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Abstract Purpose This study aims to investigate the potential role of Caprini risk assessment model (RAM) in predicting the risk of venous thromboembolism (VTE) in patients undergoing total hip or knee arthroplasty (THA/TKA). No national study has investigated the role of Caprini RAM after primary THA/TKA. Methods Data from The National Sample of Healthcare Cost and Utilization Project (HCUP) in 2019 were utilized for this study. The dataset consisted of 229,134 patients who underwent primary THA/TKA. Deep vein thrombosis (DVT) and pulmonary embolism (PE) were considered as VTE. The incidence of thrombosis was calculated based on different Caprini scores, and the risk of the Caprini indicator for VTE events was evaluated using a forest plot. Results The prevalence of VTE after primary THA/TKA in the U.S. population in 2019 was found to be 4.7 cases per 1000 patients. Age, body mass index (BMI), and Caprini score showed a positive association with the risk of VTE (P

Abstract Interactions of tumor cells with immune cells in the tumor microenvironment play an important role during malignancy progression. We previously identified that GAS5 inhibited tumor development by suppressing proliferation of tumor cells in non-small cell lung cancer (NSCLC). Herein, we discovered a tumor-suppressing role for tumor cell-derived GAS5 in regulating tumor microenvironment. GAS5 positively coordinated with the infiltration of macrophages and T cells in NSCLC clinically, and overexpression of GAS5 promoted macrophages and T cells recruitment both in vitro and in vivo. Mechanistically, GAS5 stabilized p53 by directly binding to MYBBP1A and facilitating MYBBP1A-p53 interaction, and enhanced p53-mediated transcription of IRF1, which activated type I interferon signaling and increased the production of downstream CXCL10 and CCL5. We also found that activation of type I interferon signaling was associated with better immunotherapy efficacy in NSCLC. Furthermore, the stability of GAS5 was regulated by NAT10, the key enzyme responsible for N4-acetylcytidine (ac4C) modification, which bound to GAS5 and mediated its ac4C modification. Collectively, tumor cell-derived GAS5 could activate type I interferon signaling via the MYBBP1A-p53/IRF1 axis, promoting immune cell infiltration and potentially correlating with immunotherapy efficacy, which suppressed NSCLC progression. Our results suggested GAS5 as a promising predictive marker and potential therapeutic target for combination therapy in NSCLC. A schematic diagram demonstrating the regulatory effect of GAS5 on immune cell infiltration by activating type I interferon signaling via MYBBP1A-p53/IRF1 axis in non-small cell lung cancer. IFN, interferon.

Abstract Background To investigate the clinical effects of double-dose (4 mg) aflibercept treatment in neovascular age-related macular degeneration (nAMD), compared with the standard-dose (2 mg) treatment. Methods A total of 108 eyes from 97 patients with nAMD and received intravitreal aflibercept 2 mg and/or 4 mg treatment were retrospectively reviewed. The changes of central macular thickness (CMT)/ pigmental epithelium detachment height and the recurrence rate of exudation during the 12-month follow-up were compared between the 2 mg group and the 4 mg group. Self-control comparisons (2 mg switch to 4 mg) were also made between two regimens. Results Compared with the 2 mg group, tendencies of lower intraretinal fluid incidence and more CMT reduction were observed in the 4 mg group. The later one was also observed when eyes switching from 2 mg to 4 mg regimen. The median remission interval was 5 months in the 4 mg group, 2 months longer than the 3 months in the 2 mg group (P = 0.452). Injections needed in the 4 mg group were 3.644 ± 1.670, less than the 4.286 ± 2.334 injections in the 2 mg group within 12 months as well (P = 0.151). However, no associated vision benefits were gained from the double-douse regimen. No markedly increased-intraocular pressure events, or other adverse events were found in two groups. Conclusions Compared to the aflibercept 2 mg treatment in nAMD, tendencies of anatomic gains and relieving treatment burden were brought by the aflibercept 4 mg treatment. This study may have additional importance, given the further application of high-dose aflibercept in real-world settings.

Abstract Steam-assisted gravity drainage (SAGD) is an efficient thermal recovery technique for oil sands and extra heavy oil exploitation. The development of steam chamber goes through multi-stage physical processes for SAGD production in a heavy oil reservoir with an interlayer. In this study, considering the situation that an interlayer is located directly above a pair of horizontal wells, we analyzed the whole process of steam chamber development. We divided the whole process into stages I–V, which are the first rising stage, the first lateral expansion stage, the second rising stage, the second lateral expansion stage and the confinement stage, respectively. Particularly, we further divided stage II into 2 periods and stage IV into 3 periods. These stages and periods can help us understand the development process of steam chamber dominated by an interlayer more profoundly. Based on the divided stages and periods, we established different models of SAGD production by assuming different geometric shapes of steam chamber in different stages and periods. Oval shape was assumed in stages I and III, and inverse triangle shape was hypothesized in stages II, IV and V. The formulas of the front distance of steam chamber and the oil production rate of SAGD were deduced from the established models for different development stages. At the end, we performed two example applications to SAGD production in heavy oil reservoirs with an interlayer. The real oil production rates were matched very well with the theoretical oil production rates calculated by the deduced formulas, which implies the multi-stage development model of steam chamber is of reliability and utility.

Abstract Exosomes derived from cancer are regarded as significant mediators of cancer-host crosstalk. Hypoxia, on the other hand, is one of the essential characteristics of solid tumors. This research set out to discover how circulating exosomes from hypoxic esophageal squamous cell carcinoma (ESCC) contribute to the formation of metastatic niches and distant metastasis. First, we noticed that human umbilical vein endothelial cells (HUVECs) had their tight connections disrupted and the expression of proteins involved in angiogenesis boosted by ESCC hypoxic exosomes. Hypoxia significantly induced Circ-ZNF609 expression in exosomes from ESCC, which was then internalized by HUVECs, as determined by circular RNA screening. High Circ-ZNF609 expression in HUVECs facilitated angiogenesis and vascular permeability, thereby promoting pre-metastatic niche formation, and enhancing distant metastasis in vitro and in vivo. Exosomal Circ-ZNF609 activated vascular endothelial growth factor A (VEGFA) mechanistically by sponging miR-150-5p. Exosomal Circ-ZNF609 also interacted with HuR and inhibited HuR binding to ZO-1, Claudin-1, and Occludin mRNAs, thereby reducing their translation. Collectively, our findings identified an essential function for exosomal Circ-ZNF609 from ESCC cells, suggesting the potential therapeutic value of exosomes for ESCC patients.

Semantic segmentation plays a significant role in parsing remote sensing images. However, mainstream segmentation models lack a thorough understanding of the complex structures and scale differences, and struggle to effectively locate and emphasize diverse edges. Aiming at these limitations, we propose a frequency-driven edge guidance network, named FDEG-Net, for semantic segmentation of remote sensing images. First, we design a joint sparse context aggregation module that integrates both dense local context and sparse long-range context to improve the analysis of intricate and multiscale objects. Second, an edge guidance module is developed for strong interclass edge acquisition. It applies a 2-D discrete wavelet transform, coefficient superposition method, and adaptive edge feature enhancement algorithm to reduce low-frequency information and highlight salient boundaries in spatial features. This module has two significant advantages. 1) The edge positions are defined in pixel intensity with high interpretability. 2) The modular design without additional edge labels is plug-and-play. The effectiveness and robustness of this module are validated through edge visualization results. The proposed FDEG-Net is evaluated on the Potsdam, Vaihingen, and GID datasets, demonstrating its excellent performance in accurately capturing the rich semantics of geographic space features.

Purpose: Our aim was to identify recent research trends on diabetic macular edema (DME) and focus on publications from different countries, institutions, and authors. Methods: We retrieved and analyzed data from January 1, 2003 to December 31, 2022 on the DME research field from the Web of Science Core Collection (WoSCC) database. Microsoft Excel and VOSviewer were applied to perform visualization analysis and evaluate the trends. Results: A total of 4482 publications were identified, and the annual global publications increased steadily, from 36 to 390, during this period. The United States (1339 publications, 71,754 citations), Johns Hopkins University (176 publications, 17,015 citations), and Bressler NM (76 publications, 9621 citations) were the most influential and productive countries, institutions, and authors, respectively. The top 100 keywords were classified into five clusters: (1) therapy and adverse effects of DME; (2) clinical biomarkers of DME; (3) mechanistic research on DME; (4) improving bioavailability and efficacy; and (5) early diagnosis of diabetic complications. “Diabetic macular edema,” “retinopathy,” “ranibizumab,” and “optical coherence tomography angiography” were the most frequent keywords. Regarding the average appearing years (AAYs) of the keywords, “deep learning” (AAY:2020.83), “optical coherence tomography angiography” (AAY:2019.59), “intravitreal Aflibercept” (AAY:2019.29), and “dexamethasone implant” (AAY:2019.20) were recognized as the hotspots of the DME research area in the short run. Conclusion: In the past two decades, the United States was in master status in DME research. Although intravitreal drug injection has been the mainstream therapy for a long time, the effectiveness of different drugs, such as dexamethasone, new solutions for drug delivery, such as intravitreal implantation, and more accurate tools for the classification and follow-up of DME patients, such as deep learning systems, are still research hotspots.

The complex environmental influences often complicate the detection of longitudinal tears in conveyor belts, resulting in insufficient detection accuracy, overlooked detection, and elevated false detection rates. In this study, we propose a new depth learning method specifically designed for detecting longitudinal tears in conveyor belts. This method employs a linear Charge-Coupled Device (CCD) camera to capture images of the conveyor belt. These images are subsequently processed with a modified version of You Only Look Once (YOLO)v7 model to identify instances of longitudinal tearing. The modified YOLOv7 model features Efficient Intersection over Union (EIoU) loss function as a substitute for the original loss function. Furthermore, a Simple Parameter-Free Attention Module (SimAM) is introduced in the detection head to improve detection accuracy. In this method, we introduced the SimSPPFCSPC module as a new spatial pyramid pooling model. This module enhances detection speed while maintaining detection accuracy. Experiment results demonstrate the effectiveness of the proposed method, achieving an impressive precision of 94.6% and a detection speed of approximately 110 Frames Per Second (FPS). Such accuracy and speed meet the requirements for online detection of longitudinal tearing in belt conveyors.

A tracking stability control problem for the vertical electric stabilization system of moving tank based on adaptive robust servo control is addressed. This paper mainly focuses on two types of possibly fast time-varying but bounded uncertainty within the vertical electric stabilization system: model parameter uncertainty and uncertain nonlinearity. First, the vertical electric stabilization system is constructed as an uncertain nonlinear dynamic system that can reflect the practical mechanics transfer process of the system. Second, the dynamical equation in the form of state space is established by designing the angular tracking error. Third, the comprehensive parameter of system uncertainty is designed to estimate the most conservative effects of uncertainty. Finally, an adaptive robust servo control which can effectively handle the combined effects of complex nonlinearity and uncertainty is proposed. The feasibility of the proposed control strategy under the practical physical condition is validated through the tests on the experimental platform. This paper pioneers the introduction of the internal nonlinearity and uncertainty of the vertical electric stabilization system into the settlement of the tracking stability control problem, and validates the advanced servo control strategy through experiment for the first time.

Abstract Background The poor targeting delivery efficiency and limited efficacy of single therapeutic approach have consistently posed significant challenges in tumor management. Results In this research, we have conceived and synthesized a dual-targeting nanodrug delivery system denoted as PDA-DEM-Fe3O4@M, which incorporates a polydopamine nanoparticle (PDA) with photothermal properties, diethyl maleate (DEM) as a chemotherapy agent accelerating tumor apoptosis, iron oxide nanoparticles (Fe3O4) eliciting magnetic targeting effects, and tumor cell membranes (M) contributing to homologous targeting capabilities. The synergistic effect of PDA-induced photothermal therapy and DEM-mediated chemotherapy has been demonstrated in this study to exert a robust inhibitory and cytotoxic influence on tumor cells. Additionally, the biocompatibility of this system has also been demonstrated. Conclusions Through the synergistic effects of PDA’s photothermal therapy and DEM’s chemotherapy, this system demonstrated excellent inhibition and killing effects on tumor cells. Furthermore, we established its excellent biological safety profile. This study demonstrated the potential of this nanomaterial for clinical application in tumor therapy.

Alphaherpesviruses, categorized as viruses with linear DNA composed of two complementary strands, can potentially to induce diseases in both humans and animals as pathogens. Mature viral particles comprise of a core, capsid, tegument, and envelope. While herpesvirus infection can elicit robust immune and inflammatory reactions in the host, its persistence stems from its prolonged interaction with the host, fostering a diverse array of immunoescape mechanisms. In recent years, significant advancements have been achieved in comprehending the immunoescape tactics employed by alphaherpesviruses, including pseudorabies virus (PRV), herpes simplex virus (HSV), varicella-zoster virus (VZV), feline herpesvirus (FeHV), equine herpesvirus (EHV), and caprine herpesvirus type I (CpHV-1). Researchers have unveiled the intricate adaptive mechanisms existing between viruses and their natural hosts. This review endeavors to illuminate the research advancements concerning the immunoescape mechanisms of alphaherpesviruses by delineating the pertinent proteins and genes involved in virus immunity. It aims to furnish valuable insights for further research on related mechanisms and vaccine development, ultimately contributing to virus control and containment efforts.

Background: Endothelial dysfunction is the early stage of carotid atherosclerosis (CAS) in patients with hypertension. It is worth identifying the potential hub genes of endothelial dysfunction to elucidate pathological mechanism in the progression of the disease. Method: We obtained gene expression profiles of GSE43292 from the Gene Expression Omnibus (GEO) database. Hub genes associated with CAS were identified through weighted gene correlation network analysis (WGCNA) and least absolute shrinkage and selection operator (LASSO) regression. Subsequently, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed to explore potential biological mechanisms and signaling pathways. Finally, in vitro experiments on human umbilical vein endothelial cells (HUVECs) were conducted to validate these hub genes. Results: The microarray dataset GSE43292 included 32 CAS plaques samples and corresponding macroscopically intact tissues from patients with hypertension. A total of 161 differentially expressed genes were discovered. Through WGCNA analysis, the gray60 module emerged as the most significant module associated with clinical features. The GO and KEGG enrichment analyses of genes in the gray60 module highlighted the substantial involvement of immune response–related signaling pathways. Two key hub genes (CCR1 and NCKAP1L) were pinpointed via LASSO regression. We found a significant increase in the mRNA expression level of the hub genes in oxidized low density lipoprotein (ox-LDL) treated HUVECs. Conclusions: Our study indicated that the hub genes related to immune responses are involved in the development of CAS. Two hub genes (CCR1 and NCKAP1L) of endothelial dysfunction were identified. These genes may provide a valuable therapeutic target of CAS in patients with hypertension.

Introduction: Functional electrical stimulation is important for the rehabilitation of patients with chronic heart failure. This meta-analysis of randomized controlled trials compared the efficacy of functional electrical stimulation versus conventional exercise training or placebo in patients with chronic heart failure. Methods: Studies were searched through PubMed, Embase, and the Cochrane Library databases up to 1 November 2023. The outcomes were cardiopulmonary function index (6-minute walking distance), peak oxygen consumption, and Minnesota Heart Failure Life Questionnaire quality of life scores. A subgroup analysis was conducted according to the ejection fraction. The 95% confidence interval and mean difference represented the outcome of the effect size. Results: Seventeen studies involving 732 participants were included. Compared with the control, functional electrical stimulation significantly improved peak oxygen consumption (MD = 2.84 ml/kg/min, 95% Cl: 1.99–3.68 ml/kg/min), increased 6-minute walking distance (MD = 49.52 m, 95% Cl: 22.61–76.43 m), and improved the life quality scores (MD = −12.86, 95% Cl: −17.48 to −7.88). Compared with functional electrical stimulation, exercise training also improved peak oxygen consumption (MD = −0.94 ml/kg/min −1 , 95% Cl: −1.36 to −0.52 ml/kg/min), and the quality of life (QoL, MD = 0.66, 95% Cl: 0.34–0.98, p

Allogeneic hematopoietic stem cell transplantation (aHSCT) is utilized as a potential curative treatment for various hematologic malignancies. However, graft-versus-host disease (GVHD) post-aHSCT is a severe complication that significantly impacts patients' quality of life and overall survival, becoming a major cause of non-relapse mortality. In recent years, the association between epigenetics and GVHD has garnered increasing attention. Epigenetics focuses on studying mechanisms that affect gene expression without altering DNA sequences, primarily including DNA methylation, histone modifications, non-coding RNAs (ncRNAs) regulation, and RNA modifications. This review summarizes the role of epigenetic regulation in the pathogenesis of GVHD, with a focus on DNA methylation, histone modifications, ncRNA, RNA modifications and their involvement and applications in the occurrence and development of GVHD. It also highlights advancements in relevant diagnostic markers and drugs, aiming to provide new insights for the clinical diagnosis and treatment of GVHD.

BackgroundThe effect of immune cells on autoimmune diseases (ADs) complicated by non-Hodgkin lymphoma (NHL) has been widely recognized, but a causal relationship between regulatory T cell (Treg) immune traits and ADs complicated by NHL remains debated.MethodsAggregate data for 84 Treg-related immune traits were downloaded from the Genome-Wide Association Study (GWAS) catalog, and GWAS data for diffuse large B-cell lymphoma (DLBCL; n=315243), follicular lymphoma (FL; n=325831), sjögren’s syndrome (SS; n=402090), rheumatoid arthritis (RA; n=276465), dermatopolymyositis (DM; n=311640), psoriasis (n=407876), atopic dermatitis (AD; n=382254), ulcerative colitis (UC; n=411317), crohn’s disease(CD; n=411973) and systemic lupus erythematosus (SLE; n=307587) were downloaded from the FinnGen database. The inverse variance weighting (IVW) method was mainly used to infer any causal association between Treg-related immune traits and DLBCL, FL, SS, DM, RA, Psoriasis, AD, UC, CD and SLE, supplemented by MR-Egger, weighted median, simple mode, and weighted mode. Moreover, we performed sensitivity analyses to assess the validity of the causal relationships.ResultsThere was a potential genetic predisposition association identified between CD39+ CD8br AC, CD39+ CD8br % T cell, and the risk of DLBCL (OR=1.51, p0.1). Furthermore, SLE and CD exhibited a genetically predicted potential association with the CD39+ CD8+ Tregs subset. SS and DM were possibly associated with an increase in the quantity of the CD4+ Tregs subset; RA may have reduced the quantity of the CD39+ CD8+ Tregs subset, although no causal relationship was identified. Sensitivity analyses supported the robustness of our findings.ConclusionsThere existed a genetically predicted potential association between the CD39+ CD8+ Tregs subset and the risk of DLBCL, while SLE and CD were genetically predicted to be potentially associated with the CD39+ CD8+ Tregs subset. The CD39+ CD8+ Tregs subset potentially aided in the clinical diagnosis and treatment of SLE or CD complicated by DLBCL.

Abstract Background Mandibulofacial dysostosis with microcephaly (MFDM, OMIM# 610536) is a rare monogenic disease that is caused by a mutation in the elongation factor Tu GTP binding domain containing 2 gene (EFTUD2, OMIM* 603892). It is characterized by mandibulofacial dysplasia, microcephaly, malformed ears, cleft palate, growth and intellectual disability. MFDM can be easily misdiagnosed due to its phenotypic overlap with other craniofacial dysostosis syndromes. The clinical presentation of MFDM is highly variable among patients. Methods A patient with craniofacial anomalies was enrolled and evaluated by a multidisciplinary team. To make a definitive diagnosis, whole‐exome sequencing was performed, followed by validation by Sanger sequencing. Results The patient presented with extensive facial bone dysostosis, upward slanting palpebral fissures, outer and middle ear malformation, a previously unreported orbit anomaly, and spina bifida occulta. A novel, pathogenic insertion mutation (c.215_216insT: p.Tyr73Valfs*4) in EFTUD2 was identified as the likely cause of the disease. Conclusions We diagnosed this atypical case of MFDM by the detection of a novel pathogenetic mutation in EFTUD2. We also observed previously unreported features. These findings enrich both the genotypic and phenotypic spectrum of MFDM.

Inflow and water demand prediction plays an important role in reservoir operation rulemaking. Uncertainties in meteorological and hydrological modeling increase the complexity of inflow and water demand prediction, which are not sufficiently considered in conventional inflow and water demand prediction. Thus, this study took cascade reservoirs as the research object. These cascade reservoirs were located in the mainstream of the Yellow River Basin (YRB). A three-step framework was proposed: (1) developing a distributed Soil & Water Assessment Tool (SWAT) model to determine historical and future water availability in the reservoirs; (2) constructing the AquaCrop agricultural irrigation water demand model to predict future water demand of water users at 264 nodes (reservoirs and hydrological stations) in the YRB; (3) developing an optimal regulation model of cascade reservoirs in the YRB mainstream to quantitively determine the influence of future environmental changes on hydropower generation and water supply benefits of cascade reservoirs. The results indicate that the inflow of cascade reservoirs increased in the flood season and decreased significantly during the non-flood season compared with that in the historical period (1970–2016). However, there was a slight increase in the agricultural irrigation water demand, and the contradiction became more prominent between water resource supply and demand. During the future period (2020–2050), the guaranteed rate of hydropower generation and water supply in the YRB’s lower reaches will increase significantly. Uncertainties in climate models greatly impact hydropower generation benefits and reservoir water supply, especially in the flood season. These findings can facilitate the understanding of the complexity of hydropower management and production of cascade reservoirs under future environmental changes (inflow and demand) and encourage the use of regulation models for impact assessment studies and adaptive reservoir management to mitigate climate change.

The fracture network parameters of multiple-fractured horizontal wells in shale gas reservoirs are usually obtained by interpretation of gas production data. However, it is difficult to obtain the effective fracture volume. In order to quickly obtain the effective fracture volume of shale gas wells, a fracturing fluid flowback model for multiple-fractured horizontal wells in shale gas reservoirs was established. Combining the water phase material balance equation and seepage equation, the expression for the effective fracture volume of multiple-fractured horizontal wells in shale gas reservoirs was derived. Analyzing the model solution, it was found that when water flowing enters the boundary dominated flow stage, the curve of the rate-normalized pressure and material balance time is a unit slope line in the double logarithmic coordinate. By using the rate-normalized pressure and material balance time data at this stage, the effective fracture volume of shale gas wells can be estimated. Based on this, a method for estimating the effective fracture volume of shale gas wells using fracturing fluid flowback data was proposed. The application examples showed that: (1) the fracturing fluid flowback model for multiple-fractured horizontal wells in shale gas reservoirs can quickly and reliably estimate the effective fracture volume of shale gas wells, and the results are credible; (2) the fracturing fluid flowback data during the gas testing period should be considered when estimating the effective fracture volume of shale gas wells, otherwise the results would be smaller than the actual results; (3) the proposed method can also be a means of recognizing and quantifying the fracturing interference effect of adjacent wells on the effective fracture volume of shale gas wells. The research results provide a new method for estimating the effective fracture volume of shale gas wells, and also provide a new idea and method for recognizing the fracturing interference of adjacent wells in oilfields.

Abstract Introduction Deep venous thrombosis (DVT) prediction after total hip and knee arthroplasty remains challenging. Early diagnosis and treatment of DVT are crucial. This research aimed to develop a nomogram for early DVT prediction. Methods A total of 317 patients undergoing primary total hip and knee arthroplasty in Sun Yat-sen Memorial Hospital were enrolled between May 2020 and September 2022. Data from May 2020 to February 2022 were used as the development datasets to build the nomogram model (n = 238). Using multivariate logistic regression, independent variables and a nomogram for predicting the occurrence of DVT were identified. Datasets used to validate the model for internal validation ranged from March 2022 to September 2022 (n = 79). The nomogram’s capacity for prediction was also compared with the Caprini score. Results For both the development and validation datasets, DVT was found in a total of 38 (15.97%) and 9 patients (11.39%) on post-operative day 7 (pod7), respectively. 59.6% patients were symptomatic DVT (leg swelling). The multivariate analysis revealed that surgical site (Knee vs. Hip), leg swelling and thrombin-antithrombin complex (TAT) were associated with DVT. The previously indicated variables were used to build the nomogram, and for the development and validation datasets, respectively. In development and validation datasets, the area under the receiver operating characteristic curve was 0.836 and 0.957, respectively. In both datasets, the predictive value of the Nomogram is greater than the Caprini score. Conclusions A proposed nomogram incorporating surgical site (Knee vs. Hip), leg swelling, and thrombin antithrombin complex (TAT) may facilitate the identification of patients who are more prone to develop DVT on pod7.

Abstract Endonuclease G (ENDOG), a nuclear-encoded mitochondrial intermembrane space protein, is well known to be translocated into the nucleus during apoptosis. Recent studies have shown that ENDOG might enter the mitochondrial matrix to regulate mitochondrial genome cleavage and replication. However, little is known about the role of ENDOG in the cytosol. Our previous work showed that cytoplasmic ENDOG competitively binds with 14-3-3γ, which released TSC2 to repress mTORC1 signaling and induce autophagy. Here, we demonstrate that cytoplasmic ENDOG could also release Rictor from 14-3-3γ to activate the mTORC2-AKT-ACLY axis, resulting in acetyl-CoA production. Importantly, we observe that ENDOG could translocate to the ER, bind with Bip, and release IRE1a/PERK to activate the endoplasmic reticulum stress response, promoting lipid synthesis. Taken together, we demonstrate that loss of ENDOG suppresses acetyl-CoA production and lipid synthesis, along with reducing endoplasmic reticulum stress, which eventually alleviates high-fat diet-induced nonalcoholic fatty liver disease in female mice.

Background: Articular cartilage has limited self-repair capacity, and current clinical treatment options for cartilage defects are inadequate. However, deer antler cartilage possesses unique regenerative properties, with the ability to rapidly repair itself. This rapid self-repair process is closely linked to the paracrine factors released by deer antler stem cells. These findings present potential for the development of cell-free therapies for cartilage defects in clinical settings. The aim of this study was to investigate a novel method for repairing cartilage. Methods: A rat model with articular cartilage defects was established through surgery. Hydrogels loaded with exosomes (Exos) derived from antler stem cells (ASC-Exos) were implanted into the rat cartilage defects. The extent of cartilage damage repair was assessed using histological methods. The effects of ASC-Exos on chondrocytes and rat bone marrow mesenchymal stem cells (BMSCs) were evaluated using cell viability assays, proliferation assays, and scratch assays. Additionally, the maintenance of the chondrocyte phenotype by ASC-Exos was assessed using real-time fluorescence quantitative PCR (qPCR) and western blot analysis. The protein components contained of the Exos were identified using data-independent acquisition (DIA) mass spectrometry. Results: ASC-Exos significantly promoted the repair of cartilage tissue damage. The level of cartilage repair in the experimental group (ASC-Exos) was higher than that in the positive control (human adipose-derived stem cells, hADSC-Exos) and negative control (dulbecco’s modified eagle medium) groups (p < 0.05). In vitro experiments demonstrated that ASC-Exos significantly enhanced the proliferation abilities of chondrocytes and the proliferation abilities and the migration abilities of BMSCs (p < 0.05). ASC-Exos up-regulated the expression levels of Aggrecan, Collagen II (COLII), and Sox9 mRNA and proteins in chondrocytes. Analysis of ASC-Exos protein components revealed the presence of active components such as Serotransferrin (TF), S100A4, and Insulin-like growth factor-binding protein 1 (IGF1). Conclusions: ASC-Exos have a significant effect on cartilage damage repair, which may be attributed to their promotion of chondrocyte and BMSCs proliferation and migration, as well as the maintenance of chondrocyte phenotype. This effect may be mediated by the presence of TF, S100A4, and IGF1.

Abstract Triple‐positive breast cancer (TPBC) poorly responds to current standard neoadjuvant therapy (trastuzumab plus pertuzumab and chemotherapy). Our previous MUKDEN 01 study showed a promising total pathological complete response (tpCR) rate of 30.4% with neoadjuvant pyrotinib (pan‐human epidermal growth factor receptor tyrosine kinase inhibitor) plus dalpiciclib (cyclin‐dependent kinase 4/6 inhibitor) and letrozole, but the efficacy remains suboptimal. This pilot study (NCT05228951) explored adding trastuzumab to this triplet neoadjuvant regimen in patients with stage II–III TPBC. The primary endpoint was tpCR (ypT0/is, ypN0) rate. Between February 2022 and June 2022, 12 patients were enrolled, and seven (58%; 95% confidence interval [CI], 27.7%–84.8%) patients achieved tpCR. The rate of residual cancer burden (RCB) 0–I was 75% (95% CI, 46.8%–91.1%). The objective response rate (ORR) was 92% (95% CI, 64.6%–98.5%). Mean Ki‐67 level was significantly reduced from 45.0% (95% CI, 19.5%–70.5%) at baseline to 17.2% (95% CI, 0.7%–33.7%) after neoadjuvant therapy (p = 0.03). The most common grade 3 adverse events were diarrhea (four [33%]) and decreased neutrophil count (three [25%]). No grade 4 adverse events or treatment‐related deaths occurred. This four‐drug neoadjuvant regimen shows promising pathological response with an acceptable safety profile in patients with TPBC. A randomized controlled trial (NCT05638594) of this regimen is being conducted.

A novel photoelectrochemical (PEC) aptasensor based on a dual Z-scheme α-Fe2O3/MoS2/Bi2S3 ternary heterojunction for the ultrasensitive detection of circulating tumor cells (CTCs) was developed. The α-Fe2O3/MoS2/Bi2S3 nanocomposite was prepared via a step-by-step route, and the photoproduced electron/hole transfer path was speculated by conducting trapping experiments of reactive species. α-Fe2O3/MoS2/Bi2S3-modified electrodes exhibited greatly enhanced photocurrent under visible light due to the double Z-scheme charge transfer process, which met the requirement of the PEC sensor for detecting larger targets. After the aptamer was conjugated on the photoelectrode through chitosan (CS) and glutaraldehyde (GA), when MCF-7 cells were presented and captured, the photocurrent of the PEC biosensing system decreased due to steric hindrance. The current intensity had a linear relationship with the logarithm of MCF-7 cell concentration ranging from 10 to 1×105 cells mL−1, with a low detection limit of 3 cell mL−1 (S/N = 3). The dual Z-scheme α-Fe2O3/MoS2/Bi2S3 ternary heterojunction-modified PEC aptasensor exhibited high sensitivity and excellent specificity and stability. Additionally, MCF-7 cells in human serum were determined by this PEC aptasensor, exhibiting great potential as a promising tool for clinical detection.

ObjectivesTo explore prevalence of depression and its influencing factors in middle-aged and elderly patients with chronic diseases.MethodData were extracted from the 2018 China Health and Retirement Tracking Survey (CHARLS) for 6,704 middle-aged and elderly patients ≥45 years with chronic diseases. The influencing variables were selected based on LASSO-logistic regression model, and a nomogram was further drawn to visualize regression results.ResultsComorbidity between chronic diseases and depression symptoms were detected in 3058 individuals (45.6%). Female, rural, lower education, poor, insomnia, multiple chronic disease, and functional impairment were associated with a higher proportion of depression. Meanwhile, family interaction, intergenerational financial support, social activity intensity, and satisfaction with life can protect against depression.ConclusionDepressive symptoms are common in Chinese older adults with chronic diseases. They need regular assessment and intervention, especially those with multiple diseases, female, rural, alone, impaired, poor sleep, or poor economy. These high-risk elders also need family, medical, and social support and care.

Digestive system malignancies, including cancers of the esophagus, pancreas, stomach, liver, and colorectum, are the leading causes of cancer-related deaths worldwide due to their high morbidity and poor prognosis. The lack of effective early diagnosis methods is a significant factor contributing to the poor prognosis for these malignancies. Tetraspanins (Tspans) are a superfamily of 4-transmembrane proteins (TM4SF), classified as low-molecular-weight glycoproteins, with 33 Tspan family members identified in humans to date. They interact with other membrane proteins or TM4SF members to form a functional platform on the cytoplasmic membrane called Tspan-enriched microdomain and serve multiple functions including cell adhesion, migration, propagation and signal transduction. In this review, we summarize the various roles of Tspans in the progression of digestive system tumors and the underlying molecular mechanisms in recent years. Generally, the expression of CD9, CD151, Tspan1, Tspan5, Tspan8, Tspan12, Tspan15, and Tspan31 are upregulated, facilitating the migration and invasion of digestive system cancer cells. Conversely, Tspan7, CD82, CD63, Tspan7, and Tspan9 are downregulated, suppressing digestive system tumor cell metastasis. Furthermore, the connection between Tspans and the metastasis of malignant bone tumors is reviewed. We also summarize the potential role of Tspans as novel immunotherapy targets and as an approach to overcome drug resistance. Finally, we discuss the potential clinical value and therapeutic targets of Tspans in the treatments of digestive system malignancies and provide some guidance for future research.

Abstract Pulmonary fibrosis (PF), a chronic interstitial lung disease, is characterized by over-abundant deposition of extracellular matrix consisting mainly of collagen I. In previous studies, we demonstrated that deer antler stem cells (AnSCs), a novel type of adult stem cell, are capable of significantly down-regulating collagen formation in different organs and tissues and speculated that they could effectively treat PF via reducing collagen deposition in the lung tissue. In the present study, we found that administration of AnSCs improved the survival rate of PF mice and reduced lung fibrosis, collagen deposition and myofibroblast differentiation. The effects of AnSC treatment were significantly better than the positive control (adipose-derived stem cells). Interestingly, AnSC-Exos were almost equally effective as AnSCs in treating PF, suggesting that the effects of AnSCs on reduction of PF may be mainly through a paracrine mechanism. Further, AnSC-Exos reduced the number of M2 macrophages, a type of macrophage that secrets pro-fibrotic factors to accelerate fibrotic progression, in the lung tissues. In vitro experiments showed that the effects of AnSC-Exos on macrophage modulation were likely achieved via inhibition of the recruitment of circulating monocyte-derived macrophages (reducing the number of macrophages), rather than via inhibition of M2 polarization of macrophages. Inhibition of macrophage recruitment by AnSCs may be achieved indirectly via inhibiting CCL7 expression in fibroblasts; both let-7b and let-7a were highly enriched in AnSC-Exos and may play a critical role in the inhibition of CCL7 expression of fibroblasts. Collectively, the use of antler stem cells or their exosomes opens up a novel strategy for PF treatment in the clinical setting.

In the past few years, significant advancements in microscopic imaging technology have led to the production of numerous high-resolution images capturing brain neurons at the micrometer scale. The reconstructed structure of neurons from neuronal images can serve as a valuable reference for research in brain diseases and neuroscience. Currently, there lacks an accurate and efficient method for neuron reconstruction. Manual reconstruction remains the primary approach, offering high accuracy but requiring significant time investment. While some automatic reconstruction methods are faster, they often sacrifice accuracy and cannot be directly relied upon. Therefore, the primary goal of this paper is to develop a neuron reconstruction tool that is both efficient and accurate. The tool aids users in reconstructing complete neurons by calculating the confidence of branches during the reconstruction process. The method models the neuron reconstruction as multiple Markov chains, and calculates the confidence of the connections between branches by simulating the reconstruction artifacts in the results. Users iteratively modify low-confidence branches to ensure precise and efficient neuron reconstruction. Experiments on both the publicly accessible BigNeuron dataset and a self-created Whole-Brain dataset demonstrate that the tool achieves high accuracy similar to manual reconstruction, while significantly reducing reconstruction time.

Due to the coupling effect of external environmental noise and vibration noise, the feature rate of the original hydroelectric unit fault signal is not prominent, which will affect the performance of fault diagnosis algorithms. To solve the above problems, this paper proposes a PSO-MCKD-MFFResnet algorithm for fault diagnosis of hydropower units (Particle swarm optimization, PSO; Maximum correlation kurtosis deconvolution, MCKD; Multi-scale feature fusion residual network, MFFResnet). In practical applications, the selection of key parameters in the traditional MCKD method is heavily dependent on prior knowledge. First, this paper proposes a PSO-MCKD enhancement algorithm for fault features, which uses the PSO algorithm to search for the influencing parameters of MCKD to enhance the features from the original fault signal. Second, a fault feature diagnosis algorithm based on MFFResnet is proposed to improve the utilization of local features. The multi-scale residual module is used to extract features at different scales and then put the enhanced signal into MFFResnet for training and classification. The experimental results show that our approach can accurately and effectively classify the fault types of hydropower units, with an accuracy rate of 98.85. It is superior to other representative algorithms in different indicators and has a good stability.

To better utilise the service capacity of the limited facilities of a metro station, as well as ensure safety and transport efficiency during peak hours, a large passenger flow control plan is studied through theoretical analysis and numerical simulation. Firstly, by passenger data collection and data analysis, the characteristics of the inbound and outbound passenger flow of a T metro station are analysed. Secondly, AnyLogic evacuation simulation models for the T Station during peak hours, peak hours without/with passenger flow control are established based on real passenger flow data as well as the station structures and layouts by using the AnyLogic software. The results show that there are no obvious congestions in the station hall, and the travel delay is significantly reduced when effective passenger flow control measures are taken. By controlling the speed, direction and movement path of passengers, as well as adjusting the operation of escalators, entrances and automatic ticket-checking machines, passenger flow can become more orderly, transport efficiency can also be improved, and congestion in the station can be well mitigated.

Abstract Background Cataract is the primary cause of blindness globally, and surgery offers the only method by which to remove cataracts. We aimed to examine whether previous cataract surgery is associated with cognitive function. Methods Our study included 13,824 participants. Data from the baseline of the China Health and Retirement Longitudinal Study (CHARLS) were used. The participants were categorized into two groups: with and without previous cataract surgery. Weighted multiple linear regression was used to obtain the β and 95% confidence intervals (CI). Results The participants who had previous cataract surgery (n = 261) scored lower in cognition, including both memory and mental state, than those without previous cataract surgery. After adjusting for socioeconomic factors and metabolic measures, a negative association was evident between previous cataract surgery and cognition (β = −0.647, 95% CI: −1.244, − 0.049). Furthermore, the participants who were older and female demonstrated a decline in cognition, while living in cities and having higher levels education were associated with higher cognition. Conclusions Better cognitive function was associated with less previous cataract surgery or cataract occurrence. This suggests that a period of vision loss due to cataract leads to cognitive decline, however further studies are need to dissect the impact of vision loss and cataract surgery on cognitive decline.

Background: Body mass index (BMI) is known to affect the outcomes of spirometry indices. However, its association with spirometry indices in COPD and asthma is less studied. We aimed to explore the impact of BMI on these patients.Methods: Patients with COPD or asthma who completed bronchodilator tests (BDTs) between 2017 and 2021 were reviewed. Spirometry indices were compared among patients with COPD or asthma that were subclassified as underweight (BMI< 18.5 kg/m2), normal weight (≥18.5 to < 25), overweight (≥ 25 to < 30), and obesity (≥ 30). Results.Results: Analysis was conducted on 3891 COPD patients (age:66.5 ± 7.8 years) and 1208 asthma patients (age:59.7 ± 7.5 years). COPD patients classified as underweight demonstrated significantly lower values of pre-and post FEV1 (L, %), pre-and post FVC (L, %), and pre- and post-FEV1/FVC (all p < 0.05). In contrast, COPD patients who were overweight or obese exhibited higher values for pre-and post FEV1 (L, %), and pre and post FEV1/FVC (all p < 0.05). Within the cohort of asthma patients, those underweight had lower pre-and post FEV1 (L, %), pre and post FVC (L, %), pre and post FEV1/FVC %. Obese asthma patients displayed higher pre and post FEV1/FVC (all p < 0.05).Conclusion: Significant BMI category differences in spirometry indices can be seen in patients with COPD or asthma. Both underweight and obesity could affect the diagnosis and severity of these diseases. Recognizing these effects is essential to better management and diagnosis of these patients.

AbstractPurpose To assess the utility of Sonazoid contrast-enhanced ultrasound (CEUS) for guiding percutaneous microwave ablation (MWA) for colorectal liver metastases (CRLMs).Materials and Methods The medical records of patients who had undergone ultrasound (US)-guided percutaneous MWA between July 2020 and June 2022, were reviewed. Propensity score matching (PSM) with a ratio of 1:1 was used to balance the potential bias between the grayscale US-guided and Sonazoid CEUS-guided groups. Local tumor progression (LTP), intrahepatic recurrence (IR), and complication rates were compared between the two groups.Results Of 252 patients enrolled, 247 achieved complete ablation, and the technical effectiveness was 98.0% (247/252). Of these 247 patients, 158 were in the grayscale US-guided group and 89 in the Sonazoid CEUS-guided group. The median follow-up period was 14.6 months. After PSM, there were no significant differences in LTP, IR, or complication rates between the two groups (p = 0.100, p = 0.511, p > 0.99, respectively). Multivariate analysis identified tumor size ≥ 3 cm (hazard ratio [HR], 7.945; 95% CI, 2.591-24.370; p 8 cm (HR, 3.194; 95% CI, 1.439-7.091; p = 0.004) as significant factors associated with LTP. For tumors with poor vision on grayscale US, Sonazoid CEUS-guided ablation achieved a better LTP rate than grayscale US-guided ablation (3.7% vs.14.8%, p = 0.032).Conclusion For tumors with poor vision on grayscale US, Sonazoid CEUS guidance is recommended for better local tumor control.

Coastal saline-alkali soil can be transformed to agricultural soil with sewage sludge amendment. However, sewage sludge contains a large number of microplastics (MPs), and the fate of MPs in sludge-treated saline-alkali soil needs to be studied. Therefore, we investigated the accumulation and migration of MPs, and their influencing factors in saline-alkali soil after one-time sewage sludge application (0, 25, 50, 100 and 200 t ha−1 SSA). The results indicated that sewage sludge input contributed to MP accumulation in soil, and the MP abundance in 20–40 cm soil was significantly lower than that in 0–20 cm soil. Fragments and fibers were the most abundant MPs in soil, and the proportions of fragments and 50–200 µm MPs in 20–40 cm soil were lower than those in 0–20 cm soil, while the

Objectives: Several randomized controlled trials (RCTs) indicated that first-line programmed cell death protein-1/death-ligand 1 inhibitors plus chemotherapy (PD-1/PD-L1 + chemo) led to survival benefits in extensive-stage small-cell lung cancer (ES-SCLC) compared with platinum-based chemotherapy. This study aims to identify the optimal PD-1/PD-L1 + chemo combination strategy. Methods: We included RCTs comparing PD-1/ PD-L1 + chemo versus chemo alone in ES-SCLC. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and grade ⩾3 treatment-related adverse events were considered. Odds ratios (ORs), hazard ratios (HRs), and their 95% confidence intervals (CIs) were extracted. Results: Six RCTs with 2600 patients were analyzed in this Bayesian network meta-analysis. Results showed that adding PD-1/PD-L1 inhibitors to chemotherapy led to significant benefits in OS (HR = 0.72, 95% CI: 0.66–0.79), PFS (HR = 0.69, 95% CI: 0.63–0.75), and ORR (OR = 1.32, 95% CI: 1.12–1.56), and no differences in toxicity were found (OR = 1.09, 95% CI: 0.92–1.30). Serplulimab plus chemotherapy was found to provide the best OS (HR = 0.63, 95% CI: 0.49–0.82), the best PFS (HR = 0.47, 95% CI: 0.38–0.59), and the best ORR (OR = 1.7, 95% CI: 1.15–2.53). Moreover, although there were no difference between PD-L1 + chemo and PD-1 + chemo regarding OS (HR = 0.99, 95% CI: 0.91–1.08) and ORR (OR = 1.27, 95% CI: 0.91–1.78), PD-1 + chemo showed a significant benefit in PFS (HR = 0.82, 95% CI: 0.68–0.98) compared with PD-L1 + chemo. Conclusions: Serplulimab plus chemotherapy seems to be superior first-line immunotherapy combination for patients with ES-SCLC. PD-1 + chemo seems to outperform PD-L1 + chemo in PFS.

To study the anti-seismic performance of steel structure under high temperature, the finite element analysis software ABAQUS was used to study the seismic performance of Q235 steel welded box section column at service stage under normal temperature and high temperature fire. The effects of welding residual stress, slenderness ratio, width thickness ratio and axial load level on the hysteretic behavior of columns were analyzed and the stable bearing capacity and hysteretic performance of the column under high temperature were investigated. The results show that the maximum bearing capacity of the column decreases with the increase of the residual stress peak value. With the increase of temperature, a decrease in the maximum bearing capacity of columns under constant axial force and horizontal cyclic load and an increase in the ductility occur.

Abstract Trip data that records each vehicle’s trip activity on the road network describes the operation of urban traffic from the individual perspective, and it is extremely valuable for transportation research. However, restricted by data privacy, the trip data of individual-level cannot be opened for all researchers, while the need for it is very urgent. In this paper, we produce a city-scale synthetic individual-level vehicle trip dataset by generating for each individual based on the historical trip data, where the availability and trip data privacy protection are balanced. Privacy protection inevitably affects the availability of data. Therefore, we have conducted numerous experiments to demonstrate the performance and reliability of the synthetic data in different dimensions and at different granularities to help users properly judge the tasks it can perform. The result shows that the synthetic data is consistent with the real data (i.e., historical data) on the aggregated level and reasonable from the individual perspective.

Stability control of the tank gun has emerged as a pivotal issue for moving tank gun control systems (TGCS). As a complex electromechanical integrated system, TGCS of moving tank inevitably possesses significant parametric uncertainties and uncertain nonlinearities. To effectively enhance the stabilization control performance of TGCS, in this study, we introduce an adaptive robust control (ARC) strategy based on radial basis function neural network (RBFNN) compensation. The adaptive technique is employed to address the parametric uncertainties, while the RBFNN is constructed to approximate the uncertain nonlinearities and realize feedforward compensation. Subsequently, to suppress the residual uncertainties, a nonlinear robust feedback control rate is devised to strengthen the robustness of the developed controller. Lyapunov analysis shows that the proposed controller achieves uniform ultimate bounded stability. Extensive simulation and electromechanical experimental results confirm the effectiveness of the proposed controller, which shows outstanding performance in handling strong parametric uncertainties and uncertain nonlinearities.

A method for detecting coal flow on a belt conveyor based on the two-dimensional laser is proposed in this paper to tackle the complications of poor accuracy and real-time detection of coal flow on a belt conveyor. This method collects the point cloud data of the conveyor belt surface and the lateral profile of the coal flow using a two-position laser probe and transmits the data with the industrial Internet to assure the real-time and reliability of the data transmission. The upper computer software of the detection system is designed using LabVIEW software. The improved wavelet threshold algorithm designed by MATLAB is employed for data preprocessing to enhance measurement accuracy. The results demonstrate that the method can accurately detect the coal flow of the belt conveyor, and the detection accuracy reaches more than 95%, presenting the advantages of real-time performance and high accuracy. It has broad application prospects in coal, mines, ports, electric power, and other fields.

The foreign object doped in the conveying belt is the most important factor to cause the tearing of the conveying belt. In order to solve the problem of low accuracy and poor real-time performance of foreign object detection, a new method based on improved Nanodet is proposed in this paper. The hardware of conveyor belt foreign object detection system is designed with ARM processor, and the system software is designed based on Android. It uses a conveyor belt foreign object detection system to detect foreign object. In order to detect foreign object images, a better Nanodet model is suggested. In order to increase detection accuracy while preserving processing speed, the model uses SIoU in place of the original position loss function. When the enhanced Nanodet model is applied to the conveyor belt foreign object detection system, the image of the foreign object appearing on the conveyor belt can be identified. The experimental findings indicate that a conveyor belt foreign object detection system based on an ARM processor and an Android operating system is capable of detecting foreign objects on conveyor belts with an average detection accuracy of 94.3%, a detection speed of 30 frames per second. The application of this method in the detection of foreign objects in conveyor belt can solve the shortcomings of existing methods. At the same time meet the requirements of the conveyor belt foreign object detection site environment.

Abstract Background The wide applicability of the Naples prognostic score (NPS) is still worthy of further study in gastric cancer (GC). This study aimed to construct a New‐NPS based on the differences in immunity and nutrition in patients with upper and lower gastrointestinal tumors to help obtain an individualized prediction of prognosis. Methods This study retrospectively analyzed patients who underwent radical gastrectomy from April 2014 to September 2016. The cutoff values of the preoperative neutrophil‐to‐lymphocyte ratio (NLR), lymphocyte‐to‐monocyte ratio (LMR), serum albumin (Alb), and total cholesterol (TC) were calculated by ROC curve analysis. ROC and t‐ROC were used to evaluate the accuracy of the prognostic markers. The Kaplan–Meier method and log‐rank test were used to analyze the overall survival probability. Univariate and multivariate analyses based on Cox risk regression were used to show the independent predictors. The nomogram was made by R studio. The predictive accuracy of nomogram was assessed using a calibration plot, concordance index (C‐index), and decision curve. Results A total of 737 patients were included in training cohort, 411 patients were included in validation cohort. ROC showed that the New‐NPS was more suitable for predicting the prognosis of GC patients. NPS = 2 indicated a poor prognosis. Multivariate analysis showed that CEA (P = 0.026), Borrmann type (P = 0.001), pTNM (P

Measurement(s) speed Technology Type(s) Interpolation Imputation Technique Sample Characteristic - Location Xuancheng City Prefecture

Abstract Patients with Takotsubo syndrome (TTS) admitted to the intensive care unit (ICU) always confront a higher risk of in-hospital death than those hospitalized in the cardiology unit. The prognosis of the latter was analyzed by a large number of studies. However, there was no utility model to predict the risk of in-hospital death for patients with TTS in the ICU. This study aimed to establish a model predicting in-hospital death in patients with TTS admitted to ICU. We retrospectively included ICU patients with TTS from the MIMIC-IV database. The outcome of the nomogram was in-hospital death. Least Absolute Shrinkage Selection Operator (LASSO) analysis selected predictors preliminarily. The model was developed by multivariable logistic regression analysis. Calibration, decision curve analysis (DCA), and receiver operating characteristic (ROC) measured the performance of the nomogram on the accuracy, clinical utility, and discrimination, respectively. Eventually, 368 ICU patients with TTS were enrolled in this research. The in-hospital mortality was 13.04%. LASSO regression and multivariate logistic regression analysis verified risk factors significantly associated with in-hospital mortality. They were potassium, prothrombin time (PT), age, myocardial infarction, white cell count (WBC), hematocrit, anion gap, and sequential organ failure assessment (SOFA) score. This nomogram excellently discriminated against patients with a risk of in-hospital death. The area under curve (AUC) was 0.779 (95%CI: 0.732–0.826) in training set and 0.775 (95%CI: 0.711–0.839) in test set. The calibration plot and DCA showed good clinical benefits for this nomogram. We developed a nomogram that predicts the probability of in-hospital death for ICU patients with TTS. This nomogram was able to discriminate patients with a high risk of in-hospital death and performed clinical utility.

The flow routing process plays a crucial role in underpinning the execution of real-time operations within interbasin water transfer projects (IWTPs). However, the water transfer process within the supplying area is significantly affected by the time lag of water flow over extended distances, which results in a misalignment with the water demand process in the receiving area. Hence, there is an imperative need to investigate the flow routing patterns in long-distance water transfer processes. While MIKE11(2014 version) software and the Muskingum method are proficient in simulating flow routing within a water transfer network, they fall short in addressing issues arising from mixed free-surface-pressure flows in water transfer pipelines. This study enhanced the capabilities of the MIKE11(2014 version) software and the Muskingum method by introducing the Preissmann virtual narrow gap method to tackle the challenge of simulating mixed free-surface-pressure flows, a task unattainable by the model independently. This approach provides a clear elucidation of hydraulic characteristics within the water transfer network, encompassing flow rates and routing times. Furthermore, this is integrated with the Muskingum inverse method to compute the actual water demand process within the supplying area. This methodology is implemented in the context of the Han River to Wei River Diversion Project (HTWDP). The research findings reveal that the routing time for the Qinling water conveyance tunnel, under maximum design flow rate conditions, is 12.78 h, while for the south and north main lines, it stands at 15.85 and 20.15 h, respectively. These results underscore the significance of the time lag effect in long-distance water conveyance. It is noteworthy that the average errors between simulated and calculated values for the south and north main lines in the flow routing process are 0.45 m3/s and 0.51 m3/s, respectively. Compared to not using the Preissmann virtual narrow gap method, these errors are reduced by 59.82% and 70.35%, indicating a significant decrease in the discrepancy between simulated and calculated values through the adoption of the Preissmann virtual narrow gap method. This substantially improves the model’s fitting accuracy. Furthermore, the KGE indices for the flow routing model are all above 0.5, and the overall trend of the reverse flow routing process closely aligns with the simulated process. The relative errors for most time periods are constrained within a 5% range, demonstrating the reasonability and precision of the model.

In order to explore the problems of load transfer and anchorage mechanisms of tensile anchors under pull-out load for geotechnical anchoring systems, a step-wise mathematical model is established which considers the linear–nonlinear shear stress and shear displacement of the anchorage segment, using an elasto-plastic constitutive model. The displacement, axial force, and shear stress of the anchorage interface in different stages (elastic, plastic, and debonding) are analyzed and solutions are derived. And the theoretical solutions for the ultimate pull-out load of the anchor at each stage are also presented. Two in situ pull-out tests are used to verify and apply these findings in engineering. The results show that the stepwise composite model could reflect the bonding, softening and residual characteristics of the anchoring interface. In the process of the pull-out load increasing, the pulling end of the anchor initially enters the plastic stage and the debonding stage, respectively, and the failure of the anchor occurs at the pulling end, and as the axial force transfers down deeper, the damage gradually spreads deeper. The axial force distribution of the anchorage section is a monotonically decreasing curve, and the peak point of the shear stress gradually moves deeper. The calculation results of the axial force distribution curve and load–displacement curve of the anchor are in good agreement with the measured values, which verifies the rationality and reliability of the theoretical prediction method. This method can provide a theoretical reference for the load transfer analysis and design of tension anchors for geotechnical anchoring systems.

In this paper, the influence of the construction process of large-span steel latticed arch on the geometric configuration and bearing capacity performance of the large-span steel latticed arch is calculated and analyzed by using the inverse analysis technique. By comparing the calculation results of single pre-deformation adjustment of the node co-ordinates in zero state of the whole structure and the dynamic adjustment of the node co-ordinates of the unconstructed part of the structure, it is found that the inverse analysis method of dynamic node co-ordinate adjustment is used to achieve the unification of the geometric configuration of the final structure and the bearing capacity performance of the structure. The results show that the inverse analysis method of dynamic node co-ordinate adjustment proposed in this paper can simulate and track the dynamic changes of structural geometry and stable bearing capacity performance in the actual construction process, which can not only consider the influence of the installed part of the structure on the co-ordinate adjustment value of the uninstalled part of the structure but also consider the deformation influence of the subsequent uninstalled structure on the installed structure and can realize the optimal approximation of the final state structure to the geometric configuration of the zero state structure and the accurate calculation of the bearing capacity performance with the progress of the construction process.

ObjectiveThe study investigated the differential characteristics associated with motor skill development and working memory processing during early childhood, thereby providing insights for understanding motor learning and cognitive development in young children.MethodsIn total, 101 preschool children (age: 4–6 years) were recruited for this study. The motor skill development level and the working memory capacity of the children were assessed using the MOBAK Motor Development Assessment Scale and a block task paradigm, respectively. Functional near-infrared spectroscopy brain imaging technology was used to monitor hemodynamic signals in the prefrontal cortex (PFC) of the children while they completed different memory tasks. MATLAB software and the Homer2 plugin were used to calculate the oxygenated hemoglobin (Oxy-Hb) concentration in relevant brain regions during the tasks.Results(1) The low motor skill group exhibited significantly lower accuracy during the three-memory load condition than during the two-memory load condition. Under both two-memory and three-memory load conditions, the high motor skill group exhibited significantly higher accuracy than the low motor skill group. (2) Significant differences in the Oxy-Hb concentration were observed in the left dorsolateral PFC (L-DLPFC), and right and left triangular part of the Broca’s area (R-PTBA and L-PTBA, respectively) between the two memory difficulty levels for the high motor skill group. The Oxy-Hb concentration was significantly higher during the three-memory load condition than during the two-memory load condition. Under the two-memory load condition, the high motor skill group exhibited significantly higher Oxy-Hb concentration in the L-DLPFC and L-PTBA regions than in the low motor skill group. Under the three-memory load condition, the high motor skill group exhibited significantly higher Oxy-Hb concentration in the L-DLPFC, R-PTBA, and L-PTBA regions than the low motor skill group.ConclusionA close association was observed between the motor skill levels and working memory in young children, with higher motor skill levels being associated with more pronounced brain activation patterns during working memory tasks.

Background Tumor markers (TMs) are important for the prognosis of gastric cancer (GC). However, the prognostic importance of the tumor marker index (TMI) based on GC-specific TMs for advanced gastric cancer (AGC) still needs to be further explored. Methods We retrospectively examined patients who underwent radical gastric cancer surgery between February 2014 and June 2016 at the Department of Gastroenterological Surgery, Affiliated Cancer Hospital, Harbin Medical University. The patients were divided into training and validation groups. TMI was determined as the geometric mean of the standard cancer antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) levels. Patient overall survival was assessed using the Kaplan–Meier method. Independent prognosis-associated risk factors were identified using Cox hazard regression models. A nomogram model incorporating TMI and clinicopathological factors was developed, and its performance was evaluated using a decision curve analysis, concordance index, and calibration plots. Results In the TMI training cohort, the cutoff value was set at .439, categorizing patients into TMI-High and TMI-Low groups. The 5-year survival rate in the TMI-Low group significantly surpassed that in the TMI-High group (78.2% vs 58.1% and 49.7 vs 41.6, P < .001). TMI emerged as an independent prognostic factor. The nomogram accurately predicted patient prognosis by using TMI and clinicopathological characteristics. Validation of the TMI in the independent cohort yielded satisfactory results. Conclusion The TMI constructed based on specific TMs associated with gastric cancer can offer a precise prognostic prediction for patients.

Background: Since the poor prognosis of uveal melanoma with distant metastasis, we intended to screen out possible biomarkers for uveal melanoma metastasis risk and establish a nomogram model for predicting the risk of uveal melanoma (UVM) metastasis. Methods: Two datasets of UVM (GSE84976, GSE22138) were selected. Data was analyzed by R language, CTD database and GEPIA. Results: The co-upregulated genes of two datasets, HTR2B, CHAC1, AHNAK2, and PTP4A3 were identified using a Venn diagram. These biomarkers are combined with clinical characteristics, and Lasso regression was conducted to filter the metastasis-related biomarkers. HTR2B, CHAC1, AHNAK2, PTP4A3, tumor thickness, and retinal detachment (RD) were selected to establish the nomogram. Conclusion: Our study provides a comprehensive predictive model and personalized risk estimation tool for assessment of 3-year metastasis risk of UVM with a better accuracy.