exploitation process was identified and summarized. Utilizing Java's runtime protection technology, the solution monitored sensitive behaviors, such as command execution at the Java level, and captured the current runtime context information of the system. By correlating the deserialization entry function with the context information, the system can determine if the current behavior constitutes an exploitation of a deserialization vulnerability. The solution's efficacy was validated through testing on prevalent Java applications, including WebLogic, JBoss, and Jenkins. The results demonstrate that this approach can effectively protect against Java deserialization vulnerability attacks without inflicting a substantial performance penalty on the targeted system. Furthermore, when compared to other mainstream protection solutions, this method exhibits superior protective efficacy.