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Abstract Background Left ventricular hypertrabeculation (LVHT) is a heterogeneous entity with life-threatening complications and variable prognosis. However, there are limited prediction models available to identify individuals at high risk of adverse outcomes, and the current risk score in LVHT is comparatively complex for clinical practice. This study aimed to develop and validate a simplified risk score to predict major adverse cardiovascular events (MACE) in LVHT. Methods This multicenter longitudinal cohort study consecutively enrolled morphologically diagnosed LVHT patients between January 2009 and December 2020 at Fuwai Hospital (derivation cohort, n = 300; internal validation cohort, n = 129), and between January 2014 and December 2022 at two national-level medical centers (external validation cohort, n = 95). The derivation/internal validation cohorts and the external validation cohort were followed annually until December 2022 and December 2023, respectively. MACE was defined as a composite of all-cause mortality, heart transplantation/left ventricular assist device implantation, cardiac resynchronization therapy, malignant ventricular arrhythmia, and thromboembolism. A simplified risk score, the ABLE-SCORE, was developed based on independent risk factors in the multivariable Cox regression predictive model for MACE, and underwent both internal and external validations to confirm its discrimination, calibration, and clinical applicability. Results A total of 524 LVHT patients (43.5 ± 16.6 years, 65.8% male) were included in the study. The ABLE-SCORE was established using four easily accessible clinical variables: age at diagnosis, N-terminal pro-brain natriuretic peptide levels, left atrium enlargement, and left ventricular ejection fraction ≤ 40% measured by echocardiography. The risk score showed excellent performance in discrimination, with Harrell’s C-index of 0.821 [95% confidence interval (CI), 0.772–0.869], 0.786 (95%CI, 0.703–0.869), and 0.750 (95%CI, 0.644–0.856) in the derivation, internal validation, and external validation cohort, respectively. Calibration plots of the three datasets suggested accurate agreement between the predicted and observed 5-year risk of MACE in LVHT. According to decision curve analysis, the ABLE-SCORE displayed greater net benefits than the existing risk score for LVHT, indicating its strength in clinical applicability. Conclusions A simplified and efficient risk score for MACE was developed and validated using a large LVHT cohort, making it a reliable and convenient tool for the risk stratification and clinical management of patients with LVHT.

Objective Treating patients with large thoracic scoliosis (between 70° and 100°) poses technical challenges, particularly with traditional correction techniques (TCT). To address this, we developed a novel deformity correction manipulation system (DCMS) aimed at reducing surgical complexity and trauma. This study aims to assess the safety and effectiveness of DCMS in treating large thoracic scoliosis. Methods From January 2016 to June 2021, 76 patients with large thoracic scoliosis were included in this retrospective study. The patients were divided into two groups: DCMS (n = 34) and TCT (n = 42). Basic patient data including age at surgery, sex, etiology, Risser sign, flexibility of the main thoracic curve, instrumented levels, number of screws, duration of hospital stay, and follow‐up time were collected and analyzed. Radiographic and clinical outcomes, as measured by various radiographic parameters and Scoliosis Research Society‐30 (SRS‐30) scores, were retrospectively analyzed and compared between the two groups. Adverse events were also documented. Statistical analyses were performed using two‐tailed independent t‐tests, chi‐square tests, and Fisher's exact test. Results The DCMS group exhibited significantly shorter operative times, reduced blood loss, and shorter hospital stays compared to the TCT group. However, there were no significant differences between the two groups in terms of age at surgery, sex, etiology, Risser sign, flexibility of the main curve, instrumented levels, number of screws, and follow‐up time. While preoperative major curves were statistically similar between the two groups, the DCMS group achieved a superior correction rate compared to the TCT group (74.2% ± 8.8% vs 68.1% ± 10.5%). No significant differences were observed in other radiographic parameters, SRS‐30 scores, or the incidence of adverse events. Conclusion The application of DCMS resulted in shorter operative times, reduced blood loss, shorter hospital stays, and greater curve correction compared to TCT. DCMS proves to be a safe and effective technique for treating large thoracic curves.

Previous studies have confirmed that intervertebral disc degeneration (IDD) is closely associated with inflammation-induced reactive oxygen species (ROS) and resultant cell mitochondrial membrane potential (MMP) decline. Clearance of ROS in an inflammatory environment is essential for breaking the vicious cycle of MMP decline. Additionally, re-energizing the mitochondria damaged in the inflammatory milieu to restore their function, is equally important. Herein, we proposed an interesting concept of mitochondrion-engine equipped with coolant, which enables first to “cool-down” the inflammatory environment, next to restore the MMP, finally to allow cells to regain normal energy metabolism through materials design. As such, we developed a multi-functional composite composed of a reactive oxygen species (ROS)-responsive sodium alginate/gelatin hydrogel infused into a rigid 3D-printed thermoplastic polyurethane (TPU) scaffold. The TPU scaffold was coated with conductive polypyrrole (PPy) to electrophoretically deposit l-arginine, which could upregulate the Mammalian target of rapamycin (mTOR) pathway, thus increasing MMP and energy metabolism to stimulate extracellular matrix synthesis for IVD repair. While the ROS-responsive hydrogel acting as the “mito-engine coolant” could scavenge the excessive ROS to create a favorable environment for IVD cells recovery. Demonstrated by in vitro and in vivo evaluations, the mito-engine system markedly promoted the proliferation and collagen synthesis of nucleus pulposus cells while enhancing the mitochondrial respiration and MMP under oxidative stress. Radiological and histological assessments in vivo revealed the efficacy of this system in IVD repair. This unique bioinspired design integrated biomaterial science with mitochondrial biology, presents a promising paradigm for IDD treatment.

Abstract The individuals often show consolation to distressed companions or show aggression to the intruders. The circuit mechanisms underlying switching between consolation and aggression remain unclear. In the present study, using male mandarin voles, we identified that two distinct subtypes of oxytocin receptor (OXTR) neurons in the medial amygdala (MeA) projecting to the anterior insula (AI) and ventrolateral aspect of ventromedial hypothalamus (VMHvl) response differently to stressed siblings or unfamiliar intruders using c-Fos or calcium recording. Oxytocin release and activities of PVN neurons projecting to MeA increased upon consoling and attacking. OXTR antagonist injection to the MeA reduced consoling and attacking. Apoptosis, optogenetic or pharmacogenetic manipulation of these two populations of neurons altered behavioral responses to these two social stimuli respectively. Here, we show that two subtypes of OXTR neurons in the MeA projecting to the AI or VMHvl causally control consolation or aggression that may underlie switch between consolation and aggression.

Abstract Introduction Adolescent idiopathic scoliosis (AIS), a prevalent condition among teenagers, is often accompanied by osteopenia. However, the impact of brace treatment on bone density in AIS patients remains a matter of debate. The Vertebral bone quality (VBQ) score, derived from MRI signal intensity, has been shown to correlate with bone mineral density (BMD). Yet, no studies to date have drawn comparisons between VBQ scores in preoperative AIS patients who had brace treatment history and those who have not received brace treatment. Objective This study aims to elucidate the influence of brace treatment on bone density in AIS patients using VBQ score. Methods A retrospective analysis was conducted on 243 AIS patients, each with Cobb angles ranging from 50–70°, who had undergone preoperative MRI scans. The patients were segregated into two cohorts: those who received brace treatment (n = 174) and those who did not (n = 69). Through propensity score matching, a total of 53 matched pairs were selected for further analysis. VBQ scores were extracted from T1-weighted MRI scans. Results Post-matching, no significant baseline discrepancies were observed between the two groups. Interestingly, brace-treated patients exhibited lower average VBQ scores than their non-brace-treated counterparts (2.43 ± 0.11 vs. 2.55 ± 0.12, p

Abstract Introduction Sepsis-associated acute kidney injury (SA-AKI) is strongly associated with poor prognosis. We aimed to build a machine learning (ML)-based clinical model to predict 1-year mortality in patients with SA-AKI. Methods Six ML algorithms were included to perform model fitting. Feature selection was based on the feature importance evaluated by the SHapley Additive exPlanations (SHAP) values. Area under the receiver operating characteristic curve (AUROC) was used to evaluate the discriminatory ability of the prediction model. Calibration curve and Brier score were employed to assess the calibrated ability. Our ML-based prediction models were validated both internally and externally. Results A total of 12,750 patients with SA-AKI and 55 features were included to build the prediction models. We identified the top 10 predictors including age, ICU stay and GCS score based on the feature importance. Among the six ML algorithms, the CatBoost showed the best prediction performance with an AUROC of 0.813 and Brier score of 0.119. In the external validation set, the predictive value remained favorable (AUROC = 0.784). Conclusion In this study, we developed and validated a ML-based prediction model based on 10 commonly used clinical features which could accurately and early identify the individuals at high-risk of long-term mortality in patients with SA-AKI.

Objectives Currently, anterior‐only (AO), posterior‐only, and combined anterior–posterior spinal fusions are common strategies for treating cervical kyphosis in patients with neurofibromatosis‐1 NF‐1. Nevertheless, the choice of surgical strategy remains a topic of controversy. The aim of our study is to evaluate the safety and effectiveness of anterior decompression and spinal reconstruction for the treatment of cervical kyphosis in patients with NF‐1. Methods Twelve patients with NF‐1‐associated cervical kyphotic deformity were reviewed retrospectively between January 2010 and April 2020. All patients underwent AO correction and reconstruction. The X‐ray was followed up in all these patients to assess the preoperative and postoperative local kyphosis angle (LKA), the global kyphosis angle (GKA), the sagittal vertical axis, and the T1 slope. The visual analog scale score, Japanese Orthopedic Association (JOA) score, and neck disability index (NDI) score were used to evaluate the improvement inclinical symptoms. The results of the difference in improvement from preoperatively to the final follow‐up assessment were assessed using a paired t‐test or Mann–Whitney U‐test. Results The LKA and GKA decreased from the preoperative average of 64.42 (range, 38–86) and 35.50 (range, 10–81) to an average of 16.83 (range, −2 to 46) and 4.25 (range, −22 to 39) postoperatively, respectively. The average correction rates of the LKA and GKA were 76.11% and 111.97%, respectively. All patients had achieved satisfactory relief of neurological symptoms (p

Recurrent opportunistic infections (OIs) in patients with severely immunosuppressed AIDS remain an unresolved medical challenge despite advancements in antiretroviral therapy (ART). To address this gap, we developed an HLA-mismatched allogeneic adoptive immune therapy (AAIT) specifically targeting this patient population. The safety and efficacy of this novel therapeutic approach were preliminarily confirmed in our phase 1 trial. Subsequently, a multicenter, open-label, controlled, phase 2a trial was conducted to evaluate the efficacy of AAIT in combination with ART compared with the conventional ART-only regimen. No difference in the incidence of adverse events (AEs) was observed between the two groups at the 96-week follow-up. AAIT treatment improved CD4+ T cell recovery at weeks 72 (P = 0.048) and 96 (P = 0.024) compared to the Control Group. Additionally, stratified analysis of patients in the AAIT Group showed that donor/recipient sex mismatch was significantly associated with the likelihood of patients achieving an immunological response (OR = 8.667; 95% CI, 2.010–37.377; P = 0.004). These findings suggest that AAIT serves as a promising adjunct therapy for improving the outcomes of patients with severely immunosuppressed AIDS. Further studies are needed to elucidate the immunological mechanisms underlying AAIT and identify the subpopulations that respond optimally to this therapeutic approach. This trial is registered at www.clinicaltrials.gov (NCT04098770).Trial registration: ClinicalTrials.gov identifier: NCT04098770.Trial registration: ClinicalTrials.gov identifier: NCT02651376.

Background Nonrheumatic valvular heart disease (NRVD) is increasingly becoming a significant public health concern, particularly among older people. In the context of population aging, a detailed report on the epidemiological trends of NRVD is crucial for policymakers to effectively allocate health care resources. This study aimed to explore these trends using data from the GBD (Global Burden of Disease) 2019 study. Methods and Results We assessed the changing trends of the incidence, mortality, and disability‐adjusted life years rates for NRVD by calculating the estimated annual percentage change for each. Additionally, we examined the impact of a region's level of social development on NRVD epidemiological trends and identified key risk factors contributing to NRVD‐related deaths. Between 1990 and 2019, the global incidence of NRVD showed a gradual increase, with an estimated annual percentage change of 0.39 (95% CI, 0.30–0.48). The data revealed that women and older people are more likely to develop NRVD. High‐sociodemographic index countries exhibited higher age‐standardized incidence and mortality rates compared with low‐ and middle‐sociodemographic index countries. The most significant risk factor for NRVD‐related mortality was identified as high systolic blood pressure. Conclusions Over the past 3 decades, the burden of NRVD has intensified, indicating a need for more health care resources to address this issue, which is closely associated with an aging population. Currently, high‐sociodemographic index countries report the highest incidences and deaths due to NRVD. However, low‐ and middle‐sociodemographic index countries should also implement measures to manage the rapidly increasing burden of NRVD.

Objectives There is no consensus on the treatment of moderate‐to‐severe rigid scoliosis. Anterior release and three‐column osteotomy are excessively traumatic, whereas posterior column osteotomy (PCO) alone results in poor outcomes. An emerging surgical technique, posterior intervertebral release (PR), can release the rigid spine from the posterior approach. This study was performed to compare the multi‐segment apical convex PR combined with PCO and PCO alone in patients with moderate‐to‐severe rigid scoliosis. Methods From June 2021 to June 2022, this prospective study of moderate‐to‐severe (Cobb: 70–90°) rigid scoliosis (flexibility of main curve

Objective Recently, the MRI‐based vertebral bone quality (VBQ) score has been shown to correlate with Hounsfeld units (HU) value, dual‐energy X‐ray absorptiometry (DEXA) T‐score and predict osteoporotic fractures. Preoperative cervical HU value is an independent correlative factor for early titanium mesh cage (TMC) subsidence after anterior cervical corpectomy and fusion (ACCF). However, to date the direct association between cervical VBQ score and TMC subsidence has not been studied. This study aims to investigate the predictive effect of cervical VBQ score derived from sagittal non‐contrast‐enhanced T1‐weighted MRI on the early TMC subsidence after ACCF. Methods Patients who underwent one‐level ACCF from January 2016 to January 2020 were included. We retrospectively collected baseline data on age, sex, body mass index (BMI), disease type, level of surgery and radiology parameters. The cervical VBQ score was measured using preoperative non‐contrast‐enhanced T1‐weighted MRI. Univariate and multivariate logistic regression analysis were performed to screen the independent risk factors of TMC subsidence. The receiver operating characteristic (ROC) curve and area under curve (AUC) were performed to assess the predictive ability of TMC subsidence based on the cervical VBQ score. Spearman correlation analysis was used to determine the correlations between the cervical VBQ score and TMC subsidence. Results A total of 134 patients who underwent one‐level ACCF were included in this study, and 46 (34.33%) patients had TMC subsidence. Univariable analyses demonstrated that the age, TMC placement depth and VBQ score were associated with subsidence. The cervical VBQ score in the subsidence group was significantly higher than that in the no subsidence group (3.75 ± 0.45 vs. 3.20 ± 0.42, p

Abstract Ferroptosis is a newly discovered form of cell death that is featured in a wide range of diseases. Exosome therapy is a promising therapeutic option that has attracted much attention due to its low immunogenicity, low toxicity, and ability to penetrate biological barriers. In addition, emerging evidence indicates that exosomes possess the ability to modulate the progression of diverse diseases by regulating ferroptosis in damaged cells. Hence, the mechanism by which cell-derived and noncellular-derived exosomes target ferroptosis in different diseases through the system Xc−/GSH/GPX4 axis, NAD(P)H/FSP1/CoQ10 axis, iron metabolism pathway and lipid metabolism pathway associated with ferroptosis, as well as its applications in liver disease, neurological diseases, lung injury, heart injury, cancer and other diseases, are summarized here. Additionally, the role of exosome-regulated ferroptosis as an emerging repair mechanism for damaged tissues and cells is also discussed, and this is expected to be a promising treatment direction for various diseases in the future. Video Abstract

As a generalization of a consistent pair of $ t $-structures on triangulated categories, we introduced the notion of a consistent pair of $ \mathfrak{s} $-torsion pairs in the extriangulated setup. Let $ (\mathcal{T}_{i}, \mathcal{F}_{i}) $ be an $ \mathfrak{s} $-torsion pair in an extriangulated category with a negative first extension for any $ i = 1, 2 $. By using the consistent pair, we gave a criterion for $ (\mathcal{T}_{1}\ast\mathcal{T}_{2}, \mathcal{F}_{1}\cap\mathcal{F}_{2}) $ to be an $ \mathfrak{s} $-torsion pair. Our results were then applied to the torsion theory induced by $ \tau $-rigid modules.

Abstract Background The stress hyperglycemia ratio (SHR) has been demonstrated as an independent risk factor for acute kidney injury (AKI) in certain populations. However, this relationship in patients with congestive heart failure (CHF) remains unclear. Our study sought to elucidate the relationship between SHR and AKI in patients with CHF. Methods A total of 8268 patients with CHF were included in this study. We categorized SHR into distinct groups and evaluated its association with mortality through logistic or Cox regression analyses. Additionally, we applied the restricted cubic spline (RCS) analysis to explore the relationship between SHR as a continuous variable and the occurrence of AKI. The primary outcome of interest in this investigation was the incidence of AKI during hospitalization. Results Within this patient cohort, a total of 5,221 (63.1%) patients experienced AKI during their hospital stay. Upon adjusting for potential confounding variables, we identified a U-shaped correlation between SHR and the occurrence of AKI, with an inflection point at 0.98. When the SHR exceeded 0.98, for each standard deviation (SD) increase, the risk of AKI was augmented by 1.32-fold (odds ratio [OR]: 1.32, 95% CI: 1.22 to 1.46). Conversely, when SHR was below 0.98, each SD decrease was associated with a pronounced increase in the risk of AKI. Conclusion Our study reveals a U-shaped relationship between SHR and AKI in patients with CHF. Notably, we identified an inflection point at an SHR value of 0.98, signifying a critical threshold for evaluating AKI in this population.

Objective Previous studies have confirmed that the nanohydroxyapatite/polyamide‐66 (n‐HA/PA66) cage is an ideal alternative material for degenerative lumbar disease (DLD) comparable to the polyether ether ketone (PEEK) cage due to its similar radiographic fusion, subsidence rate, and clinical results. However, these studies were restricted to one‐level surgery. The aim of this study was to analyze the long‐term clinical and radiologic outcomes between n‐HA PA66 cage and PEEK cage for patients with multi‐level degenerative lumbar diseases (DLDs). Methods We retrospectively reviewed all patients who underwent multi‐level transforaminal lumbar interbody fusion (TLIF) from June 2010 to December 2016 with a minimum 6‐year follow‐up. Matched‐pair analysis was performed using a 1‐to‐1 closest neighbor approach to match patients who received an n‐HA PA66 cage with those who received a PEEK cage. Clinical outcomes and radiographic evaluations were compared between the two groups. The independent student's t‐test and χ2‐test were applied to compare the differences between groups. Results At the end of the propensity score matching (PSM) analysis, 48 patients from n‐HA/PA66 group were matched to 48 patients in the PEEK group. No significant difference was observed in cage subsidence and bony fusion except for adjacent segment degeneration (ASD). The occurrence of ASD was 14.58% (7/48) in the n‐HA/PA 66 group, which was significantly less than that in the PEEK group (33.33% [16/48]) (p = 0.031). Although the intervertebral space height (IH), segmental angle (SA) and lumbar lordosis (LL) significantly increased after surgery in both groups, there was no significant difference at any time point after surgery (p > 0.05). The visual analogue scale (VAS) and Oswestry disability index (ODI) scores significantly improved in both groups at 3m postoperative, 1y postoperative and at final follow‐up. However, there were no significant differences in the VAS and ODI score at any time point (p > 0.05). The total complications and re‐admission rate were not different between the two groups. Conclusion Overall, our data suggest that the outcomes of n‐HA/PA66 cage group are comparable to those of the PEEK cage group, with a similar high fusion rate and low cage subsidence rate as PEEK cages, except its lower rate of ASD occurrence.

Objectives The treatment of scoliosis with a severe rib hump remains a major challenge. Traditional vertebral rotation techniques are not satisfactory, and thoracoplasty has many pulmonary complications that limit its application. A novel surgical device, the multiple screw distraction reducer (MSDR) system, provides longitudinal distraction during the corrective operation while at the same time providing lateral translation and axial derotation, which may facilitate the correction of a rib hump. This study was performed to investigate the effectiveness of the MSDR system for adolescent idiopathic scoliosis (AIS) with a severe rib hump. Methods This was a case‐matched study of patients with retrospectively collected data from our hospital between January 2017 and December 2021. Sixty‐eight patients who underwent one‐stage posterior pedicle screw‐instrumented spinal fusion were matched by the Cobb angle of the main curve and rib hump. All patients underwent a minimum of 2 years of follow‐up. The patients were divided into two groups: the MSDR group (using the MSDR system, n = 34) and the DVR group (using direct vertebral derotation, n = 34). The patients were evaluated for the height of the rib hump, deformity correction, complications, and SRS‐30 scores. The unpaired Student's t‐test and Pearson's χ2‐test were used to compare the outcome measures between the two groups. Multiple linear regression analysis was used to examine the variables that affected the correction of a rib hump. Results The rib hump was 30.21 ± 6.21 mm versus 29.35 ± 6.52 mm (p = 0.583) preoperatively and 9.18 ± 4.06 mm versus 13.82 ± 5.54 mm (p

In turning, tool wear and cutting vibration are inevitable, which have great influence on surface quality. Analyzing the influence mechanism of tool wear and cutting vibration on surface quality is important to achieve the accurate prediction of surface roughness before machining and improve machining quality. In this paper, a turning vibration experiment is conducted to reveal that the diameter of shafts is an important factor affecting the vibration amplitude and frequency. In addition, based on machining parameters, tool wear and workpiece diameter, this empirical model, the response surface method and a support vector machine are used to model and predict surface roughness. The fitting accuracy, prediction accuracy and generalization performance of the proposed methods are compared in detail. The results show that the response surface modeling method has the highest fitting accuracy, but the exponential empirical modeling method has the highest prediction accuracy and best generalization performance. Additionally, the prediction results indicate that the surface roughness increases with the increase in tool wear and decreases with the increase in workpiece diameter.

IntroductionDuring public health emergencies, online rumors spread widely on social media, causing public information anxiety and emotional fluctuations. Analyzing the co-evolution patterns of online rumor themes and emotions is essential for implementing proactive and precise governance of online rumors during such events.MethodsRumor texts from mainstream fact-checking platforms during the COVID-19 pandemic were collected and analyzed in phases based on the crisis lifecycle theory. The LDA topic model was applied to analyze the distribution of rumor themes at different stages. The Baidu AI Sentiment Analysis API was used to study the emotional tendencies of rumors at different stages. Line graphs were utilized to analyze the co-evolution characteristics of rumor themes and emotions.ResultsDuring the COVID-19 pandemic, the themes of online rumors can be categorized into five types: epidemic prevention and control, panic-inducing, production and livelihood, virus dissemination, and social figures. These themes exhibited repetition and fluctuation at different stages of the pandemic. The emotions embedded in pandemic-related online rumors evolved with the progression of the pandemic. Panic-inducing rumors co-evolved with negative emotions, while epidemic prevention and control rumors co-evolved with positive emotions.ConclusionThe study results help to understand the public’s focus and emotional tendencies at different stages of the COVID-19 pandemic, thereby enabling targeted public opinion guidance and crisis management.

PurposePrevious studies have confirmed the advantages and disadvantages of autogenous iliac bone and nano-hydroxyapatite/polyamide 66 (n-HA/PA66) cage. However, there is no conclusive comparison between the efficacy of the two implant materials in spinal tuberculosis bone graft fusion. The aim of this study was to analyze the mid-to long-term clinical and radiologic outcomes between n-HA/PA66 cage and autogenous iliac bone for anterior reconstruction application of spinal defect for thoracolumbar tuberculosis.MethodsWe retrospectively reviewed all patients who underwent anterior debridement and strut graft with n-HA/PA66 cage or iliac bone combined with anterior instrumentations between June 2009 and June 2014. One-to-one nearest-neighbor propensity score matching (PSM) was used to match patients who underwent n-HA/PA66 cage to those who underwent iliac bone. Clinical outcomes were assessed using the Japanese Orthopaedic Association (JOA) and visual analogue score (VAS). Radiographic evaluations included cage subsidence and segmental angle.ResultsAt the end of the PSM analysis, 16 patients from n-HA/PA66 cage group were matched to 16 patients in Iliac bone group. The C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) values in the n-HA/PA66 group decreased significantly from 33.19 ± 10.89 and 46.63 ± 15.65 preoperatively, to 6.56 ± 2.48 and 9.31 ± 3.34 at the final follow-up, respectively (p < 0.001). There were no significant differences in the CRP and ESR values between the two groups at the final follow-up. The VAS and JOA scores in the iliac bone and n-HA/PA66 group were significantly improved at the 3-month follow-up postoperatively (both p < 0.001). Then, improvements of VAS and JOA scores continue long at final follow-up. However, there were no significant differences in the VAS and JOA scores at any time point between the two groups (p > 0.05). Although the segmental angle (SA) significantly increased after surgery in both groups, there was no significant difference at any time point after surgery (p > 0.05). There were no significant differences in the cage subsidence and fusion time between the two groups.ConclusionOverall, our data suggest that the n-HA/PA66 cage outcomes are comparable to those in the autogenous iliac bone, with a similar high fusion rate as autogenous iliac bone.

Objectives: Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory disorder characterized by progressive airflow limitation. This meta-analysis aims to evaluate the effectiveness of respiratory muscle training (RMT) on key pulmonary function parameters, inspiratory muscle strength and quality of life in patients with stable COPD. Methods: A comprehensive search was conducted in the databases including PubMed, Cochrane, Web of Science, Embase, and ClinicalTrials.gov, from their inception to June 12, 2023. Randomized controlled trials (RCTs) evaluating the impact of RMT on stable COPD were included for meta-analysis. Results: In total, 12 RCTs involving 453 participants were included in the meta-analysis. RMT demonstrated a significant increase in maximal inspiratory pressure (PImax, MD, 95% CI: 14.34, 8.17 to 20.51, P

Abstract Wind power prediction enables advance prediction of the future capacity of wind farms to improve production, increase capacity and reduce costs, however, wind power generation data are highly unstable, making it difficult to achieve high‐precision prediction. Signal decomposition methods and optimization algorithms allow for data smoothing and optimization of parameter settings, but the limitations of parameter dependency and the slow optimization search process prevent existing research from being applied in a practical setting. To address these issues, this article proposes a multiscale ultra‐short‐term wind power prediction model based on particle swarm optimization based on greedy dynamic and integrated fitness evaluation method (GD‐IFEM‐PSO) and variational mode decomposition and back propagation network (VMD‐BP). First, this article improves the velocity update formula in the particle swarm optimization algorithm by the proposed GD weight and sets up a fitness function using multiple evaluation metrics by the proposed integrated fitness evaluation method (IFEM), so that the improved particle swarm optimization algorithm achieves high efficiency in the optimization search while ensuring the comprehensiveness of the evaluation. Second, the variable mode decomposition (VMD) decomposition algorithm is used to decompose the historical wind power data to achieve smoothing of the wind power data, and the improved particle swarm optimization algorithm is used to optimize the K and ⍺ values in the VMD decomposition algorithm to improve the comprehensive performance of the decomposition. Then, to achieve data reduction and fast model training, the components are divided into trend components, low‐frequency vibration components, high‐frequency vibration components, and random noise components according to the central frequency, so that the model can better grasp the data trend while reducing the number of components and achieving high prediction accuracy. Finally, the different components are predicted by the BP neural network and the predicted values of the different categories of components are reconstructed into the final wind power prediction values. To demonstrate the rationality and progressiveness of the proposed model, several models are compared on several data sets, and the results show that the proposed model has faster prediction speed and higher prediction performance, and is more suitable for application in real‐world environments.

Abstract Background Bone mineral density (BMD) is important for the outcome of cervical spine surgery. As the gold standard of assessing BMD, dual-energy X-ray absorptiometry scans are often not ordered or go unreviewed in patients’ charts. As the supplement, MRI-based vertebral bone quality (VBQ) was found to accurately predict osteopenia/osteoporosis and postoperative complications in lumbar spine. However, discussion of the efficiency of VBQ in cervical spine is lacking. And measurement methods of VBQ in cervical spine are diverse and not universally acknowledged like lumbar spine. We aimed to compare the predictive performance of three kinds of different Cervical-VBQ (C-VBQ) scores for bone mineral density assessment in patients undergoing cervical spine surgery. HU value of cervical spine was set as a reference. Methods Adult patients receiving cervical spine surgery for degenerative diseases were retrospectively included between Jan 2015 and Dec 2022 in our hospital. The VBQ scores and HU value were measured from preoperative MRI and CT. The correlation between HU value/C-VBQs (named C-VBQ1/2/3 according to different calculating methods) and DEXA T-score was analyzed using univariate linear correlation and Pearson’s correlation. We evaluated the predictive performance of those two parameters and achieved the most appropriate cutoff value by comparing the receiver operating characteristic (ROC) curves. Results 106 patients (34 patients with T ≥ − 1.0 vs 72 patients with T

Abstract. Background:. Red-cell transfusion is critical for surgery during the peri-operative period; however, the transfusion threshold remains controversial mainly owing to the diversity among patients. The patient's medical status should be evaluated before making a transfusion decision. Herein, we developed an individualized transfusion strategy using the West-China-Liu's Score based on the physiology of oxygen delivery/consumption balance and designed an open-label, multicenter, randomized clinical trial to verify whether it reduced red cell requirement as compared with that associated with restrictive and liberal strategies safely and effectively, providing valid evidence for peri-operative transfusion. Methods:. Patients aged >14 years undergoing elective non-cardiac surgery with estimated blood loss > 1000 mL or 20% blood volume and hemoglobin concentration

Objectives Decreased bone mineral density (BMD) is associated with complications in implantation surgery for severe spinal deformity. In this quantitative study, we aimed to investigate the impact of halo‐pelvic traction on vertebral bone mineral density (BMD) and identify the risk factors for a decrease in BMD. Methods Patients who underwent halo‐pelvic traction at our hospital between 2019 and 2022 were included in the study. Patients’ data, including height, weight, and BMD pre‐ and post‐traction, were collected and analyzed. Quantitative computed tomography (QCT) was used to determine the BMD. The paired rank sum test was used to evaluate the changes in each measurement parameter. Linear regression was used to identify risk factors for a decrease in BMD. Results Fifteen patients were included in the study, nine women and six men, with an average age of 21.2 ± 7.3 years. Eleven patients had severe rigid scoliosis, while four had tuberculotic kyphosis. One expert measured the BMD values of 345 vertebrae using QCT. The average traction time was 143.3 ± 44.4 days. The average pre‐traction BMD was 183.1 ± 73.8 mg/cm3, and the average post‐traction BMD was 140.5 ± 61.3 mg/cm3 (p

Objective Previous studies have found satisfactory clinical results with the nano‐hydroxyapatite/polyamide 66 (n‐HA/PA66) cage to reconstruct the stability of anterior cervical column. However, studies evaluating the long‐term outcomes of the n‐HA/PA66 cage in multi‐level degenerative cervical myelopathy (MDCM) have not been reported. This study aims to compare the outcomes of corpectomy anterior cervical discectomy and fusion (ACDF) hybrid procedures between the n‐HA/PA66 cage and titanium mesh cage (TMC) to treat MDCM. Methods After the screening for eligibility, this retrospective study involved 90 patients who underwent corpectomy ACDF hybrid (CACDFH) procedure from June 2013 to June 2018. The CACDFH procedure is the combination of ACDF and anterior cervical corpectomy and fusion (ACCF). According to the cage utilized, we categorized patients into a n‐HA/PA66 cage group and a TMC group. Then, stepwise propensity score matching (PSM) was performed to maintain comparable clinical data between groups. All the patients were followed up ≥4 years and the longest follow‐up time was 65.43 (±11.49) months. Cage subsidence, adjacent segment degeneration (ASD), segmental height (SH), segmental angle (SA), cervical lordosis (CL), and clinical data (visual analogue scale [VAS] and Japanese Orthopaedic Association [JOA] score) was evaluated preoperatively, at 1 week, and at the final surgery follow‐up. The independent student's t test and chi‐square test were applied to compare the differences between groups. Results Through PSM analysis, 25 patients from the n‐HA/PA66 group were matched to 25 patients in the TMC group. The occurrence of ASD was 16.0% (4/25) in the n‐HA/PA 66 group, which was significantly less than in the TMC group at 44.0% (11/25) (p = 0.031). Moreover, the cage subsidence rate was significantly higher in the TMC group as compared to the n‐HA/PA 66 group (40.0% vs. 12.0%, p = 0.024). But there was no significant difference in SH, SA, and CL at any time after surgery as determined through follow‐up. The VAS and JOA scores significantly improved in both groups at 3 months postoperative and at final follow‐up. However, there were no significant differences in the VAS and JOA score at any time between the two groups in preoperative (p > 0.05). Conclusion The n‐HA/PA66 cage is associated with lower rate of cage subsidence and ASD than the TMC in the treatment of MDCM. The n‐HA/PA66 cage could be superior to the TMC in corpectomy ACDF hybrid procedures.

We investigated the polaron-assisted nonadiabatic dynamics in protonated TiO2, as well as the polaron-H2O coupling and its effects on the relaxation of photogenerated electrons. We observed that different polaron hopping regimes result in varied nonadiabatic couplings and relaxations of excited electrons from the conduction band minimum to the gap states of protonated TiO2, with a weak dependence on the actual trapping site of the polaron. Surface-adsorbed H2O molecules can attract polarons toward the adsorbed Ti sites, with the coupling between H2O and the polaron being inversely proportional to their distance. Our findings suggest that the lifetime of the photogenerated charge carriers can be extended by reducing the polaron-H2O distances, with expected benefits to the efficiency of the reduced TiO2 samples for photocatalytic applications.

Abstract Background The COVID-19 pandemic has been linked to various psychological disorders, including anxiety, particularly among the general public. It is crucial to monitor the mental health of school students, who are considered a vulnerable group in society, and assess their self-efficacy, as it can significantly affect their mental health. This study aimed to investigate the levels of anxiety and self-efficacy among school students during the COVID-19 pandemic. Methods This cross-sectional study utilized convenience sampling to examine a sample of 335 school students from Sistan and Baluchestan province in southeastern Iran. An online questionnaire, distributed through social media platforms, was used to collect data. The questionnaire included demographic information, COVID-19 related items, the Multidimensional Anxiety Scale for Children-MASC, and the Self-Efficacy Questionnaire for Children-SEQ-C. Data analysis was conducted using IBM SPSS version 24, with a significance level set at

Abstract The abnormal lipid and glucose metabolisms are linked to the metabolic disorders, tumorigenesis, and fibrotic diseases, which attracts the increasing attention to find out the key molecules involved in the lipid and glucose metabolism as the possible therapeutic targets on these diseases. A transcriptional factor Twist1 has been associated with not only the embryonic development, cancer, and fibrotic diseases, but also the regulation of lipid and glucose metabolism. In this review, we will discuss the roles and mechanisms of Twist1 in the obesity-associated white adipose tissue inflammation and insulin resistance, brown adipose tissue metabolism, fatty acid oxidation, and glucose metabolism in skeletal muscle to provide a rational perspective to consider Twist1 as a potential treatment target in clinic. Video Abstract

Objective Although direct isthmic repair, such as PSVPH, did not affect the mobility of the fixed segment and adjacent segment, it has a relatively low rate of isthmic fusion compared with conventional fusion. The Isobar TTL dynamic internal fixation system has been widely used in clinical practice and has achieved satisfactory clinical results. However, the use of the Isobar TTL system in combination with direct isthmic repair for lumbar spondylolysis has rarely been reported. The aim of this study was to compare the clinical and radiologic outcomes between patients who underwent Isobar TTL system and PSVPH with direct repair of defect for lumbar spondylolysis. Methods Stepwise propensity score matching (PSM) for age and sex were performed to keep comparable clinical data between groups in this retrospective and matched‐pair case control study. A total of 50 patients diagnosed with lumbar spondylolysis underwent surgical implantation of the Isobar TTL group (n = 25) or PSVPH group (n = 25) from June 2009 to June 2016. Clinical outcomes were assessed using the Oswestry disability index (ODI), and visual analog score (VAS). Radiographic evaluations included range of motion (ROM) and the disc heights of stabilized segment and adjacent segment, adjacent segment degeneration (ASD) and bony fusion. Three‐dimensional reconstruction of lumbar CT scan was obtained to evaluate bone fusion of the isthmic at final follow‐up. The independent Student's t test and chi‐square test were applied to compare the differences between groups. Results A total of 25 patients from TTL group were matched to 25 patients in PSVPH group for age, sex, body mass index (BMI), defect side, spondylolisthesis meyerding, and follow‐up duration. The intervertebral space height (IH) of stabilized segment at postoperative 1 week and final follow‐up in the TTL group was higher than those in the PSVPH group, respectively (P = 0.030; P = 0.013). The ROM of stabilized segment at final follow‐up in the TTL group was significantly lower than that in the PSVPH group (P

(1) Background: This study seeks to employ a machine learning (ML) algorithm to forecast the risk of distant metastasis (DM) in patients with T1 and T2 gallbladder cancer (GBC); (2) Methods: Data of patients diagnosed with T1 and T2 GBC was obtained from SEER, encompassing the period from 2004 to 2015, were utilized to apply seven ML algorithms. These algorithms were appraised by the area under the receiver operating characteristic curve (AUC) and other metrics; (3) Results: This study involved 4371 patients in total. Out of these patients, 764 (17.4%) cases progressed to develop DM. Utilizing a logistic regression (LR) model to identify independent risk factors for DM of gallbladder cancer (GBC). A nomogram has been developed to forecast DM in early T-stage gallbladder cancer patients. Through the evaluation of different models using relevant indicators, it was discovered that Random Forest (RF) exhibited the most outstanding predictive performance; (4) Conclusions: RF has demonstrated high accuracy in predicting DM in gallbladder cancer patients, assisting clinical physicians in enhancing the accuracy of diagnosis. This can be particularly valuable for improving patient outcomes and optimizing treatment strategies. We employ the RF algorithm to construct the corresponding web calculator.

Based on the self-stress slurry reinforcement method for fractured rock mass proposed by the authors, considering the influence of rock strength on the coupling effect of self-stress slurry and rock mass, the paper selected underground sandstone, carbonaceous mudstone, sandy mudstone, and coal as the research objects. Then, the comparative tests of reinforcing fractured rock mass with different strength by ordinary slurry and self-stress slurry were carried out to further analyze the influence of rock strength on grouting reinforcement effect. The composite reinforcement effect of restrained self-stress slurry on the rock mass fracture interface was investigated from multiple angles to reveal the reinforcement mechanism of slurry self-stress. Through several engineering cases of different rock strength, the macroscopic reinforcement effect of the self-stress slurry system on the engineering surrounding rock with different rock strength was analyzed. The results showed that the reinforcement effect of self-stress slurry on the fractured rock masses with different strength, such as soft and hard rock, was greater than that of ordinary slurry. As the strength of the rock mass became weaker, the repair degree of slurry to the fractured rock mass was gradually reduced, and the grouting reinforced rock mass specimens gradually transited from shear failure along the diagonal direction to splitting collapse failure. The self-stress of the slurry improved the restrained state of the slurry-rock interface, and then increased the shear strength of the interface by increasing the friction force. The contact connection effect of the two mediums of slurry and rock had been improved. The cementation density of self-stress slurry-rock interface was significantly higher than that of ordinary slurry-rock interface. The crystal particle distribution, compactness and mechanical properties of self-stress slurry stone were obviously better than those of ordinary slurry. The ultra-fine siliceous self-stress slurry system had achieved good results in the reinforcement of broken soft rock roadways, relatively hard rock roadways, and soft coal wall.

Objective At present, the influence of Modic changes (MCs) on postoperative fusion rate of lumbar interbody fusion (LIF) is mainly focused on the medium‐ and long‐term fusion rate, while the short‐term fusion rate has not been reported. The aim of this study was to compare the short‐term fusion rate of lumbar degenerative disease patients with and without MCs after single level transforaminal lumbar interbody fusion (TLIF). Methods In this retrospective and matched‐pair case control study, we included 100 patients who underwent TLIF from January 2017 to January 2020 and had at least two follow‐up visits over a two‐year period. Fifty patients with MCs (MCs group) were matched with 50 patients without MCs (non MCs group) for age, sex, surgical level, diagnosis, operative time, and intraoperative blood loss. We collected the X‐ray and computed tomography (CT) data of patients from 3 months to 2 years after the operation to assess bony fusion and the cage union ratio. According to the type of cage, the MCs group was further divided into the nano‐hydroxyapatite/polyamide 66 (n‐HA/PA66) group and polyetheretherketone (PEEK) group, and the fusion performance between the two groups was compared. Finally, age, sex, body mass index (BMI), smoking and cage type were included in the logistic regression model for risk factor analysis. Results The bony fusion rates in the MCs group at 3 months, 6 months, 1 year and 2 years after surgery were significantly lower than those in the non MCs group (P

Abstract Background The nano-hydroxyapatite/polyamide-66 (n-HA/PA66) cage is a biomimetic cage with a lower elastic modulus than the titanium mesh cage (TMC). This study aimed to compare the long-term outcomes of the n-HA/PA66 cage and TMC in the anterior reconstruction of thoracic and lumbar fractures. Methods We retrospectively studied 113 patients with acute traumatic thoracic or lumbar burst fractures, comprising 60 patients treated with the TMC and 53 treated with the n-HA/PA66 cage for anterior reconstruction following single-level corpectomy. The radiographic data (cage subsidence, fusion status, segmental sagittal alignment) and clinical data (visual analogue scale (VAS) for pain and Oswestry Disability Index (ODI) for function) were evaluated preoperatively, postoperatively, and at final follow-up after a minimum 7-year period. Results The n-HA/PA66 and TMC groups had similar final fusion rates (96.2% vs. 95.0%). The cage subsidence at final follow-up was 2.3 ± 1.6 mm with subsidence of more than 3 mm occurring in 24.5% in the n-HA/PA66 group, which was significantly lower than the respective values of 3.9 ± 2.5 mm and 58.3% in the TMC group. The n-HA/PA66 group also had better correction of the bisegmental kyphotic angle than the TMC group (7.1° ± 7.5° vs 1.9° ± 8.6°, p

Objective Treatment of syncope in older adults places a burden on healthcare systems. We used five risk stratification tools to predict short-term adverse outcomes in older patients with syncope. Methods This was a retrospective analysis of patients with syncope (age ≥60 years) in the emergency department of an urban academic hospital. The data were evaluated using the Risk Stratification of Syncope in the Emergency Department (ROSE), San Francisco Syncope Rule (SFSR), FAINT, Canadian Syncope Risk Score (CSRS), and Boston Syncope Criteria (BSC) tools. Sensitivity, specificity, accuracy, positive and negative predictive value (NPV), and positive and negative likelihood ratios of each tool were calculated and compared for adverse events within 1 month. Results In total, 221 patients (average age 75.6 years) were analyzed. Fifty-nine patients (26.7%) had experienced an adverse event within 1 month. For the ROSE, SFSR, FAINT, CSRS and BSC tools, sensitivities were 81.3%, 76.3%, 93.2%, 71.2%, and 94.9%, specificities were 88.3%, 87.7%, 56.8%, 71.6%, and 67.3%, and NPVs were 92.9%, 91.0%, 95.8%, 87.2%, and 97.3%, respectively. Conclusion The five assessed tools could be useful for physicians in screening older patients with syncope for the risk of short-term adverse events, according to the patient’s actual situation.

Abstract Multimodal abstractive summarisation (MAS) aims to generate a textual summary from multimodal data collection, such as video‐text pairs. Despite the success of recent work, the existing methods lack a thorough analysis for consistency across multimodal data. Besides, previous work relies on the fusion method to extract multimodal semantics, neglecting the constraints for complementary semantics of each modality. To address those issues, a multilayer cross‐fusion model with the reconstructor for the MAS task is proposed. Their model could thoroughly conduct cross‐fusion for each modality via layers of cross‐modal transformer blocks, resulting in cross‐modal fusion representations with consistency across modalities. Then the reconstructor is employed to reproduce source modalities based on cross‐modal fusion representations. The reconstruction process constrains the fusion representations with the complementary semantics of each modality. Comprehensive comparison and ablation experiments on the open domain multimodal dataset How2 are proposed. The results empirically verify the effectiveness of the multilayer cross‐fusion with the reconstructor structure on the proposed model.

Objective Multiple hemivertebrae (MHV) is defined as three or more hemivertebrae, and is relatively uncommon among patients with congenital scoliosis. This study aimed to compare the natural history of different kinds of MHV and describe the surgical outcome of MHV. Methods In this retrospective cohort study, a total of 50 patients diagnosed with MHV were enrolled from June 2007 to June 2018. The medical records and radiographs of these patients were reviewed to summarize the characteristics of MHV. Patients with MHV were divided into the unbalanced (UB) group, partially unbalanced (PUB) group, and completely balanced (CB) group. Medical records and radiographs of MHV patients were reviewed to collect HV position, natural history, coronal and sagittal parameters. A Mann–Whitney U test was used to compare the radiographical data, such as the cobb angle of main curve and secondary curve, and Fisher's exact test was used to compare the patients in different kinds of MHV with surgical indication or not. Results The average number of hemivertebrae was 3.6 and the average main curve was 57.5°. Twenty‐four of 50 patients had associated anomalies, including four patients with sacral agenesis, one with tetralogy of Fallot, two with congenital imperforate anus, and 17 with Klippel‐Feil syndrome. In 22 patients who underwent MRI imaging, three patients had mild syringomyelia and three patients had diastematomyelia. The UB and PUB groups had a larger main curve and compensatory curve than the CB group. Of the 25 patients with follow‐up before surgery, the curve progression rate was highest in the UB group (12.1°/year) but similar in the PUB group (4.2°/year) and CB group (3.6°/year). All patients in the UB and PUB group met the criteria for surgery. In contrast, only 10 of 23 patients in the CB group had surgical indications. Eighteen of the 37 patients with surgical indications chose to undergo surgery and the correction rate of the main curve was 51.4%. Conclusions Early surgical intervention should be considered for most patients with UB or PUB MHV. For patients with CB MHV, surgical treatment may not be urgently needed at the first visit. Posterior hemivertebrectomy could be used for the treatment of MHV with satisfying radiographic outcome.

Abstract. With the accelerated aging society in China, the incidence of biliary surgical diseases in the elderly has increased significantly. The clinical characteristics of these patients indicate that improving treatment outcomes and realizing healthy aging are worthy of attention. How to effectively improve the treatment effect of geriatric biliary surgical diseases has attracted widespread attention. This paper reviews and comments on the hotspots and difficulties of biliary surgery in older patients from six aspects: (1) higher morbidity associated with an aging society, (2) prevention and control of pre-operative risks, (3) extending the indications of laparoscopic surgery, (4) urgent standardization of minimally invasive surgery, (5) precise technological progress in hepatobiliary surgery, and (6) guarantee of peri-operative safety. It is of great significance to fully understand the focus of controversy, actively make use of its favorable factors, and effectively avoid its unfavorable factors, for further improving the therapeutic effects of geriatric biliary surgical diseases, and thus benefits the vast older patients with biliary surgical diseases. Accordingly, a historical record with the highest age of 93 years for laparoscopic transcystic common bile duct exploration has been created by us recently.

Abstract Organ fibrosis can occur in virtually all major organs with relentlessly progressive and irreversible progress, ultimately resulting in organ dysfunction and potentially death. Unfortunately, current clinical treatments cannot halt or reverse the progression of fibrosis to end-stage organ failure, and thus, advanced antifibrotic therapeutics are urgently needed. In recent years, a growing body of research has revealed that circular RNAs (circRNAs) play pivotal roles in the development and progression of organ fibrosis through highly diverse mechanisms of action. Thus, manipulating circRNAs has emerged as a promising strategy to mitigate fibrosis across different organ types. In this review, we systemically summarize the current state of knowledge about circRNA biological properties and the regulatory mechanisms of circRNAs. A comprehensive overview of major fibrotic signaling pathways and representative circRNAs that are known to modulate fibrotic signals are outlined. Then, we focus on the research progress of the versatile functional roles and underlying molecular mechanisms of circRNAs in various fibrotic diseases in different organs, including the heart, liver, lung, kidney and skin. Finally, we offer a glimpse into the prospects of circRNA-based interference and therapy, as well as their utilization as biomarkers in the diagnosis and prognosis of fibrotic diseases. Video abstract

Abstract The higher prevalence of metabolic syndrome (MetS) in women after menopause is associated with a decrease in circulating 17β-oestradiol. To explore novel treatments for MetS in women with oestrogen deficiency, we studied the effect of exogenous butyrate on diet-induced obesity and metabolic dysfunctions using ovariectomized (OVX) mice as a menopause model. Oral administration of sodium butyrate (NaB) reduced the body fat content and blood lipids, increased whole-body energy expenditure, and improved insulin sensitivity. Additionally, NaB induced oestrogen receptor alpha (ERα) expression, activated the phosphorylation of AMPK and PGC1α, and improved mitochondrial aerobic respiration in cultured skeletal muscle cells. In conclusion, oral NaB improves metabolic parameters in OVX mice with diet-induced obesity. Oral supplementation with NaB might provide a novel therapeutic approach to treating MetS in women with menopause. Graphical Abstract Video Abstract

To demonstrate the feasibility and improve the implementation of laser weeding, a static movable lift-adjustable closed fiber laser weeding device and system have been developed, followed by experiments and performance evaluations. Physical experiments were conducted on the energy required for laser cutting of weed stems, targeting four common larger weeds (Chenopodium album, Amaranthus spinosus, Setaria viridis, and Eleusine indica) in farmland and orchards. At the same irradiation distances, the energy required to cut the same type of large weed generally increases with increasing distances and stem diameters but decreases with increasing irradiation time. The variance of stems’ power density after irradiation was larger and the values were more dispersed for Chenopodium album and Setaria viridis weeds, and the values were relatively scattered, while the power density values of Amaranthus spinosus and Eleusine indica weeds were more concentrated. When the irradiation time was 10 s, the 3.892 W/mm2 laser was sufficient to eliminate weeds and plants with the irradiation distances of 2 m. The 2.47 W/mm2 laser was more effective, as it killed weeds within a distance of 1 m in less than 1 s. This work demonstrates the feasibility of the laser weeding device and system that can completely cut off the stems of large weeds, and this technology has the potential to promote sustainable agriculture.

The most important part of fruit cultivation is transplanting, which can be completed efficiently by an automatic transplanter. In this study, an automatic solanum lycopersicum transplanter was developed. It is primarily composed of the following devices: a seedling tray fixator, a mechanical transplanting arm, double horizontal driving modules, double vertical driving cylinders, a seedling separation device, double-crank five-bar planting devices, a power distribution system, and a PLC control system. An experimental test on an automatic transplanter was carried out on dry land. The experimental results showed that when the planting frequency was 80 plants/(min·row), the transplanting success rate was 93.89%, the missed planting rate was 1.58%, the replanting rate was 0.65%, the lodging rate was 1.94%, and the exposed seedling rate was 1.94%. Each device of the automatic transplanter was coordinated to complete the transplanting process. The automatic transplanter met the operation requirements, and it not only transplanted in dry land but also provided a theoretical basis for fruit cultivation in solar greenhouses in the future.

Accurate positioning at the inter-row canopy can provide data support for precision variable-rate spraying. Therefore, there is an urgent need to design a reliable positioning method for the inter-row canopy of closed orchards (planted forests). In the study, the Extended Kalman Filter (EKF) fusion positioning method (method C) was first constructed by calibrating the IMU and encoder with errors. Meanwhile, 3D Light Detection and Ranging (LiDAR) observations were introduced to be fused into Method C. An EKF fusion positioning method (method D) based on 3D LiDAR corrected detection was designed. The method starts or closes method C by the presence or absence of the canopy. The vertically installed 3D LiDAR detected the canopy body center, providing the vehicle with inter-row vertical distance and heading. They were obtained through the distance between the center of the body and fixed row spacing. This can provide an accurate initial position for method C and correct the positioning trajectory. Finally, the positioning and canopy length measurement experiments were designed using a GPS positioning system. The results show that the method proposed in this study can significantly improve the accuracy of length measurement and positioning at the inter-row canopy, which does not significantly change with the distance traveled. In the orchard experiment, the average positioning deviations of the lateral and vertical distances at the inter-row canopy are 0.1 m and 0.2 m, respectively, with an average heading deviation of 6.75°, and the average relative error of canopy length measurement was 4.35%. The method can provide a simple and reliable inter-row positioning method for current remote-controlled and manned agricultural machinery when working in standardized 3D crops. This can modify the above-mentioned machinery to improve its automation level.

Background: Gastric cancer (GC) ranks third for cancer deaths worldwide, and glycolysis is a hallmark of several cancers, including GC. TEAD4 plays a role in establishing an oncogenic cascade in cancers, including GC. Whether TEAD4 can influence the glycolysis of GC cells remains uncovered. Hence, this study attempted to investigate the impact on glycolysis of GC cells by TEAD4. Methods: By using bioinformatics analysis, differentially expressed mRNAs were screened, and downstream regulatory genes were predicted. Expression levels of TEAD4 and PKMYT1 were assessed by qRT-PCR. The binding sites between TEAD4 and PKMYT1 were predicted by the JASPAR database, meanwhile their modulatory relationship was confirmed through dual-luciferase assay and chromatin Immunoprecipitation (ChIP). Cell viability and proliferation were assayed via CCK-8 and colony formation assays. Glycolysis was measured by assaying extracellular acidification rate, oxygen consumption rate, and production of pyruvic acid, lactate, citrate, and malate. Expression levels of proteins (HK-2 and PKM2) related to glycolysis were assessed by Western blot. Results: TEAD4 was upregulated in GC tissues and cells. TEAD4 knockdown substantially repressed glycolysis and proliferation of GC cells. PKMYT1, the target gene downstream of TEAD4, was identified via bioinformatics prediction, and its expression was elevated in GC. Dual-luciferase and ChIP assay validated the targeted relationship between the promoter region of PKMYT1 and TEAD4. As revealed by rescue experiments, the knockdown of TEAD4 reversed the stimulative effect on GC cell glycolysis and proliferation by forced expression of PKMYT1. Conclusion: TEAD4 activated PKMYT1 to facilitate the proliferation and glycolysis of GC cells. TEAD4 and PKMYT1 may be possible therapeutic targets for GC.

Accumulation of the heavy metal Cadmium (Cd) in the ovaries and placenta can affect the structure and function of these organs and induce female reproductive toxicity. This toxicity may be due to Cd’s similarity to estrogen and its ability to disrupt endocrine systems. However, the exact molecular mechanism by which Cd causes reproductive toxicity at the transcriptome level remains poorly understood. Hence, this study aimed to observe Cd-induced reproductive damage at the gene level, scrutinize the repercussions of Cd exposure on oogenesis, and explicate the putative pathogenesis of Cd-induced oogenesis based on Caenorhabditis elegans (C. elegans) as an in vivo model. The results showed that Cd exposure significantly decreased the number of offspring and prolonged the reproductive span of C. elegans. Cd exposure also reduced the number of cells in mitosis and the pachytene and diakinesis stages of meiosis, thereby disrupting oogenesis. Combined with transcriptional sequencing and bioinformatics analysis, a total of 3167 DEmRNAs were identified. Regarding gene expression, cul-6, mum-2, and vang-1 were found to be related to Cd-induced reproductive toxicity, and their competing endogenous RNA networks were constructed. We observed that mutations of mom-2 and vang-1 in the Wnt pathway could induce susceptibility to Cd-caused meiosis injury. In conclusion, the results indicated that Cd could impair the oogenesis of C. elegans and the Wnt pathway might serve as a protective mechanism against Cd reproductive toxicity. These findings contribute to a better understanding of the damaging effects and molecular biological mechanisms of Cd on the human reproductive system.

Intervertebral disc degeneration (IDD) is a major contributing factor to both lower back and neck pain. As IDD progresses, the intervertebral disc (IVD) loses its ability to maintain its disc height when subjected to axial loading. This failure in the weight-bearing capacity of the IVD is a characteristic feature of degeneration. Natural polymer-based hydrogel, derived from biological polymers, possesses biocompatibility and is able to mimic the structure of extracellular matrix, enabling them to support cellular behavior. However, their mechanical performance is relatively poor, thus limiting their application in IVD regeneration. In this study, we developed an injectable composite hydrogel, namely, Mel-MBG/SA, which is similar to natural weight-bearing IVD. Mesoporous bioactive glasses not only enhance hydrogels, but also act as carriers for melatonin (Mel) to suppress inflammation during IDD. The Mel-MBG/SA hydrogel further provides a mixed system with sustained Mel release to alleviate IL-1β-induced oxidative stress and relieve inflammation associated with IDD pathology. Furthermore, our study shows that this delivery system can effectively suppress inflammation in the rat tail model, which is expected to further promote IVD regeneration. This approach presents a novel strategy for promoting tissue regeneration by effectively modulating the inflammatory environment while harnessing the mechanical properties of the material.

Abstract Background Current evidence suggests that the magnetic resonance imaging (MRI)-based vertebral bone quality (VBQ) score is a good parameter for evaluating bone quality. We aimed to assess whether the VBQ score can predict the occurrence of postoperative cage subsidence after oblique lumbar interbody fusion (OLIF) surgery. Methods Patients (n = 102) who had undergone single-level OLIF with a minimal follow-up for 1 year were reviewed in this study. Demographic and radiographic data of these patients were collected. Cage subsidence was defined as ≥ 2 mm of cage migration into the inferior endplate, superior endplate, or both. Further, the MRI-based VBQ score was measured on T1-weighted images. Moreover, univariable and multivariable binary logistic regression analyses were performed. Meanwhile, Pearson analysis was used to evaluate the correlation among the VBQ score, average lumbar dual-energy X-ray absorptiometry (DEXA) T-score, and degree of cage subsidence. Furthermore, ad-hoc analysis was used along with receiver operating characteristic curve analysis to assess the predictive ability of the VBQ score and average lumbar DEXA T-score. Results Of 102 participants, cage subsidence was observed in 39 (38.24%) patients. According to the univariable analysis, patients with subsidence had older age, higher antiosteoporotic drug use, larger disk height change, a more concave morphology of inferior and superior endplates, higher VBQ score, and lower average lumbar DEXA T-score compared to patients without subsidence. In the multivariable logistic regression analysis, a higher VBQ score was significantly associated with an increased risk of subsidence (OR = 23.158 ± 0.849, 95% CI 4.381–122.399, p