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To study the effect of different parameters on milling force for longitudinal-torsional ultrasonic vibration milling (LTUM) of titanium alloy, the kinematic theory of LTUM is combined with the model of milling transient cutting thickness to establish the milling force equation, and experiment was carried out. The experimental results showed that milling force was positively correlated with cutting speed, cutting depth, feed per tooth (milling force increased by about 40% in increasing the cutting speed from 40 to 100 m/min, 300% in increasing the depth of cut from 0.1 to 0.4 mm, and 25% in increasing the feed per tooth from 0.01 to 0.04 mm). Milling force was negatively correlated with ultrasonic amplitude, tool helix angle (milling force reduced by about 22% in increasing the ultrasonic amplitude from 1 to 4 μm, and 23% in increasing the tool helix angle from 30 to 45°). The milling force was minimized when the ultrasonic amplitude was 4 μm; cutting speed was 60 m/min; cutting depth was 0.1 mm; feed per tooth was 0.01 mm/z, and tool helix angle was 40°. Furthermore, the empirical model of milling force was established, and accuracy was verified by experimental data. [ABSTRACT FROM AUTHOR]

Emissions trading systems (ETS) have been a widely-adopted policy instrument for global climate mitigation and a key choice in China's pledge for peaking emissions and carbon neutrality. Broader adoption and linkage of ETS programmes require a better understanding of whether, to what extent, and how existing regional programmes address carbon emissions at an aggregate level. Combining a synthetic control method and event studies, we adopt a comprehensive evaluation framework to investigate regional mitigation effects, pathways, and ancillary impacts in three Chinese regions with four independent pilot ETS programmes. The findings show economy-wide responses to pilot announcement even in non-ETS sectors, but enduring mitigation only within ETS sectors. Mitigation was achieved via improvement in energy efficiency and fuel switch, without impairing industrial activities. There were local air-pollution reduction co-benefits but no leakage or spillover. Bounded extrapolation from the pilots suggests 18%–20% reductions can be achieved in non-pilot regions by a national market, which could learn from pilots' experiences to broaden sector coverage and ensure policy consistency and transparency. Regional ETS were able to stabilize emissions with little cost, providing rationale for rapidly developing economies to adopt such systems. Key policy insights Despite being unlinked, regional ETS pilots delivered substantial climate mitigation and local air pollution reduction in China. Policy effects were initially driven by economy-wide mitigation due to policy expectations, followed by ETS-sector mitigation due to carbon pricing. Industries reduced CO2 emissions from energy efficiency improvements and fuel switch. Mitigation was accompanied by little emission leakage or impairment to the economy. Extrapolating mitigation rates in a national market suggests 18%–20% reduction of CO2. [ABSTRACT FROM AUTHOR]

Objective: Research on individuals with brain-computer interface (BCI) presents not only technological challenges but ethical challenges (e.g., psychological aspects) as well. We assessed the mental health of a senile patient with tetraplegia after an invasive implantation of BCI and a long-term daily training, in order to provide new experience about the ethical impact of BCI on users and inform future clinical applications of such devices. Methods: This case was a 71-year-old man with tetraplegia for 2 years. Prior to the implant surgery of BCI, and 1 month, 2 months, 3 months, and 9 months after training, a series of tests for cognition, emotion, social support, sleep, and quality of life were performed to evaluate the patient's mental health. Results: Compared with baseline before surgery, the patients' cognition, emotion, social support, sleep, and quality of life improved after the surgery and the long-term daily training. At 3 months post-training, the patient's cognitive score measured by Mini-mental State Examination reached the cutoff point for cognitive impairment in the elderly. Subjective well-being and quality of life showed a slight decline at 9 months post-training compared with that 3 months post-training but remained above the baseline. Conclusion: This study shows the psychological benefits in a senile patient after an invasive BCI implantation and a long-term daily training. BCI ethics is still in its early stages, and further research is needed to understand emerging psychological states of this specific population. [ABSTRACT FROM AUTHOR]

Industrial ecology (IE) research has well established expertise in accounting for the material stocks, flows, and associated impacts of industrial and consumer activities in a variety of scales and manifestations. As with many other science and social science fields, however, the pathways from IE research findings to policy and business decision‐making are often unclear and unsatisfactory. This issue creates a challenge for the application of industrial ecology to sustainable development. By reviewing several strands of literature, this article investigates alternative ways to generate and use research findings to support decision‐making and social change. It argues that advances in both the core and the emerging methods in IE complement each other to improve transparency and reliability of research evidence; extension and contextualization of current findings corresponding to different stages in policy‐making and organizational decision processes make research evidence more informative; a learning perspective makes research evidence valuable and used in more flexible ways. To better assist decision‐making for societal change, more dialogues between researchers of different methodological cultures and between researchers and other stakeholders and a paradigm shift in social systems for which industrial ecologists should be conscious and proactive are required. [ABSTRACT FROM AUTHOR]

Titanium alloy milling is prone to burrs at the edges of the workpiece, which can negatively affect surface integrity and dimensional accuracy, and even lead to part scrap. Ultrasonic vibration–assisted milling technology can effectively inhibit burr generation and improve machining quality. However, the research of ultrasonic vibration–assisted milling on burr inhibition is not clear, so this paper establishes a mathematical model of ultrasonic vibration vertical milling titanium alloy top burr size based on the chip deformation process and specifically analyses the effect of ultrasonic machining parameters on burr through experiments. The experimental results show that the depth of cut has the greatest influence on the burr size, and the ultrasonic vibration has the second greatest influence on the burr. The cutting force and the burr size on both sides of the groove show a trend of "decrease and then increase" with the increase of ultrasonic amplitude. When the ultrasonic amplitude was 3 µm, the cutting forces Fx and Fy were reduced by 34.42% and 31.36%, respectively, and the heights and widths of the burrs on the up milling side and on the down milling side were reduced by 75.49%, 44.33% and 89.16%, 47.82%, respectively, when comparing with no ultrasonic machining. The longitudinal-torsional ultrasonic vibration converted the large piled-up, rolled-up, and serrated burrs into intermittent, small-sized flocculent burrs, which significantly improved the burr morphology and weakened the serrated characteristics of the chips. [ABSTRACT FROM AUTHOR]

Summary: Circular economy concepts, practices, and policies are increasingly drawing attention as important means for the pursuit of sustainable development. This article uses a conceptual framework to catalogue and investigate policy efforts for the circular economy in China. Based on the framework, policy prototypes and specific examples are identified: resource‐oriented, production‐oriented, waste, and use‐oriented and life cycle policies. A comprehensive review of 280 related policies shows that China has a long history of resource‐oriented policies and implemented production‐oriented policies very quickly after the year 2000. China's policies toward the circular economy became more comprehensive through time, with a broad engagement of government agencies, an extensive and progressive coverage of recycling opportunities, production initiatives across multiple scales, and use of different policy instruments. The continuous progress has been driven by proactive state actors and their learning from the international society. The current policy framework, however, is concerned more with the means rather than the ends of the circular economy, and relies too much on direct subsidies and other financial incentives. Policy making can be improved by more explicit consideration of the whole production life cycle and use of market‐based policy design. [ABSTRACT FROM AUTHOR]

In this study, the PEG-Glu-Lys-Glu copolymer drug delivery system (GO/PEG-Glu-Lys-Glu) is prepared using glutamate-lysine-glutamate (Glu-Lys-Glu) modified polyethylene glycol (PEG) and connected graphene oxide nanosheets (GO). The multiple carboxyl groups of Glu-Lys-Glu and π–π interactions of GO can increase drug loading rate, and the fluorescence characteristics of GO could monitor the distribution of drug-loading systems in cells and the uptake of cells without the need for external dyes. Paclitaxel (PTX) is loaded via reduction-responsive disulfide bonds as a model medicine to examine the drug delivery potential of GO/PEG-Glu-Lys-Glu. The results showed that the drug loading content of PEG-Glu-Lys-Glu and GO/PEG-Glu-Lys-Glu to PTX is 7.11% and 8.97%, and the loading efficiency is 71.05% and 89.68%, respectively. It's speculated that the π–π interaction between GO and PTX improved the drug-loading capacity and efficiency of GO/PEG-Glu-Lys-Glu. In vitro, in a simulated drug release test, at 48 h, the release of PTX was 85.51% at pH 5.0, 65.12% and 38.32% at pH 6.5 and 7.4, respectively. The cytotoxicity assay results showed that GO/PEG-Glu-Lys-Glu cell inhibition rate to MCF-7 cells was 7.36% at 72 h. The cell inhibition rate of GO/PEG-Glu-Lys-Glu/PTX system at 72 h was 92%, equivalent to free PTX. Therefore, the GO/PEG-Glu-Lys-Glu drug delivery system has the characteristics of good biocompatibility and sustainable release of PTX, which is expected to be applied in the field of tumor therapy. [ABSTRACT FROM AUTHOR]

A 43-year-old man was admitted to the emergency department for motor vehicle collision. First clinical impression was traumatic injury of the right eye with bare light perception. A physical examination revealed multiple nodular skin lesions on the head and neck. Head magnetic resonance imaging and computed tomography scans showed intracerebral hemorrhage, trans-orbital brain herniation, and right sphenoid wing dysplasia. A diagnosis of neurofibromatosis type 1 was made. Sphenoid wing dysplasia (also known as bare orbit sign) in neurofibromatosis type 1 was a contributing factor to the trans-orbital herniation, but also helped reduce intracranial pressure after traumatic brain injury in this rare case. Mannitol was administered, and no neurosurgical intervention was needed for traumatic brain injury. Canthorrhaphy of the right eye was performed to preserve patient's right eyeball. At 1-month follow-up, patient's right eyeball was preserved, and vision improved as well. [ABSTRACT FROM AUTHOR]

Technological changes will influence the extent to which China can reduce its energy consumption and carbon emissions without hampering economic development. Based on data of 580 firms in the Top-1000 Enterprise Energy Saving Program during 2006 and 2009, we differentiate between technological change embodied in new production capital and disembodied technological change. We find that both types of changes clearly led to energy efficiency. Firms of domestic ownership and higher profit were more prone to making investment with embodied technological changes. Energy efficiency rates associated with embodied technological change were higher among younger firms and those with more intensive use of energy. Energy saving associated with disembodied technological change was higher in firms of state or foreign ownership, larger scale, orientation toward domestic market, and more intensive use of energy. The findings call for the need to carefully consider the effect of different policy instruments in energy saving, and to track long-term energy statistics at the micro-level. [ABSTRACT FROM AUTHOR]

In this paper, we study the blow-up solutions for the simplified Keller-Segel system modeling chemotaxis. We prove that there is the occurrence of blow-up to the radially symmetric solutions. We also prove that blow-up occur only at the point . [ABSTRACT FROM AUTHOR]

This paper links theoretical perspectives from energy efficiency economics with those observed from corporate environmental strategy to develop a framework for explaining energy efficiency strategies by firms in response to national policies and local regulations in China. The framework is refined through analytic generalization of 20 cases from four industries and four cities in Jiangsu Province, and reveals two strategies: 1) firms with moderate institutional pressure seek incremental competitiveness by adopting energy-saving technologies, which is reinforced by their informational, organizational, and financing capabilities, and facilitated by voluntary policies and industrial competition; 2) firms with survival risk or development constraints under regulation seek a position favored by local governments by replacing old plant and equipment with larger, more efficient ones and contributing to the local community. The Chinese case studies reveal a strong institutional impact on firms' choice of business strategies and particularly the positioning strategy. The identified business strategies shed additional light on the effectiveness and implications of different policy instruments for energy efficiency. [ABSTRACT FROM AUTHOR]

Unilateral tightening of environmental regulation is often considered to cause regulated industries to locate at places with lower compliance cost. The pollution haven effect may be offset, however, when endogenous technical change and factor reallocation can compensate increased compliance cost. This paper identifies the overall effects on industrial activities from provincially differentiated regulation of energy saving in China. Econometric specifications take into account the workings of different policy instruments, quantity and revenue-based measurement of output, policy-induced price effects, and alternative measurement of productivity and competitiveness. Results indicate that an introduction of energy-saving policies leads to loss of output and productivity in energy-intensive industries initially, which is passed on to other industries via markets of capital and energy-intensive goods. Under higher regulation, energy-intensive industries become more capital-intensive, regain productivity more quickly, and increase export rates; other industries become more labor-intensive, recover more slowly, and decrease export rates. Through capital investment and factor reallocation, China's policy has been effective in improving industrial energy efficiency without causing competitive loss or carbon leakage. An incentive-based instrument of differential electricity prices leads to similar effects on industries, implying the possibility for more efficient policy-making. [ABSTRACT FROM AUTHOR]

Highlights: [•] Three development patterns of industrial symbiosis systems are proposed and empirically examined. [•] Industrial symbiosis networks build on and strengthen the disparity of firms’ capability on building symbiotic relations. [•] Due to this disparity, self-organized industrial symbiosis networks favor the most capable firms and grow preferentially. [•] Coordinating agencies improve disadvantaged firms’ capabilities, and change the preferential growth to a homogeneous one. [•] Strong government engagement helps disadvantaged firms and facilitates non-preferential symbiosis development in a region. [ABSTRACT FROM AUTHOR]

The design of optimized nanoparticles offers a promising strategy to enable DNA vaccines to cross various physiological barriers for eliciting a specific and protective mucosal immunity via intranasal administration. Here, we reported a new designed nanoparticle system through incorporating anionic liposomes (AL) into chitosan/DNA (CS/DNA) complexes. With enhanced cellular uptake, the constructed AL/CS/DNA nanoparticles can deliver the anti-caries DNA vaccine pGJA-P/VAX into nasal mucosa. TEM results showed the AL/CS/DNA had a spherical structure. High DNA loading ability and effective DNA protection against nuclease were proved by gel electrophoresis. The surface charge of the AL/CS/DNA depended strongly on pH environment, enabling the intracellular release of loaded DNA via a pH-mediated manner. In comparison to the traditional CS/DNA system, our new design rendered a higher transfection efficiency and longer residence time of the AL/CS/DNA at nasal mucosal surface. These outstanding features enable the AL/CS/DNA to induce a significantly (p<0.01) higher level of secretory IgA (SIgA) than the CS/DNA in animal study, and a longer-term mucosal immunity. On the other hand, the AL/CS/DNA exhibited minimal cytotoxicity. These results suggest that the developed nanoparticles offer a potential platform for DNA vaccine packaging and delivery for more efficient elicitation of mucosal immunity. [ABSTRACT FROM AUTHOR]

Abstract: Industrial ecosystems improve eco-efficiency at the system level through optimizing material and energy flows, which however raises a concern for system resilience because efficiency, as traditionally conceived, not necessarily promotes resilience. By drawing on the concept of resilience in ecological systems and in supply chains, resilience in industrial ecosystems is specified on the basis of a system's ability to maintain eco-efficient material and energy flows under disruptions. Using a network model that captures supply, asset, and organizational dependencies and propagation of disruptions among firms, the resilience, and particularly resistance as an important dimension of resilience, of two real industrial ecosystems and generalized specifications are examined. The results show that an industrial ecosystem is less resistant and less resilient with high inter-firm dependency, preferentially organized physical exchanges, and under disruptions targeted at highly connected firms. An industrial ecosystem with more firms and exchanges is less resistant, but has more eco-efficient flows and potentials, and therefore is less likely to lose its function of eco-efficiency. Taking these determinants for resilience into consideration improves the adaptability of an industrial ecosystem, which helps increase its resilience. [Copyright &y& Elsevier]

Abstract: Motor neurons (MNs) communications are thought to occur primarily through spike bursts and regularly firing action potential trains. Reports of both burst and nonburst firing MNs suggest that these neurons may regularly fire in a variety of controlled output patterns with unique characteristics. Based on the cellular response to somatic current injection in these neurons, four distinct MN subtypes are identified from the spinal ventral horn. Approximately 42% of MNs exhibited regular firing, with minimal current injection (rheobase) exhibited a short latency, and with stronger current intensities exhibited significant spike frequency adaptation (SFA). Another 30% of MNs exhibited delayed onset at rheobase with a weakly-adapting firing pattern as stimulation increased. The remaining 18% and 10% of MNs exhibited transient firing patterns or exhibited irregular firing patterns when strongly depolarized, respectively. Our results provide a basis for improvement in the classification and study of MNs. [Copyright &y& Elsevier]

To reduce pollution and health damages from maritime transportation, fuel content regulation has been enforced in emission control areas and globally. But its effectiveness depends on regulatory differences, which are not reflected in prevailing ex-ante evidence. We evaluate the actual effect and its spatial distribution of fuel content regulation at four Chinese ports, based on regulatory implementation, wind pattern, and pollutants' residence time. The regulation caused immediate mitigation effects from the Shanghai Port, but not other ports that faced no penalty or were subject to earlier, more stringent regulations. Pollution mitigation from the Shanghai Port extended to more than 200 km away, far beyond the empirical focus of local externalities from transportation. We estimate a regulatory cost of 0.77–1.6 billion US dollars, considering causal effects of the regulation on shipping price and throughput. The cost is larger than the price difference from fuel switch, but much smaller than estimated health benefits. [ABSTRACT FROM AUTHOR]

Climate change entails uncertainties in the timing and scale of future impacts, imposing challenges to decision-making with intertemporal trade-offs. When making intertemporal trade-offs, future impacts are often considered distant and discounted in present decision-making and policy design. The future, however, is not only temporally distant but also perceived in culturally and psychologically different ways. Based on national statistics and individual-level survey data, statistical analyses show that both national and individual differences in future orientation affect climate perception and mitigation. At the national level, countries with languages that grammatically highlight the future are associated with higher climate concern, lower carbon emissions and energy use, and more progress in climate mitigation. Individual-level evidence suggests that future orientation helps the public understand complicated climate issues, make more personal mitigation but not necessarily collective action or policy support. The findings indicate the important role that subjective future orientation plays in climate perception and decision-making. Both behavioral intervention and climate communication can be designed based on future orientation to better address climate change. • Climate change features both interpersonal and intertemporal trade-offs. • Future perception is of cultural and psychological difference to affect decision. • We show national language speaking associates with climate perception and mitigation. • The effect is likely from future orientation and abstraction of climate change. • The effect is not likely from perceived timing precision of climate change. [ABSTRACT FROM AUTHOR]

It is critical to have an accurate prediction of surface roughness (Sa) in order to improve grinding productivity, reduce costs, and minimize the period of time required for trials and testing. Although many prediction methods have been developed, fewer studies have been conducted on the prediction of surface roughness in longitudinal ultrasonic vibration-assisted grinding (LUVAG). In this paper, a surface roughness prediction model algorithm based on ensemble learning of support vector machines (ELSVM) is proposed that can be used for surface roughness prediction of LUVAG alumina ceramics. This paper first details the development of the ELSVM surface roughness prediction model, which consists of four modules: the prepossessing module, the multi-algorithm regression module, the support vector machine algorithm (SVM) module, and the ensemble module. In addition, ELSVM was compared with four other machine learning methods based on experimental results for surface roughness prediction modeling. The error of ELSVM model was reduced by 6.3%, 7.9%, 8.9%, and 7.5%, respectively, compared to the individual prediction models such as I-AISPSO, I-AIS, SPSO, and KBaNN. Comparison results show that the ELSVM model has the lowest average ratio of Mean Absolute Error (MAE) for surface roughness prediction in LUVAG. • The artificial immune particle swarm optimization is improved. • The adaptive particle swarm optimization algorithm and the manual free algorithm are combined in parallel. • A surface roughness prediction model of support vector machine based on ensemble learning algorithm is proposed. • Longitudinal ultrasonic assisted grinding can reduce surface roughness. [ABSTRACT FROM AUTHOR]

Ultrasonic vibration–assisted grinding is an effective method for improving the surface quality of brittle and hard materials. The grinding force is one of the key factors affecting the surface quality of the machined surface, and this has been investigated both experimentally and theoretically. However, the influence of process parameters on grinding forces during longitudinal ultrasonic vibration-assisted grinding (LUVAG) of alumina ceramics has not been studied in depth. To investigate the effects of various parameters on the grinding forces of LUVAG of alumina ceramics, the kinematic theory of LUVAG was combined with the effective cutting trajectory of transient single-grain abrasives and the effective removal of transient material to develop a LUVAG alumina ceramic grinding force model and a LUVAG endface grinding force model. The experimental results showed that the grinding depth (ap) and table speed (vw) were positively correlated with the tangential grinding force (Ft) and the normal grinding force (Fn) (when vw increased from 400 to 1000 mm/min, Ft increased by about 10 to 15% and Fn increased by 30 to 45%; when ap increased from 5μm to 20μm, Ft increased by 20 to 30%, Fn increases by 25 to 30%). The ultrasonic amplitude (A) is negatively correlated with the grinding force (when A increases from 4 to 12μm, Ft decreases by 5 to 10% and Fn decreases by 25 to 30%). The grinding wheel speed (vs) was positively correlated with Ft but negatively correlated with Fn (when the grinding wheel speed increased from 1400 to 3500r/min, Ft increased by 20 to 36% and Fn decreased by 30 to 46%). According to the range analysis, Ft is the minimum when ap=5μm, vs =1400 r/min, A=12μm, vw=600 mm/min, and Fn is the minimum when ap =5μm, vs =3500 r/min, vw =600 mm/min, A=12μm. The results of the theoretical model calculations show that the predicted values of the grinding forces for the given parameters are in general agreement with the experimental results. The maximum relative mean error between the theoretical and experimental results was 12.3%, while the overall relative mean error was 4.94%. At the same time, it was demonstrated that the model can assist orthogonal experiments for factor selection and scheme optimization, which has important practical application value. [ABSTRACT FROM AUTHOR]

Accurately identification of the seizure onset zone (SOZ) is pivotal for successful surgery in patients with medically refractory epilepsy. The purpose of this study is to improve the performance of model predicting the epilepsy surgery outcomes using genetic neural network (GNN) model based on a hybrid intracranial electroencephalography (iEEG) marker. We extracted 21 SOZ related markers based on iEEG data from 79 epilepsy patients. The least absolute shrinkage and selection operator (LASSO) regression was employed to integrated seven markers, selected after testing in pairs with all 21 biomarkers and 7 machine learning models, into a hybrid marker. Based on the hybrid marker, we devised a GNN model and compared its predictive performance for surgical outcomes with six other mainstream machine-learning models. Compared to the mainstream models, underpinning the GNN with the hybrid iEEG marker resulted in a better prediction of surgical outcomes, showing a significant increase of the prediction accuracy from approximately 87% to 94.3% (P = 0.0412). This study suggests that the hybrid iEEG marker can improve the performance of model predicting the epilepsy surgical outcomes, and validates the effectiveness of the GNN in characterizing and analyzing complex relationships between clinical data variables. [ABSTRACT FROM AUTHOR]

A technique called arch-clamping was used at our institute to ensure perfusion of the lower body and brain during total arch replacement with frozen elephant trunk (TAR and FET). The aortic arch clamp is inserted between the left common carotid artery and the left subclavian artery after inserting the stented elephant trunk into the true lumen of the descending aorta during the procedure, and then clamps the aorta and graft together as the distal anastomotic edge of the aorta. After the arch clamp was in place, lower body perfusion was resumed through the femoral artery was resumed and time to circulatory arrest was reduced to approximately 4 min. Cardiopulmonary bypass (CPB) flow was gradually restored to full rate. Thereafter, the left carotid artery anastomosis was completed and rewarming began. Finally, during the rewarming period, other branches of the aortic arch and ascending aorta were reconstructed. In this paper, we describe the perfusion management strategy, discuss intraoperative monitoring parameters, and examine the feasibility of the technique from a perfusion perspective. [ABSTRACT FROM AUTHOR]

Objectives: Aortobronchial fistula (ABF) is rare but lethal condition if left untreated, and the treatment still remains challenging. We retrospectively reviewed data at our Institution and report our experience in the management of ABF.Methods: From September 2010 to May 2019, 14 patients (13 men, average age 52 ± 11 years) with ABF were treated in our hospital. Three types of management were applied according to the patients' different clinical presentation, including conservative treatment, that is, antibiotic treatment (n = 3), endovascular repair (n = 7), and open surgery (n = 4). In the open surgery group, Dacron grafts were used, two cases received in situ descending thoracic aortic replacement through left thoracotomy and two cases received extra-anatomic bypass through median thoracoabdominal incision.Results: In the conservative treatment group (n = 3), two patients died during follow-up, the third was alive in good condition. In the endovascular repair group (n = 7), one patient died 22 days after the endovascular repair because of massive hemoptysis and another patient died 4 days after the procedure because of cerebral infarction. In the medium term, two patients died of massive hemoptysis, and one was lost at follow-up. In the open surgery group (n = 4), one patient died because of massive hemoptysis 2 days after his extra-anatomic bypass procedure, the remaining patients were alive in good condition at follow-up.Conclusions: ABF is catastrophic if left untreated. Endovascular repair might be a reasonable temporary bridge solution in emergency cases, but is less durable in the long run. Open surgery, despite more challenging, provides a more definitive treatment for ABF. [ABSTRACT FROM AUTHOR]

• A clear assessment of the efficacy of nudges in reducing food waste is needed to allow evidence-based policymaking. • The overall effect of nudges on food waste reduction is a 0.38 SD (Cohen's d), with behaviorally-oriented nudges garnering stronger effects than cognitively-oriented nudges. • The effectiveness of nudges can be reinforced when applied in public (vs. private) settings and is comparable among U.S. and non-U.S. samples. Food waste is a global concern and is increasingly addressed by various policies and campaigns, especially in the consumption stage. Among these efforts, a promising instrument is gentle interventions based on nudges. To investigate whether and how a nudge works, we develop a theoretical framework and conduct a meta-analysis to synthesize empirical effects of nudges on reducing consumption food waste. The meta-analysis's summary effect size of cognitively-oriented nudges is a 0.27 SD (Cohen's d) reduction in food waste, and that of behaviorally-oriented ones is a 0.54 SD reduction. The effects of nudges are robust across sampled populations (i.e., U.S. vs. non-U.S. samples) but vary across settings (i.e., public vs. private). We further map nudge interventions to the driving factors of food waste behaviors and reveal potential research gaps in the literature. Based on these findings, we discuss implications for policy making to reduce food waste. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES The aim of this study was to investigate the early and long-term outcomes after total arch replacement (TAR) and frozen elephant trunk (FET) implantation in adult patients ≤30 years with acute type A aortic dissection (ATAAD). METHODS All young adult patients (≤30 years) with ATAAD who underwent TAR and FET between 2009 and 2017 were enrolled. The end points were major organ morbidity and mortality, aortic-related events and reoperation. RESULTS The mean age of all 83 patients was 25.9 (standard deviation, 3.3) years. The in-hospital mortality was 9.64% (8/83), and 9 (10.8%) patients required re-exploration for bleeding. The aortic-related events risk was 42.7% (32/75) and the aortic reoperation risk was 17.3% (13/75). Overall survival was 85.5% [95% confidence interval (CI), 75.9–91.5%] at 5 years and 75.9% (95% CI, 63.3–84.7%) at 10 years. The cumulative incidence of aortic-related events was 35% (95% CI, 24–47%) at 5 years and 58% (95% CI, 36–75%) at 10 years; the cumulative reoperation rate was 15% (95% CI, 7.9–24%) at 5 years and 17% (95% CI, 9.2–27%) at 10 years. Marfan syndrome significantly increased the aortic-related events (P  =   0.036) and reoperation (P  =   0.041) risks. CONCLUSIONS Despite extensive repair in young ATAAD patients, the late aortic dilatation and reoperation risk remain high. The TAR and FET procedures achieved satisfactory early outcomes and reduced late aortic dilatation and reoperation in young patients compared with other records. Close follow-up and aggressive early reintervention are essential for patients with aortic-related risk factors early in life. [ABSTRACT FROM AUTHOR]

The detection of Coronavirus disease 2019 (COVID-19) is crucial for controlling the spread of the virus. Current research utilizes X-ray imaging and artificial intelligence for COVID-19 diagnosis. However, conventional X-ray scans expose patients to excessive radiation, rendering repeated examinations impractical. Ultra-low-dose X-ray imaging technology enables rapid and accurate COVID-19 detection with minimal additional radiation exposure. In this retrospective cohort study, ULTRA-X-COVID, a deep neural network specifically designed for automatic detection of COVID-19 infections using ultra-low-dose X-ray images, is presented. The study included a multinational and multicenter dataset consisting of 30,882 X-ray images obtained from approximately 16,600 patients across 51 countries. It is important to note that there was no overlap between the training and test sets. The data analysis was conducted from 1 April 2020 to 1 January 2022. To evaluate the effectiveness of the model, various metrics such as the area under the receiver operating characteristic curve, receiver operating characteristic, accuracy, specificity, and F1 score were utilized. In the test set, the model demonstrated an AUC of 0.968 (95% CI, 0.956–0.983), accuracy of 94.3%, specificity of 88.9%, and F1 score of 99.0%. Notably, the ULTRA-X-COVID model demonstrated a performance comparable to conventional X-ray doses, with a prediction time of only 0.1 s per image. These findings suggest that the ULTRA-X-COVID model can effectively identify COVID-19 cases using ultra-low-dose X-ray scans, providing a novel alternative for COVID-19 detection. Moreover, the model exhibits potential adaptability for diagnoses of various other diseases. [ABSTRACT FROM AUTHOR]

Objective: To analyze the effect of sex on the short-time prognosis in two different age subgroups (≤55 years old and >55 years old). Methods: From January 2009 to 2019, 1522 patients with DeBakey I acute aortic dissection (AAD) underwent frozen elephant trunk and total arch replacement at a Tertiary Center in China were divided into female group (n = 324) and male group (n = 1198). The demographic characteristics, clinical presentation, management, short-term outcomes were described in the different sex groups. The risk factors of 30-days mortality for females and males were identified by univariate and multivariable logistic regression analysis. Then, random Forest regression was used to analyze the association between age and 30-days mortality in the different sexes groups. The cut-off age for 30-days mortality in females was then identified as 55 years. The patients were divided into two subgroups: young patients (≤55 years old) and elderly patients (>55 years old). Clinical prognosis between different sex groups was further compared in the age subgroups. Results: Approximately four-fifths of the patients were males. Males with DeBakey I AAD were younger than females (47 vs 52 years; p < 0.01). The proportion of males gradually declined with age. The cut-off age for 30-days mortality in females and males was identified as 55 years old and 63 years old, respectively. In young patients (≤55 years old), the 30-days mortality rate for females was lower than males (hazard ratio [HR, 2.02, p < 0.05). Following adjustment using the multivariable Cox regression analysis, females were identified as an independent protective factor for 30-days mortality (HR, 2.24, p = 0.03). Conclusions: Our study showed that females present with DeBakey I AAD less frequently than males and they tend to present with DeBakey AAD later in life. In young patients, females had better early outcomes despite similar time for symptom onset to diagnosis and surgical technique than males. [ABSTRACT FROM AUTHOR]

The open anastomosis technique has become more popular since it was first used in hemiarch replacement; however, hypothermic circulatory arrest is unavoidable. This institution performed a novel surgical technique called the arch-clamping technique. It has been used in the treatment of patients with ascending aortic aneurysm extending to the proximal aortic arch and avoids the use of hypothermic circulatory arrest. Thirty patients had a hemiarch replacement with the arch-clamping technique from 2021 to 2022; all of them were discharged uneventfully. [ABSTRACT FROM AUTHOR]

Subcallosal cingulate gyrus (SCG) is a target of deep brain stimulation (DBS) for treatment‐resistant depression. However, previous randomized controlled trials report that approximately 42% of patients are responders to this therapy of last resort, and suboptimal targeting of SCG is a potential underlying factor to this unsatisfactory efficacy. Tractography has been proposed as a supplementary method to enhance targeting strategy. We performed a connectivity‐based segmentation in the SCG region via probabilistic tractography in 100 healthy volunteers from the Human Connectome Project. The SCG voxels with maximum connectivity to brain regions implicated in depression, including Brodmann Area 10 (BA10), cingulate cortex, thalamus, and nucleus accumbens were identified, and the conjunctions were deemed as tractography‐based targets. We then performed deterministic tractography using these targets in additional 100 volunteers to calculate streamline counts compassing to relevant brain regions and fibers. We also evaluated the intra‐ and inter‐subject variance using test–retest dataset. Two tractography‐based targets were identified. Tractography‐based target‐1 had the highest streamline counts to right BA10 and bilateral cingulate cortex, while tractography‐based target‐2 had the highest streamline counts to bilateral nucleus accumbens and uncinate fasciculus. The mean linear distance from individual tractography‐based target to anatomy‐based target was 3.2 ± 1.8 mm and 2.5 ± 1.4 mm in left and right hemispheres. The mean ± SD of targets between intra‐ and inter‐subjects were 2.2 ± 1.2 and 2.9 ± 1.4 in left hemisphere, and 2.3 ± 1.4 and 3.1 ± 1.7 in right hemisphere, respectively. Individual heterogeneity as well as inherent variability from diffusion imaging should be taken into account during SCG‐DBS target planning procedure. [ABSTRACT FROM AUTHOR]

Estimating the causal effects of China's environmental regulation on air quality is of great importance for developing effective and efficient policies. Our study first compared the evaluation approaches used in applied econometrics, and environmental science and engineering. It then assessed the environmental effectiveness of the recently strengthened air pollution regulation in China, by developing quasi-experimental designs based on the pollution control programs for the APEC Meeting and the Victory-day Parade. We empirically confirmed that the regulation brought a short-term, substantial improvement in air quality in Beijing. Compared with the hypothetical situation in the absence of the programs, the Victory-day Parade regulation reduced AQI by 37.4%, and the daily average concentrations of PM 2.5 , PM 10 , O 3 , SO 2 , NO 2 , and CO by 55.8%, 50.1%, 27.2%, 35.9%, 39.9%, and 28.8%, respectively; the APEC regulation brought down the AQI by 35.9%, and the concentrations of PM 2.5 , PM 10 , SO 2 , NO 2 , and CO by 41.3%, 48.2%, 56.5%, 38.9%, and 35.5%, respectively. Further analyses of 70 cities in North China found that the effects in the assigned key control areas were greater than those in the ordinary control areas. Our study enriches the assessments of the regulatory experimentations for the two important events, and demonstrates the strengths of using the quasi-experimental approach to execute quick and reliable ex post evaluation of environmental regulation in China. It also summarizes our first-step, exploratory progress in the challenging communication among the policy-evaluation perspectives and methodologies of different disciplines. [ABSTRACT FROM AUTHOR]

Targeted optical neural stimulation comprises infrared neural stimulation and optogenetics, which affect the nervous system through induced thermal transients and activation of light-sensitive proteins, respectively. The main advantage of this pair of optical tools is high functional selectivity, which conventional electrical stimulation lacks. Over the past 15 years, the mechanism, safety, and feasibility of optical stimulation techniques have undergone continuous investigation and development. When combined with other methods like optical imaging and high-field functional magnetic resonance imaging, the translation of optical stimulation to clinical practice adds high value. We review the theoretical foundations and current state of optical stimulation, with a particular focus on infrared neural stimulation as a potential bridge linking optical stimulation to personalized medicine. [ABSTRACT FROM AUTHOR]

Objective: Sleep strongly activates interictal epileptic activity through an unclear mechanism. We investigated how scalp sleep slow waves (SSWs), whose positive and negative half‐waves reflect the fluctuation of neuronal excitability between the up and down states, respectively, modulate interictal epileptic events in focal epilepsy. Methods: Simultaneous polysomnography was performed in 45 patients with drug‐resistant focal epilepsy during intracranial electroencephalographic recording. Scalp SSWs and intracranial spikes and ripples (80–250 Hz) were detected; ripples were classified as type I (co‐occurring with spikes) or type II (occurring alone). The Hilbert transform was used to analyze the distributions of spikes and ripples in the phases of SSWs. Results: Thirty patients with discrete seizure‐onset zone (SOZ) and discernable sleep architecture were included. Intracranial spikes and ripples accumulated around the negative peaks of SSWs and increased with SSW amplitude. Phase analysis revealed that spikes and both ripple subtypes in SOZ were similarly facilitated by SSWs exclusively during down state. In exclusively irritative zones outside SOZ (EIZ), SSWs facilitated spikes and type I ripples across a wider range of phases and to a greater extent than those in SOZ. The type II and type I ripples in EIZ were modulated by SSWs in different patterns. Ripples in normal zones decreased specifically during the up‐to‐down transition and then increased after the negative peak of SSW, with a characteristically high post‐/pre‐negative peak ratio. Significance: SSWs modulate interictal events in an amplitude‐dependent and region‐specific pattern. Pathological ripples and spikes were facilitated predominantly during the cortical down state. Coupling analysis of SSWs could improve the discrimination of pathological and physiological ripples and facilitate seizure localization. [ABSTRACT FROM AUTHOR]

There are relatively few articles on the relationship between serum albumin and acute kidney injury (AKI). Therefore, the objective of this research was to study the relationship between serum albumin and AKI in patients who were undergoing surgery for acute type A aortic dissection. Methods: We retrospectively collected data from 624 patients attending a Chinese hospital between January 2015 and June 2017. The target independent variable was serum albumin measured before surgery after hospital admission, and the dependent variable was AKI, defined in accordance with the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Results: The mean age of these 624 selected patients was 48.5 ± 11.1 years, and almost 73.7% were male. A nonlinear association was detected between serum albumin and AKI; the turning point was 32 g/L. The risk of AKI decreased gradually as the serum albumin level increased up to 32 g/L (adjusted OR = 0.87; 95% CI 0.82–0.92; p < 0.001). When the serum albumin level exceeded 32 g/L, the level of serum albumin was not associated with the risk of AKI (OR = 1.01, 95% CI 0.94–1.08; p = 0.769). Conclusions: The findings suggest that preoperative serum albumin below 32 g/L was an independent risk factor for AKI in patients undergoing surgery for acute type A aortic dissection. Trial registration: A retrospective cohort study. [ABSTRACT FROM AUTHOR]

Automatic detection of epileptic seizures is important in epilepsy control and treatment, and specific feature extraction assists in accurate detection. We developed a feature extraction method for seizure detection based on multi-site synchronous changes and an edge detection algorithm. We investigated five chronic temporal lobe epilepsy rats with 8- and 12-channel detection sites in the hippocampus and limbic system. Multi-site synchronous changes were selected as a specific feature and implemented as a seizure detection method. For preprocessing, we used magnitude-squared coherence maps and Canny edge detection algorithm to find the frequency band with the most significant change in synchronization and the important channel pairs. In detection, we used the maximal cross-correlation coefficient as an indicator of synchronization and the correlation coefficient curves' average value and standard deviation as two detection features. The method achieved high performance, with an average 96.60% detection rate, 2.63/h false alarm rate, and 1.25 s detection delay. The experimental results show that synchronization is an appropriate feature for seizure detection. The magnitude-squared coherence map can assist in selecting a specific frequency band and channel pairs to enhance the detection result. We found that individuals have a specific frequency band that reflects the most significant synchronization changes, and our method can individually adjust parameters and has good detection performance. [ABSTRACT FROM AUTHOR]

Objective: Brain-machine interfaces (BMIs) aim to provide direct brain control of devices such as prostheses and computer cursors, which have demonstrated great potential for motor restoration. One major limitation of current BMIs lies in the unstable performance due to the variability of neural signals, especially in online control, which seriously hinders the clinical availability of BMIs. Method: We propose a dynamic ensemble Bayesian filter (DyEnsemble) to deal with the neural variability in online BMI control. Unlike most existing approaches using fixed models, DyEnsemble learns a pool of models that contains diverse abilities in describing the neural functions. In each time slot, it dynamically weights and assembles the models according to the neural signals in a Bayesian framework. In this way, DyEnsemble copes with variability in signals and improves the robustness of online control. Results: Online BMI experiments with a human participant demonstrate that, compared with the velocity Kalman filter, DyEnsemble significantly improves the control accuracy (increases the success rate by 13.9% in the random target pursuit task) and robustness (performs more stably over different experiment days). Conclusion: Experimental results demonstrate the superiority of DyEnsemble in online BMI control. Significance: DyEnsemble frames a novel and flexible dynamic decoding framework for robust BMIs, beneficial to various neural decoding applications. [ABSTRACT FROM AUTHOR]

We present an implantable brain-computer interface surgical case assisted by robotic navigation system in an elderly patient with tetraplegia caused by cervical spinal cord injury. Left primary motor cortex was selected for implantation of microelectrode arrays based on fMRI location of motor imagery. Robotic navigation system was used during this procedure for precise and stable manipulation. A design of bipartite incision was made to reduce the risk of surgery-related infection and facilitate BCI training. At 1-year follow-up, the neural signals were robust, and this patient was able to control three-dimensional movement of a prosthetic limb without any complications. [ABSTRACT FROM AUTHOR]

Background: Accurate electrode targeting was essential for the efficacy of deep brain stimulation (DBS). There is ongoing debate about the necessary of microelectrode recording (MER) in subthalamic nucleus (STN)-DBS surgery for accurate targeting. Objective: This study aimed to analyze the accuracy of imaging-guided awake DBS with MER in STN for Parkinson's disease in a single center. Methods: The authors performed a retrospective analysis of 161 Parkinson's disease patients undergoing STN-DBS at our center from March 2013 to June 2021. The implantation was performed by preoperative magnetic resonance imaging (MRI)-based direct targeting with intraoperative MER and macrostimulation testing. 285 electrode tracks with preoperative and postoperative coordinates were included to calculate the placement error in STN targeting. Results: 85.9% of electrodes guided by preoperative MRI were implanted without intraoperative adjustment. 31 (10.2%) and 12 (3.9%) electrodes underwent intraoperative adjustment due to MER and intraoperative testing, respectively. We found 86.2% (245/285) of electrodes with trajectory error ≤2 mm. The MER physiological signals length < 4 mm and ≥4 mm group showed trajectory error > 2 mm in 38.0% and 8.8% of electrodes, respectively. Compared to non-adjustment electrodes, the final positioning of MER-adjusted electrodes deviated from the center of STN. Conclusion: The preoperative MRI guided STN targeting results in approximately 14% cases that require electrode repositioning. MER physiological signals length < 4 mm at first penetration implied deviation off planned target. MER combined with intraoperative awake testing served to rescue such deviation based on MRI alone. [ABSTRACT FROM AUTHOR]

Background: Low-grade epilepsy-associated neuroepithelial tumor (LEAT) is highly responsive to surgery in general. The appropriate surgical strategy remains controversial in temporal LEAT. The aim of this study is to analyze the surgical seizure outcome of temporal LEAT, focusing on the aspects of surgical strategy. Methods: Sixty-one patients from a single epilepsy center with temporal LEAT underwent surgery. The surgical strategy was according to the multidisciplinary presurgical evaluation. Electrocorticogram (ECoG)-assisted resection was utilized. Surgical extent including lesionectomy and extended resection was described in detail. Seizure outcome was classified as satisfactory (Engel class I) and unsatisfactory (Engel classes II–IV). Results: After a median follow-up of 36.0 (30.0) months, 83.6% of patients achieved satisfactory outcome, including 72.1% with Engel class Ia. There was 39.3% (24/61) of patients with antiepileptic drug (AED) withdrawal. Use of ECoG (χ2 = 0.000, P > 0.1), preresection spike (χ2 = 0.000, P = 0.763), or spike residue (P = 0.545) was not correlated with the seizure outcome. For lateral temporal LEAT, outcome from lesionectomy was comparable to extended resection (χ2 = 0.499, P > 0.1). For mesial temporal LEAT, 94.7% (18/19) of patients who underwent additional hippocampectomy were satisfactory, whereas only 25% (1/4) of patients who underwent lesionectomy were satisfactory (P = 0.009). Conclusion: Surgical treatment was highly effective for temporal LEAT. ECoG may not influence the seizure outcome. For lateral temporal LEAT, lesionectomy with or without cortectomy was sufficient in most patients. For mesial temporal LEAT, extended resection was recommended. [ABSTRACT FROM AUTHOR]

Background: PET imaging has been widely used in diagnosis of neurological disorders; however, its application to pediatric population is limited due to lacking pediatric age–specific PET template. This study aims to develop a pediatric age–specific PET template (PAPT) and conduct a pilot study of epileptogenic focus localization in pediatric epilepsy. Methods: We recruited 130 pediatric patients with epilepsy and 102 age-matched controls who underwent 18F-FDG PET examination. High-resolution PAPT was developed by an iterative nonlinear registration-averaging optimization approach for two age ranges: 6–10 years (n = 17) and 11–18 years (n = 50), respectively. Spatial normalization to the PAPT was evaluated by registration similarities of 35 validation controls, followed by estimation of potential registration biases. In a pilot study, epileptogenic focus was localized by PAPT-based voxel-wise statistical analysis, compared with multi-disciplinary team (MDT) diagnosis, and validated by follow-up of patients who underwent epilepsy surgery. Furthermore, epileptogenic focus localization results were compared among three templates (PAPT, conventional adult template, and a previously reported pediatric linear template). Results: Spatial normalization to the PAPT significantly improved registration similarities (P < 0.001), and nearly eliminated regions of potential biases (< 2% of whole brain volume). The PAPT-based epileptogenic focus localization achieved a substantial agreement with MDT diagnosis (Kappa = 0.757), significantly outperforming localization based on the adult template (Kappa = 0.496) and linear template (Kappa = 0.569) (P < 0.05). The PAPT-based localization achieved the highest detection rate (89.2%) and accuracy (80.0%). In postsurgical seizure-free patients (n = 40), the PAPT-based localization also achieved a substantial agreement with resection areas (Kappa = 0.743), and the highest detection rate (95%) and accuracy (80.0%). Conclusion: The PAPT can significantly improve spatial normalization and epileptogenic focus localization in pediatric epilepsy. Future pediatric neuroimaging studies can also benefit from the unbiased spatial normalization by PAPT. Trial registration. NCT04725162: https://clinicaltrials.gov/ct2/show/NCT04725162 [ABSTRACT FROM AUTHOR]

The demons algorithm is a popular algorithm for non-rigid image registration because of its computational efficiency and simple implementation. The deformation forces of the classic demons algorithm were derived from image gradients by considering the deformation to decrease the intensity dissimilarity between images. However, the methods using the difference of image intensity for medical image registration are easily affected by image artifacts, such as image noise, non-uniform imaging and partial volume effects. The gradient magnitude image is constructed from the local information of an image, so the difference in a gradient magnitude image can be regarded as more reliable and robust for these artifacts. Then, registering medical images by considering the differences in both image intensity and gradient magnitude is a straightforward selection. In this paper, based on a diffeomorphic demons algorithm, we propose a chain-type diffeomorphic demons algorithm by combining the differences in both image intensity and gradient magnitude for medical image registration. Previous work had shown that the classic demons algorithm can be considered as an approximation of a second order gradient descent on the sum of the squared intensity differences. By optimizing the new dissimilarity criteria, we also present a set of new demons forces which were derived from the gradients of the image and gradient magnitude image. We show that, in controlled experiments, this advantage is confirmed, and yields a fast convergence. [ABSTRACT FROM AUTHOR]

Objective: T cell-mediated immune response plays a key role in Takayasu arteritis (TAK). Although previous studies have showed the roles of CD4+T cell and its subsets in TAK, the change of CD8+ T cell subsets remains unclear. This study investigated the role of CD8+ T cell subsets in TAK. Methods: The study consisted of 56 TA patients and 51 healthy controls. The percentages of CD8+T cells, CD8+GranzymeB+ T cells, CD8+Perforin+ T cells, and CD8+IFN-γ+ T cells in blood samples were analyzed by flow cytometry. Results: We found that the percentages of CD8+GranzymeB+ T cells (P = 0.030), CD8+Perforin+ T cells (P = 0.000), and CD8+IFN-γ+ T cells (P = 0.002) in CD8+T cells were higher in TAK patients compared to control group. After 6 months of treatment, the proportion of CD8+T cells in lymphocytes were significantly lower in TAK patients than the baseline assessment (P = 0.033). A lower ratio of CD8+GranzymeB+ T cells/CD8+ T cells were showed in TAK patents after treatment compared with TAK patients before treatments (P = 0.011). The change of CD8+GranzymeB+ T cells/CD8+ T cells ratio was positively correlated with the change of ITAS (r = 0.721, P = 0.002) and ITAS-A (r = 0.637, P = 0.008). Finally, the immunofluorescence staining showed the infiltration of CD8+ Granzyme B + cells in the aortic tissue of TAK patients. Conclusion: Our results disclose that the CD8+ T lymphocytes may play a role in TAK pathogenesis. Targeting CD8+GranzymeB+ T lymphocytes or Granzyme B inhibitors could be a potential therapeutic approach for the treatment of TAK. Key Points • Our study investigated role the of CD8+T cell subsets in TAK. • We found the percentages of CD8+GranzymeB+T cells, CD8+Perforin+T cells, and CD8+IFN-γ+T cells in CD3+CD8+T cells were higher in TAK patients. • The proportion of CD8+T cells in lymphocytes and the ratio of CD8+GranzymeB+T cells/CD8+T cells were significantly lower in TAK patients after treatment. [ABSTRACT FROM AUTHOR]

Recent studies showed that the local field potential (LFP) in motor cortex carries information about parameters of limb movements and could be used as a candidate neural signal in brain-machine interfaces to control external devices. However, it is yet to be clear how much information LFP can offer and how it can be effectively used in BMIs. In this article, we systematically evaluated the decoding performance of combining LFP and single-unit activity (SUA) from the primary motor cortex of rats performing the lever-pressing task. The results showed that the decoding power could be significantly improved by combining SUA and LFP in the time-frequency mode, which is based on the separation of LFP into multiple frequency bands. Furthermore, we found that using all frequency bands might be the best choice because it yielded better or no significantly worse results than using low or high frequency bands only. This implies that different frequency components of LFP carry different information. Moreover, we demonstrated that the combination could stabilize the decoding performance even if SUA disappears over time. These results suggest that the different frequency components in the LFP play different roles in kinematics decoding and the combination of LFPs and SUA could be a promising strategy for improving neural decoding in brain-machine interfaces.© 2011 Wiley Periodicals, Inc. Int J Imaging Syst Technol, 21, 165-172, 2011 [ABSTRACT FROM AUTHOR]

Deep learning techniques have led to significant advancements in seizure prediction research. However, corresponding used benchmarks are not uniform in published results. Moreover, inappropriate training and evaluation processes used in various work create overfitted models, making prediction performance fluctuate or unreliable. In this study, we analyzed the various data preparation methods, dataset partition methods in related works, and explained the corresponding impacts to the prediction algorithms. Then we applied a robust processing procedure that considers the appropriate sampling parameters and the leave-one-out cross-validation method to avoid possible overfitting and provide prerequisites for ease benchmarking. Moreover, a deep learning architecture takes advantage of a one-dimension convolutional neural network and a bi-directional long short-term memory network is proposed for seizure prediction. The architecture achieves 77.6% accuracy, 82.7% sensitivity, and 72.4% specificity, and it outperforms the indicators of other prior-art works. The proposed model is also hardware friendly; it has 6.274 k parameters and requires only 12.825 M floating-point operations, which is advantageous for memory and power constrained device implementations. [ABSTRACT FROM AUTHOR]

Purpose: Positron emission tomography (PET) with 18F-fluorodeoxyglucose ([18F]-FDG) has been increasingly applied in precise localization of epileptogenic focus in epilepsy patients, including pediatric patients. The aim of this international consensus is to provide the guideline and specific considerations for [18F]-FDG PET in pediatric patients affected by epilepsy. Methods: An international, multidisciplinary task group is formed, and the guideline for brain [18F]-FDG PET/CT in pediatric epilepsy patients has been discussed and approved, which include but not limited to the clinical indications, patient preparation, radiopharmaceuticals and administered activities, image acquisition, image processing, image interpretation, documentation and reporting, etc. Conclusion: This is the first international consensus and practice guideline for brain [18F]-FDG PET/CT in pediatric epilepsy patients. It will be an international standard for this purpose in clinical practice. [ABSTRACT FROM AUTHOR]

Objectives: Low‐grade tumors are the most common neoplasms inducing focal epilepsy; however, the short‐ and medium‐term efficacy of surgery in epilepsy patients with low‐grade tumors remains underappreciated. This study aims to summarize the clinical characteristics of epilepsy patients with low‐grade tumors and to identify factors associated with postsurgical seizure‐free outcomes. Methods: We retrospectively reviewed consecutive patients with low‐grade tumors who underwent subsequent epilepsy surgery in our epilepsy center, between 2012 and 2018 with a minimum follow‐up of 1 year. Using Engel's classification and Kaplan–Meier survival analysis, we assessed postoperative seizure freedom over time. Demographical, electroclinical, and other presurgical evaluations were then evaluated for association with postoperative seizure outcome. Results: The cohort included a total of 132 patients: 79 males and 53 females. Among them, 110 (83.33%) were seizure‐free through their last follow‐up. The Engel class I outcomes were 90.15%, 87.76%, 85.53%, 82.46%, and 73.17% at the end of the 1st, 2nd, 3rd, 4th, and 5th postoperative years, respectively. Multivariate logistic analysis revealed that longer epilepsy duration (p < 0.001, OR 1.091, 95% CI 1.040–1.144) and incomplete resection (p = 0.009, OR 3.673, 95% CI 1.393–9.684) were independently associated with seizure recurrence through the last follow‐up. Conclusions: Surgical treatment for seizure control in patients with low‐grade tumors provides excellent short‐ and median‐term outcomes. [ABSTRACT FROM AUTHOR]

Given the rising incidence of stroke, several technology‐driven methods for rehabilitation have recently been developed. Virtual reality (VR) is a promising therapeutic technology among them. We recently developed a neuroscientifically grounded VR system to aid recovery of motor function poststroke. The developed system provides unilateral and bilateral upper extremity (UE) training in a fully immersive virtual environment that may stimulate and activate mirror neurons (MNs) in the brain necessary for UE rehabilitation. Twenty‐three participants were randomized to a VR group (n = 12) to receive VR intervention (8 h within 2 weeks) plus 8‐h occupational therapy (OT) or a control group (n = 11) to receive time‐matched OT alone. Treatment effects on motor recovery and cortical reorganization were investigated using the Barthel Index (BI), Fugl‐Meyer Upper Extremity (FM‐UE), and resting‐state fMRI. Both groups significantly improved BI (P < 0.05), reflecting the recovery of UE motor function. The VR group revealed significant improvements on FM‐UE scores (P < 0.05) than the control group. Neural activity increased after the intervention, particularly in the brain areas implicating MNs, such as in the primary motor cortex. Overall, results suggested that using a neuroscientifically grounded VR system might offer additional benefits for UE rehabilitation in patients receiving OT. [ABSTRACT FROM AUTHOR]

Background: Aortic arch surgery and obesity are both related to the risk of acute kidney injury. Our hypothesis was that the risk of postoperative acute kidney injury increases as body mass index increases in patients undergoing urgent aortic total arch replacement surgery for acute DeBakey Type I aortic dissection.Methods: We conducted a retrospective cohort study in Beijing Anzhen Hospital from December 2015 to April 2017. All patients receiving urgent aortic total arch replacement surgery with a frozen elephant trunk implant for acute DeBakey Type I aortic dissection were included. Body mass index was calculated based on height and weight. Acute kidney injury was diagnosed based on the Kidney Disease Improving Global Outcomes standards.Results: We included 115 consecutive patients in this study. A total of 53.0% (n = 61) of patients had acute kidney injury. The mean age was 47.8 ± 10.7 years, and 25.2% were women. Mean body mass index was 26.2 ± 3.9 kg/m2. The results of a univariate analysis showed that BMI, eGFR, CPB time, operative time, intraoperative blood loss, intraoperative amount of PRBCs, and respiratory failure were significantly correlated with AKI. In-hospital mortality was obviously increased in the acute kidney injury group (13.1% vs 1.9%; P = 0.025). Multivariate logistic regression showed that body mass index was associated with postoperative acute kidney injury after adjusting for other confounding factors (odds ratio = 1.16; 95% confidence interval: 1.02-1.33; P = 0.0288). The risk of postoperative AKI in the BMI ≥ 24 kg/m2 group was increased by 2.35 times (OR = 3.35, 95% CI: 1.15-9.74; p = 0.0263).Conclusions: Body mass index was an independent predictor of acute kidney injury after urgent aortic total arch replacement surgery with a frozen elephant trunk implant. [ABSTRACT FROM AUTHOR]

Interictal epileptiform discharges (IEDs) often co-occur across spatially-separated cortical regions, forming IED networks. However, the factors prompting IED propagation remain unelucidated. We hypothesized that slow oscillations (SOs) might facilitate IED propagation. Here, the amplitude and phase synchronization of SOs preceding propagating and non-propagating IEDs were compared in 22 patients with focal epilepsy undergoing intracranial electroencephalography (EEG) evaluation. Intracranial channels were categorized into the irritative zone (IZ) and normal zone (NOZ) regarding the presence of IEDs. During wakefulness, we found that pre-IED SOs within the IZ exhibited higher amplitudes for propagating IEDs than non-propagating IEDs (delta band: p = 0.001, theta band: p < 0.001). This increase in SOs was also concurrently observed in the NOZ (delta band: p = 0.04). Similarly, the inter-channel phase synchronization of SOs prior to propagating IEDs was higher than those preceding non-propagating IEDs in the IZ (delta band: p = 0.04). Through sliding window analysis, we observed that SOs preceding propagating IEDs progressively increased in amplitude and phase synchronization, while those preceding non-propagating IEDs remained relatively stable. Significant differences in amplitude occurred approximately 1150 ms before IEDs. During non-rapid eye movement (NREM) sleep, SOs on scalp recordings also showed higher amplitudes before intracranial propagating IEDs than before non-propagating IEDs (delta band: p = 0.006). Furthermore, the analysis of IED density around sleep SOs revealed that only high-amplitude sleep SOs demonstrated correlation with IED propagation. Overall, our study highlights that transient but widely distributed SOs are associated with IED propagation as well as generation in focal epilepsy during sleep and wakefulness, providing new insight into the EEG substrate supporting IED networks. • An increase in slow oscillations (SOs) preceding IEDs was observed in the irritative zone and normal zone. • SOs have higher amplitudes before propagating IEDs than before non-propagating IEDs. • Pre-IED SOs show distinct evolution patterns for propagating IEDs versus non-propagating IEDs. • IEDs can exhibit a longer propagation delay (200–500 ms) than previously believed. • SOs correlate with IED generation and propagation during both sleep and wakefulness. [ABSTRACT FROM AUTHOR]

New Findings: What is the central question of this study?Insulin‐like growth factor 1 and its major binding protein insulin‐like growth factor binding protein 3 (IGFBP3) are involved in collagen deregulation in several cardiovascular diseases: what is the role of IGFBP3 in thoracic aortic dissection and does it regulate aortic smooth muscle cells' phenotypic switch?What is the main finding and its importance?IGFBP3 inhibits aortic smooth muscle cells' phenotypic switch from a contractile to a synthetic phenotype, decreases matrix metalloproteinase 9 activation and suppresses elastin degradation. These findings provide a better understanding of the pathogenesis of thoracic aortic dissection. Thoracic aortic dissection (TAD) is characterized by aortic media degeneration and is a highly lethal disease. An aortic smooth muscle cell (AoSMC) phenotypic switch is considered a key pathophysiological change in TAD. Insulin‐like growth factor binding protein 3 (IGFBP3) was found to be downregulated in aortic tissues of TAD patients. The present work aimed to study the function of IGFBP3 in AoSMCs' phenotypic switch and matrix metalloproteinase (MMP) expression. We established a mouse model of TAD by angiotensin (Ang) II infusion to β‐aminopropionitrile‐administrated mice, and found decreased IGFBP3 expression accompanied by aortic dilatation and elastin degradation in vivo. Further, mouse (m)AoSMCs were isolated from mouse thoracic aorta and treated with Ang II. Ang II induced downregulation of IGFBP3 in vitro. To further study the function of IGFBP3, primary mAoSMCs were infected with adenovirus expressing IGFBP3 followed by Ang II induction. Enforced upregulation of IGFBP3 decreased MMP9 expression and activation as well as increasing tissue inhibitor of metalloproteinase (TIMP) 1 expression in Ang II‐induced mAoSMCs. No difference was observed in MMP2 and TIMP3 expression. IGFBP3 suppressed subsequent Ang II‐induced elastin degradation in vitro. IGFBP3 inhibited Ang II‐induced mAoSMCs' phenotypic switch as evidenced by increased smooth muscle actin α‐2 (ACTA2) and myosin heavy chain 11 (MYH11) expression and decreased secreted phosphoprotein 1 (SPP1) and vimentin expression. Taken together, the present study demonstrates the role of IGFBP3 in preserving AoSMCs' contractile state and reducing MMP9 activation and thus promoting elastic fibre synthesis, which provides a better understanding of the pathogenesis of TAD. [ABSTRACT FROM AUTHOR]