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Abstract Aims The endoscopic treatment of esophagogastric varices is challenging, and the nationwide application of endoscopic therapies for various types of esophagogastric varices and different clinical scenarios remains unclear. This study investigated the use of endoscopic therapy for portal hypertension in China. Methods This study used a questionnaire survey initiated by the Liver Health Consortium in China to investigate the use of endoscopic therapies for portal hypertension. Questionnaires were released online from January 30, 2023 to February 28, 2023 and filled out by chief physicians or senior instructors responsible for endoscopic therapies in participating hospitals across 31 provinces (autonomous regions and municipalities) in China. Comparisons of guideline adherence between primary and referral medical centers were performed using the chi‐square test or Fisher's exact test. Results In total, 836 hospitals participated in the survey. For primary and secondary prophylaxis of esophagogastric variceal bleeding (EGVB), adherence to the national guidelines was 72.5% (606/836) and 39.2% (328/836), respectively. Significant differences were observed in the rate of adherence between the primary and referral centers for primary (79.9% [111/139] vs. 71.0% [495/697], p = 0.033) and secondary prophylaxis (27.3% [38/139] vs. 41.6% [290/697], p = 0.002). Of the hospitals, 78.2% (654/836) preferred endoscopic therapies for acute EGVB, and the timing of endoscopy was usually within 12 h (48.5%, 317/654) and 12–24 h (36.9%, 241/654) after bleeding. Endoscopic therapy was more likely to be the first choice of treatment for acute EGVB in referral centers than in primary centers (82.6% [576/697] vs. 56.1% [78/139], p

Introduction: The association between elevated lactate levels and the development of disseminated intravascular coagulation (DIC) in patients with severe trauma remains unclear. Hence, this study aimed to explore the association between lactate and the development of DIC in patients with severe trauma. Methods: This prospective cohort study was conducted on consecutive patients with severe trauma who were hospitalized in the intensive care unit from January 2020 to January 2023. The primary outcome measured was the occurrence of DIC in patients in the emergency department or posthospitalization. Logistic regression analysis evaluating the risk values for lactate and DIC, the receiver operating characteristic (ROC) curve, and decision curve analysis (DCA) examinations studying the predictive efficiency of lactate for DIC. The Kaplan–Meier survival curve was used to assess patient survival. Sensitivity robustness analysis included modified Poisson regression, E-value, subgroup analysis, and numerical variable transformation analysis. Results: Logistic regression analysis corrected for confounding factors showed that lactate was a risk factor for DIC in patients with severe trauma (adjusted odds ratio [OR]: 1.374, 95% confidence interval [CI]: 1.206–1.566). Lactate predicted DIC risk with a 0.8513 area under the ROC curve (95% CI: 0.7827–0.9199), 4.8 cutoff value, 0.8333 sensitivity, and 0.8014 specificity. DCA showed the correlation between lactate and DIC. The mortality rate of patients with a high risk of DIC was significantly higher than that of patients with a low risk (log-rank test, P < 0.001). The modified Poisson regression showed that lactate was a risk factor for DIC (risk ratio: 1.188, 95% CI: 1.140–1.237). E-value was 1.645, and the lower limit of 95% CI was 1.495. The logistic regression analysis after subgroup analysis and transformation of numerical variables showed that lactate remained a risk factor for DIC. Conclusions: Elevated lactate is closely associated with the occurrence of DIC in patients with severe trauma. Lactate seems to be a good predictive factor for DIC manifestation in patients with severe trauma.

As a precise and versatile tool for genome manipulation, the clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) platform holds promise for modifying fish traits of interest. With the aim of reducing transgene introgression and controlling reproduction, upscaled disease resistance and reproductive intervention in catfish species have been studied to lower the potential environmental risks of the introgression of escapees as transgenic animals. Taking advantage of the CRISPR/Cas9-mediated system, we succeeded in integrating the cathelicidin gene (As-Cath) from an alligator (Alligator sinensis) into the target luteinizing hormone (lh) locus of channel catfish (Ictalurus punctatus) using two delivery systems assisted by double-stranded DNA (dsDNA) and single-stranded oligodeoxynucleotides (ssODNs), respectively. In this study, high knock in (KI) efficiency (22.38%, 64/286) but low on-target events was achieved using the ssODN strategy, whereas adopting a dsDNA as the donor template led to an efficient on-target KI (10.80%, 23/213). The on-target KI of As-Cath was instrumental in establishing the lh knockout (LH–_As-Cath+) catfish line, which displayed heightened disease resistance and reduced fecundity compared with the wild-type (WT) sibling fish. Furthermore, administration of human chorionic gonadotropin (HCG) and luteinizing hormone-releasing hormone analogue (LHRHa) can restore the reproduction of the transgenic fish line. Overall, we replaced the lh gene with an alligator cathelicidin transgene and then administered hormone therapy to move towards complete reproductive control of disease-resistant transgenic catfish in an environmentally responsible manner. This strategy not only effectively improves consumer-valued traits but also guards against unwanted introgression, providing a breakthrough in aquaculture genetics to confine fish reproduction and prevent the establishment of transgenic or domestic genotypes in the natural environment.

Abstract Muscle quality index (MQI) is a novel indicator reflecting the quality of skeletal muscles. The association between MQI and the development of advanced fibrosis in patients with nonalcoholic fatty liver disease (NAFLD) is unknown. We investigated the association of low MQI with advanced fibrosis among adults with NAFLD using a nationally representative sample of the US population. Adults with NAFLD who participated in the National Health and Nutrition Examination Survey (NHANES) 2011–2014 were included. Sex-specific standard was used to define low and extremely low MQI. Univariate and multivariate logistic regressions were used to assess the association between MQI level and advanced fibrosis. In the study, 3758 participants with NAFLD were included. The prevalence of low and extremely low MQI was 11.7% (95% CI 10.4–13.0%) and 2.2% (95% CI 1.6–2.8%), respectively. Among these participants, 96 were assessed to have advanced fibrosis. Individuals with low [(odds ratio (OR) 2.45, 95% confidence interval (CI) 1.22–4.91)] and extremely low MQI (OR 10.48, 95% CI 3.20–34.27) were associated with advanced fibrosis in multivariable analysis. A linear trend relationship was also observed between MQI level and the risk of advanced fibrosis (P trend = 0.001). Subgroup and sensitivity analyses yielded similar results to the main analyses. Decreased MQI is highly prevalent, and is associated with an increased risk of advanced fibrosis in adult US population with NAFLD.

Abstract Background At present, conventional endoscopy and chromoendoscopy using indigo carmine (IC) is a very useful method to determine the demarcation line (DL) of early gastric cancer lesions, but it is not suitable for all lesions. Aims This study aimed to determine the applicable conditions for IC chromoendoscopy. Methods We retrospectively evaluated 187 lesions in 181 patients who had an endoscopic diagnosis of EGC and were treated with endoscopic submucosal dissection (ESD). According to the existence of the DL between the lesion mucosa and normal mucosa with IC chromoendoscopy, the lesions were divided into two groups: clear group and unclear group. Clinicopathological characteristics were evaluated in each group. From January 2022 to March 2023, the postoperative pathological sections of 19 lesions (81 slices) in the clear group and 19 lesions (80 slices) in unclear group were scanned with high definition, and the crypt structure between the two groups was evaluated. Results There was no significant difference in clinical factors between the clear group and unclear group. There were significant differences in crypt area, crypt length, and crypt opening diameter between the two groups. In the clear group, there were significant differences in crypt area, crypt length, and crypt opening diameter between the normal area and cancer area, but there was no significant difference in the unclear group. Conclusions The margins of lesions with fused or absent crypt structures, a small crypt area, a short crypt length, and a short crypt opening diameter can be easily determined with IC chromoendoscopy.

In unstructured environments, dense grape fruit growth and the presence of occlusion cause difficult recognition problems, which will seriously affect the performance of grape picking robots. To address these problems, this study improves the YOLOX-Tiny model and proposes a new grape detection model, YOLOX-RA, which can quickly and accurately identify densely growing and occluded grape bunches. The proposed YOLOX-RA model uses a 3 × 3 convolutional layer with a step size of 2 to replace the focal layer to reduce the computational burden. The CBS layer in the ResBlock_Body module of the second, third, and fourth layers of the backbone layer is removed, and the CSPLayer module is replaced by the ResBlock-M module to speed up the detection. An auxiliary network (AlNet) with the remaining network blocks was added after the ResBlock-M module to improve the detection accuracy. Two depth-separable convolutions (DSC) are used in the neck module layer to replace the normal convolution to reduce the computational cost. We evaluated the detection performance of SSD, YOLOv4 SSD, YOLOv4-Tiny, YOLO-Grape, YOLOv5-X, YOLOX-Tiny, and YOLOX-RA on a grape test set. The results show that the YOLOX-RA model has the best detection performance, achieving 88.75 % mAP, a recognition speed of 84.88 FPS, and model size of 17.53 MB. It can accurately detect densely grown and shaded grape bunches, which can effectively improve the performance of the grape picking robot.

Abstract Angiogenesis plays an essential role in the microenvironment of hepatocellular carcinoma (HCC). HOXD3 is involved in the metastasis and invasion of HCC cells; Whereas the underlying molecular mechanisms in the microenvironment of HCC remain unknown. Wound healing, transwell invasion, tube formation and spheroid sprouting assays were carried out to identify the effects of HCC-HOXD3-exosomes and genes on the migration of HCC cells. ChIP–PCR was applied to test the binding region of HOXD3 on CCR6, Med15, and CREBBP promoter. Exosome isolation and mRNA-seq were applied to examine the morphological characteristics of exosomes and the contained mRNA in exosomes. Co-IP and Immunofluorescence assays were used to demonstrate the role of CREBBP in the chromatin conformation of CCL20. The nude mice were used to identify the function of genes in regulating migration of HCC in vivo. In this study, integrated cellular and bioinformatic analyses revealed that HOXD3 targeted the promoter region of CCR6 and induced its transcription. CCR6 was delivered by exosomes to endothelial cells and promoted tumour migration. Overexpression of CCR6 promoted metastasis, invasion in HCCs and angiogenesis in endothelial cells (ECs), whereas its downregulation suppressed these functions. The role of HOXD3 in the metastasis and invasion of HCC cells was reversed after the suppression of CCR6. Furthermore, CCL20 was demonstrated as the ligand of CCR6, and its high expression was found in HCC tissues and cells, which was clinically associated with the poor prognosis of HCC. Mechanistically, HOXD3 targets the promoter regions of CREBBP and Med15, which affect CCL20 chromatin conformation by regulating histone acetylation and expression of Pol II to enhance the migration of HCCs. This study demonstrated the function of the HOXD3–CREBBP/Med15–CCL20–CCR6 axis in regulating invasion and migration in HCC, thus providing new therapeutic targets for HCC.

Antimicrobial peptides (AMPs) show promise in enhancing resistance against pathogens. Previously, we integrated two AMP genes, cathelicidin (Cath) from alligator (Alligator mississippiensis or Alligator sinensis) and cecropin (Cec) from moth (Hyalophora cecropia), into the channel catfish (Ictalurus punctatus) genome. This study examines the efficacy of exogenous AMP gene integration in improving bacterial resistance in transgenic channel catfish and assesses the direct and pleiotropic effects of gene replacement/knockout on survival and growth based on insertion site. Transgenic Cath- and Cec-expressing fish exhibited similar or higher survival rates (P ​> ​0.05) compared to controls during the initial culture. Integration of the Cec transgene doubled the survival rate when challenged with Edwardsiella ictaluri, with knock-in (KI) of Cath further increasing bacterial resistance. Coupling Cec KI with mstn knockout (KO) increased survival 3-fold after E. ictaluri infection and growth by 50% at 4 months post-fertilization (mpf). However, random integration of Cec had a minimal effect on disease resistance and did not enhance growth. Random integration of Cath increased survival 2.5-fold and 4-fold against E. ictaluri and Flavobacterium covae, respectively, without affecting growth. Cath KI at the lh locus increased survival 4-fold when challenged with F. covae and reduced growth by 10% (P ​> ​0.05) at 24 mpf, whereas Cath KI coupled with mc4r KO resulted in a 2.5-fold increase in survival following F. covae infection compared with controls, and increased growth by 80% at 3 mpf. Simultaneous KI of Cath and Cec, along with KO of mc4r and mstn, increased survival 4-fold against E. ictaluri, while increasing growth by 50% at 3 mpf. Dual insertion of AMP genes yielded the greatest resistance to disease. These direct and pleiotropic effects may increase comprehension and societal acceptance of genetic engineering in aquaculture.

ObjectiveThe presence of mental fatigue seriously affects daily life and working conditions. Non-invasive transcranial electrical stimulation has become an increasingly popular tool for relieving mental fatigue. We investigated whether transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS) could be used to alleviate the state of mental fatigue in a population of healthy young adults and compared their effects.MethodsWe recruited 10 participants for a blank control, repeated measures study. Each participant received 15 min of anodal tDCS, α-tACS, and blank stimulation. Participants were required to fill in the scale, perform the test task and collect ECG signals in the baseline, fatigue and post-stimulus states. We then assessed participants’ subjective fatigue scale scores, test task accuracy and HRV characteristics of ECG signals separately.ResultsWe found that both anodal tDCS and α-tACS significantly (P < 0.05) reduced subjective fatigue and improved accuracy on the test task compared to the blank group, and the extent of change was greater with tACS. For the HRV features extracted from ECG signals. After tACS intervention, SDNN (t = −3.241, P = 0.002), LF (t = −3.511, P = 0.001), LFn (t = −3.122, P = 0.002), LFn/HFn (−2.928, P = 0.005), TP (t = −2.706, P = 0.008), VLF (t = −3.002, P = 0.004), SD2 (t = −3.594, P = 0.001) and VLI (t = −3.564, P = 0.001) showed a significant increasing trend, and HFn (t = 3.122, P = 0.002), SD1/SD2 (t = 3.158, P = 0.002) and CCM_1 (t = 3.106, P = 0.003) showed a significant decreasing trend. After tDCS intervention, only one feature, TINN, showed a significant upward trend (P < 0.05). The other features showed non-significant changes but roughly the same trend as the tACS group.ConclusionBoth tDCS and α-tACS can be effective in relieving mental fatigue, and α-tACS is more effective than tDCS. This study provides theoretical support for tDCS with α-tACS having a alleviating effect on mental fatigue and the use of ECG as a valid objective assessment tool.

Abstract The HOXA genes, belonging to the HOX family, encompass 11 members (HOXA1-11) and exert critical functions in early embryonic development, as well as various adult processes. Furthermore, dysregulation of HOXA genes is implicated in genetic diseases, heart disease, and various cancers. In this comprehensive overview, we primarily focused on the HOXA1-4 genes and their associated functions and diseases. Emphasis was placed on elucidating the impact of abnormal expression of these genes and highlighting their significance in maintaining optimal health and their involvement in the development of genetic and malignant diseases. Furthermore, we delved into their regulatory mechanisms, functional roles, and underlying biology and explored the therapeutic potential of targeting HOXA1-4 genes for the treatment of malignancies. Additionally, we explored the utility of HOXA1-4 genes as biomarkers for monitoring cancer recurrence and metastasis.

The Proton Exchange Membrane Fuel Cell (PEMFC) is a fast-developing battery technology, and the key to its reliability and lifespan improvement lies in the accurate assessment of durability. However, the degradation mechanism of the PEMFC is hard to determine and its internal parameters are highly coupled. Thus, the development of a more accurate life prediction model that meets the actual scenarios is to be investigated urgently. To solve this problem, a multi-feature fusion life prediction method based on the Temporal Convolutional Network-Gated Recurrent Unit (TCN-GRU) is proposed. A TCN algorithm is used as the prediction base model, and two GRU modules are included with the model to strengthen the model’s expression ability and improve its predictive accuracy. Two widely recognized datasets and two operating conditions are utilized for model training and prediction, respectively. Comparisons are made with single-feature parameter models in terms of Root Mean Square Error (RMSE) and the Determination Coefficient (R2). The results show that the prediction accuracy of the TCN-GRU multi-feature fusion model is higher than that of the single-feature models in terms of stability and anti-interference under both operating conditions. The accuracy of the TCN-GRU (three-feature) model is the most optimal in a steady-state condition at 80% of the training set ratio (RMSE = 3.27 × 10−3, R2 = 0.965). Furthermore, with the increase in the input feature parameter, the TCN-GRU model is closer to the real value, which proves once again that the proposed model can meet the accuracy requirements of the life prediction of the PEMFC.

Channel catfish (Ictalurus punctatus) and blue catfish (Ictalurus furcatus) are two economically important freshwater aquaculture species in the United States, with channel catfish contributing to nearly half of the country’s aquaculture production. While differences in economic traits such as growth rate and disease resistance have been noted, the extent of transcriptomic variance across various tissues between these species remains largely unexplored. The hybridization of female channel catfish with male blue catfish has led to the development of superior hybrid catfish breeds that exhibit enhanced growth rates and improved disease resistance, which dominate more than half of the total US catfish production. While hybrid catfish have significant growth advantages in earthen ponds, channel catfish were reported to grow faster in tank culture environments. In this study, we confirmed channel fish’s superiority in growth over blue catfish in 60-L tanks at 10.8 months of age (30.3 g and 11.6 g in this study, respectively; p < 0.001). In addition, we conducted RNA sequencing experiments and established transcriptomic resources for the heart, liver, intestine, mucus, and muscle of both species. The number of expressed genes varied across tissues, ranging from 5,036 in the muscle to over 20,000 in the mucus. Gene Ontology analysis has revealed the functional specificity of differentially expressed genes within their respective tissues, with significant pathway enrichment in metabolic pathways, immune activity, and stress responses. Noteworthy tissue-specific marker genes, including lrrc10, fabp2, myog, pth1a, hspa9, cyp21a2, agt, and ngtb, have been identified. This transcriptome resource is poised to support future investigations into the molecular mechanisms underlying environment-dependent heterosis and advance genetic breeding efforts of hybrid catfish.

To improve the accuracy and robustness of autonomous vehicle localization in a complex environment, this paper proposes a multi-source fusion localization method that integrates GPS, laser SLAM, and an odometer model. Firstly, fuzzy rules are constructed to accurately analyze the in-vehicle localization deviation and confidence factor to improve the initial fusion localization accuracy. Then, an odometer model for obtaining the projected localization trajectory is constructed. Considering the high accuracy of the odometer’s projected trajectory within a short distance, we used the shape of the projected localization trajectory to inhibit the initial fusion localization noise and used trajectory matching to obtain an accurate localization. Finally, the Dual-LSTM network is constructed to predict the localization and build an electronic fence to guarantee the safety of the vehicle while also guaranteeing the updating of short-distance localization information of the vehicle when the above-mentioned fusion localization is unreliable. Under the limited arithmetic condition of the vehicle platform, accurate and reliable localization is realized in a complex environment. The proposed method was verified by long-time operation on the real vehicle platform, and compared with the EKF fusion localization method, the average root mean square error of localization was reduced by 66%, reaching centimeter-level localization accuracy.

Non-invasive neuromodulation techniques are widely utilized to study and improve cognitive function, with the aim of modulating different cognitive processes. For workers performing high-intensity mental and physical tasks, extreme fatigue may not only affect their working efficiency but may also lead to cognitive decline or cognitive impairment, which, in turn, poses a serious threat to their physical health. The use of non-invasive neuromodulation techniques has important research value for improving and enhancing cognitive function. In this paper, we review the research status, existing problems, and future prospects of transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), transcranial magnetic stimulation (TMS), and transcutaneous acupoint stimulation (TAS), which are the most studied physical methods in non-invasive neuromodulation techniques to improve and enhance cognition. The findings presented in this paper will be of great reference value for the in-depth study of non-invasive neuromodulation techniques in the field of cognition.

The Non-Synchronizer Automated Mechanical Transmission (NSAMT) demonstrates a straightforward structure and cost-effectiveness; however, the primary obstacle to its widespread application lies in NSAMT shift control. The implementation of active angle alignment effectively addresses the issue of shifting quality, but achieving active angle alignment necessitates precise tracking of the planned shifting curve by the gear-shifting actuator. To tackle the control problem of accurate tracking for NSAMT shift actuators, this paper initially analyzes the structure and shift characteristics of the NSAMT. Based on this analysis, a physical model is established using Amesim, incorporating a drive motor, two-gear NSAMT, shift actuator, sleeve, and DC motor model. An extended state observer (ESO) is designed to mitigate unknown interference within the system. Furthermore, an active angle alignment control algorithm based on “zero speed difference” and “zero angle difference” for double target tracking is constructed while planning the axial motion trajectory of the sleeve. The Backstepping algorithm is employed to successfully track and regulate this planned trajectory. Finally, through Hardware-in-the-Loop testing, we validate our proposed control strategy, which demonstrates consistent results with simulation outcomes, thereby affirming its effectiveness.

Magnetic induction tomography (MIT) is an emerging imaging technology holding significant promise in the field of cerebral hemorrhage monitoring. The commonly employed imaging method in MIT is time-difference imaging. However, this approach relies on magnetic field signals preceding cerebral hemorrhage, which are often challenging to obtain. Multiple bioelectrical impedance information with different frequencies is added to this study on the basis of single-frequency information, and the collected signals with different frequencies are identified to obtain the magnetic field signal generated by single-layer heterogeneous tissue. The Stacked Autoencoder (SAE) neural network algorithm is used to reconstruct the images of head multi-layer tissues. Both numerical simulation and phantom experiments are carried out. The results indicate that the relative error of the multi-frequency SAE reconstruction is only 7. 82°/o, outperforming traditional algorithms. Moreover, under a noise level of 40 dB, the anti-interference capability of the MIT algorithm based on frequency identification and SAE is superior to traditional algorithms. This research explores a novel approach for the dynamic monitoring of cerebral hemorrhage and demonstrates the potential advantages of MIT in non-invasive monitoring. [ABSTRACT FROM AUTHOR]

As computer technology continues to advance, factories have increasingly higher demands for detecting defects. However, detecting defects in a plant environment remains a challenging task due to the presence of complex backgrounds and defects of varying shapes and sizes. To address this issue, this paper proposes YOLO-DD, a defect detectionmodel based on YOLOv5 that is effective and robust. To improve the feature extraction process and better capture global information, the vanilla YOLOv5 is augmented with a new module called Relative-Distance-Aware Transformer (RDAT). Additionally, an Information Gap Filling Strategy (IGFS) is proposed to improve the fusion of features at different scales. The classic lightweight attention mechanism Squeeze-and-Excitation (SE) module is also incorporated into the neck section to enhance feature expression and improve the model's performance. Experimental results on the NEU-DET dataset demonstrate that YOLO-DD achieves competitive results compared to state-of-the-art methods, with a 2.0% increase in accuracy compared to the original YOLOv5, achieving 82.41% accuracy and 38.25 FPS (frames per second). Themodel is also tested on a self-constructed fabric defect dataset, and the results show that YOLO-DD is more stable and has higher accuracy than the original YOLOv5, demonstrating its stability and generalization ability. The high efficiency of YOLO-DD enables it to meet the requirements of industrial high accuracy and real-time detection. [ABSTRACT FROM AUTHOR]