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Abstract Background Glioblastoma are highly malignant type of primary brain tumors. Treatment for glioblastoma multiforme (GBM) generally involves surgery combined with chemotherapy and radiotherapy. However, the development of tumoral chemo- and radioresistance induces complexities in clinical practice. Multiple signaling pathways are known to be involved in radiation-induced cell survival. However, the role of alpha-thalassemia X-linked mutant retardation syndrome (ATRX), a chromatin remodeling protein, in GBM radioresistance remains unclear. Methods In the present study, the ATRX mutation rate in patients with glioma was obtained from The Cancer Genome Atlas, while its expression analyzed using bioinformatics. Datasets were also obtained from the Gene Expression Omnibus, and ATRX expression levels following irradiation of GBM were determined. The effects of ATRX on radiosensitivity were investigated using a knockdown assays. Results The present study demonstrated that the ATRX mutation rate in patients with GBM was significantly lower than that in patients with low-grade glioma, and that patients harboring an ATRX mutation exhibited a prolonged survival, compared with to those harboring the wild-type gene. Single-cell RNA sequencing demonstrated that ATRX counts increased 2 days after irradiation, with ATRX expression levels also increasing in U-251MG radioresistant cells. Moreover, the results of in vitro irradiation assays revealed that ATRX expression was increased in U-251MG cells, while ATRX knockdown was associated with increased levels of radiosensitivity. Conclusions High ATRX expression levels in primary GBM may contribute to high levels of radioresistance. Thus ATRX is a potential target for overcoming the radioresistance in GBM.

Abstract Background Intracerebral hemorrhage (ICH) is a common stroke type with high morbidity and mortality. There are mainly three surgical methods for treating ICH. Unfortunately, thus far, no specific surgical method has been proven to be the most effective. We carried out this study to investigate whether minimally invasive surgeries with endoscopic surgery or stereotactic aspiration (frameless navigated aspiration) will improve functional outcomes in patients with supratentorial ICH compared with small-bone flap craniotomy. Methods In this parallel-group multicenter randomized controlled trial conducted at 16 centers, patients with supratentorial hypertensive ICH were randomized to receive endoscopic surgery, stereotactic aspiration, or craniotomy at a 1:1:1 ratio from July 2016 to June 2022. The follow-up duration was 6 months. Patients were randomized to receive endoscopic evacuation, stereotactic aspiration, or small-bone flap craniotomy. The primary outcome was favorable functional outcome, defined as the proportion of patients who achieved a modified Rankin scale (mRS) score of 0–2 at the 6-month follow-up. Results A total of 733 patients were randomly allocated to three groups: 243 to the endoscopy group, 247 to the aspiration group, and 243 to the craniotomy group. Finally, 721 patients (239 in the endoscopy group, 246 in the aspiration group, and 236 in the craniotomy group) received treatment and were included in the intention-to-treat analysis. Primary efficacy analysis revealed that 73 of 219 (33.3%) in the endoscopy group, 72 of 220 (32.7%) in the aspiration group, and 47 of 212 (22.2%) in the craniotomy group achieved favorable functional outcome at the 6-month follow-up (P = .017). We got similar results in subgroup analysis of deep hemorrhages, while in lobar hemorrhages the prognostic outcome was similar among three groups. Old age, deep hematoma location, large hematoma volume, low preoperative GCS score, craniotomy, and intracranial infection were associated with greater odds of unfavorable outcomes. The mean hospitalization expenses were ¥92,420 in the endoscopy group, ¥77,351 in the aspiration group, and ¥100,947 in the craniotomy group (P = .000). Conclusions Compared with small bone flap craniotomy, endoscopic surgery and stereotactic aspiration improved the long-term outcome of hypertensive ICH, especially deep hemorrhages. Trial Registration ClinicalTrials.gov Identifier: NCT02811614.

Abstract Mixed reality navigation (MRN) technology is emerging as an increasingly significant and interesting topic in neurosurgery. MRN enables neurosurgeons to “see through” the head with an interactive, hybrid visualization environment that merges virtual- and physical-world elements. Offering immersive, intuitive, and reliable guidance for preoperative and intraoperative intervention of intracranial lesions, MRN showcases its potential as an economically efficient and user-friendly alternative to standard neuronavigation systems. However, the clinical research and development of MRN systems present challenges: recruiting a sufficient number of patients within a limited timeframe is difficult, and acquiring low-cost, commercially available, medically significant head phantoms is equally challenging. To accelerate the development of novel MRN systems and surmount these obstacles, the study presents a dataset designed for MRN system development and testing in neurosurgery. It includes CT and MRI data from 19 patients with intracranial lesions and derived 3D models of anatomical structures and validation references. The models are available in Wavefront object (OBJ) and Stereolithography (STL) formats, supporting the creation and assessment of neurosurgical MRN applications.

Abstract Background Tinnitus is very common in patients with vestibular schwannoma (VS). We analyzed the related factors of tinnitus after surgery. Methods One hundred seventy-three patients diagnosed with unilateral VS operated via the retrosigmoid approach were included in the study. All patients underwent relevant examinations and completed the THI scale before surgery and 6 months after surgery. The prognosis of tinnitus was evaluated according to the changes in THI. Results Of the 129 preoperative tinnitus patients, postoperative tinnitus resolved in 12.4%, improved in 29.5%, remained unchanged in 28.6%, and worsened in 29.5%. 18.2% of 44 patients without preoperative tinnitus appeared new-onset tinnitus postoperatively. Thirty-six patients never had tinnitus. Patients with smaller tumor sizes (≤ 3 cm) were more likely to experience preoperative tinnitus. Younger patients and those with serviceable hearing preoperatively were more likely to report their tinnitus unchanged or worsened. A new onset of postoperative tinnitus in the preoperative non-tinnitus group was found in better preoperative hearing function. Conclusions In this study, 70% of patients had persistent tinnitus after vestibular schwannoma resection. The prognosis of tinnitus was influenced by age and preoperative hearing function. Tinnitus is a bothersome symptom and is often underestimated by doctors. Assessment of tinnitus is mandatory during the management of vestibular schwannoma.

Cost estimation is a key component of project plans, yet it is challenging to provide reliable and efficient estimations using conventional methods in the conceptual phase of infrastructure projects. This study proposes a framework that integrates feature selection, extreme gradient boosting (XGBoost), Bayesian optimization (BO), and SHapley Additive exPlanations (SHAP) to provide conceptual cost estimations and explain the results for early decision-making. Correlation analysis and forward search are combined to select the key features. XGBoost is developed as the estimator and enhanced by BO in accuracy and efficiency. Model explanations were presented using SHAP. The framework is demonstrated through a case study of electric substations containing 605 samples. The results show that the proposed framework can provide satisfactory performance on conceptual cost estimations, where BO-XGBoost outperforms the benchmark models (with ${R^2}$ ~0.9567, adjusted ${R^2}$ ~0.9549, RMSE ~ 0.8690, and MAE ~ 0.4875). SHAP reveals how the features contribute to the cost based on both global and local explanations. The framework provides a guideline for more accurate, efficient, and explainable cost estimations in the conceptual phase of infrastructure projects. It can support the government and project planners in early decision-making, including reliable project budget and plan alternatives selection.

This study presents an in-depth investigation into the intersection of Building Information Modeling (BIM) and green building practices within China’s rapidly evolving construction industry. As China intensifies its efforts to mitigate environmental impacts and promote sustainable growth, the integration of BIM into green building practices emerges as a crucial area of study. A qualitative research method was adopted in this research. In the first step, utilizing semi-structured interviews with a diverse array of industry professionals, this research provides nuanced insights into the current state and prospects of BIM in the green building landscape. Secondly, thematic analysis is used to formalize the views and points from interviewees. Finally, a novel conceptual framework is proposed, addressing these challenges through technological innovation, supportive policies, cultural and educational reform, economic incentives, and collaborative dynamics. This study contributes a systematic approach to amalgamate BIM with sustainable construction, offering insights for industry professionals and policymakers to promote environmentally conscious building practices in China.

Addressing conventional neurosurgical navigation systems’ high costs and complexity, this study explores the feasibility and accuracy of a simplified, cost-effective mixed reality navigation (MRN) system based on a laser crosshair simulator (LCS). A new automatic registration method was developed, featuring coplanar laser emitters and a recognizable target pattern. The workflow was integrated into Microsoft’s HoloLens-2 for practical application. The study assessed the system’s precision by utilizing life-sized 3D-printed head phantoms based on computed tomography (CT) or magnetic resonance imaging (MRI) data from 19 patients (female/male: 7/12, average age: 54.4 ± 18.5 years) with intracranial lesions. Six to seven CT/MRI-visible scalp markers were used as reference points per case. The LCS-MRN’s accuracy was evaluated through landmark-based and lesion-based analyses, using metrics such as target registration error (TRE) and Dice similarity coefficient (DSC). The system demonstrated immersive capabilities for observing intracranial structures across all cases. Analysis of 124 landmarks showed a TRE of 3.0 ± 0.5 mm, consistent across various surgical positions. The DSC of 0.83 ± 0.12 correlated significantly with lesion volume (Spearman rho = 0.813, p < 0.001). Therefore, the LCS-MRN system is a viable tool for neurosurgical planning, highlighting its low user dependency, cost-efficiency, and accuracy, with prospects for future clinical application enhancements.

Mixed Reality Navigation (MRN) is pivotal in augmented reality-assisted intelligent neurosurgical interventions. However, existing MRN registration methods face challenges in concurrently achieving low user dependency, high accuracy, and clinical applicability. This study proposes and evaluates a novel registration method based on a laser crosshair simulator, evaluating its feasibility and accuracy. A novel registration method employing a laser crosshair simulator was introduced, designed to replicate the scanner frame’s position on the patient. The system autonomously calculates the transformation, mapping coordinates from the tracking space to the reference image space. A mathematical model and workflow for registration were designed, and a Universal Windows Platform (UWP) application was developed on HoloLens-2. Finally, a head phantom was used to measure the system’s target registration error (TRE). The proposed method was successfully implemented, obviating the need for user interactions with virtual objects during the registration process. Regarding accuracy, the average deviation was 3.7 ± 1.7 mm. This method shows encouraging results in efficiency and intuitiveness and marks a valuable advancement in low-cost, easy-to-use MRN systems. The potential for enhancing accuracy and adaptability in intervention procedures positions this approach as promising for improving surgical outcomes.

In order to protect the distributed network from complex-valued attack, a secure diffusion augmented complex-valued normalized subband adaptive filter algorithm is proposed in this article, which is derived from a novel complex-valued detection method. This complex-value detection method can be considered to consist of two parts. First, a non-cooperative augmented complex-valued normalized subband adaptive filter algorithm is used to provide reliable reference estimations under complex-valued attacks, and then the threshold test is constructed by using the reliable reference estimations to detect the trustworthy neighbors of each node. The second part is to reassemble the information from the trustworthy neighbors by using the diffusion augmented complex-valued normalized subband adaptive filter algorithm. Then, the theoretical analyses of the mean and mean-square performance of the proposed algorithm are derived based on the energy conservation framework. Finally, some experiments are performed to show the effectiveness of the proposed algorithm under non-time-varying and time-varying complex-valued attacks, respectively.

Abstract Objectives Spontaneous intracerebral hemorrhage remains a major cause of death and disability throughout the world. We tried to establish accurate long‐term outcome prediction models for hypertensive intracerebral hemorrhage (HICH) using CT radiomics and machine learning. Methods In a retrospective study of 270 patients with HICH between June 2013 and June 2018, CT images and patients' 6‐month outcome based on the modified Rankin Scale were collected. Hematomas on CT images were selected as volumes of interests (VOIs), and 1,029 radiomics features of the VOIs were extracted. Based on correlations with patients' outcome, radiomics features underwent dimensionality reduction analyses. Then, the support vector machine (SVM), k‐nearest neighbor (KNN), logistic regression (LR), decision tree (DT), random forest (RF), and XGBoost algorithms were applied with the screened features to establish prognostic prediction models of HICH. Accuracies of all models were compared. Results Eighteen radiomics features were screened as prognosis‐associated radiomics signature of HICH based on the variance threshold, SelectKBest, and least absolute shrinkage and selection operator (LASSO) regression models. Patients were randomly allocated into training (n = 215) and validation (n = 55) sets. Accuracies of all 6 machine learning algorithms in the validation set exceeded 80%. The sensitivity, specificity, and accuracy in the validation set were 93.3%, 92.5%, and 92.7% for the RF model and 92.3%, 88.1%, and 89.1% for the XGBoost model, respectively, which were the best two among all models. Conclusions Taking advantage of radiomics and machine learning, we established accurate prognostic prediction models of HICH. The RF model and XGBoost model returned the best accuracies.

For design for safety (DFS), automated compliance checking methods have received extensive attention. Although many research efforts have indicated the potential of BIM and ontology for automated compliance checking, an efficient methodology is still required for the interoperability and semantic representation of data from different sources. Therefore, a natural language processing (NLP)-based semantic framework is proposed in this paper, which implements rules-based automated compliance checking for building information modeling (BIM) at the design stage. Semantic-rich information can be extracted from safety regulations by NLP methods, which were analyzed to generate conceptual classes and individuals of ontology and provide a corpus basis for rule classification. The data on BIM was extracted from Revit to a spreadsheet using the Dynamo tool and then mapped to the ontology using the Cellfie tool. The interoperability of different source data was well improved through the isomorphism of information in the framework of semantic integration, causing data processed by the semantic web rule language to be transformed from safety regulations to achieve the purpose that automated compliance checking is implemented in the design documents. The practicability and scientific feasibility of the proposed framework was verified through a 95.21% recall and a 90.63% precision in compliance checking of a case study in China. Compared with traditional compliance checking methods, the proposed framework had high efficiency, response speed, data interoperability, and interaction.

Due to the good filter performance for the non-Gaussian noise, the adaptive filters with error nonlinearities have received increasing attention recently. From the viewpoint of the weighted function, in this paper, the existing least mean square (LMS)-based adaptive algorithms with error nonlinearities are divided into three types, i.e., V-shaped, A-shaped, and M-shaped algorithms. Then, to obtain the merits of the V-shaped and A-shaped algorithms, a new family of robust M-shaped error weighted LMS algorithms is proposed. Their steady-state mean square deviation (MSD) analyses are made, which reveal the learning abilities of error nonlinearities: 1) for the V-shaped algorithm, it can achieve smaller steady state MSD for sub-Gaussian noise than that for super-Gaussian noise; 2) the A-shaped algorithm can be used more effectively for super-Gaussian noise than that for sub-Gaussian noise; and 3) the M-shaped algorithm combines the characteristics of the V-shaped and A-shaped algorithms. Furthermore, based on the proposed robust M-shaped function, a proportionate normalized robust M-shaped algorithm is presented for echo cancellation application. Finally, Monte Carlo simulations are conducted to verify the theoretical results and to demonstrate the efficiency of the proposed algorithms in different environments.

Background Glioblastoma (GBM), the most malignant form of gliomas, is a relatively common primary brain tumor in adults. Preoperative identification of isocitrate dehydrogenase 1 (IDH1) mutations in GBM is of critical prognostic importance. The aim of the present study was to explore the feasibility and diagnostic performance of basic patient information combined with conventional magnetic resonance imaging (MRI) findings for determination of the IDH1 status (mutant vs wild type) in patients with GBM. Methods From January 1, 2016 to December 31, 2017, a consecutive series of 50 patients with GBM was retrospectively collected. The patients were divided into two group according to their IDH1 mutation status. Basic information and MRI features were analyzed for the establishment of a diagnostic prediction model using logistic regression. A receiver operating characteristic curve was used to evaluate the diagnostic performance. Results Patients with IDH1-mutant tumors were younger than those with IDH1-wild type tumors, and exhibited a larger tumor volume. The diagnostic predictive model established by combining age and the tumor size exhibited a sensitivity and specificity of 70% and 93%, respectively. The area under the curve was 0.88, which indicated high diagnostic performance. Conclusion Patient age and tumor volume can be used as indicators of IDH1 mutation status in patients with GBM, with high diagnostic performance for simple evaluations in clinical practice. The combined use of these two indicators can further enhance the diagnostic specificity.

Abstract Background: Hyperlipidemia, which is characterized by an elevation of lipids in the bloodstream, is a major risk factor for cardiac disease. Objectives: The present study investigated the role of fibrosis in the progression of hyperlipidemia in the mice heart, and whether mast cell activation was associated with the fibrosis process. Methods: Hyperlipidemia was produced in C57BL / 6 mice by feeding them on a high-fat diet for 8 weeks.To assess tissue fibrosis, picrosirius red staining was performed. Hematoxylin & eosin (H&E) staining was performed to identify the histopathological changes in the hearts. Immunohistochemistry was also accomplished to determine the localization of transforming growth factor (TGF)-β and α-smooth muscle actin (α-SMA). Western blotting was performed to analyze the expression of chymase, tryptase, TGF-β, α-SMA and activity of Wnt/β-catenin pathway. At the end, serum total cholesterol (TC) and triglycerides (TG) levels were measured. All the values were expressed as means ± SD, the statistical significance level adopted was 5%. Results: Hyperlipidemia mice showed significantly increased collagen deposition in the hearts compared with normal mice. In addition, H&E staining showed significant cellular degeneration. Cardiac muscle was arranged in disorder with fracture in mice of the model group. Immunohistochemistry and western blot analysis revealed that expression levels of tryptase, chymase, β-catenin, TGF-β and α-SMA were significantly increased in the hyperlipidemia mice compared with the control group. Conclusions: The results indicated that mast cell activation might induce cardiac fibrosis by tryptase and chymase in hyperlipidemia, which had a close relationship with the increased activity of TGF-β/Wnt/β-catenin pathway.

This study is to measure the diagnostic examination quality of magnetic resonance spectroscopy in differentiating high-grade gliomas from metastases. PubMed, Embase, and Chinese Biomedical databases were systematically searched for relevant studies published through 10 July 2016. Based on the data from eligible studies, heterogeneity and threshold effect tests were performed; pooled sensitivity, specificity, and areas under summary receiver-operating characteristic curve of magnetic resonance spectroscopy were calculated. Finally, seven studies with a total of 261 patients were included. Quantitative synthesis of studies showed that pooled sensitivity/specificity of Cho/NAA and Cho/Cr ratio in peritumoral region was 0.85 (95% confidence interval: 0.79–0.90)/0.93 (95% confidence interval: 0.80–0.99) and 0.86 (95% confidence interval: 0.76–0.92)/0.86 (95% confidence interval: 0.73–0.94). The area under the curve of the summary receiver-operating characteristic curve was 0.95 and 0.90. Pooled sensitivity, specificity, and area under the curve of magnetic resonance spectroscopy to identify high-grade gliomas from metastases were 0.85 (95% confidence interval: 0.79–0.90), 0.84 (95% confidence interval: 0.75–0.90), and 0.90, respectively. We concluded that magnetic resonance spectroscopy demonstrated moderate diagnostic performance in distinguishing high-grade gliomas from metastases. Furthermore, Cho/NAA ratio showed higher specificity and higher value of area under the curve than Cho/Cr ratio in peritumoral region. We suggest that Cho/NAA ratio of peritumoral region should be used to improve diagnostic accuracy of magnetic resonance spectroscopy for differentiating high-grade gliomas from metastases.

Acute kidney injury (AKI) is a common clinical condition that confers a risk of progression of chronic kidney disease and a high risk of death. The purpose of the current study is to investigate the anti-apoptotic and anti-fibrotic effects of Zhen-Wu-Tang (ZWT) on cisplatin (CIS)-induced renal injury and elucidate the involvement of nuclear factor (erythroid-derived 2)-like 2 (Nrf2), the PI3K/Akt signaling pathway, transforming growth factor (TGF)-β and the Wnt/β-catenin signaling pathway in the positive effects of Zhen-Wu-Tang on the kidneys. Wistar rats were randomly assigned into six groups of 6 rats each as follows: normal control 1; normal control 2; CIS 1 and CIS 2, which received single intraperitoneal injections of CIS (6 mg/kg); CIS+ZWT 4 and CIS+ZWT 10, which received ZWT (1 ml/100 g/day, ig) starting days after the CIS injection for 4 and 10 days, respectively. Hematoxylin-eosin (H&E) staining was performed to identify the amelioration of histopathological changes in the kidneys and apoptosis of the renal proximal tubular cells. Picrosirius red staining was used to evaluate renal fibrosis after ZWT treatment. The relationship between ZWT and the upregulation of Nrf2, phosphorylation of Akt, and the downregulation of TGF-β and WNT/β-catenin were determined by Western blotting. At the end of the experiment, serum was isolated from the orbital blood of rats, and blood urea nitrogen (BUN) and creatinine (Cr) levels were measured. The results showed that ZWT restored the histological alterations, aberrant collagen deposition in the kidneys and the BUN and Cr levels that were increased by CIS. Treatment with ZWT reduced the expression levels of TGF-β and Wnt and increased the expression levels of Nrf2, PI3K and Akt in the CIS-exposed kidney tissues. Furthermore, ZWT downregulated apoptosis and fibrosis by modulating the expression levels of caspase-3, Bax and alpha-smooth muscle actin (α-SMA). In conclusion, this study provides evidence for the anti-fibrotic and anti-apoptotic roles of ZWT in CIS-induced experimental kidney injury.

Recently, Wang et al. presented an efficient logistic map based block encryption system. The encryption system employs feedback ciphertext to achieve plaintext dependence of sub-keys. Unfortunately, we discovered that their scheme is unable to withstand key stream attack. To improve its security, this paper proposes a novel chaotic map based block cryptosystem. At the same time, a secure architecture for camera sensor network is constructed. The network comprises a set of inexpensive camera sensors to capture the images, a sink node equipped with sufficient computation and storage capabilities and a data processing server. The transmission security between the sink node and the server is gained by utilizing the improved cipher. Both theoretical analysis and simulation results indicate that the improved algorithm can overcome the flaws and maintain all the merits of the original cryptosystem. In addition, computational costs and efficiency of the proposed scheme are encouraging for the practical implementation in the real environment as well as camera sensor network.