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Abstract Background The atherogenic index of plasma (AIP) is considered an independent risk factor for coronary artery disease (CAD). The present study investigated whether AIP correlates with the formation of coronary collateral circulation (CCC) in CAD patients with chronic total occlusion (CTO). Methods This retrospective study included 1093 CAD patients with CTO confirmed by coronary angiography from January 2020 to December 2020 at Beijing Anzhen Hospital. Based on the Rentrop scoring system, the patients were divided into the good CCC group and the poor CCC group. AIP was calculated by log (triglyceride/high-density lipoprotein cholesterol). Meanwhile, the study population was further divided into four groups according to the quartiles of AIP. Results Patients in the poor CCC group exhibited significantly higher AIP compared to those in the good CCC group (0.31 ± 0.27 vs. 0.14 ± 0.24, p

This study employed optical microscopy (OM), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDS) to investigate the impact of vanadium (V) on the microstructure and mechanical properties of gray cast iron (GCI) HT250. Additionally, Thermo-Calc software was employed to explore the influence of V on the solidification process. The results indicate that adding trace amounts of V in GCI forms a face-centered cubic VC phase, with the precipitation temperature of the VC phase gradually increasing. When the V content reaches 0.28 wt%, the VC phase begins to precipitate during the eutectic reaction. The incorporation of V consumes carbon, reducing the graphite content and promoting the formation of type D graphite. As the V content increases, there is an enlargement in the pearlite area ratio, a decrease in the pearlite layer spacing, and a reduction in the size of eutectic cells. These microstructural alterations lead to enhanced mechanical properties. The tensile strength peaks at 336 MPa with a V content of 0.77 wt%, representing a 29% increase compared to samples without added V. Similarly, the Vickers hardness increases with increasing V content, reaching a peak of 373 HV at 0.92 wt% V, a 27% increase compared to samples without V addition. However, at this point, the tensile strength decreases to 322 MPa.

Plasmid-mediated conjugative transfer of antibiotic resistance genes (ARGs) within the human and animal intestine represents a substantial global health concern. linoleic acid (LA) has shown promise in inhibiting conjugation in vitro, but its in vivo effectiveness in the mammalian intestinal tract is constrained by challenges in efficiently reaching the target site. Recent advancements have led to the development of waterborne polyurethane nanoparticles for improved drug delivery. In this study, we synthesized four waterborne polyurethane nanoparticles incorporating LA (WPU@LA) using primary raw materials, including N-methyldiethanolamine, 2,2'-(piperazine-1,4-diyl) diethanol, isophorone diisocyanate, castor oil, and acetic acid. These nanoparticles, identified as WPU0.89@LA, WPU0.99@LA, WPU1.09@LA, and WPU1.19@LA, underwent assessment for their pH-responsive release property and biocompatibility. Among these, WPU0.99@LA displayed superior pH-responsive release properties and biocompatibility towards Caco-2 and IPEC-J2 cells. In a mouse model, a dosage of 10 mg/kg/day WPU0.99@LA effectively reduced the conjugation of IncX4 plasmids carrying the mobile colistin resistance gene (mcr-1) by more than 45.1-fold. In vivo toxicity assessment demonstrated that 10 mg/kg/day WPU0.99@LA maintains desirable biosafety and effectively preserves gut microbiota homeostasis. In conclusion, our study provides crucial proof-of-concept support, demonstrating that WPU0.99@LA holds significant potential in controlling the spread of antibiotic resistance within the mammalian intestine.

Chitosan is a naturally-occurring alkaline polysaccharide with excellent biocompatibility, biodegradability, low toxicity, and easy preparation. It has been widely used in the construction of delivery systems for various nutrients and bioactive substances. The chitosan-based nutrient delivery systems are mainly constructed by cross-linking, drying, layer-by-layer self-assembly, coalescence, covalent grafting, microfluidics and biosynthesis. Chitosan can be combined with carbohydrates, proteins and liposomes to form a composite carrier that can obtain more excellent performance and broaden its application in food packaging materials, slow release of bioactive substances and probiotic embedding. In addition, this paper further analyzes the obstacles and limitations of the actual application of chitosan-based nutrient delivery systems in the food industry, to provide important references for the application of chitosan-based delivery carriers in imparting new functional properties to foods, developing new food ingredients, and nutrient fortification.

Abstract Defense-associated sirtuin 2 (DSR2) systems are widely distributed across prokaryotic genomes, providing robust protection against phage infection. DSR2 recognizes phage tail tube proteins and induces abortive infection by depleting intracellular NAD+, a process that is counteracted by another phage-encoded protein, DSR Anti Defense 1 (DSAD1). Here, we present cryo-EM structures of Bacillus subtilis DSR2 in its apo, Tube-bound, and DSAD1-bound states. DSR2 assembles into an elongated tetramer, with four NADase catalytic modules clustered in the center and the regulatory-sensing modules distributed at four distal corners. Interestingly, monomeric Tube protein, rather than its oligomeric states, docks at each corner of the DSR2 tetramer to form a 4:4 DSR2-Tube assembly, which is essential for DSR2 NADase activity. DSAD1 competes with Tube for binding to DSR2 by occupying an overlapping region, thereby inhibiting DSR2 immunity. Thus, our results provide important insights into the assembly, activation and inhibition of the DSR2 anti-phage defense system.

Flexible pressure sensors are lightweight and highly sensitive, making them suitable for use in small portable devices to achieve precise measurements of tiny forces. This article introduces a low-cost and easy-fabrication strategy for piezoresistive flexible pressure sensors. By embedding silver nanowires into a polydimethylsiloxane layer with micro-pyramids on its surface, a flexible pressure sensor is created that can detect low pressure (17.3 Pa) with fast response (

ABSTRACT Mycophenolate mofetil (MMF) is commonly utilized for the treatment of neuromyelitis optica spectrum disorders (NMOSD). However, a subset of patients experience significant gastrointestinal (GI) adverse effects following MMF administration. The present study aims to elucidate the underlying mechanisms of MMF-induced GI toxicity in NMOSD. Utilizing a vancomycin-treated mouse model, we compiled a comprehensive data set to investigate the microbiome and metabolome in the GI tract to elucidate the mechanisms of MMF GI toxicity. Furthermore, we enrolled 17 female NMOSD patients receiving MMF, who were stratified into non-diarrhea NMOSD and diarrhea NMOSD (DNM) groups, in addition to 12 healthy controls. The gut microbiota of stool samples was analyzed using 16S rRNA gene sequencing. Vancomycin administration prevented weight loss and tissue injury caused by MMF, affecting colon metabolomes and microbiomes. Bacterial β-glucuronidase from Bacteroidetes and Firmicutes was linked to intestinal tissue damage. The DNM group showed higher alpha diversity and increased levels of Firmicutes and Proteobacteria. The β-glucuronidase produced by Firmicutes may be important in causing gastrointestinal side effects from MMF in NMOSD treatment, providing useful information for future research on MMF.IMPORTANCENeuromyelitis optica spectrum disorder (NMOSD) patients frequently endure severe consequences like paralysis and blindness. Mycophenolate mofetil (MMF) effectively addresses these issues, but its usage is hindered by gastrointestinal (GI) complications. Through uncovering the intricate interplay among MMF, gut microbiota, and metabolic pathways, this study identifies specific gut bacteria responsible for metabolizing MMF into a potentially harmful form, thus contributing to GI side effects. These findings not only deepen our comprehension of MMF toxicity but also propose potential strategies, such as inhibiting these bacteria, to mitigate these adverse effects. This insight holds broader implications for minimizing complications in NMOSD patients undergoing MMF therapy.

Purpose: Invasive micropapillary carcinoma (IMPC) of the breast has a high propensity for lymphovascular invasion and axillary lymph node metastasis and displays an ‘inside-out’ growth pattern, but the molecular mechanism of invasion, metastasis and cell polarity reversal in IMPC is unclear. Methods: and Patients: Cell growth curves, tumor sphere formation assays, transwell assays, mouse xenograft model and immunofluorescence were evaluated to investigate the effects of miR-30c and MTDH. Dual luciferase reporter assays was performed to confirm that the MTDH (metadherin) 3′UTR bound to miR-30c. MiRNA in situ hybridization (ISH) and immunohistochemistry (IHC) were carried out on IMPC patient tissues for miR-30c and MTDH expression, respectively. Results: We found miR-30c as a tumor suppressor gene in cell proliferation, metastasis and polarity reversal of IMPC. Overexpression of miR-30c inhibited cell growth and metastasis in vitro and in vivo. MiR-30c could directly target the MTDH 3′UTR. MiR-30c overexpression inhibited breast cancer cell proliferation, invasion and metastasis by targeting MTDH. Moreover, miR-30c/MTDH axis could also regulate cell polarity reversal of IMPC. By ISH and IHC analyses, miR-30c and MTDH were significantly correlated with tumor size, lymph nodule status and tumor grade, the ‘inside-out’ growth pattern, overall survival (OS) and disease-free survival (DFS) in IMPC patients. Conclusions: Overall, miR-30c/MTDH axis was responsible for tumor proliferation, metastasis and polarity reversal. It may provide promising therapeutic targets and prognostic biomarkers for patients with IMPC.

We propose a distributed multi-objective optimization (DMO) method for designing chiral plasmonic metasurface that satisfies multiple objectives simultaneously. We aim to improve the refractive index sensitivity of the archetypical Born-Kuhn type chiral plasmonic metasurface while ensuring that circular dichroism (CD) is as pronounced as possible at a designated resonance wavelength. By leveraging distributed technology, the proposed method significantly improves the time efficiency of the optimization process. The simulation results demonstrate approximately 33% enhancement in sensitivity by DMO, as well as greater than 100% boost in time efficiency compared to stand-alone optimization approaches. These findings highlight the potential of the proposed method to guide the design of chiral plasmonic metasurface sensors, enabling the simultaneous optimization of multiple objectives and facilitating advancements in chiral optics and sensing applications.

To address the issues of high attenuation, weak reception signal, and channel blockage in the current electric field communication of underwater robots, research on autonomous underwater vehicle (AUV) multi-node networking communication based on underwater electric field Carrier Sense Multiple Access with Collision Avoidance (CSMA/CA) channel was conducted. This article, first through simulation, finds that the Optimized Link State Routing (OLSR) protocol has a smaller routing packet delay time and higher reliability compared to the Ad Hoc On-Demand Distance Vector (AODV) protocol on underwater electric field CSMA/CA channels. Then, a 2FSK underwater electric field communication system was established, and dynamic communication experiments were carried out between two AUV nodes. The experimental results showed that within a range of 0 to 3.5 m, this system can achieve underwater dynamic electric field communication with a bit error rate of 0 to 0.628%. Finally, to avoid channel blockage during underwater AUV multi-node communication, this article proposes a dynamic backoff method for AUV multi-node communication based on CSMA/CA. This system can achieve dynamic multi-node communication of underwater electric fields with an error rate ranging from 0 to 0.96%. The research results have engineering application prospects for underwater cluster operations.

Montmorillonite (MMT) was used to improve the performance of starch and nano-ZnO was added to act as antibacterial agent for developing a starch-based active packaging material via solution mixing and casting methods. The effect of MMT and ZnO on the performance of starch films was investigated, and then the composite films were used for cherry preservation. The results indicated that the addition of MMT could improve the mechanical and water-vapor barrier properties of starch films, but it had only a slight impact on optical properties. However, the addition of nano-ZnO could reduce the optical, mechanical, and water vapor barrier properties of composite films. In preservation applications, compared to the other films, the composite films containing nano-ZnO could be beneficial to maintain quality and nutritional value of cherries by slowing down the growth of bacteria and thereby delaying weight loss, decreasing hardness, and decreasing pH and soluble solid content, resulting in a better preservation effect. Therefore, a starch-based active packaging film with good properties and preservation effect was developed with nano-ZnO and MMT, which could be applied in the field of preservation.

Inspired by the maxillary mouthparts of longicorn beetles, four types of bionic cutters were designed in this research to address the prevalent issues of high cutting resistance and severe stubble damage encountered during alfalfa harvesting. Finite element simulation was utilized to assess the structural integrity and cutting performance of these bionic cutters. Additionally, bench tests were conducted on a homemade stem-cutting force measurement and control rig to evaluate their effectiveness. The results indicated: (1) the bionic cutters achieved a reduction in maximum equivalent force ranging from 20.9% to 49.2% and a decrease in maximum deformation from 31.4% to 64.1% compared to conventional cutters; (2) the maximum cutting resistance of alfalfa stems was reduced by 28.6%, 43.9%, 52.4%, and 38.6%, significantly enhancing the flatness of the cut surfaces; (3) orthogonal bench tests demonstrated that the type of cutter and the slip-cutting angle significantly influenced the maximum cutting resistance of the stems (p < 0.01), with the optimal configuration being bionic cutter c, a slip-cutting angle of 10°, and a rotational speed of 2600 rpm. In conclusion, bionic cutters demonstrate substantial advantages in reducing maximum cutting resistance and improving the flatness of alfalfa stubble, suggesting their potential for widespread application and adoption.

The premelting layer on crystal surfaces significantly affects the stability, surface reactivity, and phase transition behaviors of crystals. Traditional methods for studying this layer—experimental techniques, classical simulations, and even first-principle simulations—have significant limitations in accuracy and scalability. To overcome these challenges, we employ molecular dynamic simulations based on neural network potentials to investigate the structural and dynamic behavior of the premelting layer on ice. This approach matches the accuracy of first-principle calculations while greatly improving computational efficiency, allowing us to simulate the ice–vapor interface on a much larger scale. In this study, we conducted a one-nanosecond simulation of the ice–vapor interface involving 1024 water molecules. This significantly exceeds the time and size scales of previous first-principle studies. Our simulation results indicate complete surface melting. Furthermore, our simulation results reveal dynamic heterogeneity within the premelting layer, with molecules segregated into clusters of low and high mobility.

Abstract The co‐occurrence of plasmid‐mediated multidrug resistance and hypervirulence in epidemic carbapenem‐resistant Klebsiella pneumoniae has emerged as a global public health issue. In this study, an ST23 carbapenem‐resistant hypervirulent K. pneumoniae (CR‐HvKP) strain VH1‐2 was identified from cucumber in China and harbored a novel hybrid plasmid pVH1‐2‐VIR. The plasmid pVH1‐2‐VIR carrying both virulence and multidrug‐resistance (MDR) genes was likely generated through the recombination of a virulence plasmid and an IncFIIK conjugative MDR plasmid in clinical ST23 18622 isolated from a sputum sample. The plasmid pVH1‐2‐VIR exhibited the capacity for transfer to the clinical ST11 carbapenem‐resistant K. pneumoniae (CRKP) strain via conjugation assay. Acquisition of pVH1‐2‐VIR plasmid directly converted a CRKP into CR‐HvKP strain characterized by hypermucoviscosity, heightened virulence for Galleria mellonella larvae, and increased colonization ability in the mouse intestine. The emergence of such a hybrid plasmid may expedite the spread of CR‐HvKP strains, posing a significant risk to human health.

Objective: This study aims to evaluate the clinical and preclinical efficacy of SMI in treating CHF, and to summarize the relevant mechanisms of action in order to provide evidence for its role in CHF treatment.Methods: A systematic computerized search of eight databases and three registry systems was performed, with the time frame spanning from the inception of the databases to 30 June 2023. Strict procedures were used for data extraction, quality assessment, and data analysis. The methodological quality of the included studies was assessed using RoB-2 and SYRCLE tools. Statistical analysis was performed using Rev Man 5.4 software, using either fixed-effects or random-effects models.Results: A total of 25 clinical trials (including test group 1,367 patients, control group 1,338 patients) and 11 animal studies (including 201 animals) were included in this review. The meta-analysis of clinical studies showed that SMI can improve cardiac function indicators (LVEF, LVFS, LVEDV, LVESV, LVEDD, LVESD) (p < 0.00001), reduce BNP/NT-proBNP levels (p < 0.01), and improve inflammatory markers (hs-CRP, TNF-α, IL-6) (p < 0.00001) and endothelin (ET) levels (p < 0.0001). In animal studies, SMI demonstrated improved cardiac function (LVEF, LVFS) (p < 0.05), and improved heart failure markers (NT-proBNP, p < 0.05) when compared to control groups.Conclusion: This study represents the first meta-analysis which includes both preclinical and clinical studies on SMI. Clinical and animal studies have shown that SMI can improve cardiac function in CHF patients through its anti-apoptotic effects, antioxidant activities, anti-inflammatory effects, and improvement of myocardial metabolism. This study has certain limitations in terms of literature quality, quantity, and follow-up time. Therefore, the conclusions drawn from this study may require further validation through larger-scale, high-quality RCT trials.

Bisphenol A (BPA) is one of the environmental endocrine disruptors, due to its chemical stability it exists in abundant concentrations in water and soil consequently accumulating in the food chain and causing many endocrine-related health problems. So far, studies on the effects of BPA on marine invertebrates have focused on acute toxicity, endocrine regulation, reproduction, and development. However, fewer studies have been conducted on marine benthos. The current study aimed to detect the accumulation of BPA and its impact on tissue structure, antioxidant capacity, and immune indexes in marine worm, Urechis unicinctus. U. unicinctus, as a common marine benthic animal, were exposed to different concentrations of BPA. Blood cells and intestinal tract were taken for tissue structure inspection, and supernatant of the coelomic fluid was collected for oxidative and antioxidant biomarkers. Results showed that the accumulation of BPA in muscles of U. unicinctus tended to increase with exposure time. BPA induced a rise in H2O2 and MDA content, and altered the activities of CAT, T-SOD, GST, LSZ and ACP, weaken the immune system functions. Moreover, pathological observation showed that BPA caused severe histopathology in the respiratory intestine, stomach, and midgut. These results will be helpful to understand the response mechanism of U. unicinctus under BPA exposure and provide a reference for controlling the aquaculture conditions and marine water quality of U. unicinctus.

Rapid start of antiretroviral therapy (ART) has been associated with improvement in several HIV-related outcomes in clinical trials as well as demonstration projects, but how regional and contextual differences may affect the effectiveness of this intervention necessitates further study. In this study of a large, urban, Southern US clinic-based retrospective cohort, we identified 544 patients with a new diagnosis of HIV during 2016 to 2019 and compared HIV care continuum outcomes for the first 12 months of care before and after rapid start implementation. Kaplan-Meier time-to-event curves were used to summarize time to virologic suppression, and stepwise Cox, linear, and logistic regression models were used to create multivariate models to evaluate the association between rapid start and time to virologic suppression, medication adherence, and retention in care and sustained virologic suppression, respectively. We found that rapid start was significantly associated with improved medication adherence scores (+15.37 points, 95% confidence interval [CI] 9.36-21.39, P

Abstract Understanding the structural origin of the competition between oxygen 2p and transition‐metal 3d orbitals in oxygen‐redox (OR) layered oxides is eminently desirable for exploring reversible and high‐energy‐density Li/Na‐ion cathodes. Here, we reveal the correlation between cationic ordering transition and OR degradation in ribbon‐ordered P3‐Na0.6Li0.2Mn0.8O2 via in situ structural analysis. Comparing two different voltage windows, the OR capacity can be improved approximately twofold when suppressing the in‐plane cationic ordering transition. We find that the intralayer cationic migration is promoted by electrochemical reduction from Mn4+ to Jahn–Teller Mn3+ and the concomitant NaO6 stacking transformation from triangular prisms to octahedra, resulting in the loss of ribbon ordering and electrochemical decay. First‐principles calculations reveal that Mn4+/Mn3+ charge ordering and alignment of the degenerate eg orbital induce lattice‐level collective Jahn–Teller distortion, which favors intralayer Mn‐ion migration and thereby accelerates OR degradation. These findings unravel the relationship between in‐plane cationic ordering and OR reversibility and highlight the importance of superstructure protection for the rational design of reversible OR‐active layered oxide cathodes.

The mechanical properties of a plug seedling substrate determine whether it will crush during the transplantation, thereby affecting the integrity of the root system and the survival rate of transplanted seedlings. In this study, we measured eight morphological parameters of pepper seedlings using machine vision and physical methods, and the corresponding substrate mechanical parameters of the plug seedlings were tested using a texture analyzer. Based on the experimental data, a BPNN framework was constructed to predict the substrate mechanical properties of plug seedlings at different growth stages. The results indicate that the BPNN with a framework of [8, 15, 15, 1] exhibits higher R2 and lower errors. The mean absolute error (MAE), mean squared error (MSE), and mean absolute percentage error (MAPE) values are 7.669, 88.842, and 9.076%, respectively, with an R2 of 0.867. The average prediction accuracy of 20 test data set is 90.472%. Finally, predictions and experimental validations were conducted on the substrate mechanical properties of seedlings grown for 47 days. The results revealed that the BPNN achieved an average prediction accuracy of 93.282%. Additionally, it exhibited faster speed and lower computational costs. This study provides a reference for the non-intrusive estimation of substrate mechanical properties in plug seedlings and the design and optimization of transplanting an end-effector.

Abstract Structural magnetic resonance imaging (MRI) provides useful information for biomarker exploration and intelligent classification of Alzheimer's disease (AD). Machine learning and deep learning methods have been used in feature extraction and computer‐aided diagnosis or prediction of AD. In this research, a new deep learning model is developed to detect or predict AD in an effective manner. A modified 3D EfficientNet with a sequentially connected 3D mobile inverted bottleneck convolution (MBConv) block is proposed to explore the multiscale characteristics of brain MR images for AD classification. The 3D MBConv block consists of depthwise convolution and a squeeze‐and‐excitation module to transform the input features into more compact features with fewer parameters than those in standard convolution. The proposed method was evaluated considering four classification tasks: (1) NC versus AD, (2) NC versus all MCI, (3) NC versus pMCI, and (4) sMCI versus pMCI. The proposed model achieved accuracies of 95.00%, 86.67%, and 83.33% for the classification of NC versus AD, NC versus pMCI, and sMCI versus pMCI, respectively, and exhibited a high performance in comparison with the classical networks and several existing methods. Efficient deep learning networks are powerful tools for the early diagnosis and prediction of AD.

Experimentally probing the orbital population is highly desirable to resolve the redox mechanism of cathodes materials. Here the authors quantify the orbital populations of Co and O in LiCoO2 and identify the ligand-to-metal charge transfer.

The multivalency of bioligands in living systems brings inspiration for not only the discovery of biological mechanisms but also the design of extracellular matrix (ECM)-mimicking biomaterials. However, designing controllable multivalency construction strategies is still challenging. Herein, we synthesized a series of well-defined multivalent antimicrobial peptide polymers (mAMPs) by clicking ligand molecules onto polymers prepared by reversible addition-fragmentation chain transfer polymerization. The multiple cationic ligands in the mAMPs could enhance the local disturbance of the anionic phospholipid layer of the bacterial membrane through multivalent binding, leading to amplification of the bactericidal effect. In addition to multivalency-enhanced antibacterial activity, mAMPs also enable multivalency-assisted hydrogel fabrication with an ECM-like dynamic structure. The resultant hydrogel with self-healing and injectable properties could be successfully employed as an antibacterial biomaterial scaffold to treat infected skin wounds. The multivalency construction strategy presented in this work provides new ideas for the biomimetic design of highly active and dynamic biomaterials for tissue repair and regeneration.

The approach of dynamic tracking and counting for obscured citrus based on machine vision is a key element to realizing orchard yield measurement and smart orchard production management. In this study, focusing on citrus images and dynamic videos in a modern planting mode, we proposed the citrus detection and dynamic counting method based on the lightweight target detection network YOLOv7-tiny, Kalman filter tracking, and the Hungarian algorithm. The YOLOv7-tiny model was used to detect the citrus in the video, and the Kalman filter algorithm was used for the predictive tracking of the detected fruits. In order to realize optimal matching, the Hungarian algorithm was improved in terms of Euclidean distance and overlap matching and the two stages life filter was added; finally, the drawing lines counting strategy was proposed. ln this study, the detection performance, tracking performance, and counting effect of the algorithms are tested respectively; the results showed that the average detection accuracy of the YOLOv7-tiny model reached 97.23%, the detection accuracy in orchard dynamic detection reached 95.12%, the multi-target tracking accuracy and the precision of the improved dynamic counting algorithm reached 67.14% and 74.65% respectively, which were higher than those of the pre-improvement algorithm, and the average counting accuracy of the improved algorithm reached 81.02%. The method was proposed to effectively help fruit farmers grasp the number of citruses and provide a technical reference for the study of yield measurement in modernized citrus orchards and a scientific decision-making basis for the intelligent management of orchards.

Polyetheretherketone (PEEK) is a desirable alternative to conventional biomedical metals for orthopedic implants due to the excellent mechanical properties. However, the inherent bioinertness of PEEK contributes to inferior osseointegration of PEEK implants, especially under pathological conditions of osteoporosis. Herein, a programmed surface is designed and fabricated on PEEK to dictate osteoimmunomodulation and bone regeneration sequentially. A degradable hybrid coating consisting of poly(lactide-co-glycolide) and alendronate (ALN) loaded nano-hydroxyapatite is deposited on PEEK and then interleukin-4 (IL-4) is grafted onto the outer surface of the hybrid coating with the aid of N2 plasma immersion ion implantation and subsequent immersion in IL-4 solution. Dominant release of IL-4 together with ALN and Ca2+ during the first few days synergistically mitigates the early acute inflammatory reactions and creates an osteoimmunomodulatory microenvironment that facilitates bone regeneration. Afterwards, slow and sustained delivery of ALN and Ca2+ in the following weeks boosts osteogenesis and suppresses osteoclastogenesis simultaneously, consequently ameliorating bone-implant osseointegration even under osteoporotic conditions. By taking into account the different phases in bone repair, this strategy of constructing advanced bone implants with sequential functions provides customizable and clinically viable therapy to osteoporotic patients.

Solid-state polymer electrolytes are crucial for developing future rechargeable batteries, but they are still limited in performance. Here, the authors designed a topological polymeric solid electrolyte, enabling an all-solid-state high-voltage lithium metal pouch cell to cycle 200 times efficiently.

Load forecasting is an important prerequisite and foundation for ensuring the rational planning and safe operation of integrated energy systems. In view of the interactive coupling problem among multivariate loads, this paper constructs a TCN-GAT multivariate load forecasting model based on SHAP (Shapley Additive Explanation) value selection strategy. The model uses temporal convolutional networks (TCN) to model the multivariate load time series of the integrated energy system, and applies the global attention mechanism (GAT) to process the output of the network hidden layer state, thereby increasing the weight of key features that affect load changes. The input variables are filtered by calculating the SHAP values of each feature, and then returned to the TCN-GAT model for training to obtain multivariate load forecasting results. This can remove the interference of features with low correlation to the model and improve the forecasting effect. The analysis results of practical examples show that compared with other models, the TCN-GAT multivariate load forecasting model based on SHAP value selection strategy proposed in this paper can further reduce the forecasting error and has better forecasting accuracy and application value.

In our recent work, it was first demonstrated that aluminum (Al) ions generated in the process of H2O2 plasma sterilization can penetrate the sterilization package and contaminate the surgical instrument inside. In this paper, it is first reported that Al ions can be adsorbed in plasma by sterilization package with surface modification, significantly reducing the contamination, up to 92%. The surface modification is carried out by introducing a functional layer on the surface of the sterilization package. The special chemical groups in the functional layer can combine with Al ions in two ways, ion exchange and chelation, preventing them from contaminating the surgical instrument in the sterilization package. Through the research on the diffusion coefficient of Al in Si sterilized using the modified sterilization packages, it is found that surface modification of sterilization packages has a great influence on the physical mechanism of Al contamination.

ObjectiveTo use CiteSpace and VOSviewer visual metrology to analyze the research status, frontier hotspots, and trends in research on atrial myxoma.MethodsThe Web of Science core collection database was used to retrieve relevant literature on atrial myxoma from 2001 to 2022. CiteSpace software was used to analyze keywords with a co-occurrence network, co-polymerization class, and burst terms, and a corresponding visual atlas was drawn for analysis.ResultsA total of 893 valid articles were included. The country with the highest number of articles was the United States (n = 186). The organization with the highest number of articles was the Mayo Clinic (n = 15). The author with the highest number of articles was Yuan SM (n = 12). The highest cited author was Reynen K (n = 312). The highest cited journal was Annals of Thoracic Surgery (n = 1,067). The most frequently cited literature was published in the New England Journal of Medicine in 1995, which was cited 233 times. The keywords co-occurrence, copolymerization analysis, and Burst analysis revealed that the main research focuses were surgical methods, case reports, and genetic and molecular level studies on the pathogenesis of myxoma.ConclusionsThis bibliometric analysis revealed that the main research topics and hotspots in atrial myxoma included surgical methods, case reports, genetic and molecular studies.

Cancer cachexia (CC), a wasting syndrome of muscle and adipose tissue resulting in weight loss, is observed in 50% of patients with solid tumors. Management of CC is limited by the absence of biomarkers and knowledge of molecules that drive its phenotype. To identify such molecules, we injected 54 human non–small cell lung cancer (NSCLC) lines into immunodeficient mice, 17 of which produced an unambiguous phenotype of cachexia or non-cachexia. Whole-exome sequencing revealed that 8 of 10 cachexia lines, but none of the non-cachexia lines, possessed mutations in serine/threonine kinase 11 (STK11/LKB1), a regulator of nutrient sensor AMPK. Silencing of STK11/LKB1 in human NSCLC and murine colorectal carcinoma lines conferred a cachexia phenotype after cell transplantation into immunodeficient (human NSCLC) and immunocompetent (murine colorectal carcinoma) models. This host wasting was associated with an alteration in the immune cell repertoire of the tumor microenvironments that led to increases in local mRNA expression and serum levels of CC-associated cytokines. Mutational analysis of circulating tumor DNA from patients with NSCLC identified 89% concordance between STK11/LKB1 mutations and weight loss at cancer diagnosis. The current data provide evidence that tumor STK11/LKB1 loss of function is a driver of CC, simultaneously serving as a genetic biomarker for this wasting syndrome.

Abstract Aims This study intends to explore whether, or to what extent, the estimated remnant-like particle cholesterol was associated with coronary collateralization in patients with chronic total occlusion lesions. Methods 792 patients with at least one coronary chronic total occlusion lesion were enrolled. Serum level of lipid profiles were determined and the estimated remnant-like particle cholesterol was calculated. The development of coronary collateralization was graded as low (Rentrop score 0–1) or high (Rentrop score 2–3) collateralization according to the Rentrop classification system and then the association between the estimated remnant-like particle cholesterol and collateralization was assessed. Results 222 participants were classified into low collateralization group. The estimated remnant-like particle cholesterol level was significantly higher in low collateralization (P

In response to the issues of low-velocity zones and non-uniform jet velocity distribution in the airflow field of traditional air-assisted orchard sprayers, an arc-shaped air outlet suitable for axial-flow air-assisted systems is designed. This article employs the method of CFD numerical simulation and experimental verification to compare and analyze the internal flow field of the air-assisted system and validates the reliability of the numerical simulation results through calculation error and chi-square test. The wind speed of the cross-section is measured at different distances from the outlet, and the distribution characteristics of the outflow field wind speed before and after the structural optimization of the air-assisted system are compared. The horizontal distribution of fog droplets is collected using a fog collection chamber. The experimental results show that the design of the arc-shaped outlet increases the average wind speed of the annular outlet from 14.95 m/s to 18.20 m/s and reduces the proportion of low-speed area from 20.83% to 0.71%. When the rounded corner radius of the air outlet is 50 mm, optimal parameters are attained. The maximum error between the simulated and experimental values is 9.52%. At a significance level of 0.05, the χ2 value is 0.252, indicating that the simulated values follow the distribution of the actual measurement values. On the cross-sections located at distances of 0.5, 0.75, 1, 1.25, and 1.5 m from the air outlet, the wind speed distribution with no arc-shaped air outlets exhibits a “low left and high right” type, tending to shift towards the right as a whole. Fog droplets also display a drift tendency towards the right side. The wind speed distribution with arc-shaped air outlets shows a symmetric “high in the middle and low on the sides” type. Fog droplets concentrate in the central position. The optimized air-assisted system can reduce the air field’s low-flow area, increase the airflow distribution uniformity, improve the average wind speed at the outlet, and decrease fog droplet drift. This provides a reference for the structural design of air-assisted systems in current orchard sprayers of the same type.

Machine learning-based neural network potentials often cannot describe long-range interactions. Here the authors present an approach for building neural network potentials that can describe the electronic and nuclear response of molecular systems to long-range electrostatics.

In order to examine the quality of different types and different brands of plant-based meat, sensory evaluation and instrument testing were performed on 18 commercially available plant-based meat products, and the correlation analysis between the sensory evaluation results and the instrumental analysis results was carried out, and instrumental analysis results were analyzed to further explore the risk of allergens. The appearance, flavor and taste of the indicators could effectively evaluate the authenticity of the plant-based chicken nuggets, plant-based beef patties, and plant-based meat filling categories. The chewiness and shear force in the texture profile analysis (TPA) parameters could effectively evaluate the sensory indicators. The cohesiveness, chewiness (instrument) and shear force results of the plant-based meat could be used to predict the sensory softness, hardness, juiciness, firmness, graininess, fiber, elasticity (sensory) changes of the samples. There were significant differences in the color a* value of different types of plant-based chicken nuggets and plant-based beef patties before cooking (P

Polyetheretherketone (PEEK) has been widely used as orthopedic and dental materials due to excellent mechanical and physicochemical tolerance. However, its biological inertness, poor osteoinduction, and weak antibacterial activity make the clinical applications in a dilemma. Inspired by the mussel adhesion mechanism, here we reported a biomimetic surface strategy for rational integration and optimization of anti-infectivity and osteo-inductivity onto PEEK surfaces using a mussel foot proteins (Mfps)-mimic peptide with clickable azido terminal. The peptide enables mussel-like adhesion on PEEK biomaterial surfaces, leaving azido groups for the further steps of biofunctionalizations. In this study, antimicrobial peptide (AMP) and osteogenic growth peptide (OGP) were bioorthogonally clicked on the azido-modified PEEK biomaterials to obtain a dual-effect of host defense and tissue repair. Since bioorthogonal clicking allows precise collocation between AMP and OGP through changing their feeding molar ratios, an optimal PEEK surface was finally obtained in this research, which could long-term inhibit bacterial growth, stabilize bone homeostasis and facilitate interfacial bone regeneration. In a word, this upgraded mussel surface strategy proposed in this study is promising for the surface bioengineering of inert medical implants, in particular, achieving rational integration of multiple biofunctions to match clinical requirements.

Due to the impact of climate change and rapid urbanization, issues around global urban flood control and water environment security have emerged as major global concerns. As a practical way to address these issues, exploitation of urban rainwater resources has become a worldwide hotspot for research and application. This paper 1) briefly examined the evolution of rainwater utilization management modes in advanced countries, 2) classified urban rainwater utilization measures from the utilization stages into three categories—source control, medium transmission, and terminal treatment, 3) summarized the advantages, disadvantages, and scope of the application of these measures, 4) reviewed the benefits, drawbacks, and application areas of these measures, and 5) conducted a quantitative analysis of their impact on rainwater pollution and flood control.

Abstract Ni‐rich layered (NRL) cathodes have been widely considered to undergo a degeneration from layered to spinel‐like phases and finally to a rock−salt phase, which jeopardizes the battery's performance and safety. However, this process does not sufficiently explain the drastic structure collapse that occurs during thermal runaway, as the lattice constants of these structures are similar. Herein, an intermediate β‐Li2NiO3 phase is identified during the thermally driven structural evolution via in situ heating scanning transmission electron microscopy imaging. The antihoneycomb‐ordered structure leads to a larger lattice mismatch of up to ∼15% with the layered structure. The resulting strain triggers huge bulk stress and the labile oxygen of the β‐Li2NiO3 phase aggravates the oxygen release, severely reducing the thermal stability of NRL materials. Finally, based on the screening for 3d transition metals, doping elements are chosen to suppress the β‐Li2TMO3 phase and enhance thermal stability. The findings provide comprehensive insights into the structural degradation process of NRL materials and pave the way to design high‐performance and safe battery systems.

Abstract. Background:. Finding an optimal treatment strategy for adolescent idiopathic scoliosis (AIS) patients remains challenging because of its intrinsic complexity. For mild to moderate scoliosis patients with lower skeletal growth potential (Risser 3–5), most clinicians agree with observation treatment; however, the curve progression that occurs during puberty, the adolescent period, and even in adulthood, remains a challenging issue for clinicians. The aim of the study is to investigate the efficacy of Schroth exercise in AIS patients with lower skeletal growth potential (Risser 3–5) and moderate scoliosis (Cobb angle 20°–40°). Methods:. From 2015 to 2017, data of 64 patients diagnosed with AIS in Peking University Third Hospital were reviewed. Forty-three patients underwent Schroth exercise were classified as Schroth group, and 21 patients underwent observation were classified as observation group. Outcomes were measured by health-related quality of life (HRQOL) and radiographic parameters. HRQOL was assessed using the visual analog scale (VAS) scores for back, Scoliosis Research Society-22 (SRS-22) patient questionnaire. Radiographic spinopelvic parameters were obtained from anteroposterior and lateral X-rays. The pre-treatment and post-treatment HRQOL and radiographic parameters were tested to validate Schroth exercise efficacy. The inter-rater reliability of the radiographic parameters was tested using the interclass correlation coefficient (ICC). The paired t test was used to examine HRQOL and radiographic parameters. Clinical relevance between C2-C7 sagittal vertical axis (SVA) and thoracic kyphosis was analyzed using Spearman correlation. Results:. In Schroth group, VAS back score, SRS-22 pain, and SRS-22 self-image domain were significantly improved from pre-treatment 3.0 ± 0.8, 3.6 ± 0.5, and 3.5 ± 0.7 to post-treatment 1.6 ± 0.6 (t = 5.578, P = 0.013), 4.0 ± 0.3 (t = −3.918, P = 0.001), and 3.7 ± 0.4 (t = −6.468, P

Abstract Background Recent studies have substantiated the role of the triglyceride glucose (TyG) index in predicting the prognosis of coronary artery disease (CAD) patients, while no relevant studies have revealed the association between the TyG index and coronary collateralization in the event of coronary chronic total occlusion (CTO). The current study intends to explore whether, or to what extent, the TyG index is associated with impaired collateralization in CAD patients with CTO lesions. Methods The study enrolled 1093 CAD patients undergoing cardiac catheterization for at least one CTO lesion. Data were collected from the Beijing Anzhen Hospital record system. The degree of collaterals was determined according to the Rentrop classification system. The correlation between the TyG index and coronary collateralization was assessed. Results Overall, 318 patients were included in a less developed collateralization (Rentrop classification 0-1) group. The TyG index was significantly higher in patients with impaired collateralization (9.3±0.65 vs. 8.8±0.53, P

We investigated 2 and 2.9 μm mid-infrared fiber lasers passively Q-switched by MIL-68(Al) and MIL-68(Fe), which were fabricated via the hydrothermal method. The modulation depth of MIL-68(Al) was found to be 9.12% at 1.99 μm. And the modulation depths of MIL-68(Fe) were found to be 18.89% and 15.79% at 1.99 μm and 2.87 μm, respectively. We report Q-switching pulse generation in both Tm3+-doped and Ho3+/Pr3+ co-doped fiber lasers by using the as-prepared MIL-68 (M, M = Al3+, Fe3+) as SAs. The center wavelengths were at 1.99 μm and 2.87 μm, respectively. These results indicate that MIL-68(M) has wideband nonlinear optical properties and promising application prospects in the field of optical modulators at 2- and 2.9-μm mid-infrared waveband. Work clearly accessible to a broad readership.

With the rapid development of communication technology, unmanned aerial vehicle–mobile edge computing (UAV-MEC) networks have emerged with powerful capabilities. However, existing research studies have neglected the issues involving user grouping and relay selection structures under UAV cluster-assisted communication. Therefore, in this article, we present a comprehensive communication–computing resource allocation for UAV-MEC networks. In particular, ground users make stable user groups first, and then multiple UAVs act as relays in order to assist these user groups in simultaneously uploading their tasks to the terrestrial base station at the edge server. Moreover, in order to maximize the system’s overall throughput, a more flexible and hierarchical matching relay selection algorithm is proposed in terms of matching the ground user groups and corresponding UAVs. For vulnerable users, we also propose a weighted relay selection algorithm to maximize the system performance. Furthermore, simulation results show that the proposed relay selection algorithm achieves a significant gain in comparison with the other benchmarks, and the stability of the proposed algorithms could be verified.

Orthorhombic molybdenum oxide (α-MoO3), as a one-layered pseudocapacitive material, has attracted widespread attention due to its high theoretical lithium storage specific capacity (279 mAh/g) for lithium-ion batteries’ cathode. Nevertheless, low conductivity, slack reaction kinetics, and large volume change during Li+ ions intercalation and deintercalation seriously limit the practical application of α-MoO3. Herein, we added a small number of CNTs (1.76%) to solve these problems in a one-step hydrothermal process for preparing the α-MoO3/CNTs composite. Because of the influence of CNTs, the α-MoO3 nanobelt in the α-MoO3/CNTs composite had a larger interlayer spacing, which provided more active sites and faster reaction kinetics for lithium storage. In addition, CNTs formed a three-dimensional conductive network between α-MoO3 nanobelts, enhanced the electrical conductivity of the composite, accelerated the electron conduction, shortened the ion transport path, and alleviated the structural fragmentation caused by the volume expansion during the α-MoO3 intercalation and deintercalation of Li+ ions. Therefore, the α-MoO3/CNTs composite cathode had a significantly higher rate performance and cycle life. After 150 cycles, the pure α-MoO3 cathode had almost no energy storage, but α-MoO3/CNTs composite cathode still retained 93 mAh/g specific capacity.

Abstract Background The triglyceride-glucose (TyG) index is an alternative marker of insulin resistance (IR) and is closely associated with the prevalence and prognosis of atherosclerotic cardiovascular disease (ASCVD). However, the association between the TyG index and in-stent restenosis (ISR) after drug-eluting stent (DES) implantation in patients with acute coronary syndrome (ACS) remains unknown. Methods The present study retrospectively recruited patients who were admitted for ACS and underwent coronary angiography at 6 to 24 months after successful DES-based percutaneous coronary intervention (PCI). In addition, we calculated the TyG index with the following formula: Ln(fasting triglyceride [mg/dL] × fasting blood glucose [mg/dL]/2) and divided patients into 3 groups according to the tertile of the TyG index. Most importantly, multivariate logistic regression analysis models were also constructed to assess the association between the TyG index and DES-ISR in patients with ACS. Results A total of 1574 patients with ACS (58.4 ± 9.4 years, 77.4% male) were included in this study. At the median follow-up time of 12 (9–14) months, the prevalence of DES-ISR increased stepwise with the increasing tertile of the TyG index (11.6% vs 17.3% vs 19.4%, p = 0.002), and the TyG index was also higher in the ISR group than in the non-ISR group (9.00 ± 0.58 vs 8.84 ± 0.61, p

Abstract Background Lipid phosphate phosphatases (LPP) are critical for regulating the production and degradation of phosphatidic acid (PA), an essential signaling molecule under stress conditions. Thus far, the LPP family genes have not been reported in rapeseed (Brassica napus L.). Results In this study, a genome-wide analysis was carried out to identify LPP family genes in rapeseed that respond to different stress conditions. Eleven BnLPPs genes were identified in the rapeseed genome. Based on phylogenetic and synteny analysis, BnLPPs were classified into four groups (Group I-Group IV). Gene structure and conserved motif analysis showed that similar intron/exon and motifs patterns occur in the same group. By evaluating cis-elements in the promoters, we recognized six hormone- and seven stress-responsive elements. Further, six putative miRNAs were identified targeting three BnLPP genes. Gene ontology analysis disclosed that BnLPP genes were closely associated with phosphatase/hydrolase activity, membrane parts, phosphorus metabolic process, and dephosphorylation. The qRT-PCR based expression profiles of BnLPP genes varied in different tissues/organs. Likewise, several gene expression were significantly up-regulated under NaCl, PEG, cold, ABA, GA, IAA, and KT treatments. Conclusions This is the first report to describe the comprehensive genome-wide analysis of the rapeseed LPP gene family. We identified different phytohormones and abiotic stress-associated genes that could help in enlightening the plant tolerance against phytohormones and abiotic stresses. The findings unlocked new gaps for the functional verification of the BnLPP gene family during stresses, leading to rapeseed improvement.

In this paper, it is first demonstrated that Aluminum (Al) contamination is present; H2O2 plasma sterilization is widely used for sterilization of surgical instruments. The contamination amount of Al can reach as high as 7.9 × 1012 atoms/cm2. Aluminum is well known as a harmful element to human health, which may damage bones and the brain. During the use of the surgical instruments after H2O2 plasma sterilization in surgery, the contaminated Al may enter and reside in the human body and threaten the health and even life safety. Therefore, it is necessary to study the Al contamination present in H2O2 plasma sterilization to arouse public attention and take countermeasures. The physical mechanism of the Al contamination presented in H2O2 plasma sterilization is diffusion. In our previous study, we developed two physical models for calculating the diffusion coefficient. In this study, both models are used to calculate the diffusion coefficient of the contaminated Al in sterilized Si samples. From the calculation results, it is inferred that the contamination mechanism of Al presented in H2O2 plasma sterilization is closer to the model, where the diffusion coefficient value is a function of the plasma treatment time.

Weld feature point detection is a key technology for welding trajectory planning and tracking. Existing two-stage detection methods and conventional convolutional neural network (CNN)-based approaches encounter performance bottlenecks under extreme welding noise conditions. To better obtain accurate weld feature point locations in high-noise environments, we propose a feature point detection network, YOLO-Weld, based on an improved You Only Look Once version 5 (YOLOv5). By introducing the reparameterized convolutional neural network (RepVGG) module, the network structure is optimized, enhancing detection speed. The utilization of a normalization-based attention module (NAM) in the network enhances the network’s perception of feature points. A lightweight decoupled head, RD-Head, is designed to improve classification and regression accuracy. Furthermore, a welding noise generation method is proposed, increasing the model’s robustness in extreme noise environments. Finally, the model is tested on a custom dataset of five weld types, demonstrating better performance than two-stage detection methods and conventional CNN approaches. The proposed model can accurately detect feature points in high-noise environments while meeting real-time welding requirements. In terms of the model’s performance, the average error of detecting feature points in images is 2.100 pixels, while the average error in the world coordinate system is 0.114 mm, sufficiently meeting the accuracy needs of various practical welding tasks.

Here, Zhang et al. succeed in creating a heavily distorted oxygen deficient film of lanthanum cobaltite. The new phase of LaCoO2.5 has several unique properties, most notably, a Curie temperature of 284 K, significantly larger than the films from which it was derived.

Abstract Background Few studies describe thoracolumbar disc herniation (TLDH) as an isolated category, it is frequently classified as the lower thoracic spine or upper lumbar spine. Thus, less is known about the morphology and aetiology of TLDH compared to lumbar disc herniation (LDH). The aim of study is to investigate sagittal alignment in TLDH and analyze sagittal profile with radiographic parameters. Methods Data from 70 patients diagnosed with TLDH were retrospectively reviewed. The thoracic-lumbar alignment was depicted by description of curvatures (the apex of lumbar curvature, the apex of thoracic curvature, and inflexion point of the two curvatures) and radiographic parameters from complete standing long-cassette spine radiographs. The rank sum test was utilised to compare radiographic parameter values in each subtype. Results We found two subtypes differentiated by the apex of thoracic kyphotic curves. The sagittal profile was similar to that of the normal population in type I, presenting the apex of the thoracic kyphotic curve located in the middle thoracic spine. The well aligned thoracic-lumbar curve was disrupted in type II, presenting the apex of the thoracic kyphotic curve located in the thoracolumbar region in type II patients. Thirty-six patients were classified as type I, and 34 patients were classified as type II. The mean sagittal vertical axis, T1 pelvic angle and L1 pelvic angle were 27.9 ± 24.8°, 8.2 ± 7.3° and 6.2 ± 4.9°, respectively. There was significant difference (p

Poor osseointegration ability and the release of worn debris after implantation are the main issues impeding the clinic application of polyether ether ketone (PEEK) as orthopedics. To address these problems, we expect that the initial deposition of diamond-like carbon (DLC) coating on PEEK substrate and the subsequent introduction of amino groups onto sample surface using plasma immersion ion implantation (PIII) have the potential to simultaneously improve the mechanical performance and osseointegration. On one hand, the surface hardness is raised from 0.38 ​GPa to 2.99 ​GPa and the elastic modulus reaches 35 ​GPa after DLC deposition, while no failure is observed in the scratch tests even the loading force is up to 100 ​N. On the other hand, the introduced amino groups facilitate the adhesion, proliferation, and osteogenic differentiation of the osteoblasts in vitro, and further enhanced the peri-implant bone regeneration in vivo. With the merits of low cost, clean approach, and ease of operation, the approach described here holds great potential for biomedical applications.

Abstract Background Upper limb and hand motor dysfunction is one of the challenges in rehabilitation after cerebral ischemic stroke (CIS), and the clinical efficacy of rehabilitation needs to be improved. This study aims to combine Jin’s three-needle acupuncture (JTN) therapy with mirror therapy (MT) for hemiplegia after CIS, objectively evaluate the clinical effects and safety of JTN to treat upper limb dysfunction, and use functional magnetic resonance imaging (fMRI) of the brain to investigate the central mechanisms of the effects, which would provide a powerful evidence-based medical basis for further supporting the application of JTN combined with MT. Methods/design This trial will be a single-blind, randomized controlled study. Patients who meet the study criteria will be recruited and randomly assigned to either the combined treatment group (JTN+MT) or the JTN group. Both interventions will be conducted for 6 days per week and last for 4 weeks. The primary outcome will be the effective rate based on the Fugl–Meyer Assessment for Upper Extremity (FMA-UE). Other outcome measures will include scores on the motor assessment scale (MAS), action research arm test (ARAT), activities of daily living (ADL) scale, and fMRI analyses. For safety evaluation, adverse events will be observed and recorded. Discussion This study may help to identify the efficacy and safety of acupuncture combined with MT for upper limb dysfunction after CIS and explore the central mechanisms with brain fMRI. Trial registration Chinese Clinical Trial Registry ChiCTR-IOR-17012174 . Registered on 5 April 2017.

Recent years, unmanned aerial vehicles (UAVs) have attracted much attention for providing intermediate relay to ground mobile user equipments (UEs) for their flexible mobility. UEs can offload computing-intensive task to mobile cloud computing (MCC) or mobile edge computing (MEC) for fast processing. However, with multi-UAV and ground mobile UEs in the system, heterogeneous performance requirement as well as fast-changing communication condition make the system more complicated. Meanwhile, both UEs and UAVs are battery-driven. How to optimize the energy efficiency for UEs' transmission and UAVs' position should be carefully considered. Since this is a non-convex and mixed-integer optimization problem, a heuristic joint power and quality of experience (HJPQ) algorithm is proposed in this article, where the UEs' offloading delay, MIMO channel, transmission power, as well as UAVs' placement are jointly optimized. The numeral simulations not only reveal the effectiveness of HJPQ, but also guarantee the great quality of experience (QoE) performance for UEs with different priorities. Furthermore, the comparison experiments with random assignment and deep deterministic policy gradient (DDPG) show the superiority of HJPQ in lower complexity, faster convergence, shorter offloading delay as well as higher energy efficiency.