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Abstract Purpose To compare the difference in analgesic effect between femoral triangle block (FTB) and adductor canal block (ACB) during arthroscopic knee surgery. Methods Patients who underwent arthroscopic knee surgery were randomized preoperatively to FTB group or ACB group. For each group, 20 mL of 0.1% ropivacaine was injected. Primary outcomes: The numeric rating score (NRS) at 12 h after surgery at rest and during movement. Secondary outcome: (1) The NRS at post anesthesia care unit (PACU) and 2, 24 h after surgery at rest and during movement; (2) The quadriceps muscle strength at PACU and 2, 12, 24 h after surgery; (3) Consumption of Rescue analgesia; (4) Incidence of adverse reactions. Results The NRS at 12 h after surgery at rest and during movement of ACB group were higher than FTB group. Among secondary outcomes, the NRS at PACU at rest and during movement, 2 h after surgery during movement of FTB group lower than ACB group; the quadriceps muscle strength at 2 h after surgery of FTB group stronger than ACB group. After multiple linear regression model analysis, the data showed additional statistically significant reduction NRS at 24 h after surgery at rest (0.757, p = 0.037) in FTB group. Other outcomes were similar between two groups. Conclusions The FTB appears to provide superior pain control after knee arthroscopy than ACB, the FTB is superior to the ACB in quadriceps muscle strength at 2 h after surgery. Trial registration The trial was registered in the Chinese Clinical Trial Registry (ChiCTR2300068765). Registration date: 28/02/2023.

Abstract Ductal carcinoma in situ (DCIS) represents pre-invasive breast carcinoma. In untreated cases, 25–60% DCIS progress to invasive ductal carcinoma (IDC). The challenge lies in distinguishing between non-progressive and progressive DCIS, often resulting in over- or under-treatment in many cases. With increasing screen-detected DCIS in these years, the nature of DCIS has aroused worldwide attention. A deeper understanding of the biological nature of DCIS and the molecular journey of the DCIS-IDC transition is crucial for more effective clinical management. Here, we reviewed the key signaling pathways in breast cancer that may contribute to DCIS initiation and progression. We also explored the molecular features of DCIS and IDC, shedding light on the progression of DCIS through both inherent changes within tumor cells and alterations in the tumor microenvironment. In addition, valuable research tools utilized in studying DCIS including preclinical models and newer advanced technologies such as single-cell sequencing, spatial transcriptomics and artificial intelligence, have been systematically summarized. Further, we thoroughly discussed the clinical advancements in DCIS and IDC, including prognostic biomarkers and clinical managements, with the aim of facilitating more personalized treatment strategies in the future. Research on DCIS has already yielded significant insights into breast carcinogenesis and will continue to pave the way for practical clinical applications.

Abstract Osteoarthritis (OA) is a chronic degenerative disease resulting joint disability and pain. Accumulating evidences suggest that chondrocyte extracellular matrix calcification plays an important role in the development of OA. Here, we showed that Krüppel-like factor 10 (Klf10) was involved in the regulation of chondrocyte extracellular matrix calcification by regulating the expression of Frizzled9. Knockdown of Klf10 attenuated TBHP induced calcification and reduced calcium content in chondrocytes. Restoring extracellular matrix calcification of chondrocytes could aggravate chondrocyte senescence. Destabilization of a medial meniscus (DMM) mouse model of OA, in vivo experiments revealed that knockdown Klf10 improved the calcification of articular cartilage and ameliorated articular cartilage degeneration. These findings suggested that knockdown Klf10 inhibited extracellular matrix calcification-related changes in chondrocytes and alleviated chondrocyte senescence.

Abstract Background In order to improve survival outcomes in resectable non‐small cell lung cancer (NSCLC), strategies for neoadjuvant therapy need to be revisited. We evaluated and compared the efficacy of different neoadjuvant therapeutic modalities in a real‐world setting. Methods A total of 258 patients with clinical stage IIA to IIIB NSCLC was included. All the patients underwent surgical resection after one to four cycles of neoadjuvant treatment consisting of chemotherapy (83), immunotherapy (23), and immunotherapy plus chemotherapy (152). Results The radiologic response rate in the combined immunochemotherapy group was 67.8%, higher than that of 48.2% in the chemotherapy group and 4.3% in the immunotherapy group (p

The rapid advancement of artificial intelligence (AI) has impacted society in many aspects. Alongside this progress, concerns such as privacy violation, discriminatory bias, and safety risks have also surfaced, highlighting the need for the development of ethical, responsible, and socially beneficial AI. In response, the concept of trustworthy AI has gained prominence, and several guidelines for developing trustworthy AI have been proposed. Against this background, we demonstrate the significance of psychological research in identifying factors that contribute to the formation of trust in AI. Specifically, we review research findings on interpersonal, human-automation, and human-AI trust from the perspective of a three-dimension framework (i.e., the trustor, the trustee, and their interactive context). The framework synthesizes common factors related to trust formation and maintenance across different trust types. These factors point out the foundational requirements for building trustworthy AI and provide pivotal guidance for its development that also involves communication, education, and training for users. We conclude by discussing how the insights in trust research can help enhance AI’s trustworthiness and foster its adoption and application.

Background:Langerhans cell histiocytosis is a rare disease characterized by the abnormal proliferation of Langerhans cells within a single organ or multiple organs. This case report aims to improve the knowledge of the presentation of gastrointestinal Langerhans cell histiocytosis to facilitate the diagnosis and management of this rare disorder.Case presentation:A 19-month-old female presented with repeatedly mucinous bloody stools. The abdominal ultrasound revealed a slightly enlarged spleen. The initial colonoscopy revealed chronic enteritis with a very early onset inflammatory bowel disease. After anti-inflammatory treatment without improvement, an intestinal biopsy was performed at The Forth Affiliated Hospital of Zhejiang University. The final intestinal biopsy and histopathology examination confirmed the presence of Langerhans cell histiocytosis. After diagnosis, additional lung and head imaging examinations revealed no abnormalities. Her condition improved gradually after being treated with chemotherapy (vincristine and prednisone) and molecular-targeted drug(dalafinil) treatment.Conclusion:The clinical symptoms of Langerhans cell histiocytosis involving the gastrointestinal tract are not specific and may resemble symptoms observed in inflammatory bowel disease and other primary gastrointestinal tumors. Therefore, in cases of infants presenting with inflammatory gastrointestinal symptoms that do not resolve after treatment, a biopsy is essential to obtain a differential diagnosis.

In order to reduce the environmental pollution of economic development, countries around the world pursue high-quality economic development model. However, the relationship between R&D investment agglomeration and high-quality economic development has not been thoroughly revealed in existing studies. Taking 30 provincial-level regions in China from 2009 to 2018 as research samples, this paper empirically examines the relationship between regional R&D investment agglomeration and high-quality economic development by using system GMM method and spatial econometric model. Theoretical analysis shows that regional R&D investment agglomeration promotes regional high-quality economic development by increasing regional knowledge capital, improving innovation efficiency, and promoting knowledge spillovers through scale effect, synergy effect, and spillover effect, respectively. The empirical results show that regional R&D investment agglomeration can significantly promote regional high-quality economic development. The degree of regional integrated innovation can positively adjust the promotion effect of regional R&D investment agglomeration on regional high-quality economic development. Regional R&D investment agglomeration can effectively promote the high-quality economic development of surrounding regions.

The S-transform is a fundamental time–frequency (T-F) domain analysis method in ground penetrating radar (GPR) data processing and can be used for identifying targets, denoising, extracting thin layers, and high-resolution imaging. However, the S-transform spectrum experiences energy leakage near the instantaneous frequency. This phenomenon causes frequency components to erroneously spread over a wider range, impacting the accuracy and precision of GPR data processing. Synchrosqueezing is an effective method to prevent spectrum leakage. In this work, we introduce the synchrosqueezing generalized phase-shifting S-transform (SS-GPST). Initially, it resolves the compatibility issue between the S-transform and the synchrosqueezing strategy through phase-shifting. Subsequently, the SS-GPST accomplishes spectral energy focusing and resolution enhancement via a generalized parameter and synchrosqueezing. A synthetic signal test shows that the SS-GPST excels over other methods at focusing degree, spectral resolution, and signal reconstruction accuracy and speed. In actual GPR tunnel detection data processing, we assess the adaptability of the SS-GPST from three aspects: spectral energy distribution, thin layer identification, and data denoising. The results indicate: (1) compared to other methods, the SS-GPST accurately expresses spectral components with a strong focusing degree and fewer interference components; (2) high-frequency slices of the SS-GPST accurately detect the top and bottom interfaces of a 3.0–3.5 cm reinforcement protection layer; and (3) due to fewer interference components in the SS-GPST spectrum, reconstructing GPR profiles through the SS-GPST inverse transform is an efficient denoising technique. The SS-GPST demonstrates adaptability to different data processing purposes, offers high-resolution T-F spectra, and shows potential to supersede the S-transform.

Radiation-induced cerebral necrosis, also known as radiation encephalopathy, is a debilitating condition that significantly impacts the quality of life for affected patients. Secondary central nervous system lymphoma (SCNSL) typically arises from highly aggressive mature B-cell lymphoma, but rarely from extranodal natural killer T-cell lymphoma (ENKTL). Treatment will be guided by differentiation between lymphoma progression from brain necrosis, and is particularly important for critically ill patients in an acute setting. However, differential diagnosis remains challenging because they share similar clinical manifestations and have no specific imaging features. We present the case of a 52-year-old man with ENKTL who suffered an emergency brain herniation secondary to massive radiation necrosis. The diagnosis established by brain biopsy ultimately led to appropriate treatment. The importance of the diagnostic biopsy is highlighted in this case for distinguishing between radiation necrosis and SCNSL.

The southern red soil region (SRSR) of China, a region that is environmentally sensitive, suffers severe soil erosion (SE) as a result of climate change and human activity. The factors driving SE changes in the SRSR of China under changing settings have, however, only been the subject of a small number of research. Changting County is a typical SE area in the SRSR of China. The spatiotemporal variation characteristics of SE in Changting County from 2000 to 2020 were investigated using the revised universal soil loss equation (RUSLE), while the dominant factors influencing the spatiotemporal dynamic change of SE were analyzed using the optimal parametric geographical detector (OPGD) and logarithmic mean Divisia Index (LMDI). The results showed that the average annual soil erosion modulus in Changting County shows a decreasing trend, with the SE modulus decreased from 10.00 t·hm−2·a−1 in 2000 to 3.38 t·hm−2·a−1 in 2020. Slight SE intensity was the dominant SE class, accounting for more than 75% of the total area, and the proportion is trending upwards. Natural and anthropogenic factors showed significant effects on the spatial variation of SE, of which land use and vegetation cover were the main factors influencing the spatial distribution of SE. Furthermore, the interaction between these two dominant factors explained greatly the spatial variation of SE. The mitigation of SE was mainly attributed to the increase in vegetation cover following the implementation of various ecological projects, contributing to the reduction of SE by 68.7%. In addition, the changes in land use types and rainfall amounts also played positive roles in reducing SE, showing contributions of 20.2% and 11.1%, respectively.

Abstract Background The transforming growth factor-beta (TGF-β) signaling pathway is an important pathway associated with the pathogenesis of osteoarthritis (OA). This study was to investigate the involvement of circRNAs in the TGF-β signaling pathway. Methods Cell Counting Kit-8 (CCK-8) assay and 5-ethynyl-2′-deoxyuridine (EdU) assay were used to detect the proliferation of primary mouse chondrocytes (PMCs). RNA-sequencing together with bioinformatics analysis were used to systematically clarify TGF-β1 induced alternations of circRNAs in PMCs. The regulatory and functional role of circPhf21a was examined in PMCs. Downstream targets of circPhf21a were explored by RNA-sequencing after overexpression of circPhf21a and verified by RT-qPCR in PMCs. Finally, the role and mechanism of circPhf21a in OA were explored in mouse models. Results We found that TGF-β1 promoted the proliferation of PMCs. Meanwhile, RT-qPCR and western blotting indicated that TGF-β1 promoted extracellular matrix (ECM) anabolism. RNA-sequencing revealed that a total of 36 circRNAs were differentially expressed between PMCs treated with and without TGF-β1. Of these, circPhf21a was significantly decreased by TGF-β1. Furthermore, circPhf21a knockdown promoted the proliferation and ECM synthesis of PMCs, whereas overexpression of circPhf21a showed the opposite effects. Mechanically, the expression profiles of the mRNAs revealed that Vegfa may be the target of circPhf21a. Additionally, we found that circPhf21a was significantly upregulated in the mouse OA model, and inhibition of circPhf21a significantly relieved the progression of OA. Conclusions Our results found that TGF-β1 promoted the proliferation and ECM synthesis of PMCs via the circPhf21a-Vegfa axis, which may provide novel therapeutic targets for OA treatment. Video abstract