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BackgroundThe effects of blood transfusions on splanchnic oxygenation and complications related to blood transfusions, including red blood cell (RBC) transfusions, in premature infants undergoing enteral feeding, to provide clinical evidence for a management protocol for premature infants during the peri-transfusion period.MethodsThis single-blind, randomized, controlled trial enrolled sixty eligible preterm infants who were randomly divided into the withholding feeding group (n = 30) or feeding group (n = 30). Enteral feeding was withheld for 8 h, beginning from the start of transfusion infants in the feeding group were fed according to the pre-transfusion feeding approach during and after RBC transfusion.ResultsBaseline characteristics of those in the withholding and feeding groups were as follows: gestational age (weeks) 27.52 (24.86–30.14) and 27.13 (25.43–30.14); birth weight (g), 1,027 (620–1,450) and 1,027 (620–1,270); blood transfusion day, 48 (14–79) and 39 (10–78); and hemoglobin before blood transfusion (g/L), 81.67 (±10.56) and 85.93 (±14.77). No significant differences were observed between groups at baseline. No significant differences were observed in the average splanchnic tissue oxygenation changes or clinical results at any time. One patient in the withholding feeding group experienced transfusion-associated necrotizing enterocolitis.ConclusionsNo differences in splanchnic oxygenation observed these feeding protocols. This study suggests the feasibility of a sizable trial to evaluate clinical outcomes. The risks of mesenteric ischemia and transfusion-related necrotizing enterocolitis for premature infants were not increased by enteral feeding during RBC transfusion.Clinical trial registrationChiCTR2200055726 (https://www.chictr.org.cn/).

Abstract Data security is a key feature of future communications networks. Physical layer introduces rich physical mechanisms to increase the complexity of deciphering and provides extensive protection, but faces challenges in compatibility with commercial systems. Quantum noise stream cipher (QNSC) has been proposed as a promising solution to overcome this problem by fusing the stream cryptography regime with the quantum noise masking physical mechanism. However, it has limitations in terms of digital to analog conversion and clock data synchronization of ultra-high-order ciphertext as well as flexible control of masking noise. Here we report a 147.9-Gbps device-compatible quadrature amplitude modulation (QAM) QNSC secure scheme over 75-km fiber. Thanks to delta-sigma modulator, the transmission of 220 × 220-order QAM-QNSC signal are established through the low-order digital signal. We develop a theoretical model for flexibly regulating the transmission rate and security performance. Broadband optical chaos introduces true randomness and acts on the masking noise.

To counter heterodyne measurements, correlation attacks, and known plaintext attacks, seed key refresh is critical to the security of a quantum noise stream cipher system. Integrated key distribution is an important means to reduce the deployment cost, as key exchange and public transmission are performed over the same channel. In this paper, we propose a novel method for integrated key distribution by optical steganography based on dither-remodulation in a bias controller of the Mach-Zehnder modulator. No extra wavelength or bandwidth is used for the stealth channel, which is transmitted together within the public channel. The concealing depth of the stealth signal reaches −36.2 dB, and its steganographic effect provides additional security, which further improves the overall security of the optical physical layer. The bidirectional stealth transmission can support light-weight temporary key exchange mechanism, combined with asymmetric encryption algorithm, to achieve high security and forward/backward security of seed keys. We experimentally demonstrate a real-time integrated key distribution via optical steganography in a QNSC system. The experimental results show that a real-time bidirectional stealth link is established at a rate of 1 kbps in a fiber transmission distance of 97 km for a public QNSC transmission at a rate of 32 Gbps, providing a seed key refresh frequency of over 1 Hz.

Rhabdomyosarcoma of the prostate is a rare mesenchymal tumor that originates from undifferentiated mesenchymal cells. Spindle cell rhabdomyosarcoma is a variant of embryonal rhabdomyosarcoma. The vast majority of these two pathological types occur in children, with only a few adult cases reported to date, and both are associated with poor clinical outcomes. We herein report a case involving a man in his early 40s with spindle cell embryonal rhabdomyosarcoma of the prostate. His chief complaint was difficult urination. The diagnosis was confirmed by puncture biopsy of the prostate, and pelvic lymph node metastasis was already present at the time of diagnosis. The patient underwent three courses of chemotherapy. However, his response to the treatment was very poor, and he died of the disease 4 months after diagnosis.

Background This systematic review and meta-analysis aims to explore the potential impact of the route of administration on the efficacy of therapies and occurrence of adverse events when administering medications to premature infants with patent ductus arteriosus (PDA). Method The protocol for this review has been registered with PROSPERO (CRD 42022324598). We searched relevant studies in PubMed, Embase, Cochrane, and the Web of Science databases from March 26, 1996, to January 31, 2022. Results A total of six randomized controlled trials (RCTs) and five observational studies were included for analysis, involving 630 premature neonates in total. Among these infants, 480 were in the ibuprofen group (oral vs. intravenous routes), 78 in the paracetamol group (oral vs. intravenous routes), and 72 in the ibuprofen group (rectal vs. oral routes). Our meta-analysis revealed a significant difference in the rate of PDA closure between the the initial course of oral ibuprofen and intravenous ibuprofen groups (relative risk (RR) = 1.27, 95% confidence interval (CI) [1.13–1.44]; P

Lower limb rehabilitation is essential for recovery post-injury, stroke, or surgery, improving functional mobility and quality of life. Traditional therapy, dependent on therapists' expertise, faces challenges that are addressed by rehabilitation robotics. In the domain of lower limb rehabilitation, machine learning is progressively manifesting its capabilities in high personalization and data-driven approaches, gradually transforming methods of optimizing treatment protocols and predicting rehabilitation outcomes. However, this evolution faces obstacles, including model interpretability, economic hurdles, and regulatory constraints. This review explores the synergy between machine learning and robotic-assisted lower limb rehabilitation, summarizing scientific literature and highlighting various models, data, and domains. Challenges are critically addressed, and future directions proposed for more effective clinical integration. Emphasis is placed on upcoming applications such as Virtual Reality and the potential of deep learning in refining rehabilitation training. This examination aims to provide insights into the evolving landscape, spotlighting the potential of machine learning in rehabilitation robotics and encouraging balanced exploration of current challenges and future opportunities.

Introduction: An ideal bone repair scaffold should have dual functions of osteoinductive ability and in vivo imaging. In this study, the simultaneous substitution of silicon (Si) and gadolinium (Gd) in hydroxyapatite (HA) as potential multifunctional bone graft materials has been successfully developed.Methods: A series of HA nanoparticles (HA NPs) doped with different proportions of Si and Gd were prepared. The chemical structure and phase composition of the materials were analyzed using Fourier transform infrared (FTIR) spectroscopy and X-ray diffraction (XRD). The microstructure, magnetic properties, surface potential, and cytotoxicity of the materials were also analyzed. The magnetic resonance imaging (MRI) effect of Gd&Si-HA/poly(lactic-co-glycolic acid) (Gd&Si-HA/PLGA) composite materials was evaluated. Osteogenic-related gene expression, alkaline phosphatase (ALP) level, and mineralization capacity of MC3T3-E1 cultured on Gd&Si-HA/PLGA composite materials were also detected.Results and Discussion: The 1.5Gd&Si-HA@PLGA group showed good ability to promote osteogenic differentiation of cells. The MRI effect of the 1.5Gd&Si-HA@PLGA scaffold was observable. This HA material containing Si and Gd co-doping has a broad application prospect in the field of bone tissue engineering owing to its ability to enhance osteoinductive property and improve MRI effect.

Background/Aims: Prenatal ethanol exposure (PEE) could induce intrauterine programming of hypothalamic-pituitary-adrenal axis-associated neuroendocrine metabolism, resulting in intrauterine growth retardation and susceptibility to adult hypercholesterolemia in offspring. This study aimed to analyse the effects and interactions of PEE, a post-weaning high-fat diet (HFD) and gender on the occurrence of adult hypercholesterolemia in offspring rats. Methods: Wistar female rats were treated with ethanol (4 g/kg.d) at gestational days 11-20. The offspring were given a normal diet or HFD after weaning, and the blood cholesterol metabolism phenotype and expression of hepatic cholesterol metabolism related genes were detected in 24-week-old offspring. Furthermore, the interactions among PEE, HFD, and gender on hypercholesterolemia occurrence were analysed. Results: PEE increased the serum total cholesterol (TCH) and low-density lipoprotein-cholesterol (LDL-C) levels and decreased the serum high-density lipoprotein-cholesterol (HDL-C) level in adult offspring rats; the changes in female offspring were greater than those in males. At the same time, the mRNA expression levels of hepatic cholesterol metabolic enzymes (apolipoprotein B (ApoB) and 7α-hydroxylase (CYP7A1))—were increased, while the mRNA expression levels of the scavenger receptor B1 (SR-B1) and LDL receptor (LDLR) were decreased. Furthermore, a three-way ANOVA showed there were interactions among PEE, post-weaning HFD and gender. For PEE offspring, a post-weaning HFD aggravated the elevated hepatic ApoB and CYP7A1 expression and reduced SR-B1 and LDLR expression; the changes in hepatic SR-B1 and CYP7A1 expression were greater in female HFD rats than in males. Conclusion: Our findings suggest that a post-weaning HFD could aggravate offspring hypercholesterolemia caused by PEE and that this mechanism might be associated with hepatic cholesterol metabolic disorders that are aggravated by a post-weaning HFD; hepatic cholesterol metabolism was more sensitive to neuroendocrine metabolic alterations by PEE and a post-weaning HFD in the female offspring than in the male offspring.

This paper is concerned with reduced-complexity detection, referred to as iterative reconfigurable tree search (IRTS) detection, with application in iterative receivers for multiple-input multiple-output (MIMO) systems. Instead of the optimum maximum a posteriori probability detector, which performs brute force search over all possible transmitted symbol vectors, the new scheme evaluates only the symbol vectors that contribute significantly to the soft output of the detector. The IRTS algorithm is facilitated by carrying out the search on a reconfigurable tree, constructed by computing the reliabilities of symbols based on minimum mean-square error (MMSE) criterion and reordering the symbols according to their reliabilities. Results from computer simulations are presented, which proves the good performance of IRTS algorithm over a quasistatic Rayleigh channel even for relatively small list sizes.