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This study investigated fiction readers' motivations for reading, their relevant needs regarding the fiction attributes, and their expectations for future fiction recommendation services. Seventy-six participants shared their fiction search and reading experiences through an open-ended, free-writing-style online survey. Findings show that readers' motivations (a sense of connection, comfort and safety, diverse selection, escapism, coping with stressful circumstances) and corresponding fiction elements (e.g., author's background information, themes, mood) were closely related to the situations or contexts that readers experienced, especially so for stress stemming from the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Context: Choline is a critical nutrient. Inadequate choline intake during pregnancy increases the risk of adverse maternal and offspring health. Objective A systematic review and meta-analysis were conducted to examine the current recommendations for choline intake by pregnant women, estimate the overall prevalence of pregnant women with adequate choline intake, and explore associations between maternal choline level and adverse pregnancy outcomes (APOs). Methods Choline recommendations for pregnant women were assessed from eight nutrient guidelines of the United States, United Kingdom, Canada, Australia, Asia, International Federation of Gynecology and Obstetrics, and World Health Organization. Data on the prevalence of pregnant women with adequate choline intake and the association between maternal choline level and APOs were collected from 5 databases up to May 2023. Meta-analyses with random effects and subgroup analyses were performed for the pooled estimate of prevalence and association. Results Five recent nutrition guidelines from the United States (United States Department of Agriculture), United States (Food and Drug Administration), Canada, Australia, and the International Federation of Gynecology and Obstetrics have emphasized the importance of adequate choline intake for pregnant women. Of 27 publications, 19 articles explored the prevalence and 8 articles explored the association. Meta-analysis of 12 prevalence studies revealed a concerning 11.24% (95% confidence interval, 6.34–17.26) prevalence of pregnant women with adequate choline intake recommendations. A meta-analysis of 6 studies indicated a significant association between high maternal choline levels and a reduced risk of developing APOs, with an odds ratio of 0.51 (95% confidence interval, 0.40–0.65). Conclusion The existing guidelines highlight the importance of choline in supporting maternal health and fetal development during pregnancy. Furthermore, a high maternal choline level was likely to be associated with a lower risk of APOs. However, 88.76% of pregnant women do not achieve the optimal choline intake. Therefore, specific policies and actions may be necessary to improve choline intake in pregnant women's care and support the well-being of pregnant women. Systematic Review Registration PROSPERO registration no. CDR42023410561. [ABSTRACT FROM AUTHOR]

Radio stations are seriously affected by transmission line reradiation interference, but most of the existing methods for analyzing and solving reradiation interference on transmission lines focus on approximating the physical problem through mathematical models and algorithms, and it is difficult to study the correlation between transmission lines and reradiation interference in depth. This paper introduces the characteristic mode theory to study the influence factors of reradiation interference on transmission lines, which can decompose the surface induced current of transmission lines into a series of mutually orthogonal mode currents. This paper verifies the correctness of applying the MS (mode significance) value of the characteristic mode theory to analyze the reradiation interference through a simple transmission line example. Taking a line with 5 towers as an example, by analyzing the characteristic mode currents of transmission lines with different forwarding angles and linear arrangements, we not only verified that the characteristic mode currents can well characterize the reradiation interference, but also verified that the characteristic currents of different modes have a direct connection with the structure of the line, which can be applied in the process of designing or reconstructing the towers of the transmission lines, to predict the influence of different structural parameters on electromagnetic scattering, so as to optimize the tower design to reduce the reradiation interference effects and thus optimize the tower design to reduce reradiation interference. © 2024 Institute of Electrical Engineers of Japan and Wiley Periodicals LLC. [ABSTRACT FROM AUTHOR]

Proprotein convertase substilin/kexin type 9 (PCSK9), a pivotal protein regulating lipid metabolism, has been implicated in promoting microthrombotic formation and inflammatory cascades, thereby contributing to cardiovascular ischemia/reperfusion (I/R) injury. However, its involvement in cerebral I/R injury and its potential role in microcirculation protection remain unexplored. In this investigation, we utilized a middle cerebral artery occlusion/reperfusion (MCAO/R) mouse model to simulate ischemic stroke. Different concentrations of evolocumab (1, 5, 10 mg/kg, i.v.), a PCSK9 inhibitor, were administered to assess its impact. Immunofluorescence staining was employed to analyze changes in the expression of occludin, claudin-5, thrombocyte, ICAM-1, VCAM-1, and CD45, providing insights into blood-brain barrier integrity, platelet adhesion, and immune cell infiltration. Moreover, the Morris water maze and elevated plus maze were utilized to evaluate neurological and behavioral functions in MCAO/R mice, shedding light on the effects of PCSK9 inhibition. Our findings revealed a surge in plasma PCSK9 levels post-MCAO/R, peaking at 24 h post-reperfusion. Evolocumab (10 mg/kg) treatment significantly mitigated brain infarction and neurological deficits, evidenced by enhanced locomotor function and reduced post-stroke anxiety. However, it did not ameliorate cognitive impairment following MCAO/R. Additionally, evolocumab administration led to diminished leakage of evans blue solution and upregulated expression of occludin and claudin-5. Thrombocyte, ICAM-1, VCAM-1, and CD45 levels were notably reduced in the penumbral area post-evolocumab treatment. These protective effects are speculated to be mediated through the inhibition of the ERK/NF-κB pathway. The PCSK9 inhibitor evolocumab holds promise as a therapeutic agent during the acute phase of stroke, exerting its beneficial effects by modulating the ERK/NF-κB signaling pathway. [ABSTRACT FROM AUTHOR]

Proprotein convertase substilin/kexin type 9 (PCSK9), a pivotal protein regulating lipid metabolism, has been implicated in promoting microthrombotic formation and inflammatory cascades, thereby contributing to cardiovascular ischemia/reperfusion (I/R) injury. However, its involvement in cerebral I/R injury and its potential role in microcirculation protection remain unexplored. In this investigation, we utilized a middle cerebral artery occlusion/reperfusion (MCAO/R) mouse model to simulate ischemic stroke. Different concentrations of evolocumab (1, 5, 10 mg/kg, i.v.), a PCSK9 inhibitor, were administered to assess its impact. Immunofluorescence staining was employed to analyze changes in the expression of occludin, claudin-5, thrombocyte, ICAM-1, VCAM-1, and CD45, providing insights into blood-brain barrier integrity, platelet adhesion, and immune cell infiltration. Moreover, the Morris water maze and elevated plus maze were utilized to evaluate neurological and behavioral functions in MCAO/R mice, shedding light on the effects of PCSK9 inhibition. Our findings revealed a surge in plasma PCSK9 levels post-MCAO/R, peaking at 24 h post-reperfusion. Evolocumab (10 mg/kg) treatment significantly mitigated brain infarction and neurological deficits, evidenced by enhanced locomotor function and reduced post-stroke anxiety. However, it did not ameliorate cognitive impairment following MCAO/R. Additionally, evolocumab administration led to diminished leakage of evans blue solution and upregulated expression of occludin and claudin-5. Thrombocyte, ICAM-1, VCAM-1, and CD45 levels were notably reduced in the penumbral area post-evolocumab treatment. These protective effects are speculated to be mediated through the inhibition of the ERK/NF-κB pathway. The PCSK9 inhibitor evolocumab holds promise as a therapeutic agent during the acute phase of stroke, exerting its beneficial effects by modulating the ERK/NF-κB signaling pathway. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the osteogenic performance of allograft particulate bone and cortical bone blocks combined with xenograft under bovine pericardium membranes, for treating different degrees of labial bone defects in the aesthetic zone. Materials and methods: Twenty-four patients with bone defects were divided into two groups based on defect severity (Terheyden 1/4 and 2/4 groups). The Terheyden 1/4 group received granular bone grafts alone, while the Terheyden 2/4 group received cortical bone blocks combined with granular bone grafts. Cone beam computed tomography scans were taken preoperatively, immediately postoperatively, and six months postoperatively. Primary outcomes included labial bone formation, alveolar bone formation, bone resorption rate, osteogenic efficiency, and complications. Results: Labial bone thickness in both groups exceeded 2 mm after six months. Labial bone formation at the implant shoulder in the Terheyden 1/4 group was 2.35 ± 2.68 mm, and 2.26 ± 1.66 mm in the Terheyden 2/4 group (p > 0.05). Labila and alveolar bone formation at 2–5 mm below the implant shoulder was significantly greater in the Terheyden 2/4 group (p < 0.05). Alveolar bone resorption and the bone resorption rate at 2–5 mm below the implant shoulder was lower in the Terheyden 2/4 group (p < 0.05). Osteogenic efficiency was 64.43 ± 2.76%, with no significant difference between groups (p > 0.05). No complications were observed. Conclusion: Both treatment approaches achieved satisfactory bone regeneration, but combining cortical bone blocks with granular grafts provided better outcomes for larger defects, with greater bone formation and less resorption. Further research with longer follow-up is required to confirm long-term stability. Trial registration: The study was retrospectively registered in the Chinese Clinical Trial Registry (http://www.chictr.org.cn/) with the registration number ChiCTR2300070538 on April 14, 2023. [ABSTRACT FROM AUTHOR]

In the context of increasing carbon emissions and strengthening regulatory measures, an increasing number of stakeholders are paying more attention to corporate carbon information. To further explore the relationship between the quality of carbon information disclosure and enterprise value, this study uses a sample of companies listed on the Shanghai and Shenzhen stock exchanges from 2013 to 2021. The aim is to investigate the link between the quality of carbon information disclosure and enterprise value, while also analyzing the role of green innovation in this relationship. The empirical results show that the quality of carbon information disclosure can significantly enhance enterprise value, with green innovation playing a mediating role in this effect. After robustness checks, including replacing the measurement variables and addressing endogeneity issues, the conclusions remain valid. Further analysis reveals that the effect of carbon information disclosure quality on enhancing enterprise value is more pronounced in non-high-pollution industries, non-state-owned enterprises, and firms located in eastern regions. This study provides valuable insights for future policy optimization related to carbon information disclosure and the promotion of low-carbon development in enterprises. [ABSTRACT FROM AUTHOR]

Common carp (Cyprinus carpio) is extensively cultured and widely consumed in Heilongjiang Province, China. Due to the proximity of freshwater ponds to agricultural cultivated areas, these aquatic systems are inevitably influenced by the historical application of organochlorine pesticides (OCPs), due to their prolonged half-life and resistance to degradation. Gas chromatography-tandem mass spectrometry (GC-MS/MS) was utilized to quantify the levels of hexachlorocyclohexane (HCHs) and dichlorodiphenyltrichloroethane (DDTs) in the muscle tissue of cultured common carp. This study examined the enrichment characteristics of HCHs and DDTs in fish muscle, as well as their correlation with sediment and associated risk assessments. The results showed that the residual levels of HCHs and DDTs in fish muscle ranged from 0.387 μg·kg−1 to 3.418 μg·kg−1 and from 0.114 μg·kg−1 to 0.420 μg·kg−1, respectively. They were all below the maximum residue limits specified in GB 2763-2021 (HCHs: 100 μg·kg−1, DDTs: 500 μg·kg−1). The concentrations of HCHs and DDTs in sediment were found to be lower than those in muscle tissue. Notably, the concentrations of HCHs were higher than those of DDTs in both muscle and sediment. Among the HCHs, γ-HCH was the predominant residual substance, contributing a significant proportion of 42.16% to 86.47%. No significant residues of DDT derivatives were detected. A significant correlation was observed between the concentrations of HCHs and DDTs in the muscle tissue and those present in the sediment (p < 0.01). The health risk assessment indicated that both the carcinogenic and non-carcinogenic risks associated with OCPs from common carp muscle and sediment were within acceptable limits. Therefore, it was recommended to regulate fish consumption during the breeding period. [ABSTRACT FROM AUTHOR]

Polycystic ovary syndrome (PCOS) is a primary endocrine disorder affecting premenopausal women involving metabolic dysregulation. We aimed to screen serum biomarkers in PCOS patients using untargeted lipidomics and ensemble machine learning. Serum from PCOS patients and non-PCOS subjects were collected for untargeted lipidomics analysis. Through analyzing the classification of differential lipid metabolites and the association between differential lipid metabolites and clinical indexes, ensemble machine learning, data preprocessing, statistical test pre-screening, ensemble learning method secondary screening, biomarkers verification and evaluation, and diagnostic panel model construction and verification were performed on the data of untargeted lipidomics. Results indicated that different lipid metabolites not only differ between groups but also have close effects on different corresponding clinical indexes. PI (18:0/20:3)-H and PE (18:1p/22:6)-H were identified as candidate biomarkers. Three machine learning models, logistic regression, random forest, and support vector machine, showed that screened biomarkers had better classification ability and effect. In addition, the correlation of candidate biomarkers was low, indicating that the overlap between the selected biomarkers was low, and the combination of panels was more optimized. When the AUC value of the test set of the constructed diagnostic panel model was 0.815, the model's accuracy in the test set was 0.74, specificity was 0.88, and sensitivity was 0.7. This study demonstrated the applicability and robustness of machine learning algorithms to analyze lipid metabolism data for efficient and reliable biomarker screening. PI (18:0/20:3)-H and PE (18:1p/22:6)-H showed great potential in diagnosing PCOS. [ABSTRACT FROM AUTHOR]

Climate issues significantly impact people's lives, prompting governments worldwide to implement energy-saving and emission-reducing measures. However, many areas lack carbon emission data at the lower administrative divisions. Additionally, the inconsistency in the standards, scope, and accuracy of carbon dioxide emission statistics across different regions makes mapping carbon dioxide spatial patterns complex. Nighttime light (NTL) data combined with land use data enable the detailed spatial and temporal disaggregation of carbon emission data at a finer administrative level, facilitating scientifically informed policy formulation by the government. Differentiating carbon emission data by sector will help us further identify the carbon emission efficiency in different sectors and help environmental regulators implement the most cost-effective emission-reduction strategy. This study uses integrated remote-sensing data to estimate carbon emissions from fossil fuels (CEFs). Experimental results indicate (1) that the regional CEF can be calculated by combining NTL and Landuse data and has a good fit; (2) the high-intensity CEF area is mainly concentrated in Shanghai and its surrounding areas, showing a concentric circle structure; (3) there are obvious differences in the spatial distribution characteristics of carbon emissions among different departments; (4) hot spot analysis reveals a three-tiered distribution in the Yangtze River Delta, increasing from the west to the east with distinct spatial characteristics. [ABSTRACT FROM AUTHOR]

In recent years, significant progress has been made in testing methods for deep neural networks (DNNs) to ensure their correctness and robustness. Coverage-guided criteria, such as neuron-wise, layer-wise, and path-/trace-wise, have been proposed for DNN fuzzing. However, existing coverage-based criteria encounter performance bottlenecks for several reasons: ❶ Testing Adequacy: Partial neural coverage criteria have been observed to achieve full coverage using only a small number of test inputs. In this case, increasing the number of test inputs does not consistently improve the quality of models. ❷ Interpretability: The current coverage criteria lack interpretability. Consequently, testers are unable to identify and understand which incorrect attributes or patterns of the model are triggered by the test inputs. This lack of interpretability hampers the subsequent debugging and fixing process. Therefore, there is an urgent need for a novel fuzzing criterion that offers improved testing adequacy, better interpretability, and more effective failure detection capabilities for DNNs. To alleviate these limitations, we propose NSGen, an approach for DNN fuzzing that utilizes neuron semantics as guidance during test generation. NSGen identifies critical neurons, translates their high-level semantic features into natural language descriptions, and then assembles them into human-readable DNN decision paths (representing the internal decision of the DNN). With these decision paths, we can generate more fault-revealing test inputs by quantifying the similarity between original test inputs and mutated test inputs for fuzzing. We evaluate NSGen on popular DNN models (VGG16_BN, ResNet50, and MobileNet_v2) using CIFAR10, CIFAR100, Oxford 102 Flower, and ImageNet datasets. Compared to 12 existing coverage-guided fuzzing criteria, NSGen outperforms all baselines, increasing the number of triggered faults by 21.4% to 61.2% compared to the state-of-the-art coverage-guided fuzzing criterion. This demonstrates NSGen's effectiveness in generating fault-revealing test inputs through guided input mutation, highlighting its potential to enhance DNN testing and interpretability. [ABSTRACT FROM AUTHOR]

Metachromatic leukodystrophy (MLD) is an inherited disease caused by a deficiency of the enzyme arylsulfatase A (ARSA). Lentivirus-modified autologous hematopoietic stem cell gene therapy (HSCGT) has recently been approved for clinical use in pre and early symptomatic children with MLD to increase ARSA activity. Unfortunately, this advanced therapy is not available for most patients with MLD who have progressed to more advanced symptomatic stages at diagnosis. Patients with late-onset juvenile MLD typically present with a slower neurological progression of symptoms and represent a significant burden to the economy and healthcare system, whereas those with early onset infantile MLD die within a few years of symptom onset. We conducted a pilot study to determine the safety and benefit of HSCGT in patients with postsymptomatic juvenile MLD and report preliminary results. The safety profile of HSCGT was favorable in this long-term follow-up over 9 years. The most common adverse events (AEs) within 2 months of HSCGT were related to busulfan conditioning, and all AEs resolved. No HSCGT-related AEs and no evidence of distorted hematopoietic differentiation during long-term follow-up for up to 9.6 years. Importantly, to date, patients have maintained remarkably improved ARSA activity with a stable disease state, including increased Functional Independence Measure (FIM) score and decreased magnetic resonance imaging (MRI) lesion score. This long-term follow-up pilot study suggests that HSCGT is safe and provides clinical benefit to patients with postsymptomatic juvenile MLD. [ABSTRACT FROM AUTHOR]

Three previously undescribed coumarins (1–3) were obtained from the roots of Notopterygium incisum. Their chemical structures were elucidated using a variety of spectroscopic techniques and chemical calculations. The inhibitory effects of these new compounds on NO production and pro-inflammatory factors (IL-1β, IL-6, and TNF-α) in LPS-stimulated RAW 264.7 cells were investigated. Further studies revealed that compound 1 suppressed the expression of COX-2 and iNOS while also reduced ROS accumulation. Western blot analysis demonstrated that compound 1 could inhibit the PI3K/AKT pathway by decreasing the levels of p-PI3K and p-AKT. Collectively, these findings suggest that compounds 1–3 exhibit promising anti-inflammatory properties. [ABSTRACT FROM AUTHOR]

The asymmetry of the multi-orifice spray will cause uneven heat load of the marine diesel engine, thereby affecting its working performance and service life. Therefore, an in-depth understanding of the spray and flame characteristics of multi-orifice nozzles will guide the optimization of the nozzle structure, needle design and diesel atomization and combustion process. For this reason, four groups of dual-orifice nozzles with different hole diameters (0.1–0.55 mm) and mass flow rates covering the typical marine medium-speed diesel injections are designed and customized, and the constant volume chamber (CVC) with high temperature and pressure is used to simulate the actual in-cylinder working conditions of the diesel engine for the spray visualization experiment. To study the asymmetry of the fuel sprays discharged from a diesel injector, the multi-orifice nozzle is simplified as a dual-orifice nozzle in this study. Combined with X-ray Computed Tomography (CT) imaging technology, the influences of the nozzle internal structure on the spray and flame asymmetry are studied in the constructed supercritical environment. It is found that the asymmetry of the inlet angle and the equivalent length-diameter ratio is positively correlated with the inconsistency of the dual sprays. With an increase in the injection pressure and nozzle diameter, the asymmetry of the dual spray becomes more pronounced, resulting in greater disparities in the ignition delay times and ignition positions of the two sprays. Moreover, the increase in nozzle diameter also leads to combustion instability, resulting in a flame with a serrated appearance. With the increase of ambient temperature, the proportion of liquid phase in the jet decreases and the relative density of spray front decreases. [ABSTRACT FROM AUTHOR]

Background: Obtaining a full understanding of the anatomical structure of the eyeball and the contents within the eye plays a crucial role in learning eye diseases. However, it can be challenging for beginners to quickly learn, memorize, and apply this anatomical knowledge. To improve the teaching of ocular anatomy and help students overcome learning difficulties in ophthalmology clerkship, Zhongshan Ophthalmic Center developed an integrated ocular anatomy course comprising three main components: 'online preview,' 'lecture,' and 'wetlab dissection'. Methods: Fifty-five fourth-year medical students from Sun Yat-sen University were recruited for this study. The impact of the integrated course was evaluated through three in-class quizzes (T1: pre-teaching assessment, T2: post-wetlab training, and T3: end of clerkship) and assessments of students' self-confidence levels. Additionally, students' course evaluations were gathered via a questionnaire survey. Statistical analyses were conducted via ANOVA and the Kruskal–Wallis test. Results: The integration course significantly improved the mean scores of post-teaching tests (67.08 ± 10.27 vs. 74.36 ± 12.75 vs. 78.81 ± 12.70, P < 0.0001) and the students’ self-confidence scores (P < 0.0001). Fifty-four participants were satisfied with the integrated anatomy course (79.3% strongly agreed, 18.2% more agreed). Fifty-two participants agreed (76.4% strongly agreed, 18.2% more agreed) that the course could help them better understand the anatomy of the eye. Conclusions: This integrated ocular anatomy course can aid students in better understanding and retaining the anatomy and function of ocular structures, serving as a valuable adjunct teaching strategy that can be further applied to ophthalmology clerkship. [ABSTRACT FROM AUTHOR]

Background: Obtaining a full understanding of the anatomical structure of the eyeball and the contents within the eye plays a crucial role in learning eye diseases. However, it can be challenging for beginners to quickly learn, memorize, and apply this anatomical knowledge. To improve the teaching of ocular anatomy and help students overcome learning difficulties in ophthalmology clerkship, Zhongshan Ophthalmic Center developed an integrated ocular anatomy course comprising three main components: 'online preview,' 'lecture,' and 'wetlab dissection'. Methods: Fifty-five fourth-year medical students from Sun Yat-sen University were recruited for this study. The impact of the integrated course was evaluated through three in-class quizzes (T1: pre-teaching assessment, T2: post-wetlab training, and T3: end of clerkship) and assessments of students' self-confidence levels. Additionally, students' course evaluations were gathered via a questionnaire survey. Statistical analyses were conducted via ANOVA and the Kruskal–Wallis test. Results: The integration course significantly improved the mean scores of post-teaching tests (67.08 ± 10.27 vs. 74.36 ± 12.75 vs. 78.81 ± 12.70, P < 0.0001) and the students’ self-confidence scores (P < 0.0001). Fifty-four participants were satisfied with the integrated anatomy course (79.3% strongly agreed, 18.2% more agreed). Fifty-two participants agreed (76.4% strongly agreed, 18.2% more agreed) that the course could help them better understand the anatomy of the eye. Conclusions: This integrated ocular anatomy course can aid students in better understanding and retaining the anatomy and function of ocular structures, serving as a valuable adjunct teaching strategy that can be further applied to ophthalmology clerkship. [ABSTRACT FROM AUTHOR]

The driving forces of transpiration are not only atmospheric evaporation but also root zone water supply and stomatal regulation among species. However, the biophysiological drivers of transpiration remain incompletely understood in heterogeneous karst habitats. This study investigated the commonly coexisting tree species Mallotus philippensis and Celtis biondii in two typical karst habitats: rock‐dominated (RD) habitat and control soil‐dominated (SD) habitat. Over 2 years, soil moisture, transpiration, root distribution, and leaf water potential were measured. The results showed that soil moisture in the RD habitat was significantly lower than in the SD habitat. Transpiration patterns also differed between habitats, with species‐specific distinctions driven by biophysiological traits. M. philippensis showed small hydroscape areas and its root system mainly distributed in the soil zone in both habitats. The isohydric behaviour and lower root density in the RD habitat drove M. philippensis to reduce transpiration in response to soil water deficiency. Conversely, C. biondii had large hydroscape areas and roots capable of penetrating bedrock. It transpired higher relying on ample accessible water through anisohydric behaviour and having a more robust root system both in soil and bedrock zones in the RD habitat. Our study highlights the critical role of root water accessibility and leaf iso/anisohydric tendencies in driving transpiration. Summary statement: Isohydric behaviour and low root density drive Mallotus philippensis to reduce transpiration under soil water deficiency. Conversely, Celtis biondii can maintain high transpiration by accessing bedrock water through anisohydric behaviour and a robust root system extending into both soil and bedrock zones. [ABSTRACT FROM AUTHOR]

Background: Automatic sleep staging is essential for assessing sleep quality and diagnosing sleep disorders. While previous research has achieved high classification performance, most current sleep staging networks have only been validated in healthy populations, ignoring the impact of Obstructive Sleep Apnea (OSA) on sleep stage classification. In addition, it remains challenging to effectively improve the fine-grained detection of polysomnography (PSG) and capture multi-scale transitions between sleep stages. Therefore, a more widely applicable network is needed for sleep staging. Methods: This paper introduces MSDC-SSNet, a novel deep learning network for automatic sleep stage classification. MSDC-SSNet transforms two channels of electroencephalogram (EEG) and one channel of electrooculogram (EOG) signals into time-frequency representations to obtain feature sequences at different temporal and frequency scales. An improved Transformer encoder architecture ensures temporal consistency and effectively captures long-term dependencies in EEG and EOG signals. The Multi-Scale Feature Extraction Module (MFEM) employs convolutional layers with varying dilation rates to capture spatial patterns from fine to coarse granularity. It adaptively fuses the weights of features to enhance the robustness of the model. Finally, multiple channel data are integrated to address the heterogeneity between different modalities effectively and alleviate the impact of OSA on sleep stages. Results: We evaluated MSDC-SSNet on three public datasets and our collection of PSG records of 17 OSA patients. It achieved an accuracy of 80.4% on the OSA dataset. It also outperformed the state-of-the-art methods in terms of accuracy, F1 score, and Cohen's Kappa coefficient on the remaining three datasets. Conclusion: The MSDC-SSRNet multi-channel sleep staging architecture proposed in this study enhances widespread system applicability by supplementing inter-channel features. It employs multi-scale attention to extract transition rules between sleep stages and effectively integrates multimodal information. Our method address the limitations of single-channel approaches, enhancing interpretability for clinical applications. [ABSTRACT FROM AUTHOR]

To investigate the relationships between inflammatory parameters, including neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR) and systemic immune-inflammation index (SII), and quantitative flow ratio (QFR) in stable coronary artery disease (CAD) patients (n = 450) enrolled in this cross-sectional study. Logistic regression was performed to evaluate the associations of NLR, PLR, MLR, and SII evaluated as continuous and binary variables with QFR ≤0.80. When treated as continuous variables, lnNLR was associated with QFR ≤0.80 with borderline significance in univariable (odds ratio (OR) = 1.60, p =.05) and multivariable analysis (OR = 1.72, p =.05), while lnMLR was associated with QFR ≤0.80 significantly in univariable analysis (OR = 1.87, p =.03) and with borderline significance in multivariable analysis (OR = 1.91, p =.05). When treated as binary variables, high levels of MLR and SII were significantly associated with QFR ≤0.80 in univariable (MLR: OR = 1.91, p =.02; SII: OR = 2.42, p =.006) and multivariable analysis (MLR: OR = 1.83, p =.04; SII: OR = 2.19, p =.02). NLR, MLR, and SII, but not PLR, were significantly associated with the severity of coronary physiology in stable CAD patients. [ABSTRACT FROM AUTHOR]

Sign language utilizes changes in hand shape, body movements, and facial expressions to collaboratively convey information. Most of the current continuous sign language recognition (CSLR) models focus on extracting information from each frame of the video, neglecting the dynamical changing characteristics of the signer across multiple frames. This contrasts with the essence of continuous sign language recognition: which aims to learn the most essential feature of changes in both hand-controlled and non-hand-controlled parts and convert them into text. In this paper, a feature alignment method is first employed to explicitly capture the spatial position offset and motion direction information between neighboring frames, direct a dynamic attention mechanism to focus on the subtle change region. A dynamic decoding module based on maximum backtracking probability is proposed to decode word-level features and achieve word consistency constraints without increasing computational resources. We propose a comprehensive CSLR model (DAM-MCD) that combines a Dynamic Attention Mechanism and Maximum Backtracking Probability Dynamic Decoding, enhancing the model's inference capability and robustness. Experiments conducted on two publicly accessible datasets, RWTH and RWTH-T, demonstrate that the DAM-MCD model achieves higher accuracy compared to methods using multi-cue input. The results further show that our model effectively captures sign language motion information in videos. [ABSTRACT FROM AUTHOR]

Infrared imaging technology relies on detecting the electromagnetic waves emitted by an object's spontaneous thermal radiation for imaging. It can overcome the adverse effects of complex lighting conditions on the detection of pedestrians and vehicles on the road. To address the issues of low accuracy and missed detection in visual detection under complex traffic conditions, such as during rain, snow, or at night, a pedestrian and vehicle detection model using infrared imaging has been proposed. This model improves the neck network and incorporates an attention mechanism. First, by adding a multi-scale feature fusion small-object detection layer to the model's neck, enhancing the capture of detailed information about small infrared objects and reducing missed detections. Second, a novel dual-layer routing attention mechanism is designed, allowing the model to focus on the most relevant feature areas and improving the detection accuracy of small infrared objects. Next, the CARAFE upsampling method is used for adaptive upsampling and context information fusion, which enhances the model's ability to reorganize features and capture details. Finally, a lightweight CSPPC module is constructed using partial convolutions to replace the C2f module in the neck network, which improves the model's frame rate. Experimental results show that, compared to the baseline model, BCC-YOLOv8n improves precision, recall, mAP@0.5, and mAP@0.5:0.95 by 1.4%, 4.8%, 5.3%, and 4.5%, respectively, while reducing the number of parameters by approximately 7%. Additionally, a frame rate of 70.8 FPS was achieved, satisfying the requirements for real-time detection. [ABSTRACT FROM AUTHOR]

Background: Robotic ventral hernia surgery may provide better patient outcomes. Whether it is provided equitably based on race remains unknown. Methods: We examined whether patients from the Abdominal Core Health Quality Collaborative who were Black had equitable access to robotic surgery for ventral hernia repair with permanent mesh compared to white counterparts from 2013 to 2023. We performed propensity-score matching to address confounding and then chi-squared testing to examine access to robotic, laparoscopic, and open approaches. Secondary outcomes included 30-day readmissions, complications, and death and 1- and 2-year hernia recurrence and quality of life measured by HerQLes Summary and PROMIS Pain T-Scores analyzed with chi-squared, Fisher exact, and Wilcoxon testing. Results: 2397 patients identified as Black, and 21,900 identified as white. Our propensity-score matched cohort included 2374 Black patients and 7122 white. Black and white groups had the same rates of laparoscopy (15% vs 15%). Patients who identified as Black were more likely to undergo robotic surgery (36% vs 32%). Open approach was 49% for Black and 53% for white (p = 0.005). For 30-day complications, we found Black patients were more likely to experience reoperation (2% vs 1%, p = 0.005) and less likely surgical site infection (1% vs 2%, p < 0.001). Hernia recurrence scores and perceived abdominal health based on HerQLes were not statistically significantly different. At 2 years, absolute reported T-Scores were higher for Black patients (median 40 (IQR 31–49) vs 36 (31–46), p = 0.031). Conclusions: This is the first large-scale study examining access to robotic surgery, complications, and quality of life measures. We found patients who identified as Black were more likely than white counterparts to undergo robotic surgery, but they were more likely to require reoperation and had higher pain scores. Our data suggest equitable access still may not translate to equitable patient outcomes. [ABSTRACT FROM AUTHOR]

Background: This study evaluated the clinical effects of the use of a temporary bi-frame fixator in conjunction with minimally invasive percutaneous plate osteosynthesis (MIPPO) for treating AO/OTA 41B3 and 41C tibial plateau fractures (TPFs). Methods: This was a retrospective analysis of 30 patients with TPFs affected by vertical compression seen from October 2019 to October 2020. All patients were treated with a bi-frame fixator to correct the vertical shortening deformity, with the MIPPO technique used after reduction. All patients underwent routine examinations at 1, 3, 6, 12 and 24months postoperatively and then annually. Clinical parameters assessed included the Hospital for Special Surgery score (HSS), number of assistants, intraoperative hemorrhage, intraoperative fluoroscopy frequency, length of hospital stay, and time to fracture healing. Radiographic findings were assessed using Rasmussen scores. Results: All patients had satisfactory fracture reduction on postoperative imaging. The average operating time was 112.03 ± 20.9 min, with 15.79 ± 3.45 fluoroscopic exposures; the average blood loss was 66.63 ± 10.88 mL, the average length of hospital stay was 12.86 ± 5.11 days, and the average fracture healing time was 10.33 ± 1.48 weeks. The mean follow-up time was 23.18 ± 2.59 months. At the last follow-up, the Rasmussen anatomical score was excellent in 22 (75.3%) patients, good in 5 (16.7%), and fair in 3 (10%). The average HSS was 65.7 ± 3.26, 82.26 ± 2.28, and 87.66 ± 2.4 after 1, 6, and 12 months, respectively, and it was 92.56 ± 2.96 at the last follow-up (F = 1073.073, P < 0.001). No complications occurred in any patient during follow-up. Conclusion: For AO/OTA 41B3 and 41C fractures of the tibial plateau, the use of a temporary bi-frame fixator combined with the MIPPO technique can correct the compressed displacement, reduce soft tissue damage, and facilitate surgical reduction, which aid the recovery of joint function. [ABSTRACT FROM AUTHOR]

Prostate cancer, a common malignancy in older men, often requires laparoscopic radical prostatectomy, considered the gold standard treatment. However, postoperative complications can significantly impact quality of life and psychological well-being. The emergence of mobile internet health management offers a promising approach for accessible and effective post-discharge care. This study evaluates the effectiveness of mobile internet management in postoperative care for prostate cancer patients, focusing on disease knowledge, psychological well-being, self-care capabilities, and quality of life. From September 2020 to September 2021, prostate cancer patients who underwent radical surgery at our Department of Urology were divided into a control group receiving standard care and an intervention group receiving mobile internet-based care. Patients were followed over six months, with assessments conducted at both 3 and 6 months post-intervention. We evaluated changes in disease knowledge, psychological status (using SAS/SDS scales), self-care ability (via the ESCA scale), and quality of life (measured by SF-36). A total of 112 patients were divided into two groups of 56 each. Repeated measures ANOVA indicated significant improvements in disease knowledge over time, between groups, and in their interaction (P < 0.05). Mastery scores of disease knowledge increased at both 3 and 6 months post-intervention compared to baseline (P < 0.05). The intervention group showed significantly reduced scores on the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) compared to the control group (P < 0.05). Self-care capabilities—including self-directed concept, nursing responsibility, skills, and health knowledge level—also improved, with more pronounced gains in the intervention group (P < 0.05). Quality of life scores in domains such as social function, mental health, vitality, role emotional, bodily pain, role physical, physical function, and general health were higher in the intervention group than in the control group post-intervention (P < 0.05). Mobile internet management significantly enhances postoperative care for prostate cancer patients by improving disease knowledge, psychological well-being, self-care capabilities, and quality of life. These findings support further research to validate long-term benefits and broader application potentials. [ABSTRACT FROM AUTHOR]

Although there have been many studies on how regular physical exercise and reducing dependence on mobile phones can improve cervical dysfunction, there is currently a lack of model research to verify the interaction between the three. In addition, as a high-risk group for cervical spine dysfunction, college students' education level may have a moderating effect on this model, which will provide more targeted and effective suggestions for developing intervention strategies to improve cervical spine dysfunction in college students. From January 2023 to May 2023, an electronic questionnaire survey was conducted on 861 college students in the southwest region, with education levels including vocational, undergraduate, and graduate students, The survey content includes demographic information, the Physical Activity Rating Scale (PARS-3), the Mobile Phone Addiction Index (MAPI), and the Neck Disability Index (NDI). The PARS-3 of college students was negatively correlated with NDI (r = -0.142, p < 0.01), PARS-3 was negatively correlated with MAPI (r = -0.09, p < 0.01), MAPI was positively correlated with NDI (r = 0.353, p < 0.01), indicating that mobile phone dependency mediated the relationship between physical exercise and cervical spine dysfunction (P < 0.01); educational level could moderate the effect of physical exercise on cervical spine dysfunction (β = -0.06, p < 0.05). The physical exercise of college students in the southwestern region of China is negatively correlated with cervical spine dysfunction and mobile phone dependency; mobile phone dependency is positively correlated with cervical spine dysfunction; mobile phone dependency plays a mediating role between physical exercise and cervical spine dysfunction; the educational level of college students can to a certain extent moderate the impact of physical exercise on cervical spine dysfunction. Those with higher baseline education levels have a greater degree of improvement in NDI through physical exercise; On the contrary, people with lower levels of education have relatively less improvement in NDI through physical exercise. [ABSTRACT FROM AUTHOR]

Background: The treatment of all-trans retinoic acid (ATRA) and arsenical agent has revolutionarily improved the prognosis of acute promyelocytic leukemia (APL) both in adults and children. Nevertheless, coagulation disorder and differentiation syndrome (DS) are the main causes of early death in APL patients. Early chemotherapy to reduce leukocytes during induction is an important measure to reduce complications and mortality. However, the incidence of hyperleukocytosis (WBC > 10 × 109/L) was significantly higher in pediatric patients without chemotherapy than in adults. Although ATRA plus arsenic is the standard therapy for non-high-risk adult patients, it remains controversial whether chemotherapy is necessary for induction therapy in pediatric APL. Methods: This study was designed as a multicenter randomized controlled trial. Children with APL were randomly assigned into experimental group (ATRA-RIF plus chemotherapy) and control group (ATRA-RIF). The experimental group was treated with ATRA-RIF plus chemotherapy for induction, while the control group was treated with ATRA-RIF alone. In addition, both groups received the same regimen of ATRA-RIF plus chemotherapy for consolidation and maintenance. Discussion: This trial aims to compare the efficacy of ATRA-RIF plus chemotherapy versus ATRA-RIF in pediatric non-high-risk patients with APL to demonstrate that chemotherapy during induction therapy can reduce the incidence of complications such as hyperleukocytosis and DS, thereby reducing mortality. Trial registration: Chinese Clinical Trials Registry, ID: ChiCTR2000038877. Registered on October 8, 2020, https://www.chictr.org.cn/showproj.html?proj=60733. V1.0 date 08/01/2020. [ABSTRACT FROM AUTHOR]

Background: Long-term air pollution exposure and inflammation are considered to be associated with cognitive decline. However, whether air pollution exposure related cognitive decline is dependent on inflammation remains uncertain. Materials and methods: The present study collected data from China Health and Retirement Longitudinal Study (CHARLS) at baseline in 2011, with a follow up period in 2015. Concentration of air pollutants (particles with diameters ≤ 1.0 μm [PM1], ≤ 2.5 μm [PM2.5], ≤ 10 μm [PM10], nitrogen dioxide [NO2] and ozone [O3]) were obtained from China High Air Pollutants (CHAP) dataset. Hypersensitive C-reactive protein (hs-CRP), a systemic inflammation marker, was measured in blood of subjects and cognitive function was assessed by standardized questionnaire. Results: A total of 6434 participants were included in the study. Lower exposure to PM2.5, PM1, PM10 and NO2 were associated with mitigated cognitive decline. The odds ratios (ORs) for air pollutants changes and cognitive decline and 95% confidence intervals (CIs) were as follows: PM2.5-0.934(0.925, 0.943), PM1- 0.945 (0.935,0.955), PM10-0.977(0.972,0.982) and NO2-0.962(0.950,0.975), respectively. Hs-CRP showed no significant correlation with cognitive decline or change in levels of air pollution. The interaction regression analyses, both unadjusted and adjusted, did not uncover any significant correlation between hs-CRP and air pollution with respect to cognitive decline. Bootstrap test exhibited no significant mediating effect of hs-CRP on the relationship between any air pollutants and cognitive decline, the indirect effects of hs-CRP in conjunction with exposure to different air pollutants were all found to be non-significant, with the following bootstrap CIs and p-values: PM2.5-1.000([1.000,1.000], P = 0.480),PM1-1.000([1.000,1.000], P = 0.230),PM10-1.000([1.000,1.000], P = 0.650), O3-1.000([1.000,1.000], P = 0.470), ΔNO2-1.000([1.000,1.000], P = 0.830). Conclusion: Ambient air pollution exposure was linked to cognitive decline independent of hs-CRP level. [ABSTRACT FROM AUTHOR]

Galvanized high-strength steel has emerged as a key focus in automotive lightweighting research. During resistance spot welding of galvanized steel, the phenomenon of liquid metal embrittlement (LME) can occur, which is characterized by the appearance of irregular cracks on the weld spot surface. However, the impact of LME cracks on the mechanical properties of joints remains unclear. This study investigates the LME phenomenon and its effects on the performance of spot-welded joints using galvanized QP980 steel as the subject. By combining theoretical analysis, experimental methods, and simulations, the formation and characteristics of LME cracks are explored through resistance spot welding experiments and elemental analysis. The influence of LME cracks on the static strength of joints is assessed through quasi-static tensile tests, fracture surface analysis, and theoretical calculations. Finite element simulations of the static tensile process reveal that LME cracks alter the stress–strain fields during joint failure. Additionally, the study examines how the location and size of LME cracks influence these effects. Finally, fatigue testing and fracture analysis of spot-welded joints demonstrate that LME cracks can negatively impact the fatigue life of joints. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis (OA) is a chronic condition characterized by joint pain and disability, driven by excessive oxidative stress and inflammatory cytokine production in chondrocytes, resulting in cell death and cartilage matrix breakdown. Our previous study showed that in monosodium iodoacetate (MIA)-induced OA rats, oral administration of heat-killed Lactobacillus delbrueckii subsp. lactis 557 (LDL557) could significantly decrease OA progression. Methods: Accordingly, we designed an in vitro cell culture study aimed at investigating the effects of heat-killed LDL557 extracts on chondrocytes using SW1353 cells (a human chondrosarcoma cell line) challenged with 5 μM MIA to mimic OA conditions. Results: The results showed that the 10 μg/mL LDL557 extracts protected SW1353 cells from MIA-induced death and reduced extracellular matrix (ECM) loss, as evaluated by toluidine blue O staining and extracellular matrix component synthesis with RT-qPCR measurement. This was achieved by decreasing the expression of MIA-induced pro-inflammatory cytokines, including IL-1β, IL-6, and TNF-α, while slightly increasing the MIA-suppressed expression of the anti-inflammatory cytokine IL-10, which were evidenced by RT-qPCR analysis. Moreover, the RT-qPCR evaluation also indicated that the LDL557 extracts slightly reduced the expression of COX-2 compared with the control, while it did not reduce the MIA-increased expression of microsomal prostaglandin E synthase-1 (mPGES-1). In addition, the LDL557 extracts influenced neither the matrix-degrading protease expressions measured via RT-qPCR nor the oxidative stress measured via fluorescence flow cytometry in the cells with or without the MIA challenge. Conclusions: This study demonstrates that LDL557 extracts may protect chondrocytes from OA damage by reducing inflammation-related factors and thus mitigating cartilage matrix loss, suggesting LDL557 extracts are attractive alternatives for OA applications. [ABSTRACT FROM AUTHOR]

Farm management has a significant impact on microbial composition and may affect the quality of raw buffalo milk. This study involved a diversity analysis and traceability of the microbial communities in raw buffalo milk from three buffalo farms at different management ranks in Guangxi Province, China. The microbial composition of the raw buffalo milk and its environmental sources were investigated using 16S rRNA gene sequencing and bioinformatics analysis. The results demonstrated that different management ranks significantly influenced microbial composition in milk, with the primary sources of contamination varying across farms. The env.OPS_17 was the predominant differential bacterium in farm rank A, whereas Enterobacteriaceae, Aerococcaceae, and Planococcaceae were dominant in farm rank B. The Fast Expectation–Maximization for Microbial Source Tracking model revealed that while the sources of microbial contamination varied across farms at different management ranks, the teat and teat liner consistently emerged as the primary sources of microbial contamination in raw buffalo milk. This study provides important insights into how different farm management ranks affect the microbial composition of raw buffalo milk, highlighting the importance of improved management practices during milk production, particularly in cleaning the milking equipment and farm environment, as these are key factors in ensuring the quality and safety of raw buffalo milk. [ABSTRACT FROM AUTHOR]

To evaluate the clinical efficacy and safety of fractionated plasma separation and adsorption combined with continuous veno-venous hemofiltration (FPSA-CVVH) treatment in patients with acute bipyridine herbicide poisoning. A retrospective analysis of 18 patients with acute bipyridine herbicide poisoning was conducted, of which 9 patients were poisoned by diquat and 9 patients by paraquat. All patients underwent FPSA-CVVH treatment. The serum cytokine levels in pesticide-poisoned patients were assessed. The efficacy of FPSA-CVVH in eliminating cytokines, the 90-d survival rate of poisoned patients, and adverse reactions to the treatment were observed. Fourteen patients (77.8%) had acute kidney injuries and 10 (55.6%) had acute liver injuries. The serum cytokine levels of high mobility group protein B-1 (HMGB-1), interleukin-6 (IL-6), IL-8, interferon-inducible protein-10 (IP-10), monocyte chemotactic protein-1 (MCP-1), and macrophage inflammatory protein-1β (MIP-1β) were significantly elevated. A total of 41 FPSA-CVVH treatment sessions were administered. After a single 8-h FPSA-CVVH treatment, the decreases in HMGB-1, IL-6, IL-8, IP-10, MCP-1, and MIP-1β were 66.0%, 63.5%, 73.3%, 63.7%, 53.9%, and 54.1%, respectively. During FPSA-CVVH treatment, one patient required a filter change due to coagulation in the plasma component separator, and one experienced a bleeding adverse reaction. The 90-d patient survival rate was 50%, with 4 patients with diquat poisoning and 5 patients with paraquat poisoning, and both liver and kidney functions were restored to normal. Cytokine storms may play a significant role in the progression of multiorgan dysfunction in patients with acute bipyridine herbicide poisoning. FPSA-CVVH can effectively reduce cytokine levels, increase the survival rate of patients with acute bipyridine herbicide poisoning, and decrease the incidence of adverse events. [ABSTRACT FROM AUTHOR]

Retinal diseases stand as a primary cause of childhood blindness. Analyzing the progression of these diseases requires close attention to lesion morphology and spatial information. Standard image registration methods fail to accurately reconstruct pediatric fundus images containing significant distortion and blurring. To address this challenge, we proposed a robust deep learning–based image registration method (RDLR). The method consisted of two modules: registration module (RM) and panoramic view module (PVM). RM effectively integrated global and local feature information and learned prior information related to the orientation of images. PVM was capable of reconstructing spatial information in panoramic images. Furthermore, as the registration model was trained on over 280,000 pediatric fundus images, we introduced a registration annotation automatic generation process coupled with a quality control module to ensure the reliability of training data. We compared the performance of RDLR to the other methods, including conventional registration pipeline (CRP), voxel morph (WM), generalizable image matcher (GIM), and self-supervised techniques (SS). RDLR achieved significantly higher registration accuracy (average Dice score of 0.948) than the other methods (ranging from 0.491 to 0.802). The resulting panoramic retinal maps reconstructed by RDLR also demonstrated substantially higher fidelity (average Dice score of 0.960) compared to the other methods (ranging from 0.720 to 0.783). Overall, the proposed method addressed key challenges in pediatric retinal imaging, providing an effective solution to enhance disease diagnosis. Our source code is available at https://github.com/wuwusky/RobustDeepLeraningRegistration. [ABSTRACT FROM AUTHOR]

Peanut is an important oil crop. However, food safety and industrial development of peanuts were limited by aflatoxin contamination. Breeding and applying resistant varieties have been effective approaches for aflatoxin control. However, progress in the identification of resistant germplasm resources and resistance breeding programs was hampered by complex, costly and unreasonable methods of A. flavus infection resistance in peanut seeds. In this study, the classification of peanut seeds after infected by A. flavus in the evaluation method was optimized and adjusted based on previous methods.The previous score for A. flavus infectione to peanuts seeds with 4 levels (referred to as "4-level score") was improved to 9 levels (referred to as "9-level score"). The results from evaluating peanut seeds infection with A. flavus using the 9-level score showed that it could better distinguish the difference in-the A. flavus infection resistance among peanut varieties compared to the 4-level score. Furthermore, the results of comparing 9-level score and 4-level score were used in screening the A. flavus infection in a hybrid progeny population showed, the 9-level score was more efficient in identifying resistant materials and detected more QTLs in genetic linkage analysis. These results indicate that the 9-level score is an effective and stable index for A. flavus resistance peanut evaluation. [ABSTRACT FROM AUTHOR]

This study focuses on investigating the prevalence of various airborne pollens and their correlation with clinical characteristics of childhood respiratory allergic diseases in southeastern China. Methods: From November 2020 to October 2021, this research employed Durham monitoring samplers to collect airborne pollen. Simultaneously, skin prick tests (SPTs) were performed on children with respiratory allergic conditions at the Children's Hospital of Soochow University and standardised questionnaires are also administered to assess children's symptoms. Results: Over the course of November 2020 to October 2021, the study identified more than 36 pollen species. Notably, the spring season (March to May) exhibited the highest pollen concentrations, with Broussonetia accounting for 30.04% and Pinus for 26.38%. Similarly, the autumn months (September to October) saw prominent taxa like Humulus scandens (47.55%) and Gramineae (35.93%). Among the patients, a significant 92.7% exhibited positive reactions, with 81.7% showing sensitization to house dust mites (HMD), 17.8% to pollen, and 3.7% to Cockroach. Noteworthy the five most common pollens were observed for Bermuda (6.0%), Elm pollen (6.0%), Birch pollen (4.6%), and Mugwort (4.6%). The study indicated a substantial multisensitized ratio among pollen-sensitized patients in comparison to non-pollen-sensitized ones (97.4% vs 1.6%, P < 0.001). Moreover, weekly total airborne pollen concentrations showed positive correlations with weekly admissions due to allergic rhinitis(AR)(r=0.642, P < 0.001), bronchial asthma (BA) (r= 0.472, P< 0.001), and the coexistence of AR and BA (r=0.485, P < 0.001). Conclusion: The findings found that there were two peaks of pollen count in a year during March-May and September-October. The findings emphasize the critical role of specific airborne pollens in driving sensitization and exacerbating respiratory allergic diseases in children. [ABSTRACT FROM AUTHOR]

There is a debate over whether to transect or completely reduce the hernia sac during laparoscopic tension-free repair of inguinal hernia. This study endeavors to systematically assess the efficacy and safety of two approaches, namely transected sac (TS) and completely reduced sac (RS), in laparoscopic tension-free repair of inguinal hernia. Utilizing a meta-analysis methodology, we aim to provide a comprehensive analysis of these techniques. A comprehensive search was conducted across PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov databases to identify comparative studies focusing on laparoscopic tension-free repair of inguinal hernia, specifically comparing TS and RS techniques. The selected studies were subjected to meta-analysis using RevMan 5.3 software. A total of 8 studies, involving 2995 patients with inguinal hernia, were included in the analysis. The meta-analysis results revealed that the TS group had a higher incidence of seroma compared to the RS group [OR = 1.74, 95% CI (1.35, 2.25), P < 0.0001], and a prolonged time to return to normal activity postoperatively [MD = 0.99, 95% CI (0.85, 1.14), P < 0.00001]. However, no statistically significant differences were observed between the two groups in terms of operation time [MD = −1.75, 95% CI (− 8.72, 5.22), P = 0.62], incidence of postoperative pain [OR = 1.00, 95% CI (0.41, 2.44), P = 1.00], overall postoperative complication rate [OR = 0.98, 95% CI (0.43, 2.20), P = 0.95], and recurrence rate fOR = 2.53, 95% CI (0.61, 10.39), P = 0.20]. Transected sac in laparoscopic inguinal hernia repair is associated with an increased incidence of seroma and a longer recovery time for patients to return to normal activity. Clinical trial registration Registration number is INPLASY20223110070 [ABSTRACT FROM AUTHOR]

Objectives To investigate the effects of non-pharmacological treatments on sarcopenic obesity (SO). Methods A search for randomized controlled trials (RCTs) on SO was conducted in PubMed, Web of Science, CINAHL, CENTRAL, SPORTDiscus, CNKI, Wanfang and VIP. A meta-analysis was conducted using random-effects models for MDs. Results The meta-analysis on 21 RCTs showed that exercise improved PBF (MD: −1.67%, p  < .01, I2 = 35%), grip strength (MD: 2.2 kg, p  = .03, I2 = 61%), GS (MD: 0.08 m/s, p  = .02, I2 = 0%), TCR (MD: 2.22 repetitions, p  < .01, I2 = 0%), TUG (MD: −1.48 s, p  < .01, I2 = 61%), UE strength (MD: 1.88 kg/kg, p  < .01, I2 = 0%) and LE strength (MD: 2.19 kg/kg, p  < .01, I2 = 0%). Nutritional interventions improved grip strength (MD: 1.52 kg, p  < .01, I2 = 0%). Combine interventions improved PBF (MD: −1.97%, p  < .01, I2 = 38%), ASMM (MD: 0.4 kg, p  < .01, I2 = 6%), grip strength (MD: 1.83 kg, p  < .01, I2 = 38%) and GS (MD: 0.04 m/s, p  < .01, I2 = 0%). Combined interventions were more effective than nutrition alone for reducing PBF (MD: −0.8%, p  = .05, I2 = 0%). Conclusion The effects of exercise and nutrition interventions on SO are limited individually, especially regarding muscle mass, but their combination can yield optimal results. Additionally, physical therapy also demonstrated some potential. [ABSTRACT FROM AUTHOR]

In modeling survival data with a cure fraction, flexible modeling of covariate effects on the probability of cure has important medical implications, which aids investigators in identifying better treatments to cure. This paper studies a semiparametric form of the Yakovlev promotion time cure model that allows for nonlinear effects of a continuous covariate. We adopt the local polynomial approach and use the local likelihood criterion to derive nonlinear estimates of covariate effects on cure rates, assuming that the baseline distribution function follows a parametric form. This approach ensures that the model is identifiable and we adopt a flexible method to estimate the cure rate locally, the important part in cure models, and a convenient way to estimate the baseline function globally. An algorithm is proposed to implement estimation at both the local and global scales. Asymptotic properties of local polynomial estimates, the nonparametric part, are investigated in the presence of both censored and cured data, and the parametric part is shown to be root-n consistent. The proposed methods are illustrated by simulated and real data with discussions on the practical applications of the proposed method, including the selections of the bandwidths in the local polynomial approach and the parametric baseline distribution family. Extension of the proposed method to multiple covariates is also discussed. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Are serum vitamin D levels associated with the incidence of endometrial polyps (EPs) in infertile patients? SUMMARY ANSWER Serum 25(OH)D levels were nonlinearly correlated with the incidence of EPs in infertile women. WHAT IS KNOWN ALREADY EPs are a common condition that may affect the receptivity of the endometrium in women of reproductive age. Vitamin D regulates cell proliferation and differentiation, apoptosis, angiogenesis, anti-inflammation, and immunomodulation, in addition to its well-known functions in balancing calcium and phosphorus. Previous studies have shown that vitamin D concentrations are associated with reproductive outcomes, and that low vitamin D levels are associated with the incidence of colorectal polyps and nasal polyps. There is little evidence regarding the relationship between EPs and serum vitamin D levels. STUDY DESIGN, SIZE, DURATION We conducted a cross-sectional study using data from Guangdong Women and Children Hospital from January 2019 to October 2023, enrolling 3107 patients. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 3107 infertile patients who underwent hysteroscopy were included in this study; 642 patients had endometrial polyps and 2465 had a normal uterine cavity. Hysteroscopy findings included risk of EPs, polyp size, percentage of multiple polyps, and incidence of chronic endometritis (CE). Serum vitamin D were assessed by measuring total 25(OH)D using chemiluminescence. According to international guideline recommendations for vitamin D deficiency, patients were divided into two groups: the <50 nmol/l group and the ≥50 nmol/l group. Univariable and multivariable logistic regression models, stratified analyses, and smooth curve fitting were used to examine the relationship between serum 25(OH)D levels and risk of EPs. MAIN RESULTS AND THE ROLE OF CHANCE Of all patients, 23.8% (740/3107) were vitamin D deficient (<50 nmol/l). The incidence of EPs was significantly higher in the 25(OH)D < 50 nmol/l group than in the ≥50 nmol/l group (24.9% vs 19.3%; P  =   0.001). However, there were no differences in polyp size, proportion of multiple polyps, and presence of CE between the two groups. After controlling for confounders, 25(OH)D ≥ 50 nmol/l (compared with <50 nmol/l) was negatively associated with risk of EPs (adjusted OR, 0.733; 95% CI, 0.598–0.898). Other variables that had an impact on polyp incidence included BMI, type of infertility, CA125, and CD138-positive plasma cells. In addition, a linear regression model between age and serum 25(OH)D levels showed a positive linear association. Subgroup analyses were performed for different age groups, and the risk of EPs was significantly higher in the 25(OH)D < 50 nmol/l group than in the ≥50 nmol/l group, both in the younger subgroup (23.8% vs 19.1%) and in the older subgroup (28.0% vs 19.9%). The smooth curve fitting model showed a nonlinear correlation between 25(OH)D levels and risk of EPs (nonlinear P- value = 0.020), with an optimal threshold of 51.8 nmol/l for 25(OH)D levels. Moreover, subgroup smooth curve fitting models showed a nonlinear correlation between 25(OH)D levels and polyp risk in patients aged <35 years (nonlinear P- value = 0.010), whereas a linear correlation between 25(OH)D levels and polyp risk was found in patients aged ≥35 years (nonlinear P -value = 0.682). LIMITATIONS, REASONS FOR CAUTION Caution should be exercised in interpreting our findings as this is a correlational study and causality cannot be inferred from our results. In addition, because of strict inclusion and exclusion criteria, our results may not be generalizable to unselected populations, including premenopausal women or women of other races. WIDER IMPLICATIONS OF THE FINDINGS This study demonstrated for the first time that vitamin D deficiency is an independent risk factor for the incidence of EPs in infertile patients. Identifying modifiable risk factors (e.g. vitamin D deficiency) can help in the development of new strategies for treating polyps or to protect against polyp development. Further clinical intervention trials and laboratory studies are needed to evaluate the effect of vitamin D on the development of EPs and to elucidate the mechanisms. STUDY FUNDING/COMPETING INTEREST(S) The study was funded by the National Natural Science Foundation of China (82101718) and Natural Science Foundation of Guangdong Province, China (2022A1515010776). No competing interest was involved in this study. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Introduction: Numerous studies have identified diabetes mellites (DM) as a significant risk factor for postoperative wound morbidity, with suboptimal preoperative glycemic control (GC) posing an even greater risk. However, this data largely excludes ventral hernia patients. Our study examined the association between diabetes and preoperative GC and postoperative outcomes following open complex abdominal wall reconstruction (AWR). Methods: We identified diabetic patients who had undergone open, elective, clean VHR with transversus abdominis release (TAR) and permanent synthetic mesh at the Cleveland Clinic Foundation between January 2014 and December 2023. Their 30-day outcomes were compared to non-diabetic patients undergoing the same procedure. Subsequently, diabetic patients were categorized based on GC. status: "Optimal GC" (HbA1c < 7%), "Sub-optimal GC" (HbA1c 7-8.4%), and "Poor GC" (HbA1c ≥ 8.5%) and their outcomes were compared. Results: 514 patients with DM who underwent clean elective TAR were identified, of which 431 met the inclusion criteria. GC was deemed optimal in 255 patients, sub-optimal in 128, and poor in 48 patients. Demographics were similar, except for anticoagulation treatment (p = 0.014). The entire study population exhibited significantly higher rates of wound morbidities and overall complications compared to non-diabetic patients. However, rates of surgical site infection (SSI), surgical site occurrence (SSO), SSO requiring procedural intervention (SSOPI), and reoperation did not differ significantly among the three cohorts of presurgical glycemic control (p = 0.82, p = 0.46, p = 0.51, p = 0.78), respectively. No occurrence of mesh removal was documented. Conclusion: In general, diabetes is a marker for increased wound morbidity and complications following complex abdominal wall reconstruction. However, we could not establish a hard cutoff to justify withholding surgery in symptomatic patients based on an arbitrary HbA1C level. We believe this data is important for shared decision-making when considering AWR for symptomatic ventral hernias in diabetic patients. [ABSTRACT FROM AUTHOR]

In recent years, the transformative evolution of cloud computing has reshaped organizational practices by enabling the outsourcing of web service applications. This shift has led to the emergence of the cloud environment, characterized by the involvement of Cloud Service Providers (CSPs) and intelligent applications. Cloud Service Composition (CSC) has become pivotal in this context, playing a crucial role in enhancing efficiency, Quality of Service (QoS), and customer satisfaction through the aggregation of diverse Cloud Services (CSs) to create composite services. However, the vast array of available CSs presents a challenge in efficiently addressing specified QoS requirements, turning CSC into a recognized NP-hard problem. Existing solutions, often involving third-party brokers, struggle with scalability in large-scale systems and overlook crucial security concerns. To address these limitations, we propose the Hierarchical Service Composition (HSC) approach, leveraging blockchain and federated learning to minimize computational complexity. The integration of Blockchain-enabled Federated Learning (BFL) facilitates machine learning model training with decentralized data, ensuring practicality and fairness. HSC comprises an initialization phase and two selection layers. The first selection layer enables each CSP to efficiently select services using a pre-trained model, while the second selection layer employs a blockchain-based QoS-aware mechanism for the final composition result, addressing privacy concerns. HSC introduces a novel framework, collaborative service selection methods, and a smart selection algorithm, demonstrating remarkable composition efficiency in extensive simulations compared to the baseline approach. [ABSTRACT FROM AUTHOR]

Objects: Taurine exhibits protective effects in the context of cardiovascular pathophysiology. A range of evidence suggests that hypertension activates inflammatory responses and oxidative stress in the paraventricular nucleus (PVN), elevating the arterial tone and sympathetic activity, while it induces gut–brain axis dysfunction in the context of hypertension. However, the mechanism underlying taurine's anti-hypertensive effects via the gut–brain axis remains unclear. Method: Male spontaneously hypertensive rats (SHRs) were administered 3% taurine in their drinking water for eight weeks, with their arterial pressure measured weekly. Molecular techniques were employed to investigate taurine's effects on the hypertensive gut and PVN. Additionally, 16S rRNA gene sequencing was used to analyze the gut microbiota composition, and untargeted metabolomics was applied to assess the fecal metabolites following taurine supplementation. Results: Taurine supplementation not only reduced the blood pressure, sympathetic activity, and inflammatory and oxidative stress in the PVN but also improved the cardiac pathology and microbiota composition while alleviating gut inflammation in hypertensive rats. The untargeted metabolite analysis indicated that the primary effect of the taurine intervention in SHRs was exerted on tryptophan metabolism. The levels of serum metabolites such as kynurenine, L-tryptophan, serotonin (5-HT), and 5-hydroxyindole-3-acetic acid (5-HIAA) were altered in hypertensive rats following taurine treatment. Conclusions: Taurine supplementation restored the microbiota balance, strengthened the mucosal barrier, reduced intestinal inflammation, and stimulated tryptophan metabolism. The metabolites derived from the gut microbiota likely crossed the brain barrier and reached the paraventricular nucleus, thereby reducing the inflammatory responses and oxidative stress in the PVN via gut–brain communication, leading to decreased sympathetic nerve activity and blood pressure in the studied hypertensive rats. [ABSTRACT FROM AUTHOR]