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Background: Learning policies for decision-making, such as recommending treatments in clinical settings, is important for enhancing clinical decision-support systems. However, the challenge lies in accurately evaluating and optimizing these policies for maximum efficacy. This paper addresses this gap by focusing on two key aspects of policy learning: evaluation and optimization. Method: We develop counterfactual policy learning algorithms for practical clinical applications to suggest viable treatment for patients. We first design a bootstrap method for counterfactual assessment and enhancement of policies, aiming to diminish uncertainty in clinical decisions. Building on this, we introduce an innovative adversarial learning algorithm, inspired by bootstrap principles, to further advance policy optimization. Results: The efficacy of our algorithms was validated using both semi-synthetic and real-world clinical datasets. Our method outperforms baseline algorithms, reducing the variance in policy evaluation by 30% and the error rate by 25%. In policy optimization, it enhances the reward by 1% to 3%, highlighting the practical value of our approach in clinical decision-making. Conclusion: This study demonstrates the effectiveness of combining bootstrap and adversarial learning techniques in policy learning for clinical decision support. It not only enhances the accuracy and reliability of policy evaluation and optimization but also paves avenues for leveraging advanced counterfactual machine learning in healthcare. [ABSTRACT FROM AUTHOR]

Surgical gesture recognition is an important research direction in the field of computer-assisted intervention. Currently, research on surgical gesture recognition primarily focuses on robotic surgery, with a lack of studies in traditional surgery, particularly open surgery. Therefore, this study established a dataset simulating open surgery for research on surgical gesture recognition in the field of open surgery. With the assistance of professional surgeons, we defined a vocabulary of 10 surgical gestures based on suturing tasks in open procedures. In addition, this paper proposes a surgical gesture recognition method that integrates the R3D network with a multi-head attention mechanism (R3D-MHA). This method uses the R3D network to extract spatiotemporal features and combines it with the multi-head attention mechanism for relational learning of these features. The effectiveness of the R3D-MHA method in the field of open surgery gesture recognition was validated through two experiments: offline recognition and online recognition. The accuracy at the gesture instance level for offline recognition was 92.3%, and the frame accuracy for online recognition was 73.4%. Finally, its performance was further validated on the publicly available JIGSAWS dataset. Compared to other online recognition methods, the accuracy improved without using additional data. This work lays the foundation for research on surgical gesture recognition in open surgery and has significant applications in process monitoring, surgeon skill assessment and educational training for open surgeries. [ABSTRACT FROM AUTHOR]

The thermal performance of a lithium-ion battery pack for an electric vehicle by adding straight rib turbulators in battery cooling plate channels has been numerically investigated in this paper and the numerical model of the battery pack has been validated by experimental data, which exhibits a satisfactory prediction accuracy. The effects of rib shapes, rib angles, rib spacings, and irregular gradient rib arrangement configurations on the flow and heat transfer behaviors of battery pack cooling plates have been thoroughly explored and analyzed in this paper. In addition, the thermal performance of the ribbed battery cooling plates was examined at actual high-speed climbing and low-temperature heating operating conditions. The results indicate that compared to the original smooth cooling plate, the square-ribbed battery cooling plate with a 60° angle and 5 mm spacing reduced the maximum battery temperature by 0.3 °C, but increased the cross-sectional temperature difference by 0.357 °C. To address this issue, a gradient rib arrangement was proposed, which slightly reduced the maximum battery temperature and lowered the cross-sectional temperature difference by 0.445 °C, significantly improving temperature uniformity. The thermal performance of the battery thermal management system with this gradient rib configuration meets the requirements for typical electric vehicle operating conditions, such as high-speed climbing and low-temperature heating conditions. [ABSTRACT FROM AUTHOR]

Point cloud completion aims to restore full shapes of objects from partial scans, and a typical network pipeline is AutoEncoder, which has coarse-to-fine refinement modules. Although existing approaches using this kind of architecture achieve promising results, they usually neglect the usage of shallow geometry features in partial inputs and the fusion of multi-stage features in the upsampling process, which prevents network performances from further improving. Therefore, in this paper, we propose a new method with dense interactions between different encoding and decoding steps. First, we introduce the Decoupled Multi-head Transformer (DMT), which implements and integrates semantic prediction and resolution upsampling in a unified network module, which serves as a primary ingredient in our pipeline. Second, we propose an Encoding-aware Coarse Decoder (ECD) that compactly makes the top–down shape-decoding process interact with the bottom–up feature-encoding process to utilize both shallow and deep features of partial inputs for coarse point cloud generation. Third, we design a Stage-aware Refinement Group (SRG), which comprehensively understands local semantics from densely connected features across different decoding stages and gradually upsamples point clouds based on them. In general, the key contributions of our method are the DMT for joint semantic-resolution generation, the ECD for multi-scale feature fusion-based shape decoding, and the SRG for stage-aware shape refinement. Evaluations on two synthetic and three real-world datasets illustrate that our method achieves competitive performances compared with existing approaches. [ABSTRACT FROM AUTHOR]

Background: The TetR family of transcriptional regulators (TFRs), serving as crucial regulators of diverse cellular processes, undergo conformational changes induced by small-molecule ligands, which either inhibit or activate them to modulate target gene expression. Some ligands of TFRs in actinomycetes and their regulatory effects have been identified and studied; however, regulatory mechanisms of the TetR family in the lincomycin-producing Streptomyces lincolnensis remain poorly understood. Results: In this study, we found that AbrT (SLCG_1979), a TetR family regulator, plays a pivotal role in regulating lincomycin production and morphological development in S. lincolnensis. Deletion of abrT gene resulted in increased lincomycin A (Lin-A) production, but delayed mycelium formation and sporulation on solid media. AbrT directly or indirectly repressed the expression of lincomycin biosynthetic (lin) cluster genes and activated that of the morphological developmental genes amfC, whiB, and ftsZ. We demonstrated that AbrT bound to two motifs (5′-CGCGTACTCGTA-3′ and 5′-CGTACGATAGCT-3′) present in the bidirectional promoter between abrT and SLCG_1980 genes. This consequently repressed abrT itself and its adjacent gene SLCG_1980 that encodes an arabinose efflux permease. D-arabinose, not naturally occurring as L-arabinose, was identified as the effector molecule of AbrT, reducing its binding affinity to abrT-SLCG_1980 intergenic region. Furthermore, based on functional analysis of the AbrT homologue in Saccharopolyspora erythraea, we inferred that the TetR family regulator AbrT may play an important role in regulating secondary metabolism in actinomycetes. Conclusions: AbrT functions as a regulator for governing lincomycin production and morphological development of S. lincolnensis. Our findings demonstrated that D-arabinose acts as a ligand of AbrT to mediate the regulation of lincomycin biosynthesis in S. lincolnensis. Our findings provide novel insights into ligand-mediated regulation in antibiotic biosynthesis. [ABSTRACT FROM AUTHOR]

The potential influence of pituitary-related hormones (including both pituitary gland and target gland hormones) on functional recovery after traumatic brain injury has been observed. However, the relationship between these hormones and the recovery of consciousness in patients with disorders of consciousness (DOC) remains unclear. In this retrospective and observational study, 208 patients with DOC were recruited. According to the Glasgow Outcome Scale (GOS) scores after 6 months, patients with DOC were categorized into two subgroups: a favorable prognosis subgroup (n = 38) comprising those who regained consciousness (GOS score ≥3), and a poor prognosis subgroup (n = 156) comprising those who remained in DOC (GOS score <3). Comparative analyses of pituitary-related hormone levels between the two subgroups were conducted. Further, a binary logistic regression analysis was conducted to assess the predictive value of pituitary-related hormones for the patients' prognosis. The favorable prognosis subgroup showed a significant increase in adrenocorticotropic hormone (ACTH) levels (p = 0.036). Moreover, higher ACTH levels and shorter days since injury were significantly associated with a better prognosis, with odds ratios (ORs) of 0.928 (95% confidence interval [CI] = 0.873-0.985, p = 0.014) and 1.015 (95% CI = 1.005-1.026, p = 0.005), respectively. A subsequent receiver operating characteristic (ROC) analysis demonstrated the potential to predict patients' prognosis with an area under the curve value of 0.78, an overall accuracy of 75.5%, a sensitivity of 77.5%, and a specificity of 66.7%. Our findings indicate that ACTH levels could serve as a clinically valuable and convenient predictor for patients' prognosis. [ABSTRACT FROM AUTHOR]

Bodily self-consciousness (BSC), a subject of interdisciplinary interest, refers to the awareness of one's bodily states. Previous studies have noted the existence of individual differences in BSC, while neglecting the underlying factors and neural basis of such individual differences. Considering that BSC relied on integration from both internal and external self-relevant information, we here review previous findings on individual differences in BSC through a three-level-self model, which includes interoceptive, exteroceptive, and mental self-processing. The data show that cross-level factors influenced individual differences in BSC, involving internal bodily signal perceptibility, multisensory processing principles, personal traits shaped by environment, and interaction modes that integrate multiple levels of self-processing. Furthermore, in interoceptive processing, regions like the anterior cingulate cortex and insula show correlations with different perceptions of internal sensations. For exteroception, the parietal lobe integrates sensory inputs, coordinating various BSC responses. Mental self-processing modulates differences in BSC through areas like the medial prefrontal cortex. For interactions between multiple levels of self-processing, regions like the intraparietal sulcus involve individual differences in BSC. We propose that diverse experiences of BSC can be attributed to different levels of self-processing, which moderates one's perception of their body. Overall, considering individual differences in BSC is worth amalgamating diverse methodologies for the diagnosis and treatment of some diseases. [ABSTRACT FROM AUTHOR]

The mechanical‐electrical‐magnetic coupling effects caused by the air gap deformation in in‐wheel motors exacerbate motor magnetic force oscillation, deteriorating the in‐wheel motor operation and ride comfort. In order to enhance vehicle performances, it is imperative to mitigate these coupling effects during the design of hub‐driven electric vehicle suspensions. In this paper, the analytical investigation is conducted on the coupling effects between electromagnetic excitation and transient dynamics in EVs based on the half‐vehicle model. The dynamic responses of hub‐driven EVs considering coupling effects are explored under both open‐loop and closed‐loop systems at various speeds and road conditions. Numerical simulations demonstrate that the closed‐loop system with wheelbase preview robust control exhibits superior comprehensive performance in suppressing coupling effects of the rear wheel hub motor and enhancing ride comfort compared to the system without preview control. Furthermore, as vehicle speed increases, robust preview control effectively reduces fluctuations in pitch angle acceleration, pitch angle, and rear wheel rotor eccentricity. In addition, robust preview control yields better performance in reducing vehicle body centroid acceleration and rear wheel rotor eccentricity and enhancing motor and vehicle performance with increasing road roughness. This work provides a practical vibration model and control reference for studying the dynamic characteristics of hub‐driven EVs. [ABSTRACT FROM AUTHOR]

In this study, a novel fabrication method was used to synthesize phenolic resin/phosphate hybrid coatings using aluminum dihydrogen phosphate (Al(H2PO4)3, hereafter denoted as Al), SC101 silica sol (Si) as the primary film-forming agent, and phenolic resin (PF) as the organic matrix. This approach culminated in the formation of Al+Si+PF organo–inorganic hybrid coatings. Fourier-transform infrared spectroscopy (FT-IR) and X-ray photoelectron spectroscopy (XPS) results confirmed the successful integration of hybrid structures within these coatings. The crystalline structure of the coatings post-cured at various temperatures was elucidated using X-ray diffraction (XRD). Additionally, the surface and cross-sectional morphologies were meticulously analyzed using scanning electron microscopy (SEM), offering insights into the microstructural properties of the coatings. The coatings' porosities under diverse thermal and temporal regimes were quantitatively evaluated using advanced image processing techniques, revealing a significant reduction in porosity to a minimum of 5.88% following a thermal oxidation process at 600 °C for 10 h. The antioxidant efficacy of the phosphate coatings was rigorously assessed through cyclic oxidation tests, which revealed their outstanding performance. Specifically, at 300 °C across 300 h of cyclic oxidation, the weight losses recorded for phosphate varnish and the phenolic resin-infused phosphate coatings were 0.15 mg·cm−2 and 0.09 mg·cm−2, respectively. Furthermore, at 600 °C and over an identical period, the weight reduction was noted as 0.21 mg·cm−2 for phosphate varnish and 0.085 mg·cm−2 for the hybrid coatings, thereby substantiating the superior antioxidation capabilities of the phenolic resin hybrid coatings in comparison to the pure phosphate varnish. [ABSTRACT FROM AUTHOR]

Background: Curcubita ficifolia Bouché (Cucurbitaceae) has high value as a food crop and medicinal plant, and also has horticultural value as rootstock for other melon species. China is home to many different cultivars, but the genetic diversity of these resources and the evolutionary relationships among them, as well as the differences between C. ficifolia and other Cucurbita species, remain unclear. Results: We investigated the chloroplast (cp) genomes of 160 C. ficifolia individuals from 31 populations in Yunnan, a major C. ficifolia production area in China. We found that the cp genome of C. ficifolia is ~151 kb and contains 128 genes, of which 86 are protein coding genes, 34 encode tRNA, and eight encode rRNAs. We also identified 64 SSRs, mainly AT repeats. The cp genome was found to contain a total of 204 SNP and 57 indels, and a total of 21 haplotypes were found in the 160 study individuals. The reverse repeat (IR) region of C. ficifolia contained a few differences compared with this region in the six other Cucurbita species. Sequence difference analysis demonstrated that most of the variable regions were concentrated in the single copy (SC) region. Moreover, the sequences of the coding regions were found to be more similar among species than those of the non-coding regions. The phylogenies reconstructed from the cp genomes of 61 representative species of Cucurbitaceae reflected the currently accepted classification, in which C. ficifolia is sister to the other Cucurbita species, however, different interspecific relationships were found between Cucurbita species. Conclusions: These results will be valuable in the classification of C. ficifolia genetic resources and will contribute to our understanding of evolutionary relationships within the genus Cucurbita. [ABSTRACT FROM AUTHOR]

Background: Spinal cord ischemia‒reperfusion injury (SCIRI) can lead to paraplegia, which leads to permanent motor function loss. It is a disastrous complication of surgery and causes tremendous socioeconomic burden. However, effective treatments for SCIRI are still lacking. PANoptosis consists of three kinds of programmed cell death, pyroptosis, apoptosis, and necroptosis, and may contribute to ischemia‒reperfusion-induced neuron death. Previous studies have demonstrated that hydrogen sulfide (H2S) exerts a neuroprotective effect in many neurodegenerative diseases. However, whether H2S is anti-PANoptosis and neuroprotective in the progression of acute SCIRI remains unclear. Thus, in this study we aimed to explore the role of H2S in SCIRI and its underlying mechanisms. Methods: Measurements of lower limb function, neuronal activity, microglia/macrophage function histopathological examinations, and biochemical levels were performed to examine the efficacy of H2S and to further demonstrate the mechanism and treatment of SCIRI. Results: The results showed that GYY4137 (a slow-releasing H2S donor) treatment attenuated the loss of Nissl bodies after SCIRI and improved the BBB score. Additionally, the number of TUNEL-positive and cleaved caspase-3-positive cells was decreased, and the upregulation of expression of cleaved caspase-8, cleaved caspase-3, Bax, and Bad and downregulation of Bcl-2 expression were reversed after GYY4137 administration. Meanwhile, both the expression and activation of p-MLKL, p-RIP1, and p-RIP3, along with the number of PI-positive and RIP3-positive neurons, were decreased in GYY4137-treated rats. Furthermore, GYY4137 administration reduced the expression of NLRP3, cleaved caspase-1 and cleaved GSDMD, decreased the colocalization NeuN/NLRP3 and Iba1/interleukin-1β-expressing cells, and inhibited proinflammatory factors and microglia/macrophage polarization. Conclusions: H2S ameliorated spinal cord neuron loss, prevented motor dysfunction after SCIRI, and exerted a neuroprotective effect via the inhibition of PANoptosis and overactivated microglia-mediated neuroinflammation in SCIRI. [ABSTRACT FROM AUTHOR]

The inhibition of Nav1.7 is a promising strategy for the development of analgesic treatments. Spider venom-derived peptide toxins are recognized as significant sources of Nav1.7 inhibitors. However, their development has been impeded by limited selectivity. In this study, eight peptide toxins from three distinct spider venom Nav channel families demonstrated robust inhibition of hNav1.7, rKv4.2, and rKv4.3 (rKv4.2/4.3) currents, exhibiting a similar mode of action. The analysis of structure and function relationship revealed a significant overlap in the pharmacophore responsible for inhibiting hNav1.7 and rKv4.2 by HNTX-III, although Lys25 seems to play a more pivotal role in the inhibition of rKv4.2/4.3. Pharmacophore-guided rational design is employed for the development of an mGpTx1 analogue, mGpTx1-SA, which retains its inhibition of hNav1.7 while significantly reducing its inhibition of rKv4.2/4.3 and eliminating cardiotoxicity. Moreover, mGpTx1-SA demonstrates potent analgesic effects in both inflammatory and neuropathic pain models, accompanied by an improved in vivo safety profile. The results suggest that off-target inhibition of rKv4.2/4.3 by specific spider peptide toxins targeting hNav1.7 may arise from a conserved binding motif. This insight promises to facilitate the design of hNav1.7-specific analgesics, aimed at minimizing rKv4.2/4.3 inhibition and associated toxicity, thereby enhancing their suitability for therapeutic applications., (© 2024 The Author(s). Advanced Science published by Wiley‐VCH GmbH.)