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Background Knee joint injury is a common military training injury, which seriously affects the combat effectiveness of soldiers. In recent years, the prevention and treatment of military training injury becomes more and more important. Ultrasound therapy and Qingpeng ointment are commonly used to treat sports training injuries. However, the protective effectiveness of ultrasound combined with the external use of Qingpeng ointment for knee injury in sports training injury patients is less reported. Objective To comprehensively assess the clinical efficacy of Qingpeng ointment combined with ultrasound therapy in the treatment of knee injuries caused by military training. Methods Fifty-six patients with knee injury who were treated in the Fifth Pentry Outpatient Clinic, the General Hospital of the Western Theater Command PLA from May to July 2022 were selected and randomly grouped into control group (4 cases fell off during the study, n=24) and treatment group (n=28) using IBM-SPSS 25.0 statistical software to generate random numbers. The control group was given ordinary coupling agent ultrasonic therapy, and the treatment group was given Qingpeng ointment ultrasonic therapy, once a day, 10 times a course, a total of 2 courses. The Lysholm knee joint score, VAS score, Hamilton Depression Scale-17 (HAMD-17), and knee range of motion were compared between the two groups after a twenty-minute intervention. Results Before treatment, there was no significant difference in Lysholm knee joint score, VAS score, HAMD-17 score and knee joint motion between the two groups (P>0.05). After 2 courses of treatment, the passive joint motion of the knee in the treatment group was better than that in the control group (P

Abstract This study aimed to develop and validate a predictive model of all-cause mortality risk in American adults aged ≥ 18 years with diabetes. 7918 participants with diabetes were enrolled from the National Health and Nutrition Examination Survey (NHANES) 1999–2016 and followed for a median of 96 months. The primary study endpoint was the all-cause mortality. Predictors of all-cause mortality included age, Monocytes, Erythrocyte, creatinine, Nutrition Risk Index (NRI), neutrophils/lymphocytes (NLR), smoking habits, alcohol consumption, cardiovascular disease (CVD), urinary albumin excretion rate (UAE), and insulin use. The c-index was 0.790 (95% CI 0.779–0.801, P

Marine heatwaves (MHWs) have recently been recognized as extreme climate events considering their devastating impacts on marine ecosystems. Our study explored the spatial and temporal variability of short (duration

Abstract Introduction Fifteen to 25% of patients with colorectal cancer have combined liver metastases at the time of diagnosis, whereas an additional 15 to 25% will develop liver metastases after curative resection of primary colorectal cancer, with the vast majority (80–90%) of liver metastases unresponsive to curative resection at first. Colorectal cancer liver metastasis is also the leading cause of death in patients with colorectal cancer. In recent years, several studies have demonstrated that intestinal flora, especially Fusobacterium nucleatum, plays a crucial role in the development of colorectal cancer liver metastasis, so we hypothesized that long-term metronidazole use could effectively reduce the incidence of postoperative liver metastasis in colorectal cancer patients. Methods/design This study is a prospective, single-centre, randomized, double-blind controlled study in which 300 patients will be randomly assigned to the test group or the control group in a 1:1 allocation ratio. The aim of this trial is to demonstrate that long-term oral antibiotics can effectively reduce the incidence of postoperative liver metastasis in patients with colorectal cancer. Ethics and dissemination Ethics approval was obtained from the Ethics Committee at the Chinese Ethics Committee of Registering Clinical Trials (ChiECRCT20210229). The results of this study will be disseminated at several research conferences and as published articles in peer-reviewed journals. Trial registration Chinese Clinical Trial Registry ChiCTR2100046201. Registered on July 05, 2021.

The advent of the big data era has triggered a major change in teaching methods, and personalized learning based on adaptive learning platforms with big data analysis technology has become a new paradigm of education technology. Firstly, the basic information characteristics of learners are described, and the learner characteristic model is constructed with cognitive level, learning style, learning emotion, and learning ability. At the same time, the framework construction of the learning path method is completed based on the knowledge map. On this basis, the adaptive learning path system improved based on a genetic algorithm was used to characterize the higher-order English learners, and then the clustering algorithm was used to analyze the characteristics of the higher-order English learners by clustering analysis. Eight clustering variables were selected to divide the learners into four categories. The first category of the “excellent learners” scored very high in the eight elements, indicating that the learners had a very high score in the adaptive learning path. The first category, “excellent learners”, scored high on all eight elements, indicating that the learners have strong learning abilities in the adaptive learning path. In order to verify the effect of the learning path on students’ academic performance, a pre-and post-test was conducted, and the difference in the mean values reflected that the learning path system has a significant effect on the improvement of performance. The learners’ perception of the system’s usefulness and ease of use resulted in F-values of 9.539 and 5.856, respectively, and the Sig. The values are 0.005 and 0.016, which are less than 0.05, and there is a significant difference. It indicates that the optimized adaptive learning path is highly recommended for use among higher-order English learners.

Study design and objection: Idiopathic pulmonary fibrosis (IPF) is a progressive chronic disease characterized by damage to alveolar epithelial cells and abnormal deposition of the extracellular matrix. Although the disease course for most patients with IPF is progressive, in some cases the disease may appear as an acute exacerbation. Mechanical ventilation life support plays an important role in the treatment of patients with IPF but is associated with an increased risk of acute exacerbation of IPF (AE-IPF). Treatment is controversial and is not supported by sufficient clinical evidence. AE-IPF after lung cancer surgery is extremely rare, and the etiology and mechanism remain unclear, and its clinical manifestations are very similar to acute pulmonary edema and are easily misdiagnosed. Summaryof background data: We describe a 66-year-old male patient with IPF complicated with lung cancer who underwent thoracoscopic resection of the right upper lobe of the lung. Seventy-two hours after surgery, chest computed tomography indicated that AE-IPF in the mechanically ventilated lung was significantly greater than that in the operated lung. The patient’s own lung was used as a control and proved that mechanical ventilation can lead to AE-IPF. Results and conclusions: By highlighting the clinical characteristics of patients with acute exacerbation of idiopathic pulmonary fibrosis, this article will enhance the vigilance of clinicians on AE-IPF caused by mechanical ventilation. Importantly, preoperative nintedanib therapy should be applied in advance to prevent AE-IPF on in patients with mild IPF. Precise pulmonary protective ventilation strategies need to be formulated for patients with IPF to reduce mortality.

Abstract Objective This study aimed to compare the effects of continuous hand-sewn esophagojejunostomy with barbed suture and mechanical anastomosis in total laparoscopic gastrectomy for esophagogastric junction cancer. Materials and methods The clinical data of 60 patients who underwent total laparoscopic total gastrectomy from January 2020 to October 2021 were collected retrospectively. Baseline data and short-term surgical results of patients in the hand-sewn anastomosis (n = 30) and mechanical anastomosis (n = 30) groups were analyzed. Results No significant differences were detected in the baseline data between groups. Meanwhile, the hand-sewn group had a shorter anastomosis time (21.2 ± 4.9 min vs. 27.9 ± 6.9 min, p < 0.001) and a decreased operation cost (CNY 70608.3 ± 8106.7 vs. CNY 76485.6 ± 3149.9, p = 0.001). The tumor margin distance in the hand-sewn group was longer than in the mechanical group (2.7 ± 0.4 cm vs. 2.2 ± 0.75 cm, p = 0.002). In esophagojejunostomy anastomosis, the distance between the jejunal opening and jejunal stump in the hand-sewn group was significantly shorter than that in the mechanical group (2.2 ± 0.54 cm vs. 5.7 ± 0.6 cm, p < 0.001). No significant difference was detected in the incidence of postoperative anastomotic complications. Conclusion The continuous hand-sewn anastomosis with barbed suture in total laparoscopic gastrectomy for esophagogastric junction cancer is practical, safe, and cost-effective. It is also an effective supplementary technique for mechanical anastomosis.

Coastal flooding induced by storm surges and heavy rainfall is one of the most frequent climate-related natural hazards along the southeast Australian coast, home to more than 55% of the Australian population. Flooding in this densely populated region is a threat to public safety, coastal infrastructure, ecological systems and the economy. Although climate change is expected to cause an increase in major floods, few studies have quantified the potential changes in flood severity. This study quantifies the changes in flood peak discharge flowing to the Georges River estuary in Australia due to climate-change. An event-based hydrological model, Watershed Bounded Network Model (WBNM), was used to predict flood discharge. This hydrological model was forced by rainfall data obtained from the New South Wales and Australian Capital Territory Regional Climate Modelling Project version 1.5 (NARCliM1.5) for both historical and the Representative Concentration Pathway 8.5 (RCP8.5) conditions. Model calibration for the floods of March 1978 and March 2022 achieved a general agreement between the predicted and observed hydrographs, with an overall average 14% error in the peak values, further demonstrating that the modelling approach is generally reliable in projections of flood severity. Using high resolution climate model projections, the present study observed an increase of 22% in the model ensemble average from historical conditions to the RCP8.5 scenario for the 20-year average recurrence interval (ARI) 24 h extreme rainfall. This heightened extreme rainfall consequently resulted in the changes in flood discharge with an average rise of 55%. This study provides specific assessment of climate-generated risks for densely-populated regions, especially those on Australian east coast. Global studies have suggested that extreme precipitation events will increase under climate change. This study supports and enhances these assertions by using high resolution downscaling to quantify the specific changes within a large catchment.

PurposeTo propose a five-category model for the automatic detection of myopic macular lesions to help grassroots medical institutions conduct preliminary screening of myopic macular lesions from limited number of color fundus images.MethodsFirst, 1,750 fundus images of non-myopic retinal lesions and four categories of pathological myopic maculopathy were collected, graded, and labeled. Subsequently, three five-classification models based on Vision Outlooker for Visual Recognition (VOLO), EfficientNetV2, and ResNet50 for detecting myopic maculopathy were trained with data-augmented images, and the diagnostic results of the different trained models were compared and analyzed. The main evaluation metrics were sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), area under the curve (AUC), kappa and accuracy, and receiver operating characteristic curve (ROC).ResultsThe diagnostic accuracy of the VOLO-D2 model was 96.60% with a kappa value of 95.60%. All indicators used for the diagnosis of myopia-free macular degeneration were 100%. The sensitivity, NPV, specificity, and PPV for diagnosis of leopard fundus were 96.43, 98.33, 100, and 100%, respectively. The sensitivity, specificity, PPV, and NPV for the diagnosis of diffuse chorioretinal atrophy were 96.88, 98.59, 93.94, and 99.29%, respectively. The sensitivity, specificity, PPV, and NPV for the diagnosis of patchy chorioretinal atrophy were 92.31, 99.26, 97.30, and 97.81%, respectively. The sensitivity, specificity, PPV, and NPV for the diagnosis of macular atrophy were 100, 98.10, 84.21, and 100%, respectively.ConclusionThe VOLO-D2 model accurately identified myopia-free macular lesions and four pathological myopia-related macular lesions with high sensitivity and specificity. It can be used in screening pathological myopic macular lesions and can help ophthalmologists and primary medical institution providers complete the initial screening diagnosis of patients.

Abstract Introduction The optimal preoperative preparation for elective colorectal cancer surgery has been debated in academic circles for decades. Previously, several expert teams have conducted studies on whether preoperative mechanical bowel preparation and oral antibiotics can effectively reduce the incidence of postoperative complications, such as surgical site infections and anastomotic leakage. Most of the results of these studies have suggested that preoperative mechanical bowel preparation for elective colon surgery has no significant effect on the occurrence of surgical site infections and anastomotic leakage. Methods/design This study will examine whether oral antibiotic bowel preparation (OABP) influences the incidence of anastomotic leakage after surgery in a prospective, multicentre, randomized controlled trial that will enrol 1500 patients who require colon surgery. The primary endpoint, incidence of anastomotic leakage, is based on 2.3% in the OABP ± mechanical bowel preparation (MBP) group in the study by Morris et al. Patients will be randomized (1:1) into two groups: the test group will be given antibiotics (both neomycin 1 g and metronidazole 0.9 g) the day before surgery, and the control group will not receive any special intestinal preparation before surgery, including oral antibiotics or mechanical intestinal preparation. All study-related clinical data, such as general patient information, past medical history, laboratory examination, imaging results, and surgery details, will be recorded before surgery and during the time of hospitalization. The occurrence of postoperative fistulas, including anastomotic leakage, will be recorded as the main severe postoperative adverse event and will represent the primary endpoint. Ethics and dissemination Ethics approval was obtained from the Chinese Ethics Committee of Registering Clinical Trials (ChiECRCT20200173). The results of this study will be disseminated at several research conferences and as published articles in peer-reviewed journals. Protocol was revised on November 22, 2021, version 4.0. Trial registration ChiCTR2000035550 . Registered on 13 Aug 2020.

Postmenopausal osteoporosis (POP) is a chronic disease of bone metabolism that occurs in middle-aged and elderly women. POP can cause abnormalities of the skeletal system in the whole body, and the jaw bone is also impacted, affecting the function of the oral and maxillofacial regions. Mandibular bone marrow mesenchymal stem cells (MBMSCs) play an important role in mandibular bone metabolism, and abnormal differentiation of MBMSCs can affect the metabolic balance between new and old bone. MicroRNAs (miRNAs) can induce the differentiation of MBMSCs. In this study, the changes in biological characteristics of mandible and MBMSCs in the bone microenvironment of postmenopausal osteoporosis were firstly analyzed, and then the key miRNAs screened from miRNAs gene chips were sorted out for verification and functional exploration. It was found that miR-344d-3p promoted the osteogenic differentiation of MC3T3-E1 and MBMSCs. It inhibited the adipogenic differentiation of 3T3-L1 and MBMSCs. In addition, Dnmt3a may be the target gene of miR-344d-3p. In conclusion, this study found new biological indicators related to bone metabolism, which are of great significance in the field of bone reconstruction.

This study developed a geo-spatial framework for assessing multi-hazard threat on the Bangladesh coast, integrating environmental hazards (EH), geo-environmental attributes (GA), and anthropogenic modifications (AM) based on their potential contribution to overall threat. For this purpose, a fuzzy logic based analytical technique was integrated with geospatial mapping. Thematic layers were prepared for twenty-three theoretically important factors representing the three components of threat. The spatial variations of threat and its components were delineated through spatial overlaying of the respective layers in a GIS environment. The final threat map revealed 32% (5338 km2) and 4% (646 km2) of the area of the western deltaic coast, which encompassed >50–60% of the areas of Khulna, Bagerhat, and Satkhira districts, was under high and very high threat, respectively, owing primarily to frequent cyclones, salinity ingression, and subsidence, and secondarily to the low elevation of the coast, high astronomical tide, shallow bathymetry, excessive groundwater extraction, and polder construction. High and very high threat zones within the central estuarine coast corresponded to 27% (4518 km2) and 16% (2618 km2) of the area, including most of Bhola, Barguna, and Patuakhali districts, which was attributable to the effects of coastal erosion, sea-level rise, flooding and the ancillary effects of strong wave action, high river discharge, deforestation, and land transformation. Around 14% (948 km2) and 3% (164 km2) of the eastern cliff coast, comprising the southwestern part of the Coxsbazar district, was found to be under high and very high threat, respectively, due to the direct effects of sea-level rise, storm surge, erosion, and indirect effects of closeness to the shoreline, alluvial composition of the beach, tourism, and pollution from industries. The outcomes of this study could guide the coastal managers of Bangladesh in prioritizing actions aimed at disaster risk reduction and sustainable development of this region.

The interaction between plants and microbes dominates plant growth and fitness in specific environments. The study of the relationship between plant genotypes and rhizobacterial community structure would provide a deep insight into the recruitment strategies of plants toward soil bacteria. In this study, three genotypes of 18-year-old mature poplar (H1, H2, and H3) derived from four different parents were selected from a germplasm nursery of Populus deltoides. Rhizosphere soil carbon, nitrogen, and phosphorus properties as well as the 16S rDNA sequences of rhizobacterial communities were analyzed to determine the relationship between poplar genotypes and rhizobacterial communities assembly. The results showed there were significant differences in the diversity (Chao1, ACE index, and Shannon index) of rhizobacterial communities between H1 and H2, as well as between H2 and H3, but no difference between H1 and H3. Principal component analysis also revealed a similar structure of rhizobacterial communities between H1 and H3, whereas the rhizobacterial communities of H2 demonstrated significant differences from H1 and H3. Linear discriminant effect size analysis indicated that there were 11 and 14 different biomarkers in the H1 and H3 genotype, respectively, but 42 in the H2 genotype. Co-occurrence network analysis indicated that the rhizobacterial communities of H2 had a distinct network structure compared to those of the other two genotypes, whereas H1 and H3 had a similar pattern of co-occurrence network. Threshold indicator taxa analysis revealed that 63 genera responded significantly to NO3–-N content and 58 genera to NH4+-N/NO3–-N ratio. Moreover, the stochastic assembly process was found to be decreased with increasing NO3–-N content and fluctuated with increasing NH4+-N/NO3–-N ratio. All results indicated that the structure of poplar rhizobacterial communities were influenced by host genotypes, and available nitrogen might play a dominant role in the assembly of rhizobacterial communities. This study would promote the future selection and utilization of rhizobacteria in poplar breeding.

BackgroundProximal gastrectomy has gradually gained more attention due to its superiority in retaining the function of part of the stomach. The inevitable loss of the antireflux barrier and postoperative complications resulting from proximal gastrectomy can severely affect the quality of life. Continuous improvements in digestive tract reconstruction after proximal gastrectomy have yielded the development of a variety of methods with antireflux functions. Recently, our center attempted the left-open single-flap technique and initiated a multicenter, prospective, randomized controlled trial for patients undergoing proximal gastrectomy to reduce the difficulty of surgical anastomosis and the incidence of perioperative complications compared with the double-flap technique. These findings will provide more evidence-based medical research for the development of clinical guidelines.Methods/designThis study is a prospective, multicenter, randomized controlled clinical trial. We plan to recruit 250 patients who are eligible for proximal gastrectomy. After informed consent is obtained, patients will be randomly assigned to the trial group (left-open single-flap technique) and the control group (double-flap technique) in a 1:1 allocation ratio.DiscussionIncreasingly, clinical studies have focused on the improvement of reconstruction modalities after proximal gastrectomy. Among these methods, the double-flap technique is a clinically effective method. The purpose of this study is to establish a prospective randomized controlled trial to compare the efficacy of the left-open single-flap technique versus the double-flap technique after proximal gastrectomy, aiming to provide more evidence-based medical studies for digestive tract reconstruction in proximal gastrectomy.Clinical Trial RegistrationClinicalTrials.gov, identifier [NCT05418920].

The hydrodynamics and sediment characteristics of muddy estuaries and coasts during typhoons are closely related to the geomorphic evolution, ecological environment, and economic development of coastal zones. Taking the macro-tidal turbid Hangzhou Bay (HZB) as an example, the sediment characteristics and effects of wave-current interactions on sediment dynamics during Typhoon Mitag were studied using a fully-calibrated numerical model. The model considered tide-wave sediment interactions and the reconstructed typhoon wind field. Net sediment fluxes were controlled by residual currents and suspended sediment concentration (SSC). The combined interactions of currents and waves led to a high SSC during the typhoon. Under calm weather conditions, the impact of wave-current interactions (wave dissipation, form drag, wave radiation stress, mean current advection and refraction) was small, except for the combined bottom stresses. The combined bottom stress was the primary wave-current interaction that changed sediment resuspension and increased SSC, particularly in shallow waters or during storms. The advection term, which played an essential role in reducing SSC in HZB, mainly affected SSC by increasing the velocity. The wave dissipation term enhanced vertical mixing, which involved the vertical exchange of suspended sediment and currents. In the shallow waters of the southern bay, the wave dissipation term mostly led to decreased bottom stresses, increased currents, decreased SSC, and increased SSC in deep waters. The effects of form drag, wave radiation stress, and refraction terms on the suspended sediment dynamics were relatively small. These findings provide a theoretical foundation for the study of dynamic geomorphology in macro-tidal estuaries.

Abstract Background The purpose of this study was to evaluate the clinical value of color and power doppler sonography (CPDS) when combined it with 99mTc-dimercaptosuccinic acid scintigraphy (DMSA) in assessment of acute pyelonephritis (APN) in infants. Methods A total of 79 children with APN admitted to our hospital from June 2016 to Jan 2019 were enrolled, including 52 boys and 27 girls, age range 1 month to 3 years old. All cases followed the diagnostic criteria for acute pyelonephritis and excluded anatomical abnormalities of urinary system. All 79 patients were examined by urinary ultrasonography (US), CPDS, and DMSA within 48 h of fever and analyzed the clinical value of combining the two methods in the assessment of APN in infants. Results Among 79 children, urinary ultrasonography revealed 2 cases of renal cortical echo changes, both located in the upper pole of the kidney, 24 cases of kidney enlargement, and 1 case of left kidney shrinkage. Ninety-five kidneys were shown to be diseased with DMSA, while 105 kidneys abnormal by CPDS. The sensitivity of CPDS was 69.4%, and the specificity was 38.1%. In children younger than 6 months, the sensitivity of CPDS was 56.9%, which was 84.2% in childeren between 6 months to 1 year, and 94.4% from 1 to 3 years old, respectively. The corresponding specificity of CPDS was 44.1, 26.7, and 35.7%. There was no significant correlation between CPDS levels and DMSA positive results. The abnormal rate of intermediate part in the kidneys was significantly lower than that in the upper and lower poles. Children with abnormal CPDS have a greater risk of renal scarring(p

Objective To investigate the current status of anticoagulation therapy for the elderly patients aged 75 years or over with non-valvular atrial fibrillation in secondary and tertiary hospitals in Chongqing. Methods A total of 3 821 patients aged 75 years old or over with non-valvular atrial fibrillation from 19 hospitals (6 secondary hospitals and 13 tertiary hospitals) in Chongqing between January 1, 2018 and December 31, 2018 were enrolled in this study. The clinical data of patients were collected by electronic medical record system. Their baseline data, scores of CHA2DS2-VASc and HAS-BLED, anticoagulant rate and anticoagulant drugs were compared and analyzed. Results All the patients had their CHA2DS2-VASc score ≥2, and those with HAS-BLED score ≥3 accounted for 25.0%. The overall anticoagulant rate was 36.2%. And of these patients, 10.8% and 25.4% were treated with new oral anticoagulants (NOAC) and warfarin respectively, 43.3% were treated with antiplatelet alone without anticoagulant, and 20.5% were not treated with any antithrombotic therapy. The prescription rate of NOAC and warfarin in these patients was much lower in secondary hospitals than tertiary hospitals (5.3% vs 13.0%, P

Multispectral remote sensing data have proven to be useful in deriving tidal flat topography. However, limited satellite observations over a certain period have large uncertainties. In this study, we used MODIS time-series data with a high observational frequency to generate accurate tidal flat topography in Nantong, China based on the relationship between the T_Tide-derived tidal levels and the MODIS-derived inundation frequency map. First, 8-day MOD09Q1 data from 2007 to 2008 were used to perform the land-water classification. Second, 92 land-water maps were stacked to generate the inundation frequency map of the tidal flat. Then, the T_Tide package was applied to calculate the tidal levels at Lvsi Tide Gauge Station. Finally, the inundation frequency map and the tidal levels were integrated to derive the tidal flat topography, which agreed well with the in-situ elevation data (RMSE = 0.40 m, r = 0.89) and the Landsat-based elevation data (RMSE = 0.18 m, r = 0.98). In addition, the derived slopes agreed well with the slopes from the in-situ elevation data (RMSE = 1.00‰, r = 0.85). We highlighted the necessity of using all MODIS data for deriving an accurate tidal flat topography. Our proposed method has a potential to derive tidal flat topography and temporal changes over the past 20 years from MODIS data.

Empirical models have been widely used to retrieve shallow water bathymetry from multispectral/hyperspectral satellite imagery. In traditional studies on deriving the topography and monitoring its temporal changes, a single date satellite image without clouds corresponded to a bathymetric map and multidate images corresponded to multiple bathymetric maps. The satellite image noise caused by various environmental conditions and satellite sensors can inevitably introduce errors or gaps in deriving bathymetric maps. Also, empirical models are limited in some remote areas due to the lack of prior bathymetric points. In this article, using only satellite data, including multitemporal Sentinel-2 images and Ice, Cloud, and land Elevation Satellite-2 (ICESat-2) data, a multitemporal stacking method was developed to derive highly accurate and cloud free shallow water bathymetry with accuracy of approximately 1 m and the depth range exceeding 22 m. The proposed method was tested and validated by an airborne bathymetric lidar. To be specific, our method using multitemporal Sentinel-2 images can achieve a mean root mean square error (RMSE) of 1.08 m (R2 = 0.94) by comparing with in-situ airborne lidar data around Ganquan Island, which is better than the result (R2 = 0.92, RMSE = 1.46 m) derived from single date image based methods.Also, the gaps in a bathymetric map due to clouds or other noise can be avoidable benefitting from the stacking of multiple date satellite images. In the future, this satellite data driven method can be further extended to the globe to produce highly accurate and cloud free bathymetry around clear shallow water benefited from prior ICESat-2 bathymetric data.

The charging of Fe and Mn oxide anodes in lithium-ion batteries are believed to form rocksalt phases via reconstructive conversion reactions. Here, the authors show that M x O y (M = Fe, Mn) transform into non-native body-centred cubic FeO and zincblende MnO via topotactic displacement-like pathways.

BackgroundAppropriate gastrointestinal reconstruction after proximal gastrectomy can effectively reduce the incidence of postoperative complications in patients with proximal early gastric cancer. However, there is still great controversy about the choice of digestive tract reconstruction after proximal gastrectomy, and there is no clinical consensus on the choice of digestive tract reconstruction after proximal gastrectomy. Currently, there is a lack of large-sample, prospective, randomized controlled studies to compare the efficacy of Kamikawa, double-tract reconstruction, and tube-like stomach reconstruction after proximal gastrectomy.Methods/designThis study will investigate the efficacy of three reconstruction methods after proximal gastrectomy in a prospective, multicenter, randomized controlled trial, which will enroll 180 patients with proximal early gastric cancer. Patients will be randomly divided into three groups: Group A (Kamikawa, n = 60), Group B (double-tract reconstruction, n = 60), and Group C (tube-like stomach, n = 60). The general information, past medical history, laboratory findings, imaging findings, and surgical procedures of the patients will be recorded and analyzed. The incidence of reflux esophagitis will be recorded as the primary endpoint. The incidence of anastomotic leakage, anastomotic stenosis, operative time and intraoperative blood loss will be recorded as secondary endpoints.DiscussionThis study will establish a large-sample, prospective, randomized controlled trial to compare the efficacy of Kamikawa, double-tract reconstruction, and tube-like stomach reconstruction after proximal gastrectomy.Trial registrationThis study was approved by the Chinese Clinical Trial Registry and registered on April 30, 2021. The registration number is ChiCTR2100045975.

Abstract Background To explore the relationship between the lymph node status and preoperative computed tomography images texture features in pancreatic cancer. Methods A total of 155 operable pancreatic cancer patients (104 men, 51 women; mean age 63.8 ± 9.6 years), who had undergone contrast-enhanced computed tomography in the arterial and portal venous phases, were enrolled in this retrospective study. There were 73 patients with lymph node metastases and 82 patients without nodal involvement. Four different data sets, with thin (1.25 mm) and thick (5 mm) slices (at arterial phase and portal venous phase) were analysed. Texture analysis was performed by using MaZda software. A combination of feature selection algorithms was used to determine 30 texture features with the optimal discriminative performance for differentiation between lymph node positive and negative groups. The prediction performance of the selected feature was evaluated by receiver operating characteristic (ROC) curve analysis. Results There were 10 texture features with significant differences between two groups and significance in ROC analysis were identified. They were WavEnLH_s-2(wavelet energy with rows and columns are filtered with low pass and high pass frequency bands with scale factors 2) from wavelet-based features, 135dr_LngREmph (long run emphasis in 135 direction) and 135dr_Fraction (fraction of image in runs in 135 direction) from run length matrix-based features, and seven variables of sum average from coocurrence matrix-based features (SumAverg). The ideal cutoff value for predicting lymph node metastases was 270 for WavEnLH_s-2 (positive likelihood ratio 2.08). In addition, 135dr_LngREmph and 135dr_Fraction were correlated with the ratio of metastatic to examined lymph nodes. Conclusions Preoperative computed tomography high order texture features provide a useful imaging signature for the prediction of nodal involvement in pancreatic cancer.

The Ganges-Brahmaputra-Meghna delta, located in the southern part of Bangladesh, is periodically exposed to severe tropical cyclones. It is estimated that two-fifths of the world’s total impact from tropical-cyclone-induced storm surges occur in this region, and these cause fatalities and economic losses every year. A barotropic numerical 3D model is used to investigate wave dynamics during a cyclone-induced storm-surge event. The model is calibrated and validated for Cyclone Sidr (2007) and applied to ten idealized cyclonic scenarios. Numerical experiments with different coupling configurations are performed to understand wave–current interactions on significant wave heights. Results show that the water level is the dominant factor in significant wave height modulation when the wave propagates into shallower regions from the deeper ocean, whereas the current modulates the deep ocean wave height. The WCI causes higher significant wave heights in shallower waters close to the coast compared with the deep ocean. Wave energy dissipation related to whitecapping processes plays a greater role in reducing the wave height nearshore than the dissipation due to depth-induced breaking and bottom friction in the GBMD during a cyclone-induced storm-surge event.

The Ganges–Brahmaputra–Meghna Delta (GBMD) located in the head of the Bay of Bengal is regularly affected by severe tropical cyclones frequently. The GBMD covers the Bangladesh coast, which is one of the most vulnerable areas in the world due to cyclone-induced storm surges. More than 30% of the total country’s population lives on the Bangladesh coast. Hence, it is crucial to understand the underlying processes that modulate the storm surge height in the GBMD. A barotropic numerical 3D model setup is established by using Delft3D and SWAN to investigate a cyclone-induced storm surge event. The model is calibrated and validated for Cyclone Sidr in 2007 and applied to six idealized cyclonic scenarios. Numerical experiments with different coupling configurations are performed to distinguish the contribution of wind, tides, waves, and wave–current interactions (WCI) on the storm surge height. Results show that the wind-driven setup is the dominant contributor to the storm surge height during cyclonic events. Based on the tidal phase and wind direction, the interaction between tide and wind can increase or decrease the magnitude of the storm surge height. Finally, considering the wind-driven wave may increase the surge height up to 0.3 m along the coastline through a strong wave setup.

Achieving coastal and shallow-water bathymetry is essential for understanding the marine environment and for coastal management. Bathymetric data in shallow sea areas can currently be obtained using SDB (satellite-derived bathymetry) with multispectral satellites based on depth inversion models. In situ bathymetric data are crucial for validating empirical models but are currently limited in remote and unapproachable areas. In this paper, instead of using the measured water depth data, ICESat-2 (Ice, Cloud, and Land Elevation Satellite-2) ATL03 bathymetric points at different acquisition dates and multispectral imagery from Sentinel-2/GeoEye-1 were used to train and evaluate water depth inversion empirical models in two study regions: Shanhu Island in the South China Sea, and Heron Island in the Great Barrier Reef (GBR) in Australia. However, different sediment types also influenced the SDB results. Therefore, three types of sediments (sand, reef, and coral/algae) were analyzed for Heron Island, and four types of sediments (sand, reef, rubble and coral/algae) were analyzed for Shanhu Island. The results show that accuracy generally improved when sediment classification information was considered in both study areas. For Heron Island, the sand sediments showed the best performance in both models compared to the other sediments, with mean R2 and RMSE values of 0.90 and 1.52 m, respectively, representing a 5.6% improvement of the latter metric. For Shanhu Island, the rubble sediments showed the best accuracy in both models, and the average R2 and RMSE values were 0.97 and 0.65 m, respectively, indicating an RMSE improvement of 15.5%. Finally, bathymetric maps were generated in two regions based on the sediment classification results.

The accurate estimation of the state of charge (SOC) plays a crucial role in ensuring the range of electric vehicles (EVs) and the reliability of the EVs battery. However, due to the dynamic working conditions in the implementation of EVs and the limitation of the onboard BMS computational force, it is challenging to achieve a reliable, high-accuracy and real-time online battery SOC estimation under diverse working scenarios. Therefore, this study proposes an end-cloud collaboration approach of lithium-ion batteries online estimate SOC. On the cloud-side, a deep learning model constructed based on CNN-LSTM is deployed, and on the end-side, the coulomb counting method and Kalman’s filter are deployed. The estimation results at both sides are fused through the Kalman filtering algorithm, realizing high-accuracy and real-time online estimation of SOC. The proposed approach is evaluated with three dynamic driving profiles and the results demonstrate the proposed approach has high accuracy under different temperatures and initial errors, where the root means square error (RMSE) is lower than 1.5% and the maximum error is lower than 5%. Furthermore, this method could achieve high-accuracy and real-time SOC online estimation under the cyber hierarchy and interactional network (CHAIN) framework and can be extended to multi-state collaborative online estimation.

The accurate estimation of the battery state of health (SOH) is crucial for the dependability and safety of battery management systems (BMS). The generality of existing SOH estimation methods is limited as they tend to primarily consider information from single-source features. Therefore, a novel method for integrating multi-feature collaborative analysis with deep learning-based approaches is proposed in this research. First, several battery degradation features are obtained through differential thermal voltammetry (DTV) analysis, singular value decomposition (SVD), incremental capacity analysis (ICA), and terminal voltage characteristic (TVC) analysis. The features highly related to SOH are selected as inputs for the deep learning model based on the results of a Pearson correlation analysis. The SOH estimation is achieved by developing a deep learning framework cored by long short-term memory (LSTM) neural network (NN), which integrates multi-source features as an input. A suggested method is validated using NASA and Oxford Battery Degradation datasets. The results demonstrate that the presented model provides great SOH estimation accuracy and generality, where the maximum root mean square error (RMSE) is less than 1%. Based on a cloud computing platform, the proposed method can be applied to provide a real-time prediction of battery health, with the potential to enhance battery full lifespan management.

We present a methodology for accessing the cation short-range ordering (SRO) in disordered rocksalt (DRX) materials by decomposing their pair distribution function (PDF) pattern in terms of a set of basis PDFs, pre-determined via Metropolis non-negative matrix factorisation analysis. These basis PDFs, underpinned by structure modelling, point to specific SRO types that subsequently enable identification and quantification of their presence in the DRX structure. Rapid identification of the evolution of SRO addresses a key bottleneck in the analysis and understanding of high energy density characteristics of DRX materials.

Coastal slope is a fundamental land characteristic that can influence the hydrodynamic and morphological processes, which is the essential parameter to calculate the wave setup and wave run up for further estimating extreme coastal water levels. Slope information of coastal zones also plays a key role in estimating the coastline erosion and evaluating the coastal vulnerability under sea level rise. However, accurate estimates of coastal slopes are currently limited, especially over sparsely populated and remote areas. The recent ICESat-2 photon-counting lidar provides unprecedented along-track dense and accurate height measurements in coastal zones. This study aims to demonstrate the potential of ICESat-2 measurements to estimate coastal slope of sandy beach at a large scale, and the proposed method is tested in Texas, USA. The validation with local airborne lidar data (with an average slope of 0.023 in Texas) indicates that, the ICESat-2 derived coastal slopes (0.026) have much better accuracy than current large-scale coastal slopes (0.0032) derived from SRTM and MERIT DEMs. With globally covered ICESat-2 datasets, this method can be expanded to estimate coastal slopes even at a global scale.

Since 1949, the Miao nationality in China has encountered historic opportunities for development. This paper reviews four aspects of the historical achievements of the Miao nationality in China: education, youth organizations, cultural heritage, and new media and women’s empowerment.By analyzing official statistics and autoethnographic data, we demonstrate that the agency of the Miao has contributed to these historical achievements. We argue that the Miao have seized many chances to promote development. Moreover, this paper emphasizes that the Miao have diverse cultures and an imbalance in development in various areas. These diverse features demonstrate that a single criterion cannot be used to measure the complicated situation and we call for further transdisciplinary research.

Summary: Binary metal oxides have received sustained interest as anode materials due to their desirable capacities, exceeding theoretical values particularly in the first discharge. Although they have received increasing attention in recent years, topical debates persist regarding not only their lithiation mechanisms but also the origin of additional capacity. Aiming to resolve these disagreements, we perform a systematic study of a series of iron and manganese oxides to investigate their phase behavior during first discharge. Using a combination of in operando pair distribution function measurements and our recently developed Metropolis non-negative matrix factorization approach to address the analytical challenges concerning materials’ nanoscopic nature and phase heterogeneity, here we report unexpected observation of non-equilibrium FeOx solid-solution phases and pulverization of MnO. These processes are correlated with the extra capacities observed at different depths of discharge, pointing to a metal-dependent nature of this additional capacity and demonstrating the advantage of our approach with promising prospects for diverse applications.

L-ascorbic acid (L-AA), also named as Vitamin C, is necessary for human beings due to its antioxidant and other wholesome functions. However, ascorbic acid would degrade natural pigments like anthocyanins in food systems, especially in beverages, and the stability of L-AA itself is low in aqueous solution. 2-O-D-glucopyranosyl-L-ascorbic acid (AA-2G), a kind of ascorbic acid derivative, has outstanding thermal stability and the ability of metabolizing to release L-AA in vivo, which leads to a hot topic in food, healthcare and cosmetic fields. Considering the economic benefit, AA-2G is mainly used in high value-added products. Methods for reducing manufacturing cost so as to get more widely used in food industry are under discussion. This review focuses on the properties, biotransformation production and applications of AA-2G compared with L-AA according to latest studies. Besides, suggestions for further research in terms of improving antioxidant efficiency has been proposed.

In San Francisco Bay (SFB), light availability is largely determined by the concentration of suspended particulate matter (SPM) in the water column. SPM exhibits substantial variation with time, depth, and location. To study how SPM influences light and phytoplankton growth, we coupled a sediment transport model with a hydrodynamic model and a biogeochemical model. The coupled models were used to simulate conditions for the year of 2011 with a focus on northern SFB. For comparison, two simulations were conducted with ecosystem processes driven by SPM concentrations supplied by the sediment transport model and by applying a constant SPM concentration of 20 mg l–1. The sediment transport model successfully reproduced the general pattern of SPM variation in northern SFB, which improved the chlorophyll-a simulation resulting from the biogeochemical model, with vertically integrated primary productivity varying greatly, from 40 g[C] m–2 year–1 over shoals to 160 g[C] m–2 year–1 in the deep channel. Primary productivity in northern SFB is influenced by euphotic zone depth (Ze). Our results show that Ze in shallow water regions (

The East Australian Current (EAC) is a highly dynamic western boundary current of the South Pacific Gyre. The EAC frequently encroaches shoreward, drives upwelling, changes coastal bio-physical dynamics, and thus exerts significant impacts on coastal marine ecosystems. In this study, with high frequency (HF) radar and mooring data, for the first time accurate daily mapping and tracking of a rapid EAC intrusion event was conducted and the impacts of the EAC intrusion on the shelf water off Coffs Harbor were monitored. The results show that, during the event, the EAC was highly dynamic with a mean daily onshore/offshore movement of ~5 km/day. In addition, we found that the bottom ocean temperature and the surface current speed on the shelf varied linearly with the EAC-to-coast distance. This study thus demonstrates the value of HF remotely sensed data for the ongoing quantitative monitoring of the highly dynamic EAC fluctuations.

Astragalus membranaceus has been used as a highly popular Chinese herbal medicine for centuries. Triterpenoids, namely astragalosides I, II, III, and IV, represent the main active compounds in this plant species. Transcription factors have a powerful effect on metabolite biosynthesis in plants. We investigated the effect of the Arabidopsis MYB12, production of anthocyanin pigment 1 (PAP1), and maize leaf color (LC) transcription factors in regulating the synthesis of astragaloside metabolites in A. membranaceus. Overexpression of these transcription factors in hairy roots differentially up-regulated these active compounds. Specifically, the overexpression of LC resulted in the accumulation of astragalosides I–IV. The content of astragalosides I and IV were, in particular, more highly accumulated. Overexpression of MYB12 increased the accumulation of astragaloside I in transgenic hairy roots, followed by astragaloside IV, and overexpression of PAP1 resulted in the increased synthesis of astragalosides I and IV. In addition, we found that overexpression of PAP1 together with LC increased astragaloside III levels. At the transcriptional level, several key genes of the mevalonate biosynthetic pathway, especially HMGR1, HMGR2, and HMGR3, were up-regulated differentially in response to these transcription factors, resulting in astragaloside synthesis in the hairy roots of A. membranaceus. Overall, our results indicated that heterologous expression of Arabidopsis MYB12, PAP1, and maize LC differentially affected triterpenoids biosynthesis, leading to the increased biosynthesis of active compounds in A. membranaceus.

This study quantifies some of the potential impacts of climate change and nutrient pollution to identify the most important factors on water quality changes and algal blooms in the study region. Three variables, air temperature and streamflow, representing climate change, and nutrient runoff, were varied in eight hypothetical scenarios to determine their impact on water quality and algal blooms by the calibrated and validated water quality model QUAL2K. Water quality was assessed by the concentrations of dissolved oxygen, total nitrogen, and phosphorus. Algal blooms were identified by phytoplankton concentration. An increase in air temperature of up to 2 °C resulted in an average increase of 3% in water temperature and 4.79% in phytoplankton concentration, and an average decrease of 0.48% in dissolved-oxygen concentration. Projected decreases in streamflow not only made the above phenomenon more significant but also significantly increased the concentration of total nitrogen, total phosphorus, and phytoplankton with the same pollution inputs. Under climate change, the biggest cause of concern for estuarine water quality is reduced streamflow due to decreases in rainfall. Water quality improvement is possible by regulating the concentration of non-point-source pollution discharge. By reducing nutrient runoff, the total nitrogen and phosphorus concentrations were also reduced, resulting in a significant increase in the dissolved oxygen concentration. This study highlights the most significant factors for managing water quality in estuaries subject to climate change.