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Abstract Excessively high temperatures inside a power transformer can accelerate the ageing rate and even cause unplanned outages. Accurately estimating the hot‐spot temperature (HST) of a power transformer is important for regulating the load and ensuring long‐term operation. In this study, a closed‐loop model of a 110‐kV product transformer with an oil natural/air forced (ONAF) cooling mode is built to predict HST, in which the compression ratio of windings, equivalent heat source and radiator geometry are considered. According to the flow field of the winding, the ‘dead oil zone’ and reverse oil flow are observed in the horizontal oil channels. The accuracy of the proposed model is experimentally validated by temperature‐rise tests. The results show that the absolute errors between the measured results and simulation are below 5°C, and the average error is ∼2°C. Furthermore, the arrangements of windings and radiators are studied to enhance the oil circulation. By adding 5 washers to the high‐voltage winding, the average temperature can be decreased by 6°C compared with the case without a washer. Elevating the radiator can also mitigate the characteristic temperatures, and the optimal height difference between the radiator and winding centre is suggested to be 0.66 m.

Abstract Background Radiomics is increasingly utilized to distinguish pulmonary nodules between lung adenocarcinoma (LUAD) and tuberculosis (TB). However, it remains unclear whether different segmentation criteria, such as the inclusion or exclusion of the cavity region within nodules, affect the results. Methods A total of 525 patients from two medical centers were retrospectively enrolled. The radiomics features were extracted according to two regions of interest (ROI) segmentation criteria. Multiple logistic regression models were trained to predict the pathology: (1) The clinical model relied on clinical‐radiological semantic features; (2) The radiomics models (radiomics+ and radiomics−) utilized radiomics features from different ROIs (including or excluding cavities); (3) the composite models (composite+ and composite−) incorporated both above. Results In the testing set, the radiomics+/− models and the composite+/− models still possessed efficient prediction performance (AUC ≥ 0.94), while the AUC of the clinical model was 0.881. In the validation set, the AUC of the clinical model was only 0.717, while that of the radiomics+/− models and the composite+/− models ranged from 0.801 to 0.825. The prediction performance of all the radiomics+/− and composite+/− models were significantly superior to that of the clinical model (p 0.05). Conclusions The present study established a machine learning‐based radiomics strategy for differentiating LUAD from TB lesions. The ROI segmentation including or excluding the cavity region may exert no significant effect on the predictive ability.

Immune checkpoint blockade (ICB) therapy potently revives T cell's response to cancer. However, patients suffered with tumors that had inadequate infiltrated immune cells only receive limited therapeutic benefits from ICB therapy. Synthetic biology promotes the alternative strategy of harnessing tumor-targeting bacteria to synthesize therapeutics to modulate immunity in situ. Herein, we engineered attenuated Salmonella typhimurium VNP20009 with gene circuits to synthetize granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin 7 (IL-7) within tumors, which recruited dendritic cells (DCs) and enhanced T cell priming to elicit anti-tumor response. The bacteria-produced GM-CSF stimulated the maturation of bone marrow-derived dendritic cells (BMDCs), while IL-7 promoted the proliferation of spleen isolated T cells and inhibited cytotoxicity T cell apoptosis in vitro. Virtually, engineered VNP20009 prefer to colonize in tumors, and inhibited tumor growth by enhancing DCs and T cell infiltration. Moreover, the tumor-toxic GZMB+ CD8+ T cell and IFN-γ+ CD8+ T cell populations conspicuously increased with the treatment of engineered bacteria. The combination of GM–CSF–IL-7-VNP20009 with PD-1 antibody synergistically stunted the tumor progress and metastasis.

Semantic segmentation using cross-modal data is a hot topic in the field of Earth observation. Compared with single-modal strategies, cross-modal networks fuse multiaspect information and yield higher segmentation accuracy, which is widely used in urban planning, environmental monitoring and so on. In this study, an end-to-end adaptive cross-modal fusion network (ACFNet) is proposed for semantic segmentation task using high resolution and light detection and ranging images, because of the difference of sensor resolution, different modal data have different abilities of ground object expression. Therefore, multimodal data fusion should consider the features with different spatial scales, while most existing methods simply use the same spatial scale features for fusion. In this work, we first design an adaptive scale fusion module that can automatically choose the features with optimal spatial scales, making full use of the representation properties of ground object details. Second, the important feature guidance module is designed, which can evaluate the influence weights of deep semantic features and shallow spatial detailed features, achieving adaptive deep and shallow feature fusion, and reducing the semantic-spatial information dilution caused by layer-by-layer up and down sampling. Finally, we introduce a divide Fourier context learning (DFCL) module to transform the feature maps from spatial domain to frequency domain. Compared to the limited perception of current spatial convolution kernels, the DFCL module can easily model the contextual dependencies of cross-modal features, which will improve the segmentaion accuracy for complex ground objects of cities, especially for occlusion. To demonstrate the generalisation performance of our module, we conduct extensive experiments and ablation studies on three datasets: Potsdam, Vaihingen, and IEEE GRSS DFC 2018. Results show that the proposed ACFNet is effective in semantic segmentation.

Abstract Background Microvascular pathology is one of the main characteristics of diabetic cardiomyopathy; however, the early longitudinal course of diabetic microvascular dysfunction remains uncertain. This study aimed to investigate the early dynamic changes in left ventricular (LV) microvascular function in diabetic pig model using the cardiac magnetic resonance (CMR)-derived quantitative perfusion technique. Methods Twelve pigs with streptozotocin-induced diabetes mellitus (DM) were included in this study, and longitudinal CMR scanning was performed before and 2, 6, 10, and 16 months after diabetic modeling. CMR-derived semiquantitative parameters (upslope, maximal signal intensity, perfusion index, and myocardial perfusion reserve index [MPRI]) and fully quantitative perfusion parameters (myocardial blood flow [MBF] and myocardial perfusion reserve [MPR]) were analyzed to evaluate longitudinal changes in LV myocardial microvascular function. Pearson correlation was used to analyze the relationship between LV structure and function and myocardial perfusion function. Results With the progression of DM duration, the upslope at rest showed a gradually increasing trend (P = 0.029); however, the upslope at stress and MBF did not change significantly (P > 0.05). Regarding perfusion reserve function, both MPRI and MPR showed a decreasing trend with the progression of disease duration (MPRI, P = 0.001; MPR, P = 0.042), with high consistency (r = 0.551, P

Abstract Background Linezolid exhibits antibacterial activity against sensitive and drug-resistant strains of Mycobacterium tuberculosis. Knowledge on the distribution of linezolid in different types of bones in patients with spinal tuberculosis (TB) is lacking, which limits the pharmacokinetic and pharmacodynamic studies of linezolid. This study aimed to evaluate the distribution of linezolid in diseased and nondiseased bones in patients with spinal TB. Methods Spinal TB patients treated with linezolid-containing regimens and whose diseased and nondiseased bones were collected during surgery were enrolled retrospectively from January 2017 to February 2022. Blood, nondiseased bones, and diseased bones were collected simultaneously during the operation. Linezolid concentrations in the plasma, nondiseased bones, and diseased bones were subjected to high-performance liquid chromatography–tandem mass spectrometry. Results Seven eligible spinal TB patients, including one rifampicin-resistant case, were enrolled. Following a 600 mg oral administration of linezolid before surgery, the median concentrations of linezolid in plasma, nondiseased bone, and diseased bone of the seven patients were 8.23, 1.01, and 2.13 mg/L, respectively. The mean ratios of linezolid concentration in nondiseased bones/plasma, diseased bones/plasma and diseased bones/nondiseased bones reached 0.26, 0.49, and 2.27, respectively. The diseased bones/plasma presented a higher mean ratio of linezolid concentration than nondiseased bones/plasma, and the difference was statistically significant (t = 2.55, p = 0.025). Pearson’s correlation analysis showed the positively correlation of linezolid concentrations in diseased and nondiseased bones (r = 0.810, p = 0.027). Conclusions Linezolid exhibits a higher concentration distribution in diseased bones than in nondiseased bones.

Abstract Background Lung metastasis is a significant adverse predictor of prognosis in patients with breast cancer. Accurate estimation for the prognosis of patients with lung metastasis and population-based validation for the models are lacking. In the present study, we aimed to establish the nomogram to identify prognostic factors correlated with lung metastases and evaluate individualized survival in patients with lung metastasis based on SEER (Surveillance, Epidemiology, and End Results) database. Methods We selected 1197 patients diagnosed with breast cancer with lung metastasis (BCLM) from the SEER database and randomly assigned them to the training group (n = 837) and the testing group (n = 360). Based on univariate and multivariate Cox regression analysis, we evaluated the effects of multiple variables on survival in the training group and constructed a nomogram to predict the 1-, 2-, and 3-year survival probability of patients. The nomogram were verified internally and externally by Concordance index (C-index), Net Reclassification (NRI), Integrated Discrimination Improvement (IDI), Decision Curve Analysis (DCA), and calibration plots. Results According to the results of multi-factor Cox regression analysis, age, histopathology, grade, marital status, bone metastasis, brain metastasis, liver metastasis, human epidermal growth factor receptor 2 (HER2), estrogen receptor (ER), progesterone receptor (PR), surgery, neoadjuvant therapy and chemotherapy were considered as independent prognostic factors for patients with BCLM. The C-index in the training group was 0.719 and the testing group was 0.695, respectively. The AUC values of the 1-, 2-, and 3-year prognostic nomogram in the training group were 0.798, 0.790 and 0.793, and the corresponding AUC values in the testing group were 0.765, 0.761 and 0.722. The calculation results of IDI and NRI were shown. The nomograms significantly improved the risk reclassification for 1-, 2-, and 3-year overall mortality prediction compared with the AJCC 7th staging system. According to the calibration plot, nomograms showed good consistency between predicted and actual overall survival (OS) values for the patients with BCLM. DCA showed that nomograms had better net benefits at different threshold probabilities at different time points compared with the AJCC 7th staging system. Conclusions Nomograms that predicted 1-, 2-, and 3-year OS for patients with BCLM were successfully constructed and validated to help physicians in evaluating the high risk of mortality in breast cancer patients.

Abstract Aims Assessing the global burden and health inequalities of Hypertension Heart Disease (HHD) during the period from 1990 to 2019. Methods Secondary analysis of the Global Burden of Disease (GBD) study in 2019, focusing on the burden of diseases, injuries, and risk factors worldwide. Disability-Adjusted Life Years (DALYs) data related to HHD are extracted from the 2019 GBD. Inequality Slope Index (SII) and Concentration Index are calculated to assess health inequalities across regions and countries. Results The total DALYs for HHD reached 21.51 million, demonstrating a substantial increase of 54.25% compared to the figures recorded in 1990, while the age-standardized DALY rates per 100,000 population for HHD in 2019 showed a notable decline to 268.19 (95% UI 204.57, 298.07), reflecting a significant decrease of 26.4% compared to the rates observed in 1990. The DALYs rate of hypertensive heart disease increases with age. Countries with moderate SDI accounted for 38.72% of the global burden of HHD in terms of DALYs. The highest age-standardized DALY rates (per 100,000) are predominantly concentrated in underdeveloped areas. In 1990 and 2019, the SII (per 100,000 population) for DALYs were − 121.6398 (95% CI -187.3729 to -55.90684) and − 1.592634 (95% CI -53.11027 to 49.925) respectively. The significant decline suggests a reduction in the inequality of age-standardized burden of HHD between high-income and low-income countries during this period. Conclusion The unequal prevalence of HHD across different populations can hinder the achievement of the “health for all” objective. Persistent disparities in HHD have been observed globally over the past thirty years. It is crucial to prioritize efforts towards reducing avoidable health inequalities associated with hypertension-related heart disease, particularly in low-income and middle-income countries.

Abstract Behavior trees have attracted great interest in computer games and robotic applications. However, it lacks the learning ability for dynamic environments. Previous works combining behavior trees with reinforcement learning either need to construct an independent sub-scenario or train the learning method over the whole game, which is not suited for complex multi-agent games. In this paper, a framework is proposed, named as MARL-BT, that embeds multi-agent reinforcement learning methods into behavior trees. Following the running mechanism of behavior trees, we design the way of collecting samples and the training procedure. Further, we point out a special phenomenon in MARL-BT, i.e., the unexpected interruption, and present an action masking technique to remove its harmful effect on learning performance. Finally, we make extensive experiments on the 11 versus 11 full game in Google Research Football. The introduced MARL-BT framework could get an 11.507% improvement compared to pure BT for certain scenarios. The action masking technique could greatly improve the performance of the learning method, i.e., the final reward is improved around 100% times for a sub-task.

This survey provides a comprehensive review of hybrid circuit breakers and their applications in 1 kV to 800 kV, both alternating current and direct current systems. The paper introduces the research motivation and key applications of hybrid circuit breakers, followed by a detailed analysis on the generic structure and operation principles of four core components: the mechanical switch, the semiconductor devices, the energy absorbers, and the commutation switch. Critical challenges on the optimization of each component are identified and potential solutions are suggested. Moreover, the paper innovatively summarizes the system-level considerations that are critical for the holistic development of hybrid circuit breakers, such as current sensing, control latency, hardware in the loop validation, and integration of multiple HCBs for multi-terminal DC system protections. This review seeks to provide design considerations and streamline the prototyping process of hybrid circuit breakers from the component, topology and system integration perspectives, which will benefit the advanced protection equipment in emerging systems such as renewable energy integration, electrified transportation, and multi-port power systems.

As an emerging, alternative mode of transportation, an in-depth understanding of autonomous shuttle (AS) experiences among all age groups, with and without disabilities, may impact acceptance and adoption of the AS, shape industry guidelines, and impact public policy. Therefore, this study analyzed qualitative data from older (n = 104), younger, and middle-aged (n = 106) adults and people with disabilities (n = 42). The data were obtained by asking participants four open-ended questions from an Autonomous Vehicle User Perception Survey. The result revealed seven themes (Safety, Ease of Use, Cost, Availability, Aging, AS Information, and Experience with AS) for older, younger, and middle-aged adults and six themes (all of the previously mentioned except for Aging) for people with disabilities. Frequency counts indicated priority attention, among all groups, to Safety and Ease of Use. This study provides valuable information pertaining to the experiences, concerns, and motivations of all potential users across age groups and disabilities—and may inform policymakers and industry partners to address their needs more adequately. These findings may contribute to improving and enhancing AS programming, design, and deployment in a safer, accessible, affordable, and tailored way.

Abstract Background Partial nephrectomy (PN) is usually recommended for T1 stage clear cell renal cell carcinoma (ccRCC) regardless of the nuclear grades. However, the question remains unresolved as to whether PN is non-inferior to RN in patients with T1-ccRCC at higher risk of recurrence. In fact, we found that patients with high nuclear grades treated with PN had poorer prognosis compared with those treated with radical nephrectomy (RN). Therefore, this study was designed to evaluate the associations of PN and RN in the four nuclear grade subsets with oncologic outcomes. Methods A retrospective study was conducted in three Chinese urological centers that included 1,714 patients who underwent PN or RN for sporadic, unilateral, pT1, N0, and M0 ccRCC without positive surgical margins and neoadjuvant therapy between 2010 and 2019. Associations of nephrectomy type with local ipsilateral recurrence, distant metastases, and all-cause mortality (ACM) were evaluated using the Kaplan–Meier method and multivariable Cox proportional hazards regression models after overlap weighting (OW). Results A total of 1675 patients entered the OW cohort. After OW, in comparison to PN, RN associated with a reduced risk of local ipsilateral recurrence in the G2 subset (HR = 0.148, 95% CI 0.046–0.474; p

Abstract Correction of leg length discrepancy (LLD) in skeletally mature patients with osteosarcoma was rarely reported and quite challenging. This study aimed to propose a treatment strategy of staged lengthening and reconstruction with a standard static prosthesis to address LLD and restore limb function. It also evaluated the effectiveness of the strategy in terms of leg lengthening, functional outcomes, and complications. The strategy for lengthening included three stages. In stage 1, the previous prosthesis was removed and an external fixator with a temporary rod-cement spacer was placed. In this stage, the external fixator was used to lengthen the limb to the appropriate length. In stage 2, the external fixator was removed and the old rod-cement spacer was replaced with a new one. In stage 3, the rod-cement spacer was removed and the standard static prosthesis was planted. Nine skeletally mature distal femoral osteosarcoma patients with unacceptable LLD were treated in our institution from 2019 to 2021. We performed a chart review on nine patients for the clinical and radiographic assessment of functional outcomes, LLD, and complications. The mean (range) leg lengthening was 7.3 cm (3.6–15.6). The mean (range) LLD of the lower limbs decreased from 7.6 cm (4.1–14.2) before the lengthening to 0.3 cm (− 0.3 to 2.1) at the final follow-up with statistical significance (P = 0.000). The mean (range) Musculoskeletal Tumor Society score improved from 30.3% (16.7%–53.3%) before the lengthening to 96.3% (86.7%–100%) at the final follow-up with statistical significance (P = 0.000). Three patients (33.3%) had a minor complication; none needed additional surgical intervention. In the short term, the current staged lengthening and reconstruction with standard static prosthesis provided satisfactory functional outcomes and LLD correction with few complications. The long-term effects of this method need further exploration.

The fusion genes NRG1 and NRG2, members of the epidermal growth factor (EGF) receptor family, have emerged as key drivers in cancer. Upon fusion, NRG1 retains its EGF-like active domain, binds to the ERBB ligand family, and triggers intracellular signaling cascades, promoting uncontrolled cell proliferation. The incidence of NRG1 gene fusion varies across cancer types, with lung cancer being the most prevalent at 0.19 to 0.27%. CD74 and SLC3A2 are the most frequently observed fusion partners. RNA-based next-generation sequencing is the primary method for detecting NRG1 and NRG2 gene fusions, whereas pERBB3 immunohistochemistry can serve as a rapid prescreening tool for identifying NRG1-positive patients. Currently, there are no approved targeted drugs for NRG1 and NRG2. Common treatment approaches involve pan-ERBB inhibitors, small molecule inhibitors targeting ERBB2 or ERBB3, and monoclonal antibodies. Given the current landscape of NRG1 and NRG2 in solid tumors, a consensus among diagnostic and treatment experts is proposed, and clinical trials hold promise for benefiting more patients with NRG1 and NRG2 gene fusion solid tumors.

The fatigue property of the recycled mixture affects the structural design of recycled pavement. In order to explore the effect of different reclaimed asphalt pavement (RAP) content on the fatigue properties of recycled mixtures, the fatigue properties of recycled mixtures were analyzed through an indoor fatigue test and finite element numerical simulation. Based on the phenomenological method and the dissipated energy theory, the fatigue properties of recycled mixtures with different RAP contents were analyzed and the fatigue damage of the mixtures were also studies under various strain levels. Based on the finite element numerical model of fatigue damage, the stress distribution and internal damage field distribution of trabecular specimens under different temperatures, strain levels and RAP contents were analyzed. The results showed that the anti-fatigue level of the mixture decreased as the RAP content was increased. The relative change rate of dissipated energy for different types of mixtures showed a two-stage change rule with the change of load times, that is, the value is large and decreasing, and the value is small and stable. The correlation between the plateau value (PV) and the fatigue life was established under the double logarithm coordinates, which could better analyze the influence law of the RAP content on the fatigue performance of the recycled mixture. Under different temperatures, strain levels, and RAP contents, the stress at the bottom of trabecular specimen and the overall damage field were mainly generated at the upper part under compressive stress and the bottom under tensile stress, and the damage field distribution area accounted for a small part of the whole specimen. According to the test results and fatigue damage distribution, it is recommended that the content of recycled aggregate in recycled asphalt mixtures be less than 30% to ensure good performance. The research results have important practical significance for the improvement of fatigue performance and engineering application of recycled mixtures.

Abstract Background Sarcopenia is frequently found in patients with heart failure with reduced ejection fraction (HFrEF) and is associated with reduced exercise capacity, poor quality of life and adverse outcomes. Recent evidence suggests that axial thoracic skeletal muscle size could be used as a surrogate to assess sarcopenia in HFrEF. Since diabetes mellitus (DM) is one of the most common comorbidities with HFrEF, we aimed to explore the potential association of axial thoracic skeletal muscle size with left ventricular (LV) remodeling and determine its prognostic significance in this condition. Methods A total of 243 diabetes patients with HFrEF were included in this study. Bilateral axial thoracic skeletal muscle size was obtained using cardiac MRI. Patients were stratified by the tertiles of axial thoracic skeletal muscle index (SMI). LV structural and functional indices, as well as amino-terminal pro-B-type natriuretic peptide (NT-proBNP), were measured. The determinants of elevated NT-proBNP were assessed using linear regression analysis. The associations between thoracic SMI and clinical outcomes were assessed using a multivariable Cox proportional hazards model. Results Patients in the lowest tertile of thoracic SMI displayed a deterioration in LV systolic strain in three components, together with an increase in LV mass and a heavier burden of myocardial fibrosis (all P

Abstract Wearable Internet of Things (WIoT) and Artificial Intelligence (AI) are rapidly emerging technologies for healthcare. These technologies enable seamless data collection and precise analysis toward fast, resource-abundant, and personalized patient care. However, conventional machine learning workflow requires data to be transferred to the remote cloud server, which leads to significant privacy concerns. To tackle this problem, researchers have proposed federated learning, where end-point users collaboratively learn a shared model without sharing local data. However, data heterogeneity, i.e., variations in data distributions within a client (intra-client) or across clients (inter-client), degrades the performance of federated learning. Existing state-of-the-art methods mainly consider inter-client data heterogeneity, whereas intra-client variations have not received much attention. To address intra-client variations in federated learning, we propose a federated clustered multi-domain learning algorithm based on ClusterGAN, multi-domain learning, and graph neural networks. We applied the proposed algorithm to a case study on stress-level prediction, and our proposed algorithm outperforms two state-of-the-art methods by 4.4% in accuracy and 0.06 in the F1 score. In addition, we demonstrate the effectiveness of the proposed algorithm by investigating variants of its different modules.

Abstract Transmembrane serine protease 6 (Tmprss6) has been correlated with the occurrence and progression of tumors, but any specific molecular mechanism linking the enzyme to oncogenesis has remained elusive thus far. In the present study, we found that Tmprss6 markedly inhibited mouse neuroblastoma N2a (neuro-2a) cell proliferation and tumor growth in nude mice. Tmprss6 inhibits Smad1/5/8 phosphorylation by cleaving the bone morphogenetic protein (BMP) co-receptor, hemojuvelin (HJV). Ordinarily, phosphorylated Smad1/5/8 binds to Smad4 for nuclear translocation, which stimulates the expression of hepcidin, ultimately decreasing the export of iron through ferroportin 1 (FPN1). The decrease in cellular iron levels in neuro-2a cells with elevated Tmprss6 expression limited the availability of the metal forribo nucleotide reductase activity, thereby arresting the cell cycle prior to S phase. Interestingly, Smad4 promoted nuclear translocation of activating transcription factor 3 (ATF3) to activate the p38 mitogen-activated protein kinases signaling pathway by binding to ATF3, inducing apoptosis of neuro-2a cells and inhibiting tumor growth. Disruption of ATF3 expression significantly decreased apoptosis in Tmprss6 overexpressed neuro-2a cells. Our study describes a mechanism whereby Tmprss6 regulates the cell cycle and apoptosis. Thus, we propose Tmprss6 as a candidate target for inhibiting neuronal tumor growth.

The microstructure and impact toughness of subcritically reheated coarse-grained heat-affected zone (SCGHAZ) of X80 pipeline steels with different Mo content (0Mo and 0.11 wt%Mo) were investigated. Gleeble 3500 thermal simulation experiment was used to simulate the heat-affected zone (HAZ) of X80 pipeline circumferential weld, and the two samples were characterized by a series of material testing techniques such as SEM, TEM, EBSD and XRD. The research showed that: Appropriate addition of Mo element can improve the hardenability of the matrix, increase the content of bainitic ferrite (BF) in the microstructure, refine the BF lath, cause plastic deformation, and reduce local stress concentration. The increase of BF content greatly increases the proportion of high angle grain boundary (HAGB) in order to effectively inhibit crack propagation. On the other hand, Mo element influences precipitation with solid solution, reduces the early energy barrier for nucleation, delays the disappearance of dislocation lines at high temperature, forms high-density dislocation grid, so that it can increase the nucleation site for NbC precipitation, prevent the coarsing of NbC, increases the threshold of external stress required for the generation of micropores induced by precipitation, and hinder crack initiation. The impact toughness of SCGHAZ was significantly improved by adjusting the microstructure and second phase morphology of HAZ by using Mo element microalloying.

This study aims to develop simulation methods, performance evaluation methods, and optimization strategies for blood pumps. Computational fluid dynamics, in-vitro hemocompatibility experiments and clinical data were utilized to analyze 8 clinical blood pumps across approximately 150 conditions. Results indicated that using the transient RANS and LES models with over 20 million mesh cells improves predictions of hydraulic performance and haemocompatibility. Optimal haemolysis model coefficients were identified to align closely with experimental results. A method to assess thrombosis, bleeding, and stroke risks caused by blood pumps was developed and validated with clinical data. Single haemolysis indicators were found insufficient, highlighting the need for a multi-indicator method to evaluate haemocompatibility. An energy loss-based optimization strategy was proposed and applied to enhance the haemocompatibility of a blood pump. This study provides robust simulation, evaluation, and optimization methods applicable to blood pumps, facilitating their performance assessment and optimization.

AbstractIn contemporary times, the employment of vitrification freezing technology has led to the widespread adoption of frozen-thawed embryo transfer (FET) worldwide. Meanwhile, hormone replacement therapy (HRT) is a crucial protocol for priming the endometrium during FET cycles. Estrogen is required in HRT cycles for the induction of progesterone receptors and to promote endometrial thickness. However, there is no universal consensus on the treatment duration, dosage regimen, administration route, and target serum estrogen levels. Therefore, this study aimed to offer a comprehensive review of these topics. A shorter duration of estrogen exposure may elevate the risk of early miscarriage, while prolonged exposure to estrogen does not seem to confer advantages to general population and may be attempted in individuals with thin endometrium. Moreover, excessive estrogen levels on the day of progesterone administration may be associated with higher miscarriage rates and lower live birth rates (LBR). To offer more comprehensive guidance for clinical practice, extensive and prospective studies involving a large sample size are warranted to determine the optimal concentration and duration of estrogen exposure.

AbstractThis study aims to evaluate the effectiveness of various individual machine learning and their ensemble techniques such as Stacking, Voting and Meta-learning in landslide susceptibility assessment taking Poyang, Jiangxi, China as an example. Multi-source geo-environmental data including field surveys, Sentinel-2A/B satellite images, Digital Elevation Models (DEM), and geological and hydrological data were utilized to construct and validate landslide susceptibility models. Results show that the Stacking Classifier outperformed other models, achieving the highest F1 Score of 0.846 and AUC (Area Under ROC Curve) of 0.923, demonstrating its strong predictivity, followed by the Voting Classifier with the F1 Score of 0.829 and AUC of 0.922. Among the individual models, the Multi-Layer Perceptron (MLP) performed best with the F1 Score of 0.828 and AUC of 0.904. Furthermore, the explainable Artificial Intelligence (XAI) technique was applied to better understand the mechanism of classifiers in predicting landslide susceptibility and it suggests a significant correlation between land use, distance to fault, and landslide occurrences. In conclusion, Stacking and Voting hybrid learning models show clear advantages over the individual ones for landslide risk zoning. The results of study may provide technical support for disaster mitigation efforts and future urban planning in areas prone to landslides in Poyang.

ABSTRACTMonitoring rapidly changing inland water bodies using remote sensing requires a temporal resolution of at least 3 days and a spatial resolution of at least 30 meters. However, the current satellite data falls short of meeting these monitoring requirements. Spatiotemporal fusion (STF) presents an effective method for obtaining continuous high-resolution data. This study explores five established STF algorithms, namely Spatial and Temporal Adaptive Reflectance Fusion Model (STARFM), Enhanced Spatial and Temporal Adaptive Reflectance Fusion Model (ESTARFM), Robust Adaptive Spatial and Temporal Fusion Model (RASTFM), Flexible Spatiotemporal Data Fusion (FSDAF) and Unmixing-Based Data Fusion (UBDF), through experimentation across 45 lakes worldwide. Results are comprehensively compared and analyzed using two indicators: Root Mean Square Error (RMSE) and Robert’s edge (Edge) based on a dataset that contains 360 image pairs collected in 2021. The five algorithms underwent 950 random experiments. The results indicate that: (1) ESTARFM outperforms the other four algorithms in terms of visual effect and accuracy assessment. Its average RMSE of and EDGE are 0.0023 sr−1 and −0.0419, respectively. Followed by: FSDAF (RMSE: 0.0026 sr−1, EDGE: −0.0584), RASTFM (RMSE: 0.0029 sr−1, EDGE: −0.4128), STARFM (RMSE: 0.0027 sr−1, EDGE: −0.5207), and UBDF (RMSE: 0.0030 sr−1, EDGE: −0.6505) algorithms. (2) the algorithms have varied performance in different water monitoring missions: for water body extraction, the ESTARFM and FSDAF algorithms are recommended; for algae bloom detection, the FSDAF algorithm is recommended; for seasonal water body monitoring, the ESTARFM is recommended; for quantitative monitoring, the ESTARFM, FSDAF, and UBDF algorithms are recommended. (3) STARFM-like algorithms are sensitive to radiometric uncertainties and UBDF algorithm is sensitive to spatial uncertainties. The findings of this study can help generate high spatiotemporal resolution remote sensing datasets for water quality monitoring, waterbody detection, algae bloom tracking, and other water environmental monitoring missions.

ABSTRACTIn the context of global warming and the increasing water shortage in dry areas, it is necessary to find a sustainable pathway for utilization of land resources (ULR) to solve these problems. For this purpose, using socioeconomic and environmental indicators from 2006 to 2018 and taking the Tarim Basin, China as an example, this study employed an integrated approach composed of the indicator evaluation system (IES) and the System Dynamics (SD) model to evaluate the possibility of sustainable ULR in the basin. During the simulation, three scenarios namely traditional development (TD), economic priority (EP) and harmonious development (HD) were designed, and different thresholds were set for each indicator of potential ULR in each sub-region to predict their future development status. The IES was established to derive the sustainable utilization degree (SUD) of ULR. The results show that the SUD in Tarim in 2030 is likely be 0.60 (TD), 0.62 (EP) and 0.68 (HD), indicating that only in HD scenario is it possible to find pathway to solve water scarcity problem and achieve sustainable ULR. This study provides a supportive idea for decision-making on sustainable ULR in Tarim and also an approach for similar sustainability assessment in other dry areas.

ABSTRACTThis open-label, randomized, phase 3 study in China (V260-074; NCT04481191) evaluated the immunogenicity and safety of concomitant and staggered administration of three doses of an oral, live, pentavalent rotavirus vaccine (RV5) and three doses of an intramuscular, inactivated poliomyelitis vaccine (IPV) in 400 healthy infants. The primary objective was the non-inferiority of neutralizing antibody (nAb) responses in the concomitant- versus the staggered-use groups. Antibody responses were measured at baseline and 1-month post-dose 3 (PD3). Parents/legal guardians recorded adverse events for 30 or 15 d after study vaccinations in the concomitant-use or staggered-use groups, respectively. At PD3, >98% of participants seroconverted to all three poliovirus types, and the primary objective was met as lower bounds of the two-sided 95% CI for between-group difference in nAb seroconversion percentages ranged from − 4.3% to − 1.6%, for all poliovirus types, p

Background Renal microcirculation plays a pivotal role in kidney function by maintaining structural and functional integrity, facilitating oxygen and nutrient delivery, and waste removal. However, a thorough bibliometric analysis in this area remains lacking. Therefore, we aim to provide valuable insights through a bibliometric analysis of renal microcirculation literature using the Web of Science database.Methods We collected renal microcirculation-related publications from the Web of Science database from January 01, 1990, to December 31, 2022. The co-authorship of authors, organizations, and countries/regions was analyzed with VOSviewer1.6.18. The co-occurrence of keywords and co-cited references were analyzed using CiteSpace6.1.R6 software to generate visualization maps. Additionally, burst detection was applied to keywords and cited references to forecast research hotspots and future trends.Results Our search yielded 7462 publications, with the American Journal of Physiology-Renal Physiology contributing the most articles. The United States, Mayo Clinic, and Lerman Lilach O emerged with the highest publication count, indicating their active collaborations. ‘Type 2 diabetes’ was the most significant keyword cluster, and ‘diabetic kidney disease’ was the largest cluster of cited references. ‘Cardiovascular outcome’ and ‘diabetic kidney diseases’ were identified as keywords in their burst period over the past three years.Conclusion Our bibliometric analysis illuminates the contours of nephrology and microcirculation research, revealing a landscape ripe for challenges and the seeds of future scientific innovation. While the trends discerned from the literature emerging opportunities in diagnostic innovation, renal microcirculation research, and precision medicine interventions, their translation to clinical practice is anticipated to be a deliberate process.

This study aimed to investigate the correlation between ultrafiltration rate (UFR) and hemoglobin levels and erythropoietin (EPO) response in patients receiving maintenance hemodialysis (MHD). 225 MHD patients were divided into three groups according to the UFR: < 10 ml/h/kg, 10–13 ml/h/kg, and >13 ml/h/kg. Clinical parameters and prognosis were compared among the groups. Multiple linear correlation and regression analyses were conducted. SPSS 26.0 (IBM, Chicago, IL, USA) was used to analyze all statistics. The UFR < 10 ml/h/kg group was older than the other groups (p 13 ml/h/kg group had the highest SpKt/V (p

AbstractFluid shear plays a key role in hemostasis and thrombosis, and the purpose of this study was to investigate the effect of shear gradient change rate (SGCR) on platelet reactivity and von Willebrand factor (vWF) activity and its mechanism. In this study, we developed a set of microfluidic chips capable of generating different shear gradients and simulated the shear rate distribution in the flow field by COMSOL Multiphysics software. Molecular markers of platelet activation (P-selectin, activated GPIIb/IIIa, phosphatidylserine exposure, and monocyte-platelet aggregate formation) were analyzed by flow cytometry. Platelet aggregation induced by shear gradient was studied by a microfluidic experimental platform, and plasma vWF ristocetin cofactor (vWF: RCO) activity was investigated by flow cytometry. The expression of p-Akt was studied by Western blotting. The results showed that the faster the SGCR, the higher the expression of platelet p-Akt, and the stronger the platelet reactivity and vWF activity. This indicates that fluid shear stress can activate platelets and vWF in a shear gradient-dependent manner through the PI3K/AKT signal pathway, and the faster the SGCR, the more significant the activation effect.

In this article, Chinese German learners’ use of the prepositions um and in is analyzed in the context of conceptual metaphor theory using the CDLK corpus and Falko corpus. The study reveals that the error rate of the preposition in is significantly higher than that of the preposition um, which is ultimately due to the differences in cultural and conceptual systems between Germany and China. Chinese German learners use the spatial and temporal meanings of the prepositions more frequently, while they use the metaphorical meanings less frequently. Furthermore, there is no clear correlation between the learning time of Chinese German learners and the number of errors. The conclusions of this study could provide insights for improvements in teaching.

Abstract As the fourth largest CO2 emitter, Russia's constituent entities collectively contribute with vast territory and regional heterogeneity. Existing studies only present production‐based inventories; state‐level consumption‐based emissions patterns and driving forces remain rare. Here, we built the Russia state‐level Multi‐regional input‐output table to ascertain heterogeneity in consumption‐based emissions and track carbon flows in the inter‐state. We found that 60% of consumption‐based emissions coming from affluent areas (top 20% of the GRP), including Moscow (139.1 Mt) and St. Petersburg (50.5 Mt). Energy‐intensive regions also had huge consumption‐based emissions (31.6 Mt in Khanty‐Mansi Autonomous Okrug and 29.4 Mt in Republic of Tatarstan). Household consumption emissions accounted for 41%–73% of consumption‐based emissions in the 83 regions, except for Tula and Lipetsk, where fixed capital formation dominated. In addition, the major contributor of embodied emissions in households were power and services sectors, which contributed about 8%–61% (0.03 Mt–12.7 Mt) and 12%–40% (0.1 Mt–20.1 Mt). In Russia's low carbon transition, policymakers should not only focus on a local mitigation policy in developed states (such as Moscow and St. Petersburg), but on key sectors to curb the consumption. Regions with high carbon intensity should switch to renewable energy and implement cleaner production techniques in high‐emission industries.

Abstract Copper, a trace element and vital cofactor, plays a crucial role in the maintenance of biological functions. Recent evidence has established significant correlations between copper levels, cancer development and metastasis. The strong redox‐active properties of copper offer both benefits and disadvantages to cancer cells. The intestinal tract, which is primarily responsible for copper uptake and regulation, may suffer from an imbalance in copper homeostasis. Colorectal cancer (CRC) is the most prevalent primary cancer of the intestinal tract and is an aggressive malignant disease with limited therapeutic options. Current research is primarily focused on the relationship between copper and CRC. Innovative concepts, such as cuproplasia and cuproptosis, are being explored to understand copper‐related cellular proliferation and death. Cuproplasia is the regulation of cell proliferation that is mediated by both enzymatic and nonenzymatic copper‐modulated activities. Whereas, cuproptosis refers to cell death induced by excess copper via promoting the abnormal oligomerisation of lipoylated proteins within the tricarboxylic acid cycle, as well as by diminishing the levels of iron‐sulphur cluster proteins. A comprehensive understanding of copper‐related cellular proliferation and death mechanisms offers new avenues for CRC treatment. In this review, we summarise the evolving molecular mechanisms, ranging from abnormal intracellular copper concentrations to the copper‐related proteins that are being discovered, and discuss the role of copper in the pathogenesis, progression and potential therapies for CRC. Understanding the relationship between copper and CRC will help provide a comprehensive theoretical foundation for innovative treatment strategies in CRC management.

Objectives: This study aimed to develop and validate a radiomics nomogram based on multiparameter MRI for preoperative differentiation of type II and type I endometrial carcinoma (EC). Methods: A total of 403 EC patients from two centers were retrospectively recruited (training cohort, 70 %; validation cohort, 30 %). Radiomics features were extracted from T2-weighted imaging, dynamic contrast-enhanced T1-weighted imaging at delayed phase(DCE4), and apparent diffusion coefficient (ADC) maps. Following dimensionality reduction, radiomics models were developed by logistic regression (LR), random forest (RF), bootstrap aggregating (Bagging), support vector machine (SVM), artificial neural network (ANN), and naive bayes (NB) algorithms. The diagnostic performance of each radiomics model was evaluated using the ROC curve. A nomogram was constructed by incorporating the optimal radiomics signatures with significant clinical-radiological features and immunohistochemistry (IHC) markers obtained from preoperative curettage specimens. The diagnostic performance and clinical value of the nomogram were evaluated using ROC curves, calibration curves, and decision curve analysis (DCA). Results: Among the radiomics models, the NB model, developed from 12 radiomics features derived from ADC and DCE4 sequences, exhibited strong performance in both training and validation sets, with the AUC values of 0.927 and 0.869, respectively. The nomogram, incorporating the radiomics model with significant clinical-radiological features and IHC markers, demonstrated superior performance in both the training (AUC = 0.951) and the validation sets (AUC = 0.915). Additionally, it exhibited excellent calibration and clinical utility. Conclusions: The radiomics nomogram has great potential to differentiate type II from type I EC, which may be an effective tool to guide clinical decision-making for EC patients.

Two-dimensional metal chalcogenides have garnered significant attention as promising candidates for novel neuromorphic synaptic devices due to their exceptional structural and optoelectronic properties. However, achieving large-scale integration and practical applications of synaptic chips has proven to be challenging due to significant hurdles in materials preparation and the absence of effective nanofabrication techniques. In a recent breakthrough, we introduced a revolutionary allopatric defect-modulated Fe7S8@MoS2 synaptic heterostructure, which demonstrated remarkable optoelectronic synaptic response capabilities. Building upon this achievement, our current study takes a step further by presenting a sulfurization-seeding synergetic growth strategy, enabling the large-scale and arrayed preparation of Fe7S8@MoS2 heterostructures. Moreover, a three-dimensional vertical integration technique was developed for the fabrication of arrayed optoelectronic synaptic chips. Notably, we have successfully simulated the visual persistence function of the human eye with the adoption of the arrayed chip. Our synaptic devices exhibit a remarkable ability to replicate the preprocessing functions of the human visual system, resulting in significantly improved noise reduction and image recognition efficiency. This study might mark an important milestone in advancing the field of optoelectronic synaptic devices, which significantly prompts the development of mature integrated visual perception chips.

Study region: a typical humid karst region of southwestern China. Study focus: Temporally stable soil moisture variability (SMV) helps clarify stress on vegetation growth. In the humid karst region of southwest China, large-scale vegetation restoration has affected the soil moisture. However, most studies here have focused on changes in the soil moisture content, and changes in the SMV have not been considered. New hydrological insights for the region: In this study, changes to the SMV after vegetation restoration were analyzed using two indicators: the soil moisture coefficient of variation(SMCV) and soil moisture memory(SMM). The results showed that the SMCV decreased by an average of 22.3 % and the SMM increased by an average of 17.2 % in the Karst region of southwest China. the SMV had significantly decreased after vegetation restoration, and the overall decrease was larger on 15-day, monthly, and yearly scales and smaller on the weekly scale.When the effects of different vegetation types were considered, SMV greatly decreased in forestland and grassland on the 15-day and monthly scales, in shrubland on the annual scale, and in sparse woodland on the 15-day, monthly, and annual scales. Four geomorphic regions in particular showed large reductions in the SMV: the karst basin, peak cluster depression, peak forest plain, and non-karst region. In addition, changes in SMV after vegetation restoration have a significant positive influence on geochemical and climatic factors and a non-significant negative influence on geological structure factors. Among them, the significant influence factors of CaO content and MgO content are greater than SiO2 content by 0.71 and 0.63. precipitation and temperature are greater than vapor pressure difference by 0.51 and 0.4. Overall, vegetation restoration was found to make the SMV in the humid karst region more stable.

In recent years, aerosols have been recognized as a prominent medium for the transmission of antibiotic-resistant bacteria and genes. Among these, particles with a particle size of 2 μm (PM2.5) can directly penetrate the alveoli. However, the presence of antibiotic-resistant genes in aerosols from pet hospitals and the potential risks posed by antibiotic-resistant bacteria in these aerosols to humans and animals need to be investigated. In this study, cefotaxime-resistant bacteria were collected from 5 representative pet hospitals in Changchun using a Six-Stage Andersen Cascade Impactor. The distribution of bacteria in each stage was analyzed, and bacteria from stage 5 and 6 were isolated and identified. Minimal inhibitory concentrations of isolates against 12 antimicrobials were determined using broth microdilution method. Quantitative Polymerase Chain Reaction was employed to detect resistance genes and mobile genetic elements that could facilitate resistance spread. The results indicated that ARBs were enriched in stage 5 (1.1–2.1 μm) and stage 3 (3.3–4.7 μm) of the sampler. A total of 159 isolates were collected from stage 5 and 6. Among these isolates, the genera Enterococcus spp. (51%), Staphylococcus spp. (19%), and Bacillus spp. (14%) were the most prevalent. The isolates exhibited the highest resistance to tetracycline and the lowest resistance to cefquinome. Furthermore, 56 (73%) isolates were multidrug-resistant. Quantitative PCR revealed the expression of 165 genes in these isolates, with mobile genetic elements showing the highest expression levels. In conclusion, PM2.5 from pet hospitals harbor a significant number of antibiotic-resistant bacteria and carry mobile genetic elements, posing a potential risk for alveolar infections and the dissemination of antibiotic resistance genes.

Trimethylamine-N-oxide (TMAO) is a gut-derived metabolite formed from dietary choline and l-carnitine, known to impede cholesterol metabolism and is implicated in the pathogenesis of thrombosis and atherosclerosis, contributing to the etiology of cardiovascular diseases. We present a dataset derived from an experimental study designed to elucidate the cardiotoxic effects of TMAO. This dataset encompasses echocardiographic assessments from two cohorts of mice: one subjected to a 6-week regimen of 20 mg/kg/day TMAO injections (n = 16) and a control group (n = 18). Each subject's echocardiographic dataset comprises six high-resolution TIFF images, capturing both B-type and M-mode views in standard echocardiographic planes, along with two additional M-mode images enriched with analysed cardiac functional data. Complementing these images, a CSV-formatted report details critical cardiac parameters, including heart rate, ejection fraction, and fractional shortening, among others. In a novel approach to enhance data integrity and permit tailored analyses, we provide the original output files from the echocardiography apparatus, which researchers can reprocess using dedicated analysis software. This dataset is anticipated to be instrumental in advancing our understanding of the mechanistic links between TMAO exposure and cardiac dysfunction.

Rearrangements involving the neurotrophic-tropomyosin receptor kinase (NTRK) gene family (NTRK1, NTRK2, and NTRK3) have been identified as drivers in a wide variety of human cancers. However, the association between NTRK rearranged thyroid carcinoma and clinicopathological characteristics has not yet been established. In our study, we retrospectively reviewed medical records of thyroid cancer patients and identified 2 cases with NTRK rearrangement, no additional molecular alterations were observed in either of these cases. The fusion of the rearrangement in both cases was ETV6(E4)::NTRK3(E14). By analyzing the clinicopathological features of these two cases, we found that both were characterized by multiple tumor nodules, invasive growth, and central lymph node metastases, indicating the follicular subtype of papillary thyroid carcinoma. Immunohistochemical staining profiles showed CD56-, CK19+, Galectin-3+, HBME1+. These clinicopathological features suggest the possibility of ETV6-NTRK3 rearranged thyroid carcinoma and highlight the importance of performing gene fusion testing by FISH or NGS for these patients.

PurposeBulky tumor remains as a challenge to surgery, chemotherapy and conventional radiation therapy. Hence, in efforts to overcome this challenge, we designed a novel therapeutic paradigm via strategy of Stereotactic Central/Core Ablative Radiation Therapy (SCART).), which is based on the principles of SBRT (stereotactic body radiation therapy and spatially fractionated radiation therapy (SFRT). We intend to safely deliver an ablative dose to the core of the tumor and with a low dose at tumor edge. The purpose of the phase 1 study was to determine dose-limiting toxicities (DLT)s and the Maximum Tolerated Dose (MTD) of SCART.Methods and materialsWe defined a SCART-plan volume inside the tumor, which is proportional to the dimension of tumor. VMAT/Cyberknife technique was adopted. In the current clinical trial; Patients with biopsy proven recurrent or metastatic bulky cancers were enrolled. The five dose levels were 15 Gy X1, 15Gy X3, 18GyX3, 21GyX3 and 24GyX3, while keeping the whole tumor GTV’s border dose at 5Gy each fraction. There was no restriction on concurrent systemic chemotherapy agents.Results21 patients were enrolled and underwent SCART. All 21 patients have eligible data for study follow-up. Radiotherapy was well tolerated with all treatment completed as scheduled. The dose was escalated for two patients to 24GyX3. No grade 3 or higher toxicity was observed in any of the enrolled patients. The average age of patients was 66 years (range: 14–85) and 13 (62%) patients were male. The median SCART dose was 18Gy (range: 15 - 24). Six out of the 18 patients with data for overall survival (OS) died, and the median time to death was 16.3 months (range: 1 - 25.6). The mean percent change for tumor shrinkage between first visit volumes and post-SCART volumes was 49.5% (SD: 40.89, p-value:0.009).ConclusionSCART was safely escalated to 24 GyX 3 fractions, which is the maximum Tolerated Dose (MTD) for SCART. This regimen will be used in future phase II trials.

Abstract Endotoxemia‐related acute liver injury has a poor prognosis and high mortality, and macrophage polarization plays a central role in the pathological process. Pregnane X receptor (PXR) serves as a nuclear receptor and xenosensor, safeguarding the liver from toxic stimuli. However, the effect and underlying mechanism of PXR activation on endotoxemic liver injury remain largely unknown. Here, the expression of PXR is reported in human and murine macrophages, and PXR activation modified immunotypes of macrophages. Moreover, PXR activation significantly attenuated endotoxemic liver injury and promoted macrophage M2 polarization. Macrophage depletion by GdCl3 confirmed the essential of macrophages in the beneficial effects observed with PXR activation. The role of PXR in macrophages is further validated using AAV8‐F4/80‐Pxr shRNA‐treated mice; the PXR‐mediated hepatoprotection is impaired, and M2 polarization enhancement is blunted. Additionally, treatment with PXR agonists inhibited lipopolysaccharide (LPS)‐induced M1 polarization and favored M2 polarization in BMDM, Raw264.7, and THP‐1 cells. Further analyses revealed an interaction between PXR and p‐STAT6 in vivo and in vitro. Moreover, blocking Pxr or Stat6 abolished the PXR‐induced polarization shift. Collectively, macrophage PXR activation attenuated endotoxin‐induced liver injury and regulated macrophage polarization through the STAT6 signaling pathway, which provided a potential therapeutic target for managing endotoxemic liver injury.

Objective We compared the effects of early and delayed rehabilitation on the function of patients after rotator cuff repair by meta-analysis to find effective interventions to promote the recovery of shoulder function. Methods This meta-analysis was registered in PROSPERO (CRD42023466122). We manually searched the randomized controlled trials (RCTs) in the Cochrane Library, Pubmed, Cochrane Library, EMBASE, the China National Knowledge Infrastructure (CNKI), the China VIP Database (VIP), and the Wanfang Database to evaluate the effect of early and delayed rehabilitation after arthroscopic shoulder cuff surgery on the recovery of shoulder joint function. Review Manager 5.3 software was used to analyze the extracted data. Then, the PEDro scale was employed to appraise the methodological quality of the included research. Results This research comprised nine RCTs and 830 patients with rotator cuff injuries. According to the findings of the meta-analysis, there was no discernible difference between the early rehabilitation group and the delayed rehabilitation group at six and twelve months after the surgery in terms of the VAS score, SST score, follow-up rotator cuff healing rate, and the rotator cuff retear rate at the final follow-up. There was no difference in the ASES score between the early and delayed rehabilitation groups six months after the operation. However, although the ASES score in the early rehabilitation group differed significantly from that in the delayed rehabilitation group twelve months after the operation, according to the analysis of the minimal clinically important difference (MCID), the results have no clinical significance. Conclusions The improvement in shoulder function following arthroscopic rotator cuff surgery does not differ clinically between early and delayed rehabilitation. When implementing rehabilitation following rotator cuff repair, it is essential to consider the paradoxes surrounding shoulder range of motion and tendon anatomic healing. A program that allows for flexible progression based on the patient’s ability to meet predetermined clinical goals or criteria may be a better option.

Rana hanluica: an endemic amphibian of China, is found in the hills and mountains south of the Yangtze River. In this comprehensive study, we collected 162 samples from 14 different localities to delve into the genetic diversity of Rana hanluica using mitochondrial Cytb and nuclear RAG2 as genetic markers. Our findings reveal that the Nanling Mountains, specifically regions like Jiuyi Shan, Jinggang Shan, Mang Shan, and Qiyun Shan, are genetic hotspots harboring remarkable diversity. The research results also indicate that there is gene flow among the various populations of the species, and no distinct population structure has formed, which may be due to migration. Moreover, populations in some regions, as well as the overall population, show signs of a possible genetic bottleneck, which we speculate may have been caused by climate change. However, given the exploratory nature of our study, further investigations are warranted to confirm these observations. Through phylogenetic analyses, we uncovered indications that R. hanluica might have originated within the Nanling region, dispersing along the east-west mountain ranges, with a significant contribution originating from Jiuyi Shan. The genetic distributions uncovered through our research reflect historical migratory patterns, evident in the distinct haplotypes of the RAG2 gene between the western and eastern parts of the studied area. Moreover, Heng Shan and Yangming Shan exhibited unique genetic signatures, possibly influenced by geographic isolation, which has shaped their distinct genotypes. The insights gained from this study hold profound implications for conservation efforts. By identifying regions rich in genetic diversity and crucial gene flow corridors, we can develop more effective conservation strategies. Preserving these genetically diverse areas, especially within the Nanling Mountains, is vital for maintaining the evolutionary potential of R. hanluica. In conclusion, our research has laid a solid foundation for understanding the genetic landscape of R. hanluica, shedding light on its origins, population structures, and evolutionary trajectories. This knowledge will undoubtedly guide future research endeavors and inform conservation strategies for this endemic amphibian.

BackgroundThe effect of type 2 diabetes mellitus (T2DM) on coronary atherosclerosis detected on coronary computed tomography angiography (CCTA) in hypertensive patients has attracted increasing attention. This study investigated the relationships of T2DM with coronary artery plaque characteristics and semiquantitative CCTA scores in hypertensive patients.Materials and methodsIn this single-center study, 1,700 hypertensive patients, including 850 T2DM [HT(T2DM+)] and 850 non-T2DM [HT(T2DM−)] individuals, were retrospectively analyzed after propensity matching. Plaque type, extent, coronary stenosis, segment involvement score (SIS), segment stenosis score (SSS), and CT-based Leaman score (CT-LeSc) based on CCTA were assessed and compared between the two groups.ResultsHT(T2DM+) patients had more coronary segments with calcified plaque (2.08 ± 2.20 vs. 1.40 ± 1.91), mixed plaque (2.90 ± 2.87 vs. 2.50 ± 2.66), nonobstructive stenosis (4.23 ± 2.44 vs. 3.62 ± 2.42), and obstructive stenosis (1.22 ± 2.18 vs. 0.78 ± 1.51), a lower proportion of 1-vessel disease (15.3% vs. 25.5%), a higher proportion of 3-vessel disease (59.6% vs. 46.7%), and higher SIS (5.5 ± 3.1 vs. 4.4 ± 3.0), SSS (10.3 ± 8.5 vs. 7.7 ± 7.1), and CT-LeSc (9.4 ± 5.6 vs. 7.9 ± 5.2) than HT(T2DM−) patients (all P-values 4 (OR = 1.910), SSS > 6 (OR = 1.718), and CT-LeSc > 5 (OR = 1.584) in hypertension population (all P-values 5 in hypertensive patients. More attention should be given to the assessment and management for coronary atherosclerosis in hypertensive patients with T2DM, as this population may have a higher risk of cardiovascular events.

Abstract This study systematically analyzed the molecular mechanism and function of nuclear factor kappa B subunit 2 (NFKB2) in colorectal cancer (CRC) to investigate the potential of NFKB2 as a therapeutic target for CRC. Various experimental techniques, including RNA sequencing, proteome chip assays, and small molecule analysis, were used to obtain a deeper understanding of the regulation of NFKB2 in CRC. The results revealed that NFKB2 was upregulated in a significant proportion of patients with advanced hepatic metastasis of CRC. NFKB2 played an important role in promoting tumor growth through CD8+ T‐cell exhaustion. Moreover, NFKB2 directly interacted with signal transducer and activator of transcription 2 (STAT2), leading to increased phosphorylation of STAT2 and the upregulation of programmed death ligand 1 (PD‐L1). Applying a small molecule inhibitor of NFKB2 (Rg5) led to a reduction in PD‐L1 expression and improved response to programmed death‐1 blockade‐based immunotherapy. In conclusion, the facilitated NFKB2‐STAT2/PD‐L1 axis may suppress immune surveillance in CRC and targeting NFKB2 may enhance the efficacy of immunotherapeutic strategies. Our results provide novel insights into the molecular mechanisms underlying the contribution of NFKB2 in CRC immune escape.

Maritime area detection technology applies equipment such as high-orbit satellites, gateway ships and Unmanned Aerial Vehicles to detection. In this scenario, real-time uploading and analysis of maritime data is crucial. In the existing scenario, UAV data are gathered to the gateway ship and uploaded to the shore-based cloud via the high-orbit satellite, because the communication distance of the high-orbit satellite is far, and when the uploaded data volume is large or the access to the equipment increases, the propagation delay of the uploading of the data from the gateway ship to the satellite and the forwarding of the data from the satellite to the shore-based cloud is longer, and the processing delay of the shore-based cloud is increased, and the efficiency of the data transmission and communication will be affected as well. Aiming at the problem of increasing delay caused by communication limitations in maritime area detection, this paper proposes a maritime area detection scheme based on cloud-side collaboration. The scheme solves the problem of communication limitation from the following two aspects. First, the edge computing nodes are deployed on the ship side of the gateway, and the optimal offloading ratio is sought through game theory to offload a part of the tasks from the center cloud to the edge cloud for processing, which improves the efficiency of processing data and thus reduces the data transmission latency and data processing delay. Secondly, low-orbit (LEO) satellites are introduced to provide communication services, because low-orbit satellites have low orbital altitude and short propagation delay, which can transmit the data at the gateway ship to the shore-based cloud more quickly and improve the data transmission efficiency. Finally, it is also verified by designing experiments that the proposed scheme adopts the optimal offloading ratio and has a lower total delay than the original scheme, thus proving the effectiveness of the proposed scheme.

ObjectiveBreast cancer is highly heterogeneous, presenting challenges in prognostic assessment. Developing a universally applicable prognostic model could simplify clinical decision-making. This study aims to develop and validate a novel breast cancer prognosis model using coagulation-related genes with broad clinical applicability.MethodsA total of 203 genes related to coagulation were obtained from the KEGG database, and the mRNA data of 1,099 tumor tissue samples and 572 samples of normal tissue were retrieved from the TCGA-BRCA cohort and GTEx databases. The R package “limma” was utilized to detect variations in gene expression related to coagulation between the malignancies and normal tissue. A model was constructed in the TCGA cohort through a multivariable Cox regression analysis, followed by validation using the GSE42568 dataset as the testing set. Constructing a nomogram incorporating clinical factors to enhance the predictive capacity of the model. Utilizing the ESTIMATE algorithm to investigate the immune infiltration levels in groups with deferent risk. Performing drug sensitivity analysis using the “oncoPredict” package.ResultsA risk model consisting of six coagulation-associated genes (SERPINA1, SERPINF2, C1S, CFB, RASGRP1, and TLN2) was created and successfully tested for validation. Identified were 6 genes that serve as protective factors in the model’s development. Kaplan-Meier curves revealed a worse prognosis in the high-risk group compared to the low-risk group. The ROC analysis showed that the model accurately forecasted the overall survival (OS) of breast cancer patients at 1, 3, and 5 years. Nomogram accompanied by calibration curves can also provide better guidance for clinical decision-making. The low-risk group is more likely to respond well to immunotherapy, whereas the high-risk group may show improved responses to Gemcitabine treatment. Furthermore, individuals in distinct risk categories displayed different responses to various medications within the identical therapeutic category.ConclusionWe established a breast cancer prognostic model incorporating six coagulation-associated genes and explored its clinical utility. This model offers valuable insights for clinical decision-making and drug selection in breast cancer patients, contributing to personalized and precise treatment advancements.

The impact of mitochondrial dysfunction on the pathogenesis of cardiovascular disease is increasing. However, the precise underlying mechanism remains unclear. Mitochondria produce cellular energy through oxidative phosphorylation while regulating calcium homeostasis, cellular respiration, and the production of biosynthetic chemicals. Nevertheless, problems related to cardiac energy metabolism, defective mitochondrial proteins, mitophagy, and structural changes in mitochondrial membranes can cause cardiovascular diseases via mitochondrial dysfunction. Mitofilin is a critical inner mitochondrial membrane protein that maintains cristae structure and facilitates protein transport while linking the inner mitochondrial membrane, outer mitochondrial membrane, and mitochondrial DNA transcription. Researchers believe that mitofilin may be a therapeutic target for treating cardiovascular diseases, particularly cardiac mitochondrial dysfunctions. In this review, we highlight current findings regarding the role of mitofilin in the pathogenesis of cardiovascular diseases and potential therapeutic compounds targeting mitofilin.

Background: Psoriasis is a chronic, inflammatory skin disease with autoimmune characteristics. Recent research has made significant progress in the field of psoriasis metabolomics. However, there is a lack of bibliometric analysis on metabolomics of psoriasis. The objective of this study is to utilize bibliometrics to present a comprehensive understanding of the knowledge structure and research hotspots in psoriasis within the field of metabolomics. Methods: We conducted a bibliometric analysis by searching the Web of Science Core Collection database for publications on metabolomics in psoriasis from 2011 to 2024. To perform this analysis, we utilized tools such as VOSviewers, CiteSpace, and the R package ''bibliometrix''. Results: A total of 307 articles from 47 countries, with the United States and China leading the way, were included in the analysis. The publications focusing on metabolomics in psoriasis have shown a steady year-on-year growth. The Medical University of Bialystok is the main research institution. The International Journal of Molecular Sciences emerges as the prominent journal in the field, while the Journal of Investigative Dermatology stands out as the highly co-cited publication. A total of 2029 authors contributed to these publications, with Skrzydlewska Elzbieta, Baran Anna, Flisiak Iwona, Murakami Makoto being the most prolific contributors. Notably, Armstrong April W. received the highest co-citation. Investigating the mechanisms of metabolomics in the onset and progression of psoriasis, as well as exploring therapeutic strategies, represents the primary focus of this research area. Emerging research hotspots encompass inflammation, lipid metabolism, biomarker, metabolic syndrome, obesity, and arthritis. Conclusion: The results of this study indicate that metabolism-related research is thriving in psoriasis, with a focus on the investigation of metabolic targets and interventions within the metabolic processes. Metabolism is expected to be a hot topic in future psoriasis research.