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Abstract Axillary lymph node status, which was routinely assessed by axillary lymph node dissection (ALND) until the 1990s, is a crucial factor in determining the stage, prognosis, and therapeutic strategy used for breast cancer patients. Axillary surgery for breast cancer patients has evolved from ALND to minimally invasive approaches. Over the decades, the application of noninvasive imaging techniques, machine learning approaches and emerging clinical prediction models for the detection of axillary lymph node metastasis greatly improves clinical diagnostic efficacy and provides optimal surgical selection. In this work, we summarize the historical axillary surgery and updated perspectives of axillary management for breast cancer patients.

Abstract A vacuum-levitated metal mechanical oscillator with an ultra-low damping rate is an ideal tool for detecting mass-related short-range forces; however, its realization at room temperature has not yet been achieved, limiting its practical applications. In this study, we developed such an oscillator using a diamagnetically levitated bismuth sphere. We derived an accurate general formula for the sphere’s eddy current damping rate and, based on this, constructed the oscillator from microparticles, successfully reducing its damping rate experimentally to (144 ± 6) μHz—nearly three orders of magnitude lower than that of the untreated sphere. This improvement allows the sub-millimeter-sized levitated metal mechanical oscillator to theoretically achieve a force sensitivity of $$(5.17\pm 0.12)\,\,{\mbox{fN}}/\sqrt{{\mbox{Hz}}\,}$$ ( 5.17 ± 0.12 ) fN / Hz and an acceleration sensitivity of $$(0.30\pm 0.01)\,\,{\mbox{ng}}/\sqrt{{\mbox{Hz}}\,}$$ ( 0.30 ± 0.01 ) ng / Hz at room temperature. Calculations indicate that using this sphere as a test mass can detect gravitational forces from sub-milligram sources, highlighting its potential for short-range force sensing and the exploration of quantum gravity.

Abstract Impaired glucose uptake in the brain is an early presymptomatic manifestation of Alzheimer’s disease (AD), with symptom-free periods of varying duration that likely reflect individual differences in metabolic resilience. We propose a systemic “bioenergetic capacity”, the individual ability to maintain energy homeostasis under pathological conditions. Using fasting serum acylcarnitine profiles from the AD Neuroimaging Initiative as a blood-based readout for this capacity, we identified subgroups with distinct clinical and biomarker presentations of AD. Our data suggests that improving beta-oxidation efficiency can decelerate bioenergetic aging and disease progression. The estimated treatment effects of targeting the bioenergetic capacity were comparable to those of recently approved anti-amyloid therapies, particularly in individuals with specific mitochondrial genotypes linked to succinylcarnitine metabolism. Taken together, our findings provide evidence that therapeutically enhancing bioenergetic health may reduce the risk of symptomatic AD. Furthermore, monitoring the bioenergetic capacity via blood acylcarnitine measurements can be achieved using existing clinical assays.

Abstract Background Circular RNAs (circRNAs) are increasingly recognized for their potential as cancer biomarkers. Although various studies have investigated the biological function of ciRS-7 and circHIPK3 in malignant tumors, their prognostic value in pan-cancer has not been systematically analyzed. Methods We systematically searched the PubMed, Web of Science, and Cochrane Library databases from January 1, 1990, to October 14, 2024. The impact of ciRS-7 or circHIPK3 on prognostic outcomes, including overall survival (OS) and disease-free survival (DFS), was assessed by pooled hazard ratios (HR). The association between CiRS-7 or circHIPK3 and clinical features was evaluated using odds ratios (OR). The Data analysis was conducted using Review Manager 5.4. Results For most cancers, our meta-analysis of 14 studies (N = 2140) and 15 studies (N = 1045) showed that high ciRS-7 and circHIPK3 were associated with worse OS. Pooled analysis of 5 studies (N = 421) and 2 studies (N = 248) indicated that high ciRS-7 and circHIPK3 were also associated with shorter DFS. Additionally, high ciRS-7 and circHIPK3 expression were associated with worse histological grade, higher TNM stage, larger tumor size, more lymph node and distant metastasis. Conclusion High ciRS-7 and circHIPK3 were significantly associated with poor prognosis and advanced clinical features in most cancers, suggesting their potential as prognostic biomarkers.

Abstract Bridges with shallow foundations are highly susceptible to flood scouring due to their limited embedment depth and small contact area between the soil and foundation. This can lead to foundation voids, posing a serious threat to bridge safety. To prevent and mitigate scouring risks, this paper investigates the riverbed scouring characteristics of shallow foundation bridges under different hydrological conditions.The study found that under high water levels and flow velocities, scour depth significantly increased.Under extreme hydrological conditions, a horseshoe vortex forms at the base of the front end of the bridge pier, causing scour pits on both sides of the upstream face of the foundation, which is the main cause of foundation voids that first appear at 2580 s with a maximum scour depth of -2.51 m and a void area of 0.5%, continuing to increase over time.Based on simulated scouring data, this study proposes a method for converting boundary conditions from a scouring model to a mechanical model. This method utilizes point cloud reverse engineering technology to generate a riverbed surface from the three-dimensional coordinate matrix of the boundary and import it into the structural analysis field. Hydraulic effects are calculated using a CFD model and transferred to the structural domain through fluid-structure interaction technology, achieving multi-physical field coupling among water flow, soil, and structure. This method addresses the current limitations in simulating complex scouring forms in bridge flood damage research, providing reliable technical support for subsequent studies on the damage behavior of shallow foundation bridges under flood scouring conditions.

Abstract Intestinal fibrosis, as a late-stage complication of inflammatory bowel disease (IBD), leads to bowel obstruction and requires surgical intervention, significantly lowering the quality of life of affected patients. SAA3, a highly conserved member of the serum amyloid A (SAA) apolipoprotein family in mice, is synthesized primarily as an acute phase reactant in response to infection, inflammation and trauma. An increasing number of evidence suggests that SAA3 exerts a vital role in the fibrotic process, even though the underlying mechanisms are not yet fully comprehended. This study utilized dextran sulfate sodium (DSS) to establish an IBD mouse model and observed that the SAA3-deficient mice exhibited more severe intestinal fibrosis. Our results further indicated that SAA3 genetic disruption in fibroblasts enhanced cell activation to myofibroblasts through HSPB1/NF-κB/TGF-β1/Smads signaling cascade, exacerbating the pathological phenotype of intestinal fibrosis. Collectively, our results shed novel lights on regulating SAA3 in intestinal fibrosis and indicate the potential to develop therapeutic strategies for IBD patients.

Abstract Background Although the TNM staging system plays a critical role in guiding adjuvant chemotherapy for colorectal cancer (CRC), its precision for risk stratification in stage II and III CRC patients with proficient DNA mismatch repair (pMMR) remains limited. Therefore, precise predictive models and research on postoperative treatments are crucial for enhancing patient survival and improving quality of life. Methods This retrospective study analyzed 1051 pMMR CRC patients who underwent radical resection and were randomly assigned to training (n = 736) and validation (n = 315) groups. Immunohistochemistry and hematoxylin and eosin staining were utilized to evaluate regulatory-Immunoscore (RIS), tertiary lymphoid structures (TLS), and tumor budding (TB). The Tumor Aggression-Defense Index (TADI) was derived through a multi-factor COX regression model. Subgroup analysis demonstrated potential of TADI in guiding personalized adjuvant therapy for stage II and III CRC. Results Univariate and multivariate Cox analysis indicated that TADI was an independent prognostic indicator. Among stage II CRC, chemotherapy was significantly correlated with improved recurrence times in individuals with intermediate (95% CI 0.19–0.59, P

ObjectiveTo identify core targets of hepatocellular carcinoma (HCC) by using bioinformatics and specific algorithms, explore their relationships with immune cells, and investigate the causal relationships between immune cells and HCC through Mendelian randomization. MethodsRelevant genes associated with the development of HCC were screened using the GEO and TCGA databases. Immune infiltration analysis was conducted using GSVA and CIBERSORT algorithms. A bidirectional Mendelian randomization analysis was then performed to explore the causal relationships between immune cells and HCC. ResultsA total of 284 HCC-related genes were identified, with 120 genes recognized within the protein interaction network. Immune infiltration analysis revealed significant correlations between key genes and immune cells. Mendelian randomization results indicated that HLA DR on CD33+ HLA DR+ CD14dim (OR=1.097, 95%CI: 1.002–1.201, P=0.045, PBonferroni=0.091) and CD8 on CD28+ CD45RA+ CD8+ T cell (OR=1.123, 95%CI: 1.027–1.228, P=0.011, PBonferroni=0.022) were the risk factors for HCC. Conversely, HLA DR++ monocyte absolute count was identified as a protective factor for HCC (OR=0.812, 95%CI: 0.702–0.938, P=0.005, PBonferroni=0.139). ConclusionThe occurrence and development of liver cancer may be related to CDK1, CCNB1, and CDC20, showing a high degree of correlation with Th2 cells, T helper cells, Th17 cells, and DCs. Mendelian randomization shows that HLA DR on CD33+HLA DR+ CD14dim and CD8 on CD28+CD45RA+CD8+T cells are associated with an increased risk of HCC. The risk of hepatocellular carcinoma is associated with a decrease in the level of HLA DR++monocyte absolute count.

Abstract Background: Clinically, the ability to distinguish which Crohn’s disease patients can benefit from Adalimumab is limited. Aims: This study aimed to develop a model for predicting clinical remission probability for Crohn’s disease patients with Adalimumab at 12 weeks. The model assists clinicians in identifying which Crohn’s disease patients are likely to benefit from Adalimumab treatment before starting therapy, thus optimizing individualized treatment strategies. Methods: Demographic and clinical characteristics of Crohn’s disease patients were utilized to develop a model for clinical remission probability. LASSO regression was used to select predictive factors, and predictions were made using a logistic regression model. The model was internally validated using the bootstrap method (resampling 1000 times). Results: 68 patients with Crohn’s disease were enrolled in this study. Clinical remission was observed in 55.9% at 12 weeks. Three variables were selected through the least absolute shrinkage and selection operator regression method, including Adalimumab-positive cell count, disease duration, and neutrophil count of Crohn’s disease patients. A predictive model was constructed by multivariate logistic regression (Adalimumab-positive cell count (OR, 1.143; 95%CI, 1.056–1.261), disease duration (OR, 0.967; 95%CI, 0.937–0.986), and neutrophil count (×109/L) (OR, 1.274; 95%CI,1.014–1.734)). The predictive model yielded an area under the curve of 0.866 (95%CI, 0.776–0.956), and in the internal validation, the area under the curve was 0.870 (95%CI, 0.770–0.940). Conclusions: This model provides a convenient tool to assess the likelihood of patient remission prior to Adalimumab treatment, thereby supporting the development of personalized treatment plans.

Abstract There are numerous types of orbital tumors, among which orbital ameloblastoma is a rare metastatic benign tumor that often originates in the jaw and later metastasizes to the orbit. The mystery of it lies in that, although it is classified as a benign tumor, it exhibits high recurrence and malignant potential with high invasiveness, posing a serious threat to ocular health and the quality of life of patients. The prognosis of orbital ameloblastoma is relatively poor, but there is still hope. With aggressive treatment and close follow-up observation, patients may still have the possibility of achieving a longer survival period and a better quality of life. The global incidence of ameloblastoma is 0.92 cases per million people per year. According to world literature reports, there are 32 cases of maxillary bone metastasis to the orbit and 4 cases of mandibular bone metastasis to the orbit. With more and more cases and related research being reported, it is necessary to comprehensively review the etiology, clinical manifestations, diagnosis, treatment, and prognosis of orbital ameloblastoma, in order to enhance ophthalmologists' understanding and diagnostic and treatment skills of this disease, and ultimately improve patients' prognosis and quality of life.

Objective: Contactless detection and classification of abnormal respiratory patterns is challenging, especially in multi-person scenarios. While Software-Defined Radio (SDR) systems have shown promise in capturing subtle respiratory movements, the presence of multiple people introduces interference and complexity, making it difficult to distinguish individual breathing patterns, particularly when subjects are close together or have similar respiratory conditions. Results: This paper presents a contactless, non-invasive system for monitoring and classifying abnormal breathing patterns in both single and multi-person scenarios using orthogonal frequency division multiplexing (OFDM) signals and deep learning techniques. The system automatically detects various respiratory patterns, such as whooping cough, Acute Cough, eupnea, Bradypnea, tachypnea, Biot's, sighing, Cheyne-Stokes, Kussmaul, CSA, and OSA. Using SDR technology, the system leverages OFDM signals to detect subtle respiratory movements, allowing real-time classification in different environments. A hybrid deep learning model, VGG16-GRU, combining convolutional neural networks (CNNs) and gated recurrent units (GRUs), was developed to capture both spatial and temporal features of continuous respiratory data. The model successfully classified 11 distinct breathing patterns with high accuracy, achieving an overall accuracy of 99.07%, precision of 99.08%, recall of 99.09%, and an F1-score of 99.07%. The dataset, collected in an office environment, includes complex scenarios with multiple subjects, demonstrating the system's effectiveness in distinguishing individual breathing patterns, even in multi-person settings. Conclusions: This research advances contactless respiratory monitoring by offering a reliable, scalable solution for real-time detection and classification of respiratory conditions. It has significant implications for the development of automated diagnostic tools for respiratory disorders, offering potential benefits for clinical and healthcare applications. Future work will expand the dataset and refine the models to improve performance across diverse respiratory patterns and real-world data from a respiratory unit.

Abstract Background N6-methyladenosine (m6A) methylation plays a key role in tumor progression. However, the significance of methyltransferase-like 3 (METTL3) in biological processes of soft tissue sarcoma (STS) patients, and the relationship between METTL3 and STS are unclear. Methods The expression of METTL3 in STS and its relationship with patient prognosis were determined from database analyses. Immunohistochemical staining and 18F-FDG radioautography were performed on tumor tissues from 39 patients with STS undergoing 18F-FDG PET before treatment. METTL3 expression in tumor and peritumoral tissues was evaluated with the Wilcoxon test. The Mann-Whitney U test and Spearman’s correlation analysis were used to explore correlations of METTL3 expression with both clinicopathological characteristics and 18F-FDG uptake. One-way analysis of variance and ROC analysis were used to evaluate the efficacy of 18F-FDG PET metabolic parameters in predicting METTL3 expression. Results METTL3 expression was significantly higher in STS tumor tissues than normal tissues (all p values 0.05). METTL3 expression positively correlated with the expression of CD163 (r = 0.502, p = 0.011), CD68 (r = 0.381, p = 0.017), and CD8 (r = 0.319, p = 0.048), and exhibited a trend toward correlation with CD4 expression (r = 0.310, p = 0.055). Moreover, 18F-FDG metabolism positively correlated with METTL3 expression in STS (r = 0.580 for PET and r = 0.434 for radioautography, all p values

Hydrogen tanks (HT) with different connection modes are an integral part of the shipborne hydrogen fuel cell system. To ensure the safe and reliable operation of the shipborne multi-tank cascade system, this study innovatively develops 3D models of four different connection modes for the shipborne multi-tank cascade system, namely Type-22, Type-211, Type-121, and Type-112. Through computational fluid dynamics (CFD) numerical simulation, the variations in parameters of different multi-tank cascade systems during the hydrogen storage process are analyzed. The results indicate that the maximum temperature of Type-112 is 271.107K, which is 2.220 %, 4.779 %, and 3.993 % lower than that of Type-22, Type-211, and Type-121, respectively, and thus the optimal parameters such as the initial temperature in the tank and pre-cooling temperature are derived. Type-112's maximum temperature is reduced by 14.02 % and 16.66 % compared to systems connected solely in series or in parallel. The study identifies the optimal structure and reasonable hydrogen storage parameters, effectively reducing heat generation during the refueling process while optimizing space utilization, thereby strongly ensuring the stability of hydrogen storage and opening up new avenues for addressing related hydrogen storage issues in the future.

The hydrogen circulation pump is one of the core components of hydrogen cycle system. To solve the problem of low hydrogen density and the possibility of hydrogen leakage, a vortex hydrogen circulation pump is designed. Taking the three-dimensional flow field of the hydrogen circulation pump as the research object, the CFD (computational fluid dynamics) numerical calculation model of the pump cavity flow field was established, and the internal flow field simulation calculation was performed to analyze the performance characteristics of the hydrogen circulation pump at different speeds and determine. To investigate the effects of flow rates of 80 L/min, 100 L/min, 120 L/min, 140 L/min, rotational speeds of 80 r/min, 100 r/min, 120 r/min, 140 r/min, and the number of vanes of 32, 36, and 40 on the internal flow field of the hydrogen circulating pump. It was found that when the rotational speed was maintained at 15 000 rpm, the flow rate interval was from 80 L/min to 120 L/min, and its pressure difference was always around 270 Pa; When the flow rate is guaranteed to be constant, change the speed of the rotor, the results show that the higher the speed, the higher the differ-ence in pressure between the inlet and outlet; When studying the effect of different number of vanes, the results show that the average static pressure is the most stable when the number of vanes is 36, and the static pressure is stable at 101 345 Pa, while the average value of static pressure is the largest when the number of vanes reaches 40. This work provides ideas for the research of hydrogen cycle system for fuel cells in the future.

Carbon capture, utilization, and storage (CCUS) technology plays a critical role for significantly reducing greenhouse gas emissions. The integrity of the cement sheath in storage wells is essential to secure the subsurface CO2 storage, however, acidic CO2 can erode the cement sheath over time, leading to chemical and mechanical damages of cement, risking CO2 leakage. The advancement of nanotechnology has introduced nanomaterials into cementing operations, enhancing oil well cement durability against storage conditions due to their high surface area and reactivity. To enhance the security of CO2 storage, it is proposed to incorporate self-healing materials into the cement, which autonomously repair microcracks to maintain the cement sheath's sealing integrity. This review firstly discusses the hydration and carbonation processes of in wellbore cement, and evaluates the influences of various nanomaterials on the cement durability. Subsequently, the self-healing mechanisms of such cement is introduced, along with the effects of different materials on the self-healing performance of oil well cement. Finally, by analyzing existing research achievements and issues, the future important research directions are provided.

Jianpi Yiqi Busui Prescription (JYBP), a traditional Chinese medicine (TCM) formula, is used in the treatment of myasthenia gravis (MG). However, its mechanisms of action still require further clarification. In this study, an experimental autoimmune myasthenia gravis (EAMG) rat model was established for research. Changes in body weight, forelimb grip strength, Lennon clinical score, and antifatigue ability of EAMG model rats were recorded to evaluate the effectiveness of JYBP. Flow cytometry was utilized to count Th17, Th1, Th2, and Treg cells in lymphocytes. ELISA and RT-qPCR were used to measure acetylcholine receptor antibody (AChR-Ab) and Th17-related cytokines, including IL-17, IL-21, IL-23, TNF-α, TGF-β, IL-1β, and IL-6. Western blot and immunofluorescence staining were used to detect the expression levels of key proteins and their phosphorylated forms, such as transforming growth factor beta-activated kinase 1 (TAK1), P38 mitogen-activated protein kinase (P38 MAPK), and eukaryotic initiation factor 4E (eIF-4E). The results indicate that JYBP can increase the body weight of EAMG model rats, improve grip strength and antifatigue ability, and reduce the Lennon clinical score and AChR-Ab concentration. Mechanistic studies indicate that JYBP can inhibit the differentiation of CD4+ T cells into Th17 and Th1, promote their differentiation into Th2 and Treg, and regulate the expression of Th17-related cytokines. Further research shows that JYBP can reduce the expression of related proteins in the TAK1/P38 MAPK/eIF-4E signaling pathway. In conclusion, JYBP can alleviate the condition of EAMG model rats, positively affecting MG treatment. The inhibitory effect of JYBP on the differentiation of CD4+ T cells into Th17 may be related to the TAK1/P38 MAPK/eIF-4E signaling pathway.

Systemic sclerosis (SSc) is a perplexing autoimmune disorder, characterized by mysterious causes, high mortality rates, and a lack of effective treatments. The role of abnormal glycosylation in the onset of autoimmune diseases has been recognized for some time. Nonetheless, the intricate details of intact glycopeptides in SSc remain elusive owing to challenges in their detection. In this study, we characterized plasma immunoglobulin G (IgG) intact N-glycopeptides from 30 SSc patients and 30 healthy controls (HCs) via our recently developed intact glycopeptide analysis method GlycoQuant. Through this approach, twelve differentially expressed intact N-glycopeptides were identified. The correlation of specific intact N-glycopeptides with the clinical features of SSc patients was analyzed. The results revealed a notable increase in the levels of 6 intact N-glycopeptides (IgG2-N3H3F1, IgG2-N3H4F1, IgG2-N4H4F1, IgG2-N4H5F1, IgG2-N5H4F1, and IgG2-N5H5F1) and a decrease in the levels of another set of 6 intact N-glycopeptides (IgG1-N4H3F1, IgG2-N3H6F1A1, IgG2-N4H4F1A1, IgG2-N5H3F1, IgG3-N4H3F1, and IgG3-N4H4F1). These changes in the levels of intact N-glycopeptides are associated with various aspects of SSc, including diffuse SSc (dSSc), interstitial lung disease (ILD), disease progression, cardiovascular involvement and C-reactive protein in the peripheral blood. In summary, this study offers a detailed overview of the intact N-glycopeptide profile in the peripheral blood of patients with SSc, providing valuable insights that could propel further research into SSc.

ABSTRACT Vaginitis is the most common problem afflicting women of childbearing age. However, the underlying etiological factors remain poorly understood, leading to recurrent vaginitis and constraining clinical management. Here, we explored whether the gut microbiota influences the risk of vaginitis by performing a two-sample Mendelian randomization analysis using the largest genome-wide association studies to date. Four gut taxa in genus levels were identified related to vaginitis: Candidatus Soleaferrea (inverse-variance weighted [IVW] odds ratio [OR] = 2.20, P = 0.026), Dialister (IVW OR = 2.62, P = 0.029), Lachnospiraceae UCG-008 (IVW OR = 0.41, P = 0.0067), and Ruminiclostridium 5 (IVW OR = 0.080, P = 1.42 × 10−5). We further explored the mediation effect of the plasma metabolites by two-step Mendelian randomization (MR) and multivariable MR. The findings indicated that 3-phosphoglycerate and lysophosphatidylcholine antagonistically act against the two identified risk factors (Candidatus Soleaferrea and Dialister, respectively) of vaginitis, thus appearing to confer protective effects against vaginitis. On the contrary, the elevation of arachidonate/pyruvate ratio and reduction in palmitate/myristate ratio mediated the protective effects of Lachnospiraceae UCG-008 against vaginitis. These findings support a potential causal role for gut microbiota in the development of vaginitis, thereby providing potential strategies for its prevention and intervention.IMPORTANCEVaginitis is the most common problem afflicting women of childbearing age. However, the underlying etiological factors remain poorly understood, leading to recurrent vaginitis and constraining clinical management. Besides, the human gut and vagina are important organs that are both colonized by thousands of microorganisms impacting human physiology and health. Whether there is an interplay between the microecosystems is intriguing and unclear. This study evaluated the potential causal relationship between the gut microbiota and vaginitis and suggested that specific types of gut microbiota may be the potential risk or protective factors of vaginitis mediated or suppressed by certain plasma metabolites. These findings provide treatment insights for vaginitis.

Background Left ventricular diastolic function as assessed by tissue Doppler echocardiography predicts cardiovascular event rates at 4 years of follow-up in patients with hypertension. Our aim was to evaluate whether this extends to predicting cardiovascular mortality after 20 years of follow-up.Methods Conventional (E) and tissue Doppler (e′) echocardiography was performed on hypertensive participants in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) with long-term follow-up ascertained via linkage to the Office of National Statistics. Cardiovascular mortality was defined as death from coronary heart disease, stroke and other cardiovascular aetiology such as heart failure or peripheral vascular disease. Unadjusted and adjusted Cox regression survival models were constructed to investigate the association between tissue Doppler echocardiography measurements and long-term cardiovascular mortality.Results Among 506 hypertensive patients (median age 64, interquartile range (58, 69), 87% male), there were 200 (40%) deaths over a 20-year follow-up period. 60 deaths (12%) were cardiovascular-related.A reduction in e′ was independently associated with increased cardiovascular mortality, after adjusting for the ACC/AHA Atherosclerotic Cardiovascular Disease (ASCVD) risk score, with an inverse HR of 1.22 per 1 cm/s decrease (95% CI 1.04–1.43). A higher E/e′ ratio was independently associated with increased cardiovascular mortality, after adjusting for the ASCVD risk score, with an HR of 1.12 per 1-unit increase (95% CI, 1.02 to 1.23).Conclusions Impaired left ventricular diastolic function, measured using tissue Doppler echocardiography through e′ and E/e′, independently predicts increased cardiovascular mortality over 20 years in hypertensive patients, highlighting its long-term prognostic significance.

BackgroundIncorporating artificial intelligence (AI) into medical education has gained significant attention for its potential to enhance teaching and learning outcomes. However, it lacks a comprehensive study depicting the academic performance and status of AI in the medical education domain. ObjectiveThis study aims to analyze the social patterns, productive contributors, knowledge structure, and clusters since the 21st century. MethodsDocuments were retrieved from the Web of Science Core Collection database from 2000 to 2024. VOSviewer, Incites, and Citespace were used to analyze the bibliometric metrics, which were categorized by country, institution, authors, journals, and keywords. The variables analyzed encompassed counts, citations, H-index, impact factor, and collaboration metrics. ResultsAltogether, 7534 publications were initially retrieved and 2775 were included for analysis. The annual count and citation of papers exhibited exponential trends since 2018. The United States emerged as the lead contributor due to its high productivity and recognition levels. Stanford University, Johns Hopkins University, National University of Singapore, Mayo Clinic, University of Arizona, and University of Toronto were representative institutions in their respective fields. Cureus, JMIR Medical Education, Medical Teacher, and BMC Medical Education ranked as the top four most productive journals. The resulting heat map highlighted several high-frequency keywords, including performance, education, AI, and model. The citation burst time of terms revealed that AI technologies shifted from imaging processing (2000), augmented reality (2013), and virtual reality (2016) to decision-making (2020) and model (2021). Keywords such as mortality and robotic surgery persisted into 2023, suggesting the ongoing recognition and interest in these areas. ConclusionsThis study provides valuable insights and guidance for researchers who are interested in educational technology, as well as recommendations for pioneering institutions and journal submissions. Along with the rapid growth of AI, medical education is expected to gain much more benefits.

In this paper, the propagation characteristics of generalized surface waves on a piezoelectric semiconductor half-space with the presence of the rotation are studied. First, the governing equations of motion of the piezoelectric semiconductor solid which rotates about any axis are derived by the method of vector decomposition. Next, the dispersive relations of generalized Rayleigh wave and generalized Shear surface wave are obtained. The dispersion, attenuation and frequency shift features of generalized Rayleigh wave and generalized Shear surface wave under two different boundary conditions are studied numerically with considering the rotation and the biasing electric fields. Influences of the rotation round axes with different azimuthal angles on the dispersion, attenuation and frequency shift of surface waves are discussed for both cases of open circuit and short circuit.

Ferroptosis is a form of cell death that occurs when there is an excess of reactive oxygen species (ROS), lipid peroxidation, and iron accumulation. The precise regulation of metabolic pathways, including iron, lipid, and amino acid metabolism, is crucial for cell survival. This type of cell death, which is associated with oxidative stress, is controlled by a complex network of signaling molecules and pathways. It is also implicated in various respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), acute lung injury (ALI), lung cancer, pulmonary fibrosis (PF), and the coronavirus disease 2019 (COVID-19). To combat drug resistance, it is important to identify appropriate biological markers and treatment targets, as well as intervene in respiratory disorders to either induce or prevent ferroptosis. The focus is on the role of ferroptosis in the development of respiratory diseases and the potential of targeting ferroptosis for prevention and treatment. The review also explores the interaction between immune cell ferroptosis and inflammatory mediators in respiratory diseases, aiming to provide more effective strategies for managing cellular ferroptosis and respiratory disorders.

Background & Aims: Notch and TAZ are implicated in cholangiocarcinogenesis, but whether and how these oncogenic molecules interact remain unknown. Methods: The development of cholangiocarcinoma (CCA) was induced by hydrodynamic tail vein injection of oncogenes (Notch1 intracellular domain [NICD]/AKT) to the FVB/NJ mice. CCA xenograft was developed by inoculation of human CCA cells into the livers of SCID mice. Tissues and cells were analyzed using quantitative reverse transcription polymerase chain reaction, Western blotting analyses, immunohistochemistry, chromatin immunoprecipitation-quantitative polymerase chain reaction and WST-1 cell proliferation assay. Results: Our experimental findings show that TAZ is indispensable in NICD-driven cholangiocarcinogenesis. Notch activation induces the expression of methyltransferase like-3 (METTL3), which catalyzes N6-methyladenosine modification of TAZ mRNA and that this mechanism plays a central role in the crosstalk between Notch and TAZ in CCA cells. Mechanistically, Notch regulates the expression of METTL3 through the binding of NICD to its downstream transcription factor CSL in the promoter region of METTL3. METTL3 in turn mediates N6-methyladenosine modification of TAZ mRNA, which is recognized by the m6A reader YTHDF1 to enhance TAZ protein translation. We observed that inhibition of Notch signaling decreased the protein levels of both MELLT3 and TAZ. Depletion of METTL3 by short hairpin RNAs or by the next generation GapmeR antisense oligonucleotides decreased the level of TAZ protein and inhibited the growth of human CCA cells in vitro and in mice. Conclusion: This study describes a novel Notch-METTL3-TAZ signaling cascade, which is important in CCA development and progression. Our experimental results provide new insight into how the Notch pathway cooperates with TAZ signaling in CCA, and the findings may have important therapeutic implications.

Background & Aims: The RNA-binding motif protein 39 (RBM39) functions as both an RNA-binding protein and a splicing factor in a variety of cancer types. However, the function of RBM39 in cholangiocarcinoma (CCA) remains undefined. In this study, we aimed to investigate the role of RBM39 in CCA and explore its potential as a therapeutic target. Methods: The expression of RBM39 in CCA was investigated by analyzing human CCA tumor specimens. CRISPR/Cas9 or shRNA-mediated depletion of RBM39 was performed in vitro and in vivo to document the oncogenic role of RBM39 in CCA. The anti-tumor effect of the RBM39 inhibitor, Indisulam, in combination with the EZH2 degrader MS177 was assessed in vitro and in vivo. Results: RBM39 is significantly increased in human CCA tissues and associated with a poor prognosis in patients with CCA. Depletion of RBM39 by CRISPR/Cas9 or shRNA inhibited CCA cell proliferation in vitro and prevented CCA development and tumor growth in mice. Mechanistically, our results showed that depletion of RBM39 suppressed EZH2 expression via disrupting its mRNA splicing. RBM39-regulated EZH2 controls WNT7B/β-catenin activity. Pharmacological co-targeting of RBM39 (with Indisulam) and EZH2 (with MS177) resulted in a synergistic antitumor effect, both in vitro and in vivo. Conclusion: This study discloses a novel RBM39-EZH2-β-catenin signaling axis that is crucial for CCA growth. Our findings suggest that simultaneous inhibition of RBM39 and EZH2 presents a promising therapeutic strategy for CCA treatment.

Exosomes, extracellular vesicles originating from endosomes, were discovered in the late 1980s and their function in intercellular communication has since garnered considerable interest. Exosomes are lipid bilayer-coated vesicles that range in size from 30 to 150 nm and appear as sacs under the electron microscope. Exosome secretion is crucial for cell-to-cell contact in both normal physiology and the development and spread of tumors. Furthermore, cancer cells can secrete more exosomes than normal cells. Scientists believe that intercellular communication in the complex tissue environment of the human body is an important reason for cancer cell invasion and metastasis. For example, some particles containing regulatory molecules are secreted in the tumor microenvironment, including exosomes. Then the contents of exosomes can be released by donor cells into the environment and interact with recipient cells to promote the migration and invasion of tumor cells. Therefore, in this review, we summarized the biogenesis of exosome, as well as exosome cargo and related roles. More importantly, this review introduces and discusses the factors that have been reported to affect exosome secretion in tumors and highlights the important role of exosomes in tumors.

A magnetic suspension bearing is a device that suspends the rotating shaft in a balanced position by magnetic force, thereby eliminating the friction between the rotor and the stator. Different from traditional bearing support methods, magnetic bearings show significant advantages in terms of speed, accuracy, and loss. Because there is no contact, magnetic bearings enable high-speed operation, precise control, and zero friction. Magnetic bearings, with their excellent performance, are widely applied in fields such as industrial production, flywheel energy storage, and aerospace. However, with the continuous growth of the demand for high-performance bearings and the deepening of the concept of low-carbon and environmental protection, breakthroughs in the key technologies of magnetic bearings are urgently needed. In this paper, relevant research on magnetic bearings is summarized. Magnetic bearings are classified according to the different ways in which they generate suspension forces. Research on the topological structure design, mathematical modeling, and control strategies of the magnetic bearing system is covered. The aim is to provide readers and researchers with a comprehensive overview of the key technologies of magnetic bearings from a new perspective.

In the process of reservoir water flooding development, the characteristics of underground seepage field have changed, resulting in increasingly complex oil–water distribution. The original understanding of reservoir physical property parameters based on the initial stage of development is insufficient to guide reservoir development efforts in the extra-high water cut stage. To deeply investigate the spatio-temporal evolution of heterogeneity in the internal seepage field of layered reservoirs during water flooding development, water–oil displacement experimental simulations were conducted based on layered, normally graded models. By combining CT scanning technology and two-phase seepage theory, the variation patterns of heterogeneity in the seepage field of medium-to-high permeability, normally graded reservoirs were analyzed. The results indicate that the effectiveness of water flooding development is doubly constrained by differences in oil–water seepage capacities and the heterogeneity of the seepage field. During the development process, both the reservoir’s flow capacity and the heterogeneity of the seepage field are in a state of continuous change. Influenced by the extra resistance brought about by multiphase flow, the reservoir’s flow capacity drops to 41.6% of the absolute permeability in the extra-high water cut stage. Based on differences in the variation amplitudes of oil–water-phase permeabilities, changes in the heterogeneity of the internal seepage field of the reservoir can be broadly divided into periods of drastic change and relative stability. During the drastic change stage, the fluctuation amplitude of the water-phase permeability variation coefficient is 114.5 times that of the relative stable phase, while the fluctuation amplitude of the oil-phase permeability variation coefficient is 5.2 times that of the stable stage. This study reveals the dynamic changes in reservoir seepage characteristics during the water injection process, providing guidance for water injection development in layered reservoirs.

The application of machine learning and artificial intelligence to solve scientific challenges has significantly increased in recent years. A remarkable development is the use of Physics-Informed Neural Networks (PINNs) to solve Partial Differential Equations (PDEs) numerically. However, current PINN techniques often face problems with accuracy and slow convergence. To address these problems, we propose an importance sampling method to generate optimal interpolation points during training. Experimental results demonstrate that our method achieves a 43% reduction in root mean square error compared to state-of-the-art methods when applied to the one-dimensional Korteweg–De Vries equation.