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Objective The reported date in the repeat surgical intervention for adolescent lumbar disc herniation (ALDH) after percutaneous endoscopic lumbar discectomy (PELD) was quite scarce. This study aims to introduce cases of repeat surgeries after PELD for ALDH and assess the incidence, chief causes, repeat surgery methods, and surgical outcomes of repeat surgeries after PELD for ALDH. Methods A retrospective multicenter observational study was conducted on patients undergoing repeat surgeries after PELD for ALDH at four tertiary referral hospitals from January 2014 through August 2022. The incidence of repeat surgeries, chief causes, strategies for repeat surgeries, and timing of repeat surgeries were recorded and analyzed. The clinical outcomes were evaluated by the Numeric Rating Scales (NRS) scores and the modified MacNab criteria. Statistical analyses were performed with the Wilcoxon signed‐rank test. Results A total of 23 patients who underwent repeat surgeries after PELD for ALDH were included. The chief causes were re‐herniation (homo‐lateral re‐herniation at the same level, new disc herniation of adjacent level). The repeat surgery methods were revision PELD, micro‐endoscopic discectomy (MED), open discectomy and instrumented lumbar inter‐body fusion. The NRS scores decreased significantly in follow‐up evaluations and these scores demonstrated significant improvement at the last follow‐up (p

Abstract Human stem cells and derivatives transplantation are widely used to treat nervous system diseases, while the fate determination of transplanted cells is not well elucidated. To explore cell fate changes of human brain organoids before and after transplantation, human brain organoids are transplanted into prefrontal cortex (PFC) and hippocampus (HIP), respectively. Single‐cell sequencing is then performed. According to time‐series sample comparison, transplanted cells mainly undergo neural development at 2 months post‐transplantation (MPT) and then glial development at 4MPT, respectively. A different brain region sample comparison shows that organoids grafted to PFC have obtained cell fate close to those of host cells in PFC, other than HIP, which may be regulated by the abundant expression of dopamine (DA) and acetylcholine (Ach) in PFC. Meanwhile, morphological complexity of human astrocyte grafts is greater in PFC than in HIP. DA and Ach both activate the calcium activity and increase morphological complexity of astrocytes in vitro. This study demonstrates that human brain organoids receive host niche factor regulation after transplantation, resulting in the alignment of grafted cell fate with implanted brain regions, which may contribute to a better understanding of cell transplantation and regenerative medicine.

In the Response to Intervention framework, a psychometrically sound screening tool is essential for identification of children with emotional and behavioral risk. The purpose of this study was to examine the validity of the Pediatric Symptom Checklist-17 (PSC-17) screener in school-based settings. Forty-four teachers rated 738 preschoolers using the PSC-17; children were later assessed using long forms of the Behavior Assessment System for Children (BASC-2) Preschool form or the Achenbach System of Empirically Based Assessment (ASEBA) Caregiver--Teacher Report Form to identify emotional and behavioral disorder. Validity evidence including examinations of a multilevel factor structure, internal consistency, and criterion-related validity supported the conclusion that the PSC-17 is a high-quality universal screening tool in school-based settings. Finally, to identify emotional and behavioral risk with young children, receiver operating characteristic curve analyses with the PSC-17 yielded a lower cutoff score (i.e., 7) than the original cutoff score (i.e., 15) based on a clinical sample.

Ventilation provides the oxygen required for coal combustion, but it also accelerates the thermal loss of reaction system. To investigate the influence of ventilation on coal combustion, the characteristic temperatures and stage variation were analyzed. Furthermore, the kinetic mode was determined and the apparent activation energy was calculated. The results indicated that the increase of ventilation rate made the boundary temperatures for different stages decreased. The contribution of thermal decomposition effect to mass loss increased, and the contribution of burning effect correspondingly decreased. The ventilation rate mainly presented an influence on the kinetic mode at the second half of coal burning. The kinetic mode transformed from three-dimensional diffusion to random nucleation and subsequent growth when the ventilation rate reached 200 ml/min. In addition, under the same conversion rate, the apparent activation energy during thermal decomposition first increased and then decreased, and reached the maximum when the ventilation rate was 100 ml/min. The apparent activation energy during coal burning first decreased and then increased, and again decreased, and the increasing trend appeared when the ventilation rate was within 100–150 ml/min. These findings will provide guidance for the control and prevention of coal combustion by adjusting air leakage.

PurposePolypoidal choroidal vasculopathy (PCV) is an irreversible retinal choroidal disease. Individuals with PCV exhibit diverse baseline characteristics, including systemic characteristics, ocular traits, metabolic factor levels, and different responses to intravitreal anti-VEGF therapy. This study aims to investigate the pathogenesis of PCV by analyzing the systemic characteristics, ocular traits, and cytokine levels at baseline within a cohort of patients who exhibit different responses to anti-VEGF treatment.MethodsWe conducted a retrospective analysis involving 80 eyes diagnosed with PCV. Patients were categorized into two groups based on responses to suboptimal intravitreal ranibizumab injection therapy: those with suboptimal responses and optimal responses. Aqueous humor samples were collected from the experimental eyes, and cytokine expression levels were assessed using cytometric bead array analysis. All subjects were further stratified into two groups according to the median choroidal thickness. Subsequently, logistic regression analysis and the ROC curve were employed to examine the relationship between cytokine expression levels, choroidal thickness, and anti-VEGF response.ResultsThe results revealed that compared to the group of optimal anti-VEGF response, the choroid in the suboptimal response group exhibited a significantly greater thickness. Additionally, compared to the suboptimal anti-VEGF response group, the expression levels of VEGF and VCAM-1 were markedly lower observed in the optimal anti-VEGF response group, while TNF-α showed the opposite trend. Logistic regression analysis indicated that VEGF, VCAM-1, and TNF-α in the aqueous humor were independent risk factors for a suboptimal anti-VEGF response. After adjusting other risk factors, the risk of suboptimal anti-VEGF response decreased to 0.998-fold, 0.997-fold, and 1.294-fold. The AUC values for VEGF, VCAM-1, and TNF-α were determined to be 0.805, 0.846, and 0.897, respectively. Furthermore, the risk of VEGF, VCAM-1, and TNF-α were significantly associated with an increased risk of suboptimal anti-VEGF response after correction for risk factors in the thick choroid group.ConclusionsOur study demonstrated that PCV exhibits systemic and ocular characteristics variations based on different anti-VEGF responses. The levels of cytokines in aqueous humor were found to have a significant correlation with the anti-VEGF response in PCV. VEGF, VCAM-1, and TNF-α are potential targets for assessing treatment response in thick choroidal PCV.

The rapid development of artificial intelligence and remote sensing technologies is indispensable for modern agriculture. In orchard environments, challenges such as varying light conditions and shading complicate the tasks of intelligent picking robots. To enhance the recognition accuracy and efficiency of apple-picking robots, this study aimed to achieve high detection accuracy in complex orchard environments while reducing model computation and time consumption. This study utilized the CenterNet neural network as the detection framework, introducing gray-centered RGB color space vertical decomposition maps and employing grouped convolutions and depth-separable convolutions to design a lightweight feature extraction network, Light-Weight Net, comprising eight bottleneck structures. Based on the recognition results, the 3D coordinates of the picking point were determined within the camera coordinate system by using the transformation relationship between the image’s physical coordinate system and the camera coordinate system, along with depth map distance information of the depth map. Experimental results obtained using a testbed with an orchard-picking robot indicated that the proposed model achieved an average precision (AP) of 96.80% on the test set, with real-time performance of 18.91 frames per second (FPS) and a model size of only 17.56 MB. In addition, the root-mean-square error of positioning accuracy in the orchard test was 4.405 mm, satisfying the high-precision positioning requirements of the picking robot vision system in complex orchard environments.

Convolution is a crucial component of convolution neural networks (CNNs). However, the standard static convolution has two primary defects: data independence and the weak ability to integrate global and local features. This paper proposes a novel and efficient dynamic convolution method with global and local attention to address these issues. A building block called the Global and Local Attention Unit (GLAU) is designed, in which a weighted fusion of global channel attention kernels and local spatial attention kernels generates the proposed dynamic convolution kernels. The GLAU is data-dependent and has better adaptability and the ability to integrate global and local features into each layer. We refer to such modified CNNs with GLAUs as “GLAUNets”. Extensive evaluation experiments for image classification compared to classical CNNs and the state-of-the-art dynamic convolution neural networks were conducted on the popular benchmark datasets. In terms of classification accuracy, the number of parameters, and computational complexity, the experimental results demonstrate the outstanding performance of GLAUNets.

Abstract Retinal ganglion cells (RGCs) axons are the signal carriers of visual information between retina and brain. Therefore, they play one of the important roles affected in many optic neurodegenerative diseases like glaucoma. Among the genetic risks associated with glaucoma, the E50K mutation in the Optineurin (OPTN) gene are known to result in glaucoma in the absence of increased intraocular pressure (IOP), whereas the relevant pathological mechanism and neurological issues remain to be further investigated. In this study, the OPTN (E50K) mutant mouse model was established through CRISPR/Cas9-mediated genome editing, and aging-related RGCs loss and the visual dysfunction were identified. In E50K mice 16 months old, the axonal transport decreased comparing to wild-type (WT) mice at the same age. Furthermore, results of electron microscopy demonstrated significant morphological anomaly of mitochondria in RGCs axons of young E50K mice 3 months old, and these changes were aggravated with age. These indicated that the damaged mitochondria-associated dysfunction of RGCs axon should play an etiological role in glaucoma as an age-related outcome of OPTN (E50K) mutation. The findings of this study have potential implications for the targeted prevention and treatment of NTG.

Vertical silos have become the first choice for large silos to store grain due to their large capacity and small footprint. However, the problem of grain accumulation and small volume in star silos has not been well resolved. Based on the midas Gen2019 software, this paper expands the capacity of the silos for a comprehensive terminal project in a port area, and connects the silos with short walls to form a new silo layout. Through the overall finite element simulation analysis of 7 kinds of grain load conditions, the internal force distribution law of the short wall and the adjacent warehouse wall is studied. and the design control conditions are found, which provides a reference for the silo design of similar type of layout.

Heart murmurs play a critical role in assessing the condition of the heart. Murmur quality reflects the subjective human perception of heart murmurs and is an important characteristic strongly linked to cardiovascular diseases (CVDs). This study aims to use deep neural networks to classify the patients' murmur quality (i.e., harsh and blowing) from phonocardiogram (PCG) signals. The phonocardiogram recordings with murmurs used for this task are from the CirCor DigiScope Phonocardiogram dataset, which provides the murmur quality labels. The recordings were segmented, and a dataset of 1266 segments with average lengths of 4.1 s from 164 patients' recordings was obtained. Each patient usually has multiple segments. A deep neural network model based on convolutional neural networks (CNNs) with channel attention and gated recurrent unit (GRU) networks was first used to extract features from the log-Mel spectrograms of segments. Then, the features of different segments from one patient were weighted by the proposed "Feature Attention" module based on the attention mechanism. The "Feature Attention" module contains a layer of global pooling and two fully connected layers. Through it, the different features can learn their weight, which can help the deep learning model distinguish the importance of different features of one patient. Finally, the detection results were produced. The cross-entropy loss function was used to train the model, and five-fold cross-validation was employed to evaluate the performance of the proposed methods. The accuracy of detecting the quality of patients' murmurs is 73.6%. The F1-scores (precision and recall) for the murmurs of harsh and blowing are 76.8% (73.0%, 83.0%) and 67.8% (76.0%, 63.3%), respectively. The proposed methods have been thoroughly evaluated and have the potential to assist physicians with the diagnosis of cardiovascular diseases as well as explore the relationship between murmur quality and cardiovascular diseases in depth. [ABSTRACT FROM AUTHOR]

Background: Elevated tumor necrosis factor alpha (TNF-α) expression is correlated with the progression of intervertebral disc degeneration (IVDD). Progranulin binding to tumor necrosis factor receptor (TNFR) and its derivative Atsttrin are effective for treating inflammatory arthritis. We hypothesize that Atsttrin has a protective effect in IVDD through different roles of TNFR receptor type 1 (TNFR1) and TNFR receptor type 2 (TNFR2) in degenerated discs. Methods: IVDD models were established in TNFR1−/−, TNFR2−/− mice and their control littermates. Nucleus Pulpous (NP) samples from human patients and IVDD murine models were evaluated by X-ray, micro-MRI, μCT, histological staining and immunofluorescence staining. NP cells isolated from wild-type (WT), TNFR1−/− and TNFR2−/− mice were treated with TNF-α or Atsttrin and then assayed by Western blotting, qRT–PCR, and ELISA. Results: TNFR1 and TNFR2 expression was significantly elevated in the disc tissues of both human patients and IVDD murine models. TNFR1 knockout contributed to reduced disc degeneration. In contrast, TNFR2 knockout was associated with enhanced IVDD severity, including degraded cellular composition, increased cell apoptosis and elevated vertebral destruction. Atsttrin protected against IVDD in WT and TNFR1−/− mouse models but had no effect in TNFR2−/− IVDD models. Additionally, in vitro NP cell-based assays demonstrated that TNF-α-stimulated catabolism and Atsttrin-activated anabolism depended on TNFR1 and TNFR2, respectively. Conclusion: TNFR1 is associated with the degenerative progression of IVDD, while TNFR2 contributes to the protective effect on the discs. Atsttrin protects against IVDD at least partially by inhibiting the TNFα/TNFR1 inflammatory/catabolic pathway and activating the TNFR2 protective/anabolic pathway. The translational potential of this article: This study demonstrates that TNFR1 and TNFR2 have disparate roles in disc degeneration and hlights the potential use of Atsttrin as a therapeutic agent against IVDD in mice.