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Abstract Metal micro/nanoparticle ink-based printed circuits have shown promise for promoting the scalable application of flexible electronics due to enabling superhigh metallic conductivity with cost-effective mass production. However, it is challenging to activate printed metal-particle patterns to approach the intrinsic conductivity without damaging the flexible substrate, especially for high melting-point metals. Here, we report a pressure-constrained sonication activation (PCSA) method of the printed flexible circuits for more than dozens of metal (covering melting points from room temperature to 3422 °C) and even nonmetallic inks, which is integrated with the large-scale roll-to-roll process. The PCSA-induced synergistic heat-softening and vibration-bonding effect of particles can enable multilayer circuit interconnection and join electronic components onto printed circuits without solder within 1 s at room temperature. We demonstrate PCSA-based applications of 3D flexible origami electronics, erasable and foldable double-sided electroluminescent displays, and custom-designed and large-area electronic textiles, thus indicating its potential for universality in flexible electronics.

The poultry red mite Dermanyssus gallinae, a prevalent ectoparasite in egg-laying poultry, severely compromises bird health and impedes the poultry industry's development. However, the escalating drug resistance due to sustained reliance on chemical acaricides highlights the urgent need for new mite management strategies. Therefore, plant essential oils (EOs), which exhibit natural acaricidal properties and environmental compatibility, represent promising candidates for developing eco-friendly acaricides. In this study, we formulated binary mixtures of the median lethal concentrations (LC50) of carbaryl and EOs of Cinnamomum cassia and Origanum vulgare at ratios from 1:9 to 9:1 and then evaluated their contact toxicity, fumigant toxicity, and ovicidal effects against D. gallinae. The binary mixtures of C. cassia–carbaryl (2:8), O. vulgare–carbaryl (6:4), and C. cassia–O. vulgare (7:3) exhibited the most effective contact toxicity and achieved mite mortality rates of 60 %, 66.7 %, and 65.5 %, respectively, with poison ratios of 1.22, 1.25, and 1.24, respectively, indicating synergism. In the fumigant trials, the O. vulgare–carbaryl (6:4) mixture achieved 97 % mite mortality at 48 h, whereas the C. cassia–carbaryl (2:8) mixture demonstrated low mite mortality of 18 %. Notably, the C. cassia–O. vulgare mixture at 7:3 resulted in 87 % mite mortality, which was lower than that of the other ratios for this mixture. Furthermore, the ovicidal effects of the optimal binary mixtures of C. cassia–carbaryl (2:8), O. vulgare–carbaryl (6:4), and C. cassia–O. vulgare (7:3) were significantly better than those of a single drug, with egg hatchabilities of 2.3 %, 6.6 %, and 4.3 %, respectively, thus indicating strong inhibition of D. gallinae eggs. These combinations outperformed the single-agent controls, with egg hatchability rates of 31 % for C. cassia EO, 33.3 % for O. vulgare EO, and 20 % for carbaryl. Compared with the control group, mite eggs treated with the optimal binary mixtures and single drugs exhibited significant shrinkage and structural damage, which are consistent with low egg hatchability. These results demonstrate that integrating EOs with carbaryl could represent a viable alternative strategy for the management of poultry red mites.

Aflatoxin B1 (AFB1) has been recognized as a serious health risk for ruminant animals. From a molecular perspective, indole-3-acid (IAA) possesses the potential to enhance the removal of AFB1 by rumen microbiota. Therefore, this study aims to investigate the impact of different concentrations of IAA on the removal of AFB1 by rumen microbiota using an in vitro technique. Experiment 1: interaction between AFB1 and rumen fermentation. Experiment 2: The study used a randomized design with five IAA levels (0, 15, 150, 1,500, and 7,500 mg/kg) to examine the effect of IAA on AFB1 removal and its impact on rumen fermentation. The results showed: (1) the content of AFB1 gradually decreased, removal rate of up to 75.73% after 24 h. AFB1 exposure altered the rumen fermentation pattern, with significantly decreased in the acetic acid/propionic acid ratio (p

Abstract The study aims to investigate the predictive capability of machine learning algorithms for omental metastasis in locally advanced gastric cancer (LAGC) and to compare the performance metrics of various machine learning predictive models. A retrospective collection of 478 pathologically confirmed LAGC patients was undertaken, encompassing both clinical features and arterial phase computed tomography images. Radiomic features were extracted using 3D Slicer software. Clinical and radiomic features were further filtered through lasso regression. Selected clinical and radiomic features were used to construct omental metastasis predictive models using support vector machine (SVM), decision tree (DT), random forest (RF), K-nearest neighbors (KNN), and logistic regression (LR). The models’ performance metrics included accuracy, area under the curve (AUC) of the receiver operating characteristic curve, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). In the training cohort, the RF predictive model surpassed LR, SVM, DT, and KNN in terms of accuracy, AUC, sensitivity, specificity, PPV, and NPV. Compared to the other four predictive models, the RF model significantly improved PPV. In the test cohort, all five machine learning predictive models exhibited lower PPVs. The DT model demonstrated the most significant variation in performance metrics relative to the other models, with a sensitivity of 0.231 and specificity of 0.990. The LR-based predictive model had the lowest PPV at 0.210, compared to the other four models. In the external validation cohort, the performance metrics of the predictive models were generally consistent with those in the test cohort. The LR-based model for predicting omental metastasis exhibited a lower PPV. Among the machine learning algorithms, the RF predictive model demonstrated higher accuracy and improved PPV relative to LR, SVM, KNN, and DT models.

Abstract Introduction Dichoptic training has emerged as a promising rehabilitation approach for improving binocular visual function in patients with strabismus. A prospective observational study design was employed to assess the effectiveness of online video game-based dichoptic training in rehabilitating binocular visual function in patients who had undergone an operation for intermittent exotropia. Methods A total of 64 patients who had undergone an operation for intermittent exotropia were recruited and divided into the training group and the control group based on whether they would receive the dichoptic training. The dichoptic training was conducted for 3 months in the training group and the control group would not accept any form of orthoptic therapy. Assessments of binocular visual functions and deviation were conducted at baseline, 3-month and 6-month follow-up. Results Twenty-nine participants in the training group (mean 9.69 ± 2.66 years old) and 26 participants in the control group (mean 8.41 ± 2.64 years old) completed follow-up. At both 3- and 6-month follow-ups, the training group showed superior distance stereopsis compared to the control group, with near stereopsis only showing significant difference at the 6-month follow-up. Additionally, the training group exhibited significantly less distance exo-deviation drift than the control group at these times, and no significant difference was observed in near exo-deviation drift between the groups. The control group had a significantly higher rate of suboptimal surgical outcomes at both the 3- and 6-month follow-up. However, no significant differences were observed in simultaneous perception and fusion functions between the two groups. Conclusions Online video game-based dichoptic training has the potential to become a novel postoperative rehabilitation strategy for patients with intermittent exotropia.

Abstract Background Homologous recombination plays a vital role in the occurrence and drug resistance of gastric cancer. This study aimed to screen new gastric cancer diagnostic biomarkers in the homologous recombination pathway and then used radiomic features to construct a prediction model of biomarker expression to guide the selection of chemotherapy regimens. Methods Gastric cancer transcriptome data were downloaded from The Cancer Genome Atlas database. Machine learning methods were used to screen for diagnostic biomarkers of gastric cancer and validate them experimentally. Computed Tomography image data of gastric cancer patients and corresponding clinical data were downloaded from The Cancer Imaging Archive and our imaging centre, and then the Computed Tomography images were subjected to feature extraction, and biomarker expression prediction models were constructed to analyze the correlation between the biomarker radiomics scores and clinicopathological features. Results We screened RAD51D and XRCC2 in the homologous recombination pathway as biomarkers for gastric cancer diagnosis by machine learning, and the expression of RAD51D and XRCC2 was significantly positively correlated with pathological T stage, N stage, and TNM stage. Homologous recombination pathway blockade inhibits gastric cancer cell proliferation, promotes apoptosis, and reduces the sensitivity of gastric cancer cells to chemotherapeutic drugs. Our predictive RAD51D and XRCC2 expression models were constructed using radiomics features, and all the models had high accuracy. In the external validation cohort, the predictive models still had decent accuracy. Moreover, the radiomics scores of RAD51D and XRCC2 were also significantly positively correlated with the pathologic T, N, and TNM stages. Conclusions The gastric cancer diagnostic biomarkers RAD51D and XRCC2 that we screened can, to a certain extent, reflect the expression status of genes through radiomic characteristics, which is of certain significance in guiding the selection of chemotherapy regimens for gastric cancer patients.

Abstract The active-cooling elastomer concept, originating from vascular thermoregulation for soft biological tissue, is expected to develop an effective heat dissipation method for human skin, flexible electronics, and soft robots due to the desired interface mechanical compliance. However, its low thermal conduction and poor adaptation limit its cooling effects. Inspired by the bone structure, this work reports a simple yet versatile method of fabricating arbitrary-geometry liquid metal skeleton-based elastomer with bicontinuous Gyroid-shaped phases, exhibiting high thermal conductivity (up to 27.1 W/mK) and stretchability (strain limit >600%). Enlightened by the vasodilation principle for blood flow regulation, we also establish a hydraulic-driven conformal morphing strategy for better thermoregulation by modulating the hydraulic pressure of channels to adapt the complicated shape with large surface roughness (even a concave body). The liquid metal active-cooling elastomer, integrated with the flexible thermoelectric device, is demonstrated with various applications in the soft gripper, thermal-energy harvesting, and head thermoregulation.

Indole and skatole (3-methylindole, C9H9N) are common nitrogen-containing heterocyclic pollutants found in waste, wastewater treatment plants, and public restrooms and are the most notorious compounds in animal feces. Biodegradation was considered a feasible method for the removal of indole and skatole, but a comprehensive understanding of the metabolic pathways under both aerobic and anaerobic conditions was lacking, and the functional genes responsible for skatole biodegradation remained a mystery. Through metagenomic and gene cluster functional analysis, Acinetobacter piscicola p38 (NCBI: CP167896), genes 1650 (styrene monooxygenase: ACDW34_08180), and 1687 (styrene monooxygenase: ACDW34_08350) were identified as having the potential to degrade indole and skatole. The heterologous expression results demonstrate that the genes 1650 and 1651 (flavin reductase: ACDW34_08185), when combined, are capable of degrading indole, while the genes 1687 and 1688 (flavin reductase: ACDW34_08355), in combination, can degrade indole as well as skatole. These reactions necessitate the involvement of flavin reductase and NAD(P)H to catalyze the oxygenation process. This work aimed to provide new experimental evidence for the biodegradation of indole and skatole. This study offered new insights into our understanding of skatole degradation. The Acinetobacter_piscicola p38 strain provided an effective bacterial resource for the bioremediation of fecal indole and skatole.

Abstract At present, no study has established a survival prediction model for non-metastatic primary malignant bone tumors of the spine (PMBS) patients. The clinical features and prognostic limitations of PMBS patients still require further exploration. Data on patients with non-metastatic PBMS from 2004 to 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Multivariate regression analysis using Cox, Best-subset and Lasso regression methods was performed to identify the best combination of independent predictors. Then two nomograms were structured based on these factors for overall survival (OS) and cancer-specific survival (CSS). The accuracy and applicability of the nomograms were assessed by area under the curve (AUC) values, calibration curves and decision curve analysis (DCA). Results: The C-index indicated that the nomograms of OS (C‐index 0.753) and CSS (C‐index 0.812) had good discriminative power. The calibration curve displays a great match between the model’s predictions and actual observations. DCA curves show our models for OS (range: 0.09–0.741) and CSS (range: 0.075–0.580) have clinical value within a specific threshold probability range compared with the two extreme cases. Two nomograms and web-based survival calculators based on established clinical characteristics was developed for OS and CSS. These can provide a reference for clinicians to formulate treatment plans for patients.

Abstract Background Intermittent exotropia (IXT) is the most common type of strabismus in China, but the best treatment and optimal timing of intervention for IXT remain controversial, particularly for children with moderate IXT who manifest obvious exodeviation frequently but with only partial impairment of binocular single vision. The lack of randomized controlled trial (RCT) evidence means that the true effectiveness of the surgical treatment in curing moderate IXT is still unknown. The SOMIX (surgical treatment versus observation in moderate intermittent exotropia) study has been designed to determine the long-term effectiveness of surgery for the treatment and the natural history of IXT among patients aged 5 to 18 years old. Methods/design A total of 280 patients between 5 and 18 years of age with moderate IXT will be enrolled at Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. After initial clinical assessment, all participants will be randomized to receive surgical treatment or observation, and then be followed up for 5 years. The primary objective is to compare the cure rate of IXT between the surgical treatment and observation group. The secondary objectives are to identify the predictive factors affecting long-term outcomes in each group and to observe the natural course of IXT. Discussion The SOMIX trial will provide important guidance regarding the moderate IXT and its managements and modify the treatment strategies of IXT. Trial registration ClinicalTrials.gov: NCT 02736526 . Registered April 13, 2016

Abstract The health risk stemming from drinking alcohol is serious, sometimes even life-threatening. Alcoholic steatohepatitis (ASH) is a critical stage leading to cirrhosis and end-stage liver disease. However, its pathogenesis is still far from clearly understood, and a treatment that is widely recognised as effective has not been discovered. Interestingly, PDPK1,3-phosphoinositide-dependent protein kinase 1, also known as PDK1, was observed to be obviously increased in the ASH model by our researchers. We also investigated the protective role of autophagy in ASH. Here, we studied the function of PDPK1 and found an efficient treatment to alleviate symptoms by targeting PDPK1 in ASH. In our study, PDPK1 affected hepatocyte self-healing by inhibiting autophagy. Both inhibiting PDPK1 and the phosphorylation of PDPK1 (ser241) could protect hepatocytes from suffering heavy alcoholic hepatitis.

Tongue squamous cell carcinoma (TSCC) is closely linked to head and neck cancers. Here, we sought to explore the role and mechanism of lncRNAs in the occurrence and progression of TSCC and cisplatin resistance. The results of next-generation transcriptomic sequencing revealed that lncRNA-SNHG26 was differentially expressed and was associated with TSCC cisplatin resistance. The Cancer Genome Atlas dataset and tumor tissue analysis revealed that high SHNG26 expression was associated with the occurrence, progression, and poor prognosis of TSCC. Evidence from cell and animal experiments showed that SNHG26 expression was positively correlated with TSCC proliferation, epithelial-mesenchymal transformation, migration, invasion, and cisplatin resistance. Furthermore, in TSCC cells, SNHG26 was found to bind directly to the PGK1 protein, inhibiting its ubiquitination and activating the Akt/mTOR signaling pathway. These findings suggest that lncRNA-SNHG26 may be a promising target for inhibiting TSCC progression and improving sensitivity to cisplatin chemotherapy in TSCC.

To analyze the effect of flow characteristics on electrochemical water softening, characteristics of flow fields in the vicinity of vertical plate electrodes in a bench-scale electrolysis cell for electrochemical water softening were visualized using particle image velocimetry technology, and the hardness drop values under different process conditions were measured. Properly increasing the current density or reducing the electrode spacing can increase the average flow velocity in the electrode gap. Excessive current density will cause bubble accumulation, form a bubble vortex, interfere with the orderly flow of surrounding liquid and reduce mass transfer efficiency. When the electrode spacing is 120 mm, the highest water softening efficiency measured at the current density of 60 A/m2 is 16.56%. When the current density is 50 A/m2, the highest average speed measured at the electrode spacing of 60 mm is 0.00169 m/s, but the highest water softening efficiency measured at the electrode spacing of 90 mm is 23.3%.The circulation efficiency in the electrode gap of a semi-closed structure is lower than that of a free convection structure. The behavior of bubbles is the key to flow and mass transfer. It is important to consider its influence on bubble behavior when optimizing electrochemical parameters. HIGHLIGHTS Effect of flow characteristics between vertical plate electrodes on water softening efficiency.; The main flow patterns of mass transfer between vertical plate electrodes.; Effect of bubble behavior on flow patterns between vertical plate electrodes.; Optimization of flow mass transfer efficiency by current density, electrode spacing and electrode position.; Trend of velocity distribution between vertical plate electrodes.;

Water resources allocation is an important technical tool to alleviate the conflict between water supply and demand, improve water resources utilization efficiency, and achieve the control target of total water resources utilization. However, the current water resources allocation theory is immature, and there are few objective and quantitative allocation methods, which leads to the relatively backward allocation practice. Moreover, the amounts of allocable water resources change dynamically, which makes the static and single traditional allocation scheme difficult to adapt to changes. To address the above issues, this research comprehensively integrated multiple types of allocation models to build a multi-method integrated simulation system for water resources allocation. The results show that the system supports visually generated schemes and dynamically simulates water resources allocation. The application of the simulation system enhances the reliability of results. And the dynamic adaptability of allocation results supports allocation decisions. HIGHLIGHTS Integrated application of multiple allocation methods can make up for the limitations of a single method.; The dynamic simulation system of water allocation helps to improve the adaptability of allocation schemes.; The horizontal comparison of various model schemes provides better decision support for water resources allocation.;

Unmanned Aerial Vehicle (UAV) communications have recently entered a new period of interest, motivated by technological advances and the gradual emergence of the Space-Air-Ground Integrated Network (SAGIN). The current survey aims to capture the use of UAVs in the SAGIN while highlighting the most promising open research topics. The traditional UAV network architecture is not adequate to meet the challenges presented by the SAGIN, and an effective and secure space-air-ground integrated UAV network needs to be constructed. Given its well-distributed management and consensus mechanism, blockchain technology can make up for the deficiency of the traditional UAV network. In this work, we review the role of UAVs in the SAGIN. Then, three applications of the blockchain-envisioned UAV network are introduced through several classifications. Future challenges and the corresponding open research topics are also described.

BackgroundColorectal cancer (CRC) has the third-highest incidence and second-highest mortality rate of all cancers worldwide. Early diagnosis and screening of CRC have been the focus of research in this field. With the continuous development of artificial intelligence (AI) technology, AI has advantages in many aspects of CRC, such as adenoma screening, genetic testing, and prediction of tumor metastasis.ObjectiveThis study uses bibliometrics to analyze research in AI in CRC, summarize the field’s history and current status of research, and predict future research directions.MethodWe searched the SCIE database for all literature on CRC and AI. The documents span the period 2002-2022. we used bibliometrics to analyze the data of these papers, such as authors, countries, institutions, and references. Co-authorship, co-citation, and co-occurrence analysis were the main methods of analysis. Citespace, VOSviewer, and SCImago Graphica were used to visualize the results.ResultThis study selected 1,531 articles on AI in CRC. China has published a maximum number of 580 such articles in this field. The U.S. had the most quality publications, boasting an average citation per article of 46.13. Mori Y and Ding K were the two authors with the highest number of articles. Scientific Reports, Cancers, and Frontiers in Oncology are this field’s most widely published journals. Institutions from China occupy the top 9 positions among the most published institutions. We found that research on AI in this field mainly focuses on colonoscopy-assisted diagnosis, imaging histology, and pathology examination.ConclusionAI in CRC is currently in the development stage with good prospects. AI is currently widely used in colonoscopy, imageomics, and pathology. However, the scope of AI applications is still limited, and there is a lack of inter-institutional collaboration. The pervasiveness of AI technology is the main direction of future housing development in this field.

In order to promote the application of electrochemical water softening technology in industrial circulating cooling water systems, electric field type, cathode structure and solution residence time are selected for optimization analysis of an electrochemical water softening device. The experimental results show that the water softening performance per unit area of mesh cathode is better than that of a plate cathode. In addition, the softening amount per unit area of the mesh cathode can be further increased when the high-frequency (HF) power supply is applied. When the HF power supply is applied, the softening amount per unit area is 158.58 g/m2·h−1 more than when the direct current power supply is applied. In order to explore the growth mechanism of calcium carbonate, micro-analysis technology and high-speed bubble photography technology are used. The results show that the bubbles escape along the longitudinal direction of the electrode plate, and the main growth direction of calcium carbonate growth is consistent with the escape direction of the bubble; that is, the bubbles grow along the longitudinal direction of the electrode plate. The special structure of the diamond-shaped mesh cathode facilitates the growth of calcium carbonate crystals. HIGHLIGHTS The high-frequency power supply can further increase the descaling amount per unit area of the mesh cathode.; The special structure of the diamond-shaped mesh cathode facilitates the growth of calcium carbonate crystals.; The maximum desalination rate of this experimental device is 604.5 g/m2 h−1.;

Panicle length (PL) is an important trait closely related to rice yield. More than 200 quantitative trait loci (QTL) for PL have been identified, but only a few can be used for breeding. Dongxiang wild rice contains many excellent genes, and mining favorable PL-related QTL from DXWR is helpful for rice variety improvement. Here, we report a QTL analysis for PL using a recombinant inbred line population consisting of 143 individuals derived from a cross between Dongxiang wild rice and indica cultivar Guangluai 4. A total of four QTL (qPL1-37, qPL4-26, qPL7-25, and qPL8-4) for PL were identified and located on chromosomes 1, 4, 7, and 8. Among them, qPL7-25 showed the largest F-value of 32.32 and 16.80, and the QTL explained 18.66% and 13.06% of the phenotypic variation of Dongxiang wild rice in Hangzhou and Hainan, respectively. QTL mapping was performed using a population of 1800 individuals derived from the crossing of NIL-qPL7-25 and GLA4. qPL7-25 was located between two InDel markers, InDel-24591 and InDel-24710, in a 119 kb region containing 14 predicted genes. Using Sanger sequencing and qRT-PCR analysis, we propose that LOC_Os07g41200 is probably a new allele of the well-known GL7 gene, which affects grain length and appearance quality in rice. These results provide new insights into the use of molecular marker-assisted selection for breeding high-yielding and high-quality rice varieties.

Abstract Purpose and background Recently, we found that maximal medial rectus recession and lateral rectus resection in patients with complete lateral rectus paralysis resulted in a partial restoration of abduction. In an attempt to understand some of the mechanisms involved with this effect we examined gene expression profiles of lateral recti from these patients, with our focus being directed to genes related to myogenesis. Materials and methods Lateral recti resected from patients with complete lateral rectus paralysis and those from concomitant esotropia (controls) were collected. Differences in gene expression profiles between these two groups were examined using microarray analysis and quantitative Reverse-transcription PCR (qRT-PCR). Results A total of 3056 differentially expressed genes (DEGs) were identified between these two groups. Within the paralytic esotropia group, 2081 genes were up-regulated and 975 down-regulated. The results of RT-PCR revealed that PAX7, MYOG, PITX1, SIX1 and SIX4 showed higher levels of expression, while that of MYOD a lower level of expression within the paralytic esotropia group as compared with that in the control group (p

Electrochemical water softening has been widely used in industrial circulating cooling water systems; however, their low deposition efficiency is the main drawback that limits usage in medium to large enterprises. In this work, the effect of different parameters on the hardness removal efficiency and energy consumption of the electrochemical water softening system is experimentally studied, and the performance of water softening applied by high frequency electric fields and direct current electric fields are comparative analyzed. The impact factors of the electrochemical water softening system are as follows: initial feed concentration of solute, magnitude of voltage, inter-electrode distance, area of cathode and frequency of power supply. To improve the analysis efficiency, the L25 (55) orthogonal table is used to investigate the five different factors at five levels. The experimental results are shown that the initial feed concentration of solute is the most significant factor affecting the hardness removal efficiency. The optimal combination for water softening in the group applied by high frequency electric field and direct current electric field are A3B2C1D4E3 and A2B5C3D1 respectively. The energy utilization of the device applied by high frequency electric field is 3.2 times that applied by direct current electric field. The practice shows that direct current electric fields have a better softening effect, and are is more suitable for scaling ion removal. Particle image velocimetry (PIV) was used to observe the flow field induced by the electrolysis and found that the vertical and horizontal velocities of the flow field at low voltage are conducive to the migration of scaled ions to the cathode, and then the electrolytic reaction and deposition reaction synergy effect is the optimal. HIGHLIGHTS Orthogonal experiments were used to optimize electrochemical water softening.; The initial concentration determines the electrochemical softening rate.; PIV technology is used to analyze mass transfer process.; Water softening performance depends on the synergistic reaction of electrolysis and mass transfer.; Water softening performance is enhanced by high frequency electric field.;

Efficient stimulus-responsive phosphorescence organic materials are attractive, but are extremely rare because of unclear design principles and intrinsically spin-forbidden intersystem crossing. Here, the authors present a facile strategy to achieve ultraviolet irradiation-responsive ultralong room-temperature phosphorescence in several simple amorphous polymer materials.

Abstract In recent years, large‐scale satellite networks have been studied emphatically due to its advantages in high throughput and low latency. Many companies and institutions are keen to build large‐scale low earth orbit satellite constellations to provide space‐based Internet services, which poses a great demand for the design of efficient and reliable routing schemes. Three attribute indexes to evaluate the performance of the satellites are proposed. With the Dempster–Shafer theory, the attributes can be fused for the routing decision‐making process. Based on the Message Identification divergence (M‐I divergence) measure method, a Belief Message Importance divergence based Routing algorithm is proposed. By adjusting the characteristic parameter, it can amplify the divergence between distance‐based evidence and others properly. In this way, Belief Message Importance divergence‐based Routing attempts to find the optimal shortest path according to the status of intermediate nodes. Compared with existing satellite routing schemes, the algorithm that is proposed can approach the optimal routing performance, increasing the throughput by 47.2% on average, and decreasing the total delay and packet drop rate by 59.5% and 42.1% on average, respectively.

Amblyopia is a common eye disease characterized by impaired best-corrected visual acuity. It starts in early childhood and leads to permanent vision reduction if left untreated. Even though many young patients with amblyopia are well treated in clinical practice, the underlying mechanism remains to be elucidated, which limits not only our understanding of this disease but also the therapeutic approach. To investigate the molecular mechanism of amblyopia, primate and rodent models of monocular-deprived amblyopia were created for mRNA screening and confirmation. We obtained 818 differentially expressed genes from the dorsal lateral geniculate nucleus (dLGN) of a primate model of amblyopia. After Gene Ontology and kyoto encyclopedia of genes and genomes (KEGG) enrichment analyses, the main enriched pathways were related to neural development. Interestingly, a particular neurotransmitter pathway, the dopaminergic pathway, was identified. The downregulation of dopamine receptor D1 (DRD1) was confirmed in both monkey and mouse samples. Furthermore, the immunofluorescence staining indicated that DRD1 expression was downregulated in both ventrolateral region of the contralateral dLGN and the dorsomedial region of the ipsilateral dLGN in the mouse model. The regions with downregulated expression of DRD1 were the downstream targets of the visual projection from the amblyopic eye. This study suggested that the downregulation of DRD1 in the LGN may be a cause for amblyopia. This may also be a reason for the failure of some clinical cases of levodopa combined with carbidopa applied to amblyopes.

Brown adipose tissue (BAT) is a kind of adipose tissue engaging in thermoregulatory thermogenesis, metaboloregulatory thermogenesis, and secretory. Current studies have revealed that BAT activity is negatively correlated with adult body weight and is considered a target tissue for the treatment of obesity and other metabolic-related diseases. Additionally, the activity of BAT presents certain differences between different ages and genders. Clinically, BAT segmentation based on PET/CT data is a reliable method for brown fat research. However, most of the current BAT segmentation methods rely on the experience of doctors. In this paper, an improved U-net network, ICA-Unet, is proposed to achieve automatic and precise segmentation of BAT. First, the traditional 2D convolution layer in the encoder is replaced with a depth-wise over-parameterized convolutional (Do-Conv) layer. Second, the channel attention block is introduced between the double-layer convolution. Finally, the image information entropy (IIE) block is added in the skip connections to strengthen the edge features. Furthermore, the performance of this method is evaluated on the dataset of PET/CT images from 368 patients. The results demonstrate a strong agreement between the automatic segmentation of BAT and manual annotation by experts. The average DICE coefficient (DSC) is 0.9057, and the average Hausdorff distance is 7.2810. Experimental results suggest that the method proposed in this paper can achieve efficient and accurate automatic BAT segmentation and satisfy the clinical requirements of BAT.

PurposeTo review the surgical procedures and outcomes of supramaximal horizontal rectus recession–resection surgery for abduction deficiency and esotropia resulting from complete unilateral abducens nerve palsy.MethodsA total of 36 consecutive cases diagnosed as complete abducens nerve palsy, receiving supramaximal medial rectus recession (8.5 ± 1.4 mm, range: 6–10) combined with a supramaximal lateral rectus resection (11.1 ± 1.7 mm, range: 8–14) as performed over the period from 2017 to 2020, were reviewed retrospectively. All surgeries were performed by a single surgeon. Pre- and post-operative ocular motility, ocular alignment, forced duction test, binocular vision, abnormal head posture, and surgical complications were assessed.ResultsOf these 36 cases, 23 (63.8%) were followed up for greater than 2 months (Mean ± SD = 8.4 ± 6.0, range: 2–24) after surgery and the collected data was presented. Mean ± SD age of these patients was 41.7 ± 14.4 (range: 12–67) years with 73.9% being female. Trauma (52.2%, 12/23) and cerebral lesions (21.7%, 5/23) were the primary etiologies for this condition. Esodeviation in primary position improved from 55.5 ± 27.2 prism diopters (PD) (range: +25 to +123) to 0.04 ± 7.3 PD (range: −18 to +12) as assessed on their last visit. Pre-operative abduction deficits of −5.6 ± 1.0 (range: −8 to −4) reduced to −2.4 ± 1.4 (range: −4 to 0) post-operatively. The mean dose-effect coefficient of 2.80 ± 1.20 PD/mm (range: 1.07–6.05) was positively correlated with pre-operative esodeviation. Rates of overcorrection and ortho were 69.6 and 26.1%, respectively, on the first day after surgery, while on their last visit the respective levels were 4.3 and 82.6%.ConclusionSupramaximal horizontal rectus recession–resection surgery is an effective treatment method for complete abduction deficiency. The dose-effect was positively correlated with pre-operative esodeviation. Overcorrection on the first day post-operatively is required for a long-term satisfactory surgical outcome.

PurposeTo provide a new classification system for diplopia and evaluate the etiology and clinical features of diplopia subtypes in south China.MethodsIn this retrospective study, all patients presenting with diplopia over the period from 2012 to 2014 in south China were reviewed. Patients were categorized into 3 groups according to their extraocular muscle (EOM) dysfunction: single EOM (sEOM), multiple EOMs (mEOMs), and a comitant strabismus group. Clinical data evaluated included age, sex, medical history, etiology and duration of diplopia, ocular alignment, and ocular motility.ResultsA total of 303 patients were enrolled. The most common type of EOM dysfunction was sEOM (158 cases, 52.1%), followed by mEOMs (n = 119, 39.3%), and finally the comitant strabismus group (n = 26, 8.6%). Overall, the most common cause of diplopia involved orbital diseases. Within the sEOM group, microangiopathy (n = 42, 26.6%) and trauma (n = 41, 25.9%) were the major etiologies, with the lateral rectus (LR) (n = 86, 54.4%) being the most frequently involved. There were 12 (4.0%) patients who were considered as nasopharyngeal carcinoma (NPC)-associated diplopia (10 caused by radiation neuropathy following radiation therapy). Thyroid associated ophthalmopathy (TAO, 56 cases, 47.1%) was the predominant etiology found in the mEOMs group. Acute acquired comitant esotropia (AACE, 14 cases, 53.9%) was the most common etiology in the comitant strabismus group.ConclusionsThis new classification system for assessing diplopia as based on EOM dysfunction represents an easy-to-follow approach that can be readily adapted for the clinical use. While microangiopathy and trauma represent common etiologies of diplopia, both orbital diseases and NPC-associated diplopia also warrant special attention when assessing diplopia within patients in south China.

To address the problems of the text of earthquake emergency information keeps changing incrementally with the time of an earthquake’s occurrence and there being more and more information categories, thus making it difficult to identify earthquake emergency key information, this paper proposes an intelligent recognition algorithm of earthquake emergency information based on the optimized BERT-BiLSTM-CRF algorithm. Based on the historical seismic emergency information dataset of the past 10 years, first, the BIO sequence labeling method is used to classify the seismic entities, and the BERT pretraining model is constructed to represent the seismic emergency text with sentence-level feature vectors. The BiLSTM algorithm is used to obtain the contextual information of the bidirectional seismic emergency text, and we introduce the attention mechanism to enhance the recognition effect of the seismic emergency key information in the statements. Finally, we use conditional randomization to enhance the recognition of earthquake emergency key information in the utterance. The conditional randomization algorithm is applied to extract the dependency relationship between adjacent vectors and improve the accuracy identification to realize the intelligent recognition of earthquake emergency information. The experimental results show that our model can extract earthquake emergency information from online media efficiently and accurately, with better performance than other baseline models.

Most high-performance semantic segmentation networks are based on complicated deep convolutional neural networks, leading to severe latency in real-time detection. However, the state-of-the-art semantic segmentation networks with low complexity are still far from detecting objects accurately. In this paper, we propose a real-time semantic segmentation network, RecepNet, which balances accuracy and inference speed well. Our network adopts a bilateral architecture (including a detail path, a semantic path and a bilateral aggregation module). We devise a lightweight baseline network for the semantic path to gather rich semantic and spatial information. We also propose a detail stage pattern to store optimized high-resolution information after removing redundancy. Meanwhile, the effective feature-extraction structures are designed to reduce computational complexity. RecepNet achieves an accuracy of 78.65% mIoU (mean intersection over union) on the Cityscapes dataset in the multi-scale crop and flip evaluation. Its algorithm complexity is 52.12 GMACs (giga multiply–accumulate operations) and its inference speed on an RTX 3090 GPU is 50.12 fps. Moreover, we successfully applied RecepNet for blue-green algae real-time detection. We made and published a dataset consisting of aerial images of water surface with blue-green algae, on which RecepNet achieved 82.12% mIoU. To the best of our knowledge, our dataset is the world’s first public dataset of blue-green algae for semantic segmentation.

Developing novel long-lived room-temperature polymer phosphorescence (RTPP) materials could significantly expand their application scope. Herein, a series of RTPP materials based on eight simple vanilla derivatives for security ink application are reported. Attributed to strong mutual hydrogen bonding with polyvinyl alcohol (PVA) matrix, vanilla-doped PVA films exhibit ultralong phosphorescence emission under ambient conditions observed by naked eyes, where methyl vanillate shows the longest emission time up to 7 s. Impressively, when vanilla-doped PVA materials are utilized as invisible security inks, and the inks not only present excellent luminescent emission stability under ambient conditions but also maintain perfect reversibility between room temperature and 65°C for multiple cycles. Owing to the unique RTPP performance, an advanced anticounterfeiting data encoding/reading strategy based on handwriting technology and complex pattern steganography is developed.

Purpose: To compare the density of iris collagen and anterior segment parameters in eyes with chronic primary angle closure glaucoma (CPACG) and their fellow eyes with confirmed or suspected primary angle closure (PAC/PACS). Methods: Nineteen patients with CPACG in one eye and PAC/PACS in the fellow eye requiring trabeculectomy in the CPACG eye and iridectomy in the fellow eye were recruited. Anterior segment optical coherence tomography (AS-OCT) measurements were conducted under light and dark conditions. Iris specimens, obtained by iridectomy/trabeculectomy, were analyzed by sirius red polarization for quantifying type I/III collagen density. AS-OCT parameters and type I/III collagen densities were compared between the two eyes. Results: The iris curvatures were flatter in CPACG eyes in light and dark conditions (P < 0.05). The iris areas in light condition and iris thicknesses in dark condition were smaller in CPACG eyes (P < 0.05). The density of collagen type I in CPACG eyes was lower (P = 0.048). The light-to-dark changes in CPACG eyes and PAC/PACS eyes, respectively, were −0.679 ± 0.701 and −1.627 ± 0.802 mm for pupil diameters, and 0.069 ± 0.113 and 0.258 ± 0.157 mm2 for iris areas, which differed significantly (P < 0.001). With the decrease of type I collagen, anterior chamber width increased and iris areas decreased in dark condition. Conclusion: Dynamic changes in pupil diameter and iris areas differed significantly between CPACG eyes and their fellow PAC/PACS eyes. Decreased type I collagen density in iris tissue was associated with decreased iris area and increased anterior chamber width, which may contribute to disease progression.

Abstract Background Small cell lung cancer (SCLC) is a highly malignant cancer, and over 70% of patients with SCLC present with the metastatic disease. We aimed to explore some novel differentially expressed genes (DEGs) or microRNAs (miRNAs) associated with the lymph node metastasis of SCLC. Methods The DEGs between the metastasis and cancer groups were identified, and GO functional and KEGG pathway enrichment analyses for these DEGs were implemented. Subsequently, the protein–protein interaction network and subnetwork of module were constructed. Then the regulatory networks based on miRNAs, transcription factors (TFs) and target DEGs were constructed. Ultimately, the survival analysis for DEGs was performed to obtain the DEGs related to the survival of SCLC. Results Here, 186 upregulated (e.g., GSR, HCP5) and 144 downregulated DEGs (e.g., MET, GRM8, and DACH1) were identified between the SCLC patients with lymph node metastasis and without lymph node metastasis. GRM8 was attracted to the G-protein coupled receptor signaling pathway. Besides, miR-126 was identified in the miRNAs-TFs-target regulatory network. GRM8 and DACH1 were all regulated by miR-126. In particular, GSR and HCP5 were correlated with survival of SCLC patients. Conclusion MiR-126, DACH1, GRM8, MET, GSR, and HCP5 were implicated in the lymph node metastasis process of SCLC.

OBJECTIVE: To compare the effectiveness of surgical bypass and endovascular therapy for juxtarenal abdominal aortic occlusion. METHODS: Data of 37 patients treated with open arterial bypass surgery or endovascular therapy for juxtarenal abdominal aortic occlusion in the last 10 years were retrospectively analyzed. RESULTS: Of the 37 cases, 32 were male and five were female; the mean age was 58.5 years; the mean disease history was 8.2 months. Open surgery was performed in 18 cases and endovascular treatment was done in 19 cases. No significant differences in either technical success rate or perioperative symptom improvement rate were found between the open surgery and endovascular therapy groups. There w as much more blood loss, hospital stay time, and fewer hospitalization expenses in the open group than the endo group. In the open group, the mean follow-up time was 60.5 months and graft patency rate was 94.4%; in the endo group, the mean follow-up was 52.5 months but the patency rate was 82.4% (P = 0.009). CONCLUSIONS: Both open surgery and endovascular treatment are effective for juxtarenal aortic occlusion. In comparison, open surgery has lower cost with better long-term eff icacy, while endovascular therapy has less invasiveness with faster postoperative recovery. O perative approach should be made according to the patient's clinical conditions.

Abstract Here we describe a modified preserved nasal and lacrimal mucosal flap technique in endonasal endoscopic dacryocystorhinostomy (EES-DCR) for patients with epiphora secondary to primary acquired nasolacrimal duct obstruction (PANDO) and evaluate its outcomes. Twenty-five patients with PANDO were retrospectively reviewed. Modified preserved nasal and lacrimal mucosal flap technique in EES-DCR was applied in all 27 eyes of 25 patients. The patients were evaluated with objective (anatomical patency) and subjective (symptomatic cure) success rates within the duration of follow-up. In the present study, all of the patients’ surgical procedures were successful. There were 2 cases of flap dislocation from the rhinostomy site 1 week post-operation. After a mean follow-up of 4.9 ± 1.8 months, the success rate of anatomical patency was 100% (27/27) and the success rate of symptomatic cure was 92.6% (25/27). No significant complications occurred intraoperatively. We concluded that the modified preserved nasal and lacrimal mucosal flap technique in EES-DCR for treating PANDO is simple and safe, can effectively cover the bare bone around the opened sac, and provide a similar or even better clinical outcome compared with other routine treatment techniques used for this condition.

Summary: Re-establishing normal binocular visual processing is the key to amblyopia recovery beyond the critical period of visual development. Here, by combining perceptual learning, behavioral testing, and steady-state visually evoked potentials (SSVEPs), we examined how monocular perceptual learning in the amblyopic eye could change binocular visual processing in the adolescent and adult amblyopic visual system. We found that training reduced the interocular difference between amblyopic and fellow eyes and increased the amplitude of a binocular SSVEP component, with a significant negative correlation between the two measures. Our results demonstrate that training in the amblyopic eye primarily improves binocular rather than monocular visual processing in the amblyopic visual system, suggesting that behavioral training could potentially address key neural deficits in adolescent and adult amblyopia. : Biological Sciences; Behavioral Neuroscience; Sensory Neuroscience Subject Areas: Biological Sciences, Behavioral Neuroscience, Sensory Neuroscience

Epstein-Barr virus (EBV) causes infectious mononucleosis and is associated with multiple human malignancies. EBV drives B-cell proliferation, which contributes to the pathogenesis of multiple lymphomas. Yet, knowledge of how EBV subverts host biosynthetic pathways to transform resting lymphocytes into activated lymphoblasts remains incomplete. Using a temporal proteomic dataset of EBV primary human B-cell infection, we identified that cholesterol and fatty acid biosynthetic pathways were amongst the most highly EBV induced. Epstein-Barr nuclear antigen 2 (EBNA2), sterol response element binding protein (SREBP) and MYC each had important roles in cholesterol and fatty acid pathway induction. Unexpectedly, HMG-CoA reductase inhibitor chemical epistasis experiments revealed that mevalonate pathway production of geranylgeranyl pyrophosphate (GGPP), rather than cholesterol, was necessary for EBV-driven B-cell outgrowth, perhaps because EBV upregulated the low-density lipoprotein receptor in newly infected cells for cholesterol uptake. Chemical and CRISPR genetic analyses highlighted downstream GGPP roles in EBV-infected cell small G protein Rab activation. Rab13 was highly EBV-induced in an EBNA3-dependent manner and served as a chaperone critical for latent membrane protein (LMP) 1 and 2A trafficking and target gene activation in newly infected and in lymphoblastoid B-cells. Collectively, these studies identify highlight multiple potential therapeutic targets for prevention of EBV-transformed B-cell growth and survival.

Summary: CD40 has major roles in B cell development, activation, and germinal center responses. CD40 hypoactivity causes immunodeficiency whereas its overexpression causes autoimmunity and lymphomagenesis. To systematically identify B cell autonomous CD40 regulators, we use CRISPR/Cas9 genome-scale screens in Daudi B cells stimulated by multimeric CD40 ligand. These highlight known CD40 pathway components and reveal multiple additional mechanisms regulating CD40. The nuclear ubiquitin ligase FBXO11 supports CD40 expression by targeting repressors CTBP1 and BCL6. FBXO11 knockout decreases primary B cell CD40 abundance and impairs class-switch recombination, suggesting that frequent lymphoma monoallelic FBXO11 mutations may balance BCL6 increase with CD40 loss. At the mRNA level, CELF1 controls exon splicing critical for CD40 activity, while the N6-adenosine methyltransferase WTAP negatively regulates CD40 mRNA abundance. At the protein level, ESCRT negatively regulates activated CD40 levels while the negative feedback phosphatase DUSP10 limits downstream MAPK responses. These results serve as a resource for future studies and highlight potential therapeutic targets. : CD40 is critical for B cell development, germinal center formation, somatic hypermutation, and class-switch recombination. Increased CD40 abundance is associated with autoimmunity and cancer, whereas CD40 hypoactivity causes immunodeficiency. Jiang et al. performed a genome-wide CRISPR/Cas9 screen to reveal key B cell factors that control CD40 abundance and that regulate CD40 responses. Keywords: B cell activation, NF-kappaB, MAP kinase, CRISPR screen, TNF receptor superfamily, humoral immunity, immunodeficiency, N6-Methyladenosine, ESCRT, germinal center

Background As the fifth most common cancer worldwide, Hepatocellular carcinoma (HCC) is also the third most common cause of cancer-related death in China. Several lncRNAs have been demonstrated to be associated with occurrence and prognosis of HCC. However, identification of prognostic lncRNA signature for HCC with expression profiling data has not been conducted yet. Methods With the reuse of public available TCGA data, expression profiles of lncRNA for 371 patients with HCC were obtained and analyzed to find the independent prognostic lncRNA. Based on the expression of lncRNA, we developed a risk score model, which was evaluated by survival analysis and ROC (receiver operating characteristic) curve. Enrichment analysis was performed to predict the possible role of the identified lncRNA in HCC prognosis. Results Four lncRNAs (RP11-322E11.5, RP11-150O12.3, AC093609.1, CTC-297N7.9) were found to be significantly and independently associated with survival of HCC patients. We used these four lncRNAs to construct a risk score model, which exhibited a strong ability to distinguish patients with significantly different prognosis (HR = 2.718, 95% CI [2.103–3.514], p = 2.32e−14). Similar results were observed in the subsequent stratification survival analysis for HBV infection status and pathological stage. The ROC curve also implied our risk score as a good indicator for 5-year survival prediction. Furthermore, enrichment analysis revealed that the four signature lncRNAs may be involved in multiple pathways related to tumorigenesis and prognosis. Discussion Our study recognized four lncRNAs to be significantly associated with prognosis of liver cancer, and could provide novel insights into the potential mechanisms of HCC progression. Additionally, CTC-297N7.9 may influence the downstream TMEM220 gene expression through cis-regualtion. Nevertheless, further well-designed experimental studies are needed to validate our findings.

To compare changes in anterior segment parameters under light and dark (light-to-dark) conditions among eyes with chronic primary angle-closure glaucoma (CPACG), fellow eyes with confirmed or suspect primary angle-closure (PAC or PACS), and age-matched healthy eyes.Consecutive patients with CPACG in one eye and PAC/PACS in the fellow eye, as well as age-matched healthy subjects were recruited. Anterior segment optical coherence tomography measurements were conducted under light and dark conditions, and anterior chamber, lens, and iris parameters compared. Demographic and biometric factors associated with light-to-dark change in iris area were analyzed by linear regression.Fifty-seven patients (mean age 59.6±8.9 years) and 30 normal subjects matched for age (60.6±9.3 years) and sex ratio were recruited. In regards to differences under light-to-dark conditions, angle opening distance at 500 μm (AOD500μm) and iris area during light-to-dark transition were smaller in CPACG eyes than fellow PACS/PAC eyes and normal eyes (P

Background. Retinitis pigmentosa (RP) comprises a group of inherited disorders in which patients typically lose night vision in adolescence and then lose peripheral vision in young adulthood before eventually losing central vision later in life. A retrospective case-control study was performed to evaluate differences in ocular biometric parameters in primary angle-closure glaucoma (PACG) patients with and without concomitant RP to determine whether a relationship exists between PACG and RP. Methods. We used ultrasound biomicroscopy (UBM) to measure anterior chamber depth (ACD). A-scan biometry was carried out to measure lens thickness (LT) and axial length (AL). Propensity score matching and mixed linear regression model analysis were conducted. 23 patients with chronic primary angle-closure glaucoma (CPACG) associated with RP, 21 patients with acute primary angle-closure glaucoma (APACG) associated with RP, 270 patients with CPACG, and 269 patients with APACG were recruited for this study. Results. There were no significant differences on ACDs, ALs, and relative lens position (RLP) (P>0.05) between patients with PACG associated with RP and patients with PACG; however, patients with APACG associated with RP had a significantly greater LT than patients with APACG (P

The aim of this study was to evaluate the efficacy of two botulinum toxin A (BoNT-A) injection patterns with or without the medial lower eyelid (MLE) in treating benign essential blepharospasm (BEB) and influencing lacrimal drainage. Two different injection patterns of BoNT-A were randomly applied to 98 eyes of 49 BEB patients: MLE Group received a full injection pattern of 5 sites and non-MLE Group received a MLE waived injection pattern of 4 sites. Tear breakup time (BUT), Schirmer I test, lagophthalmos height, and lower lid tear meniscus height (TMH) were measured and Jankovic Rating Scale (JRS) was surveyed before injection and at 1 week, 1 month, and 3 months after injection. The symptom of BEB was relieved in both groups as suggested by JRS scores at all time points after injection, and MLE Group came up with a better JRS score at 3 months. The increases of Schirmer I test value and TMH in MLE Group were higher than those in non-MLE Group at 1 week after injection. This study shows that the MLE-involved full injection pattern is a better choice for patients with BEB. It has longer-lasting effects in relieving BEB symptoms and better efficacy in reducing lacrimal drainage. Clinical Trials registration number is NCT02327728.

To describe a novel method for quantitative measurement of area parameters in ocular anterior segment ultrasound biomicroscopy (UBM) images using Photoshop software and to assess its intraobserver and interobserver reproducibility.Twenty healthy volunteers with wide angles and twenty patients with narrow or closed angles were consecutively recruited. UBM images were obtained and analyzed using Photoshop software by two physicians with different-level training on two occasions. Borders of anterior segment structures including cornea, iris, lens, and zonules in the UBM image were semi-automatically defined by the Magnetic Lasso Tool in the Photoshop software according to the pixel contrast and modified by the observers. Anterior chamber area (ACA), posterior chamber area (PCA), iris cross-section area (ICA) and angle recess area (ARA) were drawn and measured. The intraobserver and interobserver reproducibilities of the anterior segment area parameters and scleral spur location were assessed by limits of agreement, coefficient of variation (CV), and intraclass correlation coefficient (ICC).All of the parameters were successfully measured by Photoshop. The intraobserver and interobserver reproducibilities of ACA, PCA, and ICA were good, with no more than 5% CV and more than 0.95 ICC, while the CVs of ARA were within 20%. The intraobserver and interobserver reproducibilities for defining the spur location were more than 0.97 ICCs. Although the operating times for both observers were less than 3 minutes per image, there was significant difference in the measuring time between two observers with different levels of training (p