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Traditional Chinese medicine (TCM) has relied on pulse diagnosis as a cornerstone of healthcare assessment for thousands of years. Despite its long history and widespread use, TCM pulse diagnosis has faced challenges in terms of diagnostic accuracy and consistency due to its dependence on subjective interpretation and theoretical analysis. This study introduces an approach to enhance the accuracy of TCM pulse diagnosis for diabetes by leveraging the power of deep learning algorithms, specifically LeNet and ResNet models, for pulse waveform analysis. LeNet and ResNet models were applied to analyze TCM pulse waveforms using a diverse dataset comprising both healthy individuals and patients with diabetes. The integration of these advanced algorithms with modern TCM pulse measurement instruments shows great promise in reducing practitioner-dependent variability and improving the reliability of diagnoses. This research bridges the gap between ancient wisdom and cutting-edge technology in healthcare. LeNet-F, incorporating special feature extraction of a pulse based on TMC, showed improved training and test accuracies (73% and 67%, respectively, compared with LeNet’s 70% and 65%). Moreover, ResNet models consistently outperformed LeNet, with ResNet18-F achieving the highest accuracy (82%) in training and 74% in testing. The advanced preprocessing techniques and additional features contribute significantly to ResNet18-F’s superior performance, indicating the importance of feature engineering strategies. Furthermore, the study identifies potential avenues for future research, including optimizing preprocessing techniques to handle pulse waveform variations and noise levels, integrating additional time–frequency domain features, developing domain-specific feature selection algorithms, and expanding the scope to other diseases. These advancements aim to refine traditional Chinese medicine pulse diagnosis, enhancing its accuracy and reliability while integrating it into modern technology for more effective healthcare approaches.

Background: Intrauterine adhesion (IUA) results from serious complications of intrauterine surgery or infection and mostly remains incurable. Small extracellular vesicles (sEVs) derived from mesenchymal stem cells (MSCs) have emerged as a potential new approach for the treatment of IUA; however, their impact is not fully understood. Here, we performed a meta-analysis summarizing the effects of sEVs on IUA in preclinical rodent models. Methods: This meta-analysis included searches of PubMed, EMBASE, Cochrane, and the Web of Science databases from January 1, 1997, to April 1, 2022, to identify studies reporting the therapeutic effect of sEVs on rodent preclinical animal models of IUA. We compared improvements in endometrial thickness, endometrial gland number, fibrosis area, embryo number, vascular endothelial growth factor (VEGF), transforming growth factor β1 (TGFβ1), and leukemia inhibitory factor (LIF) levels after treatment. Results: Our search included 100 citations, of which 7 met the inclusion criteria, representing 231 animals. Compared with that in the control group, the fibrosis area in the sEV-treated group was significantly reduced (standardized mean difference (SMD) = −6.87，95 % confidence interval (CI) = −9.67 to −4.07). The number of glands increased after the intervention (95 % CI, 3.72–7.68; P = 0.000). Endometrial thickness was significantly improved in the sEV-treated group (SMD = 2.57, 95 % CI, 1.62–3.52). Conclusions: This meta-analysis is highlighting that sEV treatment can improve the area of endometrial fibrosis, as well as VEGF, and LIF level, in a mouse IUA model. This knowledge of these findings will provide new insights into future preclinical research.

Background: In intensive care units, mechanical ventilation is an important therapy to help patients with dyspnea. However, long-term ventilator dependence would consume huge medical resources and increase the risk of morbidity and mortality. The aim of the study was to examine the efficacy of the acupuncture combined with western medical care on ventilator parameters in ventilator-dependent patients. Methods: In this clinical trial, 80 ventilator-dependent patients aged 20 to 80 years old were randomly assigned to acupuncture group and control group in the respiratory care center (RCC) of Changhua Christian Hospital. Besides regular medical care and therapy, participants in the acupuncture group received acupuncture therapy at the same 17 acu-points for 20 minutes once a day, a total of 12 sessions. The ventilator parameters were recorded to evaluate the respiratory efficiency for all participants. The primary outcome was rapid shallow breathing index (RSBI), and secondary outcomes were respiratory rate (RR), tidal volume (TV) and ventilation per minute (MV), Results: Though there was no significant difference in the parameter between the acupuncture group and the control group, we found the trend of decreasing RSBI in the acupuncture group. In subgroup analyses, the mean of RSBI significantly decreased 16.02 (with the SD in 60.84) in acupuncture group, while it increased 17.84 (with the SD in 39.38) in control group (p=0.036) after 12 sessions. Conclusion: Acupuncture treatment can improve breathing ability of patients with respirator dependence in respiratory care center.

Endometrial cancer (EC) is one of the most common gynecological cancers, and its risk factors include obesity and metabolic, genetic, and other factors. Recently, the circadian rhythm has also been shown to be associated with EC, as the severity of EC was found to be related to night work and rhythm disorders. Therefore, circadian rhythm disorders (CRDs) may be one of the metabolic diseases underlying EC. Changes in the circadian rhythm are regulated by clock genes (CGs), which in turn are regulated by non-coding RNAs (ncRNAs). More importantly, the mechanism of EC caused by ncRNA-mediated CRDs is gradually being unraveled. Here, we review existing studies and reports and explore the relationship between EC, CRDs, and ncRNAs.

Abstract Background Premature ovarian insufficiency (POI) is the main cause of female infertility. Adipose-derived stem cells (ADSCs) are ideal candidates for the treatment of POI. However, some deficient biological characteristics of ADSCs limit their utility. This study investigated whether melatonin (MLT)-pretreated autologous ADSCs were superior to ADSCs alone in the treatment of the POI mouse model. Methods Autologous ADSCs were isolated and cultured in MLT-containing medium. Surface markers of ADSCs were detected by flow cytometry. To determine the effect of MLT on ADSCs, CCK-8 assay was used to detect ADSCs proliferation and enzyme-linked immunosorbent assay (ELISA) was used to detect the secretion of cytokines. The POI model was established by intraperitoneal injection of cyclophosphamide and busulfan. Then, MLT-pretreated autologous ADSCs were transplanted into mice by intraovarian injection. After 7 days of treatment, ovarian morphology, follicle counts, and sex hormones levels were evaluated by hematoxylin and eosin (H&E) staining and ELISA, and the recovery of fertility was also observed. The expressions of SIRT6 and NF-κB were detected by immunohistochemical (IHC) staining and quantitative real-time polymerase chain reaction (qRT-PCR). Results Flow cytometry showed that autologous ADSCs expressed CD90 (99.7%) and CD29 (97.5%). MLT can not only promote the proliferation of ADSCs but also boost their secretory function, especially when ADSCs were pretreated with 5 µM MLT for 3 days, improving the interference effect. After transplantation of autologous ADSCs pretreated with 5 µM MLT, the serum hormone levels and reproductive function were significantly recovered, and the mean counts of primordial follicle increased. At the same time, the expression of SIRT6 was remarkably increased and the expression of NF-κB was significantly decreased in this group. Conclusions MLT enhances several effects of ADSCs in restoring hormone levels, mean primordial follicle counts, and reproductive capacity in POI mice. Meanwhile, our results suggest that the SIRT6/NF-κB signal pathway may be the potential therapeutic mechanism for ADSCs to treat POI.

This study presents detailed time-integrated and time-resolved spectral analysis of the Fermi Gamma-ray Burst Monitor observations of the bright GRB 231129C. The results reveal its distinct spectral characteristics, featuring a hard low-energy spectral index ( α ) and soft high-energy spectral index ( β ), similar to GRB 090902B, suggesting a possible dominance of thermal emission. Further analysis indicates that 92% of the spectral indices exceed the synchrotron “line of death,” with the hardest index at α ∼ +0.44. Simultaneously, 53% of the spectra can be well fitted by the nondissipative photosphere model, supporting a potential origin from a nondissipative photosphere. Additionally, we observe strong correlations between the spectral index α and peak energy E _p with flux. For the α − F relationship, we employ F = F _0 e ^(3.00±0.10) ^α to describe it, whereas the E _p − F relationship requires a smoothly bending power-law function. Based on the framework proposed by Hascoët et al. and Gao & Zhang, the jet characteristics of this burst were studied, revealing that both methods support the suitability of a pure fireball model for this GRB at small initial jet radii.

There is no consensus yet on whether the precursor and the main burst of gamma-ray bursts (GRBs) have the same origin, and their jet composition is still unclear. In order to further investigate this issue, we systematically search 21 Fermi GRBs with both a precursor and main burst for spectral analysis. We first perform Bayesian time-resolved spectral analysis and find that almost all the precursors and the main bursts (94.4%) exhibit thermal components and that the vast majority of them have a low-energy spectral index ( α ; 72.2%) that exceeds the limit of synchrotron radiation. We then analyze the evolution and correlation of the spectral parameters and find that approximately half of the α (50%) of the precursors and the main bursts evolve in a similar pattern, while peak energy ( E _p ; 55.6%) behaves similarly, and their evolution is mainly characterized by flux tracking; for the α − F (the flux) relation, more than half of the precursors and the main bursts (61.1%) exhibit roughly similar patterns; the E _p − F relation in both the precursor and main burst (100%) exhibits a positive correlation of at least moderate strength. Next, we constrain the outflow properties of the precursors and the main bursts and find that most of them exhibit typical properties of photosphere radiation. Finally, we compare the time-integrated spectra of the precursors and the main bursts and find that nearly all of them are located in similar regions of the Amati relation and follow the Yonetoku relation. Therefore, we conclude that main bursts are continuations of precursors and may share a common physical origin.

GRB 211211A is a peculiar long gamma-ray burst (GRB) with very high brightness and short burst properties. Its full light curve consists of three emission episodes, i.e., a precursor, a main burst, and an extended emission. We find that a recently detected long-duration GRB 230307A also includes the three consistent emission episodes. Furthermore, the two bursts have similar redshifts, 0.076 and 0.065, respectively. We perform a detailed temporal and spectral analysis of the two GRBs to compare their temporal and spectral properties. Our analysis shows that the two bursts share great similarities for both the whole emission and the three corresponding emission phases, which are listed as follows: (1) they have near zero spectral lag; (2) they have very short minimum variability timescale (MVT); (3) they lie in the same region of in the MVT– T _90 , Amati relation and hardness– T _90 planes; (4) the three phases are quasi-thermal spectra; (5) both the peak energy and the low-energy index track the flux; (6) the time-resolved spectra are much wider than those of the blackbody predicted by the model; (7) there are strong correlations between thermal flux and total flux and the correlation coefficients, and the slopes for the corresponding stages are very consistent; and (8) the photosphere emission properties are very consistent. Other investigations and observations suggest that the two GRBs indeed belong to a short burst with a compact star merger origin. Therefore, we think that GRB 230307A and GRB 211211A are rare and similar GRBs, and the photospheric radiation can interpret their radiation mechanisms.

We report a recently detected long-duration gamma-ray burst (GRB) event by Fermi-GBM, GRB 220304A. The spectral analysis of the burst by the Band function shows that both the time-integrated and time-resolved spectra are very narrow, with low-energy spectral index 〈 α 〉 = −0.05 ± 0.30 and high-energy spectral index 〈 β 〉 = −3.53 ± 0.30. It is reminiscent of GRB 090902B, a special GRB with photosphere radiation characteristics. Then, we perform spectral analysis using the Planck function (blackbody, BB) and the multicolor BB model. It is found that the spectra within −1 ∼ 3 s is well fit by the BB model, indicating that the observation within the first 4 s is a pure thermal event. Apart from that most of the spectra can be well modeled as a multicolor BB. We conclude that GRB 220304A is a GRB dominated by thermal radiation. We also find that the spectral widths of the time-resolved spectrum of the burst gradually increase with time. Based on the Amati relation, we infer the redshift to be 0.23, the physical properties of the relativistic outflow, and find that the relationship between the bulk Lorentz factor and the isotropic luminosity Γ– L _iso,52 still exists.

Abstract Primary ovarian insufficiency (POI) is a rare gynecological condition. This disease causes menstrual disturbances, infertility, and various health problems. Historically, hormone replacement therapy is the first-line treatment for this disorder. Women diagnosed with POI are left with limited therapeutic options. In order to remedy this situation, a new generation of therapeutic approaches, such as in vitro activation, mitochondrial activation technique, stem cell and exosomes therapy, biomaterials strategies, and platelet-rich plasma intra-ovarian infusion, is being developed. However, these emerging therapies are yet in the experimental stage and require precise design components to accelerate their conversion into clinical treatments. Thus, each medical practitioner bears responsibility for selecting suitable therapies for individual patients. In this article, we provide a timely analysis of the therapeutic strategies that are available for POI patients and discuss the prospects of POI therapy.

ObjectiveIntrauterine adhesions (IUAs) are a major cause of female infertility. Stem cells can be used to restore endometrial function owing to their regenerative abilities. We compared the safety and efficacy of autologous and allogeneic stem cell treatments in patients with recurrent IUA after conventional therapy based on a systematic review of the related literature.MethodsThe PubMed, Embase, and Cochrane databases were systematically searched. All analysis were performed using Review Manager 5.4. We compared improvements in endometrial thickness, pregnancy rates, menstruation, and side effects after autologous and allogeneic stem cell therapy. The study was registered with PROSPERO, CRD 42022322870.ResultsOur search returned 154 reports, 10 of which met the inclusion criteria, representing 116 patients. Of these, 44 patients in two studies were treated with allogeneic stem cells and 72 patients in eight studies were treated with autologous stem cells. Improvements in endometrial thickness and pregnancy rates after intrauterine device treatment were compared between the autologous and allogeneic stem cell groups. Endometrial thickness increased more after autologous stem cell IUA treatment (mean difference, 1.68; 95% confidence interval [CI]: 1.30–2.07; P < 0.00001), and the pregnancy rate was also improved (relative risk, 1.55; 95% CI: 1.19–2.02, P < 0. 001). No obvious and serious adverse reactions were observed during stem cell therapy in either group.ConclusionsThis meta-analysis and systematic review of the results of randomized trials of autologous and allogeneic stem cell treatments for IUA suggests that autologous stem cells have a better effect in improving the endometrium thickness and pregnancy rate.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022322870.

Many studies have shown that the X-ray flares in gamma-ray bursts (GRBs) have similar properties to the prompt emission pulses that occur in GRBs, suggesting that they may come from the same origin. We attempt to extend the evolution behavior that exists among GRBs to within individual GRBs. By selecting 12 GRBs with both multipulses and multiflares, we systematically study the overall evolution behaviors of the pulses and flares that occur within GRBs, including the width ( w ), peak time ( t _peak ), rise time ( t _rise ), decay time ( t _decay ), and spectral lag. We find that correlated relationships exist within the GRBs, even if the overall evolution slopes of the pulses and flares in different GRBs are different. We also study the relations between the full pulse width ( ω ), the ratio of the rising width to the decay width ( r / d ), and the energy ( E ) of multipulses and multiflares within GRBs. It is found that there is a power-law anticorrelation between ω and E and a power-law correlation between r / d and E , with the mean values of the two power-law indexes being −0.42 and 0.07, respectively, which are very close to the values that are obtained for the prompt emission pulses. In addition, we find that the percentages of the positive lags for pulses and flares are 83% and 92%, respectively, with the lags of the flares being much larger than those of the pulses. Our results indicate that the overall evolution behaviors of the pulses and flares within individual GRBs are similar to the evolution behavior among GRBs, and that flares are low-energy extensions of pulses, providing further evidence that both come from the same origin.

Long-duration GRB 211211A that lacks a supernova emission even down to very stringent limits at such a low redshift z = 0.076 and is associated with kilonova emission, suggests that its physical origin is from a binary compact star merger. By reanalyzing its data observed with the Gamma-Ray Burst Monitor on board the Fermi mission, we find that both time-integrated and time-resolved spectra can be fitted well by using a 2SBPL plus blackbody (2SBPL+BB) model in the prompt emission. The bulk Lorentz factors (Γ _ph ) of the outflow can be inferred by invoking the observed thermal emission at the photosphere radius within a pure fireball model, and we find out that the temporal evolution of Γ _ph seems to be tracking with the light curve. The derived values of Γ _ph are also consistent with the Γ _ph – L _γ _,iso / E _γ _,iso correlations that had been found in other bursts. Moreover, we also calculate the magnetization factor σ _0 in the central engine and σ _ph at the photosphere radius within the framework of a hybrid jet model, and find that the values of both 1 + σ _0 and 1 + σ _ph are larger than 1 for different time slices. It suggests that at least the Poynting-flux component is indeed existent in the outflow. If this is the case, one possible physical interpretation of thermal and nonthermal emissions in GRB 211211A is from the contributions of both $\nu \bar{\nu }$ annihilation and the Blandford–Znajek mechanisms in the relativistic jet when a stellar mass black hole resides in the central engine.

Intrauterine adhesion (IUA) is an endometrial fibrosis disease caused by repeated operations of the uterus and is a common cause of female infertility. In recent years, treatment using mesenchymal stem cells (MSCs) has been proposed by many researchers and is now widely used in clinics because of the low immunogenicity of MSCs. It is believed that allogeneic MSCs can be used to treat IUA because MSCs express only low levels of MHC class I molecules and no MHC class II or co-stimulatory molecules. However, many scholars still believe that the use of allogeneic MSCs to treat IUA may lead to immune rejection. Compared with allogeneic MSCs, autologous MSCs are safer, more ethical, and can better adapt to the body. Here, we review recently published articles on the immunomodulation of allogeneic and autologous MSCs in IUA therapy, with the aim of proving that the use of autologous MSCs can reduce the possibility of immune rejection in the treatment of IUAs.

Accurately forecasting ocean waves during typhoon events is extremely important in aiding the mitigation and minimization of their potential damage to the coastal infrastructure, and the protection of coastal communities. However, due to the complex hydrological and meteorological interaction and uncertainties arising from different modeling systems, quantifying the uncertainties and improving the forecasting accuracy of modeled typhoon-induced waves remain challenging. This paper presents a practical approach to optimizing model-ensemble wave heights in an attempt to improve the accuracy of real-time typhoon wave forecasting. A locally weighted learning algorithm is used to obtain the weights for the wave heights computed by the WAVEWATCH III wave model driven by winds from four different weather models (model-ensembles). The optimized weights are subsequently used to calculate the resulting wave heights from the model-ensembles. The results show that the optimization is capable of capturing the different behavioral effects of the different weather models on wave generation. Comparison with the measurements at the selected wave buoy locations shows that the optimized weights, obtained through a training process, can significantly improve the accuracy of the forecasted wave heights over the standard mean values, particularly for typhoon-induced peak waves. The results also indicate that the algorithm is easy to implement and practical for real-time wave forecasting.