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Abstract In this study, the necessity of radiotherapy (RT) for hormone receptor-negative older breast cancer patients after breast-conserving surgery (BCS) was investigated. The data of hormone receptor-negative invasive breast cancer patients who underwent BCS were extracted from the Surveillance, Epidemiology, and End Results (SEER) database from 2010 to 2015. All patients were separated into two groups, namely, the RT group and the no radiotherapy (No RT) group. The 3- and 5-year overall survival (OS) and cancer-specific survival (CSS) rates were compared between the No RT and RT groups after propensity score matching (PSM). The nomograms for predicting the survival of patients were constructed from variables identified by univariate or multivariate Cox regression analysis. A total of 2504 patients were enrolled in the training cohort, and 630 patients were included in the validation cohort. After PSM, 738 patients were enrolled in the No RT group and RT group. We noted that RT can improve survival in hormone receptor-negative older breast cancer patients who undergo BCS. Based on the results of multivariate Cox analysis, age, race, tumour grade, receipt of RT and chemotherapy, pathological T stage, N status, M status and HER2 status were linked to OS and CSS for these patients, and nomograms for predicting OS and CSS were constructed and validated. Moreover, RT improved OS and CSS in hormone receptor-negative older breast cancer patients who underwent BCS. In addition, the proposed nomograms more accurately predicted OS and CSS for hormone receptor-negative older breast cancer patients after BCS.

Abstract Background The Omicron wave of Coronavirus disease 2019 (COVID-19) remains the dominant strain worldwide. The studies of nutritional status in geriatric people with COVID-19 Omicron variant are limited. Thus, the aim of this study was to investigate the incidence of poor nutritional status among Omicron infected older patients, and to explore the correlation between the nutritional status and the severity of Omicron infection in older patients. Methods This is a retrospective cross-sectional study. According to the clinical symptoms, patients were divided into two groups: mild and moderate to severe. Mini Nutritional Assessment short-form (MNA-SF) was conducted when patients were admitted and poor nutritional status was defined as MNA-SF score of 0–11. The inflammatory markers including neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and systemic inflammatory index (SII) were calculated and compared between two groups. Results Total of 324 patients were enrolled, with median [interquartile range (IQR)] age of 73 (17) years. Overall, 241 cases were mild, 83 cases were moderate to severe at the time of diagnosis and that 54.3% of patients had poor nutritional status. Patients with poor nutritional status were found to be older (P

BackgroundThe treatment strategy for stage II rectal mucinous adenocarcinoma (RMA) recommends neoadjuvant chemoradiotherapy (NCR) followed by total mesorectal excision (TME). However, the necessity of adjuvant chemotherapy (AC) remains controversial.Materials and methodsChi-square test was used to assess the relationship between pathological classification, AC and clinicopathological characteristics. Kaplan-Meier (KM) curves and the log-rank test were utilized to analyze differences in overall survival (OS) and cancer-specific survival (CSS) among different groups. Cox regression identified prognostic factors. Nomogram was established utilizing the independent prognostic factors. X-tile divided patients into three risk subgroups.ResultsCompared to RMA, rectal adenocarcinoma (RA) demonstrates longer OS and CSS in all and non-AC stage II patients, with no difference in OS and CSS for AC stage II patients. Propensity score matching analyses yielded similar results. Stratified analysis found that AC both improve OS of RA and RMA patients. Age, gender, pathologic T stage, regional nodes examined, and tumor size were identified as independent prognostic factors for RMA patients without AC. A nomogram was constructed to generate risk scores and categorize RMA patients into three subgroups based on these scores. KM curves revealed AC benefits for moderate and high-risk groups but not for the low-risk group. The external validation cohort yielded similar results.ConclusionsIn summary, our study suggests that, compared to stage II RA patients, stage II RMA patients benefit more from AC after NCR. AC is recommended for moderate and high-risk stage II RMA patients after NCR, whereas low-risk patients do not require AC.

Automated organ segmentation in anatomical sectional images of canines is crucial for clinical applications and the study of sectional anatomy. The manual delineation of organ boundaries by experts is a time-consuming and laborious task. However, semi-automatic segmentation methods have shown low segmentation accuracy. Deep learning-based CNN models lack the ability to establish long-range dependencies, leading to limited segmentation performance. Although Transformer-based models excel at establishing long-range dependencies, they face a limitation in capturing local detail information. To address these challenges, we propose a novel ECA-TFUnet model for organ segmentation in anatomical sectional images of canines. ECA-TFUnet model is a U-shaped CNN-Transformer network with Efficient Channel Attention, which fully combines the strengths of the Unet network and Transformer block. Specifically, The U-Net network is excellent at capturing detailed local information. The Transformer block is equipped in the first skip connection layer of the Unet network to effectively learn the global dependencies of different regions, which improves the representation ability of the model. Additionally, the Efficient Channel Attention Block is introduced to the Unet network to focus on more important channel information, further improving the robustness of the model. Furthermore, the mixed loss strategy is incorporated to alleviate the problem of class imbalance. Experimental results showed that the ECA-TFUnet model yielded 92.63% IoU, outperforming 11 state-of-the-art methods. To comprehensively evaluate the model performance, we also conducted experiments on a public dataset, which achieved 87.93% IoU, still superior to 11 state-of-the-art methods. Finally, we explored the use of a transfer learning strategy to provide good initialization parameters for the ECA-TFUnet model. We demonstrated that the ECA-TFUnet model exhibits superior segmentation performance on anatomical sectional images of canines, which has the potential for application in medical clinical diagnosis.

Coal tar pitch (CTP) has become an ideal choice in the preparation of anode precursors for lithium-ion batteries (LIBs) and sodium-ion batteries (SIBs) because of its abundant carbon content, competitive pricing and adjustable structure properties. In this paper, sulfurized pitch-based carbon (SPC-800) was obtained by allowing CTP to react with sulfur at 350 °C and subsequently achieve carbonization at 800 °C. SPC-800 was more disordered and had a larger layer spacing than carbonized CTP (PC-800). Upon utilization as an anode for LIBs, SPC-800 possessed a higher reversible specific capacity (478.1 mAh g−1 at 0.1 A g−1), while utilization in SIBs displayed a capacity of 220.9 mAh g−1 at 20 mA g−1. This work is an important guide to the design of high-performance anodes suitable for use with both LIBs and SIBs.

A Ti/β-TCP composite porous scaffold with a hierarchical pore structure composed of 3D printed interconnected macroscopic pores and sintered microscopic pores was prepared by direct ink writing (DIW) 3D printing technology. This method can control the extrusion of composite ink at room temperature and produce a 3D scaffold using layer-by-layer deposition. We studied the effects of the β-TCP powder particle size, β-TCP/Ti powder ratio and solid loading on the rheological properties of the ink and optimised the DIW printing process parameters. After sintering, the compressive strength and elastic modulus of the composite scaffold reached 45 MPa and 1 GPa, which is close to the strength of human cancellous bone. The cell culture experiment confirmed that the composite scaffold had better biological properties than the pure titanium scaffold. The composite scaffold has satisfactory mechanical and biological properties, meeting the requirements for orthopaedic implants.

The monotone variational inequalities are being widely used as mathematical tools for studying optimal control problems and convex programming. In this paper, we propose a new prediction-correction method for monotone variational inequalities with linear constraints. The method consists of two procedures. The first procedure (prediction) utilizes projections to generate a predictor. The second procedure (correction) produces the new iteration via some minor computations. The main advantage of the method is that its main computational effort only depends on evaluating the resolvent mapping of the monotone operator, and its primal and dual step sizes can be enlarged. We prove the global convergence of the method. Numerical results are provided to demonstrate the efficiency of the method.

Abstract Background Dietary-induced inflammation is potentially associated with sarcopenia. Nevertheless, few studies have investigated the structure of the inflammatory diet and its correlation with muscle function and performance in both the upper and lower limbs. This study was performed to explore the association of the dietary inflammatory index (DII) with sarcopenia and its diagnostic parameters. Methods We conducted a cross-sectional survey on a sample of 515 Chinese community-dwelling older adults selected through multistage cluster sampling from three districts in Shanghai. DII scores were calculated using a validated food frequency questionnaire. Sarcopenia and its diagnostic parameters were determined based on the definition set by the Asian Working Group on Sarcopenia (AWGS). Results The mean age of study participants was 71.31 ± 4.71 years. The prevalence of sarcopenia in the cohort was 12.4%. Older adults in the highest DII quartile had a 3.339 times increased risk of sarcopenia compared to those in the lowest quartile (OR Quartile4vs1:3.339, 95%CI: 1.232, 9.052, p-trend: 0.004) after adjusting for confounding factors. Additionally, a more pro-inflammatory diet was associated with lower appendicular skeletal muscle index (ASMI) (OR Quartile4vs1: 3.005, 95%CI: 1.275, 7.318, p-trend: 0.005), a higher 5-times sit-stand test time score (OR Quartile4vs1: 4.942, 95%CI: 1.745, 13.993, p-trend: 0.005), and lower gait speed (OR Quartile4vs1: 2.392, 95%CI: 1.104, 5.185, p-trend: 0.041) after adjusting for confounding factors. However, there was no significant association between DII, handgrip strength, and Short Physical Performance Battery (SPPB) score in either the unadjusted or adjusted model. Conclusion This study found that the association between consuming a more pro-inflammatory diet and sarcopenia in Chinese community-dwelling older adults was mainly due to underlying low intakes of dietary energy, protein, and anti-inflammatory foods, and not due to the high intake of pro-inflammatory foods. Meanwhile, DII was more highly correlated with lower limb muscle strength and performance compared to upper limb muscle strength.

Extruded ice is a common disease in road engineering in Sichuan-Tibet cold region, which seriously threatens the safety of road construction and operation. Preventing groundwater from being exposed to the surface or the groundwater level being too high can slow down or eliminate the formation of extruded ice. Field investigation and satellite map identification show that extruded ice in Sichuan-Tibet cold region is mainly overflow type. The prevention effects on extruded ice of backfilling with gravelly coarse sand or pebbles to dredge groundwater and laying waterproof geotextiles are analyzed by indoor physical simulation experiments. The results show that extruded ice will gradually form when the frozen depth is lower than the depth of groundwater level. Backfilling seepage layer with gravelly coarse sand or pebbles can accelerate the discharge of groundwater and reduce the pore water pressure effectively. Compared with the untreated slope, the volume of extruded ice is reduced by 85.4% and 93.9% respectively, and the pore water pressure is reduced by 46.2% and 58.1% respectively. By blocking groundwater with waterproof geotextile, the volume of extruded ice is reduced by 97.5%, but the pore pressure will increase. Considering the sufficient pebble (or gravel) materials in Sichuan-Tibet alpine region, it is recommended to use permeable pebble (or gravel) as backfill layer to accelerate groundwater drainage and control extruded ice disease in subgrade slope. And waterproof geotextile is recommended to be laid on backfill layer. The research results can provide reference for the prevention of extruded ice in Sichuan-Tibet traffic roads.

Communication networks are used as an important guarantee for information interaction and efficient collaboration within many fields and systems; however, under information technology conditions, the destruction of a number of nodes in a network may have a great impact on the overall operation of the network. Therefore, it is important to accurately determine the critical nodes in the network to enhance the network’s resistance to destruction. Combining the characteristic attributes of the communication network, a node contribution evaluation matrix is proposed based on the efficiency matrix, from the perspective of node receiving information; a node value evaluation matrix is proposed from the perspective of a node providing information to neighboring nodes, and node importance is calculated by integrating the evaluation results of the two matrices and the node’s own attributes. The algorithm is suitable for directed-weighted network node value evaluation, and the effectiveness and accuracy of the algorithm are verified by comparing other algorithms for a small-scale network. In further experimental validation, a hybrid weighted communication network evolution model based on organizational structured networks is proposed, and networks of different sizes are generated for experimental simulation. The results show that when nodes with high importance are removed from the network, they can cause a rapid decrease in the network efficiency and maximum connectivity, confirming the accuracy of the algorithm in evaluating the importance of nodes and identifying critical nodes in the network.

Jochen Büttner was not included as an author in the original publication [...]

ObjectiveTo evaluate the feasibility, safety, and outcomes of percutaneous endoscopic transforaminal discectomy (PETD) for thoracolumbar junction disc herniation (TLDH) with or without calcification.MethodsThis study included 12 patients diagnosed with TLDH with or without calcification who met the inclusion criteria and underwent surgery for PETD from January 2019 to December 2021. The mean patient age, operation time, hospitalization time, time in bed, and complications were recorded. Patients were followed up for at least 9 months. Visual analog scale (VAS) scores for low-back and leg or thoracic radicular pain and modified Japanese Orthopedic Association score (m-JOA) scores were preoperatively evaluated, at 1 day and 3, 6, and 12 months postoperatively or at last follow-up. The modified MacNab criteria were used to evaluate clinical efficacy at 12 months postoperatively or at last follow-up.ResultsThe mean patient age, operation time, hospitalization time, and time in bed were 53 ± 13.9 years, 101.3 ± 9.2 min, 4.5 ± 1.3 days, and 18.0 ± 7.0 h, respectively. The mean VAS scores of low-back and leg or thoracic radicular pain improved from 5.8 ± 1.5 and 6.5 ± 1.4 to 2.0 ± 0.9 and 1.3 ± 0.5, respectively (P

Identifying a set of critical nodes with high propagation in complex networks to achieve maximum influence is an important task in the field of complex network research, especially in the background of the current rapid global spread of COVID-19. In view of this, some scholars believe that nodes with high importance in the network have stronger propagation, and many classical methods are proposed to evaluate node importance. However, this approach makes it difficult to ensure that the selected spreaders are dispersed in the network, which greatly affects the propagation ability. The VoteRank algorithm uses a voting-based method to identify nodes with strong propagation in the network, but there are some deficiencies. Here, we solve this problem by proposing the DILVoteRank algorithm. The VoteRank algorithm cannot properly reflect the importance of nodes in the network topology. Based on this, we redefine the initial voting ability of nodes in the VoteRank algorithm and introduce the degree and importance of the line (DIL) ranking method to calculate the voting score so that the algorithm can better reflect the importance of nodes in the network structure. In addition, the weakening mechanism of the VoteRank algorithm only weakens the information of neighboring nodes of the selected nodes, which does not guarantee that the identified initial spreaders are sufficiently dispersed in the network. On this basis, we consider all the neighbors nodes of the node’s nearest and next nearest neighbors, so that the crucial spreaders identified by our algorithm are more widely distributed in the network with the same initial node ratio. In order to test the algorithm performance, we simulate the DILVoteRank algorithm with six other benchmark algorithms in 12 real-world network datasets based on two propagation dynamics model. The experimental results show that our algorithm identifies spreaders that achieve stronger propagation ability and propagation scale and with more stability compared to other benchmark algorithms.

Ancient numismatics, the study of ancient coins, has in recent years become an attractive domain for the application of computer vision and machine learning. Though rich in research problems, the predominant focus in this area to date has been on the task of attributing a coin from an image, that is of identifying its issue. This may be considered the cardinal problem in the field and it continues to challenge automatic methods. In the present paper, we address a number of limitations of previous work. Firstly, the existing methods approach the problem as a classification task. As such, they are unable to deal with classes with no or few exemplars (which would be most, given over 50,000 issues of Roman Imperial coins alone), and require retraining when exemplars of a new class become available. Hence, rather than seeking to learn a representation that distinguishes a particular class from all the others, herein we seek a representation that is overall best at distinguishing classes from one another, thus relinquishing the demand for exemplars of any specific class. This leads to our adoption of the paradigm of pairwise coin matching by issue, rather than the usual classification paradigm, and the specific solution we propose in the form of a Siamese neural network. Furthermore, while adopting deep learning, motivated by its successes in the field and its unchallenged superiority over classical computer vision approaches, we also seek to leverage the advantages that transformers have over the previously employed convolutional neural networks, and in particular their non-local attention mechanisms, which ought to be particularly useful in ancient coin analysis by associating semantically but not visually related distal elements of a coin’s design. Evaluated on a large data corpus of 14,820 images and 7605 issues, using transfer learning and only a small training set of 542 images of 24 issues, our Double Siamese ViT model is shown to surpass the state of the art by a large margin, achieving an overall accuracy of 81%. Moreover, our further investigation of the results shows that the majority of the method’s errors are unrelated to the intrinsic aspects of the algorithm itself, but are rather a consequence of unclean data, which is a problem that can be easily addressed in practice by simple pre-processing and quality checking.

Fatty liver diseases are a spectrum of liver disorders consisting of the benign fatty liver, which could eventually lead to cirrhosis or even hepatocellular cancer (HCC) without timely treatment. Therefore, early diagnosis is crucial for fatty liver diseases. Liver biopsy is regarded as the gold standard in the diagnosis of fatty liver diseases. However, it is not recommended for routine use due to its invasiveness and complicated operation. Thus, it is urgent to diagnose fatty liver diseases with non-invasive and precise methods. In this regard, fluorescence imaging technology has attracted intensive attention and become a robust non-invasive method for fatty liver visualization, and a series of fluorescent probes are being intensively designed to track the biomarkers in fatty liver. In this brief review, the small molecular fluorescent probes employed in fatty liver are summarized, mainly focusing on the last four years. Moreover, current opportunities and challenges in the development of fluorescent probes for fatty liver will be highlighted.

Comprehensive mechanical properties (high strength, good fatigue resistance and tunable stiffness) are significant for large and load-bearing implants, but still remain a challenge in practical applications. Polyetheretherketone (PEEK)-Ti6Al4V interpenetrating phase composites (IPCs) with comprehensive mechanical properties were developed using a two-step process: fabricating Ti6Al4V microlattices using powder bed fusion (PBF) and subsequently manufacturing PEEK-Ti6Al4V IPCs using vacuum infiltration. The strut defects in the Ti6Al4V microlattices induced by PBF process were filled with PEEK, and thus excellent interfacial connection was achieved. Mechanical tests, under both quasi-static loading conditions (compression and three-point bending conditions) and dynamic loading condition (three-point bending condition), were carried out on the PEEK-Ti6Al4V composites with low and high modulus (20.0 and 60.0 vol% Ti6Al4V) and the bare Ti6Al4V microlattices of equivalent elastic moduli. It was found that the composites had higher compressive and flexural strengths than the lattices. Moreover, the composites exhibited higher fatigue strength and longer fatigue life than the lattices. The fracture behaviors and the FEM simulation results revealed that the enhancing mechanisms for the PEEK-Ti6Al4V composites can be the alleviation of strut deformation and the resistance to crack propagation. Thus, the PEEK-Ti6Al4V composites can be promising materials for large and load-bearing implants.

Abstract Background Coronary artery aneurysms (CAAs) are rare, and giant CAAs are even rarer. The pathophysiology of this phenomenon is still unknown. Case presentation Herein, we present the case of a 49-year-old male with a giant aneurysm in the left anterior descending artery. Conclusions The optimal treatment for CAAs is debatable, but surgical intervention is preferred for giant CAAs.

To reasonably allocate mobile conventional missile battle positions and improve the survivability and combat effectiveness of the missile weapon system, a missile position deployment optimization design model based on Mixed-Integer Nonlinear Programming (MINLP) is established. First, for the multilevel position network, an optimization model with the goal of maximizing the viability is established, and a two-stage solution method is proposed. Second, the whale optimization algorithm (WOA) is improved, and the convergence factor which changes nonlinearly with the number of evolution is introduced to coordinate the local development and global search ability of the algorithm. The diversity mutation operation is carried out on the optimal individual to reduce the probability of premature convergence of the algorithm, and the improved whale algorithm is used to solve the optimization model. Finally, the performance of the improved algorithm is verified by example analysis and simulation experiments, which provides a reference for the deployment mode of mobile missile positions.

Strong and tough β-TCP/PCL composite scaffolds with interconnected porosity were developed by combining digital light processing and vacuum infiltration. The composite scaffolds were comprised of pure β-TCP, β-TCP matrix composite and PCL matrix composite. The porous β-TCP/PCL composite scaffolds showed remarkable mechanical advantages compared with ceramic scaffolds with the same macroscopic pore structure (dense scaffolds). The composite scaffolds exhibited a significant increase in strain energy density and fracture energy density, though with similar compressive and flexural strengths. Moreover, the composite scaffolds had a much higher Weibull modulus and longer fatigue life than the dense scaffolds. It was revealed that the composite scaffolds with interconnected porosity possess comprehensive mechanical properties (high strength, excellent toughness, significant reliability and fatigue resistance), which suggests that they could replace the pure ceramic scaffolds for degradable bone substitutes, especially in complex stress environments.

Background As a critical metabolic substrate, glutamine is not only involved in the progression of many cancers but is also related to angiogenesis. Glutamate dehydrogenase (GLDH), a key enzyme in glutamine metabolism, has been reported to regulate tumor proliferation; however, its relationship with microvascular invasion (MVI) is unclear. This study evaluated the ability of preoperative serum GLDH levels to predict MVI and the long-term survival of hepatocellular carcinoma (HCC) patients after liver transplantation (LT). Methods HCC patients that underwent LT from January 2015 to May 2020 at the First Affiliated Hospital of Sun Yat-Sen University were enrolled in our retrospective analysis. Clinicopathological variables were extracted from medical records. A receiver operating characteristic curve was created to determine the optimal cut-off value of GLDH for MVI. Results Preoperative GLDH was significantly elevated in the MVI-positive group (U = 454.00, p = 0.000). The optimal cut-off value of GLDH for MVI was 7.45 U/L, with an area under the curve of 0.747 (95% CI [0.639–0.856], p = 0.000). The sensitivity was 79.3%, while the specificity was 64.5%. GLDH > 7.45 U/L (p = 0.023) and maximum diameter >5 cm (p = 0.001) were independent risk factors for the presence of MVI. Patients with GLDH > 7.45 U/L had significantly poorer overall survival (p = 0.001) and recurrence-free survival (p = 0.001) after LT than patients with GLDH ≤ 7.45 U/L. Similarly, patients with MVI were associated with poor survival (p = 0.000). Conclusions Preoperative elevated serum GLDH levels predict MVI and poorer long-term survival for HCC after LT.

Fast charging capability is highly desired for new generation lithium-ion batteries used in consumer-grade electronic devices and electric vehicles. However, currently used anodes suffer from sluggish ion kinetics due to limited interlayer distance. Herein, the coal-based semicoke was chosen as precursor to prepare cost-effective carbon anodes with high-rate performance through a facile pyrolytic strategy. The evolution of microstructure and its effect on electrochemical performance are entirely studied. The results show that large number of short-ordered defective structures are generated due to the occurrence of turbostatic-like structures when pyrolyzed at 900 °C, which are propitious to large interlayer distance and developed porous structure. High accessible surface area and large interlayer spacing with short-ordered defective domains endow the sample treated at 900 °C under argon (A900) with accelerated ion dynamics and enhanced ion adsorption dominated surface-induced capacitive processes. As a result, A900 delivers high capacity (331.1 mAh g−1 at 0.1 A g−1) and long life expectancy (94.8% after 1000 cycles at 1 A g−1) as well as good rate capability (153.2 mAh g−1 at 5 A g−1). This work opens a scalable avenue to fabricating cost-effective, high-rate, and long cycling life carbon anodes.

Abstract Background Carotid artery geometry is important for recapitulating a pathophysiological microenvironment to study wall shear stress (WSS)-induced endothelial dysfunction in atherosclerosis. Endothelial cells (ECs) cultured with hydrogel have been shown to exhibit in vivo-like behaviours. However, to date, studies using hydrogel culture have not fully recapitulated the 3D geometry and blood flow patterns of real-life healthy or diseased carotid arteries. In this study, we developed a gelatin-patterned, endothelialized carotid artery model to study the endothelium response to WSS. Results Two representative regions were selected based on the computational fluid dynamics on the TF-shaped carotid artery: Region ECA (external carotid artery) and Region CS (carotid sinus). Progressive elongation and alignment of the ECs in the flow direction were observed in Region ECA after 8, 16 and 24 h. However, the F-actin cytoskeleton remained disorganized in Region CS after 24 h. Further investigation revealed that expression of vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) was greatly increased in Region CS relative to that in Region ECA. The physiological WSS in the carotid artery system was found to stimulate nitric oxide (NO) and prostacyclin (PGI2) release and inhibit endothelin-1 (ET-1) release after 24-h perfusion experiments. The effective permeability (E.P) of fluorescein isothiocyanate (FITC)–dextran 40 kDa in Regions ECA and CS was monitored, and it was found that the turbulence WSS value (in Region CS) was less than 0.4 Pa, and there was a significant increase in the E.P relative to that in Region ECA, in which laminar WSS value was 1.56 Pa. The tight junction protein (ZO-1) production was shown that the low WSS in Region CS induced ZO-1-level downregulation compared with that in Region ECA. Conclusions The results suggested that the gelatin-based perfusable, endothelial carotid artery model can be effective for studying the pathogenesis of atherosclerosis by which flow dynamics control the endothelium layer function in vitro.

The non-dominated sorting genetic algorithm III (NSGA-III) has recently been proposed to solve many-objective optimization problems (MaOPs). While this algorithm achieves good diversity, its convergence is unsatisfactory. In order to improve the convergence, we propose an improved NSGA-III using a genetic K-means clustering algorithm (NSGA-III-GKM), which can also ensure diversity and automatically provide the number and direction vector of the subspaces. Compared with the NSGA-III, the proposed NSGA-III-GKM has two key features. First, the initial reference points are clustered using a GKM clustering algorithm, which realizes automatic learning of the number of clusters. Second, as the reference points are replaced by cluster centers, a penalty-based boundary intersection (PBI) aggregation function is introduced to replace the perpendicular distance. The proposed NSGA-III-GKM and other similar optimization algorithms (NSGA-III, MOEA/D, U-NSGA-III, DC-NSGA-III and B-NSGA-III) are tested on DTLZ test problems and UF test problems. The simulation results demonstrate that the NSGA-III-GKM exhibits better diversity and convergence performance than the other algorithms.

To identify relationships among entities in natural language texts, extraction of entity relationships technically provides a fundamental support for knowledge graph, intelligent information retrieval, and semantic analysis, promotes the construction of knowledge bases, and improves efficiency of searching and semantic analysis. Traditional methods of relationship extraction, either those proposed at the earlier times or those based on traditional machine learning and deep learning, have focused on keeping relationships and entities in their own silos: extracting relationships and entities are conducted in steps before obtaining the mappings. To address this problem, a novel Chinese relationship extraction method is proposed in this paper. Firstly, the triple is treated as an entity relation chain and can identify the entity before the relationship and predict its corresponding relationship and the entity after the relationship. Secondly, the Joint Extraction of Entity Mentions and Relations model is based on the Bidirectional Long Short-Term Memory and Maximum Entropy Markov Model (Bi-MEMM). Experimental results indicate that the proposed model can achieve a precision of 79.2% which is much higher than that of traditional models.

On the basis that satellites given fixed count and orbit elements can be served in bounded time when an on-orbit serving mission order is set at any uncertain time in a given time interval, the deployment of on-orbit service vehicle (OSV) serving satellites becomes a complex multiple nested optimization problem, and the essence of deployment is to determine the count and orbit elements of OSVs. In consideration of the characteristics of this deployment problem, we propose a fuzzy adaptive particle swarm optimization (FAPSO) algorithm to solve this problem. First, on the basis of double pulse rendezvous hypothesis, a transfer optimization model of a single OSV serving multiple satellites is established based on genetic algorithm (GA), and this is used to compute the indexes of the subsequent two optimization models. Second, an assignment optimization model of OSVs is established based on the discrete particle swarm optimization (DPSO) algorithm, laying the foundation of the next optimization model. Finally, the FAPSO algorithm, which improves the performance of PSO algorithm by adjusting the inertia weight, is proposed to solve the deployment problem of multiple OSVs. The simulation results demonstrate that all optimization models in this study are feasible, and the FAPSO algorithm, which has a better convergence result than that obtained using the other optimization algorithms, can effectively solve the deployment problem of OSVs.

We consider a variant of the online semi-definite programming problem (OSDP). Specifically, in our problem, the setting of the decision space is a set of positive semi-definite matrices constrained by two norms in parallel: the L∞ norm to the diagonal entries and the Γ-trace norm, which is a generalized trace norm with a positive definite matrix Γ. Our setting recovers the original one when Γ is an identity matrix. To solve this problem, we design a follow-the-regularized-leader algorithm with a Γ-dependent regularizer, which also generalizes the log-determinant function. Next, we focus on online binary matrix completion (OBMC) with side information and online similarity prediction with side information. By reducing to the OSDP framework and applying our proposed algorithm, we remove the logarithmic factors in the previous mistake bound of the above two problems. In particular, for OBMC, our bound is optimal. Furthermore, our result implies a better offline generalization bound for the algorithm, which is similar to those of SVMs with the best kernel, if the side information is involved in advance.

Abstract Background Metastasis associated lung adenocarcinoma transcript 1 (MALAT1) plays an important role in vascular remodeling. Down-regulation of MALAT1 can inhibit the proliferation of vascular endothelial cells and vascular smooth muscle cells, reduce cardiomyocyte apoptosis and improve left ventricular function, which is closely linked to numerous pathological processes such as coronary atherosclerotic heart disease (CAD). The aim of this study was to investigate whether polymorphisms in MALAT1 were associated with the susceptibility to CAD. Methods A total of 508 CAD patients and 562 age-, gender-, and ethnicity-matched controls were enrolled in this study. Four polymorphisms in MALAT1 (i.e., rs11227209, rs619586, rs664589, and rs3200401) were genotyped using a TaqMan allelic discrimination assay. Results The rs619586 AG/GG genotypes and G allele were associated with a reduced risk of CAD (AG/GG vs. AA: adjusted OR = 0.66, 95% CI: 0.48–0.91; G vs. A: adjusted OR = 0.68, 95% CI: 0.51–0.90). Stratification analyses showed that CAD patients with rs11227209 CG/GG, rs619586 AG/GG, and rs3200401 CT/TT genotypes exhibited lower levels of TCH (P = 0.02, 0.04, and 0.02, respectively). Moreover, CGCC haplotype was associated with a decreased risk of CAD (OR = 0.28, 95% CI: 0.16–0.48). Multivariate logistic regression analysis identified some independent risk factors for CAD, including rs619586 and rs664589. Subsequent combined analysis showed that the combined genotypes of rs619586AG/GG and rs664589CC were associated with a reduced risk of CAD (OR = 0.29; 95%CI, 0.16–0.53). Conclusions These findings indicate that rs619586AG/GG genotypes in MALAT1 may protect against the occurrence of CAD.

This study was aimed to find the causes of pick-up destruction of tomato root lumps using X-ray microcomputed tomography, and to identify the pick-up parameters of low root lump destruction. The roots and pores were reconstructed three-dimensionally and analyzed quantitatively. It was found that the roots acted winding and wraping the root lumps and thus preventing the substrate from loosening. The major causes for root lump destruction were pore aggregation and crack formation. The apex and circumference of pick-up pins were areas where root lumps were prone to fracture and breakage, respectively. Lacunarities of these two areas were used as index to quantify the root lump destruction. Single-factor analysis of variance was conducted with pick-up pin shape (circular, flat), diameter (2, 2.5, 3 mm) and initial pick-up angle (18°, 21°, 24°) as the test factors and then the effects of these three factors on root lump destruction were studied. It was found the lacunarities at the fracturable area and breakable area both increased with the rise of pick-up pin diameter and decreased with the rise of initial pick-up angle. At the same pick-up conditions, lacunarities with the use of flat pins always surpassed that of circular pins. When circular pick-up pins with diameter of 2 mm and initial pick-up angle of 24° were used, the destruction rate of root lumps (6.63%) was smaller than under other test conditions. The optimized pick-up parameters can be used to guide gripper design and to improve the working performance of automatic transplanters.

Deflection is one of the key indexes for the safety evaluation of bridge structures. In reality, due to the changing operational and environmental conditions, the deflection signals measured by structural health monitoring systems are greatly affected. These ambient changes in the system often cover subtle changes in the vibration signals caused by damage to the system. The deflection signals of prestressed concrete (PC) bridges are regarded as the superposition of different effects, including concrete shrinkage, creep, prestress loss, material deterioration, temperature effects, and live load effects. According to multiscale analysis theory of the long-term deflection signal, in this paper, an integrated machine learning algorithm that combines a Butterworth filter, ensemble empirical mode decomposition (EEMD), principle component analysis (PCA), and fast independent component analysis (FastICA) is proposed for separating the individual deflection components from a measured single channel deflection signal. The proposed algorithm consists of four stages: (1) the live load effect, which is a high-frequency signal, is separated from the raw signal by a Butterworth filter; (2) the EEMD algorithm is used to extract the intrinsic mode function (IMF) components; (3) these IMFs are utilized as input in the PCA model and some uncorrelated and dominant basis components are extracted; and (4) FastICA is applied to derive the independent deflection component. The simulated results show that each individual deflection component can be successfully separated when the noise level is under 10%. Verified by a practical application, the algorithm is feasible for extracting the structural deflection (including concrete shrinkage, creep, and prestress loss) only caused by structural damage or material deterioration.

Objective: To evaluate the efficacy of stereotactic soft-channel and hard-channel aspiration in the treatment of primary brainstem hemorrhage., Methods: The clinical data of 146 patients with primary brainstem hemorrhage at the First Hospital of Hebei Medical University from August 2014 to August 2023 were analyzed. At admission, 146 patients were divided into soft-channel group or hard-channel group using a random number table method. Sixty-five patients were treated with stereotactic soft-channel aspiration, and 81 patients were treated with stereotactic hard-channel aspiration. The amount of residual hematoma was evaluated by head CT immediately after the operation, and the length of the indwelling drainage tube was recorded. Survival status at 30d after the operation and treatment outcome (mRS score and GOS score) at 90d after the operation were also recorded. The amount of residual hematoma immediately after the operation, the length of the indwelling drainage tube after the operation, the mortality rate and the treatment outcome were compared between the two groups., Results: There was significant difference in the mortality rate 30d after the operation (41.5% vs. 14.8%, χ 2 = 20.192, P = 0.035) between stereotactic soft-channel aspiration and stereotactic hard-channel aspiration for brainstem hemorrhage. The hard-channel group had a higher survival rate. There was significant difference in the treatment outcome at 90 days after treatment (18.5% vs. 32.1%, χ 2 = 4.783, P = 0.047). The hard-channel group showed better treatment outcomes 90 days after surgery., Conclusion: Stereotactic hard-channel aspiration for primary brainstem hemorrhage has greater clearance efficiency than soft-channel aspiration and can significantly reduce patient mortality and improve treatment outcomes. Stereotactic hard-channel aspiration is a safe and effective method for treating primary brainstem hemorrhage., Competing Interests: Declaration of competing interest The authors report no declarations of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: With the improvement of anastomotic techniques and the iteration of anastomotic instruments, robotic intracorporeal suturing has become increasingly proficient. The era of fully intracorporeal anastomosis in robotic gastric cancer resection is emerging. This study aims to explore the impact of totally robotic distal gastrectomy (TRDG) and robotic-assisted distal gastrectomy (RADG) on patients' quality of life., Patients and Methods: This study is a comparative retrospective study of propensity score matching. This study included 306 patients who underwent robotic distal gastrectomy for gastric cancer between June 2016 and December 2023 at our center. Covariates used in the propensity score included sex, age, BMI, ASA score, maximum tumour diameter, degree of histological differentiation, Pathological TNM stage, Pathological T stage, Pathological N stage, and Lauren classification. Outcome measures included operative time, intraoperative bleeding, time to first venting, time to first fluid intake, postoperative hospital stay, total hospitalization cost, total length of abdominal incision, postoperative complications, inflammatory response, body image, and quality of life., Results: According to the results of the study, compared with the RADG group, the TRDG group had a faster recovery time for gastrointestinal function (P = 0.025), shorter length of abdominal incision (P < 0.001), fewer days in the hospital (P = 0.006) less pain (P < 0.001), less need for additional analgesia (P = 0.013), and a postoperative white blood cell count (P < 0.001) and C-reactive protein content indexes were lower (P<0.001). In addition, the TRDG group had significantly better body imagery and cosmetic scores (P = 0.015), physical function (P = 0.039), role function (P = 0.046), and global function (P = 0.021) than the RARS group. Meanwhile, the TRDG group had milder symptoms of fatigue (P = 0.037) and pain (P < 0.001). The PASQ Total Subscale Score (P < 0.001) and Global Subscale Score (P < 0.001) were significantly lower in the TRDG group than in the RADG group at postoperative 3 months., Conclusion: Totally robotic distal gastrectomy has a smaller incision, faster gastrointestinal recovery time, fewer days of postoperative hospitalization, and lower inflammatory markers than robotic-assisted distal gastrectomy. At the same time, postoperative cosmetic and quality of life outcomes were satisfactory. Clinically, these benefits translate to enhanced patient recovery, reduced surgical trauma, and better postoperative outcomes. These findings could guide surgeons in selecting more effective surgical approaches for patients undergoing gastrectomy, leading to better overall patient satisfaction and outcomes., (© 2024. The Author(s).)

Background: This study aims to analyze the influencing factors of postoperative Low Anterior Resection Syndrome (LARS) in patients with middle and low rectal cancer who underwent robotic surgery. It also seeks to predict the probability of LARS through a visual, quantitative, and graphical nomogram. This approach is expected to lower the risk of postoperative LARS in these patients and improve their quality of life through effective prevention and early intervention., Patients and Methods: This research involved patients with middle and low rectal cancer who underwent robotic surgery in the Department of Gastrointestinal Surgery at the First Affiliated Hospital of Nanchang University from January 2015 to October 2022. A series of intestinal dysfunction symptoms arising from postoperative rectal cancer were diagnosed and graded using LARS scoring criteria. After the initial screening of all variables related to LARS with Lasso regression, they were included in logistic regression for further univariate and multivariate analysis to identify independent risk factors for LARS. A prediction model was then constructed., Results: The study included 358 patients. The parameters identified by Lasso regression included obstruction, BMI, tumor localization, maximum tumor diameter, AJCC stage, stoma, neoadjuvant therapy (NAT), and postoperative adjuvant therapy (AT). Univariate and multivariate analyses indicated that a higher BMI, lower tumor localization, higher AJCC stage, neoadjuvant therapy, and postoperative adjuvant therapy were independent risk factors for total LARS. The AUC of the prediction nomogram was 0.834, with a sensitivity of 0.825 and specificity of 0.741. The calibration curve demonstrated excellent concordance with the nomogram, indicating the prediction curve fit the diagonal well., Conclusion: Higher BMI, lower tumor localization, higher AJCC stage, neoadjuvant therapy, and adjuvant therapy were identified as independent risk factors for total LARS. A new predictive nomogram for postoperative LARS in patients with middle and low rectal cancer undergoing robotic surgery was developed, proving to be stable and reliable. This tool will assist clinicians in managing the postoperative treatment of these patients, facilitating better clinical decision-making and maximizing patient benefits., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background/aims: To evaluate the efficacy and safety of doxorubicin-eluting beads combined with transcatheter arterial chemoembolization (DEB-TACE) compared with conventional TACE (cTACE)., Methodology: PubMed, EMBASE, MEDLINE and Cochrane Controlled Trials Register were searched for articles published to identify randomized controlled trials evaluating efficacy and side effects between DEB-TACE and cTACE. The RR (relative risk) with a 95% confidence interval (CI) was calculated by the Revman 5.0 software., Results: Totally 4 studies, including 527 patients, compared the efficacy and safety of DEB-TACE with cTACE. The DEB-TACE achieved fewer side effects in alopecia (p = 0.0002, RR = 0.05, 95% CI: 0.01-0.24) and myelosuppression (p = 0.009, RR = 0.32, 95% CI: 0.14-0.75). Meanwhile, there was no significant difference in efficacy evaluation including complete response (p = 0.16, RR = 1.36, 95% CI: 0.89-2.08), partial response (p = 0.48, RR = 1.14, 95% CI: 0.80-1.62), stable disease (p = 0.73, RR = 0.93,95% CI: 0.60-1.40), progressive disease (p 0.19, RR = 0.80, 95% CI: 0.56-1.12), objective response (p = 0.26, RR 0.91, 95% CI: 0.48-1.72) and disease control (p = 0.05, RR = 1.18, 95% CI: 1.00-1.39)., Conclusions: DEB-TACE shows similar therapeutic efficacy to cTACE method and fewer adverse events.

This study demonstrates a new biomaterial system composed of Sr-containing hydroxyapatite (Sr-HA) and Sr-containing tricalcium phosphate (Sr-TCP), termed herein Sr-containing biphasic calcium phosphate (Sr-BCP). Furthermore, a series of new Sr-BCP porous scaffolds with tunable structure and properties has also been developed. These Sr-BCP scaffolds were obtained by in situ sintering of a series of composites formed by casting various Sr-containing calcium phosphate cement (Sr-CPC) into different rapid prototyping (RP) porous phenol formaldehyde resins, which acted as the negative moulds for controlling pore structures of the final scaffolds. Results show that the porous Sr-BCP scaffolds are composed of Sr-HA and Sr-TCP. The phase composition and the macro-structure of the Sr-BCP scaffold could be adjusted by controlling the processing parameters of the Sr-CPC pastes and the structure parameters of the RP negative mould, respectively. It is also found that both the compressive strength (CS) and the dissolving rate of the Sr-BCP scaffold significantly vary with their phase composition and macropore percentage. In particular, the compressive strength achieves a maximum CS level of 9.20 +/- 1.30 MPa for the Sr-BCP scaffold with a Sr-HA/Sr-TCP weight ratio of 78:22, a macropore percentage of 30% (400-550 microm in size) and a total-porosity of 63.70%, significantly higher than that of the Sr-free BCP scaffold with similar porosity. All the extracts of the Sr-BCP scaffold exhibit no cytotoxicity. The current study shows that the incorporation of Sr plays an important role in positively improving the physicochemical properties of the BCP scaffold without introducing obvious cytotoxicity. It also reveals a potential clinical application for this material system as bone tissue engineering (BTE) scaffold.

Unlabelled: During the past few years, the combination of medical imaging and rapid manufacturing technique has proven to be a very important development. On the other hand, the conventional method has some drawbacks. For example, it takes longer time to complete an operation and it also presents some difficulty in matching the repaired contours. With advanced software and hardware, an image of an undamaged bone similar to that of the patient can be made from computerised tomography (CT); and a physical object constructed by the mirror-processed image data can be quickly fabricated with a high degree of fitting with the patient's bone. This paper presents a methodology for the design and fabrication of an individual titanium tray for the repair of mandible defects. Methods for the tray modeling using CAD system are presented: A 3D model of the bony defect is generated after the acquisition of helical CT data. An individual tray is designed using freeform surfaces geometries and fabricated by rapid prototyping (RP) technology. The results of tray filling with bone-grafting materials are then presented., Result: the tray is inserted into the patient mandible segment. The symmetry and reconstruction quality contour of the repaired mandible was satisfactory. Thus, the patient is able to eat normally. The bone-grafting material harvested from the anterior ilium was low. The clinical experience showed that rapid prototyping and reverse engineering software are effective methods of fabricating custom trays for mandibular reconstruction after bone loss due to a tumor.