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Abstract Background Gastric cancer poses a significant global health challenge. We aim to use period analysis to assess the changes in gastric cancer treatment at our center over the past 15 years. This study reflects the current state of gastric cancer treatment at our center and provides valuable data to support clinical advancements. Method We used period analysis to evaluate the survival status of 3915 patients with gastric cancer at Nanfang Hospital, Southern Medical University, over a 15-year period spaning from 2008 to 2022. The 5-year relative survival rates were analyzed. Result Our findings indicate that the 5-year relative survival rate at our center from 2018 to 2022 is 71.4%. From 2018 to 2022, the 5-year relative survival rates for patients aged

Abstract We investigated a diffraction optical waveguide structure with a double layer coupling configuration. This double layer-coupled diffraction optical waveguide structure modulates light information through wavefront modulation for propagation within the optical waveguide and then reproduces the light information through further wavefront modulation, thus achieving optical information transmission. Analysis indicates that the theoretical maximum field of view can reach 90° × 90°. With an actual field of view set to 53° × 53°, an entrance pupil size of 3.2 × 3.2 mm², an eye relief of 10 mm, and 50 pupil expansion, the system’s total energy transmission efficiency is 37%, with field of view uniformity at 91% and uniformity within the eye movement range reaching 97%.

Abstract Background Pulmonary hypertension (PH) is marked by elevated pulmonary artery pressures due to various causes, impacting right heart function and survival. Disulfidptosis, a newly recognized cell death mechanism, may play a role in PH, but its associated genes (DiGs) are not well understood in this context. This study aims to define the diagnostic relevance of DiGs in PH. Methods Using GSE11726 data, we analyzed DiGs and their immune characteristics to identify core genes influencing PH progression. Various machine learning models, including RF, SVM, GLM, and XGB, were compared to determine the most effective diagnostic model. Validation used datasets GSE57345 and GSE48166. Additionally, a CeRNA network was established, and a hypoxia-induced PH rat model was used for experimental validation with Western blot analysis. Results 12 DiGs significantly associated with PH were identified. The XGB model excelled in diagnostic accuracy (AUC = 0.958), identifying core genes DSTN, NDUFS1, RPN1, TLN1, and MYH10. Validation datasets confirmed the model’s effectiveness. A CeRNA network involving these genes, 40 miRNAs, and 115 lncRNAs was constructed. Drug prediction suggested therapeutic potential for folic acid, supported by strong molecular docking results. Experimental validation in a rat model aligned with these findings. Conclusion We uncovered the distinct expression patterns of DiGs in PH, identified core genes utilizing an XGB machine-learning model, and established a CeRNA network. Drugs targeting the core genes were predicted and subjected to molecular docking. Experimental validation was also conducted for these core genes.

Abstract Simultaneously activating metal and lattice oxygen sites to construct a compatible multi-mechanism catalysis is expected for the oxygen evolution reaction (OER) by providing highly available active sites and mediate catalytic activity/stability, but significant challenges remain. Herein, Fe and S dually modulated NiFe oxyhydroxide (R-NiFeOOH@SO4) is conceived by complete reconstruction of NiMoO4·xH2O@Fe,S during OER, and achieves compatible adsorbate evolution mechanism and lattice oxygen oxidation mechanism with simultaneously optimized metal/oxygen sites, as substantiated by in situ spectroscopy/mass spectrometry and chemical probe. Further theoretical analyses reveal that Fe promotes the OER kinetics under adsorbate evolution mechanism, while S excites the lattice oxygen activity under lattice oxygen oxidation mechanism, featuring upshifted O 2p band centers, enlarged d-d Coulomb interaction, weakened metal-oxygen bond and optimized intermediate adsorption free energy. Benefiting from the compatible multi-mechanism, R-NiFeOOH@SO4 only requires overpotentials of 251 ± 5/291 ± 1 mV to drive current densities of 100/500 mA cm−2 in alkaline media, with robust stability for over 300 h. This work provides insights in understanding the OER mechanism to better design high-performance OER catalysts.

This paper proposes a noise reduction technique that combines empirical mode decomposition (EMD) and wavelet thresholding to eliminate the noise interference caused by metal slag in the steel cord conveyor belt damage signal. Initially, the original signal undergoes decomposition by EMD into high- and low-frequency intrinsic mode function (IMF) components based on metal slag signal feature analysis. The wavelet threshold de-noising method is then applied to filter out the high-frequency noise while preserving the low-frequency IMF components. The IMF components containing slag noise are discarded, and the filtered signal and the low-frequency IMF components are used for signal reconstruction to obtain an optimal noise reduction effect. The study demonstrates that this method is more effective in suppressing metal slag noise, environmental noise, and other noise interferences than traditional EMD decomposition noise reduction and wavelet threshold noise reduction methods. This research provides a valuable reference for noise reduction in steel cord conveyor belt detection data.

Abstract Coronary atherosclerotic heart disease (CAD) is among the most prevalent chronic diseases globally. Circadian rhythm disruption (CRD) is closely associated with the progression of various diseases. However, the precise role of CRD in the development of CAD remains to be elucidated. The Circadian rhythm disruption score (CRDscore) was employed to quantitatively assess the level of CRD in CAD samples. Our investigation revealed a significant association between high CRDscore and adverse prognosis in CAD patients, along with a substantial correlation with CAD progression. Remarkably distinct CRDscore distributions were also identified among various subtypes. In summary, we have pioneered the revelation of the relationship between CRD and CAD at the single-cell level and established reliable markers for the development, treatment, and prognosis of CAD. A deeper understanding of these mechanisms may offer new possibilities for incorporating "the therapy of coronary heart disease based circadian rhythm" into personalized medical treatment regimens.

IntroductionThis study aims to explore the incidence of different metastatic patterns in paraaortic lymph nodes and their corresponding survival outcomes in patients with endometrial cancer, as well as to identify the associated risk factors of such metastasis.Material and methodsPubMed, Embase, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform, and Clinical Trials.gov were searched from inception to February 10, 2024.The analysis was conducted using R version 4.2.3.ResultsA total of 47 studies involving 33,425 endometrial cancer patients were analyzed. Meta-analysis results revealed that the rate of isolated paraaortic lymph node metastasis, where pelvic lymph nodes were negative but paraaortic lymph nodes were positive (PLN-PAN+), was found to be 2.58% (95% CI 0.0195-0.0329). The rates for PLN+PAN- and PLN+PAN+ were notably higher at 8.54% (95% CI 0.0642-0.1092) and 8.37% (95% CI 0.0613-0.1090), respectively. For clinical stage I EC, the occurrence rate was 5.92% for PLN+PAN- (95% CI 0.0258-0.1032), 1.00% for PLN-PAN+ (95% CI 0.0081-0.0120), and 2.99% for PLN+PAN+ (95% CI 0.0188-0.0431). The survival outcomes indicate a decreasing trend from the PLN-PAN+ and PLN+PAN- groups to the PLN+PAN+ group. Additionally, the survival outcomes of patients with isolated paraaortic lymph node metastasis appear to be comparable to, or not inferior to, those of the PLN+PAN- group. The analysis indicated that pelvic lymph node metastasis (OR 16.72, 95% CI 10.03-27.86), myometrial invasion ≥50% (OR 5.18, 95% CI 3.09-8.69), lymph-vascular space invasion (LVSI) (OR 3.46, 95% CI 2.49-4.81), cervical invasion (OR 4.00, 95% CI 2.09-7.66), and non-endometrioid cancer (OR 2.39, 95% CI 1.17-4.86) were risk factors for paraaortic lymph node metastasis.ConclusionsIsolated paraaortic lymph node metastasis, though relatively rare, can still occur even in clinical stage I endometrial cancer. The survival outcomes of patients with isolated paraaortic lymph node metastasis appear to be comparable to, or not inferior to, those of the PLN+PAN- group. Even in patients with negative pelvic lymph nodes, careful consideration should be given to the possibility of paraaortic lymph node metastasis, especially in those with high-risk factors.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024503959.

Background Abnormal white blood cell count after kidney transplantation is an important adverse clinical outcome. The abnormal white blood cell count in patients after surgery may be caused by the use of immunosuppressive agents and other factors. A lower white blood cell count than normal will greatly increase the probability of adverse outcomes such as infection and reduce the success rate of surgery. Objective To establish a machine learning prediction model of leukocyte drop to abnormal level after kidney transplantation, and provide reference for clinical treatment. Methods A total of 546 kidney transplant patients were selected as the study subjects. The time correlation feature of the ratio of the duration time of each variable to the total time in different intervals was innovatively introduced. Least absolute shrinkage and selection operator algorithm was used for correlation analysis of 85 candidate variables, and the top 20 variables were retained in the end. Eight machine learning algorithms, including Logistic-L1, Logistic-L2, support vector machine, decision tree, random forest, multilayer perceptron, extreme gradient boosting and light gradient boosting machine, were used for the five-fold cross-validation on all data sets, and the algorithm with the best performance was selected as the final prediction algorithm based on the average area under the curve. Results As the final prediction model, the accuracy, sensitivity, specificity and area under the curve values of the multilayer perceptron model in test set were 71.34%, 61.18%, 82.28% and 77.30%, respectively. The most important factors affecting leukopenia after surgery were the proportion of time of lymphocyte less than normal, blood group AB, gender, and platelet CV. Conclusions The multilayer perceptron model explored in this study shows significant potential in predicting abnormal white blood cell counts after kidney transplantation. This model can help stratify risk following transplantation, subject to external and/or prospective validation.

ObjectiveTo summarize stage migration and survival outcomes in patients with cervical cancer at Stage IIIC according to the 2018 FIGO staging system, and to investigate prognostic factors influencing Stage IIIC1.MethodsPubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), International Clinical Trials Registry Platform (ICTRP), and Clinical Trials.gov were searched from inception to February 6, 2024. The analysis was conducted using STATA 16.0.ResultsA total of 25 studies with 82954 cervical cancer patients were included in the analysis. The migration rates to FIGO 2018 Stage IIIC ranged from 18% to 37% for early-stage tumors (Stage IB to IIA) in FIGO 2009, and from 32% to 52% for advanced stage tumors (Stage IIB to IIIB). The overall survival (OS) for Stage IIIC1 is poorer compared to Stage IB1 (HR 0.53, 95% CI 0.35-0.80, p=0.003) and Stage IB2 (HR 0.61, 95% CI 0.43-0.85, p=0.004). It is comparable to Stage IB3, yet it shows better survival outcomes than Stages IIB (HR 2.91, 95% CI 1.01-8.39, p=0.047), IIIA (HR 1.96, 95% CI 1.78-2.17, p=0.000), and IIIB (HR 1.56, 95% CI 1.04-2.35, p=0.031). Tumors size ≥4cm (HR 1.45, 95% CI 1.10-1.92, p=0.00), metastatic lymph node ≥ 3 (HR 2.21, 95% CI 1.56-3.15, p=0.000) and T stage are prognostic factors for OS of Stage IIIC1.ConclusionsThe migration rates to FIGO 2018 Stage IIIC varied between 18% and 52% for patients initially classified under FIGO 2009 Stages IB1 to IIIB. The FIGO 2018 staging system underscores the pivotal role of lymph node metastasis in predicting prognosis and provides valuable insights into the distinct prognostic implications associated with different stages, particularly for early stages. For advanced stages, incorporation of tumor-related factors such as T stage might better elucidate survival differences and guide clinical treatment decisions.Protocol registrationCRD 42023451793.

The sodium taurocholate co-transporting polypeptide (NTCP), a bile acids transporter, has been identified as a new therapeutic target for the treatment of liver disease. This paper thoroughly investigates the function of NTCP for regulating bile acid regulation, its correlation with hepatitis B and D infections, and its association with various liver diseases. Additionally, in this review we examine recent breakthroughs in creating NTCP inhibitors and their prospective applications in liver disease treatment. While this review emphasizes the promising potential of targeting NTCP, it concurrently underscores the need for broader and more detailed research to fully understand the long-term implications and potential side effects associated with NTCP inhibition.

The developmental toxicity and human health risks of triazole fungicides (TFs) have attracted worldwide attention due to the ability to enter the human body in a variety of ways. Nevertheless, the specific mechanism by which TFs exert remains incompletely understood. Given that retinoic acid (RA) signaling pathway are closely related to development, this study aimed to screen and identify developmentally disabled chemicals in commonly used TFs and to reveal the potential effects of TFs on developmental retardation through the RA signaling pathway in mouse embryonic stem cells (mESCs). Specifically, six typical TFs (myclobutanil, tebuconazole, hexaconazole, propiconazole, difenoconazole, and flusilazole) were exposed through the construction of an embryoid bodies (EBs)-based in vitro global differentiation models. Our results clarified that various TFs disturbed lineage commitment during early embryonic development. Crucially, the activation of RA signaling pathway, which alters the expression of key genes and interferes the transport and metabolism of retinol, may be responsible for this effect. Furthermore, molecular docking, molecular dynamics simulations, and experiments using a retinoic acid receptor α inhibitor provide evidence supporting the potential modulatory role of the retinoic acid signaling pathway in developmental injury. The current study offers new insights into the TFs involved in the RA signaling pathway that interfere with the differentiation process of mESCs, which is crucial for understanding the impact of TFs on pregnancy and early development.

Ethane, the second most abundant gaseous hydrocarbon in vast anoxic environments, is an overlooked greenhouse gas. Microbial anaerobic oxidation of ethane can be driven by available electron acceptors such as sulfate and nitrate. However, despite nitrite being a more thermodynamically feasible electron acceptor than sulfate or nitrate, little is known about nitrite-driven anaerobic ethane oxidation. In this study, a microbial culture capable of nitrite-driven anaerobic ethane oxidation was enriched through the long-term operation of a nitrite-and-ethane-fed bioreactor. During continuous operation, the nitrite removal rate and the theoretical ethane oxidation rate remained stable at approximately 25.0 mg NO2–N L−1 d−1 and 11.48 mg C2H6 L−1 d−1, respectively. Batch tests demonstrated that ethane is essential for nitrite removal in this microbial culture. Metabolic function analysis revealed that a species affiliated with a novel genus within the family Rhodocyclaceae, designated as 'Candidatus Alkanivoras nitrosoreducens', may perform the nitrite-driven anaerobic ethane oxidation. In the proposed metabolic model, despite the absence of known genes for ethane conversion to ethyl-succinate and succinate-CoA ligase, 'Ca. A. nitrosoreducens' encodes a prospective fumarate addition pathway for anaerobic ethane oxidation and a complete denitrification pathway for nitrite reduction to nitrogen. These findings advance our understanding of nitrite-driven anaerobic ethane oxidation, highlighting the previously overlooked impact of anaerobic ethane oxidation in natural ecosystems.

In order to clarify the microflora structure in Cheddar cheese processing, MiSeq high-throughput sequencing technology was used to analyze the community structure of Cheddar cheese at three stages of processing (post-pasteurization, curdling, and ripening 0, 30, 60 and 90 d) in this study. The results showed that the community structure varies widely of cheddar cheese during processing. The highest microbial community diversity and abundance were found after pasteurization (Chao1 index and Shannon index mean values were 6.09 and 1415.78, respectively). The dominant microflora in the pasteurization stage at the genus level was Stenotrophomonas (21.04%). The community structure was relatively similar in the curd and ripening stages, Lactococcus were the dominant flora in both stages, with abundance averaging more than 85%. During the ripening period, the relative abundance of Lactococcus increased first and then decreased. The community structure in the pasteurized cheeses was different compared to the other groups, and there was less change in the community structure of the groups during the ripening period. This study provides a basis for clarifying the community structure of Cheddar cheese, and has a certain reference value for the expansion of Cheddar cheese microbiome information.

Extensive power shortages and airstrikes have plunged Gaza into a severe humanitarian crisis. Here, we introduce a rapid and efficient framework to evaluate the impacts of armed conflict and monitor potential humanitarian crises in the Gaza Strip based on multi-source satellite imageries and cutting-edge artificial intelligence (AI) techniques. Since October 9th, 2023, the complete blockade had led to widespread power outages across the entire Gaza Strip, particularly in the southern region. Airstrikes destroyed more than 20% of buildings, including nearly 60% of shops and hospitals, as well as 80% of water infrastructure. The affected vulnerable population exposure is further quantified at the block level, which further helps determine high-risk humanitarian crisis locations and aid in the precise allocation of humanitarian resources. In general, the proposed framework performs well in applying to complex environments during an armed conflict. It can also offer rapid and continuous monitoring of the Gaza Strip and can be broadly applied in armed conflicts or natural disasters. Our research is one of the early studies to apply AI foundation models to improve the efficiency of rapid post-disaster investigation.

Pancreatic tumors are small in size, diverse in shape, and have low contrast and high texture similarity with surrounding tissue. As a result, the segmentation model is easily confused by complex and changeable background information, leading to inaccurate positioning of small targets and false positives and false negatives. Therefore, we design a cascaded pancreatic tumor segmentation algorithm. In the first stage, we use a general multi-scale U-Net to segment the pancreas, and we exploit a multi-scale segmentation network based on non-local localization and focusing modules to segment pancreatic tumors in the second stage. The non-local localization module learns channel and spatial position information, searches for the approximate area where the pancreatic tumor is located from a global perspective, and obtains the initial segmentation results. The focusing module conducts context exploration based on foreground features (or background features), detects and removes false positive (or false negative) interference, and obtains more accurate segmentation results based on the initial segmentation. In addition, we design a new loss function to alleviate the insensitivity to small targets. Experimental results show that the proposed algorithm can more accurately locate pancreatic tumors of different sizes, and the Dice coefficient outperforms the existing state-of-the-art segmentation model. The code will be available at https://github.com/HeyJGJu/Pancreatic-Tumor-SEG.

Human iPSC line, SDHi001-A, was generated from 65-year-old male patient with mitral valve prolapse, using non-integrative reprogramming method. This cell line shows pluripotency both in vitro and in vivo, and has a normal karyotype.

Abstract Phosphodiesterase‐5 (PDE5) inhibitors are used clinically for the treatment of erectile dysfunction, pulmonary arterial hypertension, and other urological diseases. Emerging evidences have suggested the therapeutic capacity of PDE5 inhibitors as the repurposed drugs in oncology. However, the essential immune function of PDE5 inhibitors against cancer in tumor microenvironment (TME) remains unclear. This review aimed to summarize the recent advances regarding the repurposing of PDE5 inhibitors as anti‐cancer agents for cancer management to enhance the anti‐tumor immune response by mediating various immune cells, which included the myeloid‐derived suppressor cells, macrophages, T cells, fibroblasts, and natural killer cells in TME. Moreover, artificial intelligence (AI), as a new approach, is composed of traditional machine learning and deep learning methods and could be potentially used to identify the targets of immune cells in TME and predict the efficacy for repurposed drug toward malignancies. In summary, these endeavors provide novel insights into the comprehensive strategies for PDE5 inhibitors mediating immune cells against cancer and AI‐based approach for future drug repurposing exploration.

Abstract Objective In this study, multimodal magnetic resonance imaging (MRI) imaging was used to deeply analyze the changes of hippocampal subfields perfusion and function in patients with type 2 diabetes mellitus (T2DM), aiming to provide image basis for the diagnosis of hippocampal‐related nerve injury in patients with T2DM. Methods We recruited 35 patients with T2DM and 40 healthy control subjects (HCs). They underwent resting‐state functional MRI (rs‐fMRI), arterial spin labeling (ASL) scans, and a series of cognitive tests. Then, we compared the differences of two groups in the cerebral blood flow (CBF) value, amplitude of low‐frequency fluctuation (ALFF) value, and regional homogeneity (ReHo) value of the bilateral hippocampus subfields. Results The CBF values of cornu ammonis area 1 (CA1), dentate gyrus (DG), and subiculum in the right hippocampus of T2DM group were significantly lower than those of HCs. The ALFF values of left hippocampal CA3, subiculum, and bilateral hippocampus amygdala transition area (HATA) were higher than those of HCs in T2DM group. The ReHo values of CA3, DG, subiculum, and HATA in the left hippocampus of T2DM group were higher than those of HCs. In the T2DM group, HbAc1 and FINS were negatively correlated with imaging characteristics in some hippocampal subregions. Conclusion This study indicates that T2DM patients had decreased perfusion in the CA1, DG, and subiculum of the right hippocampus, and the right hippocampus subiculum was associated with chronic hyperglycemia. Additionally, we observed an increase in spontaneous neural activity within the left hippocampal CA3, subiculum, and bilateral HATA regions, as well as an enhanced local neural coordination in the left hippocampal CA3, DG, HATA, and subiculum among patients with type 2 diabetes, which may reflect an adaptive compensation for cognitive decline. However, this compensation may decline with the exacerbation of metabolic disorders.

We describe a technique to reattach the detached Descemet’s membrane, following cataract surgery. From the main clear corneal cataract incision, aqueous humor is ejected completely by apposition of the cornea to the iris for approximately 3 s. This ensures the fluid in the space between the stroma and Descemet’s membrane is ejected and the detached Descemet’s membrane returns to its original position. Sterile air is injected through a paracentesis 180 degrees away from the Descemet’s membrane detachment, to maintain a complete air-filled chamber. Full air tamponade is maintained for 20 min, following which one-third of the air is ejected from the chamber to prevent an increase of postoperative intraocular pressure.

1,8-Cineole is a bicyclic monoterpene widely distributed in the essential oils of various medicinal plants, and it exhibits significant anti-inflammatory and antioxidant activities. We aimed to investigate the therapeutic effect of 1,8-cineole on anti-Alzheimer's disease by using transgenic Caenorhabditis elegans models. Our studies demonstrated that 1,8-cineole significantly relieved Aβ1–42-induced paralysis and exhibited remarkable antioxidant and anti-Aβ1–42 aggregation activities in transgenic nematodes CL4176, CL2006 and CL2355. We developed a 1,8-cineole/cyclodextrin inclusion complex, displaying enhanced anti-paralysis, anti-Aβ aggregation and antioxidant activities compared to 1,8-cineole. In addition, we found 1,8-cineole treatment activated the SKN-1/Nrf-2 pathway and induced autophagy in nematodes. Our results demonstrated the antioxidant and anti-Alzheimer's disease activities of 1,8-cineole, which provide a potential therapeutic approach for Alzheimer's disease.

Abstract The rational design of efficient bifunctional single-atom electrocatalysts for industrial water splitting and the comprehensive understanding of its complex catalytic mechanisms remain challenging. Here, we report a Ni single atoms supported on oxygen-incorporated Mo2C via Ni-O-Mo bridge bonds, that gives high oxygen evolution reaction (OER) and hydrogen evolution reaction (HER) bifunctional activity. By ex situ synchrotron X-ray absorption spectroscopy and electron microscopy, we found that after HER, the coordination number and bond lengths of Ni-O and Ni-Mo (Ni-O-Mo) were all altered, yet the Ni species still remain atomically dispersed. In contrast, after OER, the atomically dispersed Ni were agglomerated into very small clusters with new Ni-Ni (Ni-O-Ni) bonds appeared. Combining experimental results and DFT calculations, we infer the oxidation degree of Mo2C and the configuration of single-atom Ni are both vital for HER or OER. This study provides both a feasible strategy and model to rational design highly efficient electrocatalysts for water electrolysis.

Abstract The percent global glomerulosclerosis is a key factor in determining the outcome of renal transfer surgery. At present, the rate is typically computed by pathologists, which is labour intensive and nonstandardized. With the development of Deep Learning (DL), DL-based segmentation models can be used to better identify and segment normal and sclerosed glomeruli. Based on this, we can better quantify percent global glomerulosclerosis to reduce the discard rate of donor kidneys. We used 51 whole slide images (WSIs) from different institutions that are publicly available on the internet. However, the number of sclerosed glomeruli is much smaller than that of normal glomeruli in different WSIs, which can reduce the effectiveness of Deep Learning. For better sclerosed glomerular identification and segmentation performance, we modified and trained a GAN (generative adversarial network)-based image inpainting model to obtain more synthetic sclerosed glomeruli. Our proposed inpainting method achieved an average SSIM (Structural Similarity) of 0.8086 and an average PSNR (Peak Signal-to-Noise Ratio) of 22.8943 dB in the area of generated sclerosed glomeruli. We obtained sclerosed glomerular segmentation performance improvement by adding synthetic sclerosed glomerular images and achieved the best Dice of glomerular segmentation in different test sets based on the modified Unet model.

Background: The purpose of this study was to compare the efficacy and safety of utidelone plus capecitabine for advanced first-line versus second-line or above therapy in metastatic breast cancer patients who had previously received anthracycline and taxane. At the same time, we compared the efficacy of utidelone plus capecitabine and vinorelbine plus cisplatin in advanced first-line treatment of metastatic breast cancer. Patients and methods: A retrospective cohort of 11 patients with metastatic breast cancer previously treated with anthracycline and taxane (including neoadjuvant and adjuvant therapies) for advanced first-line with utidelone plus capecitabine, 32 patients treated with second-line or above, and 60 patients with vinorelbine plus cisplatin between October 2011 and August 2022 was collected. The first and second groups were treated with utidelone plus capecitabine, and the third group was treated with vinorelbine plus cisplatin. The primary endpoint was progression-free survival (PFS), and secondary endpoints were overall survival (OS), objective response rate (ORR), and treatment safety. Results: By 03/31/2023, median PFS reached 11.70 months (95 % CI 0.093–0.141) in utidelone plus capecitabine group in the advanced first-line therapy, compared to 5.60 months (95 % CI 0.025–0.079) in the second-line or above therapy [HR 0.42, (95 % CI 0.226–0.787), P = 0.0077]. In utidelone plus capecitabine, the median OS was not reached in the advanced first-line therapy, with a mean overall survival of 23.16 months (95 % CI 0.198–0.265); whereas the median OS in the second-line or above therapy was 19.50 months (95 % CI 0.083–0.307), with a mean overall survival of 16.89 months (95 % CI 0.136–0.202) [HR 0.26, (95 % CI 0.098–0.678), P = 0.0495]. The ORR for advanced first-line therapy was 27.27 % (95%CI 0.060, 0.610) compared with 15.63 % (95%CI 0.053, 0.328) for second-line or above. In advanced first-line therapy, utidelone plus capecitabine was superior to vinorelbine plus cisplatin with a median PFS of 6.12 months (95 % CI 0.051–0.072) [HR 0.49, (95 % CI 0.286–0.839), P = 0.0291]. Compared with utidelone plus capecitabine, the median OS in vinorelbine plus cisplatin advanced first-line therapy group was 35.37 months (95 % CI 0.258–0.449), and the mean overall survival was 40.79 months (95 % CI 0.315–0.501) [HR 0.54, (95 % CI 0.188–1.568), P = 0.2587]. The ORR for vinorelbine plus cisplatin was 18.33 % (95 % CI 0.095, 0.304). The most common adverse events in our study were neurological toxicity, hand-foot syndrome, hematological toxicity, gastrointestinal toxicity, and hepatic and renal function abnormalities. There were no deaths due to adverse effects during the utidelone plus capecitabine treatment period. Conclusions: In MBC, advanced first-line therapy with utidelone plus capecitabine resulted in more favorable PFS, OS, and ORR than second-line or above therapy. In advanced first-line therapy, utidelone plus capecitabine had superior PFS, and ORR compared with vinorelbine plus cisplatin. This study concludes that utidelone plus capecitabine is a more valuable chemotherapy option in advanced first-line MBC.

Abstract Monitoring extent and severity is vital in the ulcerative colitis (UC) follow-up, however, current assessment is complex and low cost-effectiveness. We aimed to develop a routine blood-based clinical decision support tool, Jin’s model, to investigate the extent and severity of UC. The multicentre retrospective cohort study recruited 975 adult UC inpatients and sub-grouped into training, internal validation and external validation set. Model was developed by logistics regression for the extent via Montreal classification and for the severity via Mayo score, Truelove and Witts score (TWS), Mayo endoscopic score (MES) and Degree of Ulcerative colitis Burden of Luminal Inflammation (DUBLIN) score. In Montreal classification, left-sided and extensive versus proctitis model achieved area under the receiver operating characteristic curve (AUROC) of 0.78 and 0.81 retrospectively. For severity, Mayo score model, TWS model, MES model and DUBLIN score model achieved an AUROC of 0.81, 0.70, 0.74 and 0.70 retrospectively. The models also were evaluated with satisfactory calibration and clinical unity. Jin’s model was free with open access at http://jinmodel.com:3000/ . Jin’s model is a noninvasive, convenient, and efficient approach to assess the extent and severity of UC.

In response to the severe air pollution caused by winter heating, the Chinese government has proposed a clean heating policy since 2017. This paper first uses air quality monitoring and household micro-survey data in northern cities to investigate the impact of this policy on air pollution through the DID approach. The empirical results show that the air quality index of the pilot cities has decreased by 12.3 units, which means that the clean heating policy has significantly reduced air pollution. The finding still holds through a series of robustness analyses such as controlling for confounding policies and Goodman-Bacon decomposition. Besides, we explore the mechanism at the urban and household levels. It shows that this policy has significantly increased the consumption of natural gas and the number of natural gas users in urban central heating and also prompted more households to use natural gas and electricity instead of solar energy to replace coal for heating. The heterogeneity analysis shows that this policy has a greater impact on both low-urbanization cities and developed cities. Furthermore, we analyze price sensitivity and the costs and benefits of the policy, and find that the increase in natural gas prices significantly inhibits the policy effect, while the price of coal has no significant effect. In addition, the policy significantly reduces the incidence of lung disease among middle-aged and elderly people and leads to a significant increase in household heating costs in winter, which indicates that the clean heating policy has generated environmental and health benefits despite increasing government and household expenditures.

Accurate measurement of a Radar Cross-Section (RCS) is a critical technical challenge in assessing the stealth performance and scattering characteristics of radar targets. Traditional RCS measurement methods are limited by high costs, sensitivity to environmental conditions, and difficulties in distinguishing local scattering features of targets. To address these challenges, this paper proposes a novel RCS measurement method based on enhanced imaging and scattering center extraction. This method integrates sub-aperture imaging with image fusion techniques to improve imaging quality and enhance the detail of target scattering characteristics. Additionally, an improved sequence CLEAN algorithm is employed to effectively suppress sidelobe effects and ensure the accuracy of scattering center extraction. Experimental results demonstrate that this method achieves higher precision in RCS measurement of complex targets and is particularly effective in environments with strong interference, where it successfully separates the scattering contributions of the target from those of the interference sources. This method offers a new technological approach for precise RCS measurement of radar stealth targets in the future.

Background: Metabolic associated fatty liver disease (MAFLD) is a widespread liver disease that can lead to liver fibrosis and cirrhosis. Therefore, it is essential to develop early diagnosic and screening methods. Methods: We performed a cross-sectional observational study. In this study, based on data from 92 patients with MAFLD and 74 healthy individuals, we observed the characteristics of tongue images, tongue coating and intestinal flora. A generative adversarial network was used to extract tongue image features, and 16S rRNA sequencing was performed using the tongue coating and intestinal flora. We then applied tongue image analysis technology combined with microbiome technology to obtain an MAFLD early screening model with higher accuracy. In addition, we compared different modelling methods, including Extreme Gradient Boosting (XGBoost), random forest, neural networks(MLP), stochastic gradient descent(SGD), and support vector machine(SVM). Results: The results show that tongue-coating Streptococcus and Rothia, intestinal Blautia, and Streptococcus are potential biomarkers for MAFLD. The diagnostic model jointly incorporating tongue image features, basic information (gender, age, BMI), and tongue coating marker flora (Streptococcus, Rothia), can have an accuracy of 96.39%, higher than the accuracy value except for bacteria. Conclusion: Combining computer-intelligent tongue diagnosis with microbiome technology enhances MAFLD diagnostic accuracy and provides a convenient early screening reference.

BackgroundCurrently, disease-modifying therapies (DMTs) for progressive multiple sclerosis (PMS) are widely used in clinical practice. At the same time, there are a variety of drug options for DMTs, but the effect of the drugs that can better relieve symptoms and improve the prognosis are still inconclusive.ObjectivesThis systematic review aimed to evaluate the efficacy and safety of DMTs for PMS and to identify the best among these drugs.MethodsMEDLINE, EMBASE, the Cochrane Library, and clinicaltrials.gov were systematically searched to identify relevant studies published before 30 January, 2023. We assessed the certainty of the evidence using the confidence in the network meta-analysis (CINeMA) framework. We estimated the summary risk ratio (RR) for dichotomous outcomes and mean differences (MD) for continuous outcomes with 95% credible intervals (CrIs).ResultsWe included 18 randomized controlled trials (RCTs) involving 9,234 patients in the study. DMT can effectively control the disease progression of MS. Among them, mitoxantrone, siponimod, and ocrelizumab are superior to other drug options in delaying disease progression (high certainty). Mitoxantrone was the best (with high certainty) for mitigating deterioration (progression of disability). Ocrelizumab performed best on the pre- and post-treatment Timed 25-Foot Walk test (T25FW; low certainty), as did all other agents (RR range: 1.12–1.05). In the 9-Hole Peg Test (9HPT), natalizumab performed the best (high certainty), as did all other agents (RR range: 1.59–1.09). In terms of imaging, IFN-beta-1b performed better on the new T2 hypointense lesion on contrast, before and after treatment (high certainty), while siponimod performed best on the change from baseline in the total volume of lesions on T2-weighted image contrast before and after treatment (high certainty), and sWASO had the highest area under the curve (SUCRA) value (100%). In terms of adverse events (AEs), rituximab (RR 1.01), and laquinimod (RR 1.02) were more effective than the placebo (high certainty). In terms of serious adverse events (SAEs), natalizumab (RR 1.09), and ocrelizumab (RR 1.07) were safer than placebo (high certainty).ConclusionDMTs can effectively control disease progression and reduce disease deterioration during the treatment of PMS.Systematic review registrationhttps://inplasy.com/?s=202320071, identifier: 202320071.

Utilizing the asymmetry of the micro-nano structure to excite Fano resonance in dielectric metasurfaces presents low loss and high field enhancement factors, and has a broad range of applications in optical sensing. Nevertheless, the asymmetry of the structure often leads to polarization-sensitive characteristics, significantly reducing the quality factor and sensitivity of the metasurface, thereby hindering its further application. In this study, the metasurface composed of dielectric materials is designed to be completely insensitive to x and y polarization. The metasurface is composed of semicircular disks, which are asymmetrically and periodically placed on a quartz substrate. By controlling the radius of the two semicircular disks, the symmetry is broken, and the bound states in the continuum (BIC) transition to quasi-bound states in the continuum (q-BIC), resulting in an ultra-narrow Fano resonance peak. Simulation results show that the magnetic dipole (MD) dominates the resonance. The designed metasurface structure was fabricated and then integrated into a microfluidic system for spectral refractive index sensing experiments. In the near-infrared band, our tests demonstrate refractive index sensing performance of 405 nm/RIU and a Q factor of up to 319, with significant symmetry of the polarization angle, which agrees well with theoretical simulations. Furthermore, the spectral response of the designed structure can be flexibly controlled by adjusting the polarization angle of the incident light. We believe that this study provides a novel integrated platform for applications such as biosensing and environmental detection, and also has certain reference value for the design of polarization optical switches and metasurface absorbers for encrypted communication.

Polycyclic aromatic hydrocarbons (PAHs) are hazardous organic contaminants commonly found in soils. This study investigated an integrated remediation approach combining white rot fungal augmentation and nano-zero-valent iron (nZVI) activated persulfate oxidation to enhance the degradation of PAHs in soil. The white rot fungus Peniophora incarnata demonstrated efficient degradation of lower molecular weight PAHs including phenanthrene (91% removal) and anthracene (71% removal) in liquid culture, but had limited degradation of high molecular weight benzo[a]pyrene (35% removal). Inoculation of P. incarnata in non-sterilized soil led to 54% phenanthrene and 46% anthracene removal after 42 days. Co-inoculation with Pseudomonas aeruginosa slightly improved the degradation by 15% and 13%, respectively. However, benzo[a]pyrene removal was negligible through bioremediation alone. Direct nZVI/persulfate oxidation removed 55–75% of lower molecular weight PAHs and 68% of benzo[a]pyrene in soil. Integrated treatment combining nZVI/persulfate oxidation followed by P. incarnata inoculation resulted in 92–96% degradation of phenanthrene, anthracene and benzo[a]pyrene after 42 days, which was significantly higher than either approach alone. The enhanced PAH removal was attributed to the coupled effects of chemical oxidation and microbial degradation. P. aeruginosa is capable of directly metabolizing and mineralizing lower molecular weight PAHs such as phenanthrene and anthracene. The presence of this additional PAH-degrading bacterium likely contributed to the increased degradation observed. Overall, the sequential nZVI/persulfate and fungal treatment provides an effective and sustainable option for remediating soils co-contaminated with PAHs and other persistent organics. Further research should optimize treatment parameters and evaluate long-term impacts on soil quality.

Hyperspectral unmixing (HU) aims to decompose mixed pixels into a set of endmembers and corresponding abundances. Deep learning-based HU methods are currently a hot research topic, but most existing unmixing methods still rely on per-pixel training or employ convolutional neural networks (CNNs), which overlook the non-local correlations of materials and spectral characteristics. Furthermore, current research mainly focuses on linear mixing models, which limits the feature extraction capability of deep encoders and further improvement in unmixing accuracy. In this paper, we propose a nonlinear unmixing network capable of extracting global spatial-spectral features. The network is designed based on an autoencoder architecture, where a dual-stream CNNs is employed in the encoder to separately extract spectral and local spatial information. The extracted features are then fused together to form a more complete representation of the input data. Subsequently, a linear projection-based multi-head self-attention mechanism is applied to capture global contextual information, allowing for comprehensive spatial information extraction while maintaining lightweight computation. To achieve better reconstruction performance, a model-free nonlinear mixing approach is adopted to enhance the model’s universality, with the mixing model learned entirely from the data. Additionally, an initialization method based on endmember bundles is utilized to reduce interference from outliers and noise. Comparative results on real datasets against several state-of-the-art unmixing methods demonstrate the superior of the proposed approach.

The Sichuan-Yunnan block is a tectonically active region in China, with frequent large earthquakes occurring in and around it. Despite most earthquakes being concentrated along boundary faults, intraplate faults also have the potential to generate damaging earthquakes. Remote sensing makes it possible to identify these potential earthquake source faults. During an active fault investigation in the Liangshan area, a distinct lithological boundary named Caimashui fault was found. The geometric distribution and kinematic parameter of the fault is crucial for assessing seismic hazards and understanding the deformation pattern within the Sichuan-Yunnan block. The Caimashui fault is mapped with remote sensing interpretation, a field survey, and UAV measurement. Through trenching and Quaternary dating, the Late Quaternary active characteristics of the fault are studied. The fault is a Holocene active dextral strike-slip fault with a reverse component, exhibiting a dextral strike-slip rate of ~0.70 ± 0.11 mm/a. Paleoseismic investigation shows that the last surface rupture event of the Caimashui fault occurred later than 4150 ± 30a BP, with a magnitude of M ≥ 7.0. The fault may act as a secondary splitting fault, absorbing the deformation caused by various sinistral strike-slip rates of the boundary faults and the potential energy from the counterclockwise rotation of the Central Yunnan micro-block.

The numerical aperture of the spectrometer is crucial for weak signal detection. The transmission lens-based configuration has more optimization variations, and the grating can work approximately in the Littrow condition; thus, it is easier to acquire high numerical aperture (NA). However, designing a large aperture focusing lens remains challenging, and thus, ultra-high NA spectrometers are still difficult to acquire. In this paper, we propose a method of setting image plane tilt ahead directly when designing the large aperture focusing lens to simplify the high NA spectrometer design. By analyzing the accurate demands of the focusing lens, it can be concluded that a focusing lens with image plane tilt has much weaker demand for achromatism, and other monochromatic aberration can also be reduced, which is helpful to increase the NA. An NA0.5 fiber optic spectrometer design is given to demonstrate the proposed method. The design results show that the NA can achieve 0.5 using four lenses of two materials, and the MTF is higher than 0.5 when the spectral dispersion length is 12.5 mm and the pixel size is 25 μm, and thus, the spectral resolution can achieve 6.5 nm when the spectral sampling ratio is 2:1. The proposed method can provide reference for applications when appropriate materials are limited and high sensitivity is necessary.

Abstract Background Voiding trials are used to identify women at risk for postoperative urinary retention while performing optimal voiding trial management with minimal burden to the patient and medical service team. We performed a systematic review and meta-analysis of postoperative void trials following urogynecologic surgery to investigate (1) the optimal postoperative void trial methodology and (2) the optimal criteria for assessing void trial. Method We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and relevant reference lists of eligible articles from inception to April 2022. We identified any randomized controlled trials (RCTs) in English that studied void trials in patients undergoing urogynecologic surgery. Study selection (title/abstract and full text), data extraction, and risk of bias assessment were conducted by two independent reviewers. Extracted study outcomes included the following: the correct passing rate, time to discharge, discharge rate without a catheter after the initial void trial, postoperative urinary tract infection, and patient satisfaction. Results Void trial methodology included backfill-assisted and autofill studies (2 RCTs, n = 95). Backfill assistance was more likely to be successful than autofill (RR 2.12, 95% CI 1.29, 3.47, P = 0.00); however, no significant difference was found in the time to discharge (WMDs = − 29.11 min, 95% CI − 57.45, 1.23, P = 0.06). The criteria for passing void trial included subjective assessment of the urinary force of stream and objective assessment of the standard voiding trial (3 RCTs, n = 377). No significant differences were found in the correct passing rate (RR 0.97, 95% CI 0.93, 1.01, P = 0.14) or void trial failure rate (RR 0.78, 95% CI 0.52, 1.18, P = 0.24). Moreover, no significant differences were found in the complication rates or patient satisfaction between the two criteria. Conclusion Bladder backfilling was associated with a lower rate of catheter discharge after urogynecologic surgery. The subjective assessment of FOS is a reliable and safe method for assessing postoperative voiding because it is less invasive. Systematic review registration PROSPERO CRD42022313397

During the COVID-19 pandemic, elderly patients with underlying condition, such as tumors, had poor prognoses after progressing to severe pneumonia and often had poor response to standard treatment. Mesenchymal stem cells (MSCs) may be a promising treatment for patients with severe pneumonia, but MSCs are rarely used for patients with carcinoma. Here, we reported a 67-year-old female patient with lung adenocarcinoma who underwent osimertinib and radiotherapy and suffered from radiation pneumonitis. Unfortunately, she contracted COVID-19 and that rapidly progressed to severe pneumonia. She responded poorly to frontline treatment and was in danger. Subsequently, she received a salvage treatment with four doses of MSCs, and her symptoms surprisingly improved quickly. After a lung CT scan that presented with a significantly improved infection, she was discharged eventually. Her primary disease was stable after 6 months of follow-up, and no tumor recurrence or progression was observed. MSCs may be an effective treatment for hyperactive inflammation due to their ability related to immunomodulation and tissue repair. Our case suggests a potential value of MSCs for severe pneumonia that is unresponsive to conventional therapy after a COVID-19 infection. However, unless the situation is urgent, it needs to be considered with caution for patients with tumors. The safety in tumor patients still needs to be observed.

Radiation-induced lung injury (RILI) is frequently observed in patients undergoing radiotherapy for thoracic malignancies, constituting a significant complication that hampers the effectiveness and utilization of tumor treatments. Ionizing radiation exerts both direct and indirect detrimental effects on cellular macromolecules, including DNA, RNA and proteins, but the impact of oxidized RNA in RILI remains inadequately explored. Mesenchymal stem cells (MSCs) can repair injured tissues, and the reparative potential and molecular mechanism of MSCs in treating RILI remains incompletely understood. This study aimed to investigate the therapeutic effects and mechanisms of action of three distinct sources of MSCs, including human umbilical cord mesenchymal stem cells (UCMSCs), bone marrow mesenchymal stem cells (BMSCs), and adipose-derived stem cells (ADSCs), in thoracically irradiated mice. Comparative analysis revealed that all three types of MSCs exhibited the ability to mitigate radiation-induced inflammatory infiltration, alveolar hemorrhage, and alveolar wall thickening in the lung tissue of the mice. MSCs also attenuated RILI by decreasing inflammatory factors, upregulating anti-inflammatory factor expression, and reducing collagen accumulation. Immunohistochemical results showed that all three MSCs reduced radiation-induced cell apoptosis and promoted the regeneration of lung tissue cells. The analysis of malondialdehyde (MDA) and 8-hydroyguanosine (8-OHG) content indicated that MSCs possess reparative properties against radiation-induced oxidative damage in lung tissue. The study provides evidence that UCMSCs are a more appropriate therapeutic option for RILI compared to BMSCs and ADSCs. Additionally, MSCs effectively reduce the accumulation of oxidized RNA in RILI, thereby, presenting a unique avenue for investigating the underlying mechanism of MSC-based treatment for RILI.

Aim. To explore the potential factors that influence the presentation and recovery of postoperative chylous ascites (CA) in gynecological malignancies. Methods. We reported two cases of postoperative CA following gynecological surgery and reviewed the clinical features of 140 patients from 16 relevant papers. Patients’ clinicopathological characteristics, surgical approach, and management were summarized. The onset and resolution times of postoperative CA in different groups were analyzed separately. Results. The two patients in our report had recovery after conservative treatments. According to the literature review, the median time of onset of postoperative CA was 5 days (range, 0–75 days) after surgery. The median resolution time was 9 days (range, 2–90 days). Among patients, 87.14% of them had lymphadenectomy during gynecological surgeries, while 92.86% of the patients had resolution after conservative treatments. Conclusions. Lymphadenectomy during surgery may be relevant to the postoperative CA. Conservative management could be the initial choice for postoperative CA treatment.

BackgroundThere are many similarities in the clinical manifestations of human norovirus and SARS-CoV-2 infections, and nucleic acid detection is the gold standard for diagnosing both diseases. In order to expedite the identification of norovirus and SARS-CoV-2, a quantitative one-step triplex reverse transcription PCR (RT-qPCR) method was designed in this paper.MethodsA one-step triplex RT-qPCR assay was developed for simultaneous detection and differentiation of human norovirus GI (NoV-GI), GII (NoV-GII) and SARS-CoV-2 from fecal specimens.ResultsThe triplex RT-qPCR assay had high detection reproducibility (CV

Skillful utilization of mental arithmetic can significantly improve students' mathematical computation ability. However, it was observed that primary school students often resort to reiterating the process of written arithmetic in their minds during mental arithmetic, which is not conducive to their numerical ability improvement. This paper devises a set of graphic teaching aids for primary school students' mental arithmetic improvement based on mental arithmetic strategies, schema theory, and working memory. To validate the effectiveness of schema teaching in enhancing mental arithmetic ability among primary school students, a controlled experiment was conducted with two groups of third-grade students randomly selected from a primary school in Jingshan City. The results, obtained through descriptive statistical analysis and the multitrait-multimethod approach (MTMM), indicated that the experimental group (n = 52) demonstrated significant improvements in speed, accuracy, and stability in mental addition and subtraction after a 14-day instruction period in schema teaching. This study offers a potent mental arithmetic teaching strategy for elementary mathematics education, which can lead to a comprehensive enhancement of students' mental calculation abilities. It also holds promise for inspiring innovative teaching methodologies in primary and secondary mathematics education in the future.

ABSTRACT Phage therapy has become one of the most promising alternatives to antibiotics as the surge of multi-drug-resistant (MDR) bacteria severely threatens global public health. The lack of a thorough understanding of pharmacokinetics (PK) and the safety study of phage has limited its clinical application. In this study, we aimed to evaluate the PK and safety of a lytic phage PA_LZ7 that infects MDR Pseudomonas aeruginosa using intravenous (IV) route in an uninfected immune-competent mice model. The active phage of PA_LZ7 exhibited an exponential decay in plasma at 2*108 (low dosage), 2*1010 [medium dosage (MD)], and 2*1011 PFU/kg [high dosage (HD)] after IV administration, and the phage titer dropped to ~4 log10 PFU/mL over 24 h for all dosages. Phages primarily accumulated in the spleen at 1 h post-administration and gradually decreased in all dosages. The active phage titer in other organs decreased globally within 72 h as well. Plasma cytokines IL-6, IL-10, KC/GRO, and tumor necrosis factor-alpha sharply increased 1 h post-administration in mice of MD and HD groups and dropped to a normal range within 24 h. No obvious toxic effect was observed, except for the increased spleen weight and relative spleen weight in the MD and HD group and the slight lymphocytosis in the white pulp of the spleen in the HD group. In conclusion, PA_LZ7 possesses good PK properties and shows no obvious toxicity; it could be considered as a potent therapeutic candidate for the treatment of MDR P. aeruginosa infections in future phage therapy. IMPORTANCE Phage therapy is gaining traction as an alternative to antibiotics due to the rise of multi-drug-resistant (MDR) bacteria. This study assessed the pharmacokinetics and safety of PA_LZ7, a phage targeting MDR Pseudomonas aeruginosa, in mice. After intravenous administration, the phage showed an exponential decay in plasma and its concentration dropped significantly within 24 h for all dosage groups. Although there was a temporary increase in certain plasma cytokines and spleen weight at higher dosages, no significant toxicity was observed. Therefore, PA_LZ7 shows potential as an effective and safe candidate for future phage therapy against MDR P. aeruginosa infections.

ObjectiveTo explore the factors influencing the successful implementation of same-day discharge in patients undergoing minimally invasive hysterectomy for malignant and non-malignant gynecological diseases.MethodWe searched PubMed, Embase, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform, and Clinical Trials.gov from inception to May 23, 2023. We included case-control and cohort studies published in English reporting same-day discharge factors in patients undergoing minimally invasive hysterectomy for malignant and non-malignant gynecological diseases. STATA 16.0 was used for the meta-analysis. Risk factors were assessed using odds ratios (OR) (relative risk (RR)/hazard ratios (HR)) with 95% confidence intervals (CI), and logistic regression determined the same-day discharge rate (%).ResultsWe analyzed 29 studies with 218192 patients scheduled for or meeting same-day discharge criteria. The pooled rates were 50% (95% CI 0.46-0.55), and were similar for malignant and non-malignant gynecological diseases (48% and 47%, respectively). In terms of basic characteristics, an increase in age (OR: 1.03; 95% CI: 1.01–1.05), BMI (OR: 1.02; 95% CI: 1.01–1.03), and comorbidities including diabetes and lung disease were risk factors affecting SDD, while previous abdominal surgery history (OR: 1.54; 95% CI: 0.93–2.55) and hypertension (OR: 1.53; 95% CI: 0.80–2.93) appeared not to affect SDD. In terms of surgical characteristics, radical hysterectomy (OR: 3.46; 95% CI: 1.90–6.29), surgery starting after 14:00 (OR: 4.07; 95% CI: 1.36–12.17), longer surgical time (OR: 1.03; 95% CI: 1.01–1.06), intraoperative complications (OR: 4.68; 95% CI: 1.78–12.27), postoperative complications (OR: 3.97; 95% CI: 1.68–9.39), and surgeon preference (OR: 4.47; 95% CI: 2.08–9.60) were identified as risk factors. However, robotic surgery (OR: 0.44; 95% CI: 0.14–1.42) and intraoperative blood loss (OR: 1.16; 95% CI: 0.98–1.38) did not affect same-day discharge.ConclusionsAn increase in age, body mass index, and distance to home; certain comorbidities (e.g., diabetes, lung disease), radical hysterectomy, surgery starting after 14:00, longer surgical time, operative complications, and surgeon preference were risk factors preventing same-day discharge. Same-day discharge rates were similar between malignant and non-malignant gynecological diseases. The surgery start time and body mass index have a greater impact on same-day discharge for malignant diseases than non-malignant diseases.

The development of mobile networks has led to the emergence of challenges such as high delays in storage, computing and traffic management. To deal with these challenges, fifth-generation networks emphasize the use of technologies such as mobile cloud computing and mobile edge computing. Mobile Edge Cloud Computing (MECC) is an emerging distributed computing model that provides access to cloud computing services at the edge of the network and near mobile users. With offloading tasks at the edge of the network instead of transferring them to a remote cloud, MECC can realize flexibility and real-time processing. During computation offloading, the requirements of Internet of Things (IoT) applications may change at different stages, which is ignored in existing works. With this motivation, we propose a task offloading method under dynamic resource requirements during the use of IoT applications, which focuses on the problem of workload fluctuations. The proposed method uses a learning automata-based offload decision-maker to offload requests to the edge layer. An auto-scaling strategy is then developed using a long short-term memory network which can estimate the expected number of future requests. Finally, an Asynchronous Advantage Actor-Critic algorithm as a deep reinforcement learning-based approach decides to scale down or scale up. The effectiveness of the proposed method has been confirmed through extensive experiments using the iFogSim simulator. The numerical results show that the proposed method has better scalability and performance in terms of delay and energy consumption than the existing state-of-the-art methods.

Abstract Growth hormone (GH) therapy has been used in patients with growth retardation and short stature due to various reasons. The safety of GH treatment is still debatable, one of which is the occurrence and development of scoliosis. In order to explore the effects of GH on the occurrence or progression of scoliosis, this review summarizes previous studies, summarizes the influence of GH treatment on the pathogenesis and progression of scoliosis, and analyzes the possible mechanism of GH in the pathogenesis and progression of scoliosis. Hopefully, it can provide a direction for future research.

Neonicotinoid insecticides (NNIs) are widely used in agriculture, horticulture, forestry, and household environment, but their potential impact on human health remains a subject of concern. This study aimed to investigate the relationship between NNIs and their metabolites in urine with serum lipid profiles in adults using data from the National Health and Nutrition Examination Survey (NHANES) 2015–2016. The study included 1192 participants aged over 20 years with urinary NNIs levels, serum lipid parameter levels and potential confounders. Urinary concentrations of NNIs, including imidacloprid, acetamiprid, clothianidin, thiacloprid, N-desmethyl-acetamiprid, and 5-hydroxy-imidacloprid, were quantified. Serum lipids profiles, such as total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (Apo-B), were assessed. Considering the effects of lipid-lowering medications, the censored normal regression model was used to explore the associations between urinary NNIs and TC, TG, HDL-C, LDL-C and Apo-B levels. The results revealed a significant increase of 9.0 mg/dL (95%CI: 2.0, 16.1) in TC levels among participants with detectable N-desmethyl-acetamiprid compared to those with undetectable levels. Stratified analysis indicated that the association between N-desmethyl-acetamiprid and HDL-C levels was more pronounced among participants aged ≥ 46 years compared to those aged between 20 and 45 years with undetectable N-desmethyl-acetamiprid (pinteraction=0.044). Additionally, there were marginal effect modification of BMI on the association between N-desmethyl-acetamiprid and LDL-C (pinteraction=0.097) and Apo-B (pinteraction=0.052) levels. Specifically, participants with BMI ≥ 25 kg/m² and detectable N-desmethyl-acetamiprid tended to have higher LDL-C and Apo-B levels compared to those with BMI

Abstract Type 2 diabetes mellitus (T2DM) is closely linked to cognitive decline and alterations in brain structure and function. Resting-state functional magnetic resonance imaging (rs-fMRI) is used to diagnose neurodegenerative diseases, such as cognitive impairment (CI), Alzheimer’s disease (AD), and vascular dementia (VaD). However, whether the functional connectivity (FC) of patients with T2DM and mild cognitive impairment (T2DM-MCI) is conducive to early diagnosis remains unclear. To answer this question, we analyzed the rs-fMRI data of 37 patients with T2DM and mild cognitive impairment (T2DM-MCI), 93 patients with T2DM but no cognitive impairment (T2DM-NCI), and 69 normal controls (NC). We achieved an accuracy of 87.91% in T2DM-MCI versus T2DM-NCI classification and 80% in T2DM-NCI versus NC classification using the XGBoost model. The thalamus, angular, caudate nucleus, and paracentral lobule contributed most to the classification outcome. Our findings provide valuable knowledge to classify and predict T2DM-related CI, can help with early clinical diagnosis of T2DM-MCI, and provide a basis for future studies.

Abstract Background Venous thromboembolism (VTE) including Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE), is a serious cause of patient morbidity and mortality in hospitals. Neurosurgical hospitalized patients have higher rates of immobility and bed rest, thus increasing their risk of developing VTE. This highlights the need for their thromboprophylaxis regimens. Patients’ awareness of VTE is essential for promoting strategies such as early ambulation and encouraging self-assessment and self-reporting of VTE signs and symptoms. This study evaluated neurosurgical hospitalized patients’ awareness of VTE and explored the influencing factors to provide a theoretical basis for nursing intervention. Methods We selected one tertiary level hospital in Hunan Province and randomly sampled eligible patients from each five neurosurgical units. We conducted a cross-sectional survey of the hospitalized patients of neurosurgery using the self-designed and validated VTE knowledge questionnaire, and the influencing factors were analyzed using SPSS 26.0. Results A total of 386 neurosurgical hospitalized patients completed the survey. The score of VTE knowledge in neurosurgical hospitalized patients was 13.22 (SD = 11.52). 36.0% and 21.2% of participants reported they had heard of DVT and PE, respectively. 38.9% of participants were unable to correctly identify any symptoms of VTE. The most frequently identified risk factor was ‘immobility or bed rest for more than three days’ (50.0% of participants), and 38.1% of patients agreed that PE could cause death. 29.5% of participants were unable to identify any prophylactic measures of VTE. The results of Negative Binomial Regression showed that the influencing factors of VTE knowledge in neurosurgical hospitalized patients were education level (P

Conventional microfluidic systems that rely on capillary force have a fixed structure and limited sensitivity, which cannot meet the demands of clinical applications. Herein, we propose a dual-drive microfluidic device for sensitive and flexible detection of multiple pathogenic microorganisms antigens/antibodies. The device comprises a portable microfluidic analyzer and a dual-drive microfluidic chip. Along with capillary force, a second active driving force is provided by a removable self-driving valve in the waste chamber. The interval between these two driving forces can be adjusted to control the reaction time in the microchannel, optimizing the formation of antigen-antibody complexes and enhancing sensitivity. Moreover, the material used in the self-driving valve can be changed to adjust the active force strength needed for different tests. The device offers quantitative analysis for respiratory syncytial virus antigen and SARS-CoV-2 antigen using a 35 μL sample, delivering results within 5 min. The detection limits of the system were 1.121 ng/mL and 0.447 ng/mL for respiratory syncytial virus recombinant fusion protein and SARS-CoV-2 recombinant nucleoprotein, respectively. Although the dual-drive microfluidic device has been used for immunoassay for respiratory syncytial virus and SARS-CoV-2 in this study, it can be easily adapted to other immunoassay applications by changing the critical reagents.

To measure vibration signals, a low-frequency fiber Bragg grating (FBG) acceleration sensor featuring a flexible hinge with a spring support and symmetric compensation structure has been designed. Based on the mechanical model of the sensor’s structure, the expressions for sensitivity and resonant frequency of the sensor are derived. The structural parameters of the sensor are optimized, and a simulation analysis is conducted using ANSYS 19.2 software. According to the results of simulation analysis and size optimization, the sensor prototype is constructed. Subsequently, its amplitude-frequency response, sensitivity, and temperature characteristics are investigated through vibration experiments. The experimental results show that the resonant frequency of the sensor is 73 Hz, the operating frequency range is 0~60 Hz, and the sensitivity measures 24.24 pm/g. This design meets the requirements for measuring vibration signals at low frequencies.